Galen’s most deeply held professional values included clarity of expression and the epistemological importance of clinical experience. Therefore, it is not surprising that he thought and wrote about communication with patients. His stories about patients show that he questioned them about their symptoms and history, and some stories explicitly teach the lesson that this type of questioning is important. His stories often quote patients indirectly or directly; they are often told partly from the patient’s perspective, and some contain constructions indicating that Galen paid attention to an individual patient’s exact words. In On the Affected Parts, his discussion of the vocabulary of pain – a problem in medical communication still important today – he privileges the common usage of patients over the technical vocabulary invented by Archigenes. He argues that only by listening to patients and their words can we construct a useful vocabulary of metaphors for pain that can bridge the gap in experience between physician and patient. He does not dismiss the words of women or enslaved patients; on the other hand, in a few stories where the patriarch of a family is present and the patient is female or enslaved, Galen’s dialogue tends to engage the head of the household rather than the patient. While some of his stories show off his ability to diagnose patients without talking to them, and others raise the problem of the lying patient, none of these stories would have meaning unless the patients’ words were normally crucial to clinical practice.

When kidney transplantation evolved from an experimental into a clinical treatment of end-stage renal disease (ESRD) in the 1960s, it was conceptualised as a collaborative therapy. Before specific immunosuppressants were introduced in the 1980s, the best chances for patient and graft survival were expected from finding ‘good’ matches between donor and recipient tissues. Therefore, the pioneers of clinical transplantation in Europe started to recombine their growing patient pools. They created trans-border organ exchange organisations such as Eurotransplant and Intertransplant, based on shared patient databases.

The article traces international and transnational co-operation in kidney exchange using the example of state-socialist Germany. How did the German Democratic Republic (GDR) get involved with the interconnected networks of knowledge, data, and organ exchange in ESRD treatment? In what ways did the domestic system of kidney transplantation depend on intra- and trans-bloc exchange? How did the GDR profit, and what did it have to offer on an international scale, both in the First and the Second World? The article sheds light on the under-explored transplantation history of the socialist East and thereby investigates the possibilities and limits of trans-bloc collaboration in Cold War Europe.

In recent years, the digitisation of historical data containing cause-of-death information has significantly increased. However, these data show considerable variations in diagnostic practices and nosology over time and place. Examining vague historical causes of death, often denoting symptoms rather than specific diseases, is a particular challenge. Infantile convulsions are an example of a common yet problematic cause of death. To improve our understanding of infantile convulsions, we propose an innovative mixed-methods, comparative approach. This study combines qualitative analyses of historical medical thinking on infantile convulsions with quantitative analyses of individual-level death records from four European cities: Amsterdam, Hermoupolis, Maastricht, and Rostock, covering different periods between 1800 and 1955. Our findings reveal that infant deaths attributed to convulsions encompass a multitude of causes from different disease categories. Significant differences emerged in the patterns of convulsions across time, age groups, and locations, even within the same country. The decline in convulsions mortality seems to be more related to the introduction of uniform registration regulations and systems, and advancements in medical knowledge than to the decline in overall infant mortality. This study’s outcome serves as a cautionary note that challenges the prevailing attitude towards convulsions and emphasises the complexity of interpreting deaths from convulsions. These were highly dependent on historical context, especially local medical culture and the variable accuracy of cause-of-death registration. These findings have implications for studies on infant mortality even when the main interest of such studies is not convulsions mortality.

This paper aims to provide the first comprehensive evaluation of Carl Gustav Carus’s writings on race and human inequality. We demonstrate that Carus, an eminent nineteenth-century physician emblematic of romantic medicine, was deeply engrossed in racial science, exploring anatomical, anthropological, and craniological dimensions of race across no less than twenty-five works spanning three decades. Carus’s engagement with race stemmed from naturphilosophisch anatomical and physiological considerations, which evolved into physiognomic and psychological inquiries. While previous research has construed Carus as a precursor of Arthur de Gobineau, we argue that he was intellectually much more closely aligned with the ‘American School’ of ethnology, represented by figures such as Samuel G. Morton, George R. Gliddon, and Josiah C. Nott. Closely monitoring international discourses of scientific racism, Carus sought to propagate these notions among German readers and position himself within international debates. The international reception, however, was limited by the Romantic framework of Carus’s scientific racism, which was unintelligible to contemporaries. While sharing an implicit methodological bias with Morton and his followers, affirming white superiority and legitimising colonisation, the Romantic underpinning of his race treatises made it difficult for mid-nineteenth-century race theorists to fully endorse him. Nonetheless, Carus, often lauded as polymath with a humanistic orientation, besides his achievements, helped to create a theoretical basis for the othering and dehumanisation of large parts of the global population.

In December 1937, influential physician and politician Lord Dawson of Penn introduced an Infanticide Bill into the House of Lords. Seven months later, following minor amendments, Dawson’s Bill passed into law as the Infanticide Act, 1938. This legislation significantly altered the earlier provisions of the Infanticide Act, 1922, which introduced the offence of infanticide into English and Welsh courtrooms for the first time. Under Dawson’s reforms, a woman could be found guilty of infanticide rather than capital murder if the killing of her child, aged no more than one year old, could be attributed to a disturbance in the balance of the mother’s mind following childbirth or from lactation. Although the language and implications of the 1938 Act have ignited significant debate within legal scholarship, the creation of Dawson’s Bill and the leading role medical practitioners played in its enactment have received limited attention from historians. This article helps to address this gap by analyzing the critical response of the inter-war British medical profession to the question of infanticide reform against a backdrop of growing psychiatric ambivalence about a causal link between insanity and female reproductive states. Crucially, this paper contends that ancillary concerns over citizenship, motherhood, and the health of the nation informed Dawson’s motivations and justification for infanticide reform during the 1930s. It also seeks to foreground the physician’s distinct contribution to the birth of the 1938 Act by underscoring his efforts in devising and promoting the Bill within Parliament and among inter-war medical and legal communities.

In the late 1930s, children in three Malawian villages were subjected to a peculiar test for vitamin A deficiency devised by Dr. Benjamin Platt, director of the Nyasaland Nutrition Survey and a leading colonial nutrition scientist. Platt constructed a makeshift adaptometer, appropriate for field conditions, that could be placed over a subject’s head to measure retinal adaptation to light. He built this contraption from simple materials, including a five-pound tea-box and sticking plaster. This article takes the curious commingling of commodity objects and scientific materials (where a discarded tea-box finds new life as an experimental technology) as an entry point for examining how scientific practices are woven from semiotic and material threads, demonstrating how heterogeneous social and material elements overlap and influence one another. The article first analyses how Platt’s tea-box adaptometer – and the discourses and ambitions framing the Survey – imagined a new kind of nutrition research hinged to the space of the field rather than the laboratory. It then proceeds to consider how the tea-box, an incipient manifestation of ‘appropriate technology’, points us towards the more tacit ways that tea wove itself into the fabric of the Survey and colonial society, as a gustatory discourse steeped in racial anxieties. Attending to the ‘stuff’ of scientific work cued me to broader imperial circuits and interests that shaped colonial nutrition research.

This paper provides an account of a specific operation – the removal of the thymus gland (thymectomy) to treat the rare neurological condition myasthenia gravis – from its first performance in 1936, by the American surgeon Alfred Blalock, to the publication in 2016 of an international multicentre randomised controlled trial (RCT) of the technique. Thymectomy was the subject of a transatlantic controversy in the 1950s, in which the main players were the English surgeon Geoffrey Keynes, and American neurologists and surgeons from New York, Boston, and the Mayo Clinic. The resolution of this controversy involved the use of increasingly sophisticated statistical techniques, but also crucially other influences including the social transformation of thoracic surgery, and competition between the leading American centres. The consensus achieved after this controversy was challenged in the late 1970s, eventually prompting the implementation of a trial acceptable to twenty-first-century evidence-based medicine. This account will demonstrate that surgical innovation in the period covered required increasing attention to the statistical basis of patient selection and outcome evaluation; that the processes of technical innovation cannot be regarded as separate from developments in the professional culture of surgery, and that one of the consequences of these changes has been the gradual eclipse of the prestigious autonomous surgeon.

This article analyses the depictions of immunity and immunological functions employed in proprietary medical advertising in British newspapers between 1890 and 1940. Using marketing copy to gain insights into the ways immunity was presented to the public and normalised outside of medical institutions and publications, I offer four main areas of discussion. First, I present an analysis of the ways advertisements evoked both natural and artificial immunity in their marketing copy, thereby affording us insights into the ways immunity was made palatable both to those supportive of and opposed to vaccinations. I then unpack the ways in which this advertising copy often emphasised immunity rather than the immunological, that is, presented immunity as resistance to infection achieved by purchasing particular brands, rather than as part of a defensive process taking place at a cellular level. Third, I examine the ways in which advertisements engaged with futurity and drew on a narrative of social exclusion that pitted created communities of the immune against the non-immune. Finally, I analyse the ways in which immunity was used to connect the biological and the psychological, looking particularly at the ways immunity against worry was sold to the public.

We chart and assess the scope and utilisation of state-supplied hospital infrastructure in British Africa, c. 1900–60. Using archival sources, we examine the heterogeneity in colonial administrations’ investment into curative healthcare provision across various regions of British Africa. Our research highlights significant disparities in healthcare provision during the colonial period. These disparities were shaped by a range of observable factors, including differences in colonial policies, budgets, investment priorities, and the availability of medical personnel. We test stylised facts about public goods provision derived from previous literature and highlight the importance of understanding the historical context in shaping healthcare systems in Africa today.

In the first months of the Spanish Civil War, the Spanish doctor Frederic Duran Jordà developed a new method of blood transfusion which overcame the era of direct arm-to-arm transfusions. While Duran was experimenting in Barcelona and the Aragon front, hundreds of foreign doctors came to Spain with the help of internationalist associations and offered their services to the Republican government. The Czechoslovak Dr Karel Holubec entered Spain in May 1937 and practiced in a mobile hospital funded by the Czechoslovak Committee to Aid Democratic Spain, receiving blood from Duran’s laboratory. This article aims to study how Duran and Holubec transferred the method of blood transfusion to Czechoslovakia through interpersonal contact, conferences, and performances. This paper argues that while individual actors played a crucial role in the diffusion of medical practices, this circulation was determined by a unique historical and socio-political framework. The Spanish Civil War, the International Brigades, and the invasion of Czechoslovakia by Nazi Germany were not only the historical context of medical innovation but an integral part of it.

Although historians have given close attention to the anti-vaccination movement that gripped late-Victorian England, relatively little scholarship explores how doctors and health officials responded or asks what strategies and assumptions structured how they might oppose the vaccine opponents. This article traces the advent and actions of the Jenner Society, a smallpox vaccination advocacy group founded in 1896 by Dr. Francis Bond. His goal was to publicly confront the leading anti-vaccinationists and to effectively conduct an anti-anti-vaccination campaign. The Jenner Society appeared amidst disputes over how and even whether vaccination should be publicly debated – disputes shaped both by long-standing attitudes toward professional propriety and also by indecision about what sorts of political advocacy were suitable for medical practitioners. Vaccination was shifting toward a more voluntary administration, and the Jenner Society represents how civil society, the popular press, and the modern tools of persuasion were becoming increasingly central to public health governance. The Jenner Society encapsulated the profession’s disdainful attitude toward populist medical dissent, and this essay argues that the tone and deportment of anti-anti-vaccinationism had the effect of encouraging doctors to overlook and neglect other, probably more significant, sources of vaccine skepticism. Preoccupied with rebutting and attacking vaccination’s enemies, public “controversialists” like Bond waged the first true large-scale pro-vaccination propaganda campaign, but they ultimately were unable to address the underlying dynamics of vaccine evasion. This history holds important lessons today for those interested in constructing more effective ways to effectively counteract medical misinformation and anti-vaccinationist beliefs.

This essay responds to Brack et al., ‘Plague and the Mongol Conquest of Baghdad (1258)? A reevaluation of the sources’, which is a critique of our 2021 essay in this journal, ‘Plague and the Fall of Baghdad (1258)’. We argue that Brack and colleagues have misunderstood our investigation as an attempt to pinpoint the exact timing of the outbreak of plague connected with the Mongol siege of Baghdad, and so believe that an altered timeframe invalidates our suggestion that plague was involved. Taking this opportunity to revisit the state of plague historiography in western Asia, we address four issues: (1) why Mongol historiography has, until recently, avoided the question of plague’s late mediaeval resurgence within the Mongol Empire and why the ‘new genetics’ of plague now makes the question unavoidable; (2) why reconstruction of the biological processes of ‘focalisation’ is now the most urgent question in plague historiography since it constitutes what we call the prodromal stage of the Black Death pandemic; (3) how a newly informed biological perspective on disease history can allow a more sensitive reading of past observers’ reports of epidemics; and finally, (4) what a plausible scenario might look like for plague’s presence in western Asia and the eastern Mediterranean region in the late-thirteenth and early-fourteenth centuries as an emerging zoonotic disease with occasional epizootic and human outbreaks, before the more catastrophic outbreaks of the 1340s commonly referred to as ‘the Black Death’.

Taiwan became a Japanese colony in 1895 and in the Second World War was geographically central in Japan’s wartime possessions and strategically important, with military airfields, ports, and a copper mine. Its sixteen prisoner-of-war camps included four labour camps. Taiwan was also the first place to which senior officers and colonial officials were dispersed after the Allied surrenders in Hong Kong, Singapore, Indonesia and the Philippines. Forty-five doctors from the British, Australian, Dutch and American forces were identified who spent at least part of their captivity on Taiwan. This article uses their personal accounts, official documents and secondary sources to describe them and their work. Although the oldest had experience in the First World War and some had practised in the region, others were young, recently-qualified generalists. Most were transferred between several camps, with one consequence that few contemporaneous medical records survive. Doctors shared the risks and hardships of all prisoners: they lost weight and had the same nutritional disorders, infections and infestations as their patients. Two died. They became significant, scrutinised figures in the camps. Their patients valued their work and understood that they lacked resources for fully effective medical practice.

This article discusses early modern North Indian ways of expressing how barrenness could be mapped onto a woman’s maternal identity. Scholars have engaged with the historical evolution of women’s identities, focusing overwhelmingly on their economic and political potential. This article is the first to use medical and erotological sources from the seventeenth and eighteenth centuries to study women as procreative agents, and the socio-sexual anxieties prompted by infertile female bodies. Through a critical study of a wide range of medical material, I demonstrate that by the eighteenth century, several transformations in medical discourses can be mapped onto textual transmissions from Sanskrit (and Braj Bhasha) to Persian, as well as between competing but conterminously flourishing medical paradigms, Ayurveda and Yunani. While cures for childlessness have a much longer history, a new genre of ‘anonymous’ sources, particularly focused on the sexual diseases of men and women emerged in early modern North India. Lastly, my comparative methodological approach to different textual genres will complicate our understanding of early modern medical episteme and its intended audience.

Ulrich von Hutten (1488–1523), a renowned sixteenth-century German humanist, documented the symptoms of the epidemic that swept through Europe starting around 1495, commonly known as the French Disease. While it has traditionally been associated with venereal syphilis, Dutch tropical physician Willem F. R. Essed proposed in 1933, largely unnoticed to this day, that this new disease might instead be tropical yaws. This study establishes a clear link between Hutten’s reported symptoms and yaws, especially in its secondary and tertiary stages. The skeleton discovered in 1968 on Ufnau Island in Lake Zurich where Hutten died and was buried, exhibits distinct bone manifestations of ancient treponematosis with a pattern more consistent with yaws than syphilis. Furthermore, the correspondence between Hutten’s main symptoms and the lesions observable on the 1968 skeleton further confirms the identification of these human remains. The historical evidence of yaws significantly contributes to our understanding of this early modern epidemic.

Historians have written copiously about the shift to ‘germ theories’ of disease around the turn of the twentieth century, but in these accounts an entire continent has been left out: Antarctica. This article begins to rebalance our historiography by bringing cold climates back into the story of environmental medicine and germ theory. It suggests three periods of Antarctic (human) microbial research – heroic sampling, systematic studies, and viral space analogue – and examines underlying ideas about ‘purity’ and infection, the realities of fieldwork, and the use of models in biomedicine. It reveals Antarctica not as an isolated space but as a deeply complex, international, well-networked node in global science ranging from the first international consensus on pandemic-naming through to space flight.

Historical research on efforts to reduce the stigma associated with venereal disease (VD) generally dates these campaigns back to the 1930s. Within the United States, one of the earliest attempts to detach VD from its traditional association with sexual immorality occurred during the late nineteenth- and early twentieth-century, when the New York City dermatologist Lucius Bulkley coined the term syphilis insontium (‘syphilis of the innocent’) in the hopes of demonstrating that many of those who contracted this disease did so through non-sexual contact. Gaining widespread acceptance within the medical community, Bulkley’s ideas served as the intellectual foundation for a discursive assault on the prevailing belief that syphilis constituted the ‘wages of sin’—one designed to destigmatise the disease and to promote more scientific responses to it. However, the effects of this anti-stigma rhetoric were often counterproductive. Encouraging doctors to discern ‘innocence’ or ‘guilt’ through assessments of a patient’s character, syphilis insontium often amplified the disease’s association with immorality. With the passage of time, physicians became increasingly aware of these problems, and in the 1910s, a backlash against Bulkley’s ideas emerged within the American medical community. Yet even with the resultant demise of his destigmatisation campaign, discourses of ‘innocent syphilis’ continued to circulate, casting a long shadow over subsequent stigma reduction efforts.

This article primarily concentrates on the theoretical and intellectual dimensions of nature cure, particularly efforts to revive it during the second half of the nineteenth century. Little is known about specific medical professionals or theories concerning the Victorian philosophy of nature cure, although this philosophy is mentioned in general terms in studies on alternative medicine and hygiene. This article illuminates a Victorian nature cure philosophy through the works of Edward W. Lane (1823–1889). As a physician and hydropathist, Lane aspired to create a new form of medical system, ‘hygienic medicine’, seeking answers to the questions ‘What is disease?’ and ‘What is medicine?’ throughout his career. Lane was among many physicians interested in nature’s healing power during his time. However, few undertook as thorough a theorisation of nature cure philosophy as Lane did in the latter half of the nineteenth century, a period that presented unprecedented challenges in reconciling medicine with nature. This study explores the subtle nuances of the concepts that Lane actively used in his theoretical explanations, including ‘nature’, ‘laws of health’ and ‘vital force’, interpreting his efforts as a reconciliation between Romantic naturalism and laboratory medicine. The aim of this study is not to re-evaluate the significance of Lane’s medical theory itself. It rather uses Lane as a lens to reveal the intricacies of Victorian nature cure philosophy.

This investigation sheds light on the social history of pathogenic dirt and its significance for shaping medical practices during the nineteenth century. It consists of an analysis focusing on Swedish medicine, using 8800 yearly reports written 1820–1900 by Swedish provincial doctors for the National Board of Health in Stockholm. The main argument is that the provincial doctors’ perceptions of the relationship between dirt and health during this century can be better understood by focusing on similarities in the handling of different kinds of pathological dirt over the course of many decades, rather than seeing interest in cleanliness as something mostly unprecedented. A novel cleanliness regime became dominant during the latter third of the century, meant to counter a new hybrid between everyday dirt – bodily emanations from healthy bodies – and matter believed to have caused miasmatic and contagionistic disease. New ideas about filth and its impact on health played a crucial role in the development of public health and sanitation movements, and were a precondition for everyday dirt becoming a central medical problem around the turn of the twentieth century, but as is shown, they built on old precedents. Thus, the miasmatic and contagionistic approach to disease shaped conceptions of hygiene and cleanliness.