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The establishment in 1904 of a British hospital at Gyantse, in southwestern Tibet, marked the formal introduction of biomedicine into that Himalayan state. In the ensuing decades, officers of the Indian Medical Service (IMS) offered treatment to Tibetans from their Gyantse base as a part of the British imperial relationship with the Tibetan state.
Not to be eaten before the month of May, eaten with pig's liver it will cause blackheads, with mushrooms one develops haemorrhoids.
A visceral tonic and vitalizer. Makes the bones and muscles strong and able to endure cold and heat. It relieves inflammation. With ginger and red mung bean it cures diarrhoea and dysentery. Fried in cream it is fattening to the belly, but it is good for reducing the abdomen swollen on account of water retention. For the chronic disorders of children.
Puerperal fever was a devastating disease. It affected women within the first three days after childbirth and progressed rapidly, causing acute symptoms of severe abdominal pain, fever and debility. Although it had been recognized from as early as the time of the Hippocratic corpus that women in childbed were prone to fevers, the distinct name, “puerperal fever” appears in the historical record only in the early eighteenth century.
In early 1919 my father, not yet demobilized, came on one of his regular, probably irregular, furloughs to Carisbrook Street to find both my mother and sister dead. The Spanish Influenza pandemic had struck Harpurhey. There was no doubt of the existence of a God: only the supreme being could contrive so brilliant an afterpiece to four years of unprecedented suffering and devastation. I apparently, was chuckling in my cot while my mother and sister lay dead on a bed in the same room.
The growth of statutory compensation for industrial injuries and illness has attracted considerable attention from historians of state welfare and students of organized labour in both Europe and North America. The rights of legal redress for disease and accidents in the workplace have become the subject of some debate among historians of occupational health and safety, most particularly in regard to asbestos-related illnesses. Among the most detailed and scholarly accounts of the subject in Britain are those by Peter Bartrip and his collaborators. In contrast to many accounts in labour and medical history which express strong empathy with the plight of workers who faced injury and death in the workplace, Bartrip adopts a model of industrial behaviour which is closer to rational-choice assumptions of mainstream economics. His recent account of government regulation of occupational diseases since the nineteenth century offers limited comment on the attitudes of trade unionists to accidents, though he broadly maintains that British unions have historically been more concerned with winning compensation awards than pressing for the prevention of hazards in the industrial workplace.
Epidemiology, like any branch of medical science, functions within a social and historical context. That context influences what questions are asked, how they are investigated, and how their conclusions are interpreted, both by researchers and by the public. The international debate over whether abortion increases breast cancer risk, which has been the subject of many studies and much heated controversy in recent decades, became so intensely politicized in the United States that it serves as a particularly stark illustration of how elusive the quest for scientific certainty can be. Although a growing interest in reproductive factors and breast cancer risk developed after the Second World War, it was not until the early 1980s, after induced abortion had been legalized in many countries, that studies began to focus on this specific factor. In the US these were the years following Roe v Wade, when anti-abortionists mounted their counterattack and pro-choice forces were on the defensive. As a result, epidemiologists found themselves at the centre of a debate which had come to symbolize a deepening divide in American culture. This paper traces the history of the scientific investigation of the alleged abortion-breast cancer link, against the backdrop of what was increasingly termed an “epidemic” of breast cancer in the US. That history, in turn, is closely intertwined with the anti-abortion movement's efforts, following the violence of the early 1990s, to regain respectability through changing its tactics and rhetoric, which included the adoption of the “ABC link” as part of its new “women-centred” strategy.
The knowledge and interpretation of the practice of anatomy in the Renaissance have recently undergone a profound change. To a large extent, this is the result of new directions taken in the social and cultural history of medicine since the late 1970s. In the last decade, several important works have been published, which are undeniable evidence of this historiographical change. However, there has as yet been no attempt to produce a synthetic view of all this new work, in which there is not always agreement. Such a synthesis would undoubtedly produce an interpretation of Renaissance anatomy very different from the traditional one.
Modern medical opinion is almost universally in favour of breastfeeding as the best food for newborn infants. Yet this was not always the case. American social historian Rima Apple has argued convincingly that medical attitudes in the United States undermined breastfeeding in the first half of the twentieth-century. She explains how the concept of “scientific motherhood”, successfully promoted by the medical profession during the first half of the twentieth century, “fostered the acceptance of, when not the wholesale commitment to, bottle feeding under physician-supervision”. In her recent book on breastfeeding in the United States, Jacqueline Wolf argues that while many doctors in the United States supported breastfeeding, they inadvertently undermined it by advocating routine feeding and by providing a viable alternative through milk formulas. Considering the experience of breastfeeding in two further environments, Britain and New Zealand, contributes to the discussion of the role of health professionals in promoting breastfeeding. Doctors in Britain and New Zealand did not promote the move from breast to bottle, as Apple found in America. Nor did they appear to undermine breastfeeding by their advocacy of routine feeding. The decline in breastfeeding occurred later than in America. It coincided with the new fashion for “demand feeding”, and with a new movement to medicalize breastfeeding itself. A study of breastfeeding in different countries and over time indicates that the attitudes and advice of health professionals were significant factors in the success or otherwise of breastfeeding.
The general principle that the experience of combat damages servicemen's long-term physical and mental health is recognized. However, controversy has raged over the nature of particular post-combat disorders such as shell shock, disordered action of the heart (DAH), effort syndrome, effects of Agent Orange and, not least, Gulf War syndrome. We, among many others, have argued that they should be classified as functional syndromes characterized by medically unexplained symptoms, which include: fatigue, weakness, sleep difficulties, headache, muscle ache and joint pain, problems with memory, attention and concentration, nausea and other gastro-intestinal symptoms, anxiety, depression, irritability, palpitations, shortness of breath, dizziness, sore throat and dry mouth. Despite popular claims to the contrary, no simple biomedical aetiology has been discovered to account for these disorders, hence the term “medically unexplained”. Furthermore, they are not easily interpreted using accepted psychiatric classifications. Without demonstrable organic cause, war syndromes have attracted diverse causal explanations, ranging from pressure on the arteries of the chest, constitutional inferiority, toxic exposure, bacterial infection to microscopic cerebral haemorrhage.
The lack of professional qualifications was felt keenly by some nineteenth-century medical and dental practitioners. In 1860, the Lancet highlighted a scheme “to avoid the operation of the Medical Act, and to enable uneducated and unprincipled men to defraud the public”. It quoted an advertisement from a daily newspaper. Mr T Vary had announced that “Doctors, Druggists, Chemists, or Dentists, who have no Medical Diploma, can hear of an easy method of obtaining one” by writing to him at Jones's Coffee House in London's Tottenham Court Road. In response to an enquiry, Vary told the Lancet that he had just come from America where a friend “had graduated … in 1857, with all the honours”. However, the latter “had to leave America without his diploma” because of a lack of money for his graduation fees, and so had asked him to pay off the debt and bring back the diploma to Europe. Vary said: “I have done so; but have been detained longer than was anticipated, and now find my friend dead”. Indicating that he did not want to lose the money which he had paid on behalf of his friend, Vary continued: “Fortunately, as is common in America, the space for the name is left blank, to allow the graduate to have it filled up to suit his fancy by some writing master”. He proposed to sell the diploma and supporting papers for £23, which, he pointed out, was “as good as if five years' labour and 1500 dollars had been given to obtain it”. Later in the same year, the Lancet stressed that the practice of buying a Continental degree of MD, without examination or residence, was clearly a “fraud upon the public … repugnant to professional honour and destructive of professional character”. It published details of a proposition sent to Mr Pound, a surgeon in Odiham, to obtain a degree “by simple purchase”. Enclosed was a printed circular: “If you wish to become a M.D. without absenting yourself from your professional duties, I can procure you the degree from a Continental University of the highest reputation, on terms more moderate than any hitherto known in this country”. The circular was accompanied by a letter addressed personally to Pound by a Dr H A Caesar, MD, FRCSI. There is no way of knowing how many doctors or dentists actually bought copies of that or similar false diplomas.
Historians of medicine have tended to be preoccupied primarily with scientific research, the development of therapeutically significant medicines, and ethical business practice. Roy Porter, however, adopted a wider conception. Referring to the eighteenth and early nineteenth century, he redefined the role of “the vile race of quacks” (so described by their own contemporaries) as a manifestation of a burgeoning medical entrepreneurship in an emerging consumer society. He maintained that “Irregular medicine … mobilised the growth of medicine as business”, an aspect of medical history which he believed to have been largely ignored hitherto and one which requires of historians an understanding of the market for pharmaceuticals. Anne Digby has examined the market for medical services during the nineteenth century in an analysis of interactions between doctors and patients at a time when self-dosing was prevalent. However, interactions between medical practitioners and suppliers of medicines in Britain for most of this period remain largely unexplored (with the significant exception of the work by Jonathan Liebenau) and as a result, it will be argued, have been misunderstood.
In the early 1950s, when the National Health Service (NHS) was still in its infancy, the British public was gripped by news reports of two attempts at the surgical separation of conjoined twins. The first operation involved one-year-old twin girls from Kano, Nigeria. The twins were xiphopagus (joined at the lower sternum) and shared a liver, separation was attempted at London's Hammersmith Hospital in December 1953. One child survived. In February 1955 news broke of the birth of craniophagus twins (joined at the head) in Keighley, West Yorkshire. Separation of the month-old girls was attempted at London's University College Hospital, but neither child survived.