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Torsten Riotte

In this chapter, Torsten Riotte takes up the interaction between medical and political spheres in the context of nineteenth-century Germany, and poses questions about accountability, medical negligence, and the nature of individual and collective responsibility in relation to accidents. Beginning with the first recorded court case in 1811, when a doctor at the Berlin Charité hospital sued a colleague over the death of a female patient, Riotte draws upon the files of the so-called medical commissions (medical advisory boards to ministries of the interior in the German states) in order to analyse the professional and public debate that ensued and to engage in a discussion of medical negligence as an aspect of professional accountability. The emergence of medical courts of honour from the mid-1870s onwards, and the complementary development of liability insurance for doctors, illuminate the shifting moral, economic, and social structures in which medical practices were embedded.

in Progress and pathology
The Fowlers and modern brain disorder
Kristine Swenson

In this chapter, Kristine Swenson turns to popular reform movements which arose in response to what mainstream medicine considered largely innate, unchangeable conditions. Drawing on the emergence of the American Fowler family – led by the brothers Orson and Lorenzo, their sister, Charlotte, and her husband Samuel Wells – as her central case study, Swenson considers the Fowlers’ empire of phrenological lecture tours, publishing, and therapeutics as a practice that not only kept phrenology in the public eye long after its dismissal from scientific practice, but also responded to the perceived ills of industrialised capitalism by touting progressive self-improvement and self-care. The Fowlers exploited the potential of phrenology as a form of practical self-help allied to hydropathy, dietetics, vegetarianism, dress reform, and temperance. As cultural fears of degeneration and race suicide spread, and the middle classes were increasingly seen as subject to the ‘modern illnesses’ of neurasthenia and dyspepsia, the Fowlers sought means of facilitating social and personal adjustment to the demands of a newly industrialised society. Their reform-oriented late-century phrenology promised personal improvement through proper living habits and ‘exercising’ of the faculties, and seemed to mitigate the harsh physiological and psychological consequences of Darwinian evolution and hereditary conditions.

in Progress and pathology
Hysterical tetanus in the Victorian South Pacific
Daniel Simpson

In this chapter, Daniel Simpson delineates a complex model of imperial and cultural entanglement in the context of the death of the naval captain James Graham Goodenough under a hail of poisonous arrows on the Santa Cruz Islands in 1875. This was a moment in which previously vague British fears of the poisons of Santa Cruz were seemingly confirmed. However, the ship’s surgeon, Adam Brunton Messer, pointed to certain medical, cultural, and environmental factors that countered this popular hysteria. Superstitious dread of the reputed poisons of the region, Messer argued, had predisposed British sailors to a nervous irritability which either mimicked or encouraged the onset of tetanus. Furthermore, he insisted, endemic neurosis amongst sailors was responsible for the increasing prevalence of tetanus in the wounds of those struck by ostensibly poisonous arrows. Drawing upon new psychopathological understandings of the relations between mind and body, Messer effectively collapsed any distinctions between ‘civilised’ and ‘uncivilised’ peoples clashing in the South Pacific by imagining that modern medical education might work in both cases to supplant antiquated superstitions and anecdotal evidence. His medical hypotheses, deployed at a juncture of intense intercultural contact, served both to characterise and to realise a form of medical modernity.

in Progress and pathology
Open Access (free)
Medicine and culture in the nineteenth century

This collaborative volume explores changing perceptions of health and disease in the context of the burgeoning global modernities of the long nineteenth century. During this period, popular and medical understandings of the mind and body were challenged, modified, and reframed by the politics and structures of ‘modern life’, understood in industrial, social, commercial, and technological terms. Bringing together work by leading international scholars, this volume demonstrates how a multiplicity of medical practices were organised around new and evolving definitions of the modern self. The study offers varying and culturally specific definitions of what constituted medical modernity for practitioners around the world in this period. Chapters examine the ways in which cancer, suicide, and social degeneration were seen as products of the stresses and strains of ‘new’ ways of living in the nineteenth century, and explore the legal, institutional, and intellectual changes that contributed to both positive and negative understandings of modern medical practice. The volume traces the ways in which physiological and psychological problems were being constituted in relation to each other, and to their social contexts, and offers new ways of contextualising the problems of modernity facing us in the twenty-first century.

Open Access (free)
The French human sciences and the crafting of modern subjectivity, 1794–1816
Laurens Schlicht

Laurens Schlicht opens the volume at the moment of the French Revolution, which inculcated a profound sense of moral and political shock within its citizens. Writers within medicine, politics, and the developing human sciences maintained that it had been necessary to inflict this kind of shock in order to dismantle the rigid structures of society and make way for a radically new regime. Sustained metaphors of the medicalised human body, the social body, and the body politic commingled in the critical questions that were raised about the relationship between individuals and their wider social collective, and about the ways in which the passions might be either stirred into action or carefully regulated by external influences. Manifestations of this conscious interaction between medical and political spheres included the emergent psychiatric practice of intentionally shocking patients as a form of therapy, and the evolving instruction of deaf-mute pupils, as schools and asylums provided experimental spaces for controlling and adjusting the passions. In addition to an overt politicisation of the body and its responses to shock and strain, these discussions carried sustained analyses of the medicalised human body, and informed an evolving scientific practice directed towards an essentialised sphere of individuality.

in Progress and pathology
Open Access (free)
Health as moral economy in the long nineteenth century
Christopher Hamlin

Christopher Hamlin takes up the unstable and often polarised relationship between cultural experience and interpretation on the one hand, and biomedical objectivity on the other. In so doing, he draws attention to a phenomenon which is so frequently missing from current scholarship: embodied subjectivity. The chapter ranges widely from public health archives to literary texts, interrogating E. P. Thompson’s seminal concept of the ‘moral economy’ through the social history of health, and questioning how we might meaningfully register the experiences of those whose words and emotions are lost to history. Questioning the very voices and vocabularies through which the social history of health is constructed, Hamlin recognises both the usefulness and the limitations of our approaches to illness and the history of medicine, while adopting an integrative, holistic approach to notions of disease. Paralleling the historical figure of the nuisance inspector with the gamekeeper (or lover) in D. H. Lawrence’s Lady Chatterley’s Lover, and the tales of patients of Hardwicke Hospital, Dublin, with the complaints of Agnes Fleming in Charles Dickens’s Oliver Twist, he opens up the possibilities of work which crosses literary and medical histories as a context in which the formation of an embodied subjectivity might be considered.

in Progress and pathology
Jane Brooks

The creation of spaces conducive to healing is a critical aspect of the provision of good nursing care. The nursing sisters of the British Army, having trained in the British hospital system would have been well versed in the need to create and maintain and environment in which healing could take place. The zones into which they were posted during the Second World War and the spaces they were given in which to care for their patients, were however, rarely either favourable to health or to the ‘serenity and security’ needed for recovery. Extreme weather conditions, limited water supplies, equipment and electricity combined to hinder all aspects of patient care. The often hostile places in which nurses worked demanded that they develop clinical skills and the ability to improvise and innovate in order create healing spaces for their soldier-patients. However, as the chapter argues it was the highly feminised home-maker work that created these spaces, which the nurses themselves credited to be an essential aspect to the healing process in which they were the critical performers.

in Negotiating nursing
Open Access (free)
Jane Brooks
in Negotiating nursing
Open Access (free)
Nursing work and nurses’ space in the Second World War: a gendered construction
Jane Brooks

The introduction contextualises the Second World War and the position of nurses within it. It argues that the developments in weapons’ manufacture and transport technologies created a war in which mass killing and maiming could be achieved across the globe. The injuries and diseases caused by the mobility of troops and modern weaponry demanded a highly responsive medical service close to the action. This introductory chapter therefore provides a frame for the book within the historiography of wartime medical services, women’s participation in war and that of nurses more specifically. Negotiating Nursing uses written and oral testimony to explore the work and experiences of nurses on active service overseas. The introduction examines the nature of the sources and the value of personal testimony to the history of Second World War military nursing.

in Negotiating nursing
Open Access (free)
British Army sisters and soldiers in the Second World War
Author: Jane Brooks

Negotiating nursing explores how the Queen Alexandra's Imperial Military Nursing Service (Q.A.s) salvaged men within the sensitive gender negotiations of what should and could constitute nursing work and where that work could occur. The book argues that the Q.A.s, an entirely female force during the Second World War, were essential to recovering men physically, emotionally and spiritually from the battlefield and for the war, despite concerns about their presence on the frontline. The book maps the developments in nurses’ work as the Q.A.s created a legitimate space for themselves in war zones and established nurses’ position as the expert at the bedside. Using a range of personal testimony the book demonstrates how the exigencies of war demanded nurses alter the methods of nursing practice and the professional boundaries in which they had traditionally worked, in order to care for their soldier-patients in the challenging environments of a war zone. Although they may have transformed practice, their position in war was highly gendered and it was gender in the post-war era that prevented their considerable skills from being transferred to the new welfare state, as the women of Britain were returned to the home and hearth. The aftermath of war may therefore have augured professional disappointment for some nursing sisters, yet their contribution to nursing knowledge and practice was, and remains, significant.