This thesis is an ethnography and situated history of Tibetan medical practitioners in Tsang and Shigatse Prefecture, Central Tibet. It analyses how as individuals and groups, Tibetan medical doctors – the so-called amchi – have adapted and transformed their medical practices and multiple traditions of the Tibetan Science of Healing, or Sowa Rigpa. The principal argument is that amchi in the area studied have, at times and in certain places, held considerable agency in processes of transforming their traditions. This is despite and because of the ongoing Communist reforms, campaigns and structural changes enacted within the wider domains of health care provision and Tibetan medicine. Based on my research, I am able to articulate more clearly the role of individual amchi, their patients and other individuals and social groups, in shaping and adapting aspects of Tibetan medical practice. A central claim is that amchi participated and creatively used (and, in some cases, resisted and circumvented) the structures and policies employed by the state to administer provision of health care and reconfigure parts of Tibetan medical theory and practice. So far our understanding of Tibetan medicine during the 20th century has been largely limited to the history and contemporary work of central (Lhasa-based) government institutions of Tibetan medicine, notably the Mentsikhang and the Chakpori, and the practitioners associated with them. The fresh insights gained from my work with more marginal amchi – in private clinics, at home, in government hospitals and clinics, at monasteries – and also with members of international NGOs, allow us to discern more clearly what I call temporalities and socio-political geographies of amchi agency, which play a significant role in passing on and shaping dynamic Tibetan medical traditions. As the practices of the study population reflect, it is due to the efforts of those who were able to negotiate and preserve their medical work, as well as continue to innovate and adapt it, that multiple Tibetan medical traditions continue to exist in Tibet today.

This dissertation explores the various contexts of curative and preventive health in a particular economic zone, the tea estates of northern Bengal (Darjeeling, Duars, and the Terai) in the colonial period. The sanatorium of Darjeeling was established in the mid-nineteenth century as a European retreat from the dusty and clamorous plains of Bengal. The white/European settlement in Darjeeling encouraged tea plantations in the surrounding lands, by clearing the forests and transplanting them with tea plants and encouraging immigrant labour, demarcating enclosures, thereby rapidly creating a distinct site of economic activity in the region. When the tea plantations extended to the virgin forests in the foothills of the Himalayas, the region known as the Terai and then to the in the newly annexed (from Bhutan) plains beyond in the western Duars, the plantation economy predominated the landscape where large tea estates were interspersed with pockets of newly ploughed jute and paddy fields cultivated by tenant-sharecroppers. The processes outlined above led to a complex set of colonial enclaves. Darjeeling was conceived as a European retreat, a site of recovery for the white race in the tropics- an enclave of one kind. The tea plantations were constructed as enclaves of a different kind flanked by villages these were 'estates' where the labourers, overseers and the management resided in the estates in accommodations that varied according to a strict hierarchical order. Through an analysis of various archival sources including municipal and medical papers, private papers of officials and planters, publications of the tea industry, as well as contemporary medical journals this dissertation attempts to examine diseases, medical practices, and the role of the state within the dual enclaves of the hill-station and the tea plantations.

This thesis addresses the history of obstetric anaesthesia and analgesia in England and Wales between 1945 and 1975. It is based on an analysis of archival material from the Ministry of Health Department for Health and Social Security, the Central Midwives Board, the Medical Research Council, the Royal College of Obstetricians and Gynaecologists, the Obstetric Anaesthetists' Association and the National Birthday Trust Fund. Other sources used include the popular and medical press, British governmental publications, oral history interviews and a prosopography of the Obstetric Anaesthetists' Association. In this period the management and elimination of the pain of childbirth became the subject of great interest not only for mothers and anaesthetists, but also for obstetricians, midwives, clinical scientists, healthcare administrators, politicians and the press. Broadly speaking, existing work on the history of obstetric anaesthesia and analgesia treats this subject in two contrasting ways. Practitioner-historians of anaesthesia have characterised it as one of co operation between mothers and medical practitioners, but many historians of obstetrics and midw ifery have preferred to emphasise the role of obstetric anaesthetists in medicalising and hospitalising birth. This thesis places the development of obstetric anaesthesia and analgesia in the context of three related narratives. These narratives emerged in the first half of the twentieth century, but after 1948 operated within wider debates over the centralisation and hospitalisation of state healthcare under the NHS. First, the emergence and consolidation of anaesthesia as a hospital- based clinical speciality. Second, the demographic shift from home to hospital birth. Third, arguments over the role of midwives in birth. It uses four case-studies to explore these narratives: the Analgesia in Childbirth Bill, 1949 the development of new analgesics for use by unsupervised midwives obstetric anaesthesia and analgesia in the governmental Reports on Confidential Enquiries into Maternal Deaths and the early history of the Obstetric Anaesthetists' Association and its role in debates over epidural analgesia.

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This dissertation explores the cultural production of homoeopathy as a ‘vernacular science’ in Bengal between 1866 and 1941. In mapping homoeopathy’s vernacularisation, it studies the disparate ways in which the historical understanding of ‘homoeopathy’ and ‘family’ in late nineteenth- early twentieth century Bengal informed one another. It builds upon the historical literature published on homoeopathy and family in colonial Bengal in studying the myriad registers in which the two categories intersected. The first Bengal based private family firm investing in homoeopathic publications and in the importation and sale of homoeopathic drugs was established in 1866. In 1941 under the imperatives of the nationalist Congress Party, homoeopathy was formally recognised as ‘scientific medicine’ by the colonial state and a State Faculty of Homoeopathy was established. This dissertation looks at the interactions and conversations between North Calcutta based familial homoeopathic firms, sporadically dispersed mofussil actors, the British colonial state and the emergent nationalist governments to explore the ways in which homoeopathy was domesticated as a specific worldview, an ethic, a vision and regimen of looking at and leading life in Bengal in the period under study. Imbued with potent nationalist sensibilities and invested with deep religio-cultural resonances, homoeopathy managed to inhabit the liminal space between being a European science and an indigenous quotidian life practice. By examining such ambiguities inherent in Bengali homoeopathy this dissertation draws upon and speaks to the histories of nationalist imaginings, colonial modernities and governmentality. In so doing, it elaborates on the centrality and recurrence of the category ‘family’ in the history of homoeopathy by studying cultures of business practices, of biographising, processes of translations, indigenisation, and quotidian health managements.

How a medical entrepreneur functioned daily in America's nineteenth- and early twentieth-century marketplace is examined in this study of an adept medical entrepreneur, S Andral Kilmer, MD. Although the "medical marketplace" came into vogue in mid-1980s history of medicine, historians have still done little to unpack its scale, scope, or dynamics. The "who could fall for that" theme pervades literature on quackery, only rarely admitting that we remain an ever gullible public, still taken in by miracle cures. Recently, Takahiro Ueyama's Health in the Marketplace has shaken this orthodoxy of medical historiography while re-invigorating a dormant marketplace discourse. Since Victorian purveyors of medical commodities aspired to scientific status, confusion abounds concerning the shady border between regular and irregular practitioners, but Ueyama's study stops short of fully illuminating that commercial juncture. This thesis unpacks that regular/irregular overlap with substantive and methodological contributions, particularly through analysis of advertising imagery, legal and travel related records, and patient case records. To ground the work, make the scale manageable, and provide an in-depth core, the focus is on the career of one physician who identified himself as the "Invalid's Benefactor" and "Cancer's Conqueror," while his enemies branded him an itinerant quack on the basis of his penchant for self-promotion. Although trained by leading regular physicians, Kilmer settled upon an eclectic practice, ideologically oriented to the physio-medical movement. His life encapsulates a paradox of contemporary fame versus historic obscurity in the fickle and faddish realm of American medical consumerism. This examination of how a medical entrepreneur navigated the changing healthcare marketplace is relevant and timely. Despite the twentieth century tendency for physicians to be employed in hospital or research settings, self-sufficiency persists as a foremost characteristic of American medicine, and young physicians are increasingly encouraged to be entrepreneurs.

This thesis studies some of the most popular alternative treatments for neurasthenia in Japan in the period of 1890 to 1945, including breathing exercise, quiet-sitting, hypnotism-derived mental therapy and Morita therapy. Neurasthenia, with its supposed relation to modern civilization, was a widely used and preferred disease label in Japan. As the official Western medicine failed to provide satisfactory solutions to this obstinate and debilitating disease, a variety of alternative treatments were invented or reinvented and some of them became very popular. Concerning the popularity and effectiveness of these treatments, this thesis argues that they provided contemporary Japanese, who had been experiencing rapid and dramatic change to lifestyle, culture and society, with models by which they could perceive, conceive and strengthen their neurological, circulatory and psychological systems by their analogy to ki. Known as a nervous disorder, neurasthenia was also perceived and understood as a disorder of ki, with insufficiency, stagnation, obstruction and turbulence still thought to be the major faults. Through undergoing and practicing these treatments, Japanese neurasthenic patients could control and invigorate the flow of nervous currents, blood and ideas as they previously cultivated ki. This thesis also investigates these treatments in the context of Japanese nationalism. Their advocates often claimed that they were embedded in traditional Japanese culture and hence particularly effective for Japanese patients. Returning to traditional lifestyle and culture was regarded by them as a cure for neurasthenia, which they thought was a disease of ‘de-Japanization’. Furthermore, they founded a large number of groups and organizations for the practice and promotion of these treatments, which were in many ways like traditional extended families and provided patients with a much-needed sense of security and belonging. These treatments were endowed with social and cultural significance, which was also crucial to their therapeutic effectiveness for neurasthenia.

This dissertation analyses the politics of medicine and opiate use in Soviet Tajikistan since the establishment of this republic in 1924. The closing date of this dissertation, 1958, corresponds to the end of the era when the Communists proclaimed that they had ‘eliminated’ drug addiction in their territories. During this period, the mainstream Soviet position on opiate use was transformed from a view that it constituted ‘a survival of the backward past’ and an impediment to social progress, to the declaration that drug addiction disappeared within a few years of Bolshevik antidrug measures. Many Soviet commentators on drugs in Central Asia have taken this position at face value and explained the ‘elimination’ of addiction in Tajikistan in the following ways: in the absence of drug treatment facilities in Tajikistan, Tajik drug users were treated in neighbouring republics; drug use prevention strategies were successfully implemented through ‘cultural and sanitary enlightenment’ clubs. This dissertation will systematically challenge an array of assumptions which underpin contemporary understandings of the Communists’ responses to drug addiction in early Soviet Union, with particular focus on Tajikistan. The author will argue that, on the contrary, none of these treatment and prevention strategies were carried out in the way that the Soviet authorities declared. Using a wide range of archival documentation, this dissertation shows that drug use and users in Tajikistan were repressed in the course of an ‘administrative struggle’, which culminated during the years of the Great Terror in the late 1930s. The thesis looks broadly into the politics of drug use in early Soviet Union, at the ‘nexus’ between the medical profession, law enforcement bodies and other actors in the trade and consumption of drugs. It will make several historiographical interventions which are relevant to the understanding of contemporary drug policies and discourse in Central Asia.

This thesis argues that medical concerns, concepts and values underpin many of the texts produced by the nineteenth-century psychologist and philosopher William James (1842-1910). The medical themes in question deal with the ethical and aetiological nature of disease, hygienic principles, mental therapeutic practices and the political standing of the invalid. They are discussed explicitly in The Principles of Psychology (1890), Talks to Teachers (1899), The Varieties of Religious Experience (1902) and other essays and lectures. Analysis of James’s extensive personal papers indicates, moreover, that this same set of themes comprises an extremely significant intellectual context within which to situate other well-known works, including The Will to Believe (1897) and Pragmatism (1907). The central aim of this thesis is to trace the multiple, and mutable, ways in which illness and philosophy were profoundly interconnected within James’s writings. From early adulthood onwards, he closely identified the concept of evil with the existence of disease and infirmity and was fervently devoted to the notion of health as an ethical ideal. To this end he championed the importance of hygienic practices, for himself as an individual and for society at large. These twin commitments, to the prevention of disease and the promotion of health, are in evidence across the disciplinary breadth of James’s corpus. They are also the locus of a significant epistemological transformation. During the mid-1880s James lost faith in the medical profession and their exclusive worship of the physiological “laws of health”. He began to embrace the world of unorthodox practitioners and “mystical” medicine and moved towards a more inclusive, pragmatic theory of (medical) truth. Ultimately, James concluded that both scientific and religious forms of knowledge may facilitate the quest for health: a state that he came to understand as having “bodily mental and moral” dimensions.

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