The causes of the retardation of the infant mortality decline in the latter part of the nineteenth century in England has been the subject of debate amongst historians and medical professionals for the last hundred years. The varieties of explanations that have been offered tend to only indicate the overwhelming complexity ofthe question. This thesis examines the issues surrounding the infant mortality decline in the late nineteenth and early twentieth centuries in five English urban areas. It appears far more plausible to consider that the national figures only represent an average of a multitude of local circumstances and it is only by reference to these that a viable explanation for the infant mortality decline can be detected.

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This thesis uses medical and psychiatric records to explore how physicians analysed `female sexual inversion' in Italy and Britain, c. 1870 to 1920. It investigates why sexology emerged when it did and considers the role national, political and cultural debates played in shaping sexological research. I argue that sexology both upheld and challenged national cultural norms and sought to address various broader problems that shadowed social and political debate in these societies. For Italy, detailed case histories of female inverts are presented. In Britain, however, female homosexuality was observed within other medical concerns because physicians were reluctant to study sexual inversion until at least the late 1890s. In each national context close attention is paid to `typical' locations of female homosexuality, for example asylums, brothels and schools, and to particular figures and relationships; the `tribade-prostitute', the 'fiamma', and the so-called nymphomaniac. Italian and British sexologists had different approaches to the study of these women-only environments, in which female homosexuality was supposedly widespread. By comparing the debates around female sexual inversion it is possible to chart important and illuminating differences of language, status and politics. I will highlight the proliferation of these studies in Italy and the relatively marginal status of British sexologists. Moreover, in Italy criminal anthropology was critical in shaping sexological studies, while in Britain, political motivations linked to laws against `sodomy' were crucial. In the central chapters, the works of Cesare Lombroso and Pasquale Penta in Italy, and Henry Havelock Ellis and William Blair Bell in Britain, are crucial. Alongside texts explicitly discussing `female sexual inversion' as a psychiatric disease, the thesis also examines other medical concerns related to female sexuality. Questions of sexuality and homosexuality were important to wider discussions about women's role in society, female education, prostitution, and broader debates about progress, civilisation and national well-being.

It has been well recorded that, until fairly recent times in this country, dentitions disintegrated at a relatively young age. In way of explanation it has generally been assumed that the complete lack of oral hygiene that existed resulted in a rapidly advancing periodontitis. The almost universal finding of exposed root surfaces at a young age did much to confirm the hypothesis that the attachment loss observed was inflammatory in origin. Furthermore, from the 17<SUP>th</SUP> century onwards the prevalence of dental caries escalated rapidly as the carbohydrate level of diets in this country rose due the importation of sugars from abroad. The existence of these two dental diseases seemed to explain adequately the observed early loss of dentitions. However, in studying historic skeletal material close inspection often reveals that despite the severe attachment loss the alveolar bone appear to be reasonably healthy with only minimally damaged septal areas. A further observation in almost all historic skeletal material is that of severe occlusal attrition of dietary origin. Many of the earlier workers in the field of dental paleopathology believed that the root exposure they observed was not due to inflammatory alveolar bone loss but was secondary to occlusal attrition and was in fact explained by the teeth continuing to erupt to compensate for the lost tooth height. This thesis investigates the relationship between occlusal attrition, compensatory eruption and the prevalence of periodontitus. It attempts to determine the reasons for the early disintegration of dentitions and investigates material covering a period of some three thousand years. The findings suggest that the prevalence of periodontal disease has changed little over this period and was therefore unlikely to have been responsible for the early loss of dentitions. Evidence is provided to show that compensatory eruption of the human dentition does occur in response to occlusal wear of dietary origin and that this supereruption is past a static alveolar crest, thus exposing root surface. The conclusion is drawn that the early loss of dentitions in this country prior to the 17<SUP>th</SUP> century was more likely to be due to complications associated with compensatory tooth eruption secondary to severe attrition of dietary origin. But after this period the escalating prevalence of dental caries became the major factor in tooth loss. Softer diets reduced the incidence of supereruption of the teeth. From the results of this study recommendations are made regarding epidemiological studies on both clinical and skeletal material and the point is stressed of the importance of recording the presence or absence of occlusal attrition if linear measurements of attachment loss are used to record periodontal status.

Challenging significant historiography this study argues that the period 1845-1914 was a time in which to have been in receipt of the care of county lunatic asylums was substantially preferable to the alternatives for the local poor and mad, suggesting wider studies might show the same for other parts of England. Case examples are provided from the close research of two pauper lunatic asylums built in Hampshire during the period. Underpinning these is a methodology which synthesises an ‘alltagsgeschichte’ deriving from the Annales School with medical and local history. The research follows a metaphorical patient-journey beginning with the pre-patient stage when policy enforced the building of county lunatic asylums, examining the concept of architecture for sanity as well as local reaction to the building programme. It has identified a novel perspective for our understanding of the loci of control responsible for translating ideology into the physical structure of the asylum. Patient assessment and the asylum admission process are critically reviewed, and the identification of the symptoms of insanity as well as contemporary beliefs about aetiology are interrogated. Medicalization of aberrant behaviour and the early attempts at classification and diagnosis are subsequently analyzed. Significant differences in causes for and forms of disorder were revealed between rural and urban populations, contributing new knowledge. An important question, which hitherto has been incompletely addressed, is the extent to which insanity had risen to epidemic proportions. This study comprehensively evaluates local evidence to conclude that it had not. The medical and physical treatments prescribed are scrutinized and eliminated as contributing to the recovery rate whereas the dominant method of intervention, the dual approach of moral treatment and management was found to be significantly successful as curative or palliative. The roles of the staff in contributing to the comfort and welfare of patients are examined within the spirit of policy, legislation and developing scientific knowledge.

This thesis investigates the ways in which hereditary degeneration was discussed by Scottish psychiatrists in the late nineteenth and early twentieth centuries with particular reference to the anti-alcohol debate. I examine the theoretical writings of both clinical and forensic psychiatry to show how the theory of degeneration functioned as part of a new understanding of legal medicine and that psychiatric knowledge was always implicitly related to a broader conception of criminal capacity and the role of the modern state. While the argument is situated in the wider literature covering psychiatry and degeneration in Europe and America during the late nineteenth and early twentieth centuries, I trace a rather singular story rooted in the institutional peculiarities of Scotland, showing how psychiatrists attempted to use the problem of alcoholic degeneration to mould their science into a branch of public health, propelling them into their preferred role as guardians of the race. This public health campaign facilitated the creation of new categories of psychiatric knowledge consisting of mental abnormalities that did not amount to absolute insanity, but that none the less had a bearing on how people thought about the mind, conduct, and criminal capacity. All the leading figures of Scottish psychiatry had a significant interest in alcohol as a cause of degeneration, and in their descriptions of the condition, the legal applications of the doctrine were never from view. One reason for this was undoubtedly the autonomous nature of the Scottish legal system which, when combined with the relatively small professional population of Scotland, greatly increased the rate of intellectual exchange between psychiatrists and lawyers while intensifying the political implications of associating with certain doctrines. Thus, a large part of my thesis will also be devoted to the legal interpretation of psychiatric claims, and in later part of the thesis I examine in depth the extent to which psychiatric knowledge claims were able to modify the laws of Scotland. Three substantive themes protrude from the documents consulted: Heredity, degeneration and alcohol, and medico-legal interaction. In analysing these themes, I engage with specific aspects of the social and institutional life of Scottish psychiatrists in the late-nineteenth and early-twentieth centuries.

This thesis presents a critical edition of John Hall’s casebook (composed around 1634-1635) and commentaries on aspects of it. My research involved close reading of Hall’s Latin, and its translation into English. In the process it became apparent that Hall had made considerable use of unattributed borrowings from Latin medical books, making up between thirty and forty per cent of his text. These were mostly identified by detailed word searches of on-line databases. This is a use of medical texts not previously noted, and makes a clear connexion between Latin medical texts and routine medical practice. The thesis is presented in four sections, plus introduction and conclusion. The first section, the Background, gives the history of Hall’s manuscript from its composition in 1634-35 to its acquisition by the British Library. It sets out the reasons for producing a new translation, the editorial principles and practice followed, and some medical themes running through Hall’s case reports. Section two contains the critical edition itself, with parallel Latin and English texts. Footnotes to the Latin text give the sources of all of Hall’s borrowings from and references to medical and other texts. The third section (Chapter 1) analyses the process and results of identifying Hall’s working library, of forty-three authors and sixty titles, from his borrowings. It puts his library in the early modern medical context in terms of its contents and categories of composition. I show that there were changes in the books Hall acquired over time, from those suitable for a student through to his later interests in chymical practice and the diagnosis of scurvy. Despite these changes, he continued to rely on old familiar texts for most of his remedies throughout his life. The fourth section (Chapter 2) examines Hall’s manuscript in the context of casebooks generally. It differs from the majority of casebooks, the differences being explained by its composition as the draft for a book to be published. It shows that a casebook can have an internal structure related to the chronologies of its composition and the cases it draws on. This thesis demonstrates the importance of Latin sources in at least one medical casebook of the early seventeenth century. I show that borrowings such as Hall’s were not unique even if rarer in other texts. The possibility of a Latin textual source should be considered for any Latin text in a casebook of that period.

This thesis considers the role of individual members and groups of the Religious Society of Friends (Quakers) in the development of therapeutic communities and other types of therapy that consider social environments. The thesis focuses on the history of one specific therapeutic community (anonymised in the research) established and governed by a group of Quakers. The study also provides a contextual history of therapeutic environments, particularly those involving Quakers. The thesis then considers attitudes towards dealing with conflict, and how this topic has been explored in notions of 'youth' and 'adolescence', in therapeutic environments, and in Quakerism. This work was initiated as the first studentship to be supported collaboratively by the University of Birmingham and the Institute for the History and Work of Therapeutic Environments. The thesis is just one part of a process of encouraging multidisciplinary discussion of this topic among historians, archivists, practitioners and policy makers.

The history of 19th century nursing reforms has focussed almost entirely on the activities and lives of nurse leaders, to the exclusion of the ordinary nurses. The lives of such nurses at one London hospital, St George's, have been investigated using a methodology based on prosopographical techniques. It was found that by the end of the century, far from becoming the exclusive preserve of middle class women, as some historians have argued, the Nursing Department at this particular hospital had become a melting pot of social classes. Appointment and promotion depended on ability rather than social position, and many women at the Hospital viewed nursing as a career, rather than a stop-gap before marriage. Evidence has also been accumulated which challenges the image of late 19th century nurses as being meek and docile women. The nurses at St George's were prepared to challenge the authorities to gain recognition for their various causes. Between 1850 and 1900, the Hospital Managers focussed increasingly on improving conditions of employment (including wages, accommodation and holidays) as a means of achieving stability within the Nursing Department, and of attracting a 'better quality' of woman. Nursing training was introduced during the fifty years of this study, although this was a slow process compared to its introduction at other hospitals. Financial considerations appeared to play a greater role in the development of probationer schemes, than a desire to improve the quality of nursing within the Hospital. The study of a group of Victorian nurses, such as this, provides insight into the development of nursing during the period, and reveals details which contradict the writings of nurse reformers. It also aids in the understanding of wider issues, including the changing role of women in Victorian society, and in particular their increasing participation in the labour market.

Little has been written about nursing in the period 1870-1960 within the geographical boundaries and surrounding areas of Halifax and Huddersfield. This thesis aims to explore the development of nursing within these towns. The focus is on general nurses in hospital and community roles. Rosenberg’s eight areas of importance were used allowing the construction of an historical analysis of both nursing and nurses locally. Archival sources were found in twenty-five main archives and twelve of these were investigated further. Primary documents belonging to local retired nurses such as personal documents, photographs and memorabilia were included. In total 1493 individual items were subjected to documentary analysis. The second stage of data collection involved conducting oral history interviews to capture memories and experiences of local retired nurses. A total of 373 named nurses were identified, sixty-eight contacted, forty-four agreed to participate and twenty-one were interviewed. A life story approach recorded their personal lives and nursing careers. This approach required the ethical issues of biographical research methods and interviewing to be addressed. Interviews were recorded on audio tape and transcribed ready to be deposited in the University of Huddersfield archives. Data was subjected to analysis using NVivo computer software and Rosenberg’s eight areas of importance used as a priori themes. Nursing in these two provincial towns changed during the ninety years under study often in response to local or national issues such as professional registration. Nurse education occurred in all but the early years and developed alongside the increasing specialization of nurses and as each nursing branch emerged. Nurses in West Yorkshire were subject to particular local issues such as its geography, environment and industrial heritage. The merits of this research are it provides a unique account of the local development of nursing adding to the professions history and presenting implications for present day practice.