This thesis is concerned with the artificial feeding of very young children during the second half of the nineteenth century, and its implications for infant health and survival. The decline of breastfeeding which occurred in England between the years 1850 and 1900 was regarded by contemporary critics as largely responsible for the high rate of infant mortality which persisted throughout the half century, at a time when premature deaths in other age-groups were declining in number. This thesis examines, in the light both of contemporary judgements and of modern knowledge, the artificial feeding methods which were adopted in place of breastfeeding. Changes in medical attitudes and opinion during this period in relation to artificial feeding are described, and their influence on popular feeding practice in different social contexts discussed. Rival influences, such as shortcomings in the supply of certain foods and the pressure of commercial advertising, are also examined, and the influence of social factors in general on the development of effective methods of artificial feeding assessed. Finally, the state of health of handfed infants as described in contemporary sources is considered in relation to their diet. Contemporary assumptions about the relationship between artificial feeding and high infant mortality and morbidity are largely found to be justified; it is argued that the period 1850 to 1900 was, nevertheless, one of notable advance both in attitudes towards handfeeding and in the technical skill and understanding which was brought to bear on the problems it involved. Although this period itself saw no reduction in the infant mortality rate, it is seen as a time of adjustment to new ideas and practices, forming a necessary prelude to subsequent and more effective attempts at reform.

This thesis analyses the aspirations and achievements of the lay women who were active in the campaign to improve women's health, and of those women who sought entry into paid occupations in the health services. After an introduction, Section One is intended to place the substantive data in context. Middle-class women's enthusiasm for voluntary work and the terms on which women entered national politics are discussed. These issues are used to illustrate the effects the maintenance of rigid social-class divisions had on the unity of the women's movement and the implications for the future of the movement of the decision to seek entry to the public domain on the grounds that women could make a unique contribution. Section Two is devoted to the lay women. First, the effect of the maintenance of rigid social-class divisions on the women's health campaign and on women seeking a career in the health services is discussed. Secondly, the consensus between both middle-class and working-class women, the medical profession and the Ministry of Health on the need to extend medical services is analysed, revealing an eagerness to follow technical advice which affected the strategy of the lay campaign and meant support for women workers in the health services was often circumspect. Thirdly, the reasons for the collapse of this consensus in the l93Os are discussed. This section is concluded with an assessment of the lay women's health campaign and a discussion of the impact the campaign had on women health workers. In Section Three, women's position as paid employees in the health services is analysed, and three occupations, midwifery, medicine and health visiting, have been selected. Difficulties these women encountered establishing themselves in paid employment, and their status and their relations with male colleagues and with the Ministry of Health are assessed. The differences between these three occupations, which prevented a sense of solidarity and an identification with the goals of the women's movement, are discussed. Their achievements during the period are assessed, and the effects of the medicalisation of childbirth and the increasing involvement of the state in maternity and child welfare are investigated. A fourth, concluding section draws these strands together. The lay women's health campaign and the goals and tactics of the women health workers are related to the maintenance of the existing social-class divisions, the ideological splits within the women's movennt and the persistence of barriers preventing women from competing on equal terms with men in the public domain. Although the number of women working in the health services increased dramatically and women's place in these services was assured, women generally remained in subordinate positions, excluded from the prestigious and lucrative posts, while they achieved only a statutory presence on decision-making bodies.

This thesis explores the histories of mild to moderate depression and the use of over the counter (OTC) St. John’s wort (St. John’s wort) during the 1990s. In doing so it not only investigates the diagnosis and definition of mental illnesses, it also raises questions about the interface between conventional and alternative medicine. Using a variety of printed sources, including popular media articles, scientific and medical journal publications, and St. John’s wort self-help books, a number of historical themes are explored. This thesis takes issue with existing medical historical studies of depression. Firstly it is argued that they have presented progressive depression histories. Secondly, it is suggested that they have retrospectively diagnosed depression on the basis of similar symptoms. It is therefore argued that illness is specific to the time in which it exists and should be understood within its own historical timeframe. During the 1990s standardised St. John’s wort was promoted as a natural and safe remedy. Adverts and media reports also highlighted the fact that it had a long medical history. Although this thesis establishes that the plant has been traditionally used to treat physical illnesses, it seems that a growing distrust of conventional antidepressants, combined with an established interest in alternative medicine, encouraged some lay people to use the remedy to treat mild mood disorders. It is further argued that lay people have a history of self-treating minor mental illnesses using preparatory and OTC remedies such as preparatory nerve tonics. Not only did lay people desire autonomous treatments, it also seems that standardised St. John’s wort provided a functional role as an OTC remedy. By the 1990s the concepts of responsible self-care and self-treatment were being actively encouraged by medical authorities. Therefore this thesis reclassifies the passive mild to moderately depressed patient as an active consumer. Following an analysis of the popular media it is suggested that the 1990s coverage of depression and its treatments was confusing. Indeed, depression and its treatment with conventional medicines and St. John’s wort were sometimes presented as part of a wider life style choice. Finally, it is argued that by the 1990s standardised St. John’s wort received the same scientific and medical scrutiny as conventional medicines. It is therefore suggested that the remedy represents a situation in which the boundaries between conventional and alternative medicines have become increasingly indistinguishable.

Sri Lanka gained prominence in international policy circles as an apparent 'success story' first as a model colony in early 1950s and later as a development model for South Asia by 1970s. In naming Sri Lankan 'success story' experts pointed to the decreasing population growth rate and decreasing mortality. Renowned demographers attributed this to the improvements in the field of social indicators such as high literacy rates, increased life expectancy and rise in female age at marriage. In this 'success story' women's health serves as a linchpin to the attainment of national progress. But a focus on women's health – as statistics and indicators – has also served to silence questions about Sri Lankan women's broader experiences of their disaggregated health. In particular, while Sri Lankan 'women's health' served the Sri Lankan state's 'success story' well, what is less clear is how women's individual bodies have fared within subsequent tellings of its other twentieth century Sri Lankan stories of late colonial, national, developmental, neoliberal and militarised phases. My thesis examines this question through a critical examination of women's health history of this island nation. I trace its history from initial birth control, family planning (1953) to development population control to militarisation, financialisation of women's bodies and ends with a critical examination of recent policies that claim to emancipate women's health 'beyond' a myopic focus on their role as reproducer. Although women's health was vigilantly 'controlled' and 'planned' for the state building project and women's bodies were framed around the notion of social reproduction for the nation building project of post independent Sri Lanka, women were neither subjects nor objects of these two projects. Women's reproductive bodies were, rather, the ground for a complex and competing set of struggles on population, family planning, development, modernisation and ethno nationalism of post independent Sri Lanka. Further women's health/women's bodies analysis helps to elucidate the manner in which we can track the operation of power that serves to silence women's own corporeal subjectivity and to delimit the realms in which she can exercise her own agency.

This thesis examines obstetric practice associated with cephalopelvic disproportion in Glasgow between 1840 and 1900. Disproportion is a complication of labour, which occurs when there is a physical disparity between the size of the fetus and the size of the birth canal. The majority of these cases involved women who had suffered from rickets as a child, and had a deformed pelvis as a result. During this period the number of children affected by rickets appeared to increase, and as a consequence more cases of disproportion were encountered towards the end of the century. Descriptions of these cases found in a wide-range of published and unpublished materials have been used to analyse changes to obstetric practice in Glasgow. The complex nature of medical decision-making in cases of disproportion is shown. Methods available for the treatment of disproportion included caesarean section, craniotomy, forceps, induction of premature labour, symphysiotomy, and turning. Medical practitioners’ decisions were subject to social, medical and scientific factors. Practitioners’ choices were influenced by their experience, reports of successful cases both abroad and at home, the severity of the pelvic deformity, innovations in medical technique, perceptions of the value of the mother compared to her unborn child, location, and the decisions of the women and their friends and family. After the 1870s there was an increase in the number of women who were delivered by one of these forms of intervention at the Glasgow Maternity Hospital. This change can be attributed to an increase in the prevalence of this condition, but it also reflected a shift from women being admitted on social grounds to medical reasons. This change was in response to an acknowledgement that selecting cases earlier improved the chances of a successful outcome, as evidenced by Murdoch Cameron’s work with caesarean section. In addition, as obstetrics emerged as a specialism, obstetric practitioners claimed these difficult cases for themselves. It was stressed that general practitioners and midwives should send women to obstetric physicians as soon as they were aware of complications, and that obstetric specialists were to replace general surgeons as the operator in severe cases of disproportion when caesarean section was required.

This thesis examines the development of the Edinburgh Royal Maternity Hospital in the context of medical care in Edinburgh during the period 1844-1914. It is based primarily on casebooks of the hospital and, in particular, on in-depth micro-studies of all of the hospital's Indoor and Outdoor cases in four discrete years, at approximately 20-year intervals. The central argument of the thesis is that Over the period 1844- 1914, professionals and patients at the hospital came to understand birth as a medical rather than a social event, and that this had repercussions for both groups as well as the institution itself. Chapter 1 places the thesis in the context of other secondary uork on the development of maternity hospitals and care, and examines the use of casebooks as primary sources. Chapter 2 considers the hospital and its staff in relation to the city and the Edinburgh medical community in particular. Chapter 3 examines the patients who attended. It argues that, in the nineteenth century, their perception of the hospital was as a place of social shelter. However, by 1912 a greater number attended for otherwise unaffordable medical care at birth. Chapter 4 examines the medical treatment given to patients. It argues that there was increasing acceptance of medicalisation by patients in the period studied, and increasing confidence in giving such treatment by the professionals involved. Chapter 5 discusses the staff and male and female trainees at the hospital. It suggests that, prior to the introduction of national requirements, the provision of training was driven by commercial concerns, and therefore varied throughout the period studied, particularly in the amount of practical experience offered. The relationship between the different grades of staff and the treatment they offered, described in the chapter, suggests increasing stratification in the roles of doctors and nurses at delivery and during the puerperium. The increase in nursing care following the birth indicates the creation of a professional role that among the poor had previously been undertaken by family members. The role played by increasing anxiety over infection following the introduction of strict antiseptic measures is discussed. The thesis concludes that in Edinburgh the medicalisation of childbirth among the poor was well-advanced by 1912, and suggests that this was a result of increasing patient acceptance combined with the increasing professionalisation of care.

In the mid-1950's McKeown and Brown advanced a controversial thesis concerning the effectiveness of medical measures available in the eighteenth century. Hitherto it had been widely believed that the rise of population in England and Wales in the eighteenth century had been the result of a fall in mortality partly due to medical improvements such as the growth of hospitals and advances in medical knowledge, a view that had been put forward by Griffith in the 1920's . McKeown and Brown argued that hospitals probably did more harm than good and that contemporary medical treatment with the possible exception of inooculation and vaccination against smallpox, was of little value. They pointed out that surgery, before the introduction of anaesthesia. and antisepsis, was very unsafe and the results of surgical procedures very poor; that in the field of midwifery the introduction of institutional confinements carried greater risks than home deliveries; and that few of the drugs then available were of therapeutic value. They concluded that eighteenth century population growth was not caused by a rise in the birth rate but by a reduction in the death rate probably caused by a decline in the incidence of infectious diseases due primarily to improvements in living conditions and to a lesser extent to changes in the virulence of certain diseases. In a later paper McKeown and Record extended the analysis to 1900 and concluded that the decline in mortality in the second half of the nineteenth century was largely due to improvements in the standard of living, particularly to improvements in diet; hygienic changes introduced by the sanitary reformers accounted for the decline of typhus, typhoid and the diarrhoeal diseases, while changes in virulence of the causative organism accountfor the decline of scarlet fever. They suggested that medical treatment in the nineteenth century had an insignificant impact on mortality; the only effective prophylaxis available was for smallpox and this was responsible for only a small part of the decline in the death rate These conclusions have been questioned; Razzell has argued that the introduction of inoculation against smallpox in the eighteenth century was a major factor contributing to the decline in mortality and Sigsworth, Cherry, and Woodward have stressed from studies of individual hospitals that conditions in voluntary hospitals were better than McKeown and Brown had suggested, particularly in the late eighteenth and early nineteenth century, that surgical mortality was not as high and that a high proportion of patients were discharged "cured" or relieved". The object of this study is to test McKeown's thesis at the 16cal level by considering the relationship between mortality and hospital, medical, and public health provision in Glasgow 1855-1911. Unlike McKeown's studies, use has been made of detailed local sources relating to the hospital, public health and other medical institutions in the city. Minutes and reports of voluntary hospitals and dispensaries have been examined as well as minutes of committees of two of the Glasgow poorhouses and reports and minutes of the committee of health, the sanitary department and the infectious disease hospitals. Mortality rates in Victorian Glasgow were exceedingly high but they did fall in the period under consideration; despite the evident gross poverty and poor living conditions a considerable saving of life was achieved in the second half of the nineteenth century. This study attempts to identify the major diseases contributing to the mortality decline in Glasgow and in Scotland and to discover how the mortality experience of a large industrial city like Glasgow differed from the national pattern.

Ce travail de recherche a pour but d'analyser les relations entre le domaine de la rhétorique et les divers aspects de la thérapeutique exposée par Celse, encyclopédiste romain du 1er siècle ap. J.­ C., dans son livre intitulé De Medicina, ou Sur la Médecine. Il s'agit principalement de tenter d'offrir une approche globale de l'ouvrage celsien, qui prenne en compte tous ses aspects, depuis sa réalisation par l'auteur jusqu'à sa possible mise en pratique par un soignant, professionnel ou amateur. / This PhD thesis aims at analyzing the relationship between rhetoric and therapeutiques exposed by Celsus, a Roman encyclopaedist from the 1st century AD, in his De Medieina, or On Medicina. Our main concem is to try and provide with a global approach of Celsus' worlc, taking into account every single aspect of it, from its writing to its putting into practice by a professional or amateur healer.

A hypothetical journey from the moment a soldier was wounded to his discharge from the field hospital was detailed in order to provide an idea of the organisation of military health services, evacuation strategy and roles of health care personnel during the Spanish Civil War. It was observed that despite both Nationalists and Republicans formally banning female nurses as part of the military units stationed on the front lines, nurses working at the auto-chirs, advanced surgical units and some field hospitals often found themselves only metres from the firing lines. Both men and women volunteered to nurse the war casualties from the start. It was soon observed, however, that untrained nursing staff could often cause more harm than benefit to patients, hence training courses for both nurses and orderlies were organised by a variety of organisations and political groups all over Spain. Due to the circumstances of war, nursing experienced a clear practical development expanding its professional boundaries from core to complex procedures which, until the outbreak of war, had been the sole responsibility of another professional group known as practicante. Nursing's unchallenged evolutionary process during the Spanish Civil War was explained by a number of factors including not only the war situation itself but the large number of nurses available, their determination, adaptability and capacity to evolve in order to meet the new health care needs of the population. The impact of key individuals such as Mercedes Mil, Inspector General of all Female Hospital Personnel, in the Nationalist side, and the nurses of the International Brigades, in the Republican side, on Spanish nursing was also significant. The evidence confirmed the hypothesis that the Civil War exerted a positive impact on Spanish nursing.

This thesis describes medical aspects of the expeditions of the Heroic Age of Antarctic exploration (1895-1922). It is divided into three sections. Section 1 describes the drugs and medical equipment taken to the Antarctic by these expeditions. There is an introductory discussion followed by papers on ophthalmic drugs, injections, inhalations and suppositories, oral drugs and topical preparations. Sledging medical cases are considered separately. Brandy was often used as a medicine and the medical uses of alcohol are described. Some expeditions took what were described as “medical comforts”. This term was sometimes used as a euphemism for alcoholic beverages but, in fact, encompassed a wide range of foods for invalids. Burroughs Wellcome and Co. supplied many of the expeditions with drugs and their medical chests. They used the expedition link in their advertising and the relationship between the expeditions and drug companies is described. Section 2 describes some of the medical problems encountered. The most serious problems were scurvy and a condition often called “polar anaemia”, which seems to be the same as a condition known at the time as “ship beriberi” and what is now described as “wet beriberi”. The controversy as to whether Captain Scott and his colleagues died of scurvy is also discussed. Other problems included frostbite and snow blindness. At least 11 general anaesthetics were given, including two for amputation of frostbitten toes. Psychological problems were common and there was some serious psychiatric illness including alcohol abuse. Section 3 describes the doctors and some of the research that they carried out. The most common research done by doctors was bacteriological. Most doctors collected biological data on the explorers including weights and haemoglobin measurements. This was largely for health monitoring but one doctor pursued physiological research. Three doctors and a medical student studied geology.