In 1846 and 1847, ether and chloroform were used and celebrated for the first time in Britain and the United States as effective surgical anaesthetics capable of rendering individuals insensible to physical pain. During the same decade, British novels of realism were enjoying increasing cultural authority, dominating readers' attention, and evoking readers' sympathy for numerous social justice issues. This dissertation investigates a previously unanswered question in studies of literature and medicine: how did writers of social realism incorporate realistic descriptions of physical pain, a notoriously difficult sensation to describe, in an era when the very idea of pain's inevitability was challenged by medical developments and when, concurrently, novelists, journalists, and politicians were concerned with humanitarian reforms to recognize traditionally ignored and disadvantaged individuals and groups in pain? By contextualizing the emergence of specific realist novels including works by Elizabeth Gaskell, Charles Reade, William Howard Russell, and Charles Dickens, within larger nonfiction discourses regarding factory reform, prison reform, and war, this dissertation identifies and clarifies how realist authors, who aim to demonstrate general truths about "real life," employed various descriptions of physical pain during this watershed moment in medicine and pain theory, to convince readers of their validity as well as to awaken sympathetic politics among readers. This study analyzes Gaskell's first industrial novel, Mary Barton (1848), Reade's prison-scandal novel, It is Never Too Late to Mend (1856), Russell's Crimean War correspondence (1850s) and only novel, The Adventures of Doctor Brady (1868), and Dickens's second Bildungsroman, Great Expectations (1861), thereby revealing different strategies utilized by each author representing pain - ranging from subtle to graphic, collective to individualized, urgent to remembered, and destructive to productive. This study shows how audience expectations, political timing, authorial authority, and medical theory influence and are influenced by realist authors writing pain, as they contribute to a cultural consensus that the pain of others is unacceptable and requires attention. These realist authors must, in the end, provide fictionalized accounts of pain, asking readers to act as witnesses and to use their imaginations, in order to inspire sympathy. / English

This thesis examines the development of vivisection as a method of physiological research between 1875 and 1901 in Great Britain, by examining some of the arguments, discussions, and ideas put forth by physiologists for the utilisation of vivisection in their research. Because this study operates within the context of medical history, questions of legitimacy, scientific development, and professional image are lifted. The development of vivisection during this period took place with a larger shift in scientific practice playing out in the background, where experimentalism began overtaking the previously more analytical approach to medicine and the sciences. The First Royal Commission on Vivisection in 1875 marks the beginning of this study, and the discussions within allow for a more nuanced picture of the professional debates on the practice, where both proponents and sceptics at times found common ground. Technological and societal aspects were central to much of the argumentation for the further development of vivisection, with technology easing the practical aspects of the method, and the concept of the "gentleman" allowing British "vivisectors" to argue against charges of cruelty, pointing rather to continental schools of physiology as the culprits, whilst lifting the "humanity" behind animal experimentation in Great Britain. In conjunction with pointing out the importance of the method for the development of medical science, the Cruelty to Animals Act and the lobbying on behalf of the professional journals British Medical Journal and The Lancet helped legitimise the practice in Great Britain. The Act allowed vivisection under set circumstances, and the two journals served as megaphones for scientific development on behalf of vivisection, at times even openly criticising sceptical opinions. At the same time, some saw experimental research through vivisection as merely one aspect of medical practice. One which needed to gain foothold in order to help advance medical science for the larger benefit of all humanity.

This thesis examines women’s experiences of, and attitudes towards, motherhood between 1945 and 1970. The thesis is based on ninety-two oral history interviews with women from different locations in Oxfordshire – rural, urban and suburban. Oral history is a methodology that can provide objective information about women’s lives, but also reveals their thoughts and feelings through the subjectivity of their accounts. The thesis forms a qualitative study looking at six aspects of motherhood. The first is the portrayal of motherhood in contemporary social surveys and community studies. The second is the issue of education for motherhood and questions over whether mothering was innate to women or needed to be taught. Thirdly, the thesis investigates maternity care provision and disputes over who should provide it (namely midwives, GPs or consultants); where this care should take place; and whether pregnancy and childbirth were medical conditions at all. Next it discusses theories of child development and discourses of ‘good’ and ‘bad’ mothers, in order to look at women’s relationship with authorities on childcare. Then it considers critiques of working mothers and debates over whether women should work outside the home; if so, when they should do so; and what strategies they should employ so that work and motherhood could be combined. Finally it analyses popular conceptions of motherhood, marriage and the family, and how the interviewees related to representations of the ideal mother figure during the immediate post-war decades and beyond. The thesis concludes by demonstrating the real difficulties mothers faced during the period 1945-1970; that interviewees from all types of background shared an understanding of how ‘normal’ women should behave; and also that the stereotyping of the period as one of conservatism before the changes that began in the later 1960s and 1970s means the ways in which women were already organising themselves to improve their lives has tended to be disregarded.

This thesis investigates the emergence of an internationally renowned psychiatric community in Uganda. Starting at the beginning of colonial rule in 1894, it traces the changing nature of mental health care both within and beyond the state, examining the conditions that allowed psychiatry to develop as a significant intellectual tradition in the years following Independence in 1962. This ‘golden age’ of psychiatry saw Uganda establish itself as a leader of mental health care in Africa, an aspect of history that is all the more marked for its contrast with the almost complete collapse of mental health care after the expulsion of the Asian population by Idi Amin in 1972. Using a wide range of new source material, including interviews with psychiatrists, traditional healers, and community elders, this thesis pushes the history of psychiatry in Africa beyond the examination of government policy and colonial hegemony. It brings together the history of psychiatry with the histories of missionary medicine, medical education, and international health by asking what types of people, institutions, and organisations were involved in the provision of mental health care; how important the growth of Makerere Medical School was for intellectual and institutional psychiatry; and how ‘African’ mental health care had become by the end of the period. It presents a history of mental health care in a country that has tended to be overshadowed by Kenya in the historiography, yet whose engagement with medical missionaries and efforts to advance medical training meant that the trajectory of psychiatry came to be quite different. Focusing in particular on the significance of western-trained Ugandan medical practitioners for mental health care, the thesis not only analyses African psychiatrists as historical actors in their own right, but represents the first attempt to examine the development of psychiatric education in Africa.

This thesis studies the literary genre of pastoral between 1559 and 1647. The first of these dates is that of a work that changed the course of early modern pastoral, Montemayor’s Diana; and the second marks the English translation of Gomberville’s Polexandre, a pastoral romance which exemplifies the shifts in cultural values that re-shaped Montemayor’s model over the century that followed its publication. My study focusses on the significance for this genre of the ethical quality known to classical moral philosophy as otium, and translated in early modern English by words such as peace, leisure, retirement, ease and idleness. Otium has strong historical associations with the tradition of Virgilian pastoral. Its significance in early modern pastorals, however, has been largely overlooked, despite the fact that early modern interest in otium had been revitalised by the rediscovery of some of its most important classical discussions. This renewed interest in otium, I argue, was essential to the development of early modern pastoral. My argument challenges both old and new critical perspectives on pastoral, and engages with key issues in early modern culture which literary scholars have neglected. Older studies understood pastoral otium simply as idyllic retreat; newer ones accept this view, but argue against its privileged and quietist political implications, preferring to concentrate on the tradition of interpreting pastoral as political allegory. Otium’s principal connotations, however, were neither quiet nor idyllic. Though its restorative qualities were sometimes cautiously acknowledged, otium’s potential to corrupt was ever-present, and affected a range of areas including privacy, politics, moral psychology and medicine. When people wanted to imaginatively explore those effects, I argue, pastoral was the genre to which they were most likely to turn. Listening to what pastorals say about otium can play an important role in reconstructing this crucial and misunderstood aspect of early modern culture.

This study considers the history of trauma, both as a psychiatric concept and as a diagnosis, and its social and cultural representation from a transnational perspective after WWII. The intellectual evolution of trauma was determined by various medical, social and cultural variables, institutions, and people who wielded influence in the postwar world order as well as diverse local contexts. This thesis focuses on the globalisation and localisation of such concept and diagnosis shaped by international and local mental health experts at the World Health Organization and the National Taiwan University Hospital. Through the efforts of these experts, trauma not only became one of the most globally diffused psychiatric diagnoses, but also a hyperbole appropriated by Taiwanese psychiatrists to account for extreme forms of social suffering. Studies have criticised the universality and the Anglo-American-centred approach to the history of traumatic psychiatry. Scholars have also begun to explore transnational histories of psychiatry by systematically comparing or tracing the diffusion routes of psychiatric topics. Their methods of enquiry and problems solved, however, differ. My research analyses a disparate collection of evidence at the level of international organisations and from local aspects, allowing not only a critical reconsideration of trauma in the trend of global medicine, but also its reception, contestation and appropriation in the non-Western contexts. Guided by the works of medical historians, literary critics and cultural anthropologists, this project combines archival research with oral history interviews to challenge the existing historical accounts of trauma, and provide evidence of the limited capacity of globalised psychiatric norms and their reception and appropriation beyond the imagination of world citizenship. It argues that such scientific artefacts were not only produced through mutual reference between Eastern and Western experiences, but also measures of instrumental rationality employed by postwar internationalists to engineer their modernity in the Global South.

This thesis examines the role of microscope technology in informing medical and anatomical knowledge during the Enlightenment. Past historians have claimed that microscopy generally stagnated until the popularisation of achromatic microscopes and cell theory in the middle of the nineteenth century. As evidence for this decline, historians have pointed to the poor quality and slow development of microscope designs until the popularisation of achromatic microscopes in the 1820s. In contrast, this thesis highlights the role of specific Enlightenment-era microscopes in answering medical and anatomical questions. It suggests that medical microscopy was far more advanced than previous scholarship has ascertained. Thus far, instrument historians have focused more attention on competing instrument makers as opposed to rival instrument users. This thesis presents several case studies which explore both makers and users. These concern the histories of Enlightenment-era epidemiology, reproduction theory, anatomy, and physiology as well as the different types of microscopes which influenced these fields. In terms of methodology, this thesis neither follows nor casts doubt on any particular theory of historical development; rather, it attempts to shed further light on available primary sources and their contexts. Presenting key case studies illustrates the difficulties that early microscope users faced in acquiring and publishing new observations. To explore the practice of early microscopy further, this thesis presents re-enactments of these case studies using Enlightenment-era microscopes and modern tissue samples. Thus, this thesis is a call to broaden the scope of primary sources available to historians of science and medicine to include instruments and re-enactments. This thesis finds that technological advances did not correlate to microscopical discovery in medicine or anatomy. Both simple and complex microscope designs aided anatomical and medical research. Broader advances in anatomy, physiology, and medical etiology dictated the utility of medical microscopy. Although various groups, such as the French clinicians, saw little need for microscopy towards the end of the eighteenth century, microscope-based evidence continued to play a diagnostic role among lesser-known practitioners despite its lack of visibility in medical literature.

It is commonly accepted that, prior to the rise of paediatric medicine as a formal medical specialisation in the nineteenth and twentieth centuries, medical care of children was primarily conducted by women in the context of the household. However, as this thesis argues, there was vibrant medical interest in children prior to the development of formalized paediatric medicine. Over the course of the eighteenth century, a network of medical practitioners interested in children’s health sought to establish their authority over the subject and, in doing so, devoted increased attention to children, channelling general medical interest into the basis for future medical specialisation. As this thesis argues, medical authority over children’s health was gradually constructed over the eighteenth century through printed texts, institutional experience, medical understandings of disease, and efforts to devise therapeutic practices suitable to children. Key to these developments were the efforts made by medical men to supplant women as authorities on children’s health. Also crucial was the role played by institutions in providing spaces for medical practitioners to encounter children. Institutions, such as the Dispensary for the Infant Poor and the London Foundling Hospital, increased the opportunities for medical practitioners to gain experience treating child patients. As this thesis demonstrates, it was the children of the poor who provided medical practitioners with the hands-on experience necessary to bolster their emerging claims of authority. As such, institutions and poor children both had essential roles to play in the development of medical interest in children, and the translation of that interest into claims of medical authority.

In this thesis it is argued that a full and complete understanding of the eugenics movement may only be gained by examining those who were implicated in its criticisms. Using the example of three Christian missionary organisations that worked amongst largely poor and immigrant communities in London and New York, it is demonstrated that eugenics was a pervasive ideology outside its 'official' societies. Moving away from an understanding grounded in ideas of conflict and concession, it will be demonstrated that those whose work was challenged by eugenic claims were able to interpret the ideology according to their existing reformist agendas. Hereditarian ideas did not sound the death knell for reformers, and these organisations demonstrated both the willingness and capacity to shape eugenic ideas within and outside their organisations. From these examples it is argued there is a need to move beyond definitions of eugenics that limit the movement to a small subset of its methods. Far from being a peripheral aspect to the history of eugenics, it will be seen that these missionary agencies occupied a position at the centre of eugenicists' concerns. As prominent providers of charity, a work charged by eugenicists with unnaturally hindering the natural laws of selection, religious communities were, in part, one of the reasons that eugenics was deemed necessary in the first place. This picture is confirmed by an examination of two eugenics societies, one on each side of the Atlantic, where the impact of religious sentiment and ideas exerted a dramatic effect upon policies and propaganda work. There was no one-way flow of ideology from eugenicists towards reformers, but rather a two-way dialogue which created a marked impression on both groups.

How the world of experience, text-based medicine, and the social world came to interact with each other in a historically situated way is the subject of this doctoral thesis, which studies what I shall call zhang ("miasma") medicine in Song China (960-1279 CE). By the phrase "the world of experience," I refer to the bodily experience of the environment in a given region as well as to experiences of medical practices. "The social world" broadly refers to concomitant social, intellectual, and political events or trends. This thesis proposes a new approach to the study of the environment within the history of medicine in Imperial China (around 202 BCE-1911 CE), an approach which is inspired by anthropological analytical concepts. It highlights individuals' world of experience, treating their knowledge about environmental medicine as the culmination of a dynamic collaboration of their experiential world and existing culture-specific concepts, such as those deriving from scholarly medicine. This new approach dictates a re-examination of the sources that have received intensive attention in the history of medicine in Imperial China: texts up to the thirteenth century on the aetiology, therapies, and prevention methods of zhang as disorders endemic in Lingnan (in Guangdong and Guangxi provinces). Based on this re-examination, I contend that the Song period witnessed the emergence of a pronounced explanatory mode among authors of writings about zhang medicine about how their world of experience informed and affirmed their medical knowledge and practices relating to zhang. This Song explanatory mode embodies, I argue, the endeavor of Song scholar-officials and physicians to extend the proliferation of scholarly medicine at that time to zhang medicine, which lacked widely acknowledged textual references and therapies of medicinal effectiveness. The findings in this thesis firstly broaden our understanding of the development of environmental medicine in Imperial China and, secondly, extend our knowledge of the expansion of scholarly medicine into southern China in Song times.