Preliminary Programme

Tue 13 April
    8.30
    10.45
    14.15
    16.30

Wed 14 April
    8.30
    10.45
    14.15
    16.30

Thu 15 April
    8.30
    10.45
    14.15
    16.30

Fri 16 April
    8.30
    10.45
    14.15
    16.30

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Tuesday 13 April 2010 14.15
F-3 HEA03 Doctors and Hospitals
Vestibule, muziekcentrum
Network: Health and Environment Chair: Alex Mold
Organizers: - Discussant: Alex Mold
Logie Barrow : Wobbly Elitism: Interwar British Medics
From, here irrelevantly, 1914 continental commentators gasped at the "land of Jenner" with its strikingly low uptake of smallpox-vaccination and with its often strikingly high incidence of smallpox. But the long-term causation featured less. Insensitive compulsion during the later decades of the 19th century had helped bring two liberalisations, in ... (Show more)
From, here irrelevantly, 1914 continental commentators gasped at the "land of Jenner" with its strikingly low uptake of smallpox-vaccination and with its often strikingly high incidence of smallpox. But the long-term causation featured less. Insensitive compulsion during the later decades of the 19th century had helped bring two liberalisations, in 1898 confusingly and in 1907 clumsily. England's political traditions and institutions had fashioned vaccinal compulsion into a generations-long boomerang-flight.
During the same generation, most ideologues of established medicine had been happy to laud vaccination as first-fruit of science in their field. From around 1914, what comforts were available to their successors? The rest of the paper will survey, first, the rise and partial ebbing of enthusiasm for serum-therapy as, in effect, a rhetoric about vaccination's impending strategic truimph . Consciously or not, such rhetoric occluded recent reverses against 'merely' one disease. Second, during 1910-14 when such reverses were becoming undeniable, medical ideologues had interminably reiterated their intellectual contempt for the stupid non-vaccinating masses. They thus joined a chorus of wails (historiographically familiar ever since George Dangerfield's allegedly "Strange Death of Liberal England") about widespread collapse of industrial and gender-control during those years. The rhythm of these wailings was liable to accelerate with perceptions that "democracy" could not be delayed much longer. Vaccinally, would loss of control bring epidemics even greater than the masses' stupidity? If so, might not the inevitable sufferings be a worthwhile price for restoration?
Whatever the range of party-political allegiances, our interwar medical ideologues inherited or developed fewer vaccinal reasons to resist the eugenic dirge which was to remain loud through and beyond the interwar decades, than to follow and to add a variation or two to it. (Show less)

Diane Carpenter : Mental Health Care and Treatment in Hampshire, UK, 1845-1914
From the beginning of the C19, regulation of private madhouses and subsequent Acts of Parliament heralded an extensive building programme of public asylums (mainly for paupers) to empty the workhouses, gaols and bridewells of lunatics. Care, or neglect, by families was replaced by the unity of policing the insane with ... (Show more)
From the beginning of the C19, regulation of private madhouses and subsequent Acts of Parliament heralded an extensive building programme of public asylums (mainly for paupers) to empty the workhouses, gaols and bridewells of lunatics. Care, or neglect, by families was replaced by the unity of policing the insane with humanity and economy. The C19 also saw a philosophical shift from romanticism to empiricism across Europe. In Britain, Thomas Arnold classified insanity in a way that debunked the mythology that preceded it and influenced the movement toward releasing psychotic patients from their physical restraints. His work may, to some extent, still be recognised in terms of modern classifications of mental illnesses. This is so despite the criticism by the anti-psychiatry movement of the mid C20 of the underpinning science and despite the criticism by post-modernist philosophers such as Foucault of the concomitant incarceration and treatment.

The research explores the extent to which the policies and legislation, the medical science, the philosophers, and the mental health care professionals affected the care and treatment of the mentally ill in the local population of Hampshire in the United Kingdom during this period. It seeks to examine the influence, impact and experience of mental health care and treatment from the mid-nineteenth to early twentieth centuries, and utilising a case study design, aims to:
1. Synthesise data from local primary sources with the relevant national policies, legislation, medical science and curricula for the training of health-care professionals.
2. Evaluate the experiences of mentally ill patients and their carers.
3. Examine the dynamics of attempting to solve a key C19 social problem. (Show less)

Stephan Curtis : Doctors on the move: The travels and travail of 19th-c. Swedish physicians
This study examines the comprehensive travel reports that twenty nineteenth- century Swedish physicians and medical students submitted to state officials after completing their visits to various renowned European medical schools and institutions as part of their medical training and careers. It demonstrates that this oft neglected ‘peripheral’ part of Europe ... (Show more)
This study examines the comprehensive travel reports that twenty nineteenth- century Swedish physicians and medical students submitted to state officials after completing their visits to various renowned European medical schools and institutions as part of their medical training and careers. It demonstrates that this oft neglected ‘peripheral’ part of Europe was much more firmly integrated into the swirl of medical innovations occurring particularly in France, Germany, and Austria than is often believed. These Swedish practitioners created complex professional and personal webs with other physicians both at home and abroad that enabled them to become actively involved in the international transmission of medical innovations. In addition to illuminating the level of integration between Swedish and continental medicine, these travel reports also suggest underlying concerns and shortcomings about the state of medicine in Sweden and how it might be improved. Reading between the lines it is also possible to see how these practitioners felt that travel abroad might benefit their own medical practices. Some of those who travelled abroad became leaders in Swedish medicine either in the country’s medical schools where they influenced the education that their students received, or in their capacity as government officials responsible for ensuring the health of all citizens. Even the less renowned physicians brought back skills and ideas that they incorporated into their daily practices.

This paper is part of a larger project that examines the mechanisms by which academic medicine was able to extend its reach into remote parts of the country. Instead of emphasising the role of state authorities it instead highlights the necessary creation of a sense of trust between practitioners and their patients. This trust was obtained partially by the physicians’ knowledge of effective medical innovations. (Show less)

Tore Gronlie : Hospital Sector Structure and Organization in Britain and Scandinavia - A Contribution towards a Comparative Study
In general comparisons of health care systems, Britain and the Scandinavian countries are often cited as examples of highly different systems. The British National Health Service is often described as the true prototype of a centralized state-run system, while the Scandinavian countries are grouped together in a category comprised of ... (Show more)
In general comparisons of health care systems, Britain and the Scandinavian countries are often cited as examples of highly different systems. The British National Health Service is often described as the true prototype of a centralized state-run system, while the Scandinavian countries are grouped together in a category comprised of highly decentralized systems, based on local or regional-level organization. On the other hand, Britain and the Scandinavian countries are sometimes viewed as similar, in that both systems are based on extensive public ownership and funding of health care institutions. In this regard, the Scandinavian and British systems are different from systems with a much larger element of non-public participation, like social insurance systems, systems built on charity or non-profit institutions or corporate models.
This paper questions the use of highly generalized models in health care historical research, by sketching a four-country comparison of the hospital structure and organization of Britain, Norway, Sweden and Denmark over the last three quarters of a century. How far do models carry when historical hospital development over a long time span is taken into account? Most observers will know that the British National Health Service of 1948 represented a break with a highly decentralized hospital structure built upon a strong position of voluntary organization. Less well-known is the fact that the Scandinavian decentralized structure differed greatly from country to country, and that in one of the countries, Norway, state ownership and direction in 2002 replaced county organization. Is it possible to explain long-time developments in the four countries, and do explanations leave any place for models? (Show less)



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