This article provides an overview of the historiography of medical education and calls for greater attention to the connections between medical schools. It begins by reviewing research on medical education in imperial metropoles. Researchers have compared medical schools in different national contexts, traced travellers between them or examined the hierarchies that medical education created within the medical profession. The article then shows how historians have emphasised the ways in which medicine in colonial empires was shaped by negotiation, exchange, hybridisation and competition. The final part of the article introduces the special issue ‘Medical Education in Empires’. Drawing on a variety of sources in English, French, Dutch and Chinese, the special issue builds on these historiographies by juxtaposing cases of medical schools in imperial contexts since the eighteenth century. It considers who funded these medical schools and why, what models of medicine underpinned their creation, what social changes they contributed to, what life was like in these schools, who the students and teachers were and what graduates did with their medical careers. This special issue thus contributes to clarifying the role of medical education in empires and the long-term impact of empires on the medical world.

During the last decades of colonial rule, Belgian colonial authorities, health agencies and researchers intensely engaged with kwashiorkor, a severe syndrome that was deemed widespread among young children in some parts of the Belgian Congo and Ruanda-Urundi and chiefly attributed to protein malnutrition. To fight kwashiorkor, the Belgian government, in the early 1950s, set up a joint milk distribution campaign with the United Nations International Children’s Emergency Fund, Food and Agriculture Organization and World Health Organization, the first of its kind in colonial Africa. Placing this campaign in the context of mounting international and inter-imperial concern about kwashiorkor and other nutritional problems in Africa and across the globe, this article explores its rationales, mechanisms and consequences, and in particular, how the campaign was shaped and publicised by FORÉAMI, one of the main health providers on the ground. It not only contributes to the history of European colonial medicine and nutritional policies, but also opens new perspectives on international health collaboration during late colonialism. It argues that Belgian authorities were wary of international interference in colonial policies, but that especially FORÉAMI also viewed and used the campaign as an opportunity to display its ‘mastery’ in rural and infant healthcare and control the narrative on Belgium’s colonial medicine.

This article deals with the presence of physicians, surgeons and apothecaries in the early modern Portuguese empire and the dissemination of medical knowledge there. In Portugal itself, the health care sector had been the target of considerable royal interference since the final years of the fifteenth century, during the construction of the early modern state. Regulatory frameworks were established to harmonise health care practice throughout the country and to control the organisation and distribution of the available health care practitioners among local communities. As this was also the time when Portugal was investing heavily in its colonies, how were these policies reflected in the empire? Did health care feature in the Portuguese government’s colonial strategies? How did the official policy to send medical personnel overseas work on the ground? Did it operate at a large enough scale to transform local practices?

This paper addresses the relative scholarly oversight of the history of public health in Haiti through a close examination of the colonial public health system constructed and operated by the United States (US) during its occupation of Haiti from 1915 to 1934. More than simply documenting a neglected aspect of Caribbean history, the paper offers the US occupation of Haiti as a remarkably clear example of a failed attempt to use a free public health service to cultivate a health conscientiousness among the Haitian citizenry through the aggressive treatment of highly visible ailments such as cataracts and yaws. I argue that the US occupation viewed the success of the Haitian Public Health Service as critical to the generation of a taxable, compliant and trusting citizenry that the colonial state could enter into a contract with. This idealistic programme envisioned by the US occupation was marred by financial mismanagement, racism, delusions of grandeur and contempt for Haitian physicians that resulted in the production of a far more precarious public health service and administrative state than the US occupation had hoped. By the time the Great Depression arrived in 1930 the Haitian Public Health Service was gutted and privatised, having successfully provided the majority of Haitians with free healthcare, yet failed to have persuaded them of the value of being governed by a centralised administrative state.

Motivated by both science and empire, European explorers increasingly ventured into the high Himalaya after 1800, where they encountered the insidious yet little understood effects of altitude sickness. They did not, however, do so alone. Tensions arising from the highly unpredictable distribution of symptoms were exacerbated by explorers’ dependence on pre-existing networks of labour and expertise, which forced them to measure their bodies against those of their Asian companions. This article examines altitude physiology in the early nineteenth century, largely overlooked by scholars in favour of the more systematic scientific studies of the later period. I consider engagement with indigenous explanations (resulting from poisonous miasmas from plants), the tropes travellers used in their accounts to avoid inverting hierarchies around bodily performance, and attempts to quantify symptoms and instrumentalise bodies by measuring pulses. I argue that high mountains became spaces of comparison, intensified by uncertainty over the scientific status of altitude sickness, and use this to bring into focus the practical, everyday aspects of relationships between explorers, guides, and porters. By considering comparisons at multiple scales, this article also historicises the formulation of high mountain medical topographies in the context of upland frontiers and imperial expansion.

A pressing question during the first half-decade of the third plague pandemic (1894–9) was what was a ‘suitable soil’ for the disease. The question related to plague’s perceived ability to disappear from a given city only to reappear at some future point; a phenomenon that became central to scientific investigations of the disease. However, rather than this simply having a metaphorical meaning, the debate around plague’s ‘suitable soil’ actually concerned the material reality of the soil itself. The prevalence of plague in the working-class neighbourhood of Taipingshan during the first major outbreak of the pandemic, in 1894 in Hong Kong, led to an extensive debate regarding the ability of the soil to harbour and even spread the disease. Involving experiments, which were seen as able to procure evidence for or against the demolition or even torching of the area, scientific and administrative concerns over the soil rendered it an unstable yet highly productive epistemic thing. The spread of plague to India further fuelled concerns over the ability of the soil to act as the medium of the disease’s so-called true recrudescence. Besides high-profile scientific debates, hands-on experiments on purifying the soil of infected houses by means of highly intrusive methods allowed scientists and administrators to act upon and further solidify plague’s supposed invisibility in the urban terrain. Rather than being a short-lived, moribund object of epidemiological concern, this paper will demonstrate that the soil played a crucial role in the development of plague as a scientifically knowable and actionable category for modern medicine.

Within the colonial setting of the Belgian Congo, the process of cutting the body, whether living or dead, lent itself to conflation with cannibalism and other fantastic consumption stories by both Congolese and Belgian observers. In part this was due to the instability of the meaning of the human body and the human corpse in the colonial setting. This essay maps out different views of the cadaver and personhood through medical technologies of opening the body in the Belgian Congo. The attempt to impose a specific reading of the human body on the Congolese populations through anatomy and related Western medical disciplines was unsuccessful. Ultimately, practices such as surgery and autopsy were reinterpreted and reshaped in the colonial context, as were the definitions of social and medical death. By examining the conflicts that arose around medical technologies of cutting human flesh, this essay traces multiple parallel narratives on acceptable use and representation of the human body (Congolese or Belgian) beyond its medical assignation.