This article studies the impact caused by the success and dissemination of Broussais’ theories on the use of leeches as a medical supply on Spanish–French trade relations, as well as its consequences for the Spanish market between 1821 and the 1860s. Analysing the documents produced by the different public administrations, together with newspaper and archival sources in both Spain and France and the literature and legislation of that period, allows us to understand the evolution of this trade and the heavy impact it had on the autochthonous population of this animal resource. The article reveals how, at the beginning of the 1820s, leeches became an important medical supply and how the demand for them increased significantly. This gave rise to a trade relation between Spain and France that led to the overexploitation of the resource, the issuing of regulations on the matter, and the search for technological solutions to increase the production of leeches.

The application of machine-learning technologies to medical practice promises to enhance the capabilities of healthcare professionals in the assessment, diagnosis, and treatment, of medical conditions. However, there is growing concern that algorithmic bias may perpetuate or exacerbate existing health inequalities. Hence, it matters that we make precise the different respects in which algorithmic bias can arise in medicine, and also make clear the normative relevance of these different kinds of algorithmic bias for broader questions about justice and fairness in healthcare. In this paper, we provide the building blocks for an account of algorithmic bias and its normative relevance in medicine.

This article provides a critique of the monolithic accounts that define justice in terms of a single and often inappropriate goal. By providing an array of real examples, I argue that there is no simple definition of justice, because allocations that express justice are governed by a variety of reasons that reasonable people endorse for their saliency. In making difficult choices about ranking priorities, different considerations have different importance in different kinds of situations. In this sense, justice is a conclusion about whether an allocation reflects the human interests and priorities that are at stake. The article describes how several principles of justice have a legitimate place in medical allocations. To achieve justice within medical practice, professionals should focus on the human interests and compelling reasons for prioritizing specific principles within their specific medical domain.

While some historians have noted the absence of animals in medical history, few have made the animal the central object of their historical gaze. Twenty years ago W.F. Bynum urged medical historians to follow historians of science in paying attention to the role of non-human animals in the material practices of medicine. Yet few have responded to his call. In this paper we again ask the question: what work can the non-human animal achieve for the history of medicine? We do so in the light of the conceptual possibilities opened up by the rapidly emerging field of ‘animal studies’. This interdisciplinary and sophisticated body of work has, in various ways, revealed the value of the ‘animal’ as a tool for exploring the co-constitution of species identity. We asked ourselves, surely, in our present biomedical world, this must be an area that we as medical historians are best placed to comment on; and what better place to start than the well-known, yet surprisingly little-studied, medical leech?

We have designed a robotic arm based on a double parallel four bar linkage to act as an assistant in minimally invasive surgical procedures. The remote center of motion (RCM) geometry of the robot arm kinematically constraints the robot motion such that minimal translation of an instrument held by the robot takes place at the entry portal into the patientApos;s body. In addition to the two rotational degrees of freedom comprising the RCM arm, distal translation and rotation are provided to manoeuver the instrument within the patient's body about an axis coincident with the RCM. An XYZ translation stage located proximal to the RCM arm provides positioning capability to establish the RCM location relative to the patients anatomy. An electronics set capable of controlling the system, as well as performing a series of safety checks to verify correct system operation, has also been designed and constructed. The robot is capable of precise positional motion. Repeatability in the ±10 micron range is demonstrated. The complete robotic system consists of the robot hardware and an IBM PC-AT based servo controller connected via a custom shared memory link to a host IBM PS/2. For laparoscopic applications, the PS/2 includes an image capture board to capture and process video camera images. A camera rotation stage has also been designed for this application. We have successfully demonstrated this system as an assistant in a laparoscopic cholecystectomy. Further applications for this system involving active tissue manipulation are under development.