This article is an attempt to reconstruct the history of the first Nigerien psychiatric service, and diverse aspects of the ordinary functioning of Pavillon E in Niamey (Niger): the organisation of daily life, the position occupied by coopérant doctors, the precise perimeter and development of practices taken from social and community psychiatry, and relationships with the outside world (families, police, legal system, the public health office).

This research allows us to rehistoricise and refine the details of a period from 1950 to 1980 which, up until now, was viewed as fixed and anachronistic. We draw on precious sources of empirical data – medical and administrative archives, students’ dissertations, oral sources – which invite us to reconsider both colonial/post-colonial (dis)continuities and the temporal caesuras in the literature or in reports from the time.

This landscape of mental healthcare appears to be more or less deeply affected by regional and international dynamics, such as the French coopération system, the networks of ethnopsychiatry and transcultural psychiatry, or the network of pharmaceutical groups and their subsidiaries.

Studying this service also raises the issues of the chronology and daily life of post-independence psychiatric care in francophone West Africa. Finally, our research interrogates the intellectual partitions between reforming disalienist movements and day-to-day psychiatry, and addresses fundamental epistemological questions on how historiography can restore the balance of knowledge between them.

In this article, I examine the history of the concept of herd immunity, beginning with British epidemiologists in the 1920s and ending with the controversy surrounding it during the COVID-19 pandemic. I argue that competing historical and contemporary understandings of herd immunity reveal an underlying tension between observing the effects of infection-acquired herd immunity on the population dynamics of infectious diseases and actively cultivating it through immunisation. Originally offering an explanatory mechanism for the rise and fall of epidemics, the concept soon became entangled with strategies of disease control and technologies for producing immunity, particularly as mass vaccination became more common in the postwar era. This tension between observing herd immunity and cultivating it has produced diverse interpretations ranging from the temporary abatement of an outbreak due to the accumulation of infection-acquired immunity to the principle undergirding disease elimination through mass vaccination. I close by suggesting that the scientific debates and uncertainties regarding the relevance of herd immunity to public health strategies during the COVID-19 pandemic reflect this long-running tension between observing and cultivating immunity in populations.

The best known historical narrative of the international mental hygiene movement among English-speaking audiences locates its origins in the publication of A Mind That Found Itself, the autobiographical account of Clifford Beers (1876–1943), a Yale graduate and former psychiatric patient. The success of the book is thought to have prompted the creation of the first Society for Mental Hygiene in Connecticut in 1908. Beers’ biography, published as Advocate for the Insane in 1980, contends that mental hygiene abroad developed from seeds first sown in the USA and subsequently in Canada.

This article offers a critical reappraisal of that narrative and advances an alternative framework for understanding the history of the international mental hygiene movement during the first half of the twentieth century. It draws on a body of scholarship, emerging since the 1980s, that has sought to decentre the prevailing account, exposing the multiplicity of forces at work in a history that diverges from any straightforward, linear trajectory radiating from a single point of origin.

By tracing this decentred history, the article highlights the contested nature of the ‘international’ in the context of the mental hygiene movement. Case studies from the USA, France, Brazil, and Argentina reveal both the conflicts it engendered and the diverse meanings and significance it assumed within distinct national settings.

Since Foucault’s seminal work in the 1960s on the consequences of eighteenth-century discursive shifts in medicine, the establishment of hospitals during this period has often been interpreted as a progressive innovation driven primarily by medical scientists. However, less attention has been given to the ways in which the founding of hospitals was intertwined with domestic traditions and the practical challenges inherent in their implementation. By examining the establishment of the Seraphim Hospital in Stockholm, along with subsequent hospital foundations in Sweden, the practical difficulties involved become evident. Some of these challenges, particularly those related to funding difficulties, bear a striking resemblance to contemporary discussions on enhancing the efficiency of healthcare, despite the differing historical contexts. In the Swedish eighteenth-century context, ecclesiastical authority in medical matters persisted and played a role in the establishment process, while the military character of the kingdom also influenced hospital development. The conclusion drawn is that both national and local conditions shaped how medical reforms were conceived and practised. The historiographical emphasis on novelty and change may, at times, obscure the continuity of past practices, which undeniably played a crucial role in shaping the new. The concept of path dependency is thus employed not only to trace these historical connections but also to explore the ways in which they influenced the Swedish context, ultimately shaping the trajectory of hospital development in the country.

Following the decisions of the scientific session ‘For the further flourishing of Pavlov’s doctrine’ of the Academy of Sciences and the Academy of Medical Sciences of the USSR in 1950, important reforms were introduced under political control in the USSR and the Eastern Bloc countries. Research plans of science institutions and medical university curricula were changed according to these decisions. Scientists and university professors were forced to adopt courses in Pavlovian doctrine. The reforms affected the work of hospitals and sanatoriums, whose staff was instructed to reform the everyday practice. Regarding the clinical work, the session had two main consequences: the introduction of the so-called Curative-Protective Hospital Regime and the introduction of sleep therapy for the treatment of psychiatric diseases, hypertension, ulcers, rheumatism, and other diseases. As a widespread therapeutic method, it was established in the 1950s in the USSR and in the countries of the Eastern Bloc as a general reform of health politics. Political (Soviet influence), ideological (dialectical materialism), theoretical (Pavlovian teaching), and practical medical considerations intersected in the implementation of the therapeutic methods which made patients objects of this treatment. This study explores the process of dissemination and establishment of sleep therapy in Bulgarian hospital practice based on the hospital documentation of the Pediatrics Clinic at the Medical Academy and the Clinic of Cardiac Diseases in Sofia in 1952–1953.

Developments such as the opening of the first psychiatric outpatient clinic, the emergence of psychiatric social work, the surge of interest in psychology and psychiatry, and the tightening of notions about sexual hygiene, intersected with the rise of the mental hygiene movement in India from 1930s. There exists little to no discussion on how mental hygiene developed in the colonies. This study is the first to shed light on the lesser-known chapter of psychiatry in India. The dynamics of family, childhood, and nation-state when merged with ideas about racism, caste, and communalism were critical in the making of new nation-states like India. Moreover, the trajectory of India’s participation in international health movements, such as psychoanalysis and mental hygiene, allowed for exchange and participation. India’s participation in the mental hygiene movement allowed the growth of psy-disciplines in innumerable ways. This paper fills in a major lacuna in historical writing by providing an outline of the number of interconnected developments in the colonies, which are often sidelined. The international visibility of India also permitted India to take centre stage in many significant studies that were conducted by the World Health Organization after the Second World War.

This article explores female healthcare at the crossroads of bacteriology and obstetric research. Puerperal fever or childbed fever manifested as an epidemic since the nineteenth century, and in both Europe and America, it charted a distinct course for bacteriological research. With the identification of bacteriological causes, new sets of public health regimes were instituted in both regions. The experience of the colonies, however, differed. This paper focusses on how colonial discourse on obstetric nursing, midwifery, clinical hygiene, and maternal healthcare can be positioned in this global history of female health research. The paper explores why, in India, on one hand, bacteriological research in female health suffered in terms of priority (unlike that of cholera and plague) despite the alarming rate of maternal mortality. On the other hand, medical practitioners trained in Europe worked as the conduit through which the bacteriological research of Europe made its way into India. Contemporary documents reveal how colonial prerogatives were channeled through the race theories linked to Indian cultural practices related to midwifery and obstetric nursing, and how the female health discourse was still marred by the notion of tropicality.

Examining the systemic exploitation of mentally ill individuals, this study focuses on the practices of the British colonial administration in Kabba Province, Northern Nigeria (1900–1947). This research investigates how colonial authorities employed biopolitical strategies to categorise, control, and exploit this vulnerable population for labour, prioritising colonial economic and administrative interests. The study utilises a qualitative methodology, primarily analysing archival documents from the National Archives of Nigeria (NAK), Kaduna, and Arewa House Archives (AHA), to uncover the forced labour system’s practices and rationalisations. Crucially, it incorporates oral sources from direct descendants of ethno-medical practitioners, former colonial staff, traditional chiefs, and learned community members. This oral history component provides vital intergenerational knowledge, contextualising archival findings and offering perspectives often absent from official records, ensuring a nuanced understanding of pre-colonial mental health practices and colonial-era lived experiences. Secondary literature on colonial biopower, mental health history, and regional history provides a comparative framework. Findings indicate the colonial administration systematically repurposed traditional care and established new mechanisms to identify, isolate, and compel mentally ill individuals into various forms of forced labour for infrastructure and economic extraction. In conclusion, this research significantly contributes to scholarship on vulnerable populations during colonialism, illuminating the intricate link between mental illness, labour, and power in colonial Nigeria, and informing contemporary debates on mental health, human rights, and historical justice.

This article deals with the tuberculosis policy in Communist Bulgaria from the 1940s to the end of the 1950s. The focus is on the BCG vaccination as the major preventive tool. The article’s reconstruction of decision-making draws on evidence from archive records produced by the Bulgarian Ministry of Health. The main question guiding the research is how past Bulgarian experiences on the one hand, and international traditions, on the other, influence medical opinion and state policy towards tuberculosis and patients with tuberculosis. How did the Cold War context shape BCG vaccination policy? The author presents the story of the ‘Bulgarian’ BCG strain, which was made possible by the international research networks and travels of the Bulgarian scientist Srebra Rodopska (1913–2006). Her story has recently been rediscovered and made popular in Bulgaria, in the context of debates about COVID-19. This article aims to correct the public history narrative, which has thus emerged by placing the story of the BCG vaccine within its Cold War context. The author pays attention to dependencies between medicine and politics, and to the role of the state. Despite the popular story of Rodopska as the inventor of a ‘Bulgarian’ BCG strain and vaccine, what actually happened was that in Bulgaria of the 1950s and 1960s, the Soviet strain and vaccine production technique were used. This was also due to Soviet pressure to follow the Soviet model of public health infrastructure.

This article examines the place of habit in the medical thought and practices of 18th-century Britain. Scholars, including Steven Shapin and Phil Withington, have shown that habit was important to the broadly humoral understandings of health, disease, and regimen that dominated in Europe for much of the early modern period. In this article, I offer the first sustained attempt to understand the role of habit in the medical thought of 18th-century Britain, focusing on the influential Scottish physician William Cullen. For the first time engaging with all of Cullen’s work on habit, including his correspondence, pathological lectures, and clinical lectures, I show that medics of the 18th century developed a new understanding of habit, linked to changing ideas about the nervous system. Increasingly, they emphasised the role that habit could play in causing the periodical return of bodily functions, even when there appeared to be no plausible physical cause. In so doing, medics engaged with one of the key debates of the 18th century – the contested notion that human nature itself might be contingent on social and environmental conditions. For them, habit provided the means by which society could quite literally change the body. These ideas come through clearly in the striking suggestion – hitherto unnoticed – that menstruation was the product of habit, arising not from nature but from culture. Discussions of menstruation reveal the political stakes of habit, with links to highly contested debates about the role that bodies of different genders might play in society.

The article introduces the special issue by mapping the field of pertinent scholarship and situating the articles with regard to the special angles and contributions they have to offer. As our five articles present case studies from Bulgaria and the GDR, both state socialist countries and their health care systems are portrayed here to provide context. The introduction locates each of the contributions and the overarching aims of the special issue within current scholarly discussions and demonstrates the issue’s innovative potential.

This article analyzes the medicalisation strategies deployed by Peruvian alienists in the daily life of the Lima Asylum during the last third of the 19th century. Special attention is given to the process of hospitalisation of the insane in the psychiatric hospital, since this administrative procedure reveals the dialogue, confrontation, and negotiation between the asylum staff and the state and social bodies in the public management of insanity. Through the support of the civil authorities in charge of the psychiatric hospital administration, we argued that the local alienists sought to impose medical knowledge in the asylum space as the legitimate criterion for the confinement of the insane in Peru. This process was not without tensions, setbacks, and disputes, especially with the families and the state agencies of control and social defence seeking to preserve their former prerogatives over the fate of their insane.However, we propose that these medicalisation strategies promoted by the alienists in the daily space of the Lima Asylum managed to situate psychiatric care as a state problem and these actors as experts in the public management of insanity.

This article assesses the impact of the discovery of bacteriophages, which emerged from an investigation into a 1915 outbreak of bacillary dysentery in France, on influenza virus research. Specifically, it details the way in which the phages became a vehicle for importing certain assay techniques into the study of influenza and other viruses that cause infectious diseases in humans and other animals, thereby enabling the scaling up of vaccine production for these diseases. Very soon after his 1917 report of the discovery of bacteriophages, Felix d’Herelle developed an assay technique based on their ability to form countable plaques on solid media when incubated along with the dysentery bacteria. This basic technique was further refined by Macfarlane Burnet in the late 1920s. Still later, in the wake of a 1935 influenza outbreak in Australia, Burnet applied the principles of serial dilution and plaque counting, honed during his work on the phages, to develop a technique for cultivating influenza viruses in fertilised eggs and assaying them by counting the pocks induced on the chick embryo membranes. The ability to grow and assay these viruses proved crucial in developing the first successful vaccines against influenza. In the 1950s, bacteriophage assay techniques were once more carried over to the assaying of viruses on cultured cells by Renato Dulbecco and Marguerite Vogt. The importance of quantification in science, as well as the ability to apply the results of investigations in one area of biology to another, relatively unrelated field, is also discussed.

With this paper, I suggest focusing on diplo-scientific actors as a fruitful approach to study how certain actors have helped to shape international organisations through their diplomatic activities and scientific practices. Using the example of the Swedish medical physicist Rolf Sievert, I show how Sievert’s personality and preferences came to decisively shape the post-war trajectory of the International Commission on Radiation Protection (ICRP) and more broadly the international landscape of radiation protection. In the inter-war period, Sievert was engaged in the ICRP and its mother organisation, the International Radiological Congress (IRC), dealing with the interwoven questions of how to formulate international radiation standards and radiation protection initiatives. Following the Second World War, Sievert became concerned with the proliferation of nuclear technologies and the spread of radioactive fallout following nuclear test bombings. Because of this concern, Sievert set out to separate the ICRP from the IRC and form a new, independent group that could deal with the dangers of the new ‘Nuclear Age’. While Sievert was ultimately unsuccessful, his attempts would decisively change the purview and trajectory of the ICRP. This had large ramifications, as the ICRP continues to be the prime international organisation on radiological and medical radiation protection, formulating recommendations that are used by international, regional, national, and local groups, informing epistemic judgements on radiation research.

This article examines the evolution of breastfeeding practices in twentieth-century China, focusing on the complex interplay between medical knowledge, state policies and social transformation. This study demonstrates how medical recommendations concerning lactation timing, intervals and weaning were shaped by factors beyond purely scientific developments. Mid-twentieth-century biochemical studies validated traditional practices while revolutionising attitudes towards colostrum, marking a critical juncture in Chinese infant nutrition science. Following the establishment of the People’s Republic in 1949, maternal and child health initiatives underwent fundamental changes. Drawing on new understanding of breast milk’s nutritional value, health benefits, and economic advantages, healthcare professionals and state authorities actively promoted scientific breastfeeding methods. Their multifaceted approach reflected both the dissemination of medical knowledge and the state’s strategic consideration of female labour force participation. This study analyses how women’s liberation from feudal constraints, changing employment patterns, Soviet medical influence, and advances in artificial feeding technologies shaped breastfeeding practices. Through examining the intersection of medical advice, health policies, and women’s labour liberation, it provides fresh insights into the evolution of breastfeeding discourse within Chinese medical circles. Situating these developments within broader medical, social and cultural contexts, this research not only illuminates the multiple factors that shaped modern Chinese infant feeding practices but also contributes to our understanding of the complex relationships between medical practice, state policy, and social change in twentieth-century China.

In this article we trace a biography of vacuum aspiration in Spain between the 1960s and 1980s. Analysing the local but transnationally connected history of vacuum aspiration during late Francoism and the democratic transition, we argue that this technology was since the mid-1960s reincarnated in mainstream medical discourse as vacuum curettage, presented as a major medical innovation in diagnosis and therapy. While abortion activists working at the end of the 1970s emphasized the group and political components of a technique they called the ‘Karman method’, doctors performing illegal abortions within the family planning network defined vacuum aspiration in terms of safety and medical innovation. As we demonstrate, this technique embodied meanings that at times overlapped, at others conflicted, contingent on whether aspirations were linked to medical innovation, pro-abortion activism, or social justice.

Ghostwriting autobiographies has gained so high a profile that novels and films focus on the ghost. To deepen understanding of such collaborations in science and medicine, this article reconstructs the making of A Matter of Life (1980), ‘the sensational story of the world’s first test-tube baby’. Although critiqued by feminist scholars, revised through research and embellished in fiction, this double autobiography of Robert Edwards and Patrick Steptoe is still the standard history of the British team’s work to achieve in vitro fertilisation (IVF). It is thus high time to investigate the debt acknowledged only by ‘gratitude for his invaluable help’ to the physician and poet Dannie Abse. I use previously unexploited manuscripts to illuminate relationships among authors, rewriter, and editor, and among those they cast as involved in the research. The records show that Abse rewrote underwhelming drafts for a publisher that had bought and sold the doctors’ story of the ‘baby of the century’ and needed a bestseller. To engage readers, he reworked the text so that alleviating infertility appeared as a career-long quest. As a result of adding vivid scenes with characters and expository dialogue, Abse began to give women—wives, assistants and patients—larger roles in the drama. The objections of Edwards and his circle to various literary references and factual claims were overruled. Yet the authors came across more sympathetically, and IVF was promoted more effectively, than in their own drafts. The process puts recent retellings of the story into perspective and exemplifies how collaboration can shape scientific and medical autobiographies.

Addiction was considered ‘alien to Socialism’. At least, that was the narrative upheld by the socialist East German state, which thus followed the traditional argumentation of socialist and social democratic movements since the turn of the century. While the state clung to this ideological claim, the consumption and abuse of beer, spirits, and benzodiazepines continued to increase. However, there was never a central strategy for the treatment and prevention of addiction in the German Democratic Republic (GDR). The hesitation and ignorance of the state authorities created a vacuum that was filled by local initiatives and expert discussions aimed at improving the situation of people with addictions. In this article, I analyse the introduction of new treatment methods in a psychiatric hospital in the GDR and show that doctors, psychologists, patients, and local officials had certain freedoms to test new approaches, many of which originated in the West. Even though they had to adapt concepts such as the ‘therapeutic communities’ of British reformer Maxwell Jones to the specific socialist and East German context to avoid restrictions by state authorities, the Berlin Wall did not prevent the transfer of knowledge. This article, therefore, paints a nuanced picture of the therapeutic methods used to treat people with addiction in the GDR. From condemning individuals as outcasts of socialist society for socially deviant drinking behaviour and relying exclusively on aversion therapy and moral accusations, there was a shift towards a mixture of treatments that became increasingly specialised and individualised, especially in the 1970s and 1980s, comparable to Western standards.

The article focuses on the export of cadaveric pituitary glands from communist Bulgaria in the 1980s, used for the production of human growth hormone. The case is explored in the broader context of practices and transnational networks for the supply of pituitaries. Special attention is paid to the changes resulting from the turn to the production of recombinant growth hormone in the mid-1980s, which put an end to the international ‘market’ of pituitary glands. In the last sections, different perspectives are explored to make sense of the case under scrutiny: those of bioethics and biolaw, on the one hand, and of bioeconomy in a globalising world, on the other.