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This article examines the inter-relationship between psychiatry and sex, both fertile fields within the recent historiography of colonialism and empire. Using a series of case files pertaining to European patients admitted to the Mathari Mental Hospital in Nairobi during the 1940s and 1950s, this article shows how sexual transgression among colonial Europeans precipitated, and was combined with, mental distress. Considering psychiatric treatment as a form of social control, the article investigates a number of cases in which a European patient had been perceived to have transgressed the normative sexual behaviour codes of settler society in Kenya. What these files suggest is that transgressive sexuality in Kenya was itself framed by indices, as insistent as they were uncertain, of gender, race and class. While psychiatry as social control has some degree of purchase here, more valuable is an attempt to discern the particular ways in which certain forms of sexual behaviour were understood in diagnostic terms. Men who had sex with Africans, we see, tended to be diagnosed as 'depressed' on arrival at the hospital but were judged to be mentally normal consequently. Women, by contrast, were liable to be diagnosed as psychopathic, a diagnosis, I argue, that helped to explain the uniquely transgressive status of impoverished European women living alone in the margins of white society. Unlike white men, moreover, women did not have to have sex with non-Europeans to transgress sexual codes: this is because female poverty was a sexual problem in a way that male poverty decidedly was not. Poor white women were marked by uncertainty over their sexual behaviour—and dubious racial identity in its turn—and the problem of social contamination was described by reference both to the polluted racial ancestry of an individual and to the prospective contamination of healthy racial stocks. This article aims to address current historical debates around sex and empire, 'white subalternity' and the social history of psychiatry and mental health. All names have been changed to protect patient anonymity.

Teeth cut across cultures. They transgress cultural boundaries but also define social boundaries. They provide information about what goes into the mouth, and what the mouth is appropriately used for. Scrutiny of teeth identified a new biomedical space to analyze pain, and created a new culture of medicine for such practices. This paper uses the evolution of dentistry since the 18th century to look at how our social and scientific understanding of teeth has shaped cultural attitudes about pain, politics, beauty and prophylaxis. It then raises questions about how these attitudes in turn create ethical contexts for the practice of dentistry around the world.

Consulting by letter was fairly common practice among the educated, upper classes of early modern Europe. Surviving letters of consultation written by patients, relatives or friends count among the most valuable source for the analysis of pre-modern experiences of disease and the body. This essay gives a brief overview of the various types of consultation letters and related documents which resulted from this practice before tracing the historical development of epistolary consultations from the late Middle Ages through the heyday medical correspondence in the 18th c. before its decline in the 19th c. It presents "experience", "self-fashioning" and "discourse" as three particularly fruitful levels of analysis on which patients' letters can be used within the wider framework of a cultural history of medicine. These three levels of analysis, or three distinct approaches, enable historians to access a greater awareness of the ways in which the experience of illness and the body is culturally framed with an analysis of the performative effects of patients' narratives and the influence of medical discourse among the wider society.

The massive use of laxatives, emetics and blood-letting in pre-modern medicine has often intrigued historians. Why did generations of prominent and often quite empirically minded physicians resort to methods which, in hindsight, were usually much more likely to do harm than good? And why did the patients not rebel?Based on patients' personal documents and, in particular, on the letter consultations many of them wrote ot renowned early modern physicians, this essay traces, how the sick and their relatives experienced and responded to this kind of treatment. These sources provide ample evidence, first of al, that early modern lay-men not only accepted evacuative treatment with laxatives and the like but often explicitly demanded it. To them these methods seemed plausible and indispensable in the light of their notions of disease causation. For diseases were generally though to result no so much from an imbalance of humours or qualities (as is often believed) but from a specific, impure, morbific matter which had to be expelled. And patients frequently felt better or even totally cured immediately after taking a drastic laxative. In hindsight, we may attribute this to a placebo effect or the self-limiting nature of most disease episodes. But in the patients' experience the efficacy of evacuative treatment was thus constantly reconfirmed. Indeed, the very physical perception of curative effects was already shaped by their deeply embodied belief in the predominantly humoural nature of human physiology and pathology, increasing the likelihood of placebo effects from treatment that occasioned a marked, clearing visible evacuation. Therapeutic failure, on the other hand, was a common experience, too, but it could easily be explained on a case to the case basis, as a result of divine will or, more commonly, of the physician's incompetence. Presumably he had not chose the right evacuative treatment or drug, which was adequate in the specific case and another physician with a slightly different approach might well have more luck. The beneficial effects of evacuative treatment as such, however, were not called into question. Treatment with laxatives, emetics and blood-letting thus became obsolete very gradually only, in the nineteenth century, when new, more solidistic body concepts started to prevail also among the population.

Changes in the human subjectivity concept, expressing influences of cultural and outlook elements on formation of object of the European medicine, have so much affected evolution of the discipline, that it is currently directed to bring an image of a human body to anatomy, to treat a course of a disease in medical aspect and to give to diagnostic processes and therapy a character of means which can be verified in an empirical way. The changes are also reflected in a patient - physician relation, which develops in that time. A direct nature of contacts between the treated and the treating persons was taken as grounds of the relation. But reasons of the privileged position of therapists in comparison to patients have changed. The paper aims to show main trends in development of the patient -physician relationship and to represent the changing reasons for superiority of the treating persons who are in a therapeutic relation with a patient.

The word "rheumatism", introduced in ancient times, is still used directly or indirectly, in parallel with the terms of the modern nosography. The reasons for this persistence can be sought in the history of the concept, which can be approached via quotations from texts written either by authors who describe popular beliefs or their own sufferings; or by physicians known to have played a prominent role in the individualization of rheumatology. The word "rheumatism" was first used mainly to designate a painful fluxion of the tissues located between the skin and the internal organs. It gradually lost ground to more descriptive terms suggestive of joints. Thus, the concept of "rheumatism" still bears the hallmark of its "popular" roots and is on a level parallel to but distinct from that of modern nosography. Awareness of its origins may improve communication between physicians and patients and also raises questions about the foundations of the concept of "rheumatic disease".