Clio Medica 84:
Attending Madness: At Work in the Australian Colonial Asylum
Lee-Ann Monk

‘He is what we would call a very good attendant, who would not run away or flinch from any patient, but would try to have his orders carried out if possible.’ Such was the view of William Coady, attendant to the insane in the British settler colony of Victoria, Australia in the 1870s.

Attending Madness is a history of William Coady’s occupation, a history of asylum work and workers in nineteenth-century Australia. It considers not only who attendants were and why they worked in the asylum, but also how they and others variously defined ‘the very good attendant’.

Colonial asylum advocates imagined the attendant as an archetype, drawing on ideas from Britain about the nature of insanity and its treatment. In exploring the articulation of these ideas in a colonial context, and their effect on the asylum workplace, Lee-Ann Monk makes an important contribution to the international history of the asylum. She also opens new dimensions in the history of this occupation, on which the fate of patients very much depended, by analysing attendants’ efforts to construct an occupational identity and give meaning to their work, thus providing new insights into their sense of themselves and their occupation.

Lee-Ann Monk is an Australian Research Council Postdoctoral Fellow (Industry) in the History Program, La Trobe University, Australia, where she is writing a history of Kew Cottages, Australia’s first purpose-built institution for people with learning disability, as part of an interdisciplinary research team funded by an ARC-Linkage Grant.

Clio Medica 82:
Control and the Therapeutic Trial: Rhetoric and Experimentation in Britain, 1918-48
Martin Edwards

How do doctors decide whether their drugs, or other treatments, actually work? In practice this can be fiendishly difficult. Nowadays the gold standard is the randomised controlled trial (RCT). But the RCT is a recent invention, and the story of how it came to dominate therapeutic evaluation from the latter half of the twentieth century involves acrimony, confrontation, and manipulation of the powerful rhetoric of 'control'.

Control and the Therapeutic Trial examines the development of the RCT from the eclectic collection of methodologies available to practitioners in the early-twentieth century. In particular, it explores the British Medical Research Council's (MRC) exploitation of the term 'controlled' to help establish its own 'controlled trials' as the gold standard for therapeutic evaluation, and, ultimately, the MRC itself as the proper authority to adjudicate on therapeutic efficacy. This rhetorical power still clings, and is exploited today.

Control and the Therapeutic Trial will be of interest not only to historians of twentieth-century medicine and practising clinicians who take therapeutic decisions, but to anyone who seeks a broader insight into the forces that shaped, and control, the modern controlled trial.

Clio Medica 80:
Healing Bodies, Saving Souls: Medical Missions in Asia and Africa
Edited by David Hardiman

Missionary medicine flourished during the period of high European imperialism, from the late-1800s to the 1960s. Although the figure of mission doctor - exemplified by David Livingstone and Albert Schweitzer - exercised a powerful influence on the Western imagination during the nineteenth and early-twentieth centuries, few historians have examined the history of this important aspect of the missionary movement. This collection of articles on Asia and Africa uses the extensive archives that exist on medical missions to both enrich and challenge existing histories of the clinic in colonial territories - whether of the dispensary, the hospital, the maternity home or leprosy asylum.

Some of the major themes addressed within include the attitude of different Christian denominations towards medical mission work, their differing theories and practices, how the missionaries were drawn into contentious local politics, and their attitude towards supernatural cures.

Leprosy, often a feature of such work, is explored, as well as the ways in which local people perceived disease, healing and the missionaries themselves. Also discussed is the important contribution of women towards mission medical work.

Healing Bodies, Saving Souls will be of interest not only to students and historians but also to the wider reader as it aims to define the place of the missionary within the overall history of medicine.