Michael Bresalier

One health, many histories

In another of Veterinary Records series of articles on One Health, Abigail Woods and Michael Bresalier discuss the complex history of veterinary-medical collaboration and highlight the social, political and institutional factors that have contributed towards shaping the One Health model

One Health in history.

The One Health concept of combined veterinary and human health continues to gain momentum, but the supporting literature is sparse. In this book, the origins of the concept are examined and practical content on methodological tools, data gathering, monitoring techniques, study designs, and mathematical models is included. Zoonotic diseases, with discussions of diseases of wildlife, farm animals, domestic pets and humans, and real-world issues such as sanitation, economics, food security and evaluating the success of vaccination programmes are covered in detail. Discussing how to put policy into practice, and with case studies throughout, this book combines research and practice in one broad-ranging volume.

‘Saving the lives of our dogs’: the development of canine distemper vaccine in interwar Britain

This paper examines the successful campaign in Britain to develop canine distemper vaccine between 1922 and 1933. The campaign mobilized disparate groups around the common cause of using modern science to save the nations dogs from a deadly disease. Spearheaded by landed patricians associated with the country journal The Field, and funded by dog owners and associations, it relied on collaborations with veterinary professionals, government scientists, the Medical Research Council (MRC) and the commercial pharmaceutical house the Burroughs Wellcome Company (BWC). The social organization of the campaign reveals a number of important, yet previously unexplored, features of interwar science and medicine in Britain. It depended on a patronage system that drew upon a large base of influential benefactors and public subscriptions. Coordinated by the Field Distemper Fund, this system was characterized by close relationships between landed elites and their social networks with senior science administrators and researchers. Relations between experts and non-experts were crucial, with high levels of public engagement in all aspects of research and vaccine development. At the same time, experimental and commercial research supported under the campaign saw dynamic interactions between animal and human medicine, which shaped the organization of the MRCs research programme and demonstrated the value of close collaboration between veterinary and medical science, with the dog as a shared object and resource. Finally, the campaign made possible the translation of ‘laboratory’ findings into field conditions and commercial products. Rather than a unidirectional process, translation involved negotiations over the very boundaries of the ‘laboratory’ and the ‘field’, and what constituted a viable vaccine. This paper suggests that historians reconsider standard historical accounts of the nature of patronage, the role of animals, and the interests of landed elites in interwar British science and medicine.

Fighting Flu: Military Pathology, Vaccines, and the Conflicted Identity of the 1918–19 Pandemic in Britain

This article explores the decisive role of British military medicine in shaping official approaches to the 1918 influenza pandemic. It contends that British approaches were defined through a system of military pathology, which had been established by the War Office as part of the mobilization of medicine for the First World War. Relying on the bacteriological laboratory for the identification and control of pathogenic agents, military pathology delivered therapeutic and preventive measures against a range of battlefield diseases, and military and civilian authorities trusted that it could do the same with influenza. This article traces how it shaped efforts to establish the etiology of the pandemic and to produce a general influenza vaccine. It highlights the challenges involved in both strategies. Understanding the central role of military pathology helps make sense of the nature, direction, scale, and limitations of medical mobilization against the pandemic in Britain and the authority accorded to specific medical bodies for elaborating and coordinating strategies. Crucially, it demands that we rethink the relationship between the war and pandemic as one about the social organization of medical knowledge and institutions.

Uses of a Pandemic: Forging the Identities of Influenza and Virus Research in Interwar Britain

Summary This paper counters the tendency to retrospectively viralise the 1918–19 pandemic and to gloss the important historiographical point that, in Britain, such knowledge was in-the-making between 1918 and 1933. It traces the genesis of influenzas virus identity to British efforts in 1918–19 to specify the cause of the pandemic and it examines how, in the 1920s, the British Medical Research Council used the connection between a virus and the pandemic to justify the development of virus research and to make influenza a core problem around which it was organised. It shows that the organisation of medical virus research was inextricably linked to the pandemic before the actual discovery of flu virus in 1933. Recognising that the relationship between the virus and the disease itself has a history demands we rethink the pandemics medical scientific legacy and the crucial role of virus research in shaping its history.

‘A Most Protean Disease’: Aligning Medical Knowledge of Modern Influenza, 1890–1914

This article reconstructs the process of defining influenza as an infectious disease in the contexts of British medicine between 1890 and 1914. It shows how professional agreement on its nature and identity involved aligning different forms of knowledge produced in the field (public health), in the clinic (metropolitan hospitals) and in the laboratory (bacteriology). Two factors were crucial to this process: increasing trust in bacteriology and the organisation of large-scale collective investigations into influenza by Britain’s central public authority, the Medical Department of the Local Government Board. These investigations integrated epidemiological, clinical and bacteriological evidence into a new definition of influenza as a specific infection, in which a germ – Bacillus influenzae – was determined as playing a necessary but not sufficient role in its aetiology, transmission and pathogenesis. In defining ‘modern influenza’, bacteriological concepts and techniques were adapted to and selectively incorporated into existing clinical, pathological and epidemiological approaches. Mutual alignment thus was crucial to its construction and, more generally, to shaping developing relationships between laboratory, clinical and public health medicine in turn-of-the-century Britain. While these relationships were marked by tension and conflict, they were also characterised by important patterns of convergence, in which the problems, interests and practices of public health professionals, clinicians and laboratory pathologists were made increasingly commensurable. Rather than retrospectively judge the late nineteenth-century definition of influenza as being based on the wrong microbe, this article argues for the need to examine how it was established through a particular alignment of medical knowledge, which then underpinned medical approaches to the disease up to and beyond the devastating 1918–19 pandemic.

Introduction: Centring Animals Within Medical History

This chapter lays down the volume’s aims and objectives: to make a programmatic contribution to the field of medical history by elucidating some of the largely unrecognised ways in which animals informed the knowledges, practices and social formations of medicine; to enhance the burgeoning field of animal history by offering the first substantive account of animals within medicine that goes beyond the much-studied context of the laboratory; and to provide a history of, and critical reflections on the present-day agenda known as One Health. It introduces the field of animal history for the benefit of medical historians who may not be familiar with this scholarship, and draws from it to explain the volume’s core concepts, approaches and cross-cutting themes.

From Healthy Cows to Healthy Humans: Integrated Approaches to World Hunger, c.1930–1965

This chapter is concerned with diseased and undernourished dairy cattle, and how they came to be perceived not simply as threats to agriculture but also as contributors to world hunger and ill health. Moving from interwar Britain and its empire to the post-war international stage, it explores how developments in nutritional science and veterinary medicine combined with economic depression, wartime food shortages and the aftermath of war, drew attention to the undernourished, unhealthy bodies of both cows and humans, and suggested connections between them. Enrolled by the United Nations and its agencies in their campaign against hunger in the developing world, cows inspired the formation of new health structures that aimed to tackle their unproductive bodies. Within these, experts in human health, veterinary medicine and agricultural science came together to survey the situation, and plan interventions that would create new bovine bodies and new experts capable of supporting their provision of health and nutrition to humans.

Book Review: The Medical War: British Military Medicine in the First World War

Two decades ago, historians of military medicine started asking, ‘Is war good for medicine?’ Mark Harrison has made important conceptual and methodological contributions towards answering this question.In particular, he has helped develop a Weberian approach, which examines the complex interchange between industrial, military and medical discourses, practices and institutions in the prosecution of modern warfare. The Medical War marks the culmination of this project, which has already yielded a monograph on the Second World War and two pioneering collections. Bringing to bear a sociological history on the organisation, development, and role of British military medicine in the First World War, Harrison shifts concern from war as a vehicle for medical modernisation, to argue that, between 1914–18, modern medicine became crucial to waging modern war. This book redresses the relative lack of historical work on this relationship and, in rich empirical detail, explains how it was forged. Harrison convincingly shows that British military success (and failure) cannot be fully understood without taking into account organisational and technical innovations in military medicine. The book’s broad scope, examining the workings of the medical machine in different theatres, represents a major rewriting of the official medical history of the War. As late as 1914, British military planners resisted the idea that medicine was crucial to the war machine. Harrison attributes this situation to the recalcitrance of Victorian military attitudes, poor professional relations between medical and military officials, and a general lack of foresight about the unique demands of modern warfare. The shock of the Western Front prompted the reconstruction of military medicine based on a highly integrated, hierarchical, and increasingly specialised system of forward medical provision and casualty evacuation. This system became the benchmark for the organisation of medicine in other theatres, and Harrison justly devotes almost half the book to its development, highlighting innovations and changes in surgery, wound treatment, disease prevention, orthopaedics, cardiology, physiology, and psychiatry. Much of this story is well known, but Harrison’s synthesis of existing studies should be welcomed. What he also provides is an explanatory framework that traces the roots of the new system to the conditions of trench warfare and changing battlefield tactics; the demands of manpower economy and keeping soldiers fighting fit; and the increasingly important role of medicine in maintaining morale among troops and civilians. This last point is especially important, as it sheds light on how medicine was mobilised as a vital symbolic resource for humanising the War, and also how it became the target of far-reaching criticisms of the War’s management. Particularly salient is the contrast between the new administrative rationality orchestrated by the War Office and the hard realities of implementing the medical system. Professional tensions between civilian consultants and enlisted practitioners had to be overcome, as did worries over bringing women – primarily as nurses – into the ranks. Harrison’s narrative comes alive when he turns from high-level organisational politics to the view from the ground, where administrative decisions both saved and cost lives. His use of medical officers’ diaries and personal accounts to reconstruct the challenges of putting the new system into action makes for compelling reading. Stories of ambulance and frontline services struggling to retrieve and attend to thousands of injured, humanise the rational schemes of medical planners. Harrison’s discussion of the uniquely British problem of building an effective medical system out of services drawn from across the Empire is especially significant, as it sheds new light on the peculiar difficulties of incorporating Indian soldiers and medics into the war machine. When Harrison shifts from the Western Front to campaigns in Gallipoli, Mesopotamia, Salonika, and East Africa, the story of medical success also shifts to one of near calamitous failure. By examining these campaigns a comparative perspective is introduced, illuminating the different environments in which the War was waged, and the varied demands they placed on medical organisation. This perspective gives insight into the difficulties of adapting the medical system to other contexts. Much of the analysis in these chapters revises historical accounts of official commissions into mismanagement and failures in medical provision during the first years of the War. Harrison shows how the commissions drew attention to perilous medical conditions in theatres far from home, and how subsequent public and political pressures factored into efforts to improve the system. While Harrison reserves making strong retrospective judgements, he nonetheless argues that failures to provide effective casualty evacuation, control measures against malaria and other tropical diseases, and adequate supplies of water in these theatres, were rooted in incoherent command structures in which individual generals and senior medical officers lacked accountability. This analysis will be of interest to military historians. But it is rather traditional, largely concentrating on rewriting official history. More generally, The Medical War is not especially innovative historiographically. It makes sparing use of a large body of gender and cultural history of the War. Cultural questions about military medicine as an institution are taken up in terms of the familiar problem of citizenship, and framed around examples such as hygiene duties to ward off venereal diseases. In this respect, The Medical War reveals a key limitation with the sociological history of military medicine that Harrison has helped to pioneer. For although this approach provides a powerful tool for reconstructing the organisational rationality underpinning war medicine, it offers correspondingly little insight into its subjects – the sick, the wounded, or the dying soldier. Harrison’s narrative recapitulates the brutal logic of the manpower economy that military medicine served to maintain. But rarely does one encounter the suffering body to which medical officers, surgeons, nurses, and stretcher-bearers had to tend, and around which medicine was organised. Harrison acknowledges this limitation, but there remains a significant gap in the story of how medicine became essential to the making and success of the British war machine. For surely soldiers’ experience of medicine had a crucial bearing on their perceptions and performance, and is thus central to understanding the relationship between military medicine and the prosecution of the War. So while The Medical War is essential reading for military and medical historians of the First World War, and most certainly will become a standard teaching text, the soldier’s experience in military medicine still needs to be written into the story.