The Balkan Wars in prof. Přecechtěl's memories

Professor Přecechtěl's memories of the Balkan Wars of 1912-1913 have various facets and encompass different impressions and phases of these events. They trace the preparations in Prague and the journey to Montenegro, the ancient city of Cetinje among the poor and primitive people, experiences in the Albanian environment plagued by diseases, and the war experienced in Bulgaria. Czech doctors enthusiastically aided their Slavic brethren in the Balkans, who fought for liberation and rights. Initially, they were received coolly and with reservation as the local population had no experience with Czech doctors. However, over time, the medical expeditions proved their worth. Albania presented many obstacles, including a shortage of medicines and suitable food. The army suffered from droughts and exhaustion, leading to high mortality rates and infections. Medical activities were carried out under difficult conditions, lacking hygiene and basic supplies. Despite all the difficulties, the doctors strove to provide help, and their work was invaluable. Memories of the Balkan War are filled with stories of scarcity, challenges, human suffering, and determination to aid and solidarity.

Retrodicting the rise, spread, and fall of large-scale states in the Old World

Understanding the rise, spread, and fall of large-scale states in the ancient world has occupied thinkers for millennia. However, no comprehensive mechanistic model of state dynamics based on their insights has emerged, leaving it difficult to evaluate empirically or quantitatively the different explanations offered. Here I present a spatially- and temporally-resolved agent-based model incorporating several hypotheses about the behavior of large-scale (>200 thousand km²) agrarian states and steppe nomadic confederations in Afro-Eurasia between the late Bronze and the end of the Medieval era (1500 BCE to 1500 CE). The model tracks the spread of agrarian states as they expand, conquer the territory of other states or are themselves conquered, and, occasionally, collapse. To accurately retrodict the historical record, several key contingent regional technological advances in state military and agricultural efficiencies are identified. Modifying the location, scale, and timing of these contingent developments allows quantitative investigation of historically-plausible alternative trajectories of state growth, spread, and fragmentation, while demonstrating the operation and limits of the model. Under nominal assumptions, the rapid yet staggered increase of agrarian state sizes across Eurasia after 600 BCE occurs in response to intense military pressure from ‘mirror‘ steppe nomadic confederations. Nevertheless, in spite of various technological advances throughout the period, the modeled creation and spread of new agrarian states is a fundamental consequence of state collapse and internal civil wars triggered by rising ‘demographic-structural’ pressures that occur when state territorial growth is checked yet (warrior elite) population growth continues. Together the model’s underlying mechanisms substantially account for the number of states, their duration, location, spread rate, overall occupied area, and total population size for three thousand years.

The Unique Identification of an Unknown Soldier from the Estonian War of Independence

The identification of human remains is challenging mostly due to the bad condition of the remains and the available background information that is sometimes limited. The current case report is related to the identification of an unknown soldier from the Estonian War of Independence (1918-1920). The case includes an anthropological study of the remains, examinations of documents found with the exhumed remains, and kinship estimations based on archival documents, and DNA analyses. As the preliminary data pointed to remains of male origin, Y-chromosomal STR (short tandem repeat) analyses of 22 Y-STR loci were used to analyze the exhumed teeth. Reference samples from individuals from two paternal lineages were collected based on archival documents. Y-chromosomal STR results for the tooth samples were consistent with a patrilineal relationship to only one reference sample out of two proposed paternal lineages. Based on the provided pedigrees in the consistent case, the Y-STR results are approximately four million times more likely if the tooth sample originated from an individual related along the paternal line to the matching reference sample, than if the tooth sample originated from another person in the general population. Special considerations have to be met when limited evidence is available.

Health impacts for New Zealand military personnel from the South African War of 1899-1902

AIM

We aimed to update and provide more complete epidemiological information on the health impacts of the South African War on New Zealand military personnel.

METHODS

Mortality datasets were identified and analysed. Systematic searches were conducted to identify additional war-attributable deaths in the post-war period. To estimate the morbidity burden, we analysed a random sample of archival military files of 100 military personnel. Lifespan analyses of veterans included those by level of combat exposure (eg, a non-combat sample came from a troopship that arrived at the time the war ended).

RESULTS

We identified 10 additional war-attributable deaths (and removed three non-attributable deaths) to give a new New Zealand total of 239 war-attributable deaths. Given the average age of death of 26 years, this equates to the loss of 10,300 years of life. Most deaths (59%) were from disease rather than directly from the conflict (30%). Over a third (39%; 95%CI: 30%-49%) of personnel were estimated to have had some form of reported illness (26%) or injury (14%). The lifespan analysis of veterans suggested no substantive differences by exposure to combat (68.5 [combat] vs 69.1 years [non-combat]) and similarly when compared to a matched New Zealand male population.

CONCLUSIONS

The mortality burden was larger and the morbidity impacts on the New Zealand military personnel in this war were much more substantive than revealed in the prior historical literature. There is a need to more fully describe historical conflicts so that their adverse health impacts are properly understood.

Pandemics throughout the centuries

Pandemics have ravished the globe periodically, often associated with war, at times commencing as fever and rash, beginning in recorded history in the crowded walled city of Athens during the Peloponnesian War as described in great detail by the Athenian historian and military general Thucydides in 430 BCE. As the world now faces the first major pandemic of the 21st century, we focus on the "plague" commencing in Athens in 430 BCE and the 2 pandemics of the more recent century, which killed more than one million, the Spanish flu of 1918 and the Asian flu of 1957. The latter linked with successful vaccine development thanks to the heroic efforts of microbiologist Maurice Hilleman. We now look back and then forward to the viral infection coronavirus disease 2019 now devastating the world.

The Life and Death of Lord Nelson: The Leader, the Patient, the Legend

Admiral Lord Horatio Nelson is perhaps the most renowned naval commander, who allowed Britain to have dominion over the sea for 100 years after his victory at the Battle of Trafalgar. He was able to do so despite suffering from a multitude of communicable diseases and traumatic injuries, including the functional loss of his right eye, amputation of his right arm, scalp laceration, head injury, and finally a spinal injury. These injuries had permanent consequences but did not stop him from leading the charge and allowing the British to defeat the French and Spanish fleets in the decisive Battle of Trafalgar.

Patients behind the front lines: the exchange of mentally-ill patients in the 1948 Arab-Israeli War

The British Mandate in Palestine ended abruptly in 1948. The British departure engendered a complex situation which affected all areas of life, and the country's health system was no exception. Gradual transition of the infrastructure was almost impossible owing to the ineffectiveness of the committee appointed by the United Nations. The situation was further complicated by the outbreak of the Arab-Israeli War. We relate for the first time the story of 75 Jewish patients who were left in a former British mental hospital in Bethlehem - deep behind the front lines. Despite the hostilities, there were complex negotiations about relocating those patients. This episode sheds light on the Jewish and Arab relationship as it pertained to mental institutions during and immediately after the British Mandate.

Two probable cases of mastoiditis in a cemetery from the Warring States to Han Dynasty (475 BCE-220 CE) in Qufu, Shandong Province, China

In modern clinical medical practice, middle-ear infection is a frequently reported condition. If untreated, persistent inflammation caused by infection may lead to perforation of the mastoid process or other portions of the temporal bone. When the middle-ear abscess penetrates the surrounding bone and invades the mastoid process, it causes mastoiditis. Abnormal osseous fistulae were observed on the temporal bones of individuals M137 and M199, which were unearthed in Qufu Olympic Sports Center Cemetery in Qufu City, Shandong Province, and date to the Warring States to the Han Dynasty (475 BCE-220 CE). Microscopic observation and CBCT were used to examine the lesions. A differential diagnosis suggests that the lesions were related to mastoiditis, and based on reference studies, burial information, and paleopathological observation, pollution in the living environment and poor living conditions may be potential factors that caused individuals M137 and M199 to suffer from mastoiditis. The two examples from Qufu are the earliest reported cases of mastoiditis from China; however, infections in the middle ear often go unnoticed in archaeological samples.

Leader-Follower Synergies: Lessons From Nelson and His Captains

Lord Nelson was a master of leading fleets into battle. He was also a master of leading people, instinctively understanding the value of both leadership and followership. This chapter explores the leadership behaviors Nelson used to create a powerful leader/follower synergy between him and his captains, and introduces a model based on these behaviors. While the situations presented in this chapter are military, the focus is on behavioral lessons that can be taught to students and applied in a broad range of organizational settings.

The Military Medical System and Wartime Injuries to the Spine

War has historically been a major catalyst for advancement in military medical care and medicine in general. In our current conflicts, advances in battlefield medicine, evacuation techniques, and personal protective equipment have improved survival rates among members of the armed services. With increased survival, there has been increased prevalence of serious but nonfatal injuries, particularly from blunt and penetrating trauma. Blast injuries are the major cause of trauma and have both blunt and penetrating components. With respect to the spine, blasts have led to open, contaminated wounds that are complex and difficult to treat. Additionally, blasts have led to an increased incidence of lower lumbar burst fractures and lumbosacral dissociation. As these and other injuries are being seen more commonly during war, we must ensure that our military medical system is adapting to ensure we are taking care of our military personnel at the highest level.

[Special and marginal: towards a problematization of the state intervention regarding the health of Malvinas veterans (1984-2000)]

The aim of this paper is to account for the modalities in which Malvinas veterans' health was constituted as a problem requiring state intervention between 1984 and 2000. In order to do so, we have focused on the concept of problematization as a way to analyze practices and political thought. The text consists of three sections: the first one presents the methodological basis of the analysis of public policies, whereas the second and third ones intend to analyze a series of laws, bills, decrees, reports and other documents produced by different state spheres about war veterans and their health situation. The hypothesis that we propose is that the Malvinas veterans were problematized as a marginal segment of the population, although the stabilization of a specific treatment took more than fifteen years to materialize.

War or health: a four-decade armed conflict in Iraq

Iraq has suffered 40 years of continual conflict, with large-scale traumatic events including successive wars, economic sanctions, sectarian conflict, terrorism, and organized crime. Population health and the health systems and other services and infrastructure that support a population's health usually suffer severe consequences in conflict-affect countries and Iraq has been no exception. In this article we aim to provide a historical narrative of the four decades of successive wars in Iraq and present some of the consequences of this particular situation of persistent violence and how it has reflected on the health status of the Iraqi people, as indicated by increasing morbidity, mortality, injuries, mental health problems and displacement. Continutation of the current situation of insecurity is anathema for health as war and health can never be compatible, it is a choice between war or health.

A Greek physician's portrait in Windsor Castle

To the visitor to Windsor Castle, the Thomas Lawrence portraits in the Waterloo Chamber represent the most important contributors to the military defeat of Napoleon Bonaparte, by British, Prussian, Russian and Austrian forces at the Battle of Waterloo. Nevertheless, only few individuals realise that a Greek physician, Count Ioannis Capodistrias, a native of the island of Corfu, stands among these leading personalities as a diplomat, the Russian Minister of Foreign Affairs, who contributed remarkably to European unity in the early nineteenth century and as a statesman ('Governor' of Greece) with a tragic end to his life, after establishing a Greek State practically from ruins.

[The participation of italian nurses in the spanish civil war (1936-1939): identity, ideals and motivations]

. The participation of italian nurses in the spanish civil war (1936-1939): identity, ideals and motivations.

INTRODUCTION

The Spanish Civil War broke out in July 1936 as a result of social and political tensions. It saw the nationalists and republicans of the Popular Front clash. The conflict ended in April 1939, when the Franco regime began and lasted until 1975.

AIM

The research aims at investigating the training, organization, identity, ideals and motivations of the Italian nurses who participated as volunteers in this conflict.

METHODS

The research was divided in phases according to Prosopography as a historical research method. Materials from secondary sources were analyzed at cultural sector libraries. Primary sources were then sought from national and international archives. Finally, experts in contemporary history were consulted.

RESULTS

During the Spanish civil war, about 1000 Italian nurses participated in the conflict, giving their contribution in the two distinct factions. The anti-fascist volunteers, often not professionally trained, provided assistance throughout the war front while the nurses of the Italian Red Cross, graduated and supported by a militarized health care facility, created a unique and well-organized sector.

CONCLUSIONS

Despite the limits due to the difficulty of finding the sources, the research shows that both bodies were moved by personal and political motivations. The analysis of personal data and the testimonies outlined important differences in education and social extraction, but also interesting similar elements that they shared in their humanitarian ideals.

The historical process of the masonry city walls construction in China during 1st to 17th centuries AD

Masonry city walls were common defense facilities in the cities of the Eurasian before the industrial revolution. However, they were not widespread in China until the Ming Dynasty (1368–1644). Limited in research methods, previous studies failed to make convincing arguments on this phenomenon. We collected, organized and analyzed relevant historical documents to reconstruct the spatio-temporal process of the construction of masonry walls from 1^st to 17^th century in China. We conducted a time series analysis primarily based on factors such as wars, garrisons, economy, and natural disasters. Analysis of the correlation among the construction of masonry walls and these factors provides insights into this process. From the 1^st to 14^th century, only 125 masonry city walls were built in China and the annual average number was below 0.1. While in the Ming Dynasty, a total of 1,493 masonry walls were built, with an annual average of 5.41. The construction activities in 1368–1456 spread throughout the country, but mainly appeared in the high-grade administrative cities and garrisons, as a result of the planned implementation of the central government. The construction activities in 1457–1644 had corresponding cluster areas during different periods, mainly at county-level. We found that the wall construction was stimulated by external factors such as wars and disasters. We believe that the mass construction of masonry walls in the Ming Dynasty is a phenomenon of cultural diffusion. The central government plan, the complex interactions between local governments and community, and the stimulation of external factors worked together to contribute to the diffusion of masonry city walls in the Ming Dynasty.

Death on a Napoleonic battlefield - Peri-mortem trauma in soldiers from the Battle of Aspern 1809

On the 21^st-22^nd of May1809 Napoleon Bonaparte saw his first major defeat on land at the Battle of Aspern, just north-east of Vienna. Of the 167,000 soldiers who fought for the French and Austrian armies, a total of 55,000 died on the battlefield. Salvage excavations prior to the construction of large urban development project (2008-2016) have revealed several burial sites related to the Battle of Aspern. The skeletal remains of 30 soldiers were excavated and underwent a detailed bioarchaeological study to elucidate both the impact of 19th-century military conditions on soldiers in life, as well as how they died on the battlefield. This paper presents the analysis of peri-mortem trauma observed in 21 of the 30 skeletons (70.0%) excavated from the battlefield of Aspern. Following standard criteria in forensic and palaeopathological trauma studies, this study revealed a predominance of ballistic trauma (20 cases in 17 individuals), while only nine individuals (eleven cases) displayed evidence of blunt force trauma. By contrast, no evidence of sharp force trauma was identified in the skeletal remains. These results are discussed within the historic context of the Napoleonic Wars to reconstruct causes of injury and circumstances of death.

The Knights Hospitaller of Rhodes and the Black Death of 1498: a poetic description of the plague

The study is a presentation of the sole written testimony of the great plague epidemic that struck the island of Rhodes in 1498, at the time when the Order of the Knights of St. John was settled there. The Greek poem "The Thanatikon (i.e., plague) of Rhodes", which was written by Emmanuel Georgillas Limenitis in the late 15th century and recounts the terrible events of the epidemic, was used as a source of information. Among the 644 verses of the poem, elements like the place, time, duration and how the epidemic spread can be identified. Within the historical context of the era, evaluation and analysis of the data reveal the correlation between human activities and the physical history of the disease in the Mediterranean during the 15th century. The Plague of Rhodes confirms the value of non-medical sources in the medico-historical and historico-epidemiological study of the evolution of the disease caused by Yersinia pestis while highlighting an enduring intrinsic weakness of surveillance systems. Despite modern means of epidemiological surveillance, the risk of relaxation of a health system after a long period of absence of an infectious disease constitutes a major factor for future resurgence of the specific disease.

From preparedness to risk: from the singular risk of nuclear war to the plurality of all hazards

Debates on risk have largely assumed risk to be the outcome of calculative practices. There is a related assumption that risk objects come only in one form, and that the reason not everything can be transformed into a risk is because of the difficulties in calculating and creating universal quantitative comparisons. In this article, building on recent studies of preparedness that have broadened understandings of risk, we provide an analysis of how preparedness measures might themselves produce risk, in particular through risk's durable instantiation, or what we call 'concretization'. Our empirical focus is on how government agencies in two countries shifted their attention from the risk of nuclear attack during the Cold War to an all hazards approach to preparedness. Comparing the mid- to late-twentieth century histories of the UK and Switzerland, we show that both countries shifted from focusing from a single risk to plural risks. This shift cannot be explained by a change in prevailing calculative practices, or by the fact that the risks changed historically. Instead, it is driven by historically specific changes in how risks are produced and reproduced in relation to how materializations of risk operate over time.

Commerce, conflict, and contamination: yellow fever in early-independence Veracruz in the US imaginary, 1821-1848

While commercial links between Mexico and the United States through the port city of Veracruz brought significant economic and social advantages in the early nineteenth century, public health concerns around yellow fever produced fascination and fear among US audiences (in southern and eastern port cities) from times of peace until the US invasion and occupation of Mexico (1846-1848). This article addresses the complex linkages between commerce, conflict, and contamination in reference to the port city of Veracruz and the United States in Mexico's early decades of independence. More specifically, this article addresses the concern in early nineteenth-century US periodicals around yellow fever outbreaks and potential contamination, showing the constant presence of yellow fever in Veracruz in the US imaginary.

Lead pollution recorded in Greenland ice indicates European emissions tracked plagues, wars, and imperial expansion during antiquity

Lead pollution in Arctic ice reflects midlatitude emissions from ancient lead-silver mining and smelting. The few reported measurements have been extrapolated to infer the performance of ancient economies, including comparisons of economic productivity and growth during the Roman Republican and Imperial periods. These studies were based on sparse sampling and inaccurate dating, limiting understanding of trends and specific linkages. Here we show, using a precisely dated record of estimated lead emissions between 1100 BCE and 800 CE derived from subannually resolved measurements in Greenland ice and detailed atmospheric transport modeling, that annual European lead emissions closely varied with historical events, including imperial expansion, wars, and major plagues. Emissions rose coeval with Phoenician expansion, accelerated during expanded Carthaginian and Roman mining primarily in the Iberian Peninsula, and reached a maximum under the Roman Empire. Emissions fluctuated synchronously with wars and political instability particularly during the Roman Republic, and plunged coincident with two major plagues in the second and third centuries, remaining low for >500 years. Bullion in silver coinage declined in parallel, reflecting the importance of lead-silver mining in ancient economies. Our results indicate sustained economic growth during the first two centuries of the Roman Empire, terminated by the second-century Antonine plague.

From Northern Ireland to Afghanistan: half a century of blast injuries

Introduction

Throughout the last half century, blast injuries have been a common occurrence to UK military personnel during combat operations. This study investigates casualty data from three different military operations to determine whether survivability from blast injuries has improved over time and whether the tactics used could have influenced the injuries sustained.

Methods

Casualty data from operations in Northern Ireland, Iraq and Afghanistan were reviewed and found to contain a total of 2629 casualties injured by improvised explosive devices. The injury severities were examined and the suitability of comparison between conflicts was considered.

Results

The case fatality rate and mean severity score sustained remained consistent among the operations included in this study. Using the New Injury Severity Score, the probabilities of survival were calculated for each separate operation. The body regions injured were identified for both fatalities and survivors. Using this information, comparisons of injury severities sustained at an Abbreviated Injury Scale of 3 and above (identified as a threshold for fatal injury) were conducted between the different operations.

Conclusions

The data showed that as operations changed over time, survivability improved and the proportions of body regions injured also changed; however, this study also highlights how studying casualty data from different conflicts without taking account for the contextual differences may lead to misleading conclusions.

Love and loss in wartime: An unpublished narrative by Pamela Frankau (1908-67)

This article discusses an unpublished book by the popular and prolific novelist Pamela Frankau (1908-67), which was rejected by her publishers in 1946 as "almost too personal for publication," and which for many years was believed lost. The work is addressed to Frankau's dead lover, Marjorie Vernon Whitefoord (1907-44), a fellow officer in the women's Auxiliary Territorial Service, and takes the form of a letter to Vernon. The article examines what Frankau's unpublished narrative of love and loss in wartime reveals about her life and later novels, and its implications for the official record of her life and writing.

Wounded to the bone: Digital microscopic analysis of traumas in a medieval mass grave assemblage (Sandbjerget, Denmark, AD 1300-1350)

Battle-related mass burials are considered the most unequivocal evidence of past violence. However, most published studies involve only macroscopic analysis of skeletal remains, commonly arriving only at broad conclusions regarding trauma interpretation. The current study considers a possible avenue for achieving both greater detail and accuracy through digital microscopy. Patterns of injury were investigated among 45 individuals from a Medieval Danish mass grave (Sandbjerget, AD 1300-1350). Injuries were recorded on every anatomical element, except hand and foot bones. Each was photographed and cast, facilitating remote evaluations. Macroscopic analysis was compared with digital microscopy in order to test the relative utility of the latter in characterizing skeletal injuries (mechanism, weapon class, direction, timing of injury). The location of 201 observed injuries, mainly sharp force defects, suggested that many lesions were probably not inflicted by face-to-face opponents. Some microscopic features were indicative of a specific lesion type and weapon class. Digital microscopy was therefore demonstrated to be a complementary tool to macroscopic assessment, enhancing feature observation and quantification and serving to compensate for many of the limitations of macroscopic assessment.

Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival

BACKGROUND

Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS) mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases.

METHODS

We followed 616 medical record-confirmed cases from enrollment (2005-2010) in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study until death or July 25, 2013, whichever came first. We ascertained vital status information from several sources within the Department of Veterans Affairs. We obtained information regarding military service, deployments, and 39 related exposures via standardized telephone interviews. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals. We adjusted for potential confounding and missing covariate data biases via inverse probability weights. We also used inverse probability weights to adjust for potential selection bias among a case group that included a disproportionate number of long-term survivors at enrollment.

RESULTS

We observed 446 deaths during 24,267 person-months of follow-up (median follow-up: 28 months). Survival was shorter for cases who served before 1950, were deployed to World War II, or mixed and applied burning agents, with HRs between 1.58 and 2.57. Longer survival was associated with exposure to: paint, solvents, or petrochemical substances; local food not provided by the Armed Forces; or burning agents or Agent Orange in the field with HRs between 0.56 and 0.73.

CONCLUSIONS

Although most military-related factors were not associated with survival, associations we observed with shorter survival are potentially important because of the large number of military veterans.

Politics and Health at the WHO Regional Office for South East Asia: The Case of Portuguese India, 1949-61

This paper analyses how the 1950-61 conflict between Portugal and India over the territories that constituted Portuguese India (Goa, Daman and Diu) informed Portugal's relations with the World Health Organization's Regional Office for South East Asia (SEARO). The 'Goa question' determined the way international health policies were actually put into place locally and the meaning with which they were invested. This case study thus reveals the political production of SEARO as a dynamic space for disputes and negotiations between nation-states in decolonising Asia. In this context, health often came second in the face of contrasting nationalistic projects, both colonial and post-colonial.

[The Spanish Red Cross, the repatriation of soldiers during the colonial wars and the development of medical science in Spain, 1896-1950]

This article examines the role played by the Spanish Red Cross (founded in 1864) in the introduction and spread of humanitarian technologies and the development of medical science in Spain, using the case study of medical care for sick and wounded soldiers repatriated during the wars in Cuba, the Philippines and Morocco, and analyzing the impact these measures had on health care and public health among the civilian population. The article shows how this organization set up health care for Spanish soldiers, establishing a network of specialized medical centers that were later also used to provide medical care for civilians and to address new public health problems.

[Technological innovation and humanitarianism in the transport of war wounded: Nicasio Landa's report on a new elastic suspension system for stretchers (Pamplona, May 29, 1875)]

In May 1875, in the midst of a bloody civil conflict in Spain known as the Third Carlist War, Nicasio Landa, a medical officer with Military Health, wrote a report requesting authorization for the Spanish Red Cross, of which he was Inspector General, to adopt a new elastic suspension system for stretchers that he had designed, developed and tested. Intended above all for use in farm wagons - still the most widely-used method of transporting the wounded at the time - it was an inexpensive, sturdy mechanism that improved patient comfort and could also be installed in ambulance carriages, railway carriages and hospital ships. An annotated version of the report is included, preceded by a presentation of its contents.

[A state of need: the Spanish Red Cross in Morocco, 1886-1927]

This article studies the central role of nation-states in the Red Cross during the interwar period. In the late nineteenth century, Spain pioneered the creation of European-style humanitarian institutions in Morocco. However, its perennial instability as a state, aggravated by the colonial disaster of 1898, put an end to the regenerationist project of a Moroccan Red Cross. When the Spanish protectorate was established in 1912, the Spanish Red Cross was overshadowed by competition from its French counterpart, the internationalization of Tangiers and resistance from the local inhabitants. This culminated in the so-called Rif War of 1921-1927, a mixture of anticolonial revolt and international war that vividly exposed the ingrained deficiencies of the Spanish State and its Red Cross.

[Scientific communication and technological innovation in the first Red Cross, 1863-1876]

The early years of the international Red Cross movement coincided with great technological changes in war medicine. The organizational peculiarities of the International Association for Relief of Wounded Soldiers in Campaign, set up by the Geneva Committee, and by the Red-Cross' national committees; the convergence in various professional conferences and publications of doctors from different national societies of this association; and the construction of a body of shared practical expertise tested during the Franco-Prussian War (1870-1871) provide keys for understanding the technological innovations introduced by the Spanish Red Cross during the third and last Carlist War (1872-1876).

Reinventing the political role of health professionals in conflict prevention & reconciliation: the Sudanese model

Given the persistent recurrence of armed conflict, influential actors owe it to the affected communities to take action. The legitimacy of health professionals to mitigate the effects of conflict relates to their ability to save lives and address the physical and mental consequences of armed conflict during which thousands of lives may be lost. Medical professionals have unique and potentially far-reaching skills. These become crucial during wartime and disasters in terms of providing medical services and humanitarian aid. However, they are insufficiently used in one area: involvement in politics as a tool to foster peace. Despite this, Sudanese individuals from medical backgrounds have participated actively in conflict resolution and peace-building processes. In fact, their political actions throughout the last six decades have aimed to prevent conflict at four different levels, which are described by Yusuf et al. in their article on the political involvement of health professionals in prevention. Their stand against President Nimeiri's Sharia laws was primordial prevention of religious conflict at the national level. Their leading role in the second Sudanese Intifada uprising was a key factor in saving the country from civil war, and another example of primary prevention. Sudanese physicians were also involved in secondary prevention by being influentially involved in almost all national peace agreements. Avoiding disputes at the tertiary level represents the weakest link in their repeated efforts. This paper outlines the different roles Sudanese medical personnel have taken in peacemaking. It also critically evaluates them in order to consider new methods of political involvement that suit future challenges.

Impact of 20th Century Wars on the Development of Neurosurgery

The treatment of neurosurgical casualties suffered during the wars of the 20th century had a significant impact on the formation and early growth of neurosurgery as a specialty. This chapter explores how the evolution of military tactics and weaponry along with the circumstances surrounding the wars themselves profoundly influenced the field. From the crystallization of intracranial projectile wound management and the formal recognition of the specialty itself arising from World War I experiences to the radical progress made in the outcomes of spinal-cord-injured soldiers in World War II or the fact that the neurosurgical training courses commissioned for these wars proved to be the precursors to modern neurosurgical training programs, the impact of the 20th century wars on the development of the field of neurosurgery is considerable.

Neurology and Neurologists during the Franco-Prussian War (1870-1871)

The Franco-Prussian War (1870-1871) ended with the firm establishment of the French Republic and with German unity under Prussian leadership. After describing the events leading to the war, we explain how this conflict was the first involving the use of machine guns; soldiers were struck down by the thousands. Confronted with smallpox and typhus epidemics, military surgeons were quickly overwhelmed and gave priority to limb injuries, considering other wounds as inevitably fatal. Here, we present detailed descriptions of spinal and cranial injuries by Léon Legouest and of asepsis prior to trepanning by Ernst von Bergmann. Both the war and the Commune had disastrous effects on Paris. Jean-Martin Charcot continued to work intensely through the conflict, caring for numerous patients at La Salpêtrière Hospital according to his son Jean-Baptiste's account, which we've also excerpted below. As for young Dejerine, he treated the wounded from France who had taken refuge in Switzerland. Désiré-Magloire Bourneville also took heroic initiatives, as did Charles Lasègue, Alfred Vulpian, Alix Joffroy and Victor Cornil.

Psychiatric care at a national mental institution during the Spanish Civil War (1936-39): Santa Isabel de Leganés

The scanty research available regarding the health of the mentally ill during the Spanish Civil War is largely due to the loss of most documents, and to the difficulty in accessing the existing archives for decades. Up to the present time, historiography has described overcrowded facilities for the mentally disturbed and the fact that old buildings such as convents and spas were turned into establishments for treating patients with mental problems during the Civil War. However, research reviewing the institutional life and conditions of psychiatric patients during this war is still rather scarce.The aim of our article is to discuss the characteristics of the patients at Santa Isabel National Mental Asylum between 1936 and 1939, as well as the functioning of this institution located in Leganés, a city to the south of Madrid (Spain). The method for this study includes a review of the medical records, statistical registers and other documents kept in the institution's Historical Archive. In addition, using documents from other Spanish archives, as well as information obtained from contemporary and secondary sources, we attempt to describe similarities to and differences from other mental institutions.

Lady Brilliana Harley (1598-1643): Her medicines and her doctors

Lady Brilliana Harley was the redoubtable chatelaine of Brampton Bryan Castle in Herefordshire during the mid-seventeenth century. Her many letters reveal much about the medications which she dispensed to her family and about the family's medical attendants. Whenever possible the Harleys preferred to consult university-educated physicians rather than the local apothecary or surgeon. These physicians are all known from other sources but Brilliana's letters add to what is known of their provincial practices. In particular, they reveal their willingness to undertake blood-letting, often thought to be the province of the more lowly surgeon, and they emphasise the great distances travelled by these practitioners and the difficulties faced by two of them during the Civil War.

The letters of Alix Joffroy (1844-1908), a medical intern at Lariboisière's Hospital at the time of the Commune of Paris

Since opening in 1848, Lariboisière's Hospital was strongly associated with the history of Paris and especially with the terrible days of the siege of Paris and the fights of the Commune. On the day after the surrender, Alix Joffroy wrote his first letter to his mother. He described the events as he experienced them, expressing his feelings about the causes of this political and military disaster and his experience there as an intern. Some weeks after the defeat of France by the Prussians, humbled Parisians attacked governmental troops. From March to May 1871 an improvised insurrectionary movement, The Commune of Paris, had taken power in the capital During the Bloody Week from 21 to 28 May 1871; this movement was suppressed by the Versaillaise Army. In his second letter, Joffroy related with great realism the tooth and nail fighting at the barricades and then the savage repression by the Army of the Communards around Lariboisière's Hospital. Two letters preciously preserved by Alix Joffroy's descendants give this man's unique direct account of a tragic period of the 19th century.