Inward Conquest: Conflicts over Health Care and Policing in the Nineteenth and Early Twentieth Centuries

This paper uses new data on hospitals, insane asylums, midwifery, police forces, prisons, and vaccinations to examine political conflicts over public health and public order in Western Europe, North America, and the Asia-Pacific region in the nineteenth and early twentieth centuries. Liberals, Catholics, conservatives, socialists, and fascists fought bitterly over the control of these services, and we show how political regimes and institutions shaped these conflicts, with profound consequences for political developments ever since. We show that where political conflicts between conservative and liberal elites in the nineteenth and early twentieth centuries resulted in a decisive victory for either side, governments introduced more centralized and uniform systems of health care and policing. We also demonstrate that in many religiously heterogeneous societies, public services were provided by publicly funded private organizations, especially churches and religious orders. Finally, we show that emerging professional groups – such as doctors, nurses, and midwives – were simultaneously involved in the state-making process and in intra- and inter-professional conflicts.