A corpus built on corpses

The Healing Arts - Health, Disease and Society in Europe 1500-1800 - Medicine Transformed - Health, Disease and Society in Europe 1800-1930
February 25, 2005

There was a time when the history of medicine was largely the hobby of retired doctors. They aimed to chart the progress of medical science, hail the achievements of great predecessors and, at least implicitly, present the rise of modern medicine as the triumph of Reason over Darkness.

The producers as well as the consumers of the genre were medical professionals - they had little expertise and less interest in exploring the broader contexts of medicine and concentrated on technical aspects and the chronology of momentous discoveries. Although many of those medical historians did valuable research, they did not regard their hobby as a branch of historical scholarship; academic historians were rarely invited to join the conversation, and most would not have wanted to do so anyway.

As Sam Goldwyn is supposed to have said, we have passed a lot of water since then. The new social history of medicine, which began to assume prominence in the 1970s, was created by academic historians whose intellectual interests, understandably, were very different from those animating the old doctors.

Out went the old preoccupations with the technical aspects of medicine, in came topics such as the social structure of the medical profession, the economics of health care or the patient's perspective on medicine. This new history of medicine was to expand enormously over subsequent decades and although, like any academic discipline, it has had its share of cranks, zealots, mediocrities and jargon-spouting show-offs, its consistent stress on the broader contexts of health, disease and healing has pushed the study of medical history into the heart of the curriculum.

Today, medical history is not solely for doctors. It attracts students and researchers from disciplines as wide-ranging as English, history, sociology, anthropology, philosophy, biological sciences and psychology.

Teaching the subject to such a varied constituency can, of course, be a challenge. With the exception of Roy Porter's The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present (1997), there is no truly satisfactory overview of the entire history of medicine that is accessible to students with no prior knowledge of the subject.

Although we are richer in textbooks that have a narrower focus - such as Mary Lindemann's outstanding synthesis Medicine and Society in Early Modern Europe (1999), or W. F. Bynum's Science and the Practice of Medicine in the Nineteenth Century (1994) - I cannot think of a teaching text comparable to the four-volume set under review. Compiled by the Open University for its course "Medicine and Society in Europe, 1500-1930", the set features two source books of primary and secondary readings and two textbooks, each with 13 original contributions examining different aspects of the history of health, disease and medicine.

The chapters are by specialists on the topics; they incorporate the latest research and are clearly written and beautifully illustrated. Since space does not permit the detailed discussion of each and every chapter, I shall concentrate only on those that I think would be most useful for teaching purposes.

Sachiko Kusukawa's splendid survey of learned medicine in Western Europe around 1500 in The Healing Arts is one such valuable chapter, but it is not the only brilliant essay in that volume. Silvia De Renzi's overviews of women and medicine and early modern concepts of the body deal lucidly with complicated themes, and Mark Jenner's essay on ideas linking health and environment is a model of interdisciplinary scholarship.

Among other contributions, I was especially impressed by Andrew Wear's learned and humane survey of the history of early colonial medicine, Ole Peter Grell's analysis of the relationship of medicine to warfare, and Peter Elmer's succinct account of Paracelsian medicine.

The second volume, Medicine Transformed , deals with the 19th and early 20th centuries, perhaps the most crowded and complex period in medical history.

It has several essays of outstanding merit. Roger Cooter's study of the impact of war on medicine and Thomas Schlich's overview of modern surgery are both virtuoso performances. Punchy, erudite and provocative, they are all that textbook chapters should be and more. Hilary Marland's survey of the history of hospitals and Paul Weindling's examination of the impact of bacteriology on public health are also very informative and would be of enormous help to students as well as teachers.

Michael Worboys' survey of colonial and imperial medicine is comprehensive and nuanced, and James Moore's chapter on eugenics, although it occasionally mistakes flippancy for wit (Darwin, we are informed, was a "humane gent"), provides a beautifully clear analysis of a complex and controversial subject.

Deborah Brunton's chapter on differences in people's access to healthcare over time is an illuminating piece, but her other contributions on laboratory medicine, professionalisation and pre-bacteriological public health, although generally competent, are unlikely to endanger the popularity of competing accounts. (Indeed, at one point in her chapter on laboratory medicine, Brunton is so overwhelmed by the complexities of her theme that she advises the student to read about them in Porter's Greatest Benefit .)

On the history of psychiatry, one would, in any case, have to look elsewhere: Jonathan Andrews' analysis of historiographical debates on mental asylums in Britain is a splendid piece of scholarship, but it is far too narrowly focused for introductory courses.

On the whole, however, these four volumes represent a remarkable pedagogical achievement. Not only are most of the chapters of high quality, but they benefit from dovetailing with the carefully abridged excerpts in the accompanying source books.

The primary sources included in the latter will acquaint students with the raw materials of history, while the excerpts from recent studies will give them a clear conception of the multiplicity of interpretive approaches available to historians.

The editorial apparatus is unfailingly helpful: virtually every confusing concept or term is highlighted in the text and explained pithily in the glossary; the captions to the illustrations explain their contexts and significance; each chapter incorporates exercises testing one's understanding of the arguments and concludes with a list of references to more advanced studies; and there are frequent marginal cross-references directing the reader to more detailed discussions of particular themes in other chapters.

Teachers and students of medical history will be grateful to the Open University for providing them with such a comprehensive and useful set of resources. General readers with any serious interest in medicine and its past would also do well to dip into these volumes.

Chandak Sengoopta is senior lecturer in the history of science and medicine, Birkbeck College, University of London.

The Healing Arts: Health, Disease and Society in Europe 1500-1800. First edition

Editor - Peter Elmer
Publisher - Manchester University Press
Pages - 408
Price - £17.99
ISBN - 0 7190 6734 0

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