A social history of medicine

comprehensive idea of his methods and his clinical attitudes is presented by dealing at length with the regimen of health prescribed for John Hamilton, archbishop of St. Andrews. In spite of its brief compass, this book is a mine of instruction and is to be highly commended. M. Fierz' modesty, expressed in the foreword, is also something to be admired. The social history of medicine is the ideal Procrustean victim. It obediently submits to amputation or elongation to fit the historian's preconceptions. The final size of the subject in the present case is determined by the author in his first sentence: "The primary purpose of a social history of medicine must be to describe how the practice of medicine has affected the health and development of people". Given this framework , Dr. Cartwright displays the truncated corpse with considerable erudition. The work contains excellent chapters on the growth of modem medical education, the hospital system, and the National Health Service and pointedly draws out their contributions to national health. Especially detailed are the chapters on the major epidemic and endemic diseases of civilization and their demographic and economic effects. He displays admirably the progress made towards the eradication of epidemics in the Western world and the not altogether untainted blessings of modem medicine. His decision to forage in the history of ideas is more questionable. Chapter one for example is a remarkable farrago of speculative anthropology, audacious historicism, and old-fashioned error. The flavour, however, is entertaining: "The remedial custom of 'eating the god' which started as ritual cannibalism, the consuming of a sanctified human to absorb divine power, developed into the beginnings of a pharmacopoeia" (p. 1). In general though, this is an easily readable and factually correct account of much British medical history. It should form a useful adjunct to any teaching programme. It is impossible, however, not to lament such curtailment of the subject in a series designed for a wide audience. Once again medicine is presented as something superimposed on society and whose only important function is healing the sick by the best methods available at the time. There is no suggestion, for instance, that disease might be socially rather than pathologically defined, or that ideas about sickness or the body might be products of a very specific social organization and not just the best ideas available at the time. In consequence the author fails to recognize …