The Medical World of the Eighteenth Century

THE MEDICAL WORLD OF THE EIGHTEENTH CENTURY. By Lester S. King. Chicago, The University of Chicago Press, 1958. 346 pp. $5.75. This book by Dr. King is a collection of essays which is concerned with the complexities and variables which influenced the practice of medicine in the eighteenth century, and the efforts of this discipline to progress as an art and a science. The rise of modern pathology, the development of medical ethics, methods of scientific thought and investigation, efforts toward classification of disease, and the professional struggles of physician against physician and physician against apothecary are adequately and interestingly pursued by the author. One of the more delightful essays concerns itself with the professional career of Samuel Hahnemann, the creator of homeopathy, of whom the author writes these descriptive phrases. "Profound scholarship that lacked common sense. Penetrating intellect that could not see the obvious. Great logical acumen that ignored facts." When homeopathy's meager birth and its lack of experimental and clinical evaluation are realized, the growth and development of this discipline appears awesome. In the setting of the eighteenth century, however, homeopathy appears as a somewhat justifiable alternative to the accepted standard of medical care which advocated the administration of complex medications which contained numerous active ingredients. The patient appeared destined to receive either superfluous or insufficient therapy. Dr. King notes that Hahnemann prescribed a single pure drug for a specific malady but in a ridiculously inadequate dosage. The "shot-gun" therapy against which Hahnemann rebelled seems to be ever present. The essay on fevers effectively describes the confusion and inadequacy of medical thinking in the eighteenth century. The possibility is then suggested that our own thinking concerning the etiology and pathogenesis of arteriosclerosis and cancer may be similarly viewed by our medical colleagues of the twenty-second century. The numerous similarities between the social, moral, economic, and intellectual problems confronting the eighteenth century medical practitioner and his twentieth century counterpart are made at once obvious and impressive to the reader of these essays. In conclusion, I should like to borrow the author's own words inasmuch as they seem best to describe the lessons to be learned from a familiarity with the phenomenon of medicine as it existed two hundred years ago. "The practice of medicine changes constantly, just as does the art of painting or of architecture. But the soul of the artist does not significantly change, nor does the soul of the doctor." WILLIAM L. KISSICK