Patterns of philanthropy: charity and society in nineteenth-century Bristol

seems rather too neat. And in her eagerness to identify the mixed motives of the medics who voluntarily proffered their services and the middling sort benefactors whose subscriptions kept the institution financially afloat, she may underemphasize the role of pure human compassion. Certainly a genuine desire to assist the sick poor was not incompatible with "a shrewd calculation" (p. 115) of the social capital one could accrue, but to conclude that "far from being disinterested Good Samaritans ... Georgian patrons of the Bath Infirmary were able to follow a series of economic, social, political and ethical goals" (p. 387) is perhaps to end on slightly too cynical a note. Borsay is apt to belabour her points and the comprehensive summaries which preface every chapter become somewhat formulaic: one suspects that some of the detail in the book might have been sacrificed without diminishing its overall impact. Even so, there are one or two gaps. The author comments that at Bath the holistic assumptions which underpinned balneology helped preserve "a degree of meaningful consultation" (p. 128) between doctors and their clients at a time when scientific knowledge and terminology was widening the gulf between them and erasing the patient's narrative from hospital records. And yet there is relatively little consideration of clinical encounters between practitioners and patients, of the reactions of the latter to the philanthropic endeavours of the elite, or indeed, of the medical techniques which physicians and surgeons employed. Nor is much room made for discussion of the relationship between the regimen of treatment experienced by the inmates and the fashionable practice of taking the waters which centred on the Pump Room. These reservations aside, Medicine and charity in Georgian Bath is a model contribution to Ashgate's History of Medicine in Context series: deft, perceptive and carefully crafted, it takes us beyond the imposing portico of the Infirmary to a nuanced understanding of the values and preoccupations at the heart of eighteenthcentury society itself.