Disease, Medicine and Society in England 1550–1860

ROY PORTER, Disease, Medicine and Society in England 1550-1860, Studies in Economic and Social History for the Economic History Society, Basingstoke and London, Macmillan Education, 1987, 8vo, pp. 79, £3.95 (paperback). In this thought-provoking and eloquent survey (intended largely as an introductory text for students and teachers) Roy Porter has examined a number of interconnected themes in the social history of medicine. These include the effects of disease upon English society, the relationship between orthodox and unorthodox medicine, and the changing status ofmedical practitioners in a three hundred year period of ubiquitous disease and death, prior to the great advances of the late nineteenth century. The picture that finally emerges is of a largely impotent and defensive medical establishment, gradually acquiring increased status at the expense of less orthodox but no less popular "alternative" therapies. It is argued, for example, that "alternative medicine continued to grow alongside conventional medicine even during the Georgian and early Victorian period". Dr Porter raises many important issues, including the relative indifference of the medical establishment to preventative medicine in the nineteenth century ("public health was a matter of engineering not medicine"), and the notion of the medical authorities as sinister agents of social control (dismissed here on the grounds that this was in an era of considerable "client control") and concludes with an assessment of the negligible contribution made by medicine to the post-1740 population expansion. Dr Porter has accomplished the difficult task of encapsulating a three hundred year period of English medical history in sixty-five pages. In the process he has written an informative, stimulating and often entertaining study. The useful bibliography will undoubtedly encourage further debate.