The spirit of voluntarism: a legacy of commitment and contribution: the United States pharmacopeia, 1820–1995

The editors claim too much. This is a thin collection of essays that range widely from the thirteenth to the twentieth centuries and from pharmacy to midwifery to medical students to foreign doctors in London. Some of the pieces are narrowly focused on small events or a single text, while others seek to explain particular developments over a century or more. Only a few of the authors seek to relate their subjects to the broader development of the healing arts in Britain. A conclusion reached in one essay, moreover, seems at times to contradict that in another. The writing styles vary from rambling, pedantic prose to a few sprightly essays to three or four clear and stimulating presentations. Yet the collection is not without redeeming qualities. Among the authors and editors are some of Britain's ablest medical historians and some of them do make small additions to our understanding of the particular path followed by Britain in educating its practitioners. The essay by Irvine Loudon, for example, not only offers an excellent summary of his previous work on the training of general practitioners but actually deals with some of the real questions raised by the volume's title. W F Bynum's contribution on 'Sir George Newman and the American way' compares developments in early twentieth-century Britain with the contemporary model in the United States. New to this reviewer is the explication of the Scottish-Australian connection in medical education in the nineteenth century by Laurence M Geary. A suggestive piece by Stephen Jacyna explores more deeply than elsewhere the changes in scientific teaching in Edinburgh in the years from 1790 to 1870. Some of the other contributions also present suggestions and ideas that are new and worthwhile. What disappoints is the opportunity lost to make a new assessment of the peculiarly national course of medical education in Britain. Perhaps a different title might have raised fewer expectations. British training in medicine was different from that on the Continent and in North America. To understand that difference, historians must look anew at some of the larger questions of medical pedagogy in the context of British society and British polity. For all the wonderful outpouring of materials by the creators of Britain's medical history industry, it remains for someone-Loudon? Porter? Bynum?-to do some serious organizing and make sense of what we already know about the education of doctors and other health practitioners in Britain.