William Osler: a life in medicine

his unwillingness to publish" (p. 102); he points out that misunderstandings "were Semmelweis's fault and no one else's" (p. 100). But there is no reason to think these judgements inaccurate or unfair; Semmelweis was, and remains, a difficult figure. If Loudon has introduced nothing new, he has recounted Semmelweis's part in the puerperal fever story with an admirable lack of sentimentality. Loudon demonstrates that sporadic and epidemic puerperal fever were both important (ch. 4); he clarifies the highly ironic connection between lying-in hospitals and puerperal fever (ch. 5). Historio-graphically noteworthy is Loudon's review of the myriad theories about puerperal fever-its causes, treatment, cure through history. 'Puerperal fever: causes and contagion' (ch. 6) and 'Monocausalists, multicausalists, and germ theory' (ch. 8) show Loudon at his explanatory best. "What we are trying to do in discussions such as this is to get under the skin (or into the minds) of past practitioners as they struggled to make sense of the vagaries of fevers and epidemics...." (p. 83). Assuming there was "a clear and agreed system of beliefs that it is our job as historians to interpret and understand," he insists, "leaves no room for plain, ordinary, muddle and confusion, which, I strongly suspect, was, in many instances, the prevailing state of mind" (p. 84). Loudon has updated an old story; he has made comprehensible the disease of puerperal fever (ch. 1) and its epidemiology (ch. 12). He has introduced a more complete cast of players in this drama than most writers have done, adding, for instance, Simpson, Cullingworth, Hervieux, and Colebrook. He has exposed the most tragic feature of the story, the stumbling and wholly inadequate efforts well into the twentieth century to cope with a very curable disease. This connects directly to the way Loudon uses the story of puerperal fever to convince us that "questions of disease specificity and changing virulence" in the past are key to understanding such questions in the present. In The four doctors John Singer Sargent positions the founding fathers of Johns Hopkins Medical School in front of a globe, reflecting their universal contributions. But, ever since Lytton Strachey's Eminent Victorians (1919), we have examined great men with revisionist eyes. Such an approach is certainly justified for three of Sargent's doctors. Not only did William Halsted, arguably the most important surgeon in American history, run his department with withering scorn and bullying, but his long absences …