Doctor of Society, The Popularization of Medicine, 1650-1850
- Doctor of Society: Thomas Beddoes and the Sicktrade in Late-Enlightenment England
Roy Porter – Routledge, 1992 - 238pp.- £40
- The Popularization of Medicine, 1650-1850
Edited by Roy Porter – Routledge, 1992 - 297pp.- £50
- Philanthropy and the Hospitals of London: The King's Fund 1897-1990
F.K. Prochaska - Clarendon Press, 1992 - 308pp. - £35
Each of these books reflects a current preoccupation of medical historians, and probably of others too.
Doctor of Society reveals obsessions about certain individuals in the past. Some historians live, breathe and dream about their subjects, identifying with their lives and personalities as well as with their ideas and beliefs. On his own admission, Roy Porter has 'Beddoes in his bonnet'. Porter is a clever, wide-ranging and individualistic enthusiast in the history of medicine, especially the eighteenth century, and much more. Thomas Beddoes (1760- 1808) was a clever, wide-ranging and individualistic enthusiast in the eighteenth century practice of medicine, and much more. One of the delights of contemporary medical historical life is the sight and sound of Porter, resplendent in gold chains, reading or declaiming from Beddoes' texts to an enthralled audience. He was recently congratulated drily by a conference chairman for having managed to talk for more than thirty minutes before mentioning Beddoes' name. Now he has written a book about him. Porter tells us that Beddoes was 'alongside Erasmus Darwin, the most challenging and original medical man active in England in the era of the French Revolution'. He was also an original thinker in many subjects, a medical scientist, a political radical, a disappointed idealist, an eighteenth-century individualist, a prolific author and the centre of a group of Bristol intellectuals that included Samuel Taylor Coleridge, Robert Southey and Humphry Davy. He called the Medicine of his day 'lucrative homicide' and thought long and hard about the place of the doctor in society and the social, economic and political roots of ill-health and how to eradicate them. As one would expect, Porter's book is about much more than Beddoes.
Through Beddoes he gives us insight into such things as medicine in the eighteenth century against a background of the Enlightenment, the advancement of scientific medicine, the idea and possibilities of reform, attitudes to quacks and the development of popular instruction in the art of health. This small book contains a wealth of well-written material, informative and scholarly notes and a splendid bibliography. It is a pity that the portrait of Beddoes on the jacket is not reproduced inside for the benefit of the library readers who are likely, considering its price, to be in the majority.
The Popularization of Medicine, 1650-1850, is a product of the one day symposia that are organised by the Wellcome Institute in London. The Wellcome Trust pays for speakers to come from all over the world. The meetings cover many topics, attract audiences from many fields and often deliberately cross boundaries, disciplines and cultures. The conference on popular medicine was held in January 1991 and this small book consists of its papers nicely produced and with additions, but at a price that seems staggering. Roy Porter has edited it attractively and has written the Introduction. His own contribution to the conference, Spreading medical Enlightenment, the popularization of medicine in Georgian England, I feel constrained to mention, is about Beddoes and much more.
The process by which regular medicine is diffused to the wider lay public has lately become a subject of interest to medical historians. It has become increasingly obvious that the available media have always been used to communicate medical facts, information and advertisements. Books seem to have been the main medium during the 'long eighteenth century', although before the invention of printing, instruction was by manuscript and word of mouth. 'Popularization is a historically significant part of the medical enterprise' (p.2) though 'its full history remains to be charted'. This is partly remedied here.
Among the papers, Andrew Wear summarises studies of early modern England and warns of the dangers of categorisation while Mary E. Fissell discusses actual texts written in the vernacular. Philip Wilson writes of some of the difficulties of acquiring 'surgical know-how' in the eighteenth century, particularly regarding bladder stone, a common condition at the time. He points out that accepting the term 'popularization' too readily tends to hide a variety of processes, particularly advertisement and self-promotion, and that the difficulty of knowing how it is received helps to make 'popularization' a blanket term to hide our ignorance. Other papers extend the subject into France, Spain, Hungary and America. In a paper not given at the conference, Stephen Jacyna discusses eighteenth-century London in terms of N.D. Jewson's theory of patronage in clinical interactions and different attitudes towards the new tendency towards clinical examination. He shows how medical values
need to be considered in relation to those of society at large.
Philanthropy and the Hospitals of London was financed largely by the King's Fund and has a foreword by HRH the Prince of Wales as its president. This raises the vexed question of 'commissioned' or 'contract' history', now particularly topical because recently views on the subject led to recriminations, resignations, alteration of text under threat of litigation and goodness knows what else. This does not concern Prochaska directly but may affect the way his book is received. Can there be a fair or even a valuable history if the subject (usually an institution) is paying for it? Why" has the institution commissioned it? How far should the author permit influence or interference from the paymaster and can this be avoided? How far does he temper his product to please his paymaster? How far do contracts skew written history towards what can he paid for in this way, and are they always so different from other contracts, for example with universities, who choose the historians they want? How often does this occur without historians and their readers even being aware of it? The distortions that are introduced by the contract are at least visible. Are they worse than other, less obvious, influences? These might: be political aims, either narrow or wide, a desire to please or annoy a certain individual or body, an eye to future personal prospects, or simply personal idiosyncrasy, emotion, hidden inner drives and fantasies. These can be far more influential, distorting and corrupting.
Prochaska, distinguished and prolific historian of British philanthropy, has written the history of one of Britain's most influential charities, aware that the history of hospital provision in Britain, like the history of social policy generally, 'has been distorted by collectivist perspectives'. To counter this, he looks at the subject from the voluntary point of view, which makes it look rather different. He gives a detailed account of the foundation and development of the King's Fund, 'a central agency for the support of London hospitals' and what it has achieved. In a fascinating book he describes the founding of the Fund (through the Prince of Wales, later King Edward Vll) and the reasons for this. He explores the personalities, motives and actions of the participants who raised money (for example, by getting people to pay to have their children photographed beside a photograph of the royal princes - as today they are snapped beside a monkey or parrot) while competing; with the many other charities in the field. It is the story of how they wooed the general public: and others (especially royalty) to contribute to the enterprise, and how they promoted their own interests, assuaged their own guilt, sought honours and often achieved them and promoted the good of patients.
Through a mass of detail (invaluable to those who need it) there runs the thread of what probably really happened and how and why. Prochaska is acutely aware that philanthropy is much more than a desire to benefit suffering humanity and is a specific sphere of human activity and politicking, hope and ambition, social climbing and skulduggery. He concludes somewhat gloomily that an 'ahistorical planning-mentality, materialist and managerial in outlook, has become pervasive in British political culture, even in conservative circles' so that even the voluntary sector, despite its respect for inherited tradition, 'shows signs of losing touch with the past' (p.242). For example, the King's Fund College of Hospital Management (founded in 1949 'to produce managers who would promote flexibility, initiative, and decentralization in the NHS' [p.18]), dropped its lectures on the history of hospital administration to make way for courses 'in keeping with the latest perception about public-sector management' (p.243), part of a general tendency to replace collective memory with procedural memory. 'After 40-odd years under government control,' writes Prochaska, 'the hospitals of London look set for another decade of disorder and demoralization'. Could more history stop the rot?
- ANN DALLY is the author of Women under the Knife: A History of Surgery (Radius, 1991).