This volume, one of the Cambridge Illustrated History series, focuses on the development of mainstream western medicine as practised in Europe and North America. This restriction, which is acknowledged in the introduction, allows the authors to concentrate on a clearly‐defined area of knowledge, and to explain how we got to where we are in medicine. The authors have concentrated on ten specific areas which raise important questions for medical science and practice as it is at the end of the twentieth century.
The first chapter covers the history of disease, the origin of human diseases, plagues, diseases spread by colonial activities, major diseases like tuberculosis and cholera, and newly emergent diseases. The social and historical factors which cause different diseases to spread through different peoples and at different times in history are described. In the next chapter, the rise of medicine in ancient Egypt and Babylonia, and on through Greece and Rome and into medieval Europe; is outlined. This chapter provides background to later chapters. The next question addressed is what is disease. The theoretical background to the practices of premodern medicine is discussed. This chapter covers the late Middle Ages, the Renaissance and the Enlightenment, and shows how developments in philosophy informed developments in medicine. The development of medical science, that is a scientific basis for medicine, has a separate chapter. Starting with anatomy, and later physiology, a detailed knowledge of the human body was developed. Along with this descriptive information came aids to diagnosis, such as X‐rays and ECG monitors, and a range of clinical tests. The specific science of pharmacology has a separate chapter.
The chapter on primary care outlines the development of the general practitioner, or family doctor. In this area the patient has more control and popular expectations of medicine often constrained what doctors could do. Much of the care was supportive and advisory; it is only with the rise of efficacious drugs that the GP has had the ability to cure diseases. Now people expect a cure for everything, and the supportive role of the family doctor has declined. A later chapter deals with the rise of hospitals. These began as care for the poor, including the disabled, the old and the destitute as well as the ill. In time, the various categories of deserving were separated. One effect of the rise of the hospital was the development of increasingly sophisticated surgery. Mental illness is treated in a separate chapter. It is the only group of diseases to be discussed in detail in this book. It still raises questions about the concepts of health, the role of the medical practitioner, the concept of diseases and the position of the patient. It also raises questions about the attitude of the “healthy” to the “diseased”.
“Medicine, society and the state”, describes the development of the public provision of health care, and in particular the National Health Service. The chapter also covers the development of the present situation where the major problem in health care is cost control. The final chapter looks to the future, the promises and the problems. There are brief accounts of human genome mapping, fertility treatments, quality of life and other problem areas. The emphasis is on the value, and the social and ethical problems of such changes rather than the technology.
A quick sketch such as this does not properly demonstrate the vast amount of information, the critical comments, and the clear observations made in the text. The style is narrative history, which makes for easy comprehension of the vast sweeps of time and subjects covered. There is a small number of information boxes where general interest would require more information than would be appropriate in the text: subjects as diverse as the cause of the plague to voluntary euthanasia (the title of which is omitted). The text would stand by itself, but it is enlarged by the many, mainly black and white illustrations; there are few double spreads that do not have at least one picture. They do, actually, add to the information given and do not just decorate the pages. The book ends with a chronology of medical history, brief notes on major diseases, notes on the chapters and further reading. There is an index of medical personalities and a general index.
The detailed indexes and the chronology make it possible to use the book in the narrow sense of an encyclopaedia, but much can be gained from reading the complete chapters, and over a period of time the whole book. This is a good public library and higher education institution book, and should probably be in the loan collection. Medical practitioners, students and administrators would gain much understanding of why modern medicine is the way it is by reading this book. Social historians, lacking the knowledge of medicine possessed by the seven authors of this volume, would gain insights into the specific period of study here. It is a good read.
