The Western Medical Tradition: 1800–2000

very interesting

I was really looking forward to reading this book having enjoyed the first volume of the series very much. However, where the first volume was erudite and vast ranging across time and geography, identifying patterns and trends and then explaining them with anecdotes and stories, this volume by complete contrast was a huge disappointment. Broadly speaking, the book can be divided into 19th century history and 20th century. The 19th century is significantly flawed by the complete air-brushing out of Scotland as a whole. This may not have mattered so much except for the fact that Scotland, and especially Edinburgh, were centres of medical innovation to the point where the publisher, Cambridge University Press, published a book entitled “Edinburgh and the Medical Revolution” regarding this period. This omission creates significant disjoints in the book where the air-brushing is glaringly apparent, for example, in a discussion about “Medicine in Transformation, 1800-1849” the point is made of the separation of surgeons from physicians, the former being considered manual workers and the latter gentlemen, and laments how their training was essentially flawed as a result. It then goes on to discuss how William Hunter miraculously brought these two professions together through his scientific credibility as a surgeon, as if he had landed from another planet. Yet the truth is that this wasn’t miraculous at all: he was trained and educated in an integrated, modern manner at Glasgow and Edinburgh, where teaching was in many respects similar to today, with preclinical and clinical integrated courses with a strong scientific basis. Edinburgh graduates were responsible for founding medical schools around the world, including Harvard, Pennsylvania, McGill and many others. You would have no idea from reading this book alone. The first half of the book might as well be renamed “The West London Medical Tradition”. I’m not Scottish and don’t live there but you can understand why the Scottish wish for independence after such treatment. By contrast, the second half, which focusses on the 20th century, is broader ranging (though still air-brushing Scotland and also Australia and New Zealand from the picture). However, this section lacks focus, fails to identify significant trends, and jumps all over the place for apparently random reasons. For example, there is an extensive section on Soviet Russia and on Nazi Germany. Soviet Russia can hardly be said to be part of the West and the Nazis contributed only by defining with clarity what lay outside of Western medicine and ethics. As a consequence, the whole book feels disjointed, lacks erudition and is fundamentally flawed in its myopic London-centric and gadfly lack of focus. Cambridge University Press should be ashamed of issuing such a book. Disappointing.