Vivid history

Roy Porter may have left this earth prematurely, but this most productive of modern scholars had some of his best books still in the publisher’s pipeline and he continues to delight and surprise us. Formerly Professor in the Social History of Medicine at the Wellcome Trust in London, Porter brings the outstanding scholarship of our time to the general reader. His vivid narrative enlightens and invites us to reflect on the large questions that medicine and care of the sick pose for a civilised society.

He begins with a history of human disease, what he calls that “war between disease and doctors fought out on the battleground of the flesh” that has “a beginning, a middle and no end”. We are reminded that most disease is of our own making, an unwitting product of our drive to farm, irrigate, domesticate herd animals, live in towns and cities, travel, conquer and colonise. Likewise, our determination to extend our mortal coil demands a price in chronic illness, disability and dementia.

Chapters discuss, in turn, doctors, the body, the laboratory, therapies, surgery and the hospital, each exploring its theme with a long historical view from ancient to modern. There is no more lucid guide to Hippocrates, Galen, the Scientific Revolution and the Paris Clinic to be found.

The final chapter on medicine in modern society reviews the transition from the private relationship between patient and healer to a healthcare industry that is integral to the machinery of an industrialised society.

Yet, for all biomedicine’s achievements, the health of the world’s poor has scarcely improved, while the “worried well” of the West consume a disproportionate amount of the available health dollar. Thus at the beginning of the 21st century, after “a golden age of some generations back, the public climate is not one of optimism but of new-millennial anxiety.”

Janet S McCalmanReader in History Johnstone-Need Medical History Unit University of Melbourne, VIC