Medical Lives in the Age of Surgical Revolution.
Medical Lives in the Age of Surgical Revolution, by A. Anne Crowther and Marguerite W. Dupree. Cambridge Studies in Polutiona, Economy and Society in Past Time. Cambridge, Cambridge University Press, 2007. xvi, 425 pp. $134.00 US (cloth).Cohort and prosopographicai studies, or any of the other names by which such collective biographies have become known, are becoming more common in the field of medical history. Having recently read a multi-authored history of the Army Medical Service, I was particularly interested in reviewing this volume which traces the educations and careers of another British medical community. In this case, the authors concentrate on approximately two thousand medical practitioners (1938 to be exact), who began their studies at Britain's two largest medical schools-- Edinburgh and Glasgow--between 1866 and 1874 and practiced medicine over the next half century. Begun as an exercise in historical commuting, the work gradually expanded into "an international study of the spread of Listerian surgery and medical networks," many of these budding practitioners having attended the lectures and assisted the operations of Joseph Lister, the father of antiseptic surgery and an instructor at Glasgow (1861-69) and Edinburgh (1869-77). As a result, it offers a unique glimpse of study, practice, and innovation in an age of surgical revolution, much as the title implies.
The volume is organized chronologically, the first four chapters describing the first decade of students' career paths, literally from the moment of their arrival at their respective universities to the first five years in practice; on average students took 5.5 years to complete their Scottish degrees (p. 53). An array of tables usefully supports arguments about students' ages at matriculation, birthplaces, social origins (for the Glasgow cohort only) and previous places of study, twenty-seven per cent of Edinburgh's cohort having studied elsewhere prior to their arrival in the Scottish capital. While coming from a variety of backgrounds, students shaped their own social networks through coursework and extramural activities, though one of the most potent means of encouraging esprit de corps, as you might expect from a study in which Lister plays the central role, was through the influence of a famous teacher. On the other hand, one of the more divisive influences at medical schools during these years was the subject of education for women, to which Crowther and Dupree devote an entire chapter. Though essentially offering a comprehensive summary" of existing studies, their coverage of female students' experiences extends beyond this single chapter. Besides being highlighted in the cover illustration (reproduced on page 86), the subject is repeatedly addressed throughout the book's remaining chapters.
The second half of the book concentrates on the major career paths of the student cohort. Besides examining the various specialisms in which they excelled, it analyzes their networks, both inside and outside Britain, as well as the ways in which Scottish graduates attempted to incorporate Listerism in their various fields of practice. In general, nearly half of the doctors in the sample described themselves as general practitioners. While often also describing their methods as Listerian, they appear to have adapted Lister's teachings pragmatically and in ways their famed instructor could not have contemplated, using for example alternative antiseptics. Nearly three hundred members of the sample went on to make careers outside Britain, primarily in the Empire, the majority settling at least for a time in Australia (5.4 per cent), India/Ceylon (3.8 per cent), and South Africa (2.3 per cent). Abroad, Lister's methods, not surprisingly, were promoted as "a symbol of scientific medicine" (p. 288) and remained most influential in those places where good hospital hygiene was hardest to achieve. Though honours were more often bestowed on London's medical elite, a number of the study's members went on to achieve success in their own field, and 7 per cent and 4 per cent of Listerians based in England and Scotland respectively left estates valued at more than £ 25,000 (p. 356); not surprisingly, the least successful graduates appear to have been female practitioners and medical missionaries. Unsually, the book's conclusion is followed by a short methodology section, which perhaps merits careful scrutiny given the recent proliferation of such collective biographies. While this section describes the way in which addresses, posts and deaths, among other topics, were researched, it does not consider the problems of relying heavily on particular sources, such as obituaries, as the authors do throughout. The remainder of the appendix contains a number of other tables, including a final one listing the numerous other professors, who taught at Glasgow and Edinburgh between 1860 and 1880; these, no doubt, also exterted an influence on their students, though in ways which are perhaps more difficult to elucidate.
Given the huge amount of work that went into this study, it seems a shame to conclude this review with a list of shortcomings. Perhaps most notable is the failure of the authors, who claim to be interested in the diffusion of an influential surgeon's surgical techniques in both the acknowledgement and introduction, to engage with the vast extant literature in this area. Instead, readers themselves are left to consider the way in which the research builds on existing innovation studies. Neither does the study engage with theoretical work on networks from Durkheim and Simmel to Harrison White and Linton Freeman despite attempting to reconstruct what amounts to a global medical network. On the other hand, while specialization is never really indicated as a major theme in the book's introduction, the authors devote dozens of pages to their cohort's chosen specialties and have carefully considered the impact of their findings on current work in the field. The subject of "postgraduate courses," while receiving a single page entry in the index, is also regularly touched on throughout the volume, albeit described in other words.
In contrast to many histories of the medical profession, which have emphasized rivalry and conflict between practitioners, this study returns scholars to a world of Strong communal loyalties, as are commonly expressed in medical biographies of the past. The similarities between this and previous Whiggish accounts of professionalization in medicine, however, are minimal. Nevertheless, it is significant that medical historians have returned to histories of practitioners, rather than attempt similar studies of patients, as has been advocated by leading medical historians for more than two decades. This study adequately demonstrates the potential of computing technology, not to mention collaborative research, and will hopefully inspire studies of patients during the same period. While it will probably not become a standard text in the history of medicine, and leaves many other subjects, including innovation and social network analysis, to be carried out by others, the volume will attract a wide readership, and not only among Lister enthusiasts. It will be particularly useful to anyone working on the lives of individual members of this cohort, or undertaking similar collective biographies for other medical communities, whether in the British, American, or colonial contexts.
Jonathan Reinarz
University of Birmingham
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| Author: | Reinarz, Jonathan |
|---|---|
| Publication: | Canadian Journal of History |
| Date: | Mar 22, 2008 |
| Words: | 1153 |
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