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  • Island Doctor: John Mackieson and Medicine in Nineteenth-Century Prince Edward Island
  • Ronald Rompkey (bio)
David A.E. Shephard. Island Doctor: John Mackieson and Medicine in Nineteenth-Century Prince Edward Island McGill-Queen’s University Press. xxviii, 188. $44.95

John Mackieson (1795-1885), a Scottish physician schooled in eighteenth-century medicine and the ideas of the Scottish Enlightenment, inexplicably leaves his native heath in 1821 and establishes himself at Charlottetown, Prince Edward Island. A few years later, he marries the daughter of a prosperous merchant and former speaker of the House of Assembly as he proceeds to develop a comfortable general practice. In due course, he receives state appointments as port health officer and later medical superintendent of the Charlottetown Lunatic Asylum, both of which he is obliged to resign through his apparent incompetence. Still, he continues to work to the end of his sixty-three-year career, having witnessed many transformations in his field, and outlives all of his family except one daughter.

The long career of John Mackieson, a practitioner responsive to all that British North America could offer him, presents rich possibilities for [End Page 441] medical biography. Indeed, David Shephard, a Charlottetown anaesthesiologist and a former editor of the Canadian Medical Association Journal, seems to have had biography in mind for the present volume, for he writes, 'My intentions in this biography of John Mackieson are similar [to writing the biography of a minor poet]: to understand a minor figure in medicine - the character of the man and his work as a doctor, as indicated primarily by his manuscripts.' But despite the many opportunities offered by Mackieson's life and his personal and clinical manuscripts at the Medical Society of Prince Edward Island, this short volume falls short of biography. What does emerge is a sketch of a rather cautious and empirical practitioner working within the constraints of his time.

The strength of Shephard's exploitation of the Mackieson papers resides instead in his representation of the physician's daily round in the pre-anaesthetic, pre-Listerian, pre-antibiotic era. Moreover, Mackieson's career, which pre-dates the scientific opportunities offered by the stethoscope, the microscope, the ophthalmoscope, and the thermometer, demonstrates what Mackieson was required to draw on from his own intellectual and physical resources. Added to that, Charlottetown lacked in his early career a general hospital, trained personnel, running water, and electricity - all that he would take for granted today. Based on 257 case histories in medicine, surgery, obstetrics, gynaecology, and mental health, it is therefore a portrait of a profession rather than a professional, a practice rather than a practitioner.

Shephard's accomplishment lies not in his reconstruction of events or his narrative style but in his representation of the individual cases occupying thirty-three pages of the book. Here he combines his clinical training and his interest in medical history to give the professional and non-professional reader alike a sense of Mackieson's clinical methods, which still included bloodletting. We follow him step-by-step as he treats pneumonia, congestion in the head, hydrothorax, inflammation of the brain, and, on the surgical side, strangulated hernia, burns and scalds, fractures, and tumours. His treatment of such widespread afflictions as puerperal fever, lingering labour, uterine haemorrhage, eclampsia, and peritoneal fever recall forcefully the perils of childbearing, often leading to death. And finally, Mackieson's superintendency of the Charlottetown Lunatic Asylum (both a hospital and a poorhouse), for which he was indicted but never prosecuted, illustrates the deficiencies of the asylum system and the kinds of diagnosis and treatment offered in the pre-Freudian era.

Mackieson's knowledge embraced the full range of medical and surgical practice as it was known at the time, both clinical and administrative - he even engaged in politics by petitioning the House of Assembly to recognize the profession in law. Shephard quite rightly points out that his papers are probably unique and that they present a paradigm for medical practice [End Page 442] elsewhere in North America. 'It is because little has been written about Mackieson and his texts,' he writes, 'that this book seems warranted.' Not only is it warranted - it beckons to the biographer...

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