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  • Medical Lives in the Age of Surgical Revolution
  • Janis McLarren Caldwell (bio)
Medical Lives in the Age of Surgical Revolution, by M. Anne Crowther and Marguerite W. Dupree; pp. xvi + 425. Cambridge and New York: Cambridge University Press, 2007, £65.00, $134.00.

The title of this book might lead a reader to hope for some explanation of the precipitous rise in surgical prestige over the course of the nineteenth century. After all, the revolution in cultural regard for the surgeon is one of the most remarkable stories of professional triumph as, over the course of the nineteenth century, the surgeon finally shed his association with the barber, emerging by the twentieth century a highly paid interventionist. But this book is definitely not an exercise in cultural speculation; instead, it is more modest in its goals, more responsible, and ultimately more rewarding. The "surgical revolution" of the title is, quite specifically, Listerian antisepsis—the application of disinfectant agents to wounds in an effort to stem putrefaction. And the "medical lives" are a group of nearly 2000 students who began medical school in the 1860s and 1870s at the Scottish medical schools that dominated British medicine in the period: the Universities of Edinburgh and Glasgow. M. Anne Crowther and Marguerite W. Dupree follow these lives from medical school to death, carefully mapping the various shapes of many medical careers. The result is a fascinating type of history: a cohort study lodged somewhere between biography and social history. [End Page 695]

In their efforts to stitch together the shapes of these medical lives, Crowther and dupree have tracked through thickets of medical registers, directories, unpublished theses, minutes of associations, wills, and obituaries. The authors present a number of graphs, but they interpret and weave together this data into an annotated outline, marking directions, choices, and achievements, which are punctuated occasionally by pieces of personal narrative. The reader gets a sense of both the trends of the group and the texture of some of the individual lives. We learn, for instance, that the training period was literally life-threatening, as a number fell ill from exposure to diseases such as tuberculosis and enteric fever. Before the close of the first chapter, fully one-third of the cohort is lost to failure and illness before they qualify to practice. Remarkably, after this ordeal, it was not unusual for students to seek extra training and experience before practicing independently. And, with no organized postgraduate training, the most successful students gained hospital positions through influential contacts, while others sought to enhance their credentials with further training in europe. Some, especially if their health was troubled, took positions as ship-surgeons, as the sea-going life was thought to benefit the constitution. Many entered directly into general practice, working grueling hours to gain a stable, paying clientele. The overall picture of these medical "lives" is one of academic, economic, and practical challenges faced by the ordinary practitioner, with greater possibilities open to the select few who captured the notice of teachers (sometimes relatives) who could promote them into academia or a wealthier practice.

The importance of student-teacher relationships and the dissemination of ideas via networks of maturing students are major themes of this book. Joseph Lister, as the most prominent of this cohort's teachers, receives the bulk of the attention. At times, it seems that Listerian antisepsis became widespread purely because of his effectiveness as a teacher and his student network's diligence in promoting his ideas. But, in the context of other social histories, this is an even-handed treatment, largely suspicious of theories of great men or narratives of scientific progress, as it reinstates Lister as a major force in medical history.

A secondary focus is the much smaller cohort of women who entered medicine in this period under the leadership of sophia Jex-Blake. Their careers were, in many ways, medical lives pursued in spite of surgical revolution, both because Lister opposed the entry of women into the profession and because the women who did manage to get educated were largely excluded from surgery, as anatomy and surgery were regarded as indelicate. For the most part, these women were confined...

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