Malthus, Medicine, and Morality: "Malthusianism" after 1798. Clio Medica (review)

Brian Dolan, ed. Malthus, Medicine, and Morality: "Malthusianism" after 1798. Clio Medica, vol. 59. Wellcome Institute Series in the History of Medicine. Amsterdam: Editions Rodopi, 2000. v + 232 pp. Ill. $53.00, Hfl. 125.00, £37.50 (cloth, 90-420-0851-2); $17.00, Hfl. 40.0, £12.00 (paperbound, 90-420-0841-5).

Many social historians of medicine would emphasize that they regard medical practitioners as part of larger systems of charity and care in the culture they study. It is ironic, therefore, that Christopher Hamlin and Kathleen Gallagher-Kamper can observe that "medical history has found little room for Thomas Malthus" (p. 115). This useful collection, deriving from a symposium held at the Wellcome Institute in London two hundred years after the 1798 publication of Malthus's Essay on Population, shows how far his work and reputation are as much part of the history of medicine as of the histories of political economy, demography, science, and environmentalism. The volume's contents can be divided into three broad categories. Some essays deal with the development of Malthus's thought and writings, others focus on British responses to his oeuvre in the first half of the nineteenth century, and a third group discusses aspects of the history of birth control.

Timothy Alborn elegantly demonstrates how Malthus's 1817 pamphlet Statements Regarding the East-India College, written in defense of the pedagogic system of Haileybury College (where he taught), accorded with his concerns about the inculcation of moral restraint. Brian Dolan explicates Malthus's treatment of Scandinavia, drawing on the revisions to the Essay and records of his travels there. These papers are complemented by Brian Young's stimulating discussion of Malthus's annihilationism and of the complex relation between his theodicy and varying strands of eighteenth- and early-nineteenth-century Protestantism.

Roy Porter, meanwhile, surveys with gusto early-nineteenth-century physicians' often hostile responses to the Essay on Population, and Robert Young rather grumpily reiterates that Darwin's reading of Malthus was crucial for the development of his thought. More interestingly, Young highlights how with each revision of his work Malthus accorded greater importance to the role of "moral restraint"—what we might now term "culture"—in the history of human populations, and argues forcefully for the abiding relevance of such nuanced reflections on human beings' capacity to accommodate themselves to biological limits. In their excellent "Malthus and the Doctors," to my mind the best piece in the collection, Hamlin and Gallagher-Kamper successfully wed these broader issues to detailed historical research. Malthus's account of the consequences of population growth, they observe, placed (and continues to place) physicians in a number of dilemmas: Were their therapeutic interventions actually counterproductive? What was the appropriate relationship between health care and social or economic policy? What would a social medicine look like? Drawing on medical commentary on the Irish fever epidemic of 1816-19 and on Dr. William Pulteney Alison's campaign in the early 1840s for a Scottish poor law, as well as on English examples, they show both how far Malthus's writings informed discussions of public health policy and how they could be read in a variety of ways. The range of ways in which physicians engaged with, criticized, or accepted aspects of Malthus's work suggests not only that it is too simple to write of the early nineteenth century in terms of pro- and anti-Malthusians, but also that there was more than one Malthus.

The last section is much less satisfying. Lesley Hall and Antonello La Vergata give overviews of the politics and history of birth control in nineteenth- and twentieth-century Britain and Europe, and Angus McLaren describes the connections between the French birth-control movement and the anarchist Left, ca. 1880-ca. 1910. All three pieces are useful additions to the historiography of birth control, but because they do not center on how the figure of Malthus...