Locating Medical History: The Stories and Their Meanings

9 The Historiography of Medicine in the United Kingdom

C H A P T E R N I N E The Historiography of Medicine in the United Kingdom Roy Porter We’ve all endured those ‘‘Twenty Countries in Seven Days’’ package holidays from which the wretched tourist emerges dazed and dizzy, remembering nothing at all about anywhere he’s been. If I attempted to visit all the main trends in British history of medicine in this occasion it would induce a similar sort of academic travel sickness. In the interests of mental health—yours and mine—I shall impose a strict regimen. First, I propose to say nothing about movements common to Western scholarship at large.1 Thus, I shall not rehearse yet again the rejection of Whiggish triumphalism or revisit the impact of feminist history, of structuralism, of Foucauldian savoir-pouvoir, postmodernism, Derridean textual analysis, and the wider linguistic turn. These tendencies have been felt from San Diego to St. Petersburg and even in Sheffield and Southampton.2 Second, I shall keep silent about fields and periods beyond my competence, for example medieval studies, or the politics of modern health care.3 Third, I shall restrict myself to British-based historians writing about British medicine—while reminding you that many of the finest works produced by British scholars in recent years have been on foreign topics, for instance Lawrence Brockliss and Cohn Jones’s magisterial The Medical World of Early Modern France.4 Historiography of Medicine in the United Kingdom 195 Fourth, I hope to steer my historiographical ship between two reefs. On the one hand, I shall not speak abstractly of -isms and -ologies. To my mind, not only would that be tedious, it would also be misleading because the practice of the history of medicine in Britain is not, in fact, ideologically polarized into doctrinaire sects but is characterized by a healthy pluralism and diversity: among historians English individualism still rules OK.5 On the other hand, I shall refrain from bombarding you with fleeting and instantly forgettable references to hundreds of names, topics, and titles. My plan, rather, is to address in some detail a mere handful of books that seem to me indicative of new trends and influential as rethinkings of the field. That way, I trust, we will at least avoid intellectual indigestion. By way of prologue, I must say something about the institutional developments underpinning such scholarly tendencies. When I started out in the mid-1960s, history of medicine in Britain was generally thought an intellectually mediocre pursuit, holding no fascination for brash and bumptious apprentice historians of science like myself: it had no big issues, no clashes of the kind provoked by Popper, Lakatos, Kuhn, or Feyerabend. It seemed to be the unproblematic chronicle of how dreadful diseases had been conquered by great doctors. All this was to change. Over the last thirty years, new diseases like AIDS have challenged the progress saga, while public attitudes toward scientific medicine and the medical profession have grown critical. As an inevitable consequence, the history of medicine has itself been problematized.6 British scholars have been well placed to take advantage of such new ferments thanks to two developments. The discipline has been energized during the last quarter-century thanks to the founding and flourishing of the Society for the Social History of Medicine, a radical outfit that brought together younger historians , social scientists, and left-leaning health professionals. Its thrice-yearly journal , Social History of Medicine, is now ten years old.7 A comparable stimulus has come from the Wellcome Trust. By supporting the Wellcome Institute in London; units in Oxford and Cambridge,8 Manchester and Glasgow; and lectureships in almost thirty universities, the Trust has set study of the history of medicine—once largely conducted by retired or Sunday doctors— onto a proper academic footing. Most Wellcome appointees are trained historians working in or alongside history departments. That has its pros and cons—arguably certain research topics really do require professional medical expertise and experience. But it has ensured that the history of medicine has been exposed to the trade winds of history and is now undertaken with due historiographical sophistication. 196 A Generation Reviewed The most influential scholarship during the last generation has not been history of medicine in the traditional, narrow sense at all—that is, top-down accounts of doctors, by doctors, for doctors. It has been about health, in many cases...