The Western Medical Tradition, 800 B.C. to A.D. 1800 (review)

There has long been a need for a new survey of the history of Western medicine that could be suggested as both a readable and an accurate introduction to the field, something between Erwin Ackerknecht’s Short History of Medicine (1st ed. 1955) and Fielding Garrison’s huge Introduction to the History of Medicine (1st ed. 1913). This new text, the first of a projected two volumes, fits the bill very well. Written by members of the academic unit of the Wellcome Institute for the History of Medicine in London, it presents a thorough and literate overview of medicine from the Greeks to the French Revolution, framed in terms of a Western-civilization-style textbook, with plentiful illustrations. The authors cover the history of medical ideas and of medicine and society, adding information on the history of medical institutions. Imparting a generally robust and wide-ranging sense of the medical past, this should be not only a useful course text but a fine general introduction for anyone who wants an overview of the subject.

Organizationally, the text is divided into familiar blocks: medicine in the Greek world; Roman medicine; late antiquity and the early Middle Ages (all written by Nutton); the Arab-Islamic tradition (Conrad); medicine in medieval western Europe (again by Nutton); early modern European medicine (Wear); and the eighteenth century (Porter). Neve adds a conclusion that raises historiographic questions. It is perhaps a bit surprising that, despite recent concerns about the overly Hellenic view of Western medicine, this work deals far less with Egyptian and Middle Eastern medicine than do many older texts. Nutton’s statement that Greek medicine was “open to intellectual influences of all kinds . . . in contrast to the medicine of the Near East” (p. 19) raises more questions than it resolves; once he turns to Greek and Roman medicine themselves, however, he writes with energy and authority. It is perhaps unfortunate that Nutton (such a fine student of classical medicine) had to be asked to write on the European Middle Ages as well, when so many others are doing exciting work in that area. Yet given the constraints of having to find authors in-house, he does a very creditable job. Wear’s chapter (longer than all the chapters of Nutton put together) is sometimes turgid, but thorough; Porter’s hundred pages flow along delightfully. The last two chapters also make valiant attempts to break from the Anglocentric orientation of their authors’ own research.

In perhaps the most important chapter of the volume—one that ought to be read carefully by anyone with even a passing interest in the subject—Conrad makes every effort to treat Islamic medicine in its own right, demolishing the myth of its origins at Judishapur along the way. Only the traditional placement of the chapter between late antiquity and the rise of universities in Latin Christendom will give comfort to those who see the significance of Islamic and Arabic medicine merely as a stage in the transmission of Greek knowledge to the West. Neve’s concluding musings about history and what it all might mean are often thoughtful and provocative.

The authors have created an impressive volume. Nevertheless, there is still much to be added to class discussions, especially regarding questions of causality. Patrons, religious institutions, municipalities, and states are mentioned along the way, but not consistently; on occasion, rising population and urbanization are invoked as causes of medical change; the medical marketplace figures in the story from time to time, but the mechanisms of production and exchange are not pushed; class conflict is almost entirely absent. All the authors but Neve do, however, give a consistently central place to the history of medical ideas, which are treated in a generally chronological fashion, giving the impression that one set of ideas led to another. The history of ideas framework is not necessarily a...