Histoire de la pensée médicale en Occident. Vol. 3: Du romantisme à la science moderne (review)

Mirko D. Grmek, ed. Histoire de la pensée médicale en Occident. Vol. 3: Du romantisme à la science moderne. Originally published as Storia del pensiero medico occidentale, vol. 3, Dall' età romantica alla medicina moderna (Laterza, 1998). Translated by Louise L. Lambrichs. Paris: Éditions du Seuil, 1999. 422 pp. Fr.F. 299.00.

This book is the third in a four-volume series on the intellectual history of medicine. Its two predecessors were Antiquité et Moyen Age (1995; English ans., 1998) and De la Renaissance aux Lumières (1997). With its publication, the historical portion is now complete. The fourth volume was to contain essays by scientists representing various thought-styles and disciplines of the twentieth century, but due to the death of the editor, Mirko Drazen Grmek, in March 2000, its future is now in doubt. Nevertheless, the three extant volumes provide a fresh new look at certain aspects of Western medical thought--à la Lester S. King, L. J. Rather, or T. S. Hall--aspects that have been somewhat neglected of late by the compelling preoccupations of social history. In bringing medical epistemology back to the fore, the authors have taken pains to integrate social history. A recent work that is similar in conception is Irvine Loudon, ed., Western Medicine: An Illustrated History (1997).

Sixteen authors (fifteen of them male) from seven countries, and many with M.D. degrees, wrote the fifteen essays, in their preferred language. The chapters were then translated or edited into a uniform and pleasingly lucid French by the writer Louise Lambrichs--collaborator, and now widow, of the editor. They address the following topics: romanticism in medicine, normal and pathological structure, experimental physiology, neuropsychiatry, microbiology, disease concepts, diagnosis, diagnostic technologies, therapeutic strategies, pharmaceutical products, surgery, specialties, dominant diseases, medicine and society, and the biomedical revolution of the nineteenth century.

The result displays a few of the problems that typify collaborative endeavors. Most to be regretted is the absence of a subject index; the meticulous index of proper names and the annotated table of contents do not suffice for a history of ideas. Other difficulties will be apparent only to the very few who, like this reviewer, read the work from cover to cover. For example, some accounts are repetitious, as key ideas become relevant to several chapters (e.g., cell theory is discussed several times). Reexamination of a topic from different angles is not unwelcome; however, without a subject index or cross-referencing, readers will miss some discussions. Finally, the essays are uneven for their erudition in both primary and secondary sources. It would be easy to dwell on missing references to North American work, some of which are striking: for example, a chapter on therapeutics fails to cite John Harvey Warner [sic, as he was called on p. 301]; a discussion of obstetrics as a specialty relies on a secondary source from 1958 and makes no mention of Judith Walzer Leavitt; a section on technology does not mention Joel D. Howell. But to be fair, I myself would be unable to identify missing references to German and Italian literature, and I found many intriguing sources in those languages that were previously unknown to me.

Generic problems aside, the work is well worth the attention of North American readers. With its value-added focus on European scholarship, it sports a Continental accent and a new perspective. Some essays constitute succinct new summaries of old topics with excellent sources: François Duchesneau on cellular pathology; Bernardino Fantini on microbiology; Frederic L. Holmes on experimental physiology; Russell Maulitz and Steven Peitzman on diagnosis; Ulrich Tröhler on surgery. The essay by Grmek and Jean-Charles Sournia on dominant disease is an unusual approach to the history of public health, using the concepts of "pathocenosis" and "dominant diseases," the latter a metaphor derived from genetics, to...