Gentlemen, Scientists and Doctors: Medicine at Cambridge, 1800-1940 (review)

Mark W. Weatherall. Gentlemen, Scientists and Doctors: Medicine at Cambridge, 1800-1940. History of the University of Cambridge, Texts and Studies, no. 3. Woodbridge, U.K.: Boydell Press, in association with the Cambridge University Library, 2000. x + 341 pp. $90.00 (0-85115-681-9).

Cleverly, Mark Weatherall has subtitled his book "Medicine at Cambridge," not "The Cambridge Medical School." Medicine has had a presence in Cambridge since the sixteenth century and the political maneuverings of the medical lobby are central to the story Weatherall tells, but a "school," in the sense of a place where one could obtain a comprehensive clinical education as well as a preclinical one, existed for only twenty-seven of the years covered by this volume--and even in those years many students supplemented their Cambridge clinical experience with time in London. That, in a nutshell, summarizes an extremely complicated tale. For most of the period covered here, the question at issue was: should Cambridge turn out physicians much the same as those who appeared from Edinburgh or St. Bartholomew's, or should it produce preclinical students scientifically trained beyond practical requirements and groomed to adopt positions of professional excellence and power after clinical work elsewhere? This question appertains to the period after the Medical Act of 1858, but it was certainly a legacy of the earlier period when Cambridge educators assumed that their progeny would constitute the elite of the profession.

This and related questions were academic ones, but not in the pejorative sense of the term. They were fought out in general boards, special boards, faculty boards, and goodness only knows what other top-hamper an ancient university entering the modern world could construct. Weatherall leads us through this with a clarity I only realized was there when I reread various sections. Anyone (like me) who has never been to Oxbridge will be confronted here with the familiar feeling that Oxbridge folk take for granted things about the workings of their places that mystify outsiders. The innards of Cambridge administration are revealed here--they just take some finding and remembering before they crop up again. Weatherall can scarcely be blamed if the excellent map of an ancient institution that he has drawn is not immediately decipherable.

In the early part of this book, in many ways, we watch the scene shifters at work setting the stage for the struggles to come. Cambridge elitism is moved into place, as is the specter of William Whewell and respect for the natural sciences. The independent Addenbrooke's Hospital, with its comparatively meager bed allowance and its governors who seemed to put the needs of patients before those of clinical teaching, appears as very important background. What follows is a mixture of comedy and tragedy, whose major players will be familiar to anyone working on this period. Key to the creation of Cambridge as a prominent medical school was the "Great Triumvirate": George Humphry, George Paget, and Michael Foster. Humphry was an anatomist and a surgeon, and a liberal in university politics; the physician Paget was Tory and a college man. Both, from the 1840s to the 1860s, were advocates of more natural science at Cambridge, although Paget came to regret the money that was spent in that quarter at the expense of medicine. Humphry was instrumental in gaining the appointment of the third of the triumvirate, and the best-known figure of the period, the physiologist Michael Foster.

It is impossible to do justice here to the arguments and politics that Weatherall describes for the period 1880-1920, but they almost always involved physiology. Institutional questions divided college and university, medical boards and natural science boards, and hospital and university. Intellectual issues were often centered on the Natural Science Tripos (one of those mysteries that insiders take for granted), and how much physiology medical students should learn, and whether a training in physiological methods was a training...