A History of Scottish Medicine: Themes and Influences (review)

Helen Dingwall is under no illusions about the size and difficulty of her task, although this reader at least got the feeling that she realized its magnitude only once the project was under way. She has attempted nothing short of a comprehensive history of medicine in Scotland, from the earliest recorded evidence of healing in the area that was to become that country to modern times. Further, she has not restricted her account to orthodox medicine but takes in all varieties of religious, magical, and folk healing. Finally, she endeavors to give the book overall structural cohesion by repeatedly posing the question, was there a distinctly Scottish medicine—that is, one in which there was some characteristic that identified healing as unique to that nation, whether it was practiced by the crofters of the Western Isles or taught in the University of Edinburgh? The work is divided into three chronological sections: before 1500, 1500-1800, and 1800-2000. This is a deliberately popular book, and professional historians will find its Whiggish tone irksome.

Dingwall recognizes the problematic nature of her project from the outset: how is it possible to write about Scottish medicine in the earliest time before the idea of Scotland itself existed? Undaunted, however, she gives an account of evidence of early medicine, including trepanning carried out "to let out evil spirits or evil matter" (p. 25). If Dingwall's thesis of Scottish medicine's having a distinct identity works at any point, it is in the medieval period when the cohesive agent was Christianity. The idea of monastic medicine in particular serves her well as a unifying agent. She does not have a great deal of patience with the Church, however, finding it a cause of "stagnation and hindrance" to Scottish medicine (p. 35): Christianity had the effect of "stifling progress in medical knowledge" (p. 37); it was "secularisation and literacy" that were to come to the rescue (p. 43). Each of these factors is described as being a "process," a term I slowly came to realize was invoked with great frequency as an explanatory agent in this book.

The Enlightenment is also designated a process (and curiously dated to the third quarter of the eighteenth century) (p. 69). By the Enlightenment Dingwall's account has more or less shifted away from any form of medicine but that of orthodoxy. The Enlightenment in Scotland, particularly Edinburgh, is rightly given its due, but there is a distinct feeling of triumphalism in the account—as in, "the Bell brothers began to take anatomy out of the mists and mysteries of the past" (p. 115). Perhaps in line with her view that the Enlightenment was a late eighteenth-century phenomenon, William Cullen is described as being head-hunted by Edinburgh in the 1770s (p. 117); in fact, he went there in 1756. On another point of substance, John Hunter is identified as being the product of an unspecified Scottish medical institution (p. 4); to my knowledge, he never attended one in his life, his formal surgical education having been acquired in London.

Dingwall's survey of the nineteenth century takes in public health, mental illness, hospitals, and a number of subjects given slightly less space, such as medicine and war. The twentieth century, where she seems at her most comfortable, ends with AIDS. This is a brave survey, although I doubt all will endorse its historiographic assumptions.