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  • Advancing with the Army: Medicine, the Professions, and Social Mobility in the British Isles, 1790–1850
  • Scott Hughes Myerly
Advancing with the Army: Medicine, the Professions, and Social Mobility in the British Isles, 1790–1850. By Marcus Ackroyd et al.. Oxford: Oxford University Press, 2006. ISBN 0-19-926706-5. Illustrations. Tables. Appendixes. Notes. Bibliography. Index. Pp. xv, 393. $120.00.

This major prosopographical study by a team of scholars addresses the emergence of the modern medical profession, and considerably expands knowledge about that process, together with the histories of society, family, medicine, British identity, and Army surgeons. It covers Army medicine’s original low status, its improvement in the Napoleonic era, and ends with the retirement of British Army Medical Director General James McGrigor in 1851. This study is based on biographical questionnaires of Army surgeons initiated by McGrigor, which are considerably expanded upon by numerous online resources (e.g., genealogical, family, local, educational, and publishing) and anecdotal evidence. Using data on 454 surgeons (about thirty percent of army doctors between 1772 and 1833), the authors gauge this cohort’s social and economic advancement into mid-century, focusing on educational backgrounds, marriage alliances, relatives’ social status, wills, significant scholarly achievements, etc. Using a wealth of statistical data, they argue convincingly that these men did “advance with the army” through their proven competence, oftentimes enhanced by acquiring additional education and sometimes by scholarly publishing (although the era’s aristocratic patronage system was still decisive for promotions). To a significant degree, Advancingcorrects and refines previous knowledge about the emergence of medicine as a profession, despite some fragmentary statistical information.

For the Army background and anecdotal evidence, the authors utilize the four major published studies of Army medicine. However, they presume that statistical analysis is more substantive than other primary sources, even though there are hundreds of published military memoirs, diaries and letters, as well as many depictions of Army surgeons in the era’s voluminous literature. Future scholars could use these to advance and refine this work’s conclusions. A good start would be [Dr. Daniel Wentworth (or William?) Maginn] Military Sketch Book(1827), and Tales of Military Life, 3 vols. (1829).

A weakness of the book is the military background; for example, the authors ponder why even retired non-commissioned officers described themselves as “gentlemen.” Retired and half-pay “fighting” officers – however poor – were then considered as such, unless they went into trade, and even privates were “gentlemen” within the regiments. Advancingalso may be too optimistic about the surgeons’ social status; did becoming officers advance their status as it did for middle-class “fighting” officers who got wartime commissions? Membership in a regimental mess or being addressed as “gentlemen” in official documents didn’t necessarily establish status in others’ eyes, and some surgeons were not members of the mess; each regiment then tended to do what it pleased. One also wonders whether advances in medical treatment helped enhance all doctors’ status before the Act of 1858 which modernized medical standards, or if attaining military officer status was decisive.

The authors seem rather optimistic in viewing Army surgeons, and some conclusions seem overly positive. Some of the Crimean war’s medical horrors are downplayed with flimsy excuses; the bureaucratic stupidity and neglect much resembles earlier practices – even predating 1793 – and McGrigor’s protégé, consummate intriguer and self-promoter Dr. John Hall, deserved much of the criticism he got, while governmental penny-pinching [End Page 944]only partially excuses that disgrace. But these failures might have been exacerbated by a lower and uncertain status – and thus authority – for Army surgeons as some scholars have claimed.

As in many innovative, high quality works, more investigation would enhance the foundation established by this substantial, valuable study, which is recommended to scholars and students.

Scott Hughes Myerly
Evansville, Indiana

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