History of Medicine: A Scandalously Short Introduction (review)

Jacalyn Duffin. History of Medicine: A Scandalously Short Introduction. Toronto, University of Toronto Press, 1999. xvi, 432 pp., illus. $70 (cloth), $24.95 (paper).

As someone who is often asked to review books, one with the words "scandalously short" in the subtitle is appealing. Fortunately, Duffin’s book is not only concise but also entertaining and enlightening. Duffin’s approach in this History of Medicine is largely thematic. The fifteen chapters include historical accounts of topics such as anatomy, physiology, epidemic diseases, medical technology, women’s medicine, and pediatrics. In each of the chapters, Duffin uses a chronological approach, ably describing the evolution of these subjects over time. For example, in the chapter on epidemics, she begins with the Plague of Athens ca. 430 B.C., proceeds to the spread of syphilis in the sixteenth century, and concludes with the modern challenges of human immunodeficiency virus (HIV) infection and AIDS.

In addition to her series of historical overviews, Duffin includes quotations from primary sources (generally set apart in boxes) and accounts of historiographic trends and debates. The book also contains numerous images and charts that break up the text in helpful ways. The most effective of these are various paintings of past medical practices. Of particular value is Duffin’s emphasis on Canadian medical history, which is too often neglected by U.S. and European historians. Duffin is a professor of medicine at Queen’s University in Kingston, Ontario, where she is also a practicing hematologist.

The most provocative and insightful aspects of History of Medicine are the author’s comments on the value of teaching history to physicians and physicians-in-training. Although one may not choose to try Duffin’s amusing "Heroes and Villains game," in which first-year medical students at Queen’s get their earliest exposure to history, the game’s lesson is of primary importance to all health practitioners: "Medical history, like medical practice and medical science, is about questions and answers, evidence and interpretation" (p. 6).

Indeed, throughout the book, Duffin ably shows how past instances of medical dogma were subsequently disproven. For example, she notes how Julius Wagner-Jauregg and Egas Moniz were awarded Nobel Prizes for rather dubious discoveries: malarial-fever treatment for syphilis and frontal lobotomy for psychosis, respectively. Yet at the same time, Duffin emphasizes why physicians in the early to middle twentieth century hailed both of these accomplishments. Progress in medicine, she rightly notes, cannot be understood outside of its specific historical context.

An unabashed proselytizer for the value of history, Duffin makes her last chapter "How to Research a Question in Medical History." In this section, she hopes to interest medical students, physicians, and other clinicians to pursue historical studies. Duffin includes helpful information about research tools, such as MEDLINE and the Bibliography of the History of Medicine, and instructs readers on how to best use primary and secondary sources. Of particular interest is an aside on the ongoing tensions between physician-historians, who often write internalist, Whiggish histories of medicine, and Ph.D. historians, whose externalist accounts may criticize past medical practices. Duffin commendably finds value in both types of works and urges these scholars to build on one another’s findings.

Because of its thematic, as opposed to chronological, nature, History of Medicine necessarily contains frequent cross-references to discussions that take place in other chapters. Some may find this distracting, although I did not. What I did find was a valuable, good-natured overview of a large topic that challenges everyone who teaches the history of medicine to do a better job.

Reviewed by Barron H. Lerner, M.D., Department of Medicine,
Columbia College of Physicians & Surgeons, New York, New York 10032.

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