A History of Scottish Medicine. Themes and Influences

The author in her introduction highlights the dilemma that faces historians of medicine: whether to deal with medicine in Scotland or Scottish medicine. The title tells us about her decision, although she does acknowledge that 'the complexities of the past' and her particular approach do not provide a complete answer to the question and she is less certain that in the age of technology medicine in Scotland has remained distinctively Scottish.

This new work is significant in that it is the first wide-ranging account of Scottish medicine to appear for nearly a quarter of a century and, more importantly, the first to be written by someone who is not a Scottish physician or surgeon; in other words it is not a doctor's history. However, as the author points out, this work is not intended to be a comprehensive review of all aspects of Scottish medicine; rather, her intention is 'to offer a general perspective as a basis for further detailed research.' In the space of less than 300 pages Dr Dingwall has dealt not only with the influences shaping Scottish medicine in Scotland but also with the impact of Scottish doctors on the development of medicine in other countries and in particular areas of medical practice--in England, the Empire, Russia and in the early years of the United States of America; at sea, as military surgeons and in the field of public health.

Her research illustrates the degree to which the study of medical history has progressed since Comrie's history of Scottish medicine was published in 1932; Dr Dingwall has moved away from the "peoples and places" approach of Comrie and while not ignoring a chronological narrative she has placed the development of Scottish medicine firmly in the context of cultural, social and economic change, at the same time exploring the influence of European teaching on Scottish medical education. As John Pickstone put it in a recent review: '[medical history] cannot be understood without reference to the major intellectual and political movements...' (Social Histor y of Medicine 18 (2005) 308) and in this volume the author has fulfilled that task.

The book is in three parts, divided chronologically: from earliest times to c.1500; from c.1500 to c.1800; and from c. 1800 to 2000. Each section is prefaced by a chapter offering 'brief general historical surveys' and setting the context in which medicine changed and developed. To take one example, the development of the medical and surgical colleges in Scotland is handled skilfully, setting their emergence in the context of economic transformation and the population shift which occurred with urbanisation. It is this contextual approach that is valuable, a methodology that is markedly different from that used by the majority of doctor historians. This technique of scene-setting works well on the whole, but this reader was left feeling that too much information was presented in the space available; a larger format may have proved more successful. The further reading list and bibliography are comprehensive, covering historical theory, Scottish history and all aspects of Scottish medicine from the general to the specific; such topics as alternative medicine, dentistry, hospital histories, women in medicine and the military are included.

There were sections that I found less satisfactory, in particular that dealing with the nineteenth century, but this may be the consequence of a perspective born of a career in surgery and a more recent involvement in the study of nineteenth century epidemics. However, this does not detract from a first-rate achievement: this is a text which will undoubtedly prove to be an important introduction to Scottish medicine and an essential source in this expanding field.