Medical Lives in the Age of Surgical Revolution (review)

Large-scale collective biography is a demanding and time-consuming way of writing history. But Crowther and Dupree's study of the lives of the 1,938 medical students who matriculated at the Universities of Edinburgh and Glasgow in the period from 1866 to 1874 shows that there are substantial rewards to be reaped by those who are prepared to invest the necessary effort. Doctors lend themselves well to such study. By the time Crowther and Dupree's students entered university, medicine had achieved a high degree of awareness of itself as a profession, with sophisticated institutional networks through which that awareness was maintained. Doctors' individual and collective lives can consequently be traced through a wealth of published and archival sources, including registers of training and qualifications, professional directories, records of medical societies and associations, and obituaries. Doctors also left a wide range of literary and epistolary writings to augment the more functional records maintained by the profession. Consequently, Crowther and Dupree have been able to amass an immensely rich range of sources from which to reconstruct individual careers and to generalize about the kinds of patterns those careers, seen together, describe.

Their findings tell us much about the diverse career opportunities available to doctors who trained at the Scottish universities during the third quarter of the nineteenth century. Their results are broadly consonant with Anne Digby's in Making a Medical Living: Doctors and Patients in the English Market for Medicine 1720–1911.¹ However, they augment Digby's findings by including not only Scotland and Ireland within their purview but also by devoting two substantial chapters to the many medics who made part or all of their careers overseas. Moreover, their methods enable them to go considerably beyond Digby's conclusions by analyzing the factors that influenced what particular career paths different students were able to pursue. Although talent and hard work enabled a small number of students to rise to relative eminence from humble beginnings, class and the material and social resources afforded by family background were overwhelmingly influential in determining the opportunities that would be available to an aspiring young doctor. Gender was even more constraining: among Crowther and Dupree's cohort were the first female doctors to study in a British university medical school, and their stories make clear just how confined were the choices available to them. These broad generalizations are perhaps unsurprising. But Crowther and Dupree's sources also allow them to get below the level of generality to illuminate the many contingent factors and choices that could influence individual career paths. Thanks to this wealth of anecdote, Medical Lives in the Age of Surgical Revolution is not just an edifying portrait of a rising profession but also a pleasure to read.

Additionally, the book throws new light on the phenomenon of Listerism. Many of Crowther and Dupree's cohort were taught by Lister during his years in Glasgow and Edinburgh, and most would continue to define themselves as "Listerians" throughout their careers. From specialist surgeons in hospital operating theaters, to general practitioners performing domestic surgery, to society homeopaths: practically anyone could call themselves Listerians and be generally accepted as such by their peers. Seen in this light, Listerism appears less as a scientific school than as a social movement. Lister's principle of excluding germs from surgical and other wounds could be invoked to justify a diversity of practices, not all of which were commensurable with one another: there was no single Listerian paradigm. Nor does there seem to have been much effort to define a Listerian orthodoxy or police its boundaries. Listerism was more about professional solidarity than doctrinal purity—it was a banner under which a rising generation of predominantly provincial practitioners could lay claim to the innovative power of science and...