Companion Encyclopedia of the History of Medicine (review)

It is always difficult to review a reference book—especially one with this unusual self-description. What exactly is a “companion encyclopedia”? It is not organized like the familiar version of a traditional genre, an alphabetically organized and would-be comprehensive survey of accepted knowledge. Nor is it a dictionary: it is made up of essays, not entries. These two thick volumes are more like a multiauthored textbook than a standard encyclopedia—a series of synoptic essays amounting collectively to a synthetic history of (mostly Western) medicine.

On the whole, the editors have done a splendid job, both in recruiting a distinguished group of contributors and in dividing up and parceling out the subject-matter assignments. The chapters, moreover, are clustered in a creative and constructive fashion. An introductory section includes a number of orienting historiographic pieces; there follows a series of foundational essays on “Body Systems”—on the anatomical, microscopical, physiological, biochemical, pathological, and immunological approaches to understanding the body. A third section focuses on “Theories of Life, Health, and Disease,” and a fourth—and somewhat overlapping—section gathers together essays on “Understanding Disease.” A fifth set of contributions organizes itself around “Clinical Medicine”—including, for example, articles on diagnosis, therapeutics, medical ethics, surgery, and childbirth. “Medicine in Society” constitutes the sixth section, a group of contributions focusing on what might in past generations have been called the social relations of medicine—that is, on such issues as hospitals, nursing, medical education, and public health. A final section entitled “Medicine, Ideas, and Culture” is something of a residual or default section, but it includes a number of particularly useful essays—such as those on charity, philanthropy, imperialism, war, and medical technology. There are, altogether, seventy-two essays and somewhat over seventeen hundred pages of text.

This book should be in every medical library and would be a valuable addition to any large public reference collection. However, it will, I think, disappoint the casual reader searching for a standard encyclopedia essay; a high-school or college student, for example, looking up the dates and biography of Sydenham, would not find this the ideal reference tool. It is nevertheless indispensable for advanced students or scholars who want an introduction to the field in general, or to some aspect of it in particular. I have already recommended it to a number of graduate students preparing for a doctoral field examination in the history of medicine. Insofar, moreover, as such a thing as the humanistic physician still exists, these essays would speak to his or her needs. But I doubt somehow that it will serve as a “companion”—in the sense of resting comfortably in the lap of a reflective physician exhausted by clinical duties and seeking an understanding of medicine’s complex past and challenging present. Such humanistically inclined physicians are thin on the ground at the end of the twentieth century (and a good number of this minority, at least in the United States, would be more likely to consult a handbook of bioethics than one of the history of medicine).

The book’s content reflects, of course, the era in which it was organized and written. There is less on antiquity and the Middle Ages, for example, than there would have been a half-century ago, and there is less on the twentieth century and the non-West than there will be a generation from now. There is still comparatively little space allotted to certain issues prominent in today’s academic world; in regard to women, for example, there is only the previously mentioned essay on childbearing, another brief essay of twenty pages on nursing history, and a general essay with the traditional title of “Women and Medicine.” Despite such marginal quibbles, however, I have read this book with consistent admiration for its generally (although not invariably) consistent and coherent style and with gratitude to the well-informed authors who have contributed their time and intellectual energies to this project...