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BOOK REVIEWS Medicine and Society in Wakefield and Huddersfield, 1780—1870. By Hilary Marland . New York: Cambridge University Press, 1987. Pp. 503. $59.50. Professional and Popular Medicine in France, 1770-1830. By Matthew Ramsey. New York: Cambridge University Press, 1988. Pp. 406. $49.50. The quality of volumes in the Cambridge History of Medicine has generally been very high, and the two books under review here join that worthy company with honor. Hilary Marland's Medicine and Society in Wakefield and Huddersfield, 1780—1870 and Matthew Ramsey's Professional and Popular Medicine in France, 1770-1830 tell us both something about the practice of health care in the late eighteenth and early nineteenth centuries and something about the practice of modern social historians of medicine. Marland and Ramsey have a good deal in common in their discussions of the worlds of medicine in the time of the French and Industrial Revolutions. They agree that a wide spectrum of medical practitioners must be considered; both accept only a simple legal definition of "regular" or "fringe" practice that does notjudge expertise or the efficacy of the therapies offered. Both believe that the entire social context of medicine is important—context that reveals the social and economic pressures favoring one style of medicine over another, that considers the social position and prospects of the practitioner, and that explores the mentality of a population in order to understand conceptions of health and disease. Both find that (at least in the period of their concern) the consumers of health care wielded considerable power, which forced practitioners to become entrepreneurs. And while neither Marland nor Ramsey would admit that they write medical history without mentioning the medicine (as the Journal of the History of Medicine, referred to by Ramsey, said on another occasion), both authors give relatively short shrift to ideas and techniques concerning diagnostics, therapeutics, nosology, and etiology—especially those emanating from the camp of the established physicians. Their books differ in some important respects. While both would agree on the importance of regional variations in medical practice, Hilary Marland (as her title makes clear) has undertaken a deliberately narrow regional study, confining herself to two towns and their immediate hinterlands in the West Riding of Yorkshire. In some respects therefore her book is modest, although her findings should contribute to larger generalizations about practice in England as a whole. Permission to reprint a book review printed in this section may be obtained only from the author. 460 Book Reviews Matthew Ramsey performs a more ambitious and synthetic task, surveying the entire French scene; he pays frequent attention to regional differences, but hopes that his work may inspire more local studies—presumably of the sort illustrated by Marland. Perhaps because of the different scales of their works, perhaps because of their different training, and perhaps because they wanted it so, Marland and Ramsey have different historical styles as well. Both illustrate some modern trends in historical writing, and the differences are of degree rather than kind. Marland's history has elements of the sociological and the institutional: she seems happiest when in the possession of quantifiable data (when she can find them), and she works easily and fluently with the framework of institutional structures, whether of medicine or of local government. Ramsey has more concern with mentalités, and with the intersections of history and ethnology ; although one of his major conclusions relates the importance of politics to the profession of medicine in France, he paradoxically gives less attention to the effect of government on day-to-day practice than does Marland. That paradox may grow out ofthe national (as opposed to the local) focus ofhis study, or ft may reflect differences between French and English societies in this period. Beginning her book with a general examination of the social and economic features of her two towns, Marland then proceeds to their medical institutions and practitioners. Wakefield—and to a lesser extent Huddersfield—possessed a reasonable number of practitioners in the late eighteenth and early nineteenth centuries, and, while the overall growth of population probably exceeded the growth in the number of physicians in the nineteenth century, Marland believes that the proportion of physicians...


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