Medicine in the Making of Modern Britain, 1700-1920

This book is part of Routledge’s Historical Connections series of short books that promise “original and challenging works of synthesis that will make new themes accessible, or old themes accessible in new ways, build bridges between different chronological periods and different historical debates, and encourage comparative discussion in history” (Series editors’ preface). This volume proposes to explain how British medicine took its present form, and how medicine claimed the place it occupies in contemporary British society. It has a brief introduction and even shorter conclusion but offers the bulk of its discussion in three chapters—one on the eighteenth century, one on the early and middle decades of the nineteenth century, and one on the period from about 1870 to 1920. Since these chapters are very short, collectively occupying only sixty-five pages, achieving synthesis in addressing the major problems the book is designed to discuss becomes a very tall order.

Christopher Lawrence has nevertheless been remarkably successful in synthesizing much of the best of recent historical scholarship on British medicine. The discussion twists and turns as he finds ways to incorporate the generalizations and claims from the substantial list of secondary works in his bibliography. For the most part the transitions are smooth and graceful. Although the discussion ranges very widely, three processes receive repeated attention: the creation of a bounded profession, medicine’s assumption of a role in running modern society, and medicine’s role in creating the explanatory categories used in modern life.

Specialized quibbles are probably out of place in reviews of works like this one. It is obvious that in a book of this sort no topic can be pursued so that its subtleties are explored, nor can the variety of historical interpretations of other issues be introduced. I do regret the omission of a couple of topics that seem to beg for inclusion—the entrance of women into the medical profession, and of middle-class patients into hospitals. The work’s greatest weakness is imposed by the publisher’s restriction on length. Reading Medicine in the Making of Modern Britain is a bit like watching a videotape at fast-forward. If one has read many of the works in the bibliography it is possible to follow the author’s argument, appreciate the effort of synthesis, and occasionally find fresh insights, just as one who has previously seen the videotape at normal speed can follow the action at fast-forward. However, I fear that readers who are new to the history of medicine—the apparent target audience for this series—will find the discussion frequently cryptic and occasionally confusing.