"On Second Thought" and Other Essays in the History of Medicine and Science (review)

In 1977 Owsei Temkin published a selection of his essays in his well-received The Double Face of Janus (Baltimore, The Johns Hopkins University Press). This book, another collection of previously published essays, is a sequel to that volume. Among the topics discussed are ethics in medicine (including a revised version of his classic essay on the Hippocratic Oath), medical libraries, the history of nutritional and drug therapies, the history of science in the time of Copernicus, phrenology in the time of Gall, and the place of Galen in the history of medicine. The book is introduced by a thoughtful, personal chapter in which he discusses his “second thoughts” about the history and historiography of medicine in the one-hundredth year of his life. [Editor’s Note: The distinguished historian of medicine, Owsei Temkin, M.D., former director of the Institute of the History of Medicine at The Johns Hopkins University and William H. Welch Professor Emeritus, died July 18, 2002. He was 99. The Journal of the History of Medicine notes with sorrow the enormous loss of Dr. Temkin.]

Given that the infirmities of old age have long made it extremely difficult for Dr. Temkin to travel or attend meetings and conferences, it is unlikely that many readers of the Journal know him personally. However, the essays in this book clearly illustrate why he is one of the legendary figures in our field. The range of his scholarship is astonishing. He writes thoughtfully and incisively about the history of medicine as a whole—in all times, places, and aspects, from the Hippocratic period through our own. His command of the intellectual development of medicine is unmatched. No one is better than he in deftly tracing the evolution of an idea or practice from antiquity through the present. Yet he also keenly appreciates the social context of medicine—that physicians and patients are human actors, that the history of medicine is deeply embedded in culture as well as in science, and that history is untidy and frequently much more complex than portrayed in textbooks. He writes with unusual clarity, insight, and force, and he often teaches by example or raising questions rather than by fiat.

Perhaps Temkin’s most impressive gift—which is abundantly clear in these essays—is his ability to make the history of medicine come alive for the current generation of students and practitioners of medicine. Medical ideas, practices, and techniques are continually evolving, which is why so many doctors mistakenly think that discarded ideas of the past have no relevance to their current concerns. However, many dilemmas of medicine are timeless, and no one uses the history of medicine to demonstrate this point more effectively than Temkin. The doctor-patient relationship, the conflict between the individual and the public, the reliance of medical research on reason and experience, the factors that led some doctors to experiment on themselves at the expense of their own health, or that led other doctors to stand firm in spite of resistance and ridicule that confronted their work—these are but a few of the ways that the past not only preceded us but is very much with us now. To Temkin, the goal of the history of medicine is not merely to relate the ideas and practices of the past but to try to fathom the patient’s experience of being ill and the efforts of doctors and other healers to prevent and relieve suffering. The history of medicine shows not only “that many of the problems facing us today also faced past generations under conditions different from ours but also illustrates how differently doctors understood their task and shaped their lives and how they have become models for possible emulation or...