History of Medicine: A Scandalously Short Introduction (review)

Jacalyn Duffin. History of Medicine: A Scandalously Short Introduction. Toronto: University of Toronto Press, 1999. xvi + 432 pp. Ill. $65.00 (cloth), $24.95 (paperbound).

Jacalyn Duffin, who teaches at Queen's University, Kingston, has produced a quite exemplary introductory textbook for students. It is well organized and expressed in clear and accessible language. It is lively and engaging. Its scholarship and historiography are up-to-date. It earns high marks for accuracy--though this British reviewer was amused to find the late-Enlightenment chemist and philosopher twice turned mysteriously into Joseph B. Priestley. Above all, it displays a sure sense of what it is about.

Rightly recognizing that any attempt to sprint in just four hundred pages through the entire history of medicine, from the Paleolithic to the present, would produce a complete blur of names and dates--a modern Garrison--Professor Duffin has opted to be selective. She has sensibly gone in for a thematic breakdown, in successive chapters covering key developments in anatomy, physiology, pathology, and so forth. This is an approach that inevitably has weaknesses as well as strengths. On the positive side, it encourages a focus on questions, problems, and changing paradigms. More negatively, to isolate disciplines in this way means that medicine's complex interactivity is sidelined--insufficient feel is conveyed of the symbiosis, at any particular time, between science, medicine (theory and practice), and society, and between medical thought and medical institutions. There are some welcome inclusions: a fine chapter on blood; another, as one might expect from the biographer of Laennec, on technology and disease, centered on the stethoscope; and a lively account of the history of pediatrics. Among the regrettable (if perhaps unavoidable) exclusions are public health, medicine and the state, and any but the most token mention of non-Western and alternative medicine.

What makes this Scandalously Short Introduction genuinely innovative is that it is expertly crafted as a teaching tool, explicitly targeted at medical students--to whom it is affectionately dedicated; indeed, the precise educational aims of each chapter are formally tabulated. With this pedagogical mission in mind, Professor Duffin opens with a discussion of saints-and-sinners histories, and explains how to wean students off their heroes. The body of the text engages with methodological issues often found problematic by medical students, most notably the perils of presentism. And the book concludes with a lively chapter called "Sleuthing and Science: How to Research a Question in Medical History," a guide to writing a student project or dissertation that is particularly valuable regarding the use of electronic information and online resources. Appendices include listings of Nobel Prize winners, library catalogs, and journals in the history of medicine. And the whole text is helpfully sprinkled with quotations and anecdotes in side-boxes, alongside excellent photos, tables, time-lines, and graphs.

This user-friendly quality is greatly to be welcomed. The lack of a medical history textbook specifically designed to meet the needs of today's medical students has often been deplored. The gap has now been filled, and I can only say that, to judge by this book, Professor Duffin's students are a lucky bunch.

The snag for all non-Canadian readers is that the text is primarily targeted at a Canadian readership, incorporating a quite disproportionate number of examples drawn from Canadian physicians and the Canadian health-care system. Ever since William Osler, of course, Canada has had its fair share of distinguished medical practitioners; it is no bad thing to have the story of diabetes told once again; and non-Canadian readers need to be familiar with the workings of Canada's public medical service. But too often for comfort, the rest of the story is marginalized or sacrificed for Canadian materials. Thus, respecting the influenza pandemic of 1918-19, we are told that the epidemic killed fifty thousand Canadians, but we are not given the slightest indication of the fatality total worldwide...