The Making of Modern Medicine: Turning Points in the History of Disease (review)

This slender volume takes the reader through a ‘greatest hits’ of Michael Bliss’s own work as an historian of medicine and Canada. The structure and concept for the book was born out of the lectures that Bliss gave for the Joanne Goodman series at the University of Western Ontario in 2008, and charts the progression from religious fatalism to the age of fervent belief in medicine’s ability to cure disease, save lives, and soothe souls. Building upon themes and incidents covered in his previous works, Bliss examines three key turning points in medical science between 1885 and 1922 to show the evolution of society’s relationship with health. First, he turns to the last great outbreak of smallpox in the Western world at Montreal in 1885, which established the benchmark for the religiously based fatalism that gradually evaporated by the end of the period. Then, Bliss traces the career of Sir William Osler, who had practiced in Montreal during the epidemic, and later brought his scientific, research-based approach to medicine to the 1893 founding of Johns Hopkins medical school in Baltimore. The final case study explores how the faith in scientific research that Osler instilled at Hopkins was taken up at other medical schools and contributed to the discovery of insulin at the University of Toronto in 1922.

Each of the case studies has a Canadian connection, and Bliss suggests that Canada continually punched above its weight where health care was concerned. Canada can certainly claim Sir William Osler as its own, and the insulin therapy for diabetes was an unquestionably important contribution to the history of medicine. Moreover, the importance of the North Atlantic triangle and the multinational character of scientific discovery is a constant refrain. Canada was able to play such a pivotal role in the forward march of medical science by virtue of its place between Great Britain and the United States. Bliss also alludes to the funding structures of Canadian hospitals, medical schools, and scientific laboratories – another area of overlap between American philanthropy and Canadian achievement that underscores the international nature of scientific discovery in the period that continues to have relevance today.

The central theme that links the entire narrative together is the gradual substitution of faith in the healing power of medicine for the traditional religious acceptance of disease and death. Given the prominent place occupied by Sir William Osler in each of the episodes that Bliss recounts, it is perhaps unsurprising that the intersection of faith and science underpins the entire volume. As the son of a clergyman, Osler was well-acquainted with the consolation that religion could provide at the time of an individual’s death. Over the course of his life, he witnessed the turn away from religious fatalism and belief in God to the secular faith in health care, evidenced not least by the tendency to deify physicians. Furthermore, with the elongation of life comes a fear of mortality, and the tendency to disparage physicians who are unsuccessful in their attempts to stave off fatal disease is the clear legacy of the progression from religion to science as the basis for society’s understanding of the force that is responsible for determining life and death.

For all the breadth in this short study, Bliss’s argument continually returns to advancements in laboratory science. Though he is attentive to the role of religion and poverty in influencing the response of Montrealers to vaccination campaigns in the 1880s, and emphasizes the contributions of philanthropic organizations in funding the medical research itself, these factors serve as mere supporting characters in the larger narrative. In orienting the book thus, Bliss devalues the impact that improved nutrition, sanitation, and housing had on the morbidity and mortality of Canadians and people around the world. The tension between the magic bullet cures and public health measures that have the capacity to improve the health of entire populations is...