Two Views : Bad Medicine: Doctors Doing Harm Since Hippocrates

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This is book unashamedly revolutionizes the "history of medicine." Published by a major university press, it breaks through conceptual barriers that until now have confined studies in that field to the fringes of the discipline of history as a whole.

Bad Medicine should challenge Social Historians no less than it does medical historians. As readers will soon see, Wootton's trail-blazing study is all about "attitudes" and in particular about the attitudes of university-educated members of the medical profession in times past and in the present. As defined by Wootton, the presumed task of members of the medical profession has always been to prolong life, by actually curing disease. But this they singularly failed to do during the long centuries between 250 BCE (Hippocrates) and the birth of those of our contemporaries who are only now nearing retirement age.

Wootton correctly attributes this failure to the cultural and psychological obstacles which for more than two thousand years prevented medical professionals from recognizing that the standard all-purpose cures (blood-letting, induced vomiting, induced diarrhea) that they had been taught to use by canonic texts (Galen, transmitted by way of the Canon of Avicenna, and then by direct translations of "Hippocrates" from Greek) nearly always did patients more harm than good. These "cures" shortened life, rather than prolonging it.

The book reminds us that during these two millennia, the lay elite (Custodians of medico-scientific knowledge) adamantly refused to stop patronizing the medical professionals who erroneously claimed they had the ability to cure. This was because they (as Custodians) labored under the illusion that the Wisdom and Knowledge possessed by the Ancients (ie ancient "Science") was of greater validity than the opinions expressed by their own non-university-educated contemporaries. Due to the continued financial and moral support they (as Custodians) gave to professionally-educated medical personnel, technological breakthroughs made by low-status persons in fields such as surgery and obstetrics and in trades other than medicine were pushed under the carpet and ignored for decades, and sometimes for centuries.

Wootton for instance tells us of the invention of a perfectly serviceable microscope by Antoni van Leeuwenhoek of Delft (Holland), a draper with no academic education, and his sighting of tiny heretofore unknown organisms under its lens in 1677. For sociological and cultural reasons, these discoveries (which might have led to germ theory—now recognized as central to the creation of modern medical theory and then of theory-practice) were not fully taken up by the medical profession until 1876 when Robert Koch of Prussia made his studies of anthrax (a disease of cattle and, more rarely, of humans). Even then, the conversion of "theory" into actual cures for diseases suffered by humans did not happen until thirty years later.

Wootton quite correctly reminds readers that the history of medicine in the West is the history of Discontinuity, of time wasted, and of the early deaths of millions of people who might have lived a few years longer than they did. It is the history of technologies ignored, of theories ignored, and of blind trust in the Authority of the (secular) Ancients. Modern curative medicine could not come into being until medical professions took it upon themselves to junk the Received Wisdom of the Past and to start afresh, with the active support and encouragement of the lay Custodians of medical knowledge. Wootton, perhaps, does not sufficiently emphasis the fact that this situation most notably pertained in the rump kingdom of Prussia after its humiliating defeat by Napoleon in 1806. In that polity, ruling elites and finance officers were not bitten by the bugs of "possessive individualism" and of quests for overseas Empire (English diseases) and were willing to wait decades until such time as laboratory-based experimental medical theories finally led to the creation of new techniques that actually worked. Programs designed along these lines were instituted at the new University of Berlin (founded in 1809) and in...