Book Review

The Popularization of Medicine 1650-1850

N Engl J Med 1994; 331:1594-1595December 8, 1994

Article

The Popularization of Medicine 1650-1850
(Wellcome Series in the History of Medicine.) Edited by Roy Porter. 297 pp., illustrated. New York, Routledge, Chapman and Hall, 1993. $87.50. ISBN: 0-415-07217-4

It is easy, in the late 20th century, to acknowledge the importance of popularization in any well-rounded understanding of the social aspects of medicine. It is far harder to define “popularization” precisely and to study it in detail using specific historical cases. The authors of these essays strive to do just that -- to give the idea of popularization more precision and to chart its constituent processes in a historically focused manner. Most of the 10 chapters deal with the 18th and 19th centuries, and despite their broad geographic range (Britain, France, Spain, Hungary, and the United States), they return time and time again to two 18th-century figures, early heroes of popular medical writing -- William Buchan and Samuel Tissot. As a result the book has a sense of continuity. It is interesting to see how the advice Buchan and Tissot gave was received in different countries and to appreciate something of the ideological agendas involved. However, rather too many of the contributions limit themselves to describing popular medical publications and fail to offer satisfying historical explanations.

A number of the contributors go beyond simplistic views of popularization, in which knowledge from an elite source is simplified for a less well educated audience that is considered relatively passive. Books can be interpreted in a variety of ways, but the mere fact of ownership reveals little of how they were used and read. Although direct evidence on such matters is always hard and sometimes impossible to find, Andrew Wear and Mary Fissell, both writing about early modern England, suggest ways in which historians can think constructively about the impact of vernacular medical texts. Roy Porter's contribution helps draw attention to the overtly political language of many popular works -- for example, in their stress on democratizing medicine and reforming its abuses.

The star piece of The Popularization of Medicine is undoubtedly the last one, which comes at the topic from a wholly original angle. Stephen Jacyna examines the quest of one British patient for a cure in the mid-1820s. The documentation for this case is exceptionally rich and allows us an insight into what patients knew about medicine, where they got their knowledge, and how they used it. The patient in question was a gentleman, but he was also a layman and a client, and what happened to him and his response to his own illness shed considerable light on the concept of popularization.

Jacyna weaves these questions into general debates about how early-19th-century medicine should be interpreted; hence, his chapter has broad relevance for medical history.

Porter has edited a useful book. It is accessible and will be particularly helpful in teaching. It should encourage others to venture into this important but challenging subject.

Ludmilla Jordanova
University of York, Heslington, York Y01 5DD, United Kingdom