Book Review

The Greatest Benefit to Mankind: A medical history of humanity

N Engl J Med 1998; 339:54-55July 2, 1998

Article

The Greatest Benefit to Mankind: A medical history of humanity
By Roy Porter. 831 pp., illustrated. New York, W.W. Norton, 1997. $35. ISBN: 0-393-04634-6

There has not been a book of this scope since Garrison's An Introduction to the History of Medicine (Philadelphia: W.B. Saunders), the fourth edition of which appeared in 1929. In reviving the single-authored, encyclopedic, universal history, Roy Porter seeks to make serviceable for the 21st-century reader a model that ultimately derives from the positivistic German medical handbuch of the 19th century. That he has mixed success is probably due more to the way readers and writers have changed than to any deficiencies on his part.

Best known for his prolific contributions to the social history of medicine, especially the history of popular healers and mental illness, Porter here demonstrates a confident familiarity with the “great doctors” and much else. Although discussions of the former constitute the core of the book, discussions of the latter are substantive and brilliantly condensed and conveyed. Porter's recurrent examinations of epidemiology, public health and demography, medical institutions, the social role of medicine and its practitioners, women and medicine, and treatment of mental disorders at various periods reveal admirably how medical historiography has broadened and deepened since Garrison's era.

Nearly half the text of this book follows a chronologic course from prehistoric times to the end of the 18th century (including surveys of Islamic, Indian, and Chinese medicine), whereas the past two centuries are approached thematically and, as Porter acknowledges, selectively. There are chapters on “Medicine, State, and Society” and “Medicine and the People,” as well as chapters dealing with medical practice and research.

Throughout the book, Porter presents masterly introductory and concluding summaries of each section in a fluent, often amusing, and sometimes irreverent style. The text is enlivened by numerous quotes from lay and medical contemporaries. Although respecting his universalist goal, Porter explains that Western medicine receives the most attention because it has largely triumphed around the world, and he draws the majority of his historical case examples of professional and social developments from Great Britain (his own area of research).

What, then, are the problems with The Greatest Benefit to Mankind? The apparently few factual errors (several with respect to Vesalius, and the erroneous statement that Dr. Guillotin invented the instrument named after him), which are inevitable in such an ambitious survey, do not pose a serious problem, nor does the judicious coverage and balanced interpretation of medical history. Instead, as the extremely informative 45-page list of further readings (usefully rated by Porter with stars for those he has found most helpful) indicates, the problem is that medical historiography, particularly since around 1980, has experienced such a boom in quantity, quality, and diversity that no single-volume total history can hope to do more than briefly summarize while pointing the reader toward more extensive sources. Although readable, this book is dauntingly crammed with information that moves by at a rapid clip. It is likely to overwhelm the novice but hold few surprises for the specialist. It will probably find its greatest use as a modern, comprehensive, and reliable reference work, a point of entry to the literature and a valuable aid to those teaching the subject.

Toby Gelfand, Ph.D.
University of Ottawa Faculty of Medicine, Ottawa, ON K1H 8M5, Canada