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Doody's Review ServiceReviewer: Robert L. Martensen, MD, PhD (University of Kansas Medical Center)
Description: Based on extensive research of hospital and medical society records in 18th century London, Susan Lawrence explains how charity patients became teaching objects and how hospitals became de facto medical schools. She demonstrates that hospital practitioners gradually gained authority through their clinical teaching, research, and social status in London's urban medical culture, thereby transforming the old tripartite division of physicians, surgeons, and apothecaries into a loosely unified group of de facto general practitioners dominated by hospital men.
Purpose: A major purpose of the book is to show the crucial role of hospital-based practitioners in the transformation of the three traditional medical occupations — physician, surgeon, and apothecary — into the modern medical profession before the advent of organic chemistry, systematic microscopy, or anesthesia.
Audience: The book should interest students of medical philanthropy, medical education, hospitals, professionalization, and English social history.
Features: The notes, references, and index are first-rate. Of particular interest to historians are the numerous tables and graphs illustrating the composition of hospital staffs and medical publications in 18th century London.
Assessment: Written clearly and subtly, the book explores many shifting interactions among institutions, ideas, values, and careers. In doing so, it reveals the ways voluntary London hospitals shaped the identities of staff physicians and surgeons whose charitable work consolidated their elite status. For those who wish to know more about the formation of modern medical authority and its relationship to the formation of the modern teaching hospital and medical philanthropy, the book is a valuable resource.