The Greatest Benefit to Mankind: A Medical History of Humanity from Antiquity to the Present / Edition 1

Paperback (Print)
Buy Used
Buy Used from BN.com
$14.68
(Save 41%)
Item is in good condition but packaging may have signs of shelf wear/aging or torn packaging.
Condition: Used – Good details
Used and New from Other Sellers
Used and New from Other Sellers
from $5.00
Usually ships in 1-2 business days
(Save 79%)
Other sellers (Paperback)
  • All (38) from $5.00   
  • New (11) from $11.66   
  • Used (27) from $5.00   

Overview

"To combine enormous knowledge with a delightful style and a highly idiosyncratic point of view is Roy Porter's special gift, and it makes [this] book . . . alive and fascinating and provocative on every page."—Oliver Sacks, M.D.

Hailed as "a remarkable achievement" (Boston Sunday Globe) and as "a triumph: simultaneously entertaining and instructive, witty and thought-provoking . . . a splendid and thoroughly engrossing book" (Los Angeles Times), Roy Porter's charting of the history of medicine affords us an opportunity as never before to assess its culture and science and its costs and benefits to mankind. Porter explores medicine's evolution against the backdrop of the wider religious, scientific, philosophical, and political beliefs of the culture in which it develops, covering ground from the diseases of the hunter-gatherers to today's threat of AIDS and ebola, from the clearly defined conviction of the Hippocratic oath to the muddy ethical dilemmas of modern-day medicine. Offering up a treasure trove of historical surprises along the way, this book "has instantly become the standard single-volume work in its field" (The Lancet). "The author's perceptiveness is, as usual, scalpel-sharp; his manner genially bedside; his erudition invigorating." - Simon Schama

"...praised by Sherwin Nuland & Oliver Sacks for its thorough & intriguing look at medicine's evolution & the societal & cultural revolutions it instigated...details changes in public health & medical specialties & practices."

Read More Show Less

Editorial Reviews

Thomas Laqueur
...Porter is on to something important here and the tension between his two narratives — the Exodus narrative of liberation from ignorance and disease, the other its ironic doppelganger — suffuses his book....Porter's is perhaps the first major post-Holocaust undertaking of its kind and we will never be able to view the history of medicine in as sanguine a way as we once did....Porter ends inconclusively and perhaps that is the best we can do for now.
London Review of Books
LA Times
Porter's latest book demonstrates anew his daring and his erudition....A t riumph, simultaneously entertaining and instructive, witty and thought-provoking....Splendid and thoroughly engrossing.
Boston Sunday Globe
Remarkable...A vivid, cautionary tale...brisk without being breathless, comprehensive without being tedious, rigorous without being obscure, judicious without being jejune.
Publishers Weekly - Publisher's Weekly
Porter's magisterial chronicle of medical thinking and practice deserves the popularity of his bestselling London: A Social History. Neither demonizing nor glorifying modern high-tech medicine, his epic history underscores the enormous progress achieved when Western medical science, by dint of anatomical and physiological investigations beginning in the Renaissance, broke decisively with the world's traditional medical systemsancient Greek, Chinese, Indian Ayurvedic, herbalism, and the likewhich viewed health as a precarious balance among the body, the universe and society. At the same time, he is nonjudgmental, examining each healing system on its own terms for possible value today. Although the scope of Porter's account of physicians, theories, advances and diseases can be daunting, he leavens his presentation with allusions to Molire, Boccaccio, Swift, Pepys and Maugham, and extends his analysis of medicine's social dimensions to patient-doctor relations, medical responses to insanity, the influx of women healers into a male monopoly, the politics of public health and the intertwining of medicine with colonization, conquest, urban growth and religion. Finally, he weights the breakthroughs of the last 50 years in genetics, immunology, bacteriology and psychopharmacology against a record of disastrous drugs, iatrogenic (physician-induced) illness, medicalization of normal events, unequal access to health care, emerging lethal viral diseases and the intractability of chronic disorders. His diagnoses: modern medicine urgently needs to redefine its goals and priorities. Written with storytelling flair and erudition, this study will be of interest to laypersons and professionals alike. Porter is a professor of the social history of medicine in London. (Apr.)
KLIATT
This sweeping, fascinating history won a Los Angeles Times Book Award and was a New York Times Notable Book of 1998. It is clearly written without obfuscatory jargon, has an easy chronological table of contents to follow, useful illustrations and a well-constructed index. All in all, it's an excellent book for any high school student doing research on medical history. Chapters on Antiquity, the Medieval West, Indian Medicine, the Renaissance, etc. run 15-50 pages. Porter is a professor of the social history of medicine, and his comfort ranging widely over diverse material is obvious and a benefit to all readers. KLIATT Codes: SA—Recommended for senior high school students, advanced students, and adults. 1997, Norton, 831p, 24cm, bibliog, index, 98-10219, $17.95. Ages 16 to adult. Reviewer: Daniel J. Levinson; History and English Teacher, Thayer Acad., Braintree, MA, May 2000 (Vol. 34 No. 3)
Library Journal
Porter examines what healers have done and the impact of their ideas and actions. His focus is on Western medicine "because Western medicine has developed in ways which made it uniquely powerful and...uniquely global." (LJ 2/15/98) Copyright 1999 Cahners Business Information.
Library Journal
A new, comprehensive book on the history of medicine has been long overdue since the 1940s, and there is no one better to write it than Porter, a professor at the Wellcome Institute for the History of Science in London and author of The Cambridge Illustrated History of Medicine (Cambridge Univ., 1997). Here he thoroughly covers all aspects of medicine from classical antiquity and ancient Chinese medicine through modern public health. Insightful and convincing, Porter makes the people who discovered or performed landmark acts come alive to the reader. Social, political, and religious issues related to medicine are also discussed. This is a great work that will be used for a very long time. Eric D. Albright, Duke Medical Ctr. Lib., Durham, N.C.
David A. Hollinger
Porter places the triumphs of modern scientific medicine in the context of centuries of resignation in the presence of unstoppable, mysterious diseases.... Porter's crisply written, often entertaining history alternates between devastating epidemiological events, like the Black Death of the 14th century, and the routine pains and infirmities confronted by amateur and professional healers the world over. -- David A. Hollinger, The New York Times Book Review
NY Times Book Review
A prodigious history of medicine from antiquity through issues like H.M.O.'s, tobacco companies and Dr. Jack Kevorkian.
Thomas Laqueur
...Porter is on to something important here and the tension between his two narratives — the Exodus narrative of liberation from ignorance and disease, the other its ironic doppelganger — suffuses his book....Porter's is perhaps the first major post-Holocaust undertaking of its kind and we will never be able to view the history of medicine in as sanguine a way as we once did....Porter ends inconclusively and perhaps that is the best we can do for now.
London Review of Books
Kirkus Reviews
A learned, lively history of medicine "from Stone Age to New Age, from Galen to Gallo. Unable to find a modern, readable, one-volume history of medicine for his students, Porter (A Social History of Madness, 1988, etc.), of London's Wellcome Institute for the History of Science, has filled that gap admirably with this fascinating survey of medical theory and practice through the centuries. While he looks at medicine in early societies, and Islamic, Indian, and Chinese medicine, his focus is on Western medicine, which he finds uniquely powerful and now uniquely global. He explores its foundations in ancient Greece and Rome, the impact of the new science of the Renaissance, and the initial failure of biomedical findings to deliver effective new therapies. The accomplishments of individuals are here's Harvey, Koch, Pasteur, Lister, Freud., etc. but Porter does not tell history simply through great men. The influence of French hospitals on medical education; how German laboratories created a new pathology, physiology, and pharmacology; the development of specialization; public health measures; medicine's role in the expansion of imperial powers all are included. In stylish prose, he paints a panoramic picture filled with memorable anecdotes, apt quotes, startling statistics, and sobering conclusions. At intervals he returns to specific topics, such as treatment of the insane, to demonstrate the shifts taking place in both social attitudes and medical practice. Approaching modern times, Porter reports on the great strides made in biomedical research, paying special attention to neurology, endocrinology, cancer, cardiology, genetics, and immunology. In his closing chapters, he turns tothe politics of contemporary medicine, examining the changing relationship between the state and medicine and between medicine and the people. Never before, he notes, has medicine achieved so much nor attracted such great suspicion. With its triumphs "dissolving in disorientation," medicine, warns Porter, must now redefine its limits. Thoroughly impressiveþmerits a broad lay readership in addition to med students.
Read More Show Less

Product Details

  • ISBN-13: 9780393319804
  • Publisher: Norton, W. W. & Company, Inc.
  • Publication date: 10/28/1999
  • Series: Norton History of Science Series
  • Edition number: 1
  • Pages: 872
  • Sales rank: 306,258
  • Product dimensions: 6.20 (w) x 9.20 (h) x 1.50 (d)

Meet the Author

The late Roy Porter was professor of the history of medicine at University College, London. His books include The Greatest Benefit to Mankind, winner of the Los Angeles Times Book Award.

Read More Show Less

Read an Excerpt

The Greatest Benefit to Mankind

A Medical History of Humanity
By Roy Porter

W. W. Norton & Company

Copyright ©1999 Roy Porter
All right reserved.

ISBN: 0393319806


CHAPTER ONE

INTRODUCTION

THESE ARE STRANGE TIMES, when we are healthier than ever but more anxious about our health. According to all the standard benchmarks, we've never had it so healthy. Longevity in the West continues to rise -- a typical British woman can now expect to live to seventy-nine, eight years more than just half a century ago, and over double the life expectation when Queen Victoria came to the throne in 1837. Break the figures down a bit and you find other encouraging signs even in the recent past; in 1950, the UK experienced 26,000 infant deaths; within half a century that had fallen by 80 per cent. Deaths in the UK from infectious diseases nearly halved between 1970 and 1992; between 1971 and 1991 stroke deaths dropped by 40 per cent and coronary heart disease fatalities by 19 per cent -- and those are diseases widely perceived to be worsening.

The heartening list goes on and on (15,000 hip replacements in 1978, over double that number in 1993). In myriad ways, medicine continues to advance, new treatments appear, surgery works marvels, and (partly as a result) people live longer. Yet few people today feel confident, either about their personal healthor about doctors, healthcare delivery and the medical profession in general. The media bombard us with medical news -- breakthroughs in biotechnology and reproductive technology for instance. But the effect is to raise alarm more than our spirits.

The media specialize in scare-mongering but they also capture a public mood. There is a pervasive sense that our well-being is imperilled by 'threats' all around, from the air we breathe to the food in the shops. Why should we now be more agitated about pollution in our lungs than during the awful urban smogs of the 1950s, when tens of thousands died of winter bronchitis? Have we become health freaks or hypochondriacs luxuriating in health anxieties precisely because we are so healthy and long-lived that we have the leisure to enjoy the luxury of worrying?

These may be questions for a psychologist but, as this book aims to demonstrate, they are also matters of historical inquiry, examining the dialectics of medicine and mentalities. And to understand the dilemmas of our times, such facts and fears need to be put into context of time and place. We are today in the grip of opposing pressures. For one thing, there is the 'rising-expectations trap': we have convinced ourselves that we can and should be fitter, more youthful, sexier. In the long run, these are impossibly frustrating goals, because in the long run we're all dead (though of course some even have expectations of cheating death). Likewise, we are healthier than ever before, yet more distrustful of doctors and the powers of what may broadly be called the 'medical system'. Such scepticism follows from the fact that medical science seems to be fulfilling the wildest dreams of science fiction: the first cloning of a sheep was recently announced and it will apparently be feasible to clone a human being within a couple of years. In the same week, an English widow was given permission to try to become pregnant with her dead husband's sperm (but only so long as she did it in Belgium). These are amazing developments. We turn doctors into heroes, yet feel equivocal about them.

Such ambiguities are not new. When in 1858 a statue was erected in the recently built Trafalgar Square to Edward Jenner, the pioneer of smallpox vaccination, protests followed and it was rapidly removed: a country doctor amidst the generals and admirals was thought unseemly (it may seem that those responsible for causing deaths rather than saving lives are worthy of public honour). Even in Greek times opinions about medicine were mixed; the word pharmakos meant both remedy and poison -- 'kill' and 'cure' were apparently indistinguishable. And as Jonathan Swift wryly reflected early in the eighteenth century, 'Apollo was held the god of physic and sender of diseases. Both were originally the same trade, and still continue.' That double idea -- death and the doctors riding together -- has loomed large in history. It is one of the threads we will follow in trying to assess the impact of medicine and responses to it -- in trying to assess Samuel Johnson's accolade to the medical profession: 'the greatest benefit to mankind.'

'The art has three factors, the disease, the patient, the physician,' wrote Hippocrates, the legendary Greek physician who has often been called the father of, medicine; and he thus suggested an agenda for history. This book will explore diseases, patients and physicians, and their interrelations, concentrating on some more than others. It is, as its sub-title suggests, a medical history.

My focus could have been on disease and its bearing on human history. We have all been reminded of the devastating effects of pestilence by the AIDS epidemic. In terms of death toll, cultural shock and socio-economic destruction, the full impact of AIDS cannot yet be judged. Other 'hot viruses' may be coming into the arena of history which may prove even more calamitous. Historians at large, who until recently tended to chronicle world history in blithe ignorance of or indifference to disease, now recognize the difference made by plague, cholera and other pandemics. Over the last generation, distinguished practitioners have pioneered the study of 'plagues and peoples'; and I have tried to give due consideration to these epidemiological and demographic matters in the following chapters. But they are not my protagonists, rather the backdrop.

Equally this book might have focused upon everyday health, common health beliefs and routine health care in society at large. The social history of medicine now embraces 'people's history', and one of its most exciting developments has been the attention given to beliefs about the body, its status and stigmas, its race, class and gender representations. The production and reproduction, creation and recreation of images of Self and Other have formed the subject matter of distinguished books. Such historical sociologies or cultural anthropologies -- regarding the body as a book to be decoded -- reinforce our awareness of the importance, past and present, of familiar beliefs about health and its hazards, about taboo and transgression. When a body becomes a clue to meaning, popular ideas of health and sickness, life and death, must be of central historical importance. I have written, on my own and with others, numerous books exploring lay health cultures in the past, from a 'bottom-up', patients' point of view, and hope soon to publish a further work on the historical significance of the body.

This history, however, is different. It sets the history of medical thinking and medical practice at stage centre. It concentrates on medical ideas about disease, medical teachings about healthy and unhealthy bodies, and medical models of life and death. Seeking to avoid anachronism and judgmentalism, I devote prime attention to those people and professional groups who have been responsible for such beliefs and practices -- that is healers understood in a broad sense. This book is principally about what those healers have done, individually and collectively, and the impact of their ideas and actions. While placing developments in a wider context, it surveys medical theory and practices.

This approach may sound old-fashioned, a resurrection of the Whiggish 'great docs' history which celebrated the triumphal progress of medicine from ignorance through error to science. But I come not to praise medicine -- nor indeed to blame it. I do believe that medicine has played a major and growing role in human societies and for that reason its history needs to be explored so that its place and powers can be understood. I say here, and I will say many times again, that the prominence of medicine has lain only in small measure in its ability to make the sick well. This always was true, and remains so today.

I discuss disease from a global viewpoint; no other perspective makes sense. I also examine medicine the world over. Chapter 2 surveys the emergence of health practices and medical beliefs in some early societies; Chapter 3 discusses the rise of formal, written medicine in the Middle East and Egypt, and in Greece and Rome; Chapter 4 explores Islam; separate chapters discuss Indian and Chinese medicine; Chapter 8 takes in the Americas; Chapter 15 surveys medicine in more recent colonial contexts, and other chapters have discussions of disorders in the Third World, for instance deficiency diseases. The book is thus not narrowly or blindly ethnocentric.

Nevertheless, I devote most attention to what is called 'western' medicine, because western medicine has developed in ways which have made it uniquely powerful and led it to become uniquely global. Its ceaseless spread throughout the world owes much, doubtless, to western political and economic domination. But its dominance has increased because it is perceived, by societies and the sick, to 'work' uniquely well, at least for many major classes of disorders. (Parenthetically, it can be argued that western political and economic domination owes something to the path-breaking powers of quinine, antibiotics and the like.) To the world historian, western medicine is special. It is conceivable that in a hundred years time traditional Chinese medicine, shamanistic medicine or Ayurvedic medicine will have swept the globe; if that happens, my analysis will look peculiarly dated and daft. But there is no real indication of that happening, while there is every reason to expect the medicine of the future to be an outgrowth of present western medicine -- or at least a reaction against it. What began as the medicine of Europe is becoming the medicine of humanity. For that reason its history deserves particular attention.

Western medicine, I argue, his developed radically distinctive approaches to exploring the workings of the human body in sickness and in health. These have changed the ways our culture conceives of the body and of human life. To reduce complex matters to crass terms, most peoples and cultures the world over, throughout history, have construed life (birth and death, sickness and health) primarily in the context of an understanding of the relations of human beings to the wider cosmos: planets, stars, mountains, rivers, spirits and ancestors, gods and demons, the heavens and the underworld, and so forth. Some traditions, notably those reflected in Chinese and Indian learned medicine, while being concerned with the architecture of the cosmos, do not pay great attention to the supernatural. Modern western thinking, however, has become indifferent to all such elements. The West has evolved a culture preoccupied with the self, with the individual and his or her identity, and this quest has come to be equated with (or reduced to) the individual body and the embodied personality, expressed through body language. Hamlet wanted this too solid flesh to melt away. That -- except in the context of slimming obsessions -- is the last thing modern westerners want to happen to their flesh; they want it to last as long as possible.

Explanations of why and how these modern, secular western attitudes have come about need to take many elements into account. Their roots may be found in the philosophical and religious traditions they have grown out of. They have been stimulated by economic materialism, the preoccupation with worldly goods generated by the devouring, reckless energies of capitalism. But they are also intimately connected with the development of medicine -- its promise, project and products.

Whereas most traditional healing systems have sought to understand the relations of the sick person to the wider cosmos and to make readjustments between individual and world, or society and world, the western medical tradition explains sickness principally in terms of the body itself -- its own cosmos. Greek medicine dismissed supernatural powers, though not macrocosmic, environmental influences; and from the Renaissance the flourishing anatomical and physiological programmes created a new confidence among investigators that everything that needed to be known could essentially be discovered by probing more deeply and ever more minutely into the flesh, its systems, tissues, cells, its DNA.

This his proved an infinitely productive inquiry, generating first knowledge and then power, including on some occasions the power to conquer disease. The idea of probing into bodies, living and dead (and especially human bodies) with a view to improving medicine is more or less distinctive to the European medical tradition. For reasons technical, cultural, religious and personal, it was not done in China or India, Mesopotamia or pharaonic Egypt. Dissection and dissection-related experimentation were performed only on animals in classical Greece, and rarely. A medicine that seriously and systematically investigated the stuff of bodies came into being thereafter -- in Alexandria, then in the work of Galen, then in late medieval Italy. The centrality of anatomy to medicine's project was proclaimed in the Renaissance and became the foundation stone for the later edifice of scientific medicine: physiological experimentation, pathology, microscopy, biochemistry and all the other later specialisms, to say nothing of invasive surgery.

This was not the only course that medicine could have taken; as is noted below, it was not the course other great world medical systems took, cultivating their own distinct clinical skills, diagnostic arts and therapeutic interventions. Nor did it enjoy universal approval: protests in Britain around 1800 about body-snatching and later antivivisectionist lobbies show how sceptical public opinion remained about the activities of anatomists and physicians, and suspicion has continued to run high. However, that was the direction western medicine followed, and, bolstered by science at large, it generated a powerful medicine, largely independent of its efficacy as a rational social approach to good health.

The emergence of this high-tech scientific medicine may be a prime example of what William Blake denounced as 'single vision', the kind of myopia which (literally and metaphorically) comes from looking doggedly down a microscope. Single vision has its limitations in explaining the human condition; this is why Coleridge called doctors 'shallow animals', who 'imagine that in the whole system of things there is nothing but Gut and Body'. Hence the ability of medicine to understand and counter pathology has always engendered paradox. Medicine has offered the promise of 'the greatest benefit to mankind', but not always on terms palatable to and compatible with cherished ideals. Nor has it always delivered the goods. The particular powers of medicine, and the paradoxes its rationales generate, are what this book is about.

* * *

It may be useful to offer a brief resume of the main themes of the book, by way of a sketch map for a long journey.

All societies possess medical beliefs: ideas of life and death, disease and cure, and systems of healing. Schematically speaking, the medical history of humanity may be seen as a series of stages. Belief systems the world over have attributed sickness to illwill, to malevolent spirits, sorcery, witchcraft and diabolical or divine intervention. Such ways of thinking still pervade the tribal communities of Africa, the Amazon basin and the Pacific; they were influential in Christian Europe till the 'age of reason', and retain a residual shadow presence. Christian Scientists and some other Christian sects continue to view sickness and recovery in providential and supernatural terms; healing shrines like Lourdes remain popular within the Roman Catholic church, and faith-healing retains a mass following among devotees of television evangelists in the United States.

In Europe from Graeco-Roman antiquity onwards, and also among the great Asian civilizations, the medical profession systematically replaced transcendental explanations by positing a natural basis for disease and healing. Among educated lay people and physicians alike, the body became viewed as integral to law-governed cosmic elements and regular processes. Greek medicine emphasized the microcosm/macrocosm relationship, the correlations between the healthy human body and the harmonies of nature. From Hippocrates in the fifth century BC through to Galen in the second century AD, 'humoral medicine' stressed the analogies between the four elements of external nature (fire, water, air and earth) and the four humours or bodily fluids (blood, phlegm, choler or yellow bile and black bile), whose balance determined health. The humours found expression in the temperaments and complexions that marked an individual. The task of hygiene was to maintain a balanced constitution, and the role of medicine was to restore the balance when disturbed. Parallels to these views appear in the classical Chinese and Indian medical traditions.

The medicine of antiquity, transmitted to Islam and then back to the medieval West and remaining powerful throughout the Renaissance, paid great attention to general health maintenance through regulation of diet, exercise, hygiene and lifestyle. In the absence of decisive anatomical and physiological expertise, and without a powerful arsenal of cures and surgical skills, the ability to diagnose and make prognoses was highly valued, and an intimate physician-patient relationship was fostered. The teachings of antiquity, which remained authoritative until the eighteenth century and still supply subterranean reservoirs of medical folklore, were more successful in assisting people to cope with chronic conditions and soothing lesser ailments than in conquering life-threatening infections which became endemic and epidemic in the civilized world: leprosy, plague, smallpox, measles, and, later, the 'filth diseases' (like typhus) associated with urban squalor.

This personal tradition of bedside medicine long remained popular in the West, as did its equivalents in Chinese and Ayurvedic medicine. But in Europe it was supplemented and challenged by the creation of a more 'scientific' medicine, grounded, for the first time, upon experimental anatomical and physiological investigation, epitomized from the fifteenth century by the dissection techniques which became central to medical education. Landmarks in this programme include the publication of De humani corporis fabrica (1543) by the Paduan professor, Andreas Vesalius, a momentous anatomical atlas and a work which challenged truths received since Galen; and William Harvey's De motu cordis (1628) which put physiological inquiry on the map by experiments demonstrating the circulation of the blood and the heart's role as a pump.

Post-Vesalian investigations dramatically advanced knowledge of the structures and functions of the living organism. Further inquiries brought the unravelling of the lymphatic system and the lacteals, and the eighteenth and nineteenth centuries yielded a finer grasp of the nervous system and the operations of the brain. With the aid of microscopes and the laboratory, nineteenth-century investigators explored the nature of body tissue and pioneered cell biology; pathological anatomy came of age. Parallel developments in organic chemistry led to an understanding of respiration, nutrition, the digestive system and deficiency diseases, and founded such specialities as endocrinology. The twentieth century became the age of genetics and molecular biology.

Nineteenth-century medical science made spectacular leaps forward in the understanding of infectious diseases. For many centuries, rival epidemiological theories had attributed fevers to miasmas (poisons in the air, exuded from rotting animal and vegetable material, the soil, and standing water) or to contagion (person-to-person contact). From the 1860s, the rise of bacteriology, associated especially with Louis Pasteur in France and Robert Koch in Germany, established the role of micro-organic pathogens. Almost for the first time in medicine, bacteriology led directly to dramatic new cures.

In the short run, the anatomically based scientific medicine which emerged from Renaissance universities and the Scientific Revolution contributed more to knowledge than to health. Drugs from both the Old and New Worlds, notably opium and Peruvian bark (quinine) became more widely available, and mineral and metal-based pharmaceutical preparations enjoyed a great if dubious vogue (e.g., mercury for syphilis). But the true pharmacological revolution began with the introduction of sulfa drugs and antibiotics in the twentieth century, and surgical success was limited before the introduction of anaesthetics and antiseptic operating-room conditions in the mid nineteenth century. Biomedical understanding long outstripped breakthroughs in curative medicine, and the retreat of the great lethal diseases (diphtheria, typhoid, tuberculosis and so forth) was due, in the first instance, more to urban improvements, superior nutrition and public health than to curative medicine. The one early striking instance of the conquest of disease -- the introduction first of smallpox inoculation and then of vaccination -- came not through 'science' but through embracing popular medical folklore.

From the Middle Ages, medical practitioners organized themselves professionally in a pyramid with physicians at the top and surgeons and apothecaries nearer the base, and with other healers marginalized or vilified as quacks. Practitioners' guilds, corporations and colleges received royal approval, and medicine was gradually incorporated into the public domain, particularly in German-speaking Europe where the notion of 'medical police' (health regulation and preventive public health) gained official backing in the eighteenth century. The state inevitably played the leading role in the growth of military and naval medicine, and later in tropical medicine. The hospital sphere, however, long remained largely the Church's responsibility, especially in Roman Catholic parts of Europe. Gradually the state took responsibility for the health of emergent industrial society, through public health regulation and custody of the insane in the nineteeth century, and later through national insurance and national health schemes. These latter developments met fierce opposition from a medical profession seeking to preserve its autonomy against encroaching state bureaucracies.

The latter half of the twentieth century has witnessed the continued phenomenal progress of capital-intensive and specialized scientific medicine: transplant surgery and biotechnology have captured the public imagination. Alongside, major chronic and psychosomatic disorders persist and worsen -- jocularly expressed as the 'doing better but feeling worse' syndrome -- and the basic health of the developing world is deteriorating. This situation exemplifies and perpetuates a key facet and paradox of the history of medicine: the unresolved disequilibrium between, on the one hand, the remarkable capacities of an increasingly powerful science-based biomedical tradition and, on the other, the wider and unfulfilled health requirements of economically impoverished, colonially vanquished and politically mismanaged societies. Medicine is an enormous achievement, but what it will achieve practically for humanity, and what those who hold the power will allow it to do, remain open questions.

The late E. P. Thompson (1924-1993) warned historians against what he called the enormous condescension of posterity. I have tried to understand the medical systems I discuss rather than passing judgment on them; I have tried to spell them out in as much detail as space has permitted, because engagement with detail is essential if the cognitive power of medicine is to be appreciated.

Eschewing anachronism, judgmentalism and history by hindsight does not mean denying that there are ways in which medical knowledge has progressed. Harvey's account of the cardiovascular system was more correct than Galen's; the emergence of endocrinology allowed the development in the 1920s of insulin treatments which saved the lives of diabetics. But one must not assume that diabetes then went away: no cure has been found for that still poorly understood disease, and it continues to spread as a consequence of western lifestyles. Indeed one could argue that the problem is now worse than when insulin treatment was discovered.

Avoiding condescension equally does not mean one must avoid 'winners' history. This book unashamedly gives more space to the Greeks than the Goths, more attention to Hippocrates than to Greek root-gatherers, and stresses strands of development leading from Greek medicine to the biomedicine now in the saddle. I do not think that 'winners' should automatically be privileged by historians (I have myself written and advocated writing medical history from the patients' view), but there is a good reason for bringing the winners to the foreground -- not because they are 'best' or 'right' but because they are powerful. One can study winners without siding with them.

Writing this book has not only made me more aware than usual of my own ignorance; it has brought home the collective and largely irremediable ignorance of historians about the medical history of mankind. Perhaps the most celebrated physician ever is Hippocrates yet we know literally nothing about him. Neither do we know anything concrete about most of the medical encounters there have ever been. The historical record is like the night sky: we see a few stars and group them into mythic constellations. But what is chiefly visible is the darkness.

Continues...


Excerpted from The Greatest Benefit to Mankind by Roy Porter Copyright ©1999 by Roy Porter. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Read More Show Less

Table of Contents

List of Figures
List of Illustrations
Acknowledgements
I Introduction 3
II The Roots of Medicine 14
III Antiquity 44
IV Medicine and Faith 83
V The Medieval West 106
VI Indian Medicine 135
VII Chinese Medicine 147
VIII Renaissance 163
IX The New Science 201
X Enlightenment 245
XI Scientific Medicine in the Nineteenth Century 304
XII Nineteenth-Century Medical Care 348
XIII Public Medicine 397
XIV From Pasteur to Penicillin 428
XV Tropical Medicine, World Diseases 462
XVI Psychiatry 493
XVII Medical Research 525
XVIII Clinical Science 561
XIX Surgery 597
XX Medicine, State and Society 628
XXI Medicine and the People 668
XXII The Past, the Present and the Future 710
Further Reading 719
Index 765
Read More Show Less

Introduction

THESE ARE STRANGE TIMES, when we are healthier than ever but more anxious about our health. According to all the standard benchmarks, we've never had it so healthy. Longevity in the West continues to rise -- a typical British woman can now expect to live to seventy-nine, eight years more than just half a century ago, and over double the life expectation when Queen Victoria came to the throne in 1837. Break the figures down a bit and you find other encouraging signs even in the recent past; in 1950, the UK experienced 26,000 infant deaths; within half a century that had fallen by 80 per cent. Deaths in the UK from infectious diseases nearly halved between 1970 and 1992; between 1971 and 1991 stroke deaths dropped by 40 per cent and coronary heart disease fatalities by 19 per cent -- and those are diseases widely perceived to be worsening.

The heartening list goes on and on (15,000 hip replacements in 1978, over double that number in 1993). In myriad ways, medicine continues to advance, new treatments appear, surgery works marvels, and (partly as a result) people live longer. Yet few people today feel confident, either about their personal health or about doctors, healthcare delivery and the medical profession in general. The media bombard us with medical news -- breakthroughs in biotechnology and reproductive technology for instance. But the effect is to raise alarm more than our spirits.

The media specialize in scare-mongering but they also capture a public mood. There is a pervasive sense that our well-being is imperilled by `threats' all around, from the air we breathe to the food in the shops. Why should we now be more agitated about pollution in our lungs than during the awful urban smogs of the 1950s, when tens of thousands died of winter bronchitis? Have we become health freaks or hypochondriacs luxuriating in health anxieties precisely because we are so healthy and long-lived that we have the leisure to enjoy the luxury of worrying?

These may be questions for a psychologist but, as this book aims to demonstrate, they are also matters of historical inquiry, examining the dialectics of medicine and mentalities. And to understand the dilemmas of our times, such facts and fears need to be put into context of time and place. We are today in the grip of opposing pressures. For one thing, there is the `rising-expectations trap': we have convinced ourselves that we can and should be fitter, more youthful, sexier. In the long run, these are impossibly frustrating goals, because in the long run we're all dead (though of course some even have expectations of cheating death). Likewise, we are healthier than ever before, yet more distrustful of doctors and the powers of what may broadly be called the `medical system'. Such scepticism follows from the fact that medical science seems to be fulfilling the wildest dreams of science fiction: the first cloning of a sheep was recently announced and it will apparently be feasible to clone a human being within a couple of years. In the same week, an English widow was given permission to try to become pregnant with her dead husband's sperm (but only so long as she did it in Belgium). These are amazing developments. We turn doctors into heroes, yet feel equivocal about them.

Such ambiguities are not new. When in 1858 a statue was erected in the recently built Trafalgar Square to Edward Jenner, the pioneer of smallpox vaccination, protests followed and it was rapidly removed: a country doctor amidst the generals and admirals was thought unseemly (it may seem that those responsible for causing deaths rather than saving lives are worthy of public honour). Even in Greek times opinions about medicine were mixed; the word pharmakos meant both remedy and poison -- `kill' and `cure' were apparently indistinguishable. And as Jonathan Swift wryly reflected early in the eighteenth century, `Apollo was held the god of physic and sender of diseases. Both were originally the same trade, and still continue.' That double idea -- death and the doctors riding together -- has loomed large in history. It is one of the threads we will follow in trying to assess the impact of medicine and responses to it -- in trying to assess Samuel Johnson's accolade to the medical profession: `the greatest benefit to mankind.'

`The art has three factors, the disease, the patient, the physician,' wrote Hippocrates, the legendary Greek physician who has often been called the father of, medicine; and he thus suggested an agenda for history. This book will explore diseases, patients and physicians, and their interrelations, concentrating on some more than others. It is, as its sub-title suggests, a medical history.

My focus could have been on disease and its bearing on human history. We have all been reminded of the devastating effects of pestilence by the AIDS epidemic. In terms of death toll, cultural shock and socio-economic destruction, the full impact of AIDS cannot yet be judged. Other `hot viruses' may be coming into the arena of history which may prove even more calamitous. Historians at large, who until recently tended to chronicle world history in blithe ignorance of or indifference to disease, now recognize the difference made by plague, cholera and other pandemics. Over the last generation, distinguished practitioners have pioneered the study of `plagues and peoples'; and I have tried to give due consideration to these epidemiological and demographic matters in the following chapters. But they are not my protagonists, rather the backdrop.

Equally this book might have focused upon everyday health, common health beliefs and routine health care in society at large. The social history of medicine now embraces `people's history', and one of its most exciting developments has been the attention given to beliefs about the body, its status and stigmas, its race, class and gender representations. The production and reproduction, creation and recreation of images of Self and Other have formed the subject matter of distinguished books. Such historical sociologies or cultural anthropologies -- regarding the body as a book to be decoded -- reinforce our awareness of the importance, past and present, of familiar beliefs about health and its hazards, about taboo and transgression. When a body becomes a clue to meaning, popular ideas of health and sickness, life and death, must be of central historical importance. I have written, on my own and with others, numerous books exploring lay health cultures in the past, from a `bottom-up', patients' point of view, and hope soon to publish a further work on the historical significance of the body.

This history, however, is different. It sets the history of medical thinking and medical practice at stage centre. It concentrates on medical ideas about disease, medical teachings about healthy and unhealthy bodies, and medical models of life and death. Seeking to avoid anachronism and judgmentalism, I devote prime attention to those people and professional groups who have been responsible for such beliefs and practices -- that is healers understood in a broad sense. This book is principally about what those healers have done, individually and collectively, and the impact of their ideas and actions. While placing developments in a wider context, it surveys medical theory and practices.

This approach may sound old-fashioned, a resurrection of the Whiggish `great docs' history which celebrated the triumphal progress of medicine from ignorance through error to science. But I come not to praise medicine -- nor indeed to blame it. I do believe that medicine has played a major and growing role in human societies and for that reason its history needs to be explored so that its place and powers can be understood. I say here, and I will say many times again, that the prominence of medicine has lain only in small measure in its ability to make the sick well. This always was true, and remains so today.

I discuss disease from a global viewpoint; no other perspective makes sense. I also examine medicine the world over. Chapter 2 surveys the emergence of health practices and medical beliefs in some early societies; Chapter 3 discusses the rise of formal, written medicine in the Middle East and Egypt, and in Greece and Rome; Chapter 4 explores Islam; separate chapters discuss Indian and Chinese medicine; Chapter 8 takes in the Americas; Chapter 15 surveys medicine in more recent colonial contexts, and other chapters have discussions of disorders in the Third World, for instance deficiency diseases. The book is thus not narrowly or blindly ethnocentric.

Nevertheless, I devote most attention to what is called `western' medicine, because western medicine has developed in ways which have made it uniquely powerful and led it to become uniquely global. Its ceaseless spread throughout the world owes much, doubtless, to western political and economic domination. But its dominance has increased because it is perceived, by societies and the sick, to `work' uniquely well, at least for many major classes of disorders. (Parenthetically, it can be argued that western political and economic domination owes something to the path-breaking powers of quinine, antibiotics and the like.) To the world historian, western medicine is special. It is conceivable that in a hundred years time traditional Chinese medicine, shamanistic medicine or Ayurvedic medicine will have swept the globe; if that happens, my analysis will look peculiarly dated and daft. But there is no real indication of that happening, while there is every reason to expect the medicine of the future to be an outgrowth of present western medicine -- or at least a reaction against it. What began as the medicine of Europe is becoming the medicine of humanity. For that reason its history deserves particular attention.

Western medicine, I argue, his developed radically distinctive approaches to exploring the workings of the human body in sickness and in health. These have changed the ways our culture conceives of the body and of human life. To reduce complex matters to crass terms, most peoples and cultures the world over, throughout history, have construed life (birth and death, sickness and health) primarily in the context of an understanding of the relations of human beings to the wider cosmos: planets, stars, mountains, rivers, spirits and ancestors, gods and demons, the heavens and the underworld, and so forth. Some traditions, notably those reflected in Chinese and Indian learned medicine, while being concerned with the architecture of the cosmos, do not pay great attention to the supernatural. Modern western thinking, however, has become indifferent to all such elements. The West has evolved a culture preoccupied with the self, with the individual and his or her identity, and this quest has come to be equated with (or reduced to) the individual body and the embodied personality, expressed through body language. Hamlet wanted this too solid flesh to melt away. That -- except in the context of slimming obsessions -- is the last thing modern westerners want to happen to their flesh; they want it to last as long as possible.

Explanations of why and how these modern, secular western attitudes have come about need to take many elements into account. Their roots may be found in the philosophical and religious traditions they have grown out of. They have been stimulated by economic materialism, the preoccupation with worldly goods generated by the devouring, reckless energies of capitalism. But they are also intimately connected with the development of medicine -- its promise, project and products.

Whereas most traditional healing systems have sought to understand the relations of the sick person to the wider cosmos and to make readjustments between individual and world, or society and world, the western medical tradition explains sickness principally in terms of the body itself -- its own cosmos. Greek medicine dismissed supernatural powers, though not macrocosmic, environmental influences; and from the Renaissance the flourishing anatomical and physiological programmes created a new confidence among investigators that everything that needed to be known could essentially be discovered by probing more deeply and ever more minutely into the flesh, its systems, tissues, cells, its DNA.

This his proved an infinitely productive inquiry, generating first knowledge and then power, including on some occasions the power to conquer disease. The idea of probing into bodies, living and dead (and especially human bodies) with a view to improving medicine is more or less distinctive to the European medical tradition. For reasons technical, cultural, religious and personal, it was not done in China or India, Mesopotamia or pharaonic Egypt. Dissection and dissection-related experimentation were performed only on animals in classical Greece, and rarely. A medicine that seriously and systematically investigated the stuff of bodies came into being thereafter -- in Alexandria, then in the work of Galen, then in late medieval Italy. The centrality of anatomy to medicine's project was proclaimed in the Renaissance and became the foundation stone for the later edifice of scientific medicine: physiological experimentation, pathology, microscopy, biochemistry and all the other later specialisms, to say nothing of invasive surgery.

This was not the only course that medicine could have taken; as is noted below, it was not the course other great world medical systems took, cultivating their own distinct clinical skills, diagnostic arts and therapeutic interventions. Nor did it enjoy universal approval: protests in Britain around 1800 about body-snatching and later antivivisectionist lobbies show how sceptical public opinion remained about the activities of anatomists and physicians, and suspicion has continued to run high. However, that was the direction western medicine followed, and, bolstered by science at large, it generated a powerful medicine, largely independent of its efficacy as a rational social approach to good health.

The emergence of this high-tech scientific medicine may be a prime example of what William Blake denounced as `single vision', the kind of myopia which (literally and metaphorically) comes from looking doggedly down a microscope. Single vision has its limitations in explaining the human condition; this is why Coleridge called doctors `shallow animals', who `imagine that in the whole system of things there is nothing but Gut and Body'. Hence the ability of medicine to understand and counter pathology has always engendered paradox. Medicine has offered the promise of `the greatest benefit to mankind', but not always on terms palatable to and compatible with cherished ideals. Nor has it always delivered the goods. The particular powers of medicine, and the paradoxes its rationales generate, are what this book is about.

* * *

It may be useful to offer a brief resume of the main themes of the book, by way of a sketch map for a long journey.

All societies possess medical beliefs: ideas of life and death, disease and cure, and systems of healing. Schematically speaking, the medical history of humanity may be seen as a series of stages. Belief systems the world over have attributed sickness to illwill, to malevolent spirits, sorcery, witchcraft and diabolical or divine intervention. Such ways of thinking still pervade the tribal communities of Africa, the Amazon basin and the Pacific; they were influential in Christian Europe till the `age of reason', and retain a residual shadow presence. Christian Scientists and some other Christian sects continue to view sickness and recovery in providential and supernatural terms; healing shrines like Lourdes remain popular within the Roman Catholic church, and faith-healing retains a mass following among devotees of television evangelists in the United States.

In Europe from Graeco-Roman antiquity onwards, and also among the great Asian civilizations, the medical profession systematically replaced transcendental explanations by positing a natural basis for disease and healing. Among educated lay people and physicians alike, the body became viewed as integral to law-governed cosmic elements and regular processes. Greek medicine emphasized the microcosm/macrocosm relationship, the correlations between the healthy human body and the harmonies of nature. From Hippocrates in the fifth century BC through to Galen in the second century AD, `humoral medicine' stressed the analogies between the four elements of external nature (fire, water, air and earth) and the four humours or bodily fluids (blood, phlegm, choler or yellow bile and black bile), whose balance determined health. The humours found expression in the temperaments and complexions that marked an individual. The task of hygiene was to maintain a balanced constitution, and the role of medicine was to restore the balance when disturbed. Parallels to these views appear in the classical Chinese and Indian medical traditions.

The medicine of antiquity, transmitted to Islam and then back to the medieval West and remaining powerful throughout the Renaissance, paid great attention to general health maintenance through regulation of diet, exercise, hygiene and lifestyle. In the absence of decisive anatomical and physiological expertise, and without a powerful arsenal of cures and surgical skills, the ability to diagnose and make prognoses was highly valued, and an intimate physician-patient relationship was fostered. The teachings of antiquity, which remained authoritative until the eighteenth century and still supply subterranean reservoirs of medical folklore, were more successful in assisting people to cope with chronic conditions and soothing lesser ailments than in conquering life-threatening infections which became endemic and epidemic in the civilized world: leprosy, plague, smallpox, measles, and, later, the `filth diseases' (like typhus) associated with urban squalor.

This personal tradition of bedside medicine long remained popular in the West, as did its equivalents in Chinese and Ayurvedic medicine. But in Europe it was supplemented and challenged by the creation of a more `scientific' medicine, grounded, for the first time, upon experimental anatomical and physiological investigation, epitomized from the fifteenth century by the dissection techniques which became central to medical education. Landmarks in this programme include the publication of De humani corporis fabrica (1543) by the Paduan professor, Andreas Vesalius, a momentous anatomical atlas and a work which challenged truths received since Galen; and William Harvey's De motu cordis (1628) which put physiological inquiry on the map by experiments demonstrating the circulation of the blood and the heart's role as a pump.

Post-Vesalian investigations dramatically advanced knowledge of the structures and functions of the living organism. Further inquiries brought the unravelling of the lymphatic system and the lacteals, and the eighteenth and nineteenth centuries yielded a finer grasp of the nervous system and the operations of the brain. With the aid of microscopes and the laboratory, nineteenth-century investigators explored the nature of body tissue and pioneered cell biology; pathological anatomy came of age. Parallel developments in organic chemistry led to an understanding of respiration, nutrition, the digestive system and deficiency diseases, and founded such specialities as endocrinology. The twentieth century became the age of genetics and molecular biology.

Nineteenth-century medical science made spectacular leaps forward in the understanding of infectious diseases. For many centuries, rival epidemiological theories had attributed fevers to miasmas (poisons in the air, exuded from rotting animal and vegetable material, the soil, and standing water) or to contagion (person-to-person contact). From the 1860s, the rise of bacteriology, associated especially with Louis Pasteur in France and Robert Koch in Germany, established the role of micro-organic pathogens. Almost for the first time in medicine, bacteriology led directly to dramatic new cures.

In the short run, the anatomically based scientific medicine which emerged from Renaissance universities and the Scientific Revolution contributed more to knowledge than to health. Drugs from both the Old and New Worlds, notably opium and Peruvian bark (quinine) became more widely available, and mineral and metal-based pharmaceutical preparations enjoyed a great if dubious vogue (e.g., mercury for syphilis). But the true pharmacological revolution began with the introduction of sulfa drugs and antibiotics in the twentieth century, and surgical success was limited before the introduction of anaesthetics and antiseptic operating-room conditions in the mid nineteenth century. Biomedical understanding long outstripped breakthroughs in curative medicine, and the retreat of the great lethal diseases (diphtheria, typhoid, tuberculosis and so forth) was due, in the first instance, more to urban improvements, superior nutrition and public health than to curative medicine. The one early striking instance of the conquest of disease -- the introduction first of smallpox inoculation and then of vaccination -- came not through `science' but through embracing popular medical folklore.

From the Middle Ages, medical practitioners organized themselves professionally in a pyramid with physicians at the top and surgeons and apothecaries nearer the base, and with other healers marginalized or vilified as quacks. Practitioners' guilds, corporations and colleges received royal approval, and medicine was gradually incorporated into the public domain, particularly in German-speaking Europe where the notion of `medical police' (health regulation and preventive public health) gained official backing in the eighteenth century. The state inevitably played the leading role in the growth of military and naval medicine, and later in tropical medicine. The hospital sphere, however, long remained largely the Church's responsibility, especially in Roman Catholic parts of Europe. Gradually the state took responsibility for the health of emergent industrial society, through public health regulation and custody of the insane in the nineteeth century, and later through national insurance and national health schemes. These latter developments met fierce opposition from a medical profession seeking to preserve its autonomy against encroaching state bureaucracies.

The latter half of the twentieth century has witnessed the continued phenomenal progress of capital-intensive and specialized scientific medicine: transplant surgery and biotechnology have captured the public imagination. Alongside, major chronic and psychosomatic disorders persist and worsen -- jocularly expressed as the `doing better but feeling worse' syndrome -- and the basic health of the developing world is deteriorating. This situation exemplifies and perpetuates a key facet and paradox of the history of medicine: the unresolved disequilibrium between, on the one hand, the remarkable capacities of an increasingly powerful science-based biomedical tradition and, on the other, the wider and unfulfilled health requirements of economically impoverished, colonially vanquished and politically mismanaged societies. Medicine is an enormous achievement, but what it will achieve practically for humanity, and what those who hold the power will allow it to do, remain open questions.

The late E. P. Thompson (1924-1993) warned historians against what he called the enormous condescension of posterity. I have tried to understand the medical systems I discuss rather than passing judgment on them; I have tried to spell them out in as much detail as space has permitted, because engagement with detail is essential if the cognitive power of medicine is to be appreciated.

Eschewing anachronism, judgmentalism and history by hindsight does not mean denying that there are ways in which medical knowledge has progressed. Harvey's account of the cardiovascular system was more correct than Galen's; the emergence of endocrinology allowed the development in the 1920s of insulin treatments which saved the lives of diabetics. But one must not assume that diabetes then went away: no cure has been found for that still poorly understood disease, and it continues to spread as a consequence of western lifestyles. Indeed one could argue that the problem is now worse than when insulin treatment was discovered.

Avoiding condescension equally does not mean one must avoid `winners' history. This book unashamedly gives more space to the Greeks than the Goths, more attention to Hippocrates than to Greek root-gatherers, and stresses strands of development leading from Greek medicine to the biomedicine now in the saddle. I do not think that `winners' should automatically be privileged by historians (I have myself written and advocated writing medical history from the patients' view), but there is a good reason for bringing the winners to the foreground -- not because they are `best' or `right' but because they are powerful. One can study winners without siding with them.

Writing this book has not only made me more aware than usual of my own ignorance; it has brought home the collective and largely irremediable ignorance of historians about the medical history of mankind. Perhaps the most celebrated physician ever is Hippocrates yet we know literally nothing about him. Neither do we know anything concrete about most of the medical encounters there have ever been. The historical record is like the night sky: we see a few stars and group them into mythic constellations. But what is chiefly visible is the darkness.

Read More Show Less

Customer Reviews

Average Rating 5
( 5 )
Rating Distribution

5 Star

(4)

4 Star

(1)

3 Star

(0)

2 Star

(0)

1 Star

(0)

Your Rating:

Your Name: Create a Pen Name or

Barnes & Noble.com Review Rules

Our reader reviews allow you to share your comments on titles you liked, or didn't, with others. By submitting an online review, you are representing to Barnes & Noble.com that all information contained in your review is original and accurate in all respects, and that the submission of such content by you and the posting of such content by Barnes & Noble.com does not and will not violate the rights of any third party. Please follow the rules below to help ensure that your review can be posted.

Reviews by Our Customers Under the Age of 13

We highly value and respect everyone's opinion concerning the titles we offer. However, we cannot allow persons under the age of 13 to have accounts at BN.com or to post customer reviews. Please see our Terms of Use for more details.

What to exclude from your review:

Please do not write about reviews, commentary, or information posted on the product page. If you see any errors in the information on the product page, please send us an email.

Reviews should not contain any of the following:

  • - HTML tags, profanity, obscenities, vulgarities, or comments that defame anyone
  • - Time-sensitive information such as tour dates, signings, lectures, etc.
  • - Single-word reviews. Other people will read your review to discover why you liked or didn't like the title. Be descriptive.
  • - Comments focusing on the author or that may ruin the ending for others
  • - Phone numbers, addresses, URLs
  • - Pricing and availability information or alternative ordering information
  • - Advertisements or commercial solicitation

Reminder:

  • - By submitting a review, you grant to Barnes & Noble.com and its sublicensees the royalty-free, perpetual, irrevocable right and license to use the review in accordance with the Barnes & Noble.com Terms of Use.
  • - Barnes & Noble.com reserves the right not to post any review -- particularly those that do not follow the terms and conditions of these Rules. Barnes & Noble.com also reserves the right to remove any review at any time without notice.
  • - See Terms of Use for other conditions and disclaimers.
Search for Products You'd Like to Recommend

Recommend other products that relate to your review. Just search for them below and share!

Create a Pen Name

Your Pen Name is your unique identity on BN.com. It will appear on the reviews you write and other website activities. Your Pen Name cannot be edited, changed or deleted once submitted.

 
Your Pen Name can be any combination of alphanumeric characters (plus - and _), and must be at least two characters long.

Continue Anonymously
Sort by: Showing all of 5 Customer Reviews
  • Posted June 19, 2014

    I Also Recommend:

    Remeber the days of pulverised crocodile dung... During my time

    Remeber the days of pulverised crocodile dung...

    During my time studying medicine I constantly found myself skipping between books, unable to locate all the historical information I was seeking in one volume. Would that I had "The Greatest Benefit to Mankind" back then! It seems that Roy Porter's students had the same issue which is what inspired the teacher-turned-author to write this book.


    Porter's historical account of medicine and healing is fascinating and delves deep to reveal how people's attitudes toward medicine has changed over the years, including the big breakthroughs. While the book covers a global history, it is primarily European - which is explained by the fact that "Western medicine has developed in ways which made it uniquely powerful and... uniquely global." Sounds a bit like the power of imperialism...


    The book is a refreshing read and is certainly anything but boring. His tone is comical, engaging, enlightening, and that of a lecturer all at once. Porter has structured his work perfectly and the chapter titles give you the option to quickly look up what you need to know if you're in a hurry. Perfect if you're a student! If you are simply interested in medical history this is a must-read, but be sure to also look at Sexuality: An Illustrated History.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted May 5, 2010

    A great book on the history of medicine

    Porter's book "The Greatest Benefit to Mankind" is a great resource for understanding medical history. It places famous historical actors in their contexts, and it explains generally trends expertly. This is the kind of book that it's good to take notes while reading, especially if you don't know most of the names beforehand. However, it has helped me more than any other medical history in understanding how medicine changed, what role historical actors had in that change, and where the medicine of today came from. I highly recommend to anyone interested in the subject.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Posted December 19, 2009

    The best history of medicine and will remain significant for a long time

    This is a well-written book with little bits of humor to make it especially enjoyable. It is a full history of western medicine and tells also of the traditions of China and India. The author offers some comment about the situation of medicine in society at this time.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted April 17, 2005

    Amazingly thorough

    This books got it all in the history of medicine. I ended up reading it like a text book also gathering the facts that I associated with not-so common knowledge. I also found it easier to read while reading other books, I couldn't focus all of my attention on it because it's so thorough it's prosaic at times. As with the earlier review(s) the book is better used for it's early chapters than it's synopsis of contemporary medicine.

    1 out of 1 people found this review helpful.

    Was this review helpful? Yes  No   Report this review
  • Anonymous

    Posted January 12, 2012

    No text was provided for this review.

Sort by: Showing all of 5 Customer Reviews

If you find inappropriate content, please report it to Barnes & Noble
Why is this product inappropriate?
Comments (optional)