History in Focus

Roy Porter (1946-2002)

Julia Sheppard's obituary of 'one the best historians of his generation' reflects on the life and career of an historian whose 'prolific output brought social and medical history to new audiences'. One of his more than 100 books, The Cambridge Illustrated History of Medicine, is reviewed by Graham Mooney. An introductory text to the subject, such as this is, could only benefit from the fact that Professor Porter was ''in a unique position to bring together other medical historians of like stature'.

In his reply Professor Porter reflects on the pioneering use of visual material in the book, commenting that the decision in this instance that 'the illustrations would not just be tacked on as optional extras, or all clumped together in the middle ... marks a real advance upon almost any other history of medicine yet written by scholars'.

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Mental Health

Reflecting 'the efflorescence in the history of psychiatry over the course of the last quarter century', the IHR has commissioned a number of reviews of books examining the history of mental health and psychiatry. Masters of Bedlam: the Transformation of the Mad-Doctoring Trade, by Andrew Scull, Charlotte MacKenzie and Nicholas Hervey (Princeton University Press, 1996), in the words of Jonathan Andrews, 'represents a highly successful attempt to locate the lives and works of some of the most prominent members of Victorian psychiatry's elite in Britain against a broad cultural, contextual and structural background'. Dr. Andrews suggests 'that [the book] should in many ways serve as a model for historians embarking on biographical studies of professional men, and more generally for anyone concerned with the ways in which individuals both impacted on and reflected wider historical patterns and changes'. In his response, Professor Andrew Scull admits that he is 'naturally delighted that [the] overall assessment of the book is so positive and laudatory', but does take issue with the fact that 'virtually every time a historian reviews my scholarship, s/he seems compelled to allude to or make an issue of my background as a sociologist'. 'Sociologists do not have a good name among many historians, very often with good reason', but nonetheless, 'the study of human beings and human societies requires us to transcend the artificial boundaries that threaten to limit and distort our understanding, not to embrace or reinforce them'.

Dr. Mark Jackson begins his review of Mental Disability in Victorian England: The Earlswood Asylum 1847-1901, David Wright (OUP, 2001) with his teenage memories of the 'view of the asylum at Earlswood, visible from the windows of the 7.50 train to London, [which] left an indelible impression on my young, receptive mind'. Professor David Wright's history of that same asylum is 'a fine, constructive and substantial contribution to the history of psychiatry and mental deficiency'.

The institutional history of insanity is also treated in Insanity, Institutions and Society, 1800-1914: a Social History of Madness in Comparative Perspective, ed. Joseph Melling and Bill Forsythe (Routledge, 1999). Dr. Anne Borsay points out that 'the strong focus on institutions during the long nineteenth century provides a natural coherence which is sustained across the comparative perspective taking in British India and the Cape Colony as well as Wales, Scotland and Ireland'. Dr. Joseph Melling responds to the accusation that is 'morally the most serious for any historian of insanity', that is, that he or she does not 'permit the insane a voice', concluding that 'It is, in my view, impossibly romantic to assume we can rescue the mad from the enormous condescension of their contemporaries and restore to them a voice that society denied'.

James Mills's Madness, Cannabis and Colonialism (St. Martin's Press, 2000), reviewed by Satadru Sen, 'adds a dimension that has not been adequately explored in recent studies of colonial institutions of medicine and punishment in the second half of the nineteenth century: clinics, lock hospitals, prisons, penal colonies, schools and reformatories'. Professor Sen notes the prominence given to native voices in the book, establishing 'the indigenous discourse of insanity, which saw madness in terms of an externally imposed affliction' in contrast to 'the late nineteenth-century British view of madness as an internal disorder of the lunatic's body'. In his response, James Mills highlights his argument that 'individuals even in the midst of such a colonial and disciplinary institution as the asylum can be driven by agendas that take no account of the systems and the power of the coloniser'.

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Suicide

The two volumes of Suicide in the Middle Ages (vol. 1, The Violent against Themselves; vol. 2, The Curse on Self-Murder) are discussed by Professors Ralph Houlbrooke and David d'Avray. Alexander Murray's 'scrupulous and detailed' first volume (Oxford University Press, 1999) 'deals with suicides themselves, their motives, and other immediate circumstances of their deaths'. Professor Houlbrooke muses on the fact that, while 'suicides have never made up more than a tiny minority of any known human population', 'the subject has attracted an increasing amount of attention from social historians driven to enquire what motives underlay so drastic a response to human misfortune, and to what extent those motives changed in the course of time'.

In the second volume, also by Murray (Oxford University Press, 2001), 'the unifying argument of the volume is that harsh treatment of suicide in the Middle Ages does not derive from the specific rationality of the dominant religion'. Professor d'Avray concludes that 'not only historians of many periods, but also scholars in many disciplines ought to study this rather amazing book'.

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Plagues, Epidemics and Contagion

In his review of Christopher Wills's Plagues: their Origin, History and Future (Harper Collins, 1996), Dr. Chris Galley reflects on the dualistic aims of the book: 'small-scale ones which seek to explain the impact of each individual disease, and the large-scale one of providing an all encompassing theory of plagues'. He concludes that it 'is highly readable, but is of probably only limited interest for most historians'. In his response, Christopher Wills argues that the problem has much to do 'with the infamous two cultures and the divide between them' - 'The point of the book is not that it is supposed to be a history of the plagues written by a historian. It is an examination of plagues, broadly defined, by a scientist'.

Michael Worboys reviews Sheldon Watts's Epidemics and History: Disease, Power and Imperialism (Yale University Press, 1997), suggesting that it is 'very much of its time, a "big picture" history of disease focusing on medicine and public health in non-Western countries'. Whilst stressing that nothing 'should detract from [his] admiration of Watts's work', Worboys comments on the fact that the book 'is based on assumptions that most social historians of medicine will be uncomfortable with'. Sheldon Watts's response is framed in order to 'help inform the historical profession as a whole about recent developments in cultural-medical history'.

Professor Pam Pilbeam's review of Contagion: Disease Government and the 'Social Question' in Nineteenth-Century France, by Andrew R. Aisenberg (Stanford University Press, 1999) notes that the book 'emphasises that the intellectual debate over contagion and the conflicts between engineers and doctors had more to do with the careers of individuals than science'. Professor Pilbeam believes that 'Experts in the history of medicine will welcome the insights into the minds of nineteenth-century professionals'. Dr. Aisenberg welcomes the identification of the key themes in his work, but argues that 'What is missing in the review ... and what is crucial to the engagement with the fields of modern French social history and the history of medicine that is at the centre of this book, is the characterization of the relationship among these themes'.

In the words of Dr. Phillip Schofield, 'The study of the Black Death has undergone something of a renaissance in recent years', and Colin Platt's King Death: the Black Death and its Aftermath in late Medieval England (UCL Press, 1996) 'is a work of synthesis which continues this trend'. He concludes that Professor Platt 'attempts to assess the plague's overall impact but still, despite his warning to avoid a too strict division of history, encourages us to see the Black Death as a point of crisis from which English society made real recovery'. Professor Platt notes that Dr. Schofield, as a demographer, is inevitably preoccupied with demographic problems and issues in the book, but suggests that 'if we currently know less about population history than the demographers believe we ought, they are themselves at least partly to blame'.

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Sexual Health and Fertility

Professor Virgina Berridge reveals that when she told a colleague that she was reviewing Sex, Sin and Suffering: Venereal Disease and European Society since 1870, ed. Roger Davidson and Lesley Hall (Routledge, 2001) she expressed concern that there was anything left to write about on the subject. Davidson's and Hall's work, however, 'demonstrate[s] that quite clearly there is'. Professor Berridge concludes that 'The production of this volume shows that the area now has a growing European and international critical mass of historical interest which should sustain research interest. It indicates, too, that there are allied areas - youth culture, policy making in the last fifty years for example, - which await more attention'.

Professor Michael Mason reviews Simon Szreter's 'remarkable and very important book', Fertility, Class and Gender in Britain, 1860-1940 (Cambridge University Press, 1996). The thrust of the book is 'in effect, that coincidence has deceived the historians of family sexuality in the period 1860-1960'. Simon Szreter admonishes historians that 'their cherished unitary fertility decline is riddled with coincidence' and, Professor Mason argues, 'If he is right, he has completely rewritten this tract of English social history, and also created a model for enquiry into the subject which will be influential for years to come'.

In reply Dr. Szreter picks up the theme of 'profitable future directions for research' and suggests that 'the history of sexuality (which I understand to be a collective noun embracing all inclinations) and the history of fertility (also widely interpreted, to include marriage and its alternatives, non-marital fertility, and infertility) cannot be understood without intimate reference to each other'.

Chris Nottingham's The Pursuit of Serenity: Havelock Ellis and the New Politics (Amsterdam University Press, 1999) is, in the words of Dr. Lesley Hall 'an important book which deserves wide circulation ... perhaps the only satisfactory extended study yet produced of that important cultural figure Havelock Ellis and the impact of his writings'. In his reply, Nottingham concludes that 'whatever else we may feel about Ellis, we must recognise a staggeringly successful intellectual career. Largely unaided and sometimes in the face of nagging privations he took himself from lower middle class obscurity to an honoured seat in the progressive firmament'.

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Public Health

Dorothy Porter's Health, Civilisation and the State: a History of Public Health from Ancient to Modern Times (Routledge, 1999) is reviewed by Professor Gert H. Brieger. Professor Brieger argues that 'Public health, though often insufficiently appreciated by the other specialties of medicine, has since the nineteenth century helped to bridge the traditional gulf that exists between individual medicine and the greater society in which it functions. Thus it is public health, with its emphasis on populations rather than individual patients, that has provided medicine its ultimate rationale'. Professor Porter welcomes the 'thoughtful' treatment of her work, taking issue only with the treatment of her interpretation of the work of Thomas McKeown.

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The Place and Space of Illness

In her article The Place and Space of Illness: Climate and Garden as Metaphors in the Robben Island Medical Institutions, Dr. Harriet Deacon looks at three Robben Island hospitals in the Cape Colony during the second half of the 19th century (a leper hospital, chronic sick hospital and mental asylum), and examines attitudes towards the natural environment surrounding them. She concludes that 'The links between environment and society were often expressed through the medium of ideas about healthiness: the genre of medical topography [and] this understanding of human interaction with the environment did not vanish with the advent of germ theory and scientific medicine. It continues to influence European attitudes to other countries today as well as struggles within former colonial territories over land and access to natural resources'.

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Medicine in the English Middle Ages

Peregrine Horden's view that 'Much of the very best synoptic writing on the medieval medicine of any country has, in recent decades, been elicited by the English evidence' is borne out by Faye Getz's Medicine in the English Middle Ages (Princeton University Press, 1998). He suggests that 'Getz's work has revealed a rare combination of strengths' and that the book should be viewed as 'a feat of interpretation which no student of the subject can creditably ignore'.

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Epidemic Disease in London

We would like to thank the Centre for Metropolitan History for allowing us to include their publication Epidemics in London in this issue. This is taken from a collection of working papers given at the Symposium 'Epidemic Disease in London: from the Black Death to Cholera' held at the Institute of Historical Research, 19 March 1992.

In a paper entitled Plague in London: Spatial and Temporal Aspects of Mortality, Graham Twigg questions whether instances of epidemic disease in Britain between 1348 and 1665 can really be attributed to the plague. He contends that 'A multi-origin high death-rate would doubtless complicate matters but must be considered as a possibility'. Meanwhile, the practicalities of disposing of the dead are addressed by Vanessa Harding in Burial of the Plague Dead in Early Modern London . She observes that by the seventeenth century 'mortality rates were higher' and that the 'absolute numbers of dead' were 'very much greater further from the centre'. The environment of London itself and its role in epidemics is considered in Epidemics and the Built Environment by Justin Champion. He provides a 'survey [of] some of the approaches that can be employed to explore the social topography of disease in metropolitan spaces'.

Meanwhile in Discourses of the Plague in Early Modern London, Margaret Healy observes that the 'the discourses of the plague handed down to us from the sixteenth century reveal a particularly interesting story of the complex interplay between religion, politics and medicine'. The role of medicine is analysed by Anne Hardy in The Medical Response to Epidemic Disease During the Long Eighteenth Century. She asserts that 'individualism seems to be the key to the eighteenth-century response to epidemic diseases......Medical treatment, and the medical response to illness, centred on the individual patient, and did not extend from the individual to the implications for society at large'. In 'Epidemics and Skeletal Populations: Problems and Limitations', Margaret Cox considers the research challenges posed when contemporary documentation of death is compared against the evidence that modern scientific methods can yield - 'excavation of the crypt beneath Christ Church .. was undertaken to retrieve a documented skeletal sample which would serve as a means of testing the reliability of the then currently employed osteological and forensic methodology'.

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