Theodore Dalrymple

Through whiggish spectacles

The distillation of a vast quantity of historical material into a tolerably readable concentrate is a considerable skill, the historian’s equivalent of good popular science, and the late Professor Porter manifestly had that skill. To produce a history of medicine, little more than 150 pages long, that is not a completely arid list of names is a considerable feat, though not one that calls for deep originality of thought, which was never the strong point of Porter’s large, indeed manically enormous, oeuvre.

A short history like this must have an organising principle, and the one that Porter chose was the Whig interpretation of history. It is difficult, indeed, to see what other organising principle he could conveniently have chosen, for if the idea of progress applies to any human endeavour, it must surely apply to medicine. The degree to which we owe our present magnificent state of health (compared with that of all previous generations, though not perhaps with our imagined state of perfection and immortality) may be disputed; but what is indisputable is that doctors now have a therapeutic armamentarium of undreamed of efficacy. The writer of this review, for example, would long ago have died or, even worse, have sunk into a state of complete lethargic amentia, to spend the rest of his short life as an idiot in a mental asylum, were it not for modern medicine.

But we are not grateful for the advances that have made our lives for the most part pain-free; and while Porter points out the paradox that so-called alternative medicine has flourished again precisely as scientific medicine has become more effective, he does not delve very deeply into the meaning of this paradox. In the first place, alternative medicine is a misnomer: it is additional, not alternative, since most consumers of it enthusiastically consume the services of ‘orthodox’ physicians as well.

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