The Greatest Benefit to Mankind: A Medical History of Humanity 1st Edition

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.

Reviewed by Toby Gelfand, Ph.D.
Copyright © 1998 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

Porter examines the history of Western medicine in its relations to society, and his many previous publications suggest that he has been preparing for this major work for some time. To write a one-volume history of medicine, one must have background, preparation, and courage. Porter has all three, and he assembles a massive amount of material after having taken the time to organize his thoughts carefully. Presenting technical terms and medical and scientific advances clearly, he addresses both the general reader and the medical student. Among the greatest pleasures he affords are his skillful weaving of quotations and analogies from novels, plays, and poems into the text and his cogent disagreement with the late epidemiologist Thomas McKeown's popular argument that medicine had little to do with the major improvements in life in the nineteenth and twentieth centuries. With its lengthy, useful, and comprehensive further reading list and detailed and accurate index, this is a book for public, college, and medical school libraries alike. William Beatty

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 hereHarvey, 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 powersall 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 to the 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 impressivemerits a broad lay readership in addition to med students. (40 illustrations) -- Copyright ©1998, Kirkus Associates, LP. All rights reserved.

A prodigious history of medicine from antiquity through issues like HMOs, tobacco companies and Dr. Jack Kevorkian. -- A New York Times Notable Book of 1998; New York Times Book Review, 6 December 1998

A remarkable achievement...brisk without being breathless, comprehensive without being tedious, rigorous without being obscure, judicious without being jejune. -- A Boston Globe Best Nonfiction Book of 1998; Boston Globe, George Scialabba, 6 December 1998

In almost all relevant respects, it must be accounted a triumph: simultaneously entertaining and instructive, witty and thought-provoking, a coherent overview comprising within its 832 pages an elegant and moving set of reflections on our collective efforts to grapple with disease and debility and to come to terms with the frailties of our flesh. -- The Los Angeles Times Sunday Book Review, Andrew Scull

Only the unique artistry of Roy Porter could have created this panoramic and perfectly magnificent intellectual history of medicine. It makes no difference whether one reads it for its wisdom, insight, inimitable perspective, or simply for its plenitude of information--this is the book that delivers it all, plus the sheer joy of hearing the distinctive voice of one of today's most fascinating commentators on the development of the ancient art of healing. -- Sherwin B. Nuland, M.D., clinical professor of surgery, Yale University, and author of How We Die

Porter also shows his usual keen eye for the ambiguities of medical power and scientific progress. And he finishes with the paradox which his long book makes one appreciate more keenly: that in just a few decades our expectations have far outstripped medicine's power to deliver. Perhaps we hoped we could finally forget that we are all soft bags of mortality. If so, history as compulsive as this is a splendid reminder of this essential truth. Not a festive thought, but an admirable and, yes, a richly enjoyable book. -- New Scientist, Jon Turney

Porter writes history with direction and authority....[it is] a work that is comprehensive, but coherent and readable. This will satisfy most readers, particularly those familiar with medical science. -- New Physician, Ralph J. DeBerardinis, December 1998

Roy Porter adroitly manages to encompass this enormous subject, deal with varied topics and individuals, and still bring new insights and even new details to the reader with a wonderful economy of words....Anyone who is curious about the details of medicine and how its practitioners came to be as they say will be enriched by reading this tome. -- Science Books and Films, Olen R. Brown, November 1998

"The Greatest Benefit to Mankind" was shortlisted for the 1998 National Book Critics Circle General Nonfiction Award.

Roy Porter is professor of the social history of medicine at the Wellcome Institute for the History of Science in London. He is the editor of the Norton History of Science series and, most recently, the author of the best-selling London: A Social History, among many other books.