Possessed by the Idols

Letters

Vol. 28 No. 24 · 14 December 2006

From David Wootton

Steven Shapin says Bad Medicine is ‘not history’, and advises me to ‘consider another way of making a living’ (LRB, 30 November). Are my facts wrong? Is my argument incoherent? Are there gaps in my reading? No. It’s something much worse: I’ve discussed progress. ‘Academic historians of medicine didn’t – with rare exceptions – criticise the idea of medical progress,’ Shapin writes, ‘so much as fall silent about it.’ Shapin and his colleagues have been relying on that silence; but now I have broken it. Shapin can’t reply by attacking my book head on, because, as he says, there really is ‘genuine and substantial medical progress’, and there is ‘no “logical” flaw or “fallacy”’ in the idea of a narrative of progress. At the heart of his review then, there is no argument.

I haven’t just broken the silence, I have written a book of interest to what Shapin condescendingly calls ‘the laity’. I’ve written a history of medicine that makes sense to doctors (‘required reading’, the BMJ has called it). I’ve addressed a topic that he says has ‘the strongest grip on lay imaginations’. But apparently I’ve gone wrong because I have rejected the principle of ‘charitable interpretation’. He forgets that his own book Leviathan and the Air Pump (written with Simon Schaffer) is systematically and explicitly uncharitable to Boyle. And his review is remarkably uncharitable in its reading of my book. Shapin says I hold that ‘doctors were willing victims of Bacon’s “Idols of the Theatre”.’ He knows the whole point of an Idols argument is that people unwillingly fall into error. He claims I find Roy Porter obtuse. Actually I describe him as ‘the greatest medical historian of his generation’.

For 2300 years medicine did more harm than good. ‘On Wootton’s account you have to wonder why’ medicine survived, Shapin says. True, and I devote a chapter to an explanation. It’s wrong to assume, I say, that the modern increase in life expectancy is due to medicine. ‘Yet there are serious debates over what portion of increased longevity can legitimately be ascribed to medicine,’ Shapin says, as if this would be news to me, though that’s the subject of another chapter. Worse, he directly misrepresents my argument. I say that it is ‘plain wrong’ to think ‘there is a straightforward logic of discovery’; Shapin claims ‘Wootton insists’ on such a logic. Finally he asserts that I take my information ‘overwhelmingly at second-hand’. This is false: an example is my discovery of two previously unnoticed early germ theorists. I found them within days of starting work, and conclude that the field is ‘relatively unexplored’, and Shapin finds this statement ‘bizarre’.

People went on consulting doctors, despite the fact that medicine didn’t work. Shapin says: ‘it’s reasonable to infer from this that they felt they were getting value for money.’ Since they weren’t being cured, they must have been paying not for a cure but for what Shapin calls ‘meaning’. Well, people paid astrologers to find lost and stolen goods. They consulted them even though their success rate was abysmal. Did they feel they were getting value for money? Yes – or at least they thought other customers were. Did they get what they were paying for? No. The problem lies in this gap between belief and reality, and it won’t be dissolved by saying that although they weren’t recovering their goods they were getting ‘meaning’. It’s problems like this that historians have been passing over in silence. And of course if you consistently deny the existence of any tension between belief and reality, what you end up with is relativism. What is at stake here is nothing less than what is history, and who controls it.

David Wootton
University of York

Steven Shapin writes: If being right is to be the criterion for historians’ attention, when exactly shall we start? Who and what are we permitted to write about? I applaud Wootton for aiming to instruct the laity; I regret that he has served them so badly.