Possessed by the Idols
- Bad Medicine: Doctors Doing Harm Since Hippocrates by David Wootton
Oxford, 304 pp, £16.99, June 2006, ISBN 0 19 280355 7
Historical progress is back, even if it was only in some genres of academic history that it ever went away. It’s been some time, certainly, since historians of art saw painting as a triumphal progress from Titian to Tracey Emin, or historians of music celebrated a linear ascent in compositional quality from Bach to Birtwistle. It was, perhaps, in political history that historians first recognised their job to be something like interpreting the past in its own terms, warning themselves against the tendency to award points to past actors insofar as their thinking anticipated the present. What Herbert Butterfield in 1931 called ‘the Whig interpretation of history’ counted as much as a prescription of what historians should avoid as a description of how history had been written in the bad old days.
However, Butterfield’s one foray into the history of science – The Origins of Modern Science: 1300-1800 (1949) – was a triumphalist performance, and George Sarton, the founder of the modern academic history of science, spoke for many of his contemporaries when he wrote that ‘progress has no definite and unquestionable meaning in other fields than the field of science.’ Science was not just progressive itself: it was the source of all other progressive tendencies in civilisation. Who could doubt it? The progress of science was evident not only in its ever increasing depth of understanding, its power of explanation and its ability to predict, but in the applications that flowed from it. If technology was progressive, then its progressiveness must arise from its changing scientific basis. But historians of science followed Butterfield’s preaching more than his practice. By the 1960s and 1970s, most of them had come to consider progressivism and presentism as professional sins, and embraced what anthropologists called ‘charitable interpretation’.
This left them exposed, both to scientists, many of whom – if they thought about history at all – thought that history’s vicissitudes had led us out of the dark past into the bright present, and to the laity, whose engagement with scientific knowledge was typically slight but whose experiences with science textbooks enshrined the general idea of its linear progressiveness. What ‘everyone knew’ about the history of science was precisely what academic historians no longer knew, or, at least, what their writings were no longer predicated on: science progresses, and its successful applications are powerful testimony to that progress. Indeed, it is the applications of science that have the strongest grip on lay imaginations and seem to offer the most powerful proofs of progress. Take medicine. If what you want is a long, healthy and pain-free life, you would not choose to live in any time other than the present or in any part of the world where there aren’t a lot of doctors around. Accept that health, long life and the mitigation of suffering are the results of medical intervention, and that medical progress is the upshot of scientific progress, and you have no better testimony to the progress of science.
Academic historians of medicine didn’t – with rare exceptions – criticise the idea of medical progress so much as fall silent about it, seeing their job as something other than its documentation and celebration. So they were vulnerable to anyone who reckoned that this was just what they ought to be doing. In recent decades a gap opened up between professional medical history and the sort that tended to be written by practising or emeritus physicians, many of whom saw little point, and perhaps some lese-majesty, in ‘charitable’ history. It is a surprise that a strident assault on anti-triumphalist history of medicine should come from a historian not previously known for his interest in the subject and taking his information overwhelmingly at second-hand from specialists, just like Butterfield writing his only history of science. It is still more surprising that it should come from David Wootton, an early modern intellectual historian whose 1983 study of Paolo Sarpi, a late Renaissance theologian, concluded by cautioning historians not to act as a ‘jury’.
There are two stories folded into Wootton’s Bad Medicine: one concerns the reality, nature and dynamics of medical progress; the other explains why his colleagues have been derelict in their duty. Medicine has progressed, and historians have either wilfully conspired to ignore that progress or been duped into denying it. Wootton’s target of choice is Roy Porter, who wrote that ‘only the most dyed-in-the-wool Whig history still polarises the past in terms of confrontations between saints and sinners, heroes and villains.’ Wootton is happy to acknowledge that his book ‘is written against the grain of contemporary historical writing’ and that the identification of heroes and villains is just what he’s about – and just what medical history ought to be about.