Roy Porter

Anna Davin has risen admirably to the challenges facing the historian of working-class life in London. Dealing with the documents is daunting enough. To begin with, there are 17 volumes of Charles Booth’s Life and Labour of the People in London, published between 1889 and 1903. For all its faults it is the first survey of outcast London that can be described as social science and it remains a unique quarry of ‘statistics of poverty’, recording how much (or little) Whitechapel widows got paid for glueing a gross of matchboxes or how they fed a family of 14 on a few coppers a day. There is also the more personal testimony, essential for any historian concerned to capture ‘experience’ but hard to handle: nostalgic autobiographies like Charlie Chaplin’s and novels like Arthur Morrison’s Tales of Mean Streets (1894) or Israel Zangwill’s Children of the Ghetto (1892). These and a multitude of other sources, especially school records, have been meticulously sifted by Davin. Associated from its conception with the History Workshop Journal, she is a fine oral historian; her tapes go back to the Seventies – one of her interviewees was born in 1882.’

From the Church Fathers, through St Ignatius Loyola and Pascal to the Marquis de Sade, the problem of pain was agonisingly debated, not least because mortification was holiness and judicial torture the authorised engine of truth. But nowadays, pain, in either its medical or its metaphysical aspects, is oddly little discussed given the ubiquitous misery it causes.

The solution to today’s cannabis problem, this book concludes, is to legalise it ‘for all uses’ and remove it ‘entirely from the medical and criminal control systems’. The authors, respectively a professor of psychiatry and a lecturer in law at Harvard Medical School, believe legalisation is desirable for all the reasons now widely adduced in the UK, not least by some senior police officers and by last year’s Lib Dem Party Conference: that the criminalisation of cannabis is absurd given the promotion of tobacco and alcohol; that it creates black markets, police corruption and crime; that the law against it is impossible to enforce, and, manifestly lacking the endorsement of millions of otherwise law-abiding citizens – there may be twelve million users in the USA – compromises respect for the law and the police. Lester Grinspoon and James Bakalar’s argument, however, is that marijuana should be legalised because of its medicinal properties. Its benefits as a general ‘feel-good’ drug, preferable to certain anti depressants and tranquillisers manufactured by the pharmaceutical industry, have been widely touted by legalisation groups: Grinspoon and Bakalar seek to publicise its more specific therapeutic applications.’

When is a disease not a disease? No quibbling academic riddle this, but a problem increasingly pressing upon medical practice and ethics alike. So many questions crowd in. Is it valid to talk of a person being ill without a disease, or having a disease without being sick? When and how do we draw dividing-lines between conditions, disabilities and abnormalities, on the one hand, and diseases, on the other? This can be a crucial issue when it comes to final authority in deciding the fate of severely-malformed babies. If, say, Down’s Syndrome is a disease, then, arguably, it’s the doctor’s dilemma; if not, not.

Early in the 18th century, the populariser of Newton and fashionable physician George Cheyne advanced his own medical ‘inverse square law’: the health of nations varied in inverse ratio to the wealth of nations. The greater the progress this country had made – in material goods, urbanisation, leisure and civility – the greater the visitations of sickness upon her people. An entirely new name was needed for this phenomenon: the ‘English Malady’ described a chronic degenerative nervous disorder, commonly culminating in suicide. Civilisation, Cheyne contended, had always been the cradle of sickness. Egypt and Greece had often been praised for inventing medicine, but such credit was out of court. Earlier societies had had no need of doctors, for they had suffered little disease. It was sedentary cultural centres and the civilising process itself which had bred sickness.’