Mark Jackson’s contribution to the growing introductory literature in the history of medicine fulfils its brief as a ‘beginner’s guide’ with both style and authority. In two hundred readable pages, Jackson steers his reader through several thousand years of medicine’s global history, mapping changes and continuities in modes of knowledge-making about the body in sickness and in health, and practices of health preservation and restoration. The book’s largely chronological structure is easy to follow, and Jackson helpfully introduces key developments in wider social, cultural and political history as he moves across his enormous timespan. Its periodisation aligns with conventional ‘Western’ history but any readers still expecting a traditional narrative of great medical men and great scientific discoveries may be surprised. Jackson identifies printing, not penicillin or the Pill, as (medical) history’s greatest revolution, and repeatedly reminds his audience of the very limited immediate effects of many, perhaps even most, medical innovations on the lives and bodies of the vast majority of the world’s population.
At its core, The History of Medicine: A Beginner’s Guide describes the emergence and effects – political and social as well as therapeutic – of what we know today as biomedicine. Thus it documents the gradual and contested rise of mechanical and materialist understandings of the body and explanations of its internal workings, and tracks their divergence from the holistic and systemic models which preceded them across the world’s great scholarly and lay traditions. Unusually for an introductory volume of this kind, Jackson has integrated attention to South and East Asian medicine systems with his more detailed descriptions of developments in the Western tradition. This is an important shift. Europe may not be provincialised here, but it is certainly contextualised, even if Latin America first appears in conjunction with the Columbian exchange (p. 71), while Africa enters this account alongside the slave trade (p. 72).
Similarly, Jackson’s volume is innovative in presenting information about sacred and secular healing practices side by side; in addressing the co-existence – and sometimes co-constitution – of both elite and non-elite medical traditions; and especially in its comparatively detailed treatment of mental health not just from the by-now conventional starting point of the ‘great confinement’ but from the book’s opening chapter on health and medicine in the ancient world. He likewise acknowledges therapeutic concern with chronic disease as an abiding aspect of medicine, rather than one that would emerge only in the late nineteenth and twentieth centuries, as the shadow of acute infectious disease gradually shrank.
Of course, for the readers of this journal, Jackson’s account will hold few major surprises. By necessity, the stories told in this volume are familiar ones, not least because they have in many cases been at the heart of medical historiography since its inception, or at least since its reinvention as social history in the 1980s. Their familiarity makes them no less important or intriguing for the ‘beginners’ who are this book’s intended audience, however, and they are presented here in clear, vivid and straightforward terms. From the lazaretto to the laboratory, from the healing touch to the rise of hygiene, and from homeopathy to homeostasis, Jackson introduces key actors (human and non-human), ideas, institutions, spaces and social contexts of healing in each of the book’s six long periods. Through the lens of global transmissions of diseases and cures alike, readers witness the health impacts of trade, slavery, military movements and colonialism. At the same time, Jackson traces the influence of wider social trends – the Enlightenment focus on reason and distaste for irrationality for example – on medical epistemology, practice and rhetoric. Valuably, across these chapters, Jackson repeatedly illustrates the ways in which new theories and models of the body permeated and remodelled, rather than simply replacing older ones. Thus, for instance, the reader encounters the persistence of humouralism alongside mechanism, and then localised pathology, in medical practice throughout the eighteenth and into the nineteenth century.
Jackson’s history is certainly not an uncritical one. He includes accounts of medical failure, nepotism, abuses of power and outright charlatanism (within as well as beyond the orthodox profession, at least for the West). He also tracks, with a light touch, the emergence of major historiographical debates, for instance those that have swirled around the McKeown hypothesis, Illich’s iatrogenesis, anti-psychiatry, the medical marketplace, and various responses to the social determinants of health and health disparities. This ‘beginner’s guide’, unlike some earlier introductory texts, displays a healthy engagement with both gender and class as lenses for critical analysis of medical history. There is a clear effort to delineate the presence of female healers, midwives and carers in the medical mainstream, and Jackson’s attention to domestic medicine and public health also offers a useful window on class differences. The inclusion, however briefly, of material on folk traditions and various forms of minority medicine is useful. Here in particular he pays attention to continuities across geography, healing traditions and time, in relation to herbal medicine. Interactions between medicine and race are, in contrast, less evident in Jackson’s narrative (indeed, neither ‘race’ nor ‘ethnicity’ appear in the book’s index).
As with so many of the increasing number of introductory texts on the history of medicine, this volume lacks ‘scholarly apparatus’. Consequently, there is little to distract the novice reader from the text and argument. On the other hand, the curious reader, left eager to hear just a bit more – where, for example, were the anti-colonialist campaigns against western medicine most successful? – will sometimes be poorly served by the publisher’s decision to do away with footnotes. This volume’s well-thought-out index redeems many such deficiencies, as does a chapter-by-chapter guide to further reading; the volume’s timeline, like its text, will certainly appeal to general and student readers. Indeed, in this lively and accessible volume, those of us who teach the history of medicine at the introductory level may find an answer for the eager students who ask, ‘what can I read to prepare for your class?’
