“Science and the practice of medicine in the nineteenth century” is William F. Bynum’s explanation of the changes in medical care that occurred between 1800, when medical knowledge was still firmly based on two thousand year old Greek teachings, and World War I. These changes created the modern medical science that we know today. I have been reading medical history for a few years and I already agreed with his premise, the nineteenth century did see the birth of scientific medicine, but I knew few of the details. Bynum supplies those details in this entertaining and readable survey of medical advances. Some of what Bynum writes about is already well known, Snow’s Ghost Map, Pasture proving that life only comes from life, Koch’s identification of the Cholera bacillus, but most of the book covers less well known or understood advances, such as the musician/physician who needed to listen to a “Ladies” chest but could not “assault” her by placing his ear to her bosom. Laennec’s stethoscope was just the first of many advances in medical technology the book examines.

The author earned his MD from Yale in 1969 but instead of practicing medicine he went on to Cambridge for PhD in the history of science. He has served as head of the Academic Unit of the Wellcome Institute for the History of Medicine and has written and edited many books and articles on the history of science and medicine so when he wrote that the biggest medical advancement in the first half of the 18th century was made in the study of statistics I had to put aside my skepticism and listen to his explanation. After reading his well reasoned and clear explanation of that position I have to agree with him. The entire book is written in what is, given the subject, surprisingly clear and simple language.

Bynum apologizes in the preface for being anglocentric and for not looking into advances in southern Europe during the time covered, that, he said, was outside his expertise. I did not see the book as anglocentric. Many, if not most, of the important advances discussed originated in France and Germany . The United States is included in the discussion although little in the way of medical pioneering took place here. Bynum’s examples of how these medical advances affected society are principally illustrated with British examples and given the resources most available to him, the Wellcome Trust Library, that is understandable.

I recommend this book to anyone interested in the history of medicine or science. The discussion of how hospitals were paid for was enlightening and unexpected. I am looking forward to finding more of Bynum’s work. ( )