A Short History of Medicine (Revised and Expanded Edition)

Book Title: A Short History of Medicine (Revised and Expanded Edition)

Book Author: Erwin H. Ackerknecht

Publication Information: Baltimore, MD, Johns Hopkins University Press, 2016, 272 pp., $29.95, paperback

Originally from Germany, Dr Erwin Ackerknecht studied in Germany and France, held professorships in the history of medicine at the University of Wisconsin and the University of Zurich, and throughout his career worked (at least intermittently) as a practicing clinician. A Short History of Medicinewas originally published in 1955 and subsequently updated by the author in 1982. This “revised and expanded” edition bookends Dr Ackerknecht’s own work with a foreword and a concluding essay by Charles Rosenberg (emeritus professor of the history of science at Harvard, and a former student of Dr Ackerknecht) and a bibliographic essay by Lisa Haushofer, also of Harvard. Thus, in one text, we have both Ackerknecht’s survey of the history of medicine, and a vantage point from which to assess his Short History as a historical document in its own right.

In the main text, Dr Ackerknecht begins with “paleopathology and paleomedicine,” exploring both what we know of medicine from the earliest written documents, and what might be surmised of even earlier medical endeavors with insights gained from archaeological finds and other artifacts. After chapters on primitive medicine, “ancient civilizations,” and ancient India and China, three chapters explore Greek medicine, two more cover renaissance and medieval medicine, and a chapter apiece is given to 17th and 18th-century medicine. Not surprisingly, given that more recent history tends to be better documented, fully eight chapters are dedicated to 19th-century developments, then a final concluding chapter addresses trends in the 20th century.

Throughout the book, the reader is given not just a history of ideas and trends, but also of the people, circumstances, and specific developments that shaped each stage of medical history. Furthermore, this is not just a history of medicine per se, rather Dr Ackerknecht tells the story of medicine as part of a broader historical narrative. For the 21st-century reader, the descriptions of various competing schools of thought at different historical junctures provide a useful comparison against which to assess current debates over competing approaches to medical knowledge and medical practices. Indeed, when he argues that “iatrophysics” and “iatrochemistry” in the 17th century demonstrated the “premature application of basic scientific data to clinical medicine” (p. 96), he seems to be describing a foreshadowing of current debates over “disease-oriented” and “patient-oriented” evidence.

While Dr Rosenberg’s foreword is a relatively standard introduction to the book, his concluding essay provides perspective from which to view Dr Ackerknecht’s work itself as a part of medical history. He posits that Dr Ackerknecht’s own approach to history was a product of his time, and yet it also shaped subsequent approaches to medical history writing. Even reading the text, one notes early on terms such as “primitive medicine,” and Dr Ackerknecht’s comparative approach of using what we think we know about current-day “primitive societies” to attempt to fill in the gaps of our knowledge about medical prehistory. Nonetheless, Rosenberg argues that Dr Ackerknecht’s breadth of vision, including social medicine and ethnography, played a role in reshaping standards for writing medical history, to include “life and death, environment and economic growth, concepts of the body in health and disease, of the normal and the abnormal” (p. 206).

Perhaps the thorniest question of medical history comes in Rosenberg’s critique that Ackerknecht “found it difficult to avoid placing his protagonists in innovation hierarchies—a world of “contributions” and “advancements” (p. 202). In other words, is history better told from a detached and relativizing academic perspective, or from the perspective of the practitioner engaged daily in the field—or perhaps from some vantage point in between?

This concise and engaging text can easily be read by busy learners or faculty, yet the breadth of Dr Ackerknecht’s writing also provides a fertile starting point for broader explorations of the relationship between medicine and society through time, and the foreword and concluding essays help one think about the historian’s own place in history.

“If civilization is able to survive the catastrophies which threaten it; then most of the history of medicine so far may be hardly more than ‘prehistory’ to future historians and doctors. Yet their debt to their predecessors will be as immeasurable as is ours to the anonymous caveman who once in the dim past discovered the use of fire” (p. 191).