Vers la médecine sociale by René SandReview by: George SartonIsis, Vol. 40, No. 1 (Feb., 1949), pp. 90-91Published by: The University of Chicago Press on behalf of The History of Science SocietyStable URL: http://www.jstor.org/stable/227455 .

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90 Reviews

will indicate. Aranzi (p. 47) is also said to have studied under Vesalius at Padua which would indeed have been remarkable since Aranzi was but eleven years old when Vesalius left that city permanently. In addition, Aranzi's numerous false claims are accepted at face value. Picco- lGmini's two anatomical treatises are mentioned (p. 49) without realizing that the second was the fraudulent work of a book-dealer. The most amazing feature of du Laurens' book is said to be his ignorance of the work of his predecessors (p. 49), yet his illustrations are drawn from, indeed are copies of, those of Vesalius, Valverde, Coiter, etc. We are told that Cesalpino taught that "in systole, the heart sends blood into the aorta, and in diastole, receives it back from the vena cava," (p. 50) which is surely a most dis- torted statement of what Cesalpino did say. Knowledge of the venous valves is attributed to Berengarius. (p. 50.) William Cowper's Anat- omy, with the plates plagiarized from Bidloo, is confused with his Myotomia reformata, a dif- ferent work. (p. 70.) Dr Mettler's estimate of the great biologist-surgeon John Hunter will find little acceptance. "He made some anatomic investigations although their originality is not marked. The effect he exerted in stimulating torpid people was more significant than his merit as an investigator." (p. 84.) On such an important matter as the cell theory, Schleiden and Schwann are dismissed as relatively incon- sequential contributors, (p. 99) while A. R. Rich's conclusions on Dutrochet are accepted without challenge. (Compare J. Walter Wil- son's articles on the cell theory Isis, I944, 35: i68, I947, 37: I4.) These are but a few of the fallacious or misleading statements taken from the first hundred pages of the work and the reviewer could continue for many more pages enumerating similar examples. From the above it is abundantly clear that Dr Mettler's History of Medicine must be used with caution even as a work of reference. However, it should be emphasized in justice to the author and her work that these deficiencies become progres- sively less evident as she proceeds to the more recent periods.

The organization of Dr Mettler's work is unique and designed specifically to facilitate the teaching of the history of medicine in the medical curriculum. Realizing the limitations of the medical curriculum and that teaching in its various branches necessarily occurs at different intervals often separated by years, the author has so arranged her material that the study of the history of any one subject may be pursued concurrently with the formal instruction in that field. The arrangement of the text, therefore, follows the familiar organization of courses in a medical school being divided into a series of sec- tions covering the history of anatomy, physi- ology, pharmacology, pathology and bacteriol- ogy, physical diagnosis, medicine, neurology and psychiatry, venerology, dermatology, pediatrics, surgery, obstetrics and gynecology, opthalmol-

ogy, otology and laryngology. Any teacher in the history of medicine will immediately recog- nize that such a method of presentation has much to commend it in view of the brief period available in the average course and the immen- sity of his field. Furthermore, the method not only enables the student of medicine to follow the development of the subject in the study of which he happens to be engaged, but it provides a convenience for both general practitioner and specialist desirous of acquiring rapidly informa- tion in a particular area of interest. On the other hand, the method carries with it distinct disadvantages in its tendency to partition knowledge. The student of medicine already suffers unduly from the existence of rigid de- partmental barriers. Above all he requires greater opportunities to see things whole and to integrate the many diverse facets of his teach- ing. Surely there is no field in the entire pro- fessional curriculum where these many forces which have influenced the progress of medicine can be more suitably revealed than in the teach- ing of medical history.

J. B. DEC. M. SAUNDERS

RENA SAND: Vers la midecine sociale. 67I pp. Paris: Bailliere; Liege: Desoer, I948. In one of the first volumes of Isis (4, I22-23),

it was my great pleasure to write an enthu- siastic review of Dr Sand's earlier work Organi- sation industrielle, midedne sociale et dducation civique en Angleterre et aux Etats-Unis (896 pp., Bruxelles 1920). The present volume is in some respects an amplification of the former one and much of what was said in the first review might be repeated in this one; some criticisms apply to the new volume as well as the old one, but the praise, great as it was, must be increased. This is indeed an excellent book and so rich in contents that it defies a complete description. It must suffice to indicate how it is built. It is divided into nine parts: i. History of the medi- cal profession, 2. History of hospitals, 3. His- tory of personal hygiene, 4. History of public hygiene, 5. History of social hygiene, 6. History of industrial medicine, 7. History of welfare work, 8. History of social sciences (les sciences de l'homme), 9. The coming of social medicine. This is completed by a bibliography, and elabo- rate indexes of names, nations, and subjects. The scope of the book is encyclopaedic and the amount of miscellaneous information tucked away in every chapter almost incredible.

The author is not a trained historian, but he is a trained observer and interviewer with a very large experience in medical work (chiefly public health and social medicine) in many countries. He is professor of social medicine at the uni- versity of Brussels (Isis 36, 250) and was general secretary of the Belgian Ministry of Public Health. He has travelled considerably and taken an active and brilliant part in many international conferences. His international out-

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Reviews 9I

look was increased by the circumstance that he is a member of a small nation where the people are either parochial or world-minded, and he belongs to the enlightened minority which is international as a matter of course. He is in- quisitive and sensitive, a man of wide and wise reading, acquainted with the practical idealists of his own kind all over the world. It is im- possible to give an idea of the abundance of topics dealt with or of the number of men of all ages and all countries to whom he refers. His tribute to Richard Clarke Cabot (i868- I939) pleased me very much because Dr Cabot did not receive his mead of praise in his own university (Harvard) and was spoken ill of by some of his own colleagues, who could not understand or imagine his greatness.

As the nine parts of the book are not mutu- ally exclusive, some overlapping was unavoid- able. Welfare work (or a little more broadly "assistance") would include some account of hospitals. The separation between "public health" and "social health" is not always clear to me, for is not everything public also social, and vice versa? It would probably not be very difficult to find errors among the innumerable details. Some statements are obviously wrong or very doubtful, e.g., that the Ayurveda dates from a thousand years B. C. (p. 287; see my Introd. 3, I2I7) or that distillation was prac- tised in China and India at least c. 8oo B.C. (P. 290; Introd. 2, 408); the Arabic or other oriental names are often misspelled, or their spelling is inconsistent; we should remember that his book was not written primarily for scholars but for physicians, and especially for the new physicians, the social physicians of to-day and to-morrow. Their number is increasing rapidly and the fundamental problems which they are trying to solve are understood not only by practical physicians, but by historians like Sigerist (Isis 33, 553) or myself, by administra- tors like Raymond Blaine Fosdick. I was happy to reread in Dr Sand's book (p. 33) the noble words written by Fosdick in his Rockefeller Report for the year I946. To conclude, I warmly recommend the translation of Dr Sand's book into English. Whether in its French origi- nal or in English translation, it ought to be prescribed reading for every medical student, or at least for every student attending courses in the history of medicine or social medicine. I wish that Russian students would read it too; they would find in it generous appraisals not only of the splendid efforts made in their own country but also of comparable efforts in many other countries.

GEORGE SARTON

WILLIAM C. MENNINGER: Psychiatry in a Troubled World: Yesterday's War and To- day's Challenge. xiv+636 pp. New York: The Macmillan Company, I948. $6.oo In a brilliant statement regarding psychiatry,

Alan Gregg is quoted in the introduction to this volume as saying that psychiatry makes it pos- sible to bring to others the light of reason, the oneness-with-others and an attitude of sympa- thetic humility, and understanding. With this text, Doctor Menninger offers a superb analysis of psychiatry during World War II, and sug- gests the peace-time applications of what was learned through this extraordinary experience. With an astonishing amount of factual material, with skilled organization and interpretation of the data, Doctor Menninger reaches conclusions which may be of extraordinary significance as their importance becomes better appreciated.

This volume is an excellent example of the manner in which the current history of science may be written. In discussing the odds against the inauguration of an effective program of psychiatry for the Army, Doctor Menninger interestingly discusses some of the psychiatric problems involved in bureaucracy, entrenched prejudice, tradition, and authority. It is amaz- ing that under the stress of war conditions, psy- chiatry could make such significant contribu- tions not only to the management of psychiatric soldiers, but even to the organization of the Army itself.

Various factors relating to personality, en- vironmental stresses and strains, and emotional factors are discussed in relation to morale and the function of the fighter. There is an excel- lent chapter discussing the role of women in the Army. Combat reactions, maladjustments of various sorts, and behavior disorders are thoroughly analyzed. Malingering is skillfully handled, and the problem of homosexuality is well described.

Doctor Menninger criticizes the lack of taxonomic skill in relation to psychiatry, with particular regard to diagnostic labels. He gives much information on the problems involved in selection and in management of psychiatric patients. In parallel columns, the progress of psychiatry is cleverly shown in the improved circumstances of World War II as compared with World War I.

Nearly half the volume is devoted to the applications of psychiatry, as learned from the war experience, to the problems of peace. Emphasis is placed upon the problems involved in maintaining mental health. Social readjust- ment is thoroughly discussed, and the influence of the home is emphasized. Broad community problems are analyzed and a careful critique is made of the defects in civilian medicine. The need for careful education and research in psychiatry is emphasized. The public health aspects of psychiatry are discussed, and the importance of mental hygiene is shown for industry and business. There is an excellent discussion of the role of psychiatry in criminol- ogy.

Doctor Menninger's volume is important for historians, intelligent laymen, sociologists, phy- sicians, and military leaders. With thorough

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