Bodies Politic: Disease, Death and Doctors in Britain 1650-1900
Roy Porter
304pp, Reaktion Books, £25
A head for heights, a nose for news, no stomach for a fight . . . We incorporate - happy word - the body into the language of survival. We stopped believing in the four humours, but we remain bilious, choleric, sanguine and phlegmatic. Such words are a hangover from an orgy of ills we barely remember. In an antibiotic, immunised and cosmetic age, in which doctors do (mostly) save lives, we forget the world in which they mostly didn't. Until the 20th century, miserable suffering, disfigurement and untimely death were a part of family life, and physicians and barber-surgeons, with their bleedings, purges and cuppings, were the professional accomplices of all three. Everybody knew it: you could say they lived with it. They certainly died with it.
The doctor's nostrums were as likely to hasten death as delay it. "His Farces are Physic / his Physic a Farce is," the actor David Garrick is supposed to have sung of the doctor-playwright Sir John Hill. Doctors knew of their own complicity with death. In June 1719, two fashionable doctors duelled with swords. One disarmed the other and generously said "Take your life", to which the other riposted "Anything but your physic!" Another, rebuked for not keeping appointments, philosophically observed: "Nine of them have such bad constitutions that all the physicians in the world can't save them, and the other six have such good constitutions that all the physicians in the world can't kill them."
Modern medicine dates its beginning from the 17th century: William Harvey confirmed the heart's role in circulating the blood, and began to study the development of the chick within the egg. Scientific observation would, slowly, lead to the discovery of vaccine, hygiene, anaesthetic, a germ theory of disease, healthy diet and finally drugs that worked. But you would not have been aware of this slow trajectory then, either in Hogarth's Gin Lane or in the Puritan landscape of sickness as a reward for sin. This was the world of hare lips, club feet, cleft palates, suppurating ulcers and hideous wens. Teeth dropped out from scurvy, the pox consumed noses, birthmarks and moles were the devil's stigma. Dwarfs and the disfigured found a career in the freak shows. Madness itself became theatre: people went to Bethlem, or Bedlam, for a thrill, as they went to public executions.
Medicine was in some ways wilfully irrational. In such a world, a royal hand might heal scrofula - the young Samuel Johnson was so touched by Queen Anne - and physicians were applauded for their confidence rather than their bags of tricks. "I can scarce express," marvelled one observer, "what Influence the Physician's Words have upon the Patient's Life"; it is salutary to remember that doctors continue to be valued for their bedside manner.
Medicine began as art; anatomists taught art students at the Royal Academy. Sickness, and death too, were displayed as if hung in the gallery, or performed in a kind of theatre of disgust. Medicine, says Roy Porter in this wonderful book, "was a corpus of preachings and teachings, a vehicle of spiritual and psychological healing, a lancet of satire, a medium for moralising, a social balm or caustic". The bitter pill purged, and either purified or poisoned. Either way, it was an occasion for black humour, or at least sick jokes. The evidence for this medical mayhem is there in the pamphlets and the ballad sheets, in Sterne's Tristram Shandy , in Ben Jonson's Volpone .
But most of all, the evidence is in the illustrations. Porter is a chronicler of the history of medicine, of the Enlightenment, of London, of Bethlem, of gout, of charlatans. He says in his introduction that he turned his eye from text to illustration and saw a new story to tell. There are 153 illustrations in this book, 32 in colour, and every one is an exultation in the fleshly horrors of the era. They end with late-Victorian cartoons from Punch that implicitly reveal new expectations of the medical profession, but they start with the doctor as a preposterous figure, in an etching from Tristram Shandy , and continue, like tableaux in a cavalcade, mordant, comic and disgusting. Hogarth is there, with an enthusiastic dissection of an executed killer and a picture of the woman believed to have given birth to live rabbits. Cruikshank is there with a study of poverty, and Gillray with his 1804 political cartoon Britannia, Between Death and the Doctors .
And of course there is Rowlandson, with a picture of Joanna Southcott, who claimed to be pregnant at 64, exposing herself to leering doctors. At every level, ideas are made flesh. Medicine provided a wonderful metaphor for politics, although how many visual puns on the "rump" of parliament would you wish to see? But this was an age of censorship, and criticism of princes was perilous. "Under such circumstances," remarks Porter, "pictures may say more than is permitted in words." You might say he had said a mouthful.
