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Book Reviews a vaccine was fierce. He begins with a somewhat such as Dorothy Horstmann—a Yale investigator superficial overview of the history of polio from who was the first to discover the ‘‘viremic phase’’ Galen to Warm Springs, Georgia. This is a large of polio, the very brief period of time when swath of time, the later portion of which has vaccination is effective—and Isabel Morgan—a already been covered in great detail by Naomi Johns Hopkins researcher who, Oshinsky Rogers in Dirt and disease: polio before FDR speculates, could ‘‘have beaten Salk to the polio (1992). The author hits his stride, however, a vaccine’’ if she had been willing to use children third of the way through the book, when he as experimental subjects and avoided marriage at unpacks the complicated interrelationship the age of thirty-eight (p. 132). Oshinsky rarely between private fundraising campaigns discusses polio victims themselves, except (spearheaded, in the case of polio, by the for a brief mention of teenager Bill Kirkpatrick, National Foundation for Infantile Paralysis, or Salk’s ‘‘Subject No. 1’’. In today’s literature, NFIP), the new post-war media machine, polio is a topic of both disease and disability bi-partisan politics, and the science of virology. history—one wonders why Oshinsky did not We learn why Jonas Salk became a household draw upon the work of Daniel J Wilson better to name in the United States, while Albert Sabin—a address the view of those on the ground leading international figure in polio research— who personally experienced what it meant to did not. Oshinsky takes us from the optimism have polio. of April 1955, when newspapers ran headlines Nevertheless, Oshinsky has written a highly proclaiming that ‘‘Polio is Conquered’’, to readable history about the leaders behind the sudden wave of scepticism that hit the America’s mid-century campaign to eradicate country later that same year after dozens of polio. Albert Sabin, Jonas Salk, Basil children who received vaccines from Cutter O’Connor (director of the NFIP) and FDR Laboratories of Berkeley, California, contracted ‘‘represent[ed] the public face of polio—the the disease and were left paralysed. By ending courageous victim, the devoted foundation his book with a discussion of the first bouts leader, [and] the brilliant researchers with their of Post-Polio Syndrome in the 1980s, lifesaving vaccines’’ (p. 112). It is a top-heavy Oshinsky indicates that the history of polio is story, but one of extreme importance to not a simple story of medical triumph but understanding how laboratory science operates one marked by numerous setbacks and in a consumer-conscious, media-saturated, complications. risk-adverse society. There are many thematic threads to this book that will be of interest to medical historians. First, Beth Linker, historians of medical ethics and human University of Pennsylvania experimentation will find Oshinsky’s discussion of the moral quandary of using children John Russell Silver, History of the treatment (institutionalized and not) as research subjects in of spinal injuries, New York and Dordrecht, the early live-virus vaccine trials compelling and Kluwer Academic/Plenum Publishers, 2003, pp. rich. And those who study the history of media xvii, 297, illus., £76.00, d110.00, $121.00 and medicine will find Oshinsky’s story (hardback 0-306-48032-8). noteworthy, since he claims that the NFIP ‘‘created the concept of philanthropy as In an age of politically-correct disability consumerism’’ (p. 5). For historians interested in consciousness, the Stoke Mandeville centre for women scientists, disability studies, or the spinal injuries is not just renowned, it’s iconic. patient perspective, Oshinsky has only a few Here, paraplegic sports replace basket-weaving brief sentences to offer. He leaves his reader and poetry as the pinnacles of human and medical wanting to know more about the women achievement, and an endless succession of VIPs scientists who were essential to the development line up for photo-shots. The would-be of the vaccine in the late 1940s and early 1950s, normatizing of social intercourse with persons

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Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.229, on 02 Oct 2021 at 09:51:28, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0025727300001137 Book Reviews not long ago regarded as basket-case cripples is worked under Otfrid Foerster in Breslau, treating inexpensive PR. spinally-injured miners. He had done some Like curb-cuts and wheelchair ramps, then, the research on peripheral nerve injury, was history of Stoke Mandeville and the history of the passionate about sweat therapy, and was an treatment of spinal injuries in general, can never advocate of physical re-education. An ugly be entirely a self-sealed medical story. As John man—as keen to take all the credit for successes Silver reveals in this converted MD thesis, the as to blame anyone else if things went wrong— political, the economic, and the cultural intrude at Guttmann ‘‘bullied and humiliated’’ those nearly every turn. Albeit, ‘‘the intrusions’’ here around him (p. 90). But at the same time, are mostly inadvertent; like other such apparently, he stimulated his staff, and was as practitioner histories, the dominant narrative of respected for his neurological knowledge as for this one is positivist, heroic and progressive. The the rigorous regimes he instituted. Patients, too, ‘‘dark ages’’ of dying paraplegics (mainly from were inspired by him—or perhaps just frightened bed-sores and dirty catheters) is seen inevitably into the kinds of behaviour that led medical to give way to happy, hopeful, scientific times. visitors to describe them as imbued with The ‘‘nothing-much-could-be done’’ days of restorative ‘‘spirit[s] of confidence and worker-patients paralysed by falling bales on self-dependence’’ (p. 96). busy docks, or crushed by shunting locomotives Stoke Mandeville became every inch and reckless transport wagons, progresses Guttmann’s fiefdom. He instituted research ultimately to inspired medical enthusiasts at all levels, insisted on meticulous note-taking determined to turn a unremunerative backwater for future studies, organized case presentations, into something other. tutorials and lectures on German lines, and It takes only two short chapters to get us there. conducted bedside teaching of doctors, We gallop through antiquity, Moslem, Hindu, physiologists, and nurses. Not least, he taught and Chinese medicine, Pare´, the usual stock of patients how to look after themselves. He was nineteenth-century surgeon grandees, on to ‘‘cruel to be kind’’ wrote one of them reflecting Cushing, Sargent, Holmes, Riddoch and Head on how her rehabilitation was as gruelling during the First World War, to arrive along the psychologically as it was physically. A way at the setting up in 1916 of the world’s first micro-manager and authoritarian, Guttmann specialist spinal outfit, the historically neglected often turned up on ‘‘his wards’’ in the Royal Star and Garter in Richmond. Short shrift middle of the night to check if staff and is given to the interwar doldrums with their cut- patients were following his orders. He blasted backs, institutional dissolutions, and meagre the truant. signs of professional interest, to reach the Second John Silver ought to know; intermittently he World War and the setting up of Stoke was a practitioner at Stoke Mandeville in the Mandeville as a Ministry of Pensions naval 1950s and 1960s, and collaborated with hospital in 1944. Guttmann on several research papers. His book Whereas doom and gloom prevailed at the Star combines personal recollections with sources and Garter, with patients ‘‘totally dependent on from the National Archives. Oddly, however, he the orderlies, regimented and addicted to does not pursue the history of Stoke Mandeville morphine’’ (p. 53), at Stoke Mandeville the sun through to the glory days when he was the shone from the start. Primarily, this was due to neurological consultant there, from 1970 to his Hitler. It was thanks to his 1933 expulsion of retirement in 1993. Instead, half-way through the Jewish doctors from university appointments that book he waves goodbye to the place forever, Ludwig Guttmann was led to seek refuge in offering thereafter a potted history of spinal England in 1939, eventually to become (after five injury treatment in the USA, Canada, the unhappy years at Oxford’s Nuffield Department German-speaking world and France. After four of Neurosurgery) Stoke Mandeville’s first chapters of organized historical disorder—with Medical Officer. Guttmann (1899–1980) had sub- and sub-sub sections on biography,

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Downloaded from https://www.cambridge.org/core. IP address: 170.106.35.229, on 02 Oct 2021 at 09:51:28, subject to the Cambridge Core terms of use, available at https://www.cambridge.org/core/terms. https://doi.org/10.1017/S0025727300001137 Book Reviews therapies, institutions and ‘‘summaries’’—the Henderson devotes a chapter to the discovery volume concludes with a ‘Discussion’ on of secretin (1902), Starling’s role in the ‘‘Brown the principles of treatment and a review of the Dog’’ vivisection trial (1903), and the creation of literature. As Sir Roger Bannister puts it in the UCL Institute of Physiology (1909). We are the book’s foreword, Dr Silver ‘‘achieves a also introduced to Starling as ‘‘politician and unique balance of historical perspective and iconoclast’’: his robust views on medical neurological expertise’’ (p. vii). research, science and education, attacks on the ‘‘Harley Street cabal’’, and admiration for Roger Cooter, Germany. A further chapter considers The Wellcome Trust Centre for the Starling’s ‘‘Law of the Heart’’ (1914). History of Medicine at UCL Henderson regards this as of less importance than the microcirculation and secretin work, but provides a detailed discussion in view of John Henderson, A life of Ernest Starling, continuing debate about the circulatory People and Ideas series, Oxford, published for the system. American Physiological Society by Oxford During the First World War, Starling became University Press, 2005, pp. xvi, 227, £35.99, engaged in gas warfare research, and later gas $59.50 (hardback 0-19-517780-0). defence training. According to Henderson, his There have been two accounts of Starling’s criticisms of War Office policies led to his life, by Carleton Chapman and Jens Henricksen, posting to Salonika in November 1916. but this volume draws upon new material—a Returning to Britain in July 1917 he served as collection of family letters. And instead of the chair of the Royal Society’s Food (War) thematic approach of the earlier books, Committee, and as a member of staff of the Henderson treats Starling chronologically. A Ministry of Food. Three post-war chapters deal prelude outlines the history of medical education with the Starling’s final activities. As Pre- and physiology, before proceeding to Starling’s Clinical Dean, he was much engaged in teaching, childhood, education and early career at Guy’s and a Rockefeller Foundation gift for a new Hospital. Initially demonstrator in physiology anatomy institute. He also advised on the (1889), Starling developed a close relationship establishment of an all-India Research Institute. with William Bayliss of University College From late 1919 he suffered from colon cancer London (UCL), during their joint work on the but, after an operation, resumed research in 1921, heart’s electrical activity and nervous his research time increasing on his appointment stimulation. Starling published the first edition of to the Foulerton Professorship in Physiology his textbook, Elements of human physiology,in established by the Royal Society. Starling’s final 1892, and studied tissue fluid and lymph research was on kidney function and blood formation, in 1896 explaining movement pressure control. The former work, conducted between capillaries and tissues in terms of with Basil Verney, used a heart-lung-kidney hydrostatic and osmotic pressure—the preparation and demonstrated the effect of ‘‘Starling Forces’’. Using Guy’s Hospital pituitary extract upon the composition of urine, minutes, Henderson demonstrates Starling’s the starting point for the rest of Verney’s dissatisfaction with his job insecurity, research. As for the blood pressure work, remuneration, and teaching load. Guy’s Starling’s involvement seems to have petered out surgeon, Cuthbert Golding-Bird, described as between his health deteriorating in 1925 and his ‘‘vindictive’’, was apparently responsible for death in 1927. In the final chapter, Henderson the situation. Similarly, Starling’s move to the surveys Starling’s life, continuing discussions of UCL Jodrill chair of physiology (1899) was his attitudes towards Germany and medical opposed by the surgeon Rickman Godlee, science, the reasons for his failure to receive a creating a ‘‘gruesome slice of university Nobel prize or a knighthood, and his scientific politics’’. contributions.

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