Book Reviews

attention to such things as the importance of the medicine an empirical art. Similarly, tensions Apothecaries Act of 1815, the criticisms of the existed between those who attempted to promote hospital schools made by the Lancet and the the University and its examinations and those sometimes strained, although usually cordial, who defended the autonomy of the school and relationship of the clinical teachers with the favoured the conjoint examination of the Royal hospital governors. Although not a ``great man'' Colleges. Bart's did embrace laboratory history, it is clear from Waddington's story that science and university ideals, notably between some figures did have an enormous effect on the wars, being among the first institutions to the growth of the school. One such was the establish medical and surgical professorial units physician Peter Mere Latham whose stress on in 1919. Two years later hospital and College bedside teaching and physical examination were legally separated. Most interesting in this shifted the emphasis of the school. connection is that Waddington puts flesh on the Clinical medicine was not the only subject bone of what up till now had been mostly taught at Bart's. Anatomy, physiology, anecdote and gossip. As a medical school Bart's chemistry, materia medica and a variety of other always had a conservative reputation, yet in other disciplines were all built into the curriculum, ways it showed itself amongst the most especially after the 1830s. In two of the strongest innovative. The creation of the units brought out and most original chapters of the book, this contrast. The individualist older clinical `Mid-Victorian medical education', and teachers clearly held the professorial, unit system `Mayhem and medical students, 1662±1939', in some contempt. Waddington addresses in detail how it was that A good third of the last part of this book is the frequently wild, riotous, sometimes drunken devoted to the Second World War and after. medical student of the early nineteenth century Waddington chronicles changes in this period was turned into the relatively docile, studious, with the same meticulousness that characterizes aspiring bourgeois doctor of the Edwardian era. his account of earlier times. He shows too how First a residential college on the Oxbridge model tensions between conservatives and reformers was founded. Here students could be corralled persisted. This is an important study that adds and supervised. A system of scholarships and more detail to the once impressionistic picture of prizes was introduced. Written examinations London medical education. appeared. A Discipline Committee was established along with attendance registers. Christopher Lawrence, Philosophical societies and, later, sports clubs, The Wellcome Trust Centre for the fostered the new ethos. By no means perfect, the History of Medicine at UCL reforms did, however, encourage Bart's many medical students to be pupils their institution could be proud of. No doubt broader changes in Edward Davies, The North quarry Victorian morality and the growth of a single hospitals and the health and welfare of the profession were also at work besides these quarrymen, Archives Service, obvious external curricular and institutional Gwynedd Council, 2003, pp. vii, 311, illus. changes. $hardback 0-901337-83-8). Waddington's next major theme has two strands: the growth of laboratory science and the This important study represents the fruits of rise of academic medicine, the latter long, exemplary research by a practitioner of that development being intimately related to the honourable tradition of the doctor-scholar. establishment of the University of London. The Dr Eddie Davies has remained true to his roots as introduction of the experimental sciences into the a native of the north-west Wales slate district Bart's curriculum was no easy matter. Many of of , spending thirty-eight the clinical teachers, notably Samuel Gee, years of his career serving the population of approved of science in its place but considered Cerrigydrudion, an upland village which

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bestrides Telford's Chester to Holyhead his account of the bone-setting traditions of coaching road. Over those years he has played families like the Isaacs of Cwm Pennant who significant roles as long-serving editor of the eventually produced ``conventional'' Welsh-language medical journal Cennad, and in practitioners of some distinction. promoting the activities of the History of Well illustrated with photographs, the book Medicine Society for Wales. In his retirement he also includes appendices with quarry injury/ has laboured to produce a tour de force of mortality statistics and constitutions/rules of synthesis, simultaneously a history of medical workers' welfare societies. These serve to institutions, a region, an industry, and a culture. underline the earlier point that this is truly a As such, the title of the book might be thought to ``total'' history by an organic intellectual do the author's achievement a disservice. immersed in the life and culture of his ``bro'' Around six of the fifteen chapters are devoted $locality) and its neighbouring communities. almost entirely to the quarry hospitals. These Even should he not achieve elevation within the are amongst the earliest examples of an orders of the Gorsedd of Bards, he most certainly occupational health service anywhere in Britain. deserves to become honorary MO to the Annales ThePenrhynQuarryHospitalwasopenedin1825, School! the Oakeley in 1848, the Dinorwig in 1860 and the Since the author draws on numerous Welsh Llechwedd in 1888. These small institutions sources, the book will prove invaluable to dealt with a large number of amputations, head researchers unacquainted with the language. and eye injuries. The quarry doctors, many of However, one word of advice for readers not whom were expert surgeons and experienced intimately familiar with these mountainous general practitioners, were quick to adopt new districts of north Wales. Given the centrality of techniques, such as the use of ether, antiseptic kinship and place in the construction of Welsh spray and X-ray equipment. The hospitals, which identities and in particular the histories of were funded by both employers and workmen, medical dynasties and associated quarrying evolved to provide some services for the local communities, the average reader would find their community, but their origins were in direct access to this rich source of information response to the hazards faced by the quarrymen. facilitated by prior acquisition of the relevant The photograph on the dust cover of an injured ordinance survey maps. quarryman being carrried in a box stretcher from the Cwmorthin quarry in Blaenau Ffestiniog, Pamela Michael, conveys the scene. Employed in dangerous work University of Wales, Bangor carried out in the adverse climatic conditions of a mountainous environment, slate workers' risks Jonathan Oberlander, The political life of were compounded by their generally poor Medicare, University of Chicago Press, 2003, physique and conditions of material existence. pp. xi, 262, £13.00, US$18.00 $paperback Work accidents were frequent and related to 0-226-61596-0). many features of the extractive, processing and transportation aspects of the industry. In In 1965 the United States enacted a national describing these practices the author displays an health insurance programme for persons of awesome command of the minutiae of quarrying sixty-five years and over called Medicare. techniques and working practices. In 1972, Congress extended eligibility for The book provides invaluable insights into the Medicare to individuals of any age with proven struggles of the 's medical disabilities and $after a dramatic public practitioners to establish their professional demonstration of kidney dialysis) to those with hegemony by challenging the attempts to have end-stage renal disease. This only-in-America them work alongside ``bone-setters''. Davies complex of beneficiaries represented continuing conveys the complexities of the relationship political efforts to sustain the viability of private between doctoring and ``quackery'' through health insurance for the healthiest, least costly

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