The four books thus far released in OUP's new Biographies of Disease series share the traits of being lively and readable, and of being the conceit of telling a disease's life story. Beyond this, they are very different books. Two are written by historians (Jackson and Hamlin), one by a sociologist/historian (Scull), and one by a clinician with a long interest in medical history, whose own biography is entwined with that of his subject (Tattersall). Only one pays significant attention to classical accounts of its disease, or makes any effort to incorporate non-Western traditions; all focus most of their attentions on the modern period, and particularly the nineteenth and twentieth centuries. All likewise make links to the present, though in greater or lesser detail, and in quite distinctive ways.
Mark Jackson opens Asthma: The Biography with a vignette from the life of one of its most famous sufferers, the novelist Marcel Proust. He then explores asthma's long classical history, offering capsule biographies of key historical figures and explaining terms and concepts of this period briefly but lucidly along the way. Along the way, too, Jackson takes the opportunity to correct some of the abiding myths of popular history – for example, the idea that the Arab world simply preserved Graeco-Roman knowledge until Renaissance Europe was once more ready to take up the torch. This disease biography is strengthened by Jackson's attention to accounts of asthma in the scholarly medical traditions of South and East Asia. Throughout the volume, Jackson highlights points of change and continuities both in understandings of asthma, and in patients' experiences of the condition. The latter is given additional analytical importance by Jackson's observation of the roles played by asthmatics in writing and rewriting the biography of their disease as healers and experts in the early modern and Renaissance periods (and indeed, up to the present). The first half of the book is rounded out with the emergence of the ‘bronchospasm’, neurotic and inflammation/irritation models of asthma in the late eighteenth and nineteenth centuries. The remainder of the volume covers asthma's twentieth-century rise in prevalence and prominence, with interesting sections on, among other topics, clinician and patient activism, asthma in India, and corporate investigations of traditional and popular asthma remedies – an intriguing example of Big Pharma bioprospecting in Europe's own folk knowledge. Jackson closes by exploring perceptions of asthma from the mid-century in a (global) modern world, and concludes that it remains a diffuse and fluid, contested but recognizable – and now endemically fatal – disease for many.
Of the four books initially released in this series, Christopher Hamlin's account of cholera takes its biographical remit most seriously. It is also by far the most polemical of the biographies. Hamlin opens with a very big picture, linking cholera to the liberal state, to concepts of ‘civilization’ and citizenship, to capitalism, and to ‘progress’. A bold, if occasionally problematic historiographic prologue sets the stage, tackling one of the abiding complexities facing historians of medicine: the problem posed by the (contested) ontological independence of medicine's ostensible objects – behaviours, anatomical structures, microbial organisms, biochemical constituents and the like – alongside the obviously social, political and cultural interpretation of their effects. As Hamlin's account indicates, the once simple and exclusive association of epidemic cholera with a South Asian comma bacillus was politically and culturally convenient, but only emerged gradually from a complex medico-social background, and is again in some circles a matter of debate. While demonstrating the transformative power of this once-dominant understanding through a very readable history of its emergence and application, Hamlin also rebukes those who uncritically accepted the identification of this particular ‘cholera’ with the cholera Vibrio (and, indeed, those like poor Max von Pettenkofer, who did not). Medical certainty, in Hamlin's view, should be suspect, perhaps especially for historians, with their well-rehearsed examples of medicine's socially constructed fads, follies and victories alike. Hamlin proposes instead to write of the experience of ‘cholera’ (incorporating its symptoms, its study, its social and political impacts, its victims and professionals) as a fluid, composite, but genuine entity. He briefly skims classical, non-Western and early modern understandings of cholera morbus, before turning to the meat of his biography: the dramatic nineteenth- and twentieth-century history of the disease, and its role as a prompt to the sanitary city, as germ theory's ‘proof of concept’, and as a tool of colonialism. Like Jackson, Hamlin uses his disease biography to reflect on larger events, and to offer readers an alternative perspective on established history. His informal, opinionated and sometimes witty prose may not appeal to every reader, but the volume certainly raises intriguing debating points for the classroom (and the pub).
Like cholera, the disease diabetes has produced considerable medical and scientific drama and controversy. These, and in particular the remarkable transition of diabetes from acute to chronic disease status, are the principal focus of Robert Tattersall's instalment of the disease biographies series. Tattersall charts the contested discovery of insulin, its miraculous effects on the skeletal survivors of ‘controlled’ diabetes, and its subsequent transition from ‘miracle drug’ to ‘life sentence’ for patients with diabetes. Tattersall also devotes considerable space to type 2 diabetes, and its emergence in the twentieth century as a global ‘epidemic’. This volume studies diabetes largely from the perspective of the professionals involved with its investigation and care; simultaneously, it painstakingly documents the gradual process of innovation in the treatment of a deadly but chronic disease. Among those innovations are the expected parade of new drugs, insulins, and insulin-delivery devices – but also the emergence of the specialist diabetic nurse, the patient association and self-monitoring technologies. Moreover, and perhaps most interestingly, as a clinician, Tattersall writes sensitively of the practical impact of diabetes and its therapies on patients' lives. Once more in this biography, the reader is presented with the important and active roles played by lay and professional sufferers in the scientific exploration and management of their diseases – despite, in many cases, the unwillingness of their doctors to see them as agents, rather than as passive subjects.
As Andrew Scull acknowledges, this tension between the agency and the passivity of the patient, no less than the tension between somatic and psychic illness, is at the heart of both lay and professional understandings of hysteria. While Hamlin revolts against unacknowledged ambiguities in cholera's traditionally linear medical biography, Scull revels in the hotly contested nuances of hysteria's long history. Like Jackson, Scull opens his study with an engaging account of an individual case: here, the 1602 case of teenaged Mary Glover, the crone tried for bewitching her into fits, Elizabeth Jackson, and the eminent physician, Edward Jorden, who argued that Mary was not ensorcelled, but sickened by her own womb. While etiologies of hysteria moved from the womb to the nerves over the course of the seventeeth century, the condition remained tainted by an association with ‘animal spirits’ and unmanageable ‘passions’. Scull examines developments in the conception and treatment of hysteria through a succession of chapters focused on leading figures and practices related to it. Thus we see the condition – and its social and medical context – through the eyes of Willis, Cheyne, Brudenell Carter, Weir Mitchell, Charcot and Freud, and hazily through the eyes or at least the performances of their patients. Appallingly, but unsurprisingly, Scull documents the centuries of creative sadism expended on hysterics (male and female) by medical and other authorities attempting to winkle out the secret wilfulness and agency in hysterical afflictions. From the court-ordered burns inflicted on the teenaged Mary Glover, to the clitoridectomies and ovariotomies of the nineteenth century, to the testicular electric shocks meted out to enlisted sufferers during the First World War, the palpable anger and distrust focused by doctors on hysterics is evident. Scull closes by noting that this anger and scepticism have not disappeared with ‘hysteria’, but continue to affect those afflicted by illnesses lacking in clear somatic causes. ‘Hysterics’, like sufferers of asthma and diabetes, have fought to gain agency in their own diagnoses and treatments. It is revealing of more than the dynamics of medicine alone that they have been so far unsuccessful.
OUP is not the only press currently promoting disease-focused histories of medicine; Johns Hopkins also hosts a series entitled Biographies of Disease, edited (like OUP's offerings) by an eminent historian of medicine, Charles Rosenberg. Both series are intended for a general readership, and are appealing also for classroom use. Both, however, face the problem of most such efforts: the need to dispense with scholarly apparatus does limit the ways in which the books can be explored. While each of the books examined above offers a short further-reading section, often charmingly enthusiastic and usefully critical, the absence of fuller notes and a complete bibliography must be regretted. Surely the general reader, even more than the student, could benefit from these tools of exploration.
