Blood & Guts: a short history of medicine, by Roy Porter

The late Roy Porter re-wrote the prescriptions for medical history, says Chandak Sengoopta

Not so long ago, the history of medicine was something that doctors worked on during weekends or after retirement. Although the histories they produced had many admirable qualities, their gaze was not always broad enough to encompass themes beyond the narrowly scientific. The history of medicine, even for the best historians of that generation, was the story of scientific progress. Few "real" historians showed much interest in such technical matters and the doctor-historians didn't expect them to.

All that has changed radically over the last three decades or so. The history of medicine – in its broad sense as "the historical interaction of people, disease and healthcare, set in context of societies and their beliefs", to steal Roy Porter's succinct definition – has become a thriving area of full-time scholarship. Historians have discovered the body, as have literary scholars and sociologists. Although doctors have not surrendered their historical interests, the centre of gravity has moved to the humanities and social sciences.

This "new" history has little interest in the technical and scientific, and charting of progress is not on its agenda. It concentrates, instead, on the social, cultural and human dimensions of health, illness and healers. As with most academic endeavours, hardly any of this research ever makes it to the public domain. In spite of the ever-increasing popular interest in topics such as sexuality, genetics, addiction and mental illness, relatively few medical historians have contributed as ably to public discourse as political and cultural historians.

Perhaps the sole medical historian to defy academic purdah regularly was the author of this book. Roy Porter, who died suddenly on 4 March this year at the age of 55, was one of the earliest and best-known professional historians of medicine. Over the decades he spent at the Wellcome Institute, part of University College, London, he became legendary for his industriousness and for the generous, erudite and inspiring leadership that he provided to students, postdoctoral fellows and visiting scholars.

His research on every aspect of healthcare in 18th-century Britain galvanised a whole generation of students and researchers, conquering vast new domains – from madhouses to quack remedies, from gout to melancholia, from famous doctors to unknown patients – for the evolving discipline.

Committed as he was to the history of medicine, however, narrow specialisation was anathema to Porter. Nothing gave him more joy than to finish a book on gout and turn, without pause, to the history of the British Enlightenment. Or, for that matter, to take up the history of the Bedlam Hospital (the best-known British insane asylum) as soon as he had completed a vast social history of London.

Although he spent his entire career in the groves of academe, Porter never forgot that there was a real world out there, with an audience no less stimulating than his professional colleagues. He wrote copiously for his peers but always remained a public intellectual in the highest sense. Scorning jargon, earnestness and condescension, he communicated the excitement of history, the joy of ideas and the sheer exhilaration of thought to people everywhere, whether to the listeners of Radio Four, the readers of The Independent and other papers' review pages, or the students at schools and adult-education institutes.

Historians of medicine will come and go; many will contribute profusely to the discipline in their own ways. Roy Porter's personal blend of learning, generosity and near-universal accessibility, however, is unlikely ever to be matched. They just don't make them like that any more, as I realised again while leafing through this book.

Those of us who teach medical history have long lamented the lack of suitable introductory surveys – not textbooks, but brief, wide-ranging and fluently written overviews of the field that one could recommend to students who had no previous knowledge. The available texts were either too old, too dull, too arcane, or, as with Porter's own The Greatest Benefit to Mankind, too long. With Blood & Guts, however, we finally get the perfect pocket-sized introduction to the history of medicine, the perfect refresher course for professional historians who have forgotten some of the basic facts and issues (or are looking for a quick crib-sheet), and the perfect mind-stretcher for doctors who wonder where they came from. Beginning with ancient Greece, Porter shows not only how medical science and the medical profession have grown over the centuries, but also how the healer's art, initially concerned with individuals and their bodies, gradually became not only big science but also the object of enormous economic and political battles.

In eight beautifully crafted chapters, Porter deals with the evolution of diseases, the development of the medical profession, the growth of anatomy, physiology and therapeutics, the history of hospitals and the growing socio-political significance of medicine. Each of these topics has been addressed in isolated ways by scholarly monographs, but this little book provides the big picture that one must master before approaching those tomes. Despite the occasional factual error (beriberi is not caused by a deficiency of Vitamin A) this is an impressively researched, generously imagined and superbly written introduction to a grand subject affecting us all. It should, ideally, be read with Madness: a brief history (Oxford), published shortly before Porter's death and providing an equally compact and luminous synthesis of its own complex subject. The brilliance of these valedictory works will be a revelation to those unfamiliar with Porter's work, and remind the rest of us of the extent of our loss.

Chandak Sengoopta teaches in the Wellcome Unit for the History of Medicine, University of Manchester