James C. Eisenach, M.D., Editor

The Age of Miracles: Medicine and Surgery in the Nineteenth Century. By G. Williams. Chicago, Academy Chicago Publishers, 1987. Pages: 234. Price:$10.00.

A good place to start with this book is its companion and earlier volume, The Age of Agony, also by Guy Williams, which focuses on the century before The Age of Miracles. One gains a deeper appreciation for the “miracles” when one has just visited the pustule-laden, pockmarked, vermin-ridden eighteenth century patient undergoing horrific “medical” ministrations (of which death by hemorrhage from blood-letting was one of the less disgusting methods of mistreatment). The advances of nineteenth century western medicine, such as anesthesia, asepsis, knowledge of vectors of infection, and attention to cleanliness, then become even more striking.

The Age of Miracles is meant for the layman with an interest in the history of medicine. I was pleased to discover this history book is easy to read and entertaining because I am less than an expert in the field (the last history book I read covered American history and was called Dave Barry Slept Here). Most likely, scholars of the history of medicine would be frustrated by the minimal references provided and the brief index. The index is only useful for looking up historical figures because other subjects are severely underrepresented.

The book contains 16 chapters of variable length, each with a different theme or central figure. Surprisingly enough, Williams chooses to place Edward Jenner and the smallpox vaccine story in his previous book, although the first vaccination was not performed until 1796, and places John Hunter (1728–1793) in the current book. However, Williams posits that Hunter, through his teaching and 13,000-specimen collection, was of incomparable influence on the development of medicine in the nineteenth century. Other chapters devoted to single innovators focus on Florence Nightingale, Hugh Owen Thomas (orthopedics), Jean-Martin Charcot, and Marie Curie. Theme-oriented chapters, such as “Antiseptics,” are still biographical in nature but bring in a wider range of players. Thus, Pasteur and Lister are given center stage, with rather brief reference to Koch, Holmes (Oliver Wendell, not Sherlock), and Billroth. In a book striving for brevity, editorial choices must be made, but it is still surprising that no mention appears of the preeminent pathologist of the century, Rudolf Virchow (a compelling portrait of Virchow can be found in Doctors: The Biography of Medicine by Sherwin B. Nuland).

Williams is decidedly Anglocentric, and, wherever possible, he emphasizes the British contribution. Hence, in the 17-page chapter on “Anaesthetics” only four pages are devoted to the American discovery-the rest describes British figures such as Humphry Davy, James Simpson, and John Snow.

The strength of the book is Williams' ability to tell a good story-interesting childhood and domestic biographical details allow us to grasp historical figures as people in particular social and cultural contexts. Further, the liberal use of quotations from primary sources defines the characters and makes an already lively story even livelier. For example, the oral confession of an infamous bodysnatcher is directly quoted-we hear the chilling details of a murder committed to provide a young body for anatomic dissection.

The Age of Miracles is informative, entertaining, and-here's another miracle-it only costs 10 bucks.

Audrey Shafer, M.D.

Associate Professor; Department of Anesthesia; Stanford University School of Medicine; Staff Anesthesiologist; Veterans Affairs Palo Alto Health Care System; Palo Alto, California 94304