BioMed
Porter follows healing from ancient systems through hospitals, laboratories, public health and modern biomedicine, asking when medical power actually improved human life.
Medicine's success and the public's distrust of it have risen together. At the moment medicine can do more than ever before, it also draws more doubt than ever before, so more power does not earn it more trust.
How a society explains and treats illness grows out of its wider religious, scientific, philosophical and political convictions. Healing is never a self-contained technical field; to understand a medical practice, look at what the surrounding culture already believes about the world.
The urge to know where diseases come from, and what can be done to control them, has done more than anything else to push medicine forward. New medical ideas tend to arise as answers to these two questions.
Sickness can settle military and political contests as surely as generals do. Fresh citrus kept sailors free of scurvy and helped win a naval war. Mosquito-borne fever wrecked an army sent to retake a rebel colony.
When travellers reach populations that have been cut off from the wider world, they bring infections those people have never met. Sexual disease, tuberculosis and measles arrived alongside the explorers, so encounter itself became a channel of devastation.
Medical knowledge is also an instrument of power. Keeping soldiers and colonists alive in hostile disease environments made it possible for imperial states to expand, so healing and conquest advanced together.
Medicine advances through institutions more than through individual heroes. Hospitals turned the bedside into the classroom for training doctors, and laboratories produced whole new sciences of disease, bodily function and drugs. Progress depends on organised settings, not on a few famous discoverers.
Healing grew from scattered individual practitioners into a coordinated system. Specialised fields split off from one another, and ambitious public health programmes came to manage the health of entire populations. Medicine came to operate at the scale of society, not just the single patient.
Early medicine could rest on simple, firmly held codes of conduct. As medicine's abilities grew, those codes gave way to murky ethical dilemmas, and its triumphs turned into disorientation. Medicine now has to decide where its proper limits lie.
Many societies built their own systems of healing, but Western medicine became uniquely powerful and spread across the whole world. As a result, one tradition's methods now set the terms for health care almost everywhere.