|A fresh look at Scottish medical history|
|Monday, 05 March 2012|
Helen Dingwall and Iain Macintyre reveal the extensive planning and research that went into a new title on the development of medicine in Scotland
For World Book Day in 2003 a group of German authors wrote, corrected, printed and bound a book all within 12 hours! By contrast our book, another group project, was over four years in the making. The project was initiated by Iain Macintyre and David Wright, and the other three authors – Helen Dingwall, David Hamilton and Morrice McCrae – were invited subsequently to join. We aimed to provide a history of Scottish medicine which would appeal to a general more than an academic readership and to produce a work in which illustrations would have prime significance.
The three general histories of Scottish medicine published between 1932 and 2003 are academic works, two of which have little or no illustration, and it was felt that there was a need for a general, and lavishly-illustrated, history of medicine in Scotland. Today’s readership increasingly comes to expect visual adjuncts in expression and communication.
The 330 images are a key feature of the book – indeed its raison-d’être. They are used not only to complement the text, but as historical sources and evidence in their own right. From an early stage, we realised the importance of captions; ideally each image and its caption should tell a story, linked with but independent of the main text. For example, the iconography in this painting of Old Surgeons’ Hall illustrates several aspects of Edinburgh medicine in the late seventeenth-century:
Although potential illustrations were, naturally, much more plentiful with the advent of photography, we agreed that each chapter should have a similar number of images. Over 1000 images were considered for inclusion, and it is hoped that eventually a website will be created to display the many images not included. The choice of images for the earlier chapters was more limited, emphasising medicinal plants, archaeology and artistic reconstruction. We were able to commission new art work from two young artists and several professional photographs.
After much discussion, and with a contract from the publishers Birlinn in place, it was decided that the most appropriate approach would be a combination of chronological and thematic. Each of the five authors took responsibility for covering a specific period in Scottish history, and for finding suitable illustrations. A general template was agreed, so that there would be a common approach to each chapter, although the changing nature and development of Scottish medicine meant that, within the template, individual themes received different emphasis.
“Over 1000 images were considered for inclusion, and it is hoped that eventually a website will be created to display the many images not included”
Major themes covered in all chapters include: the general historical context in terms of the socio-economic and political background; threats to health, including factors such as famine, endemic and epidemic disease; evolving medical philosophies; the rise of ‘official’ medicine and its attendant institutions; the contributions of notable individuals; lay healers and alternative treatments. Elements of continuity as well as change were noted – for example epidemic and endemic disease are still present, but their nature has changed from the age of the Black Death to the ‘modern’ epidemics of sexually-transmitted diseases or new strains of influenza. New themes were introduced in the chapters dealing with more modern periods, including the entry of the state and national government into medical politics, organisation and registration, the role of women in all branches of medicine, and the immense changes brought about more recently by the rapid improvements in medical technology.
The significant contribution of Scots to worldwide medical advance over many centuries was also important.
Other design features include textboxes, which allow fuller details on specific individuals, medicines or artefacts to be included without detracting from the flow of the argument. Some of these textboxes, as with the images, are independent of the main text.
Although each chapter was written by one author, all the text and images were discussed by all the authors. This forum allowed correction of the occasional factual error, improved the expression, ensured that each chapter addressed the same core themes, and also provided fresh insights into the topic.
We hope that the end product is a book which will provide information, analysis and, importantly, illustration of how medicine in Scotland evolved from pre-historic times to the present day. Although intended for a general audience, the book includes an extensive bibliography and list of further reading for those who wish to pursue particular aspects in more detail.
The project was only made possible by financial support from the three Scottish medical royal colleges, the Scottish Society of the History of Medicine, the Carnegie Trust, the Russell Trust and the Wellcome Trust.
Visit the book’s website at www.scottishmedicine.co.uk