The birth of the clinic. An archaeology of medical perception

JOHN C. KRANTZ, jr., Historical medical classics involving new drugs, Baltimore, Williams & Wilkins Co., 1974, 8vo., pp. x, 129, illus., $8.50. Reviewed by Edwin Clarke, M.D., F.R.C.P., Wellcome Institute for the History of Medicine, 183 Euston Road, London NWI 2BP In times of financial stringencies, it is natural to wonder why books of this kind should be published. The author has gathered together the histories of digitalis, morphine, nitroglycerin, aspirin, adrenaline, arsphenamine, insulin, vitamin B12, sulphonamides, penicillin, streptomycin, LSD, and fluorinated anaesthetics. He includes biographical accounts of the pioneers, and illustrates their discoveries by presenting excerpts from their classic papers or books. The work is intended" ... as an ancilliary text for the training of the student in the multifaceted field of the health sciences ... ." (p. vii), but unfortunately it is most unsuitable for this purpose. In the first place it is packed with errors, both factual and interpretative. Some are minor, but some are not, as for example when it is claimed that both Van Helmont and Beaumont discovered hydrochloric acid in the stomach! Why in the first place Beaumont's investigations are included is not clear. The analysis of historical developments are frequently in error and much of the vital secondary literature is omitted. Thus the section on penicillin contains the usual panegyric to Fleming, with Florey and Chain dismissed in a sentence. It is based on the distorted and unreliable Maurois biography, with no reference to Sir Ernst Chain's recent account of the true sequence of events, or to the remarkable "practical history" of Ronald Hare. The last "classic" in the book concerns the discovery of fluorinated anaesthetics, and the main reason for its inclusion seems to be that the author and one of his students were involved. The extracts from primary sources contain many errors, especially in those translated into English. Identification is often faulty or absent. Documentation is minimal and occasionally erroneous. If, in addition, it is pointed out that most of this material has been presented before in an excellent book by B. Holmstedt and A. Liljestrand (Readings in pharmacology, Oxford, etc., Pergamon Press, 1963), there is even more justification for exclaiming, "why, oh why?"