ARTICLES IN JOURNALS, MAGAZINES, NEWSPAPERS
BY DATE OF PUBLICATION
Roy Porter. ‘Cambridge in the French Revolution’. Christ’s College Magazine 1971;
61 (1): 16-19.
‘William Frend graduated from Christ’s in 1779. He became fellow and tutor of
Jesus. He was expelled from his college in April 1793 by judgement of the Masters
and Fellows on the charge that his writings tended to “prejudice the clergy in the
eyes of the laity”, “to disturb the harmony of society”, and “to disturb the harmony and
interests of the college”: vague, vaporous charges, impossible to disprove, and which
the Master refused to put in writing. Within a month he had been expelled from the
University too ... What was Frend’s crime? ... [he] had opened deep wounds by his
fierce campaign of polemic and satire against the Anglican exclusiveness of the
university ... then his pamphlet Peace and Union [was] open in its support for the
French Revolution and stigmatized Pitt’s war against revolutionary France as a
deliberate conspiracy of the rich and the reactionary, which could only multiply the
sufferings of the great mass of the people ... Frend’s expulsion was the only radical
cause célèbre in Cambridge during the French Revolution. Fellows and
undergraduates who had applauded the fall of the Bastille did not harden into an
active radical core.’
Roy Porter. ‘Charles Lyell and the principles of the history of geology’. British
Journal for the History of Science 1976; 9: 91-103.
‘To understand the polemical significance of Lyell’s history [Principles of geology]
involves contrasting it with the received accounts of the science – its nature and
history – in the period leading up to 1830: the outlook of such as Buckland,
Conybeare, Fitton, and the major encyclopaedias. Like the rest of the Principles, it
has a vision, a range, a show of premeditated design which elevate it above the
crowd, and compel respect for Lyell’s intelligence and craft. Other histories, though
no British ones, were longer, and discussed more geologists: one should mention
Desmarest, Brocchi, and, slightly later, Keferstein. But alongside Lyell these shrivel
to compilations ... Most British chroniclings of geology had concentrated chiefly on
native science. Lyell strategically makes the entire world his parish.’
Roy Porter. ‘William Hobbs of Weymouth and his The earth generated and
anatomized (?1715)’. Journal of the Society for the Bibliography of Natural History
1976; 7: 333-341.
‘Hobbs … nicely illustrates what one might call the first law of the history of English
geology, that most early English geologists came from or lived in the vicinity of the
Oolitic and Lias series of sedimentary rocks running from Dorset, Wiltshire and
Gloucestershire through up to Yorkshire. Hobbs sought to explain why marine,
animal and vegetable exuviae are found embedded in sedimentary rocks … Hobbs
argued that land gradually built up out of the sea by the action of tides and currents
accumulating sands, silts, gravels, pebbles and the like, stratum super stratum … In
this process, marine creatures, particularly shell fish, because of their immobility,
became entangled with the debris, while it was still plastic … Hobbs’s theory …
avoids the difficulties of contemporary explanations of both strata and fossils, as
being either the instantaneous work of Creation, or the product of a Universal Deluge
… Hobbs offers a more radical argument, which I have not encountered in other
contemporary works. The six days of creation stand for six synchronic processes, all
occurring simultaneously … life was already in being when the land and waters were
being separated, and the conception of original fossiliferous strata is shown
compatible with Scripture … to my knowledge, no subsequent writer in all the
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debates on Genesis and geology up to the time of Darwin makes a similar
interpretation.’
Michael Neve, Roy Porter. ‘Alexander Catcott: glory and geology’. British Journal for
the History of Science 1977; 10: 37-60.
‘Fieldwork steadily grew in popularity throughout the eighteenth century … It
reflected the growing ease and importance of scientific travelling. Enlightenment
naturalism, the call of the sublime, picturesque, and romantic lured naturalists out
into the field … theories of the earth were in the melting pot, challenged by new
observations. The scientific career of Alexander Catcott (1725-1779) shows these
pressures to relate observation and theory, and the tensions which they could
produce … His main body of publications is a defence of the true Hutchinsonian
philosophy of Creation … emphasis upon the literal truth of the Biblical explanation
… pervaded his entire consciousness and was manifest in his hostility to the diluted
creed of liberal rational religion, as also to the Enlightenment world of newspapers,
circulating libraries, and dilettante fossil collectors … he also sought evidences for
his beliefs in the earth itself … Undertaking fieldwork was central to his elaboration of
Hutchinson …He did not, of course, undertake his fieldwork with any intention of
putting his theories to the test, or even of discovering truths about phenomena about
which he was ignorant … [nevertheless] he read works of all shades of opinion, albeit
with a mission of refuting atheistical geology … Catcott believed the earth preeminently showed signs of order, indicating wise design …the chief sign of order was
the horizontality of the strata … it showed that no random, ‘accidental’ forces (such
as earthquakes, volcanoes, denudatory processes) had been operating over aeons
of time, gradually modifying landforms, as ‘atheistical’ geologists pretended …
Disorder was God’s emblem, the reminder of His own power over nature … Catcott
tried to show in his journals and Treatise on the Deluge how disorders in landforms
could have no other origin but through the violent universality of the Noachian Deluge
… Fieldworking provoked major disturbances in his thought … fieldworking was soon
to become the hinge upon which investigations of the earth, and indeed the new
science of geology itself, were seen to turn.’
Roy Porter, Kate Poulton. ‘Research in British geology 1660-1800: a survey and
thematic bibliography’. Annals of Science 1977; 34: 33-42.
‘This article surveys recent scholarship on the early history of British geology. It finds
that many of the developments called for a decade ago by Dr Eyles and Dr
Rappaport have not yet been realized. However, there has been progress in the
broader understanding of geological ideas in their historical context, and a start has
been made on the social history of the science. Some suggestions are offered as to
a field of problems for the future, and a selective bibliography of secondary materials,
thematically arranged, is appended.’
Roy Porter. ‘Gentlemen and geology: the emergence of a scientific career, 16601920’. The Historical Journal 1978; 21: 809-836.
‘In the emergence of the career pattern of the geological scientist, professionalization
was actually a secondary stage. For it arrived when external pressures dictated, ie.
when institutions and paymasters developed, aiming to incorporate already-existing
geologists, and thereby directing their modus operandi. More historically significant,
however, was the earlier and quite separate appearance of the career geologist. For
the creation of that type was largely generated by inwardly directed ethics of
knowledge. Nineteenth-century naturalists came to conceive of geological careers
as vocations, and became a self-sustaining, self-validating knowledge elite,
guardians of expertise in their field of intellectual endeavour.’
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Roy Porter. ‘George Hoggart Toulmin and James Hutton: a fresh look’. Bulletin of
the Geological Society of America 1978; 89: 1256-1258.
‘According to Gordon L Davies (1967), George Hoggart Toulmin (1754-1817)
probably plagiarized from James Hutton, and was not important in the history of
geology. But Toulmin’s views differed from Hutton’s in important respects, and he
was perhaps more indebted to Georges Louis Leclerc de Buffon and to John Brown.
That Toulmin translated the geological writings of JAC Chaptal shows that his
interest in geology was a lasting one.’
Roy Porter. ‘George Hoggart Toulmin’s theory of man and the earth in the light of
the development of British geology’. Annals of Science 1978; 35: 339-352.
‘Historians generally assume that the geological theories of George Hoggart Toulmin
(1754-1817) are identical to those of James Hutton. This paper seeks to establish
that Toulmin’s ideas are significantly distinct and possess and independent interest.
It argues that Toulmin was highly exceptional in his treatment of the nature and
history of Man within the discipline of geology, for he saw Man (like the earth) as
being eternal, and also treated Man totally naturalistically, as an integral, nonprivileged part of the terraqueous system. The neglect of Toulmin by subsequent
geologists is examined, and it is suggested that it was in part attributable to the
unacceptability of his interpretation of Man.’
Roy Porter, Kate Poulton. ‘Geology and Britain 1660-1800: a selective biographical
bibliography’. Journal of the Society for the Bibliography of Natural History 19781980; 9: 74-84. (Periodicals Room)
‘This article … lists writings about the most important figures in the early history of
the geological sciences in Britain, taking the term broadly to include all scientific
studies of the Earth’s crust and surface, organizing the references biographically …
for references to more broadly interpretative studies of the early development of the
Earth sciences in Britain, see Roy Porter and Kate Poulton (1977), ‘Research in
British geology 1660-1800: a survey and thematic bibliography’. Annals of Science
34, (1): 33-42. We have to some degree included writings about observations made
by continental geologists in Britain (such as Faujas de St Fond and RE Raspe), and
about the travels of British geologists abroad.’
Roy Porter. ‘Philosophy and politics of a geologist: GH Toulmin (1745-1817)’.
Journal of the History of Ideas 1978; 39: 435-450.
‘George Hoggart Toulmin (1754-1817) ... published his theory of the earth as an
overt gesture of political radicalism ... The fundamental thrust of Toulmin’s
geophilosophy was to establish the eternity of the earth, and hence all forms of
minerals, plants, and animals – man included – which populated it, as part of the
eternity of the entire system of nature. The earth – like nature in general – he viewed
as self-contained, and self-sustaining. No evidence indicated that the earth had ever
enjoyed, or suffered from, external divine intervention. There was no sign that the
system of nature was in decline or coming to an end.’
Roy Porter. ‘Medicina e illuminismo nell’Inghilterra del settecento’. Quaderni Storici
1979; 40: 155-180. Reprinted as ‘Medicine and the Enlightenment in eighteenth
century England’. Society for the Social History of Medicine 1979; 25: 27-40.
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‘… general social historians have seen no need to connect medicine and the
Enlightenment to developments in English society … It would be indeed paradoxical
if English medicine and Enlightenment thought had not significantly interacted,
because numerous philosophes were medically active, and many medical men were
men of letters, from Locke, Berkeley and Mandeville, through Smollett and Hartley, to
Erasmus Darwin and Beddoes … There are three basic changes in the evaluation of
medicine and health in the English Enlightenment … the first is its secularization …
the second is … an increase of [medical] provision by the rich for the poor … an
expression of the fashionable Enlightenment virtue of philanthropy … The third new
perspective is that of changing expectations about health … philosophes aspired to
the triumph of scientific medicine over pain and death … My contention is that
Enlightenment currents will explain major changes in the evaluation of life which
occurred in the eighteenth century … The offspring of the Enlightenment and
medicine must be sought in England not in the medical profession nor in the State,
but amongst the propertied classes, who were pre-eminently individualistic. The
clinical gaze must be lowered onto the laity.’ (This paper contains much that is in
‘Was there a medical Enlightenment in eighteenth-century England?’ British Journal
of Eighteenth-Century Studies 1982; 5: 49-63.)
Roy Porter. ‘Società scientifiche di provincia di provincia e opinione pubblica
nell’Inghilterra dell’eta dell’Illuminismo’. Quaderni Storici 1979; 42: 925-963.
Reprinted as ‘Science, provincial culture and public opinion in Enlightenment
England’. The British Journal for Eighteenth-Century Studies 1980; 3: 20-46.
‘Why did science become an important feature of provincial life in eighteenth-century
England? As recently as twenty years ago, this might have seemed a non-question.
Science was widely believed to have sunk into torpor between the age of Newton
and the nineteenth-century triumphs of Davy and Dalton, Faraday and Darwin.
Popular culture was little studied ... and the provinces were ignored by a
historiography whose field of vision extended little further than London and
aristocratic estates ... It is my contention that understanding provincial Enlightenment
aspirations will put provincial science’s development in perspective ... To provincial
eyes, Enlightenment values (rationality, moderation, politeness, humanitarianism)
offered a leg-up from rusticity, associated with barbarity and riot, towards
metropolitan – indeed, cosmopolitan – urbanity ... provincials embraced
Enlightenment values because they spelt out culture. And – I shall claim – it was
because science was a branch of culture, rather than because it primarily meant
industrial utility, or Dissent, or the education of youth or employees, or even the
advancement of research, that provincials embraced science.’
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Roy Porter. ‘John Woodward: a droll sort of philosopher’. Geological Magazine
1979; 116 (5); 335-343.
‘The founding of the Woodwardian Chair of Geology 250 years ago was a
remarkable event. It was a “first”: the first professorship in geology established in
Britain – and, one can argue, in the world. By contrast Oxford had to wait till over a
century later, and Edinburgh did not win its first geology chair till 1871. Indeed, what
Cambridge acquired in 1728 was not merely a geological lectureship, but a
handsome estate to ensure generous support to the holder, and what was probably
the finest scientific collection of minerals and fossils in the country ... The founding of
the chair was manna from outside. It was the bequest of one John Woodward ...
Anyone who had known him in his early life would have been astonished to hear that
he would eventually found a Cambridge science chair, for he had started life in
relatively lowly circumstances, and was a self-made man.’
Roy Porter. ‘Die Geologie Grossbritanniens im Zeitalter der Aufklärung’. Zeitschrift
für Geologische Wissenschaften 1980; 8: 53-61.
‘Pre-Enlightenment theories of the earth, produced in seventeenth century Britain,
regarded the earth primarily in Christian terms. A true account of the earth’s creation
and history was believed to be contained in Scripture. God had created the earth for
man, and had repeatedly intervened miraculously in its development. Enlightenment
ideas had an important impact in changing such theories of the earth. One geologist,
GH Toulmin, was an atheist, who denied the divine creation of the earth, and who
asserted that the earth, and all its products, man included, were eternal. Many, such
as James Hutton, were Deists, who believed that God had not intervened in the
world since its creation. Many other geologists remained Christians, but increasingly
detached their geological theories from the Scriptural account. In particular,
influenced by Enlightenment ideas, they accepted a long time-scale for the Earth,
and tended to explain geological problems not through divine miracles but through
the regular action of natural laws. The focus of geological thought became the earth
itself, rather than God or man. In these ways, the Enlightenment played an important
part in shaping the science of geology as it expanded at the beginning of the
nineteenth century.’
Roy Porter. ‘Being mad in Georgian England’. History Today 1981; 31: 42-48.
‘Bethlem Hospital, rebuilt in palatial manner at Moorfields in 1676, was for most
Englishmen not just the epitome of insanity but their closest experience of it, for up to
100,000 people a year paid their penny to stare at and tease the inmates of this
human zoo … Madness and madmen loom large in the writings of Restoration and
Augustun men of letters such as Butler, Swift and Pope, and the moral message was
clear: there is an utter gulf between madness and humanity, mad talk and truth …
The moralist’s job was to expose the insane as ridiculous, contemptible and
disgusting. Far from their madness being divine, he must show it issued from some
offensive organ or abuse of their vile bodies: a gross excess of food, drink, sex … In
its turn, their madness caused physical loathsomeness: ravings, fits, tics, wallowing
in excrement … If madness was a disease of the body, it needed physical treatment:
restraint … chains, darkened rooms; and depletion … blood-letting, purges, and
drugs. Shock therapy … cold showers, rotating chairs, and electrification … The
sane needed to be protected … During the Georgian century, attitudes towards the
mad began a long sea-change … the currents of Enlightenment benevolism and
humanitarianism … liberalised attitudes towards the mad … Quixotic eccentricity
became permissible … the Tuke family at the newly founded York Retreat
[developed] what became known as “moral therapy” …to remotivate the mad into
civilised behaviour … But did the sympathisers get nearer to the heart of madness?
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Did they actually understand the mad any better? … the new “moral therapists” were
no more interested in entering into the witness of the mad, in negotiating with their
testimony … than the advocates of mechanical and medical treatment.’
Roy Porter. ‘L’illuminismo e l’Inghilterra’. Intersezioni 1981; 1: 75-102.
‘Affrontare la questione dell’Illuminismo in Inghilterra significa immergersi nelle
sabbie mobili di un paradosso storico. Nel corso del secolo diciottesimo gli Aufklärer
di tutte le nazioni manifestarono ammirazione per il governo, la società e il modo di
pensare inglesi, considerando tutto ciò come la quintessenza dell’Illuminismo. Gli
anglofili decantavano la costituzione, il diritto e la libertà britanniche, l’apertura del
tessuto sociale inglese, la sua tolleranza religiosa e la prosperità ... Tuttavia
l’ideologia illuminstica mostrò, nei tempi lunghi, di essere penetrata a fondo. In
quanto forniva una legittimazione laica dell’economia capitalistica di libero mercato,
essa ha continuato a permeare il liberalismo vittoriano del “self-help” e le moderne
apologie della società aperta. In quanto proclamava il principio del progresso
individuale per mezzo della ragione essa poté evocare l’immagine di un futuro
gradualmente progressivo, che rese immuni i radicali dalle ideologie della lotta di
classe e del socialismo umanitario. L’owenismo, la frenologia, il secolarismo, il
movimento fabiano sono tutti lasciti dell’Illuminismo inglese. La tesi di Halévy
richiede forse qualche integrazione: che sia stato proprio l’Illuminismo a rendere
L’Inghilterra impermeabile alla rivoluzione francese e a tutte le rivoluzioni
successive? I “chierici” inglesi, e perfino il clero vero e proprio, come il dott. Norman
ci ha recentemente ricordato, ancora leggono il mondo e interpretano la sua storia
alla luce dell’Illuminismo. Le peculiarità degli Inglesi sono, in non piccolo misura, un
prodotto delle peculiarità dell’Illuminismo inglese: non bisogna dimenticarlo con
troppa legerezza.’
Roy Porter. ‘The old boy’s tale’. The Head 1981; 1 (5):13.
‘Back to school. Once a year. The last Thursday of September, the drawing of
curtains of leaves on the summer. The Freudian high-spot of the calendar: Jesu!
Lover of my soul, Let me to thy bosom fly! Twenty years have passed, the streets
where I grew up are now a new world, and parents grow old. But school is fixed
outside change and mortality. That is the way with alma maters ... Why do I go back,
once a year (on Founder’s Day), to give a pious talk on the school’s past glories
(...the chronicle of the cane, episode 689)? Like a snail, unwillingly. Yet, I am
drawn. Somehow, school fills the memory, haunts my dreams as the great formative
experience ... School was never bleak house to me. It was terror, tedium, the exam
treadmill, the cybernetics of wasting time. But it was also the discovery there were
intelligent, witty, cultured, engaged adults, anxious to share with you. And the
window on the world, the ladder with the skylight at the top, though the climb was
always giddying.’
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Roy Porter. ‘Charles Lyell: the public and private faces of science’. Janus 1982; 69:
29-50.
‘Lyell (1797-1875) studied as an undergraduate at Oxford, then read for the Bar and
practised law in a desultory way for a few years. He found the legal profession
neither intellectually satisfying, nor remunerative. He decided that he would like to
devote his working life to geology and did so, becoming the most single-minded
geologist in England … Lyell wanted scientific glory and social prestige … [he] fumed
throughout his career at the lack of secure career openings in England for men of
science … He attacked the universities’ indifference to research, and their co-option
of science to theological purposes … In this respect he admired America … Having
no tenured post, Lyell looked to writing for an income … His Principles of geology (3
vols, 1830-33) fitted the bill perfectly: it was a work of revolutionary intellectual
implications for the scientific community … yet it was untechnical and elegantly
readable by the intelligent layman … He posed not just as the discoverer of a new,
live geological system, but as the champion of science, truth, and freedom in a
civilization in which psychological phantoms and sinister monopolistic interests
(particularly those of ecclesiastics) strove to maintain ignorance, error and
superstition … Privately he wrote that the aim of his Principles was to “free the
science from Moses” … In public Lyell chose not to confront Mosaic geology head-on
… his friend Darwin developed a theory of evolution built on Lyell’s own geology …
and made scientific sense of much that Lyell had puzzled over … Yet, if true, it both
undermined his entire life’s work, and also entailed consequences for Man’s status –
in Lyell’s view, destroying the dignity of Man and putting personal immortality in
doubt – which he found difficult to stomach.’
Roy Porter. ‘Was there a moral therapy in eighteenth century psychiatry?’ Lychnos
1981-1982: 12-26.
‘Amid the shifting sands of historical interpretation in the history of psychiatry there
seems to be one eternal rock: the belief that the turn of the nineteenth century saw a
switch from mechanical and medical to moral therapy for the mad ... The change is
depicted as sharp and sudden, and is associated with Philippe Pinel in France (who
in 1793 literally and metaphorically struck the chains off the inmates of the Bicêtre),
and in England with William Tuke, who published in 1813 an account of the novel
therapy at the Retreat. Pinel and the Tukes made claims for the distinctiveness of
their therapies, which they contrasted with the useless cruelty of traditional methods
of restraint and polypharmacy ... Historians ought to be suspicious of heroes-andvillains Whiggish histories, created by self-styled pioneers and confirmed by
professional lobbies. Yet this orthodox reading of the coming of moral therapy in the
development of psychiatry has held up well, partly because it is largely true (at least
for England ...)’
Roy Porter. ‘La prospettive della “follia”: scienza, medicina e litteratura
nell’Inghilterra del ‘700’. Intersezioni 1982; 2 (1): 55-76.
‘… vorrei suggerire che il punto cruciale della follia nei secoli XVII e XVIII in
Inghilterra è il problema di come adattare persone cresciute in un orizzonte
essenzialmente cristiano di aspettative e di comprensione di sé, entro una società
sostanzialmente interessata ai problemi di questo mondo. Medici e psichiatri erano
ostili a considerare le manifestazioni di religiosità nei loro propri termini: anzi, si
trattava per essi di un problema che doveva essere affrontato con vari strumenti di
tipo paternalistico. I letterati, nonostante fossero per delega comprensivi verso I
recluse e I sofferenti, erano poco più interessati ad entrare nel loro mondo.
L’effettivo divario non si produceva tra letteratura e scienza, ma tra il normale e il
deviante in fatto di religiosità.’
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Roy Porter. ‘Ministering angels’. New Society 1982; 59: 24-25.
‘Nurses and their private lives have long been fair game for fiction. Mrs Gamp, the
infamous monthly nurse who lurches and hiccups her way through Martin
Chuzzlewit, is the early Victorian stereotype. But Dickens’s caricature approach
soon gave way to something very different: piety. The popular image of nursing
changed during the 19th century from gin-soaked crone to ethereally beautiful
ministering angel … an image of (typically Victorian) femininity: passive, soothing,
silent, chaste. Does present-day romantic fiction still nurture these stereotypes? It’s
easy to see why nurses might appeal to authors intent on pulling at a reader’s
heartstrings … a nurse’s work brings her to the very pulse of life: births, deaths and
dangers are her daily bread. One could hardly ask for a better source of dramatic
material. And then, as romantic heroine, the nurse is in a particularly interesting
position; always, as it were, under the doctor … Their place in the medical hierarchy
throws them constantly into the company of dashing men-of-action who Save Lives
and Slay the Dragons of Disease … The doctors need the nurses, and the nurse’s
traditional role of silent competence is ideally suited to scenes of suppressed
emotions as they sweat together over the operating table, the doctor realising
suddenly that the hand that wipes his brow might well in time rock his – or his
offspring’s – cradle. Are these the limits beyond which the writer of romantic fiction
dare not stray?’
Roy Porter. ‘The descent of genius: Charles Darwin’s brilliant career’. History Today
1982; 32 (7): 16-22.
‘Looking back on his brilliant career, Charles Darwin wrote in 1871: “I have been
speculating ... what makes a man a discoverer of undiscovered things, and a most
perplexing problem it is. Many men who are very clever – much cleverer than the
discoverers – never originate anything”. Darwin did, of course, originate something –
the Origin of Species – and was a supreme discoverer of undiscovered things. But
whether Darwin was also clever has been debated ... Historians such as Herbert
Butterfield and Charles Gillispie have idealized the scientist as the revolutionary hero
who dares to scrutinize Nature through new spectacles, puts on a new thinking cap,
picks up the other end of the stick ... Yet a counterpoint idealism has always, by
contrast, praised the model scientist as humble, co-operative, and anonymous ... Our
image of Darwin himself is a classic epitome of this schizophrenia.’
Roy Porter. ‘The Enlightenment: a bibliographical essay’. History Today 1982; 32
(2): 51-52.
‘What is Enlightenment? Immanuel Kant tackled this question back in 1784. If, two
hundred years on, historians are still searching for an answer, it is not through sloth,
for new works are cascading from the presses ... This enthusiasm, however, is fairly
recent. In the wake of the Romantics, the nineteenth century damned the Age of
Reason, scornfully lampooning the philosophes as Panglossian poseurs, whether
impractical idealists like Rousseau, or glib rationalists like Voltaire ... This century,
great scholars have put the Enlightenment back on the map, forcing us to take its
convictions seriously.’
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Roy Porter. ‘The sexual politics of James Graham’. British Journal of EighteenthCentury Studies 1982; 5: 199-206 or 202-206.
‘Dr James Graham is one of those colourful sub-plot clowns in the tragicomedy of
history who are such godsends to barrel-scraping historians. You need a graphic
anecdote or two to illustrate what a rollicking, naughty, fun-loving, liberal, permissive,
advanced and enlightened, frank and frolicsome, sexy time the Georgians had? Or
to prove they were disgusting, decadent and debauched? Then sex-doctor Graham
is waiting in the wings ... Yet Graham was no gutter sexploiter. Rather he
championed a comprehensive sexual philosophy, contextualising coitus within a
synthetic morality of the family, society, state and the cosmos ... For him the
correlate of sex was health ... “the genitals are the true pulse, and infallible
barometer of health” ... Graham’s sexology was therefore, to recoup health, restore
the libido, and thereby restock the nation ... Graham’s sexual ideas resonate with
Enlightenment harmonies ... On the one hand, Graham had no truck with the
fundamentalist Calvinist or Evangelical distrust of sexual passion and the pleasures
of the flesh, seen as the sinful and carnal wages of the Fall. But neither did he
countenance the voluptuary’s decadent erotomania and priapic self-expression of a
kind found in libertine writing and dressed up en philosophe in France between
Diderot and de Sade.’
Roy Porter. ‘The natural science tripos and the “Cambridge School of Geology”,
1850-1914’. History of Universities 1982; 2: 193-216.
‘… the second half of the nineteenth century saw the novel and sudden
transformation of geology in Britain from an amateur pursuit to a professional career,
orientated increasingly to an academic structure … Much of the most profound and
original research at the turn of the century was still being done by men outside the
university structure – Peach and Horne, and then Bailey, in the Geological Survey
(founded 1835) … unlike most sciences, the growth of professionalization did not
have a liberating effect on geology … Geologists wished to do their “geology out of
doors” … not in the lecture hall or the town … Cambridge was one exception.
Cambridge went through the same process whereby geology became academic, but
more swiftly, more successfully, less painfully …Cambridge had had a chair of
geology, the Woodwardian, since 1728 [but] was transformed by the setting up of the
Natural Sciences Tripos from 1851 … An intense, highly competitive examination [it]
imparted dynamic momentum for change, entirely absent before, to geological
studies … the Cambridge Tripos was corporate. The whole range of sciences … had
to be attempted within one sitting of examination papers …a first in Part II
(established 1882) was effectively a meal-ticket for life … it creamed off talent with
positive research advances in the science … it bred up its own younger generation of
teachers and researchers … And it trained geologists to go out into the world … The
Cambridge school of Geology was the offspring of the setting up of the Natural
Sciences Tripos.’
Roy Porter. ‘Was there a medical Enlightenment in eighteenth-century England?’
British Journal of Eighteenth-Century Studies 1982; 5: 49-63.
‘[The] built-in vision that medicine automatically advances, and that medical
advances are enlightened is the Unmoved Mover behind most accounts of medical
change in Georgian society … yet … the bulk of eighteenth century medical practice
remained – by any definition – unenlightened, and highly traditional, like the ancient
regime imposed by the Monros at Bedlam with their ritual Spring blood-lettings.
Ancestral folk-lore continued … “I drank snail tea for breakfast”, wrote the Hon John
Byng, “for my chest is very sore”. The incompetence of surgeons and physicians
(Hogarth’s Company of Undertakers), the gin-fuddledness of nurses, and the
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feculence of hospitals remained butts for satirists and rebukes to reformers … This
scepticism does not mean however that the Enlightenment “failed” to influence
English medicine. Rather it requires us to rethink what we mean by the
Enlightenment, and in what ways such a movement could plausibly affect medicine
and health ... In England Enlightenment attitudes grew in a soil of political and
cultural individualism … we should not be searching in the bills of mortality to
ascertain the Enlightenment’s impact on medicine, but rather scrutinising changing
categorisations of life and death, health and sickness, the normal and the deviant,
the stages of life … not in scientific medicine, the professionalisation of doctors, nor
in a state medical police, but amongst the propertied classes, polite society.’ (This
paper contains much that is in ‘Medicine and the Enlightenment in eighteenth century
England’. Society for the Social History of Medicine 1979; 25: 27-40.)
Roy Porter. ‘White coats in vogue. One year quarks are à la mode, the next gravity
waves are passé. Roy Porter looks at scientific fashions and argues that it is time
science and humanities lost their mutual suspicion’. In The Times Higher Education
Supplement 1982; no 522 (5 November): 12-13.
‘The world was full when Voltaire left Paris; when he reached London, it was empty.
Voltaire’s swipe at scientific fashions – the Cartesian plenum all the rage amongst
French savants, Newton’s void space with the English – is typical of the sceptic who
loved to see the vanity of dogma tripping up on the recalcitrance of experience.
Jesuits and Jansenists, rationalists and empiricists, Cartesians and Newtonians – all
claimed a corner on the truth market ... Are scientific schools like Paris fashions? ...
Phlogiston chemistry and tricorn hats went out at the same time, replaced by the cult
of tall round hats and oxygen. Throughout the eighteenth century English
mathematicians clung on to outmoded fluxions, while the continentals modelled the
trendy calculus ... In early Enlightenment England, Newtonianism was the latest
thing, but then natural history had its vogue. By 1820, however, geology was le
dernier cri (no one was studying it, however, a century later). By then, eugenics was
smart, soon to be challenged by the dandies of elementary particle physics and the
taste for a physics of life ...’
Roy Porter. ‘Forum: Roy Porter listens to the words historians use’. History Today
1983; 33: 3-4.
‘In the beginning were Words; which is just as well for historians, especially students
of pre-photographic times. But, Clio’s bane as well as life-blood, words are deceivers
ever ... When an eighteenth-century medical book tells us that “gout and other
congenial diseases” can be alleviated by “unsavoury water”, it gives even the tonedeaf historian a jolt ... ‘congenial’ here does not mean agreeable but related; and
‘unsavoury’, not unpleasant but without taste (“tasteless” would still cause the same
problems!) ... Locke terms Isaac Newton a “nice” man. He didn’t mean – as today –
amiable, but, rather, touchy, difficult to please (or, as he might have written,
“humorous”, which meant not droll but moody or peevish). But if Locke in his tabletalk had called a woman “nice”, he would have been saying she was lascivious.’
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Roy Porter. ‘In the 18th century were English lunatic asylums total institutions?’ Ego:
Bulletin of the Department of Psychiatry, Guy’s Hospital 1983; 4: 12-34.
‘... 18th century England saw no Great Confinement. There was no concerted drive
by central or local government to sequester the mad poor. Parliamentary powers to
incarcerate the mad poor were not granted till 1808 and such asylums did not
become mandatory until 1845 ... In England, the number of lunatics confined was
low. The House of Commons Committee of 1815 found a total of 2248 lunatics
confined through the whole nation ... less than half the total of inmates in Colney
Hatch a century later. The sum of the mad poor in Bristol, a town of 30,000 souls,
was 20 – throughout the county of Oxfordshire there were 22. About 400 people
were being admitted to private asylums a year, mainly for short stays. Foucault’s
notion that reason so abominated unreason that it had to lock it away is, for England
at least, a fantasy’.
Roy Porter. ‘On doctor’s orders?’ In The Observer; 18 September 1983.
‘”What should I do?” asks the woman in labour in the opening shot of Monty Python’s
The meaning of life. “Nothing, don’t worry,” soothe the obstetricians, “leave it all to
us” – and to the machine that goes “ping”. That’s one solution, of course, to sorting
out doctor-patient relationships. Having the patient passive and supine – like the
Victorian child, seen but not heard, except when throating the obedient “Aaaaahh!” –
is just what the doctor orders. With today’s high-tech scanners and computer
diagnosis, the patient hardly even needs to be asked any more where it hurts. And if
you view ailments as mechanical breakdowns (here some tubes blocked, there a
screw loose), all that’s left for the patient is to lug his body along to the surgery, as
though he is taking his car for a service.’
Roy Porter. ‘One man’s herb, another man’s medicine’. The Listener; 23 June1983:
14-15.
‘Radicals have criticised modern medicine, attacking it as too narrowly “scientific”,
preoccupied with disease rather than health, with microbes rather than men. Yet the
really disturbing criticism is made by the public protesting with its feet. More and
more people are seeking treatment elsewhere ... Diverse though these responses
are, they share one thing in common: the suspicion – often the opposition – of the
medical profession ... It is the mention of the weasel word “quackery” that clinches
the issue. For, put the choice in these terms, and who would not, of course, opt for
science not nonsense, for integrity not exploitation, for the expert, public-serving
doctor rather than the self-serving quack? ... How can we tell what is good medicine?
In the past, true blue medicine, sanctioned by the sacred names of Hippocrates and
Galen, prescribed blood-letting by the pint, and administered copious purges, sweats
and emetics. Within our own century, waves of fashion in scientific surgery have
gone in for removing organs such as tonsils, colons, breasts and even slices of brain,
seemingly with gay abandon, yet with dubious benefit. But none of this is quackery.
How do we know? Because the doctors tell us so.’ (From a Radio 3 broadcast)
Roy Porter. ‘The doctor and the word’. Medical Sociology News 1983; 9: 21-28.
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Roy Porter. ‘The rage of party: a glorious revolution in English psychiatry’. Medical
History 1983; 27: 35-50.
‘”Madness and Phrensie”, thought Thomas Tryon, “do generally, and for the most
part arise and proceed from various Passions and extream Inclinations, as Love,
Hate, Grief, Covetousness, Dispair, and the like”, which “stire up the Central Fires”,
leading to “Hurley-Burley, Confusion, Strife and Inequality”, an “intestine Civil War” –
all of which “subverts the government of the inward Senses and Spirit of Wisdom,
and puts Reason under Hatches” … sanity was rational government of the parts,
madness the appetites’ insurrection … But I want to ask how ideas of mental health
were affected by the two generations of boiling turmoil – dynastic, political,
ecclesiastical, intellectual – from the Exclusion Crisis and Glorious Revolution of the
1680s through to the sedative “growth of political stability” under sir Robert Walpole
…the interests of leading oligarchical groups under the late Stuarts informed
psychiatric dispute and eventually encouraged a new direction in psychiatry … I don’t
think these interests lay directly in imposing bourgeois economic rationality and
shutting up the unreason of the poor: mad-doctors’ interests in the poor were a
nineteenth-century, not an eighteenth-century, development … The priority rather lay
with defusing the threat to consensus posed by the transcendental truth-claims of
prophecy, through removing its Archimedean point. This disqualification of spiritual
authority … took many forms, but one lay in a reductionist psychiatry curing the
voices of enthusiasm. That danger surmounted, and single vision established
alongside single party government, the complaints of an acquisitive society could be
rationalized, normalized, as neuroses, as the privilege of progress, and managed
ever after by the emergent profession of psychiatry.’
Roy Porter. ‘William Hunter, surgeon’. History Today 1983; 33 (9): 50-52.
‘Hunter (born in 1718 in East Kilbride) is a case of the poor boy made good, proof of
how open Georgian society actually was to young men of talent and ambition,
particularly if they could gain the support of patrons … Like so many Scots, he found
London was the place to make his fortune … Hunter became a highly successful,
skilful, polished, bedside physician, tending the illnesses of London’s rich and
famous. But he was much more than that … William Hunter’s prime claim to fame is
that he set up London’s best school for teaching anatomy to budding surgeons and
future general practitioners … The teaching labours of William Hunter (matched by
those of his brother John at St George’s Hospital) helped to put surgery on the map
… Hunter’s second achievement lay in the field of obstetrics … [he] helped to raise
obstetrics to respectability, both through his own gynaecological practice and through
his obstetrical lectures.’
Roy Porter. ‘Cleaning up the great wen: public health and eighteenth-century
London’. Bulletin of the Society for the Social History of Medicine 1984; 35: 24-25.
‘… It is widely assumed that eighteenth-century London was an exceedingly
unhealthy, insanitary and offensive place … I suggest that the urban improvement
was more effective than is sometimes allowed … initiatives came essentially at the
local level, from groups of interested private citizens, working via a string of private
acts of Parliament … these directed vestries to appoint commissioners empowered
to raise a household rate and to treat with contractors for street management … the
medical profession took important active measures to combat the deadly fevers
which swept Georgian London, promoting general and specialised hospitals,
including the London fever hospital. The dispensary movement was especially
important … Certainly, doctors thought that Londoners’ health was improving, and
these subjective impressions are confirmed by contemporary Bills of Mortality and by
modern scholarly analyses of them.’
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Roy Porter. ‘Do we really need doctors?’ New Society 1984; 69: 87-89.
‘It’s accepted by most people today that medicine is sick. At first sight, this is
paradoxical. Hasn’t our generation produced unparalleled advances in transplant
surgery, diagnostic technology, pills to cure ills; hasn’t it cracked the code of life? ...
Yet there seems no end of fusillades from humanists, Marxists, feminists and the
great war hordes of “alternative culturalists”, all pronouncing modern medicine
pathological. Medicine, the arguments run, has become a kind of technocrats’ fun
palace. It treats people as if they were just diseases, or at best reduces people to
patients (that is, to passivity) ... In the world we have lost, people didn’t become
dependent upon doctors and their doses, because neither doctor nor the sick
believed that medicine held all the answers to people’s complaints. After all, there
were some diseases that killed you, and some which nature would cure; and,
sandwiched between these, the physician was not left with much of a hero’s role to
play.’
Roy Porter. ‘Eat your heart out’. New Society 1984; 70: v-viii.
‘Hypochondria: they called it the English disease. For the first thing that struck
visitors to these shores a couple of centuries back (once they’d got over the
poisonous coffee) was the morbid depression hanging over the natives like a fog ...
For us the hypochondriac is le malade imaginaire, even the malingerer. His pains, if
not all in the mind, at least all come from there. But patients in the past meant
something more tangible by the term ... hypochondria was fundamentally something
wrong with your guts ... The English malady turns out to be our old friend, overindulgence. Foreigners could hardly credit the way the English pigged themselves at
table. It positively nauseated the Duc de Liancourt, who couldn’t fathom why the
English thought dining was all about feeding.’
Roy Porter. ‘Sex and the singular man: the seminal ideas of James Graham’.
Studies on Voltaire & the Eighteenth Century 1984; 228: 3-24.
‘For recovering late Enlightenment sexual discourses, James Graham is a good
subject, because his public standing lay in promoting the joy of sex from a biomedical
viewpoint ... Born in Edinburgh in the starcrossed year of the ’45 ... he studied
medicine (as did his brother William) at his home university under Monro Primus,
Black, Whytt and Cullen, though, it seems, not graduating ... Opening his Temple of
Health (the Templum Aesculapio Sacrum) in 1780 at the fashionable Adelphi, he
combined lectures and multi-media spectacle with a practice based largely on
electrical therapy ... Graham was indisputably a quack and a “sexploiter” in one
respect: he made his living by selling his medical and sexual opinions in the marketplace ... in the most private part of the Temple, the Celestial Bed, won him
contemporary sexual notoriety ... Graham insisted that the bed was not for
voluptuaries but for couples desiring children, being designed to overcome flaccidity
or barrenness by “an electrical stroke or two” ... the touchstone of health was the
strong, eager, and vigorous physical capacity to ensure the biological future of the
species ... sexual appetite was flagging because other appetites went uncurbed ...
The emphasis on moderation and self-control was of course traditional and universal,
operating within the framework of the “non-naturals”. What was perhaps special in
Graham was his emphasis on restraint not primarily for the moral-religious goal of
controlling the passions per se, but rather with a view to maximising sexual
effectiveness …Graham had no truck with fundamentalist Calvinist or Evangelical
devaluation of sexual urges and the pleasures of the flesh seen as sinful and carnal
consequences of the Fall. But neither did he countenance the voluptuary’s decadent
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erotomania and priapic self-expression of a kind traditionally found in much libertine
writing and which Lester Crocker shows dressed en philosophe in France between
Diderot and Sade.’
Roy Porter. ‘Spreading carnal knowledge or selling dirt cheap? Nicolas Venette’s
Tableau de l’amour conjugal in eighteenth century England’. Journal of European
Studies 1984; 14: 233-255.
‘…the Georgian age is often characterized as one of sexual permissiveness – and
not unreasonably, for it was, after all, the century of Boswell and Wilkes, Tom Jones
and Fanny Hill … the eighteenth century … witnessed a staggering increase in
published opinion, in newspapers, periodical essays, and, not least, in the literature
of advice … sex being no exception … books purporting to be sexually informative
and improving, such as Onania, the best-selling English-language tract against
masturbation, were in fact essentially lewd … should we attribute any general
significance to the fact that more people, it seems, were now reading about sex? …
the most important such work in Georgian England was Aristotle’s Masterpiece
(1684) … Aimed at the common reader, [it] went through at least forty-three editions
by 1800 … The jaunty semi-bawdy tone and explicit physical details of genitalia
characteristic of early editions gives way later in the eighteenth century to rather
more uplifting generalities, stressing morality and matrimony … the most popular of
the European sex manuals … The Mysteries of Conjugal Love Revealed (1703) …
was a commendably faithful translation of the Tableau de l’amour conjugal (1696),
the pseudonymous work of the La Rochelle physician, Dr Nicholas Venette … and a
landmark in the history of medically-grounded books of sexual advice … it was still in
print in the 1950s … Venette’s concerns are quintessentially organic; he
concentrates on the anatomy and physiology of the genitalia, the physical
procedures and postures of copulation, the biological intricacies of embryology,
gynaecology, and heredity … Venette made the indissolubility of sex, health and
generation central to his work … Like many physicians of the Enlightenment …
Venette gloried in his role as a paladin of science battling against the foes of
superstition, credulity and ignorance … He exploded the superstition that it was seed
from the right testicle which guaranteed male offspring, and from the left, female …
these “vulgar errors” … were reinserted into [18th century editions of] Conjugal Love
… for it seems that, as Venette’s text came to be dressed up for a lower class of
readers, it was by contrast actually diluted and adapted specifically to what were
anticipated to be their pre-existing opinions … by the standards of Venette’s original
text … sexual texts of the last decades of the eighteenth century … can be seen as
sowing the seeds of sexual anxiety, guilt and repression … the final edition of
Venette (post-1744) was somehow travelling in its own distinct time-capsule … an
incongruous conglomerate of late eighteenth-century Protestant piety with
seventeenth-century Catholic and Humanist medicine.’
Roy Porter. ‘The Caliban of literature’. New Society 1984; 70: 368-369.
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Roy Porter. ‘”Mad all my life”: the dark side of Samuel Johnson’. History Today
1984; 34 (12): 43-46.
‘”Ursa Major”, The Great Bear, was the pet name many of his friends used for
Samuel Johnson; and we habitually think of him now as some indestructible great
beast, larger than life, typical of that ‘John Bull’ character of which eighteenth-century
Englishmen grew so proud. Tall, big boned, big featured, and inclined to fat,
Johnson ate with gusto, not to say greed ... and could knock back the drink.
Constitutionally, he was strong as an ox ... and in his heyday he was surprisingly
athletic ... When he was well into his sixties, he stood up remarkably well to his
gruelling jaunt round the Highlands and Island with Boswell. It can then come as a
shock to hear the other Johnson. “I have been mad all my life ...” he confided to
Boswell ... In the grip of melancholy – “that general disease of my life” – everything
could look black: “life is progress from want to want”, he judged, “not from enjoyment
to enjoyment” ... in Johnson’s case there’s no need to probe deep into his infancy
and his unconscious to explain his traumas, for they lay closer to the surface than
that. For Johnson’s dreads and depressions arose out of the way his life had turned
into a constant struggle.’
Roy Porter. ‘As others read us’. History Today 1985; 35 (6): 6-7.
‘The mailbag page in History Today tells a fascinating story. Letters shower in,
taking contributors to task for their errors and often the original author replies. Mostly
they accept correction (even if they may be muttering “pedant” under their breath) …
but what invariably turns scholars apoplectic is the feeling that they have actually
been misread or misrepresented by their correctors … to be autobiographical for a
moment, when a generous critic (whom I respect), reviewing my social history of
eighteenth-century England, writes “Dr Porter has faith in central planning that not all
would share”, I’m amazed. I have no faith in central planning at all. So how did my
text convey that impression? The trouble stems from a remark I made about how
the growth of turnpiking was ad hoc. My critic inquires: “Would a centrally planned
turnpike system have necessarily been a good thing?” I quite agree … I merely said
nobody aimed to construct one … Yet the words that left my head had obviously
taken on a life of their own by the time they’d got onto the printed page … Margaret
Drabble recalls that a reader contacted her querying the meaning of the last
sentence of her novel, The Needle’s Eye, when her heroine Rose is said to have
been “weathered into identity”. Did “identity” here mean “uniqueness” or
“sameness”? The novelist reflected that she did not know and it didn’t matter. But
let the historian try telling that to his reviewer.’
Roy Porter. ‘Il male inglese: la follia in epoca Georgiana’. Kos 1985; 2 (12): 33-48.
‘Mai l’espressione “gabbia di matti” ebbe o avrà un senso così letterale come
nell’Inghilterra di Giorgio III. Per quasi tutto il Settecento, circa centomila “spettatori”
pagavano ogni anno una modica soma per godersi lo spettacolo tumultuante dei
pazzi. Il biglietto d’ingresso all’inferno di Bethlem o Bedlam, il celeberrimo
manicomio di Moorfields ne pressi di Londra, consentiva non solo di osservare quello
zoo umano di lunatici, ossessi, esagitati e squinternati, ma addirittura di provocarli e
sbeffeggiarli. Poi un pugno di intellettuali illuminate, di medici compassionevoli e di
alienate illustri, tra I quail lo stesso re Giorgio, indussero la società a darsi una
psichiatria dal volto meno feroce.’
83
Roy Porter. ‘Introduction’. Kos 1985; 2 (14): 3-4.
‘… Ma quanto patetiche e miopi appaiono queste visioni di passati divisi e di presenti
settari! Giacché la grande lezione impartita dalla Storia, se consideriamo
l’evoluzione dell’arte medica esposta in questo numero speciale di KOS, è senza
dubbio che la sua forza e il suo successo sono dipese dalla capacità di assorbire ed
integrare tradizioni culturali e intellettuali diverse, elaborate dale menti di uomini
professanti credi diversi. Soprattutto, parlando in generale, la medicina così come la
si intende oggi, fonde I due maggiori simoli generatti dalla scienza e dalla religione:
alla filosofia naturale greca dobbiamo infatti l’amore per la conoscenza e la ricerca
della verità, mentre il perseguimento della bontà o della santità è il contributo delle
religioni orientali, non ultima quella cristiana, in contrapposizione allo spettacolo
dell’impotente, apatica sagacia del Mondo Antico in decadenza …’
Roy Porter. ‘Lay medical knowledge in the eighteenth century: the evidence of the
Gentleman’s Magazine’. Medical History 1985; 29: 138-168. Reprinted as ‘Laymen,
doctors and medical knowledge in the eighteenth century: the evidence of the
“Gentleman’s Magazine”.’ In Roy Porter (ed). Patients and practitioners: lay
perceptions of medicine in pre-industrial society. Cambridge University Press,
Cambridge & New York 1985: 283-314.
‘…the Gentleman’s Magazine first published in 1731, and running continuously into
the present century, attained at its peak a circulation possibly of over 10,000 copies,
and far more readers …it offered a middle-of-the-road viewpoint, reflecting a
moderate, enlightened common sense [and] shows a high density of medical
insertions … the first account of plastic surgery to appear in England, describing the
techniques as used in India, can be found in the Magazine’s issue for October 1794
… a close check was kept on the health of public figures and the royal family …
night-by-night bulletins in 1789 on the condition of George III in his “madness” … the
printing of the London Bills of Mortality … The readership seems to have welcomed
items about health [often in verse] … The general tone of Gentleman’s Magazine
contributions is one of accepting modern regular physick as part of rational
enlightenment … Faith in “holy oil” as a cure-all, for instance, got short shrift as both
popish and vulgar … The most prominent [interest] was the request for, and
exchange of, practical remedies for specific ills, to relieve personal suffering … how
do you cure corns? or get rid of chilblains? or relieve cramp? How do you purge
worms? treat viper bites? How do you grow senna? Why is it believed that a good
antidote to excessive water retention is to apply a live toad to the region of the
kidneys? … remedies taken from medical publications nestle cheek-by-jowl with folk
and herbal recipes, letters from the laity alongside prescriptions from practitioners …
there are relatively few requests for treatments for the great killer complaints:
consumption, malignant fevers, apoplexy, child-bed and infant fevers … madness or
cancers … Snake bites are common, as are injuries sustained on the farm … bites
by mad dogs … conditions transmitted from livestock and domestic animals …
accidental poisonings caused by eating toadstools … gentian roots, or swallowing
arsenic poison put down for vermin … Gentleman’s Magazine readers gazed out into
the community … swaddling was condemned, breast-feeding advocated …
sympathetic attitudes towards suicides … proponents of [provincial] voluntary
hospitals made full use of the pages of the Gentleman’s Magazine for publicity …
obituaries … in the early years being divided into two sections, “Deaths” and
“Casualties” (ie. death by accident) … “Of convulsions in her bowels, occasioned by
the thunder on Monday evening, Miss Hallam of Islington …” … Mr Monro devoured
by a tiger … they show little evidence of the medicalization of death … In the
Georgian period, lay culture was not in opposition to the physic of the practitioners,
nor was it being threatened or suppressed by them … It is not until the nineteenth
century that we can properly identify powerful lay-directed movements which deserve
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to be styled “fringe” or “alternative” medicine, defining themselves in opposition to the
orthodoxy of the faculty.’
Roy Porter. ‘Looking backwards’. History Today 1985; 35: 3-4.
‘History may ultimately be story-telling, but one moral that’s lost on most historians is
that every picture tells a story. Plunge into the vast majority of books scholars write,
and all you’ll find are oceans of words … we don’t protest – as we should – that only
a tiny percentage of scholarly books are illustrated at all; and in these the pictures
are generally few in number, bunched together, physically divorced from the relevant
text … Why doesn’t visual evidence get more of a look-in? … Words are princely,
pictures are “plebby” … Leave the visual material to the visual experts, to the art
historians, the costume connoisseurs, the iconographers, the museum men (…the
collectors, the antiquarians, the amateurs…). And, of course, the book-trade must
shoulder its share of the blame … “another five pounds on the label … beyond the
student bracket…”. But basically it’s we historians who are the ones to blame … The
sounds, smells, tastes and feel of the world we have lost are beyond direct recall.
But its sights survive in abundance, in art and artefacts, and it is high time historians
made more use of them … Our forebears knew the importance of appearances …
why else did iconoclastic Protestants smash the “scenic apparatus” of Popery? Like
the Puritans, historians tend to shun the seductions of the image in favour of the
purity of the word. Popular idiom knows better. “Can’t you see?”, we ask when we
want to know if someone understands. If we’re to understand history better, it’s time
we opened our eyes.’
Roy Porter. ‘Making faces: physiognomy and fashion in eighteenth-century England’.
Études Anglaises 1985; 38: 385-396.
‘Physiognomy had a long learned history stretching back to Antiquity… And yet, from
the mid-seventeenth century, its intellectual foundations were shaken, above all by
the New Science [which argued] that scientific truth lay not in superficial façades but
deeper, beneath the surface in invisible particles … Tristram Shandy himself ponders
the difficulty of “taking a man’s character … our minds shine not through the body,
but are wrapt up here in a dark covering of uncrystalized flesh and blood” … Black
paradox indeed that the mark of the rational man should be his ability to cheat.
Recent historians have argued that fashion came to dominate economic, social and
cultural life in eighteenth-century England as never before. Many Georgians would
have agreed. Disapprovingly, they saw the consequence was a civilization of
façades … as Hazlitt put it, “fashion is gentility running away from vulgarity” …
Mutating from household managers into mannequins, ladies slipped into a femininity
worn for the gaze of men, which had traditionally been the prerogative of actresses
and whores … Lord Chesterfield advised his son, Philip Stanhope, never to be seen
laughing, for laughter betrays rusticity – and carious teeth – and involves a “shocking
distortion of the face” … the later Georgians … aspired towards a new confidence in
personal communication … Expression, so urged the prophets of sensibility, must
cast cold composure aside, and register the most exquisite, involuntary pulses of the
nerves: tremblings, palpitations, blushing, weeping, quivering, swooning ... it was
Lavater, the charismatic Zurich pastor, whose Physiognomische Fragmente, first
published in 1775 … who gave [physiognomy] a new intellectual respectability … it
appealed to the world of letters. From the Gothic vogue of the 1790s through to the
Victorian social novel, writers insistently depicted their characters through
physiognomical eyes … it was given a further lease of life by being incorporated into
phrenology, craniometry, and through these into physical anthropology and racial
theory, both of which Lavater himself believed physiognomy illuminated.’
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Roy Porter. ‘Medicina e sensualita’. Prometeo 1985; 3: 6-15.
‘Che pensare del sesso nel XVIII secolo? I pareri al riguardo sono curiosamente
discordanti. Quando, quasi per gioco, pensiamo all’ormai “bislungo secolo”,
sappiamo che esso esordisce con Pepys e Rochester e giunge fina a Byron e Harriet
Wilson, soffermandosi strada facendo su James Boswell e le sue diciassette dosi di
sifilide, su Casanova e Lawrence Sterne, John Wilkes e l’Helfire Club, il tutto riflesso
nell’ininterrotta immagine di un’orgia letteraria che ha per protagonisti Captain
McHeath, Tom Jones, Lovelace, Moll Flanders, Don Giovanni e una fornita équipe di
libertine, mezzane, bei tenebrosi, belle di notte e baldanzosi spadaccini, meretrici e
donzelle corrotte. Tempi di sfrenata baldoria, dissoluti e licenziosi che videro John
Bull come infaticabile corteggiatore di Fanny Hill …’
Roy Porter. ‘Mirrors of sickness and health. 1 – Doctors and patients’. The Listener,
28 February 1985: 10-12.
‘In his wickedly funny play, The Doctor’s Dilemma, George Bernard Shaw posed the
ethical problem facing the medical profession of his day. His physician hero, Sir
Colenso Rigeon, possesses a new wonder drug. But it’s in too short supply for all his
patients. The doctor’s dilemma is which of his patients should he save? Today that
problem has receded. So great is modern medicine’s success story that wonder
drugs are readily available to save the lives of millions who would have died in
Shaw’s time. Yet success has created a new dilemma in its place, centring on the
mystique of the doctor as a miracle worker or panacea ... Doctor dependency is quite
recent. It would have been thought very odd in earlier centuries ... Don’t believe the
old Romantic myth that our forebears didn’t experience pain as acutely as we do. It’s
not true. But they did grit their teeth and bear it more. They had to. There were no
ways of escaping the torments of life – hunger, cold, utter fatigue, disease – and
even the remedies for sickness were themselves extremely painful: purges, vomits,
surgery with anaesthetics ... We should be immensely grateful for modern medicine.
But it doesn’t help us as patients if we cast our doctors as miracle workers, or indeed
as social workers; it doesn’t help our doctors if we encourage them to see
themselves as gods.’ (From a Radio 3 broadcast)
Roy Porter. ‘Mirrors of sickness and health: 2 – Freeing the mad’. The Listener, 7
March 1985: 10-12.
‘In many parts of the Western world, a daring experiment is being tried. It involves
people suffering from serious psychiatric disorder. It’s the attempt to rehabilitate
them into society. Traditionally, mad people have been locked up in madhouses.
Over time, we’ve tried to soften the brute realities of this fact by toning down the
words we use … The Victorians got squeamish about the word “madhouse”, and
spoke instead of the asylum. Then we had “mental hospital” … and today we have
the blander term “psychiatric unit” … two important arguments have suggested the
benefits of emptying the asylums. One is the critique of institutions developed by
Erving Goffman. Goffman’s view was that institutions corrupt … the insane don’t get
cured in the asylum … it breeds addiction to the institution, and disqualifies people
for life outside … The other influential viewpoint has been radical libertarianism, and
specifically anti-psychiatry … Thomas Szasz in America and RD Laing in Britain,
have alleged that psychiatry creates rather than cures craziness … it specifically
denies the rationality and therefore the voice of its victims … The trouble is that [the]
vision of how people respected the mad in the days before the asylum is hopelessly
romanticised … it was common to shut mad relatives up in cellars or outhouses …
the vagrant mad – the Tom O’Bedlams – would be licensed to beg. But, filthy and
half-naked, they aroused terror in the villages they approached, they were the sport
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of schoolboys … and they were whipped from parish to parish ... Yet the historical
record is not entirely pessimistic …[since medieval times] the community of Geel in
Belgium [have been] boarding large numbers of difficult and disturbed people, and
integrating them as far as possible into families and the patterns of the rural economy
… ’ (From a Radio 3 broadcast)
Roy Porter. ‘Mirrors of sickness and health. 2 – The sexual dilemma’. The Listener,
14 March 1985:10-11.
‘We seem to have got ourselves into a pickle over sex. Today we are all the children
of Freud. Our conventional wisdom is that in sexual matters, before Freud, all was
ignorance and suppression, a guilty conspiracy of silence. The Victorians didn’t dare
mention sex and this was unhealthy. Everything had to be covered up, from
unmentionable secrets down to suggestive piano legs ... Nor is this mere caricature
... Finding herself not pregnant some years after marriage, Marie Stopes, a scientist
with a PhD, went off to look up physiology textbooks in the British Museum to find out
what she and her husband were doing wrong. She discovered – to her surprise and
anger – that their marriage had never been consummated ... It may sound surprising
that equivalents of The Joy of Sex were in common circulation two or three centuries
ago ... What do they reveal? ... They don’t tell people that their sex-lives are all
wrong .. They don’t pile on shrill warnings about the dangers of sex. They don’t
demand abstinence ... these early manuals take it for granted that there’s a positive
relation between sex and good health. Good sex was the guarantee of health and its
barometer as well ... a glance at history makes crystal clear that we’re wrong to
suppose we are faced with a black-and-white choice between the full Freudian works
on the one hand, and repression on the other ... We need carnal knowledge.’ (From
a Radio 3 broadcast)
Roy Porter. ‘The drinking man’s disease: the “pre-history” of alcoholism in Georgian
Britain’. British Journal of Addiction 1985; 80: 385-396.
‘Drinking played an extremely important social role in eighteenth century England,
and heavy drinking was considered manly. At times, especially during the “gin craze”
of the 1730s and 1740s, consumption levels rocketed alarmingly, creating vast social
and medical problems and perturbing public opinion. The medical writers of
Georgian England had no doubt that heavy alcohol consumption was often
responsible for ill-health and disease, and not least was one of the triggers of
madness (and for this reason much health advice literature was at pains to moderate
consumption). But was habitual drunkenness itself seen as a disease?
Conventional wisdom amongst historians is that the disease concept of habitual
drunkenness (which later became labelled “alcoholism”) essentially stems from the
writings of Benjamin Rush and Thomas Trotter. Scrutiny of earlier writers on the
subject, however, particularly those of Lettsom, Cheyne and Mandeville, indicates no
substantial differences between their outlooks and those of Trotter. Trotter was part
of a continuing tradition, rather than the beginning of a new one.’
Roy Porter. ‘The history of institutional psychiatry in Europe’. Typescript, Wellcome
Institute for the History of Medicine, London 1985. (Student loan reprint)
‘Ever since Graeco-Roman times, European societies have had mixed feelings
towards the mad. Madness could be idealized in the figure of the holy fool or
innocent, and the witty fool – “natural” or artificial – in his role as court jester might be
allowed great license in speaking truth through nonsense; the great majority of the
mad, however, probably suffered neglect or casual cruelty. That madness came in
varied forms was clearly recognized, just as it was equally well understood that
madmen of many stripes – raving maniacs, suicidal -melancholics, empty-headed
idiots – posed problems for the business of everyday life and for the law. Could the
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insane exercise the rights and duties which appertained to normal subjects and
citizens? Were mental defectives or epileptics to be held responsible for their
actions, punished for their crimes? Could they make decisions, hold property, enter
contracts, and so forth? And if not, what arrangements were to be made on their
behalf …’
Roy Porter. ‘The patient’s view: doing medical history from below’. Theory and
Society 1985; 14: 175-198.
‘In medicine’s history, the initiatives have often come from, and power has frequently
rested with, the sufferer, or with lay people in general, rather than with the individual
physician or the medical profession at large. Yet the sufferers’ role in the history of
healing – in both its social and cognitive dimensions – has been routinely ignore by
scholars … we lack a historical atlas of sickness experience and response,
graduated by age, gender, class, religious faith, and other significant variables … in
the past, managing and treating sickness remained very largely in the hands of the
sufferers themselves and their circles, the intervention of doctors being only one
weapon in the therapeutic circle … it is precisely the dynamic interplay between
sufferers and practitioners that requires study, the tug-of-war supply and demand,
patient power and doctor power … Medicalization theory harbors another insidious
assumption, the implication that the rise of medical power is in some sense
ineluctable and unilinear, the ghost train speeding down the old Whiggish mainline
from magic to medicine. But a people’s history of health will show something much
less monolithic … that sufferers are fertile in their resources, and that feedback
processes sometimes mean that medicalization boomerangs back on the faculty, as
patients borrow the doctors’ lines … A people’s history of suffering might restore to
the history of medicine its human face.’
Roy Porter. ‘”The secrets of generation display’d”’: Aristotle’s Master-piece in
eighteenth-century England’. In Robert P Maccubbin (ed). ‘Unauthorized sexual
behaviour during the Enlightenment’. Eighteenth-Century Life 1985; 9: 1-21.
‘… One of the great debts we owe the late Michel Foucault is for his emphatic denial
that sexuality is timeless. He contended that our notion of the sexual economy is
distinctively modern; we should not foist it on the past. This advice is well taken
when approaching Aristotle’s Master-piece (first published 1690) … few of the topics
prominent in modern sexology receive even a mention. Little is said of sexual desire
as a source of fear, guilt, or danger (medical, moral, or religious). There is no inkling
of perversion or of psychopathia sexualis, nothing about homosexuality,
masturbation, sadomasochism, prostitution, and nymphomania or about any intimate
dialectic of sex with neurosis … Rather, Aristotle’s Master-piece assumes that sex is
nature’s way of providing for “the business of generation” … it is an integrated and
coherent work whose unifying theme is the subject of reproduction … and
overcoming the spectre of sterility (it lays responsibility on the woman) … the
compiler did not see his main task as giving readers instructions in the art of
lovemaking itself … (was anyone before certain eminent Victorians and the likes of
Marie Stopes ever ignorant of the mere mechanics of copulation?) … marriage, it
was emphasized, had been instituted in paradise as the divine instrument for
peopling the world … The text’s trust in nature perhaps interweaves into one fabric
the organic philosophy of Aristotle, the optimistic naturalism of the early
Enlightenment, and the earthy realism of popular culture. Aristotle’s Master-piece is
generally relaxed about what Christian churches had made an inflammatory subject.
This might help to explain its enduring success.’
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Roy Porter. ‘”Under the influence”: mesmerism in England’. History Today 1985; 35
(9): 22-29. Reproduced with additions in ‘”Coming under the French influence”: the
early history of mesmerism in England’. Typescript, Wellcome Institute for the
History of Medicine, London 1985. (Student loan reprint)
‘Exactly two hundred years ago, Mesmerism first came to England. We know about
Mesmerism today largely as the forerunner of later movements – hypnotism, which
became important in Victorian medicine, spiritualism, and not least, pschyo-analysis,
since in his early practice Freud used Mesmerism as his therapeutic medium
…Mesmer (1734-) studied medicine in Vienna … investigating the rhythms of the
human body in health and sickness … [he conceived of] a distinct natural force which
he termed “animal magnetism” … a superfine fluid permeating the universe … and
he became convinced that its free flow through the body produced health, whereas
disease was the state of its obstruction or imbalance … opposition to his unorthodox
theories pressured him to quit Vienna in 1778 and, after a period of travels, he
settled in Paris … He enjoyed the limelight for five years [until] public concern over
the Mesmeric craze led Louis XVI to set up a Commission of Inquiry in 1784 … it
denied that there was evidence to support the reality of the animal magnetic fluid
…Disappointed and broken, Mesmer left Paris … In his absence, there sprang up
Mesmerism without Mesmer … Within Germany in the Romantic period, Mesmeric
doctrines became idealised into transcendentalism, while in America Mesmerism
provided the core for Mary Baker Eddy’s Christian Science … Animal magnetism first
came to England in 1785 … Its first and best mouthpiece was John Benoit De
Mainauduc … who had studied medicine in London … and then from 1782 sat at the
feet of Mesmer and D’Eslon in Paris … But the London Mesmerists failed to establish
a headquarters, or even a group identity …as hostility grew to the French Revolution
… Mesmerism became a prime target in the politics of panic … James Tilly Matthews
… a London tea merchant … [believed] that teams of “magnetic spies” had infiltrated
into England … for: “Surrendering to the French every secret of the British
government” … Hauled before the Privy Council and examined, he was committed to
Bedlam in January 1797 … Matthews’ fear of the use and abuse of Mesmerism was
no singular paranoid delusion but a common perception of danger … his voicings of
these fears led to his being locked up as a lunatic for his pains.’
John Pickstone, Roy Porter, Simon Schaffer, Simon A Shapin, Bob Young, J Ziman.
‘What is the history of science?’ History Today 1985; 35 (5): 46-53.
‘… to our grandfathers, science was the epitome both of objectivity and utility. It was
right that primitive thought-forms like magic were crumbling before science’s hard
facts and conclusive experiments; good that the humanities themselves were
becoming scientific … Not surprisingly then the aim of traditional history of science
was clear-cut. It was to trace the march of mind, to show, for instance, how in
astronomy Ptolemy had yielded to Copernicus, how in physics Newton had
superseded Descartes … Yet it is being overturned … judging the past by the
present produces bad history … We shouldn’t take sides. Losers need study as
much as winners … the historian mustn’t just stand back and admire genius; he must
anatomise the thought-worlds of the “discoverers” … Above all, the new history of
science is on its guard against interpreting science’s past by present scientific
orthodoxy … We live in paradoxical times. Science flourishes as never before. But
we are becoming less sure whether it is a blessing or a bane. And, not least,
following Einstein and Heisenberg, even the very notion of scientific truth is in the
melting pot. In this situation, the job of the historian of science is not to play
historiographer royal to science, but to undertake detached analysis of how science
really operates, and to examine its place within the wider spheres of thought, culture
and society.’ (This extract is from Roy’s contribution only)
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Roy Porter. ‘Before the fringe: quack medicine in Georgian England’. History Today
1986; 36 (11): 16-22.
‘”Quack” was and is a term of abuse … It pointed a finger against incompetence:
quacks are all mouth and no skill. It also branded a man as a fraud, a cheat, or, in
Ben Jonson’s inimitable phrase, a “turdy-facy-nasty-paty-fartical rogue” … Georgian
quacks were not just ignorant frauds or a fringe avant la letter. New socio-economic
opportunities and pressures in the eighteenth century were important in shaping the
whole range of medical practice under the Georges … There seem to be four main
reasons for the success of quacks … the low therapeutic efficacy of Georgian
medicine … when diseases decimate and regular medicine is not reliable, people try
anything – folk brews, proprietary medicines, quack remedies ... Outside London,
practically no restrictions [against the practice of medicine] applied; there was no
medical register, no licensing system, no penalties for irregulars …foreign
mountebanks could obtain royal licences to practise in England …regular physicians
were to a large degree the clients of fashionable patients, dependent upon them,
more than on their peers, for career advancement … where the lay customer
exercises large powers of the purse and patronage, distinctions between
professional and irregular will count for little, and quacks will flourish who are adept
at pandering to patients who want pampering … Georgian England witnessed the
birth of the consumer society … quacks showed an eye to the main chance by
exploiting new market opportunities … a shelf-full of nostrums became household
names – “Dr James’ Powders”, “Anderson’s Scots Pills” … “Daffy’s Elixir” … “Joshua
Ward’s Pill and Drop”, “Velno’s Vegetable Syrup” … nostrum-mongers endlessly
exploited the opportunities of that crucial new Georgian medium, the newspaper …
Without quack ads, many newspapers would have gone bankrupt … What was
habitually labelled quackery should best be understood as the emergence of a
flourishing market sector of medicine.’
Roy Porter. ‘Gibbon, the secular scholar’. History Today 1986; 36: 46-51.
‘Have we seen the decline and fall of Edward Gibbon? What standing does his
lifework carry today? ... Today’s reading public is not given to poring over what
Gibbon called “corpulent volumes” such as his, running to nearly a million and a half
words ... Nor, for many readers, does Gibbon even cut a very attractive figure. Squat
and ugly, this vain and self-regarding man full of fussy bachelor mannerisms, hardly
matches the Romantic ideal of the intellectual as honest doubter or unworldly truthseeker ... Gibbon aimed to do more than preserve the dry bones of the past; through
the art of interpretation, he resurrected it ... He was a dedicated, even a passionate,
scholar ... as a man of the Augustan age, Gibbon refined history as an art, leaving it
to his successors to pioneer its ‘science’ ... The Decline and Fall is a tribute to
immense labour ... it was inspired by Gibbon’s visit to Rome in 1764; over a decade
then elapsed before the first volume saw the light of day, and the whole opus
occupied Gibbon for fully two decades ... it is to Gibbon that we must look for history
as a vocation ... the critical scholarship of Bayle and others had cast dark doubts
upon the possibility of any historical discipline. Facing such scepticism, the
Enlightenment turned to “conjectural” or “philosophical” panoramas, deducing man’s
past from speculation rather than building it piecemeal from the records. It was
Gibbon’s triumph to demonstrate ... that the sweep of human history could be
convincingly reconstructed from the written remains.’
Roy Porter. ‘History says no to the policeman’s response to AIDS’. British Medical
Journal 1986; 293 (no 6562): 1589-1590.
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‘Should we seek to curb AIDS by legal sanctions through public health agencies
using notification, isolation, and prosecutions? … Quarantine measures taken across
Europe helped halt bubonic plague from the seventeenth century. The same applies
to the cholera pandemics of the nineteenth century …[in England] the Public Health
Act of 1875 and the Notifiable Diseases Act of 1889 – empowered health authorities
to act decisively – for example, by compulsory admission to hospital for specified
infectious diseases … should we add AIDS to the schedule of notifiable diseases?
Historical precedent says “no”. For, unlike contagious diseases, sexually transmitted
diseases constitute a special case in which the direct methods of the law have been
tried, found wanting, and abandoned. The crucial experiment was the
euphemistically named Contagious Diseases Acts passed in mid-Victorian times in
hopes of preventing the British armed forces being defeated by syphilis. The Acts
specified that in named ports and garrison towns the police should be empowered to
detain any woman suspected of being a prostitute, compel her to undergo medical
examination, and, if she was found to be infected, enforce treatment. What is
important is the wrath the Acts aroused … Pressure from all sides brought their
repeal … It is a misfortune, not a crime, to contract a disease … If we begin to treat
victims like criminals we alienate those whose cooperation is most needed … not
least we risk turning doctors into gaolers.’
Roy Porter. ‘Love, sex and madness in eighteenth-century England’. Social
Research 1986; 53: 211-242.
‘… mind/body and mind/matter distinctions have been profoundly influential, not just
for mapping reality but also for evaluating ideas and experiences … Love … aspires
to the spiritual, the soulful, the ideal. Sex, by contrast, … has characteristically been
seen – condemned indeed – as lower, mechanical, or merely animal … love’s
disorders were mental disorders … love madness early became integral to the
province of mad-doctors and the emergent psychiatric profession. Robert Burton
devoted no less than one third of his highly influential Anatomy of Melancholy (1621)
to “love melancholy” … Dr William Black’s pioneering statistical survey of Bedlam
patients at the beginning of the nineteenth century gave “Love” as the fifth most
common cause for their admission …But how did people see the relations between
sex and insanity? …In Freud’s view, sexual psychopathology was bound to be a
common disorder, because the biological imperatives of sex grated against the moral
goals of civilization … Masturbation became the model. By 1828 [George Man]
Burrows could judge: “The lamentable vice of masturbation is a frequent and
formidable cause of insanity” …it seems that eighteenth-century physicians believed
that aberrant sexuality was simply much rarer than Victorian psychiatrists thought …
no contemporary psychiatric text seems to mention [masturbation] … the treatment
of hysteria [also] shows a form of disturbance not attributed to sexual causes.
Certainly nineteenth-century psychiatry increasingly saw sex at the root of hysteria …
That was why morality demanded that respectable women should be “passionless”
… Most eighteenth-century accounts … saw hysteria not specifically as a disease
arising from the sexual organs but rather one caused by general constitutional
weakness and overexcitation … Psychological typing of sexual deviants [the
prostitute, the homosexual] was a development almost wholly reserved for the
nineteenth century … the typical message of eighteenth-century medical opinion
was: Sex in accord with the promptings of nature confers health, giving bloom to the
individual and revitalizing the national stock. Frustrate sex and you endanger health.
If evil social arrangements such as delayed marriages force sexual desires into other
channels – masturbation, prostitution – ill health will result.’
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Roy Porter. ‘Medicine and the decline of magic’. Strawberry Fare, Autumn 1986: 8894. Reprinted in Society for the Social History of Medicine Bulletin 1987; 41: 24-27.
Reprinted in Cheiron Newsletter 1988; 6: 40-46.
‘The early seventeenth-century parson-physician, Richard Napier, was an exponent
of religious healing; he would pray for recovery. But to protect his patients “against
evil spirits, fairies, witcheries”, he would often give them sigils and amulets to wear …
Similarly, when Samuel Pepys totted up his medical accounts at the end of 1664 and
found himself in exceptionally good health, he was unsure whether the cause was
leaving off his gown, taking turpentine pills every morning, or his hare’s foot … There
is not the slightest doubt that medical magic was widely accredited and practised
across the social spectrum through the sixteenth and seventeenth centuries … the
parting of the ways on medical magic in the Georgian era … is merely yet another
facet of that long withdrawal of patrician from plebeian culture … Medical magic
certainly did not tumble because of grand therapeutic advances amongst regular
medicine. There were none such … Very broad shifts in cultural psychology were
undoubtedly at work. Amongst the educated classes this … involved Enlightenment
outlooks which characteristically equated everything tainted with “magic” as the
marks of ignorance, religious superstition and the infancy of society … ideologies
were translated into medical actuality [through] the emergence of the general
practitioner, the rise of medicine under the poor law, the growing availability of
medicines and drugs over the counter, and the emergence of commercial quackery
…’
Roy Porter. ‘Plague and panic’. New Society, 12 December 1986: 11-13.
‘Who can deny that the “gay plague” hysteria has spawned ghastly phantoms in the
public imagination? After all, a Thames Television camera crew recently refused to
set foot inside the Terrence Higgins Trust (the major support group for AIDS
patients), terrified of picking up the disease from the air or off the furniture …People
have never been content just to make war on disease. The disease too had to be
blamed, scapegoats found and the victims vilified. The Black Death, for instance,
was said to be the doing of the Jews … The great plagues of Tudor and Stuart times
were divine thunderbolts against sinner, blasphemers and idolators … When cholera
hit Europe in 1831 … some saw … a sinister plot, an infection actually planted by the
authorities, with the physicians’ connivance. By unleashing cholera, the ruling
classes would decimate the surplus poor, and doctors would get bodies galore for
their sordid dissections …AIDS has already been labelled a CIA plot …History shows
the wisdom of softly-softly approaches rather than coercion … One reason why the
problem of traditional sexually transmitted diseases has remained manageable this
century is precisely because of the special, voluntary nature of the VD clinics –
anonymous, confidential, set apart from the regular GP and hospital system –
established in a rare flash of moral enlightenment at the end of the first world war.
Public health professionals know that adding AIDS to the list of notifiable diseases
would multiply stigma, forfeit cooperation …’
Roy Porter. ‘The diary of a madman, seventeenth-century style: Goodwin Wharton,
MP and communer with the fairy world’. Psychological Medicine 1986; 16: 503-513.
‘Goodwin Wharton (1653-1704) was a nobleman’s son and a Whig MP from 1690 to
his death in 1704 who played no small part in English public life. His manuscript
journal shows, however, that he also lived a bizarre secret life of the mind which, in
later generations, would have led to his confinement as suffering from mental illness.
Above all, through the offices of his medium and lover, Mary Parish, he entered into
elaborate relations both with the fairy world and with God and his Angels … In
Wharton’s self-portrait, the conventional and the abnormal jolt against each other
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right from the beginning … his family wronged him; he suffered endless “injuries” and
was treated “like a slave”, coming under their “remedilesse lash” … Soon he found
himself entrusted with supernatural powers … in 1683, seeking someone to put him
in touch with the angels, Wharton was directed to … Mary Parish, a London healer,
cunning-woman and medium … A Catholic in her early fifties, she had been married
three times … had had scores of children … she had been in and out of debtors’
prisons …Mary Parish and Wharton … would go and visit the fairy kingdom … on
Hounslow Heath … accessible to humans only for a few minutes at the new moon
…in the course of these agonizing trips, Mary Parish and Wharton, aided by trusty
spirits, located priceless treasure hoards …the footing of the relationship changed,
turning from business to friendship … finally, it became sexual … Mary Parish
conceived immediately at their first love-making, the first of one hundred and six
conceptions she enjoyed by Wharton … Penelope [Queen of the fairies] vowed to
marry Wharton … she even used Mary as her matchmaker … Mary Parish started
being visited … by the angels, unambiguous signs of divine favour … Goodwin
himself began to have first-hand experiences … hearing sonorous voices, seeing
bright and flashing lights … during his last decade, the intensity of his involvement
with the spirit world probably diminished … on the death of his father in 1696, he had
stopped being hounded by creditors; from 1695 he possessed a society mistress,
Lady Elizabeth Gerard … Mary Parish … kept communing with the fairies to the end
of her days … Wharton gave her a fine burial at St Giles-in-the-Fields …Deciding
whether Wharton was mad … should be a lesser priority for the history of psychiatry.
More urgent, more intriguing, is the task of exploring where the boundaries between
sanity and insanity were perceived in any particular age, and how they shifted over
time …’
Roy Porter. ‘Historians and their work: Edward Gibbon’. History Sixth 1987; 1: 2829.
‘The Decline and Fall is a work of quite exceptional breadth. It opens with the
Empire at its height under the admirable Antonine emperors around the close of the
second century AD. It traces the collapse of this mighty empire (overwhelmed, as
Gibbon slyly explained, by “barbarism and Christianity”) over the next thirteen
centuries no less … What makes the Decline and Fall such an enduring classic of
the craft of the historian? It is, for one thing, a marvel of erudition and accurate
scholarship. Unusually for his time, Gibbon listed his sources, with full references, at
the foot of the page … no less important is Gibbon’s interpretative vision … [he]
wrote universal history as secular history. He was concerned with the social,
political, military and psychological causes of the rise and fall of empires, with how
men made or marred their own affairs. Above all he was ambitious to write the
secular or naturalistic history of religion, treating the rise of Christianity not as
preordained by God’s foresight, but as the product of the interplay between the cast
of men’s minds (“fanaticism” and “superstition”) and crises in human affairs …
Gibbons’ Decline and Fall … made history serious … but it also made history
readable. Gibbon became instantly famous as the supreme stylist; he has never
been surpassed. When John Perceval, son of the assassinated Prime Minister,
Spencer Perceval, went mad in the 1830s and was locked up in a lunatic asylum,
there was one book which he begged to be allowed to study in order to restore his
sanity. It was none other than Gibbon’s Decline and Fall.’
Roy Porter. ‘Madness and society in England: the historiography reconsidered’.
Studies in History 1987; 3: 275-290.
‘… Until the latter half of the seventeenth century, it was highly exceptional in
England for mad people to be housed in special institutions for the insane. Indeed,
93
only one such official, public institution existed, Bethlem Hospital, at Spitalfields, in
London … the vast majority of lunatics and simpletons remained within the
community … it was acknowledged that madness was a mysterious condition and
commonly intractable … it would be a mistake to assume that mental abnormality
was routinely understood as being due to diabolical possession … the treatment of
the mad in the Georgian century is … commonly presented as “unreformed”, as are
so many other aspects of the age. The condition of Bethlem is taken as
representative … neglect of patients, the lack of any therapeutic innovations, the
brutality and peculations of its staff … the … French thinker Michel Foucault … has
argued that all over Europe, from about the 1660s onwards, the age of the “great
confinement” dawned … bureaucratic and police powers generally linked to the
modern state and absolutism, combined physically to sequester and institutionally
confine all the “irrational” elements of society … Foucault’s interpretation … fits ill
with the facts for England during the “long eighteenth century” … it would seem that
by 1800 perhaps no more than about 5,000 people were institutionally confined
…Most of the institutions set up – there were perhaps … 50 by 1800 – were privately
owned, very small and highly individualistic …Enlightenment optimism believed that
mad people … could be “improved” …From 1808 onwards, legislation permitted local
authorities to build county lunatic asylums … from 1845 it was compulsory … to
provide … public accommodation for … pauper lunatics … A rising spiral set in …
the new breed of specialist psychiatric doctors could make the spread of the
reformed asylum … appear a highly progressive movement … asylums increasingly
silted up with chronic and hopeless cases … “voluntary” confinement and the “open
door” policy came late to England …we know far too little about those disturbed
people who were never actually institutionalised … The history of private nursing,
and of nursing homes, remains a mystery, as does the recent history of small private
mental institutions … Lastly, it would be a mistake if research remained myopically
chauvinistic. Until genuinely comparative work on the history of madness is
undertaken, it will remain unclear precisely how to interpret the specific cultural and
social dimensions of the subject.’
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Roy Porter. ‘Medicine and religion in eighteenth-century England: a case of conflict’.
Ideas and Production. Issue 7 – History of Science. Cambridgeshire College of Arts
& Technology, Cambridge 1987: 4-17.
‘… today’s scholarship argues that – with the exception of a few specific episodes – it
makes little sense to present the history of the rise of science as the counterpart of
the story of the decline and fall of religion …[in] eighteenth-century England, all the
indications are that … medicine and religion typically made good bedfellows … The
seventeenth-century mind had been preoccupied through and through with finding
particular personal providential explanations of individual visitations. Disease was a
divine direct hit … the balance was certainly tipping during the eighteenth century
towards more secular accounts … yet I wish to pinpoint certain specific areas where
conflict did indeed occur, or some boundary-shifting was taking place during the age
of the Enlightenment … there was a degree of popular gut religious hostility to
smallpox inoculation … as Dr Richard Blackmore put it, “multitudes looked upon the
Practice as inconsistent with the Christian Religion, that forbids its Followers to tempt
Providence …” and this was formalized in sermons … What is important, however, is
not that these objections were voiced but that they carried so little weight …
perceptions of the nature of madness and of its proper treatment were fundamentally
to change … the notion that divine transports and religious melancholy were caused
by the suggestion of the Devil disappeared almost completely … most importantly,
amongst the elite there was a growing tendency to view all forms of transcendental
religious experiences … hearing divine voices, seeing vision, speaking in
Pentecostal tongues … as cases of madness … medicalization was ideologically
instrumental in silencing critical voices of protest. The disturbing was called
disturbed, and the disturbed were labelled diseased … one key facet of Georgian
quackery lay in the way it cashed in on the kudos of religious healing … most
commonly, nostrum publicity made verbal hints at the possession of supernatural
qualities … [for example] Dr Trigg’s “Golden Vatican Pill” …remembering how
medicine is through and through about people, values and practice, it would be
wrong to reduce analysis of religion and medicine merely to intellectual abstractions;
they have socio-cultural, ideological and practical dimensions which are vitally
important.’
Roy Porter. ‘The origins of the English pharmaceutical industry: Thomas Corbyn’.
Society of the Social History of Medicine Bulletin 1987; 41: 64-65.
‘... Born in Worcestershire in 1711, Corbyn came to London and was apprenticed to
an apothecary, Joseph Clutton. On Clutton’s death, Corbyn went into partnership
first with his widow and then with his son, Morris. On Morris Clutton’s death in 1754,
Corbyn bought the business outright, although he subsequently traded with a variety
of partners, who brought valuable capital to the firm. Corbyn described himself as a
chemist or druggist; there is no sign that he practised medicine himself ... Corbyn’s
business had several different sides. He had a small over-the-counter retail trade.
He sold materia medica and compound drugs to dispensing apothecaries in London
and to apothecaries and physicians in the provinces. He sold bulk consignments of
drugs to the newly founded voluntary hospitals. Most of his trade and profit however
came from overseas trade, above all with the American colonies ... Corbyn set little
store by “science” or by innovating with nostrums and proprietary drugs. He astutely
saw that what his customers wanted were tried and tested favourites, such as
sassafras and senna, supplied to dependable and constant standards of purity ...’
Roy Porter. ‘Brunonian psychiatry’. In Bynum WF, Porter Roy (eds). Brunonianism
in Britain and Europe. Medical History 1988; Supplement 8. Wellcome Institute for
the History of Medicine, London: 89-99.
95
‘John Brown … took no special interest in mental disorder, though he of course had
no difficulty in fitting mania and melancholia respectively into his general scheme of
sthenic and asthenic diseases … a champion of Brunonian psychiatry is George
Nesse Hill. Born in 1766, Hill … was too young to have been a pupil of Brown …and
was utterly out of step with his times … But his basic understanding of the nature of
insanity was impeccably Brunonian … mania set in when the excessively stimulated
constitution erupted not merely in such physical symptoms as fever, but in mental
agitation; and melancholia resulted when too little stimulus, under-excitement,
produced not only such physical signs as debility, but an under-stimulated mind …
characterizing madness thus … demolished the whole taxonomic fantasy-world
originally created by William Cullen … insanity was “one species” only, as a process
characterized by physiological actions and reactions, stimuli and responses … A
pillar of Hill’s system … was the need to treat individual cases individually … routine
treatments characteristic of the madhouse as the group annual Spring blood-let and
vomit at Bethlem … were quite criminal … he deplored metaphysical accounts of
mental illness … It was arbitrary to separate mind from body … Insanity, he argued,
“is never a purely mental disease”; it “always has corporeal disease for its
foundation” …by stressing the corporality of insanity … he removed madness from
the realms of mystery, and rendered it as intelligible as all other diseases … he [also]
rendered insanity as amenable to medical therapeutics as other comparable
diseases such as fevers … particularly evil was the indiscriminate use, very common
in large asylums, of pacifying medicines, largely as a way of ensuring tractability …
madhouses … were … “manufactories of madness” … in An essay on the prevention
and cure of insanity (1814) [Hill] ended up penning the most dramatic rejection of the
whole emergent system of care and treatment of lunatics, and the most closely
argued alternative. In spite of Hill’s arguments, asylums were reformed, fortified,
enlarged, rationalized, liberalized, and reformed again and again … Only nowadays,
perhaps, are we once more seriously grappling with the possibility that the distinction
of psychiatry from general medicine may have proved a vast strategic mistake.’
Roy Porter. ‘Ever since Eve: the fear of contagion’. Times Literary Supplement
1988; May 27-June 2: 582, 597.
‘It is vital to differentiate plagues and contagions as perceived agents of danger. In
the plague paradigm, each victim is struck down directly by divine will … God will
visit whom he chooses. And then he is satisfied … AIDS rather is seen as a disease
other people give you … it comes from enemies within … Years may elapse before
any symptoms of being HIV-positive appear: who knows who is carrying it? …
Renaissance Italy … began the long-term hospitalization of those new moral lepers,
syphilitic prostitutes … The (“great”) pox became the locus classicus of the
contagious disease. The Contagious Diseases Acts (1860s) lay bare powerful
prejudices about contagion. Their most blatant implicit message is, of course, the
classic double-standard assumption that it is women who are the sources of
contagion. Ever since Eve, men have always been infected, with sin or sickness,
through the wiles of femmes fatales. The Acts then specifically identify the prostitute
as the archetypal swamp of sickness … any condition designated as contagious is
liable to be associated with illicit fornication … Once AIDS was admitted to be
contagious, a Pandora’s Box was opened, letting out all those destructive fears
which fester when we believe our troubles are due to unseen agents spread by other
people … Plagues descend, decimate and depart. The fears evoked by AIDS –
fears of the latent, lurking dangers of infected carriers in our midst – will prove far
more lasting and deadly.’
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Roy Porter. ‘Interpreting quackery in Georgian England’. Medical Historian 1988; 1:
3-9.
‘Viewing all irregular medicine as “quackery” became an article of faith amongst
champions of the cause of ethical medicine in the Victorian age … the cumulative
effect of this reformist tide was that series of legislative changes from the
Apothecaries Act (1815) through to the Medical Registration Act (1858) which set
medicine on a more professional, more ethical plane, in part through erecting a
cordon sanitaire between it and what it labelled money-mongering quackery … and
the [18th] century itself waged a concerted attack on its quacks in precisely these
terms … for quacks cheated people not only of their money but their health … the
quack is presented as all mouth, a peddler of velvet sales patter … emperor of
bunkum … The question, however, is whether this line of exposure of quacks as
vulgar, hum-bugging, mercenary crooks is historically helpful. All the evidence, for
example, suggests that many quacks sincerely believed in their remedies and
powers … some commonly labelled as quacks had excellent medical training …
regular and quack medicines were often identical …Augustan satire teems with
caricatures of the pomp of physicians with their Latin mumbo-jumbo, their carriages
and running-footmen … It would be a forlorn and historically misguided enterprise, I
wish to argue, to draw hard and fast lines between proper practitioners and quacks,
using criteria such as integrity, scientific method, or therapeutic efficacy.’
Roy Porter. ‘Margery Kempe and the meaning of madness’. History Today 1988; 38
(2): 39-44.
‘”Living high above her bodily wits” – but was the “madness” of a fifteenth-century
English gentlewoman divine folly, marital stress of the stirrings of a self-conscious
feminist? ... The opening pages of what is in effect the earliest English autobiography
present an account of a woman going mad. “When this creature was twenty years of
age, or somewhat more,” wrote Margery Kempe – or rather “dictated” since she, like
most late medieval women, was illiterate – “she was married to a worshipful burgess
and was with child within a short time, as nature would have it”. She was sick during
pregnancy, and after childbirth, what we would call puerperal insanity set in. “She
despaired of her life and sent for her confessor”, for “she was continually hindered by
her enemy – the devil”. She believed she was damned ... Margery Kempe’s
experience, recorded early in the fifteenth-century, commands attention as the story
of a mad person; but it is doubly interesting as an account of a mad woman, for these
are rare so many centuries ago ... not only did she record her experiences in great
detail, but was able to make sense of them, during her mad bouts and in their
aftermath – though not in terms of being a mad woman, but through the idiom of the
Christian life of the spirit.’ (Article based on a talk given to the Past and Present
Society in Oxford at a meeting sponsored by History Today, and on a chapter in Roy
Porter. A social history of madness: stories of the insane. Weidenfeld & Nicolson,
London 1987. Reprinted in paperback 1989.)
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Roy Porter. ‘Mad Margery’ (comment Patrick Collinson, reply Roy Porter). History
Today 1988; 38 (6): 60-61.
Patrick Collinson suggests that ‘in this article we encounter the useable rather than
historical past’ and that ‘Margery Kempe’s “autobiography” raises historical problems,
primarily of a textual order which Roy Porter’s treatment fails to address’. He goes
on to say that ‘the lady … should never have been let out of the Early English Text
Society (the literary equivalent of a nunnery) into the more dangerous world of
Penguin Classics’. Roy Porter replies: ‘… Why release Margery Kempe even so far
as the EETS? Would it not be safest – so runs the logic of his argument – never to
print such misusable texts at all, but to keep them in the top security wing of the
manuscript archives where they can do no harm? The history of the insane cannot
be left to psychiatrists; interpreting it sets down a challenge to historians. Hence I
argued that to label someone mad should be the starting point not (as so often) the
conclusion of historical enquiry, and suggested that Kempe’s madness begins to
make sense once historically contextualised.’
Roy Porter. ‘Points of entry: the Foundling Hospital’. History Today 1988; 38 (3): 6162.
‘Before Thomas Coram, a retired man of the sea, obtained a charter in 1739 for his
“Hospital for the Maintenance and Education of Exposed and Deserted Young
Children”, there were no orphanages at all in this country. In this respect Britain
lagged well behind the Continent … moral and religious hardliners had traditionally
insisted that such homes would encourage bastardy by absolving fornicators from
paying the price of vice. The climate of opinion was shifting in early Georgian
England … under the impact of what we can loosely call the Enlightenment.
Punitiveness melted into pity … Attitudes towards children were probably changing
as well … But the Enlightenment also championed utilitarianism. Children who died
or went to the bad were a waste of national stock … Coram and his fellow governors
(men only) … bought a fifty-six acre sight in attractive Bloomsbury (then on the very
outskirts of London) where the infants would have … fields and fresh air …
Foundlings were admitted (no questions asked about parentage) within two months
of birth … Music played a large part in the educational scheme, and all the boys were
taught a trade. The thirty-eighth child admitted – christened “Thomas Coram” – rose
in life to become a ship-builder, and eventually a governor of the institution which had
probably saved his life.’
Roy Porter. ‘Sick people, health and doctors in Georgian England’. Historian 19881989; 21: 3-6.
‘Health took on an even greater than usual significance in Georgian England.
Enthusiastic for this-worldly improvement, propagandists of the Enlightenment
substituted sanitation for salvation in pressing for a healthy, rather than a holy,
society. It is no accident that many leading Enlightenment figures in England were
either trained as, or were practising physicians, from John Lock himself to Erasmus
Darwin ... During the eighteenth century, ... in Britain, more than anywhere else ...
sick people became medical consumers. They consulted more doctors more
frequently than ever before [although] ... lay people continued to perform physick,
and even surgery, upon themselves and their acquaintance ... some self-doctors
mixed physical and spiritual remedies. “Took Caster Oil – read Tristram Shandy”,
wrote John Baker in his mid-eighteenth century diary ... never before had the medical
profession so saturated the market with writings, from sixpenny pamphlets to weighty
tomes, targeted at a health-conscious lay readership ... The increasing perception of
man in the consumer society as being a consumer of medicines found expression in
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a new stereotype: the hypochondriac ... the doctors’ victim as well as their bane, the
creation of over-attention by physicians and over-dosing by apothecaries.’
Roy Porter. ‘Poetry, genius and the “mad writers” of Bedlam’. Bethlem & Maudsley
Gazette 1988; 34: 28-30.
‘During the present century, many forms of therapy have been devised encouraging
the mentally ill to express themselves through painting or poetry … Yet, in truth, such
ideas would have been quite commonplace to many psychiatrists and asylum
keepers of the last century. After he was confined to Bethlem in 1844 for murdering
his father, the painter Richard Dadd was positively encouraged to take up his
brushes again … Matthew Allen, the proprietor of High Beeche Asylum, Epping …
was extremely sympathetic to the idea that self-expression could be beneficial …
One of his patients was the tragic poet, John Clare … Ever since the ancient Greeks,
insanity and original talent had both been believed to be the product of similar
qualities or casts of mind: an abnormally vivid imagination … Thus Michael Drayton
praised his fellow poet, Kit Marlowe: “For that fine madness still he did retain, Which
rightly should possess a poet’s brain” … Yet a counter-view was gaining ground
towards the end of the seventeenth century and into the eighteenth … in which the
hallmark of the great poet was his rationality, or judgement … Trapped between the
old view of the crazy poet, and the new idea of the poet as the light of reason was a
man named James Carkesse who spent some years confined in Bethlem in the
1670s, under the physician, Dr Allen … Carkesse took to writing poetry to prove [his
sanity] … Dr Allan told him that “till he left off making Verses, he was not fit to be
discharg’d” …’
Roy Porter. ‘The new taste for nature in the eighteenth century’. The Linnean 1988;
4: 14-30.
‘We must not … assume that educated Englishmen of the Georgian century imbibed
a love of Nature with their wet-nurse’s milk … Dr Johnson for example took a very
down-to-earth view of Nature as adjunct to human survival: “That was the best
garden”, he dogmatized, “which produced most root and fruits; and that water was
most to be prized which contained most fish” … Nature was good provided it was
conquered and cultivated … [there was however] a massive surge of interest in
natural history during the 18th century … scientific study surged ahead. Linnaeus’s
taxonomies brought order and clarity to the anarchy of botany. Geology, as a
coherent discipline, came into being … Eminence in natural history was not passed
down from the professors or the professionals. Rather it welled up from the
amateurs … Many such men were enabled, through possession of independent
wealth, simply to pursue their natural history passions just as they chose: Sir Joseph
Banks, James Edward Smith … Others such as Sir Ashton Lever, Charles Greville,
the Earl of Bute … could convert their riches into vast collections. Others used
wealth and freedom for explorations abroad … Sir William Hamilton, Sir James Hall,
Roderick Murchison, Charles Lyell … in natural history … property ownership …
permitted the disinterested pursuit of truth, unsullied by commercial motives, fear or
favour … the [18th century sees a new] rapport with Nature … the genre of landscape
art increasingly coming into its own … the fashionability of the natural … reproduced
in the English garden … the underlying message – change, process, the infinite –
was of course Romantic … what came to be distinctive about the surging popular
taste for natural history in the 18th century, what distinguishes say Erasmus Darwin,
Joseph Banks or Gilbert White from Joshua Childrey, Robert Plot, Nicholas
Culpeper, or even perhaps John Ray, is just that imaginative, emotional rapport with
their subject matter, Nature.’
99
This paper is a transcript of an address delivered by Roy Porter to the Linnean
Society, 30 April 1987.
Dorothy Porter, Roy Porter. ‘The politics of prevention: anti-vaccinationism and
public health in nineteenth-century England’. Medical History 1988; 32: 231-252.
‘Under the 1853 [Vaccination] Act, all infants had to be vaccinated within the first
three months of life, in default of which parents were liable to a fine or imprisonment.
The 1867 Act made it compulsory for children under the age of fourteen to be
vaccinated … a parent found guilty of default could be fined again and again, with the
sentence increased … The law was further tightened in 1871 … Resistance to
compulsory vaccination had occurred from the outset … Both the anti-vaccinationists
and the public health service held philosophies of the prevention of disease …
Charles Creighton (1887) argued that vaccination was a foul poisoning of the blood
with contaminated material, which could provide no protection from a disease caused
by effluvia arising from decaying organic matter … Edgar M Crookshank … first
Professor of Bacteriology at King’s College London … tried to show that [Jenner’s
lymph] had itself been the source of a separate disease, vaccinia, and was
responsible for the secondary transmission of syphilis … Dr Watt from Glasgow …
suggested that removing smallpox from the community simply redistributed mortality
amongst other diseases … The sociologist Herbert Spencer used vaccination to
exemplify his belief in the folly of expanding the role of the state … Alfred Russel
Wallace … denounced the insidious growth of the power of the medical profession –
a view later reiterated by George Bernard Shaw … Anti-vaccinationist literature
proliferated during the 1870s and ‘80s … The [Vaccination] Inquirer (founded 1879)
claimed to serve both the aims of those believing vaccination to be entirely injurious
and the cause of those unconcerned about its efficacy, but implacably hostile to
compulsion … A new Vaccination Act was passed in 1898, relaxing the terms of
compulsion by introducing the possibility of conscientious objection … By far the
majority of the community throughout the kingdom remained vaccinated in the latter
half of the nineteenth century and it is unknown how many defaults resulted from
negligence rather than conscience.’
Dorothy Porter, Roy Porter. ‘What was social medicine? An historiographical essay’.
Journal of Historical Sociology 1988; 1: 90-106.
‘The very term “social medicine” originated with Jules Guèrin (1801-1886), the editor
of the Gazette Médicale de Paris, and it has been used in many different contexts
since …In the English context, the term prevention dominated discussion on the
social relations of health and disease between about 1890 and 1914. In this
historically specific context, a mixture of ideologies operated. As in the development
of social medicine in Germany, there was an ideological continuum ranging from
primarily economic, to primarily biological analyses. Taking Germany and Britain
together, the poles of the axis could be characterised at one end by the philosophy of
Rudolf Virchow, who believed that morbidity and mortality were largely preventable
through medical economic welfare: this was a philosophy echoed by Medical Officers
of Health such as Arthur Newsholme and Edward William Hope. At the other end,
social medicine became a system of socio-biological planning to be achieved through
biotechnical engineering and moral prophylaxis, as advocated by [Alfred] Grotjahn or
[James] Barr. There are certain common threads and denominators within social
medicine. One is a particular theory of the state. For Virchow as for Barr, social
medicine depended on scientifically-informed, technocratically determined actions by
the state. This technocratic vision differentiates the ideas of social medicine from
theories of socialist medicine in which the vision of the state is political not technical.
The latter looks for the causes of health and sickness in the economic relations of
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production and the social relations of class, and seeks prevention through changing
the political relations of power.’
Roy Porter. ‘When the naked truth does matter’. Evening Standard, 16 February
1988.
‘Imagine opening today’s Standard and finding great wastes of blank paper where
news, comment and pictures should be. Imagine that somebody had censored those
features out. Interference of that kind – common enough these days in South Africa
– kills media freedom in a free society. But such expurgation from on high would be
intolerable to us ... It’s appallingly patronising to assume that once you give people
free choice, they always choose the worst ... Drive sex underground and it’s sure to
turn nasty. Swings in public morals over the last 200 years prove that. Sex was
open and no-nonsense in Georgian times, the age of Fanny Hill and the Prince
Regent. Disgusted by such obscenity, the Victorians crusaded for respectability and
chastity; books were bowdlerised, and legs were covered, even piano legs. But all
this achieved was a nation of prudes seething with frustration, neurosis, and above
all, hypocrisy ... The naked truth is always preferable to a conspiracy of silence.
When, just over a year ago, the Government launched its AIDS education campaign,
there were protests aplenty. Showing condoms, grumblers complained, was
offensive; talk of safe sex condoned immorality. Norman Fowler, thank goodness,
stuck to his guns. Statistics for the spread of AIDS suggest his frank campaign may
be working.’
Roy Porter. ‘”A little learning”: knowledge and health in the 18th century’. Festscrift
for Sir Christopher Booth. Gut 1989; 30: 75-80.
‘Many high minded, improving physicians in 18th century England became convinced
that the physician’s vocation went beyond the merely clinical … They devoted their
energies to good causes, from the small scale, such as the founding of dispensaries,
to the visionary (for instance, the abolition of the slave trade). They passionately
subscribed to the Enlightenment conviction that the advancement of knowledge –
both in medical science itself, and in terms of the broader education of the public –
must make its contribution to the progress of health, well being and decency … Yet
these very doctors also … became anxious that “progress” was producing, not the
expected improvement of health, but its deterioration … During the 18th century,
pulmonary tuberculosis became a veritable “white plague” … a “giant-malady”, as
Erasmus Darwin called it … medical opinion … was inclined to look to precipitating
causes endemic to civilised society … intellectual endeavour was a sedentary
occupation that taxed the nerves …lack of exercise, over rich food, excessive
drinking, and the need to shine in a competitive world dominated by fashion,
weakened the body and ruined the nerves …Pastimes designed to “exercise the
sensibility” proved “highly enervating” …masturbation became the target of Georgian
medical writers who exposed it … as ruinous to health … because it allegedly
induced wasting conditions … [as did] vegetarianism … it was the thing to be thin …
[Thomas] Beddoes … advocated a return to the simpler ways of a less educated era
…his most touted tuberculosis therapy was the “cow-house method”. Beddoes
urged consumptives to live in barns … Joseph Priestley’s daughter … “found a cowhouse a much more comfortable abode than she had formed an idea of”, though the
stench was “nauseous” and “successive generations of flies were a considerable
nuisance” …’
Roy Porter. ‘Female quacks in the consumer society’. The Clark Library Newsletter,
Spring 1989: 1-4. . Reprinted with additions in ‘Female quacks in the consumer
101
society’. History of Nursing Society Journal or History of Nursing Bulletin 1990; 3: 125. (This abstract is taken from the 1990 article)
‘Overall, I would suggest, during the seventeenth, eighteenth, and, even the
nineteenth centuries, class counted more than gender as the prime determinant of
patient/doctor power relations … it is true that women forced an entry into the
modern – that is, post-Medical Register, post-GMC medical profession … but
females had earlier abounded in the traditional occupation of healing … There were,
of course, the amateurs: ladies bountiful … and parson’s wives … then there were …
women who made, or topped up, their living out of medical care: herbalists,
midwives, leechwomen … and the ubiquitous, all-purpose nurse – women employed
not primarily … in hospitals, but in the home, as the need arose … female healers
and surgeons of Tudor and Stuart times did not … have to battle against appalling
public prejudice … the emergence, from the mid-seventeenth century onwards, of a
thriving … market in manufactures and services did not destroy the female healer,
but rather expanded the trade … Not … amongst the thin red line of the orthodox …
But certainly amongst the hordes of the irregulars … Sally Mapp, the Epsom bonemanipulator … became one of the most celebrated medical figures in England … Mrs
Joanna Stephens … sold the secret remedy [for her stone-dissolving medicine] to the
nation for a knock-down £5000 … Anne Trow, born into a smallholder’s family in late
eighteenth-century Gloucestershire, rocketed to become New York’s most
fashionable abortionist …Yet female quacks were also angling to win, or to create, a
distinctive market of their own …One such area … was “cosmetics” – a term which
… had a far wider application than today … in an age of smallpox, scurvy and
scrofula, of sores and ulcers slow to heal, cosmetics .. helped enable otherwise quite
disfigured people to put on a good face in public …certain female quacks promised
cures for the pox: “ …if Venus should misfortunately be Wounded … by tampering
with Mars” … male and female quacks commonly operated in partnership …the
proprietor of the “Herculeon Antidote against the Pox” told women too bashful to
consult with himself, to see his wife … It would be good to know how far the spouses
of regular doctors – whom Thomas Beddoes sneeringly called their husband’s
“Sergeant Kite in petticoats” – provided similar services for their patients … What is
clear is that such “partnerships” could never be advertised.’
Roy Porter. ‘Mix ‘n match: traditional medicine in China’. Journal of Traditional
Acupuncture 1989; 11: 21-23.
Roy Porter. ‘Ragione, follia e Rivoluzione Francese’. Quaderni Storici 1989; 71:
563-588. Reprinted as ‘Reason and madness in the French Revolution’. In Brown
LE, Craddock PB (eds). Studies in eighteenth century culture 1990; 20: 55-80.
‘… as institutionalization grew standard from the eighteenth century … and
particularly as scandalous cases of the incarceration of the sane came to light, so it
became an urgent matter of priority to establish cast-iron medico-legal criteria for
certification … James Tilly Matthews was a Welsh tea-broker trading from 84
Leadenhall Street, London … In the wake of the French Revolution, which he
welcomed … he sought from 1792 to convey peace overtures to Pitt and other
ministers in … self-appointed shuttle-diplomacy missions between Paris and London
… arrested in 1793, he was held in Paris until 1796 … While in France Matthews
became au fait with Mesmerism … Matthew hastened back to England in March
1796, believing he was privy to intelligence that could save his country … [he]
proceeded to the gallery of the House of Commons where he accused the ministry of
“traitorous venality” … he was committed to Bethlem on 28 January 1797 …[in] 1809
… his relatives and parish [Camberwell] petitioned for his release, claiming his sanity
… When the petition was turned down, his family and parish took out a writ of
102
habeas corpus [and] persuaded two London practitioners, George Birkbeck … and
Henry Clutterbuck, to examine him. These judged him basically sane … Thomas
Monro [Bethlem’s physician] [and] John Haslam [apothecary to Bethlem] were
convinced of the opposite … Most critically, Haslam claimed that Matthew’s political
opinions entailed that, if released, he would be a formidable security risk … George
III’s life had already been the target of several lunatics such as Margaret Nicholson
and James Hadfield (themselves now safe in Bethlem) … Haslam was provoked to
vindicate himself in print … His Illustration of Madness (1810) [was] the first work in
the language devoted to a single psychiatric case-history … [Nevertheless] he felt no
obligation to … diagnose Matthew’s disorder … or elucidate meaning [of his
delusions] …[In 1815, the year that Matthews died], the House of Commons Report
on madhouses disgraced Bethlem, and … its governors had access to an account
written by Matthews, accusing Haslam of malpractice … Haslam was astonished
when the governors treated it as sense not nonsense … Despite Haslam’s defence,
the governors dismissed him in 1816 …’
Roy Porter, Dorothy Porter. ‘The rise of the English drugs industry: the role of
Thomas Corbyn’. Medical History 1989; 33: 277-295. Reprinted in J Liebenau, GJ
Higby, EC Stroud (eds). Pill peddlers: essays on the history of the pharmaceutical
industry. American Institute of the History of Pharmacy, Madison Wis 1990: 5-28.
‘… from 1704 apothecaries enjoyed the legal right to give medical advice … so long
as they charged only for their medicines … recent research has demonstrated how
handsomely apothecaries benefited from a medicine boom they had helped to start
… William Broderip, the Bristol apothecary, had an annual income around the turn of
the eighteenth century of as much as £6,000 … Thomas Macro was five times mayor
of Bury St Edmunds … At this point, historians tell us … the apothecary’s monopoly
as dispenser of drugs was challenged … by the sudden expansion of the numbers of
shopkeeping chemists and druggists … apothecaries lobbied Parliament to outlaw
dispensing by druggists … In this, as the Apothecaries’ Act (1815) shows, they were
unsuccessful … apothecaries had already waged – and lost – an almost identical
campaign against the druggists as early as the 1740s … Many of the early druggists
had businesses big by any standards … Thomas Corbyn, a Quaker, born in
Worcestershire in 1711, was apprenticed in 1728 to Joseph Clutton, a London
apothecary … [In 1754] Corbyn bought out Cluttons’s heirs and took over the
business single-handed … although a freeman of the Apothecaries Company, there
is no sign that [he] spent any time caring for the sick … he wrote “the drug trade is
my proper business … it will pay better than any other merchandize” … [his]
business lay in the manufacture and sale of drugs, both wholesale and retail, though
the former comprised the heart of the enterprise … in 1747, the business seems to
have been worth about £4,000 … by the 1780s it was worth around £20,000 … in
1747 … Corbyn’s operated with a balance of just over £2,114 clear profit on the year,
a tidy sum for frugal Quakers … the business received a number of regular,
substantial orders annually … from such London hospitals as St George’s, Guy’s,
and St Thomas’s … from London apothecaries … from other London manufacturing
chemists … from country surgeons and apothecaries … from export, principally in
the Americas … it was the moral and business codes of the Quaker International
which made long-distance … trade in drugs a viable enterprise …the colonies and
even the … United States were slow to develop their own drug industries … it is
surely time to acknowledge the key importance of the druggists’ emergence to the
whole organization, structure, and enterprise of medicine.’
Roy Porter. ‘Divided selves and psychiatric violence’. Cycnos 1990; 6: 95-106.
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‘… in the non-professional public mind, organic approaches to mental illness are
notorious for supposedly being more “invasive”, less “person-orientated”, and above
all more violent, than psychosomatic approaches … it would be a mistake
automatically to assume that such a dichotomy … applies generally throughout the
past … I shall examine … just one mental condition: hysteria – itself, of course,
through the notion of “conversion”, absolutely central of the mind/body division …
Fashionable physicians in the age of the Enlightenment had many reasons for
claiming the seat of “hysteria” and similar disorders … was organic. Not least, they
wanted to share in the glories of Newtonian mechanical science. But …if “hysteria”
was construed as a “nervous disease”, sufferers could not be accused of being fullblown lunatics, diabolically possessed, or mere malingerers … This sympathetic
tradition of treating hysteria as a disease of the nerves continued throughout the
nineteenth century … “nerves” precluded moral blame, by hinting at a pathology not
even primarily personal, but social, a Zeitgeist disease … “nerve doctors” continued
to treat physical symptoms with physical means, steering clear of skirmishing with
the mind … The social history of Victorian medicine on the one hand, and of the
“woman problem” on the other, leave it surely no accident that the first psychogenic
theory of hysteria was misogynistic and victim-blaming. For the raison d’être of
psychologizing hysteria was precisely to deny its authenticity as a malady … We
should not regard somatic and psychological notions of disease aetiology and nature
as essentially entailing particular moral judgements upon the sick (stigmatizing,
sympathetic, or exculpating). The implications of such approaches depend upon the
cultural and historical contexts within which they are advanced.’
Roy Porter. ‘Foucault’s great confinement’. History of the Human Sciences 1990; 3:
47-54. Reprinted in A Still, I Velody (eds). Rewriting the history of madness.
Routledge, London & New York 1992: 119-125.
‘Time has proved [Madness and Civilization] by far the most penetrating work ever
written on the history of madness (and, above all, the history of reason) …Central to
Foucault’s interpretation … is the idea of a “great confinement” … activated from the
mid-seventeenth century, in context of political absolutism and Enlightenment
rationality … Those whose lives affronted bourgeois rationality – beggars, petty
criminals, layabouts, prostitutes – became liable to sequestration higgledy-piggledy
with the sick and the old, the lame and lunatic …their common denominator was
idleness … it is a concept which I do not find especially applicable to England (still
less, one might add, to Scotland and Ireland) … the vast majority of the poor and the
troublesome were not interned within institutions … perhaps not many more than
5,000, and certainly fewer than 10,000, people were confined as mad in England by
the early nineteenth century … it would be profoundly misleading to see Bethlem as
anything like a London equivalent to the hospital general … another image …
became prominent in the Enlightenment, one scarcely acknowledged by Foucault:
the madman not as emblematic of the full “animality of madness”, but as he who
reasons wrongly – and who may therefore be capable of re-education and reform …
John Locke’s contention that madness arose from the (mis)association of ideas was
eagerly and explicitly taken up by numerous Georgian writers and mad-house
keepers especially William Battie and Thomas Arnold … Foucault implies that the
“moral therapy” of the Tukes (kindness, humanity, reason) marks an authentic break
in England, much as the reforms of Pinel in France …The research of the last
generation has revealed the extent of the preaching and practice of reforms of
“moral” treatment, drawing upon Locke’s psychology, in the era preceding the
Tukes.’
Roy Porter. ‘Healthy history’. History Today 1990; 40: 8-11.
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‘Over the last decade, the government has decided to take a stand on the teaching of
history. History must be relevant, history must confirm a sense of British identity,
history should be taught on tangible grids of dates and facts. These directives raise
two questions. First, what is the purpose of history? (The official assumption is that
good history is usable history.) Second, what should be the contents of history?
Here the Education Secretary has favoured teaching a common core focusing upon
some supposed common national heritage ... Many fellow historians find the
government’s proposals retrograde; I share their views ... The AIDS crisis has
revealed the public looking to history for information and guidance [and] shows how
important it is that we cultivate a catholic sense of what kinds of history matter, what
should be taught, in what fields research should be encouraged. The educational
policies of the Thatcher government have sought to bring history-teaching back to a
highly traditionalist curriculum, concentrating upon the political history and traditions
of the United Kingdom. Let us not deny that, properly done, this would provide a
valuable body of knowledge and insights ... Citizens need to know about the political
institutions which shape their lives. But they also need to be able to make wellinformed judgements about the worlds of work, of the family, of social and moral
values. People need sound bases upon which to shape their own opinions, and
understand the views of others.’
Roy Porter. ‘”I live too chaste. ‘Tis not a common fault”. The eighteenth century
rewrote medicine, Christianity and belief in the goodness of nature, and soon all
europe was doing what comes naturally. In our own time, writes Roy Porter, we do
not find these ideas so remote’. The Independent, 28 July 1990.
‘”Where is male chastity to be found?” expostulated John Wesley: “Amongst the
nobility, among the gentry, among the tradesmen, or among the common people of
England? How few can lay claim to it at all?” For preachers to condemn fornication
is, of course, nothing new, and yet something is noteworthy in Wesley’s accusation,
for he accurately pinpointed the extraordinary ubiquity of sexual licence in his
lifetime. In the age of Wesley – the age of Mozart – commentators the length and
breadth of Europe were struck by the universal profligacy that seemed to infect all
ranks of society ... What made this diluted libertinism palatable to ordinary
eighteenth-century minds – made it seem sense, not sin – was, of course, that
fundamental liberalisation of Christianity codified by seventeenth-century rationalism
and the scientific revolution ... newly explored “primitive” societies confirmed the new
view that sex could be a social boon, not a bane ... navigators who explored the
Pacific paradise of Tahiti found the natives generous in spontaneously bestowing
sexual favours, yet happy and socially stable ... in 1780, the chaplain to the London
VD hospital, the Rev Martin Madan, argued for the restoration of polygamy. It would,
he thought, kill several birds with one stone, ending male frustration, giving all
women the chance to marry, and putting a stop to prostitution and debauchery ... On
the brink of the 21st century, in an age when an unprecedented hedonism has been,
for many, the only god, we do not find the eighteenth-century libertine so remote, nor
his philosophies unthinkable.’
Roy Porter (ed) and ‘Introduction’. The medical history of waters and spas. Medical
History 1990; Supplement 10. Wellcome Institute for the History of Medicine,
London.
‘One of the most intriguing changes in the orientation of medicine this century has
been the decline and fall of the spa and water cure in the English-speaking world. It
is a demise that has been dramatic: even as late as the turn of the present century,
doctors, patients, and therapeutic systems alike were commonly ardent advocates of
the healing powers of water – whether pumped, imbibed, bathed in, swum in, sat in,
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splashed through, or whatever … Few regular physicians these days make much of
hydrotherapies; water cures and hydros are equally conspicuous by their relative
absence from the armoury of contemporary fringe medicine and alternative medical
philosophies; and, not least, the culture of the spa-resort – so vital even in the gilded
age of Edward VII – has fossilized into a facet of “heritage” … Collectively, these ten
essays testify to the enduring vitality of water treatments and spa regimes over the
course of two thousand years. They show the lasting faith of the sick in water as the
atavar of purity, operating coterminously with the growing capacity of the medical
profession to commandeer the specific (reputed) powers of mineral-saturated fluids,
taken internally and externally. They demonstrate the degree to which past cultures
of health were complex performances – enterprises shared between the sick and the
medical profession …and drawing upon elaborate rituals of regimen. The bizarre
aspects of such procedures did not escape the eye of the satirist or the unmasker of
quackery; yet they lasted – at least until the era of modern scientific, professional
medicine – because they satisfied a deep desire that the healing enterprise should
proceed within frameworks essentially sociable in their nature, and suffused with
symbolic cultural meanings. As such, the histories of the spa and of its surrounding
balneological disciplines can serve as illuminating epitomes of medicine itself in the
world we have lost.’
Roy Porter. ‘Manufacturing drugs in the early consumer society: the case of
Corbyns’. Pharmaceutical Historian 1990; 20: 2-5.
‘Many of the early druggists were, economically speaking, big business … amongst
them were the Bevans’ pharmacy at Plough Court, which eventually became Allen
and Hanburys [and] Richard Battley’s at St Paul’s Churchyard, ultimately taken over
by Thomas Keating of flea-powder fame … one of the largest … 18th century
pharmaceutical manufacturers [was] Thomas Corbyn … Corbyn’s business lay in the
manufacture and sale of drugs, both wholesale and retail, though the former
comprised the heart of the enterprise … Corbyn’s made and vended simple drugs
such as senna, rhubarb, clove oil, arrow root and bark; compound medicines and
galenicals such as theriac, tartar emetic, Balsamic Tincture … nostrums such as
Daffy’s Elixir … various toiletries … such as dentifrice … Corbyn … a no-nonsense
Quaker … never attached his own name to proprietary medicines …Corbyn traded
from premises at 300 Holbourn … further premises were taken at Poultry in the City.
He had a separate laboratory, and a vast warehouse in Cold Bath Fields … the firm
had in the region of ten employees at any one time in the 1760s … he often shipped
consignments of other merchandise to his overseas agents and customers – gloves,
shoes or haberdashery … his overseas outlets … [were] principally in the Americas
[and] comprised surgeons, physicians, dealers, and general agents … Some were
personally known to him; most were not. What almost all had in common was that
they were Quakers … William Phillips, of Halifax, Novia Scotia, was routinely sending
orders … totalling thousands of pounds (some of these were for colonial hospitals).
Dealings with Australia began to appear … after too much academic neglect and
condescension, it is surely time to acknowledge they key importance of the
emergence of druggists to the whole organisation, structure and enterprise of
medicine. It was the making and marketing of drugs which provided the commodity
upon which the modern business of medicine is founded.’
Roy Porter. ‘Silly civil war that leaves patients bleeding’. The Independent, 11
September 1990.
‘Last week’s cancer report in The Lancet [8 September: 606-610] came as a bit of a
bombshell. Women suffering from breast cancer who stick to regular treatments
such as chemotherapy fare far better, it seems, than those at the Bristol Cancer
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Health [should be “Help”] Centre, which supplements conventional treatment with
meditation, exercise and vegetarian diets. Such findings are good to know. Too
often with cancer ignorance prevails, or we meet walls of silence ... On the negative
side, the danger is that these figures will be quoted as gospel ... their real value lies
not in giving scientific medicine its seal of approval, but in pinpointing further areas
for investigation ... “Heroes and villains” judgements on different sorts of healing are
foolish ... Medics long remained obtusely disparaging about treatments incompatible
with their philosophy, be they bone manipulation or non-Western techniques such as
acupuncture ... Alternative movement have been eager to whip up hysteria of their
own. Scientific medicine is damned as impersonal and mechanical, with practitioners
interested in pills and pathogens, not people ... It is myopic to get preoccupied with
this or that treatment. We should pay far more attention to prevention.’
Roy Porter. ‘The ghost of Edwin Chadwick: We need more giants like him – ready to
take on governments’. British Medical Journal 1990; 301: 252.
‘Not so long ago a healthier, safer Britain seemed assured. Epidemics had dwindled,
and hygiene was improving. Public health’s mission apparently accomplished, the
medical officer of health was painlessly put to sleep in 1974. A new beast,
community medicine, moved into his shoes programmed for “management”. Today,
that optimism seem misplaced. Legionnaires’ disease, salmonella, AIDS, drug
misuse, homelessness, pollution, and environmental blight are all rampant –
symptoms of the deprivation and despair created by divisive socioeconomic policies
... What has medicine to say? The Victorian Public Health Legacy: a Challenge for
the Future speaks out. This pamphlet, issued by the Public Health Alliance and the
Institution of Environmental Health Officers to mark the centenary of Edwin
Chadwick’s death, reminds us that it was to tackle just these problems that public
health was created.’
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Roy Porter. ‘Anatomy of madness’. Observer Magazine, 29 September 1991: 1116.
‘To “define true madness”, muses Polonius, “what is’t but to be nothing else but
mad?” Pedant though he was, Polonius hit the nail on the head. Madness seems
the mystery of mysteries. If a crazy person gave a cogent account of his condition
we’d judge him, Catch-22-style, sane, not mad. Yet if a normal person truly got
under the skull of lunacy, we’d fear he was going round the twist. Reason and
madness seem worlds apart, and reasoning about madness is a perilous venture.
But we have to take it. Madness matters. At least one in 10 of us will sooner or later
seek psychiatric help ... there is no unanimity about psychiatric disorder, its causes,
nature, or cure. Some even question its reality ... The point was put in a nutshell by
the seventeenth-century playwright, Nathaniel Lee, on being consigned to Bethlehem
Hospital. “They called me mad,” he protested, “and I called them mad, and damn
them, they outvoted me.” ... the mad were increasingly put under lock and key in
madhouses ... Once cured, they could be restored to society ... It was a noble ideal.
It didn’t work. In the twentieth century ... psychoanalysis offered a distinctive new
deal – the talking cure ... Freud certainly expected no miracle cures. And he was
right: none came ... from the 1950s, breakthroughs in psychopharmacology were
rapturously received ... the shortcomings of what patients have called “the liquid
cosh” are now becoming more apparent ... “community care” was introduced with
little hard cash for care, and little hard thinking about community ... And madness
remains shrouded in mysteries.’ (Madness, by Jonathan Miller for Brook
Productions, begins next Sunday (?6 September 1991) on BBC2. Roy Porter is
senior consultant on the series).
Roy Porter. ‘Cleaning up the great wen: public health in eighteenth-century London’.
In Bynum WF, Porter Roy (eds). Living and dying in London. Medical History 1991;
Supplement 11. Wellcome Institute for the History of Medicine, London: 61-75.
‘… The eighteenth century may have lacked a public health movement … yet it
certainly possessed a public sickness movement, and an effective one at that …
Easily Europe’s biggest city, London was indeed notorious for its crush of humanity
… The submerged classes crammed sardine-like into the slums of Whitechapel,
Clerkenwell, and St Giles …The Thames still served both as the chief source of
domestic water and as the main outlet for personal and industrial waste … London
fell repeatedly victim to fever epidemics … The dangers of dirt were compounded by
political inertia … there are few signs even of the desire for comprehensive public
health regulation in Hanoverian England … Admittedly, neither Parliament nor the
City Corporation took initiatives to clean up the capital … yet … strides were made
by groups of influential vestrymen and other citizens in metropolitan parishes …
Georgian doctors neither wrung their hands in despair, nor mounted political
campaigns for transforming the urban environment by statute. Rather they acted to
remove some of the sick from the sites of contagion … During the eighteenth
century, the two medieval London hospitals were augmented by five new general
hospitals and about eleven specialized hospitals … the dispensary movement
became … a living fountain of medical services to the London poor … By the close of
the century, baptisms had risen, and the burials total was, for the first time, dropping
… These improvements in Londoners’ health did not last, of course … by 1840 a
million new inhabitants, largely working-class, were occupying new slum areas that
lacked any public services …’
Roy Porter. ‘A doctor in the house’. Wiltshire Family History Society Journal, July
1991: 14-17.
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‘Orthodox histories of medicine have always started with the premise that the further
back you go, the fewer doctors were available to treat the population. Modern
research has shown that this is not necessarily so … until the eighteenth century …
in England, Scotland and Wales at least, there were far more reasonably trained,
reasonably competent men available than ever went to university. Most medical
training was acquired by a seven year apprenticeship to a barber-surgeon or
apothecary, and this gave the lad more practical knowledge of real patients with real
disease than the university man had till after years in practice … There were many
itinerant quacks, selling patent medicines, like Dr Trigg’s Golden Vatican Pills, which
were a popular purge for Protestant stomachs. Above all, there were many home
remedies, kept in every larder, and kitchen gardens grew herbs and plants to supply
almost all the simple medications required … Most doctors did treat the very poor,
knowing they would never pay much or at all, relying on levying much higher charges
on the local gentry. Pills which the carpenter got for 2/6 were a guinea to the squire
– and the rich accepted their obligation to subsidise in this way … Some patent
medicine like Eno’s Fruit Salts, which started early in the last century, are still around
today. Samuel Holloway, with his Pink Pills for Pale People and other remedies, was
a major exporter and even managed to advertise his goods on the Great Pyramid.
Schweppe’s carbonated waters began as cures for consumption and catarrh …’
Roy Porter. ‘Introduction’. In Bynum WF, Porter Roy (eds). Living and dying in
London. Medical History 1991; Supplement 11. Wellcome Institute for the History of
Medicine, London: vii-xviii.
‘Ever since Babylon, the great city has been damned as a great evil … But the city
also looms large, not just … in our demonologies of decay and doom, but in our
positive cultural ideals … In short, if the city breeds sickness, hunger, lawlessness
and mortality, its promise is also to give us drains, hospitals, granaries, government,
and that final, desperate, death-defying device of the psyche, culture … Already, by
the high Middle Ages, and, significantly, the Black Death, London was emerging as
one of Europe’s great cities – demographically, commercially, politically … In the
seventeenth century, London rose to become easily the largest city in Christendom
… Such developments mean that the economic, demographic, and medical
development of London was truly a succession of leaps in the dark for
contemporaries, forced to make utterly unprecedented responses to human
challenges, to a far greater degree than can be said of most communities elsewhere
… the new London histories – the plural is crucial - are shifting attention from high
society and from high-level official and legislative activities to the teeming, confused
– and all-too-often frustrating to research! – mass of life swarming below … We must
abandon the notion of a single, uniform public health problem that steadily worsened
over the generations – water supplies growing ever fouler, graveyards filling to
bursting point, infant mortality becoming ever more catastrophic – until, prompted by
necessity, or by Benthamism, or by the Evangelical conscience, remedial action was
finally taken … Without mutual aid, demographic history, economic history, and
administrative history make little sense. All must co-operate under the ampler
umbrella of the social history of London. Above all, this applies to medical history.
Studies of the medical profession and of medical provision cannot be carried far
without a wider understanding of the conditions of living and dying in London.
Roy Porter. ‘History of psychiatry in Britain’. History of Psychiatry 1991; 2: 271-279.
‘British history of psychiatry … has been transformed over the last decade. As in
other countries, until recently the history of psychiatry was undertaken largely by
psychiatrists … with the usual admixture of strengths and weaknesses associated
with in-house approaches … Since the mid-1970s, there have been two striking
changes. First, the history of psychiatry has become contested, because psychiatry
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itself has … Second, wholly thanks to the controversies sparked by anti-psychiatry
and by Foucaultian notions of unreason, the last fifteen years have seen the
emergence of basic research into the grassroots history of mental disorder, above all
the asylum … The history of twentieth century medicine largely remains to be written.
This stricture applies – with the obvious exception of Freud and his circle – especially
to modern psychiatry … we remain profoundly ignorant of the development of the
claims and institutions of psychiatry outside the asylum – within general medicine
and the NHS hospital, within children’s clinics, within schools, industry and the penal
system … Historians of the North American scene … have pioneered these areas;
they remain to be taken up in Britain.’
Roy Porter. ‘Is Foucault useful for understanding eighteenth and nineteenth century
sexuality?’ Contention 1991; 1 (1): 61-81.
‘”… rather than the uniform concern to hide sex, what distinguishes these last three
centuries is the variety, the wide dispersion of devices that were invented for
speaking about it” … it is Foucault’s thesis that what counted down the centuries was
the “production of sexuality rather than the repression of sex” … Moreover, just as
the history of sexuality is not to be construed in terms of struggles between official
and radical discourses, neither must it be seen as the policing of group by group, or
class by class … I am, nevertheless, left overall unconvinced and perplexed … many
of the books adduced by Foucault as proof of the crescendo of erotic discourse,
including Krafft-Ebing, were themselves prosecuted, expurgated, or hidden from
history in safe places such as the British Museum’s private case … As recently as
1953 … the Kinsey Report narrowly escaped Home Office prosecution for obscenity
… Foucault is being tendentious, or, at least from the historian’s viewpoint,
irresponsibly selective in his choice of facts, and nowhere does he address himself to
questions of typicality, cultural differentiation, or to the task of evaluating and
interpreting contemporary testimony … this picture of the pluralistic multiplication and
intensification of sexuality since the seventeenth century – is it not utterly discrepant
with the vision presented in the earlier Madness and Civilization of the “great
confinement” of the poor and the mad in the same epoch … it needs to be stressed,
the most catastrophic absence in Foucault’s opus is his apparent indifference to the
role of sexual discourse in the management of women, and the politics of gender. It
is these models, not the wayward idiosyncracies of Foucault, which signal ways
forward.’
Roy Porter. ‘Psychiatry pre-1800’. Current Opinion in Psychiatry 1991; 4 (5): 738742.
‘The interface between madness and religion provides the key thread linking most
important work over the last year in the history of pre-1800 psychiatry. In respect of
conditions, much attention has been paid to hysteria; socially, the significance of the
law court as a site for contestation between doctors, priests and lawyers over the
insanity plea is providing a fruitful research focus.’
Roy Porter. ‘Georgian Britain: an ancien régime?’ British Journal for Eighteenth
Century Studies 1992; 15: 141-144.
‘ ... let us call Georgian Britain an ancien régime, if so doing, we are reminded of the
paucity of truly insurrectionary radicals, and of the near-total absence of out-and-out
atheists, of root-and-branch republicans; if it underlines the limited aims of rioters
(‘the moral economy’) and of the conservatism of figures like Wilkes; and if it insists
upon the tardy and incomplete rise of the middle classes to political consequence,
and the relative insignificance of manufacturing wealth as contrasted to landed and
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inherited wealth. Let us call eighteenth-century Britain and ancien régime if so doing
helps keep clearly in mind the enduring political sway of monarchy throughout the
Georgian century, and the growing grip upon power (as David Cannadine and others
have insisted) of a small, coherent, and essentially landed and titled political élite.
Yet do not let us confuse these truths with the notion ... that little significant change
was taking place ... If the English went to Italy to see Antiquity, foreigners came to
England to see Modernity ...’
Roy Porter. ‘Hearing the mad: Communication and excommunication’. Institutt for
Kriminologi, Universitetet i Oslo. Stensilserien nr 69, 1992.
Text of a lecture given by Roy at the Department of Criminology, University of Oslo in
1991.
‘… As a historian, it is not for me to say whether psychiatrists should engage in
dialogue with madness. As a historian, however, I must qualify Hunter and
Macalpine’s assumption that psychiatry has spent its time listening to its clients.
When I read case histories, asylum records, psychiatric textbooks, and what are
perhaps not accurately called court hearings from the seventeenth century onwards,
I find, all too often, dialogues of the deaf; too often those who have been shut up
have indeed been shut up, or at least nobody has attended to what they have said,
except to put down their dislocated speech as a proof of derangement … The history
of psychiatry tells tales less of communication than of excommunication … Speech
disturbance had long been elided with mental disturbance – hence double meaning
of “dumb”: mute and stupid … influential trends in emergent psychiatry set a kind of
sound barrier between doctor and patient … Not so, of course, with “office
psychiatry”, with its more intimate exchanges between patient and doctor, governed
by a customer-driven cash nexus which guaranteed the sick some semblance of say.
Yet, for all its liberating claims or potential, psychodynamics has never established a
free communicative exchange … the analyst’s contract, as John Forrester has
argued, was essentially to hold his tongue, the patient’s to blab more than he or she
knew … both Thomas Tryon and Jonathan Swift made the observation, so
premonitory of Freud, that the true distinction between madness and sanity was that
crazy people uttered everything that burst into their minds, whereas the sane used
judgement to filter out the interference … Swift approved this self-editing: the world
was too full of nonsense as it was. Tryon was less sure: the madman was at least
honest, the self-concealing man of reason so easily a hypocrite …’
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Roy Porter. ‘La rivoluzione scientifica ha prodotto una rivoluzione medica?’
Intersezioni 1992; 12: 87-103.
‘In questo articolo pongo la seguente domanda: in che misura e con quail modalità la
medicina si sforzò di diventare “scientifica” nel diciottesimo secolo, in risposta
all’onda d’urto provocata dalla rivoluzione scientifica del diciassettesimo secolo e
facendo propri gli obiettivi dell’Illuminismo? Più che a scrivere la storia del presente
sono contributo dei pre-moderni al progresso della medicina, né una valutazione
sulle attuali relazioni tra medicina e scienza …’
Roy Porter. ‘Pre-modernism and the art of shopping’. Critical Quarterly 1992; 34: 326.
‘… something revolutionary was confronting shoppers in the last decades of the
[nineteenth-century]. William Whiteley had launched his Westbourne Grove store in
1863, not accidentally a matter of weeks after the Metropolitan line opened … his
one-time employee, John Barker, was expanding no less briskly in Kensington, while
Charles Digby Harrod was turning his Knightsbridge grocers into an emporium
dealing … Starting in Glasgow in 1872 and specialising in ham, eggs, and tea,
Thomas Lipton was soon able to style himself ‘King of the Dairy Provision Trade’, by
virtue of his success in opening branches nation-wide (by 1898 he had 245) … the
fin de siècle was the era of Hepworths the tailors and Dunns the hatters, of Jesse
Boot and Timothy White’s, of Freeman Hardy Willis, Thomas Lilley, and Stead &
Simpson … there was also a revolution in style. The giant store had an ambiance, a
theatricality, that was eye-catching and alluring … [However] the English economy
had long been on the boil … there were a staggering 150,000 retail outlets in midGeorgian England, serving a population of not much over six million (one shop per
forty people!) … English people in the Georgian era were electrified by novelty, and
became zealous participants in a shopping game that blended leisure with allure …
‘Years ago’, a character remarks in Arthur Miller’s The Price, ‘a person, he was
unhappy, didn’t know what to do with himself – he’d go to church, start a revolution –
something. Today you’re unhappy? … What is the salvation? Go shopping!’ My
guess, pace Miller, is that at any time over the last two centuries you’d have found
that unhappy person browsing in Hatchard’s (founded in 1797).’
Roy Porter. ‘Psychiatry pre-1800’. Current Opinion in Psychiatry 1992; 5: 718-721.
‘No single major theme has dominated the literature on pre-1800 history of psychiatry
in 1991. The year, however, has seen valuable individual contributions on the history
of demonology, on the Bethlem Hospital, on the evolution of the notion of nervous
disorders, and on the early history of eating disorders.’
Roy Porter. ‘Seeing the insane’. Institutt for Kriminologi, Universitetet i Oslo.
Stensilserien nr 68, 1992.
Text of a lecture given by Roy at the Department of Criminology, University of Oslo in
1991.
‘… Everyday life, one may suggest, requires the concept of madness to identify and
demarcate certain disturbing dispositions and antisocial behaviours – violence,
withdrawal, persecution fears. Hence common wisdom has assumed that madness
is as madness looks … By a sort of visual association of ideas, the mentally
disturbed have often been associated with other varieties of the Excluded and
Unclean, other moral lepers … We are eager to know what the insane looked like ...
but we must never forget that those who portrayed them were trained in the
conventional language of art, and had motives and messages of their own … One
standard bogey-person throughout the history of psychiatry has, of course, been the
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lunatic whose particular psychopathology consists in the talent for masquerading as
sane … The claims of nineteenth century psychiatrists to a privileged place as expert
witnesses in law courts where the insanity plea was made, naturally depended upon
their assertions of unique skills at reading visual stigmata of insanity invisible to
others … Case-notes kept by asylum doctors always paid great attention to facial
features, and students who combined artistic and anatomical interests, such as
Charles Bell in Britain at the beginning of the nineteenth century, made special
studies of the physiognomy of the mad … many psychiatrists, such as Hugh
Diamond, superintendent at the Surrey Asylum, aspired to create a complete
photographic record of insanity … It was not until the 1870s onwards that
psychiatrists began to pay close attention to the image-making of the mad. A major
pioneer was Cesare Lombroso … The paintings of lunatics were characterized by
distortion, originality, imitation, repetition, minuteness of detail, absurdity,
arabesques, eccentricity, obscenity, and, above all, symbolism. The unspoken
message of this diagnosis was that if the mad painted like that, then those who
painted like that were mad. And that was precisely the verdict passed by no small
number psychiatrists upon generations of artists, from Impressionism through
German Expressionism, Surrealism, and later Abstract Expressionism …’
Roy Porter. ‘Social history: current trends’. Journal of the Social History Curators’
Group 1992; 19: 5-13.
‘... Traditionally there were antiquarians on the one side, and, on the other,
professional historians, who were rather dismissive about those who collected and
preserved mere objects. This has changed, and social, cultural and economic
historians have become fascinated with the history of material culture and the
meaning of things, indeed with the advent of the consumer society ... Around 1650,
even middle class households appear to have been rather sparsely furnished,
commonly lacking many items which had become standard by 1730 ... Simon
Schama has emphasised how the Dutch, in their golden age, gloried in their world of
objects – fairly mundane articles, though richly wrought – as proofs of success and
as emblems of the moral qualities they prized ... The history of the family, the
expansion of consumerism, and the social transition to a successful industrial
society, were ... all intimately interlinked, and need to be studied as such ... These
issues in turn demand discussion of shifting gender roles, and of the sexual politics
of a developing commercial society ... in the eighteenth century so many of the new
and expanding work “opportunities” still clustered around the home-based workshop.
Women were extremely prominent in managing, or at least working in, shops, inns,
the clothing trades, putting-out industries, and the service industries, all greatly
expanding sectors ... Historians must not be afraid of “artistic” sources and fiction ...
Understanding the languages of the imagination will tell us much about the
conventional codes of society. The better we grasp the ironies encrusting so many
sources for eighteenth century social history, the better will be our insight into the
society itself.’
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Porter Roy. ‘Thomas Beddoes and the Bristol Enlightenment’. Transactions of the
eighth international congress on the Enlightenment. Vol 1. Voltaire Foundation,
Oxford 1992: 113-125.
‘Thomas Beddoes was born, in 1760, … into a prosperous tradesman’s family from
Shifnal in the West Midlands … [proceeding] in 1776 – that annus mirabilis! - to his
local university, Oxford, securing a comprehensive grounding in all the major
European languages, and developing a passion for science. Choosing medicine, he
moved in 1781 to London … before going on, three years later, to complete his
medical education in Edinburgh … He returned to Oxford in 1786, taking his MD …
His scientific circle grew … Erasmus Darwin, James Kier, William Withering, William
Reynolds, James Watt …He was ready for the French Revolution … On 14 July
1791, we find Beddoes sporting a tricolour and singing revolutionary songs … By
1792 he had made plenty of foes … [and] in 1793 he left Oxford [for] Bristol, where
he set up in practice in the fashionable new suburb of Clifton … Beddoes found
himself, surely not accidentally, in one of the nation’s hotbeds of intellectual
radicalism … In Beddoes’ views, the despicable Pitt was seizing the chance afforded
first by fear, and then by the outbreak of Anglo-French hostilities, to wage diabolical
war on English liberties, through suspending habeas corpus, arresting Painite
leaders, and introducing gagging bills … Beddoes pursued Pitt with implacable
venom, partly as a political pamphleteer, but largely in the guise of a doctor and
sanitarian, appalled that Pittite adventurism was reducing the people to penury,
dearth, and ill-health … forcing people to brick up their windows … callous
indifference to “plenty” … Beddoes thought commercial society was in some ways
pathological … [it] encouraged commercial healing, that is, quackery. Beddoes
hated quacks … the profession itself had turned charlatan … regulars were no
laggards in touting for clients, albeit behind a genteel veneer … practitioners … had
turned from healing to dealing … sickliness had become a status symbol … Beddoes
the social physician was to recognise that illness was not simply an adventitious foe.
It was more like a familiar, integral to sufferers’ lives: wealth-specific, class-specific,
gender-specific, mores-specific … he conceived his mission as the replacement of
self-deception by enlightenment. The sick, rich and poor alike, were often
desperately mistaken about their health: “we propose to undeceive and rescue
them”.’
Roy Porter. ‘John Hunter: a showman in society’. Transactions of the Hunterian
Society 1993-1994; 52: 19-24.
‘In the house (No 28) on the east side of Leicester Square that [John Hunter]
occupied … he had assembled a vast hoard of everything weird and wonderful …
throughout the area – down to the Strand, Covent Garden and Fleet Street, or up to
what is now Piccadilly Circus – doctors’ residences and anatomy schools rubbed
shoulders with freak shows and exhibitions – the dwarf, Robert Powell’s puppet
shows in the Little Piazza, Covent Garden; the ‘wonderful tall Essex woman’ at the
Rummer in Three King’s Court, Fleet Street, who was ‘seven feet high’ … ‘a Calf with
eight legs, two tails, two heads, and only one body’ on display ‘ … Hunter’s house
was part of a great archipelago of shows, galleries, theatres, cockpits and
exhibitions. Our instinct is to elevate Hunter above all that. The Town loved
spectacle, Hunter loved science. Perhaps; but to some degree the distinction is
anachronistic. Science was still at the accumulative stage, where all novelties were
news …John Hunter captured the biggest prize of all. The Irish giant, Charles Byrne
… he stood well over eight feet tall … [Hunter] made, it seems, an advance offer for
his bones – which provoked such terror in Byrne that he apparently made
arrangements to be buried at sea in a lead coffin. Hunter was persistent … in May
1783, when Byrne, in a drunken stupor, was dying … in Cockspur Street, some deal
was evidently struck with the attending ‘corpse watcher’ - £500 reportedly changed
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hands … Hunter was not, by temperament or predilection, a showman; his business
was not show business. But he lived in an age in which Nature was itself a show.
The theatre of nature required its audience. Hunter was its supreme exhibitor.
Roy Porter. ‘A professional malaise: how medicine became the prisoner of its
success’. Times Literary Supplement 14 January1994; no 4737: 3-4. Reprinted as
‘Eine behandlungsbedürftige Malaise. Wie die Medizin zur Gefangenen ihres Erfolgs
wirde’. Freibeuter 1994; 60: 40-49. (See also letters in response to this article from
Raymond C Tallis and John Pattman. Times Literary Supplement, 28 January 1994:
15).
‘… Beyond a shadow of a doubt, the break-throughs of the past fifty years have
saved more lives … than those of any epoch since medicine began … the “first
pharmacological revolution” … beat the bacteria, improved control of deficiency
diseases … produced the first effective medications for mental illness … organ
replacement was developed … electron microscopes, endoscopes, CAT and PET
scans, Magnetic Resonance Imaging, lasers, tracers, ultrasound … revolutionized
medicine’s diagnostic capacities … Iron lungs, kidney dialysis machines and
pacemakers … Crick and Watson’s cracking of the genetic code (1953) … genetic
screening and engineering … In the US and several EC countries, more than 10 per
cent of GNP is now spent on health … and global health has had some striking
successes, notably the final eradication of smallpox in 1977 … Yet people aren’t out
today waving the flags. Euphoria bubbled over penicillin, over Barnard … Back in
1978, Louise Brown, the first test-tube baby, prompted jubilation. Today the publicity
over Laura Davies carries darker messages for medicine; and news of a fifty-nineyear-old woman giving birth to twins after fertility treatment, and a black woman
having a white baby, created uproar … Meanwhile, Doctor Kildare has given way to
Casualty, and doctors hit the headlines now chiefly when they bungle smear tests …
Hence medicine’s finest hour becomes the dawn of its dilemmas. For centuries,
medicine was impotent and hence unproblematic. From the Greeks to the Great
War, its job was simple: to struggle with lethal diseases and gross disabilities, to
ensure live births, and to manage pain. It performed these uncontroversial tasks by
and large with meagre success. Today, with mission accomplished, medicine’s
triumphs are dissolving in disorientation. Medicine has led to vastly inflated
expectations, which the public has eagerly swallowed. Yet as these expectations
grow unlimited, they become unfulfillable. The task facing medicine in the twentyfirst century will be to redefine its limits even as it extends its capacities.’
Roy Porter. ‘Bodily functions’. Tate 1994; issue 3: 40-47.
‘Post-Renaissance culture has expressed contradictory attitudes towards the body …
Language, especially metaphor, fleshes out the ceaseless thinking of the world
through the body and the body through the world: we talk of bodies of knowledge,
body politics … Modern consumer hedonism makes the body beautiful its god. Yet
in our cultural heritage, the flesh bespeaks vile bodies. It is theologically fallen: dirty,
sordid, worm-eaten … When, two or three centuries ago, English people mentioned
their bodies, it was largely in the context of diseases, doctors and death. In 1650,
and still in 1850, the position of the physician was precarious …”When a nation
abounds in Physicians,” bantered Joseph Addison’s Spectator, “it grows thin of
people” … The great tradition of English political cartoons, in particular, is fixated
upon the body. Strikingly prominent in the cartoonists’ portrayal of medicine are
violation and violence. Practitioners endlessly perform procedures that invade,
wound and pain the body … In prints and the press doctors thus presented threats to
one’s body. Not just through therapeutic violence, but sexually too … Rowlandson’s
doctors gawp and grope their patients in a most un-Hippocratic manner … the
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practitioner’s apparatus – his cane, enemas, lancets, squirts and clyster-pipes –
assume an erotic air, sometimes bawdily comic, though occasionally, as doctors
gaze upon and inject patients’ genitals, the pornography is quite overt … Maladies
were often represented by cartoonists as sinister manikins: goblins, demons, imp …
The body enjoys a deeply ambiguous status. It may be the target of brutality. Or it
may be the agent of hatred and contempt: hence the explosive power of the fart in
cartoons and low humour, and many other tropes of the “kiss my arse” variety, or of
statesmen shitting upon the people … To understand the priorities and prejudices of
a culture, there is no better guide than to explore the various ways in which it has
chosen to represent the body.’
Roy Porter. ‘Curtains for the capital’. New Statesman & Society, 11 November
1994: 30-31.
‘What is London’s likely future? What are the options? These days many think the
forecast lies between the dismal and the dire ... Homelessness, single-parent
families, the isolation of the old, classroom violence, joblessness, rising crime,
poverty, drug-dealing, neo-Nazi racial attacks – all these now-familiar troubles foretell
alienation, anti-social behaviour and despair ... we sense things are cracking up –
more muggings, fewer buses, and those awful eyesores the beggars – but it’s doubly
hard to be sure, because we’re so easily seduced by beguiling models of what
stable, integrated urban life should be (and we fondly think, has been) like ...
Between 1500 and 1600, London grew tenfold in numbers, swollen by an influx of
provincials and foreigners. Yet, despite all the rumours of villainous cutpurses, in
truth Tudor London was remarkably free of crime, violence and revolt ... The
Georgian century brought deeply deepening social bifurcation, with growing splits
between West End and East End, Court and Port ... But the truth is that London
never shattered into fragments. There were always enough forces making for
integration or at least creating common meeting and crossover points. Buoyant
labour and land markets provided the hidden hand that held Victorian London
together ... Until the second world war, full employment aided by the London County
Council’s Fabian paternalism kept London an integrated city: the Blitz spirit is proof of
that ... The fact that all this is changing needs no saying. For myriad reasons – many
of them the upshot of the demise of empire – London’s secured traditional
employment basis was undermined ... These days market forces are no solution to
the capital’s problems. Lacking direction, we are experiencing a dangerous drift into
the urban ghetto. Without bold action, that tendency may become irreversible. The
price will be catastrophic.’
Roy Porter. ‘Dr Doubledose: a taste of one’s own medicine’. British Medical Journal
1994; 309: 1714-1718.
‘Jokes, Freud taught us, are the acceptable face of aggression. Humour has, not
surprisingly, provided a way for the people to fight back against the powerful; and, on
account of their own highminded aspirations, the liberal and learned professions
traditionally laid themselves particularly open to lampoon. Anti-priest and anti-doctor
was not only a form of revenge, it was also designed to deflate, exposing pretension
and humbug ... Doctor bashing was nothing new: medieval illuminators and carvers
depicted them as apes ... the decades around 1800 brought the golden age of the
cartoon with Rowlandson, Gillray, and the Cruikshank family. What is most striking
about the portrayals of medicine in early cartoons is violence. Practitioners endlessly
perform procedures that invade, wound, and pain their patients ... Sex and medicine
coalesce ... In [Rowlandson’s] Medical Dispatch or Doctor Doubledose Killing Two
Birds with One Stone, with one podgy hand the physician takes the pulse of the
cadaverous senseless invalid, while throwing an arm around the neck of the nubile
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girl. In The Cow-Pock, Gillray spoofed variolation, implying that the vaccinated would
develop horns, tails, and udders ... Maladies were represented as sinister manikins:
goblins, demons, imps – energetic, well drilled, and deadly effective ... The shocking
fact about the cartoons is not just death’s omnipresence but the role of doctors as
Death’s disciples ... The 18th century practitioner was chiefly lampooned as a
dangerous ignoramus. His 19th and 20th century successor was satirised for his
aristocratic pretensions ... And it is appropriate that the man who taught us the
unconscious meaning of wit should have triggered the best modern humour. Today’s
most biting medical jokes are invariably targeted against the shrinks.’
Roy Porter. ‘Gout: framing and fantasizing disease’. Bulletin of the History of
Medicine 1994; 68: 1-28. (The Fielding Garrison Lecture delivered to the sixty-fifth
annual meeting of the American Association for the History of Medicine, Seattle,
Washington, 1 May 1992). Reprinted in abbreviated form as ‘The ruin of the
constitution: the early interpretation of gout’. Transactions of the Medical Society of
London 1995; 110: 90-103. A further abridged version as ‘Desirable diseases’.
Churchill Review 1998; 35: 59-61.
‘Gout, we all know, is the classic comic disease, tailor-made for after-dinner
speeches, providing the perfect excuse for anecdotes and illustrations of rubicund,
corpulent gluttons and gourmands, guzzling away, swilling their port, their feet
swathed in shock-absorbing bandages reclining on gout stools … the Revd. Sydney
Smith quipped that gout was ‘the only enemy that I do not wish to have at my
feet’…Medical historians have followed suit and treated gout as a bit of a joke …
Plague and smallpox, tuberculosis and AIDS command earnest analysis … but in our
anatomizings of disease, chronic disorders have been neglected. Small wonder as
they are neither sexy nor sensational … As with scurvies, scrofulas, cancers,
consumption and assorted cachexiae, gout was typically attributed to excess … Gout
was, above all, identified as a monarch among maladies … a high-life complaint … a
success tax … Proud of his ‘gouty bootikins’, Horace Walpole recommended sitting it
out stoically: ‘… it purges itself, and requires no medicines. To quack it would kill me’
… Top families sported gout, hereditary and acquired, because they lived in the lap
of luxury … ‘It prevents other diseases and prolongs life,’ puffed Horace Walpole …
A gouty paroxysm, doctors argued, served cleansing, purifying purposes … From the
1770s, Nicolas Husson, a French army officer, was vending his Eau médicinale as a
sovereign specific against gout … it contained colchicum … In 1776, the Swedish
chemist Karl Scheele isolated uric acid … from colchicum, nineteenth-century French
chemists extracted the alkaloid colchicine, effective in countering the build-up of uric
acid … the language of politics and the language of gout continually echoed each
other … It is no accident that the gout debate climaxed against a backdrop of
mounting alarms of the ‘constitution in danger’, culminating, of course, in the French
Revolution … For William Stevenson, war on gout required the eradication of the
disease of aristocracy itself … Old Corruption assailed by reformers, aristocracy
threatened by a new, individual, meritocractic liberalism; indeed, I would contend, the
gout controversy is unintelligible unless its politics are understood.’
Roy Porter. ‘Interview with EP Thompson’. Socialist History 1994; 6: 29-33.
This is an edited transcript of an interview which Roy conducted with EP Thompson
which was broadcast on Nightwaves, BBC Radio 3, 20 May 1993.
‘ ... I think that the orthodox, Stalinist-type Marxism is one of the most discreditable
episodes in intellectual life altogether. At the same time I have to say that I would not
want to repudiate the strong influence upon me of the Marxist tradition. It’s been
inhabited by really extremely intelligent, able, and creative historians in this country,
in France and elsewhere, and has been an international vocabulary of discourse, and
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there are certain concepts in that discourse which I would not like to see just
discarded. The very notion of class itself for one, although everyone’s now telling us
it’s got past its sell-by date. The concept of ideology in the Marxist tradition I think is
valuable, the concept of contradiction ... an awful lot of what I do as a historian is get
hold of documents and read them upside down. Here is a picture that the lawyers or
the judges or the politicians had of working people ... what does it tell us when you
turn it upside down and look at it for how they perceived those above them?...’
Roy Porter. ‘London is falling down’. The Spectator, 12 November 1994: 19-20.
‘In his generous and astute review of my London: A Social History (Centre point, 29
October), Simon Jenkins takes issue with the dismal diagnosis advanced in the final
chapters. There I highlighted the economic and social malaise threatening the
capital since mid-century and casting long shadows over its future ... Is Jenkins
bouncy simply because he can nowadays buy a decent espresso on Paddington
station, whereas Porter is peevish because he has experienced the theft of three
heavily padlocked bicycles in Central London within the last two months? I think
there’s more to it than that ... The London Jenkins loves – the London I love – is the
London that can’t fail to be enjoyed by people like us: affluent, professional males in
work and consuming conspicuously. But there are other Londons too: slum London,
jobless London, outcast London ... We are witnessing the emergence of an
underclass made up of males never effectively integrated into the world of work and
of women running single-parent families – to say nothing of drunks and dossers and
others without real prospects, trapped by dependency, resented by the rest, leading
to a degree of ghettoisation little known in the heyday of the Cockney ... To expect a
sunny future without a secure base for employment or capable government will be
the triumph of boosters over gloomsters. I can only hope that it is booster Jenkins
who is right.’
Roy Porter. ‘Rethinking institutions in late Georgian England’. Utilitas 1994; 6: 6580.
‘James Tilly Matthews was a Welsh tea-broker trading from 84 Leadenhall Street,
London … His support for the French Revolution … led to his becoming involved …
in complex political and diplomatic negotiations in Paris, thrown into captivity by the
Jacobins but released after three years … On his return to London … his revelations
[of] atrocious French plots … against Britain … led to his detention … in Bethlem
Hospital … There Matthews was abused and tortured over the next decade by the
apothecary, John Haslam … Matthews was systematically set under the surveillance
of spies … disguised as lunatics … and tortured by means of an airloom [including]
“Fluid Locking”, “Thigh-talking”, “Stomach-skinning”, “Cutting Soul from Sense” [and]
“Lengthening the brain” … Matthews freely volunteered the information … in order to
convince the world that he was the object of persecution; Haslam published it to
convince the world that Matthews was an instance of persecution mania, or paranoia
… when, some five years later, a parliamentary committee … exposed abuses at
Bethlem … the governors … sacked Haslam, citing as grounds for their action
documents presented to them by James Tilly Matthews, demonstrating his
mistreatment and molestation over the years … Let us suppose that, instead of
ending up in Bethlem … Matthew’s family had … confined him in the … rather
illustrious Fishponds Asylum in Bristol, under the care of Joseph Mason Cox, MD? …
Cox made a name for himself as an advocate of the manipulation of the “total
environment” to create theatres of terror designed to shock sufferers out of their
delusions … he would awaken patients “by imitated thunder or soft music” … or …
deploy “signs executed in phosphorus upon the wall of the bed chamber” … One
patient was confronted by a thespian … dressed up as the Holy Ghost … Cox’s
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favourite device was the swing chair. The patient was strapped into this contraption,
and revolved at up to a hundred gyrations a minute … I hope my point will be clear
… as this thumbnail sketch suggests, we see institutions not just as instruments of
disciplinary power but as objects of contention, struggle, contradictions, resources
being used differently by distinct and conflicting interest groups. Not least, we see
the patient fighting back …’ (The Janet Semple Memorial Lecture delivered at
University College London, 26 November 1993)
Roy Porter. ‘The assault on Jeffrey Masson’. Contention 1994; 3: 3-21. Reprinted
in NR Keddie (ed). Debating gender, debating sexuality. New York University Press,
New York 1996: 277-296.
‘…It is Masson’s aim to show that the traditional entrenched telling of the “birth of
psychoanalysis” is incorrect, and also to advance a new explication of the motivation
prompting Freud’s change of mind. From the late 1880s, Freud grew extraordinarily
interested in hysteria. He arrived at the view that the women he treated fell sick
because they had suffered childhood sexual abuse, generally at their fathers’ hands.
He later abandoned this seduction theory, contending that the women’s “memories”
were in truth infantile incestuous fantasies; it was the libidinous desire, followed by its
guilty suppression, that triggered the neurosis … Masson counterargues that the
earlier seduction theory had been essentially correct – that is to say, based upon
clinical evidence. Freud’s abandonment of it was not a discovery of the truth but its
betrayal … Freud forsook the seduction theory, Masson contends, partly because it
reflected too badly on adult males like himself, and partly because its hostile
reception by the Viennese psychiatric community convinced him that the continued
espousal of the theory would hamper his career … In reality, things are more
complicated and Masson’s case cannot be substantiated; neither, however, should it
be dismissed out of hand … It is also worth keeping in mind, against Masson, that
Freud never blatantly denied the reality of the seduction or abuse of children by adult
figures … it was simply the case that notions of childhood sexuality, fantasy, and
repression were to attain prime significance within the structure of his theories … It
would be unfortunate, however, if Masson’s work were joked or jeered off the stage.
For his work, and the controversy surrounding it, have stimulated a crucial
awareness of how far our received “historical” account of Freud is not history at all,
but an uncritical mishmash of memoir, memory, myth of origin, and psychoanalytic
doctrine, chronologically laid out in convenient legendary mode …’
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Roy Porter. ‘The prophetic body: Lady Eleanor Davies and the meanings of
madness’. Women’s Writing 1994; 1: 51-64. (Roy served as a member of the
editorial board of Women’s Writing (an international journal on women’s writing prior
to 1900 which is edited by Marie Mulvey Roberts and Janet Todd) from its first issue
in 1994 until his retirement in 2001).
‘... In 1609, at the age of twenty, Eleanor Touchet, daughter of Lord Audley ...
married Sir John Davies ... soon to become Attorney General for Ireland ... both were
strong personalities, and it was a stormy marriage ... On 28 July 1625, while lying in
bed, Lady Eleanor underwent a vision ... “a Voice from Heaven” ... called upon her to
broadcast her prophetic mission ... She wrote down her divinations on paper, but this
“book”, she later recalled, “was sacrificed by my first husband’s hand, thrown into the
fire”. In retaliation, her divine gift ... prophesied his death ... Her husband died the
following year. Within three months Lady Eleanor had another husband, Sir
Archibald Douglas ... this match was no more happy than the first ... Sir Archibald
followed Sir John in burning her writings, and his wife ... cursed him with a prophesy
of doom ... within a year, “Sir Archibald ... was strooken bereft of his sences” ... In
June 1628, she forecast that the Duke of Buckingham ... would be assassinated ..
Buckingham was duly struck down by John Felton on 23 August ... her fame soared
... [In 1633] the divine prophetess foretold that the King [Charles I] would eventually
be executed ... such auguries were, naturally, criminal offences ... and Lady Eleanor
was summoned to the Court of High Commission ... fined £3000 and sentenced to
imprisonment in the Gatehouse at Westminster, where she was detained from 1633
till 1635 ... On her release, Lady Eleanor left London to live in the cathedral town of
Lichfield ... and carried out acts of desecration ... [in] the Cathedral ... she was
committed to what she was to call “Bedlam’s loathesome Prison” ... [where] she
remained for sixteen months ... This pattern of prophesying and suppression
continued ... The rise of Oliver Cromwell ... finally provided some respite for Lady
Eleanor; for Cromwell combined a prudent acceptance of religious toleration with
genuine interest in those claiming to be the instrument of Divine Will ... Was she
properly a Bedlam case? ...’
Roy Porter. ‘The two cultures revisited’. Cambridge Review 1994; 115: 74-80.
Reprinted in Boundary 2 1996; 23: 1-17.
‘”Snow or Leavis? The bland scientism of The Two Cultures or, violent and illmannered, the one-track, moralistic literarism of the Richmond Lecture?” – that was
the choice offered by Aldous Huxley’s Literature and Science, published in 1963, four
years after Snow’s Rede Lecture … An erstwhile physical chemist turned popular
novelist, and soon to be promoted to Harold Wilson’s white-hot MinTech, Charles
Percy Snow … deplored the polarisation of the English intelligentsia into two camps
… the arts establishment, while enjoying the greater kudos, was a bunch of “natural
Luddites”, tainted by modish angst-ridden pessimism … Though scientists had “the
future in their bones” and were the harbingers of hope, they had been turned into
figures of fun, with flat vowels and flat caps …Aldous Huxley deemed that there was
nothing, objectively speaking, new about his attempt to tackle the two cultures
problem … And he was broadly right. From the “two classes of men” in early
nineteenth-century Cambridge identified by David Newsome, and especially ever
since Matthew Arnold delivered his Rede Lecture back in 1892 on the subject of
“Literature and Science”, the question of cultures – the one or the many – had been
ceaselessly discussed. How then do we explain Snow’s intervention? Why did he
feel he was saying something new? … Snow’s formulation of the two cultures
problem and its resolution was an autobiographical device … He struggled to
Cambridge from what he called a “poor home” in Leicester …His family straddled the
two cultures; his grandfather was an engineer – he brought the electric tram to
Leicester – his father [was] a clerk in a boot factory but also a Fellow of the Royal
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College of Organists … When Snow deplored the “gulf of mutual incomprehension”
between the arts and sciences, he perceived that canyon not in philosophical but in
physical terms: it was, literally, about four miles wide.’
CP Snow’s Rede Lecture, “The Two Cultures”, was first delivered and published in
1959. Invited to give the CP Snow Lecture at Christ’s College in 1994, Roy Porter
chose to address the issue anew, and this paper is a transcript of his lecture.
Roy Porter. ‘Who will give us back our lost pride?’ Evening Standard (London
voice), 31 October 1994: 31.
‘London, you hear it said a lot today, is at a crossroads. And it’s easy for us to rattle
off a long list of reasons why: grid-lock, poor schools, homelessness, Docklands
disaster – we all have our favourite beef as to why “fings ain’t wot they used to be”,
and our pet scheme for putting them right. But maybe the malaise isn’t just a matter
of break-ins and break-downs, or the tattiness of Oxford Street and the rattiness of
the public transport system. There’s something deeper and more disquieting,
something that’s become part of our soul. Do we any longer seriously think of
ourselves as Londoners? Or, if we do, does it any longer mean very much? ...
London pride goes back a long way. In the 12th century a monk, William
FitzStephen, boasted ... that the city “pours out its fame more widely, sends to farther
lands its wealth and trade, lifts its head higher than the rest” ... In the 150 years after
Henry VIII came to the throne, London’s population increased a staggering tenfold.
Yet there’s little sign that it led to massive crime, rootlessness or even disaffection ...
And by the 19th century, townies could glory in a new identity, that of the cockney – at
term not at first confined to East Enders ... True cockneys thought well of
themselves. The cockney was a smart cove, he had a love of glitter. He was bright
and sharp, never-say-die, ever the optimist ... But recently things have not been
going well for London ... After the GLC fiasco, the Thatcherite policy of ruling London
by quango is profoundly undermining our sense of identity ... A city like ours cannot
survive without a sure sense of its identity. That is what the word citizen means.
Things will not be well until, like St Paul, we truly feel we are citizens of no mean
city.’
Roy Porter. ‘Animating history: Films such as Pocahontas, Braveheart and Rob Roy
distort the past. But does that mean they are not worth watching?’ The Sunday
Times (section 9), 30 July 1995: 10.
‘ ... A mere 10 minutes into The madness of King George, Nigel Hawthorne is letting
forth the obligatory ripe fart, and soon he is seen, breeches down, caught short by
the walls of Windsor Castle. Almost all the cast of Rob Roy water the heathers at
some time or another; even Jessica Lange, our hero’s bawdy wife, takes a loch-side
squat. Dirt, dinginess and debasement have now become bywords for the past. So
history tends to get painted as all fair or foul, and scholars protest: things weren’t like
that! Strictly speaking, Professor Dry-As-Dust, heard holding forth in the library
tearoom, will be right ... if chapter and verse is needed for every scene we
reconstruct – we would have no history in the movies at all (or anywhere else, for
that matter), for all history is reconstruction and inference ... Revisionist historians
have proved that Davy Crockett, Matt Dillon and most of the rest of How The West
Was Won was fantasy; but it’s the way with myths that they become realities ... More
recent Dickens (the RSC’s Nicholas Nickleby on stage, or the film of Little Dorrit)
have renovated the Victorians as fun or fashionable ... In short, I do not despair, I
rejoice when I see history (albeit misrepresented) in the movies. It may be
inaccurate; and the overt moral or hidden message is often bogus or tainted with
unsavoury politics. But it’s surely healthy to recognise that all our yesterdays are
relevant to all our today’s ... Movie history is moving history.’
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Roy Porter. ‘Medical lecturing in Georgian London’. British Journal for the History of
Science 1995; 28: 91-99.
‘… the domains of commerce, showmanship and spectacle, and science knew no
fixed boundaries … Improving citizens, fashionable society and learned gentlemen
would go along to hear William Hunter lecture on anatomy – Adam Smith and
Edward Gibbon were amongst his auditors - no less than they would ogle orreries …
[Nevertheless] medical lecturing in the eighteenth century was different from
scientific lecturing because it was principally vocational … The London [private]
medical lecturer … had an audience of young men wishing to practice medicine …
this mainly meant that they lectured on subjects that newly emerging general
practitioners thought requisite for practical and prestige reasons … near the top of
the list was midwifery … for the baby you brought into the world became your patient
for life … lectures were delivered by the cream of the profession (London had no
university), men like William Cheselden … George Fordyce … and, above all, the
brothers William and John Hunter … William Hunter’s auditors heard of his
researches on aneurysm, the placental circulation, the lymphatic system and the
gravid uterus, nowhere available in print … Another attraction lay in the high-grade
specimens, preparations, models and demonstrations devised as teaching aids …
the Hunters, Matthew Baillie and Joshua Brookes … developed vast private
museums of specimens available to students … Above all, private lecture schools
proved popular because of the excellent opportunities they offered for practical
anatomy … to achieve such a supply [of cadavers], operators like William Hunter
needed to be in cahoots with teams of professional body-snatchers … A student
attending leading London lectures in 1790 probably acquired as good a training as
was anywhere available … the critical breakthrough came with on-site [hospital]
lecturing … For the future of medical education, it proved crucial in bringing droves of
students into the hospital. In just over twenty years at St George’s, John Hunter
taught about a thousand students …’
Roy Porter. ‘The complacency of Sir Aubrey’. Times Literary Supplement, 25
August 1995.
‘Balancing the books at a fin de siècle is ever a hazardous enterprise, and nowhere
more so than with psychiatry. The curious onlooker find that the messages coming
across, from historians, sociologists and psychiatrists themselves, have been
persistently confused and confusing ... “Whiggish” histories of psychiatry traced twin
arrows of improvement, one rising from barbarous neglect to therapeutic
humanitarianism, and the other from ignorance, religion and superstition to modern
medical science ... (In 1961) Sir Aubrey Lewis, Professor of Psychiatry in the
University of London and arguably the doyen of the British psychiatric establishment,
presented a similarly reassuring view ... Alongside many who honour him, some
psychiatrists have put Lewis himself on the couch ... Whatever its future, psychiatry
has succeeded in getting under the skin ... every new disorder label suggests
persistent disorder in the taxonomy of psychiatry ... controversy rages, within and
beyond the psychiatric profession, about the success (or rather failure) of
deinstitutionalization and “community care”; voices are heard calling for the
reinvention of the asylum. In such circumstances, who can blame the bystander for
suspecting that psychiatry itself remains somewhat confused?’
CWP MacArthur, Roy Porter. ‘’”An erroneous bias”: the mental illness of JeanFrançois Berger’. History of Psychiatry 1996; 7: 397-424.
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‘This article examines an aspect of the life of the early nineteenth century
mineralogist and geologist, Dr Jean-François Berger (1779-1833), who between
1808 and 1813 undertook geological travels and explorations in the United Kingdom.
He then dropped out of the British scientific scene. This disappearance was
explained at the time and in subsequent obituaries in terms of “ill health”. In reality,
such phrases were euphemisms for serious mental disorder that overwhelmed him
early in 1814, involving depression, persecution feelings and other delusions. His
friends and colleagues experienced severe difficulties in handling an agitated
condition that culminated in eighteen days’ confinement. The sad story of Dr Berger
is rehearsed … as a prelude to reproducing documents concerning the case. They
are of interest in the history of psychiatry, recording … the opinions and responses of
members of the intellectual elite attempting to deal with an unfortunate, painful and
embarrassing condition in one of their colleagues. They illuminate ambiguities in the
understanding and handling of mental illness in the years before it fell, later in the
century, completely into the hands of the psychiatric profession. They go beyond
many of the familiar stereotypes of madness and its treatment, and afford
considerable insight into personal and social attitudes towards the mentally disturbed
…’
Roy Porter. ‘Drawing on one’s capital: Hogarth’s London’. The New Rambler 19941995, published 1996; 10: 21-27. This is a reprint of the lecture delivered to the
Johnson Society of London, 21 January 1995.
Roy Porter. ‘Editorial’. Wellcome History. Issue no 1, June 1996: 1.
Roy Porter. ‘Editorial’. Wellcome History. Issue no 2, October 1996: 1.
Roy Porter. ‘Editorial’. Wellcome History. Issue no 3, December 1996: 1.
Roy Porter. ‘John Coakley Lettsom and the “highest and most divine profession that
can engage human intellect”’. Transactions of the Medical Society of London 1996;
111: 22-34.
… my involvement with John Coakley Lettsom is surprisingly long and sentimental. I
went to school in Camberwell and on wet and windy evenings we grammar school
boys were dispatched on running practice through Lettsom Road, up Camberwell
Grove, round Grove Park, down Grove Lane, and back all steaming and sweaty to
school. Little did it then cross my mind … who had lived at the top of the handsome
road up which I panted ... Lettsom was born in 1744 on the Caribbean island of Little
Vandyke, his Quaker father being a plantation owner … [and] sent to England at the
age of six … Lettsom remained at school only till the age of fourteen … being
apprenticed … to Abraham Sutcliff, a surgeon and apothecary at Settle in Yorkshire
… Lettsom moved at the age of 20 to London where John Fothergill arranged for him
to serve as a surgeon’s dresser at St Thomas’s Hospital … In 1767 he returned to
Tortola, the island where his father [who had died] had had his plantation … ‘I found
my chief property was in slaves, and without considering of future support, I have
them freedom, and began the world without fortune …’ Lettsom remained in the
Caribbean long enough to amass a couple of thousand pound from medical practice.
He then returned to Britain to made his medical living, indeed his medical fortune …
he recorded that he generally prescribed for som 50 sufferers before breakfast, and
often far more … By 1791, he observed that ‘during the last nineteen years not one
holiday have I taken’ … His carriage became home from home … at Grove Hill,
Camberwell [erected 1779] … he planted five acres of garden, some 200 fruit trees,
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including 16 types of grape vines, an apiary of 64 hives, walks, lawns, fountains,
ponds, statues and an avenue called ‘Shakespeare’s Walk’ … He also found time
major medical philanthropic projects … the founding of the Sea-Bathing Infirmary at
Margate (1791) … setting up a pioneering charitable institution in London, the
Aldersgate Dispensary … the Royal Humane Society (1774) … the Medical Society
of London (1773) … Lettsom had a passionate commitment to the dignity of the
profession of medicine. He hated quackery … He displayed many Quaker
characteristics: he was sober, industrious, philanthropic. Yet he showed none of the
austerity of so many Friends – nor any religious bigotry. He was affable, he loved
living well … he was widely regarded as a bit of a social climber … He throve on
work. ‘I love my profession,’ he wrote … Medical business is not my plague but my
pleasure’.
Roy Porter. ‘The rise and fall of the age of miracles’. History Today 1996; 46: 69-75.
‘Roy Porter charts the whirlwind of medical triumphs that promised limitless progress
in human health and our more sober reflections on the eve of the third millennium ...
The propaganda for progress beamed out ever since the Enlightenment became a
reality during the nineteenth century, embodied in conspicuous improvements in
science, technology and material civilisation ... But what was medicine’s part in this?
... In critics’ eyes, medicine has proved extremely successful in dealing with certain
facets of disease, but has all too often failed to address the wider picture. No longer
the motor of progress, medicine has maybe lost its way. Indeed, many think that
medicine has now become not a solution but part of the problem.’
Roy Porter. ‘The history of the “drugs problem”’. Criminal Justice Matters 1996; 24:
3-4.
‘If you’d talked about the “drugs problem” two hundred years ago, no one would have
known what you meant. There was no notion then of “drugs”, in the sense of a small
group of substances scientifically believed to be harmful because addictive or
personality destroying, the availability of which is restricted by law. The term “drugs”
as a shorthand for a bunch of assorted narcotics is in fact a twentieth-century
coinage ... Even the idea of addiction is quite recent ... nobody before 1800 thought
in terms of substances having chemical properties that routinely caused dependency
... To some degree, the British “drugs problem” as it emerged in the twentieth century
was simply a pale reflection of American attitudes and policies. Press panic-creation
early in the century centred on the Chinese “dope-fiends” of Limehouse and their
Bohemian hangers-on; by the 1960s it was juvenile delinquents who were identified
as the drug-taking demons. From then on, being “tough on drugs” became the
slogan of every macho police chief and every Home Secretary seeking the votes of
the moral majority. The rest is depressingly familiar ...’
Roy Porter. ‘Thomas Beddoes: physician and author’. Newsletter: Thomas Lovell
Beddoes Society 1996; 2: 1B-6B.
‘... Thomas Beddoes was born into a prosperous Shropshire tradesman’s family in
1760 … [proceeding] in 1776 – that annus mirabilis! - to his local university, Oxford ...
securing the comprehensive grounding in languages and literature that later enabled
him to shine as a sophisticated polymath ... Beddoes also cultivated scientific
interests. Opting for medicine ... in 1781 he abandoned Oxford, moving to London …
Three years later he proceeded to Edinburgh to complete his medical education … In
1786 he returned to Oxford, taking his MD … His scientific circle grew, warm
friendships sprouted with Lunar Society members like Erasmus Darwin and, slightly
later, with James Watt …in 1787 Beddoes took a summer jaunt to France ... From
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1789, Beddoes speedily grew politicized ... sporting a tricolour and singing
revolutionary songs ... Though he did not know it, the Home Office was having him
observed … he penned an epic poem, Alexander’s Expedition down the Hydaspes &
the Indus to the Indian Ocean (1792), a meditation on destructive and cleansing
violence ... Beddoes quit Oxford in 1793, migrating to Bristol, and setting up in
medical practice in the fashionable suburb of Clifton … Beddoes himself grew
politically quieter ... his most substantial writing writings in the new century – Hygëia:
or Essays Moral and Medical, on the Causes Affecting the Personal State of our
Middling and Affluent Classes (1802 and 1803) and ... Manual of Health: or, the
Invalid Conducted Safely Through the Seasons (1806) ... may be read as a hybrid
between medical autobiography and scathing soap opera, a death’s jest book in
which Beddoes formulated, almost in a free-associating manner, his final reflections
upon the theatre (or sociology) of sickness in the modern commercial and industrial
order ... Beddoes obviously found much about the sick, and the sick society, hard to
stomach ... Beddoes died, almost forgotten, on Christmas Eve, 1808, just forty-eight.
Although he expired prematurely, he had outlived his time ...’
Roy Porter. ‘Trust me, I’m a doctor’. The Observer Review, 16 June 1996.
‘Oh you can’t trust them anymore.’ It’s not just politicians you hear that being said
about these days but doctors too … you never see the same doctor twice and at
night all you get is locums; GPs don’t even look up when you step into the surgery
and then they just pack you off for tests and fob you off with pills …every day’s
papers tell of smear tests needing to be redone, or of some psychiatrist discharging
another homicidal maniac for a spot of community killing … You might say that we’ve
heard all this before – and also that tomatoes no longer have any flavour and you
can’t get a decent plumber … the idea of a halcyon past everyone respected their
doctor is pure nostalgic nonsense … ‘God heals and the Doctors take the Fee,’
sniggered Benjamin Franklin … ‘Met Mr Forbes the surgeon going to kill a few
patients,’ jotted Parson William Holland in his diary of 1802 … ‘You tell your doctor
that you’re ill And what does he, but write a bill’ the poet Matthew Prior put it in a
rhyming nutshell … After all, what effective weapons did a doctor carry in his bag in
mad King George’s reign? He could dose you up with opium to numb the pain …
[and] also, as of May 1796, vaccinate you against smallpox … We readily forget that
until antibiotics were pioneered from the 1930s, no medicines at all actually cured
lethal diseases. ‘I will lift up mine eyes unto the pills,’ bantered Malcolm Muggeridge
in 1962: no one could have made the quip much before then … The good old days
when the doctor came to the sickroom to perform heroic healing miracles are a myth
that also misses the point … The old role (kindly, pipe-smoking, avuncular) was, in
truth, easy to adopt because there was no alternative. Things are bewildering for
physicians now because awesome choices loom … doctors stand at the crossroads
and, if they pick the wrong path, GPs will go the way of MPs and forfeit public trust.
And that would be a sad fate indeed.’
Roy Porter. ‘A moral arena: Hogarth’s views of London’. Art Quarterly 1997; 29: 2629.
‘”I was born in the City of London, on the 10th day of November 1697.” So reads the
first sentence of William Hogarth’s autobiography, displaying the importance of the
capital in his sense of identity ... London permeates his art and it was his inspiration
... Hogarth brings us face to face with many corners of the capital ... At the outset of
his career he designed theatre tickets and he engraved Southwark Fair (1734) with
all its acrobats and actors. He was a passionate fan of David Garrick, depicting him
in various poses ... Hogarth envisaged London as a theatre of public ritual, decked
out with eloquent props ... This is the key to Hogarth’s depiction of London. His
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targets were pride, pharisaism, and vanity and he saw that such messages could
best be conveyed by capturing the audience’s interest with a familiar local habitation
and a name. Hogarth’s dramatization of London is most conspicuous in the print
sequences that unfold through a sequence of acts. His progresses – The Rake’s
Progress, The Harlot’s Progress, and the careers of the industrious and idle
apprentices – are scenes from a moral pageant and literal journeys through a
symbolic metropolitan geography ... Like Defoe and Fielding, Hogarth excelled at
dramatizing moral contrasts that mingled stage and audience. “My picture was my
Stage,” he recalled, “and men and women my actors, who were by means of certain
actions and expressions to exhibit a dumb shew.”
Article celebrates the centenary of Hogarth’s birth and draws attention to the
exhibitions and events taking place in the London area. These included ‘Hogarth the
Painter’, Tate Gallery, 4 March – 8 June; ‘Hogarth’s Rake’s Progress’, Sir John
Soane’s Museum. 26 March – 31 August.
Roy Porter. ‘Bethlem/Bedlam: methods of madness?’ History Today 1997; 47: 4146.
‘”Bedlam” has become a by-word for a wild and crazy place, but what is the historical
reality behind a distinguished London institution? ... Bethlem is 750 this year,
possibly the oldest psychiatric facility in Europe. Founded in 1247 by Simon fitzMary,
an alderman and twice Sheriff of London, it arose out of the dealings of that first
great multi-national, the Roman Catholic Church ... the first Bethlem lunatics are
recorded in 1403, possibly transferred from an existing site at Charing Cross.
Bethlem then houses six deranged men: an inventory listed four pairs of manacles,
eleven chains, six locks and two pairs of stocks (though these may not all have been
for the lunatics) ... Visitors to twentieth century Bethlem came away with the
impression that it was less like an asylum than “a first-class hotel or a hydro” ... What
was crucial was that for centuries Bethlem was unique. And it spilled over into the
streets through the Abram-man or Tom o’Bedlam, blanket-covered, filthy and with
elfin-knotted hair like Edgar in King Lear, wandering the lanes, haunted by the foul
fiend Flippertigibbet, or gaudily dressed and supposedly singing Bedlamite ballads
that told mad tales and perpetuated the Bedlam myth ... Bedlam could always be
made to serve, like the Inquisition, as the bogey image of the bad old days and ways:
Gothic horror, the black myth, the antithesis of psychiatric progress ... We hear a lot
these days about the mad person as scapegoat, but Bethlem itself was stigmatised.’
Roy Porter. ‘Editorial’. Wellcome History. Issue no 4, March 1997: 1.
Roy Porter. ‘Editorial’. Wellcome History. Issue no 5, June 1997: 1.
Roy Porter. ‘Editorial’. Wellcome History. Issue no 6, September 1997: 1
Roy Porter. ‘Lunatic ideas and the truth about asylums’. The Times Higher
Educational Supplement, 10 October 1997.
‘Causes rewrite history, and the anti-psychiatry movement launched in the 1960s
was no exception. Thanks to the phenomenal appeal of Michel Foucault’s Madness
and Civilization, originally published in French in 1961, radical new readings of
psychiatry’s past came to the fore which have now, in their turn, assumed the status
of received truths, at least among humanities scholars … Much of this revisionist
story is true, and a valuable corrective to the once popular, upbeat, inhouse
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Whiggish histories. Other aspects are plain wrong. There never was a ship of fools,
it was a literary fantasy; likewise the ‘great confinement’ was something that
happened in Paris, but nowhere else in Europe … there is today a real risk of
underestimating how far madness was all the time understood as an illness, one
which was in principle curable … Bethlem Hospital’s [celebrating its 750th anniversary
this month] rich archives show how the institution, for long England’s only public
refuge for lunatics, handled the condition of insanity. And that bears little
resemblance to the portrait which Foucault painted of the Hôpital Général and which
he applied to Europe at large … As Foucault maintained, institutional psychiatry has
been put to use to smother social nuisances … But this is only half the story. From
the mid-19th century the new psychiatric professionals have claimed that lunacy falls
within the medical domain (though cynics might call this an aggrandising professional
strategy); and the mad have undergone a long succession of therapeutic
interventions. These, however, have never enjoyed the same success as
microbiology’s magic bullets against infectious diseases.’
Roy Porter. ‘A plague from all our animals’. The Sunday Times (section 6), 4
January 1998: 5.
‘Cattle provided tuberculosis and smallpox; pigs and ducks gave us influenza; horses
brought the common cold. Measles, which kills 1m children a year, is from canine
distemper ... The fatal interchange of disease between animal and man, however
disastrous in the short term, is the story of civilisation itself. Disease is a social
development no less than the medicine that combats it ... our primitive ancestors
really were practically free of the pestilences that later ambushed mankind ... This
was because they were hunters and gatherers, living in scattered nomadic groups of
perhaps 30 or 40 ... All changed when the ice caps melted at the end of the last ice
age about 10,000 to 12,000 years ago. Instead of hunting, Stone Age stalkers were
forced to grow their own food and settle in one place ... Many of the worst human
diseases were created by proximity to animals ... Bubonic plague is basically a
rodent disease. It strikes humans when infected fleas fail to find a living rat when a
rat host has been killed and pick a human instead ... Between 1346 and 1350,
Europe alone lost perhaps 20m to the disease ... Not long ago, medicine’s triumph
over disease was taken for granted ... A signal event was the worldwide eradication
of smallpox in 1977. Yet a conclusive victory over disease should always have
seemed naive since that would fly in the face of a key axiom of Darwinian biology:
ceaseless evolutionary adaptation. This is something that disease accomplished far
better than humans, since it possesses the initiative.’
Roy Porter. ‘Can the stigma of mental illness be changed?’ Lancet 1998; 352:10491050.
Disease has always attracted aspersions of defilement and disgrace … Prominent
amongst those who have been stigmatised are lunatics. In medical texts, in art, and
in the popular imagination, maniacs were standardly depicted as savage, bemired,
and bestial … It would be silly to blame all this scapegoating on doctors, for beliefs
about sickness are not simply matters of pathogens but functions of social tensions
too … In the seventeenth century, for example, witchcraft became a bone of
contention between the church and the physicians … ruling elites, terrified by the
anarchy of the witch-craze, happily medicalised the condition as hysteria … The
trouble was that the hysteria diagnosis itself, of course, became in turn stigmatising
… The eighteenth-century physician, George Cheyne, came up with the formula of
the ‘English malady’ … Though the mental symptoms were real, they were deemed
to be responses to somatic change … 30 years ago, the psychiatrists Ida Macalpine
and Richard Hunter declared that George III had never been mad at all. Rather he
had been suffering from variegate porphyria, an inherited metabolic condition … Of
course, it may be no great victory to destigmatise mental illness merely by
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reclassifying it as organic. In earlier times, madness spoke the language of God …
Erasmus’s figure of Folly spoke wisdom, and Truth poured from the mouths of fools
and simpletons … What is clear from history is that if we are going to take the stigma
out of mental illness, we cannot simply leave that task to the doctors.
Roy Porter. ‘Death plc reports’. New Statesman, 27 February 1998.
‘The second millennium got off to a sticky start, with peace movements unsettling the
markets. Fortunately the Crusades proved good for business, triggering internecine
religious conflicts which if peaking in the glories of the Reformation and its Wars of
Religion, have remained a reassuring source of strife, massacres and civil wars.
Though leprosy proved a bit of a letdown, microbes came up trumps with the Black
Death ... Some jitters were felt in the eighteenth century, as the Age of Reason
spurred dreams of peace, and for awhile there were anxieties that capitalism would
beat swords into ploughshares ... Thanks to two world wars carnage has hit record
levels. We march into the new millennium with every confidence in a catastrophic
future.’
Porter Roy. ‘Desirable diseases’. Churchill Review 1998; 35: 59-61.
‘What I find specially fascinating about the history of medicine are the opportunities it
offers for studying the interaction of biology and society ... Diseases are biological
realities but they are also full of cultural resonances: think of leprosy, syphilis, plague,
or in our own day AIDS. Mostly these meanings are stigmatizing (as in “moral
leper”). Just occasionally they are positive. Migraine carries a kudos which mere
headaches lack. In English history, the truly high-prestige malady was the gout –
note the definite article! ... Gout, opined the Revd. Edmund Pyle, “is fit for a man of
quality”. “Gout is the distemper of a gentleman”, insisted Lord Chesterfield, “whereas
the rheumatism is the distemper of a hackney coachman” ... there was the idea –
weird in our eyes – that gout was positively good for you ... So long as gout was in
possession of the body, no deadlier enemy could invade ... it was, as Gibbon said,
nature’s way of throwing off peccant humours.’
‘Feminism revisited: a symposium. In 1988 we asked a number of male writers: what
impact has feminism had on your work? Ten years on, we repeat the question to a
different, mixed group of contributors’. Times Literary Supplement, 20 March 1988:
13-15.
Roy Porter: ‘... feminism has affected my practice as a historian in three ways. First
... it has opened my eyes to areas of human experience utterly absent from my
undergraduate training ... Second, it has proved a key stimulus to fields in which I
have been researching ... most of the best work in the history of sexuality, the history
of the body and the history of psychiatry has come from feminist scholars or has
been inspired by issues they have raised ... Third, I have found feminism a
provocation and a puzzle. I have always been baffled by those feminist historians
(mainly Americans) seemingly insistent on demeaning women as helpless victims,
and have been glad to counter their neo-misogynistic myths, like the notion that 9
million women were burnt as witches or that all women were traditionally sexually
supine and exploited. Shall I, I wonder, in time view this reaction of mine as an
instance of redundant, defensive gallantry?’
Roy Porter. ‘Madness and the family before Freud: the view of the mad-doctors’.
Journal of family history 1998; 23: 159-172.
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‘… the birth of psychoanalysis was bad news for the old-style model of the family;
from then on, there were not just problem families – the family itself was a problem
… In today’s ‘victim’ society, the institution that takes the rap is the family, the
‘baddies’ are the daddies (and even the mammies). But where did psychiatric
opinion stand two, three, or four hundred years ago? … In the world we have lost,
the family was hegemonic, the paramount economic, moralizing, and normalizing
agent. The Filmerian father was the first therapist, and emergent psychiatry was
designed to buttress the family unit. Private sector psychiatry was there to stabilize
the family, bringing errant members into line … In the public sector, as John Walton
has shown, there might be considerable give-and-take between families, Poor Law
authorities, and county asylum doctors respecting the casting out and taking back of
mad relatives. In such circumstances, psychiatrists were hardly likely to develop
theories or practices holding the family itself to be pathogenic. What was
problematic, rather, was the family member who did not fit … the antipsychiatry
movement of the 1960s, led in Britain by RD Laing, construed the bourgeois family
as psychogenic, in particular blaming mothers for the double binds of schizophrenia
… As prime minister [in the 1980s], Mrs Thatcher applauded Victorian values, and
the defense of the family became a political cause in the United Kingdom. This
marks a further late twentieth-century about-turn in convictions and policy … once
more, as part of the rolling back of the state and the backlash against
permissiveness, the family unit, pace Laing, is being sanctified – and hence being
expected to shoulder the burdens of care.’
Roy Porter. ‘Pushing 40? Don’t worry, only another 100 years to go.’ The Observer
Review, 7 June 1998: 2-3.
‘Breakthroughs in genetics now seem a dime a dozen, but one announcement last
week caught my fancy. Two Canadian scientists are, it seems, set to produce a
report on how they have identified a genetic mechanism which may dramatically slow
ageing by protecting cells ... Most of us crave long life, but the last thing we want is
actually to grow old. The Jacquesian nightmare of senility spent in the geriatric ward
sans everything – except Alzheimer’s – has already become a reality for many and a
threat for us all ... our society has always been ageist ... greybeards commanded
respect so long as they could toil, but they were worked till they dropped, for peasant
economies could not afford to carry passengers, and, except for the affluent, there
was no concept of retirement ... the particular allure of an elixir persists: the magical
or supernatural recipe for rejuvenation, designed to cheat Nature ... Alchemy, for its
part, held out dreams of gold tinctures (aurum potabile) with fancy names like “the
red dragon” ... In 1889, the eminent French physiologist, Charles Edouard BrownSéquard, astounded the world by claiming to have rejuvenated himself through
injections of guinea-pig and dog testicles ... Such goolie grafts looked state of the art,
but proved a nine-day wonder. Will the new gene of life turn out to be just another
hype? All we can be sure of is the wisdom in the dictum of the Gerontological Society
of America: our true priority in all these matters should be to “add life to years, not
years to life”.’
Roy Porter. ‘Reading is bad for your health’. History Today 1998; 48: 11-16.
Reprinted in Snowman D (ed). Past masters: the best of History Today. Sutton,
Stroud 2001: 435-444.
‘…Reading is, quite literally, disastrous for your health … every occupation has its
maladies: housewife’s knee, athlete’s foot. Authors too have their afflictions. One of
course is writer’s block … The diametrically opposite disorder is writer’s itch … the
perils of writing were judged but a fleabite compared with those of reading …
“Students”, thought [Robert] Burton, are commonly troubled with “gouts, catarrhs,
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rheums, wasting, indigestion, bad eyes, stone, and colick, crudities, oppilations,
vertigo, winds, consumptions …” Samuel Johnson’s friend, Mrs Thrale, told the tale
of a fourteen-year-old who had been bashed over the head by his Master with a
dictionary …”which so affected his health that his powers of Study were straingely
impaired, his Memory lost …” “On Tuesday last”, reported the Glasgow Journal on
June 21st, 1742, “as an Old Man was lying in the Green reading a Book, he was
attack’d by the Town Bull, who tore two of his Ribs from the Back Bone, and broke
his Back Bone …” The price of learning can be high indeed … Bookishness was
recognised as addictive, psychopathological … On visiting Bethlem in 1786, the
German novelist Sophie von la Roche … met Margaret Nicholson, George IIII’s
would-be assassin, sitting reading Shakespeare … Novel-reading among fashionable
young ladies was said to lead to hysteria or the vapours … Occasionally at least the
printed page has been positively therapeutic … When [in Tristram Shandy]
Phutatorius’ membrum virile is frazzled by a roast chestnut which plops off his plate
down into his breeches, cure is effected by application of a leaf from a new book, still
damp and inky from the press …’
Roy Porter. ‘The historiography of medicine in the UK’. Medicina nei Secoli Arte e
Scienza 1998; 10: 253-269.
‘The practice of the history of medicine in Britain is characterized by a health
pluralism and diversity. Thirty years ago, history of medicine in Britain was generally
considered a space of no particular relevance to history at large; today, public
attitudes towards scientific medicine and the medical profession have grown critical,
and the history of medicine has itself been problematized, commanding widespread
scholarly attention. This article deals with some of the historiographical fields, thanks
to which the discipline has been energized over the last thirty years: the history of
health, analyzing the healthiness of populations, the length of their lives and the
causes of death; the history of the body which has been considered as a biological
and as a sociological entity; the history of sexuality and sexual behaviour; the
demographic and epidemiological history, both connected with the environmental
history; the history of death and corpses; the history of mental disorders; the
historical role of the hospital in the reformation of popular health care.’
Roy Porter. ‘Classics revisited: the hour of Philippe Ariès’. Mortality 1999; 4: 83-90.
Roy Porter, Michelle Stokes. ‘Mean time’. Cultural Values 1999; 3 (2): 235-243.
Roy Porter. ‘Medicine facing modernity’. Transactions of the Medical Society of
London 1999; 114: 31-41.
Enlightenment opinion … maintained that, amidst general improvements in science,
sentiment and society, medicine itself was improving, and stood poised to effect truly
revolutionary transformations … medical spokesmen argued that … they must
become the luminaries of humanity and the physicians of the body politic … Sickness
had to be understood, and hence treated … not just individually but as a social
system … Progress was realizing man’s right to happiness and … Yet a dark shadow
loomed: for did not civilization itself breed disease? … Luxury, thundered critics,
corrupted private morals, public virtue, and, not least physical stamina … In the
1730s, George Cheyne gauged that a third of all disorders were nervous … What
would soon be called ‘alcoholism’ was part and parcel of growing abuse of stimulants
and intoxicants – opiates, tobacco, tea, coffee, cordials, and, most disturbingly,
medicines – increasingly consumed in the emergent consumer society … People had
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always eaten and drunk themselves to death. Now, critics complained, sufferers
were worrying and were medicating themselves to death … The irony is that,
precisely because of their advanced involvement with chemistry, experimentation
and humanitarianism, such ‘experimentalists’ as [Thomas] Beddoes were particularly
responsible for drug-induced human tragedies … Enlightenment fascination with the
self – with exposing traditional false-conscious and creating new sciences of the
mind for a new society – led to the framing of new categories of disorders rooted in
the psyche: psychiatric disorders, masturbation, alcoholism, nymphomania, addiction
and neurosis. The Enlightenment conscription of mind as the engine of liberation
itself laid bare the self-imprisoning, morbific potential of the psyche. It is no accident
that Beddoes was fond of the epigraph: ‘Physician: heal thyself’.
Roy Porter. ‘Perversion in the past’. Orvostörténeti Közlemények : Communications
de Historia Artis Medicinae 1999; 166-169: 17-26.
‘... The idea of the perverse and the perverted ... was first formulated as a
complement to the idea of the inverse and the invert (that is, homosexual) in the
decades after 1870, in the writings of a succession of physicians, psychiatrists and
new and self-styled sexologists ... before the fin de siècle ... a different language of
differentiation was traditionally employed: that of “natural” and “unnatural” practices.
These had been distinguished throughout medieval and early modern times
according to their tendency of procreation: natural sex made babies, unnatural sex
didn’t ... The sexual best-sellers of the seventeenth and eighteenth centuries ... give
their approval, greater or lesser, to erotic acts liable to lead to pregnancy, and
condemn all behaviour designed to thwart or bypass conception ... developments
after 1850 gave a new scientific footing to what remained essentially the ancient
distinction between procreative and non-procreative sex, and shifted from
condemnation of one-off unnatural acts (classical sodomy) to the new categories of
the perversions (eg. zooerasty, bestiality, coprolangnia, exhibitionism, fetishism,
flagellation, frottage, sado-masochism, satyriasis, transvestism, urolagnia,
voyeurism, male and female homosexuality) and their perpetrator, the pervert ...
From Krafft-Ebing to the present, nothing has remotely rivalled the perversions for
gratifying psychiatric prurience ... Within Freud’s theory, all the classic manifestations
of perversion ... are residues of infantile practices that immature individuals never
transcend ...’
Roy Porter. ‘Architects of happiness’. BBC History 2000; 1: 14-19.
‘The 18th century was a turning point in British thought and behaviour, when
pleasure-lovers grasped life, liberty and the pursuit of happiness ... The Ancients
taught: “be virtuous”, and Christianity: “have faith”; but the Moderns proclaimed: “be
happy”. Replacing the holiness preached by the Church, the great ideal of the
modern world has been happiness, and it was the thinkers of the 18th century who
first insisted upon that value shift ... Early Enlightenment philosophers like Locke
gave ethics a new basis in psychology. It was emphasized that, contrary to
Augustinian rigour, human nature was not hopelessly depraved; rather the passions
were naturally benign ... For “new hedonist” was not old rake “writ large”, but the man
or woman of sensibility who could pursue satisfaction through sociable behaviour,
and whose good nature would give as well as take pleasure ... a key feature of
Enlightenment hedonism was its frank acceptance of erotic pleasures. It is no
accident that one of the best-sellers of the age was John Cleland’s Memoirs of a
Woman of Pleasure (1749), popularly known as Fanny Hill, the first major
pornographic novel written in English ... Fear often went with pleasure, however:
there was a public panic over the deleterious effects of masturbation, and the “molly
houses” (gay bars) which emerged in London drew fierce criticism. However,
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utilitarian philosopher Jeremy Bentham, wrote an essay urging the decriminilization
of homosexuality ... It is no accident that the Victorians, who prided themselves on
the importance of being earnest and whose Queen was not amused, looked back
with stern disapproval upon their pleasure-loving, enlightened forebears.’
Porter Roy. ‘Happy hedonists’. British Medical Journal 2000; 321: 1572-1575.
‘... I often bump into Jeremy Bentham – that is, his stuffed body on display in the
college (University College London) that he helped to found just over 170 years ago
(embalming, he thought, was cheaper and more effective than sculpture). Bentham
was the founder of utilitarianism, the philosophy that proclaimed that the “greatest
happiness of the greatest number” (the “felicific calculus”) was the only scientific
measure of good and bad, right and wrong – the only worthy goal in life ... Bentham,
who judged that pushpin (a tavern game; we might say “pool”) was as good as poetry
if it gave as much pleasure, wanted all such “gainsayers” to come clean. And there
lies one of the reasons that, as historian and as human being, I feel so drawn
towards the 18th century: the Georgians were remarkably frank and forthright about
pleasure loving ... The quest for happiness was crucial to enlightened thinkers
throughout Europe ... the leisure and pleasure industries now expanded, thanks to
commercial energies and the “consumer revolution” ... Homes grew more
comfortable as domestic good that had hitherto been preserves of the rich grew more
common ... Urban space was restyled ... Shops grew more attractive, bright and airy,
seducing bystanders with the latest fashions ... And were not simple pleasures best?
Archeacon Paley, a tutor at Christ’s College Cambridge, wrote that “the summum
bonum of human life ... consists in reading Tristram Shandy, in blowing with a pair of
bellows into your shoes in hot weather, and roasting potatoes under the grate in
cold.”’
Porter Roy. ‘Healing and dealing’. BBC History 2000; 1: 24-29.
‘As anyone in pre-modern England would tell you, quackery was a bad thing, and the
quack was a wretch – a “turdy-facy, nasty-paty, lousy-fartical rogue”, in Ben Jonson’s
definitive expression, from Volpone ... It would be misleading to imply that official
medicine has always been competent whereas fringe medicine has been ineffectual
or fraudulent ... Both evolved a certain showmanship. Orthodox healers cultivated a
gentlemanly bedside manner of their own, the use of Latin as mumbo-jumbo, the
ancestor-worship of Hippocrates and Galen, and grave rituals like urine-gazing – all
these created the aura of the medicine man within the profession, by way of parallel
to the mountebank’s zany with a monkey, black cats, snakes or canting neologisms
... In centuries when disease was king, and death omnipresent, not only the poor
patronized irregular healers ... James Ward, marketer of the “Pill and Drop”, won
fame and public confidence after putting George II’s dislocated thumb back in place,
receiving the testimonies of celebrated men including the novelist Henry Fielding ...
quacks exploited a psychological appeal, playing upon human unhappiness and
unfulfilled expectations, the susceptibilities of the short, the fat, the inarticulate, the
impotent, the ageing, the unsuccessful, the shy, the spotty ... In its individualist and
itinerant form, quackery had peaked by 1800 ... How far modern medicine still
contains a quackery of its own is another issue.’
Roy Porter. ‘Digging for the rural truth.’ Financial Times (London), 18 November
2000: 11.
‘Roy Porter urges a fresh look at the past before looking at the countryside of the
present ... What I would not deny is that the age of enlightenment brought great
enthusiasm for “improvements” in husbandry. In Gulliver’s Travels, Swift has the
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King of Brobdingnag memorably declare that “whoever could make two Ears of Corn,
or two Blades of Grass to grow upon a Spot of ground where only one grew before,
would deserve better of Mankind, and do more essential Service to his Country, than
the whole Race of Politicians put together”; and to that, enlightenment thinkers – and
George III (“Farmer George”) – would have intoned their collective “amen” ...
Agriculture looked to experimentation. Agricultural chemistry was developed to
improve fertilisers. Erasmus Darwin, Charles’s grandfather, pioneer evolutionist and
scientific polymath, devoted his 600-page Phytologia (1800) to dung and drainage,
cattle and pigs quite frankly as meat-producing engines, selected so as to increase
expensive cuts and minimise bones and waste: animals were thus reduced to
machines. Rather like Newton’s prism, his fatstock served as icons of enlightenment
... the irony is that the rural environment that conservationists try to preserve from
agribusiness – the familiar chequerboard fields, hawthorn hedgerows and coppices –
is not “natural” at all, but the very products of Georgian agricultural capitalism.’
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Roy Porter. ‘Millennial musings – are almost certainly bound to be wrong’. Editorial,
British Medical Journal 2000; 321: 1092-1093.
‘Historians, AJP Taylor once said, make rotten prophets, and I don’t suppose that
historians of medicine like myself are any exception. All I can see ahead are banana
skins. But it’s not clear that doctors are any better when it comes to crystal ball
gazing. Little over 130 years ago, for example, the distinguished surgeon Sir John
Erichsen, of University College Hospital, proclaimed that “the abdomen, the chest
and the brain [will] be for ever shut from the intrusion of the wise and humane
surgeon” ... back in 1936, Sir Crisp English informed readers of the BMJ that within
20 years “the doctor will see on the television screen the tongues and tonsils of his
patients ... he will also see his guineas, but will be unable to reach them” ... Three
things can be said for sure about the medicine of generations to come. Firstly, there
will simply be more of it, moving in a greater variety of fields, developing new
subspecialties, interacting in novel ways ... secondly, the electronic communications
revolution is still in its early days and will be destined to transform the practice of
clinical medicine like no information change before ... the third change will be the
most unsettling. The very aims and goals of medicine will become destabilised as
we move into the future ... Medicine will become more market orientated and “patient
centred” – responding responsibly to this change is the greatest challenge facing the
medical profession as it advances into the new millennium.’
Roy Porter. ‘Heart and soul’. New Scientist 2001; 170: 50-51.
‘In the early days of medicine, the heart was a bit of a puzzle. Blood clearly travelled
from the right side to the left. But how did it do it? To us the answer is perfectly
plain: it travels in a loop, via the lungs. Living after William Harvey, we know that
blood circulates all the time. But at the dawn of medicine these things were far from
obvious. Galen (2nd century AD) … proposed that blood passed directly from the
right to the left chamber of the heart … “sweating” its way imperceptibly through the
fleshy [septum] that divides the two … Galen’s ideas didn’t wash with Andreas
Vesalius (1543) [who] scoffed at the notion of a septum dotted with little perforations
… This proved a turning point for it led fellow anatomists such as the Italian Realdo
Colombo (1550s) to advance the idea of the “pulmonary” transit … Unlikely though it
may seem, a Spanish theologian, Michael Servetus, was a few years ahead of him
…Servetus described the transport of the blood through the lungs – in the form of an
unorthodox account of how the Holy Spirit entered man … nearly three hundred
years before these anatomists … the 13th century Arab physician “Ala” al-Din Ibn alNafis … contended that no blood could possibly pass through the septum and must
therefore pass through the lungs … The crucial question is whether Servetus and
Colombo knew of Ibn al-Nafi’s findings … Where does the truth lie? It’s impossible to
be sure. What can be said for certain is that for patients suffering cardiovascular
diseases, the delay in the uptake of new ideas cannot have made one jot of
difference to the treatment they received. Indeed, the new teachings … seem to
have frightened patients off. “I have heard him say”, the gossipy biographer John
Aubrey reported of William Harvey, “that, when his book on blood circulation cam
out, his practice suffered and people called him mad”.’
134
Roy Porter. ‘Gresham Lecture: Matrix of modernity’. History Today 2001; 51: 24-31.
(Revised text of Royal Historical Society Gresham Lecture delivered in November
2000)
‘This millennium year led historians to address moments in the past which represent
epochs in human affairs. The Enlightenment comprised such a turning-point, since it
secularised the world-view and trained eyes and attention towards the future. British
thinkers played an influential part in this intellectual revolution – though that is a
contribution often ignored or played down, by contrast to that of France. In the
eighteenth century, attention became focused, perhaps for the first time ever, on the
future rather than the past, and the drive to create a better future generated a belief
in progress. The achievement of scientists like Isaac Newton (1612-1727) and
philosophers like John Locke (1632-1704) bred new faith in man’s right and power to
achieve knowledge of himself and the natural world, and encouraged practical action
in such fields as overseas exploration, technology, manufactures, social science and
legal reform. Philosophers became committed to the ending of religious strife,
bigotry, ignorance, prejudice and poverty, and the creation of polite new social
environments and lifestyles … Crucial to the birth of the modern was a rethinking of
economics … the new political economy … repudiated moral or statesmanly policing
of wealth … Science was acclaimed as vital not just to utility but to the civilising
process … Farming became regarded as a form of manufacturing, with Robert
Bakewell’s fat sheep serving, rather like Newton’s prism, as icons of Enlightenment
…Technology was the cutting-edge of novely … Business promoted not just wealth
but well-being … Josiah Wedgwood … thought big: “I shall ASTONISH THE WORLD
ALL AT ONCE”, he declared to his partner, Thomas Bentley, “for I hate piddling you
know”. Becoming “vase-maker general to the universe”, he died worth half a million
… Robert Owen (1771-1858) … urged rational social rebuilding on the basis of
universal education … Uniting arts and sciences, medicine, physics and technology,
[Erasmus] Darwin (1731-1802) was the embodiment of enlightened values … As the
summation of his myriad ideas, Darwin developed the first comprehensive theory of
biological evolution … Darwin and his peers presented a man-centred view of man
making himself – a Promethean vision of infinite possibilities …’
Roy Porter. ‘James Gillray and bodies politic’. Tate 2001, issue 25: 25-31.
‘Graphic satire cultivated a grotesque and often gross rhetoric of the repulsive body
… the eighteenth-century imagination was haunted by the omnipresence of bodily
pain … And all the while the metaphor of the “body politic” sustained the age-old
motif of politics as theatre … it was second nature for satirists to turn to the body in
pain as the perfect model for figuring the body politic, and to make disease, death
and the doctors personify key actors and actions upon the stage of power … James
[Gillray] was born in 1757, and little is known of his early artistic training except that
he was, like Hogarth, apprenticed to an engraver, later enrolling as a student at the
Royal Academy where he overlapped with Blake … Initially devoted to social scenes
… his long career as a political caricaturist getting off the ground in 1782 … crowds
would gather when new Gillrays were put on view … … Early in his career, [Gillray]
seems to have been a “hired gun”, even-handedly negative in his portrayals of
statesmen of all stripes … But in 1797 … a pension of £200 a year was bestowed
upon him by Prime Minister Pitt. Not surprisingly, a welter of virulently anti-Whig
prints followed … On Pitt’s being ousted in 1801, Gillray lost his pension … in his
later years, the somewhat morose and solitary artist went off the rails. He took to
drink and from 1811 sank … into some kind of a demented condition … He died,
aged 58, on 1 June 1815 … Gillray left virtually no independent verbal clues to his
personal attitudes and feelings … He certainly displayed deep disdain for the
animalistic plebs at home and a hatred of the French Revolution … especially
Napoleon … his arrogant, posturing “Little Boney” became definitive in English
135
propaganda … In Gillray’s “The French Invasion” (1793), England is turned into a
person, the map of the realm doubles as a portrait of George III, and he shits the
Royal Navy into the face of France … In Gillray’s satires, the physician is typically a
dunce, a dolt, or a danger to the body politic … What exactly Gillray thought about
the body – or for that matter about disease, death and doctors – is unknown and, at
bottom, beside the point. What is abundantly clear is his genius for making the body
speak through an astonishing repertoire of savage commentaries on the politics of
the day.’
Roy Porter. ‘The Wilkins Lecture 2000: Medical futures’. Notes & Records of the
Royal Society 2001; 55: 309-329. (Lecture delivered at The Royal Society, 11 July
2000 and at Christ’s College, Cambridge 18 July 2000.) Reprinted in
Interdisciplinary Science Reviews 2001; 26: 35-42.
‘Over the centuries, the future of medicine has provoked no end of speculation …
back in 1936, Sir Crisp English informed readers of the British Medical Journal that
within twenty years …”The doctor will see on the television screen the tongues and
tonsils of his patients; … he will also see his guineas, but will be unable to reach
them” … with the “scientific revolution” of the 17th century … the perfect society was
increasingly envisaged as an achievable future … In his New Atlantis, Francis Bacon
imagined a great scientific centre, Salomon’s House, directing research with a view
to the “effecting of all things possible” … the same cannot be said for doctors and
medicine … Plato would have no doctors in his Republic. What about the unhealthy?
His answer was clear: the social good would be best served if such inferior sorts
were allowed to die … in the land of the Houyhnhnms … Gulliver (Gulliver’s Travels)
was rather scandalized to find those rational horses had no doctors at all – being
disease-free, the noble beasts had no need of them. And they, in turn, were left cold
by his gushing praise for the medical art … Various [Enlightenment] philosophes
looked on the art of government as social medicine applied to the body politic, and
cast the physician as the natural ruler of society … Thomas Beddoes … was one
who entertained such a vision … Condorcet … equally envisaged doctors as playing
a key part in human progress … Insofar as professional medical men figured in 19thcentury Utopias, they were mainly cast in the guise of bureaucratic sanitary experts
… in 1875 … Benjamin Ward Richardson … inventor of the galvanised iron dustbin
… imparted a vision to his fellow sanitarians of “Hygeia: A City of Health” … people
would live at a density of just 24 per acre in houses not more than four storeys high,
surrounded by lawns and gardens … it was a city from which, moreover, alcohol and
tobacco had totally disappeared … Within a generation, however, the sanitarian
receded from the Utopian dream to be replaced by the eugenist … The state,
Darwin’s cousin (Francis Galton) suggested in his Utopian fragment Kantsaywhere,
should issue P.G. certificates (“Passed for Genetics”) to those qualified to breed,
while those who failed might be shunted off into celibate labour colonies … a vision
of brain triumphant over bodies proved popular in the Utopian thinking of the … first
half of the 20th century … Social prophets have thus been happy to celebrate the
scientist, the biologist, the eugenist and the geneticist: but the physician has rarely
been admitted into the Utopian pantheon …’
136
Roy Porter. ‘The aphrodisiac death’. In La bohème programme. English National
Opera, Autumn 2001.
‘Two of opera’s great tragic heroines – Mimi in La bohème and Violetta Valéry in La
traviata – die of tuberculosis. TB, or “consumption” as it was then called, was not
just one of the nineteenth century’s most lethal diseases; it was also a malady with
meaning, like HIV nowadays, full of symbolic significance and moral messages ...
Tuberculosis was the staple fare of Romantic tragedy ... Its wasting effect was
portrayed as enhancing female beauty; in sickness the fallen woman paradoxically
became purer than her prim and proper judges. Disease represented the
impossibility of innocent love in a wretched world, and the consumptive courtesan
thus became a motif for Woman herself, seductively simple, desirable yet doomed.
These associations of tuberculosis were not purely the figments of Murger and
Dumas, Puccini and Verdi; they were the convictions of the age, as expressed by
physicians no less than poets ... According to the doctors, two sorts of young people
were especially tuberculosis prone. There was the masturbating adolescent,
generally male. Self-abuse spent the seed ... And there was also the amorous young
woman whose ladylike exterior was betrayed by erotic cravings within. In Murger’s
and Puccini’s heroines, the lapses were venial – the flirtatiousness and freedom of
Paris’s grisettes, shopgirls and milliners out for a good time ... To the Romantic
writer, tuberculosis was a disease that intensified the allurements of the female,
rendering her delicate, exquisite, enticing. Its mortal nature also ensured she would
pay for her fatal attraction.’
Roy Porter. ‘The body politic: diseases and discourses’. History Today 2001; 51:
23-29.
‘… The professional position of early modern medics was precarious. Disease and
death held sway … Dr Frank Nicholls was asked whether one should consult an old
or young physician. “The difference”, replied the doctor, is this: “The former will kill
you, the other will let you die” … The portrayal of medicine is marked by violation and
violence … Illness is painful but so is being physicked … Doctors in prints and the
press thus presented threats to one’s body. Not just through therapeutic violence but
sexually too. Scores of sketches feature the physician as lecher, and clinical
consultations as erotic skirmishes … Rowlandson’s doctors gawp, grope and glyster
their patients in a most un-Hippocratic manner … the practitioner’s apparatus – his
cane, enemas, lancets, squirts and clyster-pipes – assume an erotic air … Georgian
culture took endless pot-shots at charlatanry … Maladies were represented as
sinister goblins, demons and imps … Small surprise then that political cartoons have
been fixated upon the body … When a cartoonist wants to depict a set-to between
Britain and France, the trick has been to boil the idea down into contrasting
physiques. See a citizen having his teeth yanked out by a politician and we know the
people are yet again being ripped off from Westminster … During the eighteenth
century … cartoons became barbed and biting, featuring identifiable Spitting-Image
individuals, rendered in a body language trading upon vulgarity and scatology …
“Magna Farta” … “Broad Bottoms” … Politicians were practitioners, and the people
patients, suffering from the diseases of war, impressments, taxation and poverty …
the chief patient, of course, was John Bull … he was a typical yokel, foolish, coarse,
often drunk … In “Radical Quacks Giving a New Constitution to John Bull”, George
Cruickshank sketched the national hero, with both legs amputated (one peg is
inscribed “Universal Suffrage”, the other “Religious Freedom”) … ‘
137
Roy Porter. ‘The prince’s poison’. New Scientist 2001; 169 (2274): 42-43.
‘To some people, the lilac-petalled autum crocus is just a pretty flower, a welcome
touch of colour in a drab October landscape. The delicate blooms, known to British
countryfolk as meadow saffron or dainty maidens, spring up after the leaves have
died away. To farmers, they are anything but welcome. Every part of the plant is
packed with poisons – enough to kill a sheep or a cow. But there is one group of
people for whom the toxic nature of Colchicum autumnale is what makes it so
attractive. For thousands of years, victims of gout have relied on the lily – it’s not
really a crocus at all – to relieve the agony in their joints. But if it hadn’t been for a
prince’s royal pains, colchicum might have been consigned to history ... George, the
Prince Regent, was middle-aged, overweight and overindulgent in all departments.
Lampooned at the time for his gluttony and debauchery, George paid for his
pleasures with pain ... eventually he was swallowing 1200 drops of laudanum a day,
without relief. One day in 1817 ... the prince rounded on his doctors. “Gentlemen, I
have borne your half measures long enough to please you,” he declared. “Now I
shall please myself, and take colchicum” ... After so long in the wilderness, colchicum
was rapidly rehabilitated. In 1820, French chemists discovered its active ingredient,
the alkaloid colchicine ... Colchicine remained unrivalled for its effective and rapid
control of pain in acute gout until the advent of allopurinol in 1963.’
Roy Porter. ‘What was the Enlightenment?’ The Guardian, 12 June 2001.
Extract from Roy Porter. Enlightenment: Britain and the creation of the modern
world. Allen Lane, The Penguin Press, London 2000. Revised and reprinted in
paperback by Penguin, Harmondsworth 2001.
Roy Porter. ‘When the west wind blows’. New Statesman (London) 2001; 14 (659):
xiv-xv.
‘”This street is in the East End,” opens Arthur Morrison’s Tales of Mean Streets, one
of the great London novels, published just over a century ago. “There is no need to
say in the East End of what … But,” Morrison continued, “who knows the East End?”
Morrison’s question was what flashed into my mind when I saw Ken Livingstone’s
recent consultation document outlining his ideas for transforming the capital … In
that 100-page “bold new vision”, Ken declared he wanted to shift the axis of London’s
economy and prosperity from the west to the east. He looks in particular to the
potential of Stratford, due to become an international interchange with the opening of
the Channel Tunnel rail link … All well and good … But what does this tell us about
Ken? “All my life, the activity has been in the west,” the MP for Brent East informs
us. “Now it is the turn of the East End.” Really? Where has the Mayor been
hanging out for the past 20 years? I find it rather depressing that Ken seems to be
so eager to go back to the tired old game of playing the East End off against the
West End. The clichéd stereotyping which that involves riled Morrison a century ago
… The “East End”, Morrison hinted, was all in the mind, an anthropological artefact
populated by legendary cockney sparrers, the tribe of Fagin, and potential victims of
the lurking Ripper.’
138
Roy Porter. ‘Why historians of medicine need your help’. Health Information &
Libraries Journal 2001; 18: 137-138.
‘Dear Librarian – Future generations will need to know about medicine today, not just
for “antiquarian” reasons but often for the sake of pressing scientific, medical and
epidemiological inquiry. Those researchers will largely be dependent upon what you
do now. Sensible preservation policies must depend upon the closest possible cooperation and communication between librarians, archivists, historians and policy
makers. Future researchers will bless or blame us, depending upon how wisely we
act now. Yours sincerely, Roy Porter.’
Roy Porter. ‘Crazy for you: psychosis’. New Statesman 2002; 15 (695): 40-41.
‘Psychiatric disorders are endemic and proliferating, not only in the home and on the
streets, but also in the collective professional consciousness. Published in 1952, the
first editiojn of the American Psychiatric Association’s diagnostic manual was a slim
134 pages; the latest revision of the bible runs to a staggering 943, so many new
mutations has disturbance undergone. Now we are told that one in three of us will
need psychiatric help during our lifetime… The west has always viewed insanity not
just as a disease, but as a potential gift. Christian teachings prized the holy fool …
ancient medicine, too, held that melancholy – that is, a surplus of black bile humour –
begat the genius: a moody, broody, idiosyncratic outsider … William Blake, the
visionary, gloried in the guise of the mad artist … Friedrich Nietzsche was the
quintessence of the syphilis-tormented genius – and the model for the (anti-) hero of
Thomas Mann’s Doktor Faustus … Nijinksky turned his madness to dance … Sylvia
Plath’s Bell Jar portrayed electroconvulsive therapy as both a shocking assault and
the spur to her poetic voice … for better or worse, the positive tradition (“good
madness”) is on the way out … with pains being chemically palliated and sufferers
normalised out of chaotic genius, such developments will surely speed the decline of
the once modish conceit of mental torment as the crucible of creativity … the
confessional mode is now to the fore.’
Roy Porter. ‘In praise of folly’. BBC History Magazine 2002; 3: 12-16.
‘Modern medicine has pathologised mental illness, but in late medieval and early
modern Europe, many believed that in a “mad” world, the only realist was a “fool” …
All societies judge some people mad. Quite aside from what are considered strict
clinical justifications, grounded upon the evidence of science, medicine and the law,
it is part of the wider business of marking out the different, deviant and perhaps
dangerous … Setting the sick apart sustains the fantasy that we are whole …
Madness donned many disguises and acted out a multiiplicity of parts in early
modern times: moral and medical, negative and positive, religious and secular. After
all, man was an “amphibian”, part angel, part beast, and hence a divided self – and in
any case was fallen: no wonder his pretensions were mocked by madness … Since
Bethlem Hospital was open to visitors, the sane and the mad were there brought
tantalisingly face-to-face: who could tell the difference? … in the words of the
moralising Baptist Thomas Tryon, “the World is but a great Bedlam, where those that
are more mad, lock up those that are less”… If insanity grew medically pathologised
and, with the asylum movement, “shut up” in both senses of the term, the mad
genius … was central to Romanticism while love madness has remained a key
theme of novels and the drama. Madness can be the target of stigma, but also an
object of appeal. Therein lies the enduring mystery of what is beyond reason.’
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