10 years ago, I took a GCSE history course on Medicine through Time, which was so engaging for me that I now credit it as part of why I ended up studying science communication. Since then, medical history has stayed as one of my cyclic background interests.
Quackery aims for a tone somewhere between a medical history textbook and a standard popular-science narrative, then strikes that note precisely throughout. It focuses on information about historical treatments, figures and ideas, rather than any autobiographical elements or personal narratives. Because Quackery is so consistent, it skirted the edge of monotony when I read much of the book in one sitting. However, the authors’ quick pace, and their frequent dry-humoured side notes and reactions, liven up the text.
“Edinburgh physician James Young Simpson was another nineteenth-century pioneer in anaesthesia. That is, if pioneering meant inhaling random substances with your colleagues, just to see what would happen.”
Because it’s been a long time since I first became interested in medical mishaps, I had already learnt about many of the individual inventions and beliefs mentioned in Quackery. This left me slightly disappointed because less of the book was new to me than I expected. However, that’s not a criticism of the book or of the careful research behind it.
After reading a large chunk of Quackery in one day, I noticed a pattern at its core: most of its stories followed two main themes. In many stories, a person watched one specific substance appear to cure one person’s illness. Then, they extrapolated too far and assumed the substance cured every illness in everyone.
“After Hippocrates and Galen, we begin to see more and more evidence of leech use for everything from removing evil spirits (Themison of Laodicea) to treating hearing loss (Alexander de Tralles). One medieval physician even claimed that “it sharpens the hearing, stops tears,…and produces a musical voice”. If only we could all just apply a squirmy bloodsucker and became Beyoncé.”
In the others, a person developed an idea about how illness works, then doggedly advertised their idea regardless of how often evidence failed to support their idea. To me, it seems like Quackery would have been more memorable if the authors had highlighted or discussed the patterns lying dormant under these individual cures and theories.
The authors’ descriptions of past medical practitioners and theories can feel surreal, as seeing practitioners casually disregard the idea of testing their cures or getting actual evidence for their beliefs goes against everything we associate with medicine today. This is especially true for what we see as fundamental rules like cleaning your hands before operating on patients. Surgery was hundreds of years old before someone spotted that far fewer patients died on wards with nurses who washed their hands: even then, people ignored that evidence for years.
These “common sense” failures drive home how terrifying every illness (and every cure) used to be. Quackery will make you feel renewed gratitude for modern medicine. Despite this, Quackery falls short when discussing current medical practices. Each chapter ends with a half-page summary that explains whether the treatments discussed have been replaced or whether they are still used in rare cases. Because these summaries are so brief, they have no room for complexity; their usual message is “modern medicine knows better now, and we don’t do these practices any more”.
The authors paint an idealistic picture of medicine as a discipline that has learned its lesson and atoned for its past. Unfortunately these Utopian reassurances didn’t sit right with me, thanks to other books and articles I’ve read. Last year I discovered the AllTrials project, which collects data about the money clinical trials of treatments which simply disappear from record because no-one reports their results. Other books I’ve started recently show how modern medicine frequently ignores opportunities to get the evidence for straightforward questions, and how treatments which lack evidence can be overused to the point of causing harm. While medicine is drastically better than it was in the past, there are still many improvements left to make, so Quackery’s rosy view felt a little shallow to me.
Quackery aims to be a compendium of interesting stories and facts from medical history. It aims to be both factual and humourous, and it delivers on both goals. It offers facts and historical anecdotes, written concisely and with care. It seems well-researched and trustworthy. However, I can’t help wishing it had done just a little more and aimed to elucidate as well as to explain. Quackery offers strong explanatory writing but if it had dug into the patterns it explains, and examined how they have weaved through centuries, it would have been more powerful and lasted for longer.