Book: A Physician Reflects: Herman Boerhaave and other essays
Authors: Boleslav L Lichterman
Journal: BMJ (2004)

In this, his second volume of essays, Christopher Booth covers a range of topics across three centuries—from the life and work of Herman Boerhaave (1668-1738), who wrote the first modern medical textbooks and implemented clinical teaching in Leiden, to the changing concepts of health and disease during the 20th century. Like his 18th century predecessors Booth believes “that it was science that could best improve the healing art” and reminds us that the word “physick” was defined by Samuel Johnson in the first edition of his dictionary as “the science of healing.” Booth the historian is particularly interested in the Age of Reason, and five of the 15 essays are dedicated to 18th century British medicine and society.​society.




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Wellcome Trust Centre for the History of Medicine, £15/$24, pp 214 ISBN 0 85484 093 1 www.ucl.ac.uk/histmed/occasional.html

Rating: ★★★




Roy Porter, who reviewed Booth's first collection of essays, Doctors in Science and Society: Essays of a Clinical Scientist (BMJ 1987;294:1681), described him as “a tireless evangelist for clinical research.” Booth the witness included in his book personal records of his professional life as a clinical scientist. His specialty was gastroenterology, which was influenced by developments in science and technology after the second world war. Booth describes the most important discovery in his field as the understanding of fluid and electrolyte balance, which led to cholera mortality being reduced from between 20% and 40% to less than 0.5%. Booth disagrees with sceptics who declare that the age of optimism has ended, because “optimism is a feature of human condition.”

In the 1950s Booth discovered that vitamin B-12 is absorbed in the ileum. But what is discovery? Booth humbly agrees that, unlike a creation of art, scientific discoveries should be repeatable. That is why there are many examples of rediscovery in the history of medicine and why precedence is so important to many medical historians.

Booth the editor knows that publication in obscure journals and in languages other than English may be the reason why original discoveries are neglected. When he was a student he wrote for Chiasma, the official publication of the St Andrews University Medical Society. The new journal, he wrote, was to be “a record of the past, an observer of the present, a prophet of the future and an inevitable excursionist in the realms of fantasy.” Half a century later his concept of a medical journal has not changed. A Physician Reflects has two essays that are a must for anyone involved in medical publishing. The first (“'Publish and be Damned': Medical Literature, the Old and the New”) is a story of the publication of medical journals in Britain and the United States, with special reference to the Lancet and the BMJ. He describes how the founding of a journal plays a key role in the specialisation of medicine. The second essay (“A Gastroenterologist among the Editors”) provides interesting details of Booth's career in medical journalism in different capacities: author, reviewer, and editor (he edited Gut). He gives useful hints on how to deal with negligent reviewers and how to review books: “It is a wise rule never to write a review that is totally destructive.” He describes a funny hoax that was played on him: “When Gut was sent a paper entitled `Scanning electron microscopy of the surface of the normal human stool,' I have to confess—and it may have been unworthy—that I had my doubts. The aspiring contributor to whom I expressed those doubts, a fibre buff, responded by sending me a bag of bran.”

Booth tells a story about Dr Anthony Fothergill (1736/7-1813), who asked in his will that a funeral sermon be preached on the text, “Let us work while it is yet day for the night cometh wherein no man can work.” Let Booth's day last longer. Let us wait for the third volume of his essays.