The Greatest Benefit to Mankind: A Medical History of Humanity

The Greatest Benefit to Mankind: A Medical History of Humanity, Roy Porter, W.W. Norton & Company, New York and London, 1997, 831 pages.

The Greatest Benefit to Mankind takes the reader on a wild ride through the history of medicine from the ancient world through the present day.  Porter is the author of another book entitled Blood and Guts, which is the short version of this lengthy tome.  Oft’ was the cure worse than the disease.  Blood flows freely through this gruesome story.  Porter tells a good story that is bursting with gory detail.  The long litany of human suffering and the barbaric-seeming efforts to alleviate it, is relieved frequently by, I hesitate to say, side-splitting anecdotes which are often really gross.  If we in the 21st century have been brainwashed into believing that modern medicine will deliver us from evil once and for all, Porter puts some sense into our gullible heads.  A good history of medicine like this one reminds us that we are on a continuum of ever-changing knowledge, that today’s shining truths are tomorrow’s embarrassments.  In the end, Porter, a British historian who died unexpectedly in 2002 at the age of 55, rails against the  medical establishment which is forever probing and poking an idolatrous public, looking harder and harder for disease.  He writes:

The irony is that the healthier western society becomes, the more medicine it craves — indeed, it regards maximum access as and a right and duty.  Especially in free market America, immense pressures are created — by the medical profession, by medi-business, the media, by the high-pressure advertising of pharmaceutical companies and dutiful (or susceptible) individuals – to expand the diagnosis of treatable illnesses.  Scares are created.  People are bamboozled into lab tests, often of dubious reliability.  Thanks to diagnostic creep or leap, ever more disorders are revealed….

The root of the trouble is structural. … Doctors and ‘consumers’ are becoming locked within a fantasy that everyone has something wrong with them, everyone and everything can be cured.

Medical consumerism — like all sorts of consumerism, but more menacingly — is designed to be unsatisfying.  The law of diminishing returns necessarily applies.  Extending life becomes feasible, but it may be a life exposed to degrading neglect as resources grow overstretched and politics turn mean.  What an ignominious destiny if the future of medicine turns into bestowing meagre increments of unenjoyed life!

Throughout medical history there are many moments of triumph to be sure.  It was not so very long ago that humankind acquired a complete knowledge of human anatomy and came to an accurate understanding of what all our organs and body parts do and how they thrive.  Many bacterial diseases reared their ugly heads as advances in transportation allowed people to travel further and faster.  Antibiotics cured many of these dreaded diseases that were introduced into new populations because of accelerated travel and the expansion of cites often provided the perfect breeding ground for deadly epidemics.  Anesthetic and antibiotics combined to elevate surgery from a barber’s butchery to a relatively safe intervention.  Porter does a brilliant job of putting it all in perspective.  He has an amazing command of detail and is a spellbinding storyteller.

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