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JISS Book Reviews

Medics and Sceptics
Liz Neesam (University of Aberdeen)
A review of
Roger L. Emerson, Essays on David Hume, Medical Men and the Scottish Enlightenment: ‘Industry, Knowledge and Humanity’ .
(Farnham: Ashgate, 2009). ISBN 978-0-7546-9338-3, Hardback, 316pp, £63.

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In this recent collection of essays, Roger L. Emerson has pursued a broad study of the Scottish Enlightenment within the context of enlightened thought across Europe.  Under the banner ‘Industry, Knowledge and Humanity’, Emerson focuses upon the enlightenment history of Scotland in three key areas; the contribution of David Hume and Archibald Campbell to intellectual life and the importance of patronage; the contemporary response to matters of religion; and the development and economic impact of a medico-scientific culture.  This latter aspect is one of particular interest, situated as medicine was not only between the scientific revolution of the earlier century and the rise of  the laboratory in the nineteenth century, but also by its prominence in contemporary economic life and the tensions that existed between the intellectual elite and the practical application of medicine, both orthodox and heterodox.

A constant thread running through the volume is one of the Scottish Enlightenment as a fundamentally practical movement. Emerson argues that although the many intellectual and associational spaces that gave voice to enlightened thought were primarily urban, this gave rise to attempts to improve almost everything.  However, whilst he is at pains to recognise the universal practical intent behind the theorising, Emerson focuses upon Edinburgh, with lesser billing from the other major university centres, and offers little on the wider society and the impact of enlightenment upon the bi-lingual tradition of Scotland.            

Of the ten essays in the collection, four are specifically about Hume, now recognised as one of the world's greatest philosophers, and each essay offers a very useful introduction to the life and work of this 'most excellent and never to be forgotten friend' . Emerson analyses Hume's life and experiences to explain his religious scepticism and the intellectual development of his moral and political theories, much of which is a well-travelled path. It is when Emerson considers the motivations and nature of Hume's interest in history in 'Hume's Histories' (pp.127-154), that a more piquant note is raised.  Emerson's basic premise is that Hume used his six-volume series, The History of England (1754-1762), to embed the moral, political and economic messages that he believed were necessary to re-energise a moribund Britain. His Histories, Emerson states, are now  acknowledged as 'one of the four or five great histories written in the period c.1650-1800' (p.100), and are of interest not only for their  style, but the revelations they offer of Hume's intellectual development and opinions.           

Collectively, the Hume chapters not only provide a broad analysis of the great man which take us beyond the familiarity of Hume the philosopher and political theorist, to expose and explore his economic realism and religious scepticism, but Emerson adds colour to his character and life. In terms of contemporary impact, he advises that Hume had audiences not only at home in Britain, but across the Channel and the Atlantic, reaching the attention of influential men of note both in Europe and America. Hume, the much admired man of letters, states Emerson, is now recognised  to have 'cast a long shadow' (p.101).           

Medicine, whether in practice or in the context of the much vaunted Scottish medical educational system is writ large as a feature of the enlightenment landscape.   Emerson's study of the Scottish medical tradition in 'Numbering the Medic' (pp.163-224), offers a refreshing venture into a much underdeveloped facet of the Enlightenment; a situation recognised some years earlier by Charles W.J. Withers and Paul Wood   who called for new directions in the study of science and medicine, to better inform the sense of unity and utility they contributed to the public and associational culture of eighteenth-century Scotland.                  

Yet, whether discussing the tradition of Scottish medical men, Scots medics trained in the continental tradition, or the impact of Archibald Campbell's patronage, a theme Emerson concentrated upon in his earlier work, Academic Patronage in the Scottish Enlightenment (2008), a paradox emerges.  Whilst the economic powerhouse that Scottish medicine became is a well recognised phenomenon, Emerson highlights the difficulties of confidently approximating the numbers that negotiated the medical educational system in its various guises from university training to apprenticeships and the challenges in establishing the origins of these medics, where they went to, and thus the differences they made along the way.            

In 'Numbering the Medics', Emerson has harnessed to his cause, a broad range of extant studies on the student cohort who received their medical education in Scotland.  He complements these earlier researches with a dazzling and complex range of extrapolations, associations and speculations to suggest that the numbers of Scottish medics have been historically understated and that as many as c.5,500 Scots and c.8,400 'outsiders' may have received their medical education in Scotland throughout the period (p.175 and p.178).            

Whilst such an approach will attract attention, his research underlines previous studies that explore the economic arguments that lay behind the development of the medical schools in Edinburgh and Glasgow.  It is well understood that the two cities benefitted by attracting students from England, for whom Oxford and Cambridge Universities were unavailable due to their religious affiliations, whilst the adoption of the Leiden model, with its practical bedside teaching, and the cheaper lecture fees also attracted those from further afield including Ireland and America.            

However, whilst Emerson identifies aspects of the direct economic benefits achieved and indeed as an intellectual and practical export, Scottish medicine was arguably unparalleled, the wider economic and intellectual impact of Scottish medical education proves a much more elusive and problematic calculation, and one which remains unresolved.    Equally, Emerson's research into medical destination is interesting, but unbalanced, with a greater focus upon the transatlantic flow than that which spread to the Indian subcontinent or the Caribbean, which is unfortunate. He appears to recognise this however, in his catch-all conclusion that the period can benefit from further study. Research into medics graduating from the Scottish system, the paths they followed and their impact on the populations they served, both medically and in a broader politico-cultural context, would indeed be a valuable addition to this field of study.  Overall, Emerson, an eminent and respected scholar, has produced a valuable and informative contribution to the Enlightenment canon; even so, this is a book which challenges other researchers to pick up the threads that he tantalisingly trails.

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