The American medical ethics revolution

inconsistencies in the quality, style and intention of the essays. Some contributors content themselves with quite straightforward empirical narrative; others have felt theoretically (or speculatively) more ambitious. Scholarly authority is likewise occasionally uneven. In this respect, however, the principal fault often does not lie with the individual authors. A number of contributors (Hall, for instance, Charles Webster on the welfare state, Joel Howell on hospitals) have been fortunate enough to be allocated subjects upon which they have already researched and published extensively. Some of the essays are on events or episodes upon which we have a reasonable historical perspective (Michael Worboys on tropical medicine is a good example) because they took place largely in the first, rather than the second, half of the twentieth century. A few authors have, however, been asked to take up the challenge of areas of historical research in which both they and the medical history community as a whole are comparative novices. Thus Cantor makes many thoughtful observations about the 'Diseased body', but he is unable to offer much in the way of convincing general conclusions. Not his fault, as I say, just a reflection of the overall state of scholarship. Warwick Anderson, on the 'Third world body', likewise sets out an agenda for further research. It is inevitable also that, despite the range and scope of the essays, one can readily point to lacunae. There is, for example, no chapter on the history of medicine itself (although there are some interesting remarks in the introduction) nor one on medical sociology. Thus the rise of learned discourses that are about medicine but not wholly of medicine-surely a notable, and virtually a distinctive, feature of the twentieth century is not described. In conclusion, one can virtually unreservedly applaud the ambition and achievement of Medicine in the twentieth century. By any reasonable standard, it constitutes a magnificent historiographical accomplishment. It will, I have no doubt, be a fixture on library shelves and student reading lists for several decades of the twenty-first century. But it is telling that, in Chapter 1, Pickstone does not fully address the other major research question he poses, namely how best to describe twentiethcentury medicine in terms of the perspective of a longer history of medicine. Thus, as far as the definitive historical character of twentieth-century medicine is concerned, one must concur with the proverbial Chinese Sage it is too early to say.