Abstract
Many pathologists are visual learners. Even now, journals such as the New England Journal of Medicine make effective and regular use of medical illustrations to convey to readers the molecular mechanisms of disease. Unfortunately, for reasons of cost, our discipline makes limited use of medical illustrators. Nevertheless, a place remains in veterinary medicine for high-quality drawings, particularly in pathology, molecular microbiology, and anatomy.
I bought this book in the hope it would be a resource for teaching a course in the history of zoonotic and other diseases. I anticipated images from the pre-photography era, especially infectious diseases of the early modern period: typhoid, typhus, tuberculosis, the poxes, venereal and parasitic diseases, dysentery, and cholera. Indeed, many are represented. All images are of gross specimens. No histologic images are included.
Alas, I should have checked the author’s academic background. The author specializes in the history and philosophy of science. He is not a pathologist. The result is a lavishly illustrated, well-researched, and scholarly book that is likely to frustrate the average pathologist, even rare non-irritable ones.
The text has strengths. Chapters on skin disease (chapter 5) and soft tissue pathology (chapter 6) contain extraordinary color images of gross lesions from the nineteenth century. Advances in printing technology allowed the reproduction of drawings, color stipple engravings, and aquatints that did justice to artists’ original work. Other chapters deal with illustrations of lesioned tissue, mostly as woodcuts from the 1500s and 1600s (chapter 1), bone pathology based on dried museum specimens (chapter 2), fixed soft tissue samples (chapter 3), and early lesions (chapter 4). The book addresses the capabilities and biographies of illustrators, as well as selected surgeons, physicians, and pathologists from Holland, Germany, France, Italy, and England.
The book draws almost exclusively on monographs, which made greater use of color and high-quality images than early scientific journals. Some images appear to have been chosen for their aesthetic or shock value, rather than the importance of the condition portrayed. Several major entities are memorably represented. One, from 1833, is of a young woman in bed, asleep or dead, with widespread cutaneous lesions of scarlet fever. Another, from 1829–1835, is a color lithograph of a cholera victim’s intestines.
The main problem is the text. In spite of being a learned treatise, little effort is made to explain arcane medical terminology. Readers are confronted with, among others, terms such as dropsy, liver cirrhosis, ephelis, heart polyps, fungus haematoides, porcupine man, scrofulous formations, and more than one scirrhus. Legends for images appear to come from original monographs and are not otherwise explained. If a second edition is in its future, the book’s author might involve a physician to give context for diseases and lesions. Someone might advise that most illustrations are not pathologic, as the title states.
You may decide to buy the book for its images alone. The occasional astonishing historical image keeps students awake and may even provoke a question. But you will need access to a dictionary of obscure medical terms. A better approach, if your institution is flush, is to ask your library to buy a copy.