Medical London: City of Diseases, City of Cures
By Richard Barnett and Mike Jay
Strange Attractor Press and Wellcome Institute, £14.99, 500 pages
FT Bookshop price: £12.79

It is rare to be able to review not just the contents of a book but also the way it looks and feels. Medical London comes in a cloth-bound slip case that contains a book of essays and a series of fold-out maps that detail six medical walks around London, as well as a hardback directory of the main sites and addresses throughout the city.

As a book of many different parts, it is the perfect reflection of its subject matter: the history of London and medicine. Like two white-aproned anatomists, debut author and historian Richard Barnett and seasoned chronicler of madness, medical experimentation and drugs Mike Jay stand above the still-breathing body of the city. Through a careful reading of the lesions, scar tissue and marks, they record a full history of the sickly patient.

What they reveal is more than the expected symptoms of epidemics and quackery that have stalked the streets of the capital for centuries. They unveil a new and thrilling pathology – the city and the patient are one and the same: changing attitudes to disease have often influenced the city, while ideas about what the city is have guided the hand of the doctor by the bedside. The anatomists’ report proves that medicine is not just a science, that urban living is not solely an art.

Medical London encourages the reader to enjoy the city to the full. One of the walks in the collection recreates a day in the life of an 18th-century medical student. It reminds us how packed is that small quarter of London from Blackfriars to Smithfields: within an hour’s stroll you encounter signs of medieval therapies, the Great Fire of London, the old ale houses used by the grave robbers known as “resurrection men”, Newgate Prison, where hanging continued outside the gates until 1868 (the local pubs offered hanging breakfasts) and even the former site of Rackstrow’s Museum of Anatomy and Curiosities, which had an unusually wide collection of wax models of genitalia.

Walking the city is a type of reading, and Burnett and Jay are excellent guides but their box of medical delights also contains a thorough and entertaining history of medicine in the metropolis. It is a narrative of disease, freakery and awkward negotiations between sympathy and profit.

The city is a body. When Christopher Wren devised his new plan for the capital after the Great Fire of 1666, he was thinking as much of experiments on the circulation of the blood as he was of architecture. His youthful tests of injecting spaniels with alcohol had a profound influence on how he planned the modern city.

Similarly, the poet William Blake saw that living in a city was a form of sickness; surprisingly, Jane Austen’s Emma would agree when she said “nobody is healthy in London, nobody can be”. This same attitude determined the Victorian clearances of the 1860s when the Metropolitan Board of Work attempted to cure the city by knocking down the rookeries and slums, making way for new shiny highways and tenement buildings.

Medical London reminds us that caring for the city’s ill has never been simple. In particular, defining and treating London’s mad has always been about finding the divide between everyday madness and insanity. This dilemma is summed up in the sigh of the 17th-century Bedlam patient Nathaniel Lee, whom we meet here: “They called me mad, and I called them mad: damn them, they outvoted me.”

On the other hand, feigning sickness can turn a profit: Mary Toft, for example, in 1726 claimed to have been startled by a hare early in her pregnancy and had given birth to 15 baby rabbits; she convinced even George I’s surgeon of the miracle.

Yet we’re also called to spare a thought for the physicians, apothecaries, barber surgeons and exhausted housemen who have tried to treat us for the last 2,000 years; some better than others. Among the city’s medical heroes is John Snow, who in the 1840s proposed that cholera was waterborne rather than in the atmosphere; he demanded that the handle of the pump on Broadwick Street in Soho be broken off so no one could draw the contaminated water. He won, and saved a whole community. You can see the pump today, still without a handle – just follow the Soho walk in Medical London, “The Pox and Pleasure”.

Leo Hollis is the author of ‘The Phoenix: St Paul’s Cathedral and the Men who Made Modern London’, published by Weidenfeld & Nicholson

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