Flesh in the Age of Reason: The Modern Foundations of Body and Soul - Hardcover

Roy Porter was professor in the social history of medicine at the Wellcome Trust Centre for the History of Medicine at University College, London.

Roy Porter died too young. One of the most distinguished and prolific medical historians of the day, Porter had recently taken early retirement from the Wellcome Trust Centre for the History of Medicine at University College London when, in the spring of 2002, he collapsed while riding his bicycle and died at the age of 55. This book, alas, will be his last. (Figure) And what a book it is. Porter takes us on a romp through the long 18th century, exploring ideas about health and disease, ruminations about the soul and what awaits us after death, reflections on the declining role of religion, and conceptions of the relationship between the human mind and the body in which it resides. After an early chapter devoted to the time of Hippocrates and Galen, this lively and erudite book centers on English sources, both familiar and little known, from the Glorious Revolution of 1688 to the rise of Romanticism in the 1800s. Readers should not expect a single, linear path of argument. Instead, Porter combines a broad set of questions with fine-grained detail about the day-to-day world his many subjects embodied in some instances and created in others. He gives us particularly insightful readings of autobiographies and first-person novels that are "preoccupied with the relations between the body and the consciousness belonging to it." His careful, innovative analysis of a wide range of sources alerts us not only to what is present but also to what has been omitted. Even though there is an 80-page, double-columned bibliography, Porter's death meant that his editors were not able to locate the precise editions from which the numerous quotations were taken. There is much here for readers of the Journal. We learn about the creation of dividing lines that today are taken for granted; some founders of modern science, for example, tried hard to prove the supernatural through science. We read about debates over whether the mind can exist without the body and how the mind can divert attention from the ailments of the flesh. Porter gives us much detail (perhaps more than some readers would want) about the travails of the flesh in the 18th century. The Earl of Shaftesbury was troubled at the dawn of that century by the "squalor of snot," and he debated with Bernard de Mandeville, a physician-satirist who grappled willingly with the realities of the flesh and its many emanations. But both men, like others of the day, put aside the religious emphasis on managing the body that had characterized earlier learned discussions. As religion receded in relevance, clergymen gave way to physicians at the bedside in the management of death. Some aspects of the world that Porter describes presage issues and customs of the 21st century. Santorio Santorio, who did early work on the thermometer, lived in a balance machine, weighing his intake and output, measuring, measuring everything. He was followed a century later by Lord Byron, an exercise fanatic who mastered his body through a regimen so rigorous that not an ounce of excess flesh remained. Corpulence became undesirable, the slim look became popular, and long before our current understanding of obesity took root, a cult of thinness had developed, from which we have not yet emerged. Eighteenth-century critics shared our contemporary concern about overpopulation. William Godwin trusted individuals to solve the problem, believing that as medicine enabled people to live forever, sexual urges would abate and reproduction would thus cease. Perhaps the most poignant part of this book comes in Porter's discussion of the great historian and autobiographer Edward Gibbon, author of the classic, six-volume Decline and Fall of the Roman Empire. Gibbon suffered from a whole host of painful and obvious ailments. But those ailments were merely of the body, subordinate to the life of the enlightened mind. Gibbon did not believe in an immortal soul, but he hoped that his Memoirs would mean that "one day his mind [would] be familiar to the grandchildren of those who are yet unborn." As Porter observed, "His mind will thus live on" through his immortal words. One could make the same observation for the words of Roy Porter, and for that we all should be very thankful. Joel D. Howell, M.D., Ph.D.
Copyright © 2004 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.