Untitled-9 © 1993 Nature Publishing Group AUTUMN BOOKS Maynard Smith he also argues that "only the meek can inherit the earth": unless, in opposition to what game-theory tells us, we are all more selfless we shall go the way of all flesh. To impose the altruistic spirit, we must, he insists, reaffirm religious ideals and reinstate a priest class. Is the author arguing that we should all be religious or that a controlling class should manipulate the masses by encouraging religious ideals? Either way, from an understanding of the author's possible religious inclinations, many of his opin- ions start to fit into a mould. His appeal against mechanistic views of conscious- ness and of life, for instance, have a decidedly metaphysical ring to them. Although I, and I suspect many others, can concur with many aspects of the author's ethical stance, for instance his concern for a moral standard in the treatment of animals, his affirmation of religion is to me unsatisfactory. Just as science got us into this mess, is not science the best way out? But how then, one might argue, can we expect the necessary selfless acts of martyrs and saints? Do we not need a higher ideal to inform our morality? Perhaps so, but not one, I would argue, based on unquestion- ing obedience. During the siege of Lenin- grad in 1941-42, at least nine scientists, Lee reports, at the Vavilov Institute of Plant Diversity starved to death rather than eat the seeds that they had been en- trusted to preserve. Although I find this story almost too incredible (and would like to know more), I would also like to believe that they died because of their understanding of the importance of bio- diversity. If so, then it is perhaps to these few that we must look for inspiration, for, unlike any deism, their higher ideal was rooted in solid ground. 0 Laurence D. Hurst is in the Department of Genetics, University of Cambridge, Down- ing Street, Cambridge CB2 3EH, UK. Strong medicine for weak stomachs Walter Gratzer The Literary Companion to Medicine. By Richard Gordon. Sinclair-Stevenson: 1993. Pp. 431. £18. AN odd lot, doctors. To engage from choice in the exploration of other people'S bodily orifices or shoving a fist into an abdomen full of quivering offal surely betokens an unusual cast of mind. Are they perhaps seeking to exorcise the daemons of death and disease, or is there a touch of necrophilia in some dark crevice of the psyche? Richard Gordon's excellent but unsettling anthology will do nothing to allay such suspicions, for it has much of the grisly fascination of the Hunterian Museum. It progresses from Sir Thomas Browne on the disposal of the dead - death here at its most deliques- cent, all worms and snakes "out of the spin all marrow", lixivious liquors of the body and grave wax - through Pujol the Petomane, the musical virtuoso of the anal sphincter, to George Orwell, down and out among the paupers in a Paris ward of primaeval squalor, to conclude magni- ficently with Gordon's own finest cre- ation, Sir Lancelot Spratt, the imperious surgeon in Doctor in the House. Orwell's memoir is not easily eradicated from the memory. In H6pital X (which Gordon identifies as the melancholy H6pital Vaugirard) he looks on as death releases an old man from some hideous disease, only a foot or two away: a "natu- ral" death, Orwell ruminates, such as you pray for in the Litany. '''Natural' death, almost by definition, means something slow, smelly and painful. Even at that it 380 makes a difference if you can achieve it in your own home and not in a public institution. This poor old wretch who had just flickered out like a candle-end was not even important enough to have anyone watching by his deathbed. He was merely a number, then a 'subject' for the students' scalpels .... " Powerful stuff and not for weak stomachs. More Grand Guignol, this time unfamiliar, at least to me, is a description by the Hungarian humorist, Frigyes Karinthy, writing in 1935, of his operation for the removal of a brain tumour under local anaesthetic - the very stuff of night- mares. Gordon has a keen ear for com- manding prose, and his chosen passages from Melville, Trollope, Flaubert (trans- lated by himself) and Robert Louis Stevenson are guaranteed to bring up gooseflesh or make the gut heave. There are gruesome narratives from fiction and fact of the deeds of the Resur- rection Men, though Jeremiah Cruncher from The Tale of Two Cities does not appear, nor yet the reprobates who rob- bed the dead on the Napoleonic battle- fields of their teeth to grace the dentures of well-heeled parties back home ("Waterloo teeth" they were called). He includes some fragments of verse by George Crabbe, but not the poet's story of how, when he was a medical student, his landlady found a dead child in a cupboard in his room, which she conviced herself was her own recently departed William. In France there were no Resurrectionists: the bodies of those who died in hospital and were not claimed within the day were rushed to the dissecting rooms. As to these, I would have included the lurid account by Hector Berlioz of his first day as a medical student in one such charnel house. Eugene Sue was another who described these and other loathsome aspects of life in the Paris of the poor during the last century. To list omissions is too easy of course, and probably otiose, for a good anthology has to reflect the tastes, literary and historical, of its editor and nobody else. All the same, while I found it hard to relate the extracts from Brillat-Savarin, Malthus, Jane Austen and one or two others to medicine (not of course that they are any the worse for that), I did rather miss A. J. Cronin, Francis Brett Young and Axel Munthe, all celebrated for their tales of the medical life in their time. No doubt Gordon felt the style to be too faded for the robuster tastes of today. But then Gordon scores a wholly un- expected winner with a clutch of Victorian lady novelists, all of whom laid aside the stethoscope for the pen. The extracts, which could adorn a Stuffed Owl of prose writing, will leave Messrs Mills and Boon reeling. Gordon's choice of verse includes broad swathes of W. E. Henley - surprisingly affecting on his long years as a patient - and of Robert Bridges, the doctor poet laureate (the subject incidentally of one of the great newspaper headlines, which appeared after he had failed on his arrival in New York to recite for the reporters who greeted him at the dockside: "King's Canary Won't Sing", it proclaimed). Gordon does not mention Bridges' ac- count of life in the outpatient clinic at Bart's, where the average invalid received 1.28 minutes of attention, even if at death's door, and the casualty doctor 0.7 pence per examination. For my part, I think I should have included Thomas Hood ("I vowed that you should have my hand/But fate gives us denial/You'll find it there at Mr Bell's/In spirits in a phial" ... and more in this vein), and perhaps a restorative dash of Belloc? Or among more modern and substantial figures, there are William Carlos Williams and Danny Abse, who both drew inspiration from their doctoring. But perhaps more typical was Sir John Hill, MD, playwright, who lives on in Garrick's celebrated epigram: "For physic and farces his equal there scarce is/His farces are physic; his physic a farce is." You will not find the hapless Hill in Gordon's pages, but there are riches in plenty and catharsis for all; and if you are of a nervous or hypochondriacal disposition, then take comfort from Napoleon's observation at a low point in his life: "Well, at least there is always death". 0 Walter Gratzer is in the MRC Muscle and Cell Motility Unit, King's College London, 26--29 Drury Lane, London WC2B 5RL, UK. NATURE . V0L366 . 25 NOVEMBER 1993 Strong medicine for weak stomachs