Abstract
The name of Sir John Pringle (1707–1782), the subject of Morrice McCrae’s biography, may be familiar to Edinburgh medical graduates as one of their own numbers, but St. Andrews can lay claim to him for his early education. Leyden and possibly Paris completed his medical training. Returning to Edinburgh, he was invited to join others in revising the Edinburgh Pharmacopoeia, thereby drastically reducing the number of acceptable medications. Although only those of apparently proven efficacy were retained, millipedes, beetles, spiders, and unicorn horn remained on the list.
His income in Edinburgh being meagre, Pringle improved it in 1742 by obtaining an invitation to the War of the Austrian Succession, rapidly becoming Physician-General to the Army. During the campaigns in the Low Countries and Germany, he reduced the disease mortality of the British Army through improved organization of hospitals. This included controlling the referral of patients from regimental infirmaries to the larger General Hospitals, the siting of hospitals in what he perceived to be the healthiest locations, eliminating overcrowding, improving ventilation, and ensuring adequate staffing. (Are some of these themes familiar today?) Pringle’s time in Europe and further experience in the ‘45 campaign in Britain gave him the material for Observations on the Diseases of the Army (1752 and many later editions), the influential work which underlies much of Morrice McCrae’s book. Pringle produced a sophisticated review of fevers, concluding that hospital fever and jail fever were the same condition, probably what we know now as typhus.
Having forsaken Edinburgh by 1748, Pringle achieved further distinction in London as a popular doctor, Physician to George III and President of the Royal Society, while continuing to advise the army. By diverting from Pringle’s life at frequent intervals, McCrae gives us a painless introduction to, or reminder of, concepts of disease and medical treatment prevalent in the 18th century. He covers the basics of humoral medicine and mentions the greats of Hippocrates, Galen, Paracelsus, Pringle’s teacher Boerhaave, and many others all doctors should know about. On the way McCrae gives us the army movements in the campaigns of the Earl of Stair, the Duke of Cumberland, Frederick the Great and others, as well as the early history of the Royal College of Physicians of Edinburgh, and a slightly muddled account of Maskelyne’s gravity observations of the mountain Schiehallion.
There are many other diverting historical digressions, but one has to come back to Pringle, who sometimes appears only in the background of this book. Pringle left a second major work, embargoed until recently, the 10 volumes of his Medical Annotations held in the Royal College of Physicians of Edinburgh. McCrae devotes only eight pages to this work, citing a few descriptions of common diseases, possibly from only one volume. After the rollick through the 18th century and earlier times, most medical readers would wonder if McCrae could not have given us more of Pringle’s medicine, even if the man himself must remain elusive.