William Pulteney Alison, the Scottish philosophy, and the making of political medicine

This article considers the public health and social-reform agitations of Dr. William Pulteney Alison (1790-1858), professor of medicine at Edinburgh University and leader of the Scottish medical profession, in the context of Scottish moral philosophy. Throughout his career, Alison reflected on what has come to be recognized as a central problem of social medicine: where did its domain end? At what point did the medical mission of identifying and eliminating factors that harm health pass into a non-medical domain-the provinces of political economy, individual liberty, participatory politics, or acceptance of nature's dictates? On these issues Alison was an expansionist, relentlessly pushing back the borders of medicine. Drawing on Alison's writings on such disparate topics as the philosophy of mind, the epidemiology of infectious diseases, and modes of agrarian organization, the article argues that the trajectory of much of Alison's work was to discover the structural implications of a comprehensive biological reading of human capacity and behavior. It is therefore appropriate to see him as a promulgator of a political medicine, which he presented as a critical alternative to the classical political economy of the Scottish Malthusians. The article concludes by suggesting that Alison's work (and influence) have been under-recognized and remain pertinent to modem social epidermiology, public health, and medicine more broadly.