In the past, the connection between medicine and literature was spontaneous or natural, arising from the general education that all doctors had received, combined with their experience of human existence, an experience that was necessarily wider, deeper, and more varied than that of most people. Doctors are privy, after all, to their patients’ deepest secrets, but at the same time retain an attitude of objectivity. No situation could be more propitious for a writer.

But if no one is broadly educated or cultivated, that is the end of broad education and cultivation itself. We will be reduced to a society of technocrats, each absorbed in their own narrow specialism. Notwithstanding the horrible example of Hans Frank, this is not a state of society to which I look forward. Apart from anything else, some among us will be specialists in the exercise of power, against whom the rest of us will be defenceless.

Perhaps the greatest, because unintended, tribute to the triumph of modern medicine is the number of detailed literary accounts now published of illness experienced by patients or witnessed by their relatives: for writers choose as subject matter what strikes them as out of the ordinary or worthy of note. Where illness rather than health is quotidian, therefore, accounts of it will not be frequent. Only where good health is assumed to be normal, the default setting of the human frame, as it were, will the experience of illness be thought worth writing about.

The similarities, both in causes and effects, were startling. I will just take a few of them at random.

In France, as in England, recent governments have made education a supposed priority. They have done this for the same ostensible reasons: standards have been falling despite vast state expenditures, such that about 20 per cent, perhaps more, of French children leave school unable to read, write or reckon with facility. Reforms are introduced one after the other and abandoned in favour of yet other reforms before they have time to fail. Every such reform has its accompanying rhetoric, promising to raise standards, promote equality and prepare children for the outside world. None ever works, except in the sense of providing bureaucratic employment.

Illiteracy has been actively promoted by the use of whole-word teaching methods, so idiotic that that they could be have been dreamt up only by a leisured professoriat in search of occupation. Spelling and grammar have been deemed oppressive to the lower orders, whose natural creativity is stunted by them. The result has been a general decline in accomplishment, even in the higher reaches of the system: entrants to the Grandes écoles now commonly make spelling errors that would have been unthinkable only a few years ago.

Though he has often noted the disastrous effect of mass fatherlessness, Dalrymple expresses his discomfort with David Cameron’s official criticism of it, in today’s Independent:

Sentimentality is frequently the reverse side of the coin of cruelty, and this was shown by Mr Cameron’s call in the same article for the stigmatisation of absent fathers. It is one thing for stigma to arise spontaneously from a society’s shared mores, when such stigmatisation may be for good or evil, or some mixture of both. But it is quite another when the head of a government calls for it.

Are we to have a National Stigmatisation Agency, complete with public denunciation ceremonies, to which admission could be charged? This might help to reduce our deficit, but it would be very nasty.

In resorting to the sentimental use of his own happy relations with his father, Mr Cameron was implicitly expressing contempt for the people of his own country, whom he thereby deemed incapable of grasping an argument about the desirability of fatherhood for children without the aid of Hello! magazine-type illustrations. This is to reduce our politics to the intellectual level of American tele-evangelism.

Before long the right to assisted suicide will be interpreted not as the right to find someone who will provide you with an easeful death but the duty of the health service to kill you on demand. And if you have a right in this sense to death someone has a corresponding duty to kill you.

It sometimes seems as if the respect given to doctors, or at least to doctors’ orders, is inversely proportional to the state of medical knowledge. The more we know (as a profession, I mean, not as individuals), the less uncritically we are believed.

The best known book of Ford Hermann Hueffer (1873–1939), who changed his name to the less Germanic sounding Ford Madox Ford, was The Good Soldier. It is an exceedingly complex love story, first published in 1915, and is more eternal octagon than triangle. It would be an excellent intellectual exercise to summarise it in, say, 30 words, but I won’t even try.

However, heart disease, or alleged heart disease, plays a large part, as well as the self confident but ignorant pronouncements of doctors. Two of the four most important characters are supposed to have such disease. Edward Ashburnham, a philandering British officer, supposedly has heart trouble: “a heart,” in the parlance of the day, brought on by “approximately, polo, or too much hard sportsmanship in his youth.”

He who expects honesty in advertising expects palm trees in Antarctica and penguins in the Congo: in other words, marvels never to be found. Though many know this, however, many are influenced by advertising, and the two groups probably overlap. People are inclined to believe that because there is no smoke without fire, no encomium can be entirely without foundation.

This is particularly true of advertising of patent medicines. I happened recently, for research purposes, to be leafing through a provincial newspaper of the 1840s, much of the advertising space of which was occupied by encomiums to patent medicines. The advertisement for Lord Eldon’s aperient pills, for example, starts with a quotation from John Abernethy, late surgeon to St Bartholomew’s: “Habitual costiveness, I have no hesitation in saying, is the foundation or forerunner of every disease to which the human frame is subject.”