Neue Wege in der Seuchengeschichte

to 1842 in order to produce this comprehensive account of medical aspects of the early U.S. Navy. His principal sources are those familiar to any historian of a government bureaucracy-official correspondence regarding complaints, accusations, petitions for promotion, ship inventories, and pension allotments. Private letters, diaries, and trial reports supplement this rich trove of detail, and provide the author with many individual stories of bravery, injustice, competence, and debauchery. Yet this very richness in part betrays the author, for he is prone to get lost in these tales, and after recounting a string of such vignettes, moves on without drawing conclusions about the era under discussion as a whole. There are many trees sketched with fascinating detail, but the forest remains amorphous. Langley begins his story in 1794, when the Federal government first commissioned frigates for a "proto-navy" and assigned surgeons to them, and ends it in 1842, when the navy was reorganized into five bureaus, including the Bureau of Medicine and Surgery. He recounts the major points of growth for the navy, and hence its medical department, in between-the quasi-war with France in the 1790s, the struggle against the Barbary pirates that followed, the War of 1812, and drive in the 1820s and 1830s to reform the navy and its medical corps. His account of the origin of the Marine Hospital Service, the first federal health care programme in the United States which covered the civilian merchant marine, is one of the most detailed and insightful that this author has seen. It is unfortunate that the parallels between its story and that of the naval medical system are dropped soon after they are raised. Indeed, the early professionalization of the naval medical corps after the War of 1812, with its exams, degree requirements, and higher pay, is a remarkable fact that is best appreciated by contrast with the Marine Hospital Service (which reached this level only in the 1870s) or the feeble efforts at reform postulated by the fledgling American Medical Association in the late 1840s. Langley's evident lack of familiarity with American medical historiography outside the field in naval history limits his ability to make these comparisons, and draw interesting conclusions from the wealth of detail which encumbers this book. There is little grasp of nineteenth-century medical theory evident in Langley's discussion of therapeutics and etiological thought. At some points he feels the need to challenge the accuracy of …