Medical America in the nineteenth century. Readings from the literature

American medicine was derivative in its origins. Beginning as an element of a culture brought from Europe by the first settlers, it was influenced by European sources and trends throughout much of its evolution. According to Dixon Ryan Fox, cultural transfers of this kind occur in four stages. First, a few educated in the mother country emigrate to the new settlement; then, the colonial youth are drawn back to the mother country for training; in the third stage, schools are established in the newly settled country but numerous students and teachers are still educated abroad; the fourth stage is present when the educational establishments of the younger country become independent and attract students to themselves. Focusing more specifically on American medicine, Richard H. Shryock divided its development into five chronologic periods, of which three are of particular interest here. These are: the "Second Century, 1720-1820: Speculative 'systems' of pathology and heroic practice; The Middle Period, 1820-1870: Advent of 'modem' pathology and clinical studies; The Germanic Epoch, 1870-1920: Early influence of science on public health and surgery". No matter whether Fox's or Shyrock's stages of development are used in analysing the evolution of American medicine, the crucial transition during which it overcame its persistent cultural colonialism and began to rise to a level of scientific independence and leadership occurred in the second half of the nineteenth century and the early twentieth century, between 1865 and 1914. During this period there also began to emerge problems of community health which are still of major interest in the United States. An understanding of the process underlying this transition must take account of the conditions out of which it developed and the factors that entered into it. However, the student of nineteenth-century American medicine who wishes to comprehend its evolution faces a major problem, the difficulty of finding one's way through the massive literature on the subject. For those who find themselves in this situation, aid is now available through the source book on medical America in the nineteenth century compiled and edited by Professor Brieger. Under eight headings: medical education, medical literature, the medical profession, medical practice, surgery, psychiatry, hospitals and hygiene, he has brought together thirty selections from medical periodicals and books, medical school prospectuses, and non-medical publications. There is a ninth section, with no headings, which offers the announcement of the John Hopkins Medical School. Logically, this belongs under medical education, …