Kindly medicine: physio-medicalism in America, 1836–1911

in America as throughout Europe, a sweeping reaction against speculative systems was the rule everywhere by 1820, even in romantic Germany, and it is very difficult to disentangle this overall trend (due only in part to Paris medicine) from the influence of those who went abroad. How would American medicine have been different if no American had gone abroad? And how much of the heavily-touted revolt against system in the United States was simply due to the peculiar rise and success of homeopathy, eclecticism, and other "systems" that had no real counterpart in Europe? How is one to account for the far larger number of Americans who stayed at home and yet also embraced empiricism, clinical teaching, and expectant healing? The theme, in short, cannot bear the heavy weight given to it and seems more like an added thought than the unifying core of the book. In other respects, the book is often repetitious and the argument is lost in the enormous details. There are other questions. Did British students really react so differently from Americans to the French experience? This is a very fine and difficult distinction that Warner makes, qualified by many cavils and exceptions. It might be argued, on the contrary, that their reactions were far more similar than dissimilar when compared with the reactions of Germans and other students in Paris. And what of Canadians, who presumably shared British concerns about medical "polity" and American concerns about "epistemology"? Almost no use is made of the letters and memoirs of French teachers and students-what were their impressions of the interests of Americans as contrasted with those of English or German visitors? My impression is that both French and German teachers tended to see their British and American disciples as very similar in their practicality and zeal for hands-on experience, and in the lack of understanding of how their educational systems worked. How representative and how influential was the small number of Americans who went abroad anyway? They certainly complained after their return of their lack of success in changing American institutions and practices. Warner disputes the estimates of Russell Jones of the number of Americans who went to Paris over the half-century beginning in 1815. He argues that his larger figure of a thousand or more (still a small number when spread over fifty years) includes those who did not matriculate. Who were the non-matriculants? Were most …