Development as an Evolutionary Process

his lifetime included the American Medical Association, the Board of Scientific Directors of the Rockefeller Institute, the Executive Committee of the Carnegie Institution of Washington, and the National Academy of Sciences. Fittingly, the last major responsibility he assumed during his life was that of chair of the history of medicine at Johns Hopkins. Fleming does an excellent job of integrating his account of Welch's personal life with the virtual revolution of modern medicine which began around the turn of the century. He skillfully sets the stage for his account of Welch's accomplishments. He establishes Welch's descent from a long line of doctors and discusses Welch's decision to pursue a career in medicine, although his initial ambition upon graduating from Yale College in 1870 was to be a tutor in Greek. Fleming also conveys to the reader a great deal about Welch's private life, which was not as idyllic as his public life. Fleming's biography is not as exhaustive as Simon Flexner and James T. Flexner's William Henry Welch and the Heroic Age ofAmerican Medicine (New York, 1941). Its merit lies in its accessibility and in Fleming's skillful entwining of Welch's life with the many upheavals occurring in medicine during his lifetime. The new afterword sheds some light on the directions which medicine has taken since Welch's death and also includes many suggestions for additional reading. This book represents a refreshing approach to biography, and I highly recommend it to students of medicine, public health, nursing, and American history.