American surgery: an illustrated history

by the horrors Dean so lavishly catalogues, and overkill and compassion fatigue soon set in. The account of the psychological sequelae of the war and their clinical treatment is absorbing, but sheds little light on modem problems. It is unclear whether Dean commends or deplores the harshness with which so many of these cases were handled; unclear, too, as the book progresses, whether comparison between two disparate eras serves any real purpose. A full-length study of the American Civil War in its own psychological terms, rather than through the "lens of Vietnam", might have been more valuable. In a field as slippery as military psychiatry, comparisons across time have always been hazardous; yet something about Vietnam-the long tradition of rhetorical excess, perhaps-drives scholars to make them. Jonathan Shay's much mocked invocation of the Trojan war in his Achilles in Vietnam (1992) did at least shed light on the importance of rites of absolution in re-integrating warriors into society; whereas Dean's seemingly more sensible excursion back to the 1860s pays smaller dividends. Simpler comparisons-say, with Australian soldiers' adjustment after Vietnam-are presumably too obvious to attract publishers. By 1900 American surgeons regarded themselves as the greatest practitioners of their art (science, said some) in the world. A triumph that many of them put down to the individualism and courage that, they said, had made the frontier disappear into the Pacific Ocean. There is much truth in this story. By 1900 Europeans were beginning to make the transatlantic crossing to watch William Halsted operate (or more likely find the work being done by the young Harvey Cushing). Since then American pre-eminence has been widely acknowledged. It is strange therefore that until now no one has undertaken the challenge of writing this tale (and of course 1900 could be taken as a starting point). Ira Rutkow has now picked up the gauntlet. Historians of surgery will be familiar with and grateful to Rutkow already for his valuable bibliographies of American surgery. The present volume is an impressive piece of work, the more so for being produced by a man whose regular occupation is surgery not history. This book is devoted to the United States, surgery in Canada is not included. It aims at comprehensiveness, starting with 'Native American surgery', it follows a chronological path with biographies of eminent practitioners at the end of the chapters. The final ten chapters are devoted to the world …