Two Centuries of American Medicine 1776-1976

The work is well organised into three sections covering the first century, the period of scientific advance 1876-1946 and the period of explosive growth 1946-1976. In the first section there is a selective account of medical education and practice and of hygiene and hospitals and of the conflicts and stresses in a country where varied standards prevailed. In the period of scientific advance the development of medical education, the foundation of the great teaching centres and especially Johns Hopkins, and the impact of the Flexner report are all well presented. This is followed by an organised survey of medical research presented in terms that a layman could understand. In these and in chapters on hospitals and medical practice mention is made of nearly all the notable events and figures of American medicine up to 1946. In the period of explosive growth there is less about education and more about government involvement. Advances are described under such headings as modern drugs, cardio-vascular diseases, enzymes and hormones, genetics, immunology, cancer and the neurosciences. Of course the emphasis is on the American contribution, but in general it is fair. All in all it is a fascinating accotnt of the growth of modern medicine and a worthy tribute to the bicentennial year.