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The Cover
March 27, 2002

Two Sisters With Puppy and Flowers

JAMA. 2002;287(12):1495. doi:10.1001/jama.287.12.1495

By the middle decades of the 19th century, the United States had become like an adolescent with a newly discovered libido. In 1840, its population stood at 17 million; 50 years earlier it had been only a quarter of that. The population shift was exuberantly westward, its pace accelerating with every census. The nation's people expended its energy on whatever venture seemed opportune to the moment: trade, commerce, industry, travel, exploration, manufacturing, services. If the venturer was rich, he was an entrepreneur; if poor, a peddler. The rich man reached his clients by stage or railway, the poor man on foot or horseback. Rich men made deals; poor men—and they were the majority—hawked their wares and services to the locals—anything and everything from buttons and beads to patent medicines, from business signs to family portraits, from dentistry and amputations to bonesetting.

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