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July 24, 1981

American Medicine in Transition

JAMA. 1981;246(4):391. doi:10.1001/jama.1981.03320040059039

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The usual historical review includes a description of outstanding events or personalities and a text that is built around them. The emphasis in this book is far different. In a series of essays, the author succeeds in portraying the struggles of the entire medical profession as it escaped from a myriad of deficiencies and entered the scientific era, characterized by the appearance of the Flexner Report in 1910.

The main subjects include "humors," bloodletting, administration of drugs, transcendental medicine, midwifery, medical education, the business and ethics of medicine, and Darwinism. From these disparate topics the author has melded an absorbing account that is factual, critical, and occasionally humorous. He has fortified his conclusions with extensive notes and bibliographic references.

Many interesting facts are related; only a few examples can be given. Jacksonian democracy had fostered individualism and distrust of elitism. Consequently, a profusion of cults developed; homeopaths, eclectics, Thomsonians, Rushites,