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HISTORY OF MEDICINE IN AMERICA

James Cassedy's Medicine in America, A Short History takes a comprehensive look at medical
progress in America from its colonial days to the present time. The book takes on five
different themes in discussing medicine. First, it discusses the medical establishment,
and how it develops over time. Second, it looks at the alternative to established
medicine. Alternatives consist of any kind of medical practice outside the orthodox
practice of the time. Third, Cassedy explores the science of medicine, taking time to
recognize individuals who make significant discoveries in the field of medicine. The role
of government in science is the fourth theme studied by Cassedy. The government makes
considerable efforts into the regulation of medical practice in America. The final theme
is the role of the environment in the health of Americans. In covering these themes,
Cassedy breaks American history into four different time periods. The book will best be
reviewed by looking at each of these time periods, and how they cover the aforementioned
themes.
Logically, the book begins by discussing the period of time that America is under the
control of Britain. The first inhabitants of the continent took a beating from diseases
carried by Europeans. Native Americans did not have the immunities instilled in
Europeans. Disease is accredited to wiping out nearly 90 percent of Native Americans. The
colonies, however, also had to deal with diseases. Very few physicians lived in the
colonies due to the fact that Britain was still the mother country. With the medical
establishment being as small as it was, the women of the household often took care of the
day to day healing. Midwives handled childbirths, and basically anyone with any knowledge
of medical literature was considered capable of healing. Some of the common treatments
included steam baths, religious rights, and herbal remedies. Surgical methods were
basically limited to that of setting bones and pulling teeth. Realizing that sanitation
was a problem, larger towns eventually began to pass regulations on the removal of
garbage and dead animals. Health related science was circulated by means of periodicals.
Along with being a contributor to medicine as a scientist, Benjamin Franklin often
published medical information in his newspapers. A strong supporter of inoculation, the
Reverend Cotton Mather frequently wrote about medical matters in terms of religion. The
colonial years saw the beginning of a medical establishment. As small groups of British
physicians began moving to the colonies, medical schools began to arise and give a
foundation to practices in America.
The separation of the colonies from Great Britain caused a break in medical advancement
in America. Many physicians saw fit to pack up and return home. Main stream medicine at
the time could be considered barbaric by today's standards. Treatments such as excessive
blood letting, which was thought to balance the body's four humors, often did more harm
than good. Sometimes they even led to death. The government began efforts at this time to
pass laws requiring physicians be licensed. Thirteen states passed such laws, but eleven
eventually repealed the laws. The government reluctantly involved itself in matters such
as quarantines and public vaccinations. The spread of the population westward resulted in
the lack of available physicians. This led to the rise of many people turning to
unorthodox methods of medicine. Quacks, or people who claimed medical knowledge who
really had none, often hurt people rather than cure them. "Irregular" practitioners began
to use new methods in surgery, hygiene beliefs, and new medical systems that were
generally frowned upon because the public was not used to it. It took awhile for the
United States to become advanced and wealthy enough to produce any serious output in
scientific discovery. In 1807, Thomas Jefferson encouraged the medical community to look
into research more. Members of the medical community began to research more into specific
fields of medicine. For example, anatomy became much more detailed from 1776 to 1865. The
Civil War produced enormous amounts of experience in dealing with wounds afflicted in
battle. While disease spread rapidly through overcrowded urban communities, farmers faced
vulnerable months during early settlement. Medical institutions were based mainly around
the larger cities, so the rural population continued to rely on traveling physicians and
home remedies.
The medical establishment in America from 1864 to 1940 made a switch to specialized
medicine. Everything from veterinarians to pharmacists began to appear in urban areas as
well as rural areas. General practitioners were more popular in small towns due to their
wide range of services. Health practices outside the general establishment consisted
mostly of people tending to their not so serious ailments by themselves. Quack medicine
still remained prosperous well into the twentieth century.
Due to the quick spread of disease after the Civil War, the government became more
involved in helping citizens. They began to require physicians to report cases of
infectious disease, as well as fund institutions of health education. Bureaus such as the
Children's Bureau were founded for special reasons. The Children's Bureau worked to
improve birth and death rates. Scientific research on disease, such as Walter Reed's work
with typhoid fever, led to better understanding of such diseases.
World War II gave America a social and economical boost, and the hundreds of thousands of
dead and wounded gave way to the construction of wartime hospitals. Due to the practice
of vaccination, many diseases that plagued America in the last century were virtually
non-existent. Rises in technology have led to the improvement of medicine overall, and
has led to new fears in the consequences of technology. An example would be nuclear
weapons and the affects of radiation. The AIDS epidemic is an example of a modern day
disease that prompts massive government funded research and public awareness. The medical
establishment now is maintained by such organizations as the American Medical Association
(A.M.A). The emergence of effective medicine gave way to more success and trust in the
American medical institution. Current advancement in medicine, however, tends to be
tainted by the glory of discovery. While orthodox medicine continues to flourish, people
still tend to seek unorthodox methods of healing, such as acupuncture. All things
considered, medicine in America has made dramatic improvements since its colonial days.
James Cassedy has made an excellent overview of the history of medicine in America.
Granted that this book will not win any literary awards in the near future, it is still a
well-written tool in beginning one's research of medicine. He presents his topics in a
manner that makes them interesting, and causes readers to question the past of their
medical culture. His choice of themes leaves little to be desired, and he thoroughly
discusses each of them in relation to his specified time intervals.

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