The Development of American Physiology: Scientific Medicine in the Nineteenth Century (review)

cellor in March 1933. During most of this period he suffered varying degrees of dementia with memory loss. Ramsay MacDonald was British Prime Minister from 1931 to June 1935, when he was succeeded by Stanley Baldwin. MacDonald also had a physical collapse in 1931 and severe depression in 1933 and March 1935. He was diagnosed as having true Alzheimer's disease. Jozef Pilsudski, grand marshall and hero of World War I, was, along with Joseph Beck, in power at the time of the German invasion. He also suffered from organic brain syndrome and nocturnal dyspnea with congestive heart failure. He unfortunately believed in the power of Polish Horse Cavalry against German tanks. The influence of illness on a nation's leaders certainly can be well documented when the illness is so overt and blatant that the individual was obviously inoperative (e.g., the 7 months when Wilson was incommunicado and periods when Churchill was in a state of poor health). It is problematic whether Roosevelt was at full strength at either Tehran or Yalta. One must judge the total overall record of a leader, rather than focusing on a single incident. Eisenhower may have kept us out of the Vietnam War by deciding not to go to the relief of Dienvienphu even when he had incipient cardiac problems. Wilson's League of Nations laid the groundwork for the United Nations, proposed by Roosevelt. Churchill's illness during his second term as prime minister delayed Anthony Eden's ascension to the prime ministership. Since Eden was reported to be highly dependent on amphetamines, Churchill's tenure may have prevented disasters greater than the Suez Canal fiasco, if Eden had become prime minister earlier. The drinking problems of Ulysses S. Grant were overbalanced by several Union victories. Complete revelation of an individual's health may preclude the ascension to power of individuals with courage, intelligence, and ability. Individuals with poor health may have far greater abilities than someone at the proper weight, good nutrition, no bad health habits, and lack of discernible disease. The book is tremendously interesting. It fully documents the illnesses of a number of world leaders during critical periods of history. It is particularly pertinent for a neurologist to look at the health ofworld leaders, many of whom had severe cerebral problems. I recommend this work with enthusiasm. Donald W. King Division of Biohgical Sciences University of Chicago Medical Center TL· Development ofAmerican Physiology: Scientific Medicine in tL· Nineteenth Century. By W. Bruce Fye. Baltimore: The Johns Hopkins University Press, 1987. Pp. 308. $35.00. This book is a scholarly and readable discussion of the development of physiology as an organized discipline separate from but essential to medicine in the United States during the nineteenth century. The discussion centers around the careers of four pioneers of the discipline in this country: John Call Dalton of New York, S. Weir Mitchell of Philadelphia, Henry P. Bowditch of Boston, and Perspectives in Biology and Medicine, 31,3 ¦ Spring 1988 \ 465 H. Newell Martin of Baltimore. A narration of the struggles and contributions of these eminent men is followed by a chapter on the organization of the American Physiological Society and a chapter on the development of the concept that physiology is the scientific basis of medicine and therefore essential to the education of physicians. Fye describes how the ideas about the nature and role of physiology propounded by Dalton, Mitchell, Bowditch, and Martin were derived from those of the great nineteenth-century European physiologists under whom they studied—Claude Bernard in France, Emil Ludwig in Germany, and Thomas H. Huxley in England. The biographies of the four American pioneering physiologists are used to illustrate the nineteenth-century conflicts that persist in the academic medicine and medical sciences of our own day: full-time or professional science versus part-time investigation carried out by physicians whose primary dedication is to medical practice; basic science versus clinically oriented sciences; the merits of subspecialization in a scientific discipline; the notion that physiology should be taught by scientists engaged in active scientific research, not by professional teachers not currently active in the laboratory; the idea that physiology taught to medical students should be confined to...