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president. This section has not been tested adequately. In one instance, when President Reagan went under anesthesia for surgery for a gunshot wound, Richard Darman, now head of the budget office and then a young presidential aide, apparently deliberately blocked the preparation of papers that would transfer power from President Reagan to Vice-President Bush. The second time President Reagan underwent surgery for colon cancer, the president wrote a letter to the Speaker of the House and the majority leader in the Senate saying that Vice-President Bush would be acting president. At the same time he questioned the validity of the law, which, he suggested, was not meant for temporary incapacitation. Thus, although the law suggests that the president, whenever incapacitated for more than a few minutes and not sleeping, should transfer power, it has only been done in a roundabout grudging manner and the precedent is not yet firmly established. Section 4 is the most controversial and the most interesting. This would speed the removal of a president from office who was so incapacitated that he could not function effectively. It requires the vice-president with the majority of the cabinet to initiate the proceedings and report their recommendations to the Speaker of the House and president pro tempore of the Senate. This is exceedingly difficult because it requires the medical testimony of the president's physician . In the case of Wilson, it probably would never have been given. Second, it requires that individuals (vice-president and cabinet) appointed by the president acknowledge in public that the president is either physically or mentally incapacitated . Thus it would take an overt condition for action to ever take place. The critical word is "disability." Who can make the judgment when someone is disabled and what is the course of action to be followed without gross political ramifications? The authors review recommendations that there be a medical commission appointed to oversee the health of the president. It is doubtful that politicians will ever agree that their actions should be controlled by such an extraneous group of individuals. Donald W. King Department ofPathology, University of Chicago 5841 S. Maryland Avenue Chicago, IllinoL· 60637 Perfecting the World: The Life and Times ofi Thomas Hodgkin (1798-1866). By Amalie and Edward Kass. New York: Harcourt Brace Jovanovich, 1988. Pp. 624. $34.95. The first half of the nineteenth century witnessed widespread changes within many social institutions in Great Britain. The Industrial Revolution was in progress , and the new working class of factory workers was growing. Class barriers were shifting as an agrarian society was becoming a technological one. Debate had begun over society's responsibilities for the urban poor. Slavery had been banned in Britain, but the slave trade between Africa and America continued. Charitable societies formed to assist in the repatriation of freed slaves back to Perspectives in Biology and Medicine, 33, 1 ¦ Autumn 1989 \ 147 Africa and for the protection (and conversion to Christianity) of native peoples throughout the world. The controlling grip of the Church of England and the ancient universities of Oxford and Cambridge on the professions was slipping, and nonconformist religious groups and new universities were pushing forward new social agendas, curriculum reforms, and professional structures. Amid all of these changes could be found Thomas Hodgkin, a Quaker physician and reformer , who unceasingly railed against the humanitarian shortcomings of his age while pushing medicine forward into the scientific age. The biographers of this physician-scientist and philanthropist of diverse accomplishments have undertaken a difficult task. The book is unfortunately uneven , with certain events in Hodgkin's life and times covered in great detail and others passed over more rapidly. The text is supported by extensive footnotes referring to the Hodgkin family's letters, which have been preserved on microfilm , and to other primary sources. Occasional interesting anecdotes and details that would have enlivened the text itself are described only in notes at the end of the book. Readers with a medical background will be left dissatisfied that the history and significance of some of the medical discoveries and reforms are not more thoroughly discussed, while the nonmedically trained reader may be put off by terminology, diseases, and circumstances that...

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