Medicine and Society in America 1660-1860 by Richard Harrison Shryock (review)

The Antecedents ofMan. By Wilfrid E. LeGros Clark. Chicago: Quadrangle Books, i960. Pp. vii+374. $6.00. The subtitle ofthis book, "An Introduction to the Evolution ofthe Primates," better describes the theme than does the main title. Man himselfis given his due as a primate, but only as one among many, and the outstanding merit ofthe book is the presentation ofhuman evolution in proper perspective and setting. To a great extent, Antecedents ofMan is a revision ofa much earlier book by LeGros Clark. Since it was published, views which were at first greeted as biologicalheresy have become more or less orthodox, particularly the opinion that the australopithecines are close to the human ancestral line. The treatment follows the sequence: tree-shrews, lemurs, tarsiers, monkeys, apes, and man—which is the order oftheir appearance in time; and the general evidence ofskeleton, teeth, brain, senses, and the digestive and reproductive systems is presented in a straightforward and always interesting way. The book is offered as a textbook ofanthropology, biology, and anatomy, at not too advanced a level. Itis better suited perhaps as a collateral or extension study in connection with a rigorous course in comparative vertebrate anatomy. Certainly it should be read by all zoology and anatomy students at some stage in their careers, either as undergraduates or in the possibly more relaxed easy-chair attitude ofpost-doctoral life. N. J. Berrill McGiIl University Medicine and Society in America 1660-1860. By Richard Harrison Shryock. New York: New York University Press, i960. Pp. viii+182. $4.00. Four Anton G. Phelps Lectures on Early American History given by the author at New York University in 1959 are brought together in this volume. It is a thoroughly readable though well-documented book which synthesizes in less than 200 pages the essence of many weighty tomes on the history of American medicine. But its greatest value lies in Dr. Shryock's brilliant insight into the many social factors that tended to exert much greater influence upon the early American medical scene than did contemporary European scientific discoveries. The first lecture, "Origins ofa MedicalProfession," beginswith adescriptionofseventeenth -century British medicine, which served as an approximate model to the colonial physician, although few ofthem had a medical education resembling even remotely that provided by the mother country. It is estimated that on the eve ofthe Revolution not more than 400 ofthe },soo established practitioners had received formal training, and only half of those held degrees. With increasing urbanization came opportunities for "genteel" practice: then American medical schools founded by American graduates of foreign universities markedly changed the physician's educational aspirations. The urge for medical independence followed political independence; and in 1820 a new medical chauvinism led Dr. Chapman to proclaim, somewhat prematurely, in the first issue of his Journal oj Medical and Physical Science, "It may be safely said that in no country is 124 Book Reviews Perspectives in Biology and Medicine · Autumn i960 medicine . . . better understood or more successfully practiced than in the United States." The lectures "Medical Thought and Practice" and "Health and Disease" further describe the period from 1660 to 1820. The final and longest lecture, "Medicine and Society in Transition," develops allmedical aspects ofthe subsequent fortyyears, when American medicine began to form its own pattern. During this period the few medical periodicals published in this country changed from their earlier practice ofreprinting foreign articles to accepting American contributions, and the intellectual ties with England were transferred to France, where not only did medical advances excel, but also the nostalgic American student enjoyed a "Ungering Revolutionary feeling." They took home from France a strong interest inthe study ofpathological anatomy, and the practice ofmaking autopsies became widespread in the United States. With the introduction ofanesthesia in 1846, America made its first major contribution to world medicine. The founding of the American Medical Association in 1847 led to the first cautious attempts to standardize medical training, licensing, and practice. Yet, in general, the scientific lag between American and European medicine was still emphatically manifest. By i860, the terminal date ofDr. Shryock's study, American medicine had begun to show characteristics ofmaturity. The picture was far from encouraging, however, and not even the most fervent optimist...