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.