Chapter 34. Nature-Healing and Simple Remedies
- Natural history emphasis encouraged among doctors
- many naturalists with medical backgrounds
- collecting, describing, and interpreting done by American physician-naturalist, while systematizing was done in England
- European medicine bogged down in dogma
- single cause explaining human health
- each professional offering his own simplistic explanation of bodily functions
- rigidity lasted well into 19th century as doctors actually did more to kill than to cure their patients
- American amateur doctor was likely to let nature run its course, where the European physician used whatever extreme measures that were part of his dogma
Chapter 35. Focus on the Community
- Ailments which were endemic in England became epidemic in America
- Similarities in interests and achievements of Ben Franklin and Cotton Mather
- undiscriminating universality of interest unconfined by prior theories
- lack of originality
- intense practicality
- unsystematic and random approach to philosophy
- willingness to be challenged by New World opportunities
- Mather's Angel of Bethesda (1724)
- first general treatise written in the colonies
- expressed a non-theoretical view alien to many learned European doctors
- less interested in causes than in remedies of disease
- Mather's progress against smallpox
- public appeal to doctors in Boston to inoculate
- set off violent controversy
- despite opposition's outburst, Mather could conduct successful inoculation experiments and show results that commanded attention
- his progress opened minds to the curability of other diseases
- influence spread up and down the colonies
- how inoculation became established as an American institution
- crude, empirical strain
- carelessness of theory
- insistence on results
- by 1776, smallpox was under control
- increased in England until 1800
- epidemics became less frequent and stirred less terror
Chapter 36. The General Practitioner
- English social snobbery
- result of a rigid, well-established aristocracy
- boundaries between occupations
- resisted new knowledge and new ways of doing things
- along with clergy, law and medicine were most elaborately subdivided
- Changes for the worse taking place in the organizations of numerous medical professions in 17th and 18th centuries
- rigidity and complexity increased
- Royal College of Medicine chose applicants on basis of social accomplishments
- no real instruction given
- this absurd situation did not cross the Atlantic
- Professional organization of doctors in America
- loose conglomeration
- boundaries of specialists were vague or non-existent
- government control over medicine never developed
- fluid situation rather than ancient institutions shaped medical practices
- much of early doctoring done by ministers
- Results of America's redefinition of medical role
- numerous English specialties became combined into the work of a general practitioner
- general practitioner became more involved in the larger class of persons concerned with the political and religious welfare of the community
Chapter 37. Learning from Experience
- Apprentice system
- few Americans could afford to study abroad
- about 1 in 9 doctors had medical degrees
- usual, almost exclusive path to profession
- John Morgan (1735-1789)
- Philadelphia doctor who pleaded for specialization (physic, surgery, pharmacy)
- helped to establish first medical school
- Impoverished American medical situation
- lack of theoretical advances
- no imaginative or fruitful laboratory investigations
- frontiers of speculative medicine remained in England
- American experience broke down social as well as intellectual distinctions among different medical branches
- reuniting divided fragments of experience
- improvement of hospital and nursing
- Pennsylvania Hospital
- founded by Dr. Thomas Bond in 1751 with help of Ben Franklin
- extraordinarily successful according to standards of the time
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