History of Medicine (United States)

The history of American Medicine has been relatively short, as compared to European Medicine, but has had a global impact despite that brevity. This article focuses on the development of the professional practice and education of physicians in the United States. It it includes some background on the popular traditions of healing arts by both the Native Americans and the early European and African immigrants, whose remedies, in part, became incorporated into medical practice. Early American Medicine was characterized not only by diverse roots, the important position that medical doctors held in port cities like New York, in determining the safety of allowing ships to dock and unload. In the 19th Century, as compared to European countries like England and France, Medicine in the United States was largely unregulated and marked by an enormous range of practices and practitioners. The lack of standards in medical education sparked a reaction in the early 20th Century by a coalition formed by philanthropists and the American Medical Association, and the requirements for obtaining a medical degree became more, rather than less, stringent than in most other western countries. The rise of technology after World War II, along with increasing financial support of medical research and education, brought the level of academic medicine in the US to an equal or superior level with any other country in the world.

Medicine in Colonial Era

Disease conditions

There was a fundamental difference in the human infectious diseases present in the indigenous peoples and that of sailors,explorers and settlers from Europe, Africa and Asia. Some viruses, like smallpox, have only human hosts and appeared to have never occurred on the North American continent before mass immigrations of the 16th and 17th centuries. The indigenous people lacked genetic resistance to such new infections, and suffered overwhelming mortality when exposed to smallpox, measles, malaria, tuberculosis and other diseases.

In the southern colonies malaria was endemic, with very high mortality rates for new arrivals. Children born in the new world had some immunity --they suffered mild recurrent forms of malaria but survived.

Practice

The first medical society was organized in Boston in 1735. Many young men went to Europe for medical training; 41 were trained at the University of Edinburgh in Scotland before 1775. Smallpox inoculation was introduced 1716-1766, well before it was accepted in Europe. The first medical schools were established in Philadelphia in 1765 and New York in 1768. The first textbook appeared in 1775, though physicians had easy access to British textbooks. The first pharmacopoeia appeared in 1178.

Hospitals

Pest houses were established in port cities, notably Boston (171), Philadelphia (174) Charleston (1752) and New York (1757). The first general hospital was established in Philadelphia in 1752.

19th Century

Public health conditions were poor in most cities, with cholera and yellow fever epidemics every few years.

Infant Mortality Rate, for Massachusetts:
1851 to 1970: deaths under 1 per 1000 live births
1970		16.8
1960		21.6
1950-54		22.8
1945-49		28.4
1940-44		34.3
1935-39		43.2
1930-34		53.9
1925-29		67.6
1920-24		78.7
1915-19		100.2
1910-14		116.7
1905-09		134.3
1900-04		141.4
1895-99		153.2
1890-94		163.2
1885-89		158.5
1880-84		161.3
1875-79		156.3
1870-74		170.3
1865-69		146.3
1860-64		142.5
1855-59		122.9
1851-54		131.1

source: Historical Statistics of the United States" (1976) Series B148

20th Century

Medical financing

see Medicare, Medicaid

Bibliography

• John Duffy. From Humors to Medical Science: A History of American Medicine (2nd ed. 1993)
• Judith W. Leavitt and Ronald L. Numbers, eds. Sickness and Health in America: Readings in the History of Medicine and Public Health (3rd ed 1997)
• Packard, Francis R. A History of Medicine in the United States (1931)
• Charles E. Rosenberg. The Cholera Years: The United States in 1832, 1849, and 1866. (2nd ed 1987)
• Paul Starr. The Social Transformation of American Medicine (1982)
• Rosemary Stevens, American Medicine and the Public Interest (1971) cover 1900-1970
• John Harley Warner, ed. Major Problems in the History of American Medicine and Public Health: Documents and Essays (2000)