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American Medical Schools and the Practice of Medicine: A by William G. Rothstein

By William G. Rothstein

During this greatly researched background of scientific colleges, William Rothstein, a number one historian of yank medication, strains the formation of the scientific tuition from its beginning as a resource of clinical lectures to its present prestige as a middle of undergraduate and graduate clinical schooling, biomedical learn, and really expert sufferer care. utilizing quite a few ancient and sociological innovations, Rothstein thoroughly describes tools of clinical schooling from one iteration of medical professionals to the subsequent, illustrating the altering occupation paths in drugs. while, this research considers clinical faculties in the context of the nation of clinical perform, associations of treatment, and common better schooling. the main entire and thorough basic heritage of clinical schooling within the usa ever written, this paintings focuses either at the ancient improvement of scientific faculties and their present prestige.

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10 Operative surgery was severely limited by the absence of both satisfactory anesthetics and methods for preventing infection in the surgical wound. The available methods for deadening pain were opium, whiskey, and similar drugs, and, in amputations, tightly binding the part involved. The pain of surgery discouraged its widespread use and the high risk of infection greatly limited the range of permissible surgical procedures. Any operation on the head, thorax, or abdomen was almost always fatal and was avoided by all surgeons.

Substantial social pressure was placed on the young physician to do this. A grossly mishandled case produced enough public disapproval in a small town to affect a physician's career for years. Older physicians and patients frequently reminded apprentices and young physicians of the failed careers of physicians who mishandled cases. The apprenticeship system had some major flaws. Any physician could serve as a preceptor, and many were motivated to do so by the prospect of the apprenticeship fee and the free labor of the apprentice.

By the 1780s the hospital had become largely an insane asylum. The number of paying patients continued to equal or exceed the number of charity patients until the 1830s. 33 After 1800, the federal government became a major source of financial support for voluntary hospitals in seaport towns and cities. Many of the strangers needing health care were merchant seamen who lacked friends or funds. " Although the legislation permitted the construction or purchase of federal hospitals, and one was built near Boston, the government preferred to contract with local hospitals, if available, or with boarding houses or individual physicians for the care of seamen.

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