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Prior to the nineteenth century, the practice of medicine in the Western world was as much art as science. But, argues W. F. Bynum, 'modern' medicine as practiced today is built upon foundations that were firmly established between 1800 and the beginning of World War I. He demonstrates this in terms of concepts, institutions, and professional structures that evolved during this crucial period, applying both a more traditional intellectual approach to the subject and the newer social perspectives developed by recent historians of science and medicine. In a wide-ranging survey, Bynum examines the parallel development of biomedical sciences such as physiology, pathology, bacteriology, and immunology, and of clinical practice and preventive medicine in nineteenth-century Europe and North America. Focusing on medicine in the hospitals, the community, and the laboratory, Bynum contends that the impact of science was more striking on the public face of medicine and the diagnostic skills of doctors than it was on their actual therapeutic capacities.

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• List of illustrations
• Preface
• Acknowledgements
• 1 Medicine in 1790
• 2 Medicine in the hospital
• 3 Medicine in the community
• 4 Medicine in the laboratory
• 5 Science, disease, and practice
• 6 Medical science goes public
• 7 Doctors and patients
• 8 Conclusion: did science matter?
• Bibliographical essay
• Sources of quotations
• Index

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CHOICE Review

In this newest addition to the Cambridge History of Science series, Bynum (Wellcome Institute for the History of Medicine) examines the evolution and impact of the basic sciences during the course of the 19th century on medical education, professional identity, and technology of health care delivery; these sciences ultimately shaped the practice of medicine of the time. In recording the changes in medicine, Bynum analyzes them in the context of the social and political environment of the period that modulated them and which in turn they affected. His thesis is that the changes that occurred between 1800 and the beginning of WW I that laid the foundations and shaped the concepts, institutions, and professional structures of modern medicine as practiced today, despite the vast changes brought about by further advances in the biomedical sciences during the 20th century. Bynum focuses principally on Great Britain, France, and Germany, where in fact the rigorous experimental methods of the basic sciences--physiology, pathology, bacteriology, and immunology--had their roots and first exerted their influence on the conceptual foundations and practice of medicine. This important piece of scholarship enriches the understanding of the evolution of medicine and the process of translating scientific knowledge into effective curative and preventive measures. General; undergraduate through professional. G. Eknoyan; Baylor College of Medicine