ANCESTORS OF ARROWSMITH Doctors on Horseback. Pioneers of American Medicine.
By James Thomas Flexner. (Heinemann. 16s.) MOST educated people in England have heard of the Mayo clinic at Rochester, but many of those who have heard of it (including many doctors) believe, I have found, that it is the glory of Rochester, New York. But the Mayo brothers have done their work not in New York but in remote Minnesota where, a century ago, the only regular surgical work was carried on by the Sioux and was merely a . simple exterior incision on the top of the head. In this fascinating book, Mr. Flexner has told the story of some of the great pioneers of American medicine, the men who brought to the revolting colonies the latest theories and practice of the great European professors, of the Hunters and the Cullens, and the still more dramatic story of the pioneert who,. in the great western wilderness, remote from Edinburgh and Paris, dared to open the abdomen, and, aided by good fortune, studied digestion in the living laboratory of the stomach of Alexis St. Martin. Some of the stories told here with great literary skill as well as historical scholarship are familiar to all who know the rudiments of medical history. • The obscure and romantic army surgeon, William Beaumont, exiled in the western woods, had the energy and the inventive genius to take advantage of the gun-shot_ wound that opened St. Martin's stomach to scientific observation. The story of the triangular relation between the doctor, turned experimental physiologist, the illiterate voyageur tormented by the mockery 'of his fellows and by the tactless bullying of Beaumont and the unclosing stomach that was their common link and asset, told again by Mr. Flexner, is, or should be, familiar to many, but it has never been so well told as it is here. For Mr. Flexner sees that there was a human problem as well as a scientific one ; he can sympathise with the unfortunate St. Martin as well as with the absorbed Beaumont whose laboratory, the stomach that made him an immortal, worthy of the respect of Claude Bernard, was unfortunately in the custody of a lazy and home-sick voyageur who not only cleared off to Canada when he could, but might have been got at by other doctors, either for their own glory or for the profits of exhibiting him in a show. Beaumont had to fear not only plagiarism, but the mute inglorious Barnums of the early nineteenth century.
Yet the showmen who might have cut out Beaumont played a great part in another triumph of primitive American medicine, the discovery of anaesthesia. But for the travelling showman's use of laughing gas as an attraction for the simple tastes of rural America, Crawford W. Long might not have made those first experiments in the conquest of pain that should have made him immortal. In the controversy between the partisans of Long and Morton, Mr. Flexner leans to the side of Long, although he admits that the historically prior discovery of Long did not affect medical practice, while the publicity given to Morton's patent-medicine by the great Boston doctors
ensured that the discovery of anaesthesia would not be lost. But Mr. Flexner is for the neglected pioneer, not for the flam- boyant and crooked salesman of science. The question is another example. of the Mendel-Bateson problem and Mr. Flexner is for Long, as Bateson was for Mendel. But the complete ignoring of chloroform is a little surprising to the British reader, who has occasionally wondered whether it is only patriotism that keeps that rival of ether still in service in Britain, especially in Scotland.
Mr. Flexner has a keen sense of character and the personal lives of these pioneers were almost as interesting as their discoveries. In Dr. Shippen, the villainous doctor-politician of the Revolution, Mr. Flexner has unearthed a villain black enough to surprise readers of Dr. Cronin. In Daniel Drake, a self-taught polymath, we have as much an ancestor of George F. Babbitt as of Martin Arrowsmith. He was a booster of his adopted city, Cincinnati, and of his adopted State, Ohio. There, since the Revolution, he asserted, " society has been progressive, higher destinies have been unfolded, and a reactive Buckeye influence, perceptible to all beholders, must continue to elevate our beloved country among the nations of the earth." By his ill-rewarded zeal for medical education, Drake earned the right to such optimism, even though he had no definite achievement to his credit to compare with Beaumont's or with the pioneer surgery of Ephraim McDoivell who dared to remove an ovarian tumour despite the disapproval of the British medical profession. Although the versatile French- Canadians have shown, in our own time, that they are unrivalled for giving country doctors opportunities for fame, the medical pioneer of today is not the Dr. Dafoe, but the member of the great research institutes. If only to remind us that great men lived before Agamemnon, this book is welcome, but it has many other merits and uses. It has a Plutarchian charm and it is a real contribution not only to medical but to general American history, for these contemners of routine, these takers of chances, these violators of precedent and ingenious circumventors of nature are as unmistakably American as Andrew Jackson
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