Book Review

Canada and the United States

John Harley Warner has written a magisterial book. In examining how nearly a century of American physicians remembered and reconstructed their experiences studying medicine in Paris, Warner explains how Americans invented and reinvented their own profession, shaped and expressed their values, and even developed their personal identities. Although Warner is particularly concerned with exploring the meanings that American doctors ascribed to their European experiences, he also offers rich descriptions of the underlying realities of medical life and thought. He chronicles the transmission of European medical ideas to the United States, and he offers revealing accounts of medical practice and education in both North and South, in both antebellum and post-Civil War America. Warner's overarching narrative integrates medical reform and medical sectarianism, the changing content and meaning of medical science, and comparisons and contrasts of the multiple contexts—American, British, French, and German—within which these issues played out. Warner bases his argument on prodigious research and on careful and sensitive readings of his sources. This is a work of enormous ambition, and it is enormously successful.

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Paris attracted Warner's American doctors—a narrow professional elite at the outset of his narrative—because of the rich opportunities for experiential learning its hospitals and dissecting rooms offered. State control had replaced church ownership of the city's many hospitals; revolutionary morality had displaced the religious qualms that might otherwise have blocked postmortem examination; and public funding had opened access to Parisian hospital clinics to foreign medical students at no cost. Warner returns time and again to the issue of access, to the fact that Paris excited the American medical imagination less because it was in the forefront of medical science than because it allowed students and physicians closely to observe and touch sickness at the bedside and to dissect an endless supply of cadavers.

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