Thanks also to my agent Raphael Sagalyn, as good a professional as there is. I've had many editors but only one agent, a fact that speaks for itself.
Finally I thank my brilliant wife, Margaret Anne Hudgins, who helped me in too many ways to enumerate, including both in concept and in the particular (but chiefly by being herself. And then there are the cousins.
Notes
Abbreviations
APS
American Philosophical Society, Philadelphia
HSP
Historical Society of Philadelphia
JHU
Alan Mason Chesney Medical Archives, the Johns Hopkins University
LC
Library of Congress
NA
National Archives
NAS
National Academy of Sciences Archives
NLM
National Library of Medicine
RG
Record group at National Archives
RUA
Rockefeller University Archives
SG
Surgeon General William Gorgas
SLY
Sterling Library, Yale University
UNC
University of North Carolina, Chapel Hill
WP
Welch papers at JHU
PROLOGUE
the smartest man: Personal communication with Dr. David Aronson, Jan. 31, 2002, and Dr. Robert Shope, Sept. 9, 2002.
fifty million deaths: Niall Johnson and Juergen Mueller, 'Updating the Accounts: Global Mortality of the 1918/1920 'Spanish' Influenza Pandemic,' Bulletin of the History of Medicine (2002), 105/15.
'doubly dead': Sherwin Nuland, How We Die (1993), 202.
college degree: Kenneth M. Ludmerer, Learning to Heal: The Development of American Medical Education (1985), 113.
'vibrate and shake': William James, 'Great Men, Great Thoughts, and Environment' (1880); quoted in Sylvia Nasar, A Beautiful Mind (1998), 55.
''Tis writ, 'In the beginning'': Johann Wolfgang Goethe, Faust, Part One (1949), 71.
Part I: The Warriors
CHAPTER ONE
'the hostile Sioux': Washington Star, Sept. 12, 1876.
'For God's sake': New York Times, Sept. 12, 1876.
'great change in human thought': H. L. Mencken, 'Thomas Henry Huxley 1825/1925,' Baltimore Evening Sun (1925).
'voice was low, clear and distinct': For accounts of this speech, see New York Times, Washington Post, Baltimore Sun, Sept. 13, 1876.
endowed chairs of theology: Simon Flexner and James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (1941), 237.
theories that attributed epilepsy: Roy Porter, The Greatest Benefit to Mankind (1997), 56.
'a theory is a composite memory': Quoted in Charles-Edward Amory Winslow, The Conquest of Epidemic Disease: A Chapter in the History of Ideas (1943), 63.
four kinds of bodily fluids: For a discussion of the theory, see Porter, The Greatest Benefit to Mankind, 42/66, passim.
'the true path of medicine': Ibid., 77.
'recognizable only by logic': Vivian Nutton, 'Humoralism,' in Companion Encyclopedia to the History of Medicine (1993).
'our own observation of nature': Quoted in Winslow, Conquest of Epidemic Disease, 126.
'unequalled' between Hippocrates and Pasteur': Ibid., 142.
'Don't think. Try.': Ibid., 59.
'I placed it upon a rock': Quoted in Milton Rosenau's 1934 presidential address to the Society of American Bacteriologists, Rosenau papers, UNC.
'more simple and consistent system': For an excellent review of this see Richard Shryock, The Development of Modern Medicine, 2nd ed. (1947), 30/31.
'sagacity and judgment': Ibid., 4.
still seen as a manifestation: Charles Rosenberg, 'The Therapeutic Revolution,' in Explaining Epidemics and Other Studies in the History of Medicine (1992), 13/14.
natural healing process: Ibid., 9/27, passim.
'profuse perspiration': Benjamin Coates practice book, quoted in ibid., 17.
never had a peaceful bath again: Steven Rosenberg in personal communication to the author.
'withered arm of science': Quoted in Richard Shryock, American Medical Research (1947), 7.
Michel Foucault condemned: John Harley Warner, Against the Spirit of the System: The French Impulse in Nineteenth-Century American Medicine (1998), 4.
'The practice of medicine': Ibid., 183/84.
'Why think?': See Richard Walter, S. Weir Mitchell, M.D., Neurologist: A Medical Biography (1970), 202/22.
'Nature answers only': Winslow, Conquest of Epidemic Disease, 296.
'if all disease were left to itself': Quoted in Paul Starr, The Social Transformation of American Medicine (1982), 55.
In 1862 in Philadelphia: Charles Rosenberg, Explaining Epidemics and Other Studies in the History of Medicine (1992), 14.
'popular crafts of every description': Thomsonian Recorder (1832), 89; quoted in Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (1962), 70/71.
'False theory and hypothesis': John Harley Warner, 'The Fall and Rise of Professional Mystery,' in The Laboratory Revolution in Medicine (1992), 117.
'priests' and Doctors' slavery': Quoted in Rosenberg, Cholera Years, 70/71.
'a greater humbug': John King, 'The Progress of Medical Reform,' Western Medical Reformer (1846); quoted in Warner, 'The Fall and Rise of Professional Mystery,' 113.
only thirty-four licensed physicians: Burton J. Bledstein, The Culture of Professionalism: The Middle Class and the Development of Higher Education in America (1976), 33.
'the Diminished Respectability': Shryock, Development of Modern Medicine, 264.
court-martialed and condemned: Ludmerer, Learning to Heal, 10, 11, 23, 168.
not to treat malaria: Rosenberg, 'The Therapeutic Revolution,' 9/27, passim.
'all the worse for the fishes': Bledstein, Culture of Professionalism, 33.
'a vast deal to be done': Quoted in Donald Fleming, William Welch and the Rise of American Medicine (1954), 8.
7,000 to 226,000: Edwin Layton, The Revolt of the Engineers: Social Responsibility and the American Engineering Profession (1971), 3.
fail four of nine courses: Ludmerer, Learning to Heal, 37 (re: Harvard), 12 (re: Michigan).
'truths that lie about me so thick': Quoted in ibid., 25.
not know how to use a microscope: Ibid., 37.
'something horrible to contemplate': Ibid., 48.
'can't pass written examinations': Bledstein, Culture of Professionalism, 275/76.
'No medical school has thought': Ludmerer, Learning to Heal, 15.
'simply horrible': Ibid., 25.
Against the advice: James Thomas Flexner, An American Saga: The Story of Helen Thomas and Simon Flexner (1984), 125; see also ibid., 294.
'strongest evidence of this demand': Benjamin Gilman, quoted in Flexner, American Saga, 125.
CHAPTER TWO
eightieth-birthday celebration: Flexner and Flexner, William Henry Welch, 3/8, passim.
fifteen hundred stores: Ezra Brown, ed., This Fabulous Century, The Roaring Twenties 1920/1930 (1985), 105, 244.
'beyond the capacity of an individual parent': Quoted in Sue Halpern, 'Evangelists for Kids,' New York Review of Books (May 29, 2003), 20.
work of Rudolph Virchow: Flexner and Flexner, William Henry Welch, 33.
'accurate observation of facts': Ibid.
filled him with repugnance: Ibid., 29.
begged his cousins: Fleming, William Welch, 15.
'every noble and good quality': Flexner and Flexner, William Henry Welch, 50.
'the light of his own mind': Quoted in ibid., 49.
'the labyrinths of Chemistry': Ibid., 62/63.
scientists had met in Berlin: Shryock, Development of Modern Medicine, 206.
'I can only admire': Flexner and Flexner, William Henry Welch, 64, see also 71.
'the easiest examination': Ibid, 62.
&nb
sp; 'a voyage of exploration': Ibid., 76.
fifteen thousand American doctors: Thomas Bonner, American Doctors and German Universities: A Chapter in International Intellectual Relations, 1870/1914 (1963), 23.
'those who have studied abroad': Welch to father, March 21, 1876, WP.
'a source of pleasure and profit': Welch to stepmother, March 26, 1877, WP.
'Germany has outstripped': Flexner and Flexner, William Henry Welch, 83.
'certain important methods': Welch to father, Oct. 18, 1876, WP.
'carry on investigations hereafter': Welch to father, Feb. 25, 1877, WP.
'observe closely and carefully': Welch to father, Oct. 18, 1876, WP.
'He is almost the founder': Welch to father, Sept. 23, 1877, WP.
'The facts of science': Quoted in Flexner and Flexner, William Henry Welch, 87.
'constantly astonished at the wealth of experience': Quoted in Shryock, Development of Modern Medicine, 181/82.
'the greatest and most useful': Quoted in ibid., 182.
'the first men to be secured': Quoted in Flexner and Flexner, William Henry Welch, 93.
'a modest livelihood': Ibid., 106.
'cannot make much of a success': Ibid., 112.
'the drudgery of life': Ibid.
CHAPTER THREE
'leak knowledge': Ibid., 70.
'a larger circle of hearers': Quoted in ibid., 117.
'poisoning of half the population': John Duffy, A History of Public Health in New York City 1866/1966 (1974), 113.
the zymote theory: For more on zymotes see Phyllis Allen Richmond, 'Some Variant Theories in Opposition to the Germ Theory of Disease,' Journal of the History of Medicine and Allied Sciences (1954), 295.
laurel wreath 'such are given to the brave': Paul De Kruif, Microbe Hunters (1939), 130.
'What was theory': Charles Chapin, 'The Present State of the Germ Theory of Disease,' Fists Fund Prize Essay (1885), unpaginated, Chapin papers, Rhode Island Historical Society.
'powerless to create an epidemic': Michael Osborne, 'French Military Epidemiology and the Limits of the Laboratory: The Case of Louis-Felix-Achille Kelsch,' in Andrew Cunningham and Perry Williams, eds., The Laboratory Revolution in Medicine (1992), 203.
'however bright the prospect': Flexner and Flexner, William Henry Welch, see 128/32.
'not be so cheaply earned': Welch to stepmother, April 3, 1884, WP.
'in no way discuss with him': Ibid.
'on a high plane of loneliness': Flexner and Flexner, William Henry Welch, 136, see also 153.
'deliberately break off relationships': According to Dr. Allen Freeman, quoted in ibid., 170.
'already has a German reputation': Welch to father, Jan. 25, 1885, WP.
the greatest name in science: Florence Sabin, Franklin Paine Mall: The Story of a Mind (1934), 70.
'a small chemical lab': Sabin, Franklin Paine Mall, 24.
'What we shall consider success': Flexner and Flexner, William Henry Welch, 225.
'which will cost $200,000': Sabin, Franklin Paine Mall, 112.
'You make the opportunities': Ibid.
'the real pioneer of modern': Martha Sternberg, George Sternberg: A Biography (1925), see 5, 68, 279, 285.
build a theory on the right ones: An anecdote related by Dr. Steven Rosenberg, July 1991.
'keystone of the arch': Flexner and Flexner, William Henry Welch, 165.
'putting an opponent down': Ibid., 151.
'the richness of the world': Ibid., 230.
'atmosphere of achievement': Ibid., 165.
'never anything quite like it': John Fulton, Harvey Cushing (1946), 118.
CHAPTER FOUR
'no evidence of preliminary education': Flexner and Flexner, William Henry Welch, 222.
'long and painful controversy': Ludmerer, Learning to Heal, 53.
'The talk was of pathology': Fulton, Harvey Cushing, 121.
'what was true of Harvard': Shryock, Unique Influence of Johns Hopkins, 8.
'and want no others': Quoted in Ludmerer, Learning to Heal, 75.
'to one man (Franklin P. Mall': Shryock, Unique Influence, 20.
'whether they were saved': Michael Bliss, William Osler: A Life in Medicine (1999), 216.
fifty-three became professors: Bonner, American Doctors and German Universities, 99.
'the whole still concert': William G. MacCallum, William Stewart Halsted (1930), 212.
'violate all the best precedents': Flexner and Flexner, William Henry Welch, 263.
'flick of a wrist': Ludmerer, Learning to Heal, 128.
endowments totaled $500,000: Shryock, Unique Influence, 37.
marvelous curative agent: Victor A. Vaughan, A Doctor's Memories (1926), 153.
'an epoch in the history of medicine': Flexner and Flexner, William Henry Welch, 207.
'a body of research': Wade Oliver, The Man Who Lived for Tomorrow: A Biography of William Hallock Park, M.D. (1941), 238.
'little less than lunatic': Frederick T. Gates to Starr Murphy, Dec. 31, 1915, WP.
'to become a pioneer': Ibid.
accepting the Jew: James Thomas Flexner, American Saga, 241/42.
'every letter handwritten': Ibid., 278.
'not have anything to do with': Benison and Nevins, 'Oral History, Abraham Flexner,' Columbia University Oral History Research Office; Flexner, American Saga, see 30/40.
'never heard a heart or lung': James Thomas Flexner, American Saga, 133.
'great gaps': Ibid., 421.
'He read' as he ate': Benison and Nevins, 'Oral History, Abraham Flexner.'
'days of acute fear': James Thomas Flexner, American Saga, 239.
'a museum in print': Peyton Rous comments, Simon Flexner Memorial Pamphlet, Rockefeller Institute of Medical Research, 1946.
'His mind was like a searchlight': Corner, History of the Rockefeller Institute, 155.
'final as a knife': Ibid.
'or they can be bled further': Flexner to Cole, Jan. 21, 1919, Flexner papers, APS.
'Individuals were as nothing': Peyton Rous comments, Simon Flexner Memorial Pamphlet.
mortality rate fell to 31.4 percent: Simon Flexner, 'The Present Status of the Serum Therapy of Epidemic Cerebro-spinal Meningitis,' JAMA (1909), 1443; see also Abstract of Discussion, 1445.
'Remarkable results were obtained': Ibid.
a shouting match ensued: Wade Oliver, Man Who Lived for Tomorrow, 300.
'mortality rate of 25 percent': M. L. Durand et al., 'Acute Bacterial Meningitis in Adults (A Review of 493 Episodes,' New England Journal of Medicine (Jan. 1993), 21/28.
'I advise the publication': Flexner to Wollstein, March 26, 1921, Flexner papers.
'Before night your discovery': Corner, History of the Rockefeller Institute, 159.
'frequent ballyhoo of unimportant stuff': Ibid., 158.
'he also was tender': Saul Benison, Tom Rivers: Reflections on a Life in Medicine and Science, An Oral History Memoir (1967), 127.
'made to believe': Corner, History of the Rockefeller Institute, 155.
'I won't expect anything': Ibid., 158.
'a great inspiration': Heidelberger, oral history, 1968, NLM, 66.
'an organism, not an establishment': Peyton Rous comments, Simon Flexner Memorial Pamphlet.
'science isolated Dr. Koch': For an account of this meeting see Wade Oliver, Man Who Lived for Tomorrow, 272/76.
CHAPTER FIVE
'wasn't afraid to fight': Benison, Tom Rivers, 30, 70, 204.
'quite remarkable in that way': Heidelberger, oral history, 83.
'Cole was adamant': Benison, Tom Rivers, 70.
'urged to undertake experimental work': Benison, Tom Rivers, 68.
'results were better than the system': Quoted in Flexner and Flexner, William Henry Welch, 61.
Not until 1912 would Harvard: Fleming, William Welch, 4.
a blistering' report: Vaughan, A Doctor's Memories, 440.
fifty-seven medical schools: Ludmerer, Learning to Heal,
116.
only eight thousand members: Paul Starr, The Social Transformation of American Medicine (1982), 109.
'my initial visit to Baltimore': Ludmerer, Learning to Heal, 172.
'make better farmers': Ibid., see 169/73.
6,843 locations: Meirion Harries and Susie Harries, The Last Days of Innocence: America at War, 1917/1918 (1997), 15.
'to' legitimize' ' capitalism: E. Richard Brown, Rockefeller's Medicine Men (1979), quoted in Starr, Social Transformation, 227.
thirty-one states denied licensing: Ludmerer, Learning to Heal, 238/43.
still 25 percent less: Shryock, Development of Modern Medicine, 350; Ludmerer, Learning to Heal, 247.
'The AMA deserved' the credit': Fulton, Harvey Cushing, 379.
$154 million into medicine: Ludmerer, Learning to Heal, 192/93.
'the sole argument for putting': Charles Eliot to Abraham Flexner, Feb. 1 and Feb. 16, 1916, WP.
Part II: The Swarm
CHAPTER SIX
'A slow rain fell': Santa Fe Monitor, Feb. 28, 1918.
didn't suffer fools: Material on L. V. Miner comes from an interview with his daughter-in-law Mrs. L. V. Miner Jr. on Aug. 27, 1999, and granddaughter Catherine Hart in July 2003, and from Kansas and Kansans (1919).
hold the train for him: For a description of a typical western practice, especially in Kansas, see Arthur E. Hertzler, The Horse and Buggy Doctor (1938) and Thomas Bonner, The Kansas Doctor (1959).
'sick with pneumonia': Santa Fe Monitor, Feb. 14, 1918.
'influenza of severe type': Public Health Reports 33, part 1 (April 5, 1918), 502.
'Most everybody over the country': Santa Fe Monitor, Feb. 21, 1918.
'John will make an ideal soldier': Santa Fe Monitor, Feb. 28, 1918.
'animosity towards me': Maj. John T. Donnelly, 341st Machine Gun Battalion, Camp Funston, RG 393, NA.
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