It is surprising to realize how slow the rise of the medical establishment has been. Up to the 20th century most physicians were considered a churlish lot, no better than they ought to be. And surgeons were worse. Duffy, a distinguished professor of medical history, has written a thoughful and literate account of medicine in America from the Plymouth settlement to the present day. He describes the changing climate of opinion--the humoral theory of disease, the ethic of suffering, the homeopaths and ""eclectics""--and the assorted heroes and villains that personified such camps. Along with anecdotes, statistics, and brief biographies, he sketches a picture of urban and rural life, regional differences, attitudes towards the mentally ill, and continuing attempts to better the human condition through public health measures or improved medical education. He adds some new and interesting material on the establishment's prejudices against blacks, Jews, and women. (The same bluestocking ladies who founded Bryn Mawr saw to it that Johns Hopkins Medical School admitted women.) Finally he discusses present trends toward national health care, cautioning the AMA establishment that a continued hard stand may be self-defeating. A fine comprehensive work which makes a useful and readable one-volume reference.