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     : Gettyimages.com (https://www.gettyimages.com/), Fotodom.com (http://fotodom.com/)



John M. Barry, 2004, 2005, 2009, 2018

This edition published by arrangement with Viking, an imprint of Penguin Publishing Group, a division of Penguin Random House LLC.

   , , .   , 2021



  .           () .  ,  ,   ,  ,   ,          .  ,   ,     ,  ,          ,      ,   ,       .

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    ,    ,   29,4  105  .   ,  ,     19181919.   ࠖ    675 .     105110 . ,   285 ,      1 750.  20182019. (   )     35,5  ࠖ   490600,  34200 (       ).    (2017.),           290650.

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 COVID-19          .  , ,  ,      ,      H1N1  2009.,      .       ,  ,        ,      .  :    ,     .      .   2019.      The Economist                 .    195 .            .    ,  , ,      COVID-19.



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  .  1918.  (  ,   )  ,       ,     ,      .        1920.,     ,        .     ,  XIV.                 ,    ,  ,   .

   ,   21 ꠖ             .        ,  , , .   ,     50⠖ , ,   100[2 - Niall Johnson and Juergen Mueller, "Updating the Accounts: Global Mortality of the 19181920 'Spanish' Influenza Pandemic," Bulletin of the History of Medicine (2002), 10515.].

        蠖    .       ,     1918.           ,  20  40.  ,  ,         , ,     ,   [3 - Sherwin Nuland, How We Die (1993), 202.] (         ).

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   ,           .          ,   ,             ; ,          ,       .

         ,       .     (    ,     )    ,       .           ,     ,      .            .

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 , ,   .           ,   .    .

             ,   -     ⠖  ,    .     XIX.,       ,   ,  ,  ,     ,  2000 .  ,   ,      ,        堖   . ,    ,      .          , , ,    .

                        ,     ,     1900.      ,    .    100         (     ),    .   20%            ,         !          [4 - Kenneth M. Ludmerer, Learning to Heal: The Development of American Medical Education (1985), 113.].               .    ,       .    ,     ,       ࠖ       .

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 ,   ,       (       ).  ,              [5 - William James, "Great Men, Great Thoughts, and Environment" (1880); .: Sylvia Nasar, A Beautiful Mind (1998), 55.].

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 I







 


,  12 1876.    ,    蠖      .  ,      ,      ,     :     ,     .       .        :         ,        .        .     ,          .     ,    .

       .  ,    The NewYork Times,     ,       .

  ,    ,     ;  ,      ,     ,   ,     .

 ࠖ       .            ,        .        The Washington Star     ,   ,            [7 - The Washington Star, Sept. 12, 1876.].

     ,     :      蠖    ⠖    .             ,     ,  .      , ,        .   300         , ,  ,   ,      ,      The NewYork Times:  ,      ![8 - The NewYork Times, Sept. 12, 1876.]

          ,            ,          .     ()     ;        ,        .        ,         :         ,    堖         ,     ,  .               ,  ,  ,   .

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  11      .        ,     . ,   ,  ,     .     ,     :   ,  -    .

,       (       ,    ),   ,     ,      .         .    :   蠖       . 蠖  ,     ࠖ  :       ,  .    ,              ,       .   ,     :   蠖   ,  .

             .  1876.              .  :      ,   ,   ,      , ,   XIX.[9 - H.L. Mencken, "Thomas Henry Huxley 18251925," Baltimore Evening Sun (1925).].

       .       .

     ,         .     ࠖ   ?   ,   ,           . ,     ,      - ,  ,    ,      젖     ,      ,   . ,    ,  ,    ,     堖       ,    ,     .

  ,   [10 -     . The NewYork Times, The Washington Post, The Baltimore Sun, Sept. 13, 1876.],    .       ,     ,  .    ,   ,      .     ,   ,      ; ,          .

     ,     ,   (             ),      ,       ,  -  ,         .

  ,    ,    ,           젖 .           ,           ,           ,    .

        ,     :        ,       .     ,     (, , )   .      ,      200     [11 - Simon Flexner and James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (1941), 237.]; ,     ,                .

      :     ,     .

          ,     ,            ,     .           

 1918.,      ,     ,  (   )    ,     .   :         , ,      .



    :    ?      ?.

 ,  ,     젖     .    -   ,   (     )    ?.

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 ?    .    ,       : ?

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 ,   . ,             .      , ,          -  ,   .          ,     .

 ,        ,       ,  : ,      ,          .  , ,   ,      ,     .      ,       ,  .     ,     ,   .

  蠖      ,    .         .  ,   ,   . ,   ,  ,       ,     ,  ,     .       : ,   ,    .    ,      ,     .      .

        .   ,     ,  ,     ,     ,    .  :   - ,        ,   , .       .

  ,                       .         .        25 ⠖        .

         .  堖   ,   V.  ..    .   ,     ( ,  ,   )          ,     .

    460.  ..       (  ,    ,     )    ,    [12 - Roy Porter, The Greatest Benefit to Mankind (1997), 56.].        ,     .    :        ,   ,  ,     ,   ,       ,               [13 - . . .  . . .:  , 1998.].

,       ,        .



-,        .    .

      -    .       .           .    砖           .        :  ,  .      ⠖     .         .    .

        .  ,    ,  ,    .   ,       ,      :   (   ),   .       ,      ,  : , ,    [14 -    . Porter, The Greatest Benefit to Mankind, 4266,    .]. (          ,      ,  ,   .)

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       ,    :     ,     (, ,   )   ,   (, ,   ).

       ,  .       蠖     .  :      ,     ,       .  ,    ,     .  ,        ,     [15 -  , . 77.].

    .   ,      .      ,    , ,       .  ,       .       , :       ,   ,   ,  ,     ,        .         .     ,        ,              ,      [16 - Vivian Nutton, "Humoralism," in Companion Encyclopedia to the History of Medicine (1993).].

            ,       15 ⠖        .    ,  ,        .  ,       :       .     ,        .  ,  ,   , ,    .          ,      ,   ,     ,  ,   .

   ,  ,           ࠖ  ,           ( ,    ).    .       ⠖       .

  XIX. ,   ,      .     ,   ,     ,    . , ,     ,        .   XIX. ,  ,     ,   ,      .      .

     ,     ;  ,     ,   ,     ,    .            2000.

  , ,    2000        ,     .      ,       .          ,          .

     ,         :      ,  堖       ,      (,  ),    ,  .

   XVI.   ,       .  ,         ,     ,     [17 - . : Winslow, Conquest of Epidemic Disease, 126.].

  ,           :     .      ,     .

  , ,       ,      ,   ()              .        ,  , , 젖    [18 -  , . 142.].

        , ,  .  ,         .           .

  ,    ,   .    ,      ,  .  1620.             : ,   ,               .  : ,   ,      ,      ,   .    ,  .

 1628.      堖  , ,    .   ,   XIX.     .       .           .    ,   ,      .  1753.           ,         .          limeys .      ,  ,   .    [19 -     , .  . . .]      ,        .            . ,       , ,   .

,  1798.  ,  ,    (    :  , [20 -  , . 59.]).    ,    :    ,     .         ,  ,   ,     .  ,       . ( ࠖ  ,      Variolae vaccinae,     ).

       ,   ,        .  ,           ,      ,        XVI.  蠖   蠖                ,     .         ,       .  1721. ,            ,   ,    .    ,    (   Variola  )   .       .

   , ,         .      :       ,   젖       [21 - .         (1934),   ,    .].

      .    ,     ,  ,      ,      ,  .  (  ) ,    ,   -          .

 ,  22      16   ,  , -,   -,   ,          ,          ,      [22 -       Richard Shryock, The Development of Modern Medicine, 2nd ed. (1947), 3031.].

 1796.     ,   ,   ,   .         ,    ,     ,   :        . ,    ,  ,        .      , ,   ,         .         젖   . , , .

        . ,     .   XIX.      ,     ,              [23 -  , . 4.].

                    ⠖ The Lancet. ,       .

     頖       ,        300      ,         - ,   -      .

   ?     ?

         ,        ,            ?       ?

     ,        , , ,   . ,     .  ,  ࠖ         ,     .

堖           . ,     ,  : ,  ,   ,      .     堖 ,       .     ,     ,   .      ,        . ,                 ,         .       :  ,    .

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, ,       .      .  ,           ,         .      ,     ,   .      XIX.                    ,      .    ,       ,      .     ,   ,          ,     ,       [24 - Charles Rosenberg, "The Therapeutic Revolution," in Explaining Epidemics and Other Studies in the History of Medicine (1992), 1314.].   ࠖ                        .

   ,     ,         ,   [25 -  , . 927,    .]. ,     ,    ࠖ , , , .     ,   .       . ,  ,    ,     ,        ,   [26 - Benjamin Coates practice book, .  , . 17.].   ,     .

          ,   . ,  1889. Merck Manual     ꠖ   100   ,        ,      ,         .  ,              ,  ,   .

   ,    ,     ,           ,       .           :    ,     頖       !     .  ,     ,   ,     ,     堖 ,   , .        - .

  :  ,      .     ,  ,        ,    ,    - .     ,       .

       .     ,   -   ,            .       .  ,     ,  ,        ,   ,      , :         ,      ,                . (     ,  ,    :          12. ,      .)



             : , ,  ,      蠖 頖    ,    .  ,  ,     , ,       ,      .  ,           ,      .   -     ,     [27 -    .].

,    .     ,  .   -  .          ,     .     ,   .        ,           .    ,      .

     ,          ,    .         .       ,  ,              ,      -; ,          .        XVIII.,       젖    .    ,  ,    ,   ,    ,     .     ,  -  ,          .    , ,  ,      ,   :   ,   ,           ,            .

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           ,   .



  XIX.     ,           .   ,         ,          . ,  ,     ,      ( ),              .  ,    -          .  ,             ,    .

,    ,  1800. ,                 , ,    .  1800.,     ,     [28 - . : Richard Shryock, American Medical Research (1947), 7.].

 XIX.   ,    . ,        ,         ࠖ    .        , ,  , ,        ,   ,     .     ,  .

           .     .      ,        ,    ,   ,      ,            .  20-  XIX.,  200   ,       .  -   XVIII.        .

            .  ,     ,  렖    ,     頖   ,         ,    .          .      .      ,   蠖      .

     -       ,          .         ,       (  ,   ),        ,        .   ,     ,      .

 堖    堖       ,  .  XVII.     ,    ,    -     ࠖ        .      ,     .

        ,   ,      .     .

     ,      ,  . , , ,     ,    ࠖ          ,      ;     .   ,        堖            ,        [29 - Michel Foucault condemned: John Harley Warner, Against the Spirit of the System: The French Impulse in Nineteenth-Century American Medicine (1998), 4.].

,  ,     .      :  ,   ,   ,     ,            ,  [30 -  , . 183184.].

  ,         젖     .  4050- . XIX.          -  .          , ,  ,   ,         .             ,      .    - .  ,   ,            .

 ,       ,     ,     .  ,       50- . XIX.,        .   ,  堖     ,     ,          100   1000 .        ,    ,  ,        .

  ,              .  堖  ࠖ   :              .            ,     .   ,              ,                 . ,     ,  ,  -          .

      黠     .     ⠖   ,     ,  ,  ,   ,      ,        .    ,      ,         ,    ,    .      The New England Journal of Medicine,  ,     .  ,         ,   ,       頖   ,    ,     ,     ,          .


?

               .             .      .         ,    ,     30- . XIX.,        .

        ,   ,  ,   ,   ,      XIX.      ,            . (   ,     ,        ,  ,      .    ,     ,     :  ?   ,    [31 - . Richard Walter, S. Weir Mitchell, M.D., Neurologist: A Medical Biography (1970), 20222.].)

      ⠖  ,        1843.       .     ,      .       ,            .  ,   ,    ,     :    ,    [32 - Winslow, Conquest of Epidemic Disease, 296.].

   :     ,      ,   .

        .

                 頖          (       ).    ,   ,   . ,  1868.       ()   ,    ,     .     ,    ,      1918.,     (     ),      .

    ,        .       ,     .  1835.                ,      ,      ,         ,       [33 - . : Paul Starr, The Social Transformation of American Medicine (1982), 55.].

    .   ,  ,           .     ,       ,    ,      .     XIX.  , ,   ,    .  1862.       , ,    9502         [34 - Charles Rosenberg, Explaining Epidemics and Other Studies in the History of Medicine (1992), 14.].

               .    ,    ,        ,     ,      .      ,      - .

 ,  ,     .      ,  :      1810.,    ,         .        ,   .       .

 ,  ,             , ,      ,     , , ,       . ,    ,         ,   ;  ,  ,           [35 - Thomsonian Recorder (1832), 89; .: Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (1962), 7071.],        .      ,   :      [36 - John Harley Warner, "The Fall and Rise of Professional Mystery," in The Laboratory Revolution in Medicine (1992), 117.].

        ,   .   ,   ,  ,        .           :

		     :
		, , .
		   ,
		    ,  .
		     
		   [37 - . : Rosenberg, Cholera Years, 7071.].

    ,     ,                   , ,      .  XVIII.,    ,       .          .       ?     ?  ,  - ?     1846.:       ,    ,         [38 - John King, "The Progress of Medical Reform," Western Medical Reformer (1846); quoted in Warner, "The Fall and Rise of Professional Mystery," 113.].        ,      ,    ,        ,     .        ,    .   1900.    41 ,  35  ,    34 [39 - Burton J. Bledstein, The Culture of Professionalism: The Middle Class and the Development of Higher Education in America (1976), 33.].         1858.  :          ?[40 - Shryock, Development of Modern Medicine, 264.]

        䠖    .      .     ,         1846.     ,   ,       ,    .

,               ,    ,    .         ,    ,       .      ,   ,     :  ,           .       ,     .              ,           [41 - Ludmerer, Learning to Heal, 10, 11, 23, 168.].

            ,   .   ,    ,    . (    ,      - ,    ,   ,        .)

   ࠖ ,   頖    , ,       ,          ,      ,    -  .    ,     ,   [42 - Rosenberg, "The Therapeutic Revolution," 927,    .].      - (  )   , :   ,    materia medica,     ,    ,      頖     [43 - Bledstein, Culture of Professionalism, 33.].

      -.   .   ,     ,   ,    .  1832.       ⠖     ,      .      ,     .    ,         :       ,     .        ,  ,    ,   [44 - . : Donald Fleming, William Welch and the Rise of American Medicine (1954), 8.].

 ,        ,       .       , , .    ⠖  7   XIX.  226     [45 - Edwin Layton, The Revolt of the Engineers: Social Responsibility and the American Engineering Profession (1971), 3.].      .        ,  ,  ,      ,   ,        ,  ,   ,        .   . ,       ,   .     ,     ,       ,    .

      70- . XIX.           ,    .    ,      ,  堖      頖   ,       ,      .                ;           ,    .        ,  堖  .  1870.    -      ⠖       [46 - Ludmerer, Learning to Heal, 37 (  ), 12 (  ).].

  ,    -,    (  ),        .   ,   -,  ,   ,         ,    [47 - .  , . 25.].   70- . XIX.,             (          ),               堖         ,          .  1871.             ,      ,         .     1871.      ,     [48 -  , . 37.].

  1869.       (       ,       ).   ,  :          .         ,      ,   ,  [49 -  , . 48.].

            ,    ,    .                - .    ,     ,       : []            .    ,           -.       .  ,                   ,    [50 - Bledstein, Culture of Professionalism, 27576.].

               ,  - ,    .            .                [51 - Ludmerer, Learning to Heal, 15.].

 ,   , :     ,  ,           ,  ,    ,         ,    ,  .    ,       ,            [52 -  , . 25.].



    1873.,      3,5      .          .                   .       :       ,             .  10%       .

    ,  ,  .      ,           [53 - James Thomas Flexner, An American Saga: The Story of Helen Thomas and Simon Flexner (1984), 125; . . 294 .],          ,   ,   ,        .

     ,       ;  ,    , ,   ,  .       :           ,                 -,     [54 -   , .: Flexner, American Saga, 125.].  ,      .              .

      :     .  ,          ,     .    ,   -,       ,   ,    ,    .      頖     c   .       : ,        ,      .

,         .   蠖       .

       ,           .         (  ,    ),    .      - ,           .

        ,      ,       .   ,  ,              :     .

 ,          ,        ,      .

       .          ,   .

     1876.      ,  1893.,         ,                 .



   .   , ,  ,    :         ,      ,    ,       ,   ,       .

     ,      ,       , ,        .          .

         .




 


        ,      .

     ,        ,       1930.[55 - Flexner and Flexner, William Henry Welch, 38,    .] ,              ,   ,    , -  ,  ,   -,  , , ,   .          ,      ,     ,       .           ,    .        ,         .

         , ,     .      ,     ,    ,         (      ).   ,          , ,           ,   32,         (  ),          .

            ,  堖      ,  ,     .        ,      ,       ,             .          ,       ,      .

              (  ,      )    .     ,     蠖      ,   ,     .

      ,        ,     .   -,   1900.     ; 1920- .     1500 [56 - Ezra Brown, ed., This Fabulous Century, The Roaring Twenties 19201930 (1985), 105, 244.];      ,       ,      1930.      ,        ,     ,      ,    -    ,     [57 - . : Sue Halpern, "Evangelists for Kids," NewYork Review of Books (May 29, 2003), 20.].






           .     - ,         .         ,  :  ,  -    .



,        ,     ( )           .

    ,            .         .    ,       ,     ,    ,  ,   ,  ,       ,   .

      堖     .        ;    , , . ,   ,      ,      ,        頖    .  ,     ,     -  ,  -    .      ,    .  堖       .



   1850. ,        ,     .  ,  ,       .         1857.        .       ,  ,      1868.   ,               .  , -     ,         [58 - Flexner and Flexner, William Henry Welch, 33.].   :             [59 -  .].

,       ,    .       ,    ,       [60 -  , . 29.].

,      ,    .   ,    .        ,          .          ,         .      ,      .

    ,      : ,   .    .      .      ,       ,  .        ,       [61 - Fleming, William Welch, 15.].  .          ,        15               .

    ,          .      ,  ;  ,    ,        ,          .          ,       .      .      .

     젖           .  ,     ,      ,    .        ,          .   ,    ,        ,         .

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         . ,  .       ,      ,        . ,  ,     -        ,     .       .   .                  - . ,   ,      .

             .    ,   ,       ,     ,    .  ,  1870.,           ,         .

    .        :          ?    - ,        ,      .   ,       XIX.,   :    ,     ,  .    ,   ,      ,       [63 - . . . . .].

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  .


   .

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notes








1


      , 31 2002.,    , 9 2002.




2


Niall Johnson and Juergen Mueller, "Updating the Accounts: Global Mortality of the 19181920 'Spanish' Influenza Pandemic," Bulletin of the History of Medicine (2002), 10515.




3


Sherwin Nuland, How We Die (1993), 202.




4


Kenneth M. Ludmerer, Learning to Heal: The Development of American Medical Education (1985), 113.




5


William James, "Great Men, Great Thoughts, and Environment" (1880); .: Sylvia Nasar, A Beautiful Mind (1998), 55.




6


ø . .  / .. . .: , 2012.




7


The Washington Star, Sept. 12, 1876.




8


The NewYork Times, Sept. 12, 1876.




9


H.L. Mencken, "Thomas Henry Huxley 18251925," Baltimore Evening Sun (1925).




10


    . The NewYork Times, The Washington Post, The Baltimore Sun, Sept. 13, 1876.




11


Simon Flexner and James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (1941), 237.




12


Roy Porter, The Greatest Benefit to Mankind (1997), 56.




13


. . .  . . .:  , 1998.




14


   . Porter, The Greatest Benefit to Mankind, 4266,    .




15


 , . 77.




16


Vivian Nutton, "Humoralism," in Companion Encyclopedia to the History of Medicine (1993).




17


. : Winslow, Conquest of Epidemic Disease, 126.




18


 , . 142.




19


    , .  . . .




20


 , . 59.




21


.         (1934),   ,    .




22


      Richard Shryock, The Development of Modern Medicine, 2nd ed. (1947), 3031.




23


 , . 4.




24


Charles Rosenberg, "The Therapeutic Revolution," in Explaining Epidemics and Other Studies in the History of Medicine (1992), 1314.




25


 , . 927,    .




26


Benjamin Coates practice book, .  , . 17.




27


   .




28


. : Richard Shryock, American Medical Research (1947), 7.




29


Michel Foucault condemned: John Harley Warner, Against the Spirit of the System: The French Impulse in Nineteenth-Century American Medicine (1998), 4.




30


 , . 183184.




31


. Richard Walter, S. Weir Mitchell, M.D., Neurologist: A Medical Biography (1970), 20222.




32


Winslow, Conquest of Epidemic Disease, 296.




33


. : Paul Starr, The Social Transformation of American Medicine (1982), 55.




34


Charles Rosenberg, Explaining Epidemics and Other Studies in the History of Medicine (1992), 14.




35


Thomsonian Recorder (1832), 89; .: Charles Rosenberg, The Cholera Years: The United States in 1832, 1849, and 1866 (1962), 7071.




36


John Harley Warner, "The Fall and Rise of Professional Mystery," in The Laboratory Revolution in Medicine (1992), 117.




37


. : Rosenberg, Cholera Years, 7071.




38


John King, "The Progress of Medical Reform," Western Medical Reformer (1846); quoted in Warner, "The Fall and Rise of Professional Mystery," 113.




39


Burton J. Bledstein, The Culture of Professionalism: The Middle Class and the Development of Higher Education in America (1976), 33.




40


Shryock, Development of Modern Medicine, 264.




41


Ludmerer, Learning to Heal, 10, 11, 23, 168.




42


Rosenberg, "The Therapeutic Revolution," 927,    .




43


Bledstein, Culture of Professionalism, 33.




44


. : Donald Fleming, William Welch and the Rise of American Medicine (1954), 8.




45


Edwin Layton, The Revolt of the Engineers: Social Responsibility and the American Engineering Profession (1971), 3.




46


Ludmerer, Learning to Heal, 37 (  ), 12 (  ).




47


.  , . 25.




48


 , . 37.




49


 , . 48.




50


Bledstein, Culture of Professionalism, 27576.




51


Ludmerer, Learning to Heal, 15.




52


 , . 25.




53


James Thomas Flexner, An American Saga: The Story of Helen Thomas and Simon Flexner (1984), 125; . . 294 .




54


  , .: Flexner, American Saga, 125.




55


Flexner and Flexner, William Henry Welch, 38,    .




56


Ezra Brown, ed., This Fabulous Century, The Roaring Twenties 19201930 (1985), 105, 244.




57


. : Sue Halpern, "Evangelists for Kids," NewYork Review of Books (May 29, 2003), 20.




58


Flexner and Flexner, William Henry Welch, 33.




59


 .




60


 , . 29.




61


Fleming, William Welch, 15.




62


Flexner and Flexner, William Henry Welch, 50.




63


. . . . .




64


.  , . 49.




65


 , . 6263.




66


Shryock, Development of Modern Medicine, 206.




67


Flexner and Flexner, William Henry Welch, 64, . . 71 .


