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250 Years of American Medicine
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1776-1826

In the Early Republic, varying levels of medical training and limited professional standards yielded loosely organized practice of medicine. People sought out common therapeutic practices—including bloodletting, purging, surgery, and home remedies—from family members, communities, and physicians. Shaped by wars and limited public sanitation, smallpox, yellow fever, and other infectious diseases were major health concerns. The spread of smallpox inoculation, expanding medical education, and scientific inquiry advanced the medical profession. Explore a selection of NLM items produced between 1776 and 1826. Topics include wartime medicine, smallpox inoculation, Native American health and healing, yellow fever epidemics, botanicals and herbal remedies, and more.

1776-1826
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1776-1826

In the Early Republic, varying levels of medical training and limited professional standards yielded loosely organized practice of medicine. People sought out common therapeutic practices—including bloodletting, purging, surgery, and home remedies—from family members, communities, and physicians. Shaped by wars and limited public sanitation, smallpox, yellow fever, and other infectious diseases were major health concerns. The spread of smallpox inoculation, expanding medical education, and scientific inquiry advanced the medical profession. Explore a selection of NLM items produced between 1776 and 1826. Topics include wartime medicine, smallpox inoculation, Native American health and healing, yellow fever epidemics, botanicals and herbal remedies, and more.

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1827-1876
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1827-1876

American medicine became more organized during the 19th century as medical schools, hospitals, and professional societies expanded, though standards and training varied widely. Physicians practiced surgery, obstetrics, and emerging scientific medicine, while many people also turned to homeopathy and other alternative therapies. Infectious diseases such as cholera, smallpox, and rabies remained major threats, prompting growing interest in quarantine, sanitation, and public health. Significant advances included the use of ether anesthesia, improvements from Civil War medicine, and the development of professional nursing. Presented is an assortment of National Library of Medicine collection items printed between 1827 and 1876, covering topics such as homeopathy, nursing, infectious disease, administering ether, sanitation, women in medicine, Civil War medicine, and more.

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1877-1926
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1877-1926

Between 1877 and 1926, American medicine became increasingly scientific and professionalized as medical education and licensing became required by the states. Physicians relied on laboratory science, surgery, nursing care, and new diagnostic tools, while some Americans used widely advertised patent medicines alongside conventional treatments. Infectious diseases such as tuberculosis, influenza, rabies, and yellow fever remained major concerns, driving advances in public health and disease prevention, including the development of several vaccines. Germ theory, antiseptic surgery, X-rays, bacteriology, and the discovery of insulin transformed medical practice and outcomes. View this selection of items from the NLM collection produced from 1877 to 1926, which include works about pharmacology, surgery, infectious disease, public health, nursing, World War I medicine, and more.

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1927-1976
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1927-1976

By the mid-20th century, American medicine had become highly professionalized as physicians, nurses, hospitals, and public health agencies took on leading roles in healthcare. Medical practice increasingly relied on laboratory science, pharmaceuticals, vaccinations, and advanced technologies. These changes led to many Americans receiving care through hospitals, clinics, and expanding insurance systems. Infectious diseases declined as sulfa drugs, antibiotics, and vaccines transformed treatment and prevention. Chronic diseases, smoking-related illnesses, and environmental health concerns gained attention. Major medical breakthroughs included blood banking, open-heart surgery, organ transplantation, and DNA research. Explore a selection of NLM collection items produced between 1927 and 1976 about the discovery of DNA, substance use, World War II medicine, environmental health, computers in medicine, biotechnology, and more.

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1977-2026
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1977-2026

Since 1977, American medicine has become more technologically advanced and evidence based. Physicians, nurses, and allied professionals deliver specialized and team-based care. Patients access health services through hospitals, outpatient clinics, telemedicine, and digital health platforms, reflecting major changes in communications and access. Many health concerns from years past persist, like cancer and mental health disorders, while new ones have emerged, including the opioid epidemic, infectious diseases such as Ebola and COVID-19, and chronic conditions tied to lifestyle and aging populations. Advances in genomics, imaging, immunotherapy, and artificial intelligence continue to transform diagnosis and treatment, alongside major public health campaigns and public policy responses. Browse these NLM collection items created between 1977 and 2026, on subjects including HIV/AIDS, COVID-19, the opioid epidemic, mental health, telemedicine, public health communications, and more.

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Anatomy and Surgery
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Anatomy and Surgery

In the United States, the histories of anatomy and surgery have long been closely intertwined. Whereas early physicians often relied on limited anatomical knowledge and rudimentary surgical procedures to treat patients, later improvements in fields such as education, anesthesia, antibiotics, and blood transfusion made operations safer and more effective. Learn more about some of these important historical developments in this digital gallery.

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Cultures of Medicine
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Cultures of Medicine

Medicine has always involved cultural forces that impact the discipline as a whole. These forces impact the way in which individual physicians undertake their work and researchers discover various treatments for diseases. From stories about doctors and patients to the organizations that support their efforts, medical professionals are part of a broader system that helps to keep the entire nation healthy. Scroll through this digital gallery to learn more about the cultural history of medicine in the U.S.

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Diseases and Conditions
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Diseases and Conditions

Over the past 250 years, the list of diseases and conditions that affect people in the U.S. has changed dramatically. In the early Republic, cholera, yellow fever, and smallpox were among the leading causes of death. Today, advances in sanitation and public health mean that these illnesses have been eradicated or replaced, leaving chronic conditions such as cancer, diabetes, and heart disease as the most pressing health concerns. Learn about the changing history of diseases and related conditions in this digital gallery.

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Drugs and Treatments
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Drugs and Treatments

Drugs and therapeutic treatments have played an important role in U.S. medicine since the founding of the country in 1776. Whereas early physicians generally relied on traditional methods such as bloodletting and herbal remedies, later advances in vaccines, pharmaceuticals, antibiotics, and chemotherapy have helped to radically to improve patients’ health. Learn more about the development of some of these innovative drugs and treatments in this digital gallery.

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Laboratory Science
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Laboratory Science

Researchers working in laboratories across the United States have made some of the most important medical breakthroughs of the last 250 years. These include the first use of general anesthesia and the discovery of the cause of yellow fever, as well as more recent innovations like recombinant DNA technology, GLP-1 inhibitors, and CAR-T Cell therapy. Learn about a handful of these important laboratory discoveries in this digital gallery.

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Medical Technology
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Medical Technology

Since 1776, the history of medical technology in the United States has often reflected the broader scientific, industrial, and social progress of the nation. From the earliest surgical tools used during the Revolutionary War to more recent developments such as artificial heart valves and magnetic resonance imaging (MRI), U.S. technical innovation has always proceeded hand in hand with improvements in patient health. Learn more about some of these incredible inventions in this digital gallery.

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Military Medicine
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Military Medicine

Throughout its history, the United States has participated in numerous armed conflicts that have contributed to the growth of military medicine. From the War of Independence to the U.S. Civil War and more recent struggles in Europe, Vietnam, and Afghanistan, the country has relied on a dedicated group of doctors, nurses, and field medics to keep their troops healthy and combat ready. Learn more about their stories and the history of U.S. military medicine in this digital gallery.

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Mind and Brain
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Mind and Brain

Between the founding of the U.S. in 1776 and today, medical research into patients’ minds and brains has shifted from the field of philosophy to the natural and social sciences. During this time, researchers have become increasingly interested in the ways in which various physical and chemical structures in the brain contribute to human cognition. This in turn has revolutionized how we see learning, memory, and indeed mental health. Learn more about this historical transition in the digital gallery below.

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Preventive Medicine
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Preventive Medicine

Though we often think of preventive medicine as a recent historical development, the idea of taking proactive steps to ensure personal health is at least as old as the United States itself. For centuries, U.S. doctors and physicians have recommended a wide variety of herbal remedies, workout regimes, and dietary plans—each designed to help their patients live a healthier lifestyle. Learn about some of these innovative and unusual therapies in this digital gallery.

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Public Health
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Public Health

Public health has shaped the medical, political, and social life of the United States since the nation was first born two and a half centuries ago. Beginning with the efforts of local officials to contain an outbreak of Yellow Fever in Philadelphia in 1793, the U.S. government has consistently played an important role in improving living conditions and promoting healthy behaviors in communities all across the country. Learn more about the history of U.S. public health in this digital gallery.

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Audiovisuals
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Audiovisuals

Moving images serve as a vital tool for health education, document significant events and breakthroughs in medicine, and provide a way of sharing scientific scholarship. Explore this selection of audiovisual materials in the NLM collection, produced over the past century, originally in film, videocassette, and webcast.

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Born-Digital
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Born-Digital

Since the mid-20th century, digital media has transformed American health and medicine, changing how medical knowledge is created, shared, and preserved; empowering patients with greater access to information; enabling community action in the pursuit of wellbeing; and accelerating biomedical research and discovery. Learn about born-digital materials in the NLM collection, including websites and software, in this digital gallery.

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Manuscripts
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Manuscripts

Medical manuscripts document the development of American medicine. Physicians, researchers, students, hospitals, and public health officials manually record and collect observations, treatments, research findings, and institutional activities. These records support medical education and facilitate the exchange of knowledge. Today, medical manuscripts remain invaluable sources for understanding the scientific, social, and cultural history of health and medicine in the United States. Explore this selection of working notes and correspondence from clinicians, researchers, and patients.

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Still Images
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Still Images

From anatomical drawings and clinical photographs to public health posters and advertisements, still images help doctors diagnose illness, communicate scientific knowledge, educate the public, and shape perceptions of medicine. They have also served as records of medical practice, scientific discovery, and patient experience, preserving visual evidence of how health and medicine have evolved over time. Explore a selection of these still images from the collection in this digital gallery.

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Texts
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Texts

Over the past 250 years, medical texts have been the primary means of organizing and sharing medical knowledge gained in America. Textbooks, journals, and reference works have standardized medical education and clinical practice while supporting the professionalization of the field. They have enabled scientific communication, recorded shifting understandings of disease, and translated research into practice. Medical texts also provide a lasting scholarly record that continues to inform education, care, and historical research. Explore this assortment of medical texts from the NLM collection.

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51 Images

The title page of Plain Concise Practical Remarks on the Treatment of Wounds and Fractures.

Plain Concise Practical Remarks on the Treatment of Wounds and Fractures, John Jones, Philadelphia, PA: Robert Bell, 1776

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The title page of Plain Concise Practical Remarks on the Treatment of Wounds and Fractures.
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A browned page covered in printed text with the words General Orders at the top.

General Orders for the Army Under the Command of Brigadier General McDougall, General Alexander McDougall, Fishkill, NY: Samuel Loudon, 1777

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A browned page covered in printed text with the words General Orders at the top.
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The title page of An Epitome of the Theory and Practice of Physic.

An Epitome of the Theory and Practice of Physic, Hartford, CT: Watson and Goodwin, 1778

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The title page of An Epitome of the Theory and Practice of Physic.
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A blank page from a lined form book used to record the names of soldiers dismissed from the Continental Army, including a list of the items they took with them

Model forms to improve U.S. Army Hospital Administration During the American Revolution, James Tilton, 1779

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A blank page from a lined form book used to record the names of soldiers dismissed from the Continental Army, including a list of the items they took with them
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A hand written letter on brown paper from George Washington

Letter Written by George Washington, 1780

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A hand written letter on brown paper from George Washington
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The title page of The New Method of Inoculating for the Small Pox.

The New Method of Inoculating for the Small Pox, Benjamin Rush, Philadelphia, PA: Charles Cist, 1781

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The title page of The New Method of Inoculating for the Small Pox.
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The title page of A Narrative of a Discovery of a Sovereign Specific for the Cure of Cancers.

A Narrative of a Discovery of a Sovereign Specific for the Cure of Cancers, Hugh Martin, Philadelphia, PA: Robert Aitken, 1782

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The title page of A Narrative of a Discovery of a Sovereign Specific for the Cure of Cancers.
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The title page of Observations on the Superior Efficacy of the Red Peruvian Bark in the Cure of Agues and Other Fevers.

Observations on the Superior Efficacy of the Red Peruvian Bark in the Cure of Agues and Other Fevers, William Saunders, Robert Hodge: Boston, MA, 1783

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The title page of Observations on the Superior Efficacy of the Red Peruvian Bark in the Cure of Agues and Other Fevers.
Observations on the Superior Efficacy of the Red Peruvian Bark in the Cure of Agues and Other Fevers, William Saunders, Boston, MA: Robert Hodge, 1783
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The title page of Some Observations on the Situation, Disposition, and Character of the Indian Natives of this Continent.

Some Observations on the Situation, Disposition, and Character of the Indian Natives of this Continent, Anthony Benezet, Philadelphia, PA: Joseph Crukshank, 1784

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The title page of Some Observations on the Situation, Disposition, and Character of the Indian Natives of this Continent.
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The title page of Animal Magnetism.

Animal Magnetism, Benjamin Franklin, Paris, France, 1785

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The title page of Animal Magnetism.
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The title page of a handwritten manuscript entitled Notes from a Course of Lectures ... with a Surgeon Generals Office Library stamp.

Notes from a course of lectures on the practice of physic delivered by Benjamin Rush, 1786

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The title page of a handwritten manuscript entitled Notes from a Course of Lectures ... with a Surgeon Generals Office Library stamp.
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A series of 13 diagrams depicting the different parts of fireplaces, including arrows showing how air flows through each part

Observations on the Causes and Cure of Smoky Chimneys, Benjamin Franklin, Philadelpha, PA: John Debrett, 1787

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A series of 13 diagrams depicting the different parts of fireplaces, including arrows showing how air flows through each part
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The title page of The Institution of the Humane Society of the Commonwealth of Massachusetts.

The Institution of the Humane Society of the Commonwealth of Massachusetts, Humane Society of the Commonwealth of Massachusetts, Boston, MA, 1788

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The title page of The Institution of the Humane Society of the Commonwealth of Massachusetts.
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The title page of An essay on the Causes of the Variety of Complexion and Figure in the Human Species

An essay on the Causes of the Variety of Complexion and Figure in the Human Species, Samuel Stanhope Smith, Philadelphia, PA: John Stockdale, 1789

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The title page of An essay on the Causes of the Variety of Complexion and Figure in the Human Species
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The title page of the The Charter, Constitution and Bye Laws of the College of Physicians of Philadelphia.

The Charter, Constitution and Bye Laws of the College of Physicians of Philadelphia, College of Physicians of Philadelphia, Philadelphia, PA: Zachariah Poulson, 1790

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The title page of the The Charter, Constitution and Bye Laws of the College of Physicians of Philadelphia.
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An illustration from an old book depicting six different surgical implements, including a saw, a hook, and a clamp.

A System of Surgery, Benjamin Bell, Worcester, MA: Isaiah Thomas, 1791

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An illustration from an old book depicting six different surgical implements, including a saw, a hook, and a clamp.
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The title page of An Historical Account of the Climates and Diseases of the United States of America.

An Historical Account of the Climates and Diseases of the United States of America, William Currie, Philadelphia, PA: T. Dobson, 1792

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The title page of An Historical Account of the Climates and Diseases of the United States of America.
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The title page of A Short Account of the Malignant Fever Lately Prevalent in Philadelphia.

A Short Account of the Malignant Fever Lately Prevalent in Philadelphia, Matthew Carey, Philadelphia, PA, 1793

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The title page of A Short Account of the Malignant Fever Lately Prevalent in Philadelphia.
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An abstract geometric illustration of a military unit in the process of executing a marching maneuver through a narrow gorge.

Regulations for the Order and Discipline of the Troops of the United States, Baron von Steuben, Exeter, NH: Henry Ranlet, 1794

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An abstract geometric illustration of a military unit in the process of executing a marching maneuver through a narrow gorge.
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The title page of Medical Advice to Seamen.

Medical Advice to Seamen, Samuel Holden Parsons Lee, New London, CT: Samuel Green, 1795

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The title page of Medical Advice to Seamen.
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The title page of The Immortal Mentor, or, Mans Unerring Guide to a Healthy, Wealthy, and Happy Life.

The Immortal Mentor, or, Man's Unerring Guide to a Healthy, Wealthy, and Happy Life, Mason Locke Weems, Philadelphia, PA: Francis and Robert Bailey, 1796

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The title page of The Immortal Mentor, or, Mans Unerring Guide to a Healthy, Wealthy, and Happy Life.
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The title page of Evidences of the Efficacy of Doctor Perkinss Patent Metallic Instruments.

Evidences of the Efficacy of Doctor Perkins's Patent Metallic Instruments, Elisha Perkins, New London, CT: Samuel Green, 1797

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The title page of Evidences of the Efficacy of Doctor Perkinss Patent Metallic Instruments.
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A series of 8 diagrams depicting canons used in friction experiments, some of which appear embedded inside a large wooden box

Illustration Showing Cannon Used in Friction Experiments from Essays Political, Economical, and Philosophical, Benjamin Rumford, London, England: T. Cadell and W. Davies, 1798

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A series of 8 diagrams depicting canons used in friction experiments, some of which appear embedded inside a large wooden box
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The title page of A Brief History of Epidemic and Pestilential Diseases.

A Brief History of Epidemic and Pestilential Diseases, Noah Webster, Hartford, CT: Hudson & Goodwin, 1799

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The title page of A Brief History of Epidemic and Pestilential Diseases.
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The title page of The Midwives Monitor and Mothers Mirror.

The Midwives Monitor and Mothers Mirror, Valentine Seaman, New York, NY: Isaac Collins, 1800

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The title page of The Midwives Monitor and Mothers Mirror.
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The title page of The American Herbal, or Materia Medica.

The American Herbal, or Materia Medica, Samuel Stearns, Walpole, NH: David Carlisle, 1801

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The title page of The American Herbal, or Materia Medica.
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An image depicting a series of pustules cause by the cowpox vaccine and those caused by smallpox of a number of days.

Practical Observations on Vaccination, or Inoculation for the Cow-Pock, John Redman Coxe, Philadelphia, PA: James Humphreys, 1802

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An image depicting a series of pustules cause by the cowpox vaccine and those caused by smallpox of a number of days.
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The title page of An Epistle to a Friend, on the Means of Preserving Health.

An Epistle to a Friend, on the Means of Preserving Health, Charles Willson Peale, Philadelphia, PA: R. Aitken, 1803

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The title page of An Epistle to a Friend, on the Means of Preserving Health.
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The title page of An Inaugural Essay on the Influence of Music in the Cure of Diseases.

An Inaugural Essay on the Influence of Music in the Cure of Diseases, Edwin Augustus Atlee, Philadelphia, PA: B. Graves, 1804

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The title page of An Inaugural Essay on the Influence of Music in the Cure of Diseases.
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An illustration from a book of a patient on a table with straps around his left hip and knee while a man in a suit manipulates his knee and ankle.

"Orthopedic Apparatus for Setting a Dislocated Thigh Bone" from The Philadelphia Medical Museum, Philadelphia, PA: John Redman Coxe, 1805

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An illustration from a book of a patient on a table with straps around his left hip and knee while a man in a suit manipulates his knee and ankle.
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An illustration depicting three instruments for conducting experiments with heat, including a thermometer, a boiling box, and a set of water jugs.

Plain Discourses on the Laws or Properties of Matter, Thomas Ewell, New York, NY: Brisban & Brannan, 1806

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An illustration depicting three instruments for conducting experiments with heat, including a thermometer, a boiling box, and a set of water jugs.
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The title page of An Essay on the Truth of Physiognomy.

An Essay on the Truth of Physiognomy, Richard Brown, Philadelphia, PA: Thomas T. Stiles, 1807

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The title page of An Essay on the Truth of Physiognomy.
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The title page of A Popular Essay on the Disorder Familiarly Termed a Cold.

A Popular Essay on the Disorder Familiarly Termed a Cold, E.L. White, Philadelphia, PA: Bradford & Inskeep, 1808

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The title page of A Popular Essay on the Disorder Familiarly Termed a Cold.
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An illustration of a man standing on a short stool and holding a metal chain connected to a large device designed to generate electricity.

An Epitome of Electricity & Galvanism, Jacob Green, Philadelphia, PA: Jane Aitken, 1809

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An illustration of a man standing on a short stool and holding a metal chain connected to a large device designed to generate electricity.
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A page from an old handwritten book that provides recipes for treating diseases such as fever and epilepsy.

Recipe Book, William Elmer, 1810

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A page from an old handwritten book that provides recipes for treating diseases such as fever and epilepsy.
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An illustration of a man strapped to a chair with a large wooden block covering the top part of his head and eyes.

"The Tranquilizing Chair of Benjamin Rush" from The Philadelphia Medical Museum, Benjamin Rush, Philadelphia, PA: John Coxe Redman, 1811

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An illustration of a man strapped to a chair with a large wooden block covering the top part of his head and eyes.
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An image depicting two thermometers entitled Temperance and Intemperance, each of which are labeled with a series of more or less healthy alcoholic beverages.

"A Moral and Physical Thermometer"from An Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind, Benjamin Rush, Boston, MA: Manning & Loring, 1812

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An image depicting two thermometers entitled Temperance and Intemperance, each of which are labeled with a series of more or less healthy alcoholic beverages.
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An illustration of a man with various gash wounds on his head and face.

Elements of Surgery, John Syng Dorsey, Philadelphia, PA: Edward & Richard Parker, 1813

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An illustration of a man with various gash wounds on his head and face.
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The title page of Proposals for Establishing a Retreat for the Insane.

Proposals for Establishing a Retreat for the Insane, George Parkman, Boston, MA: John Eliot, 1814

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The title page of Proposals for Establishing a Retreat for the Insane.
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A map of the city of Cincinnati in 1815, including a numerical key listing important locations.

Natural and Statistical View or Picture of Cincinnati , Daniel Drake, Cincinnati, OH : Looker and Wallace, 1815

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A map of the city of Cincinnati in 1815, including a numerical key listing important locations.
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The title page of Military Laws, and Rules and Regulations for the Army of the United States.

Military Laws, and Rules and Regulations for the Army of the United States, U.S. Adjutant-General's Office, Washington, DC: E. de Krafft, 1816

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The title page of Military Laws, and Rules and Regulations for the Army of the United States.
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A colorful illustration of a blackberry plant, including its stem, leaves, flowers, and berries.

American Medical Botany, Jacob Bigelow, Boston, MA: Cummings and Hilliard, 1817

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A colorful illustration of a blackberry plant, including its stem, leaves, flowers, and berries.
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The handwritten title page of Abstracts from Lectures on Surgery.

Abstracts from Lectures on Surgery, Chandler Redfield, 1818

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The handwritten title page of Abstracts from Lectures on Surgery.
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The title page of A Treatise on the Nature and Cure of Gout and Rheumatism.

A Treatise on the Nature and Cure of Gout and Rheumatism, Charles Scudamore, Philadelphia, PA: Edward Earle, 1819

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The title page of A Treatise on the Nature and Cure of Gout and Rheumatism.
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A list of deaths in Savannah from July to November 1830, including the names of the deceased, their ages, their country of origin, and the cause of death.

An Official Register of Deaths in the City of Savannah, Savannah, GA: Henry P. Russell, 1820

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A list of deaths in Savannah from July to November 1830, including the names of the deceased, their ages, their country of origin, and the cause of death.
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The title page of Lectures on the Natural History and Management of the Teeth.

Lectures on the Natural History and Management of the Teeth, Levi Spear Parmley, New York, NY: Clayton, 1821

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The title page of Lectures on the Natural History and Management of the Teeth.
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An illustration of a boy wearing a headband that is attached by a chain to medical harness on his chest, along with further images of surgical implements such as scissors and a scalpel.

The First Lines of the Practice of Surgery, Samuel Cooper, New York, NY: James V. Seaman, 1822

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An illustration of a boy wearing a headband that is attached by a chain to medical harness on his chest, along with further images of surgical implements such as scissors and a scalpel.
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A table describing the different nerves in the human head, as well as their function, origin, course, connections, and appearance in other mammals.

Neurological Table: Exhibiting a View of the Nerves of the Head (Table), John Davidson Godman, Philadelphia, PA, 1823

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A table describing the different nerves in the human head, as well as their function, origin, course, connections, and appearance in other mammals.
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A detailed illustration depicting the anatomy of the human inner ear.

Observations and Correspondence on the Nature and Cure of Deafness, Samuel Akerly, New York, NY: E. Conrad, 1824

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A detailed illustration depicting the anatomy of the human inner ear.
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The title page of Practical Observations on Diseases of Children.

Practical Observations on Diseases of Children, George Logan, Charleston, SC: A.E. Miller, 1825

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The title page of Practical Observations on Diseases of Children.
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The title page of Discourses on Cold and Warm Bathing.

Discourses on Cold and Warm Bathing, John Coffin, Boston, MA: Cummings, Hilliard & Co., 1826

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The title page of Discourses on Cold and Warm Bathing.
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