The principal medium of communication for instruction, recording observations, and providing a forum for expression of opinion in medicine has always been its “literature.”  Only a meager medical literature was produced in America untilwell after the Revolution and most books and journals of that time were European.  In its first catalog of 1723 theHarvard CollegeLibrarylisted only 58 medical volumes .  America’s first medical journal, the Medical Repository , was published in 1797.  Later, the Eclectic Repertory, first published in 18ll, achieved immortality through its 1817 account of Ephraim McDowell’s ovariotomy, widely accepted as the first abdominal surgery.  By the mid-19th century some 250 journals had been published and by 1913 nearly half of the worlds 1,654 medical journals were published in America.