The literature of American internal medicine: a historical view.

The literature of medicine is shaped by social and intellectual forces as well as by scientific discoveries. In America, the literature of internal medicine evolved gradually in response to changes in the structure and philosophy of medical education and the growing emphasis on research during the past century. When careers in medical education and research became possible through philanthropic and government support, Americans became more productive in research. As academic advancement came to depend primarily on publication, the literature of American internal medicine expanded dramatically. The current scope and character of the medical literature also reflect the persistent trend toward specialization and subspecialization that began more than a century ago. Although medical journals have been the most important medium for the publication of new medical knowledge for nearly 200 years, recent dramatic advances in the technology of information storage and transfer promise to undermine their primacy.