The second in a projected four-volume series that will cover the history of the Army Medical Department from 1775 to 194 1, this volume traces the development of the department from its establishment on a permanent basis in 1818 through the final days of the Civil War in 1865. The uninterrupted existence of the Medical Department after 1818 made possible the gradual transformation of its staff from a collection of physicians of varying skills and attitudes into a group of highly trained and disciplined medical officers, proud of their organization and of their roles in it. Although the state of the art of medicine before 1865 gave the military surgeon few effective weapons again stillness and infection, after 1818, as this most recent volume in the series demonstrates, the length of the military career of the average medical officer and his professional attitude toward the challenges he met led him to concentrate his efforts on the Army's health problems and to work persistently to improvise ways in which to meet them. The Army Medical Department, 1818-1865 is, like its predecessor, a significant and long-needed contribution to the history of military medicine.