For each soldier killed in combat during the Spanish-American War, more than seven died from diseases such as typhoid fever and malaria-a rate higher than that of the Civil War. During a time of rapid medical innovation and discovery, why did these soldiers die so needlessly? Bullets and Bacilli: The Spanish-American War and Military Medicine is the first book to focus primarily on military medicine during this conflict. Historian Vincent J. Cirillo argues that there is a universal element of military culture that stifles medical progress. This war gave army medical officers an opportunity to introduce to the battlefield new medical technologies, including the X-ray, aseptic surgery, and sanitary systems derived from the germ theory. With few exceptions, however, their recommendations were ignored almost completely. Scientific knowledge was not sufficient; putting these ideas into military practice required the cooperation of line officers and volunteer soldiers as well as a restructuring of military education. The influence of military experiences on the history of American medicine is often overlooked. Cirillo shows how preventable deaths during the Spanish-American War led to reforms that continue to save the lives of both soldiers and civilians to the present day.