Jeanne E. Abrams. Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and in Health. New York: New York University Press, 2013. 314 pp. $30.00 (cloth), ISBN 978-0-8147-8919-3.
Reviewed by Jon Ault
Published on H-War (May, 2014)
Commissioned by Margaret Sankey
Debates over health care, and government’s proper role in providing it, have long dominated the sociopolitical dialogue in the United States, reaching a crescendo over the past two decades. In her new book Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and Health, Jeanne E. Abrams examines the origins of this issue by discussing how selected founders grappled with the rampant diseases that threatened (and all too often ravaged) the American populace of the Revolutionary and early national eras. By tracing the personal experiences of such leaders as George and Martha Washington, John and Abigail Adams, Benjamin Franklin, and Thomas Jefferson, Abrams suggests that they helped to lay a foundation for national health care that was devoted to providing people with the best that contemporary science and medicine had to offer (though not without a few lingering antiquated beliefs and practices). However, as their political philosophies diverged, so, too, did their notions of the proper extent of governmental involvement.
As Abrams amply demonstrates, epidemic diseases such as smallpox and yellow fever spared few in the infant nation, wealth and social class notwithstanding. Serious illnesses afflicted the principal characters in her study and their families with alarming frequency and severity, often causing premature death. The teen-aged George Washington, for example, contracted malaria and smallpox in the course of his early work as a surveyor and as a result of his 1751 voyage to Barbados with his terminally ill brother Lawrence. Dysentery then plagued him during his military service in the French and Indian War. To contend with such problems, the people of this era relied on home remedies and, if they were sufficiently wealthy, on the services of physicians of varying quality and education.
Concomitant with the founders’ struggle to forge a new nation were their efforts to improve its population’s general health. Having lost his son Frances at the age of four to smallpox in 1736, Benjamin Franklin became an early supporter of the inoculation procedure. He advocated and practiced moderation in diet and regularity in exercise. Furthermore, in frequent collaboration with leading British and American medical professionals, Franklin advanced medical education in England and the colonies. His efforts culminated in his co-founding and administering the first public hospital in the colonies, located in Philadelphia. Similarly, Thomas Jefferson supported widespread adoption of Edward Jenner’s safer method of vaccination against smallpox, tasked Meriwether Lewis and William Clark with noting Native American curative methods during their transcontinental journey, and helped ensure that the College of William and Mary and the University of Virginia would be leading institutions of medical education in the new nation.
Abrams implies that these founders’ differing political philosophies may have influenced their respective contributions to the health history of their country. It is interesting to note that, of all the individuals profiled in this study, only the two Federalists, Washington and Adams, proposed national health care governmental initiatives. In 1777, General Washington ordered that the soldiers of the Continental Army be inoculated against smallpox. In 1798, President Adams signed into law the Act for the Relief of Sick and Disabled Seamen. However, these acts were limited in scope and duration. Although advances in medical science gradually reduced outbreaks of epidemics and improved mortality rates over subsequent decades, federal involvement in healthcare remained sporadic through the mid-twentieth century, and medical treatment usually remained beyond the reach of the poorest strata of society.
Tying her study to the present day, Abrams concludes with a speculation on what these founders might have thought of the current debates on government-sponsored healthcare. She suggests that, though they would likely have approved of the intent of the Affordable Health Care Act, they would have “balked at requiring all citizens to purchase health care insurance” (p. 239). One could argue this point. However, Abrams ably illuminates the origins of this debate with this engaging contribution to early American history.
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Jon Ault. Review of Abrams, Jeanne E., Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and in Health.
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