New Jersey History Book Reviews
Published by H-New-Jersey@h-net.msu.edu (February 2006)
Karen Reeds. A State of Health: New Jersey's Medical Heritage. New Brunswick: Rutgers University Press, 2001. xxi + 142 pp. Illustrations, notes, bibliography, index. $45 (cloth) ISBN: 0-8135-2998-0
Reviewed for H-New Jersey by Sandra Moss M.D., M.A. (History)
Health and Health Care in New Jersey Have a Lot of History
Karen Reed's A State of Health: New Jersey's Medical Heritage was conceived as a catalogue for a gallery exhibition of medical illustrations and artifacts, mounted in 1999 at Alexander Library, Rutgers University. Reeds, a medical historian, shortchanges her book in describing it as a mere "catalogue." A State of Health joins David Cowen's 1964 Medicine and Health in New Jersey: A History as a key resource for all New Jersey historians.
In a fluid narrative that illuminates three centuries of what might be termed the "medical marketplace," Reeds covers a wealth of information and a multitude of subjects without seeming to rush or shortchange the reader. She introduces us to midwives, nurses, horse-drawn ambulance drivers, radium dial painters, and a wide assortment of doctors and patients. The main text is supplemented by lists of relevant websites as well as New Jersey libraries, museums, and historic sites which would be of interest to readers. Her cohesive volume is characterized by attention to historical context; health care in New Jersey simultaneously reflected national trends and local circumstances.
New Jersey is often neglected by American medical historians focused on famous doctors, forward-looking medical schools, and prestigious hospitals. The shadows of New York and Philadelphia, as always, loom large. And, indeed, medicine in New Jersey was provincial in practice and outlook until the mid-twentieth century. At the end of the Civil War, New Jersey lagged far behind New York and Philadelphia in areas such as hospital construction, medical libraries, national professional leadership, publication of medical journals, and, most importantly, medical education. Reeds succinctly summarizes the long struggle for a medical school in New Jersey, a state of affairs that was not remedied until Seton Hall graduated its first class of medical students in 1960. She does a particularly good job of illustrating and explaining New Jersey's transition from traditional healthcare practices to a modern "state of health." At the same time, New Jersey was unique in its concentration of pharmaceutical companies with productive research facilities. Unfortunately, exposures to industrial toxins such as asbestos, radium, and mercury simultaneously contributed to the state's negative national image.
Reeds uses carefully selected primary and secondary sources and the multimedia resources of the state's historical repositories to weave a complicated tapestry of people, practices, and institutions. For example, our mental image of the midwife is brought to life by pictures of the instrument bag of Newark's Mary Giacomini (New Jersey Historical Society collection) and the early twentieth-century birth reports of Magdalena Kovacs of New Brunswick (Special Collections, Rutgers University Libraries). The expanding role of the physician in childbirth is highlighted by a photograph of wooden-handled obstetrical forceps manufactured in East Orange in the mid-nineteenth century (Robert Wood Johnson Medical School collection). The pictorial highlight of the book is a montage of scores of colored post cards bearing images of New Jersey hospitals, past and present (Special Collections, University of Medicine and Dentistry of New Jersey).
Hundreds of carefully chosen illustrations illuminate and expand the text, which is arranged thematically in four chapters. "Epidemics!" takes us back to the smallpox epidemic at Washington's Morristown encampment; quarantine placards tacked to houses where children lay sick with influenza or measles; and the dangerous exposure to toxic mercury among New Jersey's industrial hatters. Some readers may be surprised by scenes of New Jersey's tuberculosis hospitals, which dotted the state and accommodated thousands of victims before streptomycin (discovered at Rutgers) and other new therapies rendered these sanatoria obsolete.
New epidemics, particularly AIDS, take their place in New Jersey's history. "Children's Health and Public Health" chronicles the struggle against the deadly throat infection known as diphtheria, and the desperate (and much publicized) journey of four Newark boys to Pasteur's laboratory in Paris to receive his new rabies vaccine. In addition, Reeds discusses the campaign for safe milk, as well as the recognition of pediatric AIDS. "Healers and Hospitals" introduces us to an array of "regular" and sectarian practitioners, midwives, herbalists, social activists, nurses, pharmacists, researchers, and assorted quacks such as phrenologists and water-cure doctors.
The final chapter, "Jersey Cures for Jersey Ills," highlights therapeutics, from botanics to Valium. Here she depicts the freewheeling days of patent medicines such as "Green's August Flower Remedy," as well as breakthrough pharmaceuticals such as steroids and antibiotics. She also discusses leeches and the implantable New Jersey Knee, before closing with a brief reflection on the quandaries raised by modern medical capabilities as exemplified in the landmark New Jersey case of Karen Ann Quinlan.
Physician readers might be disappointed in the lack of focus on what nineteenth-century doctors liked to call "the profession" and its institutions such as the Medical Society of New Jersey. However, this need has already been met by previously published histories of state and county medical societies and a number of monographs on New Jersey physicians.
Today, many historians recognize that political, economic, social, and even military history cannot be fully understood without an appreciation of the role of health and disease – particularly epidemic disease – in daily life. For historians outside the state, A State of Health, like Cowen's earlier book, offers a coherent overview of New Jersey's medical history. Primarily, however, the book is aimed at ordinary New Jerseyans who will enjoy this highly accessible gateway into the history of health and medicine in the Garden State. Ambitious New Jersey students embarking on careers in medicine will find that A State of Health gives them a valuable perspective on the healing professions. Such books provide much-needed perspective (and a welcome respite) for those inundated with the very real concerns of a modern health care system in crisis.
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