Jeanne E. Abrams, Revolutionary Medicine: the Founding Mothers and Fathers in Sickness and in Health
1In her book, Jeanne Abrams offers an extensive and detailed chronicle of illness and health care in the age of the founding fathers. Despite the fact that literature around America’s founders is flourishing, Abrams has noted that their experiences with health and disease seem to have escaped proper critical attention. Her book, coming as a response to that, delineates their personal encounters with disease and subsequent loss of loved ones, as well as their resulting realization of the connection between individual health and the health of the nation which prompted their laying the foundations of the American health care system. This book is the latest in a series of contributions to the field of American history, which include numerous books, such as History of Jewish Denver (1982), Blazing the Tuberculosis Trail (1991), Jewish Women Pioneering the Frontier Trail (2006), and Dr. Charles Spivak: A Jewish Immigrant and the American Tuberculosis Movement (2009).
2In her introduction to the book, Abrams discusses the predominant “miasma” theories of eighteenth-century medicine, the scourge of quacks in the new world as a result of a notably low number of officially trained physicians, and the tragic outbreaks of smallpox epidemics which killed more than one hundred thousand people in a time frame of ten years. Furthermore, Abrams underlines the prominent role of eighteen-century American women as the primary caretakers of the diseased and particularly notes Martha Washington and Abigail Adams as trained in all kinds of home-remedies.
3Abrams’s first chapter is dedicated to America’s first president, George Washington. Having suffered from numerous serious illnesses such as tuberculosis, smallpox, malaria, and dysentery, Washington developed a strong interest in medicine and to that end he possessed several self-help manuals, medical books, and supplies of herbal remedies. Moreover, he maintained a type of hospital in both his estates and inoculated all his people for smallpox at a time when there was a strong debate as to its effectiveness and perils. His keen interest in medical matters provided him with a fairly sophisticated and advanced grasp of public health measures. As it is discussed, his forward thinking about the sources of contagion and the role of poor hygiene and malnutrition in the spreading of disease led him to put into practice the first large-scale state-sponsored immunization campaign in American history.
4The second chapter of the book discusses Benjamin Franklin as a revolutionary leader and statesman, a skillful diplomat, and an innovative scientist, or as the author calls him, the “first scientific American” (81). Abrams devotes a significant part of the chapter to his intellectual activity which earned him various awards and two honorary degrees from Harvard and Yale, but focuses mainly on his persistent support of the then controversial smallpox inoculation. The 1731 smallpox epidemic wreaked havoc in Philadelphia, deprived Franklin of his young son and, according to Abrams, made him an even more determined advocate of smallpox inoculation. The catastrophic consequences of the numerous outbreaks of the disease, of which Franklin recorded meticulous statistics, made him realize that a healthy city would be inviting to residents who would contribute to its economic growth and prosperity. Franklin not only welcomed information and theories about virtually every disease and its treatment, but even acted as an informal medical practitioner with medical ideas on contagion and transmission of contagious illnesses, such as the common cold, which were surprisingly advanced for his era. Furthermore, he was an ardent supporter of the Pennsylvania Hospital project and used the Pennsylvania Gazette to promote important information regarding numerous epidemic and illnesses. His understanding of contagion, which is obvious in both his life and his texts, made him a strong advocate of preventative measures such as exercise, a moderate diet and proper ventilation of enclosed spaces. His innovative experiments and scientific discoveries made him a symbol of political and scientific progress and attracted the admiration of scientists on both sides of the Atlantic.
5The third chapter of Abrams’s book discusses John and Abigail Adams, a presidential couple in whose life illness was a constant. Despite the fact that New England was the region with the strictest anti-inoculation regulations both John and Abigail were inoculated against the Variola major virus most probably due to John Adams’s pragmatist view of medicine as a means to cure or prevent illnesses by using even the most neoteric treatments and medications. Both John and Abigail Adams were constantly preoccupied with disease in their everyday lives, John due to his intermittent health breakdowns and his hypochondriac nature, and Abigail due to her efforts to educate herself about successful treatments of common ailments and illnesses as well as her assuming the role of the principal caretaker of any suffering member of the family circle. Abigail Adams was a skilled herbalist and had obtained such a good understanding of contagion that she advised the Boston Medical Society as to the causes of Tuberculosis infection and disinfected meticulously her house with hot vinegar to avoid the spread of diseases. Abrams dedicates a significant part of the chapter discussing the couple’s correspondence which often revolved around the ailments and illnesses from which each of them or their children suffered, and records their stoic reaction to numerous losses as a result of various diseases. John Adam’s interest in the health of the nation is underlined in his satisfaction over the 1777 legislation that expanded the army’s Hospital Department as well as his 1798 law that established the Marine Hospital Service. Having realized the dangers infected seamen posed to the health and prosperity of American ports, as well as the importance of maritime shipping to the American commerce and security, he established this first federal health program which eventually evolved into the modern Public Health Service.
6The last two chapters of the book focus on Thomas Jefferson, the fourth chapter focusing more on his personal views on medicine and his family life, while the fifth mainly analyzing his activity during his political career and presidency. Jefferson was an inventor, an expert in the use of medicinal plants, he had a keen interest in medical research, and he had realized that both the treatments and the causes of many diseases were either poorly understood or relied on outdated theories and not empiric evidence. As Abrams describes, he maintained a healthy lifestyle with emphasis on good dietary habits, regular exercise, and adequate sleep. Furthermore, Abrams stresses the fact that Jefferson was keenly aware of the mind-body connection as far as various ailments and diseases are concerned, as well as the fact that he was recognized as the most outstanding scientist in Virginia. As it is argued in the last chapter of the book, as a president he promoted the new, controversial albeit more effective procedure of vaccination for the smallpox, variolation, or as it came to be known, the Jenner method. In addition, his insistence on an expedition to gather information about Indian diseases as an integral part of the country’s westward expansion is an indicator, as Abrams claims, of the realization that the health of the Americans was inextricably connected to the political and economic prosperity of the nation. Contrary to many of his contemporaries, he was aware of the fact that certain diseases were communicable before symptoms occur and this awareness led him to promote preventative measures such as the quarantine for Yellow Fever. In 1825 he performed an achievement of paramount importance, the opening of the University of Virginia, of which he was not only the founder but also the principal designer. As Abrams notes, the design of the buildings was such that it promoted both the physical and mental health of the students and prevented the spread of infectious diseases.
7In her epilogue, Abrams concludes her diligent discussion of America’s founders by underlining the fact that they all made significant contributions to the advancement of American medicine, guided not only by Enlightenment thought and a humanitarian philosophy, but also by their vision for the growth of the American economy. In the last pages of her book, the author argues that the founders have bequeathed to the Americans a legacy focusing on medical progress and appropriate government involvement which is, at present, more instructive that ever, since America stands at the brink of a health care reform with the Obama debate in progress.
New York: New York University Press, 2013. Pp. 306. ISBN: 978-0-8147-8919-3
Georgia Diomi, « Jeanne E. Abrams, Revolutionary Medicine: the Founding Mothers and Fathers in Sickness and in Health », European journal of American studies [Online], Reviews 2014-2, document 4, Online since 20 June 2014, connection on 25 March 2017. URL : http://ejas.revues.org/10314Top of page