Dr. Benjamin Waterhouse: A Life in Medicine and Public Service (1754–1846) (review)

Benjamin Waterhouse is justly famous in the history of American medicine for his early and vigorous championing of Jenner’s method of smallpox vaccination in the new world. Professor Cash’s biography of Waterhouse goes well beyond previous biographies of this controversial physician, natural historian, and academic gadfly in the depth of exhaustive (and sometimes exhausting) detail supplied to the interested reader.

The book is not strictly chronologic in its organization but is divided into sections based on Waterhouse’s activities, each section treated internally in a more or less chronologic fashion. Thus, we are almost 90% through the book before even cursory attention is paid to Waterhouse’s marriages and children. His preoccupation with vaccination and his tumultuous career as the first Professor of the Theory and Practice of Medicine at Harvard Medical School were simultaneous events, and their treatment in separate sections is mildly disorienting. The events of a person’s life are inextricably bound to one another, and it is difficult to try to comprehend the nature of an individual when each aspect of his/ her life is treated separately from the others. On the other hand, a strict chronologic rendering of a life can be tedious, and I suspect the author wished to avoid this pitfall.

Although the twenty-six chapters are not formally divided into sections, they are presented such that they can be easily categorized. The first chapters deal with Waterhouse’s early life and medical training in England, Scotland, and Holland and then with the early years after his return to New England. Raised a Quaker in Newport, Rhode Island, his upbringing appeared to have surprisingly little effect on his later life. Although an ardent American patriot, he spent the entire period of the Revolutionary War in Europe. We are teased with oblique references to how his absence from the new nation was viewed by his compatriots, but the impact of this decision by the youthful Waterhouse is not explored in any depth. While Waterhouse’s experiences in Europe were germane to his later career, the impact of them becomes apparent only after many pages have passed. His formal training certainly played a major role in his appointment to the Harvard faculty, yet it appears unsurprisingly to have engendered resentment on the part of other prominent physicians in Boston and Cambridge.

The longest section of the book deals with Waterhouse’s enthusiastic acceptance of Jenner’s discovery, his recruitment of allies (and enemies), and the inherent difficulties in obtaining and distributing effective vaccine. In one of the more fascinating discussions in the book, the author explores the conflict between professional responsibility and morality and the need for a physician to make a living, a conflict as apparent in the twenty-first century as it was in the eighteenth and nineteenth centuries. Waterhouse’s desire to develop a “Vaccine Trust” with which to control access to active vaccine is not unlike the development of entrepreneurial clinics in our own time.

Waterhouse’s approach to the business of vaccination and the proposal for a Vaccine Trust engendered the enmity of other established physicians and presumably led in part to his later travails, but other factors clearly played a role in his eventual battles with the “medical establishment” of Massachusetts and his eventual dismissal from the Harvard faculty. Not the least of these factors was his argumentative personality. Although Professor Cash alludes in numerous passages to these aspects of Waterhouse, I would have welcomed at least a full chapter exploring his personality, the aspects of his life that led to his fractiousness, and his approach to interpersonal relationships.

Among the factors which separated Waterhouse from his peers was his adoption of Jeffersonian Republicanism in opposition to the Federalism of the Boston elite. Although an early and apparently close friend of John Adams, and later of John Quincy Adams, Waterhouse became an active correspondent of Jefferson...