- "The Furnace of Affliction":Health Care in Early America
House Minority Leader Nancy Pelosi recently remarked, "When we celebrate Independence Day, we'll also be observing health independence." Pelosi asserted that the Affordable Care Act "captures the spirit of our founders, the spirit they wrote in the Declaration of Independence: Life, liberty and the pursuit of happiness." She was, of course, touting the anniversary of the Supreme Court's decision to uphold its major provisions and anticipating the implementation of the landmark legislation known more commonly as Obamacare. But her statement equating health and independence would have resonated with Americans during and after the Revolution. Early Americans did see affliction as an impediment to independence, and for many Americans political freedom and good health were interrelated goals.
Perhaps the most striking confluence of these often parallel concepts [End Page 213] occurred in July, 1776. On July 3, while the Second Continental Congress in Philadelphia debated the final wording of the Declaration of Independence, the Massachusetts General Assembly, facing an unrelenting smallpox epidemic, allowed inoculation to begin in Boston. Despite the dangers of infection, the people of Boston and the surrounding areas cheered the news. Ezekiel Price, a court official and insurance broker, declared "Liberty is given for to inoculate for the small-pox; many begin upon it this afternoon" (259). Nearly five thousand Bostonians underwent inoculation in the summer of 1776. Hannah Winthrop described the scene: "Boston has given up its Fears of an invasion & is busily employd in Communicating the Infection. Straw Beds & Cribs are daily Carted into the Town. . . . Men Women & children eagerly crowding to inoculate is I think as modish as running away from the Troops of a barbarous George was the last year" (129). Revolutionary Boston had become a hospital for inoculation. Abigail Adams and her four children went into the city to undergo inoculation in her uncle's home while her husband, John, was away advocating for independence. She, along with other convalescents and the immune, went out to King's Street on July 18 "to hear the proclamation for independence read and proclaimed." She noted that the crowd would have been larger, "but the smallpox prevented many thousands from the country" (A. Adams 56).
In his letters back home, John Adams paired his hopes for a new nation free of monarchy alongside his hopes for his family, his colony-turned-state, and his country free from illness. In a letter to Abigail on July 3, he wrote that he hoped "one Hospital will be licensed in every County, if not every town," before informing her of the vote for independence. John Adams likened Americans in the throes of Revolution to the Israelites who were tested by God in the "Furnace of Affliction." He assured his wife that "It may be the Will of Heaven that America shall suffer Calamities still more wasting and Distresses yet more Dreadful." But, he insisted, "the Furnace of Affliction produces Refinement in States as well as Individuals" (J. Adams 27-28).
America has always been a unique furnace of affliction, burning hotter at certain times and for certain groups of people. European medical philosophies and practices alone seldom seemed to calm the fits of American bodies, stoked as these disturbances were by "virgin soils" (Crosby 289). The three books under review in this essay not only uncover how early [End Page 214] Americans understood, coped with, and healed their bodies but also reveal the many ways in which domestic life and private pains influenced public health and public culture. Rather than showing early American health care as static, quaint, or unfathomably gruesome, each study shows that bodies—and the assumptions and choices that ordinary Americans made about them—could provoke important social and...