Works on the history of medicine in early America have enjoyed a resurgence over the last twenty years or so. Elaine Breslaw’s newest monograph continues to expand a field that has splintered into various subfields, histories of medicine that focus on gender, race, chronology, and the state. Specifically in Lotions, Potions, Pills, and Magic, Breslaw follows a historiographic trend made popular by historians of medicine in the late 1980s and 1990s in which scholars began to reveal the complicated disputes between medical doctors and the state in the colonial and antebellum eras. In this text, Breslaw provides a synthetic history of early American health care. The book covers health care, medicine, and public policy from the Columbian exchange to the antebellum era. Breslaw’s research, although largely based on secondary sources, is compelling. The full story she reveals is one that upsets earlier narratives that portrayed the origins of American medicine as triumphant and progressive. From Breslaw’s point of [End Page 501] view, which is persuasive, American medicine lagged behind because of resistance by early Americans to relying on scientific knowledge in medicine and their ideas about the country’s “exceptionalism.” Outside of surgical innovations, especially gynecological surgeries, American medical doctors existed in a state of arrested development largely until the end of the Civil War.
A theme that runs throughout the book is the static nature of American medicine. Medical doctors’ unexamined attachments to their belief in the “exceptionalism” of the United States influenced their refusal to follow the lead of Europe in the integration of scientific research in medicine. In one of Breslaw’s most compelling chapters on medical growth in the new nation, she argues, “The spirit of nationalism that followed on the Revolution did nothing to advance scientific medicine in the United States” (p. 112). American doctors not only contested colonial governments, and later the national government, they also did not have a general medical orthodoxy that guided them on how to care for their patients. In graphic detail, Breslaw describes how much damage their confusion and strife caused their patients.
Breslaw also reveals that many of the internal struggles that doctors, legislators, female healers, Native American shamans, and enslaved healers fought over were for the right to control their bodies. Although the text is primarily about the role white male doctors played within the construction of American medicine, Breslaw injects the stories of women, black people, and various members of Native American groups who refused to relinquish the reins of power (however narrow those reins were) to medical men who believed it was their right to intrude into the medical affairs of members of those groups. It is in these moments in which her analytic voice is most clear as she uncovers the lives, and sometimes the muted voices, of the marginalized from eighteenth-century travelogues, oral histories, and medical manuals. Breslaw’s heavy reliance on a largely secondary literature sometimes hampers the fullness of a polyphonic discussion on race, status, and difference that needed to be expressed more fully.
The other quibbles I have with this text center on the book’s organization [End Page 502] and its editing, specifically the number of typographical errors. The chapters do not have smooth transitions; they often end abruptly and began anew without contextualization. These critiques should not detract from the contribution Elaine Breslaw has made to the larger historiography on American medicine. This monograph will prove useful for undergraduate students, specialists, and a lay audience interested in learning about the trajectory of American medicine and its slow trod towards progress.
DEIRDRE COOPER OWENS is an assistant professor of history at the University of Mississippi. She specializes in nineteenth-century U.S. history, with a particular focus on slavery, medicine, and immigration. She is currently working on a book based on her dissertation, which examined the medical experiences of enslaved and Irish immigrant women and how slavery and immigration affected the growth of modern American gynecology.