Cover

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pp. 1-1

Title Page, Copyright, Quotes, Dedication

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pp. 2-9

Contents

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pp. 10-11

Illustrations

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pp. xi-xii

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Acknowledgments

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pp. xiii-xiv

The writing of this book was a collaborative process. Except in a few instances, the original research supporting my conclusions is based on the more detailed investigations of other scholars. Many of those students of history and medicine who contributed...

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Introduction

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pp. 1-8

Good health in the twenty-first century depends on diet, exercise, and the right genes. Good health in early America depended on diet, exercise, and the right genes. That much has not changed. But there is a world of difference between those two eras, both in the quality of life we expect in the modern age and our ability to overcome...

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1. Columbian Exchange

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pp. 9-26

The winter had started when the Pilgrims, religious exiles from both England and Holland, arrived at the Massachusetts coast on November 11...

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2. Epidemics

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pp. 27-42

In early May 1721, the ship Seahorse readied its crew to leave Boston harbor. Captain Wentworth Paxson, a Boston resident, had successfully offloaded his cargo and prepared to set sail again. He was delayed: a man on board showed the telltale signs of smallpox...

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3. Tools of the Trade

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pp. 43-60

On October 14, 1743, Dr. William Wooten visited the family of James Cann, a carpenter in Anne Arundel County, Maryland. Mrs. Cann complained of “a long Continued Intermittent Fever.” For this condition Dr. Wooten prescribed a “vomit” and gave...

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4. Abundance

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pp. 61-76

When the teen-aged Eliza Lucas in South Carolina described her environment to her brother, Lucas, at school in England in 1742, she extolled the very fertile soil that easily produced even European fruits and grains. “The Country,” she continued...

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5. Wartime

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pp. 77-94

For failure to pay his debts, Ezekiel Brown of Concord, Massachusetts, was sentenced to jail in March 1773. In an unusual circumstance Brown’s creditors kept him there for years. Most debtors, according to Robert Gross, who describes Brown’s ordeal...

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6. New Nation

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pp. 95-112

September 11, 1793. Philadelphia, the temporary capital of the United States, had suffered for weeks from (in the parlance of the day) a bilious malignant fever. The victims had black grainy vomits, nosebleeds, and headaches. Their skin and eye whites turned...

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7. Giving Birth

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pp. 113-134

The weather on November 18, 1793, was stormy and cold when Martha Ballard, midwife, set out from her home in Hallowell, Maine, to tend a “Lady in Labour.” The rain had turned to snow before the prospective father, Captain Molloy, was able to contact...

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8. The Face of Madness

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pp. 135-150

On November 5, 1824, Henry Sewall of Augusta, Maine, reported in his diary that he had “a Bunk made for M. to sleep in, with a lid to shut down.” The M. referred to his twenty-four-year-old daughter...

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9. Democratic Medicine

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pp. 151-168

William W. Dyott, a bootblack, arrived in Philadelphia from England in the 1790s. He was an entrepreneurial immigrant who demonstrated his business acumen early on by extending his bootblacking enterprise to the manufacture of the needed shoe polish. The surplus he sold to other bootblacks. So successful was this early manufacturing...

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10. Public Health

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pp. 169-184

Dr. John H. Griscom, a city inspector in Manhattan, walked the streets of lower New York eyeing the drains: open sewers containing human waste, dead animals, manure, and the effluvia from nearby slaughterhouses. The stench was overpowering, the worst he had ever experienced in a summer heat. What he saw was even more horrifying...

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Conclusion

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pp. 185-192

The medical profession teetered on the edge of the abyss by the mid-nineteenth century. American doctors, often caught up in their own desire for preservation as a profession and clinging to outmoded therapies, proved to be doing more harm than good...

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Epilogue

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pp. 193-200

Admittedly this book has shown a gloomy picture of the early state of health care and the medical profession. The picture since then has been quite different. Medical practice did not begin to change until the 1890s with the establishment of the first endowed...

Abbreviations

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pp. 201-202

Bibliographic Essay

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pp. 203-226

Index

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pp. 227-236

About the Author

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pp. 237-237