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ROBERT TOMES WHY WE GET SICK Editor's Note History abounds in recurring themes. One of the more fascinating is the supposed relationship of the hectic way of American life to various diseases. Robert Tomes (1817-82), a journalist, was an astute observer of the American scene a century ago. The following article appeared in a popular magazine in 1856, and much of it, except for some words and phrases that date it, could as readily appear today. A short time after "Why We Get Sick" appeared, Harper's Magazine published an article entitled "How to Keep Well."1 To settle the question, we need not call the doctor, the author (probably also Tomes) proclaimed. "When that learned gentleman drives up to the door, we step out and leave the case to him and the undertaker. Our office is to dispense the ounce of prevention, and thus save the necessity of swallowing the by no means agreeable or infallible pound of cure." Our way of life, our "living" in cities, our eating habits, all cause old age to come nearly a score of years earlier in America than elsewhere, the author informed his readers. The popular health field was an active one in the mid-nineteenth century. Besides the many medical sects which published their own journals, there were also many health journals, such as the one edited by Sylvester Graham, who is now better remembered for his cracker.2 Articles on health, doctors, and medical discoveries, which still appear in the magazines of today, are, as in former times, probably the prime source of medical information for most of the public. If, as some ill-natured fellow has said, sickness is a sin, we Americans are great sinners. That much of the ill-health of the world, and of our portion of it especially, may be directly traced to a positive disobedience of the laws of Harper's Monthly Magazine 13 (1856): 642-47. 1 Harper's Magazine 14 (1856): 56-61. 2 See especially Richard H. Shryock's article "Sylvester Graham and the popular health movement, 1830-1870," reprinted in Medicine in America (Baltimore: The Johns Hopkins Press, 1966), pp. 111-25. 256 ROBERT TOMES 257 nature cannot be questioned; and that this disobedience is culpable, requires no casuist to prove. As, however, nature sufficiently vindicates its own justice by the heaviest penalties, there is no occasion for us to mock the criminal on his road to execution. Our object is to prevent, not to punish. The Americans should be the healthiest people in the world; but, if we compare them with other nations, in the aggregate,they will be probably found to have no claim to this superiority. This, however, is not a fair comparison, as the condition of the masses with us more nearly approaches that of the prosperous classes than of the poor of foreign countries. Material advantages alone, apart from moral causes, have given the Americans a position far in advance of all other nations. Physical comfort is the rule with us, while it is but the exception elsewhere. If a potato patch, as in Ireland, were the only barrier between our people and starvation, there might be some excuse for our countrymen not being healthier; for a want of physical comfort is among the most powerful causes of disease. With abundance of food, and such liberal rewards of labor that humblest American can supply himself with those comforts of life which are only within the reach of the prosperous classes abroad, it is but fair to compare him with the latter. In this comparison he will be found very deficient on the score of health. Sickness is mostly a choice and not a necessity with us; and we now propose to show why we get sick, when we might as readily keep well. The Americans work too much and play too little, and would that it were only with the usual effect of making Jonathan a dull boy. The result, however,is worse than this, for it tells very seriously against his health and vigor. If modern civilization has its blessings, it has its curses too, and of these the United States have a disproportionate share. There is a large class of diseases which were unknown to our forefathers, but which are fearfully wasting the health and happiness of the present generation. If our ancestors made the journey of life in slow coaches, they had the satisfaction of running less risks by the...

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