Doctor Franklin's Medicine (review)

Because 2006 was the 300th anniversary of Benjamin Franklin's birth, and because the Founding Fathers are receiving much laudatory popular attention, books about this most scientific—and perhaps most multifaceted—of Founding Fathers have been pouring off the presses. Bookseller Amazon.com lists more than 2,300 pages of Franklin publications: some are serious scholarly works, some entertaining, and some slapdash. This contribution by Stanley Finger, a professor of psychology at Washington University, looks at Franklin's connections to medicine and clearly falls into the entertaining category: The prose is lively. The book is generously illustrated. Both well-known and lesser-known aspects of Franklin's life and thought are explored, and the range of subjects and the intrinsic interest of many of the vignettes can be fascinating.

Finger defines medicine broadly, looking at what are now called lifestyle issues (particularly diet and exercise) as well as medical therapeutics, smallpox inoculation, zoology, medical publishing, air quality, lead poisoning, mental health, institutional development, research methods, debunking of medical fads, prosthetics, and Franklin as a patient. Even ballooning gets a chapter, because of a chance remark by Franklin that balloons might transport invalids more comfortably than carriages. Finger has read deeply in Franklin's voluminous published papers, has consulted the published letters of several of Franklin's many correspondents, and has sampled the secondary literature on eighteenth-century medicine.

The book is hagiographic: Franklin is always the leader, is virtually always correct, is unique among his peers. That he might have been peripheral to many of the contemporary medical questions discussed here, or that he might even at times have been retrograde in his understanding of some medical issues, is not seriously considered. Finger discounts the degree to which medical knowledge and experimentation were widespread in the eighteenth century—many of Franklin's contemporaries in Philadelphia also voraciously read medical tracts and experimented with cures and preventive behavior. Other almanacs had more medical content than Poor Richard's, while Dr. William Buchan's Domestic Medicine, a home guide to health that went through scores of editions, undoubtedly had a greater impact than Franklin's scattered and often private writings on medicine.

Finger sometimes goes beyond his evidence in attempting to assert Franklin's medical prominence. He notes, for example, that Franklin was aware of Leeuwenhoek's discoveries of microscopic life forms, and he quotes Franklin on the contagious quality of the common cold (which Franklin confused with influenza) and concludes that he assigned causality to "minute living matter" (p. 164)—but there is no inkling that Franklin himself made that connection. What Franklin wrote (quoted on p. 160) was that colds were probably caused by putrid exhalations, "frowzy corrupt Air from animal Substances, and . . . perspired Matter"—that is, decayed and decaying airborne material or miasmas. Franklin is here only a man of his times, perhaps a little original in combining contagionist theories of disease with miasmic theories by having sick people breathe out diseased vapors and spreading the putrefaction (not life-forms) that led to illness. The evidence presented does not support the implication that he either subscribed to contemporary germ theories or anticipated the discoveries of the next century. Likewise, the claim that he provided "new medical tools, such as medical electricity" (p. 324) is not borne out by the unsuccessful attempts to cure paralysis or melancholy (a single case of a seeming cure of hysterical epilepsy notwithstanding); these exercises were experimental dead ends and had no lasting impact on medical practice. Too much of the argument rests on terms like "probable" or "must have." Finger finishes with a fine discussion of the elderly Franklin's many health problems.

This is an informative book, if the reader guards against the occasional interpretive leaps of faith. It provides a window on a vibrant period when specialists and nonspecialists alike hoped to advance human happiness by preventing and curing the diseases that plagued mankind.