Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and in Health by Jeanne E. Abrams (review)

In Revolutionary Medicine, Jeanne E. Abrams mines the lives and careers of several key figures from the founding era of U.S. history to find out how the experience of disease touched their lives personally and how they contributed to the science and practice of medicine. Through their individual cases, the author attempts to survey their world of health and illness more generally.

Structurally, the book resembles a group biography in the style of Joseph Ellis’s Founding Brothers, rotating through chapters on George and Martha Washington, Benjamin Franklin, and John and Abigail Adams, and concluding with two chapters on Thomas Jefferson. Others, including Benjamin Rush and James and Dolley Madison, surface periodically throughout the narrative. Abrams’s sensitive renderings of the founders’ personal experiences with disease and medicine offer an unusually intimate view of an often-familiar cohort, as when she details a young George Washington struggling with malaria, or the myriad ills that beset the Adams family.

Vivid vignettes often segue into more general discussions of broader issues, but the focus on the individual founders sometimes crowds out satisfying explanations of the period’s wider medical and intellectual landscape. Abrams sketches out a vague consensus built on a foundation of humoral theory, but sometimes loses the texture and nuance of important debates over contagion, nosology, and the nervous system, among other controversies.

A handful of minor anachronisms creep into the text. Abrams inexplicably includes cholera among the dangers of the founders’ epidemiological world, despite the fact that all of her key figures (save the Madisons, who occupy a significant but secondary place in the text) had already died by 1832, when the disease first arrived on American shores.

At times, gaps in the broader intellectual history also strain the book’s biographical threads. Franklin suffers the most, as his insights become the inspired products of an individual genius, rather than the always-gregarious Franklin’s contributions to the era’s lively and complex medical discourse. Abrams ignores the substantial literature on sensibility and the nerves, for example, when she argues that Franklin’s willingness to acknowledge a psychosomatic aspect to physical ailments testified to a “sophisticated, sensitive understanding of the human mind” that set him ahead of his contemporaries (p. 95).

Pulling her subjects out of their own context, Abrams frequently tries to fit them into our own. Rather than examining Franklin’s experiments with electrical medicine in relation to the era’s other electromagnetic healers, Abrams cites modern efforts to treat Parkinson’s disease with deep brain stimulation to prove that Franklin was ahead of his time, hobbled only by technological limitations. Elsewhere, she muses on how the founders would view the Affordable Care Act’s individual mandate provision.

Interestingly, the sections on Abigail Adams are among the book’s strongest examples of intellectual history, demonstrating how the Massachusetts matriarch read sources like William Buchan’s Domestic Medicine, then implemented or circulated them in her broader community. Freed of the obligation to be a genius, Abigail Adams illustrates more clearly than her compatriots how medical ideas spread, and how Americans received and adapted them.

Abrams is much stronger discussing the political aspects of medicine than explaining the development of medical concepts. She provides a readable and suggestive account of Washington’s decision to order the inoculation of the Continental Army, and devotes careful attention to Jefferson’s efforts to encourage the spread of smallpox vaccination during his presidency.

Revolutionary Medicine is strongest as biography, and Abrams tells the founders’ stories in a lucid and engaging narrative voice. She renders their pains and pleasures with sensitivity and insight. Its pages will hold few surprises for the specialist, but any reader interested in the revolutionary era or the lives of the American founders will surely learn a great deal from Abrams’s study.