Medicine in America

Medicine in America E.RichardBrown. Rockefeller Medicine Men: Medicineand Capitalism in America. Berkeley: University of California Press, 1979.271pp. J.WorthEstes. Hall Jackson and the Pwple Foxglove: MedicalPractice and Research in Revolutionary America, 1760-1820. Hanover, N.H.: The University Press of New England,1979.279pp. JohnEttling. The Germ of Laziness: Rockefeller Philant /11opy and Public Health in the New South. Cambridge, Mass.: Harvard University Press, 1981.203pp. AnitaClair Fellman and Michael Fellman. Making Sense of Self: MedicalAdvice Literature in Late 19th Centw:v America. Philadelphia:University of Pennsylvania Press, 1981.192pp. StephenNissenbaum. Sex, Diet and Debility in Jacksonian America: S1·lvester Graham and Health Reform. Westport, Conn.: Greenwood Press,1980.189pp. Martin Kaufman Thehistory of American medicine has been a relatively "new" field of study forthe professional historian, and over the past two decades a number of studieshave revolutionized our knowledge and understanding of the history of medical science, medical education and the medical profession. 1 These fivebooks are exceptional examples of the new approaches to history in generaland medical history in particular, and they range from the traditional tothe radical, both in approach and interpretation. Although each book has itsfaults and limitations, taken together they add a great deal to our understanding of the process of history as it relates to medicine and public health. Ineffect, these books can provide the reader with an introduction to the historyof medicine in the United States, covering the period from the Revolution towellinto the twentieth century. The earliest book, in terms of time-frame, is the one on Dr. Hall Jackson andthe introduction of the purple foxglove (digitalis) to American medicine. The author, J. Worth Estes, is a physician who teaches pharmacology at the BostonUniversity School of Medicine, and although he approaches his subjectfrom a medical (rather than an historical) perspective, this book is in many waysthe most diverse and enlightening. The book is in reality more a collection ofsomewhat related articles than a coherent, well organized monograph, but itillustrates the medical world of the late colonial period, clinical research atitsearliest stage, and professionalism during a most trying period in American Canadian Review of American Studies, Volume 14, Number 3, Fall 1983, 287-96 288 Martin Kaufman history. Estes makes extensive use of charts and graphs, and utilizes a computer to provide us with a breakdown of mortality, life expectancy and medical care, not only focusing on New Hampshire where Jackson resided and practiced medicine, but also illustrating the situation throughout America. During the late colonial period, leaders in the medical profession beganto develop local and state medical societies, and they thus gained the right to examine applicants for licenses to practice medicine. This was the earliest step toward the elimination of competition from the hordes of quacks and mountebanks who seemed to abound like locusts in colonial America. The physicians who were trained in medical schools, representing less than 10% of the total number of practitioners, and those trained by apprenticeship, representing approximately 70%of the total, joined to destroy competition from the totally uneducated practitioner. 2 Then, during the 1790s,Benjamin Rush provided the basis for a new phase in medical history. Rush discovered during the 1793yellow fever epidemic that he could not cure his patients with traditional treatments, and so he began to experiment with purgatives and with bloodletting. He found that purging with calomel and relieving his patients of two, three or more pints of blood brought about relief from the fever, and he developed a new theory of disease and treatment. Rush concluded that there was only one disease, based on vascular tension, and only one cure, bloodletting and purging. Rush urged his students at the University of Pennsylvania school of medicine to revere the lancet and to bleed, bleed and bleed some more, fighting disease to the death. Many of his students went home to establish their own medical schools, and they taught their students what they had been taught by Rush, thus spreading the practice of bloodletting and extensive purging for every ailment. America entered what has been called "the age of heroic medicine." 3 It did not take long before there were alternatives to heroic practice. The first medical sect to develop in...