Revolutionary Medicine: The Founding Fathers and Mothers in Sickness and in Health

Introduction: Health and Medicine in the Era of America’s Founders

« 1 » Introduction Health and Medicine in the Era of America’s Founders Experience learns us to be always anxious about the health of those whom we love. —Thomas Jefferson to Martha Jefferson, April 7, 1787 Above all worldly goods, I wish you health, for destitute of that great Blessing, few others can be enjoyed. —Abigail Adams to Thomas Boylston Adams, June 2, 1799 Introducing the Founders The literature about America’s early leaders continues to proliferate, but instead of placing the usual emphasis on the political roles of the nation’s founders or their personal relationships, this book will focus a lens on their experiences with health, illness, and medical treatment. The lives of America’s founding mothers and fathers demonstrate that today’s preoccupation with good health and illness is not a new one. Abigail Adams fretted over her family’s health and particularly that of her husband throughout the American Revolution as well as John’s days as president, although ironically Abigail was by far the more fragile of the two. Thomas Jefferson often involved himself in the treatment of ailments that affected his family and slaves. He professed and practiced a surprisingly modern outlook and regimen for fostering good health, and he and his contemporaries Abigail and John Adams took the controversial step at the time 2 « Introduction of making sure that they and their family members were immunized against smallpox. After the Continental Army was devastated by smallpox in 1776, George Washington insisted that all his soldiers be inoculated . Benjamin Franklin was an early and staunch advocate of smallpox inoculation and a primary initiator of the first voluntary public hospital and medical school in America. His inventions included bifocal glasses and a flexible urinary catheter, and his keen interest in what today would be termed preventative medicine led to numerous medical experiments as well as often sound advice on healthful living.1 Despite differences in personality and political outlook, George Washington, Benjamin Franklin, John Adams, Thomas Jefferson, and James Madison shared the revolutionary desire to make fundamental changes in American social and political relationships, including the role of government in the lives of individuals and government’s ability to promote general welfare. As historian Peter Gay has observed of the Enlightenment era, “The most tangible cause for confidence lay in medicine . . . . Medicine was the most highly visible and the most heartening index of general improvement.”2 The founders recognized early on that government had compelling reasons to shoulder some new responsibilities with respect to ensuring the health and well-being of its citizenry. For example, on July 16, 1798, Adams signed a bill “to provide for the relief and maintenance of disabled seamen,” creating the United States Marine Hospital Service. It gave rise to a network of hospitals located at sea and river ports across the United States, and slowly over the next century it ultimately evolved into the national American Public Health Service. In the beginning, in a process administered by their employers, sailors paid a twenty-cent tax every month out of their wages as their share toward a form of insurance for hospital care, which provided for doctors, room and board, and medicine, and the government directed the use of those funds and underwrote most of the real remaining costs. The tax was turned over quarterly to the United States Treasury, and it was used in the district where it was collected.3 With the Seaman’s Act, for the first time in American history, the federal government mandated and paid for the temporary medical treatment of individuals who could not afford their own private care, creating a safety net for thousands of mariners. The seaman’s bill was signed into law following a severe outbreak of yellow fever as sailors often brought a Health and Medicine in the Era of America’s Founders » 3 variety of serious diseases with them to ports, including smallpox, cholera , and malaria, and quarantine was sometimes necessary. Although it took almost a century to take hold, in essence the legislation established a precedent for federal intervention in the health care arena. Forward-thinking political men such as Adams understood that the failure to address the illnesses of sailors endangered the well-being of all citizens in American port cities. Adams as well as Washington, Jefferson , Franklin, and Madison clearly recognized that the health of the nation was inextricably tied up with the health of individuals...