Mariola Espinosa is assistant professor of history and director of Latino and Latin American Studies at Southern Illinois University.
Before the advent of modern antibiotics, one’s life could be
abruptly shattered by contagion and death, and debility from infectious
diseases and epidemics was commonplace for early Americans, regardless of
social status. Concerns over health affected the founding fathers and their
families as it did slaves, merchants, immigrants, and everyone else in North
America. As both victims of illness and national leaders, the Founders occupied
a unique position regarding the development of public health in America. Revolutionary Medicine refocuses the
study of the lives of George and Martha Washington, Benjamin Franklin, Thomas
Jefferson, John and Abigail Adams, and James and Dolley Madison away from the
usual lens of politics to the unique perspective of sickness, health, and
medicine in their era. For the founders, republican ideals fostered a reciprocal
connection between individual health and the “health” of the nation. Studying
the encounters of these American founders with illness and disease, as well as
their viewpoints about good health, not only provides us with a richer and more
nuanced insight into their lives, but also opens a window into the practice of
medicine in the eighteenth century, which is at once intimate, personal, and
first hand. Perhaps most importantly, today’s American public health
initiatives have their roots in the work of America’s founders, for they
recognized early on that government had compelling reasons to shoulder some new
responsibilities with respect to ensuring the health and well-being of its
The state of medicine and public healthcare today is still a
work in progress, but these founders played a significant role in beginning the
conversation that shaped the contours of its development.
At the national level, southern congressional leaders fought to establish a strong federal health agency, but they were defeated by the young American Public Health Association, which defended states' rights. Local responses and results were mixed. In New Orleans, business and professional men, reacting to the denunciation of the city as the nation's pesthole, organized in 1879 to improve drainage, garbage disposal, and water supplies through voluntary subscription. Their achievements were of necessity modest.
In Memphis--the city hardest hit by the epidemic--a new municipal government in 1879 helped form the first regional health organization and during the 1880s led the nation in sanitary improvements. In Atlanta, though it largely escaped the epidemic, the Constitution and some citizens called for health reform. Ironically their voices were drowned out by ritual invocation of local health mythology and by unabashed exploitation of the stigma of pestilence attached to New Orleans and Memphis. By 1890 Atlanta rivaled Charleston and Richmond for primacy in black mortality rates.
That the public health movement met with only limited success Ellis attributes to the prevailing atmosphere of opportunistic greed, overwhelming debt, economic instability, and inordinate political corruption. But the effort to combat a terrifying disease not fully understood did eventually produce changes and the vastly improved health systems of today.
Many of the issues of public health education in the early twentieth century are still debated today. What is the proper relationship of public health to medicine? What is the relative importance of biomedical, environmental, and sociopolitical approaches to public health? Should schools of public health emphasize research skills over practical training? Should they provide advanced training and credentials for the few or simpler educational courses for the many?
Fee explores the many dimensions of these issues in the context of the founding of the Johns Hopkins school. She details the efforts to define the school’s structure and purpose, select faculty and students, and organize the curriculum, and she follows the school’s growth and adaptation to the changing social environment through the beginning of World War II. As Fee demonstrates, not simply in its formation but throughout its history the School of Hygiene served as a crucible for the forces shaping the public health profession as a whole.
Samuel J. Crumbine was a medical educator without peer, who used his department of health to disseminate the latest developments he and others throughout the world were achieving in public health. He found it necessary to propagandize a skeptical and sometimes hostile public to accept the germ theory, the idea that invisible microbes were making them ill and that they should clean up their environment and their food and water sources. He had to convince the public to rely on modern medicine, not snake oil and other miracle cures for a healthy living. R. Alton Lee's historical account might offer insight in today's threat of Bird Flu and other recent medical threats for any reader.
"If you go to Antigua as a tourist, this is what you will see. If you come by aeroplane, you will land at the V. C. Bird International Airport. Vere Cornwall (V. C.) Bird is the Prime Minister of Antigua. You may be the sort of tourist who would wonder why a Prime Minister would want an airport named after him--why not a school, why not a hospital, why not some great public monument. You are a tourist and you have not yet seen . . ."
So begins Jamaica Kincaid's expansive essay, which shows us what we have not yet seen of the ten-by-twelve-mile island in the British West Indies where she grew up.
Lyrical, sardonic, and forthright by turns, in a Swiftian mode, A Small Place cannot help but amplify our vision of one small place and all that it signifies.
The untold story of a heroic band of Caribbean pirates whose defiance of imperial rule inspired revolt in colonial outposts across the world
In the early eighteenth century, the Pirate Republic was home to some of the great pirate captains, including Blackbeard, "Black Sam" Bellamy, and Charles Vane. Along with their fellow pirates—former sailors, indentured servants, and runaway slaves—this "Flying Gang" established a crude but distinctive democracy in the Bahamas, carving out their own zone of freedom in which servants were free, blacks could be equal citizens, and leaders were chosen or deposed by a vote. They cut off trade routes, sacked slave ships, and severed Europe from its New World empires, and for a brief, glorious period the Republic was a success.