America's Health in Two Centuries

It seems appropriate that on the occasion of the golden anniversary of the American School Health Association and the 200th anniversary of our nation we take a look at health care 200 years ago and 50 years ago. The signal improvements in mankind’s understanding of the body, of disease, of disease-causing organisms and conditions, and the treatment and prevention of these are so dramatic that they test credibility of our recording. It seems improbable, almost impossible, that so much could have happened in so short a time span. Some wag has said, “Don’t look back unless you plan to go that way.” There is, however, at least two good reasons to look at the past: one is t o help us better understand the present, and the other is to provide a basis for projecting into the future. Winston Churchill said, “If we open a debate between the past and the present, we shall find that we have lost the future.” The purpose then, of this brief inquiry into the past, is to know where we have been as a means of assessing our present and charting our future. Recounting our health quotient a t the time of the nation’s birth may easily become a litany of what we did not know, did not have, and could not manage. This paper is in no sense a comprehensive review of health conditions circa 1776. It merely proposes t o take some samples of the health problems of the time, which may be displayed against the common knowledge of the present for contrast. Vaccination for any disease, as we know it, did not exist in 1776. Edward Jenner was working on his idea for using a strain of cowpox t o inoculate against smallpox at that time. Benjamin Franklin was among those in this country who advocated inoculation or intentional infection, with material from a pox as a form of preventive smallpox infection. He kept records on some cases using this type