Highly anticipated among scholars of American art and American cultural history alike, Wendy Bellion’s Citizen Spectator is among the most significant book-length studies of early American art to appear in print during the past decade. Derived from Bellion’s 2001 Northwestern University dissertation, it is indispensable, as ambitious and important as Margaretta M. Lovell’s Art in a Season of Revolution: Painters, Artisans, and Patrons in Early America (2005) and Michael Gaudio’s Engraving the Savage: The New World and Techniques of Civilization (2008).

Philadelphia was at once a “thriving intellectual, social, and commercial hub,” a “hothouse of political inquiry,” and a “laboratory for looking, a place where the visual ideologies of the early republic could be put to the test of objects and experiences”

As the dust jacket indicates, Citizen Spectator is the “first book-length exploration of illusionistic art in the early United States.” Unlike the much-studied optical devices, hoaxes, and trompe l’oeil paintings of the later nineteenth century, Bellion’s world of illusion has received only passing mention or fragmentary treatment. She makes a case for its importance by underlining the relations between “early national cultures of art and politics” (11). Citizen Spectator “contends that illusions functioned to exercise and hone skills of looking” (5). “During an era in which the senses were politicized as agents of knowledge and action,” Bellion writes, “public exhibitions of illusions challenged Americans to demonstrate their perceptual aptitude. Thresholds for the practice and performance of discernment, deceptions made exhibition rooms into spaces of citizen formation” (ibid.). To see clearly, to live “undeceived,” Bellion argues, were primary concerns for Americans in the earliest years of the United States. Although she occasionally ventures north to Boston, south to Washington, D.C., and across the Atlantic, she focuses on early national Philadelphia and the well-known Peale family of artists, scientists, and entrepreneurs. As the “second-largest city in the British Atlantic world,” the “site of the Revolutionary and Continental congresses of the 1770s and 1780s [and] the seat of the federal government during the 1790s,” Philadelphia was at once a “thriving intellectual, social, and commercial hub,” a “hothouse of political inquiry,” and a “laboratory for looking, a place where the visual ideologies of the early republic could be put to the test of objects and experiences” (8).

Bellion builds her argument about the interdependency of deception and discernment in early national America by attending to objects as diverse as optical instruments, public exhibits and museum displays, paintings both large and small, printed matter of many different sorts, drawings, maps, as well as the built environment, which she has in many cases painstakingly re-imagined or reconstructed. Obviously, much of the documentation is visual, and the book is generously and appropriately illustrated with 12 color plates and more than 80 black-and-white illustrations. Although the black-and-white illustrations are very good, the color plates, grouped near the center of the volume, are too dark in tonality. Of the works I have seen in person that Bellion is describing and analyzing, virtually all are impressive, indeed wonderfully subtle. In the main the color plates do not do the original objects justice.

Chapter 1, “Theaters of Visuality,” introduces the “late-eighteenth-century culture of visual curiosity” in Philadelphia that preceded and primed the populace for later trompe l’oeil paintings (17). Perpetual motion machines, an anamorphic print of a horse, solar microscopes, and phantasmagorias, for example, fostered the capacious perceptual capacity that was the cornerstone of a discerning citizenry. In the second chapter, “The Politics of Discernment,” Bellion offers a dense and impressive reading of Charles Willson Peale’s Staircase Group (Portrait of Raphaelle and Titian Ramsay Peale) of 1795, contextualizing the work in relation to its production for and siting in the Columbianum exhibition in the Pennsylvania State House. As Bellion points out, “[T]he Columbianum exhibition transformed a chamber designed for political deliberation into a space for looking” (65). A virtuosic display of illusionism, the painting takes the shape of a doorway and pictures two of Charles Willson Peale’s sons at the threshold of a sharply turning and upwardly winding staircase. Period debates about representation and transparency in government between Federalists and Antifederalists are as critical for Bellion’s case here as is the contemporaneous development in Philadelphia of the nation’s first art academy, museum, and then current aesthetics and art theory. Whereas Federalists favored a big government led by a “natural aristocracy,” which inevitably led to accusations of monarchism, Antifederalists argued for more radical, democratic values, and they were particularly mistrustful of representation (73). During 1795, at the very moment when the Staircase Group was first publicly displayed, Antifederalists vigilantly attacked governmental secrecy at the State House, epitomized by closed-door deliberations in the Senate concerning the controversial Jay’s Treaty.

In Chapter 3, “Sight and the City,” Bellion deals with a group of twenty-eight engravings by William and Thomas Birch. Dating to 1798-1800, the prints picture sites around the city of Philadelphia. Bellion reads the engravings’ formal peculiarities, including their imperfect perspective, not as flawed draftsmanship but as signs of the Birches’ complex engagement with Enlightenment values in their lived experience of the urban environment. While “[t]o a certain extent,” she writes, “the prints reproduce [the] crucial paradigms of order” that are “the grid and the market,” “the views undermine the presumed logic and transparency of these systems through their distortions of scale, their fracturing of perspectival space, and their fixation on certain types of material objects” (122). The engravings, she suggests, “help illuminate the dialectical nature of perception—its capacity for judgment and susceptibility to deception—that was a central political and cultural concern of the early republic” (ibid.). “Imitations and Originals” focuses on the paired display in early nineteenth-century Philadelphia of trompe l’oeil rack pictures and corresponding originals by one Samuel Lewis. This chapter functions as a brilliant extension of the analysis of the Birches’ engravings. Bellion shows us how Lewis’s trompe l’oeil pictures relate to his work not only as a writing master, but also as a cartographer. Depicting motley collections of paper—from pieces of newspaper and tickets for the theater and exhibitions, to small books and pamphlets, playing cards and business cards—tacked between diagonally organized ribbons in a shallow picture plane, Lewis’s pictures are themselves works on paper, composed in graphite, ink, and watercolor. If, to this point in the volume, there were any doubt in the reader’s mind as to the intelligence of early American trompe l’oeil representation, here it is dispelled. Lewis is as witty as he is technically proficient. Ultimately, the display together of Lewis’s trompe l’oeil renderings and their models encouraged the development of “judgment” in the early national populace—it showed viewers how “to distinguish image from object, copy from original” (210).

In Chapter 5 Bellion considers an amusement popular in the early nineteenth century—the “Invisible Lady.” This “rational recreation” challenged audiences to explain the source of a woman’s voice in a room possessed of various displays of speaking trumpets, but no visible human body. As Bellion notes, “[P]rint helped generate an audience for aural illusion outside the actual space of the exhibition hall,” thus broadening access to this and other similar amusements (239). These amusements also mark a transition toward Romanticism. Although “sensory discernment was still critical to maintaining civic order,” as time went on a cultural fascination with irrationality became hitched to late Enlightenment cultural practices (245). At the peak of its popularity (during Jefferson’s presidency) the Invisible Lady prompted audience experiences that resonated with renewed criticism of governmental secrecy. The chapter closes with ruminations on the Invisible Lady and debates circa 1800 about women’s voices. In the “reactionary” environment of the turn of the century—following the publication of Mary Wollstonecraft’s A Vindication of the Rights of Woman (1792)—”the Invisible Lady put female orality on display…function[ing] to reflect the emerging limits on female speech” (275). “Even as it modeled the range of female vision and voice,” writes Bellion, “the exhibition occasioned a symbolic containment of female authority” (280). “[A]ttempts to bring the Invisible Lady into visibility reveal the extent to which discernment itself was a gendered construction” (ibid.). The final chapter, Chapter 6, deals with a new type of illusionistic painting that developed in the United States in the 1820s. Modeled on François-Marius Granet’s The Choir of the Capuchin Church in Rome (1814-1815), first displayed in a Philadelphia gallery in 1820, such pictures were all about absorption in art over and against discernment. Rembrandt Peale’s Patriae Pater (ca. 1824)—the so-called “porthole” portrait of George Washington—is Bellion’s central example of this new kind of painting. Explicated in light of the waxing culture of Romanticism, including phantasmagoria shows, as well as the Second Great Awakening, such images celebrated visual fantasy, memory, and escapism, placing them at odds with the earlier culture of discernment.

The contributions of Citizen Spectator are manifold. Bellion shows the merits of careful study and contextualization of topics in a period of the history of American art that is still very much overlooked, if not demonized, for its seeming lack of aesthetic and intellectual value. By looking with patience at a type of painting that has been disparaged historically by critics and aesthetic theorists (i.e. trompe l’oeil), Bellion demonstrates why we ought to take this sort of representation more seriously than we often have: if such pictures are playful, their play is a form of considerable pictorial intelligence. The creativity and skill with which Bellion analyzes the interrelatedness of art and politics offer a model for anyone interested in expansive thinking about the interactions of these two topics. Throughout I admired the ways in which she thought long and hard about contingencies of display, whether working out in detail the locations for which specific trompe l’oeil paintings were designed, or considering how idiosyncrasies of period exhibition practices contributed to surprising juxtapositions of art objects and spaces with what we have come to think of as non-art objects and spaces. For anyone who holds out hope that the history of early American art can be productively separated from the history of early American culture more generally, this book sounds a death knell. And against those who would oppose cultural spectacle and the cultivation of self-awareness, Bellion tenders this provocation.

Race, gender, and class are mentioned here and there throughout the volume, though it is only in the fifth chapter that Bellion addresses one of these categories of difference—gender—at length. Given the limited access many people had to the artworks and exhibits she describes, Bellion emphasizes that the “citizen spectator” of her book is, generally speaking, raced (white), gendered (male), and classed (not very poor). Although there are additional ways in which Bellion could have dealt with difference in the book—I was surprised, for instance, that she did not talk more in Chapter 6 about the forcefully marginalized black servant figures around which Henry Sargent’s dinner and tea party paintings of the 1820s are organized—she is overall quite self-conscious in explaining how forms of social and cultural bias informed ideas about and access to technologies for the development of discernment or judgment in the early United States. Her claim at the end of Chapter 5 that “[a]gainst the rhetorics of discernment and judgment that pervaded cultural constructions of citizenship, the [Invisible Lady] demonstrated that not all Americans had equal access to visuality” made me wonder what it means to cultivate self-awareness in the absence of an egalitarian society or citizenry (280). Bellion suggests that the culture of illusionism functioned ideologically to naturalize the bonds between white male privilege, seeing, and self-awareness. In this sense, the objects and displays she analyzes deceived even in undeceiving.

Despite the many bold moves one finds throughout Citizen Spectator, the book’s conclusion focuses rather predictably on the later history of trompe l’oeil in the nineteenth-century United States. I would have preferred to read here about how the subject of Bellion’s book resonates today. Indeed, I was struck by how much early American illusionistic artworks could resemble contemporary illusionistic artworks. Consider the “trompe l’oeil grotto” in the Peale Museum, which calls to mind the Space Division Pieces (beginning 1976) of the Light and Space artist James Turrell. Like Peale’s grotto, Turrell’s installations confront the viewer with a heightened sense of perceptual self-awareness; Turrell achieves this by presenting what appears at first to be a large-scale abstract canvas hanging in a dimly lit gallery, but which upon further inspection turns out to be a rectangular recess cut into the gallery wall.

The closest parallels in contemporary art for Bellion’s politically engaged works promoting discernment or judgment are what the art historian Carrie Lambert-Beatty has called “parafictions.” A global phenomenon, exemplified in the production of Michael Blum, 01.ORG, The Yes Men, and The Atlas Group, such works constitute spectacular ruses that conflate fact and fiction; they are characterized by “purposeful deception.” Whether what Lambert-Beatty writes of this art could be said of the artworks and exhibitions Bellion describes in Citizen Spectator is an open question: “Parafictions train us in skepticism and doubt, but also, oddly, in belief.” Parafictions help to “work facts alive.” For Lambert-Beatty what separates the contemporary culture of parafictional art from earlier cultures of trompe l’oeil is the work it does to resuscitate conceptions of truth, knowledge, and factuality, all laid low in postmodernity. We might say that in the early United States no such resuscitation was yet necessary. Whatever the differences between illusionistic art in the early republic and illusionistic art today, the continued aesthetic and political importance of deceiving and discerning suggests that Citizen Spectator should enjoy a wide readership. We will want to think more about its relevance to and implications for art and life in the present.

This article originally appeared in issue 11.4.5 (September, 2011).

Jason D. LaFountain is a Ph.D. candidate in the Department of History of Art and Architecture, Harvard University.

American cultural history is full of disappearing acts. But no act has ever disappeared–or been expunged–as thoroughly as the popular anatomical museum. Its kissing cousins, the dime museum, the freak show, the medicine show, leave behind a nostalgic afterglow; the museum of anatomy is roadkill. The collective memory retains almost nothing and there are few traces for historians to kick over. Yet the museum was a part of American urban life for almost a hundred years. The nation’s first popular anatomical museum appeared in the 1840s; the last closed its doors around 1930. In the three decades following the end of the Civil War, museums of anatomy could be found in New York, San Francisco, Philadelphia, Chicago, Boston, Baltimore, St. Louis, New Orleans, and some smaller cities too.

The popular anatomical museum didn’t disappear from an excess of modesty. Back in the day, it was known (by patrons and critics alike) for the lurid visibility of its curiosities. The anatomical museum was not just a transgressor of public morality, it was a notorious, flagrant transgressor, a public institution devoted to the display of things that should not be displayed. The popular anatomical museum affronted public decency (if the public had any decency to affront).

And how did it do that? In every way possible. An 1871 article in the New York Times on downtown entertainments described it this way:

Out . . . upon the thoroughfare, and following the crowd, we journey on to a “museum of anatomy.” To it, gentlemen only can obtain admission on presentation of twenty-five cents. You hand your quarter, and receiving your pasteboard, step into the store. Facing you, with spear and tomahawk in hand, and an ominous grin upon his leather visage, stands the famous body of a savage of the Islands of Senegambia, killed in battle by a certain doughty Captain, who followed the customs of the savages, and prepared the body of his fallen adversary as a trophy. Next, have you any desire to study obstetrics, or equally improving surgery?–you can gratify it so far as viewing waxen models of operations and abnormal monstrosities will permit. Among all the curiosities of wax are the most revolting specimens of cutaneous disorders, and other things instructive no doubt, but very disgusting to the ordinary spectator. People come and go to this place from morning until night, putting money in the proprietor’s purse, and after a stay of perhaps ten minutes, depart, as we did, with a lurking suspicion of having been sold twice in half an hour in Chatham-street.

The popular anatomical museum was a museum among dime museums. It inhabited the Bowery and other plebeian entertainment districts, places where novelty acts and freak shows proliferated alongside houses of prostitution, gambling, and all kinds of petty and not so petty crimes. And amidst the displays of oddities and curiosities, the museum of anatomy was in some ways the oddest and most curious. It specialized in persons and conditions that lacked, or exceeded, the boundaries provided by aesthetics, morality, physiology, race, or the law. Its province, in other words, was pathology and grotesquery, sex and impulsive desire, savagery and murder, death and decay. The anatomy museum–a mix of real specimens and models–blurred those categories, and staged them as a theater of the body. What was exhibited was the Body with a capital B, separated from, deprived of, punished by, or in rebellion against, a moralizing, rationalizing, disciplining Spirit. The result was an orderly arrangement of souvenirs of embodied life run amok. The museum piled on an excess of body parts. An excess of meaning. An excess of everything.

And if Spirit disciplined the Body, with criminal and physiological and moral laws, that too was excessive. Alongside “anatomical and surgical,” “pathological,” and “obstetrical and monstrosity” departments–and plenty of models and specimens of vaginas, penises, breasts, and partly dissected (and therefore unclothed) females–the museum featured displays of gruesome crimes and gruesome punishments. Dr. Baskette’s Free Museum of Anatomy, in Chicago, contained “historical collections” displaying the guillotine and its victims (and also an “extra Mormon cabinet” detailing the massacres and polygamous practices of the Mormons). Philadelphia’s European Museum of Anatomy, Pathology and Ethnology featured a special display on the Spanish Inquisition and antique European torture devices. The 1867 New York Museum of Anatomy displayed executed murderer Anton Probst’s head and right arm (which struck the fatal blows). Exhibitions of punished bodies–dissected, diseased, dismembered–commingled with exhibitions of punished criminals and criminal punishments. The museum crowd had plenty to gawk at.

Professional versus Popular

But the popular anatomy museum was also a museum among medical museums. In the nineteenth century, any medical college worth its salt had an anatomical museum and pathological cabinet. There was a pedagogical circle of life: medical students and colleagues were expected to study specimens and also to produce them. Membership in the profession was consolidated by a common culture of collectorship. In formal medical discourse the specimen was accounted as an educational aid or as a record of a typical or unusual anatomical feature or pathological condition. Informally, there was the pleasure of acquisition and possession and a connoisseur’s appreciation of the artistry of the preparation. The professional anatomical museum was a repository of medical souvenirs. In other words: stuff in jars, skeletons, dried preparations, casts and models in wax, plaster, papier mâché, and wood. Some of them were typical, others were oddities, still others were records of a historical event, the skull of a man who had been shot at Waterloo or a relic of a notorious criminal who was hanged and then given over to the surgeons for dissection.

Such items were common to both the professional and popular anatomical museum. Their differences had to do with proportion, quality, audience, and legitimacy: popular museums tended to have more sex- and crime-related material; the professional museum tended to have more “natural” specimens, and fewer models. The popular museum was open to a “for-gentlemen-only” public that was predominantly working class, with a large admixture of immigrants. The professional museum was generally open only to doctors and medical students, although respectable members of the laity were sometimes granted access. There was also a different ideological valence. The objects of the professional museum represented the triumph of medical knowledge, the conquest of reason and the law over the body. Doctors were known to keep a few specimens or a cabinet of material on display in their offices as trophies and, more broadly, as objects that advertised a medical vocation (as did diplomas, weighty medical tomes, medicines, and instruments). The specimens served as a credential, proof that the doctor had dissected and had special knowledge of the interior of the body.

In the Company of Men

The displays of the popular anatomical museum also advertised a medical practice. The museum was a clinic of a peculiar sort, catering entirely to men. Its proprietor typically described himself as a physician (but was suspiciously silent as to where he obtained his medical degree). The museum also featured a resident “lecturer” who transfixed customers with a pitch on the medico-moral-sexual maladies man was heir to. This was a long list that included syphilis, gonorrhea, chancre, impotence, incontinence (a category that included bedwetting, premature ejaculation, and nocturnal emissions), infertility, but also masturbation, promiscuity, sexual obsession, horniness, or a lack of libido. The lecturer’s litany of woes (symptoms of a larger malaise denoted as “nervous exhaustion,” “nervous debility,” or “neurasthenia”) was designed to produce a state of anxiety in the clientele–a worried frame of mind that was heightened by the surrounding displays of syphilitic faces and diseased genitalia. The marks could then be easily persuaded to buy a book or patent medicine, or even better have a consultation with the doctor–who for an extra charge might perform a microscopic or chemical analysis of the patient’s urine. The nightmarish displays of anatomy and pathology (read: death and disease) functioned as a kind of moral shock therapy and, from the business end, helped to overcome sales resistance. The microscope and chemical apparatus, like the displays of specimens, bolstered the museum’s claims to be scientific and modern.

Popular museums varied in size and pretension (most were at the low end of the spectrum), but that was the format. A Boston Medical and Surgical Journal editorial of July 24, 1873, denounced a museum that was “a type of its class,” Dr. Jourdain’s Gallery of Anatomy: “It was a collection of anatomical models and dissections, with representations of skin and venereal diseases, most improper for public exhibition, and calculated to excite the morbid curiosity of the young together with it peculiar forms of hypochondria. Vile pamphlets were on hand to induce those having or fearing disease to consult the proprietor. The harm which this single establishment must have done cannot be calculated.”

Such warnings had a long shelf life, perhaps even outlasting the museums themselves. In the teens or early 1920s, the United States Public Health Service mounted a lantern slideshow against the “quack trickery” of doctors who practiced at anatomical museums. Medical establishments had a vested interest in drawing the lines between legitimate and illegitimate practitioners–and suppressing competition.

The claim, by the Boston Medical and Surgical Journal and other medical critics, was that the museum fostered a “morbid curiosity” that killed the cat. But did it really? We can only speculate as to how the anatomical museum affected its patrons, medically or morally. Some men must have come to the museum already panicked over visible signs of syphilis, gonorrhea, or other diseases they might be reluctant to speak about to the family doctor: the museum was their VD clinic; they came for treatment. (What was in the ointments and tonics they purchased is unknown to us, as it was to them, but museum pamphlets typically condemned mercury-based medications, which were then the standard treatment for syphilis. Mercury’s effectiveness in arresting the progress of syphilis is debatable, but clearly it had terrible side effects. If the museum doctor’s prescription was more benign, patients may actually have been protected from harm.) Other men, susceptible to suggestion, fretted all the way to the museum doctor’s consulting room without having anything physically wrong with them. But still other men–the majority?–must have visited the museum purely for fun. Maybe they defined themselves in opposition to pathology–or maybe they perversely embraced it. Maybe they resisted the blandishments of the lecturer, or maybe they laughed all the way to the doctor. Maybe the doctor and the fretting were part of the entertainment, like a roller coaster ride that makes you scared and a bit nauseous.

It was a man’s world. Women were denied the pleasures of viewing the displays, which were rife with “Florentine Venuses” and models of sexual anatomy and obstetrics that featured unobscured vaginas, adorned by realistic thatches of pubic hair. We don’t know who exactly visited the museum of anatomy–how many middle- and upper-class men condescended to enter?–but it was a place where things that can’t be said or seen in mixed company get said and seen. And such places, by definition, mixed men of different classes, especially younger men who used the museum to satisfy a morbid curiosity about sex and death and disease, and also the urban demimonde in which the museum was situated. The museum was not quite a refuge from the parlor–it provoked too much anxiety for that–but, like the men’s club and the fraternity, it catered to a shared male voyeurism. It was a place where men could be men.

Down by Law

Given all that, it comes as no surprise that the museum of anatomy was not well respected. A stigma attached itself to institutions that trucked in death and desire, emotions and appetites, corpses and body parts. The museum claimed to serve the cause of moral reformation, but it really worked on base emotions and bodily appetites. Then, as now, there was a cultural hierarchy that placed reason and spirit at the top and the body at the bottom. The museum engineered sensations in the museum goer–the sensation of revulsion was continually cited in contemporary commentaries–and a worrying, tickling obsession with sex and sexual pathology, a condition that both burdened and pleasured patrons. Like pornography, the museum was a technology of incitement, of arousal. The displays of tertiary syphilis, freakery, criminality, savagery, and dissected bodies and body parts combined to produce a kind of nightmare eroticism that simultaneously reinforced and subverted the museum’s self-proclaimed mission to uphold sexual morality (a modus operandi not unlike that of present-day teen slasher movies, which also pair sexual desire and pleasure with pain, mutilation, dismemberment, and death).

And this brings us to the popular anatomical museum’s relation to the Law (capital L). The museum of anatomy presented a jurisprudential interpretation of disease and desire. The penalty for sexual crimes and misdemeanors, and by extension sexual desire and all the other appetites, was written on the body and body parts. The specimens of the museum made moral transgression manifest. There was no escape: spirit was incarcerated inside flesh. Such notions, we should remember, had profound resonance in a society in which a considerable portion of the population suffered from syphilis, gonorrhea, and other diseases (with few effective treatments) and the visible signs of the harm of sexual desire were displayed for all to see on their faces and bodies.

The popular anatomical museum’s displays and justifications dramatized the Law. The museum made sense to its patrons because the Law was their cultural logic, the cultural logic of their performance of sexuality, selfhood, social class, gender, race, and a bunch of other things. The Law was inside the museum (and inside the patrons). But the Law–in this case literally the governmental structure of penal codes, police departments, and courts and trials–was also outside the museum. And the museum was outside the Law. It was a pariah institution, to its many critics a moral pathology: sexually transmitted disease staged as a burlesque, as an incitement to pleasure.

Decline and Fall

The museum of anatomy was robust. As a flower of evil it was a hardy perennial, a crowd pleaser. So why did it die? Well for one thing, there was no shortage of people who wanted to kill it. From the outset, popular anatomical museums attracted enemies who objected to its displays of partially and wholly undressed (and partially and wholly skinned) bodies, with females far outnumbering males. In 1850, the district attorney indicted the proprietors of the New York Anatomical Gallery–the nation’s very first popular anatomical museum and then only three years old–for “exhibiting . . . figures of men and women naked in lewd, lascivious, wicked indecent, disgusting and obscene groups attitudes and positions to the manifest corruption of morals in open violation of decency and good order.” Similar attacks on the museum occurred at intervals. Police in Rochester, New York, shut down the European Anatomical, Pathological and Ethnological Museum and seized its “obscene representations” in 1874; the proprietors moved on to Buffalo, Philadelphia, and Chicago. In 1888, Anthony Comstock’s Society for the Suppression of Vice and the New York City police conducted a campaign against the city’s four anatomical museums, confiscated and destroyed most of their objects, and put three of them out of business. A jury refused to shut down Kahn’s Museum of Anatomy, the oldest and most substantial of the four. The trial transcript hasn’t survived, but in his notes, Comstock complained that he wasn’t permitted to destroy some “wax figures of females life size, some pregnant & some otherwise & 37 cases of filthy penises.” Comstock didn’t give up: in 1896 he lobbied for an amendment to the state penal code that outlawed all museums of anatomy save those “designed for physicians or medical students when kept to their lawful uses or purposes” (along with a ban on performances by women wearing tights). This effort failed: at least two anatomical museums operated in New York City in the first two decades of the twentieth century. A similar prohibition was successfully enacted into law in Chicago in 1922, as part of a reorganization of the penal code (progressives often used this stratagem to push through rafts of minor reforms).

These turn-of-the-century efforts at suppression made life difficult for museum operators. But the museum of anatomy was probably already history. A New York Times article of 1895 used it as a marker of a bygone era, “the darkest days” of the city, “the period of the dance halls, cellar dives, and ‘anatomical museums’ after the [Civil War],” even though a museum or two still lingered on the Bowery. By 1911, the Times was waxing nostalgic for “the smaller, less sophisticated, less civilized town of the era of pump water, blue omnibuses, cobblestone pavements, black mud, oyster shells and orange peel, Dew Drop inns and anatomical museums.” So even as reformers continued efforts to ban museums of anatomy, in many places the museums had already disappeared or were declining into decrepitude, obscurity, or quaintness.

And why was that? We don’t really know, but here are some factors to consider. The decline and fall of the popular anatomical museum coincided with decline and fall of the dime museum, a fate that most observers attributed to the rise of competing entertainments, most notably the movies, vaudeville, and amusement parks. It also coincided with the decline of the professional anatomical museum, as the glass slide, the photograph, photomicrograph, stereograph, film, and statistical table became the media in which anatomy and pathology were documented. And this coincided with changing models of disease causation–germ theory began to supersede environmental explanations of disease; and microbiology and radiography began to supersede anatomy as emblems and methods of medical science. In other words, if the anatomy museum’s claim to be scientific and modern legitimated its medical treatments and its displays of the sexual body and the grotesque, then by the turn of the century that claim was looking kind of tattered. From the time of Vesalius onward, anatomy fellow-traveled with modernity. It was a good run, but after four centuries, the anatomical museum, both professional and popular, seemed like a dusty antique.

There is also the issue of shelf life, the longevity of curiosity. The museum of anatomy was a collection of novelties and curiosities; the proprietor’s capital investment was in a stock of objects. But after several decades such pieces could no longer be regarded as novelties. American popular culture is notoriously a careening, accelerating, succession of attention-deficit trends, fads, and fashions. While the rate of change in the early twentieth century nowhere approached the supersonic speed of the music-video-cable-ready-Internet generation, it exceeded the capacity of the anatomical museum, a low-profit, low-rent operation, which utterly failed to reinvent itself.

Whatever the case, we know that the popular anatomical museum lost its public and lost its lease. Part of the museum’s appeal was that the anatomical specimen was a mirror. People saw themselves in the objects, and they saw double: the museum was a carnival of self and other. But over time the museum of anatomy became so identified with the body and desire that its outlaw valence simply outweighed the disciplinary valence. To put it another way, the museum’s representations of a body ruled and punished by anatomical boundaries and physiological law became so invested with eroticism and desire that its claims to teach science and morality no longer served, even as a fig leaf.

Or maybe the museum lost its salience because more supple, more dynamic, and more friendly modes of erotic representation came around to supersede the scary jurisprudential model that was the museum’s thematic. If so then, in the final analysis, the museum lost its mojo. Compared to the engaging, sexy, kinetic offerings of the cinema, the burlesque, and the peep show, the anatomical museum was devoid of eroticism and vitality, and had nothing new to offer. By the 1920s and ’30s, it was regarded as something of a joke, if it was regarded at all. In its final days, before its total disappearance, the museum of anatomy lingered on, not as a collection of curiosities, but as itself a curiosity.

Further Reading:

Nineteenth- and early-twentieth-century popular anatomical catalogues and pamphlets can be found at the New York Public Library, the Library of Congress, the National Library of Medicine, the American Antiquarian Society, and other historical collections. The first scholarly treatment of popular anatomical museums appeared in George Odell’s massive fifteen-volume compendium, Annals of the New York Stage (New York, 1931). More recently, popular anatomical museums are discussed in Brooks McNamara, Step Right Up (rev. ed.; Jackson, Miss., 1995), a history of the medicine show, and in Michael Sappol, A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in 19th-Century America (Princeton, 2002), as part of a larger discussion about the role of anatomy in American culture. English popular anatomical museums are discussed in Richard D. Altick’s The Shows of London (Cambridge, Mass., 1978).

This article originally appeared in issue 4.2 (January, 2004).

Michael Sappol is curator-historian at the National Library of Medicine, Bethesda. He is the author of A Traffic of Dead Bodies: Anatomy and Embodied Social Identity in 19th-Century America (Princeton, 2002). His most recent exhibition, Dream Anatomy, was on the history of anatomical representation. He is currently preparing an exhibition on the history of forensic medicine.

Generally speaking, the New England Journal of Medicine is not a publication of much interest for scholars of early America. However, scholars of the Antinomian Controversy occasionally cite a 1959 article titled “New England’s First Recorded Hydatidiform Mole” (note: fee required to access full article). This article–or note, more precisely–offers a medical diagnosis for the “monstrous birth” alleged to have issued from Anne Hutchinson. “Monstrous birth” was the name Hutchinson’s opponents gave to the miscarriage she suffered shortly after she was expelled from the Massachusetts Bay Colony in the wake of what scholars term the Antinomian Controversy, a collection of religious, political, and social conflicts in the Massachusetts Bay Colony in the 1630s. The religious valences of the conflict can seem to modern readers to revolve around relatively abstruse theological questions, but the social and political stakes are clearer. Shortly after her arrival in Boston, Hutchinson began leading a lay discussion of that day’s sermon, which quickly attracted a large following. Evidently, the popularity of this lay group threatened some of the ministers and magistrates of the Bay Colony theocracy, and Hutchinson found herself accused of various heresies. After a civil and ecclesiastical trial, Hutchinson, and some of her followers–termed “Antinomians” because of their insistence on the primacy of grace over works–were banished. Hutchinson settled in Rhode Island, where she miscarried, and later departed for present-day Westchester County, New York, where she and her family were massacred by Indians.

“New England’s First Recorded Hydatidiform Mole” allows its authors, writing in a scientific age, to offer a scientific explanation for what Hutchinson’s antagonists called “30 monstrous births or thereabouts, at once; some of them bigger, some lesser … few of any perfect shape, not at all of them, (as farre as I could evern learne) of humane shape.” In the New England Journal of Medicine, we can see science displace fear and superstition as explanations for Anne Hutchinson’s miscarriage. In the historiography of the Antinomian Controversy, this article offers a name and an explanation we can use in place of the slanderous maledictions of Hutchinson’s enemies. As scholars, we are moved to exclaim “what a difference an Enlightenment makes” or words to that effect.

And yet. My interest in the historiography of Anne Hutchinson led me to track down the article, and what I found was less informative, but more interesting, than I might have hoped. The NEJM does take Hutchinson’s miscarriage out of the realm of divine judgment, and into the realm of medical science, but reading a 1959 article about a 1639 miscarriage in 2011 reveals how little the discourse about women’s bodies evolves over 320 years. The subject of the NEJM article is Anne Hutchinson, or more precisely, a growth inside of Anne Hutchinson. Briefly reviewing the antagonism between Hutchinson and Bay Colony Governor John Winthrop may help explain why he was so keen to investigate and publicize Hutchinson’s obstetrical woes.

Anne Hutchinson is the most prominent figure in a theological dispute that erupted in the newly settled Massachusetts Bay Colony in the late 1630s. In the summer of 1634, Anne Hutchinson and her family arrived in Boston from England, having followed the famous Puritan minister John Cotton from Lincolnshire. At some point in the next two years, Anne Hutchinson began to hold meetings in her house to discuss the previous week’s sermons. The only records of these gatherings come from Hutchinson’s opponents. Initially, they attracted a small circle of predominately female friends, but over time they grew and came to include more men. As these discussions grew in popularity, Hutchinson evidently took more liberties in her analyses, and identified shortcomings in the theology of the Bay Colony ministers who were not Cotton, in terms of the respective relation of justification and sanctification in the process of an individual’s salvation. The distinction between these terms constitute a whole field of Christian apologetics unto themselves, but basically, justification is the manifestation of God’s grace in the heart of a sinner, while sanctification is living a life that shows evidence of God’s grace. As Calvinists, the orthodox ministers of the Bay Colony believed in the inherent wicked and sinful nature of each human being. These wretched souls could be saved only by a free gift of God’s grace, according to Calvinist doctrine. At the same time, there was nothing an individual could do to deserve to be saved, because of his or her inherently wicked nature.

To a contemporary audience, these may seem like technical quibbles on the road to heaven, but the inference Hutchinson and her followers drew was that many of the Bay Colony’s ministers preached a covenant of works, against the Calvinist orthodoxy of a covenant of grace. One way to interpret Hutchinson’s teaching is that she was claiming the vast majority of Bay Colony clergy were preaching a false doctrine. To staunch the flow of heresy, in October 1636, Bay Colony ministers convened a “conference in private” with Hutchinson, Cotton, and John Wheelwright, Hutchinson’s brother-in-law. This meeting served to address Hutchinson’s unorthodox ideas, but also to consider if John Cotton was their source. The ministers were able to settle these questions, but parishioners of the Boston church loyal to Hutchinson proposed that Wheelwright take the place of John Wilson, a Hutchinson opponent, as the second minister of the Boston church. Winthrop resolved this confrontation in favor of Wilson, but it led to a second meeting of ministers with Cotton and Hutchinson. In the meantime, on December 7, Hutchinson sympathizer Henry Vane resigned as governor, and then withdrew his resignation, but returned to England.

The next gubernatorial election, on May 17, 1637, was moved to Newtown (Cambridge) in an effort to temper the influence of Hutchinson’s followers over the proceedings. This effort was successful, and Winthrop carried the election. After this attempt to address the civil threat posed by Hutchinson’s followers, called Antinomians by their opponents, the Bay Colony clergy convened a synod, beginning on August 30. Tensions continued, and on November 2 the General Court voted to disenfranchise and banish the leaders of the Antinomian party, and to impose lesser penalties on the other colonists who had signed a petition in favor of Wheelwright. Hutchinson’s civil and ecclesiastical trials followed, which culminated in her excommunication on March 22, 1638.

Hutchinson, her family, and some of her followers, both legal and voluntary exiles, followed her south to Aquidneck, or the Island of Rhode Island, where they settled the town of Portsmouth. After settling in Portsmouth, Hutchinson found herself pregnant for the sixteenth time, an unusual but not exceptional situation for a woman in colonial New England. At some point in 1639, she miscarried. Rather than a recognizable fetus, she delivered an indistinct mass of some 30 globules. Word of this misfortune reached John Winthrop, who wrote to request details. John Clarke, a physician of Rhode Island, obliged. His report was transcribed in Winthrop’s journal:

“I beheld … several lumps, every one of them greatly confused … without form … not much unlike the swims of some fish.” Following up in search of more information, the governor learns that “The lumps were twenty-six or twenty-seven, distinct and not joined together; there were no secundine after them; six of them were as great as his fist, and one as great as two fists, rest each less than the other, and the smallest about the bigness of the top of his thumb. The globes were round things, included in the lumps, about the bigness of a small Indian Bean, and like the pearl in a man’s eye. The two lumps, which differed from the rest, were like liver or congealed blood, and had no small globes in them, as the rest had.”

This is rather more information than it might today seem appropriate for a doctor to disclose about a subject he has examined, especially to one of his patient’s chief political antagonists. It is also worth noting that Winthrop recorded it in his journal, which was a quasipublic document. But Winthrop was not done. In 1644, Winthrop wrote Short Story of the Rise, Reign, and Ruine of the Antinomians, Familists, and Libertines in an effort to assure Londoners who were concerned that the colony and its independent Congregational, rather than Presbyterian, churches, were fostering a nursery of error. As part of this narrative, Winthrop relates, “Then God was pleased to step in with his casting voice, and bring his owne vote and suffrage from heaven, by testifying his displeasure against their opinions and practices, as clearely as if he had pointed with his finger, in causing the two fomenting women in the time of the height of the Opinions to produce out of their wombs, as before they had out of their braines, such monstrous births as no Chronicle (I thinke) hardly ever recorded the like …” (Mary Dyer, Hutchinson’s supporter, also miscarried a badly malformed fetus, also described by Winthrop in detail.) “Mistriss Hutchinson, being big with child, and growing towards the time of her labour… she brought forth not one… but (which was more strange to amazement) 30 monstrous births or thereabouts, at once; some of them bigger, some lesser, some of one shape, some of another; few of any perfect shape, none at all of them (as farre as I could ever learne) of humane shape.”

A forty-six-year-old woman suffers a miscarriage of her sixteenth pregnancy. Sad and unfortunate, but not remarkable. It is hard to imagine it being worth inquiring from Boston to Portsmouth for details, let alone recording these details in a public place, and publishing these details in London. The pathology that seems salient here is the pathology in the minds of the men who were so keen to exchange and publicize details of this event, rather than the pathology of a weary woman’s body. The key to understanding Winthrop’s interest in a middle-aged woman’s obstetrical travails lies in his providential understanding of the world–the cringe-inducing details are unpleasant to read, but politically, the salient portion of the passage lies in Winthrop’s insistence that God was “testifying his displeasure against their opinions and practices, as clearely as if he had pointed with his finger.”

This willingness to take political advantage by publicizing an adversary’s miscarriage as evidence of God’s will, we might imagine, is a function of a long-ago and unenlightened time. However, Anne Hutchinson arrives in contemporary medical discourse in a way that is not appreciably different from Winthrop’s treatment of her. In 1959, Margaret V. Richardson, B.A., M.T., and Arthur T. Hertig, M.D., published a brief article in the New England Journal of Medicine, titled “New England’s First Recorded Hydatidiform Mole.” This article by the senior research assistant, and the Shattuck Professor of Pathological Anatomy, of the Department of Pathology, at Harvard Medical School analyzes the various descriptions of Hutchinson’s travail, and determines that she suffered from a hydatidiform mole, a condition where a fertilized embryo does not develop, but instead becomes a mass of placental tissue, like a bunch of grapes in its form. Richardson and Hertig conclude the article with a long quotation from Winthrop’s journal, where he transcribes the account of the Rhode Island physician who examined Hutchinson.

The NEJM article offers an account of the pathology that afflicted Hutchinson’s pregnancy, but not the pathology that pervades the discourse surrounding it. It is a short piece, subtitled “A Historical Note.” The first three paragraphs offer an overview of the literature on hydatidiform moles, dating back to the third century B.C. An F. Mauriceau, writing in 1664, represents the closest contemporary to Hutchinson, and “considered the main factor for molar formation to be too frequent coitus.” Richardson and Hertig then cite more recent scholarship, including Hertig’s own entry on the hydatidiform mole in the Atlas of Tumor Pathology from 1956.

Richardson and Hertig learn of Hutchinson’s case from an unusual source: “The present case, that of Anne Hutchinson, was mentioned in the book The Winthrop Woman by Anya Seton.” Seton was a popular writer of historical novels, and in this one, she turns her hand to colonial New England, telling the story of John Winthrop’s niece. Seton was popular in her day–this novel was the eighth-best-selling novel of 1958–behind Dr. Zhivago and Lolita, as it happened. Thus, it seems likely that Hertig, or Richardson, or an associate, came across the account of Hutchinson’s travail, and decided to do some ex post facto pathologizing. The authors conclude that “It is our belief that this was the first hydatidiform mole to be recorded in New England.” This sentence offers a peculiar intersection of chronology, geography, and pathology. This is the New England journal of medicine, but the relevance of this particular geographic scope is hard to understand. Moreover, firstness seems interesting and relevant when documenting instances of human achievement–the first school, or hospital, or synagogue in a given region seem worth commemorating, but the first New England instance of a complaint that was familiar in Europe? Attaching significance to Hutchinson’s condition in these terms suggests a preoccupation with firstness–and New Englandness–that extends well beyond this article. It is hard to travel very far in New England, or in New England historiography, without encountering a reference to the first or the oldest of something–iron works, printing press, university. There does, however, seem to be a difference between monuments of human achievement like these, and the case of the first instance of a specific uterine tumor identified in New England.

Surprisingly, Richardson and Hertig leave the pathologizing to their seventeenth-century investigators. The rest of the article offers a brief sketch of Hutchinson’s life, then excerpts Cotton’s stated belief that “a mole was ‘several lumps of a man’s seed, without any alteration or mixture of any thing from the woman’.” The article concludes by describing Winthrop’s zeal to know more, and ends by quoting Clarke at great length, and without comment, as he describes the sizes and shapes of the various components of the mole.

The pathology of this pathologizing of Anne Hutchinson, I argue, is as present in 1959 as it is in 1644. Boston was, in many ways, a more tolerant place in 1959 than it was three centuries previously. However, these representatives of a leading medical school–affiliated, as it happens, with a college founded to produce the ministers needed to combat the errors issuing forth from the likes of Hutchinson–publishing in a prestigious journal, do little more than perpetuate the grotesque lack of regard for Hutchinson’s privacy by failing to consider how we know what we know about her.

A diagnosis, a name for the illness of what the article calls “the case,” creates the sense that with this diagnosis, Hutchinson’s case is closed. In this respect “God’s casting voice” and “hydatidiform mole” are structurally equivalent in their function as names for a symptom. The larger question of why Hutchinson’s political opponents were allowed to examine the contents of her womb, and why they wanted to, remain unasked. In failing to ask these questions, this article perpetuates the notion that women really speak when their bodies yield up evidence to an examining physician.

Reading a document like “New England’s first recorded Hydatidiform Mole” points to divergent ways one can read such a text. It is history, in the literal sense that it provides information about the past. Developments in medicine between the 1640s and 1950s permit us to give a name, a diagnosis to Hutchinson’s misfortune, taking it out of the realm of divine judgments, and into the realm of science. Rather than note the approximate homology between the number of lumps her body produced, and the number of errors her brain produced, we can call this a “hydatidiform mole,” and look it up in the Atlas of Tumor Pathology. We have, in this respect, come a long way, baby.

But we can also read an article like this as a historical document in itself, as a marker of the lack of progress in Boston between 1643 and 1959. It’s not hard to find scholars who have commented on the creepy and callous nature of the Bay Colony’s leaders’ interest in the Hutchinson and Dyer monstrous births. But it is worth noting that a prestigious, peer-reviewed journal could print an article in 1959 that shares Winthrop and Clarke’s total indifference to the humanity of the owner of the womb it discusses.

It may be perverse, or self serving, for a scholar of the humanities to read an article in a scientific journal and insist on a more humane approach. There is potential heuristic value in post-facto diagnoses, and fields like forensic anthropology address these kinds of questions with this kind of evidence regularly. Nevertheless I do think there is some benefit to considering the case of Winthrop and Clarke and the case of Richardson and Hertig together. We recognize the chilling detachment of Winthrop’s account, the delight he took in making political propaganda from it, and the lack of regard for the humanity of his antagonist. However, that same lack of regard is as present in 1959 as it was in the 1630s and 1640s. Richardson and Hertig consider the firstness and even the New Englandness of the growths within Hutchinson’s body, but not the body that contained these growths. The sum of the progress in the discourse about Anne Hutchinson from the 1630s to the 1950s is essentially a change of name from “monstrous birth” to “hydatidiform mole.” Either we have come a very long way since 1959, or we have not, in fact, come as far as we would like to think.

Three hundred and sixty-six years separate us from Hutchinson’s life. Enlightenment virtues like empirical observation and the scientific method emerged in the interval. Hutchinson lived in an early modern world; we live in a postmodern one. Moving forward from Hutchinson’s time to our own, we were 86 percent of the way to the present day when Richardson and Hertig wrote their article. The treatment that Hutchinson suffered is unimaginable today. It is (one hopes at least) hard to imagine a sitting governor prodding an associate in a neighboring state for details of a political opponent’s miscarriage, then publicizing the results for propaganda purposes. And yet it’s hard to shake the sense that we have not entirely escaped a culture where what really matters about women is the matter that comes out of their vaginas, rather than the words that come out of their mouths.

Further reading:

I had the opportunity to present a version of this article at the History of Women’s Health Conference at Pennsylvania Hospital, Philadelphia, in 2009. I am grateful to conference organizer Stacey Peeples and to the conference attendees for their questions.

This article is part of my ongoing interest in the history of the historiography of Anne Hutchinson’s life, and part of a book project still in its early stages titled Antinomian Idol: Anne Hutchinson and American History. I lay out a statement of my approach in “The Antinomian Controversy Did Not Take Place,” Early American Studies 6.2 (2008). My interest in Hutchinson is in the persistent and enduring interest her story has held for generations of writers, from John Winthrop to the present. Her story is compelling, but relatively light on detail, and provides a narrative that is malleable enough to be reworked in any number of forms–she is variously figured as a proto-Quaker, a proto-Transcendentalist, and a proto-feminist, to name only a few. Engaging with the mutability of Hutchinson’s story, I will develop a literary analysis of this body of historiography, with the broader goal of offering some insights about how we write about the past. As such, this forthcoming book will be the full-length version of the bibliographical essay accompanyingCommon-Place articles, but in the meantime, here are a few salient texts:

We can start with David Hall’s The Antinomian Controversy, 1636—1638: A Documentary History, 2nd ed. (Durham, N.C., 1990). David Hall has done more for Hutchinson scholarship than anyone since John Winthrop. I strongly suspect that his effort to put many of the salient documents of the Antinomian Controversy in such accessible form has shaped the field of early American studies by making work on this topic easier to pursue than others–it is hard to find a monograph on early New England published since Hall’s collection that does not include an Antinomian Controversy chapter. I am debating whether it is overstating the case to call this the “Hall Effect.”

Eve LaPlante’s American Jezebel: The Uncommon Life of Anne Hutchinson, the Woman Who Defied the Puritans (New York, 2004) is written for a general audience. It suffers a bit from the kind of ancestor worship that characterized an older generation of New England historiography, but is a decent introduction to Hutchinson’s story.

Readers specifically interested in the obstetrical dimensions of the story should consult Anne Jacobson Schutte’s “‘Such Monstrous Births’: A Neglected Aspect of the Antinomian Controversy” Renaissance Quarterly, 38.1 (Spring, 1985): 85-106. It does an excellent job of putting Hutchinson’s alleged experience in the broader cultural context of early modern scientific thought.

Readers interested in the theological dimensions of the controversy will profit from Michael P. Winship’s Making Heretics: Militant Protestantism and Free Grace in Massachusetts, 1636-1641 (Princeton, 2002), a serious effort to engage with the controversy on its own terms. A companion text is Winship’s The Times and Trials of Anne Hutchinson: Puritans Divided (Lawrence, Kansas, 2005), which considers the legal case against Anne Hutchinson.

This article originally appeared in issue 11.2 (January, 2011).

Jonathan Beecher Field is an associate professor of English at Clemson University. In 2009, he published Errands into the Metropolis: New England Dissidents in Revolutionary London; this article is part of a new project titled Antinomian Idol.

“STAY CLEAR AT ALL COSTS” reads a caption on the live ebola map online, where one can see the distribution of the disease since it reemerged in 2014. It’s a global map with icons that resembled a horned monster with flailing arms (the shape is three arcs making a barbed circle) marking confirmed cases (which bear the caption above), “monitored cases,” and even “suspected cases” (fig. 1). The fact that even suspected cases are recorded attests to the importance of rumor and fear in the discourse—visual and otherwise—of the disease.

A map of the 2016 outbreak of the Zika virus uses dark red splotches to represent sites of reported cases, making the map look as if it is bleeding (fig. 2). Although present in some degree all over the map, the red marks are concentrated around North and South America, giving the impression that those regions have been critically wounded. Also amplifying the impact of the jarring red pools is the fact that the map has no boundaries. Rather than being contained by a border, the world and red-soaked regions repeat across the screen, giving the impression that the globe is saturated with it.

Disease maps have become a staple figure in the visual rhetoric of a disease outbreak, as are the images of masked doctors in white hazmat suits and patients sending haunting looks through the camera lens. As part of that discourse, disease maps, far from objective graphics, can articulate affect, as we can see from the earliest global maps of an outbreak: cholera maps from 1832.

Readers might be most familiar with regional disease maps of yellow fever in Philadelphia in 1793 or John Snow’s “Ghost Map” of the 1856 that traced the spread of cholera in a London neighborhood to a specific water pump. But the cholera maps of 1832 are the first to trace the global spread of disease. These maps were included in the front covers of three book-length studies on cholera produced during the pandemic: Henri Scoutteten’s Medical and Topographical History, the Massachusetts Medical Society’s (MMS) Report on Spasmodic Cholera, and Amariah Brigham’s Treatise on Asiatic Cholera (figs. 3-4). The titles of these volumes identify the works as “reports,” “treatises,” “medical and topographical histories,” promising sobering facts about the disease. Nonetheless, these written texts reflect a cultural interpretation of the disease as a “demon malady,” something menacing, supernatural, even apocryphal.

Throughout the world from 1831-1832, cholera travelled from one territory to another rapidly, defying quarantine efforts. Its movement within a body was equally swift and terrifying, reportedly killing someone in the evening who had been well in the morning. A before and after drawing of a young Venetian woman struck with cholera illustrated the effects of dehydration that gave her a cadaverous aspect, gaunt features and a bluish coloration, typical of the disease. Her clothing changed from a dress to a chemise or nightgown, but her hairstyle, albeit mussed, was the same, indicating that this transformation occurred on the same day (fig. 5).

Cholera’s dramatic impact, the lack of experience with or understanding of the disease, and the ever-growing panic inspired doctors to study the disease and publish reports for medical and popular audiences. For example, the Boston Medical and Surgical Journal published the following statement:

It will not be the fault of the present race of physicians if posterity should obtain an inadequate idea of the history of the existing epidemic … The medical pen has been, for the last two years, teeming with productions on this subject; and we still go on, with unabated vigor and industry, adding to the number … At present, the mania for publication seems distinctly transmitted to this country, and we already rival our transatlantic friends in fertility on this topic.

As we can see, even medical language was “infected” with cholera mania, and many ostensibly objective resources like medical treatises and maps reflected and contributed to the growing fears associated with cholera.

Cholera maps have been examined by scholars as examples of nineteenth-century maps or disease history maps (i.e., Susan Schulten and Tom Koch), but they have not been studied as companions to the treatises they accompanied wherein fears about the disease were manifested in print. Using the texts as guides to read the maps can show how the fears conveyed in the text became visual and spatial on what we might expect to be an objective tool and unmediated artifact of the pandemic.

The visual impact of the maps and the production of that impact was designed to reflect the terror associated with the disease. The fact that readers of the maps had to physically unfold them also invokes the readers’ bodies and connects them with trails of sickness in the red lines (figs. 6-8). The maps opened to reveal a linear or webbed pattern of disease circulation (I don’t use the word “contagion” here because whether the disease was contagious or not was in dispute, and none of the maps used the word). In each, a printed dotted line marked the spreading disease. This line was then covered by hand with a red line. The color of blood, danger, and alarm, the red lines were not a neutral feature. They attest to the fear of the disease along the trail of sick bodies that cholera left in its wake (figs. 9 and 10).

Doctors agreed that fear was one of the predisposing conditions of cholera. In other words, one could catch cholera if one was afraid of it. Doctors believed that fear could provoke a physical reaction in a body (sometimes called “embarrassment to the heart”) that would weaken the system, making one more vulnerable to the disease. What’s worse, the physical manifestations of fear resembled the initial symptoms of cholera (fever, cramping, irregular pulse, and diarrhea), making it difficult to discern whether someone was infected with the cholera bacteria or terror. Dr. Amariah Brigham, in his text that included a map, wrote, “Almost every person who has written upon the causes that produce the cholera, mentions the fear of the disease, as among the most frequent and powerful.”

When we look at the different examples of cholera maps that were folded into book-length treatises on the disease, we have to consider the information they offer, but also their embodied affect—their role in furthering fears about the dreaded disease and, therefore, endangering the bodies of readers.

What No Eye Could Ever See

The symbols marking or lines tracing a disease on a disease map may suggest a more uniform or totalizing outbreak than people living in diseased regions experience, which shows that the primary objective is to convey a dramatic representation of its spread. To scare. As a tool, disease maps lack nuance; there is often no indication of the degree of impact, the race, class or gender of the sick, or anomalous cases. As Tom Koch argues, a disease map does not reflect the number of people who got sick, who recovered, what their circumstances were. What they do reflect is simply that people were diagnosed in a given location.

When we read the cholera maps in treatises by Scoutteten, the MMS, and Brigham, we see the movement of disease indicated in red lines, but as Koch says, we have to consider how we’re seeing disease and how the map-makers saw disease and its symptoms; in the case of cholera, that had everything to do with fear. The curve of the red lines through a region indicated the occurrence of cholera and/or cholera-like symptoms: fever, stomach pains, pulse fluctuations, and diarrhea. The distinction between actual cholera symptoms and fear-of-cholera symptoms was illegible. Brigham wrote: “Facts innumerable might be adduced to show that fear does produce the same symptoms that are now called premonitory symptoms of cholera.”

Therefore, in tracing symptoms consistent with both cholera and the fear of cholera, the red marks roping around the world in the cholera maps showed both bodies that were infected with cholera and bodies that were infected with fear. And given the attention to fear as a companion to cholera in the popular and medical press, doctors and nonmedical viewers would recognize the fear in those red lines and were likely to respond with fear themselves, perhaps even experiencing those cholera-like symptoms.

The authors of the texts that included these maps likewise drew terror on the pages of their treatises. Dr. Scoutteten offered the following as an opening to his Medical and Topographical History: “Amid the afflicting events which pour upon and threaten us, a plague formidable from its ravages, and progress, has attacked the north of Europe. Both princes and people are terrified, and the instinct of self-preservation, which governs all other interests, has diverted our attention from political debates, and fixed it upon the prospects of our material existence.” The Report on Spasmodic Cholera from the Massachusetts Medical Society claimed that “The disease is evidently one which does not lurk in the constitution. Its cause, like the venom of a viper, or a narcotic poison, produced immediate effects.” And Dr. Brigham wrote, “this country, which has until the present year escaped the ravages of a general pestilence, is at present overshadowed by the angel of death.” Overwhelming terror, viper venom, and the angel of death—these characterizations show an investment in documenting but also in recreating affect in words as the maps did in images.

Because these authors were not alone in their hyperbolic, terror-inducing characterization of cholera, medical and nonmedical readers of the maps and their red lines would have brought to their map-reading previous encounters with countless references to cholera as a body-ravaging entity, even a supernatural beast. Even in medical texts, cholera was referred to as an “avenging angel,” a “destroyer,” “death’s wing,” “foul demon’s breath,” “the demon from the East,” “the Eastern Sphinx.”

As a supernatural beast, the disease could outmaneuver even the most skilled and knowledgeable doctors, making it virtually unbeatable. As one article in the Cholera Gazette, a medical journal, noted: “The history of cholera in this city [Boston] seems to be destined to add to the number of wonders in regard to this strange malady, and to increase the difficulty of coming to any conclusion as to the laws of its appearance and progress. It is, in very truth, a most strange phenomenon—an invisible comet—a potent, relentless, and capricious enemy, striking blows in the dark, and mocking at our efforts to evade its force, or deprecate its fury.” Another doctor-author imagined a scene where “the destroying angel stood in the midst of us, with his arrow fixed and bow drawn, ready to let fly the deadly weapon, whilst half mankind lay crouching in terror at his feet.” Readers would have recognized the flight of that deadly weapon in the path marked in red on the cholera maps, unimpeded by medical intervention.

Scoutteten’s text referenced the red lines on the accompanying map in the treatise itself; this reference showed intention behind this particular detail and its relationship to the hyperbolic, sensational prose that infused the writing on cholera (the map also had printed words referring to the red lines [fig. 11]). Scoutteten wrote:

[W]e are not disposed to imitate those who close their eyes to avoid the danger: no! we yield only to conviction, and we express ourselves confidently, for it is to fulfill a duty and to oppose the progress of fear … In order to trace the Cholera, and to form an idea of it collectively, we have constructed a chart of the places where it has occurred. Its course and different directions are marked by a red line.

A few pages later, he wrote: “The vast extent of territory over which it has passed, and its rapid and fatal progress have terrified every one; we now tremblingly trace its course on the map, as we would that of a devastating army.”

Scoutteten’s use of the words “tremblingly trace” clearly reflected fear and its physical manifestation: a hand made unstable and wobbly by the path of danger it plotted in red ink on the black and white map—the effort of which could be read in the imperfections of a hand-drawn line with what was probably fountain pen ink (fig. 12). By invoking the physical effort of the person tracing the line, albeit strained by fear, Scoutteten’s text also underscored the value of using a hand-drawn line that could show affect as opposed to a printed line. In fact, the printed maps did include a thin black dashed line that provided a guide for the manually added red line. Because this was neither a solid nor bold black line, the red mark traced over it easily covered it. And without a solid printed line, the person drawing the red line might draw a less precise and all the more human, all the more trembling, red line.

Tremblingly Traced

The three cholera maps discussed here were produced at different stages of the pandemic and, therefore, document different extents of cholera’s progression as the red lines extended into additional regions on each—the fear growing as the lines reached across Europe and eventually the Atlantic.

Even though the disease existed before 1832, it did not appear on any world maps because it did not have a consistent reach beyond India and was not a cause for alarm among Westerners. A map bearing red marks indicating cholera infections would have been saturated with red, as if stabbed, around India, with some possible spatter-like red spots in Europe. Until 1817, the primary sufferers of this bacterial infection were East Indians who lived near or travelled through the Ganges River delta (it was a common result among Hindu pilgrims who travelled to the river). But due to British military and commercial routes in India, the disease travelled westward, and doctors began to take notice of it. From 1817 until 1822, it circulated irregularly in Europe. As Scoutteten wrote, “During the winter from 1830 to 1831, the cholera rested.” It may have been resting—a creature recuperating strength, but it woke up in 1831 and reached a pandemic level in 1832.

As cholera’s spread gained momentum and reach, theories arose to explain why and how it moved. For Americans who read about the progress of cholera in Europe for months before it reached the United States, these theories offered comfort. Assuming it traveled in the air, some argued that cholera wouldn’t be able to cross the Atlantic from Europe to North America, and other claims listed predisposing conditions that Americans believed were not present in the U.S., although prominent in Europe. For instance, a committee from the Massachusetts Medical Society who wrote Report on Spasmodic Cholera, which included a map, claimed the “chance that the spasmodic cholera will extend to us may be small” because American dwellings and diets were imagined to be more salubrious.

All of the three cholera maps discussed here were printed in the United States, but only the map in Brigham’s text showed North America; the absence and eventual insertion of North America on the maps reflect the hope and eventual loss of hope that the continent—the U.S. in particular—would be spared. The Scoutteten and MMS map represented a quasi-global view prominently featuring Africa, unmarred by red lines across its interior (figs. 4 and 13). Neither North nor South America is represented on this map. It features an overprint map of the British Isles, where it had reached by the time the volumes were printed. Only one, Amariah Brigham’s, showed cholera’s arrival in North America with what looks like an overprint divided by a thick line (fig. 3). So between these maps and in those red lines, we see the unraveling hope of American exceptionalism in the face of cholera.

Foul Demon’s Breath

The cholera maps, their accompanying texts, and other medical and popular writing about the disease were ostensibly created to help stop the spreading fear and warn readers against allowing themselves to become afraid. As a predisposing condition to cholera, fear could bring on the disease itself. Nonetheless, the use of hyperbolic, mythical or superstitious imagery and language employed to discuss cholera in the medical publications promoted fear by constantly reminding the readers of texts and maps that those red lines could be trembling toward them. In other words, given the understandings of the interconnectedness of cholera and fear at this time, readers ran the risk of getting ill because of these maps and their companion texts.

Running through the red striations on the cholera maps of 1832 are reports of symptoms, transformed bodies, failed interventions, hyperbolic, sensational characterizations, lost hopes of escape, fear, and its physical effects that twinned cholera’s.

As tools tracing a pandemic, these maps are artifacts of both warning and threat. For readers who believed that fear could both cause and mimic cholera itself, the anxiety these maps raised could prove deadly. Therefore, the red line—a human detail that stood out sharply against the black and white of mechanized print—warned readers (as red does) but only after they had already been caught in the winding tendrils that traced the disease.

Further Reading

Charles Rosenberg was the first to rediscover the cultural and social impact of cholera in the nineteenth century. His timeless work, The Cholera Years: The United States in 1832, 1849, and 1866 (Chicago, 1987), addresses the municipal response (or lack thereof) to the disease in New York City during three peak epidemics. Rosenberg also edited a modern reproduction of the Cholera Bulletin, a periodical composed by doctors for the general public with information about the disease and stories (often sensational) about doctors’ encounters with it. A more recent historiography of cholera and its defiance of medicine can be found in Owen Whooley, Knowledge in the Time of Cholera: The Struggle Over American Medicine in the Nineteenth Century (Chicago, 2013).

To learn more about disease maps, see Tom Koch, Disease Maps: Epidemics on the Ground (Chicago, 2011), or Susan Schulten, Mapping the Nation: History and Cartography in Nineteenth-Century America (Chicago, 2012), especially chapter 3. Other excellent resources on maps and their cultural significance include Martin Bruckner, The Geographic Revolution in Early America: Maps, Literacy, and National Identity (Chapel Hill, N.C., 2006), and Christian Jacob, The Sovereign Map: Theoretical Approaches in Cartography Throughout History (Chicago, 2006).

For more a contemporary overview of cholera’s physiological effects and the process of infection, see Ethne Barnes, Diseases and Human Evolution (Albuquerque, N.M., 2005), especially 282-283.

This article originally appeared in issue 17.1 (Fall, 2016).

Sarah Schuetze is an assistant professor of English and Humanistic Studies at the University of Wisconsin-Green Bay. Her current book project on narratives about disease in early America (including cholera) is tentatively called Calamity Howl.

Marine hospitals in the early republic

In the introduction to the Scarlet Letter, Nathaniel Hawthorne offers a snapshot of the old Salem customhouse. “Here, before his own wife has greeted him,” writes Hawthorne, was the “sea-flushed ship-master, just in port, with his vessel’s papers under his arm in a tarnished box.” Nearby, too, was the anxious merchant, about to learn the fate of “his scheme.” Fresh from the countinghouse, “the smart young clerk, who gets a taste of traffic as a wolf-cub does of blood,” hovered about. “Cluster all these individuals together,” concludes Hawthorne, and “it made the Custom-House a stirring scene.”

Also nearby was the merchant mariner—a crucial laborer in an early American economy that was deeply dependent on foreign commerce. Sailors helped carry American produce to European, Caribbean, and Asian markets. They also brought foreign goods back home to the United States. But seafaring was extremely dangerous work. Storms and plagues frequently struck Atlantic waterways. Falling crates and crashing barrels caused great harm to life and limb. Indeed as Hawthorne observed, these working conditions often left returning sailors “pale and feeble.”

In Salem, and elsewhere in the young United States, merchant mariners thus appeared at the customhouse in search of “a passport to the hospital.” In 1799 the federal government established these hospitals, or marine hospitals, in most ports throughout the country to care for sick and disabled merchant mariners. The government financed the hospitals by a tax on sailors’ monthly wages. As ships returned to port, customs officials collected the marine hospital tax and forwarded it to the federal Treasury Department in Washington, D.C. The Treasury then distributed these funds to customs officials to hire doctors and nurses to care for merchant mariners. In larger ports, such as Boston, Philadelphia, Baltimore, Charleston, and New Orleans, the federal government operated its own hospitals. Throughout the nineteenth century the marine hospitals grew westward with the nation. By 1900 the hospitals had treated hundreds of thousands of merchant mariners.

That the federal government created this health care system for merchant mariners in the early American republic will surprise many. This is due in no small measure to the tenor of political debate about health care in American society. Advocates of government structured, universal health care plans claim that the times are too fast and costs too high to return to the old days of “pay-as-you-go” care. Deregulationists counter that only by removing the stamp of government from health care can society relive the great success of decades and centuries past. Both sides presuppose that government regulation and provision of health care is a new development. But the story of the marine hospitals in the early American republic suggests that the United States has a long history of using institutions to manage public health. Through the marine hospitals, the federal government used health care to regulate a crucial labor force in an age of maritime commerce. Treating sick and disabled merchant mariners helped stabilize the maritime labor force. More broadly, through the marine hospitals, we witness the actual points of interaction between government, community, and individuals. A glimpse within hospital walls reveals the rich, diverse personal experiences of working in, or being treated in, an early federal marine hospital. To be sure the marine hospitals were effective instruments of politics and policy. But within the marine hospitals, medical practice and administration was far more than an abstract tool of political economy. Rather, the stories of sickness, injury, admission, treatment, resistance, and regulation that characterized life within the marine hospitals reveal how the federal government shaped the social, economic, and political order of the early republic to a degree scholars have only just now begun to appreciate.

The Rise of the Marine Hospitals

The United States’ approach to health care for maritime laborers built upon British and colonial antecedents. Since Elizabethan times, Great Britain supported hospitals—the “Chatham Chest” and Greenwich Hospital—by taxing naval and merchant mariners’ monthly wages. In 1710, Virginia imposed a small tax on tobacco exports to England to fund a hospital for mariners at Hampton, Virginia. Nineteen years later Parliament ordered Pennsylvania to tax seamen’s wages for a marine hospital in Philadelphia. In 1749 Charleston, South Carolina, ordered churchwardens to create a hospital for sick and disabled sailors. Finally, voluntary “marine associations” in Boston (1742) and New York (1769) also cared for ailing sailors.

Why did Anglo-American society lavish such attention on health care for the merchant marine? First, mercantilist economic theory emphasized the importance of a healthy maritime labor force. In mercantilism, economic dominion was the extension of war by commercial means. Countries vied with one another for control of the most markets, over the broadest expanse of land. Mariners were the foot soldiers in this race for global power. But governments also regulated maritime health for moral reasons. In Anglo-American society, mariners were partially free and partially unfree laborers. It was believed that the mariner had volition enough to choose his course and negotiate for wages. But it was also believed that the mariner lacked sufficient sense to care for his own wellbeing. From this sentiment arose the infamous stereotype of “Jack Tar” as a coarse, hard-drinking character who purposefully exposed his own body to great harm. If Jack Tar failed to care for himself and if commerce and society so depended on Jack Tar, was it not society’s responsibility—and was it not in society’s best interest—to preserve and protect the mariner for his own good and for the public good? As Maine Senator F. O. J. Smith put it in 1838, “both the Government and the merchant” had “almost the same abiding interest with the sailor himself, in a matter upon which so much depends for a requisite supply of healthy and able-bodied seamen.”

This concern for the health of merchant mariners loomed large in postcolonial America. During the American Revolution, some dreamed of a self-sufficient economy that would not rely upon distant and often politically problematic European markets. But during the 1790s such utopianism gave way to a hard, and ultimately lucrative, reality: the United States economy remained tethered to European markets and long-distance maritime trade. Great profits awaited American merchants who did business in England, France, and the colonial ports of the West Indies. Now again society realized the great significance of the merchant marine. Commentators of every political stripe—editors such as John Fenno, political economists such as Pelatiah Webster, and physicians such as Benjamin Rush and Samuel Latham Mitchill—found common ground in their advocacy of a system of marine hospitals. Importantly, the United States Constitution mandated a uniform, national system. Dr. Mitchill, soon to be elected to Congress, made this clear in a 1799 petition to Congress. Since “the regulation of commerce belong[s] exclusively to the National Legislature,” only Congress and the federal government could handle the problem of maritime labor that had once fallen to the individual colonies.

In 1798, Congress thus enacted a law “for the relief of sick and disabled seamen.” The bill taxed mariners’ wages—at the rate of twenty cents per month—to finance health care for ailing sailors in ports throughout the country. The gentlemen attorneys and merchants who wrote this legislation did not trust mariners to personally pay hospital taxes. Rather ship captains garnished the wages and paid them directly to federal customs officials. In this sense the marine hospital tax was a progenitor of the payroll tax. But this method of taxation also conveniently fit the maritime master-servant relationship in the early republic. As maritime historian Marcus Rediker illustrates, the merchant vessel was a highly disciplined space in which sea captains exerted immense authority over the mariner’s body and labor. Captains and merchants also enjoyed advantages in the bargaining of labor contracts, which were typically informal and unwritten. These power relations even influenced the disbursement of wages. To prevent desertion, full payment came only at the conclusion of a voyage. The marine hospital tax now functioned on the same principle and power structure. The merchants and sea captains, who controlled the mariners’ labor and wages, now ensured that mariners would pay the taxes necessary to maintain a healthy and productive labor force.

The federal customhouses efficiently collected the marine hospital tax. Rough estimates suggest that from 1800 to 1812, mariners’ wages fluctuated from fifteen to twenty dollars per month. Marine hospital taxes constituted a withholding of between 1 and 1.33 percent per month. In these years, tax collection peaked in 1809 at $74,192, the majority of which came from New York, Boston, Philadelphia, Baltimore, and Charleston—a trend that would continue throughout most of the century. On the strength of the marine hospital tax, the federal government established a network of hospitals and other health care facilities for the merchant marine.

As a matter of policy, the marine hospitals treated several thousand mariners per year, and in so doing, helped to maintain a stable supply of healthy maritime workers. This was a goal that Alexander Hamilton had articulated in Federalist no. 11. “When time shall have more nearly assimilated the principles of navigation,” wrote Hamilton, “a nursery of seamen…will become a universal resource.” This “nursery of seamen” indeed powered the United States economic expansion. Moreover, over time, the marine hospitals’ function as a medical safety net for mariners was understood to serve as an incentive, as Senator F. O. J. Smith opined in 1838, “to induce a certain portion of its citizens” to become seamen despite “risks of health, and of life itself, far beyond what are incident to any other class of pursuits.”

One measure of the importance of the marine hospitals to the American economy was the great demand for new hospitals in emerging markets. In 1802 Natchez, Mississippi, a growing entrepôt that connected the plantation trades with the Northwest and Gulf Coast, petitioned Congress for a marine hospital to care for sailors who “fall victims to climate and disease.” Two years later the Mississippi Territorial Legislature reiterated that since “the whole commerce of the Western Country is brought to that place,” the “aid of the general government” was required to construct a hospital at Natchez. In 1807 Thomas Jefferson’s son-in-law took up the lobbying effort. Only a marine hospital could preserve the “many lives of valuable laboring citizens.” In New Orleans the federal government created a marine hospital before the United States officially assumed control of the Louisiana Purchase. President Thomas Jefferson raised the issue during his annual message to Congress in February 1802. Two months later, Congress directed customs officials in nearby Fort Adams to tax mariners’ wages to support the lease of ward space from the Crescent City’s municipal Charity Hospital. Supervising the hospital would be Benjamin Franklin’s grandson, Dr. William Bache. In 1803 the New Orleans Marine Hospital treated over four hundred American sailors. Although fire destroyed the Charity Hospital in 1808, marine hospital patients and others continued to receive treatment in City Hall until the construction of a new facility in 1815.

Life Inside the Hospital Walls

On April 4, 1808, a twenty-five-year-old merchant mariner arrived in the port of Baltimore after a long voyage from the Netherlands. The Baltimore Medical and Physical Recorder referred to this sailor only as “LD,” to preserve his anonymity, but believed that the sailor suffered from some sort of fever. His temperature had fluctuated over the course of a long and arduous voyage. His abdomen “was swelled to twice its natural size, and the thighs and legs also considerably enlarged.” Across his entire body appeared “a yellow bilious aspect.” Five days later “BH” appeared, origins unknown, sporting “large swelling” throughout his body and “numerous small ulcers scattered over his whole body.” His was clearly a case of syphilis. BH himself had admitted “the infection had been received…about twelve months before, during all which time he had been at sea.” Both patients would receive treatment at the Baltimore Marine Hospital.

For mariners such as LD and BH, the path to a hospital bed began at the customhouse. As these sailors disembarked from their vessels, they faced examination by customs officials to determine eligibility for the marine hospital. Customs officials first decided whether or not the petitioner was truly a member of the merchant marine. Generally, as was policy at the Boston customhouse, the collector required “a certificate from the captain they sailed with or the owner” attesting to the sailor’s service. These were by no means formal documents. Most often these “certificates” were scraps of paper adorned with hasty scrawl. Next the collector ensured that the mariner had contributed his fair share of hospital taxes. Each customhouse maintained a large ledger with these hospital tax records. Sick or disabled mariners who passed both of these tests received a chit recommending entry into the marine hospital. These informal certificates bore the signature of the highest-ranking customs official at the port.

With a customhouse certificate in hand, the mariner now made his way to the marine hospital. In smaller ports, there was no “hospital” to speak of, as the customs collector contracted local physicians to care for mariners who were boarded in a single room in a private residence. In such a case the resident of the house took informal care of the mariner, while the physician stopped in periodically—usually daily—to monitor the patient’s progress. In Providence, for example, a local physician, Dr. Levi Wheaton, paid small amounts to local residents, including women, to house sick sailors. Repeat appearances in the marine hospital records suggest that many of these women may have depended upon the marine hospital payments—which occasionally exceeded $120 per quarter—for their income.

More is known about the larger facilities, especially the first marine hospital in Boston. From the customhouse at the end of the city wharf in Boston harbor (presently home to the New England Aquarium), the mariner made his way across the Charles River Bridge to Charlestown, where a two-story structure, one hundred feet long by forty feet wide, awaited. At the door the mariner would hand over his customhouse pass to the hospital steward, who monitored the patients around the clock. Now the mariner entered the marine hospital.

Medical treatment within these federal institutions was archaic by modern standards. “Nitrate of potash,” or potassium nitrate, was frequently fed to patients as a healing tonic. Sulfur, nitric acid, and ammonia were also used unsparingly. Mercury was a common treatment for rashes and bruises associated with venereal diseases. Through a process known as “salivation by Mercury,” physicians rubbed mercury into mariners’ mouths. This practice eventually fell into disuse, according to a Baltimore physician, because it caused “offensive symptoms,” including excessive saliva production, “soreness” of mouths, the loosening of teeth. But the marine hospitals did provide succor to some patients. Delirium tremens, a syndrome of uncontrollable convulsion and mental delusion caused by alcoholism, was swiftly treated through the liberal “use of sulphuric ether,” testified Boston Marine Hospital physician Charles Stedman in 1851. Marine hospitals also doled out laudanum, an opium derivative, to manage pain.

The marine hospitals proved useful to the rising medical profession in the early republic. Many medical schools permitted medical students to witness procedures, or intern, at the marine hospitals. The marine hospitals also served as venues for medical events. Pioneer physician Daniel Drake, for instance, inaugurated an important lecture series at the “New Clinical Amphitheatre of the Louisville marine hospital” in 1840. The marine hospitals even had the occasional innovation. In 1844, Dr. John Gorrie invented artificial refrigeration and a form of air conditioning as a treatment for malaria and other “fevers” in the Apalachicola Marine Hospital. Gorrie quickly recognized the potential of his discovery. “We know of no want of mankind more urgent than the cheap means of producing an abundance of artificial cold,” reported Gorrie in the Apalachicola Commercial Advertiser.

But there was more to life within these hospitals than the practice of medicine. Inside the marine hospitals, the interaction between government administration, local regulation, and individual volition influenced the functionality of these federal institutions. In the hospitals sailors found an atmosphere that contrasted sharply with their difficult life at sea. Rooms were small and quarters were cramped, to be sure. But an 1866 inventory of the Galena Marine Hospital suggests that mariners enjoyed straw beds adorned with hair pillows, cotton sheets, and wool blankets. The marine hospitals also had full service kitchens, although in New York, the quality of food was a frequent cause of complaint. “We will soon all be rotton [sic],” wrote nurse James Duffe, “for our butter is rotton and stinks worse than a skunk.” The food was not the only malodorous stench in the air. “The only constant condition accompanying the residence of a patient under this roof,” lamented Boston Marine Hospital physician Charles Stedman, “is that of being enveloped in the fumes of tobacco.” “From the smoke of tobacco, certainly, the house is never free,” concluded Stedman.

Smoking was hardly the only point of contention between hospital staff and patients. Conflict was a daily reality within the marine hospitals, as staff enforced rules that aimed to hasten convalescence but that curtailed the mariners’ customary behavior. Class may have had something to do with this. Marine hospital physicians lived in a different world from the merchant marine. For instance, Dr. Benjamin Waterhouse, a Boston Marine Hospital physician, was born into a middling Quaker family in Rhode Island. Yet he learned medicine in Edinburgh and Leiden. He was a roommate of John Adams and a correspondent of Thomas Jefferson. When Waterhouse returned to the United States in 1783 he received an appointment as Professor of the Theory and Practice of Physic at Harvard University.

Benjamin Waterhouse’s marine hospital was a disciplined environment. At the crack of dawn the hospital staff supervised and helped sailors bathe and clean their rooms. Patients were shaved twice a week. Apparel was changed every Sunday. Waterhouse also promised expulsion for mariners committing certain forbidden behaviors: spitting, writing on walls, thieving, absconding to the city, playing cards “or any other game of hazard,” and engaging in “all games of amusement.” In short, the rule of the marine hospital was “strict obedience.” For Waterhouse, it was vital that the mariner, quite literally, change his act when inside the hospital.

To be sure, sailors were accustomed to disciplined spaces. On board the merchant vessel, as discussed above, sea captains enjoyed great power over mariners. But sailors understood the marine hospital, not as an extension of the workplace, but as a place of rest and, in some cases, an opportunity for leisure. Staff, such as steward Adams Bailey of the Boston Marine Hospital, often charged that healthy patients feigned continued distress to prolong their stay in the marine hospital. “Imposters,” he claimed in 1812, purposefully scarred their limbs to avoid discharge. Eventually customs and treasury officials restricted the length of hospital stays. In 1821 Secretary of the Treasury William Crawford banned the marine hospitals from admitting “incurable” and “insane” seamen. That same year Boston collector of customs Henry A. S. Dearborn emphasized that the hospitals existed only to provide “temporary relief” before mariners rejoined the workforce.

Such measures were only partly successful. Many patients, observed Benjamin Waterhouse, “make a practice of passing a great part of the night in Boston” and stumble back to the hospital grounds under the influence. Similarly, in keeping with mariners’ rough reputations, in the New York Marine Hospital, “slick and quick” theft was a daily reality. “Last night,” observed nurse James Duffe, “there was a pretty haul made of clothing and other articles out of Marine House.” The next day, Duffe recalled, with “3 constables here,” “2 men [were] discharged on suspition [sic] of stealing.”

Institutions in Early Republican Society

The marine hospitals grew rapidly in the early republic. A system that included twenty-six facilities in 1818 expanded to include ninety-five by 1858. Much of this expansion owed to the efforts of Dr. Daniel Drake, perhaps the United States’ most famous physician of the antebellum era. Drake, echoing Alexander Hamilton in the Federalist, believed that “the commerce of the West,” must serve as “a nursery of seamen” for the nation. The seemingly transcendent American desire for equal regional distribution of pork and patronage was also important. The “old Atlantic States” already had federal marine hospitals, so why did the newest states deserve any less? According to Drake, “justice requires that the advantages they would afford should be reciprocally enjoyed.” By 1860, new marine hospitals were to be found in western ports, such as Napoleon, Ark., Evansville, Ind., and San Francisco; on the hubs of the Great Lakes, such as Cleveland, Chicago, and Galena, Ill.; and even in some aging eastern ports, such as Burlington, Vt., Portland, Me., and Ocracoke, N.C. Annual hospital admissions, which ranged in the low hundreds throughout the first decade of the nineteenth century, consistently exceeded ten thousand during the 1850s.

The marine hospitals’ rapid westward expansion illustrates the durability and significance of this federal institution in a changing economy and polity. By the Jacksonian era, the center of the American economy had shifted away from foreign commerce, into domestic agriculture and manufacturing. Merchant sailors aboard river steamboats, rather than Atlantic schooners, were crucial links in this new American economy. But these laborers remained mariners nonetheless. Thus cities such as Paducah, Kentucky, demanded only a “NATIONAL HOSPITAL, with national funds, and administered by national functionaries.”

But the story of the marine hospitals in the early republic also suggests the broader significance of government and institutions in early republican society. Central government institutions touched the lives of many individuals and communities throughout the country. Long before the Interstate Commerce Commission, the New Deal, or the military industrial complex, federal institutions such as the marine hospitals provided tangible and necessary services to a vital sector of the American polity. The marine hospitals, with the military, customs service, postal service, patent office, lighthouse service, land office, military pension system, and other institutions, formed the heart of an active, vibrant, and increasingly visible early American state.

Further Reading:

On the use of a mythical stateless nineteenth century in contemporary public health debates, see William J. Novak, “Private Wealth and Public Health: A Critique of Richard Epstein’s Defense of the ‘Old’ Public Health,” Perspectives in Biology and Medicine 46 (Summer 2003, supplement): S176-S198.

Previous histories of the marine hospitals are: John Odin Jensen, “Bulwarks Against a Human Tide: Governments, Mariners, and the Rise of General Marine Hospitals on the Midwestern Maritime Frontier, 1800-1900” (Ph.D. diss., Carnegie-Mellon University, 2000); Ralph C. Williams, The United States Public Health Service, 1798-1950 (Washington, D.C., 1951); Richard H. Thurm, For the Relief of the Sick and Disabled: The U.S. Public Health Service at Boston, 1799-1969 (Washington, D.C., 1972); William E. Rooney, “Thomas Jefferson and the New Orleans Marine Hospital,” Journal of Southern History 22:2 (May 1956): 167-182.

Useful studies of the culture and political economy of maritime labor are: Daniel Vickers with Vince Walsh, Young Men and the Sea: Yankee Seafarers in the Age of Sail (New Haven, Conn., 2005); Paul A. Gilje, Liberty on the Waterfront: American Maritime Culture in the Age of Revolution (Philadelphia, 2004); Jesse Lemisch, “Jack Tar in the Streets: Merchant Seamen in the Politics of Revolutionary America,” The William and Mary Quarterly, 3d ser. 25:3 (July 1968): 371-407; Harold D. Langley, Social Reform in the United States Navy, 1798-1862 (Urbana, Ill., 1967).

On the history of American medicine, see John Duffy, The Healers: A History of American Medicine (Urbana, Ill., 1979); Richard H. Shryock, Medicine and Society in America, 1760-1860 (New York, 1960). Early medical journals and treatises are the best guide to the standard treatments administered in the marine hospitals. A good list of these is provided by Stephen D. Williams, “Notice of Some of the Medical Improvements and Discoveries of the Last Half Century, and More Particularly in the United States of America,” in the New York Journal of Medicine 8:2 (March 1852): 157-184.

For biographies of marine hospital officials, see George A. Zabriskie, John Gorrie, Inventor of Artificial Refrigeration (Ormond Beach, Fla., 1950); Philip Cash, Dr. Benjamin Waterhouse: A Life in Medicine and Public Service, 1754-1846 (Sagamore Beach, Mass., 2006).

The unpublished diary of James Duffe is housed at the New York Historical Society, BV Duffe James 1848. The Galena manuscript inventory is located in the National Archives, Great Lake Region, Entry 1729B, RG36, Chicago, Illinois, Collection District.

Microfilmed correspondence about the marine hospitals between local customs officials and the Treasury Department is located in the National Archives, College Park (Archives II), M174 and M175. Daniel Drake’s 1835 report on western marine hospitals is 282 Senate Document 270, 24th Congress, 1st Session, January 6, 1835.

This article originally appeared in issue 9.1 (October, 2008).

Gautham Rao is 2008-09 Postdoctoral Fellow in the Program for Early American Economy and Society at the Library Company of Philadelphia. He will receive his Ph.D. in American history from the University of Chicago in December 2008. He has recently completed a dissertation on the state and the marketplace in the early American republic.

During the thirty-two years I taught college-level American literature I homed in on two academic specialties: seventeenth- and eighteenth-century American women writers and the literary form called the captivity narrative. Mary Rowlandson’s (c. 1637-1711) famous account of her three-month captivity among the Nipmuck, Narragansett, and Wampanoag Indians combines my two research interests, and I published widely on it (fig. 1). As a good Puritan—a minister’s wife, no less—Rowlandson used biblical rhetoric and precedent to channel her terror at being taken from her home in Lancaster, Massachusetts, and forced into what she called “the vast and desolate Wilderness.” She composed her narrative shortly after she had safely returned to the fold, and in its exquisite final paragraph, she tried to reach the spiritually assuaging but psychologically wrenching conclusion that God loved her so much He had sent a horrific trial to test her. Yet all was not well. Spiritual security eluded her and she continued to suffer from nightmares and insomnia.

When I was diagnosed with ovarian cancer in 2014, I too was abruptly removed from a familiar, comfortable life (“in health, and wealth, wanting nothing” as Rowlandson says) and dumped into a desolate thicket. Surprisingly, it seemed to me that the conditions of cancer and captivity shared physical, emotional, and spiritual correspondences. Like Rowlandson, I wondered whether my faith would sustain me and whether my affliction was truly god-sent. I’m a liberal Episcopalian so my theological frame of reference is, of course, radically different from that of a late seventeenth-century Puritan woman. Yet Rowlandson’s reflections on the redemptive role of affliction in her conclusion reached me viscerally as a sister-in-suffering. And her repeated attempts to convey her pain and guilt at the end of her account through the nouns “affliction” (which she used six times), “trials,” “difficulties,” and “troubles” and the verbs “chasteneth/chasten,” “scourgeth/scourge,” “afflicted,” and “troubled” particularly moved me.

In my many re-readings of Rowlandson’s narrative over the years, the following sentence in her last paragraph had always rankled, “And I hope I can say in some measure, as David did, It is good for me that I have been afflicted” (fig. 2). After my cancer diagnosis, her words assumed a profoundly personal significance. They haunted me during my treatments until, one day, I burst out, “No! It is not good for me that I have been afflicted and I am not a better person for it.” I tend to see Rowlandson’s finale as a capitulation to Puritan orthodoxy despite narrative tensions elsewhere that hint at her rebelliousness. But some other scholars assert that her words do not affirm providentialism as much as they question or even reject it.

In the twenty-first century, a belief in the positive role of suffering is not confined to people of faith. There’s a secular version too. We’ve all heard family or friends say that a trauma, especially a serious illness, changed their life for the better. Not immediately, perhaps, but as they reflect on their experience, they discern a clearer sense of priorities that rationalizes what happened to them and helps them to accept it. It’s as if the kaleidoscope of life shifts into new patterns and colors. Several people I know who also went through cancer treatments came right out and said, “I am a better person now.” They apparently assumed that I would agree with them about cancer’s role in self-improvement.

Some went even further and called cancer a gift, which I found truly offensive. On this subject I concur with Lisa Bonchek Adams, who blogged and tweeted about her struggle with metastatic breast cancer but who eventually succumbed to the disease in 2015. A New York Times Magazine article about her explains, “She detested the notion that cancer was a gift. (Really, she asked, would you give it to somebody?).” Barbara Ehrenreich also debunks the prevailing cultural imperative that cancer be uplifting in her essay “Smile! You’ve Got Cancer.” She is particularly outraged that patients who (understandably) exhibit anger and negativity are dismissed outright or accused of being complicit in their own decline as if they are committing a social sin. The cruel disconnect implied in Ehrenreich’s title says it all. Is secular providentialism or spiritual providentialism more disquieting? The latter, I suppose, because it figures a punitive and perverse God—the very God, I believe, that Rowlandson tried so hard to come to terms with.

Apart from my personal reaction to Rowlandson’s narrative, the scholar in me was curious to explore two questions about Puritan culture that I had not previously considered: how did deterministic Puritans interpret serious illnesses like cancer, and did they see an afflictive connection between cancer (illness) and captivity? On the surface, such a link seemed unlikely, but when I probed further I found plenty of supporting evidence.

While the nuts and bolts of Puritan belief in the colonies were hotly debated toward the end of the seventeenth century and into the eighteenth, the various factions subscribed to certain basic tenets. Puritans thought that their place in heaven or hell was predetermined and that God was omnipotent, omniscient, and omnipresent. Since God was hyper vigilant, it behooved them to be, too—as far as humanly possible. So they became inveterate interpreters as they tried to assign meaning to events. The clergy, of course, possessed the most experience and authority to read the signs of both major occurrences (“special providences”) and minor ones (“common providences”), including disease and captivity. Because Puritans needed to shun pride, they could not bask in good fortune or conclude for very long that God favored them. Hence, for much of Rowlandson’s life, she felt “jealous” of those whom God tried with “sickness, weakness, poverty, losses, crosses, and cares of the World.” Comfort caused complacency; suffering fostered spiritual growth. Yet underlying the belief that God tried those He loved was another aspect of Puritan theology: that the stricken were being punished for their own or for communal errors or both. Indeed, illness and incarceration constituted such acute, immediate afflictions they could easily be yoked to individual as well as public wrongdoing.

Puritans often took their interpretive cues from prominent ministers like the physician-poet Michael Wigglesworth. Best known for his epic poem The Day of Doom (1662), Wigglesworth also published a variety of popular verses including a series of poems collectively titled “Meat out of the Eater” (1670). The latter work tackled the thorny nature of human affliction and divine reward through the segment “Riddles Unriddled, or Christian Paradoxes,” which is further subdivided into subsections consisting of several meditations or songs. The titles of these subsections verbally dramatize Puritanism’s theological contradictions: “Light in Darkness,” “Sick Men’s Health,” “Strength in Weakness,” “Poor Men’s Wealth,” “In Confinement Liberty,” “In Solitude Good Company,” “Joy in Sorrow,” “Life in Deaths,”[sic] and “Heavenly Crowns for Thorny Wreaths.” The most tangible trials on this list are illness and imprisonment, leading Wigglesworth biographer Richard Crowder to say that the preacher’s “two chief instances of affliction were sickness and incarceration.” Or, if I can use my own synecdochic terms to signify all illnesses and all confinements, cancer and captivity. Wigglesworth believed that his own prolonged ill health and family tragedies provided incontrovertible evidence of the relationship between physical entrapment and spiritual growth, and he drew on his experiences to sway others.

For example, in “Meditation 1” of “Sick Men’s Health,” Wigglesworth states that “Of all Afflictions that / The outward man oppress, / None are more grievous to endure / Than Pains and Sicknesses” and he cites the trials of Job, Hezekiah, and Lazarus. And in verse five of “Song 1” in the subsection “In Confinement Liberty,” he describes the ironically liberating effects of bondage: “God bindeth some in Chains, / And in Afflictions Cords, / And by these Bands, unto their Souls / More Libertie affords. / Who would not be in thrall, / Soul-Liberty to gain, / Rather than Sins and Satan’s thrall, / And Captive to remain?” Wigglesworth was not the only commentator who thought that the most excruciating trials lay in sickness and bondage. For early Americans constantly faced daunting dangers from disease, death, and captivity, especially those like Wigglesworth who lived in vulnerable outlying villages.

While illness or captivity alone was bad enough, affliction was reinforced when individuals experienced both conditions at the same time. And a number of testimonials attest to this double misery. Rowlandson’s narrative, for example, contains information on the wounds she sustained during the initial raid on her home as well as her mental fragility afterward. Indeed, years ago, I wrote an article suggesting that she exhibited standard symptoms of what’s now called PTSD. Many captivity narratives also included information on the captive’s ill health, such as physical and psychological problems as a result of childbirth plus injuries sustained during or after an attack. In addition, there’s a whole sub-genre of early American accounts about quarantine, yet another form of confinement, necessitated by contagious diseases like smallpox and yellow fever.

But whether Puritan theology really supported the claim that illness and captivity were the two worst afflictions that could befall human beings is a different matter. Wigglesworth, for example, may have simply handpicked biblical passages to prove his point. My rector Bill Van Oss, at St. Paul’s Episcopal Church in Duluth, Minnesota, observes that other troubles have always taken a much greater toll on people. He says, “alienation, isolation and discrimination are some of the worst challenges human beings face,” and, he thinks, “scripture, especially the Gospels, point this out over and over.” So even if Wigglesworth and his ilk couldn’t see the typological wood for the trees, some Puritan ministers presumably focused on the abstract/general interpretations of biblical trials (such as isolation) rather than the concrete/specific ones (such as illness).

The link between early captivity narratives and suffering is widely accepted. In fact, scholar Adrian Weimer claims that “Perhaps the best-known colonial reflection on affliction is Mary Rowlandson’s captivity narrative.” This haunting quotation from Rowlandson’s conclusion illustrates the human cost of enduring that pain.

Before I knew what affliction meant, I was ready sometimes to wish for it . . . and that Scripture would come to my mind, Heb. 12. 6. For whom the Lord loveth he chasteneth, and scourgeth every Son whom he receiveth: but now I see the Lord had his time to scourge and chasten me. The portion of some is to have their Afffliction by drops, now one drop and then another: but the dregs of the Cup, the wine of astonishment, like a sweeping rain that leaveth no food, did the Lord prepare to be my portion. Affliction I wanted, and Affliction I had, full measure (I thought) pressed down and running over.

This excerpt also points out the dual functions of Rowlandson’s narrative as both a jeremiad (lecture) illustrating physical captivity and a spiritual autobiography illustrating the soul’s bondage to the body. For ironically, the longer Rowlandson’s body was held in thrall, the more her soul was liberated and her faith deepened.

Since the connections between affliction and captivity are so well established, I focus in the rest of this essay on the less studied topic of incapacity and illness. Cotton Mather, one of Rowlandson’s contemporaries and one of the Massachusetts Bay Colony’s premier ministers, writers, scientists, and intellectuals, argues in Mens Sana in Corpore Sano: A Discourse upon Recovery from Sickness (1698) that people receive both secular and spiritual blessings through ill health and recovery (figs. 3, 4). Indeed, by tying maladies to transgressions, he sought to persuade wrongdoers that their choices led to bad physical and spiritual health, and that affliction might be at least partly self-inflicted. According to Mather, God goads us into seeking forgiveness for our wrongdoing when He delivers us from sickness instead of letting us die in a sinful state. Using extended metaphors of disease and healing, Mather traces a causal line from original sin to the medical conditions of his day, as in this example, “If Crudities, [digestive problems and flatulence] and Obstructions, and Malignities, are the Parents of our Sicknesses, ‘tis very sure, that Sin is the Grand Parent of them, and the Sin of our First Parents is the First Parent of them all.” He continues by drawing even closer correspondences between certain sins and their manifestations, “Original Sin, is the Plague of the Heart. Every Lust, is a Distemper [throat ailment or diphtheria] of the Soul. An Unsteady Soul has a Palsey. A Wanton Soul, has a Feaver. A Worldly Soul has a Dropsy [fluid build-up]. An Angry Soul, has an Erysipelas [feverish skin infection]. Envy, is a Cancer in the Soul.” The metaphorical power of envy corroding the soul as cancer corrodes the body is particularly dramatic and compelling.

Yet Mather also acknowledged that mental and physical illnesses sprang from natural causes. Perhaps his attempts to scientifically categorize and theologically contextualize such origins led him to undertake the project that became The Angel of Bethesda: An Essay upon the Common Maladies of Mankind. Begun in the 1690s and completed in 1724, this work has sixty-six chapters, though several sections, including the one on cancer, are now lost. The work remained unpublished until 1972. But we know from the index that Mather titled the missing chapter on cancer “Magor-Missabib. Or, The Cancer,” which can be translated as “terror on every side.” How apt that naming cancer in this way so powerfully captures its nature as a relentless and merciless enemy.

The Angel of Bethesda dramatizes the growing conflict between medical providentialism and scientific rationalism in the early eighteenth century. As shown in Marc Priewe’s book Textualizing Illness: Medicine and Culture in New England 1620-1730, Mather tried to resolve these inherent contradictions in various ways. First, he believed that symptoms could be relieved by natural (but not, of course, occult) remedies that God revealed to physicians and others. So it was not a sin to seek relief from suffering, even though a respite could only be temporary if the underlying spiritual malaise were not addressed. Second, Mather established “a theory of disease” and claimed that illnesses originated in a fluid-filled border between the soul and the body that he called the “Nishmath-Chajim,” which is Hebrew for “breath of life.” Third, he described the ways in which individuals and the society they lived in became zones through which various forces from the natural and supernatural worlds might enter, including illnesses. He may have reached these conclusions following his involvement in the debate over smallpox inoculation a few years earlier. During 1721 and 1722, the medical and ministerial communities in Boston vehemently argued the pros and cons of vaccination to halt smallpox epidemics. Mather placed himself in the scientific vanguard when he supported such preventive measures and seemed to challenge determinism by valorizing human agency (free will) to combat such a scourge.

Siddhartha Mukherjee’s masterful history of cancer, The Emperor of All Maladies (2010), explains that while evidence of cancer goes back to the ancients, it was only named around 400 BCE, in Hippocrates’s time. Etymologically, even then the name cancer, meaning crab, suggested a tenacious disease and a formidable adversary. What the Greeks, and the Puritans twenty centuries later, referred to as “cancer” or “a cancer” did not necessarily possess the same meanings as today. Yet it turns out that cancer continues to be a shape shifter, so that its definitions are constantly in flux. Mukherjee states that in ancient Greece “cancers” meant “mostly large, superficial tumors that were easily visible to the eye” and that could as easily be benign as malignant. By approximately 160 CE, the physician Galen extended Hippocrates’s theory of the four humours and held that cancer arose from an internal systemic imbalance of black bile resulting in external swellings. Since it was thought that excising tumors would not counteract the systemic accumulation of bile, surgery was not usually recommended. Instead, apothecaries prepared a range of remedies. In the sixteenth century, the Swiss doctor Paracelsus challenged the theory of humours and established a theory of disease based on chemistry.

According to Patricia Watson, however, Puritan medics still subscribed largely to Galenic medicine. Their healing practices often relied on local plants, so that knowledge of herbalism (and the handbooks called herbals or, more formally, pharmacopoeia) was important. Further, Puritan physicians might utilize and pass on remedies they themselves had created or had gleaned from other sources, leading to what Watson terms a “remedy-exchange network.” Within the colonies in the seventeenth century, a few physicians also subscribed to the Paracelsian school of “iatrochemistry,” literally “chemical medicine,” a field that originated in alchemy and that believed in chemical solutions to disease. Both Galenic and Paracelsian theories raised questions about the efficacy of cures and about individual genetics versus environmental factors in causing disease.

But the best source of information about cancer in the seventeenth and eighteenth centuries occurs in Alanna Skuse’s 2015 book Constructions of Cancer in Early Modern England: Ravenous Natures. Although she does not explicitly cover New England, we can assume that transatlantic travel and communication at the time meant that at least some of the thinking and writing about causes, cases, and cures made it to America. Because most diagnosed cancers then were visible or palpable at or just beneath the body’s surface, much of the information on the disease concerns skin, breast, and facial tumors. Skuse agrees with other scholars’ conclusions that in early modern times a woman’s body, particularly her breast, was “the paradigmatic site of cancerous growth.” Indeed, she claims that most of the recorded cases of cancer concerned women. My own research also indicates that for a host of social, cultural, medical, and biological reasons, what was diagnosed as breast cancer figures more frequently than other cancers in the seventeenth and eighteenth centuries. Likely, the sexual and maternal symbolism of the breast that originated in the Bible through the conflicting female identities of Eve (lover) and Mary (mother) account for such attention in early modern texts.

Consider, for example, the complicated nexus of interpretive possibilities in the following treatment for cancer mentioned in the Salem physician Zerobabel Endecott’s 1677 “Synopsis Medicinae: Or a Compendium of Galenical and Chymical Physick,” a compilation of medications he left in a manuscript which was first published in 1914: “A woman at Casko bay had a Cancer in her breast which after much means used in Vain they applied strong beer to it with Double Cloths which it drank in Very Greedily & was something eased afterwards beer failing they Used Rum in Like manner which seemed to Lull it a sleep afterwards they put Arsenic into it & dressing it twice a day it was Perfectly whole in the mean time her Kind husband by Suking drew her breast with ye Loss of his Fore teeth without any farther hurt.” An alcoholic breast that responds first to beer, then to rum, and finally to arsenic? No, rather a description of what could be seen as an exclusively sexual act but is also a compassionate if not filial one in which a man/baby suckles his wife’s breast and sacrifices his front teeth to save it.

The disease also attracted Cotton Mather’s attention primarily because his beloved first wife, Abigail, was sick for months from what was apparently breast cancer. In his diary entry on October 22, 1702, he wrote of a dream she had in which a “grave Person” appeared to her and suggested ways to relieve her suffering, “First, for her intolerable Pain in her Breast, said he, let them cut the warm Wool from a living Sheep, and apply it warm unto the grieved Pain. . . . She told this on Friday, to her principal Physician; who mightily encouraged our trying the Experiments. We did it; and unto our Astonishment, my Consort revived at a most unexpected Rate.” Unfortunately, the improvement was short-lived and Abigail died that December. Mather’s diary entries on his wife’s decline reveal his torment about what wrongdoing within his family circle might have brought on such a trial. And his diary notations on other parishioners stricken with cancer show that the disease elicited particular sympathy from him and led him to reflect further on the link between sin and affliction.

My wise friend Pattie Cowell was treated for ovarian cancer more than twenty years ago. Happily, she remains cancer-free today. An academic and early Americanist like me, in 1999 Pattie published a personal essay on her experiences titled “Deep Focus” in the creative writing journal Prairie Schooner. Here’s how she responded when I first floated the idea of “Cancer and Captivity” past her: “Seems to me we humans most always ‘capture’ our lives in the narratives we’re familiar with. . . . I framed mine around ideas of story-telling, probably because I’ve been fascinated for years by the many ways literature (that is, narrative) shapes or gives us a framework for expressing our concepts of lives and experience.”  Correspondingly, for decades I’ve been drawn to works about captivity and confinement because, as I wrote in the preface to my book The War in Words: Reading the Dakota Conflict through the Captivity Literature (2009), these intriguing texts “enact culture clashes, culture-crossing, cultural confusion, and cultural exchange.” The cultures I had in mind were ethnic and to some extent drew from my own mixed Armenian, English, German, and Irish background. I could never have anticipated that the culture of cancer with all its specialized terminology, treatments, and practices could ever be part of my research or that I could apply elements of captivity to my own experiences.

The long-term effects of captivity on Rowlandson are unknown. Some scholars speculate that she married a military man, rather than a minister, the second time around because she sought physical protection from the kind of attack that had led to her three-month confinement. Certainly the final sentences of her narrative, written soon after her return, show a deeply troubled woman filled with secular and spiritual anxieties. I don’t believe (as some do) that storytelling anesthetizes people from their ills, but I do believe it can restore some sense of control they lost during their trials. That empowerment is elusive, of course, and for Rowlandson at least it functioned as a means to deeper spiritual growth. Indeed, she would have held that writing-as-witness was far more valuable than writing-as-therapy. So her narrative needed to show that she had been transformed by her experience, that she was a better person, a better Puritan, for it.

The only conclusion I can draw from being a cancer survivor is that while experience may affect identity, it does not erase or even, in my case, improve an earlier self. I cannot accept that a loving creator would make people suffer just to get their attention or to punish them. So of course I reject outright Cotton Mather’s astonishing claim in Mens Sana in Corpore Sano that “Diseases may be Love Tokens” from God (fig. 5). But I do admit that I felt myself sustained throughout my affliction, though by what, I’m not sure. During a brief respite from dealing with the illness and death of many relatives (including her beloved daughter’s diagnosis of breast cancer and subsequent mastectomy), Abigail Adams wrote on December 8, 1811, to her son John Quincy, “amidst this complicated Scene of distress, grief and Sorrow, I am alive to relate it—Spared Sustained, Supported beyond what I could conceive—yet my Heart has bled at every pore” (fig. 6). I too emerged on the other side of my sickness “alive to relate it” and reasonably intact physically, emotionally, and spiritually. I am grateful.

Acknowledgments

Many thanks to Pattie Cowell, Annette Kolodny, and Dan Williams, who provided helpful comments on an earlier version of this article.

Further Reading

The text of Mary Rowlandson’s captivity narrative can be found in many places online and in hard copy. For hard copy versions with helpful introductions and notes, I recommend Neal Salisbury’s edition of The Sovereignty and Goodness of God . . . (Boston, 1997) and the text in my own collection, Women’s Indian Captivity Narratives (New York, 1998).

Elizabeth Weil’s New York Times Magazine article about Lisa Bonchek Adams is titled “Follow Me: She Taught Us How to Die” (December 27, 2015). Barbara Ehrenreich’s article “Smile! You’ve Got Cancer” appeared in The Guardian on January 1, 2010.

The scant number of studies about Michael Wigglesworth includes Edmund S. Morgan’s edition, The Diary of Michael Wigglesworth 1653-1657: The Conscience of a Puritan (New York, 1946); Richard Crowder’s biography, No Featherbed to Heaven: A Biography of Michael Wigglesworth, 1631-1705 (East Lansing, Mich., 1962); Ronald A. Bosco’s edition, The Poems of Michael Wigglesworth (Lanham, Md., 1989); and a recent article in Early American Literature by Adrian Chastain Weimer, “From Human Suffering to Divine Friendship: Meat out of the Eater and Devotional Reading in Early New England” (2016).

My article on Rowlandson’s mental state is “Puritan Orthodoxy and the ‘Survivor Syndrome’ in Mary Rowlandson’s Indian Captivity Narrative,” in Early American Literature (1987). See also Cynthia L. Ragland, “The Urban Captivity Narratives: The Literature of the Yellow Fever Epidemics of the 1790s” in Colonial and Post-Colonial Incarceration, edited by Graeme Harper (London, 2001), and Sarah Schuetze, “’The Fever and the Fetters’: An Epidemiology of Captivity and Empire,” in Women’s Narratives of the Early Americas and the Formation of Empire, edited by Mary McAleer Balkun and Susan C. Imbarrato (Basingstoke, England, 2016).

See these two works by Cotton Mather, Mens Sana in Corpore Sano (Boston, 1698), and Cotton Mather: The Angel of Bethesda: An Essay upon the Common Maladies of Mankind, edited by Gordon W. Jones (Barre, Mass., 1972). Also note Otho T. Beall and Richard H. Shryock’s biography Cotton Mather (New York, 1979). Many studies examine Cotton Mather’s medical contributions, including his involvement in smallpox inoculation: Ola E. Winslow, A Destroying Angel: The Conquest of Smallpox in Colonial Boston (Boston, 1974); Jennifer Lee Carrell, The Speckled Monster: A Historical Tale of Battling Smallpox (New York, 2003); Tony Williams, The Pox and the Covenant: Mather, Franklin, and the Epidemic that Changed America’s Destiny (Naperville, Ill., 2010); Kelly Wisecup, Medical Encounters: Knowledge and Identity in Early American Literature (Amherst, Mass., 2013); and the chapter “Thresholds of Modernity: Cotton Mather’s Medical Writings” in Marc Priewe, Textualizing Illness: Medicine and Culture in New England 1620-1730 (Heidelberg, Germany, 2014).

For works on the history of medicine in early New England, see John B. Blake, Public Health in the Town of Boston: 1630-1822 (Cambridge, Mass., 1959); Patricia A. Watson, The Angelical Conjunction: The Preacher-Physicians of Colonial New England (Knoxville, Tenn., 1991); Karen Gordon-Grube, “Evidence of Medicinal Cannibalism in Puritan New England: ‘Mummy’ and Related Remedies in Edward Taylor’s ‘Dispensatory,’” Early American Literature (1993); Linda Myrsiades, Medical Culture in Revolutionary America: Feuds, Duels, and a Court-Martial (Cranbury, N.J., 2009); Oscar Reiss, Medicine in Colonial America (Lanham, Md., 2000); Walter W. Woodward, Prospero’s America: John Winthrop, Jr., Alchemy, and the Creation of New England Culture, 1606-1676 (Chapel Hill, 2010); and Marc Priewe, Textualizing Illness: Medicine and Culture in New England 1620-1730 (Heidelberg, Germany, 2014).

For studies dealing with various aspects of the history of cancer, see Edith B. Gelles, Portia: The World of Abigail Adams (Bloomington, Ind., 1992); James Olson, Bathsheba’s Breast: Women, Cancer, and History (Baltimore, 2005); Siddhartha Mukherjee, The Emperor of All Maladies: A Biography of Cancer (New York, 2010); and Alanna Skuse, Constructions of Cancer in Early Modern England: Ravenous Natures (Basingstoke, England, 2015). Skuse’s publisher, Palgrave Macmillan, has made her work available as an open source text.

See Zerobabel Endecott’s 1677 medical compendium, Synopsis Medicinae: Or a Compendium of Galenical and Chymical Physick (Salem, Mass., 1914), with an introduction and annotations by George Francis Dow, and also Diary of Cotton Mather with a preface by Worthington Chauncey Ford (New York, 1911), and The Diary of Samuel Sewall, edited by M. Halsey Thomas (New York, 1973).

Pattie Cowell’s essay “Deep Focus” appeared in the summer 1999 issue of Prairie Schooner.

This article originally appeared in issue 17.2 (Winter, 2017).

Zabelle Stodola is professor of English, emerita, University of Arkansas at Little Rock, and currently an independent researcher living in northern Minnesota. She is the author of six books, most recently the co-edited volume A Thrilling Narrative of Indian Captivity: Dispatches from the Dakota War (2012). From 2003 to 2005, she was president of the Society of Early Americanists.

Simon Finger announces his new book, The Contagious City, as “a political and cultural history” of early Philadelphia “with the medicine put back in” (xi). “Back in?” the reader may instantly query. When was it ever removed? Surely medicine is a scientific subject, following immutable scientific laws, framed to serve both the individual and the common weal?