The United States is among the wealthiest nations in the world. But that wealth hasn't translated to a higher life expectancy, an area where the United States still ranks thirty-eighth—behind Cuba, Chile, Costa Rica, and Greece, among many others. Some fault the absence of universal health care or the persistence of social inequalities. Others blame unhealthy lifestyles. But these emphases on present-day behaviors and policies miss a much more fundamental determinant of societal health: the state. Werner Troesken looks at the history of the United States with a focus on three diseases—smallpox, typhoid fever, and yellow fever—to show how constitutional rules and provisions that promoted individual liberty and economic prosperity also influenced, for good and for bad, the country’s ability to eradicate infectious disease. Ranging from federalism under the Commerce Clause to the Contract Clause and the Fourteenth Amendment, Troesken argues persuasively that many institutions intended to promote desirable political or economic outcomes also hindered the provision of public health. We are unhealthy, in other words, at least in part because our political and legal institutions function well. Offering a compelling new perspective, The Pox of Liberty challenges many traditional claims that infectious diseases are inexorable forces in human history, beyond the control of individual actors or the state, revealing them instead to be the result of public and private choices.

Now an LA Times Book Prize finalist: a timely and fascinating account of the raucous public demand for smallpox inoculation during the American Revolution and the origin of vaccination in the United States. Finalist of the LA Times Book Prize for History by the LA Times The Revolutionary War broke out during a smallpox epidemic, and in response, General George Washington ordered the inoculation of the Continental Army. But Washington did not have to convince fearful colonists to protect themselves against smallpox—they were the ones demanding it. In The Contagion of Liberty, Andrew M. Wehrman describes a revolution within a revolution, where the violent insistence for freedom from disease ultimately helped American colonists achieve independence from Great Britain. Inoculation, a shocking procedure introduced to America by an enslaved African, became the most sought-after medical procedure of the eighteenth century. The difficulty lay in providing it to all Americans and not just the fortunate few. Across the colonies, poor Americans rioted for equal access to medicine, while cities and towns shut down for quarantines. In Marblehead, Massachusetts, sailors burned down an expensive private hospital just weeks after the Boston Tea Party. This thought-provoking history offers a new dimension to our understanding of both the American Revolution and the origins of public health in the United States. The miraculous discovery of vaccination in the early 1800s posed new challenges that upended the revolutionaries' dream of disease eradication, and Wehrman reveals that the quintessentially American rejection of universal health care systems has deeper roots than previously known. During a time when some of the loudest voices in the United States are those clamoring against efforts to vaccinate, this richly documented book will appeal to anyone interested in the history of medicine and politics, or who has questioned government action (or lack thereof) during a pandemic.

"Werner Troesken looks at the history of the United States with a focus on three diseases (smallpox, typhoid fever, and yellow fever) to show how constitutional rules and provisions that promoted individual liberty and economic prosperity also influenced, for good and for bad, the country's ability to eradicate infectious disease. Ranging from federalism under the Commerce Clause to the Contract Clause and the Fourteenth Amendment, Troesken argues persuasively that many institutions intended to promote desirable political or economic outcomes also hindered the provision of public health"--Dust jacket.

The untold story of how America's Progressive-era war on smallpox sparked one of the great civil liberties battles of the twentieth century. At the turn of the last century, a powerful smallpox epidemic swept the United States from coast to coast. The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century. At the dawn of the activist Progressive era and during a moment of great optimism about modern medicine, the government responded to the deadly epidemic by calling for universal compulsory vaccination. To enforce the law, public health authorities relied on quarantines, pesthouses, and "virus squads"-corps of doctors and club-wielding police. Though these measures eventually contained the disease, they also sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights. At the time, anti-vaccinationists were often dismissed as misguided cranks, but Willrich argues that they belonged to a wider legacy of American dissent that attended the rise of an increasingly powerful government. While a well-organized anti-vaccination movement sprang up during these years, many Americans resisted in subtler ways-by concealing sick family members or forging immunization certificates. Pox introduces us to memorable characters on both sides of the debate, from Henning Jacobson, a Swedish Lutheran minister whose battle against vaccination went all the way to the Supreme Court, to C. P. Wertenbaker, a federal surgeon who saw himself as a medical missionary combating a deadly-and preventable-disease. As Willrich suggests, many of the questions first raised by the Progressive-era antivaccination movement are still with us: How far should the government go to protect us from peril? What happens when the interests of public health collide with religious beliefs and personal conscience? In Pox, Willrich delivers a riveting tale about the clash of modern medicine, civil liberties, and government power at the turn of the last century that resonates powerfully today.

A horrifying epidemic of smallpox was sweeping across the Americas when the War of Independence began, and yet little is known about it. Fenn reveals how deeply "variola" affected the outcome of the war in every colony and the lives of everyone in North America. Illustrations.

Based almost entirely on materials reproduced from: The writings of George Washington from the original manuscript sources, 1745-1799 / John C. Fitzpatrick, editor. Includes indexes.

National Book Award Winner! This deeply provocative novel reimagines the past as an eerie place that has startling resonance for readers today. It sounds like a fairy tale. He is a boy dressed in silks and white wigs and given the finest of classical educations. Raised by a group of rational philosophers known only by numbers, the boy and his mother — a princess in exile from a faraway land — are the only persons in their household assigned names. As the boy's regal mother, Cassiopeia, entertains the house scholars with her beauty and wit, young Octavian begins to question the purpose behind his guardians' fanatical studies. Only after he dares to open a forbidden door does he learn the hideous nature of their experiments — and his own chilling role in them. Set against the disquiet of Revolutionary Boston, M. T. Anderson's extraordinary novel takes place at a time when American Patriots rioted and battled to win liberty while African slaves were entreated to risk their lives for a freedom they would never claim. The first of two parts, this deeply provocative novel reimagines the past as an eerie place that has startling resonance for readers today.

Average Americans Were the True Framers of the Constitution Woody Holton upends what we think we know of the Constitution's origins by telling the history of the average Americans who challenged the framers of the Constitution and forced on them the revisions that produced the document we now venerate. The framers who gathered in Philadelphia in 1787 were determined to reverse America's post–Revolutionary War slide into democracy. They believed too many middling Americans exercised too much influence over state and national policies. That the framers were only partially successful in curtailing citizen rights is due to the reaction, sometimes violent, of unruly average Americans. If not to protect civil liberties and the freedom of the people, what motivated the framers? In Unruly Americans and the Origins of the Constitution, Holton provides the startling discovery that the primary purpose of the Constitution was, simply put, to make America more attractive to investment. And the linchpin to that endeavor was taking power away from the states and ultimately away from the people. In an eye-opening interpretation of the Constitution, Holton captures how the same class of Americans that produced Shays's Rebellion in Massachusetts (and rebellions in damn near every other state) produced the Constitution we now revere. Unruly Americans and the Origins of the Constitution is a 2007 National Book Award Finalist for Nonfiction.

When he and his tutor escape to British-occupied Boston, Octavian learns of Lord Dunmore's proclamation offering freedom to slaves who join the counterrevolutionary forces. 75,000 first printing.