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VOLUNTARY ASSOCIATIONS AND THE RISE OF THE PROFESSIONS



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VOLUNTARY ASSOCIATIONS AND THE RISE OF THE PROFESSIONS Before the first decades of the eighteenth century medical practice as a professional endeavor was unknown in the American colonies Self medication folk and herbal healing midwifery by knowledgeable women of the community be it rural or urban were the rule A few places had the advantage of ministers who also practiced medicine Fewer still could avail themselves of the handful of practitioners who had been trained in the newly founded English hospitals only the French and Italian universities taught medicine The absence of an organized medical profession imposed no great burden on the colonists before 1700 Accidents and childbirth aside life in North America was extraordinarily healthy Because there was so little communication between rural settlements epidemic diseases even when they swept the coastal cities seldom spread to the countryside But the rise of the market economy in the colonies after 1700 brought with it an alarming deterioration of public health infant mortality doubled between 1670 and 1760 in rural New England two thirds of the men born before 1700 could expect to live past the age of 60 but less than half of those born after 1700 would have that life expectancy Hall 1983 109 In the eighteenth century colonial towns and cities were devastated by periodic epidemics of smallpox while increasingly crowded living conditions brought with them the often fatal diseases associated with poor sanitation Even so disease and increased mortality did not in themselves encourage the development of organized medicine or public health measures As the Boston riots of the 1720s against efforts to introduce smallpox inoculation suggest many colonists clung to a medieval fatalism about death and disease resisting the perfectionist ideas of 1 the Enlightenment which asserted that people could improve their health along with their social economic and political circumstances The rise of medical profession would stem



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