Authors: Jill Lepore
S
he took out her Book of Ages:
my Eldest son Ed mecom Died Decr 7-1758
He was twenty-seven.
She turned the page:
January the 18 1762 this morning Died a worthy & Dutifull Son Ebenezer mecom
He was twenty-six.
1
“I have had some children that seemed to be doing well,” she wrote her brother, “till they were taken off by
Death.”
2
Three of her children died in infancy. None died in childhood. Only in adulthood did the rest begin to fade, one by one. And then, so did their children.
Neddy left a wife and two children. His older daughter followed him to the grave; then his younger daughter, Jenny, began to fail. “Poor Litle Jeney Mecom,” Jane wrote, “seems to be going the same way of her father & sister.” She offered details: “She Pines a way Looses her Apetite but withal her Bowels swells Prodidgusly so that with a Litle slip out of a Chare she bust her self, She seems often to have something choaking in her throat & dont Incline to stir but mostly keeps in her cradle.”
3
The baby died.
Jane understood affliction as a message from God.
Distrust not Providence
. Her doctor thought differently. John Perkins leaned toward Franklin’s Newtonian view of the world: he was a natural philosopher; Franklin
called him a fellow “Searcher into Nature.”
4
Perkins made a particular study of meteors and tornadoes, corresponding with Franklin on these subjects at length. In recognition for his treatise
The True Nature and Cause of the Tails of Comets,
Perkins was elected to the
American Philosophical Society.
5
In a philosophical essay,
Thoughts on Agency,
published by Benjamin Mecom—and, therefore, very likely read by Jane—Perkins examined “the origin, nature, and bounds of moral freedom.” Shadowing Hume, he tried to reconcile self-determination with
Providence; he did this by defining liberty as constrained by morality. “All Creatures do as they list,” Perkins wrote, “but moral Freedom should be something very different from merely doing as one lists.” To be free, Perkins argued, is to act in accordance with reason and discernment and in obligation to human and divine
law, which no man can ignore because, no matter man’s “Self-Direction,” he is the object of
God’s “special Providence.” In short, “Providence is not incompatible with Freedom.”
6
Perkins’s attempt to straddle a providential and a liberal view of the world shaped his understanding of
disease. He once wrote an essay called “A Few Thoughts on Epidemic Colds or Catarrh Fevers,” containing his observations on bad cold and flu seasons in Boston in 1748, 1750, 1753, 1757, 1760, 1765, 1767, and 1768.
7
He sent it to Franklin. In another essay, “Of the Diseases & casualtys incident to Mankind,” Perkins categorized diseases as natural, constitutional, or adventitious (further cleaving this last category into “some by our own faults, others by the people about us”). Perkins was trying to explain what made some years worse, and some people sicker, than others. He didn’t blame an angry god; he made a study of circumstance. “Fevers are more frequent than any other illnesses of mankind, & more die of them,” he wrote. “But it is hard to say whether the illness of itself or the imprudence of the person himself & those about him are the chief cause of fatality.”
8
Franklin, too, searched into nature. He took, for instance, a great deal of interest in Grace and Jonathan Williams Sr.’s oldest son, Josiah, a blind
musical prodigy. “Let me know how the eldest does, who had the Misfortune of losing his Sight,” Franklin wrote to Jonathan Williams Sr. in 1762. Franklin sent the boy a harpsichord. He began researching treatments.
9
Jane accepted affliction as the workings of fate; Franklin and Perkins did not. But Perkins, for all his searching and speculating, could not possibly have understood what afflicted Jane’s family because, in the eighteenth
century, no one understood it. Nor is it possible, centuries later, for historians to diagnose diseases from the scant evidence recorded by people who understood sickness and health very differently.
10
All the same, it seems likely that Neddy, Eben, little Jenny, and Jenny’s sister succumbed to what would later be called
tuberculosis, which might be also what took the life of Jane’s husband, her son Johnny, and her daughter Polly and affected her daughter Jenny, and possibly her sons Peter and Benjamin, too.
Tuberculosis—the term originated in the nineteenth century—is a bacterial disease. Infected with
Mycobacterium tuberculosis,
the body appears to be wasting away, exhausted, consuming itself, which accounts for the name by which such suffering was known in the eighteenth century: consumption.
11
Ed
ward, Neddy, Eben, Johnny, Polly, Jenny, and Neddy’s two daughters all suffered periods of profound lassitude. What Jane’s daughters endured she had “Grate Reason to fear Incureable,” she wrote, describing one as suffering from “a Painfull Deseas” and “the other falling in to a Languishing.”
12
Sometimes they could hardly get out of bed. During the
French and Indian War, Edward and Neddy served only briefly, too weak to fight. Peter enlisted but deserted after five weeks; he came home from camp sick.
13
The most common form of tuberculosis is pulmonary. Inhaled, the bacteria infect the lungs. When someone infected with tuberculosis coughs, the bacteria spread. Jane described Neddy as “Raising Blood”: coughing blood, which is what happens when the infection is severe. Jane described how another of her sons suffered, in the last months of his life, from a list of symptoms that, a century later, would have readily been disagnosed as tubercular. “Johney has been sick,” she wrote. He “has a Bad cough, & a chilly fitt & Fevour Every Day has not been Able to Do any work nor so much as write.” There was nothing left of him but “Skin & Bons.”
14
He died at twenty-nine.
Adults infected with
tuberculosis often show no symptoms. Sometimes symptoms appear only when someone has become weakened for another reason—for instance, having endured the hardships of
childbirth or war. In the eighteenth century, infected people often sickened and then lingered for years before finally wasting away. For infants, young
children, and old people, the disease was usually more swiftly lethal.
Tuberculosis has existed for centuries. Jane and Benjamin’s grandmother
Jane White Francklin, who died in
Banbury in 1662, in her mid-forties, when Josiah was five, seems to have been felled by it. (Their uncle Benjamin wrote about how his mother had languished “nere seven years undr. that flattering Lingering distemper, a consumtion.”)
15
It had been in the colonies since their founding. But it became widespread only in the eighteenth century, when people began living closer together, in cities. By the beginning of the nineteenth century, tuberculosis is estimated to have accounted for between a quarter and a third of all deaths in New England.
16
Some people got sick more easily, and more acutely, than others. Tuberculosis is a disease of crowding: the bacteria are typically inhaled in a closed space. It is most common in cities and among people whose lives are sedentary, and especially among people who live and work in confinement.
17
John Perkins was an astute observer of the relationship between circumstance and sickness. He knew that “Some businesses are unhealthful.” Among these trades he counted “
Glaziers, potters & painters.”
18
Saddlers, soap boilers, dyers, and
chandlers belong on this list, too: these trades involve working in a closed space and toiling over vats of fumes. Edward and Neddy were saddlers, and, with her daughters, Jane boiled soap and dyed cloth. Soaking leather, boiling lye, dipping candles, dyeing. People who did this kind of work indoors seemed to have trouble breathing.
Jane, like her parents and her brother Benjamin, enjoyed an extraordinarily stout constitution. But even she suffered from coughing spells, which she called asthma. “I have had a bad fit of Astme,” she would report. “Coughing Shocks Every Part of the boddy,” she complained.
19
She once wrote to her brother about gasping for air. He wrote back, “Your Shortness of Breath might perhaps be reliev’d by eating Honey with your Bread instead of Butter, at Breakfast.”
20
That might have helped the coughing; honey soothes the throat. But honey couldn’t conquer lung disease. In treating signs of consumption, Perkins followed the best eighteenth-century medical practice: he recommended exercise and fresh air. “In general an active life is the most healthfull,” he advised. “Few will bear a constant sedentary one.”
21
A long journey by horseback and, especially, travel to the ocean were the most common treatments for lung trouble. (This prescription of sailing was occasionally challenged, as in an eighteenth-century tract called
An Account of the
Effects of Swinging, employed as a Remedy in the Pulmonary Consumption and Hectic Fever,
which recommended swinging—on a swing—instead; the idea was that swinging would pump air into the lungs.)
22
Neddy’s two daughters, Jane’s grandchildren, died quickly, but Perkins would have urged the adults to get outdoors, especially to the ocean. This advice they appear to have complied with. “Sister wrote me word that Polley was gon to Nantuckit,” Deborah reported to her husband, “and shee had heard that shee was better.”
23
(Polly was not better; she was already dead by the time Deborah wrote this letter.) Eben moved to Gloucester, a seaport.
But glazers, potters, painters, saddlers, soap boilers, dyers, and
chandlers were not often the sort of people who could afford to go for a long journey by horseback or move to the seaside. For patients too weak to get outdoors or too poor to follow his recommendations, Perkins suggested other remedies. None of his case notes for any of the Mecoms survive, but in 1750, Perkins treated another consumptive in
Boston and recorded his treatment of this young man, named Gould, for an ailment Perkins wasn’t quite sure about—it might have been an acute condition (pneumonia) or it might have been a chronic one (consumption). “Young Mr Gould being low constitution’d & dispos’d to Consumption I took small Quantities of Blood,” Perkins wrote. He noticed that Gould’s spit was “a little yellow at Times but mostly white & Frothy.” Perkins recorded his treatment: “I vomited him at first & gave him the Pectoral opening Infusion but there appear symptoms of pleurisy.”
24
The tuberculosis bacteria often affect the lungs but can affect other parts of the body, too. Jane’s granddaughter Jenny Mecom, the little girl Jane described as suffering from “choaking in her throat,” may have had what would later be called laryngeal or pharyngeal tuberculosis. Extrapulmonary tuberculosis can also affect the central nervous system, and, like syphilis, it can lead to insanity.
The emotional unsteadiness of Jane’s sons Peter and Benny seems likely to have been a hereditary condition. Or it could have had been caused by, or worsened by, a chronic bacterial infection like tuberculosis. Either way, it seems to have begun with Jane’s husband, who may have contracted tuberculosis in
debtors’ prison, which is exactly the sort of place the bacteria thrive. In 1738, when Mecom was fending off creditors, Perkins was called in to treat one of Jane’s children. By 1742, Mecom was unsteady
enough, or unwell enough, that Jane was taking in
boarders to support the family. Her husband seems never to have recovered.
Peter and Benny were, at first, only erratic. Peter, when he was twenty, was hauled into court after having attacked a tailor.
25
Two years later, he was unable to get anything done.
26
By the time he was twenty-four, he was violently insane.
Benny started out flighty. “I fear he will not for some Years be cur’d of his Fickleness,” Franklin wrote about Benny at twenty-three.
27
But he was never cured of it. This looked to Franklin, who was forever urging
industry, like laziness. It didn’t look quite that way to Jane. It didn’t look that way to William Franklin, either. “His Pride and Laziness are beyond any Thing I ever knew,” William reported to his father, describing Benny in his thirties. And then he added something more: “I look upon him to have a Tincture of Madness.”
28
The Mecoms were a very sickly family, but no eighteenth-century doctor could have cured them. Jane was baffled. Whatever was wrong with the Mecoms, it’s possible Jane unwittingly made it worse. “Physicians, after having for Ages contended that the Sick should not be indulg’d with fresh Air, have at length discover’d that it may do them good,” Franklin once wrote, but Jane, like many poorer people, subscribed to the older view; she believed that fresh air could be dangerous. In winter, and even in summer, she kept the house shut up, preferring, as she explained to her brother, to be “Less Exposed to Doers opening on me which in cold wether Increeces my cough.”
29
“The
Aerophobia
that at present distresses weak Minds,” Franklin observed, made people like his sister “choose to be stifled and poison’d, rather than leave open the Window of a Bedchamber, or put down the Glass of a Coach.” Repeatedly he berated her, urging her “not to be afraid of her Friend Fresh Air.”
30
She tried to take this advice. “It is a very hapy circumstance that you Injoy yr helth so perfectly,” she wrote him, and “it is a Blesing vouchsaifed to me also Exept some trifeling Interuption & that but sildom which I a good deal atribute to my observation of yr former Admonitions respecting fresh Air & diet.”
31
But the problem wasn’t only the air. New England winters are long, and dim. The windows in Jane’s house were small, and shut. Fresh air would have helped, but what really seems to make people susceptible to tuberculosis,
and what makes it worse for people who’ve got it, isn’t lack of air. It’s lack of
sunlight.
32