James C. Riley

Smallpox and American Indians Revisited

Smallpox ravaged the people of Europe and the Americas in the early modern era. Why it was a catastrophic cause of death for American Indians that helped lead to severe depopulation, but a manageable cause among Europeans that allowed continued population growth, has puzzled scholars. Research on variola continued after smallpox eradication in 1977, prompted in part by the fear that aerosolized smallpox might be used in bioterrorism. That research updates factors that may have aggravated smallpox lethality in American Indians, giving new information about infectivity, the proportion of people who may have contracted smallpox, the burden on infants of mothers who had not had smallpox, and the toll for pregnant women. This essay reviews old and new hypotheses about why so many in the New World died from smallpox using recent smallpox research and older sources.

Foreign Credit and Fiscal Stability: Dutch Investment in the United States, 1781–1794

IIHE importance of foreign credits and subsidies to war and peacetime finance during the Confederation is well established. Compared to the nominal value of paper currency and interest-bearing note issues, those credits and subsidies produced rather little. But a more accurate comparison would be based on the specie value of fiat money and domestic loan certificates, and would acknowledge the difficulty of finding domestic resources for such essential foreign purchases as military supplies. Little attention has been given foreign borrowing in the early years of the federal government, another critical period in which domestic resources were inadequate. In attempting to achieve financial stability for the new regime, Alexander Hamilton had to cope with a bequest from the Confederation combining a debt-revenue ratio unparalleled in Europe with tenuous or wholly exhausted domestic credit resources. Nor until the mid-1790s could sufficient tax revenues be collected, for the authority given Congress by the Constitution could not be transformed quickly into enough income to meet military, naval, administrative, debt service, and other expenditures. Save default, the only option left was to turn to the reputation for financial dependability which, ironically, had been built for the Confederation on the Amsterdam capital market since 1781. Hamiltons program of national public finance, an adept compromise among conflicting interests, succeeded not merely because it satisfied many potential antagonists, but because Hamilton, recognizing the necessity of foreign credit, took advantage of Dutch loans and the readiness of Dutch rentiers to invest heavily in the American domestic debt. Revenue and expenditure reconstructions show that Hamiltons establishment of a reliable system of public finance was funded substantially by foreign capital, for which there was no substitute, and from which important monetary and economic benefits were also drawn.

Book Review: Mortal coil: a short history of living longer.

Four centuries ago in western Europe more people died in infancy than at any other age. Those who survived childhood could be expected to live to about today’s age of retirement, and a few to eighty or a bit more. Since then death before the age of sixty has become uncommon. The number of centenarians has surged; this year Japan deemed bonuses formerly paid to centenarians no longer affordable. We appear to be on the way to having significant numbers of people live to be 100, even 110, but probably not 120. Judged by an ability to perform physical and mental tasks, old age has receded. This past, projected forward, gives us hope of mentally and physically active years pushing through the eighties for most people. In every age some branch of learning has imagined much longer lives. Today geneticists and geriatric researchers, and scholars from other fields impressed by their findings, are fashioning their own version of exceedingly long lives, ending at age 150 or even 200. Childhood will remain the same; old age measured by physical capabilities will be compressed; the physical and intellectual attributes of the middle years will be stretched out by decades, even by more than a century. David Boyd Haycock gives us a history of prolongevity thinking during the last 400 years and of the sources of inspiration for such hopes. Deliberately, without irony, he links the modern expression of this idea, based on science, to past expressions based on the Old Testament and the belief that the patriarchs lived hundreds of years; on hope in the perfectibility of humankind, not just in morality but also in immortality; on the supposed long lives of some individuals who understood secrets about ageing; on the belief that disease would be conquered, leaving people to discover how long their natural lives could be. Scholars and the curious among the general public will be delighted by this book. Haycock writes engagingly about an intriguing topic, and is always ready to re-seize the reader’s attention with a digression or an apt illustration. Indeed historians of science may want to use this book as a text. Haycock knows how to introduce scientists from Bacon, Boyle, Descartes, and Condorcet to Hayflick, Kirkwood, and Walford in ways that fix them in the mind. He knows how to present the serious and still today important parts of their thought even when it is embedded in language that seems merely fantastic, spiritual, credulous, or impenetrable. Undergraduates will discover useful things about how science proceeds when, armed by little more than curiosity, scientists probe the unknown. In the early parts of this account, prolongevists experimented mostly on themselves. In the twentieth century they began to experiment on volunteers, some from their laboratories and some from the credulous public. To date, their work has had no specifiable effect on human longevity, except for maiming some lives and cutting others short. All the while prolongevists went ahead, always, it seems, lacking any sense of the history of the idea. Until now, when an historian sympathetic to these ideas has arrived. Major steps forward in knowledge engender confidence that ageing can be understood and manipulated. Most of the time science demands that we sacrifice for these longer lives, for example, not just watching our diet but eating only a fraction of the recommended intake. The persuasive sign that something is afoot will probably lie in steps that extend cancer treatment from management to reversal, cure, or prevention. Haycock is not a sceptic; for him super long lives of perhaps 200 years are a plausible expectation that will be delivered by science now in progress.

Sickness, Aging and Death

The uniform nature of the age-dependent deteriorations that occur in human beings dictates that any significant prolongation of life-span ... will require a uniform prolongation of general health maintenance.l

Sickness and Death in the Twenty-First Century: A Transformation toward Health?

Two visions of the future emerge from this review of the past, and the two seem at first glance to be at odds. According to one, both aggregate and age-specific morbidity rates will increase when the death rate declines. The death rate has declined during the past century, and further decline can be forecast. Therefore, the future would seem to promise more sickness. According to the other, the amount of sickness and the timing of death are influenced from four directions: genetic traits and propensities, exogenous hazards, endogenized hazards or insult accumulation, and age. During the last century, certain kinds of exogenous insults, usually infectious dis-eases, have been avoided or have had diminished effects on the health of some age groups, especially infants and children. Fewer ill-health episodes mean a slower rate of insult accumulation and arrival at advanced ages with better health histories. From this perspective, the future should promise less sickness.

The Experience of Sickness before 1870

Two types of sources inform us about the experience of sickness from the seventeenth century into the nineteenth. One consists of a complex assortment of beliefs and assumptions now held. These beliefs and assumptions are based on testimony about disease and death, which is unambiguous in thrust and is usually held to be unambiguous in implication, too. Disease and death were rife, and mortality rates were high. The other source consists of case studies in which the by-now-familiar gauge, absence from work attributed to illness or injury, is used to measure the incidence and duration of sickness. Neither source will, by itself, give a satisfactory account. On the one hand, some of the beliefs and assumptions will be false but, in the absence of ways to examine the foundations of these beliefs and assumptions, it is extraordinarily difficult to decide which may be false. On the other hand, the case studies are few in number and represent small segments of the overall historical population at risk to sickness. Used together, the two sources can sharpen the questions asked and guide research.

Sickness and Death in the Twentieth Century

Twentieth-century observers sometimes express puzzlement about what seems to be a paradox in health demography: as the death rate shrinks toward the minimum consistent with the human life span, ill-health rates and health spending rise rather than decline. But there is no paradox. Even if we set aside other reasons why health spending might increase in real terms — such as greater access to physicians and health facilities, a shift from less to more costly health problems, the earlier or more comprehensive discovery of health problems, and greater awareness of health problems — reasons why ill-health rates and health spending should be expected to increase are apparent. They follow from increased numbers of the aged in the population, the prevalence and duration of ill health among the aged, and the intractability of many sicknesses of the aged. They follow also from changes in the composition of the population that occur because of the decline in the death rate. And they follow because the decline of death rates is a sign that health conditions are improving, but not that health itself is improving. Focusing on the mortality and morbidity experience of males in the United States since about 1880, this chapter will show that it is possible to take away from and add to factors determining health. Following male experience makes it easier to compare this part of the record with earlier periods, in which male experience is better known than female.

Sickness in the Second Half of the Nineteenth Century

To enter the second half of the nineteenth century is to confront a choice. The volume of information about morbidity is much greater and extends through the European and Europeanized world, from Scandinavia to New Zealand. The record becomes richer in detail, revealing more about the individuals insured and more also about their sicknesses. Suddenly, the questions that might be answered exceed the space and resources available. My response will be to focus on the part of the world about which the most detailed information is available — Britain, especially England and Wales — and on questions attractive for their broad implications and for the degree to which they prepare us to understand twentieth-century sickness experience.

The Boundary of Survival

Life leaves us in suspense, not about the eventuality of death but about its timing and causes. Like many other organisms, the human species faces a boundary on survival, a maximum or potential life span quantifiable on a graph. It is difficult to imagine a situation in which all of the space up to this boundary might be filled, in which, that is, everyone would survive to the limit of the human potential. The difficulty arises from our familiarity with the history of death. This history shows that some people will die in every stage of life, and that illnesses and injuries likely to cause death will accumulate, especially in old age. Eliminating each of the causes reported on death certificates would not extend the human life span indefinitely, but, at least in theory, such an achievement would allow all members of the species to live to the boundary.

Health and Sickness in Europe, 1600–1870

La mort ne pourra etre apprehendee de maniere satisfaisante que par l’etude globale de la morbidite.l [Death can only be satisfactorily understood by the comprehensive study of morbidity.]