Bruce Pitts

#1185 Doctor Beltramini

#1185 Doctor Beltramini

We are so pleased to welcome Dr. Bruce Pitts this week, who joins us to report about his recent trip to the Palladio Museum in Vicenza, Italy. He interviewed the director of the museum, Doctor Beltramini, about connections between Thomas Jefferson and Andrea Palladio and how Jefferson was influenced by Palladio in his own architectural work. Palladio is widely considered to be the most influential individual in the history of architecture.

#1158 The Cause of Civilization

In an out-of-character program, Clay S. Jenkinson, the creator of the Thomas Jefferson Hour, speaks with our Paris Correspondent, Bruce Pitts and with Dr. Geoffrey Wawro, author of Quicksand: America's Pursuit of Power in the Middle East, about the recent terrorism attacks in Paris.

Further reading:


Bruce Pitts' Tour Map: 2015 Episodes

PittsMap

Road-tripping in France circa 1787: Roads and Canals

In his circumnavigation of France, Thomas Jefferson took roads, floated canals, sailed seas, rode mules, and rode horses. But mostly he took roads. The roads of 18th Century France were highly variable – some good, some grand, some execrable (little more than cakes of rubble) – and they were maintained by a system of local slavery called “le cuvée.” The roads of Languedoc were superb. The roads of sandy Brittany deteriorated faster than they could be built, leading to the unusual predicament that the more they were worked on the shorter they became. And the best roads were those constructed 2000 years earlier by the Romans. In this segment we talk about the roads that Jefferson traveled, with brief mention of the marvelous Canal du Midi.

References:

Robb, Graham, Th-1788-1789e Discovery of France: A Historical Geography from the Revolution to the First World War, WW Norton, 2007.

Gabler, James M. Passions: The Wines and Travels of Thomas Jefferson, Bacchus Press, 1995.

Young, Arthur, Travels in France During the Years 1787 – 1788 – 1789, Doubleday Anchor Books, 1969.

 

Overview of our Jeffersonian tour of France

Eighty-three thousand one-hundred eight days after Thomas Jefferson left Paris in his American-made horse-drawn carriage to circumnavigate France, we departed Paris in our tiny diesel Renault to do the same. Our intention was to follow his footsteps through the vineyards, antiquities, engineering marvels, cities, and pastures that he passed – to recreate to the extent possible his experience 227 years later, to understand what it must have been like to travel the country alone in 1787, to try to channel the people he met along the way.

References:

Peterson, Merrill D. (Ed.) Thomas Jefferson: Writings, Library of America, 1984.

Gabler, James M. Passions: The Wines and Travels of Thomas Jefferson, Bacchus Press, 1995.

 

Road-tripping in France circa 1787: How Jefferson Traveled

What few travelers there were of 18th Century France spent more time on water than they did on roads, taking advantage of rivers, coastal waters, and an extensive system of canals. Thomas Jefferson spent a good deal more time than other travelers in his private carriage, driving along the Royal Postal Road that had only recently been opened to private traffic. He opted not to ride with others in a “diligence” or stage coach which, in his time, would have been crowded, dirty, smelly, uncomfortable, and so dangerous that a French-German phrase book of the time included such entries as “I believe the wheels are on fire” and “Gently remove the postilion from beneath the horse.” Jefferson chose to travel alone – in cognito – which added a dimension of dangerous novelty to his adventure that may seem inconsequential in our time but was extraordinary in his.

References:

Robb, Graham, The Discovery of France: A Historical Geography from the Revolution to the First World War, WW Norton, 2007.

 

Bruce Pitts grew up in Rhode Island, attended Yale and then attended medical school at the University of Pennsylvania and completed his residency in internal medicine at Temple University. In 1982, he joined the Fargo Clinic where he has practiced for the past 30 years. He is married and has two children.

His lifelong interest in American history comes from two sources: growing up near Plymouth Colony and the seven years he spent in where he became fascinated by American revolutionary history and the found of the nation.

Read Bruce Pitts' blog, Pitts in Paris.


The Medicine that Jefferson Knew and Saw in Paris

On October 15, 1785, Thomas Jefferson wrote a letter to John Banister (who, I presume, was the Virginia Banister, a member of the Continental Congress.) Banister had, it seems, written to Jefferson to solicit his advice "respecting the best seminary for the education of youth, in Europe." In his response, Jefferson stressed the dangers of exposing young men to the temptations of European life and to the degeneracy of the European aristocracy. He strongly praised the education provided by American institutions like the College of William and Mary. The only exception he made was for a man who intended to study medicine. Jefferson wrote, "For [this], he must come to Europe: the medical class of students, therefore, is the only one which need come to Europe."

Jefferson's time in Paris, 1784-1789, fell at the very beginning of what would become a French revolution in the understanding of illness and the practice of medicine. As early as the 1860s American physicians were journeying to Paris to experience its superior medical education. France had formal medical schools that were allied with hospitals and universities. The American colonies had a system of apprenticeship for aspiring doctors. And the French were doing three things that their American counterparts were not, all of which revealed the French fascination with learning through observation. First, they examined their patients. Second, they took advantage of their easy access to cadavers to study the body and, through observation, to better understand disease. Finally, they expected medical students and doctors to examine women, something that was thought unseemly for doctors in the American colonies and early United States.

One of the earliest American physicians to study medicine in Paris was John Morgan. Between 1760 and 1765 he studied at Edinburgh in Scotland and at the Royal Academy of Surgery in Paris. He returned to the United States in 1765 to found America's first university- and hospital-affiliated medical school at what is today the University of Pennsylvania. After Morgan, the list of American doctors who studied medicine in Paris became long and distinguished. 
Benjamin Rush studied in Paris in 1768 and 1769. In later years Jefferson thought Rush to be America's pre-eminent physician. The early 19th Century saw a virtual exodus of American medical students to Paris, among them Oliver Wendell Holmes, Sr.

Jefferson is reported to have been skeptical about the medicine practiced in his time. He subscribed to the theory that the body possessed naturally curative tendencies that needed to be exploited and supported during times of illness. Despite this belief, Jefferson turned to doctors and to medications when confronted with the specific ailments that afflicted him: headaches, rheumatism, and diarrhea. He reported in his letters that his headaches responded better to travel and relaxation than to quinine and other drugs, and that his rheumatism was alleviated by hot springs in western Virginia (although he got skin boils from the experience). Chronic diarrhea is reported to have been his most incapacitating ailment. For a while he found that riding his horse at a trot for 2-3 hours daily was helpful in that it strengthened the muscles surrounding the rectum. In time, however, he resorted to a doctor's prescription of laudanum. He depended on this drug for many years. Laudanum is a tincture of opium comprised of 10% pure opium powder suspended in a 100+ proof alcoholic extract of bark.

Jefferson's thoughts about medicine may be inferred from his expectation that Lewis and Clark take with them on their Expedition, if not a physician, at least the best that American medicine had to offer. He sent Meriwether Lewis to Philadelphia to study with Dr. Benjamin Rush for three months at what is now the University of Pennsylvania School of Medicine. Rush was a firm believer in expunging from the body whatever ill humors had accumulated there, by whatever exit route might be most advantageous – laxatives, emetics, bleedings, and purgatives of all types. Lewis thus left Philadelphia equipped with new skills in phlebotomy and surgery and $90.69 worth of equipment and drugs. The equipment included lancets, forceps, gonorrhea syringes, and scissors. Among the 30 or so drugs were laudanum, opium, calomel, and mercury (for syphilis – the adage at the time being, "One night with Venus, a lifetime with Mercury.") Finally, Rush equipped Lewis with 50 dozen of his patented "Rush Pills." Rush believed his violently potent laxative to be effective in treating numerous ailments. The members of the Expedition used them liberally and called them "Thunder clappers."

When Jefferson arrived in France in 1784, the application of science to the practice of medicine was a novel idea, understood by few and practiced by still fewer. And the science of the time was not the experimental science that we know today. It was based largely on qualitative observation alone – a big step forward, but not the more objective quantitative testing of nature that we take for granted today.

Some French philosophers (as scientists were then called) were, however, dabbling in quantitative experimental science, and Jefferson was interested. Antoine Lavoisier, later known as "The Father of Modern Chemistry," had taken the understanding of elements and compounds from the realm of qualitative observation and into a new world of quantitative predictability. He discovered the role of oxygen in combustion, named oxygen and hydrogen, constructed an early list of elements, and helped develop a metric system that could measure all things. Like so many of his fellow nobles of the time, Corvoisier was guillotined in 1794.

In a letter to the "the Rev. James Madison" from Paris on July 19, 1788, Jefferson wrote,

Speaking one day with Monsieur de Buffon [the great French naturalist who piqued Jefferson by contending that the animal species of the Americas were inferior to, and smaller than, those of Europe], on the present ardor of chemical inquiry, he affected to consider chemistry as cookery, and to place the toils of the laboratory on a footing with those of the kitchen. I think it, on the contrary, among the most useful of sciences, and big with future discoveries for the utility and safety of the human race. It is yet, indeed, a mere embryon. Its principles are contested; experiments seem contradictory; their subjects are so minute as to escape our senses; and their result too fallacious to satisfy the mind. It is probably an age too soon, to propose the establishment of a system. The attempt, therefore, of Lavoisier to reform the chemical nomenclature, is premature.

This being medicine and science at the time of Jefferson's appearance in Paris – two separate and nearly unrelated endeavors – what would the new minister from the United States have seen of French medicine in his time there?

He would have known the Hotel Dieu adjacent to Notre Dame on Ile de la Cite (The House of God), and he would have known the Hopital Salpetriere in the southeastern outskirts of town. Images of "then" and "now" are shown below.

It is no wonder that Jefferson was a skeptic about the medicine and doctors of his time. He was witnessing only the first traces of science in medicine. It is impossible to know if he even recognized them as such. In his time the Hotel Dieu was a place where the poor died in wretched squalor. The Hopital Salpetriere was where undesirables of many sorts were housed in their misery. When Jefferson was in Paris, the great men of French scientific medicine were just beginning to change the way that doctors understood and cared for "patients." For example, Dr. Philippe Pinel, chief physician of Hopital Salpetriere from 1895-1826, had not yet identified what we know today as schizophrenia and epilepsy as medical conditions, and to treat them as such. In the meantime, while Jefferson was in Paris, these unfortunate people were separated from civil society as morally flawed, demonically possessed, dangerous, or simply hard to have around. The greatest French contributions to patient care – and to American medicine - would follow Jefferson's departure from France. How I would love to talk with him about all of this!

 

Bruce Pitts grew up in Rhode Island, attended Yale and then attended medical school at the University of Pennsylvania and completed his residency in internal medicine at Temple University. In 1982, he joined the Fargo Clinic where he has practiced for the past 30 years. He is married and has two children.

His lifelong interest in American history comes from two sources: growing up near Plymouth Colony and the seven years he spent in where he became fascinated by American revolutionary history and the found of the nation.

Read Bruce Pitts' blog, Pitts in Paris.