Book Review

The Angelical Conjunction: The Preacher-Physicians of Colonial New England

N Engl J Med 1993; 328:820March 18, 1993

Article

The Angelical Conjunction: The Preacher-Physicians of Colonial New England
By Patricia Ann Watson. 187 pp. Knoxville, Tenn., University of Tennessee Press, 1991. $29.95. ISBN: 0-87049-696-4

In colonial New England, formally trained physicians were few and congregated in urban areas. Harvard College, founded in 1636, was of no help in remedying this dearth of practitioners, since it concentrated on turning out classical scholars whose main occupation was to be teaching or the ministry. Only in the years surrounding the American Revolution were fledgling medical schools established at Dartmouth, Harvard, and the University of Pennsylvania. Until then, the colonists of New England relied on foreign-trained physicians who could be attracted to the New World or on practitioners whose knowledge was of a less formal sort.

Very often these “physicians” were clergymen. Patricia Watson has written a long-needed book on the history of preacher-practitioners in colonial New England. Other historians have alluded to this group, but here for the first time we can see how large their numbers were and how extensively they practiced. Watson makes it clear that although these men (and they were all men) no doubt prayed on the same visits during which they dispensed medicines, they were in no way “faith healers.” They did not seek divine intervention to cure disease. Rather, they used what medical knowledge they could glean from the available textbooks to start a second career in medical practice. These were men who were often poorly paid and who needed the money medicine could bring them. Moreover, there was intense competition for clerical positions. A solid reputation as a healer as well as a preacher provided a certain amount of job security.

These physician-preachers traded recipes for medicines as latter-day cooks would for pumpkin pie. Their knowledge came almost entirely from books and their own experience. Later in the colonial period, some apprenticeship opportunities were available. Paracelsan medicine, with its emphasis on mercurial dosing, gradually made inroads into the older Galenic tradition, a transition Watson delineates very nicely.

The book leaves one wanting to know more about these men, but the available primary sources probably will not answer such questions. We do not know the extent to which the physician-clerics practiced, for example. Cotton Mather is listed, yet it seems probable that he actually practiced very little. Although he wrote a book on medicine that extolled the physician as the best mediator for the spiritual aspects of disease, he called in a physician when members of his own household were ill. Similarly, there may have been other physician-clerics with a professed interest in medicine but no actual practice. Furthermore, this book does not tell us much about how the practice of these men differed from that of contemporary physicians, if at all. Did their clerical training affect their medicinal choices or styles of practice? How did the absence of formally trained physicians and their replacement by the physician-clerics affect the quality of health care for colonial New Englanders? In other words, what difference did these men make?

This book will be of obvious interest to the historian of colonial American medicine. Beyond that, it raises interesting questions for physicians who sometimes wonder how their role crosses that of traditional religious healers in other cultures. The healers Watson describes are fairly close to us in time and culture; that they blended these roles so easily holds valuable clues about the physician's enduring function as a source of comfort, inspiration, and explanation.

Margaret Humphreys, M.D., Ph.D.
Harvard Community Health Plan, Quincy, MA 02169