THOMAS JEFFERSON AND A FEW OF HIS PHYSICIAN FRIENDS OSCAR A. THORUP JR CHARLOrESVILXLE VA.

I will briefly review some of Thomas Jefferson's correspondence with three physician friends. The letters exchanged with Dr. Benjamin Waterhouse are emphasized, as they provide unique insights into several aspects of Jefferson's philosophy ... especially in the latter part of his life. On December 1, 1800, Jefferson received a letter from Waterhouse that began a correspondence which continued until Jefferson's death in 1826. "Cambridge Mass. Dec. 1. 1800 Sir Having long regarded Mr. Jefferson as one of our most distinguished patriots & philosophers, I conceived that a work which had for its' end the good of the community would not be unacceptable to him.-Under that impression I have here sent him "A Prospective of Exterminating the Small-pox" and with the utmost consideration and respect his very humble serv't Benj.n Waterhouse Hon'b Thomas Jefferson, (1)" The two men did not actually meet until nearly 26 years later. Benjamin Waterhouse was appointed the first Professor of Medicine at Harvard College in 1783. He was widely acknowledged to be the best educated physician in America but many resented the appointment of this outsider to the faculty. He was often overbearing and soon demonstrated a lamentable lack of tact in dealing with his colleagues on the faculty and in practice. As a Jeffersonian democrat living in the stronghold of the high Federalists in their waning days, he soon found himself engaged in acrimonious political, religious, and scientific debate. In time he became ever more quarrelsome, always ready to attack his enemies in the public media . . . as was the habit of the day (2, 3). But he was intelligent and had a deep devotion to medicine. He had followed Jenner's work carefully and was probably the first to obtain the cow-pox virus and begin vaccination in the United States. To extend the benefits of vaccination to the South and knowing Jefferson's interest in science, he had written to the Vice-President. Jefferson was aware of Jenner's work as well as that of Waterhouse and he wrote (in part) on Christmas day as follows: 138

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"Washington Dec. 25. 1800 Sir '... Every friend of humanity must look with pleasure on this discovery, by which one more evil is withdrawn from the condition of man; and must contemplate the possibility, that future improvements and discoveries, may still more lessen the catalogue of evils. In this line of proceeding you deserve well of your country; and I pray you to accept my portion of the tribute to you (4).' Jefferson helped him in his vaccination efforts by introducing physicians in this area to the process and providing the initial conduit by which the vaccine could be obtained. He made significant suggestions to Waterhouse on the conditions necessary to maintain the vaccine during its transport and on timing the harvest of the virus. Controversy swirled constantly about Waterhouse and appears to have coalesced over his efforts to establish the vaccination; some denied its efficacy, others questioned his motives, some churches even opposed the use of animal material in humans (5, 6). Ultimately, vaccination was established but the efforts of his enemies remained undiminished. Dr. Benjamin Rush urged Jefferson to appoint Waterhouse to the Marine Hospital in Charlestown in 1807 and the appointment brought on a storm of protests. Jefferson wrote to Rush about the incident:

"Washington Jan. 3. 08 Dear Sir Dr. Waterhouse has been appointed to the Marine Hospital in Boston as you wished. It was a just-tho small return for his merit in introducing the vaccination earlier than we would have had it. His appointment makes some noise there and here, being unacceptable to some; but I believe that schismatic divisions in the medical fraternity are at the bottom of it." Here Jefferson makes one of those statements for which he is so greatly admired: "My usage is to make the best appointment my information and judgement enable me to do, and then fold myself up in the mantle of conscience, and abide unmoved the peltings of the storm." (7) The intense hostility of the physicians on the faculty, and of the majority of those in Boston, toward Waterhouse continued to grow and some sought other ways in which to attack him. Alarmed that his old enemies were once again plotting against his position at the Marine Hospital, Waterhouse wrote to Jefferson of his early successes at the hospital and then continued as follows:

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"Cambridge 21 June 1809 Sir. 'I was never so anxiously situated; ... because I fear an avenue, may possibly be opened through which my most powerful enemies ... may effect the ruin of me & my family-not as regards the hospital merely, but through that as it regards my professorship in the University.' (8) President James Madison, who succeeded Jefferson in 1809, was, indeed, led to believe that some of the actions taken by Waterhouse in the job were improper. Waterhouse rejected the accusations and refused a chance to resign. In July 1809, he was removed from office because his activities "rendered it impracticable to continue him in the public service." (9) In July 1810, Harvard moved its medical school to Boston. Waterhouse had opposed the move but reluctantly agreed to teach in Boston. He was soon again publicly engaged in charge and countercharge with other members of the faculty. The Corporation finally decided that the harmony of the school required his removal from his Hersey Professorship and from the faculty (10). His enemies had won. Benjamin Rush earned his undergraduate degree from Princeton College before undertaking the study of medicine at the University of Edinburgh. He had broad interests in agriculture, medicine, education, political science, theology, and criminology. A biographer wrote; "He mixed in the most important councils of the nation and his talents as a writer were faithfully employed in the acquisition of our liberty." (11) Their similar interests and efforts on behalf of the revolution brought Rush and Jefferson together in Philadelphia and their friendship lasted until Rush's death in 1813 (12). Rush met Waterhouse through John Adams and the two physicians had become fast friends. And, like Waterhouse, Rush gathered many enemies as the result of his writings and strongly held medical and political positions. The perceptive John Adams compared the two friends in the course of a long letter to Waterhouse: January 16, 1813 Dear Sir, . . . "Your enemies, are in their hearts Rush's Enemies and for the same Reasons, medical and political. But you are both too fluent (& dextrous (sic)) with your Pens. They dare not attack you openly. ... " (13) The dismissal of Waterhouse from the Harvard faculty, after 29 years, prompted Adams to write to Rush, in part, as follows:

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December 21, 1812, Quincy Dear Sir, ... "Can nothing be done to save an amiable Family and a Man of first rate Merit from oppression, from becoming a sacrifice to Tory Vengeance and professional envy?" (14) Finally, John Adams, Benjamin Rush, and others who felt that Waterhouse had been treated unjustly, appear to have succeeded in convincing Madison of their position. He was appointed to another position of "public trust"; that of Medical Superintendent for the Military Stations in New England in June 1813 (15). He maintained that position, while living at home, until honorably discharged June 1, 1821 (16, 17). I have found no evidence that Jefferson believed the charges of wrongdoing lodged against Waterhouse. His thoughts were well expressed in the following letter: "Monticello, 13 October 1815 Dear Sir I was highly gratified with the receipt of your letter ... and by the evidence it furnished me of your bearing up with firmness and perseverance against the persecutions of your enemies, religious, political, and professional ... none of them pardon the proof you have established that the condition of man may be ameliorated .... In lieu of these enmities you have the blessings of all the friends of human happiness, for the great peril from which they are rescued." (18) Mr. Jefferson and Mr. Adams had a falling out after Jefferson's election to the Presidency at the time when Adams was standing for re-election and Jefferson was his sitting Vice-President. All communication between them had ceased by late in 1804. Rush felt that a reactivation of an exchange of letters between these old friends would be a comfort to them and a great boon to history. He was anxious to bring them together again and repeatedly appealed to each without success. Well aware of Rush's continuing efforts to restore a cordial relationship between himself and Mr. Adams, Jefferson wrote to Rush of the results of an unplanned visit by two of his neighbors to Quincy where they had seen Mr. Adams. They reported that Adams had commented on the unprincipled licentiousness of the press against Jefferson and had then added the comment: "I always loved Jefferson and still love him". Jefferson then continued his letter: Poplar Forest December 5, 1811 '... this is enough for me. I only needed this knolege (sic) to revive towards him all the affections of the most cordial moments of our lives. why should we be dissocialized by mere differences of

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opinion, in politics, in religion, in philosophy, or anything else. His opinions are as honestly formed as my own, our different views of the same subject are the result of a difference in our organization & experience....' (19) Dr. Rush immediately wrote to Adams of Jefferson's letter and included those passages from the letter with the kindest expressions of regard (20). This time Rush was successful. Mr. Jefferson received a letter from John Adams dated January 1, 1812 and the old correspondence that had ceased as of Nov. 19, 1804, was revived. The continuing exchange of letters between these old patriots has given history insights that only they could have provided (21). Dr. Benjamin Rush, the major go-between, died on April 19, 1813 (22). Among the many physicians with whom Jefferson corresponded was Dr. Sam Brown . .. who lived for a period in Natchez. Dr. Brown was born and raised in Virginia and received his BA degree from Dickinson College and studied Medicine with Benjamin Rush before going to Aberdeen where he received his MD. degree (23). Interested in horticulture, Dr. Brown would often send Jefferson seeds to test in the soil of Monticello. One such seed was from a plant known in Natchez as the poison plant, which prompted the following reply from Mr. Jefferson: "Monticello, July 14, 1813 Dear Sir, ... I have so many grandchildren and others who might be endangered by the poison plant that I think the risk overbalances the curiosity of trying it. The most elegant thing of that kind is a preparation of the Jamestown weed ... invented by the French in the time of Robespierre. Every man of firmness carried it constantly in his pocket to anticipate the guillotine. It brings on the sleep of death as quietly as fatigue does ordinary sleep, without the least struggle or motion. Condorcet, who had recourse to it, was found lifeless on his bed a few minutes after his landlady had left him there, and even the slipper which she had observed half suspended on his foot, was not shaken off." Mr Jefferson concluded; . .. Could such a medicament be restrained to self administration, it ought not be kept secret. There are ills in life as desperate . . . as (they are) intolerable, to which it would be the rational relief, e.g., the inveterate cancer." (24) Throughout his life, Jefferson was accused by a variety of religious leaders of being atheist, deist, or agnostic. But Jefferson, while anticlerical and antidoctrinal, regarded himself as a Christian (25).

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He rarely shared his ideas of religion, but in response to a letter from Waterhouse regarding the religious problems in the North Eastern states, (26) he was prompted to confide his beliefs in his return letter as follows: "Monticello June 26, 22 Dear Sir, ... The doctrines of Jesus are simple, and tend all to the happiness of man. 1. That there is only one God, and He is all perfect. 2. That there is a future state of rewards & punishments. 3. That to love God with all thy heart and thy neighbor as thyself, is the sum of religion...." (27) On 8 July, 1822, Waterhouse asked permission to publish his letter, (28) but Jefferson wrote: "Monticello July 19, 22 Dear Sir. .... No, my dear Sir, not for the world. Into what a nest of hornets would it thrust my head? ... Don Quixote undertook to redress the bodily wrongs of the world, but the redressment of the mental vagaries would be an enterprise more than Quixotic ... I should as soon try to bring .... Bedlam to sound understanding .... I am old and tranquility is now my summum bonum...." (29) As he grew older, Jefferson's letters contained frequent references to the aging process and to senility in particular. A note from Waterhouse in 1825, regarding the state of John Adams' health, prompted several additional comments on long life and dotage. Eighteen months before his own death, Jefferson wrote: "Monticello, January 8, 1825 Dear Sir ..... Your account of Mr. Adam's situation afflicts me deeply, and I join with him in the question" Is existence, such as either his or mine, worth anxiety for its continuance? "The value of life is equivocal with all its faculties and elements of enjoyment in full vigor. But when they have been withdrawn from us by age, the balance of pain predominates unequivocally.... The most undesirable of all things is a long life, and there is nothing I have ever dreaded so much. Altho subject to occasional indispositions, my health is too good generally not to give me fear and alarm on that subject .. Still however a start or stumble of my horse or some one of the accidents which constantly beset us, may cut short life and relieve me from the evil of dotage. Come when it will, it will find me neither unready nor unwilling." (30)

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John Adams and Thomas Jefferson both died July 4, 1826 .... on the 50th anniversary of the signing of the Declaration of Independence. REFERENCES 1. Thomas Jefferson Papers, Library of Congress Microfilm Reel 22, Benjamin Waterhouse, Cambridge Mass., to Thomas Jefferson, Washington D.C., 1 December 1800. 2. Dictionary of American Biography Vol. 10 pp 529-532, Edited by Dumas Malone, Charles Schribner's Sons, N.Y. 3. Trent JC., "Benjamin Waterhouse (1754-1846)" J. Hist. Med. July 1946. p 361. 4. Thomas Jefferson Papers, L.C. Microfilm Reel 22, Thomas Jefferson, Washington D.C., to Benjamin Waterhouse, Cambridge Massachusetts. December 25, 1800. 5. Blake, JB "Benjamin Waterhouse and the Introduction of Vaccination; a Reappraisal." Philadelphia, University of Pennsylvania Press, 1957. 6. Trent JC., "Benjamin Waterhouse (1754-1846) J. Hist. Med. July 1946. p. 362. 7. Thomas Jefferson Papers. L.C. Microfilm Reel 40, Thomas Jefferson, Washington D.C., to Benjamin Rush, Philadelphia, Pennsylvania. January 3, 1808. 8. Thomas Jefferson Papers. L.C. Microfilm Reel 43, Benjamin Waterhouse, Cambridge, to Thomas Jefferson, Monticello, June 21, 1809. 9. Blake, JB. "Benjamin Waterhouse, Harvard's First Professor of Physic" J. Medical Education 33: 771, 1958 p 777. 10. Ibid. p 779. 11. Sanderson, J. "Biography of the Signers to the Declaration of Independence" Pomeroy RW, Philadelphia. 1820-1827, Vol. IV, pp 279-280. 12. Dictionary of American Biography, Vol. 8, pp 227-231, Editor Dumas Malone, Charles Schribner's Sons N.Y. 13. "Statesman and Friend" Edited by Ford, WC. Little, Brown, and Co. Boston 1927, John Adams, Quincy to Benjamin Waterhouse, Cambridge. January 16, 1813. 14. John Adams to Benjamin Rush Dec. 21, 1812 in "Old Family Letters: Copied from the Originals for Alexander Biddle." Series A. pp 325-326. JB Lippincott Co., Philadelphia. 1812. 15. Blake, JB "Benjamin Waterhouse, Harvard's First Professor of Physic" J. Medical Education 33: 779-780, 1958. 16. Thurm, RH "Dr. Waterhouse and the Boston Marine Hospital" Ann. Int. Med. 76: 801-813, 1972. 17. Papers of James Madison Vol. 1 Edited by Rutland, RA et al Univ. Virginia Press pp 194-196 Elbridge Gerry, Cambridge to James Madison, Washington D.C. 20 May 1809. 18. Thomas Jefferson Papers L.C. Microfilm Reel 48, Thomas Jefferson, Monticello, to Benjamin Waterhouse, Cambridge, October 13, 1815. 19. Thomas Jefferson Papers. L.C. Microfilm Reel 45. Thomas Jefferson, Poplar Forest, to Benjamin Rush, Philadelphia, Dec. 5, 1811. 20. Thomas Jefferson Papers. L.C. Microfilm Reel 45. Benjamin Rush, Philadelphia, to Thomas Jefferson, Monticello, December 17, 1811. 21. The Adams-Jefferson Letters. Vol. 2, pp 283-289 Edited by Cappon, LJ The University of North Carolina Press 1959. 22. The Adams-Jefferson Letters Edited by Cappon, LJ., The University of North Carolina Press, 1959 pp 323, 326. 23. Dictionary of American Biography. Vol. 2, Edited by Johnson A., and Malone D., Charles Scribner's Sons NY. pp 152-153. 24. Thomas Jefferson Papers. L.C. Microfilm Reel 46. Thomas Jefferson, Monticello, to Sam Brown, Natchez, July 14, 1813.

145 25. Malone, D., "Jefferson and His Time. Vol. 6 The Sage of Monticello" Little, Brown and Company 1881 p. 199 26. Thomas Jefferson Papers. L.C. Microfilm Reel 53. Benjamin Waterhouse, Cambridge, to Thomas Jefferson, Monticello, June 8, 1822. 27. Thomas Jefferson Papers. L.C. Microfilm Reel 53. Thomas Jefferson, Monticello, to Benjamin Waterhouse, Cambridge, June 26, 1822. 28. Thomas Jefferson Papers. L.C. Microfilm Reel 53. Benjamin Waterhouse, Cambridge, to Thomas Jefferson, Monticello, July 8, 1822. 29. Thomas Jefferson Papers. L.C. Microfilm Reel 53. Thomas Jefferson, Monticello, to Benjamin Waterhouse, Cambridge, July 19, 1822. 30. Thomas Jefferson Papers. L.C. Microfilm Reel 54. Thomas Jefferson, Monticello, to Benjamin Waterhouse, Cambridge, January 8, 1825. DISCUSSION

Richardson, Richmond: Oscar, Jamestown weed seems a desirable drug as age and its attendant woes loom closer, if it indeed meets Mr. Jefferson's claim that "it brings on the sleep of death as quietly as fatigue does ordinary sleep, without the least struggle or motion." Do you have any knowledge of its pharmacology or even its name? Oscar A. Thorup Jr.: I understand that it is a strong concentration of the lethiferous principle of the Jamestown weed, Datura-Stramonium. It contains atropine-like substances.

Thomas Jefferson and a few of his physician friends.

THOMAS JEFFERSON AND A FEW OF HIS PHYSICIAN FRIENDS OSCAR A. THORUP JR CHARLOrESVILXLE VA. I will briefly review some of Thomas Jefferson's correspon...
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