Surgeons, Smallpox, and the Poor: A History of Medicine and Social Conditions in Nova Scotia, 1749-1799

Cynthia R. Comacchio is an associate professor of history at Wilfrid
Laurier University and the author of Nations Are Built of Babies: Saving
Ontario’s Mothers and Children.

Although an expanding field, the social history of medicine in Canada is
still in its infancy. Health and medicine were crucial concerns in
colonial society. This meticulous study provides students of the British
colonies, of the Atlantic provinces, and of medical history with a
fascinating account of the interconnections between health, medicine,
and society in the second half of the 18th century.

Five concise and clearly written chapters detail the arrival and
settlement of colonists in the early years; the predominance of military
and naval surgeons between 1749 and 1763; the growing importance of poor
relief as a community measure; the impact of the Loyalists on medicine
and charity; and the state of health and welfare up to the century’s
end. A nine-part appendix provides information on such related topics as
contemporary medications and treatments, legislative acts designed to
address health and welfare concerns, hospital administrators, and causes
of death in the colony. The book also includes maps, tables, and
illustrations.

The wealth of information on smallpox—its incidence and management by
the public, physicians, the military, and the government—is set within
the context of traditional and emergent attitudes toward community care
of the poor and sick. More attention might have been given to women and
children. The author notes that “the regiments sent to Halifax during
the middle years of the eighteenth century were accompanied by a
surprisingly large number of women and children.” Since women and
children, as he also notes, were prominent among the ill and
indigent—a historical situation still largely unexplored—it is a
shame that a chapter was not devoted to their circumstances. Marble has
opened the door for just such a study with his own impressive work.