Transcripts For CSPAN3 Book Discussion On Revolutionary Medicine 20140704

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historic building. someone asked me before how i moved from american history to jewish history to jewish women's history and back to colonial american history, and it reminded me what really launched me in my career in history was the trip i took many, many years ago as a freshman in college to the new york city historical society. i was given an assignment to do a paper on loyalists in the american revolution in new york, and, really, to my astonishment, when i went into the society, i asked for some materials, and they handed me a packet of original letters written by loyalists. in those days, no one handed you gloves, that tells you how long ago it's been, and i fell in love, the idea that i had papers in my hands that had endured for hundreds of years was really thrilling to me and started a love affair with primary sources and really the colonial and early national period. i've gone in a round about way, but 40 years later, i was back to working on american colonial history and combining my interest in medicine with the stories of the founders. the literature about america's early leaders continues to proliferate, but instead of the usual emphasis on the political roles of our nation's founders, my book focuses the lens and their experiences with health, illness, and medical treatment. the lives of america's founding fathers and mothers demonstrate that today's preoccupation with good health and illness is not a new one. abigail adams fretted over her family's health, in particular, that of her husband's throughout the american revolution as well as john's days as president. although, ironically, abigail was the far more fragile of the two, and if you have a chance to read the book, you'll see that john was actually quite a hype condolence yak. every cold was death to him, but he lived to the age of 90, a considerable age at the time. thomas jefferson often involved himself in the treatment of ailments that affected his own family and slaves. he professed and practiced a surprisingly modern outlook and a regimen for fostering good health, and he and his contemporaries, abigail and john adams took what was then a controversial step making sure that they and their family members were immunized against smallp smallpox. someone here asked me about revolutionary war medicine. after the continue thenal army was devastated by smallpox in 1776, george washington insisted that all the remaining solders be inoculated. another founding father, benjamin frankly, was a strong and staunch advocate of smallpox inknocklation, and many people don't know he was also a primary initiator of the first voluntary public hospital in america in philadelphia, and the first medical school in america. we all know, i think, famous, all know he was famous for his electrical experiments, and most of us probably know he invented the bifocals, and i've seen sketches that he drew, rather simple, but ingenious. he told his sister that he was tired of taking one glass here to read and one glass there to look at a distance, so he basically glued what we consider glue together the upper and lower to invent bifocals so that he could see without having to change those glasses. he also really went on to conduct medical experiments with electricity. he also tried to treat what we would consider parkinson's disease today, and he used electrical impulses to try to stop what was called pulsy, and he had limited success, but i read just a year or two ago, and i'm sure you're familiar with the fact that many physicians now use electrical brain stimulation to help treat parkinson's disease, so franklin, again, was way ahead of his time, and given the right technology, his idea was something that actually could work. despite differences in personality and political outlook, washington, franklin, adams, jefferson, and james madison all share the revolutionary desire to make fundamental changes in american social and political relationships including the role of government and the lives of individuals, and government's ability to promote general welfare. during the era, many enlightenment inspired leaders felt that medicine was the most highly visible and most heartening index of general improvement. for instance, the french philosopher, voltaire, went so far as to declare there was no happiness possible without good health. you can start to see why health mattered so much to the founders. good health. the founders recognized early on that government had compelling reasons to shoulder some new responsibilities with respect to ensuring the health and well being of its citizenry. for example, on july 16th, 1778, he sign a bill to provide for the relief and maintenance for disabled seamen, creating the united states marine hospital service. it gave rise to a network of hospitals located at ports all across the united states and slowly over the next century, that ultimately evolved into the national public health service. in the beginning, the way it worked -- in the beginning, administered by their employers, sailors paid 20 cents a month out of the wages as their share towards a form of insurance for hospital care. which provided for doctors, room and board, and medicine, and the government underwrote the remaining costs. with the seamen's act for the first time in american history, the federal government mandated and paid for the temporary med cam relief of individuals who couldn't afford their own private care. this created a safety net for thousands of mariners. forward thinking, political men such as adams understood that the failure to address the illnesses of sailors endangered the well being of citizens in all american port cities. adams as well as washington, jefferson, franklin, and madison clearly recognized that the health of the nation was inextricably tied up with the health of individuals. improving general health care and the state of medicine could have far-reaching consequences, positive economic and social consequences, and was therefore beneficial for all americans. the founders were witnesses to the fact that epidemics not only brought personal devastation to individuals, family, and communities, but also played havoc with commerce. although, during their era, public health still remaineded primary a local responsibility. the contemporary, really, the contemporary debate over the federal bill in health care had roots with america's founders. even though the washington's, franklin's, adams', and jefferson's were part of the colonial e lite, none of the founding families were immune to sickness and disease, and concerns over health frequently shaped the trajectory of their daily lives. it's not that obviously we have not eliminated most illnesses today, but it's -- we really have to step back a moment and think about how during the lives of the founders, there were daily, daily, really assaulted by different illnesses and health issues. indeed, really, before the advent of modern antibiotics, one's life could be abruptly shattered by con they onand death and disability from infectious diseases was common place in every ethnic group and class. surgery was especially risky in an era with no reliable aesthetics or antiseptics. for example, sadly, john and abigail's daughter only surviving daughter contracted breast cancer in her 40s. she underwent double that segtmy, hen had a double shot of whisky. she survived the surgery, but the cancer spread throughout her body, and up fortunately, she died, i think she was 49 a year or two after the original operation. just to give you a little idea of the health challenges the founders themselves faced, adam and john -- abigail and john adams were predeceased by four of their six children. franklin only had three children, and he lost a much beloved 4-year-old son to smallp smallpox, which was, at the time, one of the greatest scourges of the age. even given the grim mortality statistics of the day, jefferson suffered what seemed to be disproportioned number of tragedie tragedies. he grieved deeply over the loss of his young life, martha, and death in infancy of four of their six chirp and later loss of an adult daughter only in her mid-20s. only one of the jefferson's children was still alive when jefferson, himself, died. as he wrote to a friend in the 17 80s, and i'm quoting from a letter exactly, i am born to lose everything i love. washington battled a number of serious life threatening illnesses in life, and he was predeceased by his two stepchildren, a favorite nephew, and all his brothers, most of whom died of tuberculosis. his wife, really sadly rivalled jefferson with regard to family loss. by the time martha was only in her mid-20s, her first husband and two of her small children had succumbed to fatal illness. her remaining daughter died as a teenager as a result of an epileptic see sueizure, and her last surviving son died in his late 20 s of typhus contacted in a late war in an army camp. the experiences serve as really extreme, but far from unique reflections of the high rate of mortality among children and young adults at the time. it demonstrates how easily illness could devastate a family. all of them were acutely aware how often during their era life ended tragically early. once martha washington lamented to a niece in a letter, and quoting her exactly, it is the case with all parents that have many children. they lose them as soon as they raise them, generally. the words of john jackson to his sister-in-law, dolly madison, were -- are really a poignant reminder that death and illness were almost a daily occurrence at the time. arriving home late in the fall of 1808 shortly after he lost his wife to disease, he found his children, quote, very ill with a bill fever, when shall sick bs and death seek to terrify and distract me, jackson wrote in dispair. dolly madison, i don't know if people know dolly madison, herself, lost her first husband and a baby in the notorious philadelphia yellow fever epidemic in 1873, and only her and her 2-year-old son survived. really how this group of american founders coped with illness and tragedy and mustered the fortitude to go on with their lives reveals much about their character as well as about early american medical history. i wanted to spend a little time talking to you about what medical theory was like in the time of the founders. medical theory in colonial america had not develop far from that espoused by the greek physician in the second century, and many continue to emphasize that good health was the result of four body humors which included yellow and black vile, blood, and plem. the goal of the cure, so to speak, was the alleviation of the outward signs because they really didn't understand the connection between symptoms and underlying illnesses. in other words, they saw the symptoms as the disease. the major mechanism for coping with illness was blood letting. he recommended ridding the body of the bad humors through taking blood. blood was -- bleeding or blooding was used to relieve a patient of excess blood that contained in their minds disease matter thought to have caused a fever. franklin and jefferson actually were among the first american leader to argue for medical treatment that was based on empirical evidence. jefferson in particular, was not a fan of physicians or certainly not the ones that he thought practiced invasive medicine. this may be aprok full, but the story goes jefferson said when he saw two or three doctors speaking together, he'd look up in the sky to see if there were vultures hovering overhead. no one at the time understood the role of microbes or the diseases were frequently spread, not only through direct physical contact, but also through droplets of the ear results from coughing and sneezing. although, franklin entertained a theory on contagion. franklin wrote a informative essay on colds and how one caught a cold. he understood that, for instance, he was a tremendous advocate of open windows and fresh air, and there's a very amusing story. franklin and adams room together on the way down to the continental congress at one point, and adams recorded in his diary that franklin insisted that the window be open, and ads adams thought that's how you caught a cold. jefferson opened it, adams closed the window. often went on all night. there was a great lecture about the benefits of fresh air, and adams was so bored he fell asleep with the window open, finally. again, they didn't understand germ theory. of course, it was many, many years, well over a century or two before that was accepted, and because of that, in early america, a number of radical therapies and theories thrived. medicine in the 18th century pointed to morbid error, vapors rising from stagnant water or decomposing fillth and rotting garbage as the cause as all common diseases like malaria and yellow fever which we understand today are viral in organism with microbe passed through contaminated food and water or in the case of yellow fever, malaria by infected insects that multiplied in filthy, standing water. i mentioned the famous 1793 yellow fever epidemic in philadelphia. close to 5,000 people died during that epidemic. about 10% of the city's population, and another 20,000 fled. they offered various theories. it was kind of a perfect storm that year for yellow fever, humid summer, tremendous amount of mosquitos, nobody made the connection between the mosquitos and spread of the illness, and one of the major theories behind the cause of the illness was they considered the strong possibility that rotting coffee caused yellow fever, and the leading doctor at the time, dr. benjamin rush, basically, his treatment for yellow fever was bleeding. in tremendous amounts. so while he was very well-intentioned and in many ways a very humane physician, far ahead of his time in many other ways. for instance, here's considered the father of psychiatry in the united states. he was very sympathetic to people with mental illness, but probably hurried many of the victims to their death with the excessive bleeding, which also caused anemia in many parties and other side effects. probably the most effective, advanced so to speak, factor in cloep yal medicine was the introduction of inoculation for smallpox. it was introduced in new england by the famous colonial minister mather along with other doctors who were just coi understand didn'tly john adam's great uncle, and they did not have sterile labs the way we experiment today. the way they experimented was to try inoculation on their own children and families. what inoculation involved was inserting a small portion of live smallpox virus into the skin of the patient, and it was very controversial at the time, so controversial that boilston was threatened with hanging and mathers's house was bombed unsuccessfully by an irate critic, but gradually, it became more accepted. most of america's founders, if not wealthy, they were comfortably off, and they had enough money, really, to afford some of these new treatments. adams, for instance, underwent smallpox inoculation when he was in his 20s. jefferson traveled from virginia to philadelphia at the age of 23 to be inoculated. it was outlawed in virginia at the time, and it signals their forward thinking ideas about health and illness at the time. again, as i mentioned, smallpox was one of the most serious threats to early americans. the widespread outbreaks that ravaged the country between 1775 and 1782 killed more than 100,000 people, and remember, a population was relatively small at the time, and snuffed out many more lives than the british army did during the revolutionary war. with the memory of the revolutionary war, devastation in his mind, really propelled by keen interest in public health, in the beginning of the 19th century, jefferson would play a pivotal role in the american enter duction of the safering more effective, general cow pox seth of vaccination, first enter deuced in england in 1898. jefferson actually worked with doctor benjamin waterhouse in the boston area to provide smallpox inoculation around the country. i don't think people realize that at times, jefferson was a medical practitioner himself. he personally inoculated family members and slaves in virginia to try to prevent the spread of smallpox in his own family, and as president, he work really to deseminate free distribution of the new smallpox matter around the country. you know, jefferson, always the invent e it was difficult to often transfer the cow pox material around the country, so jefferson invented a container that held another container inside it to stay safe, particularly in the humid days in the summer. madison, james madison actually followed in jefferson's footsteps in addressing the threat of smallpox. in 1813 he we want a step beyond jefferson when he signed into law a statute to encourage wider smallpox vaccinations, one. nation's first public health bills. the legislation was aim at regulating the vaccine to protect american citizens from unscrupulous per -- purveyors. this was the first federal law to oversee drug purity with an eye towards consumer protection, and it also gave the president the power to appoint a medical officer who was able to deliver vaccine free around the country, sending free packages of vaccine that weigh under half a ounce free of charge through the united states mail for any interested parties. many of you -- maybe i should move forward with a couple of pictures -- there are many, many portraits of washington who was named america's foundingist father, and he's always depig d picketed as a tall figure, slim, strong muscular my seek. indeed, at over 6 feet tall, he towered over his con temporaries, and by all accounts, he was revered and imposing man who commanded great respect. however, noticeably absent from the paintings are the lightly marked skin, result of smallpox he got as a teenager, the sunken cheeks we do not see here which was the eventually loss of his teeth due to decay, and increasing disability he had with often vague and serious illnesses, bouts with malaria, flu, and intestinal di sen tear. he contracted smallpox. they were hoping the warmer weather would act as a cure for his brother. it did not. washington contract ed small bo, and according to the diary at the time, he was in bed for three week, and he probably experienced the common symptoms of smallpox at the time including raging fever, unquenchable thirst, headache, and back ache, and that would have been followed by that infamous rash, red sores, that rash turns to scabs, and sometimes many. one diary that i looked at from a young man, i believe, who was from rhode island, mentioned that he had 400 scabs he was able to count across his body, but the good point is once you had smallpox, you had a lifelong immunity, so that helped washington when he became the head of the continental army. wash was really very forward thinking, i think, in his ideas about health care and sanitation. his first general order during the revolutionary war was to say the general has nothing more at heart than the health of the troops. smallpox would ignite all up and down the east coast, threatening the continental army, and washington, particularly emphasize cleanliness, ordered officers to pay attention to keeping the men eating clean, and he really was of great concern, smallpox to him, and he wrote in 1775, if we escape the smallpox in this camp and the country around it, it will be miraculous. really, in the spring of 1776, it reeked havoc on the army, and then, again, he insisted that all the soldiers be inoculated, which probably save d the revolutionary army during the war. a direct quote, during the early years of the war, washington wrote to his head of his medical department, we should have more to dread from the smallpox than the sword of the enemy. in april, john adams echoed the thoughts writing to abigail that disease destroyed ten men for us when the sword of the enemy has kill one. probably the little recognized resolution to inoculate the continental forces was probably one of his most important decisions of the war. pardon me for a minute. i don't know if it's the lights, but it is extremely hot in here. i'll move out for a minute. are there any questions while we're up here? >> paid 20 cents a month. was that a week's worth of wage? >> no. it was not that high. they probably had -- no. probably had a couple dollars a month, so it was not insignificant, but it was find. jennifer? i think if i don't sit down, i'm going to pass out. it's so hot up here. >> okay, let me get you a chair. >> okay. well i throw you off terribly for filming if i sit? >> here -- >> can i put her right here? >> no, right where she is. >> okay, all right. okay. >> sorry. i think i'm okay. i'm right by the heater and the light. as i mentioned to you, franklin was behind the first voluntary hospital in america, and he also helped establish the first school there. really, it was the tragic loss of his son, frankie, that really pushed him to be very concern about smallpox inoculation, and franklin was quite well to do. i don't know if you know, but he retired in his early 40s from the lucrative printing business, and as he mentioned to his mother, his mother criticized him, of course, for the early retirement felt he was losing out on making a lot of money, and he wrote back to her saying he'd rather have it say on the grave that he did good than he die rich. so, again, he not only helped -- he paid personally for a pamphlet on funding on directions for smallpox inknocklation, and he was also able to pay for and indeuce local physicians to actually inoculate some of the poor children free in philadelphia because it was quite a cost for the common man. again, frank lin and jefferson knew about medicine as much as any physician in the day. nickname dr. franklin, received a lots of honorary titles including the name of doctor from the school of medicine and corresponded with really hundreds of physicians during his time. again, i think i mentioned to you that franklin was very attuned to specifies of medicine, but p so is jefferson. he was very concern that people resorted to medicine when the best thing would have been to prevent illness. he was a great advocate r exercise, healthy living. he, himself, tried to get eight hours a sleep every day. he would go to sleep as soon as it got dark, and he got up as the first crack of sunlight came through the house, and, again, he was, again, skeptical of physicians, but friendly with a number of physicians who he influenced and, again, when he was in france, he learned about french medicine which he felt was much, much more attuned to the body. his philosophy was the body healed itself as long as physicians did not interfere, and any of you been to monticello, he had an extremely extensive garden, and he actually grew many, many medicinal herbs there, treated his own headaches and that of the families, so his emphasis really was on preventative medicine. in the face of really terrifying ubiquitous threats of diseases of their era such as smallpox, chole cholera, yellow fever, and typhoid, the founders not only act the with personal courage, but admirable self-sacrifice. again, franklin's lifelong effort to reduce incidence of smallpox, forward thinking ideas in the revolution, and when i get to the end, i'll flip through pictures and show them to you, but washington's life, really, illustrates constraints of medicine at the time and lack of knowledge. anybody know how washington died? >> contacted a chill and treated by the best physicians of the day, and they, i believe, blood let him four times, and i believe that probably -- what's the thinking now? >> so washington contracted probably some form of strep throat, and it swelled up, and so he called in -- his wife called in several of the local physicians, and, as you said, they bled him, so he -- first of all, he suffocated basically because his throat swelled up, but more so, he was bled three or four times, and his body went into shock, so something that we would consider easily treatable today, and even in extreme cases, physicians would do track yatmy if a throat swelled to that extent, really ended his life. he was forward thinking on medicine in so many ways, he felt bleeding was positive and encouraged them to continue bleeding him, so i've found it ironic that some of the people most forward thinking clung to blood letting, probably had some kind of a psych logical impact. they thought they were going to be feeling better, so they did feel a little better at the time, and actually, today, there are a couple of examples of bleeding where there are some me call positive outcomes. for example, the fda approved the use of leeches in certain cases, and they call it a medical device, and in certain ways leeches give off a certain chemical to help repair broken blood vessels, and so that, in one sense, they were possibly on to something. it also seems to be mo rat bleeding helps people with metabolic disorders so losing some blood may help people with insulin disorders and things like that, but we're light years ahead of what they were like in colonial times. however, i think if our founding fathers would come back today, dangerous to speculate because i obviously can't know exactly what was going on in their heads, they certainly, i think would look at awe with the medical treatments we have today, but some of the diseases that are so common today, up fortunately, heart disease, diabetes, cancer, while they were not entirely absenced, certainly at their time, they are nothing like the epidemic proportions today, and a lot of that probably has to do with our sedentary lifestyles today, our multiple choices of foods, things that they didn't -- that they didn't contend with at the same time. i also feel -- i'm often asked what they might have thought about obamacare. again, i can't -- i've been chastised for giving the answer at times, but i feel by studying their ideas, i think they were all, again, extremely extord their civic minded. they very much cared about helping their fellow citizens, so i think they would have been pleased with the idea of being able to provide health care for the people, particularly children, but remember, too, they fought a bloody revolution, and i think they would have been apal at the idea of requiring people to buy health insurance. again, that's my opinion only. there are so many things to tell you about them, but, also, i wanted to mention before we close too, that they very much, almost all of them, practiced medicine on some level themselves. it was very common for people to first be treated in the home. even diseases like cancer today, they would have had some initial treatment considered first, and some were quite crazy. forward thinking in so many ways, one of his sisters contracted breast cancer, and they talked about a wooden cone he heard about he felt would be helpful, obviously, couldn't have done anything. sometimes some, again, some of the ideas were crazy, but in many ways, they were very forward thinking. i'll take a minute to go through the slides, and then i'll open it up to questions and answers now that i'm back to normal temperature again. okay. here is a picture of washington with martha and his grandchildren by marriage. as i mentioned to you, first of all, washington, obviously, never fathered any children, and all four of martha's children died young, but her son had been married and had three or four children, and so the washingtons virtually adopted two of those grandparent, which was quite common at the time when mortality rates were so high that other relatives took chirp children in, and so they had a very close relationship. here's a very idealized portrait of washington on the death bed with the grandchildren, martha hovering, and the doctors who probably did more to kill him than cure him at that time. again, a picture of franklin who was so important for many reasons in terms of medicine, one, of course, being his forward thinking ideas on smallpox, but actually the idea that he helped found the first voluntary hospital in america, and he was also a wonderful fundraiser, and he developed the idea of what we now think of as matching funds. he was able to secure private subscriptions for the hospital, and the rest he was able to get the colonial legislature to pie for the remaining funds on the w idea he could raise some voluntarily. kind of a half and half matching fund. also, again, the first medical school in the country. here's his sketch for the bifocal glasses, and he explains to his sister -- oh, he also sends her, i think it's fascinating, sends her a whole bunch of different glasses and he tells her just to work until she finds the one that suits her best, kind of like going to an opt motion today to find the clear es set of glasses. again, john adams also quite advanced, and, oh, i want to interje interject. a story that talks about mortality of the day, john adams was in philadelphia when abigail gave birth to a stillborn baby during the american revolution. i mean, she was not quite on her own. her mother was there, her sisters, and a community of women, but she wrote him to tell him about the stillborn baby, and we have a stereotype of adams as being a difficult man. he may have been at times, but he was very fond of his wife, abigail. as a matter of fact, all their letters to one another are addressed to my dearest friend, and that's how they regarded themselves, and abigail was very devout. she was actually the son of a minister, and she wrote to him and said, you know, unfortunately, this perfect baby was born still born, and -- but she really felt that she used the phrase in the writings that she felt watching over every single person and every sing the act so it was fated in a sense to be this, but sure he would be grateful she was well, his dearest friend, and this, out of the all the letters, and i read thousands and thousands of letters of the founders, this was the most poignant to me. adams wrote back and said, of course, he was so grateful that his dearest friend, her life had been spared, but he wrote something to the effect, i'm paraphrasing, isn't it strange how much one can miss someone they've never met? so about that stillborn baby. here's abigail in their older years, i don't think the most attractive portrait, but there's few of her. she was a very petite, apparently very attractive young lady. thomas jefferson with some of his always studying something. this was interesting to me. these are the instructions for smallpox inoculation, cow inoculation, with the exact instructions. again, james madison, dolly madison, and, again, most people are not aware what a tragic life she led before she married james madson. her husband, her child, her al fever in one fell swoop. and that's it. i'll give you a little time. i apologize for my little heat spell in the middle. [ applause ] but i think we've got some good time for questions. sorry? oh, the mike will go. >> it was illegal in some states like virginia. i'm assuming there was a reason. what was the success rate or failure rate, death rate of that procedure when it began? >> the success or failure rate of the small pox inoculation using the live human matter was between one in five deaths to 100. fairly high, but again, it was a devastating disease. in most cases, it was on the lower side. john adams, again, was considered very radical at the time to have the inoculation. he had just become engaged to abigail. wrote a whole series of letters, some of them very amusing how it worked. what they would do is take a little cut in the skin and put the live matter in and then they would put some cotton over it and bandage it up. they knew there was some contagion period. they weren't quite sure how long that was, but most these people who went to small pox hospitals the way john adams did, and that was really just going to someone's house. he went with his brother and several friends. they were kind of confined to quarters for a week to ten days. he wrote letters to abigail at the time. they understood to some level contagion because all the letters he wrote her were double smoked. that means they tried to at least rid them of possible contagious matters. yet on the other hand, abigail adams and her children weren't inoculated until after the declaration of independence. she had gone out to read and she was out in public when she was still contagious. obviously, there was not a clear understanding what the incubation period was. >> you had mentioned dr. shipton. any relation to benedict arnold wife's family? >> it's shipton. i think her name was shifton so i don't think it's the same family, but not that i know of. >> did barbers play a particular role as surgeons at this time? >> when you say barbers, you don't mean necessarily barbers. they were called barbers, people who set bones, things like that, is that what you meant? >> that was part of their training, not just cutting hair. >> right, right. so doctors and surgeons were separate. physicians were a little, considered a little higher level. there were no regulations for physicians at the time. so you didn't have to go through either a formal training. actually, some people who had more practical apprenticeship were probably better physicians than those who actually went through universities, particularly in europe because most of that medicine was theoretical. they may have studied a lot of ideas about medicine but never had ever treated a patient. some like these barbers, we would consider something a physician would do today, but they would do some surgery, amputations and setting bones. they were considered physicians. >> when did we have the first medical education university in this country? >> out of the university of pennsylvania. in philadelphia. then became part of columbia university. until then and even after then, many, many physicians would go to europe for their advanced medical training. berlin, edinbourgh were all considered top teaching medical schools. >> were there any stories from the british side about outbreaks? >> british had very, a very small percentage of small pox. anybody want to venture why the british would have less of an outbreak of small pox than the americans? >> more exposure? >> more exposure, right. as we said before, once you were exposed then you were generally -- i'm sure there were some exceptions -- but generally immune. many recruits to the continental army were young men from rural areas who never had any exposure to small pox and they just fell sick almost immediately. it's not that no one contracted small pox but many developed their immunity back in europe. anyone else? thank you and thanks for being patient. you are watching american history tv. all weekend, every weekend on cspan3. to join the conversation, like us on facebook at c-spanhistory. >> now to put that in perspective, vanderbilt is in our peer group and they're at $6 billion. harvard represents the pinnacle of the nation's endowment at 34 billion and they have a $6 billion campaign going on right now, just to put it in perspective. if we are going to aspire to have that type of excellence, those types of facilities to produce that type of excellence in our campus we have to have that type of investment. it's my responsibility now as interim president and the 17th president's responsibility when named to expand those revenue streams. >> dr. wayne a.i. frederick on the challenges facing the predominantly black university sunday night at 8:00 eastern and pacific on c-span's q&a. remind your children in this bicentennial year when we are the first generation of americans to have experienced attacks on the continental united states, we are the first generation of americans to have felt what it was like to have our government buildings attacked. remind your children freedom is not free and that our country's greatness is found in one another. that's what the star-spangled banner is about. that's what this commemoration year is about. to tell that story and to lift every voice and to sing. >> the 200th anniversary of the star-spangled banner, tonight at 8:30 eastern. saturday night at 8:00 visit the college classroom of professor joel howell as he talked about u.s. government human radiation experiments conducted after world war ii through the cold war. and a preview of presidential historian manuscript on george h.w. bush and the peaceful end to the cold war. i tell this story about how i, whose every aspect of whose identity is in one way or another a threat to israel. my gender is male. my religion is muslim. my citizenship is american, my culture is middle eastern. everything about me sends off all the warning signals for israel. so the experience of an iranian american single man trying to get through bengourian airport in the 20th century is a reminder despite how globalization has brought us closer and diminished the boundaries that separate us as nations, ethnicities, people, as cultures, despite all of that, all you've got to do is spend a few minutes trying to get through the airport to remember those divisions, those things that separate us are still very much alive. >> best-selling author and professor reza aslan will take your phone calls, e-mails and tweets on islamic fundamentalism, the war on terror and life in the middle east sunday noon eastern. each week american artifacts takes viewers into archives and museums. next we visit the national museum of american history in washington, d.c. for a tour of their centerpiece exhibit of the star-spangled banner. it's the 200th

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