“No man is an island, entire of itself; every man is a piece of the continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend’s or of thine own were; any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.”
–John Donne, “Meditation XVII”

In the 200 plus years since George Washington’s farewell blandishments against the peril of “foreign entanglements,” we have seen that such entanglements are as difficult to resist as a hurricane or some other comparable force of nature. Nevertheless, in recommending a kind of isolation, our first president touched upon a strain of thought that has been visibly present in all eras of American history down to the present day, from the 17th C vision of the Massachusetts Bay Colony as “The City on the Hill” to the contemporary antiwar and nativist movements. This isolationist temperament is predicated on the complementary notion that the United States enjoys a special destiny, distinct from other societies—a notion often referred to as American Exceptionalism—that derives from its virtue as a democratic experiment.

Like all learned men of the Enlightenment era, the founding fathers were great students of classical history; overwhelmingly, scholarship of this nature led to conclusions that equated expansion through power politics with institutional decay, fruitless internecine strife, and, finally, collapse. The most famous republics in historical literature—Athens, Rome, and Florence—all conformed to such a trajectory. Leaving aside the political expediency of isolation for a young, undeveloped nation of relatively little might, it is possible to see how Washington’s admonition drew on these historical lessons and, further, wed them to a conviction about the importance of national purity to democratic health.

Though the international influence of the United States has not been static since 1796 (indeed, as of March 2008, it appears to have traveled solely in one direction), opposition groups have continually invoked the catch-all of American democratic purity in their arguments against foreign policy initiatives that call for increased association with other nations and cultures. In particular, war and militarism have frequently been seen to expand the power of the executive branch of government at the expense of vital, American civil liberties, and lax immigration policy has been conceived as force of cultural erosion that will hasten the dissolution of national homogeneity necessary to maintain a properly American spirit.

Ignoring the particular moral or practical merits of these kind of arguments with respect to whatever issue was at hand, be it Irish immigration, the Spanish American War, or nuclear disarmament, one may claim that they represent an abiding popular demand that government conform to the principles that inspired the “American experiment” and were codified by its 18th C framers. The American masses, by now extracted from every corner of the globe, appear to have assimilated to the idea that the United States is unique, and regularly testify that her “foreign entaglements” will only drag her down.

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Ring around the rosy
A pocketful of posies
Ashes, ashes
We all fall down!
—trad. English rhyme

The devastation visited upon Europe and Asia by the Black Death of 1347–51 defies the imagination: The death toll from the slaughters and genocides of the 20th C, themselves beyond the realm of the conceivable, pale in proportional comparison to the human casualty count wrought by the plague. Historical estimates vary, due to lack of reliable data, but it is generally agreed that, in Europe, the rate of fatality clocked in at somewhere between thirty and sixty percent of the total population (a decimation three to six times over). Traditional authorities—clerics, kings, and feudal lords—were at a loss for action; given the magnitude of the calamity, it is a fair bet that today’s presidents, parsons, and cable news anchors would manage no better. The Black Death was the end of the world. The Black Death was the cessation of all law, all morality, all justice. The Black Death was the Devil laughing over the corpse of Christendom. The Black Death was why every major poet and playwright down through the Nineteenth century hated, hated, hated doctors.

But just how much of this anti-medicalism was a case of “ears despising tongues for ever, which possessed them with the heaviest sound that ever yet they heard?” That is to say, was there anything about the specific practices of medieval doctors beyond their obvious failure to combat the plague that led people to have such a negative opinion of them?

For starters, the notion of a “bedside manner” was centuries away from development; in fact, a doctor’s outlandish garb (pictured below)—which included a wide-brimmed hat, a beakéd mask, thick black clothes covering all surfaces of the body, all capped by long black overcoat—was designed, in part, to be intimidating so as to better scare off the evil spirits residing in the infected bodies of the sick.

In addition to their formidable uniforms, doctors treated patients with a variety of herbal concoctions that met with different degrees of success. In general, the grab bag of potions and unguents prescribed by apothecaries—including the new and wildly popular distillation from the Orient, liquor—produced better results than the aromatic cures (posies) thought to combat the malignant odors of disease.

In summary, medical philosophy of the time was based on the Greek doctrine of the four humors as well as certain aspects of atropaic folk wisdom, so while some knowledge of medicine and surgery progressed during the era, the fundamental understanding of the human physiology did not. Despite their almost complete ineffectiveness in confronting the plague, doctors escaped the actual persecution and pogroms carried out against many Jews, gypsies, lepers, people with acne, and cats (the usual suspects). Jean de la Bruyere’s dictum—“as long as men are liable to die and are desirous to live, a physician will be made fun of, but he will be well paid”—seems to have held true, but it did no good for the general reputation of medical practitioners.

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