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During the first half of the nineteenth century a major shift occurred in the medical treatment of illness in the United States, as physicians abandoned the use of “heroic” depletive therapies—the pukes and purges made famous in the 1790s by Dr. Benjamin Rush of Philadelphia—in favor of a let-nature-take-its-course approach to most diseases. Standard histories of American medicine have long attributed this shift to new theories and training methods as well as increased competition from homeopaths and botanical doctors. In this book, Catherine L. Thompson challenges that interpretation by emphasizing the role of patients as active participants in their own health care rather than passive objects of medical treatment.

Focusing on Massachusetts, then as now a center of U.S. medical education and practice, Thompson draws on data from patients' journals, medical account ledgers, physicians' daybooks, and court records to link changes in medical treatment to a gradual evolution of patient expectations across varied populations. Specifically, she identifies three developments—the increasing use of cash in medical transactions, growing religious pluralism, and the rise of malpractice suits—as key factors in transforming patients into active medical consumers unwilling to submit to doctors' advice without considering alternatives.

By showing how nineteenth-century patients shaped therapeutic practice “through the medical choices they made or didn't make,” Thompson's study alters our understanding of American medicine in the past and has implications for its present and future.

In this richly illustrated book, Robert Macieski examines Lewis W. Hine's art and advocacy on behalf of child laborers as part of the National Child Labor Committee (NCLC) between 1909 and 1917. A “social photographer”—as he called himself—Hine created images that documented children at work throughout New England, revealing their exploitation in the North as he had for rural working children in the South. Hine staged his images, highlighting particular types of labor in specific places: the “newsies” in Connecticut cities; sardine canners in Eastport, Maine; cranberry pickers in Cape Cod bogs; industrial homeworkers in Boston and Providence; and cotton textile workers throughout the region. His association with the NCLC connected him to a network of local and national reformers, social workers, and child welfare professionals, a broad coalition he supported in their fight to end this unethical labor practice. Macieski also chronicles Hine's efforts to mount major exhibitions that would help move public opinion against child labor.

In Picturing Class, Macieski explores the historical context of Hine's photographs and the social worlds of his subjects. He offers a detailed analysis of many of the images, unearthing the stories behind the creation of these photographs and the lives of their subjects. In telling the story of these photographs, their creation, and their reception, Macieski demonstrates how Hine worked to advance an unvarnished picture of a rapidly changing region and the young workers at the center of this important shift.

For pious converts to Christianity in late eighteenth- and early nineteenth-century New England, all reality was shaped by religious devotion and biblical text. It is therefore not surprising that earnest believers who found themselves marginalized by their race or sex relied on their faith to reconcile the tension between the spiritual experience of rebirth and the social ordeal of exclusion and injustice.

In Piety and Dissent, Eileen Razzari Elrod examines the religious autobiographies of six early Americans who represented various sorts of marginality: John Marrant, Olaudah Equiano, and Jarena Lee, all of African or African American heritage; Samson Occom (Mohegan) and William Apess (Pequot); and Abigail Abbott Bailey, a white woman who was subjected to extreme domestic violence. Through close readings of these personal narratives, Elrod uncovers the complex rhetorical strategies employed by pious outsiders to challenge the particular kinds of oppression each experienced. She identifies recurrent ideals and images drawn from Scripture and Protestant tradition—parables of liberation, rage, justice, and opposition to authority—that allowed them to see resistance as a religious act and, more than that, imbued them with a sense of agency. 

What the life stories of these six individuals reveal, according to Elrod, is that conventional Christianity in early America was not the hegemonic force that church leaders at the time imagined, and that many people since have believed it to be. Nor was there a clear distinction between personal piety and religious, social, and political resistance. To understand fully the role of religion in the early period of American letters, we must rethink some of our most fundamental assumptions about the function of Christian faith in the context of individual lives.

Boston Harbor served as a colonial gateway to the world, witnessed the Boston Tea Party, and helped the community transform itself from an outpost of a few hardy settlers into a bustling metropolis and self-proclaimed hub of the universe. Yet for hundreds of years Boston Harbor was also a cesspool. Long before Bostonians dumped tea into the harbor to protest English taxes, they dumped sewage there. 

As the Boston area grew and prospered, its sewage problems worsened, as did the harbor's health, to the point where in the 1980s it was considered the most polluted harbor in the country and ridiculed as the “harbor of shame.” Then, in one of the most impressive environmental comebacks in American history, Boston Harbor was dramatically cleaned up. All it took was two lawsuits, two courts, dozens of lawyers, the creation of a powerful sewage authority, thousands of workers, millions of labor hours, and billions of dollars. 

Sewage management is rarely as compelling and exciting as higher profile environmental issues such as global climate change, preserving endangered species, or protecting tropical rainforests. But it can be, as Eric Jay Dolin shows in this engaging narrative account. Boston's struggle to deal with its sewage is an epic story of failure and success, replete with colorful characters, political, bureaucratic, and legal twists and turns, engineering feats, and massive amounts of money. In the end, success hinged on the often overlooked yet monumentally important act of responsibly disposing of the waste people produce every day.