By my count, the word “absurd” appears 36 times in Adam Smith’s Wealth of Nations, but for me the most memorable use of this word is when Smith refers to “the absurd prescriptions” of doctors in Book II, Chapter 3 of his magnum opus. Here, Smith draws a direct analogy between two types of health systems, micro and macro, so to speak: i.e. the health of any given solitary individual (micro) and the financial health of an entire nation (macro):
“The uniform, constant, and uninterrupted effort of every man to better his condition, the principle from which public and national, as well as private opulence is originally derived, is frequently powerful enough to maintain the natural progress of things towards improvement, in spite both of the extravagance of government and of the greatest errors of administration. Like the unknown principle of animal life, it frequently restores health and vigour to the constitution, in spite, not only of the disease, but of the absurd prescriptions of the doctor.” (WN, II.iii.31, p. 343)
What I wish to explore further, however, is the last part of this famous passage. Specifically, when Smith observes that a man might often regain his health in spite “of the absurd prescriptions of the doctor,” is he writing from personal experience? That is the subject of a new paper that I am writing.
In summary, my paper will be structured as a three-act play, with each “act” corresponding in chronological order to a different medical practice that Adam Smith encountered during his lifetime:
- Act I explores one form of quackery that Smith himself fell for during his student years at Balliol College, Oxford: tar water. The young Smith was so sold on this miracle remedy that he recommends it to his mother in a letter dated 2 July 1744 (Corr. 6).
- Act II takes place across the English Channel during an excursion at Louis XV’s royal hunting lodge in Compiègne, France, where Smith’s travel companion and student, the 3d Duke of Buccleuch, contracts a “slight fever.” (Corr. 94) Here, Smith will witness, most likely for the first time, one of the most common medical procedures and “absurd prescriptions” of the time: bloodletting.
- Act III will describe a fatal encounter with 18th-century medicine that Smith witnessed first-hand during his last days in Paris: the sudden and severe ailment of Duke Henry’s younger brother, Hew Campbell Scott, which Smith himself describes as “vomitings” and “Purgings” (Corr. 97), followed by a wide variety of ultimately fruitless prescriptions and medical treatments, including ippecacuana, opium, and rhubarb.
- Lastly, I conclude with an epilogue exploring a Smithian anomaly of sorts. Although Adam Smith defends some forms of aggressive government regulation in Book II of The Wealth of Nations and calls for the provision of universal public education in Book V (a truly original and radical idea at the time!), as late as 1774 he was decidedly pro-market and anti-regulation when it comes to doctors and medicine.
As an aside, what Smith calls the “absurd prescriptions” of doctors has a long and colorful history. See generally Lydia Kang and Nate Pederson’s 2017 book Quackery: A Brief History of the Worst Ways to Cure Everything.
prior probability 