The Course of God’s Providence: Religion, Health, and the Body in Early America
To read Philippa Koch’s The Course of God’s Providence in 2021 is to realize that the gap between the world of the eighteenth century and that of the twenty-first century is much smaller in some ways than a reader might have believed had the book been published only two years previously. Prior to the COVID-19 pandemic, the past two centuries of advance in medicine and health care seemed to be fostering a steady increase in human control over the epidemic diseases that wrought frequent cycles of havoc in social life before the development of antibiotics and vaccines. Historians of earlier generations frequently explained religious belief in general, as well as specific belief in the concept of providence, as a symptom of previous generations’ lack of control over their disease environment. In that context, religious belief helped people make sense of the irrational suffering and death that so often wrenched apart families and sometimes whole communities. The concept of providence has frequently been cast as a peculiar Calvinistic version of belief, a fatalistic notion that God has ordained a predetermined sequence of causes and consequences that move inexorably forward to some inscrutable, divinely ordained end. It takes only a short step from this characterization of providence to treat it as a tool of social control—a means for religious spokespersons of that inscrutable deity to prop up their communal and moral authority to secure and enforce standards of belief and behavior. Explained in these terms, providence has often functioned as a set piece in a narrative of modernity’s disenchantment of the world, an increasingly outdated notion which once provided a framework of “otherworldly or salvific significance” for their experiences, but increasingly fell into disuse with the discoveries of science, medicine, and reason.
Koch notes that the narrative of disenchantment itself has become badly frayed by the stubborn persistence of religious belief into the contemporary world and by the growing recognition of science’s own limitations. Her analysis of providential thought in the eighteenth century challenges the common assertion that scientific discoveries of that era ever seriously diminished early Americans’ belief in providence or their embrace of the doctrine for comfort and meaning in the face of illness and suffering. Furthermore, Koch argues, belief in providence extended well beyond Calvinist Puritans and their heirs to encompass most Protestants of the period. A broad range of Protestant confessions shared a very similar set of beliefs and practices about divine governance of human events and affairs. This belief persisted well into the nineteenth century, providing not only a basis for pastoral counsel but a theistic framework for scientific discovery and advancements in medicine. Pastors and religious leaders across the colonies drew upon rich and deep repositories of Christian providential thought to provide counsel, encouragement, comfort, and hope to the bereaved, those afflicted by illness, or those overtaken by accident or calamity. Lay diarists and letter writers listened and learned, applying the lessons of sermons and devotional manuals to their own circumstances and those of friends and family members in sensitive and perceptive ways. Early Americans across a broad confessional spectrum learned to frame their everyday experiences in providential terms.
Koch organizes her argument into five chapters. In the first two, she traces the pastoral dissemination and lay reception of pastoral teaching and application of the doctrine of providence. Two pastoral manuals, both widely used in early America, form the core source material of her first chapter. Cotton Mather’s Wholesome Words represents the Puritan and Reformed view traditionally thought to dominate providential thought. The Lutheran Pietist Samuel Urlsperger’s The Health of the Sick and the Life of the Dying offers a non-Calvinist perspective that, in Koch’s analysis, harmonizes remarkably not only with Mather’s, but also with those of influential figures from other traditions such as the Methodist John Wesley. Her second chapter explores lay writings on illness and suffering in manuscript sources such as journals, letters, and personal narratives. The evidence demonstrates how people absorbed providential ideas from published sources and sermons and applied the lessons to their own personal experiences.
Koch’s next three chapters explore how these lessons on providence that Protestants had so thoroughly absorbed came to frame the social and intellectual imaginary in which they engaged science, medicine, and philosophy in their pursuit of benevolent activities concerning health and social welfare. The third chapter demonstrates how Calvinists, Wesleyans, and Pietists all engaged scientific and medical thought and practice, asserting in various ways the importance of the soul and spiritual life in human health and flourishing. They selectively embraced medical advances such as smallpox inoculation as providential means to alleviate sickness and affliction while supporting Christian evangelization. Her fourth chapter explores how the language of providence intertwined with that of enlightened benevolence and nationalism in the period of the Early Republic, giving transcendent meaning not only to the application of medical treatment during public health crises such as Philadelphia’s yellow fever epidemic of 1793 but also providing providential comfort when treatment reached its limits. It also informed powerful nationalist impulses, often expressed through missionary activity at home and abroad, as well as reform. The final chapter turns to the expression of providential thought in eighteenth-century writing, debate, and medical practice on maternity, a powerful subject of scientific and medical inquiry as well as a central concept of emerging republican ideology. Here again, Koch demonstrates how thoroughly the concept of providence shaped debates over midwifery versus physician attendance at childbirth, lactation, breastfeeding, and infant care, and the larger providential purpose of motherhood in the cultivation of “virtue, loyalty, and civilization.”
The Course of God’s Providence is a model of thorough scholarship crafted by a historian practiced in the art of identifying long-neglected sources of eighteenth-century thought and experience, listening carefully and sensitively to what they have to say about their thoughts and experiences, and organizing her findings into a faithful, persuasive exposition. Philippa Koch not only teaches her readers something new and profound about the mental and spiritual world of early America, but she also deals a crucial blow to the claim that eighteenth-scientific thought mounted any serious challenge to providential belief in that period. In fact, she demonstrates exactly the opposite. In her telling, the eighteenth-century providential imaginary thoroughly absorbed and shaped scientific endeavors in the fields she explores.
The Course of God’s Providence also serves as a powerful reminder of the ongoing relevance of providential thought to twenty-first century experience. The yellow fever epidemic of 1793 turns out not to be so foreign to modern experience. If anything, the limits of scientific control are more visible and more globally consequential in the age of SARS-CoV-2 than ever before. To be sure, any effort to explain such events in providential terms is no less vexed now than were similar attempts in the eighteenth century. Even so, the pastoral dimension of providential thought is as capable of providing comfort to twenty-first century believers as to their eighteenth-century forebears. Eighteenth-century providentialists such as Cotton Mather and Samuel Urlsperger still have something to teach us today.
Tim, have you read Providence and the Invention of American History, by Sarah Koenig? It would form a really interesting sequel to Koch’s argument. My reading of 17th century providentialist theology doesn’t seem to suggest big differences across confessional line either. I’m really interested in the application of providence to natural philosophy, including medicine. Thank you for the review.