On September 23, 2026, I sat within the hushed, glass-walled reading room of Yale University’s medical library. Before me lay the brittle, rag-paper pages of The Medical Dissenter, a London journal published in the 1830s. My finger traced the bottom of a page, eventually resting on a headline that seemed to leap across the centuries: “Report from Mrs. Butt to Mr. Hudson.”
The letter was penned by a woman named Jane Butt. It was dated September 23, 1834. I was reading her words exactly 192 years to the day after she had written them. This serendipitous encounter with the past has become a lens through which to view the volatile intersection of public health, institutional authority, and the modern populist movements that are currently reshaping the American healthcare landscape.
A Village Crisis: The Measles Outbreak of 1834
Jane Butt lived in the village of Broughton, a quiet English hamlet that, in the autumn of 1834, found itself in the grip of a measles outbreak. In her letter, Jane provided a harrowing account of the contagion as it swept through the local children. She described the initial infection of one of her own offspring, followed by a tally of 36 other cases within her immediate community.
Her observations were granular and grounded in the anxieties of a parent witnessing an epidemic. She noted that some children suffered from severe lung inflammation—a precursor to the deadly complications that made measles a feared killer in the pre-vaccine era. Ever the observer, she attributed the severity of the symptoms to a “cold east wind,” an environmental theory of disease common in the 19th century. Yet, despite the gravity of the situation, she reported that all 37 children in her cohort survived.
Jane credited these recoveries not to physicians, but to Morison’s pills. James Morison, a merchant devoid of formal medical training, had become a lightning rod for controversy. He championed the use of harsh purgatives, believing they could expel “impure blood” and restore the body’s natural equilibrium. Jane’s devotion was absolute; she administered these pills twice a day, even to a toddler not yet two years old, and provided them to women and their newborns.
The Rise of the Hygeists: A Historical Parallel
Morison’s followers, who branded themselves “Hygeists,” were the medical populists of the 1830s. They viewed established physicians with deep suspicion, attacking the medical profession as a greedy monopoly that “bled and poisoned” its patients—a characterization that, given the state of medicine before the advent of germ theory, was not entirely without merit.
At the time Jane wrote her letter, women were systematically excluded from medical education and were being pushed out of the field of midwifery by the burgeoning professional authority of male doctors. Lacking credentials, women like Jane were silenced in traditional medical discourse. The Hygeist movement offered her something the establishment would not: a platform. She wrote that because “so much [was] said and done to prejudice the public mind against Mr. Morison’s most invaluable medicine,” she felt a moral imperative to speak out.
The Medical Dissenter, the very journal that published Jane’s letter, was not a neutral record. It served as an official London depot for the sale of Morison’s pills. It was a publication defined by its adversarial stance against mainstream science, even going so far as to mock Edward Jenner and his successful vaccination for smallpox, decrying it as a “vaccinic mania.”
The Return of the Measles: A 2026 Reality Check
After transcribing Jane’s story, I pulled out my iPhone and captured the page as a PDF. As a historian of medicine, I have spent my career studying epidemics from the Civil War to the squalor of tenement houses. However, reading Jane’s words felt different, because measles has ceased to be a mere historical curiosity.
In 2026, measles is once again raging in my home state of Pennsylvania. Federal health officials have reported six measles-associated deaths, though the exact toll remains a point of bureaucratic contention. The United States has recorded more than 4,500 cases of the disease this year—the highest number since 1991.
Supporting data from the CDC indicates that public trust in the medical establishment is fracturing. During the last school year, a record 4.2% of kindergartners were exempted from at least one required vaccine. Consequently, the national measles vaccination coverage has slipped to 92.4%, falling below the critical threshold required to maintain herd immunity. In some communities, the vaccination rates are significantly lower, leaving the population vulnerable to outbreaks that were once considered eradicated.
Medical Populism and the MAHA Movement
The current explosion of measles has fundamentally altered my perception of the past. The “Make America Healthy Again” (MAHA) movement, which has gained significant traction in the political sphere, is rooted in the same grievances that fueled the Hygeists nearly two centuries ago.
MAHA is, according to reports, composed largely of women who have followed figures like Robert F. Kennedy Jr. into the political fray. These mothers feel alienated by an institutional medical system that has historically dismissed their concerns, ignored their insights, and treated their fear as irrational. The movement capitalizes on the deep-seated chauvinism of a medical authority that began to consolidate power in the 1830s.
Yet, there is a fundamental irony at play. The act of counting, which Jane performed in her letter, was once the hallmark of an emerging empirical scientific method. Before the professionalization of public health, ordinary people like Jane observed patterns—tracing disease from house to house. This counting was a precursor to modern epidemiology. It was a move toward understanding that disease was not a supernatural judgment on sin, but a measurable, patterned phenomenon.
The Failure of Anecdote: Why the Science Matters
Jane’s method of dosing suffered from a fatal flaw: she failed to account for a control group. She observed that 37 children survived after taking the pills, but she could not know how many would have survived without them. Indeed, most children in the 1830s survived measles regardless of the intervention.
In contrast, the physician Pierre Louis, a contemporary of Jane’s working in Paris, was utilizing the same tool of counting to challenge the efficacy of bloodletting. He asked the crucial scientific question: What happens to comparable patients who are treated differently?
The modern vaccine performs exactly what Jane believed her pills did, but it has undergone rigorous, systematic testing that her remedy never faced. Today’s parents who refuse vaccination are effectively mirroring Jane’s error in reverse: they are discounting a life-saving intervention because, thanks to the success of that very vaccine, measles has become a stranger to them.
Implications: A Call for Inclusive Medicine
The medical populism we see today is often presented as a groundbreaking rebellion, but the history of the 19th century suggests otherwise. Ordinary people have always been involved in the discourse of health, but institutional medical authority has consistently grown in ways that frame their engagement as “dissent.”
Jane Butt could not be heard in the medical circles of 1834. Her gender relegated her to the pages of a fringe publication, and her endorsement of quackery gave her a headline. If the medical establishment of the 19th century had been less exclusionary, and if it had recognized that the insights and fears of ordinary people were a valid part of the conversation, Jane might not have reached for purgative pills. Similarly, if modern medical authorities were more adept at listening, women today might not be turning to pyrotechnic, anti-science platforms to have their voices acknowledged.
When I eventually left the library, passing the portraits of the great men of medicine whose names line the rotunda, I realized that Jane’s name—and the names of thousands of other women who witnessed the history of health from the front lines—would never appear on those walls.
It does not have to remain this way. The future of public health does not depend solely on top-down mandates or the silencing of dissenters. It requires a fundamental shift toward an inclusive practice that validates the role of the ordinary observer. The journey to a healthier society begins not in the clamor of a political rally, but in the quiet, humble observation of a child’s health, just as it did for Jane Butt in 1834.
Jim Downs is the author of "Medicine by the People: How Ordinary People Changed American Healthcare" (W. W. Norton, 2026). He is the Gilder Lehrman-NEH professor of history at Gettysburg College and a visiting faculty fellow at Brown University’s Center for the Study of Race and Ethnicity in America.
