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Community Health and Wellness

Principles of primary health care

6E

Jill Clendon & Ailsa Munns

2
Table of Contents

Cover image

Title Page

Copyright

Dedication

Foreword

Preface

About the Authors

Acknowledgements

Reviewers

Section 1 Principles of primary health care

3
Introduction

Introduction to the section

Chapter 1 Fundamentals of creating and maintaining a healthy

community

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

Chapter 2 Healthy policies for healthy communities

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

Chapter 3 Communities of place

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

4
Section 2 Primary health care in practice

Introduction

Introduction to the section

Chapter 4 Primary health care in practice

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

Chapter 5 Assessing the community

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

Chapter 6 Planning for intervention

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

5
 References

Section 3 Health and wellness throughout the

lifespan

Introduction

Introduction to the section

Chapter 7 The early years

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

Reflective Questions: How would I use this knowledge in practice?

References

Chapter 8 Transitions to adulthood and beyond

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

6
Section 4 Evidence to support primary health
care

Introduction

Introduction to the section

Chapter 9 Inclusive communities

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

Chapter 10 Inclusive research

Introduction

Conclusion

Reflective Questions: How would I use this knowledge in practice?

References

Appendix A The McMurray Community Assessment Framework

Appendix B Calgary Family Assessment Model

7
Appendix C HEEADSSS Assessment Tool for use with Adolescents

The Tool

References

Index

8
Copyright

Elsevier Australia. ACN 001 002 357

(a division of Reed International Books Australia Pty Ltd)
Tower 1, 475 Victoria Avenue, Chatswood, NSW 2067

This edition © 2019 Elsevier Australia.

All rights reserved. No part of this publication may be reproduced or

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This book and the individual contributions contained in it are

protected under copyright by the Publisher (other than as may be
noted herein).

ISBN: 978-0-7295-4274-6

Notice
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any information,

9
methods, compounds or experiments described herein. Because of
rapid advances in the medical sciences, in particular, independent
verifi cation of diagnoses and drug dosages should be made. To the
fullest extent of the law, no responsibility is assumed by Elsevier,
authors, editors or contributors for any injury and/or damage to
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National Library of Australia Cataloguing-in-Publication Data

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Printed in China by 1010 Printing International Ltd

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Dedication

This book is dedicated to all community health

practitioners; for the visionary contribution they make to the
health and wellbeing of people, families and communities.

Jill Clendon, Ailsa Munns

September 2018

11
Foreword
This text is based on the foundational principles of primary health
care, which guide the reader to consider the health of individuals and
populations in their personal, family and community environments.
Health professionals engaging with communities use these
principles as a basis for implementing a range of strategies to assist
people in their journey towards better health. The primary health
care mindset recognises that health is socially determined, and the
book unpacks the social and structural elements that sometimes
enable and at other times compromise health. For the learner, this
edition of the text has been streamlined on the premise that evidence
for practice is increasingly accessible on the internet and through
other electronic means of sharing information. The text therefore
provides not only a guided tour through the most important
elements of health care knowledge for practice, but also inspires the
reader's appetite for further learning by signposting other sources of
knowledge. Together this information can be used to tailor practice
strategies to individual ages and stages in the context of community
resources and needs. A strength of the text lies in the practice
applications of knowledge through case studies, while drawing
attention to the fundamental points contained in each chapter, and
encouraging the reader to reflect on situations, needs, goals and
strategies.
Our trans-Tasman societies are multilayered and the authors
outline a broad range of caring approaches that can be adapted for
different populations and social geographies. Community health and
wellness depends on comprehensive assessment, and this is
addressed extensively as the first step in any of these approaches.

12
Moving forward from a base of assessment data relies on
understanding features of the health care system as well as
government policies, which are constantly changing. These features
and policies are presented as a point of departure for planning
inclusive, equitable, adequate, culturally appropriate and accessible
pathways to health, despite occasional roadblocks. By situating this
information in the context of different types of communities and
different locations for care, the authors have attempted to instil a
sense that health goals can be achieved, and that by working in
partnership with nurses and other health professionals, people can
be empowered to change unhealthful lifestyles. Another notable
feature of the text is its focus on evidence-based practice, including
evaluation of current practice. The authors underline the need for all
of us to help generate new evidence to fill the gaps in our knowledge.
Researching communities is unique; it relies on deep understanding
of the dynamics of a community and the cultural conventions that
determine how its citizens interact with health care. This is captured
in the text to whet the reader's appetite for what should be a lifelong
journey in the evolution of knowledge for practice. I am pleased to
recommend this edition of Community Health and Wellness to you
with best wishes for your learning enjoyment and scholarly
fulfilment.
Emeritus Professor Anne McMurray AM

13
Preface
This book is intended to guide the way nurses and other health
practitioners work with people as they seek to maintain health and
wellbeing in the context of living their normal lives, connected to
their families, communities and social worlds. Life is lived in a wide
range of communities, some defined by socio-cultural factors such as
ethnicity or Indigenous status, some defined by geography of ‘place’,
others by affiliation or interest, and some by relational networks
such as social media. Because most people live within multiple
communities it is important to understand how their lives are
affected by the combination of circumstances that promote or
compromise their health and wellbeing. Knowing a person's age,
stage, family and cultural affiliations, employment, education, health
history, and recreational and health preferences has an enormous
effect on the way we, as health practitioners, interact with them.
Likewise, our guidance and support are heavily influenced by the
environments of their lives: the physical, social and virtual
environments that contribute to the multilayered aspects of people's
lives. Knowing how, why and where people live, work, play, worship,
shop, study, socialise and seek health care, and understanding their
needs in these different contexts, underpins our ability to develop
strong partnerships with people and communities to work together
as full participants, in vibrant, equitable circumstances to achieve
and enable community health and wellness.
This edition of the text represents contemporary thinking in
community health and wellness from local, trans-Tasman and global
communities. We have condensed much of the book from previous
editions to reflect the growing accessibility of information online.
Access to up-to-date information is available today at the push of a

14
button, so we have therefore focused on the fundamental principles
of primary health care that underpin community health and
wellness. Using these principles as a foundation, the reader can then
use the internet to investigate other, specific areas of interest while
maintaining a core understanding of what comprises community
health and wellness. We have signposted many areas where readers
may want to explore further and we encourage you to also access the
supplementary material available online.
Primary health care continues to be an integral approach to
promoting health and wellness throughout the world and we apply
the principles of primary health care to our practice in this part of the
world. These principles are outlined in Chapter 1 and elaborated on
throughout the text. A primary health care approach revolves around
considering the social determinants of health (SDH) as we work in
partnership with individuals, families and communities. The text
examines the interrelatedness of the SDH throughout the various
chapters, to examine where such things as biological factors,
employment, education, family issues and other social factors that
influence health and the way we approach our role in health
promotion and illness prevention. As partners our role is to act as
enablers and facilitators of community health, encouraging
community participation in all aspects of community life. Another
foundational element that guides our consideration of community
health is the notion that health is a socio-ecological construct. As social
creatures, we are all influenced by others and by our environments,
sometimes with significant health outcomes. The relationship
between health and place is therefore crucial to the opportunities
people have to create and maintain health. Interactions between
people and their environments are also reciprocal; that is, when
people interact with their environments, the environments
themselves are energised, revitalised and often changed. Analysing
these relationships is therefore integral to the process of assessing
community strengths and needs as a basis for health promotion
planning. The first two sections of the text focus on the principles
and practice of primary health care. A new element of this edition is a

15
section on project planning, equipping the practitioner with the skills
to plan projects in and with communities to achieve wellness.
Our knowledge base for helping communities become and stay
healthy is based on understanding the structural and social
determinants of health that operate in both global and local contexts.
We also know that what occurs in early life can set the stage for
whether or not a person will become a healthy adult and experience
good health during the pathways to ageing. Along a person's life
pathway, it is helpful to know the points of critical development and
age-appropriate interventions, particularly in light of
intergenerational influences on health and wellbeing. We outline
some of these influences and risks in Section 3 of the book, which
addresses healthy families, healthy children, adolescents, adults and
older people. We provide a set of goals in each chapter for achieving
health and wellbeing.
Maintaining an attitude of inclusiveness is the main focus of Section
4. Within the chapters of this section, we suggest approaches that
promote cultural safety and inclusiveness in working with
Indigenous people and those disadvantaged or discriminated
against. To enable capacity development within communities, we
need to use knowledge wisely, which means that we need evidence
and innovation for all of our activities. Clearly, our professional
expertise rests on becoming research literate and developing
leadership skills for both personal and community capacities to
reach towards greater levels of health, vibrancy and sustainability for
the future.
As you read through the chapters you will encounter the Mason
family in Australia and the Smiths in New Zealand. Their home lives
revolve around their respective communities and the everydayness of
busy families. Throughout the chapters you will see how each family
deals with their lifestyle challenges and opportunities as they
experience child care, adult health issues, and some of the
characteristics of their communities that could potentially
compromise their health and wellbeing. We hope you enjoy working
with them and develop a deeper sense of their family and community

16
development, and how nurses can help enable health and wellness.
Throughout the text, we have included boxes that will encourage
you to stop and think on the content (key points and points to
ponder) and direct you to find further information (‘where to find
out more on…’). We have also included group exercises and
questions that can be used in practice or tutorial groups to help add
depth to your conversations on how to improve community health
and wellness.

17
About the Authors
Jill Clendon is a registered nurse and member of the College of
Nurses, Aotearoa. She is currently Acting Chief Nursing Officer at
the Ministry of Health in New Zealand. Jill is also an Adjunct
Professor in the Graduate School of Nursing and Midwifery at
Victoria University, Wellington. Jill spent the 18 years previous to her
current position in nursing policy, research, and child and family
health. Jill's research has examined issues with contemporary
nursing workforces, the efficacy of community-based nurse-led
clinics, and nursing history. Jill has taught at both undergraduate and
postgraduate levels with a specific interest in primary health and the
contemporary context of community-based well child care in New
Zealand. Jill's qualifications include a PhD in Nursing and a Masters
of Philosophy in Nursing from Massey University, and a Bachelor of
Arts in Political Studies from Auckland University. She also holds a
Diploma in Career Guidance and Certificate of Adult Teaching from
the Nelson Marlborough Institute of Technology. She has held a
range of community positions including Chairperson of Victory
Community Health in Nelson, and as a member of the Nelson Bays
Primary Health Care Nurse Advisory Group. Jill has a clinical
background in public health nursing and paediatrics.
Ailsa Munns is a registered nurse, registered midwife, and child
and adolescent health nurse. Ailsa has practised in a range of
hospital and community health settings in metropolitan, rural and
remote health settings in Western Australia. She is currently working
at the School of Nursing, Midwifery and Paramedicine at Curtin
University in Western Australia as a Lecturer, Course Coordinator of
the Postgraduate Child and Adolescent Health Nursing Programs

18
and Coordinator of the Community Mothers Program (Western
Australia). Ailsa has a range of research interests including
exploration of current practice for child health nurses, Aboriginal
community-based antenatal care, peer-led home visiting support for
Aboriginal and non-Aboriginal families, community nurse-led grief
and loss strategies in primary school aged students and prevention
of childhood iron deficiency anaemia in rural and remote Aboriginal
communities. Her academic qualifications include a PhD in Nursing
from Curtin University, Master of Nursing from Edith Cowan
University and Bachelor of Applied Science (Nursing) from Curtin
University.

19
Acknowledgements
We offer our appreciation to colleagues, students and friends who
supported and encouraged us in the writing of this book; sharing
their stimulating ideas, stories and photos have made community
health come alive in the hearts and minds of readers. We are grateful
to our reviewers who helped strengthen the book, and the team at
Elsevier who provided invaluable assistance in producing this work.
Bringing a trans-Tasman perspective to the book has been both
challenging and rewarding, showing how community health practice
underpins health and wellbeing across international communities.
Being able to bounce ideas off one another and melding together the
various perspectives we bring has been both inspirational and
enjoyable. We hope that communities on both sides of the Tasman
will benefit from the insights that have come from working together.
We would also like to thank and acknowledge our families for their
support and patience.

20
Reviewers
Sandra Bayliss RN, BN, MN, Programme Leader and Lecturer,
Nurse Education Team, Faculty of Health and Sciences, Universal
College of Learning, Palmerston North Campus, New Zealand

Leah East RN, BN(Hons), PhD, GradCertAP, Associate Professor

in Nursing (Primary Health Care), School of Health, University of
New England, Armidale, NSW, Australia

Steve Goldsmith MPET, RN, BN, BN(Psychiatric), Registered

Nurse and Educator, School of Nursing, Faculty of Health Science
Youth & Community Studies, Holmesglen Institute, Vic, Australia

Anne McMurray BA (Psych), MEd, RN, PhD, AM,

FACN, Emeritus Professor of Nursing, Griffith University,
Principal Research Fellow, Centre for Health Economics, Menzies
Health Institute, QLD, Australia

Patricia (Trish) Thomson RN, MEd(merit), CTLT, Senior Nurse

Lecturer, Te Hoe Ora, Department of Nursing, Midwifery and Allied
Health, Ara Institute of Canterbury, Christchurch, New Zealand

21
SECT ION 1
Principles of primary health care
OUT LINE

Introduction
Chapter 1 Fundamentals of creating and maintaining a healthy
community
Chapter 2 Healthy policies for healthy communities
Chapter 3 Communities of place

22
Introduction

CHAPTER 1 Fundamentals of creating and

maintaining a healthy community
CHAPTER 2 Healthy policies for healthy
communities
CHAPTER 3 Communities of place

23
Introduction to the section
The three chapters that introduce this text provide a foundation to
help frame what we understand about communities in contemporary
society, and how community health and wellness is achieved and
maintained. Chapter 1 defines ‘community’ and the principles and
foundations for creating and maintaining community health. The
overall goal for those working with communities is to nurture health
within a primary health care philosophy; that is, providing care for
the community and its people in a way that is socially just. This
overarching goal is guided by an understanding of the social
determinants of health (SDH). The SDH outlined in Chapter 1
explain that health is a product of social and environmental factors,
which underlines the importance of place in health.
Chapter 2 provides an overview of the health systems in Australia
and New Zealand, providing the context within which primary health
care is provided. The chapter also discusses the way policy is formed
and how nurses and other health practitioners can be involved in
developing policy to achieve healthy communities. Our discussion
culminates in a list of characteristics of an ideal health system, so
that we can all strive beyond today, to create a better policy
environment, more responsive systems and healthier communities
for tomorrow.
In Chapter 3 we address communities of place, beginning with the
global community and examining features of urban and rural
communities in Australia and New Zealand. The chapter then
examines relational communities of people bound together virtually
through electronic and social media, and communities of affiliation,
which create a bond based on occupation, religious or cultural
characteristics. At the end of each chapter, we revisit the Smith and
Mason families, demonstrating how many of the concepts we have
learned are played out in the realities of their lives.

24
25
C H AP T E R 1

26
Fundamentals of creating and
maintaining a healthy community

27
Introduction
For most people, ‘community’ is a friendly term, conjuring up a sense
of place, a sense of belonging. Healthy communities are where
people are empowered to come together to improve their
communities for individuals, families and the whole community
(Health and Human Services 2017). This is essentially an ecological
relationship. Ecology embodies the idea that everything is connected
to everything else. Health is both a social and ecological
phenomenon, in that it is created and maintained in the context of
community life. Although as individuals we can experience relative
states of health or ill health because of our biological make-up, these
are manifest within the supporting or challenging social ecology of a
community. Health is therefore dynamic, changing as a function of
the myriad interactions between biology and our genetic
predispositions, and the psychological, social, cultural, spiritual,
physical and political environments that surround us. We explore the
socio-ecological model of health in relation to models of care further
in Chapter 6.
As health practitioners, our role in working with communities is
quite different from that of working within a health care institution.
Whereas institutional care is focused on an episode of illness, the
community role ranges from preventing illness to protecting people
from harm or worsening health once they have experienced illness, to
recovery and rehabilitation. To undertake this type of role requires
extensive knowledge of people in the many contexts of their lives.
Community practice also revolves around caring for the community
itself. It is multilayered in that it can include protecting communities
from harm or stagnation, helping its citizens to enhance their
existing capacity for future development by fostering health literacy
(that is, knowledge that contributes to health and wellbeing), and
working in partnership with them to become empowered to make
decisions that will maintain the community's viability and capability
to cope with any future challenges.

28
 We start this chapter by defining ‘community’ and the principles
and foundations for creating and maintaining health. We explore a
range of definitions and differing interpretations of health, wellness,
community, the social model of health, public health and the social
determinants of health (SDH), and introduce readers to the
fundamental principles underpinning primary health care.

Objectives
By the end of this chapter you will be able to:

1 explain health, wellness and community health in socio-

ecological terms
2 identify the SDH and discuss how they impact on individuals,
families and communities
3 define the principles of primary health care and explain how
they guide community health practice
4 explain the concept of health literacy and how it enhances
health capacity for individuals, families and communities
5 describe the differences between health education and health
promotion and the significance of each in community health
practice.

The Ecological Multilayered Perspective of

Community Health
What is health?
The concept of health can be varied and difficult to define. The World
Health Organization (WHO) definition of health encompasses a
holistic approach where health is not seen as one half of a dichotomy
of health and illness, but ‘a state of complete physical, mental and
social wellbeing and not merely the absence of disease or infirmity’
(WHO 1974:1). In subsequent years, recognising increasing rates and
lifelong impacts of chronic disease, Huber et al. (2011) highlighted

29
health as being the capacity of people to adapt and self-manage
within social, physical and emotional environments.
Health itself is multifaceted. Each of us brings a number of factors
influencing our health which are unique to us alone, including:

▪ a personal history
▪ our biology as it has been established by
heredity and moulded by early environments
▪ previous events that have affected our health,
including past illnesses or injuries
▪ our nutritional status as it is currently, and its
adequacy in pregnancy and early infancy
▪ stressors; both good and bad events in our
lives that may have caused us to respond in
various ways.
Biological factors provide the foundation for an individual to
develop into a healthy person, but these are shaped by the
environments or conditions of their lives. Becoming and staying
healthy depends on our ability to reduce the environmental risks to
health, with 23% of global deaths and 26% of deaths among children
under five being influenced by modifiable environmental factors
(Prüss-Ustün et al. 2016). Biological factors provide the foundation
for an individual to develop as a relatively healthy person, which is
an adaptive process. Personal development and wellbeing occurs
when an individual is positively engaged with their physical, social,
political, economic and structural environments (Keleher &
MacDougall 2014). Reciprocal exchanges between people and their
environments, therefore, build the capacity for individual, family and
community health.
Concepts of health are not uniform with contrasting

30
understandings between groups and individuals. People's
understandings of health are influenced by a wide range of
experiences, social norms and contexts. As health practitioners, we
need to be aware of these different cultural interpretations and what
it means for individuals, families and communities to be ill or well
(AIHW 2017). For example, Indigenous Australian and New Zealand
people have very holistic definitions reflecting the importance of
social, emotional, spiritual and cultural wellbeing of individuals and
whole communities, along with their physical environment, dignity,
self-esteem and justice (National Aboriginal Health Strategy
Working Party 1989). It is also important to recognise that these
meanings may vary between specific Indigenous environments. This
differs from the Western mainstream biomedical approach,
emphasising a community perspective.
The inclusion of cultural perspectives within health frameworks
highlights issues of health governance for the delivery of services.
Supportive government policies for resources and models of care are
essential for health service provision across a wide domain
(Boddington & Raisanen 2009), which will be explored more
extensively in the following chapter.

What do we mean by community?

The meaning of ‘community’ can be varied. It is usually explained as
being geographical or functional, where members interact and share
both a sense of identity and resources (Talbot & Verrinder 2014).
Communities can be defined by culture or issues of interest
(Hampton & Toombs 2013), accommodating a dynamic diversity of
ethnicities, strengths and needs. Of growing interest across age
groups is the emergence of virtual communities, which involve
members using a range of communication technologies to interact as
groups (Demiris 2006).
Feelings of connectedness have been positively associated with
higher levels of physical and mental health, social support and
having control over issues affecting their lives (Talbot & Verrinder
2014). A community is often seen as a context for action, particularly

31
in the areas of health and social wellbeing. These are impacted by
members' varying beliefs, traditions, feelings of collective identity
and determinants of health. There are many contextual meanings for
community, and its influence on the capacity of individuals and
families to interact meaningfully will be explored throughout this
text.

Points to Ponder
What is Community?

• A place we share with others?

• A network of like-minded people?
• A group who lives, works and plays together?
• An interdependent group of people inhabiting a common space?
• A context for action?

Wellness
Health influences the sense of wellness of individuals and
communities. Healthy people's lives are characterised by balance and
potential. A wellness perspective reduces the focus on illness
prevention alone. Wellness is individually constructed dynamic
relationships between people and their many everyday
environments, and how they can maintain purposeful connections in
the social, emotional, physical, intellectual, spiritual, occupational
and environmental dimensions of their lives (Roscoe 2009). In a
balanced state of health and wellness, there are feelings of life
purpose, optimism and cohesion (Adams et al. 2000). When these
dimensions are part of a healthy community there are opportunities
for the community as a whole to develop high levels of health or
wellness, thereby supporting individuals and families. This socio-
ecological connectivity between people and their environments
embodies community health and wellness in that people feel

32
supported and able to develop health capacity. For example, they may
feel they have lifestyle choices, and if they choose, they will be able to
exercise or relax in safe spaces. They have access to nutritious foods;
students balance study with recreation; young families immunise
their children and have time out from work to socialise. Older people
are valued for their contribution to the community and inclusive
policies promote opportunities for all citizens to participate fully in
the community and lead a high-quality, happy life.

Key Point
Health and wellness are ecological.
Biological factors provide the foundation for an individual to
develop into a healthy person, but these are shaped by the
environments or conditions of their lives.

The Social Determinants of Health (SDH)

From birth, individuals are programmed through experiences to
develop certain biologically preset behaviours at critical and sensitive
developmental periods. This is called ‘biological embedding’, and it
is influenced by how people interact with the genetic, social and
economic contexts of their lives. Early life adversity within these
environments increases the risk for a range of physical and
psychosocial health problems later in life (Ehrlich et al. 2016).
Overlapping family, cultural, community and political characteristics
and aspects of the wider society can be termed SDH, creating
opportunities or threats to lifelong health and wellness, and
associated areas such as learning, behaviour and resilience
(Hertzman 2012).
A World Health Organization report (Wilkinson & Marmot 2003)
identified ten SDH which impact on people's ability to adopt healthy
lifestyles.

33
 1 The social gradient
2 Stress
3 Early life
4 Social exclusion
5 Work
6 Unemployment
7 Social support
8 Addiction
9 Food
10 Transport

Source: Reprinted from Wilkinson, R., Marmot, M. (Eds.), 2003.

Social determinants of health: The solid facts, 2nd edition. Geneva,
Switzerland, World Health Organization.
Fig. 1.1 demonstrates the determinants.

FIGURE 1.1 The social determinants of health

The WHO (2017a) has more recently recognised the influence of

34
genetics and access to and use of health services as being further
determinants influencing health. Within the SDH are a number of
structural conditions. For example, in order to improve a
community's development, employment opportunities and
environments supporting healthy physical and psychosocial
development are needed. Food security in relation to accessible and
nutritious foods at a reasonable cost is an ongoing national and
international issue (PMSEIC 2010). People also need to have
reasonable working conditions with adequate transport and spaces
for recreation so they can achieve a work–life balance. Other
structures within the community supporting the maintenence of
health and wellbeing include hospitals, medical practitioners, nurses,
non-govenmental organisations and allied health practitioners who
are accessible where and when they are needed.
SDH strongly influence healthy child development. Parenting
support and skills, family stability and adequate physical and socio-
economic resources are integral to health and well​b eing. Interactions
between individuals, families and communities, such as having
healthy and supportive neighbourhoods, accessible services for child
health and child care are additional supports for families and
children. Employment conditions such as parental leave without loss
of promotional opportunities, flexible working hours and income
protection in the case of unemployment all support healthy growth
and development. On-site and out-of-hours child care underpin
contemporary working conditions that facilitate economic and family
security.

The social gradient

The SDH create advantages and disadvantages for individuals,
families and groups, with some members of society having reduced
chances of reaching their full health potential (Guzys & Petrie 2014).
Those who earn income at successively higher levels have better
health than those who are unemployed or have lower levels of
income. Research studies have shown there is a ‘social gradient’ in
health, whereby those employed at successively higher wealth-

35
producing levels of employment have better psychosocial health than
those on lower levels (Kendall et al. 2017). This inequity creates
disadvantage from birth for some children. A child born into a lower
socio-economic family for example, may be destined for an
impoverished life, creating intergenerational ill health. This child
lives in a situation of ‘double-jeopardy’, where interactions between
the SDH conspire against good health. Without external community
supports, the family may spiral into worsening circumstances,
affecting their child's opportunities for the future. This is the case for
many Indigenous people, whose parents have not had access to
adequate employment or community supports that would sustain
their own health, much less that of their children. They become
caught in a cycle of vulnerability where the SDH interact in a way
that creates disempowerment across generations. Political decisions
governing employment opportunities may hamper the parents'
ability to improve finances. A less than optimal physical environment
may deprive both parents and the child of a chance to access social
groups or gatherings. There may be few opportunities for education,
health care or transportation to access services. Parenting skills may
be absent for a range of reasons, including younger age, a lack of role
modelling, geographic disadvantage or illness.
Reducing the impact of inequities requires people, communities
and governments to take action on the SDH. Many of these
determinants are influenced by the social, political and economic
environments in which people live. People may have very limited
opportunities to exert control over their SDH. As such, attributing
blame or a lack of commitment to decision making in relation to
these particular situations further disadvantages people (WHO
2017a). Global, national and local policy decisions such as
employment strategies and public health priority setting affect the
ability of people and communities to influence their own health
decisions. Any marginalisation of individuals and families through
adverse SDH prevents them from fully interacting with community
assets, leading to social exclusion (WHO 2017b). Social exclusion
leaves many members of society without the support and resources

36
they need for health and wellbeing. In contrast, social inclusion
creates social capital, trust, norms of reciprocity and cohesion: the
essence of a healthy community.

Community health
SDH help determine strengths and challenges in community health.
When people are asked to define community health, their responses
usually reflect a blending of community, public health and
population health characteristics. Public health focuses on
promoting and sustaining the health of populations (Fleming &
Parker 2015), with programs involving measurement and surveillance
with development of evidence-based strategies to prevent or
overcome diseases. The field of community health concentrates on
the self-identified needs of individuals and families within
communities. Health practitioners may use aspects of public health
research and strategies in partnership with communities when
working towards the shared goal of improving health (Goodman et
al. 2014). Population health is similar to public health in that its focus
is health and disease in the community, but population health
programs tend to address disparities in health status between
different groups.

Key Points
Public health focuses on promoting and sustaining the health of
populations.
Population health aims to address disparities in health status
between different groups.

Healthy communities are the synthesis or product of individual

people interacting with their environments with their unique
understandings of what it is to be healthy, working collaboratively to
shape and develop the community in a way that will help them
achieve positive health outcomes.

37
 Our definition of community health is as follows:

Community health is characterised by the presence of strong social

capital, engaged and empowered community members, a dynamic
and healthy physical, social and spiritual environment, accessible,
affordable and equitable services and resources, and a system of
governance that is inclusive and responsive to community members
in addressing the SDH.
This and other definitions of community health embody an ideal
where all community members strive towards a common state of
health. Of course, in real life, communities and societies are neither
consistent nor stable, which reflects the variability among individuals
and the dynamic changes that occur in people's social lives. Social
conditions are particularly important to community health, because
social environments provide the context for interactions in all other
environments. Social support fostering positive connections, feelings
of trust and social inclusion enables people to feel empowered, and
have greater control over their lives and their health (Leach 2014). We
call this social inclusion. On the other hand, if their social situation is
plagued by civil strife, an oppressive political regime, crime, poverty,
unemployment, violence, discrimination, food insecurity, diseases or
a lack of access to health and social support services they may be
disempowered, leaving them less likely to become healthy or recover
from illness when it occurs. As Talbot and Verrinder (2014:58)
explain, ‘empowerment is about increasing people's power over
things influencing their lives’, and needs to occur through
community development activities. The community health
practitioner can be an advocate for community empowerment,
facilitating and encouraging transforming strategies that take into
account SDH (Fleming & Parker 2015). When people live in situations
of disadvantage or disempowerment they are unable to access the
same resources for health as those who live in more privileged
situations, and their lives and potential for the future are
compromised. This is called social exclusion. Chapter 9 explores these

38
themes in more detail.
The role of health practitioners in community health is to
recognise enabling and challenging features within a range of
cultural, economic, social, and health environments, working with
individuals, families, groups and political entities to collectively
identify issues and strategies to enhance health and wellbeing. One
of the challenges is the development of relevant, acceptable and
sustainable approaches that take into account the complexities and
impacting social determinants of communities (Goodman et al.
2014). Community health practitioners need to step outside
traditional models of practice and work within an increasingly
recognised social model of health, incorporating a primary health
care approach.

Key Points
The characteristics of an enabling community health practitioner
include:

• promoting health and providing care where people live, work

and play
• advocating for the community, its people and its physical, social
and spiritual environments
• promoting equity, access, social inclusion and adequate
resources by assessing community needs and disadvantage and
then lobbying for change where required
• encouraging empowerment and health literacy to promote
citizen participation in decisions for health and wellbeing
• generating the evidence base relative to community health
needs.

Primary Health Care

When working with communities, nurses are aware of the need to

39
address goals for social justice, along with promoting equity and
access to health resources (Hepner et al. 2014). The ‘social
determinants’ approach to health resonates with the notion of
human rights and social justice, which underpins the social model of
health (Guzys & Arnott 2014). As such, nurses have an obligation to
identify unfairness and health inequities and their predisposing
social determinants, facilitating extra resources for disadvantaged
individuals, families and communities (Guzys 2014).
Primary health care is a set of principles and an organising
framework to guide nurses and other health practitioners in
facilitating socially just, equitable conditions for good health. The
International Conference on Primary Health Care was held in Alma
Ata in 1978, where a resolution was passed calling on the
international community to protect and promote the health of all
people (WHO & UNICEF 1978). Primary health care is defined in the
1978 Declaration of Alma-Ata as:

Essential health care based on practical, scientifically sound and

socially acceptable methods and technology made universally
accessible to individuals and families in the community through their
full participation and at a cost that the community and country can
afford to maintain at every stage of their development in the spirit of
self-reliance and self-determination. It is the first level of contact with
individuals, the family and community with the national health
systems bringing health care as close as possible to where people
live and work and constitutes the first element of a continuing care
process
Reprinted from World Health Organization (1978) Declaration of the
Alma-Ata, http://www.who.int/publications/almaata_declaration_en.pdf

Primary care is a term which is often used instead of primary

health care, however there are several differences. Primary care
typically relates to medical and allied health management of
conditions with an emphasis on the medical model of care, focusing

40
on early diagnosis, treatment and screening (Keleher & MacDougall
2011, Talbot & Verrinder 2014). General practice is often described as
primary care. However, in terms of improving overall health
outcomes, a broader primary health care approach that addresses
SDH such as housing, employment and food security is necessarily
more encompassing and more likely to address the inequities that
leave some population groups disadvantaged. Primary care, while an
important aspect of care provided within the health sector, comprises
part of a primary health care system, not the entirety of the system
(Keleher & MacDougall 2011).

Box 1.1
Practice Profile: Practice Nurse
Hi. My name is Carter and I'm a Practice Nurse.
What the role entails:
The role of a Practice Nurse involves working closely with patients to
support them with their health needs whatever these may be. A
typical day may include immunising a baby, working through a diet
plan with a person newly diagnosed with diabetes, managing an
acute asthma attack, following up on lab results or removing a set of
stitches. I work hard to improve population health, meet my
responsibilities under the Treaty of Waitangi and address inequity in
a community-based way.
How I came to be in the role:
I came to practice nursing within a year of graduating from my
education. Practice nursing is not a traditional place for male nurses
to find themselves but I wanted to work closely with people in the
community and I have an active interest in healthy living and
lifestyle. Practice nursing seemed an ideal place to be able to
support people achieve healthy lives.
What I find most interesting about the role:

41
I enjoy the ongoing interaction and relationship development with
my patients that a general practice allows. It is rewarding to help
people of all ages maintain good health and successfully manage
chronic conditions. The generalist setting and multidisciplinary
team approach helps me advocate for patients and guide them
through the system. Sometimes, it is simply the honour of listening
to people share their fears and to help them find context, meaning
and acceptance.
Advice for anyone wanting to become a Practice Nurse:
Build your skills and knowledge of working in the community by
taking relevant courses on smoking cessation, cardiovascular risk
assessment and immunisations. Consider courses on motivational
interviewing, advanced assessment and prescribing. Talk with other
Practice Nurses and spend a day working with one to see what they
do.

Where to find out more on…

The differences between primary care and primary health
care
The following online discussions are valuable in reviewing
differences in primary care and primary health care.

• http://blogs.crikey.com.au/croakey/2010/06/10/primary-care-vs-
primary-health-care-and-who-cares/
• http://blogs.crikey.com.au/croakey/2010/06/17/primary-care-vs-
primary-health-care-who-cares-part-2/

Primary Health Care Principles

The principles of primary health care guide our activities in illness
prevention, health promotion, and structural and environmental

42
modifications that support health and wellness. These are identified
as:

▪ Accessible health care

▪ Appropriate technology
▪ Health promotion
▪ Cultural sensitivity and cultural safety
▪ Intersectoral collaboration
▪ Community participation
These principles are a framework to guide us to work towards
equitable social circumstances, equal access to health care, and
community empowerment through public participation in all aspects
of life. The literature on primary health care includes cultural
inclusiveness as a common thread in each of these principles.
However, we include cultural sensitivity as a separate principle. This
acknowledges the important work on cultural safety that has been
done over the past two decades, particularly in New Zealand. Being
culturally sensitive and enabling culturally appropriate health care
that protects cultural safety is one of the most important factors in
achieving primary health care. The principles are interconnected, but
they are examined separately below to underline the importance of
each to the overall philosophy of primary health care (see Fig. 1.2).

43
 FIGURE 1.2 Primary health care principles

Accessible health care

In many countries of the world, including those considered highly
developed, there is a widening gap in access to health services
between population groups such as Indigenous and non-Indigenous
people, and those living in urban and rural or remote areas (Ware
2013). These factors cause disparity between rich and poor, which is
inequitable and socially unjust. The major objective of providing
equity of access is to eliminate disadvantage, whether it is related to
social, economic or environmental factors. Barriers to access include
areas such as unemployment, lack of education and health literacy,
age, gender, functional capacity and cultural or language difficulties.
These factors inhibit the development of capacity for individuals and
families. Barriers to community capacity include geographical
features that isolate people from services or opportunities, civil
conflict or inadequate supporting structures and services.

44
Key Points
Inequity
Unfair distribution of resources and support (e.g. lack of health
practitioners in rural areas)
Inequality
Disparity in health status or capacity (e.g. poorer health among
Indigenous people than non-Indigenous people)

As the OECD (2016) reports, evidence has shown that in any

country, the greater the income gap between rich and poor, the worse
the health status of all its citizens. This occurs unevenly, as health is
distributed differently among different groups. Analysis of
population data from OECD countries has confirmed that the health
of any society is better when wealth is more equally distributed
(Devaux 2015). Various interactions among the different influences
also produce different levels of health and illness, and there are also
variations in the way different generations respond to events in their
social world. Some inequities also affect the community itself. Global
warming, food security, disease outbreaks and the harmful effects of
globalised industrial processes hinder a community's ability to
maintain healthy environments (Spickett et al. 2008). Decisions for
community health should therefore be based on simultaneous
assessments of the impact on individuals, families and communities,
future generations and the global community. Social justice, or
equitable access for all, needs to ensure the least advantaged people
in a community receive equal opportunity, education, care and
service as those who are advantaged by virtue of both tangible
(finances) and intangible (knowledge) resources.

Appropriate technology
The failure of health care systems to address inequities in health is
due, in part, to the use of inappropriate technologies in health care.
Primary health care requires efficiency, effectiveness and

45
Another random document with
no related content on Scribd:
and James Reynolds. What had Mr. Hamilton to say to that? Even under the
least provocative circumstances, Hamilton was quick-tempered, and here
was something to arouse the lion in him. For a moment he raged in his
resentment. The visitors, a little moved, perhaps, stood their ground. They
had papers and the right to an explanation. His fury having consumed itself,
Hamilton realized that there was something to explain, and he was ready.
Would they meet him at his house that night? They would. The three men
rose, bowed, departed.
When they reached the Hamilton home that winter night, they found
Oliver Wolcott, the protégé of the host, there before them. In the presence
of these enemies it was wise to have one friend as a witness. The visitors
were received with the courtly courtesy of which Hamilton was capable,
and after they had found chairs about the table, he produced some papers of
his own, spreading them out by the candlelight, before him. Then, quite
calmly, and with an occasional touch of humor, he made a remarkable
confession.
It was the old story of a great man’s weakness. One summer day in 1791
a Mrs. Reynolds had appeared at his home with a pathetic story of her
desertion by her husband and a plea for funds to enable her to return to her
family in New York. Strangely enough, no description of this adventuress
has come down to us, but it is a reasonable presumption that she was
comely. The family of Hamilton was in the house. The master was moved.
Naturally he would accommodate her, but at the moment he had no money
with him. He would take her address and send or bring it in the evening.
That night the gods looking down from Olympus might have seen one of
their favorite earth-children furtively making his way through the dimly
lighted streets, away from the fashionable quarter into the section of cheap
boarding-houses. The woman received him in her room. It was the old story
of Cæsar and Cleopatra, albeit this was a Cleopatra of the more vulgar sort.
‘After that,’ said Hamilton, ‘I had frequent meetings with her at my own
house, Mrs. Hamilton and her children being absent on a visit to her
father.’[698] The comedy hurried on. At length he thought to bring it to a
termination, and it was then that Mrs. Reynolds proved herself a mistress of
her art. She was passionately in love. A separation would break her heart.
Here, surely, was a violent attachment—perhaps it would be better to break
off gradually. The lover was not lacking in the finer sensibilities, and then,
too, his vanity was pleased.[699] With the continuance of the amour, Mrs.
Reynolds, simulating a consuming passion, began to flood her innamorato
with tender epistles.[700] The climax was on the wing. One day an
hysterical note announcing the husband’s discovery of her infidelity, and
warning that, if no answer was forthcoming to the letter the Secretary would
receive from the irate husband, Mrs. Hamilton would be informed. Would it
not be wise to see him? Hamilton thought so and summoned Reynolds to
his office. The cunning rascal had his story ready: the wife discovered
writing a mysterious letter—a black messenger traced to the Hamilton
house—the accused wife on her knees confessing all.[701] After
negotiations the heartbroken husband decided that a thousand dollars would
salve his wounded honor. ‘And I will leave the town ... and leave her to
Yourself to do for her as you think proper,’ he added.[702]
In the midst of these painful revelations, Muhlenberg and Venable
declared themselves satisfied, but Hamilton insisted on telling the story to
the end. Then followed the most amazing part of the tale. The husband
invited his wife’s lover to resume the amour. Hamilton was coy. Mrs.
Reynolds added her plea in illiterate, pleading letters. The vanity of
Hamilton was likewise persuasive, and the comedy was resumed. When he
sought to escape notice by going by the back way, Reynolds was indignant.
‘Am I a person of such a Bad carector [character] that you would not wish
to be seen Coming to my house in the front way?’ he wrote.[703] This
should have put Hamilton on his guard, but he fell into the trap. A witness
had been provided in another blackmailer, Clingman, who had been a clerk
in Hamilton’s office, and was an unspeakable scoundrel. Then more money
was demanded. Mrs. Reynolds was again alarmed. Her husband was often
morose and beat her. At times he threatened to murder Hamilton. Loans
were made. This, then, was the nature of the mysterious financial relations
with Reynolds.
When the party rose to leave, Muhlenberg and Venable were apologetic
—but not so James Monroe. He bowed stiffly, the sternness of his features
unrelaxed, as the three passed out into the winter night. Hamilton had
vindicated his official honor at a painful sacrifice. It was understood that the
confession should be sacredly confidential, but in a sense he had lost. As he
sat with Wolcott before the fire after his tormentors had departed, he
realized that his enemies were out to wreck his official reputation. He may
have had a premonition of the storm that was about to break.

III

Nine days after the scene enacted by candlelight in Hamilton’s library,

the bill authorizing the President to negotiate a loan of two million dollars
to be applied to the reimbursement of a loan made of the Bank came up for
consideration in the House. William B. Giles, who was now dividing the
leadership of the Jeffersonians with Madison, was instantly on his feet with
a request for postponement. Perhaps some method could be found without
recourse to a new loan. It might be better to pay the loan by selling the
stock the Nation owned in the Bank. The watchful Sedgwick was shocked
at the suggestion. Dumping so much stock upon the market would reduce
the price and not enough money would be realized to meet the country’s
obligation to the Bank. It was a mild premonitory skirmish.[704]
Christmas Day brought an armistice, but the next day the discussion was
resumed, with Madison taking a leading part. Why was so much more to be
borrowed than was demanded by the Bank? To his personal knowledge a
large sum was lying idle and unappropriated in the Treasury. If this balance
was appropriated by the President, he wanted to know it. A delicate subject
to discuss, suggested Sedgwick. Not at all, thought Madison. It was time for
some ‘candid explanation.’ Was the appropriation lying dormant in the
Treasury, borrowed to meet the obligations to France, being demanded by
the country to which it was due? The important question concerned the
diverting of money appropriated to that specific purpose to the payment of
Bank installments. Could gentlemen justify themselves to their constituents
for such conduct? The debt to France was one of gratitude and justice, and
he wished the money could be sent thither on the wings of the wind. True,
the debt in whole was not yet due, but in the critical condition of our
benefactor, it would no doubt be particularly acceptable and he was
opposed to the diversion of any part of it.[705] Why two millions for the
Bank? demanded Giles. True, two hundred thousand dollars would be due
the Bank on January 1st, but why two millions? No one had offered an
explanation of how the money lying dormant was disposed of, or how it
was intended to dispose of it. No member rose to explain, and the bill was
lost.
 During the next month the lobbies, boarding-houses, taverns, buzzed
with discussions of the finances of the country. After all, even the members
of the House, presumed to be familiar with the fiscal affairs of the Nation,
knew scarcely anything. They had appropriated blindly. There was
something uncanny in the silence. Would the raising of the curtain disclose
skeletons in the closet of the Treasury? At any rate, the House had a right to
the facts and figures. Throughout the month Madison and Giles were
frequently at the table or about the blazing fire at Jefferson’s. Here the
campaign was planned. The fight should be forced into the open on the
floor of the House. Jefferson could not participate, for manifest reasons, but
he could direct. Madison could assist in the preparation of the resolutions
and in the debate. Giles, who was a masterful debater, fearless and slashing
in attack, could sponsor the resolutions and lead in the assault. Because of
the part he then played, it has been the fashion to dismiss him flippantly
with a shrug and a sneer—but this is absurd. Giles of Virginia was
unsurpassed by any American debater of his time.

IV

Giles was a veritable D’Artagnan of debate, a gusty, lusty Gascon

transplanted to the tobacco-fields of Virginia, eager always for a fight or a
frolic, and lightning-swift with his blade. A blustering fellow, true, quick to
assert his rights and repel assault, he carried himself with a swagger that did
not endear him to the Federalists, who rather plumed themselves on having
a monopoly on that particular vice or virtue. But sneers at his ability are
absurd. He who won the admiration of Patrick Henry,[706] commanded the
confidence and respect of Jefferson, Madison, and Monroe, received the
discriminating praise of Randolph of Roanoke,[707] and the reluctant tribute
of Justice Story,[708] cannot be sneered from a respectable place in history
by a wretchedly unfair caricature by a partisan English biographer of one of
his enemies.[709]
The young Virginian who appeared in Philadelphia in the winter of
1790-91 was not prepossessing in appearance. Of average height, the
fullness of his person conveyed the impression of a squat figure. His face,
large, round, but colorless, bore none of the indications of genius, albeit
there was something of virility in his brown eyes that harmonized with the
robustness of his physique. One who knew him has recorded that he was of
fair complexion,[710] but another who heard him frequently in debate
commented on his dark color, and, since his hair and eyes were those of a
brunette, we may accept the latter as more probable than the former.[711]
All agree that he was careless in his dress, after the then prevailing Virginia
manner,[712] although we have the record of one dramatic appearance in the
Virginia Legislature, at the height of his renown, ‘elegantly dressed in blue
and buff’ and with the Gascon touch of being ‘booted and spurred, with a
riding-whip in his hand.’[713] If there was nothing imposing or picturesque
in his appearance, his manners were such as to make him stand out
conspicuously among his fellows. These were such as to impress the none
too finished Maclay that ‘the frothy manners of Virginia were ever
uppermost.’ It is easy enough to reconstruct the scene at Washington’s table
where Maclay met our Gascon, with Giles, the good liver, dwelling
unctuously on Virginia canvasback ducks, Virginia hams, Virginia chickens,
and the old Madeira, which was a little more mellow when drained from a
Virginia glass in a joyous Virginia dining-room. Proud of Virginia was this
provincial from the tobacco country, and proud as D’Artagnan himself of
his physical prowess, for didn’t he take more manual exercise than any man
in New England? No place like the Old Dominion where the living was
‘fast and fine,’ where from noon to night the people drank wine or cherry
bounce like gentlemen. Thus he thundered along, to the amazement of
Maclay, who observed that ‘he practiced on his principle every time the
bottle passed.’[714] The picture is no doubt true, for Giles was racy of his
native soil. The Amelia County of his early days was of the frontier, with all
that that implies of the primitive vices and virtues. The sparsely settled
country, with its miserable roads, lived very much to itself, and strangers
who ventured among its inhabitants were treated coldly. The living was
truly ‘fast and fine’ and rather loose, for the men were careless, indifferent
to dress, heavy drinkers, inveterate smokers, their conversations picturesque
with profanity; and they were fighters, too. Dumas’s three immortals would
have found it to their liking, and had they encountered young Giles at some
crossroads tavern they would have taken him to their hearts. The spirit of
independence flamed on every hearth, and the religious dissenters found it a
happy hunting-ground.[715] It was in this atmosphere that Giles grew up.
Like most of the Jeffersonian leaders, he was a frontiersman.
 When he went to Princeton to complete his education, we get again the
D’Artagnan touch. He set forth like a Virginia gentleman with his negro
slave to serve him, no doubt kicking, cursing, and loving him all the way.
Then followed a law course at William and Mary—and then a law office
was opened in the little tobacco town of Petersburg. We are interested in
this period of his career only in that it throws light on his character and
capacity. He favored the ratification of the Constitution, and, as a fascinated
spectator of the debates in the Virginia Convention, formed a deep
admiration for Madison. In the evenings he argued for ratification at the
tavern, no doubt in the taproom. Hearing him one night, George Mason, a
leader of the opposition, made the comment that ‘he has as much sense as
one half of us, though he is on the wrong side.’[716] He was not, then, an
anti-Federalist on the Constitution.
Immediately on entering Congress at twenty-eight, he commanded
attention, for he had a genius for congressional life. He became at once a
giant in debate. When John Randolph, more cynic than flatterer,
pronounced Giles the Charles James Fox of the House, he referred to the
impression made by the Virginian in action. Fox was a student; Giles was
not. Fox was capable of sustained research; Giles was not. Fox was a lover
and reader of books, and Giles cared nothing for them. He bore a closer
resemblance to Mirabeau or Danton in his methods, absorbing his
knowledge from others in conversation. In the tavern, on the highway, at the
dinner table, he was a tireless talker, and by provoking his friends into
discussion he tested, corrected, and formed his impressions of events and
measures. His mind absorbed like a sponge, his memory was retentive. The
idea that Jefferson or Madison outlined his speeches for him is ludicrous.
He merely assimilated what they said—and then gave it out more forcefully
than either could in debate.[717]
It is impossible to reconcile the slurring references of some historians to
his manner in debate with the speeches that speak for themselves on the
musty pages of the ‘Annals of Congress.’ Here was a man speaking directly
to a purpose. No critic need kill off his Roman consuls, for there were none.
No craving here for a reputation for erudition. No mere rhetorical flourishes
to confuse the sense. No theatrical appeals to the emotions. No verbosity at
all—but ‘a clear, nervous expression, a well-digested and powerful
condensation of language,’ which could make an impression on the
scholarly Story. That great jurist, an unfriendly witness, could not hear him
without admiration. ‘He holds his subject always before him,’ he wrote,
‘and surveys it with untiring eyes; he points his objects with calculated
force and sustains his positions with penetrating and wary argument. He
certainly possesses great strength of mind.’[718]
Having prepared himself to meet all comers, he thus dashed to the
combat. Having assimilated all that he had absorbed, his native
resourcefulness and ready command of good plain English did the rest. He
spoke with the forceful fluency which was the best possible substitute for
eloquence. A powerful voice, a virile manner, compelled attention and
respect. Did an enemy attack him as he rushed along? He either crushed
him with brutal strength, or cleverly ducked the blow—and was on his way
again. Instinctively he knew when to strike and when to dodge. When on
the floor, he dominated the scene. This was the man, so much belittled,
whom Benton wrote down in cold deliberation as ‘the most accomplished
debater which his country has ever seen.’ This the man selected in the
conferences of Jefferson and Madison to lead the attack on the Secretary of
the Treasury.

During this period of waiting, with the gossips busy in the taverns and
the streets, Freneau was zealously seeking to create the right atmosphere for
the attack. With the Hamiltonians ascribing all prosperity to the policies of
their chief, Freneau and other editorial enemies were making much of the
protest of ‘Patriot,’ who had been ruined through the abuse of these fiscal
policies.
The tale is true [it ran]. I loved my country. In 1775, my only son fought
on Bunker Hill.... His mother sent the chair down to carry him home. She
wiped the blood from his face and dressed the wound in his breast. He died.
My neighbor, Smallacre ... said it was the proper reward for rebellion, but
that a halter would have been more proper. I persevered in the cause of
freedom. Congress wanted money—I called in my debts and sold all my
land excepting forty acres. In ... 1778 I had 12,000 in paper. I loaned the
whole, and when they were consolidated at forty for one I had a loan office
certificate for $300. In 1784 the General Court issued a large tax. As I could
obtain neither the interest or principal of my loan office note I was obliged
to sell it. My neighbor, Smallacre, saved his property from the waste of a
cause to which he was heartily opposed, and he appeared to buy my note at
Three Shillings for Twenty. By this means I paid my State tax of Nine
pounds, ten shillings and had four pounds left for town and parish taxes. As
my son was dead I was content to be poor.... My old chair and horse
remained.... My neighbor, Smallacre, has now become rich by purchase of
public securities from people distressed as I was. He tells me that our
Hancocks and our Sam Adams and those kind of men know how to pull
down a government, but do not know how to build one.[719]
Prosperity? Yes, but for whom? demanded the enemies of Hamilton,
poking the ‘Patriot’s’ protest under the nose of his defenders. With the
Hamiltonians crediting their idol with all the good things that had occurred,
Freneau was moved to mirthful verse:

‘Whales on our shores have run aground,

Sturgeons are in our rivers found—
Nay—ships have on the Delaware sailed,
A sight most new.
Wheat has been sown—
Harvests have grown—
On coaches now, gay coats of arms are borne
By some who hardly had a cent before—
Silk gowns, instead of homespun, now are seen,
Instead of native straw, the Leghorn hat,
And, Sir, ’tis true
(Twixt me and you)
That some have grown prodigious fat,
And some prodigious lean.’[720]

This press crusade against Hamilton was carried on along with much
laudation of Jefferson, inspired by the report of his decision to retire from
the Cabinet. ‘Mirabeau’ heard with distress that ‘the leader of democracy’
wished to ‘seek the peaceful shades’ to ‘solace himself with his favorite
philosophy.’ True, the sea had been made tempestuous for him, but ‘the
crew are his friends, and notwithstanding the endeavors of the officers to
raise a mutiny to supercede him ... his honest labor and firmness has
frustrated their wicked intentions and he rides triumphant.’ But with his
retirement ‘monarchy and aristocracy would inundate the country.’[721]
Right, agreed ‘Gracchus,’ ‘for though he has been in office near four years
he has never assumed the insolence of it. His department has been that of a
Republican and in no one action or expression has he manifested a
superiority over his fellow citizens.’[722]
Hamilton and his followers had frankly sought to drive Jefferson from
the Cabinet and failed; the plan was now complete for driving Hamilton
himself into private life.

VI

On January 23d, the result of the deliberations of Jefferson, Madison,

and Giles appeared when the latter rose in the House to present a set of
resolutions calling upon the President to submit complete reports on the
fiscal operations of the Government. To these the House was clearly
entitled. Nor was there anything violent or outrageous in Giles’s speech in
which he explained them. The House had been legislating for four years
‘without competent official knowledge of the state of the Treasury or
revenue.’ They had ‘engaged in the most important fiscal arrangements,’
and had ‘authorized a loan of the Bank ... for more than $500,000 when
probably a greater sum of public money was deposited in the Bank.’ They
were now on the point of authorizing a further loan of $2,000,000 in the
dark—and they were entitled to light. ‘I conceive that it is now time for this
information to be laid before the House.’[723] No one rose to object and the
resolutions were adopted.
To Hamilton, who looked upon Congress as a meddlesome body, they
appeared as something more than a bore. They were an imposition and an
insult. He was entrusted with the financial arrangements, and all he asked
was to be let alone. But he realized that such a lofty tone could not be
publicly assumed. Suppressing his indignation, he set to work with
meticulous care to prepare the fullest possible reports before the expiration
of the congressional session. His enemies thought to burden him with a task
that could not be performed in so short a time. Their strategy was to let the
resolutions with their implications seep in on the minds of the people
throughout the ensuing summer; his cue was to thwart them in that purpose,
to achieve the impossible, to meet the resolutions during the session, and
win a triumph.
 Not for him, that winter, the gala nights at the new Chestnut Street
Theater, nor the dinners at the Binghams’, nor the dances at the Stewarts’,
nor the felicities of the hearth with Eliza at his side. His place was at the
Pemberton mansion, day and night, until the work was done. Oliver Wolcott
and the clerks were doomed to the same drudgery. Far into the night the
lights gleamed in the windows of the old house, and dark and deserted were
the streets when the workers made their way to their various homes after
dreary hours of poring over figures, assembling facts, and writing
explanations.
Within twelve days, the first report, with elaborate tables containing the
most minute details of transactions, was sent to the House. Two days later,
the second report was done and in. A week more and the third was sent.
Another six days, and the last was finished. The intense application, the late
hours, the nervous strain, told perceptibly on Hamilton, who was never
robust. The color left his cheeks when they were not flushed with
excitement. His nights were all but sleepless. His waning strength was
sustained by the driving force of his powerful mind. When it was over, even
Wolcott found that his routine business had fallen behind and that he would
‘be busy for some time to bring it up.’ To his father he apologized for
failure to answer letters. There was no time for letters. ‘The winter ... has
required every exertion which I could make.’[724]
As these voluminous reports poured in upon the House in rapid
succession, the Jeffersonians were amazed and the Hamiltonians beside
themselves with joy. A startling intellectual feat, to be sure. ‘I can recall
nothing from the British Minister in all the conflicts of party equal to it,’
wrote one admirer. ‘Even Neckar’s boasted account of the finances of
France ... is inferior, although that was the result of long study and elaborate
preparation, and Hamilton’s the work of a moment. Poor fellow, if he has
slept much these last three weeks I congratulate him upon it.’[725]
Wonderful reports, agreed the ‘Centinel’ of Boston. ‘The manly
unequivocable sentiments—the fair and accurate statements, and the
judicious arrangements ... must fix his character as a Patriot, a statesman,
and an able and honest financier.’[726] Yes, added another, ‘he will come
forth pure gold.’[727]
But his enemies were not so much delighted. They read and studied the
reports, complaining that the wizard of the speculators was up to his old
tricks. A maze of words, interminable sophistries, columns of confusing
figures, arguments instead of facts, and special pleading—no one could
understand these reports—such the verdict of the rank and file. To which
the Hamiltonians responded with a sneering verse:

‘The Secretary makes reports

When’er the House commands him;
But for their lives, some members say,
They cannot understand him.
In such a puzzling case as this
What can a mortal do?
‘Tis hard for ONE to find REPORTS
And understanding too.’[728]

But the leaders among the Jeffersonians were studying the reports and
finding a few things that they could understand. Evidence of corruption
they did not find, but they found technical violations of the law, an
indifference on Hamilton’s part to the clear intent of Congress in making
appropriations—quite enough, as they thought, on which to continue the
attack. Again Giles and Madison sat with Jefferson in his home going over
the reports, and framing the second set of resolutions with which it was
hoped to drive their enemy from the Cabinet.

VII

Three days before the end of the session, Giles presented his famous
resolutions in condemnation of Hamilton’s official conduct, based on the
disclosures in his reports. It does not matter who originally wrote them. A
scholarly historian[729] has produced proof of the part played by Jefferson.
In the very nature of things he must have had a part. Madison
unquestionably made suggestions and possibly revamped the copy
produced by Jefferson. Giles presented them, and they embodied the
conclusions of the three outstanding leaders of the opposition.
These resolutions, intemperately denounced from the day of their
appearance, set forth some novel theories, in view of the manner in which
the Treasury had been administered, but, read in the light of the present
regulations in the matter of appropriations, they are scarcely remarkable and
not in the least vicious. They set forth that ‘laws making specific
appropriations of money should be strictly observed by the administrator of
the finances’; that a violation of this rule was tantamount to a violation of
the Constitution; and charged that Hamilton had violated the law passed
August 4, 1790, making appropriations of certain moneys authorized to be
borrowed in the following particulars, viz.:
First, by applying a certain amount of the principal borrowed to the
payment of interest falling due upon that principal, which was not
authorized by that or any other law.
Secondly, by drawing part of the same moneys into the United States
without the instruction of the President.
They charged him with deviating from the President’s instructions, with
neglecting an ‘essential duty’ in failing to give Congress official
information of his proceedings in the transactions of the foreign loans.
More to the point, politically, was the charge that he ‘did not consult the
public interest in negotiating a loan with the Bank of the United States, and
drawing therefrom $400,000 at five per cent per annum, when a greater sum
of public money was deposited in various banks at the respective periods of
making the respective drafts.’ In conclusion, it was provided that a copy of
the resolutions should be transmitted to Washington.
The main thing proved by the investigation was something that required
no proof—that Hamilton had been managing the finances in the spirit of an
autocrat, a little contemptuous of the rights of Congress, a little indifferent
to the specific terms of the appropriations. These he had not hesitated to
juggle to suit his own purposes. In so doing he had been guilty of technical
violations of the law, but he had committed no crime. His hands were clean.
Yet money intended for France had not been paid, and money not intended
for the Bank had gone into its vaults. This was enough. Suspicion did the
rest.
The most censurable feature of the attack was the introduction of the
resolutions on the eve of adjournment. Jefferson, Madison, and Giles had no
idea that they would or could be disposed of before Congress should
automatically expire. Copies had gone to the papers of the four corners to
be read by the people, and it is probable that it was the intent that they
should have the summer and autumn to make their impression on the public
mind. It was manifestly an unfair advantage. But the Hamiltonians had no
thought of permitting any such delay. They were in a majority in the House.
In the Pemberton house, by candlelight, the Treasury clan was summoned
to a council of war, and they went forth to force the fighting to a speedy
finish.
The reports had settled nothing with Hamilton’s enemies. ‘When
Catullus[730] invited America to look through the windows of his breast and
judge of the purity of his political motives, he did not invite in vain,’
exulted ‘Decius’ in the ‘National Gazette.’[731] Willing to meet his
accusers? sneered ‘Franklin.’ ‘Pardon me, sir, if I am one of those
unbelievers, who, placing no confidence in any of your professions, do
verily think that you neither wish, desire nor dare to meet full and fair
inquiry. Have you asked it, sir?’[732] These jeers and exultant cries were
intolerable. The vindication of the House must come speedily.
On the last day of February there was a preliminary skirmish, and on
March 1st, the contending armies were marshaled for a decisive struggle.
Sedgwick and the faithful Smith of South Carolina led off for Hamilton,
and Giles followed for the Resolutions. Fitzsimons of Philadelphia and
Laurance of New York City, both representatives of the commercial
interests, attacked, and Mercer of Maryland replied. Boudinot defended
Hamilton, and Madison rose to make the premier argument in
condemnation of the policies of the Treasury; and Ames, the most brilliant
of the Hamiltonian orators, who had been held in reserve for Madison,
replied. Thus the day wore on, darkness fell, and the candles had long been
lighted before the House adjourned for dinner. Seven o’clock found the
galleries packed, Senators upon the floor, favored spectators in the rear of
the Chamber packed in close. The leading drawing-rooms were dark that
night, for their mistresses looked down upon the drama of the black eyes
and bloody noses. The struggle continued far into the night.
Here let us pause to catch the drift of the speeches. The supporters of
Hamilton made the most of the failure to find any evidence of criminality.
‘They present nothing that involves self-interest or pecuniary
considerations.... Instead of anything being detected that would disgrace
Pandemonium, nothing ... which would sully the purest angel in Heaven.’
Thus spoke Smith. No longer ‘the foul stain of peculation,’ but ‘the milder
coloring of an illegal exercise of discretion and a want of politeness in the
Secretary of the Treasury,’ said Barnwell.[733] What if a critical
examination had revealed a deviation from the letter of the law, exclaimed
Laurance. Was that an excuse for sounding ‘the alarm from St. Croix to St.
Mary’s?’ No corruption! cried Mercer, who had been forced to deny
campaign charges he had made. ‘I still entertain the opinion that there is
corruption.’ The House was in turmoil, and the Marylander was sharply
called to order. On he plunged, recklessly fighting his way against calls to
order.
No charge of corruption stained the lips of Madison, who moved on
solid ground. There had been a technical violation of the law, and he proved
it. There had been a disregard of the instructions of the President, and he
showed it. He went thus far, no farther, and he hammered home the facts. ‘I
will not deny,’ he said, ‘that there may be emergencies in the course of
human affairs of so extraordinary and pressing a nature as to absolve the
Executive from an inflexible conformity to the injunctions of the law. It is,
nevertheless, as essential to remember ... that in all such cases the necessity
should be palpable; that the Executive sanction should flow from the
supreme source; and that the first opportunity should be seized for
communicating to the Legislature the measures pursued, with the reasons of
the necessity for them. This early communication is equally enforced by
both prudence and duty. It is the best evidence of the motives for assuming
the extraordinary power; it is a respect manifestly due to the Legislative
authority.’ On this ground he stood, and there stood Giles.
The charges were dismissed by Ames, ex-cathedra-wise, with a shrug.
What if there had been a juggling of the funds? ‘It is impossible,’ he said
unblushingly, ‘to keep different funds, differently appropriated, so
inviolably separated as that one may not be used for the object of the other.’
Nothing criminal had been proved.[734]
One by one the resolutions were taken up and overwhelmingly voted
down—voted down even where Hamilton had admitted the charge and
justified his acts. Before the last vote was reached, many of the members,
worn by the excitement, the confinement, and fatigue, and confident of the
result, deserted their posts and wandered forth into the winter night.[735]

VIII

Hamilton had sought, through his anonymous letters, to drive Jefferson

from the Cabinet—and failed. Jefferson had tried, through this
investigation, to drive Hamilton from public life—and failed. The struggle
must go on. Each had caused the other some distress, each drawn a little
blood, but neither had inflicted a serious wound.
With the adjournment of Congress, the skirmishing was taken up all over
the country through the press. The Boston Federalists opened fire upon the
‘Boston Argus.’ It had published the resolutions, but not the Hamilton
reports. The resolutions had been carried on the same mail that conveyed
the vote of vindication, and the defeat of Giles had not been mentioned.
Infamous![736] ‘Marat’ proposed satirical resolutions declaring ‘highly
reprehensible’ every official ‘who by integrity, talents, and important
services ... conciliates the esteem and affections of the people.’[737]
Hamilton had come out pure gold, wrote a Philadelphian to a citizen of
Rhode Island. ‘The more it is rubbed, the more it will shine.’[738] A writer
in the ‘Connecticut Gazette’ was moved to a frenzy of indignation. ‘Dutch
Republicans murdered De Witt and ate his heart. Republicans banished
Aristides, the first, and condemned Socrates to Hemlock. And yet we have
confined the punishment of eminent services and ability to attempts to
degrade them from office by innuendoes, electioneering slanders, and
newspaper detraction. This however may be the prelude to eating and
banishing.’[739] A traveler in the Southern States wrote of the effect of the
investigation in Virginia. It had ‘opened the eyes of many who have hitherto
been under the explicit direction of a certain would-be umpire of the United
States.’[740] He found that prejudice had been created against Hamilton on
the ground that he ‘had not done as much as he ought to assist certain needy
men to their claims for services,’ but he was pleased to find that ‘the unjust
prejudice against the industrious patriot is decreasing daily.’[741]
Everything possible was done to make Hamilton’s vindication a veritable
triumph. When the Providence Society of New York met at Haut’s Tavern
for a dinner, the toast, ‘The Secretary of the Treasury—may his
distinguished talents and integrity command universal respect,’ was
received with shouts and the clicking of glasses.
But the Jeffersonians were unimpressed. ‘After all,’ they said, Hamilton
‘acknowledges the freedom taken with appropriations and strives to work
out an apology, rather than a justification.’[742] A week later, the ‘National
Gazette’ presented an analysis of the vote of which the Jeffersonians were
to make much. Vindication, indeed!—and by whom? Three were directors
of Hamilton’s National Bank. Fifteen or twenty were reputed to be
stockholders in the same institution. ‘Can these men be admitted as judges
—men who in fact are parties to the cause?’[743] All over the land the
Jeffersonians were making it uncomfortable for many members who had
voted to vindicate, and the Kentuckians soon had Christopher Greenup
begging for a suspension of judgment until he could explain.[744]
‘Vindicated!’ cried the Hamiltonians. ‘Yes, and by whom?’ answered the
Jeffersonians. ‘By Bank directors, by Bank stockholders who profited, by
congressional speculators in the funds.’

IX

Thus the Jeffersonians sought to explain their defeat and even turn it to
account. The master mind among them expressed no surprise at the result.
He drew up a list of the members who had voted the vindication, indicating
which owned Bank stock and which speculated in the funds. When
Jefferson journeyed back to renew his strength and courage on his beloved
hill, others of his party followed. A little later there was a movement of the
leaders to the country home of John Taylor of Caroline at Port Royal,
Virginia, where the conferences were continued. Thither went Giles,
Senator Hawkins of North Carolina, and Nathaniel Macon. The master of
Port Royal was a remarkable character, an ardent Republican, an earnest
champion of the agricultural interests, a robust, original thinker with
something of the political philosopher, an able writer, a dignified though
reluctant Senator. His mind ran much in the same groove with Jefferson’s
and Madison’s, both of whom were anxious to enlist him more actively in
their fight.
Just what occurred at the conferences that summer is not known. A few
months later, however, the probable fruit of the discussions appeared in
Philadelphia in the publication of a startling pamphlet, ‘An Examination of
the Late Proceedings of Congress Respecting the Official Conduct of the
Secretary of the Treasury.’ Here in an analysis of the vote the charge that
interested parties had furnished the majority was not only made, but names
were given. Of the thirty-five supporters of Hamilton, twenty-one were set
down as stockholders or dealers in the funds, and three as Bank directors.
Referring to the fervent declaration of Smith of Charleston that Hamilton
was as free from taint ‘as the purest angel in Heaven,’ the author of the
pamphlet commented that ‘it is well known that [Smith] holds between
three and four hundred shares in the Bank of the United States, and has
obtained discounts, ad libitum.’ As for Hamilton’s reports, they contained
vindications of his conduct ‘in certain particulars relative to which no
charge had been brought forward.’ His explanation of the shuffling of
appropriations was unimpressive. A deficiency in the appropriation? ‘In
such event it becomes his duty to state the fact simply and correctly to the
Legislature, that they might, in turn, furnish fresh and additional funds.’
Hamilton had done nothing of the sort. He had treated the House with
contempt and violated the law.
Here was clearly the answer of the Jeffersonians to the vote of the
House. It found its way to every city, town, and hamlet, to the cabin in the
Kentucky clearing, to the mansion of the master of many slaves on the river
James, to the pioneers about Fort Pitt on the far frontier. John Taylor of
Caroline had struck his blow.[745]
Thus the congressional battle merely served to accentuate the differences
of the parties. It marked, in great measure, the close of the purely fiscal
phase of the struggle. Neither Jefferson nor Madison was qualified to cross
swords with Hamilton in the field of finance. Giles was hopelessly
inadequate. A little later, a Jeffersonian leader was to join them whose
genius as a financier would be as far above all the Federalists, save
Hamilton alone, as Hamilton was superior to Giles, but he was still waiting
in the wings for Fate to give the cue for his appearance.
Even as Taylor wrote, a new issue had appeared, made to order for the
purposes of Jefferson.
 CHAPTER X

ÇA IRA

U P to this time Jefferson had been fighting under a disadvantage. In the

field of finance he was unable to cope on equal terms with his great
protagonist. The mass of the people were not consciously concerned
with the Hamiltonian policies, few comparatively had been swindled by the
speculators, and, while they resented their neighbors’ sudden acquisition of
wealth, it was not easy to capitalize their discontent.
Then the French Revolution entered a more dramatic stage, captivating
the imagination of the multitude. As the real significance of the struggle
began to take form, with the crowned heads of the Old World marching in
serried ranks under the leadership of Brunswick on the French frontier, the
excitement was electric; and when they were turned back by the gallant
resistance of the Revolutionists the floodgates of enthusiasm broke. One
prolonged, triumphant shout went up from the masses. The ‘people of no
particular importance’ somehow felt that the victory was theirs. They had
been a little indifferent, these men of the shops, taverns, wharves, and the
frontier, over the disputed financial and economic policies of their country,
but they could understand the meaning of ‘liberty, equality, fraternity.’ It
meant democracy. Thus the news of the French victories shook the bells in
the New York steeples, Tammany celebrated with song, shout, and speech
in her wigwam, and the bung was knocked out of the barrel of illiterate
oratory in the beer saloons. These ‘people of no importance’ had been
inarticulate, and they were moved to eloquence. They had found a cause
they believed their cause—the cause of the people against privilege.[746]
The enthusiasm swept over the country, and the scenes of riotous joy at Mr.
Grant’s fountain tavern in Baltimore[747] were imitated at Plymouth,
Princeton, Fredericksburg, Norfolk, Savannah, Charleston, Boston,
Philadelphia.
In Boston there was a salute of cannon at the castle, and a picturesque
procession moved, fluttering French and American flags, bearing a roasted
ox of a thousand weight for the barbecue and a hogshead of punch to wash
it down, while girls and women waved from the windows, boys shouted
from the roofs, and the frenzied throng roared approval to the eloquence of
Charles Jarvis, the Jeffersonian leader, and to the Revolutionary poem by
‘Citizen’ Joseph Croswell.[748] The cheers of Boston were echoed back
from Charleston, where the artillery boomed in the day, mingling its
thunder with the bells of Saint Michael’s. Only ‘the pen of a Burke could
describe the scene on State Street’ packed with exultant humanity, with men
looking down from the chimney-tops, while ‘bevies of amiable and
beautiful women’ blessed the marchers with their smiles from the balconies
of the houses.[749] On to Saint Philip’s tramped the crowd for religious
exercises, for these men were not anarchists or criminals, but decent
citizens, moved to the depths by the defeat of the persecutors of France.[750]
And observing the unprecedented enthusiasm from his quiet corner,
Thomas Jefferson rejoiced. At length the masses were politically awake,
and the enemies of democracy had their answer.

II

The issues precipitated by the French Revolution had everything to do

with American politics—inevitably so. There were sentimental reasons for
the popular enthusiasm for the nation that had served America with men
and money; and there were economic reasons for the opposition in the fact
that the great merchants operated on English credit. But the political
significance of the divisions soon to appear have been persistently written
down, where they should be written up.
With some exceptions the Hamiltonian leaders were hostile to the
purposes of the French Revolution from the beginning. Here was a rising of
the people with a claim to power, and the keynote of Federalist policies was
distrust of the people; here was defiance of ‘authority,’ and they were
sticklers for constituted authority; here was a challenging of privilege, and
they honestly believed in privilege; here was democracy, and they hated it.
They were against it, just as Burke was against it, because it was an
iconoclastic movement, a trampling on tradition. The death of the King, the
slaughtering by the guillotine, the stupidity and infamy of Genêt, the
intemperance of the American ‘Jacobin clubs,’ the defiance of
Washington’s proclamation—on these they were to seize to neutralize or
destroy the popularity of the Revolution, but it was the proclaimed
principles of the Revolution that they hated.
In the Senate, where the Hamiltonians were dominant, this was evident
from the beginning. As early as December, 1790, when the resolutions of
condolence adopted by the National Assembly on the death of Franklin
were submitted to the Senate, Adams, in reading the letter from the
President of that body which accompanied them, referred sarcastically to
the writer’s titles, apropos of the action of the Assembly in abolishing titles
of nobility.[751] A few weeks later Oliver Ellsworth and Rufus King, the
ablest Federalists in the Senate, openly denounced the French, and ridiculed
their claims upon American gratitude, and when Maclay made indignant
protest, Ellsworth, taking snuff, pretended not to hear, Adams talked
audibly with Otis the secretary, and other Senators gathered in groups to
talk aloud. As early as February, 1791, the Hamiltonians in the Senate were
in no mood to listen to a defense of France.[752] Even the concession of a
constitution by Louis XVI was resented by the senatorial fathers of the
Federalist persuasion. The more democratic House adopted a reply praising
‘the wisdom and magnanimity’ shown in its formation and acceptance, but
when it reached the Senate, George Cabot objected to the word
‘magnanimity,’ Ellsworth supported him, the Federalists voted accordingly,
and it was stricken out. ‘Too many Frenchmen, like too many Americans,
panting for equality of persons and property,’ grumbled Adams as early as
April, 1790.[753] ‘We differed in opinion on the French Revolution,’ wrote
Adams in retrospect to Jefferson many years later.[754] Adams and
Hamilton, King and Ellsworth, Cabot and Ames, Jay and Bingham, looked
with mingled cynicism and alarm upon the Revolution from the moment it
began to take on a popular character and to aim at the destruction of
privilege.
Jefferson was just as ardent in its support. He knew the miserable state to
which the feudalistic institutions of the Bourbons had reduced the masses of
the people. He had seen justice bought and sold in France on the auction
block, the operations of the hideous game laws that threw open the
peasants’ fields to the trampling of the horses of the aristocracy, the bestial
poverty of the poor, the insulting of their wives and the debauching of their
daughters, with justice open-eyed and leering. He knew the wantonness of
Versailles, the drunkenness of the King, the profligacy of the Queen, and he