Without Adam Smith there's a good chance the economic theories and policies at work today wouldn't exist. Basically the first capitalist thinker, and a proponent of laissez-faire methods at that, his free market ideas laid the framework for production-oriented growth currently dominating Western economies.
The Wealth of Nations came at the cusp of the Industrial Revolution. To call it groundbreaking would be an understatement—the words capitalism and (even more surprising) economics weren't even in use when it was first published in 1776, and parts of Europe were still dominated by feudalism. His contributions to the theories of self-regulating price systems, the origins of money, and the real value of any commodity determined the course of debate and policy-making for the next two and a half centuries.
His thoughts concerning the tension between laborers and employers (or, as he called them, "masters") foreshadowed similar debates between unions and corporate magnates. When workers join together, he pointed out, wages go up; when employers close ranks, however, wages go down. In England during his day, anti-union laws were harsh and strict, and his sympathy for disenfranchised workers was severely criticized.
Not often does a book come along the significance of which is so great it continues to shape its field centuries after its initial release. The Wealth of Nations is such a book. Economics without Adam Smith, it doesn't seem all that presumptuous to say, would not be economics, at least not as it is defined now. Charlie Darwin did it for science; Thomas Hobbes did it for political science; an eccentric Scotsman who never married and chronically moved back in with his mother did it for economics.
Smith's impact wasn't just on mainstream thought, either. The Austrian School as helmed by Ludwig von Mises, with its emphasis on the free market and libertarian self-regulation, was directly influenced by Smith's pioneering work. Even Karl Marx, whose attitude toward the ideas espoused in The Wealth of Nations was decidedly antagonistic and negative, was nevertheless deeply affected by what he read of the Scotsman.
The original edition of Smith's book is weighted down with what for modern readers can only be described as worthless statistics (unless you're an expert on 18th century European commerce). Fortunately for us, this edition has been abridged from its original 1200+ pages, and the theories distilled from the pages and pages of charts and boring material. A great introduction to a great thinker and his seminal work.
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