Ann Preston: First Woman Medical School Dean

By Maggie MacLean, 10-10-2012

Ann Preston (December 1, 1813–April 18, 1872) was a doctor and educator of women in Pennsylvania. One of the most notable achievements of the Religious Society of Friends (Quakers) in the 19th century was the role it played in the entrance of women into medicine. Ann Preston was one of those pioneer Quaker women doctors.

Through her leadership and her persuasive influence, Dr. Preston promoted educational, professional and social changes that eventually established the right of women to study medicine and removed the barriers which blocked the path of those women who aspired to become competent and successful physicians.

Early Years
Ann Preston was born on December 1, 1813 in West Grove, Pennsylvania, Quaker community near Philadelphia. She was the oldest daughter and second of nine children of Quaker minister Amos Preston and Margaret Smith Preston. Of their three daughters, Ann was the only one to survive to adulthood.

Ann grew up in a close knit family revolving around the West Grove Meeting. Her parents were abolitionists and supporters of women's rights. The famous Quaker minister Lucretia Mott was a friend of the Prestons and often visited them.

Ann was educated at the local Quaker school, then at a boarding school in Chester, Pennsylvania, until she had to return home to care for her family when her mother became ill. To continue her education she attended lectures of the local literary association and lyceum, where such poets as James Russell Lowell and John Greenleaf Whittier came to speak, and began to write her own essays and poetry.

Ann also became a member of the temperance movement and the Clarkson Anti-Slavery Society, for which she wrote petitions and lectures. After her younger brothers were old enough to care for themselves, Ann became a teacher, and in 1849 she published a book of children's rhymes, Cousin Ann's Stories.

Because girls were restricted to sedentary and indoor activities and dressed in tight clothing, Ann believed that women should know more about their own bodies. After some intense study of those subjects, she began teaching physiology and hygiene to all-female classes.

For the first half of the 19th century all medical schools uniformly refused to admit females. In 1847 Geneva College in New York made a one-time exception for Elizabeth Blackwell, and she became the first American woman doctor. But others who wanted to train were forced to study medicine in the offices of physicians and could not gain the status of 'medical doctor.'

Medical Education
Encouraged by Philadelphia Quakers who were becoming interested in medical education for women, in 1847 Ann Preston became an apprentice in the office of Dr. Nathaniel Moseley. After two years of medical training under Dr. Moseley, Preston applied to four medical colleges in Philadelphia but her applications were rejected because of her gender.

To provide opportunities for women to study medicine, a group of Quakers founded the Female Medical College of Pennsylvania in 1850 - the first institution in the world established to train women in medicine and offer them the degree of Doctor of Medicine. The first year the faculty of the College was all male, but in 1851 Hannah Longshore was selected as a demonstrator in anatomy and was listed as a faculty member.

Preston enrolled in the first class, graduating in December 1851 at the age of 38. She returned to the college the following year for postgraduate work, then ran a series of lectures on hygiene for women. In 1853 Preston was appointed professor of physiology and hygiene at the Female Medical College, and spent the rest of her life in service of women in medicine.

Woman's Hospital of Philadelphia
In 1857, the Philadelphia Medical Society spoke out against the Female Medical College, effectively barring its women students from educational clinics and medical societies in the city. Undeterred, Dr. Ann Preston organized a board of "lady managers" to fund and run a teaching hospital to care for women, where her students could gain clinical experience.

The area around the Medical College was too crowded to add a hospital wing, and it was therefore necessary to find a new location. But to buy such a site meant raising money. The supporters of the college had already given as much as they could, while other wealthy Philadelphians objected to women doctors. In 1858 Preston began walking from door to door soliciting funds.

During this time, she began to suffer from rheumatic fever and exhaustion, and she was confined to a hospital for three months to recuperate.

During the Civil War (1861-1865), the Medical College was forced to close due to lack of financial support. However, Dr. Preston had raised enough money to send friend and colleague, Dr. Emmeline Horton Cleveland, to Paris to study obstetrics so that she could be the resident physician at the new hospital.

When there was still not enough money in the coffers, Preston borrowed her family's horse and buggy and began to go from farm to farm in Bucks, Montgomery and Chester Counties, calling on Quaker families and pleading her cause. Her earnestness and faith were deeply moving, and slowly the money trickled in.

In 1861, Preston and her supporters founded the Woman's Hospital of Philadelphia to offer medical and surgical care for women by women. Its purposes were to:

"establish in the City of Philadelphia a Hospital for the treatment of diseases of women and children, and for obstetrical cases; furnishing at the same time facilities for clinical instruction to women engaged in the study of medicine, and for the practical training of nurses; the chief resident physician to be a woman."

Woman's Hospital accepted its first patient, to the "Lying In Department (maternity)," on December 16, 1861. By April of 1862, twelve patients occupied beds. The hospital grew steadily; by 1875 it housed 37 beds, treated nearly 2,000 patients at their homes (with visits carried out largely by students), and saw more than 3,000 visitors in its dispensary. Women and children were admitted "without regard to their religious belief, nationality or color."

After the Female Medical College was re-opened in 1866, student Mary Putnam Jacobi was refused a medical degree by Edwin Fussel, though she met the required qualifications. Most of the faculty, including Preston, disagreed with the decision. Fussell resigned following the incident, and Preston was appointed dean.

Dean of Woman's Medical College
Dr. Ann Preston served as dean of the college from 1866 through 1872, becoming the first woman dean of an American medical school, a position that allowed her to champion the right of women to become physicians. Under her leadership the college trained the first African American and the first Native American women doctors in the country, as well as the first women medical missionaries to Asia.

The school changed its name to Woman's Medical College of Pennsylvania in 1867. Soon many eminent physicians, male and female, were among its teaching staff. When many small medical colleges were forced to close because of the introduction of higher standards in medical training, the College survived. In 1863 the school began to train nurses, one of the first institutions in the United States to do so.

Some of the women who audited the courses at the college gave lectures on physiology and hygiene to women in the poorest sections of the city of Philadelphia, thus pioneering medical outreach as a branch of social work. One of these women was Sarah Mapps Douglass, an African American teacher and Quaker.

While she had achieved her goal of establishing a woman's hospital, Ann Preston believed that her female medical students deserved the right to attend the larger, all-purpose clinics and hospitals in Philadelphia so they might learn to deal with a greater variety of medical conditions. At first all the hospitals barred "lady doctors."

However, in 1868 Preston won the right for her students to attend the teaching clinics at Blockley Hospital. When the first women arrived, however, they were met by an angry demonstration. The male medical students shouted insults and threw paper, tinfoil and tobacco quids at the women. The female students remained composed and attended the clinic, but on their way out they were pelted with rocks.

Following this demonstration, the faculty of the University of Pennsylvania and of Jefferson Medical College held a meeting attended by representatives of the medical staffs of all the hospitals in Philadelphia to discuss the admission of women medical students and declared themselves to be opposed to the "admixture of the sexes at clinical instruction in medicine and surgery."

Because of the publicity over the behavior of the male medical students at Blockley and Preston's protest against it, public opinion began to swing in favor of the education of women doctors. In 1869 she made a similar arrangement with the Pennsylvania Hospital. Dr. Preston accompanied her students to the first clinic and witnessed the harassment by male students firsthand.

In a letter written February 21, 1925, one of Preston's former students, Sarah Hall, recalled the events that day for the 75th anniversary of the Woman's Medical College:

"We were allowed to enter by way of the back stairs, and were greeted by the men students with hisses and paper wads, and frequently during the clinic were treated to more of the same. The Professor of Surgery came in and bowed to the men only. More hisses... We retired the same way we entered and, on reaching the outer door, found men students lined up on one side of the way, and we, to get out, had to take the road and walk to the street to the tune of 'The Rogues March.' Our students separated as soon as possible. All who could took the little antiquated horse cars in any direction they were going. The men separated also, and in groups of twos, threes and fours, followed the women."

Late Years
By this time Ann Preston was gravely ill, suffering from articular rheumatism. She continued to teach at the college, serving as professor of physiology, and to serve as consulting physician at the Woman's Hospital, but she had to restrict her private practice to office visits because she could no longer ride out to visit her patients in their homes.

Nevertheless, her spirit remained strong, and she was a constant inspiration to her students. Year after year she addressed the graduating class of the Female Medical College, urging them to continue to practice the highest standards of medical care despite opposition. In 1871 Preston suffered an attack of acute articular rheumatism, which left her in a weakened state.

Dr. Ann Preston died on April 18, 1872 and was buried near her beloved friends Lucretia and James Mott and many other Quaker abolitionists at Fair Hill burial ground in North Philadelphia. Ann left her instruments and her life savings to her beloved college for a scholarship. Six years later, her friend Dr. Emmeline Cleveland died and was buried next to Dr. Preston, as she had requested.

There is a beautiful sequel to Ann Preston's life. The Woman's Hospital that she founded flourished on North College Avenue for many years and then was moved to West Philadelphia, where the street facing it was named Preston Street. The neighborhood around it deteriorated, there was less need for a woman's hospital, and it was abandoned some years ago. However, it has now been rehabilitated by a Quaker group, Friends Rehabilitation Corporation, as housing for elderly and homeless women.

SOURCES
Wikipedia: Ann Preston
Pioneer Woman Doctor: Ann Preston
Changing the Face of Medicine: Dr. Ann Preston
Wikipedia: Woman's Medical College of Pennsylvania

From: civilwarwomenblog.com

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Prostitution and the Civil War

By Annika Jensen ’18

It was to my slight disappointment that I found out that the term “hooker,” one of many referring to prostitutes (or, as they were called during the Civil War era, “public women), is not actually a play on the name of Joseph Hooker, the infamous and promiscuous Union general. Fighting Joe may, however, have helped elevate the term to its current popularity; after all, a certain red light district in Washington, D.C. was dubbed “Hooker’s Division.”

Pushing past the etymology, however, I discovered a vast array of sources, anecdotes, and documents leading to the world of prostitution in the Civil War era. In an earlier post I explored the prudish nature of domestic sex, a topic not often discussed or even performed. Indeed, prostitution and sex work was held in contempt by the majority of Victorian society: William Quesenbury Claytor on Virginia penned in his diary in 1852 that “impudent prostitutes” were often seen in Alexandria at night, and Union officer Josiah Marshall Favill wrote that in the same city in 1862 houses were “thronged” with sex workers. As discouraged and taboo as the practice was, however, it continued to expand and thrive during the Civil War era.

Sexually transmitted diseases indicate the prevalence of prostitution during the war itself; an estimated 8.2% of Federal soldiers were diagnosed with either syphilis or gonorrhea throughout the war, and far more likely went undiagnosed. These venereal diseases were a tremendous setback for the army, as treatment could put troops out of combat for long periods of time; officers had to ensure discipline and order to keep their men from frequenting brothels. Such problems proved especially prevalent in Union-occupied Southern cities like Nashville and New Orleans.

One effort taken by the Union to eradicate this fraternization was to ship the prostitutes to other states. This was attempted in Nashville, where women were put on trains and sped off to surrounding cities. However, many of them were close enough to find their way back, and more drastic measures were sought. The army decided the solution was to transport the women to different states by boat; they called upon Captain John Newcomb of the steamboat “Idahoe” to transport 100 prostitutes to Kentucky. The captain protested, not willing to tarnish the reputation of his ship, which he claimed would becoming known as a “floating whorehouse,” but he could not stand up to the army, and his trip went underway. Unfortunately for Newcomb, no city in Kentucky, or any other state, would accept his cargo, and he was forced to circle back to Nashville. The result was a ruined ship and a city that had not rid itself of its prostitutes.

The documentation of prostitutes and legalization of their work became an effective—though not necessarily morally sound—solution. This system was implemented in Nashville in August 1863, when public women were required to report to a newly-transformed clinic and be tested and licensed. Thus, prostitution essentially became legal and much safer, as sex workers were required to be tested every two weeks; if they failed the medical exam, they were sent to the hospital until they were deemed “cured,” after which they could return to their work. Unlicensed prostitutes caught working were incarcerated.

In the roughly two years that this system was used in Nashville, nearly 400 licenses were issued and the city and Union army alike became considerably healthier. The moral question was naturally raised, to which the army could only conclude that the safety and health of its soldiers transcended ethical values.

So, while the Civil War era is generally regarded as a part of prudish Victorian society, in which intimacy in the home was of a taboo nature, there was no lack of sex.

Sources:

Claytor, William Quesenbury. Diary of William Claytor, 1849-1896, vol. 1. Alexandria, VA: Alexander Street Press, 2002.

Favill, Josiah Marshall. The Diary of a Young Officer Serving with the Armies of the United States during the War of the Rebellion. Chicago, IL: R.R. Donnelley & Sons Co., 1909.

Lowry, Thomas P. “The Army’s Licensed Prostitutes.” Civil War Times Illustrated 41, no. 4 (August 2002): 30-36. America: History and Life.

Schogol, Jeff. “Do ‘hookers’ Owe Their Moniker to a Civil War General?” Stars and Stripes. April 28, 2011. stripes.com.

Serratore, Angela. “The Curious Case of Nashville’s Frail Sisterhood.” Smithsonian. July 8, 2013.

Image: General Benjamin Butler enforced harsh discipline on the people of Union-occupied New Orleans; he is noted for threatening to publicly denounce women as prostitutes if they acted out against his soldiers. This editorial cartoon illustrates the resulting change in behavior.

From: gettysburgcompiler.com

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History of Abortion

From: prochoice.org

In the United States, the history of abortion goes back much farther than the 1973 Supreme Court case Roe v. Wade, which made abortion legal and marked an important turning point in public health policy.

Abortion Was Legal

Abortion has been performed for thousands of years, and in every society that has been studied. It was legal in the United States from the time the earliest settlers arrived. At the time the Constitution was adopted, abortions before “quickening” were openly advertised and commonly performed.

Making Abortion Illegal

In the mid-to-late 1800s states began passing laws that made abortion illegal. The motivations for anti-abortion laws varied from state to state. One of the reasons included fears that the population would be dominated by the children of newly arriving immigrants, whose birth rates were higher than those of “native” Anglo-Saxon women.

Medical Practice

During the 1800s, all surgical procedures, including abortion, were extremely risky. Hospitals were not common, antiseptics were unknown, and even the most respected doctors had only primitive medical educations. Without today’s current technology, maternal and infant mortality rates during childbirth were extraordinarily high. The dangers from abortion were similar to the dangers from other surgeries that were not outlawed.

As scientific methods began to dominate medical practice, and technologies were developed to prevent infection, medical care on the whole became much safer and more effective. But by this time, the vast majority of women who needed abortions had no choice but to get them from illegal practitioners without these medical advances at their disposal. The “back alley” abortion remained a dangerous, often deadly procedure, while areas of legally sanctioned medicine improved dramatically.

The Medical Establishment

The strongest force behind the drive to criminalize abortion was the attempt by doctors to establish for themselves exclusive rights to practice medicine. They wanted to prevent “untrained” practitioners, including midwives, apothecaries, and homeopaths, from competing with them for patients and for patient fees.

The best way to accomplish their goal was to eliminate one of the principle procedures that kept these competitors in business. Rather than openly admitting to such motivations, the newly formed American Medical Association (AMA) argued that abortion was both immoral and dangerous. By 1910 all but one state had criminalized abortion except where necessary, in a doctor’s judgment, to save the woman’s life. In this way, legal abortion was successfully transformed into a “physicians-only” practice.

Back-Alley Abortions

The prohibition of legal abortion from the 1880s until 1973 came under the same anti-obscenity or Comstock laws that prohibited the dissemination of birth control information and services.

Criminalization of abortion did not reduce the numbers of women who sought abortions. In the years before Roe v. Wade, the estimates of illegal abortions ranged as high as 1.2 million per year.1 Although accurate records could not be kept, it is known that between the 1880s and 1973, many thousands of women were harmed as a result of illegal abortion.

Many women died or suffered serious medical problems after attempting to self-induce their abortions or going to untrained practitioners who performed abortions with primitive methods or in unsanitary conditions. During this time, hospital emergency room staff treated thousands of women who either died or were suffering terrible effects of abortions provided without adequate skill and care.

Some women were able to obtain relatively safer, although still illegal, abortions from private doctors. This practice remained prevalent for the first half of the twentieth century. The rate of reported abortions then began to decline, partly because doctors faced increased scrutiny from their peers and hospital administrators concerned about the legality of their operations.

Liberalization of Abortion Laws
Between 1967 and 1973 one-third of the states liberalized or repealed their criminal abortion laws. However, the right to have an abortion in all states was only made available to American women in 1973 when the Supreme Court struck down the remaining restrictive state laws with its ruling in Roe v. Wade.

Roe v. Wade
The 1973 Supreme Court decision in Roe v. Wade made it possible for women to get safe, legal abortions from well-trained medical practitioners. This led to dramatic decreases in pregnancy-related injury and death.

The Roe case arose out of a Texas law that prohibited legal abortion except to save a woman’s life. At that time, most other states had laws similar to the one in Texas. Those laws forced large numbers of women to resort to illegal abortions.

Jane Roe, a 21-year-old pregnant woman, represented all women who wanted abortions but could not get them legally and safely. Henry Wade was the Texas Attorney General who defended the law that made abortions illegal.

After hearing the case, the Supreme Court ruled that Americans’ right to privacy included the right of a woman to decide whether to have children, and the right of a woman and her doctor to make that decision without state interference.

After Roe v. Wade
The reaction to Roe was swift. Supporters of legal abortion rejoiced and generally felt their battle was won. However, others faulted the Court for the decision. Those opposed to legal abortion immediately began working to prevent any federal or state funding for abortion and to undermine or limit the effect of the decision.

Some turned to measures directly aimed at disrupting clinics where abortions were being provided. Their tactics have included demonstrating in front of abortion clinics, harassing people trying to enter, vandalizing clinic property, and blocking access to clinics.

As time passed, the level of anti-abortion violence escalated. Increasingly, clinic bombings, physical attacks, and even murders endanger abortion providers and create a hostile environment for women seeking abortions.

Retreat from Roe v. Wade
Initially, the framework of Roe v. Wade was the basis by which the constitutionality of state abortion laws was determined. In recent years, however, the Supreme Court has begun to allow more restrictions on abortion.

For instance, the Supreme Court’s ruling in Planned Parenthood v. Casey in 1992 established that states can restrict pre-viability abortions. Restrictions can be placed on first trimester abortions in ways that are not medically necessary, as long as the restrictions do not place an “undue burden” on women seeking abortion services.

Many states now have restrictions in place such as parental involvement, mandatory waiting periods, and biased counseling. Only the requirement that a woman involve her spouse in her decision was disallowed.

A Timeline of Reproductive Rights
1821: Connecticut passes the first law in the United States barring abortions after “quickening.”

1860: Twenty states have laws limiting abortion.

1965: Griswold v. Connecticut Supreme Court decision strikes down a state law that prohibited giving married people information, instruction, or medical advice on contraception.

1967: Colorado is the first state to liberalize its abortion laws.

1970: Alaska, Hawaii, New York, and Washington liberalize abortion laws, making abortion available at the request of a woman and her doctor.

1972: Eisenstadt v. Baird Supreme Court decision establishes the right of unmarried people to use contraceptives.

1973: Roe v. Wade Supreme Court decision strikes down state laws that made abortion illegal.

1976: Congress adopts the first Hyde Amendment barring the use of federal Medicaid funds to provide abortions to low-income women.

1977: A revised Hyde Amendment is passed allowing states to deny Medicaid funding except in cases of rape, incest, or “severe and long-lasting” damage to the woman’s physical health.

1991: Rust v. Sullivan upholds the constitutionality of the 1988 “gag rule” which prohibits doctors and counselors at clinics which receive federal funding from providing their patients with information about and referrals for abortion.

1992: Planned Parenthood of Southeastern Pennsylvania v. Casey reaffirms the “core” holdings of Roe that women have a right to abortion before fetal viability, but allows states to restrict abortion access so long as these restrictions do not impose an “undue burden” on women seeking abortions.

1994: Freedom of Access to Clinic Entrances (FACE) Act is passed by Congress with a large majority in response to the murder of Dr. David Gunn. The FACE Act forbids the use of “force, threat of force or physical obstruction” to prevent someone from providing or receiving reproductive health services. The law also provides for both criminal and civil penalties for those who break the law.

2000: Stenberg v. Carhart (Carhart I) rules that the Nebraska statute banning so-called “partial-birth abortion” is unconstitutional for two independent reasons: the statute lacks the necessary exception for preserving the health of the woman, and the definition of the targeted procedures is so broad as to prohibit abortions in the second trimester, thereby being an “undue burden” on women. This effectively invalidates 29 of 31 similar statewide bans.

2000: Food and Drug Administration approves mifepristone (RU-486) as an option in abortion care for very early pregnancy.

2003: A federal ban on abortion procedures is passed by Congress and signed into law by President Bush. The National Abortion Federation immediately challenges the law in court and is successful in blocking enforcement of the law for its members.

2004: NAF wins lawsuit against federal abortion ban. Justice Department appeals rulings by three trial courts against ban.

References
Tietze C, Henshaw SK. Induced Abortion: A World Review, 1986. New York: The Guttmacher Institute, 1986

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Civil War Life: A Letter to Her Husband, Benjamin Wells

From: edinborough.com

This letter was written by Melissa Hoisington Wells of Fabius, Michigan, to her husband. At the time, Benjamin was stationed near Nashville, Tennessee with the 11th Michigan, Company A.

Fabius
Sunday June 22nd 1862
Dearest Ben,

After a silence of three long weeks I again resume my pen to let you know that I am still in the land of the living although I am not enjoying the best of health at the present time. I do not know how long or how nicely written my letter will be for my hand trembles so that it is with difficulty that I can write but I will do the best I can, hoping that you will make all due allowances. No doubt you are feeling anxious to hear from me and I would have written before had I been well enough but likely you know the reason before now. I have received five letters from you since I wrote and I will answer them all as soon as I can the dates of them were May 23rd and 26th and 30th and June 5th and 10th. To tell the truth I hardly know what to say but I will try to think of enough to make out a letter if it is not as interesting as it might be. The rest of the folks are well as usual.

I have been quite sick for nearly three weeks but am on the gain now. I have not fully regained my strength yet but if nothing happens any more than I know of now, I think I shall soon be restored to good health again. Perhaps you would like to know some of the particulars concerning my sickness but to be frank about it, I am half ashamed to tell you anything about it. But I presume there is no one that feels any more anxious to know than you do and if you will not think that I am immodest I will tell you.

Fred wrote to you two weeks ago today and told you all the news. You have doubtless received the letter by this time however I hope you have not for I would have been much obliged to him if he had waited and given me a chance to write the particulars. I think it would been more suitable than for him to have done it. After he had written the letter, he brought it down and read it over to me before enclosing it. I did not feel very well pleased with all he wrote and I do not see what he meant by writing as he did. I should thought he would know that you would feel bad enough without his taking particular pains to hurt your feelings. Now I have not the least recollection of wishing any such thing on you as he stated to you in his letter.

It would been very ungenerous for me to wish you to suffer because I had to and I do not think that I said any such thing, although I was suffering such extreme pain that I might have said and done a great many things that I know nothing about now-- for I do not believe that I was conscious half the time of what was going on. As for Em, I cannot say much for her for you know as well as I do that she is very apt to say just what she thinks when she is angry but since I have been sick she has been very kind and attentive and willing to do all she possibly could for me, and I do not believe she really meant what she said-- at least she says she did not and I have every reason to believe what she says and I cannot help feeling out of patience with Fred for writing such a letter. He should never sent it-- had it been in my power to prevent it but I could not help myself. The letter was written and of course he would do as he pleased with it whether I liked it or not. I think it was very unfriendly of him but likely he thought it was all right so I thought I would do the next best thing as soon as I was able I would write to you and tell you how the thing was and have the matter made right if I possibly could. You must not feel hard nor mind anything about it for I certainly do not wish to hurt the feelings of the best friend I have and now don't feel bad nor care anything for what he said and I am sure you will not, now that you know how it is. I cannot blame you if you did feel hurt when you received his letter I think I would had I been in your place.

I had a long painful time in the beginning. I was sick over 48 hours and it seemed as if I never could live through it I was in such agony all the time from the time I was taken until I got through-- which was from Thursday night until Sunday morning. But it appears I did and am living yet and thank fortune I managed to get along without the help of a doctor and I think that is half of the battle and it is my most earnest wish that I may never be called to pass through another such a siege, although I little know what suffering there is yet in store for me. I can be content to live with but one child in all the rest of my life rather then endure again what I already have. I thought of you many times during those long tedious hours and often wished that you were with me. It seemed as if I could endure the trial with much better fortitude, but since it is over with, I cannot help feeling thankful that you were not here to witness my suffering, for such it surely is I do not think I never had one faint idea of what it was until I had the experience. I had no other help but Mother and Mrs. Parsons. I think she is excellent help at such a time and if there were more like her, the world would be so much the better off. I shall never believe if I live to be a hundred years old that it is any place for a Physician-- but perhaps you are getting impatient to know the result of all this fuss, but you likely know for Fred wrote it in a letter to pay me for all this trouble.

I have a boy that weights 8 lb and 1/4. He is two weeks old today, born the 8th inst. I cannot describe to you how he looks but he resembles other babies I think for they all look alike to me when they are so young, but just as he is at the present time you can imagine a little round chubby form lying near me as I write in a long white flowing dress and blue edged blanket sucking his tiny fist in the innocence of babyhood.

Dear Ben, how I wish you could see him. I am sure you would love it quite as well as I do it you could only come home now what times we could have I feel even more anxious to see you than before, but I live in hopes that the time will soon come when you will be at home again and we will be happy once more as we used to in times gone by. I feel sometimes as if I could not wait for the time to come it seems so long since you went way. It is nearly 7 months ago. I think that is a long, long time to be separated from the dearest and best friend I have, but I will hope for the best. I feel more encouraged now than I have for some time before, for I feel that with me the worst time is now passed and if you were only with me now I should think that long dark night had indeed passed away and the bright morning had again dawned.

I received those things you sent also your likeness for which I was very happy to receive. It looks quite natural but I cannot help think very sober. You must felt downhearted about something when it was taken. What was the matter with you, my Benny dear? I would like to know. You must excuse this bad writing for my pen is a miserable concern. I can hardly make a respectable looking mark. I will write again as soon as I feel well enough and try to write a longer letter and a better one if I can write soon and I remain,

your affectionate wife
Melissa
Courtesy: Bentley Historical Library at the University of Michigan.

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Famously Fiery First Lady Gets Modern-Day Medical Diagnosis

By Jonathan Lapook, 7-16-16

Mary Todd Lincoln had a lot of tragedy in her life. She lost two young children -- and, of course, was sitting next to President Lincoln when he was assassinated.

All of that contributed to years of depression, but now a medical expert believes there was a physical cause for her mental struggles.

History has not been kind to the wife of our 16th president. She was known to be a tempestuous, unpredictable force, and her son eventually had her committed. Sally Field's 2012 portrayal of Mary Todd showed a fierce and sharp-tongued first lady.

"You think I'm ignorant of what you're up to because you haven't discussed this scheme with me as you ought to have done," she said in one scene. "When have I ever been so easily bamboozled?"

But Dr. John Sotos, a physician and medical historian, says the famously fiery first lady was not only misunderstood - but misdiagnosed. Sotos puts forth a new theory about Mary Todd Lincoln -- her erratic behavior was caused by a condition called pernicious anemia.

"Pernicious anemia is an autoimmune disease that starts in the stomach and that impairs the body's ability to absorb food efficiently," Sotos said. "And as a result, the person becomes B12 deficient eventually, and that causes lots of problems in every organ of the body."

It was a fatal illness until treatment was discovered decades after her death. The disease can lead to many of the symptoms exhibited by Mary Todd Lincoln: a sore mouth, pale skin, difficulty walking and psychiatric problems. It can also cause swelling.

"The puffiness is not in a way that would occur with just an accumulation of fat," Sotos said.

Today, the disease can be picked up on a simple blood test and easily treated with B12 supplements.

"She had a sick brain and was doing the best that she could in a very complicated, relentlessly demanding environment," Sotos said. "And I think to have done as well as she did with the kind of handicaps that she had, I think that deserves admiration."

Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News.

From: cbsnews.com

Learn more about the health of Mary Todd Lincoln at www.CivilWarRx.com

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Women and Medicine

From: mnwelldir.org

Surgery during this period killed as many as it cured, mostly due to sepsis. It was in Europe, where the surgical arts were being perfected, at this time, specifically France, and new techniques flourished there and were quickly disseminated among European medical schools. However, even in Europe, sepsis [infection] was still a problem.

Most surgeries in the US involved the treating of wounds, as well as battle wounds. Amputation was most probably the leading surgical procedure performed.

In 1809, Jane Todd Crawford (Lincoln’s wife’s—Mary Todd— cousin) was diagnosed with a very large ovarian cyst which had originally been diagnosed as a pregnancy. At the time, no tumor had ever been removed successfully. However, there was a visiting surgeon from Edinburgh who agreed to do the surgery. According to Gail Collins, he gave her opium and alcohol to ease the pain, and a month later she returned home cured.

Legend has it that an angry crowd surrounded the doctor’s home while he was treating Mrs. Crawford, threatening to kill him for his outrageous assault on a female body. [Collins]

It was not until mid century that anesthesia was being used, as is outlined in our tongue in cheek article, The History of Anesthesia. At this time Dr J Marion Sims began experimenting with his female slaves.

Females of this period had a rough time where medicine was involved, for doctors were determined to treat every facet of female passage, from puberty through menopause as a disease.

Many doctors believed that during their periods, women were deprived of blood to the brain, leaving them “idiotic” or temporarily insane. [Collins]

During childbirth, regulars bled women into unconsciousness, mainly to relieve their own anxiety at hearing the screams and moans accompanying most births. How woman handled menstruation at this time will remain a mystery because it was something that no one mentioned in private or public. Even diaries have no mention of this monthly visitor, though many have theories on the subject, with some guessing that the use of multiple skirts and petticoats was to hide the great variety of “napkins” women had developed and used at the time.

What we do know for sure is that personal hygiene was extremely poor. Diapers were not even washed till just prior to the Civil War. Bathing was considered unhealthy. Magazine articles exhorted people to brush their teeth, but again, accounts of visitors returning to Europe spoke volumes of the poor dental care in Americans of that time. Much of our tooth loss and gum disease, though, was attributable to mercury poisoning from traditional medicine.

Because of modesty, and no regular female physicians, doctors were not allowed to look upon the naked bodies of their female patients. Many palpated (felt around) under the skirts, while others examined women with the aid of a mirror (to avoid looking directly). Collins points out that one of the best obstetricians of that period, a Dr Degorges, was blind. Many a physician exhorted medical students in their care to avoid viewing a half naked woman (even giving birth) under their care for it could result in sexual perversion leading them to adultery and madness. Students had to learn from textbooks and manikins.

Things sexual were strictly taboo, leading to much ignorance on the subject of birth control and sexually transmitted diseases, though an efficient mail system supported our young entrepreneurial spirit in the trade of sexual goods:

… Americans could send away for birth control pamphlets, medical devices like diaphragms and syringes, condoms, spermicides for douching, and pills that promised to induce abortions. Ads for condoms, cures for venereal disease, aphrodisiacs, and abortion services were an economic mainstay of the urban newspapers. Agents distributed ads for birth control devices on street corners and mailed them to newlyweds. “French” was a code for a contraceptive, and “Portuguese” for something that induced abortion . . . .  [Collins]

Abortions, performed early, were a socially accepted form of birth control. Even the Catholic Church looked the other way, as the fetus was not considered human till movement was perceived. Midwives hung flags out their windows signifying that they performed abortions. [Collins]

Infant mortality was high, even though, as Collins points out, “Americans were more likely to live to adulthood than ever before.” With husbands gone most of the time and no easy way to call for help, young wives were left alone to their superstitions. Everyone knew a handful of stories of a happy, bouncing baby struck by a sudden fever and dead before morning.

Traditional medicines at this time did more harm than good (history seems to repeat itself, e.g. Vioxx) and parents began to drug their children.

An 1833 guide used by southern women suggested daily doses of laudanum, an opium derivative—four drops for a nine-month-old and five to six drops for a toddler. [Collins]

American women, according to the European visitors, aged rapidly. Be it due to the ravages of raising a family or poor nutrition or poor medical care, one visitor penned this maxim:

"… charming and adorable at fifteen . . . faded at twenty-three, old at thirty-five and decrepit at forty." [Collins]

It was right around the mid 19th century that our personal hygiene habits began to improve. It became genteel to have a fresh water basin awaiting one’s morning ablutions. Babies where no longer swaddled (very tightly fitting clothing) in unwashed linens, but were loosely clothed and their diapers washed regularly, and not allowed to dry while the baby still wore them. The belief that children were born unsullied sprouted at this time, and since the mother was a child’s main influence, she often took all the blame should her child go astray. Women’s magazines, physicians, clergy, and neighbors offered plenty of unsolicited advice to raising the perfect child, but the perfect child was only to be found in books. The story of young George Washington still finds life in many an elementary school today.

Women were not allowed in medical schools, period. The reasons for this were varied, and today, quite comical. It took the Blackwell sisters to finally breach this barrier, though the barrier still remained sturdy for many, many years.

Elizabeth Blackwell was inspired to go into medicine because women had a hard time discussing their issues with male doctors. She’d had a close friend dying of uterine cancer who told her of her troubles communicating with her physician. Elizabeth applied at nearly every medical school available at that time, and was turned down time after time, with some faculty members even suggesting she disguise herself as a man and try Paris. [Collins]

As luck would have it, the faculty of a small medical school in upstate New York decided to ask the student body about admitting women, and boys being boys, particularly rowdy that day, cheered and hollered and yipped their approval (most assuredly along with gratuitous lewd gestures) and that was that. Wouldn’t you like to have been a fly on the wall the day Elizabeth Blackwell showed up for her first day of class? The student body thought it had been a joke, but, as the saying goes, the joke was on them. “A hush fell over the class as if each member had been stricken by paralysis.” [Jordan Brown, Elizabeth Blackwell, Physician (p.52)].

Learn more about 19th century women doctors and women's health at www.CivilWarRx.com

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The Evolution of Cancer Treatment

From: cjonline.com, 10-23-10

Mammography is most likely the most important technological advancement in the area of breast cancer detection.

Treatment for breast cancer no longer involves cauterization with hot instruments or surgeries without anesthesia. While surgery is still an option, modern-day treatments for breast cancer also include the use of radiation, chemotherapy, hormone therapy, biological therapy or a combination of them.

Here's a look at the evolution of breast cancer treatment.

— 1600 B.C.: The Edwin Smith Papyrus describes eight cases of tumors or ulcers of the breast that were treated by cauterization, using a hot tool called the fire drill.

— 460-370 B.C.: Greek physician Hippocrates used the terms "carcinos" and "carcinoma" to describe non-ulcer-forming and ulcer-forming tumors. The words refer to a crab and mostly likely described the spreading nature of the disease.

— 1713: Italian doctor Bernardino Ramazzini reported a relatively high incidence of breast cancer and absence of cervical cancer in nuns. The observation was instrumental in the later identification and understanding of hormones and cancer risk.

— 1761: Italian Giovanni Morgagni did autopsies to relate the patient's illness to pathological findings after death. This laid the foundation for scientific oncology, or the study of cancer.

— Mid-1760s: Scottish surgeon John Hunter suggested some cancers might be cured by surgery if the tumor hadn't invaded nearby tissue and was movable. At that time, surgeries were done without anesthesia. Hunter believed cancer spread through the lymphatic system.

— 1840: German surgeon Karl Thiersch showed that cancer metastasizes through the spread of malignant cells, not through fluid.

— 1846: Anesthesia was discovered, and surgeries to remove cancer increased.

— 1860s: Prussian-born Rudolf Virchow provided the scientific basis for the modern pathological study of cancer. Body tissues removed by a surgeon now could be examined, a precise diagnosis made and a determination made whether the surgery had removed all of the cancer. He determined that all cells, including cancer cells, were derived from other cells, not lymph.

— 1882-90s: William Halsted, a professor of surgery at Johns Hopkins University, developed the radical mastectomy, which called for the removal of the breast, lymph nodes and the muscle connecting the breast to the chest wall. He believed local removal of the cancer would cure it. If cancer appeared elsewhere, it was considered a new process. Radical mastectomy was used until the 1970s, when clinical trials demonstrated less extensive surgery was equally effective for most women with breast cancer.

— 1889: English surgeon Stephen Paget concluded cancer cells spread by way of the bloodstream to all organs but were only able to grow in a few organs. This idea eventually led to the development of systemic treatments that could be used before or after surgery to destroy cells.

— Late 1895-96: Scottish surgeon Thomas Beatson discovered that removal of the ovaries often resulted in improvement of breast cancer and believed the ovaries could be a cause of breast cancer. His work provided the foundation for the use of hormone therapy to treat and prevent breast cancer.

— Early 1900s: The use of radiation therapy to treat cancer, administered in daily doses over several weeks, increases.

— Mid-1940s: The U.S. Army found that nitrogen mustard, which is related to mustard gas, worked against cancer in the lymph nodes. The discovery led to other agents that killed rapidly growing cancer cells by damaging their DNA.

— 1956: Metastatic cancer is first cured by methotrexate, a cancer treatment drug still used today.

— 1962: Tamoxifen is discovered. Some breast cancer cells require estrogen to grow. The drug prevents estrogen from binding to the estrogen receptor in breast tissue.

— 1960-90s: Mammography methods were developed. Partial mastectomies, called lumpectomies, replaced radical mastectomies and allowed less normal tissue to be removed during breast cancer surgery. Exploratory operations were replaced by ultrasound, computed tomography (CT scans), magnetic resonance imaging (MRI scans) and positron emission tomography (PET scans). Advances in radiation therapy allowed beams to better target the disease or large doses of radiation be directed to a small tumor. Adjuvant therapy was first tested in breast cancer and indicated chemotherapy after surgery could destroy remaining cancer cells. Combinations of chemotherapy drugs were used to treat cancer.

— 1994-95: BRCA 1 and BRCA 2, the gene mutations that cause breast cancer, were discovered. Herceptin, a monoclonal antibody that blocks the growth of cancer, was approved.

— 2008: Avastin, an angiogenesis inhibitor, was approved to treat metastatic breast cancer. The drug stops tumors from making new blood vessels, which the tumors need to continue growing.

Sources: American Cancer Society; "Bathsheba's Breast: Women, Cancer & History," by James S. Olson

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The Complicated Birth of Midwifery

By Abby Norman on September 13, 2015

Around 353,000 babies are born every day. Some of them will be born in hospitals, others at home with the assistance of a midwife or doula, while others will make their grand entrance in the back of a car or ambulance somewhere in between home and hospital.

The history of childbirth, and in particular of midwifery, is a complicated and often cyclical one. Throughout 19th century America, midwives attended the majority of births, especially in the American South. Improved medicine and accompanying technologies meant that by the early 20th century, midwifery was highly discouraged, only to come around again when the natural birth movement was born in the 1960s.

In other words, the natural act of childbirth reflected the technological, social and medical beliefs and practices of the time. You can learn a lot about what life was like in a particular time period by examining societal attitudes toward childbirth.

16th Century
Midwives have been around since the beginning of human history. No doubt our caveman ancestors had other female tribe members help hold them up or stagger into a cave long enough to give birth. Even prior to modern language, some human acts require no verbal communication: coitus and childbirth among them.

If we start by looking at a period in history when midwifery became a specified community role, we’d start around 1522. At this point, elder females in communities worldwide ruled the roost when it came to helping younger women deliver babies. Having been licensed and educated in childbirth, midwives were highly respected community members. So much so that when they arrived to aid a laboring woman, it was the mom-to-be’s task to make the midwife feel at home and appreciated, offering her “groaning beer” or special cakes.

Midwife History Medieval
Thus childbirth became a very social event, where women close to the new mom would join the midwife in the home to cluck around, eat cake, drink and maybe lend a hand as the woman struggled. These women had a cute nickname, too: God sibs. Over time, the name morphed into a term you’re probably more familiar with: gossips.

Towards the middle of the century, and after hearing horror stories of childbirth fatalities, a family known as the Chamberlens created a tool that they believed would change the birthing game forever. They created the obstetric tool commonly known as forceps, and they guarded their invention ferociously.

They would often attend births with the tool hidden under their cloaks, blindfolding the mother so that she wouldn’t see it, and bang pots and pans to disguise the sound of the tool (which they feared, if heard, could give away the key to its design). It would be another two hundred years before forceps became widely used, in part because the original prototype would be discovered in the floorboards of the Chamberlens’ house long after the inventors had died.

Midwife History Experiments
The next major renaissance in midwifery and obstetrics came from the Antebellum South. Young doctors practiced suturing techniques on female slaves and often bought slaves specifically with that purpose in mind. Subsequently many common gynecological procedures were developed during this time, most notably the treatment of fistulas, tears that can occur during childbirth and lead to complicated infections if they aren’t repaired.

Victorian England
Across the pond, London’s destitute women were dying in droves of something called “childbed fever”, or puerperal fever. “Lying-in” hospitals, which were also cropping up in many U.S. cities during this time, were almost entirely dedicated to delivering the poorest women’s babies. It’s an interesting corollary to modern times, when giving birth to a baby in the hospital can cost up to $32,000.

As women came into the hospital to give birth—only to die within a week—young doctors were scurrying back and forth between the birthing room and the morgue to suss out why these women had died. Unfortunately, they weren’t washing their hands after conducting the autopsies, and continued to spread the very bacteria that had killed the women on whom they were performing autopsies to the otherwise healthy women in the ward.

Midwife History Crib
Luckily for the women of London, “germ theory” (what we would call bacteriology today) began to take hold in city hospitals, and new medical students were being taught proper hand washing and sterilization techniques. Not surprisingly, as soon as these simple innovations were added to lying-in protocols, the occurrence of childbed fever dropped dramatically.

PR damage had already been done, however, and most upper class Victorian women wouldn’t be caught dead in a hospital to give birth. Queen Victoria herself gave birth at Buckingham Palace—though, not without help. It was she who blew the next winds of change into midwifery in the form of ether.

Twilight Sleep

Midwife History Victoria
Word got out that the Queen herself had made use of ether to ease the pain of childbirth, and many religious figureheads were strongly opposed to it. Pain was the point of birth, because it was the punishment women endured on Eve’s behalf (eating the apple and all that). Queen Victoria thought that was hogwash, and many women followed suit. They began to regularly request not just the use of ether, but cocaine, marijuana and opium.

Obstetricians and occasionally midwives attended births at the homes of middle and upper class women, bringing along their drugs and tools. Given these women’s perceived delicate nature, many worried that if they were not relieved of childbirth pain, their babies would suffer because they would be too exhausted to parent. Thus, it was not the poor, inner city women of the lying-in hospitals who got the ether, but the countesses, duchesses and baronesses.

Midwife History Nurse
The decades wore on and women’s rights—particularly their reproductive rights—became a social focus in a way that they hadn’t been before. In the decades that would follow, women would essentially surrender themselves entirely to the childbirth process. They would kiss their husband goodbye, go into the hospital, be knocked out with a drug cocktail (called scopolamine) and wake up several hours later cleaned up with a pink, sleepy baby in their arms. This was Twilight Sleep.

What the women weren’t aware of, however, was that while they were in this “sleep” they were often strapped to the bed to keep from injuring themselves—or nurses—as they writhed about in agony. It wasn’t uncommon for them to be put in padded pens so that they couldn’t escape during the birth, which was often a problem considering the drug cocktail was known to cause vivid hallucinations. But since women woke up from Twilight Sleep with no memory of the birth, they had no complaints and hailed it as a revolution.

Natural Birth Movement and Lamaze

Natural Birth Figures
Childbirth became largely medicalized during the early to mid 20th century. Women went into the hospital, had their Twilight Sleep, and woke up fresh-faced with a baby in their arms. The baby went home and a woman had the wise words of Dr. Benjamin Spock to guide them in child-rearing. The supportive, female-empowering and maternal community of midwives had been somewhat forgotten—along with the entire childbirth experience, thanks to scopolamine.

As the Gestalt theory of psychology, being more in touch with one’s inner experience, became more prevalent, the idea that a woman should be an active and aware participant in the birth of her child soon followed. This was the basis for Dr. Lamaze’s work, which followed in the footsteps of Russian psychologist, Ivan Pavlov. Remembered largely for his studies with salivating dogs, Pavlovian psychology had one key offering to laboring mothers: the art of mental preparation.

Dr. Lamaze was convinced by the idea of “psychoprophalaxis”: if a woman could convince herself that she was ready to give birth, then she would be. By psychologically conditioning herself for the reality of giving birth, she could manage her pain without drugs. This idea was further ingrained into the minds of women everywhere when Dr. Grantly Dick-Read published his formidable tome, Natural Childbirth, in the 1970s. Dr. Dick-Read promoted the idea that childbirth itself wasn’t painful, women just made it painful by worrying about it.

Yoga Moms
This was the foundation for the Lamaze classes of the ‘80s, which have by contemporary standards almost become a trope: a room full of heavily pregnant women, their birth partners, and a lot of “hee hee hoo hoo” going on. The co-founder of Lamaze, Elizabeth Bing, also taught many of the courses and lauded the technique.

That is, of course, until she had her own children.

In an interview many decades later, Bing admits that she not just requested—but demanded—an epidural and drug relief when she gave birth to her son. Despite decades of debunking the necessity of either to thousands of women, she wasn’t even a little bit sorry.

Modern Times

In today’s world, women have more options than ever before when it comes to having babies on their own terms—at least when it comes to delivery (abortion restrictions in the U.S. continue to abound) and, assuming a woman has health insurance to pay for the costly services. They can choose home births, hospital births, hospital births with a midwife, doulas, water births, planned cesarean sections or, if they’ve had a c-section before, they can opt for a “VBAC” —a vaginal birth after cesarean.

Regardless of what the mother has in her birth plan, one thing has been true about childbirth since the dawn of time: the baby is the one that decides when it’s time to be born.

Abby Norman is an author based in New England. Her memoir FLARE has been acquired by Nation Books (Hachette). Her work has been featured on The Rumpus, Medium, Hippocampus Magazine, The Atlantic, The Mary Sue and The Huffington Post.

From: all-that-is-interesting.com

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U.S. Abortion History

From: abort73.com

PAGE SUMMARY:
For those who support abortion, there is a tendency to argue that it has always been widely practiced and broadly accepted. Those who oppose abortion, however, generally argue that its permissive and widespread use is a recent phenomena. The truth probably lies somewhere in between.

Anyone who is honestly interested in the history of abortion in the United States, and is willing to put in the time to get it, need look no further than Marvin Olasky's Abortion Rites. It is thorough, honest, meticulously well-researched, and will defy the over-simplified history that people on both sides of the debate often give it.

For those who support legal abortion, there is a tendency to argue that abortion has always been widely practiced and broadly accepted in America. Those who oppose abortion generally argue that the permissive and widespread use of abortion is a recent phenomena. The research of Mr. Olasky puts the truth somewhere in between. On the one hand, abortion has been used with alarming frequency for much of the nation's history. On the other hand, though abortion has long been popular on the fringes of society, it was not until recently that it began to enjoy anything like "mainstream" support. The research provided in Abortion Rites is the foundation for the brief survey of abortion history below. Unless otherwise noted, all quotes come from Mr. Olasky's book.

Prior to the 1800's, most states practiced some variation of English Common Law which generally lacked explicit codification. Add to this the fact that solid statistics about abortion and/or unwed pregnancy simply do not exist for the time period, and you begin to see why it is so difficult to compile an accurate history of abortion in early America. Individual accounts, from journals, periodicals or court records, are all we can rely on for acquiring the anecdotal evidence necessary to make some conclusions.

The first known conviction for the "intention to abort" was handed down in Maryland in the year 1652. Four years later, also in Maryland, a woman was arrested for murder after procuring an abortion, but the case was thrown out when she married the only witness, who then refused to testify. A 1710 Virginia law made it a capital crime to conceal a pregnancy and then be found with a dead baby. Likewise, a 1719 Delaware law made anyone who counseled abortion or infanticide an accessory to murder. Olasky notes that at this point in history, "infanticide was probably the most frequent way of killing unwanted, illegitimate children." "Abortifacients were known and used in early America," but since using them "was like playing Russian roulette with three bullets in the chambers."

While individual state laws were varied and didn't always have specific legislation for abortion and/or infanticide, those that did all shared a common problem. It was almost impossible to produce the evidence necessary to convict. Pregnancy was hard to confirm, there was almost never a corpse or witness, and there was always a great deal of jury sympathy for desperate and abandoned women. Nevertheless, there were plenty of non-legislative factors working against the widespread use of abortion and infanticide. One of the chief of these factors was the existing social pressure that expected a man to "act honorably" and propose marriage if he impregnated a woman out of wedlock. "In one Massachusetts county during the 1760's, over 80 percent of non-maritally conceived births were legitimated by the marriage of their parents, and counties in other colonies had similar records... Where fathers resolutely refused marriage, courts in Virginia and other colonies ordered payment. Thus economic desperation was unlikely to drive most unmarried, pregnant women to infanticide or abortion."

Adding to the influence of society in general was a religious community that uniformly condemned abortion, both for the way the Bible speaks of unborn children and for the testimony of well-known church pillars, the likes of John Calvin, who explicitly forbade abortion. The scientific community, from the 1600's all the way through to the 1800's, believed that babies actually existed before conception, in either the sperm or the egg. Such thinking, faulty though it was, was another anti-abortion influence. Finally, the very difficulty of confirming pregnancy before quickening, made early abortions almost impossible, and late term abortions ruined marriage prospects and were extremely dangerous. "With physical, social, theological and 'scientific' reasons all making abortion unacceptable, only those in extreme duress or with contempt for existing standards would resort to it."

Nevertheless, as America grew and expanded, many of the support mechanisms which helped provide for women during "crisis pregnancies" began to wane. Increased social isolation and separation through urbanization removed the societal and familial safety nets which pregnant, unwed women had been able to fall back on. "The probability of premarital intercourse leading to marriage declined as mobility increased and community enforcement of moral codes decreased." Because of the physical obstacles and risks still associated with abortion, concealment of pregnancy before birth and the smothering of the baby after birth, was a more likely "choice." Nevertheless, abortion itself was starting to gain a foothold. It was still not considered legitimate or legal, but its frequency increased as more young women found themselves pregnant and alone, and more men were willing to pressure towards and perform abortions. It was at this point in the nation's history that Dr. John Trader of Missouri, "contended that men were (the ones) pushing women into abortion: 'We do not affirm, neither would we have you think for a moment, that the onus of this guilt lies at the feet of women. Far from it. In the majority of cases, they are more sinned against than sinning.'"

Historically, "the impulse of short-sessioned early nineteenth-century legislatures was to pass laws only when necessary, and generally only after near unanimity was achieved." Social pressure and education had been effective abortion deterrents in the past, but as the morality of America grew more relaxed, "non-governmental means of containment seemed inadequate." Abortion gained a larger foothold in American life, so lawmakers had to start dealing with it specifically and explicitly. In 1821, the first abortion legislation was passed in Connecticut, and lawmakers elsewhere did their best to keep up (New York legislation changed on abortion 10 times between 1828 and 1881). The frequency of abortion, however, continued to increase.

Newly established abortion laws, like the less explicit laws that had gone before, still faced a real problem of convictability. Since juries would not generally convict a person of a capital crime without conclusive proof, the penalties associated with abortion were often reduced in an attempt to secure more convictions.

The refusal to make abortion a capital crime did not mean that the committee was viewing the unborn child as less than human life; the committee explicitly stated that the being in question was 'alive from conception and all intentional killing of it is murder.' The question was one of how best to put abortionists out of business... The New York Times praised the bill as one 'far-reaching enough to catch hold of all who assist, directly or indirectly in the destruction of infant life; it constitutes the crime of felony, and it imposes an imprisonment of not less than four years on... the rogues male and female who carry on their hideous trade.

The precedent, at this time, was that women themselves would not generally be prosecuted for abortion. Those who performed the actual abortions were the ones who faced sentencing.

Some states gave immunity to women from all criminal liability, partly because women pregnant after seduction were considered desperate victims rather than perpetrators, and partly because of the search for any kind of edge in prosecution. New Jersey, New York, and other states gave women immunity from prosecution in exchange for testimony... By providing either no or low penalties, so that a woman would testify that she had been pregnant, prosecutors had a chance to leap the evidentiary hurdles of convincing a jury an abortion actually had occurred."

During the 1840's and 1850's, 13 states passed laws forbidding abortion at any stage. Three others made abortion illegal after quickening. In 1856, the Iowa Supreme Court held that pre-quickening abortion was not a crime, but in the next legislature, the prohibitions against pre-quickening abortions were restored. Despite this newfound devotion to legislative intervention, abortionists continued to make inroads. They began advertising heavily in the Penny Press, though never using the word "abortion." Women were offered instant relief from "menstrual suppression," or were told of pills that were so effective at restoring a woman's regular monthly cycle that they should never be taken by pregnant women (hint, hint).

Abortion made its biggest gains, however, on the back of another infamous and fast-growing American practice: prostitution. Increased industrialization made business travel far more common for many American men, and the anonymity that went along with such travel gave them far more opportunities to seek the "comforts" of a prostitute. For the prostitutes themselves, higher wages for a lot less "work" was hard for many young women to pass up. By the middle of the century, there were somewhere in the vicinity of 60,000 prostitutes employed in America.17 With not much in the way of birth control, and with an average of 30-40 sexual encounters a week, frequent pregnancy was a given. Since being pregnant would put them out of work, abortion became the happy alternative. New York detective John Warren noted that abortionists were "flourish[ing] and grow[ing] rich from prostitution as a source of income'. Many doctors agreed, "Our profession is not entirely clear of complicity in the crime of feticide. Tempted by thirty pieces of silver ...individuals may be found in whom the honorable instincts and teachings of the guild are lost in the influence of unprincipled cupidity." Then, like today, many abortionists entered the field driven by profit rather than principle, and saw an opportunity to secure "loans" and guarantee wealth. Those seeking out abortion have always valued their anonymity, and abortion providers have not always been scrupulous in their demands to not leak information. One of the 19th century's most notorious abortionists, Madame Restell, made an art of securing large "loans" from former clients, loans that were never returned. According to The New York Times, "The residence of Mme Restell is one of the best known in New York...Her wealth is entirely the proceeds of her criminal profession."

Marvin Olasky estimates, based on a careful 10-point equation, that approximately 100,000 prostitution-related abortions were occurring each year at this point in American history. The moral relaxation that seemed to be sweeping much of America began to have a significant impact on public opinion. For the first time, abortion wasn't just a dirty little secret, there were actually people beginning to defend the practice in public. Detective Warren further lamented that, "Social crimes like infanticide, that were once placed on the same level as murder, are now not only looked upon with complacency... but are defended on principle by certain theorists." Despite the growing support that these "theorists" provided, the most significant members of the medical community continued to stand firmly against abortion. Dr. Stephen Tracy writes:

"Whoever for the sake of gain, or for any other possible reason, designedly destroys [the fetus] excepting in cases where it is certainly and indispensably necessary, in order to save the life of the mother, commits a most awful crime, and will be called to give an account at the judgement of the Great Day...

"The life of this new human being is sacred, and no one but God himself either has, or can have, the least shadow of a right or liberty to take it away. To destroy its life, for the sake of saving one's self from exposure and mortification, is but to add a greater to a lesser crime...
At forty-five days, the form of the child is very distinct... The head is very large; the eyes, mouth, and nose are to be distinguished; the hands and arms are in the middle of its length – fingers distinct . . . at two months, all the parts of the child are present . . . the fingers and toes are distinct. At three months, the heart pulsates strongly, and the principal vessels carry red blood."

Ironically, the unrest leading up to the Civil War also became an opportunity for abortion to make more inroads. "For better or worse, the priority for many northern reformers became the evil down south rather than the evil in their own backyards." As a result, "great opportunities were missed [when] good citizens often felt themselves called to deal with the great problems hundreds of miles away rather than the equally severe ones close to home."

It was around this same period, that abortion began to be associated with married women for the first time (though it was a very specific group of married women). The spiritist revolution of the mid-century enticed large numbers of people into throwing off all religious constraint so as to pursue their own sexual satisfaction in any way they saw fit. Married partners swapped spouses with great celebration, but certainly didn't want to deal with the offspring of these illicit affairs. Olasky here estimates, again as laid out in a detailed 6-point equation, that during 1860, there may have been as many as 45,000 abortions performed on the roughly 600,000 spiritist women. When these married women first began seeking abortions from Dr. Charles D. Meigs in 1842, the Philadelphia doctor described them as "persons so ignorant of their own moral duties, or so uninstructed as to the character and duties of medical men, [that they came to him] with a bold-faced proposition to procure an abortion." His answer to such requests: "by common law [abortion] is felony, and by the law of God murder."

Still, not all doctors agreed with Dr. Meigs' clear assessment. A national debate was brewing, and the arguments both in favor of and in opposition to abortion sounded very much the same as they do today. Meanwhile, most churches of the time didn't know what to do with abortion. Some were bold in their testimony, as evidenced by an 1868 Congregational church conference declaration on abortion:

Full one third of the natural population of our land, falls by the hand of violence; that in no one year of the late war have so many lost life in camp or battle, as have failed of life by reason of this horrid home crime. We shudder to view the horrors of intemperance, of slavery, and of war; but those who best know the facts and bearing of this crime, declare it to be a greater evil, more demoralizing and destructive, than either intemperance, slavery or war itself.

The Presbyterian Church in the United States officially declared that, "the destruction by parents of their own offspring before birth," is, "a crime against God and against nature." Continuing:

"The whole power of the ministry and Church of Jesus Christ should be put forth in maintenance of the truth...We also exhort those who have been called to preach the gospel, and all who love purity and truth, and who would avert the just judgement of almighty God from the nation, that they be no longer silent or tolerant of these things, but that they endeavor by all proper means to stay the flood of impurity and cruelty."

Most other churches had very "little appetite for exposing wrongdoing when many members and some ministers wanted their own wrongdoing to be let alone." In 1891, Brevard Sinclair, in his book The Crowning Sin of the Age stated that, regarding abortion, Americans witnessed "the Church asleep." Nevertheless, in the decades leading up to the 20th century, abortion was clearly losing ground. The allure of "spiritism" had faded, and the American Medical Association, despite the perennial problem of convictability, began pursuing more stringent anti-abortion laws, primarily for the educational impact these laws would have on American morality. The National Abortion Federation (NAF) tells us that "by the 1870s, all states had criminalized abortion," and it had almost nothing to do with religious pressure. According to the NAF, "physicians were the leading force in the campaign to criminalize abortion in the USA," arguing that abortion was "both immoral and dangerous." At the same time, abortion opponents began to realize that laws, by themselves, were not enough. Dr. Joseph C. Stone, entered Congress in 1877 with the intention to "pass good laws when possible, but to stress conversion and education." When a noteworthy physician was interviewed by the National Police Gazette and asked what the best hope was for preventing abortion, he answered:

"Publicity. Let people know that is going on around them. There is no remedy for a great social secret sin like exposure."

While the nature of the abortion-related arguments were virtually the same 150 years ago as they are today, the lines of support have clearly shifted. In that day and age, "anti-abortion and anti-prostitution campaigns were liberal causes, carrying forward the solid anti-slavery impulses." Some of the most outspoken and courageous abortion opponents were members of the mainstream media. The afore-mentioned National Police Gazette devoted itself to exposing abortionists, and The New York Times emphasized that the fight against abortion was a fight against money and power: "Great mansions on grand avenues are occupied by disgusting 'practitioners' who continue to escape prosecution."

While newspaper editorials pulled no punches in their condemnation of abortion, the ad departments often undermined their efforts by selling increasing numbers of ads to abortion providers. In 1904, Dr. Rudolph Holmes set out to address this grievance by convincing the Chicago Medical Society to form a Committee on Criminal Abortion. The committee then went after all the papers in Chicago who sold "veiled" ads to abortion providers. Despite, significant loss in ad revenue, most papers succumbed to Dr. Holmes' request for fear of the exposure he would have brought were they to continue such practice. The result was, that while "a typical issue of the Chicago Tribune in March 1905 contained seventeen abortion ads," by the end of the year, "there were no noticeable ads for abortionists [left]."

On top of the public pressure applied both by the medical community and by the major media outlets, there also was a growing commitment to establishing more practical support measures to help pregnant, unmarried women. In 1895, Chicago, itself was known to have dozens of shelters for just such women. Eventually, though, the victories gained by the pro-life movement began to be undermined and reversed. Abortionists, instead of advertising in the newspaper, printed up thousands of business cards to be directly distributed in brothels and boarding-houses. "Chicago abortionists had their own legal department, with witnesses on tap and ready to swear that 'the young woman had an operation elsewhere and the doctor was merely performing a life-saving operation'." Many of those who had worked so tirelessly in opposing abortion fell into public despair as their efforts began to fade. Dr. Holmes lamented in 1908:

"I have come to the conclusion that the public does not want, the profession does not want, the women in particular do not want, any aggressive campaign against the crime of abortion. I have secured evidence. I have asked different physicians, who either had direct knowledge of crime against the prisoner before the bar or who could testify as to general reputation, to come and testify. They promised to come, but when the time for trial is at hand no one appears."

Holmes concluded that while Illinois abortion law could not be improved on paper, a total lack of enforcement made such laws almost useless. He also noted the growing problem of national complicity. "It is not possible to get twelve men together without at least one of them being personally responsible for the downfall of a girl, or at least interested in getting her out of her difficulty." Clergy were condemning abortion less and less, medical students were not being adequately informed of the enormity of the crime, laws continued to go unenforced and a general public apathy all combined to have a tragic snow-ball effect. Dr. M.S. Iseman concluded in 1912, that "except in the formal letter of the statute books, the sanctity which nearly twenty centuries of Christianity has conferred upon the unborn human being is repudiated." Dr. Matthew Liotta writes in 1931, "Never before in all past ages has there been such merciless killing of innocent, helpless and unborn human beings as is going on at the present time."

Gradually, even the opposition to abortion began to lose much of its moral framework. In medical text books, abortion was counseled against for the potential risks it presented to women rather than for the life it destroyed. "The right to destroy," in fact, became central to the belief system Margaret Sanger began espousing in her publication, The Woman Rebel. She celebrated the "virtue" of sexual promiscuity and attacked any women's shelter which counseled otherwise. Margaret Sanger would go on to found Plannned Parenthood, which remains the largest abortion provider in the United States. Much to Sanger's delight, social work began to be secularized. Government funding required the removal of all religious indoctrination, and "professional social workers" replaced "evangelically-oriented matrons." The notion of compassion shifted from helping people do what was right to helping people do whatever they wanted to do. Major media outlets had long returned to the lucrative business of abortion advertising, and it wasn't long before the editorial departments fell into line with the publisher's desire to better accommodate their advertising partners. Distinctions were suddenly made between "good" abortionists and "bad" abortionists. Those promoting contraception touted that it "would do away entirely with the evil of abortion." Whether they ever actually believed this in private is debatable, but the sexual emancipation that the widespread promotion of birth-control helped accommodate certainly added to the business of the professional abortionist.

The birth control issue, split the pro-life community for many years and hamstrung their efforts during the crucial 1960's, when public opinion began to shift in significant fashion. In 1962, national news reports of a women who died from an illegal abortion (and then was cut into pieces) horrified the nation, and "All-American" mom, Sherri Finkbine, became famous for having to go to Sweden to abort the child she feared would be disabled. The average American began to perceive illegal abortion, rather than abortion itself, as the real problem. In 1967, Colorado and California became the first states to legalize abortion for pregnancies that resulted from rape or incest, for pregnancies that threatened the life of the mother, or for pregnancies of severely handicapped children. Over the next three years, Alaska, Arkansas, Delaware, Georgia, Hawaii, Kansas, Maryland, Mississippi, New Mexico, North Carolina, Oregon, South Carolina and Virginia all followed suit. In 1970 New York became the first state to offer unrestricted abortion during the first 24 weeks of pregnancy. Hawaii, Alaska and Washington soon followed. One year later, in 1971, the famed Roe v. Wade first came to trial. When the verdict was handed down in 1973, all state laws regulating abortion were stricken, and abortion on demand became the law of the land.

The history of abortion since 1973 is far more well-known and can be examined further in The Legality of Abortion.

In the end, examining the history of abortion in America reveals that abortion has been a significant part of the American landscape from as far back as the early 1800's. It also reveals, however, that some of the best minds in American history consistently condemned abortion, and it offers us insight for combatting abortion today. Where a resolute commitment to educating the public is in place, and where there is support for women in crisis pregnancy, and where there are laws on the books to inform public morality, the prospects for reversing the current frequency and acceptability of abortion are very promising.

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The Feminist Origins of “Eight Cups a Day”: The Water-Healing Quackery That Empowered Women’s Medicine. (Excerpt)

By Erika Janik

Today, when it seems that most Americans carry a water bottle to drink their eight daily glasses, the importance of water to health seems obvious. But for 19th-century hydropaths, water was more than just a sugar- and calorie-free drink: It was a social good able to cure nearly every disease as well as the social and cultural ills that threatened the health and stability of the nation.

Drinking was not the only way to enjoy water’s munificence, though; water was also to be experienced through elaborate rituals of bathing, showering, soaking, sweating, and wrapping. This diversity of baths, not to mention the idea of bathing itself, was highly unusual for most Americans. In 1835, a letter from a reader in the Boston Moral Reformer asked, “I have been in the habit during the past winter of taking a warm bath every three weeks. Is this too often to follow the year round?” Although it offered cures for disease, hydropathy functioned more as a water-based lifestyle plan with a vision of radically transforming the world through personal health achieved through nature’s purest substance.

Hydropathy grew out of the observations and experiments of Vincent Priessnitz. A peasant born in 1799 on a farm in Grafenberg in Silesian Austria, located in today’s Czech Republic, Priessnitz discovered water’s potential as a cure-all after an 1816 farm accident. One day while he was baling hay, a runaway horse and wagon trampled the teenaged Priessnitz, leaving him with several broken ribs and a bruised left arm. The doctor from a nearby town told him that the severity of his injuries made it unlikely he’d ever work again. Priessnitz, however, refused to accept this prognosis. He wrapped himself in wet cloths and ate very little while consuming large quantities of cold water. To reset his broken ribs, he pressed his abdomen against a chair and inhaled deeply, allowing the expansion of his chest to push his ribs back into place. Priessnitz eventually recovered from his injuries, and the success of his self-cure led him to broaden his investigation into the curing power of water.

Priessnitz sought not only to wash disease away but to deny it entry into the body through a healthy lifestyle of diet and exercise. Priessnitz argued that filth and a poor diet gave disease easy access into the body. In The Hydropathic Encyclopedia, American hydropath Dr. Russell Trall explained that disease was “produced by bad air, improper light, impure food and drink, excessive or defective alimentation, indolence or over-exertion, [or] unregulated passion.” For Trall, it all boiled down to “unphysiological voluntary habits.” In other words, sickness resulted from laziness, a lack of exercise, and junk food, the familiar chords of obesity debates to this day.

Perhaps hydropathy’s most visible legacy is in the popularly held belief in drinking eight glasses of water a day. This notion was appropriated and echoed with increasing fervor in the late 19th century by the temperance movement. By the 1910s and 1920s, American newspapers and magazines were filled with exhortations to consume eight glasses of water for health on a daily basis. Although scientists and doctors continue to disagree over how much water is enough, the idea of drinking fluids regularly for health remains undisputed.

Priessnitz’s water cure became renowned throughout the Western Hemisphere. Visitors marveled at Priessnitz’s ability to diagnose disease and devise a treatment plan simply by studying the quality and cast of a patient’s skin. He never checked the pulse, looked at the tongue, or asked patients about their complaints. By 1840, nearly 1,700 patients per year sought treatment at Grafenberg.

Priessnitz’s success spurred countless imitators and admirers. The first water cure in the United States opened its doors in 1843, followed by a second the next year. Both were in New York City and were operated by disillusioned regular doctors. But it was Mary Gove Nichols and her husband, Thomas, who made hydropathy famous. Born in Goffstown, N.H., in 1810, Mary Sargeant Neal was the precocious daughter of a freethinking father who encouraged her active and curious mind. As a teenager, she pored over the pages of the books her medical-student brother brought home, fascinated by the workings of the human body but perhaps also wondering why she could find so little information on the health of women like herself.

An unhappy marriage in 1831 to Hiram Gove, who disdained her reading and creative writing, helped turn Mary into a champion of women’s rights and a prominent health reformer. To ease her mental and physical suffering, Mary defied her husband and turned back to the medical books that had so enthralled her as a child. She discovered Sylvester Graham, an early advocate of dietary reform, vegetarianism, and hygienic reform and determined that women’s well-being and happiness depended on the freedom achieved through personal health. Excited by her newfound knowledge, Mary wanted to tell other women of the salvation that could be found in knowing about and taking charge of their own bodies.

In 1838, Mary made a name for herself lecturing (a scandal in and of itself for a woman) on the shocking topics of women’s health, anatomy, and physiology. Women’s health was a topic rarely, if ever, discussed at the time, much less in public. With no female regular doctors, many women ignored their own health problems and endured in silence to avoid being seen by male doctors, which social mores deemed improper. Hundreds packed lecture halls to see the thin, dark-haired woman with an open and intelligent face and exuberant brown eyes discuss the healthy female body.

In the summer of 1845, finally free of her husband, Mary traveled to Brattleboro, Vt., to investigate Priessnitz disciple Dr. Robert Wesselhoeft’s Hydropathic Institution—one of the most exclusive and expensive water cures in the United States. Impressed by what she saw, she began training as a water-cure physician, offering physiology lessons to patients in exchange for her education.

While Priessnitz’s original system called for water to be used both internally and externally, most American hydropaths believed that water worked best when applied gradually through the skin. The wet sheet became the standard method of application. First, the attendant would dip a sheet of cotton or linen in cold water and spread it on several thick wool blankets. The patient would then be wound up in the sheet and blankets by the attendant and secured with pins or tape. Once wrapped, patients would shiver and then lie sweating on feather beds for anywhere from 25 minutes to several hours depending on the seriousness of the illness. After they worked up a good sweat, the attendant unwrapped them and plunged them in a cold bath followed by a brisk drying. For severely debilitated patients, the wet-sheet treatment could be too much, so an alternative known as the wet dress was used instead. A loose-fitting nightgown-like garment, the wet dress allowed patients to dispense with the services of an attendant and to walk comfortably while also soaking up water. Most wet-dress patients also went to bed in the outfit, a damp and presumably clammy night of sleep.

Wesselhoeft taught his students, Mary among them, the art of individual prescription, adapting cures to each patient’s symptoms, stamina, and age. “The same treatment that would cure one might fail entirely with another,” she later noted.

After three months in Brattleboro, Mary moved to New York City in 1846 and began giving lectures and writing articles and books on health and hydropathy.

Though she’d never attended medical school, by the late 1840s, she led a doctor’s life and had earned a reputation as a trustworthy medical expert. Mary’s husband, Hiram Gove, finally consented to a divorce in 1847. That same year she met a young writer named Thomas Low Nichols, whose writing and progressive views on women she admired. The two married the following July. Inspired by his new wife’s work in hydropathy, Thomas enrolled in medical school to study “the very errors and absurdities” of regular medicine, graduating from New York University with his medical degree in 1850.

Most hydropaths believed that the only qualifications necessary to practice should be a personal commitment to the principles of hydropathy and a willingness and ability to practice them responsibly. Unlike regular medicine, hydropaths de-emphasized the authority of the physician in favor of creating independent patients able to diagnose and care for themselves. Patients thus had a substantial responsibility for their own outcomes. “If a patient thoroughly understands his or her disease, and has the requisite energy to accomplish a cure,” wrote Mary, “it may be done almost anywhere, and with very meager advantages.” She recounted stories of female patients who managed to heal themselves even while weak with disease through their own “indomitable energy.” Hydropaths believed that hygienic habits were best mastered through willpower and self-control, an ideology that mirrored wider societal beliefs about personal responsibility and social improvement.

In 1851, Mary and her new husband opened the nation’s first hydropathic medical school, the American Hydropathic Institute, in New York City. Concerned about the dangers of the misapplication of cold water, not to mention charlatans masquerading as hydropaths for profit, the Nicholses believed that the potency of water required expert guidance. More than teaching about water, though, Nichols wanted to provide a medical education for women to meet the national demand for female doctors.

With few exceptions, most of the nation’s medical schools refused to admit women. By and large, regular medicine tended to regard being female as a disease in and of itself. At the American Hydropathic Institute’s inaugural ceremonies, Mary delivered an address entitled “Woman the Physician” that argued for the importance of female doctors. Rather than reject cultural assumptions about women’s caring nature, she claimed women’s innate talents uniquely qualified them for the profession. The Nicholses’ progressive views of women aligned perfectly with hydropathy’s expansive understanding of women and women’s health. Hydropaths shared their era’s belief in women’s softer, more caring nature: They just did not see this as a justification for keeping women out of the medical profession.

Encouraging women to get involved in hydropathy contributed to the financial health of the nation’s water cures as well. To attract women and their money, hydropaths needed female attendants and practitioners to serve them. Women consistently outnumbered men in attendance at hydropathic institutes. It’s not hard to imagine why. For many women, visiting a water cure was the first, and perhaps only, time their needs were put above those of their husbands and children.

Hydropathy took the radical step of naturalizing women’s life stages. For hydropaths, puberty, menstruation, childbearing, and menopause were not dread diseases needing intervention but natural processes in a woman’s life. Women did not become weak and ill because of their sex but because of some outside cause, just like men. Hydropaths urged women to take an active role in their own health and to maximize their health and happiness through diet, exercise, and other hygienic practices, all of which dramatically expanded women’s power to determine and control their own lives. As a result, hydropathy provided a refuge for progressive women, and many of America’s first generation of female doctors came out of hydropathy.

Excerpted from "Marketplace of the Marvelous: The Strange Origins of Modern Medicine" by Erika Janik, out now from Beacon Press.

Erika Janik has written for Smithsonian.com, Mental Floss, The Onion, and Wisconsin Public Radio.

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