A Book on Medical Discourses in Two Parts – Rebecca Crumpler, M.D. (1883)

My chief desire in presenting this book is to impress upon somebody’s mind the possibilities of prevention.

Traveling around the web, as one does, I came across an interesting nugget of American history when I met Rebecca Lee Crumpler who was the first African-American female physician in the U.S. when she graduated from the New England Female Medical College in 1860. (She was also the college’s only African-American graduate.)

Consider this statistic: there were only 54,543 physicians in the whole of the country in 1860. Only 300 of those physicians were women and Crumpler was the only African-American female physician. (And, in fact, as late as 1920, there were still only 65 African-American female docs in the entire country. I wonder what the stats are now…

(ETA: Only 4 percent of practicing physicians in 2016 are African-American, most graduating from HBSUs. Only 2 percent of nation’s physicians are female African-Americans. Female physicians now make up 34 percent of the whole physician population, but are still underpaid compared with men (64 cents for every dollar a man earns). Overall population of US (now) is 15 percent black (2013, US Census Bureau).)

Back to Crumpler: Crumpler was a remarkable woman and this is thought to be the very first medical text by any African-American author.

Imagine the U.S. as the country as it was then when Crumpler was getting her medical education as a “doctress” (as the title says). How very courageous and determined she was:

  • 1860 – Crumpler graduates from the medical college as a “doctress”.
  • 1863: US Emancipation Proclamation (meant that slaves were now free in the Southern/Confederate States).
  • 1865 – US 13th Amendment ended slavery in all states. Establishment of Freedman Bureau (agency to help millions of black slaves and poor whites in the South after Civil War.) (Actually, Crumpler and her hub moved to Virginia to work for the bureau and “more than 30,000 colored” after the war.)
  • 1868 – 14th Amendment secured American citizenship for African-Americans.
  • 1870 – 15th Amendment secured voting rights for African-Americans (on paper)

But obvs slavery still happening. (Look at Barracoon by Zora Neal Hurston (2018) which covers the life of Oluale Kossula who arrived in the U.S. from West Africa where he had been captured as part of the slave trade in 1860, same year as Crumpler is attending her first year at the medical college.)

Rebecca Lee Crumpler, doctress.

So, absolutely loads to think about with this nonfiction read, and that’s not even getting to the actual contents just yet!

Since this book is more of a how-to manual for the healthcare of people (not just African-Americans although they may well have been the main (and only audience for this text), I’ve put together a few notes on her healthcare guidance during this late Victorian period in case you’re curious. (Crumpler was also more than likely to only have been allowed access to care for the African-American populations as well…)

It’s in a bullet list since that seemed the easiest way to present such disparate info:

Baby health advice (under 5s):

One of the main baby healthcare advice chapters is titled this: Necessity of Agreeable and Soothing Surroundings. It’s meant to be in reference to infants but it certainly works for me as well. 🙂

All loud talking or laughing should be strictly prohibited. To insure this, no sly jokes should be indulged in by anyone present; for by so doing convulsions of an alarming nature may be brought on. “  (Chapter 5)

If the baby has a rattling or wheezing noise in its throat, Mrs. Crumpler recommends using a real feather (that has been wetted to tamp the down) to tickle the back of the tongue to make the child cough or gag… Don’t give the baby “soot tea”, by any means.

Saffron tea is really crocus tea?  And was popular for baby’s poop problems?

Don’t give infants a “little weak toddy” to “bring up wind and make them sleep”. It can cause intoxication and then a “fearful attack of purging”. Plus it may “inculcate a desire for tippling in many of our weak-minded youth”.

Later on: watch out if giving your baby any alcohol: it “tends to stunt the intellect and dwarf the stature of the youth of our land…”  

And no oysters for the young one: they are “most dangerous”. A broiled lamb chop of beef would be fine to give the baby though, as support for the diet of mother’s milk though. (They help to prevent “cholera of infants at the breast, especially in our crowded cities”.)

And too much soda (i.e. in making breads) makes your baby bald.

And don’t overfeed or do the “coarse habit of ‘stuffing’ babes, to avoid frequent feeding of them” – the habit needs to “vanish like dew before the noonday sun” …

Children who eat candy are also at risk of developing “dwarfed statures”… but kids will also be troubled with worms at the same time (due to the candy).

If your child is teething, “the greater mischief is done to the whole nervous system by the unnatural but ancient custom of pressing and rubbing gums – it is possible to trace the cause of insanity to this pernicious custom

Teething and not wearing shoes in puddles are believed to be a combo that directly cause lung fever (another name for pneumonia) in infants. If your child does get pneumonia, the best treatment is “patient watchfulness, pure air and absolute quiet”.

Apparently, babies have always been tough to get to sleep. “Many children screamed with fright at the noise created to get them to sleep”… What were the family doing to make the kids scream when they’re trying to get them to go to sleep? The mind boggles…

Once you do have your child sleeping, don’t let your baby sleep too long in soiled clothes: it can cause “soft bones, enlarged joints, inverted feet, flattened back-heads, sickening sores, dropsy, blindness or numerous ills”…

If you are a family of “moderate means” and you are not able to keep more than one fire going in your house during the cold season, taking a baby from a hot room to a colder one can cause frequent and severe colds… So, try to live with all your rooms on the same floor in your tenement to avoid (or mitigate) this problem and help the heat (from your one fire) spread throughout the house more evenly…

If your baby does has a lot of snot in his/her nose, try to unstop it with goose oil on a feather. But – be gentle. If you’re not careful, you can break the baby’s nose and that causes cancer. (What?)

Reading for kids is also dangerous:
Can you not cut short the certain destruction that awaits your sons and daughters, through the influence of impressions gained by the constant perusal of fictitious, and in many cases, corrupt library books?

For a breast-feeding mother:

If the mother’s nipple [for breastfeeding] is not prominent for the baby to suck, “a friendly adult or child could soon draw out the nipple by sucking so that the babe can get hold…” !!

(Just try not to do this when one’s mouth is full of snuff as it can cause other health problems (including “instant death”) for el bebe who breastfeeds immediately after this.)

If a new mom is waiting for her milk to “drop”, watch out: “diarrhea, convulsion, or even insanity may be brought on through the means of any excitement whatever” unless you’re careful… Diarrhea is also caused by “emptiness” in a baby (or a baby being hungry).

Don’t drink a glass of iced water when your baby is breastfeeding or this could happen: “the babe was seized with rigid convulsions and dropped from the breast” while the mother became “almost helpless with fright”…  But some quick-thinking from Mrs. Crumpler with a tub of hot water and some mustard managed to save the day… Phew.

Do try to avoid cholera if you can:

There was a whole chapter on the issue of child/infant starvation – it must have been a huge problem for the many poor families… Plus, failure-to-thrive (or malnourishment) was also seen as an early symptom of cholera in children (and cholera was one of the largest causes of infant mortality in those days)…

Cholera could also be caused by the mothers adding in a mixed or meat and veg diet too early after the birth of a child. (Poor mothers! They get blamed for everything!)

Cholera also increases the risk of having a “hair worm” which had been noticed to “infest the throat of some patients”. (Woah. What is that “hair worm” thing?)

And what is the cause of infantile cholera? No one really knows at that time, but Mrs. Crumpler swears that it’s not contagious but does offer this nugget: if you’re in a crowded space in the middle of a cholera epidemic, it’s best to leave if you can. Poverty, “wretchedness” and crime spread cholera.

And who’s responsible for all this?…

Places a heavy blame on mothers to “make a little sacrifice for the sake of equipping the mind” and look after their children better… Also, the child studying too hard can endanger your child’s health.

Mothers should learn more about health and prevention of illness, and get this: Crumpler, unsurprisingly, is pro-women’s vote. (But this wouldn’t happen until 1965!)

(But she does earnestly wish that mothers would try harder to not give their children to the alms houses… “Our women work hard, seemingly…” ooh. Them’s fighting words.)

Crumpler also strikes a critical note when she reports that women “appear to shrink from any responsibilities demanding patience and sacrifice”… Yikes.

She also blames the declining mortality in the “colored population of Boston” on “neglect to guard against the changes of the weather.’’

Advice for women’s health in general:

Exercising during your period will cause you to go barren, have ovarian inflammation, dropsy or consumption. (Periods also called “bringing on the turns”).

Monthly cramps are caused (and worsened by) having cold and/or wet feet (or even when sweeping the floor). Interestingly, another household task (sewing at a treadle sewing machine) also causes vaginal ulcers (mainly from getting frustrated with the machine itself). (This, although very serious stuff, cracked me up at the time since I remember frustrations when I was learning to use my mum’s treadle sewing machine. Not sure about the vaginal ulcers but definitely caused me some strife!)

Poverty, with chastity, is an enviable condition.

Menopause is worsened by drinking ice-water (which, in fact, could cause paralysis) and helped by “securing cheerful exercise for the mind, with an abundance of outdoor scenery”… Drinking more water just prolongs the hot flashes.

(But how best to control the size of your family (i.e. birth control)?: Mrs. Crumpler recommends that “if these little ones are given in quick succession, it is just as well to have and get through with it. Many are the women who have borne a dozen or more children into the world, and afterwards filled positions of trust and nobility…” Huh.

Colds are typically caused by northeast and easterly winds…

Beware of sudden changes in air, food or medicines (especially those that contract or depress muscles): “may cause suffocation and death at any moment.”

Tumors of all kinds are caused by fish, eggs, oysters, pork, gaseous vegetables, and anything that depresses or excites the mind. Also, gas and “loaded bowels”. Anointing the entire body with goose oil should help.

Brain fever was caused by “some irregularity, over-work or undue excitement” and effective treatment includes shaving your head sitting in a cool dark room and keeping wet cool material wrapped around your neck.

Fascinating stuff!

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