For Her Own Good: Two Centuries of the Experts Advice to Women
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It was the self-assigned duty of the medical profession to define “her natural physical and mental constitution,” no matter how galling the facts might be to any interest groups or vocal minorities. In 1896, one physician asserted peevishly that the feminist influence had become so powerful that “the true differences between men and women have never been pointed out, except in medical publications.”41 But with great determination—and we might add, imagination—the doctors set out to elaborate the true nature of woman, the sources of her frailty, and the biological limits of her social role.
The groundwork had already been laid in the natural sciences. Nineteenth-century scientists had no hesitation in applying the results of biological studies to human society: All social hierarchies, they believed, could be explained in terms of natural law. Nothing was more helpful in this intellectual endeavor than the Theory of Evolution. Darwin’s theory proposes that man had evolved from “lower,” i.e., less complex, forms of life to his present condition. Nineteenth-century biologists and social commentators, observing that not all men were the same and that not all were in fact men, hastened to conclude that the variations represented different stages of evolution which happened to be jostling each other within the same instant of natural history. Some went so far as to declare that rich men must be in the evolutionary vanguard, since they were obviously so well adapted to the (capitalist) environment. (Andrew Carnegie was an ardent subscriber to this theory.)
Almost all agreed that the existing human races represented different evolutionary stages. A vast body of research—consisting chiefly in measurements of brain weights, head sizes, and facial proportions—“proved”—to no one’s great surprise—that if the ethnic groups were ordered in terms of their distance up the ladder of evolution, WASPs would be in the lead, followed by Northern Europeans, Slavs, Jews, Italians, etc., with Negroes trailing in the far rear.
This was the intellectual framework with which nineteenth-century biologists approached the Woman Question: everyone must have an assigned place in the natural scheme of things. Attempts to get out of this place are unnatural and in fact diseased. By the eighteen sixties, natural scientists could pinpoint woman’s place on the evolutionary ladder with some precision—she was at the level of the Negro. For example, Carl Vogt, a leading European professor of natural history, placed the Negro (male) as follows:
… the grown-up Negro partakes, as regards his intellectual faculties, of the nature of the child, the female, and the senile White.42
(Where this left the Negro female one shudders to think, not to mention the “senile” female of either race.)
But it was not sufficient to rank women on a static evolutionary scale. A full response to the Woman Question required a dynamic view, including not only where woman was now, but where her evolutionary destiny was taking her. Darwin’s theory postulates a drift toward ever greater biological variation and differentiation among the species. Where once there were a few formless protozoa, now there were porcupines, platypuses, peacocks, etc.—each one specialized to survive in a particular environmental niche. Nineteenth-century medical men read this loosely to mean that everything is getting more “specialized,” and that “specialization” was the goal of evolution—an interpretation which was no doubt influenced by the ongoing formation of the academic disciplines (and within medicine, the medical specialties and subspecialties).
The next step in the logic was to interpret sexual differentiation within a species as a kind of “specialization” and mark of evolutionary advance. As G. Stanley Hall, a founder of psychology and leading child-raising expert of the early twentieth century put it in his famous book Adolescence:
“In unicellular organisms the conjugating [mating] cells are alike, but forms become more and more dimorphic. As we go higher [up the evolutionary ladder] sexes diverge not only in primary and secondary sex characteristics, but in functions not associated with sex.”43 Thus the difference between the sexes could be expected to widen ever further as “man” evolved, and since evolution was commonly equated with progress, this must be a good thing. As natural history professor Vogt saw it, “the inequality of the sexes increases with the progress of civilization.”44
What was this difference between the sexes which was widening with every evolutionary leap? The answer rested on a certain masculinist assumption about the process of evolution itself. Evolutionary change occurs as environmental conditions “select” for certain variants in the species. For example, in an arctic environment the fox which is accidentally born with white fur has a survival advantage over its red sisters and brothers, so white foxes tend to displace red ones over time. We know now that the variations that allow for change occur through the random and unpredictable process of genetic mutation. But to nineteenth-century scientists, who knew nothing whatsoever about genes, heredity, mutations, etc., the ability to vary in potentially successful ways (as the white fox had done) seemed to require a degree of cleverness and daring. It must, therefore, be a male trait. So in the grand chain of evolution, males were the innovators, constantly testing themselves against the harsh environment while females dumbly passed on whatever hereditary material they had been given. Males produced the variations; females merely reproduced them.
From there it was only a hop, skip, and jump to a theory of contemporary human sexual differences. Males were made to “vary,” that is, to fill a variety of functions in the social division of labor. Females, being more primitive, were non-varying and identical in evolutionary function, and that function was to reproduce. Woman represented the ancient essence of the species; man represented its boundless evolutionary possibilities. (G. Stanley Hall leaped quickly to the implications for the professions: “The male in all the orders of life is the agent of variation and tends by nature to expertness and specialization, without which his individuality is incomplete.”)45 [Emphasis added.] Suddenly the professional differences among middle-class men represented the “variations” required for evolution, as if natural selection would be picking between psychologists and mathematicians, gynecologists and opthamologists! It followed in his line of reasoning that women could not be experts because they represented a more primitive, undifferentiated state of the species and were incapable of “specialization”: “She is by nature more typical and a better representative of the race and less prone to specialization.”46
But of course in the post-Darwinian scientific value system, “specialization” was good (“advanced”); de-specialization was bad (“primitive”). Now put this together with the fact that the species as a whole was getting ever more “specialized” sexually as part of its general evolutionary advance: it followed that men would become ever more differentiated, while women would become progressively de-differentiated, and ever more concentrated on the ancient animal function of reproduction. Taken to its extreme conclusion, this logic could only mean that for every rung of the evolutionary ladder man ascended, woman would fall back a rung, as if, in some Elysian future, a superman would stand at the top of the ladder, a blob of reproductive protoplasm at the bottom.
Hall backed off from this conclusion with a diversionary outburst of chivalry, calling for
… a new philosophy of sex which places the wife and mother at the heart of a new world and makes her the object of a new religion and almost of a new worship, that will give her reverent exemption from sex competition [i.e., competition with men] and reconsecrate her to the higher responsibilities of the human race, into the past and future of which the roots of her being penetrate; where the blind worship of mere mental illumination has no place.…47
The fact was, as Charlotte Perkins Gilman observed too, but with a very different set of emotions, that society was channeling women (or at least the more affluent of them) into the “sex function.” If the natural scientists were right, she would evolve to become ever more exclusively consecrated to sex, shedding “mere mental illumination” and other artifices, as she strode—or, more likely, crawled toward h
er evolutionary destiny.
The Dictatorship of the Ovaries
It was medicine’s task to translate the evolutionary theory of women into the language of flesh and blood, tissues and organs. The result was a theory which put woman’s mind, body, and soul in the thrall of her all-powerful reproductive organs. “The Uterus, it must be remembered,” Dr. F. Hollick wrote, “is the controlling organ in the female body, being the most excitable of all, and so intimately connected, by the ramifications of its numerous nerves, with every other part.”48 Professor M. L. Holbrook, addressing a medical society in 1870, observed that it seemed “as if the Almighty, in creating the female sex, had taken the uterus and built up a woman around it.”49 [Emphasis in original.]
To other medical theorists, it was the ovaries that occupied center stage. Dr. G. L. Austin’s 1883 book of advice for “maiden, wife and mother” asserts that the ovaries “give woman all her characteristics of body and mind.”50 This passage written in 1870 by Dr. W. W. Bliss, is, if somewhat overwrought, nonetheless typical:
Accepting, then, these views of the gigantic power and influence of the ovaries over the whole animal economy of woman,—that they are the most powerful agents in all the commotions of her system; that on them rest her intellectual standing in society, her physical perfection, and all that lends beauty to those fine and delicate contours which are constant objects of admiration, all that is great, noble and beautiful, all that is voluptuous, tender, and endearing; that her fidelity, her devotedness, her perpetual vigilance, forecast, and all those qualities of mind and disposition which inspire respect and love and fit her as the safest counsellor and friend of man, spring from the ovaries,—what must be their influence and power over the great vocation of woman and the august purposes of her existence when these organs have become compromised through disease!51 [Emphasis in original.]
According to this “psychology of the ovary” woman’s entire personality was directed by the ovaries, and any abnormalities, from irritability to insanity, could be traced to some ovarian disease. Dr. Bliss added, with unbecoming spitefulness, that “the influence of the ovaries over the mind is displayed in woman’s artfulness and dissimulation.”
It should be emphasized, before we follow the workings of the uterus and ovaries any further, that woman’s total submission to the “sex function” did not make her a sexual being. The medical model of female nature, embodied in the “psychology of the ovary,” drew a rigid distinction between reproductivity and sexuality. Women were urged by the health books and the doctors to indulge in deep preoccupation with themselves as “The Sex”; they were to devote themselves to developing their reproductive powers and their maternal instincts. Yet doctors said they had no predilection for the sex act itself. Even a woman physician, Dr. Mary Wood-Allen wrote (perhaps from experience), that women embrace their husbands “without a particle of sex desire.”52 Hygiene manuals stated that the more cultured the woman, “the more is the sensual refined away from her nature,” and warned against “any spasmodic convulsion” on a woman’s part during intercourse lest it interfere with conception. Female sexuality was seen as unwomanly and possibly even detrimental to the supreme function of reproduction.
The doctors themselves never seemed entirely convinced, though, that the uterus and ovaries had successfully stamped out female sexuality. Underneath the complacent denials of female sexual feelings, there lurked the age-old male fascination with woman’s “insatiable lust,” which, once awakened, might turn out to be uncontrollable. Doctors dwelt on cases in which women were destroyed by their cravings; one doctor claimed to have discovered a case of “virgin nymphomania.” The twenty-five-year-old British physician Robert Brudenell Carter leaves us with this tantalizing observation of his female patients:
… no one who has realized the amount of moral evil wrought in girls … whose prurient desires have been increased by Indian hemp and partially gratified by medical manipulations, can deny that remedy is worse than disease. I have … seen young unmarried women, of the middle class of society, reduced by the constant use of the speculum to the mental and moral condition of prostitutes; seeking to give themselves the same indulgence by the practice of solitary vice; and asking every medical practitioner … to institute an examination of the sexual organs.53
But if the uterus and ovaries could not be counted on to suppress all sexual strivings, they were still sufficiently in control to be blamed for all possible female disorders, from headaches to sore throats and indigestion. Dr. M. E. Dirix wrote in 1869:
Thus, women are treated for diseases of the stomach, liver, kidneys, heart, lungs, etc.; yet, in most instances, these diseases will be found on due investigation, to be, in reality, no diseases at all, but merely the sympathetic reactions or the symptoms of one disease, namely, a disease of the womb.54
Even tuberculosis could be traced to the capricious ovaries. When men were consumptive, doctors sought some environmental factor, such as overexposure, to explain the disease. But for women it was a result of reproductive malfunction. Dr. Azell Ames wrote in 1875:
It being beyond doubt that consumption … is itself produced by the failure of the [menstrual] function in the forming girls … one had been the parent of the other with interchangeable priority. [Actually, as we know today, it is true that consumption may result in suspension of the menses.]55
Since the reproductive organs were the source of disease, they were the obvious target in the treatment of disease. Any symptom—backaches, irritability, indigestion, etc.—could provoke a medical assault on the sexual organs. Historian Ann Douglas Wood describes the “local treatments” used in the mid-nineteenth century for almost any female complaint:
This [local] treatment had four stages, although not every case went through all four: a manual investigation, “leeching,” “injections,” and “cauterization.” Dewees [an American medical professor] and Bennet, a famous English gynecologist widely read in America, both advocated placing the leeches right on the vulva or the neck of the uterus, although Bennet cautioned the doctor to count them as they dropped off when satiated, lest he “lose” some. Bennet had know adventurous leeches to advance into the cervical cavity of the uterus itself, and he noted, “I think I have scarcely ever seen more acute pain than that experienced by several of my patients under these circumstances.” Less distressing to a 20th century mind, but perhaps even more senseless, were the “injections” into the uterus advocated by these doctors. The uterus became a kind of catch-all, or what one exasperated doctor referred to as a “Chinese toy shop”: Water, milk and water, linseed tea, and “decoction of marshmellow … tepid or cold” found their way inside nervous women patients. The final step, performed at this time, one must remember, with no anesthetic but a little opium or alcohol, was cauterization, either through the application of nitrate of silver, or, in cases of more severe infection, through the use of much stronger hydrate of potassa, or even the “actual cautery,” a “white-hot iron” instrument.56
In the second half of the century, these fumbling experiments with the female interior gave way to the more decisive technique of surgery—aimed increasingly at the control of female personality disorders. There had been a brief fad of clitoridectomy (removal of the clitoris) in the eighteen sixties, following the introduction of the operation by the English physician Isaac Baker Brown. Although most doctors frowned on the practice of removing the clitoris, they tended to agree that it might be necessary in cases of nymphomania, intractable masturbation, or “unnatural growth” of that organ. (The last clitoridectomy we know of in the United States was performed in 1948 on a child of five, as a cure for masturbation.)
The most common form of surgical intervention in the female personality was ovariotomy, removal of the ovaries—or “female castration.” In 1906 a leading gynecological surgeon estimated that there were 150,000 women in the United States who had lost their ovaries under the knife. Some doctors boasted that they had removed from fifteen hundred to two thousand
ovaries apiece.57 According to historian G. J. Barker-Benfield:
Among the indications were troublesomeness, eating like a ploughman, masturbation, attempted suicide, erotic tendencies, persecution mania, simple “cussedness,” and dysmenorrhea [painful menstruation]. Most apparent in the enormous variety of symptoms doctors took to indicate castration was a strong current of sexual appetitiveness on the part of women.58
The rationale for the operation flowed directly from the theory of the “psychology of the ovary”: since the ovaries controlled the personality, they must be responsible for any psychological disorders: conversely, psychological disorders were a sure sign of ovarian disease. Ergo, the organs must be removed.
One might think, given the all-powerful role of the ovaries, that an ovaryless woman would be like a rudderless ship—desexed and directionless. But on the contrary, the proponents of ovariotomy argued, a woman who was relieved of a diseased ovary would be a better woman. One 1893 advocate of the operation claimed that “patients are improved, some of them cured;… the moral sense of the patient is elevated … she becomes tractable, orderly, industrious, and cleanly.”* 59 Patients were often brought in by their husbands, who complained of their unruly behavior. Doctors also claimed that women—troublesome but still sane enough to recognize their problem—often “came to us pleading to have their ovaries removed.”60 The operation was judged successful if the woman was restored to a placid contentment with her domestic functions.
The overwhelming majority of women who had leeches or hot steel applied to their cervices, or who had their clitorises or ovaries removed, were women of the middle to upper classes, for after all, these procedures cost money. But it should not be imagined that poor women were spared the gynecologist’s exotic catalog of tortures simple because they couldn’t pay. The pioneering work in gynecological surgery had been performed by Marion Sims on black female slaves he kept for the sole purpose of surgical experimentation. He operated on one of them thirty times in four years, being foiled over and over by post-operative infections.61 After moving to New York, Sims continued his experimentation on indigent Irish women in the wards of the New York Women’s Hospital. So, though middle-class women suffered most from the doctors’ actual practice, it was poor and black women who had suffered through the brutal period of experimentation.