an undergraduate journal of the history of science
Issue 4, May 2013
Editors-in-Chief Catherine Flynn ‘13 Jenay Powell ‘13 Helen Yang ‘12 To the readers of Synthesis,
Associate Editors Jana Christian ’12
We are proud to announce the fourth issue of Synthesis, an undergraduate journal in the history of science. As a publication, it is our mission to foster a lively community of scholarship in what is sometimes a smaller field when it comes to undergraduate study. This spring’s issue includes intriguing and innovative works of original scholarship hailing from both coasts of the United States, from Brigham Young University to Yale. Every year we strive to externally strengthen the bonds of intellectual discourse between undergraduate history of science institutions and grow internally as an organization. Our fourth issue’s content defies the limits of time and space, as evinced by its intergalactic cover art, exploring a great variety of times and places, people and ideas. From seventeenth century astronomy and mathematics to twentieth-century medicine and education to our interview with a most modern professor of physics, this new issue truly has something for every reader. We sincerely appreciate your patience for bearing with us as we have worked tirelessly to bring you the newest addition to Synthesis’ body of work. It has been a long time coming, but we believe (and we hope you will as well, dear reader) that it has been worth the wait. Prepare to be enthralled by high-quality scholarship as you browse these pages. If you would like to join us in creating a community of collaboration and intellectual thought amongst undergraduates in the history of science as a sponsor, contributor, editor, or collaborator, please contact us at email@example.com. We look forward to hearing from you!
Allen Shih ’13 Staff Editors Julie Barzilay ’13 Humza Bokhari ‘14 Samantha Pickette ‘13 Rossi Walter ‘14 Danny Wilson ’14 Stephanie Woo ‘12 Shirley Zhou ’13 Design Catherine Flynn ‘13 Jenay Powell ‘13 Advisors Prof. Anne Harrington Dr. Christopher Phillips
Ms. Allie Belser Catherine Flynn and Jenay Powell Co-Editors-in-Chief (2012-2013) Helen Yang Editor-in-Chief (2011-2012)
original cover art by Frederic Hua, photo of David Kaiser by Donna Coveney
Table of Contents Letter from the Editors
The Impact of American Cold War Politics on the 1956 President’s Council on Youth Fitness: Totally Nuts or Totally Fitness? Cynthia Tassopoulos, Harvard University ‘13
The AIDS Memorial Quilt as Memorial and Media Ilana Seager, Yale University ‘12 Nourishing the Child: Dr. Thomas Morgan Rotch’s Percentage Feeding Movement and the Re-conception of Reform, Health, and Motherhood Julie Barzilay, Harvard University ‘13
An Interview with David Kaiser, Physicist and Historian Shirley Zhou, Staff Writer
From Epicycles to Ellipses: Kepler’s Heideggerian Projection of Nature Sean Driscoll, Brigham Young University ‘12
Making a Medically Reputable Movement: Margaret Sanger’s Medical Institutionalization of Birth Control, 1921-1937
Rosemary Imms, Harvard University ‘12
The Impact of American Cold War Politics on the 1956 President’s Council on Youth Fitness: Totally Nuts or Totally Fitness? Cynthia Tassopoulos, Harvard University ‘13 In 1956, the newly established President’s Council on Youth Fitness adopted total fitness philosophy as its platform as it developed a national fitness agenda to improve the poor fitness of the American youth. This paper seeks to understand the political and societal issues that led the council to total fitness, and illuminates the effects of the changing American Cold War political ideologies that challenged the Council’s total fitness stance so soon after its conception. In looking at the total fitness narrative, this paper aims to generally understand how government affects the physical body through specific policy implementations.
n June 18th and 19th of 1956, President Dwight D. Eisenhower assembled the nation’s top leaders in “government, education, medicine, recreation, public health, sports, civic and youth programs, and the communications media” at a national conference aimed to significantly improve the poor fitness that plagued the nation’s Post-WWII youth.1 The result was the establishment of the Presidents Council on Youth Fitness, a Council that set a new national youth fitness agenda oriented around total fitness philosophy – a philosophy that emphasized the development of the emotional, social, mental, and physical elements of fitness. With the threat of WWIII between America and the USSR looming overhead, the American government needed to ensure that its youth, the future Cold War citizens of America, were well prepared “physically as well as mentally and spiritually.”2 Thus, the Council placed its hope in total fitness in order to construct the American fitness program that would achieve this preparedness. Yet the story of the President’s Council in Youth Fitness and total fitness philosophy is not so simple; obstacles from the changing American Cold War ideology, the American public, and even America’s own President complicated the Council’s adoption of total fitness.3 From its formation in 1956, the Council strategically positioned itself in a withdrawn, handsoff role, consciously promoting a local-based, grassroots American fitness program rather than a nationally mandated and regulated fitness program. At the same time, Cold War 1
President’s Conference on Fitness of American Youth. 1956. Fitness of American Youth: A Report to the President of the United States (Washington, D.C.: President’s Council on Youth Fitness), III. 2 Fitness of American Youth: A Report to the President of the United States, 13. 3 Matthew T. Bowers and Thomas M. Hunt, “The President’s Council on Physical Fitness and the Systematization of Children’s Play in America,” The International Journal of the History of Sport 28 (2011): 1496-1511.
America began to shift towards a more technocratic, federal control-centered mode of operating due to the 1957 launch of Sputnik and the later efforts of the Kennedy administration.4 Thus, with the vision of a strong technocratic society that promised to maintain American superiority permeating society, the Council’s idea of fitness as a total experience run by local communities clashed with fitness as strictly physical enforced by the government. As a result, in spite of the Council’s high hopes for this American fitness style, total fitness philosophy had a short lifespan from its 1956 conception to its 1961 demise at the hands of the Kennedy Administration. Little secondary literature on this topic of total fitness philosophy as an embodiment of American Cold War policy exists. The literature that does exist, including Shelly McKenzie’s 2008 dissertation “Mass Movements: A Cultural History of Physical Fitness and Exercise, 1953-89” and Matthew Bowers and Thomas Hunt’s essay “The President’s Council on Physical Fitness and the Systematization of Children’s Play in America,” seems to insufficiently address the shifting tensions that influenced the Council’s decision-making and later challenged total fitness. McKenzie argues that the Council’s failure to solidify concrete goals and proposals for youth fitness led to both the nullification of the Council’s initial intention to improve youth fitness and the eventual demise of total fitness philosophy. While McKenzie’s observation that the Council did not produce specific standards or suggestions is technically valid, it overlooks and undermines the Council’s motivation for this withdrawn approach and for not defining set standards.5 History of physical education scholars Bowers and Hunt draw a similar conclusion as McKenzie about the 4
Lucas, W. Scott, “Mobilizing Culture: The State-Private Network and the CIA in the Early Cold War,” in Dale Carter and Robin Clifton, eds., War and Cold War in American Foreign Policy, 1942-62 (New York, N.Y., 1988), 83-107, 100. 5 McKenzie, Shelly. 2008. Mass Movements: A Cultural History of Physical Fitness and Exercise, 1953-89. PhD diss., The George Washington University.
SPRING 2013 cause of total fitness’s demise, although they reach it by exploring the differences between the youth fitness policies of the Eisenhower and Kennedy administrations.6 However, even though Bowers and Hunt acknowledge the “role of Cold War era politics in shaping the course of children’s physical activity in the United States,” a focus that McKenzie misses, they too imply that Eisenhower’s total fitness policy was less successful.7 Therefore, this paper takes on a chronological exploration of the 1956 Council’s surrounding events in order to fill in where the historical literature lacks. By analyzing the rhetoric of the Council’s various publications, this paper tries to get directly at the heart of the Council’s motivation behind adopting total fitness, using a hands-off approach, and reaffirming its dedication to total fitness in the midst of a changing Cold War America.8 Understanding this motivation is important because it unveils the history of the idea of fitness and the history of the politicalized body from the late 1950s to the early 1960s. Fitness was no longer being defined arbitrarily, but rather, was being used as a tool by the American government in a way that actually affected the physical bodies and minds of the American youth. The government’s perceptions of what fitness was, what a fit body should look like, and how fitness should be carried out, permeated Cold War ideology as well as the national fitness programs of Eisenhower and Kennedy. Thus, this paper hopes to shed light on the link between the perception of fitness and the politics of Cold War during this small window of time when total fitness took priority. Before the Council: Post-World War II Numbers and the Threat They Posed As the United States exited World War II, two statistical reports emerged that prompted the United States to reconceptualize the nation’s fitness and the physical standards of fitness in the military and in society at large. The first report was a 1945 interim report published by the U.S. Subcommittee on Wartime Health and Education that revealed that a shockingly high four and half million men were declared unfit based on the military’s lowest possible physical standards.9 As this statistic started to appear repeatedly in New York Times articles from the later years of WWII to the mid 1950s, the number began to permeate the public mind, spurring an evaluative period when the federal government called into question the fitness of the American soldiers.10 Yet, the 1945 6
Bowers and Hunt, 1504. Bowers and Hunt, 1496. 8 Fitness of American Youth: A Report to the President of the United States. 9 Ibid, 1. 10 “Draft Held Proof of Youths’ Fitness,” New York Times, Jul 17, 1943; “House Unit Backs a Two-Year Draft of Youths 19 to 26,” New York Times, May 4, 1948; “Schools Linked to Physical Fitness,” New York Times, Nov 18, 1945; “New Manpower Policy Based on Big Reserve,” New York Times, Dec 26, 1954;“The Army Ponders Why G.I.’s Crack Up,” New York Times, Jul 4, 1951;“Truman Warns of Need for Doctors and Nurses,” New York Times, Jan 13, 1951. 7
report not only exposed the poor fitness of male soldiers already in the Army, but also the poor fitness of American boys and teenagers who would become future soldiers. Consequently, society began to recognize the causal link between youth and soldier fitness. Shortly thereafter in 1953, Dr. Hans Kraus and Ruth Hirschland published their “Muscular Fitness and Health” article in The Journal of Health, Physical Education, and Recreation.11 In this article, the second check on youth fitness, Kraus and Hirschland compared the fitness of European and American children; their results showed that while nine percent of European children failed a physical exercise test, a substantially larger fifty-eight percent of American children failed.12 With these results threatening the idea of American superiority over other nations, this article incited panic again among the American public.13 Thus, these two reports became the cornerstones of the new post-WWII standards for fitness in an America concerned about the critical state of American fitness, particularly the fitness of young males who made such “an important contribution to national defense.”14 The reports’ ability to drastically change the government and public’s thoughts about fitness comes from the publication of these authority documents at a crucial time for United States’ post-war ideology – when America found itself trapped between its traditional post-war strategy and the new demands and military strategy of the Cold War.15 Previously, the recurring trend had been to relax and stop emphasizing fitness when the country was not at war. 16 Now, as David Fautua notes in “The Long Pull,” the materialization of Cold War anxiety and uncertainty due to a lack of a definitive battlefield, time span, or concrete physical enemy blurred the previously distinct line between wartime and peacetime.17 The United States was in unfamiliar territory fighting a limited war with an additional ideological component that required the development of a new Cold War Army who would “defend the principles of democracy in an era of uncertain peacetime.”18 Thus, in order to avoid the mistakes of WWII and ensure the preparedness of America’s “new generation of soldiers,” the US government seized onto these reports as the impetus for change, acting quickly to both shine the national spotlight on youth fitness and assuage growing Cold War anxieties.19 11
Ruth P. Hirschland and Hans Kraus, “Muscular Fitness and Health,” The Journal for the American Association for Health, Physical Education, and Recreation (Dec 1953): 1-3. 12 Welch, 172. 13 Welch, 177. 14 1942. Youth and the Future: Health and Fitness, The High School Journal 25, no. 2 (Feb): 53-58, 53. 15 David T. Fautua, “The ‘Long Pull’ Army: NSC 68, the Korean War, and the Creation of the Cold War U.S. Army,” The Journal of Military History (61, 1, Jan, 1997), 93-120, 96. 16 Welch, 128. 17 Fautua, 98. 18 Ibid, 115. 19 Welch, 128.
SYNTHESIS ISSUE 4 Total Fitness Emerges: The 1956 President’s Council on morally sound, competitive, and socially adjusted in addition Youth Fitness to being physically fast and strong. With this emphasis, the In 1955, only two years after the Kraus-Hirschland article, Council’s new orientation revealed that the American youth’s President Eisenhower called for “139 leaders in education, “capacity to function in every way at one’s own best” had taken government and athletics to attend the President’s Conference over as the new common concern.27 Thus, by solidifying total on the Fitness of American Youth,” to come together and fitness as its core tenet and driving force in its 1956 Report, work towards improving America’s problem of youth fitness.20 the Council advocated for a new American fitness program A year later, on June 18th and 19th, 1956, Vice President Nixon that would develop well-rounded youths, thereby preparing the led the Conference at the United States Naval Academy in United States for whatever new Cold War challenges it would Annapolis, Maryland.21 The men and women in attendance face. brought together their combined experiences and knowledge Yet, what was the Council’s rationale for adopting total to identify current problems in youth fitness, propose new fitness as its philosophical foundation? The United States was program measures, and determine general recommendations diving head first into a limited warfare strategy that soldiers for society at large. Perhaps encouraged by their military locale, had a hard time understanding because the limited war tactics the Conference seemed to be rooted in the fundamental, meant there was no clear winner or loser.28 Ideological victory motivating idea that, “the strength of our Nation tomorrow is requiring certain psychological preparedness was replacing the fitness of its youth today.”22 straight-lined victory.29 Thus, as President Eisenhower The four-part “Fitness of American Youth: A Report to remarked in the 1956 Report, “national policies will be no the President of the United States on the Annapolis Conference” more than words if our people are not healthy of body, as well report, published immediately after the Conference, includes as of mind;” a fitness program that only addressed the physical a complete compilation of the Conference’s findings and element of fitness would be ineffective in preparing the nation’s recommendations that addressed a rather long range of youth for the emotional and psychological challenges of this problems including the need for new programs and facilities, new unconventional warfare.30 Therefore, total fitness became health examinations, and an all-around coordination of the the Council’s solution because of its ability to transform home, community, state, and national resources.23 In the our “most precious asset – our youth” into a collection of end, the Conference concluded that they needed a “top-level individuals ready to handle the physical, mental, and emotional committee of Federal departments having programs and burdens that might arise.31 activities relating to the fitness of youth” to shepherd in these As seen in the 1956 Report, the Council clearly complicated yet necessary changes.24 A month later, President had specific motivations and goals in mind as it set out Eisenhower issued Executive Order No. 10673 that established to conquer youth fitness with its total fitness philosophy. the President’s Council on Youth Fitness.25 However, although the Report itself recommended that As its first order of business, the newly established “Fitness programs should be developed to meet recognized President’s Council on Youth Fitness published the 1956 standards,” the Council left this statement open-ended because “Fitness of American Youth” Report, listing ways to improve it never actually identified which recognized standards should the fitness of the nation’s youth. The Council oriented its be followed.32 In the Report’s list of recommendations, the new fitness program around the idea of total fitness, which Council wrote that a program should “be designed to motivate advocated for the conceptualization of fitness as more than just fitness of youth for normal peacetime living,” “be designed physical. In its very first pages, the Report’s made clear reference for maximum appeal to stimulate voluntary participation,” and to this philosophy by defining an optimal fitness program as, should “provide exercise to develop strength, flexibility, and “one which encompasses the total person – spiritual, mental, other qualities.”33 While the Council had a vision of a proper emotional, social, cultural, as well as the physical. Therefore, fitness program, this vision stayed at an ideological level rather any stress on the physical element of youth development must than narrowing in on detailed explanations or suggestions about be done in recognition of the interweaving of all personality how to motivate the youth and stimulate participation. This factors.”26 A boy or girl could not be deemed fit without being example supports Shelley McKenzie’s critique in her “Mass Movements” dissertation that said, “other than raising vague 20 “U.S. Names Aids to Fitness Group,” New York Times, Sep 18, notions of ethics, morals, good character and self-discipline, 1955. 8
Fitness of American Youth: A Report to the President of the United States,
Ibid, 3 Ibid, 3-8. 24 Fitness of American Youth: A Report to the President of the United States, 7. 25 Ibid, 49-51. 26 Ibid, 4. 23
Ibid, 19, 22. Fautua, 97. 29 Ibid, 113. 30 Ibid, 13. 31 Fitness of American Youth: A Report to the President of the United States, 13. 32 Ibid, 4. 33 Ibid, 5. 28
TASSOPOULOS / FITNESS SPRING 2013 9 the President’s Council on youth Fitness officials did little to contradictory. The Council used the 1956 Report to fervently specifically explain how total fitness in the nation’s youth was promote the philosophy it believed would be highly effective in to be achieved.”34 By not delving deeply into what constituted improving youth fitness, but then riddled it with broad language and distinguished one element from the other, the Council and nonspecific prescriptions. Yet, by understanding the Cold maintained a removed role in the direct implementation of War political tensions that challenged the development of a total fitness. national fitness program, one can start to unravel the Council’s The Council’s “refusal to set guidelines” or to “formally reasoning. As Soviet-American tensions ran high, the Council endorse” any specific program is further identified when was intensely wary about developing a program that would compared to the prescriptions of other national organizations draw comparison to the top-down, mass regimentation fitness also concerned with youth fitness and physical education.35 The programs characteristic of Nazi Germany or Communist Council’s undefined standards meant that the task of specifically USSR.42 In fact, Vice President Nixon explicitly warned “the identifying what constituted the total fitness’s four elements [Council] against trying to impose ‘a single straightjacket fell to these organizations. Abraham Ribicoff, in a speech given program’ on the country,” that would, “emulate the Soviet at the Boy Scouts of America National Meeting, advocated youth festivals, which [Nixon] declared ‘stress the mass for a 15-minute minimum of physical developmental activities and ignore the individual.’”43 Even President Eisenhower per student every day.36 He also validated the use of physical promoted caution, explicitly stating, “I do not mean that achievement tests to encourage “self-evaluation and provide we should have an over-riding Federal program.”44 At the a strong motivation for development within the individual same time, the American Cold War ideology of “ ‘freedom’, pupil.”37 The American Association for Health, Physical which exalted individual choice as it condemned control of Education, and Recreation (AAHPER) was another example all aspects of life in Communist systems,” necessitated the because two members, Karl and Carolyn Bookwalter, wrote development of a strictly American style of fitness that would a book titled Fitness for Secondary School that supplemented the reinforce American values of individualism and liberty. Thus, 1956 Report by breaking each fitness aspect further down into recognition of these emerging political tensions helps one subsections explaining contributing factors to total fitness.38 understand the Council’s willingness to sacrifice any allusions For example, in describing, “what we know about physical to a specific definition or standard. With the current American fitness,” the Bookwalters discussed knowledge from the Cold War ideology, the government and public would have areas of “nutrition, cardio-vascular and respiratory, muscular, rejected any move, unintentional or not, towards implementing sensory, […] and teeth.”39 Mental fitness similarly broke a national program because it would have failed to condemn down into a discussion of the causes of mental breakdown the Communist systems;45 thus, consciously adopting a handsand mental fitness in schools.40 Even though Ribicoff and off implementation of total fitness was the most politically the AAHPER engaged with total fitness by emulating the and socially appropriate choice in 1956 United States. 1956 Report’s rhetoric and structuring their stances around fitness’s four values, these organizations were left to their own Federal versus Local: The Battle of Educational Policy discretion. They had the freedom to define and then interpret In the years surrounding the Council’s 1956 formation, total fitness into specific prescriptions based on their own another tension also surfaced that complicated and challenged priorities, and to even develop national campaigns like the the Council’s rejection of federal control: educational reform. AAHPER’s Operation Fitness USA that tested over 20 million With new nuclear weaponry, scientists and academics became children nationwide in 1959.41 By looking at these 50s and 60s just as, if not more, important than soldiers in the Cold War. interest groups and how they took the Council’s proposal of To compete with the USSR in the nuclear arms race, the United total fitness and expanded, solidified, and deviated from it, the States needed a strong academic system to produce these Cold Council’s hesitancy to define total fitness becomes that much War scientists.46 However, critics identified many problems more transparent. when they evaluated the American school system in the early At first glance, this hands-off approach seems 1950s, like the “lowered the aims of the American public schools” whose academia moved away from the liberal arts 34 McKenzie, 60. and scientific disciplines.47 As Ellen Lagemann observes in An 35
Ibid, 59, 60. Abraham Ribicoff, “Total Fitness,” Public Health Reports (18961970), Aug, 1961, iv. 37 Ribicoff, iv. 38 Karl W. Bookwalter and Carolyn W. Bookwalter, Fitness for Secondary School Youth (Washington, D.C.; American Association for Health, Physical Education, and Recreation, 1956). 39 Bookwalter and Bookwalter, 43. 40 Ibid, 45. 41 McKenzie, 50. 36
Ibid, 51. Ibid. 44 Fitness of American Youth: A Report to the President of the United States, 13. 45 Ibid. 46 Ellen Condliffe Lagemann, An Elusive Science: The Troubling History of Education Research (Chicago: The University of Chicago Press, 2000), 164. 47 Arthur Eugene Bestor, Educational Wastelands: The Retreat from 43
10 SYNTHESIS ISSUE 4 Elusive Science: The Troubling History of Education Research, these location for all necessary change. 53 With this focus, the new critics, particularly the salient Arthur Bestor, wanted to “return federal education reform realized the technocratic vision of responsibility for school content to disciplinary specialists,” an re-establishing the American school as the birthplace of the argument that echoes the rising presence and dominance of future Cold War scientists. technocratic thought in Cold War America.48 Allan Needell’s This sudden shift in American education policy greatly Science, Cold War, and the American State elucidates the term complicated the Council’s 1956 pre-Sputnik total fitness technocracy, defining it as “the delegation of planning and platform. The post-1957 American public now agreed with decision-making authority to experts, with the democratic and supported the federal government’s heavy-handed role in participation of citizens and their elected political leaders education reform.54 Yet, despite educational reform’s strong limited to holding those experts strictly accountable for their pull that created a fundamental tension between the Council performance.”49 Cold War relationships began shifting towards and society’s new alignment, the Council stayed the total expert-based technocracy as a way to secure the United fitness course, continuing to espouse its hands-off approach State’s ideology of freedom, bringing the academic education in two post-Sputnik publications. In 1958, the Council system with them. Yet, even though “Americans increasingly published “Report to the President of the United States on recognized education as a national priority, […] traditions of the Fort Ritchie Meeting,” a report containing the record of local and state control over education were still very powerful.”50 the Council’s second annual meeting.55 Based the discussion of The American public did not yet accept the more technocratic, the “hierarchy of government,” “the relative balance desirable federally inclined mindset that was less compatible with the between government service and voluntary activity,” and Council’s grassroots, hands-off approach, and would not until the “appropriate role of the government,” the report clearly the 1957 Soviet launch of Sputnik. Thus, the 1956 Fitness emerged in a post-Sputnik America filled with a zeal for federal Report was conceived, published, and accepted by this pre- reform.56 Yet, this discussion is used to accentuate the Council’s Sputnik, pre-complete federal control America. Consequently, rejection of federal reform, explicitly stating multiple times, the Council comfortably adopted their hands-off approach, “There shall be no federal control over local, state, or national even as a federally appointed council. programs of youth fitness.”57 The 1958 Report demonstrates In 1957, the American public’s acceptance of federal the Council’s belief that it should strictly be a “catalytic agent” education reform changed as it entered a state of frenzied to the existing local, state, community, and national programs, panic after the Soviet launch of Sputnik. The United States’ rather than taking an active and intervention-oriented stance. failure to win the Space Race could indicate other larger losses 58 It reads: to come. Now, in the face of a national crisis, the majority of Our purpose is not to develop an the public was ready to accept federal aid in the academic arena additional branch of the Federal Government. and see immediate educational reform. 51 First, the National […] Our job is to build men and women of Education Defense Act, marking the federal government’s physical, moral, and spiritual strength – without first heavy involvement in education policy, passed in 1957 building another government bureau. Our aim to allocate funds to math and science. Concurrently, an is to strengthen, enrich, and focus attention on explosion of educational reform literature brought the earlier the programs of existing youth organizations.59 technocratic arguments of Bestor and other reformists to The Council’s second post-Sputnik publication, the 1959 the forefront of policy.52 Reaffirming educational reform as “A Community Project: Youth Fitness” brochure, similarly advantageous to national defense, these reformists endorsed reiterated and reaffirmed the previous Reports’ focus on schools – the “instruments of federal programs aimed at grassroots fitness programs and this “catalytic” role.60 By achieving particular domestic and international goals,” – as the 53 Christopher Phillips, Discipline and Rigor: The ‘New Math’ and the Learning in Our Public Research (Urbana: University of Illinois Press, 1953), 8. 48 Lagemann, 160. 49 Allan A. Needell, Science, Cold War, and the American State (Washington, D.C.: Smithsonian Institution, 2000), 108. 50 Carl F. Kaestle and Alyssa E. Lodewick, To Educate a Nation: Federal and National Strategies of School Reform (USA: University Press of Kansas, 2007), 20. 51 Kaestle and Lodewick, 190. 52 Kenneth W. Richmond, Education in the U.S.A.: A Comparative Study (New York: Philosophical Library Inc., 1956); H.G. Rickover, Education and Freedom (New York: E.P. Dutton & Co., Inc); Augustin G. Rudd, Bending the Twig: The Revolution in Education and Its Effect on Our Children (New York, Stratford Press, 1957).
Creation of the Mid-Century American Subject (Harvard University, 2011), 6. 54 Kaestle and Lodewick, 190. 55 President’s Conference on Fitness of American Youth. 1958. Fitness of American Youth: A Report to the President of the United States on the Fort Ritchie Meeting. (Washington, D.C.: President’s Council on Youth Fitness). 56 Fitness of American Youth: A Report to the President of the United States on the Fort Ritchie Meeting, 35. 57 Ibid, 2. 58 Ibid, 28. 59 Fitness of American Youth: A Report to the President of the United States on the Fort Ritchie Meeting, 9. 60 President’s Council on Fitness of American Youth, A Community Project: Youth Fitness. (Washington, D.C.: President’s Council on
TASSOPOULOS / FITNESS SPRING 2013 11 allowing “each [local and state] community [to be] its own changes, while simple, essentially eliminated any traces of best judge of how it can meet the challenge to promote civic total fitness’s concept of four separate but equal elements and action” and make their own decisions, the Council continued the 1956 Council’s local, bottom-up focus, replacing them a to reject the post-Sputnik Cold War technocratic impulse that federally run program that enforced the idea of measurable placed all control in the hands of the experts who supposedly physical fitness defined by standards derived by the nation’s possessed more knowledge.61 Thus, both documents reveal experts.64 Thus, with these changes came the demise of total the Council’s hesitancy to give in to the push for technocratic fitness philosophy at the hands of the Kennedy administration federal control even amidst a shifting public opinion. Instead and its “technocratic governance style.”65 of grappling with the problems of implementing a top-down, Soviet style program, problems that the Council so fervently Physical Fitness over Total Fitness: Who Made the Right tried to avoid in 1956, the Council stayed steadfast to total Decision? fitness and its hands-off approach. In a brief five or six years, the American public saw the formation of the President’s Council on Youth Fitness, the Total Fitness’s Demise: President Kennedy’s Return to Council’s promotion of total fitness as its core tenet, and the the Physical complete breakdown and re-orientation of this Council under However, this shift in the American public’s opinion the Kennedy administration. It seems to be such a small blip cannot be ignored because it plays a key role in the eventual on the radar screen of American Cold War history that it is demise of the Council’s total fitness, grassroots approach in the almost easy to overlook. Some scholars, such as McKenzie early 1960s under President John F. Kennedy’s administration. and Bowers and Hunt, might even argue that total fitness Even though the Council firmly believed in its total fitness was the United States government’s misstep away from the philosophy, some Americans in this post-Sputnik world started technocratic, top-down federal policies that both dominated to speak out in very public ways against total fitness. Perhaps the United States and were more successful in improving the the most important citizen to speak out was actually President youth’s physical fitness. John F. Kennedy. In a 1960 Sports Illustrated article titled However, this is where I as a ‘history of the idea of “The Soft American,” the then President-Elect discussed both fitness’ scholar diverge. While I do agree that the demise of his concern for the nation’s fitness that threatened to “strip total fitness was inevitable in the new technocratic, federaland destroy the vitality of a nation,” and his plan to ensure its control focused United States, this unavoidable demise does improvement.62 He states, “the harsh fact of the matter is that not automatically imply that the 1956 Council chose wrongly there is also an increasingly large number of young Americans in implementing total fitness. Rather, after trying to understand who are neglecting their bodies – whose physical fitness is not the Council’s motivations for total fitness, there is certainly what it should be – who are getting soft.” To him, the Council’s validity in claiming that total fitness was the right decision for total fitness and hands-off approach was not effective. Instead, the Council, even if that fitness philosophy did not remain the Kennedy wanted the Council to be re-oriented towards the best right after its conception. By emphasizing the complete physical fitness and the physical bodies of the American youth, person, and more specifically, the complete American youth with an emphasis on a hands-on, federal control methodology. that is mentally healthy, socially adjusted, and emotionally Kennedy writes: mature, total fitness offered the United States the advantage “This is a national problem, and requires of promoting confidence in a national fitness program, national action. President Eisenhower helped assuaging societal anxieties about the Cold War, and creating show the way through his own interest and by a future generation of soldiers who could handle the new calling national attention to our deteriorating limited warfare. At a time when the American youth’s poor standards of physical fitness. Now it is time fitness threatened the identity of the American people and the for the United States to move forward with a stability of the country, total fitness was the solution. Thus, national program to improve the fitness of all throughout this short yet intense narrative of total fitness from Americans.”63 its conception to its demise, this paper’s deconstruction of the When Kennedy took office, he placed the new national following questions – Is fitness strictly physical? When is a program under the direct control of the Department of person deemed fit? And, how does a government go about Health, Education, and Welfare’s direct control, and changed improving fitness? – reveals a rich and complex ‘history of the the Council’s name from the President’s Council on Youth idea of fitness’ at this moment in Cold War America. Fitness to the President’s Council on Physical Fitness. These Youth Fitness). 61 A Community Project: Youth Fitness, 2. 62 John F. Kennedy, “The Soft American,” Sports Illustrated, December 26, 1960. 63 Kennedy, 3.
Bowers and Hunt, 1501. Ibid, 1504.
The AIDS Memorial Quilt as Memorial and Media Ilana Seager, Yale University ‘12 When the first murmurings of a “gay cancer” hit the United States in the summer of 1981, few could have imagined the immense impact the disease would have on generations to come. The condition, now known as HIV/AIDS, massacred the decade’s newly visible gay community, leaving behind fear, grief and a need to be heard that culminated in the creation of the AIDS Memorial Quilt. Using archival research, the present paper explores the classification of the Quilt as media and argues that in fact the artwork was an early form of social media, utilizing everyday people to share their stories in a highly visible and public way. This interpretation of the NAMES Project re-imagines both the historical narrative of the Quilt and modern debates over social media and activism. The social media lens also helps us reconsider our narratives of patient identity in the 20th century.
ver the weekend of October 11, 1987, thousands of people attended the inaugural display of the 1,920-panel AIDS Memorial Quilt on the Capitol Mall in Washington, D.C.1 Two short years later, directors of the project announced that the Quilt could no longer be shown in its entirety, for there was no public space in the United States large enough to display its now more than 15,000 panels, which would cover nearly 30 acres.2 3 The AIDS Memorial Quilt is both a memorial and a form of media. It not only allows mourners to remember and celebrate the lives of their loved ones in a safe and supportive environment but also has many characteristics of the news media: it tells a story, it informs, and it reaches the attention of many. One could argue however, that rather than being a part of traditional media, the Quilt fits the description of modern social media. For instance, media and its production means, like printing presses and other expensive technologies, are traditionally privately owned and controlled, but in social media, the instruments required to produce media are accessible to the masses, allowing anyone to create a panel without the same level of censorship that is expected in the traditional media. Perhaps more importantly, the authorship of traditional media is restricted to a single reporter and his or her editor, while social media, like the AIDS Memorial Quilt, expands that power of authorship and of recording experience to a network of people. In a way that no other media source during the 1980s did, the Quilt allowed mourners to remember and celebrate the lives of their loved ones in a safe and supportive environment 1
Sandra Boodman, “Giant Quilt Names 1,920 AIDS Victims,” Washington Post, October 10, 1987, A.1. 2 The NAMES Project, “Keep the Love Alive: The Quilt in Washington D.C.” pamphlet, 1989, AIDS Collection. Manuscripts and Archives, Yale University Library. 3 The NAMES Project, “The entire NAMES Project AIDS Memorial Quilt on display in Washington, DC” pamphlet, 1992, AIDS Collection. Manuscripts and Archives, Yale University Library.
while also recording the experience and informing the general public about the disease. But while war memorials and memorials for victims of natural disasters bring together the family and friends of those who died in a past event, the AIDS Memorial Quilt is ongoing, commemorating the dead in an epidemic that has yet to end. Many of the people who visited the Quilt in 1987 on the Mall were themselves memorialised as panels in the quilt years later. Some, knowing this, made their own panels.4 “[The Quilt] simultaneously humanises and personalises an often faceless disease; a disease that affects “other people,” photographic journalist Sal Lopes wrote.5 The AIDS Memorial Quilt represents the collective and public memory of the AIDS crisis and in this way, it could be considered an early form of modern social media. The idea for the AIDS Memorial Quilt came about in October 1986 when gay activist Cleve Jones struggled to find a way to commemorate the lives of friends who had died from the disease. 6 More than one thousand people had died from AIDS-related complications in a ten-block radius of the Castro District in San Francisco in the space of six years 7 and Jones felt he needed to bring this story to the wider world. He remembered a night in November 1985 when he called for people to plaster the façade of the old federal building in San Francisco with posters declaring the names of people who had died from HIV/AIDS. “It was a strange image,” Jones recalled later, but one that he felt could tie the issue of HIV/AIDS to the wider community and use to 4
“Common Threads: Stories from the Quilt,” directed by Rob Epstein and Jeffrey Friedman (1989; New York, NY: Telling Pictures, 2004), DVD. 5 Sal Lopes, Living with AIDS: A photographic journal (Boston: Blufinch Press, 1994), 3. 6 Cindy Ruskin, The Quilt: Stories from the NAMES Project (New York: Pocket Books, 1988), 7. 7 The NAMES Project, “AIDS Memorial Quilt: A symbol of love and remembrance, A gift from the hearts and hands of thousands,” pamphlet, AIDS Collection. Manuscripts and Archives, Yale University Library.
One of the more than 8,000 blocks that make up the AIDS Memorial Quilt. Each twelve square foot block is made of eight panels, and each panel commemorates a life lost to AIDS. The quilt continues to grow, but at press time measured 1.3 million square feet. Photograph courtesy of The NAMES Project Foundation.
de-marginalise the gay community’s experience of the epidemic.8 “By providing a glimpse of the lives behind the statistics, it will create an extraordinary, dramatic illustration of the magnitude of this epidemic—to the President, to Congress, and to the country,” he said, adding that the aggression and fear shown by so many people towards those infected with the disease9 is not the right way to approach the epidem8
Cleve Jones and Jeff Dawson, Stitching a Revolution: The Making of an Activist (New York: HarperCollins, 2000), 106. 9 “AIDS Victim Held to Blame Self for Loss of Home,” Los Angeles
ic. “We want to create something that is beautiful. The Quilt touches something in people that is pure and good—this is how the country should respond to the AIDS epidemic.”10 The dearth of coverage of the disease in its early years presented space for the creation of new media like the Quilt. At the beginning of the AIDS epidemic, few media outlets were willing to cover the disease and those who did tended to print highly sensational images of emaciated, lesion-ridTimes, September 12, 1987, 2. 10 Ruskin, The Quilt, 12.
The AIDS Memorial Quilt was a highly visible, highly visual way of communicating the vast and profound devastation of the AIDS epidemic on a generation of young people to the mainstream public. Photograph by Mark Theissen, courtesy of The NAMES Project Foundation.
den gay patients with AIDS.11 Because the epidemic was centred in neighbourhoods and communities like the Castro in San Francisco and the Village in New York, the general public was disconnected from the disease. For many, the media became their sole encounter with HIV/AIDS12 and so the AIDS Memorial Quilt became, to some extent, a centre point for telling the personal narrative of those directly affected by the disease during the late 1980s and 1990s. The Quilt communicated the mortality statistics of the epidemic through its ever-increasing number of panels, as well as the reading of the names of people killed by the disease at every public viewing. The Quilt’s promotional materials, and reports by the news media of this media, also helped to deliver the latest death tolls. In doing so, the Quilt broke down ideas of HIV/AIDS as an exclusively gay disease by demonstrating the range of people affected: drug users, mothers, babies, haemophiliacs and nurses among others. 11 12
Lopes, Living with AIDS, 3. Lopes, Living with AIDS, 3-4.
Using Barbie dolls, bubble wrap, buttons, car keys, leather, wedding rings and condoms, among other materials,13 friends and family of those who were lost to HIV/AIDS created 3’x6’ panels that symbolised lives of those who died, telling the world about their struggles, their loves, their inspirations and their experiences. “Some of the panels work as powerful graphic statements,” journalist Heather McHugh said in an article about the Quilt, “but even the least sophisticated (perhaps especially these) are very moving.”14 The stories told on the Quilt are not simple tales of contracting an illness and passing away, but instead complex and nuanced stories that convey the struggles of the illness’ victims in maintaining normal lives until the end. They embody a material culture of the pains and struggles of collective memory. The NAMES Project, “La Colcha Conmemorativa del SIDA,” factsheet, 1995, AIDS Collection. Manuscripts and Archives, Yale University Library. 14 Heather McHugh, “They Shall Not Go Homeless,” New York Times, July 31, 1988, 18. 13
SPRING 2013 15 SEAGER / AIDS QUILT One panel commemorates the life of David C. Camp- aggressive campaigning like that exhibited by radical activbell, a landscape architect based in Washington D.C. who ists like Larry Kramer had passed. “I’ve had my share of died on November 19, 1984.15 In the 1989 documentary leading angry crowds against police barricades and throw‘Common Threads: Stories from the Quilt,’ Campbell’s part- ing myself against the hard blue line. And it was effective ner Tracey Torrey, who is himself confined to his bed due and necessary,” Jones said in his 2000 book ‘Stitching a Revto AIDS-related infections, describes Campbell’s life-long olution: The Making of an Activist’. “But today’s conflicts discomfort with his sexuality and his fear of the cause of are not those of fifteen, ten, even five years ago… If given his death being discovered by others. Just before Campbell the choice, I choose the strategies less likely to end in blood died, nine days after he was diagnosed with AIDS, he asked on the streets.”23 The Quilt thus evolved into an attempt Torrey not to reveal his true cause of death to anyone. The to “translate the body count of AIDS cases and deaths… morning after Campbell passed away, Torrey returned to his into compelling human terms” in a way that unlike previwork at the Pentagon without a word of his loss because ous generations, tried to draw in a wide range of support he too was not open about his homosexuality for fear of through a communal activity entrenched in American tradilosing his job or being discriminated against.16 Campbell and tion — quilt-making.24 Indeed, as time passed, the creation Torrey’s story illuminates for the general public the struggle of panels spread beyond the friends and family of those of maintaining a public heterosexual image in order to avoid lost. Many panels were created for famous people and acdiscrimination while simultaneously fighting for one’s life tivists affected by HIV/AIDS. A quick online search of the and needing the support of one’s friends and family. This AIDS Quilt website returns no fewer than sixteen results for is a message rarely portrayed in the early media surrounding Rock Hudson, a well-known 1950s and 1960s movie star, the epidemic, which tended to focus more on statistics than alone.25 One could argue that this evolution of the Quilt on the experience of living with HIV/AIDS17. The Quilt on from a symbol of grief to a symbol of determination26 sigthe other hand, socializes the disease, encompassing thou- nals the beginning of the Quilt as media. This shift in 1988 sands of stories, including Torrey’s heartache at losing all and 1989 from the artwork and memorial of individuals to but a few of his friends, family and lovers to the disease. a social remembrance by many, demonstrates the Quilt’s Torrey said in the film, “I just tell myself, ‘Hang in there intent to inform and educate like the traditional media. buddy, it won’t be too long until we’re together again.”18 However, the methods remain distinct. Where tradiThe AIDS Memorial Quilt also aims to inform and tional media creators have specialised skills — for instance, to educate. In a pamphlet published by The NAMES Pro- journalists have training and education about ethics and ject Foundation, the organisation that coordinates the Quilt, interview techniques — in social media anyone can conthe mission of the project is “to illustrate the enormity of tribute. NAMES Project organisers actively promoted the the AIDS epidemic by showing the humanity behind the idea that anyone could create a panel as long as it was 3’x6’ statistics through the AIDS Memorial Quilt.” They hoped and they wrote a short letter describing the person they to achieve this in part by increasing public awareness of have memorialised.27 Furthermore, anyone could particithe AIDS epidemic and HIV prevention through creative pate in the reading of names at the Quilt unfolding cerexpression.19 “Though the panels are created in sorrow, emonies. Through these different methods, the NAMES there is hope sewn into each one – hope that those who Project incorporated much of the philosophy of social view it will be moved to act,” one such pamphlet said. 20 media — that anyone and everyone has the right to exBy August 1989, 57,094 people were known to have press him- or herself and that that expression is valuable. died of AIDS in the United States.21 NAMES Project leaders Social media, unlike traditional media, is also in like Capital Chapter board member Michael Bento said they a state of constant flux. After an event happens, it is refelt that there was a growing perception by this time that the corded on the Internet through social media outlets usuepidemic had peaked, and that there was no longer anything ally long before traditional news organisations have time to worry about.22 Director Cleve Jones felt that the time for to write up an article or film a television segment. The AIDS Memorial Quilt was one of the most regularly up15 Boodman, “Giant Quilt Names 1,920 AIDS Victims,” A.1. dated records of the people who died from HIV/AIDS 16 “Common Threads: Stories from the Quilt,” 1989 in the late 1980s and its huge influx of panels over even 17 Randy Shilts, And the Band Played On: Politics, People and the AIDS Epidemic (New York: St. Martin’s Press, 1988), 1-582. 18 “Common Threads: Stories from the Quilt,” 1989 19 The NAMES Project, “AIDS Memorial Quilt,” pamphlet, ca. 1992 AIDS Collection. Manuscripts and Archives, Yale University Library. 20 The NAMES Project, “AIDS Memorial Quilt.” 21 Elizabeth Aoki, “Ever-Growing AIDS Quilt Set for Finale.” Washington Post, August 10, 1989, D.1. 22 Aoki, “Ever-Growing AIDS Quilt Set for Finale,” D.1.
Jones and Dawson, Stitching a Revolution, xiii. Boodman, “Giant Quilt Names 1,920 AIDS Victims,” A.1. 25 The AIDS Memorial Quilt, accessed April 14, 2011, http:// www.aidsquilt.org. 26 Sandra Boodman, “AIDS Quilt, Larger Than Last Year, Returns to Mall,” Washington Post, October 7, 1988, A.18. 27 The NAMES Project, “AIDS Memorial Quilt: A symbol of love and remembrance, A gift from the hearts and hands of thousands.” 23 24
16 SYNTHESIS ISSUE 4 just its first two years explicitly demonstrates the number but if the millions of dollars raised through the project34 of people affected by the disease in a more personal way and the thousands of panels are any indication, the AIDS than statistics could. From 1987 to 1988, the reading of the Memorial Quilt was just what the legions of people directly names even increased from lasting two hours to sixteen.28 or indirectly affected by HIV/AIDS had been waiting for. By 1995 the AIDS Memorial Quilt had been visited by more than 5.57 million people and included panels from 39 countries.29 It was officially the largest piece of community folk art in the world and on the Quilt’s 1989 public display in the Capital it took 3,000 volunteers to set it up.30 The Quilt garnered the attention of celebrities; at the inaugural unfolding ceremony in 1987, 60 volunteers including actress and comedian Whoopi Goldberg and Democratic Representative Nancy Pelosi31 spent hours reading names of people who had died from the disease, which attracted the attention of other media outlets. It also travelled to public schools, hospitals, churches, theatres, airports, a museum in Russia and even a maximum-security prison in California.32 Throughout this promotion and travel, the Quilt’s display became somewhat localised. According to a brochure from the NAMES Project, because the Quilt is so large, only panels with names of people from the area are displayed at each location.33 One might draw parallels here with modern social networks in which the collective memory of an event often begins as a news item shared by many, but which segments into geographical, political, and social groups. By becoming localized, the Quilt captured more than just the individual experience of AIDS so lacking in traditional media — it also spoke to a wider community remembrance and grief. In conclusion, the AIDS Memorial Quilt was not the most common type of media in the 1980s at the height of the epidemic. It was, however, an extremely effective form that shared with the general public the personal and collective experience of this horrific epidemic that killed thousands. The Quilt went beyond the statistics, telling the stories of people who had died from AIDS and the struggles of those they left behind. The Quilt’s rapid growth signalled the scale of the epidemic and organisers and contributors alike used the Quilt to impress upon the government and the public the need for increased funding and education about AIDS. And all of this hinged on the Quilt’s large audience and that audience’s participation in its creation. The Quilt hinted at the beginning of social media as an effective form of communication, and pointed to the potential of alternative media in forming support networks around the disease. Never before had quilt-making been used to rally thousands behind a cause, The NAMES Project, “Keep the Love Alive: The Quilt in Washington D.C.” pamphlet, 1989, AIDS Collection. Manuscripts and Archives, Yale University Library. 29 The NAMES Project, “La Colcha Conmemorativa del SIDA.” 30 Aoki, “Ever-Growing AIDS Quilt Set for Finale,” D.1. 31 Boodman, “Giant Quilt Names 1,920 AIDS Victims,” A.1. 32 Lopes, Living with AIDS, 15. 33 “AIDS Quilt to Be Shown in 20 Cities,” New York Times, March 17, 1988, C.9. 28
The NAMES Project, “La Colcha Conmemorativa del SIDA.”
Nourishing the Child: Dr. Thomas Morgan Rotch’s Percentage Feeding Movement and the Re-conception of Reform, Health, and Motherhood Julie Barzilay, Harvard University ‘13 Dr. Thomas Rotch’s infant feeding reforms are often grouped with the Industrial reforms of the 1880s and 1890s and explained in terms of the either the professionalization of pediatrics or equilibrium-focused pictures of health commonly accepted at the time. However, analysis of Rotch’s speeches, papers, and lectures reveals a vision of pediatricians as crucial advisors monitoring the development of the next generation, a rhetoric of health as a physician-dominated battle, and an emphasis on subordinating maternal wisdom to physician expertise in child-rearing. These trends suggest that Rotch’s reform agenda was more aggressive and expert-dependent than other movements of his time, engaging different assumptions about human nature and the nature of health. Finally, tracing his messages through several childcare pamphlets from the 1900s confirms that his programs launched permanent changes that transformed the role of mothers in child-rearing—and the relationship between pediatricians, mothers, and children—that persist to this day.
Rock-a-bye, baby, up on the bough You get your milk from a certified cow [….] Shun the trot horses your grandmother rides— It will work harm to your little insides. Mamma’s scientific—she knows all the laws— She kisses her darling through carbolized gauze. Rock-a-bye, baby, don’t wriggle and squirm: Nothing is near you that looks like a germ. —“A Modern Lullaby,” 19151
t the end of the nineteenth century, concerns about female sickliness, child-rearing in industrialized cities, and the transmission of morals through breast milk fueled initiatives to medicalize infant feeding.2 A key player in these movements was Harvard Medical School’s first pediatrics professor, Dr. Thomas Morgan Rotch, who launched a lab-based system of purifying and personalizing milk known as the “percentage feeding system.” While the system was short-lived, it experienced rapid growth from the 1890s until about 1915. Rotch also penned an influential pediatrics textbook, spoke widely about clean milk policies, and wrote prolifically on the importance of monitoring child development. On the heels of Gilded Age excess and industrialization, Rotch’s feeding program was launched in an era rife with social activism. Reforms addressing sanitation, labor, and urban poverty abounded as pragmatists re-conceived democracy as a social endeavor, the Social Gospel promoted Christianity-infused welfare, and middle-class women seized responsibility for injecting virtue The Forecast: A Magazine of Home Efficiency 9 (1915): 391. In Rima D. Apple, Perfect Motherhood: Science and Childrearing in America, (New Jersey: Rutgers University Press, 2006) 34. 2 Meckel, Richard A, Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850-1929 (Michigan: The University of Michigan Press, 1990) 44-70. 1
into the corrupt public sphere.3 Rotch’s actions are often lumped with these Industrial Era reforms, many of which dealt with infant mortality and hygiene. However, careful analysis of Rotch’s messages and language reveal that his platforms were actually quite distinct from the reform mentalities of the time. Industrial-Era health reform was often conceived in terms of restoring equilibria within urban environments, but Rotch’s movement was rooted in physician expertise, an understanding of health as the consequence of active research and skilled striving, and a dramatic re-imagining of the role of mothers in American society. Because Rotch aggressively promoted his feeding system, his speeches and articles provide fertile ground for historical analysis both of his medical findings and of his agenda as a pediatrician. Furthermore, analysis of early-1900s motherhood pamphlets demonstrates that Rotch’s messages were adopted and propagated for decades. This legacy underscores the relevance of using Rotch as a case study to illuminate changes in mother-physician relationships at the turn of the century: a firmer grasp on Rotch’s motives and methods can illuminate the power structures surrounding medicine and child-rearing in modern times. After establishing the secondary source and historical background for this analysis, I will explain how Rotch’s programs differed from other Industrial Era reforms, discussing both his practical suggestions and the language he couched them in. I will then address the way he dealt with mothers in his writings and speeches, emphasizing how their wisdom was subordinated to pediatrician expertise. Finally, I will trace Rotch’s messages in subsequent manuals for mothers to explore the extent to which his legacy was perpetuated after James Kloppenberg. “Gilded Age and Popular Protest.” “From the Cult of True Womanhood to the New Woman.” “Progressive Reform, the Social Gospel, and Social Settlements.” History 1330 Lecture. Harvard University. Sever Hall, 8 September, 22 September, and 4 October 2011. 3
SYNTHESIS ISSUE 4 the decline of his feeding system. As the “Modern Lullaby” can fill gaps left by Charles R. King in A History of Child printed in The Forecast: A Magazine of Home Efficiency Health in America, which describes feeding guidance as a indicates, by 1915 the notion of scientific motherhood was so response to maternal requests for advice about weaning, food familiar that it was mock-able. Analyzing Rotch’s methods and supplements, and digestion. mindsets can illuminate why his ideas were so widely adopted, In her 1997 work Growing Pains: Children in the and the extent to which his programs influence childhood, Industrial Age, Ferguson Clement explains how in the midmotherhood, and pediatrics today. 19th century, uncertainty about training children for a rapidlychanging world precipitated an obsession with child-rearing. Secondary Source Review Breastmilk was, in the late 1800s, often thought to transmit As historians of medicine attest, Rotch’s percentage moral values. Broadly speaking, Clement writes, “Food and feeding system sprang from a dynamic web of social, medical, femininity were tied in Victorian culture. Appetite was both a and cultural developments unique to the Gilded Age. Scholars sign of sexuality and an indication of lack of self-restraint.”8 often explain this web using one of three frameworks: medical This conflation of morality and diet illuminates the gravity with specialization, changing ideas about motherhood, and general which mothers viewed nursing in the 1890s. Elliot West’s 1996 reform in the Gilded Age. Each frame highlights different guide to Growing Up in Twentieth-Century America explains elements of Rotch’s aims: he attempted to promote pediatric that Industrial reformers believed threats to children’s health expertise by exaggerating the complexity of infant feeding, “could not be separated from other aspects of their lives,” like contributed to the displacement of mothers as child-rearing their homes, work, and play habits.9 Meckel added that midexperts, and both drew on and departed from reform trends 1800s health reformers aimed to identify “factors that made launching around him in the Industrial Era. the young of the urban poor significantly less able to adjust In Sydney A. Halpern’s 1988 work, American Pediatrics: to and resist internal excitements like teething and external The Social Dynamics of Professionalism, 1880-1980, she posits excitements like disease, heat, cold, and improper feeding and that the emergence of specialty associations, certifying boards, foodstuffs.”10 While this mindset was an important backdrop teaching hospitals, and training programs helped physicians for Rotch, I aim to challenge the notion that conceptions of “articulate distinct professional ideologies” and “sustain health as equilibrium map perfectly onto pediatrician-fueled unique professional roles.”4 Richard Meckel notes in his 1990 dietary philosophies.11 book Save The Babies that pediatrics was, paradoxically, a “holistic specialty,” focused on children but dealing with the A Climate of Reform whole body. As such, it struggled to attain recognition from Halpern and Meckel argue convincingly that early specialists who prided themselves on mastering particular American pediatricians carved out infant feeding as a niche organs or technologies.5 Meckel explicitly applies Halpern’s in which their expertise could reign supreme. I argue that ideas about professional quests for self-affirmation to the rise Rotch’s message and techniques in this pursuit of legitimacy of pediatrics at the turn of the nineteenth century, claiming necessitated a novel brand of reform: rather than attempting pediatricians “staked out infant feeding as a field in which they to holistically remove barriers preventing high standards of would battle for professional legitimization as a specialty.”6 living, Rotch encouraged the public to proactively shape their Rima D. Apple’s 2006 work Perfect Motherhood: health by following expert advice. To understand Rotch’s Science and Childrearing in America traces a transition from departure from the norms of reform, it is important to mothers as critical advice-seekers to individuals dependent on understand Industrial Era approaches to improving society and physician-experts. She claims concerns about women’s frailty health. Meckel explained that mid-nineteenth century health amidst the stresses of modern life fueled “dramatic shifts” reformers cited a child’s ability to “resist” stresses and “adjust” in physicians’ views of mothers that “justified increasingly to stimulation as crucial factors in determining whether a child authoritarian attitudes and greater intervention into everyday would survive infancy.12 Meckel says health phenomena not life by the early 20th century.”7 Bernice Hausman emphasizes attributable to constitution and heredity were explained in in her 2003 book Mother’s Milk that conceptions of women terms of the body’s “vital powers” that enabled adjustment to as fragile fueled infant feeding reform, and that a focus on the exposures and influences, and which were thought to be finite breast as the nurturant center of family life diminished as it 8 Clement, 46 became sexualized in the late 1800s. Hausman’s perspective 9 18
Sydney A. Halpern, American Pediatrics: The Social Dynamics of Professionalism, 1880-1980, (Berkeley and Los Angeles, CA: University of California Press, 1988) 2. 5 Richard A. Meckel, Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850-1929 (Michigan: The University of Michigan Press, 1990) 47. 6 Meckel, 55. 7 Apple, 18. 4
Elliot West, Growing Up in Twentieth Century America: A History and Reference Guide, (Connecticut: Greenwood Press, 1996) 57. 10 Meckel, 22. 11 It is also important to note that Rotch’s advice was often realizable only by wealthy mothers who could afford pediatric consultations, while many of the Industrial Era reforms were targeted at alleviating the health woes of the lowest classes. 12 Meckel, 22.
SPRING 2013 19 BARZILAY / ROTCH 13 and exhaustible. These ideas led medical experts to worry human milk in terms of acid content and carbohydrate level, that “exposure to disease agents, excessive heat and cold, and Rotch devised an “immensely complicated” method of formula improper food” would deplete a child’s powers to adjust to or mixing, known as percentage feeding.17 He determined that resist stimulation. In an era of pollution-spewing factories and each infant’s gastrointestinal system was unique, and that “what urban poverty, Gilded Age health experts turned their attention is one infant’s food may be another’s poison.” Holt jumped on towards child rearing, sanitation, nutrition, and hygiene. board with Rotch’s complex calculations, deeming percentage Progressive reformers like Jane Addams, Florence Kelley, feeding “the Eden of Pediatrics.”18 A few wealthy Bostonians and John Dewey embraced the philosophy that the purpose were so captivated that they funded milk laboratories in which of democracy was to facilitate the development of individual Rotch crafted personalized milk for infants. Gastrointestinal freedom and personality—that the individual was “brought to disorders in babies that imbibed his milk were incontrovertibly reality in the state.”14 This principle motivated the Settlement reduced—but less obvious was whether this success derived House movement and reforms addressing prostitution, from Rotch’s designer milk or the fact that his milk was made consumer exploitation, labor abuse, and corporate corruption. in sanitary conditions conducive to low bacterial counts. At her Settlement House, Hull House, Addams taught nursing Rotch spoke nationwide to rally funding and support classes, provided home-cooked food, offered cultural and art for sanitary milk production, and many hospitals adopted his clubs, and encouraged playtime for youngsters in the hopes feeding system.19 Meanwhile, he published papers domestically that such an environment would restore physical and mental and abroad, became Harvard’s first instructor in the diseases equilibrium, enable social mobility, and make America more of children in 1879, served as the first president of the New of a social democracy.15 These notions of fixing individual England Pediatric Society, and co-founded the American problems through holistic reform aimed at restoring balance Pediatric Society. In 1903, he authored an influential textbook, and enabling individuals to realize their potentials thus Pediatrics: The Hygienic and Medical Care of Children. predominated as infant feeding took center stage. In an era Fritz B. Talbot, founder of the Children’s Medical Service at when the term “social housekeeping” was bandied about as Massachusetts General Hospital, described Rotch as friendly, the ideal public role for women, it is no coincidence that many and as “something of a dandy,” who would arrive at the of these reformers were women, righting social wrongs with hospital in a “snappy open buggy” with a coachman and a motherly care. Amidst this backdrop of holistic, maternal beautiful horse.20 But Rotch’s popularity was not universal: an reform, a “very visible triumvirate” of male experts— incident in which he failed to support an assistant tarnished his American pediatricians Thomas Rotch, L. Emmett Holt, and professional reputation, and not everyone was as receptive to Abraham Jacobi—took it upon themselves to make “perfecting Rotch’s system as Holt. and monitoring infant feeding” the “single most important Jacobi took particular issue with the calculations required 16 activity” of pediatricians. for Rotch’s program, and Meckel notes that by 1910, percentage feeding was increasingly criticized for its complexity. In a The Rise and Fall of the Percentage Feeding System 1902 effort to discredit Rotch, a Harvard Pharmacological As early as 1873, Jacobi penned a book entitled Infant Laboratory physician showed that the composition of milk Diet that emphasized the havoc that female sickliness could samples from Rotch’s labs varied significantly and diverged wreak on a nursing child. Rather than advocating wet nursing, from their purported makeups. Rotch did not halt his crusade many pediatricians set out to demonstrate that cow’s milk, for children’s health as his system’s popularity waned, however: if hygienically produced, was the best alternative. Rotch’s he continued to espouse his nutrition ideas for several decades. percentage feeding system was built on the research of 17 Meckel 55-57. Bermuda-born obstetrics professor Charles Dulcena Meigs, 18 Meckel 57. who claimed in the 1850s that the indigestion elicited by 19 One extremely compelling fact about Rotch’s life not mentioned drinking cow’s milk was caused by elevated percentages of the in many secondary sources or referenced by Rotch in his papers is protein casein. In 1867, German researcher Justus von Leibig that his son, Thomas Morgan Rotch, Jr., only lived to be three years marketed his own infant food concoction in Europe and the old. Kelly and Burrage write, “Although Dr. Rotch bore up bravely United States, prompting a proliferation of manufactured under this affliction and did not allow it to interfere in any way infant foods in Europe and the US, including Ridge’s Food, with his work, he never fully recovered from the blow.” The illness of his wife Helen, which became severe in 1910, also wore on Nestle’s Milk Food, Mellin’s Food, and Horlick’s Malted Milk. Rotch and “indirectly was the cause of his death,” they write: “She Prompted by German pediatrician Philipp Biedart’s survived him but a few months.” It is inconceivable that losing discovery in the late 1860s that cow milk was different from his only son did not influence Rotch’s passion for reducing infant Meckel, 22-23. John Dewey, “The Ethics of Democracy” (1888), in The Political Writings ed. Debra Morris and Ian Shapiro, (Indianapolis/ Cambridge: Hackett Publishing Company, 1993) 60. 15 Addams, 196. 16 Meckel, 48. 13 14
mortality, and Rotch’s choice to separate his personal from his professional life by keeping his son out of so many of his papers and speeches is illuminating in itself. Kelly and Barrage, 1003. 20 Fritz B. Talbot, “Pediatric Profiles: Thomas Morgan Rotch (18491914),” (Journal of American Pediatrics, , July 1956, 49(1): 109-112) 110.
SYNTHESIS ISSUE 4 politicians, milk vendors, and health officials to persuade PART I: Doctor Knows Best them to unite for the “common cause” of the “intelligent While Industrial reformers hoped to free individuals from protection of early life.”25 The word “intelligent” says it all: his the constraints of sub-par environments, Rotch contended attempts at solidarity were really strategies aimed at securing that only physicians held the power to truly lift infants out of networks through which he could disseminate the knowledge illness and misery. In a sense, his reforms were grounded in of trained experts like pediatricians. Rotch exaggerated the the assumption that individuals were helpless without expert extent to which infant health was an uncharted territory—and medical guidance, whereas other reforms of the era assumed of vital societal import—to stress that scientists were needed humans could flourish if the impediments of modern to elucidate its secrets. He wrote in a plea for funding for a society were alleviated. This sentiment drove the mentality Memorial Infants Hospital that: that humans—especially children—needed to be constantly A remarkable anomaly in the world’s record, checked on by experts. As Halpern confirms, pediatricians however, is shown if we compute how much of the became “technical expert[s] on developmental benchmarks world’s money and brains have been expended on that in children and norms of age-appropriate behavior” in the intricate marvel, the human infant, without which the 21 twentieth century. world would have in it little of comparative value. Is it not, Rotch’s conviction that only trained experts could lay then, inconceivable that the inventive genius and wealth down the rules that would result in better health was born of adults are not directed to the preservation of young out in his arguments that pediatricians should be consulted by human beings, heirs to the world’s discoveries and final educators and employers to evaluate children’s capabilities. In a arbiters of the world’s progress? The infant at birth is so speech to the American Pediatric Society in 1909, he explained frail, is so easily affected to its detriment by new external that “There is a need for a developmental index by which influences and dies so easily, that we would suppose that physicians acting as an advisory council to the people shall be every means would be employed for protecting its life able to determine fitness for school and for physical work of in the wisest way for our own future use and our own the early years of life.”22 His obsession with the best way to personal ambitions.26 gauge development in children (Age? Weight? Teeth? The Rotch’s language is stylized for the purposes of charming Roentgen Method of assessing skeletal maturity?) reflected his donors, but the near-sacred aura of mystery in which he cloaks belief that it was impossible to diagnose disease without first infancy, as well as his emphasis on the need for inventive establishing what was “normal” for any given phase.23 Disease geniuses to grapple with intricate questions of child health, was therefore a “relative term” for Rotch, as he argued in his reinforce his message that health reform was inconceivable textbook: the right symptoms at the wrong stage—like teething without experts.27 His dramatic assertion that the fate too early—constituted a challenge to health that required the of the free world rested with infants, and his appeal to the attention of a medical professional. 24 humanitarian and utilitarian interests of donors, also served to This is not to say that Rotch felt he could raise the heighten urgency. His tendency to phrase reform suggestions next generation single-handedly. Rotch repeatedly addressed as a call-to-arms attests to his conviction that society would 21 Halpern, 13. suffer without the skilled advice of physicians, even if he 22 Thomas Morgan Rotch, “The Position and Work of the American acknowledged that such reforms could not be implemented Pediatric Society Toward Public Questions” (1909), In Transactions without help. 20
of the American Pediatric Society, Volume 21, Reprinted in the Archives of Pediatrics 1909-1910 (New York: E.B. Treat and Co., Publishers, 1910) 27. 23 Rotch in fact concluded that the Roentgen Method was superior to any of the aforementioned options, because “the skeleton represents an illustrative steel framework of development on which the body is built, and this development, when determined, presents the best source from which to evolve an anatomic index for practical use in the safeguarding of early life.” This fascinating vision of children’s frameworks drove Rotch to argue that physicians should “determine in what group the especial child belongs, physically and mentally, and state which work it is fitted for.” Thomas Morgan Rotch, “The Position and Work of the American Pediatric Society Toward Public Questions” (1909), In Transactions of the American Pediatric Society, Volume 21, Reprinted in the Archives of Pediatrics 1909-1910 (New York: E.B. Treat and Co., Publishers, 1910) 28. 24 Thomas Morgan Rotch, Pediatrics, the hygienic and medical treatment of children. (Philadelphia, London: J.B. Lippincott Company, 1903) [c 1895, 1901, 1903], 19.
Rotch’s Rhetoric: Health as an Expert-Dominated Battle The language Rotch used in his speeches and papers to legitimize pediatrics promoted a novel conception of disease that departed from the standard equilibrium model claimed by many historians claim to have pervaded the Industrial Era. His new conception preserved the traditional view that Thomas Morgan Rotch, “A Memorial Hospital For Infants As a Centre of Education for the Study of Early Life,” (The New England Magazine: Volume 41, 1910) 682. 26 Rotch 1910, 681 27 One of Rotch’s most passionate causes was the planning and erection of the Thomas Morgan Rotch, Jr. Memorial Building, completed just before Rotch’s death. According to Kelly and Barrage, “one of the saddest incidents connected with his career is that instead of delivering the first lecture in the new building, as he had anticipated for many years, his funeral was held there.” Kelly and Barrage, 1003. 25
SPRING 2013 21 BARZILAY / ROTCH goal for most American parents in the mid-1800s, according to environment, diet, and other factors conspired to determine health—but Rotch advanced a new notion pediatricians should Catherine Beecher’s Treatise on Domestic Economy (reprinted serve simultaneously as master architects of healthy living and yearly from 1841-1856) was to raise obedient, loving, moral aggressive generals waging a war against illness on behalf of children who would strive for salvation and become responsible each child. And instead of preserving “vital powers,” Rotch’s citizens. Later in the century, an emphasis on playfulness, depiction of milk collection creates the impression that mischief, and malleability loosened expectations on children, hierarchy, methodology, and sterilization could stamp out the but put pressure on maternal influence. In the Victorian Era, then, mothers were thought to be uniquely capable of raising insidious onset of disease. One speech rife with such imagery was Rotch’s 1899 children. This notion shifted dramatically around 1900, when address at the Fourth General Conference of Health Officers in physicians like Rotch began stressing the need for experts to Michigan. Through flattery, data, and anecdotes, Rotch aimed monitor child development. to rally the officers and assert the authority of pediatricians Mothers as Instruments Rotch’s textbook discussed mothers almost as if they regarding feeding. In an extreme-sounding comparison, Rotch analogized milk-collectors and surgeons, illuminating the degree were instruments whose activities could be fine-tuned to to which he portrayed feeding as a process in need of medical generate ideal conditions for raising infants. Table 44 in supervision. Milkers should “be trained to take antiseptic his textbook detailed the “General Principles for Guidance precautions as a surgeon is trained,” the milk-house should in Managing a Disturbed Lactation,” and took the form of be kept “completely antiseptic,” and milk should be “quickly a cause-and-effect chart: on the left were desired changes in bottled in sterilized glass jars.”28 Rotch also emphasized that maternal milk (increase fat, decrease proteins, etc.), and on cows’ water should be “protected so that nothing can filter the right were instructions for the mother (see Figure B). into it. It is cemented up to the water line with a double wall To increase total milk quantity, the chart prescribed that one around it.”29 This focus on barriers reveals a sentiment that “increase proportionately the liquids in the mother’s diet, and illness could be defeated if man rigorously embraced hygiene encourage her to believe that she will be enabled to nurse in a complex regimen available only to experts. Rotch favored her infant.”31 Rotch’s blending of physical and emotional metaphors like “we should in every way shut out all means suggestions—presented as a scientifically-minded flowof entrance” for pathogens, painting himself as a general chart—sends the message that mothers could be adjusted like defending a helpless city of untrained laymen. For Rotch, cow elaborate scientific instruments, whose psychological states milkers had to be “a set of intelligent young men trained for the were levers to be pushed or pulled. In the ensuing pages, Rotch told described the effect purpose,” and each farm needed a superintendent, physician, and bacteriologist.30 This depiction of inserting levels of male on babies of a “luxurious life on a poorly-fed but healthy technicians between mother and child highlights a departure wet-nurse,” and milk produced by a mother with continued from the maternal reforms of Addams and Kelley as well as a “uncontrolled emotions,” versus a mother “able and willing distinction between the training females could receive and the to control her emotions.”32 Rotch’s blending of anecdotal evidence with scientific tabulations reinforces his portrayal of authority-bestowing medical training of males. A similar emphasis on the complexity of feeding was mothers as particularly complex variables, ripe for adjustment made evident in the charts, tables, and studies Rotch published but fraught with human complications. This portrayal of regarding the nutritional components of milk: no one but a mothers hints that Rotch viewed the quest for child health as trained expert would be able to make sense of them. Other the job of a trained expert who could control key ingredients, statements that infants “cannot be fed by rule of thumb” rather than as a joint venture between mothers and physicians. appear to render Rotch hypocritical: he claimed no table could According to notes jotted down in 1896 by George Burgess demonstrate how to feed every child while loading his papers Magrath, one of Rotch’s Harvard Medical School students, with charts. But Rotch’s emphasis on the need for individualized Rotch also stressed adjustment of maternal mood in his regimens in fact complicated and deepened pediatric expertise lectures. The assertion that the “temperament of mother in such a way that pediatricians were rendered irreplaceable has much to do with value of milk” was fleshed out in class by a vivid anecdote33 about convulsions killing a child after a consultants. Rotch 1903, 187. Rotch 1903,190. 33 Rotch’s use of anecdotes is an interesting element of his writing and speeches. In his Grand Rapids speech, he engaged a visceral story about diarrhea induced by impure milk meant to make the audience’s stomach turn. Such colloquial, evocative storytelling underscored the extent to which Rotch was a propagandist as well as a professional physician. While his rhetorical tactics are ripe for historical analysis, it is important that some of his statements were persuasive techniques designed to elicit particular reactions and behaviors. 31
Part II: Rotch’s Treatment of Motherhood In the 1850s, as birthrate declined and birth control improved, Priscilla Clement writes that raising children carefully became increasingly important to middle-class parents. The Thomas Morgan Rotch, “Milk: Its production, its care, its use,” (An address delivered before the health officers of the State of Michigan, at Grand Rapids, October 1899) 134. 29 Rotch 1899, 135. 30 Rotch 1899, 134-135. 28
mother “nursing in temper jerked three year old child from terror,” Magrath recorded in his neat scrawl.34 Doctors in the Nursery With increasing momentum in the nineteenth century, “the cult of true womanhood” placed women at the center of the family and “exalted the role of mother,” according to Rima Apple.35 It was through maternity, she writes, that women found identity and meaning: reproduction, nurturance, and home management gave women responsibilities that ennobled them while undeniably restricting them. Rotch broadened the scope of his proclaimed authority over mothers by advising on childrearing environments and emotional nourishment. In particular, his recommendations for building the ideal nursery environment were suffused with the conviction that health was a precious commodity to be cultivated by physician research. Magrath recorded that setting nurseries on an upper floor to avoid dampness and germs, maximizing sunlight, monitoring room temperature, and prioritizing fresh air were all key to raising healthy children. According to Magrath’s cursive, colorcoded notes, Rotch spent a great deal of time detailing bathing procedures (“attend to nose by cotton stick”), clothing advice (“allow for greatest freedom of motion and keep up warmth”), and general parenting wisdom (“the child puts everything into its mouth”).36 Magrath even scribbled down that if an “ass of a father tells yarns that cause night terrors,” it is “wholly bad,” and a child should “have quiet stories.”37 The fact that Rotch stressed these child-rearing tips in a medical lecture indicates his belief that pediatricians were to supplant mothers as experts on every variable in early life. I’d like to point out that this portrayal is not meant to vilify Rotch. I believe Rotch, whose only son died at age three, was interested first and foremost in lowering infant mortality and promoting pediatrics; marginalization of mothers was a side effect rather than an explicit aim. It is the case, however, that his messages had a lasting impact: in fact, Halpern notes that Rotch paved the way for a generation of pediatricians with a “fundamentally new relation to the American family.”38 While doctors had written child-care manuals in the 1800s, programs like Rotch’s ushered in an era of “discrete professional service monitoring the growth and development of individual children,” she writes, adding that pediatricians even joked (in a 1917 meeting of the Association of American Teachers of the Diseases of Children) that they were taking over the functions George Burgess Magrath, “Lecture Notebooks for courses in the Harvard Medical School written while a student,” (Boston, n.p. 1894-1897) 75-76. 35 Rima D. Apple, Mothers and Medicine (Wisconsin: The University of Wisconsin Press, Ltd.: 1987) 5. 36 George Burgess Magrath, “Lecture Notebooks for courses in the Harvard Medical School written while a student,” (Boston, n.p. 1894-1897), 37, 55. 37 Magrath, 56. 38 Halpern, 13. 34
of neighbors and grandmothers. Doctors as Imperturbable Captains Not only did Rotch’s textbook and lectures suggest that doctors should advise and control mothers to ensure proper child-rearing, but in other forums he claimed medical experts were somehow emotionally superior to mothers. In an address to the graduating class of the Boston City Hospital Training School for Nurses in June of 1890, Rotch said, “The mother’s equipoise may be overthrown, for she is untrained. The equipoise of the nurse and of the physician has no business to be disturbed, for both nurse and physician are supposed to be trained for these very emergencies.”39 He also discounted mere experience as sufficient for learning to raise children, claiming “Intelligence is endeavoring to engraft or to force upon ignorance all over the world, in all paths of life, the principle that the work of experts trained by experts is superior to mere unguided, and hence dangerously unsafe, experience without intelligence.”40 Rotch’s central metaphor in this speech is quite illuminating: he characterizes nurses as the “trusted helmsmen” for physicians in the hour of danger, “when we, standing in the prow of the ship, anxiously watch the progress of our charge, through the varying currents of life, through the shoals and seething whirlpools of weak humanity.”41 Depicting doctors as captains navigating the storms of emotion-ridden human life reveals that Rotch viewed physicians as capable of transcending and transforming human frailty to restore equilibrium and health in their patients.42 Rotch’s attention to regulating maternal diet, exercise, and temperament, as well as his conviction that pediatricians knew best how to design a nursery, were rooted in the belief that his medical training qualified him to manipulate all elements of a child’s environment and that the main contribution a mother could offer was diligent obedience to physician recommendations.
Part III: Rotch’s Legacy While mothers had shared parenting experiences Thomas Morgan Rotch, “The Hospital Nurse in Private Nursing,” Address to the graduating class of the Boston City Hospital Training School for Nurses, June 27, 1890. In “Thirteenth year of the Boston City Hospital Training School for Nurses.” (Boston: Press of Rockwell and Churchill, 1891) 31. 40 Rotch 1890, 24. 41 Rotch 1890, 26. 42 Another illuminating detail provided by Fritz Talbot is that Rotch was a “short, stocky man, whose face was adorned by a large mustache, and his voice was high pitched.” He apparently wore an extra lift in the heels of his shoes to make him appear taller. His attempts to appear authoritative are consistent with his impassioned assertions of authority over mothers. Though in some ways this description makes it harder to take Rotch’s claims of “captaincy” seriously, knowing Rotch was small with a squeaky voice makes his bold rhetoric and lasting legacy all the more impressive. Talbot, 110. 39
SPRING 2013 23 BARZILAY / ROTCH for centuries, the end of the nineteenth century witnessed physician expertise and top-down control of health was still a transition from communal advice-giving to expertise- perpetuated in public discourse. In 1914, Julia C. Lathrop of seeking as the rhetoric of “scientific motherhood” took hold, the U.S. Department of Labor, Children’s Bureau, released a American Studies professor Julia Grant writes in Raising Baby pamphlet entitled “Baby-Saving Campaigns: A Preliminary By the Book.43 Publications like Child Welfare Magazine and Report on What American Cities are Doing to Prevent Infant groups like the Mothers’ Club of Cambridge, begun in 1887, Mortality.”49 The pamphlet’s tone was very aggressive and were influenced by the burgeoning field of child psychology demanding – when the baby comes, step one (written in bold pioneered by G. Stanley Hall. By the 1920s and 1930s, women face) is “Send for the doctor. He prefers being called too “flocked to mothers’ study clubs” to learn the “practical slant early than too late,” and there was a list of close to fifteen of behaviorist child-rearing principles.”44 At the turn of the commandments regarding do’s and don’ts of bathing, clothing, century, The National Congress of Mothers, the American sleeping, and more. Almost all of these sections concluded Association of University Women, and the Child Study with the importance of consulting a doctor if anything Association of America debuted in the scientific motherhood unexpected arose. Dropping all pretense of uncertainty, scene. the authors boldly dictated child-rearing practices with what The National Congress of Mothers attracted 2000 seems like unwarranted certitude. For example, the pamphlet participants to its first meeting in 1897, and the AAUW unflinchingly claimed that “Hard household labor or factory attained a paid membership of over 45,000 by 1935. The work during the latter months of pregnancy tend to bring about AAUW in particular preached to its 432 child study groups miscarriages or the birth of puny or undersized children,” and that degeneration into “experience meetings” was undesirable: “The sewing machine must not be used toward the end of instead, parent education programs should abide by “facts pregnancy.”50 These commands indicate that Rotch’s approach and known principles.” By holding its sessions in a classroom to dominating disease through expertise had permeated public and prioritizing objectivity, “the group tried to professionalize discourse. However, in filtering out to public health messages, mothering and bring child study up to the standard of Rotch’s denial of rules of thumb seems to have been traded traditional academic work,” according to Grant.45 But since for uniform commandments which, if they didn’t work, mothers were not producing research literature themselves, necessitated a trip to the pediatrician—the wise expert who parenting was an unlikely candidate for professionalization.46 could pinpoint the specific problems of each child. Rather than turning mothers into experts, then, child-rearing A book written by Dr. Richard Mason Smith and authority shifted to physicians. The momentum of this trend Mrs. Rosalind Huidekoper Greene in Boston in 1915 featured helps explain why Rotch’s ideas about physician authority separate sections devoted to “Rules for the Care and Feeding caught on so quickly and proved so lasting. of Infants,” for “Suggestions to Mothers,” and for “Recipes Raising Baby By the Book and Charts.” The section targeted at mothers, Smith noted, Analysis of literature for mothers from the 1900s was written by Mrs. Greene (not an M.D.) By lending degreeconfirms that Rotch’s legacy was perpetuated well into the certified expertise to the first and last sections only, the authors twentieth century. As far away as Colorado, a “Manual for suggested that doctors could dictate definite guidelines for Mothers” by Dr. Genevieve Tucker called Mother, Baby, and child-rearing, but mothers could only hope to maximize their Nursery reassured readers that the book was “not intended child’s health through dutiful obedience to expert advice. The in any measure to take the place of a physician, but rather to Rules for Care and Feeding section mirrored the structure of aid the physician in teaching the mother to care properly for Burgess’s notes from Rotch’s class, and Smith featured four her babe when well.”47 This disclaimer that the physician was sections on diet and digestion, complete with Rotch-inspired the ultimate authority reveals the shift from trusting maternal milk percentage tables. experience and peer advice to seeking expert sources of childThe section written by Greene was radically different rearing information. In the section on feeding Rotch’s influence than Smith’s in tone and structure. To begin with, it was is starkly apparent: Tucker paraphrases Rotch’s platitude that much shorter: only 17 pages as compared to 76. It also mainly one child’s food was another’s poison, and includes many addressed day-to-day considerations like how to react to infant tables that could have come straight from his papers.48 tears and how to travel with a baby (“In the first place, don’t!”)51 A decade or so after Rotch began writing, his mantra of This tone is representative of the entire section: Greene wrote colloquially, like a sister or friend rather than a professional. 43 Julia Grant, Raising Baby by the Book: The Education of The character and content of this section promotes the American Mothers (New Haven: Yale University Press, 1998) 46. message that mothers were ignorant laywomen who could do 44 Grant, 29, 43. Grant, 67. Grant, 67. 47 Genevieve Tucker, Mother, baby, and nursery, (Boston: Roberts Brothers, 1896) vii. 48 Tucker, 180. 45 46
49 Barbara Gutmann Rosenkrantz, Advisory Ed, The Health of Women and Children, A Volume in the Series Public Health in America, (New York: Arno Press, 1977) 47-49. 50 Rosenkrantz, 52, 53. 51 Smith, 98.
24 SYNTHESIS little more than follow expert advice. In the back of the book were tables for mothers to record their baby’s weight, diet, and stools, as well as a table for predicting the date of labor. The notion that mothers should try their hands at “playing doctor” also reveals the extent to which Rotch’s conceptualization of mothers as medical tools for raising healthy children had taken root.
In July of 1977, a boycott was launched in the United States against the Swiss-based Nestlé corporation, in which campaigners claimed Nestlé’s breast milk substitute formula contributed increased mortality in infants, particularly in less economically developed countries. To this day, groups like the International Baby Food Action Network and Save the Children argue that formula has fostered health problems in babies worldwide, indicating that the interests of physicians, mothers, and corporations continue to clash over questions of child nourishment. As the tracing of Rotch’s messages into the twentieth century revealed, these clashes are colored by tensions inherent in a mother-physician power structure heavily influenced by Rotch’s vision of the role of pediatricians in society and his rhetoric of physician-dominated health. As I’ve mentioned, “mother clubs” and how-tomanuals for raising children were prevalent in the early 1900s, and many pediatricians tried, like Rotch, to legitimate their field through the cultivation of specialized areas of expertise. Rotch, however, was an early pioneer of infant feeding in America, and was particularly effective as a network-builder, reaching audiences across the country and internationally through publications and speeches. A nuanced historical understanding of the ways Rotch broke from the traditions of other Industrial Era reformers and promoted an ethos of physician control at the expense of maternal wisdom enables us to question the engrained parent-physician relationship assumptions that undergird controversies about infant feeding, child-rearing expertise, and the role of mothers today. Rotch’s memory lingers visibly at Harvard Medical School, where a professor will always bear the title “Thomas Morgan Rotch Professor of Pediatrics,” but his legacy also animates many assumptions surrounding child-rearing expertise in ways that become clear through careful analysis of his turn-of-thecentury lectures, texts, speeches, and programs for reform.
“Display Ad 18 – No Title.” Chicago Daily Tribune (1872-1963), February 3, 1956, A5. 44
Robert J. Davies and Susan Ollier. Allergy: the facts. (Oxford: Oxford University Press, 1989), 14. 45
Mike E. Parsons and C Robin Ganellin. “Histamine and its receptors.” British Journal of Pharmacology 147, no. S1 (1, 2006): S127. 46
Harry Felix Swartz. The Allergic Child, (New York: Coward-McCann, 1954), 59. 47
“The historian of science may be tempted to claim that when paradigms change, the world itself changes with them. Led by a new paradigm, scientists adopt new instruments and look in new places. Even more important, during revolutions, scientists see new and different things when looking with familiar instruments in places they have looked before. It is rather as if the professional community had been suddenly transported to another planet where familiar objects are seen in a different light and are joined by unfamiliar ones as well. ”
– Thomas S. Kuhn, The Structure of Scientific Revolutions (1962)
An Interview with David Kaiser, Physicist and Historian Shirley Zhou, Staff Writer photograph by Donna Coveney
1950s, but then crashed abruptly in the 1970s. The book traces these humongous pendulum swings in sources and funding, enrollment and employment, and in some senses, prestige in the world. The book is organized around what the young physicists wanted, what hiring wanted, and ultimately what effect they had on the character of knowledge. Another project I’m having fun thinking about is Einstein’s history of gravity through the 20th century. Again, this touches upon the issue of science in context, over long periods of time, not just in the United States, but all over the world. Research was very embedded in geopolitical context. For example, worldly situations, such as ability to send letters, ability to travel, very much shaped the work that got done.
David Kaiser is Germeshausen Professor of the History of Science at MIT and the Department Head of the Program in Science, Technology, and Society. In addition to publishing numerous award-winning publications on history of physics and physics, Kaiser is a respected physicist in particle cosmology and a Senior Lecturer in the Physics Department.
hat topics are you interested in now? My upcoming publication is looking broadly at changes in science and science policy in the United States during the Cold War. I’m fascinated by the sudden swings in the demand for and supply of physicists. The war, as you know, transformed the relationship between science and the state. Physics in particular went through enormous growth spurts in the late
How did you decide between being a physicist and a historian of science? I was interested in both topics as an undergraduate at Dartmouth. Midway through graduate school at Harvard, it dawned on me that I had to get a job, so I had to apply to something concrete. This got me into thinking about what I enjoyed the most, and I found that I enjoyed being a teaching assistant for history classes more than physics classes, in part due to the discussions that would come up. I also noticed that I enjoyed reading broadly in humanities, while for physics I was only interested in one specific area. Luckily, I was able to work it out here at MIT, where I have a career as a historian but can also pursue my interest in physics. What has been a major change to the practice of science? One thing that stands out to me is funding. People’s knee-jerk reactions about how to fund
ZHOU / KAISER
important expensive scientific experiments have changed enormously. For a long time people have thought there should be no role of the government, that funding is a local affair; but after the war, government is seen as the pure, good support while the evil corporations are distorting scientific progress. Now, with biotech […] models of doing research that seemed obvious are have been shown to be merely temporary.
of ideas, about how things come to make sense within time and context?
What do you think the most exciting part of working in History of Science is? I’m still intrigued in the central question of science in context. We’ve become good at avoiding overly easy, simple characterizations in both directions. We’re all convinced science isn’t a purified ideal in either direction. But this leaves a huge yawning gap in the middle. How do we make sense of this play
This year is the 50th anniversary of Thomas Kuhn’s publication of Scientific Revolution, and it’s a good time to look back to see what we thought before and what we think now. He clearly was very concerned with this problem of science in context. We have come up with more answers to this challenge, but I think now the challenge has only deepened.
Take gravity. It seems like something detached from the world, an abstract concept that has no material applications. It’s not like nuclear physics that obviously has worldly applications and spin-offs. But even a notion as abstruse as Einstein’s relativity has been so thoroughly embedded and shaped by political currents.
From Epicycles to Ellipses: Kepler’s Heideggerian Projection of Nature Sean Driscoll, Brigham Young University ‘13 This paper challenges the common view that Kepler discovered the elliptical orbit because of a faithful dedication to finding empirical correspondence between reality and theory—Kepler had no such naïve dedication. Kepler’s discovery itself clarifies how induction based on some sort of positivistic observation is insufficient to reach any scientific conclusion. This paper examines Kepler’s astronomical achievements in light of what Heidegger calls the mathematical and its role in science. Heidegger’s ideas illuminate both what allowed Kepler his achievements and what underlies all scientific discovery: a mathematical projection of nature.
he fact that planets orbit elliptically around the sun is now effectively common knowledge. Many even know that Johannes Kepler’s dedication to precise, empirical verification made way for that discovery. But was it really an empirical drive that led to Kepler’s monumental achievement? The dominant textbook view is that Kepler calculated based on various orbital positions and then literally played connect-the-dots.1 Nevertheless, Kepler’s “epoch-making discoveries of the famous three laws”2 required much more than empirical induction. Positivistic assumptions to the contrary ignore what really happens in science; they cover over science’s fruitful discoveries with an impotent methodology which no scientist actually employs. Martin Heidegger saw this trend as a fundamental characteristic of modern science.3 In distinction from a simplistic empirical (or even positivistic) view of science, Heidegger calls this characteristic “the mathematical.” This paper argues that Kepler’s discoveries were achieved less through his empirical devotion (for which he was so celebrated), and more for his mathematical projection of nature. Heidegger’s use of the concept “mathematical” intends to confront the dominant trend of viewing science as actually operating under a radically empirical method. According to Heidegger, science is not based on the accumulation of facts. Rather, even up through early modernity, scientists “understood that there are no mere facts, but that a fact is only what it is in
the light of the fundamental conception, and always depends upon how far that conception reaches. The characteristic of positivism… is that it thinks it can manage sufficiently with facts, or other and new facts, while concepts are merely expedients that one somehow needs but should not get too involved with, since that would be philosophy. Furthermore, the comedy—or rather the tragedy—of the present situation of science is that one thinks to overcome positivism through positivism4.”
See Job Kozhamthadam, The Discovery of Kepler’s Laws: The Interaction of Science, Philosophy, and Religion, 2-3. 2 Edwin Arthur Burtt. The Metaphysical Foundations of Modern Physical Science (Amherst: Humanity Books, 1999), 61. Though this paper will focus exclusively on the discovery of the first law, it is important to recognize the inseparable discovery of each: (1) The path of each planet is an ellipse with the Sun at one of its foci. (2) The radius vector from the Sun to a planet sweeps out equal areas in equal times. (3) With T1 and T2 representing the periodic times of two planets and a1 and a2 the length of their semi-major axes: (T1/T2)2 = (a1/a2)3. The Stanford Encyclopedia of Philosophy, s.v. “Di Liscia, Daniel A.,” accessed December 12, 2011, http://plato. stanford.edu/archives/sum2011/entries/kepler/. 3 Even Heidegger recognizes, however, that the mathematical characterizes even ancient science. His goal is to show modern science’s peculiar devotion to the project; my goal is to focus on Kepler’s devotion.
1. Astronomical History and Revolution Long before Kepler, and even before formal astronomy, the planets were called “wandering stars” because, unlike the other heavenly bodies, they zigzag across the sky in an irregular, noncircular motion called “retrograde motion.” Despite this irregularity, astronomers wished to preserve the Aristotelian
Scientists have never operated under such strict empirical methods, and accumulation of yet more facts will not validate their misplaced assumptions on the matter. What is worse, not only does modern science tend to minimize or entirely fail to recognize the non-empirical influences in its method, but it also tends to misrepresent past scientific achievement as innocently empirical. Though this “cloak of positivism”5 remains largely in the undercurrent of modern scientific sensibilities, “history affords no support for so excessively Baconian a method.”6 It is therefore expedient to transform current empirical prejudices in light of historical truth. According to Kuhn, “a new theory. . . is seldom or never just an increment to what is already known. Its assimilation requires the reconstruction of prior theory and the re-evaluation of prior fact, an intrinsically revolutionary process that is seldom completed by a single man and never overnight.”7 Kepler was no exception.
Martin Heidegger, “Modern Science, Metaphysics, and Mathematics,” in Basic Writings. Ed. David Farrell Krell. (San Francisco: Harper Collins, 1993), 272. 5 Burtt, Metaphysical Foundations, 34. 6 Thomas S. Kuhn, The Structure of Scientific Revolutions (Chicago: The University of Chicago Press, 1996), 28. 7 Ibid., 7. 4
SPRING 2013 doctrine that celestial bodies move in circular motion. In order to compensate for what they actually observed, astronomers attempted to show how several simultaneous or superimposed circular motions could explain their noncircular observations. From Apollonius’s first attempts in the 3rd century B.C.E.8 through Ptolemy’s formalized system in the second century C.E.,9 “epicycle” models demonstrated how the observed orbit of a planet could actually occur circularly: as a set of several circles. Ptolemy’s cumbersome and unintuitive system remained the dominant model of celestial motion for hundreds of years. In fact, though Copernicus’s system included fewer epicycles than Ptolemy’s,10 it nevertheless continued to attribute the planetary motion to epicycles. It was not until the young Johannes Kepler attempted to describe the orbit of mars using the accurate astronomical data of Tycho Brache that the epicycle model was disconfirmed. By discovering that planets orbit the sun in an ellipse (and that the sun occupies one foci of the ellipse), Kepler immensely improved and drastically simplified planetary science. According to Alexandre Koyré, what most distinguished Kepler was that “astronomy for him was a science of reality, and should reveal to us that which truly takes place in the Universe.”11 This commonly-accepted interpretation supposes that Kepler’s dedication to empirical induction is what finally led him to discard the epicycle model. Those who hold this view assume that Kepler literally looked to the sky, wrote down what he saw, and drew the shape that resulted. Even the acclaimed C.S. Peirce claimed that Kepler’s discovery of the Three Laws is “the greatest piece of retroductive reasoning ever performed.”12 Though his discovery was most certainly great in every well-deserved sense of the word, we nevertheless ought not to impose a modern methodological bias onto Kepler’s work. Countless scholars nevertheless attribute an excessively empirical bent to Kepler’s discoveries. For example, Robert Small writes how “Kepler, laying aside all preconceived opinions concerning the form of the orbit, now resolved to investigate . . . purely by means of observations.”13 2. The Mathematical Even if it were possible to discard all preconceptions, Dino Boccaletti, “From the Epicycles of the Greeks to Kepler’s Ellipse: The Breakdown of the Circle Paradigm,” Cosmology Through Time: Ancient and Modern Cosmology in the Mediterranean Area (2001): 3. Interestingly, besides formulating the epicycle model, Apollonius also clarified and formalized the math behind the various conic sections which would later provide Kepler with his ellipse. 9 Boccaletti, “From the Epicycles of the Greeks,” 2. 10 Burtt, Metaphysical Foundations, 47. 11 Alexandre Koyré, The Astronomical Revolution: Coppernicus— Kepler—Borelli, Trans. R.E.W. Maddison (Ithaca: Cornell University Press, 1973), 263-264. 12 In Job Kozhamthadam, The Discovery of Kepler’s Laws: The Interaction of Science, Philosophy, and Religion (Notre Dame: University of Notre Dame Press, 1994), 3. 13 Robert Small, The Astronomical Discoveries of Kepler (Madison: University of Wisconson Press, 1963), 229. 8
such would preclude that which ultimately allowed Kepler his famous discoveries. For, “empirical evidence was not adequate to arrive at the conclusions that Kepler actually did draw.”14 While the philosophical, religious,15 scientific, and biographical concerns which influenced Kepler’s discoveries will be left to the secondary literature, this investigation will treat the more fundamental mathematical character which impels all of scientific investigation—of which Kepler is an especially illuminating case. This fundamental character is not according to our everyday understanding of “mathematics” as arithmetic. Instead, Heidegger’s use of the term intends to discuss modern science’s dominant mathematical orientation to the world. This orientation influences both the rules used when approaching the world and the way things in the world present themselves—“we take cognizance of [things] as what we already know them to be in advance.”16 Because we assume the character of things a priori, our mathematical project “is that ‘about’ things which we already know.”17 This is not to say that we cannot learn anything new. Rather, it emphasizes how the mathematical causes us to bring a certain set of presuppositions to what is learned. We anticipate things as being of a certain sort—a mathematical sort. In this mathematical project we adopt when scientifically approaching the word, we wear the lenses of mathematical interpretation, concluding what we have already concluded and seeing what we have already decided to see: the mathematical character of nature. To explain the everyday concept of mathematics as arithmetic, Heidegger asks whether “the mathematical is numerical in character, or, on the contrary, is the numerical something mathematical?”18 He concludes that the mathematical does not come from numbers—or from the fact that we calculate or use numbers in science; rather, our use of numbers arises out of the commitments of the mathematical project. According to Heidegger, “in our usual dealings with things, when we calculate or count, numbers are the closest to that which we recognize in things without deriving it from them. For this reason numbers are the most familiar form of the mathematical”19—this familiar form becomes the common understanding of mathematics. Kozhamthadam, Discovery of Kepler’s Laws, 3. Of the factors listed, the discussion of Kepler’s religious views is perhaps the most relevant to this paper. Nevertheless, while it may be that all of Kepler’s discoveries were constantly informed by his religious conviction, I will not deal with it at length. Kepler regarded God as the ultimate mathematical operator, and most of his religious views centered on this orientation. According to Kepler, “The cosmos was not formed by chance; It was created by God; and God, assuredly, did not create it temere, haphazardly, but on the contrary was guided by rational considerations and followed a perfect architectural plan” Koyré, Astronomical Revolution, 122. This paper will deal, therefore, with the “rational”, or “mathematical” dedication obviously motivating Kepler. This is the most simple and most pervasive way that the scholarship deals with the question, so I will adopt it. Questions of sun worship and other occult beliefs have their discussion elsewhere and do not ultimately alter my conclusions. 16 Heidegger, Modern Science, 275. 17 Ibid., 276. 18 Ibid., 275. 19 Ibid., 277. 14 15
SYNTHESIS ISSUE 4 Thus, the arithmetic and geometry which compose math long-term obsession with an overly-empirical method “gives as a genre stem from a calculating attitude—or a mathematical us a better understanding of the limits, or preferably, the perception of nature. Because “nature is projected in modern very structure of [Kepler’s] a priori method”27—a method of physics as something about which certainty can be had,”20 it empirical induction. is understood by calculation. Numbers are consequently used, Indeed, upon first glance, it seems that Kepler’s but they are mathematical only in a narrower, derivative sense. meticulous and repetitive work with Brahe may indeed have Thus, Heidegger’s claim that “the basic character of modern had this character. Kepler’s famous “Three Year War with science is mathematical”21 does not mean modern science Mars” began when Brahe allowed Kepler provisional access deals with numbers. The occupation of mathematics which to his vault of astronomical data in order to model the motion concerns equations and numerical manipulation is secondary of Mars28 and gave Kepler strict guidelines to work on a model to the more pervasive mathematical orientation which which would support his [Brahe’s] system.29 Kepler’s efforts informs all of science. For example, when Isaac Newton concluded an eight minute difference between Tycho’s data “took vague terms like force and mass and gave them a precise and model of Mars’s orbit.30 Consequently, Kepler determined meaning as quantitative continua,” he intended “that by their that neither Brahe’s nor any other system based on compound use the major phenomena of physics became amenable to circles would satisfy Brache’s measurements, which were mathematical treatment.”22 But this treatment implies more accurate to at least 4 minutes of an arc.31 The eight minute than just counting things found in nature—Newton assumed discrepancy was small for the day and within than the standard nature had an underlying mathematical character and that it for accuracy,32 but Kepler’s confidence in Brahe’s accurate data could be approached in mathematical ways. In the modern impelled him to a more rigorous agreement. Koyré describes, age, we almost universally adopt this approach to nature. 23 “These eight minutes obliged him to reconsider, and finally reject, the fundamental axioms of the science of celestial 3. Kepler: The Empiricist Hero? bodies, which no-one had questioned for two thousand years, According to Hon, “the mathematicians cannot and which he himself had blindly accepted.”33 satisfy themselves except they reduce the motions of celestial bodies to perfect circles, rejecting spiral lines, and labouring 4. Oversight in the Mathematical Domain to be discharged of eccentrics.”24 This was true, at least, Was Kepler’s victory the triumph of the modern until Kepler. Why was Kepler satisfied otherwise? Many dedication to empiricism? Ought we to herald Kepler as the suppose this was because of the empirical nature of his astronomer who finally just looked up? Scholars like Burtt research. Certainly, if Kepler were to inherit anything from his think that “Kepler’s thinking was genuinely empirical in the employer and fellow astronomer Tycho Brahe, it must have modern sense of the term.”34 But this cannot be the case. been that radically empirical bent. According to Burtt, Brahe Kepler’s war with Mars attempted the synthesis of an extremely “was the first competent mind in modern astronomy to feel complicated arrangement of data. He was trying to calculate, ardently the passion for exact empirical facts.”25 Koyré even from a moving planet, the orbit of a different moving planet. 26 uses the word “Tychonian” as a synonym for “empirical.” Without an interpretive project, specifically the mathematical When Kepler finally gained full access to Brahe’s meticulously project, Kepler would have seen only what William James catalogued, extremely accurate, and supposedly disinterested famously called “a bloomin’ buzzin’ confusion.”35 observational data, he must have been steeped in Brahe’s Such confusion would characterize the scientific influence. Koyré believes that understanding Tycho Brahe’s enterprise if science had no ordering projection. Accordingly, Heidegger describes the mathematical as a project which “first 20 Trish Glazebrook, Heidegger’s Philosophy of Science (New opens a domain where things… show themselves.”36 If there is York: Fordham University Press, 2000), 52. no such domain, then there is no space for a solution. Kepler’s 21 Heidegger, Modern Science, 278. domain, narrowly, was his attempt to prove the Copernican 22 Burtt, Metaphysical Foundations, 32. 23 system. More broadly, his domain was his objective to model Nevertheless, Heidegger does not necessarily believe that the 30
mathematical is undesirable for science. In fact, it is essential to modern scientific progress. In the words of Khun, the mathematical character of modern science can cause “a scientific community [to be] an immensely efficient instrument for solving the problems or puzzles that its paradigms define.” (Kuhn, The Structure of Scientific Revolutions, 166). Yet, this productivity can be enormously negative. The mathematical project eventually dominates all of our possible ways of understanding—it “strives out of itself to establish its own essence as the ground of itself and thus of all knowledge.” (Heidegger, Modern Science, 296.) The mathematical is negative if it becomes the fundamental way of understanding all things. 24 Giora Hon, “On Kepler’s awareness of the problem of experimental error,” Annals of Science 44.6 (1987): 546. 25 Burtt, Metaphysical Foundations, 61. 26 Koyré, Astronomical Revolution, 175.
Ibid., 175. Ibid., 163. 29 Ibid., 165. 30 Ibid., 172-177. 31 Thomas S. Kuhn, The Copernican Revolution: Planetary Astronomy in the Development of Western Thought (New York: Random House, 1959), 212. 32 Koyré, Astronomical Revolution, 178. The standard for the Ptolemaic system, for example, was 10’ 33 Ibid., 179. 34 Burtt, Metaphysical Foundations, 61. 35 In Kuhn, The Structure of Scientific Revolutions, 113. 36 Heidegger, Modern Science, 291. 27 28
SPRING 2013 31 DRISCOLL/KEPLER the motions of the heavens mathematically. What first opens this domain is “a projection of Kepler was well a part of modern science in this respect; thingness which, as it were, skips over the things.”37 Instead he approached natural phenomena as calculable and orderable. of heeding the things themselves, scientists project nature He was dedicated to finding mathematical regularities well mathematically, leaving things no chance to “speak for before they were actually observed in the heavens. themselves.” How can this be, especially for the supposed Nevertheless, modern interpretations of Kepler’s champion of modern empiricism, Kepler? The answer is discoveries seem to have a different story to tell: the fact captured in Kepler’s famous maxim that “Ubi materia, ibi that Kepler worked to eliminate the discrepancies between geometria” 38 [where there is matter, there is geometry]. Theorists the epicycle theory and reality seems to support a more like Burtt read this claim as saying that because the matter is a empirical hypothesis. According to this theory, Kepler, unlike certain way, a “more inclusive mathematical order is something astronomers for centuries before him, allowed inconsistencies discovered in the facts themselves.”39 However, analysis of in empirical data to guide him away from epicycle theory. Kepler’s practice shows that the opposite is actually the case. The Despite the apparent plausibility of this objection, it is obvious mathematical project is what makes it possible to see the facts that astronomers before Kepler had equal devotion to accuracy. as a certain type of facts. Discoveries are possible not because The pertinent question is: why did Kepler’s aversion to the of the objects which are present to the senses, but because of discrepancies cause him to reject the epicycle model? the mathematical project; the mathematical only allows things Or perhaps the inverse question ought to be posed: why to appear as mathematical. did awareness of the same inconsistencies not provoke centuries of astronomers to reconsider the epicycle model? According to 5. Learning What is Already Known Kuhn, scientists’ first reaction to anomaly is that “they cannot Heidegger further describes how “The project is and will not falsify [their] philosophical theory… They will axiomatic. Insofar as every science and cognition is expressed devise numerous articulations and ad hoc modifications of their in propositions, the cognition that is taken and posited in the theory in order to eliminate any apparent conflict.”44 Scientists mathematical project is of such a kind as to set things upon will revise, even if they “may begin to lose faith and to consider their foundation in advance.”40 In the mathematical project of alternatives,” but they will “not renounce the paradigm that has nature, things are increasingly set up in advance as mathematical led them into crisis. They do not, that is, treat anomalies as objects. Their foundations are thus mathematically determined. counterinstances, though in the vocabulary of philosophy of This characterizes Kepler’s method and follows from his science that is what they are.”45 That ancient astronomers did not dedication to mathematical certainty in the world. According see the discrepancies in the epicycle model as counterinstances to Thorvaldsen, “Kepler was operating for the most part in a is consistent with Heidegger’s and Kuhn’s idea that a scientist long-standing tradition of numerical calculation in astronomy, cannot discover anything outside of the mathematical project. where astronomy was considered a branch of mathematics Every discovery “[tells] him a thing he [is] already prepared or geometry.”41 Kuhn further describes how Kepler “was to discover.”46 Scientists even initially suppress new discoveries a mathematical Neoplatonist or Neopythagorean who precisely because they can only accept what they anticipate. believed that all of nature exemplified simple mathematical So why was Kepler able to see in the counterinstances regularities.”42 Kepler’s thoroughly mathematical approach what others suppressed? Kepler was just as devoted to having thus determined in advance of actual observation how things a correct mathematical theory as were previous astronomers, could present themselves. Heidegger describes how but Kepler’s project was different: his dedication was not to Modern science’s way of representing pursues a specific model, but to having a precise model. Indeed, precision and entraps nature as a calculable coherence of was his model. His refusal to accept scientific error has less forces…. [It] sets nature up to exhibit itself as a to do with that it did not empirically fit his model and had coherence of forces calculable in advance, it orders more to do with his fixation on mathematical precision. its experiments precisely for the purpose of asking Kepler had decided before his observations what he would whether and how nature reports itself when set up find: mathematically precise, and therefore certain, models of 43 in this way. the universe. The failure of fitting Mars’s orbit to a circle led Kepler to write that “we should thankfully accept this gift from 37 Ibid., 291. God, and put it to good use. We must undertake to discover 38 In Kozhamthadam, Discovery of Kepler’s Laws, 170. ultimately the true nature of celestial motions.”47 Kepler had 39 Burtt, Metaphysical Foundations, 65-66, emphasis in original. found a new outlet for his mathematical projection: elimination 40 Heidegger, Modern Science, 291. of discrepancies in the search for exact, perfect, and certain 41 Steinar Thorvaldsen, “Early Numerical Analysis in Kepler’s New truth. Astronomy,” Science in Context 23.1 (2010): 41. 42 Kuhn, Copernican Revolution, 217. 43 Martin Heidegger, “The Question Concerning Technology,” in Basic Writings. Ed. David Farrell Krell. (San Francisco: Harper Collins, 1993), 326.
Kuhn, The Structure of Scientific Revolutions, 78. Ibid., 77. 46 Ibid., 56. 47 In Koyré, Astronomical Revolution, 178. 44 45
SYNTHESIS ISSUE 4 Because of Kepler’s conviction that the universe is and the steps by which they are to be obtained.”55 Like solving expressible mathematically, he “was not able to be satisfied a scientific problem, solving a jigsaw puzzle involves assuring with a mere approximation… there could not be any laxity “that all the pieces must be used, their plain sides must be between facts and theory. This agreement must be rigorous, turned down, and they must be interlocked without forcing else it is worthless.”48 This almost obsessive desire to eliminate until no holes remain.”56 Like all scientists, Kepler would not error motivated Kepler to “[exploit] his awareness of the have followed such meticulous rules in an attempt to complete occurrences of experimental errors to guide him to the right his puzzle if he did not believe it had a solution. Koyré agrees, conclusion.”49 As Kepler poured over Bahe’s data, he found stating that “Kepler always raised questions nobody else raised, that the discrepancies all varied in a consistent way, leading and sought answers on matters where certainly nobody else him to the discovery of the ellipse and thus fulfilling his own saw any problem.” But, “He was firmly convinced that an prophetic words: “Know then that errors show us the way to answer must be forthcoming to every reasonable question.”57 truth.”50 Thus Kepler provided the blueprint for his project, and sketched out in advance the structural solutions to his puzzle. 6. The Axiomatic Blueprint Besides opening a staggeringly unapproachable realm of Kepler’s devotion conforms to Heidegger’s next aspect possibilities, his difficult transfer from the circle to the oval of the mathematical: “As axiomatic, the mathematical project to the ellipse provided a discouraging number of failures and is the anticipation of the essence of things, of bodies; thus the setbacks.58 How Kepler dealt with these failures evidences basic blueprint of the structure of every thing and its relation to the strength of his mathematical projection of nature. After every other thing is sketched out in advance.”51 Krell calls this countless failures, blueprint a “grid” which “remains a transparency laminated on Kepler then said to himself… after all, the the ‘things,’”52 while Kuhn calls it “a new way of giving order circle is not the ‘sum’ of the distances, and neither to data.”53 Kuhn claims that is the oval. So, it would be better to abandon the paradigms give form to the scientific life… geometrical procedure in favor of the arithmetical, that information provides a map whose details are that is to say, calculate one by one the distances of elucidated by mature scientific research. And since small portions (1 degree) of the orbit and find their nature is too complex and varied to be explored at sum. That was what he did: and three times over, random, that map is as essential as observation and assuming different values for the eccentricity. The experiment to science’s continuing development.54 result was disastrous.59 32
Kepler’s discoveries perfectly evidence this aspect of the mathematical. The voluminous and detailed data which Kepler obtained from the Brache vaults would have been a maddening jumble to interpret without some kind of map. An insightful addition to what Heidegger means by this comes from Kuhn’s discussion of puzzles. For Kuhn, science is generally not concerned with discovering things, but with solving puzzles. This is because an infinite amount of empirical data would be senseless if it did not fit together somehow, just as the very nature of a puzzle implies a solution. A person would never attempt a puzzle if there were no solution sketched out in advance. Indeed, most puzzles even imply the method to their solution: “If it is to classify as a puzzle, a problem must be characterized by more than an assured solution. There must also be rules that limit both the nature of acceptable solutions Koyré, Astronomical Revolution, 175. Hon, Experimental Error, 573. 50 In Koyré, Astronomical Revolution, 250. 51 Heidegger, Modern Science, 292. Emphasis added. 52 David Farrell Krell, introduction to “Modern Science, Metaphysics, and Mathematics,” by Martin Heidegger, in Basic Writings. Ed. David Farrell Krell. (San Francisco: Harper Collins, 1993), 269. 53 Kuhn, The Structure of Scientific Revolutions, 90. 54 Ibid., 109. 48
Is this conclusive proof that Kepler’s mathematical approach failed? While it may seem (in contrast to the staggering number of arithmetical failures) that his real successes came from his empirical observation, Kepler’s repeated failures actually serve to further emphasize his dependence on the mathematical project. Whether geometric or numerical, the obsession that would drive anyone to calculate degree by degree anticipates a solution by the mathematical projection. The specifics of his mathematical attempts failed, but Kepler did not turn to some sort of inductive empiricism. Rather, his mathematical project continued to sketch out in advance the only foreseeable solution: the mathematical projection of nature. Only then was Kepler’s project satisfied; he writes, “My wearying work came to an end only when [I had established], by means of extremely laborious proofs and numerous observations, that the path of a planet in the sky is not a circle, but is a perfectly elliptical oval path.”60
7. The Axiomatic Implications The mathematical commitment decides that nature will Ibid., 38. Ibid., 38. 57 Koyré, Astronomical Revolution, 122. 58 Ibid., 225-241. 59 Ibid., 249. 60 Ibid., 225. 55 56
SPRING 2013 33 DRISCOLL/KEPLER 67 be of a certain sort: “This basic plan at the same time provides with which it is undertaken.” In modernity, “The manner of the measure for laying out the realm which in the future experimentation is presumably connected with the kind of will encompass all things of that sort.”61 In another essay, conceptual determination of the facts and way of applying Heidegger writes, science “will never be able to renounce this concepts, i.e., with the kind of preconception about things.”68 one thing: that nature report itself in some way or another that Experience seeks to let nature reveal itself. Experiment seeks to validate is identifiable through calculation and that it remain orderable theory. We therefore understand Kepler’s admirable claim as a system of information.”62 Nature is seen only as the type in a different light: “without proper experiments I conclude of thing that the scientific projection allows it to be; it can nothing.”69 show itself only in the way the mathematical determines. Heidegger’s final mention of the mathematical resumes Because the mathematical determines how nature the discussion of how numerical mathematics in the narrow can present itself by determining beforehand how it will be sense is derived from mathematics in the broader sense. encountered, nature consequently requires a “mode of access According to Heidegger, “Because this project establishes a appropriate to the axiomatically predetermined objects.”63 uniformity of all bodies . . . it also makes possible and requires Since nature is only as it is seen in the projected realm of the a universal uniform measure as an essential determinant of mathematical, it must be approached differently, precisely. things, i.e., numerical measurement.”70 Astronomy in the age This is accomplished by a “line of questioning [which] can of Kepler moved increasingly in this direction: planetary be instituted in such a way that it poses questions in advance motion began to assume more physical explanations,71 putting to which nature must answer in one way or another.”64 What the celestial bodies in the same explanatory realm as the happens in such a line of questioning, because of such an terrestrial ones. Because this increasing trend to see the celestial outline, is that the scientist veritably “skips over the things”65 bodies as uniform (both with respect to themselves and with themselves. As a result, things are no longer capable of respect to all physical motion), a uniform measurement was presenting themselves as themselves, but only as predetermined necessary. Kepler essentially provided just that: a uniform and by the project. mathematical system to explain the motion of all planets (as To suggest that Heidegger’s thought even here applies to opposed to the epicycle model which individually modeled Kepler seems a distortion of the facts. Indeed, it would be a each planet differently). Because of the orientation that caused radical misreading of history to claim that Kepler was guilty of that switch, math in the narrow sense becomes both possible empirical oversight. He most definitely saw the phenomena— and requisite. over and over again. In fact, it is commendable the extent to which Kepler remained grounded in the things themselves (as Kepler’s esteemed rank in scientific history is not the opposed to his contemporary Galileo, who had a reputation result of his purely empirical devotions. He did not correctly for ignoring the experimental results which disagreed with map the heavens because he was the first successful pioneer his theories66). Nevertheless, in the Heideggerian sense, even of some sort of positivistic empiricism. In Kuhn’s words, the empirical champion Kepler skipped over the things. The Kepler’s three laws were “not derived from observation and phenomena were not ignored or totally disregarded, but they were computation alone.”72 Rather, Kepler’s thorough confidence still secondary to the mathematical projection of nature. That is in his mathematical orientation led him to the correct why Kepler repeatedly produced different interpretations of mathematical projection. According to Burtt, Kepler was the same data. “entirely convinced on a priori grounds that the universe is Kepler, like all scientists under the mathematical project, basically mathematical, and that all genuine knowledge must no longer looked directly to experience. This shocking claim, be mathematical.”73 Consequently, Kepler’s efforts to align however, is not intended to say that Kepler did not experience the astronomical data with this mathematical character (by anything he wrote about. Rather, he relied instead on experiment. obsessively eliminating experimental discrepancy) led to his This terminological distinction implies less about what is major discoveries. Nevertheless, Kepler did not discover things, actually observed or physically seen, and more about the but mathematics—for he only saw the things as ordered by the scientist’s orientation. The scientist heuristically establishes this mathematical project which he had assumed. Kepler’s empirical distinction in “the manner of setting up the test and the intent triumph resulted from his mathematical approach. Heidegger, Modern Science, 272. Ibid., 272. 69 In Burtt, Metaphysical Foundations, 61. 70 Heidegger, Modern Science, 292-293. 71 The question of how Kepler’s dedication to physical explanation was influenced by his mathematical project is fascinating, but outside the scope of this paper. See Koyré, Astronomical Revolution, 121, 168, 227, and Giora Hon, and Yaakov Zik, “Kepler’s Optical Part of Astronomy (1604): Introducing the Ecliptic Instrument,” Perspectives on Science 17.3 (2009): 307-345. 72 Kuhn, Copernican Revolution, 125. 73 Burtt, Metaphysical Foundations, 71. 67
Heidegger, Modern Science, 292. 62 Heidegger, Question Concerning Technology, 328. 63 Heidegger, Modern Science, 292. 64 Ibid., 292. 65 Ibid., 291. 66 According to Hon, “when Kepler encountered a small discrepancy between the prediction of a law and the relevant observations, he spent years—having checked the observations—in modifying the law until he obtained a satisfactory agreement. Relying on his science of accident, Galileo tended in contrast to ignore discrepancies.” Experimental Error, 552. 61
Making a Medically Reputable Movement: Margaret Sanger’s Medical Institutionalization of Birth Control, 1921-1937 Rosemary Imms, Harvard University ’12 Historians recognize Margaret Sanger as the leader of the American birth control movement of the twentieth century. Sanger’s original vision for the birth control movement was to bring medical oversight and guidance of female fertility to women, and so her vision triumphed with the formal acceptance of medicalized birth control. Sanger’s choice to use the medical establishment as an avenue for the provision of contraception was not only a strategic attempt to succeed in revising state regulations of birth control, but also a reflection of her investment in medicine as a means to providing the best treatment for women. This paper seeks to analyze the connections Sanger forged between radical reformers, the state, and medicine through the American birth control movement by looking at how she pathologized female fertility and institutionalized it through the medical birth control clinic between 1921 and 1937.
“I think, if anything, we have corralled public opinion so that there is scarcely a person today who does not believe that birth control must be under medical auspices.”1 In twenty-first century America, the Planned Parenthood clinic represents a cultural touchstone of how we understand the medical, social, and political spaces of women’s sexual and reproductive wellbeing. “Planned Parenthood is working tirelessly to ensure that women will always have access to the birth control and health care they need and deserve,” notes their website.2 The facilities that Planned Parenthood operates purposefully integrate contraceptive access with health care. Contraception has become a part of sexuality in America– in popular culture, in public policy, and in medicine. It is at once the subject of heated political debate and also taken for granted as a common sense measure for anyone who is sexually active.3 Recent years have seen the inclusion of Margaret Sanger, letter to Robert L. Dickinson, Feb. 5, 1940, from Robert Latou Dickinson Papers, 1881-1972 (inclusive), 1883-1950 (bulk). Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass. 2 “About Us,” Planned Parenthood, accessed Jan 23, 2012, www. plannedparenthood.org/about-us/. 3 For example, Harvard College students have access to free condoms in a number of locations, such as laundry rooms. For pop culture references, one example can be found in MTV’s 16 and Pregnant, in which one of the questions the girls answer in each episode is whether or not they were using “protection” when they got pregnant. 16 and Pregnant, documentary, produced by Morgan Freeman and Dia Sokol Savage (2009; MTV), http://www. mtv.com/shows/16_and_pregnant/season_1/series.jhtml. These examples are just a sample of the references to contraception that abound in American society. 1
contraception in American health care reform. One century ago, such acceptance of the topic of birth control in the public arena would have been inconceivable. Certainly, the so-called “sexual revolution” during the twentieth century played an important part in this cultural transformation, but even more fundamental was the role of the birth control movement of the early twentieth century. Under the leadership of Margaret Sanger, birth control clinics grew out of this movement and institutionalized the idea that reproduction and sexuality require medical attention. A product of Sanger’s activism, the birth control movement went public in 1914 and has had farreaching historical consequences in the United States. Many historians are interested in Sanger’s role as an activist for women’s reproductive rights and explore her involvement in the birth control movement as a function of her political shrewdness, her perseverance, and her dynamic persona. While all of these factors were important aspects of her activism, they fail to completely address her commitment to a medical paradigm in her approach to birth control as anything further than a politically convenient move. Modern understandings of the importance of birth control draw upon assumptions that underestimate the historical significance of Margaret Sanger’s innovation of the birth control clinic. By looking at Sanger’s work through the lens of the history of medicine, I problematize this assumption by contextualizing the clinical institutionalization of birth control within the changing medical establishment. Sanger’s choice to use the medical establishment as an avenue for the provision of contraception was not only a strategic attempt to succeed in revising state regulations of birth control, but also a reflection of her investment in medicine as a means of providing the best
SPRING 2013 treatment for women. Margaret Sanger chose to understand female fertility as a medical condition that required medical oversight and guidance. The trajectory of the birth control movement is dependent on this choice. Her original vision for the birth control movement was to bring this medical intervention to women, and so her vision triumphed with the formal acceptance of medicalized birth control. Margaret Sanger was born in Corning, New York, in 1879. Her childhood experiences in a big, working-class family informed her progressive outlook on matters of social welfare. As an adult she decided to train as a nurse, and in this professional capacity, she realized that the plight of mothers struggling to raise large families arose from their ignorance of fertility control methods. In 1912 she focused her interest in women’s health specifically on the matter of contraception.4 Prior to the birth control movement, the Comstock Laws of 1873, a collection of purity laws, restricted any print or public communication about these matters, and even medico-scientific works on sex and reproduction were censored by the state.5 This did not bother most doctors, though, who had no interest in involving themselves with the taboo topic.6 Consequently, most women at that time learned what they knew about contraception from other women in the community or from quack salesmen. The only methods that were reasonably safe and reliable were withdrawal or condom use, both of which depended on male cooperation for any effectiveness.7 After Sanger began her work in New York City, this scenario changed dramatically and the focus shifted to the medical institutionalization of birth control and of reproductive health. By 1937, the courts interpreted the law in such a way that allowed doctors to provide contraceptive advice to preserve the health and wellbeing of their female patients, and the American Medical Association voted to endorse birth control education and research as part of a physician’s training. Birth control became an increasingly legitimate topic of study and discussion among scientists and within general society. Margaret Sanger, My Fight For Birth Control (1931; repr., New York: Maxwell Reprint Co., 1969), Chapters 1-3. 5 Sarah Marcus, “The Planned Family as a Social Constructive Measure,” February 12, 1935, 3, from the Family Planning Oral History Project. Schlesinger Library, Radcliffe Institute, Harvard University, Cambridge, Mass. In short, the Comstock Laws were designed to fight vice in American society and so “In 1873, a federal bill was passed in America known as the Comstock law. It was a general obscenity law and included in the law was the sending of birth control materials through the mails and by common carriers.” This federal law was made part of state laws. In New York, it was specifically Section 1142 of the New York State Penal Code. 6 James Reed, “Doctors, Birth Control, and Social Values: 18301970,” in The Therapeutic Revolution: Essays in the Social History of American Medicine, ed. Morris J Vogel and Charles E. Rosenberg (Philadelphia: University of Pennsylvania Press, 1979), 109. 7 Linda Gordon, The Moral Property of Women: a History of Birth Control Politics in America (Urbana and Chicago: University of Illinois Press, 2002), 145. 4
Examining the available primary sources, especially Sanger’s publications and correspondences, through the lens of the history of medicine indicates that she was consistently interested in imposing medical legitimacy on the birth control movement. Historians of medicine characterize this period of American medicine as one of professionalization during which American physicians sought to bring prestige to their institution through technocratic authority.8 Sanger was working during this time when many scientific, technological, and medical discoveries were influencing the way that people assessed the validity of social ideas.9 At the same time, though, there was a movement away from doctors casting themselves as moral authorities instead of health care providers.10 Sanger took advantage of this shifting attitude to refocus the birth control movement to view fertility as a health process requiring medical attention and intervention. By persuading physicians and scientists to take her side, she hoped to be able to convince legislators and members of society of the need for birth control. She had to align herself with these professionals though, and medicalization served as a technique that took advantage of the developing prestige associated with science and medicine and used it as an authoritative force in convincing others of the legitimate need for birth control. A natural leader, Sanger saw the opportunity to maximize the strengths of both medical and social commitments to human welfare to create a movement that would use medicine to bring about better health and wellness to women, especially those of the working class, through birth control. Sanger’s lasting legacy is grounded in her work between 1921 and 1937, when the birth control clinic took off. Lena Levine, a woman working as a doctor at the time, credited Sanger with knitting together various aspects of feminine experience under the auspices of physicians’ care.11 The Crane Decision in 1918 legally freed doctors to prescribe contraception for the cure and prevention of disease, and the George Rosen, The Structure of American Medical Practice, 18751941 (Philadelphia: University of Pennsylvania Press, 1983); Phyllis Allen Richmond, “American Attitudes Toward the Germ Theory of Disease (1860-1880),” in Theory and Practice in American Medicine: Historical Studies from the Journal of the History of Medicine and Allied Sciences, ed. Gert H. Brieger (New York: Science History Publications, 1976), 58-84. 9 Reed, “Doctors, Birth Control, and Social Values: 1830-1970,” in The Therapeutic Revolution: Essays in the Social History of American Medicine, 101-2. 10 Ibid. 11 Lena Levine, “Margaret Sanger Transcript” from Abraham Stone papers, 1916-1959. H MS c157. Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass. Levine was a prominent medical practitioner in the field of birth control. She said her work under Sanger showed her how, as a doctor, “to give to women a method to control their pregnancies, to give to women the dignity of being able to control what is so important a function in their lives and through that bettering their relationship with their husband and their children, permitting them to be able to be good wives and good mothers.” 8
36 SYNTHESIS ISSUE 4 doctors purposefully broadened the interpretation of disease. police did not interfere with the opening of this clinic because There still existed an ideological gap, though, which prevented the Crane Decision had given doctors the authority to operate doctors from assuming this responsibility. In the phase of the centers for contraceptive treatment, and Dr. Bocker was a birth control movement between 1921 and 1937, Margaret licensed medical doctor. Sanger focused her efforts on helping doctors overcome Sanger hired Dr. Bocker to begin gathering the evidence their hesitancy to get involved in birth control as a medical she needed to present a case to the medical profession that practice as well as contraception legislative reform. She did this fertility was a valid concern, and that doctors were not only by inviting doctors to play an active role in the birth control legally free to prescribe contraception but that it was their movement. medical duty to do so. Dr. Bocker proved inadequate to In order to legitimize birth control in the public and achieving these ends, though. Her lax research methods did political eye, Sanger required the assistance of a medical not provide the statistically significant results that Sanger institution in which physicians could prescribe and study needed to advance the cause of birth control, and her contraceptive methods and devices in cooperation with legal inconclusive findings failed to develop any new contraceptives. restrictions. A functioning medical institution relied on a cadre Correspondence between the two women indicates Sanger’s of trained and committed doctors, and so Sanger sought out dissatisfaction with Bocker’s methodology and practice, with physicians willing to take a professional risk to redefine female Sanger writing “two years of work at a great expenditure fertility. Sanger hoped to use this team as a sort of focus group has brought us nothing new, or nothing even as simple” as for the model she envisioned. Her professional interactions the pessaries Sanger had seen used in Holland years earlier.15 with this group of physicians under her employment reflected Bocker’s research might have been more useful had she been the struggle she faced in simultaneously surrendering her able to use the force of medical authority, but she also lacked a power over the movement while still guiding it in the track reputation as an esteemed physician in the field of reproductive she envisioned. In this track, medicine equipped women with health. All she knew about birth control was a result of her instruction in how to manage fertility. The doctors with whom tutelage under Margaret Sanger. In her application cover letter, Sanger chose to work aided her in this transition because they she wrote that she wanted to work for Sanger because she was also believed firmly in her platform and were committed to “very much in sympathy with the birth control movement,” soliciting support from their colleagues. not because she wanted to give health treatments for fertility.16 Sanger wanted to cooperate with the law and propose Sanger’s desire for medical affirmation of the movement a medically legitimate way of providing contraceptive care. trumped Bocker’s contributions towards the research, and To do this, she opened up a clinic under medical leadership, Sanger sought out a more reputable doctor whose expertise hiring Dr. Dorothy Bocker to act as director. As noted in her could serve to strengthen the results of the findings conducted resume, located in Sanger’s papers, Dr. Bocker had extensive through the BCCRB and who would mentor other interested public health knowledge and experience, though she was a physicians. These factors led to Bocker’s termination at the novice in terms of obstetrics and gynecology.12 According to end of her contract in December 1924, and the hiring of Dr. a letter from Sanger, Bocker was supposed to use the skills she James F. Cooper and Dr. Hannah Stone to serve in her stead. acquired as a public health official to “keep clinical records These two actors worked with Sanger to reach out to doctors, upon which other public clinics would be established in the demonstrating the value of birth control and educating the future.”13 This aim fit into Sanger’s vision for the clinic to serve medical profession in successful methods of treatment. multiple purposes. It would operate as a center for treating The combination of Doctors Stone and Cooper proved women, training physicians in contraceptive techniques, and a powerful addition to the movement because they had the collecting data on available forms of contraception. Through professional credentials Sanger desired, and they shared in her these facets of the operation, Sanger hoped to convince the mindset regarding medical fertility control. In a letter to Dr. medical establishment of the benefit of treating fertility in Bocker explaining why she was no longer needed in the clinic, women through medical intervention. Dr. Bocker therefore Sanger wrote that she thought “the time had come to put the faced an intimidating commitment by signing on to join Sanger. results of the research into practical use” half of the time that Besides basic medical qualifications, the position required the clinic operated, and to spend the other half on “further a candidate who was willing to risk her medical license and research, with one physician in charge assisted by a trained professional reputation, with the threat of a court case hanging and registered nurse.”17 This statement was brought into over the clinic’s operation.14 Dr. Dorothy Bocker was the first reality with the incorporation of Stone and Cooper. Doctor doctor to meet Sanger’s criteria, and with her arrival in January Hannah Stone, “a fine young woman from the Lying-In 1923 the Birth Control Clinical Research Bureau opened. The 15 Dorothy Bocker, 1922 resume, Margaret Sanger Papers. Manuscript Division, Library of Congress, Washington, D.C. 13 Margaret Sanger to Dorothy Bocker, 17 Oct. 1922, Margaret Sanger Papers. 14 Ibid. 12
Margaret Sanger to Dorothy Bocker, Nov 1924, Margaret Sanger Papers. 16 Dorothy Bocker to Dudley A. Siddall, 15 Oct. 1922, Margaret Sanger Papers. 17 Margaret Sanger to Dorothy Bocker, Nov. 1924, Margaret Sanger Papers.
SPRING 2013 37 IMMS / SANGER hospital,” had experience in obstetrics and gynecology as well Cooper’s pamphlet, Tested Methods of Contraception, he discussed as pediatrics.18 Her professional experiences made her a more the two most effective methods that clinical research had suitable candidate for this line of work, and she also had the indicated to have the highest success rates. He relied upon financial ability to volunteer her services.19 Cooper was hired the “four years of observation in our research department” to fulfill a complementary role to Stone’s. Sanger, in organizing to make the claim that the best chemical method available the Bureau, distinguished the difference between doctors who was a spermicidal jelly, and the best mechanical option was focused on research and treatment and doctors who educated the diaphragm pessary. He wrote that combining the two “has the public.20 Cooper took on the second role, and went out on given 98% success in over 1000 cases.”24 Cooper designated the road. In her letter of hire for Dr. Cooper, Sanger wrote that “this pamphlet issued only to physicians,” which that his responsibilities included “lectures, meetings, personal functioned in part to comply with Comstock Laws but also to interviews, and [to] in every way endeavor to educate and take preserve a sense of medical ownership of the topic. He wrote the message of birth control to the medical profession.” In the pamphlet “in response to a widely expressed demand by doing this, she expected him to “capture the medical profession the medical profession for a brief practical statement.”25 This for birth control.”21 Dr. Cooper’s background story suggested work exemplified the publications and attitude that Sanger that his professional observations of women struggling to wanted doctors to associate with birth control. She worked to control their fertility led him to conclude that contraception show medical authorities that by enabling women to control provided the best intervention for these women. A gifted their own fertility through medical intervention these doctors orator and firm in his stance that contraception merited medical improved the quality of life for their female patients, the attention, Cooper was well suited for his job and his speaking children of future generations, and in some of her rhetoric, engagements spanned the country, drawing large audiences and even the future of the American race.26 Through the operations increasing awareness within the medical profession.22 Neither of the BCCRB, Sanger primed the medical establishment to Cooper nor Stone participated in the birth control movement favorably view birth control through a scientific lens and assert before this moment, showing that Sanger sought medical what she believed was its rightful place under their jurisdiction. supporters over politically ideological allies. These doctors As she became increasingly involved in this practical affirmed Sanger’s commitment to medicalized birth control, fieldwork, Sanger realized she was not alone in her convictions. and their cooperation promised more extensive support from An important dimension of this phase of the movement can be other members of their profession. found in the simultaneous existence of medical professionals With Hannah Stone working in the clinical research who agreed with Sanger that doctors owed it to their patients to department and James Cooper disseminating birth control better understand the potential of contraception in improving propaganda throughout the United States, Margaret Sanger physical and mental welfare, and consequently improving had at her disposal an efficient machine to produce medical social situations such as poverty. These actors believed that support for contraception. The BCCRB collected meaningful this movement indeed belonged in the hands of physicians– data, and both of the doctors directing the facility published so much so that they wanted to remove Sanger from leadership authoritative texts on contraception.23 For example, in Dr. in it as well. Dr. Robert L. Dickinson, an esteemed obstetrician and gynecologist in New York, headed up this parallel 18 Margaret Sanger, Margaret Sanger: an Autobiography (New York: contingent of birth control activists, who strived to convince Dover Publications, 1971), 360. For more descriptions of Stone’s character and experience see also Chesler, Woman of Valor, 278; fellow medical men of the value of the cause and compel them “Augustus Hand’s Opinion,” 7 Dec 1936, Morris Leopold Ernst 27 Papers, 1933-1937, MC 208, Schlesinger Library, Radcliffe Institute, to take leadership within it. Dickinson firmly asserted that contraception held the key to reproductive health. As a leader Harvard University, Cambridge, Mass. 19 in American medicine, Dr. Dickinson held a lot of sway among Sanger, Autobiography, 360. 20 Margaret Sanger to Dorothy Bocker, 20 Dec 1924, Margaret his colleagues and he was also invested in the reputation of Sanger Papers. the medical profession.28 Like Sanger, Dickinson hoped to 21 Margaret Sanger to James F. Cooper, 5 Feb 1925, Margaret Sanger demonstrate the legitimacy of this field to doctors, with the Papers. added emphasis on the need for medical control not only of 22 S. Adolphus Knopf, “In Memoriam: James Freyer Cooper,” May fertility but also of the birth control movement. 21, 1931, Margaret Sanger Papers. Dr. Cooper “was a convincing orator on the platform, a delightful conversationalist, and was Thus, while Sanger was occupied with the BCCRB, unafraid to express his convictions either in his public or private Dickinson supervised the development of the Committee on utterances” wrote his friend and colleague, Dr. S. Adolphus Knopf in a memorial tribute to Cooper. 23 For example, Cooper published the brief but thorough booklets Tested Methods of Contraception (New York: American Birth Control League, 1928), and An Outline of Contraceptive Methods (New York: American Birth Control League, 1930). Meanwhile, Hannah Stone published annual reports on the BCCRB, a guide for starting birth control clinics, and a book written with her husband, Dr. Abraham Stone, Abraham Stone, Gloria Stone Aitken, Aquiles J. Sobrero, and Hannah M. Stone, Drs. Hannah and Abraham Stone’s A Marriage Manual: the Famous Guide to Sex and Marriage
Recommended by Doctors and Educators (New York: Simon and Schuster, 1968). 24 Cooper, Tested Methods of Contraception, 4,5,7. 25 Ibid., 3. 26 Pivot of Civilization (New York: Brentano’s), 47. 27 James Reed, From Private Vice to Public Virtue: the Birth Control Movement and American Society Since 1830, (New York: Basic Books, 1978), see Part III for a solid biography of Dickinson. 28 Ibid., 167.
SYNTHESIS ISSUE 4 Maternal Health to provide a medically sanctioned alternative this idea, writing to doctors in support of the cause and asking to Sanger’s organization. This institution, “continued by and them to join the board for this council. She believed that this under the direction of physicians, was organized March 9, organization would give her the opportunity to obtain a proper 1923, to undertake a scientific investigation of contraception, license to operate a clinic, rather than a research bureau, thus sterilization, and general problems of sterility and fertility broadening her clientele and available treatment options.32 The from a medical and physical point of view.”29 Dickinson minutes from the first meeting of the MRC noted that the firmly believed that, in the face of the cultural attention to purpose of the council was “to provide clinical facilities for contraception because of Margaret Sanger, doctors needed such patients as may be entitled to contraceptive advice under to educate themselves on the proper role of birth control the laws of the State of New York and to undertake a scientific as a health intervention. He intended to institutionalize the investigation of contraceptive methods, under the supervision discussion of sex and reproduction as a function of health and inspection of a board of gynecologists and obstetricians and wellness through a medical approach, and Sanger figured and other physicians of recognized authority.”33 Records from prominently in his actions. The Committee on Maternal the time all suggest that this collaboration sought to pursue Health, on the board of which he served as secretary, served medical research of fertility independent of other forums as his means of touting contraception to other doctors. The of birth control outreach.34 Sanger and Dickinson mutually Committee brought together an elite organization of doctors, worked toward this end in their individual campaigns, so they which Dickinson believed was a helpful selling point for this hoped that the Maternity Research Council would help reach organization. Doctors did not want to get mixed up with it faster. Sanger’s acceptance of this proposed model suggests quacks, and they also did not want to risk their professional that by this phase of the movement she had invested herself respectability by aligning with a movement “controlled largely in the goal of turning the campaign over to medicine as its by persons whose primary interest is not medical.”30 At this responsibility. She respected the scientific authority of the point in history, birth control still faced stigmatization, and board that this council brought together, and believed it had doctors who affiliated themselves with Sanger’s movement substantial potential and power to advocate on behalf of birth risked losing their professional mobility and credibility.31 control to the larger medical community. Dickinson, in organizing a separate group, hoped to remove Unfortunately for this endeavor, the application for this risk because doctors involved would be clearly pursuing a license fell through and the MRC subsequently dissolved. medical knowledge on the subject, not making a moral Sanger refused to sacrifice her model of contraceptive care, judgment on the broader social implications of contraceptive which combined outreach, education, and treatment, without use. the incentive of license.35 Some historians posit that this move Sanger and Dickinson shared a common goal for the actually stemmed from Sanger’s demand for lay involvement birth control movement, in which contraception would become in the movement, but I argue that it resulted from her shrewd a function of reproductive health care, but they both wanted leadership style.36 She had a functional model with the BCCRB, to keep their positions of power and leadership. Dickinson though not ideal without a license, and she saw utilitarian opposed a lay woman heading up this cause, and Sanger feared reasons for maintaining a broader movement at this phase. The that Dickinson would lose sight of the spirit of her campaign, unique success Margaret Sanger realized in the birth control which was that women were hampered down by their fertility movement grew out of her objective to transform medical and needed to effectively control this aspect of their bodies for opinion regarding contraception by demonstrating that female their own health and the health of society. Nonetheless, the two fertility was a valid medical concern through the BCCRB. frequently cooperated to further their shared cause within the Both in the daily treatment of women and in the studies that medical establishment. In 1925, Sanger and Dickinson flirted their cases enabled, the BCCRB operated as a fully functional with the idea of joining forces to create the Maternity Research medical treatment center and research facility. It obeyed the Council, which Sanger hoped would propel her further into letter of the law in requiring doctors to advise qualified patients the medical spotlight. Sanger was initially enthusiastic about while staying true to the spirit of the movement, which sought to expand the range of qualifying criteria for interested women. 29 “The Committee on Maternal Health,” Reprinted from the Under Dr. Stone’s leadership, the Bureau also demonstrated to American Journal for Obstetrics and Gynecology, St. Louis, Vol. 38
XII, No. 2, August, 1926, from Clarence Gamble papers, 19201970s (inclusive), 1920-1966 (bulk). H MS c23. Harvard Medical Library, Francis A. Countway Library of Medicine, Boston, Mass. 30 Committee on Maternal Health Biennial Report 1928, “Medical Aspects of Human Fertility,” from National Committee on Maternal Health records, 1920s-1959. Boston Medical Library, Francis A. Countway Library of Medicine, Boston, Mass. 31 Ibid. See also Sanger, Autobiography, 360. Sanger noted that Dr. Stone was forced to choose between her allegiance to the BCCRB and her career at the Lying-in Hospital in New York. See also Dorothy Bocker to Dudley A. Siddall, 15 Oct. 1922, Margaret Sanger Papers, in which Bocker asked for compensation for the potential loss of her medical license should she work with Sanger.
Margaret Sanger to Dr. Adolf Meyer, 28 May 1925, Margaret Sanger Papers. 33 “Minutes of first meeting of incorporation of the Maternity Research Council,” 21 Nov 1925, Margaret Sanger Papers. 34 Ibid. 35 See The Selected Papers of Margaret Sanger, v. 1. The Woman Rebel, 1900-1928, ed. Esther Katz (Urbana: University of Illinois Press, 2003), 434. 36 Ellen Chesler, Woman of Valor: Margaret Sanger and the Birth Control Movement in America (New York: Simon and Schuster Paperbacks, 1992), 279-80. 32
SPRING 2013 39 IMMS / SANGER the medical community that it had the ability to meet medical in contraceptive practices as a way to better serve their patient and professional standards. Despite these qualifications, base of fertile women.41 This decision reversed previous though, doctors hesitated to publicly endorse the Bureau for a opinions on the matter, and implied doctors’ willingness to number of reasons. Their chief concerns were that the doctors accept Sanger’s proposition that fertility was a medical need were predominantly women, Margaret Sanger was a laywoman, requiring attention from a doctor in order for the woman and mainstream medicine was not yet entirely convinced that to enjoy optimal health and produce offspring of maximum health and intelligence.42 It symbolized American medicine’s fertility demanded medical attention on a general scale. The consequences of Sanger’s efforts to medicalize the agreement to take up responsibility for the guidance and movement can be seen most clearly when, confronted with treatment of female fertility through contraception. In the decades that have passed since the AMA chose to a power struggle between the state and medical authority, doctors united behind the clinic as a medical institution and endorse contraception, scientists and researchers have created Sanger’s work began to pay off in its own right. In 1929, the new contraceptive devices and techniques with increasing New York police again raided Margaret Sanger’s birth control rates of effectiveness. Women now have a number of options clinic, this time armed with a search warrant. The police available for controlling their fertility, an ability supposed to arrested the doctors working at the clinic that morning and bestow sexual freedom– at least insofar as the physiological they used their search warrant to justify their seizure of the consequences of sexual activity are concerned. By constructing case records and medical histories collected at the clinic. This fertility as a medical condition requiring regulation and control second action clinched the case for the BCCRB, both in court for a woman to live a happy, healthy life, Sanger opened up and in a medical arena.37 Like in the early years of the birth the possibility for unprecedented scientific attention to and control movement, Sanger found herself and her movement innovation for women’s comfort and wellness. Sanger has in the public spotlight. The trial for this case moved quickly stood out in history as an activist for birth control because and brought doctors out of the woodwork of their own of her ability to recontextualize birth control into something volition to proffer support for the medical legitimacy of the both scientifically significant and socially palatable, without clinic and to protest the state’s invasion of the doctor-patient abandoning the original motives of her cause. relationship.38 Court proceedings revealed that the search was an unjustified action on the part of the police involved, and granted legal sanction to the operation of the clinic as a medical facility.39 This episode stands out in the history of the birth control movement because Sanger, though not herself on trial, successfully rounded up the support and cooperation of the state and members of the medical profession. Public sentiment generally favored contraception by this point, as evidenced by journalistic coverage of the clinic raid and trial.40 Altogether, the aftermath of this clinic raid signaled to Sanger that the BCCRB was on track to accomplish her objectives, and that she could effectively leave the medical community to shoulder the responsibility of the clinic’s operation. Doctors soon came to see that they had more power than they had realized. As a result, this moment seems to mark a change in mainstream medicine’s approval of contraception. In June 1937, at their annual conference, the American Medical Association voted to endorse medical research of and training Margaret Sanger, My Fight For Birth Control, 318-21. Sanger speculated that the policewomen who carried out the raid were doing so on behalf of the Catholic Church in New York, Their search warrant, though signed, should not have been, and they had no legal right to conduct the raid. According to Sanger, some of her Catholic patients whose records had been seized were subsequently harassed anonymously for some time. 38 BCCRB Report on Raid, Apr 1929, Margaret Sanger Papers. 39 Margaret Sanger to Havelock Ellis, 20 May 1929, in The Selected Papers of Margaret Sanger, v. 2. Birth Control Comes of Age, 1928-1939, ed. Esther Katz (Urbana: University of Illinois Press, 2003), 33. 40 For one example of many articles like it, see “Raid Sanger Clinic on Birth Control,” New York Times (New York, NY), Apr 16, 1929. 37
Proceedings of the House of Delegates of the American Medical Association, the Eighty-eight Annual Session held at Atlantic City, NJ, June 7-11, 1937, (Chicago: American Medical Association, 1937): 61. 42 Reed, “Doctors, Birth Control, and Social Values: 1830-1970,” in Therapeutic Revolution, 122-3. 41
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The students at Harvard College present Synthesis, the only undergraduate journal in History of Science! Issue 4 contains articles on Kepler...