This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
When Rebecca Davis Lee Crumpler (February 8, 1831–March 9, 1895) gathered nearly two decades of her journal notes and poured them into a book, she’d already treated hundreds—probably thousands—of women and children. Crumpler had witnessed many lives cut short prematurely and believed in the lifesaving power of preventive practices. She wanted other women to gain from her observations and accumulated knowledge. “I desire,” wrote the 52-year old Crumpler in her 145-page treatise A Book of Medical Discourses in Two Parts, devoted to mothers and children, “that my book shall be as a primary reader in the hands of every woman; and yet nonetheless suited to any who may be conversant with all branches of medical science.”
Over the course of Crumpler’s long career she worked for the Freedmen’s Bureau, which was tasked with helping formerly enslaved individuals to transition from slavery to freedom and citizenship; ran a busy medical practice in the Beacon Hill area of Boston; educated women about pregnancy and childbirth; and published an important volume on disease prevention.
Born to Absolum Davis and Matilda Webber in Delaware, Rebecca was raised by an aunt in Pennsylvania who demonstrated a clear gift for healing, though she had no formal training. As a young girl, Rebecca watched her aunt cure many neighbors, later recalling that “I early conceived a liking for and sought every opportunity to relieve the suffering of others.” In 1852 when she was 21 years old, she moved to Charlestown Mass., near Boston, where Rebecca set up a nursing practice and married Wyatt Lee (who died in 1863). In her nursing work, she came to the attention of male medical colleagues who encouraged her to apply to the New England Female Medical College (NEFMC), where she was accepted in 1860.
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Many mid-19th-century male doctors looked down on the new medical institutions for women, claiming that women were too “sensitive” or that they would not be able to fully understand the scientific curriculum. On the other hand, doctors like Israel Tisdale and Samuel Gregory, the founders of NEFMC (established in 1848, the institution later became part of Boston University) argued that only female doctors could protect female patients from “predatory” and “corrupting” male doctors. These advocates of medical education for women supported legislation that enabled women to enter the profession. Crumpler later reflected that“All honor is due to a far-seeing legislation which has recognized the importance of fitting woman for the great and natural office of nurse, or doctress of medicine.”
The Boston Herald announced Crumpler’s graduation from NEFMC on Tuesday, March 3, 1864. Crumpler was the first black female doctor in a field of over 54,000 physicians. Some 300 were women.
The end of the Civil War in 1865 left four million black Americans, as well as hundreds of thousands of poor white southerners, without adequate housing or medical care. Congress created the Freedmen’s Bureau (“the Bureau of Refugees, Freedmen and Abandoned Lands”). Along with helping to reunite families, resolve land disputes, instill just labor practices and establish schools, the Freedmen’s Bureau formed a much-needed medical branch to combat diseases like cholera and smallpox which quickly became widespread in the refugee conditions and tent-cities in the post–Civil War South. In 1866, the 35-year-old Crumpler, newly married to Arthur Crumpler, signed up to serve in the Freedmen’s Bureau, under the leadership of General Orlando Brown in Richmond, Va. She was one of only 23 African American physicians—male or female.
The national humanitarian crisis stirred a sense of Crumpler’s calling. She wrote that “my mind centered upon Richmond, the capital city of Virginia, as the proper field for real missionary work, and one that would present ample opportunities to become acquainted with the diseases of women and children.”
She continued: "During my stay there nearly every hour was improved in that sphere of labor. The last quarter of the year 1866, I was enabled, through the agency of the Bureau under Gen. Brown, to have access each day to a very large number of the indigent and others of different classes in a population of over 30,000 colored.”
A BOOK OF MEDICAL DISCOURSES
Returning from Virginia to Boston, in 1869, Crumpler set up a medical practice that emphasized care for women and children. Crumpler wanted to reach out to all women about the most “distressing of their complaints” and extend her reach beyond the patients that she could treat in person. In 1883, 12 years before her death, Crumpler published A Book of Medical Discourses, offering her accumulated knowledge and medical findings to “Mothers, Nurses, and all who may desire to mitigate the afflictions of the human race.”
Medical Discourses, which reads somewhat like a template for the 1980s What to Expect When You’re Expecting, covers pregnancy, nursing, early infancy, teething and common diseases for the first five years. Filled with suggestions and advice for new mothers, Medical Discourses includes warnings against giving children laudanum for coughs. And she cautioned against purchasing the cough syrup sold by druggists since the ingredients could be toxic. Crumpler reported that one mother who’d hoped to ease her child’s cough “had come home to a corpse.” Her admonition about the importance of a baby’s first wash was followed by a concern that male doctors left the birth scene too soon: “the male physician does not always remain long enough to see this important duty performed.”
Crumpler similarly advised that “no baby’s face should be covered while asleep.” And she encouraged new mothers to understand a baby’s cry: “children cry for pastime; so they should. [Crying] develops the lung and relieves the air tubes of any collection of phlegm.”
Indeed, Crumpler, who insisted that prevention was a better strategy than treatment, devoted two chapters to the prevention and treatment of cholera infantum. “There is no doubt that thousands of little ones annually die at our very doors, from diseases which could have been prevented, or cut short by timely aid.”
In Sick from Freedom:African-American Illness and Suffering During the Civil War and Reconstruction, Jim Downs noted that “Rebecca Crumpler, the only known black female doctor employed by the Bureau, argued that the factors that caused disease could have been prevented.”
Indeed, Crumpler’s focus was always on “the possibilities of prevention,” the central tenet of her book of medical advice. She advocated for families of all income levels to receive proper medical care, as well as diet and nutrition advice that could ward off premature mortalities from serious diseases such as cholera, diphtheria and pneumonia as well as other tragedies and household accidents.
In 2016, Melody T. McCloud, a graduate of Boston University School of Medicine and an obstetrician-gynecologist who serves as founder/medical director of Atlanta’s Women’s Health Care, urged the university to memorialize Crumpler’s accomplishments. “Dr. Rebecca Crumpler should be remembered as a role model,” says McCloud. “People need to know the courage she showed and what she overcame.” McCloud, who speaks and writes regularly about systemic racial inequities in medical care, worked with Douglas Hughes, former associate dean of academic affairs at Boston University, on Crumpler’s exhibition. Today, Boston University still showcases the exhibition in memory of Crumpler’s work along with the achievements of other alumni.
Because of McCloud’s formal suggestion and active promotion, on March 30, 2019, Gov. Ralph Northam issued a proclamation commemorating Crumpler’s “tremendous accomplishments in medicine” in Richmond. McCloud hopes to see something even more permanent set up to spread awareness about Crumpler as a historic figure in medicine.
McCloud lauds Crumpler’s perseverance. “During her work for the Freedmen’s Bureau in Richmond, Virginia, it was reported that the hospitals would deny Crumpler the privileges to admit patients,” says McCloud. “Pharmacists didn’t want to honor the prescriptions she would write. She was diminished and harassed by those that claimed the MD behind her name stood for Mule Driver. It hurts me to hear what she endured.”
McCloud adds, “I feel that Crumpler overcame incredible odds—and she deserves more national awareness.”