Why you should care
Because one of the pioneering physicians and medical writers of the 19th century was a Black woman named Rebecca Crumpler.
It’s somewhat hard today to appreciate just what an accomplishment the 145-page treatise A Book of Medical Discourses in Two Parts represents. Even the title of the 1883 work is misleadingly modest. One of the first American medical guides to offer advice for women and children, the book deals with treating everything from infant bowel complaints to hemorrhoids and diphtheria. It even offers marital advice: one way to stay happily married “is to continue in the careful routine of the courting days, till it becomes well understood between the two.”
Dedicated “to mothers, nurses, and all who may desire to mitigate the afflictions of the human race,” Medical Discourses is the masterwork of Dr. Rebecca Lee Crumpler, the first Black woman in America to earn a medical degree. She managed to blaze a path through the medical profession at a time when few Blacks or women were able to attend medical school, let alone publish books about their work.
Few photographs survive of Dr. Crumpler, and what we know about her comes mostly from her own writings. Born in 1831, she says she was raised by a “kind aunt in Pennsylvania” who spent much of her time caring for sick neighbors so that the young Rebecca “early conceived a liking for, and sought every opportunity to relieve the sufferings of others.” At the age of 21, Crumpler moved to Charlestown, Massachusetts, where she worked as a nurse for eight years and set her sights on the New England Female Medical College.
Based in Boston and attached to the New England Hospital for Women and Children, the medical school accepted its first class of 12 women in 1850 at a time when many male physicians still argued that women were too sensitive or did not have the physical strength or intellect to handle the rigors of practicing medicine. In 1860, Crumpler applied to the New England Female Medical College and was accepted. Four years later, she received, as she put it, her “degree of doctress of medicine,” becoming the school’s first and only Black graduate (it closed in 1873). Crumpler’s accomplishment is even more impressive when you consider the broader context: Of the 54,543 physicians in the United States in 1860, only 300 were women, and none of them were Black. But Crumpler’s graduation also coincided with a remarkable period of upheaval in American history, one that put an incredible strain on America’s medical profession: the Civil War and its aftermath.
The Civil War, says James Downs, a professor of history at Connecticut College, “was the largest biological catastrophe of the 19th century. More soldiers died from disease than from battle or even battlefield wounds.” According to the Library of Congress, an astonishing 29,000 of the 100,000 Black soldiers serving in the Civil War died from disease, about nine times the number that would perish fighting. And even after the war ended, as Downs chronicles in Sick from Freedom: African-American Illness and Suffering During the Civil War and Reconstruction, conditions were not much better in the Black community, especially for freed slaves. Emancipation and the long war left millions of African-Americans without adequate shelter, food or access to medical care. In the fall of 1865, there were only about 80 doctors and a dozen hospitals available to treat more than 4 million freed slaves. And most of the hospitals run by the Freedmen’s Bureau, the federal agency charged with helping those freed slaves, could treat no more than 20 patients at a time because of lack of funding.
It was an almost unimaginable public health crisis, and in 1865, Dr. Crumpler — one of the few Black women employed by Freedmen’s Bureau — rushed headlong into the breach, leaving Boston for Richmond to minister to the medical needs of as many of the freed slaves as she could. In addition to her desire to help a population of more than 30,000 people, she knew her extensive field experience in Virginia would provide her “ample opportunities to become acquainted with the diseases of women and children.” According to Downs, the Civil War offered physicians like Crumpler “the opportunity to treat an unprecedented number of patients and to learn more about medicine and the body.”
In 1869, Crumpler returned to Boston where she treated poor women and children from her home before turning her attention to her treatise, a work based on the voluminous journal notes she had kept during her years of practice. The covered topics included everything from breastfeeding and dietary guidelines to the treatment of measles, burns and cholera. “What makes Crumpler’s work particularly powerful,” says Downs, was not just how it grew out of her own experiences, but how “she frames her book as a more general study on womanhood and does not follow the traditional practice of segregating Black women and their children’s health as separate from White women’s health.”
Like Florence Nightingale, who wrote at length about sanitation and medicine following her wartime service in the Crimean War, Crumpler composed a work that was not only historic but also invaluably useful. And her legacy continues to inspire. “Her mere presence in the annals of history challenges how many imagine the past,” says Downs. “It undermines a racial ideology that persists today by presenting Black achievement in medicine as surprising and new.”