Erik Visits an American Grave, Part 839

This is the grave of Alice Hamilton.

Hamilton was born in Manhattan in 1869. Growing up in Fort Wayne, Indiana, she was loaded. Her grandfather had basically founded the city and had a huge mansion and estate there. She was encouraged by her parents to achieve the education she desired. They encouraged this of all their daughters; Edith became a renowned classicist and author and her other sisters had successful careers too. Alice wanted to become a doctor, which was very rare for women in these years. But in 1893, she received her medical degree from the University of Michigan and at first dedicated herself to working with women and children, seen as more fit for the few women professionals at this time that settlement houses, for instance, were being established. But Hamilton wanted more. She left the U.S. for advanced medical training in Germany. She studied in Munich and Leipzig, returning to the U.S. in 1897 to study more, at Johns Hopkins. She then moved to Chicago, where she became a professor of pathology at the Woman’s Medical School at Northwestern University.

Hamilton was deeply committed to helping the poor. So she moved into Jane Addams’ Hull House. Living with the poor, she became interested in the problems of workplace health and safety. That’s for good reason. Workers lived atrociously unsafe lives on the job. Many jobs were exercising in seeing how long you could live before you died or lost mental or physical capacity due to the poisons you ingested or absorbed. This is entirely besides the dangers of being burned or decapitated or electrocuted on the job. A poor worker in an American factory was one who may well not live long.

Hamilton became an expert on industrial medicine, which wasn’t that hard because it was barely studied in an America that was utterly indifferent to the question. Employers had no legal responsibility to protect their workers at all. This was still the contract doctrine era. Going back to the 1840s, courts had ruled that if an employee agreed to take a job, it was on that employee to keep themselves safe. After all, they could always quit. The Progressive Era was leading to reform, but the courts were not receptive, as the Lochner case demonstrated.

So job by job, Hamilton began exploring the horrors and seeing how to fix them. In 1910, she was named to the Occupational Disease Commission of Illinois and worked for the state on the issue for the next decade. The major issue Hamilton worked on was lead poisoning. Lead was a very common ingredient in industrial processes, nowhere more so than paint. Adults are relatively immune to small amounts of lead, but at the rates people were ingesting it, they became very sick. Lead damages the nervous system and many workers developed the drooping wrists that became a tell-tale sign of lead poisoning. Hamilton and her assistants took a systematic approach to getting a handle on this issue, visiting worksites, consulting physicians, and interviewing unionists. A huge breakthrough occurred when she visited a bathtub factory. There, a Polish worker clearly suffered from lead poisoning was painting enamel on the tubs. The managers assured her there was no lead used in the factory and let her inspect the workplace. But by asking questions, she found out that most of the enameling was done elsewhere and this was just the touch-up factory. The solution used at the second factory was 20 percent lead and the follow-up workers was being exposed. This allowed her to put the puzzle together over lead in enamel-based production processes.

This sort of thing happened over and over. Employers were incredulous. They simply couldn’t understand even thinking about questions of workplace safety. It was certainly not something they had considered before. And she had absolutely no legal authority. All she could do was try to convince them to improve their workplaces. The fact that Hamilton was very much the proper Victorian woman did not hurt her ability to operate, wrapping herself up in a cocoon of propriety and fairness. It often worked. When she went to Edward Cornish, president of the National Lead Company, to present the facts to him, he was absolutely shocked and denied that he could possibly be poisoning his workers. But he also agreed to her suggestions, including weekly visits by doctors to the factory and constructing new systems to gather up the dust and fumes that were poisoning the workers.

It was much the same with white phosphorus, which led to the notoriously awful condition of phossy jaw. White phosphorus was used in matches. It was incredibly toxic at the doses match workers experienced. It destroyed jawbones. Here is a matchworker with phossy jaw:

Bones glowed in the dark. Brain damage was frequent. The rotting bones smelled. Sometimes, removing them could lead to the life being saved. More often, it led to organ failure and death. In 1908, John Andrews and the American Association for Labor Legislation became compiling information about this. They took it to Hamilton. She helped them publicize and work on it. Hamilton wasn’t the only person starting to work to save lives; Andrews and others deserve credit too. But as a whole, no one did more than Hamilton. William Howard Taft signed legislation in 1912 that taxed matchmakers using white phosphorus as a way to move them to less toxic methods.

Let’s let Hamilton explain her work in her own words:

A Bohemian, an enameler of bathtubs, had worked eighteen months at his trade, without apparently becoming poisoned, though his health had suffered. One day, while at the furnace, he fainted away and for four days he lay in coma, then passed into delirium during which it was found that both forearms and both ankles were palsied. He made a partial recovery during the following six months but when he left for his home in Bohemia he was still partly paralyzed.

A Hungarian, thirty-six years old, worked for seven years grinding lead paint. During this time he had three attacks of colic, with vomiting and headache. I saw him in the hospital, a skeleton of a man, looking almost twice his age, his limbs soft and flabby, his muscles wasted. He was extremely emaciated, his color was a dirty grayish yellow, his eyes dull and expressionless. He lay in an apathetic condition, rousing when spoken to and answering rationally but slowly, with often an appreciable delay, then sinking back into apathy.

A Polish laborer worked only three weeks in a very dusty white-lead plant at an unusually dusty emergency job, at the end of which he was sent to the hospital with severe lead colic and palsy of both wrists.

A young Italian, who spoke no English, worked for a month in a white-lead plant but without any idea that the harmless looking stuff was poisonous. There was a great deal of dust in his work. One day he was seized with an agonizing pain in his head which came on him so suddenly that he fell to the ground. He was sent to the hospital, semiconscious, with convulsive attacks, and was there for two weeks; when he came home, he had a relapse and had to go back to the hospital. Three months later he was still in poor health and could not do a full day’s work.

Every article I wrote in those days, every speech I made, is full of pleading for the recognition of lead poisoning as a real and serious medical problem. It was easy to present figures demonstrating the contrast between lead work in the United States under conditions of neglect and ignorance, and comparable work in England and Germany, under intelligent control. For instance, when I went to England in 1910, I found that a factory which produced white and red lead, employing ninety men, had not had a case of lead poisoning in five successive years. And I compared it with one in the United States, employing eighty-five men, where the doctor’s records showed thirty-five men “leaded” in six months.

In 1912, I wrote this in the Journal of the American Medical Association:

“The contrast was brought vividly home to me by a description which I found in T. Weyl’s Handbuch der Arbeiter-Krankheiten. He is drawing what he considers a shocking picture of ”lead tabes“ or ”lead cachexia” as it used to be found years ago, but which is now almost never seen, thanks to prophylactic measures. He describes the striking pallor, the hanging head, bowed shoulders, hands that hang limply and can hardly be raised; the shambling gait, trembling movements of all the muscles of the body, the emaciation which is extreme.

“From my own experiences I can unfortunately testify to the fact that, thanks to the lack of prophylactic measures, Weyl’s lead tabes is far from being a rare condition in our country; that instances of it can be found in every town where there are lead industries of a dangerous character, and that it is not even a vanishing condition, for new instances of lead tabes are being added to the number every year. Surely there is every reason why we should devote to this disease the same intelligence and energy that we devote to other preventable diseases.”

Life at Hull-House had accustomed me to going straight to the homes of people about whom I wished to learn something and talking to them in their own surroundings, where they have courage to speak out what is in their minds. They were almost always foreigners, Bulgarians, Serbs, Poles, Italians, Hungarians, who had come to this country in the search for a better life for themselves and their children. Sometimes they thought they had found it, then when sickness struck down the father things grew very black and there were no old friends and neighbors and cousins to fall back on as there had been in the old country. Often it was an agent of a steamship company who had coaxed them over with promises of a land flowing with jobs and high wages. Six hundred Bulgarians had been induced to leave their villages by these super salesmen, and to come to Chicago. Of course they took the first job they could find and if it proved to be one that weakened and crippled them—well, that was their bad luck!

It sometimes seemed to me that industry was exploiting the finest and best in these men—their love of their children their sense of family responsibility. I think of an enameler of bathtubs whom I traced to his squalid little cottage. He was a young Slav who used to be so strong he could run up the hill on which his cottage stood and spend all the evening digging in his garden. Now, he told me, he climbed up like an old man and sank exhausted in a chair, he was so weary and if he tried to hoe or rake he had to give it up. His digestion had failed, he had a foul mouth, he couldn’t eat, he had, lost much weight. He had had many attacks of colic and the doctor told him if he did not quit he would soon be a wreck “Why did you keep on,” I asked, “when you knew the lead was getting you?” “Well, there were the payments on the house,“ he said, ”and the two kids.” The house was a bare, ugly, frame shack, the children were little, underfed things badly in need of a handkerchief, but for them a man had sacrificed his health and his joy in life. When employers tell me they prefer married men, and encourage their men to have homes of their own, because it makes them so much steadier, I wonder if they have any idea of all that that implies.

In 1919, Hamilton became the first woman hired to the medical faculty at Harvard. She retained her connections to Hull House until Addams’ death in 1935. She retired from Harvard that same year. She wasn’t done though. She started a big study of the conditions that went into making viscose rayon, which used processes that caused mental illness. Her last big project, the report she wrote went far to reform conditions in this industry. Hamilton lived all the way until 1970, when she was 101 years old. In her later years, she spoke out against McCarthyism and issued a petition to John F. Kennedy protesting American involvement in Vietnam.

Alice Hamilton is buried in Cove Cemetery, Hadlyme, Connecticut.

If you would like this series to visit other famous female doctors, you can donate to cover the required expenses here.Mary Putnam Jacobi is in Brooklyn and Ann Preston is in West Grove, Pennsylvania. Previous posts in this series are archived here.