Women and Medicine in Early America
Women and Medicine in Early America
- Rebecca TannenbaumRebecca TannenbaumDepartment of History, Yale University
Women from all cultural groups in British North America—European, African, and Indigenous American—played a central role in medicine in early America. They acted as midwives, healers, and apothecaries and drew on a variety of cultural traditions in doing so, even as they shared many beliefs about the workings of the human body. Healing gave women a route to authority and autonomy within their social groups. As the 18th century opened, women healers were able to enter the expanding world of capitalist commerce. Anglo-American women parlayed their knowledge of herbal medicine into successful businesses, and even enslaved midwives were sometimes able to be paid in cash for their skills. However, as academic medicine took more of an interest in topics such as childbirth, women practitioners faced increasingly bitter competition from professionalizing male physicians.
- Colonial History
- Women's History
Understandings of Health and Medicine in Early America
In order to understand healers and healing, it is necessary to understand the body. People of the 17th and 18th centuries conceptualized their bodies in a very different way than those of the 20th and 21st centuries. The three major cultural groups of early America—Indigenous American, West African, and Northern European—had much in common in the ways they viewed bodies and health, although many details and practices differed. All three groups understood physical health to be dependent on both an internal physical equilibrium and a balance between physical and spiritual factors. For practitioners, this meant combining religious or magical cures with those that focused solely on the physical body.
The healthy body existed in balance with its environment. The environment was social as well as natural. Thus, community and family relationships shaped health, as did the weather and diet. For Indigenous Americans, there was no distinction between the physical and spiritual environments. In most cultures, plants, animals, water, and the earth itself were spiritual entities that had an effect on both the physical and the supernatural worlds. A human being’s health depended on remaining in harmony with all of these beings.1 Similarly, among West African peoples, harmonious balance within a community and with the spirit world was crucial for maintaining an individual’s spiritual and physical health, as spirits could both cause and cure illness.2 European concepts of balance were more oriented to the physical world. The ancient doctrine of the four humors—blood, phlegm, black bile, and yellow bile—still dominated most lay thinking about bodies and health and maintained a lingering influence among physicians. In this scheme, the four substances that comprised the body were required to remain in balance to maintain health. However, while humoral medicine focused on the physical causes of illness, relationships and social harmony were still important to health. Emotional equilibrium was closely linked to physical health and vice versa.3
If health was a matter of balance, then illness was a matter of imbalance. In Indigenous American cultures, a person who upset the environmental balance—by violating a religious restriction or by showing disrespect—would experience consequences in the material world, consequences that included illness or injury. In West Africa, if a person offended a spirit by persisting in an unresolved dispute, or by not showing proper respect to the ancestors, illness would result. Among Europeans, if one humor began to predominate, it caused symptoms of disease.4
The spiritual origins of sickness were important in all three cultures. Even among Europeans, who had the most physically based understanding of disease, spiritual and supernatural causes were of prime importance. While humors could be thrown out of balance by weather, diet, or emotional shocks, they could also be influenced by an angry God who wanted to “correct” a person’s sins. While illness had physical causes, it could also be interpreted as a spiritual message. When physicians or other healers offered treatment, it was a common practice to pray that God would “bless the means” they used.5 Indigenous and African healers, however, did not make as strong a distinction between spiritual and physical causes of disease. Illness always had a strong spiritual element as well as a physical manifestation. To effect a cure, spirits and deities had to be appeased. In most cases, healing practices also involved herbal medicines or physical manipulations such as massage, but none would be effective without a complementary spiritual component.6
Another important spiritual component to concepts of health and disease was the universal belief in witchcraft and demonic possession. While the details of these beliefs varied by culture, all believed that illness could be caused by human beings wielding malevolent magic (witches) or by evil spirits who could act on their own or be directed by a witch. Spiritual healers working in African or Indigenous contexts often dealt with these afflictions on their own. Europeans usually turned to priests or ministers (or to a criminal trial), but only after eliminating physical causes for the symptoms.7
Women healers in all three cultures worked within these concepts of sickness and health. They provided both spiritual and physical comfort to their patients and exchanged medicinal techniques with other healers.
The 17th Century
Indigenous Women Healers
The arrival of European colonizers created a new world of health and disease for the Indigenous peoples of North America. Most prominently, epidemic disease devastated populations. The disastrous effects of the first-contact epidemics are well known. Wherever European settlers went, Indigenous people fell ill and died. From Mexico to New England, smallpox, influenza, measles, typhus, and other diseases took a terrible toll. The toll they took was not only physical. The dead took with them generations’ worth of knowledge, tradition, and skill, including knowledge of healing. As one Martha’s Vineyard native said of disease victims, “their wisdom is buried with them.”8
Despite the demographic and cultural disaster, many traditional healing practices survived, and women healers continued to practice. Both men and women worked as healers in most cultures, and midwifery was exclusively a woman’s job. With the exception of midwifery, there was little difference between the practice of male and female healers. While there was, of course, much variation between Indigenous cultures in the details of medical practice, there were many common elements. Most Indigenous healers were religious leaders as well as medical practitioners. Indigenous healers called on the spirits to help them cure their patients, even as they administered medicines and performed surgery. Ojibway women were at the center of spiritual and religious life and played an important role in healing. They sometimes joined the Midewiwin, a high-status medicine society that performed powerful healing rituals. Women were central to these rituals and maintained a high status. Similarly, among the Cherokee, women played important roles as priests, conducting rituals regarding agriculture and warfare as well as healing. However, not all cultures were completely egalitarian. Among the Delaware, women as well as men could receive a spiritual call to be a healer, but men’s abilities were considered more powerful.9
Practitioners began by examining the patient in order to determine a diagnosis and prescribe a cure. Some of the examination, as among the Cherokee, might involve having a patient recount their recent dreams, or taking a bit of the patient’s blood or hair to use in a divination ritual. Practitioners also looked for physical signs such as swelling or labored breathing. Once the practitioner understood the illness, she could determine what kind of cure was appropriate.10
Cures were a combination of physical and religious ministrations. Almost all practitioners used drumming, singing, or dance as part of their ministrations to patients. These practices served a variety of purposes. In some cultures they invoked healing spirits; in others they banished the spirits of illness; in still others, they called a wandering soul back to the patient’s body. At times these invocations were all that were necessary to heal the patient, but often a physical ministration was necessary as well. Sweat baths—a kind of steam bath in which water was poured over hot stones—were a widespread practice found among many peoples including the Ojibway and the Choctaw. These steam baths were often followed by a plunge into cold water or snow, similar to a European sauna. Many peoples bathed patients in smoke from bundles of burning tobacco or other plants. Among the Cree, practitioners used their hands and mouths to draw intrusive objects or animals from the patient’s body.11
Herbal remedies were also universal among indigenous peoples. This aspect of Indigenous practice has been particularly well documented, since European observers took a deep interest in local plants for curing their own diseases as well as for potential commercial exports. Indigenous women practitioners were honored by some Europeans for their deep knowledge of local plants. Among peoples with specialized practitioners, herbalists were most likely to be women.12
There are many descriptions of the uses of plants and herbs among indigenous practitioners. The Choctaw placed powdered roots on wounds to stop bleeding; the Seneca (as well as many others) used a plant Europeans called snakeroot to cure snakebite; the people of Quebec used the inner bark of spruce trees to cure what we now know as scurvy. Plants had important physical properties, but they also had spiritual power. A Jesuit observer described (with much scoffing) a ceremony in which the Miami people blessed medicinal plants and asked them for help. Among the Cherokee, medicinal plants were chosen for symbolic and spiritual value. For instance, bark and roots from plants that did not die over the winter (such as pine trees) had particularly potent healing powers. For individual maladies, plants were chosen to counteract the source of the illness. If a disease was associated with the west wind, the healer chose plants with roots that pointed east.13
Europeans were very interested in Indigenous herblore. Indeed, some European writers thought that Indigenous medicine was superior to that of the Europeans. They praised the empirical nature of Indigenous cures and urged their fellow Europeans to follow their example. Some plants native to the Americas, such as sassafras, were hailed as miracle cures by Europeans and exported in large quantities.14
As was the case in all three culture groups, Indigenous women healers were most prominent as midwives. In most Indigenous cultures, women in labor were attended only by one or two women. Unlike European women, few indigenous gave birth while lying down. Depending on the culture, they stood, squatted, or braced themselves against a tree. Indigenous midwives knew how to manipulate a mal-positioned fetus into a better position, and how to use herbs to encourage a slow labor.15
Indigenous midwives also ensured that childbirth took place with the appropriate rituals and cultural practices. Many Europeans expressed shock and amazement that Indigenous women did not moan or cry out during labor. This phenomenon has been documented in a variety of Algonkian cultures, including the Micmac, the Cree, and the Fox. Attendants and witnesses served as witnesses to the laboring woman’s stoicism and bravery. Midwives also took charge of rituals to welcome the new baby. In Algonkian cultures, the baby’s first meal was of oil or melted animal fat that linked the infant to the clan and to the community. In addition, the umbilical cord was preserved and hung around the infant’s neck in a special pouch to ensure proper growth and development. Birth attendants exercised important authority in ensuring that babies were born safely and incorporated into the family and the tribe.16
Indigenous women healers commanded respect and exercised authority both within and outside their communities. Among their own people they were powerful spiritual leaders, while among Europeans they were respected for their arcane knowledge of herbs and medicinal techniques.
African American Women Healers
Most historical writing on African American healing practices is based on 18th- and 19th-century sources, which means any conclusions about earlier periods must be extrapolated back into the past. Another issue in considering African women and medicine in this period is the skewed sex ratio of enslaved people transported to the Americas. European enslavers tended to prefer male workers and shaped their workforce accordingly. Given these limitations, however, it is possible to come to some careful conclusions about women healers and healing practices in 17th-century African American communities.
When Africans were forcibly relocated to America, they brought their healing traditions with them. Some of these traditions remained intact, but many were merged with European and Indigenous traditions. Even those traditions that retained much of their original form were divorced from their original cultural context. As Bruce Jackson has said, these practices “survived without the theological framework on which [they were] based.”17
As this mention of theology implies, most West African healing methods were deeply integrated with religious practice. In the Caribbean, these religiously based practices merged with Christianity to create syncretic magico-religious practices such as Vodou and Santeria. On the mainland, however, these syncretic practices were not as common. Nevertheless, spirituality, magic, and medicine remained deeply intertwined. Deities could both cause and cure illness, and appropriate sacrifices and rituals were part of all healing practices. Herbs and plants were associated with particular deities whose power had to be invoked when they were used. Healers were given powers by spirits or deities, who marked their chosen practitioners in a variety of ways. Healers might be born with a “caul,” or part of the amniotic sac still attached to their bodies; others might receive a message in a dream calling them to the practice of healing. The power of healing might also be passed from parent to child, either through explicit apprenticeship or through the bloodline.18
While both men and women could be spiritual leaders and healers, women had a special place as healers in the culture that developed among enslaved people. Older women were respected as preservers and teachers of traditions, even in the face of white hostility. In addition, white slaveholders often employed older women as “nurses,” giving legitimacy to their healing practice. In Jamaica, it was a common practice to send ailing slaves to a woman who could cure diseases. This small authority made some whites suspicious, however; numerous African women in Jamaica were accused of witchcraft.19
Nevertheless, healing among enslaved people remained women’s work. The practice continued for several reasons. First, women healers already had the trust of their peers. They had knowledge of the rituals and herbs that their clientele desired. Second, despite the mistrust of some whites, slaveholders had reasons to allow the practice. In Anglo-American culture, domestic medicine was the province of the housewife, so having African American women as “nurses” and “doctoresses” did not seem alien to slaveholders. Third, slaveholders saw medicine as a job for older women who could no longer do a day’s work in the tobacco or rice fields. All of this meant that enslaved women had a recognized role as medical practitioners.20
African American women practiced two kinds of medicine. One was based on African traditions, and one followed the European medicine practiced by the slaveholders. As traditional practitioners, medicinal practice blended with magic and religious ritual. They interpreted dreams, strange experiences, and other signs to understand the origin of the illness and prescribed herbal medicines accordingly. The medicines might be a “rub” applied to the skin, a bag hung around the neck, or a tonic taken internally. These “root doctors” also tended to injuries, including injuries inflicted by an overseer’s whip. Enslaved midwives also attended women in childbirth and performed traditional methods to support the mother and the proper rituals concerning the umbilical cord. In addition to these explicitly medicinal practices, archeological evidence suggests that African-derived rituals of protection for households and individuals continued through the 18th century and into the antebellum period.21
The other type of medicine was carried out under the supervision of the slaveholders. White mistresses took on the accepted role of caring for the sick in their households but delegated tasks to enslaved nurses. While a white mistress might make and prescribe a medicine, enslaved women administered it and sat with the patient to monitor its effects. This division of labor sometimes led to conflicts. While some enslaved women were praised for their healing skills and reliability, others were cause for complaint among slaveholders. Slaveholders feared that they would not administer medicines properly, or that they would ignore instructions in favor of their own “superstitions.” Still others worried that enslaved healers, especially midwives, undermined the health and reproductive capacity of their fellow slaves by providing contraceptives and abortion-inducing drugs.22
The ambivalence with which slaveholders viewed enslaved women’s medical practice ironically demonstrates the authority that healing practice can convey. A trusted healer is a figure of respect, and in enslaved communities, a preserver of traditions over which the slaveholders had no control.
Anglo-American Women Healers
In both England and its colonies, patients could choose from a wide variety of healers, many of them female. Choices of practitioner ranged from learned gentlemen with university degrees, to a female relative known for her healing skills. While women did not occupy the highest tier of this hierarchy, neither did they solely occupy the lowest level. Women practiced as midwives, as paid practitioners known as “doctoresses,” and as unpaid community healers and makers of medicines. Anglo-American women healers were (for the most part) respected members of the medical trade.
Making medicines and caring for household members was the job of the household mistress. Girls learned how to make herbal medicines and care for the sick along with skills in cooking, gardening, and preserving food. Keeping a supply of medicines on hand was just as crucial as storing food for the winter. Women dried and preserved herbs and made up cordials and “waters” to have on hand for any sickness that might arise. Literate women preserved their knowledge in recipe books that were passed down through the generations.23
When a household member fell sick, it was the job of the household mistress to arrange for care and nursing. While some of the job might be delegated—to servants, daughters, or neighbors—the housewife organized and supervised the care. Nursing involved sitting with the patient and ensuring their comfort, but it also meant observing and interpreting symptoms in order to prescribe the correct medicine. Some women practiced the art of uroscopy, or diagnosis through observation of urine, a skill shared by contemporary physicians.24
Housewives of high status had special duties. A woman with leisure might spend some of her time making elaborate medicines; a woman with financial resources could afford expensive ingredients for those medicines; a literate woman could read deeply in the medical literature and record her own recipes for others. A high-status woman with healing skills had the obligation to share them with her neighbors, much as she might tithe to the church or give other kinds of charity. A secondary effect of this activity was to boost both her husband’s status and her own. By distributing charity, a high-status woman created a network of obligation and gratitude among her patients and solidified her family’s position.25
A special case of high-status women providing medical care involved women slave holders. Plantation mistresses saw caring for sick bondspeople and women in childbirth as an important part of their role. From the earliest slaveholding plantations through the antebellum period, mistresses often provided medical care for enslaved people. However, the patients did not always view this intervention in a positive light. Anglo-American women insisted that bondspeople accept English remedies and practices and eschew African “superstition.” White healers might insist that women give birth lying in bed rather than standing or squatting; or they might insist on using drugs without proper spiritual elements. English and African medical traditions came into conflict and became power struggles over the proper care of African bodies.26
While housewives did much of the everyday work of sick care, Anglo-American women also practiced outside of the household. The most widespread form of this kind of practice was midwifery. Childbirth was almost entirely in the hands of women throughout the 17th and much of the 18th centuries. In the earlier period, male physicians were called only in desperate emergencies, when both the mother and child were in mortal danger.27
Anglo-American midwives had a wide variety of skills to call on. They knew how to turn babies from a breech to a vertex position to make delivery safer; they knew which herbal medicines could hasten labor and reduce bleeding. Like their counterparts in the African American and Indigenous communities, they knew the proper cultural rituals to welcome a new baby. Anglo-American infants had to be swaddled, for instance, to ensure that their backs and legs grew straight.28
Midwives were also respected leaders among women. Their trusted authoritative role in the birthing room extended to other contexts as well. Midwives were called upon to settle disputes between women, testify in court, and investigate crimes and sexual misconduct. Perhaps the most well-known duty of midwives was to take testimony from unmarried women concerning the fathers of their babies. Midwives named the fathers in court, and their word was taken as the only evidence necessary to make a man legally and financially responsible for the child.29
The final category of Anglo-American women practitioner is “doctoress.” Doctoresses took care of ailments other than childbirth and attended both men and women. Midwives also served as general practitioners on occasion, providing remedies and advice for non-childbirth-related ailments, but the women who called themselves doctoresses rarely if ever delivered babies. Non-childbirth-related medical care was a common paid occupation for women in England. One study of London found women working as nurses, hospital matrons, “searchers” who inspected sick people for signs of the plague, and even as surgeons. Medical institutions such as hospitals and almshouses employed many women to help care for the sick. While these roles were not as distinguished or well paid in the American colonies, women medical practitioners were well known there as well.30
Some doctoresses ran specialized hospitals for contagious diseases. Mary Hale of Boston, for instance, took smallpox patients into her home and kept them in isolation. Others practiced more like male physicians of the time, taking on a variety of cases and caring for patients either in the patients’ homes or taking them into their own for long-term care. Competing with male practitioners brought some risks—women who practiced in this way were more likely than midwives to find themselves under legal attack in the form of libel or slander accusations or even accusations of witchcraft. Ann Edmonds of Ipswich, Massachusetts, was well known in her community as a “doctoress.” Scholars know of her practice (and her title) because of her frequent appearances in court. When she sued a patient for unpaid fees, a local physician testified against her and disparaged her practice; later in her career, she was accused of witchcraft—but luckily she was acquitted. Even those who escaped legal trouble might find themselves (as Edmonds was) denounced as “quacks” or “ignorant” by male competition.31
Regardless of the negative consequences for some, it is clear that women medical practitioners of all kinds were respected and carried significant authority. Even the lawsuits launched at doctoresses speak to this respect—if they did not represent dangerous competition, they would not make such good targets. Midwives, in particular, were looked on as leaders among women, and their role in paternity suits and witchcraft cases gave them a small measure of formal power. As was the case for women in all three culture groups of Early America, Anglo-American women found medical practice to be a source of community authority and autonomy.
The 18th Century
Much remained the same in the 18th century. Midwives continued to practice in all three culture groups, Anglo-American housewives continued to grow herbs and nurse the sick, and Indigenous and African people retained their healing traditions in the face of daunting odds. However, there were also significant changes. Eighteenth-century women’s practice was marked by increasing involvement in commerce and economic exchange, as well as increasingly contentious relationships with professionalizing male physicians. While medical practice remained a source of respect, especially for white women, some traditional forms of women’s practice were beginning to lose ground against male academic medicine.
Anglo-American Women Healers
As commerce expanded in 18th-century British North America, medical practice became part of both formal and informal economies. Midwives had always charged for their services, but studies of 18th-century practice demonstrate the ways in which their practice was intertwined with both local and trans-Atlantic commerce. The Maine midwife Martha Ballard was part of networks of exchange that went far beyond her small local community. When she was paid for delivering babies, the payment was only sometimes made in cash. She might be paid in local products such as garden produce, but more often her fees were in store credit or goods such as kettles or imported medicines. Furthermore, midwifery was paid work reserved explicitly for women. Even as women were increasingly defined as “domestic” and outside the sphere of business and economics, midwives demonstrated that these definitions did not describe the reality of women’s lives. Midwives (and other paid female workers) connected women to the growth of a capitalist economy.32
Other Anglo-American women medical practitioners participated much more explicitly in commerce. Urban apothecaries such as Elizabeth Weed exploited increasing consumerism to market their wares and developed extensive networks of customers and suppliers of herbs, minerals, and other medicinal products. Weed used her medical skills to invent her own proprietary remedy, Weed’s Elixir, and used her business savvy to advertise and market it. Weed and other medical entrepreneurs like her were able to create successful businesses and support their families using traditionally female-gendered skills. Even more than Martha Ballard, these businesswomen made their way in the public world of commerce.33
However, even as some women were able to parlay their traditional healing skills into commercial success, the emerging professionalization of medicine was devaluing those skills.
As the 18th century wore on, American men began to study medicine at the great universities of Britain. Edinburgh, in particular, was the center of emerging thought on medical practice in general and obstetrics in particular. When the young Americans had finished their studies, they brought a new model of medicine back with them, one which they hoped to establish in their homeland. The first American medical school was founded in Philadelphia in 1765 by two Edinburgh alumni, William Shippen and John Morgan. Shippen delivered the lectures on midwifery, and the curriculum included techniques such as the use of opium and the obstetrical forceps, as well as recommendations for the use of therapeutic bleeding during pregnancy and childbirth.34
Shippen and his colleagues soon found a clientele among affluent urban women. The technologies of opium and obstetrical forceps addressed two of women’s greatest fears concerning childbirth—unbearable pain and death from an obstructed fetus that could not be delivered. “Man-midwifery,” as it was called, soon became an accepted if not common practice. Formally educated male physicians could offer technologies that traditional midwives could not.
Soon young physicians tried to incorporate obstetrics into their practices as a matter of course even in rural communities. The Maine midwife Martha Ballard recorded an incident in which a “new doctor” arrived to dose one of her patients with opium; while the woman had some relief from pain, it came with the consequence of stopping her labor entirely. Eventually, Ballard delivered the infant on her own without the doctor’s help. However, the incident foreshadowed a larger change—after Ballard died, the same young doctor became the primary birth attendant in the community.35
There was some backlash against men practicing midwifery. Many, including physicians, feared for women’s modesty if men were to perform such an intimate service. Some medical schools taught young men to perform pelvic examinations by touch alone to spare female patients from shameful exposure. Even so, the 19th century would see academically trained male physicians take a larger role in childbirth, even as midwives continued to practice.36
African American Women Healers
As the African American population (both free and enslaved) of British North America grew, African Americans found their lives and medical practices increasingly intertwined with whites. In some cases, African American practitioners were able to use their healing skills to raise their own status, and that of their communities. However, this step upward sometimes came at a price.
During the yellow fever epidemics of the 1790s, the free black population in Philadelphia organized to provide medical services to the city. City officials approached two prominent African American ministers, Absolom Jones and Richard Allen, to ask for their community’s help in caring for the sick and dying. Jones and Allen rallied their congregations, who nursed the sick, transported patients to the city hospital, and, when necessary, helped to bury the dead. Among the volunteers in this service were a number of women who worked as nurses. They administered physician Benjamin Rush’s regimen of bleeding and purging, cleaned up the inevitable results, and provided comforting care for the sick. Some of these volunteers died and are documented only as first names in a list of the dead. After the epidemic faded away African American volunteers were vilified by the prominent journalist Matthew Carey for exploiting the sick. This slander galvanized the African American community in Philadelphia. Jones and Allen’s congregations became the center of an activist and highly politicized African American community, and Philadelphia became one of the centers of the African American abolitionist movement.37
Enslaved practitioners were able to carve out a tiny bit of autonomy for themselves through medical practice. Enslaved midwives were valued enough to be paid for their services. Midwifery was one of the only paths to paid work open to enslaved women. Midwifery also came with other benefits. A skilled midwife was free to travel to other plantations to practice her trade, another privilege usually reserved for men. Ironically, this personal autonomy came at a cost. Slaveholders valued midwives because the “increase” of their enslaved workers meant an increase in human capital. Midwives’ skills—and the value whites placed on them—were a crucial part of supporting the institution of slavery itself. The extra freedom and autonomy also made midwives the object of white mistrust. Some were suspected (quite possibly correctly) of supporting escapes and insurrections. Enslaved midwives thus had to walk a fine line between maintaining the trust of slaveholders and that of their own communities.38
Indigenous American Healers
As the 18th century went on, Indigenous Americans had to accommodate to the new world they found themselves in. Part of this accommodation was the ability to live simultaneously in the world of the English and that of their own cultures. Healers found themselves caught between two cultures.
Europeans in general and the English in particular had a deep interest in Native American healing practices, particularly knowledge of herblore. Native knowledge became embedded in transatlantic knowledge networks, sometimes with attribution, sometimes not. Plants native to the Americas became part of commercial transactions and European medical culture. Some Native practitioners, such as Mohegan Samson Occam, recorded their systems of local knowledge in written English but maintained the indigenous context and systems of medical knowledge even in this alien form.39
Indigenous women healers also created syncretic and liminal cultural spaces for themselves. One of the best known was the Abenaki healer Molly Ocket (also known as Mollocket). As a child she spent time living with an English family, and as a young woman she spent time at a French Catholic mission in Quebec. By the time of the American Revolution, she was living on her people’s original lands in Maine and had acquired a reputation as a “great Indian doctress.” Her remedies became legendary in the area, especially her use of spruce bark to cure dysentery and the plant called “solomon’s seal” to treat wound infections. One ne’er-do-well Englishman named Henry Tufts lived in her village for several months, attempting to buy or steal her healing secrets.40 Like Tufts, some itinerant European practitioners billed themselves as “Indian doctors,” claiming to have learned their skills and secret remedies from time living among Indigenous people. Similarly, some northern New England midwives laid claim to Native descent as a source of their skills.41
Healing was only one of Molly Ocket’s livelihoods. She also traded furs and had a reputation as a savvy bargainer. At the end of her life she was rumored to be a rich woman with a substantial cache of silver and gold coins. While the rumors were no doubt exaggerated, they do point to Molly Ocket’s success as a healer and trader, as well as her integration into the cash economy of the settlers. Like Samson Occom and other Indigenous healers, she carved out a space for herself that balanced on the margins of both Native and European society.42
Discussion of the Literature
While there were many differences between women healers of the Early America, there are several themes that recur in historical discussions of their practices: community, authority, and spirituality. All healing practices of this time were embedded in a community context. Healing was inextricable from community life and took place in a matrix of social relationships. Spirituality, religion, and supernatural belief were intertwined with medical practices of all kinds. Finally, medical practice conveyed social authority onto practitioners regardless of gender or culture. While this authority varied by type of practitioner and cultural context, the healer was a respected and powerful figure.
Literature on white women healers describes them as central figures in their communities. Midwives were acknowledged leaders among women and carried their authority into the courtroom and other male spaces as well as the female-dominated birthing room.43 Laurel Ulrich has described the midwife Martha Ballard as a social node, connecting the households of rural Maine into one community of social relationships and economic exchange.44 A cohort of authors from the 2010s puts an emphasis on the economic role played by woman healers, especially their involvement in local and transatlantic commerce.45
A second theme in literature on white women healers stresses their competition and conflict with male physicians and the consequences of this competition for both practitioners and patients. Early histories of midwifery suggested that physicians deliberately disparaged and undermined midwives in order to expand their practices; later works challenged this contention and suggested that patients who had access to male physicians chose them for their perceived benefits of safety and comfort. While the debate continues, a middle ground seems to be emerging that argues that physicians promulgated their new techniques in order to expand their practices, but that patients sincerely desired these techniques once they became available. However, it is also clear that midwifery remained widespread into the 20th century.46
The most important works on African American women healers on the North American mainland focus on the 19th century, although some work from the 2000s and 2010s considers the 18th century.47 The most important theme that emerges from all of the work is medical practice as the site of power struggles between enslaved people and their enslavers. Traditional African practices helped build community among enslaved people and create an African American culture; however, slaveholders mistrusted these practices and actively repressed them, forcing enslaved people to use European medical techniques. A secondary theme that emerges, however, is that enslaved healers were crucial to the health and well-being of their communities, a position that slaveholders reluctantly acknowledged. Healers thus had to walk a fine line between maintaining the trust of whites and the trust of their patients. A final theme in this literature is the importance of medical practitioners in inadvertently supporting the institution of slavery by increasing and maintaining “human capital” even as they practiced their healing craft. Works such as that of Sara Collini and Sharla Fett explore this tension in interesting and productive ways.
There is little literature specifically on Indigenous women healers, but many works that deal with broader themes in Indigenous medicine discuss the role of women.48 Indigenous healers faced the task of maintaining and adjusting cultural traditions in the face of a new disease environment created by the arrival of Europeans. Many works from the early 21st century challenge older narratives of cultural and physical decline in the face of colonization, placing medicine in the context of both resistance and accommodation.49 Other works focus on cultural exchange and syncretism, putting Indigenous American knowledge of plants and medicines into transatlantic networks of knowledge. Many of these works focus on the necessity of code switching and maintaining multiple ways of knowledge in the face of increasing European encroachment.50
A recurring theme in the historiography of women healers in this period is the scarcity of sources, especially those that record the voices and viewpoints of the healers themselves. For instance, most early sources on Native women were written by European colonizers; other sources, such as anthropological studies done in the 20th century, must be extrapolated back into the past. Similarly, many sources concerning the lives of African American women were written by white enslavers; the few that record the voices of the women themselves are from the 19th and 20th centuries. Even white women, who are better documented, are underrepresented in the primary sources. While there are more sources than many once believed, the sources that do exist must be used carefully and creatively.
There are a few diaries and collections of letters that document the work of Anglo-American women healers. Of these, perhaps the best known is the diary of the Maine midwife Martha Ballard. Ballard’s diary covers the years from 1785 to 1812 and includes descriptions of Ballard’s work delivering babies and treating illness, as well as her relationships with her family and neighbors. The entire diary, as well as a selection of supporting documents, is available online. Second only to Martha Ballard in significance is the diary of Philadelphia matron Elizabeth Drinker. While Drinker herself was not a healer, her diary records the practices of many kinds of medical practitioners, including midwives. The entire diary has been published in a three-volume edition.51 Finally, many collections of family and personal papers document the work of women healers.
While the number of documents produced by women and women healers themselves is limited, descriptions of Anglo-American women’s practice can be found between the lines in many colonial documents. The 17th-century court records of Essex County, Massachusetts, digitized as part of the Salem witchcraft papers, contain many references to midwives, doctoresses, and other women healers. Other colonial-era court records, such as those of Middlesex and Suffolk Counties in Massachusetts, are equally rich. Collections of men’s letters and diaries also contain references to women healers.
Finally, medical manuals and recipe books document another aspect of women’s practice. A few women kept personal receipt books that contain medicinal recipes and instructions for caring for the sick. Many of these are found in collections of personal and family papers. Published home medical guides were widely read and used as well and give insight into the domestic medicine of the time.
Sources for Indigenous healers include most prominently The Jesuit Relations, a vast work that documents the French Jesuit missions from Quebec to New Orleans. Embedded in these detailed accounts are many descriptions of Indigenous medical practice. Some accounts by European travelers, such as John Lawson’s A New Voyage to Carolina, also document Indigenous medicine from a European point of view.52 A few sources come directly from Indigenous people themselves, albeit not from women. Samson Occam’s Herbs and Roots is included in a published collection of Occam’s writings.53
Much writing on enslaved African American healers depends on the oral histories collected in the early 20th century and archived at the Library of Congress. Plantation and farm records from the 18th century also document the work of healers. The papers of George Washington, for instance, include documentation of payment to enslaved midwives. Similarly, diaries and other personal records of planters describe the work of healers and the health of enslaved people. Finally, late-18th- and early 19th-century medical journals, especially those published in the South, describe (albeit disparagingly) the health and health practices of African Americans.
- Brandt, Susan. “‘Getting into a Little Business’: Margaret Hill Morris and Women’s Entrepreneurship during the American Revolution.” Early American Studies: An Interdisciplinary Journal 13, no. 4 (Fall 2015): 774–807.
- Brandt, Susan Hanket. “Marketing Medicine: Apothecary Elizabeth Weed’s Economic Independence during the American Revolution.” In Women in the American Revolution: Gender, Politics, and the Domestic World. Edited by Barbara B. Oberg, 60–79. Charlottesville: University of Virginia Press, 2019.
- Calloway, Colin G. “Healing and Disease.” In New Worlds for All: Indians, Europeans, and the Remaking of Early America. Edited by Colin G. Calloway, 24–41. Baltimore: Johns Hopkins University Press, 1998.
- Collini, Sara. “The Labors of Enslaved Midwives in Revolutionary Virginia.” In Women in the American Revolution: Gender, Politics, and the Domestic World. Edited by Barbara B. Oberg, 19–38. Charlottesville: University of Virginia Press, 2019.
- Fett, Sharla M. Working Cures: Healing, Health, and Power on Southern Slave Plantations. Chapel Hill: University of North Carolina Press, 2002.
- Plane, Ann Marie. “Childbirth Practices among Native American Women of New England and Canada, 1600–1800.” In Medicine and Healing: The Dublin Center for New England Folklife Annual Proceedings, 1990. Edited by Peter Benes, 13–24. Boston: Boston University Press, 1992.
- Schwartz, Marie Jenkins. Birthing a Slave: Motherhood and Medicine in the Antebellum South. Cambridge, MA: Harvard University Press, 2006.
- Tannenbaum, Rebecca J. The Healer’s Calling: Women and Medicine in Early New England. Ithaca, NY: Cornell University Press, 2002.
- Ulrich, Laurel Thatcher. A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785–1812. New York: Vintage Books, 1991.
- Voeks, Robert. “African Medicine and Magic in the Americas.” The Geographical Review 83, no. 1 (January 1993): 66–78.
- Vogel, Virgil. American Indian Medicine. Norman: University of Oklahoma Press, 1970.
- Wisecup, Kelly. Medical Encounters: Knowledge and Identity in Early American Literatures. Amherst: University of Massachusetts Press, 2013.
3. Nancy G. Siraisi, Medieval and Early Renaissance Medicine: An Introduction to Knowledge and Practice (Chicago: University of Chicago Press, 1990), 78–114.
4. Vogel, American Indian Medicine; Voeks, “African Medicine and Magic”; and Siraisi, Medieval and Early Renaissance Medicine.
5. Rebecca J. Tannenbaum, The Healer’s Calling: Women and Medicine in Early New England (Ithaca, NY: Cornell University Press, 2002); and David D. Hall, Worlds of Wonder, Days of Judgment: Popular Religious Belief in Early New England (Cambridge, MA: Harvard University Press, 1990).
6. Vogel, American Indian Medicine; and Sharla M. Fett, Working Cures: Healing, Health, and Power on Southern Slave Plantations (Chapel Hill: University of North Carolina Press, 2002).
7. Vogel, American Indian Medicine; Tannenbaum, Healer’s Calling; and Fett, Working Cures.
8. Colin Calloway, New Worlds for All: Indians, Europeans and the Remaking of Early America (Baltimore: Johns Hopkins University Press, 1997), 38.
9. Shirley Williams, “Women’s Role in Ojibway Spirituality,” Revue d’Etudes Canadiennes 27 (Fall 1992): 100–104; Paul Kelton, Cherokee Medicine, Colonial Germs: An Indigenous Nation’s Fight against Smallpox (Norman: University of Oklahoma Press, 2015), 65–66; and Gladys Tantaquidgeon, Folk Medicine of the Delaware and Related Algonkian Indians (Harrisburg: Pennsylvania Historical and Museum Commission, 1972), 4.
10. Vogel, American Indian Medicine; and Kelton, Cherokee Medicine.
11. Vogel, American Indian Medicine; Kelton, Cherokee Medicine; Williams, “Women’s Role”; and Calloway, New Worlds.
12. Vogel, American Indian Medicine.
13. Calloway, New Worlds, 24–30; Vogel, American Indian Medicine, 32; and Kelton, Cherokee Medicine, 74.
14. Calloway, New Worlds.
15. Vogel, American Indian Medicine, 234–235.
16. Anne Marie Plane, “Childbirth Practices among Native American Women of New England and Canada, 1600–1800,” in Medicine and Healing: The Dublin Center for New England Folklife Annual Proceedings: 1990, ed. Peter Benes (Boston: Boston University Press 1992), 13–24.
17. Bruce Jackson, “The Other Kind of Doctor: Conjure and Magic in Black American Folk Medicine,” in American Folk Medicine: A Symposium, ed. Wayland D. Hand (Berkeley: University of California Press, 1976), 259–272, 262.
18. Jackson, “The Other Kind of Doctor”; Voeks, “African Medicine and Magic”; and Fett, Working Cures, 52–54.
19. Sylvia R. Frey and Betty Wood, Come Shouting to Zion: African American Protestantism in the American South and British Caribbean to 1830 (Chapel Hill: University of North Carolina Press, 1998), 57–58.
20. Fett, Working Cures, chap. 5.
21. Fett, Working Cures, 127–129; Marie Jenkins Schwartz, Birthing a Slave: Motherhood and Medicine in the Antebellum South (Cambridge, MA: Harvard University Press, 2006); and Sharon K. Moses, “Enslaved African Conjure and Ritual Deposits on the Hume Plantation, South Carolina,” North American Archaeologist 39, (no. 2, 2018): 131–164.
22. Fett, Working Cures, chap. 5; Frey and Wood, Come Shouting to Zion, 57–58; and Schwartz, Birthing a Slave, chap. 4.
23. Tannenbaum, Healer’s Calling, chap. 2; and Elaine Leong, “Making Medicines in the Early Modern Household,” Bulletin of the History of Medicine 82 (Spring 2008): 145–168.
24. Tannenbaum, Healer’s Calling.
25. Tannenbaum, Healer’s Calling, chap. 4; and Leong, “Making Medicines.”
26. Schwartz, Birthing a Slave; Fett, Working Cures; and Tanfer Emin Tunc, “The Mistress, The Midwife and the Medical Doctor: Pregnancy and Childbirth on the Plantations of the Antebellum American South, 1800–1860,” Women’s History Review 19, no. 3 (July 2010): 395–419.
27. Tannenbaum, Healer’s Calling, chap. 1; and Laurel Thatcher Ulrich, A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785–1812 (New York: Vintage Books, 1991).
28. Tannenbaum, Healer’s Calling; and Ulrich, A Midwife’s Tale.
29. Tannenbaum, Healer’s Calling, chap. 5.
30. Deborah E. Harkness, “A View from the Streets: Women and Medical Work in Elizabethan London,” Bulletin of the History of Medicine 82, no. 1 (Spring 2008); 52–85; and Lucinda McCray Beier, Sufferers and Healers: The Experience of Illness in Seventeenth Century England (London: Routledge and Kegan Paul, 1987).
31. Tannenbaum, Healer’s Calling, chap. 6; and Harkness, “A View from the Streets.”
32. Ulrich, A Midwife’s Tale; and Tanfer Emin Tunc, “Midwifery and Women’s Work in the Early American Republic: A Reconsideration of Laurel Thatcher Ulrich’s A Midwife’s Tale,” The Historical Journal 53, no. 2 (2010): 423–428.
33. Susan Hanket Brandt, “Marketing Medicine: Apothecary Elizabeth Weed’s Economic Independence during the American Revolution,” in Women in the American Revolution, ed. Barbara B. Oberg (Charlottesville: University of Virginia Press, 2019), 60–79; and see also Susan Brandt, “Getting into a Little Business: Margaret Hill Morris and Women’s Medical Entrepreneurship during the American Revolution,” Early American Studies 13 (Fall 2015): 774–807.
34. Judith Walzer Leavitt, Brought to Bed: Childbearing in America, 1750–1950 (New York: Oxford University Press, 1986), chap. 2.
35. Ulrich, A Midwife’s Tale, 177–179.
36. Leavitt, Brought to Bed, 40–41.
37. Philip Lapansky, “‘Abigail, a Negress’: The Role and Legacy of African Americans in the Yellow Fever Epidemic,” in A Melancholy Scene of Devastation: The Public Response to the 1793 Philadelphia Yellow Fever Epidemic, ed. J. Worth Estes and Billy G. Smith (Philadelphia: Library Company of Philadelphia, 1997), 61–78; and see also Rana A. Hogarth, Medicalizing Blackness (Chapel Hill: University of North Carolina Press, 2017), chap. 1.
38. Sara Collini, “The Labors of Enslaved Midwives in Revolutionary Virginia,” in Women in the American Revolution, ed. Barbara Oberg (Charlottesville: University of Virginia Press, 2019), 19–38; and see also Sharla Fett, “Consciousness and Calling: African American Midwives at Work in the Antebellum South,” in New Studies in the History of American Slavery, ed. Edward E. Baptist and Stephanie M. H. Camp (Athens, GA: University of Georgia Press, 2006), 65–86; and Schwartz, Birthing a Slave.
39. Kelly Wisecup, “Medicine, Communication and Authority in Samson Occam’s Herbal,” Early American Studies 10 (Fall 2012): 540–565.
40. Laurel Thatcher Ulrich, The Age of Homespun: Objects and Stories in Creation of an American Myth (New York: Knopf, 2001), chap. 7, 257.
41. Peter Benes, “Itinerant Physicians, Healers, and Surgeon Dentists in New England and New York, 1720–1825,” in Medicine and Healing: The Dublin Center for New England Folklife Annual Proceedings: 1990, ed. Peter Benes (Boston: Boston University Press 1992), 95–112; and Jane C. Beck, “Traditional Folk Medicine in Vermont,” in Medicine and Healing: The Dublin Center for New England Folklife Annual Proceedings: 1990, ed. Peter Benes (Boston: Boston University Press 1992), 34–43.
42. Ulrich, Age of Homespun, chap. 7.
43. Tannenbaum, Healer’s Calling, chap. 5.
44. Ulrich, A Midwife’s Tale.
45. Brandt, “Marketing Medicine”; Brandt, “Getting into a Little Business”; and Tunc, “Midwifery and Women’s Work.”
46. There is a large literature on the history of childbirth and the nature of relationships between midwives and physicians. Leavitt, Brought to Bed makes the case for the “consumer choice” model. Ulrich, A Midwife’s Tale stresses conflict a bit more. For discussions of the relationship as it continued into the 19th and 20th centuries, see Jacqueline Wolf, Deliver Me from Pain: Anesthesia and Birth in America (Baltimore: Johns Hopkins University Press, 2009), which discusses the simultaneous development of physician-assisted birth and anesthesia; for a different perspective, see Jenny Lukes, Delivered by Midwives: African American Midwifery in the Twentieth Century South (Jackson: University of Mississippi Press, 2018).
47. Fett, Working Cures and Schwartz, Birthing a Slave are the two most important works on the 19th century. Sara Collini’s article “Enslaved Midwives” builds on this work and explores the 18th century, as does Fett’s article on midwives, “Consciousness and Calling.” There have also been works that look at the 18th-century Caribbean; see, for example, Karol Kovalovich Weaver, “The Enslaved Healers of Eighteenth Century Saint Domingue,” Bulletin of the History of Medicine 76 (Fall 2002): 429–460; as well as Hogarth, Medicalizing Blackness. Works on African American religion also include discussions of religio-magical healing practices; see, for example, Frey and Wood, Come Shouting to Zion, chap. 2.
48. Vogel, American Indian Medicine; and Calloway, New Worlds.
49. See, for example, Kelton, Cherokee Medicine; and Seth Archer, “Colonialism and Other Afflictions: Rethinking Native American Health History,” History Compass 14 (2010): 511–521.
50. Kelly Wisecup, Medical Encounters: Knowledge and Identity in Early American Literatures (Amherst: University of Massachusetts Press, 2013); Kathleen S. Murphy, “Translating the Vernacular: Indigenous and African Knowledge in the Eighteenth-Century British Atlantic,” Atlantic Studies 8, no. 1 (2011): 29–48; and Londa Schiebinger, “Scientific Exchange in the Eighteenth-Century Atlantic World,” in Soundings in Atlantic History: Latent Structures and Intellectual Currents, 1500–1830, ed. Bernard Bailyn and Patricia L. Denault (Cambridge, MA: Harvard University Press, 2009), 294–328.
51. Elaine Forman Crane, ed., The Diary of Elizabeth Drinker, 3 Vols. (Boston: Northeastern University Press, 1991).
52. John Lawson, A New Voyage to Carolina, ed., introd., and notes by Hugh Talmage Lefler (Chapel Hill: University of North Carolina Press, 1967).
53. Samson Occom, The Collected Writings of Samson Occom, Mohegan: Leadership and Literature in Eighteenth-Century America, ed. Joanna Brooks (Oxford: Oxford University Press, 2006), 44–47.