Hamilton and the Development of Occupational Medicine
Alice Hamilton: a long, productive life
Alice Hamiltons early life suggested the pioneer and social reformer.
Her genteel and isolated upbringing clashed with the woman who challenged
contemporary definitions of femininity and who moved in the traditionally
male circles of the scientific laboratory, the factory, and the university.
Born in New York City in 1869, Alice Hamilton was raised in Fort Wayne,
Indiana, in a privileged and cultured family aware of its place in American
society. She grew up on a large estate acquired by her grandfather, a
Scots-Irish immigrant who had invested in land and railroads. From her
earliest days, Alice Hamiltons deepest attachment was to her family.
The second of four sisters born within six years (there was also a younger
brother), the Hamilton girls pursued educations and professional goals
in the face of declining family fortunes. They remained close as adults.
None married and in later years they often traveled and lived together.
Edith, the eldest, became famous in her fifties as a classicist and author
of The Greek Way and Mythology.
The outside world little influenced the extended Hamilton family, which
included eleven cousins living in several houses on the property bequeathed
by their grandfather. "We needed no outsiders."
Hamilton wrote, "having our own games, our own traditions and rules
of conduct." The one outside influence on the family was religion:
what Alice called "sober" Presbyterianism. Her father, Montgomery,
was passionate about theology and insisted she learn the Westminster Catechism.
Her mother, an Episcopalian, practiced a less austere religion that stressed
the Psalms and the Sermon on the Mount.
Alice and her sisters did not go to school. Her mother objected to the
hours in the Fort Wayne public schools, and her father disliked the curriculum,
which stressed subjects he found uninteresting, such as arithmetic and
American history. Instead, the sisters received an uneven education at
home, learning what their parents thought important: languages and literature
in particular. The only formal education before college was to attend
Miss Porters School in Farmington, Connecticut. The school was a
Hamilton tradition: when young girls reached the age of seventeen, they
were sent to Miss Porters for two years. In her autobiography, Hamilton
described some of the teaching in her day as "the worlds worst."
Since students elected their subjects, Hamilton avoided mathematics and
science, choosing Latin, Greek, German, and what was called mental and
moral philosophy, which she did not understand but merely learned by memorization
In her teens, Alice Hamilton decided to become a doctor. In her autobiography,
she offered an explanation for her choice probably colored more by the
turns her life later took than by youthful idealism. "I chose medicine,"
she wrote, "not because I was scientifically-minded, for I was deeply
ignorant of science. I chose it because as a doctor I could go anywhere
I pleased to far-off lands or to city slums and be quite
sure I could be of use anywhere." Whatever the reason, she could
not go to medical school immediately after Miss Porters for two
reasons: she needed to convince her father that it was a valid choice,
and she had to overcome her lack of education in science. She studied
physics and chemistry with a Fort Wayne high school teacher, took biology
and anatomy courses at a "little, third-rate" medical school,
overcame her fathers objections, and enrolled in the medical department
of the University of Michigan in 1892.
While not exactly pioneering, Alice Hamiltons decision to become
a doctor was unusual. In the 1890s there were about 4500 female doctors
in the United States, and most trained at womens medical colleges.
Women had just begun to study at coeducational medical schools. Moreover,
her decision to study at Michigan put Hamilton in one of the leading medical
schools of the day. Unlike most, Michigan stressed clinical and laboratory
work and its curriculum emphasized lengthy and rigorous scientific study.
In addition to an excellent medical education, Michigan gave Hamilton
her "first taste of emancipation," she said, "and I loved
After graduating from Michigan, Hamilton interned at the Northwestern
Hospital for Women and Children in Minneapolis and then at the more prestigious
New England Hospital for Women and Children outside Boston. Hamilton already
had decided on a career in science rather than practicing medicine, but
she took the internships to gain clinical experience. Soon after she sailed
for Germany accompanied by her sister Edith. She intended to study bacteriology
and pathology, but German universities did not admit women. The Hamilton
sisters eventually gained permission to attend classes at universities
in Munich and Leipzig so long as they remained "invisible" to
the male students. It was not the last time Hamilton had to overcome prejudice
against women to achieve her goals.
Hamilton returned to the United States in 1896, but because she was not
in demand as a trained bacteriologist or pathologist, she enrolled at
Johns Hopkins University in Baltimore, where she worked with Simon Flexnor,
a young pathologist who later headed the Rockefeller Institute in New
York. Then she landed a job teaching pathology at the Womens Medical
School of Northwestern University in Chicago. Hamilton accepted it not
only because it was a job, but also because it provided the opportunity
to live at Hull-House, which she moved into in
1897. Founded by Jane Addams and other socially conscious reformers, Hull-House
was the most famous settlement house in the United States. The social
settlements attempted to bring the well off in contact with immigrants
and the poor. Hull-House made it possible for educated and dedicated young
people and the working class to live as neighbors. In her autobiography,
Exploring the Dangerous Trades (1943), Hamilton noted what Hull-House
taught her: "Life in a settlement does several things to you. Among
others, it teaches you that education and culture have little to do with
real wisdom, the wisdom that comes from life experiences."
It was at Hull-House in the first two decades of the twentieth century
that Alice Hamilton made her greatest mark in the development of industrial
toxicology. At Hull-House, Hamilton treated poor immigrants for diseases
often resulting from working conditions. In 1910, Hamilton took part in
a commission appointed by the governor of Illinois to study the extent
of industrial sickness in the state, particularly the high mortality rates
due to industrial poisoning in the lead and associated enamelware industries,
rubber production, painting trades, and explosives and munitions. She
served as managing director of the survey and made the study of lead industries
her special focus.
Hamilton later was asked by Charles Neill, Commissioner of Labor in the
U.S. Department of Commerce to undertake a similar survey covering all
the states. She received little government backing and no salary, though
the government agreed to buy her final report. She was then in her early
forties and had become the leading authority on lead poisoning and one
of a small group of experts in occupational diseases. Over the ensuing
years, Hamiltons many reports for the federal government dramatized
the high mortality rates for workers in dangerous trades and brought about
many changes in state and federal laws that were landmarks in American
industrial safety legislation.
Hamiltons work was recognized internationally as well. Starting
in 1924, she served a six-year term on the Health Committee of the League
of Nations. Also in 1924, she spent six weeks in the Soviet Union at the
invitation of the Soviet Public Health Service, which asked her to survey
what the country was doing in the field of industrial medicine. She toured
a Moscow hospital that was the first facility anywhere devoted only to
occupational diseases. She also expressed some envy of Russian women doctors
who seemed to be accepted by their male colleagues as equals.
In 1919, Hamilton was offered a position in industrial medicine at Harvard
Medical School. Hamilton was the first woman on the Harvard faculty, and
all her students were men, since the university still did not admit women.
The faculty position came with three stipulations: she could not attend
the Faculty Club; she could not get football tickets; and she could not
march in the commencement procession. Hamilton had a stipulation of her
own: to teach only one semester a year so she could continue her investigations
and return to Hull-House for part of each year. Hamilton was never promoted
at Harvard and during her teaching career held only a succession of three-year
appointments. She remained an assistant professor until forced into mandatory
retirement at the age of 65, when she moved with her sister Margaret to
Throughout her life, Alice Hamilton was interested in social
issues, demonstrated by her decision to live at Hull-House. Hamilton,
a pacifist, toured Belgium during the First World War and northeastern
France and famine-struck Germany in 1919. The desolate graveyards and
ruined houses destroyed by German artillery affected Hamilton deeply:
"It is like killing kittens with machine guns, they are so small
and helpless." But twenty years later, with Nazi troops on the move,
Hamilton confessed, "my clean cut principles no longer seemed to
apply." She defended her changing views:
It is no defense of war as a means of settling disputes to say that when
once war has been started by greed for power and helped on by blindness
and selfishness we cannot save the world by saving our selves, we must
get down into the arena and throw our strength on the side we think the
In her long retirement, when she was in her eighties and nineties, Hamilton
took an active role in campaigning against McCarthyism and what she considered
the excesses of American anti-communism. In 1963, when she was ninety-four,
she signed an open letter to President Kennedy asking for early withdrawal
of U.S. troops from Vietnam.
Alice Hamilton celebrated her 100th birthday in 1969, and the many plaudits
included a telegram from President Nixon praising her successes in industrial
medicine. Hamilton died on September 22, 1970, at the age of 101. Three
months later, Congress passed the Occupational Safety and Health Act.