Alice Hamilton: a long, productive life

Alice Hamilton and the Development of Occupational Medicine

Alice Hamilton: a long, productive life

Nothing in Alice Hamilton’s 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 Hamilton’s 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 Porter’s School in Farmington, Connecticut. The school was a Hamilton tradition: when young girls reached the age of seventeen, they were sent to Miss Porter’s for two years. In her autobiography, Hamilton described some of the teaching in her day as "the world’s 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 and recitation.

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 Porter’s 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 father’s objections, and enrolled in the medical department of the University of Michigan in 1892.

While not exactly pioneering, Alice Hamilton’s decision to become a doctor was unusual. In the 1890s there were about 4500 female doctors in the United States, and most trained at women’s 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 it."

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 Women’s 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, Hamilton’s 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.

Hamilton’s 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 Hadlyme, Connecticut.

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 right one.

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.

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