Cahif, Jacqueline (2010) ‘She supposes herself cured’: Almshouse women and venereal disease in late eighteenth and early nineteenth century Philadelphia. PhD thesis. http://theses.gla.ac.uk/2303/ Copyright and moral rights for this thesis are retained by the author A copy can be downloaded for personal non-commercial research or study, without prior permission or charge This thesis cannot be reproduced or quoted extensively from without first obtaining permission in writing from the Author The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the Author When referring to this work, full bibliographic details including the author, title, awarding institution and date of the thesis must be given Glasgow Theses Service http://theses.gla.ac.uk/ [email protected] ‘She supposes herself cured’: Almshouse Women and Venereal Disease in Late Eighteenth and Early Nineteenth Century Philadelphia. Jacqueline Cahif Submitted in fulfilment of the requirements for the degree Doctor of Philosophy Department of Economic and Social History Faculty of Law, Business and Social Sciences University of Glasgow January 2010 1 Abstract This dissertation will explore the lives, experiences and medical histories of diseased almshouse women living in late eighteenth and early nineteenth century Philadelphia. During this period Philadelphia matured from being a relatively small colonial city into a major manufacturing metropolis. Venereal disease was omnipresent in America‟s major port city, and diseased residents were surrounded by a thriving medical marketplace. Historians have identified the “who and why” of prostitution, however the scope of the prostitute experience has yet to be fully explored. This dissertation will address a considerable and important gap in the historiography of prostitutes‟ lives as it actually affected women. Venereal disease was an ever present threat for women engaging in prostitution, however casual, and historians have yet to illuminate the narrower aspects of the already shadowy lives of such women. Whether intentionally or by omission, historians have often denied agency to prostitutes and the diseased women associated with them, the effect of which has drained this group of sometimes assertive women of any individuality. While some women lived in circumstances and carried out activities that came to the attention of the courts, others lived more understated lives. A large proportion of the women in this study led the lives of “ordinary” women, and prostitution per se was not the only focal point of their existence. For many almshouse women their only unifying variables were disease, time and place. While prostitutes were often victims of economic adversity, they made a choice to engage in prostitution in the face of hardship and sickness. The overall aim is to consider the diseased female patient‟s perspective, in an effort to illuminate how she confronted venereal infection within the context of the medical marketplace. This includes the actions she took, and how she negotiated with those in positions of authority, whose aim was sometimes -although not always- to curtail her activities. As many diseased women became more acquainted with the poor relief system of medical welfare, they were able to manipulate the lack of coherent strategy “from above”, which left room for assertive behaviour “from below”. 2 Diseased women did not always use the almshouse as a last resort-institution as historians often have us believe. Many selected the infirmary wing as opposed to other outlets of healthcare in Philadelphia, a city that was often labelled the crucible of medicine. There is also an oft-believed notion that prostitutes and lower class women suffering from venereal disease were habitually saturated with mercury “punitive-style” as treatment for their condition. This argument does not hold for those women who were cared for in the venereal ward of the almshouse‟s infirmary wing. Broadly speaking, almshouse doctors did not sanction drastic depletion and the use of mercury compounds unless deemed absolutely necessary. Many almshouse doctors adopted a different therapeutic approach as compared with that of Benjamin Rush and his followers who dominated therapy at the Pennsylvania Hospital, a voluntary institution mostly closed off to venereal women. Such medical differences reflected wider transformations in ideas of disease causation, therapeutic approaches, medical education as well as doctor-patient relationships. 3 Contents Abstract 2 List of Illustrations 5 Author’s Declaration 6 Abbreviations 8 Preface 9 Introduction 10 Part One Chapter One Setting the Scene: a Social Profile 38 Chapter Two Our Extended Family: The view from above 72 Chapter Three „those insolent hardened Husseys go on dispensing all Rule & Order here‟: The view from below 99 Part Two Chapter 4 Setting the Scene: The Perils of Philadelphia‟s Medical Marketplace 143 Chapter Five Reconstructing the Polishing Room: the view from above 174 Chapter 6 Reconstructing the Polishing Room: the view from below 219 Conclusion 265 Appendices Appendix 1: Samuel Duffield‟s Shopping List 273 Appendix 2: Glossary of Medical and Pharmaceutical Terms 275 Appendix 3: Dr. Anderson‟s Casebook 280 Appendix 4: Pennsylvania Hospital Therapeutics 285 Bibliography 288 4 ILLUSTRATIONS Figure 1: William Birch, Alms House in Spruce Street, Philadelphia, 1799 Figure 2: Philadelphia Dispensary for the Medical Relief of the Poor, 1786. Figure 3: William Birch, Corner of Third and Market Streets, Philadelphia, 1799. Figure 4: James Gillray, „Breathing a Vein‟, 1804. Figure 5: Samuel Duffield‟s Shopping List Graph 1: Average Age of Female Venereal Admissions in Philadelphia Almshouse Graph 2: Neighbourhoods of Diseased Almshouse Women Also Arrested under Vagrancy Law, 1789-1820. Table 1: Ethnicity of Female Venereal Almshouse Admissions. Table 2: Occupations of Venereal Patients, Northern Dispensary, 1816-1817. Table 3: Birthplace of Female Servants Admitted to Almshouse Venereal, 1811. Table 4: Female Venereal Elopements, Philadelphia Almshouse Table 5: Almshouse Venereal Inmate Elopements, 1807. Table 6: Seasonal Use of the Almshouse. Table 7: Length of Time between Contracting Disease and Seeking Almshouse Treatment. 5 Author‟s Declaration I declare that, except where explicit reference is made to the contribution of others, that this thesis is the result of my own work and has not been submitted for any other degree at the University of Glasgow or any other institution. Signature Jacqueline Cahif 6 Acknowledgements This project would not have been possible without the financial support I received for both my Masters and PhD from the Economic and Social Research Council. To carry out research in America I was lucky enough to receive a Library Company of Philadelphia and Historical Society of Pennsylvania Fellowship of which I am extremely grateful, and in particular to James Green for showing such an interest in my project while I was overseas. I would especially like to thank the Gordon‟s for providing me with a home from home on my many trips to Philadelphia. They are indeed a very special family. I am also grateful to David the archivist at the Philadelphia City Archives for constantly going back and forward to retrieve the hefty almshouse ledgers for me, and always with a smile. I would also like to thank Stacey Peeples at the Pennsylvania Hospital Archives and the archivists at the Philadelphia College of Physicians. I would like to extend sincere gratitude to my supervisor Simon Newman, who frankly made me believe in my project, and myself. This thesis is the product of his never-ending support and encouragement (and sometimes criticism, although always constructive). I am additionally grateful to my other supervisor Marguerite Dupree, who provided me with the inspiration to turn my project into a medical history. And to all those I rubbed shoulders with at various conferences and seminars who called me the „VD girl‟ or „the one doing prostitution‟, I also thank you. To Alison Peden and Elaine Monteith, I will never forget the administrative and emotional support you gave me during the last three months of writing up, while I hid away in my wee office up in the gods. You made a lonely period during that cold, cold winter of 2009 actually quite enjoyable. The biscuits and chocolate from your office also helped, as did the constant laughter! And to Sam who looked after me with a constant supply of banana bread. My most special thanks goes to my close friends and family who put up with the various stresses that come hand in hand with undertaking a PhD thesis. They helped me more than words can say. This thanks extends to my uncle, an retired pharmacist who helped me decipher eighteenth century apothecary prescriptions. Finally, I truly enjoyed attempting to give a voice to the many women who were the subjects of this study. They led precarious and difficult lives, often under the direst and most painful of circumstances. They deserve to be heard. 7 Abbreviations APS: American Philosophical Society. HSP: Historical Society of Philadelphia. LCP: Library Company of Philadelphia. M.M: Managers‟ Minutes. PCA: Philadelphia City Archives. PHA: Pennsylvania Hospital Archives and Historic Library, Philadelphia. PPL: Pennsylvania Public Ledger. P.M: Almshouse Physicians‟ Minutes. Penn. M.M: Pennsylvania Hospital Managers‟ Minutes. RCSPG: Royal College of Surgeons and Physicians, Glasgow. Short Titles Dockets: Daily Occurrence Dockets. Register: Prostitutes‟ Register. Vagrancy: Vagrancy Dockets. 8 Preface In June of 1800, Rachel Ward left the Philadelphia Almshouse for the last time. Documented by the almshouse steward John Cummings as „one of our polishing room1 gang‟ and a „frequent…infamous venereal customer‟, Rachel had sought almshouse treatment on numerous occasions throughout the 1790s. Having been clothed and treated, Rachel escaped the almshouse on five occasions that we know of, usually by „scaling and jumping the fence‟. On one occasion, she „ran off half cured‟ only to return a month later, much to the irritation of Cummings who labelled her as a „hussy [who] returns at pleasure‟.