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Religion and Women’s Medical Knowledge

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This is a guest post by Philippa Koch. Philippa Koch is the John W. Kluge Center Larson Fellow in Health and Spirituality. She is a professor at Missouri State University in the Religious Studies Department. Koch researches the history of religion in America, with a focus on colonial America and the Atlantic world. In her book project, Persistent Providence: Healing Body and Soul in Early America, she examines how Christian communities responded to sickness and epidemics in a context of ever-new medical and scientific developments.

I’m working on a project on women’s health and spirituality in the colonial world at the Kluge Center. For the first few weeks at the Library, I read every eighteenth-century midwifery manual I could find. Much of what I saw agreed with the prevailing interpretation of eighteenth-century medicine and the rise of male midwifery: medical knowledge required mechanical knowledge and skill; women were the machines on which to practice these skills.

There was, it seems, nothing spiritual about conception, childbirth, maternity, or early infant care. And yet, I had a hunch that there was something spiritual lingering in this newly mechanical medical world.

I found persistent moral and religious language, for example, in the calls to aid suffering humanity through improved, and male, medical knowledge; in the insistence that mother’s milk is best for a baby, if she will only sacrifice her vanity; and in the description of women’s bodies as “designed” by nature, or the “creator,” for childbirth.

One source in particular, however, was explicit in highlighting the intersection of spirituality and health. In the 1830s, Howard Horton published An Improved System of Botanic Medicine, a three-volume treatise on medicine, treatments, and, finally, “female complaints.” I ordered Horton’s book in the Library of Congress’s Rare Book Room, because I was curious how views might have changed by the 1830s on the American frontier. What I found, however, completely surprised me.

Horton began with a lengthy theory of medical knowledge couched in deep-seated religious—and explicitly Protestant—discourse about common access to medical knowledge. And he extended this democratizing theoretical perspective to his views on women’s knowledge and interventions in matters of their health.

Horton Howard’s Improved System of Botanic Medicine (1836), Title Page. Photo by Philippa Koch

Horton’s work is, on the one hand, typical of the healing movements that emerged in the first half of the nineteenth century, movements that pushed back against the “heroic” medical interventions that had become widespread in medical education and practice. These interventions included, for example, the use of toxic mercury-based remedies and aggressive bloodletting. Two of the most well-known movements of this era were Thomsonian medicine and Grahamism, both of which focused on gentler and more accessible remedies like steam baths, herbal treatments, diet, and exercise.

Howard Horton’s life and medical career were rather meandering, which was not uncommon in his time. A North Carolina Quaker, he pursued formal medical education in his youth before becoming a land agent and moving to the Northwest Territory. He returned to the study of medicine, however, after his daughter died in a cholera epidemic in 1825. Horton witnessed with wonder the “botanical approach,” which was based in Thomsonian medicine, during the epidemic and became a follower. He eventually distanced himself, however, from Thomsonian medicine and pursued his own botanical observation and collection alongside William Hance. His curiosity was extensive; he was fascinated with “Indian remedies,” which, he informed his readers, he “procured…at considerable expense.”

Democratizing Medicine

Horton’s botanical system seems also to be rooted in a longer tradition calling for a democratized medicine. Almost one hundred years prior, in 1747, the Methodist John Wesley wrote a book on medicine, Primitive Physic, that exhorted readers to rescue medicine from the hands of profit-driven physicians and apothecaries, men who had sought to make both medical theory and treatment so complex as to be inaccessible to the common person. Wesley’s fervor was based on his theological understanding of medicine. He believed it had been providentially designed by God to be passed down, generation to generation, to alleviate suffering. University medicine and the ever-more complex medical treatments and medicine had corrupted this God-ordained order.

Horton was, like Wesley, horrified by the state of medicine in “the civilized world,” which he deemed “too dependent upon the professors of medicine.” He opened his book with a succinct statement of his goal: “Our grand leading object will be, to simplify the theory and practice of medicine, so as to adapt both, as far as practicable, to the common capacity of families; thereby enabling them, in most cases, to become their own physicians.” Medicine belonged to everyone. Every family should be their own doctor.

So far, so Wesley. But Horton then made explicit a parallel that Wesley did not. Along with a few other medical writers and physicians, including Thomas Ewell and John Brown, Horton linked contemporary medical practice with Roman Catholicism—as imagined by Protestants. Physicians and universities, he argued, were like Catholic priests. They created an aura of “mystery” around medicine, and their “darkening counsel” and “despotic sway” kept humanity in “ignorance” and in a “thralldom of medical bondage.”

Echoing the Protestant call for vernacular bibles and a widespread literacy, which would allow direct engagement with those bibles, Horton argued that medical knowledge “should be as universally disseminated as the knowledge of the bible or of religion.” People should not have to go to a doctor for an easily treatable sickness “any more than they are necessitated to go to the clergy for a knowledge of the scriptures or the means of salvation.”

An Uncommon Defense of Women’s Medical Practices

Horton was appalled that all people did not have a basic knowledge of the human body, and this was especially a problem, he believed, for women. He therefore directed his third volume, on female complaints, to be bound separately from the other two. He explained this binding choice in part by referring to the need for modesty and delicacy. But Horton was also straightforward about his goals for women’s knowledge of their body: “We wish them to study and understand it.” He went on to offer detailed discussions of women’s anatomy, menstruation, conception, gestation, childbirth, and diseases specific to women.

Horton’s defense of women’s knowledge and capability stands out—and, for the researcher, is a breath of fresh air. For much of the previous century, male midwifery manuals had argued that women’s “traditional” medical practices were flawed, superstitious, and not based in proper anatomical and physiological study.

Horton still blamed women, in some ways, for their lack of understanding of their own bodies. On menstruation, for example, he criticized some mothers of “criminal neglect” in their failure to educate their daughters on a matter “so intimately connected with her earthly happiness.” He could imagine no “rational excuse” for such ignorance.

Horton saw no purpose, however, in disparaging women or ridiculing their modesty in not seeking male practitioners. The real problem, he surmised, was the newly ascendant male medical authorities, who insisted they were the gateway to good health.

One of the plates from Horton’s book, depicting one variation of fetal position at childbirth. Photo by Philippa Koch.

For Horton, health was critically important to human happiness, but it was actually a matter “of so much simplicity.” He had little patience for the medical men and their priest-like arrogance in the simple yet essential pursuit of human health. He wanted women, like men, to “think and understand and act for themselves; and be dependent no further than necessary upon others.” His botanic system can be read as a call to a priesthood of all believers, women and men, in the pursuit of health.

Religion, Medicine, and Theories of Knowledge

The Library of Congress offers invaluable resources for researching the intersection of health and spirituality. These fields are often considered at odds, and studying their connection is sometimes seen as, simply, odd in itself. (Just last week a physician looked completely bewildered when I told him I teach courses on religion and medicine. “What is there to teach!?” he exclaimed.)

Horton’s text is a powerful reminder of how religious views shape not only ideas of modesty, diet, embodiment, and medical ethics, but also theories of knowledge. The idea of a lay knowledge of medicine is older than the history of Protestantism, to be sure, but on the early-nineteenth-century American frontier, Howard Horton defended his system of medicine and women’s right to medical knowledge by laying claim to long-standing Protestant arguments against priestly authority, privilege, and mystery and in favor of individuals and their potential to secure their own salvation—and health.


  1. Thank you for this information. I found it very interesting. I too wish I knew more about how to diagnose and take care if smaller ailments. Also your article shines a light on how and why our medical and insurance systems operate the way they do now. Personally I’ve found that Ayurvedic medicine has some of the tools that he suggests all families have access to. Unfortunately I grew up in a world treated by Western medicine and it’s hard to change at a late age.

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