James McCune Smith was the first African American to receive a medical doctorate from a university.
Born in 1813 to a poor South Carolina runaway slave who had escaped to New York City, he went on to attend Glasgow University during the 1830s. When he returned to America, he became a leading black physician, a tireless abolitionist, activist and journalist.
McCune Smith led an amazing life. He exposed false medical data in the 1840 American census. He supported women’s suffrage alongside the noted feminist Susan B. Anthony. And he wrote the introduction to Frederick Douglas’s sensational 1855 autobiographical slave narrative, My Bondage and My Freedom.
Now, for the first time, my research has revealed that McCune Smith was also the first African American known to be published in a British medical journal – and that he used this platform to reveal a cover-up by an ambitious medical professor who was experimenting on vulnerable women in Glasgow in the 1830s.
I am a historian of science and medicine. I study how people learned scientific skills and I am especially intrigued by the history of how scientists and physicians made discoveries and how that knowledge then circulated between the academy and the public.
One way to track this process is to compare what students learned in educational settings to how they used their scientific training to solve problems and make decisions later in life. My forthcoming book, Media and the Mind, for example, uses school and university notebooks to reconstruct how students historically learned to create, analyse and visualise scientific data in ways that helped them understand the human body and the natural world when they finished their education.
Several years ago, I decided to investigate the history of how the testimony of hospital patients was transformed into scientific data by physicians. I eventually stumbled across the 1837 case of a young Glasgow doctor who sought to expose painful experimental drug trials that had been conducted on the impoverished women of a local hospital.
That doctor was James McCune Smith. He had written articles detailing how the women of a local charity hospital were being subjected to a painful experimental drug. It was a career changing moment for me because I had not encountered this kind of activism in my previous research on medical education.
Who was this doctor? What led him to speak out? Where did he learn to place his knowledge of science and medicine in the service of equality and justice? Upon closer examination, despite his many accomplishments, virtually nothing had been written about McCune Smith’s time in Glasgow or about his work as a practising physician in New York.
Like the children of many runaway slaves in New York, McCune Smith grew up in Five Points, Lower Manhattan, one of the poorest and most densely populated urban areas of America at that time. Though the state fully emancipated all former slaves in 1827, when McCune Smith was a teenager, discriminatory educational policies, unsanitary living conditions, chronic illness and infectious diseases ensured that the prospects for a free African American teenager in the early part of the 19th century were limited.
Indeed, in an article entitled Freedom and Slavery for African-Americans, published in the New York Tribune in 1844, McCune Smith observed that only six of the 100 boys who attended school with him from 1826 to 1827 were “still now living”. He noted further that they were “all white”.
Though technically “free”, the lives of African Americans in New York during the 1820s and 1830s were marred by the legacy of slavery and discrimination. Runaway slaves were openly hunted in the city’s alleys, streets and wharves. McCune Smith reflected on these events in an essay that he wrote about the life of his school classmate, Henry Highland Garnet.
An abolitionist and Presbyterian minister, Garnet was the first African American to speak before Congress. McCune Smith recalled the trauma experienced by Garnet’s family in 1829 when they were tracked by slave-hunters. They barely escaped by jumping out of a two-story building and hiding in the house of a local grocer. When they returned to their home they found, in the words of McCune Smith:
The entire household furniture of the family was destroyed or stolen; and they were obliged to start anew in life empty-handed.
Despite many challenges, New York’s African Americans founded their own businesses, churches, political associations, printing presses and more. In addition to receiving support and encouragement from a community of relatives and friends, McCune Smith’s path to becoming a doctor was significantly aided by his education at the African Free School.
Older students were taught penmanship, drawing, grammar, geography, astronomy, natural philosophy and navigation. When American universities denied his medical school applications, the free school community played a role in raising funds for him to attend Glasgow University.
After sailing from New York to Liverpool, McCune Smith arrived in Glasgow in 1832. Thanks to maritime trade, it was one of the largest cities in the country and the university’s medical school was one of the best in Europe.
Britain had prohibited the slave trade in 1807 and it fully abolished slavery the year after his arrival in 1833. Though there were not many African Americans in Glasgow, black writers had been operating in Britain since the 1770s. Then, in 1809 Edinburgh University admitted William Fergusson who was from Jamaica and was the university’s first student of African descent.
Though he took medical courses at the university, Fergusson did not stay to complete a medical doctorate. Instead, he received a license from the Royal College of Surgeons in Edinburgh in 1813. He then practised as a surgeon in the British military and eventually became governor of the then-British colony of Sierra Leone. McCune Smith joined the ranks of these torchbearers and became the first African American known to graduate with a BA, MA and medical doctorate from Glasgow University.
By the time McCune Smith began his studies in Glasgow, opposition to slavery had moved beyond the walls of the university. There was a active abolitionist community and it founded the Glasgow Emancipation Society in 1833. McCune Smith, still only an undergraduate, was one of the founding members. After he graduated, a number of black students attended the university over the course of the century.
Despite living in a foreign country, McCune Smith excelled at his studies and received several academic awards. The Glasgow medical faculty placed equal emphasis on scientific rigour and hands-on clinical experience. In addition to learning chemistry, anatomy and physiology from some of Britain’s leading doctors, he witnessed cutting-edge experiments and new medical technologies being demonstrated in his lectures.
He graduated with honours in 1837 and was immediately given a prestigious clinical residency in Glasgow’s Lock Hospital. He worked there alongside the eminent Scottish obstetrician and gynaecologist, William Cumin, treating women who had contracted venereal diseases.
Missing records and racist medical theories
The difficulty in pursuing a project of this nature is that many of the scientific papers and publications of black physicians have been lost to the sands of time. Unlike the many collections that university libraries have dedicated to preserving the legacy of white doctors who were alumni or donors, there is no “James McCune Smith Medical Collection” where scholars can go to study his medical career and scientific ideas.
No one has yet told the full story of how African Americans like McCune Smith became doctors or how they used their knowledge of medical science to fight injustice and prejudice. The hidden histories of these black physicians based in countries spread around the Atlantic Ocean led me to start my current research project on how they used their scientific training to counter the rise of racist medical theories – theories which erroneously suggested that black bodies were physically different from other bodies and could more easily withstand the stress, pain and labour of enslavement.
Though a number of McCune Smith’s articles were republished several years ago, the whereabouts of his personal medical library, clinical notebooks, patient records, office ledgers and article drafts are unknown. Likewise, his manuscript Glasgow diary and letters have been lost. Though aspects of his career have received attention from historians in recent years, a biography of his extraordinary life has not been written.
This was the situation when I discovered his efforts to expose the harmful drug trials that were being conducted on the women of the Glasgow Lock Hospital. The evidence consisted of two articles that he had published during the spring and summer of 1837 in the London Medical Gazette, a weekly journal with articles about medicine and science.
I originally came upon these articles by reading page after page of medical journals housed in the National Library of Scotland in Edinburgh. When I found them, they immediately stood out because they took the testimony of poor female patients seriously. When I realised that McCune Smith was the first African American to graduate from a Scottish university, I could not believe what I had discovered.
Discovering McCune Smith’s articles was momentous because they are the first currently known to have been published by an African American medical doctor in any scientific journal. Scientists in the 19th century published articles for many reasons. Some wanted to popularise their research in a way that advanced their careers. Others hoped their research would benefit the general public.
The fascinating aspect about McCune Smith’s articles in relation to the historical emergence of the scientific journal is that they were published to expose the unethical misapplication of scientific experiments. This means that they offer new insight into how he learned to combine the power of the press with his medical training to fight inequality and injustice in Britain prior to returning to New York.
The story they tell is extraordinary. The events occurred in the spring and summer of 1837 while McCune Smith was serving in the Glasgow Lock Hospital as a resident physician in gynaecology. The hospital was a charity institution set up by the city for impoverished women suffering from acute venereal diseases such as gonorrhoea and syphilis.
After consulting the ward’s records and speaking with the patients, McCune Smith discovered that Alexander Hannay, a senior doctor in the hospital, was treating women suffering from gonorrhoea with an experimental drug called silver nitrate, a compound that a handful of doctors used as a topical treatment for infected skin tissue or to stop bleeding. But it was normally used in low concentrations mixed into a solution, with doctors emphasising that it should be applied with caution and as a last resort.
But Hannay was administering the drug in a solid form, which meant that it was highly concentrated and caused a terrible burning sensation. He fancied this usage to be innovative and was relatively unfazed when his patients repeatedly asked for less painful forms of treatment. After speaking with the women and further consulting the hospital’s records, McCune Smith realised that Hannay was effectively treating the women as guinea pigs – as non-consenting participants – in an experimental trial that involved a very painful drug.
At that time, silver nitrate was a newly available substance and its long-term effects were relatively unknown. There were a handful of military doctors who used it experimentally to cauterise skin ulcers or wounds of soldiers that would not stop bleeding. But some medical books classified it as a poison. Glasgow’s medical students, particularly those who studied with Prof William Cumin, avoided using it on internal organs due to its unknown effects. Instead, when it came to gynaecological cases involving ulcers or infections, students learned to use an alum solution because its effects were generally considered to be effective and less painful.
Hannay went beyond using the silver nitrate on the skin. He applied it to the internal reproductive organs of women, at least one of whom was pregnant. McCune Smith’s article pointed out that the baby subsequently died through complications surrounding a miscarriage. It also intimates that a few women died after the application of silver nitrate. Since the drug’s effect on internal organs was unknown, he believed that that the deaths could not be treated as a separate occurrence.
In addition to being McCune Smith’s superior, Hannay was a medical professor at Glasgow’s newly established Anderson University. The easiest thing for McCune Smith to do was to say nothing. The plight of the Lock Hospital patients would not have been a major concern for many medical men at the time. The patients were impoverished women and most doctors assumed they were former prostitutes.
But McCune Smith’s perspective was different. Unlike his peers, he had spent his early years in New York City witnessing the pain and suffering caused by poverty, inequality and exploitation. So he decided to place his knowledge of medical science in the service of these women.
McCune Smith knew that there were other effective treatments for gonorrhoea. This allowed him to see that Hannay was more interested in bolstering his reputation with a pharmaceutical discovery than helping his patients. But his studies had given him another equally powerful tool – data analysis. His ability to use this tool can be seen in his London Medical Gazette articles. The gazette was a journal of some repute, serving the British medical community as well as physicians based in Europe and America. In his article, he wrote:
The materials of my paper on the subject of gonorrhoea of women were collected whilst I held the office of clerk to the Glasgow Lock Hospital.
He made his case against the experiments by extracting figures from handwritten registers that recorded the condition of patients being treated in the hospital over an entire year. He had learned to collect, categorise, and analyse data in the clinical lectures that were required for graduation. This method was part of the new science of “vital statistics” that used medical data to predict or prevent disease in people, cities and even countries. Known as “medical statistics” today, it was becoming more commonly used in journals that published articles on medical science.
McCune Smith’s articles showed that the drug trials were ineffective and presented an unwarranted risk. They also revealed that Hannay and his team of assistants had attempted to cover up data in the hospital records that damaged their claims about the drug’s efficacy and their position that its side effects were minimal. McCune Smith did not mince his words. He wrote:
By this novel and ingenious mode of recording the Hospital transactions for 1836, [Prof Hannay’s team] keeps out of view the evidence of the severity of the treatment, and the amount of mortality, while, at the same time, the residence of the patients in the house seems shorted, the cost of each diminished, and the treatment made to appear more than usually successful.
Accordingly, he called for the trials to stop immediately. But McCune Smith was not happy to simply cite statistics. He wanted to give these women a voice too. To achieve this, he emphasised the extreme pain that they were experiencing. Their suffering had been played down by those conducting the experimental trials. Hannay even suggested that the women were dishonest and unreliable witnesses.
To counter this suggestion, McCune Smith quoted the women themselves, some of whom said that the drug felt like it was “burning their inside with caustic”. This was strong language. They were effectively saying that the drug felt like a flame being applied to their bodies.
‘Hidden gem’ in library archive
McCune Smith’s decision to use this kind of visceral language on behalf of impoverished women in a scientific article was rare at the time. Nor was it common in the lengthy, fact-laden lectures given at Glasgow’s medical school. So where did McCune Smith learn to write like this? Finding an answer to this question has been difficult because hardly any of McCune Smith’s manuscripts from his Glasgow years are known to have survived. But thanks to a recent discovery that I made with the rare books librarian Robert MacLean in the Archives and Special Collections of Glasgow University, a better picture is starting to emerge.
Based on my previous research on Scottish student notekeeping, I knew that Glasgow University kept handwritten registers of books borrowed by students from its libraries during the 19th century. Luckily, it turned out that McCune Smith’s manuscript library borrowing record did, in fact, still exist. It was a gem that had remained hidden for the past two centuries in the dusty pages of Glasgow’s library registers.
The discovery was historic because it revealed that he definitely took the university’s moral philosophy class. The course was taught by James Mylne and it encouraged students to judge the accuracy of statistical data when making moral decisions. The registers also showed that McCune Smith consulted the Lancet, the leading medical journal of research and reform that promoted the same kind of public health activism evinced in his 1837 Gazette articles.
Finding the student reading record for any historical figure is like striking gold. In McCune Smith’s case it was doubly exciting because so little is known about his intellectual development. In addition to literature relevant to his studies, he checked out several 1835 issues of the Lancet which regularly identified links between pain and maltreatment.
It is likely these accounts inspired him to use a similar approach in his gazette articles. But even the Lancet’s references to pain and cruelty barely addressed the plights of impoverished women, let alone those who had been regularly subjected to experimental drugs. In this respect McCune Smith’s concern for the Lock Hospital patients surpassed the reform agenda promoted by Britain’s most progressive medical journal.
Further investigations have revealed that there were many other black physicians who lived in America in the decades after McCune Smith became a doctor. As revealed in research by the Massachusetts Historical Society, there was, for example, John van Surly DeGrasse. He studied at Bowdoin College in Maine, received a medical doctorate in the 1840s, set up a practice in Boston and became the first African American member of the Massachusetts Medical Association.
There was also Alexander Thomas Augusta, who, despite Virginia laws that banned free blacks from learning to read, was educated by a minister, moved to Toronto and graduated from Trinity College’s medical school in 1856. Notably, both Augusta and DeGrasse served in the union army as physicians with the rank of major during the American Civil War.
After McCune Smith returned to America in the autumn of 1837, he served as a professional role model for African Americans who studied medicine from the 1840s onward. By the time younger black physicians such as DeGrasse and Augusta began their studies, McCune Smith had already opened a practice that served patients from both sides of the colour line and had published several scientific articles. For the rest of his career his name was a frequent byline in articles about health and society published by the African American press, as well as larger newspapers with mixed readership, like the New York Tribune.
An excellent example of McCune Smith’s later medical activism is the collection of articles that he published during the 1840s about the national census. The main issue was that slavery advocates had noticed that the mortality rates of African Americans in northern asylums were higher than those of black people in the southern states. This led them to conclude, erroneously, that freedom somehow damaged their mental and physical health.
Rather than engage with their desire to co-opt convenient data, McCune Smith used his knowledge of medical statistics to skillfully undermine their attempts to find scientific data that fit their discriminatory world view. He conducted his own investigation and proved that the original collection of the figures on site in the northern asylums had been flawed and that, as a result, the data was incorrect and could not be used to accurately determine the health of black asylum patients.
McCune Smith did not stop there. He turned the tables on slavery advocates by transforming the new accurate mortality statistics into a tool that could be used to fight inequality. His 1844 New York Tribune article about the census concluded:
These facts prove that within 15 years after it became a Free State, a portion of the Free Black Population of New York have improved the ratio of their mortality 13.28% – a fact without parallel in the history of any People.
Put simply, the correct data revealed that the health of African Americans unburdened by the deprivation and forced labour of slavery thrived once they left the south and lived lives as free citizens in the north.
McCune Smith’s publications are a significant early chapter in the history of how black activists have worked tirelessly over the past two centuries to disentangle erroneous interpretations of scientific data from discriminatory claims about poverty, gender and race. They provide crucial historical insight into the relationships between race, science and technology that exist today.
In many respects McCune Smith’s desire to locate and publicise correct data about asylum patients built on the approach that he had developed in his articles about the mistreatment of women in Glasgow’s Lock Hospital. He continued to publish articles throughout his career that challenged those who sought to use science to justify discrimination and inequality. In 1859 he even went so far as to challenge former President Thomas Jefferson’s discriminatory racial assumptions when he wrote: “His arrangement of these views is so mixed and confused, that we must depart from it.”
McCune Smith’s activism showed aspiring African Americans that becoming a professional black physician could be more than simply treating patients. For him, being an expert in medical science also included using his training to fight injustice and inequality.
His publications are an indispensable chapter in the American history of science and medicine. But they are an important part of British history too. Because it was in Britain where he first published articles that placed his knowledge of medicine in the service of equality and justice. It was the libraries of Glasgow University – which now has a building named in his honour – and the wards of the Lock Hospital which fed his towering intellect and fired his passion for medical knowledge, as well as the pursuit of justice for the powerless and oppressed.
First published by The Conversation in its new Insights series of long reads
Jackie Kemp says
Brilliant article – thanks xjk