Wendy Mitchinson. Body Failure : Medical Views of Women, 1900-1950. Toronto, ON: University of Toronto Press, Scholarly Publishing Division, 2013. eBook Collection (EBSCOhost), EBSCOhost (accessed November 19, 2016).
Kerry Peterson (ed.). “It’s Not Society That’s the Problem, It’s Women’s Bodies’: A Historical View of Medical Treatment of Women,” Intersections: Women on Law, Medicine and Technology (Aldershot: Dartmouth Publishing, 1997) 25-48.
Wendy Mitchinson, a historian at the University of Toronto, examined how the medical profession in the first-half of the twentieth century thought about and attempted to deal with women’s bodies. This blog post studies specifically how physicians dealt with cancer in females during this time period, specifically cervical and breast cancer, and how this may reflect larger societal trends in thinking about women’s bodies during this time. Mitchinson argues that physicians tended to view women’s bodies as inherently problematic. “Cervical and breast cancer suggested that women who met their womanly obligations to marry and have children were at risk, as if there was a design flaw in their bodies.” Additionally, physicians seemed to feel a sense of urgency in treating women for cancer, revealing “a sense that the body was guilty until proven innocent,” and they often used drastic measures to eradicate any possibility of the disease.
After infectious diseases came under greater control, cancer took over as one of the greatest risks to mortality, only behind heart diseases. Because cancer was “widespread and deadly,” doctors became very concerned with studying potential causes of the disease. Statistics revealed that women had higher rates of cancer of the “peritoneum, intestines, and rectum,” while “men suffered from cancer of the cheek cavity and from skin cancer.” Sometimes physicians pinpointed a specific gendered activity as being at fault. For example, cancer of the lip was supposedly caused by men smoking. Researchers also observed that age played a factor, as women typically died about ten years younger from cancer than did men. Therefore age and gender predictors helped physicians to create a narrative to identify both risk factors and individuals who might have been more at risk.
Treatments for cancer were largely unknown. Doctors began to perform surgeries and eventually radiation therapies, but even in the 1930s, a speculated treatment for cervical cancer suggested using “fresh human placenta and ovary” and blood transfusion, which was said to cure cancer rates in 25 percent of women when used with other methods. As awareness of the disease spread, women were encouraged to consult their doctors if they suspected symptoms of the disease but many did not for a variety of reasons, including modesty. In 1902 a physician recorded his frustration about the number of women who came in frequently with cervical cancer even though their disease had progressed too far to to be cured. If it was “too late” to treat the disease, then the death of the patient was a “happy release.” Because of lack of knowledge on the causes and treatments of cancer, as well as cultural and personal anxieties, society and the medical field felt a need to warn women to seek treatment early. Because of the prevalence of these messages, society in general also developed great anxiety about cancer in women.
Cervical cancer was supposedly the second most frequent site for cancer in women, according to doctors in 1940. Mortality rates were also high, second only to cancer of the breast. Ironically, “women who conformed to the norms of society–who married and had children, especially those with many children–were most at risk.” Physicians did not question the ability and purpose of the female body to have so many children, but rather criticized it for not being able to do so without also growing cancer. To them it seemed to be an evident “design flaw.” Some physicians suggested that cancer developed in the cervix because of “trauma” there; others suggested emotional causes of this cancer such as “worry about money, illness of husband or children,” deaths, “monotony” in their lives, and “becoming older.” These factors were thought to contribute more to cancer of the uterus, a distinctly female organ, than cancers of other parts of the body, showing the underlying belief that female’s anatomy was perhaps especially susceptible to disease. Doctors also showed their anxiety about women using birth control in the years before and during the 1930s by also assuming it to be another potential cause for cancerous growth.
In treating cancer, if a physician could not determine himself whether or not a woman had cancer, he would send her to a clinic, and “if she refused to go he should inform her relatives.” Women’s bodies were separated from their person; the body was a threat and sometimes both the woman and time were barriers to combating the disease. Doctors began recommending yearly or twice-yearly preemptive cervical checks, with the assumption that the disease was prevalent and needed to be prevented. This reminded women that their bodies were “potential sources of danger.” The internal examination became even more “normal” with the invention of the pap smear in the 1940s. Yet with the regularity of examinations and messages about preventing disease, women were also reminded that their bodies were dangerous. In 1930, H.S. Crossen and R.J. Crossen authored Diseases of Women which prescribed treatment for cancer and reproductive diseases with the presumption of removing as much of the sickly internal organs as possible, still allowing the woman to live. Few questioned the future health of the patient, but some wondered if “marital relations” could survive post-surgery.
In the case of breast cancer, doctors also tended to perceive the disease as related to women’s “essential nature” rather than external factors. Because breast cancer occurred predominantly in women, physicians often looked to women’s bodies as a causal explanation and determined it was their “improper use or nonuse of those bodies that accounted for the development of breast cancer.” For example, while it appeared that breastfeeding was declining, doctors began to determine that women who neglected the “proper” uses of their bodies for feeding their children would be more susceptible to cancer. This gave doctors more reason to endorse breastfeeding. In Canada, researcher John Joseph Cassidy theorized in 1912 that cancer was especially “liable” to parts of the body “which had survived their usefulness,” such as the breasts after menopause. E. A. Keenleyside published that “80 percent of the women suffering from breast cancer had been married and that 70 percent had had children.” However, the medical field reassured society that “It was not marriage per se that was the crucial factor but fertility and its extent.” In the 1930s and 1940s physicians also began to link the female hormone estrogen to cancer, helping to validate the perception that the female body was inherently problematic.
By studying how society and medical officials dealt with and sought to solve the problem of cervical and breast cancers, it is evident that women’s bodies were construed as both inherently flawed and dangerous, and apparently unaware of their own reproductive purposes. The fertility of a woman’s body was still viewed as its primary characteristic and deviating from traditional “uses” of one’s body to reproduce or breastfeed would be detrimental. At the same time, women who did use their bodies for these purposes and developed cancer were evidence that uniquely-female organs were inherently susceptible to disease and flawed.
Even while women were gradually gaining autonomy over their bodies (see posts 1 and 2), this article demonstrates that women were still believed to be inherently weaker and more sickly than men. Women still needed a great degree of guidance to maintain their bodies and to understand them. For women who were now expected to hearken to societal ideals of body shape and race, it is apparent that many felt anxiety about being able to control and maintain their bodies. The medical field apparently felt this way, as regulatory practices and precautions were taken in regards to women’s health that increasingly made her subject to the judgment of a doctor.