Alice Hamilton and the Development of Occupational Medicine
Dedicated September 21, 2002, at the Jane Addams Hull-House Museum in Chicago, Illinois.
Alice Hamilton helped make the American workplace less dangerous. In her quest to uncover industrial toxins, Hamilton roamed the more dangerous parts of urban America, descended into mines, and finagled her way into factories reluctant to admit her. Hamilton was a pioneer who became a leading expert in chemical health and safety.
Nothing in Alice Hamilton’s early life suggested her future as a 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 had little influence on 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 4,500 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 Flexner, 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.
—Alice Hamilton, Exploring the Dangerous Trades: The Autobiography of Alice Hamilton (1943)
Alice Hamilton’s decision to live at Hull-House enabled her to participate in a great social movement. As Hamilton wrote in her autobiography during the Second World War “we had more faith in human nature, we really believed in a steady progress of mankind, we never dreamed that the pendulum would swing back and an age of barbarism would return.” The first settlement, Toynbee Hall, was founded in London in 1884 with the intention of having university men “settle” in slums to help residents overcome poverty and misery and, in turn, to learn about “the real world” from the slum dwellers.
The settlement concept quickly spread to the United States and by 1910 there were over 400, most located in large cities. Initially, settlements were funded by donations and residents paid for room and board. Women led many of the American settlements, and many of them viewed the settlements as vehicles for social research and reform. In big cities, settlements tended to be located in ethnically diverse areas, where they helped immigrants adjust to life in a new land.
Jane Addams and Ellen Gates Starr founded Hull-House, the third American settlement and the first with men and women residents, in 1889 on Halsted Street on Chicago’s Near West Side. The residents of Hull-House formed an impressive group, but it was Jane Addams who best articulated the theory and function of the settlement and the relationship between the middle-class residents and the poor of the neighborhood, the city’s 19th Ward. According to Addams, Hull-House gave the well educated a sense of purpose and a chance to use their learning in a socially beneficial way. In turn, the poor received educational benefits and social services otherwise unavailable, and immigrants found in the settlement an institution that respected and cultivated their customs.
The residents of Hull-House lived in a sea of poverty, disease, and misery. “The streets are inexpressibly dirty,” Addams wrote in Twenty Years at Hull-House “the number of schools inadequate, sanitary legislation unenforced, the street lighting bad, the paving miserable and altogether lacking in the alleys and smaller streets, and the stables beyond description. Hundreds of houses are unconnected with the street sewer.” On those streets, English was not often heard, as the 19th Ward was home to Italians, Irish, Jews, Greeks, and many other ethnic groups.
Hull-House was responsible for many Chicago firsts: first public baths, first public playground, first public kitchen, first college extension courses, first public swimming pool, and first gymnasium for the public. Hull-House sponsored the first little theater in the United States, in keeping with Addams view that beauty and culture should be available to everyone. Hull-House residents conducted investigations of family income, school truancy, sanitation, tuberculosis, cocaine distribution, infant mortality and many other issues affecting the health and safety of the community. The settlement ran a kindergarten and nursery, a music school and an art gallery. It spawned the Juvenile Protective Association and contributed to founding the world’s first juvenile court. Hull-House residents taught English and citizenship and organized the Immigrants’ Protective League to assist immigrants with legal problems. Hull-House also helped organize labor unions at a time when many middle- and upper-class Americans opposed such organizations.
Alice Hamilton may have found living at Hull-House congenial since she came from a large, closely-knit family in which women played a dominant role. Like many of the residents of Hull-House, Hamilton had a day job, in her case teaching at a medical school, so participation in settlement activities was limited to evenings and weekends. Her greatest contribution was opening a well-baby clinic, which soon ministered to children up to eight years old. The clinic’s main function was providing baths for the children. She also advised the mothers on diet, urging only milk until their teeth came in. But she soon realized that the solid food the mothers gave their babies did no harm, adding, “those Italian women knew what a baby needed far better than my Ann Arbor professor did.” She tried without much success to educate the mothers about the dangers of contagious diseases.
In 1902, when the Women’s Medical School of Northwestern University closed, Alice Hamilton accepted a position as bacteriologist at the newly opened Memorial Institute for Infectious Diseases, a post that gave her the chance “to bring my scientific training to bear on a problem at Hull-House.” Returning that fall from her customary summer vacation on Mackinac Island, Hamilton found Chicago in the grip of a severe typhoid epidemic, with the area around Hull-House the hardest hit. Hamilton prowled about the neighborhood looking for local conditions to explain the high number of typhoid cases in the 19th Ward. She noted numerous outdoor privies, broken plumbing, standing water, and swarms of flies. She soon concluded that the flies were feeding on typhoid-infected excrement and then lighting on food. Tests on flies captured near filthy water closets and in kitchens indicated the presence of the typhoid bacillus, apparently confirming the link between the insects, contaminated water and inadequate sewage disposal.
In her autobiography Hamilton wrote “I am sure I gained more kudos from my paper on flies and typhoid than from any other piece of work I did.” But she soon discovered that the flies had little to do with the spread of typhoid in the district. The real culprit was a broken water main that spewed sewage into water pipes, a cause more discreditable to the Chicago Board of Health, which had covered up the break. “The truth,” Hamilton stated, “was more shocking than my ingenious theory…. For years, though I did my best to lay the ghosts of those flies, they haunted me and mortified me.”
With the typhoid probe behind her, Hamilton began to focus on issues of public health. Her examination of the causes of tuberculosis made the connection between unsanitary conditions, fatigue from fourteen-hour workdays, and the disease, an early example of her professional interest in the link between occupation and illness. Living in a working-class district sparked Hamilton’s curiosity about industrial diseases, especially those plaguing women in the workplace, and in the first decade of the twentieth century she began to concentrate on the study of industrial toxicology.
Hamilton lived full-time at Hull-House until 1919, when she accepted a post at Harvard Medical School. Until 1935, Hamilton taught only the fall semester of each year so that she could live at Hull-House for several months in the spring. When Jane Addams died in 1935, Hamilton was mentioned as a possible successor, but she declined.
The United States underwent rapid industrialization after the Civil War and by the end of the nineteenth century it had become the world’s foremost industrial nation. The explosive growth occurred in many areas: manufacturing, mining, transportation and commerce. Rapid industrialization was made possible by abundant resources, available and cheap energy, emerging technology, an expanding transportation system, capital accumulation for investment and a ready supply of cheap labor augmented by an influx of immigrants. Industrialization resulted in lower prices for manufactured goods and higher living standards.
But industrialization came at a cost. It produced vast disparities in wealth and frequent cycles of boom and bust. For workers, rapid industrialization meant low wages, job insecurity and dangerous working conditions. Industrial accidents and illnesses such as respiratory diseases became more and more common. Those who worked in the “dangerous trades” were at particular risk. In manufacturing and related fields, workers handled poisonous chemicals, breathed toxic dust and fumes, seldom washed their hands before eating, and wore clothing covered with poisons. Mercury poisoning in the felt hat industry caused uncontrollable jerking of arms and legs and mental illness: hence the phrase “mad as a hatter.” Those who made matches were subject to “phossy jaw,” an industrial disease that resulted from breathing fumes of white or yellow phosphorous which could penetrate the jawbone. The complications were severe, sometimes resulting in removal of the lower or upper jawbone, or both.
Lead, which enters the body slowly, was the most widely used toxic chemical in early twentieth-century industry. Workers in many industries were at risk of lead exposure, including those in the pottery and enamel trades, paint manufacturing, lead smelting and refining, and storage battery manufacturing. No one knew the precise extent of lead poisoning in the years before the First World War, but the toll in illness and even death was great. (Investigators were then unaware of the danger of lead poisoning in the general population, especially among children). Repeated small doses left no immediate symptoms, but since the body only slowly eliminates lead, the metal in time accumulates in sufficient amounts and causes severe poisoning. In acute cases, lead poisoning resulted in colic and convulsions. Lead harmed the nervous system, causing paralysis, most obvious in what was called wrist drop. In cases of chronic lead poisoning, victims suffered from loss of appetite and weight, constipation, high blood pressure, anemia, abdominal pain, fatigue and premature senility. Pregnant women ran the risk of miscarriages and stillbirths.
Controlling the risks proved difficult. Many forms of industrial poisoning were not easy to recognize since it often took years for the most toxic effects to occur. Few studies of occupational diseases existed, leaving both employees and employers ignorant of the dangers from chemicals in the workplace. Few factories employed doctors to monitor the health of their workers. Many of the more dangerous trades employed unskilled labor fearful of their job security if they complained about unsafe conditions. And many of these workers were immigrants who often did not speak English, making it difficult for them to appeal to the appropriate authorities.
Alice Hamilton’s formal investigations into the connection between occupation and disease began in 1910 when she was appointed by Illinois Governor Charles Deneen to head a survey on industrial illness in Illinois. Little was known about industrial toxicology, so the members of the commission had to figure out what trades to explore and to devise a methodology. They decided to concentrate on occupational poisons in trades known to be dangerous. In addition to managing the survey, Hamilton studied lead, the most widely used industrial poison. Others reported on arsenic, zinc smelting, brass manufacturing, turpentine and carbon monoxide.
Hamilton and her assistants visited factories, read hospital records and interviewed labor leaders and druggists to uncover instances of lead poisoning. Hamilton wrote in her autobiography, “I was put on the trail of new lead trades.” She discovered more than seventy industrial processes in which workers were exposed to lead poisoning. In addition to the more readily known industries where lead exposure was high, industries such as painting, enamelware and pottery, Hamilton found some less obvious ones, including polishing cut glass and wrapping cigars in “tinfoil,” actually made from lead.
She proudly relates one example in her autobiography, Exploring the Dangerous Trades, to demonstrate the difficulty in tracking down instances of lead poisoning and the unexpected industries where it occurred. In one hospital she found a Polish worker suffering from colic and double wrist drop. He said he worked in a sanitary-ware factory, applying enamel to bathtubs. The existing literature made no mention of lead in the paint used to make bathtubs and the managers of the factory, after assuring Hamilton that lead was not used, let her inspect the workroom. Puzzled, she tracked down the victim who told her she witnessed only the final touching up of the bathtubs. The real work occurred at another factory where “enameling means sprinkling a finely ground enamel over a red-hot tub where it melts and flows over the surface.” A specimen a worker gave her contained as much as 20 percent soluble lead. “Thus I nailed down the fact,” Hamilton wrote, “that sanitary-ware enameling was a dangerous lead trade in the United States.”
The Illinois report on industrial disease proved the connection between occupation and illness. As a result, the Illinois legislature in 1911 passed an occupational disease law requiring employers to implement safety procedures limiting workers’ exposure to dangerous chemicals, to provide monthly medical examinations for workers in dangerous trades, and to report illnesses to the Department of Factory Inspection, which had prosecutorial authority. Hamilton’s work in Illinois caught the attention of Charles Neill, the Commissioner of Labor (the United States Bureau of Labor was a part of the Department of Commerce until 1913). Neill asked her to do nationally what she had done in Illinois, first in the lead trades, then in other poisonous occupations. Hamilton described the limitations under which she worked: “I had, as a Federal agent, no right to enter any establishment — that must depend on the courtesy of the employer. I must discover for myself where the plants were, and the method of investigation to be followed. The time devoted to each survey, that and all else, was left to my discretion. Nobody would keep tabs on me, I should not even receive a salary; only when the report was ready for publication would the government buy it from me at a price to be decided on.”
Hamilton accepted Neill’s offer “and never went back to the laboratory.” Convinced that she would never be anything but “a fourth-rate bacteriologist” and that she had “no scientific imagination,” Hamilton never doubted her decision to focus on industrial toxicology, which she described as “scientific only in part, but human and practical in great measure.” Moreover, the job meant she could continue to live at Hull-House, which remained her base even as she traveled the country investigating the dangerous trades.
Hamilton began her work for the federal government by investigating white lead, commonly used as a paint pigment. Building on what she learned while conducting the Illinois survey, Hamilton looked for lead dust and lead fumes since she was convinced the danger for workers came from breathing air laden with the toxic chemical, and not from ingesting lead. Already Hamilton employed the techniques of “shoe-leather epidemiology” that marked all her probes: the careful and extensive use of hospital records to demonstrate the connection between specific illnesses and occupations, and the thorough investigation of factories to learn which industrial processes used dangerous chemicals. Hamilton could not force her way into factories, but could only request entry. Few denied her, and once inside she looked for evidence of lead dust and fumes and inquired about the degree of sickness.
Hamilton’s investigation of lead poisoning occurred before reliable diagnostic tests existed, so she relied on a self-imposed rigid standard. “I would not accept a case as positive,” she wrote, “unless there was a clear ‘lead line’… a deposit of black lead sulphide in the cells of the lining of the mouth, usually clearest on the gum along the margin of the front teeth, and it is caused by the action of sulphureted hydrogen on the lead in these cells, the sulphureted hydrogen coming from the decaying of protein in the food in the mouth.” This was the standard she employed as she probed lead poisoning among workers in smelting, enameling, painting and printing.
Hamilton was not content to merely reveal the extent of lead poisoning in American industry. Armed with the information she gathered, Hamilton personally tried to persuade factory owners and managers to remedy dangerous conditions. A lifelong dread of conflict made this difficult for Hamilton. But, perhaps owing to her Victorian upbringing, Hamilton was convinced that people of goodwill, once aware of the facts, would do the right thing. She wrote of an instance of this in her autobiography when she confronted Edward Cornish of the National Lead Company and told him that his workers were being poisoned. Cornish was “both indignant and incredulous” at first, but when she presented him with twenty-two cases of severe lead poisoning he reformed his plants by instituting dust and fume prevention by techniques never before used. Hamilton also convinced Cornish to employ doctors to conduct weekly inspections of his workers.
During the First World War Hamilton conducted studies on the dangers of toxic chemicals in the burgeoning war industries. Because of the need for explosives, factories sprang up to produce TNT, picric acid, mercury fulminate and many other substances. Her reports on the dangers in war industries led to the adoption of many safety procedures, and she later claimed, with some irony given her anti-war activism, that the war years helped make industrial toxicology a respectable field of study. There was also some irony in her reluctance to overtly protest the war since she wanted to continue working for the Department of Labor.
Her biographer, Barbara Sicherman writes in Alice Hamilton: A Life in Letters: “By 1915 Alice Hamilton had become the foremost American authority on lead poisoning and one of a handful of prominent specialists in industrial disease.” She may not have been the first or the only person studying occupational medicine, but she was probably its only fulltime practitioner. So when the Harvard Medical School began a program of industrial hygiene, Hamilton was the obvious choice for appointment as assistant professor of medicine. In 1922, she moved to the School of Public Health, launched that year by Harvard. She accepted the appointment at Harvard on condition that she teach only one semester a year so that she could continue her field studies. In 1925, she wrote the first text in the field, Industrial Poisons in the United States, and in 1934 she published Industrial Toxicology. Over the years, she studied aniline dye, carbon monoxide, mercury, benzene and other toxic chemicals, continuing to issue reports for the Department of Labor on the dangerous trades.
After her retirement in 1935, Hamilton conducted a study of the poisons used in making viscose rayon. This new industry used two dangerous chemicals: carbon disulfide, which poisoned the central nervous system and led to mental disease, loss of vision and paralysis; and hydrogen sulfide, a powerful asphyxiating toxin. Hamilton first encountered carbon disulfide in 1914 when she studied rubber making, and she later reported its use in the manufacture of viscose rayon. Despite its wide use in Europe, carbon disulfide received little attention in the United States, but Hamilton became worried in the 1930s when she received reports of serious illnesses among viscose rayon workers. She persuaded the Department of Labor to investigate and to appoint her chief medical consultant. The results of the study were published in Occupational Poisoning in the Viscose Rayon Industry. It was Hamilton’s last investigation, and she was able to write in her autobiography that “control of this dangerous trade was slow in coming but when it came it was astonishingly rapid and complete.” Viscose rayon workers, like thousands of workers in other dangerous trades, could thank Alice Hamilton for helping to control chemical toxins in the workplace.
Alice Hamilton’s move into Hull-House in 1897 marked an intellectual and political milestone in her life for three reasons. First, Hull-House brought her into the orbit of social activists and reformers like Jane Addams and the hundreds of other residents and visitors who passed through the settlement in the years Hamilton lived there. Second, living and working among the poor and the immigrants in Chicago helped turn Hamilton into a social activist, as did her later professional investigations into occupational diseases. And third, while Hull-House may not have been geographically far from her upbringing in Fort Wayne, Indiana, the two were socially and politically worlds apart. Her parents’ politics centered on a commitment to free trade and individual liberty and a distrust of the lower classes, immigrants and urban America. The social solutions and collective action at the core of settlement life were anathema to the Fort Wayne Hamiltons.
In her early years at Hull-House, Hamilton focused on her well-baby clinic and on her professional work: first in teaching and later the Illinois and federal investigations in industrial toxicology. But that changed with the opening shots of the First World War when Hamilton joined with other activist women to protest the war. In 1915 Hamilton along with about fifty other Americans, led by Jane Addams, attended the International Congress of Women at The Hague in the Netherlands. More than 1,100 women from warring and neutral nations attended the conference. The participants had little political clout, since few women possessed the right to vote and those from belligerent nations risked prosecution as traitors. The meeting backed a call for a conference of neutral nations that would offer to mediate between the opposing sides, and it endorsed creation of an international court, a world organization of nations, freedom of the seas and national self-determination.
In 1919 Hamilton was back in Europe to attend a second women’s congress, this one in Zurich, Switzerland. This congress condemned the Versailles Treaty, predicting it would create conflict among European ethnic groups that would lead to future wars. It criticized the harsh victor’s peace and the economic burden being imposed on the defeated countries as well as violations of self-determination in the carving up of the map of Europe. The delegates also called for immediate distribution of food to the millions of starving Europeans.
Hamilton toured occupied Belgium in 1915 and some of the famine ravaged regions of Europe in 1919. She wrote movingly of Belgium “under the heel of the conqueror.” In her autobiography she noted that “since then I have been in Soviet Russia and Hitler’s Germany and have learned to accept without surprise the atmosphere of suspicion and of underlying fear… but then it was all so new as to be unbelievable.” In 1919 a tour of defeated Germany left her with a succession of pictures of starvation, as seen in crèches and kindergartens and schools, in hospitals and sanatoria for the tuberculous, and in outdoor day camps for boys and girls.” In a letter to her cousin Jessie Hamilton (quoted in Barbara Sicherman’s Alice Hamilton: A Life in Letters).she wrote, “the stories of the starvation of children are bad enough, but, perhaps because I have never had children but did have Mother, that I feel even more the starvation of the old.”
Hamilton wrote in her autobiography that in the two decades after the First World War “I never wavered in my attitude toward war.” But two visits to Germany in the 1930s, where Hamilton witnessed Nazi tyranny and anti-Semitism, led to a change in view. Writing in 1943, “in the third year of this most terrible of all wars, I am among those who believe we are right in taking up arms on the side of the United Nations. As has so often happened to me, the change in my views has come slowly and almost unconsciously.” Hamilton found it possible to support U.S. entry into the Second World War because little of the nationalism and jingoism that marked the earlier war appeared in the 1940s. Indeed, to her it was the anti-war movement that now seemed “narrow and nationalistic” and that if America stayed out of the war “it would not be for generous motives but for selfish ones, and that would be very bad for our national souls.”
During her long life, Hamilton spoke out on many controversial issues, often on the losing or unpopular side. In the 1920s, when she lived in Boston while teaching at Harvard University, Hamilton became involved in the Sacco-Vanzetti case, a symbol for many of the intolerance in post-war America toward immigrants and of defects in the justice system. Hamilton never met Nicola Sacco or Bartoleomeo Vanzetti, political anarchists convicted and sentenced to die for two murders in Massachusetts. The case dragged on for many years, and on August 22, 1927, Hamilton, along with five prominent men, met with the governor of Massachusetts in a failed last-ditch effort to win a stay of execution.
After the Second World War, while in her long retirement in Hadlyme, Connecticut, Hamilton kept up a drumbeat for social justice. Never shy about reconsidering her views, Hamilton in the 1950s reversed her objection to the Equal Rights Amendment when she was persuaded it would not undermine protective legislation for women in the workplace, for which she had long fought. In these years Hamilton worked for the protection of civil liberties as she became increasingly concerned that the Cold War conflict with the Soviet Union abroad threatened freedom at home. She signed numerous petitions and frequently wrote her congressmen or local newspapers, activities that found their way into a file the FBI kept on her. But she remained undaunted and continued to protest U.S. support for repressive but anticommunist regimes abroad, such as Nationalist China and South Korea, while advocating recognition of the People’s Republic of China.
A civil libertarian throughout her life, Hamilton worried that congressional investigations during the Cold War into alleged communist subversion and calls for loyalty oaths were undermining constitutionally guaranteed liberties. She signed an appeal to President Truman, urging him to commute the death sentences of Ethel and Julius Rosenberg, convicted of espionage in aiding the Soviet Union to develop an atomic bomb. She opposed the McCarran-Walter Act of 1952 that empowered the Department of Justice to deport immigrants and naturalized citizens believed to have engaged in subversive activities. And she protested the McCarthy anti-communist “witch hunts” of the 1950s. In the 1960s, when she was in her nineties, Alice Hamilton protested U.S. involvement in the Vietnam War.
The American Chemical Society dedicated the pioneering work of Alice Hamilton in industrial toxicology a National Historic Chemical Landmark on September 21, 2002. The plaque commemorating the event reads:
In 1897, Dr. Alice Hamilton (1869-1970) came to Hull-House, a social settlement founded to address the needs of immigrants living on Chicago’s Near West Side. Through living and working in the Hull-House neighborhood, she identified occupational diseases plaguing those who worked in the “dangerous trades”: rubber, dyes, lead, enamelware, copper and mercury production, and explosives and munitions. Collaborating with the U.S. Department of Labor, Hamilton documented the occupational diseases from which these workers suffered. Her reports on the effect of lead on industrial workers, particularly women, established her as a leader in the field of chemical health and safety.
Adapted for the internet from “Alice Hamilton and the Development of Occupational Medicine,” produced by the National Historic Chemical Landmarks program of the American Chemical Society in 2002.
American Chemical Society National Historic Chemical Landmarks. Alice Hamilton and the Development of Occupational Medicine. http://www.acs.org/content/acs/en/education/whatischemistry/landmarks/alicehamilton.html (accessed Month Day, Year).
—Alice Hamilton, Exploring the Dangerous Trades: The Autobiography of Alice Hamilton (1943)