In the early twentieth century, controversies erupted when the children of parents who rejected scientific medicine as a tenet of their faith died of medically treatable conditions. Criminal trials brought parents’ decisions in caring for their little ones under the glare of public scrutiny, and the fraught discourses that surrounded them shifted concerns about children’s physical welfare beyond the walls of the private household. Throughout the remainder of the century, medical neglect cases rendered the bodies of children into sites of contention as broader medical and legal developments converged, and indeed collided, to produce these periodic controversies. This book examines religious-based medical neglect as a historical phenomenon that reflects changing social constructions of childhood in the United States.
By the last decades of the nineteenth century, an evolving understanding of children as distinct beings with particularized needs for physical care had begun to inform a broad spectrum of thinking well beyond the medical school lecture hall. The specialty of pediatrics emerged in the 1880s and evolved over the following decades in tandem with a vigorous child welfare movement that brought unprecedented public attention to matters concerning children’s physical well-being. As medical historians Alexandra Minna Stern and Howard Markel have noted, campaigns to improve children’s health rendered infant and childhood mortality rates into gauges by which to measure the nation’s social progress. The new laboratory sciences, particularly bacteriology, revolutionized the theory and practice of public health and held out the promise that a range of deadly childhood diseases could be conquered if responsible adults became informed about, and assiduously followed, the precepts of scientific medicine. Advocates of the “new public health” urged modifications in children’s immediate environments while physicians urged parents, particularly mothers, to monitor their children’s bodies closely, remaining alert to any signs indicating possible dangers and seeking out the services of trained and licensed medical practitioners should a child’s illness require professional intervention. Among the most dramatic developments of the era was the identification of Corynebacterium diphtheriae as the cause of diphtheria in 1884 by bacteriologists Edwin Klebs and Friedrich Löffler, followed by the discovery of diphtheria antitoxin by Emil von Behring in 1901. These breakthroughs occurring in German laboratories came at a time when diphtheria was a leading cause of death for American children under the age of fourteen. Historian Evelynn Maxine Hammonds has argued that the success of early twentieth-century campaigns to control the childhood scourge of diphtheria marked a critical moment in securing broader social authority for practitioners of scientific medicine in the United States. Not surprisingly, then, some of the earliest religious-based medical neglect controversies involved parents’ refusal to secure diphtheria antitoxin for their children who were infected with the disease. 1
An increasingly medicalized view of children’s welfare also found its way into American law, as courts and legislatures re-examined adults’ duties in light of changing understandings of children’s needs for physical care. Legal scholar David S. Tanenhaus has argued that the decades following the Civil War saw courts and lawmakers struggling to balance a notion of children as autonomous actors endowed with rights of their own with their status as vulnerable and dependent beings whose very survival depended upon the protection of the state. Long-established legal doctrines had obligated adults to provide the life-sustaining necessities of food, clothing, and shelter to the children living under their care. A fourth category of necessity was “physic,” a general and rather vague reference to the treatment of illness and injury. Throughout much of the nineteenth century parents had enjoyed an array of choices in meeting this obligation, as a variety of medical sects flourished and folk healing wisdom, supplemented with instructions from popular domestic advice manuals, informed adults’ decisions in caring for children’s health. In the century’s last decades, however, the term “medical attendance” began to replace the archaic “physic” in both statutory language and legal discourse, and courts began to hold adults to more exacting standards in providing for children’s physical care. At the same time, states were raising their education and training requirements for licensing the practice of medicine and, in many cases, prohibiting alternative practitioners such as homeopaths, hydropaths, and botanical healers from advertising themselves as medical doctors. Thus by the end of the nineteenth century, the legal requirement to provide medical attendance to a sick or injured child came to mean securing the services of licensed “regular” or mainstream physicians. Failure to provide professional medical attendance for conditions now regarded as treatable became defined as neglect within newly enacted child endangerment statutes. A few states went further, pursuing charges of manslaughter against parents whose children died of preventable causes without receiving medical attention. But, while scientific medicine held out great promise for saving children’s lives, it could offer no hard-and-fast guarantees and, as tragic incidents in which children died due to contaminated smallpox vaccines and diphtheria antitoxin made clear, its use could cause harm as well as healing. Parents who rejected mainstream medicine pointed to the ongoing uncertainties of science in arguing that their choices placed neither their children’s health nor their lives at risk. Christian Scientists in particular insisted that they did not, in fact, neglect their sick and injured children because they employed the services of metaphysical healers who were trained and certified by their church. Given the ambiguities of scientific medicine, courts struggled to establish bright-line standards for determining adults’ legal obligations in providing medical care to children. 2
Despite the optimism that medical advances inspired, many Americans remained wary of treading too far on the prerogatives that parents had traditionally enjoyed to raise their children as they saw fit. The emergence and rapid growth of new healing religions in the last half of the nineteenth century reflected an underlying uneasiness toward the growing presence of science in American life. Historian T. J. Jackson Lears has argued that antimodernist movements in this period represented a reaction against the rapid acceleration of industrial and urban growth that followed the Civil War. In the 1870s the influential Chicago-based evangelist Dwight L. Moody preached that the precepts of modern science, especially Darwinism’s depiction of evolutionary change as the result of indiscriminate natural selection rather than the guiding hand of a loving God, alienated traditional communities and debased the values of modern life. Biographer Stephen Gottschalk posited that the founder of Christian Science, Mary Baker Eddy, envisioned the church she established in 1879 as the vanguard of a counter-revolution against the “scientific materialism” that had begun to permeate American society. For Eddy, the belief that human beings were both physical and mortal had been reversed by the resurrection of Jesus, an eternal and unchanging truth that had been revealed in scripture but subsequently forgotten by Christians through the ages. The metaphysical healing system upon which Christian Science was founded sought to demonstrate that physical illness, and even death itself, was merely illusory. Stories of successful cures, widely circulated in the Christian Science Journal , enabled Eddy’s church to become the fastest-growing of the new healing religions, attracting adherents throughout the United States. John Alexander Dowie, who in 1896 diverged from the divine healing movement to establish the Christian Catholic Church in Chicago, declared nothing less than a “holy war” against physicians in that city insisting that, while God alone possessed the power to heal the sick and injured, he had been blessed with the gift of channeling that power through the medium of his own hands. Dowie’s publication Leaves of Healing prominently featured stories of miraculous cures, many involving children, attracting worried parents of sick and injured children well beyond the city of Chicago to the divine healer’s activities. Many of those who were drawn to the new healing religions objected to scientific medicine’s privileging of physical over spiritual concerns in child-rearing and worried that the growing social influence of medical doctors undermined parental authority in the home. They also pushed back against the incursion of the state into family matters traditionally circumscribed within the private household. Supporters of spiritual healing insisted that parents’ choice to reject scientific medicine as a tenet of their faith represented the free exercise of religion and thus it must enjoy legal protection as a right delineated in the First Amendment to the United States Constitution. 3
Many faiths, of course, regard science and prayer as complementary, rather than competing, contributors to the healing process. The theme of healing, as Amanda Porterfield has pointed out, is integrally threaded throughout ritual practices and theological precepts that are central to Christianity. In the nineteenth century a number of medical sects, including homeopathy, osteopathy and the variety of practices known as “magnetic” healing, had distinctly metaphysical dimensions that attributed health and illness to obscure forces operating beyond the limits of the physical world. Seventh-day Adventist founder Ellen G. White worked closely with John Harvey Kellogg, a physician and health reformer who headed the highly regarded Battle Creek Sanitarium, and periodically revised her church’s doctrines to comport with new understandings of bodily health and illness that emerged from mainstream medical science. Historian Heather D. Curtis has shown that participants in the mid-nineteenth century’s divine healing movement regularly debated the question of which bodily conditions counted as sickness and differed over when the resort to medical remedies was acceptable to the faith. Two of spiritual healing’s most influential leaders, however, urged their followers to make an unequivocal choice between scientific medicine and spiritual healing. Both Mary Baker Eddy and John Alexander Dowie employed aggressive rhetoric that framed the choice between spiritual and secular healing in stark and belligerent terms, creating a profound dilemma for devout parents whose children became ill or injured. Many sincere believers endured intense physical pain themselves, or allowed their children to suffer, as a sign of their steadfast commitment to these leaders’ teachings.
A historical examination of religious-based medical neglect controversies reveals a more complex narrative than a reductive “science versus religion” model might suggest. Some of the new healing churches’ most vociferous critics were in fact mainline Protestant clergy who warned their congregations against radical faith healing practices that eschewed all forms of medical attendance, especially when those being denied care were children too young or too ill to seek help of their own accord. Nor did proponents of religious healing always present a united front against their secular detractors. Dowie regularly denounced Christian Science as “mere mesmerism,” while Eddy herself took to the courts to protect her proprietary interests from competitors whom she believed had appropriated and distorted her healing system. Both Dowie and Eddy , in fact, maintained a complex relationship with scientific medicine, adopting the title of doctor for themselves at various times in their careers even as they denounced mainstream or “regular” physicians. While he was a divinity student and hospital chaplain at the University of Edinburgh, Dowie had been exposed to instruction at the premier center of western medical education, and he drew upon that experience both to assert his own status as the social equal of licensed physicians in the United States and to denounce the depraved and barbaric practices he claimed to have witnessed in Edinburgh’s anatomy laboratories. In 1881 Eddy founded the Massachusetts Metaphysical College in Boston as a state-chartered institution to train and credential practitioners of her own distinctive healing system. Eddy listed herself as a Professor of Obstetrics in the college’s literature as well as in some early editions of her church’s foundational text, Science and Health with Key to the Scriptures . Despite their attacks on the inefficacies and falsehoods of mainstream medicine both leaders frequently drew upon physicians’ emerging social authority to provide scientific verification that bodily healing had taken place by spiritual means, authentications that regularly appeared in official publications and broadcast their churches’ success stories well beyond their respective headquarters. Finally, despite their confrontational rhetoric Dowie and Eddy each made compromises with scientific medicine and its practitioners when exigent legal and personal circumstances moved them to do so. 4
Mainstream medicine’s response to practitioners of alternative forms of health care was frequently hostile, particularly as the American Medical Association moved to consolidate regular physicians’ dominance over their competitors in the medical marketplace. Nevertheless, the late nineteenth-century’s surge of interest in spiritual healing in the United States resists easy characterization solely as a populist revolt against professional elites and medical monopolies. Historian Michael C. Willrich has traced the complex social and intellectual origins of a robust movement that arose in reaction to compulsory vaccination measures imposed by health authorities in a number of states when smallpox epidemics hit major cities. While followers of spiritual healers were often denounced as ignorant and gullible rubes in big city newspapers and professional medical journals, many of those attracted to the new healing churches were in fact educated, lived in urban areas, and fell along a spectrum of socioeconomic classes. Founded in New England the First Church of Christ, Scientist shared a direct cultural heritage with the secular intellectual movement known as New Thought, a background clearly reflected in the membership of Eddy’s church, which included a large proportion of white, middle-class, and professional congregants, a ...