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Brief Contents
PREFACE v

1 Organization of the Human Body 1 14 The Cardiovascular System: Blood 333

2 Introductory Chemistry 21 15 The Cardiovascular System: Heart 350

3 Cells 40 16 The Cardiovascular System: Blood Vessels

and Circulation 369
4 Tissues 67
17 The Lymphatic System and Immunity 405
5 The Integumentary System 93
18 The Respiratory System 429
6 The Skeletal System 111
19 The Digestive System 455
7 Joints 156
20 Metabolism and Nutrition 487
8 The Muscular System 173
21 The Urinary System 503
9 Nervous Tissue 222
22 Fluid, Electrolyte, and Acid–Base Balance 523
10 Central Nervous System, Spinal Nerves, and
Cranial Nerves 238 23 The Reproductive Systems 535

11 Autonomic Nervous System 265 24 Development and Inheritance 565

12 Somatic Senses and Special Senses 276 GLOSSARY G-1

13 The Endocrine System 305 INDE X I-1

vi
 Contents
1 Organization of the Human Body 1 5 The Integumentary System 93

1.1 Anatomy and Physiology: An Overview 1 5.1 Skin 93

1.2 Life Processes 6 5.2 Accessory Structures of the Skin 97
1.3 Homeostasis: Maintaining Limits 7 5.3 Functions of the Skin 101
1.4 Aging and Homeostasis 10 5.4 Skin Wound Healing 102
1.5 Anatomical Terms 10 5.5 Aging and the Integumentary System 104
1.6 Body Cavities 15 Chapter Review 109
Chapter Review 19 Critical Thinking Applications 110
Critical Thinking Applications 20 Answers to Figure Questions 110
Answers to Figure Questions 20

2 Introductory Chemistry 21
6 The Skeletal System 111

6.1 Functions of Bone and the Skeletal System 111

2.1 Introduction to Chemistry 21
6.2 Types of Bones 112
2.2 Chemical Compounds and Life Processes 28
6.3 Structure of Bone 112
Chapter Review 38
6.4 Bone Formation 116
Critical Thinking Applications 39
6.5 Exercise and Bone Tissue 121
Answers to Figure Questions 39
6.6 Divisions of the Skeletal System 122
6.7 Skull: An Overview 124
3 Cells 40 6.8 Unique Features of the Skull 130
6.9 Vertebral Column 132
3.1 A Generalized View of the Cell 40 6.10 Vertebral Regions 134
3.2 The Plasma Membrane 41 6.11 Thorax 137
3.3 Transport Across the Plasma Membrane 43 6.12 Pectoral (Shoulder) Girdle 137
3.4 Cytoplasm 48 6.13 Upper Limb 139
3.5 Nucleus 54 6.14 Pelvic (Hip) Girdle 142
3.6 Gene Action: Protein Synthesis 56 6.15 Lower Limb 144
3.7 Somatic Cell Division 59 6.16 Comparison of Female and Male Skeletons 148
3.8 Cellular Diversity 61 6.17 Aging and the Skeletal System 149
3.9 Aging and Cells 61 Chapter Review 153
Chapter Review 64 Critical Thinking Applications 155
Critical Thinking Applications 66 Answers to Figure Questions 155
Answers to Figure Questions 66

4 Tissues 67 7 Joints 156

4.1 Types of Tissues 67 7.1 Classification of Joints 156

4.2 Epithelial Tissue 68 7.2 Fibrous Joints 157
4.3 Connective Tissue 78 7.3 Cartilaginous Joints 159
4.4 Membranes 86 7.4 Synovial Joints 159
4.5 Muscular Tissue 88 7.5 Types of Movements at Synovial Joints 161
4.6 Nervous Tissue 88 7.6 Types of Synovial Joints 164
4.7 Tissue Repair: Restoring Homeostasis 88 7.7 The Knee Joint 166
4.8 Aging and Tissues 89 7.8 Aging and Joints 169
Chapter Review 90 Chapter Review 171
Critical Thinking Applications 92 Critical Thinking Applications 172
Answers to Figure Questions 92 Answers to Figure Questions 172
vii
viii CONTE NTS

8 The Muscular System 173 12 Somatic Senses and Special

Senses 276
8.1 Overview of Muscular Tissue 173
8.2 Skeletal Muscle Tissue 174 12.1 Overview of Sensations 276
8.3 Contraction and Relaxation of Skeletal 12.2 Somatic Senses 278
Muscle 178 12.3 Olfaction: Sense of Smell 281
8.4 Metabolism of Skeletal Muscle Tissue 183 12.4 Gustation: Sense of Taste 283
8.5 Control of Muscle Tension 185 12.5 Vision 285
8.6 Exercise and Skeletal Muscle Tissue 186 12.6 Hearing and Equilibrium 294
8.7 Cardiac Muscle Tissue 187 Chapter Review 302
8.8 Smooth Muscle Tissue 187 Critical Thinking Applications 303
8.9 Aging and Muscular Tissue 189 Answers to Figure Questions 304
8.10 How Skeletal Muscles Produce Movement 189
8.11 Principal Skeletal Muscles 190
Chapter Review 218 13 The Endocrine System 305
Critical Thinking Applications 220
Answers to Figure Questions 221 13.1 Introduction 305
13.2 Hormone Action 307
13.3 Hypothalamus and Pituitary Gland 309
9 Nervous Tissue 222 13.4 Thyroid Gland 314
13.5 Parathyroid Glands 316
9.1 Overview of the Nervous System 222 13.6 Pancreatic Islets 317
9.2 Histology of Nervous Tissue 224 13.7 Adrenal Glands 322
9.3 Action Potentials 229 13.8 Ovaries and Testes 325
9.4 Synaptic Transmission 233 13.9 Pineal Gland 325
Chapter Review 236 13.10 Other Hormones 325
Critical Thinking Applications 237 13.11 The Stress Response 326
Answers to Figure Questions 237
13.12 Aging and the Endocrine System 327
Chapter Review 330
10 Central Nervous System, Spinal Critical Thinking Applications 332
Nerves, and Cranial Nerves 238 Answers to Figure Questions 332

10.1 Spinal Cord Structure 238 14 The Cardiovascular System:

10.2 Spinal Nerves 242
10.3 Spinal Cord Functions 243
Blood 333
10.4 Brain 244
14.1 Functions of Blood 333
10.5 Cranial Nerves 259
14.2 Components of Whole Blood 334
10.6 Aging and the Nervous System 261
14.3 Hemostasis 342
Chapter Review 263
14.4 Blood Groups and Blood Types 344
Critical Thinking Applications 264
Chapter Review 348
Answers to Figure Questions 264
Critical Thinking Applications 349
Answers to Figure Questions 349
11 Autonomic Nervous System 265

11.1 Comparison of Somatic and Autonomic Nervous 15 The Cardiovascular System:

Systems 265 Heart 350
11.2 Structure of the Autonomic Nervous
System 267 15.1 Structure and Organization of the Heart 350
11.3 Functions of the Autonomic Nervous 15.2 Blood Flow and Blood Supply of the Heart 357
System 271 15.3 Conduction System of the Heart 359
Chapter Review 275 15.4 Electrocardiogram 360
Critical Thinking Applications 275 15.5 The Cardiac Cycle 361
Answers to Figure Questions 275 15.6 Cardiac Output 362
 CONTENTS ix

15.7 Exercise and the Heart 364 19.8 Small Intestine 470
Chapter Review 367 19.9 Large Intestine 476
Critical Thinking Applications 368 19.10 Phases of Digestion 479
Answers to Figure Questions 368 19.11 Aging and the Digestive System 480
Chapter Review 484
16 The Cardiovascular System: Blood Critical Thinking Applications 485
Answers to Figure Questions 486
Vessels and Circulation 369

16.1 Blood Vessel Structure and Function 369 20 Metabolism and Nutrition 487
16.2 Blood Flow Through Blood Vessels 374
16.3 Circulatory Routes 377 20.1 Metabolism 487
16.4 Hepatic Portal and Fetal Circulations 396 20.2 Metabolism and Body Heat 493
16.5 Checking Circulation 399 20.3 Nutrients 495
16.6 Aging and the Cardiovascular System 400 Chapter Review 501
Chapter Review 402 Critical Thinking Applications 502
Critical Thinking Applications 404 Answers to Figure Questions 502
Answers to Figure Questions 404

17 The Lymphatic System and 21 The Urinary System 503

Immunity 405 21.1 Overview of the Urinary System 503

21.2 Structure of the Kidneys 505
17.1 Lymphatic System 406 21.3 Functions of the Nephron 509
17.2 Innate Immunity 410 21.4 Transportation, Storage, and Elimination
17.3 Adaptive Immunity 413 of Urine 516
17.4 Aging and the Immune System 422 21.5 Aging and the Urinary System 518
Chapter Review 427 Chapter Review 521
Critical Thinking Applications 428 Critical Thinking Applications 522
Answers to Figure Questions 428 Answers to Figure Questions 522

18 The Respiratory System 429 22 Fluid, Electrolyte, and Acid–Base

18.1 Overview of the Respiratory System 429 Balance 523
18.2 Organs of the Respiratory System 430
18.3 Pulmonary Ventilation 438 22.1 Fluid Compartments and Fluid Balance 523
18.4 Exchange of Oxygen and Carbon Dioxide 441 22.2 Electrolytes in Body Fluids 527
18.5 Transport of Respiratory Gases 444 22.3 Acid–Base Balance 530
18.6 Control of Breathing 446 22.4 Aging and Fluid, Electrolyte, and Acid–Base
18.7 Exercise and the Respiratory System 449 Balance 532
18.8 Aging and the Respiratory System 449 Chapter Review 533
Chapter Review 453 Critical Thinking Applications 534
Critical Thinking Applications 454 Answers to Figure Questions 534
Answers to Figure Questions 454
23 The Reproductive Systems 535
19 The Digestive System 455
23.1 Male Reproductive System 535
19.1 Overview of the Digestive System 455 23.2 Female Reproductive System 544
19.2 Layers of the GI Tract and the Omentum 457 23.3 The Female Reproductive Cycle 551
19.3 Mouth 459 23.4 Birth Control Methods and Abortion 554
19.4 Pharynx and Esophagus 462 23.5 Aging and the Reproductive Systems 557
19.5 Stomach 464 Chapter Review 562
19.6 Pancreas 467 Critical Thinking Applications 564
19.7 Liver and Gallbladder 468 Answers to Figure Questions 564
x CONTE NTS

24 Development and Inheritance 565 24.5 Labor and Delivery 577

24.6 Lactation 578
24.1 Embryonic Period 565 24.7 Inheritance 579
24.2 Fetal Period 574 Chapter Review 584
24.3 Maternal Changes During Pregnancy 575 Critical Thinking Applications 585
24.4 Exercise and Pregnancy 577 Answers to Figure Questions 585
 CHAPTER 1
Organization of
the Human Body
You are beginning a fascinating exploration of the human body in
which you’ll learn how it is organized and how it functions. First
you will be introduced to the scientific disciplines of anatomy and
physiology; we’ll consider the levels of organization that charac-
terize living things and the properties that all living things share.
Then, we will examine how the body is constantly regulating its
internal environment. This ceaseless process, called homeostasis,
is a major theme in every chapter of this book. We will also discuss
how the various individual systems that compose the human body
cooperate with one another to maintain the health of the body as
a whole. Finally, we will establish a basic vocabulary that allows us
to speak about the body in a way that is understood by scientists
and health-care professionals alike.

Fuse/Getty Images
Q Did you ever wonder why an autopsy is performed?
You can find out in Section 1.2, Clinical Connection: Autopsy

Physiology (fiz′-ē-OL-ō-jē; physio- = nature, -logy = study of) is the

1.1 Anatomy and Physiology: science of body functions, that is, how the body parts work. Because
An Overview function can never be separated completely from structure, we can
understand the human body best by studying anatomy and physi-
ology together. We will look at how each structure of the body is
OBJECTIVES designed to carry out a particular function and how the structure of
a part often determines the functions it can perform. The bones of
• Define anatomy and physiology. the skull, for example, are tightly joined to form a rigid case that
• Describe the structural organization of the human body. protects the brain. The bones of the fingers, by contrast, are more
• List the 11 systems of the human body, representative organs pres- loosely joined, which enables them to perform a variety of move-
ent in each, and their general functions. ments, such as turning the pages of this book.

Levels of Organization and Body Systems

Anatomy and Physiology Defined
The structures of the human body are organized into several levels,
The sciences of anatomy and physiology are the foundation for similar to the way letters of the alphabet, words, sentences, para-
understanding the structures and functions of the human body. graphs, and so on are organized. Listed here, from smallest to larg-
Anatomy (a-NAT-ō-mē; ana- = up; -tomy = process of cutting) is est, are the six levels of organization of the human body: chemical,
the science of structure and the relationships among structures. cellular, tissue, organ, system, and organismal (Figure 1.1).
1
2 CH APTE R 1 Organization of the Human Body

FIGURE 1.1 Levels of structural organization in the human body.

The levels of structural organization are the chemical, cellular, tissue, organ, system, and organismal.

2 CELLULAR LEVEL

1 CHEMICAL LEVEL

3 TISSUE LEVEL

Smooth muscle cell

Atoms (C, H, O, N, P)
Smooth muscle tissue
Molecule (DNA)
5 SYSTEM LEVEL
Epithelial
and
connective
tissue
4 ORGAN LEVEL
covering

Salivary glands
Mouth
Pharynx

Smooth muscle
Esophagus tissue layers

Epithelial tissue lining

Stomach

Stomach
Liver
Pancreas
Gallbladder (behind stomach)

Large intestine Small intestine

Mark Nielsen

6 ORGANISMAL LEVEL
Digestive system

Q Which level of structural organization usually has a recognizable shape and is

composed of two or more different types of tissues that have a specific function?

1 The chemical level includes atoms, the smallest units of generation to another; hemoglobin, which carries oxygen in the
matter that participate in chemical reactions, and molecules, blood; glucose, commonly known as blood sugar; and vitamins,
two or more atoms joined together. Atoms and molecules which are needed for a variety of chemical processes. Chapters 2
can be compared to letters of the alphabet. Certain atoms, and 20 focus on the chemical level of organization.
such as carbon (C), hydrogen (H), oxygen (O), nitrogen (N), 2 Molecules combine to form structures at the next level of
phosphorus (P), and others, are essential for maintaining life. organization—the cellular level. Cells are the basic structural and
Familiar examples of molecules found in the body are DNA functional units of an organism. Just as words are the smallest
(deoxyribonucleic acid), the genetic material passed on from one elements of language, cells are the smallest living units in the
 1.1 Anatomy and Physiology: An Overview 3

human body. Among the many types of cells in your body are innermost lining of the stomach is an epithelial tissue layer,
muscle cells, nerve cells, and blood cells. Figure 1.1 shows a which contributes fluid and chemicals that aid digestion.
smooth muscle cell, one of three different kinds of muscle cells in 5 The next level of structural organization in the body is the
your body. As you will see in Chapter 3, cells contain specialized system level. A system consists of related organs that have a
structures called organelles, such as the nucleus, mitochondria, common function. Organs join together to form systems similar
and lysosomes, that perform specific functions. to the way paragraphs are put together to form chapters. The
3 The tissue level is the next level of structural organization. Tissues example shown in Figure 1.1 is the digestive system, which
are groups of cells and the materials surrounding them that work breaks down and absorbs molecules in food. In the chapters
together to perform a particular function. Cells join together to that follow, we will explore the anatomy and physiology of each
form tissues similar to the way words are put together to form of the body systems. Table 1.1 introduces the components and
sentences. The four basic types of tissue in your body are epithelial functions of these systems. As you study the body systems, you
tissue, connective tissue, muscular tissue, and nervous tissue. The will discover how they work together to maintain health, protect
similarities and differences among the different types of tissues you from disease, and allow for reproduction of the species.
are the focus of Chapter 4. Note in Figure 1.1 that smooth muscle 6 The organismal level is the largest level of organization. All
tissue consists of tightly packed smooth muscle cells. of the systems of the body combine to make up an organism
4 At the organ level, different kinds of tissues join together to (OR-ga-nizm), that is, one human being. Systems join together
form body structures. Organs usually have a recognizable to form an organism similar to the way chapters are put
shape, are composed of two or more different types of together to form a book.
tissues, and have specific functions. Tissues join together to
form organs similar to the way sentences are put together to Checkpoint
form paragraphs. Examples of organs are the stomach, heart,
liver, lungs, and brain. Figure 1.1 shows several tissues that 1. What is the basic difference between anatomy and physiology?
make up the stomach. The stomach’s outer covering is a layer 2. Give your own example of how the structure of a part of the body
of epithelial tissue and connective tissue that protects it and is related to its function.
reduces friction when the stomach moves and rubs against 3. Define the following terms: atom, molecule, cell, tissue, organ,
other organs. Underneath this covering are the smooth muscle system, and organism.
tissue layers, which contract to churn and mix food and push 4. Referring to Table 1.1, which body systems help eliminate wastes?
it on to the next digestive organ, the small intestine. The

TA B L E 1.1 Components and Functions of the Eleven Principal Systems of the Human Body

1. Integumentary System (Chapter 5) 2. Skeletal System (Chapters 6 and 7)

Components: Skin and Hair Components: Bones and joints

structures associated with of the body and their associated
it, such as hair, nails, cartilages
and sweat glands and oil
Functions: Supports and
glands.
protects the body, provides
Functions: Helps regulate a specific area for muscle Bone
body temperature; protects attachment, assists with body
Cartilage
the body; eliminates some Skin and movements, stores cells that
wastes; helps make vitamin associated produce blood cells, and stores
D; detects sensations such glands minerals and lipids (fats) Joint
as touch, pressure, pain,
warmth, and cold; stores fat
Fingernails
and provides insulation

Toenails

Table 1.1 Continues

4 CH APTE R 1 Organization of the Human Body

TA BLE 1 .1 Components and Functions of the Eleven Principal Systems of the Human Body (Continued)

3. Muscular System (Chapter 8) 4. Nervous System (Chapters 9–12)

Components: Specifically refers to skeletal muscle tissue, which is Components: Brain, spinal cord, nerves, and special sense organs such as the
muscle usually attached to bones (other muscle tissues include smooth eyes and ears
and cardiac)
Functions: Regulates body activities through nerve impulses by detecting
Functions: Participates in body movements such as walking; maintains changes in the environment, interpreting the changes, and responding to the
posture; and produces heat changes by bringing about muscular contractions or glandular secretions

Brain

Skeletal
muscle
Spinal
Tendon cord

Nerve

5. Endocrine System (Chapter 13) 6. Cardiovascular System (Chapters 14–16)

Components: All glands and tissues that produce chemical regulators Components: Blood, heart, and blood vessels
of body functions, called hormones
Functions: Heart pumps blood through blood vessels; blood carries oxygen
Functions: Regulates body activities through hormones transported and nutrients to cells and carbon dioxide and wastes away from cells and
by the blood to various target organs helps regulate acidity, temperature, and water content of body fluids; blood
components help defend against disease and mend damaged blood vessels

Hypothalamus
Pineal gland Blood
Pituitary gland Thyroid vessels:
gland Vein
Thyroid
gland Adrenal Heart
gland
Parathyroid Posterior
glands view Pancreas
Artery

Testis
(male)

Ovary
(female)
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 1.1 Anatomy and Physiology: An Overview 5

7. Lymphatic System and Immunity (Chapter 17) 8. Respiratory System (Chapter 18)

Components: Lymphatic fluid (lymph) and lymphatic vessels; spleen, Components: Lungs and air passageways such as the pharynx (throat), larynx
thymus, lymph nodes, and tonsils; cells that carry out immune (voice box), trachea (windpipe), and bronchial tubes within the lungs
responses (B cells, T cells, and others)
Functions: Transfers oxygen from inhaled air to blood and carbon dioxide from
Functions: Returns proteins and fluid to blood; carries lipids from blood to exhaled air; helps regulate acidity of body fluids; air flowing out of
gastrointestinal tract to blood; contains sites of maturation and lungs through vocal cords produces sounds
proliferation of B cells and T cells that protect against disease-causing
microbes

Pharyngeal Pharynx Nasal cavity

tonsil Larynx Oral cavity
Pharynx
Palatine
tonsil Thymus Trachea Larynx
Lingual Thoracic Bronchus
tonsil duct
Lung
Spleen

Red bone Lymph

marrow node

Lymphatic
vessel

9. Digestive System (Chapter 19) 10. Urinary System (Chapter 21)

Components: Organs of gastrointestinal tract, including the mouth, pharynx Components: Kidneys, ureters, urinary bladder, and urethra
(throat), esophagus, stomach, small and large intestines, rectum, and
Functions: Produces, stores, and eliminates urine; eliminates wastes and
anus; also includes accessory digestive organs that assist in digestive
regulates volume and chemical composition of blood; helps regulate acid–base
processes, such as the salivary glands, liver, gallbladder, and pancreas
balance of body fluids; maintains body’s mineral balance; helps regulate red
Functions: Physical and chemical breakdown of food; absorbs nutrients; blood cell production
eliminates solid wastes

Salivary Mouth
gland Pharynx
Esophagus

Stomach
Liver Pancreas Kidney
Gallbladder (behind
stomach) Ureter
Small
intestine Urinary
Large bladder
intestine Rectum
Anus

Urethra

Table 1.1 Continues

6 CH APTE R 1 Organization of the Human Body

TA BLE 1 .1 Components and Functions of the Eleven Principal Systems of the Human Body (Continued)

11. Reproductive Systems (Chapter 23)

Components: Gonads (testes in males and

ovaries in females) and associated organs:
uterine (fallopian) tubes, uterus, and vagina in
females, and epididymis, ductus (vas) deferens,
and penis in males; also, mammary glands in
females
Mammary
Functions: Gonads produce gametes gland Ductus
(sperm or oocytes) that unite to form a new deferens
organism and release hormones that regulate Uterine Seminal
reproduction and other body processes; tube vesicle
Ovary Penis
associated organs transport and store Uterus Vagina Prostate
gametes; mammary glands produce Testis
milk
Uterine Ductus
tube deferens
Seminal
vesicle
Uterus Prostate
Ovary
Penis
Vagina Epididymis
Testis

differentiation to develop into a unique individual who is similar to,

1.2 Life Processes yet quite different from, either of the parents.
6. Reproduction (rē-prō-DUK-shun) refers to either (1) the formation of
OBJECTIVE new cells for growth, repair, or replacement or (2) the production of
a new individual.
• Define the important life processes of humans. Although not all of these processes are occurring in cells through-
out the body all of the time, when any one of the life processes ceases
to occur properly, the result is death of cells and tissues, which may
All living organisms have certain characteristics that set them apart lead to death of the organism. Clinically, loss of the heartbeat, ab-
from nonliving things. The following are six important life processes of sence of spontaneous breathing, and loss of brain functions indicate
humans: death in the human body.

1. Metabolism (me-TAB-ō-lizm) is the sum of all the chemical pro- Clinical Connection
cesses that occur in the body. It includes the breakdown of large,
complex molecules into smaller, simpler ones and the building up
Autopsy
of complex molecules from smaller, simpler ones.
An autopsy (AW-top-sē = seeing with one’s own eyes) is a postmortem (af-
2. Responsiveness is the body’s ability to detect and respond to
ter death) examination of the body and dissection of its internal organs to
changes in its environment. Nerve cells respond to changes in the
confirm or determine the cause of death. An autopsy can uncover the exis-
environment by generating electrical signals, known as nerve im- tence of diseases not detected during life, determine the extent of injuries,
pulses. Muscle cells respond to nerve impulses by contracting to and explain how those injuries may have contributed to a person’s death. It
move body parts. also may provide more information about a disease, assist in the accumu-
3. Movement includes motion of the whole body, individual organs, lation of statistical data, and educate health-care students. An autopsy can
single cells, and even tiny organelles inside cells. also reveal conditions that may affect offspring or siblings (such as con-
genital heart defects). Sometimes an autopsy is legally required, such as
4. Growth is an increase in body size. It may be due to an increase
during a criminal investigation. It may also be useful in resolving disputes
in (1) the size of existing cells, (2) the number of cells, or (3) the between beneficiaries and insurance companies about the cause of death.
amount of material surrounding cells.
5. Differentiation (dif′-er-en-shē-Aˉ -shun) is the process whereby un-
specialized cells become specialized cells. Specialized cells differ in Checkpoint
structure and function from the unspecialized cells that gave rise to
5. What are the different meanings for growth?
them. For example, a single fertilized egg cell undergoes tremendous
 1.3 Homeostasis: Maintaining Limits 7

changed, remonitored, reevaluated, and so on. Each monitored vari-

1.3 Homeostasis: Maintaining able, such as body temperature, blood pressure, or blood glucose
level, is termed a controlled condition. Any disruption that causes a
Limits change in a controlled condition is called a stimulus. Some stimuli
come from the external environment (the space that surrounds our
bodies), such as intense heat or lack of oxygen. Others originate in the
OBJECTIVES
internal environment, such as a blood glucose level that is too low.
Homeostatic imbalances may also occur due to psychological stresses
• Define homeostasis and explain its importance.
in our social environment—the demands of work and school, for
• Describe the components of a feedback system. example. In most cases, the disruption of homeostasis is mild and
• Compare the operation of negative and positive feedback systems. temporary, and the responses of body cells quickly restore balance in
• Distinguish between symptoms and signs of a disease. the internal environment. In other cases, the disruption of homeosta-
sis may be intense and prolonged, as in poisoning, overexposure to
temperature extremes, severe infection, or death of a loved one.
The trillions of cells of the human body need relatively stable conditions Three basic components make up a feedback system: a receptor,
to function effectively and contribute to the survival of the body as a a control center, and an effector (Figure 1.2).
whole. The maintenance of relatively stable conditions is called homeo-
- FIGURE 1.2 Operation of a feedback system.
stasis (hō′-mē-ō-STA-sis; homeo- = sameness; -stasis = standing still).
Homeostasis ensures that the body’s internal environment remains con-
stant despite changes inside and outside the body. The internal environ- The three basic elements of a feedback system are the receptor, control
ment refers to extracellular fluid, the fluid that surrounds body cells. center, and effector.
Each body system contributes to homeostasis in some way. For
instance, in the cardiovascular system, alternating contraction and
STIMULUS
relaxation of the heart propels blood throughout the body’s blood
vessels. As blood flows through tiny blood vessels, nutrients and oxy-
gen move into cells from the blood and wastes move from cells into disrupts homeostasis by
increasing or decreasing a
the blood. Homeostasis is dynamic; that is, it can change over a nar-
row range that is compatible with maintaining cellular life processes.
For example, the level of glucose in the blood is maintained within a CONTROLLED CONDITION
narrow range. It normally does not fall too low between meals or rise
too high even after eating a high-glucose meal. The brain needs a that is
steady supply of glucose to keep functioning—a low blood glucose monitored by
level may lead to unconsciousness or even death. A prolonged high
blood glucose level, by contrast, can damage blood vessels and cause RECEPTORS
excessive loss of water in the urine.
that send nerve impulses
Input
or chemical signals to a
Control of Homeostasis: Feedback Systems
Return to
Fortunately, every body structure, from cells to systems, has one or homeostasis when
CONTROL CENTER the response brings
more homeostatic devices that work to keep the internal environ- the controlled
ment within normal limits. The homeostatic mechanisms of the body that receives the input condition back to
and provides nerve normal
are mainly under the control of two systems, the nervous system and Output
impulses or chemical
the endocrine system. The nervous system detects changes from the signals to
balanced state and sends messages in the form of nerve impulses to
organs that can counteract the change. For example, when body tem- EFFECTORS
perature rises, nerve impulses cause sweat glands to release more
sweat, which cools the body as it evaporates. The endocrine system that bring about
corrects changes by secreting molecules called hormones into the a change or
blood. Hormones affect specific body cells, where they cause
responses that restore homeostasis. For example, the hormone insu-
lin reduces blood glucose level when it is too high. Nerve impulses RESPONSE that alters
the controlled condition
typically cause rapid corrections; hormones usually work more slowly.
Homeostasis is maintained by means of many feedback
systems. A feedback system or feedback loop is a cycle of events in Q What is the basic difference between negative and positive
which a condition in the body is continually monitored, evaluated, feedback systems?
8 CH APTE R 1 Organization of the Human Body

1. A receptor is a body structure that monitors changes in a controlled FIGURE 1.3 Homeostasis of blood pressure by a negative feedback
condition and sends information called the input (nerve impulses system. The broken return arrow with a negative sign surrounded by a circle
or chemical signals) to a control center. Nerve endings in the skin symbolizes negative feedback. Note that the response is fed back into the
that sense temperature are one of the hundreds of different kinds system, and the system continues to lower blood pressure until there is a
of receptors in the body. return to normal blood pressure (homeostasis).

2. A control center in the body, for example, the brain, sets the range of If the response reverses a change in a controlled condition, a system is
values within which a controlled condition should be maintained, operating by negative feedback.
evaluates the input it receives from receptors, and generates out-
put commands when they are needed. Output is information, in the
STIMULUS
form of nerve impulses or chemical signals, that is relayed from the
control center to an effector.
Disrupts homeostasis
3. An effector is a body structure that receives output from the control by increasing
center and produces a response or effect that changes the controlled
condition. Nearly every organ or tissue in the body can behave as an
CONTROLLED CONDITION
effector. For example, when your body temperature drops sharply,
Blood pressure
your brain (control center) sends nerve impulses to your skeletal
muscles (effectors) that cause you to shiver, which generates heat
and raises your temperature.

Feedback systems can be classified as either negative feed- RECEPTORS

back systems, which reverse the direction of a controlled condition, Baroreceptors
or positive feedback systems, which strengthen the direction of a in certain
blood vessels
controlled condition.
–
Input Nerve impulses
Negative Feedback Systems A negative feedback
system reverses a change in a controlled condition. Consider one
negative feedback system that helps regulate blood pressure. Blood
CONTROL CENTER
pressure (BP) is the force exerted by blood as it presses against
Brain
the walls of blood vessels. When the heart beats faster or harder,
BP increases. If a stimulus causes BP (controlled condition) to rise,
the following sequence of events occurs (Figure 1.3). The higher
Return to
pressure is detected by baroreceptors, pressure-sensitive nerve homeostasis when
cells (the receptors) located in the walls of certain blood vessels. the response brings
blood pressure
The baroreceptors send nerve impulses (input) to the brain (control back to normal
center), which interprets the impulses and responds by sending Output Nerve impulses
nerve impulses (output) to the heart (the effector). Heart rate
decreases, which causes BP to decrease (response). This sequence
of events returns the controlled condition—blood pressure—to
EFFECTORS
normal, and homeostasis is restored. This is a negative feedback
system because the activity of the effector produces a result, a drop Heart
in BP, that reverses the effect of the stimulus. Negative feedback
systems tend to regulate conditions in the body that are held fairly Blood
stable over long periods, such as BP, blood glucose level, and body vessels
temperature.

Positive Feedback Systems Unlike a negative feedback

system, a positive feedback system tends to strengthen or reinforce
a change in one of the body’s controlled conditions. In a positive RESPONSE
feedback system, the response affects the controlled condition A decrease in heart rate
differently than in negative feedback system. The control center and the dilation (widening)
of blood vessels cause
still provides commands to an effector, but this time the effector blood pressure to decrease
produces a physiological response that adds to or reinforces
the initial change in the controlled condition. The action of a Q What would happen to the heart rate if some stimulus
positive feedback system continues until it is interrupted by some caused blood pressure to decrease? Would this occur by
mechanism. positive or negative feedback?
 1.3 Homeostasis: Maintaining Limits 9

Normal childbirth provides a good example of a positive feed- FIGURE 1.4 Positive feedback control of labor contractions during
back system (Figure 1.4). The first contractions of labor (stimulus) birth of a baby. The broken return arrow with a positive sign surrounded by
push part of the fetus into the cervix, the lowest part of the uterus, a circle symbolizes positive feedback.
which opens into the vagina. Stretch-sensitive nerve cells (recep-
tors) monitor the amount of stretching of the cervix (controlled If the response enhances or intensifies the stimulus, a system is operating
condition). As stretching increases, they send more nerve impulses by positive feedback.
(input) to the brain (control center), which in turn releases the hor-
mone oxytocin (output) into the blood. Oxytocin causes muscles in Contractions of the wall of
the wall of the uterus (effector) to contract even more forcefully. the uterus force the baby’s
The contractions push the fetus farther down the uterus, which head or body into the cervix
stretches the cervix even more. The cycle of stretching, hormone
release, and ever-stronger contractions is interrupted only by the Increasing
birth of the baby. Then, stretching of the cervix ceases and oxy-
tocin is no-longer released. CONTROLLED CONDITION
Stretching of the cervix

Homeostasis and Disease

As long as all of the body’s controlled conditions remain within RECEPTORS
certain normal limits, body cells function efficiently, homeostasis Stretch-
sensitive
is maintained, and the body stays healthy. Should one or more
components of the body lose their ability to contribute to homeo-
nerve
cells in
+
stasis, however, the normal balance among all of the body’s the cervix
processes may be disturbed. If the homeostatic imbalance is
Input Nerve impulses
moderate, a disorder or disease may occur; if it is severe, death
may result.
A disorder is any abnormality of structure and/or function. Disease CONTROL CENTER
Brain
is a more specific term for an illness characterized by a recognizable set Increased stretching
of symptoms and signs. Symptoms are subjective changes in body func- of the cervix causes
the release of more
tions that are not apparent to an observer, for example, headache, oxytocin, which
anxiety, or nausea. Signs are objective changes that a clinician can results in more
stretching of the
observe and measure, such as bleeding, swelling, vomiting, diarrhea, cervix
fever, a rash, or paralysis. Specific diseases alter body structure and Output Brain interprets input
function in characteristic ways, usually producing a recognizable set of and releases oxytocin
symptoms and signs.
EFFECTORS
Muscles
in the wall
of the
Clinical Connection uterus

Diagnosis Contract more

forcefully
–
Diagnosis (dī-ag-NO-sis; dia- = through; -gnosis = knowledge) is the iden-
tification of a disorder or disease based on a scientific evaluation of the
RESPONSE
patient’s symptoms and signs, medical history, physical examination, and
Baby’s body stretches
sometimes data from laboratory tests. Taking a medical history consists of the cervix more
collecting information about events that might be related to a patient’s ill-
ness, including the chief complaint, history of present illness, past medical
problems, family medical problems, and social history. A physical exami-
nation is an orderly evaluation of the body and its functions. This process Interruption of the cycle:
includes inspection (observing the body for any changes that deviate from The birth of the baby
– decreases stretching of the
normal), palpation (pal-PA-shun; feeling body surfaces with the hands), cervix, thus breaking the
–
auscultation (aws-kul-TA-shun; listening to body sounds, often using a positive feedback cycle
stethoscope), percussion (pur-KUSH-un; tapping on body surfaces and
listening to the resulting echo), and measuring vital signs (temperature,
pulse, respiratory rate, and blood pressure). Some common laboratory Q Why do positive feedback systems that are part of a
tests include analyses of blood and urine. normal physiological response include some mechanism
that terminates the system?
Exploring the Variety of Random
Documents with Different Content
Virginia, University of, 95

Walter, Dr. Josephine, 190, 357, note

Wanzer, Lucy, 175
Warren, Mrs. Mercy, 108, 256
Washington, George, quoted, 88
Wellesley College, 46
Wesley, Susanna, 208
Wesleyan Female College, the, 92
Western States and Territories, order of admission into Union, 55
Wheatley, Phillis, 108
White, Andrew D., quoted on co-education, 80
Wilkins, Mary, 120
Willard, Emma Hart, 91;
biographical sketch of, 30
Willard, Frances E., 270;
chapter by, 399
Willets, Mary, 184
William and Mary College, chartered, 260, note
Willis, Rev. Olympia Brown, 214
Wisconsin, University of, 74
Wollstonecraft, Mary, 28, 150, 260

1. With the exception of the chapter on England, which is divided into three
parts.

2. I do not mean for an instant to imply that these principles required

emphasizing.

3. See also accounts of early education of American women authors in chapter

on Woman in Literature.—Ed.
 4. The graduates of the Harvard Annex are given a certificate issued by The
Society for the Collegiate Instruction of Women. Although the work of the “Annex”
students is acknowledged to be the same as that of the students of the University,
and the instruction is given by the University professors, the degrees that are
bestowed on the graduates of the University are refused to the graduates of the
“Annex.” It would certainly seem a more consistent position on the part of that
august institution if it disclaimed all belief in the collegiate education of women.
But Harvard smiles upon its Annex to the extent, at least, of permitting its
professors to give their valuable time to instructing “the gentle sex.” Harvard
apparently acknowledges the capacity of the female mind to attain to the heights of
Harvard culture, but strangely enough it withholds the only proper recognition
which surely is due, and fitting.
The following certificate issued by The Society for the Collegiate Instruction of
Women will some day, let us hope, be preserved only as a curious relic of an
archaic past:

THE SOCIETY FOR THE COLLEGIATE INSTRUCTION OF WOMEN.

CAMBRIDGE, MASSACHUSETTS.
We Hereby Certify that under the supervision of this Society, has
pursued a course of study equivalent in amount and quality to that for
which the Degree of Bachelor of Arts is conferred in Harvard College,
and has passed in a satisfactory manner examinations on that course,
corresponding to the College examinations.
In Testimony Whereof we have caused these presents to be signed by
our President and Secretary and by the Chairman of the Academic Board,
this day of in the year of our Lord, one thousand eight hundred
and
President.
Secretary.

Chairman of the Academic Board.

It may be added as a commentary that the Sargent prize for 1890–91 was won
by a student of the “Annex.” This prize is offered to “Undergraduates of Harvard
College and students pursuing courses of instruction in Cambridge, under the
direction of The Society for the Collegiate Instruction of Women,” and was
awarded for, “The best metrical version of the ninth ode of the fourth Book of
Horace.”—Ed.

5. The Society for the Collegiate Instruction of Women, being duly

incorporated, could also be authorized to confer degrees. But it wisely prefers to
await the time when Harvard College will bestow the University degree; meanwhile
doing what lies in its power to establish the identity of the work done in the two
colleges. In the same way as Evelyn, Barnard College is duly incorporated and is
authorized by the Regents of New York State to confer upon its graduates a degree
of its own. But Barnard prefers to waive its right and to accept the degree from the
parent University, Columbia College.
There is too much pluming of one’s self in this country, on the right to confer a
college degree, a right granted by State Legislatures in a lamentably superficial
manner. I have received many communications gravely announcing that the
degrees conferred by certain colleges are every way equal to those of the greatest
and oldest institutions of learning in the country—as the State Legislature—by a
special act—“has made them so”(!) I have always failed to see the connection
between acts of legislative bodies, and the true greatness of universities.
The trustees of Evelyn College decided to give a separate degree not because
Princeton College refused to officially recognize the work of the students of Evelyn,
but because thus far (December, 1890) no candidate has been received for a college
course answering in every way to that for which the Princeton degree is given. The
trustees of Evelyn College gives its graduates a degree which is granted for less
work than is demanded by Princeton: (Music and Art are made regular electives,
and Greek is not demanded even for entrance examinations).
Even at the risk of repetition, I will here state the relative standing of the three
American affiliated colleges. I include the following colleges in the term Affiliated
College, because each seeks in some way to extend to women the advantages that
are offered to men by another (neighboring) college. Some one has given the
raison d’être of the affiliated college to be “the economy which applies to a new
purpose resources already organized and tested.”
Harvard Annex, founded in 1879, instruction received from Faculty of
Harvard College, admits special students in all departments, gives no degree to its
own graduates, prefers to await official recognition from Harvard College.
Evelyn College, founded in 1888, instructions received from Faculty of
Princeton College, admits special students, gives its own degree, has never asked
for the Princeton degree.
Barnard College, founded in 1889, instruction received from Faculty of
Columbia College, no special students admitted except in Laboratory work and
Graduate department, degrees conferred by Columbia College. The only affiliated
college in the world, so far as I can learn, that has received full official sanction
and recognition from the University with which it is affiliated.—Ed.

6. Although this remark was made by the late President Barnard, it did not
voice the sentiment of those who inaugurated the movement to establish Barnard
College. The affiliated college is not always a mere “step toward co-education”;
there are many that believe that institutions such as the affiliated colleges, Girton
and Newnham (were their graduates entitled to the University degree), best solve
the problem of the collegiate education of women to-day. Instruction in
undergraduate work is given at the women’s colleges, and is obtained not only
from university professors, but also from some able women instructors. But in
graduate work, which is the real work of the University, men and women are most
properly allowed to attend the lectures together at the University. The vexed
problem of co-education becomes a different question as it deals with the
undergraduate work of young men and women, or with the university and
professional studies of men and women of mature age.—Ed.

7. These courses of examinations were offered by Columbia College for the

laudable purpose of “raising the standard of female education.” [Extract from the
minutes of the Board of Trustees; Report of the Select Committee, March 5, 1883.]
Notwithstanding the criticism and eloquent expostulation of some women aimed
at the “conservative” Board of Trustees of Columbia College, we must not forget
that Columbia has never refused equal recognition for equal work. It saw no
logical pause between the acknowledgement that women could follow the
collegiate course and the conferring of official sanction upon such a course.
The same Report goes on to say: “and offering suitable academic honors and
distinctions to any who, on examination, shall be found to have pursued such
courses of study with success.—Ed.

8. See article by Mrs. Annie Nathan Meyer in The Nation, January 21, 1888.
The petition to the Columbia Board for official sanction to open Barnard College
was largely based on this article.

9. See article by Annie Nathan Meyer, in University, February 22, 1888.

10. As the Cincinnati Wesleyan College is an example of the best that

Methodism has done for the separate education of women, so Albert Lea College in
Minnesota, founded and controlled by the synod of that State, would appear to be
the most ambitious attempt of the Presbyterian Church to aid the separate higher
education of women in the West. This college was founded in 1882, and opened to
students in 1885. Its president makes for it, with relation to the country west of the
Alleghanies, the same claim that the president of the Wesleyan made in its behalf
with relation to the entire country, forty-eight years ago. Its president, Dr. R. B.
Abbott, writes: “This is the only real college for women west of the Alleghany
Mountains. There are female seminaries in abundance, some of which are named
college, but are without a full college curriculum and without authority to confer
the degrees of Bachelor and Master of Arts. Albert Lea is a college in fact as well as
in name.”
Albert Lea is now in only its fifth year. I have not been able to obtain its latest
catalogue. The above quotation from its president’s letter indicates its promise.
Should it redeem this promise in its spirit and word, it would be a great blessing to
the West; not so much young because women in this part of the country need
another college within their easy reach, but because the entire community needs to
have the difference between the nominal and the real college continually
emphasized.
If Albert Lea draws sharp and visible lines between its standards and tests of
scholarship, between its quality and methods of instruction and those of the
majority of institutions in the above list, its influence will be potent in securing
greater harmony between names and things in matters pertaining to education.

11. Appendix B, Table II., gives a table by which is shown when each of these
colleges was founded, when opened, and when opened to women.

12. Prepared by May Wright Sewall at the request of the commissioners for
Indiana, for the Indiana Department of the New Orleans Exposition.—Ed.

13. It is only fair to add that one of its graduates became a college president—
Miss Alice Freeman, president of Wellesley College during six years, now Mrs.
Alice F. Palmer, member of the Massachusetts State Board of Education.—Ed.

14. Read before the Historical Society of South Carolina, August 6, 1883, and
reprinted by the Bureau of Education, Circular of Information No. 3, 1888.

15. Mention is made of a charitable school for girls, which they were not
allowed to attend after the age of twelve, and of a school, apparently for boys, kept
open by Mrs. Gaston, the wife of Justice John Gaston, at Fishing Creek.

16. See chapter “Education in the East.”—Ed.

17. See chapter “Education in the East.”—Ed.

18. Quoted in the Am. Jour. of Education, September, 1868, p. 622.

19. Mrs. Phelps, Mrs. Willard, and Maria Mitchell were the first three women
members of the American Association for the Advancement of Science.

20. The first college to grant real degrees to women was Oberlin. See chapter
“Education in the West.”—Ed.

21. Bureau of Education, 1888.

22. Historical Sketch in the catalogue for 1888–9.

23. The Bureau of Education has been extremely kind in placing its collections
at my disposal, and in making extracts for me from its manuscript statistics for
1889–90, which will not be published for two years to come.

24. An equivalent amount of French or German may be substituted for Greek.

 25. Interesting on account of an extract from a letter from a Virginia girl.

26. Catalogue.

27. Vassar was not opened until 1865. See chapter on Education in East.—Ed.

28. A Kentucky mother who had taken the trouble to send her daughter to
Helmuth College in Canada, found that she was carrying on sixteen studies at the
same time, and that she gave one half hour a week to geometry, during which the
teacher gave the demonstrations and did not permit the class to ask any questions.

29. The tuition is $150 a year.

30. Report of the Peabody Education Fund, 1889.

31. Bureau of Education Report, 1887–88.

32. See the arguments interchanged in open letters,—learned essays, between

Prof. Bischoff attacking, and Prof. Hermann defending, the admission of women to
the University of Zurich. See also the address made last year by Prof. Waldeyer,
before the Society of German Physicians and Naturalists.

33. “It is scarcely more than half a century, since among us, females were
almost the only accoucheurs.”—“Remarks on the employment of Females as
Practitioners in Midwifery,” by a Physician. Boston, 1820. See also collections
Maine Historical Society; Proceedings General Court held at Wells, July 6, 1646, to
“present” Frances Rayns for presuming to act the part of midwife. Also, Blake’s
Annals of the town of Dorchester. Record of death, in 1705, of Mrs. Wiat, aged 94
years, having as midwife assisted at the births of 1100 and odd children. Also
Thomson’s History of Vermont, sketching the career of Mrs. Thomas Whitmore in
town of Marlboro, 1765. In the town records of Rehoboth is mentioned the arrival,
on July 3, 1663, of Dr. Sam Fuller and his mother, he to practice medicine,—she as
midwife, “to answer to the town’s necessity, which was great.” So also Mrs.
Elizabeth Phillips settled in Charleston in 1718. Anne Hutchinson began her career
as a midwife. It will be remembered that the mother of William Lloyd Garrison
practiced midwifery in Baltimore, and thereby supported herself and two children,
after she had been mysteriously deserted by her husband.

34. This sturdy woman lived to be eighty-seven years of age; an ironical

comment on the theory of necessarily deficiency of endurance in the female sex.

35. “More than 150 years elapsed after the first settlement, before a single
effort was made either by public authority or by the enterprise of individuals, for
the education of physicians, or for improving the practice of medicine.... No
medical journal was published in America, until toward the close of the 18th
century.... The first anatomical dissection was made in New York, in 1750.—
Thacher, Am. Med. Biog. 1828, p. 16.

36. “It would be shocking to humanity to relate the history of our general
hospital in the years 1777 and 1778, when it swallowed up at least one half our
army, ... by crowding and consequent infection.”... “At Bethlehem, out of 40 men
who came sick from one regiment,—not three returned alive.”—Tilton on Military
Hospitals (quoted by Tower, “Medical Men of the Revolution.” Address 1876, p.
77.)

37. “It was one of the first and happiest fruits of improved medical education
in America, that females were excluded from practice; and this has only been
effected by the united and persevering efforts of some of the most distinguished
individuals of the profession.”—Remarks of a Boston physician, cited ut supra.

38. The suppression of midwives was more immediately due to the

development of obstetrical science in England, whither the more ambitious among
the colonial physicians were beginning to travel for instruction, and where their
intellects were quickened by direct contact with the minds of men of genius. In
1752 Dr. James Lloyd, returning after two years’ study in England, began to
practice obstetrics in Boston: In 1762, Dr. Shippen, similarly prepared, began to
lecture on obstetrics in Philadelphia. (“Hist. of Art of Midwifery,” Lecture by Dr.
Augustus Gardner, 1851). These actions sounded the professional death-knell of
the poor midwives. Organized knowledge must invariably triumph over
unorganized ignorance, even though tradition, decorum, and religion be all on the
losing side.

39. “Man-midwifery Espoused and Corrected; or, The Employment of Men to

attend Women in Childbirth, shown to be a modern innovation, unnecessary,
unnatural, and injurious to the physical welfare of the Community, and pernicious
in its influence on Professional and public Morality.” By Samuel Gregory, A.M.,
Lecturer on Physiology. Boston, 1848.

40. Is it possible not to seem to hear, from some quiet corner of dispassionate
observation, the echo of the immortal “Fudge!” which so disturbed the
complacency of the innocent Vicar of Wakefield?

41. “To Massachusetts is due the credit of establishing the first medical school
for women in the world.”—Chadwick, “The Study and Practice of Medicine by
Women,” International Review, October, 1879.

42. On two other occasions did these fortunes become associated with those of
homœopaths. When in 1869 the State University of Michigan opened its medical
department to women, the Legislature simultaneously ruled that two professors of
homœopathic medicine must be appointed in the school. And when in 1886 the
trustees of the Boston City Hospital inquired into the propriety of admitting female
medical students, they reported at the same time upon the application of
homœopathic physicians, to be appointed in the medical service of the wards. At
this point, however, the fortunes of the two classes of applicants diverged: the first
request was granted; the second refused.
The class of 1890 of the Boston University School only contains nine women.

43. Thus in France,—docteur en médecine, officier de santé, sage femme; in

England,—physician, surgeon, apothecary. The midwife in England, was, until
recently, assumed not to exist; but as she existed nevertheless, she became all the
more dangerous because uncontrolled. “At present date, 60 per cent. of poor
women are attended in their confinements by midwives, uninstructed and
uncultivated,—probably 10,000 in number. The fatal results to both mothers and
children arising from the ignorance of these midwives is notorious. They must
either be annihilated or instructed.”—Dr. Aveling, writing to Gen. Med. Council,
1873.
The Obstetrical Society of London now undertakes to instruct and examine
midwives.

44. Drs. Jacob Bigelow and James Jackson voted in the negative. The latter
had been the physician to introduce into Boston the midwife, Mrs. Janet
Alexander. So it would seem that his objection was not to women, but to educated
women, who might aspire to rank among regularly educated men physicians.

45. The details of Miss Hunt’s application to Harvard are dispassionately

related by Dr. Chadwick, loc. cit. When, in 1872, the London University, after a two
years’ bitter controversy, declared women eligible to its degrees, the journals were
flooded with letters from indignant physicians, who declared that by this action
their own diplomas, previously obtained, had been lowered in value, their
contracts violated, and their most sacred property rights invaded.

46. Address at Chickering Hall, New York, March 18, 1888, by Dr. Emily
Blackwell.

47. Mt. Holyoke was founded by Mary Lyon in 1837.

48. Address of Emily Blackwell, cit. ut supra.

49. Elizabeth Blackwell, like Tennyson’s Princess,

“Shuddered but to dream that maids should ape

Those monstrous males that carve the living hound.”

And also like the Princess, it was

“through many a weary moon

 She learned the craft of healing.”

50. “Medicine as a Profession for Women.” Address by Elizabeth and Emily

Blackwell, delivered Dec. 2, 1859.

51. Miss Blackwell was of English birth and family, but had come to Cincinnati
at the age of twelve.

52. Dr. Robert Weir.

53. Miss Blackwell earned money by several years’ work at school teaching, the
great resource of American girls.

54. “It was the first time that a unanimous vote was ever cast in the board.”—
Personal letter from Dr. Blackwell.

55. Especially St. Bartholomew, through the influence of Dr., afterwards Sir
James, Paget.

56. The “ancient and modern languages,” comprised Latin, Greek, French,
German, and Italian,—an unusual list of accomplishments for a self-taught,
Western bred girl of those days. Miss Blackwell particularly charmed Dr. Simpson
by translating for him into English (or Scotch) some Latin versions of old Arabic
medical treatises.

57. For modern obstetrics is almost as new a sphere as gynæcology.

58. “Story of My Life,” by Marion Sims, p. 299.

It must be said that Dr. Sims was subsequently president of the American
Medical Association, at the meeting which received its first woman delegate; and
doubtless his influence contributed toward her favorable reception.

59. It will be remembered what were the conditions of graduation in New York
in 1855.

60. “This was the thirtieth operation performed on Anarcha.” (1849.—Sims,

loc. cit. p. 246.) 1849, foundation date of American gynæcology, was the date of the
year when Elizabeth Blackwell received her diploma.

61. Dr. Sims, in his autobiography, complains that he was denounced as a

quack by the “conservative” surgeons of New York, some of whom did not hesitate
to secretly try to dissuade the ladies from doing anything about the Woman’s
Hospital, and urging that the New York Hospital already accomplished every
purpose.
Thus whatever is, invariably seeks to strangle in the birth that which is about
to be!
 62. Dr. Zakzrewska’s life has been sketched in outline down to the above date,
in a little volume entitled “Practical Illustration of Woman’s Right to Labor,” by
Caroline Dall.

63. A petition for the emancipation of negro slaves was presented to Congress
by a group of Quaker gentlemen, within a few years after the framing of the
Constitution.—Van Holst, Constitutional History of America.

64. Hannah Richardson and Rebecca White.

65. See ut supra, p. 13, note.

66. Galaxy, 1868. The innocent young Quaker girl did not find this “a
disgusting preliminary!”

67. Personal letter.

68. To them were born two children, a son who died in early childhood; a
daughter who lived to grow up and became educated as a physician.

69. Out of 189 graduates of the Philadelphia College whose status was
reported in 1881, 56 were married women. The total number of graduates at that
time was 276. (Rachel Bodley, “The College Story,” Commencement address, 1881.)

70. There were eight graduates. The first medical class that ever graduated in
Philadelphia about a century before consisted of a single number.

71. Quite a group of bystanders collected to hear the discussion, which was
animated by opposing cheers and hisses.

72. “To be addressed in public as doctor,” writes Dr. Zakzrewrka, “was painful,
for all heads would turn to look at the woman thus stigmatized.” (Personal letter.)
“Women,” said Dr. Blackwell at this time, “occupy an anomalous position, standing
alone in medicine,—often opposed or ignored by the profession, not acknowledged
by society, and separated from the usual pursuits and interests of women.”—(“An
Appeal in behalf of the Medical Education of Women.” New York: 1856).

73. Personal letter of niece.—R. L. Fussell.

74. Annual Catalogue, 1854.

75. “Every woman will be narrowly watched and severely criticised because
she is a woman. If she bear not herself wisely and well, many will suffer for her
sake. Gentleness of manner, the adornment of a quiet spirit, are as important to
the physician as the woman.... I too have felt the hopes and the aspirations after a
fuller and more satisfying life, which have arisen in the souls of some of you.... The
office of healing is Christlike.... Your business is, not to war with words, but to
make good your position by deeds of healing.... Probity, simplicity, modesty, hope,
patience, benevolence, prudence,—are needed alike by the woman and the
physician. All the brave, struggling women, who, in various walks of life, are
laboring for small compensations, will be benefited by a movement which opens to
women another department of remunerative and honorable activity.”
Contrast with these modest statements of the gentle Philadelphia Quakeress
the aggressive self-consciousness of the emancipated French woman, who rushes
into the arena, with a little red flag waving in every sentence: “À nos lectrices, à nos
lecteurs, à nos collaborateurs, à nos amis connus et inconnus, à tous ceux qui
s’interessent à notre entreprise. Salut!... Nous voyons tous les jours des professeurs
qui ont étudié dans leurs moindres détails, tous les êtres organises qui forment la
série zoologique, et qui semblent ignorer absolument ce qu’est cet être qui tient
tant de place dans l’humanité, la femme. Faisons-nous connaître, et quand ils
sauront ce que nous valons, ils nous apprecieront comme nous le meritons.”—
Mme. C. Renooz, Revue Scientifique des femmes. Paris, Mai, 1888.
The Revue is already extinguished after a year’s existence. The college survives
and prospers after forty years of struggle.

76. The celebrated Dr. Camman, who for many years held a clinic for heart
and lung diseases at the Demilt, gave valuable instruction to the women students.

77. This innovation (for it was one) was effected during the residentship of Dr.
Elizabeth Cushier, who has contributed immensely to the building up of the
hospital.

78. This is an increase of 100 patients over the preceding year.

79. In the chapter on “Women in Hospitals,” in this volume, Mrs. Ednah

Cheney gives the details of the early formation of the New England Hospital.—Ed.

80. “She was as fresh and girlish as if such qualities had never been
pronounced incompatible with medical attainments. She had, indeed, a certain
flower-like beauty, a peculiar softness and elegance of appearance and manner. I
have wondered whether she did not resemble Angelica Kaufman. Underneath this
softness, however, lay a decision of purpose, a Puritan austerity of character that
made itself felt, though unseen. “She ruled the hospital like a little Napoleon,” said
a lady who had been there.... Both the surgical talents and surgical training of Dr.
Dimock are certainly at the present date (1875), exceptional among women. It is on
this account that our loss is irreparable, for at this moment there seems to be no
one to take her place. Many battles have been lost from such a cause. But although
ours be ultimately won, we would not, if we could, grieve less loyally for this girl, so
brilliant and so gentle, so single of purpose and so wide of aim, whose life had been
thus ruthlessly uprooted and thrown upon the waves at the very moment it
touched upon fruition.”—M. P. Jacobi in New York Medical Record, 1875.
 Dr. Dimock, like so many of the early gynæcological surgeons of America, was
a Southerner, born in North Carolina.

81. Nineteenth Annual Report Chicago Hospital for Women and Children,
1884.

82. Report, loc. cit.

83. “To the fixedness and honesty of purpose of Dr. Mary H. Thompson, may
be credited these satisfactory results of nineteen years’ work. They mean a
devotion and self-sacrifice on her part that few can estimate.”—Report of results
from 1884 to 1888.

84. Medical News, 1885. Reprint of address at Birmingham by Lawson Tait.

85. The establishment of such schools, professing to further the education of

women, has continued to be the greatest bane to the movement for their effective
education. So late as the current year (1890), a lady writes from Cincinnati: “The
college already in existence is one of the unpardonable sins against a confiding
public.”

86. Memorial of Trustees of Women’s Medical College of N. Y. Infirmary,

1887.

87. The same thing had happened at Harvard, when it raised its standard of
requirements.

88. Memorial Trustees, loc. cit.

89. Ibid.

90. See history of the founding of the University of Michigan, chapter

Education in the Western States.—Ed.

91. Letter from Chicago in Boston Med. and Surg. Journal, July, 1878.

92. “History of Competitive Examinations for the Woman’s Medical College of

Chicago.” Read before its Alumnæ Association, April 1, 1889, by Dr. Marie Mergler.

93. These early experiences were, as has already been hinted, common to all
the schools ever established independently for women. Until very recently, the
gentlemen who have professed to teach surgery have never persuaded themselves
to take their subject seriously.

94. Dr. Sutro Merritt, daughter of the famous engineer, and who married a
fellow student from the University of California; and the twin sisters, Agnes and
Isabel Lowry.
 95. “The education of the college is a conquered standpoint: what remains is to
make the post-collegiate education equally easy of access to women. To duplicate
the great laboratories and the great professorships of the two or three colleges
which give adequate post-graduate instruction, would be foolish in the extreme. It
is little less than silly to suppose that seriously minded men and women could not
brave the associations of the lecture room without danger of impropriety. What
possible reason can Columbia College, or Clark University, or the Johns Hopkins
urge for not throwing open their post-graduate courses to women? What more
graceful act could be imagined with which to mark this memorable year, when
Vassar College celebrates her first quarter of a century and when Phillipa Fawcett
is four hundred marks ahead of the senior wrangler, than for these universities,
without further wheedling or coaxing or bribing, to open to women the
opportunities for hard work which women covet, and which the sense of justice of
men, tardy though it be, will not permit them much longer to refuse.”—Editorial in
New York Evening Post, June 17, 1890.

96. New York Medical Record, June 24, 1885.

97. Of which sixteen admit women. There are altogether thirty-five co-
educational medical schools. See Record, loc. cit.

98. Ut supra, p. 106.

99. Phil. Med. and Surg. Reporter, 1867, vol. 16.

100. The distinguished ovariotomist, one of the earliest in the country.

101. Quite a number of the members of the Society defied the authority of its
resolution, and “consulted” with women or even taught them. Among the latter,
Dr. Hartshorne, who became an able professor of the Woman’s College, was the
only one who took the trouble to withdraw from the County Medical Society on
account of his relations with the woman’s school.

102. Boston Medical and Surgical Journal, May 25, 1871.

103. The matter had apparently first been brought forward in 1868, at a
meeting held at Washington, D. C., by a resolution offered by Dr. Bowditch of
Boston.—N. Y. Med. Record, 1868.

104. New York Medical Record, June 10, 1876.

105. “History of Proceedings to procure the Recognition of Women Physicians

by the Medical Profession of the State.” By Dr. Hiram Corson. Philadelphia, 1888.

106. “It must be acknowledged that the strictly regular instruction imparted in
the principal medical schools for women has excited respect, and greatly tended to
overcome former prejudices. The admission of women is now a fixed fact.”—Phil.
Med. Times, 1883.

107. This society no longer exists; but it can hardly be said to have died from
the admission of women, as it never had but three female members.

108. Mary Putnam, who was in fact the first woman to be admitted to the Paris
School, though Miss Garrett of London was the first to graduate from it. The paper
read before the New York Society was on Septicæmia, and seems to have been the
first read by a woman physician in the United States, before a medical society.

109. Miss Putnam’s graduating thesis had moreover secured a bronze medal,
the second prize awarded.

110. Drs. Cushier, McNutt, Withington, Dixon Jones.

111. Drs. Peckham, Fiske-Bryson.

112. Dr. McNutt.

113. Drs. Peckham, Cushier.

 114. Dr. Cushier.

115. In 1876, the Boylston Prize, conferred every two years by Harvard
University for a medical essay, was won by Dr. Mary Putnam Jacobi. The prizes
were awarded in ignorance of the names of the writers, and consequently of their
sex; but this was the first occasion on which a woman had competed. The subject
was, “The Question of Rest for Women during Menstruation.”
Dr. Boylston, the founder of the prize, had been the first colonial physician to
practice inoculation, after this had been suggested by Cotton Mather.

116. The committee consisted of Prof. Alexander Agassiz chairman, Dr. Morrill
Wyman, President Eliot, Mr. J. Elliott Cabot, Dr. Le Baron Russell.

117. Boston Medical and Surgical Journal, May 22, 1879. The editor expresses
surprise at “so frank a confession of inferiority.” Although it was only a few years
since women physicians were ostracised on the ostensible ground of the necessary
inferiority of their means of education, the Boston editor now, in order to confute
the claim of necessity for the Harvard education, passes in most flattering review
the existing schools for women at New York, Philadelphia, and Chicago, and insists
that these offer all the advantages any reasonable woman can want. Thus (this in
1879):
Philadelphia, 29th year, class 90 students.
New York, 10th year, class 47 students.
Chicago, 9th year, class 32 students.
“Answers to letters of inquiry show that these schools for women are looked
on with great favor.”

118. Chadwick, “Admission of Women to the Massachusetts Medical Society,”

Boston Medical and Surgical Journal, 1881.

119. The editor of the Boston Medical and Surgical Journal announced this
decision with great regret. The writer declared it “to be impossible that women can
frequent our public meetings or lecture-rooms when certain topics are discussed,
without breaking through barriers which decency has built up, and which it is for
the interest of every lady and gentleman to preserve.... The moral tone of the
society will soon be perceptibly lowered.”—(Loc. cit., October, 1879.)
The success of the movement was due to the chivalrous energy of a group of
younger members, especially Drs. James and Charles Putnam, Dr. Chadwick, Dr.
Cabot, and Dr. Derby.

120. It will be remembered that it was the experience gained in the rude
hospitals of the Revolutionary War, which, by affording American physicians for
collective observation of the sick on a large scale, first breathed some scientific
spirit into the profession. Similar experience was afterwards gained in the
epidemics of yellow fever and of spotted fever, that at different times ravaged the
country. An analogous influence was exercised by the Civil War, which influence is
becoming most distinct a quarter of a century after its close.

121. It was also ruled that “any cases deemed improper for a mixed audience
should be reserved for the end of the lecture, and that the surgeon before
proceeding with them may require the withdrawal of all male or female students as
the case may be”; further, “No female patient shall be taken into the amphitheatre
without the attendance of a female nurse: and no operation upon a female patient
requiring special exposure shall be performed in the presence of male visiting
students.”
In this simple and even-handed manner were adjudged the vexed questions
that had been declared so insoluble.

122. New York Medical Record, Jan. 1, 1870.

123. These inadequacies might be rectified, without necessarily introducing

into clinical practice the brutalities that so often disfigure the European treatment
of hospital patients.

124. Including Dr. Jacobi, Dr. Emil Krackowizer, Dr. Guhleke. The two former
were German radicals of 1848, and in this action remained consistent with
philosophic principles of their youth.

125. It has been said that if any woman was admitted on the staff of internes,
all the patients would demand her for the personal services now rendered by young
men, and which are now accepted, though under protest, for the sake of the special
skill of the distinguished visiting surgeons of the institution.

126. Elizabeth Blackwell in 1848.

127. Dr. Mary P. Root.

128. Dr. Marie Mergler, loc. cit.

129. Dr. Mary H. Stinson, of Norristown, Pa.

130. Dr. Hiram Corson, Dr. A. Nebinger, Dr. R. L. Sibbett.

131. It was signed first by Dr. Kirkbride, superintendent of the Pennsylvania

Insane Asylum, and then by the surgeons and physicians, the consultants and the
assistants, the indoor and out-door staff of thirteen colleges and hospitals, of which
only one received insane patients, the Blockley. In addition were the names of
nineteen physicians unconnected with any institution.
 132. Dr. Bennett’s nomination was indorsed by eminent physicians from
Philadelphia, Drs. Joseph Leidy, Wm. Pepper, S. Weir Mitchell, H. C. Wood, W. W.
Keen, S. D. Gross. The latter venerable surgeon had formerly been bitterly opposed
to women physicians.

133. “The only regret and wonder are that a provision so humane and natural
and consoling for these unfortunate wards of the State, has not yet been made
law.”—Harper’s Weekly, 1890.

134. Woman’s Journal, April 26, 1890.

135. Rhoda Wilkins, in 1885, a graduate of the New York Infirmary School.

136. The following is a partial list of the women now or recently holding such
positions, in addition to those already named: Helen Bissell, Kalamazoo, Michigan;
Alice M. Farnham, Hart’s Island, New York City; Alice Wakeman and Augusta
Steadman, Blackwell’s Island, New York; Jane Garver, Harrisburg, Pa.; Amelia
Gilman, Blockley Insane Hospital, Philadelphia; Laura Hulme, Worcester, Mass.;
Martha Morgan, Harrisburg, Pa.; F. McQuaide, Norristown, Pa.; Martha Perry,
Taunton, Mass.; Alice Rogers, Taunton, Mass.; Julia K. Cary, Danvers, Mass.; and
others in Maine, Minnesota, Indiana, Illinois, Iowa, Nebraska, and California.

137. “It was a great step for Virginia, thus taken by the trustees, and required
considerable effort on the part of some members of the board.... Massachusetts is
the only State where it is absolutely required by law that every such hospital shall
employ one woman assistant physician.”—Springfield Republican.

138. The Directors of the Woman’s Educational and Industrial Union of

Buffalo wrote to the superintendents of insane asylums in 38 States, asking their
opinion on the law pending in the New York Legislature during its session of
1889–1890. Forty-six answers were received from 32 States, of which 33 favored
the law, 5 were opposed, 5 non-committal, and 3 not prejudiced.

139. “The Practice of Medicine by Women in the United States.” Paper read
before Social Science Association, by Emily H. Pope, M.D., Sept. 7, 1881; and “The
College Story,”—address at Woman’s Medical College of Philadelphia, by Dean
Rachel Bodley, March 17, 1881.

140. Dr. Bodley sent circulars only to the graduates of the Philadelphia school,
of whom, in 1881, there had been 276. Of these, 189 answered the circular. Dr.
Pope sent circulars to 470 graduates of all schools, and received 390 answers,
many, however, duplicating those of the Philadelphia circular of March.

141. $2907.30 exactly.

 142. The writer knows personally of two women physicians, one in large
general practice including much surgery, the other at the head of a Sanitarium,
who have each brought up and educated twelve children. One of these ladies was a
widow, with one child, when she began to study medicine; the other was never
married. A very large number of childless women adopt children, or contribute to
the education of the children of brothers or sisters.

143. A distinguished surgeon recently wrote to a woman physician, when he

had confirmed her diagnosis in a serious case, where the family then requested the
presence of the consultant at the operation the woman physician was to perform:
“I shall be out of town for a week; you had better not wait for me—go ahead and
operate yourself.” Which she did successfully.

144. The above form of consultation has greatly extended the facilities of
medical treatment for unmarried women and young girls.

145. “I believe that the department of medicine in which the great and
beneficent influence of women may be especially exerted, is that of the family
physician. Not as specialists, but as the trusted guides and wise counselors in all
that concerns the physical welfare of the family, they will find their most congenial
field of labor.” Elizabeth Blackwell, “The Influence of Women in the Profession of
Medicine.” Address before London Medical School for Women, 1889.

146. See Tenon’s report on the Hôtel Dieu of Paris, made to the National
Assembly in 1789. He describes the usage of the time, which eight centuries of
hospital existence had not taught how to improve.

147. Dr. Sims, in his treatise on Uterine Surgery, declared that the local
treatment of uterine diseases was, almost always, surgical.

148. During this year Dr. Broomall has gone to Asia, to make a tour of the
different missionary stations where there are women physicians, and there
perform capital operations on the cases which have been accumulating. This is an
expedition unique of its kind in history.

149. At the meeting of the Philadelphia Alumnæ Association, held in March,

1889, six successful cases of capital operations in abdominal surgery were reported
by members, including two Cæsarean sections and one hysterectomy. Sixteen
laparotomies were further reported from the Woman’s Hospital, but these have
been included in the statistical table.

150. See Appendix D.

151. Centenary of American Methodism.

152. Centenary American Methodism.

 153. Rev. Annie H. Shaw.

154. Christian Womanhood, W. C. Black, D.D.

155. Rev. Antoinette Brown Blackwell, the first woman ordained in this
country.
Mrs. Blackwell writes: “At the time of my ordination I was pastor of the church
of ‘South Butler and Savannah,’ New York State. The church called a council to
ordain me and install me as the regular minister. It was an orthodox society in
good and regular standing among other Congregational churches, and the
ordination was quite according to precedent; though doubtless the Congregational
body as a whole never would have ordained a woman either then, thirty-seven
years ago, nor yet to-day.”—Ed. note.

156. Rev. Louise S. Baker, pastor of the Orthodox Congregational Church, in

Nantucket, Mass., was ordained by the deacons of that church in 1884, two of the
four deacons being women.

157. Report of the Dedication of the Mary J. Drexel Home and Mother-house
of Deaconesses, December 6, 1888. In 1887 Mrs. Lucy Rider Meyer, M.D.,
connected with the Chicago Training School, with a few women to assist, gave the
first impulse to the Deaconess movement in the Methodist Episcopal Church,
which has resulted in the establishment of Mother-houses in Chicago, New York,
Boston and other large cities. The church, seeing the measureless opportunities
offered by such an institution, has wisely been prompt to adopt it, and this will
doubtless encourage the adoption of the order by other denominations.

158. The Grace House Training School for Deaconesses was opened for the
admission of candidates October (1890), in New York, adjoining Grace Church.
The General Convention of the Protestant Episcopal Church in October, 1889,
provided that every candidate for the office of Deaconess, before she is set apart,
shall have had “an adequate preparation for her work, both technical and religious,
which preparation shall cover the period of two years.” The Grace House Training
School is provided to furnish this preparation.—Ed.

159. Rev. Olympia Brown Willis.

160. “Biography of Distinguished Women,” Sarah J. Hale.

161. Dr. Kempin writes: The Law School for women was a private undertaking,
but founded with the aim to connect it with an already existing institution after
having proven its vitality. With the help of the Women’s Legal Education Society,
an incorporated body of women interested in the higher education of their sex, the
Law School succeeded in connecting itself with the University of the City of New
York. In response to a request of the Women’s Legal Education Society the doors of
the Law Department of the University were thrown open to women on the same
terms as to men, and a lectureship created to which I was selected as a lecturer on
the same footing as other lecturers in the Law Department and especially to
instruct classes of non-matriculating students who desire a knowledge of law for
practical guidance and general culture.—Ed.

162. Harvard chartered 1650; Yale, 1701; Columbia, 1754; William and Mary,
1693.—Ed.

163. See chapter on The Work of Antislavery Women.—Ed.

164. See chapter on Red Cross.

165. See chapters on Woman in the Ministry, Woman in Law, Woman in

Medicine.—Ed.

166. See chapter Hospitals and Training Schools managed by Women.—Ed.

167. See chapter Woman in Journalism.—Ed.

168. See chapter on Woman’s Work in the W. C. T. U.—Ed.

169. See Appendix E, for Civil Rights of Women.—Ed.

170. Wyoming was admitted to statehood, with equal suffrage for men and
women incorporated in her constitution, by an Act of Congress, July, 1890.

171. And yet co-education had its birth in Ohio (Oberlin, 1833).—Ed.

172. “Women as Inventors.” Mrs. Gage, North American Review, 1883, p. 478.

173. “For generations,” writes Johnstone, in his ‘History of Connecticut,’

“merchants and mechanics had been outranked by farmers.”

174. Material for the account of Lowell has been taken from Mrs. H. H.
Robinson’s interesting paper on Early Factory Life in New England, Dickens’s
American Notes, Lowell Offering, and Appleton’s American Cyclopædia.

175. “Think and Act,” “Men and Women,” “Work and Wages.” Virginia Penny,
1869.

176. See chapter, Aid for the Criminal Classes.—Ed.

177. Speech of Mr. Frederic Coudert at the Lenox Lyceum, April 7, 1890.

178. This thought of the greater benefit to be derived from the organizations of
labor as opposed to the philanthropic work done by the employing classes for the
people who work, has been ably carried out in a paper read by Mrs. Florence Kelley
Wischnewtzky before the New York Association of Collegiate Alumni, May 14,
1887, entitled “The Need of Theoretical Preparations for Philanthropic Work.” This
essay will appear in an early number of the Boston “Nationalist.”

179. Since the Grangers were first organized, that body has amalgamated its
efforts with those of the Farmers Alliances and these again with the Knights of
Labor. The Alliances are in many respects more socialistic than the Socialists,
inasmuch as the last-named have only proposed, by a transitional and
constitutional method, to arrive at the demands now made by the Alliances, and
these only after the altruistic and industrial planks in their platform have been
gradually conceded by National and State Legislatures. The Farmers Alliances,
which number possibly 5,000,000 members, demand the immediate ownership by
the people of all the means of transportation and communication, railways, canals,
telegraphs, telephones, etc. But more than this, their platform calls upon the
nation through Congress and the Treasury department for a system of sub-
treasuries, which have to aid directly in the purchase, storage, and distribution of
the products of farms and plantations—that is of all grain, tobacco, and cotton.

180. The first one established of any note was that of the Daughters of Crispin,
in Massachusetts, an organization of shoemakers, incorporated in 1872.

181. One evil that shirt-makers and seamstresses of all kinds had to contend
with was that the work was given out to contractors, families, and institutions,
principally to the Roman Catholic Protectory and the House of the Good Shepherd.

182. Ohio Report for 1887. L. McHugh, commissioner.

183. Condition of the Working Classes in England in 1844, Frederick Engels.

Translated by Florence Kelley Wischnewetzky.

184. In England this outrage on humanity was forbidden, in 1878, by Clause

No. 35 of the Factory Bill, which provided that “no young person, or woman, shall
be employed in any part of a factory in which the wet spinning of flax, hemp, jute,
or tow is carried on, unless sufficient means be employed and continued for
protecting the workers from being wetted, and, where hot water is used, for
preventing the escape of steam into the room occupied by the workers.”

185. Fall River, Lowell, and Lawrence. Thirteenth Annual Report,

Massachusetts Bureau Statistics of Labor.

186. Public attention was first directed to this hideous phase of the child labor
question through the discovery of the fact that large numbers of orphan children,
varying from eleven to fourteen years of age, were being exported from St. John’s
Asylum, Brooklyn, N. Y., to the glass factories of Fostoria and Findlay, O. Other
asylums, including the organization known as the Children’s Aid Society, were said
to be equally guilty with St. John’s Home in carrying on the business of child
trading for a money consideration.

187. New York newspapers November 23–26, 1888; Brooklyn Citizen,

November 23, 1888; Correspondence of Factory Inspectors, Harry Dorn, Ohio,
November, 1888; Correspondence of Factory Inspectors, John Franey, Albany, N.
Y., November, 1888.

188. New Jersey, 1883; Ohio, 1884; New York, 1886; Wisconsin, Rhode
Island, 1887; Connecticut, 1888; Maine, 1888; State factory inspection in
Pennsylvania in 1889; municipal factory ordinance in Chicago, 1889.

189. Massachusetts Bureau of Labor Statistics, 1875, pp. 183–84.

190. Whenever “socialism” is referred to in this essay, by the term should be

simply understood the meaning given to the word in recent editions of Webster’s
“Unabridged Dictionary of the English Language,” viz.: “A theory of society which
advocates a more precise, orderly, and harmonious arrangement of the social
relations of mankind than that which has hitherto prevailed.” This necessarily is
the very opposite of anarchy, described, in the same authority, as “The state of
society where there is no law or supreme power, or where the laws are not efficient
and individuals do what they please with impunity.” Socialism is therefore the
antithesis of anarchism. The former is constructive and altruistic, the latter
destructive, and the absolute sovereignty of the individual, consequently, disregard
of others. Nor is by socialism meant communism. Socialism recognizes the right of
the individual to the product of his own labor and certainly not the division
thereof; whereas communism means that common ownership of property which
has only been successfully carried out in the conventual orders of the Roman
Catholic Church and in the Buddhistic Lamaseries. This is the position taken in a
recently published article from the pen of the well-known social-economist Charles
Sotheran, formerly literary editor of the New York Star, but better known under
his noms-de-plume of “Colmolyn” and “Southernwood.”

191. See chapter, Work for the Criminal Classes.—Ed.

192. See chapter on Woman in Industry.—Ed.

193. See chapter, Woman in Industry.—Ed.

194. See chapter, Woman in Industry.—Ed.

195. The Association of Working Girls’ Societies was formed February, 1884,
with the following objects:
1. To strengthen, to knit together, and to protect the interests of the several
societies.
 2. To hold meetings, when reports of the societies shall be presented, and to
make more generally known their aims and advantages.
3. To promote the general adoption of the principles upon which the societies
have been formed.
4. To secure the services, by co-operation, of good teachers, lady physicians,
and lecturers.
5. To keep the several societies informed of such classes and schemes as are
proved valuable.
6. To encourage and assist in the establishment of new societies.
In April, 1890, a convention was held under the auspices of the New York,
Boston, and Brooklyn Associations of Working Girls’ Societies, and the
Philadelphia New Century Working Women’s Guild. Two hundred and twenty-five
delegates, representing ninety-six clubs, and from thirty-eight different cities and
towns, were present.—Ed.

196. The effort above referred to has during the year taken shape as the
“College Settlement,” and on September 1, 1890, its first annual report closes with
the following words:
“What are the ‘results?’ Certainly the residents are recognized as the friends of
those about them. The children turn to them with the joy of every acquisition and
the grief of every loss. The club boys of sixteen and seventeen years are proud of
their connection with the house and eager rivals in its good opinion. Even some of
the older women turn to the residents as friends upon whom they can rely. Those
who know the work best do not look for results other than this friendly relation in
any near future. The work, if it is anything, is a process of education. Character is
not formed in a year. In all the club work the object constantly sought is helpful,
personal contact. All methods are simply a means to this end. For this reason the
number of members in each club is limited. If the higher is ever to give an uplift to
the lower, must it not be through this method of friendship? Such a relation
implies giving and taking on both sides, and the workers at the Settlement find one
of the strongest points gained by residence to be, that their neighbors have a
chance to do something for them, a chance which is often improved. The
Settlement is one of the influences which go to form the lives of the people in
Rivington Street. If it shall create any higher ideals or quicken any aspirations, if it
shall awaken one soul to any sense of its own nature, the object of the College
Settlement will surely be attained.”

197. See chapter, Woman in Medicine.—Ed.

198. The story of the founding of the New York Infirmary, and the New
England Hospital for Women and Children, is told in the chapter on Woman in
Medicine.—Ed.
 199. Note.—I do not mean to claim that this result, which is very evident in
the community, is entirely due to the establishment of women’s hospitals, for it is
the consequence of a broader feeling for humanity in all institutions; but it is
certainly a marked feature of women’s hospitals. This note will apply to all that I
have said of hospitals. My subject is women’s hospitals, but I would gladly do
justice to the good work done in all hospitals, if it were not too broad a field.

200. In New York city the Woman’s Branch of the New York City Mission
sends out five nurses among the poor. These nurses have all had a full course of
training at some hospital. This mission claims to be the first society in America to
have introduced trained nurses in its work.
The Department of United Relief Works of the Society of Ethical Culture,
organized in 1879, furnishes nurses to Demilt and New York Dispensaries. During
the year 1888–1889 these nurses paid on an average 2800 visits to about 700
patients, including all diseases, even of the most infectious nature, and quite
irrespective of creed and nationality.
The Mt. Sinai Training School supplies, at its own expense (being at present a
separate organization from the hospital) from among its nurses not yet graduated,
but experienced in hospital training, a nurse who administers to the sick
irrespective of creed, nationality, or disease, under the direction of physicians
attached to what is called “District Poor Service” of Mt. Sinai Hospital. Among the
corps of physicians, all of whom give their services free, is one woman, Dr.
Josephine Walter, who devotes on an average four mornings a week to this work in
some of the poorest and most miserable districts of the city.
The order of Deaconesses, referred to in the chapter on Woman in Ministry,
also act in the capacity of nurse. Among them are many regularly trained nurses
who serve in the hospitals closely connected with the church.—Ed. note.

201. See chapter on Charity.—Ed.

202. See the story of Mrs. McFarland’s work, in “Alaska,” by Rev. Sheldon
Jackson, D.D.

203. See “Mary and I,” by Rev. Dr. Stephen R. Riggs.

204. The latest and best edition is by Roberts Brothers, Boston, Mass.

205. This was Susan La Flesche, a sister of “Bright Eyes.”

206. This was The Women’s Home Mission Society of the First Baptist Church
of Philadelphia, that of the Rev. George Dana Boardman, D.D., a society organized
by the efforts of Mrs. Boardman, the gifted wife of that distinguished preacher and
author, and largely in the interests of Indians.
 207. See also the “Sketch and Plans” of The Indian Treaty-keeping and
Protective Association, July, 1881, and “The Official Record” of The National
Indian Association for 1882.

208. The petition was as follows:

To the President of the United States, and to the Senate and House of
Representatives:
We, the undersigned men and women of the United States, resident in or near
——, do most respectfully but most earnestly request the President and the Houses
of Congress to take all needful steps to prevent the encroachments of white settlers
upon the Indian Territory, and to guard the Indians in the enjoyment of all the
rights which have been guaranteed them on the faith of the nation.

209. This was as follows:

To the Senate and House of Representatives in Congress Assembled:

We, the undersigned men and women of these United States, resident in or
near ——, do most respectfully, but most earnestly pray the Houses of Congress to
take all needful steps to prevent the encroachments of white settlers upon the
Indian Territory, and upon all Indian reservations; also to keep all treaties with the
Indians until they are changed by the mutual and free consent of both parties, and
to guard them in the enjoyment of all the rights which have been guaranteed them
upon the faith of the nation.

210.
MEMORIAL LETTER.[211]

ACCOMPANYING THE INDIAN PETITION OF 1881.

To the Senate and House of Representatives in Congress Assembled:

The men and women of this nation herewith present their second petition to
your Honorable Body for the faithful fulfillment of treaties and other guarantees
given by our government to the different tribes of Indians within our borders. Your
petitioners do not suggest any political policy to be pursued, leaving such matters
to wise statesmanship. They come with but one thought, conviction, prayer. The
thought recognizes the moral obligation of nations, as of individuals, to keep
compacts. The conviction is that recognized moral obligation should result in the
fulfillment of such obligation. The prayer is for such fulfillment as being ever, we
believe, the highest political wisdom, the truest national safety.
An objection has been made by some to treaty-keeping with Indians, on the
ground that the Indian tribes among us were never “nations,” and that, therefore,
so-called “treaties” with them were never real treaties. Your petitioners, with deep
feeling recall the fact that our government has for a hundred years recognized
these tribes as “nations,” in its hundreds of compacts with them calling the latter
“treaties,” and has, by Acts of Congress, bound itself faithfully to observe all such
made in the past, though deciding to make no new treaties with Indians. Your
petitioners, therefore, pray, for the sake of national honor, which demands honest
dealing with all men, that the terms “nation” and “treaty” may be kept to the heart
as they have hitherto been made and explained to the ear.
Again it has been urged that the law of eminent domain nullifies these
treaties, and requires our government to take legal jurisdiction of Indian lands, to
divide the same in severalty, and to open the remainder for white settlement. Your
petitioners are deeply impressed that for any government to apply the law of
eminent domain to the property of others than its own citizens, is to necessitate, if
there be resistance, a war of conquest,—a measure wholly opposed to the
fundamental principles of this government,—and that Indians, with few
exceptions, are not citizens of the United States, but are under their own legislative
and executive authority, as in the Indian Territory, and this by the terms of our
sales of territory to them, and their titles to the same.
Your petitioners therefore present their memorial to your honorable body,
feeling that the plea for treaty-keeping is a protest against any enactment of
Congress which would extend legal jurisdiction over territory not under the control
of this government, and which would do this, as for example the Oklahoma Bill
proposes, contrary to explicit treaty stipulations.
Finally, your petitioners would express the earnest conviction that the nation,
which has spent five hundred millions of dollars on Indian wars growing out of the
violation of treaties, can best afford to make it to the interest of the Indian tribes
among us voluntarily to become citizens of the United States, and not by the
coercion of Acts of our Congress.
Our petition of last year was from fifteen States; that of the present year
represents every State of the Union and several of the Territories; and has many
more than double the number of last year’s signatures. The work of circulating the
petition, and accompanying pamphlets, has been done by few persons, and chiefly
by Christian women already busy in benevolent work; yet the roll contains the
names of people of all occupations and in all ranks of society; of great business
firms and manufacturers; of distinguished men and officials; of judges, governors,
and ambassadors to foreign courts; of authors and editors; of the faculties and
students of not a few of our most noted collegiate and theological institutions, and
of literary and art associations. Besides all these, the roll includes the signatures of
women’s mission boards, Christian associations, and other benevolent societies;
the names of pastors and bishops of the churches; also the records of the
indorsement of a rising vote from various church-meetings of different
denominations; of meetings held specially to consider the Indian question; of
minister’s unions in different towns and cities, and of various other bodies. All
these and many other evidences reveal the fact that the moral sentiment of those
classes who largely make and control public opinion already requires
governmental faithfulness to our Indian treaties. For this your petitioners most
earnestly and respectfully pray.
Amelia S. Quinton.
Secretary of Indian Treaty-Keeping Committee.

211. This said:

To the President of the United States, and to the Senate and House of
Representatives in Congress Assembled:

We, the undersigned men and women of these United States, do most
respectfully but most earnestly pray our President and your honorable body:
1. To maintain all treaties with Indians with scrupulous fidelity until these
compacts are modified or abrogated by the free and well-considered consent of the
Indian tribes who were also parties to these treaties.
2. That since the number of Indian children within the limits of the United
States does not probably exceed sixty thousand, or one-third the number of
children in the public schools of some of our larger cities; and since treaties with
many tribes already bind our government to provide a teacher for every thirty
Indian children among these tribes: therefore we pray that a number of common
schools, sufficient for the education of every child of every tribe, may be provided
upon their reservations, and that industrial schools also may be established among
them.
3. We pray that a title in fee-simple to at least one hundred and sixty acres of
land may be granted to any Indian within the reservation occupied by his tribe,
when he desires to hold land in severalty, and that said land shall be inalienable for
twenty years.
4. We also earnestly pray for the recognition of Indian personalty and rights
under the law, giving to Indians the protection of the law of the United States for
their persons and property, and holding them strictly amenable to these laws; also
giving them increased encouragements to industry, and opportunity to trade, and
securing to them full religious liberty.

MEMORIAL LETTER OF THE INDIAN TREATY-KEEPING AND PROTECTIVE

ASSOCIATION, PRESENTED WITH THEIR PETITION FOR 1882.
To the Senate and House of Representatives in Congress Assembled:

Again the women of a national Indian association beg leave to present to your
honorable body the petition they have circulated and received again from the
people of the United States. Their roll represents, at a low estimate, considerably
more than a hundred thousand citizens,—instead of thirteen thousand as did their
first, three years ago,—and is an earnest plea for a righteous, speedy, and
permanent settlement of the Indian question.
 Among the petitioners are many hundreds of churches, which have adopted
the petition by a unanimous rising vote, this often having been taken at a regular
Sabbath service; various popular meetings have also here presented their plea,
similarly expressed; while the roll contains names of members of legislative bodies,
of governors, judges, and lawyers; names of bishops and of many hundreds of the
clergy—among the latter the entire ministry of three denominations in the city of
Philadelphia and numbering nearly three hundred; names of the professors and
students of theological seminaries like those at Hartford, Cambridge, Rochester,
and Upland; colleges and universities like Yale, Harvard, Brown, Cornell,
Rochester, Washington, and Lee; names of editors of leading periodicals; the
boards of hundreds of missionary and other benevolent societies, not a few of these
being national ones; with names of art, literary, and social clubs. Besides all these,
the roll contains the signatures of hundreds of business and manufacturing firms,
who control capital to the amount of many millions of dollars, and who employ
many thousand operatives—all showing that not only has there been a rapid
growth of sentiment among the religious and intellectual leaders of the
community, demanding legislation which shall end oppression of Indians and
secure to them full opportunity for industrial, mental, and religious development,
but that the commercial interests of our land also are fast coming to demand a just
and speedy settlement of the Indian question.
Permit an expression from the association who to-day present to your
honorable body their third annual petition,—an association having sixteen State
committees and one in each of the larger cities, with helpers in every State, all
these committees being composed of patriotic Christian women; permit these to
say that into their ears and hearts comes the cry of suffering, undefended, ever-
endangered, Indian women and children, and that this cry is our appeal to you to
secure for them legal protection; that the plea of Indian women for the sacred
shield of law is the plea of the sisters, wives, and mothers of this nation for them,
the plea of all womanhood, indeed, on their behalf to you as legislators and as men.
Permit us also to say, that in laboring by every means in our power to fill our land
with a knowledge of the present condition of Indians, and of our national
obligations to them, we most deeply feel, that while justice demands the
recognition of Indian personalty before the law, thus most surely and simply, it
seems to us, securing to Indians protection and fostering care, we yet feel that
legislation securing this recognition will be an honor to the present Congress and
to our beloved country. For this legislation we most earnestly and respectfully
pray.

212. One paragraph will perhaps be an encouragement to those organizing

similar women’s movements hereafter: “Under the head of ‘Meetings Held,’ the
New Hampshire branch reports twelve ladies’ meetings and a crowded mass-
meeting; the Massachusetts Association reports eleven ladies’ meetings and a very
successful mass-meeting in Tremont Temple; Connecticut reports fourteen ladies’
meetings and two mass-meetings; New York City has had various ladies’ meetings
and a mass-meeting in Rev. Dr. Hall’s church; Brooklyn has had thirteen ladies’
meetings and two mass-meetings; Philadelphia, including local auxiliaries and
meetings of the National Executive Board, has had about forty ladies’ meetings and
five mass-meetings; Baltimore has had eight ladies’ meetings and two mass-
meetings, and Washington sixteen ladies’ meetings and four mass-meetings.
Regarding the distribution of leaflets, New Hampshire reports 5500 sent out, with
401 petitions; Connecticut 5000 leaflets, and petitions sent to all her towns;
Maryland has sent leaflets to fifty towns and secured petitions representing 21,000
citizens. Of articles in the press, New Hampshire has sent sixty, and Philadelphia
over a hundred. Brooklyn has raised $325; New York, $405; Boston, $724, and,
naturally, being the home of the movement, Philadelphia has raised more than
these and all other auxiliaries combined.”

213. See “Protection of Law for Indians,” by General J. B. Leake; “The Indian
before the Law,” by H. S. Pancoast, Esq.; “Our Indian Wards,” by Col. George
Manypenny, and “Our Wild Indians,” by Col. Richard J. Dodge; “The Indian
Question,” by G. W. Owen, pages 90–97 and 639–650.

214. That of January, 1883, said:

We, the undersigned citizens of the United States, resident in or near ——,
viewing the results of our past national Indian policy; viewing also the present
positions and relations of the white and Indian races within our borders, and being
convinced by many considerations, both moral and political, that only that Indian
policy is just, and therefore wise, which has for its ultimate aim citizenship for
Indians, through the abolition of the reservation system by granting to all Indians,
not now under the Indian Government of the Indian Territory, lands in severalty,
with the same titles, law protection, property rights, common school education,
and religious liberty enjoyed by other races among us:
Now, therefore, we do respectfully but most earnestly pray that such a policy
as above suggested may be adopted and in future pursued, having due regard to
the principles of equity and justice involved in past treaties with Indians, yet
granting to them upon their present reservations as fast as individuals so desire
(and we pray that our Government will generously allure them to this desire).
First: Lands in severalty, with fee-simple titles, inalienable for thirty years.
Second: The same law-protection, legal personalty and citizenship that white
men and black men enjoy.
Third: Adequate common-school and industrial education upon their present
reservations, and,
Fourth: Full religious liberty.

215. See chapter Woman in the State.—Ed.

216. See chapter Woman in Literature.—Ed.

 217. See chapter Woman in Literature.—Ed.

218. Ohio.—Ed.

219. I have steadily refrained from adding biographical notes on the authors of
the chapters of this book, notwithstanding the fact that they themselves, in having
accomplished so very much on the very lines of progress which they have set about
to describe, have deprived us of much that could have been gracefully added, had
they been less fully identified with their subjects. Between the lines, however,
much may be gleaned; and to relate the lives of such women is to presume
ignorance on the part of the reader; a presumption of which a discreet editor would
never be guilty.
But when, through excess of modesty, the ignorance of the editor of this book
is delicately held up as a proof of the lamentably universal ignorance on the subject
of the Red Cross, the awful dignity of the editor is aroused! Without the following
explanation or extenuation, moreover, I do not see how the chapter in question
could have any place in the book. “Woman’s Work in America” can hardly be made
up of histories of work which is emphasized as “the work of men,” no matter how
gracefully apologized for.
Therefore the following little sketch of a woman’s work in the direction of
originating and applying the methods of the Red Cross in this country, written by
one connected officially with the society is presented, with the editor’s apologies to
the modesty of the President of the Red Cross: “It is with great pleasure I am
permitted to add a few words of explanation to Miss Barton’s story of the Red
Cross, and in as brief a space as possible present the colossal magnitude of this
remarkable woman’s work on Battlefield, in Hospital, amid Cyclone, Fire, and
Flood; Standing ‘alone’ among women even as a Napoleon or a Lincoln does
among men.
“Endowed by nature with a dual being, as it were; possessing the strong,
reasoning, powerful brain of a leader and the gentle, tender, loving heart of the
most delicate of women, Clara Barton stands before us a symbol of what woman
might be when she bursts the bonds that dictate to her ‘woman’s work.’
“Confined in this note to the relation of Miss Barton with the ‘Red Cross work,’
I still consider it fitting to suggest that the services rendered by her in the war for
the Union, in organizing, conducting, and leading the service of field nurses upon
actual battle-fields, in directing hospital organization, in managing other details of
field relief, and, more than all, in conceiving and carrying out the great work of
tracing and recording the fate of many thousands of missing soldiers, were
naturally and necessarily a proper prelude to the great service she has since
rendered in European combat, in presenting the Geneva Treaty to her own
government, and in so broadening its field of service as to include that of help in
great natural and national calamities.