‘Some Pumpkins’

James McCune Smith Was One Confident Young Man

As I continue editing James McCune Smith’s works, I’m struck again at the enormous confidence he displayed in his two letters to the London Medical Gazette in 1837. Written when he was a newly-minted physician – a recent graduate of the University of Glasgow’s medical school – McCune Smith boldly challenged a treatment for gonorrhea that was being administered to patients at Glasgow’s Lock Hospital by Dr Alexander Hannay. Hannay and Dr. William Cumin, McCune Smith’s midwifery professor, presided over the Lock around that time, in alternating six-month stints. McCune Smith served as one of Cumin’s clerks while he was still in medical school. Those clerkships were a privilege that Cumin awarded to his best students.

From James McCune Smith, ‘Solid Nitrate of Silver in Gonorrhoea,’ London Medical Gazette, 27 May 1837, p. 310

The Lock was a charity hospital that cared for girls and women suffering from venereal disease. Though many contemporary accounts of the Lock describe it as a horrible place where women and girls were shamed, mistreated, and coercively confined, the contemporary sources I’ve seen – including McCune Smith’s letters – give me a much less sensationalistic impression of the hospital, at least in that period. For example, the Lock’s sheltered location and strict rules for its patients seem to have been more about shielding the public from what was widely considered a bad example (it was a very religious time with very strict sexual mores, after all, and many had contracted these diseases from selling and otherwise having extramarital sex) and partly to shield the patients from prurient gawkers. And though the diseases that the patients suffered from were generally considered badges of shame, the Lock was also widely considered a very worthy charitable endeavour – after all, it helped the most vulnerable and outcast members of society – and Cumin’s clerkships were apparently coveted by his students. McCune Smith, for example, openly alluded to his work there later on with no apparent sense of shame or embarrassment or indication that he thought it was a generally bad or miserable place.[1] (Especially when Cumin was in charge, and not Hannay – McCune Smith pointed out, for example, that the Lock was fuller when Cumin was there, implying that patients preferred his care to Hannay’s, and entered, remained in, or left the hospital accordingly.[2]). So though it may not have been the most pleasant place to be, I’m left to doubt that the Lock was quite as awful as many recent commentators have made it out to be. But I digress.

When McCune Smith wrote the first of these letters to the editor of the Gazette on 17 May 1837, it was just three weeks after he received his degree as a doctor of medicine. He wrote it in response to Hannay’s recent open letter defending his silver nitrate treatment which, McCune Smith believed, was in turn a response to his medical society paper opposing it.[3] Reading that first letter again the other day, I thought once again, with a chuckle, of how McCune Smith later described his younger self at that time. In 1859, he recalled how ‘in the year of grace 1837, when, fresh from college, and considering myself “some pumpkins,” I strove to enlighten the Philadelphians on the subject of Phrenology and the study of the classics.’[4] But before he delivered those lectures after his return to the United States that autumn, McCune Smith strove to enlighten his senior colleagues on the best way to treat female patients suffering from gonorrhea – or at least, how not to treat them.

From James McCune Smith, ‘Letter from Communipaw [12 January 1859]’, in Frederick Douglass’ Paper, 21 January 1859

One scholar has described McCune Smith’s letters against the silver nitrate treatment as motivated by his desire to give a voice to his vulnerable female patients because of his sense of justice and his own experiences of oppression in New York City, and because of the reverence for evidence instilled in him by his professors at the University of Glasgow.[5] All of these, I agree, could lead him to oppose this treatment and to argue against it among his colleagues. But after a conversation I had with a historian of medicine of the time, and given McCune Smith’s later description of himself as ‘some pumpkins’ and the sometimes defensive, sometimes hard-hitting wording of his letters, I also think that McCune Smith was motivated by the desire – common among many emerging medical professionals – to make a name for himself by challenging his senior colleague vigorously and very publicly in a medical journal, and had the overweening confidence allowing him to do so.

Despite McCune Smith’s insistence that the Lock’s clinical records and patient testimony demonstrated that the silver nitrate treatment was painful, ineffective, and had serious side effects, Hannay’s clerks and colleagues rushed to his defense. They insisted that the treatment was very effective, that their patients rarely complained of discomfort when the solid silver nitrate was properly applied, and that the Lock’s clinical records actually suggested that Hannay’s care was more effective than Cumin’s. One even suggested that many patients’ apprehension of the silver nitrate treatment was instilled by McCune Smith’s own fearmongering.[6] McCune Smith finally stopped debating the treatment in the Gazette and never argued against it in future writings (at least none that are known to survive). I don’t know whether it's because his opponents’ arguments and evidence convinced him, or because he had returned home and was simply too busy to continue the debate, or for another reason. But the self-confidence that McCune Smith revealed in these letters never abated. He continued to strenuously and publicly oppose medical treatments and ideas (such as homeopathy and claims that black people were medically compromised) and (pseudo-)scientific theories (such as phrenology and scientific racism) that he believed were harmful and contradicted by the evidence for the rest of his life.

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[1] See, for example, James McCune Smith, ‘On the Influence of Opium Upon the Catamenial Functions’, The New York Journal of Medicine and the Collateral Sciences 2, no. 1 (January 1844): 56–58.

[2] See James McCune Smith, ‘Solid Nitrate of Silver in Gonorrhœa – To the Editor of the Medical Gazette’, in The London Medical Gazette, vol. 20 (London: Longman, Orme, Brown, Green, & Longmans, 1837), 310. (In Internet Archive)

[3] Alexander John Hannay, ‘On the Application of Solid Nitras Argenti in the Gonorrhœa of Women’, in The London Medical Gazette, vol. 20 (London: Longman, Orme, Brown, Green, & Longmans, 1837), 185–91.

[4] James McCune Smith, ‘Letter from Communipaw [12 January 1859]’, Frederick Douglass’ Paper, 21 January 1859.

[5] Matthew D. Eddy, ‘James McCune Smith: New Discovery Reveals How First African American Doctor Fought for Women’s Rights in Glasgow’, The Conversation, 8 October 2021, https://theconversation.com/james-mccune-smith-new-discovery-reveals-how-first-african-american-doctor-fought-for-womens-rights-in-glasgow-166233.

[6] See McCune Smith, ‘Solid Nitrate’; Joseph Bell, ‘Solid Nitras Argenti in Gonorrhœa’, in The London Medical Gazette, vol. 20 (London: Longman, Orme, Brown, Green, & Longmans, 1837), 473–75; James McCune Smith, ‘Solid Nitrate of Silver in Gonorrhœa – To the Editor of the Medical Gazette [#2]’, in The London Medical Gazette, vol. 20 (London: Longman, Orme, Brown, Green, & Longmans, 1837), 894–95; Henry Somerset Taylor, ‘Solid Nitrate of Silver in Gonorrhœa in Females’, in The London Medical Gazette: New Series, vol. 1 (London: Longman, Orme, Brown, Green, & Longmans, 1837), 63; James Cross, ‘Nitrate of Silver in the Gonorrhœa of Females’, in The London Medical Gazette: New Series, vol. 1 (London: Longman, Orme, Brown, Green, & Longmans, 1837), 99–100.