A Guide to the Stages of Womanhood
By Hannah Brewington
Tokology: A Book for Every Woman, first published in 1883, was one of the first comprehensive books regarding women’s health. Written by Alice B. Stockham, an early female physician in the United States, the book and the author herself played equally interesting and important roles in many movements of the 1900s relating to women’s health, rights, and sexual expression. Because of high demand, the book continued to be edited and reprinted, and the 1907 edition can be found in the Leo J. McCarthy, MD, History of Medicine Room and Collection at the Ruth Lilly Medical Library.
Alice B. Stockham was one of the earliest licensed female physicians in the United States, receiving her medical degree in 1882 from the Chicago Homeopathic College. She was also an early leader in the feminist movement and a sex reform advocate, and the information in her book reflects those different but closely related roles. Throughout Tokology, Stockham covers many aspects of the female experience of wellness, ranging from menstruation to pregnancy, childbirth and labor, menopause, sexual relations, and even early concepts of birth control and women’s dress reform. At this point in history, women’s health had been taken over by mainstream medicine and its male practitioners, so many women found her writings to be an incredibly valuable addition to their bookshelf as it allowed them to reclaim knowledge of their health and bodies for themselves. In fact, the book became a widespread success, and Tokology went through “more than forty-five printings selling hundreds of thousands of copies over the years.”[iii]
Part of the reason Stockham’s book was so popular was due its recognition of the female body and women’s experiences as its own unique subject, as well as the way she addressed the gendered ideas of health and wellness that were prevalent throughout the late 19th and early 20th centuries. At this time, physicians, who were overwhelmingly middle-class white men, were building the medical and social ideology that would set the foundation for how medicine would be practiced in the United States and how women’s bodies would make their appearance in this system. Influenced by social norms, they had extremely gendered ideas about the woman’s body and they “developed an elaborate medical and biological ideology that sought to rivet women to their roles as child-bearers and child rearers.”[iv] There were also ideas, coming from men, that the woman’s body was a “closed energy system” with very limited energy resources, reinforcing the idea that women were inherently weak, feeble, and must be in a married relationship in order to fulfill her role as a mother and dependent of her husband.[v] These ideas of a woman’s physiological attributes and her role in society were perpetuated by male physicians and had extremely detrimental effects on women’s overall wellbeing.
Ideas about women's natural role as a mother had negative implications for women’s health, as many women were exhausting themselves to satisfy their husband’s sexual needs and societal expectations to do so, even if it meant having many unwanted children. Pregnancy and the act of labor was not the relatively safe process that it is in the United States today, and there was a much higher risk of physical trauma or death.[vi] Additionally, many women unintentionally ended up having multiple children, which posed many health risks such as “anemia, nutritional deficiencies, and physiological and psychological depression.”[vii] Indeed, many women looked forward to reaching menopause so they could be relieved of their reproductive duties,[viii] and Tokology’s informative chapter on this stage of life may have been a selling point for many women who otherwise would have undergone this experience alone or with the advice of their male physician.
Additionally, birth control during the late 1800s was associated with prostitution and sexual immorality, so there was no widespread access to contraception for women. In addition, many women were contracting venereal diseases from their husbands.[ix] However, there was an interest among women to have some sort of control over their reproductive rights. Stockham believed that a woman’s “good health” was linked to her need for correct information about how to have healthy sexual relationships,[x] and she included much of this information in her book Tokology in order to promote holistic wellness as a path towards optimal health for women. Most notably, she promoted the idea of “voluntary motherhood” by recommending periodic abstinence except for procreation.[xi] Voluntary motherhood was a women’s health and feminist movement during the early 20th century that fought to give women control over their reproductive functions and control when a new life begins. The ovulation cycle was not understood until the 1930s, so permanent abstinence when not planning for children proved to be the most effective form of birth control at this time.[xii]
Although women widely praised and received the text by Stockham, many men were expressing “anxiety concerning women's potential for independence,” sparked by women taking control of their health and bodies, and becoming less subservient to their husbands and their sexual desires.[xiii] Legal restrictions proved useful for men as they attempted to re-exert control over women’s bodies. The Comstock postal laws of the 20th century prevented the interstate shipping of obscene materials. However, there was no clear definition or guidelines as to what may be considered obscene, and many men, out of fear of the growing women’s individuality, autonomy, and sexual expression, used this law to prevent the spreading of information about women’s birth control and their health differences. In some cases, Alice B. Stockham’s book Tokology or sections of it were not allowed to be sent through the mail across state lines, effectively censoring the information that many women were finding to be so revolutionary and necessary. However, despite the many obstacles and lack of acceptance that Alice B. Stockham faced with her comprehensive text, she was nonetheless able to help women become more educated about their bodies and take control of their health in their own hands.
This post was written for the course HIST H364/H546 The History of Medicine and Public Health (Instructor: Elizabeth Nelson, IUPUI School of Liberal Arts).
[i] Alice B. Stockham, Tokology: A Book for Every Woman (Chicago: Sanitary Publishing Co., 1886). Available online via the U.S. National Library of Medicine Digital Collections: https://collections.nlm.nih.gov/catalog/nlm:nlmuid-67130740R-bk.
[ii] The Mary Baker Eddy Library, “Women of History: Alice B. Stockham,” accessed Dec 16 2019, https://www.marybakereddylibrary.org/research/women-of-history-alice-b-stockham/.
[iii] Marsha Silberman, “The Perfect Storm: Late Nineteenth-Century Chicago Sex Radicals: Moses
Harman, Ida Craddock, Alice Stockham, and the Comstock Obscenity Laws,” Journal of the Illinois State Historical Society 102, no. 3/4 (Fall-Winter 2009): 330.
[iv] Carroll Smith-Rosenberg, Carroll, “A Richer and a Gentler Sex,” Social Research 53, no. 2 (Summer
[v] Smith-Rosenberg, “A Richer and a Gentler Sex,” 291.
[vi] Ibid., 290.
[ix] Linda Gordon, “Voluntary Motherhood; The Beginnings of Feminist Birth Control Ideas in the
United States,” Feminist Studies 1, no. 3/4 (Winter-Spring 1973): 13.
[x] Silberman, “The Perfect Storm,” 330.
[xi] Ibid., 332.
[xii] Gordon, “Voluntary Motherhood,” 9.
[xiii] Smith-Rosenberg, “A Richer and a Gentler Sex,” 287.