Polygamy,piousness,and the practice of medicine: Understanding Brigham Young and the predominance of female medical providers in early Utah

Part one: Interplay of Brigham Young, gender roles, and Dr Ellis Shipp

“A doctor, if he had good sense would not wish to visit women in childbirth. And if a woman had good sense she would not wish a man to doctor them on such an occasion”. ¹ Brigham Young, revered Prophet of the Church of Jesus Christ of Latter Day Saints (LDS), spoke these words in December 1851, expressing not only his personal dislike of physicians, but also that the proper role of women in his society fell along very traditional gender divides. Young has long been lauded for his presumably progressive attitude as he sent dozens of LDS women to the east coast of the United States to receive a formal medical education at The Women’s Medical College of Pennsylvania. However, instead of the study and practice of medicine expanding the domain of women upon their return to the Deseret Territory, the established societal norms of the era limited how women were able to study and practice medicine. Brigham Young and the LDS community of Utah in the late nineteenth century went to enormous lengths to enroll these women and have them trained. Young himself often arranged transport across the country and supplied financial aid to women beginning their medical education. On several occasions, Brigham Young was documented as endorsing trained female physicians in the Mormon community. Indeed, Young “favored the idea. (The idea) originated with him to have some of our sisters obtain a medical education”. ² By most estimates, in the first 50 years of the Deseret Territory, the area first settled by the Mormon pioneers, there were more women practicing medicine than men. ³

One such woman physician sent by Brigham Young to study medicine was named Ellis Shipp (1847–1939-see Figures 1–4) who would become one of the most influential physicians in the early Utah Territory. After answering the Prophet’s call, she would go on to found dozens of midwifery schools and deliver thousands of babies. A sister wife and biological mother to 10 children, six of whom survived infancy, she spent several of her adolescent years as Ellis Reynolds living in the Prophets home while she attended secondary school at Young’s request. The two of them would go on to form a close bond during this time which would weave their stories together, influencing each other for the rest of their lives. OPEN IN VIEWER

Although Brigham Young directly supported women’s medical education, the reasons he did so are more complex than acknowledged in accepted accounts of his leadership. In the nineteenth century, women made up a minority of physicians across the United States, in fact, it wasn’t until 1900 that women practitioners even eclipsed five percent of the overall physician workforce of the United States. ⁴ In the early Deseret Territory a half century prior, women often had very few opportunities outside of being a wife and mother, which the LDS church promoted as the highest calling for any woman. The LDS Church also desired their members to propagate the religion through reproduction with an emphasis on larger families. ⁵ Joining the workforce was the responsibility of the men of the family: their fathers, husbands, and sons. How did a faith that professed a woman’s domain to be restricted to the home at the same time have a leader who advocated for women to leave their families and travel a great distance to receive a formal medical education? By reaffirming these traditional gender roles through the practice of medicine itself.

In the late nineteenth century, medicine was sometimes practiced by individuals whose training consisted of two to three and a half years of formal education with an optional apprenticeship thereafter. In many instances, individuals in rural areas practiced medicine without any formal education whatsoever. The demand was so high for doctors in these areas that simply claiming to be an MD would provide a physician with a steady stream of patients. One physician practicing in Ohio wrote in 1868 that the entirety of his training consisted of preparing medications for a local doctor, assisting in surgeries by holding patients down during amputations, and receiving a grand total of two lectures from visiting physicians before earning his degree as a medical doctor. ⁶

Dr Shipp however did receive her training in a more formalized manner. Born Ellis Reynolds, she came to the Utah territory with her family subsequently settling in the small town of Pleasant Grove only 37 miles south of Salt Lake City. It was there she met her future husband as well as Brigham Young at a local community dance. After dancing with the Prophet who had happened upon the dance in transit back to his home in Salt Lake City, he decided Ellis Reynolds' best place was to live with him. Reynolds then spent several years living in Brigham Young’s home on the same block as the central Mormon temple. At the end of this period, she professes infatuation with a young man in her hometown and asks the Prophet if she might rejoin this man and the rest of her family at this time in Pleasant Grove. ⁷ After a period of discernment regarding her reasons for leaving his house, Young finally permits it. It is only after this time Young decided to ask the women of his territory to come forth as physicians, one of the very first was none other than Shipp herself, now a wife and mother to her newborn son reporting after her sister wife, Maggie, had failed in her studies due to the burden of loneliness and homesickness.

After being sent to The Women’s Medical College of Pennsylvania, she would spend four rigorous years learning treatments, anatomy, and physiology of the human body at great personal cost. A mother and wife to a Mormon Missionary by the name of Milford B Shipp, she often remarked in her diary how it was the love for her family and the support of her sister wives that pushed her to continue studying late into the evenings even while others at this time were attaining their status as physicians in a much less competitive and regimented manner.

Training wasn’t the only nonstandardized aspect of medicine in the United States at this time; treatments varied widely as well. In rural and newly settled areas of the frontier such as Utah and the greater Deseret Valley, plumbing was a rarity and people often worked long and arduous hours of physical labor resulting in a plethora of accidents. Tuberculosis and cholera were much more prevalent, and the 1850 US census data had the infant mortality rate at a staggering 28% across the entire nation. Physicians’ ability to treat or intervene in these ailments was often limited. Archaic practices such as bloodletting were only recently falling out of favor, but modern vaccines, antibiotics, laboratory tests, and sophisticated imaging techniques had not yet been developed. The available treatments were most often aimed at relieving symptoms rather than targeting the underlying cause of disease, which influenced the overuse of drugs such as arsenic, opium, morphine, phenactine, and acetanilid. ⁸ Most often, physicians were relegated to prescribing sensory-dulling medications and telling the patient to rest.

Not only were available medical treatments of the era very limited, but the Mormon faith was generally unwilling to accept many of them as a primary method of treatment. The general medical culture of the time, despite the existence of an all-female Quaker medical college in Philadelphia, was deeply suspicious of the idea of women physicians. Most medical institutions in the US were against having women practice medicine, and this view was held by much of the populace. A major obstacle facing female providers were patients themselves, as “male patients could not bring themselves to be seen by a woman physician and decided to live with their ailments” ⁹ when no male doctor was available. Even the most recently established medical schools, such as Toland Hall, founded in 1862 in San Francisco, featured male educators such as physician Beverly Cole, Professor of Obstetrics and Clinical Diseases of Women, who further advocated against the inclusion of women in the field. In 1875, Cole proclaimed that “female doctors were failures. It is a fact that there are six to eight ounces less brain matter in the female. Which shows how handicapped (they are).” ¹⁰

Despite his affirmation that women should practice medicine in some form, Brigham Young was quite outspoken against the mainstream medical treatments of the day. Referring to allopathic medicine as “the most imperfect of any science in existence” he went so far as to proclaim that “doctors no more understood ‘the systems of man’ than did the heavens” and “a worse set of ignoramuses do not walk the earth.” ¹¹ He warned that physicians’ treatments were meant to “kill you or cure you to get your money.” His iatrophobia and general disdain for the profession and those who practiced it led him instead to endorse healing traditions created and sanctified by the newly formed church.

Followers of the LDS faith however and other inhabitants of the Deseret Territory were not devoid of treatment options despite the Prophet’s disdain for allopathic physicians. While some health-related interventions came directly from doctrines of the faith, other types of providers, such as Thomsonian (Botanical) doctors, received the sanction of the church and were held in very high esteem. Numerous articles of the era in the Deseret News, then and now a church-owned newspaper, proclaim the church’s support for these unorthodox treatment methods. Because the LDS church put a great value on individuals who worked in manual labor, these Thomsonian doctors were expected to maintain another profession outside that of healer. Therefore, they had much greater acceptance across the populace as providing medical care was often not their primary source of income. Across most of the United States and its territories, however, Thomsonian doctors were despised. Violating a sacred and quintessential element of medicine in 1813, the founder of the botanical medical system, Dr Samuel Thomson, patented his remedies, refusing to share his formulas with others unless they paid him a 20 dollar fee to practice medicine, a practice largely unheard of at this time.

However, because Thomson’s methods were sanctioned by the church leaders, practitioners of this botanical method were commonplace across the Deseret territory. While Thomsonian-trained physicians and midwives regularly visited the sick, the hostility of Brigham Young and other members of church leadership made it nearly impossible for even the most highly trained mainstream physicians to care for members of their faith. Historical records from the latter half of the nineteenth century offer countless examples of physicians settling in the greater Salt Lake City area during this time but being forced to relocate after only a few years, due to the populace’s resistance to mainstream medicine. ¹²

Thus the history of the Mormon church includes a complicated interplay between Brigham Young and medical doctors, regardless of gender. He regarded doctors as superfluous members of the community who were not as important to Deseret society as those who accomplished manual labor and produced items of worth. “Doctors and their medicines I regard as a deadly bane to any community …” Young once proclaimed, “I am not very partial to doctors … I can see no use for them unless it is to raise grain or go to mechanical work”. ¹³ A widely circulating belief held that doctors were unnecessary, as the Mormons were such a healthy populace. A short article in the Deseret News in 1852 read:

“Health of the city good. Two physicians have removed to one of our most distant settlements and gone to farming; three more have taken to traveling and exploring the country; three have gone to California, to dig gold, or for some other purpose, and one has gone to distilling, and we are beginning to get some alcohol, which is desirable for gentleman’s shoe blacking, hatters’ water proofing, chemical analysis, washing the bodies of the well to prevent sickness, and the sick that they may be made well, when such there be. Those physicians who remain, have very little practice, and will soon have less, (we hope).”^14,15

Young’s proclamation and subsequent actions have been held up in popular narratives of the Church’s history as an advancement and broadening of the roles women would be allowed to hold in the Mormon Society of the era. However, Young’s promotion of women as physicians was, instead, an affirmation and reinforcement of traditional gender roles that even today play a very large part in the dynamic of the LDS church. Former Church Prophet and President Ezra Taft Benson, President from 1985 to 1995 stated, “It is propaganda that some women are more suited for work than for family.” These sentiments were echoed by Benson’s successor, President Gordon B Hinckley (1995–2008) when he said, “By divine design, fathers are to preside over their families in love and righteousness and are responsible to provide the necessities of life and the protection of their families. Mothers are primarily responsible for the nurture of their children.” ¹⁸ These claims are of significant importance to members of the church, as Mormon Prophets are thought to converse directly with God. Young was thus strengthening the foundation of gender roles in the LDS church, not challenging them.

The diaries and journals created by women who went east from the Deseret Territory to study medicine are often held up as evidence of the progressive nature of Brigham Young’s directive—encouraging women to seek education and increased social status. Read closely, however, they provide evidence moreso of Young’s desire to enforce limits and separations of gender roles. The ways in which the study of medicine limited and preserved traditional womanhood comes from the diaries, journals, and other records left by these women themselves. A noted journal-keeper, Dr Ellis Shipp, wrote of the rigors of her medical school curriculum and why she persevered: “tis not alone for self, but for my darling children. Oh, I must succeed for their sakes-and my dear husband.” ¹⁹ Her motives for studying medicine are then not for some altruistic purpose devoid of her traditional role as a woman in her society; rather, her status as a mother and wife serves as an integral component of her passion for studying medicine.

Dr Shipp’s written legacy is often offered by the church as an important key to understanding LDS women of that time and place. Shipp is proffered as evidence of the pinnacle of what a woman could accomplish in this pioneer era of Mormon culture under the directive of Brigham Young. Less explored is how her work specifically illustrates Young’s attitudes toward women, women as physicians, and physicians and medicine more generally. In her autobiography, While Others Slept, Shipp details her life from the perspective of how she consistently seeks to show her love for others around her, and the tenets of her faith.

Shipp, and other women who responded, exemplified what Brigham Young hoped would become of the women he sent to receive a formal medical education. He wanted these dutiful new doctors to solidify their role as nurturer of children by helping to bring them into the world. The needs of childbirth provided a perfect rationale for sending women to receive a formal medical education in Philadelphia. If, as President Young stated, it was nonsensical for a male to tend to a woman in childbirth that left only one option: women. What is now thought of as mainstream, orthodox medicine was seen as the alternative treatment option in the pioneer LDS culture of the era (similar perhaps to today’s views on acupuncture, chiropractics, and essential oils). Being a physician was therefore an ideal position for a female in this patriarchal society and a natural fit for a homemaker and wife—as long as their primary responsibilities remained that of a wife and mother. As a practitioner of alternative therapies, women were not to be burdened with the outcomes of healthcare when treatment options failed. Ultimate responsibility for the health of the general populace still resided with the Elders of the LDS Church. The main duties charged to these female medical providers were the bringing of children into the world (their own or otherwise) and associated care of new mothers.

Having female physicians to tend to the needs of members of the LDS church also helped preserve female modesty according to church teachings and traditions. Practicing medicine, in this culturally restricted form, helped to shelter women from manual labor such as farming or construction practices and was a profession sometimes even shared amongst sister wives. Although they preceded the formal discipline of medicine named Obstetrics and Gynecology, the procedures and medicine practiced by these female physicians fell almost exclusively in this realm of practice. Occasionally, they would have the opportunity to practice other areas of medicine in which they had been trained, such as pediatrics or emergency medicine in times of dire need, but this was still within the traditional construct of the woman’s role as leader of the home and caretaker of the children.

Part two: The practicing female physicians

Brigham Young’s call to have women study medicine in 1874 was answered almost immediately by five women. Upon their return to Utah from Philadelphia, these new physicians began to open up the area of medical practice specific to their traditional roles as women. They opened numerous schools and training programs, resulting in over 500 formally trained midwives who would later deliver thousands of babies across the fledgling state of Utah in the subsequent decades following their return to the Deseret Territory. Shipp herself is credited with the delivery of over 6,000 babies in her career.

It is notable how these programs, largely all founded by Dr Ellis Shipp upon her return to her family after receiving her medical education in Philadelphia at first flourished. Shipp and her sister-wife, a fellow-Women’s College of Philadelphia trained physician, Dr Margaret Curtis Shipp Roberts, began offering classes to women on childbirth in their own home before traveling around the area settled by the Mormon Pioneers. Shipp and Roberts were the two most notable female physicians of the era involved with founding and propagation of numerous schools. Yet in their surviving writings, both women emphasize often that their most strenuous and important duty is the care of their children rather than the duties associated with their medical practice and teaching.

In response to several societal stressors occurring in the final quarter of the nineteenth century, many members of the church’s all-female Relief Society thought it prudent to extend medical education in the territory even further. With the promise of impending statehood, more and more individuals from outside the LDS faith were beginning to arrive in the Deseret Territory, carrying with them their desire for orthodox medical education. In 1874 and 1876 respectively, Episcopalians and Catholics opened hospitals in the Salt Lake Valley. Pressure placed on Brigham Young by the opening of the Episcopalian hospital in 1874 may have influenced the Mormon Prophet to issue his call to the women of the territory to train as physicians in the first place. However no matter the impetus behind the call, in response to these new hospitals being built, in 1877 the Relief Society selected LDS physicians Dr Romania B Pratt and Dr Ellen Ferguson to head a new hospital, which was to be named Deseret and construction began soon thereafter. The hospital was to start small with only two physicians and three departments: a maternity ward, medical school, and emergency hospital (see Figures 1–4). ²⁰ Interestingly, the medical school was to train both males and females together. OPEN IN VIEWER

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Figure 3.

Dr Ellis Shipp posing for a portrait. Used by permission, Utah State Historical Society.

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Figure 4.

Dr Ellis Shipp appearing later in life in cap and gown. Used by permission, Utah State Historical Society.

Deseret Hospital, however, was doomed to fail. Despite being called to become doctors by the immensely influential leader and Prophet of the church, members would often see a priesthood holder for treatment or go to other hospitals staffed by male physicians, whom they believed to be superior to their female counterparts. This held true even when seeing male physicians meant specific payments for services rendered and care received from providers of the Deseret Hospital was structured more on what individuals and their families could afford, regardless of what treatments they received. Funds raised by the Relief Society for its founding and for operating expenses therefore depleted rapidly. Compounding the problem of how to sustain the hospital were several factors. First, it was a free hospital where patients paid what they could for services. Upon learning healthcare was free, even those with the ability to pay refused to do so or paid for services through produce raised by local farmers. LDS women, the majority patient demographic of the Deseret Hospital, were encouraged not to have a profession outside the home. Thus, their husbands did not see any reason to pay a woman physician, and so often sent their wives and children to the hospital without any possible means of payment. Hoping to curtail this practice, Drs Pratt and Ferguson acted in two ways. First, they hired two male physicians who possessed similar training to their own in an effort to add credibility to the hospital where previously they “felt their labors to be more or less appreciated.” ²¹ While the addition of the male physicians did cause “some brethren to come forward and (join)” it was “comparatively few.” The other measure taken to save the hospital was the addition of two new departments: one of nursing and the other of obstetrics, to train more midwives for the growing population.

In 1884, as a last attempt to save the hospital only two years following its inception, the members of the Relief Society, who had been supplying the hospital and its patrons with their donations, took out an advertisement in the Women’s Exponent, the first (and, at the time, only) women’s newspaper in the Deseret Territory. This advertisement read more like a plea than an announcement, asking individuals to “give one dollar per year to such a noble work as the care, nursing, and treatment of the sick.” ²¹ In 1894, however, the doors closed after only 12 years; despite there being two other non-LDS run hospitals concurrently running and remaining profitable in the Salt Lake Valley. Perhaps not surprisingly, the only vestiges of the Deseret hospital that remained active were the nursing and midwifery schools, until they merged in 1905 with the founding of the Groves Latter-Day-Saints hospital at the same location.

Despite rhetoric calling for women to train as physicians, upon return home to Utah the scope of their practices was greatly limited due solely to cultural understandings of their capacity as women. Dr Shipp and other Mormon women were sent away to study in Philadelphia, not for the sake of improving their status in society, but as yet another conduit for women of the era to remain in their traditional roles as wives and mothers. Although they had more comprehensive and current knowledge of medical treatments, their roles quickly devolved into caregivers for children, providers of treatments of conditions specific to women, and helpers in childbirth as these were roles deemed appropriate by their society.

A dominant narrative persists today, primarily amongst the LDS faithful, that holds Brigham Young was an advocate for women’s education, particularly in attaining degrees as physicians. This interpretation of the historical record has rarely, if ever, been questioned before. The concrete, observable data that show how President Young financed and actively campaigned for women to achieve these positions as physicians makes it difficult to propose any other motive for the prominence of female medical providers which existed in early Utah. Only through further evaluation of the political and social context of the era, combined with careful attention to the transcripts of speeches by Young and other primary sources, such as Shipp’s diaries and journals, does a different explanation arise. Rather than advocating for a wider role for women in this new society, Brigham Young co-opted the medical education of women as a tool to reinforce the narrow constraints of their world, in which women remained separate from, and inferior to, men.