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The legacies of two Dartmouth doctors

Two of the main Dartmouth players in the story of puerperal fever's elucidation during the 19th century (see "The most unspeakable terror") left legacies that went well beyond their impact on the understanding of that dread disease. The work cited in that article does not begin to scratch the surface of their lives' work, so here is a more detailed look at two products of a 19th-century Dartmouth medical education.

Charles Knowlton, DMS 1824:
The father of birth control

Charles Knowlton was, in all senses of the word, a freethinker. His body of work, though largely unaccepted and unappreciated during his lifetime, proved to be an invaluable contribution to both medicine and philosophy.

Born on May 10, 1800, in Templeton, Mass., he passed his early years plagued by sickness and worry. In 1821, he married Tabitha Stuart of Wichendon, Mass. Knowlton had come to know her through her father, Richard, an inventor who had helped Knowlton treat his ailments with electric shock therapy. Soon thereafter, in October 1821, Knowlton began studying medicine as an apprentice with Dr. Charles Wilder of Templeton.

His curiosity was not satiated, however. He became interested in dissection and began to exhume corpses from local graveyards, partly so he could practice dissecting himself and partly so he could sell some of the corpses to Dartmouth Medical School's anatomy department—for $50 apiece, an enormous sum in that day—in the hope of financing his own medical education in Hanover. And his grave-robbing did not end there. In 1824, a few months after his first term at DMS, Knowlton was convicted of illegal dissection. His father paid the $284.26 fine he was assessed, but the future physician also had to spend two months in the Worcester, Mass., County Jail.

During his time at Dartmouth, Knowlton was a social outcast, but he tried to impress the other students with his knowledge. He was a vocal member of the class and often sat in the front of the lecture hall. In 1824, he presented his graduation thesis on one of his passions—the role of dissection in the study of human health.

After an unsettled period following his graduation, Knowlton finally found success as a private practitioner in Ashfield, Mass. At first, his personality was sufficiently abnormal that he found it hard to fit in. The fact that he was assertively agnostic did not help him attract patients; he was known, for example, for playing his violin at the precise time his neighbors were on their way to church. Children of the town were even told that the doctor had horns.

But as word of Knowlton's skill as a doctor began to spread, his practice eventually grew to encompass a large swath of western Massachusetts, including towns a full day's ride on horseback from Ashfield. Also a regular contributor to the Boston Medical and Surgical Journal, Knowlton became an extremely well-respected physician among his colleagues.

In addition, Knowlton began in the late 1820s to develop his ideas about materialism, which resulted in the publication of his first book, Elements of Modern Materialism. Though he ordered about 1,000 copies, he sold only few. His next work was much more successful, though it ignited an international controversy. The Fruits of Philosophy, a treatise on the medical and social aspects of birth control, was published in 1832 under the authorship merely of "A Physician." While this is telling regarding the danger Knowlton perceived in publishing the work, he soon took full responsibility for his ideas. Indeed, voices were soon raised all over Massachusetts in condemnation of his immorality. He was first fined $50 in Taunton, Mass., for publishing an obscene book. Then, in December 1832, he was sentenced to three months' hard labor in Cambridge. A third charge came from Greenfield, Mass., but that jury was not able to come to a conclusion.

Though he was prosecuted only in Massachusetts, his work drew national and international attention. In the mid-1870s, Charles Bradlaugh and Annie Besant, two British freethinkers, became interested in Knowlton's book—not because of its content, but because of its importance in the fight for free speech. When a publisher of the book pled guilty to a charge of producing it, the two freethinkers produced many more copies and made a point of informing the authorities of the locations where the book would be sold. This insured their arrests, on March 24, 1877. It was a landmark case and garnered much support for free speech. Besant then went on to champion the birth control movement in Britain.

However, Fruits of Philosophy was not simply an ideological treatise, useful in the fight for free speech. It was an actual manual with instructions on how to control births and birth rates. It suggested practices and methods that gave couples the tools to choose when they would have a child. Though obviously one little book could not single-handedly change nationwide birth patterns, its introduction in Britain corresponded to a drastic shift in birth demographics there.

The book's first section makes the case for the importance to humanity of birth control. "I am aware that with some minds the first impression will be, that this object is not good. But I am also fully satisfied . . . that the more such minds reflect upon the subject the more favorable opinion they will have of it," Knowlton wrote in the introduction. "At any rate, it is a subject of too great and abiding influence to be passed over without a serious and impartial examination."

Subsequent sections focus on the anatomy and physiology of the reproductive organs and on many issues that sound strikingly contemporary and controversial, including abortion, fetal "rights," genetic counseling, and the pleasure of sexual intercourse. Knowlton's prescribed method of contraception was douching within five minutes of intercourse with a solution of alum or zinc sulfate.

His work was thoughtful and unbiased by the morals and norms of the time. His commitment to intellectual integrity was obvious in all his work as a physician, author, and thinker. For example, a public argument between Knowlton and a Dr. Trow, documented in letters to the editor in the Boston Medical and Surgical Journal, was summed up this way by Dr. Stephen Tabor: "His first report was not written to injure Dr. Trow, but to sustain the truth."

Knowlton clearly brought invaluable philosophical, medical, and intellectual knowledge to the world—but the world may not have been ready for it just yet.

Charles Hunt, DMS 1857:
Hero of the Civil War

Charles Hunt's story as an assistant surgeon in the 12th Regiment of the New Hampshire Infantry is that of an unsung Civil War hero. Well-respected and well-liked by his fellow soldiers, Hunt died of typhoid fever on August 20, 1863, after serving the country he loved. The disease that caused his death was brought on by fatigue as a result of caring, for a full week with little rest, for the wounded at Gettysburg. Until his dying day, Hunt remembered his roots in rural New Hampshire, where he'd dreamed he would return after the war ended.

Hunt was born in Gilford, N.H., on December 8, 1832. After graduating from Dartmouth Medical School in 1857, he returned to Gilford and practiced there until he enlisted with the New Hampshire Infantry in 1862.

His letters home reveal that he was surprised by his first months in the military. "I have seen more misery [and] suffering than I ever expected," he wrote in a letter dated January 11, 1863. Unfortunately, the following months had even more rigors in store for the young doctor. He served on the Division Amputating Board during the battles of Fredericksburg and Gettysburg, as his skill and bravery "immediately commanded a high position as an operating surgeon."

His courage during the Battle of Chancellorsville truly set him apart. There, under siege from the Confederate Army, Hunt stayed with a wounded Union officer, Colonel Potter, who was in danger of bleeding to death from a leg wound. "I saw that it was impossible to get him off alive," Hunt later wrote to a family friend. After telling the colonel that the two of them would probably be taken prisoner, the wounded man told Hunt to leave him and run for safety. But Hunt chose to stay and care for the colonel. They were indeed taken prisoner by the Southern troops. Hunt's demeanor toward the Confederate soldiers was such that they "treated [him] with respect and kindness and did all they could."

Hunt's greatest legacy, however, may have been his personality. "The experiences of army life, which so invariably make physicians of coarse natures and groveling propensities, brutal and abandoned, served only to develop the fine qualities of his head and heart, and in his death the service has lost one of the most popular, promising, and useful young men whom New Hampshire has sent into the Medical Department of the army," wrote someone identified only as M.B.G. in a "Statesman Correspondence" upon Hunt's death.

When he died, Hunt was wearing a large silver ring that had been given to him by a Louisiana soldier in thanks for saving his life. Clearly he deserves to be remembered as a true healer and a genuine hero for his service to his country.