In the 21st century climate of preventive medicine, we count on government agencies around the world to warn us about medical hazards in our lives. Yet, few people know that American national safety standards were pioneered by a 19th century female scientist, a pathologist who disliked conflict but used her fastidious research to challenge U.S. manufacturers on the issues of lead, explosives, coal and noxious dyes. Indeed, the Occupational Health and Safety Administration (OSHA) hails Alice Hamilton (1869–1970) as the founder of industrial medicine in America.
Born into a genteel family, Hamilton grew up in Fort Wayne, Indiana. Following her 1893 graduation from the University of Michigan-Ann Arbor’s medical program (she was one of only 14 women in a class of 47), Hamilton pursued a residency that took her into Boston’s slums and brothels. She followed this up with a year of study in Germany—which she relished even though she remembered being asked to make herself “invisible” and was told that a degree was “out of the question.” Returning to the U.S. in 1896, Hamilton continued her studies at the Johns Hopkins medical school for a year before receiving her first job offer as an instructor at Northwestern University’s Woman’s Medical School.
汉密尔顿出生于一个有教养的家庭，在印第安纳州韦恩堡（Fort Wayne, Indiana）长大。 1893年，她从密歇根大学安娜堡分校的医学专业毕业(她是47名学生中仅有的14名女性之一)，汉密尔顿开始了她的住院医生实习期，期间她开始接触波士顿的贫民窟和妓院。 随后，她在德国学习了一年。尽管她曾被要求让自己“隐形”，并被告知获得学位是“不可能的”，但她对那段经历还是津津乐道。1896年返回美国后， 汉密尔顿在约翰霍普金斯医学院（Johns Hopkins medical school）继续学习了一年，之后她得到了她的第一份工作，在西北大学女子医学院（Northwestern University's Woman's Medical School）当讲师。
Moving to Chicago to work at Northwestern meant that Hamilton could follow another long-cherished hope she’d flirted with since 1889 when she saw progressive Jane Addams speak about settlement communities, places designed to serve as mutually beneficial bridges between the well-to-do and the poor.
You might say Hamilton got fully “woke” when Addams made a place for her in Chicago’s Hull House, the largest of the nation’s settlement communities. Hamilton was at first overwhelmed both by the intensity of the work and by the famous social reformers with whom she shared Hull House’s dinner table: Frances Perkins, Florence Kelly, Margaret Sanger, John Dewey, Eugene Debs and Upton Sinclair. But soon Hamilton was staffing a “well-baby clinic” for Hull House’s poor, immigrant women; and fresh from her studies at Johns Hopkins with famed pathologist Simon Flexner, she observed odd symptoms such as “wrist drop,” lead palsy and a large number of widows at the clinic.
你可能会说，当亚当斯在芝加哥的赫尔馆(美国最大的移民社区)为她占据一席之地时，汉密尔顿完全被唤醒了。起初， 汉密尔顿被工作的强度和与她共进晚餐的著名社会改革家搞得应接不暇。与她共进晚餐的有:弗朗西斯·帕金斯（Frances Perkins）、弗洛伦斯·凯利（Florence Kelly）、玛格丽特·桑格（Margaret Sanger）、约翰·杜威（John Dewey）、尤金·德布斯（Eugene Debs）和厄普顿·辛克莱（Upton Sinclair）。 但是不久，汉密尔顿就为赫尔馆的贫困移民妇女开设了一家“婴儿诊所”。她和著名病理学家西蒙·弗莱克斯纳(Simon Flexner)刚从约翰霍普金斯大学毕业，就发现了一些奇怪的症状，比如手腕下垂、铅毒性麻痹、诊所里有很多寡妇。
Beginning in 1902, while living at Hull House, Hamilton also began schooling herself about lead and mercury poisoning as she got to know laborers and their wives. Supporting settlement family workers’ campaigns for the eight-hour day, Hamilton got a close-up view of the conditions of workers whose lives and families were often devastated by dangerous work environments.
In her autobiography, Exploring the Dangerous Trades (Atlantic Monthly Press, 1943), Hamilton described two of her key moments of awakening to the level of industrial lawlessness. One was her disturbing encounter with a Hungarian woman whose husband had been badly injured in a nearby steel mill and was being held “incommunicado” at a hospital. His terrified wife had no access to any information except that he was still alive. Only a formal prod from the Austro-Hungarian consul to the State Department prompted the release of information to his family.
在自传《探索危险行业》（Exploring the Dangerous Trades）（大西洋月刊出版社，1943年）中，汉密尔顿描述了使她意识到工业中的违法行为有多严重的两个关键事件。 其中之一是她与一名匈牙利妇女的令人不安的遭遇，这位妇女的丈夫在附近的一家钢厂受了重伤，被隔离在一家医院里。 他惊恐万状的妻子除了知道他还活着外，对其他情况一无所知。后来在奥匈帝国驻美国国务院领事的正式敦促下，医院才向他向家人公布了相关信息。
Hamilton’s second wake-up call occurred when she encountered a works manager of a big white-lead plant. She described him as a “gentleman of breeding and something of a philanthropist,” who had spat back at her “indignantly” when she suggested that he would be responsible for employees at his plant who experienced lead poisoning.
“It was not that the employers were brutal,” she wrote. “They really did not know what was happening in their plants, for there was no system of workmen’s compensation to open their eyes to the hazards and to force safety measures.” Couched in such gentle language Hamilton’s tone was perhaps a nod to industrialists whom she had hoped to convince to do right by their employees.
“I do feel pretty much lost for it’s starting out into a great unknown and nobody seems to know the first step,” wrote the 41-year-old when she accepted the position of medical investigator for the Illinois Commission on Occupational Diseases in 1910. This new post and funding, a result of Hamilton’s growing reputation, connections at the Hull House and advocacy work, gave Hamilton nine months to draw a direct line between "disease and occupation." Managing a team of 23 physicians, students and social workers she investigated the hazards of exposure to lead.
“When I talked to my medical friends about the strange silence on this subject [lead poisoning] in American medical magazines and textbooks, I gained the impression that here was a subject tainted with Socialism or with feminine sentimentality for the poor.”
To accomplish real change, the team needed to document specific lead poisoning cases. They tracked down hospital records, met with physicians and pharmacists in working class quarters as well as labor leaders, visiting some 304 business establishments. Within a year, the team uncovered 70 different occupational processes that exposed workers to lead poisoning. Some unexpected cases included workers exposed to “freight car seals; coffin ‘trim’; decalcomania papers for pottery decoration; polishing cut glass; brass founding; wrapping cigars in so-called tinfoil, which is really lead.”
为了实现真正的变革，团队需要记录具体的铅中毒案例。 他们查阅了医院记录，与工人阶级宿舍的医生、药剂师以及工会领袖会面，走访了约304家商业机构。 一年之内，他们的团队发现了70个不同的职业在生产过程中，会暴露在铅中毒的环境下。 一些意想不到的生产案例包括：货车封条;棺材装饰;陶器装饰用贴花纸;抛光切割玻璃;黄铜铸造;用所谓的锡纸（这是真正的铅）包装雪茄。
Hamilton’s Illinois study brought breakthroughs not yet documented in European literature. She discovered a sanitary-ware factory worker who exhibited symptoms of lead poisoning in an industry where they claimed he’d have no exposure. After meeting with the worker, she realized that she had not fully understood the enamel coating process. The work required sprinkling fine dust over a red-hot tub. A specimen revealed the existence of 20 percent soluble lead.
汉密尔顿在伊利诺伊州的研究带来了欧洲文献中尚未记载的突破。 她发现一名卫生洁具厂的工人出现了铅中毒的症状，而工厂声称该工人没有被暴露在铅中毒的环境中。 与工人会面后，她意识到自己还不完全了解搪瓷涂层工艺的生产过程。 这项工作需要在一个热得通红的盆上撒上细小的粉末。这些粉末的 标本显示其中存在20％的可溶性铅。
The Illinois survey, which included reports on arsenic, brass manufacturing, zinc smelting, carbon monoxide, cyanide and turpentine, among others, in January of 1911 documented 578 cases of lead poisoning. Several months later, Illinois passed a law requiring employers to protect their workers in the manufacture of brass smelting of lead and zinc. While at work on the Illinois report in 1910, Hamilton was invited to give a paper on the U.S. white-lead industry at the International Congress on Occupational Accidents and Diseases in Brussels. Hamilton felt embarrassed when the Belgian Labor Department criticized the U.S. lack of industrial hygiene practices.
伊利诺伊州的调查包括关于砷、黄铜制造、锌冶炼、一氧化碳、氰化物和松节油等的报告，其中1911一月记录了578起铅中毒事件。 几个月后，伊利诺伊州通过了一项法律，要求雇主保护铅和锌的黄铜冶炼制造业的工人。 汉密尔顿在1910年撰写伊利诺斯州报告期间，应邀在布鲁塞尔召开的国际职业事故与疾病大会上发表了一篇关于美国白铅工业的报告。 当比利时劳工部批评美国缺乏工业卫生规范时，汉密尔顿感到很尴尬
Returning home, Hamilton met with Commissioner of Labor Charles Neill, who asked her to launch a nationwide investigation, beginning with the lead trades in 1911. But there were stipulations. She would not have the right to enter any factory unless she could convince factory owners to give her permission to enter their premises. While the commissioner offered no salary, he thought that the government would buy her final report at a price the government would set upon completion. Hamilton agreed.
回到家后，汉密尔顿会见了劳工专员查尔斯·尼尔（Charles Neill），后者请她从1911年的铅交易开始，发起一项全国性的调查。在调查过程中，她必须遵守一些规定。其中有一条，除非她能说服工厂老板允许她进入工厂，否则她没有权利进入任何工厂。 尽管专员没有提供薪水，但他认为政府会为汉密尔顿的最终报告买单。 汉密尔顿接受了这份委托。
“I have never doubted the wisdom of my decision to ... devote myself to work which has been scientific only in part, but human and practical in greater measure.”
By 1919, Hamilton, now a recognized authority in the field of industrial medicine, was sought out by Harvard Medical School Dean David L. Edsall. He had to convince the board at Harvard, aghast at the prospect of hiring a woman, that Hamilton was the best qualified person to join the faculty as an assistant professor. She agreed to the conditions not to attend commencement or football games, nor could she enter the all-male faculty club. Though she made light of her second-class citizenship at the all-male institution in her formal autobiography, private letters show the demoralizing effects of exclusion.
1919年，汉密尔顿已经成为了工业医学领域公认的权威。那时候，哈佛医学院（Harvard Medical School）院长戴维·埃兹尔（Dean David L. Edsall）找到她，邀请她出任该系的助理教授。不过，戴维必须要说服董事会，让他们打消对雇佣女性教授的担忧，因为汉密尔顿是担任助理教授的最佳人选。汉密尔顿接受了不参加毕业典礼或橄榄球比赛，也不能进入全是男性的教员俱乐部的条件。尽管在她正式的自传中，她对自己在这个全是男性的机构里的二等公民身份轻描淡写，但在私人信件中缺透露了被排斥的消极影响。
“Alice Hamilton has done her big work so quietly that many Americans have never heard of her,” wrote Edna Yost in her book American Women of Science in 1943. Hamilton helped launch the Journal of Industrial Hygiene in 1919 and published a major piece on lead poisoning in the first issue. Her textbook Industrial Toxicology was first issued in 1934. Hamilton retired in 1935 at the age of 66, but it would be another 10 years before women were admitted to Harvard Medical School as students.
埃德娜·尤思特（Edna Yost）在她1943年出版的《美国科学女性》（American Women of Science）一书中写道：“艾丽斯·汉密尔顿完成她的伟大事业时如此低调，以至于许多美国人从未听说过她”。汉密尔顿在1919年协助创办了《工业卫生杂志》，并在第一期上发表了一篇关于铅中毒的重要文章。 她编纂的教科书《工业毒理学》于1934年首次出版。汉密尔顿在她66岁（1935年）的时候宣布退休。但对女性学生而言，在汉密尔顿退休十年后，才能正式进入哈佛医学院学习。
Joe Brain, chair of the Archives Committee at the Harvard School of Public Health and co-author of The Education of Alice Hamilton (University of Indiana Press, November 2019) viewed Hamilton as a pioneering figure in public health.
乔·布莱恩（Joe Brain），哈佛大学公共卫生学院档案委员会主席，《艾丽斯·汉密尔顿的教育》（The Education of Alice Hamilton）(印第安纳大学出版社，2019年11月)的合著者，认为汉密尔顿是公共卫生领域的先驱。
“What I find most memorable about Alice Hamilton more than other historic figures in public health is that she always felt it was one thing to get data and do good science but then you weren’t really finished unless something happened ... unless you could use that knowledge to improve labor standards and other things that were necessary.”
Brain pointed to recordings of Hamilton’s interviews in which she described being a woman as a distinct advantage. He paraphrased: “Here I was this 5’3” woman dressed in black and when I would go to the factory gates as a woman, and say, I am interested in the health and welfare of your workers and your children, they’d let me in. They might ignore me or insult me but I had access. If a man showed up with the same request, they would not let him in.”
Brain added, “At five foot three dressed in tweeds and black, she looked harmless, but she was not.”
The views expressed are those of the author(s) and are not necessarily those of Scientific American.
ABOUT THE AUTHOR(S)
Kimberly Nagy is a professional writer who covers the underreported accomplishments and perspectives of women in history.