Dr. Caroline Still Anderson and "A Thesis on Fibromata"
Caroline Still V. Wiley Anderson was a notable physician and community activist in the late nineteenth century. Over her long and illustrious career, she served a multitude of patients through her role as the City District Physician of Philadelphia. Dr. Anderson also ran a dispensary at the Berean Presbyterian Church, and served as assistant principal at the Berean Manual Training and Industrial School, where she taught hygiene, physiology, and public speaking for over thirty years.[1]
Dr. Anderson was the daughter of William Still, a prominent abolitionist and “father” of the Underground Railroad, and the granddaughter of Charity Still, a fugitive enslaved woman who escaped from her owners in Maryland.[2] It made sense for Dr. Anderson to decide on Oberlin as her college of choice in 1864.[3] Oberlin became notable as a place that assisted fugitive slaves as well as a co-educational and racially integrated institution of higher education.[4] In Aslaku Berhanu’s Biography of Caroline Still Anderson, Berhanu writes, “She would remain aware of her privileges and take full advantage of the opportunities they offered.”[5] As the alma mater of Mary Jane Patterson, the first black woman to earn a bachelor's degree from an American college, Oberlin’s prestige and legacy at the time made it a good fit for Anderson.[6] Dr. Anderson’s distinctions at Oberlin were numerous. She was the youngest graduate of the Oberlin Class of 1868, and was the only black woman in her class of forty-five. Upon graduating, Dr. Anderson became the first black student to be asked to preside over Oberlin College’s Ladies Literary Society.[7] Dr. Anderson continued to take advantage of her family’s wealth of support as she navigated medical school. A close analysis of her graduate thesis, produced later in her academic career while at the Women’s Medical College of Pennsylvania, reveals that Dr. Anderson’s work in the medical field was imbued with an awareness and deep understanding of the significance of her contributions to African Americans in Philadelphia.
While at the Women’s Medical College of Pennsylvania, Dr. Anderson wrote her thesis on fibromata, a type of benign tumor. In her piece, A Thesis on Fibromata, she describes in detail the research that had been done on the topic, the current conversations surrounding categorization and treatment for fibroids, and several case studies conducted by surgeons in the nineteenth century.[8] At the time Dr. Anderson wrote A Thesis on Fibromata, very little knowledge or understanding of fibroid tumors existed. It took less than forty-five pages for her to give a complete analysis of the existing research on the phenomenon. According to Anderson, the most common type of fibroid is the uterine fibroid.[9] Although she covers other less common ailments such as fibroids in the nerves, skull, and breast, Dr. Anderson devotes the majority of her analysis to the study and treatment of fibroids in the uterus.
Amidst her discussion of pre-existing conditions that increase the likeliness of developing fibromata, Dr. Anderson states:
"One of the usually admitted predisposing causes of fibroids is Race, the African being particularly liable it is said, but no statistics at our command throw any light upon this subject nor are any reasons offered to account for this statement."[10]
Although thorough research on this phenomenon has still never been conducted, the statistics that do exist today suggest that black women are roughly three to nine times more likely to develop uterine fibroids than white women, so it is likely that the majority of patients that Dr. Anderson may have observed or later treated for uterine fibroids would have been of African descent.[11] By focusing her research on fibromata, Dr. Anderson chose to dedicate her time and expertise to the study of a disease which primarily affected black women.
Dr. Anderson’s thesis begins with a definition of the fibroid tumor, and a review of the research that had been done on fibromata by eighteenth and nineteenth century medical professionals and researchers such as William Hunter, who first wrote about fibroids in the late 1700s, Rudolf Virchow, known as the “father of modern pathology,”[12] and Sir James Paget, who was a prominent anatomist and physician in the nineteenth century and whose work Dr. Anderson refers to frequently in her thesis.[13] The latter third of A Thesis on Fibromata is dedicated to the treatment of uterine fibroids, with special attention paid to the work of Dr. Atlee in the mid-nineteenth century.
Dr. Atlee was the first to successfully perform an abdominal myomectomy, or removal of uterine fibroids without removing the uterus, in 1845.[14] Dr. Anderson discusses in depth, the different strategies used by Dr. Atlee to treat and remove uterine fibroids. Myomectomy was a new and controversial procedure at the time, as it had a high mortality rate.[15] However, after detailing several successful procedures carried out by Dr. Atlee, Dr. Anderson concludes that surgical measures should be considered when mitigation of symptoms fails. She writes:
"Thus we have found that nature sometimes effects a cure of fibroids in various ways, that the medicinal treatment is largely palliative, but that extirpation of said tumors has been proved a necessity by the results, and the successful performance thereof entitles surgical operations upon such growths to greater favor, and consideration."[16]
Here, Dr. Anderson makes her case for the treatment of fibroids, and produces her first written contribution to the medical field.
Works Cited:
[1] Berhanu, Aslaku. “Biography of Caroline Still Anderson.” Omeka RSS, stillfamily.library.temple.edu/stillfamily/exhibits/show/william-still/historical-perspective/biography-of-caroline-still-an.
[2] Tamika Y. Nunley. At the Threshold of Liberty: Women, Slavery, and Shifting Identities in Washington, D.C. Chapel Hill: University of North Carolina Press, 2021. pp. 64.
[3] Berhanu.
[4] Morris, J. Brent. Oberlin, Hotbed of Abolitionism: College, Community, and the Fight for Freedom and Equality in Antebellum America. The University of North Carolina Press, 2018.
[5] Berhanu.
[6] “Oberlin History.” Oberlin College and Conservatory, Oberlin College and Conservatory, 14 Sept. 2020, www.oberlin.edu/about-oberlin/oberlin-history.
[7] Berhanu.
[8] Still Wiley Anderson, Caroline V. “A Thesis on Fibromata.” Women's Medical College of Pennsylvania, 1878.
[9] Still, 1878. 12.
[10] Still, 1878. 22.
[11] Stewart, Elizabeth A et al. “The burden of uterine fibroids for African-American women: results of a national survey.” Journal of women's health (2002) vol. 22,10 (2013): 807-16. doi:10.1089/jwh.2013.4334
[12] Lim, Alane. “Rudolf Virchow: Father of Modern Pathology.” ThoughtCo, Dotdash, www.thoughtco.com/rudolf-virchow-4580241.
[13] Still, 1878. 1-7.
[14] Bortoletto, P., Hariton, E. and Gargiulo, A.R. (2018), The evolution of myomectomy: from laparotomy to minimally invasive surgery. BJOG: Int J Obstet Gy, 125: 586-586. https://doi.org/10.1111/1471-0528.14936.
[15] Bortoletto, 2018.
[16] Still, 1878. 45.