Concerning Dr. Charles Knowlton, 1824M, who wrote this country's first medical treatise on birth control with stormy results.

"A Man Ahead of His Time"

DARTMOUTH ALUMNI MAGAZINE

January 1967

By Parker G. Marden1

One of the most pressing problems of the contemporary world concerns uncontrolled population growth. C. P. Snow, for example, groups the specter of overpopulation, the possibility of nuclear disaster, and the widening gap between the rich and the poor as the three greatest threats to mankind today. In more pensive moments, one cannot help reflecting on the interrelationships between these clear and present dangers. Ideas like the "population explosion," fertility, oral contraceptives, and birth control (or its more polite euphemisms of family planning, "responsible parenthood" and maternal health) confront the general public daily. There is perhaps no better index of the centrality of these topics than conversations in which no one mistakes "the pill" for some new vitamin or antibiotic.

But as in the examination of many problems of great significance, sight is often lost of the persons concerned with these demographic problems. Perhaps this is inevitable in discussions of world population where the problem is one of numbers and the roles played by individuals pale into insignificance when demographers speak of the estimated 3,300,000,000 persons who presently inhabit the earth. Yet it would be inappropriate to exclude Dr. Charles Knowlton, a little-known Dartmouth graduate of the last century, from even the most contemporary of such discussions. While the greatest impact of his writings occurred nearly thirty years after his death in 1850, and in Great Britain rather than in his native New England, Knowlton was the medical pioneer in the area of family planning. His small treatise Fruits of Philosophy, that became the center of stormy controversy, contained many ideas and recommendations that remain in force today.

During the late 1870's, the birth rate in Great Britain began a decline that was to last for more than seven decades, dropping from 36 births per 1,000 persons in 1877 to 18 per 1,000 in 1964_a decline that has been characteristic of most developed nations. Coincidentally, 1877 was the same year in which Mrs. Annie Besant and Charles Bradlaugh were tried in an English court on the charge that they had published "a certain indecent, lewd, filthy, bawdy, and obscene book." This book that so aroused the indignation of the British police was none other than Charles Knowlton's Fruits of Philosophy, which had originally been published more than forty years earlier. Interestingly subtitled "the Private Companion of Young Married People," this was not a weighty philosophical discourse but was the first discussion of birth control to be written by someone trained in medicine. Certainly one cannot overlook the fact that the trial of Bradlaugh and Mrs. Besant for publishing Knowlton's book and the beginning of the decline in British fertility occurred in the same year_1877. The exact extent of Knowlton's influence and the causal connection between these two events can be debated, but this striking coincidence cannot be ignored.

Charles Knowlton was born in Templeton, Mass., on May 10, 1800. Until he was eighteen, he lived and worked on his father's farm with his two brothers, while attempting to save enough money to finance his education. In the summer of 1818 young Knowlton attended New Salem Academy for six weeks, taught school the following winter, and returned to the Academy in 1819. Knowlton was not well as a youth, and his contact with physicians may have influenced his choice of a profession. From a biography written by his son-in-law, it is learned that Knowlton suffered from certain mental difficulties, and in a three year period he consulted ten different doctors about his condition, although the best prescriptions of the time for his depressed mental state appear to have included barks, silver nitrate, opium, and vegetable astringents.

When he was twenty, Knowlton went to live with the family of Richard Stuart of nearby Winchendon. Apparently, Stuart, a noted mechanic and inventor, could provide better therapy for Knowlton's condition than physicians of the 1820s. He recovered rapidly from his depression while taking treatments from Stuart's electric shock machine and the company of his six vivacious daughters. In April 1821, Knowlton married the oldest Stuart girl, seventeen-year-old Tabitha, and he thereafter recommended early marriage as a cure for many of the problems of youth.

In 1822, Knowlton began his formal medical training by attending the course of lectures offered at the Dartmouth Medical School, while continuing to study with various physicians in western Massachusetts and New Hampshire. Throughout his medical education Knowlton was faced with serious financial hardships. He had to leave his wife with her parents while he lived in abject poverty at Hanover with two fellow students. It would appear that Knowlton found it necessary to finance part of his education through grave robbing, as medical schools would pay fifty dollars for cadavers brought in for dissection.

Knowlton's days at Dartmouth were not altogether pleasant ones. His impoverished state required that he economize greatly on food and, with his two companions, he existed on cheap beef, brown bread, and potatoes, costing all together about thirty cents a week. One of his roommates soon collapsed from this meager diet and withdrew from school. While Knowlton himself was continually troubled with digestive problems and headaches. In addition, he was shy and retiring, and his classmates made fun of him in general and his long whiskers in particular. Knowlton was not insensitive to their comments, so he shaved off his beard and attempted to impress them through his scholarship. He prepared his lessons diligently and participated in class with enthusiasm, thereby winning some measure of respect from his fellow students. His attention to his studies and his summer work with Dr. Amos Twitchell, influential in the establishment of the Dartmouth Medical School and one of the most renowned physicians in early nineteenth-century America, probably made Knowlton into a capable young doctor as measured by the standards of that period.

After Knowlton_s graduation from Dartmouth in 1824, he was delayed in establishing his practice because another one of his body-snatching expeditions had been detected. While the court found him not guilty on the charge of grave robbing, it convicted him for conducting an illegal dissection. His father paid the young doctor's fine of $284.26, but Knowlton had to serve two months in the Worcester County jail. Following his release, Knowlton began to practice in western Massachusetts, first in the town of Hawley, later in North Adams, and finally in Ashfield. His migrations may have been stimulated in part by a lack of patients. In his first three months in Hawley, where an older physician was already well entrenched, Knowlton estimated that he made no more than twenty dollars. The fact that he was a confirmed agnostic who annoyed his neighbors by playing the violin on the Sabbath us they were on their way to church probably did not enhance his opportunity to practice his profession. The move to North Adams, however, was more directly motivated by his desire to be near a printing press as an outlet for his writings. When patients did not present themselves for his medical attention, Knowlton became increasingly concerned with ideas and issues and found ample time to pursue them.

His first book, Elements of Modern Materialism: Inculcating the Idea of a Future State in which all will be more happy under whatever circumstances they may be placed than if they experienced no misery in this life was published in 1829, and its ungainly title suggests its success. Regardless of the possible merits of the philosophical ideas it contained, Knowlton was unable to sell many of the thousand copies he had ordered. Two selling trips, one to New York City and the other ranging from eastern Massachusetts as far west as Utica, had little success. His financial difficulties mounted_compounded by the printing costs, a growing family, and a vanishing professional practice_and the second trip to sell his book was delayed by a sheriff's seizure of Knowlton's household goods to satisfy his creditors.

Lack of success with Elements of Modern Materialism did not dissuade Knowlton from further literary ventures. His next book, its title notwithstanding, was to be more relevant to his chosen profession. In 1832 the Fruits of Philosophy was published in New York with its author identified only as "a Physician." Within this slim volume, a variety of matters related to birth control were discussed. Beginning with a discussion of the social and political desirability of limiting family size, the text went on to devote detailed and careful attention to the nature of reproduction and to consider various methods of promoting and limiting conception, carefully noting their strengths and shortcomings. These discussions reflected the best medical knowledge of the time and even recent assessments have described it as "exceptionally well reasoned and balanced."

But New England in the early nineteenth century was hardly ready for such a book. In this period, families with four or five children were considered small, those with eight or nine were more usual, and even those with twelve or more were not uncommon. Combined with the Puritan legacy which frowned upon open discussion of matters concerned with sex, not to mention detailed discussions of reproduction, this emphasis on familial achievement insured that Knowlton's little treatise would not be well received. Thus, when he acknowledged the authorship of the Fruits of Philosophy he once again became embroiled in legal action. At Taunton, Knowlton was fined fifty dollars and court costs ($27.50) for publishing an obscene book. In December 1832 he was tried and convicted in Cambridge on a similar charge and was sentenced to three months at hard labor. A third prosecution at Greenfield in western Massachusetts was eventually nol prossed after the jury was unable to agree on two occasions.

Indicative of the attitude of early nineteenth-century New England towards the subject of birth control is the fact that Knowlton's trials aroused little public interest. Although a few newspapers felt that his sentence at Cambridge was excessive and a small group of Freethinkers in Pittsburgh wrote a letter of protest, Knowlton served his term without much public comment. The book went unmentioned in the public press with one exception. The Boston Medical Journal discussed the Fruits of Philosophy and concluded that "the less that is known about it by the public at large, the better it will be for the morals of the community." Only at Greenfield did Knowlton's prosecution cause much excitement, and this largely because Knowlton was a local celebrity who kept the controversy going by issuing a pamphlet, A History of the Recent Excitement in Ashfield, which attributed his legal troubles to local ministers and physicians whom he careful identified by name.

The prosecutions, of which the Greenfield case was the last, did not interrupt the circulation of Fruits of Philosophy, as Knowlton continued to distribute it through agents and to sell it at his office. While sales were considerably better than had been the case with Elements of Modern Materialism, the book could hardly be described as a best-seller. Perhaps only 10,000 copies were sold in the United States before 1840, when the whole matter seems to have been forgotten.

As for Knowlton himself, he finally developed a paying medical practice in Ashfield. As his practice grew, he had less time for developing the ideas that had previously occupied his interest, and his later writings involved nothing more argumentative than articles for medical journals on the pancreas, the autumnal fevers of New England, and puerperal fever. When he died on February 10, 1850, he was a respected citizen of Ashfield and was well known in Massachusetts medical circles.

More than 25 years after Knowlton's death, however, his book and its message were to become the center of a controversy much greater than had occurred at its original publication. In 1834 Fruits of Philosophy was transported to Great Britain where it was quietly distributed by various free thought publishers and regularly advertised in the journals of that movement. Despite its ready availability, sales were not great and only averaged between 600 and 1000 copies a year from 1834 to 1876. In the latter year, after more than four decades of distribution in England without interference Knowlton's little book came to the attention of the authorities. Henry Cook, a bookseller from Bristol, was sentenced to two years in prison at hard labor after being convicted of publishing an edition of the book illustrated with "obscene" pictures, although it has been presumed that these were nothing more than anatomical sketches. The following year, a London publisher, Charles Watts, was accused of a similar offense, but he was released upon payment of costs after pleading guilty. At this point Charles Bradlaugh and Mrs. Annie Besant entered the picture.

Bradlaugh and Mrs. Besant were English intellectuals and activists who delighted in embracing controversial causes. From his youth Bradlaugh was constantly involved in some reform movement or social agitation concerning issues that ranged from women's suffrage to trade unionism and from the liberation of oppressed nationalities to agnosticism. Powerful in physique and arrogant in manner, he was an impressive orator and would lecture on issues of the time whenever he could gather an audience.

Like Bradlaugh, Mrs. Besant was also an ardent Freethinker and this intellectual development led to a well-publicized divorce from her minister-husband. From 1874 to 1888 she worked closely with Bradlaugh in both politics and free thought propaganda, becoming a prolific writer of inflammatory pamphlets and tracts. She was the more militant of the two, supporting the cause of various socialist groups, organizing unions and strikes, and eventually becoming an ardent Indian nationalist whose activities managed to keep her in constant trouble with the British colonial authorities. Mrs. Besant also was a fiery public speaker and aggressive debater, intensively involved with social reform.

Originally, the issue of birth control was only a secondary consideration in Bradlaugh's and Mrs. Besant's activities concerning Knowlton's book. When Charles Watts, a fellow Freethinker, pleaded guilty to publishing Fruits of Philosophy they felt that his action amounted to a surrender of the right to free discussion, so they republished the book after informing the police when and where it would be sold "so as to put no technical difficulties in the way of prosecution." They were arrested on March 24, 1877 on the charge of publishing that "indecent, lewd, filthy, bawdy, and obscene book called 'Fruits of Philosophy'." Quickly, the fact that the book involved birth control became more important in the public estimation than the possibility that it violated the right to freedom of discussion, and this is how the ensuing legal actions are best remembered. They were nineteenth-century parallels to recent litigation concerning Fanny Hill or Tropic of Cancer.

The first trial of Bradlaugh and Mrs. Besant began on June 18, 1877 in the Court of Queen_s Bench where it was tried before the Lord Chief Justice. It lasted for four days and attracted a considerable amount of attention, far more than had been paid to the trials of Cook and Watts for similar offenses. No doubt Bradlaugh's reputation as an atheist had a great deal to do with it, and many believed that he had finally gone too far and was taking another man's young wife, Mrs. Besant, along with him. The courtroom was packed daily and every event, including Mrs. Besant's two-day defense of the morality of birth control, was carefully recorded in the national and local newspapers of Great Britain. This publicity placed arguments for family limitation and discussions of contraception squarely before the English public, most of whom had been untouched by the earlier efforts of birth-control propagandists, which had been treated with hostility and contempt by the press.

Numerous imitations of Fruits of Philosophy went on sale even as the prosecution was in progress, and the sales of the original book skyrocketed. While English sales of Knowlton's book have been estimated at approximately 600 to 1000 copies yearly between 1834 and 1876, between the arrest of Bradlaugh and Mrs. Besant in March of 1877 and their trial in the following June, more than 125,000 copies were sold. In three months the sales of Fruits of Philosophy tripled over the preceding forty-year period. This trend continued and in the fifteen years following the trial, not less than one million and more probably two million, various publications concerning birth control were circulated. The Bradlaugh-Besant trial was the stimulus to feverish activity as publishers sought to satisfy the demands of a curious public.

Amid such activity, the outcome of the trial itself was somewhat anticlimactic. Although the presiding justice viewed the book as a "dry, physiological treatise" rather than as obscene, the verdict went against the defendants. They were exonerated for selling the book, but the jury unanimously agreed that Fruits of Philosophy was "calculated to deprave the public morals." Judgment was reserved and an appeal was made at which time the higher court reversed the previous decision on purely technical grounds and not on the actual merits of the case. Having won, although the legality of the book s distribution was not actually established. Bradlaugh and Mrs. Besant again began to distribute the pamphlet. In fact, Bradlaugh sued the police for the recovery of the copies which had been seized, won his ease, and began to distribute these copies clearly marked "Recovered from the Police." Their sale of the book continued until it became apparent that no more legal action would result and then Bradlaugh and Mrs. Besant turned some of their attention to other issues.

But activity in support of family limitation accelerated as permanent organizations developed to propagandize for birth control, supported by many distinguished orators of the day. Within a very short time, the English birth rate began its dramatic decline as hundreds of thousands of British couples adopted the techniques set forth by Knowlton and others. It would be most incorrect to make a causal connection, however, between the legal actions centering upon the Fruits of Philosophy and the wide publicity they received and such fertility trends, as powerful social and economic forces had already been set into motion to shape such demographic developments. England of the late 1870's was a period of great change_rapid urbanization, widespread unemployment, decreased economic value of children through the new Child Labor Laws, changing status of women_and many of these factors made smaller families more desirable. The publicity given to Knowlton's book and its discussion of birth control only made the search for information on how to limit family size easier. But the fact that it was Fruits of Philosophy which was involved cannot be overlooked, as it carefully discussed every method, with the exception of the oral contraceptive, being used to limit family size in contemporary Western societies.

Surely Dr. Charles Knowlton, forgotten Dartmouth alumnus of the Medical School's class of 1824, is deserving of homage as the medical pioneer of birth control; and recognition today, when this issue is most central, is especially appropriate.