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The Roles of Health Professionals in the Development and Dissemination of Women's
Sanitary Products, 1880–1940

Author(s): JANE FARRELL-BECK and LAURA KLOSTERMAN KIDD
Source: Journal of the History of Medicine and Allied Sciences , JULY 1996, Vol. 51, No.
3 (JULY 1996), pp. 325-352
Published by: Oxford University Press
Stable URL: https://www.jstor.org/stable/24624129
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The Roles of Health Professionals in the
Development
Development and
and Dissemination
Disseminationofof
Women's
Women's Sanitary
SanitaryProducts,
Products,1880—1940
1880—1940
JANE FARRELL-BECK and LAURA KLOSTERMAN KIDD
RE VIO U S writers have pointed to the role played by

World War I nurses in the evolution of disposable san
itary napkins.1 In reality, American health profession
als had a much broader impact on the development
04, L. 1 ^ and dissemination of disposable napkins, as early as the
1880s, and tampons, in the 1930s. A few physicians
patented sanitary products. Physicians and medical writers educated the
obstetrical nurses who, in turn, instructed their patients about scrupu
lous hygiene of the genital area. Medical professionals fostered attitudes
that may have predisposed women to accept disposable sanitary products
as hygienically superior to reusable menstrual cloths. Pharmacists sold
manufactured menstrual pads and belts in drugstore "sundries" depart
ments, enabling women to acquire the desired products. The efforts of
health professionals to develop, explain, and sell disposable menstrual
pads and tampons expedited their acceptance among many women in
the United States.
i.
I.Blanche
Blanche Payne, Geitel
Geitel Winakor,
Winakor,and
andJane
JaneFarrell-Beck,
Farrell-Beck,
The
The
History
History
of of
Costume
Costume(New(New
York:
York:
HarperCollins,
HarperCollins,1992),
1992),pp.
pp.581—82.
581—82.
Vern
Vern
L. L.
Bullough,
Bullough,
"Archives:
"Archives:
Merchandising
Merchandising
the sanitary
the sanitary
napkin:
napkin:
Lillian
Lillian Gilbreth's
Gilbreth's1927
1927survey,"
survey,"Signs:
Signs:
Journal
Journal
of of
Women
Women
in Culture
in Culture
and and
Society,
Society,
1984,1984,
10, 615-16.
10, 615—16.
Anon.,Anon.,
"Modern
"Modern hygiene,"
hygiene,"Vogue,
Vogue,76,
76,1313
October
October
1930,
1930,
p. 120.
p. 120.
Autumn
Autumn
Stanley,
Stanley,
Mothers
Mothers
and Daughters
and Daughters
of of
Invention:
Invention: Notes
Notesfor
fora aRevised
RevisedHistory
Historyofof
Technology
Technology
(Metuchen,
(Metuchen,
NJ:NJ:
Scarecrow
Scarecrow
Press,
Press,
1993),
1993),
p. 313.
p. Vern
313. Vern
L.
L. Bullough,
Bullough, "Female
"Femalephysiology,
physiology,technology,
technology,
andand
women's
women's
liberation,"
liberation,"
in Dynamos
in Dynamos
and Virgins
and Virgins
Revisited:
Revisited: Women
Womenand
andTechnological
TechnologicalChange
Changein in
History,
History,
ed. ed.
Martha
Martha
M. Trescott
M. Trescott
(Metuchen,
(Metuchen,
NJ: Scarecrow
NJ: Scarecrow
Press, 1979),
Press, 1979), p.
p.246.
246.Janice
JaniceDelaney,
Delaney, Mary
Mary Jane
Jane Lupton,
Lupton, andand Emily
Emily Toth,
Toth, The The Curse:
Curse: A Cultural
A Cultural History
History
of
of Menstruation
Menstruation(Chicago:
(Chicago:University
Universityofof
Illinois
Illinois
Press,
Press,
1976),
1976),
p. 116.
p. 116.
This research is a part of the Family and Consumer Sciences Research Institute, College of Family and
Consumer Sciences, Iowa State University, Ames IA 50011. Further support was given by the American
Institute for the History of Pharmacy, University of Wisconsin and the Francis Clark Wood Institute,
Philadelphia College of Physicians.
© 1996 BY THE JOURNAL OF THE HISTORY OF MEDICINE AND ALLIED SCIENCES, INC.
ISSN 0022 — 5045 VOLUME 51 PAGES 325 TO 352
[ 325 ]

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
326 Journal of the History of Medicine : Vol. 51 ,July içç6
By the end of the nineteenth century, most physicians recognized that

menstruation occurred when the ovum remained unfertilized. Ortho
dox physicians related menstruation to the discharge of the surface layers
of the mucous membrane of the uterus. Elizabeth Emma Cobb, writing
a domestic medical reference for women, described menstruation as
"the excreting of useless materials of the reproductive economy or func
tion."2 Most doctors knew that women varied in the ages of onset and
cessation of menses, in the length of their periods, and in the quantity of
discharge during a single period.3
Writers of health books for women described the length of each cy
cle as twenty-one to thirty-one days4 and the length of active menstru
ation as three to five days,5 two to six days,6 and even one to eight days.7
The actual volume of fluid excreted during each period was merely
guessed or roughly estimated before the twentieth century.8 Anna
Galbraith and Elizabeth Emma Cobb, reflecting women's own uncer
tainty about the quantity of flow, described five to ten ounces and one
to eight ounces, respectively, as reasonable ranges.9 Whether or not
women were aware of the high estimates of flow, they improvised bulky
protection; even the earliest inventors' "improvements" to catamenial
products appear generously proportioned. By 1923, however, Catharine
2. Elizabeth Emma Cobb, The Medical Advisor (Decatur, IL: Hostetler Printing House, 1903), p. 384.
3. Joseph Brown Cooke, M.D., A Nurse's Handbook of Obstetrics, 7th ed., revised and reset by Carolyn
E. Gray, R.N. and Mary Alberta Baker, R.N. (Philadelphia and London: J. B. Lippincott, 1915), p. 45.
Gray was Superintendent of City Hospital School of Nursing, Blackwell's Island, NYC; Baker was for
mer Superintendent of St. Lukes [sic] Hospital, Jacksonville, FL. They described Cooke's text as one
that had been in favor since 1903. Howard A[twood] Kelly, Medical Gynecology (New York and London:
D. Appleton and Company, 1909), pp. 82-85. Kelly, Gynecologist at Johns Hopkins Hospital and
Professor of Gynecological Surgery at Johns Hopkins University, was a much-published and widely
honored physician with a broad knowledge of abdominal surgery and medicine. After citing the opin
ions of various other authorities, Kelly emphasized that . . precocious menstruation is frequently the
manifestation of some morbid condition of the uterus or its appendages . . (p. 82). Henry J[acques]
Garrigues, A Text-Book of the Diseases of Women (Philadelphia: W. B. Saunders, 1894), pp. 114-15.
Garrigues was Professor of Obstetrics in the New York Post-Graduate Medical School and Hospital and
Gynecologist to St. Mark's Hospital in New York.
4. Anna M. Galbraith, Hygiene and Physical Culture for Women (New York: Dodd, Mead & Co., 1895),
p. 172; Cobb, (n. 2) Medical Adviser, p. 383; Montfort B. Allen and Amelia C. McGregor, The Glory of
Woman (Jersey City, NJ: Star Publishing Co., 1896), p. 84.
5. Ibid.
6. Galbraith, (n. 4) Hygiene and Physical, p. 172.
7. Cobb, (n. 2) Medical Adviser, p. 383.
8. Laura Klosterman Kidd, Menstrual Technology in the United States, 1854-1921. Unpublished doctoral
dissertation, Iowa State University, 1994. Laura Klosterman Kidd and Jane Farrell-Beck, "Menstrual
product design and women's dress, 1854 through 1921," Proceedings, International Textiles and Apparel
Association, 1994, p. 77.
9. Galbraith, (n. 4) Hygiene and Physical, p. 172; Cobb, (n. 2) Medical Adviser, p. 383.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
Farrell-Beck & Kidd : Women's Sanitary Products 327
Macfarlane stated that "about 2 ounces is [sic] lost during the average pe
riod."10 In 1935, Barer, Fowler, and Baldridge's experimental extraction
of discharge from saturated napkins, and measurement of the iron con
tent, confirmed the more reasonable volume of 23 to 68 cc, the equiv
alent of 0.78 to 2.29 ounces.11
Based on their beliefs about the nature of menstruation, physicians
prescribed diverse hygienic measures to protect the woman's general and
reproductive health.12 Most of the advice was couched in terms of
"dont's." Even in the last decades of the nineteenth century, the major
ity of physicians—popular and scholarly, orthodox and sectarian—en
joined complete rest on women during the first two or three days of
menstruation.13 A young woman, in particular, was supposed to rest and
allow her body "to accommodate itself to a new experience"; at the very
least, "her duties should be rendered as light as possible, everything in
the way of severe exertion should be avoided."14 Dr. Bache Emmett,
who approved of outdoor exercise and sports for women, nonetheless
urged them to avoid exercise for the duration of menstruation.15
A few medical women protested this forced inactivity.16 Mary Putnam
Jacobi produced a graduate thesis, awarded the Boylston prize by Harvard
University and subsequently published, in which she adduced a wide
variety of evidence, including results of interviews and physical tests, to
show that women usually did not need to rest during their periods.17 In
ίο. Catherine Macfarlane, A Reference Hand-Book of Gynecology for Nurses (Philadelphia and London:
W. B. Saunders, 1923), p. 21.
11. A. P. Barer, W. M. Fowler, and C. W. Baldridge, "Blood loss during normal menstruation," Proc.
Soc. Exper. Biol. &Med., 1935,32,1458. Paula Weideger, Menstruation and Menopause: The Physiology and
Psychology, the Myth and the Reality (New York: Alfred A. Knopf, 1975), p. 33.
12. Joan Jacobs Brumberg has argued that physicians became involved in instructing women about
menstruation during the later nineteenth and early twentieth centuries. Middle-class mothers, unwill
ing to broach to their daughters a topic connected with sexuality, and lacking the vocabulary and con
cepts to explain reproduction, readily consented to the "medicalization of menarche." '"Something
happens to girls': Menarche and the emergence of the modern American hygienic imperative," J. Hist.
Sexuality, 1993, 4, 108-11.
13. Thomas Addis Emmet, Principles and Practice of Gynecology, 3rd. ed. (Philadelphia: Henry C. Lea's
Son & Co., 1884), p. 20; J. M. Baldy, ed., An American Text-Book of Gynecology, Medical and Surgical, for
Students and Practitioners (Philadelphia: W. B. Saunders, 1894), p. 97. Edward Clarke, Sex in Education:
Or a Fair Chance for Girls (Boston: James R. Osgood & Co., 1873).
14. Baldy, (n. 13) American Text-Book, p. 97.
15. Bache McE. Emmett, "Outline of gynaecological therapeutics," in Clinical Gynaecology, Medical
and Surgical, by Eminent American Teachers, John Marie Keating and Henry C. Coe, eds. (Philadelphia: J.
B. Lippincott, 1895), p. 172.
16. Julia Ward Howe, ed., Sex and Education: A Reply to Dr. Ε. H. Clarke's "Sex in Education" (New
York: Arno Press, 1972). Original work published 1874.
17. Mary Putnam Jacobi, The Question of Rest for Women During Menstruation (New York: Putnam,
1877).

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328 Journal of the History of Medicine : Vol. 51, July içç6
1888, Prudence Saur, graduate of Philadelphia Women's College, con

cluded that "a woman in perfect health should feel no necessity for
deviating from the ordinary duties or occupations and no special care
need be taken at this time."18 Dr. Georgia Merriam, of Bucyrus, Ohio,
argued that because menstruation was a physiological rather than a
pathological function, it should cause no more physical distress or dis
ruption of physical or mental work than would digestion or respiration.19
Some male physicians agreed. Horatio Bigelow concluded "Perhaps
the best plan is to allow the woman to do that which she feels most like
doing. If it pleases her to rest, she should rest. If she desires to walk, such
exercise may be permitted."20 The popular medical texts produced in
1880 by R. L. Robb, J. V. Bean, and S. Lucretia Robb, and in 1896 by
Montfort B. Allen and Amelia C. McGregor, merely cautioned against
"heating" or "violent" exercise but did not recommend complete rest
or abstinence from normal work and recreation.21 The Viavi health and
hygiene manual admonished menstruating "girls": "Any disinclination
for needful exercise should be determinedly conquered, but fatigue
should be strictly avoided."22 Howard Kelly wrote that rest at the outset
of the menstrual period was unnecessary unless severe dysmenorrhea
were present. He offered this example: ". . . teachers of physical train
ing, who do not suffer from dysmenorrhea, make no difference with
their systematic exercise . . ,"23
Conservative opinion flourished into the 1910s, however. Nurses
Carolyn E. Gray and Mary Alberta Baker invoked feminism in their in
troduction to the 1915 revision of Joseph Brown Cooke's A Nurse's
Handbook of Obstetrics, but they still regarded rest on the first day of men
struation as normal.24 By 1923, however, Dr. Clelia Mosher took the op
posite view; she encouraged abdominal exercises to relieve cramps and
18. Prudence Β. Saur, Maternity: A Book for Every Wife and Mother (Chicago and Philadelphia: L. P.
Miller & Co., 1888), p. 33.
19. Georgia Merriam, M.D., "Do women require mental and bodily rest during menstruation; and
to what extent?" Columbus M.J., September 18, 1894, 13, 294-301; October 2, 1894, 13, 346-52;
October 16, 1894,13, 397-401.
20. Horatio R. Bigelow, "The hygienic and dietetic regimen of uterine therapeutics," Am. J. Obstet.,
1882, 15, 135.
21. Allen and McGregor, (n. 4) Glory of Woman, p. 87; R. L. Robb.J. V. Bean, and M. Lucretia Robb,
Robb and Company's Family Physician (Burlington, IA: Robb and Company Book Publishers, 1880), p.
601.
22. H. Law and H. E. Law, Viavi Hygiene, rev. ed. (London: The Viavi Company, Inc., 1908), p. 212.
23. Kelly, (n. 3) Medical Gynecology, p. 73.
24. Cooke, (n. 3) Nurse's Handbook, p. 45.

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to curtail or eliminate the menstrual flow, which she deemed unneces
sary to health.25 Macfarlane, writing for student nurses in the same year,
denounced "excessive" exercises and sports during the menses, but she
enjoined bed rest only if the flow was too frequent, too copious, or
painful. In these cases, she said, the underlying cause needed to be in
vestigated.26 In 1936, Rachel Palmer and Dr. Sarah Greenberg took an
even more positive stance, writing that "None but the most strenuous
forms of athletics should be denied the normal, healthy girl during her
menstrual period."27 Women who followed medical advice to pursue
normal activities while menstruating surely experienced a greater need
for effective, convenient sanitary protection.
Most medical writers of the late 1800s and early 1900s subscribed to a
second tenet of healthful behavior during menstruation: Keep the body,
especially the abdomen and the feet, warm.28 Becoming chilled, indoors
or out, supposedly precipitated or worsened cramps and could halt the
flow prematurely.29 Dr. Anne Perkins regarded chilling and resulting ir
regularity of flow more philosophically, implying that it would correct
itself in due course.30 Bathing was hedged with rules, because of the
difficulty of staying warm in a house without central heating. Although
both cold and hot baths were often forbidden, the latter because they
might overstimulate the flow, tepid sponge or plunge (tub) baths re
ceived medical approval. Robb, Bean, and Robb preferred tepid water,
and encouraged ablutions several times a day.31 Cobb, bluntly con
demning "loud, offensive odors" due to the menses, directed women to
wash "the parts as thoroughly ... as can be done with a sponge or
cloth." Further, she stated: "The entire body may be sponged with hot,
or warm water and soap, any season of the year without injury or dan
ger of taking cold . . ." if the room were warm and free of drafts.32 Mary
Wood-Allen, a physician who combined medicine with moralizing on
2$. Clelia Duel Mosher, Womans Physical Freedom (New York: The Woman's Press, 1923), pp. 43-44.
26. Macfarlane, (n. 10) A Reference Hand-Book, p. 22. The first edition of this book appeared in 1908,
but was not available for study. It is possible that Macfarlane simply retained a conservative position in
later editions.
27. Rachel Lynn Palmer and Sarah K. Greenberg, Facts and Frauds in Women's Hygiene (New York:
The Vanguard Press, 1936), pp. 88-89.
28. Law and Law, (n. 22) Viavi Hygiene, p. 219. Jane E. Lane-Clapon, M.D., Hygiene of Women and
Children (London: Henry Froude and Hodder & Stoughton, 1921), p. 107.
29. Robb, Bean, and Robb, (n. 21) Family Physician, p. 601; Saur, (η. i8) Maternity, p. 33.
30. Anne Perkins, M.D., "Disorders of menstruation," Trained Nurse, 1920, 65, 510; Perkins' article
continued into the January 1921 issue.
31. Robb, Bean, and Robb, (n. 21) Family Physician, p. 602.
32. Cobb, (n. 2) Medical Adviser, p. 386.

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330 Journal of the History of Medicine : Vol. 51, July igg6
themes of the Women's Christian Temperance Union, urged sponge

baths, regular changing of underwear, and "a frequent change of nap
kins, in order to remove those which are soiled from their irritating con
tact with the body."33 Howard Kelly expanded on the topic of hygiene
in his volume Medical Gynecology:
The periods of the menstrual flow in the healthy girl require no marked devi
ation from her normal hygienic habits. Great cleanliness of person and of cloth
ing must be enjoined, in opposition to the prevalent idea that bathing and
changing of underclothing must be avoided. The daily bath must not be inter
mitted; a cold sponge bath may be substituted for a cold plunge, but there is no
necessity for changing the habit of daily bathing, while the underclothing re
quires more frequent changing than at other times. Girls should not be taught
to use a vaginal douche after each menstrual period.34
Compared to their volubility on other aspects of menstrual hygiene,

most male physicians lapsed into silence or vagueness on the subject of
protective materials, leaving women to share the specifics among them
selves.35 Doctors knew that women wore, or should wear, some type of
protective cloth. When dealing with a hypochondriac patient who in
sisted on wearing nightclothes, Thomas Addis Emmet, a world-re
nowned American gynecologist, threatened her: " Ί shall remove that
night gown, and put on your flannel undershirt, etc.' I then enumerated,
in order, every article of female dress I could think of, even to a nap
kin."36 Rare, surviving menstrual cloths demonstrate that these early
napkins were intended to be washed and reused several times. One mid
1800s napkin is cotton, in a rib-knit, with stitches loose in the center
33-Mrs. Mary Wood-Allen, M.D., What a Young Woman Ought to Know (Philadelphia: The Vir
Publishing Co., 1913), p. 148. The identical information appeared in the 1905 edition. She perceived a
soiled napkin as irritating, but did not mention its septic potential, perhaps because she was more moral
istic than clinical in her orientation to medicine.
34. Kelly, (n. 3), Medical Gynecology, p. 72.
35. It has long been assumed, as Schroeder stated in his 1976 article, that information on menstrua
tion and menstrual products were part of the "great feminine underground." (p. 103) Our review of
nineteenth- and twentieth-century health literature confirms this assessment. Drs. Joel Shaw and
Elizabeth Blackwell, writing in 1852 and 1858 respectively, agreed that mothers were responsible for in
structing their daughters in matters of health. As late as 1930, the anonymous writer of "Modern hy
giene," described sanitary pads, and claimed that "Mothers had taught their daughters how to make
them." (p. 122). Fred Schroeder, "Feminine hygiene, fashion, and the emancipation of American
women," American Studies, 1976,17, 101-110. Joel Shew, M.D., Midwifery and Diseases of Women (New
York: Fowler and Wells, 1852). Elizabeth Blackwell, M.D., The Laws of Life, with Special Reference to the
Physical Education of Girls (New York: A. O. Moore, 1858). Anon., (n. 1), p. 122. Brumberg perceived
that mothers monitored menstrual hygiene even as they ceded the role of initial teaching about menses
to medical authorities, (n. 12), p. 112.
36. Emmett, (n. 13) Principles and Practice, p. 105.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
strip and tight at the ends; a buttonhole at one end could fasten to a belt
or other undergarment. A second cloth of diaper-weave linen is marked
with the owner's name in laundry ink.37
Women physicians expounded most fully on the details of home
made menstrual products, especially in the less technical books directed
to general readership. Cobb advocated that her readers employ a sponge
or "mat," to be secured by a t-shaped bandage. These home-made nap
kin pads were composed of cotton batting enclosed in cheesecloth or
other fabric, the completed size being three to four inches wide and ten
to sixteen inches long. Cobb noted that women required eighteen cot
ton-fiber mats and six washable cloth napkins per month, for two to four
daily changes.38 Saur's 1888 text had included a similar estimate: "Some
are obliged to make but one change during the period, but they gener
ally average from ten to fifteen."39 In both the 1905 and 1913 editions of
her book, Mary Wood-Allen also suggested using an outer strip of
muslin, with inner napkins of cheesecloth, which were cheap and could
be burned after use. She encouraged shoulder suspension of napkins, to
relieve pressure on the abdomen.40
At least some gynecologists and obstetricians were cognizant of the
manufactured sanitary pads and belts that began to appear in the United
States in the mid-i88os. By 1894, An American Textbook of Gynecology,
Medical and Surgical, for Students and Practitioners, written by a team of gy
necologists, depicted a "menstrual pad" without commentary.41 (Figure
1) This was actually a composite of manufactured belt and pad, the lat
ter resembling the "surgical bandage" for which Dugald Scott filed a
U. S. patent application in 1892. Scott's design had been patented in
England in 1891, but the U.S. rights were awarded only in 1898.42
Obstetrician Joseph Brown Cooke's name was associated with one of
Johnson & Johnson's maternity packets, which reportedly contained
sanitarv Dads and was marketed in the iooos.43
37· These were exhibited at the University of Iowa Medical Museum in February 1995. The cotton
knit napkin was lent by the Valentine Museum, Richmond, VA; the linen piece was from the collec
tion of the Philadelphia Museum of Art.
38. Cobb, (n. 2), Medical Adviser, p. 386.
39. Saur, (η. i8) Maternity, p. 46.
40. Wood-Allen, (n. 33) What a Young Woman, p. 149.
41. Baldy, (n. 31) American Text-Book, p. 97.
42. Dugald Scott, "Surgical Bandage," U.S.P. 598,016, awarded 25 January 1898. Scott specified in
his claim that the bandage was a "towel for use by women during periods of menstruation," using
"towel," a still-current British term for "napkin."
43. Lawrence Foster, in his official history, A Company that Cares. One Hundred Year History of Johnson
& Johnson (New Brunswick, NJ: Johnson & Johnson, 1986), p. 44, explained that salesmen would dis

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
332 Journal of the History of Medicine : Vol. 51 ,July igg6
Menstrual Pad.
Figure ι. Menstrual pad and belt. From J. M. Baldy, ed., An American Text-Book of Gyne
cology, Medical and Surgical, for Students and Practitioners (Philadelphia: W. B. Saunders, 1894),
p. 97, Fig. 87.
Disposable sanitary products became available in the late 1800s and

were sold, through varying sources, from that time forward. The evi
dence suggests that health professionals—pharmacists, physicians, and
nurses—participated in the development and dissemination of these
products. Some contributed directly, by the invention of a menstrual
pad or tampon; others took part indirectly, by their teaching and exam
ple of stringent standards of asepsis in prenatal and postnatal care of par
turient women.
Pharmacists appear to have been first among health professionals to

offer commercial menstrual products; they were purveying sanitary nap
kins and belts by the late 1880s. In November 1884, the national trade
publication The American Druggist and Pharmaceutical Record advertised
cuss ideas for new products with physicians. Successful ideas were often named for the originating physi
cian. "A maternity kit suggested by Dr. Joseph Brown Cooke, surgeon at the New York Maternity
Hospital, was more elaborate and more expensive (than "Dr. Simpson's Maternity Packet") and con
tained sanitary napkins for the mother, a relatively new product at the time."Foster mentioned no date,
but Johnson & Johnson had sanitary napkins on the market by 1899, according to the company Price
List; "Dr. Cooke's Maternity Packet" appears in the A. Kiefer Drug Co. catalog of 1904, p. 262. It was
indeed "more expensive" at $13.00 than "Dr. Simpson's Maternity Packet," which cost $4.50.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
two menstrual assemblages manufactured by Dr. Hiram Farr.44 Farr's
products may not have been sold widely; they seem not to have been
listed in pharmaceutical wholesalers' catalogs. However, the Ladies'
Elastic Doily (napkin) Belt and an "Antiseptic and Absorbent Pad" with
the name "Horn" on the tab appeared in the 1887 Annual Price Current
of Peter Van Schaack, a Chicago-based pharmaceutical wholesaler.45
Noyes Brothers and Cutler (St. Paul), Fuller and Fuller (Chicago),
and Max Wocher & Son (Cincinnati) also advertised sanitary belts and
pads in their catalogs between 1888 and 1897.46 Johnson & Johnson
offered their own brand of sanitary napkin in a Price List dated January
1899.47 Through the end of the nineteenth century, women who were
too reticent to purchase menstrual pads and belts in a pharmacy could
order them through manufacturers' fliers,48 the catalogs of Sears, Roebuck.
Co.49 and Montgomery Ward,50 and from women's periodicals such as
Harper's Bazar,51 The Delineator,52 and Women's World and Jenness-Miller
Monthly.53 Women's magazines also carried classified advertisements for
"Lady Agents" to sell menstrual products from their homes or door-to
door.54 The anonymous New York writer of "Talks with the Trade on
Druggists' Sundries" gave insight into how sanitary belts (which often
had rubber components) and perhaps pads were purveyed in the mid
1890s:
One advantage of having rubber sundries in stock separately is that the

ladies—who lead by a large majority in the buying of such goods—may make
44- The American Druggist, November 1884, p. 30.

45. Peter Van Schaack & Sons, Annual Price Current, Chicago, 1887, p. 536. Horn was a Philadelphia
company, established in 1842, that manufactured trusses and sanitary belts, with a sideline in sanitary
pads.
46. Ibid., p. 536; 1889, p. 62$; 1897, p. 868. Fuller & Fuller Co.'s Prices Current, Chicago, 1894, p. 682;
Illustrated Catalogue and Price-List of Max Wocher & Sons Surgical Instruments, 2nd. ed., Cincinnati, Ohio,
1896, p. 53.
47. Price List, Johnson & Johnson, New Brunswick, Ν J., p. 19. J & J list branch offices in New York,
Chicago, and San Francisco. Delaney, Lupton, and Toth cite 1896 as the introduction of Lister's Towels,
but offer no documentation of this. Delaney, Lupton, and Toth, (n. 1) The Curse, p. 16.
48. Undated flier for Queen City Suspender Company, 179 Main St., Cincinnati, Ohio.
49. Sears, Roebuck & Co. Catalog, 1987, pp. 32, 322, 323.
50. Montgomery Ward & Co.'s Catalog, No. 56, Fall-Winter, 1894-95, P- 83; Montgomery Ward & Co.'s
Catalog, No. 37, Spring-Summer, 1895, p. 88.
51. Advertisement by Lewis Stein for a belt that supported hosiery and napkin, Harper's Bazar, 18, 21
November 1885, p. 758.
52. Advertisement for "Southall's Celebrated 'Sanitary Towels'," a British pad marketed by the
Canfield Rubber Company, New York. The Delineator, June 1887, 29, p. xii.
53. Bliss Mfg. Co. advertisement, Jenness-Miller Quarterly Journal, Autumn 1890, 2, p. 22.
54. The Delineator, July 1894, 46, pp. xxii; and November 1894, p. xxxviii.

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334 Journal of the History of Medicine : Vol. 51, July igç6
their selections with less publicity than in the general (drug) store. Here we
have the advantage of more privacy and a good arrangement of goods with a
view to their display. A lady assistant is kept on the floor . . ,55
The marketing of sanitary pads and belts becomes more difficult to

trace in the early 1900s. Evidently, local drug stores continued to carry
sanitary pads, belts, and components such as surgical cotton and gauze.
Such products appear steadily in pharmaceutical catalogs produced by
the wholesalers named previously, as well as by F. W. Braun & Co., Los
Angeles;56 Jerman, Pflueger & Kuehmsted Co., Milwaukee;57 Des Moines
(Iowa) Drug Co.;58 Langley & Michaels Co., San Francisco;59 The A.
Kiefer Drug Co., Indianapolis;60 and Meyer Brothers Drug Co., St. Louis.61
Sanitary belts and disposable pads were being stocked by some drug
stores in cities across the United States. Although sales records for men
strual products have not been located, it is unlikely that these products
would have been repeated in wholesalers' price lists year after year if re
tailers were not selling and reordering them.62
Department stores also sold various types of pads, belts, and moisture
proof aprons at their "notions" counters. The 1900 edition of Cole's En
cyclopedia of Dry Goods stated that "the sanitary napkin made especially for
women has within recent years become a staple commercial article."63
By 1917, these products were prevalent enough to merit four paragraphs
of discussion in Department Store Merchandise Manuals.64 Between 1902
and about 1920, however, direct advertisements to women appear in
55- India Rubber World, 10 December 1895, p. 75. Gregory Higby and Teresa C. Gallagher noted that
women whose families owned drug stores often participated in running the business, even without for
mal education in pharmacy. Women also graduated with professional degrees from schools of pharmacy,
but usually engaged in institutional pharmacy, rather than becoming proprietors of drug stores.
"Pharmacists," in Women, Health and Medicine in America, ed. Rima Apple (New York and London:
Garland Publishing Inc., 1990), p. 504.
56. W. F. Braun & Co., Price Current, 1900, p. 631; 1901, p. 817.
57. Jerman, Pflueger, & Kuehmsted Co., Wholesale Druggists, 1901, Prices Current, p. 911.
58. Des Moines Drug Company, Twentieth Century Illustrated Catalog and Price Current, 1901-03, p.
824.
59. Langley and Michaels Co.'s Prices Current, 2 January 1902, p. 331.
60. The A. Kiefer Drug Company, Drugs, Chemicals, Patent Medicines, Druggist's and Stationers'
Sundries, Vol. I, 1904, pp. 255, 262.
61. Meyer Brothers Drug Co., Prices Current, 1909, p. 310.
62. Companies that advertised by catalogue to consumers dropped lines that did not sell well. This is
made clear in Boris Emmet and John E. JeucJc, Catalogues and Counters. A History of Sears, Roebuck
(Chicago: University of Chicago Press, 1950), p. 223.
63. George S. Cole, Cole's Encyclopedia of Dry Goods (New York: The Economist Press, September
1900), p. 374.
64. M. Attie Souder, Department Store Merchandise Manuals. The Notion Department (New York: The
Ronald Press Company, 1917), pp. 109-10.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
frequently in such magazines as The Delineator, Vogue, and Harper's
Bazar.65 One advertisement for Bauer & Black's antiseptic cotton lists
among its uses "for absorbing discharges."66 This is distinguished from
"for dressing wounds" so it is almost certainly a euphemism for men
strual and other genital fluids. Added evidence for this interpretation
comes from Johnson & Johnson's 1916 Household Hand Book, which
states "Lengths of gauze folded over absorbent cotton make ideal sani
tary towels or napkins of any size desired."67
Elisabeth Robinson Scovil, associate editor of The Ladies' Home
Journal and former superintendent of the Newport Hospital, described
such home-made, disposable pads in her 1896 book Preparation for
Motherhood,68 Elizabeth Emma Cobb offered similar instructions in The
Medical Adviser, as did Mary Wood-Allen in What a Young Woman Ought
to Know.69 As late as 1936 this option was suggested by Palmer and
Greenberg: "... women with limited funds . . . can make up their own
napkins of a good grade of cotton and gauze for less than a third the price
charged for the Venus brand."70
Particularly enlightening statements about selling sanitary napkins ap
pear in a two-page spread in The American Druggist and Pharmaceutical
Record, by which Kotex introduced its sanitary pads to pharmacists in
December 1920, immediately before advertisements appeared in women's
magazines. The text confirms that drug store sales of sanitary napkins, "a
once profitable line", had experienced a "very large decrease" because
The average five cent sanitary napkin of today is a mere shadow of the nickel
seller of a few years ago—it is inadequate in size and absorption. Ten cents is
more than American women care to spend for a napkin, so millions of women
are today buying material and making their napkins in the home.71
Even discounting the "millions," it seems that women were improvis

ing disposable sanitary pads from absorbent cotton and surgical gauze in
significant enough volume to be noticed by the trade.
65- The only explanation the writers can suggest is that products specific to drug stores were rarely
promoted through women's magazines; newspaper ads promoted the store as a whole or focused on
medications or cosmetic products.
66. The Delineator, July 1913, 82, p. 58.
67. Johnson & Johnson, Household Hand Book, 1916, p. 45.
68. Elisabeth Robinson Scovil, Preparation for Motherhood (Philadelphia: Henry Altemus, 1896), p. 29.
69. Cobb, (n. 2) The Medical Adviser, p. 386; Wood-Allen, (n. 30) What a Young Woman, p. 149.
Brumberg also recognized that in the late nineteenth and early twentieth centuries middle-class women
purchased disposable components such as cheesecloth to make into napkins. Brumberg, (n. 12), p. 114.
70. Palmer and Greenberg, (n. 27) Facts and Frauds, p. 40.
71. Advertisement by Cellucotton Products Co., December 1920, pp. 8-9.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
336 Journal of the History of Medicine : Vol. 51 ,July iqq6
After Kotex's promotional blitz launched their new brand of napkin

nationwide, advertisements for napkins and belts proliferated.72 De
pending on the manufacturer, sanitary pads and belts were sold through
drug, department, or dry goods stores, as well as being dispensed from
machines in women's restrooms.73 Most major brands also marketed
their products by direct mail;74 some even sent samples free or for the
cost of postage.75 During the 1920s, any woman with the price of be
tween 45c (per dozen regular) and 90c (per dozen super) could obtain
disposable sanitary pads in a local store or through the mail. By 1931, the
range of prices had declined to between 23c and 35c per dozen.
Whereas pharmacists purveyed sanitary belts and pads, physicians
contributed to the invention of these products, as early as the 1860s. Dr.
Joseph C. Benzinger patented an "improvement in catamenial sacks" in
1866. His elaborate device consisted of a sponge pad and a supporting
"girdle" made of fine leather, canton flannel,76 elastic webbing, and silk
bindings. None of these materials is easily laundered, despite Benzinger's
intent to "maintain the person of the patient in a cleanly condition."
However, Benzinger also wanted his pad holder to be comfortable to
wear, hence the choice of components.77 Two years later, Dr. H. W.
Libbey created a similar article from oiled silk78 or rubber, with the in
tent of making it washable.79 Both doctors designed their pad holders to
72. The lesson Kotex seems to have taught other companies was the need for a discreet name to ease
the purchase of pads for embarrassed women. Veldown, Nupak, Curads, Venus, and Modess became
nationally advertised brands in women's magazines during the 1920s and 1930s. In their reference work,
Trademarks, Labels, Prints to the Textile Industry, the patent attorneys Munn & Co. listed nineteen com
panies that were producing sanitary napkins in 1921. Kotex (now Kimberly-Clark) is the only one of
these firms still in the business of making napkins.
73. Kotex sold in drug, dry goods, and department stores, as stated, for example, in the advertisement
in Good Housekeeping, March 1922, 74, p. 160. Venus brand pads sold in department stores, as stated, for
example, in advertisement in Vogue, 1 February 1930, 75, p. 111; Johnson & Johnson's Nupak could be
found in the reader's "favorite drug store" where she "probably will see it displayed," advertisement in
Harper's Bazar, September 1926, 60, p. 157. By 1928 J &J had adopted the name Modess for their san
itary napkins. Delnaps pads were sold in dry goods and department stores, as stated, for example, in the
advertisement in Vogue, March 1924, 63, p. 171.
74. Kotex cost 50^ for six large pads, postpaid, for example, in Vogue, 1 February 1922, p. 86.
75. Kotex advertisement, Good Housekeeping, May 1922, 74, p. 103; Kotex offered a test sample free
(no postage charged) to nurses in Am. J. Nursing, June 1924, p. 593. Modess advertisement, The Home
Magazine, April 1930, p. 105.
76. Canton flannel is a woven cotton cloth with a napped surface.
77. Joseph C. Benzinger, "Improvement in Catamenial Sacks," U.S.P. 57,665, awarded 4 September
1866.
78. "Thin, plain-woven silk impregnated with boiled oil and thoroughly dried . . . This treatment
renders the texture semi-transparent and waterproof." Cole, (n. 63) Encyclopedia of Dry Goods, p. 394.
79. H. W. Libbey, M.D., "Improvement in Catamenial Sacks," U.S.P. 75,484, awarded 10 March
1868.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
fit the body closely but flexibly. In 1884, Dr. Hiram Farr, of Boston, se
cured a patent for a "menstrual receptacle," consisting of a cup-shaped
device that fit into the vagina and conveyed the menstrual fluid into an
anatomically-shaped holder made of elastic material.80 (Figure 2) Unlike
Benzinger's and Libbey's devices, this assemblage and the alternative
belt-and-pad combination were actually manufactured. The previously
noted advertisements in The American Druggist and Pharmaceutical Record
(Figure 3) placed them among the first menstrual products to be adver
tised nationally.81 Dr. Albert Gray of St. Louis patented a "catamenial
sack" in 1899. His invention consisted of a trough-shaped sack made of
"dental rubber," connected to a belt. The sack contained a "pledget" of
sponge or absorbent cotton. A small pocket in front held disinfectant or
carbolic acid.82 The composite was later sold in St. Louis as "Dr. Gray's
Monthly Friend," demonstrating its commercial viability.83 Gray was ev
idently applying medical techniques for asepsis to a menstrual product
and was employing his medical title to persuade women to purchase his
washable "catamenial sack."
William D. Berry, a physician based in Louisville, Kentucky, secured
a patent in 1907 for a "catamenial appliance" consisting of a pouch se
cured to an elastic belt by elastic straps. The pouch had a triangular shape
that, combined with its securing straps and bindings, would "cause it to
fit permanently and accurately in proper position." Its straps adjusted to
different sizes and the open-meshed pouch, to be filled with absorbent
cotton, offered more comfort than previous impervious holders.84
Although tampons were well-known to late nineteenth- and early
twentieth-century physicians, their use was strictly limited to ". . . the
treatment of diseases peculiar to women,"85 and they were not being de
veloped to absorb menstrual discharge.86 By the 1930s, however, this at
80. Hiram C. Farr, "Menstrual Receptacle," U.S.P. 300,770, awarded 24 June 1884.
81. Stephen K. Ellis patented a "Suspender" to support sanitary napkins; U.S.P. 169,245, awarded 26
October 1875. Itwas advertised in a booklet of the Queen City Suspender Co., which bore no date but
whose other images suggest the mid-1870s. "Dr. Gray's Monthly Friend," advertised by the Lewis Stein
Company in the mid-i88os was patented not by a physician, but by Stein himself, U.S.P. 395,011,
awarded 25 December 1888. The advertisement appeared in Harper's Bazar, 20 May 1885,18, p. 558.
82. Albert L. Gray, "Catamenial Sack," U.S.P. 626,159, awarded 30 May 1899.
83. Meyer Brothers, (n. 61), Prices Current, p. 310.
84. William D. Berry, "Catamenial Appliance," U.S.P. 857,019, awarded 18 June 1907.
85. Clovis Gamache, Jr. and Walter S. McNear, "Tampon applicator." U.S.P. 1,224,735, awarded 1
May 1917.
86. The writers have found at least 16 patents for tampons and one for a tampon applicator, granted
between 1890 and 1921. The information in his patent text demonstrates that Anthony E. Magoris was
a physician, who had ". . . given the appliance (tampon) a thorough test in my own private practice and

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
(No Model.)
H. G. FARR.
MENSTRUAL RECEPTACLE.
No. 300,770. Patented June 24, 1884.
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Figure 2. Illustration of Hiram Farr's "Menstrual Receptac

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
Parr's
Farr'sPlexitis
Flexible Uterine
Uterine Supporters.
Supporters.
Eg!
JSgL
Tig2.
No. 2 Uterine Supporter.

Improved Uterine Supporter. Price, $4.00 each.
Price, S5.00
$5.00 each.
The Prices, to physicians, of the foregoing good·,
goodl,
Anteflexion and Retro are as follows: ■ f
version Cups.—This Cut re Improved Combined Abdominal and Uterine r '
presents Flexible Stem Cup Supporter, as shown in Fig. No. 1, . ·*5$5°®/
Combined Adjustable
Combined Acjustable Pad
Pad Supporter,
Supporter, shown
shownin'
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used with No. 1 and 2 Belts, Fig.
Fig. 2, 2· 4 4
that may be formed or bent Improved
Improved Bel
Belt, w
Adjustable
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B
by the physician to throw Fig.22
Fig. · »»
the cup at any angle desired Plain non-elastic Belt, with Uterine Cup, · 3 00
and there remaining, thus receiving and holding theFlexible Uterine Cups, Prolapsus or Anteflexion
and
and Retroversion,
Retroversion,. .. .. .. .· ·. 2 2 c0
co
uterus, no matter what the displacements are. Pelvic Uterine Supporters, · 2 3
II make
make three
three sizes Cup*.
sizes Uterine Uterine
Nos. 1,Cup*.
2 and 3,Nos. 1, and
and 2?* 2 and
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inchf·.·: Belts from
In
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FIG.Ï.
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No. 1 Menstrual Receptacle·

Menstrual
Menstrual Keceptacle,
Keceptacle, No. 2,
with
witha ayear's
year'ssupply of Absorbent,
supply of Absorbent, · · .p. "3
Price, $3.00 each. Afterwardsaayear's
Afterwards year'ssupply
supply for · *
for "4
Figure 3. Advertisement for Farr's Flexible Uterine Supporters and Menstrual Receptacles,
The American Druggist, November 1884, p. 30.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
340 Journal of the History of Medicine : Vol. 51, July 1996
titude was changing, and physicians were prominent in the development

of tampons for menstrual use. In 1932, Dr. Earle C. Haas commenced
his career as an inventor with a patent for a plunger-operated applicator
of vaginal powder.87 Less than a year later, he secured patent rights on an
immensely successful product: the design of the future "Tampax" tam
pon.88 (Figure 4) The patent was not assigned to Tampax at the time it
was awarded, but Haas later sold his design to the Tampax Company,
which acknowledged in its advertising that the product was "Perfected
by a Doctor."89 Haas continued to patent improvements, including a
tampon with "maximum of expansion when in use; a minimum of size
when not in use; . . . the removal of all of the fibers of the catamenial
core when withdrawn; and which will straighten and elongated itself to
a minimum diameter during withdrawal." Additional improvements re
lated to self-sustaining shape and smooth shape and texture of the tam
pon and its applicator.90 Since the latest filing date on Haas' patents was
2 June 1934, Tampax Company would have had sufficient time to in
corporate these improvements into the tampon that it introduced in
1936.
However, Haas was not the first physician to invent a salable men
strual tampon. Wix brand tampons also used a design patented by a
physician, Frederick S. Richardson, of Minneapolis,91 the city in which
Wix were manufactured. Richardson employed a compact roll of cot
find that it works most successfully." U.S.P. 688,188, awarded 3 December 1901. One physician was lo
cated by his publication cited in Index Medicus: Charles C. Fredigke, "Vaginal Tampon," U.S.P. 435,491,
granted 2 September 1890. Four other physicians were listed in the American Medical Directory 1909 (1923).
A Register of Legally Qualified Physicians of the United States and Canada (Chicago, A.M. A. Press): Anthony
E. Magoris, "Tampon," U.S.P. 688,188, awarded 3 December 1901; Franklin P. Gates (co-patentee
with John D. Cogswell and Henry L. Grant), "Surgical Package," U.S.P. 907,331, awarded 22
December 1908; Edmond Morse Pond, "Medicated Tampon," U.S.P. 1,395,295, awarded 1 November
1921; and Guy S. Peterkin, "Tampon," U.S.P. 1,401,358, awarded 27 December 1921. Because all of
the patents awarded from 1890 to 1921 referred to surgery or the application of medication, they are
not germane to sanitary protection.
87. Earle C. Haas, "Vaginal Powder Applicator," U.S.P. 1,878,513, awarded 20 September 1932.
88. Earl C. Haas, "Catamenial Device," U.S.P. 1,926,900, awarded 12 September 1933. Haas'
plunger was not the first for domestic use: Gamache and McNear assigned to Nur-Pon Company a
"Tampon Applicator" that women could use to insert medically prescribed tampons at home.
89. Haas himself reported this in a Chicago Tribune interview, published 5 May 1981, p. 8. Tampax
advertisement, Good Housekeeping, November 1937, 103, p. 234.
90. Earl C. Haas, "Catamenial Device," U.S.P. 1,964,511, awarded 3 July 1934; and "Catamenial
Device," U.S.P., 2,024,218, awarded 17 December 1935.
91. Frederick S. Richardson, "Catamenial Plug," U.S.P. 1,932,383, awarded 24 October 1933 but
filed 28 January 1931. Wix advertised that it was "perfected by two physicians," Vogue, 1 October 1935,
86, p. 153. However, the patent was secured only by Richardson. Wix continued to be advertised
through 1940, but no later.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
Sept:
Sept;12,
12,1933.
1933. Ε. C. HAAS 1,926,900
CATAMENIAL DEVICE
Filed Nov. 19. i931
/s
έτ/τ/ΡΔ^ C. //sœ^s
cl «OI
Figure 4. Illustration of Earl C. Haas' "Catamenial Device," patented

September 1933.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
ton covered, except at the ends, by perforated cellophane that expedited

insertion and removal of the plug, while not inhibiting absorption of the
menstrual fluid. In a statement unusual in patent texts, Richardson as
serted: "By actual commercial usage, the practicability of this device has
been fully demonstrated."92 He further asserts "So far as I know the prior
art, I am the first to have provided any practicable form of catamenial
device intended and adapted for use inside the vagina."93 His filing date,
28 January 1931, precedes that of Haas by almost ten months, support
ing his claim of priority. Wix continued to be advertised through 1940,
but disappeared from the literature thereafter.
Just as pharmacists marketed sanitary products and physicians in
vented them, obstetric nurses educated women in techniques of prena
tal and postnatal hygiene that would incline them to make—and later to
buy—disposable sanitary pads. As early as the 1890s nurses were them
selves being educated to the merits of aseptic treatment of all stages of
labor and postnatal recovery. Writers on these topics generally empha
sized using scrupulously clean vulvar dressings. Dr. Dowling Benjamin,
whose lectures for New Jersey nurses were published in The Trained
Nurse in 1895, stressed the need to "apply the principles of asepsis" in
the care of woman, prepartum and postpartum. Among the materials
listed in the "Benjamin Maternity Protection Outfit; or Obstetrical
Antiseptic Case," he listed "one dozen Aseptic Cloths, about fifteen
inches square," and "1 dozen Antiseptic Absorbent Pads." The cloths
were "used to absorb discharges during all stages of labor and for wash
ing . . . and for tampons, if need be." The pads "are to be used after la
bor, for the lochia or the menses."94 Whereas the tampons were meant
only to stanch a hemorrhage, the pads were adaptable to absorbing
lochia, which Benjamin equated to the menstrual flow.
Sectarian as well as orthodox practitioners wrote about the necessity
for perfect cleanliness surrounding women's reproductive functions. An
anonymous writer for The Eclectic Medical Journal, stated: "The great im
92. A Wix advertisement in Harper's Bazaar, July 1937, 71, p. 93, claims "Successfully used for more
than six years by American women." This harmonizes with Richardson's filing date and assertions of
priority and market testing. (Note that the spelling of Harper's magazine for women changed from Bazar
to Bazaar in December 1929.)
93. A review of more than 200 patents for menstrual products, issued from 1854 through 1921, sug
gests that Richardson's statement is correct in regard to a tampon developed for menstrual use. However,
his claim that his "catamenial device" was the first to be "intended and adapted for use inside the vagina"
is incorrect. At least 13 patents were issued for menstrual retentive cups, small cups that were inserted
into the vaginal cavity to catch and contain the menstrual discharge. Kidd, (n. 8) Menstrual Technology.
94. Dowling Benjamin, "Aseptic and antiseptic obstetrics," Trained Nurse, 1895,14, 79-80.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
portance of having an aseptic, soft, and highly absorptive dressing to take
up the lochial discharge which escapes during the lying-in period can
not be overstated."95
Anna Martha Fullerton, a physician whose Handbook of Obstetrical
Nursing for Nurses, Students and Mother's appeared first in 1890, under
scored "the value of cleanliness, antisepsis, and eternal vigilance on the part
of the nurse, in averting the dangers of childbirth."96 She described the
"antiseptic dressings used in the Woman's Hospital, of Philadelphia"
patterned after those of Henry Jacques Garrigues, Professor of Obstetrics
at the New York Post-Graduate Medical School and Hospital. These
consisted of a 6 χ 8 inch piece of "dry patent lint97 . . . rendered anti
septic by saturation in a solution of bichloride of mercury . . . covered
by a piece of gutta percha98 tissue . . . (also) wet in a 1-4000 solution of
bichloride of mercury." Such dressings were secured over the vagina by
"a napkin of sublimated cheesecloth . . . within whose folds a pad of
oakum is enclosed."99 Dressings were to be changed at least every three
hours, and burned immediately after removal. This might go on for as
long as two weeks. Fullerton reiterated that "... one of the most im
portant duties of the nurse during confinement is the frequent changing
of napkins, drawsheets, towels, etc. about the patient."100 In the 1890s,
nurses in the eastern United States, at least, were taught to maintain
scrupulously clean dressings, comparable in shape and application to
napkins, on their obstetrical patients.
This concern continued into the 1900s. Edward P. Davis, affiliated
with the Jefferson Medical College, did not share Fullerton's belief that
the dressing should actually close the puerperal "wounds." However, he
QfrpQQprl that "flip nnprnprcil wnman wac ο cnrcriral nafipnf "101 cmrl cra\7f*
95· Eclectic Med. J., April 1895, 55, 291.

96. Anna M. Fullerton, M.D., A Handbook of Obstetrical Nursing for Nurses, Students, and Mothers
(Philadelphia: P. Blakiston, Son & Co., 1890), p. v.
97. Lint is "Linen scraped or otherwise made into a soft, downy or fleecy substance for poultices and
for dressing wounds, etc. . . W. L. Carmichael, George E. Linton, and Isaac Price, Callaway Textile
Dictionary (LaGrange, GA: Callaway Mills, 1947), p. 208.
98. Gutta percha is a " . . . whitish to brown substance resembling rubber but containing more resin
and changing less on vulcanization, from the latex of several Malaysian trees of the sapodilla family." A.
Merriam-Webster, Webster's New Collegiate Dictionary (Springfield, MA: G. & C. Merriam Co., 1953),
p- 369·
99. Fullerton, (n. 96) A Handbook, pp. 49-50. The identical instructions were given in Fullerton's
1899 edition, pp. 82—85. Oakum is "Loose fiber obtained by untwisting and picking old hemp ropes
. . ." Merriam-Webster, (n. 98) Webster's New Collegiate, p. 578.
100. Fullerton, (n. 96) A Handbook, p. 78.
101. Edward P. Davis, A. M., M.D., Obstetrical and Gynecological Nursing (Philadelphia and London:
W. B. Saunders, 1901), p. 82.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
344 Journal of the History of Medicine : Vol. 31, July iqq6
detailed instructions on how the nurses were to prepare vulvar dressings

from "absorbent cotton and the cheaper quality of cheesecloth," steril
izing the pads, with or without added antiseptics. These were needed by
the new mother over a two-week period.102 Describing the practices of
the Chicago Lying-in Hospital, obstetrical reformist Dr. Joseph B.
DeLee stated that during the nurse's post-natal visit, "the patient is
dressed antiseptically and a new pad is put over the genitals."103 Thus,
even the poorer women who resorted to such hospitals104 could experi
ence antiseptic hygiene, even if they lacked the money to imitate such
practices.
Nurses shared techniques of aseptic practice among themselves, too,
and seemed especially anxious to do nothing that would endanger the
patient.105 Mary L. Keith explained that "An obstetrical nurse waiting at
the patient's home (for the onset of actual labor) will prepare ... six
dozen pads, made by folding cotton-waste106 inside absorbent gauze."107
Louella Adkins, discussing "The Care of an Obstetrical Patient," in
cluded in the supplies to be gathered by the nurse, ". . . two pounds ab
sorbent cotton; five yards gauze (sterile) . . ."108 Helen M. Stewart, ex
plaining "Obstetrics in Private Nursing," included making four dozen
"vaginal pads" from "hospital gauze, fifteen inches long and about nine
102. Ibid., p. 54. Davis estimated that the cost of such "simple dressings . . . will approximate two
dollars."
103. Joseph B. DeLee, "The technique of the Chicago Lying-in Hospital and Dispensary," Am. J.
Nursing, May 1907, 7, 612.
104. During the nineteenth century, maternity hospitals provided "... poor, homeless, or working
class married women ..." the opportunity for medical treatment and "... a chance to recuperate in an
atmosphere of moral uplift." By the 1880s, birthing in a hospital was more acceptable, as the danger of
puerperal fever abated and physicians became more skillful at obstetrics. Less than 5 percent of women
delivered in hospitals in 1900. "By 1939, half of all women and 75 percent of all urban women were de
livering in hospitals." Richard C. Wertz and Dorothy C. Wertz, Lying-in: A History of Childbirth in
America, Expanded ed. (New Haven, CT and London: Yale University Press, 1989), pp. 132—33. Judith
Walzer Leavitt also described "... the poor and largely immigrant or black community in the inner city
of Chicago at the turn of the twentieth century . . ."as the clientele of the Chicago Maternity Center.
Brought to Bed. Childbearing in America, 1750 to 1950 (New York and Oxford: Oxford University Press,
1986), pp. 82-83.
105. Hulda Osterlund, "The nurse's use of the five senses in obstetrics," Trained Nurse, 1912, 49, 152;
Mary Anna Howard, "Temperature in obstetric cases," Trained Nurse, 1912, 49, 292. W. Reynolds
Wilson, M. D. also cautioned ". . . it is here well for the nurse to protect herself from the responsibil
ity of infecting the patient through imperfect disinfection and sterilization. The risk is doubly great in
the parturient woman . . . ," "The surgical aspect of obstetrical nursing," Training Nurse, 1909, 42, 17.
Wilson was Visiting Physician to the Philadelphia Lying-in Charity.
106. Waste consists of "By-products created in the manufacture of fibers, yarns, and fabrics." Isabel
B. Wingate, Fairchild's Dictionary of Textiles, 3rd ed. (New York: Fairchild Publications, 1979), p. 663.
107. Mary L. Keith, "Preliminaries of obstetric nursing," Am. J. Nursing, 1901, 1, 257.
108. Louella Adkins, "The care of an obstetrical patient, "Am.f. Nursing, 1903, 3, 710. Adkins was a
graduate of the Women's and Children's Hospital, Kansas City.

66.163.28.139 on Wed, 17 May 2023 20:11:31 +00:00
wide, laying absorbent cotton in the center of each pad to fill about one
third of the space."109 Elizabeth Burttle refers to the "vulvar toilet" as
part of the post-natal routine.110 Even in cases where money had to be
economized, nurses employed disposable gauze and cotton to make
vulva pads, which were then sterilized.111
By 1910, some obstetrical nurses had learned the advantages of pur
chasing ready-made sterile dressings in lieu of sterilizing the materials
themselves, in a "wash boiler." Jennie Putnam explained that there were
". . . easier ways of procuring sterile goods at moderate cost and in most
large cities there are graduate nurses who make a business of furnishing
such supplies."112 Putnam disparaged the practice of "buying sterile
gauze and cotton and making it up hurriedly with hands not sterilized."
The preferred ready-made dressings were disposable; Putnam com
mented that the nurse should "Place soiled dressings and pledgets in pa
per sacks or newspaper cornucopias and have them burned."113
Even books written for lay audiences described the post-natal care of
the genital area. Elisabeth Robinson Scovil stated that during lying-in
"Small pads for use instead of (cloth) napkins should be provided. They
can be burned and lessen one of the great risks of infection."114 She cited
a price of sixty cents per dozen for ready made, with cheaper home made
versions of "absorbent cotton and cheese cloth." Myer Solis-Cohen, in
his domestic reference work Life Knowledge, listed among "Things needed
for the confinement . . . The Occlusive Bandages or Napkins." He
deemed the best to be "made of carbolized gauze and salicylated cotton"
but those were "rather expensive" and could be replaced by ones made
of "absorbent cotton or wood wool"115 and "washed cheese cloth."116
Charles Reed, Obstetrician at Wesley Memorial Hospital, Chicago,
published Obstetrics for Nurses in 1917. He, too, gave clear directives:
The vulva pads should be changed as often as they are soiled. Four a day is an
average number, and six or eight in the first three days is not unusual. . . Every
109. Helen M. Stewart, "Obstetrics in private nursing," Trained Nurse, 1907, 39, 294.
no. Elizabeth Burttle, "Obstetrical nursing," Am. J. Nursing, 1915,16, 196.
in. Sinah File Kilzing, "An inexpensive outfit for an obstetrical case," Am. J. Nursing, 1908-09, 8,
14·
112. Jennie M. Putnam, "An obstetrical case at home," Am. J. Nursing, 1910,10, 469.
113. Ibid., p. 471.
114. Scovil, (n. 68) Preparation for Motherhood, pp. 206-07.
115. Wood wool was defined as "Fine shavings made from pine wood, specially prepared and used
as surgical dressing." The Century Dictionary and Cyclopedia (New York: The Century Company, 1895),
p. 6970.
116. Myer Solis-Cohen, Life Knowledge (Philadelphia: Uplift Publishing Co., 1909), p. 177.

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time the pad is changed, the nurse should give aseptic care, and extra attention
whenever the bowels and bladder are emptied.117
He described pads made of layers of "common cotton" covered with

layers of absorbent cotton and gauze, sterilized after being made up.
Perhaps nurses, being in the thick of the work, were quicker to accept
ready-made sterile pads than were the obstetricians. Reed continued to
espouse scrupulous hygiene. Explaining the teaching of obstetrics to stu
dent nurses in a 1924 paper, he firmly supported the need of both nurse
and doctor to be
dirt sensitive, in the highest degree, both personally and professionally. ... In
this case (delivery of a child), cleanliness is next to godliness but the cleanliness
must come first, lest the godliness of the patient be suddenly and undesirably
acquired elsewhere.118
In the 1920s and early 1930s, the literature on obstetrical nursing con
tinued to stress sterile dressings, with a shift toward the ready-made va
rieties, which might "be obtained from any one of a number of firms
. . ,"119 Dr. Charles Sumner Bacon explicitly equated the vulvar dress
ing to "A large, thick napkin," when discussing care of the mother im
mediately after giving birth.120 A less invasive approach to cleansing the
perineum was emerging, one which employed warm water and soap,
rather than "antiseptic solutions" and extensive douching.121 Louise
Zabriskie, R.N., listed among "Supplies for the Mother" "four to six
dozen sanitary pads." Pads could be purchased sterilized or unsterilized,
the latter requiring ironing to render them sterile.122
There was also a trend toward reliance on the puerperal woman her
self. Nurse Nellie Perry prepared the vulvar dressings from cotton and
gauze at the patient's house, then instructed her how to boil batches of
dressings and dry them in the household oven.123 Elizabeth Wickham,
117. Charles Β. Reed, Obstetrics for Nurses (St. Louis: C. V. Mosby Co., 1917), p. 159.
118. Charles B. Reed, "Teaching obstetrics to student nurses," Am. J. Nursing, 1923-24, 24, 1211.
119. Carolyn Conant Van Blarcom, R.N., Obstetrical Nursing (New York: The Macmillan Co., 1923),
p. 159.
120. Charles Sumner Bacon, Obstetrical Nursing. A Manual for Nurses and Students and Practitioners of
Medicine, 2nd ed. (Philadelphia and New York: Lee & Febiger, 1924), p. 220. Beacon was medical di
rector of the Chicago Lying-in Hospital and professor of obstetrics at the University of Illinois and the
Chicago Polyclinic.
121. Everett Dudley Plass, "The perineal toilet," Trained Nurse, 1924, 72, 70. Plass was assistant ob
stetrician at Johns Hopkins Hospital.
122. Louise Zabriskie, R.N., Nurses [sic] Handbook of Obstetrics (Philadelphia and London: J. B.
Lippincott, 1934), p. 208.
123. Nelly E. Perry, "Hints for maternity nurses," Trained Nurse, 1917, 6, 278.

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R.N., while insisting that "sterilization of all goods must be done by the
nurse," added that . . the making up of the pads, sponges, etc. may be
left to the patient . . ,"124 Zabriskie also suggested that a nurse could
choose to "demonstrate to the patient how to iron, fold and put away
the pads if they are prepared at home."125 Thus, hard-pressed nurses
economized their own time, while inculcating hygiene in their patients.
In addition to the preachments of professional journals and texts, stan
dard curricula for nursing schools increased their coverage of menstru
ual functions and childbearing between 1919 and 1937. The curriculum
published in 1919 devoted ten hours of study to personal hygiene, one
topic of which was "hygiene of the reproductive system"—including
function, disorders, and management of menstruation.126 Obstetrical
nursing was covered in twenty hours of instruction, including both lec
tures and clinics by an obstetrician, and demonstrations, ideally by the
head of an obstetrics ward.127
By 1927, the time devoted to study of "personal hygiene" had ex

panded to 15 hours,128 and obstetrical nursing to 30 hours in lectures and
demonstrations.129 This curriculum listed "cleanliness" as the first of
"Essential qualifications of a maternity nurse."130 One of the subtopics in
the obstetrical unit was "... Instruction in personal hygiene applied to
each expectant mother in her own home and family . . ,"131 "Care of the
perineum" was explicitly prescribed as part of the topic "Nursing in
Normal Puerperium."132 A decade later, fully 60 to 80 hours of instruc
tion, labwork, and participation in clinics and on wards were dedicated
to obstetrical nursing.133 One of the curricular objectives specified: "To
acquire the special knowledge and skills. . . for giving good nursing care
and instruction to obstetric and neonatal patients in their homes as well
qq in VirwrntaU "134
124. Elizabeth Wickham, R.N., Maternity Nursing in a Nutshell (Philadelphia: F. A. Davis, 1924), p.
47. Wickham was the former supervisor of the Maternity Department at Lebanon Hospital, New York.
125. Zabriskie, (n. 122) Nurses Handbook, p. 209.
126. Standard Curriculum for Schools of Nursing, 3rd ed. Prepared by the committee on Education of the
National League of Nursing Educators, January 1920, p. 65.
127. Ibid., p. 105.
128. A Curriculum for Schools of Nursing, 6th ed. Prepared by the Committee on Education of the
National League of Nursing Educators, New York, New York, 1927, p. 81.
129. Ibid., p. 135.
130. Ibid., p. 136.
131.Ibid.
132. Ibid., p. 138.
133. A Curriculum Guide for Schools of Nursing, Committee on Curriculum, National League of
Nursing Educators, 2nd revision, 1937, pp. 441-44.
134. Ibid., p. 446.

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348 Journal of the History of Medicine : Vol.5i,Julyigg6
To what extent did women have access to a maternity nurse in the
late nineteenth and early twentieth centuries? As early as 1887, John
Keating, Visiting Obstetrician and Lecturer at Philadelphia Hospital, re
ferred to "the engagement of a nurse" early in pregnancy.135 Later in the
same volume, he directed instructions to "the monthly nurse," clearly
describing someone who attended the patient at home.136 The socio
economic level of the patients was not mentioned, but the general tenor
of the narrative implied middle to upper class.
By the early 1900s, a moderately well-off woman could have an ob
stetrical nurse visit her before confinement, be present at the delivery,
and either live-in or visit her daily after the baby's arrival, for four to six
weeks.137 Another nurse-author, Amy Armour Smith, instructed would
be maternity nurses to
Look up and save all advertisements and illustrations of maternity dresses,

corsets, binders, suspenders and other needs for the patient. Many patients have
a nurse almost from the time a physician is first called in, and she must enter
into counsel with the patient in everything.138
Whether the nurse visited the patient's home or conferred with her at
the doctor's office was not mentioned.
An "hourly nurse," did not live in the patient's home but instead vis
ited patients, including parturient women in their homes. She was
not a charity worker, nor is she the nurse of the well-to-do. Her field lies
among families with incomes from $600 to $1,500 a year, or even $2,000 to
$3,000. . . . Payments are nominal, but vary $.50 to $1.00 an hour.139
In 1917, Nellie Perry wrote of the range of women who might be at

tended by an obstetrical nurse:
The specially trained nurse who goes into the families of the rich, with their
well-oiled household machinery, does not have to face the same problems as
135-John M. Keating, Practical Lessons in Nursing. Maternity Infancy, Childhood (Philadelphia: J. B.

Lippincott, 1887), p. 14.
136. Ibid., pp. 35-36.
137. Mary Ε. M. Carter, R.N., "Maternity care for the moderately well-to-do," Am. J. Nursing, 1914,
'4, 357-60. Joseph B. De Lee, The Principles and Practice of Obstetrics (Philadelphia and London: W. B.
Saunders, 1913), pp. 231-32.
138. Amy Armour Smith, "Practical points in maternity nursing," 3rd part, Trained Nurse, 1915, 54,
345·
139. Anonymous, "The hourly nurse," Charities and the Common, 7 April 1906,16, 3. This periodical
was billed as "A weekly journal of Philanthropy and Social Advance." Charitable Organization Society
of the City of New York.

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the small-town nurse who finds her work mainly in the home of the salaried
man or the young man starting his business career, both of whom must be
aware of needless expense.140
Hulda Osterlund was even more inclusive in describing whom the ma

ternity nurse might look after:
. . . the nurse who possesses conscience, courage and tact certainly may do
much toward lessening the cares which have fallen on the puerperal woman.
This is especially true in the poorer homes, in some of which the patients know
nothing of the luxury of "being cared for."141
Although the availability of obstetrical nurses was beginning to bridge

class lines, not every woman, regardless of economic circumstance and
geographic location, could receive the utmost in nursing care. Poor
women, and those in rural areas, often had to fend for themselves.
However, it is evident that obstetrical nurses practiced hygiene and
taught its principles, including care of the genital area, to women at var
ious economic levels.142
Clearly, nursing education was providing increasing depth of knowl
edge, about both genital hygiene and care of the parturient woman, dur
ing the second quarter of the twentieth century. Dr. J.M.H. Rowland,
Dean of Maryland School of Medicine and Professor of Obstetrics, ad
mitted ruefully that "The laywoman will frequently place more confi
dence in the instruction of the nurse than in that of the physician . . ,"143
There was an explicit expectation that the nurse who engaged in ob
stetric work would teach her patients, both in the hospital and at home,
personal hygiene that included how and why to make disposable, asep
tic vulvar pads. The present writers propose that such instruction con
tributed to the trend for women to purchase the components of dispos
able napkins and, later, to acquire manufactured napkins, as these became
more readily available and affordable. Clues from the marketing of san
itary products point toward such a progression in women's acquisition
of sanitary goods.
140. Perry, (η. 123), p. 280.

141. Osterlund, (η. 105), p. 151.
142. Passage of the Sheppard-Towner Act in 1921 helped to fund prenatal instruction and, as imple
mented in some states, prenatal exams by public health nurses, for women who could not afford to re
tain nurses. The bill lapsed in 1929 due to organized opposition by medical and other groups. Wertz and
Wertz, (n. 104), Lying-in, p. 155.
143. J.M.H. Rowland, M.D., "Reduction of mortality and morbidity in childbirth," J.A.M.A. 1926,
87, 2158-59.

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Did nurses similarly contribute to the acceptance of menstrual tam

pons? The evidence is sketchy. According to Nancy E. Cadmus, General
Director of the Maternity Center Association, nurses were to be trained
in the preparation, purposes, and dangers of tampons and pessaries.144
Nurses were also expected to insert tampons to stanch hemorrhage.145
Thus they were perhaps better informed than other women in the de
cisions about use of menstrual tampons. Marie Hagele, R.N., collabo
rated with Dr. Lloyd Arnold on research into the tampons on the mar
ket in the mid-1930s. Their ninety-five subjects each wore three
unidentified brands of tampons, kept records of the hours of use, and
submitted used tampons and "backup" napkins for analysis. Eight sub
jects received complete protection from tampons, but almost 92 per cent
needed more than a tampon on days of heavy flow. These researchers
noted that tampons might block the discharge or become plugged with
a clot, and they recommended further study of long-term use of tam
ponage.146
Of course, it is one thing to offer a product and another for it to be
accepted. Is there evidence that commercial sanitary napkins were ac
cepted by U.S. women? Although sales figures from particular compa
nies were not publicly available, censuses of manufactures point to no
tably increased value of sanitary products.147
Dollar Value of Sanitary Napkins Produced

Year Sales
1929 $10,340,790
1937 $14,418,756
1939 $15,709,606
144- Nancy Ε. Cadmus, A Manual of Obstetrical Nursing (New York and London: G. P. Putnam's
Sons, 1922), p. 57.
145. Bacon, (n. 120) Obstetrical Nursing, p. 92.
146. Lloyd Arnold and Marie Hagele, "Vaginal tamponage for catamenial sanitary protection,"
J.A.M.A., 1938, uo, 790-92. Palmer and Greenberg reported a slightly earlier assessment in J.A.M.A.
(not documented) that tampons carried little danger and only slight risk of irritation from malposition.
However, they were also inadequate to absorb moderate to profuse flow. (n. 27), Facts and Frauds, p. 40.
Dr. William Danforth warned against insufficient changing of tampons, which would only plug the flow
once their absorbent capacity had been exceeded. He concluded that tampons were best used late in the
period, when flow was scant. A Woman's Health (New York and Toronto: Farrar & Rinehart, Inc.,
1941), p. 268. Danforth was Professor of Obstetrics and Gynecology at Northwestern University
Medical School and Chief of Obstetrics and Gynecology at Evanston Hospital, Evanston, Illinois.
147. U.S. Department of Commerce, Bureau of the Census, Fifteenth Census of the United States.
Manufactures: 1929. Reports by Industries (Washington: United States Government Printing Office, 1933).
p. 1373; Sixteenth Census of the United States: 1940. Manufactures 1939. Reports by Industries, Groups 11
through 20 (Washington: United States Government Printing Office, 1942), p. 574. The latter citation
contained the value of sanitary napkins produced in 1937 and 1939.

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Three factors make this increase in value of sanitary pads more striking.
First, this occurred despite a severe economic depression. Second, in the
1919 census of manufactures, the manufactured value of napkins was
small enough to be put into a miscellaneous group with other medical
supplies. Finally, the dollar increases may underrepresent the actual in
crease in number of units sold, because of the steep decline in the cost
of sanitary pads, from a range of 45c to 90c per dozen through the late
1920s, to 23c to 35c per dozen from 1931 through 1939.148
In a discussion of "Modern Hygiene," a Vogue columnist asserted that
The general acceptance of this form (manufactured napkins) was inevitable.

Labour-saving devices of every sort were being introduced, and the modern
woman is far too busy, too practical to make anything for herself that can be
made for her—and made better—by some one else.149
Although Vogue's readership has usually been above average in income,

this commentary appeared one year into the 1930s Depression, when
many women were having to scale down their expenditures. Con
temporary opinion considered the manufactured pad as having "arrived."
Disposable sanitary goods were sufficiently prevalent to merit review by
the Consumers' Union, whose tests of napkins showed a preference for
"Veldown, Modess, and Belfair" as ". . . best and most economical."
Veldown excelled in moisture proofing, closely followed by Modess.
Kotex, while good in absorbency, rated poorly in moisture proofing.150
By the 1940s, census figures began to point to acceptance of tampons,
too. The Census of Manufactures: 1947 listed tampons as a separate cate
gory, instead of being grouped with sanitary napkins as they were in
I939- "Total shipments and interplant transfers" of tampons were stated
as 538 gross dozens, with a value (freight-on-board at the plant) of
$11,099,000.151
148. Palmer and Greenberg censured International Cellucotton Products Company for fixing the
price of their product with wholesalers. These authors anticipated similar actions by other manufactur
ers resulting in "keeping the selling price of these articles entirely disproportionate to their cost of man
ufacture." (n. 27) Facts and Frauds, p. 39. This analysis overlooks the cost of research and development
which, as suggested by the increasing complexity of machinery to manufacture napkins, was not trifling.
In fact, the cost of napkins declined steeply in the 1930s.
149. Anon., (n. 1), p. 124.
150. Palmer and Greenberg, (n. 27) Facts and Frauds, p. 38.
151. U. S. Department of Commerce, Bureau of the Census, Census of Manufactures: 1947. Volume II.
Statistics by Industry (Washington: United States Government Printing Office, 1949), p. 783, Table 6.

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Many influences converged to bring about women's adoption of dis

posable sanitary products. Improving technology helped to reduce the
cost of pads and tampons, while improving their hygienic properties and
comfort in use. Declining costs of sanitary products relative to incomes
put such conveniences within the reach of more women by the mid
twentieth century. Women who worked outside their homes had a
greater need to use disposable menstrual protection. Indefatigable ad
vertising by major companies, such as International Cellucotton
Products and Johnson & Johnson, kept women aware of napkins and,
later, tampons. However, it would be a mistake to ignore the role of
health professionals in the acceptance of disposable sanitary pads and
tampons by women in the United States. As Americans' confidence in
health professionals rose, physicians, nurses, and pharmacists came to be
perceived as "experts," whose hygienic recommendations would be
sought and followed.

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The Roles of Health Professionals in the Development and Dissemination of Women's

Sanitary Products, 1880–1940

Stable URL: https://www.jstor.org/stable/24624129

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RE VIO U S writers have pointed to the role played by

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By the end of the nineteenth century, most physicians recognized that

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1888, Prudence Saur, graduate of Philadelphia Women's College, con

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themes of the Women's Christian Temperance Union, urged sponge

Compared to their volubility on other aspects of menstrual hygiene,

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Disposable sanitary products became available in the late 1800s and

Pharmacists appear to have been first among health professionals to

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One advantage of having rubber sundries in stock separately is that the

44- The American Druggist, November 1884, p. 30.

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The marketing of sanitary pads and belts becomes more difficult to

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Even discounting the "millions," it seems that women were improvis

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After Kotex's promotional blitz launched their new brand of napkin

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No. 300,770. Patented June 24, 1884.

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Figure 2. Illustration of Hiram Farr's "Menstrual Receptac

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No. 2 Uterine Supporter.

No. 1 Menstrual Receptacle·

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titude was changing, and physicians were prominent in the development

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Filed Nov. 19. i931

Figure 4. Illustration of Earl C. Haas' "Catamenial Device," patented

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ton covered, except at the ends, by perforated cellophane that expedited

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95· Eclectic Med. J., April 1895, 55, 291.

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detailed instructions on how the nurses were to prepare vulvar dressings

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He described pads made of layers of "common cotton" covered with

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By 1927, the time devoted to study of "personal hygiene" had ex

This content downloaded from

Look up and save all advertisements and illustrations of maternity dresses,

In 1917, Nellie Perry wrote of the range of women who might be at

135-John M. Keating, Practical Lessons in Nursing. Maternity Infancy, Childhood (Philadelphia: J. B.

This content downloaded from

Hulda Osterlund was even more inclusive in describing whom the ma

Although the availability of obstetrical nurses was beginning to bridge

140. Perry, (η. 123), p. 280.

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Did nurses similarly contribute to the acceptance of menstrual tam

Dollar Value of Sanitary Napkins Produced