Show-Me History Podcast
Show-Me History Podcast
Episode 15 - The Social Evil Hospital
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While the language in this episode is clean, the topic is a little on the heavy side. Parents, maybe skip this one with the little ones.


As I started researching the Social Evil Hospital, it just rabbit holed into the topic of, we’ll say, women of ill repute. This episode contains adult subject matter and may not be suitable for all ages. So, if you listen to this with kids around, screen it first. My apologies, I suppose I was naïve in setting out in my research on this topic.

Dubbed the St. Louis Experiment, the Social Evil Hospital was the first of its kind in the United States. As part of a global social hygiene movement, the Social Evil Hospital and the ordinance that created it were groundbreaking ideas for their time.

St. Louis in 1870 was a wild and wicked place. With a population of 235,000, there were 5,000 prostitutes: that’s 1 female available for “service” for every 23 males of age. Venereal diseases were on the rise. In 1869 it was reported that the city had 135+ cases of gonorrhea and syphilis per 100,000 members of the population. The Missouri Republican Newspaper had something to say about the topic: “There has been sin in the universe ever since Satan tore Heaven asunder and hell was born, and hand to hand with sin, down through the aisle of time, both in sacred and profane history, has stalked ‘The Scarlet Woman’- at once man’s creations, man’s sorrow and man’s curse”.

The location of brothels was an issue within this social evil. The far ends of the levee, Almond and Poplar Streets, Christy Avenue and Morgan Street were full of adverse establishments. Brothels attracted a certain type of undesirables in neighborhoods. Madams had the funds to outbid families on properties-including houses in what was considered good areas of the city. An article in the St Louis Democrat stated: “Everyone who knows anything about the city is aware of the fact that a very large proportion of the upper stories on 4th Street from Chestnut to Locust are occupied by gamblers, while women of bad repute monopolize whole blocks in the very heart of the city. Green Street, from 3rd to 10th, Market from 3rd to 11th, 10th Street from Clark to Chestnut, Almond, Poplar, and Spruce Streets from Main to 4th are the chosen habitations of the women of the town”.

People feared it would take over the city. Citizens urged the city government to do something about the growing problem.

City Health Officer, William Barrett made a plea to regulate the social evil. It was “destroying the health and vigor of a large portion of our inhabitants and tainting their blood with an ineradicable poison.” Back in 1858, William Sanger, a prominent doctor in New York, published a study advocating that the United States use systems similar to Paris to regulate and medically inspect prostitutes to decrease the spread of disease. William Barrett was a proponent of this philosophy. In his 1870 annual report, Barrett cited much of Sanger’s work in his presentation to the city government.

The City sought to control the issue through policy. If they could not eradicate the problem, they could attempt to regulate it. So, St. Louis became the first city in the nation to legalize prostitution. A provision in the city’s charter approved by State legislators allowed St. Louis to suppress or regulate prostitution.  The Board of Aldermen passed the Social Evil Ordinance on July 5, 1870, with a vote of 16 to 5.  The Social Evil Ordinance legalized prostitution with restrictions.  Solicitation of services was forbidden. This included street walking, actions, signs, advertisements, etc.

Women were required to register in one of 3 classes.

  1. A kept woman of long-term contract with one man.
  2. Inmates of brothels or madams.
  3. Individual women operating out of a single room.

Women had to provide their name, any aliases, permanent address, age, and other occupations (if applicable). Any changes of address had to be reported to the Board of Health. The only way to be removed from the registration list was to move to another city, legally agree and avow to leave the profession, or die.  Registered women and madams had to pay fees to the Board of Health. There was a monthly tax levy on brothels.

The city was divided into 6 districts by ward. Each district was assigned a physician to examine registered women on a weekly basis. Women who passed their exam were given a certificate of health and permission to carry out their business. Women failing were forced to report to the hospital within 24 hours for further evaluation and treatment. Initially these women were sent to the city hospital, but this was not the best idea. Other patients complained of having to share quarters with low class people and women of ill repute. It was also noted that these ladies got a little too “friendly” with the male staff members.

The ordinance also regulated the locations of brothels. Police were specifically assigned to a district to patrol and regulate terms of ordinance. They were given the right to survey establishments as the pleased and issue fines and arrest people as they deemed necessary. Doors of brothels were to be kept unlocked and available for inspection at all times.  Initially the press praised the city for the ordinance. An article in the Missouri Republican Newspaper stated, “If the evil cannot be suppressed, the wisest course of action is to regulate it with proper bounds.” St. Louis was called a model city in legislation and its attempt to control a social evil.  Within the first 8 months 1,284 women working for established and 243 individuals registered. There were 136 brothels and 9 houses on the books to be taxed.

In the Fall of 1872, the Social Evil Hospital opened. The hospital was located at the corner of Arsenal and Sublette— 4 miles outside the city limits at the time. It was near the City’s poor house and farm, as well as the insane asylum.

Side note: Let’s just put all the outcasts together outside the city limits. -Amy

Costing over $100,00 to construct, it was a tall brick building on 11 acres of land. Its operations and construction were funded by the fees and licenses from madams and individual prostitutes.  The hospital treated all types of conditions, treatment of STDs, mental illness, addictions, pregnancy, and childbirth, as well as everyday maladies. The circumstances of the hospital were not ideal for its patients. Several patients were assigned to a room with bunked beds. They were under watch and always guarded. No one was permitted to leave until they were deemed cleared by a physician.

Another side note: I’m curious as to how/when patients were deemed free of their venereal disease. The only proven cure for syphilis is penicillin, and it was not discovered until 1928- and it was not until 1943 that it was used to treat syphilis. Gonorrhea is treated with sulfa drugs, and they didn’t come along until the 1940s. Most likely the cure (and I’m doing air quotes here) was a mixture of mercury and arsenic. -Amy

Also on the campus of the hospital was a House of Industry. Here, women were urged to leave their profession and find a more suitable lifestyle. They received lectures from reformers, an attempt was made to teach them valuable skills to obtain a job in a different career path. The House of Industry lasted a short while as most women did not profit from its services.

The ordinance proved difficult to administer. By 1874, the law was falling apart. Very few brothels and individuals were registered. The system was corrupt from within. Women had certificates of health but were never examined. One woman was found to have a certificated dated 3 weeks in advance. The doctors assigned to assist with this requirement of the ordinance had a heavy case load. Only 6 physicians to attend to weekly examinations of thousands of women. They began issuing health certificates and collecting fees, but not conducting medical examinations.

The system was never really successful and began to unravel just weeks after implementation. It was an administrative nightmare to track all the women of the trade and update constant address changes. Registration had fallen by 45%.  And of course, the citizens of St. Louis had quite a bit to say about the situation.

Supporters fought for their case- the ordinance created sufficient revenue for the city. A successful madam paid a monthly tax levy of $2500. That’s $30,000 in today’s money. Others claimed it was a necessary evil of society that accompanied city life. They claimed that without access to prostitutes, men would seduce and rape women. Some doctors believed that prolonged absence from sex would lead to physiological disorders and insanity in men.

Despite these brilliant medical claims, resistance to the ordinance began to grow. Women’s organizations argued it was discriminating against women. Men of the same business were not required to register and pay fees. It was a violation of basic human rights to have to undergo unnecessary and unwanted physical examinations each week. They also felt that women did not need the right to sell their body, but equal opportunities in education to obtain proper jobs and better pay.

Women of the trade thought the regulations were too strict. Many prostitutes refused to pay fees and undergo examinations. They returned to work in their usual manner. Half of the women did not even bother to register in the first place. They still roamed the streets soliciting business. They would of course, be arrested only to return to the streets again.

Legal and patrolled brothels did not improve the tone of neighborhoods. Residents still complained of noise and bawdy behavior. In fact, people began to move out of areas with brothels, leaving vacant homes and properties. In once such case, Madam Vic De Bar was allowed to buy a house near St. Luke’s Hospital at 6th and Elm. The trustees vacated the property and moved the hospital elsewhere in the city.

One major opponent was William Greenleaf Eliot, founder of Washington University. He believed that prostitution should not be regulated but eradicated. He filed suit against Eliza Haycraft and Kate Clark, 2 of St. Louis’s best-known madams. He claimed they were breaking state law by operating brothels.

Police Chief McDonough arrested his neighbor and former prostitute, Fannie Canivan, for excessive noise coming from her house one night. He deemed her too drunk to be released and denied her proper bail. Canivan charged the police chief with arbitrary and malicious arrest. Other protesters began voicing their complaints as well. McDonough was suspended for 30 days and eventually resigned in disgrace.

In early March 1874, 72 St. Louis attorneys petitioned the Missouri legislature to repeal the law. They claimed it gave too much power to the police department. They could raid houses at will and incarcerate for indifferent amounts of time without due process. The Board of Health was forcing gynecological exams upon women. In general, the law posed a threat to civil liberties.

A bill was introduced to repeal the clause of the city’s charter permitting regulation of prostitution. It passed with a 2/3 majority vote.

On March 30, 1874, the Missouri Supreme Court declared that St. Louis could no longer regulate prostitution and nullified the Social Evil Ordinance. Both the legislation bill and court decision merely said the city could not regulate prostitution, but not technically ban it altogether. The city was back where it started. In 1879, prostitution within the city limits would be legally banned.

The state legislature and Governor Charles Johnson were concerned about the environment within St. Louis. They were worried that similar incidents regarding Police Chief McDonough would continue to occur. They feared police would use information and evidence obtained in previous years to incriminate and arrest women. They banned members of the police department from entering brothels without a warrant. They could not extort money from women to ignore past wrong doings.

After the ordinance was nullified, the Social Evil Hospital was renamed Female Hospital with the mission to care for poor women and children of all backgrounds. No men were allowed to live on the grounds since they still treated women of ill repute. It remained in use in this capacity until 1910. It was then repurposed as a home for the elderly residents of the city’s poor houses.

Female hospital side note: 1906 Carrie McDonald gave birth to a baby girl— Fred Josephine McDonald— who grew up to be Josephine Baker.

In 1915, the building was demolished to make way for Sublette Park.  The Social Evil Ordinance attempted to bring order to a chaotic scene but proved unsuccessful. For a brief moment, St. Louis was the center of attention for social do-gooders as the administration of the ordinance unfolded but was ultimately condemned for its execution.

All research, editing, and production done by River City Productions for Show-Me History.

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