Transcriber’s Note
In this text version of “Medical Women”: words in italics are marked
with _underscores_ and words in small capitals are shown in UPPER CASE.
Footnotes have been moved to end of each essay.
Variant spelling and inconsistent hyphenation are retained.
A very few changes have been made to punctuation for consistency. Other
changes are listed at the end of the book.
MEDICAL WOMEN
Two Essays
BY
SOPHIA JEX-BLAKE.
I.
Medicine as a Profession for Women.
II.
Medical Education of Women.
EDINBURGH:
WILLIAM OLIPHANT & Co., 57 FREDERICK STREET.
LONDON: HAMILTON, ADAMS, & Co.
1872.
[_All Rights Reserved._]
JOHN LINDSAY, PRINTER, 104 HIGH STREET, EDINBURGH.
Dedicated
TO
DR LUCY SEWALL,
FROM WHOSE DAILY LIFE
I FIRST LEARNED WHAT INCALCULABLE BLESSINGS
MAY BE CONFERRED ON THE SICK AND SUFFERING OF HER OWN SEX
BY A NOBLE AND PURE-MINDED WOMAN
WHO IS ALSO
A THOROUGHLY SCIENTIFIC PHYSICIAN.
I.
Medicine as a Profession for Women.
REPRINTED, WITH LARGE ADDITIONS, FROM “WOMAN’S WORK AND WOMAN’S
CULTURE.”
“We deny the right of any portion of the species to decide for another
portion, or any individual for another individual, what is and what is
not their ‘proper sphere.’ The proper sphere for all human beings is
the largest and highest which they are able to attain to. What this is
cannot be ascertained without complete liberty of choice.”--Mrs J.
S. MILL.
MEDICINE AS A PROFESSION FOR WOMEN.
“The universe shall henceforth speak for you
And witness, She who did this thing, was born
To do it; claims her license in her work.
And so with more works. Whoso cures the plague,
Though twice a woman, shall be called a leech.”
“_Aurora Leigh._”
It is a very comfortable faith to hold that “whatever is, is best,”
not only in the dispensations of Providence, but in the social order
of daily life; but it is a faith which is perhaps best preserved by
careful avoidance of too much inquiry into facts. The theory, if
applied to past as well as to present times, would involve us in some
startling contradictions, for there is hardly any act, habit, or custom
which has not been held meritorious and commendable in one state of
society, and detestable and evil in some other. If we believe that
there are eternal principles of right and wrong, wisdom and equity, far
above and greater than the “public opinion” of any one age or country,
we must acknowledge the absolute obligation of inquiring, whenever
matters of importance are at stake, on what grounds the popular
opinions rest, and how far they are the result of habit, custom, and
prejudice, or the real outgrowth of deep convictions and beliefs
inherent in the most sacred recesses of human nature. While the latter
command ever our deepest reverence, as the true “vox populi, vox Dei,”
nothing can be more superficial, frivolous, and fallacious than the
former.
In a country where precedent has so much weight as in England, it
doubly behoves us to make the distinction, and, while gratefully
accepting the safeguard offered against inconsiderate and precipitate
change, to beware that old custom is not suffered permanently to
hide from our eyes any truth which may be struggling into the light.
I suppose that no thinking man will pretend that the world has now
reached the zenith of truth and knowledge, and that no further upward
progress is possible; on the contrary, we must surely believe that each
year will bring with it its new lesson; fresh lights will constantly be
dawning above the horizon, and perhaps still oftener discoveries will
be re-discovered, truths once acknowledged but gradually obscured or
forgotten will emerge again into day, and a constantly recurring duty
will lie before every one who believes in life as a responsible time of
action, and not as a period of mere vegetative existence, to “prove
all things, and hold fast that which is good.”
The above considerations arise naturally in connexion with the subject
of this paper, which is too often set aside by the general public, who,
perhaps, hardly appreciate its scope, and are not yet fully aroused
to the importance of the questions involved in the general issue. We
are told so often that nature and custom have alike decided against
the admission of women to the Medical Profession, and that there is in
such admission something repugnant to the right order of things, that
when we see growing evidences of a different opinion among a minority
perhaps, but a minority which already includes many of our most earnest
thinkers of both sexes, and increases daily, it surely becomes a duty
for all who do not, in the quaint language of Sharpe, “have their
thinking, like their washing, done out,” to test these statements by
the above principles, and to see how far their truth is supported by
evidence.
In the first place, let us take the testimony of Nature in the matter.
If we go back to primeval times, and try to imagine the first sickness
or the first injury suffered by humanity, does one instinctively feel
that it must have been the _man’s_ business to seek means of healing,
to try the virtues of various herbs, or to apply such rude remedies as
might occur to one unused to the strange spectacle of human suffering?
I think that few would maintain that such ministration would come
most naturally to the man, and be instinctively avoided by the woman;
indeed, I fancy that the presumption would be rather in the other
direction. And what is such ministration but the germ of the future
profession of medicine?
Nor, I think, would the inference be different if we appealed to the
actual daily experience of domestic life. If a child falls down stairs,
and is more or less seriously hurt, is it the father or the mother
(where both are without medical training) who is most equal to the
emergency, and who applies the needful remedies in the first instance?
Or again, in the heart of the country, where no doctor is readily
accessible, is it the squire and the parson, or their respective wives,
who are usually consulted about the ailments of half the parish? Of
course it may be said that such practice is by no means scientific, but
merely empirical, and this I readily allow; but that fact in no way
affects my argument that women are _naturally_ inclined and fitted for
medical practice. And if this be so, I do not know who has the right
to say that they shall not be allowed to make their work scientific
when they desire it, but shall be limited to merely the mechanical
details and wearisome routine of nursing, while to men is reserved all
intelligent knowledge of disease, and all study of the laws by which
health may be preserved or restored.
Again, imagine if you can that the world has reached its present
standing point, that society exists as now in every respect but
this,--that the art of healing has never been conceived as a separate
profession, that no persons have been set apart to receive special
education for it, and that in fact empirical “domestic medicine,” in
the strictest sense, is the only thing of the kind existing. Suppose
now that society suddenly awoke to the great want so long unnoticed,
that it was recognized by all that a scientific knowledge of the
human frame in health and in disease, and a study of the remedies of
various kinds which might be employed as curative agents, would greatly
lessen human suffering, and that it was therefore resolved at once to
set apart some persons who should acquire such knowledge, and devote
their lives to using it for the benefit of the rest of the race. In
such case, would the natural idea be that members of each sex should
be so set apart for the benefit of their own sex respectively,--that
men should fit themselves to minister to the maladies of men, and
women to those of women,--or that one sex only should undertake the
care of the health of all, under all circumstances? For myself, I have
no hesitation in saying that the former seems to me the _natural_
course, and that to civilized society, if unaccustomed to the idea, the
proposal that persons of one sex should in every case be consulted
about every disease incident to those of the other, would be very
repugnant; nay, that were every other condition of society the same as
now, it would probably be held wholly inadmissable. I maintain that not
only is there nothing strange or unnatural in the idea that women are
the fit physicians for women, and men for men; but on the contrary,
that it is only custom and habit which blind society to the extreme
strangeness and incongruity of any other notion.
I am indeed far from pretending, as some have done, that it is morally
wrong for men to be the medical attendants of women, and that grave
mischiefs are the frequent and natural results of their being placed
in that position. I believe that these statements not only materially
injure the cause they profess to serve, but that they are in themselves
false. In my own experience as a medical student, I have had far
too much reason to acknowledge the honour and delicacy of feeling
habitually shown by the gentlemen of the medical profession, not to
protest warmly against any such injurious imputation. I am very sure
that in the vast majority of cases, the motives and conduct of medical
men in this respect are altogether above question, and that every
physician who is also a gentleman is thoroughly able, when consulted by
a patient in any case whatever, to remember only the human suffering
brought before him and the scientific bearing of its details; for as
was said not very long ago by a most eminent London surgeon, “Whoever
is not able, in the course of practice, to put the idea of sex out
of his mind, is not fit for the medical profession at all.” It will,
however, occur to most people that the medical man is only one of the
parties concerned, and that it is possible that a difficulty which may
be of no importance from his scientific standpoint, may yet be very
formidable indeed to the far more sensitive and delicately organized
feelings of his patient, who has no such armour of proof as his own,
and whose very condition of suffering may entail an even exaggerated
condition of nervous susceptibility on such points.[1] At any rate,
when we hear so many assertions about natural instincts and social
propriety, I cannot but assert that their evidence, such as it is, is
wholly for, and not against, the cause of women as physicians for their
own sex.
If we take next the ground of custom, I think the position of those who
would oppose the medical education of women is far less tenable than is
generally supposed; indeed, that a recent writer stated no more than
the truth when he asserted that “the obloquy which attends innovation
belongs to the men who exclude women from a profession in which they
once had a recognised place.”[2] I believe that few people who have
not carefully considered the question from an historical point of view
have any idea of the amount of evidence that may be brought to support
this view of the case.[3]
Referring to the earliest classical times, we find distinct mention
in the Iliad of a woman skilled in the science of medicine,[4] and a
similar reference occurs also in the Odyssey.[5] Euripides is no less
valuable a witness on this point. He describes Queen Phædra[6] as
disturbed in mind and out of health, and represents the nurse as thus
addressing her: “If thy complaint be anything of the more secret kind,
here are women at hand to compose the disease. But if thy distress is
_such as may be told to men_, tell it, that it may be reported to the
physicians;” thus indicating a prevailing public opinion that there
were natural and rigid limits to the medical attendance of men and
women, and that therefore some women were specially trained to do what
the regular physicians must leave undone. It is at least remarkable
to find such evidence of general feeling on this matter in a state of
society supposed to possess much less delicacy and refinement than our
own.
We find records of several Grecian women who were renowned for their
medical skill, among whom may be instanced Olympias of Thebes, whose
medical learning is said to be mentioned by Pliny; and Aspasia, from
whose writings on the diseases of women, quotations are preserved in
the works of Aëtius, a Mesopotamian physician.[7] On the authority of
Hyginus rests the history of Agnodice, the Athenian maiden whose skill
and success in medicine was the cause of the legal opening of the
medical profession to all the free-born women of the State.[8]
In more modern times, when almost all learning was garnered into the
religious houses, which were not only the libraries but the hospitals
of the day, it seems evident that the care of the sick and wounded fell
at least as often to the share of the Nunneries as of the Monasteries,
and probably medical skill, such as it was, found place among the
sisters quite as often as among the brethren of the various religious
Orders.
The old ballad of Sir Isumbras gives one illustration out of many of
the prevailing state of things, relating how the nuns received the
wounded knight, and how
“Ilke a day they made salves new,
And laid them on his wounds,
They gafe hym metis and drynkes lythe,
And heled the knyghte wonder swythe.”[9]
It may be remembered that Sir Walter Scott,[10] after describing how
Rebecca “proceeded, with her own hands, to examine and bind up the
wounds,” goes on to remark, “The youngest reader of romances and
romantic ballads must recollect how often the females, during the
dark ages, as they are called, were initiated into the mysteries of
surgery.... The Jews, both male and female, possessed and practised the
medical science in all its branches.”
In the fourteenth century, when the Medical School of Salerno enjoyed
high reputation, we find record of a female physician named Abella, who
lived there, and wrote in Latin various works on medicine.[11]
Early in the next century an Italian lady, Dorotea Bocchi, was actually
Professor of Medicine at the University of Bologna,[12] and among the
traditions of the same University is preserved the name of Alessandra
Gigliani, who, in even earlier times, was a learned student of
anatomy.[13]
In the sixteenth century, at Alcarez in Spain, lived Olivia Sabuco de
Nantes, who “had a large knowledge of science and medicine,” and whose
medical works were printed at Madrid in 1588.[14]
It is clear that in Great Britain at an early period women were
commonly found among the irregular practitioners of medicine; and
it is equally clear that their male competitors greatly desired to
deprive them of the right to practise. In 1421 a petition was presented
to Henry V., praying that “no woman use the practyse of fisyk under
payne of long emprisonment.”[15] Within a few years after the first
incorporation of the Colleges of Physicians and Surgeons, an Act[16]
was passed for the relief and protection of “Divers honest psones, _as
well men as women_, whom God hathe endued with the knowledge of the
nature, kind, and operaçon of certeyne herbes, rotes, and waters, and
the using and ministering them to suche as be payned with customable
diseases, for neighbourhode and Goddes sake, and of pitie and
charytie,” because the “Companie and Fellowship of Surgeons of London,
mynding onlie their owne lucres and nothing the profit or ease of the
diseased or patient, have sued, vexed, and troubled,” the aforesaid
“honest psones,” who were henceforth to be allowed “to practyse, use,
and mynistre in and to any outwarde sore, swelling, or disease, any
herbes, oyntements, bathes, pultes or emplasters, according to their
cooning experience and knowledge ... without sute, vexation, penaltie,
or losse of their goods.”[17]
This provision clearly referred to general practice other than that
of midwifery, which latter branch of the profession was then, as for
centuries both before and after, almost exclusively in the hands of
women. The very word _midwife_, with its Latin synonym “_obstetrix_,”
is sufficiently significant on this point, for in neither language has
it any masculine equivalent, and the clumsy term “Man-midwife” served,
when first needed and used, to mark the general sense of what the
writer in the _Athenæum_ forcibly calls “masculine intrusion into that
which natural instinct assigns to woman as her proper field of labour;”
and this same very suggestive title is the only one which at the
present day in legal phraseology distinguishes the male practitioners
of this branch of medical art.
From the time of Moses onwards this part of the profession has always
been mainly in the hands of women, and in many countries of Europe
no other usage has ever prevailed. The first regular French medical
society, “La confrairie de St Cosme and St Damien,” included within its
organization the Company of Midwives,[18] and from that time down to
the present it seems in France to have been the custom to give to these
women a regular education, terminating in sufficient examinations, an
example which England would have done well to follow.
In this country, however, midwives appear to have held a most
respectable position some centuries ago, and a curious idea of their
importance, their duties, and their credit, may be gathered from a
MS. volume (without date) now preserved in the British Museum,[19]
which was evidently written at a time when hardly any but women
were employed in the “mysteries of the profession,” and when it was
a comparatively rare thing, that needed to be specially advised in
certain cases, for them to “make use of (_i.e._, call in) a physitien.”
The writer remarks that “it is meet that the midwife be a woman well
read and well experienced,” and gives a caution that “drunkenness is a
sordid sin in any who use it, but is a blemish worthy greater blame in
ministers, magistrates, midwives, physitiens, and chirurgeons.”
Mrs Celleor, in her letter previously referred to,[20] tells us that in
1642, “the physitiens and chirurgeons contending about it, midwifery
was adjudged a chirurgical operation, and midwives were licensed at
Chirurgeon’s Hall, but not till they had passed three examinations
before six skilful midwives, and as many chirurgeons;” but for some
reason (connected probably with their occasional baptismal functions)
the midwives were, in 1662, referred for their licence to Doctors’
Commons, thus losing their official connexion with the medical world.
How it came that English midwives fell gradually from their high
estate is partly explained by a very public-spirited book (with the
appropriate motto “Non sibi sed aliis”) written by a surgeon in
1736.[21] The writer adverts to the accusations of ignorance then
brought against the midwives, and remarks that “the only method by
which this fatal distemper can be cured, is to put it in the power of
midwomen to qualify themselves thoroughly and at a moderate expense....
To which method of qualifying themselves I doubt not the midwomen will
object, and say that they would readily be at any reasonable expense
and fatigue to be so thoroughly instructed, but it is not in their
power. The midwomen cannot, and the midmen will not instruct them. The
midmen will object and say that the midwomen want both capacity and
strength (instruct them as ye please). To which I reply (_ore rotundo,
plenis buccis_) that it is not want of capacity, docility, strength, or
activity ... which is evident to a demonstration from the successful
practice of women in the Hôtel Dieu at Paris (the best school for
midwifery now in Europe).... Would not any person then be deservedly
laughed at who should assert that our women are not as capable of
performing their office had they the same instruction as the French
women?” This chivalrous surgeon then proposes that regular provision
should be made for proper instruction, and for examinations by two
surgeons (who have lectured to the women), “and six or seven other
persons appointed by His Majesty, because I don’t think it reasonable
that so many people’s bread should depend on the humour or caprice of
two men only;” adding that “If some such scheme was put in execution,
I’m satisfied that in a very few years there would not be an ignorant
midwife in England, and consequently the great agonies most women
suffer at the very sight of a man would be almost entirely prevented,”
and great expense and much life saved.
However, we must suppose that these noble words of protest fell upon
deaf ears, and the midwives, being left in their ignorance, their
practice gradually passed into the hands of the medical men, who had
every advantage of learning at their command.[22]
It is, however, only very recently that men-midwives have been allowed
to attend on royal patients in this country; indeed, I believe that
the Princess Charlotte was the first to establish the precedent, and
that our present Sovereign was the first queen who followed it. In a
very interesting series of papers, by Dr Aveling, recently published
in the _Lancet_,[23] accounts have been given of a number of the royal
midwives whose names have been honourably preserved in history, such as
Alice Dennis, who attended Anne of Denmark, and received a fee of £100
“for her pains and attendance upon the Queen, as of His Highness’s free
gift and reward, without account, imprest, or other charge to be set on
her for the same.”
The same writer mentions that Margaret Mercer was sent express from
England in 1603 to attend on “His Majesty’s dearest daughter, the
Princess Electress Palatine.”
It is also recorded that “Mrs Labany attended Mary of Modena, Queen
of James II., when she was delivered, on June 10th, 1687, of James
Francis Edward, afterwards called the Pretender.”[24] Mrs Wilkins,
another midwife, seems also to have been present on this occasion, and
it is stated that each of these persons received a fee of five hundred
guineas for her services.
It is well known that Queen Charlotte was always attended by a
woman,[25] and the late Duchess of Kent employed the Frau von Siebold,
of whom mention is made elsewhere.[26]
Now that public attention is awaking to the subject, and educated
women are once more desirous of undertaking this peculiarly womanly
work, we may indeed anticipate, with the already quoted writer in the
_Athenæum_, that a reactionary movement will soon make itself felt, and
that the usage “which even up to the present time a large proportion
of our English families, especially those of our northern towns and
outlying country districts, have never adopted, will most likely be
discontinued in all classes of English society before the end of the
present century.”
On the Continent of Europe, owing to their better education, the
midwives retain much of the position that they have for a time lost
in England; and we hear that in Russia “a medical man is very rarely
called in; notwithstanding, fatal cases are of far less frequent
occurrence in Russia than in England;” and the same authority tells us
that ladies practising midwifery are admitted into society as doctors
would be, and are well paid, both by the Government and by private
fees.[27]
While thus briefly tracing out the history of midwifery in modern
times, and the causes which led to its practice passing from the hands
of women into those of men, I have not paused to mention, in due
chronological order, those women who, in the last three centuries, have
been distinguished for a knowledge of the other branches of Medicine
and Surgery. Of these I will now enumerate a few, though my time and
space are far too limited either to give a complete list, or to relate
any but the most prominent particulars of each case mentioned; but I
can promise that any one who will consult the authorities quoted will
be abundantly repaid by the long and interesting details that I am
forced to pass over in almost every instance.
In the seventeenth century, in England, one of the women most noted for
medical skill was Lady Ann Halket,[28] born in 1622, daughter of the
then provost of Eton College. “Next to the study of Divinity she seems
to have taken most delight in those of Physick and Surgery, in which
she was no mean proficient; nay, some of the best physicians in the
kingdom did not think themselves slighted when persons of the greatest
quality did consult her in their distempers, even when they attended
them as their ordinary physicians. Many from England, Holland, and
the remotest parts of the kingdom, have sent to her for things of her
preparing; and many whose diseases have proved obstinate under all the
methods of physicians, have at length, by the physicians’ own advice,
been recommended and sent to her care, and have been recovered by her.”
In 1644 was born Elizabeth Lawrence, afterwards wife of the Rev.
Samuel Bury, of Bristol, who wrote her life,[29] and who bears witness
that “it was not possible there should be a more observant, tender,
indulgent, and compassionate wife than she was; a more sympathising
spirit is very rarely found.” He records that “she took much pleasure
in Anatomy and Medicine, being led and prompted to it partly by her own
ill health, and partly with a desire of being useful.” The difficulties
that she encountered in her studies may be guessed, since “she would
often regret that so many learned men should be so uncharitable to
her sex, and be so loath to assist their feebler faculties when they
were anywise disposed to an accurate search into things profitable
and curious. Especially as they would all so readily own that souls
were not distinguished by sexes. And therefore she thought it would
have been an honourable pity in them to have offered something in
condescension to their capacities, rather than have propagated a
despair of their information to future ages.” Her husband, however,
tells us that “she improved so much, that many of the great masters of
the Faculty have often been startled by her stating the most nice and
difficult cases in such proper terms;” and, remarking that, “How much
knowledge and skill soever she attained in the practice of Physick,
by long observation, conversation, and experience, yet she was very
distrustful of herself,” he adds that the “instances of her successes
in the preservation of human lives were not easily numbered.”
As a contemporary of these Englishwomen, we find in Germany Elizabeth
Keillen, who published several medical works, and died in 1699. She
is said by Finauer to have had “great knowledge of medicine and
chemistry.”
In comparatively recent times, Bologna was remarkable as ever for its
liberal encouragement of learned women, and about the middle of the
last century the Chair of Anatomy at that University was filled by
Anna Morandi Mazzolini, whose exquisitely delicate anatomical models,
executed in wax, became the pride of the Museum at Bologna. She first
became interested in the study of Anatomy in consequence of her wish
to help her husband, who was a distinguished anatomist, and a maker
of anatomical designs and models. He fell into ill-health and mental
despondency, and therefore “his wife, loving him dearly, and fearing
that he would desist from his work, gave herself up to his comfort;
and for this purpose became herself an anatomical sculptor, reading
works of anatomy, consulting anatomical tables and preparations, taking
theoretical and practical lessons from her husband, and, marvellous
to say, even dissecting dead bodies with resolute mind, and with
incredible perseverance.... Too long to describe are the works executed
in wax by the able hands of this illustrious woman. They were collected
in five elegant cases in our Anatomical Museum.... The fourth case
encloses delicate illustrations of all the parts belonging to the
senses of sight, smell, hearing, taste, and touch--stupendous works in
which she surpassed herself, and also her husband, and his colleague,
Ercole Lelli.... These models were for some time kept in her own house,
and each one who saw them spread her renown, so that through distant
countries was spread the fame of her works, so that every learned and
distinguished person passing through Bologna was solicitous to visit
and know personally the maker of these wonders.”[30] Signora Mazzolini
also made original discoveries in anatomical science, which obtained
for her many marks of distinction from the learned colleges and
societies of the day. She was offered a Chair at Milan, with increased
revenues, but preferred to remain at Bologna, where she lived till
her death in 1774. Medici, in his records of the Anatomical School of
Bologna, speaks of this lady with profound respect, as distinguished
alike by “rare powers, great erudition, gracious manners, and delicate
and gentle temperament,” and relates that her fame reached the ears of
the Emperor Joseph II., who visited her in 1769, and “having seen her
works and heard her conversation,” loaded her with public honours. Her
example seems to have inspired others of her countrywomen to follow
in the steps of one so honoured, alike in the stern duties of her
profession, and in the sanctities of household life; for in the course
of the next half century several Italian women availed themselves of
the thorough medical education which the Italian Universities never
refused.
In 1788 Maria Petraccini[31] took a degree in medicine at Florence,
and we find her, a little later, lecturing on anatomy at Ferrara, in
presence of the medical professors. She married Signor Feretti, and has
left several works on the physical education of children.
Her daughter, Zaffira Feretti, seems to have inherited her mother’s
talents, for she studied Surgery in the University of Bologna, and
there received a medical degree[32] in May 1800. She obtained an
appointment under the Italian Government, and for some time lived in
Ancona acting as Director-General of the midwives in all parts of the
country. She afterwards went to Turkey, and died at Patras in 1817.
Maria Mastellari seems also to have been a woman of unusual talent,
and “progressed diligently in the most rigid sciences.” She obtained
a medical degree at Bologna in 1799. She subsequently became the wife
of Signor Collizoli-Sega, and is described as possessing a “sweet and
gentle temperament, with special love of silence and quiet. She centred
her interests in her family, which she managed admirably.”[33]
Still more distinguished in the annals of medicine was Maria delle
Donne, who also studied in the University of Bologna, and “received
the doctoral laurel” in 1806.[34] She “constantly practised both
Medicine and Surgery,” and was appointed by Napoleon Bonaparte to the
Chair of Midwifery at Bologna. The _Gazette Medicale_, quoting from the
“_Raccoglitore Medico_,” gives the following account of her:--“Anna
Maria delle Donne, docteur en médecine, auteur d’élégants vers latins,
professeur d’obstetrique, à l’Université de Bologna, membre de
l’Academie, bénédictine, &c., est décedée le 9 Janvier, 1842. Cette
femme distinguée qui a succedé à Madame Mazzolini et à Madame Bassi,
est une des gloires scientifiques de Bologna. Elle soutint en 1800,
avec un très grand succès, une thèse de Philosophie, de Chirurgie, and
de Medicine. Peu après, à la suite d’un examen public, on lui conféra
le grade de docteur et de consultant. Napoleon en passant à Bologne
fut frappé du savoir de cette dame, et institua pour elle une Chaire
d’Obstetrique, où elle se fit une grande renommée.”[35]
Nor was Italy alone noted as the birthplace of women skilled in
Medicine. In Germany, early in this century, Frau von Siebold so
greatly distinguished herself in the practice of midwifery that the
degree of M.D. was conferred on her by the University of Giessen;[36]
and her daughter Marianne, afterwards Frau von Heidenreich, studied
in the Universities of both Göttingen and Giessen, and took her degree
in the regular way in 1817. She is spoken of as “one of the most famed
and eminent female scholars of Germany,” and as being “universally
honoured as one of the first living authorities in her special branch
of science.”[37] She died only in 1859.
In France, the name of Madame Lachapelle[38] was known and honoured as
that of one of the ablest teachers of Midwifery during the latter part
of the last century. She has left several valuable works on subjects
connected with her specialty. Her funeral in 1821 was followed by
all the chief physicians of Paris. Her pupil and successor, Madame
Boivin,[39] was still more distinguished for her medical knowledge and
skill, and for her contributions to anatomical science. Her “Memoire de
l’art des Accouchements” was approved by the highest medical authority,
and was appointed as the text-book for students and midwives by the
Minister of the Interior. She was invested with an Order of Merit
by the King of Prussia in 1814, and in the same year was appointed
co-director (with the Marquis de Belloy) of the General Hospital for
Seine and Oise, and in 1815 was entrusted with the direction of a
temporary Military Hospital, for her services in which latter capacity
she received a public vote of thanks. She was also entrusted with the
direction of the Hospice de la Maternité, and of the Maison Royale de
Santé, and was one of the most distinguished practitioners of the time.
She made original discoveries in Anatomy, invented various surgical
instruments, and obtained prizes for medical theses from the Société de
Medicine.
Her medical writings were distinguished by “precision et clarté,
jugement sain, erudition choisie, et savoir solide.” In 1846 one of her
books was eulogized by Jourdan as “ouvrage éminemment pratique, et le
meilleur que nous possedions encore sur ce sujet,” with the additional
remark that “tout se réunit pour lui mériter une des premières places
parmi les productions de la littérature medicale moderne.” She was a
member of the Medical Societies of Paris, Bordeaux, Berlin, Brussels,
and Bruges, and was honoured with the degree of M.D. from the
University of Marbourg. She died in 1841.
These numerous instances of the successful practice of Medicine by
women seem to have been little known, or else forgotten, to judge by
the surprise expressed when, after surmounting many difficulties,
an English lady, named Elizabeth Blackwell, succeeded in obtaining
medical education and the degree of M.D. from a medical school in
America in 1849. The novelty, in truth, was not in the granting
of the medical degree to a woman, but in its being received by an
Englishwoman, for it is hardly gratifying to one’s national pride to
find that England never has accorded such encouragement to female
learning as was found in Italy, Germany, and France; and it is still
more painful to realize that this country, almost alone, stands still
aloof from the movement of liberal wisdom that has now in all these
lands, as well as in Switzerland, and even in Russia, granted to woman
the advantage of University education and degrees. English women are
not behind others in desiring knowledge, but as yet they are forced to
seek it on foreign shores, for hitherto no British University has ever
fully admitted women to its educational advantages; and a few years
ago, that of London, with all its professions of liberality, refused a
woman’s petition even for examination for the degree of M.D.!
So much for the historical evidence bearing on this question. I am
indeed sorry to have paused so long on this part of the subject, but it
seemed essential to a proper statement of the whole case.
If, then, nature does not instinctively forbid the practice of the
healing art by women, and if it cannot be denied that some at least of
its branches have long been in their hands, we must go further to seek
on what grounds their admission to the medical profession should be
opposed.
Probably the next argument will be that women do not require, and
are not fitted to receive, the scientific education needful for
a first-rate Physician, and that “for their own sakes” it is not
desirable that they should pursue some of the studies indispensably
necessary. To this the answer must be, that the wisest thinkers teach
us to believe that each human being must be “a law unto himself,”
and must decide what is and what is not suitable for his needs, what
will and what will not contribute to his own development, and fit him
best to fulfil the life-work most congenial to his tastes. If women
claim that they do need and can appreciate instruction in any or all
sciences, I do not know who has the right to deny the assertion.
That this controversy is no new one may be proved by reference to a
very curious black-letter volume now in the British Museum,[40] wherein
the writer protests, “I mervayle gretely of the opynyon of some men
that say they wolde not in no wyse that theyr doughters or wyves or
kynneswomen sholde lerne scyences, and that it sholde apayre their
cödycyons. This thing is not to say ne to sustayne. That the woman
apayreth by connynge it is not well to beleve. As the proverbe sayeth,
‘that nature gyveth maye not be taken away.’”
If it be argued that the study of Natural Science may injure a woman’s
character, I would answer, in the words of one of the purest-minded
women I know, that “if a woman’s womanliness is not deep enough in her
nature to bear the brunt of any needful education, it is not worth
guarding.” It is, I think, inconceivable that any one who considers
the study of natural science to be but another word for earnest and
reverent inquiry into the works of God, and who believes that, in
David’s words, these are to be “sought out of all them that have
pleasure therein,” can imagine that any such study can be otherwise
than elevating and helpful to the moral, as well to the mental nature
of every student who pursues it in a right spirit. In the words of
Scripture, “To the pure, all things are pure,” and in the phrase of
chivalry, “Honi soit qui mal y pense.”
It has always struck me as a curious inconsistency, that while almost
everybody applauds and respects Miss Nightingale and her followers
for their brave disregard of conventionalities on behalf of suffering
humanity, and while hardly any one would pretend that there was any
want of feminine delicacy in their going among the foulest sights and
most painful scenes, to succour, not their own sex, but the other,
many people yet profess to be shocked when other women desire to fit
themselves to take the medical care of those of their sisters who would
gladly welcome their aid. Where is the real difference? If a woman is
to be applauded for facing the horrors of an army hospital when she
believes that she can there do good work, why is she to be condemned
as indelicate when she professes her willingness to go through an
ordeal, certainly no greater, to obtain the education necessary for a
medical practitioner? Surely work is in no way degraded by being made
scientific; it cannot be commendable to obey instructions as a nurse
when it would be unseemly to learn the reasons for them as a student,
or to give them as a doctor; more especially as the nurse’s duties may
lead her, as they did in the Crimea, to attend on men with injuries and
diseases of all kinds, whereas the woman who practises as a physician
would confine her practice to women only. It is indeed hard to see any
reason of delicacy, at least, which can be adduced in favour of women
as nurses, and against them as physicians.
Their natural capacity for the one sphere or the other is, of course,
a wholly different matter, and is, indeed, a thing not to be argued
about, but to be tested.[41] If women fail to pass the required
examinations for the ordinary medical degree, or if, after their
entrance into practice, they fail to succeed in it, the whole question
is naturally and finally disposed of. But that is not the point now at
issue.
That the most thorough and scientific medical education need do no
injury to any woman might safely be prophesied, even if the experiment
had never been tried; but we have, moreover, the absolute confirmation
of experience on the point, as I, for one, will gladly testify from
personal acquaintance in America with many women who have made Medicine
their profession; having had myself the advantage of studying under
one who was characterized, by a medical gentleman known throughout the
professional world, as “one of the best physicians in Boston,” and who,
certainly, was more remarkable for thorough refinement of mind than
most women I know,--Dr Lucy Sewall.
Of course there may always be unfortunate exceptions, or rather there
will always be those of both sexes who, whatever their profession may
be, will be sure to disgrace it; but it is not of them that I speak,
nor is it by such individual cases that the supporters of any great
movement should be judged.
The next argument usually advanced against the practice of medicine
by women is that there is no demand for it; that women, as a rule,
have little confidence in their own sex, and had rather be attended by
a man. That everybody had rather be attended by a competent physician
is no doubt true; that women have hitherto had little experience of
competent physicians of their own sex is equally true; nor can it be
denied that the education bestowed on most women is not one likely
to inspire much confidence. It is probably a fact, that until lately
there has been “no demand” for women doctors, because it does not
occur to most people to demand what does not exist; but that very many
women have wished that they could be medically attended by those of
their own sex I am very sure, and I know of more than one case where
ladies have habitually gone through one confinement after another
without proper attendance, because the idea of employing a man was so
extremely repugnant to them. I have indeed repeatedly found that even
doctors, not altogether favourable to the present movement, allow that
they consider men rather out of place in midwifery practice;[42] and
an eminent American practitioner once remarked to me that he never
entered a lady’s room to attend her in confinement without wishing to
apologize for what he felt to be an intrusion, though a necessary and
beneficent intrusion, in one of his sex.
I suppose that the real test of “demand” is not in the opinions
expressed by those women who have never even seen a thoroughly educated
female physician, but in the practice which flows in to any such
physician when her qualifications are clearly satisfactory. In England
there are at present but two women legally qualified to practise
Medicine, and I understand that already their time is much more fully
occupied, and their receipts much greater, than is usually the case
with medical men who have been practising for so short a period. Dr
Garrett Anderson’s Dispensary for poor women is also largely attended,
and during the five years which have elapsed since it was opened, more
than 40,000 visits have been made to it; 9000 new patients have been
admitted, and 250 midwifery cases have been attended by the midwives
attached to the charity, Dr Garrett Anderson being called in when
necessary.
When we turn to America, we find that a considerable number of
women have very extensive practice and large professional incomes
(more, indeed, than in some cases seems warranted by their medical
qualifications). The Report of a little hospital, managed entirely
by women, in Boston, U.S., relates that during 1867 the number of
in-patients was 198; of persons visited at their homes, 281; and of
those able to attend at the dispensary, 4,576; all these patients being
women and children only. In fact, the attendance at the Dispensary
became so excessive in proportion to the resources of the charity,
that in 1868 a rule was passed by the Committee requiring each patient
to pay twenty-five cents (or about ninepence) for medicines, at each
visit, except when she brought “a certificate of her poverty, properly
authenticated.” This regulation brought out still more strongly the
distinct _choice_ of poor women in this matter, for, though the General
City Dispensary gave medicines gratuitously, the number of those who
attended at the Woman’s Hospital was much less diminished than was
expected, being still 3,236 in 1868. In New York also, where the
Dispensary managed by women doctors is but one of many, the crowd of
patients is very great, the numbers being, in 1867, no less than 6354,
while 545 persons were attended at their homes either in confinement
or during severe illness. Of course it will be understood that each
patient thus entered on the books implies not one visit, but many, paid
to the Dispensary, or often repeated attendance at the patient’s home.
Of the Boston Hospital for Women and Children I can speak from
lengthened experience in it as a student. When standing in its
dispensary I have over and over again heard rough women of a very poor
class say, when questioned why they had not had earlier treatment for
certain diseases, “Oh, I _could not_ go to a man with such a trouble,
and I did not know till just now that ladies did this work;” and from
others have repeatedly heard different expressions of the feeling that,
“It’s so nice, isn’t it, to be able at last to ask ladies about such
things?”
As I am alluding to my own experience in this matter, I may perhaps
be allowed to say how often in the same place I have been struck with
the _contingent_ advantages attendant on the medical care by women of
women. How often I have seen cases connected with stories of shame or
sorrow to which a woman’s hand could far most fittingly minister, and
where sisterly help and counsel could give far more appropriate succour
than could be expected from the average young medical man, however
good his intentions. Perhaps we shall find the solution of some of our
saddest social problems when educated and pure-minded women are brought
more constantly in contact with their sinning and suffering sisters, in
other relations as well as those of missionary effort.