that there is at this moment a large amount of work actually awaiting
them; that a large amount of suffering exists among women which never
comes under the notice of medical men at all, and which will remain
unmitigated till women are ready in sufficient numbers to attend
medically to those of their own sex who need them, and this in all
parts of the world. From India we hear urgent demands for “educating
native women of good caste, so as to qualify them to treat female
patients and children.”[43] We are informed that “this is a work
which can only be carried on by women, as the native women in many
cases will rather die than be seen by a man in times of sickness,”[44]
and arrangements have already been made for a systematic “Female
Medical Mission,” though perhaps the standard of medical knowledge
required can, under existing circumstances, hardly be fixed as high
as is desirable. To show, however, the eagerness with which the
native women avail themselves of the aid thus offered, I may mention
that when a lady (who had had some medical training, but possessed
no degree,) was sent out by the Society[45] in December 1870, she,
during the first three months of her stay, had occasion to pay no less
than 313 professional visits to zenanas, and to treat 158 patients at
her dispensary, which was arranged with a view to affording them the
utmost privacy. Subsequently her visits to zenanas averaged as many
as seventeen a day, while nearly twice as many patients came to her
dispensary. Efforts are also being made to train native Hindoo women
for some branches, at least, of the medical profession. Dr Corbyn of
Bareilly, in 1870, wrote as follows:--“I am educating a number of
native girls, and three have already passed as native doctors. They
are of all castes,--Christians, Mahommedans, and Hindoos. My school is
divided into three classes. The first-class pupils can read and write
English and Urdee with accuracy. They are taught medicine, surgery,
midwifery, diseases of women and children (especially the latter
two). The second-class learn anatomy, materia medica, and physiology,
in English and Urdee. The pupils of the other (preparatory) class
are taught English and Urdee. We have a female ward attached to the
dispensary for women and children, and these girls entirely attend to
them, under my and the sub-assistants’ supervision. It is wonderful how
they can manipulate; they have plenty of nerve.”[46] Even more recently
we learn that “the Mahommedan Nawab of Rampoor has presented to the
Bareilly mission a large building for the purpose of a medical school
for women. Several women are now going through a scientific course of
instruction.”[47]
About eight or ten years ago, “several of the wild tribes of Russian
Asia petitioned the Government to send them out properly qualified
women to act as midwives. Their petition was granted, the Government
undertaking all the expense of the education and maintenance of a
certain number of women for this purpose. After a time one of these
tribes, the Kirgesen, petitioned further, that the women thus sent to
them should also be taught some branches of the art of Medicine. One of
the women, then being trained as a midwife, hearing of this petition,
wrote to the Kirgesen, proposing that she should study Medicine
thoroughly, and go out to them as a qualified doctor. She suggested at
the same time that they should try to get permission for her to enter
the Academy of St Petersburg as a regular medical student. The Kirgesen
welcomed the proposal, and, through an influential Russian general,
obtained an official document, empowering their future doctor to attend
the Academy as a student. They have regularly sent money for her
education and maintenance, and from the first have taken the greatest
interest in her progress and welfare, requiring, among other things,
periodical bulletins of her health. Hearing last summer that she was
not well, they sent money for her to go abroad for her holiday, and
asked for an extra bulletin.”[48]
I cite the above facts to show that the demand for female physicians is
no artificial or imaginary one, and that it does not spring out of any
fanciful whim of an over-refined social state; but lest it should be
supposed on the other hand to be confined to half-barbarous nations, I
may quote the opinions expressed on this subject two years ago in one
of the most thoughtful of our English journals: “We heartily admit
that the only way to discriminate clearly what practical careers women
are, and are not, fitted for, is to let them try. In many cases, as in
the medical profession, we do not feel any doubt that they will find
a special kind of work for which they are specially fitted, which has
never been adequately done by men at all, and which never would be done
but by women.... We have heard the opinion of one of the most eminent
of our living physicians, that one of the new lady physicians is doing,
in the most admirable manner, a work which medical men would never even
have had the chance of doing.”[49]
I am told by Catholic friends that a great many cases of special
disease remain untreated in convents, because the nuns, with their
extreme notions of feminine seclusion, think that it would be little
short of profanation to submit to some kinds of medical treatment
from a man.[50] Indeed, it is expressly laid down by a great Catholic
authority, St Alphonsus,[51] that though monks and nuns are required
to place themselves in the doctor’s care when commanded to do so by
their superiors, a special exception is to be made in the case of
nuns suffering from certain maladies, who can only be required to
accept treatment from a skilled woman, if any such be available; as,
under existing circumstances, is so rarely the case. I do not ask any
reader to applaud or even justify these poor nuns, if they, esteeming
themselves “the martyrs of holy purity,” sacrifice life to such
scruples; but I do most emphatically ask, in the name of humanity,
whether the state of things can be defended which may drive women,
from the highest and most holy motives, to submit to the extremity of
physical suffering and even death itself, because it is impossible for
them to obtain the medical services of their own sex, and because they
believe they can best fulfil the spirit of their vows by accepting no
other?
I am informed by a friend that Archbishop Manning, when expressing to
her his strong interest in the question of the medical education of
women, alluded to facts like those referred to above, as affording one
of the strongest motives for such interest in the minds of Catholics.
Nor, surely, need sympathy in such a case be limited within the bounds
of any religious denomination.
To pass to the consideration of other cases of a less exceptional
kind, there can, I think, be little doubt that an enormous amount of
preventible suffering arises from the unwillingness of very many girls
on the verge of womanhood to consult a medical man on various points
which are yet of vital importance, and to appeal to him in cases of
apparently slight illness, which yet issue but too often in ultimately
confirmed ill-health. I firmly believe that if a dozen competent women
entered upon medical practice at this moment in different parts of
England, they might, without withdrawing a single patient from her
present medical attendant, find full and remunerative employment in
attending simply to those cases which, in the present state of things,
go without any adequate treatment whatever; for I believe that many
suffering women would be willing to consult one of their own sex, if
thoroughly qualified, when they refuse, except at some crisis of acute
suffering, to call in a medical man.[52] Probably Queen Isabella of
Castile[53] was neither the first nor the last woman whose life was
sacrificed to her modesty. Even if such extreme instances are rare,
I think it cannot be denied that very much needless pain, “and pain
of a kind that ought not to be inflicted,” is caused, especially to
young girls, by the necessity of consulting men on all occasions, and I
believe that those who know most of the facts insist most strongly on
this point.
I do not know how far the Medical Profession would acknowledge the
truth of the above statement; it is probable that they are really less
competent to judge about it than women are themselves, for, as an
eminent divine remarked that it was considered a point of politeness
not to express theological doubts before a clergyman, it may probably
be thought still more obligatory not to question the adequacy of the
existing medical profession before one of its members. One can hardly
imagine a lady sending for a doctor to tell him why she will _not_
consult him; it is sufficient to know that many cases of disease among
women go without treatment; it is surely open to any one at least to
suggest the above as one of the possible reasons.
And indeed, if no such special suffering were often involved in the
idea of consulting a man on all points, it seems self-evident that a
woman’s most natural adviser would be one of her own sex, who must
surely be most able to understand and sympathise with her in times
of sickness as well as of health, and who can often far more fully
appreciate her state, both of mind and body, than any medical man would
be likely to do.[54]
Nor can I leave the subject without expressing a hope that, when women
are once practising medicine in large numbers, great gain may accrue
to medical science from the observations and discoveries which their
sex will give them double facilities of making among other women. One
of the most eminent of the so-called “ladies’ doctors” of the day
writes:--“The principal reason why the knowledge of diseases of women
has so little advanced, is the hitherto undisturbed belief that one sex
only is qualified by education and powers of mind to investigate and to
cure what the other sex alone has to suffer.” After alluding to women
physicians of both ancient and modern times, Dr Tilt further remarks,
that, “if well educated, they may greatly improve our knowledge of the
diseases of women.”[55]
Moreover, there is reason to hope that women doctors may do even more
for the health of their own sex in the way of prevention than of cure,
and surely this is the very noblest province of the true physician.
Already it is being proved with what eagerness women will attend
lectures on physiology and hygiene when delivered to them by a woman,
though perhaps not one in ten would go to the same course of lectures
if given by a medical man. I look forward to the day when a competent
knowledge of these subjects shall be as general among women as it now
is rare; and when that day arrives, I trust that the “poor health”
which is now so sadly common in our sex, and which so frequently
comes from sheer ignorance of sanitary laws, will become rather the
exception than, as now too often, the rule. I hope that then we shall
find far fewer instances of life-long illness entailed on herself by
a girl’s thoughtless ignorance; I believe we shall see a generation
of women far fitter in mind and body to take their share in the work
of the world, and that the Registrar will have to record a much lower
rate of infantile mortality when mothers themselves have learned to
know something at least of the elementary laws of health. It has been
well said that the noblest end of education is to make the educator no
longer necessary; and I, at least, shall think it the highest proof
of success if women doctors can in time succeed in so raising the
standard of health among their sister women, that but half the present
percentage of medical practitioners are required in comparison to the
female population.
Of course I do not expect that every reader will look at this
question from my point of view, or will be able to arrive at the same
conclusions respecting it. But I think that many who have never before
seen the matter in the light in which I have tried to place it, will be
ready to admit that there are at any rate _primâ facie_ grounds for my
argument, and that allowing even for considerable over-statement on my
part, there may still remain subject for serious consideration.
Even if I am wholly mistaken, and if all that needs doing _can_ in
England be effectually done by men, we have still, I think, no reason
for the exclusion of women from the medical profession;--there is still
no ground on which it can be right to refuse to every patient the
power of election between a physician of her own sex and of the other,
when women as well as men are desirous of qualifying themselves for
this work, seeing that it will after all be always a matter of choice;
for we cannot suppose that the time will ever come when women will be
arbitrarily prevented from employing men, as they now are arbitrarily
prevented from employing women, as their medical attendants.
The assertion that women _are_ at present “arbitrarily prevented from
employing women as their medical attendants” may sound startling, but
it is at this moment practically true in England, in the most literal
sense. Since medical practice has, for the protection of the public,
been made a matter of legislation, it has been absolutely illegal for
any physician or surgeon to practise as such in this country, unless
registered by the appointed Medical Board, and that Board is not
obliged to register any one who has not a British medical degree. It is
evident, then, that to deny all British medical degrees to women,--not
only to refuse them instruction, but to refuse to examine them if they
have acquired knowledge elsewhere,--_is_ most arbitrarily to prohibit
all women, whatever their qualification, from practising medicine in
the United Kingdom, except under legal pains and penalties.
Of course no such arbitrary action was even contemplated when the Act
of 1858 was passed; and I think that when once the great practical
injustice of the present state of things is fully understood by the
public, a change is inevitable,--either British medical degrees will
be thrown open to women, as is most desirable, or the legal conditions
of practice will be modified to meet the case of those to whom such
degrees are denied. It is perhaps hardly to be expected, though very
much to be desired, that medical men as a body should themselves take
the initiative in this matter, and throw open the doors to all women
who desire worthily to join their fellowship, for it proverbially
“needs _very_ good men to give up their own monopoly;” but the action
of the general public in the matter can hardly be doubtful except as
a question of time;--no English court could be expected to condemn to
legal penalties a succession of highly-educated ladies who may have
seized, often with great effort, every opportunity open to them to fit
themselves thoroughly for a work which they believe to be especially
their own.
The recent action taken in the matter by the authorities at
Apothecaries’ Hall is exactly of the kind to outrage an Englishman’s
sense of fairness, and therefore is sure before long to bring its
own redress. As the facts may not be thoroughly understood in the
non-medical world, I will briefly recapitulate them. When Miss Garrett
first began to study medicine in 1860, she tried to obtain admittance
to one School and University after another, and finally found that
Apothecaries’ Hall was the only body which, from its charter, had no
power to refuse to examine any candidate complying with its conditions.
She accordingly went through the required five years’ apprenticeship,
and obtained her diploma in 1865, having gone to very great additional
expense in obtaining privately the required lectures by recognised
Professors,--sometimes paying fifty guineas for a course when the
usual fee, in the classes from which she was debarred, was but three
or four. Not content, however, with indirectly imposing this enormous
pecuniary tax on women, the authorities now bethought them to pass a
rule forbidding students to receive any part of their medical education
privately,--this course being publicly advised by one of the leading
medical journals as a safe way of evading the obligations of the
charter, and yet effectually shutting out the one chance left to the
women![56]
Of course the efficacy of this measure ceases the moment that any
regular medical school fairly opens its doors to women; but till that
day comes, it presents a formidable, if not insuperable, difficulty.
Commenting on this proceeding, the _Daily News_ remarks:--“We recommend
these facts to the good people who think that coercion, restriction,
and the tyranny of combination, are peculiar to any one class of
society. It will be a great day in England when the right of every
individual to make the most of the ability which God has given him,
free from interested interference, is recognised, and to that goal we
are surely advancing; but our progress is slow, and it is very clear
that it is not only in the lower ranks of the community that the
obstructive trades-union spirit is energetically operating.”
While such is the state of affairs in England, other European nations
have taken a very different position. We have already seen that the
Italian Universities were, in fact, never closed to women, and that at
Bologna no less than three women held Professors’ chairs in the Medical
Faculty.[57] We have several instances of degrees granted to women in
the Middle Ages by the Universities of Bologna, Padua, Milan, Pavia,
and others; the earliest instance that I have found being that of
Betisia Gozzadini,[58] who was made Doctor of Laws by the University of
Bologna in 1209. In Germany also several such instances have occurred.
At Paris no less than seven degrees in Arts and Sciences have been
granted to women by the University of France within the last ten years,
and a number of women are now studying in the Medical School there. In
answer to my enquiries in 1868, the Secretary to the Minister of Public
Instruction made the following communication:--
“_Paris, le 18 Août 1868,
“Ministère de l’Instruction Publique._
“MADEMOISELLE,--En réponse à la lettre que vous me faites
l’honneur de m’adresser, en vous recommendant du nom de Lord Lyons,
qui a écrit pour vous à Mons. le Ministre, je m’empresse de vous faire
savoir que le Ministre est disposé à vous autoriser, aussi que les
autres dames Anglaises qui se destineraient à la médecine, à faire vos
études à la Faculté de Paris, et a y subir des examens.
“Il est bien entendu que vous devez être munie, par voie d’équivalence
on autrement, des diplômes exigés pour l’inscription à la faculté de
médecine.
“Agreez, Mademoiselle l’assurance de mon respect,
(Signed) “DANTON.”
Since this Essay was first published, two women have obtained the
degree of M.D. in Paris, after passing brilliant examinations in each
case. The first graduate was our distinguished countrywoman, Miss
Garrett, who, after passing the five examinations required, received
her degree in June 1870. The _Lancet_ records that “her friends must
have been highly gratified to hear how her judges congratulated her on
her success, and to see what sympathy and respect was shown to her by
all present.”[59]
The next lady who graduated was Miss Mary C. Putnam of New York,
who, after quietly pursuing her studies (combined with original
researches), like a second Archimedes, during both the sieges of
Paris in 1870–71, took her degree with great honour in August 1871.
The _Lancet_[60] remarked--“Miss Putnam has just been undergoing the
very strict examinations for the doctor’s degree in Paris, and has
passed very creditably. This is the second case in the Paris faculty,
the innovation being made quietly, whilst elsewhere angry discussions
intervene.”
At Lyons, also, two women have obtained degrees in Arts, in 1861 and
1869 respectively. At Montpellier a degree in Arts was also conferred
on a woman in 1865, and another lady has passed the first two
examinations in the _Ecole de Pharmacie Supérieure_ in that city.
For several years past the University of Zurich has been thrown open
to women as freely as to men; a Russian woman, named Nadejda Suslowa,
being the first to obtain a degree in Medicine, in 1867. Several more
have since then graduated, and others are at present pursuing their
studies there in the ordinary classes.[61]
In March 1870 it was announced, on the authority of the _Lancet_,
that the University of Vienna had formally decided to admit women as
students, and to confer on them the ordinary medical degrees.[62]
A month or two later the Swedish newspapers published in their official
columns a royal decree, granting to Swedish women the right to study
and practise medicine, and ordaining that the professors of the
Universities should make arrangements for teaching and examining them
in the usual way.[63]
Even Russia seems in advance of England in this matter. In 1869, “the
Medico-Chirurgical Academy of St Petersburg conferred the degree of
M.D. upon Madame Kaschewarow, the first female candidate for this
honour. When her name was mentioned by the Dean, it was received with
an immense storm of applause, which lasted for several minutes. The
ceremony of investing her with the insignia of her dignity being over,
her fellow-students and colleagues lifted her upon a chair, and carried
her with triumphant shouts through the hall.”[64]
At Moscow, also, “the Faculty of Medicine, with the full concurrence of
the Council of the University of Moscow, have decided to grant to women
the right of being present at the educational courses and lectures of
the Faculty, and to follow all the labours of the Medico-Chirurgical
Academy. The tests of capacity will be precisely the same as for male
students.”[65] Still more recently we hear from St Petersburg that “the
success of the lady physicians is encouraging other ladies to devote
themselves to medicine, and a considerable step has been made in this
direction. ... A person who interests herself in the higher education
of women has requested the Minister of State to accept the sum of
£8000, and to devote it to the establishment of medical classes for
women at the Imperial Academy of Medicine.”[66]
Nor is the progress of liberality less marked on the other side of
the Atlantic. It is well known that several of the smaller medical
schools in the United States admitted women as soon as they applied
for instruction, but until 1869 no American University threw open
its doors. About the end of that year, however, the State University
of Michigan took the initiative in this matter, and the following
statement was inserted in last year’s official Calendar:--“Recognising
the equality of rights of both sexes to the highest educational
advantages, the Board of Regents have made provision for the medical
education of women, by authorising a course of education for them,
separate, but in all respects equal to that heretofore given to men
only. The conditions of admission, as well as graduation, are the same
for all.” During the first year fourteen women appeared as students in
the Faculty of Arts, three in that of Law, and thirteen were studying
Medicine and Surgery. In the spring of 1871 Miss Sanford received the
first medical degree granted to a woman by an American University; and
it is worth notice that this lady (herself a pupil of Dr Lucy Sewall
of Boston,) took her place among the most distinguished graduates of
the year;--her thesis on “Puerperal Eclampsia” being the one selected
by the Medical Faculty for publication. The number of women studying
at Michigan University during the session 1871–72 was sixty-eight, as
compared with the thirty of the previous year; such rapid increase
being tolerably significant of the avidity with which women embrace
the long-denied opportunities of instruction, and offering sufficient
encouragement to any British University that may resolve to try the
same experiment.
It will thus be seen that many nations have, from the earliest period,
recognised and acted upon the truth that “Mind is of no sex,” and
that, where this has not been the case in former times, the barriers
are being rapidly and readily thrown down as civilization advances,
till, in truth, Great Britain now stands almost alone in refusing to
admit her daughters to the national universities, and in denying them
the opportunity of proving experimentally whether “the male mind of
the Caucasian race[67]” is indeed so immeasurably superior to its
feminine counterpart. It may be remarked, by the bye, that it is
very curious to notice how the very people who loudly maintain the
existence of this vast mental disparity are just those who strenuously
resist every endeavour to submit their theory to the touchstone of
experience, instead of welcoming the application of those tests that
might be expected so triumphantly to prove their point! But, jesting
apart, the present state of things can hardly be agreeable to English
self-respect; and it is to be hoped that our country will soon descend
from her bad eminence, and no longer be marked out as the one land
where men only can reap benefit from the educational advantages
provided at the expense of the nation at large. It can hardly be an
object of ambition to the learned men of any people to deserve the
woe pronounced of old against those who “have taken away the key of
knowledge, and them that were entering in, they hindered.”
There seems to be practically no doubt now that women are and will be
doctors. The only question really remaining is, how thoroughly they are
to be educated and fitted to take their share of responsibility in the
care of the life and health of the nation; how far their difficulties
are to be lightened or increased; and whether the state of things shall
continue by which they are driven into unwilling quackery on the one
hand, or made to suffer real oppression from irresponsible authority on
the other.