ENGLAND REVISITED
1858
The ten years during which this pioneer medical work had been steadily
carried on had thus firmly established the new departure as a useful
innovation in the United States. The reform was at that time steadily
growing, not only in New York, but also in Philadelphia and Boston,
under the guidance of able bodies of women. We were now desirous of
learning what openings existed in England for the entrance of women
into the medical profession. We knew that much interest had been felt
there in the progress of the American work, and we had been urged by
friends in Europe to give some account of it.
It was determined, therefore, in August 1858 that I should again
revisit my native land and urge the importance of this medical work.
Soon after my arrival in Europe I took the occasion of a visit made
to a sister in Paris to prepare carefully a series of three addresses
to be delivered in England, showing what was being done in medicine
by women in the United States, and the reasons for that work. The
first of these addresses was on the value of physiological knowledge
to women, the second on the value of medical knowledge, and the third
on the practical aspect of the work as established in America and
its adaptability to England. Whilst engaged in the preparation of the
lectures I entered into relations with the large-hearted Countess de
Noailles, whose devotion to sanitary reform and generous support of
benevolent enterprises were equally remarkable. This lady was very
desirous that a country sanatorium for women should be established in
England or France, being firmly convinced that hygienic conditions in
their fullest application were the chief necessity in the successful
treatment of special diseases. This lady wrote to an old friend in
Paris: ‘I wish to direct all my efforts to this object. Let me know as
soon as possible what it would cost to establish a small hospital for
women and children either in France or England, under Miss Blackwell’s
direction.’ She also requested one of her noble French relatives to
make my acquaintance. The interview is thus described in a letter to
Dr. Emily in New York.
Paris: 1858.
Yesterday I saw Madame —— by appointment at her own house.
A. says she is a daughter of the Prince de P.; to me she
seemed a stout, black-eyed Frenchwoman of forty-five,
cordial in manner, speaking English well, and knowing as
much of England and Anglo-Saxon nature as a Frenchwoman
ever can know. We conversed energetically for two hours.
She is seriously interested in the entrance of women into
the medical profession, a wish founded in her case on
the moral degradation which she has observed amongst her
own acquaintance from the practice of being treated by
men in female complaints. The fact which most struck her
in all I told her was your amputating a breast; in this
she actually triumphed. Her face became radiant with the
intense satisfaction of the thing, for it proved to her by
a fact what she wanted to believe, but could only accept
intellectually from all my reasons—viz. the necessity of
letting the midwife drop, and striking unflinchingly for
the highest position. This one fact, worth to this sort
of nature a host of arguments, gave her real faith in the
physician. She opened freely her objections, or rather
difficulties, and I met them one after another; and this
difference I observed in the encounter with the cultivated
European nature—when I gave her a reason she understood it
and accepted it; it did not go in at one ear and out at the
other as with more frivolous people; there is some soil or
substance you can plant in in this stouter nature. As years
ago with Lady Byron, so with this lady, it was of some use
talking to her. She propounded, of course, foolish as well
as serious ideas; thus she thought that women physicians
should never marry; she also would be shocked to see me with
a garland on my head dancing in a ball-room, and she thought
they should be devoted, like the sisters of charity, &c.
I combated her idea of abnegation for a while, and put in
a feeler to see if she could take in a higher notion; but
finding it was impossible, I at once ceased the attempt, and
allowed her to hold to her own highest idea, which I could
see was tinged by her French nature. Of course it wearied
me a little, and I wanted after a while to expand my lungs
and breathe freely; but I certainly made a strong impression
upon her. She thanked me and shook my hand again and again
at parting, and said that she should not think of letting
this be our last interview, and she should write to Madame
de Noailles the very next day. She had asked me previously
if I was resolved in any case to go back to America, and
I had told her ‘No,’ but described at the same time the
excellent beginning we had made there. I feel convinced that
I shall have some proposition in relation to my (or rather
our) establishment in London. What, then, ought we to say
should such an offer arise? I will accept nothing that is
not offered to us both, on that I am quite determined; we
cannot separate in practice.
Paris: November, 1858.
Preparing my lectures is a troublesome business. My first
one would not do; it was so much more adapted to an American
than an English audience. I wanted also quantities of facts
that I did not know how to get. But I have now re-written
twenty-one pages. I have written it with pleasure, though
very slowly, and I am really surprised to find how very
slowly I write. I can only write when I feel fresh in the
morning; sometimes only a page, sometimes none. I will not
force it when I don’t feel fresh, but I shall take whatever
time is necessary to do the work well, for it is really
important.
It was during this visit that I had the privilege of becoming
personally acquainted with Dr. Trélat, the head of La Salpêtrière,
and his admirable wife, who remained steadfast friends through
life. I visited them at La Salpêtrière—that large asylum for infirm
women, over which Dr. Trélat presided with truly paternal care. La
Salpêtrière was not then a great school of experimentation, but a
benevolent refuge, where the well-being and kindly protection of its
inmates formed the primary object of the director.
The following letters are descriptive of this time.
_To Lady Byron_
Paris: December 30, 1858.
160 Rue St. Dominique.
MY DEAR AND VENERATED FRIEND,—I received your letter
yesterday. The mere chance of being in any way useful
to the valuable friend you refer to is reason sufficient
for a short return at once to England, so I have made my
arrangements to reach London on Monday evening, January 3.
I have heard with great pleasure of an invitation to lecture
in London, which I will acknowledge when I receive it. I
shall be glad of an opportunity of laying very important
considerations before my fellow countrywomen, but I cannot
lecture just at present. I find that I must first go to
Italy, for reasons which I will explain when we meet;
therefore it is too soon to engage rooms at present, for
which kind offer I sincerely thank you.
My chief object in making this hurried visit of a few days
is to see Miss Nightingale and a few valued friends, amongst
whom I hope I may reckon yourself. I shall therefore remain
quietly at my cousin’s, No. 73 Gloucester Terrace, Hyde
Park, not attempting to enter into society.
_To Dr. Emily Blackwell_
London: February 1859.
I have just returned from an interview with Miss Nightingale
at Malvern in relation to a school for nurses which she
wishes to establish; and I start to-morrow for France _en
route_ for Mentone. My old friend’s health is failing from
the pressure of mental labour. I cannot go into the details
of her last five years now, but the labour has been and is
immense. I think I have never known a woman labour as she
has done. It is a most remarkable experience; she indeed
deserves the name of a worker. Of course we conversed very
earnestly about the nursing plan in which she wished to
interest me. She says that for six months she shall be
utterly unable to give any thought to the fund work, and
wants me meanwhile to observe English life very carefully,
and make up my mind as to whether I can give up America,
which she thinks a very serious matter. Unfortunately she
does not think private practice possible in connection with
her plan. If so, it would be impossible for us to help her.
She thinks her own health will never permit her to carry
out her plan herself, and I much fear she is right in this
belief.
After a short visit to the Riviera, to confer with the Countess de
Noailles about her proposed sanatorium for women, I returned to
London. There my warm friends the Misses Leigh Smith, supported
by their generous-hearted father, and Miss Bessie Rayner Parkes,
interested themselves actively in preparing for the first delivery
of my lectures. The Marylebone Hall was secured. Our young friends
brought up primroses and other lovely flowers and green wreaths from
Hastings to ornament the reading-desk, and warmly supported me by their
ardent sympathy. On March 2, 1859, the first lecture was given to a
very intelligent and appreciative audience, whose interest was warmly
enlisted. I well remember the tears rolling down the benevolent face
of Miss Anna Goldsmid, who sat immediately in front of me. But the
most important listener was the bright, intelligent young lady whose
interest in the study of medicine was then aroused—Miss Elizabeth
Garrett—who became the pioneer of the medical movement in England,
and who, as Mrs. Garrett Anderson, lives to see the great success of
her difficult and brave work.
These addresses were afterwards given in Manchester, Birmingham, and
Liverpool; Mr. Bracebridge kindly making arrangements for them in
Birmingham and the Rev. W. H. Channing in Liverpool.
The interest thus excited in London led to some effort being made
to commence in England similar work to that being done in America. A
meeting of ladies was held at the St. John’s Wood residence of Mrs.
Peter Taylor, over which Mr. William Shaen presided. A committee was
formed to consider the subject, and encouraged by the offer of help
made by the Countess de Noailles, a circular was prepared, stating
the object to be accomplished and inviting support. This circular,
which was revised by Dr. Mayo, Lady Byron, Mr. Shaen, and the Hon.
Russell Gurney, was gradually signed by a large number of influential
ladies.
[Circular.]
_Proposed Hospital for the Treatment of the Special Diseases
of Women_
The Lectures recently delivered by Doctor Elizabeth Blackwell
at the Marylebone Literary Institution have produced in
the minds of the ladies who heard them a strong conviction
of the necessity for a more general diffusion of hygienic
knowledge among women; and have led to a proposition to found
a hospital for a class of diseases, the ordinary treatment
of which too frequently involves much avoidable moral
suffering, to be placed under the direction of competent
women physicians, in connection with a Board of consulting
physicians and surgeons.
A lady, impressed with the want of such an institution, and
convinced of the value of hygienic knowledge in the treatment
and prevention of female diseases, has already promised
1,000_l._ towards the hospital, and offers 5,000_l._ more
for the endowment of a Sanitary Professorship in connection
with it, provided a sufficient sum be raised by donation
to place the institution on a permanent basis.
In order to secure the advantages of this offer, it is
proposed to raise and invest an additional sum of not
less than 10,000_l._ for the purpose of securing and
furnishing a suitable house, and forming the nucleus of a
permanent hospital endowment; and also to collect an annual
subscription list of not less than 500_l._, to assist in
defraying the current expenses of the hospital.
The ladies whose names are appended to this statement have
signified their cordial concurrence in the proposal to
establish such an institution, and their desire to aid it
in any way that may be within their power.
Contributions will be received by Messrs. Williams, Deacon
& Co., Bankers, 20 Birchin Lane, E.C. Any communications
may be addressed to Miss Braysher, Hon. Secretary, 73
Gloucester Terrace, Hyde Park, W.
Messrs. Bracebridge, the Hon. Russell Gurney, Q.C., and the Hon.
W. Cowper accepted the posts of trustees, and sixty-six names of
well-known ladies were gradually added to the circular.
_To Dr. Emily Blackwell, New York_
London: April 15, 1859.
The more I see of work in England, the more I like it. From
the Queen downwards I see signs of favour. On all hands
we make converts, and those who are indoctrinated make
converts. The whole way in which the cause is regarded by
laity and doctors is most respectful. I believe we could
get into general practice. We could shape the whole matter
in the right way, for people welcome true ideas. There is
an immense charm in this fresh field, where solid English
heads receive the highest view of truth, where generosity
and largeness of idea meet you at every turn. I like working
and living in England, and there is no limit to what we
might accomplish here. But, alas! there is the same old
difficulty. We ought to have an independent 300_l._ per
annum between us, and for want of that it is all vitiated.
I see the charm of work here as clearly as I did on my
arrival nine months ago, and feel immeasurably more hopeful
about the possibilities of English work, but I realise more
than ever the difficulty of working here upon nothing. I
am writing to you upon our last prospectus, one which is
to be widely circulated when we are satisfied with the
names appended. It has been carefully revised, and it is
contemplated to distribute many thousands of them. But we
have been six weeks shaping the prospectus and collecting
some names, and I know that it will take many weeks more
to secure the names it is hoped to obtain. In fact, it is
a long work of initiation that has to be carried on, which
would be very thorough, excellently well done, but which
I cannot wait to do.
It is very unfortunate that the probable dissolution of
Parliament and consequent ferment of re-elections will
interfere with our proceedings; all lecturing is out of
the question during the excitement of elections.
I shall probably join A. in the Isle of Wight for a week
or two. I do want to see that dear little island again, and
I shall there find leisure to revise my little book for an
English edition.
I am going to dine with the Gurneys to-night, to meet the
Rev. Mr. Maurice, who is so highly regarded by a large
party, and whom I am to convert! It will be a clerical
party to-night, and to-morrow I am engaged to meet a few
medical gentlemen at Mr. Hawes’s!
The country looks lovely, and as usual I am longing for
it, and will break away at Easter for a little holiday.
How hard you must be working! You must have a holiday when
I come back.
Easter was spent in the Isle of Wight revising the little work on
‘The Laws of Life,’ an English edition of which was brought out by
Sampson Low & Co.
During this time the plan of the proposed hospital was being circulated
in London.
It was during this visit to England that the important step was
taken of placing a woman’s name on the authorised Medical Register of
the United Kingdom. Influential friends were desirous of keeping me
in England. They presented the various testimonials of English and
Continental study given by distinguished physicians and credentials
of American practice to the Medical Council. On this council, of
which Sir Benjamin Brodie was president, were old friends of the
St. Bartholomew’s days. The subject was very carefully considered,
and after mature deliberation this just and important concession
to qualified women was authorised. I had the satisfaction of being
enrolled as a recognised physician of my native land in the Medical
Register of January 1, 1859.
_To Dr. Emily Blackwell, New York_
May 13, 1859.
My letter this week must be rather short, for I am
overwhelmed with all sorts of engagements previous to leaving
for Birmingham, where I give my first provincial lecture
next Monday. I have communicated to our little committee
Madame de Noailles’s insistence upon a country site for
the hospital, and also the necessity that exists for not
abandoning our work in New York until the institutions there
are self-supporting. They are very much disappointed by
the country condition attached to the hospital; but were I
settled in England and working there, it would not discourage
them. But all our friends seem to think that as the New York
Infirmary is the best argument that can be used for English
work, its downfall would be an irreparable misfortune, and
they are willing, under the circumstances, to let me go.
Indeed, I find it necessary to come to a decision myself,
and after carefully weighing everything I have made up my
mind to return, at any rate for some time. I can secure any
amount of personal interest from various quarters; but as
the prospect of speedily realising an institution where we
could both work is put farther off, I do not wish to stay
under the circumstances....
Edgbaston: May 17,1859.
A letter just received from the Countess de Noailles urges
me to begin a sanatorium in the country near New York. She
says: ‘As the central hospital already exists in New York,
if you will allow me to help in beginning a sanatorium in
country air I should be able to realise my idea at once.
I think you might obtain some house or farmhouse for the
purpose in the course of the autumn or spring. The importance
of convalescent hospitals in the country is beginning to
be recognised in England; let women be the first to set
the example of one in America. I believe that in women’s
complaints they are of more importance than in any other,
and that in seven cases out of ten the air alone would
effect the cure.’ Now I think this is extremely rational
and liberal, and we must discuss together how we can do it
for her.
_To Lady Byron_
73 Gloucester Terrace, Hyde Park: June 10, 1859.
It grieves me much to know of these constantly recurring
illnesses, crippling so valuable a life. What a satire it
is to call our science ‘The Art of Healing’!
My provincial trip has been very interesting to me, as
bringing me into contact with a great number of people in
different classes of society, showing me everywhere a great
want and an eager reception of what I have to give. From
Leeds, Nottingham, and Edinburgh came earnest invitations
to lecture. A message sent to my sister from Edinburgh
stated a total revolution in womanly sentiment, and that
her reception would now be as hearty as it was formerly
hostile. A student from Cambridge told me the young men
were warmly in our favour.
Mothers beg me for instruction in health. Young ladies
listen eagerly to the idea of work. Three desired to become
medical students. Wise old physicians ask me to ‘break up’
certain fashionable London practices by substituting our
own practice. Thus from many different points of view a
deep interest awakens, but everywhere the London experience
was repeated—viz. _conversion_; women thinking themselves
hostile, but receiving the idea when they knew what it
really meant. But the sympathy is necessarily intellectual
only—practical reception and familiarity with the new
position of women must necessarily be of slow growth. It
must be, in fact, a life work. The children of the present
generation will grow up accustomed to women doctors,
respecting and trusting them, but the large majority of
the adults will only hold a half-faith, and this will
be a gradual growth. I am convinced that there would not
be a rapidly brilliant success in England, such as some
enthusiastic friends dream of.
There is a call for the work, an admirable field, but the
work itself is a very slow one, the steady conquest of
innumerable difficulties—a creation, in fact. The hospital
scheme I think premature.
I had promised to bring it forward, and have done so, but I
believe, to be successful, it must spring, as in America, out
of private practice. I have no faith in its rapid success.
My own opinions and plans, then, may be briefly summed up.
There is a valuable and much-needed work to be done in
England. Slow, uphill work, not remunerative (my tour was
an expense to me); a repetition, to a great extent, of our
last seven years’ work. It would need us both to do it well;
and so greatly does England want just our experience that,
were it possible, I should counsel the transference of our
work to this side of the water. But this we cannot do, and
I shall therefore endeavour to prepare others for English
work by receiving and educating students in America. In
America, as here, it is a life work. I shall go back to
create the institutions of which we have planted only the
little germ. In ten years’ time we may hope for permanent
institutions there, worthy of their object, but we can during
that time efficiently aid earnest young Englishwomen for
their work here. Mrs. Bracebridge, who is much interested
in this plan, is coming to London in Trinity Week for the
special purpose of becoming acquainted with Mrs. Gurney
and Mrs. Battin. They will form a committee for appointing
and testing students. There will be a good deal of work
connected with these arrangements, but directly it is
completed I leave, as I am much wanted across the water.
I shall see you, my dear friend, before I leave (about
June 25). I shall be sad to say good-bye, but I know that
distance will not necessarily part us.
73 Gloucester Terrace, London: June 17, 1859.
DEAR E.,—I have only one piece of information to send, but
that is of the highest importance—viz. that the Medical
Council has registered me as physician! I have just learned
the news from my lawyer, Mr. Shaen, who made the application,
and at once forwarded the necessary fees, that I may be
published in the first register. This will be of immeasurable
value to the future of medical women in England....
73 Gloucester Terrace: July 7.
I am busy making inquiries about the plates, &c., I want
to take over to New York. I cannot go to the expense of
a journey to Paris, but I have the catalogue of Auzoux,
who stands unrivalled in the manufacture of _papier-mâché_
models. I must make a selection and let the pieces be boxed
up in Paris, and sent direct by sailing vessel. Vassourie
is the modeller in wax; his models are the most exquisite
things I have ever seen, but horribly dear. The microscope I
shall buy in England. I have settled to sail by the _Persia_
on the 23rd, but the difficulty of deciding on our future
course does not lessen. I am convinced that England is the
place where we should work to best advantage. Lady Byron,
Mrs. Bracebridge, the Peter Taylors, Miss Goldsmid—each
the centre of a large and very different set of people—are
each of them sure that we should have a large and valuable
practice. Many doctors think the same. I cannot but think
that the next ten years might be better spent in England
than America. Our work is needed, and I know not who else
can do it; indeed, we seem peculiarly suited to do this
work in England. Well, we will soon discuss these matters
together, and I am managing as well as I can in shaping
things here, and gathering information under the uncertainty.
Returning to New York in August 1859, I found the permanent fund which
had been commenced for the purchase of a hospital site prospering.
The steady friends of the movement—Stacy B. Collins, Robert Haydock,
Merritt Trimble, and Samuel Willets, formed the nucleus of an earnest
band of supporters, both men and women. The spacious house, 126
Second Avenue, was purchased and adapted to the use of hospital and
dispensary, with accommodation for several students.
Our able fellow-worker, Dr. Zackrzewska, having left us to superintend
the new hospital in Boston, we carried on the rapidly growing work of
the infirmary with the aid of intelligent graduates from Philadelphia,
who came to us for practical instruction in medicine.
In addition to the usual departments of hospital and dispensary
practice, which included the visiting of poor patients at their own
homes, we established a sanitary visitor. This post was filled by one
of our assistant physicians, whose special duty it was to give simple,
practical instruction to poor mothers on the management of infants
and the preservation of the health of their families. An intelligent
young coloured physician, Dr. Cole, who was one of our resident
assistants, carried on this work with tact and care. Experience of
its results serve to show that the establishment of such a department
would be a valuable addition to every hospital.
Correspondence with English friends continued, and we were deeply
interested by the following letters from Miss Elizabeth Garrett, who
was bravely commencing the necessary pioneer work in England:—
Aldeburgh, Suffolk: January 2, 1861.
I feel anxious to tell you how very much I enjoy the work
and study, as this is to a great extent unexpected to me. As
I had not any very strong interest in the subjects, and was
led to choose the profession more from a strong conviction
of its fitness for women than from any absorbing personal
bias, I was prepared to find the first year’s preparation
work tedious and wearing. That this has not been the case
is, I believe, mainly due to the fact of my having access
to the hospital practice, which acts as a continual aid
and stimulus to study. For three months I attended as a
probationary nurse, learning what I could both from the
doctors and nurses, and reading in the spare moments. It was,
however, very difficult to make way in this desultory manner.
The temptation to discursiveness and want of system met me
continually, and at last I determined to begin the study
of anatomy, chemistry, and materia medica, working steadily
at these and enduring the ignorance of other branches which
could not be studied rightly till a foundation of this kind
had been laid. In pursuance of this plan, when the three
months’ nursing had expired I had an interview with the
treasurer of the hospital, and asked permission to visit
the wards and go round with the house doctors. This Mr. De
Morgan agreed to, and also suggested that Mr. Plaskitt, the
apothecary, should be asked to take me as a pupil in the
dispensary, which I found him very willing to do. Mr. De
Morgan, however, will hold out no hope of my being admitted
as a regular student, and the general feeling seems to be
that each doctor is willing to help me privately and singly,
but they are afraid to countenance the movement by helping
me in their collective capacity. This will, however, come
in time, I trust, and in the meantime it is a great thing to
meet with so much individual courtesy and help. When I left
the special nursing work, Dr. Willis, the house physician,
offered to superintend my reading in private lessons at my
own house, which was precisely the kind of help I was most
glad to accept. I continue to go to the hospital early,
and go round the female medical wards alone, making notes
of all difficulties and writing descriptions of heart and
chest sounds and diagnosing as well as I can. This occupies
the time till Dr. Willis comes, when I go round again and
consult him upon all doubtful points, and learn a great
deal by observing his method and principles. After this I
go into the dispensary for two or three hours and learn the
Pharmacopœia practically, and spend the afternoon in study
in a room which the authorities have kindly lent me in the
hospital. I am to continue on my present footing till April,
but beyond that time I have no very clear plans. I wish
to get all the education that is possible in London, even
if it must be of a private or irregular kind. Perhaps it
would be best to call upon Dr. Southwood Smith, Dr. Mayo,
and Dr. Jenner, and hear if they can help me into any other
medical school.
I should be very glad to know your opinion upon the plan of
applying for admittance as a student at the Middlesex for
the next winter session, and also what you would advise in
the event of this being refused.
22 Manchester Square: May 8, 1862.
I have delayed writing, hoping that I might have at last
some good news of success to give you; now, as this seems
farther off than I had hoped it would be, I will delay
no longer. I think Mrs. Russell Gurney wrote you that I
was spending all my time just now in preparing for the
matriculation examination of the University of London. I
decided to make this the first step, in consequence of the
experience last summer brought us. We then made three very
careful and vigorous efforts to gain the admission of women
into a medical school. Those we tried were the Middlesex,
the Westminster, and the London Hospitals; and early in
this year we attempted the Grosvenor Street School. I need
not tell you we were in each case unsuccessful, though in
one or two cases the adverse decision was gained by a very
small majority of votes. In each case those gentlemen who
opposed always urged as one ground for their doing so, that
as the examining bodies were not prepared to admit women to
their examinations, the school could not educate a woman to
be an illegal practitioner, and that by doing so they would
incur the certain risk of injuring the school in the eyes of
the public without really aiding women. The medical papers
also took up the same line. The ‘Lancet’ was particularly
anxious to point out that we were beginning at the wrong
end, and that the first thing we should do was to settle
the question of examination. I also had private information
from several of the lecturers at the Middlesex that if I
could matriculate at the London University and enter as a
medical student for its examinations, my friends at their
school would do all they could to get the adverse decision
there altered. I therefore applied to the Apothecaries’ Hall
and to the College of Surgeons, asking the latter body if
they would allow me to compete for the special diploma for
midwifery which they now give. This was refused, with an
intimation that the College would not in any way countenance
the introduction of ladies into the medical profession. The
application to the Hall was more fortunate; the question
turned on a legal technicality, and was referred to counsel
and finally decided in my favour. I must, of course, conform
to all the ordinary regulations, but when I have done so
I can obtain the licence to practise granted by that body.
One of the regulations I have met without difficulty—viz.
being apprenticed to a medical man for five years before
the final examination. I had indentures made out as soon
as I knew the decision. The second one (spending three
years in a medical school in the United Kingdom) is more
difficult: it is something to be able to say when applying
for admission into a school that the Hall would examine me
and give me its licence. Still, as the licence is not all
that I want, I thought it better to make an effort at some
university for the M.D. For many reasons it seems desirable
to make the attempt at the London University. The medical
examinations there are exceedingly good; the constitution
of the body is of the most liberal description, and no
residence is required nor any teaching given, so that the
students would not be brought into any kind of contact till
they met in the examination-room. Students of all kinds
(whatever degree they may ultimately desire to take) are
required to pass the matriculation examination in arts,
and this includes the classics, natural philosophy, and
mathematics, besides a modern language and the ordinary
school subjects, history and geography, and is altogether an
examination which would require a more liberal and careful
education (in the case of girls) than is now generally
given, even if the candidates never went in for the M.A. or
B.A. degree. It was clear that the only chance of obtaining
admission to the examinations generally lay in keeping the
question on the widest, most general ground, advocating
the claims of governesses and other women who required a
good general examination, without introducing the question
of medical degrees or the admission of women to any new
professions. The university is about to have a new charter,
and we therefore thought that this was the time to raise
the question by praying the Senate to obtain the insertion
of a clause expressly extending to women the benefits of
their examinations. Before doing this we had submitted the
present charter to the Attorney-General, and had had his
opinion upon the power of the Senate to admit women upon
its authority, as it is now drawn up. He thought they had
no power to do so, and therefore there was no alternative
but to ask for a new clause. In order to get some expression
of the general feeling on the question, circulars similar
to the one I send you were extensively distributed. More
than 1,500 were sent out, and as a result we obtained a
very respectable number of names as allies. Some of their
letters were so cordial that we had extracts printed and sent
to the members of the Senate with the list of names. The
Vice-Chancellor and Mr. Grote were throughout most kindly
ready to help us, and to give the proposal the full weight
of their influence. The discussion at the Senate came on
yesterday, and was a most lengthened and animated one; of
twenty-one members present, ten were for, ten against, and
one neutral. The Chancellor (Lord Granville) then had the
casting-vote, and gave it against us.
I am exceedingly sorry, as this would have been fraught
with such great benefit to many different classes of women,
and would, I think, have been just the encouragement needed
by girls when they leave school to keep them interested in
their studies and out of the merely fashionable or domestic
life they are so liable to fall into. It would also have
been a great encouragement to parents, and would have made
them more willing to let their daughters have time and
opportunity for culture after they leave the schoolroom.
These advantages would have been widely felt, and for
professional women, whether governesses or physicians, the
opportunity of being able to take a degree would have been
invaluable. However, it is not to be had now; perhaps, when
they are having another charter eight or ten years hence, we
may try again and succeed. I do not imagine there is much
chance of being able to do more at any other university in
the United Kingdom than we can do here, so that I fear the
possibility of ever obtaining an English degree as M.D. is
a very remote one.
My notion now is to try to get into a school and obtain the
Apothecaries’ Hall licence. If this should prove possible,
it would occupy between three and four years from next
October. I should then wish to come to America and obtain
the M.D. there, and then spend a year in Paris. I should
be glad to know if you think I ought to make a point of
getting the best M.D. diploma I can, either in America or
on the Continent, if it should prove impossible to obtain
one here, and if I _can_ get the Apothecaries’ licence.
My own feeling is in favour of having the M.D.; though it
should be a foreign one, I believe it would command more
respect than the licence from the Hall would alone. I am
fortunately able to choose to do whatever is most advisable,
as I need not be in a hurry to enter upon the profession
from pecuniary or any other motives, and I think I cannot
aid the cause more soundly than by trying to do everything
in the most thorough and exact way. It would be well, I
think, to spend a good deal of time and strength on getting
the very best diploma or certificate open to women. Should
it prove to be quite impossible to get into a school, the
licence from the Hall would not be within my reach. I must,
in this case, rely entirely on foreign diplomas and on
American schools. I shall not be too ready to admit this
necessity, as I fear the advantage to the cause would be
greatly diminished by the fact of my being educated in
America.
I should be very glad to spend a year with you in the
infirmary after having studied in a school here, but I should
be very sorry to give up my English friends and interests
for the whole period of study, if it can by any means be
avoided. Still, if it cannot, I am ready to go on with the
work. The time spent in study has been most pleasant, and
I am more than ever convinced both that this special work
is one which a woman may have a divine right to engage in,
and that every single woman’s life is both happier and more
useful if she has an absorbing interest and pursuit. I shall
be very glad to have your advice, when you can kindly find
time to write to me. Believe me, yours sincerely,
E. GARRETT.
In the full tide of our medical activity in New York, with a growing
private practice and increasing hospital claims, the great catastrophe
of civil war overwhelmed the country and dominated every other
interest.
The first shot at Fort Sumpter aroused the whole North, and the
assassination of Lincoln enlisted the indignant energy of every
Northern woman in the tremendous struggle. As the deadly contest
proceeded, and every town and village sent forth its volunteers to
the fearful slaughter of civil war, the concentration of thought and
action on the war dwarfed every other effort.
The war was essentially a rebellion by a portion of the States for the
maintenance of slavery. To us, nourished from childhood on the idea of
human freedom and justice, the contest became of absorbing interest.
Though our American friends often reproached us as Englishwomen for
the action of the English Government, we threw ourselves energetically
into the cause of freedom.
On the outbreak of the war, an informal meeting of the lady managers
was called at the infirmary to see what could be done towards
supplying the want of trained nurses so widely felt after the first
battles. A notice of this meeting to be held at the infirmary having
accidentally found its way into the ‘New York Times,’ the parlours
of the infirmary were crowded with ladies, to the surprise of the
little group of managers.
The Rev. Dr. Bellows and Dr. Elisha Harris being present, a formal
meeting was organised. Whilst the great and urgent need of a supply of
nurses was fully recognised, it was also felt that the movement would
be too vast to be carried on by so small an institution. A letter
was therefore drafted on this occasion, calling for a public meeting
at the Cooper Institute, and a committee of the ladies present was
appointed to obtain signatures to this call.
The meeting at the Cooper Institute was crowded to overflowing.
The National Sanitary Aid Association was then formed, in order to
organise the energetic efforts to help that were being made all over
the country.
The Ladies’ Sanitary Aid Association, of which we were active members,
was also formed. This branch worked daily at the Cooper Institute
during the whole of the war. It received and forwarded contributions
of comforts for the soldiers, zealously sent from the country; but
its special work was the forwarding of nurses to the seat of war. All
that could be done in the extreme urgency of the need was to sift
out the most promising women from the multitudes that applied to
be sent on as nurses, put them for a month in training at the great
Bellevue Hospital of New York, which consented to receive relays of
volunteers, provide them with a small outfit, and send them on for
distribution to Miss Dix, who was appointed superintendent of nurses
at Washington.
The career of one of these nurses, a German, deserves recording. We
hesitated about receiving her, on account of her excitable disposition,
but she insisted on going. This feeble-looking woman soon drifted
away from the Washington Depôt to the active service of the front.
After the battle of Gettysburg she spent two days and nights on the
field of slaughter, wading with men’s boots in the blood and mud,
pulling out the still living bodies from the heaps of slain, binding
up hideous wounds, giving a draught of water to one, placing a rough
pillow under the head of another, in an enthusiasm of beneficence
which triumphed equally over thought of self and horror of the hideous
slaughter.
A welcome relief to the great tension of life during those years
was the visit of Mr. Herman Bicknell, F.R.C.S., who was travelling
in America after the death of his wife. I remembered him as a
fellow-student of the St. Bartholomew’s days, who sat by me in the
lecture-room; and he recalled many interesting reminiscences of that
eventful time. He was a man of great though eccentric talent, and a
clever Persian scholar, having resided long in the East. His cordial
friendship during many later years was much prized, and continued
until his premature death.
It was not until this great national rebellion was ended that the
next step in the growth of the infirmary could be taken.
The infirmary service of young assistant physicians, which had been
hitherto supplied by students whose theoretical training had been
obtained elsewhere, no longer met the New York needs.
In 1865 the trustees of the infirmary, finding that the institution
was established in public favour, applied to the Legislature for a
charter conferring college powers upon it.
They took this step by the strong advice of some of the leading
physicians of New York interested in the infirmary, who urged that
the medical education of women should not be allowed to pass into the
hands of the irresponsible persons who were at that time seeking to
establish a women’s college in New York. We took this step, however,
with hesitation, for our own feeling was adverse to the formation
of an entirely separate school for women. The first women physicians
connected with the infirmary, having all been educated in the ordinary
medical schools, felt very strongly the advantage of admission to
the large organised system of public instruction already existing
for men; and also the benefits arising from association with men as
instructors and companions in the early years of medical study. They
renewed their efforts, therefore, to induce some good recognised New
York school to admit, under suitable arrangements, a class of students
guaranteed by the infirmary, rather than add another to the list of
female colleges already existing. Finding, however, after consultation
with the different New York schools, that such arrangements could
not at present be made, the trustees followed the advice of their
consulting staff, obtained a college charter, and opened a subscription
for a college fund.
The use of a spacious lecture-room in the New York University, on
Washington Square, was temporarily obtained, until the house adjoining
the infirmary could be leased and fitted for college purposes.[7]
A full course of college instruction was gradually organised, with
the important improvement of establishing the subject of hygiene as
one of the principal professorial chairs, thus making it an equal as
well as obligatory study. Another important improvement adopted was
the establishment of an Examination Board, independent of the teaching
staff, a plan not then customary in the United States. This Board
was composed of some of the best known members of the profession, and
at the same time we changed the ordinary term of medical study from
three years to four.
During the early years of the college I occupied the Chair of Hygiene,
and had the pleasure of welcoming Miss Jex Blake, then visiting
America, as a member of the first class. The Professor of Hygiene
also superintended the important work of the sanitary visitor at
the homes of the poor. It has always seemed to me, during many years
of active private practice, that the first and constant aim of the
family physician should be to diffuse the sanitary knowledge which
would enable parents to bring up healthy children.
The most painful experience which I met with in practice was the death
of one of my little patients from the effects of vaccination. This
baby, though carefully tended and the lymph used guaranteed pure,
died from the phagedenic ulceration set up by vaccination in a rather
scrofulous constitution. To a hygienic physician thoroughly believing
in the beneficence of Nature’s laws, to have caused the death of a
child by such means was a tremendous blow!
This serious experience awakened a growing distrust as to the wisdom
of all medical methods which introduce any degree of morbid matter
into the blood of the human system; a distrust which no amount of
temporary professional opinion or doubtful statistics has been able to
remove. Although I have always continued to vaccinate when desired, I
am strongly opposed to every form of inoculation of attenuated virus,
as an unfortunate though well-meaning fallacy of medical prejudice.