CHAPTER XXV

_As part of her struggle to elevate the College standards,

she insists the students must be trained practically as well as

theoretically--Confirmation of her views by experience of Dr. J.

Marion Sims--Persistence in her convictions and refusal to pass

students whose work is below her standards make many enemies

for her--Private practice increases--She applies for admission

to the Massachusetts Medical Society--Is refused because she

is a woman--Militant ostracism of women by the Philadelphia

County Medical Society--Sketch of the Female Medical College of

Pennsylvania--Appalled by the death rate among babies, Dr. Zakrzewska

establishes a temporary asylum for infants--Continuing unable to

elevate the standards of the College, she decides to resign--Her

resignation is accepted, with the request that she relinquish her

last year’s salary--The occurrence causes a split in the College,

many of the men professors and trustees also resigning--The hospital

is discontinued, and its furniture is bought by friends of Dr.

Zakrzewska. (Thirty-two years of age: 1860-1862.)_

If the Christmastide were prosaic, the New Year’s Day (1860) was not

the less so. Business went on everywhere just the same, only that every

one shouted to each other without any kind of feeling, “Happy New Year!”

As the year progressed, lectures and dispensary work, as well as the

hospital department, went on; private practice increased, adding to

my income, which was small. As professor, I received three hundred

dollars, and as superintendent of the clinical department, an

additional three hundred dollars. Each of the gentlemen professors also

received three hundred dollars while the lady professor of physiology

had the benefit of an endowment of that chair and received five hundred

dollars. From this it must be admitted that it was not money that

induced these people to work hard every day, five times weekly, to

instruct the students, but a real interest in the cause of educating

professional women.

Had the originator of the school (Samuel Gregory), an ambitious man,

originally a missionary, been a man of higher education and broader

views, the school might have been taken up by the men standing highest

in the profession. The prevailing sentiment among these men seemed to

be that if women wanted to become physicians, the trial should be made

by giving them the same advantages as were offered to men students.

But in a monograph which had been published by this originator to

promote his plans, under the title of _Man-Midwifery_, he not

only challenged the prevailing method of practice but abused even the

best of physicians by intimating the grossest indelicacy, yes, even

criminality, in their relations with their patients. This was the

reason why no physician in Boston would openly acknowledge me as long

as I remained in connection with the New England Female Medical College.

Besides this handicap, the non-professional portion of the trustees

exercised a very fatal policy in trying to increase the number of

students regardless of their preparatory education, so that there

existed a great contrast among the students. Some had the best of

education, while others fell far below a proper standard in their

preparatory studies, to say nothing of the age of some of them. Thus,

we had a number of students over forty--one was fifty-six years old.

I admired the courage and persistency of these middle-aged women in

studying their lessons, often mechanically without understanding

their depth, yet I could not conscientiously consider them fit

subjects to enter upon the practice of a profession which requires so

much knowledge in various scientific directions as well as a broad

education, so as to enable one to comprehend the effects of all kinds

of environment upon the individual patient.

How absolutely necessary it is to cultivate in the student not only the

scientist but also the philanthropist, the humanitarian, yes, even the

philosopher, in order that one shall be fair and just in all situations

when consulted by persons morally, mentally or physically afflicted.

I constantly taught that the treatment of patients cannot be learned

from books but must be studied practically. This was a principle which

only a few of the students would admit. The idea which I emphasized,

that any other view of treating patients belongs in the realm of

quackery, was considered by these ignorant students as an insult when I

tried to explain it to them.

But it must be remembered that at this date such was the prevailing

custom in even the best medical schools for, as I have already

explained, students were expected to procure their practical training

at the hands of their private preceptors.

That this training was liable to be a will-o’-the-wisp even with male

students who had no difficulty in finding preceptors has been well

shown by the personal experiences related by Dr. J. Marion Sims in

his autobiography called _The Story of My Life_. Nowhere have I

seen the consistent results of such a method of medical education as

everywhere prevailed even at this time, so clearly described as in this

book which was published in 1884.

Dr. Sims had a preceptor and he was graduated from the Jefferson

Medical College, in Philadelphia, in March, 1835. He states that his

preceptor was a very great surgeon who was often unfitted for his

professional work by the habit of drinking. He also states that he was

very glad when he was able to leave the office of this preceptor and

attend medical lectures.

About two or three weeks after Dr. Sims opened his own office he was

called to his first patient, “a baby about eighteen months old who

had what we would call the summer complaint or chronic diarrhea.” He

continues his story, saying, “I examined the child minutely from head

to foot. I looked at its gums and, as I always carried a lancet with me

and had surgical propensities, as soon as I saw some swelling of the

gums I at once took out my lancet and cut the gums down to the teeth

... but when it came to making up a prescription I had no more idea

what ailed the child or what to do for it than if I had never studied

medicine.”

Telling the mother to send to his office for medicine, he continues,

“I hurried back to my office and took out one of my seven volumes

of Eberle, which comprised my library ... and turned quickly to

the subject of Cholera Infantum and read it through, over and over

again.... I knew no more what to prescribe for the sick babe than if

I had not read it all. But it was my only resource. I had nobody to

consult but Eberle.... He had a peculiar way of filling his book with

prescriptions, which was a very good thing for a young doctor.... At

the beginning of his article of twenty or thirty pages there was a

prescription.... So I compounded it as quickly as I knew how and had

everything in readiness for the arrival of Jennie.”

Speaking of his next visit, he continues: “As the medicine had done

no good, it was necessary to change it.” He once more returned to his

office and “turned to Eberle again and to a new leaf. I gave the baby

a prescription from the next chapter. Suffice it to say that I changed

leaves and prescriptions as often as once or twice a day. The baby

continued to grow weaker and weaker.” And in a short time it died,

although Dr. Sims says, “I never dreamed that it could die!”

About two weeks later, he was called to his second patient, another

baby which was ailing similarly to the first one. He writes, “I was

nonplussed. I had no authority to consult but Eberle; so I took up

Eberle again, and this time I read him backward. I thought I would

reverse the treatment I had instituted with the Mayer baby. So, instead

of beginning at the first of the chapter, I began at the last of the

chapter, and turned backward, and turned the leaves the same way, and

reversed the prescriptions. The baby got no better from the very first.

And soon this baby died.”

Dr. Sims was so disheartened, he decided to leave that town, and he did

so. But it is just to him to add that he further wrote, “Being obliged

to continue in the profession that I had started in, I was determined

to make up my deficiency by hard work; and this was not to come from

reading books, but from observation and from diligent attention to the

sick.”

Thus it happened at the New England Female Medical College that,

feeling as strongly as I did as to the necessity for clinical training,

I made but few friends among my listeners, and I felt out of place

except with those few who had had superior educational training. This

difference in education naturally divided the students, and the feeling

of favoritism grew stronger with the majority, while my interest in

this majority naturally grew weaker. The clinical department was

frequented only by the few, as no rule of compulsion demanded of the

students a regular attendance.

My position became tedious in its teaching duties and unendurable in

its relation to the students, yet I had nothing to complain of which

could be corrected without changing the whole policy of the school and

eliminating the most active directors, in fact, starting a college on

college foundations.

My male co-workers, men of education and experience, fully agreed with

me and told me that indorsing my election, they had hoped I would

prevail upon the founders to elevate the standard of the school.

I, a foreigner who, as such, was not greeted with a cordial welcome by

two thirds of the directors! And the Know-Nothing spirit prevailing

strongly during those years in all strata of the community!

Besides, I did not feel called upon to condemn and to reform the part

of their enterprise which had been justly praised in speech and in

print, and which had been sustained for years by the efforts of regular

physicians in the capacity of professors and private preceptors.

So, when my first college year closed, in March, 1860, and I flatly

refused to agree to the bestowal of the degree of M.D. upon several

women who presented themselves, I had laid the foundation of a hatred

which rendered my work extremely trying and hard, and which to a

certain extent prevented the growth of our out-door dispensary practice.

However, my private practice steadily increased, and in it I had

the good will, as well as the assistance when in need, of the most

prominent physicians in Boston. Among these were Drs. S. Cotting,

Walter Channing, H. I. Bowditch, E. H. Clark and S. Cabot.

These men advised me to attempt to gain admission into the

Massachusetts Medical Society, of which they were prominent members.

After preparing for the necessary examination, I presented my claim but

was refused because I was a woman, their charter allowing only male

candidates for the examination.

This refusal on the ground of sex decided these men not to break the

rules of the Massachusetts Medical Society by consulting with me or by

assisting me when advising patients to seek my attendance.

To be sure, their friendliness had not been withal an admission of

the principle that women ought to be, or could be, physicians. On the

contrary, I was informed in private conversation by some of these men

that I was considered an “exception” to my sex; that such exceptions

had existed in ancient times and were honored, and that during all the

centuries such exceptions had continued to occur. Only one famous old

physician, Dr. James Jackson, told me frankly and politely and in the

kindest manner that it would be impossible for him to recognize as a

lady any woman who was outside “her sphere.”

A similar ostracism was practiced by the Philadelphia County Medical

Society against the other medical college for women, the Female Medical

College of Pennsylvania, which had been opened in 1850, two years after

the New England Female Medical College began under the name of the

Boston Female Medical School. But the Philadelphia college had taken

the precaution from the beginning to obtain the same legal authority as

the male medical colleges for conferring the medical degree.

Nevertheless, it led a precarious existence and had to be closed

for the session of 1861-1862, and Dr. Ann Preston feared that the

institution to which she had given so much time and strength was doomed

to succumb to the weight of opposition and the absolute refusal of the

male physicians to meet the women physicians in consultation. However,

a few of the ablest men disregarded the rules of their society and

stood by the women who had just then succeeded in opening their little

hospital for women and children.

It was not until 1867 that the Philadelphia College could be considered

as on a firm basis, but within ten years from that time it produced the

first woman ovariotomist in America, Dr. Emeline H. Cleveland, who was

resident physician of the Woman’s Hospital after her return from study

in Europe, principally in the Maternité in Paris.

Thus for me the year of 1860 ended. The college course which began in

October had not varied in kind from that of the previous year, though I

could note increased personal success in practice as well as in social

connections.

The year of 1861 began for me in no way differently from the first in

Boston. The dispensary practice increased in numbers of patients and

also in greater variety and interest.

There was an especially large increase in the practice among children

and infants, which gave me an insight into the neglect which the latter

had to endure when boarded out among ignorant, and often indifferent,

families, where the small sum received for the maintenance of these

little unfortunate beings was of more consequence than their health and

existence.

The frequency with which we were required to sign death certificates of

infants whom we had seen but a day or two before, and who were then in

an almost dying condition, was out of all relation with the number who

applied in the early stages of what was then called “cholera infantum.”

This led me to inquire how far the law protected such little beings,

and how far institutions gave relief either to poor mothers by boarding

their offspring, or to foundlings. This brought me in contact with one

of the greatest philanthropists to these little creatures, namely, Miss

Matilda Goddard, who had at that time provided good homes for about

eight hundred infants, keeping a record as well as an oversight of them

all. No public provision existed save a few places in connection with a

Roman Catholic institution.

I therefore proposed to a few friends of mine the establishment of a

temporary asylum for infants, and an apartment for this purpose was

secured at the corner of Washington and Oak streets. Small as was this

beginning, we having about eight babies, it drew the attention of a

large number of philanthropists to the need of looking after these poor

beings. And then the Massachusetts Infant Asylum, as well as other

provisions for these dependents upon the Commonwealth, were called

into existence. The result was the saving of many a valuable life and

the directing of the attention of the benevolent to the absolute need

of watchfulness over those helpless beings who are at the mercy of

strangers during the first days or years of their lives.

The work at the college continued to be unsatisfactory to me, and the

year 1862, which was to become of such great importance to womankind in

general and to me in special, opened in the usual prosaic custom then

prevailing, namely, with every day filled with routine work.

However, I felt very excited, as well as very uncertain how to shape

my plans and prospects, for I had decided to leave the college and its

little hospital at the close of the term in March. I had communicated

my intention to the directors of the college at the close of the year

of my engagement, in June, 1861.

One of the most interested of the directors was Mr. Samuel E. Sewall.

He asked me what my reasons were for giving up the position, and I

replied in a letter to him of which I here make a copy:

About two years have passed since I became connected with the New

England Female Medical College. Twice I have signed the diplomas of

the graduating class, both times with reluctance and under protest.

My work as teacher in the college and as physician in the medical

department has not been performed with that ease which is the result

of a mutual understanding of all engaged in the same purpose, nor has

it given me satisfaction.

Not one of my expectations for a thorough medical education for women

has been realized; indeed, I could not even do what has been in my

power heretofore, namely, discountenance as physicians those women who

do not deserve that name. On the contrary, I am obliged by the resolve

of the majority to put my name to diplomas which justify the holders

in presenting themselves to the community as fitted to practice.

If it were the intention of the trustees to supply the country with

underbred, ill-educated women under the name of physicians in order

to force the regular schools of medicine to open their doors for the

few fitted to study, so as to bring an end to an institution from

which are poured forth indiscriminately “Doctors of Medicine,” I think

the New England Female Medical College is on the right track.

Allow me to say a few words about the school in justification of this.

To a critical observer, it will soon become apparent that the majority

of the class of students could be made to be only good nurses; whilst

some might become respectable midwives; and a very few, physicians.

Yet we have to give the diploma of “Doctor of Medicine” to all, after

they have passed the legal time in study.

After the first year of my work here had expired, I hoped to effect a

change by remonstrating in the faculty meeting against the admission

of all sorts of women, old and young, with and without common sense,

and the distribution of diplomas to them all.

But I found very little support, and I was told that it would be hard

to disappoint some women who had perseveringly labored for a diploma.

According to my ideas, which agree, I know, with the ideas of the

profession generally, perseverance alone does not entitle persons

to receive a diploma. Even should a disappointment prove to be a

deathblow to the student, it is better that one should die rather than

receive permission to kill many.

It will be perceived by you that these circumstances are not such

as to make success possible, and consequently they cannot make me

contented in my position. I therefore ask you to accept my resignation

as soon as the time expires for which I agreed to remain.

Knowing well how difficult it is to find a suitable professor for a

college for women, I thought it well to inform you of my intention

a full year in advance. Yet should you find a desirable person to

fill my place before that time, I wish you to remember that I shall

be thankful to be released from duties which are burdensome and

unsatisfactory in result.

I hope that you will not consider this an impulsive or rash step, and

in order to convince you of the deliberation with which I have made

this decision, and my firm determination not to alter it, I hope that

you will allow me an opportunity to state to you personally, more

fully, my views of the condition of the school under your patronage.

Respectfully,

MARIE E. ZAKRZEWSKA

Mr. Sewall gave me this opportunity, especially because as a lawyer

he wished to explain to me that this letter could not be presented to

the directors and trustees of the college, as it suggested many points

which would necessarily lead to legal investigations and which would

involve us all in a notoriety absolutely fatal to the whole cause.

Yet I felt that no malicious intent was in me to injure the school or

any one. I simply expressed my opinion and the opinion of professional

men outside the college, who would not countenance the school nor

assist me personally so long as my connection with it lasted.

But in consequence of Mr. Sewall’s opinion, I resigned at the end of

the college term without giving any other reason than that I felt not

contented in my position.

This led to many meetings of the trustees as a number of them were

anxious to retain my services, especially as the hospital department

depended so largely upon my superintendence. On the other hand, a

number, under the leadership of the secretary, Samuel Gregory (who had

already pronounced against such innovations as microscope, thermometer,

test tubes, etc., as proof of incapacity to recognize the ailments of

patients), tried to convince the others that “foreigners” are not fit

for American institutions, as they invariably are pedants and too rude

to treat the free American woman with that courtesy to which she is

accustomed.

Mr. Gregory brought proof of this declaration by calling before the

meetings several of the women students who were opposed to me because I

had frankly told them that they might in time become good nurses.

He also tried to convince the directors, who were in great financial

straits, that the school had existed for ten years without such an

expensive experiment as a hospital department, and that, by my leaving,

this would be discontinued as a matter of course.

Thus my resignation was finally accepted, with the request that I

relinquish my last year’s salary of three hundred dollars, as the

treasury was empty. I therefore became a benefactor to the college for

that sum, though the treasurer did not acknowledge it in his report.

Besides this, an agreement was entered into between the college

directors and my friends (who now more than ever wished to establish a

hospital for women, managed by women physicians, and for the training

of women as physicians and nurses) that all the furniture and fittings

of the hospital department of the New England Female Medical College

should become the property of these friends of mine for the sum of one

hundred and fifty dollars.

[The Annual Reports of the New England Female Medical College during

Dr. Zakrzewska’s connection with it, from September, 1860, to

September, 1862, show total expenses for the Clinical Department of

$5,362.97, and total receipts for the same department of $5,024.13,

making a total deficit of $338.84. But it must be remembered that Dr.

Zakrzewska’s connection with the department ended six months before the

date of the last report.

Dr. Zakrzewska’s forced “donation” of her salary for her third and last

year, of three hundred dollars, brought the deficit down to $38.84;

and the receipt of one hundred and fifty dollars from her friends as

purchase price of the furniture left a net profit in the hands of the

college of $111.16.

The last Annual Report contains not only the interesting omission

of acknowledgment of Dr. Zakrzewska’s donation of her three hundred

dollars salary, but also the interesting acknowledgment of “donations”

of one hundred dollars each from the two men professors who retired

from the faculty at the same time.]

The whole occurrence brought about a split in the college and the most

intelligent men, among whom was the Hon. S. E. Sewall and some of the

men professors, also resigned. This was the beginning of the end of the

college which, in 1874, was merged into the Boston University Medical

College by an act of legislation which preserved to women as full

rights as students as if they were in a college by themselves.

Thus it came about that Boston had a medical school for both sexes,

though this then became a homeopathic school.

Dr. James R. Chadwick, in an article (“The Study and Practice of

Medicine by Women”), in the _International Review_, October, 1879,

states that

“in 1874, while the proposition to transfer the New England Female

Medical College to Harvard University was under consideration by that

corporation, the trustees suddenly merged the college in the School of

Medicine of Boston University, which is under the exclusive control of

homeopaths.”

And he adds the following comment:

While this act may have involved no betrayal of trust in a legal

sense on the part of the trustees, it certainly was an indefensible

breach of trust toward those who had contributed funds to enable women

to obtain a medical education in accordance with the tenets of the

regular school.

During the three years of my life in Boston, from June, 1859, to 1862,

it was necessary to educate the laity to consider a woman doctor

a necessity in family life; to teach it that a woman can have the

endurance and fortitude of body and mind to meet the demands of the

profession, night or day, winter or summer, rain or shine. Also, to get

the profession accustomed to the thought that women will study and

practice medicine honorably and systematically. The attainment of these

ends was the real satisfaction of these first years.

Fortunately, the eyes of the laity were fully upon us and criticism was

not wanting. With watchful eagerness to grasp at the least mistake or

failure, this kind public kept us at the work.

PART II

(1862-1902)

CHAPTER XXVI

_A third American beginning--Founding of the New England Hospital

for Women and Children--Incorporation for threefold object, to

aid women as physicians, nurses and patients--Dr. Zakrzewska is

resident, attending and dispensary physician, and in charge of the

out-practice--Later, with the aid of paying guests, she is able to

establish her home separate from the Hospital--The charitable policy

of the Hospital. (1862-1863.)_

The quest approaches its goal. But the seeker knew it not, for she

writes:

In 1862, after disconnecting myself from the New England Female

Medical College in Boston, I stood alone once more, now for the third

time, and still at the beginning of my life’s work, as it appeared to

me. I was no longer needed in New York, yet nothing could I show as

the result of my eight years’ labor.

Standing there alone as she felt herself, her soul filled only with

the vision and her movements directed only towards following the

gleam, she was all unknowingly already bound to Boston by constraining

bands, the weaving of which she had shared with Clotho who spins, and

with Lachesis who allots. And around her was gathering the atmosphere

towards which her spirit had been yearning, an atmosphere made by

kindred souls who needed her for their life’s satisfaction as she

needed them for hers.

Many men and women had upheld the New England Female Medical College

because they felt called to assist in the evolution of medicine as a

field for _human_ endeavor rather than one forbidden to all but

male workers. When Marie E. Zakrzewska appeared, some of these men and

women realized that they had mistaken the light of the torchbearers

for the chariot radiance, and when she concluded to leave the college

they decided to go with her and to uphold the determination which she

expressed when she said:

“I decided to work again on the old plan, namely, to establish the

education of female students on sound principles, that is, to educate

them in hospitals.”

She continues:

Whoever is acquainted with the miraculous progress of medical science

made in Europe, and especially in Germany, will know how far behind

medical education in America had remained. This was chiefly owing

to the want of well-organized hospitals. Clinical training and

practical study can be had only at the bedside and in the deadhouse.

No pathological or physiological discovery can be made in a college,

behind the _cathedra_--it can only be proclaimed from this place.

Therefore the lecture room for the study of medicine had become

secondary to the hospital all over the continent of Europe, and our

best-educated young men and women were all longing to go to that

Eldorado of medical research and knowledge.

It was the lack of this method in all medical schools here which

we felt when starting the New York Infirmary, especially as the

few existing hospitals remained--and still remain for the most

part--closed to women students. It was our perception of this true

method for educating a physician that determined us to establish a

hospital prior to a college. We women decided to start from a sound

and correct foundation, and to this principle we owe the great success

so far attained, although it may appear small to those who now enter

upon the work.

Here let me remark that we willingly allow the newcomers to make their

criticisms of the present conditions; we admit the truth when it is

spoken, but we expect the newcomers to work as hard and to strive as

untiringly and perseveringly as we pioneers have done, to improve and

to complete what has been undertaken.

A few friends--Mr. George William Bond, Mrs. Ednah D. Cheney, and Miss

Lucy Goddard--true, firm friends of the education of women, stood

beside me, with no other ready means than some remnants of hospital

furniture, valued at one hundred and fifty dollars, which remained

from our experiment in connection with the New England Female Medical

College. On June 22, 1862, we hired, on our own responsibility, a

sunny, airy house with a large yard, located at No. 60, Pleasant

Street, corner of Porter Street, at a rent of six hundred dollars, and

here we commenced operations.

And thus was born the _New England Hospital for Women and

Children_, which began its work on July 1, 1862, a few men

physicians being willing to aid us by giving us their names as

consultants.

Other friends of women’s education soon joined us and became

directors. Among these Samuel E. Sewall, the old friend of the

college, and F. W. G. May, the ever-hopeful treasurer of a then empty

purse, gave us their indefatigable aid and unremitting interest.[8]

Thus in the midst of the Civil War we started our work. And many a

soldier’s family thanked us for so doing, for just then the darkest

days of the struggle gave us special opportunity to advise and comfort.

A Provisional Committee managed the new institution. Four of the

committee became responsible for the rent, and each of the ladies

pledged herself to obtain her proportion of the expenses from month to

month. As an example of the faith and courage of these supporters of

Dr. Zakrzewska, it is related that Mr. Bond met Mr. Abraham A. Call and

told him that a house on Pleasant Street had been rented for a hospital

but there was not a penny to pay the rent, whereupon Mr. Call handed

him a contribution of five dollars for that purpose and later became a

director of the Hospital, his daughter, Dr. Emma L. Call,[21] becoming

in time one of its leading physicians.

Meantime, Dr. Zakrzewska repeated the superhuman work which she had

already done at the New York Infirmary and again at the Clinical

Department of the New England Female Medical College--organizing

the details of the Hospital and Dispensary, serving as resident and

attending physician and responding to all calls in both out-patient and

private practice.[9]

The new institution began at once to grow and on March of the following

year (1863), it was incorporated, Miss Lucy Goddard and Mrs. Ednah D.

Cheney joining her as legal sponsors for the undertaking.

The name, the New England Hospital for Women and Children, was chosen

because Boston was considered as the center of this cluster of States

which seemed to have so generally the sentiments and relations of a

family group within the larger Union. But common usage has always been

to shorten the longer, detailed title and to call the institution

simply the New England Hospital, and by this latter title it has become

known all over the world.

The objects of the Hospital, as stated in the first by-laws, were

declared to be three:

1. To provide for women medical aid by competent physicians of their

own sex.

2. To assist educated women in the practical study of medicine.

3. To train nurses for the care of the sick.

During the first transitional year from 1862-1863, Dr. Zakrzewska’s

duties were again increased by the resignation of Dr. Breed as resident

physician, and this added care continued till September, 1863, when

Dr. Lucy E. Sewall returned from study in Europe and became the new

resident physician. As this year progressed the need for an attending

surgeon was felt and, as there appeared to be no sufficiently qualified

woman available, Dr. Horatio R. Storer was appointed.

This latter is the only instance in which a male physician has been

appointed on the attending staff of the New England Hospital. And this

cutting of the Gordian knot, which was made necessary by the lack of

opportunity for surgical training for women, is characteristic of Dr.

Zakrzewska’s attitude of mind. While her greatest interest was directed

toward developing women she was profoundly interested in all forms of

human activity, and she believed a balanced life required everywhere

the presence of both men and women. The New England Hospital was forced

to be limited to women physicians because all other hospitals denied

them entrance. Even when they were, later, grudgingly admitted to some

of these latter, it was only to the lower positions, and opportunities

for advancement were never, and are not to this day, equalized.

When the appointment of a resident physician no longer made it

necessary for her to live in the Hospital, though retaining her office

there, she rented a house in Roxbury and once more had the joy of

possessing a home of her own, sharing this with two of her sisters.

These were the youngest, who had been sent to her after her father’s

death, and another whom she was educating for self-support as a teacher.

However, as her financial condition was very precarious, she was

obliged to admit to her household as paying guests some friends and

patients. She thus found herself the head of quite an establishment,

and over this she presided with that executive ability and that

atmosphere of elder-sisterliness which we have already seen her

manifest in her first New York home.

The most notable members of this family circle were undoubtedly Miss

Julia A. Sprague, who became her faithful friend and home companion

for life, and Mr. and Mrs. Karl Heinzen. It is easy to understand how

such a personality as that of Karl Heinzen[10] would appeal to her,

especially as his name had been a household word in her home in Berlin.

She writes:

From early childhood I had heard of Karl Heinzen as the pioneer of

republicanism in Germany, whose writings my father read in secret.

He was very poor and he published a paper which was unpopular, as it

advocated not only the abolition of slavery but also “woman’s rights.”

Our friendship was, therefore, based not simply on affinity by nature

but also on principle; and we pledged ourselves to devote our strength

and our means to furthering the realization of our convictions.

This friendship lasted as long as Karl Heinzen lived (he died in

November, 1880) and its influence on both of these independent thinkers

was profound and far-reaching.

In addition to her other work she increased the Hospital funds by

lecturing to the public; some of her private patients furnished greatly

needed assistance by holding a Fair in Roxbury; and an especial service

was rendered by Miss Sprague who gave three months of her time to serve

as matron of the Hospital.

An item of interest is the contribution given by the trustees of the

Boston Lying-In Hospital who had at that time no hospital of their own.

During the years of 1861 and 1862 this body gave to the New England

Female Medical College donations of twenty dollars and fifty-one

dollars, respectively, these donations being contributions for the care

of obstetric patients in the Clinical Department under Dr. Zakrzewska’s

management. During this first year of the existence of the New England

Hospital (now become the only lying-in hospital in the city) the

donation was made to this hospital, and it reached the sum of two

hundred dollars.

Striking evidence of the growth of her work and of the faith of her

supporters is shown in the formation, already in this first year of

the life of the New England Hospital, of a Building Committee and the

beginning of a Permanent Fund, the birth of this latter being marked by

a donation of three thousand dollars from Mrs. George G. Lee and by one

of one thousand dollars from a friend of Samuel E. Sewall.

The charitable policy of the Hospital was one which presented

great practical difficulties of administration, difficulties which

have always fallen to the lot of every one who has attempted any

philanthropic work. The point of view adopted by Dr. Zakrzewska and

her director associates is admirably shown in the first annual report

(1863) and its appendices. It is especially to be noted here because of

attacks which were later made upon it, as we shall presently see.

CHAPTER XXVII

_Extracts from letters to her first Boston student, Dr. Lucy E.

Sewall, now studying in Europe--Lectures to public on “Hospitals:

their history, designs and needs.” (1863.)_

The daughter of Samuel E. Sewall became an enthusiastic admirer of Dr.

Zakrzewska during one of the visits which the latter made to Boston in

the interest of the New York Infirmary, and a close friendship between

them resulted. An amusing incident of their first meeting has been

related in an earlier chapter.

This friendship led to Lucy E. Sewall’s decision to study medicine

and she entered the New England Female Medical College as soon as Dr.

Zakrzewska became connected with it, in 1859. She remained a student

there during the entire three years that Dr. Zakrzewska continued on

the faculty, being assistant student in the Clinical Department, and

being graduated in March, 1862. Following the advice of Dr. Zakrzewska,

she then went to Europe for clinical study and for the practical

training which was denied her in her own country.

From the correspondence which ensued many interesting sidelights are

thrown on Dr. Zakrzewska’s personality and activities during these

days. Thus, she writes:

_October 16, 1862._

DEAR LUCY:

I suppose you want long letters and in order to meet this want I will

write as often as I find time, so as to fill the sheet as I go along.

After that forlorn day yesterday, I am established again as usual this

morning at the table writing.

Now let me tell you that I consider you one of the greatest

intriguants possible. You thought, I suppose, that you could catch

two flies in one beating by providing me with inkstand and pens. Of

course, I have to write if I have the materials; while the things will

not get used up in so doing, and will even be ornamental next year

after you have returned and we have an office together! But wait till

you do come home, and then see whether your speculation turns out as

you calculated.

I gave the match box and tumbler to Mr. and Mrs. Heinzen who were

greatly pleased with the little memento. Now this is all for one

morning, only let me assure you that you sha’n’t leave me again behind

you; or if you desire to do so, you shall not see me when you start.

* * * * *

_October 21._

I have had two letters now from Dr. Morton, the one I told you about

and one other, dated September 24, in which she spoke of her safe

arrival and of her terrible homesickness. She calls Paris a cold city.

She likes England very much and wants to hear from you, all about

yourself and your experiences.

... Minna writes pleasantly about her life and wants to hear from you,

too. I suppose I will have to send her your letter when you send me

one that I can send about.

... Dr. Cabot called here the other day. He was very pleasant and

accepted all as very good--arrangements as well as physicians and

students. I asked him about consultation in forceps cases. He said

it was not necessary to call him for such cases, as forceps when

skillfully applied were without danger to either mother or child. You

see, he rightly supposes we use the forceps “skillfully.”

The student, Miss Cook, has left for the Philadelphia college. I

really don’t know what else to write to you unless I tell you some of

my domestic affairs, namely, that I got, all in all, eight barrels of

pears and seven of apples; and I have any quantity of tomatoes pickled

and barberry jelly made.... On the 12th of November, we shall have

the Dress Party, which will be given by Miss Nichols in honor of Miss

Sprague’s birthday.

* * * * *

_Boston, Pleasant Street,

Saturday, November 29, at 9 P. M._

I am in Miss G.’s (the matron of the hospital) room, which is my

present abode during the nights. I have just arrived from the depot

where I left Mrs. ---- (one of her home patients) and Mrs. Heinzen,

who are going to New York. The first goes to see her son who is going

to the war, and the latter accompanies her for safety’s sake. They

both return day after to-morrow.

Before starting for Roxbury, I read your letter to the whole company

there. They all send love to you and say that it is Holiday when

your letters arrive.... We read all your letters, even those to your

father, and I assure you they are all much too short.

... Why don’t you tell me more about Miss B.’s nephew, or have you

decided on a compromise? You remember that I don’t want you to marry a

German, and your uncle forbids an Englishman; so you must try to find

one who combines all the good points of German, English and American.

... I was very much amused at your descriptions of the English

doctors. I hope they will be of use to you. What you say about

Dr. ---- and Dr. ---- is, I am afraid, correct, for they have at

times a special faculty for being haughty and making themselves as

disagreeable as anybody can do. I should like to hear more about it

because, from Mrs. ----’s expressions, I inferred the same. I am very

sorry that she has left London. I know her; she spent an evening with

me at the Infirmary and my acquaintance with her was interrupted by

another matter which took my attention.

... What kind of a bonnet did you buy? And why did you not complete

the last page of your letter by giving a description of it?

... There is no need to tell me not to forget to miss you. I am sure

I never missed any person more than I do you. I almost had it in my

heart to wish that you may not succeed in London and that you then

make a visit to Paris during the rest of the winter, and then go along

the River Seine and come home in June. I feel almost wicked to make

you homesick yet certainly I do feel provoked when you say that you

are not so; for I am homesick for you.

It is very strange how you have grown yourself into my heart. I never

before have felt such strong attachment for a woman, that is, so

“tenderly” strong. I have always appreciated and loved women more

intellectually. But you are my child. And I am going to have the

first grandbaby all to myself as my well-deserved property.

You see, I am not so very selfish. I want you to enjoy all happiness

that exists for us poor mortals--which is by no means in the single

life.

* * * * *

_Roxbury, Attic Room, Southeast Corner,

Sunday Night, 10:30._

I hope this is dated explanatorily enough to need no comments. But

where under this wet heavens are you? We have plenty of water from

above, have you still the same below you? I would almost envy you were

I not so cosily covered.

Henceforth, I fear we will have to pity you on Sundays in that pious

England. I can appreciate your loneliness, for I often have a taste of

it here on Sabbath evenings. For in spite of all the liberality of our

inmates, we have to be stupid Sunday nights to please them, and I am

always thankful when the day is over.

Mr. Heinzen said to-day that I am a great talker, and he is not so

very wrong, for it distresses me to see a whole company sitting

together doing nothing, saying nothing, and thinking nothing,

because it is Sunday and they can’t go to church, in order to hear

nothing--but words and phrases.

I often think I will make these latter myself, using innocent subjects

for the sake of conversation. The presence of people disturbs me and

prevents my thinking deeply, so I talk out what comes along. Have you

ever found me so very talkative--unless I am with people who don’t

interest me very much above a certain degree, say one above zero?

I hope this letter and the one I wrote to Miss Morton will not be

called belonging to this class. Still, I am writing to-night chiefly

to let out some steam. Some people will not do this and therefore

often burst when least desirable.

... My finger which became infected during the treatment of that

little Mrs. ---- is now progressing so that I do not fear future

trouble. It has been the most curious development of pathological

changes that you can imagine. I am sorry that you could not watch

nature in a small trouble and see her action in repairing damages.

Be careful of yourself for you know that at the time when my finger

became infected, it was apparently perfectly sound, yet there must

have been some point of entrance for the infection which followed. I

am glad that it proved to be so slight.

I have not been to see your father as I was so very busy, but I shall

go there to-morrow unless the storm continues too severely.

* * * * *

_Roxbury, December 28, 1862._

Merry Christmas and Happy New Year! I shall not tell you any more that

I miss you at any time, for I don’t, not a bit. On the contrary, I am

glad that you are gone.

I just read this paragraph to our parlor assembly and they wanted to

tear it up. Now, don’t you think that is quite a despotical sign of

our regiment here? I am sure I don’t want to write anything else, for

you shall not get too vain about yourself.

We, that is, myself and Mrs. ---- and Miss Sprague, as well as Mr. and

Mrs. Heinzen, feel quite proud of our little doctor in England, only

we feel as if that little M.D. should write a little oftener.

... Mrs. W---- has a splendid little girl of nine and one-half pounds.

She had a very hard time, thirty-six hours’ labor, and I finally

delivered her with forceps, Miss Tyng officiating as assistant. Mother

and child are doing well and send love to you.

Christmas was a very pleasant day and evening with us. We had the

parlors trimmed beautifully with laurel and holly, and when I came

home in the evening, I covered the chandeliers with wreaths.

Then we placed white cloths on the front parlor center table and on

another small one, and set plates on them with German gingerbread and

apples and nuts.

Returning from supper, we found large baskets and bundles which Santa

Claus had brought to the room and left for me to distribute.

So after each one had appropriated a plate, I called out the names,

and lots of handsome little things came out of the brown and white

papers, by and by covering the tables completely, so that the room

looked like a charming little fair, and we had ever so much fun, and

many funny things, and I only wish that you had been here, too.

Now, tell me how you are getting on in London, how your health is, how

much you are learning and how you spent Christmas.

I have been nonsensically busy, so much so that I am completely worn

out, and to-day I proposed that I go to London to bring you back for

the purpose of getting rested. Everything goes the same old, old way.

Miss ---- is with me but she stays in the same old place and, although

I like her very much, yet there is no mutual sympathy between us.

Lucy, never marry a man with whom you do not agree on all points! I

feel it more and more, the older I grow, that love grows stronger only

towards those with whom we sympathize; and that we become more and

more a burden to each other if we do not agree well. And although we

may avoid quarreling yet coldness is sometimes harder to bear than an

absolute quarrel. I feel all this with Miss ----, and yet she is far

more agreeable to me than a good many other of my acquaintances. I

really feel an attachment for her, perhaps for the very reason that I

feel we will not be obliged to be always together.

Miss ---- charged me with a great deal of love for you, and you may

help yourself to as much as you want.... On the 20th, I am giving

a lecture for our Hospital, at Chickering Hall, on the subject of

“Hospitals.” I shall let you know how it comes off.... Write soon and

put yourself into the letter, and I will send you back by the next

mail.

* * * * *

_Roxbury, January 25, 1863._

It is Sunday morning, and I am tired and worn out. I felt miserable

all last week, so miserable that I had to give up my work and my

lessons for the last three days and rest. Yesterday afternoon we all

went to the minstrels, and I am the only one who got used up by it.

I have had a great deal of practice this winter, more than is good for

me, yet I did not make so much money. People are all poor, everything

being now so dear.

Nevertheless, I am satisfied with my affairs if I can only keep strong

under the strain. My sister Anna is again quite sick, and Rosalie will

therefore come to live with me in April. Minna had everything arranged

to go to Paris in April or May, but now that gold gets higher every

day, she thinks she must give it up for another year. Would it not be

nice if she could arrive in Paris when you do? I wish gold would come

down again so that could come about.

Now, a few words as to the talk in England about a medical college for

women. Elizabeth Blackwell wrote to me about this as follows: “She

may get a great deal of valuable knowledge there, but I can judge far

better than she can of the value of their speeches. What they mean by

a ‘college’ is a school for a better class of midwives. To the broad,

true ground of admitting women to an equality in the profession, they

are stubbornly opposed; and they hold the power of exclusion entirely

in their own hands. The law in England makes medicine and surgery a

close corporation, very different from the freedom here.”

Miss Garrett seems to verify all this, and more. I know, myself,

that the same talk and the same help would be extended to you should

you go to Berlin. But all that means a different thing from native

women taking the same work, as a general thing. There are _some_

liberal men, to be sure, but they are so much in the minority that

their voices cannot even be heard.

The work for us is in America, and nowhere else. I therefore feel

extremely glad to find that some of the most prominent men in New York

have taken up the matter; they have published a circular asking the

public to give fifty thousand dollars which is to be invested, and the

interest of which is to go for scholarships in one of the great New

York medical schools, for the use of such women as are able to meet

all the demands for a preparatory education.

This is the best plan after all, both here and abroad, and the best

you can do is to learn all you can so as to come home well prepared to

enter the ranks as a practitioner. Every well-educated woman works

more for the cause of her fellow beings by doing well herself rather

than by meddling and trying constantly to help others. For the next

few years, I shall make this my working principle and after that, I

shall see what is best to be done next.

... You are very much mistaken if you think Vienna or Berlin better

than the Paris Maternité for real knowledge. For instance, in Berlin,

no student, not even a male, is permitted to perform “version” or do

anything in the way of an operation. In Paris, every midwife gets her

case of “version.”

In Vienna, only the male students get “versions.” And both there and

in Berlin the men take the places close to the beds and the women have

to stand on the outskirts; While in Paris no man stands in the woman’s

way.

... I felt very sorry that you were so homesick during the holidays. I

really missed you more than I ever missed anybody before. I hope you

will be at home next Christmas.

... I sent Miss ---- on Christmas Eve a little ivory bookmark,

beautifully cut, Swiss work; it can be used also as a paper cutter

though it is very weak.

... I am not seeing Miss ---- since she came home. I think my

friendship, or rather hers, is over, since she cannot convert me.

* * * * *

_Roxbury, February 20, 1863._

It seems to me an eternity since I wrote to you last, and the cause

of it is that I was very sick and unnaturally busy. I delivered my

lecture on January 20th. and the Hospital got some fifty dollars

profit.

I had been extraordinarily busy and had the house full of patients in

Roxbury. Besides, I was short of help at the Hospital which worried

me very much. The consequence was that I got really sick, gave up

practice entirely for a week, and when I did not get better, I packed

my bundle and went to New York on a “spree.” Now, is it not curious

that what we wanted to do for so long, namely, to take a journey

together, was realized with Miss ----. She volunteered to take care

of me, and consequently went with me and we had a real good time, at

least as far as I could have it, being really sick and blue.

Since then I am a little better, but not very well, and so busy that

I have had to disappoint Aunt Hannah three evenings, after I had

appointed the day to take tea with her and to spend a lively hour. Yet

I could not help it.

So much for myself! Next thing is the Hospital. Dr. Breed has resigned

her position, and I am therefore without a resident physician. Miss

Tyng takes charge in my absence, while Miss Abbott stands second.

She is resident student and also aids in the nursing. Miss Tyng is

splendid in all mechanical work, and together they are very helpful to

me.

As to a resident physician, I am authorized, and appointed a

committee, to ask “you” whether you will be willing to fill this post

after your return. In case you accept, we shall go on as at present,

and wait for you. Write me, therefore, at once what you think about it.

My great desire is that we shall have an office together. Now, I

do not like Pleasant Street at all, although it would not make any

difference to you where you begin practice. Perhaps we can find a more

suitable house for next fall. Ours is too small anyhow. However, this

must be left to the future.

So far, we are doing very well at the Hospital. And yesterday, Dr. H.

R. Storer called upon me and invited me to call upon him, as he is

anxious to extend colleague-ship to me. He was a student of Simpson,

in Edinburgh, and a classmate of Priestley, and he studied with Dr. B.

Brown. By the way, you must get certificates from all these men that

you studied with them, or that you visited their respective hospitals.

If it is nothing more than a simple recommendation, it will help you

amazingly over here, and also do good to the general cause of women

studying abroad. Therefore, try to get something written.

I shall go to see Dr. Storer next week and show him some of your

letters. I am sure you will find a good reception here, as I am

preparing the way for you somewhat among the physicians. I also read

some extracts from your letters in my lectures, reading especially

loudly the one where Dr. Brown introduced you as “Dr. Sewall from

America.”

... I will send you a Philadelphia catalogue next week, but I would

advise you not to encourage any students coming here at present. Dr.

Blackwell is trying very hard to make arrangements for women to enter

the New York University of Medicine. If she succeeds, it would be much

better for any woman to go there rather than to Philadelphia.

[The Female Medical College of Pennsylvania was still struggling for

existence against the bitter opposition of the men, and especially of

the Philadelphia Medical Society. It had at this time just reopened

after being obliged to close for the session of 1861-1862.]

Rather, let the English women fight their way in England. Don’t get

too much interested in the establishment of a woman’s college in

London. Dr. Blackwell is correct in her statement as to the position

women would occupy there in case they study separately from the men.

... I have not yet seen either your father or the books as I can

hardly find time for anything except my practice.

* * * * *

_Roxbury, May 7, 1863._

... I received your first letter from Paris on Saturday, May 2d. I am

very glad to hear of your success and hope you will profit by it. We

are going on beautifully here with our Hospital if only we had more

money.

... We had five days of incessant storm, and now it pours down like a

deluge. Spring has been very forward this season. Our cherries were in

bloom and we sat on the hill on April 13th. What did you do on your

birthday? We celebrated it by being out of doors all the morning and

wishing for you.... I went to New York again for about four days....

My health is tolerably good again, I think better than last spring....

Miss Sprague is now in Minna’s place, and she heads the Roxbury house

beautifully. I like her very much in this position, she takes such an

interest in the whole affair. Rosalie is with me now and acts quite

nicely as nurse.

I don’t mean to have many patients this summer; everything is so dear,

and besides it is a great burden. I would rather live by myself and

pay more for the comfort of having a free home than to make a little

profit.

... In the Hospital we are so busy that the back parlor is turned into

a ward for four beds.

... We have a fine Dispensary now--about one thousand patients this

year and an interesting Hospital. Next week we shall have one great

operation, and probably a second one.

Don’t be alarmed about my health. I am as well as usual, and I think

a little better than last spring. There are a good many things that

worry and trouble me besides my work, things which I cannot control,

and which have a good deal to do with my running down in health. At

present I feel quiet and happy.... I got a fresh supply of young

chickens this morning.... What buttons did you buy? I want to send you

the money very much.

Elsewhere Dr. Zakrzewska, in speaking of her lecture mentioned in one

of the preceding letters, says that the founding of the New England

Hospital had given rise to so many inquiries as to the need for

hospitals that she was requested to give a lecture on the “History,

designs and needs of hospitals” in general and of special hospitals in

particular. She also corrects the figures for receipts, later returns

showing a net profit of one hundred dollars, although the admission fee

was only twenty-five cents. She continues:

It is surprising how at that time hospitals were considered as places

for merely the poor and the wretched, or for the victims of accidents

in public streets or roads.

We had to cultivate the feeling that such enterprises were something

necessary and desirable, especially since the use of anesthetics and

the great improvement in surgical antisepsis have tended to make the

hospital the regular place for surgical treatment of the rich as well

as of the poor.

We had also to show the wisdom of isolation by the removal, even from

the houses of the rich, of the patient afflicted with a contagious

disease, in order to save the rest of the family as well as to offer a

greater chance of recovery to the patient.

CHAPTER XXVIII

_By resignation of the resident physician, Dr. Zakrzewska is

obliged to resume entire charge of Hospital and Dispensary and she

again shows symptoms of overfatigue and strain while awaiting Dr.

Sewall’s return from Europe to fill the vacant position--Illustrations

of the application of Dr. Zakrzewska’s humanitarian instincts and

intellectual convictions to the treatment of her patients, in

addition to technical medical care--“A Lesson”--“Another True Story.”

(1863.)_

As Dr. Sewall accepted the offer of the position of resident physician

at the Hospital, to take effect on her return from Europe in September,

Dr. Zakrzewska continued to fill the duties of this position both at

the Hospital and on the two added days in the Dispensary.

The most robust health and endurance have their limits, and she has

already been noted as giving many symptoms which showed that she

had been presuming on hers ever since the over-strenuous days of

establishing the New York Infirmary. Repeated notes of overfatigue and

strain creep into these letters to Dr. Sewall.

Specializing largely, as she did, in that branch of medicine

(obstetrics) which is most regardless of convenience and most

inconsiderate as to sleeping hours, she worked literally day and night.

And feeling the whole burden of responding to the demand for the

trained woman physician which she had so largely helped in awakening,

she refused no patients.

Her humanitarian instincts and her admirable ability to enter into the

feelings of her patients, and to recognize their limitations and their

struggles, prompted her to send no bills until they were asked for. She

writes:

If you could see my office day after day full of school-teachers,

dressmakers, mill operatives and domestics, all too proud to go to the

dispensary and yet not rich enough to pay a large fee, you would agree

with me that the prescription for good meat, wine or beer would be a

farce if I took the money with which they ought to buy these instead

of taking the small fee which allows them to keep their self-respect.

Not content with reducing her fees to a minimum or to zero, she always

added the constructive work which from her point of view belonged

within the province of her profession. This was not done by giving

charity regarding which she had definite and very modern views. She

writes:

It is not _Charity_ which we must cultivate and practice: it

is _Justice_ to one another. Charity is what an opiate is to a

patient: it soothes for the time but the same bad consequences result

as follow the drug. We must teach ourselves that the Golden Rule must

be actually practiced in order to reach and raise those who need to be

helped.

And again she emphasizes:

The Golden Rule must be practiced every day and not merely formulated

as a pious recital on Sunday.

Investigating the routine of the patient’s life, she would help her

to reorganize it along the lines of hygiene, of economics, and of a

balanced perspective; and then would follow a reëducation not only of

the patient but of the patient’s family and even friends. In this way,

her influence extended to the men of the family and of the community.

And these vied with the women in acknowledging their indebtedness to

what they called her “common sense.”

She depicts this aspect of her work so clearly in a couple of sketches

written in later years that they are inserted here to add to the

definiteness of the outlines of this phase of her history. The first of

these (_Souvenir of the New England Hospital Fair_, 1896) is:

A LESSON

_I will a round unvarnish’d tale deliver._--SHAKESPEARE.

Mary was the third child of five in a family in humble circumstances.

The father, an industrious journeyman carpenter, aided by the thrifty

mother, managed to keep all the children in attendance at the free

public schools of Boston until they graduated at the age of about

fifteen years. Soon after leaving school, Mary obtained a situation as

child’s nurse in the house of a rich family, with whom she remained

nine years in the varying capacity of nursemaid, chambermaid and

seamstress. She then married a journeyman plumber twenty-six years

of age, he being thus two years her senior. He had laid by from his

earnings a sum of money about equal to what Mary had saved from her

nine years’ wages, and these combined were amply sufficient to set

them up in respectable housekeeping in a neatly furnished tenement

having a kitchen, dining-room, living room and chamber, also a

storeroom and bathroom.

In due time, the baby made its appearance and found awaiting it a

handsome cradle, and a wardrobe not only comfortable but pretty and

plentiful. The young father with no small pride carried his son and

heir, arrayed in a white cashmere cloak and suitable belongings,

while by his side walked his prettily dressed wife, when on Sunday

afternoons they went to visit friends and relatives. Thus far, all was

well.

After the lapse of five years and a half, four little ones formed the

pride and the care of these young folks; and it was just seven years

from the time of their marriage that I first entered their home as

visiting doctor from the dispensary, the indigent being attended at

their homes when illness prevented their coming to the free dispensary

at the clinic hours.

I found the family of six living in two rooms heated by the kitchen

stove. The children were ill with scarlatina. All around was

the evidence of poverty, although not destitution nor degrading

squalor. By observation and subsequent inquiry, I soon learned the

cause of this changed condition. It was simply this--Mary, who

had gradually adapted herself with grace and intelligence to the

comforts of the rich house in which she had lived from her fifteenth

to her twenty-fourth year, could not now conform herself to the

smaller means and ways of living of a wife and mother in moderate

circumstances.

She had learned to cook delicate, expensive viands, had a sure belief

that tenderloin is the only steak fit for eating, and had great

skill in the pretty and dainty ornamentation of the babies. These

tastes which she acquired in the rich merchant’s family could not be

gratified with the workman’s means; she had unlearned the thrifty

habits among which she had lived as a schoolgirl in her parents’ home

and she became confused in her methods of work, while the steady

increase in her family reduced her in strength and added to her cares

and labors, a condition not inclined to promote the good temper of the

naturally amiable woman.

Ofter now, the husband, returning home from his work, found no table

laid for dinner, and still oftener must he start out early in the

morning to find a breakfast in a neighboring eating house, which is

always the first step towards finding rest and companionship in the

saloon.

This was the condition as it unfolded itself to me during my brief

attendance. The children recovered, and with the aid of cod-liver oil

and tonics provided by the charity of the dispensary, soon regained

full health.

A little more than a year passed when one day in October, 1876, Mary

presented herself in my private consulting room. She looked haggard

and pale, was poorly clad and in a desperate frame of mind. Her

husband had gone from bad to worse. He paid the rent for two shabby

small rooms in an old house and provided weekly the coal for the

kitchen stove. All the rest of his earnings he spent for his own

meals. Often, if he came home at all at night, it was in a state of

partial intoxication. Naturally, no firm dared give him regular

employment and he supported himself by odd jobs.

The poor woman had resorted to needlework for support, this being the

only means for her to earn money and look after her children, whom she

could not send to school for lack of shoes and decent clothing.

It was Friday afternoon. She had just carried her work to her employer

and received her pay of one dollar and sixty cents. She laid it on the

table before me and said, “This is all I with my four children shall

have to buy food with until next Friday--it is not enough to buy even

bread and tea and that is all we have lived upon for the last three

weeks.” She looked wan and hungry and cried bitterly. I sent for a

little luncheon, and while she ate it, I devised the following plan:

“Mrs. S----,” said I, “take this money and spend it as follows:

Buy 7 lbs. corned beef $0.35

21 ” potatoes .25

14 ” cabbage .28

7 ” Indian meal .21

1 qt. molasses .15

7 loaves bread .35

Salt .01

-----

$1.60

“Boil the meat in twelve quarts of water until very tender. Divide the

meat and broth in seven parts, also the potatoes and cabbage. Cook

one portion of cabbage and potatoes each day in the portion of broth.

Divide this stew into five equal parts for you and your four children.

Do the same with the Indian meal, cooking one part every morning.

Salt it well, and pour on it one-seventh part of the molasses--that is

for your breakfasts. Use one loaf of bread each day for supper. Come

again next Friday and let me know the result.”

She promised to follow this written prescription, and did so. The

ensuing Friday she again presented herself before me, looking less

distressed having earned $1.70. She said she “was glad to have done

so, as the children could eat more than the seventh part of the

purchase, and it was hard for her to eat it herself and deny the

children.” However, she had obeyed and was able to do more work

having earned ten cents more that week, although she and the children

“felt sorely the lack of tea.” I advised her to make a change in her

purchases, spending the same amount of money for a fresh shin of beef

and turnips or a salted shoulder of pork, and to use the ten cents for

extra molasses.

After two weeks, she came again to report to me. The change in her

appearance was remarkable, and her account of her children’s condition

was good. Also, she had been able to earn two dollars per week, which,

however, was the utmost she could do in the time she could spare from

the family work. At the end of another two weeks she came to me and

asked permission to give to her husband a share of the dinner on the

coming Sunday. He had smelled the stew when occasionally coming home

and desired to partake of it. It was therefore agreed that he should

add fifteen cents as his share for the cost of the dinner, which he

did, and when Christmas came, she told me had done so regularly every

day for the previous three weeks.

I made them a Christmas present of a piece of roasting beef, fifty

pounds weight of apples, and the same amount of potatoes, while

former friends to whom I had spoken of their destitution, sent tea,

sugar and milk, also shoes and stockings for the children.

After this sumptuous holiday feast, severely cold weather followed.

Careless housekeepers in all ranks of life allowed their water pipes

to burst, and great was the demand for plumbers’ work, especially in

the suburbs of Boston. Mary’s former friends were willing to employ

her husband again, under his promise of strict sobriety, as they would

not risk the danger of house-burning by the carelessness of a tipsy

plumber. Mary cooked him substantial dinners of the description given

above, and he felt like a man again in his home.

Being skillful as a workman and very obliging in disposition, he

gained friends while jobbing in the different houses. Those who had

known him before encouraged him to persevere and finally persuaded him

to remove to one of those suburban towns where his business would be

in good demand and where he would escape from the temptation of eating

house and drinking saloon. Meantime, Mary had learned good lessons

during these sixteen weeks. She now knew how to provide and cook good,

cheap and wholesome meals, and soon adapted herself entirely to such

ways and means as his earnings would provide.

It is now 1896, and the twenty years are completed since the beginning

of that time of misery in that family, who now own three houses, in

one of which Mary’s husband carries on a fine, thriving business, over

the entrance door of which may be read the sign “John Smith & Son.”

Another house is occupied by them as a dwelling, and the third, an

investment of their earnings, is rented to their daughter’s husband

who is foreman in their business.

Their life is simple and plain but comfortable, and when I met Mary

recently, she told me that she had taught all the children, two boys

and two girls, how to cook and how to mend clothes, and with great

pride she assured me that corned beef and cabbage is their favorite

dish, “although the children will often make ice cream for Sunday

dessert.”

The second sketch alluded to (_The Woman’s Journal_, May 13, 1893)

is:

ANOTHER TRUE STORY

Some years ago, the wife of a farmer living not many miles from Boston

came to my office to consult me, because she feared she was suffering

from a disease such as can only befall a woman and which she fully

believed was “killing her by inches.” With sunken cheeks, dull eyes,

sallow complexion, pale lips and no more flesh on her limbs than was

necessary to make locomotion possible, the woman sat there and told

of her ailments--sleeplessness, utter lack of appetite, backache,

depression of spirits, etc.

After listening and taking notes of her story of misery, I made a

careful examination and then told her that she was entirely free from

all disease, but that she was simply worn out and needed six months of

rest and good living.

She sighed deeply and said it was impossible to follow such a

prescription as their pecuniary means would not permit it. She said

further that their two children had outgrown the district school

of the town, and she had, with true Yankee ambition, persuaded her

husband to send them to a relative in the city that they might have

the advantage of came, she told me he had done so regularly every

extra dollar of their earnings, although from motives of economy, the

children spent Saturday and Sunday at home.

She said she felt sure a tonic would restore her appetite, and that

the relief to her mind in knowing that she was free from disease would

aid in curing her. So, carrying in her hand the valuable recipe for a

tonic which might or might not be of use, she left me, promising to

report herself in ten days.

At the end of that time she appeared, looking more dejected and

forlorn than at her first visit, so much so that I was startled, and

thought that I had made a mistake in my diagnosis as well as in my

prognosis. With sobs, she informed me that a great misfortune had

befallen them. This statement at once explained to me her appearance.

It was at the time when the first Jersey cows were imported into this

country from England, and they were held at a great price. She told

me that her husband, about six months before, had invested all the

money they had in the savings bank in the purchase of one of those

valuable creatures. On the day following the woman’s visit to me,

this precious cow had begun to be ailing. The trouble increasing, a

veterinary surgeon had been consulted, and he told them if they would

save the health and life of the cow, they must procure a faithful,

intelligent man to take charge of her from morning to night. This sad

event made it necessary for them to take for attendance on the cow the

services of their best hired man, while the hiring of another man in

his place would prevent their expending money for the charwoman who

gave the good farmer’s wife an occasional lift with the housework. She

sobbingly ended her story by saying, “I must work even harder than a

week ago--you must give me a stronger tonic.”

The case looked so sad and hopeless that I sat silently thinking for

a moment, when suddenly a bright thought sprang into my mind, and I

said, “Why don’t _you_ nurse that cow and let the charwoman do

your work in house, kitchen and dairy?”

As when a sunbeam bursts through heavy black clouds, so did a light

flash over her face and into her eyes as I said these words; but in

a moment it darkened down again as she began to think of all the

objections to such a plan. But the idea was born; it grew; and with my

vivid power of imagination, I overthrew all her objections one after

another, until her conversation became really animated, and the plan

appeared so plausible to both of us that the good woman went out of

the office with no stronger tonic than hope and courage can bestow.

The whole affair was forgotten by me in the pressure of business

and in listening to more stories of moral and physical misery. The

summer with all its joy and beauty slipped away, and brilliant October

brought a new flood of professional business and cares.

On one of these autumn days, a plump, sunburnt, cheerful-faced woman

entered my sanctum, holding in one hand a huge bouquet of gorgeous

dahlias, in the other a little jar of cream, and on her arm hung a

small basket with a dozen fresh eggs.

“Don’t you remember me?” she said. Of course I did not, although the

voice was familiar.

“Well, I am Mrs. F----, whom you advised to nurse her cow.”

I could hardly believe my eyes, even after her repeated assurances

of her identity with that miserable wreck of the May before. She gave

me an animated description of what followed her leaving my office;

of all her doubts and misgivings during her journey home as to what

her husband would say to such a proposition for both a sick wife and

a sick cow; and of how she had timidly introduced the subject to him

by telling him that I was a queer doctor who did not believe much in

medicine.

All this prepared him for the account of my plan to which contrary to

his usual habit when women proposed anything, he listened gravely, and

then said thoughtfully, “Well, my dear, we might try it.” She at once

called in the charwoman who had supplied her place that day and made

arrangements with her to come daily.

The next morning she went to the field, with her rubber waterproof,

her husband and the cow. The latter was tied to a stake, and my

patient seated herself near on the waterproof (as I had suggested

to her) while she watched the cow and petted and talked to her. The

two took kindly to each other. One day’s experiment proved that she

could keep the cow in such subjection and quietness as the surgeon had

ordered, plucking the fresh grass for her and feeding her as needed.

All went well. Let me give a part of her story in her own words:

“My husband was satisfied with the first day’s result, and made the

few arrangements necessary. And you, Doctor, ought to have seen me as

at sunrise, day after day, rain or shine, I walked to the pasture,

with a big basket on my right arm full of my mending work; in my right

hand a large white umbrella which my husband had bought for me; and in

my left hand the rope to which my bossy was tied, and which, by the

way, I did not need after a fortnight, she following me at my call

and lying close beside me when not walking a few steps for a bite of

the rich grass.

“My charwoman brought me all my meals and a pail of water for bossy.

I soon had a keen appetite, almost impossible to satisfy; even the

abundant provisions brought me and eagerly eaten with such good relish

still seemed to leave a hollow unfilled; and after my walk home at

sundown, I slept sweetly as I had not done for months.

“The cow got well; she is now followed by a strong, beautiful heifer

six weeks old for which my husband has already had an offer of just

half the money that he paid for the cow. And I--I feel strong, well

and happy, can do all my work, and have taken none of the tonic.

Besides all this, both my children are equally well, because when they

came home for their weekly sojourn, they felt that they must spend

Saturday and Sunday out in the field with poor mother who had no other

diversion than the company of a cow. I really believe that their being

with me out of doors has done them more good than they would have got

from the change we had planned for vacation, a visit to relatives up

in the mountains.

“So I thought I had better come and tell you of all the good you have

done to our whole family by your excellent advice, although it seemed

so queer to us all and, you may well believe, to our neighbors too.”

“How many months did you do this?” I asked. “Was it not tedious to be

all day in such dull company?”

“I did this same thing,” she replied, “every day, from the time that

I left you until the calf was three days old. And as for tediousness

or loneliness, I never felt it, for I have done a heap of sewing,

old and new, which had been accumulating during the past year when I

could not sew because I was so miserable. Besides, I always took some

reading matter with me, especially on rainy days when I could not

use my needle. And as my bossy liked to have me talk to her, I read

aloud the Boston _Journal_ and our town paper. These she seemed

to enjoy as much as my chatting with her, even when it came to the

obituaries, death notices and quack medicine advertisements.”

She assured me that she had not had a single cold, although she had

several times been drenched by thunder showers that had overtaken her

when she was unprotected. She said also that she had learned the great

lesson of the folly of carrying self-neglect and self-sacrifice to

such an extent as to bring trouble not only on one’s self but also on

all the family.

If this little tale should be read by the family described, I wish one

of them would send name and address (which I have no right to betray)

to the _Woman’s Journal_.

CHAPTER XXIX

_Question of escort in night practice--Expansion of Hospital

by purchase of four houses on Warren (Warrenton) and Pleasant

streets--Professional recognition slowly growing--She buys a horse

and buggy--For first time in America the name of a woman is listed

officially as specializing in surgery, Dr. Anita E. Tyng being

appointed assistant surgeon--Resignation of the consulting surgeon

(Dr. Samuel Cabot) and the attending surgeon (Dr. Horatio R. Storer),

the latter the only man ever appointed on the attending staff--Dr.

Cabot continues to act unofficially. (1863-1866.)_

Boston had already extended itself in all directions into suburbs

which still kept their dependence upon the center, but the means

of communication remained primitive, as already described in the

out-patient work which Dr. Zakrzewska established at the New England

Female Medical College. And the isolation was most complete at night,

the hour when the cry of suffering humanity rings most insistent.

So the Doctor was obliged to walk long distances to answer the calls

of those patients who could not afford to send a carriage for her. Her

familiar itinerary was from Roxbury to South Boston, to Dorchester, to

West Roxbury, to Brookline, to Cambridge, and so around the circle.

Temperatures of all degrees from below zero to up in the nineties were

never allowed to discourage her.

As in New York, she was unmolested in her travels. But she never took

unnecessary risks. She always went with the messenger who called her,

and who was generally a man. She writes:

If he could not accompany me on my return home in the night, and no

accommodation for me was possible in the little apartment, I walked

with the policeman, and waited at the end of the different beats for

the next one to take me to his limits. I was well known among them,

and was not at all surprised when a Franklin Park policeman recently

accosted me as a friend well remembered in the night walks of former

years.

The second year (1863-1864) of the existence of the New England

Hospital, and of this phase of Dr. Zakrzewska’s life, was marked

by such increased growth of the institution that it was decided to

purchase the former residence of Rev. Charles F. Barnard, No. 14 Warren

Street (later Warrenton Street), to add to it three small dwelling

houses in its rear (Nos. 13, 15, 17 Pleasant Street), and to connect

them by a covered passage. The large house was described as “well built

and convenient, airy and sunny, with a pleasant outlook on the Chapel

yard and greenhouse” (p. 331). It seemed prudent to continue to lease

two of the Pleasant Street houses to tenants but even so the increase

in accommodations was marked.

The result of this expansion [says Dr. Zakrzewska] was enabling us not

only to enlarge our work, but also to divide it into three distinct

departments--Hospital for medical and surgical cases; Lying-in

Department and Dispensary.

Had our work not been wanted [she continues], had our help not been

needed, here and throughout the country, we should not have found so

many patients asking for help and advice; nor have had so long a list

of names of students waiting for a vacancy; nor have met with that

response from the community which provided the means for carrying on

our institution and enabling us to enlarge it.

Professional recognition was slowly growing, but even slight advances

helped to lighten the almost overpowering mental strain of isolation.

In such conditions, every slight word or act of indorsement, even

though with reservations, was like a ray of hope that at last the dawn

was breaking.

Referring to this period of professional loneliness, Dr. Zakrzewska

writes in a letter to the editor in 1900:

In looking over these reports, there come back to me the many hours of

fear and anxiety when I really was the only person who stood before

the world responsible for our work in the Hospital.

The few brave men who supported my efforts were advanced in years and

had a large practice; they were often not available for consultation

when requested to come, or they came too late, when the danger was

over or had ended in death.

My co-workers were young and inexperienced, looking up to me for

wisdom and instruction, while the public in general watched with

scrupulous zeal in order to stand ready for condemnation; this zeal

being stimulated by the profession at large who wanted to find

fault but did not dare to do so openly so long as the two or three

professional men stood as a moral force behind me.

I remember how twice--once in New York and once in Boston--a man

colleague told me I was foolish to take to heart the death of a

patient which I saw coming as a natural event. Such consolations

helped to uphold me.

[Illustration: THE NEW ENGLAND HOSPITAL FOR WOMEN AND CHILDREN

This hospital was first housed in a dwelling house on Pleasant Street

further along than the rear houses here seen (1862-1864). This was

soon outgrown in favor of the one front and three rear houses here

shown or indicated (1864-1872).]

This professional loneliness must have been peculiarly poignant to her,

since it contrasted so painfully with her recollections of the cordial

fellowship which she had enjoyed with Dr. Schmidt and other leading

medical men in Berlin.

An appeal issued by the directors in June, 1864, asking for funds for

the purchase of the new buildings, contains a letter by Dr. Horatio R.

Storer giving cogent reasons for the desirability of a special hospital

for women and noting the particular conditions which made the New

England Hospital peculiarly suitable for such purpose. This appeal was

signed also by Drs. Walter Channing, C. G. Putnam, Henry I. Bowditch,

and S. Cabot.

And about this time, Dr. Walter Channing writes to Dr. Zakrzewska:

I regret I had not made my visit later as I was too early to have the

pleasure of seeing you. I was desirous to do so to express to you

my entire satisfaction in regard to the operation you performed the

evening before. It was a very difficult operation and was done under

circumstances most unpromising of success. I do not think it could

have been done better.

I write also to say that if at any time I can do anything to aid you

in the performance of your important duties, I shall be always ready

and happy to do so.

Very respectfully & truly yrs.,

WALTER CHANNING.

_Boston, 39 Mt. Vernon Street,

June 2, 1864._

Remembering the financial difficulties of both Dr. Zakrzewska herself

and this young, struggling enterprise of hers, one may well wonder at

the second annual report (1863-1864) stating:

Half of our beds are always filled by patients who pay nothing, and

the resident physician has the right to receive at half price those

whose circumstances require this indulgence.

And realizing how the prices of the necessities of life must have

advanced with the continuance of the Civil War, one is not surprised to

read elsewhere:

We have been reluctantly forced to double our price of board, placing

it at eight dollars per week.

The third year (1864-1865) of Dr. Zakrzewska’s new life of freedom,

of the longed-for opportunity for expressing her ideals, and of the

attaining of sympathy and support for the forms of such expression,

found the Hospital continuing its growth, like a manifestation

incarnate of her soaring spirit.

This growth compelled the addition, with alterations, of the remaining

two houses on Pleasant Street; and the housewarming which dedicated

this further enlargement of its opportunities netted a precious six

hundred dollars.

The Legislature of Massachusetts now voted the Hospital five thousand

dollars for the purchase of the new site, on condition that a similar

amount should be raised by subscription. And the Boston Lying-in

Hospital Corporation increased its donation to one thousand dollars.

For the first time Dr. Zakrzewska, as attending physician, presented

to the board of directors a formal report which she thus introduces:

Before this year I had never considered that a lengthy report given

by me was a necessity. Hitherto our Hospital had been so small and

so simple in its management that it was easily understood by the

directors and friends.

This is now changed: for after four years of exertion the Hospital

has assumed from a simple ward the form of a complicated institution,

with its resident and assistant physicians, its consulting, attending

and assistant surgeons, and its attending and consulting physicians.

Such an institution must necessarily attract the attention of the

community; therefore inquiries are constantly being made as to how

this institution is carried on. Nothing can answer all these different

inquiries better than a minute report.

The most striking feature in its character is that it is designed to

give to educated medical women an equal chance with their professional

brethren to prove their capacity as hospital physicians, and to admit

only female students to its wards--all other hospitals closing their

doors to women as physicians and students.

The increase in the number of patients seeking daily advice soon gave

a reputation to the institution, and the liberally inclined part of

the community as well as of the profession began to look upon it as a

test of female capability in professional life.

In this report Dr. Zakrzewska notes that the increase in the number

of patients had become so great that Dr. Storer offered to share the

dispensary work with her and Dr. Sewall, taking two mornings a week

and making an even division of the time.

Referring to the raising of the question as to whether it is not an

inconsistency to have a gentleman in attendance, as it has always

been stated that the advantage of our Dispensary is that women can be

attended by physicians of their own sex, she continues:

In reply to this, I can only say that there is a distinct notice given

on the Dispensary cards as well as in the waiting room, when Dr.

Sewall or I, or when Dr. Storer is in attendance, so that patients can

have their choice.

Interesting features of the annual meeting of the Hospital for this

year and of a levee which followed it, were an address by Dr. Elizabeth

Blackwell on “The Culture Necessary for a Physician,” and a reading of

some charming poems by Mrs. Julia Ward Howe.

Hand in hand with the growth of Dr. Zakrzewska’s Hospital work

progressed the growth of her private practice. And the year 1865 was

notable in that for the first time she felt able to set up a carriage

in proper medical style. She thus describes this felicitous occurrence:

In 1865, I bought a second-hand buggy and a horse for two reasons: one

was that I could not accomplish and do justice to my professional work

by using public conveyances; the other, that it became a matter of

necessity to uphold the professional etiquette and dignity of a woman

physician on equality with men. The effect was marvelous. Even the

newspapers took notice of the change.

At the Hospital further advance was made by the creation of the staff

position of assistant surgeon, Dr. Anita E. Tyng[11] receiving the

appointment. Thus for the first time in America the name of a woman

is listed officially as specializing in surgery. This year was also

notable for the addition of a second consulting physician, Dr. Henry I.

Bowditch accepting election.

Dr. Henry I. Bowditch was always an earnest supporter of the education

of women as physicians. He befriended Dr. Harriot K. Hunt and Dr.

Nancy Clark, and then Dr. Zakrzewska herself when the latter came to

Boston in 1856 soliciting money for opening the New York Infirmary.

He remained the steadfast champion of medical women and continued as

consulting physician to the New England Hospital until his death in

1892.

Dr. Zakrzewska realized the necessity of having on the consulting

staff of the Hospital men physicians of the highest standing in the

profession, such men serving as vouchers to the community for the

medical women and their hospital.

But aside from this vital consideration she also believed that the best

results follow when men and women work together. In this conviction she

was ably supported by Dr. Henry I. Bowditch, who wrote to her at one

time:

In regard to having a full corps of well-known experts, male and

female, connected with the hospital, I still have no doubt. As I think

there should be women physicians and surgeons in the other hospitals,

so I think it important for the fullest success to have a joint

corps at the women’s hospital. Also, I cannot but think it would be

beneficial pecuniarily to all the hospitals if such arrangements were

made.

Indeed, Dr. Bowditch was prepared to go even further, for in another

letter he expresses the opinion that all three hospitals--the New

England, the Massachusetts General and the City, should throw open

their clinical instruction to both men and women. Though he was still

conservative enough to advise that the clinics should be held at

different hours for the two sexes.

In spite of the increasing support given the Hospital, its financial

situation continued to cause anxiety. This was due to the need for

paying for the four buildings purchased, to the increased expenses of

the expanded institution, and to the disproportionately large amount of

service given free or at only nominal rates.

The acuteness of the problem continued to increase and in the following

year (1865-1866), although the mortgages had been paid off and the

general debt reduced, the institution was unable to pay its current

expenses.

To meet this situation a more conservative course was felt to be

imperative, and it was decided, except in Maternity cases, temporarily

to discontinue receiving any patients at a reduced rate except in the

free beds, those which were endowed or definitely subscribed for.

Dr. Tyng continued as assistant surgeon, and her progress was so

satisfactory that Dr. Storer writes:

During July and August, I shall be able to visit the Hospital only

on Saturdays. During my absence, I wish Dr. Tyng, in accordance with

her duties as assistant surgeon, to take my place as concerns both

the Dispensary and the Surgical Wards. Of course, operations of any

magnitude will be reserved until the days of my attendance.

In the midst of this peaceful development and orderly progress, clouds

suddenly gathered and a tempest broke forth, with much lightning

though with little thunder. This was followed by the clearing of the

air characteristic of the passing of tempests in this latitude but,

as sometimes happens, a marked change in the local landscape was the

result.

The storm center seems to have been Dr. Storer. It is often difficult

to explain misunderstandings and disagreements. Frequently, no one

person seems to be definitely responsible. Electric conditions develop

from many causes; minor frictions occur; an accident produces a spark;

and an explosion follows.

Dr. Storer was connected with the Boston Lying-in Hospital before that

institution suspended operation. He later became connected with the New

England Hospital as already related, beginning then to specialize in

the diseases of women. He worked assiduously in his department, and he

accepted the letter of his obligations to the Hospital.

Subsequent history shows that this acceptance did not include the

convictions of the spirit. Perhaps a psychoanalyst of to-day would

trace the ultimate explosion to the “complex” resulting from conflict

between this letter and spirit.

Or, perhaps (as suggested by the primary resignation of Dr. Cabot) it

was a technical disagreement as to the limits of the respective domains

of attending and consulting staffs--always a subject filled with

delicate potentialities.

Or, perhaps, as claimed by Dr. Mary Putnam-Jacobi (_Woman’s Work

in America_, published in 1891), a most careful and conscientious

observer with the true scientific spirit, it was because the successful

outcome of Dr. Storer’s operations fell too often below the boldness

of his conceptions of them. (Dr. Sewall in this year says in her

report as resident physician, “Only three deaths have occurred among

our patients, and all these took place in the surgical wards after

hazardous operations.”)

Be the explanations--one or all--as they may, the first outward

manifestation of the storm was the receipt by the board of directors of

the following letter from Dr. Samuel Cabot, the early and long-tried

friend of the Hospital who had from the beginning served as consulting

surgeon:

_Boston, June 2, 1866._

_To the Board of Directors of the New England Hospital For Women and

Children._

LADIES AND GENTLEMEN:

Feeling as I do the very warmest interest in the cause of female

education and advancement, and believing as I do that the path of

medicine and surgery, as well as every other path to honor and profit,

should be open to women as well as to men--still, I feel constrained

to send you my resignation of the office of Consulting Surgeon to

the New England Hospital for Women and Children with which you have

honored me, and to request you at your earliest convenience to accept

it and to appoint my successor.

I cannot enter into any explanation of my reasons for this step, and

can only ask you to believe that it is from no loss of interest in

the cause you represent nor from any dissatisfaction with the ladies

connected with the Hospital.

Very respectfully

Your obedient servant,

S. CABOT.

This resignation was accepted with great regret when after consultation

it was found to be irrevocable.

This letter having brought the subject of consulting physicians to

the attention of the directors, after much thought and inquiry the

following preamble and resolutions were unanimously passed at their

regular meeting on August 13:

WHEREAS, the confidence of the public in the management of

the Hospital rests not only on the character of the medical attendants

having its immediate charge but also on the high reputation of its

Consulting Physicians and Surgeons, and

WHEREAS, we cannot allow them to be responsible for cases

over which they have no control, therefore,

_Resolved_, that in all unusual or difficult cases in medicine,

or where a capital operation in surgery is proposed, the Attending

and Resident Physicians and Surgeons shall hold mutual consultation,

and if any one of them shall have doubt as to the propriety of the

proposed treatment or operation, one or more of the Consulting

Physicians or Surgeons shall be invited to examine and decide upon

the case.

_Voted_, that a copy of this resolve be sent to all medical

officers connected with this Hospital

On September 10, the board of directors received from Dr. Storer a

letter containing his resignation as attending surgeon, and on this

letter the report comments, “Its tenor left the Board no alternative

but its acceptance, which was unanimously voted.”

The report then continues,