the venerable president, the distinguished Dr. Stillé, Dr. Hartshorne’s
motion was lost, and the whole subject laid on the table without a vote.
This, however, seems to have been the last occasion on which the matter
was discussed. For in 1876, when the Association met in Philadelphia,
Dr. Marion Sims being president, a woman delegate appeared, sent by the
Illinois State Medical Society, Dr. Sarah Hackett Stevenson, of Chicago.
Dr. Brodie, of Detroit, moved that hers, “and all such names, be
referred to the Judicial Council.” A motion that this resolution be laid
upon the table was carried by a large vote, amid considerable applause.
The president asked if this vote was intended to recognize Dr.
Stevenson’s right to a seat. Loud cries of yes, and cheers, emphatically
answered the question.[104] Thus this mighty question, which had
disturbed the scientific calm of so many medical meetings, was at last
settled by acclamation. The following year at Chicago, Dr. Bowditch of
Boston, being president, congratulated the Association in his inaugural
address that women physicians had been invited to assist at the
deliberations.
The State Medical Society of Pennsylvania, where the discussion
originated, did not really wait for the action of the National
Association to rescind its original resolution of 1860. This did not
refer to the admission of women as members, that was not even
considered, but forbade “professional intercourse with the professors or
graduates of female medical colleges.” In 1871, when the Society met at
Williamsport, Dr. Traill Green moved to rescind this resolution, and,
“amid intense but quiet excitement,” the motion was carried by a vote of
55 yeas to 45 nays.
“Thus,” writes the now venerable champion of the women, Dr. Hiram
Corson, “ended successfully the movement originated by Montgomery
County, to blot from the transactions of the State Society a selfish,
odious resolution adopted eleven years before.... This report gives but
the faintest idea of the bitterness of the contest, of the scorn with
which the proceedings of the Montgomery County were received, and the
unkindness manifested against all who from year to year asked for
justice to women physicians.... What would now be their status, had not
the blunder of the Philadelphia Medical Society been committed?”[105] In
1881, the first woman delegate was admitted as member of the State
Society; and in 1888, the Philadelphia County Society also yielded, and
admitted its first woman member, Dr. Mary Willets.[106]
Pennsylvania was not the first State to admit women to medical
societies. It has been mentioned that the American Association, at its
Centennial year meeting, received Dr. Sarah Stevenson from the Illinois
State Medical Society. But, earlier than this, women had been received
in New York State and city. The very first occasion was 1869, when the
Drs. Blackwell were accepted as members of a voluntary “Medical Library
and Journal Association,” which held monthly meetings for hearing papers
on medical subjects read by its members.[107] In 1872, a paper was read
before this society by a young lady who had just returned from France
with a medical diploma, the first ever granted to an American woman from
the Paris _École de Médecine_.[108] In 1873, Dr. Putnam was admitted
without discussion to the Medical Society of New York county, at the
suggestion of Dr. Jacobi the president, whom she married a few months
later. In 1874 she was sent as a delegate from the County Society to the
State Medical Society, at its annual meeting at Albany. She also became
a member of the Pathological, Neurological and Therapeutical societies,
but was excluded from the Obstetrical Society by means of blackballs,
although her paper as candidate was accepted by the committee on
membership, and she received a majority vote. Finally, and a few years
later, she was elected, though by the close majority of one, to
membership in the New York Academy of Medicine.
The facile admission of Dr. Putnam to these various privileges, in New
York, at a time that the propriety of female “recognition” was still
being so hotly disputed in other cities, was due partly to the
previously acquired honor of the Paris diploma;[109] partly to the
influence of Dr. Jacobi. This physician may be said to have accomplished
for women in New York what was done in Philadelphia by Drs. Hartshorne,
Atlee, Stillé, and Thomas; in Boston by Drs. Bowditch, Cabot, Putnam,
and Chadwick; in Chicago by Dr. Byford. The door was opened, other women
entered without difficulty. The County Medical Society was expected to
register all regular and reputable practitioners in the city, and at the
present date contains the names of 48 regular physicians.
Four other women became members of the Pathological Society,[110] two of
the Neurological Society,[111] one of the Neurological Association,[112]
and two of the Academy of Medicine.[113] No new application has been
made to the Obstetrical Society, a private club. But the obstetrical
section of the Academy contains one female member.[114]
In Boston the “admission” of women was debated in three directions: to
the Harvard Medical School, to the Massachusetts State Medical Society,
and to the Boston City Hospital. The application of Miss Hunt to the
Harvard Medical School in 1847 and 1850 have already been described.
After the final discomfiture of this first applicant, no other attempt
to open the college doors was made until 1879,[115] when a Boston lady,
Miss Marian Hovey, offered to give $10,000 toward the new building the
college was about to erect on condition that it should receive women
among its students. A committee was appointed from among the overseers
of the university to consider the proposition;[116] and after a year’s
consideration reported, with one dissenting voice, in favor of accepting
the conditions. The committee outlined a plan for medical co-education,
substantially like that already adopted at the Michigan University,
where certain parts of the instruction should be given to both sexes in
common; for others, where embarrassment might occur, the instructions
should be duplicated. The one dissenting voice, that of Le Baron
Russell, disapproved of co-education in any shape, but urged that
Harvard University should charge itself with providing a suitable
independent school for women.
The majority report expressly advised against the establishment of a
separate school for women because “A considerable number of the most
highly cultivated women physicians of the country state that the same
intellectual standard cannot be maintained in a school devoted to women
alone, and that the intellectual stimulus obtained by female students
from their association with men is an all-important element of
success.”[117]
To guide its deliberations the committee had sent questions to 1300
members of the State Medical Society, to which 712 answers were
received; of these 550 were in favor either of admitting women to the
school, or of providing in some way for their education and recognition.
These answers helped to decide the affirmative character of the majority
report. Upon its reception, the Board of Overseers recommended the
Medical Faculty to accept Miss Hovey’s $10,000 and admit women to the
school. But of the 21 members of the Medical Faculty, seven were
strongly opposed to the admission of women, six were in favor of
admitting them under certain restrictions, eight were more or less
opposed but were willing to try the experiment. It was generally
considered too rash an experiment to be tried, at the moment that the
school was already embarked on certain improvements in its course of
education, which threatened to cause a falling off in the number of its
students. So the proposition was finally rejected by a vote of 14 to 4.
The overseers of the university, having no actual control over the
decisions of the Medical Faculty, were therefore compelled to decline
Miss Hovey’s offer. But, in doing so, they strongly recommended as
expedient that, “under suitable restrictions, women should be instructed
in medicine by Harvard University.”
The defeat at Harvard in May was, however, followed by a triumph in
another direction in October of the same year. On Oct. 9, 1879, an
editorial in the _Boston Medical and Surgical Journal_ says: “We regret
to be obliged to announce that, at a meeting of the councilors held Oct.
1, it was voted to admit women to the Massachusetts Medical Society.”
This society is not, like that of New York and many of the States,
composed of delegates from county societies, but it comprises, and
indeed consists of, all the legally qualified practitioners of the
State. Refusal to enroll women among its members, therefore, meant a
refusal to recognize the legality of diplomas that the authority of the
State had conferred. The profession, therefore, in this matter
deliberately set itself above the law, a most exceptional act in
American communities. A precedent for such action had previously been
established when the society refused to recognize homœopathic and
eclectic physicians, who also held diplomas by legal authority, inasmuch
as their schools were chartered by the State. The action of the Medical
Society towards women was, in fact, intended as a means of permanently
relegating women among classes of practitioners pronounced inferior and
unscientific, and whose legal rights merely sufficed to save them from
prosecution as quacks, and to recover their fees from such persons as
were foolish enough to employ them.
For twenty-five years the battle was waged, and arguments advanced pro
and con, of substantially the same nature as those which have already
been sufficiently quoted. A circular was sent to the 1343 members of the
society, asking the following question: Do you favor the admission of
women to the Society on the same terms with men? To this circular, 1132
replies were received, of which 709 were in the affirmative, 400 in the
negative, while 23 were indifferent. “It was thus evident that a
considerable majority of the Society, seven to four of all who answered
the circular, favor the admission of women.”[118]
In June, 1875, a committee of five was chosen from the society to report
whether duly educated women could not be admitted to membership. In
October a majority reported in favor of examining for membership men and
women without distinction. But the minority objected so vigorously, that
the whole matter was postponed indefinitely. In 1878, another committee
was appointed: in June, 1879, the members were found equally divided;
the subject was referred back to the committee, who, in October of the
same year, advised no action. But this time the minority reported to
instruct the censors to admit women for examination. The councilors
voted, 48 to 38, to adopt the minority report.[119]
But the end was not yet, for in February, 1880, the censors of Suffolk
County (including the city of Boston), voted that the society be advised
to rescind its vote of October. This, however, was never done; but,
after some further delay, the first female candidate, Dr. Emma Call, a
graduate from Ann Arbor, passed a satisfactory examination and was
admitted. The decisive step once taken, other women passed in readily,
and 1889, ten years from the date of the conclusion of the famous
controversy, a dozen women sat down to the annual banquet of the
society, among whom was one invited guest from another State. The “moral
tone” did not seem to be “perceptibly lowered,” on this occasion.
In 1882, Dr. Chadwick published a tabulated summary of the dates at
which various State societies had admitted women to membership.
In 1872, Kansas, Iowa; in 1874, Vermont; in 1875, Maine, New York, Ohio;
in 1876, California, Indiana; in 1878, New Hampshire; in 1879,
Minnesota, Massachusetts; in 1880, Connecticut; in 1881, Pennsylvania.
Rhode Island, Illinois, and Oregon also had women members, but the date
of their first admission was not known. Thus seventeen societies
contained, in 1882, 115 female members—that of New York alone having
forty-two, much the largest of all.
From this time the question of the official “recognition” of women might
be regarded as settled. Another question of equal, if not greater
importance, now came to the front,—namely, the extension to women of
opportunities for study and practice in great hospitals, opportunities
absolutely indispensable both to obtaining and maintaining a valid place
in medical practice and the medical profession. The discussion of this
question belongs to the seventh period of the history.
For this purpose the small hospitals conducted by women were (and are)
quite insufficient. There is such a demand upon their slender
accommodations and resources for obstetric and gynæcological cases, and
the claims of such cases to the special advantages of these hospitals
are so paramount, that they have so far tended to a specialism, which,
though useful for the patients, is detrimental to the physicians who
must find all their training in them. Efforts, therefore, have
constantly been made to widen the range for women, by securing their
admission as students, internes, or visiting physicians to the great
hospitals, which constitute the medical treasure-houses of the
country.[120] In describing the actual condition of the medical schools,
mention has been made of the hospital advantages which have been, little
by little, secured for their undergraduate students. In Boston, where
there is no school for women but the homœopathic school of the Boston
University, fewer opportunities exist than anywhere else.
The Massachusetts General Hospital is reserved exclusively for the
students of the Harvard Medical School. But the City Hospital remained
unappropriated, and in 1886, the President and Trustees of the Boston
University petitioned for permission for their female students to visit
there, on the same terms as the young men. A committee was appointed to
consider the matter, and after an elaborate report on the contemporary
usage in ninety-one hospitals throughout the United States, advised that
the request be granted. This enabled the female students to attend the
public lectures given and the operations performed in the hospital
amphitheatre about once a week.[121]
Similar, though more frequent, opportunities for clinical instruction
had been previously secured for women at the city hospitals of New York
(Bellevue), Philadelphia (Blockley), and Chicago (Cook County). At the
Pennsylvania Hospital in Philadelphia, moreover, the women from the
Medical School had been admitted to lectures on special days, when no
male students were present. These scanty privileges (for not much can be
learned about a patient by spectators seated on the benches of an
amphitheatre) were only obtained after a series of collisions with the
men students, occasionally rising to the dignity of a row, as upon one
memorable occasion at the Pennsylvania Hospital;[122] more often
consisting in petty teasings and annoyances, which bore considerable
resemblance to the pranks of schoolboys. To students habituated to the
daily visits in the wards of the vast European hospitals, this form of
clinical instruction, where the patient studied is seen but once, and
then at a distance, must seem ludicrously inadequate.[123] From these
defects, however, the male and female students suffer alike. But the
former have, until recently, retained the monopoly of the hospital
appointments, whereby a certain number of graduates are enabled to
acquire real clinical instruction. This monopoly is only just beginning
to break down.
Apparently the first general hospital in the country to confer a
hospital appointment on a woman, was the Mt. Sinai Hospital of New York.
Here, in 1874, Dr. Annie Angell, a graduate of the Infirmary School, was
made one of the resident physicians, at the instance of several members
of the medical staff.[124]
In 1884 Dr. Josephine Walter, another graduate of the Infirmary School,
was admitted as interne after a severe competitive examination, among
nineteen candidates, of which only two could be appointed. She also
served three years in the hospital, and then spent two years in Europe
in medical study.
Since her appointment, none others have been made, or indeed applied
for, in this or any other hospital in the city. Even in the Woman’s
Hospital, with exclusively female patients, and a host of female nurses,
the medical staff have repeatedly expressed their formal opposition to
the admission of female internes; and the Board of Lady Managers,
oblivious of the first resolution of the first founders of the hospital,
have so far remained indifferent to the anomalous injustice of the
situation.[125]
Among dispensary services, however, many women have found places. Dr.
Angell and Dr. Putnam Jacobi founded a dispensary at the Mt. Sinai
Hospital, and for a year conducted it exclusively themselves. It was
then systematically organized by the directors of the hospital, and has
since always had women on the staff. In 1882, a school was open for
post-graduate instruction in New York, and Dr. Putnam Jacobi was invited
to a place in its faculty, as the clinical lecturer on children’s
diseases, the first time a lectureship in a masculine school was ever,
in this country, filled by a woman. In the same school, another woman,
Dr. Sarah McNutt, was also appointed as lecturer, and founded a
children’s hospital ward in connection with the school. The positions at
present held by women physicians in New York dispensaries may be thus
summarized, exclusive of the dispensary of the Infirmary:
Demilt Hospital, 3; Mt. Sinai Hospital, 2; St. Mary’s Hospital for
Children, 1; Hospital for Ruptured and Crippled, 4; Manhattan Eye and
Ear Infirmary, 1; Foundling Hospital, 1 (resident physician); Nursery
and Child’s Hospital, 1 (resident at country branch); Babies’ Hospital,
1.
In Philadelphia, the Blockley Hospital, the first in the United States
to allow a woman to visit its wards,[126] appointed a female interne
upon competitive examination, in 1883.[127] Since this date, eleven
other women have received such appointments,—of whom four in 1889. Dr.
Clara Marshall and Dr. Hannah Croasdale were put on the visiting staff
in 1882. Chicago, however, is the city where the hospital privileges
have been most equitably distributed, though the opportunity has been
obtained by a struggle rendered severe, not from the opposition of those
adverse to women physicians, but from the inadequate instruction given
by those who had professed to be their friends.
In 1877, an invitation was sent to the senior class to take part in the
examination for internes at the Cook County Hospital. “To go meant to
fail. We decided to go, if only to show how little we had been taught in
surgery.” This was really an heroic determination; and the ordeal was
severe. “The students and other spectators received us with deafening
shouts and hisses The gynæcological and obstetrical examiners made
vulgar jokes. The surgeon tried to wreck us. We forced things as best we
could, but of course no one received an appointment.”[128] As a rather
unusual result of this trial, the professor of surgery at the Woman’s
College was roused to exertion, and for two years taught so well, that
on another competitive examination the Woman’s College was said to have
stood first. However, no woman was appointed, but a relative of the
commissioners, without an examination. Still the women’s pluck and
determination held out; they came up a third time,—and then, in
1881,—the coveted position was gained, and a young woman only twenty-one
years of age was nominated as interne. Since then, appointments have
multiplied, thus:
NAME OF HOSPITAL. │ DATE OF APPOINTMENT. NO. OF WOMEN
│ PHYSICIANS.
───────────────────────┼───────────────────────────────────────────────
Cook County Hospital │ 1881 1
„ │ 1888 2
„ │ 1889 2
───────────────────────┼───────────────────────────────────────────────
Illinois Woman’s │ 1882 1
Hospital │
„ │ 1887 1
„ │ 1888 1
„ │ 1889 1
───────────────────────┼───────────────────────────────────────────────
Wesley Hospital │ 1889 1
State Insane Asylum │ Unknown 2
Finally, it is noteworthy that Dr. Sarah Hackett Stevenson holds an
appointment to the Cook County Hospital as visiting physician, and Dr.
Marie Mergler a similar appointment to the Woman’s Hospital.
A special and extremely interesting branch of the struggle for hospital
positions for women physicians has related to their appointment in the
female wards of insane asylums. This movement also originated in
Pennsylvania, and in the personal efforts of Dr. Corson, supported, as
before, by Dr. Atlee. At the annual meeting of the State Society in
1877, the following preambles and resolution were read:
“_Whereas_, The State Medical Society has taken a deep interest in the
welfare of the insane during the last few years; and
“_Whereas_, The inmates of our State hospitals are in nearly equal
numbers of the sexes; and
“_Whereas_, We have many female physicians who are eminent
practitioners, and one at least[129] who has had experience in the
medical management of the insane: therefore,
“_Resolved_, That a committee of three persons be appointed by the
president of this society, to report at its next annual meeting on the
propriety of having a female physician for the female department of
every hospital for the insane, which is under the control of the
State.”
A committee was appointed,[130] and reported at length in favor of the
resolution. Just emphasis was laid on the fact that the very first
attempts ever made to reclaim the insane asylums of the State from a
condition of utter barbarism were due to a woman, Miss Dorothy Dix,
whose name has been a household word in America, as that of Elizabeth
Fry in England. The fact that at present there were no women who had
received the special training requisite for the scientific treatment for
the insane was offset by the other facts, that the existing medical
superintendents were charged with the business responsibilities of the
asylum, and thus had entirely insufficient time to devote to the medical
care of the patients; and that the subordinates, upon whom such care
practically devolved, were usually recent graduates, who were entirely
destitute of special training, and indeed for whose education in
psychiatry no provision anywhere existed.
A bill was drafted, to be presented with a memorial to the Legislature,
making the appointment of a female superintendent obligatory in all
asylums with female patients. The legislative committee returned the
bill to the House with an affirmative recommendation.
A counter memorial was, however, sent to the Senate judiciary committee,
protesting against the appointment of a female superintendent as liable
to cause clashing in the management of the asylum. The memorial said
that assistant female physicians could already be employed wherever
deemed expedient. The memorial was so copiously signed as to suggest
that much other opposition than that of superintendents, dreading
collision, had been marshaled to defeat the proposed law.[131]
Another counter thrust, however, was given by the trustees of the State
Lunatic Hospital at Harrisburg, who warmly supported the bill. Before
the adjournment of the Legislature, the bill was in fact enacted, but so
altered that the trustees are not obliged to appoint a woman chief
physician, but only empowered to do so. At this same time, a new
hospital for the insane was opened at Norristown, not far from
Philadelphia; and to this Dr. Alice Bennett, a graduate of the Woman’s
Medical College of Philadelphia, was elected by the trustees as chief
physician of the female department. Dr. Annie Kugler was appointed
assistant. Three months later, in September, 1880, the trustees of the
asylum at Harrisburg elected Dr. Margaret Cleaves to a position as
assistant.[132] Legislative action analogous to that initiated in
Pennsylvania was not long afterward taken in Massachusetts and Ohio, and
finally, during the current year, 1890, in the State of New York.[133]
In New York, the bill required the employment of a woman physician in
every State insane asylum where women are confined. It passed with only
two negative votes in the Assembly, and three in the Senate.[134]