VII. WOMAN IN MEDICINE.

BY

MARY PUTNAM JACOBI, M.D.

“Fifty years hence, it will be difficult to gain credit for the assertion that American women acquiesced throughout the former half of the 19th century, in the complete monopoly of the medical profession by men, even including midwifery, and the diseases peculiar to women. The current usage in this respect is monstrous.”—New York Tribune, Editorial, 1853.

The history of the movement for introducing women into the full practice of the medical profession is one of the most interesting of modern times. This movement has already achieved much, and far more than is often supposed. Yet the interest lies even less in what has been so far achieved, than in the opposition which has been encountered: in the nature of this opposition; in the pretexts on which it has been sustained, and in the reasonings, more or less disingenuous, by which it has claimed its justification. The history, therefore, is a record not more of fact, than of opinion. And the opinions expressed have often been so grave and solid in appearance, yet proved so frivolous and empty in view of the subsequent event, that their history is not unworthy careful consideration among that of other solemn follies of mankind.

In Europe, the admission of women to the profession of medicine has been widely opposed because of disbelief in their intellectual capacity.^[32] In America it is less often permitted to doubt—out loud—the intellectual capacity of women. The controversy has therefore been shifted to the entirely different ground of decorum.

At the very outset, however, two rival decorums confronted 140each other. The same centuries of tradition which had, officially, reserved the practice of medicine for men, had assigned to women the exclusive control of the practice of midwifery. It was assumed that midwifery did not require the assistance of medical art,—that the woman in labor traversed a purely physiological crisis, and required only the attendance of kindness, patience, and native sagacity,—all obtainable without scientific knowledge, from her own sex. This being taken for granted, the propriety of limiting such attendance to women appeared so self-evident, that, from the beginning of the world till the eighteenth century A.D., the custom was not seriously questioned. There is an exact parallelism between the relations of men to midwifery and of women to medicine. The limitation of sex in each case was decided by a tradition so immense, as to be mistaken for a divinely implanted instinct, intended by Providence as one of the fundamental safeguards of society and of morals. In each case the invasion by one sex of a “sphere” hitherto monopolized by the other, aroused the coarsest antagonism of offended delicacy. In each case finally, a real basis existed for the traditional etiquette: there was some reason for protesting against the introduction of the male accoucheur into the lying-in room, or of the ardent young girl into the medical school. But in each case, whatever reasons for protest existed, were outnumbered and outweighed by others, to whose greater importance they were finally compelled to give way. Other things being equal, it was unpleasant for a woman to be attended in the crisis of her confinement by a man. But when the necessity for knowledge was recognized, when men became skilled while midwives remained ignorant,—the choice was no longer possible; the greater decorum of female midwifery was obliged to yield to the greater safety of enlightened masculine practice. Similarly, it was occasionally unpleasant for young women students to find themselves engaged in certain subjects of medical study together with classes of young men. But in proportion as midwifery became enlarged by the new province of gynæcology, did occasions multiply on which it was extremely unpleasant for non-medical women to be medically treated by men. The difficulties of educating a relatively few women in medicine were compelled to be accepted, in order to avert the far greater difficulties of medical treatment for a very large number of women.

The history of medical women in the United States, to which these pages exclusively apply, may be divided into seven periods, as follows:

141First, the colonial period of exclusively female midwifery,^[33] many of whose practitioners, according to their epitaphs, are reported to have brought into the world one, two, or even three thousand babies apiece. The Mrs. Thomas Whitmore of Marlboro, mentioned in the note, is especially described as being “possessed of a vigorous constitution, and frequently traveling through the woods on snow-shoes from one part of the town to another by night and by day, to relieve the distressed.”^[34]

During this period of female midwifery, the medical profession proper of the colonies remained entirely unorganized and inarticulate.^[35] Without making especial inquiry, a superficial observer could have almost overlooked the existence of doctors, as a special class, in the community.

There followed, however, a second period, that, namely, of the Revolution, and the years immediately preceding and following it. During the former, physicians began to travel to Europe for instruction. During the Revolutionary war their public services in the military hospitals, though apparently not very useful to the sick,^[36] yet served to bring the profession, for the first time, out of obscurity; and the 142opportunities afforded for the collective observation of disease on a large scale, first breathed the spirit of medical science into the American profession. The first achievement of the new-born interest in medical art and education was the expulsion of “females,” from even the outlying provinces of the profession, and from their world-old traditional privileges as accoucheurs.^[37] It was a harsh return to make for the services rendered to the infant settlements by these valiant midwives, who had been tramping through the snow by night and by day to bring into a very cold world the citizens of the future republic!^[38]

Third. After this, however, came a period of reaction. In 1848, a Boston gentleman, Mr. Samuel Gregory, began to vehemently protest against the innovation of “male midwives,” and, opened a crusade on behalf of the women, with something of the pathetic ardor of the Emperor Julian for a lost cause.^[39] To judge by the comments of the public press, Mr. Gregory’s protest against “man-midwifery” awoke sympathetic echoes in many quarters. At the present day the interest in the movement thus roused, at once progressive and reactionary, lies chiefly in the remarkable similarity between the arguments which were then advanced against the intrusion of men into 143midwifery, and those which were subsequently urged against the admission of women to medicine. Thus:

“The employment of men in midwifery practice is always grossly indelicate, often immoral, and always constitutes a serious temptation to immorality.”—Summary of Mr. Gregory’s argument in “Man-Midwifery Exposed,” 1848.

“I view the present practice of calling on men in ordinary births, ... as a means of sacrificing delicacy and consequently virtue.”—Thomas Ewell, M.D., of Virginia.

“The practice (of male midwifery) is unnecessary, unnatural, and wrong,—it has an immoral tendency.”—W. Beach, M.D., New York.

“There are many cases of practice among women ... in which the sense of propriety would decide that the presence of a female practitioner is more desirable than that of a man.”—New York Observer, 1850.

“There are a few self-evident propositions which it would be questioning the common sense of mankind to doubt. One is that women are by nature better fitted than men to take care of the sick and the suffering.”—Godey’s Lady’s Book, 1850.

“The especial propriety of qualifying women to practice among 144children and their own sex, will be admitted I hope by all.”—Rt. Rev. Bishop Potter, 1850.

“We have long been persuaded that both morality and decency require female practitioners of medicine. Nature suggests it; reason approves it; religion demands it.”—Northern Christian Advocate, 1850.

“This is one of the most important projects of the day for the improvement of the condition of women.”—Zion’s Herald, 1850.

“The employment of men as ‘midwives’ is a modern custom, and one not to be commended.”—Phil. Saturday Post, 1850.

“To attend medical clinics in company with men, women must lay aside their modesty. There are still enough gentlemen who would blush to expose their mothers or sisters or wives to what, before women, would be improper and indecent.”—Letter to editor N. Y. Med. Record, 1884, by M. K. Blackwood.

“History, physiology, and the general judgment of society unite in the negative of woman’s fitness for the medical office.”—“Woman and her Physician.” Lecture, Theoph. Parvin, Prof. Dis. Women, 1870.

“If I were to plan with malicious hate the greatest curse I could conceive for women, if I would estrange them from the protection of women, and make them as far as possible loathsome and disgusting to man, I would favor the so-called reform which proposed to make doctors of them.”—Editorial Buffalo Med. Journal, 1869, p. 191.

“There are free-thinkers in the medical profession as there are free-lovers in social life.... The opposition of medical men arises because this movement outrages all their enlightened estimate of what a woman should be. It shocks their refined appreciation of woman to see her assume to follow a profession with repulsive details at every step, after the disgusting preliminaries have been passed.”—Sherry, Med. and Surg. Reporter, July 6, 1867.

“It is obvious that we cannot instruct women as we do men in the science of medicine; we cannot carry them into the dissecting room and hospital; many of our more delicate feelings, much of our refined sensibility must be subdued before we can study medicine; in females they must be destroyed.”—Remarks on Employment of Females as Practitioners, Boston, 1820.

“The ceremonies of graduating Miss Blackwell at Geneva may well be called a farce. I am sorry that Geneva should be the first to commence the nefarious process of amalgamation. The profession was quite too full before.”—Letter by D. K. to Boston Journal, Feb. 1849.

“The bare thought of married females engaging in the medical profession is palpably absurd. It carries with it a sense of shame, vulgarity, and disgust. Nature is responsible for my unqualified opposition to educating females for the medical profession.”—Dissert. on Female Phys. by N. Williams, M.D., read before a N. Y. Med. Soc., June 6, 1850.

“Females are ambitious to dabble in medicine as in other matters, with a view to reorganizing society.”—Edit. Boston Med. and Surg. Jour., 1852, p. 106.

“The serious inroads made by female physicians in obstetrical business, one of the essential branches of income to a majority of well established practitioners, make it natural enough to inquire what course to pursue.”—Ibid., Feb. 1853.

These parallel columns might be extended much further, did our space permit. We cannot, however, pass by the following gem of eloquence from an English source, but quoted in the Cincinnati Lancet and Clinic for 1881. It is from the address at the British Medical Association by the President of that year:

“I am not over-squeamish, nor am I over-sensitive, but I almost shudder when I hear of things that ladies now do or attempt to do. One can but blush, and feel that modesty, once inherent in the fairest of God’s creation, is fast fading away. You gentlemen, who know the delicacy of women’s organization,—you must know that constitutionally they are unfit for many of the duties of either doctor or nurse.

“May not habit so change that fine organization, that sensitive nature of women, as to render her dead to those higher feelings of love and sympathy which now make our homes so happy, so blessed?

“Will not England’s glory fade without its modest sympathizing women, and its race of stalwart youths and blooming maidens?

145“You now, gentlemen, know my views as to the propriety of ladies becoming doctors or nurses.”^[40]

The Fourth period of woman’s medical history was initiated when Mr. Gregory, supported by the popular enthusiasm he had aroused, succeeded in opening a School of Medicine (so called) for women, in Nov. 1848.^[41] The first term lasted three months: a second term began the following April, 1849;—and with the announcement for the second year it was declared that the twenty pioneer pupils had not only followed the lectures, but “had attended above 300 midwifery cases with the most satisfactory success.”

In the prospectus issued for the second year of the school, Mr. Gregory brought forward a new set of arguments in its support, in addition to those previously adduced. There was then (1849) in New England, a surplus female population of 20,000 persons,—and “hundreds of these would be willing to devote any necessary length of time to qualify themselves for a useful, honorable, and remunerative occupation.” They could afford, moreover, to give their services at a much cheaper rate than men, charging about a third the ordinary fees,—thus $5 instead of $15 for attendance on a confinement case.

Thus not only would the morals of the community be preserved, but the burdens on its purse be considerably lightened by the employment of educated women as obstetricians. As the medical profession had just become keenly alive to the peculiarly lucrative character of obstetrical and gynæcological practice, this suggestion that it might now profitably be undersold naturally aroused the keenest resentment. It was soon retorted that the cheaper practitioners were to be prepared by a system of education so cheap as to be absolutely worthless; and unfortunately the early history of the first medical schools for women entirely justified this accusation.

To support Mr. Gregory’s school, a Female Medical Education Society was formed in Boston, and incorporated with a state charter. Nothing seemed at the outset fairer than the promises of the new college,—but it had one fatal defect. There was no one connected with it who either knew or cared what a medical education should be. It followed that, under 146the name of medical education, was offered a curriculum of instruction, so ludicrously inadequate for the purpose, as to constitute a gross usurpation of the name,—in a word, to be an essentially dishonest affair. And still more unfortunately, the same inadequacy, naïvely or deliberately unconscious of itself, continued in greater or less degree, to characterize all efforts for the isolated medical education of women for the next twenty years. This, the fourth period of their medical history,—deserves therefore to be considered by women rather as a pre-medical or preliminary epoch; where purposes were enunciated that were only to be fulfilled many years later.

The Gregory Medical School maintained a precarious existence until 1874, when, by an enabling act of the Legislature, the funds were handed over to the Boston University, just founded,—upon condition that women should be admitted to the medical department of the latter. This condition was punctually fulfilled; women students were rendered eligible to all departments of the new university. But as the medical school, for some reason, became exclusively homœpathic,—the fortunes of medical women in the regular profession were not thereby greatly advanced.^[42]

Now, however, the movement for women had widened and reached Philadelphia, where two schools were started. One of these, the Penn Medical School, ran a permanently unenviable career of unfitness, and was finally extinguished. The other, the Woman’s Medical College of Pennsylvania, was founded in 1850, and after a long and precarious period of struggle, finally touched upon a solid basis of medical realities, and thence began its prosperous modern career. In the mean time, and fortunately for the cause, a new departure had been taken in several other directions. The Gregory School had been founded with the avowed intention of educating women for 147midwives; and it did not succeed even in this limited aim, because it was either ignorant of or indifferent to the rigid system of education imposed, wherever, as in Europe, midwives are recognized and educated. In America, where hostility to class distinctions is so profound as to interfere with the recognition of even the intellectual distinctions which are alone just,—it was probably a foregone conclusion that the various ranks in medicine which exist in European countries would never here become officially established.^[43] But a startlingly long step was taken at a stride, when, thirty years after the pæan of victory had been sounded over the complete suppression of female midwifes, so that not even this corner of possible medicine might remain in possession of women,—that then, half a dozen women, unknown to each other, and widely separated in this immense country, should appear almost simultaneously upon the scene, and demand the opportunity to be educated as full physicians. Their history marks a fifth period in the movement.

The first of this remarkable group of women was Harriet K. Hunt of Boston.

This lady had for several years assumed the responsibility of practicing medicine, while yet unprovided with a medical diploma. This was reprehensible, but from a practical standpoint, the course seems to have been justified by subsequent events. For when, in 1847, Miss Hunt requested permission to attend lectures at the Harvard Medical School, her request was promptly refused. After the graduation of Elizabeth Blackwell at Geneva in 1849, Miss Hunt thought that the times might have become more favorable, and, in 1850, repeated her application at Harvard. In mobile America, three years may sometimes effect such a change in sentiment as would require three centuries in the Old World. On this occasion, five out of the seven members of the Faculty voted “That Miss Hunt be admitted to the lectures on the usual terms, provided that her 148admission be not deemed inconsistent with the statutes.”^[44] A week later, the President and Fellows of the University announced that the statutes of the Medical School offered no obstacle to the admission of female students to their lectures. But, on the eve of success, Miss Hunt’s cause was shipwrecked, by collision and entanglement with that of another of the unenfranchised to privileges. At the beginning of the session, two, and later a third, colored man, had appeared among the students, and created by their appearance intense dissatisfaction. When, as if to crown this outrage to gentlemanly feeling, it was announced that a woman was also about to be admitted, the students felt that their cup of humiliation was full, and popular indignation boiled over in a general meeting. Here resolutions were adopted, remonstrating against the “amalgamation of sexes and races.” The compliant Faculty bowed their heads to the storm, yielded to the students, who, though young and inexperienced, were in the majority, and might possibly withdraw in a body to Yale,—and, to avoid the obloquy of rejecting, under pressure, a perfectly reasonable request, advised the “female student” to withdraw her petition. This she did; the storm subsided, and the majesty of Harvard, already endangered by the presence of the negro, was saved from the further peril of the woman. Miss Hunt returned to her private medical practice, which, though unsanctioned by law and condemned by learning, was so successful that, in 1872, she celebrated her silver wedding to it.^[45]

Thus, on this first occasion, it was not a sentiment of delicacy that forbade the Harvard students to share their privileges with a woman; but a sense of offended dignity of sex, which distinctly allied itself with the other and equally touchy dignity of race. The odd idea was advanced on this, as on so many other occasions, that whenever a woman should prove herself capable of an intellectual achievement, this latter would cease to constitute an honor for the men who had previously prized it. Hence the urgent necessity of excluding women from all opportunity of trying.

149In 1849, “Diplomas and advanced courses of study were things entirely outside the intellectual life of women.”^[46] The pioneer female colleges, the Troy Seminary and the Mt. Holyoke school, had scarcely been founded,^[47] and women everywhere received only the most rudimentary education. On the other hand, the medical education of men, was, as compared with the objects to be attained by it,—in about an equally rudimentary condition. The intrinsic tests were so shifting and unreliable, the standard of attainments so low, that it was proportionately necessary to protect the dignity of the profession by external, superficial, and arbitrary safeguards. Of these the easiest to apply was the distinction of sex. It was often difficult to decide, in the absence of intrinsic tests, whether a given individual were or were not a competent physician: but it was of course always easy to recognize that he was a man. This simple principle of distinction was adopted, therefore, as the guiding rule in future controversies. All men, however or wherever educated, were to be considered competent physicians, if only they chose to say so themselves. And all women were correlatively to be declared incompetent, no matter what care they had taken to prepare themselves. The principle was well suited to crude and uncultured societies, and became proportionately popular.

Elizabeth and Emily Blackwell were led to the study of medicine in a different manner than Harriet Hunt, their immediate predecessor. While still quite young girls, they were, by the sudden death of their father, unexpectedly confronted with the necessity of supporting not only themselves, but their mother, and a large family of younger brothers and sisters. “Then we realized the infinite narrowness and pettiness of the avenues open to women, and the crowds of competitors who kept each other down in the struggle. We determined that we would endeavor to open a new door, and tread a fresh path,—rather than push for a footing in one already filled to overflowing.”^[48]

In this determination a new key-note was sounded. The 150Blackwells, and especially Elizabeth, were less the associates of Harriet Hunt, and of their own immediate successors, than the spiritual daughters of Mary Wollstonecraft, whose courageous demand for a wider field for her sex had remained hitherto almost alone, like a voice crying in the wilderness. They did not seek wider opportunities in order to study medicine, but they studied medicine in order to secure wider opportunities for all women.^[49]

It was by sheer force of intellect, and of the sympathetic imagination born of intellectual perception, that Elizabeth Blackwell divined for women the suitableness of an occupation whose practical details were, to herself, intrinsically distasteful. Among all the pioneer group of women physicians, hers chiefly deserves to be called the Record of an Heroic Life. For with her, the struggle with bitter and brutal prejudices in the world was not sustained by the keen and instinctive enthusiasm for medicine, which has since carried hundreds of women over impossibilities. Rather was the arduousness of the struggle intensified by a passionate sensitiveness of temperament, which, under a cold exterior, rendered her intensely alive to the hardships of the social obloquy and ostracism which she was destined to encounter in such abundance.

Those accustomed to value ideas according to their intrinsive power, as shown by their originality and their fruitful result, should admit that there was real grandeur in this thought: the thought that the entire sex might be lifted upon a higher intellectual plane, by means of a practical work, for which, at the moment, not half a dozen people in America discerned the opportunity. “The thorough education of a class of women in medicine will exert an important influence upon the life and interests of women in general.” “Medicine is so broad a field, so closely interwoven with general interests, and yet of so personal a character in its individual applications, that the coöperation of men and women is needed to fulfill all its requirements.” “It is not possible or desirable to sanction the establishment of an intermediate class” [of midwives.]^[50]

151So much more broad and sound were the views of this self-taught Cincinnati school-teacher,^[51] than of the kind-hearted but short-sighted men, who in Boston were then trying to establish the Female Medical Education Society!

It was in 1845 that the plan of studying medicine became with Elizabeth Blackwell a settled resolution; and she was thus the first person on the American continent to whom such an idea did come.

It is worthy of note, that the originality of the main idea was sustained by an almost equal originality of view in regard to the true nature of a medical education.

Only a few years ago an eminent New York professor^[52] showed that it was both practicable, and a common thing to do, for men to graduate, even from New York schools, after only ten months attendance upon lectures, of which the second five months was a mere repetition of the first: and without ever having seen a sick person. If this were true of New York,—where, after all, it is possible to do otherwise,—it may be imagined what would be true of the multitude of small schools scattered through the country, where the resources for either clinical or didactic instruction were confessedly inadequate. And if this were true in 1880 the status of 1850 may be divined.

It was at this time that Elizabeth Blackwell recognized that preparation for medical practice demanded the sanction of test examinations at a respectable school; not a few months, but years of study; and above all abundant clinical experience. Rather than accept as final the indorsement of little schools established ad hoc, or exclusively for women, she applied to be admitted as student at twelve medical schools throughout the country, and among these found one, the school at Geneva, N. Y., to grant her request. The faculty referred the matter to the students, and they decided to invite the courageous applicant. Poor, dependent entirely upon her own exertions, and with others more or less dependent upon her, she nevertheless found means to devote five years to the study of her profession, of which two were spent in Europe, at that time a rare extravagance.^[53] Uninstructed or informed by the laws and customs 152of the entire country that attendance on didactic lectures was sufficient to justify a medical diploma, and hospital training was superfluous,—her native common sense perceived the absurdity of this theory, and left no stone unturned to secure such fragments of hospital training as were obtainable for her in either hemisphere. During the term of study at Geneva, she utilized a vacation to seek admittance to the hospital of the Blockley almshouse at Philadelphia, and obtained it by skillful manipulation of the opposing political influences which prevailed among the managers of the institution.^[54] After graduating at Geneva in 1849, the first woman in America or of modern times to receive a medical diploma, Miss Blackwell immediately went to Europe, and by exceptional favor succeeded in visiting some of the hospitals of both London^[55] and Paris. In Paris, moreover, she submitted for several months to the severe imprisonment of the great school for midwives, La Maternité.

Emily Blackwell was refused admission to the Hobart College at Geneva, which had graduated her sister; but was allowed, for one year, to study at the Rush College of Chicago. For this permission, however, the college was censured by the State Medical Society, and the second term was therefore refused to the solitary female student. She was, however, enabled to complete her studies at Cleveland, Ohio, and graduated thence in 1852. During one of her vacations, she obtained permission to visit in Bellevue Hospital, where Dr. James Wood was just initiating the system of regular clinical lectures. After graduation, Emily Blackwell also went to Europe, and had the good fortune to become the private pupil of the celebrated Sir James Simpson of Edinburgh. She remained with him for a year, and when she left he warmly testified to her proficiency and competence for the work she had undertaken. The testimonial is worth quoting entire:

“My Dear Miss Blackwell:

“I do think that you have assumed a position for which you are excellently qualified, and where you may, as a teacher, do a great amount of good.

“As this movement progresses, it is evidently a matter of the utmost importance that female physicians should be most fully 153and perfectly educated; and I firmly believe that it would be difficult or impossible to find for that purpose any one better qualified than yourself.

“I have had the fairest and best opportunity of testing the extent of your medical acquirements during the period of eight months, when you studied here with me, and I can have no hesitation in stating to you—what I have often stated to others—that I have rarely met with a young physician who was better acquainted with the ancient and modern languages, or more learned in the literature, science, and practical details of his profession. Permit me to add that in your relation to patients, and in your kindly care and treatment of them, I ever found you a ‘most womanly woman.’ Believe me, with very kindest wishes for your success,

“Yours very respectfully,

“James G. Simpson.”^[56]

Miss Blackwell received similar testimonials from several distinguished physicians in London and Paris, in whose hospital wards she faithfully studied. Thus equipped, she returned to New York in 1855 to join her sister, with a fair hope of success in the arduous undertaking before them.

Dr. Elizabeth Blackwell, with the aid of a few generous friends, had opened a little dispensary for women and children,—which after three years’ existence, and one year of suspension, developed into the New York Infirmary. This was first chartered in 1854. But when Emily Blackwell returned from Europe, no opportunities existed for either of the sisters to secure the hospital medical work, whose continued training is justly regarded of such inestimable advantage to every practicing physician. This was recognized even at a time that hospitals were regarded as superfluous in undergraduate education.

In 1850, Dr. Marion Sims, arriving as an exiled invalid from Alabama, with a brilliantly original surgical operation as his “stock in trade,”—succeeded, with the aid of some generous New York women, in founding the first Woman’s Hospital in the world. It was just seven years since the first imperfect medical school for women had been opened 154in Boston: six years since the first woman physician had graduated at Geneva: five years since a permanent school for women had been founded in Philadelphia. The coincidence of these dates is not fortuitous. There is a close correlation between the rise of modern gynæcology, and the rise of the movement for readmitting women to the medical profession, where they once held a place, and whence they had been forcibly extruded. While it is far from true that women physicians are intended only for obstetrics and gynæcology, it is unquestionably true that these two great branches of medicine peculiar to their sex constitute the great opportunity, the main portal, through which women have passed, and are destined to pass, to general medicine. It would have been well if those who conducted the one movement had frankly allied themselves with the leaders of the other. Unfortunately, the more important, and especially the more lucrative, the new medical spheres^[57] seemed likely to be,—the more eager were those who engaged in them to keep out women.

Dr. Sims thus describes the circumstances of the founding of the Woman’s Hospital:

“As soon as they (the New York surgeons) had learned how to perform these operations successfully” (those that Sims had invented), “they had no further use for me. My thunder had been stolen, and I was left without any resources whatever. I said to myself, ‘I am a lost man unless I can get somebody to create a place in which I can show the world what I am capable of doing.’ This was the inception of the idea of a woman’s hospital.”—“Story of My Life.”

When the New York women organized the hospital they framed a by-law,—which has since passed into oblivion,—to the effect that the assistant surgeon should be a woman. Emily Blackwell was the woman who should have been chosen. She had had an education far superior to that of the average American doctor of the day, a special training under the most distinguished gynæcologists of the time,—Simpson and Huginer—and had received abundant testimonials to capacity; while there was really not another person in New York possessed of either such opportunities or of such special testimonials. At her return, informal inquiries were made to ascertain whether the second woman physician in New York would be allowed a footing where she so justly belonged, in New York’s first Woman’s Hospital. The overtures were 155rejected: Dr. Sims passed by these just claims to recognition, and evaded the mandatory by-law of his generous friends, in a way that is most clearly shown in his own words: “One clause of the by-laws provided that the assistant surgeon should be a woman. I appointed Mrs. Brown’s friend Henri L. Stuart, who had been so efficient in organizing the hospital. She was matron and general superintendent.”^[58]

Having thus evaded the distinct and far-sighted intention of the founders of the hospital, Dr. Sims proceeded to select his medical assistant upon grounds extraordinarily frivolous.

“The hospital had been opened about six months, when I told the board of lady managers that I must have an assistant. They told me to select the man. I offered the appointment to Dr. F. N. Johnson, Jr., who had just graduated.^[59] He was about to be married, and was going to locate in the country near Cooperstown. I then offered the place to Dr. George F. Shrady. He too was about to be married, and for some cause or other he did not see fit to accept it. Soon after this, a young friend of mine at the South, was married to Dr. Thomas Addis Emmett, of New York. As I was looking for an assistant, I did not know that I could more handsomely recognize the friendship of former days, than to appoint the husband of Mrs. Emmett assistant. So to the accident of good fortune in marrying a beautiful Southern young woman, Dr. Emmett owes his appointment.”

Suffering womanhood undoubtedly owes much to Marion Sim’s inventive genius. But, on the other hand, Sim’s fame and fortune may be said to have been all made by women, from the poor slaves in Alabama who, unnarcotized, surrendered their patient bodies to his experiments,^[60] to the New York ladies whose alert sympathies and open purses had enabled him to realize his dream, and establish his personal fortunes. It would have been an act both graceful and just on his part, at this crisis, to have shared his opportunities with the two 156women who, like himself, had been well buffeted in an opposing world,^[61] and whose work and aspirations were so closely identified with his own. But this he failed to do; and the lost opportunity made all the difference to the pioneer women physicians, between brilliant and modest, between immediate and tardy professional success.

Unable elsewhere to obtain hospital opportunities, the Blackwells resolved to found a hospital that should be conducted not only for, but by women. The New York Infirmary, chartered in 1854, preceded the Woman’s Hospital by a year, and, like it, was the first institution of the kind in the world. For three years it consisted exclusively of a dispensary; then was added a tiny lying-in ward of twelve beds. At this moment the advance guard of women physicians received their fourth recruit, Marie Zakzrewska, a young midwife from Germany. She had been a favorite pupil of Dr. Schmidt, one of the state examiners of the school for midwives in Berlin, and chief director of the Charity Hospital. He had been so impressed by the talents of his pupil, as to entrust her with the responsibility of teaching his own classes, when ill-health compelled him to resign his work. Discouraged, however, by some intrigues which sprang up after the death of her powerful friend, Fräulein Zakzrewska decided to abandon the home where a career seemed ready marked out for her, and to seek a wider horizon and larger fortunes in America. Here she arrived in 1853. Her pluck and courage carried her safely through the first difficult year of an almost penniless exile; then the generous kindness of Elizabeth Blackwell secured her a place among the advance guard of women physicians, taught her English, and procured her admission to the Medical School at Cleveland. She assisted the Blackwells in the task of collecting from an indifferent or hostile community the first few hundred dollars with which to found the New York Infirmary, and in this served as physician for a year; was thence invited to lecture on midwifery at the Female Medical School at Boston; was finally summoned to build up the New England Hospital, which for many years was almost identified with her name and 157with that of Dr. Lucy Sewall,^[62] and of Dr. Helen Morton. This, the second hospital to be conducted by women physicians, was founded in 1862.

The fifth pioneer was Ann Preston, a Quaker lady of Philadelphia, an ardent abolitionist, as it was the inherited privilege of the Friends to be.^[63] Miss Preston had become early habituated to interest herself in the cause of minorities. Small and fragile in body, she possessed an indomitable little soul; and when the suggestion had once been thrown out, that a medical college for women might be opened in Philadelphia, Ann Preston never ceased working until had been collected the meagre funds considered sufficient for its establishment. This was in 1850; and the sixth annual announcement of the school mentions Dr. Preston as already installed as professor of physiology. This position she held till the day of her death.

At the outset, the new medical school was scarcely an improvement upon its Boston predecessor. Four months lectures,—composed of compilations from three or four text-books,—the same repeated the following year, constituted the curriculum. There was much zeal, but little knowledge. Dr. Preston herself, philanthropist and excellent woman as she was, was necessarily ignorant of her subject, because she had never had any opportunity to learn anything about it. The other professors were not more qualified, although without the same excuse of necessity. Ten years after the opening of the college, the Philadelphia County Medical Society found an apparently plausible pretext for refusing recognition to the school, in the fact that the lecturer on therapeutics was not a physician but a druggist,—who moreover presumed to practice medicine over his counter, and “irregular” and advertised medicine at that. Even more to the purpose than these accumulated crimes was the fact that his lectures consisted almost exclusively of strings of prescriptions, and had no real claim to be accepted as exponents of the modern science of therapeutics.

The first adequate teacher to appear in the school was Emmeline Cleveland, who, having graduated under its meagre instructions, was sent to Europe through the generosity of two 158Quaker ladies,^[64] to fit herself at the Paris Maternité to lecture upon obstetrics. Dr. Cleveland thus repeated the career of Dr. Shippen in 1762,^[65] and like him found in Europe the instructions and inspiration her native city would not afford. Dr. Cleveland was a woman of real ability, and would have done justice to a much larger sphere than that to which fate condemned her. Compelled by the slender resources of the college to unite the duties of housekeeper and superintendent to those of professor, she not unfrequently passed from the lecture room to the kitchen to make the bread for the students who boarded at the institution. Possessed of much personal beauty, and grace of manner, she had married young; but her husband had been stricken with hemiplegia early in their married life, and it was the necessity of supporting him as well as herself, which led the wife, childless and practically widowed, to enter the profession of medicine.

Of the remaining typical members of the pioneer groups of woman physicians, all were married, either already when they began their studies, or immediately after graduation. The latter was the fortune of Sarah Adamson, the second woman in the United States to receive a medical diploma, and who a year later married Dr. Dolley, of Rochester, where she at once settled and has been in successful practice for thirty-eight years. Miss Adamson was a niece of the Dr. Hiram Corson, who, in Montgomery County of Pennsylvania, was destined to wage a forty years’ chivalrous warfare in defense of women physicians. At the age of eighteen, having come across a copy of Wistar’s Anatomy, she devoted a winter to its engrossing study, and became fired with enthusiasm for the medical art, to which anatomy formed such a grand portal.^[66] At that time, 1849, the Philadelphia Medical School had not yet opened; but the Eclectic School at Rochester had announced its willingness to receive woman students, and to this Miss Adamson persuaded her parents to allow her to go. She graduated in 1851.

Besides Miss Adamson, four other ladies availed themselves of the liberality of the “irregular” eclectic school at Rochester, but of these only one graduated. Even more than her Quaker colleagues, did this lady represent a distinctive type 159among women physicians, for she was already married when she began her studies. Mrs. Gleason was the wife of a young Vermont doctor, who opened an infirmary in the country for chronic invalids, shortly after acquiring his own diploma. In the management of his lady patients, the young doctor often found it an advantage to be assisted “by his wife as an intermediary, on the one side to relate the symptoms, on the other to prescribe the directions.” Thus the wife became gradually associated with the husband’s work, while he on his part remained generously alive to her interests. He it was, who, in order to secure an opportunity for his wife for some kind of systematic medical education, persuaded the eclectics, assembled in council, to open the doors of their new school to women. “In his opinion, the admission of women was the reform most needed in the medical profession.” “I remember vividly,” writes Mrs. Gleason, “the day of his return, when he exclaimed, with enthusiasm, ‘Now, wife, you can go to medical lectures.’”^[67] The husband and wife have practiced medicine in harmonious partnership ever since this early epoch. Their sanitarium at Elmira still exists to sustain its old and honorable reputation.^[68]

There is something idyllic in this episode. Here in western New York was realized, simply and naturally, the ideal life of a married pair, as was once described by Michelet, where the common interests and activities should embrace not only the home circle, but also professional life. It is the secret ideal of many a sweet-natured woman, hitherto attained more often when the husband is a clergyman than when he is a physician, but in America is by no means unknown in the latter case. By Mrs. Gleason’s happy career, the complex experiment in life which was being made by the first group of women physicians was enriched by a special and, on some accounts, peculiarly interesting type.

The two remaining women of the group were also married, and the husband of one, Mrs. Thomas, was also a physician.^[69] She and her sister, Mrs. Longshore, both graduated in the first class sent out from the Woman’s Medical College of Philadelphia.^[70] 160Dr. Longshore was the first woman to settle in practice in this city, and her sign was regarded as a monstrous curiosity, collecting street idlers for its perusal. On one, and perhaps more than one, occasion, a druggist refused to fill a prescription signed by the “female doctor,” and took it upon himself to order her home “to look after her house and darn her husband’s stockings.”^[71] But Dr. Longshore ultimately established herself in a lucrative practice. Mrs. Thomas, the sister, first began to study medicine privately, with her husband, a practitioner in Indiana. For four years, while caring for a family of young children, Mrs. Thomas “read medicine” at all odd minutes; and at last, upon hearing that a medical college had been opened for women in Philadelphia, she made a grand final effort to secure its advantages. She sewed steadily until she had provided her family with clothes for six months in advance, and then started for the East. Returning with her coveted diploma, Mrs. Thomas began to practice medicine with her husband at Fort Wayne, and continued to do so until her death about a year ago (1889). During eight years she held the position of city physician, and for twelve years was physician to a home for friendless girls.

The married women physicians of the West, with protection and sympathy at home, and encountering abroad only a good-natured laxity of prejudice, were in a favored position compared with their colleagues in Philadelphia, Boston, and New York. At the time that the tiny New York infirmary was opened (1857) the name of “woman physician” had become a by-word of reproach, from its usurpation by a notorious abortionist, “Madame” Restell. So wide a stain could be diffused over innocent persons by a single evil reputation, that it was difficult for Drs. Blackwell and Zakzrewska to obtain lodgings or office room; their applications were refused on the ground that their business must be disreputable. Scarcely more than fifty years had elapsed since the practice of obstetrics at least was entirely in the hands of women: yet the recollection of this had so completely faded away, that the women who now renewed the ancient claim to minister to the physical necessities of their sex, were treated as reprobates.^[72] 161The little group of women who nevertheless dared to face this opprobrium, contained collectively nearly all the elements necessary for success, although in no one member of the group were these united. Instinctive enthusiasm for the science of life, instinctive predilection for medical practice, enlightened resolve to elevate the intellectual capacity and enlarge the practical opportunities of women,—the habit of progressive philanthropy,—personal interest in the pursuits of the nearest friend, the husband; literary training, exceptional among the uncultivated physicians of the day,—the tradition of centuries in the discipline of the practical European midwife,—all these were representative, and certainly none could have been spared. What was most conspicuously lacking was systematic education, which might have enabled the medical students to judge more critically of the medical education which was offered them. However, even without adequate intellectual preparation, there was a complex representation of interests which sufficiently showed that the enterprise was no isolated eccentricity, but sprang from roots widely ramifying in the permanent nature of things, and in the changing circumstances of the day.

This fourth period in the history of women physicians, to which belong the early careers of the pioneers in the movement, must nevertheless be considered as a sort of pre-medical episode, analogous in many respects to that of the entire American profession before the Revolutionary War. And this notwithstanding, and indeed a good deal because during this epoch some women were admitted to inferior or “irregular” schools, already established, and because other medical schools were founded exclusively for them. The Philadelphia school owed its foundation to the most generous impulses: but knowledge and pecuniary resources were both inadequate, and the active and bitter opposition of the medical profession of the city was an almost insuperable obstacle in the way of securing efficient assistance for instruction. The idea of the school seems to have originated with Dr. Bartholomew Fussell, a poor schoolmaster, who had been educated by an elder sister 162“to whom he looked up with veneration; and he thought that such as she ought to have a chance of studying medicine, if they desired.”^[73]

A few friends were collected, the plan was matured, the charter secured, and the school opened for the reception of students in 1850. During the first four years the yearly sessions did not last more than four months; but in the fifth annual catalogue the trustees announced with pride an extension of the course to five and a half months, and claimed that this was the longest course of instruction adopted by any medical college in the United States. They further, and with evident sincerity, declared that the curriculum of study was fully equal to that of any other medical college.

The instruction consisted of rambling lectures, given by gentlemen of good intentions but imperfect fitness, to women whose previous education left them utterly unprepared to enter a learned profession, and many of whom were really, and in the ordinary sense, illiterate. As fast as possible the brightest students were chosen, after graduation, to fill places in the Faculty, and among these one, Emmeline Cleveland, having received a real education, at least for obstetrics, in Europe, returned to Philadelphia to become a really effective teacher. For twelve years scarcely any opportunity existed for the students of the college to see sick people, an anomaly which would at the time have been considered more outrageous in any other country than the United States. As late as 1859, nine years after the foundation of the college, the Philadelphia County Medical Society passed resolutions of excommunication against every physician who should teach in the school, every woman who should graduate from it, and everybody else who should even consult with such teachers.

Had the tiny college been a virulent pest-house, the cordon sanitaire could not have been more rigidly drawn around it. Nevertheless, the trustees claimed that their graduates rapidly secured medical practice, at least to the extent of a thousand dollars a year; and that applications were frequently received from communities in different parts of the country, requesting that women physicians be sent to settle among them.^[74] In 1857 115 students had matriculated at the college.

In 1859 Elizabeth Blackwell estimated that about 300 women had managed to “graduate” somewhere in medicine, supposing 163that their studies had really “qualified them to begin practice, and that by gaining experience in practice itself, they would gradually work their way to success.” “It is not until they leave college, and attempt their work alone and unaided, that they realize how utterly insufficient their education is to enable them to acquire and support the standing of a physician. Many of them, discouraged, having spent all their money, abandon the profession; a few gain a little practical knowledge, and struggle into a second-rate position.”

This view of the realities of the situation is in curious contrast with the cheerful optimism of the leaders of the Philadelphia School. These did indeed walk by faith,—and the numerous addresses of Ann Preston, who for many years was its guiding spirit, breathe a spirit of moral enthusiasm which, as the final result proved, really did manage to compensate for the intellectual inadequacy. Dr. Preston seems to have been thoroughly convinced, that if the moral behavior of the new physicians were kept irreproachable, intellectual difficulties would take care of themselves, or be solved by an over-ruling Providence.^[75]

The fifth period for women physicians began with the founding of hospitals, where they could obtain clinical training, and 164thus give some substance to the medical education they had received in mere outline. The oldest of these institutions is the New York Infirmary, chartered, as has been said, in 1854 as a dispensary,—opened with an indoor department in 1857, with the Drs. Blackwell and Zakzrewska as attending physicians. The Infirmary was fortunate in securing several eminent New York physicians as consultants, Dr. Willard Parker, Dr. Kissam, Dr. James B. Wood, Dr. Stephen Smith, and Dr. Elisha Harris. The medical profession in New York never took the trouble to organize opposition and pronounce the decrees of ostracism that thundered in Philadelphia; its attitude was rather that of indifference than active hostility.

From 1857 until 1865, the indoor department of the Infirmary was limited to a single ward for poor lying-in women, and which contained but twelve beds. But in the dispensary, several thousand patients a year were treated, and the young physicians living in the hospital also visited the sick poor at their own homes. The persevering efforts of the Blackwells, moreover, finally succeeded in opening one medical institution of the city to their students, the great Demilt dispensary. As early as 1862, the succession of women students who annually pressed forward to fill the two vacancies at the Infirmary patiently waited in the clinic rooms of Demilt, and there gleaned many crumbs of experience and information.^[76] These, together with the practical experience gained in the obstetrical ward and the out-practice of the Infirmary, afforded the first and for a long time the only opportunity for clinical instruction open to women students in America.

In 1865, a medical college was added to the Infirmary; a new building was purchased for the hospital, which became enlarged to the capacity of 35 beds. For the first time it then began to receive private patients, chiefly from among self-supporting women of limited income, to hundreds of whom the resources of the Infirmary has proved invaluable. Their pay, though modest, has contributed materially to the resources of the hospital for the treatment of entirely indigent patients.^[77]

The report for 1869 shows a hospital staff of: Resident 165physician, 1; internes, 3; visiting physicians, 3; associate physicians, 3; out-visiting physician, 1.

Total number in-patients, 342; Total number dispensary patients, 4825; Total number patients treated at home, 768.

The Woman’s Hospital at Philadelphia was founded in 1862 during the excitements of the great Civil War. It was the outgrowth of a singularly brutal incident. In 1861 the resources of the college became entirely exhausted; there was not enough money in the treasury to hire lecture rooms, and it was reluctantly decided that the lecture course must be suspended. Permission, however, had been obtained for the students to visit the wards at the Blockley almshouse, and thither they went under the tiny escort of Dr. Ann Preston. On one occasion, in order to effectually disconcert the women students, one of the young men suddenly introduced into the room a male patient perfectly nude. The insult stung the friends of the college to renewed exertions, which were not relaxed until funds were collected sufficient to purchase a house in which might be opened a hospital where women could obtain clinical instruction by themselves. A lecture room was rented in this house, and lectures were resumed in the fall of 1862. From this date, the obstetrical chair of the college, at least, was fairly supplied with clinical material. The double institution, college and hospital, was first lifted out of its period of depressing struggle, when, at the death of its generous president, the Hon. Wm. S. Pierce, it received a bequest of $100,000. With this, a really beautiful building was erected for the use of the college.

Adjoining the college, soon sprang up a separate building for a general hospital, which has, however, always been predominantly gynæcological. Later was added a special maternity pavilion. The report of 1889 reads as follows:

Hospital staff: Resident physicians, 1; internes, 6; visiting physicians, 6; district physicians, 12; in-patients, 583;^[78] dispensary patients, 6365; patients treated at home, 695.

The woman’s hospital in Boston, the New England Hospital for Women and Children, was also founded during the war, and incorporated in 1862. The women who engaged in it were all heavily burdened by the great public anxieties of the time. But the very nature of these anxieties, the keen interest aroused in hospital work and in nursing organizations, helped to direct attention to the women’s hospitals. In New York, the first meeting to consider the organization of nursing for the army 166was held in the parlors of the Infirmary, and at the suggestion of Elizabeth Blackwell. This little meeting was the germ from which subsequently developed the splendid organization of the Sanitary Commission.

Dr. Zakzrewska was invited by the founders of the New England Hospital to preside over its organization;^[79] and to do this, she left the Female Medical School, with which great dissatisfaction was beginning to be felt. Dr. Zakzrewska received powerful assistance for the work from one of the graduates of the school, Lucy Sewall, descendant of a long line of Puritan ancestors. This young lady seemed to have been the first girl of fortune and family to study medicine in the United States. Her romantic and enthusiastic friendship formed for Dr. Zakzrewska, while yet her pupil, led the young Boston girl to devote her life, her fortune, and the influence she could command from a wide circle of friends, to building up the hospital, where she might have the privilege of working with her.

This element of ardent personal friendship and discipleship is rarely lacking in woman’s work, from the day—or before it—that Fabiola followed St. Jerome to the desert, there to build the first hospital of the Roman Empire.

Other pupils of the rudimentary Gregory school also felt the magnetism of Dr. Zakzrewska’s personal influence, and entered a charmed circle, banded together for life, for the defense of the hospital,—Anita Tyng, Helen Morton, Susan Dimock, the lovely and brilliant girl whose tragic death in the shipwreck of the Schiller, in 1875, deprived the women physicians of America of their first surgeon. Dr. Morton spent several arduous years in the Paris Maternity, where she became chief assistant in order to fit herself for the medical practice at home in which she has so well succeeded. Dr. Dimock went to Zurich, and was the first American girl to graduate from its medical school. In the three brief years that she was resident physician at the New England Hospital, she exhibited a degree of surgical ability that promised a brilliant professional career. The three surgical cases published by her in the New York Medical Record (see Bibliographical List) are of real importance and originality.^[80]

167The New England Hospital, like its sister institutions at New York and Philadelphia, outgrew, and more rapidly than they, its early narrow limits in Pleasant Street, and in 1872 the present beautiful little building was erected in the suburbs of Boston. The work was steadily enlarged, year by year. The report for 1889 shows:

Hospital staff: Resident physician, 1; advisory physicians, 3; visiting physicians, 3; visiting surgeons, 3; internes, 6. In-patients for year, 376; Dispensary patients, 3175.

In 1865, a fourth hospital for women and children was organized in Chicago, “at the request and by the earnest efforts of Dr. Mary H. Thompson, the pioneer woman physician in the city. Opened just at the close of the war, many of those to whom it afforded shelter, nursing, and medical attendance were soldiers’ wives, widows, and children, and women whose husbands had deserted them in hours of greatest need. There came from the South refugees both white and colored.”^[81] Thus in the West as in the East, we find repeated for the women physicians of the nineteenth century the experience of the men of the eighteenth; it was amidst the exigencies of a great war that their opportunities opened, their sphere enlarged, and they “emerged from obscurity” into the responsibilities of recognized public function.

In 1871, just as money had been collected to purchase a better house and lot for the small hospital, the great fire occurred; and when after it, “the remnants were gathered together, they were found to consist of one or two helpless patients, two housemaids, a nurse, a pair of blankets, two pillows, 168and a bit of carpet.”^[82] The hospital “remnant,” however, profited with others by the outburst of energy which so rapidly repaired misfortune and rebuilt the city. In 1871, a building was purchased by the Relief and Aid Society, for $25,000, and given to the hospital, on conditions, one of which was that it should annually care for twenty-five patients free of charge.

During the first nineteen years of its existence, up to 1854, over 15,000 patients had been cared for by the hospital, of which 4774 were house patients, 9157 were treated in the dispensary, and 1404 attended at home. The report of the hospital for 1888 gives a summary for four years.^[83] There is a hospital staff, comprising attending physicians, 5; pathologist, 1; internes, 3. Annual average from four years summary: in-patients, 334; dispensary, 806; visited at home, 138.

The fifth woman’s hospital was opened in San Francisco in 1875, under the name of the Pacific Dispensary, by Dr. Charlotte Blake Brown and Dr. Annette Buckle, both graduates of the Philadelphia school. During the first year, it contained but six beds. To-day, after fifteen years’ untiring work, the enlisted sympathies of generous friends have developed it to a hospital for 110 beds, to which sick children are admitted gratuitously, and adult female patients on payment of a small charge. It is under the care of six attending physicians, who serve in rotation.

Finally, in distant Minneapolis, a sixth hospital has sprung up in 1882. At its latest report, only 193 patients had been received during the year. But the history of its predecessors, and the irresistible Western energy of its friends, predict for this a growth perhaps even more rapid than that possible in cities in the East.

It is worth while to summarize the actual condition of these six hospitals in a tabulated form:

169

NAME. DATE OF ORIGIN. CAPACITY. NO. ON STAFF. ANNUAL NO. IN-PATIENTS. ANNUAL NO. DISPENSARY. ANNUAL NO. OUT-PATIENTS.

New York Infirmary. 1857 35 beds 3 visiting physicians. 342 4,825 768

3 internes, 3 associates. (report for 1889)

1 resident.

1 out-physician.

Woman’s Hospital, Philadelphia. 1862 47 beds 6 visiting. 583 6,365 695

6 internes. (report for 1889)

1 resident.

12 district.

New England Hospital. 1863 58 beds 6 visiting. 376 3,175

6 advisory. (report for 1889)

6 internes.

Woman’s Hospital, Chicago. 1865 80 beds 5 visiting. 354 806 138

3 internes. (average of collective report for 4 years)

1 pathological.

Hospital for Sick Children and Women, San Francisco. 1875 110 beds 6 attending.

2 specialists.

2 internes.

Northwestern Hospital, Minneapolis. 1882 4 visiting. 193

(report for 1889)

Thus, total number of women physicians engaged in six hospitals, 94; number renewed annually, 32; annual number indoor patients, 1828; annual number of dispensary patients, 15,171; annual number patients treated at home, 1601; total number patients, 18,600.

This represents the growth since 1857, when the only hospital conducted by women, in this country, was the lying-in ward of the New York Infirmary, containing twelve beds.

The foundation of these hospitals effected the transition for women physicians from the pre-medical period, when medical education was something attempted but not effected, to a truly medical epoch, when women could really have an opportunity to engage in actual medical work. Correlatively the theoretic education began to improve. In Boston, the Female Medical College was happily extinguished as an independent institution. In Philadelphia, the Faculty gradually struggled free of its inefficient or objectionable members, utilized its legacy of $100,000 to fully equip its beautiful college building, with amphitheatres, lecture rooms, and even embryo laboratories, museums, and libraries,—enlarged its corps of instructors until they numbered twenty-three, instead of the original and 170meagre seven,—and even, though more timidly, began to enforce something like a rigid discipline among its students, in regard to conditions of admission, examination, graduation, and terms of study. In 1885, Lawson Tait, the famous English surgeon, described the college building as “being very large and splendidly appointed. Last year twenty-six degrees of doctor of medicine were granted by the Faculty, and from the perusal of the curriculum, as well as from conversation with some of the graduates, and from discussion with both the friends and opponents of the school, I am quite satisfied that its graduates are quite as carefully trained as those in any other medical school. When I tell you that last winter 132 students matriculated in this school, that the amphitheatre in the hospital is large enough to seat 300 persons, and that every year about 4000 patients pass through this amphitheatre in the college clinics, I shall have said enough to prove to you that in the United States the practice of medicine by women has become an accomplished fact.”^[84]

In New York, after much hesitation, a charter was obtained in 1865 for the establishment of a medical college in connection with the Infirmary. “This step was taken reluctantly, because the desire of the trustees of the Infirmary, of Drs. Elizabeth and Emily Blackwell, was not to found another medical school, but to secure the admission of women to the classes for instruction already organized in connection with the medical charities of the city, and to one at least of the New York medical colleges.... The demand of women for a medical education had resulted in the founding of small colleges in different places, all, with the exception of the Philadelphia School, limited to the narrow and cheap standard of legal requirements, and producing equally cheap and narrow results in the petty standard of medical education they were establishing among women students.^[85] Application was made to the College of Physicians and Surgeons for advice, and the case was laid before the Faculty. It was stated that a sufficient number of women were studying medicine to show that there was a demand for instruction that must be satisfied; that the 171standard of education was so low that incompetent women were in possession of degrees, while competent women could not obtain the thorough instruction they desired, and those who were fitted to do good work had to contend, not only against popular and unjustified prejudice, but against the justified prejudices of those who saw the slipshod work of ignorant graduates from women’s medical colleges.”^[86] The trustees proposed to the College of Physicians and Surgeons, the oldest and most reputable in New York, that they receive a limited number of female students on scholarships established by the Infirmary, to the amount of $2000 a year. This proposition was rejected, and the opinion expressed, in no unfriendly spirit, that the ends proposed were only to be obtained by establishing an independent school for women in connection with the Infirmary.

The establishment of such a school called for money,—but the money was forthcoming. A new building was purchased for the hospital; the old one, which had done such modest but effective work, was surrendered to the use of the college, and a prospectus issued announcing the requirements of the latter. In this prospectus a bold attempt was made to outline a scheme of education, which should not only satisfy the conventional existing standard, but improve upon this. It was realized, and, oddly enough, for the first time, that the best way to compensate the enormous disadvantages under which women physicians must enter upon their work, was to prepare them for it with peculiar thoroughness. Women students were almost universally deficient in preliminary intellectual training: their lesser physical strength rendered a cramming system more often dangerous to health, and more ineffective as a means of preparation; and the prejudices to be encountered in their medical career would subject them not only to just, but also to abundant unfair criticism. Instead, therefore, of the senseless official system which then everywhere prevailed, it was proposed to establish a three years graded course, with detailed laboratory work during the first years, and detailed clinical work during the last. A chair of hygiene was established for the first time in America, and an independent board of examiners was appointed consisting of professors from the different city schools. By this means the college voluntarily submitted itself to the external criticism of the highest local authorities. 172When the Infirmary put forth this prospectus, drawn up by the Drs. Blackwell, no college in the country required such a course: it was deemed Quixotic by many medical friends, and several of its features were for a time postponed. The independent board of examiners, however, was established from the beginning, and, little by little, the other parts of the scheme were realized. In 1876, the three years graded course, at first optional, was made obligatory. At this time no college but Harvard had taken this step. The next year the class fell off one-third,—a curious commentary on the character or circumstances of the students.^[87] In 1881, the college year was lengthened to eight months, thus abandoning the time-honored division of a winter and spring course, the latter comparable to the Catholic works of supererogation, and equally neglected. At the same time entrance examinations were established. These moderate improvements upon the naïve barbarism of existing customs again reduced the classes one-half. When people first began to think of educating women in medicine, a general dread seemed to exist that, if any tests of capacity were applied, all women would be excluded. The profound skepticism felt about women’s abilities, was thus as much manifest in the action of the friends to their education as in that of its opponents. But by 1882, the friends dared to “call upon those who believe in the higher education of women, to help to set the highest possible standard for their medical education; and upon those who do not believe in such higher education to help in making such requirements as shall turn aside the incompetent,—not by an exercise of arbitrary power, but by a demonstration of incapacity, which is the only logical, manly reason for refusing to allow women to pursue an honorable calling in an honorable way.”^[88]

“A career is open to women in the medical profession, a career in which they may earn a livelihood; a career in which they may do missionary work among the poor of our own country, and among their own sex in foreign lands; a career that is practical, that is useful, that is scientific.”^[89]

Even when a theoretic demand is not entirely realized in the actual facts of the case, its distinct enunciation remains a great achievement; and, in an almost mysterious way, constantly 173tends to effect its own ultimate realization. And so it has been here.

During the current year, the college has emerged from its original chrysalis condition within the inconvenient precincts of a private house building, and entered upon a new phase of existence in a suitable building especially erected for its needs. The money for this building was collected from private subscriptions, by the indefatigable exertions of the friends of the college, and may be said to some extent to measure the growth of interest in the medical education of women, which had become diffused through the community.

In the West, two medical schools for women were opened in the same year, 1869; in Chicago a separate women’s school; in Michigan the medical department of the State University.

The State University was founded and controlled by the State Legislature. On this account, in accordance with a principle generally recognized in the West, the youth of both sexes are equally eligible to its schools, as being equally children of the citizens who support the schools by means of taxation.^[90] The application of this simple principle to the medical school at once solved the question of “medical co-education of the sexes,” which had been such a bugbear in the East. The difficulties which had elsewhere been considered so insolvable, were arranged in the simplest manner. In regard to all subjects liable to create embarrassment, if discussed before a mixed audience of young students, the lectures were duplicated, and delivered to the male and female students separately. These were thus a double course for obstetrics, gynæcology, and some sections of internal medicine and surgery. The lectures, lecturers, and subsequent examinations of the students were, however, identical, and the clinics are held in common.

The value to women of this State recognition, and of opportunity to study at a university school, was immense. There were numerous disadvantages due to the youth and undeveloped character of the school, and still more to its control by a popular legislature, unversed in the requirements of learned professions. Yet there was promise of indefinite growth in the future, and in all the development of the future, women might hope to share.

At first the course of instruction was limited to two years; it has lately been extended to three; though it still has the serious defect of demanding no thesis from students as a condition 174of graduation. Clinical instruction has been necessarily inadequate in a small country town. It has been lately proposed to transfer this part of the curriculum to Detroit, where large hospitals furnish clinical material in abundance.

In Chicago, application to admit women was made in 1865 to the Rush College, where Emily Blackwell had studied during the winter of 1851. The appeal was refused.

In 1868, application was made at a rival school, the Chicago Medical College, and was accepted. For a year female students attended the lectures and clinics in company with young men. “The women,” observes a Chicago writer, “were all right; but the men students were at first embarrassed and afterwards rude. The mixed classes were therefore abandoned, but the woman’s movement, being essentially just and correct,”^[91] was not abandoned, but led to the founding of a special school for women in 1869.

The pioneer woman physician in Chicago was Dr. Mary H. Thompson, who, having graduated at Philadelphia, and spent a year as interne at the New York Infirmary, settled in the West in 1863. At this period she was often introduced as a curiosity. Western curiosity, however, is rarely ill-natured, and in this case was soon exchanged for respect and a substantial sympathy, which enabled Dr. Thompson to establish the Hospital for Women and Children. In 1869, when the medical school was opened for women, its students found in this little hospital their first opportunities for clinical instruction. From 1869 till 1877, the collegiate course was conducted in a “small two-story building containing a dissecting room and one little lecture room furnished with two dozen chairs, a table, a portable blackboard, and a skeleton. There were scarcely any means for practical demonstration in the lectures, there was no money to procure them.”^[92] Worse than all, several among those who had consented to teach the students seemed, strangely enough, to have done all they could to discourage them. “One lecturer only delivered two lectures in the entire term, and then took up part of the time in dwelling upon the ‘utter uselessness of teaching women.’ The professor of surgery went on the staff with great reluctance, and remarked in his introductory lecture that he did not believe in female 175doctors, and that the students were greatly mistaken if they imagined the world was waiting for them. His lectures chiefly consisted of trifling anecdotes.”^[93] The class which graduated in 1871 under these discouraging circumstances consisted of three students. No one would study more than two years, “because it was found that in that time could easily be mastered all the college had to teach.” But in 1881, the graduating class rose to 17, and in 1889, to 24. There is now a Faculty of twenty members, with eight lecturers and assistants. There were 90 students in the current year, and it was announced that in twenty years had been graduated 242 pupils.

In 1863, the same year in which Dr. Thompson settled in Chicago, another graduate of the Philadelphia school penetrated still further west, and tried to establish herself in San Francisco. But this pioneer enterprise failed. In 1872, Mrs. Charlotte Blake Brown applied to be admitted to the medical colleges of San Francisco, but being refused, went to Philadelphia to study. In 1874 Mrs. Lucy Wanzer applied at the Toland Medical School. This had been founded by a generous millionaire, who presented it to the State University,—and as the State laws provide for the admission of both men and women to the State schools, the regents were compelled to receive Mrs. Wanzer, who thus was the first woman to graduate in medicine on the Pacific Coast. In 1875 the rival school, the Cooper Medical College, also opened its doors to women, Mrs. Alice Higgins being the first candidate. Both colleges now freely admit women, and there are about half a dozen in each class.

Three of the ladies at present practicing in San Francisco are, however, graduates of Paris.^[94]

Two other medical schools, both in Western New York, have for several years admitted women: the school of the Syracuse University, and the school at Buffalo.

Finally, in 1882, a fourth woman’s school was opened in Baltimore, and has connected with it a hospital, which is not, however, managed by women. The total number of students annually attending the various institutions which have now been enumerated may be approximately tabulated as follows:

176Woman’s Medical College of Pennsylvania, report in 1890, 181 students.

Woman’s Medical College, N. Y. Infirmary, report in 1890, 90 students.

Woman’s Medical College, Chicago, report in 1890, 90 students.

University of California, report in 1890, 8 female students out of total of 27.

Cooper College, San Francisco, report in 1890, 18 women out of total of 167.

From Ann Arbor I have only obtained the list of female graduates, which is 88.

The total number of graduates from the Philadelphia School, who have been enrolled among the alumnæ, is 560.

The total number of graduates of the New York School is 135.

During the current year, a movement has been inaugurated to obtain admission for women to the medical school of the Johns Hopkins University for the purpose of advanced study.^[95]

Future advance for the education of women in medicine must be in the line of their admission to the schools where the highest standard of education is maintained; and to such affiliation of their own schools with universities, as may bring them under the influence of university discipline. There is no manner of doubt that, with a few unimportant restrictions, co-education in medicine is essential to the real and permanent success of women in medicine. Isolated groups of women cannot maintain the same intellectual standards as are established and maintained by men. The claim of ability to learn, to follow, to apply knowledge, to even do honest original work among the innumerable details of modern science, does not imply a 177claim to be able to originate, or to maintain by themselves the robust, massive intellectual enterprises, which, in the highest places, are now carried on by masculine strength and energy.

Whether, as has been asserted,^[96] the tendency to quackery among women is really more widespread than among men, may well be doubted. It is true that their lesser average strength peculiarly inclines women to follow the lines of the least resistance. On that very account, it is singularly unfortunate that the greatest, indeed in this country an invincible, resistance has been offered to woman’s entrance at the best schools, while inferior and “irregular” colleges have shown an odd readiness to admit them. It would seem that co-educational anatomy is more easily swallowed when administered in homœopathic doses! Evidently, however, for the maintenance of these irregular schools,^[97] the women are not responsible: and they only have two of their own.

Because women require the intellectual companionship of man, to be able to recognize the highest intellectual standards, or to attain them in some cases, and to submit to their influence in others,—it does not follow that they have no special contributions of their own to offer to the work of medicine.

The special capacities of women as a class for dealing with sick persons are so great, that in virtue of them alone hundreds have succeeded in medical practice, though most insufficiently endowed with intellectual or educational qualifications. When these are added, when the tact, acuteness, and sympathetic insight natural to women become properly infused with the strength more often found among men, success may be said to be assured.

The sixth period is that of the struggle to obtain for women physicians official recognition in the profession. In the prolonged debate which followed, the women’s cause was defended by many distinguished men, with as much warmth as it was opposed by others. This debate began long before the close of the period which has just been described. It was the Philadelphia County Medical Society, which assumed the responsibility of being the first to check the alarming innovation of women’s schools and female doctors. In 1859, was introduced the resolution which has already been mentioned,^[98] declaring 178that any member who should consult with women should forfeit his membership. Upon this resolution the censors declined to express an opinion. Endorsement was, however, obtained from a committee of the State Medical Society. The recommendations of this society were supposed to be mandatory on all the county societies throughout the State. But one of these, that of Montgomery County, under the chivalrous inspiration of Dr. Hiram Corson, early distinguished itself by a revolutionary independence in this matter. It passed a resolution “that females, if properly educated, should receive the same treatment as males, and that it was not just to deny women admission to male colleges, and then, after they had with great perseverance established one for themselves, to refuse it recognition.” This resolution being brought before the State Medical Society in 1860, a new resolution was passed, which reaffirmed the decree of excommunication. In 1866, the State Society met at Wilkesbarre, and Dr. Corson, who then entered the lists as a champion for women, moved that this motion be rescinded. Dr. Mowry offered a resolution declaring that the resolution in question was not intended to prevent members from consulting with “regularly” educated female physicians, who observe the code of ethics. This latter resolution was finally referred for discussion to the different county societies, and in 1867, was the subject of an elaborate report from a special committee, of which Dr. Condie was the chairman.^[99]

Dr. Condie opposed the repeal of the resolution of 1860, because (he claimed) “the present condition of female colleges is rather worse than it was when the resolution was adopted.” He strongly “objected to women having schools of their own, where any physician, of any kind of notoriety, no matter what his moral or professional standing, might be admitted to teach. We will have female practitioners. We must decide whether they shall be properly educated. It cannot be doubted that there are women well qualified by nature and who could be thoroughly instructed as practitioners in medicine. To such women should be freely extended the advantages of the leading medical colleges,—and they should graduate, if at all, at the same schools and under the same conditions as men.” To this recommendation, Dr. Bell objected that there were no means at present existing where the women could be instructed. Dr. Coates said he had no doubt but that women were perfectly competent under favorable circumstances to make good practitioners, 179but it seems to be very rarely the case that they do. He did not believe it possible at that date to give women a proper medical education. “The tendency of female medical schools seems to be of the cheapening kind.”

Dr. Condie remarked that the report [which, however closed with a resolution not to “recognize” the woman’s college], begins by stating that females are competent, if properly educated, to practice medicine. History instructs us that the female mind is competent to anything the male mind has accomplished. Nevertheless females ought not to be encouraged to become physicians. God never intended them to be physicians. Dr. Atlee^[100] urged that the policy of non-recognition, if persisted in, should be placed absolutely on the ground of the status of the female colleges. “Have not women applied year after year at our doors and begged to be received, yet been rejected? In self-defense they had to organize their own college, which had now been in existence seventeen years.” Dr. Atlee then warmly defended the college on the basis of its published curriculum and on the reputation of such of the gentlemen as had dared to incur professional odium by teaching in it.

In reply to this, Dr. Maybury declared that “he knew some of his nurses who could hardly read the directions accompanying a prescription, who entered the woman’s college, and emerged shortly after, fully equipped with their legal diploma.”

Dr. Lee observed that the committee report and its concluding resolution might be considered to read about as follows: “Whereas in the opinion of this society, the female mind is capable of reaching every stage of advancement to which the male mind is competent: and whereas all history points out examples in which females have mastered every branch of science, art and literature: therefore, be it resolved, that any member of this Society who shall consult with a female physician, shall forfeit his privileges as a member of this society.” “The resolution completely stultifies the report.”

Nevertheless the resolution was adopted, and the County Medical Society, notwithstanding so many internal protests, reaffirmed its former position. The doughty little society from Montgomery then rushed to the rescue with a counter resolution, flung at its big Philadelphia neighbor like the pebble of David at the face of Goliath:

“Whereas the Woman’s Medical College is properly organized, with an intelligent and efficient corps of instructors, in possession 180of good college buildings, and of all the appliances necessary for medical instruction; that the students and graduates are irreproachable in habits and character, as zealous in the pursuit of knowledge, as intelligent and conscientious, as any of their male compeers; we hold it to be illiberal and unworthy the high character of our profession to withhold from them the courtesies awarded to male physicians.”—E. M. Corson, M.D., Recording Secretary.

In 1870, the Montgomery County Society elected Dr. Anna Lukens to membership.

In these debates the reasoning of the “opponents,” was always secretly hampered by the lack of a definite standard with which the curriculum of the condemned female schools could be compared. It was perfectly true that the idea prevailed in them, that the real preparation for medical practice was to be “picked up” by beginning to practice; and that, when a legal diploma had once been obtained, all essential difficulties had been removed, and the graduate could at once enter upon her “life work,” with a light heart and assured prospects of success. But then this same idea prevailed also in the men’s schools, that were nevertheless recognized as perfectly “regular,” and whose graduates were readily admitted to membership. On this account, detailed argument upon a legitimate basis soon broke down, and resolutions were substituted which declared the views of the Supreme Being in regard to female physicians.^[101]

The question was now transferred to the larger area of discussion in the American Medical Association. This is a great national body, composed of delegates from all the State societies, and meeting only once a year in a session of three days, at different portions of the country. In 1871, the annual meeting was held at San Francisco, and the “female physician question” was there subjected to a long and animated debate.^[102]

The preceding year, 1870,^[103] Dr. Hartshorne of Philadelphia, a physician of excellent standing, and professor of physiology in the Woman’s Medical School, had moved such an amendment 181to the constitution as would permit teachers in such schools (if men) to be received as delegates of the association. In 1871, Dr. Harding of Indiana moved the adoption of the resolution. But Dr. Davis of Illinois asked solemnly whether “the time had come by deliberate action to open the door and welcome the female portion of the community, not only into our profession, but into all professions. Do we desire this time ever to come? Is there any difference in the sexes? Were they designed for any different spheres? Are we to heed the law plainly imprinted on the human race, or are we as a body to yield to the popular breeze of the times and say it must come, and therefore we will yield to it?”

Dr. King of Pittsburgh remarked that this matter had been debated in the society many years, and on one occasion a vote was taken, 47 on one side, 45 on the other, a majority of only two against the women. This war against women was beneath the dignity of a learned society of scientific men. Prof. Gibbons of California said: “If a woman showed herself to be the equal of a man, I cannot for the life of me see what objection there should be to it.”

Prof. Johnson of Missouri did not understand that woman has asked admission to this floor. The questions only related to the admission of her teachers as delegates to the association. “I am wholly opposed to the admission of women here. Let women have their own associations. This body will stultify itself by the admission of women.”

Dr. Atlee of Philadelphia remarked that “the opposition to female colleges generally comes from the professors or controllers of other colleges. These women’s colleges stand in many respects better than many of the colleges represented in the association; they give obstetrical and clinical instruction, as is not given in a majority of the colleges represented here.... By the rules of our medical association, I dare not consult with the most highly educated female physician, and yet I may consult with the most ignorant masculine ass in the medical profession.”

Prof. Thomas asked that a committee be appointed to examine the Woman’s College, [which, amid all the discussions, had never yet been done, and indeed never was done.] The Pennsylvania State Medical Society had never dared to enforce its resolutions of excommunication. One physician had even challenged it publicly to “dare to enforce this most unjust law.”

Dr. Johnson pointed out that the president of the association, 182Dr. Stillé, was, by its rules, under the ban, because he was in the habit of consulting with women.

Dr. Storer of Boston seized the occasion in the evening session to pronounce a discourse on his favorite subject, the physiological incapacities of women. Dr. Storer had been for two years a visiting surgeon to the New England Hospital; but the boldness and ill success of many of his operations having alarmed the women physicians and the trustees, rules were passed subjecting future operations to the decision not only of the surgical, but of the medical, staff. Such rules were distinctly contrary to medical etiquette, and possibly unnecessary for the purpose in view. Dr. Storer resigned, which was not altogether unreasonable, but the letters in which he proclaimed his annoyance to the world exhibited less of reason than of irrelevant petulance. The main argument of this earlier letter was now reproduced in the memorable San Francisco debate,—although this, on the face of it, was not concerned with the philosophy of the female physician at all.

“There is,” declared the Boston orator, “this inherent quality in their sex, that uncertain equilibrium, that varying from month to month in each woman, that unfits her from taking those responsibilities which are to control questions often of life and death.”

To this Dr. Gibbons of San Francisco replied: “If we are to judge of this proposition by the arguments of my friend from Boston, I think it would prove conclusively the weakness of his side of the question.... It is a fact that a large majority of male practitioners fluctuate in their judgment, not once a month with the moon, but every day with the movement of the sun. I ask whether it be not true that one half of the male practitioners of medicine are not to a greater or less extent under the influence of alcohol at some period of the twenty-four hours? I do not say that they get drunk, but their judgment is certainly more or less affected.” A rude rejoinder to a gentleman who had traveled all the way from Boston to San Francisco to make himself heard on the eternal verities of physiology and psychology in regard to “female physicians,” which must be rescued from the “popular breeze” of contemporary opinion!

Notwithstanding the warm championship of many of the debaters, including 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, 183seems 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 184County 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 185may 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.