Part 16

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 the 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 midwives; 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 admission 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.

In 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 Blackwells, 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]

So 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 of 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 and 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 in 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 rejected: 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 women 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.