Part 17

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 with 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 Quaker 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 among 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] Dr. 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] The 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 “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 that 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 thus 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 physician, 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 was 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]

The 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: