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 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.
 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:
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, and 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:
 NAME. DATE CAPACITY. NO. ON ANNUAL ANNUAL NO. ANNUAL
OF STAFF. NO. IN- DISPENSARY. NO. OUT-
ORIGIN. PATIENTS. PATIENTS.
New York 1857 35 beds 3 visiting 342 4,825 768
Infirmary. physicians
.
3 internes, 3 (report for
associates 1889)
.
1 resident.
1 out-
physician.
Woman’s 1862 47 beds 6 visiting. 583 6,365 695
Hospital, 6 internes. (report for
Philadelphi 1889)
a. 1 resident.
12 district.
New England 1863 58 beds 6 visiting. 376 3,175
Hospital. 6 advisory. (report for
1889)
6 internes.
Woman’s 1865 80 beds 5 visiting. 354 806 138
Hospital, 3 internes. (average of
Chicago. 1 collective
pathologic report for 4
al. years)
Hospital for 1875 110 beds 6 attending.
Sick
Children 2 specialists.
and
Women,
San 2 internes.
Francisco.
Northwestern 1882 4 visiting. 193
Hospital, (report for
Minneapoli 1889)
s.
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 meagre 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 standard 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. When 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 tends 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 of 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 doctors, 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:
Woman’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 claim 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 that 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, but 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 of 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 to 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, Dr. 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, seems to have been the last
occasion on which the matter was discussed. For in 1876, when the Association met in
Philadelphia, Dr. Marion Sims being president, a woman delegate appeared, sent by the
Illinois State Medical Society, Dr. Sarah Hackett Stevenson, of Chicago. Dr. Brodie, of
Detroit, moved that hers, “and all such names, be referred to the Judicial Council.” A
motion that this resolution be laid upon the table was carried by a large vote, amid
considerable applause. The president asked if this vote was intended to recognize Dr.
Stevenson’s right to a seat. Loud cries of yes, and cheers, emphatically answered the
question.[104] Thus this mighty question, which had disturbed the scientific calm of so many
medical meetings, was at last settled by acclamation. The following year at Chicago, Dr.
Bowditch of Boston, being president, congratulated the Association in his inaugural
address that women physicians had been invited to assist at the deliberations.
The State Medical Society of Pennsylvania, where the discussion originated, did not
really wait for the action of the National Association to rescind its original resolution of
1860. This did not refer to the admission of women as members, that was not even
considered, but forbade “professional intercourse with the professors or graduates of
female medical colleges.” In 1871, when the Society met at Williamsport, Dr. Traill Green
moved to rescind this resolution, and, “amid intense but quiet excitement,” the motion was
carried by a vote of 55 yeas to 45 nays.
“Thus,” writes the now venerable champion of the women, Dr. Hiram Corson, “ended
successfully the movement originated by Montgomery County, to blot from the
transactions of the State Society a selfish, odious resolution adopted eleven years before....
This report gives but the faintest idea of the bitterness of the contest, of the scorn with
which the proceedings of the Montgomery County were received, and the unkindness
manifested against all who from year to year asked for justice to women physicians....
What would now be their status, had not the blunder of the Philadelphia Medical Society
been committed?”[105] In 1881, the first woman delegate was admitted as member of the
State Society; and in 1888, the Philadelphia County Society also yielded, and admitted its
first woman member, Dr. Mary Willets.[106]
Pennsylvania was not the first State to admit women to medical societies. It has been
mentioned that the American Association, at its Centennial year meeting, received Dr.
Sarah Stevenson from the Illinois State Medical Society. But, earlier than this, women had
been received in New York State and city. The very first occasion was 1869, when the Drs.
Blackwell were accepted as members of a voluntary “Medical Library and Journal
Association,” which held monthly meetings for hearing papers on medical subjects read by
its members.[107] In 1872, a paper was read before this society by a young lady who had just
returned from France with a medical diploma, the first ever granted to an American
woman from the Paris École de Médecine.[108] In 1873, Dr. Putnam was admitted without
discussion to the Medical Society of New York county, at the suggestion of Dr. Jacobi the
president, whom she married a few months later. In 1874 she was sent as a delegate from
the County Society to the State Medical Society, at its annual meeting at Albany. She also
became a member of the Pathological, Neurological and Therapeutical societies, but was
excluded from the Obstetrical Society by means of blackballs, although her paper as
candidate was accepted by the committee on membership, and she received a majority
vote. Finally, and a few years later, she was elected, though by the close majority of one, to
membership in the New York Academy of Medicine.
The facile admission of Dr. Putnam to these various privileges, in New York, at a time
that the propriety of female “recognition” was still being so hotly disputed in other cities,
was due partly to the previously acquired honor of the Paris diploma;[109] partly to the
influence of Dr. Jacobi. This physician may be said to have accomplished for women in
New York what was done in Philadelphia by Drs. Hartshorne, Atlee, Stillé, and Thomas; in
Boston by Drs. Bowditch, Cabot, Putnam, and Chadwick; in Chicago by Dr. Byford. The
door was opened, other women entered without difficulty. The County Medical Society was
expected to register all regular and reputable practitioners in the city, and at the present
date contains the names of 48 regular physicians.
Four other women became members of the Pathological Society,[110] two of the
Neurological Society,[111] one of the Neurological Association,[112] and two of the Academy of
Medicine.[113] No new application has been made to the Obstetrical Society, a private club.
But the obstetrical section of the Academy contains one female member.[114]
In Boston the “admission” of women was debated in three directions: to the Harvard
Medical School, to the Massachusetts State Medical Society, and to the Boston City
Hospital. The application of Miss Hunt to the Harvard Medical School in 1847 and 1850
have already been described. After the final discomfiture of this first applicant, no other
attempt to open the college doors was made until 1879,[115] when a Boston lady, Miss
Marian Hovey, offered to give $10,000 toward the new building the college was about to
erect on condition that it should receive women among its students. A committee was
appointed from among the overseers of the university to consider the proposition;[116] and
after a year’s consideration reported, with one dissenting voice, in favor of accepting the
conditions. The committee outlined a plan for medical co-education, substantially like that
already adopted at the Michigan University, where certain parts of the instruction should
be given to both sexes in common; for others, where embarrassment might occur, the
instructions should be duplicated. The one dissenting voice, that of Le Baron Russell,
disapproved of co-education in any shape, but urged that Harvard University should
charge itself with providing a suitable independent school for women.
The majority report expressly advised against the establishment of a separate school for
women because “A considerable number of the most highly cultivated women physicians of
the country state that the same intellectual standard cannot be maintained in a school
devoted to women alone, and that the intellectual stimulus obtained by female students
from their association with men is an all-important element of success.”[117]
To guide its deliberations the committee had sent questions to 1300 members of the
State Medical Society, to which 712 answers were received; of these 550 were in favor
either of admitting women to the school, or of providing in some way for their education
and recognition. These answers helped to decide the affirmative character of the majority
report. Upon its reception, the Board of Overseers recommended the Medical Faculty to
accept Miss Hovey’s $10,000 and admit women to the school. But of the 21 members of
the Medical Faculty, seven were strongly opposed to the admission of women, six were in
favor of admitting them under certain restrictions, eight were more or less opposed but
were willing to try the experiment. It was generally considered too rash an experiment to
be tried, at the moment that the school was already embarked on certain improvements in
its course of education, which threatened to cause a falling off in the number of its
students. So the proposition was finally rejected by a vote of 14 to 4. The overseers of the
university, having no actual control over the decisions of the Medical Faculty, were
therefore compelled to decline Miss Hovey’s offer. But, in doing so, they strongly
recommended as expedient that, “under suitable restrictions, women should be instructed
in medicine by Harvard University.”
The defeat at Harvard in May was, however, followed by a triumph in another direction
in October of the same year. On Oct. 9, 1879, an editorial in the Boston Medical and
Surgical Journal says: “We regret to be obliged to announce that, at a meeting of the
councilors held Oct. 1, it was voted to admit women to the Massachusetts Medical Society.”
This society is not, like that of New York and many of the States, composed of delegates
from county societies, but it comprises, and indeed consists of, all the legally qualified
practitioners of the State. Refusal to enroll women among its members, therefore, meant a
refusal to recognize the legality of diplomas that the authority of the State had conferred.
The profession, therefore, in this matter deliberately set itself above the law, a most
exceptional act in American communities. A precedent for such action had previously been
established when the society refused to recognize homœopathic and eclectic physicians,
who also held diplomas by legal authority, inasmuch as their schools were chartered by the
State. The action of the Medical Society towards women was, in fact, intended as a means
of permanently relegating women among classes of practitioners pronounced inferior and
unscientific, and whose legal rights merely sufficed to save them from prosecution as
quacks, and to recover their fees from such persons as were foolish enough to employ
them.
For twenty-five years the battle was waged, and arguments advanced pro and con, of
substantially the same nature as those which have already been sufficiently quoted. A
circular was sent to the 1343 members of the society, asking the following question: Do you
favor the admission of women to the Society on the same terms with men? To this circular,
1132 replies were received, of which 709 were in the affirmative, 400 in the negative, while
23 were indifferent. “It was thus evident that a considerable majority of the Society, seven
to four of all who answered the circular, favor the admission of women.”[118]
In June, 1875, a committee of five was chosen from the society to report whether duly
educated women could not be admitted to membership. In October a majority reported in
favor of examining for membership men and women without distinction. But the minority
objected so vigorously, that the whole matter was postponed indefinitely. In 1878, another
committee was appointed: in June, 1879, the members were found equally divided; the
subject was referred back to the committee, who, in October of the same year, advised no
action. But this time the minority reported to instruct the censors to admit women for
examination. The councilors voted, 48 to 38, to adopt the minority report.[119]
But the end was not yet, for in February, 1880, the censors of Suffolk County (including
the city of Boston), voted that the society be advised to rescind its vote of October. This,
however, was never done; but, after some further delay, the first female candidate, Dr.
Emma Call, a graduate from Ann Arbor, passed a satisfactory examination and was
admitted. The decisive step once taken, other women passed in readily, and 1889, ten years
from the date of the conclusion of the famous controversy, a dozen women sat down to the
annual banquet of the society, among whom was one invited guest from another State. The
“moral tone” did not seem to be “perceptibly lowered,” on this occasion.
 In 1882, Dr. Chadwick published a tabulated summary of the dates at which various
State societies had admitted women to membership.
In 1872, Kansas, Iowa; in 1874, Vermont; in 1875, Maine, New York, Ohio; in 1876,
California, Indiana; in 1878, New Hampshire; in 1879, Minnesota, Massachusetts; in 1880,
Connecticut; in 1881, Pennsylvania.
Rhode Island, Illinois, and Oregon also had women members, but the date of their first
admission was not known. Thus seventeen societies contained, in 1882, 115 female
members—that of New York alone having forty-two, much the largest of all.
From this time the question of the official “recognition” of women might be regarded as
settled. Another question of equal, if not greater importance, now came to the front,—
namely, the extension to women of opportunities for study and practice in great hospitals,
opportunities absolutely indispensable both to obtaining and maintaining a valid place in
medical practice and the medical profession. The discussion of this question belongs to the
seventh period of the history.
For this purpose the small hospitals conducted by women were (and are) quite
insufficient. There is such a demand upon their slender accommodations and resources for
obstetric and gynæcological cases, and the claims of such cases to the special advantages of
these hospitals are so paramount, that they have so far tended to a specialism, which,
though useful for the patients, is detrimental to the physicians who must find all their
training in them. Efforts, therefore, have constantly been made to widen the range for
women, by securing their admission as students, internes, or visiting physicians to the
great hospitals, which constitute the medical treasure-houses of the country.[120] In
describing the actual condition of the medical schools, mention has been made of the
hospital advantages which have been, little by little, secured for their undergraduate
students. In Boston, where there is no school for women but the homœopathic school of
the Boston University, fewer opportunities exist than anywhere else.
The Massachusetts General Hospital is reserved exclusively for the students of the
Harvard Medical School. But the City Hospital remained unappropriated, and in 1886, the
President and Trustees of the Boston University petitioned for permission for their female
students to visit there, on the same terms as the young men. A committee was appointed to
consider the matter, and after an elaborate report on the contemporary usage in ninety-
one hospitals throughout the United States, advised that the request be granted. This
enabled the female students to attend the public lectures given and the operations
performed in the hospital amphitheatre about once a week.[121]
Similar, though more frequent, opportunities for clinical instruction had been previously
secured for women at the city hospitals of New York (Bellevue), Philadelphia (Blockley),
and Chicago (Cook County). At the Pennsylvania Hospital in Philadelphia, moreover, the
women from the Medical School had been admitted to lectures on special days, when no
male students were present. These scanty privileges (for not much can be learned about a
patient by spectators seated on the benches of an amphitheatre) were only obtained after a
series of collisions with the men students, occasionally rising to the dignity of a row, as
upon one memorable occasion at the Pennsylvania Hospital;[122] more often consisting in
petty teasings and annoyances, which bore considerable resemblance to the pranks of
schoolboys. To students habituated to the daily visits in the wards of the vast European
hospitals, this form of clinical instruction, where the patient studied is seen but once, and
then at a distance, must seem ludicrously inadequate.[123] From these defects, however, the
male and female students suffer alike. But the former have, until recently, retained the
monopoly of the hospital appointments, whereby a certain number of graduates are
enabled to acquire real clinical instruction. This monopoly is only just beginning to break
down.
Apparently the first general hospital in the country to confer a hospital appointment on a
woman, was the Mt. Sinai Hospital of New York. Here, in 1874, Dr. Annie Angell, a
graduate of the Infirmary School, was made one of the resident physicians, at the instance
of several members of the medical staff.[124]
In 1884 Dr. Josephine Walter, another graduate of the Infirmary School, was admitted
as interne after a severe competitive examination, among nineteen candidates, of which
only two could be appointed. She also served three years in the hospital, and then spent
two years in Europe in medical study.
Since her appointment, none others have been made, or indeed applied for, in this or
any other hospital in the city. Even in the Woman’s Hospital, with exclusively female
patients, and a host of female nurses, the medical staff have repeatedly expressed their
formal opposition to the admission of female internes; and the Board of Lady Managers,
oblivious of the first resolution of the first founders of the hospital, have so far remained
indifferent to the anomalous injustice of the situation.[125]
Among dispensary services, however, many women have found places. Dr. Angell and
Dr. Putnam Jacobi founded a dispensary at the Mt. Sinai Hospital, and for a year
conducted it exclusively themselves. It was then systematically organized by the directors
of the hospital, and has since always had women on the staff. In 1882, a school was open
for post-graduate instruction in New York, and Dr. Putnam Jacobi was invited to a place in
its faculty, as the clinical lecturer on children’s diseases, the first time a lectureship in a
masculine school was ever, in this country, filled by a woman. In the same school, another
woman, Dr. Sarah McNutt, was also appointed as lecturer, and founded a children’s
hospital ward in connection with the school. The positions at present held by women
physicians in New York dispensaries may be thus summarized, exclusive of the dispensary
of the Infirmary:
Demilt Hospital, 3; Mt. Sinai Hospital, 2; St. Mary’s Hospital for Children, 1; Hospital
for Ruptured and Crippled, 4; Manhattan Eye and Ear Infirmary, 1; Foundling Hospital, 1
(resident physician); Nursery and Child’s Hospital, 1 (resident at country branch); Babies’
Hospital, 1.
In Philadelphia, the Blockley Hospital, the first in the United States to allow a woman to
visit its wards,[126] appointed a female interne upon competitive examination, in 1883.[127]
Since this date, eleven other women have received such appointments,—of whom four in
1889. Dr. Clara Marshall and Dr. Hannah Croasdale were put on the visiting staff in 1882.
Chicago, however, is the city where the hospital privileges have been most equitably
distributed, though the opportunity has been obtained by a struggle rendered severe, not
from the opposition of those adverse to women physicians, but from the inadequate
instruction given by those who had professed to be their friends.
In 1877, an invitation was sent to the senior class to take part in the examination for
internes at the Cook County Hospital. “To go meant to fail. We decided to go, if only to
show how little we had been taught in surgery.” This was really an heroic determination;
and the ordeal was severe. “The students and other spectators received us with deafening
shouts and hisses The gynæcological and obstetrical examiners made vulgar jokes. The
surgeon tried to wreck us. We forced things as best we could, but of course no one received
an appointment.”[128] As a rather unusual result of this trial, the professor of surgery at the
Woman’s College was roused to exertion, and for two years taught so well, that on another
competitive examination the Woman’s College was said to have stood first. However, no
woman was appointed, but a relative of the commissioners, without an examination. Still
the women’s pluck and determination held out; they came up a third time,—and then, in
1881,—the coveted position was gained, and a young woman only twenty-one years of age
was nominated as interne. Since then, appointments have multiplied, thus:
Name of Hospital. Date of Appointment. No. of Women Physicians.
1881 1
Cook County Hospital 1888 2
1889 2
1882 1
1887 1
Illinois Woman’s Hospital
1888 1
1889 1
Wesley Hospital 1889 1
State Insane Asylum Unknown 2
Finally, it is noteworthy that Dr. Sarah Hackett Stevenson holds an appointment to the
Cook County Hospital as visiting physician, and Dr. Marie Mergler a similar appointment
to the Woman’s Hospital.
A special and extremely interesting branch of the struggle for hospital positions for
women physicians has related to their appointment in the female wards of insane asylums.
This movement also originated in Pennsylvania, and in the personal efforts of Dr. Corson,
supported, as before, by Dr. Atlee. At the annual meeting of the State Society in 1877, the
following preambles and resolution were read:

“Whereas, The State Medical Society has taken a deep interest in the welfare of the insane during the last
few years; and
“Whereas, The inmates of our State hospitals are in nearly equal numbers of the sexes; and
“Whereas, We have many female physicians who are eminent practitioners, and one at least[129] who has
had experience in the medical management of the insane: therefore,
“Resolved, That a committee of three persons be appointed by the president of this society, to report at its
next annual meeting on the propriety of having a female physician for the female department of every
hospital for the insane, which is under the control of the State.”

A committee was appointed,[130] and reported at length in favor of the resolution. Just
emphasis was laid on the fact that the very first attempts ever made to reclaim the insane
asylums of the State from a condition of utter barbarism were due to a woman, Miss
Dorothy Dix, whose name has been a household word in America, as that of Elizabeth Fry
in England. The fact that at present there were no women who had received the special
training requisite for the scientific treatment for the insane was offset by the other facts,
that the existing medical superintendents were charged with the business responsibilities
of the asylum, and thus had entirely insufficient time to devote to the medical care of the
patients; and that the subordinates, upon whom such care practically devolved, were
usually recent graduates, who were entirely destitute of special training, and indeed for
whose education in psychiatry no provision anywhere existed.
A bill was drafted, to be presented with a memorial to the Legislature, making the
appointment of a female superintendent obligatory in all asylums with female patients.
The legislative committee returned the bill to the House with an affirmative
recommendation.
A counter memorial was, however, sent to the Senate judiciary committee, protesting
against the appointment of a female superintendent as liable to cause clashing in the
management of the asylum. The memorial said that assistant female physicians could
already be employed wherever deemed expedient. The memorial was so copiously signed
as to suggest that much other opposition than that of superintendents, dreading collision,
had been marshaled to defeat the proposed law.[131]
Another counter thrust, however, was given by the trustees of the State Lunatic Hospital
at Harrisburg, who warmly supported the bill. Before the adjournment of the Legislature,
the bill was in fact enacted, but so altered that the trustees are not obliged to appoint a
woman chief physician, but only empowered to do so. At this same time, a new hospital for
the insane was opened at Norristown, not far from Philadelphia; and to this Dr. Alice
Bennett, a graduate of the Woman’s Medical College of Philadelphia, was elected by the
trustees as chief physician of the female department. Dr. Annie Kugler was appointed
assistant. Three months later, in September, 1880, the trustees of the asylum at Harrisburg
elected Dr. Margaret Cleaves to a position as assistant.[132] Legislative action analogous to
that initiated in Pennsylvania was not long afterward taken in Massachusetts and Ohio,
and finally, during the current year, 1890, in the State of New York.[133]
In New York, the bill required the employment of a woman physician in every State
insane asylum where women are confined. It passed with only two negative votes in the
Assembly, and three in the Senate.[134]
Previous to the enactment of this law, however, women assistants had served for a year
at the Willard Asylum for the chronic insane,[135] and in 1888, two other women, Dr.
Steadman and Dr. Wakefield, were appointed in the New York City Asylum on Blackwell’s
Island. Similar appointments have been voluntarily made in ten other States, and more
than twenty women are now serving as physicians in insane asylums.[136] The latest
appointment was the greatest innovation, for it was in a Southern State, Virginia, at
Staunton, and a Southern candidate, Miss Dr. Haynes, was appointed.[137] The Springfield
Republican concludes its notice of this event (see note), with the remark: “This reform is
steadily advancing, and it will not be long before the opposition to it will be as obsolete as
it is now indecent.”[138]
Thus the last word, (so far) like the first in this long controversy, is indecency. And it is
characteristic of the world-old social position of women that it should be so; since women
have in the mass, never been publicly and officially regarded as individuals, with individual
rights, tastes, liberties, privileges, duties, and capacities, but rather as symbols, with
collective class functions, of which not the least was to embody the ideals of decorum of the
existing generation, whatever these might happen to be. These ideals once consigned to
women, as to crystal vases, it became easier for men to indulge their vagrant liberty, while
yet leaving undisturbed the general framework of order and society. But all the more
imperative was it, that the standard of behavior, thought, and life for women should be
maintained fixed and immovable. Any symptom of change in the status of women seems,
therefore, always to have excited a certain terror. This is analogous to the fierce
conservatism of savage communities, ready to punish by death the slightest deviation from
established custom, because, as Mr. Bagehot observes, without such strenuous care their
entire social structure is liable to fall to pieces. It is perfectly evident from the records, that
the opposition to women physicians has rarely been based upon any sincere conviction
that women could not be instructed in medicine, but upon an intense dislike to the idea
that they should be so capable. Failure could be pardoned them, but—at least so it was felt
in anticipation—success could not. Apart from the absurd fear of pecuniary injury, which
was only conceivable so long as women were treated, not as so many more individuals in
the community, but as a separate class, and a class alien to men of their own race and
blood and even family,—apart from this consideration, the arguments advanced have
always been purely sentimental. There has always been a sentimental and powerful
opposition to every social change that tended to increase the development and complexity
of the social organism, by increasing the capacities and multiplying the relations of its
members. The opposition to women physicians is, in its last analysis, only one of the more
recent manifestations of this universal social instinct. So true is this, that in the strife
physicians have abandoned the sentiments proper to their own profession, and have not
hesitated to revile and defame it, in order to prove that it was unfit for the delicacy or
virtue of woman. They have forgotten the tone of mind, the special mode of vision that
becomes habitual to every one who has really crossed the threshold of the sublime art; they
have talked of “revolting details” and “disgusting preliminaries,” like the veriest outside
Philistine. There are horrors in medicine, because there are horrors in life. But in medicine
these are overcome or transformed by the potency of the Ideal; in life they must be borne
unrelieved. The women, who, equally with men, are exposed in life to the fearful, the
horrible, the disgusting, are equally entitled to access to those regions of knowledge and
ideas, where these may be averted, or relieved, or palliated, or transformed.
Again: A mother occupied with her young child offers a spectacle so beautiful and so
touching, that it cannot fail to profoundly impress the social imagination. Contemplating
this, it is easy to feel that all the poetry and romance, all the worth and significance of
women are summed up in the exquisite moments of this occupation; easy to dread the
introduction of other interests lest the women be unduly diverted from this, which is
supreme. Yet nothing is more obvious than that diversion comes, a thousand times, from
frivolity, but never through work; and that these moments are preceded by many years,
and followed by many years, and for many women, through no fault of their own, never
come at all. The seventy years of a life-time will contain much waste, if adjusted exclusively
to the five or six years of even its highest happiness. The toiling millions of women of every
age of the world have not been permitted to make such an adjustment, even if they should
wish to do so. They have always worked; but they demand now, and simply, some
opportunity for a free choice in the kind of work, which, apart from the care of children,
they may perform. The invasion of the medical profession is one of the more articulate
forms of this demand.
Although, according to the census of 1880, there were 2432 women registered as
physicians throughout the United States, and several hundred must have graduated in the
last ten years, it is probable that many of them have received an education too irregular
and imperfect to justify their claim to the title in any serious sense. Thus the numbers are
still too small, the time too short, to begin to estimate the work of women physicians. A
large number of the women recorded in the census tables will not be found among the
graduates of any suitable colleges, or on the registered lists of regular physicians, and these
cannot be counted in an estimate like the present. Thus the census of 1880 records 133
women physicians in New York, but the medical register of ten years later contains the
names of but 48. There seem to be about fifty at present in Philadelphia, twenty or thirty in
Boston. Eighteen are said to be practicing in Detroit. The great majority are scattered
through the country in small towns or country villages.
It is irrelevant to inquire with Waldeyer, “What women have done?” from the scientific
standpoint, because the problem given was to enable them to become observant, faithful,
and skillful practitioners of medicine, and this is possible without the performance of any
really scientific work.
It is premature to make such inquiries, except for single cases which serve to illustrate
the possibility, for it is but little more than a generation that the first school was opened to
women; it is not more than a dozen years since the official education attainable has
approached any degree of effectiveness. What women have learned, they have in the main
taught themselves. And it is fair to claim, that when they have taught themselves so much,
when they have secured the confidence of so many thousand sick persons, in the teeth of
such vigorous and insulting opposition, and upon such scanty resources and such
inadequate preparation; when such numbers have been able to establish reputable and
even lucrative practice, to care for the health of many families over long terms of years, to
sustain medical institutions of their own, almost exclusively dependent upon the good-will
of citizens who have closely watched their work,—to serve in public hospitals in
competition with men, to care for many thousands of sick poor, to whom abundant other
medical aid was accessible, had it been preferred,—to restore to health many thousand
women who had become helpless invalids from dread of consulting men physicians, or
from delay in doing so,—to hold their own in private practice, in matters of judgment,
diagnosis, medical and operative treatment, amidst the incessant and often unfair rivalry
of brother competitors,—to do all this, we repeat, itself demonstrates a very considerable,
indeed an unexpected amount of native ability and medical fitness on the part of women.
With longer time, with more solid and varied opportunities, and with extension to the
many of those which have hitherto been shared only by a very few, the amount of work
accomplished may certainly be expected to increase, and in geometrical progression.
It could be wished that space remained to bring to light the obscure heroisms of the
many nameless lives, which have been expended in this one crusade. It has been fought,
and modestly, in the teeth of the most painful invective that can ever be addressed to
women,—that of immodesty. Girls have been hissed and stampeded out of hospital wards
and amphitheaters where the suffering patient was a woman, and properly claiming the
presence of members of her own sex; or where, still more inconsistently, non-medical
female nurses were tolerated and welcomed. Women students have been cheated of their
time and money, by those paid to instruct them: they have been led into fields of promise,
to find only a vanishing mirage. At what sacrifices have they struggled to obtain the elusive
prize! They have starved on half rations, shivered in cold rooms, or been poisoned in badly
ventilated ones; they have often borne a triple load of ignorance, poverty, and ill health;
when they were not permitted to walk, they have crept,—where they could not take, they
have begged; they have gleaned like Ruth among the harvesters for the scantiest crumbs of
knowledge, and been thankful. To work their way through the prescribed term of studies,
they have resorted to innumerable devices,—taught school, edited newspapers, nursed sick
people, given massage, worked till they could scrape a few dollars together, expended that
in study,—then stepped aside for a while to earn more. After graduating, the struggle has
continued,—but here the resource of taking lodgers has often tided over the difficult time.
These homely struggles,—the necessity in the absence of State aid, of constantly
developing popular support and sympathy for the maintenance of the colleges and
hospitals, has given a solidity, a vitality to the movement, which has gone far toward
compensating its quaint inadequacies and inconsistencies. On the European continent, the
admission of women to medical schools has depended on the fiat of government bureaus,
prepared in this matter to anticipate a popular demand, and to lead rather than to follow
public opinion. In America, as in England, the movement for such extension of privilege
has sprung from the people, it has fought its way,—it has been compelled to root itself in
popular sympathy and suffrage. Hence a feeling of enthusiasm widely diffused among the
women students, the sense of identification with an impersonal cause, whose importance
transcended that of their individual personal fortunes, and yet which could only be
advanced by the accumulation of their individual successes. The ill-taught girls at Chicago,
who, sure in advance of defeat, resolved to face ridicule and contempt at the competitive
examinations, in order to make a road for their successors, really exhibited, in a moral
sphere, the heroism of Arnold Von Winklereid on the old Swiss battlefield.
The change from the forlorn conditions of the early days has been most rapid, and those
who survived the early struggle, and whose energies were not so absorbed by its external
difficulties that not enough were left for the intrinsic difficulties of medicine, have been
really invigorated by the contest. Indeed one of the ways in which women have secured the
infusion of masculine strength essential to their success, has been by successfully resisting
masculine opposition to their just claims. It is as in the fable of Antæus,—those knocked
down to the earth gained fresh strength as they touched the ground. The character and
self-reliance natural to American women have thus been reenforced even by the adverse
circumstances of their position. And, conversely, those for whom circumstances of fortune
and education have been apparently the most propitious, even those who have received the
best theoretical education, have not unfrequently been distanced, or even dropped
altogether out of the career, because of an incurable dilettantism, for which the remedy
had not been found either in practical hardship or in native intellectual vigor.
Efforts have several times been made to estimate the actual proportion of markedly
successful practitioners among the women now engaged in medicine.[139] The two
monographs cited below are both based upon circulars of questions sent out to as many
women physicians as possible.[140] The answers to these inquiries are necessarily very
partial, and can be quoted rather as illustrations than as statistics. Among such
illustrations, the statements of the pecuniary results of practice are interesting. Dr. Bodley
received answer from 76 ladies, and their total annual income, if divided equally among
the 76, amounted to about $3000.[141] Among these, however, ten earned between $3000
and $4000 a year, five between $4000 and $5000, three between $5000 and $15,000,
and four between $15,000 and $20,000.
In Dr. Pope’s paper, 138 women reported on their income, and out of them only eleven
had then practiced over two years and failed to become self-supporting. Another item of
interest is, that 32 per cent. of these women report that they have one or more persons
partially or wholly dependent on them.[142]
So great are the imperfections, even to-day, of the medical art, so numerous all the
difficulties of applying even all existing resources, so inevitable are the illusions in regard
to the real cause of either success or failure, that it is the most difficult thing in the world to
estimate the intrinsic ability of a physician, even by his success in practice. A large practice
certainly always testifies to some kind of ability; but this is not always strictly medical. The
essential test is that of accuracy in diagnosis, and this test cannot, by means of any public
documents accessible, be applied. Its successful application can only be inferred by the
gradual development of confidence in women, both among the more intelligent and critical
of the laity, and among the more unbiassed of the professional observers, who, in
consultations, have had ample opportunity to scrutinize diagnoses.[143] For a dozen years it
has become customary in America for the most distinguished members of the profession,
even in large cities, to send patients to women physicians, in any case where the
circumstances of the illness lead the patient to prefer a woman.[144] The same is done when,
from personal acquaintance, or on account of public reputation, the patient has confidence
in some special woman physician, and desires her counsel therefore, for other reasons than
those of delicacy.
The women physicians of America share, while rather intensifying, the main
characteristics of their medical countrymen. They have, as a rule, little erudition; but they
have great capacity for bringing to bear all available and useful knowledge upon practical
issues. They certainly do not read enough; and there is, therefore, a noticeable thinness in
their discussions of medical topics when they meet in isolated council. But they have a
resolute helpfulness in dealing with the individual cases entrusted to their care, and a
passionate loyalty to those who have put their trust in them. They are possessed of
abundant motive power for concrete intellectual action, though they might lack this power,
if the work depended exclusively on abstract intellectual interest. And, after all, it is this
habit of mind which most distinctively marks the modern practicing physician, and
without it the advances in medical science would be of little profit to the sick; indeed,
would often not be made. And, what is often overlooked, it is precisely these mental habits
here described which have been usually considered as particularly characteristic of women.
Thus the introduction of women into medicine demands no modification of the typical
conception traditionally held of women, but only an enlargement of the applications which
may be made of this characteristic type.[145]
In nothing are popular views about women more at variance with fact than in regard to
their capacity for operative surgery. The popular conception of surgery is itself entirely
false, being inherited from a by-gone period, when hospital operations were conducted in
the wards, filled with shuddering patients awaiting their own fate; amid clouds of steam
from burning irons, torrents of blood, and the groans and shrieks of the victim.[146] But to-
day, with anæsthetics, hæmostatics, and antiseptics, the surgeon may operate as calmly as
on an insensible wax figure; and, moreover, with a reasonably correct technique, be
assured of success in a vast majority of cases whose result was formerly, even under the
best skill, always doubtful. The very greatness of the achievements of surgical genius have
lessened the amount of ability requisite to perform many surgical operations; and
especially have the modern conditions of operating removed the perturbating influences
which female nerves might be supposed unable to resist. Moreover, the technique has
become so precise that it can be taught; and women, even when defective in power of
original thought, are extremely susceptible of being trained by exact drill. On this very
account the model of a practical medical school should be that of a military academy,
where every operation, mental or manual, that the graduate is subsequently expected to
perform, will be rehearsed before graduation.
Now the remarkable thing about women surgeons is, not that they have learned how to
operate when they have been taught, but that, with very insufficient teaching for the most
part, they have contrived to learn so much, and to operate so successfully. Obstetrics and
gynæcology have here again offered peculiar advantages, in presenting a series of cases for
operation which vary from the most trifling[147] to the most serious capital operations in
surgery. The latter have only been attempted in the last decade, and it is worth while to
quote such statistics as I have been able to obtain, even though they are necessarily
incomplete:
New York Infirmary: From 1875 to 1890; 535 operations (29 laparotomies); operators,
chiefly Dr. Elizabeth Cushier, but in a smaller number of cases, Drs. Blackwell, Peckham,
McNutt, Putnam Jacobi.
New England Hospital: From 1873 to 1890; 829 operations (48 laparotomies);
operators, Drs. Dimock, Buckel, Keller, Berlin, Whitney, Smith, Crawford, Bissell, Kellogg,
Angell, Pagelson.
Chicago Hospital: From 1884 to 1888; 206 gynæcological, 114 general surgery. Dr. Mary
Thompson operated on all the gynæcological cases, except four; the report does not state
whether she also operated on the others.
The reports of the Philadelphia Hospital do not give the total number of operations
performed in it, but through the kindness of Dr. Fullerton, resident physician, I have
received a report of the capital operations, nearly all abdominal:
Women’s Hospital, Philadelphia: From 1876 to 1889; 91 operations (all laparotomies,
including several Cæsarean sections). Operators, chiefly Dr. Anna Broomall; for a small
number of cases, Drs. Croasdale and Fullerton.[148]
In addition to the above, Dr. Marie Werner of Philadelphia reports 23 laparotomies from
private practice.
 Other personal statistics I have not been able to obtain. Some are quoted in the list of
Literature.[149] These statistics, though still on a small scale, are, for the time in which they
have accumulated, and for the extremely meagre opportunities which have been so far
afforded, not at all unsatisfactory.
Written contributions to medical literature are also, though not abundant, at least
sufficient to prove that “the thing can be done.” The 145 citations made in the list[150] all
belong to the period ranging between 1872 and 1890, a period of eighteen years.
The intellectual fruitfulness of this period is not to be compared with that exhibited by
other and contemporary classes of medical workers, but rather with that of the first 150 or
200 years of American medicine. For, until now, it is a mentally isolated, a truly colonial
position, which has been occupied by the women physicians of America. When a century
shall have elapsed after general intellectual education has become diffused among women;
after two or three generations have had increased opportunities for inheritance of trained
intellectual aptitudes; after the work of establishing, in the face of resolute opposition, the
right to privileged work in addition to the drudgeries imposed by necessity, shall have
ceased to preoccupy the energies of women; after selfish monopolies of privilege and
advantage shall have broken down; after the rights and capacities of women as individuals
shall have received thorough, serious, and practical social recognition; when all these
changes shall have been effected for about a hundred years, it will then be possible to
perceive results from the admission of women to the profession of medicine, at least as
widespread as those now obviously due to their admission to the profession of teaching.

Note.—While these pages are passing through the press, the important announcement is made that the
trustees of the Johns Hopkins University—in view of a gift of $100,000, presented by women to the
endowment fund of the medical department,—have consented to admit women to the medical school of the
Johns Hopkins Hospital, so soon as that school shall be opened. This is the first time in America that any
provision for the medical education of women has been made at a university of the standing of the Johns
Hopkins. It is expected that the medical education of the future school will be especially directed for the
benefit of selected and post graduate students, for such as desire to make special researches and to pursue
advanced studies in medical science. The admission of women to a share in these higher opportunities is a
fact of immense significance, though only a few should profit by the advantage, the standing of all will be
benefited by this authoritative recognition of a capacity in women for studies, on this higher plane, on equal
terms and in company with men.

The directors of the Johns Hopkins have in this matter shown the broad and liberal
spirit which befits the noble trust they are called upon to administer. It is characteristic of
America that the stimulus to the trustees’ action came from without the university, from
the initiative of women. This time, women have not only asked but they have at the same
time given. The $10,000 gift originally offered by Miss Hovey to Harvard on condition of
its admitting women, and declined by its medical faculty, has been enrolled in the gift now
accepted by the Johns Hopkins. Half of the whole donation is the noble gift of one woman,
Mary Garrett,—daughter of one of the original trustees of the Johns Hopkins University.
The formation of committees among women in all the principal cities of the United States,
for the purpose of raising money for the woman’s part of the endowment fund, and even
for the remaining amount needed to open the school, is itself a most important fact, for it
indicates that interest in the intellectual advancement of women, and especially interest in
the success of women in the medical profession, has at last become sincere and widespread
in quarters where hitherto it has been entirely and strangely lacking.
Hardly had we pronounced the present position of women in medicine to be “colonial,”
when, by a sudden shifting of the scene, barriers have been thrown down that seemed