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Transcriber's Note

Footnotes have been moved to end of each essay.

Variant spelling and inconsistent hyphenation are retained.

A very few changes have been made to punctuation for consistency. Other changes are listed at the end of the book.

MEDICAL WOMEN

Two Essays

SOPHIA JEX-BLAKE.

Medicine as a Profession for Women.

Medical Education of Women.

EDINBURGH:

WILLIAM OLIPHANT & Co., 57 FREDERICK STREET. LONDON: HAMILTON, ADAMS, & Co.

JOHN LINDSAY, PRINTER, 104 HIGH STREET, EDINBURGH.

Dedicated

DR LUCY SEWALL,

FROM WHOSE DAILY LIFE I FIRST LEARNED WHAT INCALCULABLE BLESSINGS MAY BE CONFERRED ON THE SICK AND SUFFERING OF HER OWN SEX BY A NOBLE AND PURE-MINDED WOMAN WHO IS ALSO A THOROUGHLY SCIENTIFIC PHYSICIAN.

Medicine as a Profession for Women.

REPRINTED, WITH LARGE ADDITIONS, FROM "WOMAN'S WORK AND WOMAN'S CULTURE."

"We deny the right of any portion of the species to decide for another portion, or any individual for another individual, what is and what is not their 'proper sphere.' The proper sphere for all human beings is the largest and highest which they are able to attain to. What this is cannot be ascertained without complete liberty of choice."--Mrs J. S. MILL.

MEDICINE AS A PROFESSION FOR WOMEN.

"The universe shall henceforth speak for you And witness, She who did this thing, was born To do it; claims her license in her work. And so with more works. Whoso cures the plague, Though twice a woman, shall be called a leech."

It is a very comfortable faith to hold that "whatever is, is best," not only in the dispensations of Providence, but in the social order of daily life; but it is a faith which is perhaps best preserved by careful avoidance of too much inquiry into facts. The theory, if applied to past as well as to present times, would involve us in some startling contradictions, for there is hardly any act, habit, or custom which has not been held meritorious and commendable in one state of society, and detestable and evil in some other. If we believe that there are eternal principles of right and wrong, wisdom and equity, far above and greater than the "public opinion" of any one age or country, we must acknowledge the absolute obligation of inquiring, whenever matters of importance are at stake, on what grounds the popular opinions rest, and how far they are the result of habit, custom, and prejudice, or the real outgrowth of deep convictions and beliefs inherent in the most sacred recesses of human nature. While the latter command ever our deepest reverence, as the true "vox populi, vox Dei," nothing can be more superficial, frivolous, and fallacious than the former.

In a country where precedent has so much weight as in England, it doubly behoves us to make the distinction, and, while gratefully accepting the safeguard offered against inconsiderate and precipitate change, to beware that old custom is not suffered permanently to hide from our eyes any truth which may be struggling into the light. I suppose that no thinking man will pretend that the world has now reached the zenith of truth and knowledge, and that no further upward progress is possible; on the contrary, we must surely believe that each year will bring with it its new lesson; fresh lights will constantly be dawning above the horizon, and perhaps still oftener discoveries will be re-discovered, truths once acknowledged but gradually obscured or forgotten will emerge again into day, and a constantly recurring duty will lie before every one who believes in life as a responsible time of action, and not as a period of mere vegetative existence, to "prove all things, and hold fast that which is good."

The above considerations arise naturally in connexion with the subject of this paper, which is too often set aside by the general public, who, perhaps, hardly appreciate its scope, and are not yet fully aroused to the importance of the questions involved in the general issue. We are told so often that nature and custom have alike decided against the admission of women to the Medical Profession, and that there is in such admission something repugnant to the right order of things, that when we see growing evidences of a different opinion among a minority perhaps, but a minority which already includes many of our most earnest thinkers of both sexes, and increases daily, it surely becomes a duty for all who do not, in the quaint language of Sharpe, "have their thinking, like their washing, done out," to test these statements by the above principles, and to see how far their truth is supported by evidence.

I am indeed far from pretending, as some have done, that it is morally wrong for men to be the medical attendants of women, and that grave mischiefs are the frequent and natural results of their being placed in that position. I believe that these statements not only materially injure the cause they profess to serve, but that they are in themselves false. In my own experience as a medical student, I have had far too much reason to acknowledge the honour and delicacy of feeling habitually shown by the gentlemen of the medical profession, not to protest warmly against any such injurious imputation. I am very sure that in the vast majority of cases, the motives and conduct of medical men in this respect are altogether above question, and that every physician who is also a gentleman is thoroughly able, when consulted by a patient in any case whatever, to remember only the human suffering brought before him and the scientific bearing of its details; for as was said not very long ago by a most eminent London surgeon, "Whoever is not able, in the course of practice, to put the idea of sex out of his mind, is not fit for the medical profession at all." It will, however, occur to most people that the medical man is only one of the parties concerned, and that it is possible that a difficulty which may be of no importance from his scientific standpoint, may yet be very formidable indeed to the far more sensitive and delicately organized feelings of his patient, who has no such armour of proof as his own, and whose very condition of suffering may entail an even exaggerated condition of nervous susceptibility on such points. At any rate, when we hear so many assertions about natural instincts and social propriety, I cannot but assert that their evidence, such as it is, is wholly for, and not against, the cause of women as physicians for their own sex.

If we take next the ground of custom, I think the position of those who would oppose the medical education of women is far less tenable than is generally supposed; indeed, that a recent writer stated no more than the truth when he asserted that "the obloquy which attends innovation belongs to the men who exclude women from a profession in which they once had a recognised place." I believe that few people who have not carefully considered the question from an historical point of view have any idea of the amount of evidence that may be brought to support this view of the case.

We find records of several Grecian women who were renowned for their medical skill, among whom may be instanced Olympias of Thebes, whose medical learning is said to be mentioned by Pliny; and Aspasia, from whose writings on the diseases of women, quotations are preserved in the works of A?tius, a Mesopotamian physician. On the authority of Hyginus rests the history of Agnodice, the Athenian maiden whose skill and success in medicine was the cause of the legal opening of the medical profession to all the free-born women of the State.

In more modern times, when almost all learning was garnered into the religious houses, which were not only the libraries but the hospitals of the day, it seems evident that the care of the sick and wounded fell at least as often to the share of the Nunneries as of the Monasteries, and probably medical skill, such as it was, found place among the sisters quite as often as among the brethren of the various religious Orders.

The old ballad of Sir Isumbras gives one illustration out of many of the prevailing state of things, relating how the nuns received the wounded knight, and how

"Ilke a day they made salves new, And laid them on his wounds, They gafe hym metis and drynkes lythe, And heled the knyghte wonder swythe."

It may be remembered that Sir Walter Scott, after describing how Rebecca "proceeded, with her own hands, to examine and bind up the wounds," goes on to remark, "The youngest reader of romances and romantic ballads must recollect how often the females, during the dark ages, as they are called, were initiated into the mysteries of surgery.... The Jews, both male and female, possessed and practised the medical science in all its branches."

In the fourteenth century, when the Medical School of Salerno enjoyed high reputation, we find record of a female physician named Abella, who lived there, and wrote in Latin various works on medicine.

Early in the next century an Italian lady, Dorotea Bocchi, was actually Professor of Medicine at the University of Bologna, and among the traditions of the same University is preserved the name of Alessandra Gigliani, who, in even earlier times, was a learned student of anatomy.

In the sixteenth century, at Alcarez in Spain, lived Olivia Sabuco de Nantes, who "had a large knowledge of science and medicine," and whose medical works were printed at Madrid in 1588.

From the time of Moses onwards this part of the profession has always been mainly in the hands of women, and in many countries of Europe no other usage has ever prevailed. The first regular French medical society, "La confrairie de St Cosme and St Damien," included within its organization the Company of Midwives, and from that time down to the present it seems in France to have been the custom to give to these women a regular education, terminating in sufficient examinations, an example which England would have done well to follow.

In this country, however, midwives appear to have held a most respectable position some centuries ago, and a curious idea of their importance, their duties, and their credit, may be gathered from a MS. volume now preserved in the British Museum, which was evidently written at a time when hardly any but women were employed in the "mysteries of the profession," and when it was a comparatively rare thing, that needed to be specially advised in certain cases, for them to "make use of a physitien." The writer remarks that "it is meet that the midwife be a woman well read and well experienced," and gives a caution that "drunkenness is a sordid sin in any who use it, but is a blemish worthy greater blame in ministers, magistrates, midwives, physitiens, and chirurgeons."

Mrs Celleor, in her letter previously referred to, tells us that in 1642, "the physitiens and chirurgeons contending about it, midwifery was adjudged a chirurgical operation, and midwives were licensed at Chirurgeon's Hall, but not till they had passed three examinations before six skilful midwives, and as many chirurgeons;" but for some reason the midwives were, in 1662, referred for their licence to Doctors' Commons, thus losing their official connexion with the medical world.

How it came that English midwives fell gradually from their high estate is partly explained by a very public-spirited book written by a surgeon in 1736. The writer adverts to the accusations of ignorance then brought against the midwives, and remarks that "the only method by which this fatal distemper can be cured, is to put it in the power of midwomen to qualify themselves thoroughly and at a moderate expense.... To which method of qualifying themselves I doubt not the midwomen will object, and say that they would readily be at any reasonable expense and fatigue to be so thoroughly instructed, but it is not in their power. The midwomen cannot, and the midmen will not instruct them. The midmen will object and say that the midwomen want both capacity and strength . To which I reply that it is not want of capacity, docility, strength, or activity ... which is evident to a demonstration from the successful practice of women in the H?tel Dieu at Paris .... Would not any person then be deservedly laughed at who should assert that our women are not as capable of performing their office had they the same instruction as the French women?" This chivalrous surgeon then proposes that regular provision should be made for proper instruction, and for examinations by two surgeons , "and six or seven other persons appointed by His Majesty, because I don't think it reasonable that so many people's bread should depend on the humour or caprice of two men only;" adding that "If some such scheme was put in execution, I'm satisfied that in a very few years there would not be an ignorant midwife in England, and consequently the great agonies most women suffer at the very sight of a man would be almost entirely prevented," and great expense and much life saved.

However, we must suppose that these noble words of protest fell upon deaf ears, and the midwives, being left in their ignorance, their practice gradually passed into the hands of the medical men, who had every advantage of learning at their command.

The same writer mentions that Margaret Mercer was sent express from England in 1603 to attend on "His Majesty's dearest daughter, the Princess Electress Palatine."

It is well known that Queen Charlotte was always attended by a woman, and the late Duchess of Kent employed the Frau von Siebold, of whom mention is made elsewhere.

On the Continent of Europe, owing to their better education, the midwives retain much of the position that they have for a time lost in England; and we hear that in Russia "a medical man is very rarely called in; notwithstanding, fatal cases are of far less frequent occurrence in Russia than in England;" and the same authority tells us that ladies practising midwifery are admitted into society as doctors would be, and are well paid, both by the Government and by private fees.

While thus briefly tracing out the history of midwifery in modern times, and the causes which led to its practice passing from the hands of women into those of men, I have not paused to mention, in due chronological order, those women who, in the last three centuries, have been distinguished for a knowledge of the other branches of Medicine and Surgery. Of these I will now enumerate a few, though my time and space are far too limited either to give a complete list, or to relate any but the most prominent particulars of each case mentioned; but I can promise that any one who will consult the authorities quoted will be abundantly repaid by the long and interesting details that I am forced to pass over in almost every instance.

In the seventeenth century, in England, one of the women most noted for medical skill was Lady Ann Halket, born in 1622, daughter of the then provost of Eton College. "Next to the study of Divinity she seems to have taken most delight in those of Physick and Surgery, in which she was no mean proficient; nay, some of the best physicians in the kingdom did not think themselves slighted when persons of the greatest quality did consult her in their distempers, even when they attended them as their ordinary physicians. Many from England, Holland, and the remotest parts of the kingdom, have sent to her for things of her preparing; and many whose diseases have proved obstinate under all the methods of physicians, have at length, by the physicians' own advice, been recommended and sent to her care, and have been recovered by her."

In 1644 was born Elizabeth Lawrence, afterwards wife of the Rev. Samuel Bury, of Bristol, who wrote her life, and who bears witness that "it was not possible there should be a more observant, tender, indulgent, and compassionate wife than she was; a more sympathising spirit is very rarely found." He records that "she took much pleasure in Anatomy and Medicine, being led and prompted to it partly by her own ill health, and partly with a desire of being useful." The difficulties that she encountered in her studies may be guessed, since "she would often regret that so many learned men should be so uncharitable to her sex, and be so loath to assist their feebler faculties when they were anywise disposed to an accurate search into things profitable and curious. Especially as they would all so readily own that souls were not distinguished by sexes. And therefore she thought it would have been an honourable pity in them to have offered something in condescension to their capacities, rather than have propagated a despair of their information to future ages." Her husband, however, tells us that "she improved so much, that many of the great masters of the Faculty have often been startled by her stating the most nice and difficult cases in such proper terms;" and, remarking that, "How much knowledge and skill soever she attained in the practice of Physick, by long observation, conversation, and experience, yet she was very distrustful of herself," he adds that the "instances of her successes in the preservation of human lives were not easily numbered."

As a contemporary of these Englishwomen, we find in Germany Elizabeth Keillen, who published several medical works, and died in 1699. She is said by Finauer to have had "great knowledge of medicine and chemistry."

In 1788 Maria Petraccini took a degree in medicine at Florence, and we find her, a little later, lecturing on anatomy at Ferrara, in presence of the medical professors. She married Signor Feretti, and has left several works on the physical education of children.

Her daughter, Zaffira Feretti, seems to have inherited her mother's talents, for she studied Surgery in the University of Bologna, and there received a medical degree in May 1800. She obtained an appointment under the Italian Government, and for some time lived in Ancona acting as Director-General of the midwives in all parts of the country. She afterwards went to Turkey, and died at Patras in 1817.

Maria Mastellari seems also to have been a woman of unusual talent, and "progressed diligently in the most rigid sciences." She obtained a medical degree at Bologna in 1799. She subsequently became the wife of Signor Collizoli-Sega, and is described as possessing a "sweet and gentle temperament, with special love of silence and quiet. She centred her interests in her family, which she managed admirably."

Nor was Italy alone noted as the birthplace of women skilled in Medicine. In Germany, early in this century, Frau von Siebold so greatly distinguished herself in the practice of midwifery that the degree of M.D. was conferred on her by the University of Giessen; and her daughter Marianne, afterwards Frau von Heidenreich, studied in the Universities of both G?ttingen and Giessen, and took her degree in the regular way in 1817. She is spoken of as "one of the most famed and eminent female scholars of Germany," and as being "universally honoured as one of the first living authorities in her special branch of science." She died only in 1859.

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