Medical Women in America (and beyond)
1846 - 1874
“The female population of this country is destroyed to about two and three quarters times as great an extent by cancer as the male.”
Philadelphia
1846
Elizabeth Blackwell sits with her friend Mary as she suffers through what is likely advanced uterine cancer. “The worst part of my illness is that I am being treated by a rough unfeeling man. If I could have been treated by a lady doctor, most of my worst sufferings would have been spared me.” She confessed to her friend, then asked young Elizabeth:
“Why Not Study Medicine?”
1847
Elizabeth applied to the local medical colleges for admission.
Jefferson College - Dr. Samuel Jackson said he did his best but all the professors opposed the entrance of Elizabeth
Pennsylvania Medical College - Prof. William Darrach stumbled over himself making no answers “I have nothing to say either for or against it…I cannot express my opinion to you either one way or another. I have not expressed any opinion.
Temporarily sidetracked, Elizabeth began study on her own, through textbooks. When she was first exposed to a human corpse, she was not disgusted as she thought she might be. After dissecting a human wrist she remarked:
“The beauty of the tendons and exquisite arrangement of this part of the body struck my artistic sense. I begin to think there is more love of science in me than I have hitherto suspected.”
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The social stigma around cancer was significant. Knowing many cancers were hereditary, many women avoided early treatment to maintain their privacy and to protect the future prospects of sons and daughters. [WIWC, 18]. After the loss of her friend, Elizabeth could not get this question out of her mind and she was ready to take on a new challenge. She had already resigned herself to a life without love, though she wished for it, it never lived up to her expectations. She needed a path that could help secure her financial future and keep her mind occupied.
She needed to raise money for school, at least $3000, which in today’s money would be $100,000 - $120,000.
Money raised, she looked to Philadelphia, birthplace of American medical education with the establishment of is now the University of Pennsylvania (Then the College of Philadelphia, founded by two men who had trained at the University of Edinburgh).
In an attempt to dissuade Elizabeth from attending medical school, Dr. Joseph Warrington a Philadelphia doctor who founded the Philadelphia Lying-in Charity for Attending Indigent Women in Their Own Home and created the Philadelphia Nurse Society which provided training in obstetrics. It was his goal to convince Elizabeth that:
“Woman was designed to be the helpmeet for man”
Everyone was convinced of the proper positions within society, but Elizabeth was not content to be subornment, with nothing but respect for nurses, she saw no reason why she could not be a woman and also a doctor with a complete medical education. After some convincing, Dr. Warrington would go on to be one of Elizabeth’s loudest champions writing letter after letter on her behalf. [WIWC, 26]
Ether had just been introduced as a surgical anesthetic, prior to that heroic surgeons were prized for their speed over accuracy while removing as much malignant tissue as possible from a patient in agony while held down and restrained. The transition to an unconscious patient must have been a relief to operating rooms everywhere [WIWC,63]
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Twenty-nine rejections from medical schools small and large. It turns out the real fear wasn’t that women weren’t capable of being doctors, it was that the male doctors were afraid of losing their jobs. One rejection letter responded with:
“You cannot expect us to furnish you with a stick to break our heads with?”
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NEW PLAN: go to Paris, don masculine attire to gain the necessary knowledge… this was a suggestion she heard many times, who knows how many woman took this invisible route. Elizabeth didn’t want to be invisible, she wanted to make a statement.
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NEW NEW PLAN: October letter from Geneva Medical College, an invitation to start right away! The invitation was extended under slightly false pretenses. The faculty, not wanting to offend Dr. Warrington in Philadelphia opted to pass the decision of accepting a women student onto the ranks of the student body. It was put to a vote, but no one believed a woman would actually want to attend medical school, they believed it was more likely to be a prank by a rival school. It wasn’t a joke.
“The Female Student has arrived - This is Miss Elizabeth Blackwell”
The professor had her wait in the hall so he could prepare the students before she entered, the only official woman medical student in the world. The room was packed, the dean admitted the attention a woman student brought would be an advantage.
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One of Elizabeth's Uncles suggested she dress up as a man and attend medical school.
She would not have been the first. Upon her death, the Military Surgeon James Barry was found to be a woman and discovered to have stretch marks from an unknown pregnancy.
1849
Geneva Medical College: January 23, 1849 in a black brocaded silk gown and cape, tripped with black silk fringe and accented with lace collar and cuffs she remarked “I can neither disgrace womankind, the college, nor the Blackwell’s by presenting myself in a shabby gown.” After graduation, the university slammed it’s doors shut to other woman saying: “Miss Blackwell’s admission was an experiment, not intended as a precedent.” Elizabeth succeeded in becoming the first woman doctor by taking “The Geneva Route” since all other schools were closed to her.
Elizabeth heads to Europe to acquire some much needed practical experience. Dr. Elizabeth Blackwell begins interning at a hospital which will give her the important experience she will need when the governing bodies start changing the rules for being a doctor in the UK. It’s here she meets who will become her lifelong friend Florence Nightingale [WIWC, 51], [TCOTP, 33]. Elizabeth laments about the role of women in London “Prejudice is more violent the blinder it is, and I think that Englishwomen seem wonderfully shut up in their habitual views.” A life changing event would change the path of her life and impact the lives an unknown number of woman doctors who followed her route. Learn more about the event HERE
1850 “irregular women doctors”
It was important for women to have access to the best schools the country had to offer so they couldn’t be lumped into the mix of “bone-setters, hypnotists, hydropaths and unqualified midwives” found practicing medicine. It was important for them to have MDs after their names to help establish their professional status. There was also a growing demand for woman to have access to information about their own bodies or “to fully understand the physical laws which govern their own organisation.” [TCOTP, 30] There was growing demand for woman to take on more obstetric cases.
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The Female Medical College of Pennsylvania was founded in Philadelphia by a group of Quakers who believed in women’s right to education. The training offered wasn't on level with traditional medical schools, but it was a good first step for many woman who might not yet be prepared.
In 1867 the name would change to The Women’s Medical College of Pennsylvania. One of the first graduates was Hannah Longshore. She had a difficult time establishing a practice since the leading pharmacists refused to sell her drugs. She was told “you are out of your sphere! Go home and darn your husband’s stockings! Housekeeping is the business for women.”
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The American Medical Education Society, formed in Boston by Samuel Gregory in 1848 to promote the medical education of women because he believed it to be immoral for men to deliver babies [WIWC, 95]. It’s name was changed to: the Female Medical Education Society and by 1857 will be formally recognized as: the New England Female Medical College, finally merging with Boston University in 1874 to become: the Boston University School of Medicine.
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Interest in alternative medicine was growing and since traditional medical school was closed to women, some chose to train in irregular methods. Harriot Hunt was a well know practitioner, offering her patients counseling, herbs and rest. [WIWC, 31]
Her practice was well established.
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After 12 years of practice, she was encouraged to apply to Harvard after hearing of Elizabeth Blackwell's graduation from Geneva College. Harvard responded it would be "inexpedient" to accept her.
What did that even mean? She described it as "so shuffling, so shifting, so mean, so evasive." [TCOTP, 29]
Harvard won't accept a woman student for 94 years (June 5, 1944). [TCOTP, 34]
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"The debate over coeducation in Cleveland was begun in February, 1850, instigated, as in so many schools of the era, by Blackwell's graduation from Geneva Institute. Jared Potter Kirtland, professor of Physical Diagnosis and the Theory and Practice of Physic, a man esteemed nationally for his leadership in the natural sciences as well as in medicine, moved in a faculty meeting that year that "respectable ladies who were fitting for the practice of medicine be admitted to attend all the lectures of the School on the same footing as gentlemen." When a vote was called, Horace Ackley, professor of Surgery, shrewdly burdened the motion by introducing another that asked that "respectable Negroes be admitted to the same privileges," effectively silencing the discussion and tabling both motions."
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After Elizabeth “The Geneva Route” was closed, somehow Nancy Talbot Clark quietly begins studies at Western Reserve University. After losing her young daughter and then her husband to typhoid fever, the young widow made her way to Cleveland (not sure how or why - haven’t found any records or controversy of her starting classes (UNSOLVED MYSTERY). Keep reading to learn more or visit THIS LINK for additional background.
New York City
1851
Dr. Elizabeth Blackwell returned to America and was rejected for a position within a large dispensary in New York. Frustrated, she set up her own practice. She described it as a very lonely route with very little help but plenty of criticism and antagonism. She describes the time filled with loneliness, financial anxiety, professional insecurity and fear of male violence.
She didn’t find many patients among the middle class women, but found a large demand in the working class areas [TCOTP, 36]
Dr. Nancy Talbot Clark
Outside of Cleveland, Ohio
1852
Dr. Nancy Talbot Clark graduated from Western Reserve University (Case Western Reserve presently) the second lady doctor after Dr. Elizabeth Blackwell. Clark's graduation thesis: on the interdependence of the body's vital organs in the pursuit of harmony and balance.
She returned to Boston and attempted to practice medicine for two years. She attempted to gain acceptance into the Massachusetts Medical Society, but they rejected her application asserting that it was their duty to only examine male candidates for membership.
Following the post graduate path of Elizabeth Blackwell, Nancy went to Paris (“with her physician brother” who is he? UNSOLVED MYSTERY - SOLVED Israel Tisdale Talbog, he was inspired by his sister Grad of Homeopathic Medical College of Pennsylvania in 1853 & Harvard Medical School in 1854) Nancy studied in Paris, on her return voyage she met a wealthy, recently widowed gentlemen Amos Binney of Boston. Nancy would go on to have 6 children, her medical practice would take a back seat seat for a while, until she opens a free dispensary for women in 1874.
“Today the diploma of the College was conferred upon her, an honor which she has faithfully earned, for she has been a faithful student, and I am told by the Professors that she stands One of the first, if not the very first in medical knowledge in a class of more than fifty graduates. She has won the esteem and respect of all the Professors and students, and many have been the tokens of respect bestowed.”
In Cleveland, The Ohio Female Medical Education Society was formed for the medical education for women found by Caroline Severance, Martha J. Tilden along with eight others. At the same time Elizabeth Blackwell created a series of six lectures on the physical education of girls, promoting exercise and education. The courses were well attended by the Quaker community [TCOTP, 35]
Emily Blackwell (The Younger)
Near Cleveland, Ohio
1853
At Western Reserve University, the success of Dr. Nancy Talbot Clark’s graduation left an uneasy but positive atmosphere in the city. The dean held a request from Emily Blackwell, she was admitted in November.
1854
Dr. Emily Blackwell graduates from Western Reserve University (IS this also Cleveland Medical College [TCOTP, 36]. She joins her sister’s growing practice in New York City which has been officially chartered as the New York Infirmary.
New York City
Marie Elizabeth Zakrezewska
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Marie Elizabeth Zakrezewska was born in Berlin in 1829 to Polish parents fleeing Russian occupiers. Marie’s formal schooling was completed by 13, so she visited patients with her mother who was a student in the school for midwives in Berlin. She read any medical book she could get her hands on. Hoping to become a midwife, Marie Elizabeth applied to the Royal Hospital in Berlin twice and was rejected twice at the ages of 19 and 20. Finally, after gaining the attention of Dr. Joseph Schmidt, she was accepted. Marie graduated with top honors in 1851 and was appointed to a rank as professor at the college, a completely unheard of appointment - no women held positions at this rank. Dr Schmidt, her supporter died a few hours after she assumed the position. Six months later Marie was forced out of her position.
(Dr. Schmidt quarreled with Ignaz Semmelweis in Vienna about puerperal fever and it’s causes in 1850s - great quote about the birth process being slow, so it’s helpful to be close to other wards so the doctors can go into the morgue)
In 1853, Marie Elizabeth and her sister Anna set sail to New York hoping to find a world of opportunities [TCOTP, 36], she was greatly disappointed. She wasn’t able to start her own practice or find a physician to assist. The sisters were left to hand embroider worsted fabrics to sell at the marketplace to make ends meet.
1854
After struggling alone in the city, Marie Elizabeth and her sister visit a support group for immigrants called the Home for the Friendless. Here the sisters meet Elizabeth Blackwell who invite the women to join the staff of the New York Infirmary, the newly opened dispensary ran by the Blackwell Sisters. The Blackwell Sisters arranged for Marie Zakrezewska to start the medical program at Western Reserve University, the only school in America accepting women medical students. She was joining a small number of women students in a sea of 200 men. Other students joining her class were: Cordelia Green, Elizabeth Grisell & Sarah Ann Chadwick.
1855
1856
Four women graduate with the degree of Medical Doctor from Western Reserve University:
Western Reserve’s Women Doctors
1857
The New York Infirmary for Women and Children opened in spite of widespread opposition. The hospital provided badly needed resources for woman and provided woman access to obstetrics and gynaecological experience not available to women students at the time [TCOTP, 37].
Women in America seemed to have broken into the medical field with relative ease compared to the rest of the world. The success of the first wave of women working as doctors can be contributed partly to the wild nature of medicine in America. With no formal requirements to the profession, any individual could set up a practice and often they did under the names of Doctor no mater how non traditional their practice [TCOTP, 28]. The Blackwell’s were forming a small colony of women doctors in New York, while the atmosphere for women doctors in Boston was growing.
…meanwhile in England
The 1858 Medical Act
At the time, the world of medicine in England mirrored that of society. Physicians treated the Gentlemen and their families, only the fellows, members and licentiates of the Royal College of Physicians held this status within society. Surgeons were seen more like skilled craftsmen, though often as well trained and able as any physician. At the bottom of the hierarchy were apothecaries, viewed on level with tradesmen [TCOTP, 22]. A physician, though maybe ranked higher among his medical peers, was not a highly sought out position at the time. A successful doctor would send his son into the church or the army to have the most success in life. The low wages for the average medical man made them especially weary of anyone else entering the field, especially women, fearing they would gain an advantage in the growing field of obstetrics.
In Theory, the 1858 Medical Act was designed to ensure the professional quality of all medical practitioners, but in practice it acted to exclude women from the official registry of Great Britain and Ireland. Possession of one or various qualities could qualify an individual to be on the registry. One main problem was that the 19 different licensing bodies had wildly different standards of examinations so the resulting registry lacked no uniformity in expertise as expected.
The act did not make it a crime to practice medicine for those names not included on the registry, only those individuals were not protected legally the way a “doctor” was.
less than a third of of medical men had degrees, this act did nothing to change that [THOTP, 73]
1858
1859
In Boston, Dr. Marie Zakrewska is appointed Professor of Obstetrics and Diseases of Women and Children at the Female Medical College (the one founded by Samuel Gregory, she will quarrel with him and start her own hospital) [TCOTP, 37]
1860
Elizabeth Blackwell publishes another piece, “Letter to Young Ladies Desirous of Studying Medicine” which outlined the guidelines a young woman should consider. Elizabeth Garrett Anderson fit the description: between 20-30 and in good health, a liberal English education, French, Latin and Greek. Year one consists of studying at home or under the direction of a physician. Then move on to work as a nurse in a hospital, then train in a laboratory, then girls most travel to America to attend of the few medical schools open to women. [WIWC, 58]
US CIVIL WAR
April 12,1861 - April 9, 1865
Boston
1862
The New England Hospital for Women and Children (The Dimock Center) was opened on July 1st by Dr. Marie Zakrezewska. It was opened and operated by women for women and depended heavily on the feminist movement in Boston who demanded women doctors and provided financial and emotional support [TCOTP, 37]. Lucy Stone’s Women’s Journal offered publicity and countered the traditional voices attacking women at a time when the Medical Registry of Boston refused to publish the names of women doctors.
Dr. Lucy Ellen Sewall
Lucy graduated from the New England Female Medical College (Samuel Gregory). She went on to London, Paris, Zurich, Munich, Vienna and Edinburgh for additional clinical experience.
Upon her return, she became a physician for the New England Hospital For Women and Children (Zakrezewska/Dimock) eventually becoming a director [WIWC, 95].
1863
After graduating from the New York College of Pharmacy, Nany enrolled in the Woman’s Medical College of Pennsylvania (Quaker Established)
The Lancet publishes a list of 256 qualified and practicing women doctors in America [TCOTP, 75] this feels ironic because none of the journals in the US will include women in their lists of doctors. Was this a prank? Was it a threat?
(Appolinaria Suslova is in Paris, taking courses (mostly languages), dating a physician, she frequently references the students and physicians in the city - from the excerpts of her diary published in Dostoevsky’s The Gambler.
1864
Doctor of Medicine from the Female Medical College of Pennsylvania (Quakers)
After graduation Mary works for stretches with with Dr. Zakrewska & Dr. Sewall at the New England Hospital For Women and Children (Zakrezewska/Dimock). Other members of the tight community included Anita Tyng, Helen Morton, & Susan Dimock (#5 of The Zurich 7).
1865
In New York City, Mary worked at the soldier’s hospital which was treating patients wounded in the Civil War still in progress. During this time she becomes engaged to Ferdinand Mayer a German immigrant and professor of Chemistry at New York College of Pharmacy who was likely 40 years her senior [LITL, 161]. After the engagement broke off Mary headed to Paris.
Mary Corinna Putnam Jacobi
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Born in 1842 the oldest of 11 children, in London. Her father was a prominent publisher in New England.
The family returned to Staten Island where Mary was educated at home by her mother and a private Greek tutor [LITL, 161].
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In 1860, Mary published her first article in Atlantic Monthly at the age of 17.
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Mary enrolled as the first woman student at the New York College of Pharmacy. She graduated in two years.
Back in Boston
1865
Sophia Jex-Blake sails from England to Boston with her friend Isabel Bain. They stay with Ralph Waldo Emerson [poet, lecturer & editor of The Dial a transcendentalist journal popular at the time]. Sophia and Isabel were not warmly greeted in the north. England had thrown quiet support behind the south in the Civil War by repairing damaged confederate ships, the New Englanders were resentful of the brits who were forced to keep their opinions quiet [WIWC, 94]. She meets Dr. Thomas Hill the president of Harvard, not sure what they discussed.
They were received on more friendly terms by Dr. Lucy Sewall when she hosted them in Boston. Sophia was inspired by her stay and what she saw at the New England Hospital for Women and Children. It was a hospital completely run by woman for the exclusive use of women. Sophia saw the first had the support the hospital and the women doctors received from the philanthropic community (led by the New England Women’s Club) and the journalistic community (primarily Lucy Stone’s Women’s Journal). Sophia assisted Lucy one morning while she examined thirty-six patients. There was plenty of room for fun as well, Sophia recounted to her mother that there were always something jolly to do such as the theater, trips for ice cream or card games.
The hospital boasted a large electromagnetic machine used to treat all sorts of issues, often called Faradization treatments. Different makes of batteries provided either pulsating galvanic direct current or an alternating faradic current or a combination of the two.
Sophia noticed how women crowded into the dispensary on the four days women doctors were present, only a handful stopped in during the two days male doctors were there [WIWC, 99].
While in America Sophia toured American school and colleges. She will go on to write about her tour in A Visit to Some American Schools and Colleges.
London
1866
After passing the Apothecaries exam, Elizabeth Garrett became the second woman to qualify for the medical registry in Britain. In a letter to her mother, she plans to turn the ground floor of a nearby house and turn it into a dispensary for women and children. In addition, she references three pupils that will take advantage of the exposure to the practice of a small hospital. She references a room for dissections, one for lectures, another for a library and supply it by men teachers who are already teaching subjects to male students. It has been reported those other students were Frances Morgan, Louisa Atkins and Eliza Walker Dunbar, but other sources indicate the students were Frances along with Sarah Goff & Ellen Phillips. (taken from Anderson family papers - referenced from [BFMM, 162].
Global Rejections
1867
England
On January 25th, Frances Morgan, Sarah Goff & Ellen Phillips pass the Arts Examination of the Society of Apothecaries.
By the 14th of Februrary the Society’s Court of Examiners (which had previously tried to block Elizabeth Garrett Anderson’s qualifications) refused to accept the “certificates of lectures, or anatomical instructions delivered in private or to particular schools apart from the ordinary classes of recognized public “medical schools,” [See the biographys on Frances Morgan]. Since woman were prohibited from public schools, this technically represented the end of women in medicine in England. The Lancet was quick to point out that “the Society of Apothecaries had no intention of letting women sit their medical examinations” the Englishwoman’s Review described the same event as “monstrous” [TCOTP, 73]. The Lancet often used slightly paranoid forms of hysteria when talking about women doctors referring to the “charge of the parasols” and “an invasion of Amazons.” It’s no surprise there was little support for women doctors among their readers.
This marks the close of “The Apothecary Route,” with no clear options in England, Frances Morgan heads to Zurich blazing a train on “The Quiet Route” where women intend to go abroad to study medicine and return to practice whether the official registry includes them or not.
Sophia Jex-Blake argues that only wealthy women can afford to travel abroad to live and study and work. She’s right. Sophia is determined to forge a route closer to home - she is determined to be accepted in her homeland, she heads north to begin her “Assault on Edinburgh”
America
Susan Dimock and Sophia Jex-Blake apply to take the admission exam to Harvard. Harvard rejects their application. Susan borrows a significant amount of money to get started and keeps track of every penny on her route to Zurich.
Women Doctors Winning Battles
Selection an option below to follow their stories
Zurich
Paris
Edinburgh
1868
1869
1870
June, Elizabeth Garrett get’s her degree in Paris. Her thesis is on Migraines.
From here on out, it’s clear that between the two Elizabeths, Elizabeth Garrett’s primary focus is on her own career and reputation, while Elizabeth Blackwall’s focus is on the education and promotion of other women. This year EGA becomes engaged to J.G.S. Anderson a board member of the East London Hospital. His sister Mary Anderson had recently started school in Edinburgh.
IN ZURICH: Frances Morgan get’s her degree in Zurich [LITL, 170]. READ MORE HERE
IN INDIA: Clara Swain travels to India, stays to set up a dispensary.
In New York
1871
Dr. Mary Putnam returned to New York as one of the best educated doctors in town, male or female. She quickly established a successful practice eventually joining the Women’s Medical College of the New York Infirmary for Women and Children (The one established by the Blackwells & Zakrsewska). In 1873 she marries Dr. Abraham Jacobi who received his medical degree from Bonn in 1851. She stayed on as a professor for 18 years and continued to lecture at many surrounding colleges.
In London
The New Hospital for Woman is established to be staffed by women and is to be known as The Women’s Hospital. Dr. Elizabeth Garrett Anderson (Now married) headed up the dispensary which had grown to 40,000 outpatient visits within the 5 years it opened. In March she is joined by Dr. Frances Morgan who graduated from the University of Zurich.
India
1875
The public’s attention was drawn to India when it was reported the government of Madras was encouraging women to study medicine so they could be useful practitioners to look after women in childbirth and to attend to ailments. Mary Scharlieb and three other European women start a full medial degree there. Mary’s mother died from puerperal just after giving birth. She was inspired by the stories of Hindu and Moslem women who would rather bar the door to a male doctor than be treated.
In contrast to what happened in Scotland, the local authorities fully supported the women students, providing books and rooms to study. By 1878 four women received degrees [TCOTP, 176].
Boston
1876
Mary Putnam receives Harvard’s Boylston Prize for her original essay The Question of Rest for Women during Menstruation it was a response to Dr. Edward Clarke’s publication claiming any physical or mental exertion during menstruation could lead to infertility. Her essay argued against the belief that women were limited physically during menstruation, and provided scientific evidence to support her statements, including data on pulse rate and other statistics concerning the the stability of a woman's health, strength, and agility throughout her monthly cycle The entries were submitted anonymously, surely there was some debate about whether they would give the award to a woman.
She wrote a great deal, for an extensive history of women in medicine written by Mary, click the link below.
1881
Dr. Sewall along with 8 women offer Harvard $50,000 (1.6 Million in today’s dollars) to allow a woman to enter the medical school.
Selected References
[WIWC] Campbell, O. (2021). Women in White Coats: How the First Women Doctors Changed the World of Medicine. Park Row.
LOOKING FOR:
Goldstein LL. Roses bloomed in winter: Women medical graduates of Western Reserve College, 1852-1856. Dissertation Abstracts International. A. 1990;50:2951.