# Once a Week (magazine)/Series 1/Volume 2/Representative women: Dr. Elizabeth Blackwell

* related authors: Elizabeth Blackwell (1821-1910).
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REPRESENTATIVE WOMEN. DR. ELIZABETH BLACKWELL.
Miss Edgeworth opens one of her tales with a recipe of great length, for the cure of every sort of complaint, copied from a receipt-book of some beneficent great-grandmother: a recipe which serves as a good exponent of the quacking tendencies of women in days when the popular idea of medical science was less advanced than at present. The yellow old receipt-books of our grandmothers, written in ink now pale brown, in a stiff upright hand, abounding in bad spelling, are usually found to contain instructions for the composition of extraordinary medicines, intermixed with recipes for all sorts of good things, savoury and sweet; and while we laugh at the absurdities propounded with all the confidence of credulity, we are crossed by grave thoughts of the mischief done, and especially of the number of children sent out of the world, by the desperate practice which every gentlewoman formerly considered to be one of her first natural duties. When the evil began to be recognised, the remedy was found, not in giving knowledge to women, but in committing the charge of everybody’s health to men. This was a great benefit, but only a partial one. Women never have been, and never will be, debarred from practising medicine, openly or on the sly. It is so natural to them, and so irresistible while they live in families, and have the charge of the sick, that no remonstrance or ridicule has ever availed to put a stop to female quacking. The best informed and most rational physicians have always seen, and the most courageous of them have always said, from that day to this, that the only cure is in making physicians of some well-qualified women, who alone can convince their sex of the seriousness of medical practice, and the infinite mischief of meddling with the delicate organisation of the human frame, without all the knowledge that can be obtained of the structure and action of its various parts. The time has arrived for this reform to begin, as my sketch of the career of Dr. Elizabeth Blackwell will show.
As might be expected, the preparation for the change began with the case of childbirth. Three generations back, children were usually brought into the world by midwives,—ignorant and prejudiced women generally, who treated their patients with the same amount of sense and skill shown by nurses who, in fever and small-pox cases, shut doors and windows, lighted great fires, and administered brandy and gin. When this had gone on long enough, the charge was delivered over to the surgeons, to the infinite disgust of their patients. Many of us have heard tell of the domestic resistance offered when the husbands dismissed the wise woman, and bespoke the surgeon; when the pain of mind of young mothers under the new system really endangered their lives; and when, after their recovery, they would run into a shop, or down an alley, rather than meet their doctor in the street. It was at this stage of the business that Dr. Spencer, a Bristol physician, contemporary with our grandfathers, brought up his daughter to the profession of an accoucheur. She obeyed, and I believe, practised for some time; but she had not courage to go through with an experiment which drew so much notice upon her; and she changed her occupation for that of educator, in which she won the respect and attachment of all who knew her. Soon after, the late Mrs. Hockley began to practise as an accoucheur, and a very considerable practice she had; but we do not hear of her having had any comrade or successor. As there are always women who choose to be attended by women, there are always surgeons who will sell a certain amount of instruction, while protesting against delivering over their art into female hands. In our large towns, some surgeon or another has a class of women of the lower ranks for a guinea course of lectures; and now and then a woman of higher education attends a lying-in hospital for practice; but the influence of the medical profession generally is, in this country, strongly put forth to prejudice and frighten society out of any serious consideration of a method for committing this natural woman’s work into woman’s charge.
In the case of children’s diseases, the existing ​mischief and misery are even greater than in that of their mothers. How many of us there are that can bear witness to the unutterable distress of young mothers when their suffering infants are in the hands of men, often bachelors, whom they see to be incapable of interpreting the natural language of mute infancy, and unaware of the infinite delicacy of the changes which take place in a sick child, and the special nicety required in its treatment! Where is the wonder if they apply to ignorant women, as a resource against the insensibility of inexperienced men? I have seen a strange-looking infant, under a year old, large, puffy, and white in the face, to whom an eminent physician had been giving eight grains of calomel daily for weeks. Is it a wonder if the mother follows the advice of the first sympathising old nurse she meets, who can understand the child’s feelings, and foretell what will happen next, while wholly unlearned in scientific treatment? That there is no wonder in it is shown by the continued existence of quackery in a very vigorous form wherever women and children are living. It will always be so till we have able women educated for the medical profession: and some of the wisest physicians in all countries plainly admit the truth.
Our own country is behind almost every other in this admission, and in the action to which it leads. While in England we are always hearing of the preposterous remedies prescribed by women of all ranks and degrees of education, there are at least certain branches of practice regularly committed to female hands in other countries. While Florence Nightingale remarks on the wild confidence with which ladies give blue-pill as an ordinary remedy in their families, as they would give colocynth pills or salts and senna, we find lower down in society that epileptic fits are treated by tying three sprats upon the breast, when the patient goes to bed, and that the trusted remedy for tic-douloureux is putting live worms into a muslin bag, and laying it on the seat of torture, “to draw out the pain.” We find women braying snails in a mortar to make snail-tea for a consumptive patient. We find a prevalent persuasion among the poor, and among many above the poor, that “the doctors don’t know anything about the bones,” however wise in other matters; and the large fraternity of “bone-setters,” men and women, are very apt at referring a wide variety of diseases to some disorder in “the bones.” In Germany, meantime, several branches of small surgery are committed to women; and in France much more is done, and well done, by women for their own sex, and for children, than the medical profession in England would at all approve. In every German town there are female practitioners who do all the cupping and bleeding, as well as the management of blisters and the dressing of wounds and sores. It may be agreed before long that bleeding is vicious practice, and cupping little better; but while it is the approved practice, it is no small comfort to patients that the dexterous touch, and fine observation of women are available for the process. Vaccination, again, is proper woman’s work; and if it has hitherto been badly managed under female care, it can be only for want of instruction and training.
The United States are, however, before all other countries in the improvement so universally needed. In all the large towns there are now female physicians established in good practice, after undergoing the best professional training that society affords. In several of the States the legislatures vote an annual grant for the support of female medical schools and hospitals. Nowhere, perhaps, is such a reform more needed. For many years past it has been becoming evident that the greatest peril of the American nation lies in the decline of its physical condition; and especially in the feeble health of its women. The mortality of children there is beyond all precedent and example. Without going into the causes of this perilous liability, I may just say, that the best promise of a remedy lies in the establishment of a class of duly qualified female physicians who can set forth “the Laws of Life, with special reference to the Education of Girls,” as Doctor Elizabeth Blackwell has done, in her work under that title. Such a professional class is established there: and it is she who has done it.
She could tell dreary and heart-breaking things, no doubt (judging by what we otherwise know), of the recklessness with which human life is trifled with in a country where the physical vigour of the race should correspond with its political youth: she has more power to deal with the causes of the mischief than any physicians can possess who have a less free access to female confidence and to children’s nurseries: but we need not go so far from home to learn how infant mortality might be checked everywhere if the health of mothers and babies were in the charge of physicians who possess instincts of interpretation of female and infantine nature, which science alone can never compensate for. Add science to the natural gift, and the health of half the human race will be under such guardianship as it has never enjoyed before. One immediate consequence of the institution of female physicians and surgeons is that the natural practice of mothers nursing their own infants has a chance of restoration. If we had such attendance in all our towns, the practice of wet-nursing would decline from its present fearful prevalence. The influence of female physicians is altogether on the side of nature and duty; and they cannot be misled and coaxed as our doctors are by self-indulgent, or timid, and feeble women.
Women know what women can do and bear better than anybody else can know: and a trained and practised physician of their own sex can stimulate, and admonish, and encourage, and re-assure a dependent and ignorant and irresolute mother as few or no men are able or willing to do. At present our medical men, especially in London, are easily won upon to recommend a wet-nurse; and, in far too many cases, it is they who suggest and urge the mother’s relinquishment of her first duty to her child; so that we have reached such a pass that something must be done. We shall ere long know from the Registrar-General what proportion of infant mortality is due to this practice: and we are told by those who are likely to know, that ​of the children of wet-nurses not above one in twenty survives the age when weaning would be natural.
Thus the time had arrived for the appearance and action of such a woman as Dr. Elizabeth Blackwell—the first woman who ever practised under a medical diploma. She is the representative of a class now fairly established in the New World, and sure to extend over the most civilised portion of the Old.
She is our countrywoman, though our associations with her are American. Her father, Mr. Samuel Blackwell, was a sugar-refiner at Bristol, where one of the intimates of the family was Foster the essayist, whose essay on “Decision of Character” made a strong and deep impression on Elizabeth’s mind. The nine children were brought up healthily by a healthy and sensible mother, while their father was a man of great energy and benevolence. The girls had a home education, under a governess and masters; and while their intellects were duly attended to, they had a physical training of rare vigour. Long walks were not enough: there was also romping and play with their brothers, which made Elizabeth, for one, so strong that, being provoked to the trial, she, when almost a child, lifted and carried repeatedly round the room, in the presence of his wife, a saucy family friend who had insisted that nothing could give muscular strength to women. At this time she was small and fair, with delicate hands and a soft voice, and so quiet and reserved that her father nicknamed her “Little Shy.” Thus was she early qualified to give an opinion on the physical education of girls.
When she, the third of the nine children, was twelve years old, the family migrated to the United States; and when she was seventeen, her father and two aunts were dead of the climate of Ohio, and the family were left without other resource than their ability and industry. She and her elder sisters opened a school, and educated the younger ones. They experimentally felt the hardship that it was for educated women to have no other occupation at command than teaching. They talked it over, much and long; but there was nothing else to be done while others were dependent on them for bread and education.
At four-and-twenty Elizabeth found herself free to follow her own course—the younger members of the family being able to take care of themselves. In order to save money enough for a thorough professional education she continued to teach, her learning and accomplishments procuring her a high salary. She learned Latin privately, saved her money, and in three years made the bold attempt which the world will never forget. At Philadelphia her applications for admission to the medical schools were rejected with anger and insult; but she found instructors who privately prepared her to enter upon the fullest use of any opportunity which she might be able to seize of going through the regular professional course. In the midst of some shame and regret for the sort of treatment she met with, then and for several years after, from our sex, we find it a relief to know that there were men at that early time, when there were no precedents to act upon, who were willing to give instruction simply because it was desired, and would be paid for in the usual way. The first professional men who acted without “respect of persons” deserve very great credit. Professor Allen and Dr. Warrington, of Philadelphia, carried her through private courses of instruction in anatomy and midwifery, and Dr. Dickson, of New York, had before furthered her plans to the utmost of his power. At a later time she had conquered the profession; but the names of her earliest sympathisers should be gratefully remembered by others than herself.
In his last work, “Transformation,” Mr. Hawthorne gives us a glimpse of American life in the paragraph in which he speaks of “our New England villages, where we need the permission of each individual neighbour for every act that we do, every word that we utter, and every friend that we make or keep.” In a state of society like that, it requires no little moral independence in a professional man to countenance the enterprise of the first woman who seeks a diploma to enable her to practise medicine: and we may derive encouragement for older countries, where more social freedom exists, from the fact that three eminent physicians gave her their best assistance before they could have any idea whether she would conspicuously succeed or ridiculously fail.
Her next step was to make a list of all the medical colleges existing in the United States; and she applied to them in succession. Twelve of them rejected her application, supported as it was by certificates of her preparedness. Sermons, insults, rebukes, lectures on her views and proceedings accompanied the refusals to admit her. The college which did itself the honour of treating her properly was that of Geneva University, in the State of New York. The Faculty, having no objection on their own part, but thinking the matter concerned the students more than themselves (a view which of itself was an evidence of sense and liberality), consulted with the students. The students considered the question, and drew up an invitation to their proposed comrade, assuring her that she should never have cause to regret joining them in their studies. It was there that she acquired the unmoved manner and the command of countenance which are the attributes first commented on by strangers who meet her in society. It was an object of extreme importance to avoid blushing at lessons which she was sharing with five hundred young men: and she starved herself down to the requisite bloodlessness. She meant that there should be schools of medicine by-and-bye in which women could study more comfortably and properly; but this point could be gained only by somebody undergoing what she was now suffering under: and she went through with it with a calm and cold exterior. She passed to and from her seat in the lecture rooms as if she were alone in the place, and never recognised the existence of any person but the lecturer. Her eyes went straight from him to her note-book, and from her note-book to him, and saw nothing besides. Her sister, from whose Memoir of Elizabeth these anecdotes are derived, tells us ​what she did on the only occasion of breach of promise on the part of the students.
In the midst of a lecture in the amphitheatre, on a particularly critical subject, a note was thrown to her from a back row. It fell on the sleeve of her black dress. There she let it lie, making notes as if she did not perceive it: when she had finished, she raised the arm on which she knew that all eyes were fixed, and by a slight movement threw off the paper upon the floor. A burst of cheers rang through the place, followed by some hissing of the writer. She took no more notice of the one demonstration than of the other; and all that she knew of her fellow-students from that day forward was that they at once respected her reserve, and afforded every facility in their power to her attainment of her object.
She had more trouble outside the walls, where the New England village character, described by Hawthorne, seems to have extended across the frontier of the Puritan States. She could not get a lodging; she was stared at and quizzed in the street as “the lady-doctor;” and it required the countenance of the Professors’ wives to obtain admission for her to a respectable boarding-house. When they called on her she was no longer denied bed and board. She soon lived down all this prejudice: but it needed very great courage and fortitude for a woman under thirty to pass alone through so dreary a stage of social prejudice. I trust that that passage of Elizabeth Blackwell’s life is remembered by the young women who now sit in peace in the lecture-rooms of their own colleges, among congenial comrades, and safe in the respect of society. Nobody insults them: nobody wonders at them: and they do not know what it is to be alone, as she was alone. Let them never forget that she took the whole difficulty upon herself, and made the roughest places plain for them.
After a complete course of instruction, with some practice in hospital and college, she graduated in January, 1849. The occasion was memorable; and it was acknowledged to be so by the presence of a crowd of strangers, including a large proportion of women, and by the special and encouraging notice of the particular case taken by the president. He testified to the excellent effect produced upon the whole institution by the presence of the sensible and indefatigable student of the other sex; and he probably felt that the authorities and the students had reaped the natural reward of a bold course of justice and good sense. The authorities of our medical schools have not so much faith and courage. A precisely similar opportunity has been afforded to them by a countrywoman; but there was no man among us qualified to act as the Geneva Faculty had grace to act.—It is melancholy to be obliged to add that professional bigotry was so brought to bear on the Faculty at Geneva that they afterwards refused admission to Dr. Emily Blackwell, a younger sister, who obtained her object at Chicago. The same process was gone through there: and when Emily Blackwell, distinguished for learning and ability, went to resume her place for a second year, she found the doors shut against her. The Professors were grieved: but the Faculty of the State Medical Council were peremptory, and nothing could be done.
When Elizabeth Blackwell was finishing her professional education in Europe, she received very characteristic advice at Paris, where the Faculty would not hear of her attending lectures and hospitals under her own name and aspect, but advised her to wear men’s clothes. Her reply was, that as her aim was to open the profession to women, she must appear as a woman. She obtained private instruction in anatomy, with facilities for dissection; and she became an inmate of the Maternité Hospital for a course of practice.
While struggling with difficulties in Paris, she was gratified by an invitation from Berlin to go and study at the Royal Hospital there, where every facility would be afforded her. Such are the differences in civilisation of contemporary societies! She studied at St. Bartholomew’s finally; and we may be glad that we had not the disgrace of turning her away, as we think it necessary to do with our own countrywomen. She was regarded as an American, as she had graduated there; and hence she was permitted to pick up some knowledge in London.
She settled in New York in 1851; and there she is now, though more than once tempted to take up her abode in London. She has a large private practice: but (what she cares for far more) hospitals, dispensaries, and female medical schools are also flourishing under legislative grants, and large private subscriptions—some supplied, I am happy to say, from England. This is a proof that there is an English public ready to support such institutions, whenever an opening can be found for their establishment.
This case is a clear confirmation of the great truth that the emancipation and elevation of any class (outside of personal slavery) must be achieved by the class itself. There is little use in talking about wrongs—whether of women, or of the working class, or of oppressed nations. Nobody can help them till they have first proved that they can help themselves. As it is also true that the only education for the use of rights is in the exercise of them, the despots of human society chuckle over their own security. If the exercise of rights is the only education for the use of them, and if also none but the wronged can achieve their own rights, the depressed seem to be confined within a vicious circle from which they cannot escape. But the despots are mistaken in their confidence. The process of emancipation is always the same; and it never fails of success, sooner or later. Some one, or some few, cannot for ever endure the repression; and individual effort bursts the barrier, and opens the way for the many to follow. It is thus that art and science have been opened to women, never to be closed again. It is thus that every pursuit of which women are capable will in time be at their choice. It is mere loss of time to argue in advance what women can do, and what they ought to do. One after another women will do whatever they are capable of doing; and what they can do they ought to do, and will assuredly do. If they will drop all talk of rights and wrongs, except in moral disquisition, and silently prove, like the Blackwells, their capacity and their ​convictions, it is not possible for the whole world, of either sex, to keep them down. Meantime, I do not know that self-respecting and benevolent women can have a better example or encouragement than Elizabeth Blackwell, with her silent determination, her indomitable fortitude, and her womanly mind and manners, shown in her quiet dress, her gentle demeanour, her steady industry, her devotedness to the suffering, and her life-long practical testimony to social right and feminine duty. The women of all civilised nations may be thankful for her as the Representative of an ever-enlarging class.
Ingleby Scott.