CHAPTER VIENGLAND REVISITED1858The ten years during which this pioneer medical work had been steadily carried on had thus firmly established the new departure as a useful innovation in the United States. The reform was at that time steadily growing, not only in New York, but also in Philadelphia and Boston, under the guidance of able bodies of women. We were now desirous of learning what openings existed in England for the entrance of women into the medical profession. We knew that much interest had been felt there in the progress of the American work, and we had been urged by friends in Europe to give some account of it.It was determined, therefore, in August 1858 that I should again revisit my native land and urge the importance of this medical work. Soon after my arrival in Europe I took the occasion of a visit made to a sister in Paris to prepare carefully a series of three addresses to be delivered in England, showing what was being done in medicine by women in the United States, and the reasons for that work. The first of these addresses was on the value of physiological knowledge to women, the second onthe value of medical knowledge, and the third on the practical aspect of the work as established in America and its adaptability to England. Whilst engaged in the preparation of the lectures I entered into relations with the large-hearted Countess de Noailles, whose devotion to sanitary reform and generous support of benevolent enterprises were equally remarkable. This lady was very desirous that a country sanatorium for women should be established in England or France, being firmly convinced that hygienic conditions in their fullest application were the chief necessity in the successful treatment of special diseases. This lady wrote to an old friend in Paris: ‘I wish to direct all my efforts to this object. Let me know as soon as possible what it would cost to establish a small hospital for women and children either in France or England, under Miss Blackwell’s direction.’ She also requested one of her noble French relatives to make my acquaintance. The interview is thus described in a letter to Dr. Emily in New York.Paris: 1858.Yesterday I saw Madame —— by appointment at her own house. A. says she is a daughter of the Prince de P.; to me she seemed a stout, black-eyed Frenchwoman of forty-five, cordial in manner, speaking English well, and knowing as much of England and Anglo-Saxon nature as a Frenchwoman ever can know. We conversed energetically for two hours. She is seriously interested in the entrance of women into the medical profession, a wish founded in her case on the moral degradation which she has observed amongst her own acquaintance from thepractice of being treated by men in female complaints. The fact which most struck her in all I told her was your amputating a breast; in this she actually triumphed. Her face became radiant with the intense satisfaction of the thing, for it proved to her by a fact what she wanted to believe, but could only accept intellectually from all my reasons—viz. the necessity of letting the midwife drop, and striking unflinchingly for the highest position. This one fact, worth to this sort of nature a host of arguments, gave her real faith in the physician. She opened freely her objections, or rather difficulties, and I met them one after another; and this difference I observed in the encounter with the cultivated European nature—when I gave her a reason she understood it and accepted it; it did not go in at one ear and out at the other as with more frivolous people; there is some soil or substance you can plant in in this stouter nature. As years ago with Lady Byron, so with this lady, it was of some use talking to her. She propounded, of course, foolish as well as serious ideas; thus she thought that women physicians should never marry; she also would be shocked to see me with a garland on my head dancing in a ball-room, and she thought they should be devoted, like the sisters of charity, &c. I combated her idea of abnegation for a while, and put in a feeler to see if she could take in a higher notion; but finding it was impossible, I at once ceased the attempt, and allowed her to hold to her own highest idea, which I could see was tinged by her French nature. Of course it wearied me a little, and I wanted after a while to expand my lungs and breathe freely; but I certainly made a strong impression upon her. She thanked me and shook my hand again and again at parting, and said that she should not think of letting this be our last interview, and she should write to Madame de Noailles the very next day. She had asked me previouslyif I was resolved in any case to go back to America, and I had told her ‘No,’ but described at the same time the excellent beginning we had made there. I feel convinced that I shall have some proposition in relation to my (or rather our) establishment in London. What, then, ought we to say should such an offer arise? I will accept nothing that is not offered to us both, on that I am quite determined; we cannot separate in practice.Paris: November, 1858.Preparing my lectures is a troublesome business. My first one would not do; it was so much more adapted to an American than an English audience. I wanted also quantities of facts that I did not know how to get. But I have now re-written twenty-one pages. I have written it with pleasure, though very slowly, and I am really surprised to find how very slowly I write. I can only write when I feel fresh in the morning; sometimes only a page, sometimes none. I will not force it when I don’t feel fresh, but I shall take whatever time is necessary to do the work well, for it is really important.It was during this visit that I had the privilege of becoming personally acquainted with Dr. Trélat, the head of La Salpêtrière, and his admirable wife, who remained steadfast friends through life. I visited them at La Salpêtrière—that large asylum for infirm women, over which Dr. Trélat presided with truly paternal care. La Salpêtrière was not then a great school of experimentation, but a benevolent refuge, where the well-being and kindly protection of its inmates formed the primary object of the director.The following letters are descriptive of this time.To Lady ByronParis: December 30, 1858.160 Rue St. Dominique.My dear and venerated Friend,—I received your letter yesterday. The mere chance of being in any way useful to the valuable friend you refer to is reason sufficient for a short return at once to England, so I have made my arrangements to reach London on Monday evening, January 3.I have heard with great pleasure of an invitation to lecture in London, which I will acknowledge when I receive it. I shall be glad of an opportunity of laying very important considerations before my fellow countrywomen, but I cannot lecture just at present. I find that I must first go to Italy, for reasons which I will explain when we meet; therefore it is too soon to engage rooms at present, for which kind offer I sincerely thank you.My chief object in making this hurried visit of a few days is to see Miss Nightingale and a few valued friends, amongst whom I hope I may reckon yourself. I shall therefore remain quietly at my cousin’s, No. 73 Gloucester Terrace, Hyde Park, not attempting to enter into society.To Dr. Emily BlackwellLondon: February 1859.I have just returned from an interview with Miss Nightingale at Malvern in relation to a school for nurses which she wishes to establish; and I start to-morrow for Franceen routefor Mentone. My old friend’s health is failing from the pressure of mental labour. I cannot go into the details of her last five years now, but the labour has been and is immense. I think I have never known a woman labour as she has done. It is a most remarkable experience; she indeed deserves the name of a worker. Of course we conversed very earnestly about the nursingplan in which she wished to interest me. She says that for six months she shall be utterly unable to give any thought to the fund work, and wants me meanwhile to observe English life very carefully, and make up my mind as to whether I can give up America, which she thinks a very serious matter. Unfortunately she does not think private practice possible in connection with her plan. If so, it would be impossible for us to help her. She thinks her own health will never permit her to carry out her plan herself, and I much fear she is right in this belief.After a short visit to the Riviera, to confer with the Countess de Noailles about her proposed sanatorium for women, I returned to London. There my warm friends the Misses Leigh Smith, supported by their generous-hearted father, and Miss Bessie Rayner Parkes, interested themselves actively in preparing for the first delivery of my lectures. The Marylebone Hall was secured. Our young friends brought up primroses and other lovely flowers and green wreaths from Hastings to ornament the reading-desk, and warmly supported me by their ardent sympathy. On March 2, 1859, the first lecture was given to a very intelligent and appreciative audience, whose interest was warmly enlisted. I well remember the tears rolling down the benevolent face of Miss Anna Goldsmid, who sat immediately in front of me. But the most important listener was the bright, intelligent young lady whose interest in the study of medicine was then aroused—Miss Elizabeth Garrett—who became the pioneer of the medical movement in England, and who, as Mrs. GarrettAnderson, lives to see the great success of her difficult and brave work.These addresses were afterwards given in Manchester, Birmingham, and Liverpool; Mr. Bracebridge kindly making arrangements for them in Birmingham and the Rev. W. H. Channing in Liverpool.The interest thus excited in London led to some effort being made to commence in England similar work to that being done in America. A meeting of ladies was held at the St. John’s Wood residence of Mrs. Peter Taylor, over which Mr. William Shaen presided. A committee was formed to consider the subject, and encouraged by the offer of help made by the Countess de Noailles, a circular was prepared, stating the object to be accomplished and inviting support. This circular, which was revised by Dr. Mayo, Lady Byron, Mr. Shaen, and the Hon. Russell Gurney, was gradually signed by a large number of influential ladies.[Circular.]Proposed Hospital for the Treatment of the Special Diseases of WomenThe Lectures recently delivered by Doctor Elizabeth Blackwell at the Marylebone Literary Institution have produced in the minds of the ladies who heard them a strong conviction of the necessity for a more general diffusion of hygienic knowledge among women; and have led to a proposition to found a hospital for a class of diseases, the ordinary treatment of which too frequently involves much avoidable moral suffering, to be placedunder the direction of competent women physicians, in connection with a Board of consulting physicians and surgeons.A lady, impressed with the want of such an institution, and convinced of the value of hygienic knowledge in the treatment and prevention of female diseases, has already promised 1,000l.towards the hospital, and offers 5,000l.more for the endowment of a Sanitary Professorship in connection with it, provided a sufficient sum be raised by donation to place the institution on a permanent basis.In order to secure the advantages of this offer, it is proposed to raise and invest an additional sum of not less than 10,000l.for the purpose of securing and furnishing a suitable house, and forming the nucleus of a permanent hospital endowment; and also to collect an annual subscription list of not less than 500l., to assist in defraying the current expenses of the hospital.The ladies whose names are appended to this statement have signified their cordial concurrence in the proposal to establish such an institution, and their desire to aid it in any way that may be within their power.Contributions will be received by Messrs. Williams, Deacon & Co., Bankers, 20 Birchin Lane, E.C. Any communications may be addressed to Miss Braysher, Hon. Secretary, 73 Gloucester Terrace, Hyde Park, W.Messrs. Bracebridge, the Hon. Russell Gurney, Q.C., and the Hon. W. Cowper accepted the posts of trustees, and sixty-six names of well-known ladies were gradually added to the circular.To Dr. Emily Blackwell, New YorkLondon: April 15, 1859.The more I see of work in England, the more I like it. From the Queen downwards I see signs of favour. On all hands we make converts, and those who are indoctrinated make converts. The whole way in which the cause is regarded by laity and doctors is most respectful. I believe we could get into general practice. We could shape the whole matter in the right way, for people welcome true ideas. There is an immense charm in this fresh field, where solid English heads receive the highest view of truth, where generosity and largeness of idea meet you at every turn. I like working and living in England, and there is no limit to what we might accomplish here. But, alas! there is the same old difficulty. We ought to have an independent 300l.per annum between us, and for want of that it is all vitiated. I see the charm of work here as clearly as I did on my arrival nine months ago, and feel immeasurably more hopeful about the possibilities of English work, but I realise more than ever the difficulty of working here upon nothing. I am writing to you upon our last prospectus, one which is to be widely circulated when we are satisfied with the names appended. It has been carefully revised, and it is contemplated to distribute many thousands of them. But we have been six weeks shaping the prospectus and collecting some names, and I know that it will take many weeks more to secure the names it is hoped to obtain. In fact, it is a long work of initiation that has to be carried on, which would be very thorough, excellently well done, but which I cannot wait to do.It is very unfortunate that the probable dissolution of Parliament and consequent ferment of re-elections will interfere with our proceedings; all lecturing is out of the question during the excitement of elections.I shall probably join A. in the Isle of Wight for a week or two. I do want to see that dear little island again, and I shall there find leisure to revise my little book for an English edition.I am going to dine with the Gurneys to-night, to meet the Rev. Mr. Maurice, who is so highly regarded by a large party, and whom I am to convert! It will be a clerical party to-night, and to-morrow I am engaged to meet a few medical gentlemen at Mr. Hawes’s!The country looks lovely, and as usual I am longing for it, and will break away at Easter for a little holiday. How hard you must be working! You must have a holiday when I come back.Easter was spent in the Isle of Wight revising the little work on ‘The Laws of Life,’ an English edition of which was brought out by Sampson Low & Co.During this time the plan of the proposed hospital was being circulated in London.It was during this visit to England that the important step was taken of placing a woman’s name on the authorised Medical Register of the United Kingdom. Influential friends were desirous of keeping me in England. They presented the various testimonials of English and Continental study given by distinguished physicians and credentials of American practice to the Medical Council. On this council, of which Sir Benjamin Brodie was president, were old friends of the St. Bartholomew’s days. The subject was very carefully considered, and after mature deliberation this just and important concession to qualified women was authorised. I had the satisfaction of being enrolled as a recognised physicianof my native land in the Medical Register of January 1, 1859.To Dr. Emily Blackwell, New YorkMay 13, 1859.My letter this week must be rather short, for I am overwhelmed with all sorts of engagements previous to leaving for Birmingham, where I give my first provincial lecture next Monday. I have communicated to our little committee Madame de Noailles’s insistence upon a country site for the hospital, and also the necessity that exists for not abandoning our work in New York until the institutions there are self-supporting. They are very much disappointed by the country condition attached to the hospital; but were I settled in England and working there, it would not discourage them. But all our friends seem to think that as the New York Infirmary is the best argument that can be used for English work, its downfall would be an irreparable misfortune, and they are willing, under the circumstances, to let me go. Indeed, I find it necessary to come to a decision myself, and after carefully weighing everything I have made up my mind to return, at any rate for some time. I can secure any amount of personal interest from various quarters; but as the prospect of speedily realising an institution where we could both work is put farther off, I do not wish to stay under the circumstances....Edgbaston: May 17,1859.A letter just received from the Countess de Noailles urges me to begin a sanatorium in the country near New York. She says: ‘As the central hospital already exists in New York, if you will allow me to help in beginning a sanatorium in country air I should be able to realise my idea at once. I think you might obtain some house or farmhouse for the purpose in thecourse of the autumn or spring. The importance of convalescent hospitals in the country is beginning to be recognised in England; let women be the first to set the example of one in America. I believe that in women’s complaints they are of more importance than in any other, and that in seven cases out of ten the air alone would effect the cure.’ Now I think this is extremely rational and liberal, and we must discuss together how we can do it for her.To Lady Byron73 Gloucester Terrace, Hyde Park: June 10, 1859.It grieves me much to know of these constantly recurring illnesses, crippling so valuable a life. What a satire it is to call our science ‘The Art of Healing’!My provincial trip has been very interesting to me, as bringing me into contact with a great number of people in different classes of society, showing me everywhere a great want and an eager reception of what I have to give. From Leeds, Nottingham, and Edinburgh came earnest invitations to lecture. A message sent to my sister from Edinburgh stated a total revolution in womanly sentiment, and that her reception would now be as hearty as it was formerly hostile. A student from Cambridge told me the young men were warmly in our favour.Mothers beg me for instruction in health. Young ladies listen eagerly to the idea of work. Three desired to become medical students. Wise old physicians ask me to ‘break up’ certain fashionable London practices by substituting our own practice. Thus from many different points of view a deep interest awakens, but everywhere the London experience was repeated—viz.conversion; women thinking themselves hostile, but receiving the idea when they knew what it really meant. But the sympathy is necessarily intellectual only—practicalreception and familiarity with the new position of women must necessarily be of slow growth. It must be, in fact, a life work. The children of the present generation will grow up accustomed to women doctors, respecting and trusting them, but the large majority of the adults will only hold a half-faith, and this will be a gradual growth. I am convinced that there would not be a rapidly brilliant success in England, such as some enthusiastic friends dream of.There is a call for the work, an admirable field, but the work itself is a very slow one, the steady conquest of innumerable difficulties—a creation, in fact. The hospital scheme I think premature.I had promised to bring it forward, and have done so, but I believe, to be successful, it must spring, as in America, out of private practice. I have no faith in its rapid success.My own opinions and plans, then, may be briefly summed up.There is a valuable and much-needed work to be done in England. Slow, uphill work, not remunerative (my tour was an expense to me); a repetition, to a great extent, of our last seven years’ work. It would need us both to do it well; and so greatly does England want just our experience that, were it possible, I should counsel the transference of our work to this side of the water. But this we cannot do, and I shall therefore endeavour to prepare others for English work by receiving and educating students in America. In America, as here, it is a life work. I shall go back to create the institutions of which we have planted only the little germ. In ten years’ time we may hope for permanent institutions there, worthy of their object, but we can during that time efficiently aid earnest young Englishwomen for their work here. Mrs. Bracebridge, who is much interestedin this plan, is coming to London in Trinity Week for the special purpose of becoming acquainted with Mrs. Gurney and Mrs. Battin. They will form a committee for appointing and testing students. There will be a good deal of work connected with these arrangements, but directly it is completed I leave, as I am much wanted across the water.I shall see you, my dear friend, before I leave (about June 25). I shall be sad to say good-bye, but I know that distance will not necessarily part us.73 Gloucester Terrace, London: June 17, 1859.Dear E.,—I have only one piece of information to send, but that is of the highest importance—viz. that the Medical Council has registered me as physician! I have just learned the news from my lawyer, Mr. Shaen, who made the application, and at once forwarded the necessary fees, that I may be published in the first register. This will be of immeasurable value to the future of medical women in England....73 Gloucester Terrace: July 7.I am busy making inquiries about the plates, &c., I want to take over to New York. I cannot go to the expense of a journey to Paris, but I have the catalogue of Auzoux, who stands unrivalled in the manufacture ofpapier-mâchémodels. I must make a selection and let the pieces be boxed up in Paris, and sent direct by sailing vessel. Vassourie is the modeller in wax; his models are the most exquisite things I have ever seen, but horribly dear. The microscope I shall buy in England. I have settled to sail by thePersiaon the 23rd, but the difficulty of deciding on our future course does not lessen. I am convinced that England is the place where we should work to best advantage. Lady Byron, Mrs.Bracebridge, the Peter Taylors, Miss Goldsmid—each the centre of a large and very different set of people—are each of them sure that we should have a large and valuable practice. Many doctors think the same. I cannot but think that the next ten years might be better spent in England than America. Our work is needed, and I know not who else can do it; indeed, we seem peculiarly suited to do this work in England. Well, we will soon discuss these matters together, and I am managing as well as I can in shaping things here, and gathering information under the uncertainty.Returning to New York in August 1859, I found the permanent fund which had been commenced for the purchase of a hospital site prospering. The steady friends of the movement—Stacy B. Collins, Robert Haydock, Merritt Trimble, and Samuel Willets, formed the nucleus of an earnest band of supporters, both men and women. The spacious house, 126 Second Avenue, was purchased and adapted to the use of hospital and dispensary, with accommodation for several students.Our able fellow-worker, Dr. Zackrzewska, having left us to superintend the new hospital in Boston, we carried on the rapidly growing work of the infirmary with the aid of intelligent graduates from Philadelphia, who came to us for practical instruction in medicine.In addition to the usual departments of hospital and dispensary practice, which included the visiting of poor patients at their own homes, we established a sanitary visitor. This post was filled by one of our assistant physicians, whose special duty it wasto give simple, practical instruction to poor mothers on the management of infants and the preservation of the health of their families. An intelligent young coloured physician, Dr. Cole, who was one of our resident assistants, carried on this work with tact and care. Experience of its results serve to show that the establishment of such a department would be a valuable addition to every hospital.Correspondence with English friends continued, and we were deeply interested by the following letters from Miss Elizabeth Garrett, who was bravely commencing the necessary pioneer work in England:—Aldeburgh, Suffolk: January 2, 1861.I feel anxious to tell you how very much I enjoy the work and study, as this is to a great extent unexpected to me. As I had not any very strong interest in the subjects, and was led to choose the profession more from a strong conviction of its fitness for women than from any absorbing personal bias, I was prepared to find the first year’s preparation work tedious and wearing. That this has not been the case is, I believe, mainly due to the fact of my having access to the hospital practice, which acts as a continual aid and stimulus to study. For three months I attended as a probationary nurse, learning what I could both from the doctors and nurses, and reading in the spare moments. It was, however, very difficult to make way in this desultory manner. The temptation to discursiveness and want of system met me continually, and at last I determined to begin the study of anatomy, chemistry, and materia medica, working steadily at these and enduring the ignorance of other branches which could not be studied rightly till a foundation of this kind had beenlaid. In pursuance of this plan, when the three months’ nursing had expired I had an interview with the treasurer of the hospital, and asked permission to visit the wards and go round with the house doctors. This Mr. De Morgan agreed to, and also suggested that Mr. Plaskitt, the apothecary, should be asked to take me as a pupil in the dispensary, which I found him very willing to do. Mr. De Morgan, however, will hold out no hope of my being admitted as a regular student, and the general feeling seems to be that each doctor is willing to help me privately and singly, but they are afraid to countenance the movement by helping me in their collective capacity. This will, however, come in time, I trust, and in the meantime it is a great thing to meet with so much individual courtesy and help. When I left the special nursing work, Dr. Willis, the house physician, offered to superintend my reading in private lessons at my own house, which was precisely the kind of help I was most glad to accept. I continue to go to the hospital early, and go round the female medical wards alone, making notes of all difficulties and writing descriptions of heart and chest sounds and diagnosing as well as I can. This occupies the time till Dr. Willis comes, when I go round again and consult him upon all doubtful points, and learn a great deal by observing his method and principles. After this I go into the dispensary for two or three hours and learn the Pharmacopœia practically, and spend the afternoon in study in a room which the authorities have kindly lent me in the hospital. I am to continue on my present footing till April, but beyond that time I have no very clear plans. I wish to get all the education that is possible in London, even if it must be of a private or irregular kind. Perhaps it would be best to call upon Dr. Southwood Smith, Dr. Mayo, and Dr. Jenner, and hear if they can help me into any other medical school.I should be very glad to know your opinion upon the plan of applying for admittance as a student at the Middlesex for the next winter session, and also what you would advise in the event of this being refused.22 Manchester Square: May 8, 1862.I have delayed writing, hoping that I might have at last some good news of success to give you; now, as this seems farther off than I had hoped it would be, I will delay no longer. I think Mrs. Russell Gurney wrote you that I was spending all my time just now in preparing for the matriculation examination of the University of London. I decided to make this the first step, in consequence of the experience last summer brought us. We then made three very careful and vigorous efforts to gain the admission of women into a medical school. Those we tried were the Middlesex, the Westminster, and the London Hospitals; and early in this year we attempted the Grosvenor Street School. I need not tell you we were in each case unsuccessful, though in one or two cases the adverse decision was gained by a very small majority of votes. In each case those gentlemen who opposed always urged as one ground for their doing so, that as the examining bodies were not prepared to admit women to their examinations, the school could not educate a woman to be an illegal practitioner, and that by doing so they would incur the certain risk of injuring the school in the eyes of the public without really aiding women. The medical papers also took up the same line. The ‘Lancet’ was particularly anxious to point out that we were beginning at the wrong end, and that the first thing we should do was to settle the question of examination. I also had private information from several of the lecturers at the Middlesex that if I could matriculate at the London University and enter as a medical student for its examinations, my friends attheir school would do all they could to get the adverse decision there altered. I therefore applied to the Apothecaries’ Hall and to the College of Surgeons, asking the latter body if they would allow me to compete for the special diploma for midwifery which they now give. This was refused, with an intimation that the College would not in any way countenance the introduction of ladies into the medical profession. The application to the Hall was more fortunate; the question turned on a legal technicality, and was referred to counsel and finally decided in my favour. I must, of course, conform to all the ordinary regulations, but when I have done so I can obtain the licence to practise granted by that body. One of the regulations I have met without difficulty—viz. being apprenticed to a medical man for five years before the final examination. I had indentures made out as soon as I knew the decision. The second one (spending three years in a medical school in the United Kingdom) is more difficult: it is something to be able to say when applying for admission into a school that the Hall would examine me and give me its licence. Still, as the licence is not all that I want, I thought it better to make an effort at some university for the M.D. For many reasons it seems desirable to make the attempt at the London University. The medical examinations there are exceedingly good; the constitution of the body is of the most liberal description, and no residence is required nor any teaching given, so that the students would not be brought into any kind of contact till they met in the examination-room. Students of all kinds (whatever degree they may ultimately desire to take) are required to pass the matriculation examination in arts, and this includes the classics, natural philosophy, and mathematics, besides a modern language and the ordinary school subjects, history and geography, and is altogether an examination which wouldrequire a more liberal and careful education (in the case of girls) than is now generally given, even if the candidates never went in for the M.A. or B.A. degree. It was clear that the only chance of obtaining admission to the examinations generally lay in keeping the question on the widest, most general ground, advocating the claims of governesses and other women who required a good general examination, without introducing the question of medical degrees or the admission of women to any new professions. The university is about to have a new charter, and we therefore thought that this was the time to raise the question by praying the Senate to obtain the insertion of a clause expressly extending to women the benefits of their examinations. Before doing this we had submitted the present charter to the Attorney-General, and had had his opinion upon the power of the Senate to admit women upon its authority, as it is now drawn up. He thought they had no power to do so, and therefore there was no alternative but to ask for a new clause. In order to get some expression of the general feeling on the question, circulars similar to the one I send you were extensively distributed. More than 1,500 were sent out, and as a result we obtained a very respectable number of names as allies. Some of their letters were so cordial that we had extracts printed and sent to the members of the Senate with the list of names. The Vice-Chancellor and Mr. Grote were throughout most kindly ready to help us, and to give the proposal the full weight of their influence. The discussion at the Senate came on yesterday, and was a most lengthened and animated one; of twenty-one members present, ten were for, ten against, and one neutral. The Chancellor (Lord Granville) then had the casting-vote, and gave it against us.I am exceedingly sorry, as this would have been fraught with such great benefit to many different classesof women, and would, I think, have been just the encouragement needed by girls when they leave school to keep them interested in their studies and out of the merely fashionable or domestic life they are so liable to fall into. It would also have been a great encouragement to parents, and would have made them more willing to let their daughters have time and opportunity for culture after they leave the schoolroom. These advantages would have been widely felt, and for professional women, whether governesses or physicians, the opportunity of being able to take a degree would have been invaluable. However, it is not to be had now; perhaps, when they are having another charter eight or ten years hence, we may try again and succeed. I do not imagine there is much chance of being able to do more at any other university in the United Kingdom than we can do here, so that I fear the possibility of ever obtaining an English degree as M.D. is a very remote one.My notion now is to try to get into a school and obtain the Apothecaries’ Hall licence. If this should prove possible, it would occupy between three and four years from next October. I should then wish to come to America and obtain the M.D. there, and then spend a year in Paris. I should be glad to know if you think I ought to make a point of getting the best M.D. diploma I can, either in America or on the Continent, if it should prove impossible to obtain one here, and if Icanget the Apothecaries’ licence. My own feeling is in favour of having the M.D.; though it should be a foreign one, I believe it would command more respect than the licence from the Hall would alone. I am fortunately able to choose to do whatever is most advisable, as I need not be in a hurry to enter upon the profession from pecuniary or any other motives, and I think I cannot aid the cause more soundly than by trying to do everything in themost thorough and exact way. It would be well, I think, to spend a good deal of time and strength on getting the very best diploma or certificate open to women. Should it prove to be quite impossible to get into a school, the licence from the Hall would not be within my reach. I must, in this case, rely entirely on foreign diplomas and on American schools. I shall not be too ready to admit this necessity, as I fear the advantage to the cause would be greatly diminished by the fact of my being educated in America.I should be very glad to spend a year with you in the infirmary after having studied in a school here, but I should be very sorry to give up my English friends and interests for the whole period of study, if it can by any means be avoided. Still, if it cannot, I am ready to go on with the work. The time spent in study has been most pleasant, and I am more than ever convinced both that this special work is one which a woman may have a divine right to engage in, and that every single woman’s life is both happier and more useful if she has an absorbing interest and pursuit. I shall be very glad to have your advice, when you can kindly find time to write to me. Believe me, yours sincerely,E. Garrett.In the full tide of our medical activity in New York, with a growing private practice and increasing hospital claims, the great catastrophe of civil war overwhelmed the country and dominated every other interest.The first shot at Fort Sumpter aroused the whole North, and the assassination of Lincoln enlisted the indignant energy of every Northern woman in the tremendous struggle. As the deadly contest proceeded,and every town and village sent forth its volunteers to the fearful slaughter of civil war, the concentration of thought and action on the war dwarfed every other effort.The war was essentially a rebellion by a portion of the States for the maintenance of slavery. To us, nourished from childhood on the idea of human freedom and justice, the contest became of absorbing interest. Though our American friends often reproached us as Englishwomen for the action of the English Government, we threw ourselves energetically into the cause of freedom.On the outbreak of the war, an informal meeting of the lady managers was called at the infirmary to see what could be done towards supplying the want of trained nurses so widely felt after the first battles. A notice of this meeting to be held at the infirmary having accidentally found its way into the ‘New York Times,’ the parlours of the infirmary were crowded with ladies, to the surprise of the little group of managers.The Rev. Dr. Bellows and Dr. Elisha Harris being present, a formal meeting was organised. Whilst the great and urgent need of a supply of nurses was fully recognised, it was also felt that the movement would be too vast to be carried on by so small an institution. A letter was therefore drafted on this occasion, calling for a public meeting at the Cooper Institute, and a committee of the ladies present was appointed to obtain signatures to this call.The meeting at the Cooper Institute was crowded to overflowing. The National Sanitary Aid Association was then formed, in order to organise the energetic efforts to help that were being made all over the country.The Ladies’ Sanitary Aid Association, of which we were active members, was also formed. This branch worked daily at the Cooper Institute during the whole of the war. It received and forwarded contributions of comforts for the soldiers, zealously sent from the country; but its special work was the forwarding of nurses to the seat of war. All that could be done in the extreme urgency of the need was to sift out the most promising women from the multitudes that applied to be sent on as nurses, put them for a month in training at the great Bellevue Hospital of New York, which consented to receive relays of volunteers, provide them with a small outfit, and send them on for distribution to Miss Dix, who was appointed superintendent of nurses at Washington.The career of one of these nurses, a German, deserves recording. We hesitated about receiving her, on account of her excitable disposition, but she insisted on going. This feeble-looking woman soon drifted away from the Washington Depôt to the active service of the front. After the battle of Gettysburg she spent two days and nights on the field of slaughter, wading with men’s boots in the blood and mud, pulling out the still living bodies from the heaps of slain, binding up hideous wounds, giving a draught of water to one, placing a roughpillow under the head of another, in an enthusiasm of beneficence which triumphed equally over thought of self and horror of the hideous slaughter.A welcome relief to the great tension of life during those years was the visit of Mr. Herman Bicknell, F.R.C.S., who was travelling in America after the death of his wife. I remembered him as a fellow-student of the St. Bartholomew’s days, who sat by me in the lecture-room; and he recalled many interesting reminiscences of that eventful time. He was a man of great though eccentric talent, and a clever Persian scholar, having resided long in the East. His cordial friendship during many later years was much prized, and continued until his premature death.It was not until this great national rebellion was ended that the next step in the growth of the infirmary could be taken.The infirmary service of young assistant physicians, which had been hitherto supplied by students whose theoretical training had been obtained elsewhere, no longer met the New York needs.In 1865 the trustees of the infirmary, finding that the institution was established in public favour, applied to the Legislature for a charter conferring college powers upon it.They took this step by the strong advice of some of the leading physicians of New York interested in the infirmary, who urged that the medical education of women should not be allowed to pass into the hands of the irresponsible persons who were at thattime seeking to establish a women’s college in New York. We took this step, however, with hesitation, for our own feeling was adverse to the formation of an entirely separate school for women. The first women physicians connected with the infirmary, having all been educated in the ordinary medical schools, felt very strongly the advantage of admission to the large organised system of public instruction already existing for men; and also the benefits arising from association with men as instructors and companions in the early years of medical study. They renewed their efforts, therefore, to induce some good recognised New York school to admit, under suitable arrangements, a class of students guaranteed by the infirmary, rather than add another to the list of female colleges already existing. Finding, however, after consultation with the different New York schools, that such arrangements could not at present be made, the trustees followed the advice of their consulting staff, obtained a college charter, and opened a subscription for a college fund.The use of a spacious lecture-room in the New York University, on Washington Square, was temporarily obtained, until the house adjoining the infirmary could be leased and fitted for college purposes.[7]A full course of college instruction was gradually organised, with the important improvement of establishingthe subject of hygiene as one of the principal professorial chairs, thus making it an equal as well as obligatory study. Another important improvement adopted was the establishment of an Examination Board, independent of the teaching staff, a plan not then customary in the United States. This Board was composed of some of the best known members of the profession, and at the same time we changed the ordinary term of medical study from three years to four.During the early years of the college I occupied the Chair of Hygiene, and had the pleasure of welcoming Miss Jex Blake, then visiting America, as a member of the first class. The Professor of Hygiene also superintended the important work of the sanitary visitor at the homes of the poor. It has always seemed to me, during many years of active private practice, that the first and constant aim of the family physician should be to diffuse the sanitary knowledge which would enable parents to bring up healthy children.The most painful experience which I met with in practice was the death of one of my little patients from the effects of vaccination. This baby, though carefully tended and the lymph used guaranteed pure, died from the phagedenic ulceration set up by vaccination in a rather scrofulous constitution. To a hygienic physician thoroughly believing in the beneficence of Nature’s laws, to have caused the death of a child by such means was a tremendous blow!This serious experience awakened a growing distrust as to the wisdom of all medical methods which introduce any degree of morbid matter into the blood of the human system; a distrust which no amount of temporary professional opinion or doubtful statistics has been able to remove. Although I have always continued to vaccinate when desired, I am strongly opposed to every form of inoculation of attenuated virus, as an unfortunate though well-meaning fallacy of medical prejudice.
The ten years during which this pioneer medical work had been steadily carried on had thus firmly established the new departure as a useful innovation in the United States. The reform was at that time steadily growing, not only in New York, but also in Philadelphia and Boston, under the guidance of able bodies of women. We were now desirous of learning what openings existed in England for the entrance of women into the medical profession. We knew that much interest had been felt there in the progress of the American work, and we had been urged by friends in Europe to give some account of it.
It was determined, therefore, in August 1858 that I should again revisit my native land and urge the importance of this medical work. Soon after my arrival in Europe I took the occasion of a visit made to a sister in Paris to prepare carefully a series of three addresses to be delivered in England, showing what was being done in medicine by women in the United States, and the reasons for that work. The first of these addresses was on the value of physiological knowledge to women, the second onthe value of medical knowledge, and the third on the practical aspect of the work as established in America and its adaptability to England. Whilst engaged in the preparation of the lectures I entered into relations with the large-hearted Countess de Noailles, whose devotion to sanitary reform and generous support of benevolent enterprises were equally remarkable. This lady was very desirous that a country sanatorium for women should be established in England or France, being firmly convinced that hygienic conditions in their fullest application were the chief necessity in the successful treatment of special diseases. This lady wrote to an old friend in Paris: ‘I wish to direct all my efforts to this object. Let me know as soon as possible what it would cost to establish a small hospital for women and children either in France or England, under Miss Blackwell’s direction.’ She also requested one of her noble French relatives to make my acquaintance. The interview is thus described in a letter to Dr. Emily in New York.
Paris: 1858.Yesterday I saw Madame —— by appointment at her own house. A. says she is a daughter of the Prince de P.; to me she seemed a stout, black-eyed Frenchwoman of forty-five, cordial in manner, speaking English well, and knowing as much of England and Anglo-Saxon nature as a Frenchwoman ever can know. We conversed energetically for two hours. She is seriously interested in the entrance of women into the medical profession, a wish founded in her case on the moral degradation which she has observed amongst her own acquaintance from thepractice of being treated by men in female complaints. The fact which most struck her in all I told her was your amputating a breast; in this she actually triumphed. Her face became radiant with the intense satisfaction of the thing, for it proved to her by a fact what she wanted to believe, but could only accept intellectually from all my reasons—viz. the necessity of letting the midwife drop, and striking unflinchingly for the highest position. This one fact, worth to this sort of nature a host of arguments, gave her real faith in the physician. She opened freely her objections, or rather difficulties, and I met them one after another; and this difference I observed in the encounter with the cultivated European nature—when I gave her a reason she understood it and accepted it; it did not go in at one ear and out at the other as with more frivolous people; there is some soil or substance you can plant in in this stouter nature. As years ago with Lady Byron, so with this lady, it was of some use talking to her. She propounded, of course, foolish as well as serious ideas; thus she thought that women physicians should never marry; she also would be shocked to see me with a garland on my head dancing in a ball-room, and she thought they should be devoted, like the sisters of charity, &c. I combated her idea of abnegation for a while, and put in a feeler to see if she could take in a higher notion; but finding it was impossible, I at once ceased the attempt, and allowed her to hold to her own highest idea, which I could see was tinged by her French nature. Of course it wearied me a little, and I wanted after a while to expand my lungs and breathe freely; but I certainly made a strong impression upon her. She thanked me and shook my hand again and again at parting, and said that she should not think of letting this be our last interview, and she should write to Madame de Noailles the very next day. She had asked me previouslyif I was resolved in any case to go back to America, and I had told her ‘No,’ but described at the same time the excellent beginning we had made there. I feel convinced that I shall have some proposition in relation to my (or rather our) establishment in London. What, then, ought we to say should such an offer arise? I will accept nothing that is not offered to us both, on that I am quite determined; we cannot separate in practice.
Paris: 1858.
Yesterday I saw Madame —— by appointment at her own house. A. says she is a daughter of the Prince de P.; to me she seemed a stout, black-eyed Frenchwoman of forty-five, cordial in manner, speaking English well, and knowing as much of England and Anglo-Saxon nature as a Frenchwoman ever can know. We conversed energetically for two hours. She is seriously interested in the entrance of women into the medical profession, a wish founded in her case on the moral degradation which she has observed amongst her own acquaintance from thepractice of being treated by men in female complaints. The fact which most struck her in all I told her was your amputating a breast; in this she actually triumphed. Her face became radiant with the intense satisfaction of the thing, for it proved to her by a fact what she wanted to believe, but could only accept intellectually from all my reasons—viz. the necessity of letting the midwife drop, and striking unflinchingly for the highest position. This one fact, worth to this sort of nature a host of arguments, gave her real faith in the physician. She opened freely her objections, or rather difficulties, and I met them one after another; and this difference I observed in the encounter with the cultivated European nature—when I gave her a reason she understood it and accepted it; it did not go in at one ear and out at the other as with more frivolous people; there is some soil or substance you can plant in in this stouter nature. As years ago with Lady Byron, so with this lady, it was of some use talking to her. She propounded, of course, foolish as well as serious ideas; thus she thought that women physicians should never marry; she also would be shocked to see me with a garland on my head dancing in a ball-room, and she thought they should be devoted, like the sisters of charity, &c. I combated her idea of abnegation for a while, and put in a feeler to see if she could take in a higher notion; but finding it was impossible, I at once ceased the attempt, and allowed her to hold to her own highest idea, which I could see was tinged by her French nature. Of course it wearied me a little, and I wanted after a while to expand my lungs and breathe freely; but I certainly made a strong impression upon her. She thanked me and shook my hand again and again at parting, and said that she should not think of letting this be our last interview, and she should write to Madame de Noailles the very next day. She had asked me previouslyif I was resolved in any case to go back to America, and I had told her ‘No,’ but described at the same time the excellent beginning we had made there. I feel convinced that I shall have some proposition in relation to my (or rather our) establishment in London. What, then, ought we to say should such an offer arise? I will accept nothing that is not offered to us both, on that I am quite determined; we cannot separate in practice.
Paris: November, 1858.Preparing my lectures is a troublesome business. My first one would not do; it was so much more adapted to an American than an English audience. I wanted also quantities of facts that I did not know how to get. But I have now re-written twenty-one pages. I have written it with pleasure, though very slowly, and I am really surprised to find how very slowly I write. I can only write when I feel fresh in the morning; sometimes only a page, sometimes none. I will not force it when I don’t feel fresh, but I shall take whatever time is necessary to do the work well, for it is really important.
Paris: November, 1858.
Preparing my lectures is a troublesome business. My first one would not do; it was so much more adapted to an American than an English audience. I wanted also quantities of facts that I did not know how to get. But I have now re-written twenty-one pages. I have written it with pleasure, though very slowly, and I am really surprised to find how very slowly I write. I can only write when I feel fresh in the morning; sometimes only a page, sometimes none. I will not force it when I don’t feel fresh, but I shall take whatever time is necessary to do the work well, for it is really important.
It was during this visit that I had the privilege of becoming personally acquainted with Dr. Trélat, the head of La Salpêtrière, and his admirable wife, who remained steadfast friends through life. I visited them at La Salpêtrière—that large asylum for infirm women, over which Dr. Trélat presided with truly paternal care. La Salpêtrière was not then a great school of experimentation, but a benevolent refuge, where the well-being and kindly protection of its inmates formed the primary object of the director.
The following letters are descriptive of this time.
Paris: December 30, 1858.160 Rue St. Dominique.My dear and venerated Friend,—I received your letter yesterday. The mere chance of being in any way useful to the valuable friend you refer to is reason sufficient for a short return at once to England, so I have made my arrangements to reach London on Monday evening, January 3.I have heard with great pleasure of an invitation to lecture in London, which I will acknowledge when I receive it. I shall be glad of an opportunity of laying very important considerations before my fellow countrywomen, but I cannot lecture just at present. I find that I must first go to Italy, for reasons which I will explain when we meet; therefore it is too soon to engage rooms at present, for which kind offer I sincerely thank you.My chief object in making this hurried visit of a few days is to see Miss Nightingale and a few valued friends, amongst whom I hope I may reckon yourself. I shall therefore remain quietly at my cousin’s, No. 73 Gloucester Terrace, Hyde Park, not attempting to enter into society.
Paris: December 30, 1858.160 Rue St. Dominique.
My dear and venerated Friend,—I received your letter yesterday. The mere chance of being in any way useful to the valuable friend you refer to is reason sufficient for a short return at once to England, so I have made my arrangements to reach London on Monday evening, January 3.
I have heard with great pleasure of an invitation to lecture in London, which I will acknowledge when I receive it. I shall be glad of an opportunity of laying very important considerations before my fellow countrywomen, but I cannot lecture just at present. I find that I must first go to Italy, for reasons which I will explain when we meet; therefore it is too soon to engage rooms at present, for which kind offer I sincerely thank you.
My chief object in making this hurried visit of a few days is to see Miss Nightingale and a few valued friends, amongst whom I hope I may reckon yourself. I shall therefore remain quietly at my cousin’s, No. 73 Gloucester Terrace, Hyde Park, not attempting to enter into society.
London: February 1859.I have just returned from an interview with Miss Nightingale at Malvern in relation to a school for nurses which she wishes to establish; and I start to-morrow for Franceen routefor Mentone. My old friend’s health is failing from the pressure of mental labour. I cannot go into the details of her last five years now, but the labour has been and is immense. I think I have never known a woman labour as she has done. It is a most remarkable experience; she indeed deserves the name of a worker. Of course we conversed very earnestly about the nursingplan in which she wished to interest me. She says that for six months she shall be utterly unable to give any thought to the fund work, and wants me meanwhile to observe English life very carefully, and make up my mind as to whether I can give up America, which she thinks a very serious matter. Unfortunately she does not think private practice possible in connection with her plan. If so, it would be impossible for us to help her. She thinks her own health will never permit her to carry out her plan herself, and I much fear she is right in this belief.
London: February 1859.
I have just returned from an interview with Miss Nightingale at Malvern in relation to a school for nurses which she wishes to establish; and I start to-morrow for Franceen routefor Mentone. My old friend’s health is failing from the pressure of mental labour. I cannot go into the details of her last five years now, but the labour has been and is immense. I think I have never known a woman labour as she has done. It is a most remarkable experience; she indeed deserves the name of a worker. Of course we conversed very earnestly about the nursingplan in which she wished to interest me. She says that for six months she shall be utterly unable to give any thought to the fund work, and wants me meanwhile to observe English life very carefully, and make up my mind as to whether I can give up America, which she thinks a very serious matter. Unfortunately she does not think private practice possible in connection with her plan. If so, it would be impossible for us to help her. She thinks her own health will never permit her to carry out her plan herself, and I much fear she is right in this belief.
After a short visit to the Riviera, to confer with the Countess de Noailles about her proposed sanatorium for women, I returned to London. There my warm friends the Misses Leigh Smith, supported by their generous-hearted father, and Miss Bessie Rayner Parkes, interested themselves actively in preparing for the first delivery of my lectures. The Marylebone Hall was secured. Our young friends brought up primroses and other lovely flowers and green wreaths from Hastings to ornament the reading-desk, and warmly supported me by their ardent sympathy. On March 2, 1859, the first lecture was given to a very intelligent and appreciative audience, whose interest was warmly enlisted. I well remember the tears rolling down the benevolent face of Miss Anna Goldsmid, who sat immediately in front of me. But the most important listener was the bright, intelligent young lady whose interest in the study of medicine was then aroused—Miss Elizabeth Garrett—who became the pioneer of the medical movement in England, and who, as Mrs. GarrettAnderson, lives to see the great success of her difficult and brave work.
These addresses were afterwards given in Manchester, Birmingham, and Liverpool; Mr. Bracebridge kindly making arrangements for them in Birmingham and the Rev. W. H. Channing in Liverpool.
The interest thus excited in London led to some effort being made to commence in England similar work to that being done in America. A meeting of ladies was held at the St. John’s Wood residence of Mrs. Peter Taylor, over which Mr. William Shaen presided. A committee was formed to consider the subject, and encouraged by the offer of help made by the Countess de Noailles, a circular was prepared, stating the object to be accomplished and inviting support. This circular, which was revised by Dr. Mayo, Lady Byron, Mr. Shaen, and the Hon. Russell Gurney, was gradually signed by a large number of influential ladies.
[Circular.]Proposed Hospital for the Treatment of the Special Diseases of WomenThe Lectures recently delivered by Doctor Elizabeth Blackwell at the Marylebone Literary Institution have produced in the minds of the ladies who heard them a strong conviction of the necessity for a more general diffusion of hygienic knowledge among women; and have led to a proposition to found a hospital for a class of diseases, the ordinary treatment of which too frequently involves much avoidable moral suffering, to be placedunder the direction of competent women physicians, in connection with a Board of consulting physicians and surgeons.A lady, impressed with the want of such an institution, and convinced of the value of hygienic knowledge in the treatment and prevention of female diseases, has already promised 1,000l.towards the hospital, and offers 5,000l.more for the endowment of a Sanitary Professorship in connection with it, provided a sufficient sum be raised by donation to place the institution on a permanent basis.In order to secure the advantages of this offer, it is proposed to raise and invest an additional sum of not less than 10,000l.for the purpose of securing and furnishing a suitable house, and forming the nucleus of a permanent hospital endowment; and also to collect an annual subscription list of not less than 500l., to assist in defraying the current expenses of the hospital.The ladies whose names are appended to this statement have signified their cordial concurrence in the proposal to establish such an institution, and their desire to aid it in any way that may be within their power.Contributions will be received by Messrs. Williams, Deacon & Co., Bankers, 20 Birchin Lane, E.C. Any communications may be addressed to Miss Braysher, Hon. Secretary, 73 Gloucester Terrace, Hyde Park, W.
[Circular.]
Proposed Hospital for the Treatment of the Special Diseases of Women
The Lectures recently delivered by Doctor Elizabeth Blackwell at the Marylebone Literary Institution have produced in the minds of the ladies who heard them a strong conviction of the necessity for a more general diffusion of hygienic knowledge among women; and have led to a proposition to found a hospital for a class of diseases, the ordinary treatment of which too frequently involves much avoidable moral suffering, to be placedunder the direction of competent women physicians, in connection with a Board of consulting physicians and surgeons.
A lady, impressed with the want of such an institution, and convinced of the value of hygienic knowledge in the treatment and prevention of female diseases, has already promised 1,000l.towards the hospital, and offers 5,000l.more for the endowment of a Sanitary Professorship in connection with it, provided a sufficient sum be raised by donation to place the institution on a permanent basis.
In order to secure the advantages of this offer, it is proposed to raise and invest an additional sum of not less than 10,000l.for the purpose of securing and furnishing a suitable house, and forming the nucleus of a permanent hospital endowment; and also to collect an annual subscription list of not less than 500l., to assist in defraying the current expenses of the hospital.
The ladies whose names are appended to this statement have signified their cordial concurrence in the proposal to establish such an institution, and their desire to aid it in any way that may be within their power.
Contributions will be received by Messrs. Williams, Deacon & Co., Bankers, 20 Birchin Lane, E.C. Any communications may be addressed to Miss Braysher, Hon. Secretary, 73 Gloucester Terrace, Hyde Park, W.
Messrs. Bracebridge, the Hon. Russell Gurney, Q.C., and the Hon. W. Cowper accepted the posts of trustees, and sixty-six names of well-known ladies were gradually added to the circular.
London: April 15, 1859.The more I see of work in England, the more I like it. From the Queen downwards I see signs of favour. On all hands we make converts, and those who are indoctrinated make converts. The whole way in which the cause is regarded by laity and doctors is most respectful. I believe we could get into general practice. We could shape the whole matter in the right way, for people welcome true ideas. There is an immense charm in this fresh field, where solid English heads receive the highest view of truth, where generosity and largeness of idea meet you at every turn. I like working and living in England, and there is no limit to what we might accomplish here. But, alas! there is the same old difficulty. We ought to have an independent 300l.per annum between us, and for want of that it is all vitiated. I see the charm of work here as clearly as I did on my arrival nine months ago, and feel immeasurably more hopeful about the possibilities of English work, but I realise more than ever the difficulty of working here upon nothing. I am writing to you upon our last prospectus, one which is to be widely circulated when we are satisfied with the names appended. It has been carefully revised, and it is contemplated to distribute many thousands of them. But we have been six weeks shaping the prospectus and collecting some names, and I know that it will take many weeks more to secure the names it is hoped to obtain. In fact, it is a long work of initiation that has to be carried on, which would be very thorough, excellently well done, but which I cannot wait to do.It is very unfortunate that the probable dissolution of Parliament and consequent ferment of re-elections will interfere with our proceedings; all lecturing is out of the question during the excitement of elections.I shall probably join A. in the Isle of Wight for a week or two. I do want to see that dear little island again, and I shall there find leisure to revise my little book for an English edition.I am going to dine with the Gurneys to-night, to meet the Rev. Mr. Maurice, who is so highly regarded by a large party, and whom I am to convert! It will be a clerical party to-night, and to-morrow I am engaged to meet a few medical gentlemen at Mr. Hawes’s!The country looks lovely, and as usual I am longing for it, and will break away at Easter for a little holiday. How hard you must be working! You must have a holiday when I come back.
London: April 15, 1859.
The more I see of work in England, the more I like it. From the Queen downwards I see signs of favour. On all hands we make converts, and those who are indoctrinated make converts. The whole way in which the cause is regarded by laity and doctors is most respectful. I believe we could get into general practice. We could shape the whole matter in the right way, for people welcome true ideas. There is an immense charm in this fresh field, where solid English heads receive the highest view of truth, where generosity and largeness of idea meet you at every turn. I like working and living in England, and there is no limit to what we might accomplish here. But, alas! there is the same old difficulty. We ought to have an independent 300l.per annum between us, and for want of that it is all vitiated. I see the charm of work here as clearly as I did on my arrival nine months ago, and feel immeasurably more hopeful about the possibilities of English work, but I realise more than ever the difficulty of working here upon nothing. I am writing to you upon our last prospectus, one which is to be widely circulated when we are satisfied with the names appended. It has been carefully revised, and it is contemplated to distribute many thousands of them. But we have been six weeks shaping the prospectus and collecting some names, and I know that it will take many weeks more to secure the names it is hoped to obtain. In fact, it is a long work of initiation that has to be carried on, which would be very thorough, excellently well done, but which I cannot wait to do.
It is very unfortunate that the probable dissolution of Parliament and consequent ferment of re-elections will interfere with our proceedings; all lecturing is out of the question during the excitement of elections.
I shall probably join A. in the Isle of Wight for a week or two. I do want to see that dear little island again, and I shall there find leisure to revise my little book for an English edition.
I am going to dine with the Gurneys to-night, to meet the Rev. Mr. Maurice, who is so highly regarded by a large party, and whom I am to convert! It will be a clerical party to-night, and to-morrow I am engaged to meet a few medical gentlemen at Mr. Hawes’s!
The country looks lovely, and as usual I am longing for it, and will break away at Easter for a little holiday. How hard you must be working! You must have a holiday when I come back.
Easter was spent in the Isle of Wight revising the little work on ‘The Laws of Life,’ an English edition of which was brought out by Sampson Low & Co.
During this time the plan of the proposed hospital was being circulated in London.
It was during this visit to England that the important step was taken of placing a woman’s name on the authorised Medical Register of the United Kingdom. Influential friends were desirous of keeping me in England. They presented the various testimonials of English and Continental study given by distinguished physicians and credentials of American practice to the Medical Council. On this council, of which Sir Benjamin Brodie was president, were old friends of the St. Bartholomew’s days. The subject was very carefully considered, and after mature deliberation this just and important concession to qualified women was authorised. I had the satisfaction of being enrolled as a recognised physicianof my native land in the Medical Register of January 1, 1859.
May 13, 1859.My letter this week must be rather short, for I am overwhelmed with all sorts of engagements previous to leaving for Birmingham, where I give my first provincial lecture next Monday. I have communicated to our little committee Madame de Noailles’s insistence upon a country site for the hospital, and also the necessity that exists for not abandoning our work in New York until the institutions there are self-supporting. They are very much disappointed by the country condition attached to the hospital; but were I settled in England and working there, it would not discourage them. But all our friends seem to think that as the New York Infirmary is the best argument that can be used for English work, its downfall would be an irreparable misfortune, and they are willing, under the circumstances, to let me go. Indeed, I find it necessary to come to a decision myself, and after carefully weighing everything I have made up my mind to return, at any rate for some time. I can secure any amount of personal interest from various quarters; but as the prospect of speedily realising an institution where we could both work is put farther off, I do not wish to stay under the circumstances....
May 13, 1859.
My letter this week must be rather short, for I am overwhelmed with all sorts of engagements previous to leaving for Birmingham, where I give my first provincial lecture next Monday. I have communicated to our little committee Madame de Noailles’s insistence upon a country site for the hospital, and also the necessity that exists for not abandoning our work in New York until the institutions there are self-supporting. They are very much disappointed by the country condition attached to the hospital; but were I settled in England and working there, it would not discourage them. But all our friends seem to think that as the New York Infirmary is the best argument that can be used for English work, its downfall would be an irreparable misfortune, and they are willing, under the circumstances, to let me go. Indeed, I find it necessary to come to a decision myself, and after carefully weighing everything I have made up my mind to return, at any rate for some time. I can secure any amount of personal interest from various quarters; but as the prospect of speedily realising an institution where we could both work is put farther off, I do not wish to stay under the circumstances....
Edgbaston: May 17,1859.A letter just received from the Countess de Noailles urges me to begin a sanatorium in the country near New York. She says: ‘As the central hospital already exists in New York, if you will allow me to help in beginning a sanatorium in country air I should be able to realise my idea at once. I think you might obtain some house or farmhouse for the purpose in thecourse of the autumn or spring. The importance of convalescent hospitals in the country is beginning to be recognised in England; let women be the first to set the example of one in America. I believe that in women’s complaints they are of more importance than in any other, and that in seven cases out of ten the air alone would effect the cure.’ Now I think this is extremely rational and liberal, and we must discuss together how we can do it for her.
Edgbaston: May 17,1859.
A letter just received from the Countess de Noailles urges me to begin a sanatorium in the country near New York. She says: ‘As the central hospital already exists in New York, if you will allow me to help in beginning a sanatorium in country air I should be able to realise my idea at once. I think you might obtain some house or farmhouse for the purpose in thecourse of the autumn or spring. The importance of convalescent hospitals in the country is beginning to be recognised in England; let women be the first to set the example of one in America. I believe that in women’s complaints they are of more importance than in any other, and that in seven cases out of ten the air alone would effect the cure.’ Now I think this is extremely rational and liberal, and we must discuss together how we can do it for her.
73 Gloucester Terrace, Hyde Park: June 10, 1859.It grieves me much to know of these constantly recurring illnesses, crippling so valuable a life. What a satire it is to call our science ‘The Art of Healing’!My provincial trip has been very interesting to me, as bringing me into contact with a great number of people in different classes of society, showing me everywhere a great want and an eager reception of what I have to give. From Leeds, Nottingham, and Edinburgh came earnest invitations to lecture. A message sent to my sister from Edinburgh stated a total revolution in womanly sentiment, and that her reception would now be as hearty as it was formerly hostile. A student from Cambridge told me the young men were warmly in our favour.Mothers beg me for instruction in health. Young ladies listen eagerly to the idea of work. Three desired to become medical students. Wise old physicians ask me to ‘break up’ certain fashionable London practices by substituting our own practice. Thus from many different points of view a deep interest awakens, but everywhere the London experience was repeated—viz.conversion; women thinking themselves hostile, but receiving the idea when they knew what it really meant. But the sympathy is necessarily intellectual only—practicalreception and familiarity with the new position of women must necessarily be of slow growth. It must be, in fact, a life work. The children of the present generation will grow up accustomed to women doctors, respecting and trusting them, but the large majority of the adults will only hold a half-faith, and this will be a gradual growth. I am convinced that there would not be a rapidly brilliant success in England, such as some enthusiastic friends dream of.There is a call for the work, an admirable field, but the work itself is a very slow one, the steady conquest of innumerable difficulties—a creation, in fact. The hospital scheme I think premature.I had promised to bring it forward, and have done so, but I believe, to be successful, it must spring, as in America, out of private practice. I have no faith in its rapid success.My own opinions and plans, then, may be briefly summed up.There is a valuable and much-needed work to be done in England. Slow, uphill work, not remunerative (my tour was an expense to me); a repetition, to a great extent, of our last seven years’ work. It would need us both to do it well; and so greatly does England want just our experience that, were it possible, I should counsel the transference of our work to this side of the water. But this we cannot do, and I shall therefore endeavour to prepare others for English work by receiving and educating students in America. In America, as here, it is a life work. I shall go back to create the institutions of which we have planted only the little germ. In ten years’ time we may hope for permanent institutions there, worthy of their object, but we can during that time efficiently aid earnest young Englishwomen for their work here. Mrs. Bracebridge, who is much interestedin this plan, is coming to London in Trinity Week for the special purpose of becoming acquainted with Mrs. Gurney and Mrs. Battin. They will form a committee for appointing and testing students. There will be a good deal of work connected with these arrangements, but directly it is completed I leave, as I am much wanted across the water.I shall see you, my dear friend, before I leave (about June 25). I shall be sad to say good-bye, but I know that distance will not necessarily part us.
73 Gloucester Terrace, Hyde Park: June 10, 1859.
It grieves me much to know of these constantly recurring illnesses, crippling so valuable a life. What a satire it is to call our science ‘The Art of Healing’!
My provincial trip has been very interesting to me, as bringing me into contact with a great number of people in different classes of society, showing me everywhere a great want and an eager reception of what I have to give. From Leeds, Nottingham, and Edinburgh came earnest invitations to lecture. A message sent to my sister from Edinburgh stated a total revolution in womanly sentiment, and that her reception would now be as hearty as it was formerly hostile. A student from Cambridge told me the young men were warmly in our favour.
Mothers beg me for instruction in health. Young ladies listen eagerly to the idea of work. Three desired to become medical students. Wise old physicians ask me to ‘break up’ certain fashionable London practices by substituting our own practice. Thus from many different points of view a deep interest awakens, but everywhere the London experience was repeated—viz.conversion; women thinking themselves hostile, but receiving the idea when they knew what it really meant. But the sympathy is necessarily intellectual only—practicalreception and familiarity with the new position of women must necessarily be of slow growth. It must be, in fact, a life work. The children of the present generation will grow up accustomed to women doctors, respecting and trusting them, but the large majority of the adults will only hold a half-faith, and this will be a gradual growth. I am convinced that there would not be a rapidly brilliant success in England, such as some enthusiastic friends dream of.
There is a call for the work, an admirable field, but the work itself is a very slow one, the steady conquest of innumerable difficulties—a creation, in fact. The hospital scheme I think premature.
I had promised to bring it forward, and have done so, but I believe, to be successful, it must spring, as in America, out of private practice. I have no faith in its rapid success.
My own opinions and plans, then, may be briefly summed up.
There is a valuable and much-needed work to be done in England. Slow, uphill work, not remunerative (my tour was an expense to me); a repetition, to a great extent, of our last seven years’ work. It would need us both to do it well; and so greatly does England want just our experience that, were it possible, I should counsel the transference of our work to this side of the water. But this we cannot do, and I shall therefore endeavour to prepare others for English work by receiving and educating students in America. In America, as here, it is a life work. I shall go back to create the institutions of which we have planted only the little germ. In ten years’ time we may hope for permanent institutions there, worthy of their object, but we can during that time efficiently aid earnest young Englishwomen for their work here. Mrs. Bracebridge, who is much interestedin this plan, is coming to London in Trinity Week for the special purpose of becoming acquainted with Mrs. Gurney and Mrs. Battin. They will form a committee for appointing and testing students. There will be a good deal of work connected with these arrangements, but directly it is completed I leave, as I am much wanted across the water.
I shall see you, my dear friend, before I leave (about June 25). I shall be sad to say good-bye, but I know that distance will not necessarily part us.
73 Gloucester Terrace, London: June 17, 1859.Dear E.,—I have only one piece of information to send, but that is of the highest importance—viz. that the Medical Council has registered me as physician! I have just learned the news from my lawyer, Mr. Shaen, who made the application, and at once forwarded the necessary fees, that I may be published in the first register. This will be of immeasurable value to the future of medical women in England....
73 Gloucester Terrace, London: June 17, 1859.
Dear E.,—I have only one piece of information to send, but that is of the highest importance—viz. that the Medical Council has registered me as physician! I have just learned the news from my lawyer, Mr. Shaen, who made the application, and at once forwarded the necessary fees, that I may be published in the first register. This will be of immeasurable value to the future of medical women in England....
73 Gloucester Terrace: July 7.I am busy making inquiries about the plates, &c., I want to take over to New York. I cannot go to the expense of a journey to Paris, but I have the catalogue of Auzoux, who stands unrivalled in the manufacture ofpapier-mâchémodels. I must make a selection and let the pieces be boxed up in Paris, and sent direct by sailing vessel. Vassourie is the modeller in wax; his models are the most exquisite things I have ever seen, but horribly dear. The microscope I shall buy in England. I have settled to sail by thePersiaon the 23rd, but the difficulty of deciding on our future course does not lessen. I am convinced that England is the place where we should work to best advantage. Lady Byron, Mrs.Bracebridge, the Peter Taylors, Miss Goldsmid—each the centre of a large and very different set of people—are each of them sure that we should have a large and valuable practice. Many doctors think the same. I cannot but think that the next ten years might be better spent in England than America. Our work is needed, and I know not who else can do it; indeed, we seem peculiarly suited to do this work in England. Well, we will soon discuss these matters together, and I am managing as well as I can in shaping things here, and gathering information under the uncertainty.
73 Gloucester Terrace: July 7.
I am busy making inquiries about the plates, &c., I want to take over to New York. I cannot go to the expense of a journey to Paris, but I have the catalogue of Auzoux, who stands unrivalled in the manufacture ofpapier-mâchémodels. I must make a selection and let the pieces be boxed up in Paris, and sent direct by sailing vessel. Vassourie is the modeller in wax; his models are the most exquisite things I have ever seen, but horribly dear. The microscope I shall buy in England. I have settled to sail by thePersiaon the 23rd, but the difficulty of deciding on our future course does not lessen. I am convinced that England is the place where we should work to best advantage. Lady Byron, Mrs.Bracebridge, the Peter Taylors, Miss Goldsmid—each the centre of a large and very different set of people—are each of them sure that we should have a large and valuable practice. Many doctors think the same. I cannot but think that the next ten years might be better spent in England than America. Our work is needed, and I know not who else can do it; indeed, we seem peculiarly suited to do this work in England. Well, we will soon discuss these matters together, and I am managing as well as I can in shaping things here, and gathering information under the uncertainty.
Returning to New York in August 1859, I found the permanent fund which had been commenced for the purchase of a hospital site prospering. The steady friends of the movement—Stacy B. Collins, Robert Haydock, Merritt Trimble, and Samuel Willets, formed the nucleus of an earnest band of supporters, both men and women. The spacious house, 126 Second Avenue, was purchased and adapted to the use of hospital and dispensary, with accommodation for several students.
Our able fellow-worker, Dr. Zackrzewska, having left us to superintend the new hospital in Boston, we carried on the rapidly growing work of the infirmary with the aid of intelligent graduates from Philadelphia, who came to us for practical instruction in medicine.
In addition to the usual departments of hospital and dispensary practice, which included the visiting of poor patients at their own homes, we established a sanitary visitor. This post was filled by one of our assistant physicians, whose special duty it wasto give simple, practical instruction to poor mothers on the management of infants and the preservation of the health of their families. An intelligent young coloured physician, Dr. Cole, who was one of our resident assistants, carried on this work with tact and care. Experience of its results serve to show that the establishment of such a department would be a valuable addition to every hospital.
Correspondence with English friends continued, and we were deeply interested by the following letters from Miss Elizabeth Garrett, who was bravely commencing the necessary pioneer work in England:—
Aldeburgh, Suffolk: January 2, 1861.I feel anxious to tell you how very much I enjoy the work and study, as this is to a great extent unexpected to me. As I had not any very strong interest in the subjects, and was led to choose the profession more from a strong conviction of its fitness for women than from any absorbing personal bias, I was prepared to find the first year’s preparation work tedious and wearing. That this has not been the case is, I believe, mainly due to the fact of my having access to the hospital practice, which acts as a continual aid and stimulus to study. For three months I attended as a probationary nurse, learning what I could both from the doctors and nurses, and reading in the spare moments. It was, however, very difficult to make way in this desultory manner. The temptation to discursiveness and want of system met me continually, and at last I determined to begin the study of anatomy, chemistry, and materia medica, working steadily at these and enduring the ignorance of other branches which could not be studied rightly till a foundation of this kind had beenlaid. In pursuance of this plan, when the three months’ nursing had expired I had an interview with the treasurer of the hospital, and asked permission to visit the wards and go round with the house doctors. This Mr. De Morgan agreed to, and also suggested that Mr. Plaskitt, the apothecary, should be asked to take me as a pupil in the dispensary, which I found him very willing to do. Mr. De Morgan, however, will hold out no hope of my being admitted as a regular student, and the general feeling seems to be that each doctor is willing to help me privately and singly, but they are afraid to countenance the movement by helping me in their collective capacity. This will, however, come in time, I trust, and in the meantime it is a great thing to meet with so much individual courtesy and help. When I left the special nursing work, Dr. Willis, the house physician, offered to superintend my reading in private lessons at my own house, which was precisely the kind of help I was most glad to accept. I continue to go to the hospital early, and go round the female medical wards alone, making notes of all difficulties and writing descriptions of heart and chest sounds and diagnosing as well as I can. This occupies the time till Dr. Willis comes, when I go round again and consult him upon all doubtful points, and learn a great deal by observing his method and principles. After this I go into the dispensary for two or three hours and learn the Pharmacopœia practically, and spend the afternoon in study in a room which the authorities have kindly lent me in the hospital. I am to continue on my present footing till April, but beyond that time I have no very clear plans. I wish to get all the education that is possible in London, even if it must be of a private or irregular kind. Perhaps it would be best to call upon Dr. Southwood Smith, Dr. Mayo, and Dr. Jenner, and hear if they can help me into any other medical school.I should be very glad to know your opinion upon the plan of applying for admittance as a student at the Middlesex for the next winter session, and also what you would advise in the event of this being refused.
Aldeburgh, Suffolk: January 2, 1861.
I feel anxious to tell you how very much I enjoy the work and study, as this is to a great extent unexpected to me. As I had not any very strong interest in the subjects, and was led to choose the profession more from a strong conviction of its fitness for women than from any absorbing personal bias, I was prepared to find the first year’s preparation work tedious and wearing. That this has not been the case is, I believe, mainly due to the fact of my having access to the hospital practice, which acts as a continual aid and stimulus to study. For three months I attended as a probationary nurse, learning what I could both from the doctors and nurses, and reading in the spare moments. It was, however, very difficult to make way in this desultory manner. The temptation to discursiveness and want of system met me continually, and at last I determined to begin the study of anatomy, chemistry, and materia medica, working steadily at these and enduring the ignorance of other branches which could not be studied rightly till a foundation of this kind had beenlaid. In pursuance of this plan, when the three months’ nursing had expired I had an interview with the treasurer of the hospital, and asked permission to visit the wards and go round with the house doctors. This Mr. De Morgan agreed to, and also suggested that Mr. Plaskitt, the apothecary, should be asked to take me as a pupil in the dispensary, which I found him very willing to do. Mr. De Morgan, however, will hold out no hope of my being admitted as a regular student, and the general feeling seems to be that each doctor is willing to help me privately and singly, but they are afraid to countenance the movement by helping me in their collective capacity. This will, however, come in time, I trust, and in the meantime it is a great thing to meet with so much individual courtesy and help. When I left the special nursing work, Dr. Willis, the house physician, offered to superintend my reading in private lessons at my own house, which was precisely the kind of help I was most glad to accept. I continue to go to the hospital early, and go round the female medical wards alone, making notes of all difficulties and writing descriptions of heart and chest sounds and diagnosing as well as I can. This occupies the time till Dr. Willis comes, when I go round again and consult him upon all doubtful points, and learn a great deal by observing his method and principles. After this I go into the dispensary for two or three hours and learn the Pharmacopœia practically, and spend the afternoon in study in a room which the authorities have kindly lent me in the hospital. I am to continue on my present footing till April, but beyond that time I have no very clear plans. I wish to get all the education that is possible in London, even if it must be of a private or irregular kind. Perhaps it would be best to call upon Dr. Southwood Smith, Dr. Mayo, and Dr. Jenner, and hear if they can help me into any other medical school.
I should be very glad to know your opinion upon the plan of applying for admittance as a student at the Middlesex for the next winter session, and also what you would advise in the event of this being refused.
22 Manchester Square: May 8, 1862.I have delayed writing, hoping that I might have at last some good news of success to give you; now, as this seems farther off than I had hoped it would be, I will delay no longer. I think Mrs. Russell Gurney wrote you that I was spending all my time just now in preparing for the matriculation examination of the University of London. I decided to make this the first step, in consequence of the experience last summer brought us. We then made three very careful and vigorous efforts to gain the admission of women into a medical school. Those we tried were the Middlesex, the Westminster, and the London Hospitals; and early in this year we attempted the Grosvenor Street School. I need not tell you we were in each case unsuccessful, though in one or two cases the adverse decision was gained by a very small majority of votes. In each case those gentlemen who opposed always urged as one ground for their doing so, that as the examining bodies were not prepared to admit women to their examinations, the school could not educate a woman to be an illegal practitioner, and that by doing so they would incur the certain risk of injuring the school in the eyes of the public without really aiding women. The medical papers also took up the same line. The ‘Lancet’ was particularly anxious to point out that we were beginning at the wrong end, and that the first thing we should do was to settle the question of examination. I also had private information from several of the lecturers at the Middlesex that if I could matriculate at the London University and enter as a medical student for its examinations, my friends attheir school would do all they could to get the adverse decision there altered. I therefore applied to the Apothecaries’ Hall and to the College of Surgeons, asking the latter body if they would allow me to compete for the special diploma for midwifery which they now give. This was refused, with an intimation that the College would not in any way countenance the introduction of ladies into the medical profession. The application to the Hall was more fortunate; the question turned on a legal technicality, and was referred to counsel and finally decided in my favour. I must, of course, conform to all the ordinary regulations, but when I have done so I can obtain the licence to practise granted by that body. One of the regulations I have met without difficulty—viz. being apprenticed to a medical man for five years before the final examination. I had indentures made out as soon as I knew the decision. The second one (spending three years in a medical school in the United Kingdom) is more difficult: it is something to be able to say when applying for admission into a school that the Hall would examine me and give me its licence. Still, as the licence is not all that I want, I thought it better to make an effort at some university for the M.D. For many reasons it seems desirable to make the attempt at the London University. The medical examinations there are exceedingly good; the constitution of the body is of the most liberal description, and no residence is required nor any teaching given, so that the students would not be brought into any kind of contact till they met in the examination-room. Students of all kinds (whatever degree they may ultimately desire to take) are required to pass the matriculation examination in arts, and this includes the classics, natural philosophy, and mathematics, besides a modern language and the ordinary school subjects, history and geography, and is altogether an examination which wouldrequire a more liberal and careful education (in the case of girls) than is now generally given, even if the candidates never went in for the M.A. or B.A. degree. It was clear that the only chance of obtaining admission to the examinations generally lay in keeping the question on the widest, most general ground, advocating the claims of governesses and other women who required a good general examination, without introducing the question of medical degrees or the admission of women to any new professions. The university is about to have a new charter, and we therefore thought that this was the time to raise the question by praying the Senate to obtain the insertion of a clause expressly extending to women the benefits of their examinations. Before doing this we had submitted the present charter to the Attorney-General, and had had his opinion upon the power of the Senate to admit women upon its authority, as it is now drawn up. He thought they had no power to do so, and therefore there was no alternative but to ask for a new clause. In order to get some expression of the general feeling on the question, circulars similar to the one I send you were extensively distributed. More than 1,500 were sent out, and as a result we obtained a very respectable number of names as allies. Some of their letters were so cordial that we had extracts printed and sent to the members of the Senate with the list of names. The Vice-Chancellor and Mr. Grote were throughout most kindly ready to help us, and to give the proposal the full weight of their influence. The discussion at the Senate came on yesterday, and was a most lengthened and animated one; of twenty-one members present, ten were for, ten against, and one neutral. The Chancellor (Lord Granville) then had the casting-vote, and gave it against us.I am exceedingly sorry, as this would have been fraught with such great benefit to many different classesof women, and would, I think, have been just the encouragement needed by girls when they leave school to keep them interested in their studies and out of the merely fashionable or domestic life they are so liable to fall into. It would also have been a great encouragement to parents, and would have made them more willing to let their daughters have time and opportunity for culture after they leave the schoolroom. These advantages would have been widely felt, and for professional women, whether governesses or physicians, the opportunity of being able to take a degree would have been invaluable. However, it is not to be had now; perhaps, when they are having another charter eight or ten years hence, we may try again and succeed. I do not imagine there is much chance of being able to do more at any other university in the United Kingdom than we can do here, so that I fear the possibility of ever obtaining an English degree as M.D. is a very remote one.My notion now is to try to get into a school and obtain the Apothecaries’ Hall licence. If this should prove possible, it would occupy between three and four years from next October. I should then wish to come to America and obtain the M.D. there, and then spend a year in Paris. I should be glad to know if you think I ought to make a point of getting the best M.D. diploma I can, either in America or on the Continent, if it should prove impossible to obtain one here, and if Icanget the Apothecaries’ licence. My own feeling is in favour of having the M.D.; though it should be a foreign one, I believe it would command more respect than the licence from the Hall would alone. I am fortunately able to choose to do whatever is most advisable, as I need not be in a hurry to enter upon the profession from pecuniary or any other motives, and I think I cannot aid the cause more soundly than by trying to do everything in themost thorough and exact way. It would be well, I think, to spend a good deal of time and strength on getting the very best diploma or certificate open to women. Should it prove to be quite impossible to get into a school, the licence from the Hall would not be within my reach. I must, in this case, rely entirely on foreign diplomas and on American schools. I shall not be too ready to admit this necessity, as I fear the advantage to the cause would be greatly diminished by the fact of my being educated in America.I should be very glad to spend a year with you in the infirmary after having studied in a school here, but I should be very sorry to give up my English friends and interests for the whole period of study, if it can by any means be avoided. Still, if it cannot, I am ready to go on with the work. The time spent in study has been most pleasant, and I am more than ever convinced both that this special work is one which a woman may have a divine right to engage in, and that every single woman’s life is both happier and more useful if she has an absorbing interest and pursuit. I shall be very glad to have your advice, when you can kindly find time to write to me. Believe me, yours sincerely,E. Garrett.
22 Manchester Square: May 8, 1862.
I have delayed writing, hoping that I might have at last some good news of success to give you; now, as this seems farther off than I had hoped it would be, I will delay no longer. I think Mrs. Russell Gurney wrote you that I was spending all my time just now in preparing for the matriculation examination of the University of London. I decided to make this the first step, in consequence of the experience last summer brought us. We then made three very careful and vigorous efforts to gain the admission of women into a medical school. Those we tried were the Middlesex, the Westminster, and the London Hospitals; and early in this year we attempted the Grosvenor Street School. I need not tell you we were in each case unsuccessful, though in one or two cases the adverse decision was gained by a very small majority of votes. In each case those gentlemen who opposed always urged as one ground for their doing so, that as the examining bodies were not prepared to admit women to their examinations, the school could not educate a woman to be an illegal practitioner, and that by doing so they would incur the certain risk of injuring the school in the eyes of the public without really aiding women. The medical papers also took up the same line. The ‘Lancet’ was particularly anxious to point out that we were beginning at the wrong end, and that the first thing we should do was to settle the question of examination. I also had private information from several of the lecturers at the Middlesex that if I could matriculate at the London University and enter as a medical student for its examinations, my friends attheir school would do all they could to get the adverse decision there altered. I therefore applied to the Apothecaries’ Hall and to the College of Surgeons, asking the latter body if they would allow me to compete for the special diploma for midwifery which they now give. This was refused, with an intimation that the College would not in any way countenance the introduction of ladies into the medical profession. The application to the Hall was more fortunate; the question turned on a legal technicality, and was referred to counsel and finally decided in my favour. I must, of course, conform to all the ordinary regulations, but when I have done so I can obtain the licence to practise granted by that body. One of the regulations I have met without difficulty—viz. being apprenticed to a medical man for five years before the final examination. I had indentures made out as soon as I knew the decision. The second one (spending three years in a medical school in the United Kingdom) is more difficult: it is something to be able to say when applying for admission into a school that the Hall would examine me and give me its licence. Still, as the licence is not all that I want, I thought it better to make an effort at some university for the M.D. For many reasons it seems desirable to make the attempt at the London University. The medical examinations there are exceedingly good; the constitution of the body is of the most liberal description, and no residence is required nor any teaching given, so that the students would not be brought into any kind of contact till they met in the examination-room. Students of all kinds (whatever degree they may ultimately desire to take) are required to pass the matriculation examination in arts, and this includes the classics, natural philosophy, and mathematics, besides a modern language and the ordinary school subjects, history and geography, and is altogether an examination which wouldrequire a more liberal and careful education (in the case of girls) than is now generally given, even if the candidates never went in for the M.A. or B.A. degree. It was clear that the only chance of obtaining admission to the examinations generally lay in keeping the question on the widest, most general ground, advocating the claims of governesses and other women who required a good general examination, without introducing the question of medical degrees or the admission of women to any new professions. The university is about to have a new charter, and we therefore thought that this was the time to raise the question by praying the Senate to obtain the insertion of a clause expressly extending to women the benefits of their examinations. Before doing this we had submitted the present charter to the Attorney-General, and had had his opinion upon the power of the Senate to admit women upon its authority, as it is now drawn up. He thought they had no power to do so, and therefore there was no alternative but to ask for a new clause. In order to get some expression of the general feeling on the question, circulars similar to the one I send you were extensively distributed. More than 1,500 were sent out, and as a result we obtained a very respectable number of names as allies. Some of their letters were so cordial that we had extracts printed and sent to the members of the Senate with the list of names. The Vice-Chancellor and Mr. Grote were throughout most kindly ready to help us, and to give the proposal the full weight of their influence. The discussion at the Senate came on yesterday, and was a most lengthened and animated one; of twenty-one members present, ten were for, ten against, and one neutral. The Chancellor (Lord Granville) then had the casting-vote, and gave it against us.
I am exceedingly sorry, as this would have been fraught with such great benefit to many different classesof women, and would, I think, have been just the encouragement needed by girls when they leave school to keep them interested in their studies and out of the merely fashionable or domestic life they are so liable to fall into. It would also have been a great encouragement to parents, and would have made them more willing to let their daughters have time and opportunity for culture after they leave the schoolroom. These advantages would have been widely felt, and for professional women, whether governesses or physicians, the opportunity of being able to take a degree would have been invaluable. However, it is not to be had now; perhaps, when they are having another charter eight or ten years hence, we may try again and succeed. I do not imagine there is much chance of being able to do more at any other university in the United Kingdom than we can do here, so that I fear the possibility of ever obtaining an English degree as M.D. is a very remote one.
My notion now is to try to get into a school and obtain the Apothecaries’ Hall licence. If this should prove possible, it would occupy between three and four years from next October. I should then wish to come to America and obtain the M.D. there, and then spend a year in Paris. I should be glad to know if you think I ought to make a point of getting the best M.D. diploma I can, either in America or on the Continent, if it should prove impossible to obtain one here, and if Icanget the Apothecaries’ licence. My own feeling is in favour of having the M.D.; though it should be a foreign one, I believe it would command more respect than the licence from the Hall would alone. I am fortunately able to choose to do whatever is most advisable, as I need not be in a hurry to enter upon the profession from pecuniary or any other motives, and I think I cannot aid the cause more soundly than by trying to do everything in themost thorough and exact way. It would be well, I think, to spend a good deal of time and strength on getting the very best diploma or certificate open to women. Should it prove to be quite impossible to get into a school, the licence from the Hall would not be within my reach. I must, in this case, rely entirely on foreign diplomas and on American schools. I shall not be too ready to admit this necessity, as I fear the advantage to the cause would be greatly diminished by the fact of my being educated in America.
I should be very glad to spend a year with you in the infirmary after having studied in a school here, but I should be very sorry to give up my English friends and interests for the whole period of study, if it can by any means be avoided. Still, if it cannot, I am ready to go on with the work. The time spent in study has been most pleasant, and I am more than ever convinced both that this special work is one which a woman may have a divine right to engage in, and that every single woman’s life is both happier and more useful if she has an absorbing interest and pursuit. I shall be very glad to have your advice, when you can kindly find time to write to me. Believe me, yours sincerely,
E. Garrett.
In the full tide of our medical activity in New York, with a growing private practice and increasing hospital claims, the great catastrophe of civil war overwhelmed the country and dominated every other interest.
The first shot at Fort Sumpter aroused the whole North, and the assassination of Lincoln enlisted the indignant energy of every Northern woman in the tremendous struggle. As the deadly contest proceeded,and every town and village sent forth its volunteers to the fearful slaughter of civil war, the concentration of thought and action on the war dwarfed every other effort.
The war was essentially a rebellion by a portion of the States for the maintenance of slavery. To us, nourished from childhood on the idea of human freedom and justice, the contest became of absorbing interest. Though our American friends often reproached us as Englishwomen for the action of the English Government, we threw ourselves energetically into the cause of freedom.
On the outbreak of the war, an informal meeting of the lady managers was called at the infirmary to see what could be done towards supplying the want of trained nurses so widely felt after the first battles. A notice of this meeting to be held at the infirmary having accidentally found its way into the ‘New York Times,’ the parlours of the infirmary were crowded with ladies, to the surprise of the little group of managers.
The Rev. Dr. Bellows and Dr. Elisha Harris being present, a formal meeting was organised. Whilst the great and urgent need of a supply of nurses was fully recognised, it was also felt that the movement would be too vast to be carried on by so small an institution. A letter was therefore drafted on this occasion, calling for a public meeting at the Cooper Institute, and a committee of the ladies present was appointed to obtain signatures to this call.
The meeting at the Cooper Institute was crowded to overflowing. The National Sanitary Aid Association was then formed, in order to organise the energetic efforts to help that were being made all over the country.
The Ladies’ Sanitary Aid Association, of which we were active members, was also formed. This branch worked daily at the Cooper Institute during the whole of the war. It received and forwarded contributions of comforts for the soldiers, zealously sent from the country; but its special work was the forwarding of nurses to the seat of war. All that could be done in the extreme urgency of the need was to sift out the most promising women from the multitudes that applied to be sent on as nurses, put them for a month in training at the great Bellevue Hospital of New York, which consented to receive relays of volunteers, provide them with a small outfit, and send them on for distribution to Miss Dix, who was appointed superintendent of nurses at Washington.
The career of one of these nurses, a German, deserves recording. We hesitated about receiving her, on account of her excitable disposition, but she insisted on going. This feeble-looking woman soon drifted away from the Washington Depôt to the active service of the front. After the battle of Gettysburg she spent two days and nights on the field of slaughter, wading with men’s boots in the blood and mud, pulling out the still living bodies from the heaps of slain, binding up hideous wounds, giving a draught of water to one, placing a roughpillow under the head of another, in an enthusiasm of beneficence which triumphed equally over thought of self and horror of the hideous slaughter.
A welcome relief to the great tension of life during those years was the visit of Mr. Herman Bicknell, F.R.C.S., who was travelling in America after the death of his wife. I remembered him as a fellow-student of the St. Bartholomew’s days, who sat by me in the lecture-room; and he recalled many interesting reminiscences of that eventful time. He was a man of great though eccentric talent, and a clever Persian scholar, having resided long in the East. His cordial friendship during many later years was much prized, and continued until his premature death.
It was not until this great national rebellion was ended that the next step in the growth of the infirmary could be taken.
The infirmary service of young assistant physicians, which had been hitherto supplied by students whose theoretical training had been obtained elsewhere, no longer met the New York needs.
In 1865 the trustees of the infirmary, finding that the institution was established in public favour, applied to the Legislature for a charter conferring college powers upon it.
They took this step by the strong advice of some of the leading physicians of New York interested in the infirmary, who urged that the medical education of women should not be allowed to pass into the hands of the irresponsible persons who were at thattime seeking to establish a women’s college in New York. We took this step, however, with hesitation, for our own feeling was adverse to the formation of an entirely separate school for women. The first women physicians connected with the infirmary, having all been educated in the ordinary medical schools, felt very strongly the advantage of admission to the large organised system of public instruction already existing for men; and also the benefits arising from association with men as instructors and companions in the early years of medical study. They renewed their efforts, therefore, to induce some good recognised New York school to admit, under suitable arrangements, a class of students guaranteed by the infirmary, rather than add another to the list of female colleges already existing. Finding, however, after consultation with the different New York schools, that such arrangements could not at present be made, the trustees followed the advice of their consulting staff, obtained a college charter, and opened a subscription for a college fund.
The use of a spacious lecture-room in the New York University, on Washington Square, was temporarily obtained, until the house adjoining the infirmary could be leased and fitted for college purposes.[7]
A full course of college instruction was gradually organised, with the important improvement of establishingthe subject of hygiene as one of the principal professorial chairs, thus making it an equal as well as obligatory study. Another important improvement adopted was the establishment of an Examination Board, independent of the teaching staff, a plan not then customary in the United States. This Board was composed of some of the best known members of the profession, and at the same time we changed the ordinary term of medical study from three years to four.
During the early years of the college I occupied the Chair of Hygiene, and had the pleasure of welcoming Miss Jex Blake, then visiting America, as a member of the first class. The Professor of Hygiene also superintended the important work of the sanitary visitor at the homes of the poor. It has always seemed to me, during many years of active private practice, that the first and constant aim of the family physician should be to diffuse the sanitary knowledge which would enable parents to bring up healthy children.
The most painful experience which I met with in practice was the death of one of my little patients from the effects of vaccination. This baby, though carefully tended and the lymph used guaranteed pure, died from the phagedenic ulceration set up by vaccination in a rather scrofulous constitution. To a hygienic physician thoroughly believing in the beneficence of Nature’s laws, to have caused the death of a child by such means was a tremendous blow!
This serious experience awakened a growing distrust as to the wisdom of all medical methods which introduce any degree of morbid matter into the blood of the human system; a distrust which no amount of temporary professional opinion or doubtful statistics has been able to remove. Although I have always continued to vaccinate when desired, I am strongly opposed to every form of inoculation of attenuated virus, as an unfortunate though well-meaning fallacy of medical prejudice.