It is to fit ourselves for this most useful and influential position—viz., as the medical advisers of families—that, not limiting our education to any speciality, we have laboured, and must continue to labour, to remove all obstacles in the way of obtaining the fullest medical education. For this reason I have laid so much stress upon the cultivation of habits of careful observation, and I now would give a warning against sensationalism in medical study.
The unreflecting student (not unnaturally) rushes after novelties. There is a certain excitement in witnessing a formidable surgical operation, or seeing a rare case of disease that may never again be presented to our observation. But these exceptional occurrences do not fit us for our future medical life as does the careful study of the commoner forms of disease, for those are the cases that most nearly concern us. But because they are common they cease to interest the unobservant student, who applies a routine treatment. But the physician whose faculties of observation have been thoroughly drilled has learned this lesson—viz., that no two cases of illness are exactly alike, and that it is of the utmost importance to our future success as practitioners to note these individual differences, their results, and why some die whilst others recover. It is far more important to our success as practical physicians to thoroughly master measles and whooping-cough, scarlet fever and porrigo, than to study an isolated case of hydrophobia or leprosy. Moreover, I hold it to be a special duty of our profession to extirpate these common diseases, not to accept them hopelessly as necessary evils. And it is only by a profounder and more comprehensive clinical study of the ordinary diseases of domestic life that we can hope to do this.
There are two great branches of medicine whose importance will, I hope, more and more engage the attention of women physicians. These are midwifery, which introduces us to the precious position of the family physician; and sanitary or preventive medicine, which enables us to educate a healthy generation.
These two departments of the healing art will never cease from amongst us. I consider it a radical defect in our present system of medical education, that these subjects are not brought more prominently forward, and both of them raised into first-class professorial chairs.
Before closing, I must dwell for a few moments on the vital importance of midwifery to the future success of women physicians. This is the more necessary because I observe a singular and growing disposition on the part of our students, whether in America, France, or England, to despise or neglect midwifery. I do not know whether this proceeds from indolence, as midwifery is the most fatiguing and enchaining branch of the profession, or whether the neglect arises from failure to perceive the reason of our refusal to be simply midwives, for our insistence upon a complete education really means our determination to elevate, not repudiate, midwifery.
But the curious fact remains that many women doctors appear to look down upon this most important branch, and often state that they do not intend to undertake it. Yet it is through the confidence felt by the mother during our skilful attendance upon her, that we are called in to attend other ailments of the family, and thus secure the care of the family health. It is therefore of the utmost importance to our future position in medicine to establish our ability as thoroughly trustworthy obstetricians.
It is indispensable to the stability of our movement that very thorough provision be made for the obstetrical education of all our medical graduates. I do not think that any young woman physician is properly equipped for her future difficult career unless she has been to a great extent responsible for at least thirty midwifery patients, of whose cases she has made careful and discriminating records, and has had the opportunity of observing a great many more patients, in addition to the drill in all operative manœuvres that can be given in college. We need a great maternity department, thoroughly organized, which, whilst arranged with kindest consideration for the poor, will put our students through a severe drill, such as is considered necessary at La Maternité in Paris. That institution, which receives annually an average of 2,500 patients, having over 10,000 applications in the year, is not only an invaluable practical school, but it has reduced the mortality amongst its patients to a minimum; and the searching method of instruction there pursued could be studied by us to great advantage as we try to secure a well-organized maternity charity for our students in London. Such a charity, if humanely planned, would be a blessing to poor mothers, and it would to a great extent remove the reproach of being obliged to send our enterprising young doctors abroad because London does not afford them sufficient necessary practical training.
But time warns me to close these remarks, although I would gladly have enlarged upon the primary importance of preventive medicine—the medicine of the future—for it is quite certain that the greater part of disease, even including many surgical operations, is preventable disease. It is now, unfortunately, the case that unavoidable absorption in the treatment of disease makes the practical physician too often ignore the yet larger duty of preventing it.
I have tried to show (1) That women, from their constitutional adaptation to creation and guardianship, are thus fitted for a special and noble part in the advancement of the healing art. (2) That the cultivation of the intellectual faculties necessary to secure their moral influence requires a long and patient training by methods that do not injure morality. (3) That the noblest department of medicine to which we can devote our energies, will be through that guardianship of the rising generation which is the especial privilege of the family physician.
In conclusion, my young friends and fellow-workers, I would ask you all to join with me in the pledge which I gave more than forty years ago to the Chancellor of the Western University, who handed to me our first Diploma of Doctor of Medicine. I then promised ‘that it should be the effort of my life to shed honour on that diploma.’