There she gained invaluable surgical experience from having been generously received as assistant by Sir James Simpson in his extensive practice in female diseases. The genial character of this well-known physician was shown not only by his cordial reception of Dr. Emily as pupil and assistant, but by an amusing incident which occurred whilst his consulting-rooms were filled by a waiting assembly of aristocratic patients. My sister, being a classical scholar, was often employed by the Doctor in making translations or extracts for him. On one occasion, whilst thus engaged in the farthest room of the suite, he called in a low voice, ‘Dr. Blackwell,’ then a little louder, ‘Dr. Blackwell,’ and when the attention of all his patients was thus aroused, he called in a voice loud enough for my sister to hear, ‘Dr. Blackwell!’ and then from the corner of his eye, and with intense amusement, he watched the varied expressions of surprise and dismay depicted on the countenances of his distinguished patients as they saw the approach along the suite of rooms of a lady who thus answered to the summons.

The following letters to my medical sister refer to this period of the work:—

New York: May 12.

I need not tell you with what interest and hope I look forward to your Edinburgh news. The prospect is very good.... One of the most difficult points I have to contend with here is the entire absence of medical sympathy; the medical solitude is really awful at times; I should thankfully turn to any educated woman if I could find one.... Pray bear in mind to collect all the information you can about maternity, the relation of the sexes, and kindred subjects. We have a vast field to work in this direction, for reliable information is desperately needed in the world on these topics. I feel as if it were peculiarly our duty to meet this want. There is much vain thought given to these matters here. An active set of people are making desperate efforts to spread their detestable doctrines of ‘free love’ under scientific guise, placing agents with the advertisements of their books worded in the most specious and attractive manner at the doors of the conventions now being held here; on the other hand, equally misleading publications are brought out in opposition. Such teaching is utterly superficial and untrustworthy, and consequently misleading. We want facts, scientifically accurate observations, past and present, on all that bears on these matters.

You remember the pamphlet sent me by Dr. Sims of Alabama. He is now here, determined to establish a hospital for the special treatment of women’s diseases; he is enlisting much support, and will, I think, succeed. He seems to be in favour of women studying medicine. I think I shall help him in any way I can....

I have at last found a student in whom I can take a great deal of interest—Marie Zackrzewska, a German, about twenty-six. Dr. Schmidt, the head of the Berlin midwifery department, discovered her talent, advised her to study, and finally appointed her as chief midwife in the hospital under him; there she taught classes of about 150 women and 50 young men, and proved herself most capable. When Dr. Schmidt died, the American Minister advised her to come to New York; but here the German doctors wanted her to become a nurse. In desperation she consulted ‘The Home for the Friendless,’ where they advised her to come to me. There is true stuff in her, and I shall do my best to bring it out. She must obtain a medical degree....

July 24.

Don’t be discouraged. There is no doubt about our losing many opportunities because of our sex, but you must also bear in mind the disadvantages all students labour under, unless in exceptional cases. Crowded together in masses, they only see at a distance the most interesting cases; the complete study is reserved for the physician or his constant attendant. I remember expressing my impatience while in the Maternité at the restrictive rules there, and M. Blot said, ‘What you wish for are only enjoyed by the few who occupy the most favoured positions.’ Yet I gained, in spite of all difficulties, a great deal, and in accelerating ratio the longer I stayed. I remember that it seemed to me I had gained more in my fourth month at the Maternité than in the whole three preceding ones. Now I say this because I don’t want you to over-estimate the worth of pantaloons. Disguise in France or elsewhere would by no means give you all you need; if the disguise were complete you would just be reduced to the level of the common poor student, and would be, I think, quite disappointed. It needs also that influential men should take an interest in you, and give you chances quite beyond the ordinary run. I know that at St. Bartholomew’s I would not have exchanged my position for that of the simple student, though I would gladly for the clinical clerk or interne’s position. Now you can do nothing in France, except by special medical influence. Your time is limited, and you cannot wait for examinations and promotions as an ordinary student. You ask me what I did, and what can be done as a lady. I entered the Maternité, dissected at l’Ecole des Beaux-Arts alone, employed a répétiteur who drilled me in anatomy and smuggled me into the dead-house of La Charité at great risk of detection, where I operated on the cadavre. I once made the rounds of his wards in the Hôtel-Dieu with Roux, heard his lectures, and saw his operations. I attended lectures on medical generalities at the College of France and Jardin des Plantes. I believe that was all in the way of Parisian study. I applied to Davenne, Director-General of the hospitals, for permission to follow the physicians—refused; applied to Dubois and Trousseau to attend lectures at the Ecole de Médecine—refused; Trousseau advising me to disguise. You see I had no introductions, no experience. I went into the Maternité soon after going to France, and came out with a sad accident, not inclined to renew the battle, not well knowing how, and with a promising chance opened to me in London. I should do differently now. I should get the most influential introduction I could; I should tell them just what I wanted, find which hospitals would be most suited to my purpose, and if by putting on disguise I could get either an assistant’s post or good visiting privilege, I would put it on. I don’t believe it would be a disguise at all to those you were thrown with, but it would be a protection if advised by intelligent men, and would make them free to help you. I should avoid crowds, because you gain nothing in them; I don’t think either the lectures at l’Ecole de Médecine or the great hospital visits, where from one to five hundred students follow, would be of any use. It is in a more private and intimate way, and in hospitals where many students do not go, that you might gain. I know no one in a position to give you more valuable letters than Dr. Simpson, if he is disposed to. You ask me what I saw at the Maternité, but I find my notes imperfect; I have only noted down nine versions, &c. But I think the most important thing in the Maternité is the drilling in the more ordinary labours, for only where the finger is thoroughly trained can you detect varieties. The cases you send me are very interesting, and I am very glad you have made such full notes, as they will be useful hints in future solitary practice. Don’t be in a hurry to leave Dr. S., for I fear you will nowhere else find a good drilling in that department. I shall see how far I can make your notes available from time to time in my own practice. With regard to my own clientèle, I shall have advanced 50 dollars over last year; slow progress, but still satisfactory, as it is reliable practice, not capricious success. Only think, the thermometer has been up to 102 in some of the rooms down town! We have had three days’ ‘spells’ this July that seem to me a little beyond anything I have ever had to endure.

November 13.

I shall be very anxious to know what you do in Paris. I almost doubt the propriety of your entering the Maternité, or rather I hope that the necessity may be obviated by your finding other openings. That Dubois is somewhat of an old fox, and will, I presume, at once advise your entrance, to get rid of any responsibility; but I would not think of doing so until I had seen all the others and tried for better openings. I think you could get sufficient midwifery at the Ecole de Médecine, where the midwives have the night cases; the association would be unpleasant from the character of the women, but it would leave you your freedom. You have done excellently in Edinburgh, and nothing could be more satisfactory than the way you leave. I think, however, before going to Paris you had certainly better see Dr. Oldham of Guy’s; he is disposed to be friendly, and if he chose might greatly help you. It would seem as if it would be well to pursue your English studies before the Parisian; if you could follow Doctors Burrows and Baly in medicine at St. Bartholomew’s, and Oldham at Guy’s, you would do well. I am very glad you are collecting special medical statistics; we shall find them very serviceable in lecture or pamphlet form. It will be necessary next year to make an active effort for the dispensary, and I think a few lectures would be very important. My conviction becomes constantly stronger that you will return, and my plans for the future all involve that fact. A pleasant circumstance occurred to my German, Dr. Zackrzewska. I arranged a Cleveland course for her, and she entered two weeks ago; she met a very friendly reception, and found that Dr. Kirkland is in correspondence with Professor Müller of Berlin, and he had mentioned her in some of his letters in such high terms, that the faculty told her, if she would qualify herself for examination in surgery and chemistry and write an English thesis, that they would graduate her at the end of this term. Of course she is studying with might and main, and will, I have no doubt, succeed; so we may reckon on a little group of three next year. That will be quite encouraging.