Pioneer Work in Opening the Medical Profession to Women

by Elizabeth Blackwell

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 at their 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 would require 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 classes of 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 I can get 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 the most 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.