The reference at the end of Dr. Bowditch’s letter is to the course upon which Dr. Zakrzewska had decided, after mature consideration of the question of taking the examination for admission to the Massachusetts Medical Society. She expresses this decision and the reasons for reaching it, as follows:

The Massachusetts Medical Society has within the last three months decided to admit women. The perseverance of women in the practice of medicine and surgery, their professional competency, the increase in their numbers, and the impossibility of ignoring them any longer, have led to the result that physicians of this Society acknowledge women in daily practice and have thus broken the rule which binds them to friendliness and coöperation with members only. Necessity, not acknowledgment of the principle of the right of woman to practice, has finally conquered, and the Massachusetts Medical Society is willing to allow women to present themselves for examination with the view of admission.

On the other hand, the regular women practitioners have found it necessary to protect themselves against being confounded with charlatans of every description, and have formed themselves into a society which adopts the name of the Hospital in which their practice started and now centers.

Besides the physicians living in Boston, a few scattered over the New England States are members of this society. Thus a union of reliable women practitioners is begun and promises to be of interest and usefulness. If a union with the Massachusetts Medical Society can be effected by them, it would be beneficial to both and, no doubt, to the profession at large.

The obstacles to such a union consist chiefly in the fact that any one wishing to become a member of the Massachusetts Medical Society has to present himself or herself for examination before a number of censors chosen by the Society, and at present in the Suffolk District Medical Society consisting of five of its youngest members, who have to examine the candidate in Obstetrics, Histology, Anatomy, Physiology, Pathology, Materia Medica, and Chemistry, that is to say, precisely in those branches for proficiency in which the candidate has received a diploma years ago.

It is well known that wisdom and experience acquired in practice push into the background textbook knowledge, and that most physicians after ten years of practicing life have gained a great deal of knowledge which is not in the textbooks and have forgotten a great deal which is.

It is therefore a question whether the amount of benefit gained by admission into the Massachusetts Medical Society is worth the waste of time necessary for reading and studying books which we have long laid aside and simply use occasionally for reference.

To young beginners, I would advise the seeking of this privilege but as for myself, I feel constrained to make the following statement:

When I came to Boston in 1859, eight years after my graduation in Berlin as accoucheuse and three years after graduation as physician from the Western Reserve Medical College of Cleveland, Ohio, and having been regularly employed in teaching classes and private pupils in medicine, consequently, in the full life of a student—I made application for examination to be admitted into this society and was refused.

Again, five years later, that is, in 1864, I made the same application, and was not so decidedly refused. Thinking there was a possibility of my being admitted, I set myself to work reviewing some of my studies in order to prepare myself to meet the high dignitaries in the shape of the young men members and censors of that venerable society; but after several months of discussion, I again received a refusal.

This last refusal I met with the declaration that “when the time comes for women to be received into this Society—and I know it will come before I have passed out of this existence—this venerable Society cannot have me as a candidate for examination but must give me an honorary membership if it wants me at all.”

To-day, its condescending proposal for my examination for admission has been made, and I am only a little more than fifty years old. But after twenty-six and one-half years of practice (that is, nearly at the end of my career), my only personal interest in this affair is that I am happy that the younger women can have the benefit of an association which is very desirable for all beginners, and most desirable in assisting women to gain the position for which they strive.

I have done my part, and I feel satisfied with the results achieved. I have aided the women of this country by word and deed, by example and sacrifice, and I am willing to retire, leaving them the field in which to sow and to reap where I have helped to plow, associated as I have been with the pioneer women of the medical profession.

It was about this time that, at one of the meetings of the New England Hospital Society, that body was asked to give an opinion upon a question which had arisen in reformatories and prisons, that is, “whether medicines which cause anesthesia, emesis or prostration should ever be administered to refractory prisoners to enforce obedience through their action.”

A unanimous “No” expressed the instinctive feeling among all members present of the absolute wrong in the use of such remedies to compel obedience. The discussion of this subject was continued to a subsequent meeting, and Dr. Zakrzewska was requested to prepare a written statement of her views upon this point. She writes:

I. From the medical standpoint, the administering of a pharmaceutical preparation for any other purpose than to aid in the restoration of health is malpractice. An emetic or an opiate might be easily given to a culprit who is in perfect health but who refuses obedience to the prison regulations; this could be done by deceiving the offender. But the administration of ether or chloroform would meet with opposition for the overcoming of which an application of force would be needed, which would be as much in the nature of corporal punishment as would the use of the rod.

No physician could sanction the use of remedies for any other than their legitimate purpose and must refuse such demand from the prison superintendent or warden.

II. From the legal standpoint, no prison official has a right to order for the purpose of enforcing obedience the administration of powerful medicines to a healthy individual, thus rendering her ill for hours or days, shocking a system otherwise in harmonious action, and thereby also possibly producing bodily injuries, internally or externally, which may after the release of the prisoner easily lead to a complaint in a court of law, a complaint which could well be sustained.

III. From the moral standpoint, the deception which is necessary either by disguising the medicine in some usual beverage or by false statement, pretending a necessity for some medical remedy, such as hypodermic injection of morphine, would at once awaken distrust of the whole official management and would thereby destroy the very principle upon which all prisons should be conducted, that is, the reformation of those intrusted to their care.

If we once admit that medical remedies can be used by the physician under the orders of the superintendent in order to enforce obedience or as punishment, where shall we stop? The physician and the superintendent can become in time accomplices in such practices as may lead to even fatal results, for such officials have almost absolute power in these institutions which are subjected to only occasional examinations by State committees.

CHAPTER XXXV

Association for the Advancement of the Medical Education of Women—Coeducation or segregation—Dr. Zakrzewska leads another attempt to persuade Harvard to admit women to its Medical School (1881-1882)—Failure takes from Harvard final opportunity to be first great medical school to admit women on equal terms with men, this honor passing to the Johns Hopkins in 1890—Massachusetts Legislature directs that a woman physician be appointed in each State Hospital for insane patients—Dr. Zakrzewska takes a vacation in Europe—Letter to Mrs. Cheney and others—The New England Hospital requires all resident students to possess the degree of M.D., and changes their status to that of internes—The Hospital establishes District Nursing in its out-practice—Letter from Dr. Zakrzewska to Dr. Sewall who is on vacation in Europe—Dr. Zakrzewska compares earlier and later women medical students. (1879-1886.)

As a further move in the campaign for opening the larger colleges to women, there was formed the Association for the Advancement of the Medical Education of Women. This association had a membership of medical and lay men and women from different parts of the country, and Dr. Mary Putnam-Jacobi was its president for many years.

Mary Putnam, one of the earlier students of the New England Hospital, and a graduate of the Woman’s Medical College of Pennsylvania, was the first woman to be admitted to the École de Médicine of the University of Paris, from which she was graduated in 1871. Later, she married the noted Dr. Abraham Jacobi of New York, becoming herself one of the most brilliant members of the profession in America. It will be remembered that in 1876 she was awarded the Boylston Prize of Harvard University, the identity, and consequently the sex, of the competitors for this honor remaining unknown to the judges until after the verdict was rendered.

The above association not only carried on an educational campaign, but for several years it assisted the Woman’s Medical College of the New York Infirmary by paying part of the faculty’s salaries and by helping to enlarge the College and the Hospital.