I suppose that the real test of “demand” is not in the opinions expressed by those women who have never even seen a thoroughly educated female physician, but in the practice which flows in to any such physician when her qualifications are clearly satisfactory. In England there are at present but two women legally qualified to practise Medicine, and I understand that already their time is much more fully occupied, and their receipts much greater, than is usually the case with medical men who have been practising for so short a period. Dr Garrett Anderson’s Dispensary for poor women is also largely attended, and during the five years which have elapsed since it was opened, more than 40,000 visits have been made to it; 9000 new patients have been admitted, and 250 midwifery cases have been attended by the midwives attached to the charity, Dr Garrett Anderson being called in when necessary.
When we turn to America, we find that a considerable number of women have very extensive practice and large professional incomes (more, indeed, than in some cases seems warranted by their medical qualifications). The Report of a little hospital, managed entirely by women, in Boston, U.S., relates that during 1867 the number of in-patients was 198; of persons visited at their homes, 281; and of those able to attend at the dispensary, 4,576; all these patients being women and children only. In fact, the attendance at the Dispensary became so excessive in proportion to the resources of the charity, that in 1868 a rule was passed by the Committee requiring each patient to pay twenty-five cents (or about ninepence) for medicines, at each visit, except when she brought “a certificate of her poverty, properly authenticated.” This regulation brought out still more strongly the distinct choice of poor women in this matter, for, though the General City Dispensary gave medicines gratuitously, the number of those who attended at the Woman’s Hospital was much less diminished than was expected, being still 3,236 in 1868. In New York also, where the Dispensary managed by women doctors is but one of many, the crowd of patients is very great, the numbers being, in 1867, no less than 6354, while 545 persons were attended at their homes either in confinement or during severe illness. Of course it will be understood that each patient thus entered on the books implies not one visit, but many, paid to the Dispensary, or often repeated attendance at the patient’s home.
Of the Boston Hospital for Women and Children I can speak from lengthened experience in it as a student. When standing in its dispensary I have over and over again heard rough women of a very poor class say, when questioned why they had not had earlier treatment for certain diseases, “Oh, I could not go to a man with such a trouble, and I did not know till just now that ladies did this work;” and from others have repeatedly heard different expressions of the feeling that, “It’s so nice, isn’t it, to be able at last to ask ladies about such things?”
As I am alluding to my own experience in this matter, I may perhaps be allowed to say how often in the same place I have been struck with the contingent advantages attendant on the medical care by women of women. How often I have seen cases connected with stories of shame or sorrow to which a woman’s hand could far most fittingly minister, and where sisterly help and counsel could give far more appropriate succour than could be expected from the average young medical man, however good his intentions. Perhaps we shall find the solution of some of our saddest social problems when educated and pure-minded women are brought more constantly in contact with their sinning and suffering sisters, in other relations as well as those of missionary effort.
So far from there being no demand for women as physicians, I believe that there is at this moment a large amount of work actually awaiting them; that a large amount of suffering exists among women which never comes under the notice of medical men at all, and which will remain unmitigated till women are ready in sufficient numbers to attend medically to those of their own sex who need them, and this in all parts of the world. From India we hear urgent demands for “educating native women of good caste, so as to qualify them to treat female patients and children.”[43] We are informed that “this is a work which can only be carried on by women, as the native women in many cases will rather die than be seen by a man in times of sickness,”[44] and arrangements have already been made for a systematic “Female Medical Mission,” though perhaps the standard of medical knowledge required can, under existing circumstances, hardly be fixed as high as is desirable. To show, however, the eagerness with which the native women avail themselves of the aid thus offered, I may mention that when a lady (who had had some medical training, but possessed no degree,) was sent out by the Society[45] in December 1870, she, during the first three months of her stay, had occasion to pay no less than 313 professional visits to zenanas, and to treat 158 patients at her dispensary, which was arranged with a view to affording them the utmost privacy. Subsequently her visits to zenanas averaged as many as seventeen a day, while nearly twice as many patients came to her dispensary. Efforts are also being made to train native Hindoo women for some branches, at least, of the medical profession. Dr Corbyn of Bareilly, in 1870, wrote as follows:—“I am educating a number of native girls, and three have already passed as native doctors. They are of all castes,—Christians, Mahommedans, and Hindoos. My school is divided into three classes. The first-class pupils can read and write English and Urdee with accuracy. They are taught medicine, surgery, midwifery, diseases of women and children (especially the latter two). The second-class learn anatomy, materia medica, and physiology, in English and Urdee. The pupils of the other (preparatory) class are taught English and Urdee. We have a female ward attached to the dispensary for women and children, and these girls entirely attend to them, under my and the sub-assistants’ supervision. It is wonderful how they can manipulate; they have plenty of nerve.”[46] Even more recently we learn that “the Mahommedan Nawab of Rampoor has presented to the Bareilly mission a large building for the purpose of a medical school for women. Several women are now going through a scientific course of instruction.”[47]
About eight or ten years ago, “several of the wild tribes of Russian Asia petitioned the Government to send them out properly qualified women to act as midwives. Their petition was granted, the Government undertaking all the expense of the education and maintenance of a certain number of women for this purpose. After a time one of these tribes, the Kirgesen, petitioned further, that the women thus sent to them should also be taught some branches of the art of Medicine. One of the women, then being trained as a midwife, hearing of this petition, wrote to the Kirgesen, proposing that she should study Medicine thoroughly, and go out to them as a qualified doctor. She suggested at the same time that they should try to get permission for her to enter the Academy of St Petersburg as a regular medical student. The Kirgesen welcomed the proposal, and, through an influential Russian general, obtained an official document, empowering their future doctor to attend the Academy as a student. They have regularly sent money for her education and maintenance, and from the first have taken the greatest interest in her progress and welfare, requiring, among other things, periodical bulletins of her health. Hearing last summer that she was not well, they sent money for her to go abroad for her holiday, and asked for an extra bulletin.”[48]
I cite the above facts to show that the demand for female physicians is no artificial or imaginary one, and that it does not spring out of any fanciful whim of an over-refined social state; but lest it should be supposed on the other hand to be confined to half-barbarous nations, I may quote the opinions expressed on this subject two years ago in one of the most thoughtful of our English journals: “We heartily admit that the only way to discriminate clearly what practical careers women are, and are not, fitted for, is to let them try. In many cases, as in the medical profession, we do not feel any doubt that they will find a special kind of work for which they are specially fitted, which has never been adequately done by men at all, and which never would be done but by women.... We have heard the opinion of one of the most eminent of our living physicians, that one of the new lady physicians is doing, in the most admirable manner, a work which medical men would never even have had the chance of doing.”[49]
I am told by Catholic friends that a great many cases of special disease remain untreated in convents, because the nuns, with their extreme notions of feminine seclusion, think that it would be little short of profanation to submit to some kinds of medical treatment from a man.[50] Indeed, it is expressly laid down by a great Catholic authority, St Alphonsus,[51] that though monks and nuns are required to place themselves in the doctor’s care when commanded to do so by their superiors, a special exception is to be made in the case of nuns suffering from certain maladies, who can only be required to accept treatment from a skilled woman, if any such be available; as, under existing circumstances, is so rarely the case. I do not ask any reader to applaud or even justify these poor nuns, if they, esteeming themselves “the martyrs of holy purity,” sacrifice life to such scruples; but I do most emphatically ask, in the name of humanity, whether the state of things can be defended which may drive women, from the highest and most holy motives, to submit to the extremity of physical suffering and even death itself, because it is impossible for them to obtain the medical services of their own sex, and because they believe they can best fulfil the spirit of their vows by accepting no other?
I am informed by a friend that Archbishop Manning, when expressing to her his strong interest in the question of the medical education of women, alluded to facts like those referred to above, as affording one of the strongest motives for such interest in the minds of Catholics. Nor, surely, need sympathy in such a case be limited within the bounds of any religious denomination.
To pass to the consideration of other cases of a less exceptional kind, there can, I think, be little doubt that an enormous amount of preventible suffering arises from the unwillingness of very many girls on the verge of womanhood to consult a medical man on various points which are yet of vital importance, and to appeal to him in cases of apparently slight illness, which yet issue but too often in ultimately confirmed ill-health. I firmly believe that if a dozen competent women entered upon medical practice at this moment in different parts of England, they might, without withdrawing a single patient from her present medical attendant, find full and remunerative employment in attending simply to those cases which, in the present state of things, go without any adequate treatment whatever; for I believe that many suffering women would be willing to consult one of their own sex, if thoroughly qualified, when they refuse, except at some crisis of acute suffering, to call in a medical man.[52] Probably Queen Isabella of Castile[53] was neither the first nor the last woman whose life was sacrificed to her modesty. Even if such extreme instances are rare, I think it cannot be denied that very much needless pain, “and pain of a kind that ought not to be inflicted,” is caused, especially to young girls, by the necessity of consulting men on all occasions, and I believe that those who know most of the facts insist most strongly on this point.