The two remaining women of the group were also married, and the husband of one, Mrs. Thomas, was also a physician.[[69]] She and her sister, Mrs. Longshore, both graduated in the first class sent out from the Woman’s Medical College of Philadelphia.[[70]] Dr. Longshore was the first woman to settle in practice in this city, and her sign was regarded as a monstrous curiosity, collecting street idlers for its perusal. On one, and perhaps more than one, occasion, a druggist refused to fill a prescription signed by the “female doctor,” and took it upon himself to order her home “to look after her house and darn her husband’s stockings.”[[71]] But Dr. Longshore ultimately established herself in a lucrative practice. Mrs. Thomas, the sister, first began to study medicine privately, with her husband, a practitioner in Indiana. For four years, while caring for a family of young children, Mrs. Thomas “read medicine” at all odd minutes; and at last, upon hearing that a medical college had been opened for women in Philadelphia, she made a grand final effort to secure its advantages. She sewed steadily until she had provided her family with clothes for six months in advance, and then started for the East. Returning with her coveted diploma, Mrs. Thomas began to practice medicine with her husband at Fort Wayne, and continued to do so until her death about a year ago (1889). During eight years she held the position of city physician, and for twelve years was physician to a home for friendless girls.
The married women physicians of the West, with protection and sympathy at home, and encountering abroad only a good-natured laxity of prejudice, were in a favored position compared with their colleagues in Philadelphia, Boston, and New York. At the time that the tiny New York infirmary was opened (1857) the name of “woman physician” had become a by-word of reproach, from its usurpation by a notorious abortionist, “Madame” Restell. So wide a stain could be diffused over innocent persons by a single evil reputation, that it was difficult for Drs. Blackwell and Zakzrewska to obtain lodgings or office room; their applications were refused on the ground that their business must be disreputable. Scarcely more than fifty years had elapsed since the practice of obstetrics at least was entirely in the hands of women: yet the recollection of this had so completely faded away, that the women who now renewed the ancient claim to minister to the physical necessities of their sex, were treated as reprobates.[[72]] The little group of women who nevertheless dared to face this opprobrium, contained collectively nearly all the elements necessary for success, although in no one member of the group were these united. Instinctive enthusiasm for the science of life, instinctive predilection for medical practice, enlightened resolve to elevate the intellectual capacity and enlarge the practical opportunities of women,—the habit of progressive philanthropy,—personal interest in the pursuits of the nearest friend, the husband; literary training, exceptional among the uncultivated physicians of the day,—the tradition of centuries in the discipline of the practical European midwife,—all these were representative, and certainly none could have been spared. What was most conspicuously lacking was systematic education, which might have enabled the medical students to judge more critically of the medical education which was offered them. However, even without adequate intellectual preparation, there was a complex representation of interests which sufficiently showed that the enterprise was no isolated eccentricity, but sprang from roots widely ramifying in the permanent nature of things, and in the changing circumstances of the day.
This fourth period in the history of women physicians, to which belong the early careers of the pioneers in the movement, must nevertheless be considered as a sort of pre-medical episode, analogous in many respects to that of the entire American profession before the Revolutionary War. And this notwithstanding, and indeed a good deal because during this epoch some women were admitted to inferior or “irregular” schools, already established, and because other medical schools were founded exclusively for them. The Philadelphia school owed its foundation to the most generous impulses: but knowledge and pecuniary resources were both inadequate, and the active and bitter opposition of the medical profession of the city was an almost insuperable obstacle in the way of securing efficient assistance for instruction. The idea of the school seems to have originated with Dr. Bartholomew Fussell, a poor schoolmaster, who had been educated by an elder sister “to whom he looked up with veneration; and he thought that such as she ought to have a chance of studying medicine, if they desired.”[[73]]
A few friends were collected, the plan was matured, the charter secured, and the school opened for the reception of students in 1850. During the first four years the yearly sessions did not last more than four months; but in the fifth annual catalogue the trustees announced with pride an extension of the course to five and a half months, and claimed that this was the longest course of instruction adopted by any medical college in the United States. They further, and with evident sincerity, declared that the curriculum of study was fully equal to that of any other medical college.
The instruction consisted of rambling lectures, given by gentlemen of good intentions but imperfect fitness, to women whose previous education left them utterly unprepared to enter a learned profession, and many of whom were really, and in the ordinary sense, illiterate. As fast as possible the brightest students were chosen, after graduation, to fill places in the Faculty, and among these one, Emmeline Cleveland, having received a real education, at least for obstetrics, in Europe, returned to Philadelphia to become a really effective teacher. For twelve years scarcely any opportunity existed for the students of the college to see sick people, an anomaly which would at the time have been considered more outrageous in any other country than the United States. As late as 1859, nine years after the foundation of the college, the Philadelphia County Medical Society passed resolutions of excommunication against every physician who should teach in the school, every woman who should graduate from it, and everybody else who should even consult with such teachers.
Had the tiny college been a virulent pest-house, the cordon sanitaire could not have been more rigidly drawn around it. Nevertheless, the trustees claimed that their graduates rapidly secured medical practice, at least to the extent of a thousand dollars a year; and that applications were frequently received from communities in different parts of the country, requesting that women physicians be sent to settle among them.[[74]] In 1857 115 students had matriculated at the college.
In 1859 Elizabeth Blackwell estimated that about 300 women had managed to “graduate” somewhere in medicine, supposing that their studies had really “qualified them to begin practice, and that by gaining experience in practice itself, they would gradually work their way to success.” “It is not until they leave college, and attempt their work alone and unaided, that they realize how utterly insufficient their education is to enable them to acquire and support the standing of a physician. Many of them, discouraged, having spent all their money, abandon the profession; a few gain a little practical knowledge, and struggle into a second-rate position.”
This view of the realities of the situation is in curious contrast with the cheerful optimism of the leaders of the Philadelphia School. These did indeed walk by faith,—and the numerous addresses of Ann Preston, who for many years was its guiding spirit, breathe a spirit of moral enthusiasm which, as the final result proved, really did manage to compensate for the intellectual inadequacy. Dr. Preston seems to have been thoroughly convinced, that if the moral behavior of the new physicians were kept irreproachable, intellectual difficulties would take care of themselves, or be solved by an over-ruling Providence.[[75]]
The fifth period for women physicians began with the founding of hospitals, where they could obtain clinical training, and thus give some substance to the medical education they had received in mere outline. The oldest of these institutions is the New York Infirmary, chartered, as has been said, in 1854 as a dispensary,—opened with an indoor department in 1857, with the Drs. Blackwell and Zakzrewska as attending physicians. The Infirmary was fortunate in securing several eminent New York physicians as consultants, Dr. Willard Parker, Dr. Kissam, Dr. James B. Wood, Dr. Stephen Smith, and Dr. Elisha Harris. The medical profession in New York never took the trouble to organize opposition and pronounce the decrees of ostracism that thundered in Philadelphia; its attitude was rather that of indifference than active hostility.
From 1857 until 1865, the indoor department of the Infirmary was limited to a single ward for poor lying-in women, and which contained but twelve beds. But in the dispensary, several thousand patients a year were treated, and the young physicians living in the hospital also visited the sick poor at their own homes. The persevering efforts of the Blackwells, moreover, finally succeeded in opening one medical institution of the city to their students, the great Demilt dispensary. As early as 1862, the succession of women students who annually pressed forward to fill the two vacancies at the Infirmary patiently waited in the clinic rooms of Demilt, and there gleaned many crumbs of experience and information.[[76]] These, together with the practical experience gained in the obstetrical ward and the out-practice of the Infirmary, afforded the first and for a long time the only opportunity for clinical instruction open to women students in America.