The Onward Impulse to This Great Work
Only eight months after the opening of the Medical College for Women of the New York Infirmary, Elizabeth returned to England, and never left. She saw this as a logical next step, asserting in her autobiography that she viewed the early work in America as complete. She claimed that her efforts were more necessary in England, where the cause lagged behind. When she arrived in 1869, she remained the only female on the Medical Register; but she had connections to all the women currently attempting to gain entrance to the profession. Dr. Blackwell informed the Trustees of her Infirmary that she intended to remain in England before the second year of instruction at the College even commenced; yet it would be fifteen years before the title of Dean was given over to Emily.
In reality, Dr. Blackwell’s presence in England was not as essential as she had assumed. She would fill ceremonial roles, while women like Elizabeth Garrett Anderson and Sophia Jex-Blake pursued their ends through their own means. Dr. Blackwell did not feel satisfied with the progress these women made. Her ideals of female medicine were forged in her own image, and these new pioneers, with their focus on clinical practice rather than health education and commitment to scientific knowledge instead of moral righteousness, were entirely unlike her.
With little connection to the educational efforts of women in England and no interest in attracting patients, Dr. Blackwell focused her energies on public health. The National Health Society was formed in 1871 to promote sanitary practices. In keeping with Dr. Blackwell’s beliefs, the Society ranked hygiene above diagnosis, prescription, and surgery. She also leant her influence to causes she considered morally imperative; chief of which was the degenerative role of sex in society. She set her sights on the Contagious Diseases Act and joined its critics in arguing that it absolved soldiers of wrong-doing while placing the blame squarely on the shoulders of prostitutes. Dr. Blackwell believed promiscuity and poverty collided and the women being punished by these unfair laws were really the victims of circumstances they did not have the ability to avoid. Her most notable publication grew from this issue. Counsel to Parents on the Moral Education of their Children in Relation to Sex had very little information on anatomy, and focused instead on establishing the same sexual standards for men and women. Teaching children to prioritize the spiritual joys of intimacy found in marriage was necessary to break the cycles of depravity. These social causes would occupy the rest of her professional life.
The legacy left by Elizabeth Blackwell is clear in the endurance of the hospital she founded, and the number of women who followed in her stead. In 1850, Dr. Blackwell predicted that “A hundred years hence women will not be what they are now.” By the time Dr. Blackwell died in 1910 there were around 9,000 female physicians in the United States, many of whom learned at the Women’s College for Medicine or trained at the New York Infirmary for Women. Surely all of them looked to the first woman physician as an example of what could be, and were inspired to look to their own capabilities in determining what they might become.
"Madame Charrier sent for me this afternoon to present me with my portrait. It was a lithograph picture of Elizabeth Blackwell, taken from a history of sages-femmes celebres. This lady, about 1737, published a work on medical botany in two large folio volumes, in order to get her husband, a medical man, out of prison, where he was confined for debt."
Excerpt from letter dated October 30, 1849
Dr. Elizabeth Blackwell was not the first woman of that name to trespass into the realms of medicine. Mrs. Elizabeth Blackwell (not an MD) was one of the first botanical artists to personally draw, etch and engrave, and hand color her own designs. This saved her the cost of hiring a professional engraver as she was compiling her herbal to raise funds to free her husband from debtors prison.
"One of my most valued acquaintances was Miss Florence Nightingale…To her, chiefly, I owed the awakening to the fact that sanitation is the supreme goal of medicine, its foundation and its crown."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
Dr. Blackwell and Florence Nightingale met many times and even considered a partnership that would have given Dr. Blackwell access to the £45,000 Nightingale Fund. Central to Nightingale’s vision was the role of sanitary professor, in charge of training nurses in a hospital setting. She believed that this professor should be a woman and that the woman should, ideally, be a physician. Dr. Blackwell would have been the ideal candidate, if not for the fact that she believed women should be striving to become doctors, not simply nurses; while Ms. Nightingale believed that England remained unwilling to educate women doctors and hoped that by training better nurses she could educate the greatest number of women. When neither could persuade the other to abandon their course, the two women maintained a respectful professional distance from one another.
"First of all this 'Woman's Rights Convention' held at Worcester, Mass. I have read through all the proceedings carefully. They show great energy, much right feeling, but not, to my judgment, a great amount of strong, clear thought. This last, of course, one ought not to expect in the beginning; but in my own mind I have settled it as a society to respect...but not, for me, to work with body and soul. I cannot sympathize fully with an anti-man movement. I have had too much kindness, aid, and just recognition from men to make such attitude of women otherwise than painful." Excerpt from letter to "M" dated December 24, 1850.
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
Despite Geneva Medical College's close proximity to the birth place of the suffrage movement, from the moment the "Declaration of Sentiments" was drafted in Seneca Falls during the summer of 1848, Elizabeth was fairly indifferent to the cause. Even after she was lauded by the reformers who met in Rochester on August 2, 1849; she was gratified by the praise but unmoved to join a cause that seemed clearly in-line with her own. Though she could sympathize with their efforts she did not embrace their tactics and never offered her considerable influence to Suffrage.
"She [Kitty] has always been accustomed to call me 'Doctor'. On one occasion she was present during the visit of a friendly physician. After he was gone, she came to me with a very puzzled face, exclaiming, 'Doctor, how very odd it is to hear a man called Doctor!'"
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
Finding herself alone in New York City, Dr. Blackwell sought companionship by adopting an Irish orphan named Katharine (known as “Kitty”). Kitty was instructed to call her “Dr. Elizabeth” and the two formed a bond, though there was little of maternal affection in the Doctor. Kitty journeyed to England with Dr. Blackwell, but was unceremoniously enrolled in a boarding school and went without a visit from her guardian for some time. When the Doctor learned of the conditions at the school, she pulled Kitty immediately, but expected the 12 year old to make her own way to Paris. Despite these lapses in consideration, the two were devoted to one another and Kitty would be the Doctor’s constant companion until her death.
"On March 2, 1859, the first lecture was given to a very intelligent and appreciative audience, whose interest was warmly enlisted…But the most important listener was the bright, intelligent young lady whose interest in the study of medicine was then aroused -- Miss Elizabeth Garrett -- who became the pioneer of the medical movement in England, and who, as Mrs. Garrett Anderson, lives to see the great success of her difficult and brave work."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
Elizabeth Garrett Anderson qualified as a doctor six years after listening to Dr. Blackwell’s lectures. She would champion the cause of women in medicine in England for decades, establishing the London School of Medicine for Women. Unlike Dr. Blackwell, Dr. Garrett was also a suffragist and dedicated much of her energy to cause.
"The Ladies' Sanitary Aid Association [Women's Central Association for Relief], of which we were active members, was also formed…but its special work was the forwarding of nurses to the seat of war. All that could be done in the extreme urgency of the need was to sift out the most promising women from the multitudes that applied to be sent as nurses, put them for a month in training at the great Bellevue Hospital of New York, which consented to receive relays of volunteers, provide them with a small outfit, and send them on for distribution to Miss Dix, who was appointed superintendent of nurses at Washington."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
With the onset of the Civil War, the Doctors directed their attention to supporting the Union’s cause, even as they questioned whether it was truly committed to abolishing slavery or was more concerned with maintaining commercial interests in the South. An appeal run in newspapers on April 28, 1861 resulted in between 2,000-3,000 women packing into the Cooper Institute, looking for instruction and guidance on how to aid soldiers at the front. The result was the creation of the Women’s Central Association for Relief, with Elizabeth Blackwell, as the only female officer of the organization, serving as chair of the registration committee and tasked with selecting women to serve as nurses.
"This formed my introduction to that tremendous campaign against the unequal standard of sexual morality known as the repeal of the 'Contagious Diseases Acts' in which for the following seventeen years I was to take an active part, and which, from its extended bearings, moulded the whole of my future life."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
After her experiences in the syphilis ward at Blockley, and caring for the poor and misguided women at La Maternité, Dr. Blackwell knew first hand that poverty often forced women to engage in licentious behavior. Though she did not view these women as innocent victims, she did argue that punishing their promiscuous behavior did not address its cause. She thought the purchasing of women for sex was the greatest obstacle to the advancement of mankind and believed fully that sexual education of children, with a heavy focus on the moral arguments in favor of purity, was the best cure.
"The same year a small meeting was held in the drawing-room of 6 Burwood Place [site of her private practice in London], to consider the important subject of a steady and wide diffusion of sanitary knowledge among all the people. There 'The National Health Society' was formed...with its motto 'Prevention is better than cure.'"
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
The motto of the National Health Society “Prevention is better than cure” aligned with Dr. Blackwell’s belief in the role of hygiene and sanitation in health.
"From this small beginning has grown the New Hospital and London School of Medicine for Women, connected with the Royal Free Hospital. This is not the place to speak of the intelligent and persevering efforts to which those institutions owe their origin. The work of Dr. Garrett Anderson and Dr. Sophia Jex Blake will always be remembered. It was my privilege and pleasure in some small degree to encourage these brave workers in their pioneer enterprise in England."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
Elizabeth Garrett Anderson had perhaps more hurdles to surmount than the Blackwells. She obtained her medical education wherever she could, but it was only by exploiting a loophole that she was able to sit for examinations under the Society of Apothecaries and receive certification to practice. Sophia Jex Blake, after beginning her medical education as part of the inaugural class of the Medical College for Women of the New York Infirmary, was forced to cut her training short when her father fell ill. Returning home, she became a member of the Edinburgh Seven, who led the way for women’s education in Scotland. The Seven began studying medicine at the University of Edinburgh in 1869 and Blake became the first practicing woman doctor in Scotland. Blake and Garrett Anderson were co-founders of the London School of Medicine for women, the first of its kind in the United Kingdom.
"It has become clear to me that our medical profession has not yet fully realised the special and weighty responsibility which rests upon it to watch over the cradle of the race; to see that human beings are well born, well nourished, and well educated. The onward impulse to this great work would seem to be especially incumbent upon women physicians, who for the first time are beginning to realise the all-important character of parentage in its influence upon the adult as well as on the child -- i.e. on the race."
Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches by Elizabeth Blackwell (1895)
Though her maternal instincts were not strong, and she forswore the traditional roles of wife and mother, Dr. Blackwell focused heavily on these jobs as paramount to the development of humankind. While she argued that women should lift themselves above the stations they had been allocated, she simultaneously argued that raising righteous (and hygienic) children was a moral imperative. Female physicians would be uniquely situated to guide parents in the care of children, and she hoped to see more of doctors taking an interest in these issues.