Page images

instances medical women are working in conjunction with their professional brethren, and also alone in connection with various charitable and other institutions. One of the largest day schools for girls in London has a woman doctor in regular attendance, with a view to preventive rather than curative service; and I trust that this example will before long be far more widely followed. In these days of educational pressure I know of no more useful function for medical women than the constant and careful supervision of growing girls during their period of study, and I am sure that a great part of the evil results now justly deprecated could be with certainty avoided, if a sensible medical woman were entrusted with the oversight of physical health in every large centre of education for girls. Another branch of work that in America is being gradually more and more handed over to medical women, is the supervision of patients of their own sex in lunatic asylums, and also in prisons and reformatories. Few unprejudiced persons who know anything of the facts can fail to see the immense boon that might be conferred, both physically and morally, on suffering women, by the almost exclusive employment of physicians of their own sex in these special cases, and the time is probably not far off when public opinion will awake to the need I can here only indicate.

It is of course neither possible nor advisable to enter here into details of private practice carried on in this country by medical women; but, as some have ventured to question the demand for their services because they do not invariably find a ready-made practice spring up around them in a few weeks, I feel bound to record my belief that disappointment in this matter can only be experienced by those who have entertained unreasonable expectations, such as would be absurd in the case of a man; and that, other things being equal, it is invariably easier for a young medical woman than for a young medical man to build up a satisfactory practice. In point of fact women are continually doing what men hardly even attempt, viz. settling down in a strange place, with no professional introduction to practice, by purchase or otherwise; and if gifted with a moderate degree of patience, tact, and other qualities needful in every successful practitioner, they do manage to succeed in a way that certainly goes far to justify their bold adventure. Hitherto, no statistics on this subject have been taken in this country, but it may be of interest to mention that in 1881 a systematic inquiry was made respecting the 460 medical women who were known to be in practice in America, and that answers were obtained from 362 of them, which showed that 226 were satisfied with their professional incomes, and that only eleven of those who had been in practice over two years had failed to become self-supporting."

See a paper read by Dr. Emily Pope, before the American Social Science Association, at Saratoga, September 7, 1881.

[ocr errors]

It is, however, of course in India and other parts of the East that the necessity for medical women is most apparent, and their usefulness most indisputable. The great publicity given to Lady Dufferin's movement for supplying medical women to India, and the very influential patronage under which it has been organised, have brought the matter before the nation at large with an emphasis and authority that no private advocate could have commanded. For many years past, however, the facts have been familiar to those specially interested in the welfare of India on the one hand, or in the education of medical women on the other. As long ago as 1867 a medical school for native women was started by Surgeon Corbyn at Bareilly; and in 1872 the subject was brought before the Madras Government by Inspector-General Balfour, who bore witness that of the hundred millions of women in India, at least two-thirds are, by their social customs, debarred alike from receiving the visits of a medical man at their own houses, and from attending at the public hospitals and dispensaries. . . . To send among those classes women educated in the medical art seems to be the only means of providing them with scientific medical aid.' The result of this was the opening of the Madras Medical College to women in 1875. Notwithstanding this advance, Sir Salar Jung wrote in 1880, that he was of opinion that it would be a great benefit to India, a benefit that could not be exaggerated, if English medical women, educated completely in England, could settle in the chief towns of India. He estimated the number necessary at first at 1,025, but believed this number would prove wholly insufficient.' Over a thousand English medical women urgently needed for India in 1880, and in 1887 there are but fifty-four women, all told, on the British Register! Is it possible to have stronger evidence of the pressing need of increased facilities and national aid for the medical education of women?


The movement in favour of medical women in India received, however, its first great impetus from the natives themselves, when, in January 1883, a committee chiefly composed of native gentlemen was formed spontaneously in Bombay; and at a meeting held in the following March, Sir Jamsetjee Jejeebhoy in the chair, it was announced that about 4,000l. had already been raised for the purpose of bringing women doctors from England, establishing a hospital and dispensary to be worked by them, and providing for the medical education of women at the Bombay Medical College, with scholarships as required. The committee were fortunate enough to induce Dr. Edith Pechey to accept the chief appointment in the proposed hospital, and before she landed in Bombay its foundation was laid with great éclat on the 22nd of November, 1883, by H.R.H. the • Circular Memorandum, No. 4:18, issued by the Madras Government, 1874. Lecture by Mrs. Scharlieb, M.8. B.S. Lond., at Madras, November 21, 1885.

Duke of Connaught, who remarked that the introduction of female medical practitioners into India is calculated to afford a needful relief to classes which have hitherto been almost entirely deprived of medical and surgical aid. . . . It affords me much gratification that my first public act in India should be performed on behalf of so excellent an object, one which her Majesty the Empress will most highly approve of.' This, the Cama Hospital for Women and Children, was founded by the munificence of a Parsee gentleman, named Pestonjee Cama, and is now in full working order, with wards containing sixty beds, and an excellent staff of three thoroughly qualified medical women. It is a matter of interest that this is the first hospital in the Bombay Presidency that has been from the outset nursed entirely by trained English nurses, and that has attached to it a training school for nurses of all nations. The success of this department is due in great measure to the indefatigable exertions of Lady Reay, wife of the governor of Bombay. The same medical staff has also charge of a dispensary, established by the liberality of a Mussulman gentleman, named Cumoo Suliman; and the attendance here is simply enormous, for the report tells us that in 1885 no less than 5,998 new patients came for advice, with a total number of visits amounting to 27,429.

A similar hospital for caste and gosha women' was established in Madras in 1885, under the auspices of Mrs. Grant Duff, and the committee secured for it the services of Mrs. Scharlieb, M.B. Lond., who also undertook to lecture on midwifery to the women students of the Medical College at Madras. This hospital now contains about fifty beds, with a very large dispensary practice in connection.

In August, 1885, the Countess of Dufferin, wife of the Viceroy, issued the prospectus of a 'National Association for Supplying Female Medical Aid to the Women of India,' and stated that her Majesty had consented to be patron of the Association, which indeed owed its existence to her initiative, as she had personally commended the matter to Lady Dufferin's attention before she left for India. It is impossible here to give any detailed account of the very large scope and aims of this Association, which can best be learned from its reports, and also from an excellent article written by Lady Dufferin herself on the subject. One of the most interesting features of the case is the rigidly non-proselytising character of the Association, which has received, as Lady Dufferin says, large sums of money from native gentlemen, who trust in the honour of its promoters that they shall not be employed in any way hostile to the national creeds. This principle, of course, makes it impossible for the Association to co-operate in any way with the Medical Missionary Societies, but it by no means precludes friendly relations between the promoters of the two movements, which have to some extent a common aim.


Asiatic Quarterly Review, April 1886.

on the

I cannot leave this branch of the subject without remarking that the immense size of the field now open in India, and the enormous number of medical women that would be required adequately to meet its needs, are in themselves conducive to the one great danger which to my mind threatens the best interests of the movement, if not, indeed, its very existence. With but fifty women British Register, it is of course quite impossible that the demands made by India can be filled up from their ranks alone; as a matter of fact I find that ten only of these registered women are available for this field. The main supply must for the present come from America, where medical women are numbered at least by hundreds, but no doubt here also the contingent at command falls short of the needs even of the present moment. An obvious and easy remedy unfortunately presents itself only too temptingly in the employment of women very imperfectly qualified for their work by an incomplete and insufficient education, and I am sorry to find that both Medical Missionary Societies and Lady Dufferin's Association are in danger of falling into the pitfall in question. The 'Church of England Zenana Missionary Society' is a notorious offender in this respect, for it appears that out of ten women who, under its auspices, are doing more or less exclusively medical work (including even in some cases the sole charge of hospitals and dispensaries), but one has received a complete medical education, terminating in a registrable qualification! The sister society (non-sectarian), which is, I think, now called the Zenana Bible and Medical Mission,' has, I understand, on the contrary, distinguished itself by the wiser resolution to employ as medical missionaries none but fully qualified women; and, though this will no doubt for the moment limit its power of usefulness, I am sure that in the long run the wisdom of such action will be established. In the same way I think the National Association is committing a very serious error by accepting partially qualified women, and especially the lower class of 'medical practitioners,' educated at the Indian colleges with a much restricted curriculum, and placing them practically on an equal footing with the graduates of those same colleges, or of European schools, who have really had a thorough education. I do not say that imperfectly educated women may never be usefully employed, but it should certainly be only in subordinate positions, and by no means in a post of sole responsibility; and this alike for the sake of those who may rely on their professional skill, and for that of the credit of medical women at large.


It is of course a separate and most important question, which cannot be adequately discussed here, whether it is possible or, indeed,

"When women were admitted to the Madras Medical College in 1875, it was arranged, I think unfortunately, that they should have the option of studying for the ordinary M.D. degree, or for a Medical Practitioner's Certificate,' which represented a very inferior standard of education and attainment.

desirable that provision for the medical needs of the hundred millions of Indian women should be undertaken by any voluntary agency; and whether it ought not, in fact, to be made in connection with the Civil Service of this the most important dependency of our empire. This is the more worthy of consideration as the great majority of the patients are quite unable to pay remunerative fees, and the matter seems one rather for public than for private benevolence. If also medical women took their place on the Indian Medical Service we may be sure that proper regulations would be enforced, and no practitioners would be suffered to act without sufficient credentials.

It will, of course, be self-evident that in the foregoing pages have confined myself to narration only, and have not attempted to enter into any controversy with reference to the fundamental question of the desirability that women should, or should not, be educated in medicine. Any adequate discussion of this subject would require all the space allotted to the present paper; and at this moment I am content to address myself to those already interested in the matter, either because they know the real existence of a need that can be supplied by medical women only, or because they sympathise in the belief that every human being is entitled to perfect liberty of choice in the selection of his or her life-work.10 I do not propose now in any way to widen the scope of my paper, but merely in conclusion to sum up the chief difficulties and dangers which still beset the movement whose history I have brought down briefly to the present time.

1. The first difficulty lies in some remaining jealousy and ill-will towards medical women, on the part of a section (constantly diminishing, as I believe) of the medical profession itself. Some twenty years ago the professional prejudice was so deep and so widely spread that it constituted a very formidable obstacle, but it has been steadily melting away before the logic of facts; and now is, with a few exceptions, rarely to be found among the leaders of the profession, nor indeed among the great majority of the rank and file, so far as can be judged by the personal experience of medical women themselves. Unfortunately it seems strongest just where it has least justification —viz. among the practitioners who devote themselves chiefly to midwifery and to the special diseases of women. The Obstetrical Society is, so far as I know, still of the same mind as when, in 1874, they excluded Dr. Garrett Anderson, a distinguished M.D. of Paris, from their membership; and the Soho Square Hospital for Women has never revoked its curt refusal to allow me to enter its doors, when,

10 We deny the right of any portion of the species to decide for another portion, or any individual for another individual, what is, and what is not, their 'proper sphere.' The proper sphere of all human beings is the largest and highest which they are able to attain to. What this is cannot be ascertained without complete liberty of choice. (Mrs. J. S. Mill.)

« PreviousContinue »