1 Needle or Scalpel? The Doctress Debate
Prior to the establishment of the American Medical Association in 1847, no significant barriers were in place to prevent an individual from the practice of medicine. During this time, women prospered as lay healers or midwives in many areas of the United States. In the mid-19th century, however, male physicians created the AMA as well as the requirement of a medical license to engage in the medical field. This subsequently created professional and gender obstacles in a woman’s fight to become medically qualified.
During the turn of the 19th century, separatism was the new defining factor of a women’s education. Society assumed that men and women differed in physical, moral, and spiritual attributes that obligated them to distinct social tasks. This common belief, paired with the industrial revolution and rise of urban areas, established a new definition of the woman’s place in society; she was expected to contain certain moral values and domestic qualities which were best employed in the tasks of the home. As a result of this sexism, women were excluded from the male-dominated public sphere and were expected to establish their own institutions of education and occupation. In medicine, women had to open up their own schools, hospitals, and practices based on the assumption that they could not receive the same level and quality of education due to differences in strength and intellect.
Women’s medical societies – not to be confused with formal colleges – emerged in the mid-19th century with the aim of bringing more professional female physicians to the field. Organizations like the New England Hospital in Boston offered women valuable clinical training and provided them with the medical knowledge they needed to better serve their communities. Although these societies existed, women were far from equal in the medical field. Many argued this unequal system of education did nothing but hold women back, as men were still receiving a traditional medical education and were, therefore, perceived by society as more proficient and intelligent in their careers. This created a distinct gender wage gap because citizens preferred medical advice from a male physician and refused to see a female. Women also lacked representation in many sectors of healthcare. Because women were perceived to be more nurturing and fragile, they were steered into the practices of pediatrics and gynecology, and away from more “rigorous disciplines” like surgery.
As women’s medical societies rose in number, there was a surge in debate on whether females should be allowed a full and equal formal education in medicine. Critics argued that women could not fulfill both the duties of marriage and motherhood while practicing medicine. They also strongly disagreed with the sacrifice of a woman’s primary responsibilities within the family and the home. Furthermore, many also believed the demands and stress of professional work were too much for women to physically endure and that a career in medicine would destroy her health. As previously stated, there was also the common perception that women were too feeble and unintelligent to be relied upon as doctors and would never reach equality to men in the field.
In the mid-19th century, many newspapers published articles on this debate of female physicians. The Boston Journal in particular heavily reviewed and supported women regarding this issue, as their city held the most renowned female medical society of the 19th century. Below is a column written for this publication in 1855 by Fanny Fern (pseudonym for Sara P. Parton), who strongly disagreed with the admittance of women in the field, despite the journal’s dominant stance.
Transcription of “Female Physicians”
Author’s note: The source is transcribed here from the original.
“The Boston Journal strongly advocates the introduction of females into the medical profession. We consider the needle a much more appropriate weapon in the hands of women than the scalpel or bistoury. Do you? Just suppose yourself a forlorn sick bachelor, in the upper story of some noisy boarding house, whose inmates don’t care a pinch of snuff whether you conclude to die, or get well. Suppose you’ve watched that spider in the corner weave his web, till you are quite qualified to make one yourself; suppose you have counted for the thousandth time, all the shepherdesses, distorted little dogs, and crooked trees, on the papered wall of your room; gnawed you finger nails to the very quick; and twitched your mustache till every hair stands up on its own individual responsibility. Then – suppose just as you are at the last gasp, the door opens, gently, and admits (not a great creaking pair of boots, containing an oracular, solemn M.D., grim enough to frighten you into the churchyard) but a smiling rosy cheeked, bright eyed, nice little live woman doctress yet? Well, she pushes back her curls, throws off her shawl (Venus! what a figure!) pulls off her glove, and takes your hand in those little fingers. Holy mother! How your pulse races! She looks at you so compassionately from those soft blue eyes; lays her hand on your forehead, and questions you demurely about your “symptoms,” (a few of which she sees without any of your help!) Then she writes a prescription with those dainty little fingers, and tells you to keep very composed and quiet, (just as if you could) smooths the tumbled quilt – arranges your pillow – shades the glaring sunlight from your aching eyes, with an instinctive knowledge of your unspoken wants; and says with the sweetest smile in the world, that she’ll “call again in the morning;” and so – the fold of her dress flutters through the door; and then you crawl out of the bed the best way you can – clutch a looking glass to see what the probabilities are that you have made a favorable impression! inwardly resolving (as you replace yourself between the blankets,) not to get quite well as long as she will come to see you. Well, the upshot of it is, you have a delightful lingering attack of heart complaint! For myself, I prefer prescriptions in a masculine hand! I shan’t submit my pulse to anything that wears a bonnet!”
The gender stereotypes and misogyny of the time are extremely prevalent throughout Fanny Fern’s sarcastic comments on the public issue. Quotes such as “we consider the needle a much more appropriate weapon in the hands of women than the scalpel or bistoury” and “Smooths the tumbled quilt – arranges your pillow”, indicate that the author agreed with the notion that women belonged in the home performing domestic tasks, not in the professional field of medicine. This argument of critiques is furthered with rhetoric such as “The door opens, gently, and admits but a smiling rosy cheeked, bright eyed, nice little live woman doctress”, “she pushes back her curls, throws off her shawl (Venus! what a figure!) pulls off her glove, and takes your hand in those little fingers”, and “Then she writes a prescription with those dainty little fingers”; which not only define and sexualize women as objects of beauty, but reinforce the belief that women were too “dainty” and “gentle” to be taken seriously in the occupational field. Finally, Fern closes the column by directly stating “I prefer prescriptions in a masculine hand! I shan’t submit my pulse to anything that wears a bonnet!”, confirming her belief, along with others’, that women would not be and should not be trusted with the tasks of physicians.
Fern’s use of sarcasm and satire establish a tone of mockery towards female physicians and claim that women are much more preferred in the home, carrying the responsibilities of wives and mothers. As Fanny Fern was a well-established female journalist of the time, it is very unexpected that she would take on such a position within the debate for female progression in medicine. According to one source, Fern herself received “considerable criticism” from those who claimed her use of sarcasm was “unfeminine and indelicate”. More critics argued she herself “defiled the ‘sacredness’ of the home by the baseness of the work she undertook, worst of all ‘for the sake of profit”.
While seemingly controversial, Fern’s opinions on the topic were not unusual or viewed as blatant misogyny during the 19th century. In fact, many citizens shared the same opinions and fought against women’s rights to higher education. Hannah Longshore, one of the first female physicians, wrote pioneering women medical students “did not find their paths strewn with flowers, nor their advent welcomed by the general public or by the profession”; and later recounts stories of male pharmacists refusing to fill her patient’s prescriptions. Furthermore, many women (like Fern herself) strongly opposed the progression and incorporation of their own sex into professional culture. These women, along with the majority of society, believed that a woman’s utmost duty was in the home. In order to gain access to public activity, female-critics argued that an aspiring physician’s actions must not interfere with the domestic responsibilities in which they are prized. Higher education was not justified in terms of its advantages for performing household duties, and therefore was rejected by traditional standards..
To combat the argument of critics such as Fern, feminists had to claim that a medical career only improved their role as caretaker; a female physician could not only serve women with greater intuition and less violation of modesty, but would extend her role as nurturing mother by treating children’s medical needs. With this rationalization, women’s-rights activists rallied enough support to open the first female medical school, The Women’s Medical College of Pennsylvania, in the 1850s. Although female acceptance into a male-dominated medical school was still rare and separatism remained prevalent, this establishment inspired the founding of seventeen more medical schools and nine hospitals specifically for the education and treatment of women. This allowed for the influx of women into the medical field and achieved a monumental step in the women’s fight for an equal, higher education.
Meagan Marks is a second-year student at Wake Forest University.
- For more on early women in medicine, visit Mandelbaum, Dorothy Rosenthal. “Women in Medicine.” Signs 4, no. 1 (1978): 136. ↵
- For further research on the effects of the American Medical Association, visit Riska, Elianne “Women’s Careers in Medicine: Developments in the United States and Finland.” Scandinavian Studies 61, no. 2/3 (1989): 186. and Mandelbaum, “Women in Medicine.” 136. ↵
- The 19th century societal role of women as well as the impact of separatism is discussed in more depth in Riska, “Women’s Careers” 186-187. ↵
- To explore further on women’s medical societies, see Marrett, Cora Bagely. “On the Evolution of Women’s Medical Societies.” Bulletin of the History of Medicine 53, no. 3 (1979): 434. ↵
- Riska, “Women’s Careers” 187. ↵
- Mandelbaum, “Women in Medicine.” 139. ↵
- During the 19th century, many studies and surveys were performed to collect data on female physicians; The “Bodley and Pope” surveys especially produced a variety of results that supported the higher education of women. For further detail, see Drachman, Virginia G. “The Limits of Progress: The Professional Lives of Women Doctors, 1881-1926.” Bulletin of the History of Medicine 60, no. 1 (1986): 61. ↵
- For a deeper explanation of critic’s arguments, visit Drachman, “Limits of Progress” 61-64. ↵
- Sara P. Parton aka Fanny Fern, “Female Physicians” (Boston, Massachusetts: The Boston Journal, 1855) http://doctordoctress.org/islandora/object/islandora:1496/story/islandora:1541#page/44/mode/1up?width=1000&height=800&iframe=true (Accessed September 24th, 2020) ↵
- McMullen, Kevin. “Fanny Fern: A Brief Biography | Fanny Fern in The New York Ledger.” Accessed November 3, 2020. https://fannyfern.org/bio. Provides a full biography of Fanny Fern. ↵
- Wood, Ann D. “The ‘Scribbling Women’ and Fanny Fern: Why Women Wrote.” American Quarterly 23, no. 1 (1971): 4.This source offers much more on the criticism and work of Fern as well as many female writers of the 19th century. As Fern’s signature use of sarcasm distinguished her as an unconventional and unfeminine woman, it is quite ironic she would use such a device to contend against the progression of education equality. ↵
- To see the full source, visit Hannah Longshore, Autobiography of Hannah Longshore http://doctordoctress.org/islandora/object/islandora:1496/story/islandora:1582#page/9/mode/1up (Accessed September 24th, 2020) ↵
- For more on the argument against a woman’s higher education, see Hunt, Marion. “Woman’s Place in Medicine.” Bernard Becker Medical Library. Women in Health Sciences, (1980). Accessed November 17th, 2020. http://beckerexhibits.wustl.edu/mowihsp/articles/McLean.htm. ↵
- Hunt, “Women’s Place”. ↵
- “The Early Plight of Women in the Medical Field.” The University of Richmond. History Engine (2008-2015). Accessed November 17th, 2020. https://historyengine.richmond.edu/episodes/view/5150. ↵