Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from 396

WOMEN IN MEDICINE By JANET K. AITKEN, C.B.E., M.D., F.R.C.P.

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It is very agreeable to be asked to write about None of the schools, however, took since the earliest days, be- women except, of course, their own special school. cause on the whole it is a story with which the Oxford and Cambridge, King's College Hospital woman doctor is well satisfied and nowadays she and University College Hospital opened during or is, or should be, grateful to those women who just after the first world war, and retained a limited made her present career possible, and to the number of places open till the present day. Five majority of her male colleagues who have accepted other hospitals also began to take women students, this break with tradition, some even being most St. George's, Westminster, St. Mary's, Charing active in giving their assistance. Cross and London, but later they decided not to The London School of Medicine for Women, admit women, St. George's in 1919, so that it was after its early struggles, had outgrown its quarters, understood that the gesture had been purely aProtected by copyright. and boldly the Dean, Mrs. Elizabeth Garrett war measure; but the others kept on for a number Anderson, and her Council had planned a new of years and then decided against the admission of building, the first part of which was opened in women. One hospital admitted that the reason 1898; but the Council was still much in debt. was because the lessening of the number of male However, in 900o Dr. Elizabeth Garrett Anderson students diminished the number of the pool from writes, 'We have had another splendid donation which their football team could be chosen! In any this week, £5,ooo for the School, it is from a kind case it was a hardship for the women students who Mr. Turle, not a very rich man.' Obviously, had already been taken to belong to a school however, a very sincere sympathizer! where women were no longer admitted. The In I90o the School became one of the colleges same disability was felt by all the students of the of the University of London, and in I902 students West London which opened as a co-education who had qualified from the School got their school in I937 but which, on the advice of the longed-for opportunity and began to hold resident Goodenough Report to the University of London, posts at the . Appointments closed as an undergraduate teaching hospital and http://pmj.bmj.com/ to the honorary visiting staff followed. The first school in I947. At the same time Guy's, St. Bar- steps had been taken-a few women doctors were tholomew's, St. Thomas' and Middlesex, decided beginning to get the same opportunities for ex- to take a limited number of women and the Royal perience as their male colleagues. Free Hospital to take men students. At the present It was interesting that in I908 technical educa- time, therefore, in all schools there are an adequate tion was made eligible for a Parliamentary grant. number of places available for women students. No time was lost by the then Dean, Miss Cock, in Thus in the fairly early days undergraduate proving that medical training was technical. Thus teaching could be obtained with some ease, but on September 29, 2021 by guest. the London School of Medicine for Women was post-graduate experience was a different matter. the first school to obtain this handsome grant. Women students when they had qualified were Other medical schools soon followed suit and the only gradually admitted to resident house jobs, and Treasury grant became an important part of the the women often felt the need of further ex- incomes of all the medical schools. perience both for general practice and for specialist Officially the school was opened in work. In fact, of course, it was really impossible I869, but the University was not open to students to hope for consultant status without further and till I9I6, though in I886 they allowed extra-mural continued hospital experience. This lack of post- teaching and the women could obtain the Scottish graduate opportunity and the knowledge that an Conjoint Diploma. Bristol opened their doors to increasing number of patients were clamouring women in I891, Durham in 1893, and by I9II all for their services led to great efforts in starting a the Scottish and provincial hospitals were taking number of hospitals for women and children women students except Oxford and Cambridge. staffed by women doctors. Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from August 1951 AITKEN : Women in Medicine 397 As Elizabeth Garrett had qualified in I866, she Martindale in Brighton. As in London and started a dispensary practice in Seymour Place Edinburgh, the first early effort was a dispensary, and from the first Dr. Hughlings Jackson and Dr. in I898, and then a few beds followed. The Broadbent were her consulting and Mr. first branch to develop in this case was the Lady Critchett, Mr. Thomas Smith and Mr. Norton Chichester Hospital for Women and Children, acted on the surgical side. By I871, 9,000 patients' which later, after the birth of the general hospital, names were on the books. By I872 they had added the New Sussex Hospital for Women and Children, ten beds, and in I874 they leased three houses in was devoted entirely to the treatment of cases of Marylebone Road because the pressure of work early nervous breakdown. In I939 the New Sussex was so great. Two women physicians with Hospital was a most successful hospital for women Zurich degrees, Miss Morgan and Mrs. Louisa and children, with 84 beds. Atkins, joined the staff. By i888 it was necessary Another interesting enterprise was the opening, to expand, and the Prince and Princess of Wales in 190o, of the East Anglian Sanatorium, which opened the New Hospital for Women at I44, owed its existence to the zeal and enthusiasm Euston Road. It continued to progress and en- of Dr. Jane Walker. She was one of the first in this large. At the time of the death of Mrs. Garrett country to believe in open air treatment for Anderson in 1917, when there was still more tuberculosis, and she had great faith in rehabilita- building, the name of the hospital was changed to tion by encouragement in suitable occupation. the Elizabeth Garrett Anderson Hospital, The purpose of this hospital was a little different familiarly known as the E.G.A. Late in the I939 from that of some of the other hospitals described, war, when taxis were very scarce, the matron and but many women doctors got post-graduate ex- a man hailed a taxi at the same time, the driver perience at Naylands. asked each where wanted to and he chose In 1911 Miss Maud Chadbum saw the number they go Protected by copyright. the matron. She was honoured by this pre- of women who had to be turned away from the ference and had the fare plus a handsome tip Elizabeth Garrett Anderson Hospital in London ready, but the driver said, 'On no, my wife was owing to the lack of space and facilities for treat- so happy and well cared for at the E.G.A. that I ment, and she knew also that the-difficulty that vowed I'd never take a fare from anybody who women had in gaining postgraduate experience wanted to go there! ' still existed. She made up her mind to start a In Edinburgh, meanwhile, Dr. Sophia Jex new hospital on the south bank. In faith the small Blake (who had been in practice since 1878) and amount of money available was spent in buying the others were feeling the same needs, and in I885 the site and an appeal was launched. The appeal effort Edinburgh Hospital and Dispensary for Women was a letter to The Times, and this letter evoked an and Children came into being. It grew out of angry and rude reply from a male colleague. The possibilities of development on its first site and prejudice of the writer caught the eye of a friend Bruntsfield Lodge was bought, and in 1903 a new of women doctors. A representative called on hospital was opened. Meanwhile Dr. Miss Chadbur and asked her if it would be http://pmj.bmj.com/ and others had started a hospice in I899. Much certain that the new hospital would admit only obstetric work was done here and in I910 these women and children and would only be officered two pioneer efforts were united administratively. by women doctors. On being reassured on this In 1916 the University arranged that some of the point the whole sum required was promised im- obstetric teaching of the women students should mediately and anonymously! In all about be done at the hospice. In 1923 a new hospital 1Ioo,ooo was given-a large sum now, but even was built as a memorial to Dr. Elsie Inglis, who more valuable in those days. So this hospital, the had died after her return from Russia in I9I7. South London Hospital for Women and Children, on September 29, 2021 by guest. Many Scottish graduates are grateful to these did not gradually develop from small beginnings, Edinburgh hospitals for post-graduate experience, though it too outgrew its premises, new depart- both junior and senior. In Glasgow, too, the ments and buildings being added from time to women doctors were active. The Glasgow time. It is now a flourishing hospital of 260 beds. Women's Private Hospital was started in 1902. The next hospital to be started by women Only eight patients could be received, but here, as doctors, helped by generous sympathizers, was in elsewhere, it was soon found that this number was Manchester. It began with I2 cots in 1914, and quite inadequate, and in 1924 Redlands Hospital Dr. Chisholm was the Chairman of its Medical for Women came into being. At this hospital Committee and continued to remain a strong in- some very well-known women doctors obtained fluence in this hospital. This was one of the first experience to become consultants. infant hospitals and one of its main objects was to Meanwhile other prospects were being de- treat nutritional disorders in babies and to train veloped by Dr. Helen Boyle and Miss Louisa nurses for this work. In 1926 the hospital had Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from 398 POSTGRADUATE MEDICAL JOURNAL August-951 grown and had about 80 cots, and about this time In 1927 there were 183 women's hospitals the staff became a mixed staff of male and femalo. staffed by women, as well as numerous women's In 1935 2I cots were added and the name changed wards in district and municipal hospitals under to the Duchess of York Hospital. the care of women assistant surgeons. The The last women's hospital to be mentioned was women doctors trained nurses and helped in the the Marie Curie Hospital. In 1925 Dr. Helen training of men and women students. They Chambers brought before the Committee of the worked very hard but they could never feel that Medical Women's Federation a theory that to their work was not needed; in fact, they had the make real progress in the knowledge of the best satisfaction of knowing that much of it could only treatment of carcinoma of the cervix it was be done by women trained in medicine. necessary that a large number of cases should be Soon after the turn of the century women treated by the same technique. At her suggestion, doctors began to be employed in the ministries and and under the Chairmanship of Miss M. Chad- by the municipal authorities. These public bodies bur, it was decided to try to carry this out by had a tendency to hope that women doctors would starting a hospital for the purpose. All the accept lower salaries. Fortunately, on the whole, Women gynaecologists of the Royal Free Hospital, the women listened to the advice of the pioneers the Elizabeth Garrett Anderson Hospital, the and insisted on equal work for equal pay. In New Sussex Hospital and the South London I907, Dame Janet Campbell was offered an im- Hospital were to co-operate. A director, Dr. portant post as assistant to the Chief Medical Hurdon, was chosen, a distinguished woman whose Officer to the Medical Department of the Board ability and tact helped the diverse members of the of Education, but she refused because the salary staff to form a united and to carry out this was inadequate. However, in the following year, policy Dr. Newman Sir the interesting experiment. The results were most (later George Newman), Protected by copyright. illuminating. medical officer concerned, insisted on equal pay, The field of work which lay in and other and Dame Janet was appointed and the pre- Eastern countries, especially among the mission- cedent of the same salary for men and women was aries, has always attracted many women doctors. established. Later, in I918, when the Ministry of They knew, of course, that among certain groups, Health was formed, Dame Janet was put in charge such as women in purdah, they and they only of the Maternity and Child Welfare Division. could give medical help. The first women to help In the early days it may have been wise to segre- their own sex who could not avail themselves of gate women M.O.s in the one division, but te male medical care were missionaries who were so practise of the Ministry at that time in this mater. impressed with the desperate plight of some poor was followed by the local authorities, and, has souls that they tried to train themselves to give largely prevented women M.O.s from qualifying elementary medical care. The first qualified themselves for work other than maternity and child women doctors in India were American, but one welfare and the School Medical Service. This was cannot think of such work without mentioning probably one of the reasons why, for many years, http://pmj.bmj.com/ Dame Mary Scharlieb. Just before the turn of no woman M.O.H. was appointed. However the century an American, Mr. Kitteredge, in there are quite a few women who are now in other. Bombay, wrote, ' I am convinced that for success branches of public work. in India women must be recognized as the equals In August 1914, the prevailing idea was that of men in the medical care of their own sex.' He war was man's business and the women doctors and a Mr. Sorabjee Shapurjee Bengalees and were told that their services would not be re- others formed a fund, 'The Medical Women for Some of the women doctors themselves, quired. on September 29, 2021 by guest. India Fund.' Meanwhile, Mr. Pestonjee Hormus- however, felt that it was their duty to do anything jee Cama offered a huge sum to the Bombay they could to help. There were the well-known Government for a hospital on condition that the Scottish Women's Hospital Units, the various Government provided a site and maintained it, and small units that were formed and sent to Antwerp provided it were turned over to the charge of and France and . There was the Malta women doctors. The Government, though they contingent of women and the Endell Street had the example of the excellent work of the Military Hospital. When Queen Mary's' Army women pioneers, objected to the second proviso, Auxiliary Corps was formed they had women saying, 'We will willingly agree to utilize the medical officers. Still later there were women services of competent medical women acting under medical officers to the W.R.N.S. the instruction and guidance of the male superior After the outbreak of war Dr. Elsie Inglis staff, when such services are available I' Finally, realized what an all important part women could however, Dr. Edith Pechey did become the first take in the war and she started to collect money woman superintendent. to train and equip the Scottish Women's Hospitals. Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from August I951 AITKEN : Women in Medicine 399 She went to London to offer the services of herself cuss the matter, but were unsuccessful. The and her women colleagues, but was told, ' My matter was dropped as, after all, one did have a good lady, go home and sit still.' She did not sit hope at that time that the war to end war had just still and with astonishing rapidity the first two units been concluded. were ready, one for Serbia and one for France. Nothing was done until 1938 when the question The French one was under the care of Miss Ivens of the status of the women doctors was again of Liverpool, and its work at Royaumont became raised. If one has not worked in a service it is famous. The name of Dr. Elsie Inglis herself will difficult to appreciate the importance of ' status.' be linked for ever with that of Serbia, where it I had not understood it myself until the con- was remembered with something of legendary sequences of lack of status were explained to me. veneration. Covering a period of four to five years, I imagine that, before going abroad to serve, the I4 hospitals were staffed and operated in five women doctors in the first war shared this innocent countries! point of view. In any case they made no attempt to Three privately. financed hospital units, also argue about their status-they found out about its considered redundant by the British Army, were importance later. For instance, women doctors sent overseas, the first to Antwerp, the second to abroad sometimes had to travel disguised as Tourlaville near Cherbourg, and the last to soldiers' wives or as V.A.D.s; the doctors had no Serbia in 1915. Miss Stoney, the proud possessor status, therefore a pass could not be given; the of a new X-ray Coolidge tube, was in charge of the wives and the V.A.D.s had got status, so a pass first. They had to retreat of course, got home could be given! dirty and tired out, but with no casualties. They Again in this war, as in the last, the women formed again ana- set off for the Chateau de doctors were told they would not be wanted.

Tourlaville, where they did good work tending the Again the Services changed their mind and decided Protected by copyright. French and Belgian wounded. Meanwhile the that they did want women doctors after all. In French Red Cross had received cordially an offer both cases this new decision was taken at a -time of a fully-equipped surgical unit composed of when the fortunes of the country were at such a women doctors, and trained nurses under Dr. low ebb that it was impossible to protest very Louisa Garrett Anderson and Dr. . strongly against conditions of service. In this war, In The Times, 1915, was published the following however, women doctors were given the same pay, statement by Sir Alfred Keogh, D.M.S.:-he had promotion and so on as their male colleagues, but received numbers of unsolicited letters from they were not members of the medical services, and Boulogne which stated that the work of the they only worked with these services. In point of women doctors at the Front was beyond all praise. fact it worked well, largely, we believe, for two So impressed had he been that he had asked two reasons; firstly, many doctors of either sex did of the staff from Paris to come here and take bigger not know that there was any difference, and work. He had asked them to take charge of a secondly, there was real goodwill in high places hospital of 500 beds and, if they pleased, a hospital and a determination to smooth out the situation. http://pmj.bmj.com/ of i,ooo beds. This was the start of the Endell It was obvious, however, that the position was Street Hospital. In 19I8 Sir Alfred wrote to fundamentally unsatisfactory. Dr. Garrett Anderson,' It has always been to me After I945 the Medical Women's Federation a great pride to know how successful you have felt that though the financial terms were now been.' satisfactory, the question of status was still out- In 1917 the War Office woke up to the fact that standing. Women doctors were in a position quite many duties: could be undertaken different from else. were not in suitably by anyone They any on September 29, 2021 by guest. women, and the Queen Mary's Army Auxiliary service at all, that is to say they had not the pro- Corps was fogmed. Dr. Mona Chalmers Watson tection of a service; they were only working. was appointed as administrator, though not in any alongside the male medical services. It had medical capacity. The doctors in the Corps always been said that women could not legally hold formed an auxiliary part of the R.A.M.C., but land forces' commissions; this, however, turned it was considered impossible that they should be out to be a myth. The Medical Women's Federa- given commissions. tion appealed to the British Medical Association Thus, though many women doctors saw active and were successful in getting unanimous support service, mpst of their efforts were unofficial and from all except their Armed Forces' Standing their.units scattered. Committee, who argued that women doctors could When the war was over the Medical Women's not be put in the front line and were therefore: Federation realized that the position of women different from their male colleagues. The Medical: doctors in the Services should be clarified. They Women's Federation agreed that the Army might made efforts to get the War Office to agree to dis- not want to have women in the front line (though, Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from 400 POSTGRADUATE MEDICAL JOURNAL August 1951 of course, in emergency anything may happen), first and then took women as resident doctors and but it was pointed out that many of the men finally gave some of them staff appointments, be- doctors were in categories which made them not came co-educational. Before that, the students only unfit or unsuitable (i.e. consultant surgeons were all women, but the patients and the honorary and physicians) for the front line, but some of them staff were mixed; now the students are young were even unfit for service abroad., men as well as young women. All the schools It was finally agreed, in 1950, that medical which had been exclusively male agreed to take a women would in future be commissioned in the limited number of women students. R.A.M.C. and the R.A.F.M.B. in exactly the same The special hospitals are a little different, as in way as their men colleagues, and that they would this case the needs of the patients have to be con- hold the same rank titles. The Medical Women's sidered, and there are still a large number of Federation was happy to be able to report that it women who like to go to a women's hospital where had gained all its objectives. they know they will be treated by a woman. In I944 the Interdepartmental Committee on However, under the most Medical Schools (known as the Goodenough Com- of these hospitals are now part of a larger group mittee) produced a report on medical education in and as sucb are not isolated. general, including, of course, that of women. The There are doctors, even women doctors, who Medical Women's Federation was asked for a while agreeing presumably that the special women's memorandum. This needed much consideration, efforts, including their special women's associa- for women doctors have always felt that their aim tions, were necessary in the early days, have was to arrive at a state of mind; in the profession thought for many years that they were unnecessary and outside it, when the question of the sex of the and even harmful to women as they stressed the doctor did not primarily arise-a doctor to be a question of the sex of the doctors. I feel a certainProtected by copyright. doctor, and only secondarily it might turn out that sympathy with this point of view, but I feel sure the doctor be a man or a woman. In such con- that it was wrong with regard to the past. I think ditions all opportunities would be open and a it is noticeable that the status of women doctors is woman would be appointed to any position in the higher where these special hospitals exist. This profession, provided always that the individual is perhaps not surprising, for why should our woman was the best doctor available. In such colleagues accept that women are capable of being circumstances special training schools and special efficient in any branch of medicine until they have hospitals for women would be redundant. Had proved themselves so to be? In general practice such a moment arrived? The Council of the this was possible; it was the patient only on whom Medical Women's Federation knew that it had the success of the G.P. was dependent, and a not arrived to the full extent. For instance, there great many women doctors have been highly was the medical school which had taken women successful in standing this test. But as far as other students for several decades and had never given branches were concerned, appointments had to one of these students any post-graduate experience be made, and women could not prove their worth http://pmj.bmj.com/ by appointing her to a resident job in the teaching unless they were given some of these positions. hospital until 1939-not a good story. In another, The special women's hospitals gave consultants the woman gold medalist of the University of these opportunities. In the public health service London could not get anything higher than a first it is still difficult to reach the top, It is not only in house job. In the public health service it was, and certain areas in this country that it is noticeable still is, difficult for a woman to be appointed to any that women who have not proven their worth in a of the senior The Federation felt, women's are not so to

positions. hospital readily appointed on September 29, 2021 by guest. however, that the moment had come to take the higher positions. In many other countries women plunge, to risk something so that their aim that doctors do not feel in any sense tblt they have there should be no differentiation between men equal opportunities, and in these countries it is and women should gradually be accomplished. often the case that women doctors have not shown They recommended, therefore, that all schools the same corporate enterprise as in this country. should be co-educational (which meanto naturally, With regard to the future, we are all hoping that the London (Royal Free Hospital) School of that the fact that the special hospitals are being Medicine for Women should be included), pro- merged into other groups will certainly benefit vided always that the schools accepted post- these hospitals and will not be harmful to women graduate as well as undergraduate education as doctors individually. With regard to their special their responsibility. The Goodenough Com- organisation I and many others believe that the rattee reported in accordance with this memoran- Medical Women's Federation should remain in dtn, and its advice has been accepted. The being for the present. P1c*-iFree Hospital, which took women students The idea of it was born in 1915, and the prime Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from August 1951 AITKEN : Women in Medicine 401 mover was Dr. Jane Walker. It was a union of appreciated by that body. The importance of the various women's organizations over the British support of the B.M.A. cannot be stressed too Isles, and it aimed at giving, as far as possible, strongly. It is another instance of the Association's local autonomy to all its constituent local associa- willing co-operation when an organization can tions. To this day, though the offices are in place before it convincing evidence of the rightness London, about half the Council meetings are held of its cause.' elsewhere. The Federation was actually formed Again, during the war, a cost-of-living bonus in I917- different for men and women was given. This was All women doctors would probably agree that also put right with the help of the B.M.A., but such an association was necessary in the past, but only after the Medical Women's Federation had what about the present and the future? Women in produced facts and figures proving that this con- medicine are in a minority, and it is generally travened their principle of equal pay. agreed that it is wise for minorities to have a special Several other smaller injustices occurred in the organization so that the minority view may be kept war, all put right after the Medical Women's before the majority, which may have nothing but Federation had brought forward their existence, goodwill towards the minority but which, being but the B.M.A. agree that it would have been composed of human beings, is apt to put its own difficult to focus enough attention on the problems views in the forefront. However, are there still oc- had it not been for the perseverance of the Medical casions when this minority view is not identical Women's Federation. In the Colonial Service with that of the majority? Yes, there are. For in- differentiation is apt to occur unless the position is stance, at most meetings women doctors are in'a kept under review. minority and it would seem natural that this limits I feel certain that for some years at any rate their chance of election to administrative com- there will be much work for the Federation to do. mittees, limits it out of proportion to their lesser As in the past, it will work with the British Protected by copyright. numbers. This happens indeed to such an extent Medical Association. There has been, and I feel that the Council of the British Medical Association sure there will be in the future, absolutely no had to point out that they felt, at times, the need antagonism between the two bodies. of a woman on their Council who was knowledge- I believe that with the coming of the Health able and experienced in women's affairs, and could Service there will be many problems for the give them such specialized advice. They suggested, Medical Women's Federation to face. On the therefore, that such a woman should be elected by central committees women have been appointed the women doctors in the same way that they not as representatives of the Federation (none of already had two public health officers, these the members are representatives), but largely on doctors also being insufficiently represented on the the advice of the Federation. There are, however, Council on account of their minority position. many regional and local executive committees The Federation accepted the B.M.A. suggestion which have no women members or an insufficient with some trepidation, as they did not want this number of women members, and though equal, http://pmj.bmj.com/ one woman to prevent the election of women opportunities have been promised, I fear that we through the ordinary channels. may find that difficulties will arise, not from ill As the British Medical Association has had in will but from igrorance. There are the peculiarly its constitution for many years ' There shall be no woman's questions such as the work and oppor- differentiation solely on account of sex,' are there tunities of the married woman, part-time and still any special women's problems? Yes, there are. partnership problems, etc. There are medical As already pointed out, it is onlyjust the other day, advisory committees, and regional hospital manage- on September 29, 2021 by guest. for instance, that the problem of the position of ment boards, some members of which have never women in the medical services of the Crown met, let alone worked with, a woman consultant. reached a satisfactory conclusion. It.will take them some time to get used to the idea The British Medical Association helped the that a woman might be appointed. I am quite Medical Women's Federation in its efforts to certain that it is due to the existence of the Medical achieve this, and the latter published the following Women's Federation that even the limited number in its journal:- of the appointments of women in the service have 'We are most grateful to the British Medical been made. I feel, however, that women doctors Association for its valuable and, indeed, vital are near the achievement of complete equality of support. It is important to realize that it was opportunity, though they have not yet reached it. because the Federation was able to speak through The position is now that there are many women the women members' representative on the Council doctors in successful general practice all over the of the B.M.A. that this complicated subject at last country. In the early days it was almost im- became to be so completely understood and possible for a woman to buy a practice. They Postgrad Med J: first published as 10.1136/pgmj.27.310.396 on 1 August 1951. Downloaded from 402 POSTGRADUATE MEDICAL JOURNAL August I95 were obliged to set up a plate and very gradually pendulum swings back and another chance is not build up their practices. This they usually did given for some time. without much difficulty. We must hope that the There are several professors in the big teaching executive committees (on which women doctors schools, there are women doctors in the higher are not really adequately represented), now that academic positions and the big main administrative they have some say in the matter, will protect their councils, and there is one of whom we are par- interests. ticularly proud, Professor Hilda Lloyd, President In public health and the ministries there are a of.the Royal College of Obstetricians and Gynae- number of women and some are in very responsible cologists.. positions; women are doing research and there are On reading over this article it appears that I many women consultants all over the country, have given the impression that women doctors though it is noticeable that in certain areas large have had a fairly smooth path to follow, suggesting hospitals, especially non-teaching hospitals, have that they have progressed from none to ample no women on the staff. It is, I think, the first step opportunities without stress and strain. This is which counts; once a woman has been appointed, not, of course, the case; but in remembering, if she is a wise woman and good at her work, our with gratitude, all that the pioneers have done for male colleagues get used to the idea and the next us, I expect it is wise to remember that all pioneers, time a woman applies she is more or less con- in no matter what direction, are apt to meet with sidered on her merits. The first woman to be the same obstructions. They are not like us; appointed anywhere has a great responsibility, as they are 'naturally of the stuff that martyrs are if she is not found to be a good colleague the made of.' Protected by copyright.

CORRESPONDENCE Park Hospital, hours and then three-hourly for some days was Hither Green Lane, necessary to keep the eosinophil count below 15 Hither Green, S.E.I3. per cmm. The suggestion that cortisone may be more effective than eucortone is a valuable one,

June 29, I95I. http://pmj.bmj.com/ The Editor, and the drug should be made immediately available Postgraduate Medical Journal, for this type of case. Fellowship of Postgraduate Medicine, Prof. Dible mentioned that he did not know 60 Portland Place, whether there was specific localization of meningo- London, W.I. cocci to the adrenal in this type of case. I can SIR, answer this question in the affirmative. The evi- I was much interested in the report of clinico- dence is clear from sections prepared from a pathological conference No. 14 held at the Post- similar case (child of three years; illness 13 hours' on September 29, 2021 by guest. graduate Medical School, Hammersmith Hospital duration) by Dr. E. H. Bailey of the Southern (July I951). Group Laboratory, Park Hospital. They clearly The case discussed, fulminating meningococcal show capillaries stuffed with meningococci among septicaemia with adrenal haemorrhage contracted the degenerated cells of the adrenal cortex. As on, the tenth day of life, may possibly be the far as I know this evidence has not been published youngest on record. tUnder the age of six months I elsewhere than in ' Modern Practice in Infectious know of no recovery from this syndrome. Fevers,' Butterworth, London, page 3 7, Figs. As was pointed out, whole adrenal cortical ex- 77 and 78. tract in the dosage usually given is relatively in- Yours sincerely, active. Faloon, et al. (I951), controlled the treat- H. STANLEY BANKS. ment of a case, aged 17 years, by the eosinophil count and found that dosage of 20 cc. intra- BIBLIOGRAPHY venously followed by 10 cc. every hour for six FALOON, et al. (1g95), New Eng.J. Med., 42, 44.