Writing Professional Ethos: Women Physicians and the Construction of Medical Authority in Victorian and Edwardian Print Culture

Home , Coventry Patmore, Edinburgh Seven, Edith Pechey, Helen Evans, Isabel Thorne, James Crichton (soldier)

(RE)WRITING PROFESSIONAL ETHOS: WOMEN PHYSICIANS AND THE CONSTRUCTION OF MEDICAL AUTHORITY IN VICTORIAN AND EDWARDIAN PRINT CULTURE

KRISTIN E. KONDRLIK

Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy

Department of English CASE WESTERN RESERVE UNIVERSITY

May, 2016

CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES

We hereby approve the dissertation of Kristin E. Kondrlik candidate for the degree of Doctor of Philosophy*.

Committee Chair Kurt Koenigsberger

Committee Member Kimberly Emmons

Committee Member T. Kenneth Fountain

Committee Member Susan Hinze

Committee Member Athena Vrettos

Date of Defense February 26, 2016

*We also certify that written approval has been obtained for any proprietary material contained therein

Table of Contents List of Figures……………………………………………………………………………..4 Acknowledgements………………………………………………………………………..5 Abstract……………………………………………………………………………………6 Introduction…………..…..………………………………………………………………..7 Chapter 1: Women’s Medical Journals: Creating a Counterpublic for Medical Women in the Magazine of the London School of Medicine for Women……………..……………..65 Chapter 2: The Woman Doctor Novel: Sophia Jex-Blake and Hilda Gregg Refiguring the Rhetorical Possibilities of the New Woman Novel...…………..……………..…………99 Chapter 3: Short Story Serials: L.T. Meade’s Constructions of Women Physicians’ Ethos in the Strand Magazine and Atalanta…………..………………………………………..143 Chapter 4: War Correspondence: Medical Access and Nationalism in the Writing of Caroline Matthews…………….………………………………………………………..169 Epilogue………………………………………………………………………………...207 Bibliography……………………………………………………………………………219

List of Figures Figure 1: George du Maurier, “The Coming Race,” Punch, September 1872…………..19

Figure 2: George du Maurier, “Our Pretty Doctor,” Punch, August 1870………………48

Figure 3: Frontispiece of the MLSOM, No. 1……………………………………………76

Figure 4: “W.H. Russell, ESQ. L.L.D.”, Punch, 1881………………………………....184

Figure 5: Excerpt from “The Diary of Lady Fire-Eater”, Punch, 1856………………...186

Figure 6: “Caroline Matthews, M.B., Ch.B.” from Experiences of a Woman Doctor in

Serbia (1916)…………………………………………………………………..194

Figure 7: Arthur Wallis, “Eminent Woman Surgeon,” Punch, August 4, 1915………..214

Acknowledgements The completion of this dissertation is the result of the support I have received from numerous sources throughout my graduate career. I would first like to acknowledge my dissertation director and advisor, Kurt Koenigsberger, for his guidance over the years. Our conversations about this project, teaching, and learning to balance scholarship and life, were always supportive and encouraging. His feedback and guidance were vital in shaping this project into its current form. I also want to express my gratitude to other members of my committee – Kimberly Emmons, T. Kenneth Fountain, Athena Vrettos, and Susan Hinze. Each of these individuals offered critical support and advice on this project and on numerous other aspects of my graduate work throughout my years at CWRU, for which I am immeasurably grateful. The research work of this project would not have been possible without the support of numerous sources within CWRU. I am indebted to the English Department for the Adrian/Salomon Dissertation Fellowship, which provided me the time to perform key archival work in the British Library and the Wellcome Collection in London, and to Undergraduate Studies for the Eva L. Pancoast Memorial Fellowship, which provided funding for that trip. I am also grateful for the support of Case Western Reserve’s chapter of Phi Beta Kappa, which provided a research grant that allowed me to present an early version of some of this work at the North American Victorian Studies Association Conference. This conference provided formative feedback on the project in its middle stages. I would also like to thank my graduate colleagues in the English department at Case Western Reserve University, particularly Mary Assad, Cara Byrne, Nicole Emmelhainz, Catherine Forsa, and Jessica Slentz, and for their continued feedback and support throughout the dissertation process. Finally, this project would not have been possible without the love, patience, and support of my parents, my sisters, and my nephew.

(Re)Writing Professional Ethos: Women Physicians and the Construction of Medical Authority in Victorian and Edwardian Print Culture Abstract By KRISTIN E. KONDRLIK This dissertation argues that, by writing across the print culture of the late nineteenth and early twentieth centuries, female physicians negotiated their ethos by representing themselves in ways more commensurate with their own experiences and contrary to existing representations. It draws on both literary and rhetorical traditions to analyze how writers addressed the incommensurability of print representations of women with the professional roles opened to them in the late nineteenth century – specifically, the medical profession. Though they were legally recognized as physicians in 1876, British women lacked the professional authority granted their male colleagues. Across the late Victorian and Edwardian periods, popular and professional discourses such as novels, short stories and professional journals often represented women as incompetent, weak, and unfit for professional work. As they undermined women’s professional ethos – the public’s and the profession’s perceptions of their goodwill, good sense and good character, these representations damaged both public reception of female physicians and their ability to act as professionals. In chapters on war correspondence, women’s medical magazines, serialized fiction, and New Woman novels, this dissertation traces the interventions of women physicians’ supporters into conversations about women in the medical profession between 1876 and 1914. These alternative representations aided in establishing female physicians’ ethos by positing new ways of thinking not only about medical women but also about the relationships between women, the professions and turn-of-the-century society.

Introduction

In the mid nineteenth century, British women fought for legal reforms that would ensure

that they would have the education and legal recognition necessary to enter the medical

profession. Throughout the middle of the century, women patients and women hoping to

become legally recognized as physicians articulated a growing public need for women to

receive treatment by individuals of their own sex, especially for childbirth and

gynecological ailments, and for women to be granted equal opportunities to pursue

medical careers. Women recognized as physicians in other countries such as Elizabeth

Garrett Anderson and Elizabeth Blackwell argued passionately in public and professional

discourses in the 1860s and 1870s that women were just as capable of medical study as

men; that female patients would be more comfortable with female physicians; and that

women were “naturally” suited to the healing arts in ways that men were not. As Shirley

Roberts notes in her biography of pioneering physician Sophia Jex-Blake, young women hoping to become physicians, including Edith Pechey and Sophia Jex-Blake lobbied the faculty at medical schools to allow them to take the classes necessary to prepare them for medical practice, at their own – increased – expense (Roberts 77-9). As they fought for the right to benefit from the training to which their male counterparts had access, these

young women endured protests, derogations in the print publications of the general and

medical publics, and numerous administrative roadblocks. After a lengthy battle that

raged over the course of decades, women physicians in Britain eventually won the legal

right to register as physicians. These women’s advocacy convinced lawmakers to pass the

Medical Enabling Act in 1876, spearheaded in Parliament by MP Russell Gurney. 8

Roberts notes that this Act allowed British women to officially register as physicians with the British government for the first time (Roberts 138-9).

These women’s triumph represented a moment of qualified success for professional women in the late nineteenth century. At this time, British women had unprecedented opportunities to adopt professional roles previously barred by legal, social, or educational restrictions. As Anne Witz notes in Professions and Patriarchy (1992), while lower class women had worked as semi-skilled or unskilled labor throughout the nineteenth century, opportunities began to open for women of all classes in the skilled professions in the latter half of the nineteenth century (Witz 29-31). In addition to more traditionally “feminine” skilled professions such as nursing and teaching, women were able to train for the first time for occupations formerly restricted to men, working as secretaries, telegraph operators, and court reporters, and in fields requiring an extensive amount of scientific and technical knowledge, such as engineering, physics, and medicine. Some medical historians, such as Catriona Blake in Charge of the Parasols:

Women’s Entry into the Medical Profession (1990), have asserted that the Enabling Act and the establishment of the London School of Medicine for Women were the last barriers to women physicians’ full recognition as members of the medical profession

(Blake 21). Although they had won a legal battle that ensured their credentials, women physicians still struggled with the general public’s and the profession’s continued association of women with the home and domesticity, rather than the workplace. The public and the professions had yet to fully abandon traditional understandings of women’s roles in society and the professions. Representations of women popularized in the 1860s in texts such as John Ruskin’s popular lectures at Manchester (1864) and 9

Coventry Patmore’s “The Angel in the House” (1862) defined women’s work as limited

to the domestic sphere and lingered well into the twentieth century.

When female physicians were granted the legal right to take their place beside their male colleagues in 1876, the idea of female medical professionals defied such discourses of domesticity and presented a new challenge to Victorian and Edwardian ideals of gender, work and professionalism. Although women were ultimately successful in winning legal recognition through the intervention of a few sympathetic government representatives such as Russell Gurney, their legal success did not translate into immediate changes in how the public or the male members of their profession viewed them. Rather, even after the institutional accreditation of women as “professionals” in

British medicine through the passage of the 1876 Enabling Act, British women struggled to establish public and professional recognitions of their authority as medical professionals in a historically masculine field. In Medical Women and Victorian Fiction

(2005), Kristine Swenson has noted that both physicians and non-physicians depicted female doctors as incapable, incompetent, or at risk of becoming “unsexed” and immoral

(Swenson 87-8). In the decades after women were allowed to become full members of the medical profession, writers of popular and professional discourses continued to represent women physicians as weak and incompetent and, therefore, unfit for the medical profession.

In addressing the incommensurability between medical women’s new professional status and representations of these same women, scholars of literary and cultural representations of female physicians in Britain, such as Tabitha Sparks, Narin

Hassan, Carol Ann Farkas, and Kristine Swenson, have noted the entanglement of 10

representations of female physicians with society’s expectations of them in the Victorian

and Edwardian periods. These studies focus largely on the connection between societal

gender values and the inscription of these values through representation; these studies,

then, understand the issue these women faced as one of the influence of ideologies. This

dissertation extends these studies by analyzing how women responded to these

ideologies, noting the professional consequences of this entanglement for medical women

– explaining the issue these women faced as one of rhetorical authority.1 The

incommensurability of attitudes toward professional women – of lifted restrictions

allowing women to train as professional physicians and of representations of women

professionals, including physicians, as contrary to idealized womanhood – created

significant problems for female physicians, who confronted a resistant public and

profession, despite their new credentials and education. Female physicians struggled to

persuade the public and the members of their profession to accept them as deserving of

the same professional respect and status afforded their male colleagues.

This dissertation argues that the problem these women faced was of a rhetorical,

or persuasive, nature, rather than only a problem of the reiteration of gender ideologies in

print. Women physicians’ struggles to win over their fellow physicians and the general

public arose not only from the impact of representations of women and medical women

on public and professional perceptions of women physicians’ “character” – their

individual physical, mental and spiritual traits – but also from public and professional responses to their professional ethos – the persuasive power of their goodwill, good sense

1 Throughout this dissertation, I use the term “medical woman” interchangeably with “female physician,” as during the period, female physicians were the only women “professionals” in the medical community. In the nineteenth century, the majority of nurses discuss their occupation as a “trade” rather than a “profession.” 11 and good character in the communities to which they belonged. While studies of professionalism and popular parlance broadly define ethos as “character” or “ethics,” in rhetorical theory, the term ethos involves the complex relationship between “character” and an individual’s community. Aristotle defines ethos as a pisteis, or means of persuading a given audience. Of the various pistis outlined in Aristotle’s Rhetoric, including pathos (appeals through emotion) and logos (appeals through reasoned discourse), he gives the most weight to ethos, calling it “almost, so to speak, the controlling factor in persuasion” (Aristotle 38). This dissertation analyzes female physicians’ responses to the representations that undermine their ethos as members of the medical profession in the first years after they were able to become physicians.

In the years after 1876, physician-writers and their allies responded to existing representations of women physicians in the various publications of the late nineteenth and early twentieth centuries, publications where they might persuade audiences of their legitimacy as medical professionals. These women challenged existing representations both of their profession and of their gender and generated new representations of themselves as competent members of the late Victorian and Edwardian medical profession. Such representations, however, did not always allow writers to avoid the apparent incommensurability of women’s gender and medical practice. As such, supporters of female physicians had two tasks; they not only had to disseminate representations of themselves as capable physicians, but had also to propose radical alterations to public and professional opinions about medicine and women. This dissertation analyzes late nineteenth and early twentieth century female physicians’ attempts to change public and professional attitudes toward their ethos and the ethos of 12

the medical profession and women in general in the period between 1876, when women

were recognized as licensed practitioners under British law for the first time, and 1918,

the end of World War I, when the scarcity of physicians in the aftermath of the war

granted female physicians increased access to professional organizations and professional recognition.

This dissertation will work to address the following set of related questions: What is the nature of the connection between women’s professional status, rhetorical ethos and the print culture of the late nineteenth and early twentieth centuries? How did advocates for women physicians shape public perceptions of medical professionalism through generation, negotiation, and expression of medical women’s ethos? Are female physicians’ attempts to shape their own ethos fundamentally different from the intervention of other women’s attempts at political action? Which print genres were particularly receptive to the establishment of medical women’s ethos through discourse?

How did the constraints on and affordances and conventions of the print genres of this time period contribute to or limit efforts to construct a professional ethos through discourse? How did the textual environment of the Victorian and Edwardian periods contribute to the success not only of women professionals, but also the women’s movement more broadly?

In order to address these questions, this dissertation analyzes writing for print genres readily available to women physicians and their supporters at the close of the nineteenth and beginning of the twentieth centuries, including medical journals, serialized fiction, novels, and memoir. In separate chapters, I analyze the interventions of female physicians and their advocates in non-fiction writing in women’s medical journals, essays 13

about so-called woman doctor novels, a series of serialized short stories by a woman’s

rights advocate, and the writing of a female physician acting as a war correspondent in

Serbia. Each of these sites of writing allowed authors to interact with or enact influence on particular audiences – of other professional physicians, of women, or of the broader reading public – while implicitly building her own ethos. In attending to the way these writers sought to solidify medical women’s professional ethos, this dissertation argues that supporters of female physicians used different methods to reinforce women’s professional status as they approached each genre of writing, methods which were shaped by each genre’s conventions. Joining rhetorical and literary analyses yields greater insights into how advocates for social reform took advantage of the affordances and resisted the constraints of print genres during the late nineteenth and early twentieth centuries not only to encourage legal reforms, as did other movements such as that for women’s suffrage, but also to change public attitudes toward marginalized groups after such reforms had been enacted.

Viewing women physicians’ difficulty in achieving authority in their newly won positions in the medical profession as a problem of the representation of rhetorical ethos, rather than as one of “character” alone, enables scholars to understand the failures of such sympathetic representations of female physicians. When representations, however well- intentioned, fail to challenge the status quo of the medical profession, of gender, or of society as a whole, but only urge their readers to see medical women as fitting into existing models, they merely reiterate the sense of incommensurability of women with their professional ambitions. The various texts analyzed in the chapters that follow reveal

their writers as imagining and articulating not only a new ethos for female physicians, but 14 also proposing radical changes to the ethos of the various communities to which these women belonged: the medical profession, their gender, and society.

Women and professional medicine in the mid-nineteenth century

Women’s authority to speak as medical professionals was a problem for women physicians from the beginning of their fight to enter the profession in the mid-1800s.

While the struggle for women’s entry into professional occupations ranged across the skilled trades in the late nineteenth and early twentieth centuries, including law, the sciences, and engineering, women’s struggle to enter medicine represents one of the most tangibly successful but also most viciously contested battles for women’s professional recognition in the Victorian era. While women had practiced both midwifery and medicine since the ancient Greeks, the practice of medicine in Britain became increasingly restricted to men after the thirteenth century, as increasing legal and educational restrictions limited women’s opportunities. As Jean Donnison has noted in

Midwives and Medical Men (1971), even medical specialties formerly practiced exclusively by women, such as midwifery, became dominated by men in the early eighteenth century (Donnison 21). Although women began to make inroads back into

British medicine through the rise of professional nursing in the 1850s and 1860s, until the

1870s, British women were barred from professionally and legally recognized roles as physicians.

At the same time, calls increased for women to be granted greater access to professional roles and authority in the British medical profession. Many women hoping to become physicians, Sophia Jex-Blake among them, asserted that, by advocating for a 15

secure place in the medical profession, women were merely reclaiming their place in a

professional sphere they had once inhabited equally with men, and viewed the admission of women to medicine as a “re-entry,” rather than an entry into an entirely new profession

(Jex-Blake, Medical Women 15). Such calls for women’s “re-entry” were also echoed by female patients. In The Eternally Wounded Woman (1990), Patricia Vertinsky has noted many factors that contributed to increased interest in women joining the British medical profession during the mid-nineteenth century. Among these factors, Vertinsky includes the dissatisfaction of women with the treatment they received from male physicians, the increasing influence of the feminist and women’s suffrage movements on the public sphere, and health reform movements headed by women, such as sanitation reform

(Vertinsky 113).2 While women could have participated in medicine by pursuing a career

in nursing or midwifery – two professions often posed as more acceptable occupations

for women, these two professions lacked the more in-depth scientific study that would

put women at the same educational level as male physicians. Further, women objected to

the professional and financial disadvantages of midwifery and nursing. The “first British

female physician” Elizabeth Garrett Anderson writes that, although she briefly trained as

a nurse under Florence Nightingale, she abandoned this training for two reasons: first, in

the hospital, nurses were necessarily subordinate to male physicians, and second, the pay

was not representative of the work she performed.3

2 Catriona Blake also notes that, in the arguments in favor of women physicians from the 1860s and 1870s, the plight of women patients was particularly dire. These supporters of the movement of women into the medical profession, Blake writes, decried the “lamentable” lack of understanding of women’s health and bodies provided by the male members of the medical profession (Blake 66). 3 According to her daughter Louisa, also a physician, Garrett Anderson asserted, “I prefer to earn a thousand rather than twenty pounds a year” (Garrett Anderson, Elizabeth Garrett Anderson 50). 16

Despite such arguments in favor of women’s increased access to positions of

medical authority, few professionals in the Victorian period faced as many problems of

authority as British women entering professional medicine.4 As Thomas Bonner notes in

Becoming a Physician (1988), medical women in other countries such as Germany,

France and the United States could enter medical schools before mid-century (Bonner

282). While public opinion of these women in other countries was sometimes mixed, opposition to British women entering the medical field was more strident. British women hoping to enter the profession struggled against opposition from both inside and outside the medical profession throughout the mid-nineteenth century; women physicians such as

Sophia Jex-Blake recount a number of public skirmishes over the education and registration of women as physicians occurring in the 1860s and the early 1870s – most notably, in the Surgeons’ Hall Riot at the Edinburgh School of Medicine in 1870, where protesters blocked women students from a lecture hall at the University of Edinburgh

(Jex-Blake, “Medical Women, 1877” 694). Popular and professional opposition to the entrée of women into the profession at the mid-century arose from public attitudes about the nature of “women’s work,” as well as concerns about women’s ability to perform the work of medicine and the effects of professional medicine on women’s bodies and minds.

In the mid-nineteenth century, women professionals often found their authority limited by public attitudes that defined a “woman’s work” as her duties as wife and mother. Although women of the lower classes had often worked outside of the home, both Coventry Patmore in 1862’s “The Angel in the House” and John Ruskin in his 1864

4 In Victorian Feminism, 1850-1900 (1987), Philippa Levine notes that the struggle for women’s medical education was one of the most “bitter battles” waged to achieve recognition of women’s rights to a public and professional existence (Levine 42). 17

lectures at Manchester associate middle and upper class Victorian women with hearth and

home, rather than work in the public sphere. Patmore posits an idealized representation of

a woman dedicated entirely to her role as selfless wife and mother in the home, while

Ruskin contrasts the “rough work” of men in “the open world” with women’s ideal

dominion over the “home,” the space where men may take refuge from the hardships they

encounter in the exterior world (Ruskin 77). Both writers suggest that women’s “work”

should be limited to cultivating a safe and pleasant home for her husband and children.

The skilled professions, conversely, moved women out of the domestic sphere and into

the workplace. Additionally, these positions asked women to adopt a profession beyond

the “work” of wife and mother – either as a replacement for or in tandem with this role.

These attitudes had significant ramifications for medical women’s status in their

profession.

Such idealized representations of women in the home engendered resistance to

women physicians both in the profession and in popular discourse before 1876. Both

professional and popular representations of medical women in the 1860s and 1870s

emphasize women’s unfitness for the medical profession. Opponents of women

physicians asserted that the entry of women into medicine risked the status of the home, the stability of gender norms, and the safety of both physician and patient. As Tabitha

Sparks has noted in The Doctor in the Victorian Novel (2009), before the passage of the

Enabling Act, members of the medical profession often represented female physicians as

lacking the traits necessary to succeed in the world beyond the home: physical strength,

tact, and strong morals (Sparks 134). As such, women should remain in the home, where

their work was both valuable and necessary. Sparks cites a letter published in the Lancet 18 in 1870 under the pseudonym Mater, which decries women’s movement out of the domestic sphere. Mater writes, “A man’s home should be to him a rest. Will it be much of this with his wife in and out all day, called up all night, neglecting the household management, and leaving the little ones to take care of the servants? I think not” (Mater

681). Mater’s letter to the editor echoes Ruskin’s assertions in his 1864 lectures at

Manchester that women’s “work” is in making the home a refuge for her husband and children – “work” as a wife and mother – not in caring for patients outside the home. If a woman moves beyond the home, Mater suggests, the family will suffer – the safe haven of the home will not exist for the man wearied by the outside world or for his progeny.

Notwithstanding the existence of such a safe haven, in the absence of a wife, Mater suggests, its maintenance will fall to children and domestics, leaving it less edifying for the wearied man. Outside of professional discourse, even women’s rights advocate

Frances Power Cobbe, worried that women could not be both public professionals and wives and mothers, sent physician Elizabeth Garrett Anderson a poem lamenting the loss to the women’s rights movement when she learned of the other woman’s marriage in

1871 (Cobbe 105-6).5

In addition to concerns about the state of the home with the entry of women into medical practice, other representations of medical women in the years before their legal

5 The poem included the following lines that associate women in the professions and virginity: And women’s battle fought and won, Honour will aye be paid to one Who erst called foremost in the van Excelsior! But not for her that crown so bright, Which her’s [sic] had been, of surest right, Had she still cried, – serene and blest – ‘The Virgin throned by the West’. Excelsior! (Power Cobbe 105–6). 19 recognition suggest that their movement out of the home would cause a realignment of gender norms, where men may be pushed out of professions by eager young women professionals. In satirical magazine Punch, for example, George du Maurier highlights the strangeness of women’s proposed participation in the male-dominated medical profession. In an 1872 entry in du Maurier’s ongoing series about women’s rights campaigns, “The Coming Race,” du Maurier depicts a future meeting between two physicians, a woman and a man (Figure 1).

Caption: Doctor Evangeline. "By the bye, Mr. Sawyer, are you engaged tomorrow afternoon? I have a rather a ticklish operation to perform - an Amputation, you know." Mr. Sawyer. “I shall be very happy to do it for you." Dr. Evangeline. "O, no, not that! But will you kindly come and administer the chloroform for me?” Figure 1: George du Maurier, “The Coming Race”, Punch, 1872 20

The woman physician, petite and clad in virginal white, asks the more imposing male physician for his assistance in a “ticklish” operation. Although he assumes that she wants him to perform the operation – an amputation – she, in fact, wants him to administer the anesthetic, a task usually relegated to lower-status medical professionals: nurses. The image invoked of the delicate woman physician sawing off the limb of a prostrate patient while the burly male physician looks on was undoubtedly meant for humorous effect but also underscores the strangeness of women performing the masculine tasks associated with medical practice, rather than the “gentler” task given women in the past.

Women’s duties to men were not the only factors limiting their ability to win the professional authority granted through the medical profession. Both the representations in the British Medical Journal and in Punch highlight women’s unfitness for medicine on the grounds not only of their obligations to men but also their supposed inability to perform the duties of the medical profession. These inabilities purportedly made them dangerous to both themselves and their patients. Kristine Swenson notes that representations of medical women before 1876 underscore a cultural assumption that women’s physical and mental weakness made them unable to perform medical tasks without injuring themselves (Swenson 87). In the British Medical Journal, Mater concurs that women lack masculine traits such as strong morals, physical strength and care in speaking – traits essential for medicine. Likewise, the humor of du Maurier’s illustration plays on the juxtaposition of the delicate female form with the hard physical labor of surgery. Other representations suggest that the effects of practicing medicine on a woman would devastate her physically, mentally, and – in the most extreme cases – morally. In

“Elizabeth Garrett Anderson and the Professionalism of Medical Publicity” (2008), 21

Claire Brock notes that women physicians’ opponents argued that women’s participation

in the medical profession would lead to “‘self-asserting,’ ‘unsexed’ termagants” in possession of immoral knowledge about physiological processes or equally unnatural women who struggled with occupations both at home and in the surgery (Brock 323).

Practicing medicine, then, caused women to risk losing their womanhood, turning them into dangerous agents of corruption and immorality. Such a positioning put their health

and the health and well-being of their patients at risk.

At first glance, it might seem that public and professional attitudes toward other

women involved in medicine – midwives and nurses – would prove an exception to the

restriction of women from positions of medical authority on the basis of their gender. At

this time, however, neither of these two occupations was considered a distinct profession

equal with physicians and neither nursing nor midwifery escaped cultural suspicion.

Midwifery was still a highly contested field in the latter part of the nineteenth and early

twentieth centuries, as debates roiled over whether these women should be licensed and

regulated in the same ways as physicians. The independent practice of midwifery among

women was still relatively uncommon, and because they did not need to be licensed to

practice, both male and female physicians worried that midwives did not have

appropriate medical training to deliver adequate care to women and children. As Alice

Reid notes, while the 1902 Midwives Act enacted legislation that regulated the training

and registration of midwives across Britain, an oversight in the law allowed individuals to

practice as midwives without a license until 1910 (Reid 381). Midwives, then, were only

in the process of becoming a profession in the 1850s and 1860s and did not achieve such

recognition from the medical profession until after the turn of the century. 22

As did midwives and female physicians, nurses experienced resistance as they professionalized in the 1850s and 1860s. As Kristine Swenson has pointed out, in the first

years after women took up nursing, they were often linked to prostitutes, a result of their independence and their intimacy with the bodies of their patients, even as key figures such as Florence Nightingale sought to “re-domesticate” them (Swenson 54). In order to combat lurid depictions of nurses, those participating in the formation of nursing as a distinct and respectable profession framed nursing as a natural extension of women’s

“work” in the home. In her preface to Notes on Nursing (1859), for example, Florence

Nightingale connects nursing with a woman’s role as keeper of the home and warden of her husband and children’s comfort and health. She writes,

Every woman, or at least almost every woman, in England has, at one time or

another of her life, charge of the personal health of somebody, whether child or

invalid,–in other words, every woman is a nurse. Every day sanitary knowledge,

or the knowledge of nursing, or in other words, of how to put the constitution in

such a state as that it will have no disease, or that it can recover from disease,

takes a higher place. It is recognized as the knowledge which every one ought to

have–distinct from medical knowledge, which only a profession can have.

(Nightingale v)

In describing nursing, Nightingale clearly distinguishes it from medical practice. Nursing, she suggests, is based on knowledge inherent to women’s experience – caring for the sick and maintaining a sanitary home; it is not based on medical knowledge – a “professional” knowledge – as in a physician’s practice. In addition to the association of nursing with women’s domesticity, nurses did not present the same challenge to male authority as did 23

female physicians; while nurses might administer care, they were not seeking to usurp

male physicians’ roles in diagnosing and treating patients. This “re-domestication” of

nurses was ultimately successful, as nursing became more and more commonly

associated with women’s traditional domestic roles; the female nurse eventually came to

be seen as the “helpmeet” of the male physician, as she was of her husband, if she had

one.

Women physicians’ fight for legal and educational reforms

In the hostile atmosphere of the 1850s and 1860s, then, women physicians fought for

reforms to both credentialing and education, and opponents were successful in slowing

but not stopping their progress toward greater recognition of their professional authority

in medicine. Women were refused admission to professional organizations such as the

Royal College of Surgeons and the Royal College of Physicians. In describing such

exclusion, Jean Donnison offers the example of Jessie Meriton White’s application for

admission to the Royal College of Surgeons in 1856, which the male members of the

profession saw as a joke (Donnison 71). Despite such resistance, Donnison notes, one

woman, Elizabeth Garrett Anderson, qualified as a physician under the Society of

Apothecaries in 1865 through a legal loophole that did not bar a woman from membership when she had been trained abroad. In 1859, the American-trained Elizabeth

Blackwell had exploited a similar oversight, sitting for the registration exam before a swift legislative change. After Garrett Anderson qualified, Donnison notes, Parliament amended the law to prevent other women following her. Until 1876, the British 24

government recognized only Garrett Anderson and Blackwell as officially licensed

female physicians (Donnison 71).

The resistance of male physicians in the 1860s and 1870s stymied what little

progress women saw at winning the same professional status as male physicians. While

women were denied admission to the medical schools at Cambridge, Oxford and the

University of London, a group of seven women, dubbed the “Septem contra Edinam”

(“Seven against Edinburgh”) negotiated with administration at the University of

Edinburgh School of Medicine to attend lectures and participate in examinations. As

Catriona Blake notes, the university made accommodations for these women – Sophia

Jex-Blake, Isabel Thorne, Edith Pechey, Matilda Chaplin, Helen Evans, Mary Anderson,

and Emily Bovell – to matriculate at the university in 1869 (“Aesculapia Victrix” 19).

The women, however, were dogged by opposition throughout their time at the university, especially after Edith Pechey’s disqualification for the prestigious Hope Scholarship in

Chemistry in 1870.6 Resistance to the presence of these women reached a boiling point

during the Surgeon’s Hall Riot. On November 18, 1870, some of the University of

Edinburgh’s male students expressed their outrage at women being allowed to sit for an

anatomy examination. As Sophia Jex-Blake notes in her memoir, the rioters shouted

abuse and threw mud and garbage at the female students, blocking their way into the

building where the exam was to be administered. After the women finally managed to

6 In his 1877 article, “Medical Women,” Liberal MP James Stansfeld and supporter of female physicians, details the slowly growing opposition to the Seven: During the first session things went well enough, so well indeed as to arouse to an activity the reverse of creditable the hitherto latent opposition of male medical students and of medical men. Then opposition began ; professors refused to teach the women, male students mobbed them, university authorities sought escape from the honourable obligations under which they had voluntarily placed themselves, by the suggestion that they had exceeded their powers. (Stansfeld 890) 25

fight through the crowd and begin their examination, the chaos continued: rioters released

the University’s mascot – a sheep – into the examining hall (Jex-Blake, Medical Women

93).7 Regardless of such expressions of outrage from their opponents, the majority of the

women continued attending the university until 1872, when the university refused to

grant them their degrees, a decision upheld by the Scottish Court of Session in 1873

(“No. 138. June 28 1873. Jex-Blake v. Senatus of the University of Edinburgh” 784).

These legal and educational setbacks did not stop women’s campaign to join the

ranks of medical professionals.8 The 1870s saw two major developments that changed institutional strictures and, thus, who could be legally and professionally recognized as a

physician in Britain. First, the London School of Medicine for Women – the first school of medicine in Britain to allow women to train as physicians – opened its doors in 1874.

The foundation of the school was spearheaded by members of the “Seven against

Edinburgh,” as well as Elizabeth and Emily Blackwell, Thomas Henry Huxley, and

Garrett Anderson. As Sophia Jex-Blake notes in her history of the school, the London

School of Medicine for Women was staffed by lecturers from other schools of medicine in London and financed by donations and fees taken from its students (Jex-Blake,

“Medical Women, 1877” 694). The school’s establishment allowed women to finally receive an education comparable to that of their male counterparts without requiring them to hire an expensive private tutor or to travel abroad for their degree. Additionally, legal changes to medical registration gave women further claims to professional status equal to

7 In recounting her examiner’s – a physician named Dr. Handyside – reaction to the sheep, Jex-Blake remembers him saying, “Let it remain. […] It has more sense than those who sent it here” (Jex-Blake, Medical Women 93). 8 Jex-Blake directly connects the failure of medical women’s education in Edinburgh with the later foundation of the London School of Medicine for Women by many of the members of the “Seven against Edinburgh.” See Jex-Blake, “Medical Women, 1877” 694). 26 that of their male counterparts. The 1876 Medical Act (Qualifications) Bill, also known as the Enabling Act, allowed individuals trained as physicians, regardless of their gender, to sit for medical registration exams. It reads,

The powers of every body entitled under the Medical Act to grant qualifications

for registration shall extend to the granting of any qualification for registration

granted by such body to all persons without distinction of sex: Provided always,

that nothing herein contained shall render compulsory the exercise of such

powers, and that no person who but for this Act would not have been entitled to

be registered shall by reason of such registration, be entitled to take any part in the

government, management, or proceedings of the universities or corporations

mentioned in the said Medical Act. (Great Britain. Parliament. House of

Commons)

These exams, if passed, would allow the individual to register as a physician with the

British government. Thus, with these changes, female physicians could claim – at least in name – victory in their search for equal education and recognition under the law. By

1895, Garrett Anderson offered her yearly report on the state of women in the profession to the British Medical Journal and describes the state of women’s medical education as so advanced and well-organized that “there is very little to say about it” (Garrett

Anderson, “Medical Education for Women (1895)” 608). Anderson suggests that, in the twenty years after the opening of the London School of Medicine for Women, women achieved something of the professional status that was formerly limited to men.

Women quickly began to take advantage of these new opportunities. In “Driving

Ambitions: Women in Pursuit of a Medical Education, 1890 – 1930” (1998), Carol 27

Dyhouse indicates that the number of female physicians in Britain increased from twenty-

five in 1891 to two thousand one hundred in 1921 (Dyhouse, “Driving Ambitions” 321).

Similarly, in his history of medical education, Thomas Bonner has noted that the

“professional” physician around the time of the passage of the Enabling Act of 1876 was

typically male, middle class, and young. At the turn of the century, however, the

archetypical medical student took on a much different form. In addition to the slow

incursion of female physicians, new physicians, Bonner indicates, were slightly older,

more affluent, and had a stronger grounding in the laboratory sciences (Bonner 309).

Although these legal and educational reforms changed the demographics of the British

medical community and the legal status of women within that community, problems of

professional authority still plagued the newly educated and registered women.

Continuing issues of reception for female physicians

Although some medical historians, including Catriona Blake, have asserted that

registration and the establishment of the London School of Medicine for Women were

the last barriers to women physicians’ full admission into the medical profession (Blake

21), these reforms did not eliminate all obstacles to female physicians’ full recognition as

medical professionals. Women physicians still found themselves limited by educational,

credentialing, and financial difficulties. The opening of the London School of Medicine

for Women did not mean, for example, that that women were more easily able to enter

the profession or even receive the same quality of education as men. As Leah Leneman notes in “Medical Women at War” (1994), while other schools, such as University of

Edinburgh and University of London created programs for women at the turn of the 28 century, the elite universities Oxford and Cambridge – which opened their medical schools for men in the thirteenth and sixteenth centuries, respectively – refused admission to women until well into the twentieth century (Leneman 160). These schools possessed better facilities and employed more qualified teachers than the London School of

Medicine for Women, which in its first years, did not offer clinical instruction, because its administrators struggled to affiliate the school with a hospital.9

Medical women also struggled against uneven applications of the law securing their registration. Anne Witz reiterates that the 1876 Enabling Act was “permissive, rather than compulsory.” The Act allowed examining bodies to have women sit for exams but did not require them to have women sit for these exams (Witz 96).10 The nineteen medical examining boards were not, therefore, required to allow women to sit for examinations.11 Witz, thus, writes that “the success of a legalistic, equal rights tactic represented but a minor threat to the citadel of male monopoly which did not collapse, but crumbled only very slowly” (Witz 97). While increasing the opportunities for women

9 This difficulty was relieved in 1877, when the Royal Free Hospital agreed to allow female medical students to complete their clinical study at the hospital. The LSOM eventually changed its name to the London (Royal Free) Hospital School of Medicine for Women (Calman 203). 10 In analyzing the debates over 1876 Medical Qualifications Act, Witz argues that the General Medical Council “had thus declared that it was unwilling to declare that women should be excluded de jure from the medical profession. At the same time the General Medical Council’s reluctance to adopt such a legalistic tactic of exclusion in relation to the general question of women’s admission to the medical profession was matched by their unwillingness to sanction any real challenge to the credentialist mechanisms of gendered exclusion which operated in the institutional context of civil society, in the modern university and medical corporations” (Witz 97). 11 The BMJ acknowledges the limitations of the registration bill in an editorial on March 1, 1879: On the women question, the Bill seems to go no further than the present status quo. Since the only portal to practice is to be through the conjoint boards, those boards must admit women to examination; but no corporation will be called upon to give its licence to medical women unless it be willing to do so, as the University of London and the King and Queen's College of Physicians in Dublin have already agreed to do. In case of corporate bodies declining to give their licence to women by reason of their sex, the licence of the Conjoint Board becomes registrable per se. This is in fact equivalent, as will be seen in another column, to the arrangement unanimously proposed by the referees of all the English Universities and medical bodies engaged in constructing, the voluntary conjoint scheme of examination for England. (“Medical Reform” 317) 29

to adopt the title “medical professional” in the eyes of the law, legislation on medical

registration did not ensure that women were placed on equal footing with their male

counterparts in the application of the law itself.

In addition to the “slow crumbling” of the male monopoly in medicine as initiated

by educational and credentialing reforms, women hoping to become female physicians

also suffered from financial difficulties that prevented them from receiving the same

education as their male counterparts. Maintaining separate but equal medical schools for

women presented a significant financial burden for the school’s administrators and teachers. In the face of such difficulties, Garrett Anderson and other administrators made occasional appeals in the British Medical Journal, soliciting monetary and material

donations for the school. When, for example, the administrators decided to create a

library for the students, Garrett Anderson, Mary A. Marshall, and Charlotte Ellaby wrote

a letter appealing to the readers of the British Medical Journal for book and journal

donations, because “[the students] have had hitherto no library of reference where they

could, as occasion arose, consult the best literature of their profession” (Garrett

Anderson, Marshall and Ellaby 437). While the financial, legal and credentialing issues

plaguing female physicians were often barriers to their ability to practice medicine,

public and professional representations of these figures presented an even more daunting

obstacle to achieving recognition and acceptance as professionals.

Women’s problems of medical authority after 1876

Although legal and educational reforms had won them the right to practice medicine

under the law, most limiting to female physicians’ authority as professionals in the years 30

after 1876 were overarching public and professional attitudes that still viewed women’s

“work” as restricted to the domestic sphere – attitudes that themselves affected the efficacy of legal and educational reforms. While the Enabling Act gave women the legal right to be called physicians, it did little to alter public and professional attitudes.

Representations of women as possessing a set of gendered traits that made them unfit for medicine endured well into the twentieth century. Just as before the Enabling Act, writers

of professional and popular discourses continued to assert that women’s traits should

disqualify them from medical practice. Ranging across the print discourses of the late

Victorian and Edwardian periods, representations of female physicians in this period, at

their most generous, demonstrated skepticism about the presence of women in the

professions and, at their most extreme, fear of these figures. In, for example, a speech reprinted in the British Medical Journal in October 1887, Pierce Adolphus Simpson justifies his continued resistance to women physicians on the basis of the incompatibility of women’s gendered traits with the established requirements of the medical profession.

Simpson, although acknowledging women’s “pluck” in winning admission to the medical profession, asserts his continued opposition because “by [her] frame, temperament, and mental constitution woman is not well adapted for medical, far less for surgical, practice”

(Simpson 927). While he demonstrates some recognition of the struggle women physicians underwent in winning legal access to the medical profession, Simpson suggests that women are not fit for medical practice by virtue of their sex; although medical women had managed to win legal recognition, their gendered traits made them unable to perform the essential duties of medicine. 31

Representations of medical women in popular discourse after 1876 continued to

emphasize women’s inadequacy for medicine. In 1878, Punch mocked female physicians in a fictional set of meeting notes of the “Amalgamated Medical Practitioners.” One of the “speakers,” Sir W. Jenkins, criticizes women’s lack of capacity for medicine:

Sir W. JENKINS discarded the apprehension that any injury would be done to

medical men by female practitioners. He objected to them on public grounds, and

for their own sakes. Medical studies would tend to destroy female grace and

refinement, and all those charms which rendered ladies ornaments of the domestic

circle. (Hear.) The faculties of women’s minds unfitted them for medical

reasoning. Life and death were not to be trusted in their fair but fragile hands.

(Cheers.) These considerations should determine the Union to offer an organized

opposition to the employment of medical women. It had been said, “Why not

leave it alone? None need employ female doctors but those who choose.” Such

reasoning was specious but unsound. (“The Fair Sex and the Faculty” 34).

In this text, women outside of the medical profession – doing the “work” of pleasing and

soothing those around them by acting as “ornaments” – are graceful, refined and

charming, while rebellious female physicians have lost these qualities as a result of their

professional training, only retaining their womanly “fragility.” This “fragility” makes

them dangerous to medical practice. The satirical tone of the text does not derive from

men’s failures to recognize the benefits of women’s talents and intelligence in medicine;

rather, it criticizes male physicians for their exaggerated responses to the entry of women

into the profession. The text’s author mocks male physicians’ failures to recognize the

“common sense” view: women’s inadequacy in delivering medical care will eventually 32

lead the public to turn against them. Although the focus of this satirical article emphasizes male physicians’ over-reactions to the legal recognition of female physicians, then, it also reifies cultural attitudes toward women’s unsuitability for the professions.

The writer challenges neither the fictional Jenkins’ positioning of medical women as mere societal ornaments nor his assertions that women’s minds are not meant to reason on medical questions.

While not directly endangering women’s legal right to practice medicine, the attitudes engendered by such representations had serious consequences for female physicians’ medical practice. Even after receiving a medical education, passing their exams and entering the medical register, in the decades after the opening of the London

School of Medicine for Women, women physicians often found that the suspicions reiterated through such depictions restricted their practices. Swenson notes that women physicians in the late nineteenth and early twentieth centuries were viewed as valid mostly on “women’s issues and women’s bodies” (Swenson 132). Despite their medical training, the particular professional status granted female physicians by members of both their profession and the public did not often apply beyond the sickrooms of other women, as they were typically funneled into obstetrics and gynecology and away from the more prestigious branches of medicine, especially surgery. Many women doctors, including

Jex-Blake, saw the limitations of their practice to that of other women and children as acceptable, as a result of a belief that women should treat only women and men should treat only men.12 Other female physicians seeking prestigious and profitable positions in hospital administration, however, found their professional ambitions constrained by

12 Jex-Blake argues that “men should fit themselves to minister to the maladies of men, and women those of women” (Jex-Blake, Medical Women 7). 33

perceptions of women’s weakness and the discomfort a female physician might cause

patients. The British Medical Journal, for example, details a vote for a hospital

administrator – as assistant medical officer – for a work house in Lambeth in 1894 that

demonstrates such limitations. In choosing between two candidates, an experienced

woman and a less-experienced man, the administrators selected the male candidate,

despite his lesser qualifications, because “many of the guardians doubted whether in an

institution such as a workhouse infirmary her appointment would work well.” The

administrators suggested that the female candidate would be better suited for the position

of managing a women and children’s ward, rather than overseeing a large hospital of

mixed population (“Medical Women as Workhouse Doctors” 371). Such scenarios

demonstrate the existence of something like a “glass ceiling” for female physicians in the

late nineteenth and early twentieth centuries: they could only rise so far in the profession

before their attempts at promotion were stymied.

Doubts about women’s ability to function as contributing members of the medical

profession also resulted in their exclusion from the elite aspects of professional medicine.

Medical organizations such as the Royal College of Physicians and the Royal College of

Surgeons served as social organizations for some of the most distinguished and influential members of the profession, offering lectures on innovative techniques and treatments not available in medical schools. Catriona Blake has noted that both of these organizations and the British Medical Association continued to exclude women from membership in the decades after women were admitted into the medical profession

(Blake 24). The British Medical Association, for example, refused to admit newly- registered medical women until 1892. Before 1892, members opposing the admission of 34 women into the British Medical Association based their exclusion of women on their

“weaknesses” and the dangers to male and female physicians presented by this weakness.

In a series of debates published in the British Medical Journal in 1878, for example, the editors reprinted Elizabeth Garrett Anderson’s discussion of the issue. She outlines the various reasons she has read against the admission of women into the British Medical

Association. She underscores the fact that those opposing the admission of women into this organization advocate for their exclusion based on questions of propriety: that discussing medical topics in mixed company risks placing women physicians in moral peril (“The Forty-Six Annual Meeting of the British Medical Association” 225). Garrett

Anderson asserts that current attitudes toward female physicians do not reflect women physicians’ legal status or education, as these women have been vetted by the process of medical education and often have “stronger” minds and constitutions than male physicians. She also expresses her concern that these attitudes toward female physicians will limit their ability to practice the profession for which they have trained. Female physicians themselves, then, recognized the role of cultural attitudes suspicious of female physicians, such as those disseminated in their representation in popular and professional discourses, on damaging their status as professionals.

Acceptance of medical women: a rhetorical problem

Suspicion of women physicians for their deviation from cultural norms in print culture is a problem of a distinctly rhetorical nature, unlike the issues plaguing female physicians of lagging educational, legal, and financial reform noted by Witz, Leneman and Blake.

Throughout this dissertation, I approach “rhetoric” in line with Kenneth Burke’s 35

definition of the term in The Rhetoric of Motives (1950). Burke writes that rhetoric is “the

use of words by human agents to form attitudes or to induce actions in other human

agents” (Burke 41). For Burke, rhetoric “is not just trying to tell how things are, in strictly ‘scenic’ terms; it is trying to move people” (Burke 41). Rhetoric, or the use of

language to move people, is key for the practice of medicine. Medicine as a profession

rests on physicians persuading patients and colleagues to undertake particular actions. In

Health and the Rhetoric of Medicine (2005), Judy Z. Segal argues that, rather than the

mere application of scientific theory to the body, “[p]ersuasion is a central element in

many medical situations” in biomedicine and that medical “[e]xperts persuade the public

to count some states and behaviors as pathological and others as not” (Segal 1, 1-2). Key,

then, to the practice of biomedicine is the persuasion not only of patients, but also of the

public and the other members of one’s profession. Late nineteenth- and early twentieth-

century medicine involved such persuasion, as the practice of the profession was itself

bound up in attempts to change the thinking or actions of its various audiences: individual patients, other physicians, or the public more broadly. During this period, a female physician’s profession involved her ability to use discourse to persuade patients, colleagues, and the broader public in favor of recommended courses of treatment or of the validity of her individual readings of the human body – whether in research or in consultations with individual patients. Suggestions that medical women deviated from cultural norms, however, engendered public and professional attitudes that prevented them from doing such work, as these representations raised suspicions about both medical women’s gendered traits and the relationship of those traits to the communities to which they belonged. Understanding the problem of representation faced by female 36 physicians as one of a rhetorical nature opens up an opportunity to acknowledge how these representations materially affected women’s ability to perform the duties of their profession.

Failures to note the rhetorical nature of the problem medical women faced, as in the analysis of British medical women by Witz, Blake, and Leneman, mask the complexity of these representations and their resonance throughout Victorian and

Edwardian culture. In their own writing, medical women assert that the lingering resistance they faced was not solely about the public’s beliefs about women’s physical, mental or spiritual traits but rather with their relationship to the “community” of the medical profession. One young female physician, M.L.A. Boileau, in writing to the

Magazine of the London School of Medicine for Women in October 1906, describes meeting acquaintances who, although they have never met a female physician before, believe that women doctors “study just the same things as men – with the nasty parts left out” (Boileau 675). As a result of a “womanly” inability to handle the unsavory aspects of her profession, Boileau’s friends view the category of “woman doctor” as inherently separate from and inferior to that of “doctor.” Likewise, in her 1886 history and analysis of British women’s entry in the medical profession in the nineteenth century, Medical

Women: A Thesis, Sophia Jex-Blake, a member of the “Seven against Edinburgh” and one of the first female physicians recognized in Britain, highlights her growing dissatisfaction with opponents constantly undermining women’s abilities to act as competent physicians at the end of the nineteenth century: “We are told […] that nature and custom have alike decided against the admission of women to the medical profession, and that there is in such admission something repugnant to the right order of things…” 37

(Jex-Blake, Medical Women 4). As she details the success of the women’s movement in professional medicine, Jex-Blake also acknowledges that the number of detractors to female physicians has continued to increase in alarming numbers, even a decade after legal and educational reforms that, in theory, would enable women to take an equal place in the medical profession. Separated by twenty years, both Boileau’s and Jex-Blake’s accounts reveal a pervasive uneasiness with female physicians in late Victorian and

Edwardian medicine and culture: Boileau’s acquaintance suggests that only men are truly

“physicians,” and Jex-Blake’s account reiterates the opposition between women physicians and women’s typical place in Victorian “nature and custom.” Women physicians’ ability to earn the same professional respect and authority as male physicians, then, was directly challenged by representations of the female physician that undermined not only her distinctly feminine traits but also the particular fitness of these traits for her profession in the view of both the public and other members of the medical profession – a problem of rhetorical ethos.

More than a question of “character”: women’s medical ethos

Women physicians faced a problem of ethos – of the persuasiveness of their character in relationship to community. In his discussions of the nature of ethos, Aristotle delineates three distinct but related aspects of ethos: phronesis (the ability to exercise practical knowledge of a subject area), eunoia (goodwill to one’s community), and arête

(excellence or virtue). The possession of each of these three qualities by a given speaker,

Aristotle indicates “is necessarily persuasive to the hearers” (Aristotle 121). For a woman physician to be accepted as a member of the medical profession, these three elements 38

would need to be persuasive to her audience. Ethos, then, is by its nature communal.

Following on Aristotle, contemporary rhetorical scholars have emphasized this

communal nature. Risa Applegarth has glossed Aristotle’s ethos as a means of persuasion through audience perceptions of an individual’s goodwill (eunoia), good sense

(phronesis) and good character (arête) (Applegarth 43). Michael Halloran, in discussing the etymology of ethos, writes that “the most concrete meaning given for [ethos] in the

Greek lexicon is a ‘habitual gathering place,’ […] it is upon this image of people gathering together in a public place sharing experiences and ideas, that its meaning as character rests” (Halloran, “Aristotle’s” 60). This notion of ethos as a “gathering place” underscores its communal nature: a speakers’ ethos serves as a point of connection between that speaker, her audience, and the communities to which the speaker and audience members belong. A given audience’s perceptions of an individual’s goodwill, good sense and good character have a significant impact on that individual’s ability to persuade others – whether these “others” are other professionals or members of the broader public – to particular attitudes, beliefs, or actions. An aspect of ethos is persuasive if it positively affects an audience’s understanding of the relationship between an individual and their community. Women physicians belonged to a number of communities, including their profession and the “community” of the general public.

Acceptance of a woman physician as a fully credible and authoritative member of her profession in the late nineteenth and early twentieth centuries, then, relied in part on her ethos – her ability to persuade her audience of her “goodwill” to both her profession and the broader public, “good sense” and knowledge of medical and scientific practices and

“good character” in her behavior – in her role as a physician. 39

An audience’s attitudes toward an individual’s ethos are formulated through acts

of discursive exchange, most commonly through performance. Todd S. Frobish reminds

scholars that ethos is established through discourse (Frobish 19), and Helen

Constantinides writes, “Ethos is not found in the person of the speaker but in the

character of the speaker constructed in the text” (Constantinides 62). An individual

demonstrates mastery of the three aspects of ethos through writing for or speaking before

an audience, and women’s opportunities to speak in their capacities as physicians were

still emerging in the 1870s and beyond. Boileau’s encounter with her friend suggests,

however, attitudes about women’s professional ethos can arise independently of an

audience’s encounters with a female physician’s speech or writing. While individuals can

themselves enact ethos through texts, audience perceptions of an individual’s ethos can

also be shaped by other acts of discourse creation. As Carolyn Skinner has noted in her work on American women in the medical professions, because it relates to audience perceptions of an individual, ethos is formulated in response to cultural attitudes toward immutable aspects of an individual’s identity, particularly with their gender, physical embodiment, or racial background (Skinner 11). Similarly, Applegarth writes that ethos is shaped through interaction between individuals and the social and material environments within which they speak (Applegarth 49). In the late Victorian and Edwardian periods, writers in opposition to female physicians undermined each of the three areas of female physicians’ ethos in the material and social environment of late nineteenth and early twentieth century print culture through acts of representation that attacked each of the three aspects of medical women’s ethos.

Arête

Representations of female physicians after the passage of the Enabling Act often depicted women as unfit for the medical profession as a result of their “natural” inability to

perform such work, echoing attitudes from before 1876. Such depictions undermine

women physicians’ arête – their “good character” or virtue. Derogations of medical

women’s “character” depicted women as weak, unintelligent, and unable to manage

medicine’s physical and mental demands – traits typically associated with their gender.

In, for example, the debates for the admission of women into the British Medical

Association in 1878, Elizabeth Garrett Anderson notes that attitudes toward women

physicians take for granted that women as a whole cannot keep up with men in medical

lectures. Such depictions, she argues, are unrepresentative of medical women and

undermines their status in the profession.

Not only do criticisms of “good character” arise from cultural beliefs about the

traits associated with the categories to which individuals belong, but also from their

deviation from or imitation of the norms and values associated with the communities in

which they claim membership. Many representations of female physicians questioned

whether women could fulfill duties of their profession without becoming “unsexed,” a

concern that pervaded representations of medical women in the decades after the

Enabling Act – even representations of these figures crafted by writers who advocated for

women to take on increased roles in medicine. Arthur Conan Doyle’s “The Doctors of

Hoyland,” published in The Idler in 1894, for example, depicts the ethos problems of the

prize-winning and highly-skilled Dr. Verrinder Smith, who founds a practice in direct

competition with an established male physician, Dr. James Ripley. At the story’s 41

inception, Ripley vehemently opposes women physicians. By the end of the tale, after an

accident that leaves him in Smith’s capable hands, Ripley acknowledges Smith’s

professional superiority and has fallen for her “feminine charms,” which he once believed wanting in any female physician. Despite Ripley’s newfound respect and affection for

Smith, Doyle’s short story “unsexes” his female physician. At the end of the story, Smith

declares that she has devoted her life to science and cannot take on the additional

occupation of wife – his or anyone else’s (Doyle 238). Other representations by

supporters of female physicians similarly reiterate that femininity and the medical

profession are incompatible. Even when representations of female physicians focus on

physicians with a peerless character, they are often painted as weak or incapable of

fulfilling the mental and physical demands of the profession. Anne Elliot’s Dr. Edith

Romney (1883) and Henry Curwen’s Dr. Hermione (1890) suggest that the rigors of

medical practice will eventually overwhelm even the most virtuous and lively women

physicians, resulting in their emotional or physical collapse.

In addition to suggestions of women’s physical and mental incapacities, writers

such as Wilkie Collins represent female physicians as encouraging immoral behavior in

their patients. In “Fie! Fie! Or, the Fair Physician” (1882), Collins implicitly links the

treatment of male patients by women physicians to prostitution. In this story, first

published in The Spirit of the Times and The Pictorial World Christmas Supplement,

Collins’s “fair physician,” Sophia Pillico, draws the ire of the residents of south-east

London, particularly a Mrs. Crossmichael, whose sister was jilted by a man who fell in

love with Pillico. Much to the alarm of the women and pleasure of the men of the town,

Pillico “is not content to doctor her own sex only. She considers it a part of the Rights of 42

Women to doctor the men” (Collins 781). Collins represents Pillico as skirting into immorality as she expands her practice and fails to weigh the consequences of entering into intimate physical and emotional relationships with male patients. Pillico,

“sufficiently young” and “passably pretty” (Collins 777), becomes both physically and

emotionally intimate with her patients – especially the men of the town. For example, she

treats Sir John, a prominent figure in the suburb, touching him with a tender “medical”

hand. Collins describes the examination thus:

Sir John was seated bolt upright in his chair, looking at vacancy, and drawing in

and puffing out his breath in a highly elaborate manner. A finely-developed

young woman, with brown hair and eyes, and warm rosy cheeks, dressed to

perfection in a style of severe simplicity, was sitting close by him. Her arm was

around his neck, and her ear was at his breast. (Collins 782)

In this passage, Collins’ description of the physical encounter between patient and

physician aligns more closely with the language of sexual congress than of medical

examination, particularly in his description of Sir John’s “elaborate” breathing and

posture as the young physician hugs him around the neck to listen to his heartbeat.

Collins also reveals that Sir John’s thoughts on the encounter angle more toward the

sexual than the medical. Caught out in this examination by his step-son, Sir John’s

thoughts run to the following:

It was not everybody who remembered that he had once been Lord Mayor of

London, and who attended to him as a famous personage. It was also the first

occasion (for at least forty years past) on which he had felt the arm of a handsome

young woman round his neck, and the head of a handsome young woman on his 43

breast. Add that the fair physician had said, on the first day of her attendance, 'It is

a rule of mine never to accept fees from public characters' -- and the catalogue of

Sir John's overwhelming emotions will be complete. (Collins 783)

Sir John’s thoughts on the matter reinforce that, not only did he receive medical advice

on his chronic ailments, he also received pleasure at Pillico’s physical intimacy and

flattery during his examination. Pillico’s beauty and youth, as well as her physical touch,

rather than her skill as a physician, draw patients to her practice.

Although the story’s narrator does not blame Pillico for this reception by her male

patients, other characters in the story – particularly the women of the story – clearly view

Pillico as an immoral influence on her male patients. Despite the efficacy of Pillico’s cures and her obvious skill throughout the story, many members of London’s suburban society recognize the dangerous excitement Pillico stirs in the town’s men. The Lady

Dowager, on seeing Pillico’s intimate examination of her husband Sir John, speaks harshly to her son of both her husband and Pillico,

Look at that old fool, your step-father! He a knight; he an alderman? Ha! ha! a

nasty, mangy, rusty old Tom-cat. I won't live with him any longer. You're a

witness, Otto -- you see what's going on in that chair -- I'll have a divorce. Ha!

look at her hair, […] look at her hair, all rumpled with her horrid passions. I blush

for my sex. Fie, Miss Pillico -- fie! (Collins 783)

The Lady Dowager does not spare her husband or Pillico the accusation that she is a prostitute, accusing her husband of being a “Tom-cat” and engaging in “horrid passions” with the young physician. Notably, she is not incorrect in noting the pleasure her husband derives from his examination, although she and other residents of the town heap the 44

majority of the blame onto Pillico. While the men the young physician treats are “fools,”

the characters in the story term Pillico an “unnatural hussy” (783), “Susannah and her

Elders” (784),13 and a “hateful wretch” (788) and accuse her of “wickedness” (778). The

weight of these men’s indiscretions falls on Pillico and her decision to treat both men and

women. Collins recognizes this unfair distribution of blame by concluding the story on a

note from Pillico: “At my present time of life, stupid male patients persist in falling in

love with me” (Collins 792). This note does not fully absolve Pillico of blame for the

moral infraction of expanding her practice to male patients and continuing this expansion

even after these accusations. This note does, at least, recognize that Pillico should not be

alone in being blamed for the men’s immorality.

Women physicians were also frequently depicted as deviating not only from

gender norms and standards of morality but also professional norms by male physicians.

Writers to the Lancet and the British Medical Journal often distinguished the male

members of the profession from female members. Physician Dobson Poole, writing to the

British Medical Journal in 1904, three full decades after the founding of the London

School of Medicine for Women declares that women physicians are a “phase of fashion,”

much as are “hospital organizers, specialists, […] municipal medical appointments” – figures that “appear or disappear according to chance or season” (Poole 864). Strikingly, throughout the decades after the passage of the Enabling Act, writers to both the Lancet and the British Medical Journal continue to adopt the term “medical woman” or “woman

13The Lady Dowager engages in a misreading of the Biblical Book of Daniel, which paints the innocent Susannah as a loose woman. In the original text, Susannah is accosted by two men and pressured, though unsuccessfully, to have sex with them. See Daniel 13:1-64. 45

doctor” when referring to their female colleagues, reinforcing the division between

“doctors” and “women doctors.”14

In addition to the distinction between “doctors” and “women doctors,” depictions of the medical profession created standards of “character” against which medical women were to be judged by both members of their profession and the broader public. Such representations arose most pointedly in debates about whether to grant female physicians admission into the exclusive professional organizations of turn-of-the-century British medicine.15 After a vote in the Royal College of Physicians in October 1895 that rejected

a petition by the London School of Medicine for Women to allow women to sit for an

examination for entry into the Royal College of Physicians, commenters expressed both

praise for and dismay at this decision and on the characterizations of women offered in

the report from the meeting, which was reprinted in the British Medical Journal. The

writer of an unsigned editorial affirms the decision, suggesting that women, by their

nature and social situation, cannot live up to the standards established by the men of the

profession. He writes,

It will, perhaps, always be more difficult for medical women to work at literature

or pure science than it is for most men. Their lives are more complex, they are

more exposed to small interruptions, and they are not as strong physically. They

14 While Skinner has highlighted the medical “sects,” such as the Thomsonians, homeopaths and hydropaths, that dotted the landscape of professionally-accepted American medicine, due to a lack of licensing requirements (Skinner 14), the established British medical profession largely dismissed such movements as “quackery” and sought to restrict the growth of such movements. 15 Women were not admitted en masse to the British Medical Association until 1892 and excluded from taking exams to enter the Royal College of Surgeon until 1909. Two women were exceptions to this rule, because they were educated abroad before the BMA closed its membership to women in 1878: “first woman physician” Elizabeth Garrett Anderson and Frances Hoggan, who was forced to resign due to intense pressure from male physicians because she had not yet achieved certification. Eleanor Davies- Colley became the first female fellow of the Royal College of Surgeons of England in 1911. 46

cannot usually work as long as men can each day. They have to live by their

work, and having done enough for this they must, in many cases, be content to

pause. (“Medical Women and the London Colleges” 1247)

The writer suggests that women lack the physical and intellectual capacity of medical men and, as result of their inherent financial instability, accuses women of only seeking to make a living through medical practice, rather than pursuing the more elite and difficult branches of medical research or inquiry. This writing reiterates the writer’s deep distrust of female physicians’ capacity for the more rigorous physical, mental, and physiological demands of medical research and surgery, which the medical profession classified as the most advanced and elite medical specialty.

Eunoia

Representations of female physicians were not limited to critical treatments of their character or the unfitness of this character for the medical profession; writers also undermined their eunoia – their “goodwill” toward the communities to which they belonged – both late Victorian society and the medical profession. Wilkie Collins’ “Fie!

Fie! Or, the Fair Physician” represents female physicians as dangerous to the social order of late Victorian and Edwardian society. Pillico suffers accusations of corrupting her formerly peaceful country town – other women term Sophia an “unnatural hussy” for her unseemly intimacy with male patients, and Sophia becomes a social pariah, as she refuses to abandon her practice (Collins 783). At the close of Collins’s story, despite the effectiveness of her treatments and her efforts to maintain a respectable distance from her patients, Pillico is responsible for sowing discord among the men and women of the small 47 suburb where she has founded her practice. She breaks up at least one marriage and her practice results in the temporary dissolution of one engagement. Although Collins’ story considers Dr. Pillico as a capable member of the medical community, his story suggests that women doctors damaged the social order and demonstrated a lack of goodwill to the communities to which they belonged, as they continued treating patients of both sexes.

In addition to suggesting that medical women posed a danger to the general public, writers also expressed fears about dangers posed to the medical profession by the admission of women into the profession. Such fears had existed since long before the admission of women into the profession. Coupled with popular and professional concern over the well-being of patients and female physicians themselves is professional anxiety about how admitting such “dangerous” women fully into the profession would change the overall make-up of the medical profession: its status, its relationship to individual patients, and the morality and reliability of its members. One major fear was that, once admitted into the profession, women would overrun it. George du Maurier’s “Our Pretty

Doctor,” published in Punch in August 1870, the same year as both Edith Pechey’s disqualification from the Hope Prize and a few months before the Surgeon’s Hall riots, represents a female physician receiving a line of unemployed men begging for her help in finding work in nursing (Figure 2). Du Maurier’s cartoon suggests a reversal in the roles of woman and man; the woman physician is seated comfortably in her more prestigious professional position behind a window reading “Surgery,” while the unemployed men seek lower paying, lower status professional positions that were once the province of women. The line of men, coming to the female physician modestly, hats in hands, 48 suggests an emerging fear that men will be displaced from or excluded from the medical profession by the entry of women.

Figure 2: “Our Pretty Doctor,” George du Maurier, Punch, August 1870

Once women had entered the profession in 1876, such fears were exacerbated, especially in the medical journals. In writing to the BMJ to condemn male physicians’ reactions to the first vote on the admission of women to the Royal College of Physicians in 1878, for example, male physician T.K. Chambers suggests that the virulent and

“ungentlemanly” responses to the vote arise from both fear of displacement and fear of how the admission of women to the profession would affect medicine’s professional status. He writes, “It would seem to be this M.D. which has acted as a red rag to our usually sedate fellows, and made them positively rude to their fellow subjects. They are so fearful of the public confounding all M.D.s together, that they hasten to make an 49 opportunity of abjuring the connection” (Chambers 436). In addition to fearing that their patients would be stolen by women, male physicians struggled against women’s full recognition after the passage of legal and educational reforms, because it tied them to the purportedly flawed and unsexed female members of the profession, while simultaneously challenging the male-centered status quo of late nineteenth and early twentieth century professional medicine.

Phronesis

Finally, many representations of female physicians undermined women’s phronesis – her

“good sense” or her scientific and technical knowledge and her ability to wield this knowledge for the practical advantage of community. In a heated exchange in the British

Medical Journal in 1892, two correspondents – famed psychologist and neurologist

James Crichton-Browne and an anonymous correspondent adopting the pseudonym “A

Medical Woman” – argued over whether the strain of education was too taxing for women’s brains. In “Sex and Education,” Crichton-Browne argues that women’s brains, which had been shown through medical research to be lighter than men’s brains, would be overtaxed by the rigorous demands of education. While Crichton-Browne is careful to clarify that he has never called women’s brains inferior to men’s, he writes that his view is that “there can be no question of inferiority or superiority between them, any more than there can be between a telescope and a microscope, or a cabbage and a cauliflower, but that they are differentiated from each other in structure and function, and fitted to do different kinds of work in the world” (Crichton-Browne, “Correspondence. 14 May”

1047). Crichton-Browne’s assertion that women’s and men’s brains are “fitted” for 50

different sorts of “work” leads him to suggest that women are not “fitted” for higher

levels of education. While Crichton-Browne does not acknowledge it, implicit in his argument is the exclusion of women from the medical profession, a field requiring intense study and a grueling set of examinations for full legal registration. Such representations of women as lacking the mental capacity to perform medicine and make

medical judgments were not restricted to the non-fictional realm. Rather, in Punch’s 1878

“The Faculty and the Fair Sex,” fictional speaker to the Amalgamated Medical

Practitioners Jenkins suggests that women’s inability to do medical work arises from failures in the “faculties of [their] minds” and that the dangerous practical work of medicine – of managing life and death – “were not to be trusted in their fair but fragile hands” (“The Fair Sex and the Faculty” 34). Jenkins asserts that women’s intellectual failures prevent them from improving their community. Rather, their incapacity – coupled with their fragility – could directly endanger patients, suggesting not only a problem of good sense, but also of goodwill to the broader public.

Understanding women physicians’ difficulty in achieving parity with male physicians as a problem of the representation of rhetorical ethos – rather than as simply one of “character” alone – illuminates the importance of community in nineteenth and early twentieth century women’s professional lives. Acknowledging the fine distinction between the traits associated with representations of professionals and the ways these traits embodied or interacted with audience expectations of these individuals in community not only enables scholars to understand the deeply entrenched nature of the representational opposition women physicians faced in undertaking their professions but 51 also the particular means by which women physicians and their supporters sought to remove this opposition.

Women constructing medical ethos through print culture

Female physicians and their supporters recognized the relationship between the attitudes fostered by such representations and limitations on both women’s professional advancement and medical practice. Sophia Jex-Blake, in Medical Women, scolds her audience for failing to question public and professional biases against female physicians.

She argues that it is necessary to examine one’s prejudices, lest one relegate emergent truths to the “darkness” imposed by the shadow of tradition. She writes that in the time of continual change at the end of the nineteenth century, “a constantly recurring duty will lie before every one who believes in life as a responsive time of action, and not as a period of mere vegetative existence, to ‘prove all things, and hold fast to that which is good’”

(Jex-Blake, Medical Women 4). Jex-Blake recognizes women physicians’ inability to achieve full recognition as professional physicians as a major issue requiring such

“proving.” In response to the growing number of opponents to women in medicine, Jex-

Blake argues that those in favor of women’s equality with male physicians have a responsibility to “test” accusations of medical women’s unfitness. Invoking an adage attributed to Richard “Conversation” Sharpe early in the nineteenth century that “most men have their thinking, like their washing, done out,” Jex-Blake declares it “a duty for all” who do their own thinking “to test these statements [against female physicians] and to see how far their truth is supported by evidence” (Medical Women 5). Jex-Blake suggests that female physicians and their supporters ought to combat “statements” against 52

female physicians – including their representation in both popular and professional

discourse – by taking their arguments both to the profession as a whole and the wider

public, rather than waiting for attitudes toward female physicians to change over time.

Under Jex-Blake’s suggestion, allies of women physicians could “test” opposition to their

professional status by challenging the ways they were discussed in “statements” and take

on the project of constructing a new ethos in place of the outdated one.

Rhetorical scholarship has asserted two major ways that individuals participate in

the construction of their own ethos. The more traditional means of ethos building

recognized in rhetorical scholarship is performative. In her analysis of rhetorical ethos in

The Rhetoric of Expertise (2010), Joanna Hartelius argues that ethos

is more about performance than about a tacit record of personal excellence. It

ought not be defined simply as credibility, since contemporary connotations of

that term suggest stable permanence. Certainly, the audience’s perceptions is to

some extent based on preexisting knowledge of the rhetor, but ‘those qualities are

crafted anew in the texture of the discourse.’ For example, a politician’s expertise

depends on both her knowledge and experience as well as her rhetorical ability to

display competence. (Hartelius 12)

From this perspective, an individual can demonstrate her goodwill, good sense and good

character through the performance of these qualities in her discourse on a given occasion.

A female physician, then, might construct her ethos by demonstrating her concern for the

well-being of her patients and the medical profession by performing her technical skill in

discussing medical topics with competence or her devotion to principles such as social

justice as she spoke on medical topics. At the beginning of their officially recognized 53 careers as medical professionals, however, women had had few opportunities to demonstrate the three components of their ethos to the public and the profession in this manner. Women’s access to print periodicals and public spaces was often limited as a result of their gender, and individual consultations with patients were private affairs rarely discussed in public discourse.

Carolyn Skinner has argued for a broader view of how individuals approach the construction of rhetorical ethos for a group or individual beyond the performance of ethos: an interactive model. In suggesting a feminist model of ethos, she argues that a more comprehensive understanding of ethos will more clearly recognize its collective nature and its tendency to exist outside of an individual’s discourse. Such an approach, she writes, will recognize that “a rhetor can develop her ethos indirectly, by shaping her audience’s perceptions of the groups to which she belongs” (Skinner 40). A rhetor’s ethos, she notes, can be modified or created outside of the rhetor’s rhetorically and contextually-situated act of declaiming discourse; specifically, she argues that rhetors, and by extension, other writers and speakers besides the rhetor, can shape the ethos of a group by interacting with an audience’s existing perceptions of a given group. In reading female physicians’ attempts to “test” this unfitness for the medical profession after 1876, this dissertation identifies two indirect exercises of the interactional construction of ethos: critical and generative. The female physician – as well as others seeking to shape the ethos of the group to which she belongs – could indirectly participate in the establishment of ethos by criticizing existing representations of themselves or their profession, or generating new discursive representations of themselves. 54

As the print culture of late nineteenth and early twentieth century Britain reached

its zenith, those seeking to affect public opinion, such as those seeking to bolster women

physicians’ professional status, had the opportunity to generate and criticize public

discourse in unprecedented ways. In Nineteenth Century Media and the Construction of

Identities (2000), Laurel Brake, Bill Bell and David Finkelstein write that nineteenth century readers inhabited an “increasingly textual environment” that led to new public identities (Brake, Bell and Finkelstein 3). The repeal of the Stamp Act in the early

nineteenth century, the decreasing cost of paper, educational reforms acts in the 1870s,

and the progression of print technologies set the scene for a vibrant print culture in the

latter half of the nineteenth century, especially in the growth of periodicals. Following

Jex-Blake’s exhortations, female physicians and their supporters in Britain in the period

between 1876 and 1914 participated in “tests” to “prove” entrenched beliefs about gender

and the medical profession through the generation of alternate representations of the

female physician in late nineteenth and early twentieth century print culture.

Political movements of late nineteenth and early twentieth century Britain, including that for women physicians’ fuller professional recognition, drew on print culture’s ability to reach wide audiences through generic diversity, its ephemerality and responsiveness, and its multivocality. In Feminist Media History: Suffrage, Periodicals, and the Public Sphere (2010), Maria DiCenzo, Lucy Delap, and Leila Ryan argue that the multifaceted nature and broad sweep of print in this period, much as it expanded general opportunities for British citizens to reach a broad or specific audience, offered social and political movements, such as that for increased professional status for women physicians, unprecedented access to the public sphere (DiCenzo, Delap, and Ryan 24). Elizabeth 55

Carolyn Miller’s Slow Print (2013) details the ways one political movement, the “slow

print” movement, opposed the capitalist ideology of the mass-market print industry. The participants in this literary movement, such as William Morris, George Bernard Shaw, and Edith Nesbit, drew on the affordances of late nineteenth and early twentieth century print culture to create discourses to oppose the capitalist ideologies of writers to mass publications, such as George Newnes’s The Strand. Morris, for example, explores the distinct materiality of print and promotes his vision of utopian aestheticism, founding the

Commonweal and the Kelmscott Press (Miller, Slow Print 53-4). The “slow print” movement, although its aims were to change the dominant print media of the late nineteenth and early twentieth centuries, was not the only social or political movement to make use of the affordances of print in the late nineteenth and early twentieth centuries.

Others, such as the anti-vivisection, eugenics, and women’s rights movements used late nineteenth and early twentieth century print to reach broad audiences and to attempt to sway the public to their causes.

The print culture of the late nineteenth and early twentieth centuries was especially useful for women’s political movements, as they sought both legal reform and changes in attitudes towards women in the public sphere. Because print enabled the pluralization and democratization of print in a way never before possible, DiCenzo,

Delap, and Ryan argue that the nineteenth century’s abundant print was key to the promulgation of women’s movements at the close of the nineteenth century (DiCenzo,

Delap, and Ryan 24). Most notably, as Jane Eldridge Miller has argued in Rebel Women:

Feminism, Modernism, and the Edwardian Novel (1994), women’s suffrage advocates made use of the various genres of popular print media of the time, writing defenses of 56

their cause for popular periodicals such as Punch and The Daily Graphic, and in niche

magazines for women and girls, such as Victoria Magazine and The Girl’s Own Paper, in

addition to creating their own journals and magazines advocating their cause, such as the

British Freewoman and the Women’s Suffrage Journal and writing short stories and

fiction about politically-minded young women, such as Gertrude Colmore’s Suffragette

Sally (1911). Unlike other women’s social movements, such as women’s suffrage or public hygiene, however, female physicians did not act to coordinate this print movement, regardless of Jex-Blake’s exhortation to “test” the thinking of their opponents. The other key distinction between this print movement and others was that female physicians and their allies were seeking to effect social change after they had already achieved legal and educational reforms. Attempts to shore up the ethos of women in the medical profession after 1876 seek not to resolve the structural problems addressed by women’s movements or by earlier interventions of advocates for medical women but the ways these women continued to be discriminated against and mischaracterized, even under legal and professional reforms.

Many writers articulated alternative representations of women in the professions by engaging in direct, logical appeals to members of the medical profession and the broader public. During the late nineteenth and early twentieth centuries, Jex-Blake, in

addition to other female physicians, such as Garrett Anderson, passionately defended

women’s work and worthiness as medical professionals by making explicit arguments in

professional publications, although their opportunities to participate in these publications

were often limited by the lingering resistance of their editors to female physicians.

Physicians and non-physician advocates for female physicians also brought the case of 57 female physicians to popular periodicals such as The Nineteenth Century and Ludgate

Magazine and niche magazines such as Atalanta, The Girls’ Own, and Woman throughout the late Victorian and Edwardian periods. Female physicians often wrote for both popular and professional journals to aide in women’s issues of professional status.

Elizabeth Garrett Anderson, for example, wrote to the Lancet and the British Medical

Journal, as well as The Fortnightly Review to defend the female physician against her detractors.

Supporters of medical women outside of the medical profession also participated in efforts to reconfigure medical women’s ethos. In the 1913 volume of the Pall Mall

Magazine, for example, Wanda de Szaramowicz challenges her readers’ assumptions about the nature of the female medical profession. She begins her article “The Woman

Doctor” by offering her readers a description of a woman who presents a striking and charming appearance to those who observe her. De Szaramowicz describes a

“charmingly-dressed woman, with [a] fashionable hat and smart sunshade.” She asserts that the unenlightened onlooker would likely be surprised to discover that the beautiful and youthful woman she describes is also “the brilliant gynaecologist at a big London hospital” (De Szaramowicz 497). In response to the juxtaposition between her friend’s admirable appearance and her professional position, she indicates her own initial shock at the combination of her friend’s profession and charming character and appearance. She writes, “[I]f I could have taken you aside to whisper in your ear, ‘She is a fully-qualified doctor,’ I could have understood your turning round and saying, ‘I don't believe it!’” (De

Szaramowicz 497). Despite her earlier, youthful surprise that a female physician could possess an admirable character, intelligence and appearance as well as a high professional 58

position, the older, more knowledgeable De Szaramowicz expresses disappointment that

her contemporary Britons – a full four decades after the full admission of women to

medical education and medical profession – would continue to find the juxtaposition of

femininity and medical skill jarring. She indicates her dismay that “even to-day there are

many people who would at any rate reply, “You don't say so!” to her assertion that her friend is a highly qualified medical professional (De Szaramowicz 497). De

Szaramowicz’s generation of an alternative representation of this female physician both criticizes existing representations of women physicians and offers a significant alternative

to these representations.

Supporters of female physicians, however, did not limit their attempts to bolster

their professional status to such explicit arguments. Writers also advocated for equal recognition of medical women in both the medical profession and the public by generating alternative representations of women physicians in the various fictional genres of Victorian and Edwardian print culture, including short stories, non-fiction, and novels.

Female physicians and non-physician social activists wrote novels featuring virtuous and competent female physicians. These novels, from Charles Reade’s A Woman-Hater

(1877) to Hilda Gregg’s Peace with Honour (1897) depicted medical women’s lives and work in more sympathetic lights than previous representations by those opposing female physicians. Likewise, writers such as L.T. Meade and Arthur Conan Doyle published short stories about female physicians for the popular press. Writing for such diverse publications – both in fictional genres and non-fiction writing for the periodicals of the late nineteenth and early twentieth century – brought what might have been insular conversations about women physicians’ professional ethos to the general public and 59

allowed a more diverse set of writers to participate in the formation of women’s

professional ethos. These representations, however, were not always successful in

resolving the tension between society’s suspicions of women and their right to enter into the medical profession.

Merely offering alternate representations of female physicians that aimed to

improve depictions of medical women’s character did not alleviate the appearance of

incommensurability between medical women and their profession, however. Many

attempts by supporters of female physicians to represent them as fully-fledged members

of the medical profession reinforced the incompatibility of who society recognized as a

“woman” and who it recognized as a “physician.” Charles Reade’s A Woman Hater

(1877), serialized in Blackwood’s Edinburgh Magazine after the passage of the Enabling

Act of 1876, details the trials faced by fictional female physician Rhoda Gale before she

meets the eponymous “woman-hater” Harrington Vizard. Supposedly modeled in part

upon Sophia Jex-Blake after her struggles at the University of Edinburgh, Gale is

tenacious, bright, ambitious, and skillful at her profession. She both improves the living

conditions of Vizard’s tenants by instituting public health measures and saves the life of

his lover, a famed opera singer, after a head injury. Despite Gale’s skill as a physician

and her attempts to improve the lives of those around her, Kristine Swenson has pointed

out, Reade still makes the medically-competent Gale an “odd woman” with a prickly and

“unladylike” nature (Swenson 102). Thus, although Reade’s novel seeks to support

medical women, it reinforces the dichotomy between the ideals of Victorian womanhood

and medical women. This struggle was also dramatized in fictional works on women

physicians by Arthur Conan Doyle, Henry Curwen, Annie Swan, and Maxwell Grey. 60

Despite their stated support of medical women, then, writers often reinforced

assumptions about female physicians by focusing on women’s competence or character,

rather than reorienting how readers thought about womanhood or the medical profession.

In analyzing how female physicians and their supporters sought to change societal

attitudes toward the various aspects of women physicians’ ethos, this dissertation enacts

David Zarefsky’s “fourth sense” of rhetorical history. Zarefsky defines this “fourth sense” as the study of historical events from a rhetorical perspective, “beginning with the assumption that the rhetorical historian has the same subject matter as any other historian:

‘human life in its totality and multiplicity’” (Zarefsky 27). Rather than detailing economic, political or ideological shifts in history, as might historians in other disciplines, Zarefsky writes, the rhetorical historian examines history as “a series of

rhetorical problems, situations that call for public persuasion to advance a cause or

overcome an impasse.” Thus, the rhetorical historian draws on the methods of rhetorical

theory to analyze history “from the perspective of how messages are created and used by

people to influence and relate to one another” (Zarefsky 28). This dissertation recognizes

the inherent rhetoricity of medical women’s situation in the late nineteenth and early

twentieth centuries and, by drawing on rhetorical methods to analyze historical texts,

traces how these women sought to overcome the rhetorical impasse posed by the conflict

between their presence in the medical profession and the social norms of their time.

The print culture of the late nineteenth and early twentieth centuries allowed

medical women the opportunity to enact rhetorical persuasion in previously impossible

ways. The constellation of textual genres in the late Victorian and Edwardian period

allowed women physicians to exercise kairos, what Segal defines as “the principal of 61 contingency and fitness to situation” (Segal 20). Kairos is often glossed by scholars such as Susan Jarratt as “timeliness” or a sense of knowing when and how to act or speak in a particular moment for the greatest persuasive influence (Jarratt xv). Women physicians exercised kairos as they made use of the particular rhetorical opportunities afforded them by the print culture of their time period; by writing for the audiences of the various genres of late nineteenth and early twentieth century print culture, women physicians and their supporters had the potential to enact changes to the medical profession and the broader public’s views medical women’s ethos and the various communities to which these women belonged. The use of these different forms of print enabled or closed off particular ways of communicating ideological and social discourses. As Risa Applegarth has suggested, the constraints of genre as a social and discursive location “significantly shape[s] one’s possibilities for ethos” (Applegarth 50). Genres, Applegarth writes,

“organize rhetorical resources as well as structure rhetorical constraints” (Applegarth 50).

Such constraints were especially prominent in the formal, social and technological affordances and limitations of print in the late nineteenth and early twentieth centuries.

The constraints and affordances of each genre enabled writers to posit new ways of imagining female physicians, women, and the medical profession in print culture and, thus, societal and intraprofessional attitudes toward both medical women and their profession.

Women physicians writing across genres: chapter summaries

The first chapter of this dissertation details women physicians’ use of the Magazine of the

London School of Medicine for Women and Royal Free Hospital (MLSOM), composed 62 by and for the female members of the medical profession, to define a distinct “character” for medical women between 1895 and 1915. Existing models of goodwill, good sense and good character for the medical profession were crafted before women’s entry into medicine. On their entry into the profession, female physicians worked to reject or integrate these models into their roles as professionals. Founded in 1895, the MLSOM allowed women physicians to craft a print “body” that collected and disseminated the various circulating versions of medical women’s collective professional character. The articles in this magazine, however, demonstrate a “fracturing” of attitudes toward definitions of women’s character, especially their relationship to traditional femininity.

This fracturing, however, is productive, rather than damaging; beyond simply shaping a single, idealized collective character for its audience, the magazine instead hosts a number of possible characters for female physicians.

Chapter two maps female physicians’ and their allies’ frustration at the limitations of realistic fiction as a means of constructing and supporting women’s rhetorical ethos. In the 1890s, women physicians and their supporters criticized existing “lady doctor novels”

– New Woman novels with female physicians at their center – for the perfection or weakness of the female physicians represented. They called, therefore, for more realistic portrayals of the figure of the woman doctor. This chapter analyzes Sophia Jex-Blake and

Hilda Gregg’s responses to “second wave” woman doctor novels: Henry James’s The

Bostonians (1886), Margaret Todd’s Mona Maclean, Medical Student (1892) and

Gregg’s Peace with Honour (1897). Jex-Blake – a physician – and Gregg – a writer of women’s adventure fiction, approach these novels from notably different angles. Both writers worry over the failures of woman doctor novels, especially in their inability to 63

promote medical women’s cause, and conclude that writers of such novels need to take

greater care in representing their subjects. Where Jex-Blake is most concerned about the perspectives on medical women’s ethos generated by these novels, Gregg concerns center around their effects on their readers. Both writers, however, anticipate the slow death of the woman doctor novel as a distinct genre in the twentieth century, as both argue that writers should de-emphasize medicine in order to make more effective use of the political potential of novels.

Chapter three analyzes two of L.T. Meade’s popular serialized short stories published at the turn of the century. Scholars have long argued that these stories serve as an anomaly in Meade’s otherwise feminist oeuvre, as these serials represent villainous

female physicians threatening British people and the British nation. Much as Sophia Jex-

Blake and Hilda Gregg advocate for better representations of medical women’s ethos,

Meade also supported British women physicians’ ethos through her writing for The

Strand. This chapter argues that Meade’s seemingly “inconsistent” writing for The

Strand is a transformation of her feminist ideologies for a broader, less sympathetic audience. These villainous women doctors – foreign, uncredentialed, lacking British values – stand in opposition to representations of female physicians in Meade’s young woman’s magazine, Atalanta. Although Meade creates dangerous female physicians to entertain her audience in The Strand, these depictions serve not as explicit warnings against female physicians, but as endorsements of legitimate, credentialed female physicians in Britain at the turn of the century.

Chapter four charts the indirect development of ethos in Carolyn Matthews’ writing about her experiences in the Serbian War of 1913. While female physicians 64

negotiated the possibilities for professional character in their professional journals,

writers supportive of female physicians also took advantage of the popular presses and

new genres of writing to reinforce their ethos before a larger audience. In such forums,

writers negotiated ethos less directly than in the MLSOM. This chapter argues that, much

as other war correspondents did, Matthews establishes her rhetorical authority through

autopsy, or first-hand observation. This rhetorical authority also allows her to perform

other acts of ethos construction, as she foregrounds a representation of herself as a

trustworthy, knowledgeable and well-intentioned physician in the war-zone. Matthews demonstrates to her readers that, in her professional practice, as in her war correspondence, she can perform the various aspects of ethos and, thus, deserves the same rhetorical authority granted male physicians.

An epilogue synthesizes my analysis of ethos in the four genres explored above to survey the construction of professional ethos in the Victorian and Edwardian periods. As it concludes, this dissertation looks past the end of the Edwardian period. Beyond the beginning of World War I, the pressing necessity for skilled medical professionals drastically altered cultural attitudes toward female physicians. By 1920, the number of female physicians had risen to two thousand one hundred and the exclusion of women from men’s medical schools waned, as co-education began to gain ground. This epilogue argue that these advances are intimately connected with women’s earlier generative constructions of ethos, as these earlier efforts laid the groundwork for these later interventions.

Chapter 1: Women’s Medical Journals: Creating a Counterpublic for Medical Women in the Magazine of the London School of Medicine for Women

Ulysses Williams, in a July 1914 article for the Magazine of the London School of

Medicine for Women and Royal Free Hospital (MLSOM), warns his audience of female medical students about difficulties they will encounter in their future medical practice.

Williams asserts that, when these students are called to see a patient, “[the patient] cannot judge of your professional knowledge, or the accuracy of your diagnosis. She has no key to the inner workings of your mind. She can only estimate your worth by the external woman and manner that she sees” (Williams 90). Throughout his article, Williams underlines this disparity between the aspects of a female physician’s character less tangible to her audience – her knowledge, her medical skill, and the “workings” of her mind – and her patient’s perception of this same character, which is formed only through the patient’s observation of the female physician’s external physicality, behaviors, and mannerisms. For Williams, then, female physicians possess two conflicting characters in the public sphere: their individual inner “character” and the “character” perceived and articulated by others. Williams advises rising female physicians that they must be aware of and be prepared to navigate these often conflicting public and personal professional characters.

As in Williams’ example, attitudes toward the “female physician” in the late nineteenth and early twentieth centuries were formulated and circulated in the discourses of professional and general “publics” largely outside of female physicians’ control.

Michael Warner has defined “publics” as “multicontextual spaces of circulation, organized not by a place or an institution but by the circulation of discourse” (Warner

119). During the late Victorian and Edwardian periods, the discourse of these publics 66 circulated most widely through print. As in Williams’s warnings to female medical students, the print discourses of the general public and the public of the male-dominated medical profession represented female physicians as collectively possessing traits alien to how women physicians perceived their own professional character; writers of both popular and professional texts described female physicians as “unsexed,” emotionally unstable, and incompetent.

The reconciliation of these two conflicting characters had been a continual concern for female physicians since the entry of British women into medical practice in

1876. Physicians including Elizabeth Blackwell, Sophia Jex-Blake, and Mary Putnam

Jacobi had begun to articulate collective professional character for women physicians in private correspondence, monographs and general medical journals but often disagreed about the nature of their collective professional character. Until the 1890s, medical women lacked a print space where they could work through the formation of women’s collective professional character collectively and experienced resistance to their intervention into the discursive spaces of dominant publics. In May 1895, however, two decades after the admission of women into the medical profession, the staff and students of the London School of Medicine for Women (LSOMW) founded the MLSOM under the editorship of Isabel Jane Thorne, LSOMW alumna and the school’s secretary. Published from 1895 to 1947 and with a circulation that grew with the number of women in the medical profession, the MLSOM allowed female physicians to focus on the subject of medical women’s professional character in conversation with a larger number of medical women – without the need to defend their right to be physicians and without interference from men who would deny them access to the discursive spaces of their profession. The 67

magazine facilitated the process of articulating how collective ideals of physicality,

behavior, and knowledge could or should be exercised in women’s medical practice – when the bodies, skills, and behaviors of female physicians were still under suspicion in the public sphere. Thus, the MLSOM served as a host to an emerging “counterpublic” – what Michael Warner has defined as an alternate “public” consisting of a distinct group of readers or writers defined in opposition to the dominant public – of medical women

(Warner 117-8).

Hosting the discourse of the emerging counterpublic of medical women, the

MLSOM resolved some earlier conflicts over women’s collective character while

reiterating others. As in other women’s magazines of the time, the magazine’s editors

shape a clearer sense of some aspects of its readers’ collective professional character

through their decisions of what content to include in the magazine and in their editorial

comments, including women’s fitness for medicine. Despite such editorial interventions,

some aspects of medical women’s collective character remained inconsistent or, to

borrow from Margaret Beetham, “fractured,” in the MLSOM’s early run. This

“fracturing” becomes clear as contributors discuss the fields in which women could

practice in the years before World War I. As were earlier women physicians, the

MLSOM’s contributors were divided on whether women should train and practice in the

same fields as men. While they exercised a guiding hand, the magazine’s editors allowed

ambiguity on this question, which enabled members of the counterpublic of medical

women to explore and negotiate the intricacies of medical women’s collective character

in a more sustained and responsive form than the earlier writing of women physicians.

This “fracturing” did more than retread old disagreements, however, and was ultimately 68

more productive than damaging. It encouraged contributors to rework visions of this

character posited by earlier women physicians and to articulate new and diverse

imaginings of this character. Beyond simply shaping a single, idealized collective

character for its audience, the MLSOM instead hosts a number of possible collective

“characters” for the members of medical women’s counterpublic, each containing

different ideals for the interactions between women’s gender and their profession –

distinct from those circulated in the dominant publics and in the writing of earlier women

physicians. In its first twenty years of publication, then, the MLSOM served as a

collective print body that housed multiple, ever-emerging and ever-evolving collective characters for the distinct and emerging counterpublic of British women physicians.

Medical women and early attempts to define medical women’s character

The negotiation of medical women’s professional character began in private

correspondence and the public sphere after women’s full admission to the British medical

profession in 1876. While they agreed on women’s fitness for medicine, these women

often disagreed on the intricacies of women’s professional character. Scholars such as

Regina Morantz-Sanchez, Claire Brock, and Catriona Blake have noted that women

physicians wrote widely on their new professional roles. Morantz-Sanchez has discussed

the disagreement on the role of women physicians in the 1880s and 1890s in the private

writing of Elizabeth Blackwell, the first woman entered into the British Medical Register,

and American physician Mary Putnam Jacobi. Blackwell embraced a view of women

physicians “derived from the ideology of domesticity” and emphasized the differences

between the sexes (Morantz-Sanchez 196). Blackwell, Morantz-Sanchez notes, wanted

women to join the medical profession because they “exhibited unique qualities which 69

would allow them to make a distinct contribution to the profession” (Morantz-Sanchez

196). Putnam Jacobi, conversely, while conceding that female physicians possessed unique skills valuable to the medical profession, largely rejected Blackwell’s positioning of “female physician” as separate from that of “physician.” Morantz-Sanchez notes that

Putnam Jacobi urged her fellow female physicians to become more fully integrated into the medical profession and to cease thinking of themselves as separate from male physicians (Morantz-Sanchez 198). These women disagreed, then, on whether women should distinguish themselves and their medical practices from those of male physicians on the basis of their gendered traits.

This conflict over whether women physicians’ collective character should be distinguished from that of men resonated throughout other female physicians’ writing into the 1890s. Other early women physicians, including Sophia Jex-Blake, Elizabeth

Garrett Anderson, and Marie E. Zakrzewska, were divided on this question. Their writing reveals numerous practical and professional issues related to the formation of a distinct and gendered collective professional character: the “un-sexing” of medical women if they sought to conform to the masculine norms of the profession,16 whether medical women should marry and bear children,17 whether they should only specialize in women’s and pediatric health,18 whether women possessed “special knowledge” of women’s health as

a result of their “feminine” bodies,19 and women’s ability to endure the “burdens” of scientific knowledge or the full “horror” of medical practice.20

16 See Wells, Out of the Dead House: Nineteenth-Century Women Physicians and the Writing of Medicine, 6. 17See Brock, “Elizabeth Garrett Anderson and the professionalism of medical publicity,” 333-4. 18 Morantz-Sanchez 173. 19 See Sophia Jex-Blake, Medical Women: A Thesis and a History, 49. 20See Sophia Jex-Blake, Medical Women: A Thesis and a History, 39-40. 70

At the same time as they were having these discussions, women physicians lacked

discursive spaces to communicate collectively about their professional character.

Conversations between medical women about this character were limited to private

correspondence, single-authored monographs, and periodicals aimed at general

audiences. Many of the early debates over the collective character of medical women

occurred, as in the conversation between Putnam Jacobi and Blackwell, in private

correspondence. As the number of medical women climbed near the end of the century,

however, conversations about medical women’s character spilled into the public sphere.

Women physicians wrote monographs, for popular periodicals, or for general medical

journals – print spaces aimed at non-gendered or non-professional audiences. Each of these genres had significant disadvantages for facilitating discursive exchange between medical women. While monographs, such as Jex-Blake’s influential Medical Women; a thesis and history (1886), allowed a writer to delve deeply into her argument, such texts served not as mediums for negotiation, but as print artifacts where a writer could posit her sustained views on a topic at a single moment in time. Monographs could be amended through subsequent editions but were otherwise static. Women physicians ostensibly had opportunities to participate in dynamic conversations about medical women’s character in the periodicals. In most periodicals, however, women physicians wrote for the general audience of that periodical. Such writing to the general public most often centered on defending women’s rights to practice medicine or on offering histories of the movement, 71

rather than on resolving the lingering intra-professional conflict about the nature of

medical women’s collective character.21

Writing to more professionally-focused periodicals, however, did not remove

obstacles to medical women’s negotiation of their collective character in the public

sphere. Catriona Blake has highlighted movements by male physicians to bar their female

colleagues from the discursive spaces of late Victorian and Edwardian medicine (Blake

24).22 Established print institutions serving the medical profession were dominated by

male physicians, many of whom still resisted the presence of women. Women could not

publish in periodicals for the alumni of men’s medical schools and general hospitals,

professional spaces into which women had yet not made headway.23 More troublingly,

women’s voices were often excluded from the primary periodicals responsible for the

circulation of the medical public’s discourse, the British Medical Journal (BMJ) and the

Lancet. Men’s writing dominated these journals, and women’s writing appeared sparingly

– most frequently in correspondence columns, rather than in original research or commentary on the state of the profession. The Lancet was especially resistant to women physicians’ writing, as its late nineteenth century editors, James Wakley, T.H. Wakley and Thomas Wakley II, opposed women in the medical profession more vocally than the editors of the BMJ. The discourses of the medical public in the late Victorian and

Edwardian periods, consisting of the various medical journals and professional

21 See Sophia Jex-Blake, “Medical Women, 1877,” The Nineteenth Century, November 1887, 692-707; Elizabeth Garrett Anderson, “A History of a Movement,” Fortnightly Review, March 1892, 404-17; Robert Wilson, “AESCULAPIA VICTRIX,” Fortnightly Review, January 1886, 18-33. 22Male physicians positioned medicine as a “‘community’ of men, bound together by a system of exclusive associations, journals and clubs” (Blake 24). 23 Women physicians’ professional opportunities and connections were restricted to the few hospitals that treated women, and work abroad initially had no such publications. 72

organizations of medicine, then, were largely dominated by representations of and

discussions about medical women’s collective character crafted by men.

In addition to the dominance of male voices and editors in these journals, women

physicians writing to the BMJ and the Lancet faced open hostility for participating in

professional discussions. A striking example of such antagonism occurred in a run of

issues following James Crichton-Browne’s “Sex and Education,” printed in the BMJ in

May 1892. Crichton-Browne argues that men and women have distinct mental capacities

as a result of the different structures and functions of their brains (Crichton-Browne,

“Annual Oration” 949-54). A writer adopting the pseudonym “A Medical Woman” questions Crichton-Browne’s research design, particularly his small sample size (A

Medical Woman 954). Responding to this letter in a later issue, Crichton-Browne dismisses A Medical Woman’s objections to his study as “an illustration of some of the shortcomings which characterise the female intellect when applied to problems which it is structurally unfitted to deal with” (Crichton-Browne “Correspondence. 14 May 1892”

1046). Throughout his response, Crichton-Browne undermines A Medical Woman’s participation in medicine’s professional discourse by declaring her “misunderstanding” of his methods to be a result of her inferior, “feminine” brain. He writes,

[A Medical Woman] must pardon me for saying that, unwittingly I am sure,

carried away doubtless by her sympathies and predilections, she has

misrepresented my position and misunderstood my arguments, and has more than

once, with that fine feminine contempt of logic which is always charming if

sometimes perplexing, drawn an erroneous deduction from false premisses.

(Crichton-Browne “Correspondence. 14 May 1892” 1046) 73

Crichton-Browne’s dismissal of A Medical Woman does not rest on the validity of her

criticisms – the appropriateness of his sample size – but on his assertion that women

physicians cannot engage in criticism of male physicians’ scientific work. Crichton-

Browne adopts much the same approach in responding to Elizabeth Garrett Anderson’s

objections to this same study. He urges Garrett Anderson to “refer to her obstetric

textbooks” and asserts that “her somewhat exceptional experience of her own

sex” distorts her ability to understand his study (Crichton-Browne 1110-1). Thus,

Crichton-Browne differentiates the knowledge and impartiality of medical women and that of medical men – arguing that women cannot be impartial in the ways men can – and places them on different footing on the ostensibly even discursive ground of the BMJ.

This atmosphere of hostility toward medical women pervaded conversations in

the BMJ and the Lancet.24 Entering into discursive exchange with their male colleagues

in these medical journals meant that women entered the exchange at a disadvantage; their

suggestions and arguments about the state of the profession were likely to be immediately

dismissed on the basis of the “inferiority” of their “feminine” minds and bodies. What

medical women lacked, therefore, in the years after their admission into the medical

profession was a location where they could engage in discussions about their place in the

profession with other female physicians, rather than from their compromised rhetorical

24 Other correspondents to the British Medical Journal, responding to Crichton-Browne’s speech and the letters of “A Medical Woman” and Garrett Anderson echo Crichton-Browne’s criticisms of medical women’s arguments on the basis of gender, although with less naked hostility than the original author. Complaints against “A Medical Woman” and Garrett Anderson address women physicians as less qualified than male physicians to participate in medical discourse, as a result of their “feminine” failures of impartiality and inaccuracy. See W. S. Playfair, “Correspondence. Sex and Education,” British Medical Journal, May 21, 1892, 1111; and John Strachan, “Correspondence. Sex and Education,” British Medical Journal, May 21, 1892, 1111. 74

position in the existing public of the medical profession or periodicals aimed at the

general public.

Niche periodicals and the counterpublic of medical women

In the face of such limitations in public and professional discourses, women physicians

took advantage of the print culture affordances of the late nineteenth and early twentieth

centuries to found the MLSOM. The expansive print culture of this period allowed

women physicians the opportunity to create a new space where they need not enter

discursive exchange about their collective character at a disadvantage. Niche periodicals

offered female physicians and other marginalized individuals greater opportunities to

construct such distinct print spaces. As Margaret Beetham has noted, owing to

technological advances that made printing less expensive and more accessible, the niche

or “class” periodical, which addressed a narrower audience, surged in popularity during

the latter part of the nineteenth century (Beetham 5). Writers and editors could craft print

“bodies” that appealed to the particular concerns and biases of a niche audience. Women had more opportunities to find distinct communities in print, and the number of periodicals for women increased as the century drew to a close.

First published in May 1895 under the editorship of Isabel Jane Thorne, the

MLSOM represents one of the first niche periodicals for professional women, alongside

the Women’s Industrial News and Nursing Notes.25 The MLSOM, which charged two

shillings for a yearly subscription of triannual and later quarterly issues, addressed the

growing community of medical women in its early stages of formation. Initially, the

25Women’s Industrial News was first published in 1895 by the Women’s Industrial Council, and Nursing Notes was first published in 1887 by the Midwives’ Institute. 75 magazine addressed a small and circumscribed audience; it had a limited circulation of current students and staff of the LSOMW and the Royal Free Hospital – barely high enough to support its printing costs. In the magazine’s early issues, however, Thorne envisions the MLSOM as having a significantly wider reach. In May 1895, she writes that, by printing letters and accounts from graduates and students from other women’s medical schools, she hopes to connect the women of the LSOMW and beyond (Thorne

4). As the number of women in the profession expanded from twenty-five in 1891 to

2100 in 1921, the periodical fulfilled Thorne’s hopes (Dyhouse 321). As the number of female physicians grew, the MLSOM’s readership blossomed, establishing a global network of British medical women – from London to isolated outposts in the Hebrides to remote locations such as India, Canada, Australia and South America. The MLSOM served as a print body where this growing subset of the medical “public” could come together in ways not possible through private correspondence or print venues aimed at the medical or general publics.

Niche magazines such as the MLSOM enabled the formation of counterpublics.

Like publics, counterpublics are groups bound together by the circulation of discourse.

Counterpublics, Michael Warner writes, “mark themselves off unmistakably from any general or dominant public. Their members are understood to be not merely a subset of the public but constituted through a conflictual relation to the dominant public” (Warner

117-8). General periodicals in the late nineteenth century addressed general audiences – typically assumed to be male – and so often failed to address or contradicted women’s views and experiences. During this period, women could read a variety of niche periodicals designed for them: general women’s periodicals, such as The Victoria 76

Magazine and The Ladies’ Cabinet; politically focused periodicals, such as The Women’s

Signal and The Englishwoman’s Review; and domestic magazines, such as The Woman at

Home and Woman’s Life. Niche magazines for women addressed not the needs of the

male-dominated medical or general publics, but counterpublics of women whose

particular views and values differed from those of the publics addressed by general

magazines. Through the foundation of the MLSOM, medical women established their

own counterpublic by circulating discourses that would not be circulated or that would be

circulated and then dismissed as inferior in the discursive spaces of dominant publics.

Figure 3: Frontispiece of the MLSOM, No. 1 (courtesy New York Academy of

Medicine)

The MLSOM posited itself as an alternative to existing discursive spaces closed

off to women physicians, including the BMJ and Lancet. The magazine functioned as a distinct print body for medical women – a location where women physicians’ discourses could be collected, circulated and read by other members of the counterpublic. The 77

magazine’s title and tagline – “Work is as it is done” (Figure 3) – set the magazine apart

from its peers. In the magazine’s first issue, Thorne outlines female medical students’

unanimous desire for a magazine focused on conversations about their particular

experiences. Thorne expresses the magazine’s goals as “promot[ing] fellow feeling

among the different sections of our School, and [linking] together past and present

students.” She foregrounds this desire by drawing on a quotation from Alexander Pope’s

translation of Homer’s Iliad as the epigraph to her opening editorial: “By mutual

confidence and mutual aid / Great deeds are done, and great achievements made” (Thorne

3). The essay and epigraph assert the magazine’s ability to build community and, through

the “mutual confidence” and “mutual aid” afforded by that community, for the possibility

of “great deeds” and “great achievements” by its members. In its first two decades, the

MLSOM’s editors and contributors, following Thorne’s precedent, consistently frame the

magazine as a print medium for the cultivation of community and collectivity among

female physicians.26

The MLSOM’s writers and editors cultivated Thorne’s “fellow feeling” among its

ever-widening network of female physicians through the circulation of medical women’s

writing. Although it sometimes featured the LSOMW’s male staff, more often, the magazine focused on medical women’s contributions. Unlike the BMJ and Lancet, the

MLSOM presented articles from the pioneering female physicians of the late nineteenth

and early twentieth centuries, including Elizabeth Garrett Anderson, Flora Murray, and

May Thorne, as well as female students and staff at the LSOMW. The magazine’s editors

encouraged the participation of its readers, periodically calling for the students, staff and

26 See “The London School of Medicine for Women,” MLSOM, June 1901, 785 – 792, and “Hospital and School News,” MLSOM, February 1904, 300 – 308. 78 alumni of the LSOMW to submit scientific articles, accounts of work abroad, and updates on awards and appointments. Throughout its early run, the magazine also published less professionally-focused information, such as listings of marriages and births, details of women’s travel abroad, and scores from the matches of the LSOMW’s field hockey team.

The MLSOM also featured satirical content composed by its medical students, poking fun at the ignorance of patients, their classmates’ quirks, and misperceptions of female physicians in broader culture. The magazine included profiles of key figures in the movement for women physicians, including Edith Pechey, Elizabeth Blackwell, and

Sophia Jex-Blake. The inclusion of perspectives from contributors at various stages in their professional careers meant that the magazine collected a range of perspectives on personal and professional issues, including lingering questions about the nature of medical women’s professional character, in ways not possible in the general professional magazines, in periodicals for the general public or in other women’s magazines of the time.

Among the various issues they addressed in the magazine’s first twenty years, the

MLSOM’s contributors identified women’s collective professional character as a key concern. In addition to Ulysses Williams’ discussions of medical women’s sometimes conflicting professional and personal characters, other writers for the MLSOM indicated that women’s status in the profession and, thus, their collective character as medical professionals were unstable. In 1910’s “Women’s Sphere in Medicine,” E.W. Roughton outlines his belief that female physicians will inevitably take on more active roles in the profession, necessitating shifts in how women physicians are understood as professionals

(Roughton 305). Likewise, in November 1911, in “Women in Medical Research,” the 79

MLSOM’s editor writes that women’s “achievement[s]” in medicine and medical research

“will doubtless be larger in the future” as more opportunities arise. She asserts that

understandings of women in medicine need to be re-evaluated according to those shifts

(“Inaugural Address” 469). Williams, Roughton, and the editor of the MLSOM, then,

indicated a need for continued articulation of a clear but evolving collective professional

character for women physicians.

The counterpublic of medical women had the opportunity to craft such a

collective character for themselves through the MLSOM’s formal features. Recent studies on women’s niche periodicals, such as Arlene Young’s work on The Queen and Kristine

Moruzi and Michelle Smith’s work on The Girl’s Own Paper, have suggested that such periodicals shaped the collective gender ideologies of their audiences.27 The circulation

of discourse through a niche periodical, however, shapes more than gender ideologies.

Print discourses, such as those circulated in the MLSOM, are naturally bound up with a counterpublic’s collective character. Michael Warner argues that public discourse acts as a rallying cry for members of a public or counterpublic and, thus conveys a sense of collective character through what Louis Althusser has termed “interpellation” or

“hailing.” Warner writes,

Public discourse says not only “Let a public exist” but “Let it have this character,

speak this way, see the world in this way.” It then goes in search of confirmation

that such a public exists, with greater or lesser success – success being further

attempts to cite, circulate, and realize the world understanding it articulates. Run

27 See Kristin Moruzi and Michelle Smith. “‘Learning What Real Work . . . Means’: Ambivalent Attitudes Towards Employment in the Girl’s Own Paper.” Victorian Periodicals Review 43, no. 4 (2010): 429 – 445; and Arlene Young. “Ladies and Professionalism: The Evolution of the Idea of Work in the Queen, 1861- 1900.” Victorian Periodicals Review 40, no. 3 (Fall 2007): 189 – 215. 80

it up the flagpole and see who salutes. Put on a show and see who shows up.

(Warner 114)

A public discourse “hails” the members of a public or counterpublic it addresses by proposing common values and norms. Through these values and norms, public discourse, such as that circulated through the MLSOM, invites its audience into acts of identification with a collective character constituted by those values and norms in aggregate. The citation, circulation, and realization of a particular public or counterpublic’s discourse through the print body of a magazine can articulate collective character for its audience, even the small and circumscribed audience of a counterpublic in its infancy, such as that of medical women in the late Victorian period.

Such “hailing” of collective character was omnipresent in Victorian women’s magazines, both explicitly and implicitly. As Margaret Beetham and Kay Boardman have noted, Victorian women’s magazines offered guidance for their readers through advice columns and columns focusing more narrowly on issues of dress, reading, and etiquette

(Beetham and Boardman 166). The Englishwoman’s Domestic Magazine, for example, featured a popular advice column, “Conversazione.” In January 1866, for example,

“Conversazione” idealizes modesty, thrift, industry, decorum, and national loyalty.28 The magazine explicitly hails its audience by positing values and behaviors with which its audience of female readers can identify. The editors of late Victorian women’s magazines also implicitly flagged issues and conversations as valuable for readers through their

28 In the January 1866 issue of the magazine, for example, the magazine advises readers that they should only sing English ballads at holiday parties, that young girls should maintain budgets to develop skills they will use later in life, that one must not behave immodestly after one falls in love for the first time, and that a young woman is better served to find a “humble situation” near her home, rather than seeking one abroad in Paris. See “Conversazione” 32. 81

decisions of what to include in and exclude from a magazine’s pages. These magazines

promoted character ideals through their content: through profiles of society or

professional women, through fiction or poetry, by facilitating discussions about women’s

relationships to various aspects of late Victorian life, and by responding to conversations

about women’s gender identity occurring in broader culture.29 For example, alongside a short story about a female physician, an 1894 issue of Annie S. Swan’s The Woman at

Home featured columns on cooking, dinner parties, dress, house furnishing, health, personal appearance, and motherhood. As editor, Swan flagged the topics and content that she saw as significant for her readers – pairing domestic discourses with favorable representations of professional women. She hailed an audience sympathetic to both domestic and professional expressions of femininity and created a collective identity with which her audience could identify.

Much as in these other women’s magazines, the articles and speeches re-printed

in the MLSOM interpellated a particular set of traits, norms and values for its

counterpublic through its implicit idealizations of behavior, physicality, and knowledge.

The collective character interpellated in the MLSOM, however, was notably distinct from that of other women’s magazines and general medical journals. In her speech before the

Society of Medical Women, “Normal Menstruation and Conditions that Interfere with it,” re-printed in the MLSOM in November 1913, for example, Florence Willet lectures on

29 The Victoria Magazine, for example, in its July 1880 issue, devoted space to a lengthy discussion of the inevitability of women’s suffrage by reprinting a speech delivered by Mrs. Lynch at a meeting of fellow suffragists. “Women’s Suffrage” brought the debate over women’s place in the political sphere to the Victoria Magazine’s readers, as Lynch responds to broader discussions of women’s suffrage in both a speech by Lord Palmerston as well as other nineteenth century periodicals, such as Macmillan’s Magazine, the Contemporary Review, the Women’s Suffrage Journal, the Westminster Review, and the Examiner. The re-printing of the speech allowed Lynch’s words to reach an audience far beyond the drawing room where she initially delivered it. See Lynch 49 – 59. 82 gynecology and obstetrics. In addition to her own research on the subject, she focuses on menstruation because every medical woman “must have some valuable experience to contribute to the subject” (Willet 276). Willet speaks to her audience as already possessing the knowledge granted by this physical experience, positing grounds for identification. Willet does not “hail” the general public of the medical profession but, rather, medical professionals who possess a distinct set of physical traits and knowledge – assuming the audience she addresses to have experienced and possess an intimate understanding of menstruation. The editor’s choice to include this speech in the magazine contributes to its “hailing” of its audience and the creation of a collective character for the counterpublic it addresses – one that assumes female physicians to have experienced and possess a more intimate understanding of menstruation than their male peers but also to occupy a professional position that enabled them to make broader applications of this knowledge beyond their individual experiences as women. As writers crafted and editors aggregated representations of medical women’s character, the MLSOM allowed the members of its counterpublic to participate in shaping the collective character of that counterpublic.

The MLSOM interpellated a collective character for its counterpublic distinct from those posited in other publics and from earlier women physicians’ writing on a number of issues, not just medical women’s bodies. Unlike other medical journals and general women’s magazines, the magazine engaged explicitly with women physicians’ professional character and covered a significant number of issues that correlated with editors’ interpretations of this character. The question of whether women should participate in medicine’s professional discourse, for example, was a topic that Thorne, as 83

the first editor, dismissed as already settled. The magazine refused to address this issue,

which still haunted women writing for the BMJ and Lancet, beyond reiterating its

significance in the historical movement for women physicians.30 The MLSOM also interpellated a collective character for its readers distinct from those crafted by earlier women physicians. It foreclosed many of the questions about medical women’s character that troubled these writers, often by refusing to acknowledge them as points of conflict.

No text in the MLSOM suggests that women physicians should absolutely emulate men, and many writers assert the value of feminine traits in medical practice. Thus, the collective character interpellated by the MLSOM quietly refused to fully accept Putnam

Jacobi’s assertion that women needed to shape themselves to masculinized behaviors to compete in medicine. Likewise, the magazine never actively took up the conflict over whether women physicians should be married and have children. The magazine, however, included a section in every issue listing births and marriages alongside academic awards and appointments. The magazine, thus, placed the personal and professional on equal footing and subtly asserted that a woman could integrate her roles of wife, mother and accomplished physician.

Although it presented its counterpublic with an opportunity to craft their collective professional character, however, the MLSOM did not present its readers with a wholly consistent representation of this character. General uncertainty over whether women should be distinguished from male physicians still served as a major point of

30 In detailing the history of the medical women’s movement in first four issues of the magazine in 1895 and 1896, for example, Thorne characterizes women’s suitability as so settled that the struggle of the first generation of medical women – of Blackwell, Jex-Blake, Putnam Jacobi, and Garrett Anderson – is at risk of being forgotten. Thorne was a member of the “Edinburgh Seven,” one of seven women who unsuccessfully petitioned for admission to the Edinburgh School of Medicine before the opening of the LSOMW. See Blake 156, 185. 84

tension among the among the magazine’s contributors. In the magazine’s November 1911

issue, for example, Henry T. Butlin voiced his concern that women were “naturally”

more deficient than men in recording minutes and research notes (Butlin 464).31 On the

basis of this trait, Butlin questions whether women are fit for the rigors of advanced

medical research (Butlin 462). The editor responds to Butlin’s skepticism in the same

issue. She counters Butlin’s criticism of women’s “recording accuracy” by arguing that

the trait results from laziness and a lack of training rather than a “natural” flaw in

women’s professional character.32 The juxtaposition of these perspectives – whether

women are “naturally” less adept at certain tasks associated with medical practice –

offered the MLSOM’s readers a muddled sense of whether men and women physicians’

collective professional characters were distinct, rather than the cohesion Thorne and her

colleagues sought. Such disagreements occurred throughout the magazine on a host of

issues, including co-education, equal pay, and medical women’s bodies.

Such inconsistencies enact what Margaret Beetham has termed a “fracturing” of

femininity in Victorian women’s magazines. Beetham suggests that turn-of-the-century periodicals, as a result of the multiple voices and fragmentary content contained within their pages, convey a “fractured” and “heterogeneous” sense of how women should perform their femininity (Beetham 1).33 The MLSOM’s formal characteristics – its

31Butlin recounts descriptions he has heard of “lady secretaries of committees and business meetings” who are “often astoundingly inaccurate in their minutes” and whose record even “of those present cannot be relied on.” He asserts that beyond these failures to record attendance accurately, “resolutions which were passed were not properly worded in the report.” See Butlin 464. 32 As support for her perspective, the editor recounts the errors she has observed in male physicians’ notes and minutes: “[I]f we may judge from the reports of societies that are sent to us for publication, we should be disposed to five the palm not only for accuracy, but for conciseness and neatness, to the ladies.” See ““Inaugural Address” 469. 33Emily Liggins has similarly highlighted the “contradictory and ambiguous” presentation of women’s relationships to their professions posed by the inclusion of both pro-domestic and pro-professional discourses in Woman and Young Woman in the 1890s. These magazines, Liggins argues, supported 85 multivocality, intertextuality, and fragmentation – promulgated such lingering tensions on some aspects of medicine and femininity.34 Writers lauded and criticized women physicians’ performance of traits and behaviors typically coded as feminine in their medical practice, often in adjacent articles. Frances Ivens, for example, in November

1914’s “Some of the Essential Attributes of an Ideal Practitioner,” affirmed women’s innate abilities to act as “sympathetic healers” for their patients in daily practice. Other articles, such as Jane Walker’s November 1912 “Common Sense,” for example, cautioned young female physicians about a woman’s natural tendency to become distracted from her professional duties by social obligations.

Although the MLSOM reiterated some of the conflicts over women’s collective professional character that troubled earlier medical women, the magazine’s “fractured” stance on medical women’s collective character served as an opportunity for the magazine’s editors and contributors to posit multiple “characters” for medical women.

The MLSOM circulated multiple understandings of medical women’s collective character at the same time, under the guidance of its editors. A multivocal public discourse such as

women in male-dominated professions, such as medicine, science, and clerical work, by publishing positive articles about women in the professional sphere, while other articles and advertising in these same magazines value activities in the domestic sphere, such as dressmaking, child-rearing, and home- making, as indelible components of womanhood. Thus, these magazines offer their “bachelor girl” readers an incoherent representation of collective femininity. In general women’s magazines, such “fracturing,” Liggins argues, reveals editors’ and writers’ underlying doubts about women’s fitness for traditionally “masculine” professions. See Liggins 217. 34As they addressed the emerging counterpublic of medical women, the MLSOM’s editors drew on the periodical’s generic affordances, such as its responsiveness, its dialogism and its multivocality, while grappling with its formal limitations. In addition to featuring content tailored to women’s personal and professional experiences, the periodical form of the MLSOM allowed for greater responsiveness among the members of the counterpublic of medical women. Drawing on the periodical’s multivocality, the magazine’s editors encouraged readers to participate in the circulation of discourse, facilitating print dialogues through the magazine. After, for example, re-printing a speech critical of the conditions of medical work in India by Britain’s Surgeon General Charles Pardey Lukis in November 1913, the editors devoted the majority of the magazine’s next issue to content on women’s work in India, much of which engaged directly with Lukis’s speech. 86 the MLSOM does not, importantly, transfer a cohesive collective character to its counterpublic. Rather, it imagines a variety of characters that may be taken up and adopted by its readers if they identify with a particular set of presented “hailings.”

Reading Florence Willet’s speech on menstruation, for example, did not cause medical women to experience the physical signs of menstruation. Rather, medical women may have recognized their experiences in Willet’s description and, thereafter, adopted other traits she posited in her speech. The foundation of the MLSOM, importantly, did not itself create a single collective character for the counterpublic of British medical women. By positing multiple sets of norms and values, however, the MLSOM acted as a collective

“body” where multiple moments of interpellation could occur; it collected the various circulating collective characters of this counterpublic in a distinctly physical form and brought these discourses into conversation with one another, under the guidance of its editors.

Women physicians, collective character, and gendered specialization in the MLSOM

The MLSOM’s circulation of multiple collective characters for women physicians on the same issue at the same time is striking when examining conversations about the types of medicine women should practice in the magazine’s first twenty years. The MLSOM extended an existing debate as it delved into questions of women’s training and practice.

Women physicians had long been divided over whether they should specialize only in women’s and pediatric medicine. They had, in part, argued for women’s admission to the medical profession in the 1870s by asserting that the “natural” order demanded sex- segregation in both training and practice. In 1886’s Medical Women, Sophia Jex-Blake 87

notes that a woman physician can “understand and sympathize” with female patients

more than male physicians (Jex-Blake, Medical Women 49). Jex-Blake argues that women physicians’ distinction from men makes them valuable to the medical profession, because it grants them inside knowledge about women’s health and experiences. In the

1880s, Elizabeth Blackwell, Regina Morantz-Sanchez has noted, advocated that women specialize in fields that made use of their “naturally maternal” qualities – woman’s and

pediatric health (Morantz-Sanchez 196-7). Women’s restriction to practices in

gynecology, obstetrics and pediatrics, however, was not universally accepted. Mary

Putnam Jacobi, notably, writing in response to Blackwell, warned women about the

ramifications of limiting themselves to the “little corner” of women’s and children’s

health, arguing that specialization would hinder women’s professional advancement

(Morantz-Sanchez 196-7). Many early female physicians shared Putnam Jacobi’s vision

of women working beyond women’s and pediatric health. Claire Brock has noted,

however, that many women did not advocate for such advancement for fear of alienating

their supporters – many of whom occupied positions in the exclusive and wholly male

branches of medicine (Brock 322).

The negotiation of women’s distinction from male practitioners in the fields in

which they practiced continued in the MLSOM in two distinct conversations: first, about

women’s advancement in elite fields and, second, about the segregation of medical

practice and training by sex. Although they had been legally allowed to practice medicine

for nearly two decades at the magazine’s founding, women were still restricted from

more advanced medical study and continued to be funneled largely into women’s and

pediatric health – gynecology, obstetrics, and pediatrics – in 1895 (Swenson 132). 88

Writers to the MLSOM expressed their dismay about these limitations. In September

1900, Lillias Hamilton detailed her experiences of treating a man with gout in the

absence of a male physician. The man, she notes, resisted her care but eventually allowed

her to treat him because of the severity of his illness. Given the choice, she notes with

dismay, he would never have chosen a medical woman (Hamilton 727). Other women

physicians echoed Hamilton’s frustration at such devaluing of their work. In October

1906’s “The Lay Mind,” M.L.A. Boileau described a typical conversation with a member

of the “laity.” She notes that most of them believe the female physician to be “a sort of

partially-trained staff-nurse.” Even when the public understands that female physicians

are physicians, they proclaim, “Oh! Then I suppose you study just the same things as men

– with the nasty parts left out” (Boileau 672). Boileau expresses dismay at the distinction

between men’s and women’s medical work. She argues that even though the public

understands that women physicians are not nurses, the distinction of their tasks from the

tasks performed by men – that women do not study the “nasty parts” of medicine – leads

to a diminished view of women physicians in the public sphere.

As they expressed these frustrations, many early contributors to the magazine

argued for ways of understanding women’s medical practice that aligned with Putnam

Jacobi’s earlier arguments against the distinction between male and female physicians. H.

Kozakevitch Stefanovsky’s January 1900 article “Medical Women in Russia,” for example, discussed Russian medical women’s professional practices. Stefanovsky writes that women doctors in that country “have to work among patients of both sexes” and practice broadly, even in “specialties of medicine for which it seemed they had least capacity. They are skillful surgeons, oculists, accoucheuses, etc.” (Stefanovsky 580). She 89

notes that, much as their British colleagues, women physicians in Russia have

demonstrated themselves capable of undertaking practice in a wide number of medical

fields. Russian female physicians, however, have greater flexibility in both their training

and their practices than British physicians and are successful in these practices. Other

writers in the magazine’s early years also noted that women physicians demonstrated

themselves capable of working in elite medical specialties when they were allowed to

take on expanded training and practice, as in Ireland and the United States.35 These

articles outlined representations of medical women’s character and capacities that aligned

fairly closely with that outlined earlier by Putnam Jacobi, suggesting further possibilities

for medical women in Britain.

The MLSOM’s editors circulated a version of women’s collective professional

character sympathetic to this view as they made implicit arguments in favor of women

practicing medicine more broadly. The MLSOM’s content in its early years did not limit the scope of medical women’s practice to women’s and pediatric health. The magazine’s second issue in October 1895, featured a song, purportedly performed at the LSOMW six years before, “The Great M.D.” The final stanza runs:

Within my den in confusion stand

Scientific Instruments, I got them second hand,

The scantiness of patients doesn’t leave me in the lurch,

For I’m going in I tell you for Original Research,

It’s got from German pamphlets, but it does so well for me,

You’ll all be proud of knowing such a great M.D. (F.M.D. 71)

35 See “Notes on Two Centers of Post-Graduate Work,” MLSOM, September 1900, 730-5; “A Visit to Chicago,” September 1901, 26-37. 90

This song advances the possibility that, with hard work and dedication – enduring messy rooms, second-hand tools and a lack of patients – woman physicians could pursue the most elite levels of medicine and move beyond gynecology, obstetrics and pediatrics.

This song notes that women’s work in medicine need not be limited to narrow specializations in women’s or children’s health. The magazine’s clinical content in its first years reinforced this sense of possibility. It incorporated clinical articles and case studies from various fields – including the elite fields of surgery and medical research.

The magazine also included discussions of treating patients of both genders in gastroenterology,36 psychology,37 oncology,38 infectious disease,39 musculoskeletal disorders,40 tropical diseases,41 neurology,42 surgery,43 and laboratory research.44 Across the first twenty years of its run, the magazine continued to offer such variety in its clinical content, although many articles still focused on obstetrics, gynecology and pediatrics.

The MLSOM’s editors also exercised their influence to circulate this version of women’s professional character in editorial comments. In November 1911, for example,

Henry T. Butlin and the editor disagreed about the nature of women’s character. Butlin

36 See “Case of Gastric Ulcer. Under Dr. Sainsbury. Recovery,” MLSOM, October 1895, 63-4; “Case of Duodenal Ulcer. Under Dr. Sainsbury and Mr. Berry. Rupture into Peritoneal Cavity. Operation. Death,” MLSOM, October 1895, 67-8. 37 See E. Fluery, “Climacteric Melancholia,” MLSOM, October 1895, 48-60. 38 See “Case of Sarcoma of Skull. Under Mr. Battle,” MLSOM, October 1895, 68-70. 39 See Mary Scharlieb, “Sixty Cases of Tetanus”, MLSOM, May 1895, 13-8; M.L. Dobbie, “Reports of Two Cases in the Whitworth Hospital, Dublin,” MLSOM, May 1896, 150-4. 40 See M.B. Douie: “A Case of Pseudo-Hypertrophic Muscular Paralysis,” MLSOM, January 1897, 232-5. 41 See C.E. Hull, “A Note on the ‘Aleppo Button,’” MLSOM, May 1897, 260-2; Miss Octavia Lewin, “A Visit to the Lepers’ Home in Canada,” MLSOM, January 1900, 583-9. 42See M.H. Naylor, “On Electrotonus,” MLSOM, May 1898, 399 – 411. 43See E.W. Roughton and Miss R. Balmer, “Amputation of entire upper extremity,” MLSOM, June 1900, 629-31. 44See “On the Clinical Applications of Pathology. Read at a Meeting of the Royal Free Hospital Medical Society,” MLSOM, May 1898, 390-8. 91

argues that women should not be allowed into more exclusive specializations, because

they do not possess the self-discipline to perform the detail work of medical research.

The editor, conversely, represents a lack of self-discipline as a trait decoupled from

gender. Both representations of women’s collective character received space in the issue;

Butlin’s speech appeared first, followed by the editor’s remarks. The MLSOM did not

allow Butlin’s comments to stand uncontested, however. Although Butlin’s speech

touched on a range of topics, the editor’s response focused solely on refuting Butlin’s

arguments about restricting women from medical research. The editorial note develops

and promotes the editor’s opposition to Butlin’s view of medical women as naturally

unfit for the elite branches of medicine. The editor also had the last word; Butlin did not

respond in that or subsequent issues. Thus, through its content and the intervention of its

editors, the MLSOM promoted a version of women’s collective character that underlined

that their capacities for the various fields of medical practice matched that of men.

Although the magazine implicitly endorsed a dominant version of women’s

collective character less distinguishable from men in terms of their capabilities, the

magazine’s editors allowed greater “fracturing” on the related issue of whether these

capabilities should override social norms about sex-segregation in medicine – whether or

not women should treat only other women and children. The “fracturing” of medical

women’s collective character on sex-segregation occurred in the period between 1908

and 1911. During these years, the magazine housed a series of articles about sex-

segregation in medical training and practice, each of which interpellated a distinct

identity and, thus, posited a particular vision of how medical women should relate to their

patients. Some contributors based these visions of collective character on the versions 92 created by Putnam Jacobi and Jex-Blake, while others posited new interpretations of this character.

Many writers expounded on Putnam Jacobi’s perspective and argued that

Britain’s insistence on sex-segregation in medical practice was archaic. Medical women, they argued, possessed the same skills as men and so should have been able to train and practice with the same freedom as men, as they were abroad. These writers offer evidence of medical women’s success in other countries. In October 1909, for example, Mary

Magill notes that in America, “people are as ready to consult a woman as a man.”

Women, she notes, practice successfully in a wide number of fields: they are

“homeopath, osteopath, seventh day Adventist, kinesopath, electropath, hydropath and every other conceivable prefix to ‘path’ that Greek can provide” (Magill 141). Similarly, in June 1910, E.B. Haarbleicher asserts that on the Continent, men and women physicians are not distinguished from each other in practice or education. She notes with “bitter disappointment” that Britain lacks the opportunities given women physicians abroad – both in that they “are not admitted to our largest hospitals on the same footing as men” and that a number of post-graduate courses are not open to female physicians

(Haarbleicher 260). Both Magill and Haarbleicher argue that the lack of sex-segregation in other countires has no ill effects for patients or physicians. These writers outlined a collective character for medical women that echoed Putnam Jacobi's earlier refusal to distinguish between male and female physicians, but pushed beyond her initial assertions by offering multiple real world, contemporary examples of women already in medical practice in ways not possible in Putnam Jacobi’s earlier correspondence with Blackwell. 93

Other writers agreed with these contributors on the question of medical women’s

capacities for medical practice but argued that medical women had an obligation to treat

the other members of their sex. Building on Sophia Jex-Blake’s original imagining of

sex-segregation as “natural” in February 1908’s “The Study of Gynaecology,” Mrs.

Stanley Boyd asserts that, regardless of her inclinations, a medical woman will have

gynecology “forced on her” (Boyd 817). As did Jex-Blake before her, Boyd notes that

women owe their ability to practice medicine in Britain to their gender and the “need”

they fulfill for the public. She writes, “We are aware that we fill to women patients a gap

hitherto unfilled, and that none but women can fill. This knowledge justifies to us our

own existence in the profession. […] It is a responsibility which no woman practising

medicine can throw off” (Boyd 816, 817). Unlike Jex-Blake, however, as she notes that the public and the profession will inevitably push her into sex-segregated practice, Boyd recognizes that female physicians may, in fact, wish to advance beyond the limited fields of women’s health. Rather than rallying against their distinction from men, however,

Boyd encourages women to embrace the potential advancement in women’s medicine possible through their distinct and gendered knowledge. She argues that women are

“better placed than men for acquiring” knowledge of women’s anatomy and experiences and that women patients “flock” to medical women (Boyd 818). Though she reframes the

“problem” of restriction to women’s health as a professional advantage, she also asserts that medical women’s collective professional character is inextricable from her gender, limiting their medical practice to other women.

Writers also negotiated between the existing poles of medical women’s collective

character and crafted hybrid versions of this character – combining elements of earlier 94 versions of collective character to create more dynamic possibilities for medical women.

E.W. Roughton’s October 1910 “Women’s Sphere in Medicine” endorsed women as valuable members of the medical profession but asserted that any woman physician treating “all comers” was “an abomination” (Roughton 304). Unlike Boyd, Magill and

Haarbleicher, Roughton asserts a vision of medical women’s collective character that highlights the physiological differences between men and women. He writes that women have bigger brains and develop “nursing capacities” – fitting them for women’s and pediatric medicine. Men, on the other hand, excel in the use of tools – fitting them for surgical fields (Roughton 304). For Roughton, however, this distinct collective character does not mean that women should be excluded from the higher branches of medicine or restricted to gynecology, obstetrics or pediatrics. Rather, he notes, “The number of women suitable for higher branches of professional work is necessarily small, though not smaller in proportion than in the opposite sex” (Roughton 305). Women physicians’ distinction from medical men meant that they should treat only women but also that they could pursue elite medical fields as they treat those women. Roughton’s article serves as a middle ground between Boyd’s – which limited female physicians to women’s health – and those of Haarbleicher and Magill – which bristled at impediments to women’s advancement. Roughton’s article offers additional justification for women’s distinction from male physicians while simultaneously suggesting that such distinction need not mean that women’s ambition must be stifled. Although the presence of these disagreements created tension over medical women’s collective character, then, this tension also led to new articulations of alternate perspectives on this character beyond those originally imagined by Blackwell, Putnam Jacobi, and Jex-Blake. 95

Beyond the potential for editorial control and more open circulation of new

possibilities for women physicians’ collective character, the magazine’s formal

characteristics allowed for dynamic approaches to medical women’s collective character

as the social and political atmosphere of Britain evolved. Only a few years after the

discussion of sex-segregation between 1908 and 1911, the MLSOM printed articles and

editorials that relaxed the magazine’s previous ambiguity on sex-segregation in medical

practice. Pressing medical causes led contributors and the editor to argue against sex- segregation. In November 1913, Charles Pardey Lukis advocated expanded roles for women physicians in India. He notes that medical women “may do admirable pioneer work by disseminating knowledge of the laws of health and the value of preventative measures.” These broadened possibilities would confer “incalculable boon upon the populace as a whole” (Lukis 269). Lukis suggests that the dire public health situation in

India necessitates a radical shift in the patients women can treat and, thus, the ways women physicians understood their roles as medical professionals. Unlike Roughton,

Lukis asserts that women should be open to treating “all comers” in order to improve

India’s overall medical situation. The magazine also included re-articulations of women’s relationship to medicine as a result of World War I. A November 1914 editorial, a few months after Britain entered the war, asserts, “[T]he old prejudice against the appointment of medical women is breaking down in the face of necessity, and many appointments are now open either to women or men” (“Editorial” 138). This editorial foregrounded the shifting relationship between women and the types of medicine they would be asked to practice in response to many medical men leaving for the front – a shift that brought the professional character posited by the magazine more in line with 96

Putnam Jacobi’s perspective. The magazine, therefore, allowed women physicians and their supporters the space to articulate diverse, conflicting and dynamic understandings of medical women’s collective professional character as the conversation over sex- segregation in medical practice and other similar issues evolved over time.

Conclusion

The need for the MLSOM as an instrument of collective negotiation of women physicians’ collective professional character in medicine began to fade in the mid- twentieth century. Women began to win greater access to the discursive spaces of medicine’s dominant public as resistance to their professional status softened after World

War I. By the 1920s, although progress toward medical co-education was slow, the need for men to distinguish themselves from “incompetent” female physicians was beginning to look less necessary, as women proved their mettle in response to calls for more physicians in the wake of World War I. As Thomas Bonner has asserted, the harsh realities of the war – the need for more skilled and trained physicians of any gender – strengthened women’s standing in the medical profession (Bonner 314). Additionally, as the twentieth century unfolded, women were no longer barred from the Royal College of

Physicians and the Royal College of Surgeons, and so were fully credentialed participants in the discursive exchanges in meetings of those organizations. Women also took up positions in formerly male-dominated hospitals and medical schools, granting them access to the publications of these hospitals, although progress in these domains was still slow. After World War I, women’s writing also began to make up a larger portion of publications in the major medical journals such as the BMJ and the Lancet and to make 97

more substantive contributions to these journals, although they still represented a

minority. Women physicians needed to rely less on the multifaceted discursive “body”

provided by the MLSOM as the twentieth century progressed, as they transferred the

character constructed in this magazine to other discursive spaces formerly closed off to

them.

The MLSOM, however, continued to be published throughout the first half of the

twentieth century, providing women physicians a discursive body containing multiple and dynamic characters for over fifty years. The success of the MLSOM and other early niche professional magazines, such as the Women’s Industrial News, in offering a print space for counterpublics of professional women, initiated a run of such magazines during the first decades of the twentieth century: Woman Teacher, Business Girl, Humanity,

Woman Clerk, and Woman Engineer. The MLSOM itself served as the model for the

Women Students’ Medical Magazine, first published in 1901 for the female students of the University of Edinburgh School of Medicine. By the time the MLSOM published its final issue in December 1947, women physicians in Britain, while by no means a majority, were more able to participate in the dominant public of the medical profession.

The magazine saw medical women through their bitterest struggles of self-definition and dramatic changes to their professional lives, including two world wars. The MLSOM only

ceased publication as a magazine solely for medical women in 1947 when the school

began to admit men (“Undergraduate Medical Schools” 382). The MLSOM outlasted

many of the other niche magazines for professional women that it helped inspire,

including the Women Students’ Medical Magazine, which folded only a few years after

its founding. When the magazine ceased publication, women lost the counterpublic where 98 they performed the early negotiation of their professional characters and imagined possibilities for their relationships to other members of the profession, their patients and the general public.

Chapter 2: The Woman Doctor Novel: Sophia Jex-Blake and Hilda Gregg Refiguring the Rhetorical Possibilities of the New Woman Novel

Female physician Sophia Jex-Blake treats the state of literature about women physicians

in her 1893 essay, “Medical Women in Fiction,” a review of what she terms “woman

doctor novels.” Largely published between 1876 and 1900, the twenty-five years after

women’s full admission into the medical profession, “woman doctor novels” detailed the

lives and struggles of female physicians. Jex-Blake opens her essay with a quotation

attributed to “Fletcher”: “Let me make the ballads, let who will make the laws!” (Jex-

Blake, “Medical Women in Fiction” 261). Jex-Blake, fond of using aphorisms in her

writing, here cites a corruption of Andrew Fletcher’s political essays, which were popular

in the late nineteenth century.45 In his An Account of a Conversation concerning a right regulation of Governments for the common good of Mankind (1704), Fletcher, a Scottish writer and advocate for Scottish independence, recounts a conversation with Sir

Christopher, an earl. Sir Christopher notes that “infamous songs sung in every corner of the streets” lead citizens to “all manner of lewdness” (Fletcher 10). Responding to his colleague, Fletcher writes, “I said I knew a very wise man [who] believed if a man were permitted to make all the ballads he need not care who should make the laws of a nation, and we find that most of the ancient legislators thought that they could not well reform the manners of any city without the help of a lyric, and sometimes of a dramatic poet”

(Fletcher 10). In this passage, Fletcher expands on Sir Christopher’s assertions of the motive power of poetry. Rather than decrying the misbehavior that can result from corrupting popular songs, as does his colleague, however, Fletcher’s “wise man” notes

45 In an 1882 volume of The Antiquary: A magazine devoted to the study of the past, James Purves notes that the popular circulation of the phrase both condenses it and attributes the sentiment directly to Fletcher himself, rather than a separate “very wise man” (153). 100 the rhetorical power of literature: that it can enact changes to the behavior or attitudes of the general public not possible through legal intervention. Fletcher goes so far as to argue that, in the past, lawmakers relied on literature to perform this persuasion for them;

Fletcher, then, highlights poetry’s rhetorical nature – its ability to alter the attitudes, beliefs and actions of its audience.

It may seem strange for a nineteenth century physician discussing the state of a relatively small subset of novels written for female readers to engage a long-dead

Scottish politician. Jex-Blake, a member of the “Seven against Edinburgh” and, arguably, the most vocal advocate for female physicians in the nineteenth century, however, sees the task of reviewing novels about her profession as intimately connected to the ideas of her fellow Scotsman. Speaking of her own time, she writes, “[T]hough Fiction cannot aspire […] to the position that was held by popular poetry in the Middle Ages, still it may be taken as in some sort its equivalent and successor” (Jex-Blake, “Medical Women in

Fiction” 261). Jex-Blake argues that, although late nineteenth century fiction – and more precisely, the class of novel about women physicians – lacks the cultural cachet of medieval poetry, they are parts of the same tradition. Both poetry and nineteenth century women’s fiction possess rhetorical potential to sway the opinions of the masses in ways that legal strictures cannot. Woman doctor novels, Jex-Blake asserts, can be sites of rhetorical persuasion – they can shape the attitudes, beliefs and behaviors of their readers.

Marking nearly twenty years after the passage of the Enabling Act of 1876, Jex-

Blake’s 1893 review essay underlines the importance of vigilance toward politically- focused texts, as literature addresses subjects and representations of individuals who could suffer real consequences from their treatment as literary subjects. As Jex-Blake 101

takes up an analysis of novels that have “dealt more or less seriously with the genus

medical woman” (Jex-Blake, “Medical Women in Fiction” 261), she finds the majority of

them wanting, although she sees hope in later novels focused on the woman doctor. Jex-

Blake was not alone in taking a critical stance on the state of these novels. Hilda Gregg, a defender of women’s rights, who mostly wrote adventure novels and short stories under the pseudonym Sydney Grier, also engaged with the “woman doctor novel” as a site of rhetorical exchange with potentially serious consequences for medical women and the public’s recognition of them as qualified professionals. Unlike earlier studies of woman doctor novels by Kristine Swenson, Carol Ann Farkas and Tabitha Sparks, which discuss woman doctor novels as evolving opportunities for women physicians to explore and critique their professional roles, this chapter engages with writers’ discussions of the rhetorical effects of these novels on their readers.

As they evaluated the rhetorical potential of woman doctor novels, Jex-Blake and

Gregg responded largely to a turn in the tide of literature about medical women, what

Kristine Swenson has termed the “New Woman doctor novel.” Swenson notes a shift in the woman doctor novel in the 1890s, when female physicians began to represent their profession in fiction. These writers, she notes, took more critical views of the social and political positioning of women physicians in British culture and sought to move beyond the tragic representations of women physicians in earlier novels (Swenson 125-6). At the emergence of these more politically-minded and socially-aware woman doctor novels,

Jex-Blake and Gregg reflect back on the state of the genre as a whole. This chapter analyzes these two women’s responses to the woman doctor novel and the two sometimes 102

converging and sometimes diverging directions that they suggested for the future of the

woman doctor novel during its “second wave.”

Both Jex-Blake and Gregg note tension between writers’ overt attempts to

strengthen the public’s reception of women physicians – strengthening women

physicians’ ethos – and their attempts to address and connect with this same reading

public. In this respect, Jex-Blake and Gregg both echo concerns of New Realist writers,

such as George Moore, Thomas Hardy, Edmund Gosse and Eliza Lynn Linton. Earlier in

the 1890s, these writers had asserted that purportedly “realistic” fiction of the period,

presented readers with distinctly unrealistic representations of the world and other people

by relying on well-worn tropes that appealed to the tastes of the reading public, rather

than conveying accounts of individualized experience. Unlike Moore, Hardy, Gosse, and

Linton before them, however, Jex-Blake and Gregg’s concerns related to circumscribed

concerns about the practical effects of tropes about femininity: Jex-Blake on how these representations could damage the public’s acceptance of women physicians and Gregg on these novels’ alienation of non-physician readers.

In light of their concerns about potential damage to the medical women’s movement, Jex-Blake’s and Gregg’s responses to “second wave” woman doctor novels reveal a concern with who has the right or ability to wield these novels’ powerful rhetorical potential. Both women address woman doctor novels as problematic on the basis of the question of whether writers who are not women or physicians can adequately exercise the full political potential of these novels while continuing to respect the integrity of their subjects. Noting the work of Margaret Todd and Henry James, Jex-

Blake sees the genre heading in an agreeable direction, but Gregg argues that only 103 women writers can represent women accurately in fiction. Gregg takes a notably less expansive view than Jex-Blake and argues that the genre needs further reform to be an effective site of rhetorical persuasion. They disagree on who can craft woman doctor novels adequately, but Jex-Blake and Gregg both suggest reforms to the genre, beyond the “second wave”: first, composition by “insiders” or well-researched “outsiders” who understand and generate representations of medical women as professionals possessing the various aspects of ethos and, second, the de-centering of medicine, in order to minimize the potential for technical inaccuracies. This second piece of advice also helps explain the decline of the woman doctor novel as a genre at the end of the nineteenth century; as writers de-centered medical practice, New Woman doctor novels became less distinct from their non-medical counterparts. Although Jex-Blake and Gregg sought to reform the “failures” of previous woman doctor novels in the “next era” of the genre, the genre had already begun to recede at the end of the nineteenth century. Jex-Blake and

Gregg’s criticisms of this genre, then, both anticipate the decline of the woman doctor novel as a distinct class of fiction and serve as key actions in reimagining the place of fiction writing as a method of social reform.

Early woman doctor novels as both “imaginative testing ground” and failed novels

Women practicing medicine in some capacity had been represented in novels such as

Elizabeth Gaskell’s Ruth (1853) in the years before female physicians were legitimized under the law. As women physicians entered into full legal recognition in the 1870s, writers sympathetic to the cause of female physicians, such as Charles Reade, Henry

Curwen, and G.G. Alexander explored the life and trials of the medical woman through 104

so-called “woman doctor novels.” These novels served an important role in creating what

Carol Ann Farkas has termed an “imaginative testing-ground” for female physicians; they

acted as locations where writers could “invent and explore the parameters of professional

medical life for women” (Farkas 141). Early woman doctor novels offered numerous possibilities for how women could enact their practices – whether it be in a private country practice, such as that featured in Dr. Edith Romney, in acting as a warden of public health for the tenants of a wealthy landowner, as does Charles Reade’s Rhoda

Gale, or as the married partner of a male physician, as is the protagonist of Annie S.

Swan’s novels Elizabeth Glenn, MB and Mrs. Keith Hamilton, MB.

Although they suggested new possibilities for women physicians, woman doctor novels also served overtly political purposes – highlighting the continuing conflicts between societal attitudes toward their female protagonist’s gender and her medical practice. Reade’s A Woman Hater (1877) both allows its female physician, Rhoda Gale, to tell her own story of the fight for women’s right to practice in Britain and demonstrates the difficulties she has in establishing a thriving practice in the wake of her legitimization. Other novels of this genre discussed the social and romantic difficulties posed by women’s membership in the medical profession – often leaving their protagonists in dire straits. Alexander’s Dr. Victoria (1881) details its eponymous heroine’s struggle to balance her decision to pursue medicine, her ignoble parentage, and her growing affection for the wealthy Sir Francis. In the end, she remains devoted to her occupation as, in a self-sacrificing compromise, she encourages her more conventional cousin Madge to marry him. Similarly, after establishing an independent practice, the eponymous female physician in the anonymously published Dr. Edith Romney (1883) is 105

hounded so relentlessly by her male competitor that she comes down with brain fever and

leaves the profession. Each of these novels foregrounds the pressure placed on female

physicians as they adopted their new and unconventional roles in the professions. In these early novels, such circumstances often, although not always, result in the woman’s exit from the profession and entrance into marriage.

Even before Jex-Blake and Gregg’s writing in the 1890s, writers recognized the tension created by authors attempting to convey political and social messages through woman doctor novels. Responses by literary critics to woman doctor novels diagnose them as laboring under a conflict between the constraints of the novel and their attempts to persuade their readers to sympathize with their protagonists. Even when it inspired critical admiration for its revolutionary treatment of women physicians, Charles Reade’s

A Woman-Hater, was often met with derision for its overt social agenda. A reviewer for the North American Review notes that Reade always struggled with accusations that his political content impeded the reception of his works as “novels.” Specifically, the reviewer notes that the “function” of the novel “is an old question between Mr. Reade and certain of his critics; and one we would gladly leave to their debate” (North

American Review, “A Woman-Hater” 390). While the North American Review’s reviewer

is willing to forgive its glaring formal and character issues, the novel’s other reviewers

are not so forgiving of its overt attempts to persuade its readers and its poor writing. A

reviewer for the Westminster Review expresses disgust at Reade’s novel, resulting from

his belief that novels should not house discussions of political issues. He writes, “If Mr.

Reade will turn a novel into a pamphlet, he must take the consequences” (Westminster

Review, “A Woman-Hater” 273). Turning one’s novel into a polemic, the reviewer 106

argues, prevents readers not supportive of the promoted cause from engaging with the

text.46 In addition to the strain put on the novel by its political aims, then, this reviewer

indicates that its politics detract from its ability to entertain – what he views as the

inherent purpose of a novel as a genre.

Early reviewers noted the failures of other novels featuring women physicians as

novels and suggested that overtly political writing about medical women might be better

fitted for other genres. Reviewing the anonymously published Edith Romney, M.B.

(1883), the reviewer for the Saturday Review chides the author for producing a

“windbag,” full of too much “padding” and extraneous detail, rather than substantive

plot. He indicates that “the story is short, although the novel is long” (“Edith Romney”

612). Another reviewer for the Saturday Review, taking on Alexander’s Dr. Victoria

(1881), puzzles over the author’s insistence on deflecting claims of the “unreality” of his

novel. Near the close of Dr. Victoria, Alexander declares that the book had better be

burnt than understood to represent reality. Given the relationship between realism and the

novel in his own time, the reviewer notes his own perplexity over this declaration (“Two

Novels” 794). Reviewers’ issues with the fit of the woman doctor novel into the category

of “novel” continued into the 1890s with Henry Curwen’s Dr. Hermione (1890). In the

Calcutta Review, the reviewer notes that Curwen’s text contains “interesting sketches”

(“The Late Mr. Curwen and his Works” 256). As a novel, however, this reviewer notes,

46 The reviewer, notably, does not condemn the overtly political messages contained within nearly all of Reade’s novels previous to A Woman-Hater, such as It is Never too Late to Mend (1856), which addressed prison conditions, or Hard Cash (1863) and A Terrible Temptation (1871), which advocated for improved mental health facilities, for their similarly political underpinnings. Rather, the reviewer notes that A Woman-Hater is the first novel of Reade’s that he finds unreadable for its politics. He asserts that it “does not do justice to Mr. Reade’s powers. He is, for the first time, dull” (Westminster Review, “A Woman- Hater” 273). 107

Curwen’s text suffers from a “want of incident” (“The Late Mr. Curwen and his Works”

255-6). As the novel attempts to represent the character of its protagonist, he notes, it strains against the boundaries of its genre. He writes that, in Curwen’s novel “so much is said and so little is done, that the work has more of the nature of a drama than of a novel”

(255). Similarly, although he finds the novel “original enough” and “a great deal of fun,” the reviewer from the Saturday Review also criticizes Dr. Hermione’s form and suggests that Curwen’s text might work better as a piece of theater than as a novel; he argues that

Curwen’s work is more a “farce” – a theatrical form consisting of caricatures and exaggerated situations – than a novel but that it is also too lengthy to work as a true farce

(“Novels” 201). These continued criticisms underline the uneasy fit of women physicians’ social cause in the genre of the novel of the latter half of the nineteenth century, a task that writers of the “second wave” of woman doctor novels sought to remedy with limited success.

After the first wave: critical approaches to women’s positioning in New Woman doctor novels

The woman doctor novel evolved in the 1890s, as women physicians and their supporters began to write such novels with a more critical eye. Kristine Swenson and Tabitha Sparks have noted a shift in the woman doctor novel in the 1890s. Swenson has noted two eras of woman doctor novels: the “early stage woman doctor novel” and “New Woman doctor novels,” the novels by and about second-generation female physicians. While their predecessors focus on the conflict between medicine and romance, Swenson notes, “New

Woman doctor novels” in the 1890s take more obviously critical views of the social and 108 gender roles that women physicians were asked to occupy in their first years in their occupations (Swenson 125-6). Swenson notes two novels that exemplify this shift:

Margaret Todd’s Mona Maclean Medical Student (1892) and Arabella Kenealy’s Dr.

Janet of Harley Street (1893). Todd’s novel follows medical student Mona as she decides whether or not to continue pursuing medicine after the devastating experience of failing her exams, an account loosely based on the life of Sophia Jex-Blake. Throughout the novel, Mona struggles with the question of whether she should adopt a “normal” life for a woman of the period – whether or not to accept the multiple marriage proposals from the men in her life or to pursue the more difficult, but ultimately more personally satisfying, path of returning to medical school. Many of the earlier entries into the genre pose this dilemma as an “either/or” question – the women in these earlier novels must choose to pursue either the domestic life or medicine, but never both. Mona, however, ends the novel by fulfilling both roles: marrying a medical man with whom she founds a burgeoning medical practice in London.

Kenealy’s novel echoes Todd’s criticism of expectations of social roles; indeed,

Swenson has noted that Kenealy’s novel contains a number of characters strikingly similar to those in Mona Maclean Medical Student and was likely spurred by the earlier success of Todd’s novel (Swenson 150). Kenealy’s novel traces the experiences of a medical student, Phyllis Eve, trained by the eponymous Dr. Janet Doyle. Phyllis, however, differs markedly from the independent Mona Maclean, in that her story more clearly resembles the high melodrama of earlier woman doctor novels, as she later abandons her profession. The figure of the female physician, however, is treated through

Dr. Janet. Swenson has noted that the masculinized Dr. Janet serves as both physician 109

and maternal figure to Phyllis, effectively fusing these two formerly distinct roles as she

seeks to transform Phyllis into a woman doctor who still possesses “feminine charms”

(Swenson 154).

Tabitha Sparks has since complicated Swenson’s reading of these “second-wave” woman doctor novels. As has Swenson, Sparks has noted that woman doctor novels in the 1890s placed domestic and professional roles in positions more amendable to one another in novels such as Todd’s, Kenealy’s and Annie Swan’s Elizabeth Glenn, M.B.

(1894), where the female physician similarly marries a male physician but sacrifices her own profession. Importantly, however, Sparks argues that this independence is not a full liberation from the political and social ties laid on women during the period. Rather, she notes that, especially in Todd’s novel, women’s greater freedom does not extend beyond the fusion of their domestic and professional duties. Mona explicitly rejects other women’s rights movements of the period – especially the suffrage movement. Sparks notes that, as a result of such rejection, while Mona has greater agency than her forebears, she still lacks the full political and social agency sought after by so many of the other heroines of New Woman fiction of the time (Sparks 155-6). Issues of agency, however, were not the only problems troubling medical women and their supporters about the state of the woman doctor novel during the 1890s. Women physicians and their supporters were also troubled by questions about the intersections of realistic fiction and women’s professional ethos – their status as members of both the medical community and as members of late nineteenth century British society.

It is in response to the still somewhat flawed “second wave” of woman doctor novels in the 1890s that physician Jex-Blake and writer Gregg reflect on the overall state 110

of the genre over its brief history. Writing in 1893 and 1897 respectively, Jex-Blake and

Gregg express vastly different concerns from earlier critics, as they view these woman

doctor novels in aggregate and are more obviously sympathetic to the plight women

physicians faced in their first decades of legitimacy. Jex-Blake aims to determine whether

these novels themselves are fair to female physicians, not what she calls their “literary

value” (Jex-Blake, “Medical Women in Fiction” 261). While Jex-Blake refrains from

evaluating the novels on their formal characteristics, Gregg echoes in part some of the

formal criticisms of the other reviewers – expressing concerns about inconsistent style

and poor plotting. She seeks, however, not to move beyond such formal criticisms.

Rather, she notes that the tenor of earlier representations of medical women as wretched

or locked into conventional roles of wife and mother stands in stark contrast to the

“feeling of triumph” many medical women experienced in their continually growing

acceptance in British society. Rather than criticizing these novels for their stylistic

failures or the strain put on a novel by a political subject, then, both Jex-Blake and Gregg primarily focus on the failures of “outsider” writers to represent female physicians mimetically in fiction – Jex-Blake for their failures to represent medical women’s experiences, knowledge, and histories and Gregg for their failures to accurately represent any woman’s experiences and intellectual capacities.

Reimagining the woman doctor novel: Jex-Blake

Jex-Blake’s most pressing concerns were related to these novels’ rhetorical nature – whether these novels, which possessed inherent power to change the attitudes of their readers toward women physicians, present an accurate reflection of her own experiences 111

and those of her fellow female physicians. As she critiques existing woman doctor

novels, Sophia Jex-Blake worries that the representations of women in these novels harm

the reading public’s views of these women, and therefore their ethos, because they

present visions of female physicians as markedly different from such women in real life.

She most clearly articulates these concerns as she discusses the anonymously published

Edith Romney, M.B. The novel, which follows Edith Romney as she sets up a practice

that competes with a male physician. It details her struggles, illness, departure from the

profession, and wooing by her former competitor. Jex-Blake criticizes the novel for its

ungrounded representation of its protagonist. Jex-Blake balks at Edith Romney’s naivety,

given that Dr. Romney would have been educated for her profession in the 1870s, the

height of medical women’s struggles for legal recognition. Jex-Blake notes that Dr.

Romney would have been well aware of notable public scandals such as the Surgeon’s

Hall riots and the expulsion of the Seven against Edinburgh from the University of

Edinburgh (Jex-Blake, “Medical Women in Fiction” 263-4). Jex-Blake also notes that Dr.

Romney behaves in ways that undermine her as a knowledgeable member of the medical profession. A notable example of this occurs when, late in the novel, she sits up two nights and refuses “all breakfast but a cup of tea” before a strenuous day of medical practice, a decision that expedites her descent into illness (Jex-Blake, “Medical Women in Fiction” 264). Jex-Blake suggests that a knowledgeable medical professional would recognize the folly of such a decision and its potential physical ramifications.

Jex-Blake’s concerns about the “unreality” of the woman doctor novels’ representations of their protagonists arise from their disconnection from her own experiences as a female physician. Having endured harsh treatment from both the 112

members of the public and her profession as she fought for her own medical degree, Jex-

Blake bristles at Edith Romney’s inability to stand up to criticism. Jex-Blake writes that

Dr. Romney’s sensitivity is such that “[a] hiss from a drunken greengrocer 'transfixes' her

in an 'abstraction of scorching suffering'; and this, and a few similar incidents, [are

sufficient] to bring on the time-honoured deus ex machina of brain-fever, in which her

life undergoes its final transformation” (Jex-Blake, “Medical Women in Fiction” 264).

Dr. Romney’s lack of fortitude in the face of such middling slights ultimately results in her exit from the medical profession and entrance into a marriage with her former rival.

To Jex-Blake, who endured harsh criticism as a member of the group protested in the

Surgeon’s Hall riots and who was widely mocked in medical and popular periodicals when she failed her final exams at the University of Edinburgh in 1873, Dr. Romney’s capitulation of her profession as a result of incidents such as the passing mockery of a drunken grocer must have seemed an insult to the public scorn she and other female physicians endured in reality. In her reference to the “time-honoured deus ex machina of brain-fever” and her criticism of the woman doctor’s inability to face even cat-calling from a drunk, Jex-Blake reveals her true criticism of the novel. She suggests that the anonymous author of Edith Romney reflects not the experiences and knowledge of female physicians, but a set of literary tropes about how women react under criticism and stress.

Jex-Blake’s concerns about reliance on tropes rather than real knowledge of medical experiences echo, in part, other writers’ critical engagement with ostensibly

“realist” novels in the last decade of the nineteenth century. As Ann Ardis has noted,

New Realist writers at the end of the century criticized earlier strains of Victorian realism

– especially popular novels in circulating libraries – for their unrealistic depictions of the 113

world and its inhabitants. Thomas Hardy and George Moore, most notably, rail against

the literature promoted by late nineteenth century circulating libraries for its toothlessness

in representing the difficult realities of late nineteenth century life, instead capitulating to

the convention-driven demands of its audience. Ardis argues, however, that these

criticisms strike beyond the circulating libraries themselves (Ardis 32-5). Highlighting

the writing of Moore, Hardy, Elizabeth Linton, and Edmund Gosse, Ardis argues that

these criticisms of late nineteenth century realistic literature arose from realist authors’

failures to deliver a text of a truly realistic nature, as writers instead favored pleasing their

audience with existing tropes and stock characters. Linton, for example, in “Candour in

English Fiction” (1890), writes that the fiction of the time “is the most insincere, the most jejune, the least impressive, and the least tragic,” arguing that the “milk and water literature” of the day “does not go beyond the schoolgirl standard” (Linton 14). Similarly, in Questions at Issue (1893), Gosse criticizes the “madonna-heronine,” “god-like hero,”

“impossible virtues” and “melodramatic vices” of earlier writers of realism (Gosse 22).

As they criticize purportedly “realistic” novels, these writers articulate many of the

concerns later discussed by Jex-Blake: the characters in these woman doctor novels do

not present characters from whom readers will learn about the world but perpetuate

unrealistic and damaging tropes about women’s behavior and personalities.

Such a sense of disconnection from reality in favor of stale tropes occurs as Jex-

Blake brings woman doctor novels into conversation with her own experiences as a

woman physician. Jex-Blake asserts that Edith Romney is so foreign to both her own

experiences of medical women’s struggles, knowledge and character, as well as the

realities of life as a woman in the period, that the novel’s events “must have been upon 114

another planet” (Jex-Blake, “Medical Women in Fiction” 263). She writes that while “Dr.

Edith Romney is presented to us as a fascinating and high-souled woman,” she “has lived

most of her life on some astral plane” (Jex-Blake, “Medical Women in Fiction” 264).

Here, Jex-Blake highlights that, despite the interest that readers might find in such an

unusual literary character as that of Dr. Romney, she is on a different “plane” from the

events of the novel and from the realities of everyday life. Jex-Blake’s criticisms of

disconnection, however, are not limited to Edith Romney alone.

Jex-Blake notes such failures of representation in nearly every female doctor

novel. She notes the “touch of burlesque” in Charles Reade’s otherwise “kindly”

representation of medical women in A Woman-Hater (Jex-Blake 263). She criticizes Dr.

Hermione for its failures to generative accurate reflections medical practice, medical

education, and the growth of character and insight that can result from medical practice

(Jex-Blake 264-5). She laments that while the protagonist of Dr. Breen’s Practice (1881)

is attractive from an artistic point of view, the novel’s protagonist is of an unattainable

character and beauty (Jex-Blake 266). She similarly notes the “shadowless perfection of

[the] heroine” in Elizabeth Stuart Phelps’ Doctor Zay (1882) (Jex-Blake, “Medical

Women in Fiction” 267). She writes that Doctor Zay’s exaggerated physical beauty and medical prowess are such that no medical reader can read it “without some sense of unreality” (Jex-Blake, “Medical Women in Fiction” 267). As she walks readers through her literature review, Jex-Blake re-iterates that she finds the representations of medical women in each of these novels alienating and unreflective of her own experiences. Jex-

Blake fails to identify with ways female physicians are depicted in woman doctor novels, 115

and this failure leads her to conclude that these novels are not successful in giving readers an accurate view of women physicians at the end of the nineteenth century.

Although the novels she discusses in her article aim to improve women

physicians’ relationship to the reading public, Jex-Blake asserts that the mimetic failures of these representations could have a significant impact on public attitudes toward women physicians – these women’s ethos.47 Regardless of an author’s good intentions,

the disconnection of these novels from the lives, behaviors and experiences of real

medical women, Jex-Blake argues, can hinder their serious political aims. Jex-Blake

suggests that the foreignness of Edith Romney to the realities of medical women’s

character, for example, makes it “hardly possible to take the book as a serious

contribution to the [woman doctor] question” (Jex-Blake, “Medical Women in Fiction”

263). Jex-Blake asserts that fiction, because it is powerful, must be wielded carefully so

as to not inadvertently harm those it seeks to represent. She notes that writers may write

whatever they wish about female physicians and are by no means obligated to paint

flattering portraits of these women. They are not required to focus on developing

women’s ethos. She asserts, however, that “the public has a right to require” that

representations of female physicians “should not […] be evolved over a study fire, from

the depths of the author’s inner consciousness” but rather should “should be in some

sense taken from life” (Jex-Blake, “Medical Women in Fiction” 261-2). Jex-Blake, then,

asserts an obligation on the part of the author not only to her subject but also to the

47Jex-Blake offers a similar appraisal of Reade’s Rhoda Gale, which suggests that she does not find his representation of the female physician wholly harmful or erroneous. She writes, “The sketch of Rhoda Gale is altogether kindly, and is drawn with a good deal of power and insight; that it has at some points a touch of burlesque is certainly not due to any want of goodwill on the part of the author; for, to a woman's eye, this defect seems common to the great majority of Mr. Reade's female characters, in most, if not all, of his books” (Jex-Blake, “Medical Women in Fiction” 263). 116 reading public. The author, empowered by the genre of the novel, should not rely on her own unmoored ideas or conventional tropes about medical women; instead, if she wishes to contribute to these women’s cause, she has an obligation to generate accurate depictions of women physicians by respecting their real-life counterparts.

This obligation to both the public and a novel’s subject when writing with political aims, Jex-Blake argues, limits who can adequately write about professional women. She connects the unreality of representations of female physicians to the

“outsider” status of their authors. None of the novels she criticizes was written by a female physician (with the possible exception of the anonymously-penned Edith

Romney). As she reviews these novels, she notes that their shared feature is that “they are all manifestly written from the outside” and that, given their lack of connection to medical women’s experiences, knowledge, and history, “[i]t is, I think, inconceivable that any one of them could have been penned by a medical student or practitioner (Jex-Blake,

“Medical Women in Fiction” 269). Jex-Blake seats the failure of these novels not only in their authors’ lack of intimate understanding of the medical profession and its practice but also in their inadequate appreciation of how these aspects of a medical professional’s life shape their relationship to their profession and their community. As she concludes her essay, Jex-Blake muses on the relationship between author and the medical woman as a subject of fiction. She writes,

It is a curious thing that, while in the present day I suppose no home-staying

inhabitant of Central Europe would undertake to write a naval romance, few

people seem to have any hesitation in evolving from their inner consciousness the

daily facts of such a remarkably technical profession as medicine, and the results 117

to medical readers are consequently somewhat bewildering. (Jex-Blake, “Medical

Women in Fiction” 267)

Jex-Blake notes that authors somehow feel that they can write about medical women without either personal experience as a woman physician or direct exposure to these women and the breadth of their medical practice. Authors of novels in other genres – the naval romance, for instance – would not propose to write a novel so far out of their experience, if, as in Jex-Blake’s example, they had never left the land-locked countries of

Central Europe. Jex-Blake’s frustration that ill-informed writers outside of the medical profession – who lack knowledge of the experiences of medical women and the complex relationships between women, the public and other medical professionals – leads her to suggest that woman doctor novels should only be written by “insiders” or by “outsider” authors who can represent medical women without making recourse to tropes and potentially damaging medical women’s professional ethos.

Jex-Blake’s call for radical shifts in the configuration of the purportedly realist novel places her in line with some of the dominant literary voices of her period.

Conversations among realists shaped the direction of political fiction about women in this period, specifically in New Woman novels written near the end of the century. Ardis argues that many writers of New Woman fiction responded to criticisms of earlier realism through a “reconstruction” of the novel “from the inside out”: “[writers] argued for changes in the conventions of representation, changes in the unwritten rules about what subjects were appropriate for literary treatment” (Ardis 38). Ardis argues that these criticisms of earlier strains of British realism resulted in revolutionary ways of thinking about the representation of women in fiction. Jex-Blake’s engagement with “second 118

wave” woman doctor novels encouraged a similar re-imagining of the woman doctor

novel for what she saw as a clearer remediation of female physicians’ experiences and

personalities in print. Jex-Blake writes that only two novels with a female physician as a

character in the period between 1876 and 1893 avoid the charge of being limited as a

result of being written “manifestly from the outside”: “insider” Margaret Todd’s Mona

Maclean and “outsider” Henry James’s The Bostonians (1886). Jex-Blake suggests that,

through further evolution in the line of these novels, woman doctor novels can succeed in

more clearly persuading the public to accept female physicians as medical professionals.

Jex-Blake praises Margaret Todd’s Mona Maclean, Medical Student (1892) for

the accuracy of its representation of its main character. This novel, published under the

pseudonym Graham Travers, details the months after the eponymous character has failed

her medical exams for the second time. Disheartened by her failure and against the

protests of her friends and classmates, Mona abandons her London lodgings and takes on

a position as a clerk in her cousin’s shop in Borrowness, Scotland. She eventually returns

to London and medical school, passing her exams with distinction. Todd composed the

novel as a medical student, and she found an influential patroness in Jex-Blake, whose experiences inform much of Todd’s novel. Oliver Lovesey and Kristine Swenson have

both noted Jex-Blake’s extensive influence on Todd’s publishing career and on her

fictional output – that Jex-Blake essentially took on the role of Todd’s literary agent after

they met in the 1880s (Lovesey 4-5; Swenson 142). Unsurprising, then, is Jex-Blake’s

significant praise for Todd’s novel and Jex-Blake’s assertions of its accuracy in representing female physicians. 119

Jex-Blake asserts that Todd’s novel does not fall into the problems of unreality that plague so many other woman doctor novels. Todd, Jex-Blake notes, does not represent her female physician as too perfect or too weak. She asserts that the strengths of the novel’s main character arise not from her novelty or perfection but because she possesses “all the charm and freshness of reality” (Jex-Blake, “Medical Women in

Fiction” 271-2). Mona is not weak and disconnected from the realities of life, unlike the protagonists of Edith Romney or Dr. Hermione. She weathers the disappointment of her botched exam with surprising grace and pragmatism, returning to her studies in London after briefly helping her cousin with her shop. She also manages her uncle’s scorn of her profession with alacrity and good humor, even though he encourages her to give up medicine for good. He declares, “The very first day I saw your face, I felt sure that you were not the sort to make a doctor. That kind of work wants women of coarser fiber.

There is no use trying to chop wood with a razor” (Todd 323). Mona perseveres in medicine despite such pressure and is clearly fitted for its intellectual rigors, taking a prize in physiology after months of hard studying near the novel’s conclusion. Mona’s friends and suitors describe her as clever, cultured, earnest, and charming (Todd 69), and throughout the novel, Mona demonstrates her natural and easy capacity for the position of physician. Todd, however, makes clear to her audience that, despite this warmth, charm, and intelligence, Mona is not the idealized and peerless heroine represented in many earlier woman doctor novels such as Dr. Breen’s Practice and Dr. Zay. Mona has failed her end-of-term exams when the novel begins, suggesting a lack of preparation that she acknowledges later on in the novel. She is “almost handsome” but not a beauty in the way of many of her literary forebears (Todd 35). Mona is neither blindingly gorgeous nor 120

dazzlingly brilliant, but possesses a modest share of both beauty and intelligence. Mona’s

notable intelligence, charm and beauty create an admirable character, but not an

alienating one, as was the case in earlier woman doctor novels.

Jex-Blake lauds Mona Maclean for the informed “insider” insights offered by its

author. Unlike the novels she criticizes throughout her literature review, Jex-Blake writes

that Todd’s novel is “manifestly written from the inside” (Jex-Blake, “Medical Women in

Fiction” 270). In addition to details about the opposition women faced from society and their families, Todd’s “insider” status is evident as she demonstrates her deep awareness of the historical background from which medical women at the end of the century emerged. Although she is at a remove from the historical battles over women’s entry into the professions, unlike many of the protagonists of earlier woman doctor novels, Mona

expresses her awareness of and regard for the earlier women who fought for the reform of

the medical profession. As she discusses the relatively easy life she and her classmates have as they train, Mona describes the difference between her experiences and the experiences of those who came before her. She says,

The first women, who were determined not merely to creep in themselves but to

open up the way for others, must have suffered obloquy and persecution from all

but the very few, at any time. If the lives of a little band of women – I had almost

said if the life of one woman – could be blotted out, I wonder how many of us

would have the courage to stand where we do now? It is a pretty and wonderful

sight, perhaps, to see a band of young girls treacling the uphill path and singing as

they go. ‘How easy it is,’ they say, ‘and how sweet we make it with our flowers!’ 121

No doubt they do, and heaven bless them for it! But it has always seemed to me

that the bit of eternal work was the making of the road. (Todd 68)

Mona engages directly with the history of the movement. The only other woman doctor

novel to make such reference is Reade’s A Woman-Hater, through Gale’s lengthy

account of her pursuit of her medical degree. Todd’s novel has a greater sense of history

and context and, therefore, a more solid understanding of women physicians’ relationship

to their profession and the public than other, earlier woman doctor novels.

A surprising aspect of Jex-Blake’s engagement with Todd’s novel is her praise for its lack of emphasis on medicine. Although she lauds the novel for its “insider” insights, she also praises Todd for her movement away from a text solely centered on medical practice. According to Jex-Blake, Todd’s text escapes the difficulties of representing the complexity of medical practice by making it a theme in, but not the topic of, the novel.

She writes “Mona Maclean, Medical Student, is no mere 'novel with a purpose,' and indeed the medical element in it is kept strictly subordinate to the development of the story and the play of the characters introduced into it” (Jex-Blake, “Medical Women in

Fiction” 270). According to Jex-Blake, the novel benefits from its removal from a medical setting. The events of the novel, while punctuated by illness and discussions of scientific topics such as botany, center not on the accurate and intimate details of medical practice but on the ways medicine is an essential part of Mona’s sense of identity and relationship to other people. Readers see brief glimpses of the anatomy room and hear some minute details of medical education, but the novel takes place away from medical practice. Mona’s aptitude for and participation in medicine, however, are key components of her character. Although she demurs throughout the novel, flirting at times with the idea 122

of quitting her medical studies in order to become a botanist or a clerk in a shop, Mona demonstrates her aptitude and inclination for medicine by taking on the role of caregiver for various sick people she encounters in Scotland. Additionally, Mona returns to medical school before the end of the novel. Todd, however, does not represent these acts of

caregiving or medical education for her readers; rather, she discusses these encounters in

retrospect. For example, after Mona has returned to medical school, readers only see

Mona at the medical school after her lectures; the intricacies of medical study and

practice, rather than being described in the realistic detail Jex-Blake advocates for in

demanding “insider” perspectives on medicine, are glossed over and left to the readers’

imaginations.

“Outsider” status did not, however, mean that a writer could not present his or

her readers with an “accurate” representation of medical women. Jex-Blake praises Henry

James for the realism and seriousness of his representation of physician Mary Prance in

The Bostonians (1886). Jex-Blake writes that, in Mary Prance, “For almost the first time

we feel that we are standing face to face with a real person, whom we might have met in

the street any day, and whose characteristics are genuine and consistent from first to last”

(Jex-Blake, “Medical Women in Fiction” 268). Dr. Prance is a strange but key character

in James’ novel. Prance represents an important contrast to the other women – especially

the other women’s rights advocates – in both James’s novel and the woman doctor novel.

Prance is not beautiful, naïve, or unearthly; these traits fall instead to James’s protagonist

Verena Tarrant, the impressionable mesmerist’s daughter and erstwhile feminist

reformer. Nor is she, as is Olive Chancellor, unornamented, unbearably shy, or fanatical

about women’s rights. Rather, describing Prance through the eyes of the destitute 123

Southern gentleman Basil Ransom, James writes that the physician is “a plain, spare

young woman, with short hair and an eye-glass” (James 58), “tough and technical”

(James 68), and

dry, hard, without a curve, an inflexion or a grace, she seemed to ask no odds in

the battle of life and to be prepared to give none. […] She looked like a boy, and

not even like a good boy. […] It was true that if she had been a boy she would

have borne some relation to a girl, whereas Doctor Prance appeared to bear none

whatever. Except her intelligent eye, she had no features to speak of. (James 67)

Outside of her appearance, Prance is, throughout her brief appearance in the novel,

defined by her intelligence and devotion to her profession. James informs his readers,

through Prance’s landlady Miss Birdseye, that Prance is an “original” genius with a high

temper (James 66), who sharpens her surgical instruments “in the stillness of the small

hours” (James 66). As with the “insider” novel Mona Maclean, James’s Doctor Prance is

neither too strong nor too weak, neither too beautiful nor too ugly, but is “unsexed” and

defined by her devotion to her craft.

Jex-Blake seats the effectiveness of James’s novel in his decision to refrain from

representing Prance in her practice, even more than in James’s treatment of Doctor

Prance as a complex character. Jex-Blake writes,

I venture to think that such vivid touches as these present a far more living

personality, and enable medical readers to imagine more correctly even the

standard of professional ability implied, than a mass of partially understood

details which are sure to be vitiated by errors, and which provoke criticism from

their manifest unreality. (Jex-Blake, “Medical Women in Fiction” 269). 124

Jex-Blake notes that, rather than trying to accurately represent Doctor Prance, James includes only “vivid touches” of medicine, as he only notes her long hours of study and preparation for her practice. These “vivid touches,” rather than a larger number of poorly applied technical details lend James’ Doctor Prance an element of believability, a “living personality.” Jex-Blake argues that James’s novel, much as Todd’s, de-emphasizes the actual practice of medicine in favor of emphasizing medicine’s essential role in its protagonist’s character – of representing her as accurately as possible. Even though

James is an “outsider” to medical practice, then, Jex-Blake views his text as capturing more of the essence of medical women than many other novels written by or about women physicians and to offer a more accurate figure for its audience’s consumption.

Generally, then, Jex-Blake sees New Woman Doctor novels as trending in a direction that will be beneficial to its subjects – one that generates more accurate representations of medical women and aids in the development of their relationships with the broader public.

Rewriting the woman doctor novel: Gregg

An author of adventure fiction, Hilda Gregg extends Jex-Blake’s criticisms of woman doctor novels through both her own “literature review” and her fiction writing in 1897.

Gregg focuses more exclusively on the effects of these representations of women physicians on their readers, rather than the effects on women physicians’ themselves. As an author herself, she is more critical of novels about women physicians for their literary failures and male writers’ attempts to capture the complexities of professional women’s lives than is Jex-Blake. A supporter of women physicians, Gregg classes the “innovation” 125

posed by the admission of the woman into the medical profession with other

controversial aspects of British culture, such as the crinoline, the bicycle, the problem- play, and the New Woman novel (Gregg, “Medical Women” 95). Gregg acknowledges the difficulty of convincing general audiences of the validity of such “innovations,” especially in getting audiences “to take [these] innovations seriously” (Gregg, “Medical

Women” 94). Gregg here notes that women physicians continued to experience problems of ethos, as the public continued to dismiss them as less qualified than their male colleagues. The first twenty years after the opening of the London School of Medicine for

Women, Gregg argues, saw fiction that was primarily concerned with demonstrating women’s fitness for their profession. She writes that for the medical woman “it was necessary […] to prove her fitness to survive before receiving, like the feminine use of the bicycle and other social developments, the stamp of the approval of those in high places” (“Medical Women” 94-5). For Gregg, this “stamp of approval” was finally received through the British Crown’s acknowledgement of medical women through the recognition of the London School of Medicine for Women at a ceremony for the opening of new science laboratories, presided over by the Princess of Wales. She writes,

“Henceforth, even to the most reactionary mind, the medical woman is neither a fad nor a

fancy, but an established fact” (“Medical Woman” 95). Thus, she embarks on her review

of the state of British medical women in the next phase of their development – articulating what she sees as the flaws in these novels so that writers in the future can re- shape the genre for this new era.

Unlike Jex-Blake’s analysis five years before, Gregg’s commentary on these

novels takes a harsh line on their formal failings and the impact of these failings on 126

readers. Gregg criticizes Reade’s A Woman-Hater for straining the conventions of the genre, characterizing Gale’s story as a “neat little controversial tract of thirty-five pages or thereabouts,” rather than as a well-organized novel (Gregg, “Medical Women” 96).

Here, Gregg echoes the reviewer from the Westminster Review and emphasizes the forced quality of the inclusion of Gale’s lengthy and politically-charged story in the novel. For

Gregg, while Gale’s story is important, its presentation makes it awkward and an uncomfortable fit for Reade’s novel. She finds the majority of the woman doctor novels similarly poorly plotted and poorly written. Gregg mocks, for example, what she sees as the ludicrous climax of Maxwell Grey’s Sweethearts and Friends, where the protagonist,

Dr. Amy, after crying “With him or for him!,” rushes past emergency personnel and

“swarm[s] up” a rope “like a cat” in order to save her future husband from a fire. In responding to this scene, Gregg writes, “We have never seen a cat swarm up a rope; but far be it from us to limit the powers of that ingenious animal, or of Amy, who ‘could tie herself into knots, and do wonderful things on the horizontal bar’” (Gregg, “Medical

Women” 100). This passage and Grey’s other, equally lamentable stylistic choices lead

Gregg to condemn the book. She concludes, “…the funniest things in the book are those which to all appearance are not intended to be so” (Gregg, “Medical Women” 100).

Gregg finds the stylistic and plotting elements of these novels a considerable obstacle to the persuasion of their audience of the viability of female physicians. Issues of style and plot are not the only obstacles Gregg notes as hindering these novels’ persuasion of their audience of women physicians’ viability.

The underdeveloped and unrealistic representations of female physicians in these novels trouble Gregg, much as they do Jex-Blake. Gregg, however, approaches this issue 127

as a writer of fiction sympathetic to medical women’s cause and not a physician herself.

Gregg’s concerns, therefore, are less about accurately reflecting medical intricacies, but

on the ways such representations alienate readers. Most notably, Gregg takes issue with

the flat nature of women physicians as literary characters in the first wave of woman

doctor novels. Gregg asserts that some medical women in novels categorized under the label “woman doctor novel” are often merely plot devices used to further the story of other, more well-developed characters, rather than fully developed characters in their own rights. She pinpoints Reade’s Gale as her primary example of this phenomenon.

Gregg asserts that Gale, who receives the patronage of the titular “woman-hater,” is “too

obviously brought in to recount the iniquities of her opponents, and thus to provide the

necessary philanthropic purpose of the novel” (Gregg, “Medical Women” 96). As Gregg

reads the novel, Gale’s presence gives Vizard a philanthropic outlet that makes his

character more sympathetic. Rather than being a distinct character with her own goals

and attributes, Gregg suggests, Gale exists to support the fuller characterization of the

main male character in the novel. This criticism might easily be extended to characters

such as James’ Dr. Prance.

In addition to the lack of development of medical women in their own novels,

Gregg criticizes early woman doctor novels for their presentation of medical women as

possessing unrealistic abilities and strengths. Unlike Jex-Blake, however, her concerns

arise not only from the harm that can be done to women physicians’ ethos by failures of

mimesis but also from the alienation of readers resulting from the strangeness of these

representations – failures of identification. Attitudes toward readers’ – especially women

readers’ – connections with fictional characters was in flux in the late Victorian period. 128

Marisa Palacios Knox highlights tension over women readers’ identification with

characters in Victorian novels. She notes two such attitudes. First, she notes that concerns

about women’s affective responses to literature – about the potential perils of adopting

the affective states represented in melancholy or controversial literature – lingered

through the end of the century (Palacios Knox 93). At the same time, Palacios Knox notes, women’s identifications with characters in literature were often posited as an outgrowth of their natural capacity for empathy in idealized roles of wife and mother.

The absence of identification with the characters in the novels they read, Palacios Knox writes, was often seen to indicate a mental or physiological deficiency (Palacios Knox

94). Regardless of such conflicts over identification, in writing on woman doctor novels,

Gregg argues for the importance of readers of such political novels connecting with their characters, regardless of whether physicians themselves – including Jex-Blake – find

these novels’ representations of their medical practice accurate.

Gregg finds the opportunities for non-physicians’ readerly identification in these

novels limited by their exaggerated characterizations of medical women. Gregg notes that

their female physicians are either disconnected from or ignorant of the world, or possess

more than the usual amounts of mental and physical strength: from Dr. Amy’s nearly

supernatural agility in Sweethearts and Friends to Rhoda Gale’s uncanny ability to

remember and recount the minutest details of her experiences in her conversation with

Vizard in A Woman-Hater. Some of these purported issues are relatively harmless, such as the excessive combativeness of Reade’s Rhoda Gale and other fictional female physicians, which Gregg jokingly asserts might come out in a real female physician if her place in medical work was challenged as these fictional women often are (Gregg, 129

“Medical Women” 97). Gregg, however, draws her criticism not from the failures of

mimetic representation in these novels but that such representations make these women

unrecognizable and unsympathetic to physicians and non-physicians alike (Gregg,

“Medical Women” 97-8). Gregg’s criticisms of fictional female physicians arise from

their disconnection not only from the lives and experiences of medical women but also

from women readers more generally.

On the question of identification with a general audience of women readers,

Gregg takes particular issue with Henry Curwen’s Dr. Hermione. Curwen’s novel, Gregg

argues, presents its readers with a main character that does not resemble its women

readers – professional or not. Gregg notes that when she sees her love interest injured, Dr.

Hermione “shows her fitness for her duties by going into hysterics when she sees him

wounded” (Gregg, “Medical Women” 104). Gregg notes that this reaction results from

Dr. Hermione’s sheltered life. She asserts that Curwen positions Dr. Hermione as

“absolutely ignorant of the world” and “especially of men” (Gregg, “Medical Women”

104). She criticizes Curwen for this choice, which does not reflect medical women’s

education and experience. She writes, “that a woman of unusual capacity should pass

through the whole of a medical course, and that in Paris, and work largely among the poor, both in London and in the country, and still remain in a state of blissful ignorance, seems to argue that she went about with her eyes shut” (Gregg, “Medical Women” 104).

Further, she writes, “[I]n a medical school the unavoidable intercourse with the male students, who are not as a rule, we think, so entirely cut after the same pattern as our author considers, should have kept man from being an absolutely unknown animal”

(Gregg, “Medical Women” 104). Such ignorance of men and of the world in general, 130

however, Gregg writes, is uncharacteristic not only of female physicians but also of

women more generally. Gregg writes, “[E]ven the average girl picks up a certain

knowledge of both, if only from newspapers and novels” (Gregg, “Medical Women”

104). Representing Dr. Hermione as lacking knowledge of both the world around her and

of men, Gregg suggests, shows the author’s failure to depict Dr. Hermione as both an

analog of a woman physician and a reflection of real women living in the nineteenth

century. Dr. Hermione not only misrepresents its woman physicians but also alienates

Gregg as a non-physician woman reader.

Gregg, unlike Jex-Blake, acknowledges the risks writers took in trying both to

represent women physicians mimetically and to create identification with a broader

audience of readers. Gregg finds redeeming qualities in many representations of woman

physicians that Jex-Blake declares to be failures, particularly for their attempts to connect with their readers. Gregg notes that Dr. Romney is more fully realized as a character than many of her counterparts, indicating that she is “more distinctly a woman, and less the embodiment of a cause” than many of the other entries in the woman doctor novel genre

– possessing flaws and eccentricities that make her more relatable than other woman doctors in novels (Gregg, “Medical Women” 101). Edith Romney’s relatability, Gregg argues, distinguishes her from the peerless perfection of earlier female physicians, making her less of an alien to her readers and opening up grounds for her readers to

identify with her.

Attempts to create identification with readers in woman doctor novels, however,

often resulted either over-exaggerated weaknesses that alienated their readers and

foreclosed their political potential or distorted the realities of medical practice and of 131

medical women. Gregg argues, for example, that Edith Romney pushes too far in attempting to win the sympathies of its audience. Despite this somewhat more grounded portrayal of a medical woman as an actual woman, rather than a symbol, Gregg asserts that Dr. Romney lacks the mental strength medical women cultivated through their rigorous training and education. Edith Romney “gives way very quickly” in the face of opposition and “does not face her misfortunes with the spirit we had anticipated[,]” instead yielding “weakly to the ridiculous demand of the vulgar nouveau riche,” who expects her to be content with lower fees because she is a woman and making “no attempt to take arms against her sea of troubles” (Gregg, “Medical Women” 101). She writes,

[W]e should have expected to see [Dr. Romney] comforting herself with the

reflection that the next swing of the pendulum would bring [her patients] all back

to her, and otherwise putting in practice the philosophy which is popularly

supposed to be inculcated by the difficulties of a long and hard course of study.

(Gregg, “Medical Women” 102)

Gregg, as does Jex-Blake, suggests that Dr. Romney’s lack of fortitude is misaligned with the character of female physicians, although she approaches the text as an “outsider.”

Gregg, however, takes issue less with the failure to reflect medical women and more with

the alienation such a poor representation enacts on her as a reader who is somewhat

familiar with medical women and their struggles. Using the stereotypical trait of

women’s weakness to represent women physicians more realistically, Gregg indicates,

has the opposite effect; it removes the character-shaping realities of the hardships they 132 faced as they confronted opposition to women in the professions and the intellectual and mental challenges they endured through their difficult medical studies.

In addition to criticizing earlier novels, Gregg crafted her own vision of a woman doctor novel that provides insights on her idea of a future direction for the woman doctor novel after the “second wave.” In Peace with Honour (1897), Gregg’s protagonist,

Georgia Keeling, is an accomplished and established female physician. The novel details

Keeling’s travels to Ethiopia with diplomatic representatives of the British crown, including Major Dick North. North is a childhood friend, whose romantic advances she rejected ten years before the events of the novel. While her novel adopts a colonial adventure plot, including a kidnapping, multiple poisonings, disguise, and the discovery of supposedly long-dead individuals, Gregg incorporates many of the issues that concerned earlier woman doctor novels. As did other woman doctor novels, Gregg’s work includes a romance plot between its protagonists. Throughout the novel, bull- headed North pursues Keeling. As do many of his predecessors, North struggles with his affection for Keeling and his hatred of her professional position. Keeling must also deal with resistance from patients and the public as she takes on the role of sole physician after the expedition’s male physician dies of poisoning midway through the novel.

Keeling, however, distinguishes herself from earlier women physicians in romance plots.

Gregg’s novel differs from its predecessors on its protagonist’s worldliness, her strength, and its strident emphasis on the antiquated nature of criticisms of female physicians on the basis of their gender. First, Keeling is worldlier than many protagonists of early woman doctor novels. She is older and more experienced than many of her predecessors, having graduated from medical school many years before and having 133

worked abroad before her departure for Ethiopia. Keeling, having fielded criticism

toward her profession for a longer period of time than figures such as Edith Romney and

Dr. Hermione, manages North’s antagonism and the difficulties of being a female

professional in a world of men with aplomb. One of their travelling-mates, Lady Haigh notes that “Georgia has had plenty of practice in arguments of this kind, for every man she meets begins his acquaintance with her by trying to convert her. She has her most telling pieces of evidence all marshalled ready for use” (Gregg, Peace 38). Gregg also connects Keeling’s ability to manage such resistance without either succumbing to illness

– as does Edith Romney – or emotional distress – as does Dr. Hermione – to her medical training. Rather, Lady Haigh notes that the rigor of Keeling’s training has prepared her for such criticisms. She asks a fellow traveler skeptical of Keeling’s resolve, “[I]s it likely

that after going through her training as creditably as she has done, she would ever allow

herself to be convinced that it had been impossible or improbable for her to study

medicine?” (Gregg, Peace 38). This sense of Keeling’s strength and fortitude is

reinforced throughout the novel, especially at its conclusion. In a direct reversal of the

events of Edith Romney, it is the antagonist North, rather than Keeling, who succumbs to

brain fever. The role reversal is completed when Keeling nurses North back to health.

They are married, and Keeling retains her profession, unlike earlier medical women, who

abandon medicine on their entry to marriage.

In addition to a greater sense of historical context and rounder character, the novel

takes pains to assert that North’s negative attitude toward women – and women doctors

especially – are out of step with the times. Throughout the novel, Gregg dismisses

criticisms of the “unwomanly” nature of independent women. She does so by having 134 other characters in the novel continually berate North for his archaic ideas about women’s roles. North’s sister Mabel is especially critical of his attitude toward women.

She notes that North’s ideal woman is subservient to him, rather than his equal. She asserts that he likes “a woman’s eyes to drop before [his], as a sort of unconscious tribute to [his] greatness and [his] glory. A man may look at a woman with the calmest insolence, but she must only steal a glance at his face when he is not looking” (Gregg,

Peace 12). This is not to say that Keeling never makes missteps in her role as physician, as Jex-Blake and Gregg criticize in earlier novels; rather, she makes a few serious miscalculations about her status as a Western woman physician in the East – one of which leads to her brief imprisonment in the zenana with the women of the royal family.

Such errors, however, do not undermine Keeling’s reliability as a medical woman, but only enhance the sense that readers are encountering a reflection of a real woman – not an individual who is always right or who is beyond their understanding.

Gregg’s strategies for re-thinking the woman doctor novel also run up against limitations similar to those suggested by Jex-Blake, but she suggests greater limitations on who can generate accurate representations of fictional women – including medical women. Gregg, as does Jex-Blake, lays great importance of the representation of medical women by “insiders.” In her writing for Blackwood’s, Gregg praises Todd’s Mona

Maclean, Medical Student for its “insider” realism. Gregg classes Todd’s novel as the last of the “transitional texts” about female physicians. She indicates, that as the author of a novel two decades after the opening of the London School of Medicine for Women and the legitimation of women physicians under the law, Todd undertakes a more difficult task than many of her predecessors. Gregg writes, “The medical woman has vindicated in 135

the eyes of others her right to live; she has now to justify her existence in her own”

(Gregg, “Medical Women” 108). Regardless of the challenge presented to Todd, Gregg declares the novel a general success. She notes that “Mona herself is some what unduly perfect” but that, as an “ideal” or “inspiration,” Mona offers a realistic example of what a woman in the profession can achieve (Gregg, “Medical Women” 109). Gregg goes so far as to suggest that the novel could serve as a guide for women interested in the practice of medicine for understanding the complicated duties being expected of them in their new

profession.

Gregg’s novel, however, suggests that writing about medical women need not be

limited to the women of the medical profession to be representative of their character or

continued struggles against their detractors. Gregg herself was an “outsider” to the

medical profession. She had some familiarity with medical practice and training,

however, as her sister Katherine trained at the London School of Medicine for Women

and undertook medical missionary work in Japan and India. Despite her proximity to

medical practice, as in the novels of both James and Todd, Gregg adopts significant

constraints when generating representations of women in medical practice. As does Todd, she writes about a woman physician in a situation outside of typical medical practice –

but rather than removing her from medical practice, she removes her from a Western

context. While Keeling is consistently represented as a consummate physician throughout

the novel, readers do not see her in a practice with which her readers would be familiar;

rather, they see her in a foreign country practicing medicine on a population with which

they would have little to no direct familiarity. Gregg does not engage in detailed

descriptions of medical treatments, although she alludes to treatments in passing, 136

including the removal of a gangrenous limb, treatment of North for brain fever, and the

removal of cataracts from the eyes of the Shah’s wife. Unlike Jex-Blake, however, Gregg

imposes additional limitations on who can perform the realistic representation of women

– especially medical women – in novels.

Gregg argues that women alone have the best knowledge of women’s natures throughout her novel and writing for Blackwood’s. Men’s inability to understand women

comes through most clearly through the character of Major North. After meeting Keeling

for the first time in ten years, North bristles at learning of her occupation and her work

abroad. Following their encounter, North shares the following conversation with his sister

Mabel. After she asks him why he was rude to Keeling, North asserts, “I like a woman to

be a woman. These lady doctors are not womanly.” To this sentiment, Mabel quickly

responds, “Indeed! Who is the best judge of what is womanly, you or a woman?” (Gregg,

Peace 12). In this exchange, Gregg hints at North’s inability to understand

“womanliness” or to fathom Keeling’s behavior as a woman who acts independently of

societal expectations of “womanhood.” North’s inability to understand Keeling’s

devotion to her profession and her independence becomes a major theme of the novel,

only subsiding after his brain fever has led him to rashly break off their engagement and

confront the full consequences of his misunderstanding. While the female characters in

the novel understand Keeling’s decision to become a physician and the other male

characters in the novel accept this decision, North struggles to understand Keeling’s

behavior in the light of his fixed ideas about the nature of “womanhood.” The novel

suggests not that those outside the medical profession cannot understand medical 137

women’s character but that rather women’s character cannot be fully understood by men

or male writers with fixed notions of women’s roles in society.

Gregg’s novel and her writing for Blackwood’s sharply criticize the

representations of medical women in the East and their fundamental misunderstandings

of women’s inner lives. She takes particular umbrage with Rudyard Kipling. Kipling’s

Naulahka (1892) in part details the experiences of a British woman working as a “healer” in the East. Writing about Peace with Honour in her review essay, Gregg defends it

against critics who expressed a belief that it was reductive of Naulahka. Gregg asserts

that her novel is the only medical fiction that deals with a British medical woman’s

experiences in the East. She argues that Kate, the female medical professional in

Kipling’s novel, has never earned the official title of female physician. Kate, then, does

not represent the experiences of medical women in the East. Gregg also argues that

Kipling fails to accurately represent the lives of non-medical Eastern women. Kipling,

she argues, fundamentally misunderstands the pressures and demands put on these

women and, thus, does not fully represent them (Gregg, “Medical Women,” 106-7). She

suggests that, in her research on the East and understanding as a woman, these women

are much more troubled by their living situations than Kipling himself can understand or

represent.

Gregg’s antipathy to male authors’ representations of women – both medical and

non-medical – also courses through her novel. In an exchange with North, after they have

arrived in Ethiopia, Keeling expresses her resentment at Kipling’s representations of

women. Unsettled by the perilous state of women’s safety and security in the palace in

Ethiopia, she confides her observations about the unhappy state of these women to North. 138

North asserts his understanding of Eastern women as more happy and fulfilled than

Western women, which he bases on Kipling’s novels. Keeling responds to North “in high scorn,” asserting that although she admires Kipling’s writing on men, he falls short when representing women. She states,

[W]hat can he, or any man, know about women? At best they can only see results

and guess at causes. They observe very carefully all that they can see, and give us

the result of their observations in knowing little remarks, half cynical and half

patronising, and think they have gauged a woman’s nature to its very depths.

Then she does something that throws all their calculations wrong, and they say

she is shallow and fickle, and, above all, unwomanly ; whereas it is only that

either their observations or their deductions were incorrect. (Gregg, Peace 112).

While Keeling admits that men may “observe very carefully” the actions of women, she asserts that male authors such as Kipling can only observe outward signs of womanhood and report these observations. Much as Jex-Blake asserts that the writing of non- physicians is limited by their outsider status, for Keeling, the writing of male authors about women, then, is similarly hindered by men’s “outsider” status. Kipling lacks the experience of having been a woman – of having embodied and cognitive experiences as a woman and, thus, his representations of women amount to little more than “half cynical and half patronising” remarks. Male authors can never fully grasp the complexities of being a woman, and the representations that they generate of women can reiterate the disparity between women’s own experiences and men’s limited observations of these experiences. Gregg, thus, imposes limits on the gender of the writer, if the writer is to achieve a realistic portrait of the women represented in the novel. 139

Gregg does not make this argument directly in her literature review of woman

doctor novels, as she does in her fiction. One can easily recognize, however, that the sex

of the writers’ whose novels she criticizes are largely male – the exception being

Maxwell Grey’s (the pen name of writer Mary Gleed Tuttiet) novel Sweethearts and

Friends and the anonymous author of Edith Romney, whose gender is unknown. The only other novel written by a woman that she engages is Arabella Kenealy’s Dr. Janet of

Harley Street. Although Gregg notes the slightly unconventional nature of Dr. Janet’s training of an apprentice, she has little critical to say of the novel or its eponymous main character outside of noting her unusual tendencies of dress. Notably, however, she neglects James’s The Bostonians in her discussion of woman doctor novels.

Conclusion: The Death of the Woman Doctor Novel?

Although Jex-Blake and Gregg suggest new directions for the woman doctor novel in their writings in the 1890s, the woman doctor novel largely died out by the beginning of the twentieth century. As Kristine Swenson has noted, female physicians, while still featured players in novels at the turn of the twentieth century, took on less prominent roles – becoming minor “stock” characters, rather than the center of novels (Swenson

103). Beyond the loss of the narrative spotlight, writers who had successfully represented woman physician, such as Annie S. Swan and Arabella Kenealy, moved to other subjects.

Swan, published a sequel to her earlier novel Elizabeth Glenn, M.B. (1894), in 1897, Mrs.

Keith Hamilton, M.B. Rather than a novel, however, this book was a series of short stories featuring the same protagonist as her earlier novel, who had resigned her medical practice upon her marriage. Kenealy, a female physician, who had written the popular Dr. 140

Janet of Harley Street published a collection of short stories, or “sketches,” which

centered on the practice of a male physician, Dr. Smith of Queen Anne Street (1907).

Writers, however, continued to debate the woman doctor novel, even after its

“death” in the early twentieth century. In her 1910 short story, “Literature and the

Profession,” I.N. Clough satirizes the misalignment between the realities of the lives of

female physicians – their work, their knowledge, and their values – and their

representation in the then-defunct genre of woman doctor novels. In the story, Clough

presents her readers with an encounter between Mrs. Sparkles, who writes New Woman

novels under the masculine pseudonym Paul Farringdon, and a young, unnamed medical

student. For her forthcoming novel, Mrs. Sparkles has undertaken the topic of women

physicians. Mrs. Sparkles, echoing both Jex-Blake and Gregg’s assertions about the rhetorical power of woman doctor novels, argues that “the public is not sufficiently awakened to the heroism of lady doctors” and that authors have the grave task of

“educat[ing] the minds of the unthinking public which rushes to the circulating library in search of sensation and amusement” (Clough 210). Mrs. Sparkles takes the opportunity of meeting the young woman to test out the “technical details” of her new novel. The nameless young medical student quickly discovers that, despite her good intentions, like many writers of woman doctor novels before her, Mrs. Sparkles understands neither the practicalities of medicine nor the personalities of its practitioners. When, for example,

Mrs. Sparkles suggests that the female physician in her novel will attract the attention of her future lover – a surgeon – by fainting during an operation, the young physician suggests that the only way a surgeon would be distracted by such an occurrence would be if the novel’s protagonist were to faint across the patient. This idea, however, is “coldly 141

received” by Mrs. Sparkles (Clough 211). The two women’s disagreement about medical

practice and personality peaks over the question of blood transfusion. Mrs. Sparkles

wants her heroine to save her lover through the donation of her own blood, while the

young physician argues that such a course of action would be “very wrong-headed”

(Clough 213). In response to the medical woman’s condemnation of her romanticized

course of treatment, Mrs. Sparkles declares, “No sacrifice is too great for a woman to

make on behalf of the man she loves” (Clough 213). Faced with “Paul Farringdon’s

literary power” and the stakes of such a representation for “the honour of medical

women,” the young physician replies that the heroine of the novel “wouldn’t sacrifice

surgical principles and commonsense to sentiment” and condemns the course of

treatment represented in the forthcoming novel (Clough 213). The physician makes a

hasty exit immediately afterward.

This short story is critical of both the novelist and the doctor. Although the woman physician has genuine concerns about how such a representation will transform the public’s views of women in the medical profession, she is overly concerned with generating an accurate picture of medicine’s minutiae. Meanwhile, while Mrs. Sparkles

wants to aid female physicians’ cause, she does not acknowledge that her representations

of women physicians make them look foolish. Because neither woman can compromise,

the idea of the woman doctor novel never comes fully into fruition. This short story,

encapsulates the difficulties of representing women physicians as articulated in the 1890s

by Jex-Blake and Gregg – of connecting with one’s audience while remaining respectful

of a subject’s true features. These concerns about ethos became manifest in L.T. 142

Meade’s creation of dangerous women physicians in her short fiction for the Strand, discussed in the next chapter.

143

Chapter 3: Short Story Serials: L.T. Meade’s Constructions of Women Physicians’ Ethos in the Strand Magazine and Atalanta

L.T. Meade’s most famous works for the periodicals – The Brotherhood of Seven Kings

(1898) and The Sorceress of the Strand (1903), written with physician Robert Eustace –

depict powerful women who, although they lack the credentials to call themselves

“physicians” in early twentieth century Britain, achieve success and popularity as a result

of their medical skills. At the beginning of the first installment of The Brotherhood of

Seven Kings, the wealthy Mrs. Kenyon discusses the success of the mysterious Madame

Kochuly with the series’ protagonist, Norman Head. Mrs. Kenyon praises Kochuly’s

reputation, stating, “There are authentic accounts of her wonderful cures which cannot be

contradicted. There are even rumours that she is able to restore youth and beauty by her

arts. The whole of society is at her feet, and it is whispered that even Royalty are among

her patients. Of course, her fees are enormous, but look at the results!” (Meade and

Eustace, “At the Edge” 86). The medical skills of Madame Kochuly and The Sorceress of

the Strand’s similarly feted Madame Sara, however, belie the results of the “physicians’”

treatments of their patients. Rather than improving their patients’ overall well-being,

Madame Kochuly and Madame Sara are dangerous criminals who manipulate their charges, most often for money or power. While both villainous physicians often improve

the physical state of their patients, these women’s grasping for money, knowledge, or power imperil their patients’ social status, relationships, and mental health.

The persistent difficulty in interpreting Meade’s writing for the Strand is the

inconsistency between her depictions of professional women and other aspects of

Meade’s professional and ideological persona. Meade’s representations of dangerous

women physicians placed in opposition to noble male detectives and physicians presents 144 a less progressive view of the female physician – a turning back to a cultural specter of the time before women established themselves as competent professionals. Meade and

Eustace’s short story serials more closely resemble earlier and more skeptical writing about female medical professionals such as Wilkie Collins’ “Fie! Fie! Or, The Fair

Physician” (1882) than the writing of their contemporaries, such as Arthur Conan

Doyle’s “The Doctors of Hoyland” (1894). That Meade, one of the vanguard advocates of women’s rights and professionalism in her novels and her writing for the Atalanta, would generate representations of a woman succeeding in her profession as dangerous to

British society has troubled contemporary scholars and led many to devalue the entirety of her work for its seeming inconsistencies.48

In light of these dismissals, feminist scholars have sought to rehabilitate Meade’s

writings as nuanced, rather than strictly antifeminist. Sally Mitchell, most notably,

defends L.T. Meade in The New Girl (1994), contextualizing her novels about girls’

schools with her editorship of the young women’s magazine the Atalanta.49 Following on

Mitchell’s defenses of Meade, recent critical works by Winnie Chan, Janis Dawson, and

48 In contrast with Meade’s contemporary critics such as Kimberley Reynolds, J.S. Bratton, and Douglas G. Greene, Janis Dawson has underlined Meade’s acumen in both managing her public persona and as a writer of popular fiction, while also noting the seeming disparities in Meade’s stance with regards to women’s rights and the representations of women in her fiction. Meade, Dawson argues, was highly influenced by the New Woman ideology but also tried to work within the specific demands of the market without compromising those ideals (Dawson, “Write” 145). Similarly, Chan argues that Meade’s writing for the periodicals also pushed the thematic and formal boundaries of serial fiction, using her writing for the genre to promote a perspective different from the patriarchal one usually found in the print media. Meade’s women, particularly her medical villainesses, Chan writes, “upse[t] the stability of objective truth and male authority reinforced in The Strand’s iterations of the short story” (Chan 69). 49 Readings of Meade as apolitical and even antifeminist, Mitchell argues, display an overly simplistic view of both Meade’s writing as a professional woman and of the complexities of the nineteenth century women’s movements. Mitchell writes that assertions of Meade’s antifeminism ignore Meade’s very real involvement with women’s rights and feminist movements of the late nineteenth century in her writing for publications for the women-centered Girls’ Realm, her participation in feminist groups such as the Pioneer Club, and her editorship of the Atalanta, a girl’s magazine that advocated increased professional and civic opportunities for women. 145

Beth Rodgers have bolstered Mitchell’s assertions about the complexity of Meade’s

representations of professional women, arguing for Meade’s acumen at crafting a

professional persona for herself in her interviews for the periodicals, her ability to pursue

feminist goals through the male-dominated forms enacted by the periodical press, and the

influence of Meade’s Irish heritage on her attitudes toward women in the professions. In comparing representations of women physicians in Meade’s Atalanta and the Strand, this chapter joins the writing of Chan, Mitchell and Dawson in recuperating Meade’s maligned fiction.

In order to understand the disconnection between the depictions of the female physicians in her writing for The Strand and Meade’s own ideological adherence to women’s rights, this chapter explores what the categorization of Madame Kochuly and

Madame Sara as “medical experts” reveals about Meade’s attitudes toward medical women as a whole. Meade’s criticisms of the female physicians in both the Brotherhood and the Sorceress arise not from the quality of their medical knowledge or their ability to practice medicine effectively. Rather, in both her fiction and her editorial work at the

Atalanta, Meade depicts the medical profession as inherently possessing a position of high privilege, access, and rhetorical influence over patients via ethos – the public’s assumptions that professional physicians are knowledgeable, selfless and moral members of the British nation. Madame Kochuly and Madame Sara draw on the complex rhetorical authority granted physicians in early twentieth century. By illegitimately claiming the title of “physician,” Kochuly and Sara benefit from their audiences’ assumptions about the three aspects of ethos associated with individuals claiming that title: that they have medical knowledge and know how to apply it through “right judgment” (phronesis), that 146 they conform to the norms and values of their profession and British society and demonstrate these norms through virtuous acts (arête), and that they serve the best interests of their patients and their community through demonstrations of goodwill

(eunoia).

In the context of other depictions of medical professionals, such as those she presents during her editorship of the Atalanta, Meade’s criticisms of the female physicians in her short story serials for The Strand suggest a problem of legitimacy, rather than a condemnation of women in the medical profession. Meade, throughout her editorship of the Atalanta and her short story serials, suggests the privileged access to the bodies and lives of patients open to women when they become medical professionals and adopt the title “physician.” By framing themselves as possessing medical skill even though they lack the education and licensing required by British law, Kochuly and Sara access the privileged ethos of “physician,” even though both women lack the rigorous medical education and credentialing that are supposed to grant individuals access to the title “physician” and the ethos attached to it. Meade’s fiction and her editorship of the

Atalanta both place restrictions on the legitimate means by which such privileged positions are open to women: medical professionals should earn the rights to call themselves physicians and, thus, their patients’ trust only under strict adherence to existing professional norms of ethics and credentialing. Legitimate medical professionals,

Meade’s short stories suggest, are shaped into the professional norms that enable them to behave ethically in these privileged positions only through the rigors of British medical education, which molds their intellect, strength of character and selflessness. Adopting the role of physician allows Meade’s female villains increased access to the bodies of 147 their victims and although Meade draws out these dangers to entertain her audience, she uses these depictions not as explicit warnings against female physicians but as a means of using the entertaining genre of medical detective fiction to suggest the possibilities open to and responsibilities associated with women taking on the role of medical professional.

Meade’s seemingly “inconsistent” writing for The Strand, then, can be seen as a transformation of her feminist ideologies about a more expansive professional role for women for a broader, less explicitly politically-concerned audience.

Meade’s dangerous physicians

L.T. Meade’s first engagement with women physicians generates representations of them as dangerous. Despite her writing about other women in medicine – such as nurses – and male physicians in both her fiction and her non-fiction writing, The Brotherhood of Seven

Kings (1898) serves as Meade’s first foray into depicting female physicians. Written with physician Robert Eustace, the first installment of the ten part series – “At the Edge of the

Crater” – appeared in January 1898 and outlines the criminal activity associated with its female physician. The story’s British protagonist, Norman Head, describes his seduction by Madame Kochuly – a beautiful and talented Italian medical woman – and his induction into the organization of which she acted as adviser, The Brotherhood of Seven

Kings. Although he could not discover enough evidence to convict her, Head asserts that she was “the instigator, if not the author, of a most terrible crime” and that “there was little doubt that she was its moving spring” (Meade and Eustace, “At the Edge of the

Crater” 85). After his discovery, Head flees back to London, where he encounters the dangerous woman again in London society, where she treats and blackmails her English 148 patients in much the same way she ran the Brotherhood in Italy – disconnected from the immediacy of the crime, but still intimately connected with criminal actions achieved through scientific and medical influence. The remaining stories in the series detail Head’s attempts to foil Kochuly’s criminal activities, concluding with her death.

In addition to appearing in the Strand five years after the Brotherhood, Meade and

Eustace’s second set of short stories about a dangerous female physician, The Sorceress of the Strand (1903), closely resembles their earlier writing about Madame Kochuly.

These stories feature a villainous female physician who uses her medical skills to gain access to the bodies and secrets of her patients and a male protagonist – here, Dixon

Druce – who seeks to expose her treachery. Like Madame Kochuly, Madame Sara – a foreigner running a medical practice and perfumery in London, rather than the head of a crime ring – possesses extensive knowledge of medicine and science that makes her dangerous to those around her. In “The Talk of the Town,” Dr. Vandeleur, a municipal medical examiner, warns one of Madame Sara’s victims that the “scientific knowledge which Madame possesses, and which is not a smattering, but a real thing, makes a woman at times – dangerous” (Meade and Eustace, “The Talk of the Town” 62). The Sorceress of the Strand, however, rather than pitting a female physician and her former lover against each other, intensifies the personal and physical dangers to individuals – most often female patients – at the hands of their female physician. No longer, in this series of stories, is the female physician the brilliant prime mover behind a circle of criminals; instead, the Sorceress’s Madame Sara interacts directly with the individuals she attempts to manipulate, often physically adulterating the bodies of her patients – most often through poison – for her own ends. 149

Meade’s protofeminism and genre

Meade and Eustace’s treatment of these medical women in the Brotherhood and the

Sorceress stands in stark contrast with Meade’s feminist stances and activism. Meade

managed the Atalanta Magazine, a publication for young women; she was involved with

the proto-feminist Pioneer Club; and she wrote fiction centered on the experiences of

English schoolgirls.50 Meade’s Atalanta, of these three activities, can offer the most insight into the nuances of Meade’s representations of dangerous medical women in her short story serials. The Atalanta serves as her clearest engagement with women as professionals at the end of the nineteenth century. Where The Strand addressed a general audience, the Atalanta, aimed at young women and girls, served a variety of purposes – among them, entertaining and empowering young women who were preparing for the professions. Meade, as editor of the Atalanta, promoted what Mary Anne Broome later termed the “New Girl,” the “younger sister” of the New Woman, in Colonial Memories in 1904. Under Meade’s tutelage, the Atalanta, included short stories by key late

Victorian and Edwardian writers such as Rudyard Kipling and Edith Nesbit. The

Atalanta, however, took a strikingly political perspective as it also demonstrated

employment and social opportunities for its young female readers, urging them to involve themselves in public professions and featuring articles by and letters from women in

50 For contemporary critics like Christopher Pittard, that the only female physicians represented in Meade’s fiction are criminal women “posing” as physicians and taking advantage of the heightened intimacy with vulnerable women granted through the physician-patient relationship challenges assumptions about Meade’s feminist stances on women’s place in the medical profession. 150

professional careers, such as Millicent Garrett Fawcett on civil servicec, Edith Huntley on

medicine, and Ethyl Comyns on typewriting.51

Among the professions highlighted in the Atalanta, the medical professions open

to women – physician, nurse, and midwife – featured prominently. The discussions of the

various professions in the Atalanta, over which Meade held editorial control, suggest a

positive view of women’s capabilities for acting as competent and ethical members of the male-dominated medical profession, beyond the feminine-coded professional roles of nurse and midwife. Meade herself wrote nothing of women as professional physicians outside of her fiction, despite her endorsement of women in the professions. The magazine she helmed, however, featured a series of articles on women physicians in

1888. Edith Huntley – a female physician herself – argues that the medical profession offers one of the most exciting opportunities for young women. Huntley declares that medicine is “a newly-opened and most promising” career (Huntley, “Medicine – I.” 592).

Urging women to undertake medical study, Huntley recognizes the arguments levied against women who have wanted to pursue medicine in the past, writing, “It has been the custom to teach women to think the study and practice of medicine unwomanly and unwomanizing” (Huntley, “Medicine – I.” 592). Huntley, however, dismisses such proclamations against women physicians as absurd and highlights the intellectual and social benefits of an increase in the number of female physicians both for female patients and for the community more generally.

The demands and affordances of the specific periodicals with which Meade involved herself helps account for many of the seeming inconsistencies in the

51 Sally Mitchell addresses the influence of Meade’s feminism on her editorship and, thus, on the particular content of the Atalanta. See Mitchell 13. 151 representations of female physicians in Meade’s Atalanta and her own fiction for the

Strand.52 Writers for publications such as The Strand and the Atalanta, with their distinct audiences and aims – The Strand for the general public and the Atalanta for young women – respond to vastly different demands, although they may be covering similar topics or share an underlying ideology. Different genres, then, can respond to the same social need or ideology by using strategies unique to their addressed audience. Meade’s

Atalanta and the foregrounding of articles with a positive view of women as physicians display Meade qua editor’s clear investment in the possibilities open to young women in the medical profession. In The Strand, conversely, Meade wrote for a publication that promised its broader and more diverse audience of readers entertainment through the cultivated dissemination of new genres of literary writing. In the preface to the first issue of the Strand in January 1891, founder George Newnes writes that the magazine serves to supply “cheap, healthful literature” to the wider public (Newnes 3).53 The overarching goal of Newnes’s periodical, therefore, aimed at a broader swath of the public than the

Atalanta, which addressed young women. Newnes tailored his magazine’s content to please the greatest number of people by avoiding the political bias he perceived in his competitors, a stance for which Newnes received pointed criticism.54 When it did address

52 Genre theorist Carolyn Miller (1984) has argued for the potential rhetorical and literary insights available through scholarly attention to the “action” of various genres. As Miller defines it, a genre is a typified rhetorical action that responds to particular social needs (what Miller terms a “rhetorical exigence”) (Miller, “Genre” 159). 53 Although later volumes of the periodical feature serialized novels like Arthur Conan Doyle’s The Hound of the Baskervilles (1902), an implicit goal of The Strand’s early years was to step away from traditional serialized fiction and to promote new forms of fiction and journalism. Newnes specifically sought to pioneer new features that previously could not find a home in traditional periodicals. In his editor’s note, Newnes writes, “Special new features which have not hitherto found place in Magazine Literature will be introduced from time to time” (Newnes 3). 54 Such a stance won Newnes and his writers – most especially Meade – excoriation from literary critics like Arnold Bennett. In writing on the periodical in “The Fiction of Popular Magazines,” Bennett writes that 152

political topics, The Strand took a slightly conservative stance.55 That Meade’s depictions of female physicians in the Strand would aim more clearly at entertaining her audience, rather than overtly reflecting her more progressive political ideology, therefore, should not be surprising. A deeper analysis of Meade’s stories reflects a more complex attitude toward the controversial figure of the female physician and one that aligns with that promoted by the Atalanta. Both Meade’s fiction and her magazine concern themselves with the possibilities and dangers opened by the assumption of the professional title

“physician.”

Women physicians’ rhetorical status in Meade’s short stories for The Strand

One powerful possibility that Meade’s magazine and short stories both acknowledged was physicians’ ability to use their professional standing rhetorically – to influence their patients’ beliefs and actions. Such a position was only newly available to women through the medical profession. At that time, as now, medicine as a profession aimed at persuasion of patients: in consultation with individual patients, a physician used technical skills to render a judgment on a diagnosis and course of treatment and attempted to persuade her patient into a set of actions based upon that judgment. Physicians had access to and influence over their patients’ bodies and minds. Meade’s Atalanta promotes a particular vision of the access and influence granted female physicians. Edith Huntley writes that the well-trained medical woman “who has had the privilege of filling the

The Strand’s brand of sensational fiction is “a striking instance of that obsequious pampering of mental laziness and apathy which marks all the most successful modern journalism” (Bennett 135). 55 The magazine itself did not avoid politics completely, as The Strand also featured longer non-fiction articles on topics like art, culture, current events and politics, as in the satirical series “Behind the Speaker’s Chair,” which mocked the events of Parliament by depicting the representatives as animals. 153 doctor's place to patients of her own sex” has an intimate and influential relationship with her patients, both physical and emotional. The female physician develops a particular intimacy where she “see[s] their relief and gratitude in their eyes and hear[s] it in their words” (Huntley, “Medicine – I.” 592). Huntley, in her articles, asserts the social benefits offered young women in order to convince these women to undertake medical study. By becoming physicians, young women become experts in the medical field and access the powerful influence of such a professional role. The privileged position granted female physicians in Huntley’s writing for the Atalanta is, in part, an exercise of ethos, as these women use their social and professional positioning as “physicians” as a persuasive device. Ethos belongs not only to individuals but to groups, through assumptions about the relationship of that group to their community. Much as with individuals, group ethos arises from previous demonstrations of moral character, their technical prowess or expertise, and their associations with particular social and professional roles in their community.

Much as does Huntley, Meade’s short stories draw on the idea of physicians’ increased access to patients’ bodies and lives granted through their association with the role of “physician.” Neither Sara nor Kochuly holds a medical degree or a license, however. Rather, these unlicensed and undereducated female physicians illegitimately adopt the title of “physician” in order to advance their nefarious agendas. The assumption of the title “physician” grants these women privileged access to their patients’ bodies and minds. The title and role of “physician” lends credence to these false physicians and affords them the privileges and access associated with that title. Norman Head, in responding to Mrs. Kenyon’s praise of Madame Kochuly’s skill, states, “She has 154

bewitched London with her impostures and quackery” (Meade and Eustace, “At the

Edge” 86). Each woman’s adoption of “impostures” grants her access to the medical

profession’s ethos. The title of “physician” acts as a means of persuading patients into a

particular set of behaviors; in the case of Meade’s short story serials, when a character

labels herself a “physician,” however illegitimately, she places herself into a strengthened

rhetorical position – she becomes an “expert” to be trusted.

Quackery and discrepancies between an individual’s ethos and reality

Unlike the Atalanta, however, Meade’s short stories suggest the potential for a discrepancy between the promised ethos of a person claiming to be a physician and the actual person adopting that title. While the legitimate physicians in Huntley’s articles use their privileged position to help patients make good choices, the illegitimate female physicians in Meade’s short stories draw on their audience’s assumptions about the medical profession to manipulate them. Speaking to Dixon Druce in the Sorceress’s fifth installment, “The Bloodstone,” Madame Sara notes one patient’s antipathy toward her.

Meade writes,

“I wish she would consult me,” [Madame Sara] replied. “I could do her good. But

she will not. She is under the impression, Mr. Druce, that I am a quack because I

do not hold diplomas – a curious delusion I find among people.”

“But a sound one,” I answered. (“The Bloodstone” 200)

Madame Sara argues that the British system of education and oversight of the licensing of

female physicians is a frivolous requirement. For Sara, the accusation of “quackery” is 155

spurious, even though she lacks degrees, a premise that audience proxy Druce – and by

extension, Meade – rejects.

Meade condemns the illegitimate use of the title of physician through the criminal

actions Madame Sara and Madame Kochuly commit while working as physicians. Both

women use their influence and access to harm the bodies, minds, and social statuses of their patients. Drawing on the title “physician” enables the villains in each of these stories to misuse this physical and social proximity granted by their assumed title. The physical cures offered by the women in Meade’s short story serials often result in physical dangers for her patients. Madame Sara mesmerizes a patient – a young Italian beauty – in order to gain influence over Professor Piozzi in “The Talk of the Town.” In “Madame Sara,” as

Madame Sara relieves her patients’ toothaches, she packs the fillings with poison in order to win access to their inheritance through their disgraceful brother. In “The Blood-Red

Cross,” she removes her patient Antonia’s embarrassing mole, but paints her disgraceful parentage in silver nitrate on her skin, which will mark her permanently when exposed to full light. Similarly, in “The Edge of the Crater,” Madame Kochuly’s agent, Dr. Fietta, treats the young Cecil Kenyon for his seasickness with what he claims is morphine.

Although Cecil’s illness is temporarily relieved, Head later discovers that Fietta has infected the boy with a dangerous parasite. In “Twenty Degrees,” through Kochuly’s manipulations, John North becomes addicted to opium, robbing him of his physical and mental vitality. The physical relief these women offer through their medical skills, then, pales in comparison with the havoc they wreak on their patients’ bodies with their medical skills. 156

The damage these conventionally uneducated and unlicensed female physicians

inflict is not limited to their patients’ health. In addition to having physical access to her

patients’ bodies, both Madame Sara and Madame Kochuly are granted dangerous access to the emotional and social lives of their patients. The Sorceress, makes this emotional sway more central than the Brotherhood. Whereas Madame Kochuly’s power most often relies on using her medical knowledge to manipulate physical bodies – whether of her patients, of their friends and family or of those investigating her, Madame Sara uses the intimacy granted by her position as medical professional to gather valuable information about her patients, which she later uses to control them. Sara, in attempting to convince

Dixon Druce to become her partner, declares, “Knowledge is power” (“Madame Sara”

392). Sara’s power derives from the information she has gleaned through her medical practice, specifically through her consultations with her patients.

What the villainous female physicians lack, for Meade, is morality and a sense of responsibility to community conveyed by medical training, even as these women possess uncanny medical skills. Meade plays off of Huntley’s articles for the Atalanta in this respect, as Huntley’s articles outline three factors through which medical education and credentialing allow women physicians to embody the ethos of the medical profession. In order to earn the privilege of calling herself a physician, Huntley argues, the young woman must undergo significant training that shapes her knowledge, character and sense of obligations to her community. The first aspect of medical ethos in Huntley’s articles involves their medical and technical skills. Huntley’s articles claim that a medical education, required of any licensed physician in England will grant superior technical knowledge and experience. She discusses the steep technical and scientific requirements 157

for achieving the lofty title of professional physician. Huntley writes that a woman’s

medical education, as a man’s, “consists of bookwork, practical work, and examinations,

and is in all respects as thorough and complete as that undergone by the ordinary

practitioner who has from time immemorial been to all par excellence ‘the doctor’”

(“Medicine – I. 592). Huntley, then, assures her readers that, through diligent study and

practice, licensed women physicians can achieve superior technical and scientific skills

for medical practice.

The Brotherhood and the Sorceress – as they attempt to entertain their audiences through sensational plots – underline the technical abilities of their illegitimate physicians, even as they misuse these skills. Unlike Huntley’s articles, Meade’s short stories posit that, even without the legitimate title of “physician,” Madame Kochuly and

Madame Sara possess the medical knowledge necessary for treating patients. Both women cure patients of their seemingly incurable ills. In “The Winged Assassin,” Alison

Carr only finds relief for her “neuralgic pains” through her treatment with Madame

Kochuly. She asserts:

I understand that the men of the profession are mad with jealousy, and small

wonder, her cures are so marvellous. Yes, Mr. Head, I went to quite half-a-dozen

of our greatest doctors, and they could do nothing for me; but since I have been to

Mme. Koluchy the pain comes but seldom, and when it does arise from any cause

it quickly subsides. I have much to thank her for. (“The Winged Assassin” 139)

Carr describes Kochuly’s ability to succeed where legitimate – and notably male – physicians have failed. Similarly, throughout the Sorceress, both medical experts and her 158

patients marvel at Madame Sara’s knowledge and her ability to heal her hopeless cases.56

Like Madame Kochuly, Madame Sara offers physical comfort to her patients – acting as

an effective dentist in “Madame Sara” and a dermatologist in “The Blood-Red Cross.” In

“The Blood-Red Cross,” Madame Sara removes an unsightly mole that legitimate

physicians had deemed to be too dangerous to remove. In describing the removal, her

patient Antonia says, "One day Madame saw it; she said the doctors were wrong, and that

she could easily take it away and leave no mark behind. […] She gave me chloroform

and removed the mole. […] She is very pleased with the result, and says that my neck

will now be beautiful like other women's...” (“The Blood-Red Cross” 509). Despite these women’s lack of formal medical education, Meade does not condemn Madame Kochuly and Madame Sara for a lack of scientific knowledge. Rather, both women care for the physical bodies of their patients admirably well – often more effectively than those legitimate members of the medical profession.

Kochuly and Sara take advantage of their reputations as skilled caregivers to bolster their influence over and access to the rich and powerful, laying claim to the title

“physician.” Madame Kochuly and Madame Sara’s prolific popularity arises primarily as result of their technical skills, as they continually effect cures for their patients. For many of their patients, the effectiveness of both Madame Kochuly and Madame Sara’s medical skills outweighs their lack of a medical degree and wins each woman clients and respect in London society. Even Norman Head, before he discovers Madame Kochuly’s true

56 . In “The Talk of the Town,” Professor Piozzi, a promising scientist, declares Madame Sara to be one of the most talented and scientifically gifted physicians of his acquaintance, a point which she reinforces by interpreting Piozzi’s scientific data more quickly than both Piozzi and the police medical examiner, Vandeleur. Vandeleur declares that, despite her lack of British education, the “scientific knowledge which Madame possesses [is] not a smattering, but a real thing” (“Talk of the Town” 62). 159

identity as the head of the Brotherhood of Seven Kings and his former lover, observes,

“The profession, of course, pooh-pooh her, I know, but if one may credit all one hears, she possesses remedies undreamt-of in their philosophy” (“At the Edge of the Crater”

90). Kochuly’s reputation establishes her as a success, even if the medical profession

rejects her as untutored. Medical reputation and technical skill, then, play key roles in

establishing access to the public, even without official medical training or credentials.

According to Huntley, however, a physician’s technical skills are only one

element of a physician’s ethos developed by medical schooling and licensure. Huntley

also outlines two other related, less tangible aspects of medical ethos brought about by

medical education: good character and goodwill toward one’s patients. While medical

education involves extensive study of medical and scientific methods and content,

Huntley writes that the “bookwork” and “practical work” of a woman’s medical

education also prepare her to take up the title of physician in other ways, shaping her into

a more hard-working, attentive, and dedicated professional. Huntley closely associates

medical training with a fully developed moral character, which she characterizes as

including discipline, dedication, and self-denial. She writes that women unwilling to adapt to the rigorous intellectual demands of medical school “have found themselves nowhere among their fellows in their medical work, not by any means, because everybody at the school is so overpoweringly talented, but simply because their minds were not disciplined to bear the student's yoke and work steadily and systematically as the others were doing” (“Medicine – II.” 651). Female medical students needed to learn to discipline their minds and re-adjust their priorities to the specific requirements of medical study in order to be successful in medical school and beyond. In Huntley’s 160

estimation, only the serious, selfless and highly skilled woman will pass through the

mental, social, and emotional trials of attending medical school, passing her exams and

entering the official medical register.

In addition to the association of legitimate medical training and strengthened

moral character, Huntley’s essay also suggests a connection between women’s medical

education and the cultivation of goodwill to her community. The intimate interaction of

the female patient and her physician, Huntley argues, binds the female physician to the

lives of other women, as medical practice is “the hard work of a small number of women

undertaken with the earnest desire to do all other women good” (Huntley, “Medicine – I.”

592). Throughout her essays, Huntley argues that becoming a legitimately credentialed professional physician, with its increased intimacy and responsibility toward patients, is

not merely a career but an opportunity for connection with others. For Huntley, the

proximity – physical and emotional – that the practice of medicine engendered between

physician and patient creates an awareness and sisterhood with her female patients and a

sense of responsibility to the health and well-being of these patients. Rather than centering her thoughts and actions on her own desires, therefore, in order to succeed in medical school and earn credentials, the prospective physician must adapt herself to a newly acquired set of professional and personal priorities. Huntley writes that female physicians’ work must become the top priority of their lives, beginning with the development of self-denial and selflessness in the name of good medicine: “there must be hearty devotion to the work in hand as the principal object in life for the time being”

(“Medicine – II.” 651). Female physicians, Huntley indicates, carry the weight of not only their own lives, but also that of their patients and women everywhere. Medical 161

education and the process of state medical certification, Huntley argues, will, by

necessity, be the first place where the prospective female physician practices this

realignment of social priorities, as medical study and practice begin to overleap the other,

formerly more important aspects of her life.

Meade’s fiction, as does Huntley’s writing for the Atalanta, engages with the key role of medical education in shaping professional judgment, character and a sense of community obligations for her general audience. Madame Kochuly and Madame Sara possess seemingly miraculous abilities to heal their patients, even though Meade notes that these cures are unconventional and the women themselves are “quacks.” In “The

Luck of Pitsey Hall,” an installment of the Brotherhood, Norman Head observes that

Madame Kochuly “dispensed her own prescriptions” which resulted in cures in

unprecedented numbers. He continues, however, by stating that “The medical world

agitated itself about her to an extra-ordinary degree. It was useless to gainsay the fact that

she performed marvellous cures. Under her inﬂuence and treatment weak people became

strong again” (“The Luck of Pitsey Hall” 379). Madame Sara also takes advantage of

treatments that professionally-recognized members of the medical establishment refuse to

perform. In “The Blood-Red Cross,” Madame Sara proves herself to have great skill, as

she removes an ugly mole from a woman’s neck that was previously thought inoperable.

The woman, Antonia Ripley, asserts that the “Italian doctors would not remove it on

account of the position. It lies just over what they said was an aberrant artery, and the

removal might cause very dangerous haemorrhage” (“The Blood-Red Cross” 506).

Meade does not represent the unconventional cures and risky surgeries exercised by these

quacks undertake as unreasonable; neither Sara nor Kochuly harm their patients through 162 the failures of their medical knowledge. Rather, Meade suggests that the issue with these women is that they enact questionable use of the access and knowledge granted through their position and access to gain power and influence over their vulnerable patients.

Throughout her stories, Meade notes that these quacks can enact considerable damage with the way they make use of the access granted as a result of these uncanny medical skills. In “The Talk of the Town,” medical examiner Vandeleur warns Dixon

Druce of the dangers posed by the misuse of powerful and unconventional medical knowledge. Vandeleur warns Druce that “[the] scientific knowledge which Madame possesses, and which is not a smattering, but a real thing, makes a woman at times – dangerous” (Meade and Eustace, “The Talk of the Town” 62). Rather than behaving selflessly or acting as advocates for women’s health or professionalism, as would be inculcated by British medical training, both Madame Sara and Madame Kochuly use the access granted by their medical knowledge act to destroy their vulnerable female patients’ personal or professional lives for their own personal gain. Meade’s female physicians focus their destructive efforts on the social standings of their female patients or the love interests of these patients, using information they have gathered to manipulate them. Jennifer Halloran has noted that the majority of Madame Sara and Madame

Kochuly’s victims are young, vulnerable women of the upper classes, whose social standings are either newly acquired or shaky, most often due to foreign birth (Halloran,

“The Ideology” 180). As they manipulate these patients, the “physicians” lack the sense of responsibility to others, especially to other women, which would be, according to

Huntley, cultivated by proper medical training and licensure. Madame Kochuly and

Madame Sara threaten to unseat women from their social positions through knowledge 163

acquired during her consultations with them in the setting of the physician’s office.

Madame Kochuly, for example, uses her knowledge of Alison Carr’s fiancé’s gambling

to ruin him and, in “The Mystery of the Strong Room,” attempts to convince the socially

vulnerable Mrs. Carson to steal from her husband – and thus ruin her marriage – through blackmail. Similarly, Madame Sara pushes her patients toward social disaster for

personal gain: she frames Lady Bouverie for the robbery of a priceless jewel belonging to

a guest of her husband, and Madame Sara steals Professor Piozzi’s scientific discoveries

before he can reveal them to the public, resulting in professional embarrassment. The

harm these women claiming the privileged position of “physician” wreak on their

vulnerable patients in pursuit of their own aims suggests the illegitimacy of their claim to the medical ethos of the legitimate British medical community.

In these stories, Meade’s characters who have experienced the dangerous realities of the medical women in Meade’s stories attest to the disjunction between public belief about physicians’ ethos and the realities of illegitimate physicians when medical training

is lacking. In relating Madame Kochuly’s attempts to blackmail her into stealing from her

husband, Mrs. Carson declares Madame Kochuy to be a “fiend in human guise[,]” that

“she is a devil, not a woman[,]" and that she “is like adamant, she has no heart at all. Her

sweetness and graciousness, her pretended sympathy, are all on the surface. It is useless

appealing to anything in her but her avarice. Fear ! — she does not know the meaning of

the word” (“The Mystery of the Strong Room” 130, 128, 132). In the same story, Head

reinforces Madame Kochuly’s poor character and regard for others: “She possesses

consummate genius, and never yet owned to a scruple of any sort” (“The Mystery of the

Strong Room” 132). Meade, in “At the Edge of the Crater,” ties this dearth of scruples to 164

Madame Kochuly’s foreignness and her lack of British medical training, features shared by the similarly dangerous Madame Sara. In this story, Madame Kochuly’s agent, Italian physician Dr. Fietta, links Kochuly’s lack of selflessness to her foreignness. He states,

“As a medical man myself, I can vouch for her capacity, and unfettered by English professional scrupulousness, I appreciate it” (Meade and Eustace, “At the Edge of the

Crater” 90). Although they draw on the ethos of the legitimate medical profession, neither Madame Kochuly nor Madame Sara have undergone what Huntley outlines as the socialization toward selflessness and medical prudence that Huntley assures her readers are a key component of earning the title “physician.”

In Meade’s hands, the unlicensed and untrained woman physician becomes a cautionary tale about the need for greater public scrutiny of the physicians whom individuals give access their bodies and lives, even if these individuals appear charming and talented. Rather than exercising the natural good character and selflessness Huntley associates with trained medical professionals in order to practice better medicine, both

Madame Sara and Madame Kochuly use their natural beauty and charm to create a false aura of good character and selflessness in order to distract their patients from their very real misalignment with the norms of the medical profession. Both Madame Kochuly and

Madame Sara draw on their preternatural beauty and charm to mask the discrepancies between their goodwill and good character and that of the position that they claim illegitimately. Throughout the Brotherhood, Madame Kochuly “dazzles” other characters not only with her medical skills but also her good looks and charm, such that her victims fail to scrutinize her character and intentions. When, for example, describing his first encounters with Madame Kochuly, Head explains that he was “dazzled” by her beauty 165 and intellect and that she “led me where she would” (“At the Edge of the Crater” 85).

One of Madame Kochuly’s patients, Alison Carr, underlines the deception enacted by

Kochuly’s charm. Addressing Head, Carr states, “It is not only her beauty which impresses one…it is also her power— she draws you out of yourself completely. When I am away from her I must confess I am restless—it is as though she hypnotized me, and yet she has never done so” (“The Winged Assassin” 138). Through this charm, Kochuly strengthens her influence over her patients, even as she destroys their bodies and social status. Madame Kochuly also behaves in way that make it appear that she serves the interests of the community, rather than her own ends. In “The Luck of Pitsey Hall,” Head notes,

She was spoken of as a universal benefactress, taking, it is true, large fees from

those who could afford to pay, but, on the other hand, giving her services freely to

the people to whom money was scarce. This woman could scarcely walk down

the street without heads being turned to look after her, and this not only on

account of her remarkable beauty, but still more because of her genius and her

goodness. (“The Luck of Pitsey Hall” 379)

In scaling her compensation depending on the needs of her poor patients, even as she ruins the lives of others, Madame Kochuly has created an aura of goodwill and of selflessness. This illusion of beneficence – reinforced throughout the stories that center on her – protects her from scrutiny and is, in Head’s estimation, more affecting than her charm and beauty.

Like Madame Kochuly, Madame Sara’s charm and beauty are a means of hiding the discrepancy between the ethos she claims and her actual personality and intentions. 166

Meade connects her second false physician’s ability to gain influence over her patients with her personal charm and inherent assumptions about her generosity and goodwill. In describing his first encounter with Sara, Druce describes the influence she exerts before he even speaks to her. He writes, “There were many younger women in the room, but not the youngest nor the fairest had a chance beside Madame. It was not mere beauty of appearance, it was charm – charm which carries all before it” (“Madame Sara” 393). As

Meade describes Madame Sara’s ability to convince her patients of her goodwill and good character and the access she receives as result, she adopts the language of witchcraft: in “Madame Sara,” Madame Sara has “cast a spell” over Edith (“Madame

Sara” 393); in “The Bloodstone,” Madame Sara “has cast her accustomed spell over”

Violet Bouverie (“The Bloodstone” 193); and in “The Talk of the Town,” Madame Sara

“throws spells” over Professor Piozzi and his fiancé (“The Talk of the Town” 64). Like

Madame Kochuly, Madame Sara gains influence over her patients through her charm and ability to project the illusion of goodwill and beneficence.

These women’s beauty and charm work in tandem with their consummate medical prowess to win them access to the bodies and emotional lives of their patients, even as they commit criminal acts and blackmail. Away at a country estate, Madame

Sara’s name comes up in Druce’s conversation, spurring the guests into passionate defenses of both her medical prowess and her charm: “Instantly the room became full of voices, some talking loudly, some gently, but all praising Madame Sara. Even the men took her part; as to the women, they were unanimous about her charms and her genius”

(“The Blood-Red Cross” 509). The talk among members of society implicitly connects the false physicians’ charm and their skill as medical professionals. In some cases, 167 however, the illegitimate physician’s charm overrides her medical skills in attracting patients. In “The Swing of the Pendulum,” Harry De Brett, at dinner with Norman Head, praises Madame Kochuly for her interpersonal skills over her medical skills. He declares,

“Her cures are marvellous; but that is after all the least part of her interesting personality.

She is so fascinating, so wise and good natured, that men and women alike fall at her feet” (“The Swing of the Pendulum” 245). De Brett dismisses Kochuly’s astounding medical cures as the least influential part of her ethos; rather, he seats her ability to gain access to her patients in his illusory beliefs about her character conveyed by her supernatural charm. Medical skill and displays of charm, Meade and Eustace’s short story serials suggest, do not necessarily correlate with benefits to the patient or the community.

The patient, therefore, must take care in granting access to “quacks” who lack the socialization and training in good character and good judgment that medical women receive through their state education and licensure. The women in Meade’s stories demonstrate a lack of phronesis and demonstrate that medical ethos, due to its power, when not reinforced by medical education, can be dangerously misleading.

Conclusion

Female physicians in the late Victorian period could – through the acquisition of the professional title of physician – directly influence the behaviors of their patients and other members of society through ethos in a way previously barred to them. Because they were now able to adopt the authoritative title of “physician,” women entering the medical profession in Britain were granted a privileged rhetorical role formerly restricted to men.

Meade’s short story serials, rather than discounting the abilities of women in the medical 168 professions, reinforce the power of the adoption of the title of physician for late nineteenth and early twentieth century women. Through her labelling of these women as quacks, Meade and reiterates importance of placing properly trained and licensed women into these roles. Meade’s fiction writing, much as the writing she featured in the Atalanta, suggests that medical education for women assists in bridging the gap between expectations of the title of physician and the potentially inconsistent realities of an individual woman’s character, good will and knowledge. Technical skill alone should not, for Meade, entitle a woman to access the bodies and lives of their patients. Rather than undermining her position as an advocate for women’s rights, then, when read for

Meade’s specific attitudes towards the power granted women physicians as they adopt their new titles, these short story serials reveal Meade’s support for the project of building British women’s professional ethos, despite the seemingly profit-driven or frivolous nature of Meade’s writing for The Strand, a stance which more closely accords with the position Huntley advocates in her writing for Meade’s Atalanta.

169

Chapter 4: War Correspondence: Medical Access and Nationalism in the Writing of Caroline Matthews

A woman child. She dream 'd the dreams of men. Of fiery purposes, and battle's din. She left her dolls to play with soldier toys And glow'd in enterprise of heroes bold. Such a child – Grown to the kingdom of her woman's heart, Goes forth with joy beneath her country's flag. Gives of her skill to those who call for aid. She faces death in many a cruel guise, Holding life cheap, for honour and her King.

- A. M. Johns, “Foreword,” Experiences of a Woman Doctor in Serbia (1916)

Caroline Matthews’ memoir of her medical work during the First World War,

Experiences of a Woman Doctor in Serbia (1916), opens with a brief poem, composed by

A.M. Johns, that sets the overall tone for her first-hand account of her medical work on the front lines in World War I. It first introduces a “woman child” – Matthews – who

“left her dolls to play with soldier toys / And glow’d in enterprise of heroes bold”

(Matthews n.p.). These initial lines suggest a turning away from feminized trappings of childhood as Matthews rejects dolls in favor of “soldier toys” and glory in battle. The poem frames the “woman child” who later grows into female physician Matthews as an individual possessing a “woman’s heart” but who also “dream’d the dreams of men” of

“firey purposes, and the battle’s din” (Matthews n.p.). This brief poem foregrounds

Matthews’ movement from feminine “dolls” to masculine “soldier toys” and from childhood to a womanhood marked not with the accoutrements of typically feminine objectives but with the violence and disorder of battle.

This poem – with its language of heroism, soldiers, and cheating death – illuminates Matthews’ unique position as a woman writing about her experiences on the 170 front lines of battle. The poem and the memoir both note the new perspective that

Matthews brings as she reports her experiences as a wartime physician. A 1903 graduate of the Edinburgh School of Medicine for Women, Matthews worked in the Second

Balkan War and World War I as an independent physician. She tended the sick, wounded, and dying in war-torn and, later, German-occupied Serbia, serving as a volunteer physician with the Serbian Army Field Unit of the Red Cross.57 Serbia was a dangerous and volatile location during the 1910s, unstable as a result of two civil wars in the Balkans in 1912 and 1913, but also freed from the imperial rule of the Ottoman

Empire (Hammond 61). During her tours, Matthews worked saving the lives of soldiers and civilians before she was arrested on suspicion of spying and taken as a prisoner of war by the German occupying forces. As she writes about these experiences in her memoir, Matthews occupies a position largely not available to earlier women: her profession affords her access to the bloody realities of battle and grants her a degree of physical safety through her work with the Red Cross. Matthews’ memoir includes visceral descriptions of the physical devastation of war wrought not only on the nation of

Serbia, but also upon the bodies of its citizens. Throughout her memoir, Matthews recounts the battle that her readers at home – particularly female readers – cannot access.

Although she granted her readers a unique glimpse of the war in the Balkans,

Matthews’ profession and her reporting on the war position her as an outsider to the conflict; Matthews participates in the war effort, but her profession and her gender place limits on this participation. Christine Etherington-Wright has noted that, in the years before World War I, women took on unprecedented public service, at least partially

57 As Leneman has noted, Matthews funded her tours in Serbia, taking on the expense herself and using her personal equipment (Lenneman 169). 171

resulting from a growth in the number of and fuller acceptance of professional women

(Etherington-Wright 5). This advancement lessened, but did not entirely remove, women

physicians’ problems of rhetorical ethos, which were still prominent in 1916. Matthews’

text acknowledges this liminality from its epigraph: Johns’ poem suggests that Matthews

is neither fully a woman, as she seeks the decidedly non-feminized goal of battlefield

success, nor fully a man, because she is unable to participate in battle as a result of her

sex. Matthews’ liminality was only highlighted by her role as both an observer and medical professional in the two wars on which she reported. Although she describes herself as “an old campaigner” in her memoir (Matthews 6), Matthews herself never fought in battle. While then, Matthews reported her service and observations as a wartime medic in her memoir, Matthews was a non-combatant war correspondent. Stefanie

Markovits and Kate McLoughlin have noted that British writers in foreign countries, and non-combatant war correspondents more particularly, struggled against derogations of their credibility for such “outsider” status, even though they witnessed first-hand many of the events they reported back to the British public. Earlier war correspondents such as

William Howard Russell and Margaret Fuller both suffered harsh criticism for their roles as non-combatant reporters, and their credibility and motives were often called into question. Matthews’ writing about her experiences on the frontlines reveals her anxiety that she would be positioned as an “outsider” on two fronts: for her work as a “non- combatant” – but still intimately involved – war correspondent and for her status as a female physician.

As she wrote her memoir, Matthews anticipated such derogations of her credibility, even as she faced the harsh realities of war in her capacity as a war medic. 172

She drew on strategies pursued by earlier war correspondents but also amended these strategies to support her credibility. She included reproductions of various documents – visas and ration cards, for example – to verify components of her story. Beyond including such documents, however, Matthews extended rhetorical strategies used by both war correspondents and travel writers of the previous century. War correspondents in the nineteenth and early twentieth centuries often worked to combat accusations of a lack of credibility by generating representations of themselves as contributing to the goals of the communities to which they belonged, most often their nation. They strengthened their rhetorical ethos as they purported to serve their country, performing eunoia, or goodwill to the community to which they belonged. Male war correspondents, such as Russell and

Frederick Arthur Mackenzie, depicted themselves heroically – taking part in the war effort by intervening in battle. Women war correspondents could not, as a result of their gender, directly oppose Britain’s foes in battle but found other ways to contribute to the war effort – spying on behalf of their home countries, serving as nurses for wounded soldiers, and providing non-military reports critical of military actions and policy.

Matthews, much as do these other writers, positions herself as heroically assisting the British cause through non-combatant actions: both in her medical work and her writing. Rather than fighting against her status as an outside observer, however, she describes her professional work and writes about the ways this work serves distinct functions for the British nation. Matthews positions her writing, her medical practice, and her active defenses of British values as essential work for the British nation and its people, facilitated through her position as an outsider to battle and as a woman physician.

These representations of herself generate an image of her as possessing eunoia toward the 173

British nation. By performing eunoia in her writing from the margins of the war,

Matthews reinforces her ethos as a war correspondent, as a British citizen, and as a

professional physician. By emphasizing, rather than rejecting her outsider status,

Matthews foregrounds a representation of herself and of the members of her profession as trustworthy, knowledgeable and well-intentioned caregivers for the injured and dying on the battlefield and in occupied territories, as well as for the British nation as a whole.

Matthews’ writing posits a new relationship between the British public and female physicians – that female physicians’ work can serve not only to heal the bodies of the

British nation but also work to improve the nation through their unique contributions to public interest and knowledge.

“She left her dolls to play with soldier toys”: Matthews and medical war correspondence

Matthews’ account of the First World War from the Serbian front lines recorded the violence inflicted upon the Serbian people and the human horrors and triumphs of the war. This writing is an exercise of a new professional access and responsibility not available to earlier women – either war correspondents or other women physicians. The professional ground had shifted significantly as the war progressed, when women stepped into vacancies opened by greater need as many male physicians departed to fight in the war. Leneman notes,

It is clear […] that independent medical women – unmentioned in any official

records – found scope for work and experiences. Although most of their previous

work had been the care of women or children, they coped admirably well with 174

military surgery, not to mention infectious diseases, imprisonment, guns and

bombardment. They had an enviable degree of both freedom and responsibility.

(Leneman 169).

While women physicians’ practices had often been subject to discourses of domesticity and limited to treating women and children, the war allowed them to occupy new positions as wartime physicians. These new positions enacted a reversal of the limitations of the domestic sphere. Matthews’ writing about the war is enabled, then, rather than limited, by her professional position as a physician and her removal from the home.

Matthews’ position as a physician allowed her to recount the grisly physical realities of the war in Serbia first-hand, recounting her day to day life as a woman during the German occupation of Serbia and later as a prisoner of war. Matthews’ medical work allowed her to offer her readers at home a more visceral sense of the level of barbarity and destruction in the war zone. She writes, “When work was in full swing one saw the cruel side of warfare” (Matthews 31). Describing the chaos of the surgeon’s tent,

Matthews conveys a vivid description of the events not fully accessible to her British readers – even those who had fought in war or practiced medicine at home. She writes, reflecting on one patient with a leg wound,

Orderlies, Serbian and Austrian, removed dressings, as at each table a surgeon

examined the injured limb. Here were exposed huge gaping wounds in the

quivering flesh, there a leg lay bared with muscles and vessels veritably dissected

out from knee to ankle – the stench abominable – (a case of post-typhus

gangrene). The less-severely wounded, seated on forms round the room, were 175

dressed at the selfsame time. There were things done in that room without an

anaesthetic which one could never see in England. (Matthews 31)

Matthews offers her readers unflinching visual descriptions of the gore in this scene as

she notes not only the “huge gaping wounds in the quivering flesh” of her patient but also

describes the specific and bloody detail of the injury with “muscles and vessels”

dissected down the entire length of her patient’s leg. She does not spare her readers even

a note on the smell of the putrefying wound. That the repair of such a horrifying injury

would be executed without an anesthetic, which had been used in surgeries in Britain for

decades, would have seemed an unthinkable barbarity to Matthews’ British readers. This

description is jarring; through it, Matthews demonstrates the painful and distinctly

unappealing side of war to her readers back in Britain, as well as her own capacity to

continue her grueling medical work under such extreme conditions. In addition to the

extremity of this description, Matthews underscores the foreign nature of the scene –

noting that the treatment of the wound requires action beyond what readers would

recognize as conventional medical practice.

In addition to such gripping (albeit grotesque) descriptions of her medical work,

Matthews also offered her readers insights about the nature of the war in Serbia beyond the hospital tent. She often uses her account to assert the momentous courage, goodness, and fortitude of the Serbian people. She notes that the “intense ugliness of war” could only be relieved by “the wondrous fortitude, and the uncomplaining, noble courage of those shattered Serbian soldiers” (Matthews 31). Of these soldiers, she writes,

Serbia's greatest enemy cannot truthfully ignore the fact that they are an

extraordinarily courageous people. It was rarely one heard a groan, I have seen 176

more than one man biting his teeth on a folded bandage, sweat pouring from his

forehead with intensity of suffering – but the moment his mauvais quart d' heure

is past a smile is on his lips, and if it is belied by the look of cruel pain, wrung

from telltale eyes, all the more did one feel real reverence for such unselfish

heroism. (Matthews 31-2)

As in her description of the havoc wrought upon the soldiers’ bodies, Matthews here

contrasts descriptions of Serbian soldiers’ bravery against the severity of their injuries.

She notes, “Human suffering sanctified that place, and entering one was constrained to

step softly, wondering the while at such marvellous people” (Matthews 32). She writes

that, in the harrowing realities of war, the best sides of human nature are often revealed.

Despite its stark revelation of the human tolls of battle, Matthews’ account also offers a

sense of hope for its readers – that, regardless of the violence and desolation of war,

something of what they recognize in human nature as outsiders will shine through.

Matthews’ writing about war – about human nature and human casualties –

contributed to an ongoing public discourse of writers conveying reports of foreign wars

to British citizens. Where Matthews offered readers insights on war from the unique

position of a woman medical professional, women played an important role in the

development of the genre of war correspondence from the nineteenth and into the

twentieth centuries. In the Victorian era, Lady Florentia Sale’s diary of the First Anglo-

Afghan War, A Journal of Disasters in Afghanistan, 1842-43 (1843) met with acclaim.

The diary detailed Lady Sale’s travel, capture by Afghan forces, and rescue. Lady Sale,

the so-called “Grenadier in Petticoats,” found both critical and financial success after her

diary’s publication (Malhotra 287). Frances Isabella (“Fanny”) Duberly also produced a 177 popular account of her observations during the Crimean War, Journal Kept During The

Russian War: From The Departure Of The Army From England In April 1854, To The

Fall Of Sebastopol (1856). In her journal, Duberly, the wife of a cavalry officer, offers one of the most detailed first-hand accounts of battle produced by a non-combatant, including a thorough description of the Charge of the Light Brigade. Beyond writing about their experiences as the wives of military men, women also took on significant roles in shaping war correspondence into a distinct profession in its early years, especially in the United States. Margaret Fuller has often been lauded by historians as the first professional war correspondent for her real-time reporting of the 1847 French bombardment of Italy for the New York Tribune (Chambers, Steiner and Fleming 199).

Even before Fuller, however, Jane McManus Storms wrote of Mexican conflicts for the

New York Sun in 1846. After these first innovations by women writing about war, however, the landscape of war correspondence changed significantly in the wake of the

Crimean War.

By the time of Matthews’ writing, war correspondence had emerged as a significant genre, one surprisingly open to women. The end of the nineteenth century saw greater public interest in reports from Britain’s various military campaigns. Markovits has noted that the Crimean War, occurring in the 1850s, was a turning point in the way

British citizens received information about British military presence abroad. Reports from the Crimea filtered to the British public in unprecedented ways, largely thanks to changes in technology that allowed for more consistent and faster reporting from the front. Rather than memorialization of events after the fact, the focus of war correspondence shifted to real-time, eye-witness reporting from a wider variety of voices 178

(Markovits 17). Markovits also notes a greater emphasis on non-military memoirs during and after the Crimea: that is, memoirs of professionals – either professional writers or non-military workers – not directly engaged in battle. She notes that these outsiders, as non-military “witnesses” of conflict, served as a sort of “knowable community” for similarly non-military readers (Markovits 53-4). Such changes led to the ascendance of war journalists – most notably, William Howard Russell – as newspapers began to recruit reporters as the eyes and ears of the British public in Britain’s war zones.

The steadily increasing popularity of war correspondence after the Crimea led professional women – both nurses and professional writers – to take a more significant role in writing accounts of war. Florence Nightingale and Mary Seacole, who had served as nurses in war zones in the Crimea, produced detailed accounts of their experiences for the public: Nightingale in her report and “rose diagrams” for the Royal Commission and

Seacole in Wonderful Adventures of Mrs. Seacole in Many Lands (1857). In America,

Louisa May Alcott similarly recounted her brief stint as a Civil War nurse in Hospital

Sketches (1863). Practicing medicine granted women unique access to the realities of war to which they would not normally have access. They often witnessed the horrors and devastation of war first-hand, which put them in privileged positions when writing about their experiences in the war zone. Medical women’s early writing opened up opportunities for women to take on increased – although still limited – roles in writing first-hand accounts of war in the late nineteenth and early twentieth centuries, including

Britons Sarah Wilson and Florence Dixie, Canadian Kit Coleman, and Americans Cora

Stewart Taylor, Mary Robert Rinehart, and Nelly Bly. As these women and Matthews 179

wrote and published their accounts, they entered a field with a complicated relationship to

rhetorical ethos via their credibility and authority.

“Of fiery purposes and the battle’s din”: War correspondence and rhetorical

authority

War correspondents’ first-hand observations of war offer them increased credibility, but

their status as observers of war can also undermine this same credibility. War

correspondents’ credibility, including that of Matthews, benefitted from their status as

representatives of British culture in a foreign land, as they carried information about

events abroad to their audience at home. Scholars have noted a correlation between first-

hand accounts of foreign countries produced by outsiders to that culture and the rhetorical

authority of the reporter, especially at the height of imperialism. As Edward Said

indicates in Orientalism (1978), non-fiction travel writing carries specific associations

between first-hand experience of a foreign culture and authority as a speaker. Said

indicates that texts produced by travelers to foreign countries “purport[] to contain

knowledge about something actual” and that such a text “is not easily dismissed.

Expertise is attributed to it. The authority of academics, institutions, and governments can

accrue to it, surrounding it with a greater prestige than its practical successes warrant.

Most important, such texts can create not only knowledge but also the very reality they

appear to describe” (Said 94). Said asserts the discursive power of first-hand experience:

it creates not only knowledge about a subject but also can shape the reality on which that

knowledge is based.58 The inherent power of such accounts, Said notes, arises from the

58 Recently, Arabella Lyon and Lester Olson have reinforced this idea in their writing about rhetoric and witnessing, arguing that first-hand experience conveys transcendence of a spoken and lived reality. Lyon 180

novelty of first-hand experience of a new culture or event previously closed off to

readers, most often by distance or cultural barriers. War correspondents’ credibility, as

they reported on violent battles that were largely foreign to their readers, including that of

Matthews, benefitted from such novelty.

More recent scholarship has sought to explain the inherent authority of accounts

of foreign cultures – particularly of war – as reliant on a writer’s ethos in community.

Kate McLoughlin has asserted that war correspondents since the nineteenth century have

generally relied on autopsy, or first-hand experience, to establish their ethos

(McLoughlin, “War in Print Journalism” 48). This association between autopsy and ethos

when discussing the credibility of war correspondents, and Matthews especially,

however, can be understood as connected to the relationship between a correspondent and

her community. Geraldine Muhlman has noted the credibility of first-hand accounts as

arising not only from the fact of first-hand experience but also from “a sort of tacit contract” between an individual providing first-hand accounts and her community. She

asserts that the first-person account of an event “unifies a community, because it sees [the

individual], in the very singularity of his experience, as its ambassador” (Muhlman 22).

She terms the individual offering a first-hand account of an experience to their

community a “witness-ambassador,” and writes that such a role “means constantly

reminding us, more or less implicitly, that [the individual] see[s] in all our names, hence

reminding us of the pact which binds them to ‘us’, enabling them to give ‘us’ a sort of

experience by proxy. It is as if the ‘I’, singular though it may be, is at the same time

‘collective’” (Muhlman 22). By taking on a role as a representative of a community – as

and Olson have linked the recounting of first-hand experience with the creation of a counter-discourse and of a different reality (Lyon and Olson 208). 181

the eyes and ears of the nation or group to which one belongs, a “witness ambassador”

implicitly adopts what Aristotle termed eunoia, or the persuasive power of an

individual’s goodwill to community. Matthews’ writing serves to promote the goodwill

of the British nation by serving to enhance its citizens’ understanding of the war and its

ravages. In addition to drawing on their first-hand experience as a basis for the

construction of ethos, then, an individual writing a first-hand account of foreign events garners rhetorical authority for herself. Matthews draws on assumptions that the writer’s act of writing about first-hand experiences serves the community to which they belong and for whom they are writing – positioning herself and her writing as performing essential roles in serving the British nation.

Matthews positions herself as a “witness-ambassador” for her readers throughout her memoir, tapping into the ethos conveyed by the implication that she serves as a proxy for the British public. Early in her memoir, Matthews aligns herself with her audience,

including herself in her descriptions of a British public curled up by a comfortable fire,

far from the frontlines, reading about the war in newspapers but oblivious to the visceral

horror of war (Matthews 21). She is, as they are, viewing the war from the outside. Her

vantage as a female physician, however, allows her greater access to the realities of the

war. Matthews generates a representation of herself as blasted out of her former sense of

homely comfort and as having her perspective on humankind’s nature transformed by

what she has witnessed. She understands something of the evils of which people are

capable, from her experiences as a woman physician during women’s first years in the

profession. In her work as a female physician in Britain, she has seen “evil spirits look

out from men's eyes,” “the fire of a hundred raging storms,” “the cunning of the red- 182

stained hand, the snarling threat of the cad at bay matched, checked and outwitted”, and

“the desire for human blood – my blood, and the lust of a human which makes man lower

than the beasts” (Matthews 96). Matthews’ experiences in the war, however, far exceed

these earlier observations of resistance to her as a woman and a physician. This difficult

road, she suggests, is something like a summer stroll when compared to the unrelenting

hatred she notes in the German soldiers. She writes that she “had never met before such peculiarly fiendish expressions of absolute hatred” (Matthews 96-7). She connects these virulent reactions not to her gender or her profession – the combination of which would incite ire from even some of her countrymen – but to “the undisguised, unbalanced

German hatred of my race” (Matthews 98). By expressing her own former naivety about the evils of the Germans, Matthews invites her audience to see her as a more experienced representative, who can convey new information about the ongoing conflict that their nation faced through the First World War.

Adopting the role of witness-ambassador for one’s audience, however, was not a panacea for problems of authority that arose in response to war correspondence, especially in the early twentieth century. Accounts of war and violence produced by observers, such as Matthews, often struggled with issues of credibility, especially the writer’s ability to serve as an adequate witness-ambassador for her community. Notably, a significant limitation on the rhetorical authority of these writers is their role as witnesses, rather than as participants in the war effort. Lyon and Olson have observed that accounts of violence and war by individuals not directly affected by that violence often call up responses of anxiety in their readers. The act of recounting violence visited upon another person or a war in which one did not fight, Lyon and Olson note, can raise 183

doubts in readers’ minds about the influence and agency of the writer – whether they are

able to accurately convey the realities of an event to their community without having de

facto knowledge of the conflict they recount (Lyon and Olson 208). Despite their roles as

witness-ambassadors, however, the inherent association between a non-combatant war

correspondent – by definition, an individual reporting on and not participating in battle –

and their failures to participate in battle themselves served as a significant hurdle for

writers in winning the credulity of their audiences in the nineteenth and early twentieth

centuries. Matthews, in her liminal position as a battle physician exposed directly to the

physical dangers of battle, complicates the idea that non-combatant war correspondents

are not involved in or endangered by the battle on which they write.

The inherent credibility of accounts of war by non-combatants has been

challenged throughout the short history of war correspondence, especially as women such

as Matthews, took on these roles in ever-increasing numbers. Non-combatant war correspondents, whether they be physicians or professional writers, have been represented as outsiders since the first years of such reporting in the nineteenth century, as a result of their profession or their gender. Russell, for example, in the vanguard among early war correspondents, was often criticized for his remove from the conflicts on which he was reporting. Markovits notes that Russell often depicted himself at a remove from British soldiers and undermined his potential for “insider” status by constantly acknowledging his professional role as a non-combatant reporter (Markovits

31, 42). The print media of Russell’s time reacted to his self-proclaimed distance by reinforcing and mocking it in Russell’s waning years. In an 1881 issue of Punch, Russell was represented with his eyes solemnly fixed on his page, pen and paper in hand, on the 184 back of a horse, leaping over rubble (Figure 4). Russell’s face appears intensely focused on his writing, despite the explosions and desolation behind him. Russell, disconnected from the war – focused on the story, rather than the devastation around him – only sees the page on which he writes.

Figure 4: “W.H. Russell, ESQ. L.L.D.”, Punch, 1881.

Problems of credibility were particularly prominent for women until they began to enter nursing and professional medicine. Sara Mills notes that, although they often had more support when functioning in some professional or government capacity, in writing first-hand accounts of foreign travel in the nineteenth and early twentieth centuries, women struggled with claims of veracity more than men (Mills 115). These problems 185

became more pronounced as women wrote about war. Kate McLoughlin has noted that

women’s outsider status with relation to war – the fact that they, more often than not, did

not have access to the front lines – limited audience acceptance of the authority of their

first-hand experience. She notes, “The premium on first-hand experience (autopsy) –

earning the right to write about war through being there – makes it difficult for those

traditionally denied access to the war zone (primarily women) to claim validity for their

accounts” (McLoughlin, “War and Words” 16). Restricted to writing primarily about the

aftermath of battle or the material conditions of the daily lives of troops and civilians,

before their entry into nursing and medicine, women writing about war frequently

struggled against doubts about their credibility and intentions.

Women war correspondents have been positioned as outsiders to war and have

had their motives called into question across the history of war correspondence, a

situation that informed Matthews’ writing in World War I. For example, Shane Malhotra

has noted that, despite her popular success, Lady Sale’s writing for both the Times and

her later-published journal met harsh criticism on the basis of her outsider status. She was

criticized both by her travelling companions for a purported tendency toward fibbing and

self-aggrandizement and by the military for her criticism of the East India Company’s

army while lacking a full understanding of military procedures and troop movements

(Malhotra 285, 279). Similarly, print media vilified Fanny Duberly for her lack of seriousness, as she treated her account of war with greater levity and humor than Lady

Sale’s wholly grim journal. Punch mocked Duberly as “Lady Fire-Eater,” declaring that

she “went to Sebastopol as a lady at home goes out shopping, simply for the amusement

of the thing” and publishing parodies of her journal entries (Figure 5; “The Diary of Lady 186

Fire-Eater” 47). Likewise, The Examiner declared her “a comic Lady Sale” (Kelly xxxix). Such suspicion affected Matthews’ acknowledgement of her outsider status and led her to represent herself as a more active participant in the war effort through her foregrounding of her medical practice in her war writing.

Figure 5: Excerpt from “The Diary of Lady Fire-Eater”, Punch, 1856

Seventy years after the popular war writing of Lady Sale and Fanny Duberly, in an age more sympathetic to women’s rights and women in the professions, women could still not fight and die on the battlefield as conscripted soldiers in the way that men could.

In World War I, although women were writing more frequently about war and the war’s effects, women war correspondents continued to inhabit an outsider role. In her memoir,

Matthews acknowledges that her gender necessarily makes her an outsider to the war.

She explains that, while all British citizens “heard the call” to patriotic duty when war was declared, women “could not give our lives for Britain in the same manner which is open to our brothers” (Matthews 1). From the first page of her memoir, therefore, 187

Matthews notes that her status as a woman limits her ability to participate fully in the war

effort, even as she works to preserve the lives and health of Britain’s and Serbia’s soldiers.

Apprehension about women’s credibility as war correspondents results not only

from questions about their intentions or access, but also from their particular identity as

they claim the role of representative of community. A speaker’s individual identity, in her

role as witness-ambassador, is omnipresent. Muhlman notes that the very process of

having a person serve as a representative of community necessitates the constant

reiteration of that individual’s identity. She writes that, counterintuitively, the deliberate

display of the “itinerary and the personal perspective of the observer, far from being

erased, are deliberately displayed” (Muhlman 25). She asserts that, as they write to their

audience, witness-ambassadors often “open a latent debate about ‘our’ identity. […]

[T]his debate about identity involves putting ‘us’ to the test: the journalists, by their gaze,

introduce something which questions ‘our’ identity and which sets off a conflict around

this very identity” (Muhlman 28). By positing themselves as representatives of

community, witness-ambassadors trouble the way a community views itself – not only

how the community defines its values and the attributes of its members but also who has

the right to serve as a witness for the community, who can speak on its behalf, and

whether their writing as an individual serves the interests of that broader community. War

correspondents, then, can spur anxiety in their readers by positing themselves – as

individuals with particular, and sometimes controversial, traits – as representatives of

community. If they exhibit traits that are contrary to the stated values or attributes of their

community – such as traits typically associated with femininity in the early twentieth 188

century – such concerns are magnified. Such cultural anxiety can lead readers to question the eunoia of the writer – whether or not the witness-ambassador truly serves the interests

of the community through their reporting, as was the case for both Lady Sale and Fanny

Duberly.

Matthews’ identity in the “community” of 1910s Great Britain was, in many

ways, more complex and conflicted than that of her fellow female war correspondents –

excepting Mary Seacole, a Creole/Scot and self-taught but unlicensed medical woman.

Matthews’ work as a fully licensed physician, while more common in 1916 than when

Seacole and Nightingale wrote as nurses after the Crimea, made her an anomaly both in

British culture and among women war correspondents. Matthews, unlike other women writing about war, gained her observations through her work as a professional physician.

Writing or being the wife of a military officer was not, as it was for many British and

American war correspondents in the early twentieth century, her primary occupation.

Rather, maintaining the health of her patients was her major role near the frontlines.

Neither did Matthews resemble the majority of British women writing about war in her relationship to traditional gender roles. As an unaccompanied married woman physician on the war’s front, Matthews did not conform either to expectations of married women physicians – who continued to be criticized into the twentieth century if “neglectful” of their wifely duties in favor of their profession – or of a war correspondent. Unlike the women before her, Matthews was not the wife of a military officer, as were Lady Sale,

Fanny Duberly and Sarah Wilson, accompanied by her husband, as was Florence Dixie, or a single woman reporting on her observations from the more “feminine” occupation of nursing, as were Florence Nightingale and Mary Seacole. As she wrote, then, Matthews 189

needed to bolster her rhetorical ethos in ways distinct from these other women writing about war. Matthews drew on existing strategies for bolstering her ethos employed by other women but also crossed gender boundaries to draw on strategies more typically used by male war correspondents.

“She dream’d the dreams of men”: Matthews’ gendered strategies for bolstering ethos in medical war correspondence

In the years before Matthews’ account, war correspondents’ responses to such skepticism depended largely on their gender and social position. Russell, for example, described himself as an objective witness-ambassador for non-military British interests as he reported the horrors of war and the poor living conditions during battle. Notably, however, Russell occasionally depicted himself as undertaking heroic acts when confronted with difficult situations on the front lines (Markovits 42). Frederick Arthur

Mackenzie, writing about his work as a war correspondent in the Second Boer War in

Harpers’ New Monthly Magazine in 1900, also positions the work of war correspondents as heroic. He writes,

[T]he danger is very great. The mortality amongst [war correspondents] is always

enormous, considering their number. No campaign passes without several sinking

before either the weapons of the enemy, or disease that always dogs a fighting

force. They have to expose themselves more than soldiers, in order to get their

news; and when the work of the soldier is done, that of the correspondent is

beginning, for he has to write his description of the battle, and walk or ride

perhaps twenty-five miles or more to get it on the wire. (Mackenzie 209-10) 190

Mackenzie suggests that, in the interest of serving readers, of acting as their readers’ eyes, war correspondents take on even greater risks than do soldiers. Where soldiers only fight in campaigns, Mackenzie argues, war correspondents on the front lines observe the whole of the campaign and then compose and convey these observation to the reading public. Mackenzie positions the members of his profession as being willing to sacrifice their lives to give their audience a full accounting of the war. He positions the war correspondent as serving the needs of his community before his own life, inherently strengthening his eunoia and, therefore, his ethos.

Such direct options for demonstrating one’s devotion to one’s country, however, were generally not open to women writing about war in the nineteenth and early twentieth centuries. Women war correspondents in the early years of the genre, such as

Lady Sale and Fanny Duberly were often endangered by the wars they wrote about, but they existed at the edges of the conflicts, prevented from direct intervention in the war effort as a result of their gender and social position. Lady Sale and Fanny Duberly hewed closely to their established roles as wives and mothers – protecting those around them, rather than striking offensive blows to Britain’s opponents. During the first decades of the twentieth century, however, writers such as Sarah Wilson began to creep more closely to the peril of frontline reporting, as Wilson intended to spy on the Boers and was taken prisoner. Women war correspondents, however, were still largely disconnected from the heat of battle. Early women war correspondents, therefore, tended to strengthen their ethos through appeals to character, suggesting that women possessed the positive traits of both sexes and that women served the interests of their country by acting as representatives of that country in a foreign land. Matthews drew on both of these 191 strategies but also on the more direct interventions suggested by Mackenzie as she composed her memoir, defying the gendered practices established by earlier writers.

Matthews and other women war correspondents drew on the examples of earlier women writing about travel abroad as they crafted the liminality of their character in their memoirs. Such writers had long bolstered their rhetorical ethos by suggesting that they inhabited a hybrid character – possessing both masculine and feminine traits valued by

British society. Shirley Foster notes that as women wrote about their travel abroad, they adopted “masculine” virtues such as strength, initiative, and decisiveness, while retaining

“feminine” virtues such as compassion and kindness (Foster 11). Women writing about war echoed this duality: Fanny Duberly was described in turns as both “womanly” and

“unwomanly” for her stalwart behavior;59 Lady Florence Dixie represented herself as

“athletic,” hunting beside her husband and brother, but retaining some of her feminine delicacy; Nightingale, single and tenacious, worked as a caregiver to soldiers in the feminized profession of nursing. In each of these examples, these women demonstrate both stereotypically masculine and stereotypically feminine characteristics. They existed, then, in a space between the British nation’s norms of the female and male gender, ostensibly possessing the advantages of both genders and strengthening their readers’ sense of their underlying character.

Such attempts to establish credibility by embracing “otherness” of character sometimes extended beyond gender traits and into racial and cultural differences on the part of the writer. Mary Seacole, for example, does not attempt to align herself with

British masculinity or femininity. Rather, Seacole, in Wonderful Adventures of Mrs.

59 See Duberly, Frances Isabella. Mrs Duberly's War: Journal and Letters from the Crimea, 1854-6. Ed. Christine Kelly. New York: Oxford University Press, 2007. Print. 192

Seacole in Many Lands, takes pains to distinguish herself as an outsider – consistently drawing readers’ attention to her Creole/Scottish background and her existence on the periphery of white British culture in the Crimea. As Rhonda Frederick notes, Seacole, by distinguishing herself from both white Britons and African-descended Jamaicans, establishes and enacts a new subject position for herself (Frederick 493). Thus, Frederick argues, “Seacole manipulates categories set by race, gender, geography and adventure –

not to mention several literary genres – to articulate a Jamaican, Creole, female

subjectivity” (Frederick 494). As Seacole serves as a “witness-ambassador” for her

British readers, she enacts a form of self-authorship. This new, “othered” subject position enables Seacole to challenge the categories into which she would normally be placed as she writes for her white British audience and posits her own voice as worthy of rhetorical authority in her descriptions of the war zone.

As did these earlier writers, Matthews uses “otherness” to support the credibility of her character but ties this “otherness” to her profession. Matthews positions herself as

possessing traits of masculinity and femininity valued by her British readers. She notes

that, as an independent woman physician at the front, she has stepped outside of the roles

typically adopted by British women, writing, “Thank God it is generally given to our

sisters and mothers to walk on paths where the love and tenderness of stronger arms

shield and cherish them, and see their garments never reach the mud” (Matthews 97).

Matthews, who includes descriptions of the grimy and bloody work of the medical

profession, stands in the mud and outside of models of untouched femininity. As in the poem that opens it, Matthews’ memoir demonstrates Matthews’ pursuit of the less sheltered path of working at the front during the war. Matthews, as other women war 193

correspondents before her, exists in a liminal category, as she positions herself as

possessing both womanly attributes (her “woman’s heart” and compassion) and more

typically “masculine” virtues such as bravery, independence, physical endurance, and

medical expertise. She generates a representation of herself as both stalwart – as she

remains in the country when all other volunteer physicians from her country have departed – and fragile – expressing her anxiety about the physical danger she faced from her stronger male captors.

Matthews’ representation of her physical appearance further reinforces this fusion

of masculine and feminine traits necessitated by her profession. Throughout her time as a

physician on the front and as a prisoner of war, Matthews dons the khaki uniform of the

Scottish Women’s Brigade. The uniform, a military costume including a jacket, pants,

and high boots, marked Matthews as both a woman – by its association with the woman’s

medical volunteers – and outside of traditional femininity – by its definitively masculine

silhouette (Figure 6). Matthews underlines this hybridity as both an asset and a danger.

She asserts that her appearance as a woman in masculine dress is a boon for the messy

work of travel and doctoring (Matthews 48), “a great protection” in allying her with the

British Empire and reminder of her duties to her nation (191-2), and a means of helping

her in discovering her allies (224). Her hybrid dress, however, causes her enemies to see

her as a “nightmare” (169) and inflames the ire of some of her German captors (192).

Inextricable from such descriptions of her hybridity is Matthews’ devotion to her nation.

Throughout her memoir, Matthews focuses less on her liminal character itself as a means of winning the trust of her audience, but on the particular services this hybrid character allows her to perform for her nation. As does Seacole, Matthews performs acts of self- 194

authoring and self-authorizing, but distinguishes herself not on the basis of her nationality

but on using her otherness as a woman and a woman in the medical profession to underline her unique contributions to the British cause – focusing less on character and more on eunoia as a basis for her ethos in writing for the British public.

Figure 6: “Caroline Matthews, M.B., Ch.B.” from her Experiences (1916)

In addition to positioning herself as possessing positive characteristics of both masculinity and femininity, Matthews also draws on an existing discourse of British women abroad positioning themselves as ideological representatives of the British nation, although her intervention pushes beyond representation and into the typically masculinized realm of direct intervention. Women writing about their travel abroad frequently drew on the idea that they were serving their nation through that travel.

Scholars such as Shirley Foster and Kumari Jayawardena have noted the key role of 195

nationalism in establishing women’s credibility in travel writing in the nineteenth and

twentieth centuries. Foster notes that these women often represented themselves as

missionary “civilizing influences” on the countries to which they travelled. Especially

when these women travelled to colonial settlements such as India, women travel writers

wrote of themselves as agents promoting British values and norms, with the potential to

“rescue” the “uneducated” and “uncivilized” native populations through education and

work in nursing (Foster 10). Jayawardena draws on these functions as she outlines the

two primary roles British women played in the colonial sphere. British women writing

about foreign travel, she writes, largely fell into one of two categories: missionaries, who

depicted themselves as sanitizing and civilizing native people through work in education

and in converting them to Christianity; and New Women, who sought to illuminate the

mistreatment of women in other cultures by their writing for the British public

(Jayawardena 8-9).

Although their aims were sometimes at odds, through their works, missionaries

and New Women posited themselves as doing work abroad for the British Empire:

missionaries through seeking to bring native peoples into line with British values and

New Women by highlighting how the injustices native women faced either contrasted or dovetailed with those faced by British women. These women positioned themselves, as did war correspondents, as witness-ambassadors of the British nation via their writing.

Such positioning resonated across women’s war writing in the late nineteenth and early twentieth centuries, as women such as Mary Seacole, Florence Dixie, and Sarah Wilson proposed to better the British nation by observing wars abroad and critiquing the ways government and military officials handled such conflicts. 196

Matthews’ profession distinguishes her depiction of herself as a representative of

the British nation from that of both earlier women writing about their observations of

foreign countries and other women war correspondents. Matthews’ work as a physician

places a premium on her direct professional intervention into the conflict, rather than

ideological reshaping of either her readers or “natives.” Through her work as a physician,

Matthews is not, importantly, a missionary spreading British values to the “uncivilized”

peoples of the British colonies or a New Woman reporting back on the mistreatment of

women abroad. Rather, throughout her writing about the war, Matthews frames her

medical work – a field still dominated by men in 1916 – as a location where she can

make significant contributions to the British war effort. She writes that “we women can

‘do our bit’ beneath the Red Cross – for the Crosses of St. George, St. Andrew, St.

Patrick and St. David!” (Matthews 2). Invoking Britain’s protective saints, Matthews argues that, although they cannot fight alongside men on the battlefield, women can make significant contributions in working against Britain’s enemies through other avenues open to them during the war, including medical work through the Red Cross. Although she acknowledges the limitations of current social norms about women’s place in battle, then, Matthews argues that women – women physicians especially – can contribute in distinct and important ways to the defense of the British cause: most notably through medical practice, non-combat defenses of the British nation and its values, and writing to inform the British public about the realities of war.

Matthews explicitly connects her professional work as a woman physician – the work that enables her to report on the war – to her duty as a British citizen. She writes

that, after her decision to remain in Serbia after the vast majority of other physicians had 197

left, she was “upheld” by a “realization of her nationality” (Matthews 109). She asserts

that she felt it her moral duty to serve the wounded and dying allies of the British nation

in Serbia, even when the other physicians – who were all men – have fled the country.

She writes,

Could I have looked the world in the face again if I left those men? – men who

even with regular attention, regular dressing, lay on the Borderland – Death on the

one side – Life on the other. Many were lying where neglect would spell a future

worse than Death. What was left but to face the music and try to cope with the

work as far as one unaided Doctor could? (Matthews 69-70).

Matthews draws a contrast between herself – a woman who sees her only means of contributing to the war effort as through her medical practice and the men with whom she worked; where the male physicians fled home to their duties as heads of household or to fight in the war, Matthews had no such duties or expectations laid upon her as a married but childless woman in the medical profession.

Matthews’ “outsider” status as a woman physician aids her in serving her nation.

She can continue to deliver medical care as the Austro-German army moves ever closer and other “more valuable” male physicians depart. A physician from the politically neutral Switzerland, who Matthews had nursed back to health after a serious illness, declares his intention to depart and not die on the front of the war. Responding to the departure of this physician as she petitions to stay with the wounded and dying left behind, she writes, “For once I was glad to be a woman. Had I been a man my life would have been of value to the [British] Empire – a very infinitesimal value, no doubt, but still the fact remains, one man one bayonet, and, with luck, one German the less” (Matthews 198

69). Matthews assumes that she is allowed to stay and care for the wounded because she

is a woman. As a woman, her life is not “valuable” to the British Empire because she

cannot fight in battles, nor does she have children to care for at home, as does her Swiss counterpart. In this passage, however, Matthews notes that, because she cannot contribute to the success of the British campaign in either of these ways, she can stay on and

continue her work after others have retreated, bolstering the war effort during its blackest days through medical practice.

The influence of Matthews’ wartime medical practice is not limited to her work in aiding the wounded on the battlefield. Rather, Matthews asserts that she is fighting another, less visible battle for the lives of British citizens at home as she combats infectious disease. She writes,

[W]ar brings more in its train than the carnage of the battlefields, more than the

pillage and atrocities of inhuman hearts. The Angel of Death spreads forth his

Right Arm and takes his toll by the aid of every mechanical contrivance suggested

to man for the destruction of human life. His gaunt Left Hand smites heavily with

disease, scattering germs broadcast in the wake of armies, while Pestilence and

Famine sweep clean the territory demoralised by shrapnel. (Matthews 1-2)

Matthews describes the consequences of battle as extending beyond the immediate threat of damage on the battlefield – and beyond the lives and bodies of the Serbian soldiers who have engaged in battle. Here, she acknowledges both the risks to human life through the “mechanical contrivances” of war, such as bullets and bayonets, as well as war’s more treacherous and long-lasting risks to human life – the lingering potential for epidemic disease. Matthews extends her role of battlefield physician reporting on the war 199

to one of even greater significance – of preventing the devastating spread of epidemic

disease to the civilians of Serbia and, eventually, Britain.

Matthews also draws on earlier rhetorical strategies of women travel writers and of male war correspondents as she depicts herself as a representative of the British nation.

Most notably, Matthews’ memoir posits a representation of Matthews as a symbol and

defender of the English nation in a hostile zone. In writing about women’s travel

narratives, Narin Hassan has noted that British women not only acted as “civilizing agents” in foreign countries, but often bore the burden of serving as examples of English cultural norms. Separated from other British citizens by geographical distance, these women often described themselves as the sole representatives of British culture, usually

of femininity and decorum, in the face of “barbarous” foreign cultures (Hassan 3).

Matthews’ writing partakes in the nationalist strains of earlier women’s travel discourses; she is fully cognizant of her position as a symbol of Britishness in a foreign land, as to her knowledge, she is the only Briton remaining in the country. She writes, “I am

English. A very insignificant unit of the Empire – but I was all there was of it out there! I stood for England, Scotland and Ireland and the Dominions beyond the Seas! (Matthews

109).60 The idea that Matthews “stood” for her nation and its values during her time in

war-torn Serbia pervades her memoir, a theme that only intensifies after the occupation of

Serbia by Austro-German forces. She expresses her shock that the Serbians who once

relied on her – especially the women – abandon her once she has decided to stay through the occupation, noting that her nationality played a key role in some Serbian people’s

60 Matthews also asserts that her experience as a physician on the frontline leads her to a deeper appreciation of her identity as a British citizen. She writes that individuals such as herself, who have been exposed to the horrors of war, even as outsiders, “have learnt what the Empire means and our love for our King is a very real and a personal matter” (Matthews 110). 200

rejection of her care. She writes, “We must, however, remember that the Serbians are not unintelligent – and they knew, that to the War Lord's legions, the sight of a Britisher is

like a red rag to a bull!” (Matthews 73). Matthews ties the Serbian people’s reluctance to

draw on her medical expertise to their association of her with her nation and the

possibility that association with a British woman would only inflame the hostility of the

German forces. Where Hassan underlines the symbolic role British women played in

colonial texts, Matthews’ memoir positions her as acting both symbolically and directly

to defend the honor of the British Empire in the face of foreign opposition.

Matthews takes direct action to defend the British nation, unlike her fellow female

war correspondents. Throughout her memoir, she generates a representation of herself as

stalwart in the face of Britain’s enemies, giving herself a duty not to “show the white

feather to Britain's foe” (Matthews 110). As she describes this refusal to surrender in her

narrative, Matthews depicts herself as defying her German jailers and defending the

British nation in two significant incidents during her time as a prisoner of war. In the

first, she takes symbolic action to reiterate her loyalty to Great Britain. Arriving home

from a visit to a patient in town, Matthews discovers that her instruments – which she

bought herself, have been confiscated by the Germans. In the wake of this incident,

Matthews finds herself dispirited and resigned to the harsh realities of her imprisonment.

On a walk a few days later, however, Matthews buys a wooden box with an image of the

Union Jack on the inside, “the very sight of [which] did [her] good” (Matthews 180).

Generating a representation of herself as a victim not “intimidate[d]” but “rouse[d] to

action”, Matthews nails the image of the Union Jack to the door of her room, in full view

of her German captors (Matthews 131). She writes that, although “England seemed very 201

far away,” “every time I caught sight of the Red, White and Blue it encouraged me and gave me a feeling of strength” (Matthews 131). For Matthews, the flag itself serves as a key reminder of her role as a woman physician in the campaign and as doing that work for the benefit of King and country. She writes, “I looked at it, at the representation of our

Flag, and I knew that though I stood there at the mercy of those men, that I had the better

part. If I suffered our men were suffering things a thousand times still rougher – and it

was worth going through it all – for the Empire and the King” (Matthews 131). Matthews

here not only underlines her location outside the soldiers’ ranks but also reiterates her

particular role in defending the British Empire and its ruler through small acts of

rebellion. For both Matthews and her readers, then, the crudely-made British flag provides an explicit connection between Matthews and the values of the British nation during Matthews’ harrowing time as a prisoner.

Matthews’ retelling of this defiant act also positions her as an agent of goodwill to the British nation – one distinct from that of male soldiers but valuable for upholding

British values in the Serbian war zone. As she discusses her “pure defiance,” Matthews notes that “a curious thing happened.” Although the picture of the flag was in plain view of the numerous soldiers who passed by her door and “Serb or German, Austrian or

Hungarian, every man soon became familiar with the quaint device,” Matthews notes that

the “picture of our Flag was never touched” (Matthews 131). The soldiers who oppose

the Britons never took action to remove the crude image of the Union Jack on her door or

punish her for this obvious act of nationalist defiance. In this passage, Matthews suggests

that, although she is in the hands of the German army, she has won a small ideological

battle, even though she cannot take up arms and fight on the battlefield. Matthews’ 202

decision to describe the incident of the flag not only strengthens her connection to her

nation but also serves as a successful, if dangerous, act of defiance against her captors,

bolstering Matthews’ assertions that her outsider status still allows her to work for the

maintenance of the goodwill of her nation.

Matthews depicts herself not only as thumbing her nose at her captors by hanging the British flag but also as risking her own physical safety to defend the honor of her

King and country off the battlefield. Matthews describes “a nasty little episode” in Ujclik.

Matthews, confined to a hostel as she awaits further transport across Serbia, is forced to spend most of her evenings in a public house among soldiers and civilians. One evening, a German soldier insults the English people and then the English King, calling them

“pigs.” He clearly intended to rile Matthews, the only Briton present. Feeling that this insult to her King cannot stand and that the man “meant mischief,” Matthews first calls on sympathetic but “timorous” Hungarians in the room to expel the man, before finally taking decisive action herself. She writes,

[The German] began again : "The--English King ... '' He got no further. […]

I went up to the fellow. "You coward!"

And I slapped him on his mouth. (Matthews, Experiences 192).

After this physical altercation, the German is shocked into silence and a fellow Red Cross worker rushes Matthews out of the room. Although she cannot enter the battlefield, in this incident, Matthews takes direct physical action against one of the foes of her nation, assaulting the German officer who insults her King and country. Matthews positions herself as a defender of her homeland – risking her freedom and her physical safety to protect the honor of the nation she represents. Through this action, she succeeds in 203

silencing the German and in forcing the men around her to intervene on her behalf.

Matthews, then, does not limit her contribution to the war effort to her defense of the

British nation through professional or ideological intervention in the region but of physical intervention into Britain’s conflicts.

Matthews positions her act of writing about her observations of the war as an

outsider as equally beneficial to the British nation as her medical work and her active

defense of British values. She asserts that the British people not fighting in or exposed to

the war lack a full view of the horror of war because they have not been exposed to its

violence or its devastating effects. She writes, “This war is showing us the blackest side

of Civilization” (Matthews 96), a side usually not accessible at the British hearthsides

where the audience she represents as witness-ambassador sits. Most Britons, Matthews

asserts, exist in idyllic isolation from the realities of the war; they “have not yet heard the

squeal of man as cold steel enters his quivering flesh” or the “thundering of the guns, and

the crack of rifles,” and they have not seen fields “swamped with human blood” or

“hillsides embrac[ing] stiff, inert figures of [Britain’s] sons, their white drawn faces

turned towards the sky” (Matthews 21-2). Because the “pandemonium of war” has not

reached them, Matthews insists, average Britons “cannot fully realize” the “reality stern

and awful” of the war in the Balkans (Matthews 21-2). Matthews asserts that the only

way the average home-bound British reader can gain exposure to the horrors of war is

through reading accounts from the front. Matthews writes that, by their firesides, British

citizens “read of war, read of it in the beauty of Britain's Peace, with Nature's gifts

scattered richly round us, and on every side the luxury contrived by a prosperous people”

(Matthews 21). The act of reading about the war in reports from the front – reports such 204 as the one she herself is writing – allows British readers to “becom[e] war-wise” and more versed in the complexities of the conflict occurring in Eastern Europe and the

Balkans (Matthews 22). Matthews’ writing about the war as an outside observer serves to bring the conflict to British hearthsides and, thus, aids in making the men and women not participating directly in the war effort more fully informed of its realities.

Matthews characterizes this writing as a distinct contribution to the war effort that she can only make as an outside observer and physician. Matthews, unable to deny the fact that she was not present for acts of heroism on the battlefield, positions the writing of outsiders such as herself as more credible than accounts by combatants. Matthews argues that, although they might be observed and experienced by soldiers and male battle surgeons alike, the harsh realities of the battlefield are not fully narratable, and when they are narrated, accounts of war are misleading. She writes, “There is very little glamour in the hard reality of war. Heroic deeds are done as a matter of course in the way of duty.

No one sees them, no one is there to record them. War spells the grim fierce struggle of a man for life, or the wholesale slaughter in the battlefields where the Fight is raging and

Might is foe to Right” (Matthews 58). She argues that the actions typically described in accounts of war as “heroic” and “glamourous” are, in reality, subsumed in the bloody struggle for survival when men meet on the battlefield. Representations of battle heroics, by extension, are unrealistic and misleading to audiences at home. Matthews, rather than detailing heroic deeds of soldiers on the battlefield, infrequently observed and recorded events, describes the results of battle that she observed from her more objective professional role as a physician. This stance lends credence to her accounts and suggests that her reporting is more accurate than writing by those involved in war. 205

“Go[ing] forth with joy beneath her country’s flag”: Conclusion

Matthews’ attempts to construct ethos worked to convince her audience of her credibility.

Her memoir struck a chord with reviewers, both for her courage in serving the broken

bodies of Serbian soldiers and civilians and writing as an ambassador for British readers.

The Saturday Review of Politics, Literature, Science and Art praises the memoir for bringing “poor blood-stained, war-worn Serbia very clearly before the eyes” and praises

Matthews’ “courageous heart” in working as a physician after others had departed and her “single-minded purpose and devotion that kept her standing by her wounded when the enemy had overrun the country and all else had fled” (“A Friend in Need” vi, viii).

The Sphere, where Matthews had published correspondence from her first tour in Serbia, classifies the memoir as one of its “War Books Worth Reading” – in that it “stands out among its fellows” for its credibility and insights, as it declares her treatment at the hand of the Germans as “almost incredible” (“War Books Worth Reading” 78).

The nationalism pervading Matthews’ memoir also worked to reinforce her ethos in the eyes of reviewers. The reviewer for The Bookman, noting the “vivacious” nature of

Matthews’ “brave, personal volume”, also lauds the text for its focus on England’s role in the war. The reviewer writes that, in Matthews’ memoir, “England is […] well to the fore” (“Serbia, Siberia, Russia” 59). Matthews, the reviewer insists, offers her readers a clear sense of the ways English presence may be improved in the war’s coming days not available in other writing about the Serbian conflict. Likewise, James Hastings’s theological periodical The Expository Times praises Matthews as “a woman who dared and did things in which no man had the hardihood to stand beside her” and reprints the 206

incident of her slapping the German for his words against the English king as an example

of her willingness to “t[ake] nothing lying down” (“Non-Resistance” 119, 120). The reviewer takes up Matthews’ generation of a representation of herself as a defender of

Britain and even suggests that she did work that could not be done by the men on the front lines.

Matthews’ account, in addition to enhancing her readers’ understanding of the war and its effects on the Serbian people, portended a shift in the relationship between female physicians and the British nation at this volatile point in Britain’s history. Women physicians’ relationships to the public continued to shift as the war continued. After

Matthews’ writing, the war raged for two years more – years marked by additional violence and military engagement, including significant damage to British forces. More female physicians joined the war effort, becoming battle surgeons. In this atmosphere, however, women physicians’ roles as defenders of British bodies, knowledge, and values were enhanced as women physicians adopted male physicians’ medical practices when they went to war and in taking on roles as battle physicians themselves.

207

Epilogue As the chapters of this dissertation have demonstrated, in order to bolster their rhetorical ethos, women physicians and their advocates took up the task of defending professional women by generating and circulating representations that countered persistent popular images of female physicians as unstable, incompetent and dangerous to the social order.

Although many of these writers suggested that women possessed knowledge and medical abilities that matched those of their male counterparts, they also circulated representations of women physicians as fulfilling functions for the British nation distinct from those of male physicians. They described women as possessing unique knowledge as a result of their womanly bodies, as extending their domestic “work” into the public sphere, and as serving their nation by healing broken male bodies in the early stages of

World War I. Disseminated through the print culture of the late nineteenth and early twentieth centuries, these representations not only suggested possibilities for women physicians but also proposed new ways of thinking about the functions and purposes associated with the medical profession and the roles of professional women in British society in the late nineteenth and early twentieth centuries.

Even as they emphasized women physicians’ distinction from male physicians, however, early women physicians’ advocates largely worked in the shadow of existing frameworks for understanding the relationship between gender and the public sphere.

Despite their attempts to bolster medical women’s rhetorical ethos within their professional roles, supporters of women physicians continually labored under residual modes of domesticity established in the mid-nineteenth century. In each of the different representations of British women physician discussed throughout this dissertation, writers struggle to define these women’s professional roles within or against the modes of 208

domesticity established in the mid-nineteenth century. Defenders of women physicians

represented them as hybrids of masculine and feminine values and norms, stop-gaps against quackery, medical professionals decoupled from what readers would have recognized as everyday medical practice, and womanly defenders of the British nation and its values in times of war. Each of these turn-of-the-century representations work to either fit women’s work as physicians into existing domestic roles as protectoresses of the “home” – whether it be the homes of the upper middle classes, as in Meade’s stories, or the British nation, as in Matthews’ war correspondence – or to suggest that women could be defenders of the domestic sphere in their personal lives while simultaneously performing professional roles typically performed by men – as in the Magazine of the

London School of Medicine for Women and in Gregg’s and Jex-Blake’s refiguring of the woman doctor novel. Because they largely adopted one or the other of these attitudes, both of which responded directly to expectations of domesticity, women physicians and their supporters lacked opportunities to define the place of women physicians independent of their domestic roles or of the ways men already fulfilled particular functions in the professional sphere.

Women physicians’ negotiation of discourses of domesticity and their professional work in the period between 1876 and 1914 laid the groundwork for shifts in cultural representations of women physicians in the public and professional spheres in the

1910s and 1920s. The “testing” of representations of women physicians performed in the

MLSOM, Meade’s short stories, Hilda Gregg and Margaret Todd’s novels, and in

Matthews’ war correspondence imagined new ways of understanding not only women physicians but also the medical profession and women as a whole. Such broader 209

representations of women physicians in their first four decades of practice positioned them to take on more significant and authoritative roles in the aftermath of World War I.

World War I altered the constitution of the domestic and the public spheres in

Britain, both in the deaths it caused and in its lasting effects on the war’s male survivors.

Ruskin and Patmore’s mid-nineteenth century renderings of the roles of women and men depend on the idea that women prepare the home to be a safe haven to which their husbands will return. The brutal reality of World War I meant that many men did not return home or returned from the front significantly altered. Later characterized as the

“Lost Generation” by Ernest Hemingway, few young men who came of age immediately before or during the war came away unscathed. Of the nearly nine million forces mobilized across the British Empire, U.S. Government estimates put the number of men of the Empire killed in the war at nine hundred thousand, the number of wounded at two million, and the number of men missing or imprisoned at one hundred ninety thousand.

The total casualties are estimated to have been nearly three million two hundred thousand or around thirty-six percent of the total mobilized troops.61

In addition to the loss of such a great number of young men, the men who

returned were often damaged in ways that limited their ability to fulfill the non-domestic

role usually assigned them before the advent of the war. Many soldiers and battle

surgeons returned from the war front with significant mental and physical disabilities that

inhibited their ability to, in Ruskin’s words from his 1864 lectures in Manchester,

perform the “rough work” of the “open world.” Numerous examples of the mental and

physical toll on British men’s presence in public and professional life arose in the years

61 U.S. Department of Justice. “World War I Casualties and Deaths.” PBS.org. US Department of Justice, n.d. Web. 21 Dec 2015. 210 following the war. Psychologists such as W.H.R. Rivers tracked the evolution of battle traumas, and orthopedics and plastic surgery began to gain prominence as physicians sought to repair the broken bodies of returning soldiers. Representations of soldiers returning from the war and unable to fulfill their typical roles in British society took center stage in novels in the years after World War I, such as Chris Baldry in Rebecca

West’s Return of the Soldier (1918), Septimus Smith in Virginia Woolf’s Mrs. Dalloway

(1923), and Christopher Tietjens in Ford Madox Ford’s tetralogy Parade’s End (1928).

Each of these men, having suffered the harsh effects of war, returns to the domestic embrace of his country and his home, worse for wear. Each of these men is irreparably damaged by the war – Baldry has lost his memory, including those of his wife and their dead child; Smith suffers hallucinations and disconnection from the life he had established before the war; and Tietjens loses his memory and something of his mental acuity, after suffering the effects of a concussion caused by a shell explosion. In each of these cases, the domestic sphere and the women who, according to Ruskin’s rendering, should maintain it, still exist as a potential haven for the returning soldier. Baldry, Smith and Tietjens, however, have been so mentally or physically damaged by the world outside the haven of the domestic sphere that it offers little or no comfort. Indeed, in each of these cases, their wives’ attempts to serve their typical roles act not as comforts but as accusations against these men – of what they could once do and can no longer do in the aftermath of the war. For these fictional men as well as the real men of the British

Empire, the domestic sphere no longer served as a healing space managed by a wife for the benefit of husband and children; it could no longer heal the traumas imposed by the

“rough world,” which had grown more dangerous during the war. 211

Compounding the pressure on Britain’s domestic sphere in 1918 was the influenza epidemic, which was itself exacerbated by the poor sanitary conditions that

Britain’s military was forced to endure in the waning days of World War I. Almost at the same time as the declaration of peace, the influenza pandemic infected half of the world’s overall population in the period between January 1918 and December 1920. Although evaluations of the pandemic’s impact vary, Niall Johnson has estimated the total number of casualties to be anywhere from fifty to one hundred million people worldwide. In

Britain and Wales alone, death rates were reported to have been at two hundred thousand at the time of the epidemic (Johnson 81). The so-called “Spanish flu” disproportionately devastated populations typically thought to be at a lower risk from dying at the hands of infection – the young and physically healthy. Much as in the case of World War I, the damage to the British nation was not only the loss of lives. As a result of the disease’s lingering effects on the bodies of its sufferers, those who survived its ravages were often debilitated or weakened, much as were the soldiers who had just returned from war.

Susan Kingsley Kent has noted that, even after they had recovered from the worst of the symptoms of influenza, those infected with the disease had been so weakened that they could no longer work, resist other infections such as pneumonia, or care for the other ill members of their families (Kent 13). Influenza threatened the ability not only of men to work outside the home, but also the ability of women to care for the family members typically in their charge.

The ramifications of the vast number of British citizens weakened by their exposure to the influenza virus, while mimicking, in ways, the relationship of injured and mentally compromised soldiers to the public sphere, also altered the relationship between 212

the care and keeping of the home and the public sphere in ways distinct from that of the

war. Niall Johnson notes that, drawing on the still young notions of germ theory and the

hard-won knowledge of epidemics gained in the devastation of the Spanish Influenza,

public health campaigns in the wake of World War I presented sanitation and hygiene as

the responsibility of both the individual and the state, advocating for increased personal hygiene, such as hand-washing, the construction of public disinfection stations, better

food and food-handling practices at restaurants and homes, and the quarantine of

individuals demonstrating any symptoms of disease. These public health campaigns

represent a shift in the relationship between the state and private domestic spaces. The

role of the home as a safe haven remained, but public officials advocated increased care

and keeping of spaces and bodies in both the domestic sphere and the “rough world” of

the public sphere; preventing the spread of disease became not only an individual health

concern but also a civic responsibility of all citizens.

In the face of the war and the influenza pandemic, significant changes occurred in

British attitudes about gender norms in the public sphere, and shifts in gender

expectations were particularly notable for women – women physicians especially. In the

public discourses of British society, the domestic sphere no longer functioned in the same

ways it did when Coventry Patmore wrote of the “Angel in the House” in 1862. Beyond

the changes wrought to the relationship between the public and domestic spheres, also

contributing to the increased legitimization of women physicians in the 1910s and the

1920s was an increasing focus on domestic space as medicalized space. In the years

following the influenza pandemic, the care and maintenance of the home became more

closely associated with medical concerns, and the domestic sphere was invaded by the 213 language of medicine. While the germ theory of disease was established by scientists such as Robert Koch and Louis Pasteur in the 1860s and 1870s, the public health movement in Britain was slow to develop. As Nancy Tomes has noted, the fact that germs “could not be seen, smelled or touched” initially made it difficult to convince the broader public both in Britain and America of the viability of germ theory at the turn of the century (Tomes 7). In the years after the development of germ theory, the movement for public health and so-called “sanitation science,” established in the mid-nineteenth century through the legal efforts of Edwin Chadwick and Robert Peele, was expanded from the public sphere and into the private. “Disinfection, bacteria, and germs” – once terms limited to the pages of medical journals or the pamphlets of 1890s public health advocates – began to appear in women’s journals and in popular newspapers. Niall

Johnson and Susan Kingsley Kent both highlight the growth of public health campaigns during the epidemic in locations like the Times and the Illustrated London News. The responsibilities of wives and mothers became more clearly associated with preventing the spread of disease, meaning that women physicians’ medical work as professionals, while removing them from the home, became a less alien concept to British culture’s notions of the boundaries of women’s roles. Women physicians, rather than severing themselves from what, in the nineteenth century, were seen as their domestic duties, were more clearly exercising their duties; where women in the home maintained the health of its inhabitants through acts of disinfection, women physicians performed much the same function for the British nation as a whole.

Women physicians, having imagined new ways of understanding the idea of the

“physician” and women’s relationships to the professions in Britain through their writing, 214

had set the stage for women to take on increasingly authoritative roles in the radically altered public sphere. Representations of women physicians at the outbreak of World

War I began to more closely resemble women physicians’ representations of themselves, as their distinct contributions to the British public made their contributions more visible.

After Britain entered the war in August 1914 and male physicians travelled to the front to

assist British troops, calls for women to enter the medical profession increased. Cultural

representations of the woman physician in the early years of the war demonstrate

markedly less hostility to women in the profession – more closely resembling the

amenable representations generated by women physicians. In an August 1915 cartoon in

Punch, for example, illustrates a conversation between an “Eminent Woman Surgeon,

who is also an ardent Suffragist” and an injured guardsman.

Figure 7: Arthur Wallis, “Eminent Woman Surgeon,” Punch, August 4, 1915

The physician, standing by the man’s bedside and stately in glasses and a long white coat, inquires where they have met before. The guardsman, lying in bed with a heavily 215

bandaged arm, explains that he was once a police constable (Figure 7). The cartoon

implies that the female physician, as a suffragist, had been arrested for protesting in favor

of women’s votes. The former police constable, laid low by an injury, has benefitted from

the skills of the female surgeon, who he presumably once took to jail or prevented from

protesting. The guardsman, however, dismisses the potential tension with his former

adversary, declaring, “Well, Mum, bygones be bygones.”

Although it is tempting to connect such positive representations with the cultural changes caused by World War I, the Spanish Influenza and the medicalization of the domestic sphere alone, shifts in representations of women physicians were part of an ongoing conversation about women’s place in British society. In light of the radical shifts to the cultural attitudes toward women physicians, writers of the period tended to attribute the changes solely to these incidental circumstances. The notion that the war

displaced antagonism to women physicians was prominent in the public discourse of the

war and post-war periods. Carol Dyhouse notes that the popular Daily Telegraph, in the midst of World War I, declared that “To the women doctors the war has brought triumph” and many of Britain’s medical schools began to admit women (Dyhouse, “Women

Students” 111). The “triumph” of women doctors noted by the Daily Telegraph occurs not only as a result of the war, the influenza epidemic or the medicalization of the British home, but also of the resonances of earlier writers troubling the boundaries of women physicians’ roles in the “domestic” sphere.

Women physicians and their supporters had initiated the negotiation of women physicians’ ethos through their interventions into public discourses about medicine, gender, and national identity beginning in the first years after the opening of the London 216

School of Medicine for Women in 1874. Even before the beginning of World War I,

women’s place in British culture had shifted so that they had access to professional

spaces formerly closed off to them – to the Royal College of Surgeons in 1907, to the

Royal College of Physicians in 1909, and the British Medical Association in 1892

(Malatesta 136) – and had created new discursive spaces for themselves through print periodicals such as the Magazine of the London School of Medicine for Women. The writing of women physicians and their advocates of the late nineteenth and early twentieth centuries performed the important task of generating greater possibilities for the category of “woman physician,” “physician,” and “woman” within existing modes of domesticity but also troubling the borders of women’s roles as “keepers” of the domestic realm.

The work of negotiating the ethos of women physicians was not yet complete, however. Positive representations of the female physician and calls for increased participation did not completely erase resistance to grant women equal recognition with their male colleagues. Cambridge and Oxford continued to refuse women admission into their medical schools, and Leah Leneman notes that the British War Office only admitted women physicians to the war effort reluctantly and, when it did admit women, it would not allow them to serve as commissioned officers (Leneman 162). Despite the obvious necessity for women to step into the roles vacated when male physicians departed for war, then, they held a contested place in their profession.

Representations of women physicians, which had already begun to evolve at the onset of World War I, continued to shift in the years after World War I and the Spanish flu. Although women physicians had generally become more accepted by their fellow 217

physicians and the members of the broader public, some resentment of them lingered in their representations in print culture. Carol Dyhouse notes that, despite the Daily

Telegraph’s declaration of women’s “triumph,” other papers continued to reinforce the notion of a “Sex War in Medicine” and to question the admission of women in medical schools – whether educating women was a waste of time and resources when they would only leave the profession when they married and had children (Dyhouse, “Women

Students” 111). Even these skeptical treatments, however, suggest a shift away from notions that women were unfit for medicine; rather, the question of women in medicine shifted from one of ability to one of priorities. Such representations do not assert that women cannot perform medical duties or that their performance of medical duties will be a danger to the lives of others or the social order. Conversely, these representations of women physicians in public discourse suggest that medicine is not as essential to women’s lives as their roles as wives and mothers, a point which many of the first female

physicians would not entirely reject. Beyond these continued skeptical representations of

women physician’s priorities, in the interwar period, representations of women

physicians served key roles as symbols of battles for women’s equality that had

ultimately been successful. Early women physicians’ struggles to work outside the home

became symbols for the oppression women continued to face in the mid-twentieth

century. In Three Guineas (1938), Virginia Woolf drew on the example of Sophia Jex-

Blake and other early female physicians to support her arguments about the ways laws

and patriarchal structures reinforce the poor treatment of women.

Women physicians’ representations of themselves in the interwar period, much as

in the writing of early women physicians and their supporters, continued to push the 218

boundaries of women’s professional roles. In the interwar period, women physicians

posited even less conventional paths for women interested in pursuing careers in

medicine. Many women physicians, including Elise Inglis, followed Caroline Matthews

in publishing their accounts of World War I. Other women physicians and their

supporters published autobiographies and biographies of influential members of the

movement in the years after the First World War. Margaret Todd published her The Life

of Sophia Jex-Blake (1918) six years after Jex-Blake’s death and a few months before her own death. Mary Scharlieb’s autobiographical Reminscences (1924) detailed her revolutionary work in treating women in India, serving as a lecturer and examiner at the

University of Madras, and the numerous postings she had as a physician in her later career in London, all while maintaining her marriage, children and household. Even as their place in the professions had solidified, then, women physicians continued to take part in acts of self-definition and to fight for further authority and ethos, even fifty years after the opening of the London School of Medicine for Women. Female physicians

could, thanks to the efforts of earlier women physicians, participate in continually

evolving conversations about the relationship of gender and medicine from positions of

increased authority.

219

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