Postgrad Med J: first published as 10.1136/pgmj.27.309.355 on 1 July 1951. Downloaded from July 1951 THORNE: Women in Mledicine: The Early Years 355 AINSWORTH, N. J. (1928), Roy. Dent. Hosp. iMag., 2, 2-15. 27WEAVER, R. (1950), Brit. Dent. J., 88, 231. 'AINSWORTH, N. J. (1933), Brit. Dent. J., 55, 233. 2"WEAVER, R. (1948), Proc. Roy. Soc. Med., 41, 284. 9DEAN, T. (1946), 'A.A.A.S. Dettal Caries and Fluorine,' 5-3r. 2HODGE, H. D. (1950), J. Am. Dent. Ass., 40, 436. "'BLACK, G. V., and McKAY, F. S. (1916), Dental Cosmos, 58, 129. "McKAY, F. S. (I929), Dental Cosmos, 71, 747. 30KLEIN, H. (1947), Science, 105, 45. 2McCLURE, F. J. (1946), 'A.A.A.S. Dental Caries and Fluorine,' 3KLEIN. H. (1948), U.S. Pub. Health Rept., 63, 563. 74-92. 32ARNOLD, F. A., JUN. (1946), 'A.A.A.S. Dental Caries and 3McCLURE, F. J. (I949), U.S. Pub. Health Repts., 64, 34. Fluorine,' 99-107. "4BROMEHEAD, C. N., MURRAY, M. M., et al. (1943), The 33RUSSELL, A. L. (1949), J. Dent. Res., 28, 298. Lancet, April 17, 1943, 490. "4DEATHERAGE, C. F. (1943), J. Dent. Res., 22, 129. 1'McCLURE, F. J. (1943), Anm. . Disease of Children, 66, 362. 35FORREST, J. R., PARFITT, G. J., et al., in press. "McCLURE, F. J., et al. (1945), 7. Industrial Hyg. and Tox., 27, 36BULL, F. A. (1950), J. Am. Dent. Ass., 41, 146. 159. 3"BULL, F. A. (1951), J. Am. Dental Ass., 42, 29. "IMcCLURE, F. J., and KINSER, C. A. (1944), U.S. Pub. Health 3"STREAN, L. P., and BEAUDET, J. P. (1945), N.Y. State J. of Rep., 59, 1575. Med., 45, 2183. "SMITH, F. A., et al. (1950), J. Dent. Res., 29, 569. 3'IRVING, J. T. (I949), J. Dent. Res., 28, I7. "PANDIT, C. G., et al. (I940), Indian Y. Med. Res., 28, 533. 4OGEROULD, C. H. (I945), J. Dent. Res., 24, 223. 20MURRAY, M. M., and WILSON, D. C. (1948), Brit. Dent. J., "CLAPPER, W. E. (I947), Proc. Soc. Exp. Bio. and Mfed., 65, 333. 84, 97. 42DEAN, H. T., et al. (1941), U.S. Pub. Health Rept., 56, 365. "SHORT, E. M. (1944), J. Dent. Res., 23, 247. 43ARNOLD, F. A., DEAN, H. T., et al., U.S. Pub. Health Repts., "2McCLURE, F. J., and LIKINS, R. C. (1950), J. Dent. Res., 29, 57, 773. 315. 44BOREI, H. (I945), 'Arkiv. for Kemi-Mineraloci och geoloci 2oA,' "3McCLURE, F. J. (1948), J. Dent. Res., 27, 287. N. 8, 208. 2)IEAN, H. T., et al. (1939), U.S. Pub. Health Repts., 54, 862. "McCLURE, F. J. (1941), Amer. J. Dis. Child., 62, 512. "'D)EAN, H. T. (I947), Am. J. Orth. atd Oral. Surg., 33, 49. 46HODGE, H. C., and SOGNNAES, R. F. (1946), 'A.A.A.S. Dental "'IWEAVER, R. (1944), Brit. Dent. J., 75, 29. (aries and Fluorine,' 53-73. copyright.

WOMEN IN MEDICINE: THE EARLY YEARS By MAY THORNE, O.B.E., M.D., F.R.C.S.I., L.S.A. http://pmj.bmj.com/

A hundred years ago a stirring began to be felt pathy, though they could give her little help; by a few women both here and in America that but she got a little teaching and experience here they should be able to prepare themselves to enter and there and made the best possible use of it. the medical profession. Elizabeth Blackwell was After some years she learned that the Society of the first woman in America who, about i850, Apothecaries of London admitted, to their licence to who made up her mind to study medicine. She had practise medicine, students held the on October 1, 2021 by guest. Protected no idea at that time of the difficulties that stood certificate of a practical apothecary. She became between her and qualification, but by dint of apprenticed and subsequently qualified as an attending a few lectures here and there, by making apothecary, and in I865 applied for admission to use of every scrap of experience, by reading and present herself at the final examination. She was by the help of a few physicians who sympathized admitted to the examination, passed and was thus with her in her ambition, she, after some years of the first woman in England legally qualified to hard struggle and disappointing work, managed practise as a physician of medicine. The Society to present herself for examination at the University was apparently horrified at what it had done, and of Geneva in the State of New York, passed and at once took steps to alter its regulations for became a qualified physician. admission to the examination, by making a rule In England a few years later Elizabeth Garrett that in future, certificates of instruction from a had similar ambitions. She met with similar recognized medical school must be presented by trying experiences, but she, too, persevered in an all candidates for the final examination. This indomitable way. She had the friendship of some regulation prevented any other woman from pre- of the leading medical men, who gave her sym- senting herself for the final examination. Postgrad Med J: first published as 10.1136/pgmj.27.309.355 on 1 July 1951. Downloaded from 356 POSTGRADUATE MEDICAL JOURNAL Julyl 1951 At this time (1865) Sophia Jex-Blake, who had safely. No damage was done to them personally, seen something of Dr. Lucy Sewell's good work but much mud and many rotten eggs were thrown, in America, made up her mind to study medicine which soiled their clothes. The loyal band in England and applied to the University of Cam- accompanied the women to and from their anatomy bridge, among other places, to be admitted as a classes for a week or io days and the noisy young medical student, but was refused by all. She then students, finding they could not deter the women applied to the University of Edinburgh for from attending at Surgeons Hall, soon contented admission to its course of medical study, but was themselves with writing abusive anonymous letters' refused on the ground that the Senate did not see which, though unpleasant to receive, did no harm. its way to open its course in the interest of only one Several women secured marks which qualified woman. This decision received much notice in them for prizes during this session, but the usual the Press and was seen by Mrs. Isabel Thome, presentation of prizes did not take place at the my mother, who at once wrote to Miss Jex-Blake end of the winter session, as neither the President that she would be glad to join her in the event of of the C(ollege of Physicians nor the President of her making another application and that she the College of Surgeons would take the chair as thought she knew two or three friends who would usual, owing to women being amongst the prize- join them. This was done, and in the autumn of winners. 1869 five women, after passing the matriculation The question of clinical instruction now became examination of the University, received their cards an urgent matter. All medical students at Edin- of Civis Academiae Edinensis showing them to be burgh do their clinical work in the wards of the full students of the University. All now seemed Royal Infirmary. It was known that the Lord straightforward and the five women attended the Provost, at the annual meeting in January I87I, lectures for the first academic year (i869-70), would propose six members favourable to the though in separate classes as co-education was admission of women as students, but, the resolu- deemed to be inadvisable. At the end of the winter tion being lost, all chance of the women obtaining session the usual class examinations were held and hospital teaching was at an end for at least a year. in that for chemistry all the women passed, four As the agitation continued to increase and thecopyright. taking honours and one, Miss Edith Pechey, took struggles of the women to obtain a qualifying the first place. She thus became eligible for the course in the University, which had admitted them Hope Scholarship, but this was withheld and given as full students, became more widely known, many to the man who took the second place. The people became interested in their efforts and an women's success was certainly to their own dis- influential committee of over 500 members was advantage, for the men students were annoyed that quickly formed. From that time the little band the women had done so well. From this time on- of women were no longer an isolated group ward there was a feeling of opposition amongst struggling for themselves, but the pioneers of an certain of the men to the facilities accorded to the important movement strengthened by friends http://pmj.bmj.com/ Women students. willing and able to help with money and wise For the session 1870-71 women were admitted counsel. to the classes of anatomy and physiology and all The five original women students were now went smoothly for a time. The anatomy lectures eligible for the first professional examination. and weekly examinations were held in the College Three of them applied for admission, paid their of Surgeons and on a dark November afternoon in fees and had received their tickets when, 10 a days I870 crowd of noisy young students assembled before the date of the examination, they received on October 1, 2021 by guest. Protected outside the gates of the College at the time the official notice that they would not be admitted usual weekly class examination was to be held to it. The newly formed committee at once and effectually barred the way to the entrance. obtained legal opinion and on the strength of this A friendly student who was in the College grounds, the three students appealed to the Senatus of the however, opened the gate from the inside and the University; the day before the examination the women proceeded to the examination with their order was withdrawn. All the students passed, fellow men students, many of whom were always taking honours in more than one subject. very friendly and helpful to them. It was sug- The women were now refused their third-year gested to the women that they should leave the matriculation tickets, but the Senatus again over- College by a private door, as the crowd of noisy ruled the action of the Medical Faculty and young students still lingered about the gate, but declared that as long as the regulations for the the women felt it would never do to be intimidated admission of women remained on the calendar they and, accompanied by several loyal members of the must be carried out. In January 1872 the Infirmary class armed with osteological specimens, made question came up again. This time it was decided their way through the crowd and reached home that the clinical advantages ofthe Infirmary should Postgrad Med J: first published as 10.1136/pgmj.27.309.355 on 1 July 1951. Downloaded from July I951 THORNE: Women in Medicine: The Early Years 357 be available to all medical students under such regu- Classes were opened at the London School of lations as the managers might appoint. These regu- Medicine for Women in October 1874 with 14 lations were that the women's attendances should students, I2 of whom had been students in Edin- be separate from the men's and that they only went burgh. In 1875 the Provisional Council handed to the wards to which they were invited. They over the institution to a body of governors elected were, therefore, able to begin a course of qualifying by the subscribers and themselves, who made hospital instruction, though of a very limited applications to the London general hospitals for character. Thanks to the kindness of several admission for clinical instruction for their students, medical men, the students were also admitted to but without success. All the examining boards the practice of the Royal Dispensary, to Chalmer's refused to accept the certificates of attendance at Hospital and to the Poor House Infirmary. Litiga- the School in spite of the lecturers being recog- tion on many questions arose and had to be fought nized teachers. and the validity of the regulations passed in I869 The Rt. Hon. W. Cowper-Temple, M.P., who was questioned. All the statutory authorities of had carried through the Medical Act of I858, the University had authorized them, but this did declared that the Medical Act was not intended to not prevent the question of ultra vires being raised. confine the practice of medicine to men, for in The Lord Advocate for Scotland and Sheriff 1858 the question of women entering the pro- Fraser gave their opinion that the regulations were fession had not arisen. In 1876 he brought in a in order and an action of declarator was brought Bill to remove doubts as to the powers of the against the Senatus praying to have it declared that universities of Scotland to grant degrees to women, the Senatus was bound to enable the women to but its second reading was opposed by the Univer- complete their education and to present them- sity of Edinburgh and was thrown out. selves for the medical degree. The Lord Ordinary, In 1876 the Rt. Hon. Russell Gurney, M.P., Lord Gifford, before whom the action was first Recorder of London, introduced a short permissive pleaded, gave it as his judgment that the women Bill giving British examining boards power to were entitled to be admitted to the study of admit women to their examinations. The Bill medicine in the University, subject to certain con- became law, but for some years no board acted copyright. ditions, but the Senatus decided to appeal against upon it. When the three years' curriculum of this judgment. After a delay of about a year the non-clinical studies was completed in I877 the 34 appeal was brought before the 12 judges of the women who had taken it seemed as far off as ever Inner House, when by a majority of two votes it from qualification. Just when the outlook seemed was decided that legally the University had ex- most gloomy, however, the King's and Queen's ceeded its powers in I869. No more could there- College of Physicians (now the Royal College of fore be done in Edinburgh and the great object of Physicians of Ireland) decided to admit a few the women to obtain admission to examinations women who had studied in and who

Edinburgh, http://pmj.bmj.com/ that, if passed, would entitle them to be placed on now held degrees from the Universities of Berne the Medical Register seemed as far off as ever. and Zurich, to their final examination. They all There was an examination in midwifery at the passed and received the licence of the College, Royal College of Surgeons, England, that, if which entitled them to be registered by the passed, would entitle them to be placed on the General Medical Council of Great Britain and Medical Register. Two of the original five women Ireland and to enter upon the legal practice of applied for admission, but the examiners resigned medicine. Two difficulties were thus overcome, at this time and the College did not appoint others for the non-clinical studies were now recognized on October 1, 2021 by guest. Protected to take their place. There were thus, in I876, still and a qualifying examination was open to women, only two women on the Medical Register and ap- but no clinical instruction was available. After parently no hope of others being admitted to it. considerable delay the Royal Free Hospital, which Miss Jex-Blake, Mrs. Thorne and Miss Pechey then had no students, bound itself on certain con- decided to see what could be done in London and, ditions to admit students of the School to its with the help of a provisional committee on which wards for clinical instruction and experience. So sat Professor Huxley, F.R.S., Dr. Burdon Sander- at long last any woman who desired to qualify as a son, Mr. Critchett and others, it was decided to medical practitioner could take her education at form a complete course of non-clinical study given the London School of Medicine for Women and by already recognized teachers at London medical the Royal Free Hospital and could present herself schools in the hope that one or other of the I9 for examination at the King's and Queen's College medical boards would accept their certificates from of Physicians, Ireland, and, if successful, receive women as well as from men medical students. the licence of the College. Laus Deo.

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