Since this Essay was first published, two women have obtained the degree of M.D. in Paris, after passing brilliant examinations in each case. The first graduate was our distinguished countrywoman, Miss Garrett, who, after passing the five examinations required, received her degree in June 1870. The Lancet records that “her friends must have been highly gratified to hear how her judges congratulated her on her success, and to see what sympathy and respect was shown to her by all present.”[59]

The next lady who graduated was Miss Mary C. Putnam of New York, who, after quietly pursuing her studies (combined with original researches), like a second Archimedes, during both the sieges of Paris in 1870–71, took her degree with great honour in August 1871. The Lancet[60] remarked—“Miss Putnam has just been undergoing the very strict examinations for the doctor’s degree in Paris, and has passed very creditably. This is the second case in the Paris faculty, the innovation being made quietly, whilst elsewhere angry discussions intervene.”

At Lyons, also, two women have obtained degrees in Arts, in 1861 and 1869 respectively. At Montpellier a degree in Arts was also conferred on a woman in 1865, and another lady has passed the first two examinations in the Ecole de Pharmacie Supérieure in that city.

For several years past the University of Zurich has been thrown open to women as freely as to men; a Russian woman, named Nadejda Suslowa, being the first to obtain a degree in Medicine, in 1867. Several more have since then graduated, and others are at present pursuing their studies there in the ordinary classes.[61]

In March 1870 it was announced, on the authority of the Lancet, that the University of Vienna had formally decided to admit women as students, and to confer on them the ordinary medical degrees.[62]

A month or two later the Swedish newspapers published in their official columns a royal decree, granting to Swedish women the right to study and practise medicine, and ordaining that the professors of the Universities should make arrangements for teaching and examining them in the usual way.[63]

Even Russia seems in advance of England in this matter. In 1869, “the Medico-Chirurgical Academy of St Petersburg conferred the degree of M.D. upon Madame Kaschewarow, the first female candidate for this honour. When her name was mentioned by the Dean, it was received with an immense storm of applause, which lasted for several minutes. The ceremony of investing her with the insignia of her dignity being over, her fellow-students and colleagues lifted her upon a chair, and carried her with triumphant shouts through the hall.”[64]

At Moscow, also, “the Faculty of Medicine, with the full concurrence of the Council of the University of Moscow, have decided to grant to women the right of being present at the educational courses and lectures of the Faculty, and to follow all the labours of the Medico-Chirurgical Academy. The tests of capacity will be precisely the same as for male students.”[65] Still more recently we hear from St Petersburg that “the success of the lady physicians is encouraging other ladies to devote themselves to medicine, and a considerable step has been made in this direction. ... A person who interests herself in the higher education of women has requested the Minister of State to accept the sum of £8000, and to devote it to the establishment of medical classes for women at the Imperial Academy of Medicine.”[66]

Nor is the progress of liberality less marked on the other side of the Atlantic. It is well known that several of the smaller medical schools in the United States admitted women as soon as they applied for instruction, but until 1869 no American University threw open its doors. About the end of that year, however, the State University of Michigan took the initiative in this matter, and the following statement was inserted in last year’s official Calendar:—“Recognising the equality of rights of both sexes to the highest educational advantages, the Board of Regents have made provision for the medical education of women, by authorising a course of education for them, separate, but in all respects equal to that heretofore given to men only. The conditions of admission, as well as graduation, are the same for all.” During the first year fourteen women appeared as students in the Faculty of Arts, three in that of Law, and thirteen were studying Medicine and Surgery. In the spring of 1871 Miss Sanford received the first medical degree granted to a woman by an American University; and it is worth notice that this lady (herself a pupil of Dr Lucy Sewall of Boston,) took her place among the most distinguished graduates of the year;—her thesis on “Puerperal Eclampsia” being the one selected by the Medical Faculty for publication. The number of women studying at Michigan University during the session 1871–72 was sixty-eight, as compared with the thirty of the previous year; such rapid increase being tolerably significant of the avidity with which women embrace the long-denied opportunities of instruction, and offering sufficient encouragement to any British University that may resolve to try the same experiment.

It will thus be seen that many nations have, from the earliest period, recognised and acted upon the truth that “Mind is of no sex,” and that, where this has not been the case in former times, the barriers are being rapidly and readily thrown down as civilization advances, till, in truth, Great Britain now stands almost alone in refusing to admit her daughters to the national universities, and in denying them the opportunity of proving experimentally whether “the male mind of the Caucasian race[67]” is indeed so immeasurably superior to its feminine counterpart. It may be remarked, by the bye, that it is very curious to notice how the very people who loudly maintain the existence of this vast mental disparity are just those who strenuously resist every endeavour to submit their theory to the touchstone of experience, instead of welcoming the application of those tests that might be expected so triumphantly to prove their point! But, jesting apart, the present state of things can hardly be agreeable to English self-respect; and it is to be hoped that our country will soon descend from her bad eminence, and no longer be marked out as the one land where men only can reap benefit from the educational advantages provided at the expense of the nation at large. It can hardly be an object of ambition to the learned men of any people to deserve the woe pronounced of old against those who “have taken away the key of knowledge, and them that were entering in, they hindered.”

There seems to be practically no doubt now that women are and will be doctors. The only question really remaining is, how thoroughly they are to be educated and fitted to take their share of responsibility in the care of the life and health of the nation; how far their difficulties are to be lightened or increased; and whether the state of things shall continue by which they are driven into unwilling quackery on the one hand, or made to suffer real oppression from irresponsible authority on the other.

Men who, after an irregular education and incomplete training, claim the name of physicians, are justly stigmatised as quacks, and excluded from honourable fellowship, for they have refused the straight and direct path as too laborious, and have sought admittance by crooked ways. It is right enough to impose heavy penalties on them for practising without a diploma which it needs only industry on their part to obtain; but what shall we say when women are refused admission to every regular Medical School, and then, when they have perhaps painfully and laboriously gathered their own education, either in England or abroad, are excluded from the fellowship of the profession, for the sin of having been unjustly treated! That some women have succeeded in acquiring most competent medical knowledge and skill can hardly be denied, except by those who really know nothing of the facts, or are wilfully blind to them; but in almost every case they have done so at a cost of money, effort, and personal sacrifice, that can be expected only from the few. Imagine all medical students met by the difficulties which female students must encounter;—how many properly educated doctors should we have?

Many persons, however, who would gladly see women engage in the practice of Medicine, yet think it undesirable that they should obtain their education in the same schools as men; and here another practical point arises for consideration. If it is indeed true that no one is fit for the profession of Medicine unless able to banish from its practice the personal idea of sex, it certainly seems as if all earnest students seeking the same knowledge for the same ends, ought to be able to pursue their studies together. We are constantly told (and I think rightly) that no woman need object, when necessary, to consult a medical man on any point, because the physician will see in it simply an impersonal “case,” and will, from his scientific standpoint, practically ignore all that would be embarrassing as between persons of opposite sexes. If this is and ought to be true, it does not seem too much to demand equal delicacy of feeling among those who will in a year or two be themselves physicians; and, from personal experience when studying in large American hospitals with students of both sexes, I believe that no serious difficulty need ever occur, except in cases of really exceptional coarseness of character on one side or the other. That such joint study will be for the first few days novel and embarrassing is of course natural; but I believe that, as the first novelty wears off, the embarrassment too will disappear in the interest of a common study, and that no thoroughly pure-minded woman, with an ordinary amount of tact, need ever fear such association with students of whom the majority will always be gentlemen. It is of course a radically different thing to study any or all subjects with earnest scientific interest, and to discuss them lightly in common conversation.[68]

Not only in America has the system of joint education been tried, but at Paris and at Zurich ladies are at the present moment studying in the regular Medical Schools, and friends at each place assure me of the complete success of the experiment, if such it is considered. Dr Mary Putnam (the first lady ever admitted to the Parisian Medical School) in 1869 wrote thus: “There is not the slightest restriction on my studies or my presence at the Classes.... I have never found the slightest difficulty in studying with the young men with whom I am associated, not only at lectures, but in the hospitals, reading-room, laboratory, &c. I have always been treated with a courtesy at once frank and respectful.” A lady studying Medicine at the University of Michigan in 1870, wrote—“We are very much pleased with the way in which we have been received here, both by professors and students; they have treated us in every respect with great courtesy.” Another lady, when studying at Zurich, reported that “in the Medical School of Zurich, no advantage which is afforded to the male students is denied to the women. Every class is open to them, and they work side by side with the men. The students have invariably been to me most friendly, helpful, and courteous.” In answer to an official letter of enquiry, the Dean of the Medical Faculty at Zurich wrote: “Since 1867, ladies have been regularly admitted as matriculated students, and have been allowed all the privileges of cives academici. As far as our experience has gone, the new practice has not in any way been found to damage the interests of the University. The lady students we have hitherto had have all been found to behave with great good taste, and to be diligent students.” Such evidence must surely carry more weight than the opinions of those who merely theorize about probabilities, especially when such theorists start, as is often the case, with a predisposition to find “lions in the way.”

If the admission of women to the regular Medical Schools has been proved to bring no evil consequences, wherever teachers and professors have shown good will, it needs strong arguments to justify their exclusion from advantages which they can hardly obtain elsewhere; for it has been well remarked, that nothing can be more false than to confound a “small injustice” with “injustice to a small number.”

It is simply a mockery, and one calculated to mislead the public, when a medical journal[69] announces that “We would offer no obstacle to any steps which women may think would be conducive to their own benefit. But if it be indispensable that they should study Anatomy and Medicine, let them, in the interests of common decency, have an educational institution and licensing body of their own.” And again, “If women are determined to become Medical Practitioners, they are at perfect liberty to do so; but it is only consistent with decency that they should have their own special Schools and examining bodies.” Such writers know perfectly well that it is utterly impossible for two or three struggling women students to found “their own special Schools,” (though, when a sufficient number of women are educated, they may gladly make such provision for those who will succeed them,) and that, if in truth women as well as men have a right to claim opportunities of education, the duty of providing separate instruction for them clearly falls on the existing Schools, if the authorities refuse to admit them to share in the general advantages offered.

For myself, I cannot see why difficulties that have in France and Switzerland been proved chimerical, should in England be supposed (without any fair trial) to be insurmountable; as I, for one, cannot believe that less good and gentlemanly feeling should be expected from English and Scotch students, wherever their Professors set them an example of courtesy, than is found among the undergraduates of foreign Universities.

But this is a point which I do not greatly care to urge; although Medical Science can undoubtedly be most favourably studied under those conditions which only large institutions can command, and which could for many years be but imperfectly attained in a Medical College designed for women only. Still there is no doubt that women, thoroughly in earnest, and with a certain amount of means at their command, can obtain adequate medical instruction without entering any of the existing Schools for men, and no doubt arrangements could be made to secure all that is necessary with much less effort and expense than at present. We should be very thankful to have the Medical Schools thrown open to us, to be allowed some share in the noble provision made, chiefly with public money, for the instruction of medical students; but this is not absolutely indispensable; we may be refused this, and yet gain our end, though with greater toil and at greater expense. As time goes on, and as the number of women attracted by the study of Medicine increases, it will probably, apart from all extrinsic considerations, be both natural and convenient that they should have a Medical School of their own, in which every means of study should be specially provided for, and adapted to, their needs. It is not, however, I think, desirable that this should be done until the number of students is sufficient to guarantee funds for the liberal payment of first-rate teachers, and the ample provision of all needful facilities. If no women are to be made competent physicians till they have a school of their own, there never will be any at all; for those who broadly oppose the movement will always be able to say, “Women have never proved that they can use such advantages as will be thus furnished; do not establish a College for them till they have.”

So the double argument would run thus: “Do not found a Female Medical School till we are sure that women can successfully study Medicine; do not let any woman study Medicine except in a Medical School of their own.” Between such a Scylla and Charybdis who can steer clear?

Supposing, however, that this dilemma were escaped, and that adequate means of instruction were provided, (with men, or apart from them, I care not,) it would still, I think, be essential, not only to the interests of women doctors, but to those of the public at large, that the standard for medical practitioners of both sexes should be identical; that women should be admitted to the examinations already established for men, and should receive their medical degree on exactly the same terms. I do not for a moment desire to see degrees granted to women by a College of their own, or to see a special examination instituted for them; for there would be extreme difficulty in measuring the exact value of any such diplomas, and danger would arise, on the one hand, of injustice being done to those thoroughly competent, but possessing “only a woman’s degree,” and, on the other, of the standard being really lowered, and the medical degree coming to possess an uncertain and inferior value.

Of this latter danger we have abundant warning in America, where every fresh College is allowed the right of “graduating” its own students on whatever terms it pleases, and where, indeed, one is confounded by the innumerable diplomas granted by all sorts of Colleges to all sorts of people, so that one has need to inquire whether the M.D. attached to a name represents a degree granted by some “Eclectic” or “Hygeio-therapeutic” College of mushroom growth, or by the Universities of Harvard and Yale.

We cannot wish for such a state of things in England. Let British degrees continue to be of perfectly definite value; make the conditions as stringent as you please, but let them be such as are attainable by all students, and are clearly understood by the general public; and then, for all that would worthily win and wear the desired honours, “a fair field and no favour.”

Is there not one of the English, Scotch, or Irish Universities that will win future laurels by now taking the lead generously, and announcing its willingness to cease, at least, its policy of arbitrary exclusion? Let the authorities, if they please, admit women to study in the ordinary classes with or without any special restrictions (and it is hard to believe that at least the greater part of the lectures could not be attended in common); or let them, if they think needful, bid the women make their own arrangements, and gather their knowledge as they can;[70] with this promise only, that, when acquired, such knowledge shall be duly tested, and, if found worthy, shall receive the Hall-mark of the regular Medical Degree.

Surely this is not too much to ask, and no more is absolutely essential. If, indeed, the assertions so often made about the incapacity of women are true, the result of such examinations (which may be both theoretical and practical, scientific and clinical,) will triumphantly prove the point. If the examinations are left in the hands of competent men, we may be very sure that all unqualified women will be summarily rejected, as indeed it is to be desired that they should be.

If, on the contrary, some women, however few, can, under all existing disadvantages, successfully pass the ordeal, and go forth with the full authority of the degree of Doctor of Medicine, surely all will be glad to welcome their perhaps unexpected success, and bid every such woman, as she sets forth on her mission of healing, a hearty God-speed!