The paradox of female delicacy: How 19th-century medical thought created a knowledge vacuum in women's health

“ ITS IMPORTANCE.—Menstruation plays a momentous part in the female economy; indeed, unless it be in every way properly and duly performed, it is neither possible that a lady can be well, nor is it at all probable that she will conceive. The large number of barren, of delicate, and of hysterical women there are in America arises mainly from menstruation not being duly and properly performed. ”

“ With the vital system of woman, the capacity of the pelvis, and the consequent breadth of the haunches, are still more connected than with the locomotive system; for, with these, all those functions which are most essentially feminine—impregnation, gestation, and parturition—are intimately connected.
Camper, in a memoir on physical beauty, read to the Academy of Design, at Amsterdam, [34] showed, that, in tracing the forms of the male and female within two elliptical areas of equal size, the female pelvis extended beyond the ellipsis, while the shoulders were within ”

“ Women, while suffering under the severe pangs of parturition, most frequently lose much of that natural delicacy belonging to the sex, and at the moment when terror and anxiety overrule every other feeling, the man-midwife approaches, and offers to the trembling victim that disgusting insult, the examination per vaginam; an inquest both morally and physically injurious to the patient, and utterly needless, from the information previously obtained by the female attendant. ”

“ But, if there be no exposure of the person, and if the examination of the rectum be frequently made, is there, at first, no wounding of the feelings? and is there afterwards no deterioration and blunting of those feelings by the repeated daily or weekly use of the speculum vaginæ in the virgin, and [Pg 52] in the very young, even amongst the married? I loudly proclaim that there is such deterioration, and that the female who has been subjected to such treatment is not the same person, in delicacy and purity, that she was before. ”

“ How many women cannot overcome their repugnance, and die with their special ailments unsuspected, or discovered too late? On the other hand, how many women are at great pains to conceal the shrinking which they feel when exposing their peculiar ailments to even a long-known and valued medical man? Why should we have these added to our other unavoidable sufferings? The reality of these feelings is, I am certain, within the personal knowledge of every one of your female readers. No one wishes to deny modesty to the stronger sex ”

“ It will always be so till we have able women educated for the medical profession: and some of the wisest physicians in all countries plainly admit the truth.
Our own country is behind almost every other in this admission, and in the action to which it leads. While in England we are always hearing of the preposterous remedies prescribed by women of all ranks and degrees of education, there are at least certain branches of practice regularly committed to female hands in other countries. ”

“ Cure, as it is dangerous to neglect your kidneys for even one day. Bright’s disease, gravel, liver complaint, pains in the back, rheumatism, rheumatic gout, inflammation of bladder, stone in the bladder, uric acid poison, dropsy, eczema, scrofula, blood disease, offensive odour from sweating, so-called ‘female weakness,’ painful periods, too frequent desire to urinate, and painful passing of urine are all caused by diseased kidneys, and can be speedily cured by Warner’s “Safe” Cure, which has been prescribed for twenty-five years.” ”

“ One essential of health is cheerfulness of spirits. The weaknesses and diseases among females is most fearful. Only here and there is a healthy woman. And we attribute it in part to the great unrest and unspoken melancholy brooding in the great woman-soul of the world. Few, perhaps, fully realize the fearful truth of this remark. Many a beautiful woman is pining under a gloom she seldom expresses, and not more than half understands. Woman's confined life and nerve-distracting habits predispose her to revery, meditation, and morbid habits of mind and feeling. ”

“ Every woman who has any kind of liability to be a mother, or a nurse of the sick, or to meet other exhausting emergencies of the family state needs a reserved force of vital strength which many women who seem to be in perfect health find lacking in such emergencies. ”

“ The question, however, arises—which evil is the greater,—that five hundred youths, in full health and vigour, should be made a little uncomfortable by the presence of seven women, or that seven times five hundred women, unnerved by suffering, should be subjected to the very trial they shrink from.
“That women do truly shrink from this trial, the number of wretched, broken-down sufferers from chronic disease but too clearly proves. It is only when racked by constant pain that a woman’s natural delicacy at last gives way, often only to hear said the words (how bitter they are!) ”

“ I can count almost by dozens the cases which have come under my personal observation of health ruined, and life’s pleasures and usefulness alike lost with it, because young girls (and sometimes older women too) will not submit to receive from a man, however respected, the personal examination and treatment necessary for their restoration, and because no woman’s skill has been at their command. ”

“ I have known several cases of female deaths, reported as sudden, and of cause unknown, when the medical man called in during the latter hours of life has been quite unaware that his lady patient was dying of gangrene of a strangulated femoral hernia, or was bleeding to death from the bowel, or from ruptured varices of the vulva. ”

“ I was very slow to be convinced that any woman of decent character would consciously perpetrate an abortion; still slower to see how any woman calling herself pure minded could so degrade the sanctities of marriage as to make steady and persistent attempts to prevent impregnation,—and yet I had for many years felt sure that a great many so-called ‘female diseases’ were incited and developed by the luxurious and indolent habits of our women, which permit them, when neither cultivated nor philanthropic, to become conscious of every phase of gestative action or sexual excitement. ”

“ It is true that the health of women is not what it should be; but the cause of this lies neither in their peculiar organization nor in their efforts in new directions. It is to be found in the influences surrounding them from infancy, which prevent our girls from acquiring the physical vigor which should accompany maturity. This defective health is nowhere shown more conspicuously than in domestic life. Nowhere do women break down more frequently and completely than in the bearing and rearing of children, under the strain of maternity, and the wear and tear of domestic duty. ”

“ If no women are to be made competent physicians till they have a{67} 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.” ”

“ It is rather amusing to contrast the evidently keen dread of successful competition which degrades a man thus to plead in formâ pauperis, with the voluble assurances, in this and other medical papers, that nature has clearly interdicted to women the practice of medicine, and that here at least they cannot but utterly fail.”—Scotsman, Dec. ”

“ I am desired to inform you that you appear to ask no more than was offered by the Court in their resolution of the 8th ultimo, in which it was stated that, while the Court were restrained by legal doubts as to the power of the University to grant degrees to women from considering ‘the expediency of taking steps to obtain, in favour of female students, an alteration of an ordinance which might be held not to apply to women,’ they were ‘at the same time desirous to remove, so far as possible, any present obstacle in the way of a complete medical education being given to women ”

“ In their red aboriginal noses,"
we regard as an outcome of this century, and we have only just become accustomed to the idea of women physicians.
That women should hold professors' chairs in the great female colleges seems quite right and proper; but think of the thrill of surprise and dismay which would fill the breasts of the mothers of this land should a lady, young and attractive, be appointed to train the masculine mind at Yale or Harvard! ”

“ 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? ”

“ It is right enough to impose heavy penalties on them for practising without a diploma which it needs{61} 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 in our opinion no objection can be raised to our attending clinical teaching, even in the male wards, which does not apply with at least equal force to the present instruction of male students in the female wards.
“11. That we are unable to believe it to be in consonance with the wishes of the majority of the subscribers and donors to the Infirmary (among whom are perhaps as many women as men) that its educational advantages should be restricted to students of one sex only, when students of the other sex also form part of the regular medical classes. ”

“ For centuries Piles have been treated in a careless, listless manner, by physicians who through ignorance or indifference were unfit to be entrusted with such cases, or by quacks who by questionable methods and high-titled nostrums extracted dollar after dollar from patient sufferers. ”

“ Sir,—In the present controversy regarding the extension to women of facilities for obtaining a complete medical education, it is reiterated on one side that there is a no demand among women themselves for doctors of their own sex. ”

“ It shows that women can practise medicine in some fashion—they have the head to do it;—that there is nothing in the work itself, to hinder them from doing so—they have the health to do it—; it shows that women will employ them; that imperfect as their education is (as we shall presently see) , and with the distinct knowledge on the part of women, that these physicians have not the advantages of education which men enjoy, they nevertheless employ them widely and increasingly. ”

“ I think these facts will be considered as establishing the statement that the practice of medicine by women, is no longer a doubtful, but a settled thing; that a new social power is growing up in our midst, concerning which the question is—not shall it exist, but how shall it exist—shall its influence be for good or for harm? It needs but a moment's consideration to see how very deplorable the influence of an ignorant class of female physicians must be! ”

“ The advance sheets of “The Physical Life of Woman” have been read with much interest. In this book Dr. Napheys has well met a real need of the age. There are many things incident to woman's physical organization which she needs to know, and concerning which she still does not want to ask a physician, and may not have one at hand when she most desires the information. This book can be easily read and perfectly understood by those not familiar with medical terms. All matters of delicacy are treated with freedom, and still with a purity of thought and expression which is above criticism. ”

“ Starting, then, with the assumption that women may, with profit to themselves and to the community, become practitioners of medicine, it is clear that they must, in the first place, secure such an education as shall make them thoroughly competent to take their share of responsibility in the care of the national health ”

“ It has been well said that the noblest end of education is to make the educator no longer necessary; and I, at least, shall think it the highest proof of success if women doctors can in time succeed in so raising the standard of health among their sister women, that but half the present percentage of medical practitioners are required in comparison to the female population. ”

“ Moreover, there is reason to hope that women doctors may do even more for the health of their own sex in the way of prevention than of cure, and surely this is the very noblest province of the true physician. Already it is being proved with what eagerness women will attend lectures on physiology and hygiene when delivered to them by a woman, though perhaps not one in ten would go to the same course of lectures if given by a medical man. I look forward to the day when a competent knowledge of these subjects shall be as general among women as it now is rare ”

“ In 1859 she paid a further visit to England, during which she lectured on medicine as a profession for women. Among one of her audiences was Miss Garrett, now Mrs. Garrett-Anderson, who shortly afterwards began, in her turn, the study of medicine, qualifying as the first woman doctor of English education in 1865. Just before her return to America it was suggested to Miss Blackwell that she should get her name inscribed in the recently instituted Medical Register, and but for this almost accidental circumstance she might not have spent the last forty years of her existence in this country. ”