"From Lay Practitioner to Doctor of Medicine: Woman Physicians in St. Louis, 1860-1920"

“From Lay Practitioner to Doctor of Medicine: Woman Physicians in St. Louis, 1860-1920” by Martha R. Clevenger

The following article is reprinted with permission from the Winter 1987-1988 issue of Gateway Heritage, vol. 8, no. 3 ©1987 by the Missouri Historical Society.

In the mid-nineteenth century, the term “female physician” was a derogatory epithet used to describe untrained female abortionists. Until Elizabeth Blackwell earned her medical degree in 1849 there were no woman physicians, only self-taught lay practitioners, or women who employed folk remedies in their own homes. In fact few women practiced midwifery. Midwives had largely been supplanted by male obstetricians when the development of forceps to assist childbirth had given rise to obstetrics as a medical specialty.

By 1900, however, approximately 7,000 women had entered the medical profession. At several coeducational medical colleges women comprised at least ten percent of the enrollment, and in some cities, such as Boston, made up as much as eighteen percent of all physicians. By 1920 women had established their undisputed right to study and practice medicine. Their numbers, however, then began to decline, and did not rise again until the 1960s. [1 ]

In St. Louis prior to 1920, there were well in excess of 100 women physicians, almost six percent of the total. [2 ] While these figures are not as spectacular as those cited for Boston, they are nevertheless impressive; and so too are the individual accomplishments of these 100-plus women. This is especially true in light of the general status of women in nineteenth century America, and the open hostility they faced as they sought to enter the professions.

In the early nineteenth century women had no access to higher education or the professions, and married women had no legal identities apart from their husbands. Society dictated that a division of labor should separate the proper roles of men and women into two rigidly distinct spheres, the woman’s being the home, where her function as the nurturer was circumscribed by a restrictive Victorian ideal of “true womanhood” and “true domesticity.” She was seen as a weak and modest creature, whose moral sensibilities had to be protected from the evils of society. Yet her role as a mother was exalted and seen to give her a moral strength and superiority that men lacked. [3 ]

This Victorian ideal never coincided with reality. As soon as it evolved, both social conservatives and radical feminists challenged it, seeking either to expand or to re-define the proper sphere of women. The late 1840s saw the onset of the first of several waves of feminist activity and social reform, just as Elizabeth Blackwell earned her medical degree. The entry of women into the medical profession is part of a larger story, the story of the expansion of the women’s sphere and the growth of women’s rights. It is also part of the story of the nineteenth century reform movements, especially health reform, which encompassed not only public health and social hygiene, but the very transformation of medicine itself.

Reformers used the presumed virtues peculiar to women to justify the expansion of their traditional role. They argued that a woman’s supposed moral superiority suited her for benevolent and philanthropic work in the community, especially in the industrial cities, where poverty, disease, bad housing and a lack of sanitation were common, and where little institutional apparatus existed for dealing with these problems. Women, especially middle-class women, took up these causes and founded some of the first hospitals, asylums and homes to care for the unfortunates of urban society, especially the women and children. The medical care they sponsored was exceedingly social in nature, usually accompanied by moral instruction and rehabilitation. In St. Louis, many prestigious institutions owe their existence to the efforts of such women. St. Louis Children’s Hospital, for example, was founded, funded and operated by reforming and philanthropic women until 1910, when the hospital affiliated with Washington University. [4 ]

Social reform was the connecting link that justified the entry of women into the medical profession itself. Advocates of women in medicine argued that the nurturing character of women made them natural healers and gave them special skills that could be used to advantage in the combined medical treatment and moral guidance of unfortunate women and children. The concept of feminine modesty, one of the linchpins of Victorian ideology, strengthened the case for women physicians, especially in the treatment of other women. [5 ]

In 1848, Dr. Samuel Gregory founded the New England Female Medical College in Boston to train midwives, and ultimately to educate woman physicians. Gregory sought to return women to the birthing room out of the conviction that “the employment of men in midwifery practice is always grossly indelicate, often immoral, and always constitutes a serious temptation to immorality.” [6 ] Two years later, the Women’s Medical College of Pennsylvania was founded in Philadelphia. It was the first of several schools committed to the full-fledged medical education of women.

Aspiring woman physicians, nevertheless, faced monumental difficulties. Throughout the nineteenth century, the debate raged on the propriety of women practicing medicine. In 1871 American Medical Association President Alfred Stille held that women were morally unfit to practice medicine, claiming them to be ignorant, inexact, untrustworthy, unbusinesslike, lacking in sense and mental perception, and contemptuous of logic. [7 ] In addition, the modesty argument was turned against women in medicine. One critic remarked, “It is obvious we cannot instruct women as we do men in the science of medicine; we cannot carry them into the dissecting room and hospital; many of our delicate feelings, much of our refined sentiment must be subdued before we can study medicine; in females they must be destroyed.” [8 ] Last, but perhaps not least, there was another argument used against woman physicians. In an age when physicians often earned little, some practitioners bemoaned “the serious inroads made by female physicians in obstetrical business, one of the essential branches of income to a majority of well established practitioners.” [9 ]

Women, especially, had to fight to obtain medical education comparable to that available to men. Separate medical schools for women often insured only an inferior education. Women’s medical colleges often lacked financial resources and a qualified faculty truly committed to the principle of women’s medical education. Furthermore, these colleges often limited their curricula to obstetrics, gynecology and “the diseases of women and children.” Graduates of such colleges were often almost indistinguishable from trained midwives. Once out of medical school, woman physicians encountered even more barriers. Internships, hospital staff privileges, and election to medical societies were particularly difficult to obtain. Only the most exceptional women received such honors in the nineteenth century. The behavior of the American Medical Association is typical in this respect. In 1876, the AMA made the exception of seating Dr. Sarah Hackett Stevenson of Chicago as a delegate to its national convention, but refused to admit women to membership until the early twentieth century. [10 ]

In part women were able to enter the medical profession during the nineteenth century due to the chaotic state of that profession. Nineteenth century physicians were neither well respected, cohesive, self-regulating, nor especially competent. The typical nineteenth century medical school was a proprietary institution run by and for the profit of local practitioners. Admission was determined by the ability to pay, the course of study consisted of as little as two terms of lectures with the second being a repeat of the first, laboratory facilities were rarely available, and medical research was almost unknown. In fact, most physicians felt that scientific inquiry had little practical value for medicine. Finally, students seldom had clinical training. Medical schools were neither licensed nor regulated, and hospitals, such as they existed, were death houses for the poor. The arsenal of medical treatments consisted primarily of blood-letting, blistering, and massive doses of calomel, treatments that could kill the patient even if the disease did not. [11 ]

Not surprisingly, the medical profession was in disrepute. In 1869 one physician lamented, “medicine has ever been and is now, the most despised of all professions, which liberally-educated men are expected to enter.” [12 ] Socially prominent physicians in the nineteenth century were prominent in spite of, not because of, their professions. [13 ] The medical profession also lacked cohesion and a well developed institutional apparatus to regulate itself.

During the nineteenth century, the medical profession was in chaos as impulses for reform mounted challenges to, and struggled to gain acceptance within, the profession. Within this context, nineteenth century reformers had opportunities to make their influence felt in their crusades to found hospitals, and address issues of public health and social hygiene. Similarly, the chaos of the medical profession enabled women to slip into the ranks of physicians and find opportunities to practice, even if their male colleagues did not acknowledge or accept them.

Nineteenth century reformers and aspiring woman physicians did not necessarily look to orthodox medicine. Many advocated self-help and preventative medicine, and educated women on the virtues of good food, exercise and fresh air, and the dangers of tightly-laced corsets. Folk medicine, massage-therapy, water-cures, and magnetic and electric treatments gained in popularity as alternatives to the “heroic” measures of orthodox medicine, especially for treating women and children. [14 ] Most significantly, homeopathic medicine began to pose a major challenge to the supremacy of orthodox medicine that was not turned back until around 1900 when orthodox medicine at last embraced practices such as antisepsis, and sciences such as microbiology and pathology.

Developed by the German physician Samuel Hahnemann, homeopathy came to the United States in about 1835. Instead of bleeding, blistering and purging, it prescribed a regimen of exercise, diet, and fresh air, and offered its own experimental pharmacology derived from Hahnemann’s own rudimentary scientific experimentation. Based on Hahnemann’s two laws of homeopathy, “let likes be cured by likes”, and the smaller the dose, the more effective it is in stimulating a cure, homeopathic medicine claimed a theoretical legitimacy that orthodox medicine still lacked. For this reason, and because homeopathic treatments proved comparatively effective during the cholera epidemics of 1848-1852, homeopathy was able to pose a considerable challenge to orthodox medicine by the mid-nineteenth century. [15 ] In St. Louis, the proportion of physicians who practiced homeopathic medicine rose to twenty percent by 1890. In addition, eclecticism, a school of medicine that purported to combine the best of orthodox, homeopathic and other sectarian medical theories and practices, contributed another five percent of St. Louis’s physicians.

Women were attracted to unorthodox branches of medicine in proportionally higher numbers than were men. The use of small doses of drugs over heroic measures to treat the diseases of young children and women, for example, made homeopathy especially attractive to both woman reformers and woman physicians. St. Louis Children’s Hospital was staffed exclusively by homeopathic physicians until 1910. [16 ] Homeopathic and eclectic medical colleges and societies also were more willing to admit women into their ranks than were orthodox medical institutions. [17 ]

Prior to 1920 there were over 100 women in St. Louis, including both sectarian and orthodox practitioners, who can legitimately be called physicians. In addition, there were other women who called themselves physicians, but were either midwives, lay practitioners, or quacks. Using titles like “female physician” or “doctress,” most were probably engaged in obstetric practice, and some were almost certainly abortionists. In addition, there were women like Barbara Laguire who practiced “Indian” medicine, and Madame Virginia, who called herself a “clairvoyant doctress.” [18 ] The presence of lay female practitioners continued almost to the end of the century. Among them were Margaret Dossen, a legitimate obstetrician who owned her own lying-in hospital, and Louisa Svoboda, a quack who called herself a “wonder doctress.” [19 ]

The first three truly legitimate woman physicians in St. Louis arrived in the late 1860s. Over the next fifty-plus years, the number increased as more arrived and as St. Louis medical colleges began to admit women. Trained female midwives and colleges of midwifery also appeared in St. Louis. In 1860, the St. Louis City Directory listed only one midwife, whereas by 1900 the number exceeded 300. The distinction between woman physicians and midwives was not always clear. Many woman obstetricians had practices that differed little from those of midwives, and often there was little differentiation in their status. For example, at least six woman physicians with medical degrees were listed in the 1900 St. Louis City Directory as “midwives,” after having been previously listed as “physicians.”

Woman physicians appeared in St Louis in two overlapping waves. The first spanned the 1870s, 1880s and 1890s, as homeopathic and eclectic medical colleges in St Louis opened their doors to women. By 1889, seventy percent of all St. Louis woman physicians were homeopaths, and another eight percent were eclectics. [20 ] The second wave began in the 1890s and ended about 1910. It consisted of orthodox medical practitioners, many of whom graduated from some of the smaller proprietary orthodox medical colleges of St. Louis that only began to open their doors to women in the 1890s. By 1910, the number of orthodox woman physicians exceeded the number of woman homeopaths.

Of the three woman physicians who came to St. Louis before 1870, two were sectarian practitioners. One of these was Adelaide Grennan, a homeopath about whom little is known. The other sectarian practitioner was Susanna Dodds, a hygenic physician and 1866 graduate of the Hygeo-Therapeutic College of New York. Joined later by her sister-in-law, Mary Dodds, also a hygenic physician, Susanna launched a relatively successful practice in St. Louis, which used only “natural methods of treatment: diet, exercise, massage, electricity and hydrotherapy,” therapies that were typical of those pushed by female self-help advocates. The Dodds sisters’ sectarian practice, as well as their gender, kept them outside of the St. Louis medical establishment. Thus they did what many female social reformers and physicians had to do, they founded their own institutions. In 1878 they opened their sanitarium, the Dodds’ Hygenic Home, and in 1887 they founded the St. Louis Hygenic College of Physicians and Surgeons, which graduated several classes before closing due to a lack of funds. [21 ]

Well before the arrival of Adelaide Grennan, homeopathy had already attained considerable popularity in St. Louis during the 1849 cholera epidemic. In 1859 the Homeopathic Medical College of Missouri opened and continued in operation until 1910. [22 ] In 1874 this college began to grant its first degrees to women. Over the next several years it produced a number of prominent St. Louis woman physicians, including Josie Johnson, May Pearman, Clara Sauter, and Sophia Schiereck.

Despite their generally liberal outlook, St. Louis homeopaths were not completely comfortable with coeducation. Ten years after producing its first female graduates, the faculty of the Homeopathic Medical College concluded that medical education should be segregated by sex. Their reasoning stemmed from the conviction that coeducation was too much of an ordeal for a woman and endangered “her sense of modesty and innate purity,” thus “unfitting her for the noble calling of physician.”

Many homeopaths, both male and female, took exception to this view. May Pearman argued, “Though a true woman may suffer anguish and distress in the dissecting room, it does not necessarily follow that she should lose modesty or any womanly trait of character — rather, she will add to these, endurance, self-control, usefulness and independence.” She further argued that male students should “respect, nay, reverence the woman that with martyr-like spirit stands the disagreeable ordeal, though it wounds her sensibilities, that she may thereby spare others of her sex a similar pain.” A plan to open a woman’s homeopathic medical college for the 1883-1884 year did not provide a satisfactory solution. It meant that women would either receive an inferior education, or that the faculty of the Homeopathic Medical College would have to be split, causing a general deterioration of education. [23 ]

Nevertheless, in 1883, the Women’s Medical College of St. Louis opened with a faculty of nine, four of whom were women, including Josie Johnson (Hitchcock) and Clara Sauter. Leading male homeopaths joined the faculty as well. This faculty, displeased with the move to create a separate medical college for women openly belittled “the male student [who] cannot comprehend the fact that there is no sex in science” and suggested that “it is he who should be excluded from her walls instead of woman.” [24 ]

This attempt to segregate homeopathic medical education proved short-lived. Women who had already matriculated at the Homeopathic Medical College were not required to transfer to the new sister school. When in that year’s graduating class a woman, Alice B. McKibben, was elected valedictorian by her predominantly male classmates, the cause of segregated education was largely discredited. [25 ] In that same spring of 1884, the St. Louis Society of Homeopathic Physicians and Surgeons, in the process of reorganizing, resoundingly put an end to talk of excluding women from the new organization, when some prominent male homeopaths threatened to withdraw if women were excluded. With women so clearly accepted by their male colleagues, the faculty and trustees of the Homeopathic Medical College relented and voted again to “open its doors to women on the basis of co-education.” [26 ]

The victory for women in the St. Louis homeopathic medical community did not mean that women were free from the limitations imposed by prejudice. Even among homeopaths, sentiment remained strong that women were more suited to certain types of medical practice. The curriculum of the short-lived Women’s Medical College, which focused on obstetrics, gynecology and “the diseases of women and children” reflected this logic. [27 ] Furthermore, the majority of women who entered homeopathic medicine took degrees in midwifery at the homeopathic Missouri College of Midwifery. This school’s explicitly defined mission was “not to make regular practitioners of medicine; but to educate women in those branches for the profession for which they are peculiarly adapted.” [28 ] Reflecting the prejudice that woman students should be spared embarrassment, a woman, Dr. Sophia Schiereck, served as the demonstrator of Practical and Theoretical Midwifery.

The pervasive preoccupation with women’s sensibilities extended into eclecticism as well. St. Louis’ eclectic medical school, the American Medical College, produced its first woman graduate, Laura Randolph, in 1888. In the next year, she was appointed to the faculty as demonstrator of anatomy for the college’s subsequent female students. [29 ] This was the only capacity in which women served as faculty members of coeducational medical colleges in nineteenth century St. Louis.

The orthodox medical community resisted the encroachments of woman physicians for much longer than did the sectarian communities. In 1889, only five women in St. Louis practiced orthodox medicine. One was the lay practitioner Margaret Dossen, and the other four, Nancy Leavell, Mary Craffey, Mary Hancock McLean, and Sarah Hunter, had all studied medicine elsewhere.

Nancy Leavell was the first woman with a medical degree to practice orthodox medicine in St. Louis, and the third of the three woman physicians who arrived in St. Louis before 1870. An 1865 graduate of the Women’s Medical College of Pennsylvania, she came to St. Louis as the protege of the eminent St. Louis physician and future St. Louis Medical Society president Dr. Simon Pollak. He was one of the first St. Louis advocates of women in medicine. In charge of the clinic at Mullanphy Hospital, Dr. Pollak allowed Nancy Leavell to intern with him. He later wrote, “The other physicians did not like my bringing her there, but I kept her and she proved a remarkable assistant in many ways. Afterwards she did remarkably well for herself.” [30 ] He failed, however, to secure her election to the St Louis Medical Society. Nor did she ever become a member despite practicing obstetrics and gynecology in St. Louis for over forty years.

It was the third orthodox woman physician in St. Louis, Mary Hancock McLean, who first broke into the exclusively male ranks of the orthodox medical establishment. If there is one woman who can be cited as the great heroine and pathfinder of St. Louis woman physicians, it is Dr. Mary McLean, whose remarkable career included accomplishments and services to the community that have since been matched by few – male or female. [31 ] The daughter of a physician and native of Washington, Missouri, Mary McLean attended the University of Michigan’s medical college at Ann Arbor, graduating in 1883. She came to St. Louis the next year and interned at the city’s Female Hospital, a position secured for her through the influence of a family friend. As far as can be ascertained, Mary McLean was the only woman to intern at a St. Louis city hospital until the 1940s. In 1885 she became the first woman admitted to the St. Louis Medical Society, when Simon Pollak reportedly nominated “M. H. McLean” for membership, failing to mention that M. stood for Mary.

Mary McLean distinguished herself not only as a physician, but as a surgeon, philanthropist and social reformer. Her accomplishments included the use of her inheritance to endow the Bethesda Hospital for unfortunates in 1899, the founding of the Emmaus Home for the young women who came to work at the St Louis World’s Fair, the cofounding of the city’s YWCA, and the support of her own missionary work in China. In addition, in 1908, she formed a free women’s clinic, run exclusively by women for women. Several St. Louis woman physicians, including Adelheid Bedal, Frances Bishop, Ella Marx, Harriet Cory, Isabel Gray and Frances Ritchie worked with Mary McLean at this clinic, thereby gaining valuable experience. When Mary McLean died in 1930, Frances Bishop justifiably wrote: “there is in St. Louis today hardly a woman physician who does not owe in some way her introduction to medical circles to Dr. McLean.” [32 ]

Mary McLean’s success in breaking into the male dominated medical establishment was not to be equaled by another woman for several years. In 1886 Dr. Sarah Hunter’s nomination for membership in the St. Louis Medical Society was soundly rejected. According to the press, “It was admitted on all sides that no objection could be made to Dr. Hunter’s qualifications, but the edict had gone forth that no more ladies would be admitted to membership, and the society will enforce it.” [33 ]

It was not until the 1890s that women in St. Louis had access to an orthodox medical education. As the end of the nineteenth century approached, the number of orthodox medical colleges in St. Louis increased greatly. In addition to the older, larger and more prestigious Missouri Medical College and St. Louis Medical College, which date back to the 1840s, there were also the St. Louis College of Physicians and Surgeons, founded around 1870, and the Barnes, Beaumont and Marion Sims Medical Colleges, all founded in the 1890s. In addition, the Women’s Medical College of St. Louis (not to be confused with the earlier homeopathic college of the same name) opened its doors in 1892. [34 ]

This medical college was founded for the express purpose of preserving the segregation of orthodox medical education. Its first annual announcement gave voice to the conviction that coeducation “incorporated within it inseparable elements that were fatal to success . . .” [35 ] The opening of this college was only a small concession to women, and was made in the face of strong opposition. In 1892, an editorial in the Medical Mirror, a St. Louis publication, attacked the founding of the Women’s Medical College, charging that “Women are not endowed by nature or art with the qualities, nor can they gain the necessary equipment for making a successful physician.” The same article went on to suggest that women who had proven themselves competent physicians were mistakes of nature, men clothed in women’s bodies, and therefore no argument for the admission of additional women to the medical profession. [36 ] In 1894, as the first women graduated, the question of internships for women at the St. Louis city hospitals arose. As the Medical Mirror reported, however, “The Board of Health found it inexpedient to admit women to the hospitals as assistant physicians, . . . inasmuch as the admission of women would mark a change from the established order of things,” and would be impossible “without some previous consideration and rearrangement of administrative work.” [37 ] Women remained excluded from city hospital internships until the 1940s.

Few women ever graduated from the Women’s Medical College. Of those who did, only four appear to have practiced in St. Louis. And only one, Henrietta Borck, was ever admitted to the St. Louis Medical Society, and then only in 1913, nineteen years after her graduation. Another graduate, Ellen Osborne, was never admitted, despite an illustrious career. It was, however, a career that she created for herself. Unlike most woman physicians, she did not limit her practice to the “women’s specialties” or to female patients. An internist and surgeon, and founder of her own surgical and quarantine hospital, she was assisted by other woman physicians, who like her, found staff privileges difficult to obtain at other hospitals. By 1911, the Ellen Osborne Hospital was one of the network of hospitals affiliated with the Barnes Medical College. [38 ]

In 1896, the Women’s Medical College closed due to a lack of funds. During the next several years, however, coeducational opportunities began, at last, to open up for aspiring St. Louis woman physicians. The first beneficiary of such opportunities was Kate Spain in 1895. As the secretary on staff at the St. Louis College of Physicians and Surgeons, she finagled permission to attend lectures at the college, so long as they did not interfere with her secretarial duties. Her initiative and perseverance paid off in the end, when the faculty allowed her to graduate. In later years, a few additional women graduated from this college as well. [39 ]

The number of women practicing orthodox medicine in St. Louis began to climb in the 1890s. Most, however, still earned their degrees elsewhere, usually either at the Women’s Medical College of Pennsylvania or the University of Michigan. These degrees carried more prestige than the medical degrees that women earned in St. Louis. Thus the 1890s saw the arrival of such competent woman physicians as Frances Bishop, Adelheid Bedal, and Ella Marx, whose credentials, skills and service to St. Louis helped to expand opportunities for women, especially in public health and in institutional settings.

Frances Bishop was the best known of these women. Arriving in St. Louis in the mid-1890s, Dr. Bishop not only began a practice in general medicine, but became involved in public efforts to combat tuberculosis, worked to aid young girls through the YWCA, and cofounded the Missouri Hygiene Society. In addition, she became the first medical advisor of Washington University’s physical department, and with a staff of assistants pioneered a program of medical and surgical “welfare work” for a large St. Louis manufacturing concern. [40 ]

In 1903, Frances Bishop, Adelheid Bedal and Ella Marx were admitted to the St. Louis Medical Society. At last the St. Louis orthodox medical establishment formally acknowledged the legitimacy of women to practice medicine. In the next year, Kate Spain was also elected to the medical society, and was the first “home-grown” St. Louis woman physician to be so honored. [41 ]

During the first decade of the twentieth century the pioneering efforts of the first St. Louis woman physicians finally began to pay off. Barnes Medical College graduated its first woman in 1902. She was Nevada Adams, who left St. Louis to practice in New Mexico. But between 1904 and 1909 at least fifteen more women graduated from Barnes Medical College and remained in St Louis. All but two were eventually admitted to the St Louis Medical Society.

Women failed, however, both nationwide and in St Louis, to institutionalize their gains. After 1900 American medicine was in the throes of reform, reforms that effectively limited the opportunities of women to study medicine. Beginning around 1910, the percentage of woman physicians dropped to below five percent, where it remained until the 1960s.

The reform of American medicine gradually caused scientific values to eclipse the nineteenth century ideal of the humanistic and social minded practitioner. The often poor proprietary colleges started to give way to university-based medical schools that set much higher educational standards, and emphasized extensive clinical training and research. In 1910, on behalf of the Carnegie Foundation, educator Abraham Flexner surveyed and evaluated all of the United States medical colleges. Accepting only the higher standard posed by the best university-based schools, Flexner issued a report that sounded the death knell of the proprietary medical college. [42 ] The medical profession took notice and began to regulate itself, lest the state step in.

In St. Louis, no proprietary medical college, nor any college that admitted women, survived the Flexner Report by more than a few years. [43 ] Only Washington University Medical School (which had arisen out of the Missouri Medical College and the St. Louis Medical College) and St. Louis University Medical School (which had emerged from the union of Beaumont and Marion Sims Medical Colleges) possessed the resources to adopt the new standard of medical education. Neither medical school yet admitted women. One woman, Harriet Cory, had managed to complete three years of course work at Washington University Medical School and was then denied the right to graduate. She had to complete her last year at Rush Medical College in Chicago, graduating in 1910. [44 ] In 1918, Washington University finally relented and admitted two women. The percentage of women students, however, was kept at five percent or below until the 1960s. In addition, Washington University provided little assistance in securing internships for its woman graduates. With St. Louis city hospital internships closed to women until World War II, most women had to serve their internships outside of St. Louis. St. Louis University Medical School’s record was even worse. It did not admit women until 1948. In 1950, only sixty to seventy women practiced medicine in the St. Louis area. In 1900, there had been over eighty. [45 ]

The avenues by which most women had gained access to the medical profession in the nineteenth century were closed. Homeopathy was discredited, eclecticism vanished, and all but one of the women’s medical colleges closed. The new medical schools, in that they were considerably more expensive and had much stiffer admission requirements, were not as accessible as the earlier proprietary colleges. The resulting contraction of opportunities to study medicine affected women disproportionately. In addition, the medical profession as a whole became more cohesive and self-regulating. Physicians were able to close ranks and restrict the number of women they admitted into their profession. Women physicians had nevertheless won a major victory. They had secured the right to study and practice medicine.

Martha R. Clevenger is an archivist at the Missouri Historical Society.

[1] For information on women in medicine in nineteenth century America, see: Mary Roth Walsh, Doctors Wanted, No Women Need Apply; Sexual Barriers in the Medical Profession, 1835-1975 (New Haven: Yale University Press, 1979); for a review of Walsh’s book, see: Regina Morantz, “Women in the Medical Profession; Why Were There so Few?” Reviews in American History (June 1978), pp. 163-170; Regina Morantz, “The ‘Connecting Link’: the Case for Women Doctors in 19th Century America,” in Sickness and Health in America, ed. R. Numbers and J. Leavitt (Madison: University of Wisconsin Press, 1978); and Mary Putnam Jacobi, “Women in Medicine,” in Women’s Work in America, ed. Annie Nathan Meyer (1891). [Back]

[2] This and all subsequent identifying information and statistical data on St Louis women physicians was compiled by the author from the following sources: Directory of Physicians, Dentists and Druggists of Missouri, 1889 (St. Louis, 1889); St. Louis City Directories and the Annual Reports of the Health Department of the City of St. Louis, copies of which are to be found at the Library of the Missouri Historical Society; Dr. Ellen Loeffel, “A History of Women Doctors in St. Louis” (unpublished paper, 1951), YWCA Archives, Western Historical Manuscripts Collections (WHMC), University of Missouri-St. Louis; and membership records of the St. Louis Medical Society, and an unpublished list of women physicians compiled in 1950 from Polk’s Medical Directory and the American Medical Association Directory, in the archives of the St. Louis Medical Society Library. [Back]

[3] Barbara Harris, Beyond Her Sphere: Women and the Professions in American History (Westport, Conn.: Greenwood Press, 1978). [Back]

[4] Marion Hunt, “Women and Childsaving: St. Louis Children’s Hospital, 1879-1979,” Bulletin of the Missouri Historical Society 36 (January 1980), pp. 65-79. [Back]

[5] Morantz, “The ‘Connecting Link.’” [Back]

[6] Quoted in Jacobi, “Women in Medicine,” p. 143. [Back]

[7] Loeffel, “Women Doctors in St. Louis,” p. 3. [Back]

[8] Quoted in Jacobi, “Women in Medicine,” p. 143. [Back]

[9] Quoted in ibid., p. 144. [Back]

[10] Loeffel, “Women Doctors in St. Louis,” p. 3.; and Marion Hunt, “A Women’s Place in Medicine: the Career of Dr. Mary Hancock McLean,” Bulletin of the Missouri Historical Society 36 (July 1980), p. 260, n. 1. [Back]

[11] Kenneth M. Ludmerer, Learning to Heal: the Development of American Medical Education (New York: Basic Books, Inc., 1985); and Paul Starr, The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry (New York: Basic Books, Inc., 1982). [Back]

[12] Quoted in Starr, The Social Transformation of American Medicine, p. 7. [Back]

[13] Ludmerer, Learning to Heal, p. 28. [Back]

[14] Regina Morantz, “Nineteenth Century Health Reform and Women. A Program for Self-Help,” in Medicine without Doctors, ed. G. Rinse, R. Numbers, and J. Leavitt (Science History Publications, 1977), pp. 73-90. [Back]

[15] Martin Kaufman, Homeopathy in America: the Rise and Fall of a Medical Heresy (Baltimore: John Hopkins Press, 1971). [Back]

[16] Hunt, “Children s Hospital,” p. 71. [Back]

[17] Jacobi, “Women in Medicine,” p. 158. [Back]

[18] These two women were listed, respectively, in the 1859 and 1866 St. Louis City Directories. [Back]

[19] Directory of Physicians, Dentists and Druggists of Missouri, 1889, pp. 7, 87, and 257. [Back]

[20] These statistics were based on the St Louis entries in ibid. [Back]

[21] Annie Andre-Johnson, Notable Women of St. Louis, (1914), pp. 58-60; and a prescription issued by S. W. and Mary Dodds, November, 1884, in AF files-Medicine, Missouri Historical Society Archives. [Back]

[22] Samuel D. Soule, Medicine in St. Louis Medical Colleges in the Nineteenth Century (n.p. [St Louis?], n.d. [1978?]). [Back]

[23] For a discussion of this debate see: May B. Pearman, “Women in Medical Colleges,” and Clara Sauter’s letter to the editor of March 24, 1883, in St. Louis Clinical Review 6 (1883), pp. 138-42; and an editorial in St. Louis Periscope 7 (1884), pp. 206-07. [Back]

[24] The Annual Announcement of the Women’s Medical College of St. Louis, Mo., for the Session of 1863-4 [1883], a copy of which can be found in the Missouri Historical Society Library. [Back]

[25] “Another Woman Wears the Laurels,” St. Louis Periscope 7 (1884), p. 80. [Back]

[26] Editorials in St. Louis Periscope 7 (1884), pp.206-08. [Back]

[27] Annual Announcement of the Women’s Medical College . . . 1883-4. [Back]

[28] Directory of Physicians, Dentists and Druggists in Missouri, 1889, p. 252. [Back]

[29] Ibid., p. 102. [Back]

[30] Reminiscences of Dr. Simon Pollak, in One Hundred Years of Medicine and Surgery in Missouri (St. Louis: St. Louis Star, 1900), p. 41. [Back]

[31] Marion Hunt, “A Woman’s Place in Medicine;” Loeffel, “Women Doctors in St. Louis;” Johnson, Notable Women of St. Louis, pp. 146-48; Linda Fisher, “Mary Hancock McLean: 19th Century Trailblazer,” St. Louis Metropolitan Medicine (Oct. 1986), p. 47; Bertha Van Hoosen, Petticoat Surgeon (1947); and Notes by Elva Norman on a conversation with Miss Gertrude Prack, unpublished, YWCA Archives. [Back]

[32] Weekly Bulletin of the St. Louis Medical Society 24 (June 27,1930), pp. 501-02. [Back]

[33] “No Ladies Need Apply,” unidentified newspaper clipping (1886), in the records of the St Louis Medical Society. [Back]

[34] Soule, Medicine in the St. Louis Medical Colleges. [Back]

[35] Quoted in ibid., p. 52. [Back]

[36] “Women in the Medical Profession,” Medical Mirror 3 (1892), pp. 365-68. [Back]

[37] “Female Physicians as Hospital Interns,” in ibid., 5 (1894), p. 166. [Back]

[38] Johnson, Notable Women in St. Louis, pp. 174-78; and Soule, Medicine in St. Louis Medical Colleges. [Back]

[39] Loeffel. “Women Doctors in St. Louis,” p.6. [Back]

[40] Ibid., p. 5; and Johnson, Notable Women in St. Louis, pp. 25-27. [Back]

[41] Loeffel, “Women Doctors in St. Louis,” pp. 5-6; and Membership records of the St. Louis Medical Society. [Back]

[42] Ludmerer, Learning to Heal; and Starr, The Social Transformation of American Medicine. [Back]

[43] See Soule, Medicine in St. Louis Medical Colleges, for Flexner’s critiques of the St. Louis medical colleges. [Back]

[44] Loeffel, “Women Doctors in St. Louis,” p. 7. [Back]

[45] Ibid., pp. 7-8; and St. Louis City Directory for 1900. [Back]

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