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date: 22 September 2019

Blackwell, Elizabethfree

(03 February 1821–31 May 1910)
  • Regina Morantz-Sanchez

Blackwell, Elizabeth (03 February 1821–31 May 1910), physician, reformer, and medical educator, was born in Bristol, England, daughter of Samuel Blackwell, a prosperous sugar refiner, and Hannah Lane. Her father’s interest in abolitionism and in “perfectionist reform,” the belief that through education and spiritual regeneration human beings could achieve a just society on earth, coupled with a series of financial reversals, prompted a move to the United States in 1832 when Elizabeth was eleven.

In America the family struggled economically. Elizabeth’s beloved father died in 1838 but not without leaving an activist legacy to his children: Elizabeth’s brothers supported antislavery and women’s rights. Henry Blackwell married the feminist Lucy Stone, and Samuel wed Antoinette Brown (Antoinette Louisa Brown Blackwell), the first formally ordained woman minister in the United States. A poet and translator, sister Anna also dabbled in spiritualism. No doubt the family’s move, shortly before her father’s death, to Cinncinati, Ohio, a hotbed of revivalist congregationalism and avid abolitionism, further stimulated Elizabeth’s liberal thinking. She formed friendships with a circle of New England Transcendentalists who had settled in the city, remembering most fondly the Reverend W. H. Channing, nephew of the minister Ellery Channing (1780–1842) of Boston and the group’s spiritual and moral center.

As a young woman Blackwell struggled to cope with feelings that she viewed as contradictory—a powerful sexual attraction to men and the passionate desire to give purpose and direction to her life. For several years she taught school but had difficulty viewing teaching as her life’s work. This period of uncertainty was resolved when a close friend, dying of cancer, urged on her the study of medicine, insisting that the ministrations of a woman physician during this trying time would have provided greater comfort and relief. An epiphany of sorts, this experience changed Blackwell’s direction. After a year of reading medicine privately with physician friends in Charleston and Philadelphia, she finally found a school willing to accept her as a student. In 1847 Geneva Medical College in upstate New York admitted Blackwell after a reluctant faculty submitted the decision to a vote of the student body, which answered in the affirmative partially as a practical joke. When she received her medical degree in 1849, Blackwell was the first woman in the United States or Europe in the modern period to do so. Subsequently she attended clinics in London and Paris, studying midwifery at La Maternité for some months until she lost the sight in one eye when she contracted purulent ophthalmia while treating an infant suffering from the disease. Reluctantly giving up her original goal of becoming a surgeon, she returned to New York City in 1851 to hang out her shingle.

The next several years brought initial discouragement and ultimate success. In 1856 Blackwell was joined by her sister, Emily Blackwell, fresh from studying surgery with James Y. Simpson in Edinburgh, and the talented Marie Zakrzewska, a German immigrant with extensive midwifery training in Berlin who had recently graduated from Western Reserve Medical School. A year later the three founded the New York Infimary for Women and Children, one of several female-run urban institutions being established by freshly minted women physicians. A fine medical school was added to the hospital complex a decade later, one that trained hundreds of women doctors before it merged with Cornell University Medical School in 1899.

Less interested in administration than in the larger implications of the women’s medical movement, Blackwell left the management of the school to her sister while she herself emerged as the leading spokesperson for women physicians in the United States and in England, where she settled permanently in 1869. There she involved herself with the British cause, serving on the executive council and as lecturer in midwifery at the new London School of Medicine for Women in 1875 and 1876.

When her health began to fail in the early 1870s, Blackwell gave up the active practice of medicine and devoted herself full time to reform. Her notion of medical reform was always broadly conceived, and she involved herself in Christian Socialism and Theosophy (intellectual movements emphasizing social justice and mystical-religious insight), the antivivisection movement, and moral and sexual purity. Her speeches and essays on these subjects, as well as on the topic of laboratory medicine, were eventually collected in a two-volume work titled Essays in Medical Sociology (1902; repr. 1972).

On the eve of the bacteriological revolution in the 1880s, Blackwell brooded long and hard about the dangers of “medical materialism,” a term she used to accuse laboratory physicians of likening the body to a machine and turning real patients into objects. At the core of the new medicine was the “birth of the clinic”—the gathering together of vast patient populations into a hospital system that provided clinicians and students free access to sick bodies for physical examination, observation, the gathering of statistics, and autopsy. Laboratory medicine grew out of such changes and produced a new ideology of science consisting of an acceptance of the germ theory, the identification of specific disease, increasing specialization within medical practice, and a growing willingness to resort to evidence produced in a test tube. Blackwell, on the other hand, had been trained at an earlier time when sickness was viewed not as the specific affliction of a particular part of the body but as a condition affecting the entire organism. Therapy was consequently designed to treat the whole patient, and professional identity itself was embedded in ritualized interactions between doctors and patients during which intuitive and subjective factors were crucial in the diagnosis and treatment of disease. In addition, Blackwell believed there was a social, political, and moral component to illness. Prevention was even more important than cure, and insuring health meant comfortable housing, healthy food, and moral education for all. Indeed, she saw the practice of medicine as an opportunity to bring about fundamental social change.

Blackwell’s thinking about medicine was deeply influenced by her conceptions of gender. She framed a discourse about the good practitioner that utilized the nineteenth-century ideology of domesticity, depicting the female qualities of nurturing, empathy, and moral superiority as naturally flowing from the experience of maternity. Motherhood, she claimed, much like the practice of medicine itself, was a “remarkable specialty” because of the spiritual principles that underlay the ordinary tasks most mothers performed daily. These principles she labeled collectively “the spiritual power of maternity,” and they informed not only her notions of moral responsibility but her formulations of what constituted good science. Maternity as a force had much in common with the twentieth-century psychologist Erik Erikson’s idea of generativity, which he defined as a concern for insuring the healthy moral and physical growth of future generations. Not only physicians but all mankind, Blackwell argued, must learn to harness it.

Blackwell modeled the doctor-patient relationship on the interactions between mother and child, and in doing so she gendered such behavior, though she was careful to assert that it was behavior that men could learn. She went even further in her construction of notions of gender in science by arguing that the new experimental science was too masculine in style, mode of thought, and orientation. She opposed the increased use of gynecological surgery to cure ailments of the female reproductive system, complaining that irresponsible male physicians were rendering women sterile unnecessarily. She blamed bacteriology on the “male intellect” and warned her students against the tyranny of male authority in medicine. Like many of her male colleagues, she was reluctant to deemphasize the importance of physician-patient interaction at the bedside. But although she was not alone in rejecting the new medical materialism or the increasingly reductionist approaches to patient care, she was innovative in using the language of gender to drive home her point. To later generations of women physicians, Blackwell’s moralism appeared anachronistic, but we must concede her extraordinary prescience regarding the ambiguous legacy of the new science for the physician-patient relationship.

Blackwell never married, but in October 1854 she adopted a seven-year-old orphan, Katharine Barry, who played the various roles of daughter, companion, housekeeper, and amanuensis, as needed, for the rest of Blackwell’s life. Barry often wrote letters for her to Elizabeth’s extensive family, to which both remained quite close. Blackwell died in Argyllshire in the Highlands of Scotland.

Bibliography

Elizabeth Blackwell’s papers are in the Library of Congress and the Schlesinger Library, Radcliffe College. Columbia University holds a set of her letters written to the English reformer Barbara Leigh Smith Bodichon. Her autobiography, Pioneer Work in Opening the Medical Profession to Women (1895), reprinted in 1914, with a bibliography of her writings and an additional chapter by Robert Cochrane, and again in 1977, without the additions, is a helpful, if biased, source. The best biography of Blackwell remains Nancy Sahli, “Elizabeth Blackwell, M.D. (1821–1910): A Biography” (Ph.D. diss., Univ. of Pennsylvania, 1974). Also available are three popular works: Elinor Rice Hays, Those Extraordinary Blackwells (1967), Ishbel Ross, Child of Destiny (1944), and Mary St. J. Fancourt, They Dared to Be Doctors: Elizabeth Blackwell, Elizabeth Garrett Anderson (1965). See also Annie Sturgis Daniel, “ ‘A Cautious Experiment’: The History of the New York Infirmary for Women and Children and the Women’s Medical College of the New York Infirmary,” Medical Woman’s Journal 46–48 (May 1939–Dec. 1942). For a list of the numerous short biographical sketches of Blackwell, see Sandra Chaff et al., Women in Medicine: A Bibliography (1977). Specific references to Blackwell are also in Regina Morantz, “Feminism, Professionalism and Germs: The Thought of Mary Putnam Jacobi and Elizabeth Blackwell,” American Quarterly 34 (Winter 1982): 461–78, and Regina Morantz-Sanchez, “Feminist Theory and Historical Practice: Rereading Elizabeth Blackwell,” History and Theory 31 (Dec. 1992): 50–69.