Earlier this year, we missed the opportunity to celebrate the birth anniversary of Doctor Elizabeth Blackwell, born February 3rd 1821, and author of an interesting item from our stores.

The Author

Elizabeth Blackwell was the first woman Doctor of Medicine, graduating in 1849 in the USA. She was placed on the British Medical Register in 1869

Dr. Elizabeth Blackwell was the first woman to attend medical school in the United States, entering the Hobart and William Smith Colleges (then Geneva Medical College) in 1847.

Above: manuscript note of previous owner on the first fly leaf of Scientific Method in Biology, STORE 94:31

Experiencing difficulties as a woman practicing medicine, and having lost her left eye in 1849 while working in Paris [1, p.155], she instead began teaching, and published a volume of her lectures in 1852. The following year, she opened the New York Dispensary for Poor Women and Children. She was aided in this by her protégée Marie Zakrzewska, who would deserve a blog post of her own, and her younger sister Emily (third woman to obtain a medical degree in the United States).

Her career did not stop there. Blackwell travelled between the United States of America and Britain a few times, continuing to teach and practice, until she retired in 1877. By then, she had become the first woman named on the General Medical Council’s medical register, created a medical college for women attached to the dispensary in New York, and mentored several future doctors (Marie Zakrzewska, Elizabeth Garrett Anderson, Mary Putnam Jacobi, to name a few), some of which worked with her in establishing the London School of Medicine for Women.

Scientific method in Biology

After retiring from medical practice, Blackwell continued to write on medicine, morality, and education. Her 1898 work Scientific Method in Biology, her penultimate publication, is one of the earliest books on bioethics held by the Whipple Library – a term that would only be created nearly thirty years later, although it is related to the much older term of medical ethics.

This very short work (eighty pages), looks at the use of ‘conscience’ and ‘morality’ in medicine, teaching, and most importantly research – including scientific experiments. Blackwell believed in human beings’ moral duty to other ‘organic beings’, and that there was enough in the world to study for humans not to voluntarily inflict harm on one another, or on animals.

The Necessity of Medical Research

shock in necessary surgical operations*; the disappearance of blood-poisoning, hospital gangrene and erysipelas, which were the scourges of our public institutions in a former generation, are immense gains, due to the discovery of anaesthetics, antisepctics, and advancing sanitation. These blessings are the direct outcome of perservering and skillful clinical observation, of careful work in the laboratory, of humane experiment, and of happy accident ; they are not derived from cruel experimentation.
The successful control of that terrible disease - puerperal fever - which formerly destroyed such a multitude of women, is a striking conquest of humane method in modern medicine. When I was a student in La Maternité of Paris in 1849, this destructive malady of lying-in women produced a mortality varying from 10 to 15 per cent. But when I visited La Maternité in 1889 the mortality was reduced to a little over 1 per cent. this was due to rigorous cleanliness, sanitation, and the use of antiseptics, directed by the skilful sage femme en chef Madame Henri

*The former horrors of the hospital operating-room are graphically described from personal observation in Sir B.W. Richardson's treatise 'The Mastery of Pain'.

She recognises the need for research, and emphasises the importance of sanitation and sanitisation in medical environments, using the example of mortality rate due to puerperal fever (postpartum infection) to illustrate how research into the cause of the disease, followed by implementation of new protocols, saved the lives of many patients.

The importance of research, however, should not trump the ethical duty of scientists – Blackwell mentions, in particular, vivisection. While the practice had been limited by the Cruelty to Animals Act 1876, since replaced by the Animals (Scientific Procedures) Act 1986, it still allowed for pain to be inflicted on test subject if absolutely necessary. Beyond human beings’ moral duty, Blackwell also states that the lack of ethics in medicine, and the use of ‘destructive experimentations on living creature’ in the teaching of medicine, is damaging to students and eventually leads to ‘moral deterioration’.

Blackwell concludes on the following principles:

  • The aim of scientific research is ‘the attainment of truth’.
  • Different principles must be used when studying organic and inorganic subjects.
  • Research in biology should only include experiments on living bodies when the subject of study benefits from the experiment, and should otherwise observe rather than intervene.
  • Experiments ‘which create involuntary suffering’ both undermine research, and ‘degrade human conscience’.
  • Medical education should nurture respect for life in its students, and study ‘health, not disease’.

This last  point is a reference to ‘painless research’, which looks at preventing disease through sanitation and the study of the environment, diet, impact of jobs and employments, and all that surrounds bodies to determine what causes illness. Blackwell strongly emphasizes, in this book, that the pursuit of such research, coupled with rigorous scientific principles, would help medical practitioners in the long-term by preventing diseases.

Legacy

Both of the institution Blackwell founded, or participated in the foundation of, are still active today. The New York Dispensary for Poor Women and Children is now the NewYork-Presbyterian Lower Manhattan Hospital, and moved buildings in 1981. The London School of Medicine for Women merged with the University College & Middlesex School of Medicine in 1998, becoming the Royal Free & University College Medical School, then renamed UCL Medical School in 2008 [3].

Two prizes bear her name: the Elizabeth Blackwell Medal, awarded to a woman physician who is or has worked in the USA and has significantly contributed to the cause of women in medicine, and the Elizabeth Blackwell Award, which is granted to a woman ‘whose life exemplified outstanding service to humanity’ [4].

Post written and produced by Raphaëlle, Library Assistant.

References

[1] Elizabeth Blackwell. Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches. London and New York: Longmans, Green, and Co. 1895.

[2] Elizabeth Blackwell. Scientific method in biology. London: E. Stocks. 1898.

[3] University College London [UCL]. Our History.

[4] Hobart and William Smith Colleges. The Elizabeth Blackwell Award.

See also

American Medical Women’s Association. Elizabeth Blackwell Award.

Judy Chicago. The Dinner Party: Elizabeth Blackwell place setting. New York: Brooklyn Museum.

National Women’s Hall of Fame. Elizabeth Blackwell.