A Cure For Women

The Cure for Women,  by Reeder

This is a rich biography/history book that takes place in the last Gilded Age, mostly occurring after our Civil War. The main character is Mary Putnam Jacobi who is worthy of great admiration — detailed below.

Two anecdotes flowed from the book and caught my attention. The first was,  “The Philadelphia Jeering Incident.”  This was one of many events chronicled and points to the trials women seeking a medical education faced. In 1869, a group of women medical students were granted a chance to participate in a lecture that would highlight actual patients and their presenting doctors. This was a breakthrough—being a first!  Word was passed through the city’s medical colleges of this change. Hundreds of male medical students attended the lecture and aggressively taunted, jeered, and harassed the female students who sat on the same level as the patients being presented. They were pelted with not only jeers, but tobacco spit and spitballs.  The 20 women and Ann Preston, the Dean of the Woman’s Medical Collage faced this abuse without protest, but silently regarded the stage, not obviously reacting to the chaos these medical students brought to the lecture. The motive is often attributed to the male students’ concern about a potential threat to their future careers. This is not likely—there was no competition from women at this point. The issue was  broader, including social mores (should women observe undressed patients) and capabilities (did they have the intellectual capacity of memory and reasoning to actually provide clinical services), not to mention a disruption in long-accepted societal norms (a woman’s role in society). Should women of good social standing mix with lower classes?

The medical speakers were not in favor of their attendance. One presented a miner who had been partially blinded in a mining accident. He was asked if he could see, and responded, “some.”

“What do you see straight ahead,” asked the attending. “I see your assistant,” was the response.

“No, no, what do you see past him,” directing him to the first row, where the woman sat. He was silent as he squinted. “Light; I see light!”

A journalist in attendance, reported, that to him, the comment carried a much deeper, more poetic meaning: “Was there a signification in that blind man’s words? Was not light dawning upon bigotry and oppression when women were even thus allowed to avail themselves of an opportunity for acquiring knowledge that they would dispense for the alleviation of suffering?”

The jeering would continue once the lecture concluded. The women left by a segregated exit and upon reaching the outdoors, had to run a “gauntlet” of angry, jeering, young men shouting insults and throwing things. Some followed the women to the street and as they took cabs home.

The impact of this incident had the opposite effect that was hoped for by the male students: public opinion was largely on the side of women even when their role in medicine was not typically supported: Victorian social rules of comportment had been violated. These were no gentlemen! The event was a catalyst for a discussion testing other social mores: the notion of integrating mixed classes, mixed genders, and the legitimacy of women getting a college degree or pursing a career in medicine. The resolution over time was the institutions compromised over this bad press, and women secured a place for continued attendance and eventually, the standing of women physicians.

They preceded and would have inspired Gandhi!

An RFK Jr. character provides us with a timely end of the story; a medical student from New Jersey wrote to a Philadelphia paper, that he had witnessed the event and wanted to clear the record. There was no jeering. There was no inappropriate behavior with the exception of that seen in the female students.

Mary Putnam Jacobi faced similar opposition for much of her life though she did acquire credibility and admiration when during a pregnancy, she did research to counter a popular treatment for women and the ideas supporting that treatment, whose source was a fascinating character named Silas Weir Mitchell.

Dr Mitchell was quite famous and his pedigree as a neurologist is worthy of respect. Much of the book is devoted to his biographyand mind-set. He was a patrician and a man of his time whose beliefs found him proposing “The Rest Cure,” for women. A common description for ill woman was tied to the diagnosis of neurasthenia which incorporated divergent physical and psychiatric ailments and symptoms. His treatment, delivered to desperate women who gave consent, was one of isolation, confinement to bed, increased nutrition, the goal of which was to put, “pleasant curves” on a woman along with “rosy cheeks.”  Electrotherapies,  massage, and strict bowel management were included. His belief was that the biology of females did not support cerebral activity well, which when pursued, caused symptoms. One of his clients was Charlotte Perkins Gilman, a woman of some talent. When departing his care, he advised that she, “never pick up a pen, pencil, or brush again….”  Years later, she wrote a famous short story reflecting on the treatment experience: The Yellow Wallpaper.

The rest cure and variations of it was popular despite a paucity of evidence that it actually helped. His published cases were anecdotal without supported conclusions. The implications of his thesis were far reaching and variations, often mainstream, included a vulnerable period with the onset of menses that made educational efforts dangerous to the development of women. It suggested women had specific talents (God given or evolved) which largely did not include academic or “cerebral” work. One variation held that women who were educated had altered fertility and the implication was the decline over time of the white race. The argument held that if women got the vote and became professionals as men did, race suicide would be the result. The birth rates would decline precipitously.

Mary Putnam Jacobi was solicited by women’s rights advocates, as a medical doctor with a glowing reputation to compete for Harvard’s Boylston Prize which would judge papers submitted anonymously. She chose to do research, while pregnant no less, on the effect of menstruation on day to day physical and mental activities of women. She innovated, submitting random questionaires to obtain information (the first time this approach was used in a research paper). With follow up, she was able to conclude that menstruation had little if any effect on otherwise healthy women. She also was first to note that mid cycle, the temperature jumped (this finding, once confirmed and supported by other experiments led to the rhythm method, a form of birth control).

She won the prize—the first woman to do so in 1876, (the year Custer died).  Then like now, methodical research and evidence continued to struggle against societal norms and “what was obvious” to people of the culture of the Gilded Age. It took decades but progress came, especially after women got the vote in the 1920’s.

Fifteen percent of my medical school class (of 1978) was female. Current medical schools have (2025 data) 55% females entering as freshman.

A last remarkable entry regarding Dr. Jacobi: After being diagnosed with a brain tumor, Jacobi documented her symptoms and published a paper on the subject titled Descriptions of the Early Symptoms of the Meningeal Tumor Compressing the Cerebellum. From Which the Writer Died. Written by Herself.

Sir William Osler of John Hopkin’s fame, a personal friend of Jacobi’s, once said that in fact there are three sexes, not two: there are men, there are women, and there are female doctors. I take this as something of a compliment as her life as depicted was one of incredible patience, hard work, vision, and drive that was recognized by even by her detractors, and yet even her advocates and students often found her hard to get along with. It points to a dilema that still exists—one that Osler recognized before women made their gains in our society: a woman who pursues an advanced education and works hard (as a physician, for example) faces choices and difficulties in her family life, her social life, and her professional life (she had to be better than most men) that few men, or women taking a more common path ever experience. It did and continues to have a cost.