WOMAN AND HER PHYSICIAN: A LECTURE DELIVERED IN THE MEDICAL DEPARTMENT OF THE UNIVERSITY OF LOUISVILLE. BY THEOPHILUS PARVIN, M. D., Professor of the Medical and Surgical Diseases of IVomen in the University of Louisville. LOUISVILLE, KY: PRINTED BY JOHN P. MORTON & COMPANY, 156 W. Main St. 1870. WOMAN AND HER PHYSICIAN: A LECTURE DELIVERED IN THE MEDICAL DEPARTMENT OF THE UNIVERSITY OF LOUISVILLE. BY THEOPHILUS PARVIN, M. D., Professor of the Medical and Surgical Diseases of IVomen in the University of Louisville LOUISVILLE, KY: PRINTED BY JOHN P. MORTON & COMPANY, 156 VV. Main St. 1870. CORRESPONDENCE. Louisville, Ky., October 24, 1870. Dr. Theophilus Parvin, Indianapolis, Ind.: Dear Sir—We, a committee appointed by the Medical Class of the Uni- versity of Louisville, respectfully request that you furnish us with the manuscript of your Introductory Lecture, delivered before this class on the 5th day of October, 1870, which we desire for publication. Very respectfully, E. A. Waggener, W. W. Taylor, Chas. Mitchell. Indianapolis, Ind., October 29, 1870. E. A. Waggener, Chairman, and others: Gentlemen—The manuscript of a lecture delivered to the students of the Medical Department of the University of Louisville is at your disposal. Yours truly, Theophilus Parvin. WOMAN AND HER PHYSICIAN. Gentlemen : Before entering upon any of the special topics relating to the medical and surgical diseases of women, I wish to speak to you of Woman and her Physician, pre- senting some of the more prominent characteristics of the one and endeavoring to portray what should be the character of the other. In this sketch of Woman I shall but allude to her physical nature, and dwell chiefly upon her mental and moral qualities. A knowledge of these qualities will greatly facilitate both the study of many of her disorders as well as the application of therapeutic means, and be in some degree a light to guide you in your general conduct as practitioners. Coleridge once remarked that he is the best physician who is the most successful in inspiring his patient with hope. The maladies of the female sex, in a large degree, have their psychical as well as their physical expression, and are so often attended with mental depression and anxiety, that he who knows her nature best, can read most readily all mental and moral manifestations of bodily disorder, and by a cheerful and intelligent confidence arm her with patience and faith, will be woman’s most successful physician. I apprehend too that the honest study of woman’s character, in its purity, its beauty, and excellence, will lead us all to a higher appreciation of it. “Every well-educated medical man ought to know something more of woman than is con- 4 Woman and Her Physician. tained in the volumes of a medical library. Her history and literature, in all ages and all countries, ought to be gathered as the garlands with which to adorn his scholarly career as a physician.” But not merely as an adornment, but as food for strength, should we all seek this knowledge—strength for our daily work, strength for all noble aspirations and all loving gratitude. Do not regard it as a rhetorical extravagance when I speak of woman as one of man’s best blessings. The late Dr. Thomas Addison, in concluding a lecture on some of her diseases, thus spoke: “Whatever may be her lot in this world, we, as men, must acknowledge that, whilst Infinite Power gave us being, Infinite Mercy gave us Woman.” Briefly referring to some of woman’s more obvious physical characters, we observe, first, that she is inferior in weight and stature to man; that her bones are smaller, more fragile than his, and less strongly marked for the insertion of muscles. A parallelogram would nearly mark the lateral boundaries of man’s trunk, while woman’s, in consequence of the greater proportionate breadth of the pelvis, is more pyramidal in form. The greater length of woman’s clavicles explains her awkwardness in throwing, or other violent exercise with the arms, and, on the other hand, the greater ease with which she can carry or hold an infant. Her inferior extremities, more widely separated at the hips, and both relatively and absolutely shorter than man’s, do not permit her to run with either grace or rapidity. An examination of her muscles, the powers which act upon bony levers, shows them to be smaller, more delicate, less powerful than man’s; their forms are less strongly marked upon the exterior; their reliefs more gentle, thus contributing to the greater beauty of the female form. “These differences,” says Moreau, in his Natural History of Woman, “the general delicacy of muscles, and the elegance and beauty of form, belong to the essential nature of woman. Education, habits of life, may increase these characters, as Hippocrates was forced to avow, never- theless there remains a radical, innate difference, which will be found in all countries and among all peoples.” Woman and Her Physician. 5 Now if, as Voltaire asserts, the physical alzvays rules the moral, there surely is written in woman’s members, in her physical structure, the law of her life and her avocations. But, without dwelling upon this point, let us observe that a marked difference between the sexes is found in the period of physical development of each. Man does not attain his complete development until the age of thirty, while woman reaches hers at the age of twenty. Buffon’s explanation of this fact is, that woman’s organs having less volume than man’s, Nature acts in a smaller sphere, and therefore sooner accomplishes her work. Beauty is one of the most common of woman’s physical characteristics. Age, disease, poverty, suffering, ignorance, the play and power of evil passions, wicked habits of life, may mar or even destroy that beauty, not in a single indi- vidual merely, but in those deriving their origin from her; nevertheless this gracious gift is the general possession of the sex. Some of you are familiar with Anacreon’s twenty-fourth ode, wherein he speaks of Nature having given to all that breathe the air of heaven some boon of strength — wreathed horns to the bull, a hoof of strength to the steed, speed to the timorous hare, etc., and then concludes: “To man she gave in that proud hour The boon of intellectual power. Then what, O Woman! what for thee Was left in Nature’s treasury? She gave thee beauty — mightier far Than all the pomp and power of war. Nor steel nor fire itself hath power Like woman in her conquering hour. Be thou but fair, mankind adore thee; Smile, and a world is weak before thee! Turning now to woman’s mental and moral characteristics, we are struck with the fact that the organ of mind — the brain — is decidedly inferior in size to man’s. Now, does this inferiority in the size of the instrument necessarily prove the inferiority in power of that immaterial principle which acts through it and by it? No: it simply renders it probable; 6 Woman and Her Physician. for, while admitting that the quality of the brain is to be con- sidered as well as the capacity, and that we sometimes meet with large heads whose possessors are provokingly dull, and small heads that are quick with intellectual activity, we must recognize the general law, that the larger the brain the greater is the intellect. Upon this question of relative mental superiority of the sexes, one of the ablest and most philosophical writers of the present day—Mr. Lecky—makes the following observations: “ Intellectually, a certain inferiority of the female sex can hardly be denied when we remember how almost exclusively the foremost places in almost every department of science, literature, and art have been occupied by man, how infinitesi- mally small is the number of women who have shown in any form the very highest order of genius, how many of the greatest men have achieved their greatness in defiance of the most adverse circumstances, and how completely women have failed in obtaining the first position, even in music or painting, for the cultivation of which their circumstances would appear most propitious. It is as impossible to find a female Raphael or a female Handel as a female Shakspeare.” * Even by the * “We are the ‘weaker vessel.’ Whether acknowledging it or not, most of us feel this: it becomes man’s duty and delight to show us honor accordingly.”— A Woman's Thoughts About Women, by Miss Muloch. The general tone of Horace Bushnell’s recently published work—“Women’s Suffrage: The Reform Against Nature” — is to the same effect. Illustrative of this statement we quote the following from this admirable book: “Their distinc- tion of sex puts them in different classes of being, only they are classes so nearly unified by their unlikeness that they compose a whole, so to speak, of humanity by their common relationship. One is the force principle, the other is the beauty principle. One is the forward, pioneering mastery, the out-door battle-axe of public war and family providence; the other is the in-door—covert, as the law would say — and complementary mistress and dispenser of the enjoyabilities. Enterprise and high counsel belong to one, also to batter the severities of fortune, conquer the raw material of supply; ornamentation, order, comfortable use, all flavors and garnishes and charms to the other. The man, as in fatherhood, carries the name and flag; the woman, as in motherhood, takes the name on herself and puts it on her children, passing out of sight legally to be a covert nature included henceforth in her husband. They are positivity and receptivity, they are providence and use, they are strength and beauty, they are mass and Woman and Her Physician. 7 few who assert woman’s intellectual equality with man there must be acknowledged mental differences more or less striking. For example, woman has greater quickness of thought; so too she learns more readily, and probably retains less strongly. A girl at school will solve a mathe- matical problem more promptly than her male companion of equal age and opportunity, but she will not be able to trace the steps of the solution with equal clearness and certainty; the result is right, but the process by which it is attained sometimes eludes her comprehension. In this truly she exhibits one of the highest attributes of mind; indeed, some- thing akin to genius, which, without the painfully laborious steps of induction, sweeps directly to the desired object. In composition and in conversation woman is generally more fluent than man. She expresses her thoughts with more grace and facility; while the quick and delicate play of her fancy beautifies her thoughts like the gentle aurora of the northern sky. color, they are store-house and table, they are substance and relish, and nothing goes to its mark or becomes a real value till it passes both.” Let me give you still another quotation, and it shall be from one of our own great masters, the late Professor Meigs, who certainly understood woman’s nature, character, and capabilities quite as well as any of the flippant declaimers about woman’s rights, who are trying to thrust the ballot into her hands and compel her into the various professions as man’s rival and competitor, and this in spite, as I believe, of the teachings of physiology, of history, and of the Bible. “The crown, when it rests on the brow of a woman, is always a political accident, grievous and deprecated; and, even then, where woman reigns man governs. The great administrative faculties are not hers The far-reaching strength of Milton’s poetic vision went out beyond her fine and delicate percep- tion Do you think that a woman, who can produce a race and modify the whole fabric of society, could have developed in the tender soil of her intellect the strong idea of a Haihlet or of a Macbeth? Could her voice, like the accents of Hortensius or Tully or Chatham or Burke, command the bent ear of a listening senate, or move, like leaves whirled in a tornado, the agitated masses of a people tossed in the tempest of their passions, or, like a gentle west wind, soothe and calm them down again by the influences of its reasoning and powerful suasion? ‘Ille regit dictis animos et pectora mulcet.’ Such is not woman’s province, nature, power, nor mission. She reigns in the heart; her seat and throne are by the hearthstone. The household altar is her place of worship and service.” 8 Woman and Her Physician. Woman has more delicate aesthetic sensibilities; will more promptly recognize and rejoice in the beauties of a painting, a poem, or a landscape. She is more sensuous, not sensual, than man; and all images of beauty, all fragrant odors and melodies she more readily perceives. In poetry, while the greatest names are those of men, yet many a woman has done much to cheer, to instruct, to bless humanity by the divine influence of her song; indeed among all the poets of the century few names are to be compared with that of Mrs. Browning. In philosophy the number of women who have engaged is exceedingly small; smaller still those who have attained even temporary eminence. Hypatia is as unfit to be the representative of women in philosophic learning as Messalina, Locusta, or Tofania their suitable type in morals. Of woman’s greater refinement of manners and delicacy of feelings there can be no doubt. Her step is lighter, her touch more gentle, her anticipation of wants quicker, and her tact, which is but another name for touch, is more ready and sensitive. In moral excellence few will question her superiority. The records of crime and of criminal trials, the statistics of jails and of penitentiaries abundantly attest this truth. This virtue, whether we attribute it to original moral constitution or to her manner of life exempting her from contact with many of the vices and temptations of the busy world, is equally manifest in the conduct determined by the emotional nature and that founded upon the decisions of conscience. In the highest form of moral excellence — religion — woman’s life is marked by the most earnest faith and devo- tion. Man’s mind is more skeptical—demands demonstration. It was not a Mary but a Thomas who received the epithet of doubting. Woman has more of a confiding, trusting nature; there is a personality in her religious as indeed in all her attachments. It is not so much forms, abstract principles, and creeds which command her faith and enlist her devotion, as it is a personal God and a personal Christ. Whether you Woman and Her Physician. 9 observe from Protestant or Catholic stand-point, you will find women foremost in the observance of religious duties and in the manifestation of religious zeal. Lo, too, in how many nurseries throughout all Christendom will to-night the patter of little feet be stilled while child-voices lisp their evening prayers at mothers’ knees! As it was, is now, and ever shall be, mothers are the earliest and best religious teachers. Of woman’s love let us speak reverently and believingly as one of the richest blessings in all man’s pathway from the cradle to the cofifin. In old times, when one of two devoted friends expressed his attachment to the other, it was by a love passing that of women; and when the infinite God sought in human affection that with which to compare his own for his chosen people, it was the love of a mother for her sucking child. You who have experienced a mother’s loving nurture, kind caresses, and watchful care; you who have witnessed her unwearying devotion at the couch of her sick child, “that knoweth not His mother while she blesses, And droppeth upon his burning brow The coolness of her kisses; ” you who have seen many a weeping Rachel raining her tears of sorrow upon the death-bed and the grave, refusing to be comforted; you need not be told the unselfish devotion, the depth and strength of a mother’s love. The fabled pelican, feeding her young from her own self-torn, bleeding breast, is a picture of many a self-sacrificing mother. To every man the name and memory of her who bore him are precious. “ On the blue mountains of our dim childhood, toward which we ever turn and look, stand the mothers who marked out to us from thence our life: the most blessed age must be forgotten ere we can forget the warmest heart.” Shall we not gather strength for all generous deeds, for all heroic and noble works by looking back to her whose smile was our first sunshine, whose eyes were the first stars of heaven to Woman and Her Physician. us ? So too in the other relations of life, as wife, sister, daughter, woman’s high vocation is sanctified in countless happy homes. It is well for us, in a world whose hopes so often disappoint, whose strifes and toils so often weary and dishearten, and wherein purity of purpose and action is not always shield ample and stout enough to protect us from the envenomed shafts of slander, and the utmost sacrifices of kindness are often returned with the coldness of selfishness or the baseness of ingratitude, and the heart worn upon the sleeve finds abundance of daws to peck at it; it is well for us to refresh our souls and keep them from the death of despair or the poison of misanthropy by drinking from the perennial fountain of woman’s love. There may be for every man a sanctuary in some true woman’s loving heart—mother’s sister’s, wife’s — when he is wearied with the battle of life, hunted by the malice of jealous and unscrupulous rivals, where he may forget his griefs and trials, be refreshed and strengthened, and whence he may go forth anew with high hopes and manly resolves. In the silence and the solitude of many a blessed home the old story of Gethsemane’s garden, of an angel strengthening one who is sinking under his load of selected or allotted duty, is repeated. The mighty mystery of woman’s love lies in its concen- tration : here is the hiding of its power. “ Woman, in accordance with her clear-seeing nature, loses herself, and what she has in heart or happiness, in the object she loves.” Women love, and that infinitely and truly; but their affections are set on persons, not on things; on individuals, not on ideas or possessions, places or race. In religion, in politics, in patriotism, it is the leader or the leaders, not the banners, which she follows. In sexual love she is less sensual than man. Many men entertain an utterly erroneous view of woman’s nature in this regard; they think her altogether such an one as themselves, and the error is fraught with injurious consequences. It may be that the Divine Author of our being made her less under the dominion of that which is one of the most imperious Woman and Her Physician. passions in man’s breast, in order that there might be an ampler security thrown around her virtue, and that in the( purity of her love she might lift up her companion to a holier and purer life. When she lapses from virtue she is the tempted, not the tempter. “ Seducing men precede seduced women; every deterioration of the female character is but the after-winter of a similar one in men.” The citadel of her purity does not crumble or consume in the fires of passion—nay, its walls would be like asbestos in the flames; but Love, blind as the old Greek mythology represented him, stole the keys from the ward of Conscience, and unlocked the door to the cruel, heartless invader. In the heroic element of character woman is more re- markable for endurance than for performance, for passion than for action. True there have been heroines, like the shepherd-girl of France, who, from the sweet solitude and peaceful pleasures of pastoral life, guided armies to glorious victory. History tells us too of a Flora MacDonald, who periled her life to secure the safety of her hunted king; of a Catherine Douglass who, when assassins were hastening on their errand of blood into the royal apartments, secured the door with her fair arm as a bolt, and held it there until broken. But the fortitude and perseverance of Flora MacDonald saving her king were equaled by her patience as a prisoner; and all the battle glories of Joan of Arc were eclipsed in the closing scene of her life, when, with the bil- lowing volumes of smoke around her and the hungry flames roaring up to devour her, she thought only of the safety of the priest who had accompanied her to her throne of death and of immortality. Well has one of the most gifted of English writers ex- claimed, in view of the tragic story of this warrior-maiden of France, “Yet, sister Woman, though I can not consent to find a Mozart or a Michael Angelo in your sex, cheerfully, and with the love that burns in depths of admiration, I acknowledge that you can do one thing as well as the best of us men — a greater thing than even Milton is known to Woman and Her Physician. 12 have done, or Michael Angelo — you can die grandly, and as goddesses would die were goddesses mortal! ” All physicians must be struck with woman’s patience under disease — nay, with her reticence when her sexual system is the subject of such disease. This reticence arises in part from her uncomplaining disposition; in part from her ignorance, mistaking sympathetic disturbances for the true disorder; and finally, from her shrinking modesty, and from the hope, oftentimes vain, that time may cure the dis- ease. It is needless to say that this concealment of her suffering is often fraught with serious consequences, the diseases becoming chronic, requiring chronic treatment, or else advancing beyond cure. Another point which physicians do well to remember is the despondency which disease of her generative organs induces; it seems to her as if the integrity of her sexual life, of that which made her woman, were imperiled. This gloom which overwhelms her, this cloud which darkens her life, the physician will find often a most serious hinderance in the treatment of her disorders. Time will not permit me to prolong this sketch of woman. Study and admire her character if you would be true physi- cians ; if indeed you would be true men, you must have a just appreciation of woman. De Quincey makes the proper criterion of the commencement of manhood consist in the reverential feeling, sometimes suddenly developed, toward woman. “ From that moment when women cease to be regarded with carelessness, and when the ideal of woman- hood in its total pomp of loveliness and purity dawns like some vast aurora upon the mind, boyhood has ended; childish thoughts and inclinations have passed away forever; and the gravity of manhood, with the self-respecting views of manhood, have commenced.” At the very threshold of the discussion of the character- istics of woman’s physician a question as to the sex of that physician in these days obtrudes itself. Some propose to Woman and Her Physician. 13 remand obstetric and gynecologic practice into the hands of women. Schools of medicine for the education of females have been established in this country — schools shall I say, “With prudes for proctors, dowagers for deans, And sweet girl - graduates in their golden hair?” Not content with these schools, importunate women are knocking at the doors of hospitals and colleges where and when men are receiving their instructions, and into some of these they have obtained admission; but the injudiciousness, not to say the gross impropriety, of the association of the sexes, either in clinical or in didactic instruction, must be manifest to every true man who wishes to preserve his rev- erence for womanhood, and to every true woman who would preserve the modesty and delicacy which are so essential to womanly character. The majority of physicians at heart condemn this threat- ened influx into the medical ranks. Is this condemnation based upon selfishness, upon prejudice, or upon a better knowledge of woman and of the duties and responsibilities of the medical life ? Upon the last exclusively, I believe. History, physiology, the general judgment of society, and especially the opinions of those best qualified to decide this vexed question, unite in the negation of woman’s fitness for the medical office. If she be so admirably fitted by nature as the advocates of female physicians allege for the medical office, why did she not prove that fitness during the centuries that obstetricy and gynecology were confided exclusively to her? You know the history of medicine, when the seven hundred thousand volumes of the Alexandrian library were burnt by Omar in 642, and the famous Alexandrian school destroyed; how it fled to the Saracens themselves, and what diligent culture was made in some of its departments; but the study of diseases of women received no impetus, but downright impediment, for the Mohammedan creed would not permit on the part of male physicians any practical study 14 Woman and Her Physician. of such diseases; personal examination was forbidden to any but women. During the eleventh, the twelfth, and the thirteenth cen- turies there were famous female teachers in the school of Salerno; there was Abella, who edited in metrical form two books—De Atm Bile and De Natura Seminis Humani; then Mercuriadis, who wrote De Crisibus, De Curatione Vulnerum; Rebecca, whose themes were De Febribus, De Veninis, and De Embry one; and Trotta, or Trotula, belonging probably to the twelfth century, and whose chief work was entitled De Passionibus Muliermn ante, in, et post partum. Among the remedies advised by Trotula were rasped ivory, a snake-skin burnt upon the thigh, hoofs of horses burnt with cats’ feces, etc. The fact that the empire which woman once held in obstetrics and gynecology passed from her grasp with the progress of civilization, and the great advancement that has been made in these departments of medicine by men in about two centuries, while she accomplished nothing in nearly five times the period, afford an argument which should not be overlooked in weighing this question of female physicians. The obligations of medicine to woman, notwithstanding the opportunities which have been afforded her, are exceedingly small. “Why is it less womanly,” exclaims a recent writer,* “to prescribe as a physician than to tend as a nurse?” If a woman have a calling to medicine, divinity, law, etc., he goes on to say, “why should she not have a fair chance of pursuing it?” We answer, it is less womanly to be physician than nurse, because she is less fitted for the one than the other office — and upon this point we shall say a word in a moment — while as to “a calling” to this, that, or the other, there is no more abused word in the English language than that word “calling.” “A call” has put many a blockhead into the pulpit, made fools and fanatics by the hundreds in every age; the merest impulses, blind and unreasoning, the injudicious advice of friends or relatives have called many a * The “Friendships of Women,” by William Rounseville Alger. Woman and Her Physician. 15 man and woman to the exercise of social functions for which nature, education, and grace gave them no fitness. I would rather, instead of believing that woman is truly called to medicine, divinity, or law, adopt the language of Michelet: “The end of woman on this earth, her evident vocation, is love.” One must be very unfortunately constituted, very hostile to nature, very blind and crooked-souled to pro- nounce, against God himself, that this delicate organism and this tenderness of heart are destined only to isolation. “ Let us educate her,” they say, “to be self-sufficing; that is the safest plan. Love is the exception, and indifference the rule. Let her know how to live within herself—to labor, pray, die, and work out her salvation in a corner.” To this I reply, that love will never be wanting to her. I maintain that, as a woman, she earns her salvation by constituting the happiness of man. Nature designed woman to be wife and mother, to be at least the superintendent of domestic affairs, to be the pre- siding divinity in the sanctuary of home, and to be the first educator of her children; and the utter incompatibility of these functions with the office of a physician must be obvious to every thoughtful mind. Is woman fitted to endure the fatigue and the exposure incident to medical practice? What perils too must she undergo by the way in midnight visits at the urgent call of the sick in city or in country! She must be either more or less than woman if these do not affright her, and possibly she may be compelled, as the Lancet recently suggested, to invite her nearest medical neighbor of the other sex to accompany her, or else turn over all her night business to him. Our doctress may not be incumbered with husband or home or children, demanding her care and her time. She may be a vowed celibate; but her very celibacy, as is observed by Dr. Tilt, exposes a woman to certain diseases from which her more fortunate married sisters escape. And after all she is still a woman, and subject to that great law of the female economy by virtue of which, during about thirty years of her 16 Woman and Her Physician. life, she is at intervals of a month, for from four to six days, said to be, by more than a mere euphemism, unwell. Let the history of the genesis of hundreds of cases of uterine dis- order answer as to the injurious influences of exposure at such times to cold, to fatigue, to intense mental excitement and emotional disturbance; and this exposure is a part of a physician’s daily life. When we remember too how woman at her “periods” is at any rate liable to nervous disturbance— this' liability often increasing with her culture — disturbance varying from slight hysteria to absolute mania, liable too to physical suffering varying from trifling and transient pains to terrible agony, we find another argument against woman’s entering the medical profession. It is doubtful whether woman’s moral nature is equal to the grave emergencies and sudden responsibilities of our pro- fessional life. It has been mooted too as to whether woman’s mind is of that character best fitted for the solution of medical problems; she is deductive rather than inductive in her rea- soning, and medicine resting upon induction, she is not adapted for its practice; such is in brief the argument. Would woman preserve amid the trials and jealous com- petitions of medical life her native purity, delicacy, and refinement? Might she not become less of woman and more of man, and thus, “like flying fish between the two elements, hover between manhood and womanhood, injured by both, and persecuted in both kingdoms?” Goldsmith wittily ob- serves that the fabulous birth of Minerva, the goddess of arms, wisdom, arts, and sciences, was an allegory designed to show that women of natural and usual birth must not aim at those accomplishments. She sprang armed out of Jupiter’s head, without the cooperation of his consort Juno, and as such only had those great provinces assigned her. He then suggests in regard to some famous women that they were really of the “epicene gender,” and concludes the topic by saying, “ I therefore require that those women who insist upon going beyond the bounds allotted to their use should previously declare themselves hermaphrodites, and be regis- Woman and Her Physician. 17 tered as such in their several parishes; till then I shall not suffer them to confound politics, perplex metaphysics, and darken mysteries.” So-called “female medical colleges” did not exist in his days or else he “who wrote like an angel” would ungallantly have coupled medicine with politics as forbidden ground for women. It is doubtful whether female physicians would readily acquire the confidence of their suffering sisters. Certainly they would not deserve to do so if they entertained such views as were publicly expressed some months ago by a lady well known for her culture, and for her activity in reformatory movements—Mrs. Caroline Dali—“avast amount of female disease is merely simulated;” the diseases peculiar to the sex “create a morbid activity of the senses in the present women,” so that a male physician’s presence in the sick- chamber will produce “ complication of symptoms, aggravation of disorder,” etc. If female physicians are to be educated into such views—views that no pure-minded and intelligent medical gentleman would for a moment entertain—then heaven deliver women from all such physicians. No vast amount of these diseases is simulated : for one that is pretended or imag- inary there are a hundred borne in silence; and as to erotic impulses, thoughts, or desires agitating a suffering woman upon the entrance of the physician into her room, they can not be any more than if the visitor were a loving father or brother, and she would be thus led to desire the horrid crime of incest.* The vast majority of women do not ask for female physicians; nor have male physicians proved themselves so incompetent, so ignorant, so unsympathetic, and so unkind that they can be, or that they deserve to be, set aside for their female competitors. We can not believe, looking at the matter both from an historical stand-point and from woman’s nature, and from the opinions and conditions of society, however strong the present tendency toward the *Very differently from Mrs. D. does an eminent theologian speak of women. “The womanly calling is an endless multiplicity of little troubles, and the womanly destiny is loaded with manifold sexual pains.”—Lange. 18 Woman and Her Physician. education of women as physicians, that the female sex is destined to ever acquire or to permanently hold any large place in medical practice.* The diseases of women must hereafter, as heretofore, be chiefly intrusted to male practitioners. Now what manner of man ought he to be who assumes the treatment of such diseases ? Let us suppose him to present the true criterion of manhood and the requisite professional education; I re- mark, first, that he must be a gentleman. A gentleman’s first characteristic, says Ruskin,f is that fineness of structure in the body which renders it capable of the most delicate sensa- tion, and of structure in the mind which renders it capable of the most delicate sympathies—one may say simply fine- ness of structure. And again, the same eminent writer de- clares that gentlemanliness is another word for an intense humanity. Without this intense humanity the physician, however rich and varied his culture, fails of the true spirit of his profession. The highest natures are at the same time the kindest, the simplest, the gentlest, and thus in all the noblest. It does not follow that those who rise to eminence among their fellows should be, like Alpine summits, very grand but very cold. A medical gentleman is not one who has sacrificed his emotional nature, and become a frigid intelligence ; but his heart throbs with sympathy for human suffering, and his * Of course we have been discussing the question as to woman’s fitness, not as to that of individual women. As there have been so there may be some of the female sex who will not only be successful, but also be eminent in a certain department of medicine. And yet I believe that those females who are the least womanly, and marked by the fewest characteristics of the sex, will be the most successful. I might add that so far as an experimental decision of the fitness of women for physicians has been furnished in our country during the last few years it is in the negative. Quite recently I was informed by an eminent member of our profession in one of the eastern cities, who sometimes meets these lady-physicians in consultation, that “just such errors in diagnosis as might be expected from second-course students the best of them make.” It is a question whether those few members of the medical profession who lend their names and influence in behalf of female physicians, are not doing both medicine and the public a wrong; while the specious plea of giving remunerative employment to women, which is on the tongues of so many, would, carried out in all departments of life, fill every profitable place with those whose only recommendation would be that they had nothing to do. t Modern Painters. Woman and Her Physician. 19 hand not only brings relief, but brings it kindly. Coarseness, harsh tones, rude steps—downright vulgarity—are utterly alien from the true medical character. Physical suffering is hard enough to bear. Tears, groans, contortions of the face, writhing of the body—these are among the witnesses of its severity; and why should we whose office it is to remove or mitigate pain ever thoughtlessly add a feather’s weight to the crushing load ? Especially when we deal with suffering women is there requisite on our part the utmost courtesy and kind- ness. A flower opens its petals to the warm sunshine, but closes them to the night’s chilly air; the harp gives forth sweetest music to the delicate and skilled touch, but only harsh discords to the rude and ignorant hand. Woman is like the flower and the harp, and her physical disorders will be most skillfully treated by that physician whose kindly and courteous sympathies are manifest in voice and tone, in word and deed. Her physician should be a man pure in heart and life. The medical profession may compare favorably in regard to virtue with any other class of men ; yet lapses do now and then occur. When we think of the sacred confidence reposed in us, of the high responsibility under which we rest, how terribly criminal such lapses appear! Nor can he who thus dishonors his calling—who smites his unhappy victim with a more terrible evil than any disease he was called to treat, and blasts the purity and destroys the peace of a family—escape punishment. Fable tells us that the eagle, stealing meat from the altar of the gods, took with it a coal of fire, which burned up her nest and eaglets; so vengeance, swift and inexorable vengeance, though it may not be inflicted by human arm, must pursue him who, entering a family under his professional garb, becomes an adulterer or seducer, while his future blackens with a more terrible doom. Let him that standeth take heed lest he fall in some grievous hour when the tide of passion sweeps up, submerging the higher elements of his nature, and will bear him away unless his feet rest upon the eternal rock of virtue and principle. In connection with this it may be worth while to remark that woman herself involuntarily shrinks from a sensual nature; she will discover quickly, 20 Woman and Her Physician. however fair his exterior, a man of licentious habits and lustful desires. Possibly God, seeing the perils to which her virtue would be exposed, gave her this ready instinct as he gave the bird its keen vision and the beast its quick scent. No physician can be a welcome visitor to her sick-chamber whose character is not free from all taint. Purity of heart and life is the true physician’s passport to the homes of virtue and his panoply of protection in the hour of temptation. Such a physician should be a temperate man in regard of alcoholic beverages. I wish I could impress upon your minds the imminent perils to which he is exposed who even occa- sionally indulges in the wine-glass. How many a young man have I known who from such indulgence beggared himself of fortune, friends, talents, opportunities, and then sunk down, not living out half his days, into the drunkard’s dishonored grave! God save any of you from such terrible fate! Nay, now save yourself from the inevitable consequences of uncon- trolled indulgence. There is safety in total abstinence, while there is peril for nine out of ten young men in anything else. A clear eye, a steady hand, and an unclouded intellect should be always the physician’s possession ; while the besot- ting influence of intemperance is in no one a greater outrage upon decency, purity, and virtue than in him who is treating the maladies of woman. Woman’s physician should be a conscientious man. What he does and what he says, especially the promises made to a patient, should be founded on truth: all falsehood of word or act, all delusive hopes, should be utterly forbidden. Let honesty mark all his intercourse with his patient, and she will learn to confide in him, to trust his advice, and to obey his instructions. Even in that most terrible of diseases, which devours life with wasting and agony, and upon which is ineffaceably written, as it occurs in some situations and some stages, No hope! the physician, while he ought not abruptly to pronounce the dreadful doom, must gradually unfold the truth; and this knowledge, coming from him, may divert the sufferer’s thoughts more and more to a world where the pangs of disease are unknown. Woman and Her Physician. 21 One thing more. You will pardon me—but what am I saying? No, your pardon need not be asked for declaring that if the physician be truly a religious man it will add to, not detract from, other qualifications. Religion is not a matter of particular creeds and forms and ceremonies, not a shibboleth to be shouted in men’s ears, nor a sanctimonious face to be worn for men’s eyes; but, as the etymology of the word tells, a re-ligation, a re-binding of the soul to its father God, from whom it has wandered. Only here do destiny and duty blend in a common path ; only here does true light shine upon the vexed question, the unwearying riddle of human life presented to all thoughtful minds, ever recurring from age to age. The Christian physician has a strong chord of sympathy with woman, whose religious nature is so deep, so earnest. He has a power, of no little consequence in some cases, over her will in securing fidelity and persistence in the use of therapeutic means. But whether he be a Christian or not, he must feel the influence of her religious character: a virtue goes out of her blessing every nature upon which it falls. This virtue, this influence, is all the more powerful oftentimes when she is most crushed by disease, like the richer fragrance of the bruised summer flowers. The lessons taught by her unrepining suffering, by her unselfish desire for health, her hopeful trust, her willing obedience, and her pious resigna- tion, are rich beyond estimate. He will grow a wiser and a better man whose heart is open to the sweet influences of her religious life whose high eulogy for eighteen centuries has been, and must be evermore—last at the cross, first at the sepulcher!