BLACKWELL FAMILY From Jacobi, Mary Putnam ELIZABETH BLACKWELL 110 W. 34th St N. Y. Dec. 25th/88 My dear doctor, Your letter arrived this Christmas morning, and as I have an unusual hour of leisure, I sit down to reply while it is yet fresh in my mind. So indeed did I do to your pamphlet, but as you could see by the dates, -- a long interval occurred before it was finished. --First let me thank you much for the cordial expression of sympathy with my personal troubles. It may seem strange to add that these now seem to me almost outlived. Certainly they are always there fortheir worst effects are always there, -- and indeed if it were not for that,--I should have forgotten everything else. But it is so true that "man is born to trouble and as the sparks fly upwards," that whatever has been evidently lived through, has evidently not been intolerable. Life has many ressources far beyond what our contemplating intellect could divine. I often read Marcus Aurelius--which I think is far more certainly the Bible of strong persons,--than the gospel of compassion of the Nazarene,--for at least the latter comes in at an entirely different angle of [u?], and must suit entirely different kind of people.-- Moreover half,--and not the least worthy half of the Christian doctrine, consists in what it absorbed from the Stoics. My "antagonistic hairs" are only raised in regard to one mental habit,--principle,--or method of yours,--call it what you will ;--the well known transcendental method of arriving at conclusions by the force of [?] not insight, and then refusing to submit these to tests of verification. Indeedit is the latter ommission I really object to : the transcendental vision probably always comes first, in all large generalisations. It may indeed be true, that all original views or new ideas come by a sort of vision, into certain minds, without effort on the part of the latter. But whether these are to stand as effective truth or not, depends upon how far they can they can bear the tests of close conflict with facts, with innumerable details : how they can sustain the onslaught of argument and criticism. Your sex, your age, and your cast of mind, render all this difficult, I should rather say, highly improbable for you. You never have taken the trouble to go into this close conflict : you resemble your sister Anna sufficiently to prefer to remain within the sphere of large, often half mystical assertion. Those who are in sympathy with this already are convinced,--but you have no method or system to convince opponents. It is a question of belief or disbelief,--never of proof. You pay me the compliment--no--I will not use the idle conventionalism,--you say I have an able intellect,--and this is perhaps true, relatively to women's minds in general. I am not at all sure that it ever is so, if counted among men, certainly not among the men with whom I should wish to be counted, if at all. Now I have always thought of you, that you had a large mind,-- but one relatively untrained in technicalities. The most prominent fact in your history is a curious, and to me has always been a most astounding illustration of this. It is your mind that conceived the idea of women physicians in modern life,--and on a plane at which few have ever thought of it. I do not know that anyone but myself--any woman physician I mean,--has ever entered fully into all you saw in this idea : how it claimed a full equality and independence for women as nothing else ever had or perhaps could ; an intellectual, practical and social emancipation. Suffrage might be secured for women on the same terms as for the negroes ; and they would be as little advanced by it. But, "who cures the plague, Tho thrice a woman, shall be called a leech." and believing fully with Descartes, "Si nous arrivons jamais a perfectionner la race humaine, c'est dans la medecine qu'il font chercher les moyens," I have the same enthusiasm now as at eighteen,--for medicine, for this marvellous [?] of sciences, that try to unravel the mysteriesof the human body and soul,--and really go so far towards doing so.--I believe that any woman whose medical work is really effective, can take rank, has a most extraordinary influence in "that awakening of womanhood,"--that task of "curbing male arrogance and self sufficiency" of which you dream,--But while you so dream,--and while your dream has become potent enough to really stir the depths of two hemispheres, you have always disliked, ignored, and neglected medicine! The terrible misfortune of your eyesight came upon you as you told me, because you found classical medicine,--though just rejuvenated by [?Bichal] and [?Broursais],--such an arid and useless thing, that you must wander over to a peasant German charlatan,--to [Preissnitz?] water cure!--and,--(I refer to this now, because [?] you say wrongfully that you have given me stones when I have asked you for bread,)-- tho one real occasion where from your position you should have shown me much, yet failed to show me anything, was when I began to study medicine under your direction in New York. I am perfectly wellhow immense were the difficulties in the way of your being taught medicine at that time : and how immense were the difficulties in Norway of your reading. Still it has always seemed to me that the greatest real difficulty was your own intense indifference to the work. You never really descended from your vision, into the sphere of practical life within which, that vision if anywhere, must be realised. You left that for others to do. Now all this curious contradiction,--by no means unprecedented,--I have seen it in a few others, as Wendell Phillips for instance, comes up in your present writings. You start from an 'a priori' view: you are comparatively careless about how this can be adjusted to a rigid induction from observation of a sufficient number of facts. I am sometimes reminded of [Fourier?] - as when he says that the only reason male physiologists pretend that sugar is not fit as food for women and children who so greatly desire it, -is because they, women, - are too lazy to dig artesian wells in the desert of sahara, when enough sugar could be cultivated to bring down the price. Or when Fourier asserts that the population problemwill be solved when women are emancipated, and vigorous in health, - for vigorous women will bear far fewer children than sickly ones. Mr. Mill also asserts that the emancipation of women will tend to diminish over population - but he does not invent a physiological doctrine to justify this assertion. -- Now it seems to me, if you had started out with precisely the same aims in your pamphlet, - and with which I think I entirely sympathize, - but with a belief in the necessity of wrestling with a multitude of puzzling, difficult and conflicting facts, 4 instead of sailing over them, - you would have made your statement in a different way, and have made it more effective. Here on the one hand is, as you say, the great impetuous fundamental fact of creation, of reproduction, and of the instinct for it, the desire for it, the passion for it, - which dominates all living things and mankind as much or more than any: which cannot die out until "The stars grow old, and the leaves of the Judgment Book unfold." The fancy crossed mysinned once, - "what if the Earth, among all worlds, - had been especially selected to be the birthplace of souls: the seat of generation of life: whose regeneration might be pursued indefinitely elsewhere! This would account for the way in which this process is woven into the thickest [?] of our being and thoughts, - like time and Space themselves." I expressed this idea to a friend, - who had married a woman two years older than himself, and was childless. "Yes," he said, "--and with that we should always prefer the Earth to all other worlds, --and generation to regeneration! I confess i agree with him, - and I believe so do you. Mr. Mill is as pedantic on this subject as might be expected of a man who could devote himself to the platonic worship of a married woman for twenty years, and [?] seven years of married life produced no children. It seems to me, that if children became a little more rare, they might easily become objects of formal worship, - as they now are of practical worship. A beautiful child seems to me the loveliest thing in the entire world,- the most natural focus of desire. --on the other hand, there are innumerable difficultiesin the way: pressure of population, personal income, personal health, unless mankind is to submit blindly to the struggle for existence as do all other animate beings, he must control the great reproductive [*x*] force instead of being controlled by it. Here is the problem, - here the statement that flatly contradicts the church, whose dicta on the subject express a necessary exaggeration bred of the effort to repress the infanticide of antiquity: just as many of her dicta upon marriage and chastity reflect simply the struggle against the licentousness of antiquity, 5 all this you believe, and part of it you say. But I think the problem deserves to be stated more squarely more scientifically, more impartially than you state it. The question is, "Has man, - i.e. man and woman, - a right to control the production of children, - yes or no?" - The Catholic Church [st] said squarely no, -except by a savage celibacy, - which as Galton remarked - provided for the survival of the unfittest, - just as the modern application of "restraint" does. The antique would and the modern would say emphatically, yes. The next question, - how can this be done? - andI must claim that here, if you waive sentiment sufficiently to speak of the subject at all, the question of the "How" deserves a much more thorough, careful and exhaustive discussion and investigation than you give it. The pitfalls on both sides must be recognized; the danger of the demoralization of the woman, the example of France and America both show that it is possible to dangerously weaken the desire for maternity which should be the most passionate in the nature of a woman; and that while preserving intact the most loving marriage relations. If this desire were maintained powerful and only balanced by a correlative sense of responsibility: if on the other hand, the liberty of the woman were absolutely respected, and it both could be and was left to her to decide upon the moment for having a child: - if both these things were secured: - and the third, - that a man should not feel at liberty to desert his wife for strange women in order to avoid the difficulty, - then the matter would be relatively simpleBut it does not seem to me fair to pronounce an absolute condemnation upon "methods". [strikethrough: If ] at the beginning of the essay, and then suggest those same methods at the close, but "in moderation and as a last resource." I do not see why you should object to "discussing on paper" - [was this] just what your pamphlet aims to do. It would be rather more difficult to discuss some points viva-voce I read Mrs. Besant's book some years ago. I always disliked her for writing or editing it with the cooperation of a man. In fact the public discussion of the whole subject is disagreeable to me - but I suppose in England it cannot be helped. - The immense danger in England, has been pointed out both by Galtan and Greg, that the Malthusian Principle would be carried out only where it was not wanted, and far beyond what he expected, for Malthus counted on six children to a family, if the man married at thirty five, and the woman at twenty eight. I read Malthus last summer, just before coming to [London?], and found it most interesting, - but apparently not suited to thepresent times. I do not think that woman physicians should be urged to strike out for independent views, until they have demonstrated an equality of achievement in the urgent practical problems, - not of sociology but of medicine. When you shudder at "mutilations," it seems to me you can never have handled a degenerated ovary or a suppurating Fallopian tube, - or you would admit that the mutilation had been effected by disease, - possibly by the ignorance or neglect of a series of physicians, before the surgeon intervened. You always seem so much more impressed with the personalities, - sufficiently faulty, - of doctors, than with the terrific difficulties of the problems they have to face. I am myself often enough disgusted with the shallowness and skimped honour of physicians; - and certainly, in the particular operation you refer to, - there has been much reprehensible malpractice. But I do not see that the malpractice which may render a woman incapable of bearing children, differs in the nature of its guilt, from the malpractice which may result in the loss of a limb or of an eye. There is no such special sanctityabout the ovary! but if a physician, by neglecting a metritis or a gonorrhea, permits a patient to become afflicted with incurable ovarian disease; or if, for the sake of a [shamy?] operation, he deliberately deceives his patient, and performs it where it is not required, or where other measures have not been tried, - then of course he is incompetent and dishonest. - But that there are many cases of local disease, only remediable here, as elsewhere, by entirpation of diseased tissue; that there are other cases of constitutional imperfection, where the menstrual process 7 cannot be sustained without constant suffering - while health is secured when the constitution is relieved of this burden; - of the existence of these two classes of cases, there can I think be no doubt. And why should not women be delighted if they succeed in achieving a difficult and useful triumph in technical medicine? I have now written at too much length. But I should, though you say you will not be glad if you would be willing to discuss some of the details of your pamphlet - In America, where there is so much less "cant" than in England, therequestions are brought up pretty freely in the consulting rooms of the physician; and on that very account are less written about outside. My question about Ms. [Custrin?] was suggested by herself. She said, "I am sure Dr. Elizabeth does not like me." Now she is in fact a remarkably lovely woman, spirited, unselfish, generous and intelligent. I do not know what Dr. Emily would do without her. She absolutely basks in her presence; and seems as if she had been waiting for her for a lifetime Some other time I will tell you the second occasion on which your advice surprised me. - I hope your health is good! - Very sincerely yours M. [Purtam?] Jacobi (to letter of a few days ago.) P. S. Dr. Emily has been telling me that you have some thought of making a visit to America. I do wish that you would do so, and then would come and make me a visit, where I should be most proud and happy to receive you. - We could arrange receptions for you in New York, Boston Philadelphia, and, if you liked Chicago. Perhaps I would go to Chicago with you. Dr. Emily seemed to think that you would wish to make some kind of "crusade" (was her impression) among the women physicians of America,in relation to the other questions of interest in the social purity question, - opposition to vivisection, and to laparotomy operations, after reading your address at the London School, - I feel as if she perhaps exaggerated [strikethough: of] the insistence upon your special views, that you would wish to lay before your friends in America. Of course, as you know, in regard to the "vivisection" question, I should oppose you: but on the other hand, I think you would find on reflection that the practical range of this question was too minute to make it worth dealing with formally. I am tolerably confident2 that I am the only woman in the United States who experiments on animals! Indeed this is a circumstance that always seems to render the relevance of the English "antivivisectionists," surprising and quite out of proportion: in the entire civilized world there is such a mere handful of persons who have any practical share in the matter at all. -- In regard to criticism of the surgical operations that you seem to have such a special dislike to, -- it seems to me again that you would find it hardly pay to attempt to organize an opposition to them, on the part of women who have gained as yet no authorityto be heard on the subject; and who, - should they attempt to formulate a general theoretical statement would be more likely to incur ridicule than secure a hearing. - On the other hand, insistence on the special relations of women to moral questions wherever these really come in, - as of course they do often, and you may say in one sense, always, - in medical practice, - would afford, - especially if illustrated by exact details, a noble opportunity. Again, - the presentation of the field of physiological as well as pathological observation on the human subject, - if illustrated as it might be, - would3 be extremely interesting. I wish you would allow me to collect your illustrations for you. They hope to have the new college building opened next May. This would be a most appropriate occasion for you to meet your old friends, - and make the acquaintance of the new generation, which has grown up since you left Sincerely yours M. Putnam Jacobi (Mary Putnam Jacobi)