Blackwell Family
Elizabeth Blackwell
Speech: "On the Education of 
Women Physicians"1
3rd Lecture.
On the education of Women Physicians.
We have shewn in our previous lectures, the importance 
1st of Physiological Knowledge, i.e. a practical acquaintance with
the Laws of Heath to all women; 2nd the [importance of] necessity of the possession of medical
knowledge, [to] by a large class of women; and I have pointed out the 
connexion between these two subjects, shewing how it is to this class
of women only, that we [must] can look for a wide diffusion of true physiological
Knowledge.  Let me however, before entering upon the special
subject of consideration today, recapitulate [the] some of the points
which I have already [clearly] proved, that we may proceed, with a
clear comprehension of the broad relations of [our main] this whole subject.  [, The]
[medical Education of Women.]
The true meaning of this medical movement amongst women
in America, is the felt [effort of] necessity [of educating] for the education of women in, Science.
[As we understand it] It is another step to be gained in the developement of 
women, giving steadiness to their instinctive impulses, enlarging their
judgment, giving depth + earnestness to their efforts, and guiding their
kindness of heart, and moral feeling, by the power of reason.
It is not a little dabbling in medicine by women, [that is ?] converting them
into physicians rather inferior to men; It is the full cultivation of the natural
powers of a large number of intelligent women, for the purpose
of occupying positions which men cannot fully occupy, and 
exercising an influence which men cannot wield at all.
It is co-operation with the existing profession which is sought
for; the necessary developement of the medical profession in
[the] relation to Health as well as Disease; and the practical application


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of Science to domestic and social life.  The
common meeting ground of men & women in the profession is the position and duties of the
family physician; and connected with + growing out of this life
are many distinct branches of usefulness.  The chief of these are [Thus]. 1st.. the special physician,
i.e. the reliable medical advisor of women in those [pai] delicate
diseases peculiar to the sex, which the natural order of society, indicates,
should be largely treated by intelligent women.
2ndly the Teacher of health i.e. the leaders in that great movement 
[to wh] which is gradually forming, for the prevention of disease;
and which will require practical adaptation to the various classes
of social life.
3rdly..  The superiors in public Charities, and benevolent efforts of all kinds.
Those who will be the trainers of nurses, the superintendents of asylums,
drawing in good subordinate women, to these institutions, and
elevating the tone of female influence in them.
Now all these three classes of women i.e. The Special Physician, 
The Teacher of Health, The Superior or sister, classes whom I think all will
fully accept, grow directly out of the educated Physician, and that
is why I dwell upon the position  of family physician, as the meeting
ground of men and women in medical science, and the [root] trunk 
from which these good branches will grow.  It is because all
these posts require scientific knowledge, that the physician
becomes necessary, and because they require practical knowledge,
that the family physician, ie the physician of wide & varied
experience becomes indispensable; It is then by the complete education
of women physicians, that these social wants will be supplied.
I showed, in my last lecture, that this education must be
as complete in every respect, as that received by young men,
and I think it will now be evident, in view of these varied duties,3
duties that it must be broader, than the education given to
men, for it must embrace a knowledge of health as well as
of disease.  The term, Woman Physician, then as we understand
it, is a very noble name; and I think that as society learns
to draw the broad distinction between the female practitioners
whom men have hitherto educated, and the order of women,
 whom women themselves will call forth, that our sex will
learn to [glory] rejoice in the fact, and [reverence] respect the name of Woman
Physician!
Having seen then, in our last lecture, from the facts of actual
experience, that women can practise medicine successfully,
and seeing moreover the powerful reasons which exist for
educating a large number of women, thoroughly, in the Profession,
it becomes a subject of great interest, of interest to every woman,
to know in what way, we can best secure such a class 
of practitioners as is needed; and it is to this practical question
that I invite attention To-day.
[We have given much time & thought, to the consideration
of the kind of [instruction] Institution, and methods of instruction
now needed by women; we have carefully studied the Institutions
abroad where women are trained in specialties of medicine, and
have also observed all that has been done in America, & engaged in
The work ourselves, in order to understand the subject fully.]
Let one however before speaking of the true methods of education,
show clearly that women are ready to take advantage of such education,
and let me also call attention to some of the difficulties
that have to be overcome.  [Note a for 3rd]a.
The Policy of Beneficence - is the text for our thought this evening - the
[principles v method] various forms of of active Goodness, the principles which animate
them and the plans by which they seek to accomplish their end.  It is a subject
which specially claims our attention from the activity and extent of the reformatory
spirit in our country.  The freedom of our institutions giving
full play to benevolent impulse, favors that form of its manifestation
which we call reform.  It seems to be the innate tendency of the American
people to right wrongs.  We reform our internal and external relations
our laws, our religions, our life.  We form societies for attacking every
evil under the sun, and when nothing new suggests itself, we reform
our reforms.  Yet reform is an evil; that is to say, it is not consistent
with the highest form of existence.  Reform implies the presence
of evil, [the] in consideration and [combat] destruction.  We are created for the enjoyment
and improvement developement of life; the highest subject of thought is Good, [not]
[Evil] our highest aim, to [be] incarnate Goodness; [harmonious] vigorous growth towards divine
perfection produces pure happiness, and harmonious strength.  This,
reform postpones till its' work be accomplished, life meanwhile
being so sharp and engrossing a struggle, that there is danger of forgetting
the end to be attained, in the antagonisms, and advocacy of partial truths
by which it is to be reached.[Finding then that women can practise medicine
successfully, and that there are powerful reasons for
educating them thoroughly in the profession, it becomes a subject
of great interest to know in what way we can best secure 
such a class of practitioners as [we] is needed.]

[*note a for 3rd*] That large numbers of women will be attracted to
the study, is abundantly proved, both by the numerous
schools for midwives, which have long existed abroad; and
by the hundreds of women who have sought an entrance
into the profession, since the idea has been discussed in this
country. I can speak of both these classes from personal
knowledge. When an élève in the great French school of
midwifery, I studied the class of 60 young women with
much interest. They were a fair representation of the common 
class of uneducated women, for reading & writing
were the only requirements made on entrance, and even
these had to be taught to some of them. Yet there was excellent 
material in this class; the remarkable drill of the
Institution made good midwives out of the majority of them.
Some of them possessed very superior talent. I was much
interested in the examinations of one of these young women,
which took place (for local reasons) at the Ecole de Medecine,
they were very severe, for she was about to take the head of a
school for midwives in Brussels (and examinations in Europe
are much more searching tests than examinations here)
but it was passed through triumphantly, indeed Dubois told
me that he had very rarely found superior capacity amongst
young physicians; and this was by no means an exceptional
case. It is quite certain that in Europe, a class of women
collected in the usual way, presents material that might
very well be trained into the physicians life.

In America this subject still rests under the ban
of public sentiment; and our best educated women, have
not yet as a class, ventured to turn their attention to medicine. 
But even now there is much encouragement to be
drawn from many of the students. These young ladies
possess good natural abilities; are steady earnest and
deeply interested in their pursuits; and were they furnished 
with fair opportunities for acquiring their profession,
they would become highly respectable and safe practitioners. 
Their conscientiousness is remarkable.  The want
of self-assertion or apparent timidity which may be observed 
in them, [proceeds really from] is really an extreme 
conscientiousness; their knowledge [is] being very limited
[and] they are afraid that they may not do the very best thing
for the patient. Their disposition is not to experiment, or
make a personal display, but to cure the sick person;
and when they really [come] obtain a thorough knowledge
of their subject, so that they feel themselves in full possession
of all the facts; this apparent timidity entirely vanishes, and
they can maintain their position immoveably against
any opposition; for the very same reason, that now, knowing 
they are right, they are equally bound to do the very best
thing for the patient. These are valuable characteristics
for reliability in the foundation of a good physician.

It is clear then, that the material out of which to form
physicians, will not be lacking amongst women. [and]
What is needed to bring it forth, are proper opportunities
for study, a high standard of education, and such thorough 
tests of qualification, as shall ensure a proper
preparation for the [work] position. [Dr.] Women are
not afraid of work.  Provide the opportunities, lay down19
the guarantees, and the necessary effort and
preparation on their part, will not be wanting.
The [sad] fact is, that they cannot now find the opportunities which
they eagerly seek for.
Consider the difficulties with which these students
have to contend; the disadvantage indeed at which all women
work, who wish to enter into other than domestic life.
Society regarding in-door occupation as belonging to women, &
out-door occupation to men, does not recognize the endless variety
of life which [requires provisions for] produces exceptions, interlinkings
accidents and innumerable variations in this strict division of
indoor & out-door employment.  [And we make no provision]
We do not realize the fact, that large multitudes of women are
compelled to support themselves by out-door work; we make no
provision for this mass of exceptional life.  It is considered 
a misfortune for a woman to be obliged to support herself,
her life is supposed to be unhappy, if she is not provided
for in the usual way.  Women therefore pursuing an unrecognized
mode of life, find themselves out of harmony with
the customs around them; they are regarded with curiosity
or suspicion, watched, slighted, opposed; they are distrusted 
by women, and in the way of men.  They have to pick
up knowledge as they best can, a scrap here and there
that nobody else wants; they must put up with inferior
instruction, grope their way along without guides, and with
the depressing feeling, that they are never welcome in the
institutions they are compelled to visit.
They have neither encouragement, external stimulus,
nor companionship  The young man has the stimulus of
necessity, of honor to be gained, and a home to provide for; while
the sentiment of society urges the young woman to stay at


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home, and be provided for.  Thus this powerful
thing we call ["] custom, is constantly using its invisible
influence, to turn the two in opposite directions, stimulating
the one, discouraging the other.
But above all, there is no companionship for women
in science or practical life.  The most valuable part
of practical knowledge, is that which is gained by free
continual intercourse with ones peers; it is not acquired
by set instruction at definite times and places; it
comes from seeing how other men act, sharing their thought
watching their success and failure, forming part of an
acknowledged organized system of life.  It is surprising
how much encouragement help and individual growth
spring from the support of this social influence; and the
difficulties of work are immeasurably increased; where this
social support is not only wanting, but in opposition.
In addition to these social difficulties, the very limited
pecuniary resources of young women, constitutes a [very] formidable
obstacle, in their pursuit of a learned profession
Many of these young ladies obtain their education at present, by
teaching one year, and studying the next.  They are often subjected
to great privations in the common necessaries of life; and will
go without proper food for a month, in order to buy a medical
book.  Indeed the conditions under which the majority of them
live on account of their very small means is injurious to health &
of course cripples them fatally in medical study.  The four or five
years close pursuit of study, which is indispensible to the medical
student, is quite beyond their means; and they are constantly compelled
to enter prematurely into practice, from pecuniary inability 
to pursue their studies.
No discouragement should therefore be felt, if the27
success of women in medicine is neither rapid nor 
brilliant; time will be required for sure and steady growth 
in this direction.  a1  Many of the difficulties which women 
now meet with in pursuing the study of medicine, may 
be entirely removed. Such institutions may be [endowed] created 
as will furnish to women opportunities for thorough instruction 
in medicine - centres of information and companionship, 
[as will] affording them encouragement [to them], on their entrance 
upon this life; and where the expences being met chiefly by 
endowment, a long and thorough training may be given to the student.
We have given much thought to the kind of Institution 
& methods of instruction now needed by women;. We have 
carefully studied the institutions abroad where women are trained 
in specialties of medicine; and have also observed all that 
has been done in America & engaged in the work ourselves, in 
order to understand the subject fully.
The great mistake which is now made in American 
attempts to educate women in medicine, is the substitution 
of theoretical for practical [training] instruction; [the making college lectures]
[the basis & principal part of medical education. It is beginning]
[at the wrong end to establish a medical college, before there]
[is any hospital to furnish practical teaching. This method] 
[would be very injurious to the ordinary student, and it is particularly]
[unsuited to women at present, because they are less accustomed]
[to enter into intellectual & scientific pursuits, and]
[are entirely excluded from the usual means of gaining practical]
[knowledge. ' Lectures & books, that is theoretical instruction, must]
[not form the main part of education in a practical subject like]
[medicine; college instruction though invaluable at the proper]
[time should not be]

success of women in medicine is neither rapid not brilliant; time
will be required for sure and steady growth in this direction.
The preparation of women for the noble purposes that we
are considering is not the work of a day, but of a generation.  For It
is not the name we want, but the fact; and social sympathy is needed
as well as abundant pecuniary means.  Many of the difficulties
which women now meet with in pursuing the study of medicine 
may be entirely removed.  Such Institutions may be created, as
will furnish to women opportunities for thorough instruction in
medicine - Institutions which will prove centres of information
and companionship, affording them encouragement on their
entrance upon this life; and where the expences being met chiefly
by endowment, a long and thorough training may be given to the 
student.  But Institutions like these, will not spring fully formed
into life; they must grow from small beginnings, and it becomes
a matter of much importance to discriminate the true nature
of these little commencements; to see that they possess the true aim,
tend in the right direction, and contain as in a germ, the elements
of a full and perfect growth.  If this be not the case, if the right method 
be not adopted, disappointment & discouragement will inevitably
result; much noble effort, on the part of the friends of true progress will
be wasted, and the work will be hindered not helped, by these unwise
attempts.
It is not difficult to judge the truth of any effort, if we understand
what it is, that this effort attempts to accomplish; look at
the results. and enquire if they really are, what they are claimed to be.
We have a right to Dem and truthfulness as the essential basis of action; To insist that
what is done shall be well done.  If an Institution claims to educate
Physicians, let us enquire if they really are physicians whom they send forth,
individuals trained in medical science, capable of applying that
science in times of sickness; [reliable] trustworthy medical advisorswho will grow in time to occupy the positions now filled by 
the honored physicians of a preceding generation. We must 
make all due allowances for the youth, or smallness of such commencements;  
but in justice to society, and in real kindness to those who 
enter such institutions, we must insist upon their being rightly 
founded,. If a mistake has been made in the method pursued 
let that method be changed. If the attempt has been premature, and 
the means for educating the physician do not yet exist, let us wait 
until the Diploma of Doctor in Medicine can be justly given, and 
not degrade the honorable testimonial, by making it [a pretense, &]
a falsehood] of no value.
I do not think it a kindness to hide the truth in a public
matter where all are called on to cooperate, and where the true 
end is so valuable a one, as I think we shall all now acknowledge 
it to be. And I trust my criticism will not seem harsh, when it is felt 
how deeply I have the good of women at heart in this matter; and when 
I [am prepared to show] can point out, why the discouragement now felt at the results 
of these attempts to train women, was inevitable, with the wrong methods 
that have pursued; and when I am prepared to show in what way the right method may be 
substituted for the wrong.
The great [mistake] error which is now made in American 
attempts to educate women in medicine, is the [substitution] complete absence 
of [theoretical for] practical instruction; It is beginning at
the wrong end, to establish a medical college, before there is any hospital 
to furnish practical teaching. College lectures though invaluable 
at the right time, should not form the basis and principal part of 
education, in a practical subject like medicine. This method 
would be injurious to the ordinary student, and is particularly 
unsuited to [the] women at present, because they are less accustomed 

to enter into intellectual and scientific pursuits, and are
entirely excluded from the usual means of gaining practical 
knowledge. Attendance on two winter courses of lectures, 
is a most inadequate preparation for the assumption of the 
physician's duties; yet this is the only provision now made
for female students. Of course it is no matter of surprise that 
they leave college (with a diploma it is true) but quite unfitted
for practice. The foundation of medical education, must
be laid by the bed-side, in actual care of the sick; the senses must 
be cultivated by use, observation, judgment, presence of mind, 
and all those intellectual qualities which are indispensable
to the physician, must be called out by actual exercise.
This necessity for practical training is recognized 
abroad, where the schools for women are always engrafted
on some hospital.
Let me illustrate more fully [the deficiencies of our the] what it 
is that we need, by [showing] by referring to european experience, 
in related efforts. I have already shown the difference between 
the midwife and physician, proving the broader culture,
the higher responsibilities of the latter. Now let us [compare] consider the 
preparation which is considered indispensable in Europe, to 
educate the simple midwife, and [compare it] [learn from it, how to judge
with the present attempts to educate the physician] we shall then 
be better able to judge, what the education of the physician 
necessitates.It is beginning at the wrong end, to establish a medical
college, before there is any hospital to furnish practical teaching
College lectures, though invaluable at the right time, should not
form the basis and principal part of education in a
practical subject like medicine.  This method would
be injurious to the ordinary student, and is particularly
unsuited to women at present, because they are less accustomed
to enter into intellectual & scientific pursuits,
and are entirely excluded from the usual means of gaining
practical knowledge.  The following of two winter courses
of lectures, is a most inadequate preparation, for the assumption
of the physician's duties - yet this is the only provision now
made for female students[, and].  Of Course it is no matter of  surprise 
that they leave college, (with a diploma, it is true) but quite unfitted for
practice.  The foundation of medical [knowledge] education must be laid
by the bed-side, in actual care of the sick; the senses must be
cultivated by use; observation, judgment, presence of mind, and
all those intellectual qualities which are indispensible to the
physician must be called out by actual exercise.  This necessity
for practical training is recognized abroad, where the
schools for women are always engrafted on some hospital.
The Maternity of Paris to which I have already referred, presents
the most remarkable system of drill in education that I have
ever seen, and it's admirable results are obtained by the combination
of theoretical with practical instruction; there being a large
number of patients, skilful teachers, and a system of organization
by which every hour in the 24 has it's special occupation.
What is urgently needed then at present, for the aid of women 
in their entrance upon this honorable but difficult career
is an Institution for practical training in medicine, which
[shall combine within itself, the practice of a hospital the in]

23
[shall combine within itself, the practice of a hospital]
[the instruction of a college, and the class drill of repetiteurs]
[or [teachers] tutors.  a]
There are several distinct objects to be accomplished
by such a [Womans Hospital] centre of medicine for women, as is now needed; and while
dwelling upon it's importance in the education of the physician
I must point our it's hygienic use.
There are four important ends that may be accomplished
by a Woman's Hospital; they are the following;
1st The welfare of the patients.  2nd The training of nurses;
3rd Popular instruction in health; 4th The education of
physicians.
As the foundation of such a [hosp] centre, a  hospital
of at least 100 beds is necessary, for a smaller number
will not embrace a sufficient variety of disease for the students
instruction, nor sufficiently varied occupation for the
nurse.
The first object of a hospital should undoubtedly be
the good of it's patients; but in order to secure this, not only
[should] is skilful medical aid [be] necessary, but the hygienic
conditions of the hospital should be specially provided for.
Ventilation, light, heat, &e with the effects of moral conditions
on physical states are subjects of so much importance,
as to require distinct provision for their security.
I am indeb[e]tted to [?] Nightingale for the suggestion,
that a Sanitary professor should be appointed, having the
chief direction and training of the nurses, and the oversight
of the wards in all [health] arrangements involving health.
This professor would deliver popular lectures on the
subject of health; and fill the chair of Hygiene in the
College.  Indeed the more we reflect on the dutiesof this chair, the more important it will appear.
It seems strange that the prevention of disease
has not occupied the attention of physicians fully as
much as its cure.  Yet we find the most intelligent
graduates in medicine, who can treat a case of typhus
fever according to the best medical methods, quite
unable to calculate whether a sufficient number of cubic
feet of air is allowed the patient, [and] or to suggest the best
methods of ventilating his room.
The same valued friend said to me lately as the result
of her wide experience "nine-tenths of the sickness
amongst us are owing to preventible causes." If this
be so, and many experienced physicians confirm the
statement, is it not plainly our duty to stop all this
preventible sickness - sickness which should never
exist, which it is not the physicians business to cure,
but the business of each human being to prevent!
And instead of inventing new sects in medicine, and waging
fierce war as partisans of Allopathy Homoeopathy,
Hydropathy, or Mesmerism; would it not be better to endow
Sanitary Professorships, educate a class of Health
missionaries, circulate tracts on our physical needs.  In
short, in every possible way, create a demand for knowledge
on the Laws of Health, and make it as profitable
a thing, to devote time and thought to the prevention of
illness, as to it's cure.
For the best good of the patients then, and for
the delivery of popular lectures to women generally on subjects
of physiology and hygiene, an endowed Sanitary
Professorship should be attached to the [Women's] such a [Infirmary] Hospital
These popular lectures could be rendered much more
practical, when thus connected with a hospital. 
The nurses trained in the Institution may be both 
professional & non-professional; for it has already been 
tested abroad, that young ladies who wish to qualify themselves 
for visiting amongst the poor, or desire to gain 
presence of mind and skill in nursing, may very profitably 
be received into hospital training.
It is quite possible to secure these more general objects 
in connexion with a Woman's Hospital._ For the education of the woman physician, the hospital is indispensable.
A few moments reflection will enable all to see why I dwell so earnestly on the 
fact, that practical, i.e. hospital instruction must be the basis, and constant 
accompaniment. of all medical instruction,  You may speak to a blind man 
of colour, and he will never comprehend it.  So in the description of physical 
phenomena which forms the foundation of medicine, the lectures may discourse 
most eloquently, but the hearers will receive a [most] vague and 
imperfect impression; if they are not in constant communication, with the
symptoms and morbid states referred to; it is only by this familiarity with the '
things spoken of, that, they can retain the descriptions, and intelligently grasp 
the course and relations of disease.  There is a special cultivation of all the 
senses, necessary in medicine.  -The eye must be taught to see correctly, that 
is, to see all that is to be seen, and nothing more; to know the sight of healthy organs 
and tissues, with their natural healthy differences, and their various degrees 
of morbid condition. The ear has to be aroused from it's confused perceptions 
to a discrimination, of delicate shades of sound. The touch is a most important 
sense, but it has to be educated from entire obtuseness, into intelligent perception. 
The smell & even taste have their medical uses to learn. 
It is also, only by an extensive observation of disease, by the comparison of similar
morbid states in a great many individuals, that the physician is enabled 
to understand {the} each new cases as it arises in his practice; and the action of remedies 
must in the same way, be actually watched, under varying conditions. It is the 
want of this wide observation, and comparison of cases, which renders popular
judgment so fallacious in medical matters, and permits a delusion toexercise a wide sway before it dies out. If a [neighbor] woman gets well while taking some 
particular remedy, [we are] she is very apt to jump to the conclusion that the medicine 
cured her, and magnify the cure to her intimate friends; and if one of the friends 
also grows well under the influence of the same treatment, it is enough to convert 
a whole neighborhood.
But this is not sufficient for medical judgment; there are so many grounds 
of fallacy in individual cases; so much that is coincidence not consequence, 
in these cures, that until many cases have been observed, their points of resemblance,
and difference noted, and the method of operation, if possible understood, 
no reliable scientific opinion can be formed. Constant study by the bedside
therefore, is the only way by which the senses can be cultivated, and the judgment enlightened; 
and for these various reasons it is, that the hospital is indispensable for the 
education of the woman physician. [To this hospital le}
[-sible]: Lecture-ships' on the various branches of medicine
should be attached to the hospital, the Sanitary Professorship 
always forming one. A laboratory, anatomical 
rooms, museum, and other college appliances being 
added. A system of division into small classes, may 
also be adopted with great advantage, for the purpose of
special drill in the subjects of study.I have thus my friends laid before you, the principles of our work, and
 the way in which we are trying to carry it out in practice. I have had great pleasure 
in speaking to an audience of women on this subject, for it is their sympathy and 
interest I want particularly to enlist, in what is emphatically a woman's work. 
I now earnestly ask all women who recognize this effort as a true thing, not to 
suffer their interest to die out with the feeling of the moment, but to co-operate 
in the work, and feel themselves responsible for its ultimate success. 
The hospital for Women and Children, which we have commenced is only 
in its early infancy; it is not yet large enough to organize classes for physicians 
or for nurses - this you will understand after the exposition which I have given 
of the true methods of education; but it is only through the enlargement of such 
a centre that we shall gain the conditions for educating physicians & training nurses, and 
we must bend our efforts to aiding the growth of such an Institution, as the only 
possible means of accomplishing our end.  Our Infirmary already presents 
the most legitimate grounds for support, as a valuable charity for poor women.  As 
I have stated we have had about 4000 during the past year, who have most gladly 
placed themselves under our medical care; [and tho] we can only receive 12 into the 
house at a time, but the[se] beds are constantly filled by a succession of patients and we 
could fill any number [of beds], if we were able to support them.  From the 
the young ladies also, who have resided in the Institution to see the practice of the house, 
and from the nurses who have served in the wards, we receive the same encouraging 
assurance, that we can already furnish them with better practical facilities 
[for] than they have ever got been able to find.  We have therefore good grounds for askingyou to help us in the support of the Infirmary; and to assist in it's growth, so 
that we may be able to organize classes in connexion with it. The distinct 
object which we propose to friends this winter, is the purchase of a suitable house 
which [would] will require the sum of $30,000 _(that [being] is the price of the peice of property which 
the Infirmary now occupies). Our rent, (which this year will be $16,00) has been hitherto 
paid chiefly by friends, who had pledged themselves for a certain sum during three 
years _ these pledges have now expired, and it is very important that the Institution 
should now own it's own home. While it is compelled to rent, we have not only the 
labor & anxiety of collecting the rent, but we cannot take the house on a lease, or 
make the improvements, necessary for a special institution. We have made 
it a principle not to go into debt, to regulate [our] the year's expences by the sum in 
hand at the beginning of the year, and this necessity makes it impossible to secure 
a permanent home, while the Institution is compelled to rent, for we can 
never tell whether we shall have the funds to pay the rent. Indeed it has now 
become indispensable to the existence of the Infirmary, that it should own its own 
home; and therefore I ask all to help in laying this foundation stone _ the purchase 
of a house. We do not necessarily ask for money; [because] I know that women in general 
have not the control of money, but We ask for interest, and help in whatever way 
individual position will allow. Those who have facility in writing may lend 
the aid of their pens; [those] others [who have the gift of persuasion speech], may interest influential friends to obtain subscriptions & donations, 
and those who have skilful fingers, can prepare articles for the fair. There [will be] is 
distinct work for each class of talent [in promoting aiding the}, and we cordially invite 
co-operation in either of these ways. [From 1/2 past 12 to 1/2 past 1 we shall be at the}[Infirmary, No 64 Bleecker St, every day; and shall always be glad to see friends]
[who are interested in the Institution, and can in any way help it.]
[You will see on looking at the Report of the Infirmary that we have a lar number of influential]
[names on].  We very much need the [active] aid of energetic [active] intelligent women 
who will share the responsibility of this work with us. If the present meeting, will only resolve 
that this work shall succeed, and will [set to work] resolutely lend their aid, [our] it success is 
certain. If each individual present, will take a subscription book, and make it her business 
this winter to collect for [our] the building fund, I feel sure that the $30,000 needed, will be raised.3
very interesting, in elucidation of this subject, to glance at the corresponding 
[structure] natures of our humbler fellow creatures, and see how the [[?]] rudimentary 
[structures functions] structures of the lower classes of animals, adapted to their 
simple wants, have been developed in man to that rich organization which 
admits of unlimited [growth] use. No one could fail to take a deep interest, in the 
developement of the brain, for instance; traced from the scattered white points 
distributed through the bodies of the lowest living things, through the first 
appearance of a single brain, somewhat higher, then it's growth to a number 
of parts, forming that whole, and finally to the remarkable structure of the 
human being. A keen sense of responsibility is then awakened, for where 
much is given, much will be required!
[Having required] From a knowledge of the nature of the human 
body, acquired, by a view of its structure and functions ; the laws 
which govern it, naturally come under consideration.
The laws of growth, maturity, and decay, each age having its own special method of existence. The law of growth 
by exercise.__ The balance of power to be maintained amongst the various 
parts. Lest one grow at the expense of another. The alternations of action 
and rest required. The varied life of the different functions, giving to each its individuality 
and special rule. The [peculiarities] law of temperament, and 
modification from individual peculiarities. The hereditary transmission 
of qualities. The [laws] varieties of race and sex. Such are the subjects of [case] study
which present themselves, when, passing from the nature of the 
human body as seen in it's structure and functions, we consider it in the 
light of use, and proceed from individual to social use.  As an illustration 
let us consider for a moment one or two of these laws. We will take
[?] should exist in the human
socialSuch an Institution as I now suggest is nowhere to be found in Europe or America. Certain parts are worked out abroad, but the grand idea involved in it is too much in advance of the prejudices of European society, to make it suitable for present realization in the Old World. It is an old idea, but in so new a form, that America seems appropriately its birth-place. 

[But] I think it will interest you to know how the idea of woman's entrance into medicine with full & honorable recognition, was received in England; and I am sure you will excuse the personal allusions I am compelled to make, as they bear upon the general work.

I spent this last year in Europe, going there on private business, and having no intention of appearing as 


the public advocate of our cause; but being called on, as I have already stated to give some account of what we are doing here, I gladly did so. Although the visitation sent me to lecture was signed by a large number of influential names, I found that many of these ladies, and indeed the large bulk of my audience, felt no sympathy with the idea as they understood it. I was however much gratified to find that when the broad principles of this matter were laid before them, when they recognized first of all the necessity of substantial knowledge in all matters of health to the proper fulfilment of maternal and social duties; and in the second place when they found that the medical effort was no attempt to receive midwives, but to educate intelligent women thoroughly in medicine, their prejudice entirely gave way, and our work gained a large body of earnest supporters from amongst the best women of England.

I lectured to women in several large cities, and always with the same result; they [women] gave their hearty support; from the Duchess to the servant girl, I found this ready appreciation of the thought; the recognized want, and approval of the methods by which we endeavoured to meet it.

My reception by the profession was most encouraging. Ten years ago, I was a student of Lt.  Bartholomews, so that I did not come as a stranger to them; and I found that time and reflection had only increased the number of our friends. I conversed with many of the wisest men in the profession, names that you will probably recognize, Mayo, Brodie, Clark, Rigby, Paget, Hawkins, Babbington, Gibson, Southwood Smith, Forbes, and many others, who cordially endorsedthe idea, and urged me to remain in England, and carry on the work there. My application for registration under the new medical act, as physician qualified to practise in England, was at once received and my name regularly enrolled amongst English physicians.

During this visit many inducements were held out to myself and sister to settle in England, and I think it right to mention certain facts, which show the substantial nature of the interest taken in this work. One lady offered to endow a Sanitary-Professorship with $25,000, and establish a Sanitarium near London, if we would take the direction and was very desirous of at once placing the sum in the hands of Trustees. Another wished to endow a similar Professorship in connexion with an existing hospital in London, leaving us at liberty to form our own clientele. By another we were urged to accept a large sum of money unconditionally for the purposes of simply establishing ourselves in London as physicians. [Now offers so earnest and liberal as these, are not to be lightly rejected. The foundation of the first Sanitary Professorship, by a woman, for the benefit of all women, is a noble idea, and we should rejoice to develope this thought into a grand practical fact.]

But we feel a deep interest in our American work. We have originated this medical movement here, and feel responsible for its success. Until there is a centre established in America, which will furnish to women a real substantial [edu] medical education, until we have trained good physicians to carry on the work, we shall not feel that we have done her duty here. [Why should]

I know that the sum required for the complete establishment of a hospital college such as women now need is large. Fully $300,000 would be necessary to organize on a proper footing all the departments; the nursing, sanitary [?] collegiate departments. But we need not feel discouraged at this [?] is of the wider importance which I have shown.28
It was [a] the commencement of such a centre,
 that we organized our New York Infirmary for women 
and children, seven years ago. And I now call attention 
[because] to this Institution, because we have proved its value;
and I believe that were it's object generally know, it would 
enlist the hearty sympathy of all who take an interest in this work.
It was the perception that women could nowhere obtain 
practical training in medicine, [and the experience that they must]
[form their own hospital before existing hospitals would open to
them], that induced us to make this commencement. It 
was begun necessarily in the humblest way, in a little room 
in a destitute part of the city, where one woman physician 
prescribed for three or four patients weekly. In the course of 
seven years it has grown, so as to rent a large & airy house, 
receiving into it's beds about 130 patients annually, and prescribing
for between 3000 & 4000 out-door patients. It's rapidly increasing popularity 
amongst the poor is remarkable.
The whole of the medical and surgical work is performed 
by women physicians; and I believe it to be essential to the success 
of such an institution that it should be moulded by women. [*Note a*]
[+] They must for a time keep the practice in their own hands, feel 
the full responsibility of the position, find out just what their
students need, and take care that in all the arrangements of the
Institution, the benefit of women physicians and students, shall 
be especially considered. I do not think such a centre as we 
need, can be formed, where the woman element is not a preponderating 
force, working, shaping, and calling in to itself just 
that amount of ordinary medical aid, that will be of service. 
Men & women will work together in medicine to mutual 
advantage, but it will be through [the formation by] women 
forming {of} their own centre, and inviting co-operation, not by [pushing] striving

[themselves], a weak minority, to enter [into] institutions
where they are not [eanted] welcomed. [A]
It is with firm faith, that "God helps those who
help themselves," that we have in spite of innumerable difficulties,
created this little nucleus of practical work.  It's location in
New York, will ensure it's medical success, for there is no
city in the Union, that can compare with New York in material
for medical study, owing to the immense amount of
immigration, which fills all public charities to overflowing;
but it cannot be regarded as a local Institution, for the
growth of women in medicine is a national concern; and
the support of all men & women, may well be given, to a
new principle, thus struggling into existence.  [The names]
[of many of our [managers] masters are well known in New Bedford]
[and those who render help, may be assured that their help]
[will be wisely used.]  This is not an ordinary charity,
in which the work is left to hirelings; but the embodiment
of a principle in which we are profoundly interested, for which
we freely give our time and thought, and in which every
detail is carefully considered.
The economy with which our Infirmary is managed
will be seen from the annual reports.  We made it our
principle on commencing, never to go into debt, and to
regulate the year's expences, by the sum we held in hand, at
the commencement; but it is very difficult to do this, when
it's popularity is rapidly increasing amongst the poor. We
are obliged to exercise the most painful economy, and 
ask our students to share with us, an amount of personal
privations, which can only be supported for the sake of a
great end.  Our rent alone is $1300 annually, and the
positive necessities of our poor, will compel us thisyear, to make it $1600. This sum and all the expences 
of maintaining the hospital, we have to collect 
with great difficulty, and these expences are a constant
 subject of anxiety to us, in addition to the weighty responsibilities 
of the Institution itself. * The burden is too
 great, and we earnestly ask whose who feel the value of
 this work, to help us bear this great burden and secure a permanent home for the 
Infirmary. We need about $30,000 for this purpose.
 With this sum we can secure a [couple of house] couple of [moderate] good houses,
 capable of holding about 20 beds, enabling us to
 receive about 300 patients annually; with rooms for 
our [large] outdoor clinique, which now number several 
thousand. It will also enable us to accommodate
 a little group of resident students, who will gradually
 act as assistant physicians; and also some pupil
 nurses in addition to the regular staff. It will allow
 us in short to continue and improve our present commencement, 
by relieving us from those anxieties in relation 
to our annual expenditures, which the present 
insecurity of our Infirmary involves.

Any sums collected labour this first foundation-
stone of a permanent home, will form a fund for endowment.
 It has become clear to us that such an Institution 
as this [must be endowed] with the professorships that should 
be attached to it, must be endowed, on account of the very 
limited pecuniary resources of our students, to which I have
 already referred. The [board] Infirmary has reduced the expences 
of its students to the smallest possible sum, determined
 to facilitate to the utmost their acquisition of practical medicine. 
Yet coming to us, as they do, after spending a couple
 of years in study elsewhere, they are unable to stay more than

a few [six] months, for their little means are generally exhausted
by that time. We parted lately with a very promising
pupil who would most gladly have remained with us
a couple of years but, but want to means, compelled her to enter
into practice instead. We [have lately] formed this year a valuable
class for them in connection with the Infirmary, [wh] under true
physicians who are all engaged in some of the best N.Y. Medical 
Charities; they thus obtained a large amount of practical opportunity, together
with a good theoretical drill. We [have] had seven students in
this class, and they [find] found the opportunity invaluable, indeed their 
improvement during [the past] those few months [is] was most gratifying; but it
puts them to an expence of about $40 per month, and this they [can] could
not continue to meet: and we [fear we shall] are thus [be] compelled to close this little
class.
The lectureship, therefore that we hope to attach to the
Infirmary, must be endowed, that we may be enabled to furnish
instruction to our students at very small cost. It is only in the
way, i.e. by the assistance of permanent endowments, that young women will be
able to give the necessary time to their medical education, and
that we shall be able to insist upon such a standard of education,
as is really due to society. One  [*enlarge here on the whole education*] year of careful preparatory 
study, followed by three or four years of thorough medical
training, is absolutely needed by young women_ [What they 
now receive_two winters attendance on lectures! is lamentably
inadequate for their preparation!]
An endowment therefore would be needed of at least
$10,000 for each lectureship, in order to organize the college
department of a woman's hospital, on anything like a secure
or suitable basis. [This short English visit]
[(visit I made to England.]  I feel sure [therefore] that 
in America, where Lyell tells us a much larger proportionate sum
is given annually to benevolence, than in England, the means 
will not be wanting to carry on such a true work as this. 
Why should not the first Sanitary Professorship
 be established here, and endowed by an American woman! 
Why should not the noble scheme for training nurses which 
Florence Nightingale has planned, and which we have discussed 
together in many an earnest conference, be carried 
out here, in ' connexion with a Woman's Infirmary? 
Let the women of America & England engage in a noble 
rivalry of good works! As America has taken the initiative 
in this medical reform, let here carry it out substantially, 
in institutions that shall do the work effectually. 
I said to English friends, before I left, "you must send us 
over students, and we will educate them in America, to do this 
work in England." The cordial reply was, "we will send 
them, if you do not return yourself".
Now therefore, America, must help us redeem 
the pledge of education, which we have given in her behalf.
Let us build up a noble institution for women, a national 
Hospital and College, in which all parts of the Union shall join. 
Let it not be a pretense or a name merely, but a substantial fact, wisely
planned, and [generously supported] liberally endowed. [Will not] Surely this awakening 
desire of women to do their duty in this world more earnestly, 
and to overcome by patient effort the great difficulties that stand 
in their way, will enlist the sympathy and support of every generous 
man [& woman]; And we shall thus be able to create a noble centre of
instruction for women, which shall be, not only a glory to the 
New World, but a blessing to the Old World, too!