Medical Women and Female Patients in the 1890s
by Dr Claire Brock
Two Bloomsbury hospitals – one on Gray’s Inn Road, the other on the Euston Road – were key locations in which to find nineteenth-century medical women. The former, the Royal Free Hospital (RFH) was, from 1877, the only institution where female students from the nearby London School of Medicine for Women (LSMW), could carry out their clinical training. While the latter, established in 1872 by Elizabeth Garrett Anderson, was staffed uniquely by medical women. Both were general hospitals and charitable foundations, but the New Hospital for Women (NHW) admitted women and children only (boys up to the age of seven).
To inquirers, the New stressed its focus on a class of women ‘somewhat above the rank of ordinary hospital patients, who all contribute something towards the cost of their maintenance’.[1] Its expansion in 1890 saw the additional establishment of three beds for those who could pay three guineas weekly. Patients required a subscriber’s letter for admission, unlike the Royal Free, which opened its doors to the poor and needy without financial or philanthropic support. There was, however, evidence of considerable cross-over in the patient base, as surviving RFH case notes make clear. One contemporary argument claimed that vulnerable working-class patients were experimented upon by ruthless and self-serving practitioners, especially if they underwent abdominal surgery.[2] However, as the free movement of patients across these two Bloomsbury institutions indicated, often patients chose where to seek medical advice and frequently sought a variety of options, ranging from self-diagnosis and treatment to private doctors and, for a cheaper solution, chemists. A combination of all sources was not unusual.
In the 1890s, female patients would have encountered medical students of their own sex at the RFH who acted as clinical clerks or surgical dressers, assisting and learning from the male hospital staff. During this decade, they may have come across a number of young would-be medical women who would become famous as their careers progressed. Later founder of the South London Hospital for Women and Children, Maud Chadburn, was a dresser in the very early 1890s. Prize-winning students of the late 1890s, Louisa Garrett Anderson, following in her mother’s footsteps, and Frances Ivens would become celebrated for their surgical work at home and abroad during the Great War. Florence Willey (later Lady Barrett), gynaecological surgeon, obstetrician and female health and welfare campaigner was assisting on the wards by early 1900. Also at this point can be glimpsed Sophia Frances Hickman, whose mysterious disappearance from the RFH, in August 1903, sparked a press campaign to discover her whereabouts. Sadly, when she was discovered dead in Richmond Park, it also instigated a backlash against the pressures put upon women who chose such a challenging and ‘unfeminine’ profession. In the mid-1890s, however, further changes were afoot to consolidate women’s position in the hospital. The future surgeon and later Dean of the LSMW, Louisa Aldrich-Blake, could be seen giving anaesthetics during operations at the RFH while she also acted, at other times, as physician to out-patients at the NHW. She was the first to gain a Master of Surgery degree – the highest surgical qualification – at the University of London that same year.
At the New, women worked at all levels of the staff. Elizabeth Garrett Anderson left her position as Visiting Physician and Surgeon in 1892, and Mary Scharlieb, who had been educated in India and at the LSMW, became Surgeon to In-Patients, Julia Cock, another future Dean of the LSMW, Physician to In-Patients. Frances Berry, the wife of famed cleft palate and thyroid surgeon, James Berry, and later highly-skilled anaesthetist for the RFH, joined the assistant physicians in 1894. At the end of the decade, the ever-increasing number of operations meant that a new theatre and anaesthetic room had been built, a pathological laboratory opened, and the out-patients’ department enlarged. By 1899, a new out-patient department for children was added to the hospital. There were over 3,000 attendances in the Ophthalmic Department alone that year, over 33,0000 in out-patients, and 114 major operations, ranging from kidney procedures and those for malignant disease to hysterectomies and gastro-enterostomies. With increasing numbers and further demands for ever more complex medical and surgical conditions, the staff increased, allowing newly-qualified medical women the much-wanted clinical practice they struggled to obtain elsewhere.
While patient records have not survived for the New, those for the RFH, a much larger, more established institution, are plentiful and give a fascinating insight into the hazards of late nineteenth-century life and society. Female patients, of every age, from all over London, came to seek advice and treatment across the hospital’s departments. There were a number of patients who originated from the Bloomsbury vicinity itself. Indeed, several lived right on the hospital’s doorstep. Local children were often rushed in, after accidents, to the Gate, the RFH’s Casualty Department, and ended up as in-patients. One was three-year-old Agnes Connor, who lived in Gray’s Inn Road. On 23 February 1891, she was sitting near the hearth, playing with a stick and some paper, when she lit the former accidentally, and caught her face, resulting in second-degree burns. Agnes was brought at once to the hospital and dressed with eucalyptus ointment and her blisters were pricked; her surgical dresser was Maud Chadburn. She was sent home, but was admitted later that same evening; her mother was worried about further facial swellings. Poor Agnes was unable to open her eyes and was very quiet. Mrs Connor described how her fairly strong daughter had worn a truss after a hernia at birth, but also that she herself suffered from a bad cough, having once brought up a teacupful of blood. By 2 March, after ongoing treatment of her burns, Agnes could finally open both her eyes. She left the hospital six days later; the propinquity of her address undoubtedly making it easier for her to come to the Royal Free to be dressed, as instructed, every day.
Agnes’ case indicated the dangers of the domestic environment for working-class children, but twenty-nine-year-old housewife, Margaret Kenealy, who came to the hospital from Barnsbury, revealed another problem encountered in the home for married women. Mrs Kenealy told a sorry tale of physical abuse and suffering. After a drinking bout, her husband returned home at 2am on 15 December 1891, and set about attacking his wife, knocking her down and kicking her head repeatedly. She lost consciousness and was found in the passage by the landlord, covered in blood. Around six hours after the incident, Mrs Kenealy regained consciousness and could not open her eyes. Although a doctor was called, the injuries were severe enough for Mrs Kenealy to be sent to hospital. She was so unwell that she could only leave at 4pm that afternoon; interestingly, she took a cab to the RFH, from which she walked with difficulty, covered in blood. The mother of three living children, she described herself as strong, although she came from a family where one sister had died of influenza and heart disease, and a suicidal brother was incarcerated in an asylum. She had been married for eleven years, and was ill-treated from the start; she had miscarried five times from her husband’s abusive behaviour, and was currently six months pregnant. With such a background, it cannot have been a wonder to the staff when she admitted that she was sometimes intemperate. Like Agnes Connor, but for a very different reason, Margaret Kenealy could not open her eyes due to the swelling sustained from repeated kicking, but she had additional injuries to her elbow and a cut on her right middle finger, which had been made a few days before by her husband’s teeth. The swelling of her face took a week to go down, after being treated with boracic fomentations, calomel, and lead lotion, and she spent probably one of the more peaceful Christmases she had experienced in the past decade at the hospital. Her story ended abruptly on 22 December, even though she was not discharged for another five days. She disappeared, like so many patients, back into the London streets, and presumably back to the terrors of her domestic environment.
Case notes allow us into the homes and lives of the Victorians, but they also give us a greater sense of how women patients encountered women medical practitioners, whether they were students or surgeons. The RFH and the NHW were inextricably bound in this sense. A further connection would be cemented between the hospitals as the twentieth century dawned, when Louisa Garrett Anderson became, in 1901, the first women to hold a post as House Surgeon, newly opened to women at the Royal Free. A year later, Mary Scharlieb would leave the NHW and take charge of the gynaecological department at the RFH, the first woman to achieve such a senior position, alongside Ethel Vaughan (later Vaughan-Sawyer) as her junior. Female patients could be seen by women practitioners across Bloomsbury, from the Euston Road to Gray’s Inn Road, and they flocked, in their thousands, each year, to take up and benefit from this novel privilege. While it was not always the smoothest relationship, the possibilities for women to be treated exclusively by their own sex were finally being realised.
[1] Letter to Miss Bear, Hon. Sec. National Vigilance Society, 29 November 1889, in Hospital Secretary Letters Book, H13/EGA/229, London Metropolitan Archives.
[2] For example, see Aesculapius Scalpel (Edward Berdoe), Dying Scientifically (London: Swan Sonnenschein, 1888).
Primary Sources
Annual Reports of the New Hospital for Women, 1890-1902, London Metropolitan Archives.
London (Royal Free Hospital) School of Medicine for Women Magazine, 1895-1902, London Metropolitan Archives.
Mr Berry’s Patient Case Notes, Women: 1890-1891, Royal Free Hospital, H71/RF/B/02/05/001, London Metropolitan Archives.
See also:
Claire Brock, British Women Surgeons and Their Patients, 1860-1918 (Cambridge: Cambridge University Press, 2017).
Claire Brock, ‘The Disappearance of Sophia Frances Hickman, M.D.’, History Workshop Journal, 80.1 (Autumn 2015), 161-182.
Dr Claire Brock is an historian of surgery, and completed a Wellcome-Trust funded project between 2012 and 2014 on women surgeons in the late nineteenth and early twentieth century. This was published in 2017 as British Women Surgeons and Their Patients, 1860-1918 (Cambridge: Cambridge University Press, 2017; open access here: https://www.cambridge.org/core/services/aop-cambridge-core/content/view/19ED55AFB1F1D73AF0B101C74ECF9E87/9781107186934AR.pdf/British_Women_Surgeons_and_their_Patients__1860_1918.pdf?event-type=FTLA).
Recent work includes articles on the history of cleft palate surgery, and on the child surgical patient in the early twentieth century. She is currently researching a book entitled The Experience of the Surgical Patient in the Age of Specialism, 1880-1930.