Dr. Ian Carr

Professor Emeritus, Faculty of Medicine, University of Manitoba

More than half the people involved in health care are and always have been women. From the beginning of time, wise women gathered herbs, and infused them into vegetable remedies, gave the everyday nursing care that was almost all the help available for the sick until two centuries ago. They bathed the arthritic and manipulated their joints and looked after pregnant women and delivered the babies. Since most of the remedies provided by the physicians were ineffective till about a hundred years ago, it may well be said that most practical medicine was in the hands of women.

Men's names predominate in the history of medicine, partly because the manuscripts which have survived were mainly written by men, partly because for much of the early modern period, women were not admitted to medical schools, and possibly because of male historical bias.

However in classical Egypt for many centuries women had a significant role as physicians, notably in the medical schools at Heliopolis and Sais. "Agamede of the golden hair " in Homer's Iliad was skilled in medicine and herbal lore. Some women in classical Greece were known for their medical skill. Philista (318 -372 BC) lectured so well that pupils flocked to her, and was so attractive that she had to lecture behind a curtain. About the same time, Agnodice was a pupil of the more famous Alexandrian Herophilus. Women physicians were numerous during Roman times, though few of their writings have survived; but there are a significant number of tombstones like that to "Primilla, my sainted goddess , a medical women..." In the same period women physicians were common among the Germanic "barbarians."

During the dark ages, the learned of both genders in Christian monastic institutions kept alive the herbal and diagnostic skills. The best known woman was the mystic Hildegarde of Bingen. (1098-1179) She was the 10th and last child of a noble family, offered to God as a tithe. She had visions , explained to her in Latin by a voice from heaven, and explained by modern writers as migraine. She wrote two medical manuscripts, on plant animal and mineral medicines, and on physiology and the nature of disease. Her remedies were partly herbal, and partly spiritual and/or magical.

A little later in 12th century Salerno, Trotula gained repute as a physician and obstetrician, leaving behind at least one manuscript.

In classical times and in the middle ages, aristocratic women, and even empresses had skill in medicine, and interest in developing hospitals; Eudoxia, Empress and wife of the Emperor Theodosius founded a great hospital in Jerusalem, in the fifth century A.D. The Empress Julia Anicia (472-512) was deeply interested in medicine; her illustrated codex of Dioscorides' herbal has survived.

From the seventh century on, new hospitals opened controlled by the church, and organized by nuns. This was a formal beginning to the clear division of healing duties along a gender line; nurses were usually women until recently.

The guilds of male physicians and surgeons which were forming did not favour women applicants; for instance in 1322, Jacoba Felicie appeared for examination before the all male Paris guild.

It appears that she was allowed to practice, but she was one of few so licensed at the time. The Catholic Church and its Inquisition gave much energy from the fifteenth century, to the persecution of witches, usually female, and often skilled herbalists and healers. The Hammer of Witches published in 1486 was the black bible of this movement which led to the death of many thousands of innocent people. The last witch was burned in Germany in 1775.

Much obstetric care was given by midwives, whose status was systematically down played by their male colleagues, usually but not always wrongly. Women had always been deeply involved in midwifery, but the invention of effective obstetric forceps led in the eighteenth century to a male monopoly of the use of this instrument, despite much protest by midwives.

The medical profession was developing a more formal and rigid set of institutions and a hierarchical structure in 18th century Europe, at a time when men dominated the social and economic position of women. Guilds of physicians were in many though not all times and places largely male, and did not admit women to their apprenticeship. Progressively over the centuries they built up and jealously guarded their exclusive status, which was not based on the effectiveness of their treatment. Such male dominance was emphasized by the male dominated Christian religions. Women could not obtain access to Universities , and partly as a result of this were barred from a medical training.

There were few women in the formal medical profession as opposed to the practice of healing until around 1900; it is therefore not surprising that most of the treatment and investigation in traditional physician dominated medicine until that date was carried out by men, who controlled entry into the profession.

The historical record was written largely by men, and may be somewhat biassed. In the mid-nineteenth century women began to be admitted to recognised medical schools. Elizabeth Blackwell graduated from the Geneva Medical College, New York, in 1849, and shortly afterwards the Women's Medical College of Philadelphia was founded. The new English Medical Register in 1858 contained the name of one woman.

In Canada, the first Canadian woman to practise medicine was Dr. Emily Jennings Stowe. Born in 1831, she was first a school teacher, and qualified in 1867 at the New York Medical College for Women. In 1869, the new Ontario College of Physicians and Surgeons would not register her because she had not attended a course of lectures at a recognised Ontario medical school. The Ontario medical schools would not admit her. The Toronto School of Medicine admitted her and another woman Jennie Trout in the 1870's. Access to medical school remained difficult for women for decades; there were major problems at Queen's University due largely to male students. By 1906 the University of Toronto accepted women. The first woman graduated in medicine at the University of Manitoba in 1894, but until after 1945, there were few women medical graduates, partly due to social factors with the control of the medical school, partly due to bias, both overt and covert, in selection.

In most western societies there is equal access to medical schools; there is not yet equality of opportunity within many branches of medicine. The reasons for this are debatable.