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Women Healers Part Ii

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Ann Arbor, Michigan, was seventy years oíd before the first medical school, as we now know thëm, opened in this country. That was 1893. For 1 17 years, the United States had just done without medical schools. But there wére hts of doctors. One major cultural ramification of the American Revolution was a generally deepseated hostility toward professionalism and "foreign" elitism of any kind. Few European-trained professional doctors ever carne to this country. But in the open, experimental climate of post-Revolutionary America, medical practice was traditionally open to anyone who could demónstrate healing skills - regardless of formal training, race or sex. Ann Hutchinson. the New England religious dissenter, practiced the "general Physik" in the 1 600's. A freed black slave, "Dr. Primus," was one of the most respected medical men in Windsor, Connecticutt in the late 1 700's. In New Jersey, until .1818, medical practice was totally in the hands of women. Women were frequently in joint practice with their husbands: the husband handiing the surgery, the wife doing the midwifery and gynecology, and all else shared. THE AMA: ENFORC1NG THE "TRUE " AMERICAN MEDICAL PROFESSION So, then, how did the medical profession beeome totally dominated by white, upper middle class men in the reiatively short span of 1 75 years? If you ask the AMA, the answer will go something like this: there was always one true American medical profession, a scientific band of dedicated physicians whose authority flowed in an unbroken stream from Hippocrates. In frontier America these heroie, stalwart prufessionals fought not only all manner of disease, but the scandalous abuses heaped upon an innocent, unsuspecting public by a swarm of lay practitioners, usually depicted as unscrubbedi toothless women, ex-slaves, and Indians. But, fortunately for the health of the nation, these mighty professionals won a rightful monopoly of the healing arts, as the American public got behind them in the fight to rid oui Great Nation of quacks charlatans, and superstition. The truth is that the set of healers who became the medical profession did not necessarily have the Almighty God Science on their side. But they did have the support of the emerging capitalist business establishment. With all due respect to Koch, Pasteur and the other landmark researchers in medicine, it was the likes of Carnegie and Rockefeller who secured final victory for the American medical profession. During the 1800's, there were two types of doctors: the so-called "regular" doctor, who had received "formal medical training " and served the upper classes; and the various kinds of lay practitioners who served the working class folks and the poor. The regulars charged more for their brand of care because of their investment in training. However, this "training" often produced worse doctors than did the lay practioners' apprenticeships. Many "medical schools" had no clinical facilities at all, and a high school diploma was not required for admission. While lay practitioners relied mainly on mild herbal and root preparations and dietary changes to cure disease, the regulars, whose high paying clients wanted to see something happen for their money, often prescribed such noticeable measures as: massive bleeding, huge doses of laxitives and ernetics (which cause vomitting), and opium. Oliver Wendell Holmes wrote that if all the medicines used by the regulars were thrown into the sea, it would be so much better for humanity and so much worse for the fishes. But, because of their class background and the class make-up of their patients, the regulars had clout in government, just iike the AMA now, and by 1830, 1 3 (of the 26 ) states had passed medical licensing laws outlawing the "irregulars" and granting the regulars a legal monopoly on health care delivery. THE POPULAR HEALTH MOVEMENT Nonetheless, the I830"s and 40's saw a phenomenal growth in non-professional interest in health care, known as the Popular Health Movement. Led piïmarily by women who organized "Ladies Physiological Soeieties," Iike the know-your-body and self-help women's groups today, the Popular Health Movement stressed preventative care. frequent bathing (at a time when guiar doctors thought it was dangerous) whole grain cereals ánd temperance. Even 135 years ago, some elements of the Movement were pushing birth control. The Popular Health Movement was, from the start, virtually synonymous with the feminist movement of the day. The health movement supported women's rights, and the women's movement was very concerned about health care and opening up formal medical training to women. In fact, feminist s argued, using the prevailing sexist stereotypes, that women were innately bet ter suited to be doctors than were men! "We cannot deny that women possess superior capabiHties for the science of medicine," wrote Samuel Thomson, a health movement activist in 1834. Non-regular medical schools mushroomed. This was the Golden Age of lay practice. Most medical licensing laws were repealed by the 1840's in response to public outcry, and sectarian medical schools flourished. The sectarian schools generally accepted women; the regular schools did not. Harriette Hunt, a pioneering female doctor, was denied admission to Harvard Medical School , and went to a sectarian school instead. Elizabeth Blackwell, the first recog? nized female "regular", received her initial training at a sectarian school. MEDICAL REFORM-INDUSTRIAL AGE STYLE ■ By the mid 1840s the regulare began to iook like just another medical sect. To counterattack, they organized the Arnerican Medical Associatian in 1848. Through the AMA, the regulars attacked témale and lay practioe any way they could. Paternallistically, they inquired: how could any self-respecting woman travel alone at night to a medical emergency? In 1871, Alfred Stille, of the AMA, attacked {he very idea of femaJe physicians as ''monstrous," and wamed that women should not "aim towards a higher type than their.own." In the 1850's, the Popular Health Movement declined. But still. the regulars could not engineer for themselves a monopoly on the healtng arts. They could not claim to be a "profession" with the prerogative of self-regulation and advanced educational requirements simply on the basis of self-esteem and vague (disputed) claims of technical superiority. There are two essential ingredients tbr the creation of any "profession," claim to a special vital skill. and demonstration of the valué of that skill, and the valué of regulating that skill, to the people who make the laws governing it. In other words, professions are the creation of the groups who make the laws, and white wealthy males. In the latter half of the 1800's French and Germán scientísts developed the germ theory of disease, and for the first time in human history, there was a rationa! basis for the understanding and treatment of illness. Germán medical schools began teaching laboratory sciences and integrating them with clinical training in a four-year, post-college cirriculum, which was fine for the upper classes, but which effectively barred the poor from receiving medical training. Johns Hopkins Medicai School opened in Bahimore in 1893, the first man style medicai school in the U.S. Meanwhüe. the U.S erging as a leadingworid indus sr. The Industrialists whp si orious Noith with food, gurii. . iml transportaron to subjuga'c he South in the Civil War originated rüassive public philanthrophy in the iate i SOO's. But pluianthxophy is how you look at it. These few extremely wealthy business tycoons, Ainerica's first millionaires, cillectively known as the "Robber Barons," decided to remake the world to fit their elitist visión, and they invented the Foundation to do the job. ESTABLISHING WORTHWHILE MEDICAL SCHOOLS Medical "reform" was a high priority for the just-hatched Rockefeller and Carnegie Foundations, and not surprisingly, they put their money behind the regular doctors, the ones who treated them. Starting in 1903, millions in Foundation dollars were made available to medical schools, but ' ly if they adopted the Johns Hopkins model. The message was clear: "regularize and de-feminize or close." To push the message, the Carnegie Corporation (now U.S. Steel) sent Abraham Flexner around the nation to "evalúate" every existing medical school. Flexner almost single-handedly selected the medical schools he thouglit worthy of foundation support, and bitterly denounced those he concluded not worth saving in his respected "Report of 1910." In" the wake of the Flexner Report, sectarian medical schools closed by the score, including six of the nations eight black medical colleges, and the majority of schools schools which accepted women. Virtually overnight, medicine became a white, upper middle class male profession. Finally backed by huge grants and the massive propaganda machines of the foundations, the regular doctors emerged as the medical profession, aided by governmen licensing laws which the major industrialista helped "persuade" into existence. continued on page 22 ...the AMA attacked the very idea offemale physicians as "monstrous " and warned that women should not "aim towards a higher type than their own. " Oliver Wendell Holmes wrote that if all the medicines used by the regular doctors were thrown into the sea, it would be so much better for humanity and so much worse for the fishes. WOMEN HEALERS continued from page 20 OBSTETRICS OBSTRUCTS MIDWIFERY Feeling its oats, the new medical profes sion then went after midwifery, the last female stronghold of medical practice. A 1912 study by Johns Hopkins indicated that most professional doctors were less competent in obstetrics and gynecology than the midwives. However, under pressure from a more and more powerful AMA, state after state outlawed midwifery in favor of the new specialty called "obstetrics." For poor women, this meant less or no obstetrical care. Immediately following the crushing of midwifery, the infant mortality rate around Washington, D.C. rose sharply. By 1920, midwifery was all but dead in . the U.S. Women had been routed from their last stronghold as independent practitioners. Next time: Perspectives on Nursing, and the new Nurse-Activist.