As we have seen, the nineteenth century boasts a rich roster of medical women, any one of whom is the stuff of heroes: the trailblazing Blackwell sisters; the cautious Elizabeth Garrett Anderson; the firebrand Sophia Jex-Blake; the rigorous Marie Zakrzewska; the peace-keeping Lucy Sewall. Any one of them deserves all the attention our fractured post-modern consciousnesses can spare, but personally, my utmost favourite has always been the most complicated figure in that gifted pantheon – Dr Mary Putnam Jacobi (1842–1906).
Jacobi was a figure of astonishing intellect and aggressive bravery who brooked no nonsense in the pursuit of medical truth. She was a revolutionary even among revolutionaries, spurned equally by large swaths of the male medical establishment for being a woman and by the nascent women’s medical movement for being too devoted to laboratory work and original research. Only by her life’s end was she accepted for what she was: a pioneer in applying microscopic and chemical analysis to the treatment of patients, but the road to that acceptance was anything but a steady one.
Mary Putnam, the oldest of eleven children, could have chosen any path for her life. She was born the daughter of G. P. Putnam, one of the most influential publishers in nineteenth-century America, whose home was regularly visited by some of the era’s most famous writers, including Frederika Bremer and Susan Warner. Inspired by her interactions with such renowned, independent and intellectually stimulating women, Putnam determined to make her living as a writer, and started writing brief moral essays and stories at the age of 9.
Under the progressive influence of her family and circle of acquaintances, Putnam began calling standard gender roles into question. Attending Twelfth Street School in New York, she wrote an essay that took a prompt about William the Conqueror and changed it into a piece about the need to move away from meekness and passivity as the feminine ideal. If women were to become all they might be, she stated, they had to start valuing new virtues, like self-sufficiency and a thorough sense of responsibility that refused to surrender control of one’s life in exchange for mere comfort.
With her senses attuned to historical structures that enforce a cult of feminine passivity and obedience, it was inevitable that young Putnam would come into conflict with the Baptist faith of her family. She recorded her doubts, both about the inconsistencies of dogma and the historically poor record of established religion with regard to women and reason, and met with a Baptist cleric regularly in the hopes that he could show her a way back to faith. He could not, however, and his total inability to come up with reasonable answers to basic questions, coupled with his insistence on criticising her as ‘unwomanly’ for questioning the roles the church had decreed for her, resolved her to renounce her membership of the First Baptist Church in 1863. She decided that, if there were truths to existence to be discovered, they would come not from the wisdom of Bronze Age patriarchal elders, but from an open and active investigation into natural phenomena.
For some years before her renunciation of Baptist religion, Putnam had been gaining, here and there as the opportunities presented themselves, instruction in medicine. She attended lectures and dissections, and spent time with the women’s medicine pioneer Elizabeth Blackwell, who in 1847 had been the first woman to attend medical school in the United States and had, in 1857, founded the New York Infirmary for Women and Children with her sister Emily. By Putnam’s time, most universities had closed off any loopholes like those that allowed Blackwell to attend, and so Putnam was compelled to study instead at the New York College of Pharmacy.
Studying at a pharmacy college instead of a more traditional medical school was the route being charted by Elizabeth Garrett Anderson simultaneously in England, and it was to have a profound influence on how Putnam approached medicine. She studied the preparation of medications and their chemistry, which gave her a more molecular view of disease and its remedy than was available to more traditional medical students. In March 1863, she graduated from the New York College of Pharmacy and, after a brief stint as a medical volunteer on the front lines during the Civil War, she attended one of the only two schools offering medical training to women: the Female Medical College of Pennsylvania.
Her time in Pennsylvania was to prove a source of frustration for all concerned. Putnam was frustrated at the slow pace of the courses and the low quality of her fellow students. She applied to graduate early without having taken all the courses required for graduation, stating that her previous work at the College of Pharmacy and the strength of her thesis paper should be enough qualification, and that she could not possibly learn anything of value from the rambling and elementary courses the school was trying to compel her to take. Administrators were riled by the impertinence of her request and its suggestion that their standards of instruction were so low as to be beneath consideration for a student of actual talent. Nevertheless, they ultimately approved her graduation in 1864, and Putnam had her second medical degree in as many years.
Her time at Philadelphia, however, had definitively shown her that the United States was not the place to study for a woman who actually wanted to learn the details of medical practice, and especially the craft of experimental medical research. So, in 1866, she turned to Paris to truly complete her education. Influenced heavily by the cellular approach to medical research pioneered by Rudolf Virchow in the 1850s, the Parisian medical scene was the perfect place to be for a molecularly-oriented young doctor like Putnam, and she threw herself not only into her studies, but into the heady political climate of late 1860s France.
These were the last years of Napoleon III’s mixed attempt to realise for France a new empire, when democratic and socialist ideas ran rampant among the educated classes who bridled under Napoleon’s steady curtailing of expressive freedoms. Putnam fell in naturally with progressive-thinking families and intellectuals, remaining in Paris during the lean times following the fall of Napoleon in the Franco-Prussian War and experiencing the bracing but doomed culturo-political moment that was the Paris Commune.
Her main work for the half decade of her Paris residency, however, was the slow and sure execution of her plan to gain entrance to the prestigious École de Medicine. She worked in the laboratory of Antoine Ranvier, himself the assistant to Claude Bernard, originator of the concept of biological homeostasis. She wrote essays for American publications describing French scientific and political life. She worked at the Salpêtrière clinic gaining insight into neurological theory. By 1868, she had such a wide array of degrees, experiences and contacts that the École de Medicine felt it could not legitimately prevent her from attending classes, and on 25 January she walked into the medical amphitheatre there for the first time, though the achievement was muted somewhat by having to enter through a side door and sit in a specially appointed chair.
Putnam graduated in July 1871 in a Paris that was slowly piecing itself together after the dramatic collapse of the Commune, and moved back to New York shortly thereafter to begin charting an entirely new course for women medical doctors. By 1871, several women doctors were well known to the public and established in various practices and institutions, but by and large their approach to medical practice was centred more around patient care than experimental research. The predominantly male medical establishment was hard-pressed enough to find it in themselves to admit women doctors when those doctors approached their work in a reassuringly motherly manner, but a woman regularly performing tissue dissections, chemical analysis and vivisections was a creature of such unwomanly interests as to be beyond comprehension, a being of horror even to other women doctors.
Putnam set up a small office in New York upon her return and began publishing accounts of her medical findings in the Medical Record. She believed strongly in the value of what was then called nutrition as a means of evaluating and fostering health. For the late nineteenth century, ‘nutrition’ was about the investigation of how cells take in and break down chemicals in their cycle of birth, renewal and death. Approaching disease from the perspective of the chemicals needed to nourish and sustain cells, Putnam (who became Mary Putnam Jacobi upon marrying the esteemed Dr Abraham Jacobi in 1873) was able to view the workings of illnesses from a foundation-up perspective which allowed her to devise new experiments and medical procedures.
This cellular perspective put her in a position to appreciate the emerging theory of bacteriology while more traditional doctors like her husband or Elizabeth Blackwell fought against the idea that diseases could be caused by germs. Doctors attached to social reform movements particularly viewed bacteriology with mistrust. They believed diseases were caused by social and behavioural problems, and resisted any notion that a pathogen which struck rich and poor, virtuous and depraved alike, could be the root cause. Putnam made it part of her life’s work to publicise the findings of the rising bacteriology researchers, particularly after the death of her oldest child at the hands of diphtheria.
Putnam wrote 120 scientific papers over the course of her career, but none brought her the same degree of fame as 1876’s The Question of Rest for Women During Menstruation, written in the wake of the publication in 1875 of Edward Clarke’s now infamous Sex in Education; or a Fair Chance for the Girls. Clarke, a retired Harvard professor, claimed that intellectual work un-womanised women and rendered them infertile. He believed that the reproductive and nervous systems were fundamentally linked, and that resources diverted towards one could only come at the cost of the other. You want to read a difficult book? That’s fine, but it will take 2 units of resources away from your uterus. You want to be active during menstruation? All right, but it will leave you in chronic pain.
Putnam found Clarke’s work reactive and fundamentally unscientific, and proceeded gathering data about what actually happens to women, both on a psychological and cellular level, during the process of menstruation. She used her 1876 paper and subsequent 1877 book to demonstrate that, on the basis of the statistical data she gathered and chemical analyses she had performed, the women who experience the least pain during menstruation are not those who have removed themselves from all physical and intellectual effort, but precisely those who had a robust childhood and who continue to challenge themselves mentally and physically. On the basis of this data, she argued strenuously for more girls’ physical education programmes, and the expansion of educational and occupational opportunities for women as a means of saving their health from the dangers of a socially and religiously mandated torpor.
Her life was one of struggle, for women against the inherited advice of medical Victorianism, for bacteriology in the face of established social behaviour medicine, for women’s suffrage during its darkest era, and, most controversially, as virtually the only woman to argue publicly for the continued use of vivisection in medical research amidst the great anti-vivisectionist movement of the late nineteenth and early twentieth centuries. This last crusade is in many ways her most intriguing, the one it is hardest to come to a firm and fast opinion about (at least for me). On the one hand, from the point of view of a theoretically more advanced twenty-first-century sense of empathy, it is easy to see the anti-vivisectionists as the heroes, striking a blow for a more humane treatment of other species at the hands of an often luxuriously wasteful medical community that dealt out untellable amounts of suffering for often undetectable amounts of benefit.
But on the other hand, there is the figure of Putnam herself, a hard-as-nails scientist who believed that, to do things right and actually understand what is happening on a functional level, one must do certain experiments, and who was willing to do the bloody business of performing them herself amidst almost universal disgust that a woman should be so grotesque as to willingly perform such labours. She could have moved into other parts of medicine, she could have carried out her experiments but stayed away from the public stage, but she cared so little for reputation when set in the balance against advocating for what she deemed necessary for the advancement of medicine and science that she chose the long, bloody, hard path to notoriety, and there is something in that determination that is compelling even if its object is morally tendentious.
Her comments before Congress in 1900 against a proposed anti-vivisection bill were among Putnam’s last public acts. In 1896, she developed the first symptoms of a brain tumour that would ultimately take her life a decade later, and after pushing on with her work as best she could for some years, she decided to limit her responsibilities and throw herself into a complete documentation of her own case, including her heart-rending accounts of the slow loss of the two things she had always been able to count on in life: her mental sharpness and her force of will. She died on 10 June 1906, having done all that could be asked of her in one life to secure access to an intellectually and physically stimulating life for women, a future in experimental medicine for women doctors, and a cellularly-centred path forward for medicine generally. Fierce in opposition, fearless in alliance, too complicated to be a popular hero, but too deserving to be forgotten, everything about her was intensity and struggle, and it is seemingly unlikely we shall soon see her type again.
FURTHER READING:
Mary Putnam Jacobi & The Politics of Medicine in Nineteenth-Century America (2009) by Carla Bittel is the book to get, though it veers pretty wildly in price on the used market (it took me about two years to find a copy under $60, though now the prices seem pretty decent). It bears some of the marks of its time, including a tendency to use the word ‘perform’ in variously eccentric ways that was the particular fad of the first decade of twenty-first-century academia, but it thoroughly investigates all the many aspects of Putnam’s many-faceted career, including her role in bringing high society into the suffragette fold in the late nineteenth century.
Jacobi's story is also one of 140 stories of women in Medicine I told in A History of Women in Medicine and Medical Research, available on Amazon and from Pen and Sword books US or UK!
