Maligning the female reproductive system has long provided ammunition for male dominance. Way before “childless cat ladies” were impugned as a societal risk, childless women, widows, and those deprived of regular heterosexual stimulation were considered susceptible to the morbid condition known as “hysteria,” a psychological condition ostensibly caused by superfluous fluid- buildup in the uterus. The worst curse, however, depriving a woman of strength, rational thought, and dependability, was menstruation. It took the research of Dr. Mary Putnam Jacobi to disabuse that notion. In so doing, Dr Jacobi became the first woman to engage in modern medical research.
The year was 1876, a time when the menstruating female inspired fear and derision, a condition used to block women from obtaining a medical degree from “regular” medical schools as unfit, hyper-emotional, and otherwise ill-suited to the profession. Indeed, when Mary Putnam sought admission to the Faculté de Médecine de Paris, she was still climbing mountains and lancing chauvinistic monsters who objected to her admission:
"…women, being considered as legal minors from the moment they marry, cannot be held personally liable for anything; consequently, adopting Miss Putnam could entail serious complications."
- Jules Béhier, Professorof Clinical Medicine Faculté de Médecine, Paris
To secure the stature she desired, Dr. Putnam labored through the NY College of Pharmacy, becoming the first American woman to graduate in 1861; received an MD from Woman’s College of Medicine in Pennsylvania in 1864; and attended numerous courses and performed clinical training in Europe before being the first woman admitted to the Faculté de Médecine in 1868, and the second woman to graduate in 1871.
The Early Years
Mary Putnam was perhaps an unlikely - and lucky - candidate to forge the battle for a woman’s medical research to be accepted by mainstream physicians. The oldest of eleven children of publisher George Putnam, her early education was robust and unusual for a girl. She was first home-schooled by her mother before attending a private and later public school for girls. After graduating in 1859, she studied Greek, science, and medicine privately. Interested in empiric science from an early age, only maternal intervention stopped her from dissecting a rat she found when she was nine.
While neither parent was thrilled with Mary’s career choice (her father called it a repulsive pursuit), proud of their obviously gifted daughter, they supported and funded her exploits, although her father admonished her not to give up her femininity in the process.
“Be a lady from the dotting of your i's to the color of your ribbons, and if you must be a doctor and a philosopher, be an attractive and agreeable one."'
- George Putnam to Mary
Indeed, her feminine charms aided in convincing opponents when seeking admission in France, while her father’s publishing company and connections proved critical in disseminating later research. Perhaps because of her father’s exhortations and unlike many of her female medical peers, Mary Putnam was also a wife and mother, marrying Dr. Abraham Jacobi, widely regarded as the founder of American pediatrics and innovator of child health care who strongly advocated pasteurization of milk. The couple had three children, two of whom died at birth and infancy, straining the marriage and leaving Mary to single-handedly raise her daughter as her marriage fragmented.
The Woman “Problem”
Through the 1860s, jurisdiction over “female” diseases was jealously contested among midwives, medical men practicing obstetrics and gynecology, and the “scandalous” untrained women who provided abortions, which were legal at the time. [1]
On her return to the United States, Dr. Putnam focused on diseases and medical issues affecting women. The barricade for women medical students was perhaps most formidable at Harvard, which only began accepting female applicants in 1945. So convinced that menstruation was a scourge, Harvard’s Boylston Medical Society competition (run by a highly esteemed group of the medical elite) devised its annual essay contest to address the issue presented by Dr. Edward C. Clarke in Sex in Education; or, a Fair Chance for the Girls, a classic example of 19th century sexism, claiming:
“that if a woman expended too much of her energy on studying, her reproductive organs would be deprived of energy, and negatively impact her fertility. It was especially important that they rest during menstruation in order to conserve their strength.”
The Boylston essay topic was entitled: “Do Women require mental and bodily rest during menstruation and to what extent?” Because the competition was anonymous, leading female activists, including Julia Ward Howe, pressured Mary to submit an essay. Pregnant at the time, she initially declined. But upon the assurance that if she won, the prize would not be withdrawn when her sex was discovered, she proceeded full steam ahead.
The Question of Rest for Women during Menstruation was Mary Putnam Jacobi’s entry. Rather than submitting to a diatribe or a collection of opinions, Mary engaged in large-scale empirical medical research, virtually unheard of at the time. She produced 1000 questionnaires that elicited information about a subject’s medical history and experience with menstruation, using the vast network of the women’s rights movement to circulate the questionnaires and tabulate the 268 results returned. Next, with the help of women colleagues at the New York Medical Infirmary, she instituted a series of experimental work to register physiological and chemical signs of menstruation-related to muscular strength. For each patient, she measured pulse rates (with an early prototype of the blood pressure cuff), depicting the results as a visual graphic that illustrated the rise and fall of arterial pressure throughout a woman’s menstrual cycle. She tested urine for urea (to measure kidney function) and measured physical strength using a dynamometer, which gauged the compressive strength of all major muscle systems. “Finally, each participant recorded temperature by mouth, armpit, and rectum at hourly intervals,” [2] which proved to be a significant contribution to the reproductive physiology of women, later tied to the timing of ovulation.
Dr. Jacobi’s submission met with rave reviews, garnering first prize. Later, an expanded version of this work (and others) was published by her father’s press. The study heralded the demise of “rest cures” and preoccupation with ovarian and uterine diseases as a cause of mental illness. In Dr. Jacobi’s then-novel conception, menstruating women were not undergoing a crisis of sexual stimulation, hemorrhage, or hysterical response - but a normal event reflecting the growth and death of tissues.
Her later years were devoted to advocating women’s suffrage, writing Common Sense Applied to Women's Suffrage, and becoming one of six suffragists who founded the League for Political Education, fighting to adopt the 19th Amendment.
Following a long and distinguished career as a practicing physician, researcher, medical educator, and author of more than 120 articles, she did not allow death to rob her of one final contribution. Diagnosing herself with a fatal brain tumor in 1906, she chronicled her symptomatology, culminating in her last publication: Early Symptoms of the Meningeal Tumor Compressing the Cerebellum. From Which the Writer Died. Written by Herself.
Sources: Lydia Reeder, The Cure for Women
Women in White Coats, Olivia Campbell
[1] A survey by Dr. Jacobi’s contemporary, Dr. Horatio Storer, uncovered statistics revealing that abortion was more common among married Protestant white women in Boston than among single, poor women. Storer, ironically teaching at the New England Medical School for Women, spearheaded a crusade to criminalize abortion, thereby eliminating what the nascent AMA considered their prime competition: midwives and female abortionists.
[2] This research led to the breakthrough discovery of daily temperature fluctuations and pioneered later work on the “rhythm method” of contraception.
