‘Challenging Incommunicability: Tool Use amongst Women Medical Practitioners in Britain, 1860–1914’

‘Challenging Incommunicability: Tool Use amongst Women Medical Practitioners in Britain,... Abstract This article considers the extent to which British women seeking recognition as medical professionals engaged with tools to construct themselves as medically authoritative in the decades surrounding 1900. Concentrating on two technical forms (microscopes and electricity-producing devices), it demonstrates that tool use became increasingly significant for a wide range of women concerned with medicine at this time. Medicine-related tools became important for women because they could confer a form of authority on their statements and practices that challenged the prevailing critique that their bodies were inadequate to medical pursuits. By addressing women medical microscopists, as well as the emergence of controversies at the Incorporated Society of Trained Masseuses between 1910 and 1914, it is shown that this strategy of professionalisation unsettled established ideals regarding proper relations between men and women within medicine. feminism, professionalisation, technology, microscopy, electrotherapy Introduction As in the rest of Europe, late nineteenth-century Britain saw the emergence of new attitudes and beliefs regarding the importance of tools in intellectual and practical life.1 Historians have recently begun to explore how these changes related to concomitant alterations to the social and economic situations experienced by women at this time. The significance of everyday tools such as gas cookers and electric lights, along with their associated large-scale infrastructures, have been shown to have been critical to the creation of new economic and social roles for women in the years leading up to the First World War.2 Nevertheless, comparatively little attention has yet been paid to the significance of tools for British women who either were or aspired to become medical professionals at this time.3 This article addresses this lacuna. As far as the history of medicine is concerned, the significance of attitudes towards tool use has been well studied with regard to the emergence and status of medical specialisms in Britain, Europe and North America around 1900.4 Regarding the British context, historians have been especially concerned with the extent to which British gentlemen physicians resisted the emergence of medical attitudes and beliefs associated with technical practices, and their preference for personal, character-centred forms of training.5 Perhaps the most influential paper in this regard has been Chris Lawrence’s ‘Incommunicable Knowledge’, published in 1985.6 In attending to the anti-technological and anti-specialist tendencies of many British medical gentlemen of the late nineteenth and early twentieth centuries, Lawrence outlines a significant split between this group and proponents of the specialisms that were emerging at this time. Whereas Lawrence and predecessors emphasised specialists’ creation and adoption of particular tools, however, recent writers on specialisation have emphasised the broader social and economic conditions under which specialties emerged. It has increasingly come to be recognised that specialisation was not driven by the creation and adoption of tools themselves, but can rather be more fruitfully understood as an expression of broader economic and cultural trends.7 One result of this historiographical insight, however, is that the significance of tool use for early professional and professionalising women themselves has not been considered in any detail. This article re-evaluates the significance accorded technical knowledges and practices in the history of women’s medical professionalisation.8 It does so by identifying a connection between three trends: firstly, an increasing recognition that women were capable of contributing to medical science; secondly, an increasing tendency amongst women to appeal to tools as guarantors of their mental and practical abilities; and thirdly, the emergence of claims to professional status that women began to make. This approach to the question of how women claimed professional status develops the historiography of women’s medical professionalisation in Britain beyond established social interest and class-centred accounts to address experiences that were specific to women medical practitioners as a whole. The adoption and adaptation of tools by women contributed significantly, albeit in subtly different ways, to changing perceptions of women doctors, nurses, masseuses and a range of other professions allied to medicine. In his article, Lawrence suggests that, by and large, it was the anti-technical, gentlemanly side of the debate regarding medical specialisation that most fully accorded with the professionalising aims of women nurses and doctors: women ‘adopted similar standards [to elite generalist physicians], competing with men on their own terms’.9 Much of the literature on women medical practitioners at least tacitly agrees with this suggestion. Women’s medical professionalisation has in many ways rightly been portrayed as the personal achievement of individuals who fought for acknowledgement and recognition in their respective fields by institutional means. In her recent consideration of relations between women doctors and nurses, Vanessa Heggie notes that existing discussions of early professional women in Britain concern ‘the multiple arguments for women’s right—and in some cases obligation—to practice as doctors, the many conflicts between male and female doctors, the tensions between voluntary and paid nurses, and the power struggles on the wards between male doctors and nurses’.10 Although in adding relationships between women doctors and women nurses to this list Heggie presents a more general perspective than many previous accounts, her analysis, like the studies that it cites, is framed in terms of womens’ adherence to established hierarchical distinctions within the medical profession (such as those made between doctors and nurses).11 Examination of the extent to which women medical practitioners actively looked to tools as means of attaining medical authority, I argue, cuts across historical distinctions between medical professionals and the hierarchies implicit to them.12 Taken together, the two examples addressed here demonstrate that women engaged with tools to construct themselves as professionals regardless of their social and economic backgrounds. Further, they also highlight how women medical practitioners’ appropriation of particular tools and techniques influenced the ways in which British men construed themselves as medical practitioners. The holism propounded by medical men who aspired to gentlemanly ideals can in many ways be understood as an effort to maintain a particular and historically highly specific form of gender relation, in which two distinct sexes negotiated their relative dominion over particular spheres of influence. Nor were women professionals’ more enthusiastically specialist male colleagues necessarily opposed to such assumptions.13 This article shows that women medical practitioners adapted medical tools to a wide variety of professional ends. Such adaptation, it suggests, played a significant role in undermining established assumptions regarding the proper places of women and men in medical organisation and practice. This article begins then by setting out the contexts that had the most immediate significance for the lives and careers of women medical practitioners during the late nineteenth century. It highlights the extent to which many of the most prominent medical men and women agreed regarding the organisation of medicine into separate spheres. Subsequently, however, it moves on to consider the extent to which less well-studied women practitioners and investigators participated in the constitution of an alternate medical culture, in which the attribution of authority depended less on one’s character or capacity as an observer, and more on the kinds of tools that were used and the perceived competence of those wielding them.14 Two forms of medical tool feature particularly prominently in the present analysis: microscopes, and devices for creating and applying medical electricity. Examination of the late nineteenth-century status of these demonstrates the wide variety of contexts within which medical technologies such as microscopes, electricity, x-rays and surgical equipment were introduced and utilised. For example, microscopes were primarily a research tool incorporated within elite medical research, whereas electricity-producing devices tended to be used by women medical practitioners who were accorded a lower social status. It will be shown that though microscopes and electricity-producing devices were adopted by women from radically different social backgrounds, women used these tools in similar ways, and to similar ends. Though conventionally associated with elite, research-focused medicine, novel medical devices had just as much significance for those women who found themselves at the lower end of the medical hierarchy as it existed during the latter decades of the nineteenth century. The final part of this paper thereby addresses the significance of women’s adoption of medical tools for the governance of one of the least reputable forms of medical practice at this time: medical massage. Considering how women adopted different kinds of medical tool to professionalising ends indicates the diverse ways in which tool use could unsettle the assumptions regarding gender difference upon which many medical men and women in Britain founded their professional identities. In this latter respect, technology-centred medical practice was not merely impersonal and particularising: it could also subvert established moral codes and mores. The Separate Spheres of Gentlemanly Medicine It is generally acknowledged that the identification of women with a specific set of bodily characteristics became a particularly pervasive means of dismissing their claims to intellectual authority during the nineteenth century. For example, many eighteenth- and early nineteenth-century anatomists and physiologists characterised the activities of the womb as having a profound and debilitating effect on the brain, and hence on the mind.15 Moreover, the eighteenth and early nineteenth centuries were marked by the emergence of an historically highly specific ideal of gender relations. For the then-expanding upper middle class segment of society, ‘gentility’ came to be understood as a mark of social status. The gentleman, in this conception, was responsible for by-and-large public roles such as conducting business, developing friendships with other men, and ensuring the economic well-being of his family. In contrast, gentlewomen were accorded roles as ‘helpmeets’—as organisers of the domestic realm, educators of children, and, where necessary, sick-nurses.16 However, by the 1910s this ‘separate spheres’ model of intellectual and economic relation had begun to show signs of severe strain. By this time the suffrage movement was in full swing, promising to accord women a significant role in public life.17 Other, longer-term trends also contributed to a sense of confusion amongst those who believed that women’s foremost priority should be the domestic sphere. These included the gains that women began to make regarding access to higher education from the 1880 s, re-evaluation of the intellectual status of domestic work, and, significantly for this paper, the emergence of women professionals such as nurses and doctors.18 Many of the leaders of the nineteenth-century movement to train and accredit women medical practitioners did not consider themselves to be challenging the by-then long-established ideal of separate spheres. Although Florence Nightingale advocated nursing and midwifery training, she opposed state registration for nurses, preferring to portray nursing as part of women’s duty to do ‘God’s work in the world’ in both the domestic and medical spheres.19 In the course of arguing for the treatment of patients by women, Sophia Jex-Blake stated that ‘not only is there nothing strange or unnatural in the idea that women are the fit physicians for women, and men for men; but, on the contrary, … it is only custom and habit which blind society to the extreme strangeness and incongruity of any other notion’.20 Elizabeth Blackwell similarly argued that women should train ‘not as specialists, but as the trusted guides and wise counsellors in all that concerns the physical welfare of the family’.21 Such comments are notable in that they took the way women’s realm of authority was apportioned as their focus of critique, rather than the nature of that authority itself. As Antoinette Burton has shown, this approach overlapped with more general concerns regarding the medical administration of Britain and its colonies: if domesticity was defined broadly enough to encompass the ‘home’ nation, appeal to women’s pre-eminence within the domestic realm could be adapted to justify the medical authority of (caucasian, upper- and middle-class) women over (non-caucasian, subaltern) subjects of the British Empire.22 Although they did generally differ regarding the extent to which women should be allotted a realm of authority, many of the most prominent medical men of this time fully agreed with these pioneer professionalisers regarding the differentiation of the sexes. Almost all of those Lawrence cites as adherents of an ‘incommunicable’ medical ideal also contributed to upholding the ideal of separation between medical men and women’s respective spheres. William Bowman corresponded with Nightingale and supported her efforts to introduce training for nurses in his capacity as physician at the Royal London Ophthalmic Hospital, but did not contemplate the possibility that women might be trained as doctors.23 Henry Acland published one of the earliest calls for the organised teaching of nurses, and established a ‘Home for Nurses’ in Oxford as a memorial for his wife Sarah, but limited his support for women doctors to those engaging in missionary work amongst women in India.24 Others, such as Patrick Black, Dyce Duckworth and Octavius Sturges, felt it necessary to uphold the doctrine of separate spheres directly, by literary and oratory means. As part of a discussion of the function of the spleen, Black developed an extended analogy around a romance between ‘male’ blood and ‘female’ veins, in which the two meet in the spleen, and ‘only die by giving birth to countless progeny’.25 Speaking in 1877 and again in 1894 Duckworth was more explicit: I have often advised young women with fitting qualifications, and who seek an active sphere of usefulness, to adopt nursing as a profession, and I have offered this advice without violent prejudice to the adoption of the medical art proper by women. I am, however, free to confess that on this latter point I have but small sympathy … so exactly is sick-nursing a field for female energy, that I regret to find cultivated women expending their powers in a wrong direction, and robbing the ranks of skilled nursing-sisters to form a band of imperfectly trained medical practitioners.26 As well as following Duckworth’s projection of gender roles onto relations between medical professionals, Sturges suggested that patients’ trust in medicine was itself dependent on a particular conception of nursing practice: ‘It is the experience of every Medical man that the relatives of the sick are often averse to obtaining the services of a Nurse, not from distrust of her knowledge, but from fear of her learning, fear lest the wife or the mother should be set aside, and her simple home service superseded in favour of the sterner teachings of science.’27 As Lawrence suggests, a significant overlap existed between the interests of the most prominent representatives of professional women practitioners and the anti-specialist rhetoric of these elite medical gentlemen. What has not been acknowledged, however, is that this overlap was in part motivated by doubts regarding an alternative and to contemporaries far more threatening mode by which women sought medical authority. In this mode, the concern was not with re-drawing or policing the boundaries of men’s and women’s respective spheres of influence, but rather with the possibility that a capacity for medical investigation or practice may not in fact be primarily dependent on one’s individual character or bodily state at all. Although they did not generally enjoy prominence in the formation of medical specialisms (and enjoyed at best ambiguous support from many of the most prominent specialising men), women did engage closely with tools that came to play increasingly significant roles in medical investigation and practice during the latter half of the nineteenth century. This circumstance had important repurcussions regarding the status of women medical practitioners. Whereas women had largely been confined either to collecting and conveying facts and practices ‘discovered’ by men or to anonymously contributing to men’s scientific activities during the first half of the nineteenth century, by 1900 it had become difficult to deny that women were making significant and original contributions to medical sciences. Microscopy and the Appropriation of Scientific Authority by Women The first tool relating to medicine to gain widespread popularity amongst British women was the microscope. In eighteenth- and early nineteenth-century Britain, microscopes had been conceived of as much as a form of amusement as a serious means of discovering the nature of living substances.28 During the 1850s and 1860s, societies such as the Quekett Microscopical Club, The Microscopical Society of London, and even the Worshipful Society of Apothecaries continued this tradition by putting on entertainment events or ‘conversaziones’ to which women were invited.29 The popularity of these events amongst women was unprecedented, and appears to have taken many of the men who founded and participated in microscopy societies by surprise. Soon, debates began to emerge as to whether it was morally acceptable to organise such events. As one advocate of them defensively put it in 1870: The interest manifested by the members, and the satisfaction exhibited by visitors of both sexes, gave no sign of decadence. There was the same sturdy phalanx of members who had their microscope, and something under it, and the same smiling and blooming troop of female friends peeping anxiously down the hundreds of brazen tubes erected for their delectation. The prophecy that these ‘shows’ would soon come to an end, which some crusty antiquarians have been known to utter, seems as far distant as ever.30 Moves to allow women members into the London Society were however voted down, and, by the early 1870 s, microscopical conversaziones were declining in popularity. They should nevertheless be acknowledged as both reflective of and contributory to an expansion of women’s opportunities for engaging with a very particular form of intellectual practice that was emerging at this time: that of tool-centred (if not always ‘specialist’) medical science. Microscopy was taken up by a significant proportion of the British women who published on medical and medicine-related topics between 1860 and 1900.31 These included Alice Marion Hart, whose husband edited the British Medical Journal, New Hospital for Women physician Frances Elizabeth Hoggan, and, significantly, a number of Cambridge-based women students and researchers. The latter included University College London and Newnham College student Florence Eves, who published joint studies with John Langley; Marion Greenwood, who became responsible for training a new generation of women physiologists; Newnham student Rachel Alcock, who became one of Walter Gaskell’s proteges; Florence Buchanan, who would later collaborate with John Burdon Sanderson at Oxford; and Lillian Sheldon and her co-worker Alice Johnson, the latter of whose microscopical studies of newt embryos formed the basis of the first paper by a woman to be published in the Proceedings of the Royal Society.32 It was not the vogue for the instrument alone that appealed to these women: other factors played a more significant role. One was the relatively low cost of obtaining a microscope compared to, for example, developing an anatomical collection, or equipping a physiology laboratory. Another was how easily adaptable microscopic practice was to the domestic environments to which many middle-class women felt themselves restricted.33 Finally, and most significantly, the establishment in mid-nineteenth-century Britain of microscopes as invaluable for the study of organic tissues created opportunities for women to demonstrate their independence and originality as medical investigators in ways that did not rely on appeals to their bodily capacities. Close examination of the research publications of two women microscopists highlights the significance that the tool had begun to hold for some women medical professionals by the early 1880 s. In 1881, despite being reticent on professional matters, Alice Hart (who had been trained at the Laboratoire d’Histologie at the Collège de France) found it necessary to contest a claim that had been made by the physiologist Richard Norris, Professor of Pathology at Queens College Birmingham. Norris had in 1878 claimed to have observed what he described as a new translucent or ‘invisible’ species of blood corpuscle that appeared during the formation of ‘fibrine’ or blood clots.34 In a succinct article contesting his claim, Hart drew on her training to assert that the entities that Norris had seen were simply washed-out red blood corpuscles. What is especially notable about this article, however, is the way in which Hart expressed her views. Rather than deny that Norris had in fact seen his corpuscles, she cast doubt on the means by which he had seen them: Dr Norris discovers, by various means of staining, his invisible corpuscle. That it is there I do not deny, but that it is there because it previously existed in this condition in the blood in the living state is I think open to dispute … the staining agents recommended by Dr. Norris … [are] not sufficiently powerful [to detect the escape of red matter from it].35 In contesting Norris’s claim, Hart was especially careful not to appeal to her own observational capacities, deferring authority to the staining agents used. In removing her bodily self from the debate, she thereby emphasised her judgement regarding the techniques by which the blood might best be investigated, rather than any observational acuity on her own part. Hart confined herself to critiquing Norris’s approach to research rather than proposing her own interpretation of the corpuscles. But that this critique came to be perceived as well made was in no small part due to the prior emergence of a range of original claims by women microscopists during the 1870s.36 For example, in 1876 Frances Hoggan, then one of the most prominent women doctors in Britain, had announced that she had discovered an entirely new process of histological staining.37 Her presentation of this technique, however, had been beset with difficulties. Hoggan had initially sent an article on her process to the British Medical Journal, but the editor of that journal (Hart’s husband, Ernest Hart) had not responded to it. Accounts of the technique had meanwhile mysteriously begun to appear elsewhere in the microscopy press. Hoggan’s 1876 announcement—in the decidedly less reputable Journal of the Quekett Microscopical Club—was accompanied by a denunciation of the practices of the BMJ: Although that paper has been in the hands of the editor of the Journal for the last nine months, it has not been published, but inadequate, and in some cases erroneous, accounts of my process, have largely been circulated. … I have, therefore, considered it advisable to give, as shortly as possible, the details of this very simple and effective process to your Society, whose members will, I doubt not, put it to every sort of test.38 Again, what is of particular note here is that what Hoggan puts in question is not her own visual capacities, but rather the effectiveness of her technique, which (she presumes) will be tried and found useful by Society members regardless of their gender. As Hoggan characterised it, her authority as a microscopist was not dependent on the observational capacities of her mind and body, but on her capabilities as a technical innovator. By characterising investigatory possibilities as inherent in the tools of microscopy, Hart and Hoggan sought to obviate the old critique that their female bodies could not be relied upon to observe nature accurately. Thus, by deploying a technical rhetoric of scientific discovery, these women found a means by which they could gain a particular, historically-specific form of intellectual—if not institutional—authority. Nevertheless, the immediate significance of this development for women who sought professional medical status should not be overestimated. It was in research contexts such as Newnham and Girton colleges at Cambridge, rather than medical institutions such as the New Hospital for Women in London, that women microscopists gained greatest recognition as original investigators.39 For the most prominent proponents of medical professionalism, the study of medicine was an eminently practical endeavour. In their addresses, figures such as Duckworth and Sturges implied that too much ‘technical’ knowledge could cause women to overstep the proper bounds of the medical hierarchy. Most dangerously, this might entail a blurring of the boundaries between the male and female spheres. Despite the tendency of women microscopists to focus on the cultivation of scientific rather than strictly medical identities, it is possible to detect the emergence of tensions amongst women medical professionals regarding reliance on tools during the 1870 s and 1880 s. Claire Brock notes a significant difference of interests at the New Hospital For Women during the late 1880 s, in which Elizabeth Garrett Anderson, as the most prominent surgeon of the institution, sought to retain control over operations performed there. That she did this in opposition to two less well-known colleagues, Louisa Atkins and Mary E. Dowson, who criticised her practices on the basis that her methods were not adequate to the cases that she sought to undertake, speaks to the importance that individual character and judgement was accorded at this time. As Brock notes, Anderson was committed to a vision of surgery in which personal experience was valued over technical skill.40 Although little evidence is available regarding the opinions or practices of Anderson’s above-mentioned colleagues, it is perhaps indicative of the differences between them that Hoggan had resigned from the New Hospital in 1877 for similar reasons to Atkins and Dawson. Furthermore, the hospital’s consulting surgeon William A. Meredith, whose resignation precipitated the later controversy, was also a committed advocate of antiseptic surgery and other then-controversial surgical techniques. As he pointedly commented in an article published shortly after his resignation, ‘The fact that certain operators who formerly used antiseptics now obtain improved results with the help of plain water and the systematic employment of the drainage-tube, by no means convinces me that their present success is entirely due to the alteration in their system of treatment.’41 Whether or not Anderson’s practices at the New Hospital were indeed the target of Meredith’s scepticism, the latter’s enthusiasm regarding Listerian hygiene and other recent surgical developments may well have jarred with the generalist commitments of the former. Vivisection debates constituted another, even more controversial area of potential disagreement amongst women. For many, such practices constituted the absolute limit of appropriate involvement in medical science. Although Hoggan enthusiastically appropriated and adapted techniques of microscopy, as one of the leading figures of the Victoria Street Society she remained vehemently opposed to vivisection. Similarly, as well as contending that women doctors should train ‘not as specialists’, Elizabeth Blackwell denounced the integration of experimental research on animals and medical practice. Yet women did engage in interventionist animal experimentation, even in the face of potential vilification.42 The most famous of these, the American Mary Putnam Jacobi, became the target of significant critical commentary from anti-vivisectionists.43 Most likely aware of Jacobi’s experiences, British women who participated in experimentation with animals retained lower profiles. Little of the experimental work undertaken at the Cambridge Balfour Biological Laboratory for Women appears to have found its way into print.44 Florence Buchanan’s nine years at Oxford assisting John Burdon-Sanderson appear to have passed without attracting controversy, and Sarah Sowton’s later work with Charles S. Sherrington at Liverpool and Oxford remains little commented on even today.45 Nor were Buchanan and Sowton isolated figures by the second decade of the twentieth century.46 For women vivisectionists, the desire to prove their capabilities as experimental investigators predominated over any wish to attain public recognition. Late nineteenth-century women who sought recognition as medical professionals were neither a single, unified group, nor neatly categorisable into distinct professional identities. Rather, individuals and groups found a diverse range of points from which they sought to challenge the established modes of medical organisation and practice. For Nightingale and her followers, training nurses was the ultimate goal of reform—there was no need to form professional organisations or doubt that matters of physiological or surgical intervention should remain the exclusive preserve of professional medical gentlemen. Similarly, Blackwell’s and Jex-Blake’s conceptions of women doctors fed into a widely held assumption that regardless of whether women should be admitted to the established medical societies, their roles must continue to be strictly demarcated. Nevertheless, others began to challenge the assumption that limits should be put on women’s involvement with medical research or practice at this time. For these generally little-acknowledged figures, both genders were ideally joint and equal participants in scientific medical endeavour. Moreover, this latter tendency did not remain confined to the relatively small number of university-trained women. Indeed, use of novel devices became a key site of contention for members of one of the ‘lowest’ grades of the medical hierarchy: that of masseuses. As the remainder of this article details, masseuses who adopted new tools in their practice found themselves at the medical forefront of the more general breakdown in the established ideal of ‘separate spheres’ at the end of the nineteenth century. The Domestic Context of Medical Electricity As already suggested, microscopes were in part important for scientific women because of their compatibility with the domestic environments in which many middle class women found themselves. During the 1880s and 1890s, however, other medical technologies such as x-rays and novel surgical equipment began to gain in both popularity and scientific reputation. Electricity played an important role in these developments, and had particular relevance to domestic settings. With the development of commercially available mechanical devices for inducing a build-up of electric charge, and subsequently of batteries that were both portable and capable of conveying an appreciable ‘constant’ current through patients’ bodies, a new specialism (the medical electrician) had begun to emerge amongst medical men. For women generally denied formal recognition as medical specialists, in contrast, adoption of medical electrical devices and techniques presented opportunities to move beyond the domestic or otherwise exclusively ‘womanly’ contexts to which many felt unduly restricted. For the most part, early medical electricians did not practise in hospitals or other established sites of medical practice. These practitioners frequently took on responsibility for the design and implementation of electricity-producing devices themselves. As might be expected, such tools were expensive to produce, and initially remained the preserve of a small number of medical men. The historiography of medical electricity reflects these origins. Historians have variously discussed the distrust that medical practitioners initially displayed toward electrical devices, disputes over the introduction of medical electricity into hospitals, the marketplace for electrical tools and treatments, and even the constitution of an electrical sexual body.47 However, few attempts have been made to detail women’s role in and responses to the emergence and legitimation of electrical technologies during the nineteenth century.48 The identification of medical electricity and its use with medical and scientific men supports a still-pervasive assumption that women are either naturally less technologically adept, or have historically been less interested in engaging with and developing technical devices.49 Before considering the wider adoption and appropriation of medical electricity by British masseuses, therefore, I shall briefly consider how the incorporation of medical electricity into domestic contexts presented further opportunities for women to construct themselves as original contributors to the development of medical science and practice. Despite the tendency to identify the development and administration of medical electricity with medical men, historians have noted the significance of domestic contexts for its emergence. François Zanetti shows that at least as far as the Parisian context is concerned, medical electricity was initially incorporated into physicians’ homes: a circumstance that posed significant problems for the maintenance of such homes as domestic environments. With the emergence of portable devices during the 1780 s, however, moves were made to limit the extent to which electrical devices could be marketed and employed by accredited medical practitioners.50 By the late nineteenth century, medical electricity had become a distinctly commercial proposition. With this development came a plethora of devices for self-administration in homes. For example, towards the end of the nineteenth century, Cornelius Harness’s London-based Electropathic and Zander Institute offered the services of ‘certified masseuses’ along with a range of portable electrical devices. Although the Institute was discredited during the 1890s, its initial success highlights the attraction that medical electricity had for Victorians.51 Moreover, the increasing availability of high-voltage electricity in (primarily metropolitan) homes presented new possibilities regarding domestic medical electricity application. Thus in 1902 Dr Chrisholm Williams gave lectures to women massage practitioners ‘at his own house, so that the opportunity was afforded of seeing a variety of electrical apparatus … including that used in treatment by means of Electrical Currents of “High Frequency and High Potential”.’52 The increasing affordability of portable devices during the 1880s and 1890s further encouraged women to engage with medical electricity. For some women, this involvement grew into more than either an interest in paying for electrical treatment, or ownership of tools marketed as ‘electrical’: by the early twentieth century, a small number of women had themselves begun to identify as specialist medical electricians. An indication of the significance that electrical technologies could have for women medical practitioners is given by the early career of Margaret M. Sharpe, a relatively wealthy middle-class woman who would later gain recognition as a radiologist.53 Long before developing an interest in X- or ‘Röntgen’ rays, Sharpe had been a committed medical electrician and, after persuading the medical electrical company Isenthal Potzler & Co. to allow her to use the equipment at their establishment in Mortimer Street, had set up a number of high-voltage machines in her own home.54 Indeed, it was only on the basis of her skill in medical electricity that she felt able to venture any thoughts about the potential medical applications of the new rays at all. As she commented in 1900, during a presentation on skin treatments to the members of the Röntgen Society: ‘It is with greatest diffidence that I venture to appear before you this evening to plead the cause of X-ray therapeutics. … I am not a physicist, and I know very little about skin diseases, but I have had ten years’ experience of electro-therapeutics, and that is the only excuse that I can offer for my temerity in rushing in where so many abler and wiser have feared to tread.’55 Indeed, by 1905 Sharpe found herself in a position to substantiate this appeal to electrical experience. Reporting again to Röntgen Society members, she announced a new method of curing ‘chilblains and nævus’ by what she termed ‘a vacuum electrode of my own designing’: It is exhausted to a much higher degree than those usually made for use with the high-frequency current. It gives a bright-green fluorescence even in daylight, gives off no sparks or perceptible brush discharge … I have not heard or read any previous attempt having been made to treat nævi by this method, and this is the first time I have tried it myself; but one might reasonably expect with such conditions as nævi always to obtain similar results, and be free from the element of uncertainty which attends so many of the ‘cures by radiation.’56 Again, just as women microscopists had found in the development and use of the tools of microscopy a means of obviating the supposed observational unreliability of their bodies, in constructing her own medical authority Sharpe appealed not to her bodily or character-dependent skill as a medical practitioner, but rather to a tool of her own devising. Importantly, whereas microscopes were primarily used as instruments of research and diagnosis during the period in question, medical electricity could be employed in medical therapeutics directly. Medical electricity thereby brought questions surrounding technical authority within science directly into contact with the professionalising ideals of many of the most prominent women medical practitioners of this time. During the first decades of the twentieth century, British masseuses found that the incorporation of electrical devices into their practice sat awkwardly with the cultural assumptions that had underpinned their initial foray into professional self-organisation. Electrical Technologies and the Governance of Medical Massage Electrical devices had by 1910 long been a feature of massage practice, and cannot be said to have been a motivation for its initial professionalisation in Britain. Indeed, it was to contemporaries a rather more morally troubling controversy surrounding the use of massage parlours as fronts for houses of prostitution that had led to the formation of the Society of Trained Masseuses in 1895.57 This circumstance, combined with widespread scepticism regarding the therapeutic value of massage amongst Britain’s established medical practitioners, meant that the women who founded the society retained a strong sense that the status of massage as a medical practice depended on strict adherence to the then-prevalent mode of medical organisation. The first and at the turn of the twentieth century most rigorously upheld rule of the society stated: No massage to be undertaken except under Medical direction. No Medical massage for men to be undertaken. Occasional exceptions may be made at a Doctor’s special request for urgent or nursing cases.58 Like the institutional pioneers of professional nursing and midwifery, the early Council of the Society emphasised their continued obedience to (implicitly male) medical authority. Furthermore, as the first rule also indicated, one of the principal rationales for the Society was to ensure that the boundary between male and female medical realms was upheld in relation to patients as well as practitioners. One of the conditions for its incorporation in 1900 was that ‘only those masseuses shall be qualified to be members of the Society who undertake the work of massage of females and children, and that no member shall undertake massage for men except at the special request of a Registered Medical Practitioner in some urgent or nursing case’.59 Indeed, anxiety over what was portrayed as the sexual threat of masseuses was such that London’s St James Vestry for Legislation, part of a Church of England body that had historically had significant influence over state spending, proposed in 1899 that it should be made illegal for any person except a medical practitioner to apply massage or similar treatment to any person of the opposite sex … that both men and women performing such work should possess certificates of efficiency and pass an examination; [and] that all persons performing massage not possessing the necessary certificate of efficiency should be fined £100, or be imprisoned for six months.60 The concerns of the men of the Vestry accorded closely with those of the Council during the Society’s early years. In addition to their moral and institutional conventionality, the rules and beliefs that had been established at the Society’s formation were underpinned by constant reminders that massage was an inherently bodily activity. That is, early leaders of the society and their gentlemen colleagues emphasised not only that massage depended (ideally exclusively) on the use of the hands, but that masseuses should expect to be judged on their physical appearance. In a lecture to the society on the ‘responsibility of the masseuse to the profession’, Gulielma Manley proclaimed that ‘the hands of a masseuse should be of irreproachable aspect, the costume fresh and spotless’.61 In a pointed repost to suggestions that blind people be trained in medical massage, Sir William Bennett proclaimed in a 1902 lecture to the Society that there is ‘no calling in which a “sound mind in a healthy body” is more essential than in that of massage … delicate people and those that suffer from any physical defect are entirely unfit to practice’.62 Many early Society members presumed along with Bennett that masseuses should first and foremost appeal to their bodily state and physical appearance to gain the trust of patients. Nevertheless, the increasing prevalence of medical electricity in massage practice threatened to undermine the bodily, sexually differentiated, hierarchically organised vision of the Society that its council upheld. First, and most obviously, electricity-producing devices displaced the perceived source of medical activity away from the body of the masseuse, and onto a technical object. This meant that instead of a masseuses’ subordinate and docile body, patients were put into contact with a reputedly dangerous force that was under her control.63 As the medical electrician J. Curtis Webb cautioned in a 1910 lecture at the Society on the use of electricity in massage practice: Remember that everyone hates electric shock, and that most people dread electrical treatment. Therefore begin with very weak currents at the first sitting, turn on your current very slowly. Show the patients that you have confidence in yourself and in your apparatus and they will have confidence in you.64 Such comments indicate that the actual experience of receiving massage could be far from the gentle, unthreatening image of womanly medical practice that the Council adhered to. Secondly, the expansion in the number of specialist departments of medical electricity in British hospitals during the 1880s and 1890s contributed to its increasing orthodoxy as a form of medical practice.65 The incorporation of medical electricity into massage both conferred a particular form of authority on the Society, and implied a specific conception of the masseuse as a ‘scientific woman’. By the late nineteenth century, some women’s adoption of this identity, as well as the differing attitude towards gender that accompanied it, threatened to undermine the strict delineation of male and female roles on which its founders had insisted. In June 1905 Annie Manley, then in charge of the educational activities of the Society, announced that the War Office had asked the ISTM to set examinations for their (male) nursing orderlies. As Manley (who herself lectured on the topic) later happily proclaimed:66 It is a matter of some satisfaction … [that] a Society composed entirely of women … has been called upon to conduct an Examination exclusively for men. In a day when some among us are chafing at the disability of women in matters political, in a day when some bodies of men are complaining that we are ousting them from certain callings which they formally monopolised, we are glad to know that here women have not only proved their equality with men, but their superiority, or shall we say, priority in organisation.67 Such comments directly contravened the image cultivated by the founders of the Society as guardians both of existing professional hierarchies, and of established moral and physical boundaries between men and women. Finally, despite the Society’s stipulation that masseuses remain absolutely obedient to their (almost invariably male) medically qualified superiors, electricity introduced a decidedly grey area of medical authority into massage practice. Although physicians in continental Europe, and especially in France and Germany, were reputed to be highly specific in their stipulations for treatment, the cautious attitude of many British doctors to medical technologies often resulted in more vague directions being given.68 One commentator noted that the order given to the masseuse by the doctor is frequently the vague command ‘apply electricity’, and it is accordingly applied in a perfectly haphazard fashion … Lest any should fall into those errors it is imperative that they should spend some time and trouble in understanding the instruments they are dealing with and the disappointment and discomforts to which they may expose their patients.69 In the appropriation of medical electricity by masseuses then, women were encouraged not just to carry out the instructions of medical men, but also to become more knowledgeable than them regarding the technologies that they were required to employ. Between 1911 and 1915, the contradiction between the ISTM’s founding ideal of maintenance of separate spheres, and the increasing importance of technical medical practices that contributed to undermining this ideal, came to a head.70 The problems began when it was reported that one of the most established teachers of massage in the country, Elsie French, had begun handing out certificates for a course on medical electricity stating an ‘MB’ after her name. Following a brief and unsuccessful attempt to find French’s name in the Medical Register, her membership of the Society was rescinded.71 What initially seemed to be a simple matter of a massage teacher appropriating a medical title soon escalated into a full-scale dispute regarding the future direction of the organisation. The following year, French, who was based in Manchester, was found to have begun her own organisation, the Manchester and Northern Counties Incorporated Society for Trained Masseuses and Masseurs. Here, in stark contrast to the policy of the original Society, she offered to teach both men and women together in the same classes.72 Other masseuses came out in support of French’s organisation, claiming that the London-based Society was neglectful of the concerns of ‘provincial’ teachers. Whilst the original, legally incorporated Society sought to contain their Manchester rival, another dispute arose, this time in the capital itself. In 1913 a change in electoral procedure which conveyed greater powers to ordinary members (and thereby made the authority of the original Society founders increasingly contingent on the democratically expressed opinions of members as a whole) had allowed two of the most prominent members of the Society—Miss Scammell and Miss Bedingfield—to gain seats on its Council.73 These women’s reputation as leaders of their field was in part based on their collaboration with the pioneer of medical electricity use in Middlesex hospital, Mr C. R. C. Lyster.74 Despite (or possibly because) of this circumstance, it was subsequently decided by the Council that pupils of the school of which they were joint owners would not be admitted for examination in ‘Swedish Remedial Exercises’. Scammel and Bedingfield, according to the Council, had not allocated enough time for their students to be trained by a qualified teacher.75 A series of claims and counter-claims ensued over the next two and a half years, which resulted in compensation being paid to the pair for loss of earnings, a continued refusal to admit their students for examination, and their subsequent resignation from the Society. By the end of 1914 another prominent Society member had had enough of such conflicts, and resigned. Rather than identify the intransigence of Society members as the source of its problems, Kathleen Marriott Fox emphasised what she portrayed as the undemocratic practices of its Council. In her letter of resignation, published in the British Journal of Nursing, Fox admonished the Council regarding how it ‘rules the Society, that is to say whilst ostensibly consulting its members, really acting on a course of action previously decided upon’.76 Further, the British Journal itself called on the Society to ensure that any national legislative body of masseuses was ‘composed of direct representatives, elected by members of the profession to be governed’.77 Such critiques apportioned blame for the controversies not with individual Society members, but rather the organisation of the Council itself. It was not just the careers of individual masseuses that were at stake in the disputes that surrounded the Society during the early 1910 s. Indeed, the general status of massage as a medical practice was in question. Calls for the Society to become a more avowedly democratic organisation implied that a section of the membership at the very least felt that their concerns were not being heard by the Council. For its own part, the Council believed that they were merely upholding the principles of the Society as they had been set down at its foundation in 1895 and again in 1900. Whether an individual found themselves on one or another side of this dispute depended to a great extent on the attitude that they took towards the role of electricity-producing devices in massage practice. As medical electricity began to develop into a recognised medical specialism during the early twentieth century, the technical knowledge that masseuses—who it should not be forgotten came well below nurses in the established hierarchy of medical practitioners—had been required to acquire as medical subordinates placed them in a position of increasing scientific authority. The Council of the Society of Trained Masseuses had been formed to uphold the dignity and medical status of massage. To do so, they had introduced strict rules regarding the conduct of massage and the policing of boundaries between genders. The appropriation of electricity-producing devices by masseuses wishing to attain greater recognition within the profession more generally had the notable effect of blurring such boundaries. It is then not surprising that conflicts arose between the established members of the council and a new, more technically-committed group of women by the second decade of the twentieth century. The calls for the democratisation of the Society that emerged in 1914 were not simply immediate responses to the exclusion of certain participants from it. They also reflected long-emerging differences of opinion and approach amongst women medical practitioners more generally regarding the most appropriate means of attaining recognition for their contributions to medicine. Campaigns to establish the professional credibility of women practitioners depended in great part on the organisational and rhetorical efforts of their most prominent participants. However, another very different, and hitherto little commented-on route to medical recognition was pursued by many of their less socially prominent colleagues. In addition to the well-known organisational and institutional means by which women practitioners achieved acknowledgement and recognition, these women pioneered tool-centred routes to professional legitimation. Conclusion It should not be presumed that the conflicting concerns that can be discerned amongst Britain’s medical men during the late nineteenth and early twentieth centuries can be directly mapped onto the concerns of women medical practitioners. In concentrating on the extent to which women practitioners engaged with medical technologies, and the differences of opinion that such engagement could lead to, this article has left the ways these women sought to resolve disputes amongst themselves unaddressed. There is some evidence to indicate that such disagreements could lead women into conflicts that were just as damaging to the unity of their social and professional groups as those their male colleagues engaged in. Thus Garrett Anderson’s colleagues’ disagreement over her surgical practices resulted in their permanent departure from the New Hospital for Women.78 However, it should also be noted that in some instances at least, reconciliation between opposing camps came to play at least as important a role for the attainment of professional status as did the maintenance of one or another position. The above-described disputes at the Incorporated Society of Trained Masseuses precipitated an enquiry from it regarding the possibility of it being accorded Chartered status. Although initially intended as a means of subverting any claims to equivalence by its Manchester-based rival, the Society’s Charter was eventually granted once the two competing organisations found enough common ground to re-merge.79 In this case then, the attainment of greater professional authority was achieved in part through re-unification rather than the professional differentiation that has generally been associated with tool-centred medicine.80 Women practitioners experienced very different social and economic conditions than did medical men, and were less likely to possess resources with which they might forge separate identities to their colleagues. Under such circumstances, compromise and collaboration appear to have come to be valued at least as much as the assertion of difference and individual expression. Given the importance for professionalising women practitioners of presenting a unified front regarding their collective aims, it is understandable that the earliest historical accounts of the attainment of professional recognition emphasised institutional gains over technical achievements.81 One consequence of this emphasis has however been that those responsible for the latter have received comparatively little attention from historians of medicine. This is all the more unfortunate given that it was these women who were chiefly responsible for demonstrating women’s equal capacity for original medical research as well as practice. More extensive consideration of the degree to which women engaged with tools not addressed here in detail, such as x-ray-producing devices and equipment for physiological experiment and surgical intervention, would contribute to the construction of a more nuanced conception of women’s attainment of professional recognition during the nineteenth and twentieth centuries.82 By writing women who engaged with medical devices back into medical history, we can better appreciate both the complexity and the variety of the challenges that all women medical practitioners experienced at this time, as well as the determination and creativity with which such challenges were confronted. Acknowledgements I am very grateful to Jen Wallis and Sally Frampton for providing critical advice and support during the composition of this article, as well as to the invaluable encouragement of Helga Satzinger during the initial stages of its research. I am also much indebted to the two anonymous referees, whose careful attention improved the text considerably. Finally, I would like to thank all at the Wellcome Library (London) for their longstanding patience regarding and assistance with my invesigative efforts. Footnotes 1 Lorraine Daston and Peter Galison, Objectivity (New York: Zone Books, 2007), 115–90. 2 Anne Clendinning, Demons of Domesticity: Women and the English Gas Industry (Aldershot: Ashgate, 2004); Graeme Gooday, Domesticating Electricity: Technology, Uncertainty, and Gender (London: Pickering and Chatto, 2008). 3 See however Ornella Moscucci, ‘“The Ineffable Freemasonry of Sex”: Feminist Surgeons and the Establishment of Radiotherapy in Early Twentieth Century Britain’, Bulletin of the History of Medicine, 2007, 81, 139–63. It should be noted that the status of terms such as ‘tool’ and ‘technology’ in historical analysis remain contested. In this article I aim to avoid some of the more serious pitfalls associated with use of the term by referring to specific kinds of devices, and substituting specific terms such as ‘tool’ and ‘device’ for more general terms such as ‘technology’ wherever possible. On the status of technology in gender history, see Judith A. McGaw, ‘No passive victims, no separate spheres: a feminist perspective on technology’s history’, in Stephen H. Cutcliffe and Robert C. Post, eds, In Context: History and the History of Technology (Bethlehem, London and Toronto: Lehigh University Press, 1989), 172–91. For an overview of recent gender and technology studies research see Judy Wajcman, ‘Feminist Theories of Technology’, Cambridge Journal of Economics, 2010, 34, 143–52. 4 Studies with particular relevance to this paper include Glenn Gritz and Arnold Arluke, The Making of Rehabilitation: A Political Economy of Medical Specialization (Berkeley: University of California Press, 1984), esp. 15–37; Joel D. Howell, Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century (Baltimore and London: Johns Hopkins University Press, 1995); Thomas Schlich, ‘“The days of brilliancy are past”: Skill, Styles and the Changing Rules of Surgical Performance, ca. 1820–1920’, Medical History, 2015, 59, 379–403. 5 Christopher Lawrence, ‘Incommunicable Knowledge: Science, Technology and the Clinical Art in Britain’, Journal of Contemporary History, 1985, 20, 503–20; Roger Cooter and Steve Sturdy, ‘Science, Scientific Management, and the Transformation of Medicine in Britain c. 1870–1950’, History of Science, 1998, 36, 421–66; Steve Sturdy, ‘Looking for Trouble: Medical Science and Clinical Practice in the Historiography of Modern Medicine’, Social History of Medicine, 2011, 24, 739–57. 6 Lawrence, ‘Incommunicable knowledge’. 7 Major studies addressing the British context include (though are by no means limited to) Rosemary Stevens, Medical Practice in Modern England: The Impact of Specialization and State Medicine (New Haven, CT and London: Yale University Press, 1966); Lindsay Granshaw, St. Mark’s Hospital, London: A Social History of A Specialist Hospital (London: Hollen Street Press, 1985); Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine (Basingstoke and London: Macmillan, 1993); Christopher Lawrence and George Weisz, eds, Greater than the Parts: Holism in Biomedicine, 1920–1950 (New York: Oxford University Press, 1998); Christopher Lawrence, Rockefeller Money, the Laboratory and Medicine in Edinburgh 1919–1930: New Science in an Old Country (Rochester: University of Rochester Press, 2005); George Weisz, Divide and Conquer: A Comparative History of Medical Specialization (Oxford: University Press, 2006); Steven Casper, The Neurologists: A History of a Medical Specialism in Modern Britain (Manchester: Manchester University Press, 2014). For an in-depth critical appraisal of Lawrence’s conclusions as far as they concern two British hospitals see Rosemary Wall, Bacteria in Britain, 1880–1939 (London: Pickering & Chatto, 2013). 8 I use the phrase ‘women medical practitioners’ rather than ‘medical women’ in this article, as the latter was used to refer to women doctors rather than any other practitioner in the period in question. I would like to thank one of the anonymous reviewers of this article for drawing this to my attention. 9 Lawrence, ‘Incommunicable knowledge’, 508. 10 Vanessa Heggie, ‘Women Doctors and Lady Nurses: Class, Education, and the Professional Victorian Woman’, Bulletin of the History of Medicine, 2015, 89, 267–92, on 268–9. 11 Recent studies in this mode include Laura Kelly, Irish Women in Medicine: Origins, Education, Careers (Manchester and New York: Manchester University Press, 2012) and M. Anne Crowther and Margurite W. Dupree, Medical Lives in the Age of Surgical Revolution (Cambridge: Cambridge University Press, 2007), 152–75. Heggie, ‘Women Doctors’ notes further studies in this vein. 12 A significant exception is Claire Brock, ‘Surgical Controversy at the New Hospital for Women, 1872–1892’, Social History of Medicine, 2011, 24, 608–23. On the importance of technology for women within science more generally at this time see Claire G. Jones, Femininity, Mathematics and Science, c.1880–1914 (Basingstoke: Palgrave Macmillan, 2009), esp. 175–204. There is a much wider literature on women’s contemporary engagements with medical technologies as consumers and patients. See e.g. Rachel P. Maines, The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction (Baltimore and London: Johns Hopkins University Press, 1999) and Lisa Cartwright, Screening the Body: Tracing Medicine’s Visual Culture (Minneapolis and London: University of Minnesota Press, 1995), 143–70. 13 Thus Anders Ottoson argues that in the face of the identification of medical massage with women medical practitioners, the most intimate massage techniques practised on women at this time were incorporated into a specialism (gynaecology) that maintained a specifically male dominion over medical practice: Anders Ottoson, ‘The Age of Scientific Gynaecological Masseurs: ‘Non-intrusive’ Male Hands, Female Intimacy, and Women’s Health around 1900’, Social History of Medicine, 2016, 29, 802–28. 14 Note especially Schlich, “The days of brilliancy are past” in this regard. On the constitution of this culture within science more generally see Theodore M. Porter, ‘How Science Became Technical’, Isis, 2009, 100, 292–309. 15 Londa Schiebinger Nature’s Body: Gender in the Making of Modern Science (Boston, MA: Beacon Press, 1993); Thomas Laqueur, Making Sex: Body and Gender from the Greeks to Freud (Cambridge, MA: Harvard University Press, 1990). 16 Leonore Davidoff and Catherine Hall, Family Fortunes: Men and Women of the English Middle Class, 1780–1850 (Chicago and London: University of Chicago Press, 1987), 397–401 and 445–9. 17 On women doctors’ involvement with the suffrage movement see J. F. Geddes, ‘The Doctors’ Dilemma: Medical Women and the British Suffrage Movement’, Women’s History Review, 2009, 18, 203–18. 18 British women’s efforts to attain medical education in higher institutions of learning are detailed in Thomas Neville Bonner, To the Ends of the Earth: Women’s Search for Education in Medicine (Cambridge, MA and London: Harvard University Press, 1992). See also Elaine Thompson, ‘Physiology, Hygiene and the Entry of Women to the Medical Profession’, Studies in History and Philosophy of the Biomedical Sciences, 2001, 32, 105–26 for the generalist education of early women doctors in Edinburgh. On the intellectual status of domestic work, see Nancy L. Blakestad, ‘King’s College of Household and Social Science and the Origins of Dietetics Education’, in David Smith, ed., Nutrition in Britain: Science, Scientists and Politics in the Twentieth Century (Abingdon: Routledge, 1997), 75–98; Elizabeth Bird, ‘High Class Cookery”: Gender, Status and Domestic Subjects, 1890–1930’, Gender and Education, 1998, 10, 117–31. 19 Lynn MacDonald, Florence Nightingale at First Hand (London: Continuum, 2010), 47–51 and 128–9. 20 Sophia Jex-Blake, Medical Women: A Thesis and a History (Edinburgh: Oliphant, Anderson & Ferrier, 1886 [1872]), 7. Other readings of these figures are of course possible. For a study that emphasises the differences between Nightingale and Jex-Blake see Anne Crowther, ‘Why Women Should be Nurses and not Doctors’, Women in Medicine Magazine, http://www.womeninmedicinemagazine.com/profile-of-women-in-medicine/why-women-should-be-nurses-and-not-doctors. Accessed 8 May 2017. 21 Elizabeth Blackwell, The Influence of Women in the Profession of Medicine: Address Given at the Opening of the Winter Session of the London School of Medicine for Women (London: George Bell and Sons, 1889), 27. 22 Antoinette Burton, ‘Contesting the Zenana: The Mission to Make “lady doctors for India”, 1874–1885’, The Journal of British Studies, 1996, 35, 368–97. 23 Zachary Cope, Florence Nightingale and the Doctors (Museum Press: London, 1958), 142–3. 24 Henry Acland, District Nurses. Substances of Remarks Made by Desire at the Church Congress at Reading, 1883 (London: J. Masters & Co., 1883), 1. 25 Patrick Black, Essay on the Use of the Spleen, with an Episode of the Spleen’s Marriage: A Physiological Love Story (London: Smith, Elder, & Co., 1878), 38–41. 26 Dyce Duckworth, Sick-Nursing Essentially a Woman’s Mission: Being the Inaugural Lecture for the Qualifications for and the Conduct of Sick-Nurses (London: Longman’s, Green & Co., 1877), 11. 27 Octavius Sturges, ‘Nurses and Doctors: An Address to the British Nurses’ Association’, The Nursing Record, 28 March 1889, 2, 197–9 and 4 April 1889, 2, 213–215, 197–8. 28 Barbara M. Stafford, ‘Images of Ambiguity, Eighteenth-century Microscopy and the Neither/Nor’, in David Miller and Peter H. Reill, eds, Visions of Empire: Voyages, Botany, and Representations of Nature (Cambridge: Cambridge University Press, 1997), 230–57; Marjorie Nicolson, ‘The Microscope and English Imagination’, Smith College Studies in Modern Langages, 1935, 16, esp. 37–49. 29 Ruth Richardson, ‘Microscopical Conversaziones’, The Lancet, 2001, 358, 2004. On conversaziones more generally at this time see John Plunkett and Jill A. Sullivan, ‘Fetes, Bazaars and Conversaziones: Science, Entertainment, and Local Civic Elites’, in Joe Kember, Jill A. Sullivan and John Plunkett, eds, Popular Exhibitions, Science and Showmanship, 1840–-1910 (London: Pickering & Chatto, 2012), 41–60 and esp. 52–3 on microscopy at such events. 30 ‘The Soirée’, The Journal of the Quekett Microscopical Club, 1870–71, 2, 185. 31 Mary M. Creese, Ladies in the Laboratory? American and British Women in Science, 1800–1900: A Survey of their Contributions to Research (Lanham, MD and London: The Scarecrow Press, 1998); Marsha L. Richmond, ‘“A lab of one’s own”: the Balfour Biological Laboratory for Women at Cambridge University, 1884–1914’, Isis, 1997, 88, 422–55. 32 Alice Johnson, ‘On the Changes and Ultimate Fate of the Blastopore of the Newt (Triton cristatus)’, Proceedings of the Royal Society of London, 1884, 37, 65–6. Discussion of scientific activities of all of these figures can be found in Creese, Ladies in the Laboratory?), 109–10, 147–9 and 151. The Cambridge context is discussed in Richmond, “A lab of one’s own”. 33 For example, George Eliot drew on domestic microscopy in composing Middlemarch (published 1871–72): Mark Wormald, ‘Microscopy and Semiotic in Middlemarch’, Nineteenth-Century Literature, 1996, 50, 501–24. 34 Richard Norris, On the Physiology and Pathology of the Blood: Comprising the Origins, Mode of Development, Pathological and Post-mortem Changes of its Morphological Elements in Mammalian and Oviparous Vertebrates (London: Smith, Elder, & Co., 1882), xxii–xxxv. 35 Alice Hart, ‘Note on the Formation of Fibrine’, Quarterly Journal of Microscopical Science, 1882, 22, 255–9, on 255. 36 J. Lockhart Gibson, ‘On the “invisible blood corpuscle” of Norris’, Journal of Anatomy and Physiology, 1884, 18, 393–9. 37 Frances Elizabeth Hoggan, ‘On a New Process of Histological Staining’, The Journal of the Quekett Microscopical Club, 1874–1877, 4, 180–1. Hoggan’s career is detailed in Onfel Thomas, Frances Elizabeth Hoggan 1843–1927 (Newport: R.H. Johns Ltd., c. 1970). 38 Hoggan, ‘On a New Process’, 180–1. 39 Richmond, “A lab of one”s own’. On the specific challenges women faced in relation to the conduct of laboratory science more generally at this time see Jones, Femininity, Mathematics and Science, 117–42. 40 Brock, ‘Surgical Controversy’, esp. 610–11 and 614–20. 41 William A. Meredith, ‘Remarks on Some Points Affecting the Mortality of Abdominal Section. With Tables of Cases’, Medico-Chirurgical Transactions, 1889, 73, 31–56, on 32–3. 42 Mary Ann Elston, ‘Women and Anti-vivisection in Victorian England’, in Nicolaas A. Rupke, Vivisection in Historical Perspective (London and New York: Routledge, 1987) 259–94, on 277–8 and 282–6. 43 Carla Bittel, Mary Putnam Jacobi and the Politics of Medicine in Nineteenth-Century America (Chapel Hill: University of North Carolina Press, 2009), 195–204. 44 For references to the equipment in use at the Balfour Laboratory see ‘Order-Book of the Cambridge Scientific Instrument Company (1880–1884)’, Cambridge Scientific Instrument Company: Records and Papers (GB 12 MS.CSIC), Cambridge University Library (Manuscripts), Box 5. e.g. ff. 148, 150, and 158. 45 Laboratory notes by Sowton are held at the Department of Physiology, Anatomy and Genetics, University of Oxford. 46 Tilly Tansey, ‘Women and the Early Journal of Physiology’, The Journal of Physiology, 2015, 593, 347–50. 47 Iwan Morus, ‘Marketing the Machine: The Construction of Electrotherapeutics as a Viable Medicine in early Victorian England’, Medical History, 1992, 36, 34–52; Paula Bertucci and Giuliano Pancaldi, eds, Electric Bodies: Episodes in the History of Medical Electricity, Bologna Studies in History of Science, 9 (University of Bologna; Bologna, 2001); Lori Loeb, ‘Consumerism and Commercial Electrotherapy: The Medical Battery Company in Nineteenth-century London’, Journal of Victorian Culture, 1999, 4, 252–75; Iwan Morus, ‘Bodily Disciplines and Disciplined Bodies: Instruments, Skills and Victorian Electrotherapeutics’, Social History of Medicine, 2006, 19, 241–59; Takahiro Ueyama, Health in the Marketplace: Professionalism, Therapeutic Desires, and Medical Commodification in Late-Victorian London (Palo Alto, CA: Society for the Promotion of Science and Scholarship, 2010). 48 Literature addressing Ada Lovelace and Hertha Ayrton’s engagements with electrical devices are exceptions. See respectively Iwan Morus, Shocking Bodies: Life, Death and Electricity in Victorian England (Stroud: The History Press, 2011), 58–101, and Jones, Femininity, Mathematics and Science, esp. 67–92. 49 McGaw, ‘No passive victims’. 50 François Zanetti, ‘Curing with Machines: Medical Electricity in Eighteenth-century Paris’, Technology and Culture, 2013, 54, 503–30, on 513–23. 51 Loeb, ‘Consumerism and Commercial Electrotherapy’, 257–64; Ueyama, Health in the Marketplace, 191–8. 52 ‘On the General Uses of Electricity in Medicine’, Nursing Notes, Aug. 1902, 15, 105–6 on 105. 53 Creese, Ladies, 174. 54 Margaret M. Sharpe, ‘The x-ray Treatment of Skin Diseases’, Archives of the Röentgen Ray, 1900, 4, 52–60, on 53. Sharpe was not the only woman to move from electrotherapy to x-ray therapeutics at this time. See Jean M. Guy, ‘Edith (1869–1938) and Florence (1870–1932) Stoney, two Irish sisters and their contribution to radiology during the World War I’, Journal of Medical Biography, 2013, 21, 100–7, esp. 104. 55 Sharpe, ‘The x-ray Treatment’, 52. 56 Margaret M. Sharpe, ‘High-frequency Currents in the Treatment of Chilblains and Naevus’, Archives of the Röentgen Ray, 1905, 9, 50. 57 David A. Nichols and Julianne Cheek, ‘Physiotherapy and the Shadow of Prostitution: The Society of Trained Masseuses and the Massage Scandals of 1894’, Social Science and Medicine, 2006, 62, 2336–48; Ueyama, Health in the Marketplace, 227–77. The history of the Society is related in Jean Barclay, In Good Hands: The History of the Chartered Society of Physiotherapy, 1894–1994 (Oxford: Butterworth-Heinemann, 1994). On women’s authority as massage and physiotherapy practitioners during and after the First World War see Beth Linker, War’s Waste: Rehabilitation in World War I America (Chicago and London: University of Chicago Press, 2011), 61–78 and Ana Carden-Coyne, ‘Painful Bodies and Brutal Women: Remedial Massage, Gender Relations and Cultural Agency in Britain’s Military Hospitals, 1914–1918’, Journal of War & Culture Studies, 2008, 1, 139–58. 58 ‘Massage Notes: The Society of Trained Masseuses’, Nursing Notes, March 1895, 8, 37–8, on 37. 59 ‘The Society of Trained Masseuses: Incorporation of the Society’, Nursing Notes, 1900, 13, 100–1, on 101. It appears that before around 1905, men were in general either not considered appropriate candidates for medical massage, or recieved such treatment from non-specialist male medical practitioners. For the later introduction of massage in the treatment of soldiers see below and Linker, War’s Waste. 60 ‘Massage Establishments’, Nursing Notes, Jan. 1899, 12, 10. 61 [Gulielma Manley], ‘The Responsibility of the Masseuse to the Profession’, Nursing Notes, Aug. 1902, 15, 105–6 on 105. 62 William H. Bennett, An Address on Some Points Relating to Massage (London: John Bahle, Sons & Danielsson, Ltd., 1902), 8–9, quote on 8. See also John Kearsley Mitchell, ‘Massage’, in Thomas Clifford Allbutt, ed., A System of Medicine (London: Macmillan and Co., 1896), 373–85 esp. 374. 63 On the dangers associated with electricity at this time see Gooday, Domesticating Electricity, 61–89. 64 J. Curtis Webb ‘A Few Points on Electricity for Masseuses and Nurses’, Nursing Notes, April 1910, 23, 59–62, 83–4 and 112–14, on 83. 65 Ueyama, Health in the Marketplace, 170–226; Howell, Technology in the Hospital, esp. 30–68. 66 For Manley’s lecture, see Annie Manley, ‘The Curriculum Necessary for a Masseuse’, Nursing Notes, Aug. 1901, 14, 107. 67 Annie Manley, ‘Incorporated Society of Masseuses: Massage’, Nursing Notes, June 1910, 23, 154–6 and July 1910, 23, 179–182, on 180. 68 For British perceptions of attitudes in continental Europe, see [Lucy M. Robinson], ‘Massage in 1902’, Nursing Notes, Nov. 1902, 15, 146–7. 69 C.N.S., ‘Concerning electricity’, Nursing Notes, Oct. 1898, 11, 137–8, on 137. 70 Barclay, In Good Hands, 36–8. These disputes (detailed below) precipitated the formation of an ‘Emergency Committee’ of Society Council members. See Emergency Committee Minutes of the Incorporated Society of Trained Masseuses, May 1910–July 1917, Wellcome Library SA/CSP/B.1/2/1. 71 ‘Executive Committee Meeting, May 13, 1910’, ‘Council Meeting, March 10, 1911’, ‘Special Committee Meeting, April 25, 1911’ Minutes of Council of the Incorporated Society of Trained Masseuses, 1909–1913. Wellcome Library SA/CSP/B.1/1/8. (ff. 43, 63, 69). 72 ‘Council Meeting, Sept. 22, 1911’, ‘Council Meeting, Oct. 13, 1911’, ‘Executive Committee, May 10, 1912’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1909–1913. Wellcome Library SA/CSP/B.1/1/8. (ff. 78, 81, 102). 73 ‘Annual Meeting, March 14, 1913’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1913–1915. Wellcome Library SA/CSP/B.1/1/9. 74 Barclay, In Good Hands, 36–7; ‘Special Council Meeting, Dec. 12 1913’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1913–1915. Wellcome Library SA/CSP/B.1/1/9. 75 ‘Special Council Meeting, April 29 1913’ and ‘Council Meeting, Oct 10, 1913’, ‘Special Council, April 28 1914’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1913–1915. Wellcome Library SA/CSP/B.1/1/9. 76 ‘The Organisation of the Profession of Massage, The British Journal of Nursing, 6 March 1915, 54, 195–8. 77 ‘Editorial’, The British Journal of Nursing, March 20 1915, 54, 225. 78 Brock, ‘Surgical Controversy’, 616–20. 79 Barclay, In Good Hands, 36, 52–4 and 70–1. 80 Such a conclusion would complement Sturdy’s contention that disputes amongst specialist and generalist medical men have been over-stated. See Sturdy, ‘Looking for Trouble’. 81 Jex-Blake, Medical Women; Elizabeth Blackwell, Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches (New York: Schocken, 1977 [1914]); E. Moberly Bell, Storming the Citadel: The Rise of the Woman Doctor (London: Constable & Co., 1953). 82 On the slightly later significance of radiology for women medical practitioners see Moscucci, ‘The Ineffable Freemasonry of Sex’. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Social History of Medicine Oxford University Press

‘Challenging Incommunicability: Tool Use amongst Women Medical Practitioners in Britain, 1860–1914’

Social History of Medicine , Volume Advance Article – Mar 19, 2018

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© The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine.
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Abstract

Abstract This article considers the extent to which British women seeking recognition as medical professionals engaged with tools to construct themselves as medically authoritative in the decades surrounding 1900. Concentrating on two technical forms (microscopes and electricity-producing devices), it demonstrates that tool use became increasingly significant for a wide range of women concerned with medicine at this time. Medicine-related tools became important for women because they could confer a form of authority on their statements and practices that challenged the prevailing critique that their bodies were inadequate to medical pursuits. By addressing women medical microscopists, as well as the emergence of controversies at the Incorporated Society of Trained Masseuses between 1910 and 1914, it is shown that this strategy of professionalisation unsettled established ideals regarding proper relations between men and women within medicine. feminism, professionalisation, technology, microscopy, electrotherapy Introduction As in the rest of Europe, late nineteenth-century Britain saw the emergence of new attitudes and beliefs regarding the importance of tools in intellectual and practical life.1 Historians have recently begun to explore how these changes related to concomitant alterations to the social and economic situations experienced by women at this time. The significance of everyday tools such as gas cookers and electric lights, along with their associated large-scale infrastructures, have been shown to have been critical to the creation of new economic and social roles for women in the years leading up to the First World War.2 Nevertheless, comparatively little attention has yet been paid to the significance of tools for British women who either were or aspired to become medical professionals at this time.3 This article addresses this lacuna. As far as the history of medicine is concerned, the significance of attitudes towards tool use has been well studied with regard to the emergence and status of medical specialisms in Britain, Europe and North America around 1900.4 Regarding the British context, historians have been especially concerned with the extent to which British gentlemen physicians resisted the emergence of medical attitudes and beliefs associated with technical practices, and their preference for personal, character-centred forms of training.5 Perhaps the most influential paper in this regard has been Chris Lawrence’s ‘Incommunicable Knowledge’, published in 1985.6 In attending to the anti-technological and anti-specialist tendencies of many British medical gentlemen of the late nineteenth and early twentieth centuries, Lawrence outlines a significant split between this group and proponents of the specialisms that were emerging at this time. Whereas Lawrence and predecessors emphasised specialists’ creation and adoption of particular tools, however, recent writers on specialisation have emphasised the broader social and economic conditions under which specialties emerged. It has increasingly come to be recognised that specialisation was not driven by the creation and adoption of tools themselves, but can rather be more fruitfully understood as an expression of broader economic and cultural trends.7 One result of this historiographical insight, however, is that the significance of tool use for early professional and professionalising women themselves has not been considered in any detail. This article re-evaluates the significance accorded technical knowledges and practices in the history of women’s medical professionalisation.8 It does so by identifying a connection between three trends: firstly, an increasing recognition that women were capable of contributing to medical science; secondly, an increasing tendency amongst women to appeal to tools as guarantors of their mental and practical abilities; and thirdly, the emergence of claims to professional status that women began to make. This approach to the question of how women claimed professional status develops the historiography of women’s medical professionalisation in Britain beyond established social interest and class-centred accounts to address experiences that were specific to women medical practitioners as a whole. The adoption and adaptation of tools by women contributed significantly, albeit in subtly different ways, to changing perceptions of women doctors, nurses, masseuses and a range of other professions allied to medicine. In his article, Lawrence suggests that, by and large, it was the anti-technical, gentlemanly side of the debate regarding medical specialisation that most fully accorded with the professionalising aims of women nurses and doctors: women ‘adopted similar standards [to elite generalist physicians], competing with men on their own terms’.9 Much of the literature on women medical practitioners at least tacitly agrees with this suggestion. Women’s medical professionalisation has in many ways rightly been portrayed as the personal achievement of individuals who fought for acknowledgement and recognition in their respective fields by institutional means. In her recent consideration of relations between women doctors and nurses, Vanessa Heggie notes that existing discussions of early professional women in Britain concern ‘the multiple arguments for women’s right—and in some cases obligation—to practice as doctors, the many conflicts between male and female doctors, the tensions between voluntary and paid nurses, and the power struggles on the wards between male doctors and nurses’.10 Although in adding relationships between women doctors and women nurses to this list Heggie presents a more general perspective than many previous accounts, her analysis, like the studies that it cites, is framed in terms of womens’ adherence to established hierarchical distinctions within the medical profession (such as those made between doctors and nurses).11 Examination of the extent to which women medical practitioners actively looked to tools as means of attaining medical authority, I argue, cuts across historical distinctions between medical professionals and the hierarchies implicit to them.12 Taken together, the two examples addressed here demonstrate that women engaged with tools to construct themselves as professionals regardless of their social and economic backgrounds. Further, they also highlight how women medical practitioners’ appropriation of particular tools and techniques influenced the ways in which British men construed themselves as medical practitioners. The holism propounded by medical men who aspired to gentlemanly ideals can in many ways be understood as an effort to maintain a particular and historically highly specific form of gender relation, in which two distinct sexes negotiated their relative dominion over particular spheres of influence. Nor were women professionals’ more enthusiastically specialist male colleagues necessarily opposed to such assumptions.13 This article shows that women medical practitioners adapted medical tools to a wide variety of professional ends. Such adaptation, it suggests, played a significant role in undermining established assumptions regarding the proper places of women and men in medical organisation and practice. This article begins then by setting out the contexts that had the most immediate significance for the lives and careers of women medical practitioners during the late nineteenth century. It highlights the extent to which many of the most prominent medical men and women agreed regarding the organisation of medicine into separate spheres. Subsequently, however, it moves on to consider the extent to which less well-studied women practitioners and investigators participated in the constitution of an alternate medical culture, in which the attribution of authority depended less on one’s character or capacity as an observer, and more on the kinds of tools that were used and the perceived competence of those wielding them.14 Two forms of medical tool feature particularly prominently in the present analysis: microscopes, and devices for creating and applying medical electricity. Examination of the late nineteenth-century status of these demonstrates the wide variety of contexts within which medical technologies such as microscopes, electricity, x-rays and surgical equipment were introduced and utilised. For example, microscopes were primarily a research tool incorporated within elite medical research, whereas electricity-producing devices tended to be used by women medical practitioners who were accorded a lower social status. It will be shown that though microscopes and electricity-producing devices were adopted by women from radically different social backgrounds, women used these tools in similar ways, and to similar ends. Though conventionally associated with elite, research-focused medicine, novel medical devices had just as much significance for those women who found themselves at the lower end of the medical hierarchy as it existed during the latter decades of the nineteenth century. The final part of this paper thereby addresses the significance of women’s adoption of medical tools for the governance of one of the least reputable forms of medical practice at this time: medical massage. Considering how women adopted different kinds of medical tool to professionalising ends indicates the diverse ways in which tool use could unsettle the assumptions regarding gender difference upon which many medical men and women in Britain founded their professional identities. In this latter respect, technology-centred medical practice was not merely impersonal and particularising: it could also subvert established moral codes and mores. The Separate Spheres of Gentlemanly Medicine It is generally acknowledged that the identification of women with a specific set of bodily characteristics became a particularly pervasive means of dismissing their claims to intellectual authority during the nineteenth century. For example, many eighteenth- and early nineteenth-century anatomists and physiologists characterised the activities of the womb as having a profound and debilitating effect on the brain, and hence on the mind.15 Moreover, the eighteenth and early nineteenth centuries were marked by the emergence of an historically highly specific ideal of gender relations. For the then-expanding upper middle class segment of society, ‘gentility’ came to be understood as a mark of social status. The gentleman, in this conception, was responsible for by-and-large public roles such as conducting business, developing friendships with other men, and ensuring the economic well-being of his family. In contrast, gentlewomen were accorded roles as ‘helpmeets’—as organisers of the domestic realm, educators of children, and, where necessary, sick-nurses.16 However, by the 1910s this ‘separate spheres’ model of intellectual and economic relation had begun to show signs of severe strain. By this time the suffrage movement was in full swing, promising to accord women a significant role in public life.17 Other, longer-term trends also contributed to a sense of confusion amongst those who believed that women’s foremost priority should be the domestic sphere. These included the gains that women began to make regarding access to higher education from the 1880 s, re-evaluation of the intellectual status of domestic work, and, significantly for this paper, the emergence of women professionals such as nurses and doctors.18 Many of the leaders of the nineteenth-century movement to train and accredit women medical practitioners did not consider themselves to be challenging the by-then long-established ideal of separate spheres. Although Florence Nightingale advocated nursing and midwifery training, she opposed state registration for nurses, preferring to portray nursing as part of women’s duty to do ‘God’s work in the world’ in both the domestic and medical spheres.19 In the course of arguing for the treatment of patients by women, Sophia Jex-Blake stated that ‘not only is there nothing strange or unnatural in the idea that women are the fit physicians for women, and men for men; but, on the contrary, … it is only custom and habit which blind society to the extreme strangeness and incongruity of any other notion’.20 Elizabeth Blackwell similarly argued that women should train ‘not as specialists, but as the trusted guides and wise counsellors in all that concerns the physical welfare of the family’.21 Such comments are notable in that they took the way women’s realm of authority was apportioned as their focus of critique, rather than the nature of that authority itself. As Antoinette Burton has shown, this approach overlapped with more general concerns regarding the medical administration of Britain and its colonies: if domesticity was defined broadly enough to encompass the ‘home’ nation, appeal to women’s pre-eminence within the domestic realm could be adapted to justify the medical authority of (caucasian, upper- and middle-class) women over (non-caucasian, subaltern) subjects of the British Empire.22 Although they did generally differ regarding the extent to which women should be allotted a realm of authority, many of the most prominent medical men of this time fully agreed with these pioneer professionalisers regarding the differentiation of the sexes. Almost all of those Lawrence cites as adherents of an ‘incommunicable’ medical ideal also contributed to upholding the ideal of separation between medical men and women’s respective spheres. William Bowman corresponded with Nightingale and supported her efforts to introduce training for nurses in his capacity as physician at the Royal London Ophthalmic Hospital, but did not contemplate the possibility that women might be trained as doctors.23 Henry Acland published one of the earliest calls for the organised teaching of nurses, and established a ‘Home for Nurses’ in Oxford as a memorial for his wife Sarah, but limited his support for women doctors to those engaging in missionary work amongst women in India.24 Others, such as Patrick Black, Dyce Duckworth and Octavius Sturges, felt it necessary to uphold the doctrine of separate spheres directly, by literary and oratory means. As part of a discussion of the function of the spleen, Black developed an extended analogy around a romance between ‘male’ blood and ‘female’ veins, in which the two meet in the spleen, and ‘only die by giving birth to countless progeny’.25 Speaking in 1877 and again in 1894 Duckworth was more explicit: I have often advised young women with fitting qualifications, and who seek an active sphere of usefulness, to adopt nursing as a profession, and I have offered this advice without violent prejudice to the adoption of the medical art proper by women. I am, however, free to confess that on this latter point I have but small sympathy … so exactly is sick-nursing a field for female energy, that I regret to find cultivated women expending their powers in a wrong direction, and robbing the ranks of skilled nursing-sisters to form a band of imperfectly trained medical practitioners.26 As well as following Duckworth’s projection of gender roles onto relations between medical professionals, Sturges suggested that patients’ trust in medicine was itself dependent on a particular conception of nursing practice: ‘It is the experience of every Medical man that the relatives of the sick are often averse to obtaining the services of a Nurse, not from distrust of her knowledge, but from fear of her learning, fear lest the wife or the mother should be set aside, and her simple home service superseded in favour of the sterner teachings of science.’27 As Lawrence suggests, a significant overlap existed between the interests of the most prominent representatives of professional women practitioners and the anti-specialist rhetoric of these elite medical gentlemen. What has not been acknowledged, however, is that this overlap was in part motivated by doubts regarding an alternative and to contemporaries far more threatening mode by which women sought medical authority. In this mode, the concern was not with re-drawing or policing the boundaries of men’s and women’s respective spheres of influence, but rather with the possibility that a capacity for medical investigation or practice may not in fact be primarily dependent on one’s individual character or bodily state at all. Although they did not generally enjoy prominence in the formation of medical specialisms (and enjoyed at best ambiguous support from many of the most prominent specialising men), women did engage closely with tools that came to play increasingly significant roles in medical investigation and practice during the latter half of the nineteenth century. This circumstance had important repurcussions regarding the status of women medical practitioners. Whereas women had largely been confined either to collecting and conveying facts and practices ‘discovered’ by men or to anonymously contributing to men’s scientific activities during the first half of the nineteenth century, by 1900 it had become difficult to deny that women were making significant and original contributions to medical sciences. Microscopy and the Appropriation of Scientific Authority by Women The first tool relating to medicine to gain widespread popularity amongst British women was the microscope. In eighteenth- and early nineteenth-century Britain, microscopes had been conceived of as much as a form of amusement as a serious means of discovering the nature of living substances.28 During the 1850s and 1860s, societies such as the Quekett Microscopical Club, The Microscopical Society of London, and even the Worshipful Society of Apothecaries continued this tradition by putting on entertainment events or ‘conversaziones’ to which women were invited.29 The popularity of these events amongst women was unprecedented, and appears to have taken many of the men who founded and participated in microscopy societies by surprise. Soon, debates began to emerge as to whether it was morally acceptable to organise such events. As one advocate of them defensively put it in 1870: The interest manifested by the members, and the satisfaction exhibited by visitors of both sexes, gave no sign of decadence. There was the same sturdy phalanx of members who had their microscope, and something under it, and the same smiling and blooming troop of female friends peeping anxiously down the hundreds of brazen tubes erected for their delectation. The prophecy that these ‘shows’ would soon come to an end, which some crusty antiquarians have been known to utter, seems as far distant as ever.30 Moves to allow women members into the London Society were however voted down, and, by the early 1870 s, microscopical conversaziones were declining in popularity. They should nevertheless be acknowledged as both reflective of and contributory to an expansion of women’s opportunities for engaging with a very particular form of intellectual practice that was emerging at this time: that of tool-centred (if not always ‘specialist’) medical science. Microscopy was taken up by a significant proportion of the British women who published on medical and medicine-related topics between 1860 and 1900.31 These included Alice Marion Hart, whose husband edited the British Medical Journal, New Hospital for Women physician Frances Elizabeth Hoggan, and, significantly, a number of Cambridge-based women students and researchers. The latter included University College London and Newnham College student Florence Eves, who published joint studies with John Langley; Marion Greenwood, who became responsible for training a new generation of women physiologists; Newnham student Rachel Alcock, who became one of Walter Gaskell’s proteges; Florence Buchanan, who would later collaborate with John Burdon Sanderson at Oxford; and Lillian Sheldon and her co-worker Alice Johnson, the latter of whose microscopical studies of newt embryos formed the basis of the first paper by a woman to be published in the Proceedings of the Royal Society.32 It was not the vogue for the instrument alone that appealed to these women: other factors played a more significant role. One was the relatively low cost of obtaining a microscope compared to, for example, developing an anatomical collection, or equipping a physiology laboratory. Another was how easily adaptable microscopic practice was to the domestic environments to which many middle-class women felt themselves restricted.33 Finally, and most significantly, the establishment in mid-nineteenth-century Britain of microscopes as invaluable for the study of organic tissues created opportunities for women to demonstrate their independence and originality as medical investigators in ways that did not rely on appeals to their bodily capacities. Close examination of the research publications of two women microscopists highlights the significance that the tool had begun to hold for some women medical professionals by the early 1880 s. In 1881, despite being reticent on professional matters, Alice Hart (who had been trained at the Laboratoire d’Histologie at the Collège de France) found it necessary to contest a claim that had been made by the physiologist Richard Norris, Professor of Pathology at Queens College Birmingham. Norris had in 1878 claimed to have observed what he described as a new translucent or ‘invisible’ species of blood corpuscle that appeared during the formation of ‘fibrine’ or blood clots.34 In a succinct article contesting his claim, Hart drew on her training to assert that the entities that Norris had seen were simply washed-out red blood corpuscles. What is especially notable about this article, however, is the way in which Hart expressed her views. Rather than deny that Norris had in fact seen his corpuscles, she cast doubt on the means by which he had seen them: Dr Norris discovers, by various means of staining, his invisible corpuscle. That it is there I do not deny, but that it is there because it previously existed in this condition in the blood in the living state is I think open to dispute … the staining agents recommended by Dr. Norris … [are] not sufficiently powerful [to detect the escape of red matter from it].35 In contesting Norris’s claim, Hart was especially careful not to appeal to her own observational capacities, deferring authority to the staining agents used. In removing her bodily self from the debate, she thereby emphasised her judgement regarding the techniques by which the blood might best be investigated, rather than any observational acuity on her own part. Hart confined herself to critiquing Norris’s approach to research rather than proposing her own interpretation of the corpuscles. But that this critique came to be perceived as well made was in no small part due to the prior emergence of a range of original claims by women microscopists during the 1870s.36 For example, in 1876 Frances Hoggan, then one of the most prominent women doctors in Britain, had announced that she had discovered an entirely new process of histological staining.37 Her presentation of this technique, however, had been beset with difficulties. Hoggan had initially sent an article on her process to the British Medical Journal, but the editor of that journal (Hart’s husband, Ernest Hart) had not responded to it. Accounts of the technique had meanwhile mysteriously begun to appear elsewhere in the microscopy press. Hoggan’s 1876 announcement—in the decidedly less reputable Journal of the Quekett Microscopical Club—was accompanied by a denunciation of the practices of the BMJ: Although that paper has been in the hands of the editor of the Journal for the last nine months, it has not been published, but inadequate, and in some cases erroneous, accounts of my process, have largely been circulated. … I have, therefore, considered it advisable to give, as shortly as possible, the details of this very simple and effective process to your Society, whose members will, I doubt not, put it to every sort of test.38 Again, what is of particular note here is that what Hoggan puts in question is not her own visual capacities, but rather the effectiveness of her technique, which (she presumes) will be tried and found useful by Society members regardless of their gender. As Hoggan characterised it, her authority as a microscopist was not dependent on the observational capacities of her mind and body, but on her capabilities as a technical innovator. By characterising investigatory possibilities as inherent in the tools of microscopy, Hart and Hoggan sought to obviate the old critique that their female bodies could not be relied upon to observe nature accurately. Thus, by deploying a technical rhetoric of scientific discovery, these women found a means by which they could gain a particular, historically-specific form of intellectual—if not institutional—authority. Nevertheless, the immediate significance of this development for women who sought professional medical status should not be overestimated. It was in research contexts such as Newnham and Girton colleges at Cambridge, rather than medical institutions such as the New Hospital for Women in London, that women microscopists gained greatest recognition as original investigators.39 For the most prominent proponents of medical professionalism, the study of medicine was an eminently practical endeavour. In their addresses, figures such as Duckworth and Sturges implied that too much ‘technical’ knowledge could cause women to overstep the proper bounds of the medical hierarchy. Most dangerously, this might entail a blurring of the boundaries between the male and female spheres. Despite the tendency of women microscopists to focus on the cultivation of scientific rather than strictly medical identities, it is possible to detect the emergence of tensions amongst women medical professionals regarding reliance on tools during the 1870 s and 1880 s. Claire Brock notes a significant difference of interests at the New Hospital For Women during the late 1880 s, in which Elizabeth Garrett Anderson, as the most prominent surgeon of the institution, sought to retain control over operations performed there. That she did this in opposition to two less well-known colleagues, Louisa Atkins and Mary E. Dowson, who criticised her practices on the basis that her methods were not adequate to the cases that she sought to undertake, speaks to the importance that individual character and judgement was accorded at this time. As Brock notes, Anderson was committed to a vision of surgery in which personal experience was valued over technical skill.40 Although little evidence is available regarding the opinions or practices of Anderson’s above-mentioned colleagues, it is perhaps indicative of the differences between them that Hoggan had resigned from the New Hospital in 1877 for similar reasons to Atkins and Dawson. Furthermore, the hospital’s consulting surgeon William A. Meredith, whose resignation precipitated the later controversy, was also a committed advocate of antiseptic surgery and other then-controversial surgical techniques. As he pointedly commented in an article published shortly after his resignation, ‘The fact that certain operators who formerly used antiseptics now obtain improved results with the help of plain water and the systematic employment of the drainage-tube, by no means convinces me that their present success is entirely due to the alteration in their system of treatment.’41 Whether or not Anderson’s practices at the New Hospital were indeed the target of Meredith’s scepticism, the latter’s enthusiasm regarding Listerian hygiene and other recent surgical developments may well have jarred with the generalist commitments of the former. Vivisection debates constituted another, even more controversial area of potential disagreement amongst women. For many, such practices constituted the absolute limit of appropriate involvement in medical science. Although Hoggan enthusiastically appropriated and adapted techniques of microscopy, as one of the leading figures of the Victoria Street Society she remained vehemently opposed to vivisection. Similarly, as well as contending that women doctors should train ‘not as specialists’, Elizabeth Blackwell denounced the integration of experimental research on animals and medical practice. Yet women did engage in interventionist animal experimentation, even in the face of potential vilification.42 The most famous of these, the American Mary Putnam Jacobi, became the target of significant critical commentary from anti-vivisectionists.43 Most likely aware of Jacobi’s experiences, British women who participated in experimentation with animals retained lower profiles. Little of the experimental work undertaken at the Cambridge Balfour Biological Laboratory for Women appears to have found its way into print.44 Florence Buchanan’s nine years at Oxford assisting John Burdon-Sanderson appear to have passed without attracting controversy, and Sarah Sowton’s later work with Charles S. Sherrington at Liverpool and Oxford remains little commented on even today.45 Nor were Buchanan and Sowton isolated figures by the second decade of the twentieth century.46 For women vivisectionists, the desire to prove their capabilities as experimental investigators predominated over any wish to attain public recognition. Late nineteenth-century women who sought recognition as medical professionals were neither a single, unified group, nor neatly categorisable into distinct professional identities. Rather, individuals and groups found a diverse range of points from which they sought to challenge the established modes of medical organisation and practice. For Nightingale and her followers, training nurses was the ultimate goal of reform—there was no need to form professional organisations or doubt that matters of physiological or surgical intervention should remain the exclusive preserve of professional medical gentlemen. Similarly, Blackwell’s and Jex-Blake’s conceptions of women doctors fed into a widely held assumption that regardless of whether women should be admitted to the established medical societies, their roles must continue to be strictly demarcated. Nevertheless, others began to challenge the assumption that limits should be put on women’s involvement with medical research or practice at this time. For these generally little-acknowledged figures, both genders were ideally joint and equal participants in scientific medical endeavour. Moreover, this latter tendency did not remain confined to the relatively small number of university-trained women. Indeed, use of novel devices became a key site of contention for members of one of the ‘lowest’ grades of the medical hierarchy: that of masseuses. As the remainder of this article details, masseuses who adopted new tools in their practice found themselves at the medical forefront of the more general breakdown in the established ideal of ‘separate spheres’ at the end of the nineteenth century. The Domestic Context of Medical Electricity As already suggested, microscopes were in part important for scientific women because of their compatibility with the domestic environments in which many middle class women found themselves. During the 1880s and 1890s, however, other medical technologies such as x-rays and novel surgical equipment began to gain in both popularity and scientific reputation. Electricity played an important role in these developments, and had particular relevance to domestic settings. With the development of commercially available mechanical devices for inducing a build-up of electric charge, and subsequently of batteries that were both portable and capable of conveying an appreciable ‘constant’ current through patients’ bodies, a new specialism (the medical electrician) had begun to emerge amongst medical men. For women generally denied formal recognition as medical specialists, in contrast, adoption of medical electrical devices and techniques presented opportunities to move beyond the domestic or otherwise exclusively ‘womanly’ contexts to which many felt unduly restricted. For the most part, early medical electricians did not practise in hospitals or other established sites of medical practice. These practitioners frequently took on responsibility for the design and implementation of electricity-producing devices themselves. As might be expected, such tools were expensive to produce, and initially remained the preserve of a small number of medical men. The historiography of medical electricity reflects these origins. Historians have variously discussed the distrust that medical practitioners initially displayed toward electrical devices, disputes over the introduction of medical electricity into hospitals, the marketplace for electrical tools and treatments, and even the constitution of an electrical sexual body.47 However, few attempts have been made to detail women’s role in and responses to the emergence and legitimation of electrical technologies during the nineteenth century.48 The identification of medical electricity and its use with medical and scientific men supports a still-pervasive assumption that women are either naturally less technologically adept, or have historically been less interested in engaging with and developing technical devices.49 Before considering the wider adoption and appropriation of medical electricity by British masseuses, therefore, I shall briefly consider how the incorporation of medical electricity into domestic contexts presented further opportunities for women to construct themselves as original contributors to the development of medical science and practice. Despite the tendency to identify the development and administration of medical electricity with medical men, historians have noted the significance of domestic contexts for its emergence. François Zanetti shows that at least as far as the Parisian context is concerned, medical electricity was initially incorporated into physicians’ homes: a circumstance that posed significant problems for the maintenance of such homes as domestic environments. With the emergence of portable devices during the 1780 s, however, moves were made to limit the extent to which electrical devices could be marketed and employed by accredited medical practitioners.50 By the late nineteenth century, medical electricity had become a distinctly commercial proposition. With this development came a plethora of devices for self-administration in homes. For example, towards the end of the nineteenth century, Cornelius Harness’s London-based Electropathic and Zander Institute offered the services of ‘certified masseuses’ along with a range of portable electrical devices. Although the Institute was discredited during the 1890s, its initial success highlights the attraction that medical electricity had for Victorians.51 Moreover, the increasing availability of high-voltage electricity in (primarily metropolitan) homes presented new possibilities regarding domestic medical electricity application. Thus in 1902 Dr Chrisholm Williams gave lectures to women massage practitioners ‘at his own house, so that the opportunity was afforded of seeing a variety of electrical apparatus … including that used in treatment by means of Electrical Currents of “High Frequency and High Potential”.’52 The increasing affordability of portable devices during the 1880s and 1890s further encouraged women to engage with medical electricity. For some women, this involvement grew into more than either an interest in paying for electrical treatment, or ownership of tools marketed as ‘electrical’: by the early twentieth century, a small number of women had themselves begun to identify as specialist medical electricians. An indication of the significance that electrical technologies could have for women medical practitioners is given by the early career of Margaret M. Sharpe, a relatively wealthy middle-class woman who would later gain recognition as a radiologist.53 Long before developing an interest in X- or ‘Röntgen’ rays, Sharpe had been a committed medical electrician and, after persuading the medical electrical company Isenthal Potzler & Co. to allow her to use the equipment at their establishment in Mortimer Street, had set up a number of high-voltage machines in her own home.54 Indeed, it was only on the basis of her skill in medical electricity that she felt able to venture any thoughts about the potential medical applications of the new rays at all. As she commented in 1900, during a presentation on skin treatments to the members of the Röntgen Society: ‘It is with greatest diffidence that I venture to appear before you this evening to plead the cause of X-ray therapeutics. … I am not a physicist, and I know very little about skin diseases, but I have had ten years’ experience of electro-therapeutics, and that is the only excuse that I can offer for my temerity in rushing in where so many abler and wiser have feared to tread.’55 Indeed, by 1905 Sharpe found herself in a position to substantiate this appeal to electrical experience. Reporting again to Röntgen Society members, she announced a new method of curing ‘chilblains and nævus’ by what she termed ‘a vacuum electrode of my own designing’: It is exhausted to a much higher degree than those usually made for use with the high-frequency current. It gives a bright-green fluorescence even in daylight, gives off no sparks or perceptible brush discharge … I have not heard or read any previous attempt having been made to treat nævi by this method, and this is the first time I have tried it myself; but one might reasonably expect with such conditions as nævi always to obtain similar results, and be free from the element of uncertainty which attends so many of the ‘cures by radiation.’56 Again, just as women microscopists had found in the development and use of the tools of microscopy a means of obviating the supposed observational unreliability of their bodies, in constructing her own medical authority Sharpe appealed not to her bodily or character-dependent skill as a medical practitioner, but rather to a tool of her own devising. Importantly, whereas microscopes were primarily used as instruments of research and diagnosis during the period in question, medical electricity could be employed in medical therapeutics directly. Medical electricity thereby brought questions surrounding technical authority within science directly into contact with the professionalising ideals of many of the most prominent women medical practitioners of this time. During the first decades of the twentieth century, British masseuses found that the incorporation of electrical devices into their practice sat awkwardly with the cultural assumptions that had underpinned their initial foray into professional self-organisation. Electrical Technologies and the Governance of Medical Massage Electrical devices had by 1910 long been a feature of massage practice, and cannot be said to have been a motivation for its initial professionalisation in Britain. Indeed, it was to contemporaries a rather more morally troubling controversy surrounding the use of massage parlours as fronts for houses of prostitution that had led to the formation of the Society of Trained Masseuses in 1895.57 This circumstance, combined with widespread scepticism regarding the therapeutic value of massage amongst Britain’s established medical practitioners, meant that the women who founded the society retained a strong sense that the status of massage as a medical practice depended on strict adherence to the then-prevalent mode of medical organisation. The first and at the turn of the twentieth century most rigorously upheld rule of the society stated: No massage to be undertaken except under Medical direction. No Medical massage for men to be undertaken. Occasional exceptions may be made at a Doctor’s special request for urgent or nursing cases.58 Like the institutional pioneers of professional nursing and midwifery, the early Council of the Society emphasised their continued obedience to (implicitly male) medical authority. Furthermore, as the first rule also indicated, one of the principal rationales for the Society was to ensure that the boundary between male and female medical realms was upheld in relation to patients as well as practitioners. One of the conditions for its incorporation in 1900 was that ‘only those masseuses shall be qualified to be members of the Society who undertake the work of massage of females and children, and that no member shall undertake massage for men except at the special request of a Registered Medical Practitioner in some urgent or nursing case’.59 Indeed, anxiety over what was portrayed as the sexual threat of masseuses was such that London’s St James Vestry for Legislation, part of a Church of England body that had historically had significant influence over state spending, proposed in 1899 that it should be made illegal for any person except a medical practitioner to apply massage or similar treatment to any person of the opposite sex … that both men and women performing such work should possess certificates of efficiency and pass an examination; [and] that all persons performing massage not possessing the necessary certificate of efficiency should be fined £100, or be imprisoned for six months.60 The concerns of the men of the Vestry accorded closely with those of the Council during the Society’s early years. In addition to their moral and institutional conventionality, the rules and beliefs that had been established at the Society’s formation were underpinned by constant reminders that massage was an inherently bodily activity. That is, early leaders of the society and their gentlemen colleagues emphasised not only that massage depended (ideally exclusively) on the use of the hands, but that masseuses should expect to be judged on their physical appearance. In a lecture to the society on the ‘responsibility of the masseuse to the profession’, Gulielma Manley proclaimed that ‘the hands of a masseuse should be of irreproachable aspect, the costume fresh and spotless’.61 In a pointed repost to suggestions that blind people be trained in medical massage, Sir William Bennett proclaimed in a 1902 lecture to the Society that there is ‘no calling in which a “sound mind in a healthy body” is more essential than in that of massage … delicate people and those that suffer from any physical defect are entirely unfit to practice’.62 Many early Society members presumed along with Bennett that masseuses should first and foremost appeal to their bodily state and physical appearance to gain the trust of patients. Nevertheless, the increasing prevalence of medical electricity in massage practice threatened to undermine the bodily, sexually differentiated, hierarchically organised vision of the Society that its council upheld. First, and most obviously, electricity-producing devices displaced the perceived source of medical activity away from the body of the masseuse, and onto a technical object. This meant that instead of a masseuses’ subordinate and docile body, patients were put into contact with a reputedly dangerous force that was under her control.63 As the medical electrician J. Curtis Webb cautioned in a 1910 lecture at the Society on the use of electricity in massage practice: Remember that everyone hates electric shock, and that most people dread electrical treatment. Therefore begin with very weak currents at the first sitting, turn on your current very slowly. Show the patients that you have confidence in yourself and in your apparatus and they will have confidence in you.64 Such comments indicate that the actual experience of receiving massage could be far from the gentle, unthreatening image of womanly medical practice that the Council adhered to. Secondly, the expansion in the number of specialist departments of medical electricity in British hospitals during the 1880s and 1890s contributed to its increasing orthodoxy as a form of medical practice.65 The incorporation of medical electricity into massage both conferred a particular form of authority on the Society, and implied a specific conception of the masseuse as a ‘scientific woman’. By the late nineteenth century, some women’s adoption of this identity, as well as the differing attitude towards gender that accompanied it, threatened to undermine the strict delineation of male and female roles on which its founders had insisted. In June 1905 Annie Manley, then in charge of the educational activities of the Society, announced that the War Office had asked the ISTM to set examinations for their (male) nursing orderlies. As Manley (who herself lectured on the topic) later happily proclaimed:66 It is a matter of some satisfaction … [that] a Society composed entirely of women … has been called upon to conduct an Examination exclusively for men. In a day when some among us are chafing at the disability of women in matters political, in a day when some bodies of men are complaining that we are ousting them from certain callings which they formally monopolised, we are glad to know that here women have not only proved their equality with men, but their superiority, or shall we say, priority in organisation.67 Such comments directly contravened the image cultivated by the founders of the Society as guardians both of existing professional hierarchies, and of established moral and physical boundaries between men and women. Finally, despite the Society’s stipulation that masseuses remain absolutely obedient to their (almost invariably male) medically qualified superiors, electricity introduced a decidedly grey area of medical authority into massage practice. Although physicians in continental Europe, and especially in France and Germany, were reputed to be highly specific in their stipulations for treatment, the cautious attitude of many British doctors to medical technologies often resulted in more vague directions being given.68 One commentator noted that the order given to the masseuse by the doctor is frequently the vague command ‘apply electricity’, and it is accordingly applied in a perfectly haphazard fashion … Lest any should fall into those errors it is imperative that they should spend some time and trouble in understanding the instruments they are dealing with and the disappointment and discomforts to which they may expose their patients.69 In the appropriation of medical electricity by masseuses then, women were encouraged not just to carry out the instructions of medical men, but also to become more knowledgeable than them regarding the technologies that they were required to employ. Between 1911 and 1915, the contradiction between the ISTM’s founding ideal of maintenance of separate spheres, and the increasing importance of technical medical practices that contributed to undermining this ideal, came to a head.70 The problems began when it was reported that one of the most established teachers of massage in the country, Elsie French, had begun handing out certificates for a course on medical electricity stating an ‘MB’ after her name. Following a brief and unsuccessful attempt to find French’s name in the Medical Register, her membership of the Society was rescinded.71 What initially seemed to be a simple matter of a massage teacher appropriating a medical title soon escalated into a full-scale dispute regarding the future direction of the organisation. The following year, French, who was based in Manchester, was found to have begun her own organisation, the Manchester and Northern Counties Incorporated Society for Trained Masseuses and Masseurs. Here, in stark contrast to the policy of the original Society, she offered to teach both men and women together in the same classes.72 Other masseuses came out in support of French’s organisation, claiming that the London-based Society was neglectful of the concerns of ‘provincial’ teachers. Whilst the original, legally incorporated Society sought to contain their Manchester rival, another dispute arose, this time in the capital itself. In 1913 a change in electoral procedure which conveyed greater powers to ordinary members (and thereby made the authority of the original Society founders increasingly contingent on the democratically expressed opinions of members as a whole) had allowed two of the most prominent members of the Society—Miss Scammell and Miss Bedingfield—to gain seats on its Council.73 These women’s reputation as leaders of their field was in part based on their collaboration with the pioneer of medical electricity use in Middlesex hospital, Mr C. R. C. Lyster.74 Despite (or possibly because) of this circumstance, it was subsequently decided by the Council that pupils of the school of which they were joint owners would not be admitted for examination in ‘Swedish Remedial Exercises’. Scammel and Bedingfield, according to the Council, had not allocated enough time for their students to be trained by a qualified teacher.75 A series of claims and counter-claims ensued over the next two and a half years, which resulted in compensation being paid to the pair for loss of earnings, a continued refusal to admit their students for examination, and their subsequent resignation from the Society. By the end of 1914 another prominent Society member had had enough of such conflicts, and resigned. Rather than identify the intransigence of Society members as the source of its problems, Kathleen Marriott Fox emphasised what she portrayed as the undemocratic practices of its Council. In her letter of resignation, published in the British Journal of Nursing, Fox admonished the Council regarding how it ‘rules the Society, that is to say whilst ostensibly consulting its members, really acting on a course of action previously decided upon’.76 Further, the British Journal itself called on the Society to ensure that any national legislative body of masseuses was ‘composed of direct representatives, elected by members of the profession to be governed’.77 Such critiques apportioned blame for the controversies not with individual Society members, but rather the organisation of the Council itself. It was not just the careers of individual masseuses that were at stake in the disputes that surrounded the Society during the early 1910 s. Indeed, the general status of massage as a medical practice was in question. Calls for the Society to become a more avowedly democratic organisation implied that a section of the membership at the very least felt that their concerns were not being heard by the Council. For its own part, the Council believed that they were merely upholding the principles of the Society as they had been set down at its foundation in 1895 and again in 1900. Whether an individual found themselves on one or another side of this dispute depended to a great extent on the attitude that they took towards the role of electricity-producing devices in massage practice. As medical electricity began to develop into a recognised medical specialism during the early twentieth century, the technical knowledge that masseuses—who it should not be forgotten came well below nurses in the established hierarchy of medical practitioners—had been required to acquire as medical subordinates placed them in a position of increasing scientific authority. The Council of the Society of Trained Masseuses had been formed to uphold the dignity and medical status of massage. To do so, they had introduced strict rules regarding the conduct of massage and the policing of boundaries between genders. The appropriation of electricity-producing devices by masseuses wishing to attain greater recognition within the profession more generally had the notable effect of blurring such boundaries. It is then not surprising that conflicts arose between the established members of the council and a new, more technically-committed group of women by the second decade of the twentieth century. The calls for the democratisation of the Society that emerged in 1914 were not simply immediate responses to the exclusion of certain participants from it. They also reflected long-emerging differences of opinion and approach amongst women medical practitioners more generally regarding the most appropriate means of attaining recognition for their contributions to medicine. Campaigns to establish the professional credibility of women practitioners depended in great part on the organisational and rhetorical efforts of their most prominent participants. However, another very different, and hitherto little commented-on route to medical recognition was pursued by many of their less socially prominent colleagues. In addition to the well-known organisational and institutional means by which women practitioners achieved acknowledgement and recognition, these women pioneered tool-centred routes to professional legitimation. Conclusion It should not be presumed that the conflicting concerns that can be discerned amongst Britain’s medical men during the late nineteenth and early twentieth centuries can be directly mapped onto the concerns of women medical practitioners. In concentrating on the extent to which women practitioners engaged with medical technologies, and the differences of opinion that such engagement could lead to, this article has left the ways these women sought to resolve disputes amongst themselves unaddressed. There is some evidence to indicate that such disagreements could lead women into conflicts that were just as damaging to the unity of their social and professional groups as those their male colleagues engaged in. Thus Garrett Anderson’s colleagues’ disagreement over her surgical practices resulted in their permanent departure from the New Hospital for Women.78 However, it should also be noted that in some instances at least, reconciliation between opposing camps came to play at least as important a role for the attainment of professional status as did the maintenance of one or another position. The above-described disputes at the Incorporated Society of Trained Masseuses precipitated an enquiry from it regarding the possibility of it being accorded Chartered status. Although initially intended as a means of subverting any claims to equivalence by its Manchester-based rival, the Society’s Charter was eventually granted once the two competing organisations found enough common ground to re-merge.79 In this case then, the attainment of greater professional authority was achieved in part through re-unification rather than the professional differentiation that has generally been associated with tool-centred medicine.80 Women practitioners experienced very different social and economic conditions than did medical men, and were less likely to possess resources with which they might forge separate identities to their colleagues. Under such circumstances, compromise and collaboration appear to have come to be valued at least as much as the assertion of difference and individual expression. Given the importance for professionalising women practitioners of presenting a unified front regarding their collective aims, it is understandable that the earliest historical accounts of the attainment of professional recognition emphasised institutional gains over technical achievements.81 One consequence of this emphasis has however been that those responsible for the latter have received comparatively little attention from historians of medicine. This is all the more unfortunate given that it was these women who were chiefly responsible for demonstrating women’s equal capacity for original medical research as well as practice. More extensive consideration of the degree to which women engaged with tools not addressed here in detail, such as x-ray-producing devices and equipment for physiological experiment and surgical intervention, would contribute to the construction of a more nuanced conception of women’s attainment of professional recognition during the nineteenth and twentieth centuries.82 By writing women who engaged with medical devices back into medical history, we can better appreciate both the complexity and the variety of the challenges that all women medical practitioners experienced at this time, as well as the determination and creativity with which such challenges were confronted. Acknowledgements I am very grateful to Jen Wallis and Sally Frampton for providing critical advice and support during the composition of this article, as well as to the invaluable encouragement of Helga Satzinger during the initial stages of its research. I am also much indebted to the two anonymous referees, whose careful attention improved the text considerably. Finally, I would like to thank all at the Wellcome Library (London) for their longstanding patience regarding and assistance with my invesigative efforts. Footnotes 1 Lorraine Daston and Peter Galison, Objectivity (New York: Zone Books, 2007), 115–90. 2 Anne Clendinning, Demons of Domesticity: Women and the English Gas Industry (Aldershot: Ashgate, 2004); Graeme Gooday, Domesticating Electricity: Technology, Uncertainty, and Gender (London: Pickering and Chatto, 2008). 3 See however Ornella Moscucci, ‘“The Ineffable Freemasonry of Sex”: Feminist Surgeons and the Establishment of Radiotherapy in Early Twentieth Century Britain’, Bulletin of the History of Medicine, 2007, 81, 139–63. It should be noted that the status of terms such as ‘tool’ and ‘technology’ in historical analysis remain contested. In this article I aim to avoid some of the more serious pitfalls associated with use of the term by referring to specific kinds of devices, and substituting specific terms such as ‘tool’ and ‘device’ for more general terms such as ‘technology’ wherever possible. On the status of technology in gender history, see Judith A. McGaw, ‘No passive victims, no separate spheres: a feminist perspective on technology’s history’, in Stephen H. Cutcliffe and Robert C. Post, eds, In Context: History and the History of Technology (Bethlehem, London and Toronto: Lehigh University Press, 1989), 172–91. For an overview of recent gender and technology studies research see Judy Wajcman, ‘Feminist Theories of Technology’, Cambridge Journal of Economics, 2010, 34, 143–52. 4 Studies with particular relevance to this paper include Glenn Gritz and Arnold Arluke, The Making of Rehabilitation: A Political Economy of Medical Specialization (Berkeley: University of California Press, 1984), esp. 15–37; Joel D. Howell, Technology in the Hospital: Transforming Patient Care in the Early Twentieth Century (Baltimore and London: Johns Hopkins University Press, 1995); Thomas Schlich, ‘“The days of brilliancy are past”: Skill, Styles and the Changing Rules of Surgical Performance, ca. 1820–1920’, Medical History, 2015, 59, 379–403. 5 Christopher Lawrence, ‘Incommunicable Knowledge: Science, Technology and the Clinical Art in Britain’, Journal of Contemporary History, 1985, 20, 503–20; Roger Cooter and Steve Sturdy, ‘Science, Scientific Management, and the Transformation of Medicine in Britain c. 1870–1950’, History of Science, 1998, 36, 421–66; Steve Sturdy, ‘Looking for Trouble: Medical Science and Clinical Practice in the Historiography of Modern Medicine’, Social History of Medicine, 2011, 24, 739–57. 6 Lawrence, ‘Incommunicable knowledge’. 7 Major studies addressing the British context include (though are by no means limited to) Rosemary Stevens, Medical Practice in Modern England: The Impact of Specialization and State Medicine (New Haven, CT and London: Yale University Press, 1966); Lindsay Granshaw, St. Mark’s Hospital, London: A Social History of A Specialist Hospital (London: Hollen Street Press, 1985); Roger Cooter, Surgery and Society in Peace and War: Orthopaedics and the Organization of Modern Medicine (Basingstoke and London: Macmillan, 1993); Christopher Lawrence and George Weisz, eds, Greater than the Parts: Holism in Biomedicine, 1920–1950 (New York: Oxford University Press, 1998); Christopher Lawrence, Rockefeller Money, the Laboratory and Medicine in Edinburgh 1919–1930: New Science in an Old Country (Rochester: University of Rochester Press, 2005); George Weisz, Divide and Conquer: A Comparative History of Medical Specialization (Oxford: University Press, 2006); Steven Casper, The Neurologists: A History of a Medical Specialism in Modern Britain (Manchester: Manchester University Press, 2014). For an in-depth critical appraisal of Lawrence’s conclusions as far as they concern two British hospitals see Rosemary Wall, Bacteria in Britain, 1880–1939 (London: Pickering & Chatto, 2013). 8 I use the phrase ‘women medical practitioners’ rather than ‘medical women’ in this article, as the latter was used to refer to women doctors rather than any other practitioner in the period in question. I would like to thank one of the anonymous reviewers of this article for drawing this to my attention. 9 Lawrence, ‘Incommunicable knowledge’, 508. 10 Vanessa Heggie, ‘Women Doctors and Lady Nurses: Class, Education, and the Professional Victorian Woman’, Bulletin of the History of Medicine, 2015, 89, 267–92, on 268–9. 11 Recent studies in this mode include Laura Kelly, Irish Women in Medicine: Origins, Education, Careers (Manchester and New York: Manchester University Press, 2012) and M. Anne Crowther and Margurite W. Dupree, Medical Lives in the Age of Surgical Revolution (Cambridge: Cambridge University Press, 2007), 152–75. Heggie, ‘Women Doctors’ notes further studies in this vein. 12 A significant exception is Claire Brock, ‘Surgical Controversy at the New Hospital for Women, 1872–1892’, Social History of Medicine, 2011, 24, 608–23. On the importance of technology for women within science more generally at this time see Claire G. Jones, Femininity, Mathematics and Science, c.1880–1914 (Basingstoke: Palgrave Macmillan, 2009), esp. 175–204. There is a much wider literature on women’s contemporary engagements with medical technologies as consumers and patients. See e.g. Rachel P. Maines, The Technology of Orgasm: “Hysteria,” the Vibrator, and Women’s Sexual Satisfaction (Baltimore and London: Johns Hopkins University Press, 1999) and Lisa Cartwright, Screening the Body: Tracing Medicine’s Visual Culture (Minneapolis and London: University of Minnesota Press, 1995), 143–70. 13 Thus Anders Ottoson argues that in the face of the identification of medical massage with women medical practitioners, the most intimate massage techniques practised on women at this time were incorporated into a specialism (gynaecology) that maintained a specifically male dominion over medical practice: Anders Ottoson, ‘The Age of Scientific Gynaecological Masseurs: ‘Non-intrusive’ Male Hands, Female Intimacy, and Women’s Health around 1900’, Social History of Medicine, 2016, 29, 802–28. 14 Note especially Schlich, “The days of brilliancy are past” in this regard. On the constitution of this culture within science more generally see Theodore M. Porter, ‘How Science Became Technical’, Isis, 2009, 100, 292–309. 15 Londa Schiebinger Nature’s Body: Gender in the Making of Modern Science (Boston, MA: Beacon Press, 1993); Thomas Laqueur, Making Sex: Body and Gender from the Greeks to Freud (Cambridge, MA: Harvard University Press, 1990). 16 Leonore Davidoff and Catherine Hall, Family Fortunes: Men and Women of the English Middle Class, 1780–1850 (Chicago and London: University of Chicago Press, 1987), 397–401 and 445–9. 17 On women doctors’ involvement with the suffrage movement see J. F. Geddes, ‘The Doctors’ Dilemma: Medical Women and the British Suffrage Movement’, Women’s History Review, 2009, 18, 203–18. 18 British women’s efforts to attain medical education in higher institutions of learning are detailed in Thomas Neville Bonner, To the Ends of the Earth: Women’s Search for Education in Medicine (Cambridge, MA and London: Harvard University Press, 1992). See also Elaine Thompson, ‘Physiology, Hygiene and the Entry of Women to the Medical Profession’, Studies in History and Philosophy of the Biomedical Sciences, 2001, 32, 105–26 for the generalist education of early women doctors in Edinburgh. On the intellectual status of domestic work, see Nancy L. Blakestad, ‘King’s College of Household and Social Science and the Origins of Dietetics Education’, in David Smith, ed., Nutrition in Britain: Science, Scientists and Politics in the Twentieth Century (Abingdon: Routledge, 1997), 75–98; Elizabeth Bird, ‘High Class Cookery”: Gender, Status and Domestic Subjects, 1890–1930’, Gender and Education, 1998, 10, 117–31. 19 Lynn MacDonald, Florence Nightingale at First Hand (London: Continuum, 2010), 47–51 and 128–9. 20 Sophia Jex-Blake, Medical Women: A Thesis and a History (Edinburgh: Oliphant, Anderson & Ferrier, 1886 [1872]), 7. Other readings of these figures are of course possible. For a study that emphasises the differences between Nightingale and Jex-Blake see Anne Crowther, ‘Why Women Should be Nurses and not Doctors’, Women in Medicine Magazine, http://www.womeninmedicinemagazine.com/profile-of-women-in-medicine/why-women-should-be-nurses-and-not-doctors. Accessed 8 May 2017. 21 Elizabeth Blackwell, The Influence of Women in the Profession of Medicine: Address Given at the Opening of the Winter Session of the London School of Medicine for Women (London: George Bell and Sons, 1889), 27. 22 Antoinette Burton, ‘Contesting the Zenana: The Mission to Make “lady doctors for India”, 1874–1885’, The Journal of British Studies, 1996, 35, 368–97. 23 Zachary Cope, Florence Nightingale and the Doctors (Museum Press: London, 1958), 142–3. 24 Henry Acland, District Nurses. Substances of Remarks Made by Desire at the Church Congress at Reading, 1883 (London: J. Masters & Co., 1883), 1. 25 Patrick Black, Essay on the Use of the Spleen, with an Episode of the Spleen’s Marriage: A Physiological Love Story (London: Smith, Elder, & Co., 1878), 38–41. 26 Dyce Duckworth, Sick-Nursing Essentially a Woman’s Mission: Being the Inaugural Lecture for the Qualifications for and the Conduct of Sick-Nurses (London: Longman’s, Green & Co., 1877), 11. 27 Octavius Sturges, ‘Nurses and Doctors: An Address to the British Nurses’ Association’, The Nursing Record, 28 March 1889, 2, 197–9 and 4 April 1889, 2, 213–215, 197–8. 28 Barbara M. Stafford, ‘Images of Ambiguity, Eighteenth-century Microscopy and the Neither/Nor’, in David Miller and Peter H. Reill, eds, Visions of Empire: Voyages, Botany, and Representations of Nature (Cambridge: Cambridge University Press, 1997), 230–57; Marjorie Nicolson, ‘The Microscope and English Imagination’, Smith College Studies in Modern Langages, 1935, 16, esp. 37–49. 29 Ruth Richardson, ‘Microscopical Conversaziones’, The Lancet, 2001, 358, 2004. On conversaziones more generally at this time see John Plunkett and Jill A. Sullivan, ‘Fetes, Bazaars and Conversaziones: Science, Entertainment, and Local Civic Elites’, in Joe Kember, Jill A. Sullivan and John Plunkett, eds, Popular Exhibitions, Science and Showmanship, 1840–-1910 (London: Pickering & Chatto, 2012), 41–60 and esp. 52–3 on microscopy at such events. 30 ‘The Soirée’, The Journal of the Quekett Microscopical Club, 1870–71, 2, 185. 31 Mary M. Creese, Ladies in the Laboratory? American and British Women in Science, 1800–1900: A Survey of their Contributions to Research (Lanham, MD and London: The Scarecrow Press, 1998); Marsha L. Richmond, ‘“A lab of one’s own”: the Balfour Biological Laboratory for Women at Cambridge University, 1884–1914’, Isis, 1997, 88, 422–55. 32 Alice Johnson, ‘On the Changes and Ultimate Fate of the Blastopore of the Newt (Triton cristatus)’, Proceedings of the Royal Society of London, 1884, 37, 65–6. Discussion of scientific activities of all of these figures can be found in Creese, Ladies in the Laboratory?), 109–10, 147–9 and 151. The Cambridge context is discussed in Richmond, “A lab of one’s own”. 33 For example, George Eliot drew on domestic microscopy in composing Middlemarch (published 1871–72): Mark Wormald, ‘Microscopy and Semiotic in Middlemarch’, Nineteenth-Century Literature, 1996, 50, 501–24. 34 Richard Norris, On the Physiology and Pathology of the Blood: Comprising the Origins, Mode of Development, Pathological and Post-mortem Changes of its Morphological Elements in Mammalian and Oviparous Vertebrates (London: Smith, Elder, & Co., 1882), xxii–xxxv. 35 Alice Hart, ‘Note on the Formation of Fibrine’, Quarterly Journal of Microscopical Science, 1882, 22, 255–9, on 255. 36 J. Lockhart Gibson, ‘On the “invisible blood corpuscle” of Norris’, Journal of Anatomy and Physiology, 1884, 18, 393–9. 37 Frances Elizabeth Hoggan, ‘On a New Process of Histological Staining’, The Journal of the Quekett Microscopical Club, 1874–1877, 4, 180–1. Hoggan’s career is detailed in Onfel Thomas, Frances Elizabeth Hoggan 1843–1927 (Newport: R.H. Johns Ltd., c. 1970). 38 Hoggan, ‘On a New Process’, 180–1. 39 Richmond, “A lab of one”s own’. On the specific challenges women faced in relation to the conduct of laboratory science more generally at this time see Jones, Femininity, Mathematics and Science, 117–42. 40 Brock, ‘Surgical Controversy’, esp. 610–11 and 614–20. 41 William A. Meredith, ‘Remarks on Some Points Affecting the Mortality of Abdominal Section. With Tables of Cases’, Medico-Chirurgical Transactions, 1889, 73, 31–56, on 32–3. 42 Mary Ann Elston, ‘Women and Anti-vivisection in Victorian England’, in Nicolaas A. Rupke, Vivisection in Historical Perspective (London and New York: Routledge, 1987) 259–94, on 277–8 and 282–6. 43 Carla Bittel, Mary Putnam Jacobi and the Politics of Medicine in Nineteenth-Century America (Chapel Hill: University of North Carolina Press, 2009), 195–204. 44 For references to the equipment in use at the Balfour Laboratory see ‘Order-Book of the Cambridge Scientific Instrument Company (1880–1884)’, Cambridge Scientific Instrument Company: Records and Papers (GB 12 MS.CSIC), Cambridge University Library (Manuscripts), Box 5. e.g. ff. 148, 150, and 158. 45 Laboratory notes by Sowton are held at the Department of Physiology, Anatomy and Genetics, University of Oxford. 46 Tilly Tansey, ‘Women and the Early Journal of Physiology’, The Journal of Physiology, 2015, 593, 347–50. 47 Iwan Morus, ‘Marketing the Machine: The Construction of Electrotherapeutics as a Viable Medicine in early Victorian England’, Medical History, 1992, 36, 34–52; Paula Bertucci and Giuliano Pancaldi, eds, Electric Bodies: Episodes in the History of Medical Electricity, Bologna Studies in History of Science, 9 (University of Bologna; Bologna, 2001); Lori Loeb, ‘Consumerism and Commercial Electrotherapy: The Medical Battery Company in Nineteenth-century London’, Journal of Victorian Culture, 1999, 4, 252–75; Iwan Morus, ‘Bodily Disciplines and Disciplined Bodies: Instruments, Skills and Victorian Electrotherapeutics’, Social History of Medicine, 2006, 19, 241–59; Takahiro Ueyama, Health in the Marketplace: Professionalism, Therapeutic Desires, and Medical Commodification in Late-Victorian London (Palo Alto, CA: Society for the Promotion of Science and Scholarship, 2010). 48 Literature addressing Ada Lovelace and Hertha Ayrton’s engagements with electrical devices are exceptions. See respectively Iwan Morus, Shocking Bodies: Life, Death and Electricity in Victorian England (Stroud: The History Press, 2011), 58–101, and Jones, Femininity, Mathematics and Science, esp. 67–92. 49 McGaw, ‘No passive victims’. 50 François Zanetti, ‘Curing with Machines: Medical Electricity in Eighteenth-century Paris’, Technology and Culture, 2013, 54, 503–30, on 513–23. 51 Loeb, ‘Consumerism and Commercial Electrotherapy’, 257–64; Ueyama, Health in the Marketplace, 191–8. 52 ‘On the General Uses of Electricity in Medicine’, Nursing Notes, Aug. 1902, 15, 105–6 on 105. 53 Creese, Ladies, 174. 54 Margaret M. Sharpe, ‘The x-ray Treatment of Skin Diseases’, Archives of the Röentgen Ray, 1900, 4, 52–60, on 53. Sharpe was not the only woman to move from electrotherapy to x-ray therapeutics at this time. See Jean M. Guy, ‘Edith (1869–1938) and Florence (1870–1932) Stoney, two Irish sisters and their contribution to radiology during the World War I’, Journal of Medical Biography, 2013, 21, 100–7, esp. 104. 55 Sharpe, ‘The x-ray Treatment’, 52. 56 Margaret M. Sharpe, ‘High-frequency Currents in the Treatment of Chilblains and Naevus’, Archives of the Röentgen Ray, 1905, 9, 50. 57 David A. Nichols and Julianne Cheek, ‘Physiotherapy and the Shadow of Prostitution: The Society of Trained Masseuses and the Massage Scandals of 1894’, Social Science and Medicine, 2006, 62, 2336–48; Ueyama, Health in the Marketplace, 227–77. The history of the Society is related in Jean Barclay, In Good Hands: The History of the Chartered Society of Physiotherapy, 1894–1994 (Oxford: Butterworth-Heinemann, 1994). On women’s authority as massage and physiotherapy practitioners during and after the First World War see Beth Linker, War’s Waste: Rehabilitation in World War I America (Chicago and London: University of Chicago Press, 2011), 61–78 and Ana Carden-Coyne, ‘Painful Bodies and Brutal Women: Remedial Massage, Gender Relations and Cultural Agency in Britain’s Military Hospitals, 1914–1918’, Journal of War & Culture Studies, 2008, 1, 139–58. 58 ‘Massage Notes: The Society of Trained Masseuses’, Nursing Notes, March 1895, 8, 37–8, on 37. 59 ‘The Society of Trained Masseuses: Incorporation of the Society’, Nursing Notes, 1900, 13, 100–1, on 101. It appears that before around 1905, men were in general either not considered appropriate candidates for medical massage, or recieved such treatment from non-specialist male medical practitioners. For the later introduction of massage in the treatment of soldiers see below and Linker, War’s Waste. 60 ‘Massage Establishments’, Nursing Notes, Jan. 1899, 12, 10. 61 [Gulielma Manley], ‘The Responsibility of the Masseuse to the Profession’, Nursing Notes, Aug. 1902, 15, 105–6 on 105. 62 William H. Bennett, An Address on Some Points Relating to Massage (London: John Bahle, Sons & Danielsson, Ltd., 1902), 8–9, quote on 8. See also John Kearsley Mitchell, ‘Massage’, in Thomas Clifford Allbutt, ed., A System of Medicine (London: Macmillan and Co., 1896), 373–85 esp. 374. 63 On the dangers associated with electricity at this time see Gooday, Domesticating Electricity, 61–89. 64 J. Curtis Webb ‘A Few Points on Electricity for Masseuses and Nurses’, Nursing Notes, April 1910, 23, 59–62, 83–4 and 112–14, on 83. 65 Ueyama, Health in the Marketplace, 170–226; Howell, Technology in the Hospital, esp. 30–68. 66 For Manley’s lecture, see Annie Manley, ‘The Curriculum Necessary for a Masseuse’, Nursing Notes, Aug. 1901, 14, 107. 67 Annie Manley, ‘Incorporated Society of Masseuses: Massage’, Nursing Notes, June 1910, 23, 154–6 and July 1910, 23, 179–182, on 180. 68 For British perceptions of attitudes in continental Europe, see [Lucy M. Robinson], ‘Massage in 1902’, Nursing Notes, Nov. 1902, 15, 146–7. 69 C.N.S., ‘Concerning electricity’, Nursing Notes, Oct. 1898, 11, 137–8, on 137. 70 Barclay, In Good Hands, 36–8. These disputes (detailed below) precipitated the formation of an ‘Emergency Committee’ of Society Council members. See Emergency Committee Minutes of the Incorporated Society of Trained Masseuses, May 1910–July 1917, Wellcome Library SA/CSP/B.1/2/1. 71 ‘Executive Committee Meeting, May 13, 1910’, ‘Council Meeting, March 10, 1911’, ‘Special Committee Meeting, April 25, 1911’ Minutes of Council of the Incorporated Society of Trained Masseuses, 1909–1913. Wellcome Library SA/CSP/B.1/1/8. (ff. 43, 63, 69). 72 ‘Council Meeting, Sept. 22, 1911’, ‘Council Meeting, Oct. 13, 1911’, ‘Executive Committee, May 10, 1912’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1909–1913. Wellcome Library SA/CSP/B.1/1/8. (ff. 78, 81, 102). 73 ‘Annual Meeting, March 14, 1913’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1913–1915. Wellcome Library SA/CSP/B.1/1/9. 74 Barclay, In Good Hands, 36–7; ‘Special Council Meeting, Dec. 12 1913’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1913–1915. Wellcome Library SA/CSP/B.1/1/9. 75 ‘Special Council Meeting, April 29 1913’ and ‘Council Meeting, Oct 10, 1913’, ‘Special Council, April 28 1914’, Minutes of Council of the Incorporated Society of Trained Masseuses, 1913–1915. Wellcome Library SA/CSP/B.1/1/9. 76 ‘The Organisation of the Profession of Massage, The British Journal of Nursing, 6 March 1915, 54, 195–8. 77 ‘Editorial’, The British Journal of Nursing, March 20 1915, 54, 225. 78 Brock, ‘Surgical Controversy’, 616–20. 79 Barclay, In Good Hands, 36, 52–4 and 70–1. 80 Such a conclusion would complement Sturdy’s contention that disputes amongst specialist and generalist medical men have been over-stated. See Sturdy, ‘Looking for Trouble’. 81 Jex-Blake, Medical Women; Elizabeth Blackwell, Pioneer Work in Opening the Medical Profession to Women: Autobiographical Sketches (New York: Schocken, 1977 [1914]); E. Moberly Bell, Storming the Citadel: The Rise of the Woman Doctor (London: Constable & Co., 1953). 82 On the slightly later significance of radiology for women medical practitioners see Moscucci, ‘The Ineffable Freemasonry of Sex’. © The Author(s) 2018. Published by Oxford University Press on behalf of the Society for the Social History of Medicine. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)

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Social History of MedicineOxford University Press

Published: Mar 19, 2018

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