Come with me into the graveyard, all human life is here

Category: Medics

Elizabeth Garrett Anderson, and 164,440 other members of the GMC

Just in time for International Women’s Day on 8th March an article in The Guardian newspaper cited figures produced by the General Medical Council revealing that, with 164,440 women licensed to practise medicine in the United Kingdom, the number of female doctors had for the first time exceeded the number of males. Women now make up 50.04% of the nation’s doctors.

In 1865 there was only one female doctor on the medical register of the GMC: Elizabeth Garrett.

Born in 1836, Elizabeth Garrett had been educated at home and at a private boarding school for girls. She recorded her dissatisfaction with both her governess and her teachers, complaining particularly of the absence of science and maths teaching, although her sisters remembered that they received a sound grounding in literature and languages. After school and a tour abroad, Elizabeth returned home where for nine years she pursued her own studies alongside her domestic duties.

In 1859 she met Elizabeth Blackwell, the first woman to qualify as a medical doctor in the USA. Blackwell was in London to give a series of lectures on “Medicine as a Profession for Ladies.” In a biography of her mother Louisa Garrett Anderson describes a conversation a year later between her mother, her mother’s younger sister, Millicent Garrett, and their friend Emily Davies. She quotes Davies:

It is clear what has to be done. I must devote myself to higher education, while you (Elizabeth) open the medical profession to women. After these things are done, we must see about getting the vote. You are younger than we are Millie, so you must attend to that.*

The conversation may be apocryphal, but Emily Davies went on to establish and become Mistress of Girton College, Cambridge for women students, while Millicent Garrett Fawcett led the National Union of Women’s Suffrage Societies between 1897 and 1919.

Elizabeth Garrett faced implacable opposition from the British medical establishment, but she had several advantages on her side: she was clever and determined, she came from a wealthy family, and her father, a successful businessman in Suffolk, was unusually supportive of his daughters’ education and of their aspirations.

Unable, as a female, to enrol at a British medical school Elizabeth took up a position as a surgery nurse at Middlesex hospital. Despite protests from the male students, she was permitted to use the dissecting room and to attend chemistry lectures. With financial support from her father, she employed a tutor to mentor her in anatomy and physiology, securing certificates in those subjects along with chemistry and pharmacy.

Despite this evidence of her commitment and ability, the medical schools continued to reject her applications.

Undeterred, Garrett continued to study with private tutors and professors, and applied to the Worshipful Company of Apothecaries seeking to exploit a loophole in their charter preventing them from excluding students from their examinations on the grounds of sex. Nonetheless they did attempt to reject her application, backing down only when her father threatened to sue them. In 1865 Elizabeth Garrett obtained her licence from the Company. Though not a medical degree, the licence did qualify her to practise medicine, and her name appeared on the register of the GMC. The Worshipful Company took immediate steps to amend their regulations, disallowing anyone privately educated from sitting their examinations in the future.

Yet though she was now qualified Garrett could still not, as a woman, hold a post in any hospital. This time her father’s backing enabled her to open her own practice and a dispensary for women and children which became The New Hospital for Women and Children.

In 1870 she finally obtained a full medical degree from the faculty of medicine in Paris which was beginning to admit women.

Members of the medical patriarchy did their best to discourage other women from following her example. In 1874 the psychiatrist Henry Maudsley claimed that education for women led to over exertion which would reduce their reproductive capacity and render them liable to nervous and mental disorders.** Edward Hammond Clarke asserted that:

Higher education in women produces monstrous brains and puny bodies, abnormally active cerebration and abnormally weak digestion, flowing thought and constipated bowels.***

According to these physicians the trinity of menstruation, pregnancy and menopause rendered women frail, unstable and unsuitable for public life.

Garrett responded that the danger for women came not from education but from boredom in the home.

In 1874 Elizabeth Garrett Anderson (she had married in 1871) cofounded the London School of Medicine for Women (later the Royal Free Hospital School of Medicine) where she lectured. Here women were prepared for the medical degree of London University whose examinations were opened to them from 1877.

Garrett Anderson retired to her old family home Alde House, in Aldeburgh in 1902. She is buried in the family grave in the churchyard of Saint Peter and Saint Paul.

Family grave of the Anderson family, SS Peter and Paul, Aldeburgh
Newton and Louisa Anderson, Elizabeth’s parents, and some of her eleven siblings are buried here
Elizabeth Garrett Anderson MD
Memorial in the church

While lauding the achievements of Elizabeth Garrett Anderson and the other early pioneers, I had reservations about the triumphalist tone of the newspaper article: it seemed an old and long settled battle to be reviving. But days later a letter appeared in the same newspaper from an emeritus professor at St. George’s Hospital Medical School describing a study he had published with a colleague in 1985 showing that secret quotas still existed in all the London medical schools limiting the number of women admitted to study medicine. The use of discriminatory practices only ceased in the UK in 1988 as a result of this study. **** Not such an old battle then, and as Professor Collier points out, it still took forty years to achieve today’s gender balance.

*Louisa Garrett Anderson, Elizabeth Garrett Anderson:1836-1917, Faber and Faber, 1939

**Henry Maudsley, Sex in Mind and Education, Fortnightly Review, Volume 15, April 1874

***Edward Hammond Clarke, Sex and Education, 1875

****Joe Collier, Guardian letters page, 10 March 2025

Jenner, Jesty, Mary Wortley Montagu and Blossom

“ I have had my fifth Covid jab as I am immunocompromised,” read a text from my friend, “they can call me whatever they want as long as I am jabbed, jabbed, jabbed.” “ I had pneumonia with my flu jab last autumn,” I countered, but I was outclassed. “Doesn’t cut the mustard,” came the reply “fifth Covid trumps pneumonia.” My friend and I embrace our vaccinations; we belong to the fortunate generation who until recently took for granted the protection afforded to us throughout our lives by vaccines. I have no memory of receiving my smallpox, polio, and diphtheria inoculations but I remember  the sepia photograph on my grandparents’ bedroom wall of a seven-year-old boy in a sailor suit, their son who had died of diphtheria,  and the  two slightly older children in my primary school who wore callipers having contracted polio. Neither disease ever posed a threat to me. In our teenage years when my school friends and I received our BCG vaccinations we gave little thought to  tuberculosis but  speculated enthusiastically on whether our crocodiling from school to the clinic and back might involve missing maths or Latin. Personally, I hoped to miss games, but this was not a popular view. In adulthood  vaccinations  ensured my safety on holidays: typhoid, hepatitis and cholera became routine, immunisation against yellow fever spoke of exotic destinations.

The Covid pandemic  shook my complacency breaching the defences of my protected, inoculated western world, and I was afraid. When in December 2020 Margaret Keenan received the first licensed vaccine against Covid, developed by Ugur Sahin and Ozlem Tureci, I rejoiced. On a bitterly cold day in February 2021, I joined other exultant, albeit masked and socially distanced, individuals at Shepton  Mallet Social Services Hub where we thanked effusively the shivering but cheerful volunteers who told us where to park and those who managed the queue in the freezing hall with its doors and windows flung wide, reserving our most effusive thanks of all for those who administered our jabs.

Later, as the third lockdown passed, I made newly appreciative and grateful visits to early vaccinators.

A weathered slab beside the altar in the church of St. Mary the Virgin, Berkeley marks the grave of Edward Jenner along with his parents, wife, and son.

Grave of Edward Jenner

Having  noticed the immunity of milkmaids from smallpox, and linked this to their exposure to cowpox, which he believed protected them, in 1796 Jenner injected James Phipps, the eight-year-old son of his gardener, with pus scraped from the blisters of a milkmaid  who had contracted cowpox from a cow called Blossom. Six weeks later when he inoculated the boy with smallpox there were no ill effects. Jenner set up a hut in his garden, the Temple of Vaccinia,  offering free vaccinations to the poor.

The Temple of Vaccinia

Jenner’s discovery however was not universally welcomed: sections of the clergy  held it ungodly and unnatural to inoculate people with material from a diseased animal, others feared the effects. The cartoonist Gillray, who pictured people growing cows’ heads after having the vaccine, satirised the credulity of extreme opponents. When vaccination with the cowpox became compulsory in 1853 there were protest marches and calls for freedom of choice. It was not until 1980 that the World Health Organisation was able to declare that “smallpox is dead,” and today specimens remain in only two laboratories in the USA and Siberia for research purposes, held, it is said, with greater security than the nuclear bomb. An exhibition in Jenner’s house, next door to the church,  traces the horrible effects of smallpox and the history of the vaccine.

But Jenner was not  the first to inoculate with cowpox. In the graveyard of St. Nicholas in Worth Maltravers I visited the recently restored grave of Benjamin Jesty. Twenty-two years before Jenner, during  the smallpox epidemic in 1774, the Dorset farmer inoculated his wife and two children with a darning needle coated in pus drawn from lesions on an infected cow . Although his vaccine was widely used by country doctors and farmers,  Jesty  too had met with ridicule and hostility not least from  members of the medical establishment. He wrote his own epitaph  describing himself as “the first person that introduced the cowpox by inoculation.” His wife, fittingly commemorated in a grave alongside him, added the more cautious and modest “known” in parenthesis.

Grave of Benjamin Jesty, the first person (known) that introduced the cowpox by inoculation
Jesty’s wife, Elizabeth, first person (known) that received the cowpox by inoculation
Graves of the Jestys

 Before Jesty or Jenner the exotic Lady Mary Wortley Montagu had brought variolation,  inoculation with pus taken from someone with smallpox itself to produce a mild infection and then immunity in the recipient, to Europe in 1721. The practice was widespread in Africa and Asia, and after observing it in Constantinople where her husband was ambassador, she had her own children inoculated. Later she encouraged trials on Newgate prisoners: faced with execution they were offered the alternative of receiving the inoculation and their freedom if they survived. Happily, all survived. The practice was also trialled on orphans. Criticism of Montagu focused not on the dubious morality of these trials but on fears of the results  and a certain prejudice against oriental medicine. Controversial though the process was  the Straffords at Wentworth Castle  had their children treated. When their  son  inherited the estate he dedicated the Sun Monument, an obelisk  in the gardens of Wentworth, to Montagu. She is buried in the vault of Grosvenor Chapel  in London.

And Blossom? Jenner kept her hide and horns when she died. Today her hide hangs proudly in the library at  St. George’s Hospital Medical School where Jenner did his medical training, but they admit that her horns are wooden copies, a letter in their archives suggesting that an impecunious relative of Jenner’s may have sold the originals to an American university in the 1930s.

Blossom’s hide, St. George’s Hospital Medical School

The museum at Jenner’s House has in its possession no less than seven horns: one magnificent specimen lying on the desk in Jenner’s study bears a silver inscription attesting proudly that  Jenner himself polished it and gave it  as a gift; two others are on display in a glass case.

A horn on the desk in Jenner’s study, inscribed by Jenner
A pair of horns in a glass case in the Jenner museum may be those of Blossom

Rival claimants to the “true horns” include the George Marshall Medical Museum in Worcester which owns a pair; the Thackery Museum in Leeds has another two; the Science museum has one and so does the Old Operating Theatre. But Blossom’s finest memorial, and that of Jenner, Jesty and Montagu, is the protection bestowed on us  with every inoculation we receive.

Thank you, Blossom

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