Literature and Medicine I

6Dr. Charlotte Blake Brown was rejected for admittance to the San Francisco Medical Society on the grounds that she was a woman in 1875. However, she proved to be a successful surgeon, obstetrician, and medical organizer. Brown worked in the “Chinese Quarter,” serving as a physician and missionary to the Chinese community in San Francisco (Starr 47-48). Female physicians practiced medicine in Chinatown because Chinese husbands did not want their wives examined by male Caucasian physicians. The California State Medical Society drafted legislation standardizing qualifications for medical practice in California which made no mention of gender, resulting in the passage of “An Act to Regulate the Practice of Medicine” in 1876 (Cal. Stats. 1876, ch. 518, 792-94). Brown served as the first female chair of a State Medical Society in 1876, and performed the first “ovariotomy” by a female surgeon on the West Coast in 1877. She became one of five women trained in medical schools to be admitted to the San Francisco Medical Society the same year.

7The mission of the Pacific Dispensary was to be an institution “for women, controlled by women, with women physicians” (Thelander 184). All attending staff, interns, and residents were female. The Pacific Dispensary Hospital reincorporated as the Hospital for Children and Training School for Nurses to include a more extensive academic mandate in 1885. While it served as the first training school for nurses on the West Coast, the original gendered mission of the Pacific Dispensary Hospital, chiefly, “to provide for women the medical aid of competent women physicians,” was diluted. The hospital, located on a donated property at California and Maple Street in San Francisco’s inner Richmond District, could boast of having a nearby pasture of dairy cows in the Presidio. In 1889 an adjoining lot was acquired for a specialized orthopedic unit where children (like Wiggin’s character Patsy) with crippling bovine tuberculosis received treatment.

8In 1896, Dr. Charlotte Brown studied the health of adolescent schoolgirls 16 to 19 years of age in Oakland and San Francisco, to identify health problems appearing in immigrant and working-class communities that might be related to urban living (“Health” 1-7). She discovered that adolescent girls suffered from similar health complaints to professional women (teachers, telegraph operators, and dressmakers) that included dental, sinus, vision problems, and feelings of anxiety. Brown’s case histories indicated patterns among the Sweden, Germany, and Ireland immigrant populations that were similar to school girls who had long hours of homework in addition to schoolwork and household chores. She statistically correlated bad diet, sleep, and exercise habits to irregular menstrual cycles and a national trend of young mothers in urban areas having difficulties in breastfeeding. By the mid-1880s, mothers in well-to-do families chose not to breastfeed infants, providing the opportunity for mother’s milk to become commodity (Golden 139). Brown suggested some preventative measures including the erection of municipal-funded gymnasiums, health education programs, and creation of a local version of the “New England Kitchen,” a community-based, take-out, low-cost food service located in Boston’s working-class and immigrant neighborhoods (“Health” 6).

9Social historian June Golden asserted that prescriptive child-rearing literature increasingly characterized middle- and upper class women as “frail,” providing some women with a ready-made excuse to avoid nursing (Golden 44-45). The local shift from breast to bottle-feeding for babies brought disaster to families in the city’s poor working-class neighborhoods when contaminated milk brought infection and disease. The promise of safer childbirth utilizing anesthesia and forceps further assisted the shift of the birthing chamber from home to maternity hospital, and male medical academics took increasingly dominant roles on hospital staffs when they affiliated with universities in the late 1890s. Female medical practitioners were strongly encouraged to move from active roles as physicians in hospitals to supportive roles as nurses, social workers, and public health advisors.

“The Implementer”

10Adelaide Brown followed in her mother’s footsteps, becoming a surgeon, obstetrician, and gynecologist. She attended Smith College in Northampton, Massachusetts, graduating in 1888, and then returned to San Francisco where she studied at Cooper Medical School (adopted by Stanford University in 1908), earning her M.D. in 1892. Adelaide interned at Northeastern Hospital in Boston, and then traveled to Vienna to study at “leading European gynecological clinics.” When Dr. Adelaide Brown returned to the San Francisco in 1894, she joined her mother’s medical practice located at 1212 Sutter Street in San Francisco. Adelaide worked as an attending physician at Alexander Maternity Hospital throughout the late-1890s, and delivered babies at San Francisco Children’s Hospital as early as 1899. In her first paper, “A Case of Stricture of the Esophagus following a Carbolic Acid Burn,” presented before the Women’s Medical Club of the Pacific in 1895, Adelaide explained how her mother provided mentoring when she referred a case involving a toddler who could not swallow food or milk due to an irritated esophagus. She joined the staff of Children’s Hospital full-time in 1910.