Mary Putnam Jacobi and the Politics of Medicine in Nineteenth-Century America (review)

In this well-conceived, intelligent, and thoughtful biography, Mary Putnam Jacobi (1842-1906) emerges as an extraordinary woman who made major contributions in medicine and reform. She was a woman in the mold of Margaret Fuller. What to other women were obstacles were to her challenges. Seemingly destined for a literary career as the daughter of publisher George Palmer Putnam, she determined to become a physician. After study at the College of Pharmacy of the City of New York and Female Medical College of Pennsylvania (from which she graduated in 1864), she traveled to France with her sights on the University of Paris. Unwelcome at first, her persistence pushed the school to allow her to enter the École de Médecine in 1868 as its first female student. She graduated in 1871 with a bronze medal for her thesis. All the while, she wrote fiction for income and reports on French medicine for the New York Medical Record and, radicalized by reading and friendship, became caught up in revolutionary fervor. She returned to New York to form a private practice and teach at the Women's Medical College of the New York Infirmary. She became active professionally, publishing her medical writings and joining physicians' societies. In 1873 she married Abraham Jacobi, an émigré from the 1848 revolutions and the founder of pediatric medicine in the United States. The two shared philosophical positivism, radical politics, and enthusiasm for medicine. They had three children, losing one shortly after birth and another from diphtheria as a child.

Jacobi came to national attention in 1876 when her essay, The Question of Rest for Women during Menstruation, won Harvard's honored Boylston prize and appeared the following year under the Putnam imprint. Bittel offers a new understanding of Jacobi as one who employed the methods of science and the laboratory to prove women's equality. In an era whose dominant voices trumpeted the importance of sex differences, Jacobi insisted on their relative insignificance. For example, because she understood menstruation as a nutritive, not a reproductive, event, she contended that women generally did not need to protect themselves by ceasing work or study during their monthly flow. To the contrary women needed physical and mental activity to attain true health. In her nuanced and careful discussion of Jacobi's many writings, Bittel clarifies that Jacobi was hardly neutral in her research and reporting: like her medical opponents, she deployed scientific investigation to prove her social and political understandings. Left understated is a critical difference: Jacobi went beyond her adversaries' reliance on case studies to devise and perform laboratory tests and gather statistical data.

Jacobi's enthusiasm for a medicine based on laboratory research and focus on nutrition provides the key to her position on many controversial issues: her willingness to perform ovariotomies, her support of vivisection, and her advocacy for the creation of the Johns Hopkins Medical School. Jacobi's belief in equality led her to support women physicians and ultimately to become a strong voice for suffrage.

Bittel effectively treats aspects of Jacobi's intellect and character that proved particularly helpful to some women who sought her help to relieve mental suffering. Jacobi brought a respectful attitude that potentially enabled women to imagine lives of activity and purpose. One embellishment left unattended in this account is that, seemingly alone among American physicians treating hysteria, Jacobi absorbed the insights of German psychiatrist Wilhelm Griesinger. As seen in her 1881 paper, "The Prophylaxis of Insanity," his work enabled her to view mental health and illness on a continuum and imagine a complex relation between body and mind.

This minor omission does not really detract from this beautifully rendered biography. Bittel brings to her subject not only expertise in U.S. history but also a deep understanding of American medical education and practice. She sets Jacobi firmly within the contexts of...