In 1896, the city of Bombay recorded its first case of bubonic plague, a disease which would grow to claim ten million lives over the following decade as the government stumbled after a consistent health policy to combat the bacterium. At the outset of the epidemic, as doctors were warning the government that the dreaded Black Death of medieval infamy was eating into the heart of Britain’s Imperial showcase city, the government, in a move depressingly familiar to anyone reading this in 2020, decided to waste crucial months downplaying the existence of the disease at the request of Bombay’s merchants so as not to upset the city’s trade.
While the Advocate of India declared flatly that there was no bubonic plague in India, a doctor who had gained renowned as the motivating force behind women’s medical education in India took up her pen and, in the pages of the Bombay Gazette, lambasted the government for its economically-motivated inaction, and its continued inability to coordinate a sensible response for the disease clearly in their midst, claiming nearly two thousand lives a week in Bombay alone. She was Dr. Edith Pechey-Phipson (1845-1908), and at the time of the Bombay Plague she was entering her third decade of compelling medical authorities through the power of her words and example to re-evaluate the underpinnings of their theories and policies.
Pechey had burst into the British consciousness in 1869 as a member of the group organized by Sophia Jex-Blake variously known as the Edinburgh Five or the Edinburgh Seven depending on the source you have at hand. This was the group of young women organized by Jex-Blake who sought to study medicine at the University of Edinburgh, and who would spend the next four years fighting every manner of institutional obstructionism in an ultimately futile attempt to gain the degrees that their work had entitled them to. Physically threatened by male students who were being actively encouraged by reactionary professors, emotionally battered, and academically stonewalled, the women emerged from their four year ordeal with a solid but dearly bought foundation of medical knowledge and a deep skepticism about the ability of institutions to reform themselves in addressing long-standing structural problems.
Pechey was perhaps the group’s most persuasive writer and orator, her letters to the newspapers instrumental in evoking sympathy for the uneven battle being waged by the seven medical hopefuls, and her speeches a mixture of unanswerable logic and undeniable emotional impact. While Jex-Blake’s multiple duties in confronting the university administration while attempting to continue her own education stretched her to a state of mental and emotional fatigue that had an understandable way of creeping into her public statements, Pechey had the gift of somehow being able to tell people exactly what they did not want to hear, and compelling them to take action to correct it, a skill that would serve her well in getting India’s first all-woman-staffed hospital up and running a decade later.
Pechey was also the star student in the group, claiming a first place in chemistry that would have won her a Hope scholarship were it not for her professor’s concern that the male students would not respond well to having it pointed out that they had, to a man, been bested intellectually by a woman. That scholarship was awarded to a male student who had performed less well than Pechey, but the renewed example of the University’s lack of fair play with regard to its women students evoked yet more public sympathy and discussion.
The Seven did not, however, gain their medical degrees at Edinburgh, but rather broke up in 1873 when their forward progress was definitively barred by a combination of university bodies, each controlled at least in part by the influence of Sir Robert Christison, who was determined to use every shred of prestige and power at his disposal to suppress entirely women’s access to medical education. Jex-Blake, having lost the battle, decided to enlarge the scale of the conflict, and took the case of women’s education to London, where she simultaneously worked for the establishment of a women’s medical college (which opened as the London School of Medicine for Women in 1874 and which Pechey gave the inaugural address for) and for acts of Parliament that would compel universities to allow women to take the examinations that would grant them medical degrees.
Theoretically, until women could obtain such degrees, they could not openly practice as doctors in England. The only two women doctors currently practicing legally in the country, Elizabeth Blackwell and Elizabeth Garrett Anderson, had gained their licenses to work as doctors before the loopholes barring women’s medical practice had been closed off, and since 1862 they possessed no successor.
No LEGAL successor, that is, for lacking the ability to obtain a legal license to practice because of governmental and institutional prejudice, many women decided to simply carry on with their medical work, license be damned, and among them was Edith Pechey. In 1875, Pechey took up the position of house surgeon at the Birmingham and Midlands Hospital for Women, a job previously held by Dr. Louisa Atkins, who had also been operating without a medical license since her M.D., received at the University of Zurich in 1872, was not recognized by British medical licensing laws. Pechey held the post for a year, working at the time with Dr. Lawson B. Tait, who was an early advocate of using disinfectants in surgical procedures, including the radical notion that surgeons should vigorously wash their hands with soap and water between operations. A hallmark of Pechey’s work as a doctor from that time forward was a thorough belief in the germ theory of disease, the utility of disinfectants, and the need to keep constantly aware of the newest theories of safe surgical practice, all of which came into play when she began designing her own hospital procedures in India.
In the winter of 1876, after several failed campaigns to compel British authorities and universities to move forward on giving women a viable and official path forward to obtain medical degrees, Pechey and Jex-Blake, along with Annie Clark, travelled to the University of Bern to study for the medical examinations there. On January 31, 1877, Pechey took and passed her medical examination and earned the M.D. that proved the depth of her knowledge, but meant precisely nothing to the British licensing authorities who had the previous decade closed off foreign diplomas as a route women could take to creating a medical practice in England.
After receiving her M.D., Pechey elected to take the road advocated by Elizabeth Garrett Anderson – to practice in England without a license and to, by conspicuously demonstrating her competence, become another living data point compelling change in British medicine. From 1877 to 1883 she practiced privately in Leeds while lecturing on medical topics throughout England and taking part in the Medical Women’s Federation of England, which she was elected president of in 1882.
Private practice and public educational advocacy – such might have been the overall trajectory of her life had E.G. Anderson not recommended her to George Kittredge, a philanthropist and reformer who had created the Medical Women for India Fund and was currently seeking a woman doctor to head a new hospital IN Bombay to be staffed entirely by women. This hospital, the brainchild of Kittredge and Sorabjee Shapoorjee Bengallee, was to be funded by a generous grant from Pestonji Hormusji Cama and would come to be known as the Cama Hospital. It was created to respond to a desperate need in Indian society, recognized by the visionary Indian reformer Behramji Malabari (1854-1912), to improve women’s education in India and to recognize and provide for their medical needs.
As a member of the Edinburgh Seven, Edith Pechey-Phipson was the woman who dared to ask for an education. As head of Cama Hospital, she was the doctor who educated the world by her example.
Pechey agreed to Kittredge’s proposal to become head physician at the proposed Cama Hospital, and arrived in Bombay in 1883 where she would spend the next years experiencing the full brunt of Indian bureaucratic inertia, that particular amalgam of British and local practice that ensured that every request, no matter how miniscule, wandered with unspeakable lethargy up every rung of government, pushed on its way by officials who dreaded more than anything having to be responsible for being on record as having made a decision about something. Everything about the hospital and its associated dispensary had to wend its way through this ponderous labyrinth, but through an almost unfathomable patience she was able to put in place a staff, a nurse’s training program, admission procedures, a system for obtaining medicine and furnishings, and facilities that catered to the various cultural demands of India’s population.
Demand for the services of the hospital and dispensary constantly overpowered the ability of Pechey and her small staff to supply, as women from all levels of society, many of whom had been denied any thorough-going medical attention on account of strict rules forbidding certain women from being examined in any but the most indirect fashion by male doctors, flocked to a hospital known to be staffed entirely by women boasting the most modern medical educations. Some time previously, Bombay University and Grant Medical College had opened their doors to women students, and as they began to graduate, they assumed leadership roles not only in Cama, but in new organizations springing up throughout India, inspired by the success of Cama to meet a clear cultural and medical need.
Pechey held her position at Cama until 1894 when she at last retired, physically worn out by a job that consumed virtually every hour of every day and the deleterious effects of encroaching diabetes compounded by the constant strain of living and working in India’s extreme heat. During that time, she took every opportunity to promote the expansion of Indian girls’ and women’s education, and to speak out against practices that limited Indian women’s ability to determine the course of their own life, particularly the joint policies of child marriage and enforced widowhood that could see a girl married at age twelve to a man in his sixties, who upon dying perhaps two years later thereby condemned his now fourteen year old bride to live the rest of her life as a perpetual widow of socially low regard whose sustenance was dependent on the vagaries of her relatives’ good will.
She vigorously undertook the defense of Rukhmabai, a child bride who refused to obey the summons of her husband to live with him when she turned seventeen and took her case to court, thereby creating a national scandal that polarized the traditional and progressive elements of Indian society. After Rukhmabai won that case, Pechey collected funds to allow her to travel to England to study medicine there, at the London School of Medicine, and when she returned, Pechey arranged to have her serve as house surgeon at Cama Hospital for six months on her way to becoming chief medical officer at Surat’s women’s hospital for the following two decades.
Though she had retired on grounds of exhaustion in 1894, Pechey dipped into her substantial reserves of energy to meet the Bombay Plague crisis in 1896, not only using her fame and knowledge to educate the public about the real state of the disease and the government’s failures in responding to it, but serving on the staff of the Cutchi-Memon Plague Hospital as well as on house-to-house medical inspection teams, while pressing insistently against cultural prejudices for the adoption of a vaccine developed by cholera hero Dr. Waldemar Haffkine that proved remarkably effective in combatting the disease.
Having done her duty to use her medical knowledge to combat an epidemic with every means at her disposal and every reserve of her strength, she retired at last and definitively with the diminution of the plague’s ferocity, and returned to England with her husband (a merchant who had been a driving force in the sustaining of Cama hospital whom she had married in 1889), there to contribute her voice to the next great fight, that for women’s suffrage, where in spite of suffering from breast cancer and diabetes she managed, as one of her last public acts, to participate at the head of the famous 1907 London Mud March, a display of three thousand women in support of a new suffrage bill which inspired the following year’s Women’s Sunday, a gathering of half a million suffrage supporters that took place in June of 1908, two months after the death of Dr. Edith Pechey-Phipson, the woman who four decades before had dared to ask for an education, and who had since educated the world by her example.
FURTHER READING: Edythe Lutzker’s 1973 Edith Pechey-Phipson M.D. : The Story of England’s Foremost Pioneering Woman Doctor will probably be your best source for Edith Pechey for a while. It gives absolutely minute detail about the tremendous bureaucratic and institutional muck that Pechey had to wade through both as a member of the Edinburgh Seven and as head of Cama Hospital. Accounts of resolutions and counter-directives and chains of bureaucratic decrees is, granted, not the most exciting reading, but it is tremendously important to realizing the forces aligned against Pechey, and makes her eventual success all the more impressive. The book also strikes a good balance (particularly for the time) of paying heed to medical best practices while recognizing that Western moral judgments can and did get conflated with medical judgments and policy in a manner not always easy to tease apart.
Lead Image: Portrait of Edith Pechey-Phipson (1845–1908), created between circa 1883 and circa 1908 by Bourne & Shepherd; Public Domain, via Wikimedia Commons