This post is part of our #AliceClark100 Online Reading Group. In it Mary Fissell offers some reflections on chapter six of The Working Life of Women in the Seventeenth Century, on ‘Professions’. Mary is Professor in the History of Medicine at The John Hopkins University. You can access the book here.
Alice Clark’s chapter on Professions is startlingly prescient in its view of early modern women’s medical work. Many of the themes, sources, and topics she includes have become central to our discussions of early-modern medicine over the past few decades, but were not any part of the history of medicine when I started graduate school 35 years ago. Equally, when I re-read her chapter this time, I was struck by how deeply Clark’s own experiences shaped her account of women’s healing work.
Clark repeatedly uncovered women’s healing work that was largely ignored in the literature until very recently. In 1919, most English people would have thought that nursing started with Nightingale. Clark drew upon records from London’s great ancient hospitals to show us women working as nurses and matrons in them, although she wasn’t very flattering, noting that they were not “the most efficient type of women”. In the countryside, Clark found traces of nursing in local payments from parishes or charities for nursing the poor. She unearthed records of a female surgeon or two, and recognized that women performed many tasks as domestic healers, including making medicines and preserving recipes, a substantial topic in today’s literature. Such women, she noted, were trained informally in female lineages, rather than the formal education their brothers might have enjoyed. She describes the work of “searchers”, older women who inspected bodies for signs of the plague, a category of medical work almost completely ignored until the late 1990s.
Midwifery is Clark’s paramount example of the narrative of loss familiar from other chapters, as men gained access to increasingly formal scientific and medical training that became ever more valuable as knowledge progressed. But she couldn’t help noting that midwives’ skills probably didn’t worsen over the course of the seventeenth century. Here Clark was bucking the trend; as obstetricians created their specialty in the later 19th and early 20th centuries, they engaged in a fair amount of midwife-bashing about the old “Sairey Gamp” type of practitioner, but Clark saw a lot of good in the early modern midwife, noting that some were “of a high level of intelligence” and possessed “considerable skill”.
What struck me the most, however, was the ways in which Clark’s understanding of women and medicine was deeply tied up with her own personal history. I read her remark about a time that “idleness was not yet the accepted hall-mark of the lady” with a special poignancy. Alice Clark was threatened by idleness because she was tubercular, and one of the chief treatments of time was rest, or enforced idleness, and a lot of food, a treatment both she and her brother John underwent at sanatoriums.
What ultimately saved Clark from the fate of idleness or, worse, an early death, was the work of women healers, in particular, her sister Hilda Clark. Hilda attended medical school in Birmingham and then trained at the Royal Free Hospital in London, where she met the woman who was to become her life partner, Edith Pye, a trained nurse and midwife. While Hilda started her career working in a maternity hospital, she shifted focus quickly and came home to Street, in Somerset, and opened up a tuberculosis clinic. Undoubtedly her choice was shaped by her knowledge of her sister’s condition, which had recently worsened, and the unhappy coincidence that Edith Pye, too, suffered from the same disease. Hilda treated them with the new and controversial tuberculin treatment, and each made a strong recovery. Indeed, it was because Hilda healed Alice that she was able to take up the LSE scholarship that led to her book on the working life of women.
With advent of the First World War, the Clark sisters and Edith Pye saw immediate needs, and mobilized Quaker networks to build relief efforts. Edith Pye converted a former insane asylum at Chalons, 15 miles from the front, into a maternity hospital for refugees. Hilda joined her and supervised the hospital, which lacked electricity and running water. Pye continued working there even after Hilda’s health forced her to take a break, delivering a thousand babies by the war’s end. Alice started training in midwifery, but her health was not strong enough to sustain a career. Midwifery’s loss was women’s history’s gain. After the war, Hilda and Edith went to Vienna to organize relief efforts to feed undernourished children; Alice also worked organizing famine relief in Austria .
In the 1920s, Alice Clark was well enough to resume working in the family shoe business, and there developed new patterns of training and personnel management. Throughout this period, she, her sister, and Edith Pye were part of a circle of feminists, suffrage activists, and pacifists, who were anything but idle. For example, Pye worked on the executive committee of the Women’s International League, and went on a goodwill tour of Asia on their behalf. In 1929, she became president of what would become the Royal College of Midwives, a post she held for two decades.
So when Alice Clark mourned for an era in which women’s medical work was often informal, defined by twin poles of domestic caring and midwifery, she knew intimately what those kinds of work looked like, performed by women, in the modern world. Edith Pye was the new kind of midwife, trained first as a nurse; Hilda Clark was part of the first generation of British women physicians, trained in medical schools like their male counterparts. While Hilda treated both her sister and her partner with the new scientific medicine in the form of tuberculin, she also performed a much older form of female healing work in nursing them both back to health, week by week by week.
In the maternity hospital in Chalons, which Alice visited, both Edith and Hilda delivered babies in ways not so very different from skilled early-modern midwives. Her respect for the scientific training of both Edith and Hilda perhaps colored some of her scorn for the more ignorant of the early-modern women healers she mentioned, but equally, Alice’s lengthy experience of convalescence made her appreciate the daily domestic labor of caring for the sick that had long been the work of many English women.
Mary E. Fissell, “Introduction: Women, Health, and Healing in Early Modern Europe”, Bulletin of the History of Medicine 82 (Spring 2008): 1-17.
Deborah E. Harkness, “A View from the Streets: Women and Medical Work in Elizabethan London”, Bulletin of the History of Medicine 82 (Spring 2008): 52-85.
Sandra Stanley Holton, ‘To Live “Through One’s Own Powers”: British Medicine, Tuberculosis and “Invalidism” in the Life of Alice Clark (1874-1934)’, Journal of Women’s History 11.1 (1999), 75-96.
Elaine Leong, Recipes and Everyday Knowledge. Medicine, Science, And The Household In Early Modern England, (Chicago: University of Chicago Press, 2018).
Hilary Marland, ed., The Art of Midwifery, London: Routledge, 1993.