Publish or Perish: The Scientific Publications of Women Physicians in Late Imperial Russia

Publish o Pe ish: , The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia (*) MICHELLE DENBESTE-BARNETT (**) SUMMARY Types o Publica ions by Women Physicians. Hygiene and Women's Heal h: Elizabe h D en el'n and Ma iia Volko a. Aleksand a Ekke and School Hygiene. E geniia Se eb enniko a: Pionee ing Oph halmologis . Ma iia Pok o skaia: Physician, Feminis and Public Heal h C usade . Anna Shabano a: Pedia ician and Women's Righ s Ac i is . Impac o Women's Publica ions on he P o ession. Conclusions. ABSTRACT Women physicians in la e 19 h cen u y Russia eme ge jus as he Russian p o essions begin a emp ing o achie e some deg ee o au onomy om bu eauc a ic in e e ence. Women ook ad an age o his discou se o po ay hemsel es as compe en p o essionals dedica ed o be e ing he li es o Russian people. Qui e o en hese a emp s o jus i y hei wo k in he p o ession also mo i a ed hem o publish hei scien i ic indings so ~ ha hey could be iewed as legi ima e schola s and physicians. This a icle concen a es on six women physicians, Elizabe h D en el'n, Aieksand a Ekke , Ma ia Pok o skaia, E geniia Se eb enniko a, Anna Shabano a, and Ma ia Volko a (*) Much o he esea ch o his pape was conduc ed du ing wo esea ch ips o he Na ional Lib a y o Medicine in Washing on D.C. Funding o he mos ecen ip was p o ided by he Kennan Ins i u e o Ad anced Russian S udies o he Wood ow Wilson Cen e . An ea lie ip was inanced by a Phi Alpha The a G adua e s uden schola ship awa d. Ea ly d a s o he pape we e p esen ed a he Sou he n Con e ence on Sla ic S udies, Chape1 Hill, No h Ca olina in Ma ch 1998 and he B i ish Associa ion o Sla onic and Eas Eu opean S udies, Fi zwilliam College, Camb idge, Ap il 1998. ("*) Assis an P o esso , Russian His o y. A kansas Tech Uni e si y. Social Sciences and Philosophy Dep ., WPN 255, Russell ille, AR 72801, USA. DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. 216 MICHELLE DENBESTE-BARNETT who p o ide illus a i e case s udies o wha many o he women physicians we e doing. Women physicians published on a wide a ie y o opics, om women's and child en's heal h o a ious ypes o cance s and in ec ious diseases. A ew also used hei medical aining o ad oca e o wo nen's poli ical and social igh s. BIBLID [O21 1-9536(1999) 19; 215-2401 Fecha de acep ación: 30 de no iemb e de 1998 By he beginning o he wen ie h cen u y, medical schools in Russia had g adua ed la ge nuxnbe s o women physicians. The 1904 medical egis e lis s 738 women physicians. By 1914, 3,352 women a e egis e ed as p ac icing physicians. As hei numbe s g ew, hei in luence also sp ead in he medical wo ld. Women pa icipa ed in medical cong esses, gi ing epo s and speeches, and hei medical esea ch and expe ience ea ing pa ien s ound i .s way in o impo an medical jou nals. Russian women published p oli ically, especially when compa ed o women in o he coun ies who o en an up agains se e e obs acles. While elsewhe e women s uggled o p ac ice, o gain en ance o esea ch acili ies and o join medical socie ies, in Russia women accomplished hese goals ea ly and mo ed o in ol emen in shaping he u u e o Russia's medical p o ession (1). In e es ingly, Russian women no only a ended medical school ea lie han women om o he Eu opean coun ies bu hey also p ac iced, published, and pa icipa ed in , hei p o ession on a much mo e equal basis han women om o he coun ies. The na ional medical jou nal V ach egula ly ca ied a icles by and abou women physicians as did o he egional and specialized medical jou nals. The English medical jou nal The Lance by way o con as discussed women physicians only when deba ing whe he o no hey should be allowed in o medical school and wha ypes o es ic ions should be pu on hei p ac icing (2). (1) Fo in o ma ion on womeil physicians in o he coun ies see BONNER, T.N. To he Ends o he Ea h: Women's Sea ch o Educa ion in Medicine, Camb idge, Ha a d Uni e si y P ess, 1992. (2) This is pa icula ly ue ea ly on (1872-1876). The Uni e si y o London opened o women in 1877 and while publica ions by women do no appea un il la e , he DYNAMIS. Ac a Hisp. Med. Sci. His . Rlus. 1999, 19, 215-240. The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia 217 The published wo ks o Russian women physicians should be seen no only as pa o hei a emp o join he p o ession on i s own e ms bu also as a con ibu ion o he medical and social discou se su ounding e o ms in medicine and medical issues. Thei w i ings added a eminine (and some imes eminis ) oice o he deba e in he p ess, in he medical li e a u e, and a p o essional cong esses no only o e women's capaci y o p ac ice medicine bu also o e women's capabili ies and ole in socie y. By placing hemsel es in he public a ena and publishing hei scien i ic and li e a y achie emen s, hese women physicians, publicly challenged common concep ions abou women's oles and capaci ies. As Sidonie Smi h w i es, i a woman seeks a place in he public a ena, «she ansg esses pa ia chal de ini ions o emale na u e by enac ing he scena io o male sel hood. As she does so she challenges cul u al concep ions o he na u e o women and he eby in i es public censu e o he e o sn (3). Russian women a he end o he cen u y ansg essed hese bounda ies wi h less opposi ion han women in o he coun ies. Women physicians no only published bu we e ac i ely encou aged o do so by male men o s. Russian women ecei ed hei medical deg ees bo h a home and ab oad bu in o de o p ac ice in Russia, al1 physicians had o pass he s a e exam and be egis e ed on he lis o physicians. A combina ion o ac o s led o la ge numbe s o Russian women s udying medicine. By s udying and p ac icing medicine, Russian women could sa is y hei ques o scien i ic s udy (emphasized by new in ellec ual mo emen s such as nihilism) while a he same ime helping he peasan s, u ban wo ke s, and he poo (a goal o o he mo emen s such as populism). The inc edible in ellec ual and social e men in la e nine een h cen u y Russia mean ha class and gende oles we e no i mly es ablished and Russian women ook ad an age o his o y ou new possibili ies o educa ion and employmen . ea ly hos ili y owa d women in medicine g adually dissipa es. On he English si ua ion see BLAKE, Ca iona. The Cha ge o he Pa asols: Women's En o he Medical P o ession, London, The Women's P ess, 1990, pp. 178-199 and BONNER, T.N. Becoming a Physician, New Yo k, Ox o d Uni e si y P ess, 1995. (3) SMITH, Sidonie. A Poe ics o Women's Au obiog aphy, Blooming on, Indiana Uni e si y P ess, 1987, p. 8. DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. 218 MICHELLE DENBESTE-BARNETT The w i ings o women physicians lea e us a aluable his o ical eco d o hei achie emen s. Thei publica ions p o ide in o ma ion on he medical deba es o he ime, women's s uggles o en e he p o ession, daily p ac ice, and occasionally a peek in o hei p i a e li es (4). Those women who published came om a wide a ie y o medical special ies and included bo h egula physicians and women wi h Ph.D.'s. Thei publica ions can be di ided in o se e a1 gen es: memoi s, medical esea ch, sel -help o ins uc ional ma e ial designed o a gene al audience, and li e a y wo ks. Women physicians in la e nine een h cen u y Russia eme ge jus as p o essionals begin a emp ing o achie e some deg ee o au onomy om bu eauc a ic in e e ence. Women ook ad an age o his discou se o po ay hemsel es as compe en p o essionals dedica ed o be e ing he li es o Russian people. This same impulse o jus i y hei wo k in he p o ession also mo i a ed hem o publish hei scien i ic indings so ha hey could be iewed as legi ima e, p o essional, schola s and physicians. In ac , since women s udied wi h op male physicians due o he associa ion o he women's medical cou ses wi h he S . Pe e sbu g Medical-Su gical Ins i u e ( he p emie medical school in Russia), women's schola ship o en examined new and cccu ing edgen issues. A he same ime, women's eques s o be e pay, independence in he wo k en i onmen , and imp o emen s in public heal h igh ened a go e nmen al eady conce ned abou adicalism among he newly eme ging p o essional classes. TYPES OF PUBLICATIONS BY WOMEN PHYSICIANS Abou hi y-se en pe cen o women's publica ions a e di ec ly conce ned wi h women's and child en's heal h, he as majo i y (4) My da abase consis s o 270 publica ions by 140 women physicians published be ween 1870 and 1905. The da abase was compiled by sea ching medical pe iodicals such as V ach, Akushe ka, Medi sinskii Ves nik, and Ves nik O almologii and by sea ching GOLITSYN, N.N. Bibliog a icheskii sloua ' usskikh pisa el'ni s, S . Pe e sbu g, 1889; PETROV, N.P. Bibliopa icheskii ukaza el' usskikh disse a sii po medi sin,e i e e inam'i, Vyp. 1, 1860-1892 and Vyp. 2, 1893-1898, S . Pe e sbu g, 1893; ZMEEV, L.F. Russkie achi pisa eli s 1863 g., S . Pe e sbu g, '1888; and ZMIGORODSKII, K.I. Bibliog a icheskii ukaza el' ossiiskoi medi sinskoi li e a u y, S . Pe e sbu g, 1890. DYNAMZS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia 219 concen a ing on p egnancy and childbi h (5). Pa o he eason o he la ge numbe s o wo ks on gynecology lies in he deg ees g an ed o women physicians (6). O iginally, women could only o icially s udy issues ela ed o women and child en (al hough hei p o esso s o en lou ed he ule). Secondly, women could mo e easily p o ess legi imacy in he medical p o ession i hey claimed o be specially sui ed o ca ing o women and child en. Howe e , when wo king in he zems o and in emo e a eas hey had o ea whoe e came in since o he doc o s we e usually miles away. Ele en o he publica ions in my da abase a e popula manuals in ended o women o use as e e ence manuals o hemsel es and hei daugh e s. These manuals o en con ained illus a ions and discussed he phases o a woman's li e and he ep oduc i e cycle. Women physicians o his gen e conce ned hemsel es wi h educa ing women abou he dange s o co se s, b eas eeding hei babies, and basic in o ma ion on ep oduc ion and hygiene. These we e impo an opics o many women who, ea ul o discussing such in ima e opics wi h male physicians, li ed in igno ance. Women did no con ine esea ch only women and child en. A.G. A khangelskaia w o e he i s o a se ies o b ochu es pu ou by he Pi ogo socie y. He b ochu e explained he impo ance o p omp medical a en ion, indica ions o su ge y, wha doc o s migh do p io o and du ing su ge y, and he necessi y o ollowing he doc o 's ins uc ions ('7). Ano he la ge g oup o publica ions by women physicians (eigh pe cen ) conce ns he p ac ice o medicine i sel . These include epo s on medical cong esses, a icles abou o eign mee ings a ended, minu es o bo h domes ic and o eign medical socie ies, and epo s on a ious ypes o clinics and hospi als. Publica ions such as cThe condi ion o (5) A ew women physicians also published ic ional s o ies o w o e on opics un ela ed o medicine. 1 ha e le such publica ions ou o his da abase. (6) When he women's medical cou ses opened in S . Pe e sbu g in 1872, hey we e designed o be a ou yea cou se a e which s uden s ea ned he deg ee uchenaia akushe ka (lea ned midwi e). In 1876 he cou ses expanded o i e yea s and s uden s ecei ed ce i ica es s a ing ha hey we e quali ied o ea women and child en. No un il 1880 did hey ecei e he i le zhenskii ach (woman physician). (7) ARKHANGELSKAIA, A.G. Dlia chego dok o a delaiu ope a sii i kakaia o ogo by ae pol a bolhomu, Moscow, Pi ogo Commission, 1897. DYNAMIS. Ac a Hisp. Med. Sci. His . lllus. 1999, 19, 215-240. 220 MICHELLE DENBESTE-BARNETT medicine in he Wes . o «Sani a y condi ions in Moscow in 1889~ indica e he in eg a ion o women in o he p o ession (8). Women we e no me ely passi e bys ande s as o he s de ined he medical p o ession. Thei ac i i ies and hei w i ings helped o o m bo h he ques ions and he possible answe s o he di ec ion Russian medicine should ake. Women physicians also ook pa in non-medical cong esses on p os i u ion and women's educa ion. Many o he women who published on o he opics also published memoi s o hei expe ience. These memoi s ha e en icing i les such as «Wa wi h Bacillin, ~House Calls: A Day in he Li e o a Duma Woman Doc o in S . Pe e sbu g~, and .A Mission Agains Chole an (9). Many o he a icles suppo ing medical educa ion o women con ained i s hand accoun s by women s uden s a he cou ses which se ed se e a1 pu poses (10). Fi s , hey publicized he ac i i ies and successes o women physicians. Au obiog aphical w i ing o women se ed as a way o a woman o shape he own a e by publicly de ining hei own eali ies (11). Secondly, hey allowed indi idual women o w i e abou pe sonal expe iences in he con ex o a p o essional accoun . Because (8) ARKHANGELSKAIA, A.C. S sos oianii medi siny na zapade (iz pu ebykh pecha ienii). T udy 7-go gube nskogo s"ezda achei Mosko skogo zems o. Ma ch 1883, Moscow, 1884, pp. 148-64 and POKROVSKAIA, M. Sani a noe polozhenie Mosk y 1889 g. na osno anii dannylch poluchennykh iz o che o Mosko skikh go odskikh sani a nykh achei. Russkaia Medi sina, 1890, Nos. 41, 42, 43 and 45. (9) DRAGNEVICH, Na alia. Iz ospominanii zhenschiny- acha. Russkoe Boga s o, June 1903, No. 1, pp. 61-74; GRIN, S. Voina s ba sillami: Iz zame ok zhenshchiny acha. Ves nik E opy, 1890, 5, 601-654; PAEVSKAIA, A. Komandi o ka na khole a: Iz zame ok zhenshchiny . acha. Russkoe Boga s o, Nos. 7 and 8, July and Augus 1903, pp. 121-69 and pp. 49-93; and SLANSKAIA, Eka e ina. Den' dumskogo zhenshchiny- ach S. Pe e bu ge. Ves nik E opy, 1894, 3, 204-242. (10) Fo ins ance, ARKHANGELSKAIA, Aleksand a. O che Tsiu ikhogo uni e si e e za 1883 g. D ug Zhenshchin, 1883, No. 9, pp. 82-88; OKUNKOVA-GOLDENGER, Zinaida. Zhenshchina- ach za g ani sei. Medi sinskoe Oboz enie, 1876, 5, 189; and SHABANOVA, Anna. Zhenskoe achebnoe ob azo anoe Rossii. Is o icheskii Ves nik, Ma ch 1913, 131, 952-961. (11) Fo mo e on women's au obiog aphical w i ing see HELDT, Ba ba a. Te ible Pe ec ion, Blooming on, Indiana Uni e si y P ess, 1987, p. 102 and CLYMAN, Toby. Women Physicians Au obiog aphy in he Nine een h Cen u y. In: Women W i e s in Russian Li e a u e, Wes po , CN, G eenwood P ess, 1994, pp. 111-126. DYNAMIS. Ac a Hisp. Med. Sci. His . illus. 1999, 19, 215-240. The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia 22 1 many women began s udying medicine ou o a desi e o do some hing use ul o o help o he s, hei memoi s se ed an educa ional pu pose. As Anna Shabano a, a s uden in he i s g adua ing class o he Women's Medical Cou ses, explained, «Bu why did he s udy o medicine a ac women mo e han o he p o essions? ... I seems o me ha medical wo k a ac ed hem because o i s se ice o science and ies o al uis ic asks- elie ing su e ing while allowing g ea e independence han o he p o essions» (12). Women memoi is s desc ibe he appalling condi ions o igno ance, di and ill heal h in which a la ge pe cen age o Russia's popula ion li ed. They do so in o de o in o m a mo e p i ileged sec ion o socie y and o p ess o heal h and hygiene e o ms o la ge social e o ms. O he women physicians published sel -help and ins uc ional manuals o women, o en in conjunc ion wi h public lec u es, ypical o women physicians in o he coun ies as well, o his ype o publica ion p o ided an accep able place o hem in he p o ession e en among hos ile elemen s (13). Elizabe h Blackwell, a pionee ing English physician ecalled ha she was able o wa d o s a a ion and a ac possible clien s by o e ing public lec u es. Many women who published ~se ious esea ch~ also w o e wo ks in ended o he gene al public. Va a a Kashe a o a- Rudne a, he i s woman doc o educa ed in Russia w o e a ex book, Hygiene o he Female O ganism in al1 Phases o Li e, used by bo h medical specialis s and non-medical pe sonnel o i s desc ip ions o emale ana omy and hygiene (14). HYGlEIVE ANO WOMEN'S HEALTH: ELIZABETH DRENTELSVAhTD MARILA VOLKOVA Elizabe h D en el'n, ano he o he ea ly women physicians, specialized in sel -help li e a u e and es ablished he sel by w i ing and lec u ing (12) SHABANOVA, no e 10, p. 953. (13) Fo one example see HERROLD, Maude. Woman and Disease: A Collec ion o Fac s o Women, Kansas Ci y, MO, Published by he Au ho , 1896. (14) KASHEVAROVA-RUDNEVA, Va a a. Gigiena zhenskogo o ganizm uo usekh azisakh zhizn, Kha ko , 1884 and S . Pe e sbu g, 1892. DYNAMIS. Ac a Hisp. Med. Sci. His . illus. 1999, 19, 215-240. 222 MICHELLE DENBESTE-BARNETT Pho o on he opening page o Va a a Kashe a o a-Rudne a's Au obiog aphy in he anni e sa y yea book o he Medical-Su gical Academy. «A obiog a iia», D ad sa pia le ie achei bjl shikh s uden o impe a o skoi mediko- khi u gicheskoi akademii (S . Pe e sbu g, 1893), pp. 68-95. on women's heal h and liygiene. She wan ed women o become mo e knowledgeable abou hei own bodies in o de o dec ease hei ea o na u al occu ences such as childbi h and mens ua ion. O he a icles on menopause, ene eal disease and he p ocesses o childbi h a e published in V ach and Akushe ka. Elizabe h D en el'n appa en ly a ended he S . Pe e sbu g Medical Cou ses and is lis ed on he medical egis e o 1883. She w o e and lec u ed on women's heal h and main ained a p i a e p ac ice in S . Pe e sbu g on he Fon anka. He publica ions included The Heal h o Women: Fou Public Lec u es, The Necessi y o Medical Supemision o Women in Women's Ins i u ions, and On P os i u ion (15). (15) DRENTEL'N, Elizabe h. O neobkhodimos i zhenskogo medi sinskogo nadzo a u zhenskikh uchebnikh za edeniiakh, Moscow, 1897; O p os i u sii s ochki z eniia dinamiki zhizni, DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia 223 D en el'n held ai ly conse a i e iews abou he impac o educa ion on women's heal h, no ing ha physicians s ill disag eed on whe he s udying and educa ion in ensi ied women's su e ing du ing mens ua ion and childbi h. She a o ed educa ing young women abou hei heal h and ep oduc ion bu also el ha hey should be closely wa ched o any ha m ul a ec s o oo much ac i i y. D en el'n s ongly opposed keeping young women in he da k abou hei own heal h and she discussed he e o o mens ua ion o young women, igh ened by he sudden appea ance o blood, unawa e o wha is happening o hei body, and oo emba assed o ask. She ci es he example o one young gi l who, ala med by he sudden appea ance o blood, an ou side in o he snow and emained si ing he e hoping ha he cold would s op he bleeding. D en el'n hoped ha ha ing emale medical pe sonnel in he schools migh gi e gi ls he oppo uni y o ask mo e ques ions and o seek medical a en ion when necessa y. In ac , she exp essed disappoin men ha mo e women doc o s had no gone in o his line o wo k. She emphasized ha only ou pe cen o women doc o s had ound wo k a eaching ins i u ions whe eas la ge numbe s had been a ac ed o zems o wo k (16). She belie ed ha he esponsibili ies o an ins i u ional doc o (uchilishchnyi) should be b oad, o include bo h eaching and mo e pe sonal discussions wi h he pupils in o de o acili a e g ea e openness. .A school doc o should no ha e a na ow special y ... bu should ha e a b oad medical educa ionn (17). Acco ding o D en el'n, he school doc o should discuss clo hing and i s e ec s upon physiology, especially co se s, hygiene, and mens ua ion. In D en el'n's public lec u es she discussed such issues as women's ana omy, di e ences be ween men and women, g ow h ( om gi l o woman), mens ua ion, p egnancy and childbi h, women's diseases, and diseases esul ing om p egnancy and childbi h. He published e sion o hese lec u es included d awings o women's o gans, he u e us, eggs, and ep oduc i e s ages. D en el'n s o e o educa e mo he s abou hei own ep oduc i e li e and o gans and hoped o gi e hem Moscow, 1908; Zdo o 'e zhenshchiny: Che y e publichnye lek sii. Chi aniia iskliuchi el'no dlia zhenshchin Kha ko e i Mosk e 1898, Moscow, 1899. (16) DRENTEL'N (1897), O neobkhodimos i, no e 15, p. 9. (17) DRENTEL'N (1897), O neobkhodimos i, no e 15, p. 4. DYNAMZS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. 230 MICHELLE DENBESTE-BARNETT S . Pe e sbu g schools o Finnish schools which she el o be o supe- io design (26). SchooP hygiene was o g ea conce n in he la e nine een h cen u y and books and pamplile s discussed p ope ligh ing, en ila ion, loo plans, and school desks designed o c ea e he mos hygienic en i onmen possible (2'7). Ekke 's ou a icles on he subjec clea ly con ibu ed o wo k in he a ea. In one a icle she lays ou speci ic loo plans o school cons uc ion. El ke 's a icles di e om Volko a and D en el'n (also conce ned wi h hygiene) by he use o s a is ics, cha s, and diag ams o back up he a gumen s. While Volko a and D en el'n make, use o ana omical d awings and knowledge o physiology, Ekke used empi ical da a, d awn om s udies o child en o e ime. EVGENIIA SEREBRENNJKOVA: PIONEERING OPHTHALMOLOGIST No al1 women physicians wo ked on speci ically emale ela ed issues. E geniia Se eb emniko a became one o he o emos expe s on eye disease in Russia. She g adua ed om he S . Pe e sbu g medical cou ses and hen a eled o Pe m wi h he husband, also a physician. The e she wo ked o ee as he own was unwilling o pay wo doc o s (especially when hey could ge one o ee by paying he husband). Bu , ecognizing he need o an eye clinic she began ea ing and esea ching eye diseases. E en ually she ecei ed unding o se up he own clinic a he hospi al. This clinic, he i s o i s kind in Russia became he p o o ype o small ci ies elsewhe e. Se eb enniko a published o e wen y a icles on he echniques and indings and on he day o day ope a ions o he clinic (28). (26) EKKERT. Obzo no eishikh dannykh po pos oike shkol p eimushches enno usskikh i skandina skikh. Zhu nal Russkogo Obshches a Okh aneniia Na odnogo Zd a iia, 1898, 8, 541-542; EKKERT. Opy izicheskogo izsledo aniia uchashchikhsia nachal'nykh go odskikh shkolakh Pe e bu ga. V ach, 1894, 15, 708-709. (27) On school hygiene see CONROY, Ma y. School Hygiene in La e Tsa is Russia. Sla ic and Eas Eu opean Educa ion Re iew, 1981, 2, 17-26. (28) BABUSHKIN, V. A. V ach E.P. Se eb enniko a, Pe m, 1957 and SHABYNIN, A. V. Khi u gicheskaia deia el'nos zhenshchin- achei Rossii XIX eke. Ves nik khi u gii im. I.I. G eko a, 1897, 138, 128-130. DYNAMIS. Ac a Hisp. Med. Sb. His . nlus. 1999, 19, 215-240. Se eb enniko a concen a ed on ea ing achoma, a se ious and widesp ead p oblem in he la e nine een h cen u y. She augh he echniques a in e na ional con e ences. In 1891, seeking mo e knowledge she a eled ab oad and s udied in Ge many and F ance. Because she had he i s independen eye clinic she ea ed la ge numbe s o pa ien s and buil up a signi ican da abase on success ul and unsuccess ul ea men op ions which doc o s elsewhe e ook se iously. He s a is ics se he one o discussions a medical cong esses on he p ope ea men o eye disease. Fo ins ance, in he epo o 1889 she epo ed seeing 3,035 pa ien s (1,984 peasan s, 633 pe y bou geois, 261 go e nmen bu eauc a s, 86 om he cle ical es a e, and 71 me chan s). Mos o he pa ien s came om Pe m o he Pe m gube niia bu -a ew (99) a eled om o he gube niia o see he . Fo many people she would ha e been he las chance o help and he only specialis o hund eds o miles (29). Al1 physicians had some aining in eye diso de s bu Se eb enniko a was one o only nine egube niia oculis s». Fi e o he women physicians w o e a icles on blindness and eye disease and by he 1880s an en i e jou nal ( o which Se eb enniko a equen ly con ibu ed), Ves nik O almologii was de o ed o ques ions o eye disease and unc ioning o he eyes (30). In he epo s she kep ca e ul and de ailed eco ds o symp oms, diagnoses, ea men , occupa ion o he pa ien , and success o ailu es. In one yea Se eb enniko a pe o med 789 ope a ions wi h ~an isep ic p ecau ions. o such diso de s as ca a ac s, p olapsed i is, ke a o omia and emo ing cance s. Besides he epo s Se eb enniko a w o e a icles on ea ing achoma, blindness, ca a ac s and he op ic ne e, and e en on accina ions (31). Aside om he su gical p ac ice, esea ch, - SEREBRENNIKOVA, E. V. O almologicheskii nabliudenii za 1889 god iz Pe mskii gube nskii bolni sy. Ves nik O almologai, 1890, 7, 469-496. Fo example, ARKHANGELSKAIA. O che o so ne eks ak sii ka a ak zemskoi p ak ike. Medi sinskoe oboz enie, 1891, No. 15; BOKOVA, Ma iia. Sposob iskus enno p oiz odi s e nuiu slepo u, Medi sinskii Ves nik, 1862, Nos. 23 and 24; and GEORGIEVSKAIA. O swe noi skpo e i sposobe eia op edeleniia, Ph.D. diss., S . Pe e sbu g. SEREBRENNIKOVA, E.V. K lecheniiu akhomy. V ach, 1887; Neskolko slo o nashei slepo e. Sbo nik Pe mskogo Zems o, Pe m, 1886; and Ob ospop i i anii DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. 232 MICHELLE DENBESTE-BARNETT and daily p ac ice, Se eb enniko a also ound ime o aise money o he women's medical cou ses, o aise money, build and supe ise a gymnasium o blind s uden s and o each bo h a he blind gymnasium and he local eldshe school. MARIIA POKROVSKAIA: PHYSZCZAN, FEM11VZST AND PUBLZC HEALTH CRUSADER Ma iia Pok o skaia, one o he bes known o he ea ly women physicians also w o e he i s a icle on ca a ac s. Bu she la e became known mo e o he eminism and as an ad oca e o changing he p os i u ion egula ions han o he medical p ac ice. He p o essional ac i i ies included edi ing a women's jou nal Zhenskii Ves nik, pa icipa ing in cong esses on p os i u ion and on women's issues, w i ing and edi ing se e a1 books, and main aining a p i a e p ac ice. She g adua ed in 1881 om he S . Pe e sbu g medical cou ses and se ed in he zems o o se e a1 yea s be o e e u ning o S . Pe e sbu g o p ac ice medicine and w i e. Pok o skaia wo ked i elessly o a numbe o impo an causes. She w o e equen edi o ials in Zhenskii Ves nik abou he necessi y o be e educa ion o women, uni e sal su age, and he impo ance o imp o ed heal h ca e o he poo . Pok o skaia, like many o he con empo a ies, saw he medical aining as bo h a means and an obliga ion o help he poo and down odden o socie y. He medical a icles cen e ed on issues such as he unheal hy li ing condi ions o Pe e sbu g wo ke s, ea men o ube culosis, and heal h and sani a ion. One o he i s a icles, published in V ach, s udied peasan hu s in ela ion o hei en ila ion and i s e ec s on heal h (32). She unde ook he s udy because physicians belie ed ha hu s wi hou chimneys we e unheal hy and ha ca a ac s we e mo e common among people li ing in his ype o peasan hu . In he egion, howe e , mo e han hal o he popula ion li ed in hu s wi hou chimneys, so she unde ook o examine wha Pe mskoi gube nii. Doklad na ZZZs"ezde V achei Pe mskoi Gube nii 1886, S . Pe e sbu g, 1886. (32) POKROVSKAIA. Vliianie lcu nykh izb na zabole aniia o gano dykhaniia i z eniia. V ach, 1888, Nos. 4 a id 5, pp. 65-66 and pp. 89-91. DYNAMZS. Ac a Hisp. Med. S&. His . Illus. 1999, 19, 215-240. The Scien i ic ~ublica lons o Wo nen Physicians in La e Impe ial Russia 233 migh be causing he p oblems. She s udied empe a u es, he con en o ca bonic acid in he hu s, and pa ien eco ds o he illage s. She ound ewe inciden s o eye disease in he hu s wi hou chimneys han in hose wi h chimneys and hus concluded a e compa ing esul s wi h o he zems o physicians ha i was necessa y o look o o he causes o blindness and achoma (33). In ano he a icle she s udied he li ing condi ions o S . Pe e sbu g wo ke s (34). The a icle summa ized a su ey ca ied ou by ci y sani a y doc o s which ound ho ible o e c owding, a lack o basic sani a ion and oile acili ies, insu icien ligh and poo en ila ion. Pok o skaia ecommended ha mo e inexpensi e housing be cons uc ed and ha he cu en building codes be en o ced. She also el ha he people needed o be educa ed abou hygiene by way o schools, lec u es, and b ochu es w i en o a popula audience. Pok o skaia also w o e ex ensi ely on p os i u ion and abo ion. The egula ion o p os i u es h ough he medical police su eillance commi ees was an issue o conce n bo h o eminis s and o many physicians who saw i as go e nmen in ingemen on medical e i o y. Physicians di e ed on whe he egula ion should be comple ely abolished bu nea ly al1 ag eed ha physicians and no he s a e should handle egula ion. As Lau ie Be ns ein no ed in he disse a ion on p os i u ion in Russia: «The associa ion be ween p os i u ion and ene eal disease ga e physicians an oppo uni y o claim p o essional expe ise. ... Physicians hoped o see a o m o egula ion ha con o med wi h mo e enligh ened p inciples and adhe ed o he wo ds o scien is s abou he ansmission and p e en ion o diseases. ... To he Russian medical communi y, he go e nmen 's ole in egula ion ep esen ed mo e in e e ence om a bloa ed s a e ha had ne e gi en doc o s he p o essional au onomy hey dese ed. (35). (33) TUVE, Jeane e. Russian Women Physicians, New on ille, MA, O ien al Resea ch Pa ne s, 1984, pp. 93-94. (34) POKROVSKAIA. O zhilishchakh pe e bu gskikh abochikh. Russkoe Boga s o, 1897, 6, 19-38. (35) BERNSTEIN, no e 21, pp. 306-307. DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. 234 MICHELLE DENBESTE-BARNETT Pok o skaia he sel was a den ly opposed o p os i u ion (36). In he publica ions she a gued ha he key o e adica ing p os i u ion was no egula ion o p os i u es by he go e nmen bu a he educa ion and economic al e na i es o women. In 1902 she w o e ha sex educa ion aimed a young men was he key o s opping he sp ead o ene eal diseases, bu by 1908 she claimed women would ha e o con ol hei own a e by ha ing he deciding oice in ~ egula ing sexual ela ions~ (37). She also s ongly belie ed ha egula ion o p os i u es endange ed al1 women. The i ual o ounding up any «suspicious» women ound wi hou p ope iden i ica ion as p os i u es (o en de ined simply as a woman walking alone Bn he e ening o in a suspicious pa o own) had nea ly esul ed in he own a es one nigh in 1905 (38). On opics such as p os i u ion and abo ion Pok o skaia is much mo e ou spoken han many o he emale coun e pa s. Bo h male and emale physicians engaged in an always-hea ed deba e o e p os i u ion because, as Be ns ein poin s ou , he p os i u ion deba e conce ned no only gende issues bu p o essional ones as well. ANNA SHABANOVA: PEüIATñICIAN ANLI WOMEN'S RIGHTS ACTWIST Anna Nikolae na Shabano a i s s udied a Helsing o s (Helsinki) Uni e si y, aided by a small schola ship om he w i e Sal yko -Sched in. The e she suppo ed he sel h ough ansla ion wo k, e u ning home in he summe s o ea n money. When he women's medical cou ses opened in Russia, she ans e ed in o he second yea class and g adua ed (36) See o ins ance, POKROVSKAIA. Bo 'ba s p os i u siei. Doklad ZZ o deleniiu Russkaia obshches o okh aneniia na odnogo zd a iia, S . Pe e sbu g, 1900; Kak zhenshchina dolzhna bo o 'sia s p os i u siei. Zhenskii Ves nik, Feb ua y 1909, pp. 33-39; and K bo 'be s p os i u sieiu. Zhenskii Ves nik, May-June 1904, pp. 113-114. (37) POKROVSKAIA. O zhe akh obshches ennogo empe men a, S . Pe e sbu g, 1902; POKROVSKAIA, Edinaia polo aia n a s ennos '. Zhenskii Ves nik, 1910, No. 4, p. 92; and ENGELSTEIN, Lau a. The Keys o Happiness: Sex and he Sea ch Fo Mode ni y in Fin-de-siecle Russia, I haca, NY, Co nell Uni e si y P ess, pp. 224-225. (38) BERNSTEIN, Lau ie. Sonia's Daugh e s: P os i u es and Socie y in Russia, Ph.D. disse a ion, Uni e si y o Cali o nia, Be keley, 1987, p. 337. DYNAMZS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia 235 in 1878. The lec u es o pedia ician KA. Raukh us had s ongly in luenced he and she u ned o pedia ics o a ca ee (39). Though she had been in ol ed in poli ical ci cles (and was jailed b ie ly in 1866), as a pedia ician, Shabano a le he ea ly poli ical agi a ion behind and u ned he e o mis impulses o imp o ing he li es o child en. A e g adua ion Shabano a wo ked in he child en's clinic o Nikolae sky mili a y hospi al, assis ing he women medical s uden s. A he same ime she was in i ed by Raukh us o wo k as a s a physician (o dina o ) a his clinic a he Oldenbu g Child en's Hospi- al. She wo ked he e o he es o he li e, wo king he way up o senio s a physician and con inuing on as a consul an when she was in he eigh ies. Shabano a es ablished he Socie y o he T ea men o Ch onically 111 Child en. Chemis and compose , A.P. Bo odin con ibu ed he p oceeds om one o his conce s o he cause, and by 1882 she had enough money o open he i s clinic a Ga china and a second a Vinda a la e . A a ious in e na ional cong esses she explained he success o such clinics in ea ing ch onically ill child en bu bemoaned he ac ha so ew exis ed in Russia compa ed o coun ies such as Ge many and Finland (40). He clinic a Ga china had wen y- wo beds and se ed abou 1,000 child en a yea . The a e age leng h o s ay pe child was app oxima ely 130-150 days. Shabano a was in ima ely in ol ed in women's issues and ounded he Russian Women's Mu ual Aid Socie y in 1895, he i s women's igh s o ganiza ion in Russia which s o e o wo k h ough legal and peace ul means o achie e equali y o women. In 1908 she o ganized he Fi s Al1 Russian Women's Cong ess. Shabano a also pa icipa ed in he League o S uggle o he Righ s o Women. In 1899 he In e na ional Women's League o Peace elec ed he chai (al hough wi h he ad en o Wo ld Wa 1 his o ganiza ion e11 apa ). Due o he a ilia ion wi h hese o ganiza ions she a eled ab oad and spoke a in e na ional (39) SHABANOVA, Anna. D a goda Gel'sing o skom uni e si e e. Ves nik E opy, 1888, 2, 538-575. (40) SHABANOVA, Anna. Popechenii o kh onichesko bol'nykh de iakh Rossii. Zhu nal Russkogo Obshches a Okh aneniia Na odnogo Zd a iia, 1899, 9, 849-857 and SHABANOVA, Anna. Obzo deia el'nos i de skoi lechebni sy u Ga chine, S . Pe e sbu g, 1887. DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. 236 MICHELLE DENBESTE-BARNETT o ganiza ions. She published ex ensi ely and a ended p o essional cong esses bo h a home and ab oad. P io o he dea h he new Socialis Union o Doc o s hono ed he and in 1928 she ecei ed a medal as a He o o Labo . She also became one o he i s women membe s o he S . Pe e sbu g Scien i ic-Medical Socie y o Pedia icians. Shabano a's ca ee spanned se e a1 decades and she con inued wo king e en la e in he 80's. IMPACT OF WOME2V'S PUBLICATIONS ON THE PROFESSION The ac ha so many woman and men w o e on social and public hygiene should no be su p ising. The ideas o ge m heo y had only begun o be in oduced in he 1870s. Many o he hygienis s' ideas con inued o be use ul e en when used hand in hand wi h mo e mode n knowledge o bac e ia. Some physicians o he ime e en dispu ed whe he bac e iology could be use ul in Russia, claiming ha imp o ed hygiene could p oduce be e esul s (41). In ac , hygiene and s udies conce ning hygiene emained i npo an in Russia pa ly because such d ama ic imp o emen s could be made o public heal h h ough (Ccommon sense» heal h imp o emen s. lMany o hese imp o emen s could be made wi hou a la ge mone a y in es men . Women physicians o en esea ched such opics as en ila ion in schools and homes, he e ec s o smoke om peasan hu s on eye disease, and p oblems wi h he wa e supply. As hese examples show, Russian women, like women in o he coun ies published manuals o women on hei own heal h and hygiene. Howe e , unlike women in o he coun ies, Russian women physicians also published la ge nu~be s o wo ks on in ec ious diseases, « emale complain s~, su ge y and a a ie y o o he medical opics. Se e a1 women publish epo s on he men ally ill and condi ions in men al (41) On his deba e see HACHTEN, Elizabe h A. Science in he Se uice o Socie y: Bac m'ology, Medicine and Hygiene in Russia 1855-1907, Ph.D. disse a ion, Uni e si y o Wisconsin- Madison, 1991, pp. 80-100; HUTCHINSON, John F. Tsa is Russia and he Bac e iological Re olu ion. Jou nal o he His o y o Medicine, 1985, 40, 420-439; and FRIEDAN, Nancy. Russian Physicians in an E a o Re onn and Re olu ion 1856- 1905, P ince on, P ince on Uni e si y P ess, 1981, pp. 135-160. DYNAMIS. Ac a Hisp. Med. Sci. Ziis . Illus. 1999, 19, 215-240. The Scien i ic Publica ions o Women Physicians in La e Impe ial Russia 237 ins i u ions (42). A signi ican numbe o women (abou se en pe cen ) publish a icles on in ec ious diseases. O he women publish on a wide a ie y o opics such as wo m in es a ions, blood p essu e, ca bonic acid in he ai , skin ansplan s, hypno ism, cance s, and umo s. These wo ks a e published in majo medical jou nals such as V ach and Medi sinskii Ves nik. Elsewhe e women s uggled jus o ge in o medical school, gain access o labo a o ies and be allowed o p ac ice. Fo eign medical jou nals do no begin publishing medical esea ch by women un il much la e . While Russian women ce ainly me on occasion wi h p ejudice and obs acles, hey also ecei ed p o essional suppo and encou agemen in e y angible ways (such as access o esea ch acili ies and he oppo uni y o in e ac wi h colleagues a p o essional con e ences and in hospi als). One woman, speaking in he Uni ed S a es in 1900, explained: «We mus no e he ac ha women doc o s ha e eally begun o play a pa in he li e o hei coun y. Whe e e he e a e wide-sp ead epidemics, amines o o he diseases, hey a e in he on ank o he helpe s. Besides his hey w i e and lec u e; and hanks o hei e o s, in e es has been a oused in a ious sani a y p oblems, such as, o example, he ecen ly opened sani a ium o lung diseases, which was p ima ily due o he e o s o D . Pa lo skaia. ... In conclusion we may say ha he Russian women doc o s, by hei wo k, ha e gi en he possibili y o u u e gene a ions o ad ance s ill u he on he oad o independence i s opened up by hem» (43). CONCL USIONS Clea ly women physicians became ac i e in Russian medicine. Bu , while we migh expec and e en hope ha women physicians would (42) KOVALEVSKAIA, Lidiia. Zemskii dom umalishennykh Sh eie ma ke. A khi Psikhia nia, Nei ologii, i sudebno-medi sinskoi Tsikhopa ologii, 1885, 5, .83; VALITSKAIA, M.K. Idiosink aziia ili o a lenie? Russkaia Medi sina, 1886, No. 14; and VALITSKAIA. F an suzskie zakony o dushe no bol'nykh. A khi Psikhia ni, Nei ologii i sudebno- medi sinskoi Psikhopa ologii, 1885, Nos. 4 and 5, pp. 101 and 66. (43) KAZAKOVICH-STEFANOVSKY, Helene. Women Physicians in Russia. T ansac ions o he Annual Mee ing o he Alumnae Associa ion o he Women's Medical College o Pennsyl ania, 1900, 25, 66. DYNAMZS. Ac a Hisp. Med. Sci. His . Zllus. 1999, 19, 215-240. 238 MICHELLE DENBESTE-BARNETT de elop al e na i e ea men s which migh be mo e sympa he ic and a en i e o women's iieeds, his does no appea o be he case. In ac , i could ha dly be o he wise. Women we e ained by male physicians in p e iously al1 male medical schools. Thei scien i ic iew o medicine is he e o e based on he male model. One supposed eason o aining women physicians was o p o ec emale modes y. This does no seem o occu , pe haps because oo ew women a e ained o mee his need. Weal hy women ha e access o p i a e p ac i ione s in he ci ies. Poo women o en p e e o isi adi ional heale s i s and hen when hey need a physician a e willing o see whoe e is a ailable. Va a a Kashe a o a- Rudne a, allowed o a end he Medical-Su gical Academy on a schola ship in exchange o he p omise o se e Bashki women, ne e could ul ill he p omise a e g adua ion due o bu eauc a ic oadblocks. While no necessa ily p oposing adically di e en ea men s han men, women physicians did end o be mo e sympa he ic owa ds women's heal h conce ns and owa d p o iding meaning ul educa ional ma e ials o women. In Zhuk's manual on hygiene he co e s much o he same ma e ial as Volko a o D en el'n bu he p esen s diso de s in a much mo e igh ening way. While Volko a co e s wha migh be expec ed du ing no mal childbi h along wi h common complica ions, Zhuk includes ex eme examples such as pic u es o mal o med heads, a woman wi h i e b eas s, and babies in inco ec posi ions (44). Ano he impo an aspec o women's pa icipa ion in medicine was ha hey did inc ease in e es in and knowledge abou ~women's issuesn such as child ea ing, and poli icized issues such as p os i u ion, abo ion and educa ion o women. Ce ainly male physicians published and esea ched women's heal h bu only se en pe cen o women physicians who published did no w i e any hing on women's o child en's heal h. Pa o he eason o his may be ha women we e less likely han men o specialize. Wo king as a zems o, duma, o p i a e physician equi ed b oad knowledge. Secondly, he ea ly women ea ned ce i ica es s a ing hey we e quali ied o ea women, child en, and syphilis only, so while many e en ually b anched o in o b oade a eas, many began by wo king (44) ZHUK, V.N. Ma ' i di ia: Gigiena obshchedos upnom izlozhenii, S . Pe e sbu g, 1894. DYNAMIS. Ac a Hisp. Med. Sci. His . Illus. 1999, 19, 215-240. The Scien i ic ~ublica ions o Women Physicians in La e Impe ial Russia 239 in women's clinics o o he zems o whe e hey saw bo h men and women by necessi y. Because Russian male and emale physicians sha ed simila p o essional goals, he animosi y which some imes g ee ed women publishing «se ious» li e a y, jou nalis ic, o medical wo ks in o he coun ies, did no a ec Russian women physicians. They we e able o publish hei esea ch, memoi s and epo s abou hospi als, schools o egions o wo k. Schola s s udying e olu iona y women ha e no ed ha while women o en pa icipa ed in dis ibu ing p opaganda and ope a ing p in ing p esses, hey a ely had a pa in o mula ing and w i ing heo y o posi ion pape s (45). Women physicians encoun e ed no such p ejudices. The mos p es igious medical jou nals published hei wo ks as did he published epo s o smalle local physicians cong esses. Respec ed male physicians no only ole a ed hem, bu ac i ely p omo ed hei wo k, o e ing sugges ions o esea ch opics and ad ice and collabo a ion. This lack o animosi y be ween male and emale physicians may be pa ially due o he eno mous need o mo e Russian physicians. In 1896 Russia had only 16,400 physicians o a popula ion o 92 million (46). Un il 1897, when he medical cou ses in S . Pe e sbu g opened a e a decade long hia us, and he numbe s o *women s udying medicine ose sha ply, Russia had only 959 emale physicians. Thus, hey did no p esen much o a h ea o he economic well-being o male physicians. As women could no by law se e in mili a y o go e nmen posi ions, mos women se ed in he lowe paying anks o zems o wo k o p i a e p ac ice. In 1888 o ins ance, o 698 p ac icing emale physicians, 540 lis ed hei special ies as p i a e p ac ice, 92 wo ked in zems os and 66 se ed in hospi als and as duma physicians (47). A mo e di icul concep o assess is he e ec hei publica ions had on he a ge audience. Ce ainly women physicians con ibu ed o (45) See o ins ance ENGEL, Ba ba a. Mo he s and Daugh e s: Women o he In elligen sia in Nine een h Cen u y Russia, Camb idge, Camb idge Uni e si y P ess, 1983, pp. 199-205 and MCNEAL, Robe . Women in he Russian Radical Mo emen . Jou nal o Social His o y, 1971-72, 5, 143-163. (46) FRIEDAN, no e 41, p. 266. (47) AREPEV, Nikolai. Zhenskoe medi sinskoe ob azo anie Rossii i zhenskii medi sinskii ins i u , Moscow, 1898, p. 27. DYNAMIS. Ac a Hisp. Med. Sci. His . illus. 1999, 19, 215-240.