In 19th-Century Philadelphia, Female Medical Students Lobbied Hard for Mutual Aid

In the waning years of the nineteenth century, future doctors kept falling sick. Students at the Woman’s Medical College of Pennsylvania (WMCP) in Philadelphia regularly described the illnesses roiling their ranks. In diaries and other manuscripts relating their classroom triumphs, clinical foibles, and romantic entanglements, students recounted classmates who were wracked with pneumonia or delirious with fevers that kept them “rav[ing] all night long.”^[1] Much of the city shuddered from waves of typhoid fever, likely due to feces-flecked water squiggling through the Schuylkill River and into homes and businesses.^[2] WMCP wasn’t spared. Ingesting contaminated water could leave students clammy and uncomfortable, feverish and splotched with a rash. Someone’s stomach would heave as they vomited, their abdomen cramping with bouts of diarrhea. Resulting dehydration could be fatal.

Of course, this period at the cusp of the twentieth century was neither the first nor the last time that a school would wrestle with outbreaks of illness; that continues today. Long before universities responded to Covid-19 with testing infrastructure or by cloistering infectious students in isolation housing, the trainees at WMCP pushed for a collaborative and long-term solution on their own terms. Students insisted on an endowed bed at the local Woman’s Hospital of Philadelphia, where cash-strapped classmates could convalesce at no cost to themselves.

Archival materials don’t paint a clear picture of why students pushed for a hospital bed at this particular moment, but the women were acutely aware of classmates’ illnesses and deaths. In addition to commenting on these in diary entries, student groups sometimes drafted sorrowful condolences to mail to mourning families.^[3] And mutual aid had deep roots in the city; Philadelphia had been home to mutual aid efforts for over a century. Local collectives such as the Free African Society had been instrumental in responding to the city’s devastating yellow fever epidemic in 1793, often at great risk to the group’s already marginalized Black members, who could contract the disease while offering assistance.^[4] Whether they knew it or not, students at WMCP, a racially integrated school, were participating in a rich tradition when they set up a system for taking care of each other.

Students seem to have begun mobilizing for the bed around the early 1890s. Faculty meeting minutes reveal rumblings as early as November 1891, when students asked for permission to levy an annual tax of fifty cents on all matriculates to defray the $3,000 cost of endowing the bed.^[5] The instructors signed off on the plan, but the Board of Corporators – a group overseeing the school’s administrative and economic operations – ultimately nixed it.^[6] Students also tapped professors to donate a portion of their salaries, and in 1893, the faculty approved a resolution asking each to contribute $25 to endow the “Sick Fund.”^[7] That same year, students saw a broader infusion of money from wealthy donors, who gifted the school a sum of $10,000 to be invested. The donation came with a stipulation that income from the investments be “applicable to the relief of necessitous sick students of said college.”^[8]

The Students’ Association funneled the first portion of the money to the hospital by April 1895. Once the first thousand dollar-installment left the students’ hands, they found themselves with only $155.34 to put toward the next chunk.^[9] They considered several options for rustling up the remaining money, including courting the school’s alumnae association. “Our scheme met with a favorable reception by that body, and we believe we may count upon their practical aid in its fulfillment,” the chair of the Endowment Fund Committee told the Students’ Association in October 1895.^[10] Students also asked any sick classmates who availed themselves of the services to compensate the committee with whatever they could, so that the endowment could be “more speedily completed.”^[11]

For students wrist-to-wrist in the dissecting room or shuffling together behind doctors in hospital wards, WMCP had become a community. Outside of classes and exams, students posed for photos of themselves reading, strumming instruments, chatting, and melting chocolate over the glow of lamps. They looked at ease in each other’s company. Illness can be lonely, and that sense might have been magnified for students who were far from their families. Meeting minutes reveal that some students who fell ill returned home to rest, but it wasn’t always feasible. One early-20th-century class included students from India, Russia, Louisiana, California, Maine, and Massachusetts in addition to Pennsylvania, New York, New Jersey, and Delaware.^[12] Sick students frequently relied on the bed or on money from the broader fund earmarked for their aid. In the spring of 1894, a student named Frances Newton thanked the Corporators for supporting her while she was laid up with typhoid for nine weeks.^[13] The number of months per year that the bed was open to students was dictated by the amount of money that had been received toward its endowment. By 1896, the bed was available to students for three months a year, and sick trainees had occupied it for two of them.^[14] In the year ending January 1899, the hospital treated 21 sick students, though the institution’s annual report doesn’t specify how many of the student patients were pupils at WMCP, or how many of the WMCP students occupied the specific bed set aside for their use.^[15]

Still, we do know a bit about what hospital treatment looked like for WMCP students. Catherine Macfarlane, an 1898 graduate, chronicled her “light attack” of typhoid fever during her intern years (an incident she blamed on flies buzzing through her screenless windows).^[16] Care at the Woman’s Hospital included meals consisting exclusively of milk, a regimen that the Journal of the American Medical Association had declared to be “the orthodox diet in typhoid.”^[17] Another WMCP student described a swig of castor oil sometimes “disguised” by swirling it on a spoon with whiskey and wine.^[18] Patients also underwent cold therapies that escalated in intensity based on the extent of a student’s fever.^[19] A fever hovering at 102.5 warranted “cold sponging every three hours,” Macfarlane wrote, while a temperature that inched up to 103 called for being “plunged into the portable tub dragged alongside the bed and filled with cold water.”^[20] Macfarlane dreaded the tub: “I KNEW that if I had one of those baths I should get pneumonia and die,” she wrote.^[21] So she tried to avoid it however she could, taking “elaborate precautions every three hours” to cool her body down.^[22] She “pushed the bed clothes off, asked for a fresh icecap, composed myself and held my mouth open for a while before the nurse appeared with the thermometer,” she continued. In the end, she crowed, “I recovered without a tub bath.”^[23]

Other students didn’t recover at all. Sarah Herr was ill with typhoid fever for about five weeks, and spent at least some of that time in the Woman’s Hospital.^[24] We don’t have any accounts of Herr’s illness in her own words, and don’t know exactly what her treatment entailed or what her surroundings looked like, though the wards were designed to be “cheerful and well-ventilated.”^[25] If Herr stayed in a communal room, she would have been among a long row of beds dressed in crisp white linens, headboards facing bright windows with light streaming in through slatted shutters.^[26] Private rooms were much less stark, with decor including a dresser, tropical plants and cut flowers, a lively patterned rug, and a rocking chair.^[27] Maybe Herr’s classmates buoyed her spirits with notes or blooms, as they did for others; maybe she surrounded her bed with petals and letters. Whichever bed Herr occupied at the hospital, she expired there at the end of November.^[28]

Students tried to sustain the sense of community they had nurtured, sending a letter of condolence to Herr’s parents in Lancaster.^[29] But Herr’s remains were swiftly sequestered. Before loading Herr’s body onto a train to be reunited with her family in Lancaster, an undertaker signed a form swearing that it had been sealed off in accordance with the mandates of the Board of Health.^[30] The undertaker confirmed that the remains had been “securely encased” in a box made from “good sound lumber,” carefully “ploughed, grooved, and glued” and secured with “pitch or white lead and a rubber band….” to protect handlers against coming into contact with excretions that could spread disease.^[31] Herr’s family probably never got a final glimpse at her body before it was confined to the ground.

Back in Philadelphia, the sick-bed effort continued and even expanded. The relationship between the school and the Woman’s Hospital had soured and fractured as students and faculty complained about lack of opportunities for clinical experience. In the early 1900s, WMCP opened its own facility, known as College Hospital. While the bed at the Woman’s Hospital remained available to students for several decades after the split, another bequest endowed a bed at the new building, too.^[32]

Still, mutual aid wasn’t always enough; medicine wasn’t, either. As Herr’s story illustrates, treatment didn’t save everyone. But then, as now, student advocacy was powerful and treatment outcome wasn’t the only measure of its worth. The sick bed effort shares a kindredness with student-led efforts that continue to resonate today. Initiatives such as Covid Safe Campus – a group organized by disabled academics and activists, with whom I volunteer – provide support in the form of material resources such as respirators, but also less tangible forms of solidarity. They offer a space to share and learn from feelings of fear, dread, anger, glimmers of optimism. Like the sick-bed efforts, this work is infused with the ethos of community – responding to a dreadful, sometimes deadly situation with camaraderie and care.

Jessica Leigh Hester

Jessica Leigh Hester is PhD student in history of medicine at Johns Hopkins University. Her research focuses on race, class, gender, and the sensory landscape of nineteenth-century medical education in the Northeast and Mid-Atlantic United States. She examines dissection, body-trafficking, grave-robbing, and the long afterlives of human remains coopted as museum specimens and teaching tools. Jessica is also a science journalist whose work has appeared in the New Yorker, New York Times, New York Times Magazine, The Atlantic, and other publications, and the author of the book Sewer (Bloomsbury, 2023). She is working on a new book, for Random House, about fossils and the Anthropocene.

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