My first medical consultation was a curious experience. In a severe case of pneumonia in an elderly lady I called in consultation a kind-hearted physician of high standing who had been present in Cincinnati at the time of my father's fatal illness. This gentleman, after seeing the patient, went with me into the parlour. There he began to walk about the room in some agitation, exclaiming, "A most extraordinary case! Such a one never happened to me before; I really do not know what to do!" I listened in surprise and much perplexity, as it was a clear case of pneumonia and of no unusual degree of danger, until at last I discovered that his perplexity related to me, not to the patient, and to the propriety of consulting with a lady physician! I was both amused and relieved. I at once assured my old acquaintance that it need not be considered in the light of an ordinary consultation, if he were uneasy about it, but as a friendly talk. So, finally, he gave me his best advice; my patient rapidly got well, and happily I never afterwards had any difficulty in obtaining a necessary consultation from members of the profession.

In 1856 my working powers were more than doubled by the arrival of my sister, Dr. Emily Blackwell, who became henceforth my partner and able co-worker. Dr. Maria E. Zackrzewska also joined us as soon as she had graduated at Cleveland, and became for some years before her removal to Boston our active and valued assistant in the New York work.

Many cases of extreme destitution have come to the dispensary. These have been chiefly emigrants, mostly Germans, without friends or money, and ignorant of the language. Several families have been visited where some member was sick, and found utterly destitute, suffering from hunger, and though honest and industrious, disappointed in every effort to obtain work. To such families little help with money, generally in the form of a loan till work could be procured, has proved invaluable, and a small poor fund placed by some friends in the hands of the attending physician, for this special object, has saved several worthy families from despair and impending starvation. Poor women and children may be sent from any part of the city to receive the medical aid of the dispensary, it being free to all.

The physiological peculiarities of woman even in single life, and the disorders consequent on them, cannot fail frequently to interfere with the regular discharge of her duties as physician in constant attendance on the sick. How much greater must be the interruption to her duties if she enters the marriage state, and becomes a mother and nurse. The delicate organization and predominance of the nervous system render her peculiarly susceptible to suffer, if not to sink, under the fatigue and mental shocks which she must encounter in her professional round. Man, with his robust frame and trained self-command, is often barely equal to the task. The home influence of woman is one of the greatest benefits growing out of Christian civilization. More especially is this manifest when we look at her as the head of the household, a helpmate to her husband, and the confidante, guide, instructor, and loving friend of her children, whose future happiness and respectability so much depend on her tuition and example. What would be the state of the household, what the present condition and future prospects of the children, deprived to a considerable extent of their natural guardian, who would be engaged all day and not secure against calls in the night, in the service of the sick? Nor when at home, can the mother, worried and fretted and anxious about her patients, give healthy milk to her infant, or be in a fit frame of mind to interchange endearments with her beloved little ones, to receive their confidences and offer advice.

Once embarked in the practice of medicine, a female physician will not long confine herself to attendance on persons of her own sex. Curiosity, caprice, the novelty of the thing, would induce some men to ask the professional advice of a woman doctor. It is sufficient to allude merely to the embarrassments which would be encountered on both sides, in her visiting and prescribing for persons of the opposite sex. If her services be restricted to the female portion of the family, then must there be a male physician to attend on the males, and thus there will be constantly two physicians in the regular service of the family, with all the chances of counter prescriptions and advice and breach of ethics, misunderstandings and heartburnings, by each one passing the lines of the other. If a female physician be once received in full standing, and professional intercourse by consultation or at other times with a physician of our sex be allowed, the greatest latitude will be taken and given in the statement of the case of disease, whatever it may be, its symptoms and causes, and questions of treatment therapeutical and psychical. Will woman gain by ceasing to blush while discussing every topic as it comes up with philosophic coolness, and man be improved in the delicate reserve with which he is accustomed to address woman in the sick room? The bounds of modesty once passed in this professional intercourse, will the additional freedom of speech and manner thus acquired impart grace or dignity to a woman in her new character?

The first shot at Fort Sumter aroused the whole North, and the assassination of Lincoln enlisted the indignant energy of every Northern woman in the tremendous struggle. As the deadly contest proceeded, and every town and village sent forth its volunteers to the fearful slaughter of civil war, the concentration of thought and action on the war dwarfed every other effort.

On the outbreak of the war, an informal meeting of the lady managers was called at the infirmary to see what could be done towards supplying the want of trained nurses so widely felt after the first battles. A notice of this meeting to be held at the infirmary having accidentally found its way into the New York Times, the parlours of the infirmary were crowded with ladies, to the surprise of the little group of managers.

The Rev. Dr. Bellows and Dr. Elisha Harris being present, a formal meeting was organised. Whilst the great and urgent need of a supply of nurses was fully recognised, it was also felt that the movement would be too vast to be carried on by so small an institution. A letter was therefore drafted on this occasion, calling for a public meeting at the Cooper Institute, and a committee of the ladies present was appointed to obtain signatures to this call.

The meeting at the Cooper Institute was crowded to overflowing. The National Sanitary Aid Association was then formed, in order to organise the energetic efforts to help that were being made all over the country.

The Ladies' Sanitary Aid Association, of which we were active members, was also formed. This branch worked daily at the Cooper Institute during the whole of the war. It received and forwarded contributions of comforts for the soldiers, zealously sent from the country; but its special work was the forwarding of nurses to the seat of war. All that could be done in the extreme urgency of the need was to sift out the most promising women from the multitudes that applied to be sent on as nurses, put them for a month in training at the great Bellevue Hospital of New York, which consented to receive relays of volunteers, provide them with a small outfit, and send them on for distribution to Miss Dix, who was appointed superintendent of nurses at Washington.

At first he was very discouraging, to my astonishment then, but now I fancy he did it as a forlorn hope to check me; he said the whole idea was so disgusting that he could not entertain it for a moment. I asked what there was to make doctoring more disgusting than nursing, which women were always doing, and which ladies had done publicly in the Crimea. He could not tell me. When I felt rather overcome with his opposition, I said as firmly as I could, that I must have this or something else, that I could not live without some real work, and then he objected that it would take seven years before I could practise. I said if it were seven years I should then be little more than 31 years old and able to work for twenty years probably. I think he will probably come round in time, I mean to renew the subject pretty often.