With a few exceptions, women have been systematically erased from the history of nearly every field, and research and medicine are no exception. Anyone who disagrees with this assertion should honestly ask themselves: How many women do I know who have practiced medicine in past centuries? How did I learn about them? Were their contributions discussed in textbooks or taught in medical schools?

Against this backdrop, in a recent article in The BMJ, general practitioner trainee Becky Cridford, specialized foundation doctor Marina Politis, and general practitioner Jenna Chambers, all from Newcastle University and/or Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England, contend that the profound contributions of women throughout medical history have been forgotten and must be reclaimed.

From Hippocrates to Harvey, collective memory tends to focus almost exclusively on the so-called founding fathers of medicine. Women physicians of the 19th century, from Elizabeth Blackwell to Sophia Jex-Blake, are often celebrated as pioneers, when in reality they should be seen as a bridge between early modern and contemporary practitioners and the many women healers who passed on knowledge and practices rooted in the real world from one generation to the next.

Exclusion and Erasure

However, the reality is more disheartening than simple historical neglect. The healing practices of these women were not only forgotten but also actively sidelined by a frequently hostile medical establishment, a phenomenon that intensified from the 16th century with the professionalization of medicine.

From that moment, practicing medicine required university training, which, unsurprisingly, was available only to men, as well as a licence granted by a court or the Church. Consequently, women, along with men who could not afford the fees or did not conform to the dominant religious beliefs of the period, were excluded from formal medical practice. When women, who were often trusted practitioners in their communities, continued to provide healthcare, the medical establishment, composed exclusively of men, deemed their work illegitimate through persecution and punishment of women practitioners.

Recent historical analysis has not found sufficient evidence to support the once-popular theory that female midwives and healers were specifically targeted by European witch hunts. Nonetheless, the Scottish witch trial archives show that for some, healing was a risky practice: Among almost 4000 witchcraft accusations, 118 women and 24 men were persecuted for practicing folk healing or midwifery.

Barriers to Practice

“The idea that science has no ideology and is neutral because it relies solely on proven facts is another widely accepted statement that is, in fact, false.” While good science is grounded in evidence, it is also shaped by politics and ideology, like any human endeavor.

By the 19th century, as women fought for the right to study and practice medicine professionally, medical science itself was used by male doctors to prevent the inclusion of women. In 1874, psychiatrist Henry Maudsley argued that any attempt to educate women in medicine after puberty would injure their reproductive functionality, and members of the General Medical Council also reported concerns that women were not suited to the so-called exertion of medicine. Women relied on allyship and the ability to conform to pre-established exclusionary standards to obtain a foothold in professional medicine, which meant that wealthier women, supported by their families and male connections, were more likely to be successful.

Looking retrospectively helps us see how scientific authority and sociopolitical ideas became entangled, keeping medicine closed to women in the past. Fortunately, these ideas have now changed, but the original ideology can still be found in persistent structures and inequalities. Currently, in the UK, the majority of people in medical occupations are women, but gender equity remains elusive as women face pay gaps, sexism, and training barriers.

Looking carefully at the history of medicine helps move beyond simplistic thinking and reminds us that we often repeat the behaviors we criticize in our ancestors. Professionalization delivered major advances, but it also restricted who could practice, which counted as valid knowledge, sidelining women and men who could not afford a university education. Persistent inequalities in patient outcomes and medical careers reflect these factors.

Reclaiming Lost Knowledge

Seeking a full understanding of medicine’s past is not about ascribing blame through rigid categories of wealth, gender, or conformity. This means acknowledging the breadth of knowledge that could contribute to medicine, re-examining what was lost, and imagining what might be restored. This could be a greater recognition of the healing power of the environment and the real world, or the benefit of care structures that value relationships and community, not just efficiency.

As with all history, medicine has unheard voices and untold stories that we should explore; filling these gaps in knowledge may provide new ways to meet the social, climate, and demographic challenges that lie ahead.

If women had developed medicine on equal terms alongside their male contemporaries, what different structures and practices might have existed today?

There is no definitive answer, but medicine would almost certainly have been stronger at both scientific and human levels.

The authors reported having no relevant conflicts of interest. 

This story was translated from Univadis Spain, part of the Medscape Professional Network.