Robert Moorhead

Breaking New Ground: The Story of Dagmar Berne

In 1885 a young country girl enrolled in medicine at Sydney University. She was the first woman in Australia to enroll in a medical school. The medical school at this time was heavily influenced by academics who had graduated from the University of Edinburgh. At one point in her medical education she experienced difficulties with her examinations, the reasons for which are a point for debate. Under the mentorship of a famous British female medical practitioner who was visiting Australia at the time, she continued her studies in the United Kingdom. Here she was successful and returned to practice in New South Wales in 1895. Her experience of medical education was not without suffering. This young woman became part of an international group of women who at the time were trying to break into a field dominated by men.

Today in Australia and New Zealand women comprise more than half of the number of medical students in universities. ¹, ² It should not be forgotten that this has not always been the case. Internationally it was not until the middle of the nineteenth century that the first woman, Elizabeth Blackwell, graduated in medicine. She was born in England and returned after graduating in the United States, to lecture to women on medical subjects. It is recorded that one of the women attending these lectures was Elizabeth Garrett Anderson who became the first woman medical graduate in England. ³

Australia's first woman medical student was Dagmar Berne who attended the University of Sydney. It was at a crucial time in her medical course in Sydney that Elizabeth Garrett Anderson influenced her to go overseas to complete her training.⁴ There has been considerable debate about Dagmar Berne as to whether or not she was a literal and direct victim of sexism during her Sydney Course. This article revisits her journey and her inspirational determination in the face of adversity.

Path to medical studies

Dagmar Berne was born in 1866 and grew up in the country town of Bega on the South Coast of New South Wales. Her correct name was Georgina Dagmar Berne and her father, Frederick Berne, was a Danish migrant.⁵ Her mother, Georgina Witton, a widow with four children before marrying Frederick, was born in Hobart in 1837.⁶ They married in the local district⁷ and had four children of their own: Georgina Dagmar, Florence, Eugenie and Frederick.⁸ They lived in town in what is still called Denmark House, in Auckland Street opposite the bank.⁹ Dagmar did not go to school as a child, learning by asking the others questions and listening while they were being taught.¹⁰

The Bega River Valley was prone to flooding¹¹ and in March 1874 a flood claimed three lives including that of Fred Berne while he was attempting to swim a horse across the river at Frogs' Hollow Ford. His body was never recovered.¹² This tragedy forced Dagmar's mother, now a widow for the second time, to leave Bega and bring the family including Dagmar aged eight to Sydney.¹³

In Sydney the family lived in L'Avenue Newtown¹⁴ and all the children went to the local Primary School. Hutton Neve in her book, This Mad Folly records that subsequently the children had a private school education and Dagmar became a boarder at a private school in Darlinghurst. After two terms here Dagmar apparently wrote to her mother, 'I think the fees you have to pay for me are far too high for the little amount of learning which I am getting.'¹⁵ She then received private coaching for her matriculation exam, part of which occurred at Sydney University to which she rode on horseback each day to learn chemistry.¹⁶ This may have been due to the difficulty or even impossibility at the time for girls at New South Wales high schools to obtain training in chemistry and physics.¹⁷

It is not clear as to why Dagmar chose to enter medicine but she sat for matriculation for Sydney University in 1884.¹⁸ The matriculation requirements were aimed at the needs of an Arts student and were broad in nature. In order to matriculate she needed passes in Latin, Arithmetic, Algebra, Geometry and one subject chosen from Greek, French, German, Elementary Chemistry and Elementary Physics.¹⁹ She passed her matriculation and at the age of eighteen entered Sydney University to do Arts 1 in 1885. At that time Arts 1 needed to be completed before entering Medicine and this she achieved by studying Latin, French, Euclid, Algebra, Trigonometry, Arithmetic, Chemistry, Physics, and English.²⁰

The University of Sydney medical school: Foundations and early influences

On 13 June 1856 the Faculty of Medicine at the University of Sydney was formally created and the first dean appointed. It was the first medical school in Australia and New Zealand and initially served as an examining body. There was to be no teaching however for twenty-seven years.²¹

A British Empire incident eventually pulled the medical school out of its doldrums. In 1868 the visiting twenty-three-year-old son of Queen Victoria was shot at point blank range by a deranged Sydney Irish-Australian. This happened during a fundraising event full of local dignitaries.²² Immediately before the assassination attempt the prince had been chatting to the chancellor of Sydney University, Sir William Manning. The assassin also tried to shoot the chancellor but missed.²³ Prince Alfred survived and the local community as a thanks offering, and with the wish to dissociate itself from the Irish cause, raised funds which together with a generous bequest enabled the medical school as we know it to open in 1883 with a young Lowland Scottish professor, Anderson Stuart as dean and six male students.²⁴

In fact there was a strong Scottish representation on the new staff of 'men from the north of the Tweed'.²⁵ Anderson Stuart was himself an Edinburgh Medical School graduate. One of his idiosyncrasies was to keep human bones in his trouser pocket to familiarise himself with their texture and shape.²⁶ From his overworked mother he inherited a very determined will, an acute intellect and a rapier wit.²⁷ He enrolled as an undergraduate at Edinburgh in 1875 and subsequently won many medals. As a new antipodean dean his vision was the Sydney medical school and its building. In his book, Herbert Moran, an Australian doctor from the era who published his reminiscences, felt that 'Stuart's monument was the Medical School and no one can say his was a slight achievement.'²⁸ On the other hand he described him as 'a ruthless autocrat' while William Epps, Stuart's biographer, felt he was 'intensely downright and definite in his views.'²⁹ Stuart himself relayed to Epps the following story which appears in the biography:

On arrival at Sydney University he was taken to what there was of the Medical School, a little four roomed cottage still in the stages of construction. He [Anderson] is recorded as saying I spoke of 'a four roomed cottage', I should really have said 'two roomed', because Stephens, the newly appointed Professor of Natural Philosophy was teaching botany and zoology in [two of the] rooms. These rooms I wanted badly; so I contrived to make the place smell as disagreeably as possible, and he was glad to get out. Then I wanted a lecture room and a proper dissecting room, and these were added as an annex. This served us well until we moved into the new building in the year 1889.³⁰

Epps felt that 'probably the greatest defect in his character was an absence of consideration for the views of others.'³¹

Edinburgh University about this time had a poor record of encouraging women to enter. In 1870 there had been riots in the Edinburgh Surgeon's Hall by male students wishing to stop women attending an anatomy exam (as extramural students).³² The women students led by Sophia Jex-Blake had been let in to the Medical School on the proviso that they received instruction in separate classes and from volunteer professors.³³ At the time of the riot, 'one student seeing their predicament rushed out and managed to get the gates open and escorted them inside, where they sat the exam in spite of the continuing noise inside and the forcible intrusion of poor bewildered sheep, which were pushed in by rioters.'³⁴ In the year that Anderson Stuart commenced undergraduate training in Edinburgh an extramural woman student came first in Chemistry and was eligible for a 200 pounds medal and a scholarship. This was blocked by Professor Crum Brown and with the Senate's backing the next student, a male, became the recipient.³⁵ Subsequently the following poem appeared in a London review magazine:

Shame upon thee, great Edna! Shame upon thee, thou hast done Deed unjust, that makes our blushes flame as flames the setting sun. You have wrong'd an earnest maiden, though you gave her Honours crown, And eternal shame must linger round your name, Professor Brown.

And I blush today on hearing how they've treated you, Miss P., How that wretched old Senatus has back'd up Professor B. Ah! The 'Modern Athens' surely must have grown a scurvy place, And the 'Varsity degraded to incur such dire disgrace. ³⁶

By 1874 the university had managed to oust the extramural women despite passing their professional examinations at the end of the first two years of medical studies.³⁷ Edith Pechey and Sophia Jex-Blake went to the continent and received their MD at the University of Berne in 1877.³⁸

In 1872 Professor Lister of antisepsis fame was reported as saying 'I confess that I regret it as a matter of serious character for our University … with practical facilities for our enormous classes … far too scanty as they are … to be invaded by the ladies—which is much to be lamented.'³⁹ On the other hand Professor Simpson of chloroform fame was supportive of Elizabeth Garrett's (later to become Mrs Garrett Anderson) attempt to be admitted to the school and had also employed the sister of Elizabeth Blackwell in his obstetric practice.⁴⁰ It was not until the opening of the Scottish Royal Colleges' licentiate examination ('Triple Qualification') in 1886 that Scots women were encouraged to study medicine in their own country.⁴¹

An ambiguous climate for women students

Dagmar Berne was among a shortlist of pioneering women medical students in Australasia. The University of Otago, New Zealand was the first of all Australasian faculties to agree to the admission of women in 1871 followed by Adelaide in 1874, Melbourne in 1880 and Sydney in 1881.⁴² Sydney University was the first in Australasia to enroll a woman as a medical undergraduate in 1885.⁴³ This was Dagmar Berne. However the University of Melbourne was the first to confer medical degrees on women in Australia as Clara Stone and Margaret Whyte graduated there on 6 November 1891.⁴⁴ In 1896 in Dunedin, Emily Siederberg was New Zealand's first woman medical graduate. She had enrolled in the University of Otago in 1891.⁴⁵

Regarded from its inception as a male preserve the University of Sydney on the whole did not specifically exclude women. On 6 April 1881 the Chancellor Sir William Manning read a statement supporting his motion for admission of women to the University. He said:

It appears to me very desirable that steps should be taken by the Senate without further delay – for the extension to women of the advantages of high education under the auspices of the University. The following occur to me as the more prominent reasons for this course.

In a political sense, both sexes have an equal right to participate in the advantages, seeing that this University has been founded for the general benefit of the Public and is maintained at the general public cost.

I apprehend that there is nothing in the Statutes of this University which is opposed to the equality in favour of women.

Socially, I see no reason why such women as may be ambitious of and competent to attain the higher education of the University, and desirous of receiving its distinctions, should not be admitted to full participation in the advantages it offers; save only that there may be a necessity for some differences of study, both on account of the greater delicacy of the sex and of the considerations of greater appropriateness to the course of life open to women.

The tendency of modern opinions on this question, and the example set by other Universities both at home and in some British Colonies, appear to render it almost imperative that we should open our own University to women equally with men”.⁴⁶

Two years later the first dean appointed to the School of Medicine made public his contrary views in terms of equality between female and male medical students.⁴⁷

Failures and obstacles

In 1886 Dagmar took her First Professional Examination, passing eighth out of a class of sixteen and obtaining second class honours in Botany, Chemistry, Zoology and Comparative Anatomy. In the class exams she came fourth in Junior General and Descriptive Anatomy, fifth in Botany and seventh in Chemistry.⁴⁸ Robert Scot Skirving in his article on Dagmar Berne mentioned that Dr. Cecil Purser, a contemporary, described Dagmar as a 'reserved woman, with plenty of intelligence and no small industry.'⁴⁹ Scot Skirving himself described Dagmar as 'a quiet friendly sensible girl and no fool' and recalled 'I know that Dagmar did quite creditably in the earlier subjects, such as physics, chemistry, botany and zoology and also in junior and practical anatomy. Apparently she somehow got tied up in the subjects of the Second Professional Examination.'⁵⁰ Dagmar failed this examination, which was held in 1888. In 1889 she passed Anatomy and Physiology and failed Materia Medica and Pathology. She was given deferred examinations in these two subjects in March 1890, which she failed.⁵¹

Might we find some explanation for such an unexpected downturn in Dagmar's results? Let us first explore the two failed subjects. The subject Materia Medica and Therapeutics was described in the 1890 Sydney University Calendar as a course where

'special attention is devoted to the Physiological as well as the Therapeutic effects of the various remedial agents, including under the latter the various substances of value, whether Pharmacopoeial or Extra Pharmacopoeial, obtained from the organic and inorganic kingdoms, and including further such physical agencies as heat, electricity and massage. The principles of Dietetics, of Hydrotherapy, and of Climatotherapy will be considered, as well as those of prescribing. Microscopic preparations, etc will be employed in, as far as possible, illustrating the lectures.⁵²

The lecturer in Materia Medica and Therapeutics, Storie Dixon, was also an Edinburgh graduate whose contribution to pharmacology was the translation of Schmiedeberg's Gundriss der Pharmakologie in 1887. This became the standard text in that subject (Elements of Pharmacology). He had also investigated the properties of castor oil. Anderson Stuart had also worked with Schmiedeberg.⁵³ In his book Moran rather cruelly describes the lecturer as a

short bellicose man who, when he walked, swung the arm which carried his bag, very aggressively. He was a man with a grievance: he and Stuart (the Dean) were always at loggerheads. In his subject he was the supreme master of irrelevance with only one contemporary rival, the Catholic Archbishop, then Coadjutor … In the end he lost his post, as the result of a Stuart manoeuvre for setting up a full chair in Pharmacology⁵⁴

He seems to have strengths other than lecturing if the previous quote is any guide.⁵⁵
The subject of Pathology is described in the same University Calendar as

Firstly Pathology of the Circulation, the mechanism of Blood, Nutrition, Digestion, Pulmonary System and Urinary System; secondly Special Pathology … chief morbid conditions of the principal organs in the body … supplemented by demonstrations upon fresh specimens whenever occasion offers at a hospital: and thirdly a Microscopic Course, in which the student prepares for himself sections of pathological material, mounting them for future use.⁵⁶

The lecturer, William Wilkinson, an Australian who was later replaced by an Edinburgh graduate, had worked with Robert Koch in Berlin and was the first to introduce the use of tuberculin in Australia. He was described as a popular teacher but not an exacting examiner, brilliant but very arrogant and conceited, learned rather than competent.⁵⁷ To be failed by an academic who has been described as not an exacting examiner, if that description is correct is a cause for concern especially with Dagmar's track record of diligence with her studies.

Aside from the subject lecturers there are suggestions that Dagmar faced yet more obstacles from the school and university at large. Robert Scot Skirving wrote an article about Dagmar Berne in 1944. Scot Skirving was an Edinburgh graduate of 1880 in the same year as Anderson Stuart and his year included Arthur Conan Doyle.⁵⁸ He was president of the first society in Australia for the study of medical history and literature.⁵⁹ In his article he stated 'I gather from her relatives and other sources that the powers that were, were not violently encouraging to her, and she doubted of further perseverance in Sydney would lead to success.'⁶⁰ (The other sources unfortunately were not named.)

Hutton Neve in her book, This Mad Folly more strongly suggests that both the chancellor and the dean would not allow any woman to graduate in medicine.⁶¹ However this is a hard argument to accept as the first two women medical students to graduate did so in 1893, one of whom without any exam failure along the way.⁶² Moreover, failure was not an exclusive female province. In the intake of 1885, which was Dagmar's, there were 15 students including two repeating the year who ultimately discontinued. Six of the 13 graduated in minimum time and one after repeating several years. So of 14 male students at intake only half graduated and the rest discontinued.⁶³

It is easier to accept Scot Skirving's description of the 'powers that were [who] were not violently encouraging to her.' Here the dean comes into focus.

In 1912 Epps recorded that Anderson Stuart desired him to set down what follows:

Very soon after the Medical School was opened we had a woman student, a very charming lady, who continued to be so until the end of her short life. I was very often asked (and have been often been asked since) whether I didn't think that medical education would tend to make women callous and coarse. I said that no such thing would happen; and no doubt women have remained women, although medically educated. I have seen no deleterious infl uence whatsoever. All the same, for many years, I was not in favour of them. I thought, as I think now, that the proper place for women is in the home, and the proper function for a woman is to be a man's wife, and for women to be the mothers of our future generations; but the law said they were to have equal rights and privileges with men in University matters, and I have endeavoured at all times loyally to carry out the law, and have taken their part on many occasions. I have come to the conclusion that, within certain limits, they have played a useful part in medical life, but there are limits. I was often asked whether I should advise this or that girl to go in for medicine in the early years; it was my invariable custom, after giving them the advice they sought, to add that I thought they would be much better employed if they got a nice frock and a nice man. By and by my advice became proverbial, and no one asked for it, as they knew pretty well what they were going to get beforehand. In all seriousness, while there is a place for a certain number of women in medicine, there are certain limitations of usefulness, and they will never, in my opinion, take the place or be equal to men in general medical work.⁶⁴

So it seems that Dagmar Berne was in the medical school at the time the dean was not in favour of medical women.

To add to such direct opposition to her studies, it might appear, and understandably so, that Dagmar found it somewhat discouraging not to have any female academics as role models in the medical faculty and all of her examiners would have been male. The first women lecturers in the University of Sydney were not appointed until 1904, and even then only in an honorary capacity.⁶⁵

It was at this time that Dagmar needed support and this came in the person of Elizabeth Garret Anderson. Elizabeth Garret Anderson had registered as a medical practitioner in England in 1866 having exploited a loophole in the regulations of the Society of Apothecaries. Facing hostility from the male medical establishment in England she had set up St Mary's Dispensary for Women in Marylebone staffed by women. This became the New Hospital for Women in 1872 and the Elizabeth Garret Anderson Hospital in 1917.⁶⁶ In 1888 Elizabeth Garret Anderson visited Australia and Dagmar Berne, with Anderson's kindly advice, determined to go afar and see if she could get qualifications in Britain.⁶⁷

The Royal Free Hospital

In 1828 voluntary general hospitals in London required patients to have a letter of recommendation from a subscriber to gain admission. A surgeon William Marsden found a young girl dying of disease and hunger on the steps of a Holburn church who had been refused admission at three hospitals. This made him establish a hospital 'to which the only passport should be poverty and disease.'⁶⁸ This became the London Free Hospital and with Queen Victoria's endorsement, the Royal Free Hospital. In 1877 it agreed to provide teaching to students from the nearby London School of Medicine for Women. Except for World War 1 the Royal Free was the only hospital in London to accept women medical students before 1947.⁶⁹ The dean of the London School of Medicine for Women was Elizabeth Garrett Anderson and the council included Charles Darwin and Aldous Huxley.⁷⁰

Dagmar Berne applied to the London School of Medicine for Women. A testimonial accompanied the application written on a University letterhead by J.T. Wilson, Challis Professor of Anatomy in the University of Sydney and pathologist to the Prince Alfred Hospital Sydney. He wrote:

I have pleasure in testifying that I have known Miss Dagmar Berne as a diligent, earnest and painstaking student of medicine since early in 1877. She has attended all the classes here necessary for the First and Second Professional examinations in Medicine, and has passed the First Professional examination. She has attained creditable percentages in the Class examinations held from time to time in various branches of the curriculum. Finally may I say that her general conduct has at all times and in all places been most exemplary and praiseworthy.⁷¹

Dagmar entered the London (Royal Free Hospital) School of Medicine in the Winter session of 1890–91 and she gained her LSA (Licentiate of the Society of Apothecaries) in 1893.⁷²

A career and a legacy

After attaining her licence, Dagmar then moved to Claremont Crescent Edinburgh and passed the diplomas of the Scottish Triple Qualification on 19 April 1893.⁷³ The Triple Qualification was the Licentiate of the Royal College of Physicians of Glasgow combined with the Royal College of Physicians in Edinburgh and the Royal College of Surgeons of Edinburgh.⁷⁴ In the latter half of the nineteenth century eighteen Australian women were licensed in Scotland. Five graduated from the University of Edinburgh, two from Glasgow and eleven obtained the Scottish Triple Qualification, among them Dagmar Berne. The tendency among newly qualified Australians, whether male or female, was to then acquire further experience in British hospitals, as ships' surgeons or by attending European classes and clinics, especially in Berlin, Vienna, and Paris. Dublin for midwifery training and London were other favoured destinations.⁷⁵ According to the Medical Register Dagmar Berne then worked at the North Eastern Fever Hospital South Tottenham.⁷⁶

Images 1a,1b: Dagmar Berne's Application for Admission to the London School of Medicine for Women. (Courtesy of the Royal Free Archive Centre, London.)

Images 2a, 2b: Testimonial accompanying Dagmar Berne's Application for Admission to the London School of Medicine for Women. (Courtesy of the Royal Free Archive Centre, London.)

She also worked at the Rotunda hospital in Dublin in 1894. This was the first maternity hospital in the British Isles and it was opened in 1767. The name derived from a round building similar to one in Ranelagh gardens in London and it was built in the gardens of what was then the Lying in Hospital.⁷⁷

At that time John W.R. Glenn was the Senior Assessment Master at the Rotunda and on 13 April 1894 he wrote as a character reference:

I have very great pleasure in stating that Miss Berne was a member of my Class in Gynaecology for the past two months and that she displayed marked (marked was underlined) aptitude for the work. Miss Berne I feel has a knowledge of the subject far above that held by most physicians, and I have no doubt, when I consider the rapid progress she made, will in the future grace herself a distinguished alumnus of the Rotunda Dublin. Miss Berne was most popular in the Hospital - kind and sympathetic but practical withal, and patients in the outpatient Maternity ever spoke of her in the warmest terms. Miss Berne leaves the Hospital to the great regret of all, and if good wishes can further her then her future is assured.⁷⁸

For Dagmar, however, the need to study overseas due to adversity at home came at a high price. The 1890s began in financial disaster and ended in the South African War.⁷⁹ In February 1892 a run started upon the Savings Bank of New South Wales. For two days a howling mob raged around the doors, climbing over each other in a frantic endeavour to get their money.⁸⁰ Dagmar Berne's bank failed and she battled on with her studies in England under financial difficulty with the support of her sister Florence. This crisis prevented her continuing her medical studies in London. Scot Skirving described a chance meeting with her at York railway station: 'She looked worn and rather frail, but perfectly brave and determined.'⁸¹ He felt that Dagmar never had robust health after these struggles in England, reporting 'I am told that at one of her examinations there she actually rose from bed with an active pleurisy present.'⁸² Dagmar Berne never married and she returned to her mother in Sydney. She left behind a young doctor who would not leave his career in Britain. Scot Skirving commented that 'Medicine is a mistress that most times allows of no divided attention and so that romance ended, one may say “by crisis.”'⁸³

In 1895 she returned to Sydney and registered her qualifications with the NSW Medical Board and practiced for two to three years in Macquarie Street. She worked hard to support her mother, and her sister Eugenie who was teaching came and lived with her. Eugenie was worried about Dagmar's pallor and racking cough and she persuaded Dagmar to have the appropriate tests which confirmed tuberculosis. At this point country friends persuaded her to move out to the town of Trundle in NSW believing that a hot dry climate might halt her illness. She moved there and set up practice from her shared home.⁸⁴

According to Neve, an old Trundle resident, recalled that

'When Dr Berne came here she was then a very frail and sick person, and was sometimes so weak that she could hardly shake a bottle of medicine. She was still pretty, with a neat but small figure. As a doctor she was very conscientious and capable, and everyone in Trundle loved and respected her, for she was so kind and took such a personal interest in all her patients.'⁸⁵

Susanna De Vries believes that Dagmar Berne felt that the practice of medicine was a vocation and she would often refuse to accept fees from the needy. She knew that she had not long to live. She did not return home in her last few days but worked unselfishly right to the last caring for her patients.⁸⁶

In 1900 the local newspaper, the Parkes Examiner reported 'Dr Berne, a lady physician who has been practicing at Trundle, for some time, died at midnight of the 22^nd instant. The deceased lady had long suffered from chest infections.'⁸⁷ Her death certificate recorded that she was thirty-three years old and the Cause of Death was pulmonary phthisis, pneumothorax and chronic exhaustion. She was given an Anglican burial at the Trundle Cemetery.⁸⁸ Scot Skirving reported that 'by the pious act of her mother, her memory in the University of Sydney, is perpetuated by the foundation of the Dagmar Berne Scholarship to be awarded to the woman medical graduate who takes the highest marks of her year in the final examination for the MB degree.'⁸⁹

A recent University handbook shows that the criterion for the Dagmar Berne Prize has been changed. It is given to the candidate who has according to the Chair of the Community and Doctor Theme Committee done the best Elective Term Project on a Community and Doctor theme.⁹⁰

Conclusion

Unfortunately several fateful blows seem to have fallen on Dagmar Berne during her short odyssey. These include the untimely and tragic death of her father, the experience of the University of Sydney Medical School Second Professional Examination and the financial pressures of the collapse of the banks in 1892–3. The consequence of these events probably led to her ill health, and the likely role of her difficulties at Sydney University in this tragic end must at least be questioned.

Part of the key to understanding the way that women's experiences of medical education in the late–nineteenth century in Australia have been represented is to recognise it as part of a wider, international movement of opening professional opportunities for women. Louella McCarthy makes a good point that the 'very public animosity exhibited by men in British and American medical schools was not duplicated in Australia, never the less Australia's place in the British Empire, and its participation in this wider “experiment” of training medical women, ensured that tales of discrimination and pioneering were effectively incorporated within the local narrative as well.'⁹¹ While this is so, it seems clear that there was at least some overt discrimination against Dagmar Berne in the Sydney medical school in the form of the dean's views of women in medicine. Stuart Anderson had been recruited from Britain and had spent his undergraduate days in a medical school that was very hostile towards women. His own advice to women considering medicine as a professional career was that they would be better off if they 'got a nice frock and a nice man.' It can be stated with some confidence that Dagmar was not actively encouraged by the powers that be. It seems significant too that she had no local role models as all her teachers and examiners were male.

Why Dagmar failed the Second Professional Examination is not clear. No evidence can be found that she was deliberately failed. However she and her family and others felt that this is what happened. Her record included passing the matriculation subjects required for the university, and passing the First Professional Examinations. She had also attained creditable percentages in the class examinations held from time to time in various branches of the curriculum. She was at the time described as a diligent, earnest and painstaking student of medicine and no fool. In addition to this, and in deference to the lack of encouragement from Sydney's dean, there were many supporters of Dagmar as a medical student and practitioner. Among those behind her were her family, Professor J.T. Wilson and Dr. John Glenn, the international pioneer Elizabeth Garrett Anderson, the Royal Free Hospital, The London School of Medicine for Women, the Scottish Colleges, and the Rotunda Hospital in Dublin. All of this begs the question, Why did a good student fail this exam? This question cannot be definitively answered as records are patchy, but what does seem certain is that Dagmar Berne was able to succeed despite this and other setbacks. Though hers is a legacy of compassion and courage, it is also a somewhat troubling story, with lessons learned, it can be hoped, for the experiences of future generations of medical students.

The University of Notre Dame Australia, Fremantle.

Notes

^1. Catherine Joyce and Johannes Stoelwinder, “ Riding the wave: Current and Emerging Trends in Graduates from Australian University Medical Schools,” Medical Journal of Australia no.6 (2007): 309–313.

^2. Julie Fitzjohn et al., “The Demographic Characteristics of New Zealand Medical Students”. Journal of the New Zealand Medical Association, 116 (2003): 1183.

^3. Isabella Younger Ross , “The Advent of Women Into Medicine,” Medical Journal of Australia no.1 (1953): 777–9.

^4. Robert Scot Skirving, “ Dagmar Berne: The First Woman Student in the Medical Section of the University of Sydney,” Medical Journal of Australia no.2 (1944): 407–9, 407.

^5. Hutton Neve, “Australia's First Woman Medical Student”, in This Mad Folly. The History of Australia's Pioneer Women Doctors, edited by Hutton Neve (Sydney: Library of Australian History, 1980), 62–70, 62.

^6. “Colonial Tasmanian Family Links Detail,” State of Tasmania (2006), Archives Office of Tasmania – Colonial Tasmanian Family Links Database (http://portal.archives.tas.gov.gov.au), Tasmania. (accessed 4 October 2008)

^7. Historical Search Index, NSW Registry of Births Deaths and Marriages, www.bdm.nsw. gov.au (accessed 24 August 2008).

^8. Neve, 62.

^9. William A. Bayley, History of Bega. The Story of the Settlement and Development of Bega (Sydney: Brooks, 1942), 47.

^10. Neve, 62.

^11. Anthony Scott, A History of Land Use in the Murrah/Dry River Catchment. NSW South Coast, Technical Report for CSIRO Land and Water, Canberra, 1999, 54, 99.

^12. Bayley, 115.

^13.Neve, 62.

^14. “Dagmar Berne's Application for Admission to the London School of Medicine for Women,” Student's Form – Particulars Respecting Application. Royal Free Archive Centre, The Hoo, 17 Lyndhurst Gardens London. United Kingdom. 1-2, 2

^15.Neve, 62

^16. Neve, 63.

^17. Marjorie Little, “Some Pioneer Medical Women of the University of Sydney,” Medical Journal of Australia no.11 (1958): 341–50.

^18. “Application for Admission to the London School,” 2

^19. K. W. Cleland, “The Medical Sciences,” in Centenary Year Book University of Sydney Faculty of Medicine, edited by John Atherton Young, Ann Jervie Sefton, and Nina Webb (Sydney: Sydney University Press, 1984), 271.

^20. “Application for Admission to the London School,”2

^21. John Atherton Young and Nina Webb, “Prologue: The Foundation of the Faculty,” in Centenary Book of the University of Sydney Faculty of Medicine, edited by John Atherton Young, Ann Jervie Sefton, and Nina Webb (Sydney: Sydney University Press, 1984), 1.

^22. John Ross, Chronicle of Australia (Melbourne: Chronicle Australasia Pty Ltd, 1993), 340.

^23. Manning Clark, Colonial Democrats in History of Australia, abridged by Michael Cathcart (Melbourne: Melbourne University Press, 1994), 320–7,323.

^24.Nina Webb and John Atherton Young, “Anderson Stuart and the Medical School,” in Centenary Book of the University Faculty of Medicine, edited by John Atherton Young, Ann Jervie Sefton, and Nina Webb (Sydney: Sydney University Press, 1984), 174.

^25. Keith Inglis, “Centenary of the University of Sydney,” British Medical Journal no.2 (1952): 439–41.

^26. William Epps, Anderson Stuart, M.D. Physiologist, Teacher, Builder, Organizer, Citizen (Sydney: Angus & Robertson Ltd, Publishers to the University, 1922), 37.

^27.Epps, 30.

^28. Herbert M. Moran, Viewless Winds. Being the Recollections and Digressions of an Australian Surgeon (London: Peter Davies, 1941), 92.

^29. Moran, 96.

^30.Epps, 51.

^31. Ibid., 10.

^32. Graeme Morton et al., “Civil Society, Governance and Nation, 1832–1914,” in The History of Scotland. From the Earliest Times to the Present Day, edited by R. Houston and W. Knox (London: The Folio Society, 2006), 505–81,562.

^33. Margaret Ross, “The Royal Medical Society and Medical Women,” Proceedings of the Royal College of Physicians Edinburgh 26 (1996): 630.

^34.Ross, 632.

^35. Edythe Lutzker, “Edith Pechey – Phison, M.D.: Untold Story,” Medical History 11 (1967): 42.

^36. Ross, 632.

^37. Ibid., 635.

^38. Ibid., 638.

^39. Ibid., 634.

^40.Lutzker, 42.

^41.W.S. Craig, History of the Royal College of Physicians of Edinburgh (London: Blackwell Scientific Publications, 1976), 581–6.

^42.Neve, 50.

^43.Little, 342.

^44. Younger Ross, 777.

^45. Richard Robinson, “The Otago Medical School, 1875–1975,” British Medical Journa1 1 (1975): 378–82.

^46. Gerald L. Fisher, The University of Sydney 1850–1975. Some History in Pictures to Mark the 125^th Year of Its Incorporation (Sydney: University of Sydney, 1975).

^47. Epps, 118.

^48. Neve, 64.

^49. Quoted in Scot Skirving, 408.

^50. Ibid., 408.

^51.Nina Webb, “Women and the Medical School”, in Centenary Book of the University. Faculty of Medicine, edited by John Atherton Young, Ann Jervie Sefton, and Nina Webb (Sydney: Sydney University Press, 1984), 219.

^52. “The Sydney University Calendar” 1890, 178. Sydney University Archives.

^53.John Atherton Young, “Second Act: The Medical School 1882–1889”, in Centenary Book of the University of Sydney Faculty of Medicine, edited by John Atherton Young, Ann Jervie Sefton, and Nina Webb (Sydney: Sydney University Press, 1984), 118.

^54.Herbert M. Moran, Viewless Winds. Being the Recollections and Digressions of an Australian Surgeon (London: Peter Davies, 1941), 94.

^55.Atherton Young, 119.

^56. “Sydney University Calendar,” 1890, 181.

^57.Atherton Young, 123, 135.

^58. Ibid., 131.

^59.Moran, 114.

^60. Scot Skirving, 408.

^61.Neve, 66.

^62. Little, 342.

^63.Webb, 220.

^64. Epps, 118.

^65. Claire Hooker, Irresistible Forces. Australian Women in Science (Melbourne University Press, 2004), 9. The first women to be appointed as lecturers at Sydney University were Dr. Kate Hogg and Dr. Marey Booth.

^66.Nick Black, “A Cradle of Reform,” Journal of the Royal Society of Medicine 100 (2007): 179

^67.Scot Skirving, 40.

^68.Black, 177.

^69. Black, 77.

^70. Ruth Bowden, “In Memoriam. Mary Frances Lucas Keene and Her Era (1886–1977),” Journal of Anatomy 125 (1978): 199–204.

^71. James T Wilson, Testimonial dated 1890 accompanying “Dagmar Berne's Application for Admission to the London School of Medicine for Women” Student's Form—Particulars Respecting Application. Royal Free Archive Centre, The Hoo, 17 Lyndhurst Gardens, London.

^72.Victoria Rea (archivist), personal communication to author, Royal Free Archive Centre, London, 2007.

^73. Carol Parry (archivist), personal communication to author, Royal College of Physicians and Surgeons, Glasgow, 2007.

^74.Scot Skirving, 407.

^75. Laurence Geary, “Australian Medical Students in 19^th Century Scotland,” Proceedings of the Royal College of Physicians Edinburgh 26 (1996): 472–86.

^76. Neve, 68

^77.Gary Boyd, “The Hospital and the Spectacular City,” in Dublin 1745–1922 Hospitals, Spectacle and Vice (Dublin: Four Courts Press, 2006), 79–81, 79.

^78. “ Manuscript Character Reference from John W. R. Glenn, Senior Assessment Master at Rotunda, Dublin, concerning Miss Berne dated 1894,” Dagmar Berne Records MS 3700, National Library of Australia Manuscript Collection, Canberra.

^79. Moran, 13.

^80.Clark, 390.

^81.Scot Skirving, 408.

^82. Ibid., 408.

^83. Ibid., 408.

^84. Susanna De Vries. The Complete Book of Great Australian Women (Sydney: Harper Collins Publisher, 2003), 99.

^85.Neve, 69.

^86. De Vries, 100.

^87. The Parkes Examiner, 29 August, 1900.

^88. “Registry of Births Deaths and Marriages,” Sydney.1900/010053.

^89. Scot Skirving, 409.

^90.Dagmar Berne Prize/Faculty of Medicine Community and Doctor Prize, Prizes and Scholarships, 2008 Medical Faculty Handbook, The University of Sydney, http://www.usyd.edu. au/handbooks/medicine/03_prizesandscholarships.shtml (accessed 4th October 2008).

^91. Louella McCarthy, “Filtered Images: Visions of 'Pioneering' Women Doctors in Twentieth-Century Australia”, Health and History 8, no. 2 (2006): 91–110.

Why Should Physicians be Interested in the History of Medicine?

Robert Moorhead

It seems to me a paradox that clinicians ask patients about their past medical history and remain indifferent to the subject of medical history. In history taking we value the past information and try to use this in understanding the presenting problem. This sometimes results in diagnosis and subsequently considered action. I believe that we should consider medical history in the same light.	42
We should also address educating medical students about medical history. This leads us to the medical school curriculum. History can make our training more human at a time when I believe technology, reductionism, and rationing of health services are making medicine less human. History should be part of the curriculum, not an elective. It should be taught in a way that is engaging to the current generation of medical students. It should be part of the culture of all medical schools both overtly and covertly. It fits very comfortably with the medical humanities area of arts, music, literature, architecture philosophy, spirituality and last but not least, ethics.	43
Perhaps it is growing old that triggers the doctor to be interested in medical history. Does this mean more time for reflection about our profession, where it came from and where it is going? As older doctors we have seen a lot of change. Some of our patients suffered from diseases that we were powerless to prevent. Today we have vaccines, medications, and a better understanding of the cause of disease. Here is a humbling reason to be interested in medical history and to celebrate along with society our profession's successful progress. It is inspiring at a human level to see how an individual doctor made observations without technology, created hypotheses, and changed the way we practice.	44
The medical school should tap this resource of older doctors to help hand on the history with enthusiasm to the next generation of doctors. If history is not taught the legacy will be not enough academics, limited relevant resources in the medical library, and poorly argued misconceptions about the past.	45
My own interest started with the stories I was told as a child by my migrant grandparents. This was compounded by primary school history teachers who made history exciting. High school history for me however was rote learning of places, dates, and what seemed like historic buzz words. Then medical school seemed to present history as names to be remembered—you needed to know where the 'islets of Langerhan' were anatomically and what they did. It did not seem to matter who Langerhan was and how he discovered cells in pancreatic tissue which were later linked to the understanding of diabetes. (He did this as a 22 year old medical student who demonstrated meticulous observation—what a role model for students who may be thinking about research!) When I was training for general practice my mentors would mention books worthy of reading. They would be about inspiring practitioners who broke new ground by careful observation and measurement like MacKenzie, Budd, and Pickles, or the work on the doctor-patient relationship by Balint. This led me into general practice research. In clinical practice I am constantly reminded about history in general by patients and as a very small part of the health system I am forced to consider change and reflect on the history of clinical practice and politics of the past.	46
Attempts are being made to humanise medicine but while doctors need to know about a vast amount of technical medicine there is still a need for balance. Medical history should help as part of the medical humanities by encouraging refl ection and understanding past values with a view to the future.	47

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