A proper house: Bedford Lunatic Asylum (1812–1860)

ANNE WITZ, Professions and patriarchy, London and New York, Routledge, 1992, pp. x, 233, £10.99 (paperback 0-415-07044-9). Witz's book, based on her doctoral thesis, is primarily concerned to develop feminist and sociological theories of occupational development. But she does this through an analysis of the relationship between gender and the professionalization of medicine, midwifery, nursing and radiography in the late nineteenth and early twentieth centuries. So, although making few concessions to the non-sociologist in its terminology, the book may be of interest to historians interested in the development of the division of labour in health care since the nineteenth century. Witz compares the "professional projects", that is the strategies to enhance labour market resources and opportunities adopted by members or would-be members of these four occupations. What is original about her thesis is not this neo-Weberian approach but her systematic attention to the significance of the gender of the agents engaging in such strategies. She draws attention to the ways in which gender-related factors are often implicitly embedded in social institutions and structures and to the ways in which women, at least in the nineteenth and early twentieth centuries, often had to work through men to achieve change in the public sphere. One of her general arguments is that, in comparison with the male-dominated institutions of civil society such as hospitals and medical schools, "it was the nineteenth-century patriarchal state which provided the weaker link in the chain of patriarchal closure" (p. 196). Thus, in her analysis of women's campaign to enter medicine in the 1 860s and 1 870s, she argues that it was only when the women abandoned their emphasis on getting qualifications in favour of pursuing enabling legislation that they achieved at least a formal victory. Pro-registrationist nurses and midwives succeeded in getting a legally defined register on the statute books. But such successes were always constrained by women's relative inability to influence the form of, or access to credentials in other institutions. In her frustratingly brief case studies, Witz marshalls the details of what are, except for radiography, relatively well-known stories, in an often illuminating way. But, inevitably, many questions are left unexplored. Why, for example, given her stress on the state as a "weak link", does she not consider whether the 1858 Medical Act was the key to women's entry to medicine rather than the barrier that she suggests? As she herself admits in her preface, she underplays the ideological strategies and moral arguments which played a large part in these professional projects. The book is at times heavy going, but certainly should stimulate more research into female professional projects.