At a time when awarding medical degrees to women seemed laughable at best and immoral at worst, Elizabeth Blackwell persisted in making a life in medicine. Her sister Emily followed in her footsteps. In telling their story in “The Doctors Blackwell,” Janice P. Nimura invites us to learn about medicine, well-to-do women and social movements of the 19th century. After delving into the sisters’ letters and papers, the author ably illuminates the Blackwells’ struggles, the opposition they faced and the allies who helped make their success possible.

The Blackwell family emigrated from England in 1832 and eventually settled in Cincinnati. Of the eight children, five of them girls, only Elizabeth and Emily pursued careers in medicine. Elizabeth, whose life receives the majority of attention, believed that she could become a benevolent practitioner who would spare female patients from exposing themselves to male physicians. Emily followed in her footsteps and had a remarkable career as a surgeon, institutional leader and head of a medical school for women. Each sister made her way through a hostile medical terrain with crucial support from family members and both male and female supporters.

Denied admission to every institution she applied to, Elizabeth finally entered Geneva Medical College in 1847 when the faculty let the students vote on her acceptance. Some believed it was a prank. She arrived after the 16-week term began, returning the following year to hear the same lectures, as was the standard in medical education. There was little to learn. Treatment involved a “toxic arsenal of emetics, laxatives, diuretics, and expectorants” as well as “lances, leeches, and blisters.” Elizabeth studied privately with a physician before medical school and between terms observed cases in an almshouse hospital. There, she lived just off the female syphilis ward. Nimura observes that learning of prostitution from this experience led Elizabeth to write of the “hideousness of modern fornication,” a conviction that the author contends shaped Elizabeth’s career and life.

Elizabeth completed her training in Paris. Denied the opportunity to attend medical lectures, she studied midwifery at the maternity hospital. While there, she accidentally contracted conjunctivitis from an infant with gonorrhea ophthalmia and subsequently lost an eye after a long and painful convalescence. She recovered and returned to the United States, determined to make a career in medicine.

Emily’s studies began at Rush Medical College in Chicago. After being denied a second term, she graduated from Cleveland Medical College in 1854. She then joined her sister at her small dispensary, where she provided poor women medications, health advice and referrals to charities. Eventually, the New York Infirmary for Indigent Women and Children expanded into a hospital and a women’s medical college. The college closed as other medical schools began admitting limited numbers of women. The infirmary survived until 1981, long after the deaths of both women in 1910.

Although supporters of abolition, the sisters did not become allies of other activist women. Elizabeth once declared, “I don’t sympathize with these reforming ladies.” She argued with her friend Florence Nightingale about whether nursing or doctoring was the proper role for women. Both sisters resented the authority granted to Dorothea Dix, a leader in the Sanitary Commission during the Civil War. After mentoring the physician Marie Zakrzewska, who joined them at the New York Infirmary, they subsequently expressed relief when she departed for Boston. The suffrage movement similarly held no allure for them, even after one brother married suffragist and abolitionist Lucy Stone and another brother wed Antoinette Brown, an ordained minister and women’s rights advocate. The Blackwells were a literal, not a social, sisterhood.

The sisters lived apart in their final decades. Elizabeth decamped to Britain along with her companion and ward, Kitty, whom she adopted as a child. She published a book on moral education and joined organizations dedicated to social purity, and while medicine tiptoed along a more scientific path, she went down another. She rejected vaccination and vivisection and moved toward spiritualism. Emily, firmly anchored in New York, continued practicing surgery and running the institutions the two had begun. She adopted a baby and found a life partner in Elizabeth Cushier, a gynecological surgeon who worked with her. Readers may wish to know more about this partnership, but the author merely observes that it was “warmed by love.”

Nimura often sidesteps details of the Blackwells’ private lives and at times presents too much information, particularly about their clothing and residences. Despite the periodic narrative detours, the book moves at a lively pace. Readers learn in sometimes fulsome detail about the limits of “heroic medicine” — the delivery of treatments that had demonstrable effects. And they are offered descriptions of the “milder” alternatives, such as the internal application of leeches in lieu of bloodletting. Nimura correctly names medicine as heroic, not the Blackwell sisters. She presents them instead as pathbreakers; their achievements were their medical degrees and, in Emily’s case, her long practice.

In 1994, almost 150 years after Elizabeth began her studies, Hobart and William Smith Colleges, the successor to Geneva Medical College, erected a statue of her. Despite decades of medical practice and institutional leadership, Emily has yet to receive that honor. Reading this smart double biography makes clear why that delay in the first instance, and omission in the second, is regrettable.

The Doctors Blackwell

How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine

By Janice P. Nimura

320 pp. $27.95