Madeleine Brès

Madeleine Alexandrine Brès (née Gebelin; 26 November 1842 – 30 November 1921) was a French pediatrician and the first French woman to obtain a medical degree. In 1875, she defended her thesis on breastfeeding.^[1]

Madeleine Brès
Born	Madeleine Alexandrine Gebelin (1842-11-25)25 November 1842 Bouillargues, France
Died	30 November 1921(1921-11-30) (aged 79) Montrouge, France

Childhood

Born Madeleine Alexandrine Gebelin in Bouillargues, she stated in the Medical Chronicle on 1 April 1895 that her interest in medicine began in early childhood. She often accompanied her father, a craftsman, to the hospital in Nîmes where he worked periodically.^[1][2] At the hospital, a nun took a liking to her and taught her minor procedures, such as the preparation of herbal teas and poultices.^{[citation needed]}

She was twelve when the Gebelin family left for Paris, and just over fifteen when she married Adrien-Stéphane Brès, a tram conductor. Brès was able to pursue higher education thanks to the efforts of Julie-Victoire Daubié, who, in 1861, became the first woman to obtain a baccalauréat in France. However, Brès first had to obtain the consent of her husband, as French law at the time judged married women to be the legal responsibility of their husbands.^[3]

Education

In 1866, she presented herself to Charles Adolphe Wurtz, the Dean of the Faculty of Medicine at the University of Paris, and asked for permission to enroll in medical studies. The dean agreed, on the condition that she first obtain a degree in Arts and Sciences—a task she accomplished in three years. By then, she was 26 years old and a mother of three. Brès presented herself to the Dean once again, noting that there were no further obstacles to her enrollment.^[3] She also pointed out that three foreign women—the American Mary Putnam, the Russian Catherine Gontcharoff, and the English Elizabeth Garrett Anderson—held equivalent degrees known nationally.

Dean Wurtz took Brès's application to the Minister of Education, Victor Duruy, who approved her admission but preemptively brought the matter to the Council of Ministers. The Empress Eugénie also interceded on her behalf.^{[4]: 25–27} After her husband formally gave his consent to the mayor of the 5th arrondissement of Paris, she became a medical student in 1869 in the service of Professor Paul Broca at Mercy Hospital.^[3] Her admission was facilitated by the Law of 19 Ventôse Year XI (10 March 1803), which regulated the practice of medicine.^[5] She was admitted alongside Putnam, Gontcharoff, and Garrett-Anderson.

Internship and war service

Brès excelled in her studies. During her second year in 1869, she was a student under Professor Broca at the Pitié Hospital.^[6] With the onset of the Franco-Prussian War and the departure of many hospital physicians for the front, Professor Broca suggested she be made a temporary intern.^[7] She served in this capacity from September 1870 to July 1871. During the Siege of Paris and the Paris Commune, she remained at her post.^{[4]: 39–40}

Certificates from other physicians and the hospital administration praised her performance.^{[4]: 25–27} Professor Broca wrote:

Madame Brès, in my opinion, was appointed provisional intern. In that quality, during the two sieges of Paris and through the month of July 1871, she performed her service with such detail that no bombardment of our hospital was able to interrupt. Her service has always been perfect and her tenure irreproachable.^{[4]: 39–40}

Strengthened by this experience, Brès decided to pursue a hospital career and took the external and internal examinations.^[8] Despite Professor Broca's support, the director of the hospital's Public Assistance refused her authorization to apply for an externship on 21 December 1871. The refusal stated:

This is not in reference to you personally; I believe I could tell you that your permission for this could be agreed upon. However, the Council has understood that it could not henceforth restrict the questioning and the examinee on a general thesis within its applications and its consequences in future times; the Council has been unable to authorize this innovation that our Administration has decided to support.^{[4]: 25–27}

Brès did not insist further. Access to externships for female medical students did not become effective until 1882, when Blanche Edwards-Pilliet (1848–1941) became the first French extern. The application process for internships was not opened to women until 1886; the first French female intern to earn the official title was Marthe Francillon-Lobre (1873–1956) in 1900.^{[4][9]: 28–29}

Career in medicine

While studying medicine, Brès spent four years at the Museum of Natural History under Edmond Frémy and three years in the laboratory of Charles Adolphe Wurtz.^[10] She prepared a research thesis titled Of Breasts and Breastfeeding (French: De la mamelle et de l'allaitement), which she defended on 3 June 1875. She demonstrated that the chemical composition of breast milk is modified during the course of breastfeeding to better aid the growth and development of the infant.^[11]

She received a grade of "extremely good"^[2] and her thesis became known in France and abroad. She thus became the first French woman to become a Doctor of Medicine, five years after the British Elizabeth Garrett Anderson had obtained the degree in France.^{[citation needed]}

Widowed and responsible for three children, Brès decided against further pursuit of a hospital job. She moved to the Rue Boissy-d'Anglas in Paris and specialized in pediatric medicine and hygiene. She was surrounded by a wealthy middle-class clientele.^[10]

She was appointed by the Prefect of the Seine to teach guidelines to personnel in maternal schools, crèches, and kindergartens throughout the twenty administrative districts of Paris.^[12]

In 1885, she founded her own nursery at 83 Rue Nollet in the Batignolles district, where she cared for infants and children up to age 3 for free.^[13] This institution, which she financed herself,^{[14]: 146–147} was visited by Théophile Roussel and later by Marie-Louise Loubet.^{[15]: 5–8} The nursery eventually became a municipal institution but retained her name in recognition of her services.

In 1891, on a mission for the Ministry of the Interior, she traveled to Switzerland to study the organization and structure of nurseries and asylums.^[2] Brès also directed the journal Hygiène de la femme et de l'enfant (Women's and Children's Hygiene) and authored multiple books on child care and pediatric nursing.^[16]

Death

In 1921, the Pennsylvania Medical Journal reported that at age 82, Brès was "blind and penniless".^[17] She died in poverty in Montrouge on 30 November 1921.^[18]

Works and publications

• De la mamelle et de l'allaitement [Of Breasts and Breastfeeding]. Thesis for the doctorate of medicine, 1875.
• L'Allaitement artificiel et le biberon [Artificial Feeding and the Bottle].[attachment_0](attachment) G. Masson (Paris), 1877. Available on Gallica.^[11]
• A clinical report on Vin Nourry Iodotané. New York: E. Fougera & Company, 1893.^[19]

Tributes

• Several schools and nurseries (crèches) in France are named after her, including those in Bobigny, Fresnes, and Pas-de-Calais.^[20][21]
• A wing of the Hospital of Argenteuil (Val-d'Oise), opened in 2013, is named in her honor.^[22]
• Streets in Paris, Besançon, Nantes,^[23] Cabestany, Limoux, Perpignan, Poitiers, Lille, and Laval have been named after her.
• On 25 November 2019, Google celebrated her 177th birthday with a Google Doodle.^[24]

Distinctions

• Officer of the Academy (Officier d'Académie) in 1878.^[25]
• Officer of Public Instruction (Officier de l'Instruction Publique) in 1887.^[26]