People who have broken down barriers thrown up by law, social convention and institutional intolerance tend to make uncongenial company. There may be exceptions, but judging from Janice P. Nimura's "The Doctors Blackwell: How Two Pioneering Sisters Brought Medicine to Women and Women to Medicine," Elizabeth and Emily Blackwell were not among them. Though the sisters devoted most of their lives to opening the field of medicine to women, they had contempt for most members of their sex and, as a corollary, had no sympathy for the mid-19th-century struggle for women's political rights.

According to the relentlessly moralistic Elizabeth, women's inferior standing was owing to the deficiencies of women themselves, who are "so often careless mothers, weak wives, poor housekeepers, ignorant nurses, and frivolous human beings."

Improbably, the success of this eminently serious-minded pair could be said to begin with a joke. The idea of women studying the human body was considered both preposterous and indecent; but it was that attitude which, after Elizabeth had been rejected by other medical schools, opened the doors of New York state's Geneva Medical College.

The decision whether to admit her was left to the 113 (male) students in the expectation that they would veto it, but, seeing it as ludicrous and a great joke, the high-spirited young men voted her in. Elizabeth handled herself with such dignity and decorum that by the time she had received her degree in 1849 — the first woman in America to do so — she had won over both professors and students.

Eventually, after a more difficult journey, Emily received her medical degree in 1854. The same year, Elizabeth set up a dispensary in New York for poor women and, in 1857, with Emily, founded the New York Infirmary for Indigent Women and Children. It became a training hospital for the slowly increasing number of new women doctors. In 1868, the sisters went on to establish a medical school for women — despite having previously denounced such institutions as inferior to established medical schools, which they felt could better train women on an equal footing with men.

This dual biography is a detailed story of hard work, determination and evolving goals. If "The Doctors Blackwell" is not exactly a lively book, we may put this down to the "chilly company," as Nimura puts it, of its subjects. Elizabeth, it emerges, was hardest to take — even by her sister. Lofty in her dismissiveness and less interested in practical matters than Emily, she was so rigid in her belief that health and morality were linked that, even after the germ theory was generally accepted, "she could not embrace the idea that amoral microbes might be responsible for disease."

If we cannot find the sisters endearing, we must honor them for their contribution to the health and, despite their dim view of the female character, to the rights of women.

Katherine A. Powers, a Minnesota native, also reviews for the Washington Post and the Wall Street Journal.

The Doctors Blackwell
By: Janice P. Nimura.
Publisher: W.W. Norton, 352 pages, $27.95.