Ernestina Puritz-Manassé (Ernestina Paper) was born in Odessa in 1846 in a wealthy family of a Jewish merchant of Russian origin, Michele Puritz-Manassé.
I was born in Odessa and since the Russian students did not have access to the university, to study medicine I first went to Zurich and then to the medical faculty in Florence, where I am about to become the first woman to graduate after unity of Italy.
Ernestina lived in Italy from 1872 until her death, excluding the period 1897–1905, when she returned to Odessa.
The opening of universities to women took place at the Zurich Polytechnic in 1867. Before that, only a few women considered exceptional—such as Elena Cornaro Piscopia, Laura Bassi, and Anna Morandi Manzolini—were awarded degrees in an extraordinary way at the Universities of Padua and Bologna.
Higher education was still considered useless, and even harmful, for fulfilling the family role assigned to women. For this reason, many “imperial subjects” migrated to Switzerland. After attending the first two years of university in Zurich, in 1872 Ernestina moved to Pisa and then to Florence, where she completed the last two years of clinical practice at the Royal Institute of Higher Studies.
In those years, the motivation that led women to study medicine was often their perceived natural predisposition to caring for the sick. However, their choices tended to concentrate in specific fields such as pediatrics and gynecology. In fact, these were the only specializations that the medical establishment initially admitted for the first “female doctors”.
Ernestina managed to enter university thanks to a secondary school diploma obtained in Switzerland. In Italy, since there were no secondary schools for girls, it was impossible for them to access university education. She became one of the first women to regularly attend university courses in Italy. She obtained a degree in medicine and surgery at the University of Florence after the formation of the unified Italian state in 1877.
Twenty-six years later, in 1900, 250 women were enrolled in Italian universities, 287 in secondary schools, 1,178 in gymnasiums, and almost 10,000 in professional and commercial schools. Fourteen years later, in 1914, there were about 100,000 students enrolled in secondary education institutions (including technical institutes).
After marrying the lawyer Yakov Paper, she took his surname and signed herself as Ernestina Puritz-Manassé Paper.
In the 1870s, the intellectual environment of Florence was invigorated by the presence of prominent figures in the arts and sciences, both Italian and foreign, drawn not only by the city’s long cultural tradition but also by the momentum created by its brief period as the capital of the Kingdom of Italy.
Between 1877, the year of the Coppino Law, and 1878, when Ernestina Paper became the first woman in Italy to graduate, a debate emerged on women’s access to higher education. This discussion found space in the pages of the local newspaper La Nazione.
During these years of intense discussion on women’s right to higher education, Puritz took part in a committee promoting the opening of a girls’ high school in Florence. Since the creation of coeducational high schools was not even considered at the time, numerous initiatives to establish girls-only secondary schools began to appear in various Italian cities.
The Florentine committee was promoted by Bartolomeo Zandonella, professor of Greek and Latin at the city’s “Dante” high school, and included Pasquale Villari, Gaetano Cammarota (superintendent of studies), Torello Sacconi (director of the National Library), several Florentine women, and others from Jewish and foreign families, among whom was Dr. Paper.
Thus, in liberal Italy, a small number of young women began enrolling at university, encouraged by the 1876 regulation that explicitly stated that women were also allowed to enroll. In those years, national and international debates on women’s rights, journalistic reports on developments abroad, and intense discussions in the press about educational reform played an important role in encouraging women to pursue higher education. These influences gave Italian women the courage to enter a world previously reserved entirely for men.
Her husband, Yakov Paper, whom she married in Odessa, likely died early (possibly in 1881), only a few years after the birth of their daughter Eliza, who was born in 1875 in Pisa.
In 1881, during the census, Puritz declared herself a “non-practicing doctor”: these were not years in which a female physician could easily build a stable clientele. At that time, on the first floor of Via Venezia 6, Ernestina lived with her mother, daughter, and some cousins. Together with her cousin’s wife, Mary Nathan Puritz, she was very active in the Tuscan Women’s Federation, where she served as president of the Hygiene Section.
Among her many activities, two cases of amenorrhea treated by Dr. Puritz using electricity in 1884 are described in detail.
Later, in 1886, she obtained a public appointment: the city’s Telegraph Directorate entrusted her with overseeing the health of female employees. Privately, she continued to provide free medical care to the poorest women in the Santa Croce district.
In 1894, she participated as a member of an international medical congress. She was deeply involved in medical and scientific dissemination, maintained contact with various university professors, and was active not only in medicine but also in social initiatives.
One of her most interesting activities was the promotion of hygiene and scientific education, which led her in 1911 to run a school for nannies, also open to “women and young ladies,” which was successful for several years.
Ernestina also cared for children in her private practice and for women employed in the telegraph service, a profession that enabled many girls to enter the workforce in the late 19th century, as it was considered relatively “new” and did not threaten established male professions, while female labor was cheaper.
She consistently fought to expand women’s access to professional careers traditionally reserved for men. In 1879, the periodical La Donna described her as follows:
She is the angel of the family, wife, most loving mother and finds time for all her duties, professing her medicine as a true priesthood and never neglecting the study. "La donna", 1879
During the First World War, she opposed compulsory female civil service, arguing that “for the good of the family” women should remain as close as possible to home. However, she also noted that it would be impossible to enlist “4 or 5 million women in such service, since only the strictest laws can enforce military service on men.”
Puritz practiced medicine privately and often without charging fees. Through Mary Nathan, Puritz became acquainted with Amelia Pincherle Rosselli (the Nathan and Rosselli families were related and business partners in England, where Mary was born). Puritz treated her children Aldo, Nello, and Carlo, and remained in contact with Amelia at least until 1911 (Florence, Rosselli Foundation).
In 1913, Elena French Cini, president of the FFT, and Puritz, head of the hygiene section, wrote to the mayor proposing assistance for poor mothers in the Santa Croce district. The project also included free medical care provided by Dr. Puritz and Dr. Carmela Daddi (FASC, General Affairs).
In 1921, Ernestine was still active as president of the FFT hygiene section (Almanacco della donna italiana, Florence 1921, p. 362). At present, there is no documentary confirmation of press reports that described her as a physician for the women’s section of the Florence Telegraph Office.
There is limited evidence of Puritz’s scientific work. Among it: in February 1877, she was admitted as a regular member of the Anthropological Society, nominated by anthropologist Paolo Mantegazza and Russian physiologist Aleksandr Herzen (assistant to Schiff) (Archivio per l’antropologia e l’etnologia, VII, 1877, p. 271). In 1884, two cases of amenorrhea treated by Puritz using electricity were reported in detail (Rivista clinica, III, 1884, pp. 206ff.). In 1894, at an international medical congress, she was listed among the “members and affiliates” (Atti dell’XI Congresso medico internazionale, Rome, 1895, vol. I, p. 70).
Ernestina Paper lived in Florence until her death in 1926 at the age of 80.
In 2025 Italy has issued a new postage stamp dedicated to Ernestina Paper, the first woman to receive a degree in medicine and surgery in Italy after the country’s unification. The stamp is part of the “Social Values” series and has a “B” denomination. The print run totals 225,000 copies.
The design features Ernestina Paper seated at a desk with medical instruments and an anatomy textbook open on a stand, emphasizing her historical role as a pioneer for women in medicine. The stamp also includes the inscriptions “ERNESTINA PAPER,” “PRIMA DONNA LAUREATA IN MEDICINA DOPO L’UNITÀ D’ITALIA,” “1846–1926,” as well as “ITALIA” and the “B” tariff marking. The design was created by artist Matias Ermo.
