Special Keport prepared tor the United States Bureau of Education
Contributions to the History of Medical Education and Medical Institutions in the United States of America, 1776-1876.
- Author:
Davis, A.M., M.D. Wash-
ington : Government Printing Office, 1877.
The present volume informs us that during the first thirty years after the close of the war for independence, which included the first decade of the present century, seven medical colleges were organised and situated as follows : two in Philadelphia, two in New York, one in Hanover, N. H., one in Baltimore, and one in Boston. In the United States in 1810 only five colleges were in existence, since the two in Philadelphia were soon?merged into one, and one in New York was discontinued ?tfter a few years. At this date there were about 650 medical students in attendance, of whom about 100 received either the degree of bachelor or doctor of medicine.
These schools all at first adopted the policy of conferring the decree of bachelor of medicine on students who had studied medicine with some respectable practitioner not less than two years, and attended all the medical instructions in the college during one year or one college term, and the degree of doctor of medicine after three years of study and two annual college “terms.
During the Colonial period of American history, and for thirty or forty years subsequent to the achievement of the national independence, it was customary for young men entering upon the study of medicine to be regularly apprenticed to a practitioner for a term of three or four years, and during this time the preceptor was entitled to the services of the student, in dispensing and preparing medicines, extracting teeth, etc. and, when more advanced in study, in attending the sick. In return the student received instruction in all the branches of medicine. The term of apprenticeship extended in some cases to six or seven years, and commenced at the age of 15 or 16 years. The idea of founding medical schools was not to supersede but to supplement the work of the preceptor and the medical apprentice. The preceptor could only carry on to a very limited extent the study of anatomy by dissection, the illus- tration of chemistry by experiment, and the clinical observations of disease at the bedside, but by combining several preceptors, each well qualified in some particular department, in a college faculty, with access to anatomical rooms, hospital for the sick, and chemical laboratory, all the branches of medicine could be didactically reviewed in five or six months of the year. The medical department of the University of Edinburgh was founded in the beginning of the eighteenth century, and fur- nished the model after which all the first medical schools in America were organised. The several professors arranged their courses of instruction to begin nearly at the same time, usually in September or October, and to be completed in time for the public commencement and conferring of degrees in the following May or June. The bachelor’s degree was generally conferred after attendance on one full course of college instruction, and the addition of one or two years more of study in which was included a second course of instruction, entitled the applicant to proceed to the degree of doctor of medicine. The total number of medical degrees conferred by the seven medical schools prior to 1810 did not in all probability exceed 600.
Many served a regular apprenticeship with a preceptor, attended one course of college instruction, and engaged in practice with a college degree, but not a few entered upon practice with the simple certificate of their preceptor, without having ever entered a college.
At the commencement of the present century the chief medical works in use were those of Sydenham, Boerhaave and Cullen, the anatomy of Cheselden and Munro, the physiology of Haller, the surgery of Sharp, Pott, and J ones, the midwifery of Hunter and Smellie, and the materia medica of Lewis. The field of medical study was therefore very limited. Surgery had then only begun to be recognised as a department distinct from anatomy. James Spence, F.R.C.S.E., professor in the University of Edinburgh, in an introductory lecture tells us ” so late as 1777, when the college of surgeons petitioned the patrons to institute a separate professorship of surgery in the University, they were opposed by Munro, then professor of anatomy, as interfering with his subjects, and he succeeded in getting his commission altered so as to include surgery, which was thus made a mere adjunct of the anatomical course, and continued to be so taught (if it could be said to be taught) until the institution of the chair of surgery in 1831. A professorship of surgery on an equality with the other professorships was first created in the University of Pennsylvania in June 1805. Midwifery was still later in being recognised as a distinct branch of medicine, and it was not till 1808 that the chairs of anatomy and midwifery were separated. In New York, however, midwifery was recog- nised as a distinct branch at a much earlier date than in any of the other cities possessing organised medical schools.”
The pamphlet before us then enters upon an account of the medical schools established or organised since 1810, giving a statistical resume, and explaining the character and purposes of early medical schools with the changes and results that have taken place during the lapse of years.
Much interesting information maybe derived from a perusal of Dr Davis’s work, and we must congratulate the author upon the admirable manner in which his Report has been drawn up.
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