A History of the Medical Department of the University of Pennsylvania/Chapter III
CHAPTER III.
It has been stated that the medical men who first settled in the Province of Pennsylvania came with their countrymen from Europe, and that into their offices or shops apprentices were received, to be trained in a knowledge of the healing art. It was well understood, however, that the highest grade of medical acquirement could not be derived from the resources alone of private practitioners, no matter how well informed they might be, or versed in the every-day application of science to the demands that were made upon their skill; and hence the resort, on the part of the rising generation, to prominent seats of instruction abroad.
The return of these youthful travelled aspirants was hailed with pleasure by their friends and fellow-citizens. The acquirements additionally gained by them from a visit to Europe afforded promise of a life of usefulness and distinction. They were believed to be conversant with the latest discoveries and improvements, and the exponents of the progressive attainment of the age. To their preceptors they returned with interest the debt of gratitude for early instruction, becoming in turn the teachers whose field of enterprise and labor lay in diffusing the results of their studies and inquiries. In exemplification it may be stated, that Dr. Cadwalader, who had studied anatomy in London under the guidance of the celebrated Cheselden, gave demonstrations to the physicians of Philadelphia, when he settled himself among them. It is interesting to know, that the place of delivery of these lectures was in Second Street above Walnut, on the back part of the lot which faces Dock Street. The Bank of Pennsylvania subsequently occupied the site. With respect to these lectures, Dr. Wistar remarks: “I suppose that the anatomy of that day, as well as of the present, enjoyed the honorable protection of literature, and that the dissections were made under the auspices of the most profound scholar of Pennsylvania, the President, James Logan, founder of the Loganian Library.” “This probably was the first business of the kind ever done in Philadelphia.”[1]
Credit is likewise to be awarded to Dr. William Hunter, of Newport, Rhode Island, a native of Scotland, and a relative of the celebrated Hunters, who, upon settling in America, gave lectures upon anatomy in 1754, ’55, ’56. As Dr. Cadwalader had been established in Philadelphia some time before the year 1751, at which date he was appointed one of the physicians of the hospital, and gave his lectures upon his return from Europe, the probability is in favor of his having first entered upon this branch of teaching.
Dr. William Shippen, Jr., the son of Dr. Shippen already mentioned, who had recently returned from Europe, commenced a course of anatomy in 1762. In the “Pennsylvania Gazette,” November 25, 1762, is the following announcement: “Dr. Shippen’s Anatomical Lectures will begin to-morrow evening, at six o’clock, at his father’s house in Fourth Street. Tickets for the course to be had of the Doctor, at five Pistoles each, and any gentlemen who incline to see the subject prepared for the lectures and learn the art of Dissecting, Injections, &c., are to pay five Pistoles more.”
The Introductory to this course of lectures was delivered in one of the large apartments of the State House, and many of the gentlemen of Philadelphia heard it with pleasure. The number of students who attended his lectures was twelve. Dr. Wistar, in his Eulogium upon Dr. Shippen, after the preceding statement, adds, “Such was the origin of our medical school.” Three courses of this private character were delivered.
Dr. John Fothergill appears uniformly to have evinced an interest in Pennsylvania, at first in relation to medical affairs, and subsequently in a more extended way by his anxiety to avert the calamity of war between the colonies and the mother country.[2] He was of the same religious persuasion as William Penn, and hence his concern for the welfare and prosperity of the Province. Dr. Wistar tells us “that the people of Pennsylvania seem always to have been regarded with affection by this gentleman, but at the present period he was more interested in them than usual. The Pennsylvania Hospital had lately been erected; he took it for granted that students would resort to it, and supposed that they would experience great difficulty in acquiring a knowledge of anatomy. To remedy this defect in the medical education of Pennsylvania, he employed Rimsdyck, one of the first artists of Great Britain, to execute the crayon paintings, now at our Hospital, which exhibit the whole structure of the body, at two-thirds the natural size, and the gravid uterus, with many of the varied circumstances of natural or preternatural parturition, of full size. Jentry, an anatomist of London, is said to have made the dissections from which these paintings were made, and Dr. William Hunter sometimes examined the work. They are supposed to have cost two hundred guineas, which, in addition to one hundred and fifty guineas which he contributed to the institution, constitute a most substantial proof of his regard as well as of his liberality.”
The account of the arrival and reception by the Hospital of the donation of Dr. Fothergill is given in the Minutes of the Board of Managers, to wit—“At a Meeting of the Managers and Treasurer, in the Warden’s Room at the Court House, Philada., the 8th, 11 month (Nov.), 1762.
“The Board being called at the request of Dr. William Shippen, Jr., lately arrived from London, he attended and informed the Board that per the Caroline, Capt. Friend, are arrived from Dr. John Fothergill seven cases, which contain a parcel of Anatomical drawings, which the Dr. informed him, when in London, he intended as a present to the Pennsylvania Hospital, but that he has not received any letter or invoice of them, nor any further directions but what the Doctor verbally gave him, and that he concludes his constant engagements prevented his writing per the ship. But by a letter from him to James Pemberton, dated 4th mo. (April) last, he therein signifies in general his intentions of sending this Present to the Hospital, and the uses he proposes thereby. Of it the following is an abstract:—
“I distributed the books thou wast pleased to send me as desired, but they came perhaps at an unlucky juncture. Money is much wanted here for numerous purposes, and men part with fifty pounds with reluctance, when they know that a little more would purchase them a hundred; the Hospital, however, must subsist itself as well as possible till better times. I propose to send, by Dr. Shippen, a present to it of some intrinsic value, tho’ not probably of immediate benefit. I need not tell thee that the knowledge of Anatomy is of exceeding great use to practitioners in Physic and Surgery, and that the means of procuring subjects with you are not easy; some pretty accurate anatomical drawings, about half as big as the life, have fallen into my hands, which I propose to send to your Hospital to be under the cape of the Physicians, and to be by some of them explained to the students and pupils who may attend the Hospital. In the want of real subjects these will have their use, and I have recommended it to Dr. Shippen to give a Course of Anatomical Lectures to such as may attend. He is very well qualified for the subject, and will soon be followed by an able assistant, Dr. Morgan, both of whom, I apprehend, will not only be useful to the Province in their employments, but if suitably countenanced by the Legislature, will be able to erect a School of Physic amongst you, that may draw students from various parts of America and the West Indies, and at least furnish them with a better idea of the rudiments of their Profession, than they have at present the means of acquiring on your side of the water.
“Should the Managers of the Hospital think proper, I could wish that, if the drawings and casts I shall send per the next convoy come safe, they might be lodged in some low apartment of the Hospital, not to be seen by every person, but with the permission of a Trustee, or for some small gratuity for the benefit of the House.”
The Minutes, moreover, express: “And Dr. Shippen proposing to exhibit a Course of Lectures on Anatomy this winter, requested he might have recourse to the said drawings and casts; and the Managers being desirous of countenancing him in his undertaking agree he may have the use of them, in such manner and place, as after consulting with the physicians may be thought most convenient, and not prejudicial to the drawings, as they require to be handled with the greatest delicacy and care; and after consulting with the Physicians, who, on notice being sent them, attended on the occasion, viz., Thomas Bond, Phineas Bond, William Shippen, Jr., John Redman, and Cadwalader Evans, to whom the proposal of Dr. Shippen, Jr. of his exhibiting a Course of Lectures, &c., being communicated, they unanimously expressed their approbation thereof, and it was concluded that the several cases should be conveyed to the Hospital and that the physicians and managers will attend at 3 o’clock P. M. to view the contents.”
With reference to these drawings, &c., the subjoined notice will be found in the “Pennsylvania Gazette,” May, 1763: “The generous donation of Dr. Fothergill, of London, to the Pennsylvania Hospital of a set of anatomical paintings and casts in plaster of Paris, representing different views of the several parts of the human body, being now deposited in a convenient chamber of the Hospital, and as there may be many persons besides students of Physic desirous to gain some general knowledge of the structure of the human body, Dr. William Shippen, Jr., proposes to attend there on the seventh day of the week, the 21st inst., at 5 o’clock P. M., and once a fortnight during the summer season, on the same day of the week and same hour, to explain and demonstrate them to such persons who are willing to give a dollar each for the benefit of the Hospital.” At a subsequent period the drawings were deposited in the Museum of the University, where they remained until 1866, when they were retransferred to the Hospital to be placed in its Pathological Museum.
The lectures upon Anatomy by Dr. William Shippen, Jr., were thus in full operation when, in 1765, Dr. Morgan arrived from Europe. As he and Dr. Shippen, Jr., must be regarded as the fathers of systematic medical teaching in this country, it will be proper to give an account of their previous training and qualifications to assume so important a duty.
Dr. John Morgan was born in Philadelphia, in 1736, and acquired his literary education at the college of this city, from which he received the degree of A. B. in 1757, with the first class which was graduated. He studied medicine with Dr. Redman, and upon the expiration of his indentures entered the Provincial army as a surgeon. This was at the conclusion of the French war, which terminated by the expulsion of that nation from Canada. In 1760, having resigned his commission in the army, he sailed for Europe with the view of perfecting his medical knowledge.
When speaking of himself with reference to this period, he states: “It is now more than fifteen years since I began the study of medicine in this city, which I have prosecuted ever since without interruption. During the first years I served an apprenticeship with Dr. Redman, who then did, and still continues to enjoy a most justly acquired reputation in this city for superior knowledge and extensive practice in physic. At the same time I had an opportunity of being acquainted with the practice of other eminent physicians in this place, particularly of all the physicians to the hospital, whose prescriptions I put up there above the space of one year. The term of my apprenticeship being expired, I devoted myself for four years to a military life, principally with a view to become more skilful in my profession, being engaged the whole of that time in a very extensive practice in the army amongst diseases of every kind. The last five years I have spent in Europe, under the most celebrated masters in every branch of medicine, and spared no labor or expense to store my mind with an extensive acquaintance in every science that related in any way to the duty of a physician; having in that time expended in this pursuit a sum of money of which the very interest would prove no contemptible income. With what success this has been done, others are to judge, and not myself.”[3]
During Dr. Morgan’s residence in London he experienced the benefit of the instruction of the Hunters and of Hewson. With the latter, as appears from his correspondence, he was on intimate terms. He graduated as M. D. at Edinburgh in 1763, his thesis being written upon the formation of pus. It is entitled “Πυοποιεσις sive Tentamen Medicum de Puris Confectione.” This thesis, when published, was dedicated to the Medical Society of Edinburgh, in the following terms: “Societati Medicinae Studiosorum in Academia Edinburgena dudum institutæ.”
In this essay the doctrine is maintained that pus is a secretion from the vessels, and in this he anticipated Mr. Hunter. Dr. James Curry, Lecturer at Guy’s Hospital, gives the credit of priority in this statement to him, and says: “I could not avoid giving that merit to Dr. Morgan, who discussed the question with great ingenuity in his Inaugural Dissertation on taking his degree at Edinburgh in 1763; whilst I could find no proof that Mr. Hunter had taught or even adopted such an opinion until a considerably later period.”[4]
While in England Dr. Morgan became a proficient in the art of injecting organs with wax, and preparing them by subsequent corrosion.[5] Carrying with him to the continent the evidences of his skill, he acquired such a reputation as to procure his admission as a member to the Academy of Surgery of Paris. While there residing, and attending the lectures of the distinguished anatomist M. Sue, he prepared a kidney by this process, which led to the distinction specified. Besides this honor, he was elected a member of the Royal Society of London, admitted as a Licentiate of the College of Physicians of London, and as a member of the College of Physicians of Edinburgh. He was also admitted to membership of the Society of Belles Lettres of Rome.
When in Italy Dr. Morgan visited Morgagni, at Padua. Dr. Rush says, in his notice of Morgan, that “this venerable physician, who was the light and ornament of two or three successive generations of physicians, was so pleased with the doctor that he claimed kindred with him from the resemblance of their names, and on the blank leaf of a copy of his works, which he presented to him, he inscribed with his own hand the following words: Affini suo, medico præclarissimo Johanni Morgan, donat auctor.” These volumes were placed by Dr. Morgan in the library of the College of Physicians of Philadelphia.
Dr. Morgan, while in Europe, appears to have constantly revolved in his mind the course he would pursue. In writing from London, November 10th, 1764, to Dr. Cullen, he remarks: “I am now preparing for America, to see whether, after fourteen years’ devotion to medicine, I can get my living without turning apothecary or practitioner of surgery. My scheme of instituting lectures you will hereafter know more of. It is not prudent to broach designs prematurely, and mine are not yet fully ripe for execution.”[6]
It has been shown that the practice of medicine in the Colonies embraced every branch of the profession, including pharmacy. This arose from the necessity of the case, and the difficulty of division of labor in a restricted community.
The plan pursued in Europe of a separation of practice into several departments was regarded as inexpedient, and had not been adopted. When Dr. Morgan returned from Europe, he determined to take a different course from that in operation, and was the first physician who restricted himself to simply prescribing for the sick.[7] In the Preface to his Discourse he published his views with respect to the mode of practice which he thought should be pursued by the physician, enforcing them with arguments derived from the advantages which he believed would be secured by such procedure.
Having been appointed professor in the college, there was another reason, having reference to this position, which must be admitted as valid. It is thus given: “As far as I can learn everybody approves of my plan for instituting medical schools, and I have the honor of being appointed a public professor for teaching physic in the college here. Can any man, the least acquainted with the nature of that arduous task, once imagine it possible for me to acquit myself in that station in an honorable or useful manner, and yet be engaged in one continued round of practice in surgery and pharmacy as well as physic?”
“To prepare for a course of lectures every year requires some leisure, and a mind undisturbed with too great variety of pursuits. So that my usefulness as a professor makes it absolutely necessary for me to follow that method of practice which alone appears to be calculated to answer that end.”[8]
Although the opinions of Dr. Morgan were not at the time adopted, nor was his example immediately followed, still, in connection with the history of the profession they are important, from the fact that he was the first practitioner in the city of Philadelphia who placed himself upon the highest ground, by separating himself from the handicraft which requires distinct skill, and so long a training, as to constitute in itself an occupation. He insisted upon the distinction being made between medicine proper and pharmacy, which ultimately became a recognized necessity, affording relief to the physician, while, by improving pharmacy, he was provided with greater resources for the application of his skill. The course pursued by Dr. Morgan may be said to have given the original impulse to the cultivation of the profession of pharmacy, and sanctioned its independent existence.[9]
Dr. William Shippen, Jr., was born in Philadelphia in 1736, and received his elementary training from the Rev. Dr. Finlay, of Nottingham, in Maryland. He entered the College of New Jersey, then established at Newark under the direction of President Burr. He graduated in 1754, and, being distinguished for oratorical talent, was advised by Whitfield to devote himself to the clerical profession. He entered the office of his father, Dr. William Shippen, Sen., a respectable practitioner of Philadelphia, and a public-spirited citizen, by whom he is said to have been trained with reference to his future course as a lecturer. “The old gentleman must have been made sensible by his own personal experience of the value of an European medical education,” and his son was sent to Europe in the year 1757, soon after he was twenty-one years of age.[10]
In London he studied Anatomy with and resided in the family of Mr. John Hunter, but was also associated with Dr. William Hunter and Mr. Hewson.[11] While in the British Metropolis, in addition to Anatomy and Surgery, he devoted a share of attention to the rising department of Obstetrics, attending in the summer season the lectures of a celebrated accoucheur, Dr. McKenzie, which were delivered near St. Thomas’s Hospital. As he removed to this neighborhood, we may suppose it was in consequence of the practical advantages afforded by proximity to the poor, as Dr. William Hunter was then at the height of his reputation as a teacher and practitioner of Midwifery.[12] He next proceeded to Edinburgh, where he graduated in the spring of 1761. His thesis was entitled “De Placentæ cum utero nexu.” This production evinces a continued interest in obstetrical studies. He afterwards travelled in France, where he formed an intimate acquaintance with Senac and other physicians of Paris.
Dr. Shippen, as has been stated, went to Europe in 1757, where he remained until 1762, while Dr. Morgan arrived there in 1760, and returned to this country in 1765. They were therefore together between one and two years in Europe. As these two zealous and enthusiastic young men, natives of the same city and imbued with the same aspirations, were treading abroad the same ground of preparation for their calling, it is natural to conceive that they should have possessed similar sentiments with respect to the urgent wants of their common country—that they should have conferred with those interested in the subject, and that the scheme of establishing, on this side of the Atlantic, systematic medical education, which was subsequently put into operation, was there entertained by both of them. In support of this opinion, Dr. Rush may be quoted, who, in his account of Dr. John Morgan, states “that it was during his absence from home that he concerted with Dr. Shippen the plan of establishing a Medical School in this city,” meaning Philadelphia.[13] From the testimony hereafter presented it is clear that Dr. Rush was perfectly conversant with all the transactions connected with the origin of the medical school. Dr. Shippen paved the way for the enterprise, by the course which has been detailed, on his arrival in Philadelphia.
Dr. Morgan, at the time of his return from Europe, was freighted with great intents and exalted purposes. His views had been kept no secret, he had enlisted in behalf of his projects the Hon. Thomas Penn, a patron of the College of Philadelphia, and laying before the Board of Trustees of the College “a plan for establishing a medical school under their auspices,” he presented to them a letter from that gentleman recommending it to their patronage. This letter was read at a meeting of the Board of Trustees, May 3d, 1765, as follows:—
“Gentlemen: Dr. Morgan has laid before me a proposal for introducing new professorships into the Academy for the instruction of all such as shall incline to go into the study and practice of Physic and Surgery, as well as the several occupations attending upon these useful and necessary arts. He thinks his scheme, if patronized by the Trustees, will at present give reputation and strength to the Institution, and though it may for some time occasion a small expense, yet after a little while it will gradually support itself, and even make considerable additions to the Academy’s funds.
“Dr. Morgan has employed his time in an assiduous search after knowledge in all the branches necessary for the practice of his profession, and has gained such an esteem and love from persons of the first rank in it, that as they very much approve his system, they will from time to time, as he assures us, give him their countenance and assistance in the execution of it.
“We are made acquainted with what is proposed to be taught, and how the lectures may be adopted by you, and since the like systems have brought much advantage to every place where they have been received; and such learned and eminent men speak favorably of the doctor’s plan, I could not but in the most kind manner recommend Dr. Morgan to you, and desire that he may be well received, and what he has to offer be taken with all becoming respect and expedition into your most serious consideration, and if it shall be thought necessary to go into it, and thereupon to open Professorships, that he may be taken into your service.
“When you have heard him, and duly considered what he has to lay before you, you will be best able to judge in what manner you can serve the public, the Institution, and the particular design now recommended to you.
“I am, Gentlemen, your very affectionate friend,
“London, February 15th, 1765.”
In addition to this letter Dr. Morgan presented others he had received from Mr. Hamilton and Richard Peters, former members of the Board, but then residing in England. His scheme was also approved by Dr. Fothergill, Dr. Hunter, Dr. Watson, and Dr. Cullen, “men distinguished for their superior knowledge in literature, and particularly eminent in everything which relates to medical science.”[14]
- ↑ Wistar’s Eulogy upon Dr. Shippen, Jr.
- ↑ Life of Dr. Fothergill by John Coakley Lettsom, M. D., see the “Works of Dr. Fothergill,” London, vol. 3d, 1784, Oct., also in Quarto ed. The account of Dr. Fothergill’s association with Dr. Franklin is most interesting, in an effort to prevent the American war. His political papers on this subject are worthy of perusal.
- ↑ Preface to the Discourse, etc.
- ↑ London Medical and Physical Journal, 1817. New England Journal of Medicine and Surgery, vol. vi. p. 404. Beck’s Historical Sketch.
- ↑ The method of making preparations by this process was communicated to the American Philosophical Society. It is published in the second volume of Transactions, and is entitled the “Art of making Anatomical Preparations by Corrosion, by John Morgan, M. D., Professor of the Theory and Practice of Physic in the University of Pennsylvania, Member of the Royal College of Physicians, Ed., F. R. S., London.” It must have been communicated some years prior to 1786, when the volume was printed. Dr. Morgan was an active member of the American Society, which he joined in 1766, and became a member of the Philosophical Society on its union with the former in 1768.
- ↑ Thompson’s Life of Cullen, vol. i.
- ↑ Prior to 1754, the profession of medicine in Edinburgh was not exclusive. In that year the College of Physicians passed an act prohibiting their Fellows and Licentiates from taking upon themselves to use the employment of an apothecary, or to have or keep an apothecary shop. In 1765, in order, as they conceived, “to support that character and esteem which they had all along maintained, and to keep up that distinction which ought to be made between the members of the College and the practitioners of those branches of the healing art which have always been esteemed the least reputable,” they resolved “that for the future they would admit no person to be one of their Fellows whose common business it was either to practise Surgery in general, or Midwifery, Lithotomy, Inoculation, or any other branch of it in particular.”—Life of Cullen, vol. ii. p. 87, by Dr. Craigie. A continuation of Thompson’s Life.
- ↑ Preface to his Discourse.
- ↑ There was an independence of thought and action in the character of Dr. Morgan. In further illustration, it is worthy of record that he was one of the first to use a silk umbrella, to the wonderment of the citizens.
- ↑ Wistar’s Eulogium.
- ↑ From the Life of Mr. Hewson it will be seen that in the autumn of 1759 that gentleman came to London, lived with Mr. John Hunter, and attended Dr. William Hunter’s Anatomical Lectures at a house in Covent Garden. Hewson’s diligence and skill soon recommended him to the favorable notice of the brothers, and when Mr. John Hunter went abroad with the army in 1761, he left to Mr. Hewson the charge of instructing the other pupils in the dissecting-room.—“Works of William Hewson, F. R. S., edited by George Gulliver, F. R. S.” It was through this Association that Dr. Shippen became intimately acquainted with Mr. Hewson. In 1762 Mr. Hewson was in attendance upon the Lectures at Edinburgh.
- ↑ In August, 1762, Dr. Hunter was the professional attendant upon the Queen of England in her confinement.
- ↑ An Account of the late Dr. John Morgan. Delivered before the Trustees and Students of Medicine in the College of Philadelphia on the 28th of November, 1789, by Benjamin Rush, M. D.
- ↑ Morgan’s Discourse.