A History of the Medical Department of the University of Pennsylvania/Chapter XIII
In 1834 Dr. James resigned the Chair of Obstetrics.
Thomas Chalkley James was of a family attached to the Society of Friends. He was born in the city of Philadelphia in the year 1766, and was educated under the superintendence of Robert Proud. His medical studies were conducted under the direction of Dr. Kuhn, and in 1787 he took the degree of Bachelor of Medicine at the University of Pennsylvania. The following year he accepted the position of Surgeon of an East Indiaman, and made a voyage to China, with the view of acquiring funds for a contemplated visit to Europe, to finish there his medical education. In this adventure he was successful, as the trade with the East was at that time very lucrative, and the situation of surgeon on board a trading vessel afforded greater opportunities of material profit than have subsequently been presented.
In the year 1790, that of his return from China, he embarked for England, where he found his compatriot, Dr. Physick, pursuing his studies at St. George’s Hospital. By this gentleman’s advice he entered, in May, 1791, as house pupil of the Story Street Lying-in Hospital, under the care of Drs. Osborne and John Clarke, two leading obstetrical teachers and practitioners of London. While in the capital of England, he received courteous attentions from Dr. Letsom, who belonged to the same religious society as the family of Dr. James. He attended the lectures during the session of 1792-3 at the University of Edinburgh, to which, however, he did not apply for a diploma. In the summer of 1793 he returned to Philadelphia, and witnessed, as an active participant, the scourge which that season devastated the city. Dr. James was not prevented by his religious scruples from taking part in the patriotic movements of the day, or from serving the cause of his country in upholding its government and laws. When the young men of Philadelphia were called upon by General Washington, in 1794, to lend their aid in the suppression of the rebellion which first threatened the stability of the newly-formed Republic, Dr. James proffered his services, and joined the army, which marched from Philadelphia to suppress the disturbance in the western counties of Pennsylvania, which is known as the “Whiskey Insurrection.” He joined the expedition in the capacity of Surgeon of “McPherson’s Blues,” a corps d’élite of young gentlemen, who had promptly tendered their services at the request of their President.
The expedition was a bloodless one, from the force employed, which overawed the insurgents; but it tried the spirits and endurance of these delicately educated youths, and sometimes subjected them to depression. To dispel this, in a measure, fell to the lot of Dr. James, who, upon a drum-head, wrote an inspiring song, which was set to music, and sounded through the camp with renovating accents.
Upon settling himself, again, a candidate for practice, Dr. James chose the branch of Obstetrics as the vocation of his life; and, from that time to the termination of his career, gave to it his undivided attention and the exercise of his cultivated intellect. Preparatory to the position he assumed in the University, as has been detailed, he commenced, in 1802, a regular course of lectures upon Obstetrics, in conjunction with Dr. Church. With respect to these lectures, we are told that, “to render his teaching useful, Dr. James, assisted by Dr. Church, not only employed the usual modes of illustration, but zealously endeavored to instruct practically, as well as theoretically. For this purpose his influence and exertions prevailed in having a Lying-in Ward, the first in the city, established at the Almshouse, over which he presided as attending Accoucheur.” This was not, however, the first movement made to open a ward in that institution; he had been anticipated in that respect by Drs. Bond and Evans as early as 1770. To Drs. James and Church is due the credit of reviving the enterprise, and of having founded the present Obstetrical department of the Almshouse. The association with Dr. Church did not long continue, terminating by the death of that gentleman, soon after which a new alliance was entered into between Dr. James and Dr. Chapman, which, as an ultimate result, led to the introduction of both of them to the halls of the University.
In 1807 the Obstetrical department of the Pennsylvania Hospital went into operation, intended for the accommodation of poor respectable married women. Singular as it may appear, it was founded by the gallant and patriotic young gentlemen of Philadelphia, who formed the “First Troop of City Cavalry.” Their pay for services due them by the Government at the end of the Revolutionary war was generously donated for this especial purpose. The interest of the sum thus appropriated amounted annually to between five and six hundred dollars. At the time of opening these wards, Dr. James was elected Accoucheur of the Hospital, and continued in office until 1832.
Dr. James did little as a writer; he read papers occasionally upon obstetrical cases, or kindred subjects, before the College of Physicians, of which he was elected the fourth President in 1835. As one of the editors of the “Eclectic Repertory,” he contributed to its success by his industry in selecting materials for publication, as well as by his pen as a journalist; but no elaborate work upon his especial branch was attempted by him, and he contented himself most modestly with editing “Burns’ Principles of Midwifery,” and “Merriman’s Synopsis,” which were published as text-books for the students attending his lectures. He died in 1835.
In 1835 the Chair of Materia Medica and Pharmacy became vacant by resolution of the Board of Trustees. From the year 1819 this professorship had been held by Dr. Coxe.
Dr. John Redman Coxe was born in New Jersey, in 1773, and was educated in Philadelphia under the charge of his grandfather, Dr. Redman, until his tenth year, when he went to England and remained until his seventeenth year. In Edinburgh he completed his classical education, and attended a course of medical lectures at the University of that city. In 1790 he returned to America, and after studying medicine regularly with Dr. Rush, graduated at the University of Pennsylvania in 1794. The subject of his Thesis was Inflammation. He witnessed the epidemic yellow fever of 1793, while a student of medicine. After graduation, Dr. Coxe again visited Europe, and remained a pupil of the London Hospital for one year; he subsequently studied in Edinburgh and Paris, and returned to Philadelphia in 1796.
In 1797 Dr. Coxe served as one of the resident physicians of Bush Hill Hospital, under the charge of Drs. Physick and Cathrall, when, as Dr. Bell informs us, there were only twenty-three or twenty-four physicians who remained at their posts in this epidemic, and eight of their number died.
Dr. Coxe was appointed, by the Board of Health, Physician of the Port in 1798, the period of another great visitation of yellow fever. He was likewise, for several years, Physician of the Philadelphia Dispensary, and of the Pennsylvania Hospital. He was, at the commencement of the present century, an earnest, enthusiastic advocate of vaccination. After vaccinating his oldest child, then an infant, at the time the full efficacy of the practice was still in suspense in the public mind, he fully tested it by exposing him to the influence of smallpox. The result of this, then bold experiment, contributed in no small degree to establish reliance on the protective power of vaccination.
It has been stated above that Dr. Coxe succeeded Dr. Woodhouse in the Chair of Chemistry in 1809, and that he was transferred to that of Materia Medica and Pharmacy in 1819. He was possessed of considerable classical attainments, and was well versed in the ancient literature of Medicine. The doctrines and opinions of the earlier fathers of Physic had so superior a value in his estimation as to lead to too exclusive an exposition of them in his lectures. This was more particularly the case when occupying the Chair of Materia Medica and Pharmacy; but the merit is due him of opposing the extended assumption of the doctrines of solidism that prevailed, and of giving proper significance to the facts of the humoral physiology and pathology, which were gaining ground from the commencement of the present century, and are now fully admitted. He insisted upon the correctness of the doctrine of the absorption of medicinal substances, and upon the explanation, by it, of their modus operandi.
Dr. Coxe at one time was the editor of the “Medical Museum.” This periodical was commenced in 1804; the same year as the publication of Dr. Barton, and was continued regularly until 1811. It may be said to be the first uniformly issued periodical in the city of Philadelphia, but not in the United States, as, in this respect, the city of New York takes precedence.
He published, as editor, the “American Dispensatory,” a work largely derived from Duncan’s “Edinburgh Dispensatory.” In 1808 he published a Medical Dictionary. Late in life he issued an “Exposition of the Works of Hippocrates,” and an “Essay on the Origin of the Discovery of the Circulation of the Blood.” In 1829 he introduced, and succeeded in cultivating, the true Jalap plant, thus enabling Mr. Nuttall to determine its real character and position. Dr. Coxe died at the advanced age of ninety years, March 22, 1864.
The vacation of the Chair of Materia Medica and Pharmacy having taken place in 1835, an opportunity was “offered to the Trustees to extend the organization and augment the efficiency of the Faculty, without interfering with the rights of the existing Professors, or increasing the expense of the pupils. That the subjects of Practice and Institutes of Medicine, which had for many years been combined, were together too copious for the time and powers of one Professor, was obvious to all who were acquainted with their great importance, and with the vast extension recently given to the single science of Pathology. The necessity of their separation had indeed been recognized in the appointment of an assistant to the Professor who occupied the united Chairs. This appointment, however, was merely provisional. To give their due relative weight to the two branches, and to secure permanently adequate instruction in each, it was necessary to establish a new professorship. The Trustees accordingly decided that the Institutes of Medicine should form the ground of a new Chair.” No new creation took place in this arrangement, for it will be recollected that the Chair of Institutes and Clinical Medicine existed when a union of the Faculties of the two schools took place in 1791. With the election of Dr. Rush to the Chair of Practice in 1805, the subjects of both chairs were apportioned to one, and thus continued for thirty years, when a separation became expedient. The necessity of separation of the two branches, and of the revival of the original professorships, had been urged upon the Trustees in 1823, and again in 1826, by the Medical Faculty. At the beginning of the session of 1827, Dr. Jackson, with the sanction of the Board, had received the appointment of Assistant, and on Dec. 2, 1828, had been elected by the Trustees the Assistant Professor to that position.
On the 6th of October, 1835, Dr. George B. Wood was elected to the vacant Professorship of Materia Medica and Pharmacy, and, at the same time, Dr. Samuel Jackson was elected Professor of the Institutes of Medicine.
In November, 1835, the health of Dr. Dewees, which had been much impaired by age and laborious occupation, completely failed, and after the course of lectures had commenced, he was forced to resign, and was succeeded by Dr. Hugh L. Hodge, on whom the duty devolved of completing the course, and who was on the 14th of the same month elected to the Chair of Obstetrics.
The connection of Dr. Dewees with Obstetrics constitutes an epoch in the history of American Medicine. He was the first authoritative writer on this branch whom the country has produced, and wielded, at the time when his personal influence was unbounded, a sway over the opinions of his contemporaries and pupils which directed their practice and controlled their actions. He may truly be regarded as the Father of American Obstetrics.
William Potts Dewees was a native of Pennsylvania, his family being of Scottish origin. He was born in the year 1768. As his family were not in affluent circumstances, in his youth he had to contend with difficulties in obtaining an education, and to make amends for the want of extensive means of intellectual training by industry and perseverance in the use of such as were within his reach.
He determined early to study medicine, and was for this purpose placed by his father in the establishment of Dr. Phyle, a practising apothecary. Under the superintendence of this gentleman he acquired a knowledge of pharmacy and its collateral sciences. He subsequently entered the office of Dr. William Smith, and during his continuance in this position and residence in Philadelphia attended lectures in the University. In 1789, at the age of twenty-one years, he took the degree of Bachelor of Medicine.
The early professional life of Dr. Dewees was spent in the country, at Abington, a settlement to the north of the city. The appearance of the yellow fever, in 1793, having thinned the ranks of the profession in Philadelphia, Dr. Dewees was induced to remove thither in December of that year. He entered upon his new field of duty with the confidence, and, it may be stated, under the patronage of Dr. Bush. His associates and competitors for medical practice at the time were Drs. Physick and James, who had just returned from their sojourn abroad. It was at a period of need in the important branch of obstetrics that Dr. Dewees located himself as a practitioner among the citizens of Philadelphia. Its condition was not flattering, as has already been mentioned. Dr. Hodge informs us that “at that period the science was hardly known in America. The physicians who occasionally engaged in its practice had received no instruction, with the exception of a few, who, having visited Europe, brought home a general knowledge of the subject, but who, from the prejudices existing against the employment of male practitioners, had few opportunities and fewer inducements to perfect their knowledge. Hence midwifery existed almost universally as an art; the aged and imbecile nurse was preferred to the physician.” It has been seen that only so far as taught by Dr. Shippen, and as a mere appendage to the Chair of Anatomy and Surgery, from which it received necessarily but little attention, it was comparatively ignored in the medical school as a branch of scientific education. Medical men, therefore, who desired to become adepts in it were under the necessity of visiting Europe, or of relying upon their own resources. To supply the demand for skilful and intelligent assistance in the conduct of labor, Dr. Dewees, with James, Church, and others, directed their attention to this branch, and by rendering themselves especially masters of it, were enabled to communicate their knowledge and experience to others.
No one could realize more fully than Dr. Dewees the want of more extensive and efficient instruction on the subject of practical midwifery, and, to use the words of Dr. Hodge, “we find that he has the high honor of first attempting a full course of Lectures on Obstetrics in America.
“In a small office he collected a few pupils, and in a familiar manner indoctrinated them with the principles of our science, toiling year after year, in opposition to the prejudices not only of the community but even of the profession, who could not perceive that so much effort was necessary for facilitating the natural process of parturition.” In 1806, Dr. Dewees took the degree of Doctor of Medicine, his thesis on this occasion was on “The Means of Moderating or Relieving Pain during Parturition.” This essay was afterwards expanded and published as a book, which added to the reputation of the author.
When, in 1810, it was determined to erect Midwifery to an independent position in the University, Dr. Dewees became a candidate for the Chair. The struggle, we are told, was “a warm one, and the claims of opposing candidates and the influence of their respective friends rendered the event doubtful. The strong claims of Dr. Dewees, his talents, his industry, his attainments, his dexterity, boldness, decision, and judgment as a practitioner; his great success in the practice of his art; his popularity, supported by the strongest testimonials from many of the distinguished men in the profession, including Drs. Rush and Physick, were met by analogous claims of Drs. James and Chapman.” The result has been already stated.
In 1812, Dr. Dewees, under the apprehension of a pulmonary affection, retired from the profession and became a farmer. This change did not result to his pecuniary advantage, and he returned to Philadelphia in 1817. In 1825 he was elected to the position of Adjunct Professor of Obstetrics. He had then passed the meridian of life, he was fifty-seven years of age, but his constitution was firm and his energy untiring. In this secondary post he remained until 1834, when he was elected to the Professorship. He delivered but one course of lectures in this position. On the commencement of the second course his health broke down from paralysis, and his retirement became expedient, both for himself and the school.
Dr. Dewees was a voluminous writer; but his best book is his first, his “Compendious System of Midwifery.” Although not the first original treatise upon the subject in this country, it attracted the attention of European writers to American authorship. It deviated from the principles of the English authorities, and, while resting upon those of Baudelocque, who was the exponent of the French school of obstetrics, presented so much of original thought and observation as to bestow a high reputation upon the author. “To an American, therefore, the appearance of Dr. Dewees’s work on Midwifery is an important epoch in the history of our science, as being the first regular attempt to think for ourselves on Tokology, and to contribute to the onward progress of this important division of Medical Science.”
After spending a few years in the Southern States, with a view to the restoration of his health, Dr. Dewees returned to Philadelphia, where he died on May 20th, 1841.
When Dr. Dewees resigned in 1835, the Faculty stood as follows:—
|Practice of Medicine and Clinical Medicine||Nathaniel Chapman, M. D.|
|Chemistry||Robert Hare, M. D.|
|Surgery||William Gibson, M. D.|
|Anatomy||William E. Horner, M. D.|
|Institutes of Medicine||Samuel Jackson, M. D.|
|Materia Medica and Pharmacy||George B. Wood, M. D.|
|Obstetrics and Diseases of Women and Children||Hugh L. Hodge, M. D.|
- The father of Prof. Stillé was supercargo of the Indiaman.
- Dr. James did not receive the degree of M. D. until his election to the Professorship of Midwifery in the University, when, at the Commencement of 1811, the Honorary Degree was conferred upon him.
- For an account of the body of troops mentioned reference may be made to Watson’s “Annals of Philadelphia,” vol. i. p. 331, 2d ed.; and for the history of the political troubles of the time, to Marshall’s “Life of Washington,” vol. v., and the papers of the day. With reference to the readiness with which the military of the city responded to the call of their chief, and the gratification this evidence of their patriotism afforded him, the following statement was given me by a member of my family long since deceased. As a boy he made his way to near the stand of Washington, on his own door-step in Market Street, below Sixth, from which the troops were reviewed, and heard him distinctly say, with emotion, as the Blues marched by him, “God bless you!—God bless you, young gentlemen!”
- These gentlemen, in 1803, requested permission to give a course of lectures on Midwifery, in one of the rooms of the University, which was granted. In 1804 a similar request was made by Drs. Dewees and Chapman. It was, however, deemed inexpedient to introduce private lectures, and this request was declined, with that of Drs. James and Church, to repeat their course.
- A Memoir of Thomas C. James, M. D., read before the College of Physicians of Philadelphia, by Hugh L. Hodge, M. D., Professor of Obstetrics in the University of Pennsylvania, 1843.
- A similar origin of Hospitals for Lying-in Women may be referred to in England. Dr. Richard Manningham, in the year 1737, established a ward, or small hospital, in the Parochial Infirmary of St. James, Westminster, for the reception of parturient women only, which was the first thing of the kind effected in the British dominions. In this ward, which was supported by public subscription, he gave lectures, and the students had opportunities of being qualified for practice. He published a “Compendium Artis Obstetricæ,” and other works. (See Denman’s Historical Introduction to his “Treatise on Midwifery.”)
- The first intention of the Trustees of this fund was to establish a Foundling Institution. From this they were diverted by the arguments of the Managers of the Hospital, and determined, in the application of the money, to found an Obstetrical Ward. (See Records of the First Troop Philadelphia City Cavalry, and Minutes of Pennsylvania Hospital.)
- The “Eclectic Repertory,” conducted by an Association of Physicians, was begun in 1811, and terminated in 1820.
- In the “Lives of Eminent American Physicians and Surgeons,” is one of Dr. James, by Caspar Morris; M. D.
- Life of Dr. Physick, by Dr. Bell, in Gross’s “Lives,” &c.
- Dr. Edward Jenner Coxe, the eldest son of Dr. Coxe, underwent this experiment in 1801.
- The “Medical Repository” of New York was projected by Dr. Elihu Smith, assisted by Drs. Samuel L. Mitchell and Edward Miller, and issued in 1797. With reference to this periodical, the biographer of Dr. Miller, his brother, the Rev. Dr. Miller, remarks: “From this work, as a parent stock, have sprung a number of works of a similar kind in Europe and America. It is not recollected by the writer of these sheets that any periodical publication devoted to medicine and medical philosophy, that could be said to be of the same nature with the ‘Medical Repository,’ had ever before appeared.” “The ‘Medical and Physical Journal of London’ was commenced soon after the appearance of the ‘Medical Repository,’ with the avowal of the Editor that he took the hint from New York.” The extent to which medical journalism has been carried in subsequent years is known to every reader.
- Sketch of the History of the Medical Department of the University, issued in 1841, in connection with the Catalogue.
- An Eulogium on William P. Dewees, M. D., delivered before the medical students of the University of Pennsylvania, Nov, 5, 1842, by Hugh L. Hodge, M. D., Professor of Obstetrics, &c.
- Reference has been made to the efforts of Dr. Shippen in the early part of his career. Dr. Bond advertised instruction in obstetrics at the Pennsylvania Hospital, under date of October 25, 1781, in connection with his Clinical Lectures. We find in the American Daily Advertiser the announcement of a course, entitled “Anatomical, Chirurgical, and Obstetrical Lectures,” by Dr. John Foulke, October 25, 1790.
A course of private lectures was delivered by Dr. Benjamin Duffield. The advertisement of the commencement of this undertaking is as follows: “Dr. B. Duffield’s Introduction to his summer Course of Midwifery Lectures will be delivered this day, at Mr. Charles Little’s School House, at 6 o’clock in the evening. April 6th, 1793.” Dr. Church was a relative of Dr. Duffield, and became his successor, to be assisted by Dr. James, as has been stated.
Dr. Hodge does not state the year that Dr. Dewees commenced to teach Midwifery. He settled in Philadelphia in 1793, and hence the probability is that his lectures were after those of Dr. Duffield, and contemporary with those of Church and James.
- It is stated that when Dr. Shippen read this Essay, he remarked “that had he previously been acquainted with the information contained in it, how much suffering would have been spared to his patients.”
- Hodge’s Eulogium.
- Published in 1826. In 1828, three edition had already been issued. A Compendium of Midwifery was published by Dr. John Bard, of New York, about the beginning of the present century. A second edition appeared in 1811. In speaking of this work Dr. James remarks: “ It contains a large mass of practical knowledge compressed into a small space, and to me it appears as one of the best introductory books that can be placed in the hands of the student.” (MS. Introductory Lecture, 1810.)
- Hodge’s Eulogium.
The other works of Dr. Dewees were a “Treatise on the Diseases of Females,” one on the “Diseases of Children,” and his “Practice of Medicine.” His papers on various subjects may be found in the journals.