Page:Carnegie Flexner Report.djvu/21

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CHAPTER I

HISTORICAL AND GENERAL

The American medical school is now well along in the second century of its history.[1] It began, and for many years continued to exist, as a supplement to the apprenticeship system still in vogue during the seventeenth and eighteenth centuries. The likely youth of that period, destined to a medical career, was at an early age indentured to some reputable practitioner, to whom his service was successively menial, pharmaceutical, and professional: he ran his master's errands, washed the bottles, mixed the drugs, spread the plasters, and finally, as the stipulated term drew towards its close, actually took part in the daily practice of his preceptor,—bleeding his patients, pulling their teeth, and obeying a hurried summons in the night. The quality of the training varied within large limits with the capacity and conscientiousness of the master. Ambitious spirits sought, therefore, a more assured and inspiring discipline. Beginning early in the eighteenth century, having served their time at home, they resorted in rapidly increasing numbers to the hospitals and lecture-halls of Leyden, Paris, London, and Edinburgh. The difficulty of the undertaking proved admirably selective; for the students who crossed the Atlantic gave a good account of themselves. Returning to their native land, they sought opportunities to share with their less fortunate or less adventurous fellows the rich experience gained as they "walked the hospitals" of the old world in the footsteps of Cullen, Munro, and the Hunters. The voices of the great masters of that day thus reechoed in the recent western wilderness. High scientific and professional ideals impelled the youthful enthusiasts, who bore their lighted torches safely back across the waters.

Out of these early essays in medical teaching, the American medical school developed. As far back as 1750 informal classes and demonstrations, mainly in anatomy, are matters of record. Philadelphia was then the chief center of medical interest. There, in 1762, William Shippen the younger, after a sojourn of five years abroad, began in the very year of his return home, a course of lectures on midwifery. In the following autumn he announced a series of anatomical lectures "for the advantage of the young gentlemen now engaged in the study of physic in this and the neighboring provinces, whose circumstances and connections will not admit of their going abroad for improvement to the anatomical schools in Europe; and also for the entertainment of any gentlemen who may have the curiosity to understand the anatomy of the Human Frame." From these detached courses the step to an organized medical school was taken at the instigation of Shippen's friend and fellow student abroad,

  1. This statement has reference only to the United States and Canada, with which the present account alone deals. As a matter of fact, a chair of medicine was established at the University of Mexico towards the close of the sixteenth century. A complete medical school was there developed. James J. Walsh: "First American Medical School," in New York Medical Journal, Oct. 10, 1908 (based on Historia de la medicina en Mexico des de la spoca de los Indios, hasta la presente. Por Francisco Flores. Mexico, 1886).