American Medical Biographies/Warren, John
Warren, John (1753–1815)
John Warren was born in Roxbury. July 27, 1753, and died in Boston, Massachusetts, April 4, 1815. His ancestor, John Warren, came fellow passenger with Governor Winthrop in the Arabella and arrived in Salem, June 12, 1630.[1] John (so far as the records show, was the father of Peter Warren, "Mariner," whose son Joseph built the family house in Roxbury, in which his grandson, Dr. John Warren, was born. Dr. Warren's father was a highly respected citizen of the town of Roxbury and added to and improved the homestead farm by the cultivation of many varieties of fruit trees. He was killed by a fall from an apple tree in October, 1755. His mother, Mary Warren, the daughter of Dr. Samuel Stevens of Roxbury, was a woman of great intelligence and piety, who survived her husband forty-five years and died in the paternal mansion in 1800. He was the younger brother of Dr. Joseph Warren (q.v.), killed at Bunker Hill. He was not much given to studious habits and was ten years old before he began to read, but under the favoring influence of the Grammar School in Roxbury, he applied himself to study with much zeal and acquired sufficient learning to enable him to enter Harvard College at the age of fourteen in July, 1767. Of his life at Cambridge but little is known except that he became a good classical scholar and acquired a facility of speaking the Latin language which was of essential use to him later in communicating with many foreigners, both lay and professional, who had no other common tongue and with whom the political conditions of the times brought him much in contact. This industry and a tenacious memory enabled him to stand well in his class during his whole college course. After graduating from Harvard in 1771 he immediately began the study of medicine with his brother Joseph, some twelve years his senior, having already while in college developed a strong taste for anatomy. With the exception of the Medical Department of the University of Pennsylvania, then still in its infancy, there was no medical school in this country at that time and he was obliged to be content to obtain his medical education by serving an apprenticeship with an active practitioner, after the manner of the day of those who could not find the time or means to journey to the centers of medical learning, such as London, Edinburgh or Leyden. His brother Joseph had been the pupil of Dr. Lloyd, who received his medical education in England, and was in the full tide of a successful practice. Doubtless he was thus enabled to enjoy the benefit of as good a medical education as could be obtained at that time in this country.
The course of study, eminently practical, fitted the pupil from the outset to be prepared for the intimate relation between patient and doctor and at least paved the way for the initial plunge into medical practice more effectively than the more formal curriculum of a systematic course of study.
It appears that Dr. Warren at one time entertained the intention of going to Surinam and for this purpose had made himself thoroughly acquainted with the Dutch language.
Boston had at the time of the Revolution a population of less than 20,000, and the field of practice was doubtless well filled by such men as Dr. Lloyd, Dr. Jeffries, Dr. Rand and Dr. Bulfinch, and many of the highly educated surgeons of the army then stationed in the city and its neighborhood. Fortunately an opening was discovered in the neighboring town of Salem under the patronage of Dr. Holyoke (q.v.), who was supposed to have reached that point in his career where a retirement for age would soon be justified and the field for a successor seemed a promising one.
The course of study, at that time required, was two years in length and Warren accordingly established himself in Salem as a practitioner in 1773. Only those physicians who, like Lloyd, had studied at a European University (and they were few and far between) enjoyed the title of M. D. Warren therefore began practice without any other title than that which he had received from the undergraduate department of his alma mater.
The first body in Massachusetts to issue a license to practise was the Massachusetts Medical Society and this organization was not incorporated until 1781. It was originally organized as an examining body with a view to meet the special need of regulating the practice of medicine, then represented by a rapidly increasing number of medical men. Those who passed its examination were made licentiates, or men announced by the society as fit to practise medicine.[2] When later the Medical Department of Harvard University was founded a conflict arose as to the right of the university to grant diplomas. This, however, was soon adjusted but the full degree of doctor of medicine was not bestowed by Harvard to medical students until 1811. John Warren, however, received an honorary M. D. from Harvard in 1786. Bachelor of Medicine was the only degree at first regularly given in course. Provision was, however, made that the corporation be empowered to grant the M. D. degree to men who had received the degree of M. D. seven years or more before from Harvard. The first candidate to receive an M. D. under these conditions was Dr. Fleet (q.v.) in 1795 and several others later received the full degree under similar conditions.
While Dr. Warren was endeavoring to establish himself in practice political events were developing rapidly. On December 18, 1773, the tea was thrown overboard in Boston harbor and tradition has it that Warren took an active part in this demonstration. About this time he joined a militia regiment in Salem, commanded by Colonel Pickering, and became its surgeon. The following year we find him addressing the mechanics of New York in his capacity as chairman of a committee of Boston mechanics, urging them to take no part in the construction of the fortifications of Boston. Towards the close of the battle of Lexington on June 19, 1775, Col. Pickering's regiment arrived at Winter Hill, Somerville, but took no active part in the engagement. Warren was present on that occasion. Encamping for the night his regiment returned to Salem the next day. After the battle of Bunker Hill he left Salem at two o'clock the following morning and at Medford received the news of his brother Joseph's death. While seeking on the battlefield for his brother's body, he received a thrust from the bayonet of a sentinel, the scar of which he bore through life. After learning the fate of his brother he volunteered as a private in the ranks of the American Army. He was, however, assigned to the care of the wounded. On July 3 Washington arrived at Cambridge and the organization of the army was begun. After passing an examination before a medical board, Warren received the appointment of senior surgeon to the hospital established at Cambridge. Here he remained during the siege of Boston. After the evacuation he was one of the first surgeons to enter the city and made a report on the discovery of arsenic mixed with medicines left by the enemy. When the army left Cambridge the general hospital was transferred to New York, for which city he departed on May 11, 1776, when he was appointed senior surgeon of the hospital established at Long Island. He remained in the army until July, 1777, and during this year gained much experience in dealing with dysentery and what was probably typhoid fever. He was with the army at Trenton and narrowly escaped capture after the battle of Princeton.
Many changes having taken place in the meantime in the organization of the medical staff of the army and Warren having suffered from illness brought on by the hardships of the campaign, he applied for and received permission to return to Boston in April, 1777. At the time extensive military preparations were going on in Massachusetts. A hospital was therefore needed in the city itself and one was accordingly established at the corner of Milton and Spring Streets near the site of the present Massachusetts General Hospital, and on July 1, 1777, Warren was established as senior surgeon of the General Hospital in Boston, a position he held until the close of the war. This was the turning point in Warren's career. Many of the older generation of practitioners had left the city and the field was open to a younger man representing the patriotic element in the community.
On November 4, 1777, he married Abigail Collins, daughter of John Collins, afterwards governor of Rhode Island. He first met his future wife in the family of Colonel Mifflin, Washington's aide-de-camp, at Cambridge, and later in Philadelphia while the army was stationed there. His first residence in Boston was in a house at the corner of Avon Place and Central Court, and here he once more began to practise his profession in civil life. About this time we find him entering into a partnership with Isaac Rand (q.v.) and Lemuel Hayward for the formation of a hospital at Sewall's Point, Brookline, for the inoculation for smallpox and the treatment of patients attacked with that disease. He also volunteered for the Rhode Island expedition and after that campaign returned to his hospital duties and family in Boston.
As we have seen, Warren had. while in college, developed a strong taste for the study of anatomy. He now appreciated the importance of this branch of medical science both for the practice of medicine and for surgery, and accordingly in the winter of 1870 he undertook to give a course of anatomical lectures at the hospital. His audience was composed of persons attached to the army in a medical capacity, a few medical students (probably serving apprenticeships to other practitioners), physicians of Boston and some scientific gentlemen. It was necessary to conduct these demonstrations, which were performed on the cadaver, with much privacy on account of the popular prejudice against dissection. These lectures were so successful that the members of the Boston Medical Society, an organization formed the same year (may 14, 1780), passed a vote: "That Dr. John Warren be desired to demonstrate a course of anatomical lectures the ensuing winter." This course was given publicity at the hospital and was attended by many literary and scientific men, including President Willard and members of the Harvard Corporation, as well as students from the college. A third course of demonstrations was given in 1782 at the "Molineux House"[3] on Beacon Street near Bowdoin Street. This course was attended by the senior class at Harvard. In addition to the school in Philadelphia at this time, Warren says: "The military hospitals of the United States furnish a large field for observation and experience in the various branches of the healing art as well as an opportunity for anatomical investigation."
Warren's efforts at teaching had brought home to the Corporation of Harvard College the needs of a medical school and accordingly at a meeting of that body held on May 16, 1782, a committee was appointed to consider the establishment of a medical professorship. Following a report of this committee on September 19, Warren was requested to draw up plans for a course of medical instruction. He was assisted in this work by the advice of Shippen and Rush (q.v.), of Philadelphia, and on November 22 of the same year the corporation voted to establish three professorships: One of anatomy and surgery, one of theory and practice of physic and one of chemistry and materia medica—and Warren was appointed professor of anatomy and surgery. On December 14 Benjamin Waterhouse (q.v.) was chosen professor of theory and practice of physic. Dr. Aaron Dexter's (q.v.) appointment as professor of chemistry and materia medica followed on May 22, 1783. On October 7, 1783, Warren and Waterhouse were inducted into office at the meeting house in Cambridge and Dexter's induction (owing to his absence) followed a few weeks later. The first course of lectures was prepared and delivered during the winter of 1783–4.
The lectures were first given in temporary quarters, probably in the basement of Harvard Hall, and in 1800 Holden Chapel was fitted up for the reception of the Medical Department. Owing to the difficulty of access to Cambridge at that time and the absence of clinical facilities, the school was transferred to Boston. Warren was successful as a lecturer and was able to hold the attention of the class through lectures which, at that day, often lasted two or three hours. His "gentlemen, remember this" was a phrase often recalled by pupils in later years.
Dr. Warren had a large private practice and soon became one of the leading surgeons of New England. He had begun his career with a considerable experience as an army surgeon and early in his professional life performed one of the first abdominal sections recorded in this country. This operation consisted in the opening and evacuation of a dermoid cyst in the left hypochondrium with recovery of the patient.[4] A successful amputation of the shoulder joint performed at the Military Hospital, then also a novelty, helped to establish his reputation as a surgeon. According to James Jackson (q.v.), his pupil, "he enjoyed the highest confidence of those around him in all branches of his profession; but it was in the practice of surgery he attained the most extensive reputation." He was cool in operating, did not hurry, and made a point of never omitting any details. He was among the first to recognize and practise the principle of the healing of wounds by first intention.
His medical practice brought him in contact with the extensive epidemics which prevailed in those days. He took a prominent part in the management of an epidemic of yellow fever which visited Boston in 1798, of which he wrote a report. In 1802 he was one of a commission to render a favorable report on the use of vaccine, which had recently been brought from Europe, "as a complete security against smallpox."
Dr. Warren's most notable contribution to literature was entitled "A View of the Mercurial Practice in Febrile Diseases," 1813 (pp. 187), in which he refers to the treatment of many of the prevailing diseases of that period, such as measles, throat-distemper, consumption, dysentery, spotted fever and spinal meningitis. He was also the author of many contributions to the American Academy of Arts and Sciences, the Communications of the Massachusetts Medical Society and to the New England Journal of Medicine and Surgery. He delivered the first Boston Fourth of July oration in 1783.
In 1808, at the request of Dr. Warren, an adjunct professorship was created to aid him in the course of lectures which were at that time delivered in Cambridge, access to which consumed much time of a busy practitioner. His eldest son, John Collins Warren (q.v.), was elected to fill this position. For this reason, and the difficulty in giving clinical instruction, the school was moved to Boston in 1810, where Dr. Warren continued to teach to the time of his death
Dr. Warren was a member of and participated in the formation of numerous societies which sprang into being after the Revolution. The American Academy of Arts and Sciences received its charter on the 5th of May, 1780, and Warren became a member the subsequent year. He was one of the founders of the Massachusetts Medical Society in 1781 and its president from 1804 until his death. He was also one of the founders of the Boston Medical Society in 1780, which established a fee table. In 1782 he was chosen grand master of all the Massachusetts Lodges of Free Masons. He was corresponding member of the London Medical Society.
The Humane Society of the Commonwealth of Massachusetts was instituted in 1785 and Warren was its second president. This society was the forerunner of many other charitable organizations. He was also at one time president of the Agricultural Society.
He was the father of seventeen children, the eldest of whom was John Collins Warren (q.v.) and the youngest Dr. Edward Warren, his biographer.
Dr. Warren was a devout student of the scriptures and a regular attendant at the Brattle Street Church—a society at that time in a transition state from Trinitarian to Unitarian doctrine. He was a man of ardent temperament and agreeable social qualities. His frankness, candor and hospitality were conspicuous traits. His voice was harmonious and utterance distinct and full, and his language as a lecturer was well chosen.
For some years before his death he had suffered from attacks of angina and in 1811 a slight paralytic affection of the right side came on, which never entirely disappeared. He died April 4, 1815, in the full tide of his professional activities after a short illness from inflammation of the lungs in the sixty-second year of his age. The funeral services were held at King's Chapel during which "an Eulogy" was delivered by Dr. James Jackson before the governing body and the students of the university. Later a sermon was preached at the Brattle Street Church by the Rev. Joseph McKean and an oration was delivered by Josiah Bartlett (q.v.) before the Grand Lodge of Masons. His wife. Abigail, died in 1832.