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A History of the Medical Department of the University of Pennsylvania/Chapter VI

 

CHAPTER VI.

 

Connection between the medical department of the College of Philadelphia and that of the University of Edinburgh—Sketch of the origin of the Edinburgh school and of its position in 1768—Dr. Cullen.


From a comparison of the course of instruction in the College of Philadelphia, from the time of its inception to that of its complete organization, with that of the University of Edinburgh, there can be no doubt that this distinguished school was taken as the model for imitation.

The individuals who composed the medical faculty of the College, the first occupants of the chairs, were graduates of the Edinburgh school, and had unavoidably acquired an affection and preference for its system of instruction. They were familiar with all its details and methods; and on assuming their positions the bright days of their student life were vivid in their memories. Regarding with reverence and enthusiastic admiration the men who had been their preceptors, it was most natural that these zealous colonial students should desire to transfer to their native shores the peculiar doctrines that had been inculcated, as well as the stores of learning of which they had been the recipients.

But further, between our own school and that of Edinburgh the parallelism is so close as to be worthy of particular attention; indeed, the resemblance can only be explained by the laws of descent which mould the features of the child like those of the parent, and impart similar moral and mental characteristics. The medical school of Philadelphia may be said to be the legitimate offspring of that of Edinburgh. The latter had its origin with the Scotch students in attendance upon the lectures of the University of Leyden, who forty years previously were actuated by the same motives which prompted the American students, while abroad, to the projection of their enterprise.

We are told by Dr. Fothergill that “there had long been Professorships for Medicine in Edinburgh (connected with the College of Surgeons), and several attempts had been made to introduce a general course of Medical instruction; but it was not until the year 1720 that this University distinguished itself. Several gentlemen who had studied under Boerhaave with the view to revive the study of Medicine in their native country where it had formerly flourished, qualified themselves for the purpose of giving courses of public lectures on every branch of their profession. The celebrated Monro taught Anatomy after having studied it for several years under the ablest masters then in Europe. The Theory of Physic was assigned to the amiable, the humane Dr. Sinclair; Drs. Rutherford and Innes chose the Practice; Chemistry was allotted to Dr. Plummer; and the teaching of Materia Medica (of which last he was appointed King’s Professor) devolved upon the learned and indefatigable Alston.”[1] With what success the labors of these enterprising men were crowned, the record of the uniform, unswerving advancement of the Medical School of Edinburgh, and its eminent position now, afford the evidence. Has not the institution which was founded by Morgan and Shippen, by Kuhn and Rush, and Bond, been found equally worthy of praise and admiration?

Lectures upon anatomy were given in Edinburgh in 1694, by Mr. Monteith, and subsequently he delivered lectures on chemistry. Mr. Robert Eliot was appointed, in 1705, the first Professor of Anatomy in the University. To him succeeded, in 1714, Mr. Drummond, who had associated with him Mr. Magill, but in consequence of the difficulty of procuring subjects and of numerous drawbacks, which rendered their instruction irregular and unsatisfactory, they, in 1720, withdrew in favor of Mr. Alexander Monro, who is justly considered as the founder of the Anatomical School of Edinburgh. His first lecture was public. “The Lord Provost, accompanied by his friends in the Magistracy, the President and Fellows of the College of Physicians, and the President, accompanied by the Members of the College of Surgeons, honored him with their presence.”[2] “Towards the end of his third course, Mr. Monro, encouraged by the success that had attended his exertions, and with the concurrence and urgent recommendations of his friends, which indeed in this instance were only an echo of the opinion of the public, presented a petition to the honorable patrons, in which he set forth the usefulness of the study of anatomy, and the advantages it might be of to Edinburgh; and in order thereto, the necessity of putting the commission of a professor on such a footing as might encourage him effectively to follow out the design for which he was appointed.”

The following extract from the response to this petition evinces the ready acquiescence on the part of the Council: “being fully convinced of the fitness and sufficiency of the said Mr. Alexander Monro, in all respects for the said profession, and well acquainted with his diligence and assiduous application in the exercise of it, they therefore for his better encouragement, of anew, again nominate, &c., him sole Professor of Anatomy within this city and College of Edinburgh, and that, ad vitam aut culpam, notwithstanding any act of Council formerly made to the contrary.”[3]

The success of Mr. Monro’s lectures encouraged the magistrates to extend their liberal patronage in favor of public medical teaching, and induced them, in 1724, to appoint Dr. Potterfield the Professor of the Institutes of Medicine, and two years afterwards (1726) to elect Dr. Andrew Sinclair and John Rutherford Professors of the Practice of Medicine, and Andrew Plummer and John Jones Professors of Medicine and Chemistry. In subsequent arrangements, to these gentlemen Dr. Alston was added, who, although a teacher of Materia Medica and Botany at the Botanic Garden, was not appointed legally a professor until 1730. As Dr. Potterfield, as far as ascertained, did not lecture, the six other gentlemen who have been named may be regarded as, de facto, founders of the Medical Department of the University of Edinburgh.

The only degree conferred by this University was that of Doctor of Medicine; with reference to which we are informed that “the Medical Faculty being now constituted, degrees were conferred after a much more regular manner, and, with some slight variations, the forms adopted at Leyden, where the Professors themselves had been educated, were preferred.” To exhibit the requirements of the school, the following rule may be cited:—

“The Candidate must have attended the lectures given by the Professors of Anatomy and Surgery, Chemistry, Botany, Materia Medica and Pharmacy, the Theory and Practice of Medicine, and Clinical Medicine in the Hospital.”[4] The requisite examinations followed. It appears to have required nearly twenty years to thus far perfect the course of instruction in the school that must be regarded as the parent of our own.[5]

It would seem that difficulties in prosecuting anatomical investigation and teaching beset the efforts of the profession in Scotland as well as in this country. The coincidence in this respect is worthy of notice, evincing the prejudices of the populace in connection with matters deeply involving its own welfare and interests, and the mode of eradicating them by judicious management. By the historian of the University of Edinburgh, the account of Mr. Monro’s troubles is thus given: “Mr. Monro never desisted from exerting himself in the line of his profession, with that ability, diligence, and steadiness which secured the approbation of all. In some respects, however, he had a difficult part to perform. The population of the town then amounted to only thirty thousand, and he had inspired his pupils with such a taste for anatomy and the opportunities they possessed were so limited that they were uneasy under the restraint. In April, 1725, however, some of the more enterprising of the students, as was supposed, had attempted to violate the graves of the dead. Mr. Monro’s well-known character placed him above suspicion in the eyes of sober-minded men, but the vulgar of all denominations were of a different opinion. The city was in an uproar, and an Edinburgh mob was in those days very formidable. They beset Surgeon’s Hall, where Mr. Monro had from the first delivered his lectures, and had it not been for the spirited and vigorous measures of the magistrates, they would have destroyed and trampled under their feet the Anatomical preparations which he had accumulated with so much labor and expense. The tumult was fortunately quelled, but the magistrates found it necessary or convenient, in order to pacify the multitude, to offer a reward of £20 sterling to those who would discover the persons that were accessory to stealing dead bodies. The Session of the College rose in the course of a few weeks; no discovery was made, and the circumstance which occasioned the riot was speedily forgotten.” The preceding occurrence led to provision within the buildings of the University for the accommodation of the Medical School, and the greater security of the Museum belonging to it.

A similar unfortunate occurrence disturbed the quiet of Dr. Shippen’s demonstrations in Philadelphia. On one occasion his house was mobbed, and only by exercising great tact, and by the judicious interference of his friends and of the authorities was he saved from the entire destruction of his accumulated materials for teaching. The event was known for years after to the inhabitants as the Sailors’ Mob. In one of his early advertisements, Dr. Shippen exculpates himself from the imputation of procuring subjects in an illegal manner, by violating the sanctuary of the dead.[6]

In the changes that had taken place in the Faculty of the University of Edinburgh, at the period when the founders of the American School were educated within its walls, Cullen had come upon the theatre of action, and filled the highest place in their affections. As with the students of the University of Leyden, Boerhaave had been the ruling spirit, and had stamped his genius upon their thoughts and opinions, so, by the pupils who listened to his instructions, Cullen was regarded as the paragon of scientific medical intellectuality. He had succeeded Dr. Plummer in the Chair of Chemistry in 1756, and Dr. Whytt in that of Institutes in 1766, which position he was holding at the time the American students, who were the founders of our School, were in attendance upon his lectures.

The warmth of commendation on the part of Dr. Rush may be taken as an explicit illustration of the popularity of Dr. Cullen with his pupils. “Dr. Cullen (says he, in writing to Dr. Morgan) continues still to be the idol of his pupils; he has lately proposed a Theory concerning the offices of the Brain and Nerves that will do him more honour, however, than anything he has ever yet found out. I have not room to do it justice in this place; hereafter you shall be welcome to it. His Clinical lectures and his practice in the Infirmary cannot be too highly praised; in each of them he shows the most extensive reading and the most consummate skill. He intends to publish a ‘Nosologica Methodica’ next summer, which will contain a complete arrangement of all diseases under proper classes, orders, genera, and species, somewhat in the manner of Sauvages, tho’ considerably different from his in the matter of arrangement.”

When Cullen first began to lecture in the Infirmary of Edinburgh upon practical medicine, he deviated from the routine of following Boerhaave implicitly. To this, exception was strongly taken. He tells the story of the difficulties he experienced in thus deviating from so renowned a master, in his Introductory to the Session of 1783-4: “About twenty years after I had left this University as a student, I was again called to it to take a Professor’s Chair, when I still found the system of Boerhaave prevailing as much as ever, and even without any notice taken of what Boerhaave himself and his commentator, Van Swieten, had in the meantime added. Soon after I came here I was engaged to give Clinical, that is to say, practical lectures, and in these I ventured to give my own opinion of the nature and cure of diseases different in several respects from that of the Boerhaavians. This soon produced an outcry against me. In a public College, as I happened to be Professor of Chemistry, I was called a Paracelsus, a Van Helmont, a whimsical innovator, and great pains were taken in private to disparage myself and my doctrines.”[7] Cullen lived to know that his teachings had as wide a circulation and as much authority as those of Boerhaave, which ultimately gave place to them.

It was determined, as we are informed by Dr. Thomson in his Life of Cullen, that he should deliver a course of Lectures on the Practice of Medicine during the summer of 1768. He accordingly delivered his first course on that branch at the time specified, and continued to alternate with Dr. Gregory until the death of that professor in 1773, when he succeeded to the Chair. With respect to the above-mentioned arrangement, it appears that an application was made by Dr. Cullen, with the concurrence of Dr. Gregory, for a joint appointment to the Chair of Practice.[8] The movement appears to have been instigated by the students of the University, who were impressed by Dr. Cullen’s teaching at the Infirmary, although Mr. Bower states that “the origin of the whole transaction is involved in obscurity.” “The students were divided in their opinions respecting the abilities of these eminent men as public lecturers, and as usual entered very keenly into the medical theories they severally taught.”[9] This is clear from the correspondence of Dr. Rush, then in Edinburgh, which, although commendatory of Gregory, is enthusiastic with respect to Cullen. In a letter, July 27th, 1768, to Dr. Morgan, he says: “Dr. Cullen, the great unrivaled Dr. Cullen, is going on unfolding each day some new secret to us in the Animal economy; his lectures on the Practice of Physic this summer are richly worth my staying for.”

When we take into consideration the enthusiasm manifested by Dr. Rush with respect to the prelections of Cullen, how worthy of attention is the similarity of their public career. They both occupied successively the same chairs in the respective institutions of which they were conspicuous ornaments and supporters. Cullen commenced his course of teaching in the Professorship of Chemistry, was transferred to that of Institutes, and, finally, to the one of Practice; while Rush, in the term of his long life, occupied successively the chairs pertaining to each of these branches of medical science.

When Cullen became a teacher of medicine, he made an innovation which at the time was considered rash. It was the abandonment of the Latin language and the use of vernacular English. The Latin was considered the language of science, and as such was used upon the Continent, as well as in England and Scotland. He was accused of not being sufficiently familiar with it to use it readily, but from this charge he is vindicated by the fact of having received his education in that tongue, and moreover of having delivered a course of botany in it. When, about the year 1746, he adopted the new plan of delivering his lectures, he conferred a service which was afterwards acknowledged by its imitation. From this period the use of the Latin language was gradually dropped.[10]

The Lectures on the Materia Medica by Dr. Cullen, were first republished in Philadelphia, by Robert Bell, in 1775. To exhibit the estimation in which that distinguished teacher was held everywhere, the following advertisement is singularly pertinent. “The American Physicians who wish to arrive at the top of their profession are informed that the great Professor Cullen’s Lectures on the Materia Medica, containing the very cream of Physic, are now selling by the said Bell, on Third Street. Price Five dollars.” The expectation of a ready sale may be surmised from this extract.[11]

Cullen’s “First Lines of the Practice of Physic” was subsequently published in this country, in 1781. With reference to this work, an interesting extract of a letter from Dr. Rush to Dr. Cullen may be given. “One of the severest taxes paid by our profession during the war was occasioned by the want of a regular supply of books from Europe, by which means we are eight years behind you in everything. Your First Lines was almost the only new work that was smuggled into the country. Fortunately it fell into my hands. I took the liberty of writing a Preface to it, and published it during the war. The American Edition had a rapid sale and a general circulation through the United States. It was read with peculiar attention by the physicians and surgeons of our army, and in a few years regulated in many things the practice in our hospitals. Thus, Sir, you see you have had a hand in the Revolution, by contributing indirectly to save the lives of the officers and soldiers of the American Army.”[12] 16th Sept., 1783. At the time mentioned, the first volume only of the work was republished; it had been issued in Edinburgh in 1777. Cullen had able coadjutors in the University of Edinburgh. Monro (secundus) had great distinction as an anatomist and surgeon; the name of Gregory was regarded with respect; Home, Hope, and Young were filling their parts with credit to themselves and usefulness to the institution; while Black had inscribed his name upon the roll of fame, by his doctrine of latent heat and his discovery of carbonic acid. Of such luminaries was formed that cynosure in the northern firmament of medical science, which attracted the attention of the intellectual world, and directed the steps of those who sought for lights to guide them in preparation for professional duties.[13]

  1. Essay on the Character of the late Alexander Russel, M. D., F. R. S. Fothergill’s works, quarto ed., p. 430.
  2. The History of the University of Edinburgh, &c., by Alexander Bower. Edinburgh, 1817, vol. ii. p. 166. An interesting sketch of the “Early History of the Medical Profession in Edinburgh,” written by Dr. John Gairdner, has been published in the Edinburgh Medical Journal, vol. ix. Part II.
  3. Bower’s History, vol. ii. pp. 181, 182.

    In the No. of the Dublin Medical Press and Circular for May 9th, 1866, is an interesting lecture, by Prof. Struthers, of Edinburgh, before the Royal College of Surgeons, on the History of the Edinburgh Anatomical School. The details of this lecture, with reference to Mr. Monro, are in accordance with what has been given from the authorities cited. Mr. Monro was in his twenty-third year when he was elected Professor of Anatomy by the Town Council of Edinburgh.

  4. Bowers’ History, vol. ii. p. 217.
  5. The first degree of M. D. was conferred by the University of Edinburgh in 1705. See Catalogue of Graduates.
  6. See Appendix E.
  7. An Account of the Life, Lectures, and Writings of William Cullen, M. D., Professor of the Practice of Physic in the University of Edinburgh, by John Thomson, M. D., F. R. S., L. and E., Professor of Medicine and General Pathology in the University of Edinburgh, vol. i. p. 161.
  8. Bower’s History of the University of Edinburgh, vol. ii. p. 385; vol. iii. p. 108.
  9. Bower, loc. cit.
  10. See Thomson’s Life of Cullen, vol. i. p. 28.
  11. The work first published was a surreptitious edition of the Lectures on Materia Medica by Dr. Cullen, delivered in 1761. It was issued from the Edinburgh Press in 1771, when an injunction to prohibit its sale was obtained from the Court of Chancery. It was republished in London in 1773. Dr. Cullen published his “Treatise of Materia Medica” in 1789.
  12. An Eulogium upon Dr. Cullen was read before the College of Physicians of Philadelphia, by Dr. Rush, July 9, 1790.
  13. In 1768 the Faculty of the Medical Department of the University of Edinburgh was thus constituted:—

    Alexander Monro, M. D., Professor of Anatomy and Surgery
    William Cullen, M. D., Institutes of Medicine.
    John Gregory, M. D., Practice of Medicine.
    Joseph Black, M. D., Chemistry.
    Thomas Young, M. D., Midwifery.
    Francis Home, M. D., Materia Medica.
    John Hope, M. D., Botany.
    John Rae, M. D., Lecturer on Surgery in the Infirmary