68 



SCIENCE. 



[N. S. Vol. XVIII. Ko. 44C. 



obtained from the hides oi' sinews of deer, 

 and her remedies were the products of the 

 field or the forest about her. 



The first attempts at medical instrue- 

 tion in America were made in private 

 schools which siipplemented the systems 

 ■of apprenticeship just mentioned. Cad- 

 wallader of Philadelphia, Hunter of New- 

 port, and Shippen of Philadelphia, all in 

 turn gave private demonstrations in an- 

 atomy, as this department of study for 

 obvious reasons was inadequately taught 

 tinder the apprentice and preceptor sys- 

 tem. The step from private to public 

 medical schools in connection with existing 

 colleges was soon made. The first, now 

 the University of Pennsylvania, was es- 

 tablished as a department of Philadelphia 

 College in 1765; King's College, now the 

 Medical Department of Columbia Univer- 

 sity, in 1767; Harvard Medical School in 

 1783 ; Dartmouth Medical School in 1798 ; 

 the University of Maryland in 1807; and 

 Tale Medical School in 1813. It is grati- 

 fying to note that all these schools were 

 established in connection with well-known 

 and well-established institutions of learn- 

 ing, and were not independent and isolated 

 schools of medicine alone. The movement 

 which brought about the establishment of 

 the Yale Medical School, it should be re- 

 marked, came from Yale College, through 

 President Dwight. They were an out- 

 growth, however, of pioneer conditions and 

 their primary purpose was to furnish med- 

 ical teaching to supplement the apprentice 

 and preceptor system. They gave courses 

 of lectures on the science of medicine; 

 practical or, rather, clinical work followed 

 under the preceptor. The system was a 

 necessity in a new and undeveloped coun- 

 try, sparsely populated and poorly sup- 

 plied with medical men. It was a product 

 of American soil, and not an imitation of 

 conditions abroad. These schools were es- 

 tablished by well-trained, scholarly men, 



and the medical instruction given w-as fully 

 equal to that given in law or theology, 

 where a similar system of preceptors ex- 

 isted. Entrance examinations were re- 

 quired and the same standard of educa- 

 tion and fitness exacted as for admission 

 to college. Unhappily this standard of 

 educational requirements so essential to a 

 learned profession was not long main- 

 tained. After 1820, and for a half-cen- 

 tury and more, medical education steadily 

 retrograded and standards for entrance to 

 medical schools and for graduation were 

 progressively lowered. Schools of medi- 

 cine upon a commercial rather than an 

 educational foundation sprang up far 

 from centers of population or facilities for 

 clinical teaching, and degrees were con- 

 ferred upon persons who were manifestly 

 unfit to enter the profession. The ma- 

 jority of these schools were not attached 

 to any institution of learning, or, if nom- 

 inally attached, they were destitute of 

 any vital connection; they were parasitic 

 growths, like the mistletoe upon the oak, 

 having neither the leaf nor the fruit of its 

 pi-esumptive parent stem. They were 

 founded in every part of the country, and 

 the study of medicine was promoted by 

 one or more short courses of lectures, 

 generally of three or four months' dura- 

 tion, without practical work, too often 

 given to young men of very limited 

 education. The same courses were re- 

 peated year after year to the same stu- 

 dents, and no difference was recognized 

 between the instruction given to the 

 man about to graduate and the one 

 who had just entered upon the study of 

 medicine. Medical knowledge flowed like 

 the blood-stream in the human body, and 

 every stiident was supposed to be able to 

 select and to appropriate what was most 

 needed for his growth and mental develop- 

 ment. As a witty friend expi-essed it re- 

 cently, medical knowledge was pumped 



