Part 4: MD with an LLD Degree or Is It LLD with an MD Degree?

I made an javascript:void(0)error in my last post. Maryland was not the location of one of the first four medical colleges in the United States.

The Medical College of Philadelphia (now the medical school of the University of Pennsylvania) was established in 1765. King's College (now Columbia University) in New York City established a medical school in 1768. Philadelphia and New York for many years were the centers of medicine in the American colonies.

Harvard College added a medical curriculum in 1782 followed by Dartmouth Medical College in 1797. The creation of medical schools in the United States in the first 75 years of the 19th century was rather slow. Between 1801 and 1825 only 12 more medical colleges were established. Over the next 25 years 22 more schools were established followed by 33 between 1851 and 1875. However, the pace accelerated in the last 25 years of the 19th century with the addition of 86 new medical colleges. According to page 13 of The Standard Medical Directory of North America 1902, as of 1899, there were 156 medical schools in the US with 24,119 students enrolled.

This book, as well as others, claimed that during the Revolutionary War, nearly 3500 people were medical practitioners but only about 400 had medical degrees. So with only four medical schools founded between 1765 and 1797, how were most medical practitioners trained?

A few went to Europe to study. Dr. Francis Packard writes in his book that from 1758 through 1788, 63 Americans graduated with a medical degree from the University of Edinburgh in Scotland (page 156). During this period, if you had the funds, you went abroad to study in London, Edinburgh, Paris and Leiden. Unfortunately, most colonists did not have the means, thus most medical practitioners were trained through an apprenticeship.

I found that there were no standards regarding what constituted proper medical training. The following quotations taken from or about the time clearly illustrates the point:

God heals and the doctor takes the fee. - Benjamin Franklin

Few physicians amongst us are eminent for their skill. Quacks abound like locusts in Egypt, and too many have recommended themselves to a full practice and profitable subsistence. This is the less to be wondered at, as the profession is under no kind of regulation. - William Smith (1732)

The Chicago Medical College (Northwestern University) by 1859 had introduced a more rigorous curriculum and graded courses, compulsory clinical and laboratory work and lengthened the duration of the program. In 1871, Harvard Medical School adopted a similar program followed by Syracuse Medical School. However, the problem continued throughout the greater part of the 19th century at which time medical societies such as the American Institute of Homeopathy (organized 1844), Association of American Medical Colleges (1890), National Confederation of Eclectic Medical Colleges (1871) and the Southern Medical College Association (1892) pushed for the establishments of higher standards.

To be continued in my next blog: American Medical Training before the 20th Century.

Sources:
History of New York, from the First Discovery to the Year MDCCXXXII by William Smith. Albany, NY: Printed by Ryer Schermerhorn, 1814.
The History of Medicine in the United States by Francis Randolph Packard, MD. Philadelphia: J. B. Lippincott Company, 1901.
The Standard Medical Directory of North American 1902. Chicago: G. P. Englehard & Company, 1902.

Part 3: MD with an LLD Degree or Is It LLD with an MD Degree?

In my last blog entry, I indicated that I would look at physicians in private practice and not employed by a medical school to see if some percentage of these physicians had also obtained an LLD. That task is proving to be more time consuming than I had hoped.

However, while I was exploring the answer to this question, I did come across some interesting facts.

As I constructed the spreadsheet from the information in Walter Eliot's book, "Portraits of the Noted Physicians of New York 1750-1900" and filling in the information missing in the book about these 199 physicians from other sources, I noted an interesting fact. Several of the earliest practicing physicians had gone to Europe to study. In particular, these men traveled to Edinburgh, Scotland to study medicine either after earning an MD degree or after serving an apprenticeship under a practicing physician.

So what was happening in medicine in the colonies in 1750? Well, for one thing there were no medical schools. The first medical school established in the North American British colonies was in Pennsylvania in 1765 followed by medical schools in New York and Maryland. With the addition of a medical curriculum at Harvard in 1782, there were only 4 medical colleges in the United States by 1800. Clearly, the American Revolution had an impact on the establishment of medical colleges.

So it is not surprising to me that the men in Walter Eliot's book who were practicing medicine the earliest had gone to Scotland for training. As times progressed, some of the men in the book went to London, Paris and Vienna for medical training beyond the training that they received in the United States.

I am a descendant of the "first physician" in New Amsterdam. As I looked for documentation that supported this claim, I found Hans Kierstede referred as a chirurgeon. As it turns out this translates to a surgeon, but not as we think of a surgeon today. Back then, there were three occupations that provided medical care. These were the physician, surgeon and apothecary. The surgeon was associated with the military and whose function was to amputate limbs. The apothecary mixed items to create medicines.

To be continued...