subject: but it does appear to me that the proposed improvements slid,
take place in some way or other; & I must beg you, as the Directors of
literature & science, to give it that consideration it deserves ; & if the
plan proposed does not meet your approbation, that you will substitute
some oilier, such as your wisdom may judge more expedient.
" I shall be ready to enter into more exact details if you slid, be willing
to give your attention to the subject.
" I have the honor to be
" Very respectfully
"Yr obedt servt, John C. Warren."
" Boston Nov 23rd. 1835."
" Perhaps I shd. have mentioned that a new dissecting room has been
482 HARVARD MEDICAL SCHOOL
established wh. has already drawn some pupils from us. This is con-
sidered by many of the profession as the first step towards the formation
of a new medical school in Boston."
The Corporation authorized the Treasurer* to pay two
thousand dollars towards repairing the Medical College, pro-
vided the whole expense exceeded three thousand dollars.
These improvements consisted in building a new dissecting
room, equal to any in the country ; and in converting the old
dissecting room into a handsome museum, while the old mu-
seum was made over into a dissecting room for the lectures.
An effort was made in 1836 to have the examinations for
medical degrees conducted in writing. The only result of
the discussion was the arrangement of the private examina-
tion, so that the examination began at three o'clock and con-
tinued until ten, and it was understood that all the members of
the Faculty were to be present.
The dearth of anatomical material at this period led the
Faculty to remonstrate to the Mayor and Board of Aldermen
against the granting of bodies for dissection to persons other
than the Medical School of Harvard University during the
Lecture course in the Medical College. This bore directly
on the suggestion in the last part of Warren's letter, just
quoted, for then (1835) was the beginning of private medical
schools in Boston, a fact to be borne in mind. Warren's lec-
tures during his absence in Europe (1837-38) were given by
Edward Reynolds, on Anatomy, and by Hayward on Oper-
ative Surgery.
On June t, 1839, it was voted by the Medical Faculty that
the Lectures continue four months; and in May of the fol-
lowing year examinations in Latin and Natural Philosophy
were dispensed with, when the student could furnish a cer-
tificate of competency in those branches.
* Corporation Records, February, 1836.
DETAILS OF GOVERNMENT 483
May 29, 1841, it was voted, ''That hereafter two full
courses of lectures in this school be required of candidates for
the Degree of Doctor in Medicine. But for one of these
courses a substitute may be received in a course of lectures
at any other medical institution in which the number of teach-
ers is not less than six and in which the time occupied by lec-
tures is not less than four months."
The students were now divided into grades. The official
interpretation of a four months' course was seventeen weeks.
The fee for a degree was now $20.00, and soon after (May,
1844) a matriculation fee of $3.00 was established. These
lees were appropriated to the increase and care of the library
and to repairs. Students were exempted from paying a sec-
ond matriculation fee, but in 1847 it was ordered that they
pay a matriculation fee each year they attended lectures.
About this time private medical schools began to flourish,
and for the following thirty years were a factor in the history
of the Harvard Medical School. Let us briefly consider to
what state of development our School had reached before we
take up the question of private schools.
In 1841 there were 118 students registered at the School.
The Lectures began on the first Wednesday in November, and
continued four months. The course opened with an intro-
ductory lecture, each Professor in rotation delivering this.
This custom was followed for many years, and is still main-
tained in some schools of the country. The lectures and cost
were as follows:
Anatomy and Operative Surgery, by Dr. J. C. Warren, $15.
Midwifery and Medical Jurisprudence, by Dr. W. Channing, $10.
Materia Medica, by Dr. Jacob Bigelow, $10.
Principles of Surgery and Clinical Surgery, by Dr. Geo. Hayward, $10.
CTeimistry, by Dr. John W. Webster, $15.
Theory and Practice and Clinical Medicine, by Dr. John Ware and
Dr. Jacob Bigelow, $15.
484 HARVARD MEDICAL SCHOOL
' The hospital and library privileges are gratuitous. The fee for the
dissecting room is five dollars.
'The clinical lectures in Medicine and Surgery are given on cases
in the Massachusetts General Hospital, where visits are made by the
class three times a week. Surgical operations are daily growing more
frequent at the hospital and the students are encouraged to witness
the same.
" Lectures on Anatomy and Operative Surgery are delivered daily, and
are arranged to supplement each other. The large Cabinet of Dr. Warren,
lately enriched by his visit to Europe, by the addition of wax prepara-
tions to demonstrate various tumors and diseases of the skin, is used in
this course. Exceptional facilities for carrying on private dissections are
offered by the school, and a demonstrator of Anatomy has been added
to this branch. Midwifery and Medical jurisprudence are under one
Professor. Between forty-five and fifty lectures are regularly given in
Midwifery, besides the lectures given in operative midwifery. The class
is divided into sections, and these meet the professor in the afternoon, and
as often as may be necessary, for the purpose of conference and quiz.
Exercises upon the manikin are conducted to shew the use of the instru-
ments in operative cases.
" The lectures on Medical Juresprudence are confined to the statement
of the principles, with illustrations by cases. The lectures on Materia
Medica consist of the history of various articles used in Medicine, — their
preparation, form and properties, as well as their doses and application to
the treatment of disease.
" The lectures on the Principles of Surgery and Clinical Surgery con-
tinue four months during which the students visit the surgical patients
and attend all the operations at the Massachusetts General Hospital. Cases
recently admitted are used to demonstrate the lectures.
' The Chemical lectures continue four months, with five lectures each
week. During this course several lectures are given on such parts of
Natural Philosophy as are required by students who have not had a col-
legiate education.
' The course of the Theory and Practice of Physic embraces the lec-
tures given at the Medical School on the general principles of Pathology
and Therapeutics, and on the history and treatment of particular diseases;
and the clinical lectures given at the Massachusetts General Hospital.
These clinical lectures are given twice a week, and occupy two hours
each.
" Each student visits patients and practices auscultation and percussion.
'The requirements for a Degree are: an age of at least 2r years, three
years study of medicine, the attendance upon two full courses of lectures, —
one of these at least must have been attended at this school, the other in
this or in any other school which shall furnish equal opportunities for
DETAILS OF GOVERNMENT 485
medical education, i. e. a school in which the number of teachers is not
less than six. and in which the time occupied by lectures is not less than
four months. Candidates who have not had an University education
shall satisfy the Faculty of Medicine in regard to their knowledge of the
Latin language and experimental philosophy, — certificates of competency
in this condition will be accepted in lieu of such an examination. There
are two examinations annually for a degree, one on the day before the
close of the winter term, and the second one week before commencement;
four weeks' notice is required from those intending to apply for a degree,
ard a dissertation must accompany this notice."
The advertisement of the Faculty states : "Taking into view
the amount of instruction given in this school, the splendid
and extensive apparatus with which it is furnished, its con-
nection with the numerous cases and operations of one of
the best conducted hospitals in the United States, together
with the general thorough acquisition and high respectability
of its graduates, it may be doubted whether any seminary in
the country offers the means of a more complete professional
education, than may be obtained in the Medical School in
Boston".
The extension in the time of lectures from three to four
months was due to several causes. There was more or less
dissatisfaction on account of the two subjects, Anatomy and
Surgery, being under one professor, also because no pro-
visions were made for an anatomical demonstrator. Condi-
tions at Harvard were such that it was thought expedient to
lengthen the course rather than to divide the professorship.
In answer to the second cause of complaint — a lack of
anatomical demonstrations — it must be said that prior to this
time it was contrary to law to study anatomy, hence the im-
propriety of having a demonstrator of that branch. It is not
denied that the students had enjoyed some privileges in this
line, but such privileges were from the free offering of indi-
viduals connected with the school, and. if known, were not
recognized by the University. The passage of the Anatomy
486 HARVARD MEDICAL SCHOOL
Law of 1830 extended the protection of the State to the study
of anatomy, and did much to extend the length of time for
study at the Medical School.
Winslow Lewis, Jr., was added to the Faculty in 1831, as
Demonstrator in Anatomy. The holding of regular Faculty
Meetings was ordered in 1833, and it was decided that a can-
didate for the degree must actually attend the lectures at the
school, and must first pass a satisfactory examination in natu-
ral philosophy before he could take examinations.
RIVALS.
RIVALS 489
CHAPTER XX.
RIVALS.
The Berkshire Medical Institution — once famous — was a
school which calls for some consideration. I shall then deal
with the subject of Private Medical Schools.
The Berkshire School was incorporated by an Act of the
Legislature of Massachusetts, January 24th, 1823. It was
located at Pittsfield, and was under the jurisdiction of Will-
iams College. Now Williams College did not have charter
rights to confer degrees in medicine,* and when it petitioned
the Legislature for those rights (1824) it immediately encoun-
tered the opposition of the Massachusetts Medical Society.
The Society contended that Williams should be governed
by a Corporation similar to that of Harvard College. § The
opposition of the Medical Society had its effect finally, for
we find an Act of the Legislature passed April 1, 1837, estab-
lishing a Board of Overseers, consisting of the Trustees of
Williams College, the President and two Secretaries of the
Massachusetts Medical Society, together with the State Sen-
ators, for the time being, from the four Western Districts.
The Medical Society thereupon granted the Berkshire grad-
uates the same rights and privileges as those enjoyed by Har-
vard Medical graduates. By this Act the Berkshire Medical
Institution became an Independent Medical College. The
* The courts decided that the M. D., Honorary, from Williams College
was invalid, as the holder did not possess the education sufficient for a
degree, designating a highly qualified practitioner of medicine.
§ Williams College was under a board of trustees.
490 HARVARD MEDICAL SCHOOL
course of instruction consisted of a Lecture Term and a Read-
ing Term.
The Lecture Term began on the first Thursday of Septem-
ber and continued fifteen weeks. The fee for the lectures was
$40, with an additional fee of $3 for matriculation, and $1
for the use of the library. Doctors of Medicine, Fellows of
the Massachusetts Medical Society, and those who had at-
tended two full courses of Medical Lectures at an incorporated
Medical School in which the usual courses of instruction were
given, were admitted to the lectures gratuitously, the matricu-
lation fee and library ticket excepted.
The Reading Term began on the second Wednesday in
March, and, with an intermediate vacation of two weeks in
May, continued to the last Wednesday in August. A system-
atic course of instructions and recitations was carried on in
practical Anatomy and demonstrative Surgery during the first
three months of the term, and a like course of recitations on
Surgery and Obstetrics for the remainder of the term. These
courses included Theory and Practice, Materia Medica and
Pharmacy during the term, and Chemistry, Botany, Miner-
alogy and Geology, and Natural Philosophy, during parts of
the term. Students attending the reading term were required
to read semi-monthly a dissertation of their own composing,
on some subject connected with medicine. Public examina-
tions were held on the last day of the term.
Degrees were conferred at the close of the lecture term,
and at the Commencement of Williams College. The prere-
quisites for a degree were: three full years of study (includ-
ing the time devoted to lectures) with a regularly practicing
physician, and adequate knowledge of the Latin language,
attendance on two full courses of Medical Lectures, one of
which must be at the Institution, and a dissertation on some
medical subject which must be publicly read and defended.
There was a graduation fee of $15. The Faculty of Medicine
RIVALS 491
consisted of Henry H. Childs, who was active in establishing
the school, (he was elected the first Professor of the Theory
and Practice of Medicine, later he was Lieutenant Governor
of Massachusetts) ; Chester Dewey, Professor of Chemistry,
Botany, Mineralogy, and Natural Philosophy ; John D. Wells,*
Professor of Anatomy and Surgery at Bowdoin College, who
was Lecturer on Anatomy and Physiology ; John Delamater,
Professor of Pharmacy, Materia Medica and Obstetrics; and
Stephen W. Williams, Professor of Medical Jurisprudence.
In 1826-27 John P. Batchelder* joined the Faculty as Pro-
fessor of the Principles and Practice of Surgery, and Thomas
Goodsell took the place vacated by Delamater. The first class
at this school numbered 84. The economical rate of living
at Pittsfield (board, including washing, lodging and room-
rent $1.75 per week), together with the recognized ability
of Childs as a teacher, gave this school decided prestige. It
was helped along by the growing dissatisfaction with the or-
ganization of the Massachusetts Medical Society, a feeling
that crystallized later into open hostility.
With conditions and a medical course, such as I have de-
scribed, contending in rivalry, it was but natural that the Har-
vard Medical School should lose many prospective pupils who
were attracted to the Pittsfield School. This situation is
shown by the accompanying table for fifteen years :
HARVARD. BERKSHIRE.
Students. Graduates. Students. Graduates.
1823 78 15 84 7
1824 128 17 94 23
1825 118 20 112 21
1826 HO 25 IO4 26
1827 84 25 106 25
1828 83 20 IOO 28
1829 91 23 108 33
* Graduates of the Harvard Medical School.
492 HARVARD MEDICAL SCHOOL
HARVARD. BERKSHIRE.
Students. Graduates. Students. Graduates.
1830 95 21
1831 80 23
1832 83 27
1833 82 11
1*34 79 21
1835 103 20
1836 118 20
1837 87 31
1838 82 26
84
22
91
24
103
22
104
40
IOI
29
IOO
40
117
45
73
29
85
32
1 501 345 1566 446
The Berkshire School continued to prosper until about 1845,
when the increased number of medical schools throughout
the country, the greater clinical advantages afforded by schools
in large cities, where private medical schools also offered the
student closer association with his teachers, the rise of Thom-
sonianism and Homeopathy, had their effect on the School
at Pittsfield. Then, too, there was the action of the Berkshire
District of the Massachusetts Medical Society, which in 1846
took steps to crystallize opinions long held by many of the
members. In this action they lost the moral support, at least,
of the Massachusetts Medical Society toward their school.
It looked like the 181 1 question over again. The circular tells
the story: (1846)
" To The Medical Profession of Massachusetts :
" At the semi-annual meeting of the Berkshire District of the Massa-
chusetts Medical Society, held at Pittsfield, on Wednesday, the nth of
November, 1846, the Committee appointed to address the members of the
Profession in Massachusetts, on the subject of a STATE MEDICAL
SOCIETY, reported the following Circular, which was unanimously
adopted, and ordered to be printed and distributed to the Profession
throughout the Commonwealth:
"CIRCULAR.
" It is a subject of congratulation that the profession of medicine is
largely sharing in the rapid progress of the Arts and Sciences which
distinguishes the 19th. century; notwithstanding the variety of novel
RIVALS 493
forms which empiricism assumes, and the bold pretensions of exclusive
systems of practice.
" The grand object of Medical Association is, we conceive, to contribute
to this progress. Another, and by no means an unimportant object, is the
cultivation of harmony and good feeling among the members.
" Does the present organization of the Massachusetts Medical Society
fully meet these objects? We think not.
" While we entertain all proper respect for the early enactment of the
Legislature, designed for the benefit of the Medical Profession, we must
recognize the principle that great changes of circumstances call for corre-
sponding changes in all human laws.
' The Massachusetts Medical Society was formed in 1781, when the
population of the State was relatively small, and the number of physicians
proportionally so ; and when, in consequence of the sparse and scat-
tered population of the country, the difficulty of communication between
the practitioners themselves, and other adverse circumstances, the benefits
of Medical Association were of necessity chiefly confined to Boston and
a few large towns.
" The present organization might have been well adapted to the then
existing state of the Commonwealth, and wholly inappropriate now.
* * * We state a few facts.
" In the county of Berkshire there are about one hundred regular physi-
cians, and of these only about twenty are members of the Massachusetts
Medical Society.
" In some of the other counties the number of the regular Physicians
exceeds that of the members in nearly the same ratio.
" It is believed that not one-half of the regular physicians in the State
belong to the Massachusetts Medical Society.
" In this county, great efforts have been made, at different times, to
induce Physicians to join the Society, but with very little success, as its
present condition and numbers attest.
" The uniform objection urged against connecting with the Society is,
that under its present organization the burdens of the State Society must
be borne by all, while its benefits are in a great degree confined to a fezv.
" It will be remembered that, in order to be a member of a District
Society, the physician must first become a fellow of the Massachusetts
Medical Society ; and thus the State Society, instead of cherishing the
District Societies, has become the great obstacle of their success.
"We only allude to the fact that the funds, the library, and the meetings
are confined to the city of Boston, and can be of little advantage to tin-
great majority of the members.
"Without going farther into details, with which all the members are
familiar, this Society deems it a duty to express its unanimous opinion
494 HARVARD MEDICAL SCHOOL
that the present organization of the Massachusetts Medical Society is
radically defective, in that the District Societies are made the creatures
of the State Society, and that, while this obnoxious feature is retained, it
will effectually defeat all endeavors to elevate the condition of the local
District Societies.
' The new plan of organization which this Society beg leave to suggest,
is essentially that now in successful operation in New York, Connecticut
and other States.
"By the adoption of this plan the profession in each County or District
will form for themselves local County or District Societies, and the State
Society will be composed of Delegates from the several local Societies.
' Thus the whole profession of the State would enjoy all the advantages
of the local associations untrammelled — and with them, all the benefits
that can flow from any State Medical Society.
" In accordance with these views, a Memorial, signed by every regular
physician in the County of Berkshire, will be presented to the next legis-
lature, praying that the Massachusetts Medical Society may be reorganised
and in default of such reorganization, that the Profession in the County of
Berkshire may be constituted a separate and distinct Medical Society,
clothed with the usual powers and privileges pertaining to such bodies.
' The first of these two alternatives we should greatly prefer — believing
it, as we do, to be a measure fraught with good to the whole Profession
of the State.
' The Profession in the several Counties are respectfully invited to con-
sider the matter, and, if it meet their views, to co-operate with the Pro-
fession in this County in this and all other honorable means for securing
so desirable a result.
" R. W. Worthington, of Lenox, " Selden Jennings, of Richmond,
"H. H. Childs, of Pittsfield, " W. L. Fitch, of Otis,
" Millen Saein, of Lenox, " N. S. Babbit, of Adams,
" H. L. Sabin, of Williamstown." Committee.
'Pittsfield. November nth, 1846."
The fifteen weeks term was maintained at the Berkshire
School more or less faithfully until 1849, when a Lecture
Term of sixteen weeks and two Reading Terms were adopted
upon the suggestion of the American Medical Association.
In 1866 the course was changed so as to begin in June and
continue eighteen weeks. This made it a summer school,
and its final catalogue issued in 1867 announces that the
course is thus arranged in order that "students can attend
RIVALS 495
without interfering with the autumn, winter or spring course
in other colleges.''
In the forty-five years of its existence, the Berkshire Med-
ical School had in its Faculty such men as Alonzo Clark,
Gilman Kimball, Willard Parker, Elisha Bartlett, Timothy
Childs, J. V. C. Smith, Horatio R. Storer, B. J. Jeffries,
Robert Watts, Jr., and others. It certainly was a vigorous
rival for Harvard. In Boston, however, there were medical
schools conducted by groups of physicians who saw in the
defective system of medical education then prevailing through-
out the country an opportunity for supplying some of the
needs of those students who sought better things, and at the
same time for adding materially to their own incomes. Let us
recall the truth that the School which we know to-day was
to all intents a private medical school up to the year 1869.
Its degree bore the stamp of Harvard, and a prestige was
thereby obtained by the graduate, but the fees from the stu-
dents, excepting the graduation fee, went into the pockets of
the individual teachers. The lecturers, in return, paid the
expenses incurred in conducting the school. The schools to
be described now were supplementary to the Harvard School,
and out of them grew the "summer" and "graduate" courses
of the Harvard School, which to-day are among its most im-
portant features.
PRIVATE SCHOOLS.
As early as 1827 Walter Channing advertised a course of
Lectures on Midwifery. These lectures were given during
the summer months.
Another course by teachers connected with the Harvard
Medical School was one by John C. Warren, George Hayward
and Enoch Hale, Jr. These physicians gave instruction in
the various branches of medical education. They furnished
books to the pupils, and had a private room where examina-
496 HARVARD MEDICAL SCHOOL
tions were frequently held. A strong attraction of this school
was its facilities for dissection. The terms for the course
were $100 for a year, $75 for six months, and $50 for a
quarter.
' The students, in addition to the private instruction have the privilege
of attending gratuitously the Medical and Surgical practice and the Sur-
gical Operations of the Massachusetts General Hospital, and generally
private surgical operations, during the period of their pupilage ; and they
will also have free admission to the Lectures on Anatomy and Surgery,