Medicine – British Medicine in Greater Britain Part 2

Passing now to the main question of the development of this British medicine in Greater Britain, I must at once acknowledge the impossibility of doing justice to it. I can only indicate a few points of importance, and I must confine my remarks chiefly to the American part of Greater Britain. We may recognize three distinct periods corresponding to three distinct waves of influence, the first from the early immigration to about 1820, the second from about 1820 to 1860. and the third from about 1860 to the present time.

The colonial settlements were contemporaneous with the revival of medicine in England. Fellow-students of Harvey at Cambridge might have sailed in the Mayflower and the Arbella. The more carefully planned expeditions usually enlisted the services of a well-trained physician, and the early records, particularly of the New England colonies, contain many interesting references to these college-bred men. Giles Firman, who settled in Boston in 1632, a Cambridge-man, seems to have been the first to give instruction in medicine in the new world. The parsons of that day had often a smattering of physic, and illustrated what Cotton Mather called an “angelical conjunction.” He says: “Ever since the days of Luke, the Evangelist, skill in Physick has been frequently professed and practised by Persons whose more declared Business was the study of Divinity.” Firman himself, finding physic “but a meane helpe,” took orders. These English physicians in the New England colonies were scholarly, able men. Roger Chilling-worth, in Hawthorne’s Scarlet Letter, has depicted them in a sketch of his own life: “Made up of earnest, studious, thoughtful, quiet years, bestowed faithfully for the increase of knowledge, faithfully, too, for the advancement of human welfare—men, thoughtful for others, caring little for them-selves, kind, just, true, and of constant if not warm affections,—” a singularly truthful picture of the old colonial physician.

Until the establishment of medical schools (University of Pennsylvania, 1763; King’s College, afterwards Columbia, 1767; Harvard, 1782) the supply of physicians for the colonies came from Great Britain, supplemented by men trained under the old apprentice system, and of colonists who went to Edinburgh, Leyden and London for their medical education. This latter group had a most powerful effect in moulding professional life in the prerevolutionary period. They were men who had enjoyed not alone the instruction but often the intimate friendship of the great English and European physicians. Morgan, Rush, Shippen, Bard, Wistar, Hosack and others had received an education comprising all that was best in the period, and had acquired the added culture which can only come from travel and wide acquaintance with the world. Morgan, the founder of the medical school of the University of Pennsylvania, was away seven years, and before returning had taken his seat as a corresponding member of the French Academy of Surgery, besides having been elected a Fellow of the Royal Society. The War of Independence interrupted temporarily the stream of students, but not the friendship which existed between Cullen and Fothergill and their old pupils in America. The correspondence of these two warm friends of the colonies testifies to the strong professional intimacy which existed at the time between the leaders of the profession in the old and new worlds.

But neither Boerhaave, Cullen nor Fothergill stamped colonial medicine as did the great Scotsman, John Hunter. Long, weary centuries separated Harvey from Galen; not a century elapsed from the death of the great physiologist to the advent of the man in whose phenomenal personality may be seen all the distinctive traits of modern medicine, and the range of whose mighty intellect has had few, if any, equals since Aristotle. Hunter’s influence on the profession of this continent, so deep and enduring, was exerted in three ways. In the first place, his career as an army surgeon, and his writings on subjects of special interest to military men, carried his work and ways into innumerable campaigns in the long French wars and in the War of Independence. Hunter’s works were reprinted in America as early as 1791 and 1793. In the second place, Hunter had a number of most distinguished students from the colonies, among whom were two who became teachers of wide reputation. William Shippen, the first Professor of Anatomy in the University of Pennsylvania, lived with Hunter on terms of the greatest intimacy. He brought back his methods of teaching and some measure of his spirit. With the exception of Hewson and Home, Hunter had no more distinguished pupil than Philip Syng Physick, who was his house surgeon at St. George’s Hospital, and his devoted friend. For more than a generation Physick had no surgical compeer in America, and enjoyed a reputation equalled by no one save Rush. He taught Hunterian methods in the largest medical school in the country, and the work of his nephew (Dorsey) on Surgery is very largely Hunter modified by Physick. But in a third and much more potent way the great master influenced the profession of this continent. Hunter was a naturalist to whom pathological processes were only a small part of a stupendous whole, governed by law, which, how-ever, could never be understood until the facts had been accumulated, tabulated and systematized. By his example, by his prodigious industry, and by his suggestive experiments he led men again into the old paths of Aristotle, Galen and Harvey. He made all thinking physicians naturalists, and he lent a dignity to the study of organic life, and re-established a close union between medicine and the natural sciences. Both in Britian and Greater Britain he laid the foundation of the great collections and museums, particularly those connected with the medical schools. The Wistar-Horner and the Warren museums originated with men who had been greatly influenced by Hunter. He was moreover, the intellectual father of that interesting group of men on this side of the Atlantic who, while practising as physicians, devoted much time and labour to the study of Natural History. In the latter part of the last century and during the first thirty years of this, the successful practitioner was very often a naturalist. I wish that time permitted me to do justice to the long list of men who have been devoted naturalists and who have made contributions of great value. Benjamin Smith Barton, David Hosack, Jacob Bigelow, Richard Harlan, John D. Godman, Samuel George Morton, John Collins Warren, Samuel L. Mitchill, J. Aiken Meigs and many others have left the records of their industry in their valuable works and in the Transactions of the various societies and academies. In Canada, many of our best naturalists have been physicians, and collections in this city testify to the industry of Holmes and McCullough.

I was regretting the humanities a few minutes ago, and now I have to mourn the almost complete severance of medicine from the old natural history. To a man the most delightful recollections of whose student life are the Saturdays spent with a preceptor who had a Hunterian appetite for specimens—anything from a trilobite to an acarus—to such a one across the present brilliant outlook comes the shadow of the thought that the conditions of progress will make impossible again such careers as those of William Kitchen Parker and William Carmichael McIntosh.

Until about 1820 the English profession of this continent knew little else than British medicine. After this date in the United States the ties of professional union with the old country became relaxed, owing in great part to the increase in the number of home schools, and in part to the development of American literature. To 1820 one hundred and fourteen native medical books of all kinds had been issued from the press, and one hundred and thirty-one reprints and translations, the former English, the latter, few in number, and almost exclusively French (Billings).

Turning for a few minutes to the condition of the profession in Canada during this period, I regret that I cannot speak of the many interesting questions relating to the French colonies. With the earliest settlers physicians had come, and among the Jesuits, in their devoted missions, there are records of donnes (laymen attached to the service), who were members of the profession. One of these, Rene Goupil, suffered martyrdom at the hands of the Iroquois.’

Between the fall of Quebec in 1759 and 1820, the English population had increased by the settlement of Upper Canada, chiefly by United Empire Loyalists from the United States, and after the war of 1812 by settlers from the old country. The physicians in the sparsely settled districts were either young men who sought their fortunes in the new colony or were army surgeons, who had remained after the revolutionary war or the war of 1812. The military element gave for some years a very distinctive stamp to the profession. These surgeons were men of energy and ability, who had seen much service, and were accustomed to order, discipline and regulations. Sabine, in his American Loyalists, refers to the Tory proclivities of the doctors, but says that they were not so much disturbed as the lawyers and clergymen. Still a good many of them left their homes for conscience’ sake, and Canniff, in his Medical Profession in Upper Canada, gives a list of those known to have been among the United Empire Loyalists.

The character of the men who controlled the profession of the new colony is well shown by the proceedings of the Medical Board which was organized in 1819. Drs. Macaulay and Widmer, both army surgeons, were the chief members. The latter, who has well been termed the father of the profession in Upper Canada, a man of the very highest character, did more than anyone else to promote the progress of the profession; and throughout his long career his efforts were always directed in the proper channels. In looking through Canniff’s most valuable work one is much impressed by the sterling worth and mettle of these old army surgeons who in the early days formed the larger part of the profession. The minutes of the Medical Board indicate with what military discipline the candidates were examined, and the percentage of rejections has probably never been higher in the history of the province than it was in the first twenty years of the existence of the Board.

One picture on the canvas of those early days lingers in the memory, illustrating all the most attractive features of a race which has done much to make this country what it is to-day. Widmer was the type of the dignified old army surgeon, scrupulously punctilious and in every detail regardful of the proprieties of life. “Tiger” Dunlop may be taken as the very incarnation of that restless roving spirit which has driven the Scotch broadcast upon the world. After fighting with the Connaught Rangers in the war of 1812, campaigning in India, clearing the Saugur of tigers—hence his soubriquet “Tiger,” lecturing on Medical Jurisprudence in Edinburgh, writing for Blackwood, editing the British Press and the Telescope, introducing Beck’s Medical Jurisprudence to English readers, and figuring as director and promoter of various companies, this extraordinary character appears in the young colony as “Warden of the Black Forest” in the employ of the Canada Company. His life in the backwoods at Gairbraid, his Noctes Ambrosianae Canadenses, his famous “Twelve apostles,” as he called his mahogany liquor stand (each bottle a full quart), his active political life, his remarkable household, his many eccentricities—are they not all portrayed to the life in the recently issued In the days of the Canada Company?