Iowa History Project

pages 61-83

Thirty years elapsed from the appearance of Dr. Muir, an army surgeon on the Iowa side of the Mississippi, to the period when the first institution for teaching medicine was organized in Iowa. Dr. Muir was not particularly identified with civil practice, but to some extent with territorial affairs. During the period referred to, a small number of well trained physicians came to Iowa and became impressed with the idea that the time must come when some provision for the education of medical practitioners should be made to meet the growing needs of the Iowa country. Medical schools had as yet only reached a rudimentary stage of development and young men of very limited general education were admitted to their courses. The early schools were organized for the laudible purpose of preparing men to supply certain recognized needs in a sparsely settled country.

It may be true that at a later period, schools were organized for more selfish purposes and that the personal interests an dambitions were better served than the general public. Student fees, and the title of professor had attractions no doubt, and were responsible for the mulitiplication of medical schools which came later.

The above criticism does not apply in any great degree to the pioneer Iowa medical college, which finally found a permanent home in Keokuk and which was destined to become the medical center of Iowa for many years.

The College of Physicians and Surgeons of Keokuk was organized in La Port, Indiana, in 1846. Who constituted the first faculty we do not know except that Dr. W.W. Mayo who later became so widely known in Minnesota, was professor of chemistry. In 1847 this school was moved to Madison, Wisconsin, and became the medical department of the University of Wisconsin. For some reason not clear now the school migrated to Rock Island in 1848 to become the "Medical College of the Upper Mississippi". In 1849, Davenport offered greater inducements and was the center of medical education for one year. For some reason at the close of the 1849-50 session at Davenport, the school finally moved to Keokuk to begin its first session in November, 1850, where it remained for a period of fifty-eight years. In 1908 the Keokuk Medical College merged with Drake, which in turn, five years later merged with the Iowa State University, School of Medicine.

The most interesting period in the history of this pioneer institution of medicine is in its early days at Keokuk. The city of Keokuk in itself has a history unique and interesting in Iowa, quite different from the rather common place and uneventful settlement, growth and development of other cities in the state.

The medical student of today has but small appreciation of the medical college of his father and grandfather. Today the microscope, the test tube, the clinical laboratory and the clinic room, the x-ray, electrocardiograph, phthalin and other tests for kidney functions, the blood-pressure tests and many other things occupy the students attention for four years, after a preparatory course of equal length. In the fathers, or it may be the grandfather's day, eloquent lectures on the liver or on the action of opium would hold the attention of the student for the hour. Today after the professor has applied all the instruments of precision, there is still room for doubt; no so then. After an eloquent discourse on what could not be seen or felt, but by a process of logical reasoning from an unknown premise, the professor could with refreshing certainty, present the exact condition and formulate a combination of drugs which rarely failed to find the diseased tissue and work a happy result.

Let us listen to the introductory address of M.L. Knapp, M.D., president and professor of materia medica and therapeutics in the Medical College located in Rock Island, Ill. (A verbatim copy, not a punctuation mark changed.)

"No honor could be more congenial to my feelings, for since enduring some fifteen years of toil in the profession in Illinois and having held communication with several medical schools to find myself at last in this 'Ed Dorado' of the flowery West, on the banks of a lovelier than the Blue Moselle, presiding as acconcheur at the birth of a new institution of medical learning, pure, promising and undefiled by perfidy, comely in every feature and limb, matchless, indeed, at her birth, is, to me, a source of more unalloyed happiness than I could enjoy were I elevated to the chief magistracy of a state.

"The faculty herein associated for the purpose of teaching medicine, derive their powers, privileges and appointments from the Madison Medical College, an institution chartered by the sovereigh State of Wisconsin and possessing as full and ample powers for conferring degrees in the profession of medicine as any institution in the United States. A power is granted in said charter to create a branch, which power was exercised by the corporators at their meeting for organization, and the branch was located at Rock Island, and styled the Rock Island Medical School. This was done to give a central position and not to interfere with any school already in operation. Discretion was here considered the better part of valor.

"New schools are looked upon with a jealous eye, and their projectors are frequently made the target at which bad eggs from other schools are hurled. I have som reputation in this way; am a new schoolsman; have associated in getting up several; was a private at the late lamented McClelland, who got up Jefferson College and sundry other medical schools in Philadelphia, and who abused and vilified and conspired against by his envious rivals, some of the very men we opine, who now enjoy the fruits of his labors. I have had early lessons and have had late lessons and only wish I were indeed a more worthy pupil of so worth a master.

"What I wish to say is to define our position - declare our bill of rights. We hold it to be essentially our inherent and unalienable right to do just as we please, to get up a school on Rock Island or on Nantucket Island, on the Rocky Mountains or in the city of Gotham, or at any place between - among our neighbors the Flat Heads or among the High Heads whose facial angle comes up the the standard of our own - and having established it we have the unquestionable right to teach the doctrines of the Flat Heads for true physic, but the posted up doctrines of the fathers, seasoned of course with the salt and sage of our own experience to make our lessons sit well on the stomachs of students; and should the smoke of our incense rise and curl more gracefully than that from some other wigwam, or in other words the offering of our firstlings prove more acceptable like Abel's of old; we hold that no wicked, envious brother Cain should rise up and slay us outright with a paltry paper pop-gun; commit the horrid crime of fratricide and get a mark set on himself for life; yea verily, we hold that we have the inalienable right to do so as we please, albeit, in those times of reform in medicine we shall please to be found practically regarding all the reforms and usages of the enlightened and progressive age of medicine in which we first draw our birth; as a matter of priciple, in the first place because we wish and please to do right; and as a matter of policy, in the next place to present ourselves from being read our of the church as soon as christened. Other schools are reforming - we wish to start right and to be in communion with some. We have not taken our stand, be it understood in this far out, dark and be-nighted corner of the world, where hardly a rushlight sheds its feeble ray, in order to be an outlaw and carry on a border warfare with our neighbors the Sacs, Foxes or Pottawattomies, or any other tribe of Indians or white men, school or professors who may have claimed this as a portion of their stamping ground, and raised the warwhoop, brandished the tomahawk or issued anonymous scurrillous circulars. We war not with them. Let those who make asses or Indians of themselves who will, and incur the just censure of public opinion. We have too much self-respect, and too abiding a sense of what belongs to good manners and the proprieties of civilized life, to retaliate or even to respond. Not that our border foes are less vulnerable than border hordes in general, but our ambition runs not in this vein; runs not thus low.

"If we cannot devote ourselves to some higher purpose than a loathsome effort to inflict injury, let us and our cause be doomed to degeration. But ours is a nobler object; a broad effort to do good. And our mission, be it known is one of peace, order and good will to all men, to whom these presents shall come or may in any wise concern. We intend to be strict conformists to law, human, medical and devine; to set a good example to all professors and the rising generations of doctors; to treat our freinds with true friendship; our foes with extraordinary, even Parisian politeness and the more so the more they abuse us, the Journals and Reviews, with our thanks and patronage whether they notice us justly, unjustly or not at all; our Indian neighbors as though we wished to civilize and Christianize them; students of medicine with sound doctrine, line upon line and precept upon precept; and to continue to treat all mankind with gentleness and charity when well, and with the best of our skill and physic when it is their good fortune to employ us when sick. We intend to continue to pursue an honorable course in all things; in teaching or fighting, whatever others may do, and to take Dame Fortunes' favors with laughing good humor, though some few of them may come through tainted channels. We mean especially to keep up with our noble profession as closely as possible and continue to teach it; and we intend to abet all consistent reforms."

We have not been able to trace the subsequent history of this learned medical teacher and college president. It does not appear that he continued his connection with the school after it moved to Davenport.

The history of the school in 1849 when located in Davenport was apparently uneventful. The only reference we have been able to find aside from the fact of the school conducting a course of lectures for one year, is in the autobiography of the distinguished jurist, John F. Dillon who entered the Rock Island school in 1848 and graduated from the school in Davenport on 1849-50. Judge Dillon says, "the professors as a body, were able men, some of them men of great learning and even genius. Abler teacher than Professor Richards, who taught practice, Professor Sanford who taught surgery, and Professor ARmor who taught physiology, it would be difficult to find in the chairs of any comptemporary medical institution." Professor Samuel G. Armor later became professor of therapeutics in the Medical Department of the University of Michigan and still later professor of the practice of medicine in the Long Island Medical College in Brooklyn, N.Y. Dr. Armor was a graceful and eloquent lecturer. The writer well remembers the crowding of the lecture room with law and liberal arts students, University of Michigan, when Dr. Armor delivered his lectures on opium. The lectures were regarded as models of eloquence.

It appears that the course of lectures in Davenport closed in the spring of 1850 and opened in Keokuk, November, 1850. The "Regulations" for the first term of lectures in Keokuk read as follows:

The next session will commence on the first Monday in November and continue sixteen weeks. The annual commencement will be held and the degrees conferred immediately after the close of the term. Every student will be required, within ten days after the opening of the session to take out the matriculation ticket, and pay the regular fee.

The following are the requisites for the diploma:

First - The candidate must be twenty-one years of age. Second - He must have attended two courses of medical lecturers; one of which must have been delivered in the medical department of the Iowa State University, or evidence of three years reputable practice, will be regarded as equivalent to one course. Third - The candidate must have studied medicine for two years under the direction of a respectable medical practitioner. Fourth - He must write a medical Thesis either in the English, Latin, French or German languages. Fifth - He must pass an examination satisfactory to the faculty and pay the graduation fee in advance.

Fees - The fees for a full course of lecturers amount to $70. The student may attend one or more of the courses, as he may be disposed, and pay only for the lectures for which he enters. The fee for the diploma is $20. The matriculation fee is $5. The fee for admission to the dissecting rooms and demonstrations is $5. Members of the profession from every part of the country who are graduates of medicine will on presenting their diploma to the dean and paying the matriculation fee be admitted gratuitously to all the lectures. Board can be obatined in the city at from $1.50 to $2 per week. Medical books may be purchased at our extensive book stores, on as good terms as in any Western city.

JOHN F. SANFORD, M.D.
Dean of the Faculty

It may be noted here that the Keokkuk school was nominally the medical department of the State University of Iowa, recognized as such by the Iowa legislature and later was granted appropriation of public money as will be hereafter noted.

The school was now fairly launched on a long course of usefulness, but troubles soon began to appear. Dr. N.S. Davis had recently located in Chicago, but entertained "peculiar" notions in relation to medical education which were not agreeable to the views of established medical colleges even from New York to Keokuk. The Western Medico-Chirurgical Journals, afterwards the Iowa Medical Journal, notes that Rush Medical College, an institution located in the city of Chicago, announced to the class that was about to enter upon courses of instruction, a sudden change of purpose in the minds of the faculty and a resolution to reduce lecture fees, which was at once adopted and proclaimed to the profession in an introductory lecture by Dr. N.S. Davis. The note goes on to state; "It was well known that Dr. Davis had for many years held peculiar views in regard to meedical education; and that a morbid desire to force these innovations into conflict with time honored usages of the profession, had drawn upon him a severe rebuke from the eminent and venerable Professor Payne of the New York University."

Dr. Davis had just been appointed professor of physiology and pathology in Rush Medical College. The offense he was guilty of was the extension of the time of lectures and reducing the fee. Dr. Davis was of the opinion that the interest of medical education would be furthered by making longer courses and reduced fees, so as to enable students of moderate financial ability to study longer in a medical college and therefore proposed to reduce the fees to $35.00 in cash. It will be borne in mind that there were at that time many joint stock private medical colleges in the United States and by dividing the fees among the members of the faculty added very materially to the income of the professors.

The Journal referred to was edited by the Dean of the College of Physicians and Surgeons, Keokuk. This reduction of fees caused the faculty much uneasiness.

The editorial referred to speaks of the "sophistry and rotteness" of the introductory address of Dr. Davis with considerable spirit and hopes that the American Medical Association will consider the matter in a "sense of honor, dignity and propriety in cases where there is no written law applied."

It will be remembered that Dr. Davis was only able to carry out his plan of reform in medical education on the organization of the Chicago Medical College.

Another cause for grief appears in the December number of the Western Medico-Chirurgical Journal. The Evansville Medical College issued a bulletin proposing to admit "Sons of Temperance" at one-half the usual fee for tuition and in return for this concession, it seems that the "Sons of Temperance" expressed themselves as having no hesitation in recommending the school as in every way worthy of public confidence. This kind of competition was very offensive to the editors of the Journal who were also proprietors of the Keokuk College.

In the same number of the Journal appears an announcement that the "College of Physicians of the University of Iowa opened in the city of Keokuk the first Monday of November under the most flattering auspices." The special reason for this good feeling appears to be the generous action of the city council in appropriating $200 to "enable the faculty without embarrassment to make desirable additions to their various appliances." In the same number, the Journal expresses profound contempt at the opening of the Female Medical College of Philadelphia, and its disgust that seventy women have matriculated. This was in 1857.

A letter to Professor Samuel G. Armor from Professor J.F. Sanford, written from Iowa City, January 7, 1851 presents some interesting facts which show the advanced views entertained by Professor Sanford at that time in relation to medical education; he says, "A better primary education on the part of our medical students will do more to improve and maintain the honor and dignity of the profession than any arbitrary exactions of medical colleges or societies, or proscriptive legislative enactments, but numerous literary institutions in Iowa, will doubtless display their influence in the ranks of the profession."

In writing of the meeting of the State Medical Society for 1851, Dr. Sanford says:

"It is very desirable that every portion of our state may be represented at Fairfield at the meeting of the State Medical Society in May next, that an extended and combined effort may be made to develop the medical resources of Iowa."

Dr. Sanford was apparently directing some medical legislation before the General Assembly at Iowa City in relation to the question of a state lunatic asylum. It was felt that the time had come when Iowa should have an institution of this kind, and on Tuesday morning a petition for an appropriation to build a lunatic asylum signed by several hundred names was introduced into the senate and immediately after, an able memorial upon the same subject from Professor D.L. McGugin. In this memorial, after presenting the statistics of insanity for this state and showing the necessity of such an institution, the professor made an eloquent appearl in behalf of this unfortunate class of our citizens which cannot fail to excite the commiseration of every philanthropist. The census returns in which these statistics are embraced have not been offically received from every portion of the state, and we therefore cannot indicate, exactly, the number of lunatics to be provided for; but adopting the proportion to the whole population found in other Western states there cannot be less than forty or fifty of these unfortunate beings in Iowa.

The watchful editor of the Journal takes offense on reading Dr. Davis' book on the "History of Medical Education and Medical Institutions in the United States," because Dr. Davis seems to give preference to the schools in Philadelphia and New York, over those of Keokuk and Chicago. It is apparent according to the Journal that the former schools have possessed some advantages, but altogether are quite inferior to the schools of Keokuk and Chicago in that they fail to give a thorough practical education to men who are about to enter on the practice of medicine. It is a startling realization of Dr. Davis' ignorance in not being able to recognize the advantages of these two centers of medical education as set forth by the editor.

Notice is given in the April number of the Journal that Dr. Samuel G. Armor, professor of physiology and pathology in the Iowa University since the first organization of its medical department had been elected to the position of professor of natural sciences in the University of Cleveland.

It appaers from an editoria in the June number 1851, that some criticism was made by the Medical News and LIbrary of Philadelphia on the medical school at Keokuk. The Journal referred to the questionable ability of this school to properly train young men to receive the degree of doctor of medicine. The Medical News intimated that any number of physicians could associate themselves together under the general law, as the State Society, can exercise the right to decide upon the qualifications of every gentleman who practiced medicine in the state.

In the July number of the JO\ournal there is an interesting account of the meeting of the American Medical Association at Charlestown, South Carolina. At this meeting Dr. Jones of North Carolina introduced the following resolution. Resolved:

"That all the medical colleges in the United States are hereby earnestly and respectfully, through committees, chosen by them, at least once in every six years, to take into consideration the proper methods of harmoniously elevating the standard of medical education in said colleges."

In this connection Dr. Drake offered the following resolution which was adopted; that in the opinion of this association, the students of our schools be required to matriculate within the first ten days after the opening of the sessions, and continue their attendance to the end of the term, taking with them evidence of the same, to be presented with the tickets of the professors when they become candidates for degrees.

The secretary read a protest from the Iowa University against the representation of the Rush Medical College in this Association. The North-Western Medical and Surgical Journal - the organ of the Rush faculty, observed that the protest was made on the ground that Rush Medical College reduced fees for tuition as it asserted to the injury of the neighboring schools. On motion of Dr. Jervey of South Carolina the protest was referred to a select committee consisting of Drs. Huston of Pennsylvania, Grimshaw of Delaware, GAilord of South Carolina, Wood of Pennsylvania, Adams of Massachusetts and Emerson of Pennsylvania.

The ill-feeling which led to this protest grew out of what was regarded as underbidding in the matter of fees of the different medical schools.

A feeling of encouragement appears about this time in an announcement in the Journal that the means appropriated by the last General Assembly had been expended in the construction, or rather, the contract had been made which would give the University one of the finest buildings in the West. There will be three large lecture rooms, two of which seat over 350 students; one about 250 students.

"The building is situated upon a beautiful and commanding eminence and faces the river, with the front finished in the finest style of architecture of 100 feet. It is 50 feet deep and attached to the main wings of the University Hospital erected and bountifully furnished by our generous city."

We now pass from Auigust, 1851 to July, 1854 for the lack of sufficient data. In 1854 the faculty consisted of: D.L. McGugin, M.D., professor of physiology, pathology and microscopy; Freman Knowles, M.D., professor of theory and practice of medicine; J.C. Hughes, M.D., professor of surgery and dean of faculty; J.E. Sanborn, M.D., professor of chemistry and materia medica; E.R. Ford, M.D., professor of obstetrics and diseases of women and children; Edward A. Arnold, M.D., professor of anatomy; P. Van Patten, M.D., demonstrator of anatomy. Fees: Matriculation $5, diploma $30, dissection room and demonstration $5. Course of lectures for the session of 1853-1854 commence October 20 and continue sixteen weeks. Fees to each professor $10.

It is quite apparent from the following editorial that the way of the Keokuk College was not altogether smooth; that an invisible enemy was conducting a propaganda of harmfulness "frightfulness" against the institution.

"The faculty have determined"

says the editorial

"to change the time of the opening of the college course for next winter to the first of November and close about the first of March. For various reasons we have concluded to make the change and we believe it will prove more satisfactory to all concerned. Circulars will be issued soon giving particulars, to which for further information, our readers are referred."

"We would remark by the way for the gratification of the friends of the school, that the secret and undercurrent efforts to distract and break down the college have most signally failed, as all such disgraceful means will in the end do. We have not room now to dwell upon the particulars of this dark plot, but will refer to it again in the future. We take this occasion to thank our numerous friends over the state who were kind enough to put us in possession of the designs and the means employed, and also for their expressions of friendship and promises of aid if required."

"From present appearances there will be a larger class than last session, perhaps double, and we would here assure those who have determined to attend the coming session, that the faculty are determined to make it still more interesting and profitable, and that it were well for those to make their arrangements to that effect at an early a day as possible"

A period of thirteen years follows without news from the medical department of the Iowa State University located at the City of Keokuk, Iowa. Some changes had been made in the faculty and the fees for the lecture course had been changed from $10 each professor to $40 for the entire course. Matriculation, dissection and diploma remained the same. The announcement for 1868 reads as follows:

Twenty-First Announcement of the Medical Department of the Iowa State University Located at the City of Keokuk, Iowa

President of University - Rev. O.M. Spencer, D.D.
Curators of Medical Department -
E.R. Fored, M.D., president; E.H. Harrison, secretary; William Leighton, esq., Hon. Samuel F. Miller, Wm. Patterson, esq., Hon. R.P. Lowe, S. Hammill, esq., J.B. Howell, esq.
Medical Faculty -
J.C. Hughes, M.D., professor of the institutes and practice of surgery and of surgical clinics; George W. Hall, M.D., professor of physiology, pathology and general therapeutics; H.T. Cleaver, M.D., professor of obstetrics and diseases of women and children; A.M. Carpenter, M.D., professor of the institutes and practice of medicine and of medical clinic; E.J. Gillett, M.D., D.D., professor of chemistry, toxicology, materia medica and microscopy; Edward Clapham, M.D., professor of general and microscopical anatomy and demonstrator; D. Mooar, LL.D., lecturer on medical jurisprudence and forensic toxicology; L.C. Ingersoll, M.D., lecturer on the principles of dental science
Dean of the Faculty - J.C. Hughes, M.D.

Announcement
"The session of 1867-68 will commence on Wednesday, October 30. The Iowa State University was created by act of legislature during the session of 1846-47, and was munificently endowed by an appropriation from the general government. Thus, the medical department, was established by act of legislature in the year 1849, and has been liberally assisted by appropriations from the state.
"The faculty of the medical department of the Iowa State University are pleased to announce to the profession throughout the Northwest, that the twenty-first regular course of lectures of an institution whose triumph has been signal, will open on Wednesday evening, october 30, with a general introductory lecture by Prof. Gillett. The session will close on the last day of February.
"The college clinic affords ample opportunities for the student to apply the principles which he derived from the various branches taught. Patients are examined almost daily in the presence of the class, and surgical operations performed (if required) or prescried for; and here the professor conducting the clinic elaborates in detail, and explains the modus operandi of prescriptions, and the process of cure wrought by appliances and surgical operations. The surgical clinic is conducted twice a week, and frequently daily, by the professor of surgery, while the medical clinic is provided for by the professor of practice.
"By reference to the resolutions passed by the Teachers' Convention, held at Cincinnati during the session of the American Medical Association in May last, it will be observed that the length of time recommended for study is increased to four years - including three lecture terms consisting of six months each - before the student is admitted to an examination for the degree of Doctor of Medicine. While the faculty most cordially indorse the suggestions of the Teachers' Convention with a view to the elevation of the standard of medical education, we deem it best to adhere, for the present session, to the established usage of colleges throughout the country, which require three years' study, including two courses of medical lectures - or, as an equivalent, four years' reputable practice and one course of lectures - as a pre-requisite.
"Students are requested to make their arrangements to be present at the opening and remain until the close of the session; and the better to secure this end, the faculty would here state that certificates of attendance will be issued only for the time actually spent in attendance upon lectures.

Fees
"The total expense to the student is less than at any other school of the country.
Graduates of this, and other regular schools of medicine, are admitted to all lectures, upon payment of a matriculation fee of ten dollars.

For the entire course of instruction Matriculation ticket Demonstrator's ticket Hospital tickets, gratuitous Graduation fee

$40.00 $ 5.00 $ 5.00 -- $30.00

Requirements for Graduation
"Each student is required, within one week after the opening of the session, to pay the fees and procure his matriculation ticket. Candidates for graduation --
First - Must be twenty-one years of age, and present testimonials of good moral character.
Second - Must have attended two full courses of medical lectures, the last at the medical department of the Iowa State University; or, evidence of four years' reputable practice will be considered as equivalent to one course.
Third - Must have studied medicine three years (including lecture terms) under the direction of a respectable medical practitioner.
Fourth - Must furnish a satisfactory medical thesis (original and in his own hand writing), to be delivered to the dean, at least four weeks before the close of the session, accompanied by the graduation fee.
Fifth - Must pass a satisfactory examination by the faculty, at the close of the session.

"The attention of students is called to the fact that the session of four months - six lectures daily - equals, in amount of instruction, any other school in the country. The hospitals located in this city give superior clinical advantages to the student, and the moderate cost of tuition and other expenses, make it one of the most desirable points for a thorough medical education.

"Our Medical College - The coming session, 1867-68, of our medical institution, offers advantages to the student equal to any institution of the country. Our corps of professors are men of experience as teachers and practitioners, and western in their energies and ideas. Our appliances are in all the departments, every way equal to the wants of the profession and student. We labor to qualify young men for the full discharge of all professional duties not theoretically alone, but practically. We teach not only from lectures, but by daily examinations and illustrations leaving practical facts indelibly impressed upon the mind of the student. The cost, considering the length of the session and number of lectures, is less thanat any other of our regular colleges. Our aim has always been, to save time and money for the student, and give him all the advantages of a thorough medical education. This we claim for the medical department of the Iowa State University"

Clouds began to darken the horizon of the medical department of the Iowa State University at Keokuk in 1868-1869. Rumors of a new medical department located in connection with the University at Iowa City began to circulate. The views of the dean of the Keokuk school found expression in an editorial published in the Iowa Medical Journal for January and February, 1869.

The University and its Medical Department
"The subject of a medical department in connection with the literary department at Iowa City, is creating considerable discussion at this time. We had written an article for this number of the Journal, but for the want of room are compelled to withhold it until the next issue. Should our literary and law departments at Iowa City be so unfortunate as to have their quiet disturbed by a medical department, we trust that it will fare better in the Associaton than the medical department of the MIchigan University, connected with the literary and law departments, at Ann Arbor. The Medical and Surgical Reporter, of Philadelphia, December 19, speaks as follows:
--The state authorities by their course toward the medical department of the University of Michigan, are keeping that university in such a constant turmoil and excitement, that some of the profession may yet withdraw from all connection with it. They certainly will, if the policy is pursued of forcing irregular practitioners into position in the institution. This unsettled and uneasy feeling in connection with the medical teaching in that state has probably led to the organizaton of the Detroit School of Medicine, etc.--
When medical schools are wholly under state patronage, and associated with the literary and law departments, as exist in Michigan, and which the trustees of the university propose to adopt in connection with our university, it cannot but result in disaster to the school and the best interests of the profession. Unless our trustees will provide for all the pathies and isms in their organization, the friends of those several isms will be on the alert when appropriations are asked, for the support of this department. It is not to be supposed that the several legislative assemblies which shall hereafter convene in our state, will be a unit in thought, word, and action on the subject of Medical Education. I remember very well, at a meeting of our state legislature in Iowa City (the old capitol), we succeeded in securing the passage of a bill appropriating to the College of Physicians and Surgeons at Keokuk, known as the medical department of the Iowa University, the sum of $5,000. But imagine our surprise when the bill was vetoed by the governor, and in his message accompanying the veto, he gave as one of his principal reasons for the course pursued that the legislature had no right to favor by their appropriations from the state funds one class of medical men over tha of another. The same argument will be used, should the trustees of our univeersity carry out the plan proposed, and prejudice not only the medical department, but the interests of the other departments associated with it."

In spite of the warning of disaster eminating from the Jounal, the Iowa City interests continued active and finally prevailed, notwithstanding many difficulties and discouragements. The new school was organized in 1870 and still exists as the medical department of the Iowa State University. The Keokuk school struggled to maintain its identity as a department of the State University for a few years, or until the Iowa City school became an established fact, when it bacame content to continue under the name of the College of Physicians and Surgeons, but maintained a belligerent attitude for many years, until internal dissentions led to a division, giving Keokuk for a few years two schools, the new school being known as the Keokuk Medical College which finally absorbed the old College of Physicians and Surgeons. At last with the organization of the Council of Medical Education of the American Medical Association and the increased responsibilities of medical colleges in furnishing adequate medical training, the financial needs became so acute that it became necessary to merge with some other institution apparently more fortunate, and in 1908 turned over its assets to Drake University in Des Moines and became a part of the Drake University School of Medicine. The merger with Drake promised much until 1913 when the combined schools felt the increasing pressure of the higher demands of medical education, and not being able to secure sufficient financial support, merged with the State University. These mergers relieved the medical college situation in Iowa which had long divided the medical profession in the state into groups which had brought much discord and no little bitterness at times between the rival factions. The single school under the financial support of the state and the moral support of the profession has brought about the building up of a creditable school of medical activities which promises much for the future.