Iowa History Project
Medicine in Iowa
by D.S. Fairchild, M.D., F.A.C.S.
reprinted from The Journal of the Iowa State Medical Society, 1927
transcribed from the original book for the Iowa History Project by S. Ferrall
Part Third - Medical Education in Iowa
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.)
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 following are the requisites for the diploma:
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:
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:
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.
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.
says the editorial
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:
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.
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.
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