Harvard Medical School

“ Henry P. Bowditch, whose instinct for physiological inquiry was already vigorous, and who was destined to become a leader of research in America, and the teacher and inspirer of a generation of younger investigators, was another Medical School contemporary with whom he formed an enduring friendship.
The instruction given in the Harvard Medical School in the sixties was as good as any obtainable in America, but it fell short of what is nowadays reckoned as essential for a medical education to an extent that none but a modern student of medicine can understand. ”

“ The Harvard Medical School has numbered among its faculty from the first some of the most eminent physicians of our country. The professors have not been practitioners only, but men of high scientific attainments who have made notable contributions to the science of medicine. ”

“ In 1835 she opened a consulting-room and assumed the responsibility of practising without a medical diploma— reprehensible, but a course justified by subsequent events, for when in 1847 Miss Hunt requested permission to attend lectures at the Harvard Medical School—stating "that after twelve years' practice which had become extensive, it would be evident to them that the request must proceed from no want of patronage, but simply from a desire for such scientific knowledge as could be imparted by their professors"—her request was promptly refused. ”

“ He was graduated from Harvard university in 1863, and from Harvard medical school in 1866. He went directly to Europe to study, and on his return to America began the practice of medicine in Brookline, Mass. In 1869 he was appointed lecturer on the physiological action of drugs, at Harvard, and professor of physiology at Bowdoin college in the following year, resigning his chair in 1874. ”

“ It is not likely that medical students are inclined to specialize less than law students. The fact is that Harvard College provides the courses in English, history and political science needed by students of law and does not provide the courses in anatomy, physiology and pathology needed by students of medicine. [2] Instead of requiring students preparing for the medical school to take courses which they do not want, the college should offer the courses which they need. ”

“ Harvard, have followed the lead of the Johns Hopkins Medical School, and remarkable progress has been made in medical education and research in the United States in the thirty years which have elapsed since the opening of the school in Baltimore. ”

“ When the Johns Hopkins Medical School was opened seventeen years ago, it was the only well-organized department of medicine in the country. With Harvard it still maintains preeminence; but there are now some thirty schools which give adequate training for the medical profession. The commercial schools are closing and being merged every year, for by the nature of things they can not last when they do not pay. ”

“ The lack of practical facilities for study was early recognized, however, and within a few years some of the members of the Medical Faculty established a school for clinical instruction in Detroit, which eventually led to the first effort for the removal of the school mentioned in the last chapter. In spite of this difficulty the Department grew so rapidly that within ten years it had an enrolment of 242 matriculates and 43 graduates; more students than were enrolled at Yale, Harvard, or Virginia, the leading medical schools of that day. ”

“ Invalidism due to dyspepsia, brought on probably by too close an adherence to the system of the day of much and exacting attendance at school exercises which left but little time for hygienic recreation, prevented him from continuing his studies at Harvard. After a trip to Cuba in search of health in the spring of 1828 he returned to begin his medical studies under the tutelage of his father. The old homestead had been the resort of medical students who served an apprenticeship, after the custom of the time. ”

“ In other words, Harvard has copied the European plan of medical teaching in some of its essential features, and as a consequence its medical diploma is the only one issued by any prominent medical American college which is a guarantee that its possessor has been well educated in the science and practice of medicine. ”

“ It appears to the present writer that Harvard has done great harm to itself and to education by 'segregating both in time and space the work in medical science. It requires the bachelor's degree for entrance to the medical school, whereas if the sciences preliminary to medicine were carried on at the college, the liberal studies would become less aimless and the professional studies more liberal. The separation of liberal studies, professional work and research does injury to each.
MR. ADAMS ON THE AMERICAN COLLEGE.
The Phi Beta Kappa address given by Mr. ”

“ Association for the Advancement of the Medical Education of Women—Coeducation or segregation—Dr. Zakrzewska leads another attempt to persuade Harvard to admit women to its Medical School (1881-1882) —Failure takes from Harvard final opportunity to be first great medical school to admit women on equal terms with men, this honor passing to the Johns Hopkins in 1890—Massachusetts Legislature directs that a woman physician be appointed in each State Hospital for insane patients—Dr. Zakrzewska takes a vacation in Europe—Letter to Mrs. ”

“ No more objectionable proposition from a university point of view has ever been made. Officially recognized and sanctioned separation of research from teaching, especially in the clinical chairs, would not only place the university on the level of the secondary school, but would delay all progress in medicine, and, more important still, destroy what little confidence the public is beginning to have in the altruism of university medical education. ”

“ He opposed the prevailing heroic practice of blood-letting and purging with mercurials, holding that the student should keep an open mind, observe, avoid a routine system and treat disease with nature's remedies,—herbs and roots. Two years later he opened the United States Infirmary in Eldridge Street, New York, where he treated several thousand patients, and in 1837 he started the New York Medical Academy which later became the Reformed Medical College of New York, the parent school of "Reformed Medicine." ”

“ This was a great advance, for the medical schools were largely proprietary institutions whose standards were lower than in the university. But it is perhaps now true that the spirit of scholarship and research is more advanced in the medical school than in the college. When a medical school is sufficiently well endowed and its professors are men devoted to research, it is probable that it would be best for it to take charge of the education of students after they leave the high school, whether their period of instruction is to be four years or ten. ”

“ Doubtless science wins in the long run. The honest school and the honest man are the final winners, but there is a prodigious amount of waste and suffering before the public knows the difference between surgeons and bloodsuckers.
More and more the honest medical schools are brought into touch with the university. Around the university the tested educational machinery tends to center. Sound instruction in medicine demands a broad base of science—physiology, anatomy, chemistry, histology, bacteriology and above all the methods of scientific research. ”

“ After the year 1910 most of the large universities in this country will not admit further students to their medical departments unless they have a college degree or its equivalent, that is, unless they have devoted four years to college undergraduate work. It is generally understood, that in the last year of his undergraduate course the student who intends to take up medicine may elect such scientific studies in the college department as will obtain for him an allowance of a year's work in the medical school. ”

“ Those physicians who enroll themselves as students in the Washington Post-Graduate Medical School and faithfully follow the course of instruction which is open to them, can not fail to return to their professional work with broader and more exact information on many subjects relating to scientific medicine, with increased skill in the diagnosis and treatment of disease and with greater confidence in the resources of the noble profession to which they have devoted their lives. ”

“ Its professors often came from a distance and had travelled extensively for purposes of study; they attracted patients of high rank from nearly every part of Europe, and these were generous in their patronage of the school. Students came from all over, from Africa and Asia, as well as Europe, and when abuses of medical practice began to creep in, a series of laws were made creating a standard of medical education and regulating the practice of medicine, that are interesting anticipations of modern movements of the same kind. ”

“ The average age of students graduating in medicine at these institutions in 1912 was thus about 27 years. As a collegiate degree is required for admission to the medical schools at Western Reserve, Harvard and Johns Hopkins, it appears that medical students in these institutions completed their college courses at about the age of twenty-three. ”

“ President Lowell apparently wants a four-year college course, followed by a medical course which can not count on any special knowledge on the part of the student—it should in this case be five years—and this must be followed by a year or two in the hospital. Students are on the average over eighteen years old when they enter Harvard, and the physician would not begin to practise medicine and to learn what can only be taught by practise until he is nearly thirty. To this late start in life there are serious objections both educational and economic. ”

“ Research in the medical school or the hospital, on the other hand, has developed slowly and has been in most institutions a matter of secondary importance. The reason for this is not difficult of demonstration when one remembers that even schools of university rank emerged only a short time ago from the proprietary state and that most physicians just past middle age can remember the two-and three-year course. ”

“ Efforts, therefore, have constantly been made to widen the range for women, by securing their admission as students, internes, or visiting physicians to the great hospitals, which constitute the medical treasure-houses of the country. [120] In describing the actual condition of the medical schools, mention has been made of the hospital advantages which have been, little by little, secured for their undergraduate students. In Boston, where there is no school for women but the homœopathic school of the Boston University, fewer opportunities exist than anywhere else. ”

“ Following the gifts of $1,500,000 to the Johns Hopkins University and $750,000 to Washington University for their medical schools on condition that the professors of medicine and surgery shall devote their entire time to the work of the school and not engage in private practise, a gift of $500,000 has been made to the medical school of Yale University under similar conditions and the further stipulation that the school obtain control of the New Haven Hospital. ”

“ Each branch of knowledge which is necessary for a medical man is provided for and controlled by a separate professor; and it is a remarkable fact, and redounds greatly to the foresight and wisdom of our founders, that the number of professorial chairs remains the same, the only addition being the all-important one of Public Health and Hygiene, in the establishment of which we were again the pioneers among medical schools. If imitation be the sincerest form of flattery, we ought to feel proud, for every school in London is now formed more or less perfectly on the model established here in 1828. ”

“ There is not the slightest difficulty in giving sound elementary instruction in physics, in chemistry, and in the elements of human physiology, in ordinary schools. In other words, there is no reason why the student should not come to the medical school, provided with as much knowledge of these several sciences as he ordinarily picks up, in the course of his first year of attendance, at the medical school. ”

“ It is clear, therefore, that a university and its antecedent, the school, may best co-operate with the medical school by making due provision for the study of those branches of knowledge which lie at the foundation of medicine.
At present, young men come to the medical schools without a conception of even the elements of physical science; they learn, for the first time, that there are such sciences as physics, chemistry, and physiology, and are introduced to anatomy as a new thing. ”

“ Our new outlooks in medicine have not been won without toil and sacrifice on the part of its devotees, and these will still be necessary. But it is evident that in the medical colleges there must now be fuller endowment of research and more adequate provision for instruction, not only in the traditional themes of undergraduate study, so largely expanded, but also in recently developed disciplines. ”

“ In the United States, as in other civilized countries, this topic was greatly emphasized in the curriculum of almost every school teaching the health professions. Today, the subject matter contained in this branch of science is taught under the heading of several specialized fields, such as pharmacology, pharmacognosy, and drug analysis of various types. However, when the decision was made in 1881 to promote greater knowledge and interest in the healing arts by creating a section devoted to such pursuits in the U.S. National Museum, the title of Section of Materia Medica was adopted. ”