ADDIi E S S 
DELIVERED BEFORE THE 
MEDICAL SOCIETY OF THE STATE OF 
PENNSYLVANIA, 
AT ITS 
TWENTY-SEVENTH ANNUAL SESSION, 
HELD AT 
PHILADELPHIA, PA., 
MAY-JUNE, 1876. 
THOMAS M. DRYSDALE, M.D. 
BY 
EXTRACTED FROM THE TRANSACTIONS OF THE MEDIC AD SOCIETY OF THE STATE 
OF PENNSYLVANIA FOR 1876. 
P H I L A D E L P II I A: 
COLLINS, PRINTER, 705 JAYNE STREET. 
1 8 76. COMPLIMENTS OF 
T. M. DRYSDALE, M. D. 
1531 ARCH STREET, 
Philadelphia, Pa. ADDRESS 
DELIVERED BEFORE THE 
MEDICAL SOCIETY OF THE STATE OF 
PENNSYLVANIA, 
AT ITS 
TWENTY-SEVENTH ANNUAL SESSION, 
HELD AT 
PHILADELPHIA, PA., 
MAY—JUNE, 1876. 
BY 
THOMAS M. DRYSDALE, M.D. 
EXTRACTED FROM THE TRANSACTIONS OF THE MEDICAL SOCIETY OF THE STATE 
OF PENNSYLVANIA FOR 1876. 
PHILADELPHIA: 
COLLINS, PRINTER, 705 JAYNE STREET. 
1876. ADDRESS. 
Mr. President and Gentlemen of the 
Medical Society of the State of Pennsylvania. 
We extend to yon, in this old and beautiful city, the mother 
city of medical science, in this jubilee year of commemoration 
and congratulation, a most cordial Centennial welcome. Not 
the medical profession of Philadelphia alone, which has often 
rejoiced to greet you for communion and counsel, as brethren 
of the same noble calling, but the authorities of the great exhi- 
bition and the people of the city itself, accustomed to regard 
health as among the chiefest of blessings, and the guardians 
of health as the best of benefactors, delight upon this occasion 
to extend to you their heartiest welcome. 
Prom north, and south, and east, and west, of our great 
Commonwealth you reverently gather, to watch the century 
plant as it bursts into blossom; and, most familiar with the 
aloe, you notice the growth and swell of a hundred years, as 
its petals expand in the Centennial, and from all over our 
States and the kingdoms and empires of the world, the multi- 
tudes press to the cosmopolitan exhibition of the arts and 
sciences. 
Gentlemen, this is a year when, in every direction, those 
connected with the arts, the sciences, the trades, the profes- 
sions, are instructively contrasting the present condition of 
things with the condition of things one hundred years ago; 
and can I do better in welcoming and congratulating you than 
by following the common current of thought, and glancing 
for a few moments at the progress of American medical 
education through the century? It is peculiarly appropriate 
that our profession should assemble here at this time to assist 
in celebrating our national Centennial; for, if we cannot regard 
this as the exact centennial of American medicine, we can, at 
least, claim that American medicine and American independ- 
ence had the same birthplace. 4 
It is a fact not generally known that, “in one of the large 
apartments of the State House,” in the building which gave 
birth to American independence, was delivered the introductory 
lecture on anatomy by Dr. William Shippen, in the autumn 
of 1762. “The number of students who attended his course 
amounted only to twelve. This was the origin of our medical 
schools.” “ Dr. Shippen had given three courses of lectures un- 
connected with any institution, when, May 3d, 1765, Dr. John 
Morgan laid before the trustees of the college a plan for estab- 
lishing a medical school under their auspices, accompanied by 
a letter from the honorable Thomas Penn, recommending the 
plan to their patronage.” 
In September, Dr. Shippen addressed a letter to the trustees, 
stating that the institution of a medical school had been his 
favorite object for seven years; and that he had proposed it 
three years before in his first introductory lecture; upon which 
he was immediately and unanimously chosen Professor of 
Anatomy and Surgery. “The anatomical lectures were regu- 
larly delivered, from year to year, until the fourteenth course, 
which was in the winter of 1775, when they were suspended 
by the war of the revolution ;” and Shippen entered the medi- 
cal department of the army in the year 1776, and became its 
Director-General. Thus intimate were the relations of the 
birth and early history of American independence and of Ame- 
rican medicine. In this city, then, American medical educa- 
tion had its origin. 
The question, has medical education grown equally with our 
growth as a nation and with collateral sciences, has been mooted 
so often of late, that it is to be approached with hesitation; 
but without entering deeply into the subject, let us compare 
the facilities of acquiring a knowledge of our science before 
and during the time of Rush, with the present, and,also, glance 
hastily at its early history, and at some of the prominent men 
of those times. That we may do this understandingly, let us 
see what was the usual method of medical education before the 
establishment of the first medical school, and what means of 
instruction the teachers had at their disposal. 
A young man wishing to become a doctor, after an acade- 
mical course more or less complete, was apprenticed to a 
surgeon or physician by whom he was supposed to be taught 5 
all the science and practice of physic. The greater number 
of these teachers had never received a medical degree nor a 
proper medical education themselves; nor had they the facili- 
ties for teaching, even had they been competent; for, to do 
this, required books and instruments ; but, it is well known, 
that these were rare, and came mainly from England, as at 
that time there were no native medical works and no Ameri- 
can instruments. Medical journals were unknown, for no 
medical journal was published in America until near the close 
of the eighteenth century. This want of material for teach- 
ing was so well known, that later, Dr. John Fothergill, who 
took a great interest in the affairs of our colony, “ employed 
Rimsdyck, one of the first artists of Great Britain, to execute 
a series of crayon paintings, which exhibited the whole struc- 
ture of the human body of the full size, and the gravid uterus, 
with many of the varied circumstances of natural and preter- 
natural parturition,” and presented them to the Pennsylvania 
Hospital, which had just been erected. 
Nor were there any institutions, such as hospitals or dispen- 
saries ; for the Philadelphia Dispensary, the first institution 
of its kind in the United States, only came into existence in 
1786, and the Pennsylvania Hospital in 1756. With such 
teachers and with so little to aid him in acquiring a knowl- 
edge of our art, the pupil could not be expected to be very 
proficient. At a period anterior to the formation of the 
medical school, which may be called the period of dependence, 
there were about 3000 physicians in the colonies to prescribe 
for 3,000,000 of people. To be a trained doctor, it was neces- 
sary for the aspirant to cross the ocean, to spend some years 
attending lectures in Edinburgh, to stop for a few months in 
London, and then to come back courtly and conceited, to give 
British pills and potions to the colonists, as he had learned to 
compound them on British soil. But the greater proportion 
of these men were, as we have seen, wholly uneducated in 
medicine. Hence the few well-trained physicians in that 
period of ignorance shine so brightly among their compeers. 
With the early emigrants came to this country, in time, a 
number of competent practitioners. It is early in the century 
that we find John Bard and John Redman apprentices to 
Kearsley, an English surgeon in Philadelphia; for at that day 6 
apprenticeship was required equally for a clerkship in a store, 
in an attorney’s office, and for medicine. Kearsley was a churl 
and a tyrant, and Bard, the intimate friend of Franklin, was 
restive at making fires, chopping wood, doing errands, polish- 
ing shoe buckles, and helping Mrs. Kearsley on wash days. 
The system of medical teaching in those times was merely 
reading with an instructor, and following and assisting in his 
practice, until those who had the means could complete their 
education in Europe. 
John Redman, the other apprentice of Kearsley, thus 
finished his training in Europe, and, in his day, ranked among 
the most eminent of the faculty in Philadelphia, and was the 
first President of the College of Physicians. He early in life 
declined the practice of surgery and midwifery, and confined 
himself to the practice of physic. With Redman studied 
Benjamin Rush, the true father of American medicine, and 
this brings us to the next period of progress—that of medical 
independence, when Americans could attend lectures without 
departing from their native land. But before leaving this 
part of our subject, let us have a word or two more on the 
primitive old eighteenth century doctor. 
Excluding a large proportion of practitioners, who were 
intensely ignorant and inexpert, although probably quite as 
competent as were a large class at that time in Great Britain, 
we have as the early representative men of American medicine, 
Bard, Shippen, Morgan, Kuhn, and others of that standing, 
as splendid specimens of manhood, manners, and skill as the 
world could present. Samuel Bard visited his patients dressed 
to the minutest detail of a substantial, cultivated gentleman, 
with his hands enveloped in a muff, lest the winds of Kew 
York should dull his fine sense of touch ; and in his palmy 
days he carried otf the greater portion of practice in the dis- 
eases of women, from his extraordinary reputation with the. 
sex. The Shippens were proverbial for their calmness and 
unfailing good humor. Kuhn with his queue hanging down 
his back, his powdered hair, his cocked hat, his short clothes, 
gold knee and shoe buckles always shining brightly, will stand 
forth as a model physician of the early revolutionary period. 
And Redman, though deaf and nearly blind in his later 
was down to old age cheerful, even facetious, charitable and 7 
eminent in all the graces of a devoted Christian. From him 
Rush learned bleeding and the use of mercury. lie considered 
bleeding in old age as the very first of remedies. 
.But Benjamin Rush, his great pupil, rises to close that 
early period and usher in the era of American medicine. Like 
the others of whom we have spoken, perfectly educated, and 
courtly in manners, the farmer’s boy came from the plow to 
be the angel of healing to the despairing population of Phila- 
delphia, stricken with the yellow fever. There is no character 
in medical annals that will better bear the full blaze of scru- 
tiny than that of Rush, calumniated and abused, as he was, 
by Cobbett and other libellers, on account of his good strong 
principles and unwearied philanthropy. His devotion to his 
profession is well known. “ Medicine,” he said, “ is my wife, 
science is my mistress, my books are my companions.” He 
was convinced, after learning all that could be taught abroad, 
that medicine, in his day, was only in its infancy. If the 
prejudice still lingers against Rush for the excessive use of 
the lancet and calomel, let him have a fair field, and be judged 
by the standard of his own day. If he called calomel the 
Samson of the materia medica, and the wits could respond 
that this Samson had slain his thousands; and if his bleedings, 
which are now so universally deemed excessive, are condemned 
by the practice of the hour, let us not forget that bleeding 
and calomel were approved by his preceptor and by the best 
doctors of his time, and were then pronounced, by those most 
competent to judge, a great improvement in treating the dis- 
eases of the United States. 
ISTor is it to be forgotten that every method of dealing with 
the yellow fever of 1793 had proved ineffectual, and the phy- 
sicians of the day were standing helpless and aghast, when 
Rush, after studying fully and experimenting fairly, came 
back to the treatment he had abandoned ; and, in the midst 
of the dying, for whom there seemed to be no hope, by his 
bleeding and purging saved the first four out of five patients, 
and then was able to write, on the tenth day of September, 
about mid-way through the fatal one hundred days, “ Thank 
God, out of one hundred patients whom I have visited and 
prescribed for to-day, I have lost none.” The more we read of 
Rush the more we find to admire. His is indeed a grand 8 
figure, looming up through the mists of a hundred years, and 
we may well be proud of him as the great American physician. 
But, continuing with our subject, we find that the next 
marked step of progress in native medical education was, the 
adding to simple apprenticeship to a surgeon, attendance on 
medical lectures. About ten years before the war, as has been 
already stated, the Philadelphia College of Medicine had been 
organized with a corps of very able professors. Beginning in 
the lectures of William Shippen on anatomy, a faculty was 
completed by the election of Benjamin Rush to the chair of 
chemistry in 1769. Shippen, Morgan, Kuhn, Bond, and Rush 
had joined to what instruction could be received at home, the 
best advantages of the great medical institutions of France, 
London, Edinburgh, and Leyden; and, at Philadelphia, as they 
had lavishly received, they sat down, freely to give to those 
who chose to be their brethren in the healing art. They were 
giants in their day, and are not to be underrated, the state of 
medical science being considered, either in comparison with 
the Cullens, Monros, and Hunters of their own day, or with 
the most eminent professors, physicians, and surgeons of our 
own more advanced and better furnished times. These were 
the men who constructed on a permanent foundation the medi- 
cal institutions of our country. 
One hundred years ago, then, this only school of medicine 
in Philadelphia had five professors lecturing upon the follow- 
ing subjects: Shippen, on Anatomy, Morgan, on the Institutes, 
Kuhn, on Botany, Rush, on Chemistry, and Bond, on Clinical 
Medicine. With this faculty and Benjamin Franklin as presi- 
dent of the college, begins the true system of medical teach- 
ing in America. Soon an opposition school was formed, but 
a harmonious union of the contending parties was effected, 
and in 1791 they were merged in the University of Pennsyl- 
vania. “From this period,” writes Thatcher in 1828, “the 
progress and improvement of the institution have been no less 
honorable to the venerable founders than beneficial to the 
community. The commanding talents and profound erudition 
of Professors Rush, Barton, Physick, Dorsey, Chapman, and 
others have given the medical school of Philadelphia a cele- 
brity which will probably long remain unrivalled in the United 9 
States, and will enable it to vie with the most elevated semi- 
naries of the European world.” 
Benjamin Rush well represents nearly the whole of the first 
half century, beginning with 1776. The University, to which 
he lent his name and talents, until long after the period of his 
death, which occurred in 1813, continued to be the centre of 
medical instruction for the whole Union. The great advance 
in medical science begins after the death of Rush, and is con- 
temporaneous with the springing up of medical colleges in the 
main centres of population, and, in fact, belongs altogether to 
the last half century. Time forbids us to do more than glance 
at the growth of our medical schools, and we will at once 
leave the intervening period with its interesting history, and 
will note how the institutions and means of instruction to-day 
compare with what we have seen existed a century ago. 
The progress is as remarkable as it is gratifying to our' 
national pride. If Thatcher could write so glowingly of the 
condition of our single medical school in 1828, what would he 
say now? For this school has made giant strides since his 
day. Professorship after professorship has been added, until 
now its announcement displays the names of eleven professors 
and four adjunct professors ; while its new and beautiful build- 
ing, which “ is the best for its purpose in the country, if not 
in the world,” containing all the appliances and aids which 
modern scientific teaching requires, is an ornament to our city. 
Ror does this grand old school stand alone, for we can boast 
of another equally celebrated, which, although much younger, 
rivals the mother school, both in the number of its pupils and 
in the talent of its faculty. For has this progress been con- 
fined to our own city; for all over our country, from the At- 
lantic to the Pacific, can be found medical schools, some of 
them celebrated for their thoroughness of instruction and the 
talents of their professors. But, besides our schools, what do 
we find? Then a single hospital and a lone dispensary; now 
so many hospitals and kindred institutions of instruction ex- 
ist in our city, that it rivals, in the facilities for medical study 
and in the fame of her instructors, any city of the world. 
Gentlemen, this is no idle boast. It is only necessary to 
consult the Medical Guide Book, furnished you by the commit- 
tee, to prove what has been said. There you will find such an 10 
array of schools, hospitals, infirmaries, dispensaries, and other 
places of medical instruction, that it would be wearisome even 
to name them. Suffice it to say, that in all our institutions, 
in our medical libraries, in private instructors and lecturers, 
in laboratories, in the manufacturers of surgical and philoso- 
phical instruments, in our books, journals, etc., we need not look 
beyond our own city to find all that a student of medicine may 
desire. Rush wrote in 1799, as the new century was about to 
come in, “I am satisfied that the rate of intellect (in the 
United States) is as twenty are to one, and of knowledge as 
one hundred are to one, in these States, compared to what they 
were before the American Revolution.” In this general ad- 
vance in intellect and knowledge, medicine, as fully as her 
sister professions, participated. But that improvement is 
scarcely to be mentioned in comparison with the stride of the 
next generation, and more particularly with the quick step of 
the generation closing with 1876. From 1800 to 1836 it was 
an arithmetical, from 1837 to 1876 it has been a full geome- 
trical progression. The gentle silver stream of the mountain 
top has broadened and deepened, and thunders down now at 
the base a flashing, stupendous Niagara. Thus do we compare 
with our modest beginning one hundred years ago. 
One word more. Whilst viewing our present in connection 
with our previous condition, the thoughts naturally turn to a 
comparison with our brethren in Europe. Do their means of 
instruction excel our own ? Can we really learn more in Europe 
than in this country? As late as twenty-five years ago this 
would have been answered most decidedly in the affirmative; 
but now, except in a few special studies, we can truthfully 
assert that our facilities are equal to theirs. What has been 
said in regard to our institutions need not be repeated, but it 
may be affirmed, that our city rivals, as a place for medical 
instruction in all the practical branches, any other city in the 
world. 
The only exception is, perhaps, that of Vienna for obstetrics ; 
nor can we ever expect to equal this school of gynaecology. 
The habits and superior civilization of our people forbid us to 
suppose such a thing possible; and this should be a source of 
congratulation to us, rather than a reproach. A recent writer, 
in speaking of this school, asks, “Whence come so many 11 
patients?” and answers: “First, the standard of morality 
among the people is exceedingly low—so low, indeed, that a 
domestic who retains her chastity for any length of time, is 
considered a marvel of good morals. Advertisements are daily 
to be seen in the principal newspapers emanating from some 
one who desires to live with another of the opposite sex as 
companion or housekeeper, etc. Some idea may be formed of 
the extent to which the ‘social evil’ prevails in Vienna, when 
statistics show that of 27,000 births in 1875, 11,000, or more 
than 40 per cent., were illegitimate.” 
Lately it has been too much tbe fashion to depreciate not 
only the institutions of our own city, but of our country, and 
to point to those of Europe as superior in every respect to our 
own. Much of this feeling is a mere lingering of the old preju- 
dice against the native doctor, when the means of education 
were wanting; and some of it is owing to that admiration for 
distant objects, which is not peculiar to this subject. Putting 
aside the question of the temptation to which our sons would 
be subjected—for the standard of morality in Europe is very 
different from our own—when we consider that new habits 
have to be acquired, which often unfit them to act as good 
citizens on their return, a new language to be mastered, and 
many inconveniences to be borne, may we not say, in the words 
of that close observer, Rush, “That an education in our own 
is to be preferred to an education in a foreign country”? 
In 1874 the opportunity presented itself to me to visit some 
of the most celebrated schools and hospitals of the old world, 
and to witness the practice of their physicians and surgeons. 
I had also the good fortune to see the modes and result of much 
private practice. I do not wish to detract from the merit of 
our foreign brethren, but, gentlemen, I came home impressed 
with the belief that no country can excel our own in teaching 
practical medicine, and that no physicians or surgeons can sur- 
pass ours in diagnostic skill and dexterity. 
In one point we have far distanced our European brethren— 
in the perfect organization of our profession; for no other 
country possesses such medical educators as our County and 
State societies. These associations have elevated the standard 
of medical propriety and medical science, and, bringing phy- 
sicians into pleasant acquaintance, and uniting them in mea- 12 
sures for their common interest, have been of incalculable 
benefit in advancing the profession, and binding us together 
as a grand brotherhood. In thus hastily contrasting European 
with American medical education, it is not to be understood 
that it is claimed that ours is perfect. I merely wish to assert 
that, with our method of teaching, men are graduated fully 
equal in all the practical branches to theirs. 
And now may we venture to suggest that the career of Ame- 
rican medicine, beginning really with Rush and the first med- 
ical school in the United States, about 1776, ought to culminate 
in 1876 in the perfecting of our American schools of medicine, 
in the exclusion of foreign text-books from these institutions, 
and an elevation of our profession to a height which it can 
easily attain, where medical instruction and medical skill shall 
not merely be equal to any that can be afforded at London, 
Paris, Vienna, or Berlin, but be superior to anything that the 
world anywhere else can present; where, in short, the student 
in European cities, wishing to complete his preparation for 
practice most satisfactorily, shall have to consult books of 
American authorship, and turn his face to American medical 
colleges carried to the utmost point of skill and efficacy by the 
best medical tact and talent that America can afford. 
As the Jew came up to Jerusalem in the year of jubilee, 
singing exulting songs all the way, the nations are moving in 
procession this year to Philadelphia; and it may be, it should 
be, we are almost disposed to say it must be, that from this 
Centennial of 1876, all distances in the future progress of med- 
icine, in the progress of the sciences and of the arts will be 
estimated, as the Romans counted distances from the golden 
milestone which the Emperor reared in the Imperial city. 
When American cutlery is entering Sheffield, and competing 
in knives, sickles, saws, and instruments of husbandry with 
English manufactures on English ground; when in reaping 
machines, in sewing machines, in all kinds of machinery, 
America surpasses her competitors, and attracts the eyes of the 
world upon her as the home of invention and the nurse of im- 
provement,—the time has arrived for a forward movement all 
along the line; and medical science must go forward with the 
rest, not to equal merely, but to surpass the medical science of 
France, Germany, England, and all other countries.