History of Medicine

THE FIRST WESTERN MEDICAL SCHOOL

   

     In the decades after the American Revolution the “west” meant anything on the Pacific side of the Appalachian Mountains. A forested area of western Virginia was called the Transylvanian Colony, near which, in Lexington, a small Transylvania Seminary served as an educational center. In 1792 most of the area moved into the newly-formed state of Kentucky and 7 years later the Seminary merged with a rival school, the Kentucky Academy, to become Transylvania University. It included a law and medical

Transylvania Colony circa 1792 (Wikipedia)

school and earned Lexington the label “the Athens of the West”. Henry Clay, later a well-known senator, taught in the law school. The medical school had a faculty of two, Dr. Frederick Ridgely and Dr. Samuel Brown. Ridgely had been schooled in Philadelphia and served in the Revolutionary Army, while Brown had studied medicine at Edinburgh. Instruction was mainly out of their homes, with no anatomical dissections and few medical students. In 1815, however, a major overhaul began, led by the prominent and feisty surgeon, Benjamin Winslow Dudley.  

Benjamin Dudley (Wikipedia)

  

     Dudley had been apprenticed to Dr.  Ridgely. He then earned an MD degree at the University of Pennsylvania Medical School after 2 winter seasons of lectures (standard at the time). There he met 2 men important to him in later life: Daniel Drake and William Richardson. He headed for  Paris where he studied surgery with Dominique Jean Larrey, the famous surgeon who served Napoleon’s army. In London he studied with John Abernathy and Astley Cooper, both excellent surgeons, and passed the exams for admission to the Royal College of Surgeons. He was the most educated surgeon in the “west” and was appointed professor of anatomy and surgery at the Transylvania Medical School. He became famous for doing over 200 lithotomies with about a 2% mortality, unheard of at the time and possibly related to his habit of washing all his instruments with boiled water. He also published on numerous other conditions.

     Dudley recruited other talented faculty. The most important catch was Daniel Drake, appointed professor of materia medica. Drake, born in New Jersey, grew up in a log cabin in the small

Daniel drake (Wikipedia)

settlement of Mays Lick, Kentucky, where danger of Indian attacks still lurked. At age 15, barely literate, the boy was apprenticed to a Cincinnati practitioner, Dr. Goforth, who granted him a “diploma” after 4 years. Goforth was an enlightened physician for his time and introduced vaccination to Cincinnati. Drake then studied one year (1805-6) at the U of Penn under Benjamin Rush, completing his second year in 1816, gaining him an MD degree. He was bookish, read widely, and built a successful practice in Cincinnati. When Dudley offered him a professorship in materia medica and medical botany in Lexington he took it. He enjoyed teaching and the students consistently rated his lectures as the best.

     A third faculty member appointed was William Richardson, an acquaintance from U of Penn days. He had only completed one

William Richardson (from Hathi Trust)

semester at Penn and practiced obstetrics. He became professor of midwifery at Transylvania U. Two other new appointments, James Overton as Professor of “Theory and Practice” and James Blythe as Professor of Chemistry, filled out the new faculty by 1817.

     There was strife from the start. In 1818 Dudley and Richardson fought a duel. Dudley shot Richardson in the groin, severing an artery. Dudley then saved him by pressing on the artery until it could be tied. They continued to work together but it is unclear how harmoniously.

     Drake, to escape tensions, moved back to Cincinnati after one year, resumed his practice, and founded his own medical school, the Medical College of Ohio. He studied and wrote on diseases of the Ohio Valley and later taught once more at Transylvania U. He is regarded as a founder of western medicine.

     In the same year as the duel, the Kentucky legislature appropriated money for an upgrade of Transylvania U. The trustees hired Horace Holley, a Unitarian minister from Boston, as president. Holley quickly transformed the University. He enlisted Charles Caldwell from the University of Pennsylvania as dean of the medical school, who traveled to Europe to acquire scientific apparatus and especially books, the start of a fine library. There being no separate medical building, Dudley built an amphitheater onto his own house for dissections and surgical instruction. Cadavers were procured by graverobbing or sometimes by the use of deceased slaves. Other classes were held in the main building until a separate building was erected in 1839. In 1828 the respected quarterly, The Transylvania Journal of Medicine, was launched.

     The school soon began to be affected by the steamboat age. Louisville and Cincinnati, both on the Ohio River, grew rapidly as Lexington, farther from navigable rivers, remained more static. A medical school opened in Louisville, galvanizing the Lexington legislature to appropriate more money. A new medical building went up and

(from The History of the Medical Department of Transylvania University)

another team went to Europe for more books and equipment. The new library was praised as the finest in the west and among the finest anywhere. Nathan Smith (see blog of 8/12/16) and Elisha Bartlett, famous names at the time, taught there and the school flourished through the 1840s. But the schools in Louisville and Cincinnati gained in size and in 1850 several of the Transylvania faculty opened a new medical school, the Kentucky Medical School, in Louisville, to compete. Eventually, in 1860, the Transylvania medical school closed, and the new one in Louisville merged with the University of Louisville in 1908. Transylvania U eventually became the University of Kentucky.

     The Transylvania U medical school had a short but illustrious life, easily comparable to eastern schools and responsible for training most of the practitioners of the early west.

SOURCES CONSULTED:

Wright, John D. Transylvania: Tutor to the West. 1975; University Press of Kentucky.

Juettner, Otto. Daniel Drake and his Followers. 1909; Harvey Publishing Co.

Wright, James R. “Early History of Transylvania Medical College” 2019; Clin Anat 32: 489-500.

Peter, Robert. The History of the Medical Department of Transylvania University. 1905; John P Morton & Co, Louisville.

Flexner, James Thomas. “Genius on the Ohio: Daniel Drake”, chapter in Doctors on Horseback. 1937; Viking Press. pp 165-234.