The Medical Education System
The Wisconsin lecturer began with a discussion of “the personality of the doctor,” noting “no man but a gentleman has any call to practice medicine.” The “skillful physician” Covert claims should be “courteous and clean in word and deed and person…the doctor of to-day must not be an “old fogy” and antediluvian; his individualism must not be so excessive as to border on “crankiness.”” To be “en rapport with the spirit of the age,” the doctor must be “a man of ideas, of many ideas.” He reminds his listeners of the past, a time when “illiteracy in the medical profession has been a dead weight upon it…The self-made physician, like the self-made generally, is an example of what may be accomplished in spite of adverse circumstances, but, in our ideal of what the best possible physician should be, we find no place for crude illiteracy.”
This “literacy requirement for matriculation” was a new addendum to the general medical education programs nationwide. Its purpose in Dr. Covert’s mind was to enable the practice of medicine to be converted from an empirical practice, to one more contemporary, that is to say focussed on the intellectual concepts born due to scientific discoveries. Covert notes Wisconsin’s requirements that the matriculating students be learned in the English language, and “must know something of nature’s laws.” He expects the doctor to be familiar with “the physical laws which govern the universe, the forces of nature, light, heat, electricity, and chemical action.” To formulate the prescription, he claims the doctor must understand “the laws of chemical combination which govern them and the characteristics of the new combination which may ensue.” A comprehension of the stomach activity which ensues after taking a medicine is also a necessity to this new view of what once the “shot-gun” approach to performing healings.
Covert defined the “up-to-date doctor” as “a naturalist, a chemist and a pharmacist.” The doctor must be well-rounded, have “all the natural qualifications of mental and moral fitness,” the acquired education of literary and medical schooling, and “bristle with information.” Covert continues:
“The all around physician must be a specialist in every department. He must be so good an anatomist that he might be a first class surgeon under favorable environments. He ought to be an unerring diagnostician. He must have the keenness of a sleuth-hound to track symptoms back in their lair. He should be blessed with a penetration equal to an x-ray for discerning the hidden recesses of the human anatomy and preserving its condition. As a pathologist he should have no superior. As a therpeutist, what should he not be? Learned in the lore of the healing art, past and present, with the judgement to select from the vast resources at his command, wtih masterly precision, that which shall exactly meet the requirements of the case in hand.”
Covert recommends the doctor be conservative in his approach to his selection of remedies. He must be spiritually progressive, “not run after fads,” and be “liberal enough and eclectic enough not to reject the new nor to cling to the old.” To obtain all of these skills, the person wishing to become a doctor need only follow the moves taken by the Wisconsin school, where the course of medical instruction last eight months out of the year for three years, or six months per year for four years, purportedly a length of training that became a first for this sect of the medical profession. Quite representative of this new born scientific profession of medicine, Covert coins the doctor to be learned in preventing disease by way of right living and proper hygiene, and by remaining in touch with the new teachings of his profession by book and journal he becomes “a scientific doctor, who has emerged from the grossness of the past and is worthy a place in a truly learned profession.”
Most appropriately, Covert’s speech was followed by “In Methods of Teaching, are Medical Colleges up with the Times?” presented by C.N. Miller of San Francisco, “Uniformity in Requirements of Medical Colleges” by D. Maclean of San Francisco, and “Medical Education of the Present” by John K. Scudder, of Cincinatti, Ohio. Miller’s speech is a multitude of conjectures, including notes on Etidorpha, a criticism on the allopathic use of blisters, and his mockery of “the college “sheepskin;” a leather medal.” Maclean’s speech reviewed the last half-century of academic history for Eclectic Medical schools:
“With all its troubles, and throughout all its changes, the school, as a school, has been steadily advancing and is now firmly established with college in the East, West, North, South, and Pacific Coast–survivals of the fittest.”
Subsequent criticisms by MacLean lie in the number of participants in each of the allopathic, homeopathic, and eclectic programs, and the rises in these numbers during the moste recent years of 1889 to 1893. He cites a recent Illinois Board of Health study which showed participation in allopathy was up one-third, with homeopathy up by one-quarter, and eclectics up by only one-sixth approximately. For every eleven regulars to graduate, there was one homeopath; for every twenty-five regulars there was one eclectic. To improve these ratios, Maclean recommended the improvement of the teaching facilities at the Eclectic medical schools. He suggested the additions of much needed teaching hospital facilities, better teaching equipment and “better and more earnest teachers.” Filled with hopes, MacLean states: “Besides all this we need a high standard of medical education and a uniformity in the requirements of our medical colleges.”
By this period of eclectic medical history (1893), the eclectic practitioners were taught in both the regular and irregular styles of health care. According to tradition, it was up to these healers to determine which healing practices would take place in their offices. Eclectics felt their profession was one up on allopathy, since they believed they were selecting the best of all fields, instead of avoiding the alternatives as the allopaths had done for many years. Maclean felt “a time may come when a universal law of cure may be found, and medicine become exact. That time is not yet, and until it is eclecticism occupies the vantage ground.”
Along the West Coast, there was the California Medical College, with sessions lasting eight months each and lasting for four years per student. He recommended daily quizzing, less didactic learning, and “lectures to be only explanatory, demonstrative and clinical.” As the others in his section, he recommends that all scholols develop a uniform medical training program. He ends by stating:
“If we can agree on these points and formulate an advanced system of instruction, the field is ours. Prosperity will attend our efforts, and we shall stand as the beacon lights of scientific medicine, which shall attract the thoughtful and guide the seekers after truth.”
California’s Medical School history?
California had undergone several periods of great change in the history of medical education… The earliest Euro-American regular and alternative doctors to move to the Far West did so in and through California.
John K. Scudder’s biography
John K. Scudder’s talk was to be the primer for subsequent changes to be made in the Eclectic profession. With a long history in this field as chief editor for one of its major trade journals, and as a member of faculty of the long-lived Cincinatti school, his presentation on “Medical Education of the Present” was intended to send a message to the regular and other alternative healing professions. In this presentation he lists qualifications (“mental,” “educational” and “moral”) for admissions, and then details the course of medical study, its cost to the student, and the “opportunities for success in the practice of medicine.” Typical coursework for first year students was to be on physics, general chemistry, elementary biology, botany, zoology, history of medicine, microscopy, and medical terminology. The second year student was expected to learn anatomy, physiology, medical chemistry, materia medica and pharmacy, general pathology, and institutes of medicine, each of which were to serve as “the fundamental medical branches on which the more practical studies are said to be based.” The third year student took classes in special pathology, diagnosis, obstetrics and hygiene, and “practical exercises in all these departments.” Thr fourth and final year encompassed trainings in the specialty fields of eyes, earns, nose and throat, dermatology, neurology, and pediatrics, with profession- and business-related teachings in diagnostic techniques and medical jurisprudence. At least three full years of attendance are required. Some of the basic sciences classes can be taken at a preparatory school before admission to the medical school. The cost for these three years of education was estimated to be seventy-five to one-hundred dollars per annual term, with an added matriculation fee of five dollars, and a graduation fee of thirty dollars, making the four years of attendance worth at least three hundred dollars and as much as five hundred dollars.
Scudder likens the opportunities for success following graduation from an Eclectic Medical school to the futures other professional have had to face, including lawyers, thoologians, teachers, college-trained farmers, manufacturers and commercial businessmen. He recommends a review of the Polk Directory to determine what small towns and regions are in need of eclecticians:
“The United States is not at all adequately supplied with physicians of this school, nor is it likely to be for many years to come….there are hundreds of towns and cities in this country, having populations varying from a few hundreds to several thousands, in which there is not a single eclectic physician; besides, hundred of other towns amd cities exist in which there are abundant opportunities for additional physicians of our school. The well trained eclectic medical graduate has every reason to anticipate for himself and honorable and lucrative business.”
Scudder estimated there to be over ten thousand eclectic medical doctors in the United States. Having completed it seventy-third year of existence, the eclectic field Scudder felt was filled with opportunity and more in demand and in need than ever before. He judged it to be well established in the new “scientific and social world” these doctors were employed in, and estimated the sect to be a permanent addition to the country’s health care system. To support this notion, he noted eclectics to be at work in colleges, hospital and societies, and serving on government, sanitary, and state boards “equally with fellows of other schools.” With its increasing popularity, he judged eclectics to be “one of the most inviting and prominent avenues open to those whose physical, moral and intellectual qualifications fit them for its duties and responsibilities.”
Medical Legislation
Section X on “Medical Legislation and State Examining Boards” was Chaired by E.H. Carter of Des Moines, and Vice-Chaired by E.H. Curry of Baker City, Oregon. The central point of this section pertained to national and Far West State medical board history. The first speaker, Dr. E.H. Carter, discussed “Medical Laws and State Boards of Medical Examiners.”
On the initiation of discussions by state legislatures of the licensure-board controveries arising due to alternative schooling during the mid-nineteenth century, the initial laws passed were in favor of the allopathic profession. But within only a few years, criticisms of this merged from both members of the general public and politicians. The first laws enacted during the ante-bellum years were mixed in their outcomes. Some early measures restricted or prevented alternative healing practices, such as the New York bill passed banning Thomsonianism, which was soon after reversed. Other bills allowed for the practice of health care, but made it illegal for the healer to charge patients for such services; this particularly the case for the earliest widely dispersed domestic medical sect–Thomsonianism. During the post-bellum years, many of the laws reversed previous actions taken, most resulting in the passage of bills favoring allopathy, which had finally proven itself beyond a regular patient’s doubt during the Civil War.
Throughout these periods, the regular healers refused to accept the alternative healers as consisting of a bonafide profession. They not only referred to them frequently as “quacks” but also classified the alternative healers as believers in sectarian medicine, which the allopaths tried hard to exclude their own methods of practice from. Sects were most often likened to systems which had religious beliefs underlying their philosophy and reasons for their chosen methods of healing. This modification of accepted terminology, in combination with the political, clinical, financial and insurance-based tactics taken, the allopaths managed to segregate the alternative healing professions into numerous facets….. By the 1880s, allopaths tried to claim the eclectic profession as “not recognized,” actions reversed by the state legislations passed. With existing medical schools and sizeable numbers of advocates present, these States were left with no options. By the time NEMA met in Oregon, laws passed around the country had mixed feelings regarding the allowance of alternative healers on state boards. Eclectics, homeopaths and allopaths were the only sects to have State board members. Dr. Carter recommended that these boards bear equal representation for each of the three sects, by forming boards of three doctors, one for each board-admitted sect. He argues “it gives the school in the minority equal standing with the one in the majority,” which in turn provides better opportunities for fair representation when it comes to legislative actions to be taken, and an equal sharing of news reaching the local papers. The appointment of three separate boards he is against:
“In nearly every instance, so far as I am informed, eclectics have been benefitted by the passage of medcia llaws. The state vests in these boards certain powers. They are legislative and judicial bodies. They make various rules and regulations, particularly in regard to the management of medical colleges, administer oaths, grant and revoke certificates to practice medicine, etc.”
Management of medical colleges relies on these boards and their homogenous qualities. Differences which exist between the state boards are presented in the professions as differences in schooling requirements and the successful and fair administration of licensures. He criticises the establishment of three separate boards in California, the members of which are chosen for just a one year term. The Oregon board he criticizes for lacking alternatives on its three member board. The State board carries out such licensures by the administration of “an examination satisfactory to the board.” The Oregon State Medical Board’s lack of provisions for examinations befitting of the healer’s sect was also criticized, as well as some “very singular and sometimes arbitrary laws by which they are governed.”
The status of the Oregon State Medical Board during this time frame was….
p. 147.
”Aphrodite” in reverse, this refers to a fictional image protrayed by an earlier Eclectic healer and plant pharmacologist, John Uri Lloyd, who had a “vision” into eternity, which he published as Etidorpha a few years earlier.
C.N. Miller. “In Methods of Teaching, are Medical Colleges up with the Times?” pp. 250-254.
Section Secretary W.M. Durham, of Atlanta, Georgia was absent. R.L. Thomas of Cincinatti was present to act on his behalf.
p. 205.
Brian Altonen, MPH, MS 