Brian Altonen, MPH, MS

 Early Medical Associations

An important change in United States medicine following the recovery from the Post-Revolutionary War depression was the establishment of professional groups.  The value of this important political and governmental change in the profession pertained to the fears of the misuse, misapplication, misapproproiation and mismanagement of anything that had to deal with providing medical services and/or providing to the common person the different forms of medications that were being developed and promoted by the medical profession.  The growing knowledge of chemistry had by now enabled chemists to produce significantly more potent substances.  These substances to date were mostly of an inorganic nature, such as the development of purified arsenic, stronger forms of opium products, the development and popularization of the use of strong mercury-based remedies, and the development of a means to isolate some of the first poisons in medicine in order to test them and later utilize them in some very effective and productive physiological or therapeutic fashion.

These dangers inherent to medicine were unlike previous dangers that exist just a decade or two earlier, in the years prior to the Revolutionary War.  During the 1780s, many of the medicines were strong and effective, and capable of killing if given incorrectly, but it was fairly uncommon for the medicine itself to be deadly, unless it was over-administered or used in excess along with certain other medications.  It was mroe unusual for an individual to die from untreatable internal disease states than to die from the misapplciation of the medication itself.  In many of the late colonial methods of producing medicine, this problem was even more an issue because some of the most complicated recipes to produce medicine from were already carried out by chemists abroad, or on occasion locally.  One could easily obtain a “modern” version of Ancient Greece to Renaissance period medicines such as Theriac Andromachi or Venice Treacle.  This would be available in some pre-manufactured form shipped overseas and marketed by the local apothecary, who infrequently required any recommendation by a physician to sell this substance to the next customer.

Fortunately, at the purely medical and surgical level, obtaining substitute forms of care such as by undertrained physicians or self-trained, self-proclaimed experts in the profession was not as common as many stories of the past like to leave us to think.   At least in the Dutchess County setting of the Hudson Valley, there were enopugh physicians around after the war to prevent someone from initiating a business without being detected by a local community leader or doctor.  In the cases where these so call “quacks” were to be found, there was usually some underlying personal or political reason for such claims and any related court activities that commenced due to such problems.  It was more likely to see a physician of sufficient training be brought to court for a death that he could not prevent, than to learn about a local curee, herbalist, mesmerist or locally and family trained doctor.  Only the religious healers and salesmen trying to market and sell medicines that were truly in the form of quack remedies could truly be linked to any significant insensitive, money-oriented wrongdoings as a part of their profession.  Only the contemporary, troublesome medical preachers and moutebanks could truly be blamed for any form of malpractice that they might have engaged in at the time.

The issues that physicians faced about mountebanks or quacks were really the result of differences in opinions, personal or interfamily disputes, and the attempts made to develop a strong comradery amongst those who felt they were the most qualified to perform this form of medicine that they are discussing.  Only those who practiced the numerous other forms of healing then available were the quacks in need of some sort of legal punishment and/or correction.  By the mid-1790s, with the post-war depression well behind, and commerce improving to some extent, medical professions were beginning to be developed in areas where a substantial amount of people and physicians resided.  Dutchess County of course had the population in which this could be done.  As the most heavily populated region of New York began to engage in this process, so too did the County, which at this time stretched all the way to the edge of Yonkers,  So any attempt to initiate a medical professional group in Dutchess County was designed to serve the outskirts of areas that could not be monitored and developed by the New York City professional groups.   By 1797, Dutchess County had it first medical association formed.

The County’s First Medical Society

 In the Poughkeepsie Journal on September 26, 1797, a notice was published announcing the first meeting of the “Medical Society of the County of Dutchess.”  Submitted by Dr. J. Livingston Van Kleeck, this posting was dated “Poughkeepsie, September 23, 1797.”  The meeting was to be held at Timothy Beadle’s house on “the second Monday of November next.”  The purpose of the meeting was to establish a society in which the local physicians could promote their practice and share their knowledge with others in the field. 

Around this time, other practitioners of medicine in the Dutchess County region had already demonstrated their dependency on numerous healing faiths and traditions.  The Ballston Springs just south of Saratoga had been in operation for several decades.  Within the local hillsides and local mountain ranges were fresh water mountain springs and medicinal waters with a sulphurous smell that many travelers noted to be valuable remedies to take advantage of during their countryside journeys. Some of the local physicians were expert in traditional European and centuries old medicines, the kinds of remedies rarely used by the “modern” physician for the time.  With all of these healing faiths and philosophies making their way through the local social and professional networks, the increasing numbers of physicians and healers made this county in desperate needs of some sort of professional maintenance.

The letter posted in the Journal and dated September 23, 1797 was signed only by “A Physician,” but based on subsequent events we know that this physician was most likely Dr. J. Livingston Van Kleeck.  Its purpose was all of the physicians together in his local community.  It stated the following

“The Physicians of Dutchess who are not incorporated into the above society are invited to associate with its members at their ensuing meeting.  The invitation is extended to those Physicians who reside on the western limit of Connecticut. 

“It is believed that the object of this society has been sufficiently explained.  No remarks are necessary to prove that the gentlemen who compose it are influenced chiefly by motive of public good.  They have united in an instructive and a friendly research into the principles of their profession.  To restore the bloom of health to the faded cheek of disease–to reume the languid eye of sickness–to afford at least an unstable prop to sinking humanity–these incitements have been esteemed essential to the exercise of a few of those relative duties which obligate them as men and as citizens.  Shall their exertions be solitary in a cause so praiseworthy?  Fellow practitioners, you will do well to emulate their example.  And they solicit you to join them in good work in which they are engaged.  The expence of time which will accrue to you will be trifling.  The stated meetings of the society are only twice a year.”

Several weeks later, in November, the local medical society’s first meeting was held.  At this meeting, another local doctor Benjamin Delavergne was elected to serve as President of the society.  James L. Van Kleeck was elected to serve as Vice-President, Thomas Saffron as the society’s Secretary, and Abraham Halsey as Librarian.  This medical society then signed on about 25 members to join the society in November 1797.  The next formal meeting of the society wouldn’t take place for another six months, the notice for came by an announcement in the Journal dated April 21, 1798, and published in the newspaper on May 1. 

The development of a medical society enabled the profession to regulate its practice and produce licenses for the practitioners.   To obtain these licenses, the tests as of yet were not officially formalized, and typically a physician had to be known and proven and professed through experience.  Otherwise, proof of profession and education or apprenticeship had to be provided in the typical way, by way of a personally signed letter from the teacher of master of the apprenticeship, by way of some governmental document or otherwise irrefutable documetn such as a military note or the like, of by way of some indirect line of communications serving to back up any personal claims made about one reputation and skills. 

Once the medical scoeity was formed in Dutchess County, the usual path to obtaining a larger membership became documenting and engaging in an apprenticeship, obtaining some form of classroom education made available on occasion by physicians, colleges and medical institutions or schools, or, more often than not, engaging in both of these processes to prove that you knew medicine. 

In 1909, one of the early physicians of Dutchess County in regular medicine performed an extensive review of the first doctors of Dutchess County.  This review resulted in the identification of several hundred physicians, and for most of them Bayley was able to provide a brief biography or better with information on their method of receiving medical education and their activities with the county medical societies.   In their later years, many of these physicians also became affiliated with the State Association, which formed around 1811, followed by the State Regents group which formed around 1822.  For Shadrach Ricketson’s years of activity with the local associations, we can tell how many associates were in the immediate vicinty and members of the Dutch County medical society.    The names of the first physician of the county, for those active since around 1730, and ending around the year of Ricketson’s death (1837) to 1840 are as follows:

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The first licensure period in Dutchess County history began in 1797.  This was soon followed by the initiation of a membership listing for physicians accepted into the society in 1806, which was updated on a yearly basis as new members became available.  The population statistics for this time demonstrate the following changes in physician-patient ratios for the county for the periods in which this statistical information was available.

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