The Establishment of Medicine Schools and Formal Training During The Post-War Years

 The first New York Medical school opened soon after the war, on property located fairly close to the current School of Medicine at Columbia University. This medical school had a brief period of history just prior to the war, but with the initiation of war soonafter its initial formation, any chances to produce many courses of training in medicine had to be placed on hold until the War was over. Soon after the signing of the Treaty of Paris in 1783, this medical school re-opened its doors and began to provide the locals aspiring to be physicians their first classes in medicine. The most likely topics covered by these classes included pharmacy or drugs, anatomy, physiology, midwifery, and coverage on certain common disease forms like the fever, gout, rheumatism, diabetes, and “cancer,” as it came to be called.

The politics of medicine at this time was pretty much a product of social beliefs and ideology. For quite some time, medicine was demonstrating to some of the public that science, or at least what was referred to as “science”, had some sort of priority to religion. This did not mean that doctors totally excluded themselves from attending churches or engaging in theological practices as part of their health care process. Instead, it meant that physicians, like scientists, were willing to question many of the most basic beliefs religious worshippers had when it came to dealing with the body, its health, and how each of these in turn related to God’s will and the responsibility each individual had regarding penance. At first, most of the arguments any religiously devoted individual might have with a physician had mostly to do simply with whether of not an individual was taken ill because he or she deserved it. Even if this belief that God’s will was ruling your life, defining your ultimate fate and such, was no longer a part of many core religious beliefs, the notion that this kind of control over one’s own fate was still there, in the recesses of the most and least Christian of minds.

As if medical belief alone was the not enough, there were other philosophical viewpoints of the magical powers of the university being shared and passed around amongst tightly-knit social communities. The Masons and other mystical sects had begin to develop their own interpretations of what God is, some even turning God into an omnipresent form of energy, such as the universal force which Quakers came to relate to God and God’s existence. This ability to produce a theory that some allowed you to believe in an omnipresent, force as well as a not-so-religious viewpoint on this entity, more than likely was of great satisfaction to many post-Newtonians, who believed in the existence of an energy or force abundant throughout the universie, and which played an important role of people’s lives, but one which enabled us, as “Scientists” to query into why and how such an energy exists. For this reason, medicine would soon become a study that focused as much upon energy and it did upon the body and a physical, mechanical object. The corpuscular theory of the past, was being replaced by other more energy-related theories as to how and why diseases exist.

In spite of this change in the role and meaning of metaphysics to doctors, religion still had its effects upon the field. For the most part this took place as social experiences more than as professional experiences. The first medical school’s main professor, Samuel Bard, had to deal with the outcomes of these social disruptions on a fairly frequent basis–at least once a year.

The most memorables of these experiences pertained to the re-opening of the medical school in New York city followed by the re-initation of its cadaver studies. At this time, the body was still sacred, and the soul, in spite of its removal from the body following a death, was treated as though this soul and its social memory still required that the deceased body remain a part of the local community. In other words, although as an elder your soul was allowed to depart following the burial of your corpse, the removal of your corpse from the grave, devoid of its soul-related essence, was a social taboo. Soon, no one learned about this taboo better than the professors at the city’s first medical school.

For one series of cadaver classes, bodies were needed, and the fact that a class could be held led many to ponder where the body had come from. It was soon speculated that an elderly lady’s corpse was removed from the local cemetery. Soon after, a group began to form outside of professor Bard’s humble abode. After a short discourse between professors and people, this riot was fortunately prevented, although the value and purpose of riots in deciding what a medical school could and could not do had now become an important part of local history that could be re-enacted at any time should the right circumstances arise.

For the time being, this meant that the medical school would ba able to continue developing its program in how to teach prospective physicians the science of their practice, along with a little of the metaphysics. For quite a few years, the impact a medical school had on the local physicians seemed fairly minimal. It’s two other options, undergoing training through an apprentice, and travelling to Europe for a more professional form of training, seemed to soem to be better alternative. Were it not for the public distrust and dislike of the British in general, and the increasingly uncertain fate of the French Government, the European option may have become the way to spend you time learning medicine as a science and a profession. The upcoming battles and political differences prevented European from being the primary place to learn medicine, except for the financially well-off and the more respected members of certain political and family groups.

Old World Roots for the new American physician

One of the “elders” of medicine, William Thacher, a colonially trained physician who served American troops during the Revolutionary war, and who had for now became the most respected oldest members of his trade, began to write a book on medicine that would serve as one of the primary textbooks of the new school.  Thacher included in his writings a farily lengthy review of the disease of the time, producing his own review of how these disease could be diagnosed from each other and related in terms of how they impacted the body. Most important to Thacher’s views on disease was the more commonly accepted theory for disease first defined by Dr. John Brown, and what later became known as brunonianism.

Dr. Brown documented the movement of cells, a movement that under the microscope appeared to be instantaneous, recurring, constant, ongoing, and unpreventable.  This combined vibration and shaking resulted in a constantly moving appearance of the cell under the microscope, leading Brown to propose a theory stating that some form of “nervous energy” existed in the cell, the product of its existence as a living being. Thacher took this philosophy and expounded upon it, enabling his readers to develop their own philosophical ideology as to what else in the universe this energy might be related to. Once again, this return to the concept of energy having to deal with health and existence, as well as the macrocosm, led believers in astrology to redefine and rejuvenate their philosophy, enough to make it fit with the current ideology of cell and organism life, activity and what soon became known by members of the medical profession as the vital force. 

When Thacher and Brown popularized the brunonian theory during the late 1700s and early 1800s, astrology underwent another major redefinition of its philosophy and how this can be related to health and medicien.  This would be the first major revival in astrology to take place since the Renaissance Period around 1570.  Whereas during the 1600s many Christian Astrologers learned to use astrology to predict the second coming of Christ, by the eighteenth century, Mesmer had learned how to popularize his own recitation of this philosophy a century later by theorizing that the energy related to astrology could also be related to the smaller more personal aspects of an individual how each person behaved.  This ultimately resulted in the application of Mesmer’s philosophy of astrology and the universe to developing a better understanding of the human being and human psyche, what is today considered to be the study of human psychology and human behavior health.  In essence, Thacher and Brown’s popularization of the role of the nervous energy and the relationship of this energy with other universal powers impacting health, enabled the development of a several new forms of medicine, each of which would became highly popular in the years ahead.  The earliest of these new philosophies was that of the electric cure, an ideology that began to take hold in the 1790s due to improvements and popularization of the static electric generator, but began its most important growth in complexity around 1804, when Volta annouced his discovery of the early battery.   In very short time, these developments in science and philosophy led to the next popular form of new medicine for much of the intellectual world — the electric cure.

Energy, Disease and the Body

Bridging the gap between the vibrating cell and the energy of the human body and universe was still not an easy concept for many physicians to do throughout the eighteenth century.  Much less was this a concept that regular people with little to no science training or background could fully understand.  It was easier for an individual, professional or not, to understand a philosophy that it was to understanding all the making of a science.   We were all pretty much trained since childhood to capture and think about, and with time, come to some personal understanding about our microcosm and macrocosm in each of the our individual ways.  Everyone had their own idea of what electricity was, or at least its equivalents in the natural philosophy sense.  It was harder to understand the scientific reasonsing for scientists’s own unique claims about this important piece of personal philosophy and human psychology.  Even the most strained scholars were often victims of this very human experience.

This was even more the case with physicians, individual trained to pay close attention to science, and at times engage in such activities and learning experiences even to the point of dissociating onselef from the human aspects of disease and the body.  For this reason, it wasn’t always easy for a physician to understand and willfully accept everything being philosophized by his teachers, colleagues and friends about electricity and the body, and the impact of electricity on health and the human lifespan.  For this reason, other physicians had to make their own say in this new piece of medical philosophy.  Paralleling Thacher during the late 1700s was the old-time favorite in England, William Cullen. Cullen of course contested Brown’s claims. As late as 1810 in a reprint of his Materia Medica he wrote his own take on this philosophy, which was for the most part non-supporting.  However, like many generations in which arguments ensue between different philosophers or scientists defining a field, the notion that it was possible that energy might help to explain disease and provide us with a better, more miraculous means for cure, was highly attractive both in and out of this part of the medical profession.  For this reason, Thacher’s old fashioned teachings were very much threatened by the new science being generated, and the new scientists making these claims to the world.

Another preacher published in the European medical books about this time was Breton physician Francois-Joseph-Victor Broussais (1772-1838), whose philosophy of medical science included a significant amount of work focused on this energy that spread throughout the body–the electrics–but also tried to take a more chemical approach to interpreting how these events took place in nature.  

Broussais graduated with his medical degree in 1803, served as an army surgeon for Napolean, and then began promoting his own take on Brunonianism, in which he claimed heat was the form of energy that caused the parts of the body to move and circulate.  He claimed that heat is responsible for the various chemical processes the body engages in as part of the life process, and that irritation induced by changes in this heat is the actual cause for most sickness. Soonafter, this philosophy led to the irritant theory for disease development and onset–claiming that an irritation of a particular part of the body is what causes disease to commence.  Broussais called this his “foyer de maladie” (means for illness) with his ontology or cause for an ill condition defined by internal body-borne energy changes. 

It is also important to note that this philosophy was also in many physician’s minds at the time.  For this reason, it very much resembles another theory that it immediately preceded–homeopathy.  Samuel Hahnemann’s homeopathy (born. ca. 1812/15) philosophy was most likely initiated as a part of a similar philosophy developed just a few years later.  This argument would be based on very much the same notion promoted by Broussais, that symptoms define a disease, and not the tissues or organs that are influenced by it.  That which Broussais tried to take away from the theory for disease with his heat-based irritation theory, the potential metaphysical claims underlying  this premise, Hahnemann would later put back into the disease theory.  Hahnemann’s take on this however also had its parallels with the now developing theories related to the impact of the vaccination on the body.   Hahnemann’s combination of these two versions of pathogenesis (disease development) would not become popular for at least another 15 years, due mostly to the delays in totally accepting the premise that vaccinations in exceptionally small amounts of active material worked without causing the total disease.

Counterparts to Energy

Whereas Cullen defined all disease as a form of “neurosis” or nervous energy-related phenomenon, and Thacher’s followers very much adhered to old time Colonial ways, there were two other major forms of disease theory about to form in the newly formed United States.  Unlike medical theory, which focused on the premise of how and why medical practices were performed, whether they served to help the body become stronger, or help to balance its 4 humours, or help to improve its otherwise unhealthy physical make-up due to local weather or climate differences, disease theory focused very much on the cause for disease or illness.  Whereas with medical theory, physicians strived to make sure the scientific philosophy matched the state of healthiness and illness they perceived patients to have, with disease theory, doctors tried to understand the disease and focus on how best to treat it.  Because these two types of arguments existed often during colonial and early post-colonial medicine, the focus usually was first on the cure and its positive outcomes, and second on the underlying theory that could be developed to explain why this cure happened.  

At the start of the 19th century, physicians performed better and were more broadly accepted when their practice produced the positive outcome.  Whenever an attempt to treat or cure was performed based mostly upon theory, and the resulting outcomes was not always an appropriate cure, the physician practicing according to this philosophy was at risk for public disfavor and dissatisfaction.  Medical electricity cures related to the Universal energy take on brunonian concepts was a theory of practice based largely on a recurring theme in medical history, with occasional fascinating findings produced to help support the philosophy more than produce an actual cure. 

The use of herbal medicines on the other hand demonstrated a more physical type of outcome with obvious signed for change and possibly cure.  In medicine, between 1800 and 1812, these two ways of thinking were constantly being tested.   Herbal medicine won out due to the success of the emetic and strong laxative, and the failure of the lancet to effect a cure through bloodletting–the heart of regular medical thinking.  Herbal medicine also won out over medical electricity for the most part, although due to recurring fascinations the people had with medical electricity, and the hopes many people had to finding a cure for diseases untreatable with the lancet, medical electricity had its leaks and lulls of public acceptance.  Each time the interest in medical electricity faded for a short period of time, it was mostly replaced by various types of herbal medicine counterparts still being attempted.  Anything to avoid the lancet. 

It is also important to note that during this time, medical electricity already had survived several periods popularization by 1800.  A number of offshoots of this field of medicine were formed due to multiple discoveries made since the 1600s.    Due to the exploration of the part of Asia now known as China by the Dutch, scholars, writer and physician witnessed the use of moxibustion, which they had to explain using the four humours–ca 1660 they chose fire to explain this form of healing based on an energy concept akin to astrology and the body electric.   Later, the Dutch discovered the power of the Leyden Jar, a primitive conductor-like device capable of storing energy and shocking anyone who made contact with it.  Since that discovery, the use of medical electricity was tested time and time again, with reports published both supporting its use along with a few questioning the value or efficacy of this procedure.  It is important to note that each of these revivals of the electric cure philosophy were accompanied by a restating of the nervous energy concept for the human body’s activities, sometimes even bringing back some of the much older notions about electric cure already being heavily promoted locally in the Hudson Valley (more on this in the next section), such as the use of static electric generators and the earliest concepts of the battery and the role different metals played on the energies in and around the body (much less the universe), all of these practice with the teachings of magnetism and animal magnetism (Mesmer’s “mesmerism” or early hypnosis) in mind. 

This very metaphysical series of healing philosophies were countered by the growing interest in local herbalism.   For this reason, the second most popular branch of medical philosophy and ideology to be borne in the United States at the turn of the 19th century pertained to botanical medicine, in particular Native herbalism.  The emphasis in herbalism quickly became one which focused on the use of local plants to heal and produce a cure.  This philosophy in turn was based on the premise that the place in which a medicine resides is just as important as the type of medicine that it is.  As a result, between 1790 and 1800, a series of new healing faiths were about to be borne, some based on American herbalism.  Like medical electricity, the success of this new brand of botanical medicine was due primarily to the failures of regular medicine, suggested by the lesser forms of suffering patienths had with the use of herbs, versus undergoing the bloodletting process.   Unlike medical electricity, the botanical medicine faith developing was cheaper and perhaps more available than many of the practice routines and medications required of regular medicine.  In part this was due to the post-revolutionary War depression hitting the United States, but it was also due to the cost of products imported from otehr countries.  No longer were fair prices being offered by the British establishment for the medicines they shipped to the colonies.  By turning to other suppliers for these goods, costs and availability really did not improve that much.  In the end, because the local herbs were more available and could potentially be sold for a cheaper price, these became the standard in early United States history, and are a small but essential part of the reason for our recovery from the post-war depression during the early 1800s. 

The importance of price and value also had its impacts on the primary alternative to local botanical remedies–electric cure.  Te cost for local metaphysical forms of healing such as the use of an electric machine got in the way of promoting this form of healing.   Whereas in nature and in the body, electric energy is free, in terms of using this form of medicine to heal, the cost for purchasing, or making the equipment required to engage in such a process, was too much to enable this to become a very popular healing commodity.  As early 19th Century public documents show us, this form of medicine, its cost, and/or the cost of seeing a practitioner in such a field or learning how to use these devices yourself were practices left mostly to the upper class residing in urban settings.  For this reason, along the Hudson Valley, the use of  of electric cure was fairly limited, even though the philosophy took center stage in just a few years due to the rapid migration of urban residents into the valley during the worst yellow fever epidemic years.

The Post-war Years and Dutchess County

Between 1783 and 1805, several writings were produced detailing the local herbs and their potential uses as medicines. Due to the war, trade with England was diminished and at times certain types of European medicines were entirely lacking from the local apothecary. The other most common sources for medicines, the French and Dutch trade companies, assisted former colonists in obtaining their valuable drugs, but local physicians were left to re-define medicine on their own for the most part due to the scarcity of several very important medicines.   The most important medicines at the time to the regular physicians were opium, cinchona bark, and ipecac.

In spite of the war, some of the new physicians in the United States did receive training in England or Scotland, and returned to the United States to help form the first medical colleges and lecture series in the US. In rural settings like Dutchess County, New York, students such as Dr. Osborn’s sons did not have to undergo this training.  Later additions to this trade however did have to deal with the new laws now developing about who could practice medicine.  For this reason, Cornelius Remsen of Long Island, a nephew of Dr. Osborn, probably underwent some of this training under one of the most reputable medical school professors and physicians of his time–Dr. Valentine Seaman.  Cornelius Osborn’s youngest son, Thomas Osborn, was  also possibly trained by Dr. Valentine Seaman and a new physician to make frieidns withthe Osborn family, Dr. Bartow White.   The setting for yet another clash in ideologies was now forming–medical electricity, versus Native American/early American herbalism, and the type of medicine Bartow White had learned as a student of the medical school setting in lower New York.

Dr. Bartow White, the son of the famous Revolutionary War physician Ebenezer White, was trained by Valentine Seaman, and would bring this knowledge to Dutchess County medicine as it was being practiced in the Hudson Valley area.  The most important events leading to this development of a new theory for disease had everything to do with simply reconstructing some of the old ideologies in the field–the notion that miasma formed by particular places and landforms could result in disease being generated by bodies that take in that miasma.  This new take on the cause for disease was used by the Osborns, Seaman, and White to explain the behavior of the local epidemics then taking place, like the various forms of fever, dysentery and consumption that seemed to strike time and time again. 

Trained in Climatology and Medicine, Dr. White and Cornelius Osborn’s sons and nephew, came to practice America’s first unique form of medicine. This new practice made use of both European Old World and American New World herbal medicines. But for the most part, medicine was changing into a study of element, mineral and metal-based medicines as well such as arsenic and mercury salts, iron powders, sulphur balms and waters, and natural salts formed by evaporating mineral springs water.

Even though there is considerable evidence of Native American or Indian herbal remedies being introduced into medicine quite early in Colonial history, and perpetuated n the Dutchess County area, the impact of this treatment philosophy on the local disease philosophy was minimal.  There was for the most part a mismatch between the two that could not be significantly reduced. 

Defining the first most influential and economically important North American herbal medicine is difficult, if not impossible. There is evidence that even as the Revolutionary war took place, other European nationals not involved in this territorial dispute were already well involved in the exploration of the New World for new medicines. No doubt, certain economic trades continued in spite of the war with the Colonies, such as the fur trade activities in Canada and the attempts being made to explore the west coast and undiscovered parts of the Subarctic regions. In addition, even though Americans were by partaking in their war with the British, some American communities in the former colonies still interacted with Native American groups and communites, some now residing in government defined communal settings.

There are numerous herbs already documented as potential medicines prior to the revolution. During this war, Thacher had added just two important local plants to his list of remedies, a nut-bearing tree with an exceptionally caustic bark (Butternut) and possibly one or more of the local Oak trees with their strongly astringent bark. Immediately following the war, it is possible that previously mentioned herbs wer eonce again reviewed as potential medicines. The main problems physicians had to deal with during this time were the significant differences that existed between the Native American philosophy used to define how their plant medicines were used, and the very opposing philosophies believed in by now Euro-american physicians. For this reason, there was a brief period of medical thinking in United States medical history that is referred to by some classic medical historians as the “Heroic Period.” During this time, physicians had to retrace their previous steops to determine what theories were valid and could be used to define how a particular plant was to be used, and what theories were not valid, in which case they had to put the potential herbal medicine through thir own flurry of tests with their patients, in the hopes of either finding a new cure thereby making them famous, of proving a particular work in accordacne with traditions, but due to new scientific/philosophical reason–again making them famous.

During the 1780s and 1790s, there were few American published books or pamphlets on local herbal remedies. By then distinguishing between some of the herbs and their European counterparts or initial sources also made it difficult to determine whether or not a purported local cure was actually local, or simply an escape from past gardens. By now, the plantain and dandelion, and some lilies and irises, were of European origin, a history forgotten by some herbalists using them as remedies. Likewise, the destruction of many east coast wilderness settings since original habitation by the Europeans during the mid 1600s onward, led to changes in many local ecosystems, thereby replacing the Pine forest with the more common deciduous settings with various shrubs prevailing, and the once open-floored forest settings with pastoral fields, many now abanadoned for their use if growing hemp, grains and corn.