Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

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cause of his great foresight. In 1881, when cigarette rolling had become popular in Europe and was still new to the American mar- ket, James Duke decided to put his company's stake on the cigarette industry. The first cigarettes were rolled by hand but by 1884 James B. Duke was ready to open a new fac- tory with the first Consack cigarette machine used in North Carolina. Duke spent many hours with the twenty-two year old James Bonsack perfecting the machine that reduced the price of rolling cigarettes to one third and increased the profit margin to 100 percent. James B. Duke left North Carolina that year for New York where he continued to expand the company. By 1889, Washington Duke and Company produced 940 million cigarettes annually, nearly half of the nation's total pro- duction. The town of Durham expanded with the growth ofthe Duke business, but continued to be plagued with many problems involving water sanitation and supply, health, and edu- cation. Malaria, dysentenf, and diarrhea swept the city in epidemics. The incidence of tuberculosis was very high, and typhoid fever was so common as to be jokingly called 'Durham Fever. Despite several drives, however, funds could not be raised to build a hospital. At the time, hospitals were thought of as institutions where the -poor and indigent went to die. Meanwhile, Durham's citizens were striving to improve the community. Railroads were built. New companies were constructed and established ones expanded. ln addition, Trinity College was moved to Durham. ln 1890 the president of Trinity College, Dr. John Franklin Crowell, voiced his desire to move the liberal arts Methodist school to a commercial center in hopes of placing its Hnancial footing on firm- er soil. Washington Duke responded with a commitment of S85,000 to be used toward endowment and buildings if the school were moved to Durham, and women were admitted by equal standards and offered equal educa- tional opportunities. Raleigh, the only other contender, promised land and S20,500, the cost of duplicating the facilities in the new location. Previously, Baptist Female Seminary inow Meredith Collegej had rejected a similar offer from Durham in preference to Raleigh because 'Durham was lacking in culture, posessed sordid ideals, and was therefore no fit place for innocent girls to abide in. The Methodist conferences, however, voted in favor of Durham, and the Trinity recieved its first philanthropic gift from Washington Duke. Contributions from the businessmen for char- ity and education were substantial but little was done to improve the community health. Dr. Albert G. Carr was welt aware of the health problems of the community and had attempt- ed on three occasions to have a hospital erected in Durham between 1884 and 1891. His efforts and enterprise were finally rewarded when George W. Watts, then president or di- rector of a number of tobacco companies, cotton mills, railroads, and banks decided to make a large philanthropic contribution for the construction ofa hospital. Watts' donation was substantial, amounting to S80,000. Thirty thousand dollars were used forthe construction of Watts Hospital and 350,000 were left as an endowment. This was North Carolina's first private hospital and it was well recieved by the Durham community. The city's blacks, howev- er, still lacked hospital facilities for the care of the sick. Dr. Aaron Moore, a black physician, convinced Washington Duke of the need for this facility. ln 1893, Duke donated S13,000 to- wards the construction of Lincoln Hospital. ln the early 1900's the Duke family business continued to prosper and diversify. James B. Duke's foresight was again exempified when he diverted his investments into hydroelectric power, textile mills, and mining. ln 1911, when the United States Supreme Court ordered the American Tobacco Company, then owned by Duke and Watts, dissolved, four power plants were operating and more were under con- struction. The power plants were organized in 1905 into the Southem Power company which later became Duke Power Company. At the tum of the century, North Carolina's leaders became aware of the need for a medical school that would train the state's physicians and nurses. In 1890 it ranked forty- first among forty-five states in the ratio of physi- cians to population: 1 to 1250. The only existing medical training program was a two-year pre- paratory medical course at the University of North Carolina. Upon completion, students transferred into northem medical schools. Most practicing physicians in North Carolina re- 'if Trinity College, Circa 1895 ceived their education as apprentices to country doctors. ln 1892 the state claimed only five hospitals. When medical care was required patients were forced to travel north - if they could afford the cost. Four schools were built by 1912, two of which were included in Abraham Flex- ner's survey, Medical Education in the United States and Canada. These two were located in Wake Forest and Chapel Hill and only their pre-clinical departments were judged ade- quate for their purpose. the symbol of Flexners standards was the Johns Hopkins University School of Medicine in Baltimore where Euro- pean university practices and an energetic young faculty had provided a firm foundation for medical education. As early as 1916 James B. Duke told the Dean of Trinity College, William Preston Few, of his intention to give away a large part of his for- tune during his lifetime. His philosophy was to arrange his philanthropy so that the profits of his electrical power holdings were directed to the social needs of Carotinians. ln 1923 Duke com- missioned Alexander H. Sands, Jr. to survey the health needs of North and South Carolina. tt was clear that health care improved signifi- cantty over the previous thirty years. However, North Carolina's physician to population ratio was 1 to 1150 while the national average was 1 to 724. James B. Duke also directed his attention to Trinity College. He desired to expand it to in- clude Schools of Law, Religion, Business Ad- ministration, and-Engineering, a College of Women, and a Graduate School of Business Administration. A Medical School was to be constructed only when funds became avail- able after his death. On Decembertt, 1924, James B. Duke made his plans public. The Duke Endowment was 9

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THE HISTORY . . . . of Duke University Medical Center has its roots in the days of the Civil War when Durham was an insignificant railroad hamlet with a population of 200. Durham's fame as the cen- ter of the tobacco industry was the result of a historical accident that made bright-leaf tobacco popular across the nation. The growth of Durham as an industrial town and the crea- tion of Duke University were the result of a for- tuitous encounter. Two weeks before the end of the Civil War, Generals William T. Sherman and Joseph E. Johnston, the commanders of the Union and Confederate armies in North Carolina, met west of the town to discuss terms for the end of hostilities. During the few days of cease fire the troops from both camps wandered into the town and sacked the supplies of brightleaf tobacco in the warehouses. Days later the Confederates surrendered and the antici- pated battle was never fought. As the troops retumed to their home states, they distributed Durham's bright-leaf tobacco across the country. Washington Duke, a Confederate soldier, washington Duke 8 James Buchanan Duke had been captured and imprisoned by Union Troops during the war. After the surrender he was released with fifty cents in his pocket. Upon retuming to his farm in Durham he discovered his tobacco had been sacked by the Union troops. With the help of his sons Brodie L., Ben- jamin Newton, and James Buchanan and his daughter Mary Elizabeth, he packaged and sold the remainder of his tobacco. With the resulting profit he and his family managed to survive the winter. Encouraged by the populari- ty ofthe tobacco, he expanded his tobacco trade and labelled his product Pro Bono Pub- lico l For the Public Good J. During the next few years the business con- tinued to grow and Washington Duke took his sons Benjamin and James Buchanan into the firm as partners. Washington Duke retired in 1877 selling his interests in the firm to Richard Wright. Benjamin Duke continued to run the business, James Buchanan Duke operated the factory, and Richard Wright acted as a travel- ing salesman. By the time of Washington Duke's retirement the firm had accumulated a capital of S70,000 and had rapidly over- whelmed all other tobacco factories in Durham except for the manufacturers of the Bull, then owned by William Blackwell. James Buchanan Duke eventually became the leader of the company and met with great success in the tobacco industry, largely be-

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f - '5 PfF .J w Dr. Wilburl C. Davison created as a perpetual foundation for the ben- efit of orphanages, hospitals, educational in- stitutions, and the Methodist Church. The en- dowment was valued at 40 million dollars with twenty percent to be set aside until another forty million accumulated. Trinity College was to receive thirty-two percent if and when its name was changed to Duke University. The endowment trustees were instructed to set aside six million dollars for the building of the new university. Thirty-two percent of the en- dowment was set aside forthe support of every hospital in the Carolinas not operated for pri- vate gain. Each hospital was allotted up to one dollar per day for every day of care given to a charity patient. This was a substantial donation considering that the average cost per hospital bed was three dollars per day in 1925. During the summer of 1925, James B. Duke suffered from a severe illness. He was di- agnosed as having pemicious anemia and died on October 10, 1925. ln his testament, Mr. Duke left 51,326 shares of preferred stock of the Aluminum Company of America for the con- struction ofa medical school. Dean William P. Few of Trinity College carefully searched for a Dean for the new medical school. After many months of scrutiny, he selected Wilburl Cornell Davison, then Assistant Dean of the Johns Hop- kins School of Medicine. Dean Davison, the son of a Methodist minis- ter, was bam in Michigan and educated at Princeton. While at Princeton, he was awarded a Rhodes scholarship and traveled to Oxford where he studied under Sir William Osler. Davi- son studied at some of the leading schools of Europe and during the war he volunteered to senfe with the French Army. Davison returned to 10 America in 1916 to join the senior class at Johns Hopkins where under the influence of John Howland he entered the field of Pediatrics. From 1919 to 1927, Davison held teaching and administrative positions in the Department of Pediatrics at Hopkins and after 1925 he was appointed assistant to the Dean. On his arrival to Duke, Davison was faced with the enormous task of building a medical school. He was in charge of designing a curric- ulum, gathering a faculty, and, to a large ex- tent, designing the building and organization of the entire medical complex. His dynamic character and work capacity were great assets in winning the support ofthe local and state medical community. Davison traveled around the state consulting friends and experts ofthe medical community onthe construction of the new hospital. He collected books and joumals for the library and, together with Dean Few, made plans for selecting the chairmen of the basic and clinical departments ofthe new medical school. Davison's first appointment was Harold L. Amoss, then Associate Professor of Medicine at Hopkins for Professor of Medicine. Julian Deryl Hart was recommended forthe professorship in surgery. Hart, a native of Georgia where he obtained his M.D., was in the eighth year of his residency at Hopkins at the time of his appoint- ment. Wiley D. Forbus, an Associate Professor in Pathology at Hopkins, was selected to head Pathology. Following these appointments the work load on Davison's shoulders eased somewhat and the team tumed to the task of equipping the new hospital. The department heads were given authority for final selection of their new staff. Since Amoss, Hart, and Forbus were still at Hopkins, they were able to serve as on the ground recruiters. Alfred R. Shands of Hopkins was appointed Attending Orthopedic Surgeon. Robert J. Reeves, instructor in Roent- genology, was chosen from the faculty at Co- lumbia. Francis H. Swett of Vanderbilt was selected as Professor of Anatomy: George S. Eadie of Hopkins as Professor of Physiology. Also from Hopkins came Instructor Roger D. Baker in Anatomy, Frederick Bernheim in Physi- ology, surgical resident Clarence E. Gardner, Jr., and Robert R. Jones, pathology resident. Bacteriologist David T. Smith, a Hopkins gradu- ate, became Duke's Professor in charge of bacteriology with a joint appointment as Associate Professor of Medicine. Bayard F. Carter, Professor of Obstetrics at the University of Virginia, was designated head of that de- partment. After the appointment of the new faculty members and the opening of the medical school, there was a power struggle between Dr. Harold Amoss and Dean Davison. Dr. Amoss was Davison's senior by about six years and the only member of the young faculty that held an appointment as Professor at Hopkins before coming to Duke. The power struggle ended in the joint submission of resignations by Dean Davison and Dr. Amoss to the Board of Trustees. The board accepted the latter's resignation and rejected the former's and Davison re- mained as Dean of the Medical School. ln legal matters, Dean Davison was also Dr. Deryl Hart in his Laboratory 3. x 'X 1- 4