University of Maryland School of Medicine - Terrae Mariae Medicus (Baltimore, MD)

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have been in the front line of American medicine. The Maryland Theory of Davidge held that each disease was different and had to be treated and studied as such - in direct opposition to the prevailing theory of Benjamin Rush of Phila- delphia, who believed that all diseases were essentially the same and could be treated with a so-called universal cure. Davidge’s theory was increasingly accepted by the medical community. He was also an innovator in that he bled for diarrhea and purged for fever when the medical intelligence of the time called for bleeding for fever and purging for diarrhea. Professor Hall had his own inventions, such as blistering for kidney ailments, a rather drastic therapeutic effort which comprised applying gunpowder to the patient ' s back and then lighting it. It was a primitive time in medicine, when the chief devices of medical prac- tice were calomel and the lancet. It is interesting to note that Davidge opposed the use of the speculum because it smacks of immoral curiosity and that his colleague, Pot- ter, considered the stethoscope a conjuring horn. In 1820 Granville Sharp Pattison, probably the most color- ful of a host of colorful faculty, descended upon the Univer- sity, fresh from an adultery charge by a colleague in Glasgow and an unsuccessful attempt to take over the University of Pennsylvania Medical School. Although he had no lasting medical discoveries and was considered an indifferent sur- geon, this charismatic Scotsman brought new life to the Medical College. Notorious for his duels and amours, Patti- son nevertheless made a significant contribution by establish- ing a teaching hospital across the street from the medical school to be run more or less solely for the instruction of the students. The infirmary, as it was called, opened in 1823, paid for out of the personal credit of the faculty, after Patti- son failed to persuade the Baltimore City Council for funds. His Scots charm served him better at convincing the Sisters of Charity of Emmitsburg to staff the infirmary as nurses, a service they provided for the next 56 years. The University probably reached its zenith in 1826, when over 300 students from almost every state attended classes every year. Eighty-nine medical degrees were given in 1826. Coming from a prosperous home, the typical student had attended a local academy where he was tutored in Latin, Greek and natural philosophy. He had then signed on as an apprentice to an established physician, for whom he did menial chores for the privilege of following the master on rounds and studying from his library of 10-15 books. It was possible to pass the licensing exam of the Maryland Medical and Chirurgical Society after two or three years of appren- ticeship, but, over the years, the boys increasingly chose to top off their education with medical college. There were no standard admission requirements in the early years, although the professors regretted the lack. Almost anyone who could afford the tuition could attend the lectures. Nevertheless, some of the students entered medical school to the great shock and chagrin of their parents. A Maryland professor of the era expressed dismay that parents seemed to send their more intelligent sons into farming, law or the ministry, believing a medical education was appropriate only for those sons the strength of whose intellectual powers they have some doubt. The future physician, average age about twenty years, arrived at the University in early October and paid his five dollars matriculation fee to the dean. He then bought his lecture tickets for twenty dollars apiece from each of his seven professors. During the second year, the matriculation fee was waived but the candidate paid twenty dollars for the right to take the final exam. These fees varied slightly from year to year, but, remained fairly stable until the Civil War. For five, sometimes six, days a week, the student spent an hour a day with each of the seven professors. The most popu- lar course was anatomy , which required fully twice as much time as any other course. Students could dissect at any hour of the day, but, dissection didn’t become compulsary until 1848, the same year gaslight came to the lab. The cadaver supply was plentiful, thanks to Frank, our body-snat cher (a better man never lifted a spade) and Dr. Nathan Ryno Smith in 1830 was able to ship off three cadavers pickled in whiskey as a favor to a colleague at Bowdoin. The length of the term and daily schedule were up to the individual student, who enjoyed a great degree of independ- ence. The minimum requirement for a year ' s work (actually 4-6 months) was attendance at the lectures of any three pro- fessors, although students were urged to attend them all. The identical lectures were presented both years, but the students were told to simply listen the first year and concentrate on lab work - the second year they were to take verbatim notes and concentrate on clinic. Two years of classes were usually required to earn the degree , but 10% of students returned for a third year after graduation. By 1840 students could attend for either four or six months for the same fee - this was among the longest terms at any medical school. Two tests were required for a degree - a thesis and a final exam . The thesis had to be written in Latin until 1824 - one student, Ed. H. Worrell was refused a degree in 1815 after writing a Latin thesis of an immoral character. He finally got his degree after submitting a second, less controversial one. After 1850, a case study could be substituted for the thesis. Since University of Maryland was the only school in the country where a degree carried with it an automatic license to practice, the final exam was weighed very heav- ily. A student paid twenty dollars for the privilege of being grilled by the entire faculty for one hour; a majority vote was necessary to pass and a tie qualified him for a retest. Every year three or four students failed. From 1826 to 1839, the General Assembly’s growing desire to transform U. of Md. into a true state university, coupled with internal power struggles and disputes , brought an end to 3

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A Look Back Amos. Curtis. Jones. O’Connor. Snyder. Our earliest predecessors. The Class of 1812. The first graduates of The Medical College of Maryland, shortly to be known as The University of Maryland, College of Physick. Their medical education had been somewhat lacking in the usual ameni- ties. Commencing in the face of a hostile mob which demol- ished their first school building in a fit of righteous indigna- tion over human dissection , they were lectured for the rest of the first term of four months in the homes of the professors. They met variously for the rest of their medical school career in a borrowed ballroom and an abandoned schoolhouse on Fayette Street, where the professors had to shovel snow from the floor in the morning, chase rats from the cadavers and defrost the chemical apparatus with hot water . It seems quite a lot to endure to attain a profession which, in those days, except for a few noted academicians, promised neither mon- etary reward nor prestige . The history of the sixth medical school in the United States , like that of most human institutions , is a catalogue of good times and bad , periods of eminence and periods of near disgrace. From first to last, however, it seems to have func- tioned in a solid yeoman manner, providing competent clin- ical practitioners to the state of Maryland, with an occa- sional brilliant medical innovator appearing. Any history of the University of Maryland School of Medi- cine must begin with the Father of the University , as he came to be called, John Beale Davidge. Born in Annapolis, Davidge received his M.D. from Scotland ' s Glasgow Univer- sity, it being less expensive than the prestigious University of Edinburgh where he first matriculated . He came to Baltimore in 1797 and began offering lectures in midwifery as early as 1802. Together with James Cocke of Virginia, educated in London and Philadelphia, and James Shaw, a romantic ide- alist, poet and Naval surgeon, who had attended medical lectures all over the world without receiving an M . D . , Davidge built a two-story brick building behind his house on Saratoga Street in 1807. Lectures in anatomy, physiology and chemistry began there in November. In less than three weeks, an angry mob destroyed the new building and carried the lone cadaver through the streets, finally depositing the grisly relic on Davidge’s doorstep. This was an uncomfort- ably similar replay of the fate of the short-lived medical school begun by Dr. Andrew Wiesenthal in 1788, but the atmosphere had become slightly more tolerant in the inter- vening years and , less than a month after the Saratoga Street raid, the Maryland General Assembly approved a charter incorporating the College of Medicine of Maryland. It was chartered as a proprietary, profit-making school, giving the professors the right to own property, charge student fees and grant degrees. Joining Davidge, Cocke and Shaw for this enterprise were Nathaniel Potter, teaching theory and prac- tice of medicine, and Richard Wilmot Hall, lecturing in obstetrics, whose temporary position on the faculty lasted for forty years. Two years later, Samuel Baker filled the school’s vacant chair of pharmacy. The first several years of the little school, as previously mentioned, passed in step-child facilities. But as that first class of 1812 graduated, construction had begun on a perma- nent building situated on the corner of Lombard and Greene Streets on a lot sold to the physicians by Col. John Eager Howard at discount. In 1811, a lottery drew $18,000 for the proposed edifice, which was designed by Robert Carey Long to resemble the Roman Pantheon. Classes began in the unfin- ished building in the fall of 1812 and the school changed its name to the University of Maryland . Between 1812 and 1826, the school enjoyed increasing prosperity . Students from every part of the country filled the classrooms. Only Pennsylvania School of Medicine turned out larger graduating classes. The core faculty of Davidge, Pot- ter, DeButts, Baker and Hall was joined temporarily by some of the greatest medical minds of the day , attracted by the new facilities and progressive atmosphere. One of these was Joyn Crawford, who lectured at Maryland between 1811 and 1813: Crawford was a brilliant theoretician who seems to have anticipated both Pasteur and Darwin, propounding a germ theory and a theory of evolution. Crawford was not universally admired and there were those who said his wife did the University a bigger service than he did, selling his medical library to the school after he died in 1813 . Even without the visiting faculty, the College of Medicine would 2

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New University Hospital Building. the so-called Golden Age. Extramurally , the professors of the still-proprietary school were considered monopolistic money-grubbers and godless grave robbers. Intramurally , the school suffered from lack of true leadership inherent in the system- of essentially independent entrepreneurs. The final blow to autonomy came when a brilliant U. of Md. graduate, Horatio Gates Jamison, having failed to attain an appointment at the school, attempted to establish a rival medical college. His charter was rejected, but the state committee during that investigation found the University charter to be radically defective. The conclusion of the committee was that the state should assume control by a board of trustees none of whom should be professors or have any personal interest to be affected. On March 6, 1826, University of Maryland became a state university in fact. As might be expected , the medical faculty chafed under this new arrangement. Pattison sailed off to England, notify- ing no one, never to return. Davidge, DeButts and Baker all died within three years of the trustees taking control. Their replacements, attracted on the basis of the school ' s previous reputation, all left within ten years. A further blow to the school occurred in 1827, when Jamison established Washing- ton Medical College of Baltimore with lower fees and easier attainment of the M.D. degree as lures to draw off prospec- tive Maryland students. After an uneasy decade of falling income and enrollment, a confrontation over who was to be professor of anatomy in 1837, led to a takeover of University buildings by the faculty and trusted students. They were eventually forced to evacu- ate, but formed a government exile, holding classes of their own in the Old Indian Queen Hotel and the Presbyterian Church on Hanover Street. The trustees, meanwhile, recruited a group of second-rate Baltimore physicans which kept the hospital in operation and held classes in the University buildings. With Jamison’s Washington Medical College, there were now three medical schools in Baltimore. The fight over control of the school continued in the courts. In 1837, the Baltimore court ruled for the trustees, but in 1839, the Court of Appeals ruled for the faculty. On April 3, 1839, the General Assembly repealed the Act of 1826 and ordered the trustees to restore all the property to the faculty. The University was once more a proprietary school. It was in some ways a Pyrrhic victory. The faculty attempted to clean house, organizing new committees, drawing up bylaws and plans for monthly faculty meetings. But the hospital was losing about $1000 per year and they were forced to dismiss the janitor to save his $250 annual sal- ary. Each professor then became literally responsible for cleaning a portion of the hospital. But enrollment increased to 200 students by 1846 with 65 graduates a year. New faculty were recruited with a different approach to medicine - a return to the practical rather than the theoretical. Nathan Ryno Smith was the outstanding professor of the era. The most brilliant and respected surgeon of the state, he was called the Emperor by awe-struck students, partly inspired, no doubt, by the teaching stick he snapped against his trousers like a field marshall ' s baton. By the end of the 1840 ' s, the school had recovered a bit of its former eminence. New courses were instituted in auscultation, pediatrics, pathology, histology and microscopy - Maryland was probably the first school to institute microscopy as a course. The faculty-edited Maryland Medical and Surgical Journal became the official publication of the U.S. Army and Navy and, in 1848, the University played host to the first annual meeting of the American Medical Association. Wash- ington Medical College, unable to meet the competition, closed in 1851 and U. of Md. was once again the state ' s only medical school . During the U.S. Civil War, the University was a strong Southern sympathizer, sometimes approaching treason. Each year, the professors of the medical college refused to fly the U.S. flag at commencement, and each year Union troops forced them to do so . In 1862 , when the graduating class had only two union sympathizers (who were duly hissed at gradua- tion), the president of the class was the one gallant Virginia gentleman remaining at the school. Southern sympathy didn’t prevent the school from making a profit off Uncle Sam, charging the government five dollars a week for hospi- talizing wounded soldiers when the usual patient rate was three dollars a week. After the war, and before the Flexner Report of 1910, the quality of medical education all over the country deterio- rated. Diploma mills, promising easy degrees, flourished uncontrolled by state licensing bodies. Baltimore was full of them - Baltimore Medical College, billing itself as anti- Darwin and Christian was established in 1881; Atlantic Medical College was begun in 1890 by three professors who had failed to obtain licenses; Maryland Medical College, established in 1898, sold degrees to students who had been rejected everywhere else. There were other schools, how- ever, which served a legitimate purpose - because of racial and sexual discrimination, the Women ' s Medical College of Maryland (1882) and the Maryland Medico- Chirurgical and Theological College of Christ ' s Institution (1900) for Blacks met an otherwise unfilled need. Another medical school established during this period presented a different kind of competition for the Old School, as the University of Mary- land was known by then: The Johns Hopkins School of Medi- cine took in its first class in 1893, effectively removing the last semblance of leadership from U. of Md., but pointing the way for true scientific medicine. Standards at the University during this time weren ' t much higher than the diplomas mills. In 1890, a boy could come to the medical school after less than one year of high school and graduate after two terms of less than six months each. The lectures apparently were often somewhat less than stimulat- ing - one old professor had to lock his class in to assure attendance at his lectures. Since the second year students had heard all the lectures the year before, they knew all the 4