The History of New York State
Editor, Dr. James Sullivan
Online Edition by Holice, Deb & Pam
|By persisting agitation,
however, the reputable gentlemen of medicine prevailed upon the State
Legislature, thirty years after the passage of the first ineffective
law, to take legislative action against the purveyors of such
comprehensive cures of the ills of mankind. Am act passed by the New
York Assembly and Senate in 1792 was intended to curb the activities of
those ",any ignorant and unskillful persons" who
"presumed to administer physic and surgery within the city and
county of New York, to the detriment and hazard of the Citizens
themselves." This act provided that no one "should practice
physic or surgery within said city before he shall have both attended
the practice of some reputable physician for two years, if a graduate of
a college, or for three year if not a graduate, and been examined,
admitted, and approved by the Governor, Recorder, or any two of them,
taking to their aid three respectable physicians with whom the candidate
had not 'lived to acquire medical information.'" The penalty of
seven pounds for practicing "without a testimonial of
qualification" could be exacted; furthermore, no person so
practicing could recover by legal process for such services. But this
act, also, was not retroactive, neither were its provisions applicable
to those practitioners who might come from other States, or to those who
already held the degree of Doctor of medicine from any American college
or university. Even those who could not come within the exempt classes,
and were detected in violations of the act, were not without hope of
evading the consequences and continuing in practice. A leniency clause,
in effect, put them on probation, subject to call before the mayor and
recorder, if they "deemed it expedient." These loopholes
rendered the act of little value.
Still, it only applied to New York City and County. Practice might go on in the old unhampered way in, for instance, Brooklyn, or anywhere else then New York City and county. The first general law of this purpose was not enacted until 1797. It was a mild measure, requiring only that physicists and surgeons should show proof that they had been in practice for two years and had also served under a reputable physician for a further like period. Any other person who might apply for permission to practice must show that they had studied medicine for four years. Proof of this was to be the possession of a certificate "from one or more physicians or surgeons." The term of study for college graduates was made only three years. Diplomas were still recognized, "but because licenses only on being filed with the country clerk."
Physician in time began to complain of lack of State support of New York medical colleges, in that the diploma of any outside college, however lax, was recognized and such indifferently prepared graduates admitted to practice in New York where college requirements were more rigid. Still, the hindrance of medical advancement in New York cannot be wholly heaped upon the politicians. The physicians themselves were in part to blame. As Dr. Walsh points out, the first fifty years of our State history "is filled with medical bickerings and divisions between rival professors and institutions and interfering political authorities." The state of medical education in New York became so uncertain, and palpably unstable that, in 1814, an eminent physician, Dr. Jacob Bigelow, saw that New York had been left far behind by Philadelphia, also that Boston was likely to take second place. Writing to Dr. Lyman Spalding of Boston, he said: "You seem to be destined to become the rivals of Philadelphia." The medical school situation, however, was at that time probably at its lowest ebb.
Dr. James R. Manley, in his presidential address before the New York State Medical Society in 1827, reviewed some of "the elements in our medical education. . . . . which were preventing the proper development of medical education." While the State had cone little to foster medical colleges, certain professorially-inclined physicians had made matter much worse by endeavoring to monopolize collegiate teaching, exerting undue influence with legislative bodies and State departments with this object. Dr. Manley said: "The teaching, examining and the licensing powers, where they existed, were all claimed and exercised by the same men, and the emoluments accruing to the professors were made in a great measure to arise from this unnatural and impolite union." If there were comparatively few well-educated physicians, such a course might have been tolerable, Dr. Manley points out, but "prudence should have dictated the propriety of separating the temptations of interest from the nobler incentives of medical distinction."
The disturbing factor was in the endeavors of Dr. Romayne to establish a rival medical school to that of King's (Columbia) College. Dr. Nicholas Romayne was an eminent physician of the city of New York, one who professorial ability was undoubted; but he seems to have been of somewhat independent mind. In the year 1787 he opened in New York City "a respectable private medical school," continuing it as such successfully until 1791. It then occurred to him that corporate powers might be of definite advantage. So he associated with Drs. Sir James Jay, Nicoll, Moore, the two brothers Kissam, and Dr. Mitchell, in an application to the State Regents for a charter of the college of Physicians and Surgeons. It seems, however, that Dr. Samuel Bard and some of the medical friends of the matter were of opinion that King's College already possessed all that was necessary in this respect. Apparently, the medical department of King's College, the name of which had become Columbia, had no t been reorganized as yet, but Dr. Bard, in representations to the Regents, pointed out that the trustees of Columbia College were even then "organizing a faculty of medicine under their own authority, which they trusted would supersede the necessity of a College of Physicians and Surgeons till the issue of their measures was manifested." Action on Dr. Romayne's application had already advanced far, the Regents having favored it and the Legislature having passed the measure, creating the College of Physicians and Surgeons. But, upon hearing the trustees of Columbus College, all further proceedings on Dr. Romayne's petition were suspended. The medical school of Columbia College was duly organized, or reorganized, and Dr. Romayne was thus frustrated in his independent aim. Several of his associates were taken into the faculty of Columbia. Dr. Romayne, where upon, knowing well his own strength, "declared an open opposition." If he could not get corporate powers from the State of New York, he would go out of his State. He approached Queen's College (of New Brunswick, New Jersey) and had little difficulty in getting this institution (which later became Rutgers College) to recognize his school as it medical department.
It is apparent that the chief leaders of the medical factions were Bard and Romayne. They met as associates in the Medical society of the state of New York, and, for a while, as trustees of Columbia College. But, they apparently went different ways, disrupting the medical fraternity of New York City seriously. In 1799, Dr. Samuel L. Mitchell, a close associate of Dr. Romayne, was stricken from the membership rolls of the Medical Society, for nonpayment of dues. He refused to pay, notwithstanding that he tool most active part in the proceedings of the society; therefore, it seems that his delinquency must be attributed to more serious cause than financial embarrassment. Which of the factions, the Bard or the Romayne was uppermost at that time is not clear, for Dr. Mitchell was, at different times, identified with both; but his dismissal probably had some connection with the main bickerings.
But New York City practitioners were not for long allowed to hold the monopoly of organized effort in matters pertaining to their profession. Another group of New York State physicians and surgeons resolved to make themselves heard. The movement began in Saratoga County in 1796, and grew in strength until 1805, when their efforts came to fruition. In November of that year a meeting of physicians was held at Saratoga, and definite action was taken to enlist the cooperation of the physicians of the adjoining counties of Washington and Montgomery, "in vigorous measures for the suppression of empiricism, and the encouragement of regular practitioners." The resolution adopted also recited that "the evil calls loudly for the united efforts of all who sincerely wish to remove from that valuable science (of medicine) the imputation of quackery, under which, from the ignorance of some of its professors, it not unjustly labors." Drs. William Patrick, John Sterns and Grant Powell were named as a committee to forward the purposes of the resolution. On January 16, 1806, at another meeting, a memorial to the Legislature was adopted, and Drs. Asa Fitch of Washington County, John Stearns of Saratoga county and Alexander Sheldon were constituted a committee to present it. Dr. Sheldon, by the way, was Speaker of the Assembly.
At first, the thought was only to secure legislation to regular practice in these counties, but, as the question developed in the House, it was deemed wise to make the cause general and extend the legislation so as to embrace the whole State. A powerful opposition developed, a "grave danger to which the State would be exposed by the incorporation of forty distinct associations of physicians" being pointed out. Nevertheless, the "Act to Incorporate Medical Societies for the Purpose of Regulating the Practice of Physic and Surgery in this State" was passed on April 4, 1806. By its powers, each county was to organize a medical society which should have the power of licensing practitioners within its own political division, but the State Society was to be given the power to override the action of a country society, and license a candidate whom the latter had rejected.
This was the first legislative recognition of a medical society in the United States; and it obviously affected the medical society in New York City. Although the latter had for many years been known as the Medical Society of the State of New York, it would hardly take unto itself the charter of the State Society provided for in the act, inasmuch as its membership was confined to New York City. Possibly this impending legislation had had no connection with the resolution of the New York body, in 1805, to transfer its somewhat large medical library to the New York Hospital, but it is clear that immediately after the passage of the act, in April, 1806, the New York Society took prompt steps to determined its own status. By the middle of April, the New York City practitioners "though with many misgivings: had determined "to abide by the law." This meant that the New York City society must shrink to county status, and combine with any other medical society of New York county, so as to organize one medical society for that political division. But definite final action was not taken until July. On June 28, 1806, at a meeting of the old Medical Society of the State of New York, according to the entry in the minute-books of that body:
The law passed by the Legislature April 4, 1806, entitled, An Act to Incorporate the Medical Society of the State of New York, for the regulation of the Practice of Physic and Surgery in this State; being duly considered, it was determined by a majority of the Society, that although many parts of the above Act were highly objectionable, still that, under all circumstances, the profession might be benefited by a meeting of the members of this Society with the other physician of this City at the time and place appointed by law.
There seems to have been only one other medical society in New York City at that time--the Physical Society, of which Dr. James S. Stringham was president in 1804, in which year he was admitted into the membership of the Medical Society of the State of New York also. The minutes of the latter society for the year 1803 show that an effort was then made to get the State to pass a law "regulating the practice of physic and surgery, or a law of incorporation"; but this was unsuccessful, and the New York Society had no corporate existence in 1806, when the act, authorizing the creation of forty such local bodies was, at the instigation of the Saratoga group, passed. So the inevitable had to be faced. Hence, we find that, at an ordinary meeting of the Society of the State of New York, on July 8, 1806, "the Society considered that, under existing circumstances, it was necessary that the name of this institution be changed." So the original Medical Society of the State of New York passed out of existence. However, the new society, the New York County Medical Society began its career, with some justification for claiming to be "the oldest medical organization in the State of New York."
This legislation, which placed the regulations of practice absolutely in the hands of the organized medical profession of the State, was not perfect, but it was a beginning in the right direction. Unfortunately, there were several forced at work, striving to change the direction. Dr. Floyd Crandall, in 1917, #11 called attention to the three forces which, during a century from 1806, contended for control of the power to license. There were first, the organized medical profession; second, the medical colleges; third, the State of New York, acting through the regents of the university. Strife is not conducive to progress, for not even by a century of effort have we succeeded in ridding the State of quacks.
The Act of 1806 made inability to collect fees by action at law the only penalty of practicing without license. In 1807, by an amendatory act, unlicensed practitioners were penalized five dollars a month for every illegal practice; but some of the article sand sections of the 1807 legislation read like the riders of modern politics. Any person administrating medicine who did not "follow the practice of medicine as a profession" incurred no penalty. This enabled apothecaries to prescribe at their pleasure; and the unlicensed practitioners might, and did, open drugstores, over whose counters they might prescribe. Traveling quacks might trumpet their nostrums almost with impunity, for it would not be hard for them partly to fill their time with other work. The last clause of the bill provided "that nothing in the act was to be construed to debar any person from using or applying, for the benefit of any sick person, any roots or herbs, the growth or product of the United States." This permitted a horde of herbalists, "botanic practitioners," as they preferred to cal themselves, to practice, almost with endorsement by the State. Improvements in legislation did not necessarily follow the detecting of flaws: indeed, a revision of the law, in 1813, omitted all penalties for practicing with authority. Such is the uncertain and inexplicable way of politics.
For some years before the great change which came with the Act of 1806, Dr. Romayne had been in London. He was undoubtedly one of the most skillful of American physicians. His ability was recognized in England. He was esteemed by London practitioners, and the Royal College of Edinburgh recognized his professional merit by conferring upon him a fellowship. This was a marked distinction, for no other American had had that honor, so when Dr. Romayne returned to New York he was looked up to still more. He became first president of New York county society, in 1806, and had considerable influence in the State body. Through the latter, also, he became influentially intimate with the regents.
Dr. Romayne's preeminent place in organized medicine in New York State at that time brought interesting action. During his first year as president of the Medical Society of the county of New York it occurred to him and his associates that New York City was not satisfactorily meeting the needs of medical students. It also may have occurred to them that the group of medical men who constituted the Country Medical Society might regain much of the former State prestige as an association by pursuing a certain quite commendable line of action. It also may have occurred to Dr. Romayne that here was an opportunity of renewing the fight with his old rival, Dr. Samuel bard, and with Columbia College. At all events, the members of the Medical Society of the County of New York appointed Dr. Romayne to act as its representative, or delegate, on the State Society, and also, in February, 1807, named him as their delegate, for consideration by the Legislature if approved by the regents. This memorial set forth the desire of the members of the New York County society "to promote the progress of medical knowledge," and give "encouragement and protection" to the pursuit of medical science. They were firmly convinced that "their usefulness would be extended in promoting the public good and the improvement of their profession," if they, the medical society of New York City and county, were incorporated as a college, of course, "under the direction, inspection and patronage of the Regents of the University."
This admirably planned promotion was promptly favored by the regents, and on march 12, 1807, the 139 members of the Medical Society of the County of New York were incorporated as the college of Physician and surgeons of the University of the State of New York. It was an extraordinary medical society and an extraordinary college corporation, for by the charter of incorporation "all the members of said society, and all the physician authorized to practice in said city" were declared to be "trustees or members of the said college." In other words, it swept into the new corporation--at least as trustees--all the faculty of the Columbia College Medical School, and at once established itself as representative of all of New York medicine. It is not wonderful, therefore, that the College of Physician and Surgeons began its first year with an enrollment that augured well for the future. With the whole medical fraternity at its back, it seemed that the new college could hardly fail to cripple the old; e. g., that Dr., Romayne's school could hardly fail to draw almost al the strength from Dr. Bard's.
The members of the medical society, in their college capacity, were empowered to elect annually the college president, vice-president, registrar, treasurer, and censors, and be responsible for the business affairs of the institution. To the regents of the university, however, was reserved the right to appoint the faculty and confer degrees. It was found that such a large body of business managers made an unwieldy business; it was also thought unwise that the executives were required to stand for election annually. So, before the end of the first year the regents were brought to see that some amendment of the charter was "important to the stability and usefulness of the institution.' So it came to pass that legislation was secured, making it impossible that Dr. Romayne's place as the president of the college could not be disturbed by a possible change of affiliation in the groups of medical men who constituted the college board of trustees. By the amended charter, the regents took over the appointment of the faculty, and reduced the board of trustees to a more practical number of physician who would promise to "faithfully execute the several duties required of them." The faculty, elected by the trustees in 1807, consisted of: Nicholas Romayne, M. D., president and lecturer on anatomy; Samuel L. Mitchell, M. D., vice-president, and professor of chemistry; Edward Miller, M. D., professor of the practice physic and clinical medicine; David Hosack, M. D., professor of materia medica and botany, and lecturer on surgery and midwifery; Archibald Bruce, M. D., registrar and professor of mineralogy; Benjamin de Witt, M. D., Professor of the institutes of medicine and lecturer on chemistry; John Augustine smith, adjunct professor on anatomy. The last named was entitled to the letters M. R. C. S., being a member of the Royal college of Surgeons, of London. He came from Virginia to accept the appointment in the college of Physicians and Surgeons. Subsequently, the latter conferred upon him the honorary degree of M. D. All other members of the original faculty were New York men. Only one change was made by the regents, in 1808, when they appointed a faculty, in accordance with the amended charter. Dr. Hosack was dropped, and William James MacNeven, M. D., was appointed professor of obstetrics and the diseases of women and children.
The College of Physicians and Surgeons began its first course of lectures on November 10, 1807, in "a commodious building," No. 18 Robinson Street, "a short street extending west from Broadway and forming a portion of what is now Park Place." Fifty-three students were enrolled and, by arrangement with the New York Hospital, the student had the privilege of clinical instruction in that institution, under Dr. Miller. Seventy-six students attended the session of 1808. The term was of four months' duration. Five lectures were given each day, some of the professors attending each day and other four times each week. From twelve to one o'clock, the students attended clinics at New York Hospital, or Dr. MacNeven's clinics at the Almshouse on Chambers Street. There was every indication that the college was giving instruction of high standard, and that the faculty was laboring indefatigably, without heed of remuneration. Indeed, the faculty seem to have had no monetary recompense for their services, for of the total expenditure of $2,650 during the first year, $800 was for rent, $730 for furnishing the building, and the balance of $1,120 was absorbed mainly by the purchase of anatomical material, chemical apparatus, and the like. In 1809, eighty-two students were enrolled. The original quarters on Robinson Street were no longer suitable. So, in November of that year the property of the college was removed to a larger home on Magazine Street. It was necessary for the faculty--who seemed now to be the main pillars of the institution--to pledge their personal means to effect this change, Dr. Romayne pledging his credit to the extent of $5,000, and Drs. Miller and Bruce pledging other sums to secure the Manhattan Bank in a liability of $8,000. Notwithstanding this loan, it seems that the Magazine Street property, a two and half storied dwelling house, was at the outset able to afford " only a few benches and a table for the professors." Dissection work was done in the attic.
Apart from the handicaps of limited means, the college seemed to be doing well. In fact, according to a pamphlet, #12 published in 1813, anonymously, but attributed to Dr. David Hosack, "the success of the College during the three years of its establishment" (1810) "exceeded the most sanguine expectations." But all was not well. There were such differences of opinion between the president, Dr. Romayne, and some of the professors, that the latter finally withdrew. The outcome was that the enrollment was reduced to one-third. The situation called for prompt action by the regents. It was no consolation to realize that, although the College of Physicians and surgeons was temporarily under a cloud, the medical school of Columbia College had not graduated a single student since 1807. Neither did it seem likely that the College of Physicians and Surgeons on the Western District of the State of New York, a small medical school which had been founded in 1809 by the trustees of Fairfield Academy, Oneida county, could meet the requirements of the State, in case the two New York City colleges should succumb. New York City was the logical medical centre. So the regents, "with the same laudable zeal for the promotion of medical science with which they had originally organized the establishment" sought to remedy the fault in the functioning of the New York College of Physicians and Surgeons. They appointed three judges of the Supreme Court to inquire into the nature of the controversy, and advice them. Accordingly, on April 1, 1811, these judges reported that the misunderstanding between the professors had so impeded the operations of the college that "unless something effectual be done by the regents, it will become degraded in the estimation of the public and its usefulness will be inevitably destroyed." This judicial committee recommended that the faculty of the College of Physician and Surgeons be improved by the inclusion of several professors of the medical school of Columbia College, " and other eminent and distinguished men." They hoped that their action would bring about an amalgamation of the two medical schools, which merger they pronounced to be of first importance, as assuring the assembled in one institution of "a splendid collection of medical and surgical talents."
So it came about that a supplementary charter was formulated, and on April 1, 1811, granted, vesting the government of the College of Physicians and Surgeons in a board of twenty-five trustees. On the same day, the regents, by unanimous vote, elected the following faculty: Samuel Bard, M. D., president; Benjamin de Witt, M. D., vice-president; John Augustune Smith, M. D., David Hosack, M. D., William J. MacNeven, M. D., Samuel L. Mitchell, M. D., professors; John D. Jaques, treasurer and John W. Francis, registrar. This marked the exit of Dr. Romayne from the affairs of the college of Physicians and surgeons, the ousted Dr. Hosack, who had gone over to the Columbia faculty, returning with Dr. Bard. Dr. Romayne was, it seems not even to have the privilege of graduating the fist class of the college he had founded. The first Commencement was held on May 15, 1811, a procession forming at city hall and proceeding to the Brick Presbyterian Church, where the ceremony was held. There were eight graduates, #13 and upon each diploma was the signature of Samuel Bard.
At the end of the next school year, the regents observed that the college presented "a fair prospect of speedily rising to a state of usefulness and celebrity." In the next year, the building on pearl (formerly Magazine) Street was vacated, and warehouse at No. 3 Barclay Street was purchased for the college, its finances now being on a sounder basis, inasmuch as the State Legislature had made the college a beneficiary in the "Literature Fund Lotteries," to the extent of $20,000. The future was even better assured by the approval of the regents, in 1814, to the plan of the union of faculties of Columbia College Medical School and the College of Physicians and Surgeons. By this re-organization, the college of Physicians and Surgeons was represented in the new faculty by five members---Drs. DeWitt, MacNeven, Mitchell, Smith and Francis--and the Columbia College Medical School by six members--Drs. Bard, Post, Hammersley, Osborn, Stringham and Mott. The twelfth member of the faculty was Dr. Hosack, who was of both institutions.
New York was now well on the way to recovery of some of its provincial prestige as a centre of medicine, but she had fallen far behind Philadelphia. The re-organized New York Medical School opened in 1814 with an enrollment of seventy, but, as Dr. John C. peters pointed out quite dolefully, Philadelphia at that time possessed more then ten times as many medical matriculants, and had no less then four medical colleges. However, despite opposition by the Romayne faction, the college of Physicians and Surgeons prospered, each year bringing an increased enrollment, until, in 1820, the regents were able to report the college to be "in a state of rapid improvement" with a roll of students exceeding 200, some coming from "most distant parts of the Untied States." Much of this substantial progress was due to the professional And executive ability of Dr. Samuel Bard, the college president, "who commanded respect throughout the country."
This enviable standing of the school had not been won without effort. A disgruntled faction of the Medical Society of the County of New York had made matters somewhat difficult for the faculty. At the time of the re-organization of the College of Physicians and Surgeons, when Dr. Bard displaced Dr. Romayne, an attempt was made to form a rival college, again under the sponsorship of Rutgers college. This had not effect on the College of Physicians and Surgeons, but a more serious attack developed in the next decade. In 1822, the regents were called upon to consider complaints made against the faculty by the Medical Society of the county of New York. The charge was that the faculty conducted the affairs of the college in an autocratic manner, "in entire disregard of the body whence it had sprung"; indeed, it was charged that the college "had become a source of exclusive privileges and immunities, the faculty being the chief beneficiaries, the professors benefiting from the exaction of increased fees for tuition." The complainants granted diplomas after having attended lecture for two years, and in some glaring instances without attendance at all at lectures, such laxity admitting into practice men who were in "a state of wretched unpreparedness." The State and County medical societies joined in petitioning the regents to re-organize the college, forbidding the professors to continue as trustees, and making other changes which would bring the college more fully under the direction of the State and county societies.
This petition influenced the regents to rule that thereafter no professors should be elected to the board of trustees, also that a candidate for the medical degree should have studied for three years under a respectable practitioner and have attended a full course of lectures for not less then two winter sessions. They did not remove any of the professors who were then trustees, and at future elections the president and vice-president were to be always trustees, ex officis.
The History of New York State, Lewis Historical Publishing Company, Inc., 1927
This book is owned by Pam Rietsch and is a part of the Mardos Memorial Library
Transcribed by Holice B. Young
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