PHILIP CASH

The Professionalization of Boston Medicine, 1760–1803 *

THE professionalization1 of Boston medicine during the last half of the eighteenth century (1760–1803) went through three distinct periods. The first of these was the pre-Revolutionary or imperial phase (1760–1775) during which the drive toward greater professionalization of medicine in the New England metropolis quickened considerably but, unlike the younger, larger, and economically more dynamic New York and Philadelphia, produced no institutional results.2 This was followed by the highly disruptive Revolutionary period (1775–1780) which drastically altered both the composition and leadership of Boston’s medical community and the context in which the professionalization of Boston medicine would find institutional fulfillment. Lastly came the post-Revolutionary or national stage (1780–1803), the time in which both the institutional foundations of medical professionalization in Boston and the social context within which they would operate for the next three generations were firmly laid. This period began with an intense burst of institutional creativity (1780–1783), followed by an interval of adjustment and slackened pace (1784–1796), and then ended in another spurt of creative activity (1796–1803).

The number of trained doctors or what I term “physicians” in Boston rose from about fourteen in 1760 to around twenty-one in 1775,3 even though the city’s permanent population remained stable at between 15 and 16,000, and its economy generally was depressed.4 This fifty-percent increase in the number of physicians in the face of adversity intensified medical competition and heightened a sense of common interests and aspirations among the regularly prepared practitioners.5 It also accelerated the reduction of Boston’s apothecaries, midwives, and other medical practitioners to clearly subordinate and supportive medical roles. What is more, it made unlikely the repetition of a medical career such as that of Joseph Pynchon, who retired in 1760 as one of the city’s most eminent medical figures. Pynchon, scion of one of Springfield’s leading families, prominent political personage, and Harvard overseer, had received no formal training but simply began practicing during his free time while serving in the General Court and, despite such archaic therapy as his centipede soup, developed a large, well-to-do clientele.6

7. Dr. James Lloyd (1728–1810). From James Thacher, American Medical Biography (Boston, 1828). Courtesy Boston Medical Library.

8. Dr. John Warren (1753–1815). Early nineteenth-century lithograph after the portrait by Rembrandt Peale. Courtesy Boston Medical Library.

9. Anatomical lectures attendance certificate, engraved by Paul Revere in 1780. Israel Keith (c. 1749–1819) graduated from Harvard College in 1771, a year after Warren, and was practicing law when he attended Warren’s lectures. Courtesy Massachusetts Historical Society.

10. Front page of The Boston Independent Chronicle and the Universal Advertiser for 18 September 1783, describing the organization of a Medical Institution by the Harvard Corporation and the appointment of its first three professors. Courtesy Boston Medical Library.

11. Holden Chapel, Harvard College, Cambridge. Built in 1744, it was used for medical instruction from 1783 to 1810. Courtesy Harvard Medical Archives.

12. Holden Chapel, Harvard College, Cambridge, today. Courtesy Harvard Medical Archives.

13. Massachusetts Medical College, Mason Street, Boston, seat of the Harvard Medical School from 1816, five years after it first moved to Boston, until 1847, when it moved to North Grove Street near the Massachusetts General Hospital. Courtesy Boston Medical Library.

14 (facing page). A Plan of Boston from Actual Surveys, by Osgood Carleton, a copperplate engravin of 1796. The dots locate the offices or homes of the twenty-four physicians who practiced there in 1789, according to the accompanying Appendix II. At that time they were concentrated chiefly in the center of the north-south town axis, and not in either the equally well populated North End or in the dockside commercial areas. Ten years later, when there were thirty-one physicians in Boston they were more evenly distributed through most areas of the town. Map courtesy Massachusetts Historical Society.

Between 1760 and 1775 the total number of physicians who ministered to Boston’s needs was around twenty-eight. Of these, thirteen had received formal training above the apprenticeship level. All thirteen had studied in Europe and twelve had walked the wards of one of London’s great hospitals and attended one or more of the city’s justly famous courses in anatomy, surgery, and obstetrics.7 However, only three, or possibly four, had bothered to earn a medical degree.8 This heavy emphasis on London9 and the clinical-practical aspects of medicine contributed to the relatively uniform, generally pragmatic, and basically conservative nature of Boston medical practice of this time. It probably also contributed to the limited interest that Boston physicians of this period showed in medical theory and scientific investigation as compared with those in other colonial urban centers.10 However, economic and political considerations were also important.

Unlike the other major colonial ports, Boston was noted for the homogeneity of its permanent inhabitants, and its medical community was no exception. Of the forty-seven physicians who practiced in Boston between 1760 and 1798 listed in Appendix I, all but four were New England born of English stock.11 True, there were also several French and German doctors listed in the Boston directories of 1789, 1796, and 1798, but they seem to have been on the periphery of Boston’s medical world. A majority of Boston doctors of this era could trace their ancestry back to the Puritan migration of 1630–1680. Despite important religious (Anglican-Congregational) and political (Tory-Whig, Federalist-Jeffersonian) divisions, this strong pattern of cultural similarity and localism was central to Boston medicine throughout the second half of the eighteenth century and indeed much of the nineteenth as well. However, the situation had been different during the first third of the eighteenth century, when a smaller fraternity of trained medical men in Boston was greatly influenced by such foreign-born doctors as John Cutler from Holland, Lawrence Dalhonde from France, and William Douglass from Scotland.

By 1760 Boston not only had a solid corps of physicians, but also two controversial issues to bring them together and heighten their common awareness. These issues were the establishment of inoculation hospitals and the acceleration of the integration of normal deliveries as well as extraordinary obstetrical cases into the regular practice of the physician. Of the two, the establishment of inoculation hospitals was by far the more pervasive, controversial, and immediately important. In the four decades since smallpox inoculation first had been introduced to Boston amidst savage controversy, the community had worked out a compromise procedure whereby the traditional and usually successful quarantine system would be the town’s first line of defense. When it broke down, as it did in 1730 and 1752, open inoculation would be allowed for a specified interval. The chief arguments against inoculation at this time were the very valid ones that it was beyond the means of a substantial portion of the population and that it was highly dangerous. However, by 1760, improved inoculation methods, impressive statistical evidence of its effectiveness, and the promise of great profits, as well as the appearance of permanent inoculating hospitals in other colonies, made Boston physicians extremely anxious to establish them in or near New England’s premier urban center.12

In both 1761 and 1763 well-established and well-connected members of the Boston medical fraternity attempted to set up inoculating hospitals, but they were rebuffed.13 However, the smallpox epidemic of 1764 witnessed two important breakthroughs in Boston’s attack on this dreaded killer. One was the agreement of the city’s physicians to inoculate the poor gratis, a significant manifestation of increased professional responsibility and cooperation.14 The other was the establishment for the first time in the Boston area of public inoculation hospitals at Point Shirley and Castle Island. This development also benefited greatly from the strong and apparently unanimous support of the city’s physicians.15 During this epidemic eighty-seven percent of those who contracted smallpox did so by inoculation, and for the first time a smallpox year failed to stand out in Boston’s bills of mortality.16 Still, despite continued lobbying by Boston physicians, who were greatly encouraged by their recent successes, permanent inoculation hospitals continued to be banned in and around Boston until after the outbreak of the Revolution.17 Just how powerful the lure of progress and profits was during the interval between the smallpox epidemic of 1764 and the opening of the War of Independence is illustrated by the fact that on 30 July 1774, less than ten months before Lexington and Concord and with Massachusetts in virtual rebellion, Joseph Warren, a leader of the radical Whigs, and Samuel Adams, Jr., his recent apprentice and son of Massachusetts’s leading radical, joined with Thomas Bulfinch, Jr., a political trimmer, and James Latham, a British army surgeon, to sign a twenty-one-year contract to build an inoculation hospital at Point Shirley, if the town of Chelsea would assent to it. Warren, Bulfinch, and Latham also entered into another twenty-one-year partnership for erecting one or more inoculating hospitals in the other colonies from Pennsylvania northward.18 The movement by Boston’s physicians to take much of the town’s potentially lucrative normal obstetrical practice away from the midwives actually began with James Lloyd in the 1750’s, but it was in the 1760’s that his example and rationale for greatly constricting the role of midwives began to have considerable effect, especially among his students.19 Lloyd’s fees at this time indicate that midwifery could indeed be profitable. He charged £1.8s. for normal and £4 for difficult deliveries. By comparison, he charged is.4d. to extract a tooth, 3 to 6s. for a visit or to change a dressing, and £4 for an infrequent capital operation.20

The 1760’s also witnessed a quickening impulse toward the improvement of medical education throughout British North America, and Boston was no exception, although here it did not result in the founding of a medical school as it did in Philadelphia. In Boston the most immediate effect was to be seen in the expanded use of a more organized, broadened, and sophisticated method of training medical apprentices and pupils. This included the encouragement of a step-by-step study of medicine, usually beginning with anatomy and ending with physic and a smattering of other sciences, a greater emphasis on reading both basic and recentmedicalliterature, and the employment of at least an occasional lecture making use of aids such as charts, illustrations, models, skeletons, and anatomical preparations. Admittedly, the roots of this movement go back at least to Silvester Gardiner in the 1740’s, but it was not until the 1760’s, when James Lloyd and his protégé, Joseph Warren, rose to preeminence among Boston’s medical preceptors, that these improvements became well established. Between 1760 and 1775 these two trained ten—or better than one-fifth—of Boston’s physicians of the era 1760–1790, including such leaders as John Clark vi, William Eustis, John Jeffries, Lemuel Hayward, Isaac Rand, Jr., David Townsend, and John Warren.21 What is more, their other students, like Ebenezer Allen, Isaac Foster, Jr., Peter Oliver, Jr., Jonathan Norwood, and Theodore Parsons, distinguished themselves elsewhere. Undoubtedly, Lloyd’s and Warren’s efforts benefited greatly from the large number of European trained physicians in Boston at this time, the stiff competition, and the area’s fine system of public education.

A very fruitful insight into the Boston medical-political dialectic of the Revolutionary era can be gained by comparing the students of Lloyd and Warren. All were Harvard graduates. None of Warren’s went on for further medical education, while four of Lloyd’s went to Europe, and Jeffries earned an M.D. All of Warren’s were strong Whigs, and at least five served in the Continental Army, while Lloyd’s were politically divided, with three serving with the British forces and one with the Continental Army.

In addition to the work of Lloyd and Joseph Warren, there was a serious attempt by others in the Boston medical community during the decade before Lexington and Concord to deal with the most crucial defect of the apprenticeship system, the shortage of cadavers for the direct study of the human body.22 In 1765, 1768, and 1774 public lectures on anatomy, making demonstrations on a cadaver, were offered by William Lee Perkins, Benjamin Church, Jr., and John Jeffries, three of New England’s most skilled surgeons.23 However, Jeffries was stopped after one lecture when a mob made off with his subject, an excellent example of the great danger and unpopularity at this time of this vital form of medical teaching.24 Because of this, it seems highly likely that anatomical study in Boston during this period was advanced by the occasional theft of a corpse. Another important manifestation of concern with improving anatomical study was the founding at Harvard in the late 1760’s of a semisecret student “Anatomical Society,” also known as the “Spunks” or “Spunkers.” This society seems to have received its inspiration from Joseph Warren, and his brother, John, was the club’s most important member, if not its founder. They owned a skeleton, discussed anatomical, physiological, and other medical questions, and dissected animals, chiefly horses, swine, dogs, and cats.25 Given the energy and daring of some of its members as well as that of Joseph Warren, their strongest outside supporter, they also may well have secretly dissected a cadaver or two.

Although no medical school was established in New England’s foremost city until 1782, there was considerable activity to bring about the establishment of one for well over two decades prior to this. In 1764, the Boston Post-Boy and Advertiser, commenting on the disastrous fire at Harvard on 24 January of that year which had destroyed most of Harvard Hall, including the library, noted that among the losses were:

a collection of the most approved medical Authors, chiefly presented by Mr. James, of the island of Jamaica; to which Dr. Mead and other Gentlemen have made very considerable additions; Also anatomical cuts and two complete skeletons of different sexes. This Collection would have been very serviceable to a Professor of Physic and Anatomy, when the revenue of the College should have been sufficient to subsist a gentleman in this character.26

Just how long and how seriously Harvard had been thinking of a medical school or professorship before this time is a moot point. A human skeleton and a preparation of the “human veins and Arteries filled with wax” had been presented to Harvard as early as 1748.27 At any rate, the losses due to the fire of 1764 were more than replaced within several years.28 However, the impression remains that the idea of providing some sort of advanced medical education did not attain an energetic focus until Ezekiel Hersey’s bequest of 1,000 Massachusetts pounds (750 pounds sterling) to support a professorship in anatomy and physic. This bequest was made in 1770 and received in 1772.29 After this, the Harvard Corporation began to move in earnest. At their meeting of 7 December 1772 the following resolution was passed:

That the thanks of this Board be given to the Revd. Dr. Erskine for his kind service in consulting Drs. Munro [sic] and Cullen on the subject of a Professorship of Anatomy and Physic at Harvard College and for transmitting their thoughts in so very obliging a manner as he has done. They also ask this further favor that he would express the grateful acknowledgement of the Board to the said gentlemen for the notice they have taken of the affair of a Professorship, and to acquaint them that Dr. Hersey’s bequest has lately been paid into the College Treasury. Vizt. seven hundred and fifty pounds sterling [.] That they hope for additions by donations as well as by interest [.] That benefactors are from time to time adding to the Medical Library and Anatomical preparations. That when the funds are sufficient to support a Professor and it shall be thought best to send abroad for one, particular attention will be paid to the recommendation from Edinburgh.30

This little-noted resolution seems to indicate that had not Massachusetts shortly become engulfed in the turmoil of war and revolution, Harvard would have instituted medical instruction on a formal basis well before 1782. It also suggests that medical teaching at Harvard, as was the case with Yale, would have begun with a single professorship within the college. What is more, medicine at Harvard, like that at the College of Philadelphia and King’s College at New York, would have had its start within a cosmopolitan imperial context rather than a self-consciously nationalist one. Furthermore, none of the original faculty could have played a role in the school’s founding, or probably its early history.

In the 1770’s Harvard was not alone in showing an interest in establishing a more advanced form of medical education in the Boston area. In late 1774 and early 1775, a recently arrived French “physician and surgeon” by the name of Dastuge (Dastugne, Dasturge) who claimed to have studied under “the best Professors in Physic and Surgery of the Royal Academy in Paris” and who said he had enjoyed “constant Practice in several Hospitals, both in France and the West Indies,” overflowing with ambition, naïveté, and brashness, issued a call in the Boston newspapers for the physicians and surgeons of the city to “meet and form a Corps, unanimously” and build a large amphitheater where medical instruction, especially in anatomy and surgery, could be given. Also, if properly encouraged, Dastuge would start a botanical garden and give lectures in botany and chemistry. Between 1777 and 1783 this irrepressible Gaul was in New York, where he placed a series of notices in the city’s newspapers advertising his skills as a surgeon, oculist, and dentist. In one of these notices he stated that he had attended the Hôtel Dieu and the Charité in Paris.31 That a market for advanced medical instruction existed in Boston at this time is well illustrated by the fact that at least seven of the forty eight members of the Harvard class of 1772 went on to become physicians.32

Curiously enough, despite their interest in furthering the development of professional awareness, Boston physicians seem to have played only a small role in the abortive attempt in 1765 to establish a colony-wide medical society.33 However, in 1768 members of Boston’s medical community may have supported an unsuccessful attempt to get a bill through the General Court requiring the examination of candidates for regular medical practice.34

With the shots exchanged between British regulars and Massachusetts farmers at Lexington Green the movement toward increasing the professionalization of medicine in Boston entered a new phase. Over the next five years the city’s permanent population fell from 16,000 at the beginning of the siege in April 1775 to less than 4,000 at its end in March 1776; it then climbed to approximately 12,000 by 1780.35 During this time Boston was wracked by inflation, profiteering, social dislocation, substantial population turnover, and, most melancholy of all, a long list of casualties.36 In 1775 the permanent population of physicians was around twenty-one. By 1776 it had fallen to about twelve.37 By 1780 it was up to at least fourteen.38 The city also experienced a kaleidoscope of medical men connected with the Continental Army and Navy, the state navy and militia, the numerous privateers, and possibly a few civilian doctors who resided there temporarily. In addition, the medical men connected with the French forces had a decidedly positive impact on Boston medicine. It almost certainly was one of these French doctors who gave John Warren his prized copy of Sabatier’s Anatomy. Another communicated to Samuel Danforth, the town’s leading student of chemistry, the advances his countrymen were making in that study. In June 1782 the Harvard Corporation voted to award one Monsieur de la Roche, a surgeon major in the French army, the honorary degree of Bachelor in Physic, although apparently it was never actually conferred. La Roche donated a copy of Bonmaris’s Dictionary of Natural History to the college library. The most influential of all these Gallic medical allies, though, was Jean Feron, “first surgeon and physician of the French fleet in North America and of the King’s hospitals in Boston,” who, in October 1783 was among the original honorary members elected to the Massachusetts Medical Society. Feron presented two anatomical preparations to the society and communicated to them three histories of remarkable skull fractures.39 He also read one of the first papers before that body, in July 1784. In addition, he performed a chemical analysis of the waters of the Boston peninsula at the request of John Warren, his warm friend, who was legitimately concerned about their salubrity.40

The siege of Boston which began the Revolution was not only a vital political, social, and military event in the city’s history, but also of great importance to her medical development as well. At the end of it there was a huge void in her community of physicians. Joseph Warren was dead, Benjamin Church, Jr., was a convicted traitor, Miles Whitworth, Sr., was in jail and soon to die of a fever contracted there, while Silvester Gardiner, John Jeffries, and Nathaniel and William Lee Perkins had gone into exile with the evacuating British forces. This loss amounted to about one-third of the physicians then practicing in Boston and much more than that in terms of talent, experience, and leadership. Such a gaping hole facilitated two somewhat contradictory developments. One was the rehabilitation, after a brief period of harrassment, of the town’s five remaining Tory doctors (Samuel Danforth, Thomas Kast, James Lloyd, James Pecker, and Isaac Rand, Jr.), for their skills were badly needed. The other was that it allowed younger Whig physicians, despite the fact that most of them served varying lengths of time in the service, to enter Boston practice and move rapidly up the ladder, exerting a far greater influence than they could have under pre-Revolutionary conditions. Indeed, most of them probably never would have become Boston physicians without the Revolution. These younger Whig medical men included Nathaniel Walker Appleton, Aaron Dexter, William Eustis, Lemuel Hayward, John Homans, David Townsend, and Thomas Welsh. However, the greatest beneficiary was the highly able and thoroughly ambitious John Warren, who was to be the dominant force in Boston medicine from the time of his return in the spring of 1777, to assume command of the Continental Army Hospital, until his death in 1815. Of course, being the brother of a war hero also facilitated his rise to prominence.

By 1780, despite five exhausting years of war and the fact that the cause of independence was as precarious as it ever had been, both Boston and its medical community were able to rejuvenate themselves to the point at which, over the next three years, there would be an explosion of social and institutional creativity. This included the founding of the American Academy of Arts and Sciences, the Massachusetts Humane Society, and the Massachusetts Charitable Society in 1780.41 In the first two of these, Boston medical men played important roles. Three other foundings involved what most physicians thought would facilitate professional medical development. These were the Boston and Massachusetts medical societies and the Harvard Medical Institution.

The Boston Medical Society was founded in May 1780. It was composed of all the physicians of the city, both Whig and Tory, save Thomas Bulfinch, Jr., who declined membership but supported the society’s goals.42 The initial purpose of this new medical body was economic. It established a fee table which, with adjustments, lasted until the twentieth century. The following year its members agreed to insist upon immediate payment in obstetrical cases.43 It was also to this society that John Warren first turned with his scheme for providing Boston with advanced medical instruction.44 He pointed out to his fellow members that there were nearly a dozen medical apprentices and pupils within the town and that some sort of medical school should be established to meet their needs. Undoubtedly certain of being appointed the instructor in anatomy and surgery, he suggested that the influential Samuel Danforth teach materia medica and chemistry, a logical choice since he was the local physician most familiar with chemistry, although his knowledge was still quite limited, and that the learned Isaac Rand, Jr., teach the theory and practice of physic. Danforth and Rand, both of whom were Tories and highly suspicious of Warren, refused. However, although he failed in his initial attempt to get a medical school, this incident well illustrates Warren’s imagination, drive, and political skill. What is more, the society did sponsor Warren’s first public anatomical lectures, given in the winter of 1780–1781.

The Boston Medical Society also was the parent of the Massachusetts Medical Society in that its members were the original petitioners for its incorporation when the bill was presented to the state legislature in May 1781.45 By the time the bill was enacted on 1 November, they had been joined by the newly arrived Aaron Dexter and sixteen prominent physicians outside of Boston to form the thirty-one incorporators of the Massachusetts Medical Society.46

This society, which was patterned after the British model in being composed of fellows and licentiates, had three major early goals.47 In keeping with the injunction in its charter, it was to examine candidates for practice in physic and surgery, and to award certificates of approval. They did not “license” medical practitioners in the sense of excluding all others but, again in the British tradition, tried to distinguish between those they considered well qualified and those they considered to be less so or not at all. Secondly, the society sought to promote and disseminate medical and scientific knowledge. This they did through a lively and extensive correspondence both in America and abroad, the accumulation of a fine library,48 and, eventually, the publication of the Society’s Communications. Lastly, they worked to achieve a sense of collegiality and good will among their members. In all of these areas the society inevitably was subject to difficulties and disappointments, but in all they were fundamentally successful.

Two other aspects of the early Massachusetts Medical Society should also be noted. One is that, until its reorganization in 1803, it was almost totally dominated by the Boston medical community. Better than two-thirds of its executive officers, counselors, and censors were Bostonians.49 Its meetings were held in Boston, as were its examinations, and its library was there. The other is that the city’s five Tory physicians, all of whom had been founders, played particularly influential roles in the society. Danforth and Rand, Jr., became its presidents, Pecker the first vice president, and Kast a treasurer.50 Lloyd presented the Society’s bill of incorporation to the legislature, helped to draw up its first bylaws, served on the original board of counselors, and was an aggressive censor.51

Unlike the Boston and Massachusetts medical societies, the Harvard Medical Institution was an exclusively Whig affair. It was also, as Benjamin Rush observed, the first medical school to be established within a national rather than an imperial context.52 All three of its original faculty—Aaron Dexter, John Warren, and Benjamin Waterhouse—were staunch Whigs. Of the three, only Waterhouse had had any formal medical education above the apprenticeship level, and only Waterhouse had enjoyed a European medical experience. However, Dexter had seen some, and Warren considerable, military medical service, a common and beneficial form of auxiliary medical training in eighteenth-century America, with its opportunities to encounter a wide range of diseases and surgical problems, to broaden one’s social and medical outlook by coming into contact with more experienced and better-trained doctors, especially those from Europe, and to work in hospitals. Twenty of the forty-seven Boston physicians listed in Appendix I (forty-three percent) had had military medical experience. All three of these men were to have long careers on the Harvard medical faculty. Waterhouse served for twenty-eight years, Warren for thirty-three, and Dexter for thirty-four. This gave the early years of the Harvard Medical Institution both stability and a sense of continuity. Another stabilizing influence during the early years of the Institution was the tight control the Harvard Corporation exerted over it until it moved out of the college and over to Boston in 1810.53

As is well known, among the three original members of the faculty of the Harvard Medical Institution, Waterhouse was odd man out.54 There were many reasons for this. He was something of an outsider from the beginning, being from Rhode Island and raised a Quaker. Furthermore, while Dexter, Warren, and most of Harvard embraced the cause of high Federalism, Waterhouse moved in the opposite direction, going from moderate Federalism to ardent Jeffersonianism. What is more, there was widespread jealousy over the Rhode Islander’s superior education, which he never ceased to flaunt. Most important of all, though, were Waterhouse’s abrasive and combative personality and the fact that he had spent the Revolution traveling and studying in Europe while Dexter and Warren were at home fighting for the holy cause of independence. Still, even taking into account Waterhouse’s eventual dismissal in 1810, internal quarreling during the early years of the Harvard Medical Institution was really quite limited in comparison to that in most of America’s early medical schools.55 The really serious problems facing the Institution during its Cambridge years (1782–1810) were securing adequate numbers of both cadavers and “teaching patients,” and these were never overcome.56

The two men immediately responsible for the founding of the Harvard Medical Institution were John Warren and the recently installed President Joseph Willard, who as a youth had contemplated becoming a physician and who throughout his life remained a frustrated scientist.57 The second of Warren’s three sets of anatomical lectures given between 1780 and 1782 proved to be the prime catalyst.58 As mentioned before, these were sponsored by the Boston Medical Society and were given at the Continental Army Hospital during the winter of 1781–1782. They were surprisingly public and were attended not only by physicians and medical students, but by a number of laymen as well, including President Willard and other members of the Harvard Corporation and a few Harvard students. Following these lectures Willard arranged to have Warren draw up a plan for a medical school, and then secured its acceptance by the Harvard Corporation and Board of Overseers. Following this, Warren, 29, was appointed Professor of Anatomy and Surgery; Waterhouse, 28, Professor of the Theory and Practice of Physic; and Dexter, 33, Professor of Chemistry and Materia Medica.59 These men were inducted in October 1783, and their inaugural lectures were delivered on the first Friday in December of that year.60 Dexter’s lectures on chemistry were the first offered on that subject in New England.61 In 1788 Waterhouse began a senior elective course on natural history (biology and mineralogy), the first systematic treatment of these subjects at Harvard.62 He also established a mineralogical and zoological cabinet and a botanical garden. Both men’s efforts illustrate the large role played by physicians and medical schools in early American science.63

In the twenty years following the Revolution Boston first underwent a serious depression, lasting until 1787, and then enjoyed her first significant economic, physical, and population growth in well over a generation.64 Her permanent population, which had been around 12,000 in 1780, rose to 18,320 by 1791 and to 24,937 by 1800.65 Between 1780 and 1789, when the first Boston Directory was published, the number of Boston physicians rose from fourteen to at least twenty-four, an increase of seventy percent.66 Over the next decade, with continued prosperity and population growth, the number of physicians increased by another thirty percent. The Directory of 1796 listed twenty-six, and that of 1798, thirty-one.67 Of the physicians who entered practice in the city between 1780 and 1798, apparently only two had studied in Europe.68 However, during the same period, five new physicians, three of whom were to have impressive careers, were graduates of the Harvard Medical Institution.69 In addition, Amos Windship, a veteran practitioner and versatile scoundrel, also earned an M.B. degree there in 1790.70

Between 1783 and 1796 the dominant theme of Boston medicine was that of conflict and adjustment to the new institutional-professional milieu which had been created so rapidly. There were two important manifestations of this. One was the successful effort in 1784 of the Boston Medical Society to deny students of the Harvard Medical Institution access to the infirmary at the Boston Almshouse and to kill a bill which would have allowed Harvard to establish a public infirmary in Cambridge.71 The other was a two-pronged struggle between Harvard and the Massachusetts Medical Society.72 The first issue involved the right of the Harvard Medical Institution to issue certificates of approval to her students prior to their receiving a degree, a procedure which Harvard quickly abandoned upon protest by the Medical Society. The other, more difficult, issue involved a decade-long struggle over the right of the Medical Society to examine and certify Harvard medical graduates. This quarrel eventually resulted in an agreement whereby either a certificate of approval by the Massachusetts Medical Society or a medical degree from the Harvard Medical Institution would constitute a duly qualified physician. Actually, not until 1803 did the legislature recognize that a Harvard medical degree was the equivalent of a certificate of approval.73

One other event of this period also should be noted. In 1786 James Lloyd sent his former student and present associate, John Clark vi, to London to study midwifery and to collect appropriate instruments and teaching devices in order that he might lecture on the subject when he returned.74 At this time, and for many years thereafter, the only regular obstetrical instruction at the Harvard Medical Institution was a lecture in midwifery in Warren’s anatomy course.75 Unfortunately, Clark gave only one set of lectures before he died.76 It is interesting to conjecture what might have happened had Clark been able to establish at this early date a successful tradition in Boston of private medical courses wholly independent of Harvard. Certainly Boston medicine would have been more interesting. Probably it would have been less successful.

By the middle 1790’s Boston medicine had achieved a new synthesis based on the Harvard Medical Institution and the Massachusetts Medical Society, and between 1796 and 1803 the city underwent another period of medical creativity. In 1796 the Boston Dispensary was established, the third such institution in the country.77 Here free medicines and medical advice were given by selected physicians to the sick among the “worthy” poor who had been recommended by subscribers; the whole operation was supervised by a lay board of trustees. In 1799, a Board of Health was formed as a direct result of the yellow fever epidemic of the previous year.78 This Board, elected by ward annually, consisted of twelve respected citizens from varied economic and political backgrounds. In 1802 the Board of Health, Benjamin Waterhouse, and the leading physicians of Boston, after winning support at a town meeting, combined to conduct one of the most sophisticated and successful human experiments in American medical history to demonstrate conclusively the efficacy of vaccination.79 On 16 August of that year nineteen volunteer boys, including two sons of members of the Board of Health, were vaccinated before the Board at their office. A week later the participating physicians examined them and declared them to be “fit subjects” for the ensuing experiment. A temporary hospital was built on Noddle’s Island and, after some difficulty, fresh smallpox matter was obtained. Then, on 9 November, twelve of these boys, plus the son of Dr. Josiah Bartlett, who had been vaccinated two years earlier, were inoculated along with two unvaccinated youths. All were lodged in one room, given no medicines and allowed to follow, insofar as possible, their normal life style. The unvaccinated boys contracted smallpox and suffered heavily. The vaccinated ones did not. Then the thirteen vaccinated boys were inoculated again, along with the seven vaccinated volunteers who had not been inoculated previously. All remained in the single room with the two smallpox sufferers. Still none of them came down with the hated malady. Finally, in mid-December, a description of this experiment along with a strong endorsement of vaccination by eleven of the participating physicians, all of them distinguished and influential, was published by the Board of Health in a broadside. The same year a short-lived but initially busy vaccine institution was set up to serve the city’s poor and assure a fresh supply of vaccine.80 Finally, in 1803 the Massachusetts Medical Society was reorganized successfully to allow for full participation in the Society by any reputable physician, for the creation of district medical societies, and for conducting examinations in various parts of the state.81 These revisions greatly facilitated the linking of Boston medicine to that of the rest of the commonwealth.

In 1803, Boston still lacked public facilities for the insane, a medical journal, and, most important of all, a general hospital. Nonetheless, her medicine had reached a level of professional quality and maturity which allowed it to enter the mainstream of western medicine as witnessed by the famous Brahmin-Paris alliance of the next two generations of Boston physicians.

The last half of the eighteenth century was a difficult yet momentous period in Boston’s history. The city endured two depressions, a revolution, and the ordeal of adjusting to independence before finally, in the 1790’s, entering a period of stability, prosperity, and growth. Throughout the entire time Boston physicians played prominent political and social as well as medical roles. Collectively these men were ambitious, hard-headed, and strong willed. They enjoyed a high degree of racial and cultural homogeneity which helped to heighten their sense of civic pride and responsibility. Yet they were also extremely combative and contentious. Despite this, between 1760 and 1803 they made great strides in professionalizing Boston medicine by working to control and advance first smallpox inoculation and then vaccination, to extend control over obstetrics, and to improve medical training and the dissemination of medical information. They also founded two professional societies and worked to establish and maintain standards for recognition as duly qualified medical practitioners. Their attitude toward the establishment of New England’s first medical school certainly was mixed, but they soon came to recognize it as a valuable agent and ally in the struggle to control and improve medical standards and to increase the physician’s authority as a health expert. As a result, Boston medicine was much more professionalized both institutionally and in attitude in 1803 than in 1760.

appendix i

Boston Physicians,* 1760–1798

Name		Dates			College	Advanced med. ed.				Military med. exp.		Religion				Politics
1. Adams, Samuel, Jr.		1751–1788			Harvard	no				yes		Cong.				Whig
2. Appleton, Nathaniel Walker		1755–1795			Harvard	no				no		Cong.				Whig-Fed.
3. Brown, Samuel		?–1805			Harvard	Harvard Med. (m.b.)				no		Cong. to Swedenborg.				—
4. Bulfinch, Thomas, Jr.		1728–1802			Harvard	London and Edinburgh (m.d.)				no		Ang. to Cong.				Whig-Fed.
5. Cheever, Abijah		1760–1843			Harvard	no				yes		Cong.				Whig
6. Church, Benjamin, Jr.		1734–1778			Harvard	London				yes		Cong.				Whig
7. Clark, John, iv		1698–1768			none	no				no		Cong.				—
8. Clark, John, vi		1753–1788			Harvard	London				yes		Cong.				Tory
9. Clark, William		1725–1787			none	no				no		Cong.				Whig
10. Curtis, Benjamin		1753–1784			Harvard	no				yes		Cong.				Whig
11. Danforth, Samuel		1740–1827			Harvard	London				no		Cong.				Tory-Fed.
12. Danforth, Thomas		1775–1817			Harvard	no				no		Ang.				Fed.
13. Dexter, Aaron		1750–1829			Harvard	no				yes		Cong.				Whig-Fed.
14. Doubt, Nyott		1727–1764			Harvard	London				no		Ang.				—
Name	Dates			College			Advanced med. ed.		Military med. exp.				Religion	Politics
15. Erving, Shirley	1759–1813			none			no		no				Ang.	Whig-Fed.
16. Eustis, William	1753–1825			Harvard			no		yes				Cong.	Whig-Jeff.
17. Fleet, John, Jr.	1766–1803			Harvard			Harvard Med. (m.b., m.d.)		no				Cong.	Fed.
18. Gardiner, Silvester	1710 or 1727–1788			none			no		no				Cong.	Whig
19. Gardner, Joseph	1708–1786			none			London and Paris		no				Ang.	Tory
20. Hayward, Lemuel	1748/9–1821			Harvard			no		yes				Cong.	Whig-Fed.
21. Homans, John	1753–1800			Harvard			no		yes				Cong.	Whig-Fed.
22. Hunt, Ebenezer	1744–1820			none			no		no				Cong.	Whig-Fed.
23. Ingalls, William	1769–1851			Harvard			Harvard Med. (m.b., m.d.)		no				—	Fed.
24. Jarvis, Charles	1748–1807			Harvard			London		no				Cong.	Whig-Jeff.
25. Jeffries, John	1744–1819			Harvard			London, Aberdeen (m.d.)		yes				Cong. to Ang.	Tory-Fed.
26. Kast, Thomas	1750–1820			Harvard			London		yes				Ang.	Tory-Fed.
27. Linn, John	1750–1793			none			no		yes				—	Whig
28. Lloyd, James	1728–1810			none			London		no				Ang.	Tory-Fed.
29. Marshall, Samuel	1735–1771			Harvard			London		no				Ang. Cong.	—
30. Mather, Thomas	1713–1764			none			no		no					—
31. Pecker, James			1723/4–1794		Harvard	no		no			Cong, to Ang.				Tory-Fed.
32. Perkins, John			1698–1780		none	London		no			Cong.				Whig
33. Perkins, Nathaniel			1715–1799		Harvard	no		no			Cong.				Tory
34. Perkins, William Lee			1737–1797		none	London (possible m.d.)		yes			Ang.				Tory
35. Rand, Isaac, Sr.			1719–1791		none	no		no			Cong.				Whig
36. Rand, Isaac, Jr.			1743–1822		Harvard	no		no			Cong.				Tory-Fed.
37. Smibert, Williams			1733–1774		none	Edinburgh (m.d.)		no			—				Tory
38. Spooner, William			1760–1836		Harvard	Edinburgh (m.d.)		yes			Cong.				Whig-Fed.
39. Sprague, John			1718–1797		Harvard	no		no			Cong.				Whig-Fed.
40. Townsend, David			1753–1829		Harvard	no		yes			Cong. to Univ.				Whig-Jeff.
41. Warren, John			1753–1815		Harvard	no		yes			Cong.				Whig-Fed.
42. Warren, Joseph			1741–1775		Harvard	no		no			Cong.				Whig
43. Welsh, Thomas			1751–1831		Harvard	no		yes			Cong.				Whig-Fed.
44. Whipple, Joseph			1756–1804		none	no		no			Cong.				Whig-Fed.
45. Whitworth, Miles, Sr.			1715–1778		none	no		yes			—				Tory
46. Windship, Amos			1745–1815		Harvard	Harvard Med. (m.b.)		yes			Cong. to Ang. to Meth.				Whig-Jeff.
47. Young, Thomas			1731–1777		none	no		yes			Freethinker				Whig

*As defined in n. 3, 70.

appendix ii

Physicians* Listed in the Boston Directories of 1789, 1796, and 1798

Name			1789		1796		1798
1. Appleton, Nathaniel Walker South Latin School Street, near Stone-Chapel			X
2. Bertody, Francis Leverett Street					X		X
3. Bulfinch, Thomas, Jr. Bowdoin Square Cambridge Street			X		X		X
4. Cheever, Abijah Hanover Street Federal Street			X		X		X
5. Danforth, Samuel Tremont Street			X		X		X
6. Dench, Gilbert, Jr. Ann Street							X
7. Dexter, Aaron Milk Street, opposite rope-walk			X		X		X
8. Dix, William Back Street							X
9. Enslin, John Frederick Battery-march Street Blind Lane					X		X
10. Eustis, William Sudbury Street			X		X		X
11. Fay, Nahum Fleet Street Garden Court					X		X
12. Fleet, John Milk Street No. 5 Cornhill			X		X		X
13. Hall, Percival Charter Street							X
Name		1789		1796		1798
14. Hayward, Lemuel Newbury Street		X		X		X
15. Homans, John No. 6 Marlborough Street Lincoln Street		X		X		X
16. Hunt, William Ship Street, house, Hanover Street						X
17. Ingalls, William No. 15 Union Street						X
18. Jackson, William No. 29 Union Street				X
19. Jarvis, Charles Common Street Winter Street		X		X		X
20. Jeffries, John Tremont Street				X		X
21. Kast, Thomas Fifth Street Hanover Street		X		X		X
22. Leavitt, Josiah Staniford Street		X
23. Lloyd, James Tremont Street		X		X		X
24. Parker, Henry Pleasant Street						X
25. Pecker, James Hanover Street, corner of Friends Street		X
26. Peters, Alexander Abercrombie Marlborough Street		X
27. Rand, Isaac, Jr. Middle Street, just below Cross Street		X		X		X
28. Rand, Isaac, iii† Hanover Street		X		X		X
Name	1789			1796		1798
29. Read, William Milk Street				X
30. Rogerson, Robert Ship Street	X
31. Smith, Nathaniel corner Garden Court and Fleet Street						X
32. Spooner, William Cambridge Street	X			X		X
33. Sprague, John, Jr. Federal Street	X			X
34. St. Medard, Peter‡ Garden Court, North Square Back Street				X		X
35. Thomas, Joshua A nne Street, house, Liberty Square						X
36. Townsend, David§ Southack’s Court Middle Street Pleasant Street	X			X		X
37. Warren, John South Latin Street, next to Cromwell’s Head South School Street School Street	X			X		X
38. Welsh, Thomas Sudbury Street Hanover Street	X			X		X
39. Whipple, Joseph Orange Street South Bennet Street	X			X		X
40. Windship, Amos Hanover Street, near the Mill-bridge	X			X

*As defined in n. 3, 70.

† In the 1798 Directory Isaac Rand, Jr., becomes Sr., while Isaac Rand the third is Isaac Rand, Jr. For purposes of clarity I have kept Isaac Rand, Jr., as Jr. and called Isaac Rand the third Isaac Rand III.

‡ Listed as “surgeon.”

§ Townsend is listed as “Inspector of nails and potash,” which he was, but he continued to practice medicine as well. For details of his practice, see J. Worth Estes, “Therapeutic Practice in Colonial New England” below, 289–383.

* Speaker

1. David Hawke, The Colonial Experience (Indianapolis, 1966), 255.

2. Evarts B. Greene and Virginia D. Harrington, American Population before the Federal Census of 1790 (New York, 1932), 6.

3. John M. Murrin, “Review Essay,” History and Theory: Studies in the Philosophy of History, 11 (1972), 248.

4. Ibid., 256, fn. 63.

5. Ibid., 256.

6. Carl Bridenbaugh, Cities in the Wilderness: The First Century of Urban Life in America, 1625–1742 (New York, 1955), 6, 143, 303.

7. Carl Bridenbaugh, Cities in Revolt: Urban Life in America, 1743–1776, Oxford paperback ed. (New York, 1971), 5, 216.

8. James T. Adams, New England in the Republic, 1776–1850 (Boston, 1926), 54.

9. The articles on religion and the 1795 vote on the calling of another constitutional convention did not receive a two-thirds vote but were declared accepted nonetheless. See Allan Nevins, The American States during and after the Revolution, 1775–1789 (New York, 1924), 181. In the gubernatorial elections between 1780 and 1789 the voter turnout ranged between nine and thirty-two percent. See R. R. Palmer, The Age of the Democratic Revolution: A Political History of Europe and America, 1760–1800, 2 v. (Princeton, N.J., 1959), I, 227–228, fn. 19; and J. R. Pole, Political Representation in England and the Origins of the American Republic (New York, 1966), 542.

10. Delegates from coastal and island counties voted 102 to 19 in favor of the new Constitution, while those from inland counties voted 128 to 60 against. See Samuel Eliot Morison, The Maritime History of Massachusetts, Sentry ed. (Boston, 1961), 39–40.

11. Greene and Harrington, Population, 18; Bureau of the Census, Historical Statistics of the United States, Colonial Times to 1970, 2 vols. (Washington, 1975), i, 29.

1. John A. Schutz and Douglass Adair, eds., The Spur of Fame: Dialogues of John Adams and Benjamin Rush, 1805–1813 (San Marino, Calif., 1966), 44.

2. As their later writings clearly reveal, Shryock and Bell followed up many of their own suggestions. Between the two of them, however, more ideas were produced than they alone could tackle. Some of the topics identified by them as significant and worthy of in-depth investigation became scholarly monographs, such as John Duffy’s Epidemics in Colonial America (Baton Rouge, La., 1953) and John B. Blake’s Public Health in the Town of Boston, 1630–1822 (Cambridge, Mass., 1959).

3. Francisco Guerra, American Medical Bibliography, 1639–1783 (New York, 1962); Genevieve Miller, Bibliography of the History of Medicine of the United States and Canada, 1939–1960 (Baltimore, 1964).

1. John B. Blake, ed., Education in the History of Medicine (New York, 1968), 114, 121, For a 1904 rationale for medical history, see: Henry E. Sigerist, “Medical History in the United States: Past—Present—Future: A Valedictory Address,” Bulletin of the History of Medicine, 22 (1948), 47–64. Although a 1956 symposium was charged to explore whether medical history can “illuminate current problems and issues in medicine,” its published proceedings show that it did not do so: lago Goldston, ed., On the Utility of Medical History (New York, 1957). In 1969 Genevieve Miller reported on reasons for the disappearance of medical history from medical school curricula in: Bulletin of the History of Medicine, 43 (1969), 259, 344, 444, 553. Participants in an unpublished symposium on “The Implications of Current Trends in Medical Education for the Teaching of Medical History” at the American Association for the History of Medicine annual meeting in Montreal, Canada, 3–5 May 1972, blamed the chasm between historians and practitioners (including students) of medicine at least partly on an unwillingness among scholars without M.D. degrees to adapt their scholarship to the emotional, cognitive, attitudinal, and intellectual needs of medical students, and on the rapid compression of medical curricula. Newly evolving approaches to the overall problem were only lightly sketched by Stanley Joel Reiser in “The History of Medicine Program at Harvard,” Bulletin of the History of Medicine, 46 (1972), 190–191.

2. Lester S. King, “Why Celebrate?” Journal of the American Medical Association, 236 (1976), 40.

3. Thomas S. Kuhn, The Structure of Scientific Revolutions, 2nd ed. (Chicago, 1970), 1.

4. Jonathan Swift, Gulliver’s Travels. See Gulliver’s visit to the Academy of Lagado on his voyage to Balnibarbi, in any standard edition. Gulliver’s medical training was among the best obtainable in the late seventeenth century. After a four-year apprenticeship to a London surgeon, Mr. James Bates, he studied physic for another two and a half years at Leyden, but before Boerhaave was appointed professor there in 1701. Electing a career as a ship’s surgeon, Gulliver had already spent over ten years at sea before he landed on Lilliput in 1699.

* After taking his A.B. in History at Oberlin College, Dr. Brown earned his A.M. and Ph.D., also in History, at Harvard. He is now Professor and Chairman of the History Department at the University of Connecticut at Storrs. His recent books that complement this paper include: Revolutionary Politics in Massachusetts: The Boston Committee of Correspondence and the Town (1970); Modernization: The Transformation of American Life, 1600–1865 (1976); and Massachusetts: A Bicentennial History (1978).

1. The population figure of 300,000 is an estimate of the combined populations of Massachusetts and Maine. According to Historical Statistics of the United States, Colonial Times to 1970, part 2 (Washington, D.C., 1975), 1168, the population was 267,000 in 1770. Assuming a growth rate of 2.5 percent per annum the population would have exceeded 300,000 by 1775. Robert V. Wells, author of The Population of the British Colonies in America before 1776 (Princeton, N.J., 1975), estimates the population at between 310,000 and 320,000 in 1775 (personal letter, 9 March 1979). James Potter, in “Growth of Population in America, 1700–1870,” in D. V. Glass and D. E. C. Eversley, eds., Population in History (Chicago, 1965), 638, puts the population at 339,000 in 1775, but his estimate projects an annual growth of over three percent. Comparison of birthrates and longevity is with English and European populations, although it is generally believed that natural increase was greater in New England than elsewhere in Anglo-America in the seventeenth century and that life expectancy was greater in the eighteenth century as well. See: Daniel Scott Smith, “The Demographic History of Colonial New England,” Journal of Economic History, 32 (1972), 165–183, esp. 165–170; Maris A. Vinovskis, “Mortality Rates and Trends in Massachusetts before 1860,” Journal of Economic History, 32 (1972), 184–213, esp. 195–202.

2. Kenneth A. Lockridge, Literacy in Colonial New England (New York, 1974), 98–99.

3. The rising popularity of almanacs during the course of the eighteenth century was partly based on their agricultural utility. Surviving almanac-diaries commonly include information on planting and harvest dates and yields. Almanacs also facilitated “moon farming,” a system of agricultural practices calculated according to the phases of the moon. See also: Robert A. Gross, “The Problem of Agricultural Crisis in Eighteenth-Century New England: Concord, Massachusetts, as a Test Case,” paper presented at American Historical Association Meeting, Atlanta, Ga., 29 Dec. 1975; Gross, “Minutemen in a New Nation: Concord, Massachusetts, in the 1790’s,” revised manuscript of a paper presented at the Historical Deerfield Conference on New England Towns in the Early National Period, 8 Dec. 1973.

4. John Clive and Bernard Bailyn, “England’s Cultural Provinces: Scotland and America,” William and Mary Quarterly, 3rd ser., 11 (1954), 200–213.

5. Keith Thomas, Religion and the Decline of Magic (New York, 1971).

6. David E. Stannard, The Puritan Way of Death (New York, 1977), ch. 4, “Death and Dying.”

7. From stone of Seth Sumner, Milton, Mass., 11 Nov. 1771. Quoted in Dickran and Ann Tashjian, Memorials for Children of Change: The Art of Early New England Stonecarving (Middletown, Ct., 1974), 245.

8. 29 Feb. 1730, Barnstable, Mass. Recorded by author.

9. Although there was conflict between some aspects of science and Protestant belief in the eighteenth century, medicine and theology were compatible; indeed Cotton Mather, a leading divine, was an advanced medical thinker (Perry Miller, New England Mind: From Colony to Province [Boston, 1961], 443). A few physicians were privately skeptics in religion, but medicine itself was a Christian profession. See: Whitfield J. Bell, Jr., The Colonial Physician and Other Essays (New York, 1975), 20–21. The existence of God was said to be demonstrated by scientific knowledge.

10. Christianson has found evidence of 149 practitioners in the colony before 1700, and one-half of them continued their activities after that date. He dates the substantial increase in the medical corps from the mid-eighteenth century (see Eric H. Christianson, “The Medical Practitioners of Massachusetts, 1630–1800,” below, 49–67).

11. Virgil J. Vogel, “American Indian Influence on the Pharmacopeia,” American Indian Culture and Research Journal, 2 (1977), 3–7; and Vogel, American Indian Medicine (Norman, Okla., 1970), 41–45. J. Worth Estes notes the use of Indian therapies and native American plants in “Honest Dr. Thornton: The Path to Rebellion,” in George E. Gifford, Jr., ed., Physician Signers of the Declaration of Independence (New York, 1976), 73–74.

12. William G. Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore, 1972), 36–37.

13. Christianson, “The Medical Practitioners of Massachusetts, 1630–1800.” J. Worth Estes notes that the medical experience of a Leicester, Massachusetts, cleric was by no means unusual since it was commonly expected that a minister would “fill both the medical and religious needs of his parish” (“Honest Dr. Thornton,” p. 71, see n. 11).

14. Whitfield J. Bell, Jr., considers the Boston-Philadelphia comparison below. See his “Medicine in Boston and Philadelphia: Comparisons and Contrasts, 1750–1820,” 159–184.

15. The American Antiquarian Society’s copy of William Buchan, Domestic Medicine: or, a Treatise on the Prevention and Cure of Diseases by Regimen and Simple Medicines, 14th ed. (Boston, 1793), contains a pasted-in newspaper remedy. Buchan’s Domestic Medicine was first published at London in 1769.

16. Eric H. Christianson, “The Medical Practitioners of Massachusetts, 1630–1800” (below, 49–67), has found that the self-taught “doctor” was most common. Douglas L. Jones, “Charity, Medical Charity, and Dependency in Eighteenth-Century Essex County, Massachusetts” (below, 199–213), demonstrates that people who became town charges often received treatment from the most learned physician in their locale.

17. According to the Oxford English Dictionary (Oxford, 1933; reprinted 1961), VIII, 929, the term “placebo” first appeared in a medical dictionary in 1811. Since dictionaries have typically lagged behind current usage, it would not be surprising if the term was in use among eighteenth-century medical practitioners; certainly the concept was known.

18. Joseph F. Kett, The Formation of the American Medical Profession: The Role of Institutions, 1780–1860 (New Haven, 1968), 5.

19. John M. Murrin, “The Myths of Colonial Democracy and Royal Decline in Eighteenth-Century America: A Review Essay,” Cithera, 5 (1965), 53–69.

20. Quoted in James H. Stark, The Loyalists of Massachusetts and the Other Side of the American Revolution (Boston, 1910), 386.

21. Biographical sketches in E. Alfred Jones, The Loyalists of Massachusetts: Their Memorials, Petitions and Claims (London, 1930), 140–142, 179–181, 233. (See Philip Cash, “The Professionalization of Boston Medicine, 1760–1803,” below, 69–100.—eds.)

22. First series given in 1765 by William Perkins. Albert Matthews, “Notes on Dr. William Perkins (1737–1797),” PtMications of the Colonial Society of Massachusetts, 20 (1917–1919), 10–17.

23. Philip Cash, “The Professionalization of Boston Medicine, 1760–1803” (below, 69–100), notes that military service often provided supplementary medical training. Cash also describes the shift in political influence from Tory to Patriot physicians. In his Medical Men at the Siege of Boston (Philadelphia, 1973) Cash estimated that some 140 “doctors” served the revolutionaries at Boston. The social characteristics and medical training of most of these men (sixty-nine percent) are unknown. Among the forty-three whose careers could be discovered Cash found that they were mostly young men from Massachusetts (twenty-six years of age on average), and possessed of limited medical experience. Less than half had attended college. Presumably the ninety-seven others whose careers could not be traced were even less well educated.

24. Walter Muir Whitehill, “Early Learned Societies in Boston and Vicinity,” in The Pursuit of Knowledge in the Early American Republic: American Scientific and Learned Societies from Colonial Times to the Civil War, Alexandra Oleson and Sanborn C. Brown, eds. (Baltimore, 1976), 151–173.

25. Information on the early purposes and membership is drawn from Massachusetts Medical Society, Medical Papers Communicated to the Massachusetts Medical Society, To Which Are Subjoined Extracts from various Authors, containing some of the Improvements, which have lately been made in Physic and Surgery (Boston, 1790), Evans no. 22661; Kett, Formation of the American Medical Profession, 15.

26. Massachusetts Medical Society, Medical Papers (see n. 25).

27. Ibid., iii–iv.

28. Ibid., vii.

29. Ibid., vii.

30. On the continuing vitality of popular medicine see: Guenter B. Risse, Ronald L. Numbers, and Judith Walzer Leavitt, eds., Medicine without Doctors: Home Health Care in American History (New York, 1977).

* Dr. Christianson, who is currently Assistant Professor of History at the University of Kentucky, Lexington, received his A.B., A.M., and Ph.D. degrees in History from the University of Southern California. His research and teaching encompass the history of science, medicine, and several of their branches. He is now working on a study of the Medical Department of Transylvania University at Lexington.

1. Medical Essays (Boston, 1911), 312, 352–353.

2. The Early History of the Medical Profession in Norfolk County, Massachusetts: An Address before the Norfolk District Medical Society, May 10, 1853 (Boston, 1853), 6.

3. Whitfield J. Bell, Jr., “A Portrait of the Colonial Physician,” Bulletin of the History of Medicine, 44 (1970), 497–517.

4. Certainly one of the first to recommend this approach is Bell, “Suggestions for Research in the Local History of Medicine in the United States,” Bulletin of the History of Medicine, 17 (1945), 460–476.

5. An excellent discussion of this technique is Lawrence Stone, “Prosopography,” Daedalus, 100 (1971), 46–79. Though not a computerized study, Steven Shapin and Arnold Thackray, “Prosopography as a Research Tool in the History of Science: The British Scientific Community, 1700–1800,” History of Science, 12 (1974), 1–28, demonstrate persuasively the analytical potential of collective biography. The pioneer effort to employ computer analysis of collective biography in American medical history is Barnes Riznik, “The Professional Lives of Early Nineteenth Century New England Doctors,” Journal of the History of Medicine and Allied Sciences, 19 (1964), 1–16. One exceptionally solid project examining demographic aspects of an occupational group is Harry S. Stout, “University Men in New England, 1620–1660: A Demographic Analysis,” Journal of Interdisciplinary History, 4 (1974), 375–400.

6. Two fine works in this area are Peter Laslett, The World We Have Lost (London, 1965), and Robert A. Gross, The Minutemen and Their World (New York, 1976). Unless otherwise noted, the charts and other statistical material in this paper are taken from my doctoral dissertation, “Individuals in the Healing Arts and the Emergence of a Medical Community in Massachusetts, 1700–1792: A Collective Biography” (University of Southern California, 1976).

7. Among others, the Reverend Dr. Cotton Mather discussed the importance of the rninister-doctor especially in the absence of trained individuals in developing regions. Robert Heller argues that the problems of health care in rural areas during the eighteenth century are a “mirror image of the situation in the developing countries” of the Third World (“ ‘Priest-doctors’ as a Rural Health Service in the Age of Enlightenment,” Medical History, 20 [1976], 361–383). (See Richard D. Brown, “The Healing Arts in Colonial and Revolutionary Massachusetts,” above, 35–47.—eds.)

8. In my attempt to reconstruct the composition of the first Boston Medical Society (1735– c. 1741), I discovered that Ezekiel Hersey, a pupil of Dr. Hugh Kennedy of Scotland, was inoculated for smallpox. Kennedy had to visit a patient out of town, so a nurse was summoned to care for Hersey. Because he was only a pupil, not an apprentice, Hersey was sued by his mentor for the nurse’s fees. The nurse, Sarah Melendy, gave her deposition and it can be profitably perused in the Court Files of the Superior Court of Suffolk County, Mass., February 1736/7, ccxc, 92–97.

9. For developments in England during a later period, see Joseph F. Kett, “Provincial Medical Practice in England, 1730–1815,” Journal of the History of Medicine and Allied Sciences, 19 (1964), 17–30.

10. History of Medicine in Massachusetts (Boston, 1881), 15.

11. Henry R. Viets, A Brief History of Medicine in Massachusetts (Boston, 1930), 11–12.

12. The Americans: The Colonial Experience (New York, 1958), 229.

13. A Directory of English Country Physicians, 1603–1643 (London, 1962), 12–14.

14. Gloria L. Main, “Inequality in Early America: The Evidence from Probate Records of Massachusetts and Maryland,” Journal of Interdisciplinary History, 7 (1977), 559–581.

15. Example-Title Styled at Death, abstracted from my dissertation (n. 6):

Title	N	% of total
Medical	861	62.8
Medical & other	13	.9
Esquire	20	1.5
Deacon	1	1
Other	42	3.1
Missing*	433	31.6
Totals	1370	100.0%

*Includes also those individuals for whom no title exists in the records.

16. Laslett, The World We Have Lost, 266.

17. I wish to thank Professor J. Worth Estes, m.d., of the Boston University School of Medicine, for this observation based on my original growth-rate figures.

18. While there are no comprehensive analyses for other areas with which to compare the results of the present study, two scholars have estimated that during the period 1607–1800 New Jersey had 300 medical inhabitants and Virginia 927 (David L. Cowen, Medicine and Health in New Jersey: A History [New Brunswick, 1964], 8; Wyndham B. Blanton, Medicine in Virginia in the Seventeenth Century [Richmond, 1930], 260–297, and Medicine in Virginia in the Eighteenth Century [Richmond, 1931], 313).

19. Contributions to the Annals of Medical Progress and Medical Education in the United States Before and During The War of Independence (Washington, D.C., 1874), 105–106.

20. Richard H. Shryock, Medicine and Society in America, 1660–1860 (Ithaca, 1962), 12.

21. Richard D. Brown, “The Emergence of Urban Society in Rural Massachusetts, 1760–1820,” Journal of American History, 61 (1974), 29–51.

22. Eric H. Christianson, “The Emergence of Medical Communities in Massachusetts, 1700–1794: The Demographic Factors,” unpublished paper read at the 50th Annual Meeting of the American Association for the History of Medicine, 13 May 1977, Madison, Wisconsin. The selection of towns includes Attleborough, Becket, Billerica, Boston, Boxford, Bridgewater, Brookline, Charlton, Chilmark, Great Barrington, Medford, Newbury, Northampton, Pittsfield, Plymouth, Rehoboth, Salem, Taunton, Tyringham, and Worcester.

23. Also see J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383; and the Appendix to C. Helen Brock, “The Influence of Europe on Colonial Massachusetts Medicine,” below, 101–143.—eds.

24. Helpful observations on mobility during the eighteenth century in several locations are found in Gross, 90–91 (fn. 6), and Philip J. Greven, Jr., Four Generations: Population, Land, and Family in Colonial Andover, Massachusetts (Ithaca, 1970), 156–157, 162–163, 254–256.

25. T. H. Breen and Stephen Foster, “The Way to the New World: The Character of Early Massachusetts Immigration,” William and Mary Quarterly, 30 (1973), 189–222.

26. Christianson, “The Emergence of Medical Communities in Massachusetts, 1700–1794” (see n. 11).

27. Similar figures for the antebellum period are presented in Riznik (n. 5), 1–13, and in Charles McIntyre, “The Percentage of College-Bred Men in the Medical Profession,” Medical Record, 22 (1882), 681–684.

28. Christianson (n. 22).

29. Richard D. Brown, Modernization: The Transformation of American Life, 16001865 (New York, 1976), 74–121.

30. The quote is from James A. Henretta, The Evolution of American Society, 1700–1815 (Lexington, Mass., 1973), 209. The problem of how difficult it is to determine the efficacy of learned and home remedies is discussed in my article “The Description and Treatment of the Fly-Blown Ear: An Aspect of Science and Medicine in Colonial America,” The Melsheimer Entomological Series, 26 (1979), 1–12.

31. Nathaniel Ames, Jr., “An Elegy On the Death of the Late Dr. Ames,” in An Astronomical Diary, or Almanack, for . . . 1765 (Boston, 1764), n.p.

32. Education in the Forming of American Society: Needs and Opportunities for Study (Chapel Hill, N.C., 1960), 30–31.

33. Rhoda Truax, The Doctors Warren of Boston, First Family of Surgery (Boston, 1968), 85.

34. Viets (n. 11), 94–95, observes that in Boston the loyalist physicians did not fare well, but away from the hub of activity the loyalist might be watched carefully but tolerated.

35. In 1738, after ten years without a resident doctor, Northampton, along with four other neighboring towns, jointly extended an offer of £200 to Hezekiah Porter of Farmington, Connecticut, provided that he “lived among us Some years” (Northampton Town Records quoted in James Russell Trumbull, History of Northampton, Massachusetts [Northampton, 1902], II, 85–86).

36. Christianson (n. 6), 161–163, 168–171.

37. Riznik (n. 5), 3–6; William Barlow and David O. Powell, “To Find a Stand: New England Physicians on the Western Frontier, 1790–1840,” unpublished paper delivered at the 50th Annual Meeting of the American Association for the History of Medicine, 13 May 1977, Madison, Wisconsin.

38. Professional Lives in America: Structure and Aspirations, 1750–1850 (Cambridge, Mass., 1965), 55. Professor Estes demonstrates elsewhere in this volume that in New England doctors in large communities recorded a higher patient load than did their country counterparts and made more money, and that their therapies differed to some extent. Also, in another article (“ ‘As Healthy a Place as Any in America’: Revolutionary Portsmouth, N.H.,” Bulletin of the History of Medicine, 50 [1976], 536–552) he describes the greater longevity among residents of smaller towns than among their city counterparts. Few practitioners in either situation became wealthy from their patients’ fees, but it may be that inhabitants of larger towns, where mortality rates were higher, might have required greater medical attention and yielded more professional income. The city doctor, in effect, might not have to wait as long to collect fees from his deceased patients’ estates. On the other hand, it is possible that rural doctors received over a longer period of time a constant but modest income from their patients. A “surplus” of doctors in the countryside might then be heightened by their patients’ greater longevity.

39. The Doctor Shortage: An Economic Diagnosis (Washington, D.C., 1967), 5–8.

40. An excellent anthology covering the vitality of the self-help tradition in American history is Guenther B. Risse, Ronald L. Numbers, and Judith Walzer Leavitt, eds., Medicine without Doctors: Home Health Care in American History (New York, 1977). Henretta (n. 30), 111, stated that a deferential society persisted in New England and that the masses deferred to the leading families. Such customs might also explain the apparent success of medical family members in driving out the mobile interloper. “It could be said that the advent of universal literacy [in post-1760 New England] would have increased both the unity of men and their contentiousness, in a paradox typical of the modernization of attitudes” (Kenneth A. Lockridge, Literacy in Colonial New England: An Inquiry into the Social Context of Literacy in the Early Modern West [New York, 1974], 29).

41. Ames, “An Elegy . . .” (n. 31).

42. This quote is from the famous “Graph Iatroon” letter announcing in March 1765 the formation, without realization, of a medical society composed of doctors living around, but not in, Boston (Walter L. Burrage, A History of the Massachusetts Medical Society with Brief Biographies of the Founders and Chief Officers, 1781–1922 [1923], 3–4).

43. “Medicine and Learned Societies in the United States, 1660–1865,” in Alexandra Oleson and Sanborn C. Brown, eds., The Pursuit of Knowledge in the Early American Republic: American Scientific and Learned Societies from Colonial Times to the Civil War (Baltimore and London, 1976), 261–278.

44. Richard D. Brown, “The Emergence of Voluntary Associations in Massachusetts, 1760–1830,” Journal of the Volunteer Active Reserves, 2 (1973), 64–73.

45. One need only peruse chapters II, III, and X in Burrage (n. 42), to capture the flavor of ambivalence.

46. The manuscript collection pertaining to the early history of the state society contains dozens of letters written by members from all over the state making suggestions about educational qualifications for competent practice (b.ms.b.75.1, Boston Medical Library, Francis A. Countway Library of Medicine).

47. In 1755, young Bostonian William Jepson, a former pupil of Dr. Silvester Gardiner, enumerated the “many disadvantages attending a seperate [sic] way of study” in the bylaws of a group composed of recent apprenticeship graduates for the purpose of continuing their training throughout their careers (uncatalogued Silvester Gardiner Papers, Francis A. Countway Library of Medicine).

48. One of the rules governing the Berkshire Medical Association, which was located in Stockbridge, indicates the willingness of some regularly trained men to join forces with the opposition: “Any person residing within the limits of this county, and pretending to practice physic and shall refuse ... to become a member ... he shall be treated with entire neglect” (manuscript records of the Berkshire District Medical Society, 1785–1864, Berkshire Medical Institution, Pittsfield, 3–27).

49. For a detailed discussion of that ill-fated group, see Christianson (n. 6), 155–161.

50. The Rise, Progress, and Present State of Medicine, Delivered at Concord July 6, 1791, before the Middlesex Medical Association (Boston, 1792), 28. Such discord was “highly detrimental to the Profession” and provided the “chief Root from whence these very Empiricks spring” (Burrage [n. 42], 3–4).

51. Israel Atherton to M.M.S., Lancaster, 20 October 1789 (b.ms.b.75.1 f72, Boston Medical Library, Francis A. Countway Library of Medicine).

52. Calhoun (n. 38), 55.

53. Berkshire District Medical Society Records (n. 48), 5, 10.

54. Michael Zuckerman, “The Fabrication of Identity in Early America,” William and Mary Quarterly, 34 (1977), 183–214.

55. The motto coined by Theodore Parker in 1848 and quoted in Michael Kammen, People of Paradox: An Inquiry Concerning the Origins of American Civilization (New York, 1973), 57.

56. Two works detailing these developments are Joseph F. Kett, The Formation of the American Medical Profession: The Role of Institutions, 1780–1860 (New Haven, 1968), and William G. Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore and London, 1972).

* After obtaining his B.S.Ed, at Gorham State Teachers College in Maine, Dr. Cash completed his studies in History at Boston College, where he earned his M.A. and Ph.D. degrees. He is now Professor of History at Emmanuel College in Boston, where he was Chairman of the Department for nine years. His other contributions to colonial medical studies include a chapter on Dr. Oliver Wolcott of Litchfield, Connecticut, in Physician Signers of the Declaration of Independence (1976), and a book on Medical Men at the Siege of Boston, April, 1775–April, 1776: Problems of the Massachusetts and Continental Armies (1973).

1. The use of the term “professionalization” in this paper may not conform to some contemporary sociological models. It is used as a term of practicality or convenience. By it I mean an increased sense of awareness of common goals and common aspirations on the part of Boston’s trained medical practitioners (physicians) of this era. This was demonstrated primarily in increased cooperation, attempts to improve medical training, and in attempts to gain greater control over the dispensing of medical services. It also involved the founding of two medical societies and a medical school. I recognize that there was a medical profession in Boston before 1760 and that the process of professionalization continued after 1803.

2. For developments in Philadelphia at this time see Whitfield J. Bell, Jr., “Medicine in Boston and Philadelphia: Comparisons and Contrasts,” below, 159–184.—eds.

3. In analyzing the professionalization of Boston medicine between 1760 and 1803 I have considered as “physicians” only those practitioners of medicine who had undergone at least a medical pupilage or apprenticeship and who were engaged in medical practice for at least five years, including any military medical service. Admittedly, this definition is somewhat arbitrary and not wholly in keeping with contemporary usage. However, these limitations are more than offset by the fact that it provides for far greater clarity and precision of usage and allows for a systematic analysis of that element among the variegated purveyors of medical service in eighteenth-century America who would evolve into the modern doctor. So far I have been able to identify and confirm forty-seven men who meet these criteria and who were members of the Boston medical community between 1760 and 1798, although in several instances the fact of their pupilage or apprenticeship must be inferred from substantial but indirect evidence. Undoubtedly there were others who practiced in Boston during this time and who meet the above criteria, but whom I have not been able to identify or confirm. However, it is unlikely that they would seriously alter the professional profile that I have drawn. I have listed these men in Appendix I together with pertinent data as to their college education, medical training above the apprenticeship-pupilage level, military medical experience, and religious and political affiliations. In identifying and listing these men I have used 1798 rather than 1803 as the cutoff date in order to avoid including such people as James Jackson and John Collins Warren who really belong to the next generation and next era of Boston medicine. The fourteen physicians who were practicing in Boston in 1760 were: Thomas Bulfinch, Jr.; Benjamin Church, Jr.; John Clark rv; Nyott Doubt; Silvester Gardiner; Joseph Gardner; James Lloyd; Thomas Mather; James Pecker; John Perkins; Nathaniel Perkins; William Lee Perkins; John Sprague; and Miles Whitworth, Sr. The twenty-one who were active at the opening of 1775 were: Samuel Adams, Jr.; Thomas Bulfinch, Jr.; Benjamin Church, jr.; Samuel Danforth; Silvester Gardiner; Joseph Gardner; Ebenezer Hunt; Charles Jarvis; John Jeffries; Thomas Kast; James Lloyd; James Pecker; John Perkins; Nathaniel Perkins; William Lee Perkins; Isaac Rand, Jr.; John Sprague; Joseph Warren; Miles Whitworth, Sr.; Amos Windship; and Thomas Young.

4. By 1760 Boston was a city in deep economic, social, and political trouble because of the residue of bitterness left over from the monetary struggles of the 1740’s and early ‘50’s, the serious economic and human losses sustained in the last two colonial wars, and the growing competition for markets offered by commercial rivals both large and small and near and far. Between 1760 and 1764 the city was ravaged by the greatest of many fires during the colonial era and then further disrupted by a major smallpox epidemic. Over the next decade a generally depressed economy and bitter political struggle punctuated by military occupation beset the city until the news of Lexington and Concord must have come as psychic relief. See James T. Adams, Revolutionary New England, 1691–1776 (Boston, 1923), 138–416; Carl Bridenbaugh, Cities in Revolt: Urban Life in America, 1743–1776 (1955; rpt. ed., New York, 1971); Samuel G. Drake, The History and Antiquities of Boston, the Capital of Massachusetts and Metropolis of New England, from its Settlement in 1630 to the Year 1770 (Boston, 1856), 637–784; Albert B. Hart, ed., Commonwealth History of Massachusetts, 5 v. (New York, 1927–1930), II and III; James A. Henretta, “Economic Development and Social Structure in Colonial Boston,” William and Mary Quarterly, 22 (1965), 75–92; Gerald B. Warden, “The Distribution of Property in Boston, 1692–1775,” Perspectives in American History, 10 (1976), 81–130; Gerald B. Warden, Boston, 1689–1776 (Boston, 1970), 127–143; William B. Weeden, Economic and Social History of New England, 1620–1789, 2 v. (Boston, 1890), II, 637–767; Justin Winsor, ed., Memorial History of Boston, Including Suffolk County, 1630–1880, 4 v. (Boston, 1880–1881), III, 1–67, 119–175. For the permanent population of Boston during this period see Lemuel Shattuck, Report to the Committee of the City Council Appointed to Obtain the Census for Boston for the Year 1845 (Boston, 1846), 3–5, 54; Bridenbaugh, Revolt, 5, 216, 497, fn. 328:1.

5. For doctors in the colony as a whole see Eric H. Christianson, “The Medical Practitioners of Massachusetts, 1630–1800: Patterns of Change and Continuity,” above, 49–67.—eds.

6. John Langdon Sibley and Clifford K. Shipton, Sibley’s Harvard Graduates, 17 v. so far (Cambridge, Mass., 1873–), viii, 90–92.

7. The thirteen who had studied in Europe were: Thomas Bulflnch, Jr.; Benjamin Church, Jr.; Samuel Danforth; Nyott Doubt; Silvester Gardiner; Charles Jarvis; John Jeffries; Thomas Kast; James Lloyd; Samuel Marshall; John Perkins; William Lee Perkins; and Williams Smibert. Of these, only Smibert (Edinburgh m.d., 1762) had not studied in London.

8. They were Thomas Bulfinch, Jr., and Williams Smibert (Edinburgh), and John Jeffries (Aberdeen). William Lee Perkins may have earned a medical degree but where or when is uncertain, and it is quite possible that he received it after leaving Boston in 1776.

9. See C. Helen Brock, “The Influence of Europe on Colonial Massachusetts Medicine,” below, 101–116, and its Appendix, 117–143.—eds.

10. See Brooke Hindle, The Pursuit of Science in Revolutionary America, 1735–1789 (Chapel Hill, N.C., 1956).

11. The exceptions were Thomas Kast, who was born in Boston but whose father had emigrated from Germany; John Linn, an incorporator of the Massachusetts Medical Society, who came from Pennsylvania and soon returned there; Williams Smibert, who very likely was the son of the Edinburgh-born painter John Smibert, who had emigrated to Rhode Island with Bishop Berkeley’s party in 1728; and Thomas Young, whose father had emigrated from Ireland to Ulster County, New York, where Young was born and raised.

12. Josiah Bartlett, “An Historical Sketch of the Progress of Medical Science in the Commonwealth of Massachusetts, being the Substance of A Discourse Read at the Annual Meeting of the Medical Society, June 6, 1810, with Alterations and Additions to January 1, 1813,” Massachusetts Historical Society Collections, 2nd ser., 1 (1814), 106–109; John B. Blake, “The Medical Profession and Public Health in Colonial Boston,” Bulletin of the History of Medicine, 26 (1952), 218–230; John B. Blake, “The Inoculation Controversy in Boston, 1721–1722,” The New England Quarterly, 25 (1952), 489–506; John B. Blake, “Smallpox Inoculation in Colonial Boston,” Journal of the History of Medicine and Allied Sciences, 8 (1953), 284–300; John B. Blake, Public Health in the Town of Boston, 1630–1822 (Cambridge, Mass., 1959), 52–88; Bridenbaugh, Revolt, 328–329; John Duffy, Epidemics in Colonial America (Baton Rouge, La., 1953). 103; Frederick G. Kilgour, “The Rise of Scientific Activity in Colonial New England,” Yale Journal of Biology and Medicine, 22 (1949–1950), 122–138; Joseph M. Toner, “History of Inoculation in Massachusetts,” Massachusetts Medical Society Publications, 2 (1867), 153–190; Ola E. Winslow, A Destroying Angel: The Conquest of Smallpox in Colonial Boston (Boston, 1974).

13. In March 1761, Silvester Gardiner, then the most distinguished physician in Boston, offered to construct a private inoculation hospital on a remote part of the Common near where he had earlier built a hospital for the British fleet in New England waters, but nothing came of it. In 1763, Thomas Bulfinch, Jr., Joseph Gardner, and Joseph Warren, who only recently had finished his training with James Lloyd, joined in an unsuccessful effort to secure permission to build a private inoculation hospital in or near Boston. See Boston Records Commissioners’ Reports, 16, 51–52; John Cary, Joseph Warren: Physician, Politician, Patriot (Urbana, Ill., 1961), 21; silvester Gardiner, “To the Freeholders and Other Inhabitants of the Town of Boston, in Town Meeting Assembled, March, 1761,” Massachusetts Historical Society Proceedings, ser. 1, 4 (1858–1860), 324–328; Maurice Bear Gordon, Aesculapius Comes to the Colonies: The Story of the Early Days of Medicine in the Thirteen Original Colonies (Ventnor, N.J., 1949), 89–90; Samuel Abbott Green, History of Medicine in Massachusetts: A Centennial Address Delivered Before the Massachusetts Medical Society At Cambridge, June 7, 1881 (Boston, 1881), 78; Henry R. Viets, A Brief History of Medicine in Massachusetts (Boston, 1930), 79.

14. Blake, “Inoculation,” 291; Boston Post-Boy and Advertiser, 26 March 1764; Boston Records Commissioners’ Reports, 16, 116–117; Cary, Joseph Warren, 22; Esther Forbes, Paul Revere and the World He Lived In (Boston, 1942), 75–76.

15. Bartlett, “Progress,” 108; Blake, “Inoculation,” 291–292; Boston Post-Boy and Advertiser, 27 February – 25 June 1764; Cary, Joseph Warren, 21–22; J. Worth Estes, Hall Jackson and the Purple Foxglove: Medical Practice and Research in Revolutionary America, 1760–1820 (Hanover, N.H., 1979), 16–21; Green, Massachusetts, 74–76; Massachusetts Gazette and Boston News-Letter, 8 March 1764; Toner, “Inoculation,” 180–184.

16. Blake, “Inoculation,” 291.

17. Blake, “Inoculation,” 292–295; Blake, Public Health, 92–96; Toner, “Inoculation,” 204, fn. 38.

18. Warren Papers, ii (1756–1799), Massachusetts Historical Society; Edward Warren, The Life of John Warren, M.D. (Boston, 1874), 21–22.

19. Certificate of Attendance by James Lloyd at two Courses on Midwifery by William Smellie, BMS Miscellany, Countway Library, Harvard Medical School; Edwin M. Jameson, “Eighteenth Century Obstetrics and Obstetricians in the United States,” Annals of Medical History, new ser., 10 (1938), 413–432; “Notice of the Late James Lloyd, m.d.,” New England Journal of Medicine and Surgery, and the Collateral Branches of Science, 2 (1813), 127–130; Shipton, Sibley’s, xii, 184–193; James Thacher, American Medical Biography, 2 v. in 1 (Boston, 1827), i, 359–376; Henry R. Viets, “James Lloyd,” DAB, xi, 332; Viets, Massachusetts, 72–74; Henry R. Viets, “The Medical Education of James Lloyd in Colonial America,” Yale Journal of Biology and Medicine, 31 (1958–1959), 1–14. See also a letter from Lloyd’s son, James, to James Thacher, dated 16 September 1829, inserted into a volume of Thacher’s American Medical Biography, inscribed to Dr. Edward Reynolds and now in the Countway Library, Harvard Medical School.

20. Ledger of James Lloyd, 1758–1778, Countway Library, Harvard Medical School. (See J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383.—eds.)

21. Cary, Joseph Warren, 20; Shipton, Sibley’s, xii, 188–189; Thacher, Biography, I, 364; Viets, Massachusetts, 73–74, 86, 91–92. Ironically, by the late 1760’s Lloyd’s practice was so large that he could no longer be effective in carrying out his training reforms. See Shipton, Sibley’s, xviii, 188–190.

22. Albert Matthews, “Notes on Early Autopsies and Anatomical Lectures,” Colonial Society of Massachusetts Publications, 19 (1916–1917), 273–290; Frederick C. Waite, “The Development of Anatomical Laws in the States of New England,” New England Journal of Medicine, 233 (1945), 716–725.

23. Boston Gazette and Country Journal, 25 November 1765; Bridenbaugh, Revolt, 409; Cary, Joseph Warren, 33; E. Alfred Jones, The Loyalists of Massachusetts: Their Memorials, Petitions and Claims (London, 1930), 179–181, 233–234; Edward B. Krumbhaar, “Early History of Anatomy in the United States,” Annals of Medical History, 4 (1922), 282; Albert Matthews, “Notes on Dr. William Perkins (1737–1797),” Colonial Society of Massachusetts Publications, 20 (1917–1919), 10–17; Shipton, Sibley’s, xvii, 188–190. Jones mistakenly dates the Jeffries lectures as 1765, although he also credits the 1765 lectures to Perkins. See above.

24. Krumbhaar, “Anatomy,” 182.

25. Samuel F. Batchelder, Bits of Harvard History (Cambridge, Mass., 1924), 157–158; Bartlett, “Progress,” 105; Henry K. Beecher and Mark D. Altschule, Medicine at Harvard: The First Three Hundred Years (Hanover, N.H., 1977), 27; Cary, Joseph Warren, 31, 32, fn. 25; Matthews, “Autopsies,” 285–289; Thomas E. Moore, Jr., “The Early Years of the Harvard Medical School: Its Founding and Curriculum, 1782–1810,” honors thesis, Harvard University, 1952, 19–20; Francis R. Packard, History of Medicine in the United States, 2. v (New York, 1931; Hafner rpt., 1963), i, 430; Warren, John Warren, 23–26, 226–233.

26. Boston Post-Boy and Advertiser, 30 January 1764. Also see Green, Massachusetts, 76–77; Harvard Corporation Records, ii, 182, Harvard Archives, Pusey Library; Thomas F. Harrington, The Harvard Medical School: A History, Narrative, and Documentary, 1782–1905, 3 v., ed. James Mumford (New York, 1905), I, 32; Massachusetts Gazette and Boston News-Letter, 2 February 1764; Josiah Quincy, The History of Harvard University, 2 v. (Boston, 1860), ii, 480–482.

27. Quincy, Harvard, ii, 530–531.

28. Lawrence A. Cremin, American Education: The Colonial Experience, 1607–1783 (New York, 1970), 397; I. Bernard Cohen, Some Early Tools of American Science (Cambridge, Mass., 1950), 9–10.

29. Bartlett, “Progress,” 116; Boston News-Letter, 20 December 1770; Harrington, Harvard, i, 32–33; Harvard Corporation Records, ii, 350–351, 375–376, Harvard Archives, Pusey Library; Thomas E. Moore, Jr., “Early Years of the Harvard Medical School, 1782–1810,” Bulletin of the History of Medicine, 27 (1953), 530–531; Quincy, Harvard, ii, 212–213.

30. Harvard Corporation Records, ii, 378, Harvard Archives, Pusey Library. The “Reverend Dr. Erskine” continued to be a benefactor to Harvard until at least 1798. See Harvard Corporation Records, iii, 260, 307, 329–330, 396, 434, 438, 459, and iv, 535, Harvard Archives, Pusey Library.

31. Batchelder, Bits, 158; Francisco Guerra, American Medical Bibliography, 1639–1783 (New York, 1962), 533, 567, 647–651; Massachusetts Gazette and Boston Post-Boy and Advertiser, 14–28 November 1764; Massachusetts Gazette and Boston Weekly News-Letter, 12 January 1775.

32. They were John Clark vi, William Eustis, Martin Herrick, John Homans Samuel Tenney, Thomas Welsh, and Miles Whitworth, Jr. See Harvard University Quinquennial Catalogue of Officers and Graduates, 1636–1930 (Cambridge, Mass., 1930), 194–195; Viets, Massachusetts, 99.

33. The prime mover in the attempt to found a colonywide medical society in 1765 was Dr. Cotton Tufts of Weymouth, later a major force in the early years of the Massachusetts Medical Society. One of the physicians who gave him considerable support was a Joseph Gardner who Burrage says practiced in Milton and Dorchester. However, it seems likely that this was the Joseph Gardner who was a prominent physician in Boston at this time and who also was a leader in the early years of the Massachusetts Medical Society. No other Boston physician seems to have played a significant role. See Walter L. Burrage, A History of the Massachusetts Medical Society, with Brief Biographies of the Founders and Chief Officers, 1781–1922 (Norwood, Mass., 1923), 3, 62.

34. Boston Chronicle, 7 January 1768.

35. Burrage, Society, 21–22; Philip Cash, Medical Men at the Siege of Boston, April, 1775. April, 1776: Problems of the Massachusetts and Continental Armies (Philadelphia, 1973).

36. James T. Adams, New England in the Republic, 1776–1850 (Boston, 1926), 3–108; Forbes, Revere, 196–352; Allen French, The First Year of the American Revolution (New York, 1934); Hart, Commonwealth, iii, 1–354; M. A. DeWolfe Howe, Boston: The Place and the People (New York, 1903), 87–122; Allan Nevins, The American States during and after the Revolution, 1775–1789 (New York, 1924); Winsor, Boston, iii, 67–188.

37. The physicians known to have been practicing in Boston in 1776 include: Thomas Bulfinch, Jr.; William Clark; Samuel Danforth; Joseph Gardner; Ebenezer Hunt; Charles Jarvis; Thomas Kast; James Lloyd; James Pecker; John Perkins; Isaac Rand, Jr.; and John Sprague (part-time).

38. This included the thirteen members of the newly founded Boston Medical Society plus Thomas Bulfinch, Jr. See Burrage, Society, 19.

39. See William C. Wigglesworth, “Surgery in Massachusetts, 1620–1800,” below, 215–247.—eds.

40. Burrage, Society, 52–53, 55, 292; “Samuel Danforth,” Boston Medical and Surgical Journal, 1 (1828–1829), 17–21; Harvard Corporation Records, III, 148–149, 151, Harvard Archives, Pusey Library; Moore, “Years” (article), 537; Thacher, Biography, ii, 264–265; “Experiments on the Waters of Boston by Dr. Feron,” Warren Papers, ii (1780–1785), Massachusetts Historical Society; Warren, John Warren, 190–242, 418–420.

41. Bartlett, “Progress,” 111–112, 120–121; Beecher and Altschule, Harvard, 25; Burrage, Society, 13–15; Hindle, Pursuit, 263–268, 285–287, 290–292, 297–298, 357–358; Moore, “Years” (article), 534–535; Viets, Massachusetts, 104; Warren, John Warren, 233–237.

42. Beecher and Altschule, Harvard, 27; Boston Evening-Post and General Advertiser, 10 November 1781; Bulfinch to Boston Medical Society, 24 September 1780, Warren Papers, II (1780–1785), Massachusetts Historical Society; Burrage, Society, 19; Ephraim Eliot, “Dr. Ephraim Eliot’s Account of the Physicians of Boston,” Massachusetts Historical Society Proceedings, ser. 1, 7 (1863–1864), 181; Oscar and Mary Handlin, Commonwealth: A Study of the Role of Government in the American Economy: Massachusetts, 1744–1861, rev. ed. (Cambridge, Mass., 1969), 97; Harrington, Harvard, I, 77–79; Moore, “Years” (article), 533; Warren, John Warren, 222–225.

43. Boston Evening-Post and General Advertiser, 10 November 1781.

44. Beecher and Altschule, Harvard, 29; Eliot, “Account,” 181–182; Green, Massachusetts, 101–102; Harrington, Harvard, i, 77–79; Independent Chronicle and Universal Advertiser, 6–20 December 1781; James Jackson, A Eulogy on the Character of John Warren, M.D. (Boston, 1815), 14–15; Moore, “Years” (article), 534; Shipton, Sibley’s, xviii, 664; Thacher, Biography, ii, 258.

45. Beecher and Altschule, Harvard, 28; Burrage, Society, 16–19; Handlin, Commonwealth, 97; Joseph F. Kett, The Formation of the American Medical Profession: The Role of Institutions, 1780–1860 (New Haven, 1968), 14; Viets, Massachusetts, 103, 106.

46. For a list of the thirty-one incorporators, see Burrage, Society, 16.

47. Bartlett, “Progress,” 113–114; Beecher and Altschule, Harvard, 25, 28, 537, fn. 21; Burrage, Society, 1–75, 280–281, 301–313, 350–354, 388–400, 416–418; Joseph E. Garland, “Medical Journalism in New England, 1788–1924,” Boston Medical and Surgical Journal, 190 (1926), 865–879; Handlin, Commonwealth, 97, 208–209; Kett, Formation, 14–15, 24; Harold and James Kirker, Bulfinch’s Boston, 1787–1817 (New York, 1964), 224; Massachusetts Medical Society, Miscellany, i, Countway Library, Harvard Medical School; Warren, John Warren, 242.

48. By 1815 the library of the Massachusetts Medical Society contained about 4,000 volumes. See Kirker, Bulfinch’s, 224.

49. Burrage, Society, 463–467.

50. Burrage, Society, 44, 463–467.

51. Beecher and Altschule, Harvard, 27–28; Eliot, “Account,” 183–184; Lloyd to Massachusetts Medical Society, 5 November 1788, b.ms. c. 75.2, Countway Library, Harvard Medical School; Shipton, Sibley’s, xii 192–193; Viets, “Lloyd,” DAB, xi, 332.

52. Rhoda Truax, The Doctors Warren of Boston: First Family of Surgery (Boston, 1968), 88.

53. See Harvard Corporation Records, iii-v, passim, Harvard Archives, Pusey Library.

54. Beecher and Altschule, Harvard, 40–45; John B. Blake, Benjamin Waterhouse and the Introduction of Vaccination: A Reappraisal (Philadelphia, 1957); Cohen, Tools, 102–103; Jeanette E. Graustein, “Natural History at Harvard College, 1788–1842,” Cambridge Historical Society Publications, 38 (1959–1960), 73; William Coolidge Lane, “Dr. Benjamin Waterhouse and Harvard University,” Cambridge Historical Society Publications, 4 (1909), 5–22; Packard, Medicine, i, 433–445; William Roscoe Thayer, “Extracts from the Journal of Benjamin Waterhouse,” Cambridge Historical Society Publications, 4 (1909), 22–27; Josiah Charles Trent, “The London Years of Benjamin Waterhouse,” Journal of the History of Medicine and Allied Sciences, 1 (1946), 25–40; Josiah Charles Trent, “Benjamin Waterhouse (1754–1846),” Journal of the History of Medicine and Allied Sciences, 1 (1946), 357–364; Henry R. Viets, “Benjamin Waterhouse, m.d.” DAB, xix, 529–532; “Death of Benjamin Waterhouse, m.d.,” Boston Medical and Surgical Journal, 35 (1846–1847), 206.

55. See William Frederick Norwood, Medical Education in the United States before the Civil War (Philadelphia, 1944; Arno rpt., 1971).

56. Beecher and Altschule, Harvard, 31, 34; Burrage, Society, 19; Harrington, Harvard, i, 275; Moore, “Years” (article), 545–546; Packard, Medicine, i, 305–306; Barnes Riznik, Medicine in New England, 1790–1840: A Report Prepared by the Department of Research, Old Sturbridge Village (Sturbridge, Mass., 1963), 105–106; Warren, John Warren, 287–295.

57. Samuel Eliot Morison, Three Centuries of Harvard, 1636–1936 (Cambridge, Mass., 1936), 164–167, 174; Shipton, Sibley’s, xvi, 253–265. Willard was inducted into the Harvard presidency on 19 December 1781. See Harvard Corporation Records, iii, 134–136, Harvard Archives, Pusey Library.

58. Beecher and Altschule, Harvard, 29; Eliot, “Account,” 181–182; Green, Massachusetts, 101–102; Harrington, Harvard, i, 77–79; Independent Chronicle and Universal Advertiser, 6–20 December 1781; Jackson, Eulogy, 14–15; Kett, Profession, 72; Moore, “Years” (article), 534; Morison, Centuries, 168; Packard, Medicine, i, 430; Shipton, Sibley’s, viii, 664–665; Thacher, Biography, ii, 258.

59. Warren was elected Professor of Anatomy and Surgery on 22 November 1782; Waterhouse, Professor of the Theory and Practice of Physic on 24 December; and Dexter, Professor of Chemistry and Materia Medica on 22 May 1783. Warren and Waterhouse were inducted in an impressive ceremony on 7 October 1783. Dexter, who was unavoidably absent at this time, was inducted in a lesser ceremony on 16 October. See Harvard Corporation Records, iii, 160–163, 171, 178, 180–181, Harvard Archives, Pusey Library; Harvard Overseers’ Records, iii, 257–260, Harvard Archives, Pusey Library.

60. Martin Kaufman, American Medical Education: The Formative Years, 1765–1910 (Westport, Conn., 1976), 26.

61. Cohen, Tools, 73–80; Graustein, “Natural History,” 69–71; Harvard Corporation Records, iii, 171, Harvard Archives, Pusey Library; Hindle, Pursuit, 342–343; Moore, “Years” (article), 537–538; Moore, “Years” (thesis), 86–89.

62. Bartlett, “Progress,” 118; Beecher and Altschule, Harvard, 43; Cohen, Tools, 100–103, 113–123; Graustein, “Natural History,” 70–71; Harvard Corporation Records, iii, 307–308, iv, 472, 488, 495, 514, 535–536, 603, Harvard Archives, Pusey Library; Kett, Profession, 72–73; Lane, “Waterhouse,” 7–13; Moore, “Years” (thesis), 71–73; Morison, Centuries, 171–172; Benjamin Waterhouse, The Botanist, being the Botanical Part of A Course of Lectures on Natural History ... Together with A Discourse on the Principles of Vitality (Boston, 1811). Waterhouse gave his lectures on natural history first in 1786 and 1787 at commencement time at Brown University, where he served as an unsalaried professor of natural history and on the Board of Fellows. See J. Walter Wilson, “The First Natural History Lectures at Brown University, 1786, by Dr. Benjamin Waterhouse,” Annals of Medical History, 3rd ser., 4 (1942), 390–398.

63. See John C. Greene, “The Boston Medical Community and Emerging Science, 1780–1820,” below, 187–197.—eds.

64. Adams, Republic, 109–229; Hart, Commonwealth, iii, 341–357; Howe, Boston, 123–221; Kirker, Bulfinch’s; Marjorie Drake Ross, The Book of Boston: The Federal Period, 1775–1837 (New York, 1961); Walter Muir Whitehill, Boston: A Topographical History, 2nd ed. (Cambridge, Mass., 1968), 47–72; Winsor, Boston, iii 189–216.

65. Burrage, Society, 21–22; Lemuel Shattuck, The Vital Statistics of Boston (Philadelphia, 1841), xii–xvii; Winsor, Boston, iii, 168, fn. 2.

66. See Appendix II.

67. See Appendix II.

68. They were William Spooner, who received his M.D. from Edinburgh, and John Clark vi, who studied midwifery in London. Charles Williams Windship received his M.D. from Glasgow in 1797, but does not appear to have practiced in Boston in or before 1798.

69. They were: Samuel Brown; Nahum Fay; John Fleet, Jr.; William Dix; and William Ingalls. Brown, who had a tragically short career, dying in 1805, won the Humane Society prize for his excellent account of the Boston yellow-fever epidemic of 1789. Fleet was one of the first two graduates of the Harvard Medical Institution and was later appointed its first assistant (to John Warren in 1793). He also was the first consulting physician to the Boston Dispensary as well as recording secretary and librarian of the Massachusetts Medical Society. Ingalls became a distinguished professor of anatomy and surgery at the Brown medical school.

70. Harvard Corporation Records, iii, 358–359, 361, Harvard Archives, Pusey Library; Samuel Eliot Morison, “Dr. Amos Windship (1745–1813, H.C. 1771),” Colonial Society of Massachusetts Publications, 25 (1922–1924), 141–171; Shipton, Sibley’s, xvii, 673–679.

71. Beecher and Altschule, Harvard, 34; Burrage, Society, 19; Harrington, Harvard, I, 275; Harvard Corporation Records, III, 186, 191–193, 195, 236, Harvard Archives, Pusey Library; Memorial of the President and Fellows to the General Court, 5 February 1784, State House Archives, House File No. 1405; Moore, “Years” (article), 555–556; Morison, Centuries, 171; John Warren to Overseers of the Poor of the Town of Boston (tentatively dated 1789, should be dated 1784), Warren Papers, iii (1786–1795), Massachusetts Historical Society.

72. Bartlett, “Progress,” 113, 118–119; Burrage, Society, 51–52, 54, 303–306, 369; Eliot, “Account,” 183–184; Handlin, Commonwealth, 97, 208–209; Harvard Corporation Records, iii, 155–159, 215–217, 223–224, 426, Harvard Archives, Pusey Library; Hindle, Pursuit, 291; Kett, Profession, 14–15, 24, 72; Massachusetts Medical Society Documents, Miscellaneous, I, Countway Library, Harvard Medical School; Moore, “Years” (thesis), 100–102; Warren, John Warren, 285–287.

73. Handlin, Commonwealth, 129.

74. See the letter from Lloyd’s son, James, to James Thacher, dated 16 September 1829, inserted into a volume of Thacher’s American Medical Biography, inscribed to Dr. Edward Reynolds and now in the Countway Library, Harvard Medical School.

75. John Warren, Lectures on Anatomy, 1783–1812, Countway Library, Harvard Medical School.

76. There is a notebook in the Countway Library, Harvard Medical School, entitled “Theory and Practice of Midwifery.” There is no indication as to who the author or owner was, but it may well have been John Clark vi. It consists of a rather extensive course of thirty-six well-organized but simplified (as compared to those of the London teachers of obstetrics) lectures on midwifery such as would have been very useful to the type of medical student then in Boston.

77. The first two dispensaries were founded in Philadelphia in 1786 and New York in 1790. The Boston Dispensary was opened in 1796 and incorporated in 1801. See Bartlett, “Progress,” 127; Blake, Public Heallh, 239; Columbian Centinel, 14–21 December 1796; Leonard K. Eaton, Early New England Hospitals, 1790–1833 (Ann Arbor, Mich., 1957), 21–22; [William R. Lawrence], A History of the Boston Dispensary By One of the Board of Managers (Boston, 1859), 1–48; Warren, John Warren, 236.

78. Blake, Public Health, 166–167, 229.

79. Bartlett, “Progress,” 123–124; Blake, Waterhouse, 46–47; Blake, Public Health, 181–182; Boston Records Commissioners’ Reports, 35, 133–134; James Jackson Putnam, A Memoir of Dr. Jackson ... (Boston, 1906), 228–229; “Report of the Board of Health, December 16, 1802,” Boston Medical and Surgical Journal, 145 (1901), 445; Warren, John Warren, 404–406.

80. Bartlett, “Progress,” 124; Blake, Waterhouse, 64; Columbian Centinel, 22 December 1802.

81. Bartlett, “Progress,” 113–114; Burrage, Society, 58–59, 68–74, 418–419; Kett, Profession, 15; Putnam, Jackson, 244–246.

* Dr. Brock took her B.A. and M.A. in Natural Sciences, and her Ph.D. in Structural Materials in Animals, at Cambridge University. Her teaching and research at the University of Glasgow, where she is in the Department of the History of Science, span modern zoology and the life and work of James Douglas and his pupil William Hunter.

1. Cotton Mather, Magnalia Christi Americana (London, 1702), Book i, ch. ii, 7.

2. F.R. Packard, The History of Medicine in the United States, 2 v. (New York, 1931), i, 3–4

3. Francis Bacon, Novum Organum, Book ii, aphorism 52. (1620; from the translation by Joseph Devey, 1853).

4. Charles Webster, The Great Instauration: Science, Medicine and Reform 1626–1660 (London, 1975).

5. New Englands First Fruits (1643), quoted from S. E. Morison, The Intellectual Life of Colonial New England (New York, 1956), 31.

6. Irene Parker, Dissenting Academies in England (Cambridge, 1914).

7. S. E. Morison, “Charles Morton’s Compendium Physicae,” Colonial Society of Massachusetts Publications, 33 (1940), 117.

8. Albert Matthews, “Comenius and Harvard College,” Colonial Society of Massachusetts Publications, 21 (1919), 146–190.

9. Catalogus Librorum Bibliothecae Collegij Harvardini Quod est Cantabrigiae in Nova Anglia (Boston, 1723).

10. Boston Post-Boy and Advertiser, 30 January 1764.

11. Josiah Quincy, History of Harvard University, 2 v. (Cambridge, Mass., 1840), ii, 480–482.

12. Idem; Oliver Letterbook, ii, Andrew Oliver to Peter Oliver, Boston, 20 August 1770, Massachusetts Historical Society.

13. R. S. Wilkinson, “The Alchemical Library of John Winthrop Junior (1606–1676), and His Descendants in Colonial America,” Ambix, 2 (1963), 33–51.

14. J. H. Tuttle, “The Libraries of the Mathers,” Proceedings of the American Antiquarian Society, 20 (1910), 269–356.

15. G. E. Littlefield, Early Boston Booksellers (Boston, 1900).

16. Silvester Gardiner, uncatalogued papers, Countway Medical Library, Boston.

17. John Hartshorn, Diary (1752–1756), Countway Medical Library, Boston.

18. Samuel Adams, Diary (1769), New York Public Library.

19. Francisco Guerra, American Medical Bibliography, 1639–1783 (New York, 1962).

20. Silvester Gardiner, uncatalogued papers, Countway Medical Library, Boston. An unsigned letter to Captain Kirkwood, 15 November 1755, asking for a wooden leg to be procured in London.

21. See the Appendix.

22. For the extent of bleeding, purging, and other remedies, see J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383.—eds.

23. Cotton Mather, The Angel of Bethesda. ms at the American Antiquarian Society, Worcester, Massachusetts, edited by G. W. Jones and published by American Antiquarian Society and Barre Publishers, Worcester, Mass. (1972).

24. Carl Bridenbaugh, Cities in the Wilderness (New York, 1955), 88; Nathaniel B. Shurtleff, Records of the Governor and Company of the Massachusetts Bay in New England, 12 v. (Boston, 1853), ii, 278–279.

25. Sir George Clark, A History of the Royal College of Physicians of London, 2 v. (Oxford, 1966).

26. Charles Webster, The Great Instauration: Science, Medicine and Reform 1626–1660 (London, 1975).

27. J. Woodward, To Do the Sick No Harm (London, 1974).

28. C. Bridenbaugh, Cities in Revolt (New York, 1955), 5; B. B. Mitchell and P. Deane, Abstract of British Historical Statistics (Cambridge, 1962).

29. For a detailed review of medical charity, see Douglas Lamar Jones, “Charity, Medical Charity, and Dependency in Eighteenth-Century Essex County, Massachusetts,” below, 199–213.—eds.

30. Josiah Bartlett, “A Dissertation on the Progress of Medical Science in the Commonwealth of Massachusetts,” Communications of the Medical Society of Massachusetts, 3 (1810), 240.

31. P.M. Rattansi, “Paracelsus and the Puritan Revolution,” Ambix, 2 (1963), 23–32.

32. G. H. Turnbull, “George Stark, Philosopher by Fire,” Colonial Society of Massachusetts Publications, 38 (1949), 219–251; R. S. Wilkinson, “George Starkey, Physician and Alchemist,” Ambix, 2 (1963), 121–152.

33. Boston Gazette, 19 June 1744.

34. R. S. Wilkinson, “New England’s Last Alchemists,” Ambix, 10 (1962), 128–138.

35. A.J. B. Gilsdorf, “The Puritan Apocalypse: New England Eschatology in the Seventeenth Century” (Ph.D. thesis, Yale University, 1965).

* Dr. Warden earned his B.A., M.A., and Ph.D. degrees in History at Yale University. A Lecturer at Boston University, he is especially interested in the development of history curricula in schools and in colonial legal history. He directs the activities of the Cambridge Historical Society and is the author of Boston, 1689–1776, published in 1970.

1. See Anthony Giddens, Capitalism and Modern Social Theory: An Analysis of the Writings of Marx, Durkheim and Max Weber (Cambridge, Eng., 1971), 101–102, 158–160, 203–204, 234–238.

2. See David D. Hall, The Faithful Shepherd: A History of the New England Ministry in the Seventeenth Century (Chapel Hill, N.C., 1972).

3. See Charles Warren, A History of the American Bar (Boston, 1911), and Anton-Hermann Chroust, The Rise of the Legal Profession in America (Norman, Okla., 1965).

4. See Neil R. Harris, The Artist in American Society, 1790–1860 (New York, 1966).

5. See Brooke R. Hindle, The Pursuit of Science in Revolutionary America, 1735–1789(Chapel Hill, N.C., 1956), and Raymond P. Stearns, Science in the British Colonies of America (New York, 1970).

6. For early attempts at corporate organization in other colonies, see Sidney Shindell, The Law in Medical Practice (Pittsburgh, Pa., 1966), 3–4.

7. For resistance to corporate privileges, see G. B. Warden, Boston, 1689–1776 (Boston, 1970), 102–126. During discussion, the question arose about the documentation for my argument that the medical profession did not develop in colonial Boston. There is none, and my inferences are based on the absence of such documentation in the valuable work of other scholars and in my own extensive research in the Boston newspapers, town meeting reports, General Court records, and manuscript collections of the Massachusetts Historical Society, State Archives, Boston Public Library, and Suffolk County Court House. The professional consciousness of the town’s physicians was so minimal that, to the best of my knowledge, there was never even any demand for medical organization, as there was for the clergy, merchants, and lawyers. For a differing view, and for a discussion of the later organization of Boston’s physicians as a professional association, see Philip Cash’s paper, above, 69–100.

8. See C. H. S. Fifoot, History and Sources of the Common Law: Tort and Contract (London, 1949), 157–158. During the discussion at the conference, Eric Christianson confirmed the extensive number of court cases against doctors in the legal records he has examined.

9. See Warden, Boston, 102–104, 127–129.

10. See Josiah Quincy, Jr., Reports of Cases Argued and Adjudged in the Superior Court of Judicature of the Province of Massachusetts Bay, between 1761 and 1772, ed. Samuel M. Quincy (Boston, 1865), 224–226.

11. See John B. Blake, Public Health in the Town of Boston, 1630–1822 (Cambridge, Mass., 1959).

The Medical Profession in Colonial Boston 153

12. For data on obstetrical deliveries by physicians in Boston, see J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383.—eds.

13. See Perry Miller, The New England Mind: From Colony to Province (Cambridge, Mass., 1953), 345–366.

14. See Edmund S. Morgan, The Challenge of the American Revolution (New York, 1976), 88–95.

15. See Warden, Boston, 214–217.

* After earning his A.B. in History at Dickinson College, Dr. Bell took his A.M. and Ph.D. in History at the University of Pennsylvania, where he wrote his dissertation under the direction of Richard H. Shryock. Now the Executive Officer and Librarian of the American Philosophical Society at Philadelphia, he has made many contributions to colonial medical history, including John Morgan: Continental Doctor (1965), and The Colonial Physician and Other Essays (1975).

1. Andrew Burnaby, Travels through the Middle Settlements in North-America (2nd ed., London, 1775; Ithaca, N.Y., n.d.), 53–54; Robert Treat Paine, Diary, Sept.–Nov. 1751; Paine to Joseph Palmer and Richard Cranch, 26 Sept. 1751, Paine Papers (Massachusetts Historical Society); John Adams, Diary and Autobiography, ed L. H. Butterfield and others (Cambridge, Mass., 1961), II, 116, 150.

2. Daniel Coxe to Benjamin Rush, 16 May 1791, Rush mss, xxvii, 11 (Library Company of Philadelphia); Walter Charming to Benjamin Smith Barton, 29 Sept. 1811, Barton Papers (American Philosophical Society); Thomas Jefferson to Rush, 13 Oct. 1808, facsimile in Martin Meyerson, Gladly Learn and Gladly Teach (Philadelphia, 1978), 51. Jefferson expressed the same opinion in similar terms to Dr. Barton, 22 June 1807 (Boston Public Library). The records of the Pennsylvania Hospital, 1795–1820, show four or five English medical students enrolled there, in addition to a number from the West Indies and a few from Canada.

3. John F. Fulton and Elizabeth H. Thomson, Benjamin Silliman, 1779–1864: Pathfinder in American Science (New York, 1947), 23–32, 95–100; Harold J. Burr, “Jonathan Knight and the Founding of the Yale School of Medicine,” Yale Journal of Biology and Medicine, 1 (1929), 327–343.

4. Thomas Cooper, An Address delivered before the Medical Board of S. Carolina, at Columbia, December, 1821 (Columbia, S.C., 1821), 4. Cooper considered the professors of the University of Pennsylvania Medical School, Dr. Physick excepted, as undistinguished in abilities and undignified in professional conduct.

5. Population figures are conveniently collected in Evarts B. Greene and Virginia D. Harrington, American Population before the Federal Census of 1790 (New York, 1932). On the comparative growth of the cities in the colonial period see Carl Bridenbaugh, Cities in Revolt: Urban Life in America, 1743–1776 (New York, 1955).

6. Whitfield J. Bell, Jr., John Morgan, Continental Doctor (Philadelphia, 1965), 22–23.

7. On some of those mentioned here see Kenneth and Anna M. Roberts, trans. and eds., Moreau de St. Méry’s American Journey, 1793–1798 (New York, 1947).

8. Dr. Samuel A. Green, “Medicine in Boston,” in Justin Winsor, ed., The Memorial History of Boston,... 1630–1880 (Boston, 1883), iv, 527–549; J. Thomas Scharf and Thompson Westcott, History of Philadelphia (Philadelphia, 1884), II, 1578–1685; Leonard K. Eaton, “Medicine in Philadelphia and Boston, 1805–1830,” Pennsylvania Magazine of History and Biography, 75 (1951), 66–75.

9. Joseph Carson, A History of the Medical Department of the University of Pennsylvania (Philadelphia, 1869), 52ff.

10. William Cullen to Benjamin Rush, 16 Oct. 1784, Rush mss, xxiv, 56 (Library Company of Philadelphia). Cullen had written John Morgan, 18 September 1768, that the Philadelphia school had “a better Chance for transmitting what can or should pass to Posterity than any College on this Side of the Water.” Ibid., 54.

11. John Morgan to John Warren, 21 Nov. 1776, in Edward Warren, Life of John Warren, M.D. (Boston, 1874), 128; James E. Gibson, Dr. Bodo Otto and the Medical Background of the American Revolution (Springfield, Ill., 1937), 260–261.

12. George W. Corner, Two Centuries of Medicine: A History of the School of Medicine, University of Pennsylvania (Philadelphia, 1965).

13. Edward Warren, John Warren, 225–227, et passim; Benjamin Rush to Warren, 12 Oct. 1782, in L. H. Butterfield, ed., Letters of Benjamin Rush (Princeton, 1951), I, 288–289; Henry K. Beecher and Mark D. Altschule, Medicine at Harvard: The First Three Hundred Years (Hanover, N.H., 1977), 29–31.

14. Winsor, Memorial History of Boston, IV, 26.

15. Pennsylvania Gazette, 11 Jan. 1770, quoted in Journal of the History of Medicine and Allied Sciences, 23 (1968), 108–110.

16. Warren, John Warren, 26; Albert Matthews, “Notes on Early Autopsies and Anatomical Lectures,” Colonial Society of Massachusetts Publications, 19 (1916–1917), 273–290.

17. Bell, Morgan, 137–140; Bell, “For Mutual Improvement in the Healing Art: Philadelphia Medical Societies of the 18th Century,” Journal of the American Medical Association, 216 (1971), 125–129.

18. Walter L. Burrage, A History of the Massachusetts Medical Society... 1781–1922 (privately printed, 1923), 16–21, 37–41, 77–81. George Hayward, then a student in Philadelphia, in a letter to John C. Warren, 28 Feb. 1812 (Warren Papers, viii, Massachusetts Historical Society), rejoiced in the defeat of efforts to establish a college of physicians in Massachusetts.

19. See Richard D. Brown, “The Healing Arts in Colonial and Revolutionary Massachusetts,” above, 35–47; Eric H. Christianson, “The Medical Practitioners of Massachusetts, 1630–1800,” above, 49–67; and Philip Cash, “The Professionalization of Boston Medicine, 1760–1803,” above, 69–100.—eds.

20. Burrage, Massachusetts Medical Society, 302–308.

21. Herbert Thoms, “The Medical Institution of Yale College and the Connecticut State Medical Society,” Connecticut Medicine, 24 (1960), 546–551.

22. Josiah Bartlett concluded his excellent historical Dissertation on the Progress of Medical Science, in the Commonwealth of Massachusetts (Boston, 1810) with an appeal for the removal of the medical school to Boston.

23. N. I. Bowditch, A History of the Massachusetts General Hospital (Boston, 1851), 3–9. See also the address of the medical professors, 5 Sept. 1810, in which similar views are expressed. A copy is in Warren Papers, vii, 2.

24. James Jackson, A Eulogy on the Character of John Warren, M.D. (Boston, 1815), 29.

25. George E. Ellis, Memoir of Jacob Bigelow, M.D., LL.D. (Cambridge, Mass., 1880), 15–16.

26. Henry R. Viets, A Brief History of Medicine in Massachusetts (Boston, 1930), 28.

27. Clifford K. Shipton, Biographical Sketches of Those Who Attended Harvard College [Sibley’s Harvard Graduates] (Boston, 1968), xiv, 551–552.

28. Whitfield J. Bell, Jr., “Portrait of the Colonial Physician,” Bulletin of the History of Medicine, 44 (1970), 504–505.

29. R. W. Innes Smith, English-Speaking Students of Medicine at the University of Leiden (Edinburgh, 1932), passim.

30. J. Rendall, “The Influence of the Edinburgh Medical School on America in the Eighteenth Century,” in R. G. W. Anderson and A. D. C. Simpson, eds., The Early Years of the Edinburgh Medical School (Edinburgh, 1976), 95–123. Henry Lloyd generously supported the foreign medical studies of his son James, 1750–1752. The family reckoned that the reputation he would gain thereby was worth seven to ten years of practice. Papers of the Lloyd Family, I (New-York Historical Society Collections, 69 [1926], 413, et passim).

31. “Dr. Warren was probably more self-taught than any man, who has undertaken a similar office, within the last two centuries. He had indeed the books of anatomists before him; but he had not like other great teachers of our day, in this country as well as in Europe, had the benefit of personal instruction from any of the great masters in the science” (Jackson, Eulogy on Warren, 15). But, Jackson continued, his mind on current developments in Boston, a medical education confined to the walls of a university was always deficient. “A medical school can never flourish except in a large town.... In 1810 he [Warren], with his colleagues, effected the extension of the medical lectures to this town [from Cambridge to Boston]; and since that time the correctness of his judgement has been abundantly demonstrated by the increased usefulness and increased prosperity of the Institution” (ibid., 16).

32. Whitfield J. Bell, Jr., “James Hutchinson (1752–1793): Letters from an American Student in London,” College of Physicians of Philadelphia, Transactions & Studies, 4th ser., 34 (1966), 20–25.

33. Also see C. Helen Brock, “The Influence of Europe on Colonial Massachusetts Medicine,” and its Appendix, above, 101–143.—eds.

34. Betsy C. Corner, William Shippen, Jr., Pioneer in American Medical Education (Philadelphia, 1951), 25ff., 73; Whitfield J. Bell, Jr., “Philadelphia Medical Students in Europe, 1750–1800,” Pennsylvania Magazine of History and Biography, 67 (1943), 17–18.

35. James Hall to Benjamin Rush, 4 March 1784, in W. S. W. Ruschenberger, An Account of the Institution and Progress of the College of Physicians of Philadelphia . . . from January, 1787 (Philadelphia, 1887), 17.

36. Walter Channing to George C. Shattuck, 20 April 1811, Shattuck Papers, III.

37. Appendix I to Philip Cash, “The Professionalization of Boston Medicine, 1760–1803,” above, 69–100. Walter Channing summarized the difference between Edinburgh and London in bold and certainly exaggerated terms. “In Edinburgh & throughout Scotland medicine is the grand object of pursuit. It is taught upon the most liberal plan. It is considered the most respectable, & far the most important branch of the art, & looks upon surgery as upon the apothecary as a necessary appendage to its system. But in London the thing is quite reversed, & I should think throughout England, as there is no surer way to eminence than the compilation or composition of a work on surgery, ornamented with some pretty pictures. Mr. Cooper is considered as knowing nothing of medicine, & a friend of mine, a very clever man heard him declare at table that he doubted how far medicine was a blessing to society.” Happily, Channing continued, in America a practitioner was not compelled to choose one specialty or the other. Medicine and surgery were “united, & we need not degrade one, to increase the reputation of the other.” Channing to George C. Shattuck, 20 April 1811, Shattuck Papers, III.

38. Burrage, Massachusetts Medical Society, 115.

39. Ebenezer Alden to George C. Shattuck, 19 Jan. 1812, Shattuck Papers, III. Dr. Henry I. Bowditch recorded Dr. Jacob Bigelow’s recollections (in advanced old age) of his Philadelphia professors. Rush and Wistar were kindly, the latter especially was warmhearted; both “received” the students. Physick, on the contrary, was “a savage,” who never invited them to his house and would not associate with them. Barton was “egotistical, a bad reader and speaker.” Rush, “enthusiastic and eloquent,” was a great believer in medicine and drugs, an “ultra practitioner,” who used to admonish his students, “we can have no reliance on nature, gentlemen. We must turn her out of doors in our practice, and substitute for her efficient art. The vis medicatrix naturae which Cullen taught is a delusion.” Vincent Y. Bowditch, Life and Correspondence of Henry Ingersoll Bowditch (Boston, 1902), II, 285.

40. Nathan Smith to George C. Shattuck, 22 Jan. [1807] (typescript), Shattuck Papers, I.

41. Ephraim Eliot, “Account of the Physicians of Boston,” Massachusetts Historical Society Proceedings, Ser. 1, 7 (1863–1864), 179, 180.

42. For the incidence of bleeding in two Boston practices see Table IV in J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383.—eds.

43. Burrage, Massachusetts Medical Society, 26.

44. Oliver W. Holmes, “Additional Memoranda” [to Green’s “Medicine in Boston”] in Winsor, Memorial History of Boston, iV, 557; John Adems Paxton, comp., Philadelphia Directory and Register, for 1818; Boston Directory... (Boston, 1816). Bleeding was practiced little, if at all, in cases reported in the Boston Medical Commentaries, II, 39–40, 111ff., 145, 462–475. Holmes speaks with some surprise of a Boston physician whom he consulted in 1867, who carried two lancets with him at all times—he had never given up their use. Holmes, “Scholastic and Bedside Teaching,” in Medical Essays (Boston, 1899), 295.

45. General Alumni Catalogue of the University of Pennsylvania, 1922; Thomas F. Harrington, The Harvard Medical School (New York, 1905), III, 1449ff.

46. Joseph I. Waring, A History of Medicine in South Carolina, 1825–1900 (Columbia, S.C., 1967), 72.

47. Walter Channing to George C. Shattuck, [August 1808], Shattuck Papers, II; Channing to Benjamin S. Barton, 20 March [no year], Barton Papers.

48. W. Welch to George C. Shattuck, 31 May 1811, Shattuck Papers, III.

49. George Hayward to Benjamin S. Barton, 10 Sept. 1814, Barton Papers; Hayward to John C. Warren, 28 Nov. 1811, 28 Feb. 1812, Warren Papers, vii, viii.

50. Only one New Englander is listed on the roll of Rush’s “regiment of prentices,” as he called them, 1770–1812. James E. Gibson, “Benjamin Rush’s Apprenticed Students,” College of Physicians of Philadelphia, Transactions & Studies, 4th ser., 14 (1946–1947), 127–132.

51. Ellis, Memoir of Jacob Bigelow, 15–16; George C. Shattuck to Benjamin S. Barton, 9 Aug. 1807 (copy), Shattuck papers, I; Daniel Oliver to Barton, 20 May 1811, Walter Channing to Barton, 20 March [no year], Barton Papers.

52. Roswell Shurtleff to George C. Shattuck, 17 Dec. 1806; Shattuck to Shurtleff, 11 Jan. 1807, Shattuck Papers, I.

53. Shattuck to Shurlteff, 10 Nov. 1806, ibid.

54. Amos Twitchell to George C. Shattuck, 20 May 1808, Shattuck Papers, II; George Hayward to John C. Warren, 28 Nov. 1811, Thomas Foster to Warren, 14 Dec. 1811, Warren Papers, viii.

55. Benjamin Lynde Oliver to Benjamin Rush, 5 May 1808, Rush mss, xii, 57.

56. Leonard K. Eaton, “Charles Bulfinch and the Massachusetts General Hospital,” Isis, 41 (1950), 8–11.

57. Nathan Ryno Smith to George C. Shattuck, 21 Jan. 1823. A transcript of this letter, without reference to the location of the original, was given me by Miss Elizabeth H. Thomson, Department of the History of Medicine, Yale University.

* After studying Political Science at the University of South Dakota, Dr. Greene earned his M.A. and Ph.D. in History at Harvard, and he is now Professor of History at the University of Connecticut at Storrs. The author of two books on the history of evolutionary biology, he has also published, with John G. Burke, The Science of Minerals in the Age of Jefferson (1978), and is now completing American Science in the Age of Jefferson.

1. Joseph I. Waring, A History of Medicine in South Carolina, 1670–1825 (Columbia, S.C., 1964); Brooke Hindle, The Pursuit of Science in Revolutionary America, 1735–1789 (Chapel Hill, N.C., 1956), chs. 2–3; George E. Gifford, Jr., “Charleston Physician Naturalists,” Bulletin of the History of Medicine, 49 (1975), 556–574. The role of physicians in early American mineralogy is apparent in John C. Greene and John G. Burke, The Science of Minerals in the Age of Jefferson, Transactions of the American Philosophical Society, 68 (1978), part iv.

2. George W. Corner, Two Centuries of Medicine: A History of the School of Medicine, University of Pennsylvania (Philadelphia and Montreal, 1965); Whitfield J. Bell, Jr., The Colonial Physician and Other Essays (New York, 1975); George Gaylord Simpson, “The Beginnings of Vertebrate Paleontology in North America,” Proceedings of the American Philosophical Society, 86 (1943), 130–188; George E. Gifford, Jr., “Medicine and Natural History—Crosscurrents in Philadelphia in the Nineteenth Century,” Transactions & Studies of the College of Physicians of Philadelphia 4th ser., 45 (1978), 139–149.

3. Courtney R. Hall, A Scientist of the Early American Republic, Samuel Latham Mitchill 1764–1831 (New York, 1934); Christine Chapman Robbins, David Hosack, Citizen of New York (Memoirs of the American Philosophical Society, 62, 1964).

4. I. Bernard Cohen, Some Early Tools of American Science... (Cambridge, Mass., 1950); Jeanette E. Graustein, “Natural History at Harvard College, 1788–1842,” Proceedings of the Cambridge Historical Society, 38 (1959–60), 69–86; Henry R. Viets, A Brief History of Medicine in Massachusetts (Boston and New York, 1930), chs. 4–5; Edward Warren, The Life of John Warren, M.D.... (Boston, 1874).

5. Quoted in George P. Fisher, Life of Benjamin Silliman, M.D.. LL.D.... Chiefly from his Manuscript Reminiscences, Diaries, and Correspondence, 2 v. (New York, 1866), I, 19.

6. Benjamin Waterhouse, autobiographical ms at the Francis A. Countway Library of Medicine, Harvard Medical School. See also James J. Abraham, Lettsom: His Life, Times, Friends and Descendants (London, 1933), 360–361; Lloyd E. Hawes, Benjamin Waterhouse, M.D., First Professor of the Theory and Practice of Physic at Harvard and Introducer of Cowpox Vaccination into America... (Boston, 1974).

7. Sidney Willard, Memories of Youth and Manhood, 2 v. (Cambridge, Mass., 1855), I, 169.

8. Edward Warren, The Life of John Collins Warren, M.D. Compiled Chiefly from his Autobiography and Journals, 2 v. (Boston, 1860); James Jackson Putnam, A Memoir of Dr. James Jackson With Sketches of His Father Hon. Jonathan Jackson, and His Brothers... (Boston and New York, 1905); Walter L. Burrage, A History of the Massachusetts Medical Society with Brief Biographies of the Founders and Chief Officers, 1781–1922 (Norwood, Mass., 1923).

9. John Gorham to Benjamin Silliman, Boston, 20 Nov. 1809, and 28 Sept. 1810, Silliman Correspondence, Beinecke Library, Yale University. See also James Jackson, An Address Delivered at the Funeral of John Gorham, M.D.... (Boston, 1829). There is a good account of Gorham in Cohen, Some Early Tools of American Science ..., ch. 4.

10. John Gorham to Benjamin Silliman, Boston, 20 June 1811, Silliman Correspondence, Beinecke Library, Yale University.

11. Ibid.

12. Some Account of the Medical School in Boston, and of the Massachusetts General Hospital (Boston, 1824).

13. Warren, Life of John Collins Warren, I, 11, quoting J. C. Warren’s autobiographical notes.

14. John Collins Warren, A Comparative View of the Sensorial and Nervous Systems in Men and Animals (Boston, 1822). Appendix H consists of an “Account of the Crania of some of the Aborigines of the United States.” Alěs Hrdlička, in his Physical Anthropology: Its Scope and Aims, Its History and Present Status in the United States (Philadelphia, 1919), 31, describes Warren’s “Account” as being “remarkable for the systematic, technical descriptions of the specimens.”

15. George E. Ellis, Memoir of Jacob Bigelow, M.D., LL.D., Proceedings of the Massachusetts Historical Society, 17 (1879–1880), 383–467.I am indebted to RichardJ. Wolfe for letting me see a manuscript copy of his Jacob Bigelow’s “American Medical Botany,” 1817–1821 (Boston, 1979).

16. “Museum of Natural History,” New England Journal of Medicine and Surgery, 5 (1816), 189–191; see also 9 (1820), 311–313. See also Thomas T. Bouvé, Historical Sketch of the Boston Society of Natural History; With a Notice of the Linnaean Society, Which Preceded It, Anniversary Memoirs of the Boston Society of Natural History... 1830–1880 (Boston, 1880), 4–14.

* Dr. Jones earned his B.A. in History at Duke University. After studying Law at the University of Texas, he obtained his MA. in History there, and his Ph.D., in the History of American Civilization, at Brandeis University. Now Assistant Professor of History at Tufts University, he has just completed a fellowship at the Charles Warren Center for Studies in American History at Harvard. He has published several articles on the history of the law, poverty, and charity in colonial America.

1. William Bentley, The Diary of William Bentley, 2 vols. (Gloucester, Mass., 1962), II, 88.

2. These changes in Essex County are discussed in Douglas Lamar Jones, “Geographic Mobility and Society in Eighteenth-Century Essex County, Massachusetts” (Ph.D. dissertation, Brandeis University, 1975); also, see Philip J. Greven, Jr., Four Generations: Population, Land, and Family in Colonial Andover, Massachusetts (Ithaca, 1970). For a more focused discussion of poverty in Essex County, see Douglas Lamar Jones, “The Strolling Poor: Transiency in Eighteenth-Century Massachusetts,” Journal of Social History, 8 (1975), 28–54.

3. David J. Rothman, The Discovery of the Asylum: Social Order and Disorder in the New Republic (Boston, 1971); Gerald Grob, Mental Institutions in America (New York, 1973).

4. Rothman, Asylum, 3–6. One should also consult Albert Deutsch, “The Sick Poor in Colonial Times,” American Historical Review, 46 (1940–1941), 560–579.

5. For a fuller exposition of the religious concept of “affliction” and Puritan ideas of poverty and wealth, see Stephen Foster, Their Solitary Way: The Puritan Social Ethic in the First Century of Settlement in New England (New Haven, 1971), 124–129; and chapter five generally.

6. The Reverend William Bentley, Sermon No. 20 [undated], [p. 1]. The manuscript sermons of Bentley are located in the Archives of Tufts University, Medford, Massachusetts.

7. Bentley, Sermon No. 20, [p. 7].

8. Foster, Their Solitary Way, 134–144.

9. Jones, “The Strolling Poor,” 42–48; also see Hendrik Hartog, “The Public Law of a County Court; Judicial Government in Eighteenth Century Massachusetts,” American Journal of Legal History, 20 (1976), 282–329.

10. Petition and Acct. of Selectmen of Andover Abt Joshua Barker of Methuen, File Papers, 1761, Essex County Court of General Sessions of the Peace. Hereafter, references to the Essex Sessions Court will be only to the File Papers or to the Record Books. These materials are located in the Clerk’s Office, Salem Courthouse, Salem, Massachusetts.

11. Newbury v. Gloucester, File Papers, 1763.

12. Petition of the Selectmen of the Town of Marblehead, File Papers, 1752.

13. E. A. Holyoke, Leger-Book [sic], [vii], [No. ii], 1181, 1125, Holyoke Papers, Essex Institute, Salem, Massachusetts.

14. Petition of Andover for H. Long, File Papers, 1757.

15. Petitions of Tho. Rowell Etc. for Mary Flanders, File Papers, 1759; Petition of Town of Rowley, File Papers, 1769.

16. On these points, see Hartog, “The Public Law of a County Court,” 303–308.

17. Case of Mary Harris, Record Book, December Term, 1764, 37.

18. Massachusetts Acts and Resolves, ch. 17, 1758–1759, 178–179. On midwifery in early America, see Catherine M. Scholten, “ ‘On the Importance of the Obstetrick Art’: Changing Customs of Childbirth in America, 1760–1825,” William and Mary Quarterly, 34 (1977), 426–445; and Charlotte Gregg Borst, “Midwives in Early New England, 1620–1820: From Healer and Community Authority to Quack and Outsider” (M.A. thesis, Tufts University, 1977).

19. Case of Joan Reed, Record Book, February Term, 1717.

20. Petition of Selectmen of Haverhill, File Papers, 1765; Wenham Town Records (Wenham, Mass., 1930), III, 99.

21. For more general discussions of the categories of physicians and medical practitioners in early America, see Richard Harrison Shryock, Medicine and Society in America, 1660–1860 (Ithaca, 1962), 1–43; and Whitfield J. Bell, “Medical Practice in Colonial America,” Bulletin of the History of Medicine, 31 (1957), 442–453.

22. Among numerous examples, see the Case of Sarah Silver, File Papers, 1758.

23. Newbury v. Gloucester, File Papers, 1763.

24. Petition... of Andover Abt Joshua Barker..., File Papers, 1761.

25. Quoted in Henry Follansbee Long, “The Physicians of Topsfield, with Some Account of Early Medical Practice,” Historical Collections of the Topsfield Historical Society, 16 (1911), 7; also quoted in Bell, “Medical Practice in Colonial America,” 450–451, fn. 28.

26. The Holyoke ledgers and day books are in the Holyoke Papers; Amos Spofford’s book, April 1795, is a one-volume ledger, dated 1795–1804; and Nehemiah Cleaveland left three volumes of account books and six day books. All of these manuscript materials are located in the Essex Institute, Salem, Massachusetts.

27. DAB, ix, s.v. “Holyoke, Edward Augustus.”

28. Salem Town Records, 10 May 1749. Box 4 (1748–1775), folder 1, 22. This is a handwritten copy in the Essex Institute. For Holyoke’s participation, see, ibid., 16 May 1770. Box 4 (Oct 1768 – Oct. 1770), folder 8, 786–787.

29. See John Duffy, Epidemics in Colonial America (Baton Rouge, La., 1953), 127–128, 176–177; and Shryock, Medicine and Society, 91–95.

30. Jones, “The Strolling Poor,” 45.

31. Joseph B. Felt, Annals of Salem, 2 v. (Salem, Mass., 1849), II, 400–401; Rules and Orders for the Management of the Work House ... 1749–1798, v. 14, Public Welfare Department, Salem, Mass. Located in the Essex Institute. For a useful discussion of the workhouse in Salem in the very early nineteenth century, see Anne Farnam, “Uncle Venner’s Farm: Refuge or Workhouse for Salem’s Poor?” Essex Institute Historical Collections, 109 (1973), 60–86.

32. Overseers of the Poor. Miscellaneous, 1746–1832, Essex Institute. Most of the payments from the few records which remain went to Holyoke. He may have been the official physician to the poor, but no evidence indicates that this relationship was formalized with the town selectmen. Dr. Moses Little is recorded as receiving payments from the town in 1794 and 1795.

33. The sample years examined include, with the number of sick poor visited, the following: 1756 (55); 1761 (48); 1766 (39); 1771 (43); and 1776 (301). This information is taken from Leger-Book [sic], v. i, no. ii, 156; ibid., v. ii, no. ii, 233, 358; ibid., v. iii, no. ii, 477, and v. iv, no. ii, 628; ibid., v. [iv], no. [ii], 760, and v. [v], no. [ii], 885; and v. [vii], no. [ii], 1181, 1125.

34. Low mean ages of death for both lower-class men and women in two Essex County towns, Beverly and Wenham, occurred during the eighteenth century; see Jones, “Geographic Mobility and Society,” 47–52.

35. Generally, see Shryock, Medicine and Society, 100–105. For the Salem workhouse, see “Rules and Orders for the Management of the Work House,” 870, Salem Town Records. Box 4 (Oct. 1770 – Jan. 1773), folder 9.

36. Although the sample of Cleaveland’s patients is taken from the year 1784, it can be considered comparable to Holyoke’s because each year represented the early stages of medical practice for the two physicians.

37. For the daily caseloads of physicians in neighboring southern New Hampshire, see J. Worth Estes, “Therapeutic Practice in Colonial New England,” especially Table I, below, 289–383.—eds.

38. William Barlow and David O. Powell, “James Thacher’s American Medical Biography: The Sketch of Dr. Joseph Orne of Beverly, Massachusetts,” Essex Institute Historical Collections, 114 (1978), 213–221; see especially the letter from Orne to Holyoke, 218–220.

* Dr. Wigglesworth studied Sociology as an undergraduate at Harvard, where he also earned his M.D. degree. Although his primary activity is private surgical practice, he is an Instructor in Surgery at the Tufts University School of Medicine and has been studying medical history for the past ten years because he enjoys it.

1. Russell Leigh Jackson, The Physicians of Essex County (Salem, Mass., 1948), 42.

2. Thomas Franklin Waters, Ipswich in the Massachusetts Bay Colony (Ipswich, Mass., 1905), 83.

3. See C. Helen Brock, “The Influence of Europe on Colonial Massachusetts Medicine,” and its Appendix, above, 101–143.—eds.

4. Henry R. Viets, A Brief History of Medicine in Massachusetts (Boston, 1930), 11.

5. Henry E. Sigerist, A History of Medicine, (New York, 1951), I, 207.

6. Viets, Brief History, 2.

7. L. S. Bryan, “Blood Letting in American Medicine,” Bulletin of the History of Medicine, 28 (1964), 516–529; Ralph Major, A History of Medicine (New York, 1959), 53; Guido Majno, The Healing Hand (Cambridge, Mass., 1975), 417–418.

8. Ibid., 400; Allen O. Whipple, The Story of Wound Healing and Wound Repair (Springfield, Ill., 1963), 48.

9. L. M. Zimmerman and Ilza Vietz, Great Ideas in the History of Surgery (Baltimore, 1961), 96; Viets, Brief History, 3.

10. Richard Hardway Meade, An Introduction to the History of General Surgery (Philadelphia, 1968), 156.

11. For the professional education of later practitioners, see Eric H. Christianson, “The Medical Practitioners of Massachusetts, 1630–1800,” above, 49–67; Philip Cash, “The Professionalization of Boston Medicine, 1760–1803,” above, 69–100; and C. Helen Brock, “The Influence of Europe on Colonial Massachusetts Medicine,” above, 101–143.

12. Ralph Boas and Louise Boas, Cotton Mather: Keeper of the Puritan Conscience (New York, 1928).

13. Oliver Wendell Holmes, Medical Essays, 2 v. (Boston, 1892), II, 277–286. Viets’ Brief History, 48–49.

14. Viets, Brief History, 37–38; Walter L. Burrage, A History of the Massachusetts Medical Society... 1781–1922 (Norwood, Mass., 1923), 92–94.

15. Bernard Wolf Weinberger, An Introduction to the History of Dentistry In America (St. Louis, 1948), 3.

16. James G. Mumford, A Doctor’s Table Talk (New York, 1912), 252.

17. Uncatalogued manuscript notes, Edward Augustus Holyoke Papers, Essex Institute, Salem.

18. Therapeutic trial and error seem to have been infrequent; see J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383.

19. Francisco Guerra, American Medical Bibliography, 1639–1783 (New York, 1962), 462–463.

20. J. Worth Estes, Hall Jackson and the Purple Foxglove (Hanover, N.H., 1979), 5–9.

21. Burrage, Medical Society, 1. (As Professor Cash points out, the Boston doctors did not form a permanent association until after the war; see above, 69–100.—eds.)

22. Baron [Gerhard] van Swieten, The Diseases Incident to Armies with the Method of Cure (Philadelphia, 1776), 81.

23. Ibid., 81–82.

24. William Northcote, Extracts from the Marine Practice of Physic and Surgery (Philadelphia, 1776), issued with van Swieten, note 22 above, 115.

25. Ibid., 115.

26. Ibid., 116.

27. John Jones, Plain Concise Practical Remarks on the Treatment of Wounds and Fractures (Philadelphia, 1776), 5–9. The first edition had been issued in the previous year.

28. Ibid., 21–24.

29. Ibid., 25–26.

30. Ibid., 30–44, especially 41.

31. Ibid., 44–56.

32. Ibid., 56–59.

33. Ibid., 56–57

34. Massachusetts Medical Society Documents, unpublished manuscripts, Countway Library of Medicine, Boston, 11, numbers 9, 26, 32, 42.

35. John Ashurst, “Surgery Before the Days of Anesthesia,” in The Semi-Centennial of Anaesthesia (Boston, 1897), 28–29; Whipple, Wound Healing, 68.

36. Whipple, Wound Healing, 31.

37. Ibid., 32.

38. Jones, Practical Remarks, 1. For a detailed discussion of the problems in practical surgery which the introduction of anesthesia would later alleviate, see Josiah Charles Trent, “Surgical Anesthesia,” Journal of the History of Medicine and Allied Sciences, 1 (1946), 505–514.

* A student of American Literature at Middlebury College, Dr. Cassedy earned his A.M. and Ph.D. in American Civilization at Brown University. As Historian at the National Library of Medicine in Bethesda, he is Editor of the Library’s annual Bibliography of the History of Medicine. He published his Demography in Early America in 1969, and is now completing a book on Medicine, Statistics, and National Growth in Nineteenth-Century America.

1. See, for example, Tables VI through IX in J. Worth Estes, “Therapeutic Practice in Colonial New England,” below, 289–383.—eds.

2. John Southerden Burn, The History of Parish Registers in England (London, 1829); James Christie, Some Account of Parish Clerks (London, 1893); James H. Cassedy, “Medicine and the Rise of Statistics,” in Allen G. Debus, ed., Medicine in Seventeenth Century England (Berkeley, 1974), 283–312.

3. John B. Blake, “The Early History of Vital Statistics in Massachusetts,” Bulletin of the History of Medicine, 29 (1955), 46–54; Robert Gutman, Birth and Death Registration in Massachusetts 1639–1900 (New York, 1959); R. R. Kuczynski, “The Registration Laws in the Colonies of Massachusetts Bay and New Plymouth,” Journal of the American Statistical Association, 7 (1900–1901), 65–73. These state registers recorded births and deaths in place of baptisms and burials. Apart from the vital statistics registers, of course, Massachusetts colonial officials were concerned with collective mortality as a phase of political arithmetic; royal governors were regularly instructed to furnish the Board of Trade in London with information on the numbers of births and deaths.

4. Annual bills of mortality were issued in Salem starting in 1768. Boston did not make provision for regular, printed bills until 1810. See Boston News-Letter, 1704 onward; Maris A. Vinovskis, “Mortality Rates and Trends in Massachusetts before 1860,” Journal of Economic History, 32 (1972), 185–190; John B. Blake, Public Health in the Town of Boston, 1630–1822 (Cambridge, Mass., 1959), 106–107, 213–215; Cassedy, Demography, 117–147.

5. Samuel Sewall’s records of this kind of information are particularly well known. “Diary of Samuel Sewall, 1674–1729,” Collections of the Massachusetts Historical Society, 5th ser., 6 (1879). For examples of local lists of deaths that were kept by women, see Mary F. Peirce, ed., Town of Weston: Births, Deaths and Marriages 1701–1850 (Boston, 1901). See Josiah H. Benton, Jr., Early Census Making in Massachusetts 1643–1763 (Boston, 1905); and James H. Cassedy, Demography in Early America: Beginnings of the Statistical Mind 1600–1800 (Cambridge, Mass., 1969).

6. While historians sometimes refer to these journals or registers as “bills of mortality,” this terminology can and does cause confusion. In the present context, therefore, I have deliberately distinguished between the private, unpublished mortality lists of the clergyman, and the public published documents which emulated the original London bills of mortality. Unlike a few Anglican and other parishes of Philadelphia and Charleston, South Carolina, the Massachusetts churches (Congregational as well as other) apparently never published their vital records in the form of broadside bills of mortality.

7. Edmund S. Morgan, The Puritan Family (New York, 1966); Ola Elizabeth Winslow, Meetinghouse Hill 1630–1783 (New York, 1952), 99; David E. Stannard, “Death and the Puritan Child,” in his Death in America (Philadelphia, 1975), 9–29. The symbols of death which adorned eighteenth-century gravestones were often the same as those which embellished printed funeral sermons and bills of mortality. See Allen Ludwig, Graven Images: New England Stonecarving and Its Symbols 1650–1815 (Middle-town, Conn., 1966); and Margaret M. Coffin, Death in Early America (Nashville, 1976). For a discussion of some of the possibilities in quantitative studies of New England gravestones, see Edwin S. Dethlefsen, “Colonial Gravestones and Demography,” American Journal of Physical Anthropology, 31 (1969), 321–333.

8. “Diary of Samuel Sewall,” 170.

9. Among the particularly useful publications are Blake, Public Health in Boston; John Duffy, Epidemics in Colonial America (Baton Rouge, La., 1953); Ernest Caulfield, A TrueHistory of the Terrible Epidemic Vulgarly Called the Throat Distemper (New Haven, 1939); Vinovskis, “Mortality Rates and Trends in Massachusetts”; R. S. Meindl and A. C. Swedlund, “Secular Trends in Mortality in the Connecticut Valley, 17001850,” Human Biology, 49 (1977), 389–414.

10. William B. Trask, ed., “Rev. Samuel Danforth’s Records of the First Church inRoxbury, Mass.,” New England Historical and Genealogical Register, 34 (1880), 84–89, 162–166, 297–301, 359–363.

11. Isaac Backus, “Bills of Mortality (1749–1805),” unpublished manuscript at Andover Newton Theological School.

12. Thomas Prince, A Sermon occasioned by the Death of the Honourable Mary Belcher (Boston, 1736), 10–12.

13. For a discussion of these interests, see Cassedy, Demography, 111–116, 172–179.

14. Ezra Stiles, “Deaths in Newport, R.I., 1760–1764,” New England Historical and Genealogical Register, 62 (1908), 283–291, 352–363; 63 (1909), 51–58. The original manuscript of this document is in the Rhode Island Historical Society.

15. Ezra Stiles, A Funeral Sermon, Delivered Thursday, July 26, 1787 (New Haven, 1787). Stiles appended extracts and analyses from Whittelsey’s records. Jeremy Belknap, The History of New-Hampshire, 2nd ed., 3 v. (Boston, 1813), iii, 178–188.

16. The first of these periodicals, New York’s Medical Repository (v. 1, 1797–1798), included several such contributions from clergymen in its early years. Boston’s Medical and Agricultural Register did not even bother to solicit these kinds of data from doctors, but concentrated on the clergy. Ibid., I, 1806–1807, cited in Blake, Public Health in Boston, 214–215.

17. Edward Wigglesworth, "A Table shewing the Probability of the Duration, the Decrement, and the Expectation of Life, in the States of Massachusetts and New Hampshire, formed from sixty two Bills of Mortality on the files of the American Academy of Arts and Science, in the ear 1789," <i>Memoirs, American Academy of Arts and Sciences,</i> 2, parts 1-2 (1793) 131-135; American Academy of Arts and Sciences, broadside dated 10 Nov. 1785, "Sir, The American Academy. . ." (Boston 1785). For a recent analysis of the merits and shortcomings of Wigglesworth's table, see Maris A. Vinoskis, "The 1789 Life Table of Edward Wigglesworth," <i>Journal of Economic History,</i> 31 (1971), 570-590. Among other things, the Academy's 1785 questionnaire asked that annual vital statistics submittd be entered on a standard form, upon which causes of death should be listed under any of sixty-eight different suggested disease terms.

18. While it seems certain that most returns were made by clergymen, it is not now possible to verify this since the original bills collected by the Academy in the 1780’s are no longer in the Academy’s files and have not been located in other repositories. At the same time, while a great many seventeenth- and eighteenth-century mortality journals of clergymen have been located and published by historical periodicals, I have not seen any by Massachusetts physicians reproduced in such publications.

19. Edward Augustus Holyoke, “A Bill of Mortality for the town of Salem, for the year 1782,” Memoirs, American Academy of Arts and Sciences, 1 (1785), 546–550 (includes the bill for 1783); Edward A. Holyoke, “On Meteorological Observations and Bills of Mortality,” ibid., 2, part 2 (1804), 58–61; Edward Augustus Holyoke, “An Account of the Weather and of the Epidemics, at Salem, in the County of Essex, for the year 1786,” Medical Communications, Massachusetts Medical Society, 1 (1787), 17–40 (includes bill of mortality for 1786).

20. J. Worth Estes, “As Healthy a Place as Any in America’: Revolutionary Portsmouth, N.H.,” Bulletin of the History of Medicine, 50 (1976), 536–552. Josiah Bartlett did not start keeping records of the births and deaths “within the limits of his practice” in Charlestown, Massachusetts, until 1789, while Lyman Spalding did not initiate his bills of mortality for Portsmouth, New Hampshire, until 1801. Jedidiah Morse, “Topographical Account of Charlestown (Massachusetts), with Bills of Mortality, Etc., Etc.,” Medical Repository, 2 (1799), 7–12; Lyman Spalding, “Bill of Mortality for Portsmouth, New Hampshire, for a.d. 1801,” Medical Repository, 5 (1802), 354.

21. Cassedy, Demography, 117–147, 274–304.

* Dr. Gifford obtained both his B.S. and M.D. degrees at the University of Maryland, and an M.A. in the History of Science at Harvard. A practicing psychiatrist, he is also Consultant to the Historical Collections at the Countway Library and head of the section on the History of Medicine in the Department of Socio-Medical Sciences at Boston University School of Medicine. A student of the history of natural history, he edited a book on the Physician Signers of the Declaration of Independence (1976).

1. J. J. Byrne, “Medicine at Plymouth Plantation,” New England Journal of Medicine, 259 (1958), 1012–1017; H. M. Dexter, “October Meeting 1889: Catalogue of Elder Brewster’s Library,” Proceedings of the Massachusetts Historical Society, 5 (1889), 37–85.

2. T. F. Harrington, “Dr. Samuel Fuller, of Mayflower (1620), Pioneer Physician,” Bulletin of the John Hopkins Hospital, 14 (1903), 263–270; Henry R. Viets, A Brief History of Medicine in Massachusetts (Boston, 1930), 8–18, 28; James Thacher, American Medical Biography, 2 v. (Boston, 1828), I, 266–267.

3. For an excellent account of medical practice in this era, see Joseph F. Kett, The Formation of the American Medical Profession (New Haven, 1968), 1–13. For other overviews, see Richard Harrison Shryock, Medicine and Society in America, 1660–1860 (Ithaca, 1962), 1–43; Gordon W. Jones, ed., The Angel of Bethesda by Cotton Mather (Barre, Mass., 1972), xxxi–xxxv; O. T. Beall and R. H. Shryock, Cotton Mather, First Significant figure in American Medicine (Baltimore, 1954), 19–33.

4. Quoted in Richard Harrison Shryock, The Development of Modern Medicine (New York, 1947), 19.

5. Fielding H. Garrison, An Introduction to the History of Medicine, 4th ed. (1929; rpt. ed., Philadelphia, 1960), 112; Malcolm Sydney Beinfield, “The Early New England Doctor: An Adaptation to a Provincial Environment,” Yale Journal of Biology and Medicine, 15 (1942–1943), 103–104; Edward Eggleston, The Transit of Civilization, from England to America in the Seventeenth Century (Boston, 1959), 50–58.

6. For information about the “doctrine of signatures” see: Garrison, History, 205, 206, 237; C. Mettler, History of Medicine (Philadelphia, 1947), 2, 201; Ralph C. Major, A History of Medicine, 2 v. (Springfield, Ill., 1954), I, 388–390; Maurice Bear Gordon, Aesculapius Comes to the Colonies (Ventnor, N.J., 1949), 3–4; Thomas J. Pettigrew, On Superstitions Connected with the History and Practice of Medicine and Surgery (London, 1844); Arturo Castiglioni, A History of Medicine (New York, 1947), 21, 449; Byrne, “Plymouth Plantation,” see note 1; Agnes Arber, Herbals: Their Origin and Evolution (Cambridge, England, 1938), 247–263; Eleanour S. Rohde, The Old English Herbals (New York, 1922), 1, 168–169, 231; Whitehead, “Indian Medical Exhibit,” 1–26; Harvey Wickes Felter, “The Genesis of the American Materia Medica Including a Biographical Sketch of’John Josseln, Gent’,” Bulletin of the Lloyd Library, no. 26, Reproduction series no. 8 (1927), 4; Beinfield, “New England Doctor”; Scott Buchanan, The Doctrine of Signatures (New York, 1938); Encyclopaedia Britanitica (Chicago, 1952), xx, 644.

7. Quoted in Arber, Herbals, 250–251.

8. Eggleston, Transit, 57.

9. Mettler, History, 200.

10. Rembert Dodoens (1517–1585), physician to the Emperors Maximilian II and Rudolph II, is best known today as a botanist. His Crydboeck (Antwerp, 1553) was assembled with other of his writings in a huge Stirpium historiae (Antwerp, 1583), which became a model for Gerard’s Herball, according to Castiglioni, Medicine, 441. Other references to Dodoens are in Arber, Herbals, 70, 76, 81, 83–86, 91, 122–126, 155, 162, 174, 176, 227–229, 232–234, 239, 255, 266, 277–280; Rohde, Herbals, 58, 83, 86, 93–98, 100, 103–104, 211–212, 230. According to Viets, Massachusetts, 21, “Gerard took most of his material from the great Latin herball of Dodoens, claiming it to be a work of his own.”

11. E. Kremers, “American Pharmaceutical Documents, 1643 to 1780,” Badger Pharmacist, no. 15 (1937). The original 1643 letter of Dr. Stafford is in the Boston Medical Library Collections, Countway Library.

12. Oliver Wendell Holmes, Medical Essays (Boston, 1911), 318.

13. Rohde, Herbals, 29, 83, 90, 116, 142–162, 213, 214; Arber, Herbals, 134–138, 174, 176, 233, 237, 284; Mettler, History, 211.

14. Garrison, History, 289.

15. Thomas O. Cockayne, ed., Leechdoms, Wortcunning, and Starcraft of Early England (London, 1864–1866).

16. Jerry Stannard, “Medical Botany,” in Joseph Ewan, ed., A Short History of Botany in the United States (New York, 1969), 147.

17. The idea was also promulgated by N. Culpeper. In the 1661 edition of his Physical Directory, the subtitle is Being an Astrologo-Physical Discourse of the Vulgar Herbs of this Nation: Containing a Compleat Method of Physick, Wliereby a Man May Preserve His Body in Health; or Cure Himself, Being Sick, for Three Pence Charge, with Such Things Only as Crow in England, They Being Most Fit for English Bodies’; see Arber, Herbals, 261.

18. Robert Turner, The British Physician (London, 1664), quoted in Arber, Herbals, 255. This idea was also espoused by Cotton Mather who was convinced that God had placed remedies in each part of the world where they were appropriate; see his Christian Philosopher, 136.

19. Eggleston, Transit, 68–69, 79; Garrison, History, 290.

20. Charles Whitehead, “The Indian Medical Exhibit of the Division of Medicine in the United States National Museum,” Proceedings of the U.S. National Museum, 67, n.d., article 10, 18–19.

21. John B. Beck, Historical Sketch of the State of Medicine in the American Colonies... (Albany, 1850), 35.

22. For information about Indian plant remedies, see “The Herb Spirit Healeth,” Clinical Excerpts, 5, no. 3 (1941), 67–76; Lloyd G. K. Carr, “Interesting Animal Foods, Medicines, and Omens of the Eastern Indians, with Comparison to Ancient European Practices,” Journal of the Washington Academy of Sciences, 44 (1954), 229–235; C. M. Cobb, “Some Medical Practices among the New England Indians and Early Settlers,” Boston Medical and Surgical Journal, 177 (1917), 97–105; William N. Fenton, “Contacts between Iroquois Herbalism and Colonial Medicine,” Annual Report of the Smithsonian Institution, 1941, 503–526; William N. Fenton, “Medicinal Plant Lore of the Iroquois,” New York State University Bulletin to Schools, 35, no. 7 (1949), 233–237; Leaman F. Hallett, “Medicine and Pharmacy of the New England Indians,” Bulletin of the Massachusetts Archaeological Society, 17 (1955), 46–49; John U. Lloyd, Origin and History of All the Pharmacopoeial Vegetable Drugs (Cincinnati, 1929); Henry A. Sigerist, A History of Medicine (New York, 1951), 1; H. W. Youngken, “Drugs of the North American Indians,” American Journal of Pharmacy, 96 (1925), 485–502; 97 (1926), 158–185, 257–271; Beinfield, “New England Doctor,” 99–132; W. T. Bradley, “Medical Practices of the New England Aborigines,” Journal of the American Pharmaceutical Association, 25 (1936), 146; Felter, “Genesis,” 4–64.

23. Bradley, “Practices,” 153.

24. Beinfield, “New England Doctor,” 114.

25. Quoted in Ewan, Short History, 146.

26. Glenn Sonnedecker, Kremers and Urdang’s History of Pharmacy, 4th ed. (Philadelphia, 1976), 152–158.

27. Peter Kalm, Travels into North America, 2nd ed., 2 v. (London, 1772), II, 268.

28. David L. Cowen, “The British North American Colonies as a Source of Drugs” (1966), quoted in Sonnedecker, History of Pharmacy, 152.

29. Felter, “Genesis,” 21.

30. Ibid., 23.

31. Ibid., 57–58.

32. Ibid., 27.

33. Kalm, Travels, i, 160.

34. Ibid., 337–338.

35. Ibid., 155–156.

36. Quoted in Ewan, Short History, 147.

37. Quoted in Beall and Shryock, Cotton Mather, 46.

38. Ibid., 46–47.

39. Ibid., 60.

40. Sonnedecker, History of Pharmacy, 161; Robert B. Austin, Early American Medical Imprints 1668–1820 (1961; rpt. ed., Arlington, Mass., 1977), 98; Francisco Guerra, American Medical Bibliography, 1639–1783 (New York, 1962), 76–77.

41. George Griffenhagen, “Bartholomew Browne, Pharmaceutical Chemist of Salem, Massachusetts, 1698–1704,” Essex Institute Historical Collections, 94 (1961), 19–27.

42. Edward Kremers, “A Drug List of King Philip’s War,” Badger Pharmacist, no. 25 (1939), 1–18.

43. William Salmon, Pharmacopoeia Londinensis (London, 1691), 175.

44. Buckner Hollingsworth, Flower Chronicles (New Brunswick, N.J., 1958), 20; Sonnedecker, History of Pharmacy, 153.

45. Sonnedecker, History of Pharmacy, 153.

46. David L. Cowen, “The Boston Editions of Nicholas Culpeper,” Journal of the History of Medicine and Allied Sciences, XI (1956), 157; Garrison, History, 375.

47. Cowen, “Boston Editions,” 158.

48. Ibid., 165.

49. Sonnedecker, History of Pharmacy, 161.

50. Mettler, History, 216.

51. John C. L. Clark, “The Famous Doctor Stearns,” Proceedings of the American Antiquarian Society, 45, part 1 (1935), 317–324; Guerra, Bibliography, 353, 357, 379, 385, 537, 715, 724, 729; Austin, Imprints, 192.

52. Clark, “Stearns,” 355.

53. Quoted ibid., 327.

54. Quoted ibid., 328.

55. Ibid., 376.

56. Austin, Imprints, 214–215; Guerra, Bibliography, 157–158; John Wesley, Primitive Remedies (rpt. ed., Beverly Hills, Calif., 1973).

57. For information about Cutler, see Brooke Hindle, The Pursuit of Science in Revolutionary America, 1737–1789 (Chapel Hill, N.C., 1956), 303, 313–314, 357; William Parker Cutler and Julia Perkins Cutler, Life, Journals and Correspondence of Rev. Manasseh Cutler. LL.D., 2 v. (Cincinnati, 1888); Ewan, Short History, 36, 38.

58. Cutler and Cutler, Life, I, 73.

59. Ibid., 82.

60. Ewan, Short History, 37; Mettler, History, 211.

61. Hindle, Pursuit, 263–273.

62. Cutler and Cutler, Life, I, 283.

63. Mannasseh Cutler, An Account of Some of the Vegetable Productions Naturally Growing in this Part of America (Boston, 1785), 491.

64. Cutler and Cutler, Life, ii, 259.

65. Ewan, Short History, 6, 37–38, 40, 47–48, 115; Cutler and Cutler, Life, ii, 287–288.

66. Ibid., fn. 291, 289; Ewan, Short History, 41, 89–90; Beall and Shryock, Cotton Mather, 16.

67. Cutler and Cutler, Life, ii, fn., 311–312; Ewan, Short History, 8, 39–40, 47, 115–116, 148.

68. Austin, Imprints, 183; Guerra, Bibliography, 120; Helen Gere Cruickshank, ed., John and William Bartram’s America (New York, 1957), 50–51.

69. Harold W. Rickett, Wild Flowers of the United States: The North Eastern States, 2 v. (New York, 1967), ii, 417.

70. Ewan, Short History, 35.

71. S. A. Green, A History of Medicine in Massachusetts (Boston, 1881), 56; Viets, History, 70.

72. William Douglass, A Summary, Historical and Political, of the First Planting, Progressive Improvements, and Present State of the British Settlements in North America, 2 v. (London, 1755), ii, 216.

73. Douglass, Summary, I, 449.

74. Beck, Historical Sketch, 37–70; Ewan, Short History, 33, 35, 36; John Tennent, “An Epistle to Dr. Mead concerning the Seneca Rattle-snake root,” Edinburgh Medical Essays and Observations, 6 (1743), 376.

75. Jones, Angel of Bethesda, xiv, xxxix.

76. David L. Cowen, “The Edinburgh Pharmacopoeia,” in The Early Years of the Edinburgh Medical School, ed. R. G. W. Anderson and A. D. C. Simpson (Edinburgh, 1976), 25–45.

77. “Letters of Samuel Lee and Samuel Sewall Relating to New England and the Indians,” Publications of the Colonial Society of Massachusetts, 14 (1913), 159; Sonne-decker, History of Pharmacy, 156.

78. Sonnedecker, History of Pharmacy, 172–173; Hindle, Pursuit, 26, 227, 282, 307, 316.

79. Sonnedecker, History of Pharmacy, 172–173.

80. Marion E. Brown, “Adam Kuhn: Eighteenth-Century Physician and Teacher,” Journal of the History of Medicine and Allied Sciences, 5 (1950), 163–177. Also see George E. Gifford, Jr., “Medicine and Natural History: Crosscurrents in Philadelphia in the Nineteenth Century,” Transactions and Studies of the College of Physicians of Philadelphia, 4th ser., 45 (1978), 139–149.

81. George E. GifFord, Jr., “Benjamin Waterhouse the Botanist,” Harvard Medical Alumni Bulletin, 44, no. 2 (Nov./Dec. 1969), 14–16.

82. J. Worth Estes, “Concordance to Dr. Waterhouse’s Hortus Siccus,” in Lloyd E. Hawes, Benjamin Waterhouse, M.D. (Boston, 1974), 17–28.

83. George E. Gifford, Jr., “Physician of Many Facets: Jacob Bigelow,” Harvard Medical Alumni Bulletin, 39, no. 4 (March/April 1965), 34–39. Also see George E. Gifford, Jr., “The Medical Botany of New England, 1782–1842,” Proceedings of the Cambridge Historical Society, 43 (1973–1975), 127–140.

84. See note 11 above.

* After taking his A.B. in Biology at Harvard, Dr. Estes earned an M.A., in Pharmacology, and his M.D. at the Boston University School of Medicine, where he is currently Associate Professor of Pharmacology and Experimental Therapeutics, and of Socio-Medical Sciences (section on the History of Medicine). His publications relevant to this symposium include a chapter on Dr. Matthew Thornton in Physician Signers of the Declaration of Independence (1976) and a book on Hall Jackson and the Purple Foxglove: Medical Practice and Research in Revolutionary America, 1760–1820 (1979).

1. See, for a discussion of one such rare example: Lester S. King, The Medical World of the Eighteenth Century (1958; rpt. ed., Huntington, N.Y., 1971), 310–315.

2. James Thacher, The American New Dispensatory (Boston, 1810).

3. The Kendall coefficient of concordance, W, was calculated as outlined by Siegel (Sidney Siegel, Nonparatnetric Statistics for the Behavioral Sciences [New York, 1956], 229–238). The median number of drugs administered to their patients by each of the four physicians was computed by probit analysis of the cumulated percent of patients treated with increasing numbers of drugs (J. T. Litchfield, Jr., “A Method for Rapid Graphic Solution of Time-Per Cent Effect Curves,” Journal of Pharmacology and Experimental Therapeutics, 97 [1949], 399–408). Life expectancies were calculated by the method of Sachs (Rose Sachs, “Life Table Technique in the Analysis of Response-Time Data from Laboratory Experiments on Animals,” Toxicology and Applied Pharmacology, 1 [1959], 203–227).

4. Frank C. Mevers, ed., Guide to the Microfilm Edition of the Papers ofJosiah Bartlett (1729–1795) (Concord, N.H., 1976), 7–17; Frank C. Mevers, “Josiah Bartlett: Dedicated Physician, Sterling Patriot,” in George E. Gifford, Jr., ed., Physician Signers of the Declaration of Independence (New York, 1976), 99–121. Also see Frank C. Mevers, ed., The Papers of Josiah Bartlett (Hanover, N.H., 1979), which supplements the microfilm edition.

5. D. Hamilton Hurd, History of Rockingham and Strafford Counties, New Hampshire (Philadelphia, 1882), 189; Louis C. Duncan, Medical Men in the American Revolution 1775–1783 (Carlisle Barracks, Penna., 1931), 407.

6. Howard A. Kelly and Walter L. Burrage, Dictionary of American Medical Biography (1928; rpt. ed., Boston, 1971), s.v. “William Aspinwall”; Philip Cash, Medical Men at the Siege of Boston, April 1775 – April 1776 (Philadelphia, 1973), 160.

7. Ibid., 163; Kelly and Burrage, Dictionary, s.v. “David Townsend.”

8. See Douglas Lamar Jones, “Charity, Medical Charity, and Dependency in Eighteenth-Century Essex County, Massachusetts,” above, 199–213.

9. Frank C. Mevers, ed., Microfilm Edition of the Papers of Josiah Bartlett (1729–1795) (Concord, N.H., 1976), frame 3075; J. Worth Estes, “‘As Healthy a Place as Any in America’: Revolutionary Portsmouth, N.H.,” Bulletin of the History of Medicine, 50 (1976), 536–552; Robert V. Wells, The Population of the British Colonies in America before 1776 (Princeton, N.J., 1975), 72, 76.

10. William B. Weeden, Economic and Social History of New England, 2620–1789, 2 v. (Boston, 1890), II, 745–768; Carl Bridenbaugh, Cities in Revolt: Urban Life in America, 2743–1776 (1955; rev. rpt. ed., New York, 1971), 89.

11. Lyman Spalding and Richard Thurston, Bills of Mortality for Portsmouth, New Hampshire (1801–1811, 1818–1820), 14 broadsheets, Boston Medical Library. The Spearman rank difference correlation coefficient shows no similarity between the rankings of monthly morbidity in Kingston from 1751 through 1787 and of monthly mortality in Portsmouth from 1801 through 1820.

12. Wecden, Economic History, ii, 473, 484, 753–759; Bridenbaugh, Cities, 89, 252; Timothy Dwight, Travels in New England and New York, ed. B. M. Solomon & P. M. King, 4 v. (Cambridge, Mass., 1969), I, 301.

13. Ibid., iv, 327.

14. J. Worth Estes, “An Account of the Foxglove in America,” Bulletin of the History of Medicine, 47 (1973), 394–408; Kelly and Burrage, Dictionary, s.v. “William Aspinwall”; James Thacher, American Medical Biography (1828; rpt. ed., New York, 1967), 91–95; Levi Bartlett, “The Memoirs of His Late Excellency Josiah Bartlett First Governor of the State of New-Hampshire,” in Mevers, Microfilm, see note 9, ms 22, frame 5155; Josiah Bartlett to Mary Bartlett, 2 October 1775, Microfilm frame 0190; Josiah Bartlett, “Itineraries,” ms, 28 November 1775, Microfilm frame 3364. Operative details of couching can be found in J. Worth Estes, Hall Jackson and the Purple Foxglove: Medical Practice and Research in Revolutionary America, 1760–1820 (Hanover, N.H., 1979), 6–9.

15. Estes, “As Healthy a Place,” see note 9; J. Potter, “The Growth of Population in America, 1700–1860,” in D. V. Glass and D. E. C. Eversley, eds., Population in History (Chicago, 1965), 638–639.

16. More precisely, Kingston suffered 12.7 ± 7.6 deaths per year, and Kensington 9.1 ± 6.5, during the years of Bartlett’s and Rowe’s practices, respectively. These figures are more directly comparable with those in Table VII.

17. Ernest Caulfield “A History of the Terrible Epidemic, Vulgarly Called the Throat Distemper, as It Occurred in His Majesty’s New England Colonies between 1735 and 1740,” Yale Journal of Biology and Medicine, 11 (1939), 219–272. See also the same author’s paper “Some Common Diseases of Colonial Children” in Publications of the Colonial Society of Massachusetts, 35 (1951), 4–65.

18. The Kendall coefficient of concordance, W, is 0.881, its chi-squared is 66.941, at P < 0.005. Spearman rank difference correlation coefficients result in identical conclusions.

19. Thacher, Dispensatory, see note 2, 330, 366; J. Worth Estes, “John Jones’s Mysteries of Opium Revealed (1701): Key to Historical Opiates,” Journal of the History of Medicine and Allied Sciences, 34 (1979), 200–209. Camphor, still used in liniments and, by mouth, as a carminative, can cause death associated with central nervous system stimulation (Robert Kopelman, Sanford Miller, Raymond Kelly, and Irving Sunshine, “Camphor Intoxication Treated by Resin Hemoperfusion,” Journal of the American Medical Association, 241 [1979], 727–728).

20. Estes, “Foxglove in America.”

21. Pearson product-moment correlation coefficients, r, were calculated to assess the degree of relationship among the four physicians’ uses of the active ingredients listed.

22. r=0.643, P<0.01.

23. r=0.239, P<0.05, and r=0.414, P<0.01, respectively.

24. r=0.072, P>0.05.

25. r=0.615, P<0.01, for Bartlett, and r=0.330, P<0.01, for Townsend.

26. r=o.336, P<0.01.

27. r=0.529.

28. r=0.750.

29. Jeremy Belknap, The History of New-Hampshire, 2nd ed., 3 v. (Boston, 1813), III, 73–94

30. Richard Harrison Shryock, Medicine and Society in America, 1660–1860 (Ithaca, 1962), 24.

31. Bridenbaugh, Cities, see note 10, 199.

32. See, for instance, K. Danner Clouser, “Clinical Medicine as Science: Editorial,” Journal of Medicine and Philosophy, 2 (1977), 1–7; also see other papers in the same issue of that journal.

33. Shryock, Medicine and Society, 51, 66.

34. William Heberden, Commentaries on the History and Cure of Diseases (1802; rpt. ed., New York, 1962), 5–7.

35. James McKittrick Adair, Medical Cautions . . . (London, 1787), 77; Levi Bartlett, “Memoirs,” see note 14, 22–24, frames 5155–5156.

36. [Henry Mellen], poem on title page ofJabez Dow, Bill of Mortality for Kensington, N.H. (Dover, N.H., 1802).

37. King, Medical World, see note 1, 32–44, 56–58, 103, 107, 120; Oxford English Dictionary and American Heritage Dictionary, s.v. “Empiric,” “Empirical,” “Science,” “Scientific.”

38. Sometime between 1800 and 1810 Dr. Jabez Dow (1776–1839) of Dover, New Hampshire, prepared a manuscript outline of the materia medica, probably intending to publish a book on the subject. His classification resembles that used by James Thacher, although their organizations differ, especially as to the subclasses recognized by each. Dow lists the “particular” drugs he thought to be the most efficacious in each class. The drugs recommended by Dow account for about two-thirds of the prescriptions actually administered by Bartlett, Rowe, Aspinwall, and Townsend, and for about eighty percent of the active ingredients employed by them. All together the five physicians were most consonant in the drugs they used the most often. When Thacher’s Dispensatory appeared, Dow was most enthusiastic about both its relevance to the practice of medicine and its tone: “For an American physician this work is in every respect superior to Duncan’s Dispensatory & supersedes the one published some years ago at Philadelphia (Murray’s El. Pharm. & Mat. Med.). . . . [Thacher has treated his subject in a way] calculated to induce a cool & impartial trial of such of these medicines as he may not have been previously acquainted with, which appears to be the only means by which new medicines get into immediate & general use among men of medical Science.” (Jabez Dow, “Materia Medica,” MS in Jabez Dow Papers, Boston Medical Library, 18 pp.: Jabez Dow to Dr. Joseph Burden, Tamworth, N.H., 11 August 1810, in “Manuscript No. 1,” MS Blank book in Jabez Dow Papers, Boston Medical Library, 84; George Wadleigh, Notable Events in the History of Dover, New Hanpshire [Dover, N.H., 1913].)

39. Shryock, Medicine and Society, see note 30, 52.

40. Samuel P. Griffits, J. Morris, John R. B. Rodgers, Caspar Wistar, Jun., William Clarkson, and Michael Leib, [“Return of the Diseases of the Patients of the Philadelphia Dispensary,”] Transactions of the College of Physicians of Philadelphia, 1 (1793), 2–42. Many more such data will be necessary before we can definitively retute the common assumption that historic therapeutic practices were inherently irrational, or even “humbuggery,” as exemplified in Hartwin A. Schulze, “Some Old Bizarre Medical Remedies,” Scientific Monthly, May 1935, 431–439. Comparable data for a military population may be found in Estes, Hall Jackson; see note 14, Table 4.

41. For the derivation of similar conclusions from different kinds of evidence, and for the historical development of the medical profession’s concept of the vis medicatrix naturae in America, see Charles E. Rosenberg, “The Therapeutic Revolution: Medicine, Meaning, and Social Change in Nineteenth-Century America,” Perspectives in Biology and Medicine, 20 (1977), 485–506; John Harley Warner, “‘The Nature-Trusting Heresy’: American Physicians and the Concept of the Healing Power of Nature in the 1850’s and 1860’s,” Perspectives in American History, 11 (1977–1978), 291–324.

42. Belknap, History of New-Hampshire, see note 29, iii, 171–174.

43. Levi Bartlett, “Memoirs,” see note 14, 24, frame 5156.

44. Josiah Bartlett to Benjamin Rush, 25 January 1783, Mevers, Bartlett Microfilm, see note 9, item 1616; Benjamin Rush to Josiah Bartlett, 23 February 1783, ibid., item 0634.

45. Levi Bartlett, “Memoirs,” see note 14, 25, frame 5156.

* Sources of the definitions: James Thacher, The American New Dispensatory (Boston, 1810); A. C. Wootton, Chronicles of Pharmacy, 2 v. in 1 (1910; rpt. ed., Boston, 1971); Louis S. Goodman and Alfred Gilman, The Pharmacological Basis of Therapeutics, 5th ed. (New York, 1975); Walter H. Lewis and Memory P. F. Elvin-Lewis, Medical Botany (New York, 1977); The Merck Index, 7th ed. (Rahway, N.J., 1960); American Heritage Dictionary; Oxford English Dictionary; John Woodall, The Surgions Mate (London, 1617); W. Lewis, The New Dispensatory (Edinburgh and London, 1786); J. Worth Estes, “John Jones’s Mysteries of Opium Reveal’d (1701): Key to Historical Opiates,” Journal of the History of Medicine and Allied Sciences, 34 (1979), 200–209. Unless a specific reference is included in the entry, modern information about a drug’s special pharmacological and toxicological properties can usually be found in standard texts, like that of Goodman and Gilman cited just above, unless no such information is readily available.

The Professionalization of Boston Medicine, 1760–1803*

The Professionalization of Boston Medicine, 1760–1803 *