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August 23, 2013 // By John Shea // Comments

Some Firsts of the First

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Illos
John Morgan, MD

The Perelman School of Medicine at the University of Pennsylvania is the oldest medical school in the nation –- and it’s getting older every day.  In fact, it is 99.3 percent of the way to reaching 250 years old.  On May 3, 1765, the trustees of the College of Philadelphia (the University’s predecessor) approved the plan for a medical school presented by John Morgan, MD.  At the College’s commencement later that month, Morgan read his “Discourse upon the Institution of Medical Schools in America.”  Later printed as a pamphlet, the presentation required a second day for Morgan to finish.  “What I am about to propose,” he began, “is a scheme for transplanting medical science into this seminary, and for the improvement of every branch of the healing art.”  Ambitious indeed!  In November of that year, both Morgan and William Shippen Jr., MD, “his former colleague and co-strategist” delivered their first medical lectures.  Come May 2015, it will be 250 years since Morgan and Shippen received the official go-ahead for medical instruction.

Why did David Y. Cooper III, MD, and Marshall Ledger, PhD, the authors of Innovation and Tradition at the University of Pennsylvania School of Medicine: An Anecdotal Journey (University of Pennsylvania Press,1990), use the adjective “former” about Shippen?  Ah, that is another story, for another time.  Suffice to say that Shippen felt Morgan had jumped the gun and persuaded the college trustees on his own, despite the fact that the men had shared ideas about establishing a medical school in the colonies. But when Innovation and Tradition, the most recent history of Penn’s medical school, was previewed in Penn Medicine Magazine, Shippen was described as “The Other Founder.”

Fortunately, there is no argument about Penn’s being the first medical school.  George W. Corner, MD, ScD, LLD, author of Two Centuries of Medicine, which was published during the medical school’s bicentennial year of 1965, had high praise for Morgan’s vision:

            Morgan’s plan, in fact, comprised practically all the elements of medical instruction that after long, costly trial and error the American profession has since found to be essential. Affiliation with a university, qualified professors, thorough premedical preparation of the students, a planned curriculum with well-defined courses of instruction introducing the basic scientific studies before clinical work, close relations with a teaching hospital, a library, high standards for graduation -– all these are mentioned and most of them expounded at length.

It’s not surprising, then, that the medical school has accumulated many “firsts” in its history.  In 1768, Adam Kuhn was appointed the first professor of botany and “materia medica” in America -– closest to what we would now call pharmacology.  Kuhn, a Pennsylvanian, studied under Carolus Linnaeus in Sweden before returning to the colonies. The school had the first chair of chemistry in America, in the person of Benjamin Rush, MD.  Last year, Penn Medicine ran an article that considered Rush’s seminal textbook on psychiatry, the first of its kind in the United States. It appeared in 1812. Another name that looms large in Philadelphia history is Caspar Wistar. He was the first chair of “institutes of medicine,” a term then used by the University of Edinburgh to denote the study of functions of the body –- in essence, physiology.  In 1811, Wistar published A System of Anatomy, the first textbook in the nation on that subject.

Although William Shippen was the first professor of anatomy in the medical school, that topic traditionally included surgery.  It was only in 1805 that Philip Syng Physick assumed the first independent chair of surgery.  In that role, he became “one of the first of the New World physicians to gain a reputation among his European counterparts,” as Innovation and Tradition put it. He is not the only American surgeon to be called “the father of American surgery” –- there is an upstart who practiced at Johns Hopkins Hospital many years after Syng’s death -– but ostensibly neutral sites like Wikipedia acknowledge Physick. 

Physick
Philip Syng Physick

Among his many accomplishments and innovations, he designed and made new instruments to treat the urinary tract; introduced an improved technique for setting thigh fractures; performed the first surgical repair of an arteriovenous aneurysm; and pioneered the use of stomach pumps in cases of poisoning. In addition, he conceived of a surgical treatment for abdominal fistulas and developed a technique for cataract surgery. According to Innovation and Tradition, “Probably his greatest and most lasting contribution to surgery was his work on absorbable sutures.”  The ordinary sutures of silk or flax that were used then prevented wounds from healing. Syng began to use animal ligatures in their place.

 

On a somewhat different plane, Penn’s Department of Surgery had the nation’s first endowed professorship in surgery.  In 1877, a gift of $50,000 from Sarah Rittenhouse Barton created the John Rhea Barton Professorship of Surgery, in honor of her husband. D. Hayes Agnew, then one of the most respected surgeons in the United States, was the first to hold the chair.

And perhaps you have been racking your brain trying to remember the first president of the American Medical Association.  The answer: Nathaniel Chapman, an alumnus and professor at Penn’s medical school, who held the chair of the theory and practice of physic from 1816 to 1850. Delegates from 28 American medical schools met in Philadelphia in May 1847 to found the association, and two other Penn faculty members were elected officers as well.

These are only a few of the “firsts” associated with Penn’s medical school.  As its 250th anniversary draws nearer, we’ll look at others, as well as other interesting people and events in its history.

What may be a surprise, however, is that Penn’s medical school did not confer the first MD degree in the colonies.  That accomplishment goes to King’s College in New York City, later to be known as Columbia University. The degree originally offered by the College of Philadelphia’s school was a bachelor in physic (medicine), apparently modeled on the customs of Oxford and Cambridge universities, which granted the MD only after the candidate had done additional clinical work or research. King’s College awarded its sole degree, the MD, to two candidates in 1770. One year later, Penn’s school awarded the MD degree to four candidates who had earned the MB degree from the school in 1768.

 

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