In the Western World, medical societies of various sorts have served members of our profession for at least a millennium or more. In the North American colonies, medical students who had studied at European Universities helped establish medical societies on their return to America. Most of those early societies were confined to the urban areas. The first to be organized on a statewide basis was the New Jersey Medical Society, July 23, 1766. Its aims were for “the mutual improvement, the advancement of the profession, and the promotion of the public good.” It eventually imposed licensing requirements for improving the quality of physicians in the state and later enlisted the assistance of the colonial government to enact a provincial examination system in 1763.
In view of 2001 being the sesquicentennial of our Kentucky Medical Society, this is an appropriate time to look at the information about medical societies tat I have gathered through the years and consider its meaning. Undoubtedly, medical societies were formed basically because man is a social being and during the early years of life, family members met our needs, but with maturity and education, other persons and societies were needed to provide the desired camaraderie and sense of security and of professional identity, all of which can enhance a lifetime of continued learning. Also, I hope that our thoughtful look at medical societies will suggest plans for the future.
The first in Kentucky was the student-faculty medical society that announced its birth n the Kentucky gazette December 24, 1799 William Morton of Transylvania University wrote “Law and medical societies meet each week in town…” In 1821, the society incorporated as the Lexington Medical Society and was the first west of the Alleghenies and, in the USA, probably the second to the Philadelphia Medical Society, 1766. Such student-faculty medical societies had both social and teaching functions. In Kentucky in those years, faculty was an inclusive term for practicing physicians, many of whom had apprentices. The Lexington Society ceased to exist in 1834.
Inasmuch as there was no system of medical licensure until 1878, the early medical societies had only local membership and influence. Thus, by granting membership to peers, they set some standards for practice in their locale.
The first medical society in Louisville met Wednesday 24 February 1819 and announced their association in the Louisville Public Advertiser of that date. Their purpose given to the public was that it was for “The advancement of professional science… and for the regulation of fees to graduate the scale of honorable remuneration, proportionally to the advance, which has taken place in every item of human subsistence,” (slightly abridged). No fee schedule can be located.
Transylvania University Medical Department in Lexington has the distinction of being the birthplace of the first national medical society, a secret one named the Kappa Lambda Society of Hippocrtes. Samuel Browne M.D., one of the first two faculty members at Transylvania, was the Professor of Theory and Practice of Medicine. He followed Thomas Percival’s (1740-1804) efforts to develop intra-professional courtesy and decorum and also improve the standards and ideals of medical education and practice by organizing a secret society of intellectual medical leaders who might set an example for the profession, that society was formed in Lexington in 1820 and chapters were founded within a few years in Philadelphia, New York City, Boston and other medical centers. However, the Lexington Society was extinct by July 1827; Louisville never had such a society because most were not active by 1837.
The first indication that a medical society had been organized in Louisville appeared in the Philadelphia Journal of the Medical Physical Sciences, January 1824. an original paper, remarks on the Bilious Fever which prevailed in Louisville, Kentucky and its vicinity in the summer and autumn of 1821 and 1822 was read before the Louisville Society for the Promotion of Medical Knowledge. No exact date of its presentation is known but it was before January 1824.
The next indication of a medical society in Louisville is: “An Address, Delivered before the Louisville Medical Society, at their Annual Meeting January 1, 1833. Also there is some evidence that medical students were taught in Louisville as early as 1802, Richard Ferguson, M.D. advertised that he had space for one or two young gentlemen wishing to engage in the study of medicine. Also, names of several preceptors and their apprentices are available.
In 1819, a public hospital, the Louisville Marine Hospital (LMH) was chartered and as it was the only hospital as such in the state, it soon attracted physicians interested in teaching and students wanting to learn medicine. Two surgeons who came to Louisville to gain experience at the hospital were J. Coleman Roters, M.D. in 1823 and Alban G. Smith, M.D. in 1832.
The lectures at the new public hospital attracted students. There is a record of a clinical lecture in the Louisville Hospital, March 27, 1827 and of one on “The Responsibilities of the Medical Profession, “ August 27, 1831. John Pollard Harrison, M.D., who was especially interested in medical students, used his appointment to the medical staff to attract students. In February 1827, he advertised: “Medical tuition to young gentlemen who are desirous of prosecuting the study of medicine…” He charged $50 per year, but only $25 for the summer. The charge for the year was for 32 lectures. After moving to Cincinnati, he addressed the Ohio Medical Society in 1844 on “Objects of Medical Societies.” Benjamin H. Hall, M.D. who became its resident physician and superintendent, succeeded him at LMH. Dr. Hall Advertised for four students for training, “for instruction and the sue of books.”
In 1832, a charter was obtained from the legislature for a medical school in Louisville. A student-faculty medical society, the Louisville Medical Society was established in 1833 but not chartered until 1838. The society enabled students to meet faculty in less formal circumstances than at the hospital and thus facilitated learning.
In 1837, Louisville’s physicians obtained a charter form the Legislature to establish a college of Physicians and Surgeon. The society, with its 25 physician incorporators, was to be for the promotion of medical science and the encouragement of order and harmony among the members of the profession. But, the college could not create professorships, deliver lectures, nor confer degrees in medicine or surgery. The original 25 included a mix of some full-time LMH faculty and practitioners from the city; a few were considered to be “troublemakers.”
On 22 May 1840, there was a meeting at the Louisville Hotel that had been called by William Adair McDowell, M.D. it was attended by 21 members, some of whom were charter members of the college of Physicians and Surgeons. The purpose of the meeting was to demean the LMH faculty for rejecting other medical colleges, a charge that was untrue. The precipitating cause was the forced resignation of surgery professor, Joshua Barker Flint whose chair was soon filled by the appointment f the prestigious Samuel D. Gross. But, the “Town-gown” storm raged until the demise of the College of Physicians and Surgeons in the late 1860’s.
Another College of Physicians and Surgeons had been formed in Lexington 1835 but it did not flourish. Daniel Drake described one society meeting in his Western Journal of Medical and Physical Sciences that was poorly attended. The society expired in 1850.
The period 1820-1860 has been called “The Emergent Period” in American science, but those words can also be applied to medicine. Physicians were forming local societies, and as rail travel improve, local medical societies extended to include multiple counties. One example is that of physicians meeting in Washington in Mason County and forming The Medical Association of Northeastern Kentucky. They saw need for a statewide medical society and adopted a resolution urging physicians to attend a state convention in Frankfort in January 1841 “for the purpose of organizing a State medical Society.” That call was published in Daniel Drake’s Western Journal of Medicine and Surgery (Louisville) in December 1840.
On Monday, 11 January 1841, 69 physicians representing 39 Kentucky counties assembled and prepared, voted on, and approved a constitution and by-law that had section on medical ethics. A resolution calling for improvements in medical education also passed.
The second annual meeting of the new Kentucky Medical association in Frankfort was scheduled for 12 January 1842, but there were not enough members present to provide a quorum and none of the officers were present. As a consequence, no further efforts to develop the stat medical society were made until 1 October 1851 when a meeting was held in Frankfort and the Kentucky Medical Society became a permanent organization.
Before Dr. J.N McCormick’s full-time efforts to have a significant county medical society presence succeeded, some of the county societies met singly or in small groups to hear speakers and discuss cases, health problems, and , occasionally, fees. Also, in the 1870’s some regional medical societies were active; an example was the Tri-State Medical Society (Illinois, Indiana, Kentucky) that was formed in 1875; their Proceedings were often published in The Cincinnati Lancet and Observer.
The Mississippi Valley Medical Society was founded in 1875 as were the Ohio Valley Medical Association in 1889 in Evansville, and in Kentucky, such multi-county societies as the Kentucky Midland Medical society (Shelby, Bullitt, Scott, Franklin, Nelson, Bourbon, and Jefferson counties). The Fifth District Medical society, consisting of Jefferson, Carroll, Trimble, Gallatin, and Henry Counties, was organized in 1931. some of the societies had such colorful names as the Muldraugh Hill Medical society that was established in 1897 and included Jefferson, Hardin, and Nearby counties. There even was a Southwestern Medical Association in Paducah, 1866-1905, and by 1900 there was a Southern Kentucky with a membership of over 300 physicians.
As we can see, there has been a sustained flurry of interest in medical societies in Kentucky. Also, we see that many of them did not last for an extended period of time. We need to ask: “Why did they fail? The most plausible answer is that there were multiple reasons for their often having only a brief existence. Perhaps the most significant is competition of our time and interest form the demands of practice, family activities and duties, the desire for leisure, and currently, television!