Physicians in Kentucky

Walter I. Hume, Jr., M.D.

            Now that you are back from your visit in the hall, and I am to talk to you tonight, I am told from some notes I have on PHYSICIANS IN KENTUCKY.  I might explain to you why this particular topic is of interest to me.  I am, as most of you know, a second generation Kentucky physician and beyond that, some other generations that were not physicians and I learned from my Dad, at his knee practically, the names of an awful lot of physicians who were both nationally and locally known.  They were never clear in my mind and I always wondered exactly who they were and as I came back to set up practice and got acquainted again with the school here, I began to realize that this particular area, medically, has a charm and a distinction all its own.  It is known to most of you very well, probably much better than to me; but I have attempted to get together a rather panoramic view, perhaps not in sufficient depth to please the medical scholars who would like to know more about certain points; but I have tried to put together in my own mind and for you tonight some of the thoughts about how Kentucky medicine grew from its origins, what were its origins and, in a sense, where it is now with the idea that some of the problems that face us now in Kentucky medicine may become more clear in their solution, might even become a little more clear if we understand the background.

            This area has been, in essence, a very romantic area - the Dark and Bloody Ground, of course, and medicine is no different.  The first physician who came into Kentucky, as far as the historical background seems to go, was Thomas Walker who came 19 years before Daniel Boone, who came over from Virginia as the head of an exploration party and came up what is now the Cumberland Gap and along what is now, I guess, called the Wilderness Trail.  As a matter of fact, he made that journey twice at least.  He was not at that time though functioning as a physician.  I think he has the honor of being the first physician to have knowingly set foot in Kentucky.  There were, between the era when he came, 1750, and later in the 1700’s, many physicians who came into Kentucky.  One of the first who we know of and who practiced here was Dr. Hart who was known to have been in Harrodsburg, Kentucky in 1775.  He, to our knowledge, was the first practicing physician in this state.

            Louisville and Lexington were founded in the late 1700’s, Louisville in 1780 or thereabouts, Lexington close to the same time.  But the interesting thing is that almost 200 years ago, at a time when medical education on the continent was thriving, medical education in this country was just barely beginning.  A medical school arose in Lexington, Kentucky, 1799.  This was the Transylvania Medical School and it has a most interesting history.  The land was given, 8,000 acres, by the State of Virginia in 1780. It was chartered; the University was chartered in 1783.  The Reverend James Mitchell was the first Grammar Master in 1785.  Kentucky granted Transylvania University a charter in 1798 and in 1799 the medical department of that University was instituted.  It had two professors: Dr. Sam Brown who was Professor of Chemistry, Anatomy, and Surgery and Dr. Francis Ridgely who was Professor of Materia Medica, Midwifery, and Practice of Physics.  The school was started, as is well known in Kentucky.  Once you get the people behind it, they support institutions, and in this case it was started with $500 and this includes the Medical Department.  Not only did they start the Medical Department, the same two men started the Law School.  Colonel George, George Nicholas I guess it was, was Professor of Law and Politics and that was organized at the same time.  So Transylvania was chartered and was legally an institution for the teaching of medicine in 1799.  As I said, there were few practitioners in the state of Kentucky at that time.  The Medical School, of course, became the first west of the Allegheny’s, and it is of interest because it is the direct lineal ancestor of the medical school which we are all now a part, the University of Louisville.  It traces its lineage back directly to 1799.  I will show you in a minute why.

            So let’s get to the school in a minute, but first, for a moment, before we get to what happened with this school, let’s ask if the physicians in the territory who were not affiliated with the school were as bad as we have every right to believe that they should have been in the early 1800s.  Medicine was, as a matter of fact I have just finished writing an editorial over the weekend saying that up until the last 100 years, people didn’t write much about their access to medical care because they realized, quite honestly, that it didn’t matter a whole hell of a lot if they had medical care or not.  As a result, they______________.  So, in essence, I think this is probably true.  The physicians were very good at the art of medicine in those days but there wasn’t much science to it. 

            But what happened?  While there was some science to it, in 1889, there was a young gentleman whose picture you just saw, and I will show it to you again, Ephrian McDowell, who, in Danville, Kentucky, as we all know, performed the first ovariotomy and he was noted, of course, as the father of that Danville Surgery.  Was this his only claim to fame?  Of course not.  He had people referred to him for surgery from a couple of hundred miles around.  In fact, he was known as quite a noted surgeon.

            There were others; Walter Brashear, in 1806, which was almost two hundred years back, amputated a leg at the hip joint.  This was a slave who had had his leg fractured in an accident in Bardstown, Kentucky.  This was an amputation through the hip joint.  This is still a formidable procedure for a surgeon to contemplate.  There were others in that era; Joshua Taylor Bradford, who was a laprotomist, if you will.  Francis Polin in the little town of Springfield, Kentucky about the middle of the century performed the first Cesarean Section in Kentucky, that’s 1852.  These were some of the people, then, who were practicing outside the medical school.

            Let’s go back to the medical school a moment.  From 1799 when Brown and Ridgeley were the two professors, there really wasn’t much they did except take on students and say, “come along with me and watch me practice,” and they learned and talked from that particular base as they saw patients.  There was little formal education.  In 1817 and 1819 Transylvania University Medical School was reorganized.  It was reorganized under a most interesting President by the name of Horace Holley and it was an aside note there by a botanist named ________________ who some of you may have heard of, who was a fabulous, I suppose, "con man" who ever came over here and was going to have the great­est botanical gardens in the country and he sold Dr. Holley who was a minister, on this concept and yet the medical school, despite these little side distractions to Dr. Holley, he was able to attract in 1817, or thereabouts, the following men:

(Let me slide over here and use the blackboard for just a moment)

Names: 

(No names are on this tape.)

Transylvania did get off the ground in 1817 and it had names you are probably familiar with: Henry Duncan(?)  He was the Professor of Surgery.  They had an interesting gentleman by the name of Daniel Drake, he was Professor of Medicine.  Charles Caldwell, ________________________________.  He is, as I said before, he was my favorite of the whole lot.  He was an unmitigated S.O.B. who wrote the most marvelous autobiography when he was more than old enough to know better.  He was so old he didn't know better.  He had lived the history of medicine so that he was pickled in brine.  __________ you never know, including Dr. Bateman Rogers(?)  Things went on.  The same gentlemen who signed on in 1799 also one of the practitioners in medicine, and I say this "in medicine" because there were many titles.  And, then there was Lancford P. Yandell.  He was a ______.  So these gentlemen were the initial faculty in 1817 in the Transylvania Medical School.  There were others: Actually, Dr. Yandell didn't come along until a little bit later but they had others.  W. H. Richardson who was Professor of OB, Dr. Bly was a chemist.  Dr. Overton in medicine, and an interesting man named John _______Quick came in 1827 also.  He was quite a guy.  He was the man most noted for his use of calomel.  He favored large doses of calomel and didn't mind giving over a pound a day to a patient.  Now I really don't know what calomel is — I hope I escape that.  But it does seem like an awful lot of calomel.  That was one of his major accomplishments________________________________.

But, Transylvania went along being the only medical school west of the Allegheny’s.  It drew quite a group of people.  It had good professors and I will go over briefly some of their biographies in just a moment; but these men were nationally known, most all of them, they drew well, they had large classes.  And, up until the middle 1830’s this school did a fine job in a very rural section.  The population of Lexington, for instance, in 1830, I think was about 6,000 people.  There you can tell from what population they obtained their students.  They had many times two to three hundred students in a class.  I think about the time Transylvania folded in 1857, they had actually given degrees to almost 2,000 physicians.  So, they had a lot of people who matricu­lated, many who graduated without degrees, and many who were trained in medicine.  Of the many who trained but didn't get degrees went on to practice anyway in those days.

So, in 1837, as I might call to your mind a similar problem in the not too distant past, and we have been hacking it back and forth; it seems for the last 15 to 20 years; there seems to be a little dispute in the medical field between Lexington and Louisville.  In 1837, the citizens of Louisville were evidently ripe for a petition and the faculty practicing in Transylvania thought that the population increase in Louisville with its river front acti­vities and larger growth Louisville would be a much better place to have a medical school.  Now some were __________to support it.  Charlie Caldwell who was a most eloquent man and didn't use a single syllable word when polysyllable words would do came down and gave a speech to the assembled voters of Louisville and got, as I remember, $50,000 to start a medical school here by giving a most well received speech and got the school off the ground; and at that point, Caldwell, Yandell, and Cook all came down to Louisville (I will mention Cook to you a little later) and helped establish the University of Louisville Medical School.  The school was not known to Louisville by that title at that time, but that is essentially what it was.  Now, at that point, and in 1837, you have the _______________the Medical School in Louisville, and it had Caldwell, Yandell, ____________________ and Cook and _____________ and we also have the next year or so later Dr. Charles Short coming into Lexington as a populace and then Dr. J. B. Flint came from Boston as a surgeon.  Dr. Cobb, Jebediah Cobb, came from Ohio, I believe it was, as an anatomist, and Dr. Miller was the only ______________________, came to Louisville as an OB man.  Now these were the first professors at the medical school here in Louisville.  These men were also well known.  Dr. __________was, of course, a nationally known figure.  They augmented their ranks shortly after they got started in Louisville with Transylvania going on alone, lingering on until 1857, then finally the students gave way and it died.  By the way, staying home as Dr. Dudley and I guess Dr. Richardson stayed on at Transylvania and the others stayed in Louisville.  Added to the Louisville group, shortly thereafter came Daniel Drake, in 1839.  Of course he was fed up shortly, he was everywhere — Daniel Drake was a peripatetic professor, he was all over the Ohio Valley and he was going to start a medical school in Cincinnati, he was in and out of Louisville several times.  He came back into Louisville in 1839 and then Samuel David Gross came in 1841.  These two were nationally known figures.  I put Dr. Gross in, and I add, Dr. Gross was more and more apparent that he was the type of physician that I suppose, being a surgeon that I could relate to.  He was the dominant figure of his era in American surgery.  These people were of the late 1800’s who started the school in Louisville, and David Yandell, Lansford’s son came along a little later and taught for I guess 30 years, from 1867 to 1898.  These, then, were the people who started the medical school here.

McDowell, in Danville, who didn't get around to writing at all until October of 1916 when he wrote in the eclectic repertory of the Analytical Review in Philadelphia and, of course, you remember the name of his patient was Mrs. Jane Todd Crawford and, what you may not remember is that the operation was done on December 25, 1809.  Dr. McDowell trained at the University of Edinburgh and came to Danville in 1795 so he had been here for some years before he did his famous procedure.  He went ahead and did many other laporatomies and had very good results.  Very few cases of sepsis and mortality.  This is the home of Dr. McDowell; the little building on the left is where he did the surgery on Christmas day.

These are some of the early Transylvania Medical School buildings, to give you some idea, they didn’t do it lightly.  These were some of the medical schools that for that day and time weren't bad, they are not the originals.

Here are some of the people who were protagonists of the Transylvania Medical School: Dr. Dudley, who took his M.D. from the University of Pennsylvania, along with Dr. Drake and Dr. Richardson.  In 1806 he went to Europe as many of the people in the medical field did and spent some years in France, came to Transy in 1817 as Professor of Anatomy and Surgery.  Interest­ingly, he fought a pistol duel with, as history says, Dr. Richardson, one of his fellow professors in 1818 and then they got back together and went right on as though nothing had happened and taught together on the same faculty for many years thereafter.  In case there are any interfaculty problems, well, I suppose they could have been worse.  Perhaps now that I mention it, maybe they will be worse.  He stayed on at Transylvania until 1849.  He is best known as a teacher, as a surgeon, and as a laporatomist who did 225 cases.  He died and was buried in his home, Fairlawn, near Lexington.

Daniel Drake, as I mentioned, was an interesting fellow who was a traveler.  He received his autographed diploma, which was not really a diploma, from a Dr. Goforth, his Preceptor in Cincinnati after five years of study.  He had no medical school really but because he was noted as a medical educator and rapidly rose in reputation, the University of Pennsylvania gave him an M.D. degree eleven years later in an unprecedented ceremony.  He came to Transylvania in 1817 and to Cincinnati, back to Tran­sylvania, then to Jefferson for one year up in Philadelphia at Jefferson Medical College, and then came to Louisville in 1839, back and forth between Louisville and Cincinnati many times and died in 1852.  His principle hard bite(?), and the bite(?) that he put on us was the principle diseases of the Interior Valley of the U.S., published in 1850 when he was a medical teacher.  And, evidently a very good one.  He never achieved what he wanted, to found his own medical school.

Charlie Caldwell, born in 1772, died in Louisville in 1853 at the age of 81 and he had just finished his autobiography just about the time he died, he may have died before he finished it _________________ made some wonderful remarks.  He taught classics in two grammar schools at the age of 14.  He was a most remarkable native scholar.  He got his M.D. in a very disputed ceremony in 1796 at Pennsylvania in which he not only argued but fought Dr. Rush who was the preeminent medical educator of his day.  Calling him names that no one could forget and he then came to Transylvania in 1819 as Professor of Medical Institutes and stayed on until he came to Louisville in 1837.  And, as I say, he had a lot to do with the founding of this medical school, Charlie Caldwell.  He was the one who convinced Louisville that they needed a medical school and convinced them to put up some money even though there were some city problems at that time.  He wrote over 10,000 pages of medical papers.  He is a nut about phrenology - whatever phren­ology is, it is the study of heads I suppose and their configur­ation, and he just loved to say in his lectures that there were only three perfect heads in the United States.  One was Cassius (Henry) Clay, one was somebody else and one was ______________(pointing to his own head), Henry Clay was the second - right – (there were only two that he talked about and modesty precluded his identifying the second) and he included himself when he said "modesty precludes.”   If I get a chance, I will pass out this account of his medical degrees.  Sam Brown, you will remember, is the gentleman who was, in 1799, one of the first two professors at Transylvania; he graduated from Dickinson College which is interesting to me - it is still in existence - took his M.D. from Aberdeen and married a wealthy Natchez girl and retired to her plantation early on.  She died, and one of his three children died and he got restless on the plantation and came back to work in medicine and in medical education in Lexington and at Transylvania until 1825 when he retired.  He died back in Alabama in 1830.  He was interesting because he was known, among other things, as the initiator of vaccination in this country. ______________ had announced it in 1798 in Europe and by 1802 he had vaccinated over 500 people in Lexington alone.  So the medical progress wasn’t perhaps as slow as we anticipate it might have been.

Dr. Yandell who was one of the founders of both schools was a Tennessean.  He took some training at Transylvania in 1822 and 23 but got his M.D. from Maryland.  He came back to Trans­ylvania in 1831 and taught and came to Louisville and taught here.  He was best known as a good writer, he helped to establish the Transylvania Journal of Medicine and the Western Journal of Medicine and Surgery.  A very respected teacher and the father of David W. Yandell who was a very respected practitioner rather than a teacher here in Louisville.  But, he was not in on the origin of Transylvania but he was there and then was here and in on the origin of the school in Louisville.

Samuel David Gross, as I mentioned, is one of my favorites also.  He was the all around medical name of the era it seemed to me.  He came on a little later.  He was born in 1805, took his M.D. in 1828 from Jefferson and he published ANAOTMY, PHYSIOLOGY, AND DISEASES OF THE BONES AND JOINTS in 1830.  He was an Anatomy Professor in Cincinnati from 33 to 40, published ELEMENTS OF PATHOLOGICAL ANATOMY in 1839.  He had a very good grounding in the fundamentals of medicine and he wrote well about them.  He was Professor of Surgery then in Louisville from 1840 to 1856.  He published one of the most interesting and lengthy papers called "A Report on Kentucky Surgery".  He gave the report at the second meeting of the Kentucky State Medical Association in 1852.  It was a magnificent paper and it has been printed, and in it he gave the reemminent notice to Dr. McDowell as the father of laporotomy, if you will.  He was well known, but he was also well known because he helped establish McDowell.  He went from Louisville in 1856 back to Jefferson where he was Professor until 1882.  Everybody who wrote about him said he was much beloved and by all.  He came back here just before his death in 1879 and gave the MCDOWELL MONUMENT ADDRESS in Danville at the time the monument was dedicated.  He was, for instance, one of the founders of KMA, was President of AMA, President of the American Surgical Association, first President of the Kentucky Medical Association, and such a renowned man, everybody just seemed to recognize him.

Here we have David Yandell who is the son of Lunsford P. and he is the one we hear about here because of our surgical lecture.  There is, of course, a Gross Lecture of which you are aware from on of the fraternities here; the Gross, The Samuel W. Gross Lectureship and the David W. Yandell lectureship here is in honor of this gentleman and he took his M.D. in Louisville in 1846 and he was the Medical Director of the department of the West in the Civil War under Albert Sidney Johnson, who some of you probably know of better than I.  I mentioned earlier that he must have been one of the noted Generals of the North and I don’t think that was right.  I know it was the South.  I put that out to see if I would survive the statement and most of the time I don’t.  He was Professor of Medicine at U of L from 1867 to 1869 at which time he switched and became Professor of Surgery from 1869 to 1898, which goes to show really that there isn’t a great deal of difference between the two.  He established the American Practitioner in 1870 and it was interesting, he analyzed 415 cases of tetanus which was in that journal and which is an interesting commentary on the times.  He was one of the Presidents of AMA, President of the American Surgical Association, a disciple of Gross and, evidently, a well beloved individual as well.

What happened to the medical schools?  These were some of the men who made them tick, got them off the ground.  What hap­pened to medical schools?  The Louisville Medical Institute was the name of the medical school that was founded in 1837.  There were many others as you are aware.  There was the Louisville Medical College with which the Louisville Medical Institute merged in 1846.  And at that time, in 1846, they formally became, those two, the U of L Medical Department in 1846.  The Kentucky School of Medicine was established in 1850, The Louisville Medical College in 1869 and the Hospital College of Medicine in 1878.  The Medical Dep­artment of the University of Kentucky in 1898, it was established here in Louisville, and all of these merged in 1907 to become the University of Louisville Medical School.

What about some of the other people who weren’t in the schools?  During this era, of course, there were a lot of things going on besides medical education even in medicine.  There are many names that we could mention, fascinating names.  But two that I think are most important to mention for anyone who wants to know any­thing about Kentucky are the names of the McCormacks; the two, father and son, who almost ran medicine in Kentucky outside of medical schools for 65 years.  J. M. McCormack came on the Kentucky Board of Health in 1883 and stayed until 1922 as the secretary of the Board of Health.  A. T. McCormack, his son, came on in 1922 and stayed until 1943.  As I say, between them was about 65 years that they ran the Board of Health with almost an iron hand and a very sure political touch.  A. T. McCormack was also interesting in that he was secretary of the State Medical Association in addition to being the Sec­retary of the Board of Health.  He was Secretary of the Medical Association from 1907 to 1943, some 30 odd years.  He was also editor of the KMA Medical Journal from 1906 to 1943 when he died.  So here is A. T. who was secretary of the KMA, editor of the Journal, secretary of the Board of Health and you could hardly turn around in Kentucky medicine without having to ask permission from A. T. McCormack, I'm sure during those days.  He was a very powerful man, but evidently quite well liked by most.  He handled himself well, as far as I can tell from my Dad, Dr. Overstreet, and some of the others — not tyrannical.  I have a tape here and in just a moment I will play some of it.  It is from a gentleman who thought he (McCormack) was a prince among men.

So it was these, Ap Morgan Vance, Louis McMurtry, and names that you’ve heard of but we can’t go into all of them.

Well, what happened then in 1907 was that the University of Louisville Medical School had its rises and falls.  Stewart Grave’s father, among others, was the Dean for a while.  We had Dr. Moore, John Walker Moore, for a while but the old feeling began to percolate again in Lexington somewhere in the late 40s and early 50s.  I guess it had been percolating along ever since 1857 really.  By the way, Transylvania which had died in 1857, came alive again in 1907 as a separate University.  It was reconstituted from the dead in 1907 and, as you know now, Transylvania is now not a University, in fact, but a college and is teaching undergraduates very well, in Lexington.  So that is its history.

The question of what happened to get a University of Kentucky Medical School going again interested me and it bears the name that is of interest, and most of us are aware... (At this point I will shut this off...He was talking so well I went on to ask him later about his political career and other things later on.)  He is most clear, there is no doubt in his mind about Dickinson.  He may be wrong but he is not in doubt — he remembers extremely well about what is happening and what has happened.  He thinks clearly obviously, that’s very clear. H e had me feel his arm — He went on to talk about his youth for instance, when he was a farmer and how, at 75, he was still alert and so forth.  His arm is like an oak tree — it is about this big around and solid muscle.  He is a magnificent specimen, both in fine physical and mental shape at the moment.  For those of you here who are Happy Chandler fans, or even for those who aren’t - and I am not particular, I am a registered Republican; but, I think he is a remarkable guy and this was an interesting interview and, as I say, I just gave you parts of it.  This interview was interesting.  It was from a politi­cian and it does give you some idea of the background of how the University of Kentucky Medical School came to be.  As I said, I had given this little talk previously to a couple of other medical groups here in town because I am not able either physically nor intellectually to give more than one talk every six years with anything resembling any novelty to it.  So since I was coming up for a couple, I gave this talk to another group at which Dr. Sam Overstreet was President.  Dr. Sam Overstreet, for those of you who are new in town, or in Kentucky, is, I suppose, as close a phenomenon to the living spirit of Kentucky medicine in practice as we have now.  He is a fascinating guy, he must be 75 at least and he is practicing every day more vigorously than his sons, to their chagrin, and he remembers everything also.  It was inter­esting, he is a Democrat, as you well know, so that he, I suppose, had probably gotten together with Happy at times in the past on a political axis; but he did mention that there were just a few errors in fact that he could point out about Mr. Chandler’s _________.

Among these errors was that the medical school in Lexington was signed, sealed, and delivered before Happy Chandler ever took office before his second term as Governor.  That he had really nothing to do with it whatsoever.  What actually happened was that Dr. Murray Knisman, a name some of you are quite familiar with, was then Dean in 1951, Dr. Sam Overstreet who was then President of KMA that year, this was __________  (Tape ends and there is no follow up tape on this talk.)