A BROAD FOUNDATION

 

 

Longwood Quadrangle under construction

 

 

 

MILESTONES OF MEDICAL EDUCATION
 AT HARVARD

Part One : 1783-1900

 

 

 

In 1883, Harvard Medical School moved into new quarters on Boylston Street in downtown Boston, and for the first time in a century, the school was able to provide adequate laboratory and clinical space for its students.  A promotional brochure from that period describes the rationale behind the new building as “to secure for each student that direct personal supervision and instruction, forming such a marked feature of the courses offered, especially in the thorough laboratory training, which is so essential in securing a broad foundation for future clinical work.” 

 

This “broad foundation” has been the hallmark of Harvard’s efforts in medical education from the origins of the institution in the late 18th century to the present day.  Now, in the 21st century, with the centennial of the dedication of the Longwood campus and the opening of the New Research Building on Avenue Louis Pasteur, Harvard's tradition of providing excellence in medical education and research continues.  This exhibit, “A Broad Foundation,” traces the evolving history of medical education at Harvard—its faculty, students, curricula, and facilities—from the establishment of the school and its earliest days down to its current flourishing state.

 

 

The Foundation of Harvard Medical School
 

 

Harvard Hall, circa 1930

Harvard Hall
, circa 1930 

From the Collections of the Harvard Medical Library
 

 

 

Though not the first American medical school to be established, Harvard holds the distinction of being among a handful of institutions founded in the 18th century and, of that number, one of the very few still in existence today. 

 


Portrait of John Warren by Mary B. Hazelton, after Rembrandt Peale
 

Portrait of Dr. John Warren (1753-1815) by Mary B. Hazelton after Rembrandt Peale, 1934

Gift in Memory of Dr. Henry Lyman of the Former Officers of U. S. Army Base Hospital No. 5 to the Harvard Medical School, 1934

 


 

In 1780, during the Revolutionary War, surgeon John Warren (1753-1815) began to deliver anatomical lectures to physicians at the military hospital in Boston.  Warren went on to deliver public lectures during the winter of 1781-1782, at the invitation of the Boston Medical Society.  The success of these lectures prompted the Harvard Corporation to approach Dr. Warren to devise a plan and course of medical study.  On September 19, 1782, the Corporation adopted a detailed plan for medical study in Cambridge, including the formation of a library "more perfect than any in America," acquisition of medical apparatus, facilities, and anatomical preparations, and the establishment of professorships of anatomy and surgery, physic, and chemistry.  This plan became the basis for Harvard Medical School.  John Warren was appointed to the professorship of anatomy and surgery in November, and two other faculty appointments—Benjamin Waterhouse (1754-1846), to the professorship of the theory and practice of physic, and Aaron Dexter (1750-1829), to chemistry and materia medica—were made soon after. 

 

John Morgan (1735-1789)
A Discourse upon the Institution of Medical Schools in America
(Philadelphia : Printed and sold by William Bradford, 1765) 

The first book to be published on medical education in America was written by Dr. John Morgan, who founded the Medical Department of the University of Pennsylvania, the nation’s first medical school, in 1765. This particular copy is notable for its fly-leaf presentation inscription from Morgan himself to Dr. John Warren (1753-1815) in 1783, just after  Warren had been charged by the Corporation of Harvard College with the formation of a plan for medical instruction.  This was the beginning of Harvard Medical School. 

Gift of Joseph Warren to the Harvard Medical Library, 1932
 

 

Ezekiel Hersey (1709-1770)

Will : manuscript, November 29, 1770
 

Ezekiel Hersey's will, 1770

In his will, Hingham physician Ezekiel Hersey bequeathed £1,000 to the Harvard Corporation to fund a professorship in anatomy and physic [physiology].  Although it took some years for the Corporation to establish a program of medical study, in 1792, the Hersey legacy was used to endow the first two chairs at the Harvard Medical School—the professorship of anatomy and surgery, filled by John Warren, and the professorship of the theory and practice of physic, filled by Benjamin Waterhouse.

 

Purchased for the Boston Medical Library, 1970

 

The Independent Chronicle and the Universal Advertiser
(Boston : printed by Nathaniel Willis, September 18, 1783)

 
This local newspaper was one of the first to report the formation of the Harvard Medical School following the plan devised by Dr. John Warren for the Harvard Corporation.  The article announces the appointment of the first three faculty members and outlines the intended curriculum of anatomy, physic, and chemistry, along with information on admission requirements and fees.

 

Gift of Dr. Benjamin M. Banks to the Harvard Medical Library, 1975
 

 

John Warren (1753-1815)

Lectures upon Anatomy :  manuscript, 1783-1785

 

Partially in the handwriting of Dr. John Warren, this volume of lecture notes, beginning on December 10, 1783, contains the earliest surviving record of teaching at Harvard Medical School.  The lectures were delivered in Harvard Hall, on the campus in Cambridge.

 

John Warren's anatomy lectures, 1783


After summarizing the history of his subject, Dr. Warren then justifies dissection as an essential component to anatomical study: “At the first view of dissections, the stomach is apt to turn, but custom wears off such impressions.  It is anatomy that directs the knife in the hand of a skilful surgeon, & shews him where he may perform any necessary operation with safety to the patient.  It is this which enables the physician to form an accurate knowledge of diseases & open dead bodies with grace, to discover the cause or seat of the disease, & the alteration it may have made in the several parts.”

 

Bequest of Dr. John Warren to the Harvard Medical Library, 1928
 

Formal medical instruction began late in the autumn of 1783, and students attended lectures in the basement of Harvard Hall, a structure still standing and in use today.  By 1797, the condition of this facility was described—at least for Aaron Dexter's lectures on chemistry—as "unhealthy, inconvenient, and disgraceful," and new space was then provided in Holden Chapel by 1800.  One room each was allotted to the professors of physic and chemistry, and John Warren's anatomical and surgical lectures and demonstrations were delivered in the room above.  It was just the first of many moves the Medical School would make in its history.

 

Engraving of Holden Chapel


Engraving of Holden Chapel

From the Collections of the Harvard Medical Library


 

The First Faculty—and the First Students

 

The size of the faculty of Harvard Medical School grew slowly.  There were no changes to the three original chairs until 1809 when the Harvard Corporation authorized the addition of two adjunct professorships—in anatomy and surgery, filled by John Warren's son, John Collins Warren (1778-1856), and chemistry and materia medica, by John Gorham (1783-1829).

 

 

Admission ticket for the lectures of Aaron Dexter, 1790


Admission Ticket for Ichabod Tucker to the Lectures of Aaron Dexter
at Harvard Medical School
, October 14, 1790

 

The use of admission tickets for each course of a medical student’s education was common until the late 19th century.   Students paid the lecturer or professor directly and were then issued these passes for an academic session.   This particular item is the earliest admission ticket known for a Harvard Medical School course.   Aaron Dexter (1750-1829) was the professor of chemistry and materia medica and the third member, along with John Warren and Benjamin Waterhouse, of Harvard’s original medical faculty.

 

Gift of Francis H. Lee to the Harvard College Library and transferred to the Harvard Medical Library, 1917
 

 

As the first faculty was small in size, so too was the student body, with only some twenty students—including several undergraduates from Harvard College—in attendance.  Lectures ran two to three hours, and, depending on the weather, there could be any number from three to six delivered in a week.  The requirements for graduation included attendance at the course of lectures and two years of study and apprenticeship with an experienced practitioner, followed by a public examination and dissertation defense in either Latin or English.

 

The first graduates of Harvard Medical School were John Fleet (1766-1813) and George Holmes Hall (d. 1807), both members of the Class of 1788.   Upon completion of their studies, these first students did not receive a doctoral degree but rather the M.B., or Bachelor of Medicine; the actual M.D. was originally conferred by Harvard only after seven years of practice, submission of a dissertation, and an examination.  This system persisted until 1811 when Harvard conferred the medical doctorate degree on all its graduates of that year and all living alumni who had not yet received it.
 

Letter of John Fleet to George H. Hall, 1789
 


John Fleet (1766-1813)

Autograph Letter Signed : Boston, to George H. Hall, Worcester, August 13, 1789

 

In 1788, John Fleet and George Holmes Hall became the first two graduates to receive medical degrees from Harvard.   Here, in the following year, the two are in correspondence concerning treatment of several of their patients. 

From the Collections of the Harvard Medical Library
 

Pierre Laterriere's thesis, 1789


Pierre de Sales Laterrière (1747-1815)
A Dissertation on the Puerperal Fever

(Boston : Samuel Hall, 1789)
 

Dr. Laterrière’s thesis was first presented orally at the Harvard commencement ceremony in 1789.  He dedicated the printed version to Drs. Warren, Waterhouse, and Dexter as “Gentlemen not more distinguished by their literary accomplishments, and their professional abilities, than respected for their attention to students, and their talents for instruction.”

 

This copy of the Dissertation was given to Dr. John Collins Warren by Laterrière.

 

Gift of Elisha Copeland to the Boston Public Library, 1857, and deposited with the Harvard Medical Library, 1941

 


 

Mémoires de la P. de Sales Laterrière et de Ses Traverses

(Quebec City : L'Imprimerie de l'Evenement, 1873)

 

Pierre Laterrière, who first studied medicine under M. de la Rochambeau in France, came to Harvard and received the degree of Bachelor of Medicine in 1789.  He went on to practice medicine in Canada.   Laterrière’s Mémoires, although written at the end of his life and not published until 1873, contains the earliest account of a student’s experiences at Harvard Medical School and remains a seminal historical document of the institution during its first years.

 

Purchased for the Harvard Medical Library, 1941
 

 


 

Diploma of the Degree of Bachelor of Medicine conferred on Lyman Spalding, July 19, 1797

This M.B. diploma with its wax seal intact was conferred in 1797 on New Hampshire physician Lyman Spalding (1775-1821), who was later granted the M.D. as well.  It is not only one of the earliest surviving diplomas from the Medical School, but also one of the very few examples of the Bachelor of Medicine degree.

 Gift of Mrs. Laurence Sprague Stewart to the Harvard Medical Library, 1964

 

 The number of early graduates remained small, generally only one to three each year, with fewer than thirty degrees conferred by the end of the 18th century.  This would not change until the school's removal to Boston in 1810.

 

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