What sort of things were taught in medical school in the 1800s?

March 29, 2012 1:23 PM

What sort of things did doctors learn in medical school in the 1800s?

I'm interested in what the first medical schools taught, and I'm looking for a broad answer. I'm writing an article that mentions the doctors in the time period and want to add a few background paragraphs.

Since medicine was primitive, science just getting rolling, folk cures still prevalent, and little was known about the body or pharmacology, what would the average student learn in medical school that required so many years of training?

I'm assuming a doctor in 1850 was revered as being an expert, but how far from being experts would they have been by today's standards? How much could they really have known that is far and above what a layperson knows today?

I'd appreciate links or suggested reading if you don't feel like giving a long answer. Thanks!

posted by Lownotes to science & nature (16 answers total)

One thing to keep in mind is that, in the 1800s, there were several different types of medical schools, all competing with each other. Homeopathy was considered legitimate medicine by many more people than it is today, as was osteopathy and naturapathy. If you're interested in these other types of medical schools, a good book to look at is Fads and Quackery in Healing, by Morris Fishbein.
posted by Ragged Richard at 1:31 PM on March 29, 2012

Medical Education in America

Ten Good Books on the History of Medical Education

Educating Physicians in the Nineteenth Century

A fascinating episode in medical history is captured at the Indiana Medical History Museum, a nearly untouched 1895 institution which reveals much about the state of medical science and philosophies of training at that time.
posted by Miko at 1:34 PM on March 29, 2012 [3 favorites]

It depends a lot on what part of the 1800s you mean. The 1800s saw some pretty huge leaps in medicine, including the germ theory of disease, sterilization, and anesthesia, mostly in the second half of the century.
posted by jedicus at 1:37 PM on March 29, 2012

Check out the Flexner Report. Also, while it's not exactly what I think you're looking for, you might want to take a look at this article from NEJM, which contrasts the approaches taken by a physician towards a patient with asthma in 1828, 1928, and 2012.
posted by un petit cadeau at 1:40 PM on March 29, 2012 [2 favorites]

Hey my great great grandfather was a doctor in Massachusetts and lived from 1823-1887. He drove a horse and buggy. We have some of the old bottles he had as a physician. Here is a photo of him. You can read this book: The Harvard medical school: a history, narrative and documentary. 1782-1905 (free on the Google! he's mentioned n page 1481!) to get an idea of how medicine progressed during that timeframe. As jedicus says there were a lot of huge advancements during that time.
posted by jessamyn at 1:40 PM on March 29, 2012 [3 favorites]

Get yourself a copy of Druin Burch's Taking The Medicine. A great history of medicine and all the erroneous things that doctors have believed over the years.
posted by straw at 1:50 PM on March 29, 2012

Lownotes, are you talking about American doctors in particular?
posted by MonkeyToes at 1:56 PM on March 29, 2012

The University of Pennsylvania's Archives and Records Center has some potentially useful information:

A Brief History
Historical Development of Cirriculum ["The above summary is based on the book, Two Centuries of Medicine: A History of the School of Medicine, University of Pennsylvania (J.B. Lippincott Company, 1965), by George W. Corner"]
Course roster, 1863-64
1836-37 Medical Regulations (.pdf)

Have a look through Penn's online archives; I'm sure there other treasures to be found there.
posted by MonkeyToes at 2:11 PM on March 29, 2012

...there *are* other treasures...

From the last link--p. 20--"...candidate must have attended two complete courses of the following lectures in this institution: Anatomy; Practice of Physic; Materia Medica and Pharmacy; Chemistry; Surgery; Midwifery and the Diseases of Women and Children; Institutes of Medicine. He must also have attended one course of Clinical Instruction in the Philadelphia Hospital, (Blockley) or the Pennsylvania Hospital, or some other institute approved by the Faculty of Medicine."
posted by MonkeyToes at 2:26 PM on March 29, 2012

Check out Neil Postman's Technopoly. I recall that it has some discussion of the changes that took place when technology was introduced to medicine in the 1800s. I did a paper on many of these changes - introduction of the microscope, stethoscope and other tools that led to less touching of patients, more measuring of things and discounting of personal stories.
posted by Chaussette and the Pussy Cats at 2:27 PM on March 29, 2012

You may also be interested in how the first stethoscopes influenced medical students to start wearing top hats - they kept the tubes in there!
posted by Chaussette and the Pussy Cats at 2:28 PM on March 29, 2012 [1 favorite]

From Quackery to Bacteriology: The Emergence of Modern Medicine in 19th Century America: An Exhibition may be a help. Also, have you been to the Wellcome's site? Roy Porter's work might be of help if you are looking for the history of medical education in Britain.
posted by MonkeyToes at 2:56 PM on March 29, 2012

You might be interested in Oliver Wendell Holmes's essay 'Some of My Early Teachers' (1882), in which he describes his experiences as a medical student in Paris in the 1830s. At that period bloodletting was still the standard form of medical treatment, although this had begun to be challenged by one of Holmes's teachers, Pierre-Charles-Alexandre Louis, who showed that it was useless as a treatment for pneumonia and other fevers. The general reliance on bloodletting as a universal remedy was summed up by Holmes in his famous remark: "the lancet was the magician's wand of the dark ages of medicine". Another of Holmes's teachers, Jacques Lisfranc de St Martin, ordered bloodletting for all his patients, and (according to Holmes) used to reminisce fondly about the splendid guardsmen of the old Empire "because they had such magnificent thighs to amputate".

Despite this, Holmes admired the older generation of doctors for their very thorough knowledge of anatomy. In his view, there was very little advance in descriptive anatomy between the 1830s and the 1880s; all the important discoveries had already been made. The big advance was in histology (microscopic anatomy), which had scarcely existed at all in the 1830s. "I never saw a compound microscope during my years of study in Paris. Individuals had begun to use the instrument, but I never heard it alluded to by either Professors or students." This reflects the fact that medical training was still very much based in the hospital ward and the anatomy theatre, not the laboratory.

For a challenging reinterpretation of medical history, try David Wootton's Bad Medicine: Doctors Doing Harm Since Hippocrates (book, website), which argues that most medicine until the twentieth century did more harm than good. Wootton shows that doctors clung stubbornly to the traditional theory of the four humours (hence the popularity of bloodletting, which was seen as a way of correcting an imbalance of humours in the blood) and were very slow to accept new ideas (e.g. germ theory) or new methods (e.g. randomized controlled trials). His conclusion is that, with a few notable exceptions (e.g. the introduction of inoculation and vaccination into Europe in the eighteenth century), doctors had no effective means of saving lives until antiseptic surgery and antibiotics came along.
posted by verstegan at 3:10 PM on March 29, 2012 [1 favorite]

The story of Crawford Long and the use of ether as a surgical anesthesia is a good one. Before that there weren't any (origin of 'bite the bullet').
Long was at U of PA, the best med school in the US; he and his buds went to 'ether parties.' Long noticed one trip over a chair and feel no pain. He researched and put it into practice in GA c 1832.
Not a perfect fit for your Q, but it might have a place in your project.
posted by LonnieK at 7:12 PM on March 29, 2012

I'm reading George Eliot's Middlemarch at the moment, and one of the main characters is a progressive doctor (in early C19 England). The editor's notes make mention a few times of the changes taking place in the medical field, and might be interesting to you to get a feel for the time in addition to some of the resources others have mentioned.

A few of the things that have come up so far (I'm only half-way in) is that it was generally considered unnecessary to examine the patient (their symptoms being enough to go on - at one point it's remarked that he is odd in that he uses a stethoscope). It refers to the fact that doctors at Oxford and Cambridge are taught much more history and classics than medicine. Also, doctors would prescribe pills which they would then sell at a profit, which obviously created a certain level of quackery in which people were prescribed useless pills for all sorts of conditions.

Again, this is fiction, but I understand it's meant to be quite accurate in its depiction of the era.
posted by twirlypen at 8:12 PM on March 29, 2012

Before the stethoscope, doctors would actually listen to the chest or abdomen, so that's why some people thought the stethoscope was quacky.
posted by Chaussette and the Pussy Cats at 10:32 PM on March 29, 2012