# Oregon Historical Quarterly/Volume 37/Medical Education of Dr. Whitman

MEDICAL EDUCATION OF DR. WHITMAN
By Frederick C. Waite
Dr. Marcus Whitman was both by heredity and as an individual a pioneer. His ancestors and he, in a period of less than two hundred years, made four migrations, each time into more remote wilderness. The first was before 1640 from England to Massachusetts Bay; next just after the Revolutionary War from near Boston to the Berkshire Hills; then in 1799 from western Massachusetts to the frontier of western New York; and finally in 1836, across the continental divide to the distant Oregon territory. In his veins coursed the blood of a line of fearless leaders.
He was born in 1802 in a frontier hamlet in western New York settled only five years before his birth. His father was a craftsman, a tanner and a shoemaker by trade. His mother was but moderately educated. None of his forebears had been professional men. His father died in 1810, when Marcus was eight years old and he was sent two hundred and fifty miles to live with his father's half brother, Freedom Whitman, at Cummington, Massachusetts.
There is very definite record that this foster parent, Freedom Whitman was, throughout his life, a leader. Moreover there is testimony of his integrity, honesty, industry, and decisiveness. His wife, Sarah, had intellectual capability, a taste for education, and personal forcefulness.
Under the beneficial influence of these two persons, Marcus Whitman developed a personality and character marked by integrity, positiveness, and leadership. He also developed ambition and this led to another change into an environment yet more complex, for it included another home and in addition a school attended by boys from many localities.
In Plainfield, a town adjacent to Cummington where he lived from the age of eight to thirteen, was a school. It had been founded by Moses Hallock, a graduate of Yale College in ​1788 and a clergyman. It had acquired the reputation of being the best boys' school in western Massachusetts, and to it came boys of the better type not only from the adjacent area, but from other states. To this school Marcus Whitman went at the age of thirteen and remained for five years.
Mr. Hallock was an excellent teacher, and stimulated ambition in his students so that a great many of them went on to college. For many years approximately half of the students entering the neighboring Williams College, twenty miles away, came from Mr. Hallock's school.
The ambitions of his students were extended to service in professional relations. Naturally, being a clergyman, his hope was that his pupils would become clergymen, and more than fifty of them did. But many went into the two other learned professions of the law and medicine, and some became distinguished as authors, of whom the best known is William Cullen Bryant, the poet, a native of Cummington where Marcus Whitman spent five years of his boyhood.
It was in this environment of scholarship, with the oversight of an excellent teacher, and in association with other boys of capability and ambition coming from a wide area, that Marcus Whitman developed the ambition to rise above the intellectual level of his direct ancestry and become a professional man. Since the major influence in the school was toward the ministry it was natural that Marcus Whitman's early ambition tended toward that career.
He stayed at this school and studied Greek, Latin, mathematics, and the English branches, the usual curriculum of such a school of that period, until he was prepared to enter college. Then came another change of environment, and he was called back home to a mother whom he had seen but once in ten years, and to a stepfather whom he had never known.
No consideration of the career of Marcus Whitman can be complete that fails to take notice of the great influence on his life of those ten years in western Massachusetts from the age of eight to eighteen and of the stimulating influence of his foster parents, Freedom and Sarah Whitman, of Moses Hallock, under whose tutelage he was for five years, and of those cap​able and ambitious schoolmates who were his intimate associates. In those ten years his personality and character were nurtured and developed and his ambition and life plans definitely formulated.
We have no record of the reasons why Marcus Whitman, after being made ready to enter college, went back to western New York, but it was an abrupt change, from the stimulus of a good teacher and ambitious companions to the comparatively sordid life of a vocation in which his associates were craftsmen with little intellectual ambition.
In this changed environment he continued for three years, working under his stepfather at the vocation of tanning and shoemaking, and later in a sawmill which his uncle operated. His ambitions developed during his school days must have appeared to be thwarted, and for one of a weaker character they would have been, but for Marcus Whitman they were simply inhibited, not destroyed.
We read in the written testimony of his sister, who was six years younger and was in the same household, that often young Marcus wept because, as she says, “he could not become a minister.” It seems to me that she did not interpret the entire cause of his weeping. His emotion was due to the fact that his mother, whom he sincerely loved, and his stepfather, to whom he was respectfully obedient, apparently destined him for a life of business or craftsmanship while his own fixed ambition was for further education and a life of professional service. That his ambition was not entirely confined to the profession of the cloth seems to be shown by the events that soon occurred.
On September 2, 1823, Marcus Whitman reached his twenty-first birthday. Now he was his own master and free to pursue his ambition for more education, but he had no financial resources to do this and he could not expect his stepfather, even if he were able, to furnish the money to pursue a course which that stepfather did not approve. He must therefore first earn and save money to pursue his education.
Fully approved entrance to the ministry of the Congregational church then demanded an education which included ​four years in college and three years in a theological school.
There is, however, another career of service that is nearly, and some believe quite, as holy as the ministry, and that is the service of the profession of medicine.
At that time, entrance to the study of medicine did not require nearly as long a period of formal education as that to enter the Congregational ministry. A good English education—and this Marcus Whitman already had—was deemed sufficient to enter upon the study of medicine. Moreover, at that time the early phase of a medical education did not require going away to an institution with the attendant expense, but could be begun in one's own home town under the local physician, and need not occupy all of one's time, but could be pursued jointly with continuance in a vocation and earning of a livelihood, and accumulation of savings.
And so Marcus Whitman on his twenty-first birthday saw the possibility of satisfying his suppressed but not dead ambition for further study and entrance into a profession of service, a profession no less worthy than that of the ministry, toward which his mind had been directed by the associations of his school days in western Massachusetts.
Under these circumstances, not far from his twenty-first birthday, Marcus Whitman began what we may call his definitive medical education, but who shall deny that the years that had gone before, with their changes of environment, with their association with elders and contemporaries of high ideals and high ambition, were not a part of his medical education. To be sure in them he did not study the technicalities of anatomy, and physiology, and materia medica, but in them he was trained in those high qualities of character which in the practice of medicine are just as essential as technical knowledge.
We must now leave Marcus Whitman as an individual to sketch briefly the system of medical education in vogue in the northeastern United States in 1823 when he entered upon medical study.
During the first hundred and fifty years of the American colonies medical education was entirely by the apprentice system, for there were no medical schools in those colonies until ​1765. Under this system a student attached himself to a practitioner, who was called a preceptor. He read the medical books of his preceptor and was quizzed on what he had read, he assisted in compounding the crude drugs, and he accompanied his preceptor on his professional calls, and on the long rides between these calls discussed with his preceptor what they had seen.
At the end of his apprenticeship of three years, if he had been diligent, the student received from his preceptor a certificate of proficiency. The recording of this certificate with a town clerk made the young man a legal practitioner.
Just before the Revolutionary War began the formation of medical societies, first in Connecticut. After the war medical societies extended to Massachusetts and before 1810 to all the states.
Each of these societies had a group of examiners, called a board of censors, before whom an applicant must appear. If he passed the examination he was given a certificate of proficiency, called a diploma, which was accepted as evidence of qualification to practice, and upon registration with a civil authority he became a legal practitioner. The method of qualification through medical societies brought more uniformity than the method of certification by the individual preceptor.
When medical schools were established they took over that part of the duties of the preceptor which had to do with text books and recitations, and the professors in these schools, each restricted to one or two subjects, carried on the didactic features of a medical education better than the single preceptor teaching all the subjects could possibly do it, but all the clinical teaching to train in the art of medicine was left to the preceptor.
The student was required to study medicine three years under his preceptor. If in this time he attended two courses of lectures and passed the examinations, he might be graduated by the medical college, and under its chartered powers be given a degree and a college diploma. This diploma was accepted as evidence of qualification and on registration with civil authorities made him a legal practitioner. Thus there were two methods by which one might become a legal practitioner, either by ​the receiving of the diploma of a medical society, after examination, or the diploma of a medical college after attendance and examination, but each required the essential three years of study under a preceptor.
Thus the preceptor was the keystone of the medical educational system and it was through him that essentially all knowledge and training in the art of medicine was secured. Hence the quality of a medical education of an individual student depended in great degree upon the preceptor under whom he studied. The preceptor, not the school, introduced the student to medical study, since the standard requirement was that a student should have studied with a preceptor for at least a year before he might enter a medical school.
We need therefore in the case of Marcus Whitman to know something about his preceptor. In Rushville, New York, the town of Marcus Whitman's birth and of his residence from the age of eighteen to the age of twenty-three, there was a single village physician. He was Dr. Ira Bryant. Of his high qualities as a man, and his skill as a physician through thirty-five years of practice there is abundant record. It is probable, although not certain, that he never attended a medical college.
Dr. Ira Bryant was both as a man and a physician a favorable influence upon Marcus Whitman. When they came into the relation of preceptor and student Dr. Bryant was forty years of age and had been practicing about fifteen years. He had previously acted as preceptor for several students who had excellent medical careers, therefore he was experienced as a preceptor. We know that Dr. Ira Byrant was a great admirer of Dr. Benjamin Rush, and it was by Dr. Bryant's influence that shortly after the death of Dr. Rush, the town in which Dr. Bryant was practicing changed its name to Rushville in honor of that great patriot, physician, and teacher.
From such records as we have there is firm conviction that Marcus Whitman, entering upon the study of medicine, had as a preceptor a physician well above the average capability of that period. We may also be convinced that Dr. Bryant had in Marcus Whitman a student that was well above average. Educated in the excellent boys' school of Mr. Hallock, Marcus Whit​man now showed his own eagerness for further education by renewing study against the advice of his family and without their support. We shall find that Marcus Whitman not only had high ideals, but that his achievement as a student was of high order. There are many collateral reasons to believe that he entered upon his medical study with eagerness and a firm purpose to succeed.
After a period of study and saving of money came the question of choice of a school. In 1825 there were eight medical schools in New England and three in New York state. In all the rest of the United States there were but four more. In that same year two more were started.
Into the choice of a school entered four primary considerations,—proximity, expense, efficiency, and reputation. He chose a school, probably on the advice of his preceptor, that favorably fulfilled for him all four of these considerations. It was a school of which, in all probability, few who read this article have ever heard, but it was one of the most famous medical schools in the United States in the period from 1820 to 1840.
All of the medical schools organized before 1807 were closely associated with colleges of arts and sciences, or of that type now called "university” medical schools, but in 1806 there was the culmination of a long controversy in the faculty of the medical department of Columbia College and a large part of that faculty seceded and wished to start a rival school. The Medical Society of the Southern District of New York applied for a charter which was granted. It constituted all of the hundred and one members of the society as the board of trustees, but it gave them no right to grant degrees. The extent of the authority of the trustees was to recommend candidates for the degree, but the degrees were granted by the state department of education which was then and is still known by a name not understood by many, namely, as the University of the State of New York, an organization that does no teaching, but administers and controls all the educational activities of that state whether public or private.
In 1807 the new teaching medical organization began operation. It had the somewhat cumbersome name of the College of ​Physicians and Surgeons of the Southern District of New York in the City of New York. In its first year it had seven professors, forty students, and a hundred and one trustees. It had no connection with any other teaching educational institution. It was the first "independent medical school” in America.
In 1802 in Fairfield, Herkimer County, New York, a village of two hundred people about sixty miles west of Albany, was established (incorporated in 1803) an academy of the type common in New England. To it in 1808 came as a teacher of chemistry Dr. Josiah Noyes, a graduate in both arts and medicine at Dartmouth. As early as 1809 Dr. Noyes and a practitioner of a neighboring town gave courses in anatomy and materia medica and physiology.
In 1812 the Medical Society of the Western District of New York, which comprised more than two-thirds of the total area of the state, sought a charter to establish a medical school at Fairfield on the same basis as that established in New York City five years earlier, namely, with an initial grant from the state treasury of $10,000 followed by annual appropriations of $1,000 and with the degrees to be granted by the University of the State of New York.
Such a charter was granted and the institution was named the College of Physicians and Surgeons of the Western District of New York at Fairfield. Because of the cumbersome name and the similarity to the name of the institution in New York City this institution throughout its twenty-eight years of existence was familiarly called the Fairfield Medical School, instead of by its legal name, and this familiar designation will be used hereafter in referring to this school.
Up to the date of 1812 all of the eight preceding medical schools had been located in relatively large cities with the single exception of that one in connection with Dartmouth College. The origin of the Fairfield school therefore, made the second of the type which came to be known as “country medical schools.” Both on account of the influence of Dr. Noyes, a Dartmouth graduate, and the similarity of location in a country village, Dartmouth became the definite pattern of Fairfield in its organization. Instruction began in October, 1812, under ​the name of the medical school, but courses in anatomy, chemistry, physiology and surgery had been given in the academy since 1809.
The Fairfield Medical School grew rapidly and by 1825 was favorably known throughout the medical profession. It had teachers of capability and its graduates were successful. The policy of country medical schools grew in popularity in succeeding years and the Fairfield school became the accepted pattern.
It was into this school that Marcus Whitman entered early in October, 1825, after two years study under Dr. Ira Bryant as a preceptor, and we must now enquire something about this school, its teachers, and its curriculum in 1825-26.
It had an attendance in that year of one hundred and thirty students. This may seem small, but this attendance was exceeded in that year by but four of the seventeen medical schools in the United States. It had two good buildings and a dormitory, all situated near the buildings of the academy. However, the most important features of a medical school, then as now, are not its size nor its buildings, but the quality and experience of its teachers. The year that Marcus Whitman entered there were five professors.
Dr. Joseph White was president (an officer corresponding to our present dean) and professor of surgery. Born in Connecticut he settled for practice in northern New York in 1787, on the then extreme frontier. He developed an extensive practice, and was the most noted surgeon of his time in upstate New York. He was a brigade surgeon in the War of 1812. He was president of the State Medical Society and in 1812 the University of the State of New York conferred upon him the honorary degree of doctor of medicine. In 1825 he was sixty-two years of age, had had eight years experience on a medical faculty, but for twenty-five years previous he had been a popular preceptor and therefore had done much private teaching. Dr. Westel Willoughby was professor of midwifery—the term obstetrics being then little used. Born in Connecticut, in 1792 he went to northern New York where he developed a wide practice. He was a member of congress in 1815 to 1817. In the War of 1812 he was in command of the medical department ​along the Canadian border. In 1812 the University of the State of New York conferred upon him the honorary degree of doctor of medicine. In 1825 Dr. Willoughby was fifty-six years old, had been teaching on the faculty for thirteen years, which period was preceded by extensive private teaching for more than twenty years.
Dr. James Hadley, a graduate in both arts and medicine, was professor of chemistry, materia medica, and mineralogy. In 1825 he was forty years old and had had sixteen years of teaching experience. During his entire teaching career, which covered forty-four years, he held professorships in three medical colleges and two colleges of arts. His scholarly tastes were transmitted to his descendants. All three of his sons who reached maturity became professors in leading institutions. One of these sons was professor of Greek in Yale College and the son of this man was the late Arthur Twining Hadley, president for over twenty years of Yale University.
Theodoric Romeyn Beck was professor of medicine and medical jurisprudence. He was a graduate in both arts and medicine, and in 1825 he was thirty-five years of age and had had ten years experience as a professor on this faculty. He was soon after president of the New York State Medical Society. Dr. Beck was one of the leaders of American medicine in the first half of the nineteenth century.
James McNaughton, a native of Scotland, was professor of anatomy and physiology. He graduated in medicine at the University of Edinburgh in 1817. In 1825 Dr. McNaughton, then thirty-one years of age, had been a member of the faculty for five years. He had a long subsequent career in teaching, with a constantly increasing reputation.
It is evident that Marcus Whitman chose to enter a school with a distinguished group of capable, well-educated, and experienced teachers. At that time this faculty had a high reputation throughout the country and by some reliable contemporary writers was stated to be the best medical faculty in the United States.
The subjects taught at that school in 1825-26 may be judged from the titles of the professorships. They included anatomy, ​physiology, chemistry, mineralogy, botany, materia medica, medicine, surgery, midwifery, and jurisprudence. There was no such thing as the present specialties. A physician was expected to be proficient in all phases of medicine and restriction to some special field of practice was considered an admission of inferiority.
The session began early in October and extended without vacations or holidays (not even Christmas day) for sixteen weeks, ending in late January. There were four or five lectures each day, and dissection was carried on at night. The instruction was nearly all by didactic lectures supplemented by quizzes.
There was no laboratory work in physiology or pathology, and in chemistry only demonstrations. There were no clinics or dispensary. The only practical work was in anatomy, and with some study of mineralogical and botanical specimens bearing on materia medica.
The securing of dissection material was one of the great problems of medical teaching in the early nineteenth century, but the Fairfield Medical College had one distinction. It was then the only school in the United States where human dissection could be carried on legally. This gave an opportunity to Marcus Whitman that was almost unique.
Since Marcus Whitman had to earn his own money the item of expense is of interest. The student paid fees to each individual professor or, as it was said, he "bought the tickets of the professors." The total cost of the tickets of the five professors was $54 in 1825-26.
A room in the dormitory cost thirty cents a week or $4.50 for the session. Board cost eight yankee shillings, that is, a dollar a week. The item of firewood cost ten shillings, that is, $1.25 for the session. If one adds all these items given in the catalogue their total is $76. In addition there was the cost of books, of candles for light, and of laundry. We therefore see that the catalogue was correct when it said that the total estimated cost of a session was one hundred dollars. This seems small to us, but remember that it had probably taken two years for Marcus Whitman to save this one hundred dollars.
​We wish to know whether Marcus Whitman was a diligent and proficient student. That he was we have convincing evidence. Many medical students took but one course of lectures in the medical school. At the end of these lectures a student was expected to return to his preceptor. If, after a further year with the preceptor, the student was recommended he was permitted to appear before a medical society for examination, but only rarely was a student admitted to such examinations immediately after the end of his first course of lectures.
Marcus Whitman was admitted to the examinations of the Herkimer County Medical Society after one session of sixteen weeks attendance at Fairfield Medical School, and on May 9, 1826, was granted a diploma. This document recites that
   Whereas Marcus Whitman hath exhibited unto us satisfactory testimony that he hath studied Physic and Surgery for the term and in the manner directed by Law and hath also upon examination by our Censors given sufficient proofs of his proficiency in the Healing Art and of his moral character, Wherefore by virtue of the powers vested in us by law we do grant unto the said Marcus Whitman the privilege of practising Physic and Surgery in this state together with all the rights and immunities which usually appertain to Physicians and Surgeons.
Thus on May 9, 1826, Marcus Whitman, not yet twenty-four years of age, became a legal practitioner in the state of New York. The law then prescribed that a man must have studied medicine three years before he could be licensed; therefore this document is proof that Marcus Whitman studied under his preceptor, Dr. Ira Bryant, for two years before entering medical school. This sets the date of his beginning medical study in May preceding his twenty-first birthday.
This diploma also is evidence of his diligence and proficiency as a student. As stated, it was unusual to admit a man to examination immediately after his first course of lectures. The diploma is dated at Fairfield, the town in which the school was located, and the only members of that society who knew him were the professors in the school and they would not have recommended him for examination unless he had shown himself a good student. Thus we have indirect, but none the less convincing, evidence that Marcus Whitman was of good intellectual capability and had been a diligent and proficient student.
​Dr. Marcus Whitman commenced medical practice in New York state, but after a few months went to Canada. No record has yet been found of the location of his practice from May, 1826,to September, 1827. From September to December, 1827, he took over the practice of a friend who was ill, at Sugar Grove, Warren County, Pennsylvania.
Early in 1828 he settled for practice on the Niagara peninsula, twenty-five miles west of Niagara Falls, in the township of Gainsboro, where a little hamlet surrounded a sawmill, and was known as Snyder's Mills. It is now called Saint Anns. Here he practiced for a time on his New York state license, but in 1829 the medical board of Upper Canada granted him a license without examination.
There was no other physician within twenty miles. In this frontier town there was little of intellectual companionship for Dr. Whitman, except one man, the local clergyman, the Reverend Daniel Ward Eastman. He was a man of superior talents and personality, although he had entered the ministry in 1800 without going to college. He had been privately trained under a clergyman, since there were no theological schools in 1800. Mr. Eastman appears to have been the only man there who was the peer of Dr. Whitman. Dr. Whitman became a member of his church.
In the autumn of 1830 Dr. Whitman returned to Rushville, New York, the town of his birth and his mother's residence, and began study of Latin and other subjects under the local minister, the Reverend Joseph Brackett, a graduate of Williams College and former tutor there, a man of high talent. It seems probable that from contact with Mr. Eastman and knowledge that his pathway to the ministry was marked by little formal education, there was at this time a recrudescence of the desire of Dr. Whitman to enter the ministry, and that he planned to follow this method of private study under a clergyman.
Within eight months this clergyman developed an illness that resulted in his death in 1832. Thus Dr. Whitman had to face another of those serious decisions of which so many marked his life. His decision was to continue in the medical profession. He was a legal practitioner in New York state and had had four ​years of successful practice. He might well have resumed practice at once, but instead he decided upon further formal education, by again attending a medical school. This shows his ambition for thorough education.
Again he chose the school at Fairfield. Its reputation had further increased in the five years since his previous attendance and at this time there were but two schools, out of the more than twenty in the United States, that had a larger attendance, and it was said by reliable contemporary writers that this school had the best medical faculty in the United States at that time.
On the first Tuesday in October, 1831, Dr. Whitman again entered the Fairfield Medical School. The length of the session was still sixteen weeks, the expenses were essentially the same, and the curriculum was not far different from that in 1825-26, but the teachers were more experienced.
The faculty was the same as five years before with one exception. Dr. Joseph White, the former professor of surgery, retired in 1827 when he reached the age of sixty-five years. His place as professor of surgery had been taken by Dr. John Delamater. There is evidence in later years that Dr. Whitman cherished this man more than any other one of the several capable teachers under whom he studied, and that Dr. Delamater had a profound influence upon him. We need therefore to know something of Dr. Delamater.
Dr. John Delamater was at this time forty-five years of age. He had already twenty-four years of experience in practice, and eight years experience as a medical professor. He had already held professorships in three medical colleges—Berkshire, Bowdoin, and Fairfield. During his teaching career of nearly forty years he held professorships in nine different medical colleges, all "country medical schools" except that at Cincinnati. Several of these professorships were held coincidently according to the custom of the times, three in a single year. He declined appointments both in Philadelphia and New York City because he was a believer in "country medical schools." With Dr. Oliver Wendell Holmes in 1836 he reestablished Dartmouth Medical College which had become decadent. In 1843 he founded what is now the School of Medicine of Western Reserve University where he ended his teaching and where he died in 1867.
​It was repeatedly said by his colleagues that he was the best medical teacher in the United States. He was personally of equally high standing. Of the highest degree of morality and integrity, benevolent, deeply religious, and with high ideals, he was the pride of every community in which he lived.
On January 29, 1832, Marcus Whitman received the degree of doctor of medicine from the College of Physicians and Surgeons of the Western District of New York.
At times there have been implications that Dr. Whitman was not a well educated physician. This is far from the truth. He had a much better preliminary education than the average physician of his time. He had a superior preceptor under whom he studied for two years, instead of the usual single year before entering medical college, he attended a school where the privilege of dissection was unique, and under teachers of superior capability, and each with much previous successful teaching experience.
Then he had four years of independent practice, and next a year of study under the Reverend Mr. Brackett, enough capable a teacher to have been a tutor in Williams College for two years. Then he returned to his medical college, able by reason of his practice to appreciate fully the teaching under a group of familiar teachers of the highest teaching proficiency, and in a school especially devoting itself to training men for practice of the frontier.
To all this mental training must be added the training of character under the influence of men of high ideals and noble character, Freedom Whitman, Moses Hallock, Dr. Ira Bryant, the five professors at the medical school in 1825-26, the Reverend Daniel Eastman, the Reverend Joseph Brackett, and again four of his former medical teachers and finally Dr. John Delamater.
Had Marcus Whitman possessed omniscience, it hardly seems that he could have planned a medical education that would have better fitted him for the career that was ahead. When, on January 29, 1832, the diploma was handed to him, Marcus Whitman, M.D., was a thoroughly well educated physician for his times.
Some laymen might wish to end the discussion of a person's ​medical education at the moment he receives his medical diploma, but those who are in the practice of medicine know that this is the end of only the initial phase of professional education and that there are many things not taught in the school that must be learned in practice. Therefore it is fitting to sketch something of Dr. Whitman's experience in practice after graduation.
A few weeks after his graduation from medical college, he settled for practice in the spring of 1832, in the hamlet of Wheeler, Steuben County, New York, twenty-five miles south of his birthplace. In this little village he practiced for three years. There was no other physician within nine miles in one direction and six miles in the other direction. His nearest neighboring physician was the man whose practice he had taken over. Here in this rural community first settled thirty years before, Dr. Whitman became a "country doctor."
This term is not used in derision—far from it, for the country doctor is an American institution which forms the foundation of American medicine. From him springs all American medicine, since in colonial times, there being no cities, all physicians were country doctors. Of the great medical names of the nineteenth century many were country doctors.
We lack documentary evidence regarding Dr. Whitman's three years of practice as a country doctor in western New York, but there are extant many original documents concerning country doctors in that same general region and period that permit us to sketch his experience during these years.
Every doctor was a general practitioner and was called upon to serve in all the fields of medicine. There were no specialists to whom he could refer difficult cases, or call in for consultation. There were no office hours. He went whenever called, day or night, regardless of weather. The patient who was able to come to his office for treatment must wait there until more serious cases were cared for.
His method of transportation was on horseback. The doctor must be a good horseman and have a good horse, for when called he was expected to hasten. Returning from one call with a tired horse he might find another call to which he must also hasten and this required a fresh horse. The busy doctor must keep more than one horse.
​Hence a doctor who could do all his "ride" with one horse could not be very busy and the inference was he was not very capable. Such a one was called a "one-horse doctor," a term of deprecation that came to be applied to things that had nothing to do with horses, as a one-horse store, or hotel or town.
The doctor furnished the medicines to his patients. Only rarely did he write a prescription since apothecaries were rare. He bought the crude drugs, ground them with mortar and pestle, and did his own compounding. Much of his therapy was by giving the powdered crude drug itself. Sulphate of quinine was rare. Instead he gave the powdered Peruvian bark. Tinctures were little used. Instead he gave the crude drug. Few of his therapeutic agents were given in fluid form. Instead he gave powders, each dose neatly wrapped in a folded packet, and a doctor was, to some extent, judged by the neatness and uniformity of his powder packets. Bottles and vials were so expensive that they were charged separately from their contents and credit given when the empty vial was returned. To some extent the doctor used pills. These he compounded, rolled, and coated himself.
The number of drugs used was not great. Complete inventories of successful country doctors show less than fifty. A few of these were constantly used. Calomel was a stand-by. Next to this the main feature of therapy was blood letting, based on the idea that disease was due to excess of blood, and the first thing in treatment was "depletion." Contagion of certain diseases was appreciated, but no one could explain it. Vaccination against smallpox was a usual procedure.
There were no hospitals, so that all surgical operations must be done in the home, and it should be remembered that there were no anesthetics. The patient had to be forcibly held by two or more persons who could be depended upon not to quaver at the sight of blood. In an amputation of a leg or arm a tourniquet was applied and then the soft parts severed with a single encircling stroke, with a knife the length of which was proportioned to the circumference of the limb. Speed was the criterion of surgical skill. Some surgeons boasted that they could amputate an arm in three minutes and a leg in five minutes.
​There was no asepsis nor antisepsis. Instruments after use were wiped off with a rag, and were then ready for the next case. It was the day of "laudable pus” when suppuration was considered essential to successful healing. Bacteria were not discovered until fifty years later.
On his ride the doctor always had a pair of saddlebags. Many used more than a century ago are still preserved. Each bag had a capacity of about two quarts. In one he carried his medicine, in the other his instruments. His usual instruments consisted of lancets for bleeding, needles for suturing, a catheter, scalpels, small forceps, a rectal syringe for the favorite clyster (or enema,) and always a turnkey for extracting teeth, for there were no dentists in those days except in the largest cities. The use of obstetrical forceps was extremely rare at that time.
He carried no splints, bandages, or cotton. If called upon to "put up" a fracture he whittled a splint out of a shingle or hewed it from a board. For padding he used tow, found in every farm house. For bandages a sheet or old calico dress was torn up.
Some present day people who are practical minded may wish to know what fees the country doctor received. The following figures are from one of several sets of account books of country doctors in those years in the same general region where Dr. Whitman practiced.
All prices are in multiples of 6¼ cents, called by some a six-pence, but usually called a half shilling. For a visit within three miles the charge was 25 cents. For a greater distance 6¼ cents a mile was added. If a second visit were made on a patient in one day it was termed "a call" and charged at half price, i.e. 12½ cents; this to prevent the accusation that the doctor was trying to run up a bill. Medicines were charged extra, usually 6¼ cents at each visit. Patients who called at the doctor's house were charged 12½ cents plus the charge for medicine.
Surgical services were, for blood letting 12½ cents in addition to the visit charge; extracting a tooth 12½ cents; fractures from $2.00 for lower arm to $5.00 for upper leg; amputations were from $5.00 for lower arm to $20.00 for upper leg. Obstetrical deliveries were from $1.50 to $3.00 depending on the ​length of the labor. In the larger towns and cities fees were somewhat greater.
One may ask what was the annual income of a country doctor. He never spoke of it in that way, but mentioned how much "he put on his books.” He entered on his books not only deferred payments but cash received. A busy and successful country doctor would "put on his books” from $75.00 to $150 per month, depending on the season of the year, with an annual total of from $1000 to $1500 a year. On this he prospered, lived well, bought land, raised a family, and educated his children above the average.
How was he paid? In money to some extent, but also in commodities and occasionally in merchandise and often in service. The following credits are taken from account books of that period. Hay, oats, wheat, potatoes, fruit, cider, maple syrup, live animals such as sheep and pigs, dressed beef and pork, cheese, butter, and cord wood, and in merchandise-cloth of various kinds, yarn and dressed leather. A common method of payment was beeswax which had a ready market.
He also received pay in services, the doctor furnishing the material; for example, "for making me a pair of pantaloons, a coat, a beaver hat, a pair of boots, ruffled linen shirts, a dress or a bonnet for my wife, sun bonnets for my little girls, mittens for my boys, weaving a rag carpet."
These sets of books show surprisingly few uncollected bills, although some were paid very slowly. After a year interest was added to the account, but frequently was deducted to secure payment.
Three years of this type of practice added to the medical education of Dr. Whitman. It cultivated resourcefulness, judgment, and skill, and further prepared him for the career that was ahead of him, and by this experience he was prepared to cope with emergencies which he yet was to meet.
But these particular three years of 1832 to 1835 brought to him a type of education that no physician in America experienced prior to that year. Asiatic cholera had raged in northern Europe in the summer of 1831 and in June, 1832, it was brought to Montreal. In a few weeks it spread through all the region ​east of the Mississippi River, progressing along routes of water travel.
No period in American history so tried the souls of American physicians as the months from June to October, 1832. No one of them had received any instruction on this disease. None had ever seen a case. The books that they had studied or owned contained no reference to this disease. No one knew its cause or how it was contracted, but they saw men and women by the score about their usual tasks on one day and in their graves the next day. Wild conjectures were made as to the cause of the disease. The more frequently alleged cause was fresh vegetables and fruits, and in all the cities their sale was prohibited.
It was soon observed that following a brisk summer shower or thunderstorm a new group of cases developed. Consequently many thought that the disease was spread through damp air, others believed it came from electricity in the air following lightning. No one guessed that it was due to the surface washings of effluvia of former patients into the wells and cisterns, springs, and streams that served to supply drinking water.
By trial and error the profession learned that certain therapeutic measures were successful in cases early recognized in robust patients. Children and the aged and the dissipated all succumbed. The mortality rate on real cases of the disease in some places was more than 75 percent, but statistics are not reliable since many cases of ordinary summer diarrhea were called cholera, and there is no reliable record of diagnosis of the cases that recovered.
These partially successful therapeutic measures were published by medical societies in the newspapers, and the weekly newspaper became the physician's textbook.
The Erie canal had been completed in 1825. Along this water travel route the disease spread. Dr. Whitman lived about forty miles from the canal. There is no record of any cases in the town where he lived, but there were several cases and deaths in a town six miles distant on the shore of a long lake, on which there was navigation connecting with the Erie canal. It is highly probable that he saw some of these cases.
All through this summer and in the following months when​ever two physicians met, on the highway, in the village store, at church, or in society meetings, the chief topic of conversation was "the cholera."
In 1833 a few cases due to carriers appeared, but there was no epidemic. However in 1834 the disease was newly imported from Europe, this time entering at New Orleans in early May. It advanced up the Mississippi River like a prairie fire, and up the smaller rivers, along the canals, along the Great Lakes, and wherever there was water travel.
This epidemic was more extensive than the one of 1832, but the mortality rate was much less since in two years the profession had learned much about the early symptoms of the disease and its treatment, although still at a loss as to how it was transmitted.
Thus in these three years of practice Dr. Whitman acquired not only the skill and experience of the ordinary country doctor, but in addition much knowledge concerning cholera. Who will say that his medical education ended when he received his diploma in January, 1832?
These three years trained him in many qualities, not only in better knowledge of therapy, more experience in surgery, but also in judgment and in resourcefulness. If we put the beginning of his medical education when he began to study under Dr. Ira Bryant in the summer of 1823, we should continue it up to the spring of 1835, and say that his medical education to prepare him for service in the Oregon territory covered a period of twelve years.
That Dr. Whitman was a high type of country doctor, both professionally and personally, we have documentary evidence in the expressions of regret at his leaving Wheeler recorded at that time by leading men and women of that community.
When in the winter of 1834–35 the Reverend Samuel Parker was seeking a companion with medical knowledge to join him in a "missionary exploration" in the northwest he found Dr. Whitman. It is improbable that Mr. Parker realized how admirably Dr. Whitman was prepared for that exploration.
Dr. Whitman, deprived of the fruition of his early desire to enter the ministry, had chosen the sister profession of medi​cine and had done noble service in it. Now he saw the opportunity to combine these two fields of service as a medical missionary and he agreed to go with Mr. Parker.
In March, 1835, he started on horseback for Saint Louis, seven hundred miles distant. On the way he visited his uncle, and foster father and an aunt in northern Ohio, and other relatives in central Illinois, all migrating pioneers as had been their common forebears.
Early in April he reached Saint Louis and met Mr. Parker. They then went by river steamer across the state of Missouri to Liberty, the point of departure for all western journeys either to the west or southwest.
Arrangements had been made to accompany the caravan sent out each spring by the American Fur Company to carry supplies to its trappers in the Rocky Mountain region, and to bring back the furs taken by these trappers during the previous twelve-month.
In the middle of May, 1835, the caravan of the American Fur Company started from Liberty, Missouri, for the rendezvous on the western side of the continental divide. Mr. Parker and Dr. Whitman were with it. One was a minister, both were missionaries. To the sixty men of the caravan, both were praying parsons, and praying parsons were as far from the ideals of caravan men as east is from west.
Mr. Parker, having little experience in pioneering, was captious and critical of inconveniences that were the common lot of all. Such an attitude brought ridicule, and not distinguishing between the characteristics of Mr. Parker and Dr. Whitman, the caravan men soon came to despise both of them. When their backs were turned they were the targets for rotten eggs, and it was evident that their presence was unwelcome. Mr. Parker claims that he had evidence that some of the caravan men even plotted to kill both Dr. Whitman and himself.
With continuance of this condition it appeared that, for the sake of the discipline in the caravan, Mr. Parker and Dr. Whitman would soon be asked to turn back and thus their hope of reaching Oregon grew less with each passing day.
Fortune decreed otherwise, and Fortune appeared in a strange ​guise, none other than that of the most dreaded calamity of those years, an outbreak of Asiatic cholera.
Just as, after the widespread epidemic of 1832, there had been sporadic cases in 1833 arising from carriers, so in 1835 appeared sporadic cases, the legacy of the epidemic of 1834. Such a carrier was in the caravan of 1835, and at the camps near where the Platte joins the Missouri, one of the caravan sickened with cholera.
Today one can but inadequately imagine the terror that seized a group of individuals at that date when it was known that cholera was at hand. The terror of Indian raids could be better endured for one knew whence they came, but none knew whence cholera came, nor how it was communicated. Only those physicians who had been through earlier epidemics could allay the terror of the laity by example of their own courage when they faced the scourge.
The entire expedition was threatened by this outbreak. The men were likely to desert, or if they did not and any considerable number died, the caravan would be too shorthanded to go on.
As Dr. Marcus Whitman rode the byways of rural Steuben County, New York, in 1832 and 1834, and as he discussed cholera with his professional colleagues wherever he met them, little did he imagine that he was preparing himself to meet the first great emergency in his part in the settlement of old Oregon. He had learned the treatment that succeeded in cases taken early in robust men, and all the members of the caravan were robust. None other would be engaged.
The first case in the caravan occurred June 10, on the banks of the Missouri, two hundred miles from any considerable town. In 1835, for the first time in its history, the caravan had in it, although not of it, a graduate physician. He was no youngster just come from one course of lectures. He was a graduate of one of the best medical schools in the United States and experienced in practice. While some members of the caravan had occasionally faced death in Indian battle, Dr. Whitman for seven years had daily faced Death and loosened his grasp on his intended victims, for he had been schooled in the emergencies of seven years of independent country practice.
​Fontenelle, the leader of the caravan, sent for Dr. Whitman and told him there were three cases in camp that looked like cholera. What shall be done? Must the caravan turn back? Must its members all die? No, said Whitman. I know the early symptoms. I have the medicines with me. The men are young and robust. We will fight the disease and overcome it. But to succeed we must attack at the earliest symptoms. Give orders that at the slightest symptom of cramp I be notified.
Fontenelle, the strict disciplinarian, gave such orders and they were obeyed, and he himself was one of the first to need treatment. Only three men, the earliest cases, died, and in a few days. there were no new cases appearing and it was apparent that the outbreak had been conquered. The fight had been won by a physician who at this time and at many other times showed himself a leader. Moreover, he was a leader who had prepared himself for battle. The cholera outbreak was a surprise attack, but like every good leader, Whitman was ready for emergencies because of training and study and experience.
And what of those men whose lives he had saved. There was no more throwing of rotten eggs. The doctor was now the most respected man in the caravan. They even stopped ridiculing the praying parson for he was the doctor's friend, and anyway was harmless.
And so, at dawn on June 21, 1835, the caravan moved westward from the Missouri toward the land of the setting sun, and Parker and Whitman are with it on their way to far-off Oregon. Dr. Whitman by his presence, his education, and his skill, had changed his own position from that of one ridiculed and despised to a status of the highest respect and gratitude, and he had saved the American Fur Company caravan of 1835.
The first grave emergency in the series of events in the settlement of old Oregon had been met and overcome by an educated and experienced physician, Dr. Marcus Whitman. Who shall deny that God moves in a mysterious way his wonders to perform?
Fifty weary days under broiling sun across eight hundred miles of treeless prairie and plain the caravan toiled westward, horse and mule drawing the heavily laden wagons. At times ​the wheels would creak and then shrilly whine, and the caravan must halt until an animal was killed to furnish fat to grease the axles. Swimming streams, bogged in quicksands, and deep in dusty ruts, the caravan reached Fort Laramie at the foot of the eastern slope of the mountains.
Here wagons were left and their contents transferred to pack aimals. Up the eastern slopes of South Pass the caravan wound its way, pack animals, outriders to protect from marauding Indians, and footweary caravan men, moving no faster than the slowest individual man or animal.
On the morning of August 10, 1835, the caravan reached the summit of the pass, and here Marcus Whitman, Doctor of Medicine, educated by twelve years of study and country practice, crossed that imaginary line which there marks the continental divide, the first graduate of an American medical school to stand on the western side of that line. He was the pioneer of pioneers of all that throng of physicians and surgeons who for more than a hundred years have ministered to the bodily ills of millions of human beings in this great western empire.
Standing at the continental divide on that August morning one hundred and one years ago, he looked with telescopic eye first to the west and then far to the northwest, where a year later,—in the words of that poet native to the town of his boyhood days—Marcus Whitman was to
Lose himself in those continuous woods Where rolls the Oregon, and hears no sound Save his own dashings.