Improve, Perfect, & Perpetuate

by Hayward, Oliver S.; Putnam, Constance E.

• ISBN13: 9780874518603
• ISBN10: 0874518601
• Format: Hardcover
• Copyright: 1998-05-01
• Publisher: Dartmouth College

Summary

This is the first full-scale biography of Nathan Smith -- medical pioneer, founder of Dartmouth Medical School and cofounder of three other medical schools (Yale, Vermont, and Bowdoin), and progenitor of a long line of physicians. Smith was a central figure in early American medical education, from 1787 when he began practicing in New Hampshire, to his death in New Haven in 1829. In his day, Smith was probably the nation's leading physician, surgeon, and medical educator, and well ahead of his time in insisting that doctors practice "watchful waiting" and emphasizing patient-centered care. In the process of telling Smith's life and story, authors Hayward and Putnam fill out in new ways the picture of medical treatment and medical education in post-Colonial America.

The tale of Smith's remarkable career unfolds in New England, where the authors create a sense of time and place through an exhaustive study of primary and secondary sources, and especially Smith's own letters and lecture notes taken by his students. Readers become immersed in Smith's life and the spirit of the times as they examine early Victorian notions of disease, how medical students were taught (the chapter on body snatching is especially lively), the politics and economics of founding professional medical schools in early America, and other topics. The book provides a vivid description of what it was like to study and practice medicine, and be the recipient of the ministrations of physicians, during this critical period.

Author Biography

The late Oliver S. Hayward, M.D. graduated from Dartmouth and Harvard medical schools, interned at Mary Hitchcock Memorial Hospital, and practiced medicine for most of his life. He compiled his years of research on Smith into a rough draft, which has been fashioned into the present book by Constance E. Putnam, a writer who specializes in the fields of history of medicine and medical ethics.

Table of Contents

List of Illustrations	xi	(2)
Foreword	xiii	(2)
C. Everett Koop
Preface and Acknowledgments	xv	(9)
Constance E. Putnam
A Technical Note	xxiv	(1)
Introduction	xxv
Philip Cash
I. THE ROAD TO DARTMOUTH	1	(58)
1. The Early Years	3	(12)
Family Background	3	(2)
Growing Up	5	(2)
Encounter with Josiah Goodhue	7	(2)
Preliminary Studies	9	(2)
Apprenticeship	11	(4)
2. Newly Minted Doctor	15	(17)
Opening a Practice	15	(4)
Off to Harvard	19	(8)
Marriage and Family Life	27	(5)
3. New Ventures	32	(15)
Practicing Medicine, Dreaming of a Medical School	32	(7)
Study Abroad	39	(8)
4. The Founding of Dartmouth Medical School	47	(12)
First Classes	48	(4)
Appointment as Professor	52	(7)
II. PROFESSOR OF MEDICINE	59	(82)
5. The Heart of the Matter: Theory and Practice	61	(20)
Teaching Medicine	61	(6)
The Lectures	67	(7)
Making Room for Chemistry	74	(3)
Genius and Driving Force	77	(4)
6. Trouble in the Anatomy Department	81	(21)
Teaching Anatomy and Surgery	81	(7)
Visiting Anatomist: Alexander Ramsay	88	(7)
Anatomy Riots	95	(7)
7. Students, Colleagues, and Friends	102	(18)
Skeptics: William Tully and Jo Gallup	104	(3)
True Disciples: Ezekiel Dodge Cushing and Amos Twitchell	107	(4)
Fellow Teachers: Lyman Spalding and Reuben Dimond Mussey	111	(4)
Friend Beyond Compare: George Cheyne Shattuck	115	(4)
Other Lives, Other Careers	119	(1)
8. Assuring the Medical School's Future	120	(21)
Life in Hanover	120	(6)
State Politics and the New Medical House	126	(8)
College Politics and the First Colleague: Cyrus Perkins	134	(7)
III. PHYSICIAN AND SURGEON	141	(48)
9. Nathan Smith's Medical Practice: Replacing Dogmatism with Patient Inquiry	143	(22)
Theories and Nosologies	143	(10)
Fevers	153	(2)
Venesection	155	(2)
A Patient's Physician	157	(8)
10. Nathan Smith's Surgical Practice: Devising New Techniques	165	(24)
A Varied Practice	165	(6)
General Surgery	171	(4)
Ophthalmology	175	(2)
Cancer	177	(2)
Orthopedics	179	(5)
An Innovative Surgeon Ahead of His Time	184	(5)
IV. AFTER DARTMOUTH	189	(46)
11. A New Challenge	191	(18)
The Medical Institute of Yale College	191	(8)
Leaving Dartmouth	199	(2)
The New Haven Years	201	(8)
12. A Growing Reputation	209	(12)
The Medical School of Maine	209	(9)
Back to Yale	218	(3)
13. Surgeon to New England	221	(14)
Educational Advisor	222	(5)
Expert Witness	227	(6)
Medical Consultant	233	(2)
V. THE SMITH LEGACY	235	(36)
14. A Man of Many Parts	237	(34)
Medical Author	238	(7)
Man of Business	245	(5)
Family Matters	250	(3)
Like Father, Like Son	253	(8)
15. Epilogue	261	(10)
Appendix A. Chronology of Nathan Smith's Life and Career	271	(2)
Appendix B. The Generations of Smith Doctors	273	(2)
Notes	275	(62)
Bibliography	337	(1)
Chronological List of Works by Nathan Smith	337	(2)
Student Notebooks on Nathan Smith's Lectures	339	(3)
Works on Nathan Smith	342	(9)
Index	351