University of Virginia Library

IX. School of Medicine and Anatomy

When the medical school at the University of Virginia
opened its doors, there were already to be found in other
parts of the United States the like schools, which during

many years, had been in the enjoyment of a large and
lucrative patronage. The most popular of these were
situated in Boston, New Haven, New York, Philadelphia,
and Baltimore,—cities standing north of the Potomac,
and, therefore, for Southern young men so far away as to
entail both expense and discomfort in reaching them.
Many Southerners of fortune, desirous of a medical education,
turned their footsteps towards London and Edinburgh;
but the greater number sought the offices of local
surgeons of repute, who gave their lessons in the intervals
when they were not riding about the country or town
in order to visit their patients,—a provincial system that
had its exact counterpart in the training which so many
callow lawyers of the South were receiving during the
same period.

Jefferson, in forecasting a medical school for his projected
institution, certainly took into account the loss and
the inconvenience which the Southern communities had
so long suffered from the absence of such a school. The
need of it, indeed, was too patent to be blinked. But
when the chair at the University was established, no
measure was adopted by him to convert it at once into
a practical one; its chief aim, at first, was not to give
a professional education, but simply instruction in a
branch of liberal culture which every accomplished gentleman
was presumed to have studied. He held this view
solely because he was under the impression that, in the
absence of all clinical facilities, the lessons of the new
school must be confined to mere theory. Charlottesville
was a small village; the contiguous region was rather
sparsely inhabited; and the jolting conveyances of that
day shut off invalids who might have come from a distance.
There was no material to justify the erection of
a hospital, and without a hospital, how was it possible to

qualify students for active practice after leaving the University?
At one time, Jefferson seems to have thought
that this obstacle could be got over by transferring the
school, not to Richmond, but to Norfolk, where he expected
that the promiscuous and vagabond population
of a seaport would furnish a plenitude of anatomical
subjects for dissection, an extraordinary number and
variety of diseases for observation, and many accidents
for surgical operations. He was compelled to acknowledge
that, until such clinical facilities could be created,
those of his medical students who wished to practice must
seek the finishing touch in institutions situated in other
parts of the country. It was his recognition of this grave
handicap which prompted him to block the perfectly
legitimate plan of the College of William and Mary to
re-establish itself in Richmond, and to associate there with
its existing departments an additional department in practical
medicine. Jefferson anticipated that this combination
would be the ruin of his own school, or at least
would so throw that school into the shade as to bring
it into public discredit; which, in its turn, would lower
the prestige of the entire University. It is disputable
whether this would have followed; but Jefferson was
honestly apprehensive of it.

In the beginning, the course of study embraced the subjects
of anatomy, surgery, the history of the progress and
theories of medicine, physiology, pathology, materia
medica, and pharmacy. Ostensibly, there was but one
teacher in charge of the school, but in reality, there were
two, for Emmet, as the professor of natural history, gave
instruction in the medical subjects of chemistry, botany,
and comparative anatomy, while Dunglison lectured to
the classes in anatomy and medicine.

After Jefferson's death, there was a natural disposition

on the part of those in charge of the medical school
to advertise its unique course of theoretical tuition as offering
certain advantages that counterbalanced its practical
deficiencies. It was pointed out, for instance, that,
in all other colleges, the medical instruction did not extend
beyond a term of six months at most, while, in the
University of Virginia, it was spread out over nine at
least. Furthermore, in the sister colleges, the medical
professors were permitted to go on with their practice;
in the University, on the other hand, this distracting privilege
was denied them beyond its precincts, unless they
were simply called into consultation. The only object of
this exception seems to have been to give the instructors
of the school a wider opportunity to become familiar
with the characteristic diseases of the climate and
country.[8]

The Board of Visitors had soon perceived the benefit
that would follow from the establishment of a separate
chair of anatomy and surgery; and they were only prevented
from making this addition at once by the necessity
of paying the University's debt, now that the General
Assembly had positively refused to assume it. As
the most practical step, they determined to shift some
of the studies of Dunglison's school to the shoulders of
Emmet, who, with that purpose in view, was relieved of
a large part of the course in natural history, as we have
already stated; but this was not done until July 19,
1827, when materia medica and pharmacy were taken
from Dunglison and assigned to him. One motive for
this important change comes to light in a conversation
which took place between Cabell and Dr. Chapman, of

Philadelphia, early in the spring of that year. It seems
that Dr. Chapman had, on this occasion, intimated that,
if the University of Virginia would appoint a second professor
in its medical school, the University of Pennsylvania
might be willing to accept a course of medical lectures
there as equivalent, for graduation, to one course in her
own lecture-halls. Cabell, on his return to Virginia,
found that both Emmet and Dunglison warmly approved
of this tentative proposal, and he, therefore, wrote to
Dr. Chapman to obtain the formal sanction of the University
of Pennsylvania. "I would willingly call home
and educate here all our medical students," he said in this
letter. "In a long time to come, however, every such
effort would be abortive, and the wiser course seems to
be to cooperate with institutions already organized in
other States, and possessing the peculiar advantages of
large cities and extensive hospitals. The practical result
of the change now contemplated in our medical
school will be to draw to it, in the first instance, some
of the more wealthy medical students of Virginia, and
to send them on much better prepared than they are generally
at present. As our society advances and our population
augments, we may gradually become more and
more independent of foreign assistance."

It would seem that the University of Pennsylvania did
not sanction Dr. Chapman's proposition until June, 1829;
but that institution had no reason afterwards to regret
this liberal policy. "I was told some time ago by a
medical student of Philadelphia," R. Y. Conrad wrote to
Dr. Magill, "that the medical school of your University
(University of Virginia) stands there in high estimation,
and that the students of one year from your University
school almost invariably graduate in Philadelphia

the second year at the head of their classes, being much
better prepared in the science than if they had attended
the first year at Philadelphia."

In July, 1827, a demonstrator of anatomy and surgery
was appointed with the understanding that his duties
were to be defined by the professor of medicine. The
new instructor was required to teach what was technically
entitled particular anatomy, in contradistinction to
general anatomy, and also operative surgery as distinguished
from surgical pathology. Upon him also fell the
task of forming an anatomical museum in illustration of
the courses in physiological and pathological anatomy.
The departments of the medical school stood now as
follows: (1) professorship of medicine, which comprised
all the courses in the history of the progress and theories
of medicine, physiology, pathology, obstetrics, and medical
jurisprudence; (2) professorship of chemistry, materia
medica, and pharmacy; and (3) the recently erected
demonstratorship of anatomy and surgery. The only
two branches of study that had been added to those previously
taught were obstetrics and medical jurisprudence.

In 1830, Dr. Johnson, the demonstrator, was asked by
some of his own students, backed by citizens of Charlottesville,
to deliver a series of lectures on the subject
of dentistry, a department of surgery which was then ordinarily
abandoned to ignorant itinerants. There were
several of his pupils who had made up their minds to follow
the practice of this science as a vocation in life; but
Johnson refused to bring it into his existing round of
studies unless a class of at least ten could be formed,
and apparently that number failed to offer.

At first, the demonstrator did not enjoy the privilege
of a seat at the Faculty table; but within a few years after
his original appointment, he was admitted to its deliberations,

with the right to cast a vote on a footing of
equality with his associates. One of the difficulties confronting
him, in these early times, was the procurement
of cadavers for expository dissection. Those picked up
were generally the corpses of negro slaves, and in many
instances had been snatched away by students under the
blanket of darkness; but some of the subjects were white,
and had been brought from a distance; in November,
1831, permission was granted to six medical students to
go as far as Prince George county on what was described
as an "anatomical expedition." An excursion of this
kind to the cemeteries around the University always
bristled with serious risks. A student taking part in
one, in 1831, was shot while in the act of raising a body
from the grave. The members of the demonstrator's
class very frequently joined in contracting for shares in
a cadaver, which, in 1833, at least, does not appear to
have been expensive, for we find, in that year, five students
subscribing only three dollars and a half a-piece
for an equal proportion in such a subject. At this time,
there was a small brick building standing in the little
ravine situated just below the anatomical theatre, which
was used as a boiling house for the dissipation of the remnants
of the dissecting table. In 1832, the demonstratorship
was merged in the chair of anatomy and surgery,
a new department. Physiology was transferred to
this professorship two years later.

As the number of students in the medical school did not
increase, the popular impression spread that this lack
of success was due to the provincial remoteness of the
University. In 1834, Dr. Magill, in a letter to Cabell,
after voicing this conviction in incisive language, boldly
asked whether the Board of Visitors would consent to
the school's removal to Richmond, where it would be in

possession of every clinical facility enjoyed by its Northern
rivals. It was nearly impossible, he said, to impart
at Charlottesville knowledge of practical anatomy, in
spite of the fact that the class was still so small that each
member could be personally reached,—(1) the procurement
of cadavers at all was so costly at best that the
expense thrown upon the medical student, in consequence,
was fast mounting; and the supply came to an end altogether
when a long spell of wet or harsh weather set in;
(2) the absence of a hospital shut the medical students
off from the illustrations of different maladies, and prevented
the acquisition of practical skill in the use of the
surgeon's knife. "No amount of closet study, no book
learning," exclaimed Dr. Magill, "can qualify a man to
contend with disease." The room for practice at the
University, he added, was too narrow to afford either
profit or improvement to its medical professors. Without
opportunities of treating cases belonging to their respective
branches, neither the surgeon nor the physician
could become an entirely satisfactory expositor. Richmond
possessed a large hospital and also a poor-house,
and as a medical school would soon be founded there, the
corresponding department in the University was certain
to be damaged, even if it should not be totally destroyed.

Dr. Warner, a colleague of Dr. Magill, fully concurred
in these views; but apparently, Dr. Emmet was
averse to the proposed change of location.

About three years afterwards, Dr. Warner again advised
that the medical school should be uprooted and
transplanted to Richmond. He condemned its present
working for two reasons: first, each professor was expected
to lecture upon more courses that he could teach
with thoroughness; and secondly, the demonstrator was
too much pressed for time to be able to improve the

means of dissection. He urged that the school should
be divided into four courses: (1) anatomy and surgery;
(2) medicine, embracing the theories and classifications
of diseases; (3) physiology, pathological anatomy, and
medical jurisprudence; (4) chemistry, materia medica,
therapeutics, and pharmacy. Dr. Griffith emphasized
the need of anatomical and clinical facilities on the
ground. The first could be secured by the appointment
of an agent in Richmond who could forward weekly by
wagon four or five cadavers. But he thought that it was
not practical to erect a hospital. In 1825, a dispensary
had been established as an adjunct to the Anatomical
Hall. The single professor of the school, at that time,
lingered half an hour after lecture, on alternate days, to
give medical and surgical assistance to the indigent
without charge, and at the rate of fifty cents a person
for all patients who were able to pay it. The medical
students were required to attend and assist in diagnosis
and ministration. The money accumulated from fees
was expended in the purchase of the necessary supply of
drugs. This dispensary was of such small dimensions,
and was so devoid of clinical advantages, that the professors
of the medical school refused to look upon it as
even a moderate substitute for a hospital.

So acute was the alarm caused about 1837 by the rumor
of an independent school of medicine to be set up in
Richmond that the Board of Visitors were impelled to
take steps to allay it by improving the medical course at
the University. As the institution was not in possession
of sufficient means to build a hospital, even if it could be
supported by the limited patronage which it would receive
at so distant a point, it occurred to them that something
in its stead could be effected by adding another professorship.
And this, perhaps, would have been done, had

not Dr. Dunglison, who was now living in Philadelphia,
when consulted, expressed hostility to the proposition
on the ground that a fourth chair would not increase the
facilities for dissection and hospital service,—the only
deficiencies against which there was a just cause for complaint.
He was inclined to deprecate any alteration in
the system as adopted in the beginning. "One of the
great advantages of the University of Virginia as a medical
school for a first year," he said, "is that the student
is not overburdened with lectures, and has plenty of time
to study the various subjects. This recommendation of
the school I frequently hear." He, therefore, very emphatically
advised that supplementary subjects should be
taught without calling in the assistance of a fourth professor;
and this counsel seems to have impressed the Board
of Visitors favorably, for, during the ensuing session, the
requirements for the existing school became more extensive
and more elaborate. Dr. Emmet lectured to two
classes on chemistry and materia medica, and twice a
week he demonstrated the practical application of chemistry
to pharmacy and medicine. Dr. Griffith gave instruction
on the subject of medicine. His courses also
were divided into two classes: (1) theory and practice of
medicine and obstetrics, and (2) medical jurisprudence.
Dr. Cabell filled the chair of anatomy, physiology, and
surgery. His instruction was made more lucid by the
use of splendid colored plates which had been procured
from Paris.

The depression prevailing in 1836 and 1837 over the
prospects of the medical school, in competition with the
projected school at Richmond, had, by the session of
1839–40 passed away; the cheerful attitude of an earlier
date had returned; and there was now a spirit rather of
boastfulness than of dejection. The following were the

points of special merit which were now claimed for its departments:
first, the session was the same in length as
that of the academic schools; namely, ten months instead
of six at the most, which made up the session of the
Northern medical colleges. This prolongation, it was
said, put the student in possession of "unusual facilities
for gradually acquiring, and thereby digesting the information
conveyed to him by oral instruction, without that
confusion of thought and fatigue of mind which are inevitable,
when, as always happens in city schools, he
has to encounter daily six or seven lectures delivered in
rapid succession." Secondly, before each lecture, the
medical student at the University was required to answer
questions bearing on the subject of the previous lecture,
or portions of text-books that had been given out to be
mastered. The professor's explanatory comment supplied
each of his hearers "with the most valuable means
of fixing in his mind correct information, while it had the
incidental advantage of familiarizing him with the mode
of trial to which he would be subjected in his first examination
for graduation." Thirdly, the length of the session
gave the student ample time within which to cover
the elementary branches of medical science before he
was called upon to listen to discourses on the advanced
branches. Fourthly, any student of approved character
was permitted to offer himself as a candidate for graduation,
and to receive the doctor's degree, without refererence
to the period which he had devoted to the study of
medicine, provided that he had passed his examinations
satisfactorily. Fifthly, there were open to him the anatomical
and pathological museum, the infirmary,—which
was expected very soon to create opportunities for clinical
instruction—and the library. Sixthly, he had to
pay only a small fee in the class of practical anatomy;
and seventhly, the expense of living at the University
was moderate, its site, healthy, and its climate, salubrious,
whilst its remoteness from cities, and even large towns,
removed all temptation from the student to grow indolent,
or to fall into a bog of dissipation and self-indulgence.