University of Virginia Library

XII. Professional Schools—Medicine

The lectures delivered in the School of Medicine were
not seriously interrupted while the War of Secession was
in progress. After the full resumption of activity in that
school, at the beginning of the session of 1865–6, there
was no change in the original courses of study; and with
the exception of Dr. J. E. Chancellor,—who succeeded

Dr. Allen as demonstrator of anatomy, and who, in
1872–3, was succeeded by William B. Towles,—the medical
faculty comprised the same men who had devoted
their talents and knowledge to maintaining the reputation
of the several departments during so many years. Dr.
Howard, who, during the session of 1867–8, was succeeded
by James F. Harrison,[4] was still the professor of
medical jurisprudence, obstetrics, and the practice of
medicine; James L. Cabell, the professor of comparative
anatomy, physiology, and surgery; John Staige Davis,
the professor of anatomy and materia medica; and Socrates
Maupin, professor of chemistry and pharmacy.

In soliciting the patronage of the public under the altered
conditions that now prevailed, the medical faculty
again harked back to those advantages of length of session,
daily examinations, order of studies, and the like,
upon which they had relied for success from the foundation
of the school. And they had now,—what they did
not have, at least during the First Period (1825–1842),
—one very pertinent fact to emphasize, in confirmation
of the soundness of their claim to efficiency; namely, the
professional distinction of a large proportion of the
medical alumni of the University.

The medical professors, however, were still pursued by
a nightmare that had never ceased to disturb them, and
one too which had been very influential in causing them
to lay such strong and such constant stress on the superiority
of their school. The not impartial suggestion
had been again made that this school should be removed
to Richmond, in order to enjoy the clinical facilities
which were admitted to be unobtainable at Charlottesville;

and so persistent became this demand that the perturbed
medical faculty, in April, 1867, addressed a petition
to the General Assembly, in which they earnestly
protested against the possible approval of this proposal
by that body. Their reasons for objecting to the transplantation
in that year were the same as those which they
had previously brought forward so emphatically. "Only
when well versed in the principles of medicine," they
declared, "was the student prepared to profit by clinical
instruction, and not before. The value of clinical instruction
is freely conceded, but it is an unprofitable use
of time for the first-course student to give his attention
to it. It has always been the policy of the University of
Virginia to make its honors testimonials of merit, and
not certificates of attendance in a prescribed course of
instruction. Hence the degree of doctor of medicine is
often won by a first-course student. Many do graduate
in nine months. Often an academic student joins a part
of the medical, with his academic, studies, during one
session, and during the next takes the medical course and
graduates. But a majority of the medical students do
not graduate here. They spend one session reaping the
well-known advantages of the department, and then go
off to city schools to secure their degree and profit by the
clinical facilities."

This excellence as a didactic school,—which continued
during so many years of the Seventh Period, 1865–
1895,—was chiefly sustained by the institution's ability
to distribute the subjects of instruction among a smaller
number of professors than was possible in a school each
session of which did not run beyond five months. It was
quite justly claimed that this distribution rendered it practicable
for the student to take up the different sections
of the general course in their natural and logical sequence.

There was such a discriminating arrangement
of the lectures that it was in his power to acquire a competent
knowledge of human and comparative anatomy,
physiology, and chemistry, before he turned to the study
of the principles and practice of medicine and surgery,
which, after all, were only clearly intelligible when a definite
amount of information had been accumulated about
these earlier parts of the course. The amplest time was
allowed him to prepare thoroughly for each lecture as it
approached, by the study of his text-books and professorial
notes, and by collateral reading.

In addition to the regular courses of the school, the
student enjoyed the advantage of a very valuable series
of lectures on the practical application of chemistry to
medicine,—especially as related to the detection of poisons,
and the microscopical examination of animal products.
And in further enlargement, the Faculty obtained
the Board's consent to the establishment of a laboratory
course in pharmacy, with a view to affording the future
practitioners a better comprehension of their remedial
agents, and some knowledge of the compounding of their
prescriptions.[5]

About 1875, there was observed beyond the precincts
of the University of Virginia the earliest indications of
a tendency that was to lead to a revolution in the science
and practice of medicine. This was the rapid development
of physics, chemistry, and biology. It was
impossible for the medical faculty to remain entirely insensible
to this new and powerful influence, however
firmly intrenched they might be in the traditions of a
didactic school. In April, 1880, Professor Cabell submitted

a report,—afterwards adopted by the Board,—
in which he recommended that this innovating activity
should be recognized by the University of Virginia only
so far as it did not require "a sweeping departure from
the fundamental principles of its medical administration."
There were certain alterations which, in his opinion, could
be made without running amuck with these principles:
(1) the course prescribed for the degree of doctor of
medicine should be extended over two sessions; and (2)
in order to ensure a proper division of studies between the
two, there should be a junior and a senior class. The
subjects to be taught in the first should be the course in
anatomy belonging to the School of Anatomy and Materia
Medica; the course in physiology belonging to the
School of Physiology and Surgery; the course in medical
jurisprudence belonging to the School of Practice of
Medicine and Obstetrics, and the course in chemistry belonging
to the School of Chemistry and Pharmacy.
These were the elementary branches of medical science.
The student who had been successful in passing his examinations
in these junior courses, was not to be required
to submit to a second test of his knowledge of them after
he had become a member of the senior class. Nor were
the young men who had been prepared by previous study
elsewhere to be denied, at the end of their first session,
the privilege of standing all the examinations of the two
years, if they should ask for it. This right to win the
degree after an attendance of nine months only was not
refused until 1891–2, although there was always a disposition
to discourage any one who claimed it.

At a meeting of the medical faculty, held in September,
1886, a plan was adopted for the early establishment of a
dispensary, which was expected to supply some of the clinical
facilities that had been so long wanting. It was to

be placed on the ground-floor of the anatomical hall, and
was to be open to the reception of patients at least twice
in the course of each week. During the first half of the
session, only three students of the senior class were to
be admitted at one time to the consultation on these occasions;
but during the second half, every member of the
junior class was to be privileged to be present in turn.
The dispensary was started (1886–87); but its work was
soon temporarily interrupted by fire, which consumed the
equipment of the hall.

Only a month after the medical faculty had recommended
this addition to the medical school, they suggested
that a similar establishment should be set up in
Charlottesville for the benefit of the people of that community
as well as for the instruction of the students of
the University. This apparently was completed some
time prior to June, 1888. Already a small charity hospital,
under the superintendence of the Ladies' Relief
Society, had been opened in that town, which provided another
opportunity for practical tuition for the members of
the medical classes. It seems that Dr. William C. Dabney,
—who had been elected to the chair of practice of
medicine, obstetrics, and medical jurisprudence, in August,
1886,—had signalized the assumption of its duties by
the adoption of the policy, for the improvement of his
pupils, of calling with them professionally on out-patients.
This practical application was only suitable to the needs of
those students who had finished the courses of the junior
year. Insignificant in scope as this new departure was, it
was the beginning of a new period in the medical history
of the University.

After Cabell withdrew, the sentiment in the medical
faculty favorable to the reorganization of the school on a
more practical footing became more pronounced. The

Board, now forced to take this sentiment into renewed
consideration, declared that, while they would be willing
to enlarge the clinical facilities of the department, it
would only be with the understanding that the theoretical
training, which had so long been given, should continue
predominant. In the meanwhile, a new dissecting
hall had been erected and equipped with every modern
appliance and convenience. This branch of instruction
had always been conducted with conspicuous ability at the
University; and its excellent results had never ceased to be
a tacit reminder that the application of its principle to
every one of the other courses would be accompanied
by the same practical benefits. Paul B. Barringer, who
had enjoyed a thorough education in his profession, both
in this country and in Europe, and who was also a man
of vigorous personality, became adjunct professor of
physiology and surgery during the session of 1889–90.

We have already referred to the revolution in the science
and practice of medicine which was perceptible beyond
the precincts of the University about 1875. It was
not until the admission to the medical faculty of younger
men like Dabney and Barringer, who had felt the full
force of this revolution elsewhere, that the medical school
began to exhibit all the symptoms of genuine sympathy
with the new methods of study. Dr. William G. Christian,
an assistant to both Barringer and Dabney, and
sharing their views, said, in a letter to B. Johnson Barbour,
that, up to the advent of this new influence, there
was no attempt at the University of Virginia, in either
the School of Pathology or of Physiology, to demonstrate
practically the facts stated by the lecturers. Without
such illustration, the high reputation of the institution
would, in his opinion, suffer because it would not, in its
medical school, at least, be in touch with the spirit of the

age. He brought up its limited facilities for teaching
microscopy as an example of the shortcomings that were
still holding it back in the race with those rivals who
had adopted with eagerness all the modern requirements.
"The mere statement," be said, "of healthy or diseased
conditions conveys not only an inadequate, but an incorrect
idea,—so imperfect, indeed, that not one case in a
thousand will a student recognize with the microscope,
while he can repeat the description faultlessly. There
can be no scientific practice of medicine without a thorough
knowledge of pathology, and to acquire this, an
equal familiarity with histology. This was impossible
without the microscope."

Although the movement of the medical school towards
a full recognition of the new conditions was slow in its
progress, as we have seen, nevertheless it never ceased.
An important step was the adoption by the Board in
1891–2 of the rule recommended by Dr. Cabell, in 1880,
that no student should be awarded the degree of doctor
of medicine unless he had attended the lectures of the
medical professors at least two years, and passed successful
examinations in every branch of the course. The
only exception allowed was in the case of a member of the
class who had traversed at another college one course
extending over nine months, or completed two courses
before the termination of that length of time. Such a
student was permitted to become a candidate for graduation
in one session; and he was only required to pursue
the course of the senior year. But before he could obtain
his degree, he must have passed a satisfactory examination
at the University on all the subjects included
in the schedule of studies for both years.

During the session of 1891–2, the subjects of instruction
for the first year were anatomy, chemistry, normal

histology, bacteriology, physiology, and medical jurisprudence;
and for the second, materia medica, surgery,
hygiene, gynecology, practice of medicine, practical
pathology and obstetrics. The number of students in at
tendance rose, during this session, to one hundred and
forty-five,—the largest membership that had so far been
enrolled in the medical school. This increase was supposed
to be due partly to the influences which had led to
the expansion in the general list of the University matriculates,
and partly to the growing reputation of the
practical features of the medical courses. This advance
in distinction was especially conspicuous in the cases of
histology, pathology, and biology.

Clinics were held thrice a week in the Charlottesville
hospital for the second-course students; and valuable
facilities of the same character were afforded by the
charity practice in the town and contiguous districts. An
appropriation had been recently made by the Board for
the erection of a new dispensary, and work was begun on
the building during this session. This section of the
medical school was expected to offer clinical material of
importance for the benefit of the higher classes. By
this time, the old principle that descriptive teaching alone
was to be employed in the University's medical courses,
outside of the dissecting room, had been discarded by its
medical faculty as a whole. It was now ungrudgingly admitted
by this body that objective teaching must go hand
in hand with it, if the school was to subserve the best interests
of the student to the utmost. The pecuniary expense
imposed by the new method was heavier than that
imposed by the old, for there was now a demand for
an ampler supply of apparatus and material, and also for
a larger degree of laboratory assistance, and for a
greater number of thoroughly trained instructors.

By the opening of the session of 1892–3, every chair
of the medical school was occupied by an incumbent whose
appointment had been made subsequent to 1875. To
Towles was assigned the courses in anatomy and materia
medica[6] ; to Dabney, those in obstetrics and practice
of medicine; to Barringer, those in physiology and
surgery; and to Tuttle, those in biology; while Christian
was charged with the duties of demonstrator of anatomy.
Towles died before the end of the session, and
Christian was advanced to his vacant professorship in
part. Surgery was now brought under his instruction,
and in its place, materia medica was transferred to Barringer.

These men, with Barringer at their head, were so convinced
of the need of greater clinical facilities to complete
the round of a medical education at the University
of Virginia that it might have been predicted that some
practical step would, under their influence, be taken at the
earliest opportunity presenting itself to establish a large
hospital. In 1893, the Faculty earnestly recommended
that a building of this nature should be erected on the
University grounds; but the Board, while acknowledging
the advantages which it would bestow, were compelled to
say in reply that they had no funds in hand with which

to carry so imposing a project into effect. Hardly a
month later, however, the rector was instructed to petition
the Legislature for an appropriation for the construction
of the desired edifice; and he was authorized
to offer the sum of twenty-five thousand dollars out of
the Fayerweather bequest as an addition to whatever
amount might be granted by the Commonwealth. Should
the hospital be established, it was to be known as the
State Hospital. Once erected, it was hoped that the
General Assembly would be willing to contribute ten
thousand dollars annually for its support, on condition
that not less than forty patients should be receiving
gratuitous treatment at one time.

In June, 1895, a committee was appointed to draft
plans and specifications for the proposed building. It
was decided on that occasion to be best to remove the
dispensary to one wing of this projected structure, so
soon as finished, but the committee was left at liberty to
figure upon the retention of the existing edifice, as a part
of the main establishment.

In March, 1894, the Faculty recommended, and the
Board adopted, the readjustment of certain professorships
of the medical department on the following footing:
(1) the chair of anatomy and materia medica was
to be designated the chair of anatomy and surgery;
(2) an adjunct chair of pathology and hygiene was to
be created, the holder of which was to teach the didactic
and laboratory courses of those subjects. These courses
were now attached to the chairs of surgery and practice
of medicine. The new incumbent was to have charge of
the laboratory instruction in histology and bacteriology.
Christian was appointed to the professorship of anatomy
and operative surgery, and John Staige Davis, Jr., the
son of the famous instructor of the same name, to the

adjunct professorship of general and surgical pathology.
Hygiene was subsequently added to his chair. After
Dabney's death, the chair of obstetrics, gynecology, and
practice of medicine was occupied by A. H. Buckmaster.
The last important step taken, during this period,
was the nomination of joint committees of the Board and
Faculty to consider the advisability of adopting a system
of preliminary examinations for the medical department;
but in May, 1895, this was decided to be inexpedient at
that time.