Lexington Medical Society

This preface is excerpted from Medicine in the Athens of the West by W. Porter Mayo, M.D., Ph.D.

The year 1999 marks the bicentennial year of the Lexington Medical Society and its successor, the Fayette County Medical Society. The formation of the Lexington Medical Society, its eminent early members and its close affiliation with the Transylvania Medical School culminated in the first and most influential center of medical practice and learning existing in America West of the Alleghenies during the first third of the nineteenth century. Two centuries ago, anyone who wished to practice medicine did so. There was no need for a degree or even a certificate. Even so, there were among the medical practitioners in Lexington during the 1790s qualified physicians with the desire to show to the public those traits and credentials that differentiated the regular physician (allopaths) from medical pretenders (irregulars). The regular physicians’ need for respect and recognition led to the founding of a medical society with membership limited to those deemed qualified. Membership then was essentially a statement of the applicant’s educational credentials. Education, not nobility nor place, set the society members apart from pretenders. So too, did the need for elevating medical education serve as one if not the primary stimulus in the formation of the American Medical Association a half century later (1846-47). The local and county medical societies are the indispensable elements of the more renowned American Medical Association, yet their history has not been as adequately told. That such societies were in existence in the American Colonies some one-hundred years before the founding of the American Medical Association demonstrates the need for further investigation and appreciation of their role and place in the birth of American Medicine.

Since this project began about six years ago, the scope of the subject has grown far beyond the documentation of men and events of a local medical society, even one some two hundred years of age. Chapter One covers the founding of a medical society in the wilderness and how the social and economic conditions of Lexington played a significant role in erecting the first and foremost medical center West of the Alleghenies. The founding of the Lexington Medical Society in 1799 preceded the establishment of the Medical Department of Transylvania University, also in 1799. The two institutions grew side-by-side for almost thirty-five years. The founder of the Lexington Medical Society, Dr. Samuel Brown (brother of John Brown, Kentucky’s first United States Senator), was the first professor of medicine appointed by Transylvania University and a member of the American Philosophical Society. Dr. Brown made many scientific contributions. One of his major endeavors was the founding of the first national medical society in America, Kappa Lambda of Hippocrates, and an associated national medical journal The North American Medical and Surgical Journal. Chapter Two is devoted to the relationship between the Kappa Lambda Society and the subsequent founding of the American Medical Association. As expressed in the chapter, the American Medical Association is the flowering of Kappa Lambda.

The accomplishments of a later president of our society (1824), Dr. Daniel Drake, the foremost American medical educator of the nineteenth century, is likewise detailed in Chapters Three and Four, relating respectively to diseases of antebellum Lexington, essentially those of the Mississippi Valley, and to the theme of medical education in the West, initiated in Lexington but later transferred to Louisville and Cincinnati. Chapters Five and Six relate the re-emergence of the Lexington Medical Society in 1869 and 1882, following its earlier demise, a characteristic feature of early American medical societies.

Chapter Five also furnishes the reader with pictorial clips of medicine and other local affairs in Civil War Lexington as seen through the eyes of a young woman, Frances Dallam Peter, an avowed Yankee and daughter of the last dean of the Transylvania University Medical School, Dr. Robert Peter. In addition, the struggle of women and African-Americans to join the ranks of practitioners and medical societies is documented. Chapter Six depicts the twentieth century shift of emphasis from that of the general practitioner to specialist, the influence of the car, telephone and modern hospital on medical delivery and cost. Records of the month-to-month deliberations of the Medical Society prove an invaluable witness to the province of medicine, both the good and the bad.

When the author began the collection of data to initiate a review of the Medical Society many questions came to mind. First, does a history of the Medical Society exist? Who founded the Society? When? Why? Do we know the names and the number of its members? Where and how often did the Society meet? How were the members selected? Did the Society have a Constitution? Minutes? What historical information exists in the archives of the Fayette County Medical Society? The State Medical Society? What other sources are available to the historian? The few records available in the archives of the Fayette County Medical Society reflect principally those of the twentieth century. Regrettably, documents were lost long ago, including notes concerning the Lexington College of Medicine and Surgery (1836), the entire minutes of the Society from 1882 until December 1903, and the minutes from 1913-16. How then in the absence of so many primary sources was one to write a history of the Society, especially of its founding and its role in the history of the nineteenth century?

The author has sought to use primary sources and to this end many documents and conclusions not previously published have been discovered and entered into the book:

Of the many institutions visited in the preparation of this book, the Transylvania University Medical Archives proved to be invaluable. I am indebted to the able Special Collections Librarian and Transylvania University Archivist, B. J. Gooch. The Kentucky Room of the Lexington Downtown Library provided many sources, including the repertoire of newspapers referenced, namely the Kentucky Gazette, Lexington Observer Reporter and Observer, and The Lexington Reporter and the Lexington Herald-Leader, as well as city directories, telephone directories, and many books on Lexington’s and Kentucky’s history, including the History of Kentucky (two volumes) by Collins. The author also made use of the collections of the Special Collections of the University of Kentucky, the Filson Club, Louisville, the Kornhauser Library of the University of Louisville, the Kentucky Historical Society, Frankfort, and The Medical Archives of the University of Cincinnati, as well as correspondence with the College of Physicians, Philadelphia. The helpful hand of Billie Broaddus, Director of the Drake Collection, Cincinnati, deserves special recognition.

I would like to express my gratitude to a number of people who gave counsel and encouragement in the preparation of this book. In 1991 a special committee of the Fayette County Medical Society co-chaired by Dr. Thomson R. Bryant, Jr. and the author, Dr. Porter Mayo, was appointed to lay plans for a commemoration of the Society. At that time I was commissioned by the FCMS Executive Committee to write a history of the Society. The author began the process of research in 1993 and writing of the text in 1996. Once the founding year of the Society (1799) was confirmed, the Society’s Executive Committee prepared for the 200^th anniversary for 1999.

To the contributing editors, Walker P. Mayo, III, Camille Mayo Jernigan, and Florence M. Witte, the author is indebted for their valuable suggestions and encouragement. Professors Lance Banning and Eric Christianson of the University of Kentucky each read a substantial part of the manuscript offering indispensable advice and criticism. I am particularly grateful to Drs. W. Lisle Dalton and John D. Stewart, II, past presidents, and to the current president of the Medical Society, Dr. J. Michael Moore, for their support in the preparation and publication of the book and the use of the Society’s office, equipment and the many administrative courtesies by the staff. Others who gave specific aid or support included Drs. N. Lewis Bosworth, Ellsworth C. Seeley, and Walter L. Boswell; Claire R. McCann, Manuscript Librarian, Special Collections, University of Kentucky, and Jim Kurz. A special assistant, Shirley Boyd, gave vital support and long hours in the tedious and demanding editing of footnotes. Others, namely FCMS staff members Kathy Bethel, Cindy Madison and Sona Jewell, likewise aided the author in the daily essentials of typing and restoration of order in the references.

During the past nine months the manuscript has been through seemingly endless revisions. In this final effort to ready the book for the publisher three people have been so vital, so committed to the project that a special recognition is in order. First, Vicki Hoven of the FCMS staff played a major role not only in the arduous task of proofreading but served admirably in the construction of figures, labels, and publication releases. Even more, she made numerous contacts by phone, fax and e-mail to the many librarians and publisher. Carolyn Kurz, Executive Vice President and Chief Executive Officer of the Society, played many roles in bringing the book to publication. She has been instrumental in the difficult task of maintaining consistency and accuracy in the preparation of the text, saved and sheltered the multiple drafts, and correlated the many steps to take in the completion of the work. But to those of us who know Carolyn best, it is her ever present enthusiasm, loads of encouragement and can do that shine through. Walker Mayo spent countless evenings and weekends, reading, editing, researching, and aiding the author to produce a book worthy of the individuals and the institutions herein enumerated. Whatever measure of success the book may attain, its value to the historical edifice so revered by the author, is in large measure because the author knew when to listen to his son.

I would also like to thank my family, especially my wife Pat, for their patience, encouragement and support.

The Medical Society has honored many a man and one woman on their election as president of the society. However, there is one instance when the process was reversed, when the society itself was not the donor but the recipient of such an honor; the occasion was the acceptance of the presidency in 1824 by Dr. Daniel Drake, foremost medical educator in America in the nineteenth century. His presidential address follows:

The animal body is an assemblage of organs, every one of which performs a function subservient to the general economy. But in relation to the whole they are not equal: some being of greater others of less importance. By a reference to this body, the structure composition, functions and diseases of which it is the object and will for several months be our object of most of you to study, I propose to illustrate the relation for the society of which I have had the honor of being elected the presiding officer to the university of which the greater part of you have become alumni and the remainder are trustees or friend professions. This society together with the private clubs of the pupils, the Kentucky Institute and all the facilities and contrivances which have been created or exist at present within the precincts of the town may be regarded as so many organs in the system of means, which have for their end or aggregate effect, the augmentation of literary scientifical and medical knowledge. The university is the principal; our society one of the subordinate or auxiliary organs, operating in concert, but in subserviency to the dominant or ruling department.

It is not, however, a lesser degree of the same, but differs from the medical college as specifically: as the sallivary glands differ from the liver, both of which, however remote in situation, different in size, and variant in function have the same object in view, the assimilation of foreign matter to our systems. It is not my design to express an opinion that this organ in the system of instruction is inferior in the dignity; but in the magnitude of its effects. When we contemplate it in reference to these we perceive at once, that it cannot afford the same advantages as the college but that the quality of what it affords and the nobleness of its operations as far as they go, may be regarded as equal to the institution to which it is auxiliary.

To render the society prolific in useful results, it must be conducted by the rules of sound common sense, and well regulated decorum. It must direct its attention to useful objects & conduct its operations with order and judgment. In the first place, it should adopt measures calculated to elicit from its members a regular succession of well written papers, on the various subjects which fall within the purview of the society; and these papers should if possible possess at least one of the three following excellencies.

Gentlemen, these benefits will be two fold 1^st to ourselves & 2dly to the profession at large. To ourselves may come, if we choose the improvement in thinking & speaking that always results from debate, from the juxtaposition of inquisitive minds and the collisions that are the natural result of such a situation. The influence of occasions on the mind is so great, as to have given rise to the apothegm, that man is the creature of circumstances, which understood with proper limitations is undoubtedly true. Of the scenes in which it is possible for us, as students of medicine to place ourselves, I know of none, can indeed conceive of none, more eminently calculated to animate our intellectual faculties and desicate our stagnant pools of thought than debate; and I cannot believe it possible, that we shall even discuss the simplest questions in the science, without quicking our associations so as to send them into some new or untried region; nor examine the most difficult, without making some approximation toward the truths which it enveloped.

The second species of benefit which our society can be made to confer is on the profession at large and thro it upon mankind in general. This consists in promoting inquiries, and collecting and disseminating information, upon medical & scientific subjects. Such a society as ours may be made among the profession throughout our country what the voluntary or active powers of man are to his intellectual. Observation teaches us, that man requires to be stimulated; before he will act. When insulated & left to himself, his powers of mind too often remain passive his body quiescent. In this manner, hundreds of the profession vegetate to threescore then when sinking into the grave, the black waves of oblivion close over them & the world is as if they had not been. It is for association like ours, to disseminate the appropriate stimuli and rouse the slumbering lyons of literature & science to active effort. And this we may do in two different modes, 1. By resolving to engage ourselves in experimental researches; and at our various places of residence to prosecute such inquiries and make such original observations in the session or during the recess of the society or after our departure from it as may prove an example to other members of the profession, & serve to excite them to action. Secondly, we may accomplish much for the interests of the profession and of the manity by directing the attention of our professional confreres throughout the Western Country, to the countless number of interesting and important objects of investigation in which it abounds.

Among these I may refer to a variety of curious & beautiful atmospheric phenomena which daily pass before & seem to invite us to scrutinize them. The useful minerals of the Western Country, especially those employed in the processes of pharmacy. The investigation of our medicinal plants, many of which are doubtless entitled to great attention while very few of them have been thoroughly studied. The books which have been lately published on this subject indeed leave many desiderata. They are complete and worthy of great praise, in the botanical descriptions of the vegetables of which they treat but in the pharmacuetic and clinical histories of those substances they are so deficient, that I do not hesitate to say that such substantial advantage to medicine might be made to accrue by our society, would it undertake to exhort and advise the medical gentlemen of the West on this subject. It is necessary to direct their attention to specific objects if we would fix it.

The most important subjects, however, to which this society could point, those in which the community which we labor have the most deep & lively interests, are our diseases, particularly those of an endemic & epidemic character. Not a summer passes that does not give us an epidemic cholera which in certain places carries off many persons both adult & infantile; not an autumn which does not bring forth widespreading & fatal fevers which too often rage with such mortality as to spread over our social atmosphere as dark a gloom as that which in the same seasons shrouds our natural horizon. To ascertain all the physical & moral circumstances under which these maladies appear is the first step towards a discovery of their causes and a prevention of the effects of those causes. As, however, when discovered it may happen that that they are not of a kind that can be removed by human power, or avoided by human prudence it is of much importance that the diseases produced by them should be diligently & thoroughly studied: that the modifications which they exhibit in successive years, & in different situations should be compared with each other as well as the various means of cure which have been found most successful. For this to be done the profession throughout the country in which it is proposed to make observations should have a point of concentration-a sensorium commune where all intelligence should be received, compared, digested & again radiated to the profession and society at large to increase the powers of one & the blessings of the other, like the beams of heat & light which emanate from the sun to warm the earth make it prolific. To such objects might we direct our attention and it could scarcely be directed in vain.

Gentlemen, I hope to see our society active, & persevering, choosing good & great objects & prosecuting them with appropriate means, which is what constitutes wisdom; persevering in its ends and methodical functional & dignified in its proceedings. To assist in devoting it to such purposes & in conducting it in this manner are objects upon which I will cheerfully bestow every remnant of time and abilities that may be left after discharging my permanent duties to the University. I will conclude, Gentlemen, by offering you my unfeigned thanks for the honor you have bestowed upon me, in raising me to this responsible station. If I shall not be able to tread in the elevated footsteps of my learned & philosophical predecessor, I shall claim at least to equal him in my prayers for the prosperity & fame of the institution. [Daniel Drake]