Check out the 1910 Abraham Flexner Report from the Carnegie Foundation here.
1851 marked a formative year for Kentucky medicine when the Kentucky Medical Association was established. Within this period, rapid changes and developments occurred which advanced the field of medicine to a level never seen, or thought of, before. Rudolf Virchow, a specialist in cellular biology, taught the world that the body was, “a cell-state in which every cell is a citizen.” The field of bacteriology made advancements during this time thanks, in part, to the father of microbiology, Antonie van Leeuwenhoek, who described bacteria in a 1676 study and utilized their incubation. Some two centuries later, the work of Leeuwenhoek inspired the likes of Louis Pasteur and Richard Koch who were able to link germs and disease. Edwin Klebs “saw the typhoid bacillus before German pathologist Karl J. Eberth did; the diphtheria bacillus before Friedrick Loeffler; and made solid cultures of bacteria and investigated the pathology of traumatic infections before Robert Koch.
In 1865, Joseph Lister began his “epochal” work on asepsis and (eventually) changed the way modern surgery was performed in order to prevent bacteria and infections in post-operative patients. Still, yet, by the 1950s, every cavity of the human body had, at one point, been safely operated on, including the heart. It was Wilhelm Conrad Röntgen who brought about x-rays to the medical community. Initial, x-rays were utilized to identify and/or locate foreign bodies and fractures of bones but have evolved to a level that nearly every medical specialty can benefit from. Radium showed shortly after x-rays. Hypodermic needles were available in the 1840s but did not gain widespread use until well after the 1850s. Clinical thermometry, in 1851, began its use but it took decades before physicians utilized the practice as an essential part of clinical medicine. Samuel Siegfried Karl Ritter von Basch, in 1887, developed a blood pressure instrument but was not adopted until near the middle of the 20th century.
Radium, salvarsan, and sulfonamides are just a few advancements in chemistry within this period of a hundred years. The introduction of antibiotics meant that the physician could “combat” disease far better than a century preceding this period. By 1951, more than 80 percent of cases of streptococcus viridans could be treated successfully. Karl Vierdort was able to enumerate red blood cells in 1852. During Leeuwenhoek’s lifetime, he could look through “simple lenses” and see things that no man had ever seen before. By the middle of the 20th century, man could see even more with electron microscopes.
Arguably, one of the most crucial advances in medicine was the change in how physicians were educated. In 1851, “physicians” in Kentucky, along with every other state in the union at the time, could begin treating patients without ever having to attend medical school. A degree could eventually be obtained by attending two sessions at a medical school with each session lasting roughly five months each. By 1851, there were three medical schools in Kentucky; one in Lexington, Transylvania University Medical Department, and two in Louisville, the University of Louisville Medical Department and the Kentucky School of Medicine. Transylvania University Medical Department closed its doors in 1859 with the Kentucky School of Medicine intended to take its place. The remaining two schools in Louisville continued their sessions until the Civil War when there were disruptions. Open hostilities between medical faculties were not uncommon in Kentucky medical schools. Harvard president Charles William Eliot was quoted as saying (of the school’s Medical Department) “had no examination for admission and no standard of preliminary education. Anybody could walk into it from the street and many did walk in who could barely read and write.”
It was not until 1893 when Johns Hopkins University established the first “modern” school of medicine in the United States and mandated rigid entrance requirements with an emphasis on research. A rapid increase in medical school in Kentucky, such as the Southwestern Homeopathic Medical College and Hospital and the Kentucky University Medical Department, among many others, meant that evils would quickly arise. In 1910 Abraham Flexner, by way of the Carnegie Foundation for the Advancements of Teaching, released a scathing report on the status of medical school in Kentucky and throughout the country. The American Medical Association responded and instituted measures to change the deficiencies. During this time there were five medical schools in Louisville; these merged into the Medical Department of the University of Louisville shortly before the report was released. Kentucky physician Emmet F. Horine opined that a century ago (prior to 1951) calls for physicians were answered on foot, horseback, in open carts, and, sometimes, in carriages. He also noted that it was not uncommon for elderly physicians to tell stories of calls being made on horseback in winter and, to keep warm, they would dismount and walk the remainder of the way.
100 Years of Leadership in Kentucky Medicine
Past Presidents of the Kentucky Medical Association
Contributed by Shawn Logan | firstname.lastname@example.org
⁘ Works Cited ⁘
- Horine, Emmet F. The Centennium: 1851-1951. The Journal of the Kentucky State Medical Association. September 1951 Edition, pp. 379-88.
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