In the America of the mid-1800s, dispensaries—originally established in Philadelphia, New York, and Boston—existed to treat the poor. The dispensaries filled an increasing need, especially in cities where the population was growing due to an influx of immigrants—they offered free medical treatment and medicines to anyone unable to afford other means of treatment, including those who couldn’t afford hospital treatment or were unable to show that they were deserving of hospital charity.
In New Haven, Stephen Henry Bronson, M.D., was the key mover behind the New Haven Dispensary, which opened on December 1, 1871, at 31 Crown Street in New Haven. Its purpose, as recorded in the General Assembly Bill that incorporated it in May 1872, was “supplying medicines and medical advice and assistance to such as may be sick and needy, in New Haven and its vicinity.”
The dispensary was open from 9:00 until 10:30 each morning (except Sundays and holidays) with three attending physicians, including Bronson, who provided their services gratis. Bronson often prescribed for as many as 30 to 35 patients a day, and when patients were unable to come to the dispensary, he visited them at their homes, also without charge.
The dispensary kept careful records of patient ages, birthplaces, occupations, diseases, and treatments; Bronson usually prepared these reports, which show the dispensary’s huge impact in New Haven. In its first 11 months, the dispensary treated 892 patients and provided 1,700 consultations; the numbers rose steadily each year thereafter. The dispensary also served a public health function: it provided free vaccinations to the residents of New Haven, paid for by the city.
The records also showed that most of the dispensary’s patients were from the working class. In 1874, the dispensary’s 1,592 patients included housekeepers (367), people in school-related occupations (206), laborers (161), servants (103), laundresses (40), machinists (33), and shop girls (25). That year the dispensary also treated one authoress, six blacksmiths, and two engineers, in addition to three “rag pickers” and six “tramps.” Diseases treated ranged from anemia (81 cases) to ailments of the nervous system (67 cases), malaria (49 cases), rheumatism (62 cases), and cancer (five cases).
At the end of the 19th century in New Haven, the dispensary also played a critical role in providing medical students with access to patients. The Medical Institution’s curriculum of 1874–1875 makes this apparent: both the middle and senior classes spent at least five hours a week at the dispensary, compared with one hour a week at New Haven Hospital; moreover, the specialty clinics that both classes attended (these were devoted to the eye, medicine, and surgery) were held at the dispensary as well.
As William Carmalt, M.D., professor of surgery at Yale from 1881 to 1907, recalled, in the late 19th century “the directors of the hospital and a portion of its medical staff were indifferent, even, at times, antagonistic, to the function of the hospital as a factor in medical education. … During this unsatisfactory period the main supply of clinical material for the students in medicine was the New Haven Dispensary.” Beyond its services to the community, the dispensary would continue to meet an important need for the medical school, as an affiliation agreement with New Haven Hospital was still decades away.
This article has been adapted from a book by Kerry Falvey celebrating the bicentennial of the Yale School of Medicine. The book can be ordered at yalebooks.com.