The first 200 years

Today, medical students attending Yale have access to close to 1,000 full-time faculty members, modern labs and classrooms and a library containing more than 400,000 volumes and journals. It wasn’t always that way. In the early days, according to a description from a medical apprentice at the time, the curriculum was made up of “books on the shelf, the skeleton in the closet, the pestle and the pill-slab in the back room, roaming the forests and fields for roots and herbs, and following astride … the horse which was honored with the saddlebags.”

How the medical school got started was the subject of Medicine at Yale, 1701-1901, the first in a series of exhibits at the Cushing/Whitney Medical Library in celebration of the University’s Tercentennial this year. Based in part on a forthcoming history of the school by its 14th dean, Gerard N. Burrow, M.D., the exhibit touches on early events in medicine at Yale, including the awarding of the first M.D. degree by an American university in 1723 (albeit an honorary one) and the contributions to medicine of such notable Yale College graduates as lexicographer Noah Webster—whose book A Brief History of Epidemic Disease was hailed by William Osler as “the most important medical work written in this country by a layman”—and Eli Smith, a founding editor of the nation’s first medical journal.

The history of the medical school itself begins with the opening of the Medical Institution of Yale College in 1813 on Grove Street, more than a hundred years after the founding of Yale College, and its robust early years that were due largely to the reputations of two of its four founding professors, Benjamin Silliman and Nathan Smith. “They were two absolutely outstanding individuals,” says historian Burrow, “and at the time, there was no other medical school in Connecticut or even close by.” The school flourished throughout the first half of the century.

Around the 1850s, however, it became harder to attract students. More schools had opened, increasing the competition. It was also a dark period for mainstream medicine, as the number of unorthodox practitioners multiplied. “There were a lot of charlatans” trying to pass for doctors, Burrow says. “Medicine didn’t seem to be going anywhere.” To distinguish itself from the competition—and distance itself from the quacks—the medical school raised its standards. But enrollment suffered, as did the school’s finances. Rather than retreat, the faculty members, all of whom were part-time, diverted their Yale salaries to the school and took IOUs. “That is what is remarkable about the medical school, that people who were not getting a great amount of money donated their time and effort,” says Historical Librarian Toby A. Appel, Ph.D., M.L.S., who curated the exhibit. “It was like a mission for them. They really wanted it to be good.”

The first 200 years of medicine at Yale, especially the 19th century, can be summed up as “a strong start and a weak finish,” says Burrow, adding that numerous efforts to raise standards almost cost the school its existence at the start of the 20th century. But the best years were yet to come.