Oregon Historical Quarterly/Volume 27/The Development of Medical Education in the Pacific Northwest

The Development of Medical Education in the Pacific Northwest * By O. LARSELL, University of Oregon Medical School

Medical education in the Pacific Northwest may be divided quite naturally into two periods. The first of these, beginning with 1865, represents the pioneer stage. In that year was founded the Medical Department of Willamette University, which in spite of many difficulties, had a continuous existence until 1913 , when it was amalgamated with the University of Oregon Medical School. The second period began about 1913, although many of the factors which make proper the division given had begun to take effect several years prior to this date , and others had not yet begun to be felt. It is with the first of these periods that we shall deal in this paper. Willamette University was founded in Salem in 1842 , under the auspices of the Methodist Episcopal denomination. It represents the pioneer effort in higher edu cation in the Northwest, and too much credit cannot be given Jason Lee and his co -workers for their vision and self -sacrifice in establishing a college in the new settle ment. To be sure, it was not a college in the present meaning of the term, but it had the definite aim of giving higher education to the white children of the Oregon country.

In 1865, twenty - three years after the founding of the institution, another step of significance to the welfare of the state was taken in the launching under the auspices of the university of the medical department. The initial steps in this venture were taken by Governor A. C. Gibbs and others in 1864. They sent a communication to the Board of Trustees of Willamette University asking that body to organize a medical department. They further Club February 21, 1924.
 * Read at the meeting of the University of Oregon Medical History

asked that the department be located in Portland, and that certain gentlemen be elected officers and professors of the same. On February 15, 1865 , the Board voted1 to establish such a department in Portland, to be called the “Oregon Medical College, ” with certain provisions , in cluding the appointment of the medical faculty by the Board of Trustees of the university. The faculty elected consisted of Judge M. P. Deady, emeritus professor of medical jurisprudence ; R. Glisan , M. D. , professor of theory and practice of medicine ; J. A. Chapman, M. D. , professor of civil and military surgery ; A. M. Loryea , M. D. , professor and demonstrator of anatomy ; R. B. Wil son, M. D. , professor of physiology and institutes of medi cine ; Hon. A. C. Gibbs, professor of medical jurispru dence. It is interesting to note that a professor emeritus was elected before the school had begun to function. A temporary office was established at number 5 Washing ton street, which by the present system of numbering is 205 Washington street. Difficulties arose which made it impracticable to carry out the plan of establishing the department in Portland, and for a time the project was abandoned. The faculty named above never gave instruction. The pro posal to establish a school of medicine was revived, how ever, in June , 1866 , and steps were taken to bring the de partment into operation. Dr. J. H. Wythe, who became president of the university in October, 1865 , appears to have played a prominent part in renewing the efforts to establish a medical department , which it was now pro posed to locate in Salem, since it had failed to function in Portland. Dr. Wythe3 was a physician, as well as a cler gyman, and had practiced medicine in Pennsylvania be fore coming to the Pacific Coast. He had also held a po sition of some responsibility in the medical corps of the 2 1Minutes, Bd. of Tr., W. U., Feb. 15, 1865. 2Pers. com. from Geo. H. Himes, Portland. 3Larsell, Quart. Oreg. Hist. Soc., vol. 26, 1925.

Northern army during the War of the Rebellion. An other leading figure in the renewed effort to initiate a medical department was Dr. Horace Carpenter, who had come to Oregon in 1861, and had settled in Salem in 1865. In the minutes of the Board of Trustees, dated June 12, 1866 , it is recorded that a committee of three was appointed to correspond with the proposed medical department in Portland with reference to moving that department to Salem. This committee reported on July 18 and was discharged, but the nature of the report , which was oral, is not indicated. At this July meeting another committee of five members was appointed to consider the expediency of establishing a law department and other departments, in addition to those already main tained in the institution. Dr. Wythe, who had been a member of the first committee , was also included in the new committee, which " was instructed to confer with the officers of the Medical Department at Portland and re quest them to surrender the organization heretofore granted them , and if they refused to do so , to give notice that after the expiration of one year the connection will be discontinued . " 4 As a result of the activities of this committee the fol lowing resolution was adopted at a meeting on November 14, 1866:5 " Resolved, That whereas the gentlemen heretofore elected by this board of professors of Medical Depart ment of Willamette University heretofore established in Portland have failed to organize or to perform the duties imposed upon them by their election and have also re signed their positions and discontinued their relations to the University ; “ Therefore , Resolved that said Medical Department be and the same is hereby established and located at Salem . That it shall consist of seven or more professor 4Min. Bd. of Tr., W. U. , July 18, 1866. 51bid ., Nov. 14, 1866.

ships so organized and conducted as to afford a full course of instruction by lectures and studies conforming to the latest and most approved practice of the best Medical In stitutions and of such grade and character as to thor oughly qualify its graduates for the responsible duties of a professional life. " At the same meeting the following faculty was elected, composed of physicians in and about Salem , namely , H. Carpenter , M. D. , professor of civil and military surgery ; E. R. Fiske , M. D . , professor of pathology and practice of medicine ; John Boswell , M. D . , professor of obstetrics and diseases of women and children ; J. H. Wythe , M. D. , professor of physiology , hygiene and microscopy ; D. Peyton, M. D. , professor of materia medica and thera peutics ; J. W. McAfee , M. D . , professor of chemistry and toxicology ; A. Sharples , M. D . , professor of descriptive and surgical anatomy ; W. C. Worimer , M. D. , demonstrator of anatomy ; Hon . J . S. Smith , professor of medical jurisprudence . This was the first faculty to actually give medical instruction in the Northwest . A committee of the board consisting of Messrs . Waller , Hines and Moores was appointed to confer with the members of the medical fac ulty with reference to a system of rules for the govern ment and regulation of the new department. The facilities for medical instruction in Salem at that time were of the most meager sort, and at the present time we should say they were non - existent. The entire equipment of the university, so - called , consisted of one building, in which college , preparatory and a l l other de partments were housed . A new building was under con struction , but was not completed until some time later . As t o clinical facilities , they may be judged by the fact that Salem had a population of about twelve hundred a t the time , and all o f Marion County about seven thousand . Portland itself numbered but about fifteen thousand peo ple i n 1865, and one must admire the courage , not t o say the audacity , o f the men who undertook t o train phy

69 sicians under such circumstances. Yet when one com pares with other medical schools in the country at that time, and the standards, or rather , lack of standards , which prevailed in all but a very few, the infant depart ment at Salem does not suffer too much by the com parison. The first course of lectures was begun March 3, 1867 , and at commencement of that year there were three graduates in medicine. These were W. A. Cusick, D. M. Jones and J. L. Martin. The second term was begun November 4, 1867 , for it was decided that instruction could more conveniently be given during the winter. The course continued twenty weeks, and attendance at two courses of lectures was required for graduation. This department thus established represents the first attempt at professional education in the Pacific North west. A short time previously there had been established in San Francisco the Toland Medical College, so that the department established by Willamette University was not the pioneer in medical education on the Pacific Coast , but it appears to be the oldest which continued in oper ation without interruption until its absorption in 1913. The new school appears to have met with approval, for in the Salem Daily Record for June 14, 1867, we read : " The Medical Department of the University went into operation early in the spring with twenty -four students, which is considered a very favorable commencement . To give opportunity for clinical instruction this their first season , the faculty have offered to perform any needed surgical operations free of compensation , when the par ties are unable to render it . Quite a number have availed themselves of the offer, and thus far the operations have a l l been successful . Some will compare i n skill with any performed o n this coast . Six lectures a day are delivered a t the university building . The lecturing season will end 61bid . , July 2 3 , 1867.

at the annual commencement of the college, the 25th of July. The prospect of prosperity to the Medical Depart ment in the future is good, as quite a number are prepar ing to improve the advantages offered. Those interested are gratified at the success already realized. The next term will commence April 1st, 1868, by which time the expectation is to have provided every appliance necessary to make the Medical School a first class institution .” As already stated, the next term began in November rather than in the following April. The spirit which animated the undertaking of profes sional education in an institution which was as yet able to provide but meagerly for the simplest type of college work must not be left in doubt. It is not unlikely that the initial attempt to establish a school of medicine in Port land was somewhat mixed with motives of self - interest on the part of some of the petitioners, for medical facul ties in that day frequently derived considerable revenue from consultations and patients sent them, as individual physicians, by former students after the latter got into practice. It may be that some such motive had a part in the minds of some who became members of the faculty when the department was put into operation at Salem , but this was not true of those who revived the idea. It is doubtful if it could have been true of many of the orig inal initiators such as Governor Gibbs and others, who had the interests of the community primarily at heart. At any rate the purpose of the Board of Trustees of Wil lamette University in founding the medical department appears to have been in keeping with the missionary motive which founded the institution in 1842. Although there was some hesitation on their part when the project was first broached in 1864 that the time was not yet ripe for such an undertaking, " the idea had gained such head 7Ibid ., Nov. 16, 1864.

71 way by February of the following year that it was adopted with the results related above. In the language of the Board, the department was established in the belief "that the interests of the country would be promoted . ” 8 The worthy ambition to make the young and finan cially poor institution a " first class school, ” according to the American standards of that day , was not as difficult of realization as at the present time. Laboratories were practically unknown, and elaborate clinics and dispen saries were known of only as a faint echo from the large medical centers of Europe. A few cadavers which could be dissected in any kind of a room, some chairs and pos sibly a blackboard for the lecture room, constituted the principal features of equipment at this early date, in a l l probability . There are some references t o a separate building for the dissecting room , but that appears t o b e a l l i n the way o f special equipment , although more was contemplated , and was added little b y little . The story o f the first ten years o f the school's history i s somewhat fragmentary . The loose connection o f the medical faculty with the university resulted i n many misunderstandings between this faculty and the Board o f Trustees . Because o f this a resolution was presented t o the Board a s early a s August 1 5, 1868 , when the de partment had been operating less than two years , t o dis continue the medical department . This proposal was , however , laid o n the table and apparently not taken u p again for consideration . The misunderstandings arose i n part from dissensions within the medical faculty itself , and i n part from the inclination o f the majority o f this faculty t o govern itself and the department without tak ing the Board o f Trustees into consideration . The majority o f the faculty were illy fitted by train ing for the duties o f medical instruction , and probably 81bid ., Feb. 1 5, 1865 . 9Ibid ., Aug. 1 5, 1868.

none of them except Dr. Wythe had ever before been a member of a medical faculty. Wythelo had for several years been professor of physiology, pathology and micro scopy at the Philadelphia Medical College, from which school he graduated in 1850. He had also written a book on the microscope and microscopy ( 1851 ) which was apparently the first of its kind to be published in this country. He had contributed considerably to the med ical periodicals in Philadelphia before coming to the Pacific Coast, and had considerable reputation both as a scientific man and as a surgeon. Because of his previous experience and his connection with the Medical Service of the Federal army during the Civil War, it is probable that he was the best surgeon in the newly organized fac ulty, but he became professor of physiology and hygiene, while Dr. H. Carpenter became professor of surgery. An illuminating view of the whole situation which developed from the disagreements within the faculty and between the faculty and the Board, may be gained from a portion of a memorial11 presented to the latter body by two members of the medical faculty, Dr. Wythe and Dr. Fiske, who were also members of the Board of Trustees. These two gentlemen describe themselves as " the only members of the Board who had received a regular med ical education . ” They had been asked by the Board to aid in organizing the medical department, and made the following statement : “ In pursuance of our trust we found the chief difficulty to arise from the circumstance that a sufficient number of physicians resident in Salem could not be found to fill the professorships without ap pointing some whose educational qualifications were evi dently defective. “ For the sake of founding the department , however , we consented to waive the objection and every regular 10Larsell , Quart , Oreg. Hist . Soc ., vol . 26. 1925. 11Min. Bd. of Tr., W. U. , March 28, 1868.

73 physician in the town who had a diploma or who declared that he was a graduate of some medical college, was ap pointed to a professorship. “ The want of educational facilities and experience was fully acknowledged by the entire faculty at the be ginning of the enterprise, and a spirit of fraternity and mutual assistance was manifest ; but in a few months the tendencies of human nature became evident, and at times a spirit of jealousy and bitterness could hardly be sup pressed. ” The professorship of surgery particularly caused dif ficulty for it “ became a bone of contention and it required a l l the patience and management o f your memorialists t o prevent an open rupture . “ A t one time a l l the members o f the faculty except your memorialists and the Hon . J. N . Mitchell agreed t o request the professor o f surgery t o resign o r meet charges o f gross incompetence and want o f knowledge o f his pro fession . ” A serious disagreement developed , and the faculty reorganized with Dr. McAfee a s dean , but Dr. Carpenter was soon reinstated . Wythe fell out o f favor with all and was “ regularly tried , found guilty o f charges preferred against him and expelled 1 2 from the medical faculty b y i t s own vote . He appealed t o the Board , which voted t o direct the dean o f the medical faculty t o furnish the secretary o f the Board with a copy o f the proceedings connected with Dr. Wythe . This request the new dean , Dr. McAfee , re fused o n the ground that the action o f the medical faculty " i n their own judgment " was final . The Board , how ” ever , disapproved the action and censured the medical faculty for i t s presumption . The nature o f the charges preferred i s not indicated , but i t appears t o have been a quarrel a s t o authority and method . Dr. Wythe appar 1 2 Com . from dean o f medical faculty i n min . o f B d. o f Tr ., W. U. , Aug. 1 5, 1868.

ently wished to have the medical department tied closely with the university for the sake of standards, while most of the medical faculty appear to have had the notion so prevalent at that time that a medical faculty was a law unto itself and existed largely for the aggrandizement of its members. It was following this incident that the resolution to discontinue the department, to which reference was made above, was presented to the Board of Trustees. Peace was finally restored, however , and the department con tinued to function and to grow. In 1870 it was proposed in the Board to donate ground by the university to the medical department for hospital purposes, but this plan was not consummated. In 1873 the sum of two hundred dollars was appropriated by the Board for the purpose of renting quarters for the department in the town. After Dr. Wythe left Salem to assume charge of the Taylor Street Methodist Church in Portland, severing his connection with the university, Dr. Carpenter appears to have become the storm center for disagreements. Change of dean was made a number of times, but Dr. Carpen ter's name always appears as dean in the intervals. Charges were preferred against him to the Board, but this body refused to consider them. Changes in the fac ulty and proposed reorganization of the department are referred to from time to time. Matters reached a climax in 1875 when Dr. Carpenter resigned as professor of sur gery and dean. The president of the university was au thorized by the Board of Trustees to call a meeting of the medical faculty, and the agent of the university was authorized to receive " the books, papers and other effects of the Medical Department . " 13 These, however , Dr. Car ' penter refused to deliver to the agent, and doubtless due to this fact much that would be of interest and value in this sketch is lost. 13Min.ofBd.ofTr., W.U., Dec. 2,1875.

75 The school continued operation in spite of the contro versies which arose, and the year following the resigna tion of Dr. Carpenter, i. e. , in 1876, twenty -three matricu lants were registered, and Dr. D. Peyton served as dean. Apparently the difficulties of giving medical instruction in Salem became greater or perhaps were more fully rea lized by the members of the faculty, for on June 10 , 1878 , resolutions were presented to the Board of Trustees unanimously recommending removal of the department to Portland as better suited for maintaining medical in struction.14 This recommendation was adopted by the Board, and a new faculty was named ,, although it in cluded some who had been connected with the department at Salem. Dr. O. P. S. Plummer was elected dean 15 and Dr. R. G. Rex was chosen as secretary of the faculty. Dr. R. Glisan was appointed to give a public address in troductory to the course of lectures on the evening of December 16th, 1878 , when the instruction in Portland formally began. The term was also lengthened to six months. The first faculty meeting was held in Portland on June 18, 1878 , at which the actions just recorded were taken, and in addition Dr. J. A. Richardson, who had been the last dean of the department at Salem, was in structed to forward a l l property belonging t o the school from Salem t o Portland . A committee was appointed t o issue a circular and announcement , and another com mittee was instructed t o " secure rooms for lectures . " The result o f the activities of this last committee was that the school was located i n some rooms above a livery stable o n the corner of Park and Jefferson streets . I t i s o f interest t o record the names o f the faculty who attended this first meeting i n Portland . They are Doctors J . A. Richardson , A. Sharples , W. H. Watkins , R. G . Rex , W. H. Saylor , o P. S . Plummer , R. Glisan and L . L. Rowland . 141bid ., June 1 0, 1878 . 1 5 Min . faculty W. U. Med. Dep't., June 18, 1878.

The factors which brought about the removal of the school to Portland appear to be several in number, in addition to those already mentioned. It will be recalled that the original desire of those interested in organizing the department in 1864 and 1865 was to locate it in the larger city. The population of Salem at that time was about twelve hundred, while Portland boasted 6068. By 1878 Salem had grown to about 2500, while the city di rectory of Portland for that year gives its population as 19,128. The original desire to have the greater clinical facilities of the larger cities must have played a large part. A second factor of importance arose from the organ ization of the Oregon State Medical Society on September 1, 1874 . At the second meeting of this society , held in Portland September 14 , 1875 , a committee on medical education was appointed, 16 composed of Doctors F. A. Bailey, of Hillsboro ; H. W. Ross , of Oregon City , and H. J. Boughton of Albany. This committee was instructed " to prepare an annual report on the general condition of medical education in the state of Oregon, as compared with the advancement of medical science in other states of the Union . They shall report on the several medical institutions in the state , their course of instruction , the practical requirements for graduation , the modes of ex amination for conferring degrees , and the number of pupils and graduates at each during the year , and such other matters as they may deem worthy of consideration in reference to medical education and the reputable standing of the profession . " 1 7 At the fifth annual meet ing in 1878, a special committee was appointed 18 to attend the examinations of the medical department of Willam ette University, and at this same meeting the presidential 16 Proc. Oreg. State Med. Soc. , 1875. 171bid. 18Ibid ., 1878.

77 address19 by Dr. L. L. Rowland had as its topic " Medical Education . " These incidents, and others of a similar nature, indicate the interest which was developing throughout medical circles in the state, an interest that was lacking twelve years earlier. The immediate factor which brought about the re moval of the school from Salem to Portland was the or ganization in 1877 of the “ Oregon Medical College ,” which was incorporated in February, 1878.20 It will be recalled that this was the name which the first attempt at establishing medical instruction in Portland had carried in 1865, but the new attempt was entirely independent of Willamette University. The account of its organiza tion, which appeared in the Morning Oregonian for Octo ber 2, 1877 , is so illuminating that it may be quoted in full as follows : “ During the past twelve years some two or three unsuccessful attempts have been made to found a medical college in Portland, and during these years with the growth of our city, our state , and the adjoining terri tories, the facilities for the imparting of medical and surgical instruction have constantly increased. " The greatest and most important needs of medical students who leave their homes or the offices of their preceptors to obtain them are clinical instructions and opportunities to pursue the study of practical anatomy, with every available convenience in the way of material and surroundings . " With two excellently conducted hospitals ( the St. Vincent's and Good Samaritan ) , containing on an average a hundred patients, with the Insane Asylum across the river and the cases which can be brought before a class of students from the practice of our leading physicians , making mention also of a good share of eleemosynary cases which are constantly with us, Portland certainly 191bid. 20Bancroft, Hist. of Oregon, volume II , page 6 9 1.

holds out inducements for the establishing and maintain ing of a college which no other city on the coast outside of San Francisco can. “ Fully appreciating these facts and that the medical college of the Northwest should be and would eventually be located here, and with no promptings of ill-will to wards the medical department of the Willamette University, now located at Salem, nor towards any one o f those self - sacrificing men who have s o faithfully labored hitherto i n its interest , a number o f our leading phy sicians met o n Saturday evening last and organized a medical college , t o b e known a s the Oregon Medical College , t o b e located i n this city , with the follow ing named gentlemen a s a faculty . The matter o f estab lishing a medical school i n our city has been under ad visement for some time , and last Saturday evening the thing came t o a head . Several o f our enterprising doctors met , ' i n pursuance t o call ' and b y unanimous vote decided that i t was high time the ball was put i n motion and that the Oregon Medical College b e now organized . " Next they proceeded t o the election o f a faculty with the following result

Dr. P. Harvey , professor o f the theory and practice o f medicine and general therapeutics Dr. R. Glisan , professor o f obstetrics and diseases o f women and children Dr. W. H. Watkins , professor o f surgery , surgical pathology and clinical surgery Dr. W. H. Saylor , professor o f general and surgical anatomy Dr. O. P . S. Plummer , professor o f materia medica and therapeutics Dr. R. G . Rex , professor o f organic and inorganic chemistry Dr. W. B. Cardwell , professor o f physiology and hygiene Hon . M. P . Deady , professor o f medical jurisprudence . " Special lecturers

Dr. Saylor , eye and ear Dr. Cardwell , genito - urinary Dr. H. E. Jones , clinical gyne cology . " The first regular course o f lectures may b e deferred until a year from this fall, a s the faculty are determined

79 to make this institution not only live but thrive and do well in their hands, proving a credit to our city , to the profession of their choice and to themselves as co - laborers for the advancement of the standard of medical sciences in our broad growing Northwest, and a proper prepara tion will involve not only much labor on their part but also considerable expense in procuring means for use in illustrating and demonstrating the various branches of study. " The faculty also constituted the stock -holders, and subscribed to fifty -nine shares of stock of a par value of $ 100 per share . At the first meeting of the faculty, as distinguished from the Board of Directors , which meeting was held April 15 , 1878 , resolutions were passed to the effect that Portland was better suited than any other point north of San Francisco for the location of a med ical school , and that "the interests of the medical pro fession in the Northwestern States and Territories ad jacent require the maintenance of one ' institution for medical education. ” The Willamette medical faculty was invited to appoint a committee of three to confer with a similar committee of the faculty of the Oregon Medical School “ to devise a plan, if possible , whereby the interest of both institutions may be so harmonized as to lead to the continuation of one Medical College made capable of offering the most complete facilities of obtaining a medical education .” As a result of the conference be tween the two committees, which were appointed by their respective faculties, the medical faculty of Willamette University on June 3, 1878 , sent a communication to the Portland group stating that the Willamette faculty was recommending to their Board of Trustees that the Med ical Department be transferred to Portland “ on the abandonment of the projected medical school there. " Recommendations for a faculty in Portland were also made, including all of the members of the faculty of the proposed Oregon Medical School, and several of the

Salem physicians. The Oregon Medical School thereupon discontinued, and in Judge M. P. Deady's diary under date of June 8, 1878 , is entered this item , " Signed mem orandum of agreement consolidating the medical schools at Portland and Salem at Portland as the medical dep't of the Wallamet University . " 21 Thus was the establishment of a rival school in the thinly populated state, which must have resulted in detriment to both, forestalled , and at the same time the Willamette school was strengthened by the better facilities afforded in the larger city. The arrangement was evidently not acceptable to some, or was not understood , for in the presidential ad dress of Dr. H. Carpenter , who had been closely connected with the department at Salem for so many years, before the State Medical Society on June 11 of the following year, we find the following recommendations : " Itis suggested and recommended that this society do organize and establish under the incorporation laws of Oregon, a state institution to be called the 'Oregon Medical College ,' with a faculty of 8 professors the faculty to be chosen as far as possible from the membership of the State Medical Society . " The examinations for graduation to be conducted by four physicians chosen by the State Society, who shall constitute an advisory council to the faculty and shall take part in the selection of the faculty, as well as in ex amination of all candidates for the degree of Doctor of Medicine. " It is a true policy that medical men should have con trol of medical education and that they should be respon sible for the professional attainments of those who are to succeed them . “ In order to harmonize the interest of the faculty of the Medical Department of Willamette University, I sug gest that a majority of the members of that faculty be 21Diary of M. P. Deady , in library of Oreg . Hist . Soc.

81 selected as professors in the 'Oregon Medical College '. "2 2 This was the first suggestion publicly expressed of state education in medicine in Oregon . It will be noted that no reference is made, however , to control by the state university which had opened its doors at Eugene in Sep tember , 1876. Rather it was proposed to have the State Medical Society assume responsibility without interfer ence by lay boards of control , which Dr. Carpenter had found distasteful in his connections at Salem . A committee was appointed to consider these recom mendations , together wth others which had to do with medical education in general , and to report at the next annual meeting. On June 16 , 1880 , this committee re ported 23 in favor of establishing a medical journal to be published by the society , that the matter of the Oregon Medical College be referred to a special committee which should confer with the proper officers of Willamette Uni versity , and that the society prepare a memorial urging the importance of a “high standard of graduation and that higher preliminary attainments be required of all applications for admission .” The third recommendation was unanimously adopted, but the first two were indefi nitely postponed. It is of interest, in view of subsequent events, to note that Dr. S. E. Josephi, who had come to Portland two or three years previously , and who had been elected to the staff of the Willamette Medical Department in 1879, made the motions for indefinite postponement , which saved the situation for the existing school. At this same meeting of the State Society, Dr. E. P. Fraser , as chairman of the legislative committee , pre sented two bills for approval before they should be taken to the legislature of the state. One was entitled " An Act to regulate the practice of Medicine and Surgery in the State of Oregon . " The second was " An Act to establish 22Proc, Oreg. State Med . Soc ., 1879 . 231bid ., 1880.

1 a State Board of Health. " Both were approved by the so ciety, which five years later also approved “ A bill for an act to establish a State Board of Medical Examiners and Licensers and to define the duties and powers of such a Board . ” These several incidents indicate the keen interest in medical education and progress which the society had early in i t s history, and the efforts which i t made t o ele vate the standards o f the profession i n the Northwest . Such efforts could not but beneficially affect the medical school , s o far a s its own standards were concerned , and there i s the suggestion occasionally , between the lines , that they were s o intended , i n part a t least . A glimpse into the standard o f medical practice o f the day may b e gained from another portion o f the report o f the committee on medical education o f the State Society i n 1879. We read24 " I n this connection we take occasion t o protest against the prostitution o f the title ( M . D . ) s o commonly practiced . While we respect medical knowl edge and skill wherever found and however obtained , the right t o b e called ' Doctor ' i s possessed only by those who have that degree legally conferred upon them , and the man who unblushingly calls himself ' Doctor ' o r encour ages others t o d o s o , when h e does not possess a right t o that name , i s a s dishonest a s h e who assumes the prefix ' Colonel ' o r ' General , ' without the documentary evidence that h e has a right t o b e s o called . I f we would b e re spected we must respect ourselves . The ignorant pre tenders who brazenly put ' M. D. ' t o their names t o spell ' sody , ' ' sweat o i l , ' and ' blew mas ' i n their prescriptions , who cannot tell mumps from erysipelas , dyspepsia from pleurisy , who declare they have treated cases o f adhesive inflammation a t the insertion o f the internal rectus with the sphincter ani muscles , and seen young men with puer peral convulsions — such pretenders , we say d o u s but 241bid ., 1879.

83 little injury, for their ignorance is so apparent that the public is not long in perceiving it. It is our recognition of them which lowers us without elevating them. Call ing such men 'Doctors ' and counselling with them de grades us. They are not capable of imparting or receiv ing.knowledge. * * * “ The one great medicine ( to remedy these evils ) we would employ, almost the only one having any power , is medical education. Our medical colleges must be edu cated up to a proper realization of their duties. They must produce better results. As a rule their work has been by far too carelessly performed. We would not put an impediment in the way of any aspirant for medical honors, but we would insist on ability and character as absolutely necessary for the procurement of them. Of what use are laws for the suppression of quacks and self styled doctors when medical colleges confer the honorable degree of M. D. upon ignorant and incompetent men ? Justice to the public and to the candidate for the degree , require that more time be given for the acquirement of medical knowledge and a far more searching investiga tion made as to the qualifications of those furnished with authority to take charge of public health. Most of the evils which now beset us would be removed by proper care in this direction. " In another part of the report we read, “Let them rig orously and unflinchingly reject a l l who cannot pass a thorough and searching investigation i n all departments o f practical medicine and surgery . We omit details , be lieving the faculty o f every college amply qualified t o adopt rules which shall secure this end . " With reference t o the local situation the report states , “ We know o f but one medical school i n the state — the Medical Department o f Willamette University now located i n Portland . Per sonal acquaintance with the members o f the faculty gives your committee assurance that nothing will be left undone calculated t o increase the reputation o f the institution .

It should be our pride, as Oregon physicians , to point to the institution as among the best in the nation. * We are of the opinion that all applicants for admission to our medical colleges should be referred to an examin ing board composed of practical and professional business men, doctors, lawyers , ministers and school teachers and merchants, who shall impartially judge of the mental, moral and physical qualifications of the applicants and the probability of their ultimate success. The man or woman who does not possess energy enough to acquire a respectable common school education is not likely to add much to the honor, or the learning of the profession as a physician. ” The standards of admission to the local school in 1878, as compared with schools in other parts of the country, may be judged from the following extracts from the presidential address of Dr. L. L. Rowland to the State Medical Society. Dr. Rowland was at this time also state superintendent of public instruction, and had evidently given considerable thought to his subject. At the meet ing of the State Society on June 18, 1878 , he said in part25 “ The requisites for admission to American medical schools where any exist, can generally be met by the preparation received in a common school or academy. “ To this, I for one , do not at present very seriously object. I could wish for more ; but if this were more posi tively required, our system of medical education would be in a more healthy condition. Then we might hope for some thing even better. “ Harvard's requisites for admission in 1878 are these : All candidates for admission, excepting those who have passed an examination for admission to Harvard College , must present a degree in letters or science from a recog nized college or scientific school, or pass an examination in June or September in the following subjects : 251bid. , 1878.

85 " 1 . Latin : The translation of easy Latin prose . French or German will be accepted, however , as a sub stitute for Latin . Physics : Candidates will be required to show such a knowledge of this subject as may be obtained from Bal four Stewart's elementary works on Physics . This examination will be conducted in writing , and , in judging the work of the candidate , the spelling , gram mar and construction will be considered . " Toland Medical College requires in general terms that applicants shall furnish ' satisfactory evidence, show ing them to be of good moral character and of appropriate elementary education .' " Willamette University, our own school , provides that ' Every person desiring to attend as a student of medicine in this University shall satisfy the Dean of the Medical Faculty that he is possessed of the elements of a good English education . The adoption and observance of this law by our college last year very materially diminished the attendance it would otherwise have enjoyed ; but this was , it is believed , more than compensated for in the im proved character of the work accomplished . Most Amer ican colleges , however , say little and do even less , in re spect to acquiring a suitable preliminary education . " Referring to methods of instruction in medical col leges of the time, Dr. Rowland continues , " The usefulness of many a bright, promising youth , has in my opinion , been worse than wholly destroyed by the peculiar method of college instruction to which he has been subjected . For two or three years he has done scarcely anything but listen to orations on anatomy , physiology , materia medica , etc. , etc. " Rowland would substitute a closer study of text books on the part of the student, and advocates sticking to the tried and reliable methods of treatment there found. He frowns on experiment in the following words : “Besides while adventurous originality may be pardonable in the aged, yet inexperienced youth should

ever pray in the words of Propertius, 'Let me strike waters with one oar, and with the other scrape the sand '. ” Apparently Willamette had not been one of the insti tutions deserving of this harsh criticism, or else Dr. Rowland was charitable when making reference to his own school. He continues : " In conclusion, permit me to urge that the Medical Department of Willamette Univer sity whose best interests this Society will ever guard , labor assiduously and continuously for the best possible results in thorough , critical medical education . It has been deemed wise by the Faculty and concurred in by the Trustees to remove the college from Salem , where it has accomplished nobly in the past, to Portland , as a more suitable location , where , it is believed , it will achieve grander results for the future . Portland is the chief city of the Northwest and she is fast growing into leading prominence and importance on the entire Pacific . Her claims as a center of medical education , will , therefore be speedily and cheerfully recognized ; and this Faculty will , no doubt , industriously utilize to their amplest extent those boundless resources and facilities at their command. Our legislature will doubtless, at an early date , take such action as to facilitate the process of obtaining material for the successful study of Practical Anatomy. Such ought legitimately to be laid under contribution to prac tical science. " These long quotations are made for the purpose of affording an insight into the expressed purposes and ideals of the men who were largely responsible for the beginnings of medical education in this part of the country, and also afford a glimpse of conditions as they existed at that time with reference to medical instruction in the country as a whole . We cannot but commend the high purpose expressed in these quotations . The fact that accomplishment sometimes fell short of the vision of some of those engaged in the work is but a common experience of pioneers in any field of human endeavor.

87 Reference has been made to other attempts to found medical schools in Portland. In the records of the late seventies of last century, there are several references to a Homeopathic Medical College in the city. Bancroft26 states that this was a society rather than a school, and this statement is borne out by other sources of information. The officers were as follows :27 President, H. McKinnell , M.D .; secretary, G. W. Wilcox, M. D .; trustees, H. W. Corbett , Rev. J. L. Parrish, W. D. Hare , H. McKinnell , G. W. Wilcox, A. Pohl, F. C. Paine and Wm. Geiger. These gentlemen evidently had the purpose of establish ing a homeopathic school of medicine, but it never ma terialized. In other parts of the Northwest, we find several sporadic attempts. At LaGrande, in 1874 , the cornerstone of Blue Mountain University was laid. By 1878 the school was in successful operation, with G. E. Ackerman as president. Colleges of Medicine, Law and Theology were promised at an early date, but were never estab lished, as the so - called university soon ceased to exist. In 1885 provision was made for a medical department at the University of Washington, but no attempt was made to give instruction in medical subjects until 1917 , when courses in anatomy and other medical sciences were offered in connection with a pre -medical course which had been in existence for some years. There is reference28 to a " Washington Biochemic Med ical College, " organized in North Yakima in 1889. It moved to Spokane in 1892, and assumed the title of " Northwestern College of Biochemistry .” Ten days after the charter was obtained , George M. Carey , a non - gradu ate in medicine , registered a diploma which he had issued to himself . The school , which was fraudulent , became 26Bancroft, Hist . of Oregon , volume II , page 690 . 271bid . 28American Medical Directory , 6 t h e d . , 1918.

extinct in 1893. Another attempt to found a medical school was made in 1890, when the University of Spokane Falls organized a College of medicine.29 No sessions were ever held. The university itself became extinct. Returning to the Willamette Medical School, now es tablished in Portland by 1878, we find in the minutes of the faculty of June 2 , 1879 , a record of the adoption by the school of the articles of confederation of the Associa tion of American Medical Colleges, with the standards set by the Association. Under date of August 30, 1880 , it is noted that the school has been admitted to membership in this association. In 1879 an important addition was made to the faculty in the person of Dr. S. E. Josephi, who was elected lec turer on diseases of the mind. Dr. Josephi had recently come to Portland from San Francisco, where he had graduated from Toland Medical School in 1877. He had located in the part of the city then known as East Port land, and was connected with the Insane Hospital, then a Portland institution. In 1880 he was also elected to the chair of anatomy, which position he continued to fill , according to the records, until April 21 , 1882 , after which he was assigned to other work, while continuing also to lecture on nervous diseases. A new dean30 in the person of Dr. E. P. Fraser, was elected on September 25, 1880 , to succeed Dr. O. P. S. Plummer, who had served since the school moved to Port land, but who found it necessary to resign from the office. The following spring the new dean was author ized to negotiate for a building or rooms for lectures, the inference being that the rooms above the livery stable had become inadequate and perhaps uncomfortable. Ap parently the location of the school was not changed, for we find reference again several years later to the site at 291bid. 30Min. faculty W. U. Med. Dep't ., Sept. 25, 1880.

-

t h e Willamette University Medical Department erected i n 1887, and located a t Fifteenth and Couch streets , Portland .

89 Park and Jefferson streets. In October, 1884, however , plans for a new building were discussed. As an interest ing side light, the dean reported at the same meeting of the faculty that he had been obliged to resort to law to eject the janitor from the premises of the building then occupied. The undertaking of the erection of a new building which should be designed especially for medical purposes was evidently initiated by the medical faculty. The pro ject was delayed for a time, apparently because of finan cial stringency. On May 21, 1884 , the Board of Trustees of Willamette University granted a request of the medical faculty that Rev. F. A. Tower, financial agent of the university, be authorized to devote part of his time to the work of securing funds for the proposed building .31 In 1886 the work of construction was begun, and the build ing was occupied for teaching purposes in 1887. This edifice, which was a source of pride to the school , was located at Fifteenth and Couch streets, in what was designated " the heart of the city . ” It contained an audi torium capable of seating one hundred and fifty people . A dissecting room with a capacity of twenty tables is de scribed, and a new refrigerator large enough to care for thirty bodies was provided to insure sufficient and proper dissecting material . The school was now housed in a building erected for the purpose it served . Apparently it was well adapted for the medical instruction of the time . Here the school continued until its removal back to Salem in 1895 . On the educational side not much progress is evident , but it must be remembered that this was true for medical education all over the country until the establishment of the Johns Hopkins Medical School in 1893. The require ments for admission to Willamette Medical School at the time it moved to Portland have already been mentioned . 31Min . Bd. of Tr., W. U. , May 21, 1884.

In the catalogue for 1881-82 it is announced that the can didate for admission must be not less than eighteen years old, of good moral character , and must pass an examin ation, the subjects of which are not stated. It is prob able that the entrance examinations were more or less perfunctory. The course of lectures still continued twenty weeks and attendance at two courses was required in order to be eligible for medical examinations. In 1883 this re quirement was increased to three courses of lectures. It was specified that the student in the first year must study anatomy, physiology , and chemistry , and attend lectures on all other subjects. In the second year there were added as specified subjects materia medica, therapeutics , theory and practice of medicine, surgery , obstetrics , dis eases of women and children, and all the special branches. Clinics were held in the " practical branches . ” At the end of the second year final examinations were given in anatomy, physiology and chemistry, but attendance on lectures in these subjects was still required during the third year . The specified subjects of the third year in cluded surgery , theory and practice of medicine , materia medica and therapeutics , obstetrics , gynecology, and spe cial branches , together with clinics . We see here the be ginnings of a graded curriculum , such as had been estab lished at Northwestern Medical School ( then the Chicago Medical College ) in 1878 , for the first time in this country . Apparently the local school made an effort at progress , although results were meager . On May 3 , 1883 , it was voted in faculty meeting that “ A preliminary course of one month be instituted to com mence October 1 , 1884. " 3 2 Perhaps the most notable event of this year for the future of medical education in the Northwest was the election to the faculty of Dr. K. A. 32Min. faculty W. U. Med. Dep't ., May 3, 1883.

1

E W i l l a m e t t e U n i v e r s i t y C o l l e g e of M e d i c i n e , e r e c t e d in S a l e m in 1 9 0 5.

91 J. MacKenzie, as lecturer in anatomy.33 This took place on September 17, 1883. Passing over the period between 1887, when the new building was occupied, and 1895 , we find that in the latter year the Willamette school moved back to Salem. Some of the factors which led to this departure, and the history of the school during the period of eight years from 1887 to 1895, will be considered in connection with the incep tion of the University of Oregon Medical School. The immediate cause of the return to Salem is recorded in the minutes of the Willamette Board of Trustees as " sud den withdrawal of all hospital facilities ” 34 in Portland . This evidently has reference to the closing of the old Methodist hospital located at East Thirtieth and Stark streets at that time . This hospital was closed in 1895 after considerable criticism had appeared against it in the public press . 35 Other hospital facilities apparently were not available to the school, so the faculty appealed to the Board of Trustees for aid . This body was unwilling to see the school discontinued after so many years of effort to establish it on a sound basis , and provided quar ters for it in Salem again , after seventeen years of exist ence in Portland . In 1905 it occupied a new brick building which was erected for the purpose on the Willamette campus as a gift from the citizens of Salem. It is described as “ new and modern in every detail , " 3 6 but this statement requires some qualification . The dissecting room at any rate, in 1910 , was far from modern . It was located in the unfin ished top floor of the building , and consisted of a bare room in which the rafters and studdings were exposed . Aside from some tables on which cadavers reposed , there were no modern appurtenances to an anatomical labor 381bid ., Sept. 17, 1889 . 34Min . Bd. of Tr., W. U., Oct. 7, 1895. 35Pers . com . from Mr. George H. Himes . 36W . U. Catalogue , 1908.

atory. The school continued to occupy this building until 1913, when it was discontinued by merger with the Uni versity of Oregon Medical School. Attempts were made from time to time to increase the standards of the school. In 1902 the standard of ad mission was rather vague aside from the statement37 that the applicant must be not less than twenty -one years of age. Four courses of lectures of six months each were required, no two of which could be taken the same year. With the session of 1908-09, which was the forty -third in the history of the school , a high school training was an nounced as requirement for admission to the medical course. In the catalogue announcements emphasis was placed on the practical in the teaching of the school. In 1908-09 there were thirty - four students in attendance. The number increased year by year, so that in 1911-12 there were sixty students in the medical department. At the close of 1913, when the school discontinued , the num ber of graduates since the first class in 1867, was two hundred and thirteen. They included such well -known names in Oregon as J. N. Bell, 1869 ; C. H. Raffety , 1869 ; A. J. Giesy, 1876 ; Harry Lane , one time United States senator, 1876 ; R. E. L. Steiner , 1898 , and others. A new chapter in medical education had its beginning in 1887, when the medical department of the University of Oregon was organized. It will be recalled that the Willamette school was erecting a building in Portland in 1886, and a period of progress seemed to be in store for it. This would undoubtedly have been the case had not a serious schism arisen in the faculty. The causes of this misunderstanding are somewhat obscure, but were ap parently concerned in part with a reorganization of the faculty, and the election of a professor of obstetrics. At a faculty meeting on April 8, 1887 , a motion was made by Dr. A. D. Bevan, at that time professor of 37W. U. Catalogue.

93 anatomy, which " gave rise to a protracted and acrimon ious discussion during which much personal bitterness was manifested , and an apparently irreparable breach created in the faculty . " 3 8 The discussion was finally terminated by the resignation of the entire faculty and the expunging from the minutes of the greater part of the record of the meeting. Dr. Fraser continued to serve as acting dean, and in the minutes of May 7, 1887, is re corded the following communication dated at Salem on the same day : “ Dr. E. P. Fraser, Acting Dean , Medical Department , Willamette University : " Dear Sir :-You are hereby notified that at a meet ing of the Board of Trustees of Willamette University held in Salem on Wednesday, May 4 , 1887 , the following proceedings relative to the Medical Department of Wil lamette University took place : “The resignations of Dr. K . A . J . MacKenzie , as pro fessor of obstetrics ; Dr. H . C . Wilson as professor of theory and practice of surgery ; Dr. Geo . M . Wells as pro fessor of materia medica and therapeutics ; Dr. S . E . Josephi as lecturer on psychological medicine , and Dr. K. A . J . MacKenzie as lecturer in clinical medicine and surgery , were presented and accepted . " Dr. Richmond Kelly was transferred to the chair of obstetrics. ” Some other transfers were made and the positions still vacant were filled by election of practicing physicians , many not previously connected with the school. There is a discrepancy in the statement that Dr. MacKenzie re signed from the chair of obstetrics, over which the con troversy largely arose. There is no record of his having been elected to that chair at any time, so the statement is probably due to an error. The names of Doctors Wilson , Josephi, MacKenzie and others who later became prom 38Min. faculty, W. U. Med. Dep't ., April 8, 1887.

inent in the development of the University of Oregon Medical School were not included on the new faculty list , although they were at the time numbered among the ablest and most prominent physicians in the city. Under these circumstances a group of physicians, in cluding a number of those who had resigned from the Willamette faculty, undertook to organize a rival school. One of the most active in this project was Dr. C. C. Strong, a brother - in - law of Judge Deady, who was at the time president of the Board of Regents of the state uni versity. Judge Deady's interest in the new venture was sufficiently kindled so that the Board of Regents were prevailed upon to grant a charter to the proposed school, giving it the name of the University of Oregon. This charter was granted at a meeting of the Board of Regents on June 16, 1887 , and reads as follows :39 " Whereas, Holt C. Wilson , Curtis C. Strong , Otto S. Binswanger , Arthur D. Bevan , Kenneth A. J. Mac Kenzie,Frank B. Eaton, A.J. Giesy,W. H. Saylor, G. M. Wells , C. H . Wheeler , Harry Lane , William Jones , Henry E. Jones , R. B . Wilson , and S. E . Josephi, doctors of medi cine and practicing physicians in the city of Portland , have petitioned the regents of the University of Oregon for the establishment of a school of medicine at the city of Portland , and , Whereas , It appears from said petition that there is an opening for such a school at said place where it may have many exceptional advantages ; therefore , Be it Resolved , That a School of Medicine be and the same is hereby established at Portland , Oregon , with the following chairs and professors : Principles and Practice of Surgery and Clinical Surg ery - Holt C. Wilson , professor . Obstetrics and Diseases of the Mind and Nervous Sys tem -S. E. Josephi. Professor. Practice of Medicine and Clinical Medicine - Kenneth A. MacKenzie, Professor. 39Min. Bd. of Regents, U. of O. , 1887.

95 Materia Medica and Therapeutics — A. C. Panton , Professor. Physiology and Microscopy— ( record blank ), Pro fessor. General Descriptive Anatomy and Clinical Surgery Arthur D. Bevan, Professor. Medical Chemistry and Toxicology - Otto S. Bins wanger, Professor. Gynecology and Clinical Midwifery - Curtis C. Strong , Professor. With the power and authority, under the direction and sanction of the regents, to teach the science and practice of medicine in all its branches by lecture, experiments , demonstrations, clinical instructions and examinations , and to recommend for graduation therein such students as may attain the requisite proficiency in the knowledge and practice of medicine. “ The professors or occupants of the aforesaid eight chairs constitute the faculty thereof and they, or a ma jority of them , have power , subject to the approval of the regents, ( 1 ) to fill any vacancy occurring therein , ( 2 ) to select from among themselves a dean , treasurer and sec retary of the faculty, ( 3 ) to make a l l necessary and proper rules for the government and conduct o f the school including the time and course o f study therein , ( 4 ) t o employ and discharge lecturers i n the school and ( 5 ) t o prescribe , collect and receive such fees and charges for tuition therein a s they may think proper and expedient , and apply and dispose o f the same i n the support and maintenance o f said school but said faculty have no power t o incur any debts o r enter into any obligation for , o r o n account o f , which the university o r the regents thereof shall be liable under any circumstances . The course o f study i n said school o f medicine prepar atory t o graduation therefrom shall embrace two years . " June 1 5, 1899 , volume IV , page 3 8 . " The medical faculty made the following request and asked that the following resolution b e adopted

Whereas , The original charter o f the school o f med icine o f this university o f date , June , 1887, limited the number o f the medical faculty t o eight members and b y reason o f the growth o f the school and the enlargement o f

i t s sphere o f usefulness i t has been found expedient , from time t o time , t o increase the number o f professors and i t i s desirable t o include i n the faculty all active professors therefore , Be i t Resolved , that the board o f regents hereby amends the charter o f the medical school s o a s t o make all professors assigned o r who may b e hereafter assigned , by the medical faculty , t o active work i n the school mem bers o f the faculty , with the same rights and privileges a s faculty members appertaining t o each a s were orig inally granted t o the eight members mentioned i n the original charter , and further Resolved , That i n order t o remove any doubt that may exist a s t o the legality o f any acts that may have been performed by the medical faculty by reason o f the par ticipation o f other than the eight faculty members men tioned , a l l such are hereby confirmed and legalized s o far a s the Board o f Regents has the power t o d o s o . Whereas , On June 2 4, 1887 , a t a meeting o f the medical faculty , Doctors W. H. Saylor , G. W. Wells and Wm . Jones were designated t o b e nominated t o the Re gents t o the chairs respectively o f Genito - Urinary Dis eases , Pediatrics and Clinical Surgery , and through a n error o f the then secretary o f the faculty said persons were designated a s having been elected " Lecturers " and o n August 1 0, 1887 , Dr. W. A. Flinn was inadvertently elected by the faculty " professor o f Physiology " instead o f being nominated t o the Regents for said chair , now therefore be i t Resolved , That the Board o f Regents does hereby confirm a s o f date June 2 4, 1887 , W. H. Saylor , Professor o f Genito - Urinary Diseases and Clinical Surgery G . W. Wells , Professor o f Pediatrics Wm . Jones , Professor o f Clinical Surgery and o f date August 1 0, 1887 , W. A. Flinn , Professor o f Physiology . ” Dr. S. E . Josephi was elected dean o f the new school , and Dr. C. C . Strong was elected secretary o f the faculty . Instruction began i n the Fall o f 1887, i n a small frame building o f two rooms.40 This was erected for the pur 4 0 Pers . com . from Dr. S. E . Josephi .

versity of Oregon Medical School in 1887

MEDICAL • DEPARTMENT S OREGON STATE UNIVERSITY.306 8.E JOSEPHI, M.D, DEAN , C.O.BTRONG , M D., SEOY. Price zle freunce to pay tetke urdu Pillant 0. Augurt and Nuachi ,da o p l a d a t e , wethoutga 1 7 t h e findi takuuawariat fucava arécined w i t h witeerd a f t e maakivily , v i a l i k e adiec t h e r a t e o f e i g h t f o r c o u t f o r a n until paid a n d s a c a u r crékos baked ' tadbiet t h i natin a n g poster thereof m e pune brucevete f a z cock astering she I . Bangi Autuh Berau NAS WH , Baylor UKUL on the beach need etto 8 6.7.0 hiliena yra bustis t o durong M Chill Verwand Brandbu y r a Atlanton Photograph o f joint note for $ 1000, with which the first building o f the University o f Oregon Medical School was built i n 1887.

97 pose on grounds belonging to the Good Samaritan Hog pital, at what is now the intersection of Twenty - third and Marshall streets. The hospital authorities loaned sufficient ground to the school for the purpose of the building, and from the announcement , which states that the school was located in the Good Samaritan Hospital, it was evidently intended to maintain a very close rela tion between the school and the hospital. According to the Oregonian ,41 " The building was erected with funds provided out of the private purses of the faculty . It was a small affair, and though hardly equal to the demands of even a small class, yet it answered its purpose for a year or two , when an addition was built for increased attendance . " The building consisted of a lecture room on the ground floor and a dissecting room above. The latter accommodated two or three dissecting tables. The cadavers were hauled up through a trap door in the floor by means of a pulley. With respect to the means for erecting this building, while the account in the Oregonian at the time was substantially correct, more accurately the money was secured from the First National Bank of Portland on a joint note for one thousand dollars signed by members of the faculty.

The organization of the new school, which must necessarily be a rival to the Willamette Medical Department, led to some bitterness. This is reflected in the vigorous language of the report for 1888 presented by Judge Deady as president of the Board of Regents of the state university. The report42 reads in part : “Some question has been made by persons interested in a private school of medicine in Portland as to the right of the regents to maintain or conduct a school of medicine at that place. And this too, in the face of the fact that this same school a 41 0regonian, Oct. 6, 1896. 42 Report of Pres. Bd. of Regents, U. of 0., June, 1888.

is part of and maintained by the Willamette University , whose act of incorporation declares that it is ' established in the town of Salem.' " Certainly, if the Willamette University , established by law ' in Salem ' can conduct a school of medicine or any thing else , at Portland , and grant diplomas to the stu dents therein , the University of Oregon , ' located at Eu gene ,' can do the same. The objection illustrates the danger of sawing off the limb on which the objector sits , between himself and the tree .” He continues , “The ob jection however is mere cavil . The facilities for conducting schools of law and medicine in Portland are much greater than those in any other place in the state . Indeed , it is the only place in the state where there are any special opportunities for clinical instruction and ob servation . " The feeling of rivalry is also reflected in the charge of Dr. Strong to the graduating class on March 30, 1889. Because this address 43 also states in their own words the motives of the organizers of the new school, it may be quoted in part , as follows : “ As a faculty we desire to place on record the motives which influenced us in organ izing the medical school. We felt that the abundant and rich clinical material which we possessed should not be allowed to go to waste. We felt that the time was ripe for the organization of a medical school on a broad, non sectarian basis and on the highest moral grounds. We felt that this was due to the profession of the Northwest, as well as to those who should commence the study of medicine. “ This summer we shall build a permanent house which shall turn the vituperations of a l l malignant enemies o f the university a s easily and a s thoroughly a s i t will turn the gentle dew drops o f a n Oregon mist . Upon these several principles the faculty have been a s a 43 0regonian , March 31, 1889 .

University of Orėgon Medical School, erected in 1893. Destroyed by fire in 1919.

99 unit and have thrown into their work all the energy of which they were possessed. How well we have done our work and how faithful we have been to our trusts, time and the character of our graduates will tell. ” When Marshall street was opened up in 1889 , the little building first erected was moved t o Twenty - third and Lovejoy streets . Here i t continued t o serve until 1893 when i t was moved t o the adjoining lot t o make room for “ the sightly , compact , and well - equipped medical college building " which was erected that year . The new building continued t o serve the purposes o f the school, with some alterations and additions , until i t was destroyed by fire o n May 29 , 1919 , a s the equipment was being moved t o the present building o n Marquam Hill . Although the school i n its infancy would have suf fered by comparison with the best schools o f the day , yet i t also was much ahead o f many which had been longer established , both i n i t s material equipment , after the new building was completed , and i n its standards . There appears t o have existed from the first a desire o n the part o f the faculty t o maintain good standards and t o make real progress . I n this connection we may quote again from the Oregonian the contemporary feeling with refer ence t o the advance already made when the new building was completed

" The two buildings, a s they stand today , the one a poor insignificant structure , devoid o f any pre tense t o architectural symmetry , the other beautiful i n its lines and arches without , admirably fitted t o its purpose within , may almost b e regarded a s symbolic o f the ad vance made i n medical science and medical education since the first session o f this college was held i n the little building o n borrowed ground around the corner . " 4 4 A much greater advance , particularly i n medical i n struction , was just beginning about the time these words were written , and the development o f laboratory instruc 440regonian , Oct. 6 , 1896.

> a tion was destined within fifteen years to render the build ing obsolete and entirely inadequate for even the small classes of the period from 1907 to 1915. At the time it was erected it appears to have been a source of pride to the city. In the Oregonian for July 16, 1896 , we find such phrases as these in a description of the school— “Un equalled facilities for carrying on its work ;" "Now stands abreast of the best schools in the United States, " etc. These statements were of course inspired in part by local pride and by the booster spirit characteristic of growing communities , but there was a certain element of truth in them , as one may readily gather from even a cursory glance at the conditions of medical education at the time in the country generally . Many so - called colleges had as their sole material equipment " a blackboard and some chairs " 45 as late as 1906. Others “were mere quiz classes, where students were given just enough text - book knowl edge to attempt State Board examinations , and where the teacher looked for his compensation in consultations sent him by his illy qualified pupils . "' 46 It is not likely that conditions in 1893 when the new building of the University of Oregon Medical School was designed, were better throughout the country generally than when the first survey was made by the Committee on Medical Edu cation of the American Medical Association, thirteen years later, from whose report the above quotations are taken. It is therefore much to the credit of the dean and the faculty of the local school that they undertook the erection of a plant which, for the time and size of the school, was quite adequate. The decade between 1880 and 1890, which has been called the " Etiological Period " of medicine, was destined , along with other factors, to bring about a great change in the teaching of medicine. The development of the so 45Report of Council on Med. Eude., A. M. A. , 1907. 461bid.

or called laboratory sciences, together with the discovery of the causative agents of a number of diseases , brought new a wine into the old bottles of medical instruction, and as usual , the old bottles were soon found inadequate. A few medical schools in this country began early to meet the demands of the highest type of medical education. Har vard in the seventies, after the medical school had been told by the president of the university to clean house or close up shop, advanced rapidly. Johns Hopkins Medical School, from the time of i t s opening i n 1893, took the lead i n medical teaching i n this country . A few other excel lent schools upheld a high standard . But whereas Johns Hopkins required a bachelor's degree i n arts o r science from the start for entrance , most o f the schools , i f they made any pretense a t all o f entrance requirements , were satisfied with four years o f high school work . As recently a s 1908-09 many well recognized medical schools required only one year o f college work for admis sion , and s o excellent an institution a s the University o f Pennsylvania , among others , were satisfied with one year o f college preparation for admission t o its school o f medi cine a s late a s 1910. Many other schools which are i n the front rank today adopted the requirement o f even one year o f college work a s late a s 1910, when i t was forced upon them . With this brief survey o f general conditions i n the country , a s regards medical education , we are i n a better position t o evaluate such steps and efforts for pro gress i n the standards o f medical instruction a s were made i n the Northwest . I n 1886 , when the Willamette Medical Department was about t o move into its new building , the terms o f admission were listed i n the catalogue a s good moral character , a diploma from a good literary and scientific college o r high school , o r first grade teacher's certificate , o r i n lieu o f these an examination i n an English education , including the subjects o f mathematics , English com T

position, elementary physics or natural philosophy. With reference to the methods of instruction we find the fol lowing statements : “ The faculty, recognizing that no institution is complete which does not include a certain amount of personal experience have given clinical teach ing a prominent place in the curriculum. Clinical lec tures will be given at Good Samaritan and St. Vincent's Hospitals twice a week, and four clinical lectures will be given each week at the College. " 47 With regard to dissec tion, the statement is made that the students work under the immediate supervision of a demonstrator of anatomy , and “ are required to dissect all parts of the cadaver at least once ," 48 to be eligible for graduation. An abundant supply of dissecting material is stated as being available. The first announcement of the University of Oregon Medical School, in 1887 , gives under requirements for ad mission , " satisfactory evidence of knowledge of the com mon English branches, including reading , writing , spell ing , grammar , geography , arithmetic , etc. ” Under re quirements for graduation are attendance at two full courses of lectures, at least one course of practical anatomy and clinical instruction , and the study of medi cine for not less than three years . The candidate must also pass examinations in the usual branches , which are listed . In its teaching the University of Oregon Medical School had from the first the advantage of good connec tions through its faculty with the Good Samaritan and St. Vincent's hospitals , and an effort was apparently made to make use of the material available , both in sur gery and medicine . The second announcement of the school includes a long list of surgical operations which were presented at the clinics during the preceding session. In 1889 the school announced a preliminary course 47W. U. Catalogue, 1886. 481bid.

1 i commencing September 11 and continuing until the open ing of the regular course on October 2nd. This course was strongly recommended, but not required. To en courage students to take it, no fees were charged. The following subjects made up this preliminary course : physical diagnosis, urinalysis , bandaging , and minor sur gery, medical electricity , throat and nose , and practical obstetrics. The previous requirement of attendance at two courses of lectures was also increased to three courses of six months each, and two courses of practical anatomy and clinical instruction. In the announcement of 1890 it is claimed that the school stands in the front rank of medical colleges in the United States, and that its diploma receives general recognition by the medical examining boards of all the states and territories. The preliminary course was apparently discontinued in 1892, for no men tion is made of it after the first announcement. Some attention had been paid to microscopy, histology and physiology, but only by lectures and some demonstra tions. In the earlier catalogues the student is promised some demonstrations of “ vivisection " in physiology, but apparently the instructor encountered difficulties, pos sibly from using the term , and in 1892 we find the simple statement that the lectures on physiology "will be illus trated by such means as can be used to best advantage in the lecture room. " A real advance, however , was made in this year by the introduction of the beginnings of a laboratory course in bacteriology by Dr. A . E. MacKay . It is stated that “ The advances in medicine on the line of the theory of germs makes it essential that students should receive practical instruction in this branch . " 49 Dr. MacKay is said to have demonstrated the first tuber culosis bacillus to be seen under a microscope in the Northwest. He kept cultures of many pathogenic organ isms for the benefit of the students. To obtain cultures h 49Catalogue, U. of O. Med. Dept, 1892.

of the anthrax bacillus he was obliged to send to Japan. A real advance in educational method was made in 1895, when the school was established on a graded basis. At this time the course was also lengthened to four years instead of three. A knowledge of physics and elementary Latin was required for entrance, in addition to the sub jects previously specified. In 1898 the school adopted as necessary for admission the requirements of the Amer ican Association of Medical Colleges, of which it became a member. An interesting note first appears in the cata logue of this year as an appendix to the statement of ad missions requirements, namely : “ It is earnestly recom mended to the students intending to take entrance exam inations that a careful review be given the studies men tioned in order that he may be spared the humiliation of rejection .” In 1903 the session was extended to seven months, and the work in histology , bacteriology and path ology was somewhat augmented, so that the students were at least ostensibly required to do laboratory work in these branches under direction of a demonstrator. Except for some microscopes, which the school purchased , equipment was almost lacking, however , for this type of work. Some of the more enterprising of the demonstrators, who were young physicians beginning to work up a practice, and many of whom were recent graduates of some of the better schools in the East, gave work of good quality in the laboratory. Some of the other branches however were as good as not taught at all. The uncertain attend ance on their classes by practitioners whose primary aim must be to care for their own practice, was not conducive to good teaching or connected work in laboratory sub jects. The new wine was beginning to ferment, and the old bottles were already beginning to be found inadequate. About 1905 the American Medical Association , through i t s committee o n medical education , began its far - reaching investigation into the conditions prevalent i n medical schools i n the country , with the subsequent

> demand for higher standards of instruction and equip ment. In the meantime criticism of the local school had appeared from various sources. By 1907 this criticism and reflections of it had become so severe in the Portland press that the student body as well as the faculty were much concerned. At one time, in 1906, the faculty re solved to engage an attorney to determine if the attacks on the school could be considered libelous. The pace set by the Association of Medical Colleges and the American Medical Association was so fast in the way of increased requirements and standards that the school found it dif ficult to follow. In 1907 it was criticized by the Association of Medical Colleges for failure to meet certain require ments of this association, although it had apparently taken some steps to measure up to the standard set. There was considerable resentment on the part of the faculty at the criticism, and the dean wrote to Dr. A. D. Bevan , chair man of the council of medical education as to the course to follow. It will be recalled that Dr. Bevan was one of the founders of the school in 1887, and was its first pro fessor of anatomy. Since that time he had left Portland and established himself in Chicago as one of the outstand ing medical men of the country. As a result of the reply from Dr. Bevan, which was read at a faculty meeting50 on November 12, 1907 , the faculty voted that the school resign from the Association of Medical Colleges. The troubles of the school were just beginning, how ever, for in 1910 it was the object of a scathing criticism in the famous report51 of Abraham Flexner on medical education in the United States. For a time it appeared as if the institution must succumb, as had so many others. In 1906 there were one hundred and sixty -one medical schools in the country, of which number not more than eighty had any claim to recognition, according to the re 50Min. faculty U. of 0. Med. Dep't ., Nov. 12, 1907. 51Flexner, Medical Education in the United States , 1910

A port of the council on medical education. The necessity of meeting the requirements for equipment and salaries for full time instructors for at least the laboratory sub jects of the curriculum soon resulted in the extinction of many of the weaker schools, or their absorption by others. By 1910 the number had been reduced to one hundred and thirty -five, of which seventy -two were rated as class A and twenty -nine as class B. The local school was in cluded in the class A list, although the Willamette school at Salem was placed among those of class C at this time. The financial affairs of the Portland school became more and more difficult because of the insistent demands for higher standards, and it was compelled to appeal to the regents of the university for more aid. Under the leadership of President Strong, in February , 1900 , the university had been reorganized, with the medical school on a par, so far as rank was concerned , with the other schools of the university. Financially, however , it re ceived but $ 1000 per year from the general funds. The remainder of its budget was derived from fees for tuition. It is of interest to compare the budget of the school at different periods under this system. For the year end ing June 30, 1888 , the first of the school's existence , when it received no financial aid whatever from the university , the gross income was $ 2329. There had been expended on building and repairs $ 1132, and for current expenses $ 600 . The balance of $ 597 was evidently distributed among the faculty. At the close of 1900, the financial statement of the school showed receipts of $ 7171, dis bursed $ 3016.64, arrears collected $ 697 , and surplus $ 4154.36 . The surplus was distributed pro rata among twenty -five lecturers who had given 932 lectures, so that they received an average of something less than five dollars per lecture.52 62Min. faculty U. of O. Med. Dep't.

} X Some funds were spent from time to time for equip ment and other purposes which had for their object the strengthening of the work given, but when the demand for full - time instructors came as a result of the agitation for higher standards of teaching, the local school had not the necessary funds. The result of the appeal to the regents was an increase, on January 19, 1910 , from $ 1000 to $ 2500 per annum as appropriation from the university. In the report of the president of the Board of Regents submitted on September 30 of the same year, it is stated that the school would be obliged to receive aid from the state of at least $ 10,000 annually to meet the require ments for continued recognition by the standardizing authorities. The next session of the legislature came to the rescue with an appropriation of $ 10,000 for equipment and $ 20,000 for maintenance for the biennium, 1911-12. This was followed by further appropriations by subsequent legislative assemblies, so that the institution was placed on a substantial financial basis. Thanks to the earlier aid of the regents an advance step was also taken in the employment of the first full time instructor engaged by the school. This was Dr. David N. Roberg, who was appointed acting professor of anatomy on June 16 , 1910. On November 4 of the same year, Dr. J. D. MacLaren was nominated as acting pro fessor of physiology, and the follwing year , with the legislative appropriation in hand, it was possible to ap point both Dr. Roberg and Dr. MacLaren to permanent professorships at a salary of $ 2000 each.53 The school had engaged to have six salaried instruc tors on its staff by 1912-13 in order to maintain its rating with the American Medical Association. In Sep tember, 1911, Dr. F. C. McLean and Dr. R. B. Dillehunt 531bid.

were recommended 54 to the regents as acting professors of materia medica and anatomy, respectively , and they assumed their duties the following January. Dr. Ro berg, in the meantime, had been transferred to the chair of pathology. The two additional instructors on a full time basis were provided in the persons of Dr. R. L. Ben son in microscopic anatomy, and Dr. J. M. Connoly in physiological chemistry and bacteriology. The new standards of instruction also demanded in creased hospital and dispensary facilities for the students. In May, 1909 , preliminary arrangements55 were made with the county authorities to use the county hospital for teaching purposes, and in August the dean was authorized to arrange for clinics at this hospital by i t s staff . Prior t o this time there had been some pretense a t maintaining a dispensary56 i n a n old chapel i n South Portland for a time . A few bottles o f medicine were left on the shelf , but n o one was i n regular attendance . As a result there were n o patients , and the dispensary was a failure . I t was then moved into a room i n the medical school build ing on Twenty - third and Lovejoy streets , but this location was then i n a residence district o f relatively well - t o - d o people , and here also the dispensary failed t o receive pat ronage . The present dispensary i s the outgrowth o f the activi ties o f the People's Institute , which had rooms i n a build ing a t Fourth and Burnside streets . I n the Fall o f 1908 a clothes closet on the second floor o f these quarters was utilized for dispensary purposes . The janitor o f the building made a table , and with some funds which had been raised by the Mothers ' Club o f the People's Institute some instruments and other necessary supplies were pur chased . A few physicians attended , and patients were occasionally sent t o the offices o f physicians . Later , 541bid . 551bid . 5 6 Pers . com . from Dr. C. J . McCusker , Portland .

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y. . additional facilities were provided in the Men's Resort on the first floor of the same building. The number of patients from 1908 to 1910 was small, but by January of 1910 the average number had reached fifteen to twenty five per day. The advantages of affiliation with the medical school were recognized and in November, 1909 , preliminary ar rangements were made by which the medical faculty67 appointed three of the trustees of the Institute and as sumed responsibility for twenty - five dollars per month toward the payment of an attendant at the dispensary. Later Dr. K. A. J. MacKenzie was appointed chief of the clinic. The affiliation with the school took effect on January 1, 1910 , and thus the struggling school obtained in some measure the required dispensary facilities. A gift of $ 1000 was provided by Mr. Jacob Kamm , with which to equip and maintain the dispensary on a better scale.58 Additional funds were secured through monthly subscriptions by members of the Arlington Club of Portland, which provided for running expenses such as laundry, drugs , etc. In February of 1916 the present quarters at Fourth and Jefferson streets were secured. The affiliation at first was little used for teaching purposes. From 1910 to 1913 students from the school were not scheduled for attendance at the dispensary, al though many sought instruction there nevertheless. In 1913 the faculty made dispensary attendance compulsory , and credit was granted for such work Thus in this fateful year for the University of Oregon Medical School , another important step was taken toward present day standards of medical instruction. In this manner several emergencies were met, and the school passed through i t s most critical period , a t the same time completing its first quarter century o f exist 5 7 Min . faculty U . o f 0. Med . Dep't. 58Pers . com ., Mrs. Etta McOmber , Portland .

ence, at the end of 1912. At the close of this year also Dr. Josephi, who had served as dean from the time of the school's inception, asked to be relieved of further service , and Dr. K. A. J. MacKenzie was chosen as his successor.59 Thus the school and its first dean completed the twenty five years of pioneer work together. Foundations had been laid, and medical instruction in the Northwest estab lished on a permanent basis. At times the structure had been shaky, and in the light of present standards , far from sound, but to change the figure and express the situation in the spoken words of the first dean, “ You must creep before you can walk. " The Willamette Medical Department, since its return to Salem in 1895 , had made a valiant struggle for exist ence , but the limited facilities of a town no larger than Salem , and of a private university no wealthier than Willamette , made the effort to maintain the standards set by the Council on Medical Education impossible of realiz ation . As already indicated , the school was rated class C in 1910. At a meeting of the University of Oregon Medical School faculty on January 10 , 1913 , Dean Mac Kenzie read a telegram from President Campbell of the University of Oregon , reporting the advisability of ab sorbing the school at Salem . A telegram to its dean , Dr. W. H. Byrd , proposing consolidation was read and ap proved for sending . At a later meeting , on February 12 , 1913 , it was voted that the dean be empowered to conclude the merger , and by March 23 this was accomplished , under an agreement which protected the alumni of the Wil lamette school. The University of Oregon Medical School thus became the only school north of San Francisco and west of Denver to offer a full medical course. In June of the same year the Alumni Association was organized. The University of Oregon Medical school now began its second quarter century of existence with the active a 59Min. faculty U. of O. Med. Dep't.

the University of Oregon Medical School

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support, although limited as yet , of the state legislature , with its laboratory staff on a full time basis, with a dis pensary organized for instruction of students, although far short of the best standards in either organization or equipment, and with harmony, so far as competition in the field which it serves , was concerned. The difficult days of its youth had been passed safely, and it now entered upon the second period of its history. Thanks to the high character of its first dean and original faculty , and to the wise foresight and statesmanlike planning of Dean MacKenzie and his colleagues in the earlier years of the second quarter century, it is now established with excellent facilities and the prospect of a bright future , educationally and scientifically. If the foregoing account has appeared, in spots, too sympathetic, in the face of serious defects as judged by present standards , and even by the best standards of the time during periods when the school was passing through difficulties, it is more charitable , and perhaps more just , to measure its relative accomplishment in a young com munity, rather than to judge it altogether by the stand ards of the long established and relatively wealthy eastern institutions. If we may adapt the words of Dr. J. S. Billings , written in 1876, with reference to American medicine in general , namely : " We have no reason to boast or to be ashamed of what we have thus far accomplished ; it has been but a little time since we have been furnished with the means of investigation needed to give our observa tions that accuracy and precision which alone can entitle medicine to a place among the sciences, properly so called ; and we may begin the new century in the hope and belief that to us applies the bright side of the maxim of Cousin , “ It is better to have a future than a past, " 60— so we may say of medical education in the Pacific North 6 60 Billings, J. S. , A Century of American Medicine, 1876.

west also, we have no real reason to either boast or to be ashamed of what has been accomplished. We have but recently been furnished with the means necessary to carry on medical instruction in an adequate manner, and for us indeed it is better to have a future than a past.