Dr. Nathan Smith of Cornish, New
Hampshire was the founder of Dartmouth Medical School. The new medical school
attracted students from all over northern New England. Some had experienced formal medical training
already and were a little put off by Nathan’s country ways. Nonetheless, once they got to know him they realized
he was fully qualified to be one of two faculty at the new medical school, and
that it was unusual to receive training that was both high quality academically
and highly practical.
The first thing students noticed
about their lecturer was that he dressed in an “unkempt country style” and that
his mannerisms and lecturing style were unpolished, to say the least. Medical school professors were not usually so
shabbily attired. Oliver Hayward’s biography of Nathan, titled “Improve,
Perfect and Perpetuate”, quotes one of his students, William Tully’s diary, in
which Tully stated that “Dr Smith’s lectures were full of colloquial phrases,
pithy and inelegant”. In one lecture, Smith said that “it was a pleasant thing
to be called Doctor and sent for and consulted, but if anything was the matter
with his own family, he sent for old Mrs. Dewey, Deacon Dewey’s wife.” In 2014,
we prefer our college professors to have a sense of humor, but it appears that
this was not what medical students were looking for at the turn of the 19th
century.
The two first students that earned
Bachelor’s degrees in Medicine from Dartmouth Medical School were both from
Vermont. Joseph Gallup was from
Woodstock and Levi Sabin from Rockingham.
It appears that, at least in the beginning, most of the recipients of degrees
from Dartmouth Medical School were apprentices of Dr Smith as well as
students. Three 1799 graduates, Nathan
Noyes, Daniel Adams, and Abraham Hedge were all Nathan’s apprentices. Although he was busy giving lectures and
keeping the medical school going, he also continued in his medical practice,
often bringing several apprentices or students with him to see patients.
Hayward cites student diaries describing trips from\Hanover to Barre and
Corinth, Vermont and Walpole, New Hampshire from Hanover. If the patients presented an interesting case,
these same students would often hear the patient’s situation described and
discussed in lecture the next day. This sounds familiar to us as a case study,
but back in the late 1700’s this was a novel educational practice, and
certainly not one that Nathan had experienced himself as a student, at least
not in formal training, although it may very well have been common in the
meetings and lectures of the London Medical Society.
There was a good reason for
Nathan’s shabby clothing. Although he was very busy, he certainly was not
getting rich. He was keeping two households going. When he was formally invited
to become part of the Dartmouth faculty and the medical school was firmly
established, his position became much more stable than that of a private
lecturer, and he rented some rooms in Hanover.
Sally did not come to Hanover with him, however. She stayed on in Cornish, with her family of
three. In 1799 Solon was four, Ryno was
2 and Sally had a new baby, a girl who was also named Sally. Although he collected some doctor’s fees, the
majority of his time was spent at the college.
Most students paid their tuition in promissory notes, which were often
slow in being paid. Nathan himself was
slow to pay his own tuition. One of his Harvard professors, Robert Waterhouse,
ended up suing him to get his money, and another, John Warren, had to wait
twenty years.
Nathan had a new outlook on
practicing medicine that involved a careful examination of the patients, and a
thorough assessment of what they were experiencing. He also stressed the importance of good
nursing care during a sickness. He believed that a wise physician should take
advantage of every healing mechanism while watching for side affects. Hayward believes that isolation on the
frontier might have saved Nathan from engaging from new practices that were
accepted and popular on the eastern seaboard, but were actually useless and in
some cases harmful.
Nathan’s lectures were full of
practical instruction and were always changing, in comparison to Harvard’s
medical lectures, which had been the same for twenty years. Dr Smith’s case-study lecturing technique was
brand-new, and although it seemed less polished and contained less medical
theory than what some students were used to, they grew to appreciate the
practical aspects of his instruction. Nathan stressed the healing power of
nature, waiting and cleanliness, not especially popular medical theories in the
late 1700’s. Again, being isolated in
the wilderness may have had some benefit for some of his patients. He had significant success with his patients
using the methods and medicine he had on hand in the north country woods –
time, fresh air, fresh water and cleanliness.
He did not hesitate to criticize or contradict accepted medical theories
when he thought they were wrong, and admitted that there were many diseases
doctors could not cure, especially cancer. In Nathan’s granddaughter-in-law’s
book “The Life and Letters of Nathan Smith”, much of Nathan’s writing, both
speculative and instructional, relates to cancer, and you have to wonder if his
mother or father or his first wife Elizabeth died of cancer, although the fact
that Elizabeth died so young makes that unlikely.
Nathan’s lecture notebooks from his
days at Dartmouth survive, and Hayward quotes them extensively in his
book. “Medical Jurisprudence” must have
been an interesting lecture. In that lecture, he talked about wounds,
contusions, malpractice, infanticide, abortion, rape, concealed birth and
poisoning. It is always surprising to see these issues mentioned hundreds of
years ago. We think of those times as
innocent, safe, and without crime or immorality, but then evidence appears to
disabuse us of those notions. It would be fascinating to see those notebooks
and maybe get some insight on what Nathan really thought about those
topics.
Nathan had his own brushes with the
law in regards to medical science, and that is a story for another day.
