Upper Valley Anonymous

Nathan Smith was an important doctor in the Upper Valley in the late 1700’s.  His practice encompassed an area with a fifty mile radius.  He was married to Sally Chase, Jonathan Chase’s daughter, and they lived right across the road from Colonel Chase in Cornish. As the years went by, Nathan provided medical services to families on both sides of the Connecticut River, through smallpox and typhus outbreaks.  He also saw the gamut of common medical emergencies, setting broken bones and performing surgeries.

Nathan usually had an apprentice working with him.  Sometimes he had two students working in his practice, gaining their medical training the same way he did.  Nathan went to Harvard because he was dissatisfied with the level of expertise he gained from his apprenticeship, and he wanted more for his students as well. He felt strongly that every state should have a medical school that could provide a high quality medical education.

Since 1769, Dartmouth College had been providing higher education to Upper Valley students (all men – women did not go to college) and it seemed logical to Nathan to approach the nearest college with a plan to establish a medical school. When he met with the trustees of Dartmouth, they were not overly enthusiastic about the idea.  For one thing, Dartmouth was broke.  In 1795 they only had 100 students and struggled to pay their professors.  The trustees told him to come back in a year when the college might be financially better off and more able to consider the proposal.

Nathan decided that he needed further education.  Although Sally was pregnant with their second child, he decided to go to the University of Edinburgh in Scotland. Nathan was always invested in increasing his medical knowledge, but it is also likely that he thought that Dartmouth would take him more seriously if he had been to Edinburgh.

Nathan’s letters home to Sally, reprinted in his granddaughter-in-law’s book “The Life and Letters of Nathan Smith” show that he missed his wife and little boy and that he was worried about them. He writes, “ I am sure I shall ever be happy if I live to return and find you and Solon alive and well. Do be careful of our dear little son.” He doesn’t mention Sally being pregnant or any anxiety over the unborn baby.  It is hard know what to make of this.  Does he not know Sally is pregnant?  Did people in that day just not mention pregnancy in their correspondence? 

In her book, Emily Smith says that Nathan took comfort in knowing that Sally and Solon would be well cared for by Sally’s mother and father (Jonathan and Sally Chase).  Certainly the elder Chases looked after their daughter and grandson, but one wonders what they thought about the situation. Nathan and his family lived right across the road from the Chases, in a house that Jonathan owned. Things were different in those days, but it is easy to believe that at least Sally’s mother was at the very least annoyed that her daughter was left alone and pregnant.

As much comfort as Nathan took from the fact that Sally’s parents were right nearby, he was still homesick and worried about them.  Another letter says,

“Tho' I am every day surrounded with new and interesting scenes and am treated with great kindness and attention by the people here, yet my thoughts continually turn on you and our dear little son, whose name I cannot write without shedding tears on it. I imagine a thousand evils ready to befall him. I see him every night in my dreams and often wake myself by attempting to grasp him, but he always eludes my fond embrace and leaves me to mourn his absence. Do my dear, If he be still living, and I dare not think otherwise, do, I say, watch over him with maternal care, kiss him for me a thousand times each day and tell him that his papa is coming soon." In an era when infant deaths were all too common, it was perfectly reasonable that Nathan was worried about Solon.  In an era when maternal deaths were even more common, it would have been even more reasonable for him to worry about Sally and the unborn baby, making one wonder again if he knew that Sally was pregnant.

The well-being of his family was not Nathan’s only concern. Money was always an issue.  Nathan needed money for medical books, supplies, and medical equipment, as well as for food, lodging and the fare for the voyage.  Records show that he wasn’t always prompt in repaying his debts, waiting 25 years to pay back one of the people he owed. Oliver Hayward’s biography of Nathan, “Improve, Perfect and Perpetuate”, cites several instances of Nathan being slow to pay his bills. 

There is no evidence that Nathan ever matriculated and actually took courses at the College in Edinburgh, although he did attend lectures there. In his letters home, he mentions that he was disappointed in the quality of the lectures he attended. He soon discovered that the medicine’s star was rising over London, and he left Edinburgh to spend some time in London before he went home to Cornish. While he was in London, he toured the London hospital, observed some dissections on cadavers, and was nominated to and joined the Medical Society of London.

When he returned home to Cornish in September of 1797, both Sally and Solon were fine.  Nathan met his second son Nathan Ryno, called Ryno by his family, who was four months old by the time Nathan got home. There is a story, recounted in both Smith’s book and Hayward’s biography, about Nathan’s homecoming. Apparently Sally borrowed three or four neighbor babies the same age as Ryno, lined them all up with her own son and challenged Nathan to identify which one was his. Legend says that Nathan picked correctly, saying that it was easy, he just picked the prettiest baby.

As soon as he returned, Nathan returned to Hanover and Dartmouth. He didn’t wait the trustees to approve the establishment of a medical school, but started giving private lectures on his own, instructing students on various medical theories and techniques. This is much like what he experienced with the London Medical Society, which sponsored various lectures rather than offering education through an established   The difficulty of the trip soon led him to board in Hanover, leaving Sally and the boys in Cornish and coming home when the weather, the roads and his schedule permitted.

school. He traveled back and forth from Cornish to Hanover, riding horseback on poor roads, across unreliable bridges, sometimes crossing streams when bridges were out.

A painting of Dr Smith on horseback, owned by Darmouth College

 

In 1798 the trustees of Dartmouth finally approved the establishment of a medical school and Nathan became a member of the faculty at Dartmouth. He asked his friend and student Lyman Spaulding to be the lecturer in chemistry.  Together, the two made up the entire faculty of the medical school.  In 1800, Nathan lists 19 Seniors and 16 Juniors who attended his lectures for that school year. The medical curriculum included Theory and Practice of Physic; Chemistry, accompanied by actual     experiments (Nathan’s words); and Anatomy and Surgery, accompanied by dissections if subjects can be legally obtained. The fee for Anatomy and Surgery was $50, chemistry cost $23 and Theory and Practice of Physic cost $17. Nathan’s lectures were popular with the students.  According to journals of his students quoted by Hayward, Nathan spoke from experience, added anecdotes from his country practice and even sometimes used humor.

Nathan finally succeeded in getting a medical school established in the north country, so that his students could have a high-quality, formal education in the medical field instead of relying only on apprenticeship as training to become doctors.