Friday, November 28, 2014

Nathan Smith and Joseph Smith


 
Nathan Smith, a Vermont farmer’s son, became a doctor and started his medical practice in Cornish, New Hampshire, marrying Elizabeth Chase, Jonathan Chase’s daughter.  When Elizabeth died, Nathan married her sister Sally.  Unsatisified with the apprenticeship system of training doctors, Nathan applied to the Trustees of Dartmouth College for approval of a medical school and after a year or so delay, the Dartmouth Medical School was established.  Although not especially lucrative for a doctor who had a steadily growing family, both Nathan and the medical school thrived, until a court case involving grave robbery.

                Nathan felt that Dartmouth College was not doing enough to help him procure the specimens necessary to conduct the dissections he felt were so important a part of a medical student’s education. He also thought the college should have been more generous in giving the medical school money for the textbooks and equipment he needed to conduct his classes. Nathan was a big believer in hands-on experience in medical training, in an era when most medical instruction consisted of just lectures.  We know that Dartmouth College was strapped for cash during its first years, but it may also have been that the trustees felt that Nathan’s methods were ridiculous.  Then, there is the inescapable fact that dissection of cadavers was illegal.

When school was not in session, Nathan traveled amazing distances treating patients and performing surgery.  It is understandable that Sally would not want to move households to follow her husband in his endeavors, since he was all over the place anyway.  His granddaughter-in-law Emily Smith, in her book “The Life and Letters of Dr. Nathan Smith”, includes a letter dated April 20, 1811. Nathan wrote to his friend and former student George Shattuck. Nathan starts out, “I intended to spend this winter in Boston, but in reviewing my affairs found them such as required my presence at home.”  Really?  Possibly because his wife was raising eight children there by herself?  For all the times Mrs. Smith remarks on his tenderness toward his children and his family, it does not seem very tender to leave them in Hanover and spend the winter in Boston. In several of his letters to Mr. Shattuck, he describes journeys to Bath, Coos, Weathersfield, Charlestown, Boston, Merrimack, Concord, and Exeter.

Apparently George was a bill collector for Nathan, or maybe just his emissary in Boston.  In any case, much of Nathan’s correspondence to George consisted of asking – actually, more accurately, commanding – him to collect one note or another.  He also used George as a social secretary as well, asking him to ask other people if they are coming to visit him, giving dates when he is going to be home (not many), and offering alternate sites for visits in Concord or Boston. Many of these proposed social visits appeared to involve the collection of money owed – a “bring me my money and stay for dinner” kind of arrangement. Certainly it was fair that Nathan collect the money he was owed, especially with a family of eight children. The arresting thing about these letters is that their tone is so imperious, and you wonder if Nathan was giving Mr. Shattuck any money for being his emissary in Boston and southern New Hampshire.  My guess is that he did not.

Ill feelings still lingered in Nathan regarding the court case, and the general difficulties in getting dissection specimens in rural New Hampshire. The political situation in New Hampshire was not encouraging to the funding of education. It is interesting to note that Dartmouth College was petitioning the New Hampshire legislature for funds.  This is why Nathan went to Concord.  He often attended sessions of legislature to lobby for funding for the medical school. Yale College in New Haven, Connecticut had been putting out feelers to Nathan, recruiting him to teach at their newly established medical school and Nathan began leaning in that direction.  He sent both Ryno and Solon to Yale to medical school, and, in 1812, Yale offered him a position on the faculty at the medical school. 

Before he could leave for Yale, the Upper Valley was hit by an epidemic of Typhoid Fever, and Nathan, who had treated patients successfully in many previous outbreaks of typhoid, felt compelled to stay in Hanover, especially when his wife and three of his children came down with it.

In West Lebanon, a ten year old boy was suffering from a bone infection in his leg that he had gotten as a result of having typhoid. He was in excruciating pain and when his mother called in their family doctor, the doctor said his leg would have to be amputated. This type of bone infection is called osteomyelitis in 2014, and is treated with antibiotics.  My nephew had it, and was hospitalized for two days, then discharged with a fanny pack of IV antibiotics that he had to wear 24/7 for at least a week.

Nathan had been treating this type of bone infection for at least two years, by excising the dead bone and draining the infection from the area. The boy went to school with several of Nathan’s kids, and his mother, Lucy Smith, (no relation) contacted Nathan and asked him if he could come and take a look at her son, and hopefully save his leg. It is unclear whether or not she knew that Nathan was an expert at this kind of bone infection.  It is  more likely that she knew he was a very accomplished physician and surgeon and possibly more able to help her son than the local doctor who had prescribed amputation.

Nathan came and performed surgery on Lucy’s son, bringing ten medical students to observe the operation.  Often, patients were brought to the medical school to have operations at the medical school, on a table in the lecture hall.  Probably due to his age and the amount of pain he was in, Nathan operated at his home.  Lucy’s mother described the operation. “ The surgeons commenced operating by boring into the bone of his leg, first on the one side where it was affected, then on the other side, after which they broke it off with a pair of forceps or pincers. Thus they took away large pieces of bone.” Keep in mind that this whole procedure was accomplished on a ten year old without anesthesia.

Accounts of Nathan’s operation on Lucy Smith’s son, in West Lebanon, New Hampshire in 1813 can readily be found online by googling “Dr. Nathan Smith and Joseph Smith”.  The ten year old was Joseph Smith, future founder of the Mormon religion.  The Mormons consider it very significant that Nathan was the only surgeon in the country who was performing this procedure, almost one hundred years before it became standard practice in World War I. They believe that it was God’s divine intervention that put Joseph in school with Nathan’s children during that Typhoid Fever epidemic, and thus gave him access to the only doctor who could save his leg.

After the Typhoid Fever had passed, Nathan joined his sons at Yale Medical School and began his career at Yale, again leaving Sally and the rest of the children behind while he established himself there. A letter from Nathan to Sally, reprinted in its entirety in Emily Smith’s book, has Nathan yet again missing Sally and the children, promising never to leave them again. “I fear my absence has been severely felt by you and the children.  For my own part, I have had a dreary winter of it. You may rest assured that I will never leave you and the children for so long a time again during my lifetime. I think I will be able to get home by the middle of April.” In that same letter, he describes a situation between Solon and a cook in the kitchen.  “We have been having some difficulty in the school between the cooks and the scholars. A cook abused one of the scholars in the kitchen and the scholars put him under the pump and pumped him, as it is called. I think, however, it will be settled without difficulty. Solon is one who helped to pump the cook, but so many assisted in the thing that the blame will be light on individuals.  No doubt the fact that Solon was Nathan’s son also helped with the “light blame”.

 Notwithstanding all the legal difficulties surrounding dissection, Dartmouth College was loathe to let Nathan go.  Oliver Hayward, in his biography of Nathan, “Improve, Perfect  and Perpetuate”, states that students were drawn to the medical school by the reputation of Dr. Smith.  Most of them hated Hanover because it was way out in the middle of nowhere, and the weather was miserable – cold in the winter and hot, humid and buggy in the summer. Dartmouth College was concerned that the Medical School would not survive the defection of its founder.

Three years later, Sally and the kids still had not moved to Connecticut.  Nathan had to return home in 1815 when his daughter Sally died. This was the first death in the family, and by all accounts it hit Nathan hard. Regardless, he left Sally in Hanover and returned to New Haven for another year.  In 1816 he went back and gave a series of well-attended lectures at Dartmouth.  This was the last time he taught in Hanover.  Sally and the kids finally joined Nathan in New Haven in 1817, and Sally gave birth to her last child, a girl, Sally, born in 1819.  Interestingly enough, although they lived in New Haven at the time, all records at Ancestry.com show that Sally was born in Cornish, as were all of her siblings but one, who was born in Hanover.  Sally must have returned to Cornish to have the baby.  Since both of her parents were dead by then, she must have had the baby at a siblings’ house.

Nathan established two more medical schools, one in Maine and one at the University of Vermont. Although Sally visited both Maine and Vermont, the move from Hanover to New Haven was the last one she made. Nathan died in New Haven in 1829 at age 66, of what appears to have been a stroke. Sally died in Springfield, Massachusetts twenty years later and was buried in New Haven.  She may have been living with her next youngest son James, at the time, because he is listed as living in Springfield, Massachusetts in 1850. 

None of Nathan’s children lived in the Upper Valley as adults.  The boys became doctors, the girls all married and had children.  Every one of them gave one of their children “Chase” as a middle name, and most of them had a daughter named “Sally”.

Ezekiel Cushing. You can read “Improve, Perfect and Perpetuate” at the Howe library in Hanover. Emily Smith’s biography of her grandfather-in-law, “The Life and Letters of Nathan Smith”, is available online, as is Nathan’s “Medical and Surgical Memoir. http://books.google.com/books?id=QaoaAAAAYAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false (Life and Letters)

 

 


Ezekiel Cushing, the medical student arrested and charged with grave robbing, went on to become a doctor in Plymouth, Massachusetts.  He did die young, at age 38.

Nathan may very well be related to Simeon Ide (see Simeon’s story in my posts of late fall 2012/ early winter 2013). Nathan’s mother’s maiden name was Ide, originally from Rehoboth, Massachusetts, as was Simeon’s family (and mine as well). Simeon and Nathan came from the same area of Vermont.

The founder of Gifford Hospital in Randolph had his own experiences with grave robbing.  You can read about it here: http://dartmed.dartmouth.edu/winter03/pdf/Grave_Robber_Good_Doc.pdf

 

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