Teaching Medicine at Dartmouth

                The founder of the Dartmouth Medical School, Nathan Smith, started his medical practice in Cornish.  His wife was the daughter of Jonathan Chase, Revolutionary War Colonel and founder of the Cornish-Windsor bridge.  Doctors were not plentiful in the North Country at the time, and as Nathan’s reputation as an excellent doctor and surgeon grew, he found that he often had several apprentices working with him.  Nathan had studied at Harvard, and considered the apprenticeship system to be vastly inferior to a high quality formal medical education.  He approached the trustees of Dartmouth College with a proposal to establish a medical school there, and after a couple of years of waiting, during which time Nathan went to Scotland and London adding to his own medical education, the trustees approved the Medical School.

                Nathan had an attitude toward the practice of medicine that differed from that of other learned doctors of his day.  He taught his students to carefully examine their patients and pay particular attention to what they were experiencing. He believed that good nursing care was very important in the treatment of a sick person, and that the wise physician takes advantage of every avenue of treatment while being careful to watch for side effects.  During this time, medical knowledge was rudimentary at best, and there were many treatments commonly used on patients that were useless, and some that even harmed them and made them less likely to recover.  Nathan believed that “watchful waiting” was often the best course of action.  Other doctors commonly practiced “heroic measures” like bleeding and purging.  Before the medical school was established, Nathan had dealt with an outbreak of Typhus at Dartmouth College without losing a single one of his patients by opening the windows of the patients’ rooms, wrapping them in wet sheets and giving them lots of fluids.  In his biography of Nathan, Oliver Hayward, in his book “Improve, Perfect and Perpetuate” states that he believes that Nathan’s isolation on the frontier may have saved him from engaging some of the practices popular with more established doctors elsewhere.  Harvard Medical School had more than one doctor on the faculty, and these doctors had been established as medical eminences for a long time. They hesitated to stray from the accepted teachings and medical beliefs.  Nathan was younger, in charge pretty much in a vacuum, and had been practicing medicine in the howling wilderness where necessity was often the mother of invention.

                While Nathan was in Europe, he attended many classes and lectures that featured dissection of bodies.  These experiences made him committed to dissection of real human subjects and laboratory chemistry experiments as part of the education at Dartmouth Medical School.  The problem was, that dissection of human bodies was illegal in America at this time, and because of this, bodies were hard to come by.  It was especially difficult to obtain cadavers in rural New Hampshire and Vermont. In cities, medical schools often used the unclaimed bodies of paupers, or prisoners who had died in jail. There were more cemeteries in cities, and the cemeteries were much bigger, and a disturbed grave would not be noticed as quickly than it would be in the rural Upper Valley, where everyone noticed everything.  If a body was dug up in Hanover, everyone in the whole town would know about it immediately. 

                If a person was caught and convicted of graverobbing, they would receive a $2000 fine, 2 years in prison and 50 lashes.  There are multiple indications that graverobbing was rampant in the Upper Valley at this time.  Norwich cemetaries were a prime spot for grave robbers, and in the early town reports in Cornish there is documentation of the “problem of grave robbing” being discussed at town meeting, and stern warnings given by town officials toward potential grave robbers. Of course one wonders if Nathan Smith was behind the grave robberies in Cornish and whether or not his Chase relatives knew.

                In 1804, the Dartmouth Trustees voted to give Nathan a raise, on the condition that he would move to Hanover permanently, and bring his family with him.  Before this, Nathan had been maintaining two households.  He rented a couple of rooms in Hanover, but Sally and his sons remained behind in Cornish.  One assumes that the Trustees thought that Nathan was spread too thin, and he would do a better job if he could live with his family at Dartmouth.  The question is, was it financial considerations that kept the family in Cornish, or Sally’s disinclination to move to Hanover?  The family was living right across the road from her parents, in a house that her father owned.  With Nathan being so busy teaching medical school and carrying on his medical practice, she probably preferred to stay by her parents and siblings.  After Jonathan died in 1801, she may have been more amenable to a move to Hanover that she would have been before he died.  By all accounts, Jonathan was very close to his children and his grandchildren, in a way that Nathan may very well not have been.