Ohio History Journal

DANIEL DRAKE AND THE ORIGIN OF MEDICINE IN

THE OHIO VALLEY1

 

By DAVID A. TUCKER, JR.

 

Biographical Sketch.

This is the story of a man, of whom few of you have heard.

Such is fame. For Daniel Drake was in his day the greatest

physician of the West, the founder of sound medical education

in the Ohio Valley and one of the most unique and picturesque

figures in the history of American medicine.

He was born on a farm in New Jersey, October 20, 1785. His

parents were poor; his father, Isaac Drake, being a small farmer

and proprietor of a grist-mill. When Daniel was two and one-

half years old the family joined a party migrating to the western

country, setting out to cross the Alleghanies with all their posses-

sions in an old one-horse wagon. Reaching the Ohio River they

descended by flatboat, finally settling in Kentucky at Mayslick,

twelve miles southwest of the present town of Maysville and about

seventy-five miles from Lexington. When Isaac Drake reached

Kentucky his monetary wealth consisted of a single dollar, the

price of a bushel of corn. His first land holding was thirty-eight

acres, shortly increased to fifty. In 1794 a tract of two hundred

acres of unbroken forest was acquired and although Daniel was

but nine years of age at this time, he took part in the clearing

and cultivation of the farm.

His schooling was meager, received chiefly at the hands of

itinerant schoolmasters, who usually remained in one place only

long enough to have their real characters made public and who

often left hastily, and just in time to escape the irate pioneers.

The Drake library consisted of the Bible, Rippon's collection

of hymns, Thomas Dilworth's Spelling Book, an almanac, and

 

1 An address delivered before the Ohio chapter of the Alpha Omega Alpha, honor-

ary medical fraternity, Ohio State University, January 19, 1934.

(451)

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the famous history of Montellion--a romance of chivalry. As

Daniel grew other books were added: Noah Webster's Spelling

Book, John Entick's Dictionary, Scott's Lessons, Aesop's Fables,

Benjamin Franklin's Autobiography, and William Guthrie's A

New   Geographical, Historical and Commercial Grammar.

Very early the elder Drake had formed the notion of having

Daniel study medicine. During the voyage down the Ohio River

in 1788 he had made the acquaintance of Dr. William Goforth

who first settled at Washington, Kentucky, later, in 1799, remov-

ing to Cincinnati. Half in jest and half in earnest he told Goforth

that Daniel some day should become a doctor, and that Goforth

should be his teacher. Later, when Daniel was growing up he

made the two-and-a-half day trip to Cincinnati to confirm this

agreement and to arrange the terms of the apprenticeship. Thus

it came about that in December, 1800, when he was fifteen years

of age, Daniel was taken to Cincinnati, then a small frontier town

with a population of less than a thousand, apprenticed to Goforth,

and became the first medical student west of the Alleghanies. He

describes his entrance to the study of medicine as follows:

Beginning on the 20th of December, 1800, at Peach Grove where

the Lytle house now stands, my first assigned duties were to read [John]

Quincy's Dispensatory and grind quicksilver into unguentum mercuriale;

the latter of which, from previous practice on a Kentucky hand-mill, I

found much the easier of the two. But few of you have seen the genuine,

old doctor's shop of the last century; or regaled your olfactory nerves in

the mingled odors which, like incense to the god of Physic, rose from

brown paper bundles, bottles stopped with worm-eaten corks, and open jars

of ointment, not a whit behind those of the apothecary in the days of

Solomon; yet such a place is very well for a student. However idle, he

will be always absorbing a little medicine; especially if he sleep beneath

the greasy counter. But I must leave off philosophizing and return to

my narrative. New studies and a new studio awaited me; and through

the ensuing spring and summer the adjoining meadow with its forest

shade-trees, and the deep and dark wood of the near banks and valley of

Deer Creek, acted in the manner of the wilderness on the young Indian,

caught and incarcerated in one of the schoolhouses of civilization. Under-

neath those shade-trees, the roots of which still send up an occasional scion,

or among the wild flowers of the wood, which exhaled incense to Flora

instead of Aesculapius, it was my allotted task to commit to memory

Chesselden on the bones, and Innes on the muscles, without specimens of

the former or plates of the latter; and afterwards to meander the currents

of humoral pathology, of [Herman] Boerhaave and Van Sweiten; without

having studied the chemistry of [Jean Antoine, Comte de Chanteloup]

Chaptal, the physiology of [Albrecht von] Haller, or the Materia Medica

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DANIEL DRAKE                      453

 

of [William] Cullen. Such was the beginning of medical education in

Cincinnati. I say beginning, for I was its first pupil.

In May, 1804, Drake began the practice of medicine as a junior

partner with Goforth, and doubtless without having ever wit-

nessed the dissection of the human body or a single experiment

in chemistry was dubbed "doctor."

Stirred by the writings of Benjamin Rush and the enthusiasms

of Dr. John Stites, Jr., who had come from the East, and moved

by his own ambitions Drake determined in 1805 to go to Phila-

delphia for further study. At this time Goforth presented him

with an autograph diploma reading as follows:

I do hereby certify, that Mr. Daniel Drake has pursued under my

direction, for four years, the study of Physic, Surgery and Midwifery.

From his good Abilities and marked Attention to the Prosecution of his

studies, I am fully convinced that he is qualified to practice in the above

branches of his Profession.

WM. GOFORTH, Surgeon General

1st Division Ohio Militia.

CINCINNATI, STATE OF OHIO, August 1, 1805.

This was the first medical diploma ever granted west of the

Alleghanies.

After a three weeks' journey, mainly on horseback, Drake

arrived in Philadelphia on the ninth of November, 1805, and pro-

ceeded to purchase tickets for Rush's lectures on physic; James

Woodhouse's on chemistry; Caspar Wistars' on anatomy; and

Philip S. Physick's on surgery, at a cost of $70. The lectures

closed in March, 1806, and Drake immediately turned toward the

West again, reaching Cincinnati in April. He commenced prac-

ticing at Mayslick, his father's home, in the summer. In April,

1807, Drake removed to Cincinnati to take over Goforth's practice

as the latter had determined to go to New Orleans. In the same

year Drake was married to Miss Harriet Sisson, the niece of

Colonel Jared Mansfield, surveyor-general of the United States.

Occupied by practice, by commercial activities and services of

varied and public nature until 1815, Drake again went to Phila-

delphia, and after a winter of study received a diploma and a

doctor's degree from the University of Pennsylvania. The illness of

his wife required Drake's absence at the time of the regular com-

mencement so that the faculty awarded his degree at a special

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convocation. In 1816 practice was resumed in Cincinnati. Drake

had in 1810 published a small work called Notices concerning Cin-

cinnati, describing the geography, topography and botany of the

Cincinnati region, together with notices of the local industries and

institutions. The section on medical botany gained him some rec-

ognition among medical men and doubtless influenced Dr. Ben-

jamin Dudley, the distinguished surgeon of Lexington and organ-

izing genius of Transylvania, to urge Drake in 1817 to become

professor of materia medica in that institution. After considerable

deliberation he accepted and removed to Lexington, remaining only

one year. When he returned to Cincinnati he projected a sys-

tematic course of instruction for medical students, a private ven-

ture which culminated in 1819 in the founding of the Medical

College of Ohio, in spite of much opposition due to personal jeal-

ousy. Drake appeared before the State Legislature and his efforts

resulted in the passage of the law chartering the college. By this

law Drake became the president of the Board of Trustees and

professor of the institutes and practice of medicine. Internal dis-

sensions soon arose and several members of the faculty resigned.

In March, 1822, at a meeting of the surviving faculty of three,

Drake was expelled. In a pamphlet entitled A Narrative of the

Rise and Fall of the Medical College of Ohio (Cincinnati, 1822),

one of the choicest bits of satire and sarcasm in our literature,

Drake describes the meeting at which he was removed from the

faculty as follows:

On the morning of this day, Doctor [Benjamin] Bohrer resigned; and

the faculty was then reduced to Dr. [Jesse] Smith, Mr. [Elijah] Slack and

myself. Immediately after the citizens' committee was appointed, two of

its members waited upon each of us, and upon those who had resigned, to

say that they would meet the next morning, and to invite the whole to

attend personally, or make written communications to them. Messrs. Smith

and Slack informed this sub-committee that they meant, before they slept,

to expel me and let the investigations be made afterwards. At eight o'clock

we met according to a previous adjournment, and transacted some financial

business. A profound silence ensued, our dim taper shed a blue light over

the lurid faces of the plotters, and everything seemed ominous of an

approaching revolution. On trying occasions, Dr. Smith is said to be sub-

ject to a disease not unlike Saint Vitus' Dance; and on this he did not

wholly escape. Wan and trembling he raised himself (with the exception

of his eyes) and in lugubrious accents said, "Mr. President--In the reso-

lution I am about to offer, I am influenced by no private feelings, but

solely by a reference to the public good." He then read as follows:

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DANIEL DRAKE                       455

 

"Voted that Daniel Drake, M. D., be dismissed from the Medical College

of Ohio." The portentous stillness recurred, and was not interrupted till

I reminded the gentlemen of their designs. Mr. Slack, who is blessed with

stronger nerves than his master, then rose, and adjusting himself to a

firmer balance, put on a proper sanctimony, and bewailingly ejaculated:

"I second the motion." The crisis had now manifestly come; and, learning

by inquiry that the gentlemen were ready to meet it, I put the question,

which carried, in the classical language of Doctor Smith, "nemo contra-

dicente." I could not do more than tender them a vote of thanks, nor less

than withdraw, and, performng both, the doctor politely lit me downstairs.

Although public indignation compelled the rescinding of this

action within a week, Drake promptly resigned. A year later

(1823) he again joined the faculty of Transylvania as professor

of materia medica and remained for three sessions, serving as

dean for the last two. Meanwhile he acquired a large consultation

practice, patients coming to him from all parts of the South and

West, and he numbered among his friends many noted men, of

whom Henry Clay was one.

The year 1827 found Drake again in Cincinnati where he en-

gaged in practice and medical journalism until 1830. With Dr.

Jedediah Cobb he opened the Cincinnati Eye Infirmary and prac-

ticed some ophthalmic surgery. In 1830 Drake accepted the Chair

of Medicine in the Jefferson Medical College of Philadelphia

where his fame as a teacher had preceded him. It seems clear

that Drake considered this appointment as a temporary one only,

having already in mind the establishment of a second medical

school in Cincinnati as a part of the State-supported Miami Uni-

versity at Oxford, Ohio. At the end of the year, therefore, he re-

turned to the West prepared to open the new school. However, a

compromise was effected and Doctors John Eberle, James H.

Staughton and Thomas D. Mitchell who had come West with

Drake, were taken into the Medical College of Ohio. Drake having

been given a subordinate position, resigned after one session.

In 1835, Drake revived the old Cincinnati College with depart-

ments of medicine, law and arts. For four years this medical

school was highly successful, its faculty including besides Drake,

Doctors Samuel D. Gross, Willard Parker and Joseph N. Mc-

Dowell. Without endowment and lacking public support it was

finally permanently suspended in spite of the fact that its faculty

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456    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

was probably the most brilliant ever assembled in the Ohio Valley.

Drake, apparently tired of the continual fight against odds, ac-

cepted in 1840 the professorship of materia medica and pathology,

later of practice, in the Louisville Medical Institute where he re-

mained for ten years. During this time he spent much time in

the preparation and the writing of his monumental work, A Sys-

tematic Treatise on the Principal Diseases of the Interior Valley

of North America (Cincinnati and Philadelphia, 1850-1854).

Called in 1850 to the Medical College of Ohio, he spent one ses-

sion as a lecturer, then returned to Louisville. In 1852 at the

earnest request of the real friends of the Medical College of Ohio

he agreed to resume a place in that institution in order to stave

off what appeared to be its inevitable dissolution. Although he

began college work, he was suddenly taken ill in October and died

on November 6, 1852, his death being due to pneumonia and

meningitis.

In his full and busy life Drake experienced much personal

sorrow and sadness. Two children died at an early age and in

1825, his wife, to whom he was passionately devoted, succumbed

to malignant autumnal fever. In spite of a lucrative practice,

Drake amassed no fortune, being very generous to his family and

friends, unfortunate in investments, and leaving practically no

estate.

Drake as a Physician.

There is abundant evidence of Drake's skill as a physician.

Gross dedicated his Pathological Anatomy (Cincinnati, 1839) to

Drake in the following terms:

To Daniel Drake:

Distinguished alike as an accomplished and successful teacher, an

erudite and skillful physician, a zealous promoter of science and literature,

and an ardent friend of pathological anatomy, the following pages intended

to illustrate one of the fundamental branches of medical science, are respect-

fully inscribed, as a testimony of esteem for his exalted talents and attain-

ments, and as a token of sincere regard for his character.

Drake's fame as a physician was such as to attract patients

from great distances, and he was a busy consultant during his

entire career whether living in Cincinnati, Lexington or Louisville.

Shute, in his book Lincoln and the Doctors, states that in 1841

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DANIEL DRAKE                      457

 

"Lincoln wrote to Dr. Daniel Drake--a man who deservedly en-

joyed a splendid reputation throughout the great West." In a

long letter, Abraham Lincoln described his symptoms and asked

Drake to suggest a line of treatment, but the doctor replied that

it would be impossible to prescribe without a personal interview,

which would naturally include a physical examination. Albert J.

Beveridge in his Abraham Lincoln (Boston, 1928) adds this foot-

note:

Daniel Drake was the author of Pioneer Life in Kentucky [(Cincinnati,

1870)], so frequently cited in Chapter II of this volume. He was about

fifty-five years of age when Lincoln wrote him, the acknowledged head of

his profession and greatly admired and respected. Few men have had a

more brilliant career. Lincoln could not possibly have done better than to

have gone to Cincinnati and personally consulted this wise, experienced and

highly educated physician.

When Drake began the study of medicine physical diagnosis

as it is known today did not exist. Diseases were classified prin-

cipally on the basis of symptoms. Giovanni Battista Morgagni

had published in 1761 his great work De Sedibus et Causis Mor-

borum which translated is The Seats and Causes of Diseases, and

in the same year Auchbrugger had written the Inventum Novum,

describing percussion as a means of detecting diseases, particularly

in the chest. It was not, however, until Baron Jean Nicolas de

Corvisart-Desmarets (Napoleon Bonaparte's physician) translated

this latter work into French (in 1808) that it received acceptance

by the profession. The tremendous work of Marie Francois

Xavier Bichat in founding normal and pathological histology was

being accomplished. The epoch-making discoveries of Rene Theo-

phile Hyacinthe Laennec were yet to be made. Drake, however,

in spite of his backwoods isolation, became a most astute practi-

tioner of the art of percussion and auscultation, and in this he

was practically self-taught. Certain fortunate circumstances ap-

pear to have been responsible for his acquisition of such skill and

knowledge almost before the methods had become known on the

eastern seaboard. These were his association in 1817 and again

in 1823-1827 at Lexington, with physicians who had been post-

graduates in the hospitals of Paris, under Corvisart, Bichat,

Francois Joseph Victor Broussais, and Laennec; and the develop-

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458    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

ment of the extensive library of contemporary French medical

literature at Transylvania. Fortunately, this magnificent collection

of books has been rehabilitated after more than a half century of

storage in attics and cellars. Not long ago the author had the

great pleasure of examining many works which had no doubt been

studiously read by Drake himself.

It is interesting to note what Drake wrote of these methods.

In the section on pneumonia in his Principal Diseases is the fol-

lowing:

Physical Signs--Notwithstanding the sufficiency of the symptoms for

a correct diagnosis in ordinary and well-developed cases, we are by no

means to neglect or undervalue the signs afforded by auscultation and per-

cussion; the knowledge of which, in this and other maladies of the chest,

constitutes one of the greatest triumphs of medicine, and, in some cases of

disease, one of the most valuable. Yet the physical signs, in a certain sense,

but reveal to us through the ear, during life, what the scalpel will disclose

to the eye after death. They largely depend on derangements of structure,

and, in a much more limited degree, give indication of the pathological

actions from which these derangements result, and which it is the object

of treatment to avert. . . .

To reason against the practical value of percussion and auscultation,

ab ignorantia, would be manifestly absurd. Yet when writing in and for

an age and country, where a most imperfect knowledge of these signs exist,

it is agreeable to believe that our practice may, in the majority of cases,

be safely guided by the symptoms. The degree of inflammatory action is,

in every case, that which must determine the amount of treatment which

is applicable to all cases: and this is indicated by the state of the pulse,

of the drawn blood, of the skin and the tongue, taken in connection with

the structure, cough and expectorated mucus. Percussion and auscultation

tell us of the effects produced by the inflammation, and may suggest a

great deal on the prognosis of the case, and on what may be called the

secondary treatment. . . . It still remains, however, as our great duty,

to prevent the lesions of structure by subduing the inflammation, and this,

I am disposed to believe, is, on the whole, as successfully accomplished by

the physicians of the Interior Valley as by those in the great cities of the

Atlantic States or of Europe.

The fundamental cause of defective skill in percussion and auscultation

is the want of a familiar acquaintance with the natural and healthy sounds

of the chest and lungs: the study of which by personal experiment and

observation on all ages, sexes, and classes of persons, should be enforced

in the office of the private preceptor: for it cannot be prosecuted either

in the university or hospital. To come up to the study of the pathological

or abnormal sounds without this knowledge of the physiological, is as

absurd as to study the hyperinosis of the blood in pneumonia, or its hypinosis

in typhus fever or scorbutus, without having first acquired a knowledge of

its proximate elements in health. Yet the few who have an opportunity,

during their two short courses of lectures, of examining dispensary or

hospital patients, generally take up the pleximeter and the stethoscope, in

utter ignorance, as far as observation is concerned, of the normal thoracic

and pulmonary sounds; and of course the knowledge they acquire is super-

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DANIEL DRAKE                        459

 

ficial, inaccurate, and unreliable. The teaching of auscultation and per-

cussion has very unfortunately been made a specialty, which has suggested

to thousands that it cannot be prosecuted without the aid of a teacher. I

know of nothing in our science, in which a man can be more successfully

his own teacher. Any one of the numerous admirable works on these

subjects with his own fingers and ears, even unarmed with pleximeter or

stethoscope, will enable any young physician, in a brief period of time,

to become au fait in these means of thoracic diagnosis.

A paper written by Drake in 1827 entitled "The Modus

Operandi and the Effects of Medicine" was an attempt to do

the impossible, namely, to systematize a subject where only im-

perfect knowledge existed. It was, however, an heroic effort, and

gives considerable information concerning Drake's therapeutic no-

tions. As Otto Juettner remarks in his Daniel Drake and His

Followers (Cincinnati, 1909), page 76, "He was a champion of

moderation of dosage and adaptation of physiological effects to

pathological processes."

Drake as a Medical Educator.

In 1832, Drake published Practical Essays on Medical Educa-

tion and the Medical Profession in the United States (Cincinnati),

dedicating it to the students composing the twelfth graduating

class of the Medical College of Ohio. The titles of the seven

essays were as follows:

1. Selection and Preparatory Education of Pupils.

2. Private Pupilage.

3. Medical Colleges.

4. Studies, Duties and Interests of Young Physicians.

5. Causes of Error in the Medical and Physical Sciences.

6. Legislation Enactments.

7. Professional Quarrels.

This work is even now worth careful study by our medical

educators and as Fielding H. Garrison remarks, it and Abraham

Flexner's Medical Education in the United States and Canada

(Carnegie Foundation for the Advancement of Teaching, 1910)

are the two most significant American contributions to the subject

and deserve a place along with the essays of Thomas Hodgins

and Theodor Billroth. Had these essays been carefully consid-

ered by those who subsequently founded or developed medical

schools, there would never have been any necessity for the Car-

negie report on Medical Education in the United States.

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Drake favored a graded course of at least four years, advo-

cated a classical education as preparatory to the study of medicine

and emphasized the necessity of careful bedside teaching.

In discussing hospital instruction Drake spoke as follows:

And here allow me to say, that all the tendencies of the age are to

the study of medicine and surgery in hospitals. In them it is, that the

student learns pathological anatomy, diagnosis, the art of prescribing and

operative surgery. The laboratory is not more necessary for the study of

chemistry, or a garden of plants for the study of botany, than a hospital

for the study of practical medicine and surgery. The time has passed by

when students will flock to men of genius (as they once flocked to Boer-

haave) for the purpose of listening to expositions of theory, or to be

amused with creations of imagination. The school which is not based on

a hospital, may have learned and able professors; but the results of their

teaching can never be satisfactory to the student, who seeks to make him-

self a good, practical physician and surgeon. A  mathematician might

compose an admirable system of navigation, but you would prefer to trust

yourselves, on a dangerous voyage, with one of more practical skill, though

less learned.

From several other essays the following quotations are taken:

Of the various occupations in society, scarcely one requires greater

talent and knowledge than the medical profession.

The student of medicine should not only be of sound understanding,

but imbued with ambition. A mere love of knowledge is not to be relied

upon, for the greatest lovers of knowledge are not infrequently deficient

in executive talents, and go on acquiring without learning how to appro-

priate. A thirst for fame is indeed a safer guaranty than a taste for

learning, as it generates those executive efforts which are indispensable to

the successful practice of medicine.

Further, the temperament of the youth should be that of industry and

perseverance, without which he will balk at every difficulty, and require

to be goaded on through all stages of his pupilage. An indolent or irreso-

lute student, whatever may be his genius, can never figure as a physician,

and should, without delay, be apprenticed to some vocation in which the

destruction of limbs and life will not be the inevitable consequence of idle-

ness and discouragement. We may hope that the time is not distant when

the proportion of talented youth who are dedicated to the study of physic

will be much greater than at present.

The consequences of this deficiency of talent in the profession are of

serious import to the science and to the people at large. It is unquestion-

ably one of the causes which retard the progress of discovery and improve-

ment. Of the thousands who annually go forth with diplomas or licenses,

or without either, to engage in the practical duties of the profession, very

few ever contribute a single new fact to its archives, or communicate an

impulse to the minutest wheel of its complicated machinery. Acting on

the precepts of others, they may, it is true, do some good, but they also

do much harm; while to the great work of revising and correcting the

principles of the science they are, of course, utterly incompetent.

But a thorough course of preparatory learning is useful in more ways

than one. It establishes early habits of application; generates a love of

knowledge; trains the faculties; and inspires that firmness of purpose which

prevents him who puts his hand to the plough from looking back. These

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DANIEL DRAKE                            461

 

are the cardinal virtues of a student; and they are in a great degree the

effect of cultivation. We look instinctively at the grand and beautiful

aspects of nature, but this is poetry, not philosophy. A poet delineates

the surface; a philosopher decomposes the substance of things. One is

born, the other called to his vocation. Education never made a great poet,

nor nature a good philosopher. He is essentially the product of art. Toil

is his destiny. He must sink a deep shaft and draw up his treasures from

below. Therefore he should be strengthened by timely and active effort.

He must be inured to labor, and acquire adroitness in its performance.

Hence he should begin early, for then only can suitable habits be formed.

The principal branches of literature and auxiliary science to which the

student of medicine should devote a portion of his time are:

1. English grammar and the art of composition.

2. Physical geography, embracing the leading facts in meteorology.

3. The outlines of history.

4. The elements of mathematics and natural philosophy.

5. The French language.

6. The Latin and Greek languages.

In medicine, as the other sciences, that method is best which requires

the student to take nothing on trust--to anticipate no principle or leading

fact. The whole course should, therefore, as far as possible, be purely

synthetical.

Finally, he arrives, by a regular transition, at the practice of the pro-

fession--its therapeutics and operations. He studies the indications of cure,

and labors to establish in his mind correct associations between symptoms

and remedies--an association not arbitrary and empyrical, but founded on

an ample and accurate knowledge of the functions of the living body in

their regular and irregular conditions; and of the influence of external

agents in the production and cure of diseases.

1. If he now finds deficiencies in any of his preliminary acquirements,

he should supply them, without delay, by recurrence to the branches in

which they are discovered to exist.

2. In ascertaining general principles he should carefully note those

which are of a doubtful character and rest upon them as few rules of

practice as possible.

3. His practical maxims, in all cases, should be logical deductions

from his principles.

4. If they do not conform to those of the great and original writers

of the profession, he should doubt their correctness and act upon them

cautiously, but not reject them without trial.

5. He should recollect that the same diseases in different countries,

frequently require variations in their treatment, and that he must not im-

plicitly adopt the rules of practice that have been found successful elsewhere.

6. When he meets, in practical work, with different modes of treat-

ment for the same disease, he should not suppose that one only can be

correct and the others necessarily erroneous, for disease may be cured by

various methods.

7. In his practical readings he should always prefer original works

to compilations, and monography to systems.

8. He must be on his guard against the delusion of a fancied sim-

plicity in the system which he constructs. Every complex machine is liable

to a variety of irregular movements which can only be reduced to order

by a corresponding diversity of means. But of all machines, the human

body is the most complicated, exhibits the greatest number of disordered

actions, all differing from each other, and requires the greatest variety of

remedial applications.

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9. When arrived at this stage of his studies, he should no longer

stand aloof from the practical duties of the profession, but avail himself

of frequent opportunities to make an application of his knowledge. This

is the end for which he has studied, and his final success will be propor-

tionate to the facility and effect with which he can make such application.

For myself, I am convinced that every medical school ought to have

eight professors, and that with less than six, it should, in the phrase of

Lord [Francis] Bacon, "be noted as defective." As to the distribution of

the duties, there may be some diversity of opinion; but the profession,

generally, would perhaps concur in the following: (1) anatomy, (2) in-

stitutes of medicine, (3) practice of medicine and clinical cases, (4)

surgery, (5) materia medica, (6) chemistry and pharmacy, (7) obstetrics,

(8) medical jurisprudence.

I shall here offer a summary view of the desiderata which our medical

institutions seem to me to present, and shall make no other apology for

the repetition it may involve than the great importance of the subject:

1. An increase in the length of our sessions to at least five months.

2. An augmentation of the number of professors to at least seven,

with a general refusal to recognize schools that have not more than four

or five.

3. The election of professors for five or seven years, instead of an

indefinite time.

4. Students should not be allowed credit for a course unless they

matriculated by the end of the first week of the didactic lectures and then

remained to the end of the session.

5. At least four years should elapse from the commencement of the

pupil's studies until his graduation.

6. He should be required to show that he is twenty-one years old.

7. Increased attention should be paid to the preparatory or academical

attainments of candidates.

8. The examinations for a degree should be more searching than they

are generally made. This, it is true, would diminish the amount of gradu-

ation fees received by professors, but the public would be gainers.

9. Every candidate should be required to publish his thesis, and a

premium should be awarded to the author of the ablest of these productions.

10. Summer lectures, especially on the collateral and auxiliary sciences,

ought to be encouraged, and the candidate should be required to have some

knowledge of those branches.

11. A stricter regard should be had to the moral character of candi-

dates, who should never be admitted to examination until they had deposited

with the dean satisfactory evidences of good reputation.

12. Lastly, as a means of promoting this object and of advancing the

respectability of the profession, there should be in every medical school a

series of Sunday morning discourses by one of the professors on the

morale of the profession and the virtues and vices of medical men, em-

bracing their duties to their patients and a system of medical ethics.

I shall conclude with a few hints to professors on the means of

making their prelections interesting and instructive.

A dull lecture is a great evil. Politeness may reconcile the majority

of a class to such a lecture, but it falls dead-born from the lip of the

professor.  To listen, day after day, for several hours, through four

months, even to animated speakers, is a serious undertaking; but to sit

from hour to hour, beneath those who, "through the long, heavy, painful

page, drawl on," is intolerable to all who have not a facility in resorting

to early and sound sleep; the usual and best resource under such a calamity.

There is an eloquence of the lecture-room as well as of the bar and

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DANIEL DRAKE                         463

 

pulpit which every professor should attain, or feel himself in duty bound

to resign, so as not to exclude a competent man.

The faculty of awakening and sustaining the attention of an audience

is in some degree a gift of nature, and may be wanting when other

requisites are not. An original or eccentric manner is often the secret of

success; illustrations by means of anecdotes, skillfully introduced, produce

the same effect; episodes may be so managed as to answer the purpose;

flights of fancy, if well-timed, will accomplish the end in view; while in

the absence of a talent for the whole of these, unexpected and pertinent

questions with familiar conversational remarks on the answers that may

be given, will resuscitate the drooping energies of the class and enable

them to hold out to the end.

As a teacher Drake was able, captivating and impressive.

David W. Yandell, one of his confreres at Transylvania, wrote:

"As a lecturer Doctor Drake had few equals. He was never dull.

His was an alert and masculine mind.        His words are full of

vitality. His manner was earnest and impressive. His eloquence

was fervid."

Concerning his appearance in the class room Gross says:

It was here, surrounded by his pupils, that he displayed it [character]

with peculiar force and emphasis. As he spoke to them, from day to

day, respecting the great truths of medical doctrine and medical science,

he produced an effect upon his young disciples such as few teachers are

capable of creating. His words dropped hot and burning from his lips,

as the lava falls from the burning crater; enkindling the fire of enthusiasm

in his pupils, and carrying them away in total forgetfulness of everything,

save the all-absorbing topic under discussion. They will never forget the

ardor and animation which he infused into his discourses, however dry or

uninviting the subject; how he enchained their attention, and how, by his

skill and address, he lightened the tedium of the class-room. No teacher

ever knew better how to enliven his auditors, at one time with glowing

bursts of eloquence, at another with the sallies of wit; now with a startling

pun, and anon with the recital of an apt and amusing anecdote; elicting,

on the one hand, their admiration for his varied intellectual riches, and,

on the other, their respect and veneration for his extraordinary abilities

as an expounder of the great and fundamental principles of medical science.

His gestures, never graceful, and sometimes eminently awkward, the pe-

culiar incurvation of his body, nay, the very drawl in which he frequently

gave expression to his idea, all denoted the burning fire within, and served

to impart force and vigor to everything which he uttered from the rostrum.

Of all the medical teachers whom I have ever heard, he was the most

forcible and eloquent. His voice was remarkably clear and distinct, and

so powerful, that when the windows of his lecture-room were open, it

could be heard at a great distance. He sometimes read his discourse, but

generally he ascended the rostrum without note or scrip.

His earnest manner often reminded me of that of a venerable Metho-

dist preacher, whose ministrations I was wont to attend in my early boy-

hood. In addressing the Throne of Grace, he seemed always to be wrestling

with the Lord for a blessing upon his people, in a way so ardent and

zealous as to inspire the idea that he was determined to attain what he

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464    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

asked. The same kind of fervor was apparent in our friend. In his lec-

tures he seemed always to be wrestling with his subject, viewing and ex-

hibiting it in every possible aspect and relation, and never stopping until,

like an ingenious and dexterous anatomist, he had divested it, by means of

his mental scalpel, of all extraneous matter, and placed it, made and life-

like, before the minds of his pupils.

There is no question but what teaching and medical education

formed the greatest interest in Drake's life. In thirty-five years

he held nine professorships in five different schools, and in these

years no less than one-third of all graduates in the Ohio Valley

came under his instruction. How great an influence he exerted

in the development of the medical profession, cannot be measured

but only imagined. In the latter part of his life he was frequently

heard to say, "Medical schools have consumed me."

 

Drake as an Editor and Author.

As an editor and author Drake won preeminence and was one

of the foremost medical writers in the West. For many years,

1827 to 1838, he owned and edited the Western Journal of the

Medical and Physical Sciences (Cincinnati). He wrote with

facility. His style is robust, incisive, vigorous and full of anima-

tion, rising at times to heights of eloquence. Witness such state-

ments as these:

Medicine is a physical science, but a social art.

If a young tree cease to grow, we expect it to die. We know the

law of nature to be, that if it should not be advancing to full development,

it will recede.

An overweening regard for authority in the sciences is the offspring,

either of a slender understanding or a timid spirit, still further enfeebled

by bad education.

A medical professorship, is indeed a public office; and should be filled

or made vacant from no other motive than the general good.

Medical science has often been cultivated out of the large cities.

Drake's first work was Notices concerning Cincinnati published

in 1810. Following this there were frequent publications, essays

on social and medical subjects, contributions to the current medical

literature, and finally his greatest work, The Principal Diseases

of the Interior Valley of North America, the second volume of

which was not published until after Drake's death and was edited

by Doctors S. Hanbury Smith of Starling Medical College and

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DANIEL DRAKE                         465

Francis C. Smith of Philadelphia. This treatise culminated a life-

time of observation, investigation and compilation, involving every

conceivable hardship in his thirty thousand miles of travel extend-

ing from the Gulf of Mexico to Hudson Bay, from the Alleghanies

to the Sierras, from the headwaters of the St. Lawrence to the

prairies of the Far West. He traversed this vast area in every

direction on foot, on horseback, by boat or railroad. He spent

time, money and an enormous amount of labor in securing the

material for his great work. It was an original investigation,

peculiarly American in its subject, method of treatment and com-

position. As Garrison says, "Drake was the first after Hippocrates

and [Thomas] Sydenham to do much for medical geography, and

has a unique position of his own in relation to the topography of

disease." Nothing like it had appeared since Hippocrates wrote

on Airs, Waters and Places. The first volume is concerned mainly

with medical geography; the second with the description of febrile

diseases. These latter were grouped as autumnal, yellow, typhus,

eruptive and phlogistic fevers, and contain clear and complete

descriptions of the clinical features of these conditions.

It would be of interest to describe in more detail the character

and magnitude of this work but space does not permit. It should,

however, be pointed out that Drake believed in, although he could

not prove, the infectious nature of many diseases. In 1832 he

had surmised cholera to be of animalcular origin, and later thought

the same of tuberculosis and typhoid. In Volume II of the

Principal Diseases he wrote:

I have united two words to express an hypothesis which ascribed

autumnal fever to living organic forms, too small to be seen with the

naked eye; and which may belong either to the vegetable or animal kingdom,

or partake of the characters of both.

In the year 1832, I published in the Western Medical and Physical

Journal, of which I was the editor, a series of papers on Epidemic cholera,

which were afterward collected and enlarged into a small volume; in which

an attempt was made to show, that the mode in which that disease spreads,

was more fully explained by the animalcular hypothesis than by any other

which had been proposed. The brief investigation then given to the sub-

ject, reinspired my respect for the opinion long before expressed, that

autumnal fever, and many other forms of disease, might be of animalcular

origin; and the discoveries since made by the Ehrenberg school, have seemed

to render that doctrine still more probable. But I have neither had time

nor means for experimental or bibliographical inquiry; and do not propose

to dwell very long upon the subject in this place.

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Among visible plants and animals, there are species that form no

poison, and others which secrete that, which applied to, or inserted in our

bodies, produces a deleterious effect, which is generally of a definite kind.

Thus, the venom of the rattlesnake produces a disease of definite form; can-

tharides another; certain fish are poisonous when eaten; wasps and bees instil

a venom; and the smallest visible gnat, as that which inhabits the forests of

the middle latitudes, and that which is known under the name of sand-fly

on the shores of the Gulf of Mexico, inflames the skin; while the juice of

stramonium, the exhalations of the thus toxicodendron, and the fungus

which grows beneath its shade, excite peculiar diseases. It seems justifiable

to ascribe, by analogy, to microscopic animals and plants the same diversity

of properties which we find in larger beings, differing from them, as we

may presume, in nothing but size and complexity of organization. We may

suppose, then, that while many species of this minute creation are harmless,

there are others, which can exert upon our systems a pernicious influence.

 

Conclusion.

Those activities of Drake's which were directly related to

medicine have been touched upon and now the many other fields

in which he was engaged will be mentioned.

In his earlier periods of residence in Cincinnati he was the

chief leader in the literary enterprises of the day, such as the

Library Society, the Debating Society, the School of Literature

and Art, and the Lancastrian Seminary which became the founda-

tion of the Cincinnati College. He established the first public

hospital, from which has developed the present Cincinnati Gen-

eral; he procured the passing of laws to found orphanages; he

suggested and outlined a canal system for the Middle West; he

projected the building of a railroad from Cincinnati to Charles-

ton, South Carolina, anticipating and giving impulse to the con-

struction, later, of the Southern Railway. He aided in the organi-

zation of the Little Miami Railroad, now a part of the Pennsyl-

vania system.

Sir William Osler, who was greatly fascinated by the story

of Drake, wrote in March, 1912, to Paul Wooley, then dean of

the Medical College of the University of Cincinnati in part as

follows:

I want to see a fine monument to Daniel Drake in Cincinnati, one really

worthy of the man. He was a great character, and did a remarkable work

for the profession in the West. I hope to see some rich Cincinnatian put

up a $25,000 monument to him--he is worth it. He started nearly every-

thing in Cincinnati that is good and has lasted. If anybody will give the

amount I will come out and give a regular "Mississippi Valley" oration.

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DANIEL DRAKE                         467

 

Drake was intensely interested in the social movements of

his day, advocating both temperance and abolition when it took

great courage to speak publicly on these questions.

In a study of Drake's life and personality one is quickly

struck with his great facility for making both friends and enemies.

He had a limitless loyalty for his friends and unforgiving relent-

lessness for his enemies; he indulged in bitter quarrels, in his

younger days, even in physical combat; but these traits must be

viewed to some extent as an expression of the day and time in

which he lived. Undoubtedly he was of an aggressive disposition,

deeming it his duty to resent every insult, real or imaginary, that

was offered to him. This impulsive nature became restrained later

in life and Gross wrote of him, "As a colleague or companion no

man could have been more agreeable, more considerate, or more

honorable."

Gross has left a striking word-picture of Drake, which is here

quoted:

His personal appearance was striking and commanding. No one could

approach him, or be in his presence, without feeling that he was in contact

with a man of superior intellect and acquirement. His features, remarkably

regular, were indicative of manly beauty, and were lighted up and im-

proved by blue eyes of wonderful power and penetration. When excited

by anger or emotion of any kind, they fairly twinkled in their sockets, and

he looked as if he could pierce the very soul of his opponent. His counte-

nance was sometimes staid and solemn, but generally, especially when he

was in the presence of his friends, it was radiant and beaming. His fore-

head, though not expansive, was high, well-fashioned, and eminently denotive

of intellect. The mouth was of moderate size, the lips of medium thickness,

and the chin rounded off and well-proportioned. The nose was prominent,

but not too large. The frosts of sixty-seven winters had slightly silvered

his temples, but had made no other inroad upon his hair. He was nearly

six feet high, rather slender, and well-formed.

His power of endurance, both mental and physical, was extraordinary.

He seemed literally incapable of fatigue. His step was rapid and elastic,

and he often took long walks sufficient to tire men much younger, and

apparently, much stronger than himself. He was an early riser, and was

not unfrequently seen walking before breakfast with his hat under his

arm, as if inviting the morning breeze to fan his temple and cool his burn-

ing brain.

His manners were simple and dignified; he was easy of access, and

eminently social in his habits and feelings. His dress and style of living

were plain and unostentatious. During his residence in Cincinnati, previ-

ously to his connection with this University, his house was the abode of a

warm but simple hospitality. For many years no citizen of that place enter-

tained so many strangers and persons of distinction.

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In Spring Grove Cemetery in Cincinnati there is a simple

monument marking Drake's final resting-place which reads:

Sacred to the memory of Daniel Drake, a learned and distinguished

physician, an able and philosophic writer, an eminent teacher of the medical

art, a citizen of exemplary virtue and public spirit, a man rarely equalled

in all the gentler qualities which adorn social and domestic life. His fame

is indelibly written in the records of his country. His good deeds, im-

pressed on beneficent public institutions, endure forever. He lived in the

fear of God and died in the hope of salvation.

He who rests here was an early inhabitant and untiring friend of the

City of Cincinnati with whose prosperity his fame is inseparably connected.

• 18