Ohio History Journal

THE ROLE OF THE "DISTRICT" AS A UNIT IN OR-

GANIZED MEDICINE IN OHIO1

 

By ROBERT G. PATERSON, PH.D.

 

Use of the "district" as a basic unit of medical organization

and administration is, historically, the oldest in the State. It ante-

dates the county, city and state medical societies. A "district" in

the sense in which it is used here includes within its area two or

more counties. From 1811 to 1902 the history of medical organi-

zation in Ohio is full of the trial and error method in attempting

to find a satisfactory unit or units as the basis for local organiza-

tion.²

Broad Outline of Developments

Beginning in 1811 and continuing to 1833, known as the le-

gal period of organization, the laws of the State established medi-

cal districts in the then existing counties. "The first of Ohio's

eighty-eight counties (Washington) was established in 1788. The

last revision in the boundaries (Auglaize, Logan) was made in

1888, exactly one hundred years later."3      By 1833 there were

seventy counties in the State. Population was sparse and scat-

tered. The 1830 census showed 937,903 population. Physicians

were few in number and likewise scattered. Roads and transpor-

tation were primitive. So it was natural for the State legislature

to adopt the district as the basis for the establishment of local

boards of censors, the prime purpose of which was to license

physicians to practice within the State. The law of 1812 went

one step further when it provided for a State medical convention

to be composed of representatives from each of the five medical

districts. From 1811 the number of districts grew from five until

in 1833 there were twenty-two districts set up. After the repeal

 

1 While the period set for discussion covered the years 1885-1858, it was thought

best to treat this subject as a complete unit from 1811 to 1940.

2 See Guy Thompson, District Medical Organization in Ohio. Thesis, M.A., Ohio

State University, Columbus, Ohio, 1987.

3 R. C. Downes, "Evolution of Ohio County Boundaries," Ohio State Arch-

aeological and Historical Quarterly (Columbus, 1887.), XXXVI (1927), 340ff.

(367)

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368   OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

of all such laws in 1833 physicians had no means of congregating

in meetings other than those of local scope. The first of these was

the Cincinnati Medical Society organized in 1819.

In 1835 the first form of voluntary State medical organiza-

tion was created. It was known as the "Ohio Medical Conven-

tion." The present Ohio State Medical Association rightly traces

its origin to this date. The convention continued to 1851 when it

was merged with the Ohio State Medical Society organized in

1846. At first members of the State convention were listed in-

dividually from counties. By the time the State society was or-

ganized, Ohio had been divided into 83 counties. Population had

increased to 1,980,329 in 1850. Physicians also had increased in

number. Transportation and the means for travel had improved

vastly. Roads and canals had been spread in every direction

throughout the State.

Since the State meeting occured but once a year there was a

growing demand upon the part of physicians for some medium

through which they could gather together more frequently to dis-

cuss their professional problems. These media took two forms--

the county medical society and the district medical society. One

of the earliest considerations before the State society was the mat-

ter of determining what should constitute an auxiliary society. In

1857 it was deemed necessary to incorporate in the constitution of

the State society a provision which sought to improve reports

from the local societies both district and county. With variations

this attitude was continued until 1902 when all district societies

were excluded as auxiliaries and the county form was adopted as

the sole unit of organization.

 

Legal Period of District Medical Organization

A more detailed examination of the legal period of district

medical organization reveals a number of interesting develop-

ments and merits attention at this point.

Dr. Samuel Prescott Hildreth of Marietta was elected to the

House of Representatives from Washington County in 1810.

Almost immediately after taking his place in the General As-

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OHIO MEDICAL HISTORY, 1835-1858              369

sembly he introduced a bill seeking to give the State some measure

of control over those individuals who sought to heal the sick. In

a preamble to the bill⁴ it is stated, "Whereas the practice of physic

and surgery is a science so immediately interesting to society that

every encouragement for its promotion should be given, and every

abuse of it, so far as possible suppressed."

The law, effective January 14, 1811, divided the State into

five medical districts. A board of three medical censors or exam-

iners, members of which were named in the law, was provided in

each of the five districts. The boards were to meet on the first

Monday of June and November at designated centers, viz: Cin-

cinnati, Chillicothe, Athens, Zanesville, and Steubenville. Exami-

nation of the membership of these five district boards reveals

some illustrious names in the annals of medical history in Ohio.

They are as follows:

District 1. Joseph Canby, Richard Allison, Daniel Drake.

District 2. Edward Tiffin, Alexander Campbell, Joseph Scott.

District 3. Leonard Jewit, Eliphas Perkins, Samuel P. Hildreth.

District 4. John Hamm, John J. Brice, Robert Mitchell.

District 5. George Wilson, John M'Dowell, Thomas Campbell.

At the very next session of the General Assembly, the law of

1811 was repealed and a new law⁵ enacted, effective February 8,

1812. Again we find a preamble stating "Whereas well regulated

medical societies have been found useful in promoting the health

and happiness of society by more generally diffusing the knowl-

edge of the healing art, and thereby alleviating the distress of

mankind." Seven districts were created and out of these seven

districts there was created by law a State society styled "The

President and Fellows of the Medical Society of the State of

Ohio." The law listed one hundred and twenty physicians

throughout the State who were to constitute the society. Places

of meetings of the district representatives were designated as Cin-

cinnati, Chillicothe, Athens, Zanesville, Steubenville, Warren and

Dayton. Meetings were to be held on the first Monday in June.

These district societies were empowered to elect not less than

4 Ohio Laws, Statutes, etc., Acts, 9 Assemb., 1810-11 (IX), 19.

5 Ibid., 10 Assemb., 1811-12 (X), 58.

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370    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

two, nor more than three, representatives to the State society

which was to meet in Chillicothe on the first Monday of Novem-

ber. A quorum of ten members was required for this State

meeting.

On November 2, 1812, there gathered at Chillicothe five dele-

gates from the first and second districts. These hardy souls were:

Daniel Drake, Cincinnati, and Joseph Canby, Lebanon, from the

first district; Samuel Parsons, Franklinton; and John Edmiston

and Joseph Scott, Chillicothe, from the second district. It is not

clear at the present time whether the other five districts actually

appointed delegates. If they did the delegates failed to make their

appearance. Even Hildreth, the author of the first law, did not

attend. Since the law specified a quorum of ten members no con-

vention was held.

At the next session of the General Assembly this law was

repealed and a return6 made to the law of 1811. Between 1813

and 1821, the General Assembly amended, repealed and enacted

the law on three⁷ separate occasions.

On February 26, 1824, the General Assembly passed a new

law⁸ entitled "An Act to Incorporate Medical Societies for the

Purpose of Regulating the Practice of Physic and Surgery in this

State." It repealed the law of 1821 and remained in force, with

minor amendments, until 1833 when it, too, was repealed. Again,

we find the pious preamble to the effect that "whereas, well reg-

ulated medical societies have been found to contribute to the dif-

fusion of true medical science, and a correct knowledge of the

healing art."

With the rapid growth in population of the State and the in-

crease in the number of counties, which now numbered seventy, it

became necessary to divide the State into twenty medical districts.

The counties comprising each district were enumerated and the

names of physicians constituting each district medical society were

given. With variations this method was continued by the General

Assembly until 1833 when all such laws were repealed.

6 Ibid., 11 Assemb., 1812-13 (XI), 28, Jan. 19, 1813.

7 Ibid., 15 Assemb., 1816-11 (XV), 195, Jan. 28, 1817; 16 Assemb., 1817-18 (XVI),

105, Jan. 30, 1818; 18 Assemb., 1819-20 (XVIII), 162, Feb. 22, 1820.

8 Ibid., 22 Assemb., 1823-24  (XXII), 142.

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OHIO MEDICAL HISTORY, 1835-1858            371

 

Thus dosed the first period of medical organization in Ohio.

Regulation through legislation had proved a dismal failure. It

was not until 1868 that a return to this method is to be noted and

the law then enacted was so weak in its effects that in 1896 the

General Assembly finally set up the present form of regulating

the practice of medicine.

 

Voluntary Period of District Medical Organization

Between 1833 and 1835, the physicians throughout the State

had no means by which they could gather together for discussion

of their professional problems except for the few local medical

societies which existed. In 1835 the organization of "The Medical

Conventions of Ohio" on a voluntary basis was effected. These

continued until 1851^. Membership in these conventions was open

to all regular physicians throughout the State on an individual

basis. This situation continued to exist until 1846 when the Ohio

State Medical Society was organized.

The Ohio State Medical Society soon became a delegated

body and scores of local medical societies sprang up either as

auxiliary to or independent of it. A study of the Transactions

of the Ohio State Medical Society reveals that one of the earliest

considerations before it was the matter of auxiliaries. From its

auxiliaries, the State society drew its strength and it constantly

promoted local organization. It frequently found reason to quar-

rel with its component societies and in many cases refused to ad-

mit a local society because its constitution did not embrace some

code of ethics which was deemed essential.

The development of the constitution of the Ohio State Medi-

cal Society gives an insight to the story of district societies. The

first formal recognition of the need for a plan for auxiliaries is

found in a report⁹ of the committee on a new constitution and

code of by-laws and a plan for the organization of auxiliary so-

cieties. This plan which was adopted May 16, 1848, was:

Associations desirous of becoming auxiliary, must furnish to the Com-

9 Ohio State Medical Society, Transactions . . . from Its First Organization in

1846 to the Close of Its Last Session in 1850, with Addresses and Essays (Columbus,

1850), 5.

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372     OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

 

mittee on Medical Societies a copy of their Constitution and By-Laws, and

a list of their members. The Committee will report thereon, a majority vote

of the Society, admitting as members the President and Secretary, ex-officio,

together with one delegate for every ten members the proposed auxiliary

society may consist of. Delegates will present to the State Medical Society,

such papers, etc., etc., as the Association they represent may select, copies

of which they will deposit with the Committee on Publication.

In questions of a general nature affecting the profession of the State,

should the yeas and nays be demanded, the delegates, on producing the indi-

vidual authority of each, may vote by proxy for absent members of the

State Medical Society, who are also members of the Same Association with

the delegate.

Auxiliary Societies will, so far as possible, contribute to the furtherance

of the objects of the State Medical Society, by selecting from their own

archives such original papers, essays, reports, and especially statistics, as

they may deem of sufficient value, on every subject connected with medical

science.

In 1850 a listing of auxiliary societies showed the following:

1849. Hamilton County Medical Society .................Auxiliary No. 1

1849. Warren County Medical Society of Lebanon .......Auxiliary No. 2

1849. Clark County Medical Society....................Auxiliary No. 3

1849. Lancaster Medical Institute .......................Auxiliary No. 4

1849. Preble County Medical Society ...................Auxiliary No. 5

1850. Meigs County Medical Association................Auxiliary No. 6

1850. Wayne County Medical Association...............Auxiliary No. 7

1850. Richland County Medical & Surgical Society .......Auxiliary No. 8

1850. Medical Association of Adams, Brown & Clermont.Auxiliary No. 9

1850. Stark County Medical Society ....................Auxiliary No. 10

1850. Erie County Medical Society .....................Auxiliary No. 11

In 1857, it was deemed necessary to incorporate in the Con-

stitution of the Ohio State Medical Society something which

would improve reports from the local societies. From the first,

auxiliaries had been requested to submit annually a "catalogue"

which included a list of its members, papers and similar informa-

tion. The local societies were very dilatory in complying with

this request and the State secretary reprimanded them every year

in his report. Even after the amendment of 1857 the reports were

unsatisfactory.   The State secretary frequently changing each

year, appears not to have performed his work very well.

The State society was still recognizing district societies in its

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OHIO MEDICAL HISTORY, 1835-1858                 373

constitution as late as 1891. The State secretary in 1893 pointed

out that the work of the county societies was anything but satis-

factory. He lamented the general inactivity of the county societies

and gave the impression that they were losing the position of im-

portance which the State society had hoped for them. He said:

 

Why this state of lethargy or inactivity or lack of interest in the county

societies? The fact is very prominent that the county societies, which are

least active, are located within the boundaries of flourishing district societies.

Without hastening to condemn the district societies, for their success must

be prima facie evidence that they are supplying a real demand in medical

society work, we must conclude that they are depriving the county societies,

if not also the State Society of the interest that should be taken by them.¹⁰

This struggle between the county, district and State society is

to be noted each year until in 1902 when the State society changed

its constitution to comport with that of the American Medical

Association. Article III of the constitution read: "Component

societies shall consist of those county medical societies which hold

charters from this Association." The adoption of this provision

marked the downfall of district medical societies in Ohio.

So far as can be ascertained the district medical societies

which were organized in Ohio and which were represented in the

Ohio State Medical Society by delegates were:

The Medical Association of Adams, Brown and Clermont,11

was organized Jan. 21, 1847. This was the first district medical

society in Ohio and was the first such auxiliary of the State so-

ciety. It continued as such until 1884 when it disappeared from

the rolls of the State society. One cannot be sure if the organiza-

tion was really active until 1884 or if the State secretary was

careless in preparing his reports.

Records do not reveal the organization of another district

medical society in the State for seventeen years when there was

organized, April 12, 1864, the Union Medical Association of Co-

lumbiana, Mahoning, Portage, Stark and Carroll counties.¹²

This society was composed of physicians of the "old school"

10 Ohio State Medical Society, Transactions (Columbus, 1851-1904), 1893, 7-8.

11 Lancet-Clinic (Cincinnati, 1842-1916), VII (1848), 285.

12 Brant and Fuller, pub., History of the Upper Ohio Valley (Madison, Wis.,

1891), II, 161.

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374   OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

or what is termed by them "regular practice" and from the origi-

nal faith and practice it never departed. A committee of five was

appointed in 1866 to effect an organization of county societies in

the counties composing the union. This is the only instance that

was found where such an action was taken by a district society.

It continued as an auxiliary of the State society until 1902.

The Union District Medical Association was organized Oc-

tober 22, 1867. This society is unique in Ohio in that it included

counties in both Ohio and Indiana. At first it included Union

County (Indiana) Medical Society and Butler County (Ohio)

Medical Society. Later Fayette and Franklin counties (Indiana)

and Preble County (Ohio) were added. This society never be-

came an auxiliary of the State society. Delegates were sent to

the State meetings in both Ohio and Indiana. On April 27, 1939,

it held its 142d semi-annual meeting at Eaton, Ohio.¹³

The Central Ohio Medical Society was organized June 14,

1869. This society became an auxiliary of the Ohio State Medi-

cal Society July 1, 1869. It met quarterly and drew most of its

membership from Columbus and vicinity. From the record the

society existed as a paper organization after 1896. The last meet-

ing of which we have record was a joint session with the North-

western Ohio Medical Society in 1903.

The Northwestern Ohio Medical Association was organized

about 1869. The actual date of organization of this body is ob-

scure. It was admitted as an auxiliary of the Ohio State Medical

Society in 1869 and continued as such until 1902. In 1892 it as-

sented to Article 3, Section 10, of the State Constitution and thus

was allowed to continue as a component society. In that year, the

list of members which appeared in the Transactions14 numbered

255. The State society had only 428 members at this time. How-

ever, this statement should be qualified by saying that there were

probably incomplete returns of the State society's membership

from local societies. The last official trace of the society is in

1903.

The Union Medical Association of northeastern Ohio was

13 Ohio State Medical Journal (Columbus, 1905- ), XXXV (1939), 636.

14 Ohio  State Medical Society, Transactions, 1892, 18.

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OHIO MEDICAL HISTORY, 1835-1858            375

 

organized about 1870. Again, the actual date of organization of

this society is obscure. It was admitted as auxiliary of the Ohio

State Medical Society in 1870. The membership was drawn from

nine counties in northeastern Ohio and does not seem to have ex-

ceeded 250 at any one time.15

The Miami Valley Medical Society was organized June 13,

1877. This society drew its membership from Clermont, Hamil-

ton and Warren counties at the time of organization. Later it

extended its area to include Butler, Clinton, Greene and Highland

counties. In 1901 the society had a membership of only ninety-

seven members when there were 1228 physicians in the counties

comprised in the district.¹⁶ The society existed as late as 1907

when the thirtieth annual meeting was held at Loveland, Ohio,

October 8.

The North Central Ohio Medical Society¹7 was organized

March 31, 1881, at Mansfield, Ohio, largely through the active

efforts of Dr. Robert Harvey Reed. It was accepted as an

auxiliary of the Ohio State Medical Society in 1881 and con-

tinued as such until 1902. Its membership was never large, not

exceeding 100 in the best years.

The Southwestern Ohio Medical -Society¹⁸ was organized

August 31, 1889, at Cincinnati and included twenty-four counties

in its area from southwestern Ohio. Meetings were held twice a

year. Its membership numbered around 100. It never became an

auxiliary of the Ohio State Medical Society. The date it ceased

to function is shrouded in obscurity.

The Eastern Ohio Medical Association¹⁹ was organized in

1892. This society embraced Belmont, Columbiana, Harrison and

Jefferson counties. It was admitted as an auxiliary of the Ohio

State Medical Society in 1894 and remained as such until 1902.

Its membership never exceeded 100.

In addition to the district societies listed there were a number

of others organized about which data are fugitive. These were:

 

15 Ibid, 1901, 473.

16 Lancet-Clinic, XCVIII (1907), 336.

17 Mansfield Herald April 7, 1881.

18 Lancet-Clinic, LXII (1889), 257-8.

19 Columbus Medical Journal (Columbus, O., 1882-1916), XIII (1894), 65-72.

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376    OHIO ARCHAEOLOGICAL AND HISTORICAL QUARTERLY

The Northern Ohio District Medical Society was organized

sometime in the early '90's. This society was probably a combi-

nation of the three district societies in the northern part of the

State and seems to have been designed to promote a legislative

program.

The Muskingum Valley District Medical Society was or-

ganized in the later '80's. This society became an auxiliary of the

Ohio State Medical Society in 1886 and disappeared as such after

1891.

The Midland Medical Society of Fayette and Adjoining

Counties was rejected by the Ohio State Medical Society and

never appears in any lists.

It is doubtful if the Delamater Medical Association of

Norwalk and Vicinity comes within the definition of a "district

society."  The Transactions show that it was admitted as an

auxiliary of the Ohio State Medical Society in 1859 and dropped

in 1870.

Very little can be learned of the Athens, Morgan and Wash-

ington Medical Association. It appears to have been the second

district society to become an auxiliary of the Ohio State Medical

Society. This was in 1855. It was dropped from the rolls in

1884.

Nothing was learned about the origin of the Northeastern

Ohio Medical Association. It was admitted as an auxiliary of

the Ohio State Medical Society in 1870. It disappeared from the

rolls in 1892.

The Southeastern Ohio Medical Association was admitted as

an auxiliary of the Ohio State Medical Society in 1890. It was

dropped from the rolls in 1892.

Facts relative to the Ashtabula, Lake and Geauga Medical

Society are difficult to obtain. It was active in the middle '90's.

Thus we find the period 1846 to 1902 filled with the activities

of physicians organized on a district basis. Unfortunately, the

records are difficult of access or do not exist. There are physicians

in Ohio still alive who have knowledge of one or more of such

organizations and what a contribution these men could make to

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OHIO MEDICAL HISTORY, 1835-1858           377

 

medical history in Ohio if they would set themselves to the task

of detailing such histories.

After 1902 the "district" came back into use by the Ohio

State Medical Association as a basis for membership in the

"Council." The struggle between the "county society" and the

"district society" was resolved by using the "county society" as

the basis for membership in the State association and the creation

of the House of Delegates as the legislative body representing

county societies. The component county societies were then

grouped into districts for the purpose of creating a Board of

Directors of the State association which is known as the "Coun-

cil" with one representative from each of the districts, of which

there are eleven at the present time.

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