The College of Physicians of Philadelphia: “Not for Oneself, But for All”

The celebration com­menced with the ar­rival of out-of-town guests on Sunday evening, January 2, 1887. For the next two days, the fellows of the College of Physicians of Philadelphia, led by their president, S. Weir Mitchell, celebrated the centennial anni­versary of their beloved insti­tution. Although the weather was bitterly cold, the gala receptions, lavish dinners, congratulatory addresses and the many toasts were marked by the warmth of friendship and professional brotherhood. During the festivities, Mitchell and his colleagues enthusiasti­cally displayed their content­ment with the current state of the college, their supreme confidence in its future and, most of all, their great pride in its history. Today, in celebrat­ing their bicentennial, the fellows of the College of Physicians are again recalling a noble tradition, just as proudly as their counterparts of 1887.

The first recorded meeting of the College of Physicians of Philadelphia occurred on Janu­ary 2, 1787. The college was founded by twenty-four of Philadelphia’s most prominent physicians, including Ben­jamin Rush, John Redman, John Morgan and William Shippen, Jr. Modeled on simi­lar medical societies in Eng­land and on the continent, the college was created not as an academic institution as its name suggests, but as a pri­vate medical society whose purpose was “to advance the Science of Medicine, and thereby lessen Human Misery, by investigating the diseases and remedies which are peculiar to our country,” and to cultivate “order and uniform­ity in the practice of Physick.”

The college first met in the old Academy Building, home of the College of Philadelphia (now the University of Penn­sylvania), at Fourth and Arch streets. The fellows chose John Redman, probably the most eminent physician in Philadel­phia at that time, as their first president. Although Redman was elected president of the college, it was Benjamin Rush who was the moving force behind its founding. A gradu­ate of the medical school at the University of Edinburgh, signer of the Declaration of Independence, prolific author and a tireless advocate of a variety of humanitarian re­forms, Rush was the most celebrated physician in the United States at the time of his death in 1813. Although Red­man was a calm unifier, Rush was an energetic man of ideas. It was Rush, not Redman, who delivered a discourse on Feb­ruary 6, 1787, enunciating the objectives of the college.

Reiterating and expanding the purposes mandated by the college’s constitution, Rush’s address to the fellows pre­sented the aims of the institu­tion, “1st as a College, and 2ndly, as a Medical Society.” As a college, Rush believed his colleagues should primarily address matters of public con­cern, including the creation of a national dispensatory, offer­ing advice to legislative bodies on matters “that relate to health and happiness of our fellow citizens,” and establish­ing and maintaining order and uniformity in the profession. As a society, Rush saw the fellows “collecting and pub­lishing medical observations and inquiries” on various topics, holding meetings, cultivating a botanical garden and creating a medical library. During the ensuing years, the college attempted to carry out many of its original objectives.

The original membership of the college was composed of senior and junior fellows, with age and education the only discernible differences be­tween the two. This distinction was dropped in November 1787. Fellows were required to be residents of the city of Phil­adelphia, the borough of Southwark or the Northern Liberties, as well as being men of good standing within the profession. The original admis­sion fee was eight dollars and the annual subscription was two dollars. Meetings were held on the first Tuesday of each month.

From its beginning, the College of Physicians of Phila­delphia assumed the guardian­ship over the health, safety and morals of the community. On September 4, 1787, the college appointed a committee to prepare a memorial to Penn­sylvania’s state legislature, “setting forth the pernicious effects of spiritous Liquors upon the human body” and urging the adoption of a law “to diminish their consump­tion.” The memorial, pro­nouncing spiritous liquors as the cause of dropsy, epilepsy, palsy, apoplexy and madness, was sent to the legislature in November. Although nothing came of its petition at the state level, the college continued in its quest for temperance legis­lation, appealing to Congress in 1790 to levy heavy duties to discourage consumption. All the college received from Con­gress was a less-than-polite remark from a Georgia con­gressman telling the fellows, in effect, to mind their own busi­ness.

Besides temperance, the college expressed its views on other matters of public health, calling for the establishment of hot and cold baths in the city, the creation of a botanical garden and the erection of a hospital for contagious dis­eases. In 1789, the general assembly asked the college to recommend measures to pre­vent contagious diseases from being brought into Philadelphia by incoming vessels. In its response, the college ad­vised that a certificate of health should be required of every ship coming from a Mediterra­nean port.

In December 1788, a library was created when John Mor­gan donated sixteen volumes to the college, including the works of Aristotle. Soon other fellows followed Morgan’s example. The college shortly after allocated funds, not only to purchase books, but to bind them and to erect a bookcase to hold them. Meanwhile, more books came to the col­lege as a bequest from Mor­gan, among them a handsome presentation copy of Giovanni Battista Morgani’s 1761 De sedibus et causis morborum, one of the most important books in the history of medicine.

Like other medical and scientific societies, the meet­ings of the college were de­voted, in part, to the presentation of papers and communications, not only by fellows, but by American and European physicians as well. The first paper read at the college, besides Rush’s ad­dress, was a communication from Thomas Dolbeare of London describing “a Case of Curveture of the Spine.” Dur­ing the next five years, more than forty papers were pre­sented on such topics as teta­nus, influenza, measles, hydrocephalus, and an ac­count from a Maryland physi­cian of a “Headache cured by the discharge of a worm from the nose.”

The college decided to publish a volume containing a number of these papers. The first volume of Transactions appeared in September 1793, with copies sent to medical societies in the United States and abroad. In Germany the volume was translated by Christian Friedrich Michaelis of Leipzig, who had been a surgeon with German troops in America during the Revolu­tionary War, and published Medizinische Verhandlugen des Koggegiums der Aertze zu Philadelphia. Volume I of the Transactions included a pledge that more issues would be forthcoming, but subsequent volumes never appeared. In fact, the debut of the first volume was hardly noticed; the deadly yellow fever had erupted in Philadelphia.

“The yellow fever has as­sumed a most alarming ap­pearance,” Rush wrote his wife on August 25, 1793, for it “not only mocks in most instances the power of medicine, but it has spread through several parts of the city remote from the spot where it originated.” On that same day the College of Physicians, at the request of the mayor of Philadelphia, met in a special session “to con­sider what steps should be taken by them on the occasion consistent with their duty to their fellow citizens.” The college recommended a series of stringent measures, includ­ing avoiding all unnecessary social intercourse, marking doors and windows of houses occupied by infected persons, providing a large and airy hospital for those infected, and keeping the streets and wharves of the city clean.

Unfortunately, these pre­cautions and the various treat­ments employed by city physicians had little effect on the spreading fever. By the end of August more than three hundred were dead; by Sep­tember the count climbed to more than fourteen hundred. With the arrival of autumn, the fever’s virulence soared. The college quickly resolved to meet weekly “to confer upon the treatment of the existing malignant fever, but meetings were soon suspended because a number of fellows were ei­ther too busy with patients or had fled the city. Many fellows were stricken with the fever, and some died from it.

Meanwhile, Rush thought he had found a cure, a combi­nation of bleeding and purg­ing. Believing that fevers were the result of vascular tension, Rush drained up to ten ounces of blood from, and adminis­tered up to ten grains of mer­cury to, his patients in order to relieve this tension. He soon recommended this as the only sound treatment, claiming that four-fifths of his patients treated in this way from the first day recovered. Rush assured his critics that his heroic treatment would reduce the fever “to a level with a com­mon cold.”

Rush’s critics were numer­ous and vocal. Many were fellows of the college. Fellows Adam Kuhn and William Cur­rie preferred a milder treat­ment composed of camomile tea, bark or laudenum, wine, lemonade, fresh fruits and cold baths. The college as a whole supported the milder treatment over Rush’s. Rush looked upon the college’s stand as a personal affront, and felt betrayed by the state­ments of certain colleagues who referred to his treatment as being just as dangerous to the inhabitants of the city as the yellow fever. Called a mur­derer by some, repudiated by many and offended by what he considered poor treatment by his colleagues, Rush re­signed from the institution as soon as it reconvened in November following the fever’s abatement.

Benjamin Rush’s resigna­tion damaged the prestige of the college and had grave consequences for the next three decades. While Rush had been criticized by the city’s older physicians during the yellow fever epidemic, many of the younger practi­tioners supported him. These younger doctors had been his students, and they possessed an unshakable devotion to their teacher. In the twenty­-five years after 1793, only twenty-two physicians were elected to fellowship of the College. Many of the city’s most prominent physicians­ – John Redman Coxe, William Potts Dewees, John Syng Dor­sey, William Edmonds Homer and Philip Syng Physick, all supporters of Rush – were conspicuously absent from the college’s membership rolls.

As the founding fellows aged and died, unreplaced by younger members, the college entered a period of dormancy. Attendance at meetings dropped dramatically; in fact, many were cancelled due to the lack of a quorum. The library ceased to grow and thus was seldom used, and the second volume of the Transac­tions never appeared.

Beginning in the mid-1820s, the college rediscovered its purpose and renewed its com­mitment to the objectives originally established by the founders. This was clearly evident in its intervention in a case of murder involving the possibility of insanity, and its role in the creation of a na­tional pharmacopoeia. In 1824, John Zimmerman was found guilty of murdering his daugh­ter and was sentenced to be executed in Schuylkill County on November 20. His sanity was in doubt, for both his mother and two sisters were insane. Joseph Parrish, a fel­low of the college, learned of the case and believed that it was the college’s duty to inves­tigate the circumstances. The college did, asking Gov. John Shulze to postpone the execution until the question of Zim­merman’s sanity could be scientifically settled. When a committee of local physicians disagreed whether the pris­oner was insane, the governor asked the college to examine Zimmerman. Accordingly, a committee was formed­ – including president Thomas Parke, then seventy-five years old – to interview the prisoner. The committee traveled to the prison at Orwigsburg and interviewed Zimmerman four times, concluding that he was, indeed, insane. In response, the governor exercised execu­tive clemency, and Zimmer­man’s life was spared.

In 1789, the college issued a circular to American physi­cians and medical societies requesting cooperation in preparing a national pharma­copoeia (a compilation of med­ical prescriptions and formulas collected by American physi­cians). Although the response was less than the college had hoped, the institution’s per­sistence was rewarded with the publication of a national pharmacopoeia in 1820. A revision, largely the work of the College of Physicians, appeared in 1831 as The Phar­macopoeia of the United States of America by the Authority of the National Medical Convention. A year later George B. Wood and Franklin Bache, both fellows of the college, published their Dispensatory of the United States of America. The college’s associ­ation with these remarkable works of scholarship firmly gave notice to the American medical community that the college was ready to play a national role once again.

The re-emergence of the college must be credited, to a large degree, to a new genera­tion of fellows who were elected during the late 1820s and through the 1840s. Men like Wood, John Bell, Rene LaRoche, Charles D. Meigs, William Wood Gerhard, Thomas D. Mutter and Alfred Stille were just a few of the young and energetic members elected during these years. Many of these new physicians studied medicine in Paris and returned to the United States, espousing the doctrines of their French teachers. Up to 1820 the majority of fellows were either graduates of Edin­burgh University or were stu­dents of professors trained there. The Edinburgh tradi­tion, based on theoretical medicine, was now being challenged by the philosophy of the Paris school of scientific medicine, which was based on close observation, accurate and full statistics, comparison of data and the drawing of logical inferences therefrom.

The clash of these two dis­tinctly different philosophies spawned many stormy meet­ings at the college, but it also produced healthy exchanges and debates on numerous topics concerning the medical profession of the mid nine­teenth century: anesthesia, puerperal fever, cholera, medi­cal ethics, vaccination and re-vaccination. As the attendance at meetings rose, so did the quality of the papers delivered during them. And with papers to publish, the college revived the Transactions in 1842. Since that time, the Transactions has continued to publish articles of value to the profession.

While the three decades prior to the Civil War found the college enjoying a revival, the years from 1863 to 1914 were the finest in the college’s history to date. During these years, the college erected two handsome buildings, reas­serted its role in national, state and local affairs, built a unique museum and a magnificent library, and was led by a group of fellows noted for their many contributions to medical science.

In 1791, the college had moved from its cramped quar­ters in the old Academy build­ing to a larger room in Philosophical Hall on South Fifth Street, home of the American Philosophical Soci­ety. Fifty-four years later the college moved across the street to a room in the Mercantile Library. 1n 1852 the college moved yet again, this time to the Pennsylvania Hospital’s Picture House, which was originally built for the exhibi­tion of Benjamin West’s paint­ing, Christ Healing the Sick. It was not long before the grow­ing library brought the ques­tion of larger quarters to the attention of the members. Their pride in the college en­couraged them to abandon the role of tenant.

If these factors were not enough incentive for the fel­lows to build a home of their own, Dr. Thomas Mutter soon provided them with one. In 1856, Mutter, who had recently resigned the Chair of Surgery at Jefferson Medical College due to ill health, offered to donate his vast collection of pathological specimens to the college, together with thirty thousand dollars to pay for the services of a curator and lec­turer, and maintain and en­large the collection. An agreement was signed two years later, with the college pledging to build a fireproof facility within five years to house Mutter’s specimens.

The first building that the fellows could call home was a two story structure located at Thirteenth and Locust streets. When it was completed in 1863, Mutter’s collection was combined with the college’s own pathological museum, which had been established in 1849. Now in possession of one of the most impressive pathological museums in the country, the college dedicated itself to making the collection even better. Under Thomas Hewson Bache, curator of the museum from 1866 to 1883, the museum grew steadily. It was during Bache’s tenure that the museum acquired many of its notable, as well as unusual, specimens, including the re­markable skull collection of the Vienese anatomist Joseph Hurt!, the Adam Politzer col­lection of tympanic mem­branes, anatomical models by the celebrated Louis Thomas Jerome Auzoux, the “Mutter American Giant,” the “Soap Lady” and the connected livers of the famous Siamese Twins, Chang and Eng, which were removed during their autopsy at the college in 1874. These specimens, together with many noteworthy additions of the past century, are still on display at the college in the recently refurbished Mutter Museum. The museum is not only educational for the lay­man, but it is an invaluable resource for students and scholars of medicine and its history.

The spacious quarters in the new building also influ­enced the growth of the li­brary, particularly because the early years of the library had been anything but auspicious. In 1835, the library committee reported that the library was “in bad condition and going to decay.” Fellow Alfred Stille remembered his first introduc­tion to the library in 1842, when a single black bookcase held the whole collection. According to Stille, the book­case resembled an “ancient receptacle” which reminded him of a “chamber of an Egyptian tomb, where the dry and blackened mummies of the dead repose unchanged for untold ages. If the doors of it were ever opened,” mused Stille, “it must have exhaled a sepulchral odor.”

The situation changed in 1864 when the library received the first installment of what became the greatest donation of books in the college’s his­tory, the Samuel Lewis Collec­tion. That year Samuel Lewis, a Philadelphia physician and bibliophile, donated twenty­-five hundred books to the library. He continued to add more books until his death in 1890, when his total contribu­tion numbered more than eleven thousand volumes. The most treasured work from Lewis’ collection is the ex­tremely rare thick-paper first edition of William Harvey’s 1628 work on the circulation of the blood, De motu cordis. Only three copies of this work are known to exist.

From the time of Lewis to the present day, the college library has continued to grow, and is now one of the largest medical libraries in the coun­try. It is especially noted for its extensive historical collections. Organized as a separate de­partment within the library in 1953, the historical collections contain extensive holdings of sixteenth to nineteenth cen­tury materials, making it one of the largest and finest collec­tions of medical history re­sources in the United States.

If a superlative library and museum did not bring the institution prestige during the second half of the nineteenth century, then the many nota­ble physicians who were elected fellows did. Many of the most respected leaders of American medicine were ac­tive in college affairs during these years, including Samuel D. Gross, D. Hayes Agnew, William Pepper, William Osler, Alfred Stengel, W.W. Keen and S. Weir Mitchell. Mitchell was the most influential fellow in the history of the college. Admired as a novelist and respected as a neurologist, Mitchell served the college for two terms as president (1886-88, 1892-94). It was appropriate that Mitchell was president when the college celebrated its centennial in 1887, for he was the institution’s guiding inspi­ration from 1886 until his death in 1914.

Mitchell once stated that the college’s “largest office should be that of incessant watchfulness of all public interests in which questions of health are concerned.” His colleagues concurred and, as a result, the college was active in local, state and national affairs during the “Mitchell Era,” advocating the creation of a Department of Public Health and Preventive Medicine by the United States government, speaking out against anti­-vivisection legislation, cam­paigning for a bill before the state legislature to establish a State Board of Medical Exam­iners and Licensers, and advis­ing Congress on quarantine measures to combat the threat­ening epidemic of cholera in the 1890s.

When the College cele­brated its one hundredth anni­versary in January of 1887, it had much to be proud of: a distinguished tradition, a famous museum, a great li­brary and a handsome build­ing. By the turn of the century, however, this building had become too small for a bur­geoning library and museum. Even with the addition of a third story in 1888, it was obvi­ous that a new and larger structure was needed. In 1903, the college purchased a lot on Twenty-Second Street above Chestnut, and with the gener­osity of many members, friends and supporters­ – Andrew Carnegie gave fifty thousand dollars – raised the money to erect a magnificent new hall. Opened in 1909 amid two days of impressive cere­monies, the building was, and still is, one of Philadelphia’s architectural treasures.

On November 10, 1909, the fellows inspected the exterior of their new home, with its handsome brickwork of laid Flemish bond and its trim­mings of Indiana limestone. Pleased with what they saw, they entered its palatial inte­rior of Vermont marble, oak wainscoting, coffered ceilings and handsome rooms lined with dignified portraits. As the fellows entered the building they were, in effect, leaving one era and entering another. Except for taking an active role in local public health issues in the 1920s and 1930s, the college’s involvement with public affairs never approached the level of the busy years of the previous century. Content with enhancing its library and museum, the college seemed to turn inward.

The college’s purposeful retreat was not due to a lack of energy or initiative on the part of the fellowship, but a realiza­tion that the institution no longer possessed the influence it once had, especially in na­tional affairs. The proliferation of state and local medical soci­eties, the growth and domi­nance of the American Medical Association,and the expanded role of the federal government in health policy dwarfed the influence of local and private medical societies like the college. Today, the College of Physi­cians, with a fellowship of two thousand, collects and dissem­inates bio-medical information through its library, educates through its museum, publishes through its Transactions and supports historical re­search through its Francis C. Wood Institute. Soon, the college will open a health policy center that will address, in a neutral forum, critical issues facing the physician, the patient and the medical profession in general. Proud of its heritage, the college looks forward to beginning its third century of service in the spirit enunciated by the motto of its founders: “Not for oneself, but for all.”

For Further Reading

Horrocks, Thomas A. “The His­torical Collections: Past, Present, and Future.” Fugitive Leaves from the Historical Collec­tions. 1, 1 (Spring 1986), 6-10.

Lippincott, Horace Mather. Early Philadelphia. Philadelphia: J. B. Lippincott Company, 1917.

Marion, John Francis. Philadel­phia Medica. Harrisburg: Stack­pole Books, 1975.

Mease, James. The Picture of Philadelphia. Philadelphia: B. and T. Kite, 1811.

Ruschenberger, W. S. W. An Account of the Institution of the College of Physicians of Philadelphia. Philadelphia: N.P., 1887.

de Schweinitz, G. E. and W B. McDaniel. An Account of the College of Physicians of Phila­delphia. Philadelphia: N.P., 1934.

Weigley, Russell F. Philadelphia, A 300 Year History. New York: W. W. Norton and Company, 1982.

Wolf, II, Edwin. Philadelphia: Portrait of An American City. Harrisburg: Stackpole Books, 1975.

Thomas A. Horrocks is curator of historical collections for the Col­lege of Physicians of Philadelphia. He joined the institution as histo­rian in 1983. Prior to his work at the college, the author served as a researcher for the American Philo­sophical Society, Philadelphia, and as editorial assistant for the Letters of Charles Darwin (Cambridge University Press). He received his bachelor and master of arts degrees from Villanova Uni­versity and his masters degree in library science from Drexel Uni­versity.