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Fall 2011 The iH storical Importance of Transylvania University’s Medical Department (1799-1859), Focusing on the Little Known Secret Kappa Lambda Society of Hippocrates and the Origin of the American Medical Association's Principles of Medical Ethics Charles T. Ambrose University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits oy u.
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This article is available at UKnowledge: https://uknowledge.uky.edu/microbio_facpub/62 THE HisTORICAL IMPORTANCE oF TRANSYLVANIA UNIVERSITY's MEDICAL DEPARTMENT (1799- 1859), FocusiNG oN THE LITTLE KNowN SEcRET +//~ J:c;;e?:T ~ AND THE ORIGIN OF THE AMERICAN ecorded histories MEDICAL AssociATioN's PRINCIPLES about specific Rtopics arc often OF MEDICAL ETHICS deficient in some small detail or incomplctt' dm· 111 Njlill c· ll11citut ion ~. lly Charles 1: /lmbrose An example is thr ociginol IIH' Anwai l'llll M,·dh 11 l 1\ssociation.'I'IH·cdiHI', toi' VI' III I Vl' tHIIltl ll '''" ""lilt'! 1 "''''"to llasTonv OF TRANSYI.VANIA be to g.tin pt· ru ~ t· d '"' '"'""'!" llltl'll'" ' llil lt in ,' l ' l,i ~ t 'N~ny lJ N IV F RS I'IY ll'lnlt•\ 11111111' lltth• llttJWII I.H 1- ltholUI 1111 l'olll)' lllllt'tl'l'lltlt H'IIIUI )' Nl' lll' l llit'dit ,tl ll ;llt'lllit)• W h1 1~1 V, ll ;Ill' ! ~ ~ 1\ lllll t oil Ill' l'c , u, ~y l v, tll i ll '' 1,;\l ill fi H ",,,. tr•Jj :;),.,~"" and was the li e~ in ih nwmht' l ~ who h,•ltwd lound tlw A r-. 1/\. A'J. 11111111' giwn to llw land ~ ho1dcct·d hy tlw Ohio, C umberland, and 1\t'lllllrky ci w o ~ tht· (1:111 olptcst·nt day Kentucky that EARLY SECRET CO L. LE<:E I'RATERN 1'1 I ES ori14i11a lly wa~ the Wt'Stl'"' extension of Virginia. In 1780, the C ener:d Asse mbly of Virginia deeded 8,000 acres of The first student fraternity in the U.S. was Phi Beta Kappa, cscheated land "in the county of Kcntuckey" for "a publick established at the College ofWilliam and Mary in school."'fhe adjective "cscheatcd" referred to lands previously Williamsburg, Virginia, in 1776. During its early years the owned by British subjects who were no longer legally allowed fraternity had an oath of secrecy and a special handclasp to own them. or grip.1 Some histories state that in this country it was "the sole society of its kind for 50 years." 2 Indeed, other Another 12,000 acres was added later to help fi.md "the secret Greek-letter fraternities followed: Kappa Alpha, Sigma maintenance and education of youth."The public school Phi, and Delta Phi were established in 1825-27 at Union was named Transylvania Seminary and became the first College, Schenectady, New York, and Alpha Delta Phi in institution of higher learning west of the Allegheny 1832 at Hamilton College, Clinton, New York. Two notable Mountains. Instruction began in 1785. In 1792, Kentucky secret societies were also formed at Yale University-Skull and became the 15th state, and in 1798, the seminary's name Bones in 1832 and Scroll and Key in 1842. was changed to Transylvania University. 3
The distinction of being the second secret college society A fund-raising campaign for the new seminary/university ("a in the U.S. after Phi Beta Kappa, however, goes to the lamp in the forest") was promoted in Eastern cities. Pledges Kappa Lambda Society of Hippocrates, established at the totaling $10,000 were obtained. 3 An editorial in the j ournal Transylvania University Medical Department in Lexington, of the American M edical A ssociation in 1905 noted that "the Kentucky, in 1819. This fact is little appreciated today for little school at Lexington grew with phenomenal rapidity to a several reasons. Foremost among them is that the Kappa position second to none in the United States." 4 For a decade Lambda Society in Lexington survived for less than a decade, during the 1820s, Transylvania University was "ranked among although branches established in several Eastern cities con the leading institutions of higher learning" in the Union. tinued for several more. Its members greatly influenced the Indeed, Thomas Jefferson favored sending students there early character of a later important institution, the American rather than to Harvard. At Transylvania they would be Medical Association. The story of the Kappa Lambda imbued with "more of the flavor of the old cask," meaning a Society and AMA begins with Transylvania University more democratic outlook, while at Harvard they would and its Medical Department, founded in 1799. return from Cambridge as "fanatics and tories." 5 (See footnote 2.)
VoL. N, No. 2, FALL 2011 The Civil War impoverished the small colleges in the South, In the early 1800s, several large donations allowed causing many to fold. In order to survive, Transylvania Transylvania faculty to travel to Europe to purchase entire merged with the small church-funded Kentucky University private libraries of medical works, anatomical preparations, in 1865. In 1878 the Kentucky legislature chartered the and the newest scientific instruments. In 1828 the Agricultural and Mechanical College as a separate, public Transylvania medical library held over 3,000 volumes. At institution, and it moved from the Transylvania campus to the time, Transylvania was the "best endowed medical school another location in Lexington, eventually becoming the in America" and had "one of the best (libraries) in the coun University of Kentucky. The College of the Bible also try."10 The library and museum of anatomical and scientific separated from Transylvania, moving to another location items are still intact and on display today in Transylvania in Lexington in 1950 to become Lexington Theological University's Special Collections. (See footnote 5.) Seminary. Transylvania University resumed its historic name in 1908 and over the next century attained its Transylvania's Medical Department remained preeminent in present reputation as a highly regarded, sm_ all_=-li~·b~c~r=al---~~~~;tK"l trans-Appalachia for two decades, the 1820s and arts college. (See footnote 3.) - 1830s. In the mid-nineteenth century, however, steam navigation caused inland Lexington to be TRANSYLVANIA's MEDICAL eclipsed economically by two nearby cities on DEPARTMENT the Ohio River-Cincinnati and Louisville. In 1837, the Louisville Medical Institute was n 1799 the trustees ofTransylvania opened with a class of 80 students. It became University inaugurated a Medical the University of Louisville Medical Department. 3 This became the fifth Students purcbased Department in 1848. 10 I n the 1840s, I tickets for lectures at (or seventh, see footnote 4) medical school organized tbe Tramylvania enrollment at Transylvania's Medical in the United States but indisputably the fi rst west of the Medical Department. Department began to fall. Dissatis£'\ction Alleghenies. Early U.S. medical schools were commonly within the Transylvania medical facul ty, notably with the lack called "departments" or "institutes" of mcdicinc. The first had of bodies fo r dissection, led several membcrs 10 move to been established by the University of Pennsylvania in 1765, Louisville in the £'\ 11 of 1850 and form the Kentucky School followed by King's College in New York City in 1767 or ofMedicine. In 1908 the two medical schools in Louisville 1764, Harvard University in Cambridge, Massachusetts, in merged. In L exington, Transylvani a's .last class of nine doctors 1783, and Dartmouth College in llanover, New H ampshire, completed their studies during the 1858-59 term. in 1797. 6 (The Medical Institution ofY.'llc College was created around 1810.8) (Sec footnote 4.) Throughout its nearly six decade existence (1799-1859), Transylvania's Medical D epartment enrolled 4,358 students Students were admitted to rli·ansylvania's Medical and graduated 1,881 physicians. The majority of trained Department beginning in 1800 and were initially taught in physicians in the antebellum South and Southwest of this preceptorships with the fo ur or so faculty at hand. During country were graduates ofTransylvania.3 the first decade or so, lectures were given irregularly to classes of around 20 students. The academic year was only fo ur months long. A formal curriculu m was not in place until the winter of 1819, and the first class included 39 students. By 1825 the department had 281 students, its peak number. The average enrollment in the 14 medical schools of this period was 147,8 although the University of Pennsylvania had 440 medical students. 9
Transylvania's Moomick M edical and Scieme !VIuseum ind rules rare nineteentb-century anatomical specimens and models, pbarmaceuticalmaterials, electrotberapy macbines, and didactic apparatus, among otber items. A specialist from tbe Smitbsonimr Imtitutionjrulged tbe collection to be among tbe finest in tbe nation for tbis time period. T:RANSYLVANIA TllEASUilES
ORIGIN OF THE SECRET hlPPA LAMBDA SoCIETY
he Kappa Lambda Society of l l ippoc ral c~ wa ~ founded by Samuel Brown (1769 I flj()), thl' first T professor of the theoty and [>f':ll'til'c ol' nwdkinc and also professor of chemistty at Transylvan ia\ fVkdical Department. He was born in Virginia :tnd ohtain!'d hi ~ ntcd ical training in Philadelphia and Srotl:md. 'l'lw 1 ~· nowm·d nineteenth-century American surgt·on S:unut'l ( :1os~ ( I R05 84) described Brown as "a lwauli fid typt• ol 111.111 (with) a magnificent physique. ..a tho10ugh gt'lltlt•ltHnt i11 II HIIllll'r and address."To others he was ,·loqtll'lll , lt'IIII H'd , ht'lll'Vnit-111, 11 liberal, and i deaJi s ti l~ hut a dl t';III H'I, hi IIIII' Haiti.
In 1802, whik studl'lll '• Wl'll' hl ' lll ~ 11111)\ht 111.dn ly by precep tors, Brow11 wa ~ on upi1•d V1111 inntiiiH ~ ()() I ,(')0 11 )\tonians. At tlw tillH', phy>• HIII Il'• 1111 till' I'll"' lflll'ot Wl'l!' ~o~i ll tkhat in).{ tlw s:d(·ty o f th h• 1111111'du11 O~tly tw11 Yl',lll• 1'ndit· 1, 1\e nj:unin W:ttt't h ou ~ 1 · h11 d uht.lltu'd tlu fl , ot , IIWJ"'' v. 111 11H' in Amcri\':1 and h.td 1111111\llll ll'd M' l't'll IIH'IIII II' tk of h i ~ Boston h ou~dw ld . IJ Samuel Brown, professor ofc hemistry and oft he throty and pmrlirr ofmedi cine at Transylvania's Medical D eparlment,jinmded the Kappa l .ambda Society . (Photo by Kurt Gohde} In 1803, Brown lounded the l.rxlngttll l 1\ lt·dlrnl S~trit· t y. It seems to have been for the benefit of tl u nll'lil111 l ktlldl'll ts, since the Februaty minutes listed only thl'lll, htlltll' I ~ in The vulgar deportment of his medical colleagues both in number. The October minutes co t ll'~' II H' d ll'tttllll\ ,, llll'l't ill ~ Lexington and elsewhere led Brown, the idealist and place and purchasing "candle, cand les tit•lt , 1111 d •HIIillt•lr.." dreamer, to inoculate his Transylvania students against such unworthy conduct through his lectures, correspondence, and As noted above, a formal medica] curril'u h1111 lwg.111 in I H1 1J. conversations. An acquaintance wrote that Brown "sought by Part of the delay in starting regular class Will k \tl'ltltlll'd 1'1 0111 alJ means-by precept and example-to sustain the dignity, discord with local practitioners and among tilt' Mll:dl nwdit·al vindicate the honor, and raise the status of the profession." 11 faculty. Doctors in the community were wnt y of' tlw tH'W medical college, fearing that it would churn out 'ivai In 1819, with 39 restless students now attending regular physicians competing for paying pa6ents. Even wit hin dw medical lectures, performing human dissections, and occa Medical Department conflicts arose; one led to a duel in sionaJJy robbing graves, Brown may have thought that a 1818 involving three professors. (See footnote 6.) Num erous student fraternity might rein in their rowdiness and instill professional and academic disputes were spread by pamphlets some professional decorum. H e gave the new fraternity a and anonymous letters to the local newspapers and disrupted mysterious name, the Kappa Lambda Society of Hippocrates. the academic calm. Secrecy was a notable fe ature. He may have felt that a secret symbol and a secret password would make the fraternity At the same time, a physician in Philadelphia wrote I hal more appealing to spirited youths, and that a badge and his medical colleagues "lived in an almost constant state goals would help form a professional bond among them. of warfare, quarrelling, and even worse .. .st reet fights." 13 The December 1822 minutes of the Kappa Lambda Society Indeed, there was not a city or town in the whole nation listed 128 members, including one from Ireland. "where doctors were not at each other's throats." 14 The cause was competition for paying patients.
VoL. IV, No. 2, FALL 2011 he significance of the Greek Nothing of lasting significance appears letters in the society's name to have transpired in Lexington's chap T was never disclosed publicly, ter of Kappa Lambda. It remained but recall that Brown also taught active for less than a decade and faded chemistry. T he Greek from history a few years after Brown letter Kappa is thought retired and left Lexington in 1825. by some to represent the The Transylvania Medical journal Greek word "crystal," (1828-1852) was edited by members of KpuoTCXAAO<;. The sim- the Medical Department, but it had no plest crystal is the cube, and connection with the society. However, this was the symbol adopted the spirit of the Kappa Lambda by the society as its emblem Society survived in its branches, which -indicative of purity and flourished for a time in several East primitiveness. Indeed, the Coast cities. word "primitive" was a secret password to be used during introductmy conversations to hlPPA UMBDA identify a member. T he word was SociETY BRANCHES also inserted (often somewhat AND MEDICAL ETHICS fo rced) in documents of the society, e.g., "the great primitive Author of Chapters of the Kappa Lambda nanu·e" or "the trium ph of primitive Society were established in nature."The Cree k letter Lambda had Philadelphia, New York City, no particular signifkance except "to Baltimore, Washington, D.C., and lead astray the uninitiated in their con possibly elsewhere, but little or nothing jectures." 1 ~ (Sec fiwtnotc 7.) about them has been preserved. In Philadelphia the chapter was called ' J'hc fratcmity badgt• was a the Kappa
\flllJJI square (like a cube, similar Lambda Society 1111 o~\ im t/tJttial', 11 111 '·'ltr ' " to the Philadelphia Chapter .. of Aesculapius, it. I\ II ....c:i "~ ~~ 1/ (,,, badge, right) on which was :: Jl A while in New ,, ..::, ~ Ill( J,\" inscribed the words "Virtue, £: p ;::-
~ n Bpptnbltl remembered today with some dismay for aggressively bleeding and purging T he need for some socializing force in DISCOliRSI: (IN II OS I'll .\1, Ill! II/ ' J patients suffering from yellow fever and the profession as well as a fo rum fo r other febrile illnesses. But among his settling medical disputes was milling .\'OTES /.\'/) /l.IUYTIUTIU.\• more worthy medical contributions was around in the minds of various American physicians, including Daniel TIIO\JAS PtRCI\' AI, \1. D. his Lectures 011 the M edica/jurisprudence ...... ' ...... , ..... ~ .... rfthe Mind. Published in 1810, this Drake (1785-1852), the foremost was the first review of medical ethics in nineteenth-century physician in the America. Rush speculated that profes Ohio Valley region. He concluded that sional rivalry ("this peculiar professional the only solution to such conflicts was depravity") was due to physicians' to establish a neutral body-some isolation-an isolation that could be impartial medical association- that relieved by physicians holding "frequent would arbitrate disputes and elevate The parent organization oftbe Kappa Lambda social and convivial meetings." 16 the level of social intercourse among Society iu Lexington publisbed extractsfrom ThomtU physicians.14 Percival's code ofm edical etbirs in 1821 and sent tbem to its branches in Pbiladelpbia and New York City. The book became a standardfor medical etbics.
VoL. IV, No. 2, FALL 20 11 So the ethical ideas of Gregory, Hume, Percival, and Rush Northern newspapers. The lingering notoriety of his sup were likely in Brown's thoughts when he established the posed murder stirred a latent suspicion of Freemasonry. An Kappa Lambda Society in 1819. This society might have anti-Masonic hysteria swept over the country and soon been more visible in the history of American medicine had touched other secret societies. not its branches in Philadelphia and New York City been destroyed by jealous, uninitiated physicians in these two Phi Beta Kappa was one so affected. As noted previously, cities. Nonetheless, the society's influence would later be it originated as a secret society and developed chapters at expressed in another organization, the American Medical several East Coast universities. In 1831 the Harvard chapter Association. "removed the requirement for secrecy" in response to the anti Masonic fervor. All Phi Beta Kappa chapters soon assumed DEMISE OF THE the purely honorary character £1 miliar to us today. Other hlPPA LAMBDA SociETY Greek-letter fraternities relaxed their shields of secrecy. But at Yale in 1832, the ultra-secret society, Skull and I3ones, was The demise of the two Kappa Lambda Society branches founded, perhaps as a contrarian response of students there seems related to an alleged murder in western New York to the prevailing anti-Masonic, anti-secrecy sentiment. state. William Morgan was an occasional stonemason who lived in Batavia, New York. It's not known whether he was Meanwhile in Philadelphia, the secret nature of the local ever admitted to membership in any Masonic organization, Kappa Lambda branch was revealed to the general public but he acquired enough knowledge to write a book purport during a faculty fracas at Jefferson Medical College. In 1829 ing to reveal the secrets of the Masonic Order. Efforts were one of its professors, Francis Beattie, was ftred. He had said made to prevent its publication, including arson at the shop unkind things about the school's founder, George McClellan, printing the book. In September 1826, Morgan was jailed father of the future briefly for a trivial debt. When released that Civil War general. evening, four men were McClellan sued observed forcing him lkattic. l)uring th e into a yellow carriage. trial it was disclosed Morgan was never seen that Beattie was alive again. Suspicious f(mcled and sup neighbors assumed that ported by a secret he had been abducted medical fraternity, and dwwned in Lake the city's Kappa Ontario when a decom Lambda Society posed male corpse floated of Aesculapius. A ashore near the mouth of flurry of charges the Niagara River. 18 and counter charges organ's book appeared in about the rival medical M Masons was journals, one published but aroused little claiming that excitement or interest com both the pared with the mystery of University of his disappearance. No other Pennsylvania crime of the period garnered and the so much coverage in the Philadelphia H ospital were now This handwritten copy tifthe oath takm dominated by members ofthe Kappa Lambda Society is in Transylvania's Special Collections. by Kappa Lambda TRANSYLVANIA TREASURES
members. The unfavorable publicity soon led to the demise THE IDEA OF AN AMERICAN of the PhUadelphia Kappa Lambda branch. 11 MEDICAL ORGANIZATION
One tangible reminder of the Philadelphia branch resides in Contrary to the epitaph, the New York Kappa Lambda the few libraries still preserving the North American Medical Society did not succumb in 1839 but survived until 1862. and Surgicaljournal, which was edited by Kappa Lambda During its waning years, there appeared in New York C ity members from 1826-32. In 1830, while defending Beattie, the first stirrings of a more durable organization, the future the journal sought to preempt bad publicity about the secret American Medical Association. I n the late 1840s at meetings society in Philadelphia by being the first to discuss the in New York City and Philadelphia, physicians began Kappa Lambda branch there. The article added parentheti l addressing the nationwide issues of medical education, certi cally that Kappa Lambda had "a very excellent branch in fi cation, and licensure, along with the pressing problem of New York City." 11 professional etiquette and ethics. T he latter problem had led to the creation of the Kappa Lambda Society in 1819. But So it was inevitable that the northern branch would soon why in 1846-47 were the other issues fin ally being discussed come under scrutiny. By then the Kappa Lambda Society at a national level? membership in New York City had grown to include many physicians with the best hospital and academic appoinunents, twas primarily a tnatt t· r ore conomics. Competit ion for the president of the College or Phy s i c i an ~ and S u rj~C() Il S , and !Jay in ~ p :ll icnts. hnd lwr<.>lll c li <"rn·. wi 1h 1h e rnushwom some or its trustees. l11 the mid 18.\0s the trustees "brought I tng tHIIIlhn :. ol dor totll '" th r lltt toll rt•gular charges" a~: tin s t 1h e Colkgc of' Physicians nnd S"'I\I'OnHf itr phy~k i : ut ~ a11d 11 0 11 tegubr lw:tfl·ts, tlw latt er ind uding ulty ror SOil\ <.: flO W ftlt'gotiCII faul t. Many JliOfl'SS OI ~ l ( '~i ~~ · H · d honwopnl hh, lwt h:tlists ('f'hw 11psnn ian doclot's), rclel'l ics, in protest and then es tahlihhed a ntt•din d srlwcll ll ((ili:tt t•d <'111pltirs, 11 11d ' l" :tr ks. It W:l ll cstilll:llt' VoL. N , No . 2, FALL 201 1 23 Percival's book. Boston's rules were adopted by 11 other INFLUENCE OF THE hlPPA LAMBDA state medical societies from 1817-42. SociETY oN THE AMA In May 1846, delegates from 16 of the 26 U.S. states met at This essay suggests that the Kappa Lambda Society New York University to draft resolutions on various matters contributed in particular to one area of greatest concern to facing American medicine. These resolutions, intended for the AMA delegates: the principles of medical ethics. further discussion and adoption at a later meeting in As early as 1821, Kappa Lambda Society members in Philadelphia, concerned various topics: a national medical Lexington had seeded Percival's code to its branches, whose association, medical education and licensure, and a uniform Philadelphia members in tu rn proposed the code to the code of medical ethics. AMA convention in 1847. FouNDING OF THE AMERICAN n additional goal of the Kappa Lambda Society MEDICAL AssociATION was incorporated in the AM Ns preamble, as noted A above. "The cultivation of friendly and brotherly In May 1847, representatives feelings" was included in the minutes of from 40 medical societies and an 1822 meeting of the Kappa Lambda 28 medical schools convened in Society in "the Medical College of Philadelphia and approved the Transylvania University," as recorded establishment of the American by H enry Miller. H e was the 43rd Medical Association. Delegates member in the society's list for that to the earlier meeting in New year, a Transylvania medical graduate, York City had included two and in 1859 the 13th president of the prominent members of the New AMA. He practiced obstetrics in Kentucky and taught at the MedicRI York Kappa Lambda branch, h & MUlL II I TIH Edward Delafield and Alexander Institute of Louisville Universi ty. W hether he was a delegate to the H. Stevens. From the now 1846-47 meetings in New York City defunct Philadelphia branch and Philadelphia leading to founding came John Bell and Isaac Hays, u the AMA is unknown. who co-authored the report on medical ethics, which was unani In addition to the members of the mously adopted. The official code Kappa Lambda Society cited above, of conduct adopted was patterned there were eight others from largely after Percival's code, pre Philadelphia. 27 Four presidents of serving "to a considerable extent" the AMA were Kappa Lambda his phrases but also inserting members: A.H. Stevens (the second, elsewhere "the words of the late 1848), G.B. Wood (ninth, 1855), Dr. Rush." 24 H. Miller (13th, 1859), and Samuel D. Gross (20th, 1868). T he preamble of the AMA's IICIIry Miller, a Transylvania medi~al gradu~te·. was the constitution stated the purposes of 13th presidCIII oft he American Medu~l ~ssoctatlon . A. ' . . . . reprint ofhis annual meeting address tS 111 Tramylvama s In conclusion, the early focus of the the orgamzat10n, wh1ch mcluded Special Collectiom. Kappa Lambda Society on medical "fostering friendly intercourse ethics and professional courtesy and the subsequent role of its between those engaged in (the medical profession)." 25 members in founding the AMA suggest a debt owed by it to T his wording is similar to one of the original goals of the this forgotten secret medical society and the first "publick Kappa Lambda Society- that of bringing about "the cultivation of friendly and brotherly feelings between school" in~t«-C/toJ-1-~ Do~," 26 Transylvania University. 'IT the practitioners ofd 1• f"Crerent d"1 stn. cts an d states. " I PAGE EIGHT TRANSYLVANIA TREASUII.ES References 27. Mayo, W.P. "Kappa Lambda Society." ln: Mrtlirint i11tht 1/thms oftht Wrst. M cCiandan Publishing Co.; 1999, pp. 64-89. I. Phi Btl a Kappa, /l/1mulbool< for Ntw MunbtrJ. New York: The United C hapters 28. Randall, W.S. Thomns} I I. Leake, C. D. "Wh:u Wa< Kappa l.amhda?" /lmtall ~j'/1/rd/wl //iuory. 4: 1922, pp. 4. A scrupulous scholar might argue that Tr:msylvanin's 1\ l edicnl Dcp.ortmeou was 196-206. not the fifth medical school founded in the U.S., hoot the •evcnth or ci!\hth 1 because of several others estal>li shcd in the l VoL. IV, N o . 2, FAL L 20 11