THOMAS CADWALADER AND HIS ESSAY* By WILLIAM SHAINLINE MIDDLETON MADISON, WISCONSIN HE aristocracy of Philadelphia was second only to Franklin, with medicine is deeply rooted in whom he was a contemporary." the traditions of the Colonial The growing interest in that emi­ period. Dr. Thomas Wynne, a nent American would justify an in­ Tfriend and counsellor of William quiryPenn, into the career of Thomas Cad­ accompanied the latter on his first voy­ walader, even though the latter might age to America in 1682. Wynne set a prove to have no grounds for inde­ precedent of civic consciousness for pendent consideration. As the story is subsequent generations of medical men evolved, however, Cadwalader takes an by becoming the president of the first increasingly important place. As a rule Provincial Assembly of Pennsylvania. these splendid figures worked side by The hereditary order of the medical side in the common weal. Franklin was profession is a conspicuous trait. Dr. usually the leading spirit but Cadwal­ Wynne’s daughter, Mary, married Dr. ader never withheld his support. In Edward Jones and their daughter, Mar­ many instances their united strength tha Wynne Jones, in turn married John won the day. Nor did Cadwalader lack Cadwalader in 1702. The Cadwaladers the qualities of leadership that would arose from Cardiganshire, Wales. The deny independent action to him. original spelling of the name was Kad- Thomas Cadwalader was born in Philadelphia in 1707. His father, who waladyr and it meant ‘’battle arranger.” held his citizenship a serious responsi­ John, the founder of the Pennsylvania bility, died in 1734 and his mother in branch of the family, was the son of 1747. Thomas attended the Friends’ Thomas and Rebecca Evans Cadwala­ Public School in Philadelphia and the der. At 19 he accompanied William academy at Bensalem, Bucks County, Penn on the latter’s second voyage to under Rev. William Tennant. In 1725 Pennsylvania. To Martha Wynne Jones or 1726 he was apprenticed to his and John Cadwalader were born three uncle, Dr. Evan Jones, for the study children, Mary, Rebecca, and Thomas. of medicine. Two years later, young Of the last named it has been written, Thomas went to Europe to complete ” 1 here was no public interest of any his medical training. In France he is kind that Dr. Cadwalader’s active and said to have studied in the University enterprising spirit was not the fore­ of Rheims. Thereafter he went to Lon­ most in promoting, whether in the po­ don where he applied himself assidu­ litical, social, professional, or institu­ ously to the study of anatomy under tional movements of his time, and in William Cheselden. This experience in his many-sided career of usefulness he human dissection was destined to have *Read before the University of Wisconsin Medical History Seminar at the home of Dr. William Snow Miller. a much wider influence than the mere John Pringle (December 21, 1757) re­ training of a young American medical ported temporary, not permanent, ad­ student. vantage from electrotherapy in palsy. Shortly after Cadwalader’s return to Philadelphia the importunities of his medical contemporaries led him to con­ duct a series of dissections for their in­ struction. T hese dissections were made in a building in Second Street above Walnut. Caspar Wistar indicated that James Logan probably sponsored them. It is beside our present purposes to claim priority for these anatomical demonstrations (1731), but they at least served to stimulate a local inter­ est in more adequate training. Among the interested group was the elder Wil­ liam Shippen, then a medical student 18 or 19 years old, and it may be as­ sumed that this experience led him to offer his son William the opportunity for foreign study some thirty years later. Cadwalader’s nephew, John Jones, was one of his house pupils "who won distinction in the practice of medicine. In 1730 Thomas Cadwalader re­ Jones dedicated “Plain, Concise, Prac­ turned to Philadelphia and began the tical Remarks on the Treatment of practice of medicine. His background Wounds and Fractures’’ (1775) to his and training forecasted his immediate uncle in the following terms: success. To these impersonal attributes To you, whose whole life has been one were added unusual personal charm, continual scene of benevolence and hu­ poise and urbanity. Cadwalader joined manity, the most efforts to soften human Kearsley, Zachary, and Bond in prac­ misery and smoothe the bed of death will, ticing inoculation against smallpox in I know, be an acceptable present, however 1730. The correspondence between short the well-meant zeal of the author Governor Jonathan Belcher of New may fall of his purpose. Nor will you sus­ Jersey and Benjamin Franklin (1751) pect me of the vanity of supposing I shall casts serious doubt upon the claim that convey anything new or instructive to men Cadwalader, the attending physician, of knowledge and experience in their pro­ fession, much less to yourself, to whose was the first to use electrotherapy. A excellent precepts, both in physic and singular confusion has entered the ac­ morals, I owe the best and earliest lessons counts of the Governor’s disability. in my life, and if I have attained in any Apparently he suffered from paralysis degree of estimation with my fellow citi­ agitans rather than from the results of zens, it is with the most sincere and heart­ electrocution, as some accounts read. felt pleasure that I acknowledge the Benjamin Franklin in a letter to Sir source. The medical fame of Thomas Cad­ Observations as may, I hope, be of Service walader rests securely upon his early to my Fellow Creatures. contribution of a monograph on lead I he Truth of it is, there can be no more poisoning from the imbibition of Ja­ maica rum distilled in leaden vessels. Yet the included clinical description of osteomalacia with the necropsy findings offers many details of greater signifi­ cance from the medical and historical standpoints. The brochure, “An Essay on the West-India Dry-Gripes; with the Method of Preventing and Curing that Cruel Distemper" was dedicated to and printed by Benjamin Franklin in 1745. The manuscript, a gift of S. Weir Mitchell, is in the Library of the College of Physicians of Philadelphia. In many source references Cadwalader is credited with the authorship of a second article on the iliac passion. Dulles has traced this error to David Ramsey’s statement (1801): “Idle ear­ liest publication in America on a medi­ cal subject, which has come in my way, was a treatise on the iliac passion by the late Dr. Cadwallader (sic) of Phila­ delphia, printed about 60 years ago.” Dulles listed ten medical papers pub­ lished in America before Cadwalader’s Essay. The catalogue of the Library of the College of Physicians of Philadel­ phia remarks that the Essay is the a perfect work in the World, than a per­ “earliest medical treatise written and fect man. To say therefore of any Per­ printed in America known to be ex­ formance, that there are Faults in it, is in tant. The only known copy containing Effect to say no more, than that the Au­ the two prefaces, one of which was thor of it is a Man. suppressed.” I would not however be understood to For comparison the essentials of the insinuate, that the following Piece is in two prefaces are appended: any Degree as perfect in its Kind as Man First— could make it. I am sensible, that, like other Arts, the Faculty of writing well is To the Reader. only to be acquired by writing much. If It was neither Thirst after Gain, nor anything is here taught that may be use­ the Desire of Applause, but the Welfare fid to Mankind, the candid Reader will, of Mankind alone, which excited me to for its sake, excuse Faults of Method, Stile publish this Essay. I have therefore frankly and Expression; But if I have inculcated and honestly laid before the World such any Mistake that may be of pernicious Consequence, let the Publick be set right, known or practised by others. By this the whatever Opinion they may afterwards Medicinal Art has been, and may still be entertain of me. greatly improved. Many are the Advan­ Second— tages the Present Age reaps from such a disinterested Conduct in our Predecessors; To the Reader. and where we have freely received, surely I have long been of Opinion, that ’tis we should freely give. the Duty of Physicians frankly to com­ This has induced me to write the fol­ municate to the World, any particular lowing Essay on the Dry-Gripes, and to Method of treating Diseases, which they recommend a Method of Cure which ap­ have found to be successful in the Course pears to me to be drawn from the Nature of their Experience, and not generally and Cause of that grievous Distemper, and which has approved itself to me by a I he Pains are frequently so sharp, that, very extraordinary Success. the Patient will fall on the Floor and cry And tho’ the Method here laid down out violently in the greatest Agony. may be new to the Generality of the Pro­ fession. it has been practised some Years, with great Approbation, by several Gen­ tlemen of distinguished Characters in Philadelphia. From their Judgment of this Method, as well as my own, I am inclined to hope the following Piece may contribute, in some Degree, to the Welfare of Mankind. With this View I have caused it to be printed, and submit it to the candid Con­ sideration of the Publick. In both prefaces grateful acknowl­ edgment is made for the assistance of Dr.