Education: How Old The New

by James J. Walsh

With the light thrown on the early history of printing on this continent by a paragraph like this, how amusing it is to be told that the tradition among the printers and the publishers and even the bibliophiles of the United States is that the first book printed in America was the Massachusetts Bay Psalm Book printed, I believe, in 1637. There were no less than seven printing presses at work in Mexico during the sixteenth [{321}] century, fully fifty years before the Massachusetts Bay Psalm Book was issued. How interesting it is for those who still like to insist that the Catholic Church is opposed to the distribution of the Scriptures to the people or its printing in the vernacular, to find how many editions of it were printed in Mexico and in South America during the sixteenth century. This story of the printing press in Spanish America in the early days would of itself make a most interesting chapter in a volume on American origins, which could probably be extended into a very valuable little manual of bibliography and bibliophilic information that would arouse new interest in the accumulation of early American books.

The university had been founded just twenty-five years when provision was made for the establishment of the medical department. According to most of the chronicles the first chair in medicine was founded June 21, 1578, although there are some authorities who state that this establishment came only in 1580. I am a graduate of the University of Pennsylvania Medical School myself, and I yield to none of her sons in veneration for my Alma Mater, but I cannot pass over this statement of the foundation of the medical school in Mexico without recalling that we have been rather proud at the University of Pennsylvania to be known as the First American Medical School. This is, of course, only due to our fond United States way of assuming [{322}] ourselves to be all America and utterly neglecting any knowledge of Spanish America. I believe that there are tablets erected at the University of Pennsylvania chronicling our priority. One of them is to the first graduating class, the other to the first faculty of the medical school. I believe that between the erection of the two tablets there had come to be some suspicion of the possibility that South America was ahead of us in this respect and so the second tablet specifically mentions North America. When I talked some time ago before the College of Physicians of Philadelphia on this subject one of my friends, who was a teacher at the university, asked me what they should do with their tablets. I suggested that, by all means, they should be allowed to remain, and that as soon as possible an opportunity should be secured to erect the third tablet containing a statement of the real facts with regard to the place of the University of Pennsylvania as the protagonist in medicine in the United States. The tablets will then serve to show the gradual evolution of our knowledge of the true history of medical education in this country. It is all the more important that this should be the arrangement because the University of Pennsylvania has been a leader in "the discovery" of South America that has been made by us in the last few years.

Between the date of the foundation of the first chair in medicine at the beginning of the [{323}] last quarter of the sixteenth century and the foundation of the city, Mexico had not been without provision of physicians. In the very first year of the existence of the University of Mexico, though there was no formal faculty of medicine, two doctors received their degrees in medicine from the university. They had been students in Spain and were able to satisfy the faculty of their ability. This shows that the institution was considered to have the power to confer these degrees upon those who brought evidence of having completed the necessary studies, though it was not in a position to provide facilities for these studies. It is evident that this custom continued in subsequent years until the necessity for medical studies at home became evident. The intimate connection between the universities of old Spain and of New Spain is a very interesting subject in the educational history of the time. Even before the foundation of the university, however, definite efforts were made by the authorities to secure proper medical service for the colonists and to prevent their exploitation by quacks and charlatans.

Strict medical regulations were established by the Municipal Council of the City of Mexico in 1527 so as to prevent quacks from Europe, who might think to exploit the ills of the settlers in the new colony, from practising medicine. Licenses to practise were issued only to those who showed the possession of a university degree. [{324}] This strict regulation of medical practice was extended also to the apothecaries in 1529. Even before this, arrangements had been made for the regular teaching of barber-surgeons, so that injuries and wounds of various kinds might be treated properly, and so that emergencies might be promptly met, even in the absence of a physician, by these barber-surgeons. Dr. Bandelier, in his article on Francisco Bravo in the second volume of the Catholic Encyclopedia, calls attention to some important details with regard to medicine in Mexico in the early part of the sixteenth century, and especially to this distinguished physician who published the first book on medicine in that city in 1570.

Three years before that time Dr. Pedrarius de Benavides had published his "Secretos de Chirurgia" at Valladolid, in Spain, a work which had been written in America and contained an immense amount of knowledge that is invaluable with regard to Indian medicinal practice. Dr. Bravo's work, however, has the distinction of being the first medical treatise printed in America.

The issuance of these books shows the intense interest in medicine in the sixteenth century, but there are other details which serve to show how thorough and practical were the efforts of the authorities in securing the best possible medical practice. In 1524 there was founded in the City of Mexico a hospital, which still stands and which was a model in its way. That way was [{325}] much better than the mode of the construction of hospitals in the eighteenth century, for instance, when hospitals and care for the ailing reached the lowest ebb in modern times. Other hospitals besides this foundation by Cortez soon arose, and the wards of these hospitals were used for purposes of clinical teaching. Clinical or bedside teaching in medicine is supposed to be a comparatively recent feature of medical education. There are traces of it, however, at all times in history and while at times when theory ruled the practical application of observation waned, it was constantly coming back whenever men took medical education seriously. Its employment in Mexico seems to have been an obvious development of their very practical methods, which began with the teaching of first aid to the injured and developed through special studies of the particular diseases of the country and of the methods of curing them by native drugs.

A chair of botany existed already in connection with the university, and this, with the lectures on medicine, constituted the medical training until 1599, when a second medical lectureship was added. During the course of the next twenty years altogether seven chairs in medicine were founded, so that besides the two lectureships in medicine there was a chair of anatomy and surgery, a special chair of dissection, a chair of therapeutics, the special duty of which was to lecture on Galen "De Methodo Medendi," a [{326}] chair of mathematics and astrology, for the stars were supposed to influence human constitutions by all the learned men of this time and even Kepler and Galileo and Tycho-Brahe were within this decade making horoscopes for important people in Europe, and, finally, a chair of prognostics. Most of the teaching was founded on Hippocrates and Galen, and lest this should seem sufficient to condemn it as hopelessly backward in the minds of many, it may be recalled that during the century following this time Sydenham, in England, and Boerhaave, in Holland, the most distinguished medical men of their time and looked on with great reverence by the teachers of ours, were both of them pleading for a return to Hippocrates and Galen. As a matter of fact, the medical school of the University of Mexico was furnishing quite as good a medical training as the average medical school in Europe at that time, at least so far as the subjects lectured on are concerned. Indeed, it was modelled closely after the Spanish universities, which were considered well up to the standard of the time.

In the meantime additional chairs in university subjects continued to be founded. Another chair in arts was established in 1586, and further chairs in law and grammar were added at the beginning of the sixteenth century. The Spanish Crown was very much interested in Mexican education, and King Philip II of Spain, who is usually mentioned in English history for quite [{327}] other qualities than his interest in culture and education, was especially liberal in his provision from the Crown revenues of funds for the university. At the beginning of the seventeenth century, according to Flores in his "History of Medicine in Mexico from the Indian Times Down to the Present," the total amount of income from the Crown allowed the University of Mexico was nearly $10,000. This was about Shakespeare's time, and so we have readily available calculations as to the buying power of money at that time compared to our own. It is usually said that the money of Elizabeth's time had eight to ten times the trading value of ours. This would mean that the University of Mexico had nearly an income of $100,000 apart from fees and other sources of revenue. This would not be considered contemptible even in our own day for a university having less than twenty professorships.

The number of students at the University of Mexico is not absolutely known, but, as we have seen, Professor Bourne calculates that the University of Lima had at the beginning of the eighteenth century more than 2,000 students. The University of Mexico at the same time probably had more than 1,000 students, and both of these universities were larger in number than any institution of learning within the boundaries of the present United States until after the middle of the nineteenth century. After all, we began to have universities in the real sense of [{328}] that word--that is, educational institutions giving opportunities in undergraduate work and the graduate departments of law, medicine and theology--not until nearly the end of the first quarter of the nineteenth century. Our medical and law schools did not, as a rule, become attached to our universities until the second half of the nineteenth century, and even late in that. This was to the serious detriment of post-graduate work, and especially detrimental to the preliminary training required for it, and consequently to the products of these schools.

Before a student could enter one of the post-graduate departments at the University of Mexico in law or medicine, he was required to have made at least three years of studies in the undergraduate departments. When we contrast this regulation with the custom in the United States, the result is a little startling. Until the last quarter of the nineteenth century students might enter our medical schools straight from the plow or the smithy or the mechanic's bench, and without any preliminary education, after two terms of medical lectures consisting of four months each, be given a degree which was a license to practise medicine. The abuses of such a system are manifest, and actually came into existence. They were not permitted in Mexico even in the seventeenth century.