USA > Massachusetts > Suffolk County > Boston > Metropolitan Boston; a modern history; Volume I > Part 33
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"Such an advertisement and the facts which led to it do not help the interests of Massachusetts or her people. We believe this matter should be left to the regulation of the justices of the Supreme Judicial Court in future, with the assistance of the Bar Examiners, and that they should be trusted to regulate it in the interest of the public as they are trusted with all their other important duties.
"We think that all citizens of the Commonwealth, whether graduates of any educational institution or not, should stand on the same footing so far as examinations are concerned. We believe that Massachusetts should require a high standard for admission to the bar. Massachusetts cannot afford to lag behind other States in the requirements of intellec- tual training for the bar. The longer this step is delayed the worse will be the conditions of practice. We cannot expect any progress in the administration of justice without the aid of a trained and educated bar. A stream cannot rise higher than its source, and in the long run the standard of the courts cannot be above that of the bar.
"We recommend that the present statutory restrictions upon the ac- tion of the Supreme Judicial Court in this matter be removed."
Practice and Procedure-As to courts and procedure, the complaints of excessive technicality and archaic procedure which have been referred to in many recent public addresses apply mainly to other States and have little application to Massachusetts. Some of the complaints of "tech- nicality" are made by lawyers who are insufficiently trained or who do not want to take the trouble to think out their cases before they plead. Some rules of procedure are needed to save time, and it is the business of lawyers to understand these rules. The underlying purpose of pleading is a simple one-to make clear what the real dispute is about before it
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comes to trial, in order not to waste the time of everybody, and to let the parties know what they are to meet.
Our criminal pleading was simplified more than twenty-five years ago after the careful report of a commission consisting of Hon. Henry N. Sheldon, Professor Joseph H. Beale and Franklin F. Hurd, Esq. Ever since the early fifties our civil practice act has been reasonably simple. Indeed, we have gone so far in eliminating what is called "tech- nicality" in pleading that time and money of litigants is often wasted in preparing to meet issues which are really not disputed but which have to be prepared for because of the loose general character of the pleading.
One of the problems of the future is to develop a workable plan for finding out at the earliest possible moment before trial what the real fuss is about. That is the simple idea which underlies the effectiveness of the English and Canadian practice. It is important not because it is Eng- lish, but because it is sound as any layman can understand. It is not easy to bring about, however, in view of the fixed habits not only of the bar, but of the community, many of whom complain of delay but like it when they want it. We are a pretty litigious people and we need to learn to restrain our tendency to fight everything whether it is fair to fight it or not. That is one reason why a well-trained bar with decent profes- sional standards is important.
Court Organization-As to court organization and the methods of bringing about improvements, the following extracts from the report of the Judicature Commission in 1921, already mentioned, describe the gen- eral situation :
"If the problem before the Commission were one of preparing for a new community the best system of courts and of procedure which could be devised for 'a busy people who cannot afford to waste time and money,' the theory of a 'unified' or 'single' court, with different branches or divisions for all the various judicial duties required in the State, and an administrative head with adequate power and a sufficiently elastic system to enable him to dispose of all the judicial power in accordance with the requirements of the business to be done in the various parts of the State, would have much to recommend it. Even as it is, with the problem presented of recommending improvements in the system of one of the oldest American Commonwealths, the ideal of greater unity and of greater flexibility and elasticity in the administrative features, as well as of greater responsibility, must be borne in mind as one to be approached as far as practicable.
"On the other hand, we are dealing with a system for the administra- tion of justice in an old Commonwealth where, whatever may have been the defects of the system, the personal character and ability of most of
MARCUS MORTON
Associate Justice Massachusetts Supreme Judicial Court, 1825-1840; Governor of Massachusetts, 1840-41 and 1843-44.
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the individuals who have held judicial office have, on the whole, made the system work, as modified from time to time during a period of one hun- dred and forty years, in such a way as not only to retain the respect of the community but to give the State a distinguished position in the minds of all thorough students of civil government.
"It must be remembered that in the development of a judicial system sudden changes of a very radical character suggested by logical theories of efficiency are not easily effected, and that, even if adopted, there might follow in practice unexpected and undesirable results from the disturb- ance of local conditions, traditions and prejudices effected by changes, the reasons for which would not be generally understood or agreed upon by the bar or by the public.
"This danger of producing new and undesirable conditions by at- tempting to transplant suddenly in an old community an entirely new judicial structure, however logical and efficient it might be, is, in the minds of the Commission, a controlling objection to plans involving the abolition of the whole system of courts with their reconstruction on other lines. It could not be done without the support of a large body of the bar, and we do not find any general opinion in its favor.
"The central idea underlying the leading discussions of administra- tion in this country in recent years is to work out plans adapted to the different States of dividing the work to be done and placing the respon- sibility for doing it as promptly and finally as possible, in accordance with the requirements suggested by the nature of the work."
Met. Bos .- 19
CHAPTER VIII. THE MEDICAL PROFESSION.
It seems strange that the physician is so little known to fame, or that the saga of the doctor has been sung so seldom. Particularly has this been true of Boston, which has played so honorable and notable a part in the history of medicine in the United States. The story of the city is replete with great names; writers have immortalized lawyers, ministers, soldiers, merchants, sailors, but not often have they given their pens to the tales of the doctor and the surgeon. History has been written about all sorts of men and women, even fools, scoundrels and busy-bodies, but little can be found concerning the great medical men who, from the very first settlement, did so much to make the develop- ment of Boston possible, and who, in the advancing periods, brought health and wealth and honor to their city. Of the doctor, little has been recorded, and few seem to care. Each generation went its way and gave homage only to the science of the time, forgetting, apparently, that the progress of any present it based upon the knowledge of the past. Each stood upon the shoulders of the one just going out, reaching eagerly for something new, and only occasionally did someone stop and speak of those who had made possible the new.
The Strange Lack of Prominence Given to the Early Physician-By some queer whim of fate, many of the early physicians of Boston are known better by their avocations than their vocations, by the side paths into which they strayed, rather than by the main highway in which they ran their course. "Deacon" Samuel Fuller, one of the Pilgrims of the "Mayflower" from whom so many are proud to have descended, was Dr. Fuller, whose practice covered two colonies in the days when Boston had its first group of pioneers. William Gager is mentioned as a "godly man" by Governor Dudley ; he was a deacon of the Charlestown church. But he was also the first resident physician of Boston. Unfortunately he died soon after his arrival. Many of the ministers in the early Boston colony were better doctors than preachers of doctrine. John Winthrop the younger comes down to us in history as the first Governor of Con- necticut. Before coming to this country, he had studied, perhaps, under Harvey, who not so many years before had discovered the functions of the heart and the circulation of the blood. Remembered as a statesman, John Winthrop, Jr., was probably of the greatest service to his fellows as an educated practicing physician. Again, only the public works of the senior Winthrop have thrust in the background his medical knowl-
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edge and the value of his ministrations among his neighbors. Cotton said of him just before his death, that he had been a "Help for our Bodies by Physick ; for our Estates by Law."
Charles Chauncey goes down on the pages of history as the stern president of Harvard College, as does Leonard Hoar, who succeeded him, yet they were both graduates of medicine at Cambridge, England. John Rodgers, the fifth president of the college, was also a doctor. Elisha Cooke graduated from Harvard in 1657, being one of the first of the Bos- tonians to study medicine. He was a notable physician, but this has been forgotten in the prominence given to his political activities. Harv- ard College was founded in the year 1636, but from that time until 1750, but nine of its graduates received a medical degree, and these were taken abroad, two at Padua, Italy; one each at Cambridge, Oxford, Aberdeen and Leyden.
Early Prescriptions-Perhaps the "times," that ready refuge of the historian in the time of need, explains the strange lack of prominence given to the medical career of the men of the olden day. Medical sci- ence had not progressed very far at that period, but then, there are those who insist that it has not got so very far even today. The story is told of the younger Winthrop, that he valued highly a prescription whose ef- ficacy was dependent upon "Crabbes eyes" (Oculi cancorum) in vinegar. Sir Kenelm Digby, who gave him the recipe, directed to "give two spoon- fuls att a time to drink three times; and you shall see a strange effect in a weeke or two"! John Wadsworth, of Roxbury, paid fifty pounds for a certain cure for cancer. This recipe directed : "Take 3 frogs and put ym into a deep airthen Basen and power upon them as much swete oyel as will cover them, put ym into a hot oven and let ym stand a quarter of an houre ; then turn off the remaining oyel and dip tow in it and apply to the canser ; and for a plaster you must take the yolkes of 2 eggs, Burnt Allow, I oz. Boal armonick, I oz., Bay salt one half oz. Bruse all to a fine pouder and mix with yr yolkes of eggs and apply in form of a plaster to the sore every 3d day. Give a portion of a spoon of salts to cool the hete of the Blood ; this alwaise will carry off a canser humor if timely applied ; the person must make them constant Drink canser roots tea. . . . We may att sartain times apply a tode cutt in two to the wound two or three times a week the nature of the tode is such yt will draw out the canserous and pysonous and if proseded in this manner you may cure any canser."
These two weird prescriptions reek of the dark ages, but they are from an age that was dark in other respects. There was witch-craft, for one thing, and strangely enough, Margaret Jones, the first person to be executed as a witch, was also a doctress. Mather won an undying fame as a persecuter of witches, but who knows the names of any of the sev-
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eral physicians who abetted him. The first American medical publication was published in Boston and written by a minister. Its author, Reverend Thomas Thacher, first pastor of the Old South Meeting-House, has had reams written concerning him despite the fact that his "Brief Rule to guide the Common People of New England How to order themselves in the Small Pocks or Measles" was a dreary, worthless bit of credulity.
The Lack of Physicians in the Colonies-Something better than the "Times" must be sought for the explanation of the comparative silence of our histories in regard to the physician. Savage, after a "painful search," collected the names of 134 men who were doctors in the Massa- chusetts Colony during the first sixty-five years. Others, such as J. M. Toner and F. H. Brown, have also made exhaustive lists of those who practiced medicine in the early days. James Gregory Mumford narrows these lists down to the best known Massachusetts physicians of the seventeenth century, but oddly enough, ten of the eighteen are known better for other activities than as doctors. And yet the doctor ranked with the minister as a leading citizen in the early days in New England; he was in no wise handicapped by the class prejudice which held sway in the mother country. But as a leader he was also prominent in public affairs, and is remembered as a politician. In the provincial Congress of Massachusetts Bay, in 1774, there were twenty-two doctors representing as many localities !
Oliver Wendell Holmes Remembered Only as an Author-It is not necessary to delve into the past to find this lack of written appreciation of the medical man. Consider what is known of Oliver Wendell Holmes, who lived almost to the present century. He is known to the world at large as "the best beloved of the American writers" who "so represented Boston, so interpreted Boston, as to make himself its definite exemplar." Shackleton writes : "Boston is the city of Holmes, and he himself was Boston epitomized . . . the best of Boston concentrated in one human form" and goes on, like many another to rhapsodize about his literary career. In King's Chapel, where Holmes worshipped, there is a tablet placed in his commemoration which in the order of its inscription, more truthfully summarizes the activities of the "Autocrat." It reads "Teacher of Anatomy" and follows with "Essayist and Poet." To the writer of the cenotaph, his fame as an essayist was secondary to that as a teacher and surgeon, but there are but few who would agree with the order. Charles William Eliot, the late President of Harvard, was one. At a dinner given to Holmes on his seventieth birthday, there was general felicitation of Holmes as a man of letters. When President Eliot spoke he said: "It seems to be my duty to remind all these poets, essayists and story-tellers
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that the main work of our friend's life has been of an altogether different nature. I know him as a professor of anatomy and physiology at Harv- ard for the last thirty-two years. You think it is the pen with which Doctor Holmes is chiefly skillful. I assure you he is equally skillful with the scalpel." Perhaps Holmes may have wished to be remembered as a surgeon, but although Harvard honored him for his medical eminence, it is said that Boston never took him seriously as a doctor from the day when he whimsically let it be known that "fevers would be thankfully received."
Firman and Morley-Let it be recognized, then, that in the dark age of medicine, the doctor, though honored, was so because of his import- ance to the community as a minister, or lawyer, politician, or "selectman" rather than for the art he practiced. Even when medicine became allied to the sciences, this gradation still held sway. As for the surgeon, he was ranked below the doctor, for he was a barber, and the barber pole of today is the survival of the bloody pole which hung outside the barber- surgeon's establishment. Two names might be added to the meagre list already mentioned of the medical men in Boston during the seventeenth century, Giles Firman (Fairman) the apothecary (1632) and that more interesting character, Robert Morley, who was the Massachusetts Bay Company's barber and surgeon. He was so appointed at a meeting of the company in 1628, and for his services in pulling teeth, bleeding and other bits of minor surgery in this country, he was to receive the first year twenty nobles.
Plagues Which Troubled the First Settlements-Until well after 1700, the Massachusetts colony, and particularly Boston, were very feeble set- tlements, or group of settlements. People lived well scattered, farming was the main occupation. Diseases were few and there was little need for medicine or for doctors, except for the major ills. Children were born with little or no attendance by any one outside the home. If help was called, the woman mid-wife served. Children died early and often, but the survival of the fittest made for health in the grown. Death and suf- fering were considered along with the good things of life as "coming from the Lord." Perhaps the most serious health difficulty grew out of the "plagues that troubled the colony, and especially Boston." But even these plagues were usually borne meekly as the "Hand of God" raised in wrath against ill-doing, and the days of fasting celebrated on these occa- sions were not without their benefit in prevention and healing. Win- throp and his company of colonizers were fortunate in finding a land from which the Indian had been all but wiped out. A great plague, prob- ably the smallpox, had preceded the Pilgrims, and smallpox seems to have hung around to plague the white settlers who replaced the aborigine.
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It was the most dreaded hardship the pioneers had to endure. There were epidemics of this disease in 1633, 1663, 1666, 1668, 1677, 1688, 1690, and 1702. It was said that sixty per cent of mankind had been attacked by smallpox, and that ten per cent had died of it. The one common char- acteristic of humanity was a pock-marked face.
Variolous Inoculation-One of the several notable advances made in the practice of medicine, originating in Boston, came in connection with this all-pervading disease. It was the introduction of variolous in- oculation. It was tried when there was but one regularly graduated practitioner of medicine in Boston, William Douglass, a Scotchman, a fighter, and who became the bitter opponent of inoculation. We know something of the objections raised in our present day against vaccina- tion, but it is as nothing compared with the strife that raged when Cotton Mather, clergyman and layman, medically, tried to urge the new treat- ment upon the medical men of the town.
Cotton Mather vs. William Douglass-The Reverend Cotton Mather, who like many of the clergy, knew as much about medicine as many of the physicians of the town, had read in the "Philosophical Transactions" of the Royal Society at London, how the inoculation method was used among the Turks as a means of protection against smallpox. The article had been published in 1717, but evidently had received little attention. Mather, since he had gotten the paper through the kindness of Dr. Doug- lass, did the ethical thing in asking him whether he would undertake to try out the method in Boston where the pox was then epidemic. Young Douglass refused, perhaps because he disliked Mather for exploiting the possible new cure first. The old clergyman, always a lover of a fight, determined to find someone who would, and approached other physicians in the town. Douglass secured the ear of his colleagues first, he also had the press on his side. Benjamin Franklin's father led a newspaper cam- paign against the project. Legislation was all but passed forbidding any attempt at inoculation.
Eventually, Mather won the interest and aid of Dr. Zabdiel Boylston, of Brookline, a country doctor, but one appreciating the opportunity and quick to seize it. Dr. Roby, of Cambridge, and Dr. Thompson, of Rox- bury, joined the Mather party, although Boylston really bore the brunt of the battle alone. It was all a very strange affair in which not only the medical fraternity split and fought each with the other, but society itself was rent, very much as it was at a later period over the introduction of ether anaesthesia. Oddly enough, the clergy were arrayed on the side of science, a fact that should be remembered by the modern critic of religion. The Douglass faction forced the attack; they called Boylston a quack and
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dangerous experimenter. The press, under the leadership of Franklin, cried that death, if it followed inoculation, would be murder and should be punished as such.
Because of the importance of the advance made in medicine at this time, it may be well to stop and recall what is known of the men on both factions. Cotton Mather is too well known in the history of Boston to need more than mention, particularly as he was the politician and min- ister, his interest in medicine being that of the educated leader, a prog- ressive in the sciences. At the time of the inoculation fight (1721) he was an old man, but neither the activity of his mind nor the belligerency of his spirit had abated.
William Douglass-Dr. William Douglass was a Scotchman, born in 1690, who, in 1718, came to Boston, which he despised, but stayed. He had traveled widely and was proud of the fact. His medical education had been the best that the time afforded, having studied in Paris and Leyden, which made him somewhat contemptuous of his colleagues, since none of his contemporaries in Boston had his advantages. He knew something of the sciences, astronomy, mathematics, natural history, bot- any. He wrote a great deal, talked even more and well, was a scamp and sometimes strayed wide of the truth. One wittily said of him that "he was always positive and sometimes accurate." Everything that is known of him is very definite, it is either good or bad. On coming to Boston, he brought letters of introduction to Mather, but Mather snubbed him, which probably was the beginning of the trouble between the two. Doug- lass was a bitter fighter to the end. When the battle went against him, he did not acknowledge defeat. Instead, he set up a claim as the real prophet and champion of inoculation. He died October 21, 1752, having spent the whole of his professional life in Boston.
Zabdiel Boylston-Dr. Zabdiel Boylston, to whom came the glory of the occasion, was the son of Dr. Thomas B. Boylston, an Oxford gradu- ate who had settled in Brookline in 1635, where his son had been born in 1684. As Zabdiel lived until 1766, and entered his profession before the death of his father, the careers of the two in medicine covered a period of 131 years, an extraordinary incident, and possibly without equal in medical annals. If we are to accept the word of Thacher, the father "played the pedagogue in his ninetieth year." The son received much of his medical education from a Dr. John Cutter, and was a quiet, studious, high-minded and courageous man. He was undoubtedly naturally a con- servative, but once convinced of the possibilities of an innovation, there was little hesitancy on his part in putting the idea to the test. He endured the hatred of many who had been his friends while waiting for
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a chance to prove the inoculation theory. Even after success had fol- lowed the initial trials, his enemies pursued him, his very life being in danger.
Eventually the enmity passed, and the glory that came to Boylston amazed all Boston. A like controversy over inoculation had broken out in England, and the doctor was invited by Sir Hans Sloan, physician to George I, to tell his story and demonstrate his method. Again success. Four events marked his visit: He kissed the hand of royalty ; he pub- lished a defense of his case; he was given a thousand guineas by the King; and he was made a member of the Royal Society, the first native American to be so honored.
The Dramatic Test of Inoculation-So much for the principal actors in the scene; the actual test had its dramatic features. Dr. Boylston, probably because he had already suffered from smallpox and therefore could not inoculate himself, tried it on his thirteen year old son. Then two negro servants were infected-imagine their terror and their courage. Then a Mr. Walter, minister in Roxbury, and the nephew of Cotton Mather, offered himself for a test. Walter was in more danger from a mob that visited his house during the convalescence than ever he had been from the inoculation. Even after apparent success had attended the efforts of Boylston, his further work was opposed. The doctors of Bos- ton sought out a traveled person who swore to all sorts of dreadful results that he had seen, or claimed to have seen abroad, and persuaded the House of Representatives to pass a law prohibiting inoculation. Only the decision of the Governor's Council prevented its being enforced.
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