Two Hundred Years of Medicine at Dartmouth

Blough is director of alumni affairs emerita of Dartmouth Medical School and vice chair of the Bicentennial Symposium Planning Committee. Grossman is director of publications for DMS and editor of Dartmouth Medicine magazine, as well as a member of the Symposium Planning Committee.

Nathan Smith single-handedly founded DMS and played a role in the founding of three other schools, leading historians to dub him the "Johnny Appleseed of American medicine."

Like the fabled phoenix, Dartmouth Medical School has endured crisis after crisis, reinventing itself and surviving each time with renewed strength and spirit. The story starts in 1796 with Nathan Smith, a young, Harvard-trained physician from Cornish, N.H., whose patients were spread the length and breadth of the Upper Connecticut River Valley. Dr. Smith found that the distances among the scattered settlements made it hard to reach the sick when he was needed, and he reasoned that a medical school at the new college in Hanover would bring more physicians and improved medical care to the area.

That was essentially the argument Smith made in a letter of August 25, 1796, to the Trustees of Dartmouth College. Today it seems inconceivable that Dartmouth, itself poor and struggling for survival, would agree to start a school of medicine far from the sources of support enjoyed by the three existing schools-the University of Pennsylvania (founded in 1765) in Philadelphia, Columbia (1767) in New York, and Harvard (1782) in Boston. But in an extraordinary leap of faith, the Trustees did just that, commencing 200 years of continuous medical education at Dartmouth. The Board may have been swayed by Smith's promises to prepare himself by studying at his own expense in Edinburgh (then the world's center of medical knowledge), to contribute his own laboratory and classroom equipment to the effort, and to teach all the courses himself.

Although the Trustees delayed his formal faculty appointment for nearly two years, Dr. Smith moved swiftly and began lecturing on November 22, 1797. For the first two years, he taught in a rented house on Hanover's Pleasant Street; in 1799, the College gave him a room in Dartmouth Hall. Such were the Medical School's beginnings-one man, one room, and, at the outset, a handful of students.

But Nathan Smith was a gifted teacher, ahead of his time in medical theory and practice, and passionately committed to a scientific approach to medicine. Within a few years, as his reputation spread, he had all the students he could handle. He also continued his practice, taking students along with him on horseback as he treated his far-flung patients. In addition, his lectures were so popular with undergraduates that he is credited with introducing science into the College's curriculum; the 1806 catalog lists 45 medical students and 36 undergraduates in his classes.

Finances were a problem from the beginning. The College, chronically underfunded itself, could provide little help until 1805 when Dr. Smith was offered a salary of $200. Earlier, at Smith's request, the New Hampshire legislature had given him $600 for medical equipment, so when the space in Dartmouth Hall became clearly inadequate he turned to the state again. Recognizing the value of a medical school to the state, the legislature awarded him $3,450 towards construction of a three-story building. Completed in 1811, the "New Medical House" was the nation's first building constructed and used specifically for the purpose of medical education; it was razed in 1963.

Return to General Information