HISTORY
The Old Medical School of Louisville II:
A “ROSETTA STONE” FOR 19 TH CENTURY
MEDICAL HISTORY
Gordon R. Tobin, MD
L
ouisville’s Old Medical School Build-
ing at First and Chestnut Streets was
built from 1891-4 as the Louisville
Medical College (LMC), and was
immediately acclaimed as an ideal
facility and architectural masterpiece (Fig. 1).
In 1909, it became home to the University of
Louisville School of Medicine, and is a beloved
alma mater to scores of se nior Kentucky phy-
sicians. If one follows clues of structure and architecture, it is also a
“Rosetta Stone” that reveals much of 19 th century medical education,
practices and breakthroughs, just as the original Rosetta Stone deci-
phered ancient writings. For example, building layout reveals educa-
tional priorities of the time, such as incorporation of direct patient
care in the curriculum and emergence of new sciences. Also, archi-
tectural style
elements
reveal pro-
fessional
s e l f - c on f i -
dence from
newly dis-
covered ad-
vances that fi-
nally allowed
addressing
many horrif-
ic illnesses,
especially in-
fectious dis-
eases. Clues
Fig. 1 Louisville’s Old Medical School was built to house the Louisville
to these his-
Medical College.
toric events
abound in the Old Medical School. Thus, a landmark Louisville
structure memorializes a landmark medical era.
BACKGROUND: EVOLUTION OF 19 TH CENTURY
MEDICAL EDUCATION
The late 19 th century marked the transition of medical education
from ancient to modern form. The centuries-old practice of learn-
ing medicine by individual apprenticeships carried into the early
19 th century, when a 1-3 year apprenticeship was required before
admission to medical school, which then were lectures without
direct patient care experience. Thus, much of patient care lessons
were lost on unschooled apprentices. This was the pattern in the
first American medical schools, including the first “Western” school,
Lexington’s Transylvania University (opened in 1799), and the
University of Louisville (opened in 1837 as Louisville Medical
Institute). Hospitals then were simply warehouses for the ill poor,
and the educational value of their care overlooked. Then in 1840,
a pivoted insight of the U of L faculty led to building a teaching
amphitheater attached to the old City Hospital (opened in 1823). In
the years around the Civil War, leading Louisville surgeon, David
W. Yandell, MD, campaigned for construction of teaching dispen-
saries, where students could learn from direct patient contact and
dispensation of prescriptions to the poor. By the late 19 th century,
however, hospital ward rounds and dispensary duty were integrated
into the curriculum, and clinical experience was greatly enhanced.
These historic advances were clearly reflected in the site and design
of the LMC building.
BACKGROUND: LOUISVILLE IN THE LATE 19 TH
CENTURY
In addition to Louisville’s endemic diseases, ill passengers of Ohio
River steamboats provided longstanding, abundant medical learning
opportunities. At the Civil War's end, Louisville became the “gateway
to the south” for post-war reconstruction, as a major intersection of
steamboat traffic and railroad lines. With virtually all Southern cities
destroyed, Louisville attracted business, political and medical talent
from across the South. Similarly, Southern students seeking medical
education found Louisville to be the best destination, with its urban,
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