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Help me with industry sign banking arkansas medical history

hi guys um so we're going to be talking a little bit about race and medicine in Arkansas today and it's very informal if you've got any questions feel free to interrupt me and then we can also wait for questions at the end if you guys want to do that I struggle every time I give a top light or talk like this trying to decide what to title it because this talks about Arkansas I do focus in Arkansas but what I am interested in more generally is the Civil War okay and how the Civil War changed medicine in the United States and so I want to kind of start off and I'm gonna struggle with my hand today but I want to kind of start off telling you guys a story essentially about the start of medical education in Arkansas all right I mean real quickly because I'm afraid I'm going to forget this picture is of a dissecting room and it was actually taken in the Old State House because you guys know this used to be you know essentially a part of the medical school so that's kind of interesting I had to start off with this picture I don't know what room it is I also kind of want to just drop out here there are gonna be some gruesome pictures do we have any squeamish people in the audience how many doctors are here or former doctors okay usually we get a lot of former doctors who are interested so picture it November 1st of 1874 all right and I don't know if you guys know who this is but that is dr. James H Linnell and he was one of the founders of what is now UMS the medical school in Arkansas um had been a physician in Little Rock for a while but on that November evening dr. Landau had acquired a cadaver for dissection and you know things in the past were really odd you know people did not worry about doing this out in public this even though you know the culture of dissecting things was very taboo nobody was really concerned about whether you did this outside or inside or anything like that and so on that November night he begins this dissection of this african-american cadaver that he'd gotten from the State Penitentiary and he actually began it in the Little Rock barracks essentially that's the Little Rock barracks in a shed out on their property and if you guys don't know that that's MacArthur Park now and I don't know if any of you guys have ever seen this before have you need you guys ever seen this tombstone kind of weird monument so what that essentially is is a monument to that event to the event of dr. Linnell dissecting a cadaver you know in what is now in MacArthur Park they put that monument up in 1927 because this was the first legal dissection in Arkansas okay and the way we phrase that is very important it's the first legal advice section because who knows how many and I sections went on before it was legalized and we're gonna talk a little bit about the process of how it was legalized and things like that later on in this lecture but this is an interesting story okay when I first heard about it I was super interested largely because it's strange to picture a human dissection happening outside in the middle of the night the dissection went on for five or six weeks you know once again outside a few other physicians participated on and off but besides just being a weird story this story is actually a really good way to segue into the history of medicine and talking about what the history of medicine is okay and in particular the history of medical education because this story has several different aspects that kind of reflect the trends in medical education in the 1800s when this took place the first one is that doctor when I was essentially teaching himself and throughout history most of medical education was primarily self-taught very few people actually went off to medical universities and as we're going to see over the course of today there's not a whole lot of prestige in a lot of these Medellin universities so there's not a whole lot of reason why you would traditionally go to them so the first thing you know medical education is self taught second thing is that medical education throughout history and especially and then in the United States typically advanced at the expense of people who had the least access to political and economic rights so in this case it's you know it's fitting that he's dissecting an african-american in most dissections that happen throughout the 1800s are minorities african-americans the poor that kind of thing but the third thing which kind of brings me into what we're going to talk about today is that doctors in the 1800s solidified their prestige their medical authority through education even if it was self education but though talked about this a lot they talked about dissections a lot they invited people to dissections very frequently in big lecture halls and we're gonna kind of see some pictures of that as well but what I'm arguing essentially over the course of today is that medicine professional eise's through education and changes in education okay and the hard thing the complicated part of talking about medical education or medicine in general in history is how do we define it how do we define medicine and you know kind of a topic like this because you have parts of medical history where people are you know tapping holes in people's skulls and giving out doses of arsenic and is that really a part of the same story as like the development of the microscope and you know learning how to do blood transfusions and things like that and I actually argue that it is okay that these the history of medicine is not one of a clear trajectory of progress there's a lot of steps forward and backward that you see throughout history and a lot of times you know medical is taking place in this non-traditional way you know sometimes outdoors sometimes in the middle of the night but not always in this way we picture where there see no college classrooms and textbooks and things like that so something else I want to comment on is we're kind of starting this is that people throughout the past and today approached medicine largely through these lenses essentially that they have you know lenses like religion and you know their socio-economic sphere you know class all of these different aspects race is a big one and so essentially you know if you think about it dr. Linnell approached medicine and understood and use medicine very differently than the african-american man that he dissected would have understood and used medicine and so what I emphasize and work on in my dissertation is kind of community reception to early teachings of medicine and so you guys are kind of gonna get a lowdown of what that looks like throughout history today I like to organize lectures and classes that teach big section classes at the University of Arkansas every single day come into the classroom and I ask a question that I want students to think about and the one I want to ask today is essentially why do we trust doctors have you guys ever thought about that and that is what this story of the professionalization of medicine is it's answering that question why we trust doctors and of course we know now why we trust doctors you know now we trust doctors could we believe in science we believe in reaching evidence-based conclusions and you know experiments that can be replicated over and over that's why we trust doctors now but I want you guys to try to put yourselves in the mindset of somebody living in the 1400s or 1600s or 1800s where we're going to be talking about more today why would they trust doctors and the answer is that most people didn't and so what I've been interested in over the course of studying my dissertation is when did that start when did we start trusting doctors when did we start investing them with authority and over time people have trusted doctors for different reasons okay and so I'm gonna kind of start out by setting this up in Arkansas because today's talk is gonna be focusing a little more specifically about Arkansas medical education medicine so if you're thinking about the first experiences of medicine in Arkansas you first have to look at the paleo-indians you know the first people actually came to Arkansas you know centuries ago and when they settle an Arkansas like many other Native Americans at the time the people that they trusted to conduct medicine were typically shamans within the tribe and most Native Americans practiced a religion called animism they believed in spirits in plants and animals and different gods I mean their religious pantheon and so a shaman filled a weird role in the tribe essentially shamans where something like preachers but they were also you know medicine men tribal leaders but people trusted them they went to them when they were sick because they believed that they were invested with sometimes powers that granted them the ability to heal people but usually knowledge you know they had been invested with understanding of certain herbs that we had in the Americas and things like that and I kind of rushed next into European contact because we don't know a whole lot about the Paleo Indians and exactly how they practice medicine but we do know more about what happens after Europeans come in and if you guys remember anything from your you know elementary high school history classes you remember that Europeans brought disease okay and so we need to think of that moment when Europeans come in as kind of this huge explosion of medical catastrophe but also of medical transformation okay this is a very important moment in the history of Medicine so when Europeans come in and they bring tons of disease and that's what essentially does some aids Native American tribes and most of those diseases or things like smallpox measles and I don't know if you guys remember this but I'm super interested in this and just gave a lecture about this to some of my students you guys are going to benefit from some of that but Europeans did things differently the Native Americans obviously one of the things that they did differently is they lived in big dirty cities and so they'd been exposed to a lot of different germs specifically these germs that they're bringing to the Native Americans and one of the biggest differences in their lifestyles is that Europeans have fences Europeans essentially bring the real estate market to the Americas and you know when they're bringing all this diseases are all these diseases and different lifestyles with them that's gonna be a huge change and there is this quote that I love to say kind of when I'm starting off classes the beginning of the semester with students and it's a quote by Christopher Columbus because very famously I don't know if you guys have heard this before he said leaving the light or following the light of the Sun we left the old world and any of you guys ever heard that before and I love that quote okay because it's just so naive and so interesting this idea that we're leaving the old world behind to discover this new one and what I want to suggest to you today is they didn't really leave the old world behind essentially they brought the old world with them that's how they brought the diseases with them but they also brought their medical understanding with them and so what's going to happen over the course of interaction between Europeans and Native Americans you're going to see the syncretism essentially how medical practices are going to evolve with parts of both you know and they're going to in this new place primarily the French who you know come to Arkansas in the 1680s they're gonna adopt some Native American practices but they're also going to bring their old ideas with them and during this time period kind of the 1600s and 1700s really because not a whole lot is changing between those in European medicine they primarily practice what we now know as an apprenticeship system okay and so you know you come into contact with Native Americans who trusted their doctors because they believed that God's influence their doctors to be healers okay well they're coming into contact with Europeans who are really at that moment didn't trust their doctors at all there was no real reason to trust their doctors largely because there was no real medical authority essentially medicine during the 1600s and 1700s was something that you practiced on the side it was not usually where you made the most of your money it was a trade in the sense that sometimes somebody else taught it to you but not always you could usually teach yourself most of these things but there was no real medical profession okay and so you see a lot of these kind of barbershop surgeons kind of quack doctors doing some horrific stuff on the side kind of trying to teach themselves and no one during the 16 and 1700s and you're gonna find out most of the 1800s as well no one required you to go to school you could put out a sign in front of your shop and say you were a surgeon nobody's really gonna come knocking on your door and checking to see you know whether you actually know what you're doing or not it was something medicine was something that could essentially be practiced by anybody and you know when you have that little regulation you have so few positive outcomes and so that's another reason why you know people don't really trust doctors don't really have a reason to in Europe during this time and you know there's only a few medical universities that are really up to snuff in Europe most of those are located in Italy Spain France and they're kind of leading the way in regards to medicine but they're still wrong about a lot of stuff in the 16 and 1700s and so what you have is when Europeans come to the Americas the apprentices a ship's system is the most popular way if you're actually going to get a medical education to do it okay and if you guys know anything about that essentially what you have to do is if you want to become a doctor you have to find somebody who you trust who will actually teach you and that's a big problem that we see in the sources from this time period is people getting scammed by doctors as they try to enter into these apprentices apprenticeship systems but essentially they're being treated as just errand runners and bottle washers and things like that there is no real contract holding a physician to actually teaching you the practice of medicine you know even as it is back then and traditionally if you had a really good a master you know physician that you were working under they would usually take you on for a period of about three years you would for the first year and a half or so be you know studying medical texts such as they were back then and then in the last you know year or so of your apprenticeship you would go along with your doctor - or their practice was and actually observe them while they're working and that's really the only clinical experience that you would actually get and at the end of this system there's no licensing exam no-one's testing to see if that doctor actually you know did anything for you in any real way or actually taught you anything the only approval at the end of that system that you would get is a letter of recommendation by that doctor saying this is a good guy and you hang it up in your shop or wherever you're gonna practice medicine and this system was largely paternalistic in that the doctor that you worked for sometimes beat you if you didn't get things fast enough you know treated you like you were a child and there was really no sense of real obligation towards each other to actually work towards the future and progress of science and medicine okay you're just trying to make a little money essentially on the side an Arkansas which is primarily rural throughout the 17 and 1800's most of the time the experience that student doctors are getting is going ride-alongs on house visits with their physicians um so that's kind of scary when we think about it today and the other scary thing about this time period is that most people believe that one doctor was as good as another okay but the problem was there are several different sects of doctors operating several different kinds of doctors operating during this time and during the 1800s which is the period we're going to be talking about most today I'm going to go ahead and give you guys the three different knds you guys can kind of keep that in your mind as we're going through this so first kind regular physicians okay you know for those of you guys who are doctors in this room of former doctors these this is your ancestral chain okay and essentially even though you know these are the these are the ancestors of what we now have and we now trust doctors these guys had a very limited knowledge of the body most of them okay because most people couldn't just go out and get a body to dissect and not get caught by the police for it and we're going to talk about that too but they had limited knowledge of the body by our standards and limited understanding of it and so essentially if you don't understand how the body works if you're trying to you know make someone better and make someone well all you have to go off of is symptoms and so essentially they treated symptoms and so anything that they did or get any kind of medicine or treatment that they gave a person that changed their symptoms in any way positive or bad that was good because it showed that they were having some kind of impact on the body some kind of change was happening and that was better than nothing which nothing is what had traditionally been the past of medicine and medical education and all of that so any kind of change was good even though very frequently people died from the kinds of things that physicians did a lot of times they didn't really understand the connection between them what the physicians were doing and how people died but they did very frequently but there their philosophy of medicine was essentially all about balancing the body the different systems in the body and they practice good things in the 1800's like surgery and vaccinations some of these doctors did but they also practice things like bloodletting and you know they gave people mercury and arsenic because a lot of what they were trying to treat is the bowels because they believed that all sicknesses no matter what kind usually resided in the ballasts and so anything that purged or evacuated that was good because once again changing some symptoms had an effect and so patients trusted somewhat regular physicians in the 1800's because they had some kind of reaction they could do something and that brings us to the other two kinds of doctors the second you know of the three that I'm talking about is the botanical doctor essentially and these doctors practice a lot of Native American medicine and they did a lot with the you know natural herbs growing in the Americas and they wanted to balance the system too they believed in the same kind of thing that balancing the system that regular physicians did but they wanted to do it in a gentle or way because they saw some of the chemicals and some of the things that regular physicians were doing the bloodletting and they were appalled by that so their idea was you know we'll do that we'll have the same goal but we'll do it a little gentler and botanical doctors were really popular in Arkansas and arguably probably the most popular for much of the 17 and 1800's because it was a rural kind of thing you know everybody kind of had a grandma that practice rural medicine and a lot of you guys probably have that too in your past and so there are a lot of Native Americans in Arkansas this kind of medicine made sense to average everyday people the third kind of doctor and kind of way of practicing medicine in this period is the homeopathic kind of medicine and essentially what homeopathy believed was that whatever caused illness with certain symptoms in a well person could a sick person that same you know like if it was mercury or arsenic or whatever it is whatever caused those symptoms and a healthy person could cure those symptoms in a sick person okay and they too often believe that the remedies of regular physicians were too extreme and harmful and so what they do is they would take some kind of compound and dilute it down to like a millionth of its strength or almost nothing remained of that original medicine and then they would give it to people and homeopathy came to the United States and about the 1820s it was a huge fad in Europe specifically in France and a lot of the educated richer people in kind of the more urban areas of the United will the United States for the eighteen hundred's believed in homeopathy partly because it was a fad but also because it wasn't likely to kill you whereas the actual remedies of regular physicians frequently would okay and so I'm kind of essentially where we were sitting in the 1700s 1800s so one doctors about as good as the next you don't really trust any of them a lot and you know for poor people botanical medicine seems like it's the answer because it has less chemicals it's more easily accessible but you know the rich dead educated use homeopathy but all of these sects are competing with each other okay and this is actually really interesting in Arkansas which actually is you know one of these areas that doesn't have a whole lot of people in it and so we tend to think of the past as there not being enough doctors I don't know if you guys ever thought that but that's how I essentially used to think of things but we actually see is that there were way way way too many doctors essentially the ratio of patients to doctors was really high and an example of this is you can check census records which is something I love to do and 1829 there were five doctors in Little Rock caring for only 300 people okay and that is difficult old to compete when you are trying to make a living doing this and towards you know through the 1800's warmer doctors are trying to make this a profession and a living for themselves and so doctors are frustrated with each other because they're competing they're blaming each other for the economic conditions that they're having to live in and I'll go ahead and show this you can kind of see this is essentially a barbershop surgeon depiction of painting and so what is weird is we see calls for regulation of physicians coming from physicians themselves they are the ones who warrant more regulation in their profession it's not you know their patients here complaining about it as physicians because their idea is if we have state licensing laws if we have regulation that will narrow the field and I'll actually be able to make a living doing this and so Arkansas is really unique in medical history you don't know if you guys know that or not but in a lot of ways Arkansas is kind of advanced for especially if you think about in the context of the south and in 1831 the territorial assembly in Little Rock created a board of physicians and they decided that they were going to essentially have that board you know give out licenses and judge physicians if you wanted to practice in the Little Rock area you had to you know pass through this board's examination pay a $15 fee then you would have a license and this was kind of unique because most states were not interested in this at all but this guy didn't if you guys know who this is if you like Arkansas history okay that is governor John Pope and he was governor during quite a bit of the 1800s and essentially he put a stop to this board he did not want to actually have a licensing board because he thought that signified too much government interference essentially in the lives of citizens and he thought this was an attempt of some of the richer people in Arkansas to try to rob poor people of the opportunity of practicing medicine essentially by trying to regulate it that would rob people of this you know a gala terian profession up to this point and he famously said I believe that public opinion should give doctors authority you know the public opinion of their patients not any kind of you know stage board or anything like that not any kind of exam and so things are gonna kind of sit like this in Arkansas for a while and the thing that's gonna change it is the Civil War okay and that's what I am really interested in and talked a lot about in my classes and essentially scientific advancement kind of failed to take root especially in the United States until the Civil War largely because most doctors were concerned with practicing medicine and not advancing scientific knowledge you guys kind understand the difference between those things they wanted to make money off of the profession but they weren't really sharing their information with other doctors they didn't really you know record their findings and any real way for them to share in the community and there wasn't really a community of doctors because they were all competing so intensely with each other and medical advancement and warfare always go hand in hand and I always talk about that a lot in my classes and by the time the Civil War Arkansas and the whole entire rest of the United States is woefully unprepared for this because most people if they had any kind of medical education at all in any university and there were some universities in the United States it was one of these deals where they would maybe see one or two dissections and you know their school career but they'd see it kind of in a hall where they'd be looking down with you know a hundred other students not really getting that experience themselves so most of what they knew about medicine came from what few textbooks we're out there you know pictures and then you're set loose to practice this yourself and you don't really know what you're doing there's no standardized tests or tests there's no literate literacy requirements to get into you know medical schools you don't even have to know how to read all you have to do is be able to pay a tuition because that's what people who are running the schools really want anyway and only two states in the United States actually had an atomy axe and essentially an Anatomy Act is a law that allows you to dissect unclaimed bodies so most states some of them were doing it illegally but this is not a system that allows a lot of people to get real medical experience or experience dissecting anyone um a lot of this has to do with Protestantism in America we're kind of uncomfortable with the idea of dissecting bodies and understandably so and a lot of these schools have reduced the requirements so low because they wanted as many students to come into them as possible and you know to get that tuition money and most states didn't have licensing laws nothing like that and so if you wanted to be a really good doctor on the eve of the Civil War you went to Paris the Paris clinical school you did not go somewhere in the United States even though we had universities there's some kind of gruesome pictures for you sorry about that but the war premiere presents an unbelievable amount of opportunities for us because over the course of the Civil War the estimates are all over the place but we get at least 750,000 dead people okay all of these cadavers produced in the war and most of those people is you guys probably know don't die from you know battlefield injuries or anything like that they die from things like gangrene tetanus diarrhea dysentery the big ones of war and the Civil War hey does a lot with these opportunities presented and there is this effort for the first time to catalog wounded people and catalog dead people and so the Surgeon General for the Union William Hammond passes something called the circular number two and essentially what this is is is a directive to collect and dissect bodies and specimens throughout the course of the war and this is supposed to create a framework of a research society and you're supposed to give mandatory case reports if you're a surgeon for the Union Army and publish your knowledge publish the things that you're learning and so there's this massive collection of specimens and I don't know if you guys have ever been to the Army Medical Museum in Washington DC but essentially the Army Medical Museum is the product of this because surgeons in the Civil War started sending in barrels of alcohol tons of arms and legs and body parts to Washington cataloging this stuff to show that you know surgery practices they tried how illness was spreading and in one of those weird coincidences of history which I love in 1839 Samuel Morse the guy in a Morse code Telegraph develops the dagger type which is essentially the first kind of photographing ability that we really have in the United States and so this also allows people to send pictures with you know those specimens and so we see a ton of stuff like this where people are taking pictures of wounds you know writing about it and sharing it with in this community for the first time all right and we also see at the same time increased specialization and this is an early drawing of what the Army Medical Museum is supposed to look like you know physicians from all over the United States can go and visit and see what this actually is like and learn from em but you see specialists emerging for the first time plastic surgery is really developed during the Civil War where physicians focus on one thing instead of others and a lot of this is a result of new warfare technology that happens as a result of warfare okay the Monnaie ball is kind of invented on the eve of the Civil War and it was different than other bullets before that because it had this cone in the back essentially this you know rounded out part in the back and what that was supposed to do is when you fired this thing source of the air it makes contact with somebody and it flattens out and so what you see is these huge wounds like this you know big and you can kind of see here's one of them it's not fully flattened out but you can essentially see how it's working and so you have them in a ball you also have rifling that's invented on the eve of the Civil War and rifling is essentially turning that bullet you know through the cylinder of the gun through the barrel and it's more accurate okay and we have sniping and guerilla warfare in the Civil War and all of this stuff creates huge injuries new and different injuries that we hadn't really had a lot of experience dealing with before and this is where you get all those amputations and what's interesting is we always kind of think of the Civil War as the worst time to you know have a surgery in the past but what I want to say about that is I've read a lot about it and it seems to be that if you actually went the route of going ahead and letting the doctor cut that limb off you usually had about a 40% chance of survival which was a whole lot more than you would have if you had a lot of this splintered off stuff residing inside of you you get great gangrene then you die okay you can see how some of these doctors are cataloging this taking pictures of these things all of these pictures are held by the Army Medical Museum and you can see here especially with like plastic surgery and things like that and there's a lot of glare on this you know how much they really do accomplish you know over the course of the Civil War and how good they actually can get another thing that is developed over the course of the Civil Wars and aesthetics we see a ton of advancements here before the Civil War essentially most people use two things like chloroform and that's what you can kind of see doing here is you know dropping little droplets of chloroform onto this handkerchief but by the Civil War we're moving more to opium and its derivatives which are you know more reliable to actually put people under for that time period so people are using things like morphine and heroin and laudanum and of course you know you guys know these words before we see a lot of addictions come out of the Civil War because of the use of these things but for that time that was really the best people could do that was the cutting edge essentially there's a lot of legacies of Civil War medicine that I kind of want to get through before we finish talking about Arkansas for a while this is gonna drive me crazy okay I think the Civil War gets a bad rap for a lot of different reasons but some more medicine gets the worst rap and essentially there is this popular perception around today that you know civil war medicine was as gruesome as it could get and you know here's this cartoon let's play doctor you know I said let' be civil war doctor this amputation you know that's supposed to go on but a lot of that reputation comes from the end of the 1800s when people are trauma when physicians are trying to convince their patients look how bad things were 20 years ago you know look how bad things were 30 years ago we're so advanced compared to that so physicians kind of created in the late 1800s this bad reputation but the Civil War got some more surgeons God another big legacy though of the Civil War is kind of the professionalization of Medicine starts happening here because the Union Army has certain qualifications if you want to be a physician or a surgeon and work for the army and it doesn't allow homeopathic practitioners and so by the requirements of the Army we're seeing this clear cap this is what a doctor is in the 1800s you guys can't call yourselves doctors anymore and you see this increasing influence of science and the practice of medicine through the shared knowledge and that's kind of the most important thing about this and after the Civil War is over a ton of states pass Anatomy acts and start allowing dissection of unclaimed cadavers you know in medical schools and this is a huge change can you guess what the first state to pass an Anatomy Act the first former Confederate state to pass an Anatomy Act after the Civil War was Arkansas yeah which is kind of interesting and surprising um you also see things like a further development of the microscope happening in the Civil War things like that but those other legacies are what I'm more interested in but unfortunately Arkansas is kind of the exception I knew it was gonna happen okay Arkansas is kind of the exception for the south after the Civil War because the south for the most part continues to focus on practice instead of the furtherance of scientific development and this kind of gives the South a bad rap you know up until today when in regards to medicine and a lot of this has to do with the fact that the confederate medical department was not really you know prepared for the Civil War neither was the north but the Confederacy had bigger problems essentially than developing research and medicine they didn't have any kind of cataloguing of wounded or anything like that going on and so medical needs were really secondary to needs like clothing and food and whether or not your soldiers have shoes that is a bigger problem than whether you're giving them cutting edge and aesthetics and things like that I mean you can see kind of this example a lot of stuff happens in the south that kind of ruins the communication network that they had you know before the war even on its edge and so you need Sherman's neckties going through and ruining railroads and the South cannibalizes a lot of its own railroads over the course of the Civil War you know to try to keep the Union Army from entering the south and so you're seeing this big difference essentially with what's going on in the north versus the sail and the South kind of has these legacies throughout history of being different than the north in regards to medicine and one of the reasons why the South is different is because of this population of african-americans and this you know white supremacy and racism that kind of is ingrained you know over the course of the 1800s and so it causes us to deal with people differently when we administer medicine it kind of puts limits on african-americans actually being doctors another thing that is different in the south versus the north and regards to medicine is that most southern physicians believed that the southern climate caused people to get sick in different ways than the northern climate did and so it kind of makes it hard for the south to participate in this overarching story of medical advancement and medical progress but throughout the 1800s what we're gonna see is in both the north and the south by the end of the 1800s our growing up medical schools everywhere okay and obviously the most important one for today is UAMS you know that it's the early precursor essentially to UAMS which is founded in 1879 you know after Allen aus dissection after Arkansas's Anatomy act is passed and obviously after the Civil War and some prominent physicians who were veterans of the Civil War got together to actually create this medical school and what they wanted really more than anything was to make money like most people who started medical schools during this time period it didn't cost a lot for them to get the sporangia hotel and actually start having classes there and so they got to pocket essentially those tuition fees from the students that came and they didn't get state funding in the beginning the medical department of Arkansas Industrial University as UMS was originally called was not actually receiving any state funding like Arkansas industrial university was okay and the biggest problem that this school faced was competing with other schools in Little Rock and at different periods in history there's different you know schools that are essentially operating but the two biggest ones that it has to compete with are so for Rock medical school and the College of Physicians and Surgeons in Little Rock Decker is the guy who starts the sulfur Rock Medical School and you see a lot in the newspapers about this school being a diploma mill essentially just giving people what they want and schools during this time period had a ton of problems and one of the biggest problems that they had is acquiring bodies for dissection even though the Anatomy Act is passed they still need more bodies they need more experience for students and so you start seeing the african-american community responding to this fear of dissection essentially you see in newspapers vandalism happening to the early medical school that is blamed on african-americans we don't really actually know if they're the ones who did this or not but that tension is there essentially within that community what I want to suggest to you guys over the course of this and kind of towards the end is that my dissertation argues that if we ask the question of why we trust doctors you know we also have to ask ourselves the question of when that started and you know if it started in the 1800's like I believe it did you know essentially which schools did we trust you know which why did some schools survive and others fail because those other two schools I mentioned failed several medical schools fail throughout the 1800s and what my argument is in my dissertation what I'm interested in is this idea of community outreach essentially the schools that succeeded from what little I've research of it so far are the ones that offered something to people those citizens of Little Rock and UAMS was pretty good about that one of the founders this Edwin Bentley and dr. Edwin Bentley opened a free clinic for the you know minorities of Little Rock in that the back of phones brothers hardware store in kind of the weirdest place that you can and you know a lot of people were afraid to get you know its medical attention in the back of a hardware store but it was still something and this was a fairly kind of new idea for a medical school to be doing this kind of thing you know essentially acting like a philanthropy Aid Society or something like that in the 1800's the ladies benevolent association of Little Rock essentially starts a hospital in a conjunction in a lot of ways with this school you know this school you know the founders of the school in Arkansas donate a lot of money essentially to that hospital and then they take their students to go and observe and they're getting two things out of this which as the citizens of Little Rock liked them better and their students actually get this clinical observation in a way that they hadn't really before an important thing to realize about all of this is that physicians economic success in the end of the 1800s in Little Rock but kind of throughout the south and really throughout the United States depended on gaining the acceptance of both patients and other local physicians and you did that through good schools that serve their communities and that has as you guys can you know understand a lot of implications for today but education is still pretty rough throughout the south and you know north throughout the 1800s largely because there's still not a lot of that regulation and that's gonna change with a guy named Abraham Flexner and you guys ever heard about him before he's super important in medical education essentially Flexner went around to all of these different medical schools and had a list of criteria and judge them by it and you know the school of medicine in Arkansas did not do well and essentially as a result of this they're taken over by the state which actually turns out to be a great thing for what is now UAMS changes name several different times I kind of call it what is now UAMS but that state takeover insures funding it also ensures that there's going to be some measure of regulation in this and so this research all of this stuff is really important for what we actually see today okay you know UAMS right now is has been laying off a lot of people due to budget cuts okay and we still in a lot of ways people outside of the medical profession like myself judge medical schools based on how well they do things for the people in their communities okay and that is what I am interested in and that argument that school success depends on that relationship and the usefulness of the school to its state is kind of what all of this is about the professionalization of Medicine and the importance of medical education and the kind of boundaries of communicate or communities and what they do in regards to these schools okay if you're interested in any of this stuff I've said these are the books to start you out okay this one in particular is my favorite one of my favorite Civil War books most of these pictures came from the UAMS historical research society you should definitely go there okay if you're in Little Rock I love it I'm going there tonight for a bank way okay well thank you that is the end of this you all have been a good audience if you have any questions about anything let me know [Music] [Applause]

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