Adventures in the Villa

Today was our last day of sightseeing on the caravan… It’s all over all too soon…!

We drove about one hour northwest to the town of Danville, KY.  It has been around for a while… On December 4, 1787, the Virginia Legislature established Danville as a town in Kentucky County, Virginia.  Danville became a part of the Commonwealth of Kentucky when the county of Kentucky was carved out of western Virginia to became a state in 1792.

The town boasts being the site of the signing of the Kentucky Constitution.  We saw many old buildings located in the central town square…

The original Post Office is the first west of the Alleghenies, opened in 1792.

I found the hewn logs to be unique – I have never seen joints like this before…

There was also a jail and the courthouse… plus a memorial to all the Kentucky Governors…

But the real reason to come here is to learn about the achievements of Dr. Ephraim McDowell…

Ephraim McDowell (November 11, 1771 – June 25, 1830) was an American physician and pioneer surgeon.

McDowell was born in Rockbridge County, Virginia, the ninth child of Samuel and Mary McDowell.  His father, Samuel, was appointed land commissioner and moved his family to Danville, Kentucky.  There, he presided over ten conventions that resulted in the drafting of the Kentucky Constitution.

In 1802, Ephraim McDowell married Sarah Shelby, daughter of Isaac Shelby, war hero and twice governor of Kentucky.  They had nine children, but only one son and four daughters survived into adulthood.

On December 13, 1809, McDowell was called to see Jane Todd Crawford in Green County, Kentucky, 60 miles from Danville.  Her physicians thought that Mrs. Crawford was beyond term pregnant.  McDowell diagnosed an ovarian tumor.  Crawford begged him to keep her from a slow and painful death.  He then described her condition and that an operation for cure had never been performed.  He said that the best surgeons in the world thought it impossible.  Crawford said she understood and wanted to proceed.  McDowell told her he would remove the tumor if she would travel to his home in Danville.  She agreed and rode the sixty miles on horseback.

On Christmas morning, 1809, McDowell began his operation.  The surgery was performed without benefit of anesthetic or antisepsis, neither of which was then known to the medical profession.  The tumor McDowell removed weighed 22.5 pounds.  He determined that it would be difficult to remove completely, so he tied a ligature around the fallopian tube near the uterus and cut open the tumor.  He described the tumor as the ovarium and fimbrious part of the fallopian tube very much enlarged.  The whole procedure took 25 minutes.  Crawford made an uncomplicated recovery.  She returned to her home in Green County 25 days after the operation and lived another 32 years (outliving Dr. McDowell…).  This was the first successful removal of an ovarian tumor in the world.

All previous attempts at abdominal exploration before 1809 had resulted in peritonitus and death.  Descriptions of McDowell include phrases like “neat and clean” or “scrupulously clean.”  He was not only neat, but meticulous.  In his report on the operation, he described the removal of blood from the peritoneal cavity and bathing the intestines with warm water.

McDowell did not publish a description of his procedure until 1817, after he had performed two more such operations.  This was widely criticized in the English surgical literature.  There is evidence that he performed at least twelve operations for ovarian pathology.  (None of these patients is alive today…)

So we visited Dr. McDowell’s house and office and pharmacy…

The house is pretty typical for the late 18th and early 19th century, at least for wealthy, well-connected professionals living in a thriving city…

I particularly liked the custom shutter at the attic window…

The Living Room…

The Study and Men’s Lounge…

The Dining Room…

Climbing the stairs…

A unique doorway between bedrooms…

The Pharmacy…

Medical books…

A good supply of leeches is conveniently on hand…

It was an interesting look at the medical profession of 200 years ago…

One hundred years later, in 1910, Abraham Flexner wrote The Flexner Report; it is the most important event in the history of American and Canadian medical education.  It was a commentary on the condition of medical education in the early 1900s and gave rise to modern medical education.

Abraham Flexner was not a doctor but was a secondary school teacher and principal for 19 years in Louisville, Kentucky.  Flexner then took graduate work at Harvard and the University of Berlin and joined the research staff of the Carnegie Foundation for the Advancement of Teaching.  For the Carnegie Foundation, Flexner researched, wrote and in 1910 published a report entitled “Medical Education in the United States and Canada.” It is known today as the Flexner Report.

The Flexner Report triggered much-needed reforms in the standards, organization, and curriculum of North American medical schools.  At the time of the Report, many medical schools were proprietary schools operated more for profit than for education.  Flexner criticized these schools as a loose and lax apprenticeship system that lacked defined standards or goals beyond the generation of financial gain.  In their stead Flexner proposed medical schools in the German tradition of strong biomedical sciences together with hands-on clinical training.  The Flexner Report caused many medical schools to close down and most of the remaining schools were reformed to conform to the Flexnerian model.

How did this reform take place?

Abraham Flexner’s brother, Simon, became the first director of Laboratories at The Rockefeller Institute (now Rockefeller University), in 1901.  The Institute was founded by John D. Rockefeller.  Greatly elevating the prestige of American science and medicine, it was America’s first biomedical institute, like France’s Pasteur Institute (1888) and Germany’s Robert Koch Institute (1891).

As the first director of laboratories, Simon Flexner supervised the development of research capacity at the Institute, whose staff made major discoveries in basic research and medicine.  While a student at Johns Hopkins University, Flexner had studied under the Institute’s first scientific director, William H. Welch, first dean of Hopkins’ medical school and known as the dean of American medicine.

These developments lead John D. Rockefeller and his son, “Junior”, to finance the reform and re-invention of medical schools in America.  Any medical school that agreed to follow the rigorous model set by Johns Hopkins would receive funding from the Rockefellers… We owe this philanthropy for the status of today’s medical schools…

Had enough medical talk?

After Danville we drove a few miles north to The Shaker Village at Pleasant Hill.  It is a beautifully preserved and restored village of over 200 buildings on 3,000 acres.

Of course, we started with lunch…

Our lunch was in the basement of this 200 year old building… Beautiful stonework…

After lunch we took a group photo and were given a tour of the buildings; we heard about the history of Shakers in general, and this property in particular…

Notice the entry doors on these buildings:

There are two entry doors – one for men and one for women.  Inside the entry hall you see two stairways – one for men and one for women.

Shakers were celibate.  Men and women were considered equals and they lived in the same buildings, but on separate sides.  By having wide hallways, and separate doors and stairways, it would eliminate the possibility of inadvertent touching…

Shakers were Christian post-millennialists; they believed that the second coming of Christ had already occurred in the form of their founder, Ann Lee.  Therefore, they were living in the thousand year reign of Christ, and their job was to create heaven here on earth.

At one time, the Shaker Village at Pleasant Hill had 500 residents, all living communally, having given over all their worldly assets to the village… There were 15 or so Shaker Villages around the country…

The last Shaker here died in 1922.  I wonder if, in her last years, “Maybe we didn’t get this thing quite right…”

The land had been sold, in exchange for a life estate for the remaining few residents.  Forty years after that last resident died the community bought back the land, and today the village is run as a tourist attraction…

We returned to the Villa, and spent the remainder of the afternoon packing and otherwise preparing for our airline flight to California day after tomorrow…

And an enjoyable time was had by all…