the stone are these big chalk board slates. we kind of arranged them like a collage of letters or pictures that referenced all the colleges and pictures that the kids sent in. they are here almost to be an interactive piece. it is a way that kids and adults can come and still leave the same kinds of messages for the community. we really hardly ever see these blank. they are either washed off by the rain or washed off by the people that take care of the memorial. there are always people coming in to leave messages. we feel like that interaction is sort of an important part of this memorial. it is an important way of people letting other people know you are not alone. when we entered the competition to design this place, we had no idea of the weight that that

would be. but once we came here, we met the people. we started interacting with the community, with he started to feel the responsibility we had taken on. we were very fortunate to have a big team of people around us. we were fortunate in that we got to communicate with the community a lot, which was due to a process that the memorial foundation had put in place. they wanted to keep the community involved with this project and keep them up to date on everything that was happening. that was really good for us to feel like we were doing this as a partnership with the community. the weight was, it felt very heavy. at the same time, when we were finished, on the day before dedication, we really had to hand it over, we hoped we had done a good job and that we would be delivering to the community something that they could find comfort in, a place where they could come to and really find some sense of peace.

stay tuned all weekend long as american history tv features oklahoma city, oklahoma. learn more about oklahoma city and c-span's local content vehicles at cspan.org-local content. next month, we will feature wichita kansas. you are watching american history tv all weekend every weekend on c-span three. coming up, dr. ira rutkow discusses how clinical medicine changed the civil war. he is an author of "bleeding blue and gray," "civil war surgery" and "the evolution of new york medicine." the new york academy of medicine hosted this. there are graphic photographs shown and some viewers might find this disturbing.

i'm getting over a cold. if i have a coughing jag, you will understand the reason why. i appreciate the opportunity to be here. chris has already taken away my third slide. i will start with number two. i want to thank the academy for inviting me. it is always a pleasure to come back here. arlene schoenherr deserves many thanks. this is a unique place, a wonderful institution. i look forward to its history. i guess i should say a little bit about dr. latimer. this is the john k. latimer

memorial lecture. he was a product of new york city. he went to columbia undergrad and medical school. 6'4", gentleman. a hurdle star in college. he was an eclectic individual. he was really quite varied in his interests. he was chairman of surgery at columbia for almost 25 years. he really placed pediatric neurology on the map. aside from his professional endeavors including 375 scientific papers, he was really involved in many other subjects. that were outside the realm of academia. most important were -- military weapons. as a very young man he graduated medical school in 1938. during world war ii, at the time of the nuremberg trials, he was part of the medical team that took care of the nazi war criminals. he got to know many of them. and through his knowledge about them and whatever, he published this book, "hitler's fatal sickness."

it engendered a lot of criticism and a lot of discussion. he hypothesized that adolf hitler had parkinson's following a post enself-it tick disease, whether he got that during world war i or whatever, this was his discussion relative to the war. he said the war happened the way it did because of the parkinsons and hitler making what he called bizarre judgments. having said that, dr. lattimer was also a ballistics expert, he was the first nongovernmental medical individual allowed to view the photographs and the transcripts from the kennedy assassination. and this is back in the '70s, and he came out and agreed with the findings of the warren commission, that there was a single assassin. now, the most interesting thing is this right here.

he was a collector of historical relics. professor warren used some nice language about what he collected and what he didn't collect. let me just go through a couple of them, and then we will get into the civil war. well, the first thing was he owned lincoln's blood-stained collar from the night of the assassination, which was later sold at auction. he also owned gerring cyanide capsule, glass capsule that contained the cyanide when there was a suicide at nuremberg. he also owned napoleon's penis. now, how did he own napoleon's penis? he owned napoleon's penis, the story goes, when he was receiving last rites, the priest amputated his penis, i know nothing more than that. and somehow through the years it was placed in a wood encase and later on, was eventually

sold at public auction. dr. lattimer bought it in 1969 and assured everybody now, i never met dr. lattimer, i wish i had. he assured everybody that the napoleon's penis was airtight. he was the proud owner of ethan allen's sword. ethan allen, took over in the fort tie con ter roe ga back in the american evolution in 1775. in 1975, dr. lattimer, re-enacted ethan allen's sword. and his charge on fort ticonderoga. i wish i had gotten to know him but i did not. i became interested in the civil war as a very young man. when i wore a lot younger man's

clothing and i always read about the civil war throughout the years these are examples, of famous books, allen nevin's trilogy, and this is my copy, it says 1962 inside. i was a lot younger. and the -- i followed up with shelby foote, and son and father. these are all fantastic writers. nobody can compete with their writing style. but through the years, and certainly, as i went into medicine, i graduated medical school in 1975. and through my training in the '70s and early part of the '80s as i was reading more and more about civil war, it became obvious, at least to me, that combat and suffering and death were glorified. and that pomp and circumstance, masked deadly ferociousness of the battlefield. this reached at least in my mind, the zenith with mcpherson's pulitzer prize

"battle cry of freedom." this was 1989 when he won the pulitzer prize. 1990, ken burns' documentary, famous documentary on the civil war. well, for me as a physician, and a historian, despite the brilliance of the writing, in my mind, something was always missing. an understanding of the brutality and medical realities inherent to the war, i wrote this back about, seven, eight years ago. when i did "blue and gray." surely if a description of armed conflict is ever to be considered faithful, than the brutality of combat as well as the painful physical and mental restoration needs to be spoken abouts the specifics of the soldier's ghastly wound, the description of a combatant's death following a surgical procedure or the awfulness of fatal diseases, sobering truth of warfare. having said that, the question always need to be answered, why do these wonderful writers, who have won all these awards, why

do they not write about medicine during the civil war? if you go on mcpherson's book, 600 pages, there is are two pages on medicine during the civil war. a very interesting phenomenon. i can only give you my opinion. that is, medicine as those of us in the audience who are physicians understand is a very tough discipline to get to know. it takes us multiple years. and many writers just feel uncomfortable writing about medicine. the result is that they do not have a lot of input in their books relative to medical care. so i leave you with this quote by frederick shryock. he is one of the most famous medical historians. there are people that knew him. i never did. he wrote in 1962, if medical aspects of the civil war are omitted, the story is not only incomplete but is unrealistic as a total picture. and i just leave you with this thought. i think this is very important whenever we talk about the civil

war. we can glorify it. we can talk about all the economics and politics and sociology and anthropology. but ultimately it was a -- a tough war for the combatants to be in. we should always keep this in mind. well, having said all this -- let's talk about medicine. now, i actually titled this lecture, the big bang theory. now, why do i call this the big bang? i'm not talking about the television show with sheldon and leonard and penny. i am talking about the big bang theory as it involves the beginnings of the evolution of the university. because i truly believe and -- and dr. warren actually said an important phrase when he was introducing me. he said turning point. i believe that the civil war acted as the big bang for american medicine as we know out today. that there is stuff going on before, and that's what we are

going to talk about. but that, that big bang, that created everything that we know today -- that hospital just over there, down the street. it all really started at the time of the civil war. that's what i want to discuss with you. not actually the specifics of civil war medicine, but the impact the civil war medicine on the future of american medicine. these are just some individuals. 1840, 1830. this is your typical doctor. two more, this is the mexican war. i don't know if you can see over here for those of you. but this gentleman is holding what? he is holding a saw. and a bone. and the old slang term, old saw bones. i'm not telling you that it came from this picture because it didn't. if you read this, around 1842. if you read charles dickens pickwick papers he uses the term saw bones. that was published in 1837.

not certain where it started. i thought it was a great picture to have. i am going to start with two quotes. the first by nathan smith davis. who is nathan smith davis? a very important man. some times the passage of time is like a big eraser. it just erases things. in this particular case, he has probably been erased because of the passage of time and the fact he was prominent but did not write all that much. nathan smith davis founded the american medical association, two-term president, and founded jama, the journal of the american medical association. he was a very astute individual of the american medical scene. he wrote this book on medical education in the 1850s. before the big bang theory. so he wrote, this is a great quote. the great mass of the profession were like unsocial and ungoverned by ethical laws, and consequently, without harmony of action or true dignity of professional character.

key word, professional character. what do we mean by profession? and what are we talking about as medicine exists today? well, how do we define a profession? is very simple. a profession back then, mostly the ministry, law, medicine, those are the professions. a profession is a group of people who have specialized education and training. however you want to define it in today's world. there is also the question of medical licensure. we will get into that. specialized licensure and certification. there is ethics. professionals have a series of ethics they have to follow. and then there is just the entire concept of organization of the profession. national societies. local societies. all that. that is what goes into making a profession. those four things. well, i am sorry to break the news to you, but, none of that

existed in antebellum before civil war america. in fact, if you can think of the words anarchy and chaos -- anything else you want to use that is a synonym of them. that is where we are. that was american medicine at the time. and one more quote, 1824, "no body of men are less in concert or seem less influenced by espirit du corps than physicians. the quarrels of physicians are proverbialy weak when and bitter and their hatred intenity exceed that of other men. >> i leave you two quotes. this was american medicine in the first half of the 19th century. let's talk about what is going on, how the men were educated, what they diagnosed, what they treated.

so we understand american medicine at the time of the civil war. well, at the beginning of this country's founding in the 18th century and through around the first two decades of the 19th century, there were what they called apprenticeships. apprenticeships are exactly what you think they are. if i was a doctor in 1793 in upstate new york and some young man -- i use the word man throughout the lecture, because, in truth, there were no women involved in american medicine. the first md from an american medical school, female, elizabeth blackwell in 1849. in reality, putting political correctness aside, there were no women to speak of going into american medicine at the time of the civil war. these men, i would have somebody come to me and they would say, i want to learn about medicine. i would say, fine. here are my books. your father needs to pay me 100 pounds. i will take care of you. that was an apprenticeship. and if you read these, this is the articles, of indenture of joseph lemmon.

he paid zabdiel boylstun to take care of his son. it is what you think. they read books. listened to the doctor. doctor would tell them what to do. some times more than medicine. often very were like servants in the house. there were no standards. there were no regulations. there was minimal licensure. well, one thing that they did, the apprentices. was that they would some times augment their apprenticeships with lectures in anatomy, surgery and whatever. this happens to be a certificate of one young man who went and attended lectures up in harvard, actually. i only show you this because it is tough to see. right over here, i apologize, there are the initials p.r. i leave it to anybody in the audience that wants to tell me who p.r. was. but this is a paul revere engraving.

so this is very famous. and -- paul revere was an engraver at the time. he engraved this. one of the many things that he did. so these young men were apprentices. and they learned. they did whatever they want. in the 1820s, like mushrooms on a forest floor after a dewy rain, they popped up all over the place. these are proprietary medical schools. these medical schools were exactly what they sounded like. they were proprietary, pecuniary, started by doctors. doctors began to realize they can make a lot of money instead of having one-on-one, i can make a lot of money, if -- if chris and i join together, with dr. ruben, and we owned our own medical school and instead of now having three apprentice thousands, i could have 40 in the audience. there was only one criteria to

get into these medical schools. what do you think it was? it was money. money is what counted and what talked. if you'd pay dr. rubens and dr. rutkow's fee, congratulations, you are about to become a doctor. so this is rutgers medical school. this happened to be in new york city on dwayne street. an interesting story in itself. because all of you know rutgers is from what state? from new jersey. yet it was chartered in new york but given a license in new jersey. it is totally mixed up. and it folded after two years. a famous medical school. proprietary medical schools existed all over the united states. in the 1860s in 40 years. close to 60 established. from point, wisconsin, brunswick, maine, new york, lexington, kentucky. and all the major cities, this he had two and three of these. they were all fighting one another. so the medical schools grew larger and larger. and like anything else, you

know, citizens united, they became great lobbying efforts. and the reason was, was there wasn't a government that was involved with medical licensure. the federal government, state governmentings told doctors, listen, we don't want to be bothered. we have enough problems as politicians. so the county medical society, your own groups can tell us if somebody is good enough to receive a license. that's how people were licensed back then. so you had these schools. this is nathan smith talking about the schools. if a student applies for admission into one of our colleges, i.e., proprietary medical schools, the faculty dare not refuse him left he turn on his heel and walk directly into the halls of some rival institution. this is what was going on. it was all pecuniary. these men would sit there in upright chairs for six to eight hours of monotonous lecture,

over and over and over again. day after day. and this would go on for months. they would listen to their preceptors, turned pedagogues. preceptors might not have known much. the schools did not have much. there was no science. they might have a skeleton. they probably did not do anatomical dissection. this is a papier-mache model from ohio. used to teach medical students anatomy. if you look closely there are paper things. that told you this is the lungs and this is the shoulder and this is the brain. that's how they learned anatomy. this is a real object. a papier-mache anatomical model. so chris cox, chris cox was chairman of the american medical association's committee on medical education, who is chris cox?

another one of the people the eraser took care of. you don't really know much about him. he was the surgeon general of the state of maryland, vice president of the a.m.a. and president of this committee. so he is now -- all of the students have paid dr. ruben and dr. rutkow and dr. warren all this vast amount of money. we are wealthy guys counting our money from all these students. this is what surgeon general cox had to say. it's a great quote. each role of parchment endorses its possessor as a man of distinction. and he goes forth amid the sound of marshal music and rich bouquets showered upon him by the hand of fair ones. and accredited agent for life or death endowed with all the paraphernalia of a doctor of medicine but destitute of the brains. this is what was going on. and cox tells another story. in 1863, one of the premier proprietary medical schools,

half of the graduates, about 25 men, wanted to go fight in the civil war. they wanted to fight in the medical department. and by 1863, they had to take a medical examination to get into the army by then. not one was able to pass the exam to get into the army. this was the state of american medical education. so there wasn't a lot of discipline in the discipline. it did not exist. it was chaos and anarchy. but this is what the civil war changed. let's talk about hospitals from this period. this is new york hospital, early 19th century. the best of the best. hospitals in general were ignominious places, for the destitute, the insane, murderers, for the poor. you went there only for one reason, not to get better. you went there to die. wealthy people, whatever that

meant back in the 18th and 19th century, they avoided hospitals. hospitals were not something that you and i would go to at the time. and this was going to change during the civil war. that's what we are going to talk about. then finally, let's just talk real fast about treatments and diagnoses. diagnoses were very simple at the time of the civil war. because they had no ability to differentiate diseases. every disease was the same. if you had lupus or if you had lung cancer or hepatitis, you had a fever. simple as all that. pathology did not exist. they did not know about the differentiation of diseases. so the end result, one big mish-mash of just everybody being sick, with no differentiation. benjamin rush, one of my favorite individuals who i have written about in the past, a very famous doctorate the end of the 18th century going into the

19th century, signed the declaration of independence. he came up with this thesis, not original. it was his thesis, very well known. it got propagated throughout america. it was that the cause of is diseases was what he called stimulus. what did he mean by stimulus? very simple. he meant that blood vessels in the body were congested. filled up with fluid. and that there was only one thing that we could do to make you and i better. obviously, if we have too much fluid, what does that mean? we are getting rid of the fluid. so that is now called the bleed, the blister, the puke, the purge, heroic therapy. they would bleed people. i am not going to go into the specifics of bleeding. not telling you the puking, and

purging and what they use to give you other than to say that it was not a lot of fun i was called heroic theory because of the potency of its action. whether it was heroic, i would say it probably wasn't. and caused a lot more harm than good. so through this anarchy and chaos that existed in american medicine, we now have another group of physicians, doctors, maybe not mds, doctors nonetheless in the eyes of the public, who also wanted to heal people. and what did they do? very simple. these were nontraditional practitioners. they were called sectarians and irregulars, unorthodox cultists. and who were these men? and some times more women than men. they were thomsonians. they did not believe in benjamin rush. they thought you needed hot things put all around you, or in your body. that's how they took care of things.

hydropaths, adam's ail, they gave it to you externally and internally. eclectics, botanical equivalent of heroic drugs. and my favorites, vegetarians and crackers. i want to tell you a little story. you know the name, graham and cracker. graham crackers. they believe if you ingested these graham crackers, it would stop sexual urges, and prevent masturbation and premarital sex. that was their belief. i leave it to you to determine whether that is true or not. however, i relate to you one little personal story, this is the truth. in 1975 when i began my internship and residency, i was at boston city hospital, as harvard was leaving, and bu was coming in. and i distinctly remember this, absolutely true. all i remember is that at every nurse's station in boston city hospital and on every ward,

there were boxes and boxes of graham crackers. and that we all were eating graham crackers. i was married at the time. i leave it to my lovely wife to determine anything. we were eating graham crackers, right and left as residents. finally, the home e-homeopaths. like is cured by like. minuscule doses of drugs. you had all these people. you had the mds, the allopaths, a big mess of what was going on. and that was american medicine at the time. well, nathan davis again, the last picture of him that you are going to see. every species of medical delusion is allowed to spring up and grow without any legal restraint. the public press lends itself freel as a hired vehicle for heralding every variety of pretended medicine nal compound that the ingenuity of man can invent. in other words, we had no idea what we were doing.

so having now bashed doctors, we are going to spend ten minutes going forward. as i have done for the last ten minutes. we are now going to spend ten minutes going forward. i don't want you to think there were no good things going on in american medicine. there were some very famous things going on. william beaumont and his very famous book, 1833. and, of course, anesthesia, the beginnings of anesthesia. john collins warren. he is going to operate on this young man. this was taken about seven months after the initial event of anesthesia. there were no cameras for the initial event. there was -- everything was posed later. you see -- if you look at his leg over here. watch the next picture. there is the blood and bandage. early use of anesthesia. at the time, no doctor could conceive of diseases or treatments in anything resembling today's scientific terms. mid 19th century drugs and therapeutic substances consist