By Chris Dalrymple, D.C., F.I.C.C
In the 1800s the authority to examine and license medical practitioners was delegated to state medical societies. Medical licensure could be obtained either through medical society apprenticeship or through medical schooling. In the 1800s a rapid proliferation of medical schools arose in the United States and the practice of medicine was deregulated allowing for schools of medicine to turn out doctors as desired.
In 1837, the Republic of Texas passed it’s first Medical Practice Act regulating the granting of licenses to practice medicine and surgery in the republic. By the mid-1800s, however, medical deregulation was in full swing in the United States and most of the states began to repeal their medical licensing laws. Texas followed suit discontinuing its medical board in 1848. There was then no governmental regulation of the practice of medicine in Texas until 25 years later in 1873. During this period of deregulation new schools-of-thought developed about how to practice medicine. These new-schools of medicine rapidly produced their own dedicated medical practitioners to meet the needs and desires of the masses. In 1853, in response to these new-schools, 35 medical physicians chartered the Medical Association of Texas to exclude “irregularly trained doctors.”
At the end of the 1800s medical care was based upon the thought that disease was the result of poison and that the poison should be removed by bloodletting and purging. Liberal doses of mercuric chloride frequently brought death, but the belief in their value persisted. Complaints about physicians were common and during the antebellum period the quality of medical education in the United States was poor. The apprentice system was widely used and young men learned the art of healing by studying a winter or two with an established practitioner. Medical schools fell into two categories, university and proprietary. They offered a similar curriculum and faced the same difficulties, but because of their dependence on student fees, proprietary schools were commonly called diploma mills and considered of lesser value.
The American Civil War (1861-64) disrupted further changes in medical education and it wasn’t until 1865 that the first medical school in Texas was established. Shortly after the Civil War, the phrase school of thought first comes into use in 1864 to describe “people united by a general similarity of principles and methods."
In 1869 a reorganizational meeting of the Medical Association of Texas renamed that organization the Texas State Medical Association. The new state medical association stated that it had “throughout its history…campaigned for effective medical practice legislation and the suppression of medical charlatanism” [persons who, in their view, falsely claim to have a special knowledge or skill]. Stated more clearly, they existed to advocate for the medical practice of their choosing and to see that only that American Medical Association (AMA) style schools of thought – “people united by a general similarity of principles and methods” – were licensed to practice the art of medicine.
After 25 years with no state regulating the healing arts, in 1873 another regulatory law for physicians was enacted in Texas. Three years later, in 1876, the State of Texas updated its constitution and stated: “the Legislature may pass laws prescribing the qualifications of practitioners of medicine in this State, and to punish persons for malpractice, but no preference shall ever be given by law to any schools of medicine." This nearly 150 year-old “no preference” provision remains in effect today. It provides that people united by a general similarity of principles and methods” shall “ever be given preference by law.
In 1865 the first medical school in Texas was established. This was the Galveston Medical College. Poorly equipped, the school closed in 1873 after the faculty resigned in protest. It was reorganized later that same year as Texas Medical College and Hospital.
In 1881 the legislature established a state university with a medical department at Galveston. Anticipating a new and state-supported school in town, the Texas Medical College shut down. The Texas legislature, however, could not provide the funds for the new medical school, so Galveston business interests and some physicians reopened the Texas Medical College in 1888, to fill the gap until the university could begin its operations. In 1890 construction of the red brick headquarters of the University of Texas Medical Branch and it opened in 1891 with an original faculty of thirteen members, eight of whom were full-time. Only twelve of the first group of twenty-two medical students graduated from UTMB.
