NMA 2024: First in Medicine: An African American perspective from 1700 to 1940

Stephanie Marioneaux, MD, gives insight into the inspiration and research discussed in her talk “First in Medicine: An African American perspective from 1700 to 1940" as the Patricia Bath Distinguished Lecture at the National Medical Association's annual conference in New York City, NY.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Stephanie Marioneaux, MD:

Thank you very much for inviting me. I am just thrilled to be able to give this historical talk because it really prompted me to look further into my history and our history of African Americans in the United States. I learned a lot. I was inspired by Dr. Bath because obviously she was the first in so many things and she entered the medical arena in the 1940s when she was born. She was the first African American woman to complete a cornea fellowship. She's a graduate of Howard Medical School and Hunter College, and she was the first female to join a faculty and ophthalmology faculty at Jules Stein (Eye Institute). She was the first female to chair a department of ophthalmology, and that was the Drew/UCLA program. She was the first African American to receive a patent for a medical device. In fact, she received five patents for her groundbreaking invention of using the nanosecond laser to safely fecal emulsify cataract surgery. It was the basis of this groundbreaking discovery that we are all currently using, the femtosecond and the zeptosecond lasers currently in cataract surgery. She was also a five-time Hall of Famer, and she was the proud mother of Dr. Eraka Bath, who is a very accomplished psychiatrist.

In learning so much about her, it really challenged me to look back and identify who opened the doors for her and for all of us. I started in the 1700s and just went to 1940, which is when Dr. Bath was born, and learned so many amazing things. In the 1700s, we learned about Onesimus, who was a Libyan-born slave. It was apparent to his master, Cotton Mather, that all the slaves had scars on their arm, and many of them were sent to care for people who were infected with smallpox. Many of the slaves never became infected with smallpox. He asked Onesimus what was going on and Onesimus shared with him that in Africa for many, many years – and this was now 100 years before Jenner was credited for the smallpox inoculation – the Africans would take discharge from the smallpox infections and the pustules and they (would) make an incision in the arm of a healthy person. They would put the puss in that incision, and that would afford some degree of protection against future infections. Onesimus shared this technique with Cotton Mather, who was a pastor and had no medical training, so he shared it with Dr. Boylston and sadly, Boylston and Mather we're hailed as heroes for discovering this technique and an Onesimus remained a slave.

Then, we have our first African American physician, Dr. James Durham, and he was a born a slave. He had three physician masters, and his first physician master recognized his brilliance and taught him how to compound medications and allowed him to be an apprentice in his office. After all, in the 1700s that's exactly how physicians were trained. His second master took him from his family in Philadelphia and brought him to New Orleans, where he was with him during the war against the British and he was there treating wounded soldiers. His third master was so impressed with his mastery of the medical arts that he allowed him to purchase his freedom. Together, Dr. Dove and Dr. Durham went into practice in New Orleans in the 1700s. They were in practice for over 16 years when there was a law passed in New Orleans that you could only practice if you had a medical license, so that really limited his practice. Dr. Durham had really been the most distinguished of the two because it was his formulated medications for yellow fever and diphtheria – because remember there were no pre-formulated medications in the 1700s – and his treatment protocols were so successful in treating patients with both diphtheria and yellow fever. In fact, he wrote many papers describing his treatment protocols and its compounded medications. One was read to a congress of white physicians in Philadelphia by Dr. Rush, who was a white physician and an abolitionist and who read the paper. When he was sharing the formulated medications that Dr. Durham had done, the audience was so impressed that when he finished reading his paper, he said, ‘And this was written by a former slave,’ which was to just underscore that the premise that all slaves were intellectually inferior was simply not the case. Dr. Durham was a very outspoken critic of slavery and a staunch abolitionist himself, so when he was no longer allowed to practice medicine in New Orleans, he did go to Philadelphia, hoping that Dr. Rush, who had invited him to come for so many years, could assist him. He was able to have a limited practice, but they enforced the same laws and then Dr. Durham disappeared in 1802, never to be seen again. No one really knew, but they supposed that he had been murdered because he represented the antithesis of a slave. The other theory is that he went off to practice in a far-off land, so we let people ponder what they think.

The first African American to graduate from medical school was Dr. James McCune Smith. He was born an indentured servant in New York and became free at age 14. Free negros and white abolitionists paid his passage to Glasgow, Scotland, where he received his undergraduate degree, a master's in statistics, and his medical degree from University of Glasgow in Scotland and then he did an internship in Paris. He returned to pre-Civil War United States speaking seven languages: English, French, Spanish, Italian, Latin, Hebrew, and Greek. He practiced medicine, but he was also a prolific writer, and he wrote the prologue of Frederick Douglass’ autobiography, “My Bondage and My Freedom.” He also refuted – I believe it was the 1846 Census – that stated that slaves lived longer than free negros and freed negros. He refuted that soundly with his statistical training and concluded that not only did free negros and freed negros live longer than slaves, they also had a much higher quality of life and they also contributed significantly to the communities in which they lived. He ultimately became the physician at the Colored Orphan Asylum in New York, and he was worth over 20,000 pre-Civil War dollars at the time that some white insurgents burned the Colored Orphan Asylum. He and his family fled Manhattan and moved to Brooklyn, and he had 11 children. Five of them survived, all were well- educated. One of his sons was an attorney, his daughter was an educator. Sadly, Dr. James McCune Smith died 19 days before the signage of the Emancipation Proclamation.

Our first physician to graduate from medical school in the United States was about 10 years later was Dr. David Jones Peck. David Jones Peck was a free man. He had never been a slave, and neither of his parents had ever been slaves. His father was an AME minister in Pittsburgh, and he owned a successful barber shop. His mother was also a free woman and she and her husband had a school for free negros, and Dr. Peck was their top student. He graduated from Rush Medical College in Chicago and then ultimately went to Philadelphia to start a private practice. Some of the white physicians and white pharmacists refused to refer patients to him or to compound his medications, and so he closed his practice in three years. He met Dr. Martin Delany and Dr. Martin Delany was one of three African Americans who matriculated at Harvard Medical School in 1850. All three of them – Dr. Delany, Dr. Snowden, and Dr. Lang – all completed their first year at Harvard Medical School in 1850 without any academic problems. Sadly, there was a small group of white students who submitted petition after petition after petition to have the colored students removed from the classroom. Oliver Wendell Holmes, the famous anatomist, expelled Dr. Snowden, Dr. Lang and Dr. Delany from Harvard Medical School in 1851 based on race alone.

Fortunately, all three of them were able to complete their medical education, and following that, Dr. Delany actually met Dr. Peck. They were old time friends when Dr. Peck was heading West after he was leaving Philadelphia and Dr. Delany had just come back from Liberia. As many know, there was a movement to expatriate free blacks, freed blacks, rent slaves to Liberia where they would train a few and hoping that they would establish a society there. Dr. Delany had just come from Liberia, and he realized it wasn't such a good fit for him, so he was moving to Nicaragua where there was a growing community of free expatriate negroes in Nicaragua. He was encouraging Dr. Peck to join him. Dr. Peck decided and he and his wife moved to Nicaragua where Dr. Peck was the town physician and Dr. Delany was the mayor. Sadly, there was a group of white insurgents, some of whom were confederates hoping to annex Nicaragua as part of the Confederacy, and Dr. David Jones Peck was killed at I believe age 29 in Nicaraguan. There's a wonderful plaque there that commemorates the service that he contributed.

The same year that Dr. Peck did graduate from Rush Medical College, Dr. David Kearny McDonogh would have graduated from Columbia Medical School because he completed all of the academic requirements, but Columbia (University) refused to confer his degree. Dr. McDonogh contributed significantly to the society and community in New York so much so that some African American physicians erected a hospital post-houmous in his name, naming it the McDonogh Hospital. In 2020, historians, as well as one of our great ophthalmology colleagues, Dr. Daniel Laroche, and others were part of a movement to force Columbia Medical School to confer Dr. David Kearny McDonogh’s degree. They actually did in 2020, making him the first African American to graduate from Columbia Medical School and also making him the first Black ophthalmologist in the United States. Moving forward from there, we had our first hospital, 4 million runaway slaves, free men and freedmen descended upon Washington, D.C. Some of the white hospitals and physicians refused to treat them, and so there was a federal mandate to erect Freedmen's Hospital, which was the first hospital in the United States to preferentially treat people of color.

The first African American hospital administrator of Freedmen's Hospital was Dr. Alexander T. Augusta. Dr. Alexander T. Augusta was born in Norfolk, Virginia, and he was a free man; he had never been a slave. He had to travel to Toronto to receive his medical license. He opened an apothecary in 1855, and he graduated from the University of Toronto Medical School in 1856. He was such a brilliant student that they asked him to be the administrator at one of the local hospitals. He opened a private practice, and his wife was also a free negro. She had never been a slave, and she had a very successful dress shop, so the two of them were a power couple; they were a force to be reckoned with in Toronto. They were outspoken opponents of slavery. They were strong abolitionists; they spoke against racism. Not long after Abraham Lincoln signed the Emancipation Proclamation, Dr. Alexander T. Augusta wrote a letter to Lincoln requesting that he be made a commission medical officer in the Union Army and that he be stationed with the Colored Infantry because the colored soldiers were dying at a rate faster than the white soldiers and because there was a dearth of medical professionals who had volunteered to serve. Lincoln welcomed the opportunity to increase the medical manpower, and so he agreed to commission Alexander T. Augusta as a major in the Union Army, which would make him the highest-ranking medical professional or physician in the Union Army. He and his wife left everything they had accomplished in Toronto, and he came to Washington D.C., and they never returned to Toronto. He was stationed with the Colored Infantry. He was doing an exceptional job, and sadly, a few of the white physicians and nurses – all of whom he outranked because he was a major they were all of his subordinates – sent letter after letter after letter to Lincoln requesting that Dr. Alexander T. Augusta be transferred because they said they were humiliated to have to report to a colored surgeon. Lincoln acquiesced, and he transferred Alexander T. Augusta, who was a major and a physician, to be the first hospital administrator at Freedmen's Hospital in Washington, DC. So, Dr. Alexander T. Augusta became the first Black hospital administrator of any hospital in the United States, and he served there for several months, but he did not leave Toronto and leave everything that he had accumulated to be a hospital administrator. He wanted to serve the colored troops and the Colored Infantry, so he wrote letters to Lincoln to request that he be transferred to the another Colored Infantry so he could serve and help the Colored Troops. After six months, Lincoln transferred him to another Colored Infantry, where he served until the remainder of the war. He was promoted to Lieutenant Colonel again, making him the highest ranking African American in the Union Army.

There were 14 African American physicians who served in the Union Army, and eight were commissioned officers. A commissioned officer meant that you would receive a pension. Of the eight, they were truly the first in their field. There were no HBCUs at the time, so they were the first graduates. Dr. (Richard Henry) Greene was the first graduate of Yale (University) undergraduate, and then he was the first Black graduate at Dartmouth Medical School. Dr. Courtney Rensselaer was the first Black graduated at Yale Medical School, and then we had Dr. (Anderson) Abbott who graduated also from University of Toronto. In fact, all the African American physicians who served in the Union Army were freemen, they had never been slaves.

Dr. Abbott's family had owned a store in Alabama, and they were free negros and their store was burned to the ground. They had to flee to all the way to Toronto, and this was around the height of the fugitive slave law, which was essentially a law that allowed any African American essentially to be sold into slavery under the pretenses that they were runaways. It was a very frightening time for free negroes. His family became very well-established in Toronto; they were permitted to purchase property and they became very well-off. Dr. Abbott was born in Canada, and he served in the Union Army. He came from Canada to serve in the Colored Infantry.

Then, we have Dr. Revels, who was the relative of Hiram R. Revels, who was the first Black senator. Dr. Revels was also a pastor. Following that, we'll forge ahead to our first African American female who graduated from medical school. That's Dr. Rebecca (Lee) Crumpler. She graduated from a female medical college, which is no longer in existence, but it would have been affiliated with Boston University. She served the Beacon Hill community, which was a vibrant Black community in Boston at the time, to such a high degree that there is a historic marker at her home, commemorating the exceptional work that she did for her community. But ironically, neither Dr. Crumpler nor her husband, Arthur Crumpler, who was a runaway slave who became very well-educated, had headstones. Some historians and some of the Black students at Boston University Medical School petitioned the governor to – I believe it was in 2020 – to erect headstones for Dr. Rebecca Crumpler and for her husband, Arthur Crumpler.

Continuing on, Harvard University has lifted their ban on not admitting colored students, and in 1867 there were six colored students who were admitted to Harvard University. One was Mr. Edward Ruffin, who graduated from Harvard Law School. Then there were two who graduated from Harvard Dental School, and there were two who graduated from Harvard Medical School, Dr. Dorsey and Dr. Edwin (Clarence Joseph Turpin) Howard.

Dr. Edwin Howard moved to Philadelphia. His parents were also free, and he set up a private practice in Philadelphia. He was known as the “Dean of Medicine” in Philadelphia because his survival rates in treating yellow fever, where he boasted that he only lost two patients in his entire career in medicine to yellow fever based on his unique formulations of his compounded medications and its treatment protocols. Most physicians lost almost all their patients, or a significant percentage, to yellow fever and diphtheria. He was one of the first African Americans to find Sigma Pi Phi Fraternity as the first African American fraternity. There was just an all-star lineup of founders. All of the men who founded the boule in addition to Dr. Howard, every single one of them was either a physician, an MD, PhD, a dentist. The Boule is still currently in existence. It spans the entire nation and does tremendous work for our society and community at large.

We finally have an HBCU medical school, Howard Medical School. General (Oliver Otis) Howard, who was a general in the Union Army, led the charge. The first African American to be a member of a medical school faculty was Dr. Alexander T. Augusta. He also invited Dr. Purvis , who later joined the Howard University faculty. Dr. Purvis also served in the Union Army as a physician. Dr. Purvis’s grandfather was James Forten and was a well-known Black sailmaker who became a shipping magnate during the Revolutionary War. It was his knowledge of the waterways that proved to be instrumental to the colonists and helping them win that war. Dr. Purvis’s aunt, who was James Forten’s daughter Charlotte Forten, also taught the slaves in Georgia to read and write. He came from quite a distinguished family.

We are so thankful that Howard Medical School was formed because they have just been an amazing institution, and still quite a vibrant institution within our community. Shortly after that, we had Meharry Medical College that was founded in Nashville, Tennessee, and it was how Howard and Meharry were the two remaining medical schools after the AMA’s Flexner Report in the 1920s. In one of my slides, I have a picture of Dr. Josie (English) Wells, who was one of the first female graduates at Meharry, and she also has a historic marker at her home commemorating the outstanding work that she did in her community. We as African Americans are so indebted to Meharry and to Howard for their founders and for the institutions for having graduated and trained so many Black physicians. In fact, Meharry boasts that they've trained the most Black physicians and dentists working in the South, and Howard boasts that they have trained the most Black physicians and dentists period. We again are so thankful for the amount of talent that they have trained, these brilliant minds, physicians, dentists, pharmacists, nurses, and so much more.

Following that, we have Dr. Daniel Hale Williams, who was felt to be one of the fathers of cardiac surgery because he performed open heart surgery on a gentleman who had sustained a knife wound to his chest. Without transfusions or the benefit of sophisticated cardiac imaging, Dr. Daniel Hale Williams was able to repair the cardiac injury, and the patient left the hospital 51 days later and went on to lead a very productive life. In fact, Dr. Daniel Hale Williams was the founder of Provident Hospital in Chicago, and it is one of the few remaining Black hospitals. He was one of the first to start a training program for nurses, as well as an internship for physicians, and it was one of the early integrated training programs in the United States. Dr. Daniel Hale Williams also taught at Meharry and Howard, and he was one of the founders of the National Medical Association. The National Medical Association was founded in 1895, and obviously, this is the reason we're here because of our annual meeting. We are so indebted to the founders of the National Medical Association because they persevered, and they were determined and resilient in spite of being denied membership to the AMA for over 100 years. We formed our own organization, and we are still making significant contributions to our community and making sure that we're continuing to pass the baton so that there will be future generations of African American physicians.

Moving on almost to the end, we are now in the 1900s. William Augustus Hinton was the son of former slaves, and he was the first African American to author a medical textbook. It was called “Syphilis and its Treatment,” and Dr. William Augustus Hinton graduated from Harvard undergraduate, and he finished Harvard Medical School in three years. Despite his brilliance, he was denied a residency in surgery, and he was told instead to go to the morgue and do autopsies on patients who died of syphilis. He became an internationally recognized pathologist, and he also worked with Dr. Ruth (Marguerite) Easterling, who was one of the first Black female graduates at Tufts (University’s) Medical School. They were working together on trying to define a test and other research on syphilis. But sadly, Dr. Easterling died in her 40s of breast cancer. Dr. Hinton continued on, and he invented the Hinton Test for the detection of syphilis, and it replaced the Wassermann Test based on greater sensitivity and specificity. It is a test that is still used today.

As I mentioned, a little irony about Oliver Wendell Holmes, there is an Oliver Wendell Holmes Society at Harvard Medical School, and it is a society that is a very coveted society for the medical students to be a member of. In 2020, medical students learned that Oliver Wendell Holmes expelled three African American students – Dr. Martin Delany, Dr. Lang and Dr. Snowden – in 1851, based on race alone, so they expelled the Oliver Wendell Holmes Society at Harvard Medical School and renamed it the William Augustus Hinton Society. There is a beautiful oil painting that now hangs in the Waterhouse Room at Harvard Medical School, which is the room where all of the beautiful paintings of former Dean's and their esteemed professors, so we are so blessed and honored and grateful that Dr. William Augustus Hinton has been honored post-humorously at Harvard Medical School. He was also the first Black professor at Harvard Medical School.

Lastly, Dr. Charles R. Drew was just a phenomenal human being. He was an all-American athlete. He was a graduate of Amherst College. He graduated from McGill Medical School, and he was the first African American to receive a master's in medical science from Columbia (University). He was also a Rockefeller fellow. The British government credits Dr. Charles Drew with saving over a million lives in WWII based on his invention that you could use plasma to universally transfuse patients, regardless of their blood type. He also established the international system of blood banking, which is still currently in use. Dr. Drew went on to become the chair of surgery at Howard Medical School, and sadly, he died of a car accident in his 40s.

As you can see, our history is rich and very, very inspirational. I felt very motivated and empowered in learning more facts, some of which I already knew, but many of the details early on have just been very inspirational to me. It makes good sense how their legacy has allowed all of us to move forward and to hopefully continue to pass the baton.

I would hope that learning our history, because our history is largely untold, that this should also inspire them to be the best that they can be. To know that determination, hard work, resilience, and just never stop believing in yourself is something that will propel you forward. To be in the footsteps of these great men and women, it should empower you and embolden you and hopefully allow you to continue to make significant contributions in the society and the community in which we all live.