hands, and only “observed, speculated, and prescribed.”^2 During the 18th
century, the members of the Royal College of Physicians were exclusively
graduates of Oxford and Cambridge, catering to aristocratic patients, and
emulating the style and bearing of the upper class, “making every effort to
attract attention to themselves by cultivating distinctive manners and
fashionable dress.”^3 The rigidly organized social strata in England did not
apply in colonial America, where physicians, surgeons, and apothecaries
existed together, oftentimes having attended crude medical schools, if any
at all.
The Industrial Revolution broadened the middle class, expanding the
ability to pay for medical services and decreasing the dominance of
aristocratic patients propping up a small group of noble physicians. But it
wasn’t until the emergence of antiseptic surgery and the adoption of the
German scientific mindset that the philosophical demolition of the
hospital as a “death house” occurred. At the onset of the 20th century, an
explosion in hospitals had transpired; from 1872 to 1910, the number of
American hospitals had grown from 178 to more than 4,000.^4 American
skepticism about the power of physicians to heal was well founded at the
death of Abraham Lincoln in 1865, and even at the death of William
McKinley in 1901, but medicine was soon to transform from
incompetence to unimagined efficacy.
Cardiologist and medical historian Bruce Fye observed, “During the last
third of the 19th century, an avalanche of new technologies transformed
the United States. Some of the most impressive culture-changing
inventions involved communication (telephones, typewriters, and
phonographs) and transportation (expanding rail networks, turbine-
powered steamships, bicycles, and automobiles). Electricity, another
breakthrough technology that empowered machines and lit dark places,
was also touted as a therapeutic tool.”^5 In addition, modern building
techniques utilizing newfangled Bessemer steel and George Fuller’s
internal load-bearing steel structure (as opposed to history’s use of
external load-bearing structures), along with the invention of the elevator
(1883), propelled buildings higher and higher.^6 The first skyscraper was
built in 1885, and it wouldn’t take long for the new expanded building
style to have its impact on the transformation of medicine.