Knowlton Biography Chapter 13
Thirteen: Dissertation and Degree
In the fall of 1821 I commenced, with imperfect health; and in the fall of 1823 I passed a very successful examination for the degree of M.D. And during much of the two years and two months which intervened between the commencement of my studies and my examination, I labored, and did not study at all; at other times I worked for my board. Another portion of time was taken up by a prosecution; another by cooking what little I ate, and still suffering for want of food; and, finally, I had a young and affectionate wife, whom I must visit every now and then, whether-or-no. I say all this, because I had rather that my ignorance be attributed to want of advantages than to any defect in my original organization; but why a man wishes others to think well of his natural powers, when he had no hand in making them, I leave for others to solve.
In the middle of the 1823 term of medical lectures, Charles had to leave Hanover. His trial in the Worcester County court for body-snatching in Royalston the previous summer had been scheduled for mid-November. Worcester is one hundred ten miles from Hanover. Charles walked the first ninety-five miles to Templeton in harsh, early-winter weather. Then, learning his trial had been postponed until the following spring, Charles walked back to Hanover to complete his medical studies.
As part of the examination for his M.D. degree and license to practice, Charles wrote a “dissertation” that is still on file in the manuscript collection of the Dartmouth College Library. Knowlton’s dissertation is an eight-page, handwritten document, bound in a large volume with similar documents written by other students that year. Knowlton’s handwriting is strong and very legible, suggesting that he was not rushed. The orderly construction of his argument suggests the bound document may not have been the first draft of the dissertation—or if it was, that Charles had come well prepared to the examination.
The subjects of the various dissertations sharing the volume with Knowlton’s suggest that students were given some freedom to choose their topic. The medical students were probably asked to write on the work they’d done that most contributed to their qualifications to be doctors, or the accomplishments they wanted to be remembered for. Most of the writers took the opportunity to showcase their knowledge of medicines or surgical practices, or to review original research they had done during their studies. Charles, not surprisingly, chose to write about body-snatching.
“The obstacles which have of late years been thrown in the way of anatomical pursuits,” Charles began, “are of a serious nature and likely if not soon removed, ultimately to put an end to the study of anatomy altogether.” His goal was not primarily to argue for the study of anatomy, which he knew his instructors already supported. It was to convince the professors to take more decisive public action in support of dissection than they had yet dared.
Charles began his essay by sweeping away the traditional moral argument against dissection, which was based on religious authority. Knowlton’s morality was anchored not to religion, but to utility. “The value of any art or science,” he said, “should be determined by the tendency it has to increase the happiness, or diminish the misery, of mankind.” Although he probably didn’t know it at the time, Charles was putting a stake in the ground and expressing the principle that would guide him the rest of his life.
Charles continued his argument with several examples that illustrated the need for both surgeons and general practitioners to see human organs and the way they fit together in the body, in order to understand how they worked. Then he made an observation that highlighted the change he was witnessing and becoming a part of, in the practice of medicine:
Any one who takes a survey of the history of medical science, will be struck with the diversity of opinion that has existed in all ages respecting disease;—theories out of number, on almost every disorder, have been put forth, which lasted for a time, and then passed away, and are only mentioned at the present day, to illustrate the ignorance of the ages in which they were invented.
But, on an examination into the causes of this continual change of opinion on medical subjects, it will not be found very difficult of solution; a theory is good or bad, in proportion to the extent and correctness of the facts and observations on which it is founded.
On what were the theories to which I have before alluded founded? On mere conjecture in most cases; and in others, on the most narrow observation. Within a few years, opinions equally absurd as those of the ancients were held by individuals in this country; they are, however, dying away.
A change has taken place; and to what can we attribute it, if not to the more accurate views of pathology obtained by means of morbid anatomy?
Observation, Charles said, was finally beginning to overtake the authority of tradition. Medical science, he claimed, advanced by experience and discovery, not by the mining of ancient texts. Medicine would advance more quickly, Charles suggested, if students and doctors had more opportunities to gain experience by examining bodies. The secret trade in stolen corpses was hypocritical, and it perpetuated the double standard that allowed the majority to take advantage of the medical discoveries physicians made, while punishing them for the scientific work that led to those discoveries.
Even under the best conditions, working with corpses was not without its dangers to the student, Charles observed. “There is the unwholesomeness of the occupation,” he said, “and the danger incurred even by the most careful, from accidents, which in a broken up constitution, not unfrequently prove fatal.” Doctors, and especially professors at medical schools, should lead the campaign to legalize dissection and encourage people to donate their bodies to medical schools.
If the public could be convinced that dissection produced better physicians and led to advances in medicine, Charles argued, they might be able to put aside their superstitions about the resurrection of the body. “But there is little hope of enlightening the people on this subject,” Charles concluded,
until they are convinced that physicians are willing to have their own bodies carried to the dissecting room.
Let it but become a general practice for physicians, to give their bodies by will, for dissection, and the prejudice existing on the subject will soon be done away; and it will be as common for persons to request that their bodies may be dissected, as it now is, for them to beg that their graves may be guarded against the resurrectionist.
Charles passed his examinations with high marks, and received his M.D. and his license to practice medicine. He had come from near death, and in two short years had mastered everything then known about health and disease—and had begun to push beyond the limits of that knowledge. Dr. Reuben Mussey, Charles’s professor of theory and practice and one of the directors of the school, “privately expressed great satisfaction, saying, among other things, ‘You have done our Institution great honor.’” Charles’s education was complete—he was a doctor. But he still had to walk the ninety-five miles home from Hanover, through early-winter weather.