2 of 2 Parts:Abraham and Simon Flexner: Medical Education Reformers.

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Part 2 of 2 Parts (Conclusion): Abraham and Simon Flexner: Medical Education Reformers, by Franklin and Betty J. Parker, bfparker@frontiernet.net

Betty: Pritchett and Flexner let medical school heads know when and how Flexner planned to evaluate their schools. Flexner talked to medical school heads and faculty (when present), toured the facilities, returned to Louisville, drafted his report (shared with Pritchett), and sent this draft report to the medical school heads for any corrections. His final draft report, he said, would be shared with local newspapers and journals before publication. Flexner had to deal with subterfuges, as when doors in one medical school, marked “Anatomy,” “Physiology,” and “Pathology,” were locked. No keys nor janitor could be found. When the medical school dean left Flexner at the railway station, he missed his train, went back to the school at night, found and bribed the janitor to open the locked doors, and found the rooms to be unequipped classrooms, and so stated in his report. Pritchett and Flexner were threatened with lawsuits and Flexner received threatening letters. In a year and a half he finished inspecting the 155 medical schools and completed his report, Medical Education in the United States and Canada (NYC: Carnegie Foundation for the Advancement of Teaching, Bulletin No. 4, 1910). Frank?

Frank: Of the consequences of his report, Flexner wrote: “…such a rattling of dead bones has never been heard in this country before or since. Schools collapsed to the right and left, usually without a murmur. A number of them pooled their resources. The seven schools of [Louisville] were reduced to one. The 15 schools in Chicago were consolidated to three.” Here are a few excerpts from Bulletin No. 4:
Birmingham Medical College [Ala.]: “A stock company largely given over to gunshot and other wounds. The dispensary service is as yet unorganized.”
California Medical College: “Entrance requirements nominal?. No dispensary. No access to the County Dispensary. The school is a disgrace.”
University of Louisville: “Entrance requirements: less than a high-school education.”
Georgia College of Eclectic Medicine & Surgery: “A building [of] filthy conditions. Its anatomy room, containing a single cadaver, is indescribably foul.” (Bulletin 4, p. 87), Betty?

Betty: Flexner’s 1910 medical education report emerged at the height of large scale philanthropic foundation growth. Civil War devastation had inspired George Peabody (previously mentioned as having influenced Johns Hopkins) to found the pioneer $2 million Peabody Education Fund (1867-1914) to aid white and black public schools in the 11 former Confederate States plus West Virginia (because of its poverty). The PEF inspired other northerners to aid southern black education: the John F. Slater Fund (1882-1937), Julius Rosenwald Fund (1917-48), and the Anna T. Jeanes Fund (1907-37). Four Conferences on Education in the South (1889-1902) led to the Southern Education Board (1901-14), which led to the John D. Rockefeller-funded General Education Board (1902-39), which soon employed Abraham Flexner. Frank?

Frank: Scottish-born steel magnate Andrew Carnegie’s (1835-1919) 1889 essay, “The Gospel of Wealth,” urged the rich to use their wealth to correct social ills and advance public good. His Carnegie Foundation for the Advancement of Teaching was only part of his $350 million gifts to solve American problems. Larger funds were started by John D. Rockefeller, Sr. and Jr., devout Baptists who regularly tithed. Carnegie, the Rockefellers, and other giants of industry organized giant philanthropic funds, giving unheard of millions to help correct social ills. Betty?

Betty: Flexner’s 1910 medical school report impressed John D. Rockefeller, Sr.’s philanthropic advisor Frederick T. Gates (1853-1929), a former Baptist minister. Gates once told Rockefeller, Sr. (abbreviated quote): Your wealth is piling up and will bury you. It will ruin your children and their children unless you use it for vast public good. Gates and the Rockefellers favored funds that aided medicine and the conquest of disease. This purpose was dramatic and brought public approval, despite critics who said that the Rockefeller foundations were intended to offset bad publicity about Rockefeller as a monopolist robber baron. Gates enlisted Abraham Flexner to work for the General Education Board (1913-28, 15 years), funneling millions to remake U.S. medical schools. Rockefeller, Sr’s biographer Ron Chernow (Titan, the Life of John D. Rockefeller, Sr., NY: Random House, 1998, p. 493) wrote: “by the time Flexner left the GEB in 1928, it had distributed more than $78 million to the scientific approach to medical education…[creating] nothing less than a revolution. In its thirty-year existence, the GEB dispensed $130 million, equal to more than $1 billion today [c.1998].” Frank?

Frank: Abraham Flexner capped his career by creating the nation’s first significant think tank. In 1930 he was approached by Newark, N.J., merchant Louis Bamberger (1855-1944) and his sister, Mrs. Caroline Bamberger Fuld, seeking advice on a foundation they hoped to establish. Flexner explained that German universities had led the world in creating new knowledge. But since Germany’s defeat in World War I, U.S. scholars no longer flocked to German universities. The U.S. needed an Institute for Advanced Study, an intellectual retreat, a place without students or courses where scholars, unhindered, could discover new knowledge. The donors asked what such an institute would cost. Flexner said $5 million. The donors agreed. Asked to be its first director, Flexner demurred. His wife Anne insisted that he had to help get it started. Betty?

Betty: The Institute for Advanced Study was located in Princeton, N.J., near to but independent of Princeton University. Flexner sought to first fill a mathematics professorship which did not require labs or buildings, only blackboards and chalk. He sought out Albert Einstein (1879-1955), already concerned about the rise of Hitler, who left Germany for Princeton and held the chair of mathematics to his death. Opening in 1933, the Institute for Advanced Study became a haven for scores of other European scholars fleeing the Nazis, including Danish physicist Niels Bohr (1885-1962). Other Institute scholars included John von Neumann (1903-57), who built an early giant computer there; physicist J. Robert Oppenheimer (1904-67), who led the Los Alamos, N.M., scientists in developing the atom bomb (he was the Institute’s director in the 1950s). The Institute for Advanced Study currently has some 200 visiting U.S. and foreign scholars for up to two years, and 23 faculty in four schools: mathematics, natural science, social science, and historical studies. Frank?

Frank: Abraham Flexner’s wife died in 1955. In 1957 he moved to suburban Washington, D.C., to be near his married daughter. He died Sept. 21, 1959, at age 93. He often quoted French chemist Louis Pasteur (1822-95): “Chance favors the prepared mind.” He ended his 1940 autobiography I Remember, with these words by Scottish writer Thomas Carlyle (1795-1881): “I burn that I may be of use.” Betty, tell of our correspondence with Abraham Flexner and his daughter.

Betty: In 1952, when Flexner’s book, Funds and Foundations (NYC: Harper), was published, you and I were studying at George Peabody College for Teachers, Nashville (renamed Peabody College of Vanderbilt University from July 1, 1979). We soon embarked on reading George Peabody’s papers in Massachusetts, NYC, Baltimore, and in London, England. Since Flexner’s chapter on the Peabody Education Fund described it as the first pioneer U.S. multimillion dollar foundation you wrote him for his view of Peabody’s importance. He encouraged us to write a dissertation on George Peabody’s philanthropy. After his death we published three articles on Flexner : Journal of Medical Education, 36, 6, June 1961, pp. 709-714. History of Education Quarterly, 2, 4, Dec. 1962), pp. 199-209. Proceedings of the Southwestern Philosophy of Education Society, X and XI , 1959-60, pp. 16-27. Later in 1985, referring to our articles about her father, his daughter, Mrs. Jean Flexner Lewinson, wrote us. Thus, our long-time interest in the Flexners. Frank, what about Simon Flexner, based on James Thomas Flexner, An American Saga: The Story of Helen Thomas and Simon Flexner (Boston: Little, Brown, 1984)?

Frank: When Simon Flexner was 10 years old the Panic of 1873 bankrupted his father, plunged the struggling family into deeper poverty, and required those of the nine children who could work to do so. Simon, fifth born son, was small, weak, shy, and mischievous. “School,” he later wrote of his youth, “did not [then] interest me.” He barely finished grade school, never attended high school or college; instead held a succession of poorly paid dead-end jobs. At 16 he contracted typhoid fever, almost died, and suddenly saw himself in a new light. Oldest brother Jacob got him an apprenticeship in Vincent Davis’s drugstore. This devout Christian (Vincent Davis) encouraged Simon’s night attendance at the Louisville College of Pharmacy. Simon, earlier the family dunce, not only completed the pharmacy course but also won a gold medal. His son and biographer later wrote: “The ugly duckling had proven a swan” (James Thomas Flexner, p. 106). Betty?

Betty: Simon became a pharmacist in oldest brother Jake’s drugstore, open 24 hours a day. Jake subscribed to pharmaceutical and medical journals, had a good memory and liked to expound, making the drugstore a clearinghouse of medical information, and a mecca for local physicians. Simon acquired a microscope, learned much from other microscope enthusiasts among the visiting doctors, and was soon doing slide analyses for them. Yearning to become a pathologist and despite being tied to the drugstore because of the Flexner family’s financial needs, he did attend night courses at the nearby Medical Institute of the University of Louisville and earned the M.D. degree in 1889. Frank?

Frank: Meanwhile, Abraham had graduated from Johns Hopkins University, had taught in the Louisville Male High School, and was successful in the Flexner college prep school. Knowing Simon’s determination to become a pathologist, Abraham encouraged him to apply for a Johns Hopkins Medical School fellowship. Simon did apply but failed to get it. Seeing Simon’s disappointment, Abraham said to him in 1890: From my prep school earnings I will give you enough money to study pathology at Johns Hopkins for one year. Simon went to Johns Hopkins and studied under pathologist William Henry Welch, a mentor largely responsible for Simon’s becoming one of the great medical discoverers of his time. Thirty years later (June 1, 1920), Simon wrote Abraham in gratitude for “the great debt I owe you. To have sent me to the Hopkins and Dr. Welch in 1890 has meant more for me than anyone except myself can know. That you should have possessed the insight that Dr. Welch was the master in pathology is almost miraculous. How deeply I feel my unredeemable debt to you.” (Abraham Flexner, An Autobiography, p. 60). Betty?

Betty: Simon impressed Welch and others at Hopkins so that he was offered a fellowship the following year, became Welch’s assistant (1892), published studies in pathology, gained valuable experience fighting an outbreak of spinal meningitis in western Maryland (1893), visited Europe to study pathology at Strasbourg and at Prague, and was associated with Johns Hopkins during 1890-98. Studying diseases in the Philippines (1899), he discovered a widespread strain of the dysentery bacillus. He became pathology professor, University of Penn. (1899-1903), during which time (1901) he headed the U.S. Government commission investigating a bubonic plague outbreak in San Francisco. In 1903 he joined Dr. Welch in the newly organized Rockefeller Institute for Medical Research, NYC. In a 1905 NYC outbreak of spinal meningitis he found a serum that reduced mortality by 50 percent. In a 1907 epidemic of polio he identified the infectious virus and laid the basis of protective polio vaccines 50 years later. Frank?

Frank: Simon wrote over 200 pathology and bacteriology reports (1890-1909), edited the Journal of Experimental Medicine (19 years), was a Lt. Col. in the Army Medical Corps during World War I, building up its medical laboratories abroad. Simon directed all the Rockefeller Institute branches from 1924 to his retirement in 1935. He helped organized the Peking Union Medical College, China; was appointed Eastman Professor at Oxford University (1937-38); wrote with his son James Thomas Flexner, William Henry Welch and the Heroic Age of American Medicine (NYC: Viking Press, 1941), wrote in all over 400 medical and pathological reports and other books . He received many honors and died in NYC at age 83, leaving his wife, Helen, and two sons. Betty, what about his wife?

Betty: Helen Thomas Flexner was born Aug. 14, 1871 (d. April 1956), descendant of Welsh Puritans who settled in Maryland, 1650s, and became prominent Baltimore Quakers. Her older sister, Martha Carey Thomas (1857-1935), earned a European university Ph.D. degree (Zurich, 1882), helped found Bryn Mawr College for Women (Pa., 1884), and was its dean and president (1894-1922). Their father was a Johns Hopkins University trustee. Helen Thomas also attended Bryn Mawr (1889), traveled abroad, and met Simon Flexner several times: when he did post-doctoral study under pathologist Dr. Welch at Johns Hopkins Medical School, and again when he was pathology professor, University of Pennsylvania, near Bryn Mawr. Frank?

Frank: Simon Flexner was awed by her family culture and thought she was too much above him. She, too, thinking the gulf between them unbridgeable, rejected his first proposal, then had a change of heart. Despite doubts, they were married in 1903, when he was first connected with the Rockefeller Institute, NYC. She was 32, he 40. It was a wonderful marriage of 43 years, this blending of the daughter of a famous well-to-do and well-connected Baltimore Quaker family and the fifth son of a failed immigrant German Jewish peddler. One of Simon and Helen’s two sons was a mathematician and UN official; the second, James Thomas Flexner, was a prolific author, most famous for his four-volume biography of George Washington, published in one volume for the U.S. bicentennial and successfully produced as a television miniseries. Abraham and Simon were the only Flexners who married out of their parents’ faith. Surviving Simon by 10 years, Helen basked in his many honors. Betty?

Betty: Of the other Flexner children: Jacob (1857-1934), the druggist, become a successful medical doctor. His daughter, Jennie Flexner started and headed the New York Public Library’s Readers’ Advisor’s Office. Bernard (1865-1945), a prominent lawyer, was a juvenile court reformer of note; endowed at Bryn Mawr a Mary Flexner lectureship and at Vanderbilt University an Abraham Flexner fellowship; was an ardent Zionist, never married and lived in NYC with sister Mary. Mary, already mentioned, attended Bryn Mawr supported by Abraham in whose Flexner School she later taught. Frank, any last word?

Frank: At Uplands Retirement Village, Pleasant Hill, TN, where we live, fellow residents connected with Johns Hopkins include Rev. Ed. Schnieder who studied at Hopkins; Barry Evans whose daughter worked in its fund raising program; Marge Childs who studied at the Peabody Prep, the feeder school to the Peabody Conservatory of Music, part of Johns Hopkins University since 1982.

The Parkers came to Uplands May 5, 1994, from Western Carolina University, Cullowhee, N.C., where Franklin was visiting professor (1989-94). He retired from West Virginia University, Morgantown (1968-86). The Parkers, a research and writing team for over 50 years, published among other works George Peabody, a Biography (Nashville: Vanderbilt University Press, 1971, revised 1995). They met at Berea College near Lexington, Ky., 1946, attended what is now Peabody College of Vanderbilt University, 1952-56, and have completed a long manuscript: “The Forgotten George Peabody (1795-1869), A Handbook A-Z of the Massachusetts-Born Merchant, London-Based Banker, & Philanthropist: His Life, Influence, and Related People, Places, Events, & Institutions.

URLs for 138 blogontheweb.com, comprising the complete manuscript of above George Peabody (1795-1869) A-Z, can be accessed (although not in chronological order) through these blog searchers:



24 books written and published by Franklin and Betty June Parker are listed in:

End of manuscript. Part 2 of 2 Parts: “Abraham and Simon Flexner: Medical Education Reformers,” by Franklin and Betty J. Parker, bfparker@frontiernet.net

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