A South African Medical Student in St. Louis at the Turn of the Twentieth Century

August Schulenburg was born in 1879 at a Lutheran medical mission station in Rooijantjiesfontein, Transvaal province, part of British-ruled South Africa. The head of the mission was August’s father, a German-born homeopathic physician, Heinrich Wilhelm Schulenburg. Within one generation, the Schulenburg family came to identify themselves as “Boers,” or Afrikaners. At the same time, they maintained ties both with their old homeland in Europe and with various relatives who had emigrated to the United States and settled in Missouri and other Midwest states. [1]

Shortly before August was to graduate from secondary school in 1899, the armed rebellion known to us as the Anglo-Boer War broke out, pitting his people against the British. Although there may have been precise causes related to disputes over control of gold and diamond mines in South Africa, many Boers saw the conflict simply as a war of independence from the British. The young August shared in this view and left school to join the army – in support, the rector of the school sent him his diploma. He was trained as an infantryman and saw action in skirmishes with British forces sent to reinforce a garrison protecting the diamond mines at Kimberley.

August’s unit, led by Gen. Piet Cronjé, was victorious in a major battle at Magersfontein, south of Kimberley, in December 1899. Indeed the Boers won several engagements that month and in early 1900. But by late February 1900 the British began to overwhelm the determined rebels with superior troop levels and munitions. Cronjé’s army was defeated at Paardeberg, where the general himself was captured. August evaded capture at that time in part because he was sidelined before the engagement with typhoid fever. Sent home for recovery, he later rejoined comrades in Transvaal. They fought on for a year as a guerrilla band before surrendering in May 1901. [2]

August and his comrades were sent as prisoners of war to Cape Town, and from there across the Atlantic to internment on Bermuda. They were held for thirteen months in a highly unusual camp set up on two very small islands in the bay near Hamilton, the seat of government of the colony. The Boers were allowed amenities such as industrial training (his class made toy cannons and battle wagons), instruction in English and French, swimming and fishing on the beaches, and even use of a tennis court. But they were under armed guard all the while and Bermuda offered little chance of escape. In June 1902, word reached Bermuda that the war was over. The POWs were free to leave once each had pledged his loyalty to the British crown. Most elected to return immediately to South Africa, but August decided to take advantage of his proximity to the United States and put off his return home for an indefinite period. In July, 1902, he boarded a ship for New York. In those days, no distinctions were made for persons of European descent between temporary visitors and immigrants, providing they traveled first class. Knowing this, August paid the extra fare. [3]

August Carl Schulenburg and family members
August Carl Schulenburg with his Uncle Johann Christian Schulenburg, Aunt Louise and cousin Frieda

During captivity, August was permitted to correspond with his family in Transvaal and they had put him in touch with relatives in America, of which there were many. His father’s brother and no less than five of his mother’s siblings were situated in various communities from Wisconsin and Minnesota south to central Missouri. Several of the adults in this extended family were, like August’s parents, landed Lutheran missionaries. August traveled first to Wisconsin, near Milwaukee, staying a month. Then it was on to Dubuque, followed by the hospitality of cousins in the rural counties straddling the Iowa-Minnesota border. He visited the Minnesota home of the paternal uncle, Johann Schulenburg, his aunt, Louise, and cousin, Frieda. Frieda is an essential link to the information for this story. In the course of his four-and-a-half year American sojourn, August wrote her many letters that she – or someone – sent them back to him when he ultimately returned to South Africa. [4]

It was evidently a pleasure being the guest of his American relatives, and August confessed that he felt completely at home. There were many family parties and picnics. August participated in his first baseball games. On Sundays the families of course attended church services and August recorded his impressions of the sermons and the organ music. He helped with the Minnesota harvest and, when autumn suddenly turned to winter, he saw snow fall for the first time. Over the weeks he pondered career plans. Life on the farms could be prosperous, but it was not the path that he had envisioned for himself. Two of his uncles suggested instead that he study medicine. As one of them put it, “You are here, on the spot, and there are many universities where you could study.” August agreed and wrote to secure his father’s permission. [5]

The final leg of his American family tour brought August to a farm in Missouri at Billingsville, in the central part of the state and near Boonville, home of Dietrich Behrens, his mother’s brother. He was his uncle’s guest at Christmas, 1902. While there he secured his father’s authorization to study medicine and a promise of financial support. New acquaintances in the Boonville area provided August with American connections who would help in achieving this goal. Among the physicians of the mid-Missouri town were Cornelius van Ravenswaay, a Dutch-born surgeon and graduate of the University of Utrecht and his associate, Arthur J. Smith, a 1901 graduate of Washington University. Van Ravenswaay permitted August to observe surgical operations in the local hospital. “[Smith] advised me strongly to go to [his alma mater],” August later recalled: “he was [even] prepared to contact the registrar and also give me a letter of introduction should I decide to go there.” [6]

Acceptance for study and matriculation at the Washington University Medical Department (the official name of the School of Medicine back then) followed in rapid order. By later January 1903, August was in St. Louis, joining a first-year class that that had begun the previous September. He recalled it this way:

As I arrived in St. Louis as an unknown, I spent the first night in a hotel, and the next morning went to the medical school to interview the registrar and head of the school. I had the letter from Dr. Smith and also the certificate of discharge from the POW camp on Bermuda, both evidence that I was a Transvaaler from South Africa. I had, however, no evidence of previous schooling experience, and that was a problem. . . . Fortunately, the registrar, who had consulted with the authorities, informed me in the afternoon that they would accept me provisionally as a student. The proviso was that I should produce the final diploma of my high school within three months. [7]

Washington University Medical Department demonstration, ca. 1904
Washington University Medical Department demonstration, ca. 1904

August joined sixty-five other men in his freshman class. Of that number, thirty-five were from Missouri, eighteen from Illinois, and most of the remainder from other states contiguous to Missouri. There were none from the eastern seaboard states or from the far west of the United States. There were no women. August was the only foreign student admitted in 1902. [8]

The anatomy course was taught by Robert J. Terry, a nationally recognized expert on the human skeleton. Terry’s course must have been rigorous. August had a particularly difficult time, particularly having missed the whole first semester. He received a low, but passing, grade.[9] He also studied physiology under Sidney Paine Budgett. Budgett was the author of a well-known laboratory manual and used relatively advanced equipment designed by Harvard professor William Townsend Porter, who had formerly taught at Washington University. Research in fields outside of clinical practice was relatively rare in any medical school of the time. August recorded that Budgett asked him to assist him in experiments investigating “respiration of animals” after the term concluded in summer 1903. [10]

The second year included a demanding and varied course load: Organic chemistry, physiology, pathology, materia medica, therapeutics, and microscopic anatomy and histology. Terry appointed August one of his student laboratory instructors, an honor which brought with it a tuition scholarship for the entire year, but also additional pressure to achieve high marks. In early November 1903 August wrote to Frieda: “I work from 9 till 6 p.m. at the college every day to get through with my extra work. In the evening I generally study till 12.” In his next communication, he wrote: “We had two exams this week and pretty hard ones. I hope I made a pass. We had one about two weeks ago in materia medica and I made 97%. I felt kind of big as you can imagine. Next Monday we have another one in therapeutics . . . ” [11]

Business card for German pastor Richard Kretzschmar
Business card for German pastor Richard Kretzschmar

In his diaries and memoirs August recorded a varied and interesting extra-curricular life. He joined a fraternity, Phi Beta Pi. He attended football games and dances. He joined a church, the Emmaus Kirche of Pastor Richard Kretzschmar, on Jefferson Avenue, one of the many German-speaking congregations in St. Louis. He also explored various other parts of St. Louis when time permitted: His memoirs include observations such as: “The traffic on the Mississippi was huge; the street on the river front along the docks was 21 miles long . . . [I also] took frequent long walks in the beautiful flower and tree-rich parks in the city.” [12]

If at this mid-point of his medical studies August was considering becoming one of the hundreds of thousands of German-Americans of the Midwest, he might well have been deterred by a spectacular event in St. Louis, which delivered an unusual reminder of his homeland. It was part of the preparations for the Louisiana Purchase Exposition, or St. Louis World’s Fair, in 1904. August learned that one of the foreign attractions would be a Boer commando unit sent to re-enact battles of the recent war. It was headed by none other than his old commander, Gen. Cronjé, and included several of his old comrades. [13]

An advance party of the Boer Commando, led by Gen. Ben Viljoens, arrived in mid-January and August was invited to join the reception. In addition to seeing his old friends he was able to read newspapers and books from South Africa they had brought along with them. In his diary he juggled past and his present:

January 23.  Dissected all morning. . . .Read Reminiscences of the Boer War by B. J. Viljoens.

January 24.  Sunday, at Rev. Kretzschmar’s; Pleasant evening with Miss [illegible].

The excitement of these days seems not to have affected his studies aversely. To Frieda he wrote:

We had exams all last week, and started in the new, or fourth semester. Of course, we haven’t got the results of all the examinations, though I have reasons to suspect that I won’t flunk. In pathology, one of the hardest studies we have, I was awful lucky in getting the highest grade in the class – 91%. I tell you, I felt good when I heard that. Whether I deserved it is of course another question and not for me to answer.

Souvenir postcard of the St. Louis World’s Fair, 1904
St. Louis World’s Fair, souvenir postcard, 1904

The medical school year concluded a little more than a month after the official opening of the Fair: August could devote full attention to the performances of his former comrades and to all the exhibits. He was invited to stay in the quarters provided the group and he enjoyed a front-row seat for the mock battles, which were staged in an arena located in a section of the fairgrounds near the present Skinker Boulevard and the city limits of St. Louis. He jotted in his diary:

July 13.  Awoke in Boer camp. [Smelled] fish (?) . . . Japanese village, Japanese women! In the afternoon, a cup of coffee with Mrs. Cronjé.

July 14.  World’s Fair. U.S. Government Building, mines and metallurgy, liberal arts, manufactures, transportation. Stephenson’s first [steam] engine, etc. Boer War!

The Fair and the reunion with the Boer Commando concluded in November 1904. By then, August was beginning his third year of medical school when he and his classmates concentrated on clinical specialties. During that term, lectures covered internal medicine, surgery, obstetrics, pediatrics, and dermatology. The spring term featured diseases of the nervous system, hygiene, orthopedic surgery, ophthalmology, and otology. August wrote, “The courses became more and more interesting, and as the professors were well-disposed to me, especially when the clinical work started, I learned a lot and picked up plenty of experience in the various subjects.” [14]

Gustav Baumgarten, ca. 1900
Gustav Baumgarten, ca. 1900

Third year clinical instruction was concentrated at the Washington University Hospital (the former Missouri Medical College building). The class studied under Gustav Baumgarten, a practicing physician since 1856 and a Civil War veteran. A younger faculty colleague, Washington Fischel, noted that Baumgarten was “always pertinent and illuminating.” [15] In surgery, they were taught by Elisha Hall Gregory, chief of surgery at St. Louis Mullanphy Hospital and a professor since 1851. Vilray P. Blair, later a renowned plastic surgeon, would remember Gregory as “the greatest medical lecturer we . . . had.” [16]

In their fourth and final year the class also trained at St. Louis City Hospital. August recorded observing a variety of operations in this facility. In pediatrics, August worked closely with Professor John Zahorsky, chief of the new children’s clinic of the University Hospital and director of the St. Louis Pure Milk Commission. Photographs that August sent home underscore his interest in young patients. As graduation approached, August was notified that he had won the “Gill Prize,” awarded annually to the student most skilled in “diseases of children.” [17] He was studying hard for the final examinations, later recalling “these consisted of written papers, oral session and clinical tests with internal and external examiners from other universities. I passed the final examinations well, together with most of my classmates.” In point of fact, he achieved the best grade-point average in his class. [18] Schulenburg graduated with honors, receiving his MD with his class in ceremonies on May 24, 1906.

Hospital internship and residency, the next step in August’s career path, were then still in the beginning stages of evolution toward becoming a standardized and regulated part of medical training. All that Missouri law at the time required of new medical school graduates was to pass a state proficiency examination. August recorded that he “completed this examination . . . without any trouble.” Of the Medical Department graduates in his class who became interns – and fewer than half did – all took positions at hospitals in St. Louis, rather than move to institutions in other cities. [19]

St. Louis Mullanphy Hospital, 1907
St. Louis Mullanphy Hospital, 1907

Instead of becoming an intern at City Hospital as he had earlier hoped, August accepted a position at St. Louis Mullanphy Hospital. Mullanphy was located in north St. Louis and operated by the Daughters of Charity of St. Vincent de Paul. August explained in his “Reminiscences:”

I had obtained an appointment in one of the state hospitals, but before I could accept this post, I was approached by our professor of surgery [Gregory’s successor], Norman Carson, who offered me the post of house-surgeon in a private hospital, the St. Louis Mullanphy, where he was chief surgeon. As a student he had taken me often to assist him at operations at that institution. Dr. [Frank] Glasgow, our professor in obstetrics and gynecology, was also attached to that hospital and was well-disposed towards me. On the recommendation of these two gentlemen, I was duly appointed as resident. . . . It was a fine, large hospital under the control of the Catholic Church and sisters. The nurses, however, were not nuns, but lay sisters in ordinary uniforms. There was no salary attached to my post, only free board, meals, and laundry. A personal private lounge and bedroom were just ideal. [20]

August began his internship on the first of July, 1906. A letter to Frieda offers a slightly different view of the appointment:

This hospital is one of the largest in the city and, being the only house physician, I get more than my share to do. The work of course is very interesting, instructive, and seems to agree with me, since I’ve gained several pounds . . . I live very well and have all I need in every respect. The sisters and nurses are good and nice people to be with. Of course, it is a Catholic institution; probably you won’t like that, but this to me . . . makes no difference. I have very weak inclinations to bother about that. A man is a man to me, whether he be a Catholic or a non-Catholic – so don’t worry that they will convert me here. They have a very pretty chapel in the building, and have services several times a day. Meanwhile I have my services in the laboratory or in the operating rooms in doing what my hands find to do. There is room for 250-300 patients in the hospital. We have operations each day – from one to five as a rule – this will give you an idea of what I can see while here. I don’t think I’ll ever regret that I accepted the position here.

August Carl Schulenburg at work, St. Louis Mullanphy Hospital, ca. 1906
August Carl Schulenburg at work, St. Louis Mullanphy Hospital, ca. 1906

His memoirs comment further about the work of an intern:

My duties were various: anesthetics administration, assistance at operations, the performance of smaller operations, twice-daily visits to the free patients, and visits to private patients if so requested by the visiting staff. I also had to do chemical and microscopic analyses in the well-equipped laboratory . . . During the entire twelve months I never took a vacation.

During his year as an intern August was still evidently torn between his sense of duty to parents and homeland on one hand and, on the other hand, a promising future in the St. Louis region. In November 1906 he wrote to Frieda:

I’ll sail for home next summer, but will probably return again in about 6 months. Otherwise I’ll accept a position offered me for a year that will pay $100 a month and everything free; it seems possible that I’ll accept that for a short time, but can’t tell . . .; I might get a better offer yet.

Three months later, he wrote to his cousin again, expressing somewhat different intentions:

I have decided to return home this summer and will probably sail sometime in June or July. I finish my term here on the 10th of June . . . I have a very flattering offer to go into partnership with a very good doctor in Illinois, but since I don’t wish to remain in the country for the present, I must decline the offer. I am confident that I could do very well if I remained in this country, but for the present I must go back to see my parents before it is too late. It is my duty and I have a very good field to work over there.

So in the end, a sense of duty to family and homeland prevailed. August left St. Louis at the end of June 1907. He paid farewell visits to his relatives in Iowa and Wisconsin, then traveled on via Chicago, Detroit, Toronto, and Quebec City, where he boarded a ship bound for England. From there another vessel transported him south to South Africa. [21]

The story has a significant epilog. A short time after arriving home in South Africa, August visited Pretoria to apply for a license. To his surprise and dismay, he was turned down. No less than the former Boer commanding general Jan Smuts, whom the British had named colonial secretary, informed him that to practice medicine in the British Empire he had to return to England for the proper certification. “Old son,” said Smuts, “I see no other solution.” August’s parents added another hurdle: they demanded that their son remain home for nearly a year to work with them at the mission. In 1908, August was released to enroll at the Guy’s Hospital Medical College in London. A grueling and lonely twelve months of study ensued. “Of the ten million inhabitants [in the British capital],” August wrote, “I got to know no one.” Fondly looking back at his experiences in St. Louis, he added, “I would have rather returned to America, where I could have immediately begun medical practice.” [22]


Note concerning sources:

I have drawn information for this portrait mainly from documents in the August Carl Schulenburg papers in the Archives and Rare Book Section of the Becker Medical Library of Washington University in St. Louis. These materials include a typescript of “Reminiscences of August Carl Schulenburg” (an excerpt of his memoirs translated into English by his son, C. A. R. Schulenburg), his original manuscript diary and letters, and the published version of the collected memoirs in Afrikaans, Krygsgevangene, medikus, boer, edited by C.A.R. Schulenburg (Pretoria : J.L. van Schaik, 1985). Information from these and other sources are as cited below.

1. Krygsgevangene, 1-17. [Back]

2. Krygsgevangene, 18-43. [Back]

3. Krygsgevangene, 44-89, “Reminiscences.” [Back]

4. Krygsgevangene, 90-94, “Reminiscences”, diary, letters to Frieda Schulenburg. [Back]

5. Krygsgevangene, 94- 98, Reminiscences”, diary. [Back]

6. Krygsgevangene, 98-100, “Reminiscences.” [Back]

7. “Reminiscences.” [Back]

8. Medical Bulletin of Washington University, 1903-04, 69-71; April 1904, 86-88. [Back]

9. Robert J. Terry, “Class-Work in Practical Anatomy,” Medical Bulletin 3 (1904): 43-60; diary. [Back]

10. Diary; “Reminiscences”; Sidney Paine Budgett, Essentials of Physiology (Philadelphia, 1901-1916). [Back]

11. “Reminiscences”; diary; letters to Frieda. [Back]

12. Krygsgevangene, 102; “Reminiscences.” [Back]

13. Krygsgevangene, 103; “Reminiscences.” [Back]

14. Krygsgevangene, 104; “Reminiscences.” [Back]

15. Washington E. Fischel, “In Memoriam, Dr. Gustav Baumgarten,” Weekly Bulletin of the St. Louis Medical Society, 5, 25, June 22, 1911, 286-87. [Back]

16. Vilray P. Blair, “Elisha H. Gregory,” Surgery, Gynecology, and Obstetrics, 14 (1929): 714-16. [Back]

17. “Reminiscences”; Diary, Medical Bulletin, July 1906, 261. [Back]

18. Washington University Medical Department, grade ledger, 1906. The department did not officially recognize a class valedictorian, but published the names of students receiving “honorable mention for general excellence,” where August’s name heads the list: Quarterly Bulletin of the Medical Department, July, 1906, 261. [Back]

19. Ibid., 260. [Back]

20. Krygsgevangene, 105-07; “Reminiscences.” [Back]

21. Krygsgevangene, 107-111; diary. [Back]

22. Krygsgevangene, 111-14; “Reminiscences.;” diary. [Back]

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