In the first half of the 19th century, northwest Ohio was known as “the Black Swamp.”  Retreating glaciers had leveled the land, and the many rivers and streams combined with heavy clay soil made for a thickly wooded swamp that was difficult to traverse.  The area also earned the nickname “Graveyard of the Midwest” because these conditions brought about periodic epidemics of cholera, malaria, typhoid fever, and other deadly diseases.  Few settlers came to the region until the 1850s for these reasons.
            Cholera was especially deadly for area residents.  Epidemics in the 1850s wiped out whole towns, including Providence and Miltonville.  Toledo established its first board of health in 1849 because of the disease, and charged the city’s marshal to take whatever actions were necessary to stop cholera’s spread.  But hundreds died, and the city was without a hospital, nursing care, or an orphanage.  Nuns from the Sisters of Charity of Montreal came to the city to establish an orphanage for children left without parents because of the disease, and they also provided care to the sick.  Their efforts evolved into the city’s first hospital, St. Vincent.
            Medical education at the time was limited, and doctors were not licensed.  Most learned their skills by serving as apprentices or by attending proprietary schools.  Many physicians joined associations to provide them with support and the chance to learn from others.  At meetings of the Toledo Medical Association, founded in 1851, members discussed their most difficult cases with colleagues in order to improve their practices.
            Toledo was the home of two early medical schools.  The first, the Toledo School of Medicine (later Northwestern Ohio Medical College) operated from 1878 to 1891.  The Toledo Medical College opened in 1882.  It struggled to remain financially viable and maintain a level of acceptable education throughout its years of existence.  In 1904, faced with the possibility of closing its doors, the college merged with Toledo University.  But little improved for the college.  Increasing standards for medical education, poor facilities, and financial difficulties diminished the school’s reputation, and that of its graduates.  The death knell came in 1910, when Abraham Flexner’s national survey of medical education gave the school its lowest ranking.  Without additional resources, and with the inability to attract students because of its reputation, the Toledo Medical College was closed by Toledo University’s Board of Directors in 1918.  Toledo would not have another medical school until the 1960s.