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Arch Iran Med. December 2017;20(12):760-766
History of Medicine
The Westminster Medical College and Hospital in Urmia,
Iran, 1879–1915
Ahmadreza Afshar, MD1*
1Department of Orthopedics, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
Received: October 21, 2017, Accepted: December 24, 2017, ePublished: December 30, 2017
Abstract
Background: The American Presbyterian Missionary in Iran accomplished medical activities in Urmia. Doctor Joseph Plumb
Cochran established the first modern medical college (the Westminster College) in 1879 and built a modern hospital of that time
(the Westminster Hospital). The medical college and hospital trained 34 native physicians that practiced in the northwest of Iran
and its neighboring regions. Although the main aim of American Presbyterian Missionary was theological and evangelistic, their
devoted activities improved health and welfare in the northwestern part of Iran and its neighboring countries.
Cite this article as: Afshar A. The Westminster medical college and hospital in Urmia, Iran, 1879–1915. Arch Iran Med.
2017;20(12):760–766.
*Corresponding Author: Ahmadreza Afshar, MD; Department of Orthopedics , Imam Khomeini Hospital , Urmia University of Medical Sciences, Modaress Street,
Ershad Boulevard, Urmia, P. O. Box: 57157-81351, Iran. Tel: +98-912-3131556, Fax: +98-44-33469939, Email: afshar_ah@yahoo.com.
www.aimjournal.ir
http
ARCHIVES OF
IRANIAN
MEDICINE
Introduction
The American Presbyterian Missionary to the Nestorians
in the Urmia and northwest of Iran settled in the region
in 1835.1,2 They established different cultural and medical
activities. In 1835, the first Missionary school started to
work in Urmia. In 1844, the Missionary Press started
its work in Urmia and many books, commentaries,
periodicals and pamphlets were published. Although
the main aim of American Presbyterian Missionary was
theological and evangelistic, they improved the sanitary
and health conditions in the region. This brief review
presents the most prominent medical activities of the
American Presbyterian Missionary and the endeavors of
Doctor Joseph Plumb Cochran in Urmia that influenced
the Northwest of Iran and its neighboring countries.1,2
Doctor Joseph Plumb Cochran (1855–1905)
Joseph Plumb Cochran was born in 1855 in Urmia, West
Azarbaijan, Iran (Figure 1). In 1870, the young Joseph
Plumb Cochran went to the United States to study in
the Buffalo Central High School for 4 years.1-4 In the
fall of 1874, Joseph Cochran went to Yale University. In
the second year, he took medical courses in the Buffalo
Medical College. In the last year, he went to Bellevue
Medical College in New York City. In the spring of 1877,
he received his medical degree and went back to Buffalo
to work with Dr. Miner in the hospitals. He also studied
pharmacy and dentistry to be able to help the Missionar y in
as many ways as he could. He did special works on the eye
and spent one year in the Kings County Hospital (Figure
Open
Access
Figure 1. Joseph Plumb Cochran (the right boy) at the age of 12 with
his mother, sister and brother, Urmia 1867.
2). On June 10, 1878, he was appointed as missionary to
the Nestorians in Iran by the Board of Foreign Missions
of the Presbyterian Church in the United States of
America. The aim of the missionaries’ instructions was
to reform the ancient Nestorians’ church.1
On December 2, 1879, Dr. Cochran at the age of 25 years
arrived in Urmia and started to work at once (Figure 3).
He established a small dispensary with 2 rooms and 2
beds (Figures 4 to 6). In the first 4 months of his work,
he visited 1600 patients. From the outset of his work, Dr.
Cochran tutored 2 students to assist him.1
There were no drug shops or trained druggists in that
time in Urmia; therefore, Dr. Cochran had to make
and prepare all his needed medicines himself. With the
contribution of his assistants, Dr. Cochran introduced
Arch Iran Med, Volume 20, Issue 12, December 2017 761
The Westminster Medical College and Hospital in Urmia, Iran 1879–1915
vaccination on babies for the first time in Urmia.1
On June 18, 1880, he successfully performed a below
knee amputation for a little girl whose foot was mortified
because of previous fracture. In that time, one third of
patients with amputation operations expired. There were
no trained nurses and surgical assistants. Dr. Cochran
had to induce anesthesia himself and also manage the
process with chloroform. He continuously had to drop
the knife and evaluate the patient’s vital signs. From his
arrival till the summer of 1880, he visited more than 3000
patients. Table 1 demonstrates a summary of medical
works in Urmia in the first year of Dr. Cochran’s work.1
In the spring and summer of 1892, an outbreak of
cholera approached the Northwest of Persia. Dr.
Cochran prepared a pamphlet and the Missionary Press
published it in 2 languages of Farsi and Syriac. This
work was effective in treatment, recovery of the patients
and reducing death rates. In that pamphlet, the nature
of cholera, its mode of dissemination, the means of
prevention and its treatment were described. Dr. Cochran
also prepared medicines to put in bottles with directions
printed in Farsi and Syriac. The people begun to use
boiled water and refrained to use fruits and vegetables
except from their own gardens. Although 1500 death
occurred in Urmia, due to the endeavors of Dr. Cochran
the sanitary conditions of the region improved and 95%
of the patients were treated and recovered.1
Dr. Cochran was not only a capable physician but also
an accomplished surgeon. On January 20, 1903, Dr.
Cochran wrote in his accounts that he had operations on
2 merchant brothers because of gunshot wounds. One
of them who had abdominal wound died because of the
Figure 2. Doctor Joseph P. Cochran (1855–1905). Figure 6. Dr. Cochran is stirring a cup of medicine for a patient at
her home.
Figure 3. Doctor Cochran’s Residence in Urmia Circa 1880s.
Figure 4. Work in the Dispensary Day (Indoor).
Figure 5. The Dispensary Day (Outdoor).
Table 1. Medical Works in Urmia in the First Year of Work
Attendance at the Dispensary 7727
Outside office patients 3235
Visits in the city and villages 1218
Hospital patients 574
Total 12 754
Arch Iran Med, Volume 20, Issue 12, December 2017
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Afshar
complications of perforated intestine; however, the other
with a wounded shoulder joint survived with a functional
upper limb. In another account on March 30, 1903, he
wrote that he had a successful operation on a kidney to
remove stones and much accumulated pus.1
The Westminster College (1880–1915): The First
Modern Medical College in Persia
Twenty-four native doctors were trained under
supervision of Dr. Cochran from 1879 until 1905 when
he died. Except the first course where only 2 students
were trained, six 4-year courses with 4 to 6 students were
held. Dr. Oshana Badal that became the first assistant
physician of Dr. Cochran was the first graduate of
the medical school. The Missionary provided tuition,
furnished books and furnished rooms with light and heat
for the students.1,4,5
During the first and second years, the curriculum
consisted of anatomy, physiology, materia medica,
chemistry and pharmacy. During the third and fourth
years, the curriculum consisted of basic principles of
medicine, laboratory science, diagnosis of the disease,
surgical skills, orthopedics and midwifery. Medical
diploma was awarded to the students after their success
in examinations.1,4,5
In 1901, in addition to the regular alumni meetings, Dr.
Cochran arranged a medical society among physicians.
Most of the doctors were trained by Dr. Cochran;
however, there were doctors who came from Europe and
Armenia. They met once a fortnight and the progresses
of medicine during the past years such as diphtheria
antitoxin and Roentgen Rays were discussed.1
The Westminster Hospital
The need for a hospital became apparent very soon. In
the summer of 1879, Dr. Cochran sent an appeal to the
Missionary Board for $1500–$2000 to establish a hospital
in Urmia, Persia. Mr. Samuel Clement of Buffalo devoted
$1000 to establish the hospital. The hospital was named
“The Westminster Hospital” after the church in Buffalo.
Construction of the hospital started in 1880 and finished
in the fall of 1882.1
About 1 to 2 miles outside the city of Urmia, on the
river bank of the same name, the Mission had already
bought a 15-acre of land for the missionary college and
seminary. The Missionary decided to build the hospital
building on the ground of the college. Four acres of
this land enclosed by a tall wall about 15 feet high were
divided into 4 squares (Figure 7).
In one of his reports, Dr. Cochran wrote about the
hospital, “On one of these squares the hospital is built,
on another the college, and on the remaining 2 the
residences of the superintendent of the college and of the
Figure 7. The Westminster Hospital Under Construction (1880-
1882) in the Missionary Land Outside Urmia.
Figure 8. Dr. Emma T. Miller.
physicians. The building is 75 feet by 35, faced with red
brick and 2 stories and aside from accommodations for
the patients; it has drug rooms, operating and assistants’
rooms, and storerooms. It has 2 large wards, and 6 smaller
wards. The large wards have 60 beds, the smaller from 3
to 6. The beds are of straw on high wooden bedsteads,
and are furnished with sheets and quilts made in the
native style, i.e., of wool, with a covering of bright calico.
The windows are curtained with gray calico; pictures
furnished by our friends adorn the walls, and in nearly
every window are plants. The floors are either carpeted
or of brick. The kitchen is at a short distance from the
main building, where the cooking is done in a native oven
(a large earthen jar, 3 feet wide by 6 feet deep)”.1 The
hospital staff, at its fullest, were Dr. Cochran himself,
Dr. Emma T. Miller (Figure 8) for female patients, Dr.
Wright, Dr. Homlz who was Dr. Cochran’s brother-in-
law, Dr. Van Nourdon, Dr. Oshana Badal who was the
first graduate student and the first assistant physician of
Dr. Cochran, the necessary native nurses, and also a class
of medical students. Dr. Cochran’s mother, “Madam
Cochran”, was the matron of the hospital for the last ten
years of her life until she died in 1893.1–4
In 1988, during Dr. Cochran’s visits to the United States,
Mrs. George Howard of Buffalo gifted $2000 to extend
the hospital building. The Howard Annex was built as a
special ward for female patients. The hospital became the
Arch Iran Med, Volume 20, Issue 12, December 2017 763
The Westminster Medical College and Hospital in Urmia, Iran 1879–1915
heart of the medical works and training of native doctors
(Figures 9 and 10). More than 70 different diseases were
treated in the hospital. This is the report of the first year
works of the hospital: “Typhoid fever, 4; entropium, 2;
frostbite, 2; locomotor ataxia, 1; torticollis, 1; fistulas, 2
(1 in ano, and 1 urethrorectal); otitis, 1; abscesses, 2 (1
in foot, 1 in axilla); abortion, 1 ; gonorrhoea, 5 ; atresia,
nares, 1; melancholia, 2 poisoned by arsenic, 1; contusion
of ribs, 1; enlarged prostate, 2; anal warts, 1; incontinence
of urine, 2; periostitis, 2; hemorrhoids, 9; tonsillitis, 10;
valvular lesions, 5; stone in urethra, 1; stone in bladder,
23 (18 lithotomies, perineal, 1 suprapubic, 4 lithotrities);
syphilis, 2 ; ulcers, 5 (legs, hand, cheek, and chin) ; cirrhosis
of liver, 5; cystitis, 4; sciatica, 5; trichiasis, 8; conjunctivitis,
9; keratitis, 15; cataract, 24 (operations, 23); trachoma, 1;
diphtheria, 5; tumors, 6 (lipoma 3, cystic 3); hemiplegia, 4;
nephritis, 5; sterility, 2; tetanus, 1; vomiting of pregnancy,
1; glaucoma, 1; pneumonia, 4; pleuritis, 10; chronic
bronchitis, 16; tuberculosis, 16; erysipelas, 5; malaria, 30;
mastitis, 7; adenitis, 10; orchitis, 4; neuralgia, 6; tenia, 10;
lupus, 1; acute rheumatism, 9; chronic rheumatism, 2;
dysentery, 11; indigestion,18; chronic diarrhea, 8; cancer,
5 (stomach 2, breast 2, lip 1); uterine diseases, 13 (metritis
3, prolapse 4, lac. Cervix 3, menorrhagia 1, amenorrhea
2); gunshot wounds, 3 (femur, tibia, and jaw); dislocation
of humerus, 1; fractures, 4 (fibula 1, ulna and radius 1,
comp. tibia and fibular 2); amputations, 5 (toes 1, thigh
Figure 9. Dr. Cochran Visiting the Ward in 1897.
Figure 10. Dr. Cochran Attending to his Patients Toward End of his
Life Just Before 1905.
1, leg 1, arm at shoulder, 1, breast 1); caries of bones, 48
(maxilla 3, tibia 9, frontal 1, humerus 6, ulna 1, radius
2, ribs 1, femur 6, vertebrae 10, Pott’s disease, calcis 3,
palate 1, tarsal 3, jaw 2)”.1
Two crown princes of the Qajar dynasty (1789–1925)
visited the Westminster Hospital. In the winter of 1890,
the Crown Prince Mozafar-ad-Din (1853–1907), the
successor to Naser-ad-Din Shah (1831–1896) along
with the Governor General of the province visited the
Westminster Hospital. The Crown Prince spent 2 hours
visiting the hospital. He was interested in the character
of the instructions given to the medical students in the
hospital. He visited the patients that were unable to stand
up and enquired about their problems. He examined
surgical instruments in the operating room and observed
a skeleton with curiosity. He donated 30 tomans to the
college and 10 gold pieces to the medical students and
the hospital.1
In November 1901, the Crown Prince Mohamad Ali
(1872–1925), the successor to Mozafar-e-Din Shah,
visited the Westminster Hospital. He spent a half hour
in the operating room and examined the instruments
closely. He donated fifty dollars to the college and gave 3
shawls to the doctors. The Crown Prince was also invited
to attend the College Commencement and graduation
ceremony of 4 students in 1904. The Crown Prince as
well as his chief native doctor, Loghman-ul-Mamalik
indorsed the graduated students’ diplomas.1
Table 2 demonstrates a total of medical works in Urmia
including the hospital works in 1904.
Until 1891, the hospital’s appropriation and the other
medical works was $1000 per year. In the later years, the
appropriation increased to $1500. The appropriations
were largely provided by the Missionary. The local
receipts for the medical works were negligible.1
The First Medical Diploma Granted by Westminster
Medical College Urmia, Iran, 1883
Oshana Badal (1853–1911) who was a pupil of seminary
college before he became the first medical student
of Doctor Cochran and graduated from Westminster
Medical College in 1883.5 Figure 11 demonstrates Oshana
Badal’s medical Diploma in which is written:
“To all to whom those presents may come greeting
Table 2. Medical Works in Urmia in 1904
Hospital cases 455
Dispensary cases 3251
Visits outside of hospital and dispensary 5031
Visits to the homes of sick 1131
Total seen by Dr. Cochran 9868
By native assistants, about 4000
Total 13 868
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Afshar
This certifies that S. Oshana Badal of Gulpashin
Oroomieh and a graduate of Oroomieh College has
in addition to the studies there prescribed completed a
course of 7 years study with us in the Medical Sciences
viz.- Anatomy, Physiology, Matria Medica, Theory and
Practice of Medicine, Surgery, Obstetrics and Chemistry.
In connection with his didactic studies he has had the
benefit of clinical instruction in our Hospitals and
Dispensaries during his course, as well as the entire
charge of a number of the cases which he has treated
with skill and successes.
The said S. Oshana Badal has creditably passed his final
examination in those studies this 27th day of August
1883 in the Hall of Oroomieh College before a large
audience composed of the American Missionary and of
representatives of Mussulman, Nestorian and Armenian
nationalities.
We take pleasure in recommending him for his personal
worth and exemplary Christian character and processing
the necessary qualifications for the practice of his
profession.
Preceptors: George W. Holms MD and Joseph P. Cochran
MD.”
Doctor Badal’s medical diploma was the first of its
kind in Iran. According to the medical diploma, Doctor
Oshana Badal was licensed to practice medicine.
Advised by Doctor Cochran, Doctor Oshana Badal
went to Edinburgh, Scotland to extend and complete
his knowledge of medicine.5 After returning to Urmia,
he became the chief assistant of Doctor Cochran and
continued to contribute to the education of the medical
students in Westminster Medical College and running
the Westminster Hospital. Doctor Badal assisted Doctor
Cochran in every surgery he performed. In 1890, the
Crown Prince Mozafar-ad-Din (1853 – 1907) visited the
Westminster Hospital and bestowed upon Doctor Badal
and the other physicians working in the hospital the title
Figure 11. The Medical Diploma given to Oshana Badal is signed
by Hakim Saheb (Dr. Cochran) and George W. Holms MD is written
in Farsi and English languages.
“KHAN”. In 1905, Doctor Cochran died because of
typhoid fever. In that time, the mortality rate of typhoid
fever was 18% in Persia.1 Doctor Oshana Badal continued
his works in the medical college and hospital until 1911
when he died because of typhoid fever.5
American Medical Missionary after the Death of Dr.
Cochran
Dr. Cochran died in Urmia at the age of 50, on August
18, 1905. He was buried in Assyrian Missionary Cemetery
located in the side of Seer Mountain in Urmia close to
resting place of his wife Catherin and his parents.4
After Dr. Cochran, the Westminster Hospital was named
“Cochran Memorial Hospital”. Dr. Harry P. Packard
(1874–1954) (Figure 12) took the responsibility of the
medical college and the training of the medical students
until 1915. In 1907, Mr. Samuel Clement built a New
Westminster Hospital which was the first of its kind in
Iran in the city of Urmia (Figure 13). In 1909, Dr. Emma
T. Miller left the college and Urmia. In 1910, Dr. Laura
McComb (Figure 14), in 1915 Dr. Wilder Ellis (Figure
Figure 12. Dr. Harry P. Packard (1874-1954) Examines a Patient.
Figure 13. The New Westminster Hospital inside Urmia.
Arch Iran Med, Volume 20, Issue 12, December 2017 765
The Westminster Medical College and Hospital in Urmia, Iran 1879–1915
15) and in 1916 Dr. Edward Dodd came to Urmia and
helped Dr. Packard. Between 1879 and 1915, a total of
34 native doctors graduated from the medical college.
A majority of the graduated doctors were Assyrians;
however, there were 5 Moslem doctors among them.
In 1915-1916, Cochran Memorial Hospital started to
train academic nurses; however, because of the Great
War (1914–1918) all the Missionary activities including
the hospital activities stopped and all the Missionary
members including the doctors went to Tabriz.6
Dr. Cochran’s son Joseph P. Cochran Jr. returned to Persia
in 1920 to follow in his father’s footsteps through his
service in the American Mission Hospital. His daughter,
Dorothy Cochran Romson served for a short time in
Mission Nurse in Tabriz, Persia.
In the early1930s, “Cochran Memorial Hospital” became
active in academic training of nurses (Figures 16 and
17). In 1934, the Missionary activities in Urmia stopped
and the Missionary sold all its properties to the Iranian
government (Figure 18).
In 1963, on the ground of the Missionary’s garden the
faculty of agriculture which was the first faculty of Urmia
University was established. At present, Dr. Cochran’s
residence building known as the “Wooden Building”
is located in main campus of the Urmia University
(Figure 19). In 1981, on the ground of former Medical
Figure 14. Dr. Laura McComb.
Figure 15. Dr. Wilder P. Ellis, 1916.
Figure 16. The ceremony for the graduating nurses from Cochran
Memorial Hospital. Dr. Cochran’s son Joseph P. Cochran Jr. (Black suit)
is standing on the left.
Figure 17. The first nursing class to graduate from Cochran Memorial
Hospital, below. In back row Dr. Laura Muller, Wilma Pease RN and Dr.
Joseph P. Cochran Jr. 1931..
Figure 18. Map of Urmia in 1934 demonstrates the district of the Cochran
Memorial Hospital (red zone) and American school (green zone).
Figure 19. The Wooden Building, the oldest building in Urmia University
campus.
Arch Iran Med, Volume 20, Issue 12, December 2017
766
Afshar
© 2017 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.
org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
College and Cochran Memorial Hospital, the Nursing
and Midwifery School of Urmia University of Medical
Sciences was established.
In summary, Dr. Cochran’s biography collected from
his personal correspondence with friends and relatives,
reports to the Missionary station and the accounts to
the Missionary Board has been written and published
by Speer and Shedd, demonstrates his endeavors to
improve health and welfare in the northwest of Persia
and its neighboring regions.1,2 Dr. Cochran was entitled
by the local people as the Hakim Sahib. “Hakim” means
doctor and “Sahib” stands for master or Sir in Farsi.
As a doctor, he also used his influence on the different
hostile rival parties in the political turmoil in the region.
In 1887, Naser al-Din Shah (1831–1896), the king of
Iran, bestowed upon Dr. Cochran the decoration of the
Second Class of “Grand Order of the Lion and the Sun”
of Persia because of his achievements.1
Conflict of Interest Disclosures
The author has no conflicts of interest.
Acknowledgments
I would like to express my gratitude to Seyyed Hadi Tabatabaei.
M.Sc. from Documentation Center for the History of Medicine,
Urmia University of Medical Sciences; the West Azarbaijan branch
of Iranology Foundation and Clinical Research Development Unit
of Imam Khomeini Hospital, Urmia University of Medical Sciences.
References
1. Speer RE. The Hakim Sahib, the foreign doctor; A biography
of Josef Plumb Cochran, MD., of Persia. New York: Fleming H.
Revell Company; 1911.
2. Shedd WA. The Measure of a Man: The Life of Josef Plumb
Cochran. Payam Baharestan. 2012;4(2):493-529.
3. Joseph Cochran. http://en.wikipedia.org/wiki/Joseph_Cochran.
Accessed 1 September 2017.
4. Yourdshahian E, Ghavam F, Ansari MH. Life of Dr. Josef Plumb
Cochran, founder of Iran’s first contemporary medical college.
Arch Iran Med. 2002;5(2):127-8.
5. Givargis H. History of Urmia medical college. Tehran: Tehran
University of Medical Sciences Publication; 2005.
6. Packard Aro M. Hakim Sahib, “Sir Doctor”: The Great Adventure
Story of a Missionary Surgeon and Sometimes Diplomat to
Persia, Dr. Harry P. Packard, 1874-1954. Colorado: Colorado
Springs; 2003.
