Importance of Hospitals
By the mid-nineteenth century, New York City experienced rapid growth with the influx of various immigrant populations. These populations brought religious affiliations other than the Protestant faiths which comprised the dominant religious base of New York City up until that time. With massive waves of immigration in the late nineteenth century and throughout the early twentieth century, there was an influx of Jews and a significant rise in the Catholic population. As a result, there were competing charitable associations as the Protestants, Catholics, and Jews focused on their own communities. They also recognized the need to fend off discrimination. St. Vincent’s Hospital, a Catholic affiliation, was founded in 1849 and in 1855, the “Jews’ Hospital in the City of New York” opened its doors (it would be known after 1866 as Mount Sinai).  St. Luke's Hospital first began serving patients in their midtown Manhattan location in 1858 becoming one of the important hospitals established in this period of urban development.
During this time, the city was transforming into a modern industrial city with the building of roads and the development of a transit system. As part of this development, the city leased or gave away land to hospitals, schools, and museums. There was an expansion of parishes, missions, and hospitals which extended services to the sick and poor, destitute women, and orphaned children. Many of the early urban hospitals were founded as a charity for the indigent sick. This was also time of the development of the modern hospital. With advances in surgery, the introduction of antiseptic techniques, and progressive training of medical staff, hospitals expanded care to the larger community.
By the 1920s, there were developments in hospital management and administration, medical research and training, and new ideas on the relations of hospitals to the community. Willard Rappleye, Dean of the College of Physicians and Surgeons, Columbia University, from 1931 - 1958, believed hospitals should provide the highest standard of care at every level, focusing on the patient as the reason for the hospital's existence. He believed that hospitals should be a service to the community and help to educate the community on matters of health. He emphasized medical training, advances in research for the prevention and care of disease and illness, and he focused on the progressive training of hospital executives and administrators. 
Throughout the first forty years after the move to Morningside Heights, St. Luke's Hospital and Columbia University would continue to explore initiatives that expanded the reach for Columbia's medical students to obtain clinical experience and complete research work. Rappleye continued conversations between the College and St. Luke's Hospital. In his letter to Lincoln Cromwell of St. Luke's Hospital, Rappleye notes that the College was in support of a program for a plan to further the education of interns and residents in the hospitals. [Fig. 3] He expressed strong interest in working with St. Luke's and notes the importance of education and the willingness and interest of Columbia's College of Physicians and Surgeons to work with the hospital community. 
Rappleye's letter to Dr. C W. Munger, Director, St. Luke's Hospital, dated 1940, expresses some of the concerns the hospital was confronting in working with a progressive medical program. [Fig.4] Rappleye writes to Munger authorizing the use of experimental animals for medical research by students assigned to St. Luke's and working in cooperation with the medical staff of the hospital. Rappleye is responding to a request from Munger asking if this practice is legal. It is unclear if this was a problem for the hospital administration or the Episcopal Church at the time. Since the early nineteenth century, the Episcopal Church had taken a strong position against animal cruelty of any type. 
1. From Burrows, Edwin G. and Mike Wallace. Gotham: a history of New York City to 1898. New York: Oxford University Press, 1999, p. 749
2. For a full discussion of Rappleye's vision for medical education, see Atkins, Harry. Dean Willard C.Rappleye and the Evolution of American Medical Education. New York: Josiah Macy, Jr. Foundation, 1975.
3. See also the section on St. Luke's Hospital and Columbia University.
4. See full Official Statement on Animals issued by the Episcopal Church and The Humane Society. Accessed July 2015 http://www.humanesociety.org/assets/pdfs/faith/episcopal.pdf