THE teaching of psychiatry in the Medical School dates from the time of William James Herdman ('72, '75m, LL.D. Nashville '97). He was born in Concord, Ohio, on September 7, 1848. In 1875 he became Demonstrator of Anatomy, a position he held for fifteen years. In 1879 he received an additional appointment as Lecturer on Pathological Anatomy, and in 1880 he became Assistant Professor of Pathological Anatomy. Two years later he was made Professor of Practical and Pathological Anatomy. His growing interest in the new field was indicated in 1888 by his change of title to Professor of Practical Anatomy and Diseases of the Nervous System, and Demonstrator of Anatomy. With the change to a four-year course in the Medical Department in 1890, Herdman was assigned to the new chair of nervous diseases and electrotherapeutics, and in 1898, he became Professor of Diseases of the Mind and Nervous System and Electrotherapeutics.
At the time that Herdman was becoming especially interested in this field, Oscar Russell Long (M.D. Detroit Homeopathic Medical College '73, M.D. hon. Michigan '98), of Ionia State Hospital (then termed the Asylum for Insane Criminals), by request, gave a course of lectures on mental diseases before the students of the Homeopathic Medical College, but without expense to the University. The course was repeated in subsequent years.
In 1892 Dr. Jeanne Cady Solis ('92m) was made Clinical Assistant to Herdman upon her graduation from the Medical Department and was offered an assistantship in the Department of Nervous Diseases and Electrotherapeutics. There was evidence of some misgiving regarding the development of the new program. One comment from a qualified observer was that the "Department of Nervous Diseases and Mental Diseases" was well received by other departments, but "with a chip on the shoulder." Nevertheless, the study of both nervous and mental diseases, as well as electrotherapeutics, was included in the departmental program, the actual instruction consisting of a one-hour lecture on Tuesday and Friday and a one-hour quiz on Wednesday, conducted by the assistant. Herdman also held a clinic, from two to five on Wednesdays, when the patients were examined and then presented to the class. The students made no examinations.
Although the course ran throughout the senior year, the lectures covered mental diseases only at the end of the year; in May, interested students were allowed to accompany Herdman and the staff to a state hospital, either Pontiac or Kalamazoo, where they were presented with an afternoon clinic by the hospital superintendent. This activity constituted all of the clinical psychiatric material presented to the class in the early days of the department.
The Regents showed their interest in Herdman's work by requesting him to appear before them in June, 1893, when he "explained the nature of his work, …" (R.P., 1891-96, p. 160). During this period, Herdman, who realized from the first the great importance of psychiatry, was active in his advocacy before the legislature of the establishment of a psychopathic hospital at the University. Largely as a result of his efforts, the University obtained, in 1901, an appropriation of $50,000 for the Page 927construction of a psychopathic hospital in Ann Arbor, to be administered in connection with the University Hospital.
In 1894 Long had been appointed Lecturer on Mental Diseases, without salary, in the Homeopathic Medical College. In the following year he refused an appointment to the professorship of therapeutics and the deanship of the Homeopathic College, but accepted a lectureship of mental and nervous diseases in that college. He held this position until 1914, except for the period 1903-8, when he was Nonresident Lecturer on Mental Diseases. Dr. Solis became Demonstrator of Nervous Diseases in 1897, a position which she held until 1907.
These developments indicate the increasing interest of the University and of the Medical Department in the scientific study of nervous and mental diseases. Dean Vaughan reported to the Regents in 1897 that the asylum boards of the state were proposing to consider the appointment of a pathologist at the University to carry on the pathological work of all the state asylums; and he asked the University on behalf of the boards to send a representative to confer with them on the feasibility of such a project. Vaughan and Regent Hermann Kiefer were appointed as representatives of the University to meet the asylum boards in conference (R.P. 1896-1901, p. 128). Consequently, Dr. Theophil Klingmann ('90p, '92m), appointed Assistant to the chair of nervous diseases in 1897, became "Assistant in Pathology for the State Asylums" in January, 1898, with permission to use the microtomes in the Pathological Laboratory when necessary for his work with the state asylums. At this time the Regents also authorized the secretary of the University to have a room in the Pathological Laboratory made ready for Klingmann's use and to supply him with whatever might be necessary to carry on his work. The position was supported financially by the asylums for the insane, and in 1898 Klingmann was given the title of special pathologist for the asylums. Three years later, he was reappointed to the University staff as Assistant in Diseases of the Mind and Nervous System, but he continued to hold his position with the asylums until 1906.
The Regents approved, in 1898, a recommendation "that the Superintendents of the Asylums of the State, Dr. William Edwards of the Michigan Asylum, Dr. Edward Christian of the Eastern Michigan Asylum, Dr. James Munson of the Northern Asylum, and Dr. Bell of the Northern Peninsula Asylum, be appointed Special Lecturers upon Mental Diseases, provided these gentlemen consent to give one or more special lectures each, the University paying their actual expenses while giving these lectures" (R.P., 1896-1901, pp. 224-25).
The efforts in the development of a program in nervous and mental diseases under Herdman's leadership through the years subsequent to 1890 resulted in a gradual extension of the time given to the subject, although the chief emphasis was on electrotherapeutics and neurological disorders. Electrotherapy as then practiced was primarily suggestive, a type of psychotherapy which could thus well be considered in the field of psychiatry as defined today, but the specific type of treatment employed during the formative years of the department has given way to other methods.
In 1900 electrotherapeutics, included as part of the regular medical curriculum, was given daily for nine weeks of the junior year. Clinical demonstrations were given four times weekly during this period. In addition, supplementary weekly clinics were offered in the senior year. Optional courses, such as one in Page 928physiological psychology given by Professor Walter B. Pillsbury, of the Department of Literature, Science, and the Arts, were also listed. As early as 1893 the seniors attended annual clinics in each of the two state hospitals, and small sections of seniors were assigned to psychiatric wards for special study of individual cases, which were presented for discussion by the class and staff. Each of these smaller sections lasted five weeks.
Agitation for a state psychopathic hospital in Ann Arbor developed rapidly, and in May, 1901, the Regents passed a resolution declaring that they were "willing to accept the administration and control of the Psychopathic Hospital provided for by a recent act of the Legislature, in case it involves no expense to the University" (R.P., 1896-1901, p. 638). A month later, Regents George Alexander Farr and Hermann Kiefer met with the medical faculty to consider the design of the building and the management of the hospital. President Angell, in his report for 1900-1901, stated: "In this ward opportunity will be furnished to our medical students to study some of the problems of alienism. This is a consideration of much importance…" The building was started in October, 1902, and in June, 1905, Regents Lawton, Carey, and Knappen "were appointed a committee to meet the Asylum Boards and devise a plan for operating and managing the Psychopathic Ward in conformity with the State law [of 1905]" (R.P., 1901-6, p. 561).
In September, 1905, the asylum trustees and the committee of the Board of Regents were empowered to employ Albert Moore Barrett (Iowa '93, M.D. ibid. '95) as "Pathologist of the State Asylums for the Insane and Associate Professor of Neural Pathology in the Psychopathic Ward upon the hospital grounds of the State University" (R.P. 1901-6, p. 606). Barrett had been physician and pathologist of the Danvers Insane Hospital in Massachusetts from 1902 to 1905, and from 1905 until he came to Michigan, in January, 1906, had been an assistant in neurological pathology in the Harvard Medical School.
The new hospital was opened on February 7, 1906 (Hosp. Rept., 1903-8, p. 61), and Barrett's first report was received six months later. In December, 1906, Dr. Herdman died in Maryland while on leave of absence from the University. In February, 1907, on recommendation of the hospital committee of the medical faculty, Barrett became "Professor of Psychiatry and Diseases of the Nervous System, and [was] charged with the immediate care of the clinic of Nervous Diseases, without salary from the University …" (R.P., 1906-10, p. 68). At the same time it was voted that a clinical professor of nervous diseases be appointed, and the following June, upon Barrett's recommendation, Carl Dudley Camp (M.D. Pennsylvania '02) was appointed to this position. Klingmann was made Demonstrator of Nervous Diseases, and Vernon Justin Willey (Michigan Agricultural College '93, A.M. Michigan '02, ibid. '09m) became Instructor in Electrotherapeutics and Director of the X-ray Laboratory. In 1908 Albert Barlow Hale ('82, M.D. Northwestern '86, M.D. Strassburg '87) was appointed Assistant in the Roentgen Laboratory. George Milton Kline ('01m, A.M. hon. '31), later commissioner of the Department of Mental Diseases in Massachusetts, and Melvin John Rowe ('03m) were appointed as assistants in psychiatry; Donald Dinnie Johnston ('08m) was made Intern in the Neurological Service of the Hospital.
In March, 1920, the Department of Diseases of the Mind and Nervous System was divided into the Department of Psychiatry and the Department of Neurology. Page 929Barrett's title was changed to Professor of Psychiatry, and Camp became Professor of Neurology (R.P., 1917-20, p. 896).
It is interesting to note that the Announcement of the Medical Department lists electrotherapeutics for a period of more than thirty years as a compulsory and time-consuming course. In the University Calendar and in the Announcement of the Medical Department it was repeatedly stated: "For the treatment of diseases of the nervous system, the hospital is furnished with apparatus for generating all kinds of electric current. Attendants especially skilled in the application of electricity and massage are put in charge of these cases."
In the years since the introduction of neurology and psychiatry into the program of the Department of Medicine and Surgery there has been a gradual increase in the amount of teaching time allotted to these subjects, an indication of the increasing importance of psychiatry in medical education. In addition to a sophomore course in psychopathology and a junior course in psychiatry, a freshman course in medical psychology was given in the period 1930-38. In 1938 this course was increased from eight to sixteen hours and became a required subject. The senior students were taught psychiatry in sections.
From 1907 to 1936 Dr. Barrett continued in charge of the department and as head of the Psychopathic Hospital. During this period many important contributions to the development of the science of psychiatry were made by him and by those associated with him (see Part II: Neuropsychiatric Institute), and many advances were made in the teaching of the subject. A laboratory of neuropathology had been in use for a number of years, and the subject was taught in the Medical Department by Barrett. Under his supervision the laboratory became an important part of the Psychopathic Hospital. According to Michigan statutes, it was designated the Central Laboratory of Neuropathology for the State Hospitals. Konstantin Scharenberg (M.D. Hamburg '22) has been in charge of the laboratory since 1930, and during this time many important publications have been issued. The state hospital groups have provided an important source of material, particularly the institutions at Caro and Lapeer, and the superintendents of the state hospitals have been very co-operative in making material available.
In 1936 Raymond Walter Waggoner ('24m, Sc.D. Pennsylvania '30) was appointed Professor of Psychiatry and chairman of the department. He assumed office on January 1, 1937, and has continued in that position. The completion of the Neuropsychiatric Institute building in 1939, situated directly at the rear of the University Hospital and connected with it by a corridor, has permitted a much greater co-ordination of psychiatric teaching than was possible when the psychiatric unit was a separate building and has enabled students to have a much closer association with the patients.
The appointment of a psychiatrist as a consultant on a par with the internist and surgeon in the office of the surgeon general in Washington was evidence of the increasing recognition of the importance of psychiatry in military medicine. This trend is borne out by the manifestation of greater interest in the subject of psychiatry by Medical School students.
As a result of the close relationship between the Neuropsychiatric Institute and the various state hospitals, a program of clinics conducted by members of the staff of the Neuropsychiatric Institute was begun in the state institutions in 1937. At these clinics patients selected by the state hospital staffs were examined Page 930and discussed by members of both the institute and hospital staffs. The neuropathologist from the institute discussed the pathology of cases, the material of which had been received from the state hospital where the clinic was being held. The practice has been described by state hospital superintendents as a valuable addition to the teaching activities of the state hospital group.
From time to time members of the state hospital staffs come to the Neuropsychiatric Institute for a period of intensive postgraduate study; an opportunity is afforded them for graduate work in neuroanatomy and neuropathology, as well as for clinical work in psychiatry and neurology. As a part of the graduate teaching program, short postgraduate courses are held to prepare applicants for their examinations for the diplomate in the American Board of Psychiatry and Neurology. Some of the courses in the Medical School are also utilized by the Graduate School of the University for students qualified to register for the courses. This applies particularly to those students who have a significant background of psychological or sociological training.
Since 1937 some reorganization of the department has taken place, and the graduate program as it applies to interns, assistant residents, residents, and instructors is the same as it is for other departments. During the training period opportunity is afforded those who are properly qualified to do extra work necessary to obtain the degree of master of science in psychiatry or in psychiatry and neurology. Thus, there has been established an excellent postgraduate training program for those who desire to specialize in this field.