THE DEPARTMENT OF PATHOLOGY
THE early history of the Department of Pathology reflects the economy in personnel which existed throughout the University. Pathology was included in the plan of teaching at the birth of the Medical School, but of necessity the responsibility for this function was combined with a similar relationship to one or several other branches of medicine.
For the greater part, the history of the department can be written around the men who have borne the title of Professor of Pathology. Only three of them have not been concomitantly titular heads of other departments.
On January 10, 1850, Dr. Jonathan Adams Allen (Middlebury '45, M.D. Castleton Medical College '46) became Professor of Pathology and Physiology, but dissension developed in the faculty and Allen lost the support of his colleagues, who petitioned for his dismissal. Such action was taken by the Regents, and Allen's services to the University terminated on June 30, 1854.
Samuel Denton (M.D. Castleton Medical College '25) had been present at the first meeting of the Board of Regents, June 5, 1837, and he had served on numerous committees concerned with the establishment of the University in Ann Arbor and with the development of the physical aspects of the University. He was also a member of the first Committee on Professors and Salaries. During the winter of 1849-50, the appointment of Dr. Denton to a professorship in the Medical School had been proposed, and the physicians of Jackson submitted a petition in support of this proposal. Accordingly, in 1850 Denton was appointed Professor of Physic. Shortly thereafter came the dismissal of Allen and apparently his duties, so far as they concerned pathology, were taken over by Denton. No minute to this effect appears in the Proceedings of the Regents, but it seems to have been customary during that period for the professors in the Medical School to apportion actual teaching responsibilities among themselves without too strict regard for the implications of their academic titles. That the professorship of pathology had been assigned to Denton in fact, is made certain by an item in the Proceedings of the Regents, September 11, 1860: "The President formally announced the decease of Dr. Samuel Denton, Professor of the Theory and Practice of Medicine and of Pathology." Dr. Denton had died on August 17, 1860.
On September 12, 1860, Alonzo Benjamin Palmer (M.D. College of Physicians and Surgeons [West. Dist. N. Y.] '39, A.M. hon. Nashville '55, LL.D. Michigan '81) was transferred to the chair made vacant by the death of Dr. Denton. Dr. Palmer's services to the Medical Department in other capacities had been continuous since October 1, 1854. In fact, he had been appointed Professor of Anatomy in 1852, but could not be called Page 887to duty at that time, apparently because of lack of funds. He had been Professor of Materia Medica, Therapeutics, and Diseases of Women and Children since 1854. His connection with the Department of Pathology is to be dated from September, 1860, but it seems probable that someone discovered that Denton's title in respect to pathology had never been established by the Regents, for on March 28, 1861, Palmer's title was amended to "Professor of Theory and Practice of Medicine and Pathology." For twenty-seven years, and until his death on December 23, 1887, Palmer served with marked success in this dual capacity.
No biographical sketch of Palmer is included here, for his history belongs much more to Internal Medicine than to Pathology. (See also C. L. Ford's scholarly account of his life and work.)
Some of the activities of the Department of Pathology during Palmer's time may be surmised from references in the announcements and catalogues (Calendar) of the School. Beginning with that of 1863, reference was made to pathological specimens in the Museum. In the catalogue for 1866, there was a list of recommended textbooks in pathology, which included Paget, Rokitansky, and Simon. Virchow was added to this list beginning with 1872-73. The examination of tissue materials and pathological analysis were mentioned in 1874-75, but under the newly established, short-lived unit which was designated "the Polytechnic School." The first reference to teaching microscopical pathology appeared in the catalogue for 1877-78, when, with the introduction of the three-year graded curriculum in medicine, "Pathology (including Pathological Anatomy and Pathological Histology)" was listed among the courses of the second year. In 1882-83 twenty to thirty microscopes were available for an advanced course in normal and pathological histology. This was an optional course, like that described in the catalogue of 1886-87: "A special course in the Pathological Laboratory, lasting from 12-15 weeks, is offered to all students who have become sufficiently familiar with normal histology and the use of the microscope."
Several assistants to Palmer in his dual capacity are listed in the catalogues of his period. In 1878-79, Lucian G. North ('77m) was included in the faculty with the title of Assistant to the Professor of Pathology and Practice of Medicine and Clerk of the Faculty. The following year Edward Wirt Lamoreaux ('79m) was Assistant to the Professor of Pathology; and in the catalogue of 1880-81, this position is listed as held by Patrick Eugene Nagle ('80m). In the next year, William J. Herdman ('72, '75m, LL.D. Nashville '97), was Assistant Professor of Pathological Anatomy and Demonstrator of Anatomy, with Charles F. Dight ('79m) Assistant to the Professor of Pathology. Dight continued as Assistant for the next year, but Herdman's title was changed to "Professor of Pathological and Surgical Anatomy, and Demonstrator of Anatomy." In 1883-84 there was further modification to "Professor of Practical and Pathological Anatomy, and Demonstrator of Anatomy." In that year, Osbourne F. Chadbourne (83m) became Assistant to the Professor of Pathology. Herdman and Chadbourne continued in these positions through 1886-87, when Joshua S. Blanchard ('81m) was made Assistant.
Heneage Gibbes. — In 1888, shortly after the death of Alonzo B. Palmer, who had held the joint title of Professor of Pathology and of Practice of Medicine, Heneage Gibbes (M.B. and C.M. Aberdeen '79, M.D. ibid. '81) became the first to fill an independent chair of Page 888pathology in this University. The medical faculty, in a resolution of October, 1887, had urged the establishment of such a chair and had requested that instruction in the subject "should be largely given as laboratory work." Dr. Gibbes was born in Berrow, Somerset, England. His father, a minister, was the grandson of Sir G. S. Gibbes, M.D., F.R.S., who had been physician to Queen Charlotte. It is said that the Reverend Gibbes had intended that his son should prepare for the ministry, but the boy rebelled and at fourteen sailed for the East Indies instead. A period of adventurous living followed, which furnished the material for many tales of the Opium War, of combats with pirates, of shipwreck, and of commanding his own ship at twenty-one.
He then returned home, resumed his studies under private tutors, and completed his education at the University of Aberdeen. In 1879 he became a licentiate of the Royal College of Physicians. In England and in governmental service in India, Gibbes had a varied and interesting career. He was curator of the Anatomical Museum of King's College and lecturer in physiology and normal and morbid histology in Westminister Medical School, both of London, and in 1884 he was sent to India as cholera commissioner for the British government. As a student of Klein and as a well-established histologist, it was natural that he should be chosen to accompany Klein on this mission.
When Gibbes came to Ann Arbor he brought with him very definite views as to the nature of bacteria and their significance in the production of disease. These views he did not hesitate to express forcefully even after it was evident that they were unwelcome to his colleagues and were not in harmony with current advances in the field of bacteriology. In 1888 he told the Michigan State Medical Society that phthisis and tuberculosis were distinct diseases and that the tubercle bacillus had not yet been proved to have any causal relation to either, but "would seem to be a concomitant of the process of caseation." He recognized the presence of bacteria in tissues and devised and taught methods for staining them, but he thought that such organisms were present because tissues altered by disease were suitable soil for their growth and that no specific etiological relationship existed. This was a period of rapid progress in bacteriology, and his colleagues were keenly sympathetic to the changing order. Some of them were having a very important share in the demonstration of living organisms as specific causes of disease. Thus, the gap widened, and differences in point of view became more obvious. In defense of Gibbes it should be remembered that he had written freely while yet in England. His views could have been easily ascertained and probably were already well known to some members of the faculty before he was offered a chair in this University.
The discord which characterized Gibbes's tenure and the great success which Warthin achieved when, after a short interlude, he became head of the Department of Pathology have combined to belittle the work of Heneage Gibbes. While in England he had written many papers on histology, most of which appeared in the Quarterly Journal of Microscopical Science. He had also published a textbook, Practical Histology and Pathology, which ran through several editions both there and in America. While he retained his professorship in this University, he contributed more than twenty additional articles to medical journals. Although the topics on which he wrote were widely scattered in the general field of pathology, those selected for special study were so well Page 889chosen that in regard to most of them there has been well-sustained interest even to the present time. Tuberculosis, cancer, pneumonia, the hemolymph nodes, and actinomycosis appear most frequently among the titles of his papers.
It is difficult to appraise the teaching of pathology during Gibbes's professorship. The microscope was still a comparatively new aid in uncovering the processes of disease. It has been said that there was no course in microscopical pathology worthy of the name until Dr. Warthin organized one in 1895-96. As has been stated, however, an elective course of this nature was offered before Gibbes came and was continued during the earlier years when he headed the department. Moreover, beginning with 1891-92 it became a required course for all students. It is scarcely credible that one who wrote as extensively and as accurately on many phases of histology and histopathology as did Gibbes and who had had such interesting experiences in distant lands could not have given a worth-while course. Memories of success in teaching were clouded by the controversies of the period and finally by the scientifically unsound position of the teacher. Only recently, however, one who was a student of Gibbes in Detroit, Dr. William Fowler, has written appreciatively of the teaching he received from him:
I had the fortune to take a special course in Pathology from him [Gibbes] and he was a fine teacher. Pathology was a comparatively new subject and here was a man who claimed much for it … Shortly before the death of Doctor Gibbes, I spent a very pleasant afternoon with him in his home at McAllister [McAlester], Oklahoma, and it was only then that I learned that beneath a Scottish-Cockney exterior was a charming character, subdued, cultured, sympathetic, companionable and inspiring.
(Journ. Mich. State Med. Soc., 40 : 678.)
Heneage Gibbes continued as Professor of Pathology until 1895. Shortly thereafter he removed to Detroit, where he became professor of the theory and practice of medicine and of pathology in the Michigan College of Medicine, and also city health officer. He died on July 18, 1912.
In the catalogue of 1887-88, the year in which Heneage Gibbes was chosen to fill the vacancy in the chair of pathology due to the death of Dr. Palmer, William J. Herdman was continued as Professor of Pathological and Surgical Anatomy, and Demonstrator of Anatomy; and Joshua S. Blanchard appeared as Assistant to the Professor of Pathology and the Practice of Medicine and Clinical Medicine. In the following year no assistants to Gibbes were listed. It is evident that the first Professor of Pathology to be unhampered by duties in other departments was expected to do alone everything needed in pathology. Provision for this independent professorship may have left no funds with which to pay assistants. In 1889-90, Vida A. Latham ('92d, M.D. Northwestern '95) was Assistant in Pathology, Arthur S. Rogers ('85p, '90m), in 1890-91, and Martin L. Belser ('91m), in 1891-92. Belser was Instructor in Pathology from 1892 to 1895.
Changes in methods of teaching and expansion of departmental activities are indicated by brief references in the annual catalogues. The first description of the Pathological Laboratory appeared in 1888-89. The microscopes were made by R. and J. Beck of London. The staining and detection of bacteria were included in the procedures taught. Zeigler's General Pathology and, in the following year, Gibbes's Practical Histology and Pathology were added to the list of recommended textbooks. The elementary laboratory course was required of all students in 1891-92, and autopsies were done before Page 890the senior class with selected students assisting. A graduate course in pathology, including microscopical technical methods, was described in 1892-93. In the following year two hours per week were devoted to pathological histology. The detailed program for 1894-95 assigned sixty-four hours of lectures in General Pathology to Gibbes; Gibbes and Belser together gave sixteen hours of lectures, fifty hours of laboratory work, and twenty-eight hours of microscopical demonstrations in Pathological Histology, and each student received three hours of Autopsy Demonstrations.
Aldred Scott Warthin. — With the departure of Heneage Gibbes in 1895, George Dock (M.D. Pennsylvania '84, A.M. hon. Harvard '95, Sc.D. hon. Pennsylvania '04) was placed in charge of pathology, and his title was expanded to read "Professor of Theory and Practice of Medicine and Clinical Medicine and Pathology." Dr. Dock had been at the head of the Department of the Theory and Practice of Medicine since 1891, and the addition of pathology to his responsibilities was a restoration of the arrangement which existed before Gibbes was appointed. Dock was well fitted for this assignment for he had been professor of pathology at Texas Medical College and Hospital before coming to Michigan, but he was much too busy to carry this added work alone. Fortunately, he had on his staff a young man whose personal attributes and professional training made him peculiarly fitted for transfer to pathology.
Aldred Scott Warthin (Indiana '88, Michigan '91m, Ph.D. ibid. '93, LL.D. Indiana '28) was born at Greensburg, Indiana, October 21, 1866, and died at Ann Arbor, May 23, 1931. He received a Teacher's Diploma in Music from the Cincinnati Conservatory in 1887. The subject of his doctoral thesis was "The Value of Music as a Dramatic Element." He had been assistant to Dock in 1891-92 and Demonstrator of Clinical Medicine from 1892 to 1895. He had given special attention to microscopy in medical diagnosis, and each summer found him in Europe acquiring the rapidly increasing knowledge of tissue diagnosis as it was then being developed in Germany and Austria. It was natural, therefore, for Dock to place Warthin in immediate charge of his newly acquired responsibility. Thus, in 1895 Warthin became Instructor in Pathology. Dock delivered the lectures on general pathology until 1899, when Warthin was advanced to the assistant professorship, and nominally held the professorship for four years more. In 1900 the basic laboratory course was lengthened to nine weeks, with 135 hours of work. On request of the medical faculty Warthin was, in 1903, made Professor of Pathology and Director of the Pathological Laboratory.
Warthin was extremely productive in research and was a frequent contributor to medical journals. Even a partial list of the topics on which he wrote reveals the breadth of his interests. Only the more important works can be mentioned here. While yet a demonstrator in the Department of Internal Medicine, he described the accentuation of the pulmonary second sound in pericarditis and assigned diagnostic significance to this clinical manifestation, which has since been known as "Warthin's sign." Tuberculosis of the placenta, the histology and pathology of the hemolymph nodes, the generic relationship of the leukemias, Hodgkin's disease, and lymphosarcoma, the pathology of irradiation, traumatic lipemia, the lesions produced by dichlorethylsulfide (mustard gas), and the constitutional pathology of hyperthyroidism are some of the subjects to which he made important contributions. It is for his work on the pathology of latent Page 891syphilis, however, that Warthin is best known. Interested first in the lesions of congenital syphilis, he early recognized that the histopathological manifestations of syphilis exhibit an essential unity in various organs and at various stages of the disease. In a series of some forty papers he established a new conception of the pathology of late, and of latent, syphilis, particularly in the heart, aorta, pancreas, adrenals, and testes. Making use of new techniques in staining, developed in association with Allen C. Starry, Richard E. Olsen, and Robert Farrier, he was able to support his views of this disease process by the demonstration of Treponema pallidum in lesions in which it had never before been seen.
For many years medical students used Dr. Warthin's translations and revisions of the tenth and eleventh editions of Ziegler's General Pathology as well as his own Practical Pathology and Autopsy Protocols. In the later years of his life his writings reflected to a greater extent his interest in the cultural and philosophical aspects of medicine. During this period he brought out three books: Old Age (1929), The Creed of a Biologist (1930), and The Physician of the Dance of Death (1931).
Warthin held office in many of the societies in the fields of medical biology, pathology, and internal medicine of which he was a member. He was president of the American Association of Pathologists and Bacteriologists in 1908, of the International Association of Medical Museums from 1910 to 1913, of the American Society for Experimental Pathology in 1924, of the American Association for Cancer Research and of the Association of American Physicians in 1928, and of the American Association of the History of Medicine in 1930-31.
Warthin, in collaboration with Dr. M. E. Abbott and others, edited the Bulletin of the International Association of Medical Museums (1911-31), the Annals of Clinical Medicine (1924-27), and the Annals of Internal Medicine (1927-31).
Untiring energy, broad cultural attainments, personal fastidiousness, and unswerving loyalty to his chosen interests were Warthin's prominent traits. He was a vigorous and outspoken proponent of that which he believed to be right. Thus, he made many enemies as well as many friends. Students considered him a hard taskmaster, and those who had little personal contact with him generally disliked him. To the individual student, however, he was always ready to give sympathetic encouragement, and his friendly and understanding attitude toward the individual was in sharp contrast to the pedagogical pressure which he put upon his students en masse. He was fully aware of the feeling of the average student toward him and frequently reacted with the statement that he was quite willing that the students should swear at him while here, if they would swear by him after they were out in the practice of medicine. This hope was amply realized, and many who had been outspoken in adverse criticism as students, returned to voice their appreciation and to assert that from pathology, more than from any other one department, they had gained the knowledge which enabled them to succeed in practice.
Between 1903 and 1931 all junior work in general pathology was transferred to the preclinical years, the required autopsy work was greatly increased, specialized undergraduate courses were introduced, an expanded summer program was established, and an ambitious program of research and of extramural service was carried out.
Activities in connection with world war I. — The teaching load of the Department of Pathology was practically Page 892doubled during the period of American participation in World War I. Classes were greatly increased in size, and the curriculum was compressed in order to prepare young medical men for military service as rapidly as possible. Physical changes in the department also were required, and the old arrangement of tables in the main teaching laboratory (West Medical Building, Room 104) gave way, during the year 1917-18, to a more practical, if less interesting, floor plan, which doubled the number of working places. (This seemingly minor point would scarcely deserve mention were it not for the fact that as the older alumni return, they are puzzled by the unfamiliar appearance of the room which had impressed upon many their most vivid recollections of the Medical Building.) A special course, "Pathology in Relation to Military Medicine," was offered during this period and proved both popular and useful.
The War Retrospect Section of Bulletin VII of the International Association of Medical Museums, edited by A. S. Warthin and C. V. Weller during the year 1917-18, contained twenty-four articles on the special pathology of morbid conditions of military importance. Eight of these were written by Warthin; Weller was responsible for a comprehensive survey of the "Pathology of Gassing," with a complete bibliography of the medical aspects of military gassing up to that time.
This was also a period of intense research activity. Through the kindness and skill of Dr. Moses Gomberg, of the Department of Organic Chemistry of the University, a supply of pure liquid mustard gas (dichlorethylsulfide) was made available long before this potent war gas was under factory production in this country. With this pure product, and, later, with commercial mustard gas provided by the Dow Chemical Company of Midland, Michigan, every possible phase of the pathological effects of mustard gassing was investigated. Dr. George Herrmann assisted Warthin and Weller in this work and was primarily responsible for the clinical investigation of human cases of mustard gassing which became available. The results appeared in six papers published in the Journal of Laboratory and Clinical Medicine in 1918. The first study was published independently, but shortly thereafter the Pathological Laboratory became allied, through its director, with the Medical Advisory Board of the Chemical Warfare Service and had the status of a branch laboratory. The remaining investigations were given that board, appeared in abstract in its bulletins, and were later released by the board for publication in full. To meet the demand for this material for medical officers of the Army and others, it was brought out in book form. It also was utilized in The Medical Department of the United States Army in the World War, Vol. XIV, Chap. XV. This chapter, prepared by Warthin, is entitled "Pathologic Action of Mustard Gas (Dichlorethylsulfide)."
The Aldred Scott Warthin Anniversary Volume. In recognition of his thirty-five years of teaching in the Medical School of the University, and of his international reputation in pathology, a Festschrift was planned in honor of Dr. Warthin's sixtieth birthday, October 21, 1927. This book included scientific contributions from sixty-four authors, among whom Vaughan, Dock, Novy, Huber, and Rous represented his early colleagues, while each of the thirty-five classes taught by Warthin was represented by articles written by one or more of its members. The editorial work on this volume was done by Willard J. Stone, of Pasadena, and Carl V. Weller, of Ann Arbor. Formal presentation of this volume was made December 13, 1927, in the Page 893West Amphitheater of the West Medical Building. After a short address by Dean Hugh Cabot, the presentation was made by Frederick Novy.
On June 15, 1935, the Aldred Scott Warthin Memorial Plaque, a bronze bas-relief of Warthin, was unveiled in the east lobby of the West Medical Building. This was presented to the University by those who had served under Warthin as undergraduate or graduate members of the Department of Pathology staff. Of this group, seventy-eight contributed to the fund which made this plaque possible. It was modeled by Fredrika Godwin Mallette, of Ypsilanti. At the presentation exercises Dr. Howard H. Cummings represented the department staff, Dean Albert C. Furstenberg accepted on behalf of the Medical School, and President Ruthven on behalf of the Regents of the University.
In 1935-36 the executive staff of the University Hospital directed that the space for museum purposes in the Department of Pathology of the University Hospital be designated the Aldred Scott Warthin Museum of Pathology. Through Dr. Harley A. Haynes, Director of the University Hospital, a bronze tablet, carrying this designation, was provided and installed.
Until 1899-1900, Warthin had no aid in the teaching of pathology. In that year Frederick Amos Baldwin ('98m, '02, Sc.D. '04) was appointed Assistant in Pathology. He continued at this rank until he was made Instructor in Pathology in 1903-4. This position was unfilled in the faculty list for 1904-5. Elmore Ernest Butterfield (M.D. Columbian '03) was Instructor in 1905-6; Francis Peyton Rous (Johns Hopkins '00, M.D. ibid. '05, Sc.D. hon. Michigan '38, Sc.D. hon. Cambridge '38), from 1906-8; Robert Livingston Dixon (Tri-State '96, Michigan '10m), in 1908-9 and also in 1910-11, and Plinn Frederick Morse ('07, '09m, A.M. '10), in 1909-10. For a time, members of the staff of the Department of Gynecology and Obstetrics assisted in the diagnosis and teaching of gynecologic pathology. Those assisting in this way were Ralph L. Morse, 1902-4; Samuel R. Haythorn, 1904-5; Frank Clarence Witter, 1906-8; Neal Naramore Wood, 1908-9.
Carl Vernon Weller (Albion '08, Michigan '13m, M.S. ibid. '16) joined the staff as Instructor in Pathology in 1911, was made an Assistant Professor in 1916, Associate Professor in 1921, Professor of Pathology and Assistant Director of the Pathological Laboratories in 1924.
For many years much of the routine histological work was done by student volunteers of the junior staff. The first salaried technician was Ellery Adolph Schmidt, who was appointed in 1908.
Prior to 1922, the departmental janitor assisted in the autopsy room and in the general work of the laboratory. This arrangement was heartily disapproved by the Buildings and Grounds Department, and in 1922 a laboratory attendant, known still as a "Diener," was engaged in the person of John Henry Robinson. With his abundant snow-white hair and dignified bearing, Robinson added significantly to the atmosphere of the department during his fourteen years of loyal service.
With the growth of the department, the number of research and teaching assistants, of technicians, and of clerical workers rapidly increased. To name each of them is beyond the scope of this article. Their names are in the announcements of the Medical School. Only those who served as instructors or in the professorial ranks can be mentioned specifically for the later years. This is unfortunate, for among the lower staff were many who here, or elsewhere, have attained distinction in pathology or in Page 894one of the clinical branches of medicine.
Harriet Shourds Taylor (M.D. Hering Medical College '97) joined the staff of the Department of Pathology as Research Assistant in 1918-19. She returned in 1921-22 as Assistant Professor in Dental Pathology and held the title of Assistant Professor of Pathology for three years thereafter. Walter M. Simpson (B.S. Med. '22, M.S., '24, '24m), a student teaching assistant in 1923-24, became Instructor the following year and was succeeded in 1927 by Carl Hale Fortune (Transylvania '22, Michigan '26m), who remained until 1930.
From 1922 to 1924 Ruth C. Wanstrom ('14, '18m, A.M. '24) was Research Assistant in Pathology under a special grant for the investigation of syphilis. She continued in this work during the following year, when she was advanced to Assistant Professor. In 1931 she returned to the department and in 1937 was made Associate Professor in Pathology.
John C. Bugher ('21, '29m, M.S. '32) was made Instructor in 1930 and was advanced to Assistant Professor in 1933. He resigned in 1937 to accept a position with the International Health Division of the Rockefeller Foundation, in which position he directed a research laboratory and field work for the control of yellow fever in Colombia, with headquarters in Bogota.
Carl V. Weller. — In June, 1931, Weller was made Director of the Pathological Laboratories and was placed in charge of the department. In a standardization of the titles of similar faculty positions seven years later, his title was changed to Professor of Pathology and Chairman of the Department of Pathology.
Harold Gordon (M.D. Toronto '33, M.S. Michigan '34) had been associated with the department for two years as a teaching assistant when he was appointed Instructor in 1932. He continued in this capacity for three years, when he resigned to become associate professor of pathology in the University of Louisville.
Lloyd Fullenwider Catron (B.S. Med. '29, M.D. Rush Medical College '32) was appointed Instructor in Pathology in 1935 and Assistant Professor in 1937. His service was continuous from his first appointment until his resignation in 1941 to assume directorship of the laboratories of the Akron City Hospital.
Robert J. Parsons (Syracuse '28, M.D. ibid. '32) joined the staff of the department as Instructor in 1938, and was advanced to Assistant Professor in 1941. Before coming to Michigan he had been for three years assistant in the Department of Pathology and Bacteriology at the Rockefeller Institute for Medical Research.
Junior Staff and Journal Club. — About 1896 Dr. Warthin began to select groups of eight to ten junior medical students on the basis of scholarship as members of the Junior Staff and Journal Club. This group met twice a month, usually at Warthin's home. Papers on the history of medicine and sometimes on simple research problems were presented by members of the club. Membership in the club was greatly appreciated by students, but it also entailed much hard work, for to these students was assigned the preparation of microscopic sections from the material from the clinics of the University Hospital. Eventually, the clinical material became so extensive that students no longer had time to do the work. During the accelerated activities of World War I, the junior staff had to be abandoned and was never re-established.
Physical growth. — When Heneage Gibbes came to Ann Arbor as the first Professor of Pathology (as an entirely independent chair) he was given working space in the basement of the small new Page 895Anatomical Laboratory Building. This was soon outgrown and the laboratory of pathology was established in the central part of the long, low building on the north side of the campus which was largely occupied by the Homeopathic Medical School and Hospital and which was known for years as the "old" Hospital. It was here that Warthin began his laboratory teaching of pathology. The interior of this laboratory is shown in a picture of the Pathology Staff and Journal Club of 1898-99 in the Aldred Scott Warthin Anniversary Volume (p. 116). Pathology was never taught in the original Medical Building which faced East University Avenue where the Randall Laboratory of Physics now stands.
In the new building (1903) now designated the West Medical Building, comparatively generous provision was made for pathology. The more easterly of the two amphitheaters was equipped for the performance of necropsies, and a large room in the southeast corner was arranged as the Pathology Museum. Offices, laboratories, animal rooms, and storerooms occupied the remainder of the east half of the first floor and a part of the east half of the basement.
In 1926 the completion of the East Medical Building made possible the removal of three departments from the older building and the Department of Pathology acquired the basement space and the east half of the second floor, which had been used for work in anatomy and histology. Half of the one-story addition, which had been built in the central court as an overflow anatomical laboratory during World War I, became a satisfactory animal room. This expansion relieved the crowded condition created by the necessity of adding both lectures and laboratory instruction for dental students in separate classes, and by the great increase in graduate students.
Prior to 1926, bodies upon which necropsies were to be performed were transported from the Hospital to the Medical Building on the campus. All surgical specimens, also, were carried to the Medical Building. Under this plan the essential services of the Department of Pathology to the clinical units at the Hospital were rendered with great difficulty and with many opportunities for confusion and delay. Immediate frozen section diagnoses, while the patient was under anesthesia, were almost impossible. With the completion of the Hospital in 1925, the department moved into space well arranged for its needs on the subbasement floor of the surgical wing. In spite of the "subbasement" designation, these new laboratories were above the ground level. A large museum room, staff offices, a necropsy amphitheater, and numerous laboratories for technicians were provided. Most of the corresponding area of the sub-subbasement floor was equipped for storage of prepared microscopical sections and of paraffin blocks. The first necropsy in the Hospital amphitheater was performed by Dr. Warthin on February 9, 1926. This was No. 2045, A-147-AD.
At the Hospital no provision had been made for teaching sophomore medical students, dental students, or graduate students. Accordingly, space on the old campus was retained and gradually remodeled in order to meet special needs as they arose. Technical staffs were maintained both on the campus and at the Hospital. Between them the work of the department was divided on the principle that all material originating in the Hospital (necropsies and surgical specimens) was to be examined there, while all other material (surgical specimens from the Health Service and College of Dentistry, specimens from outside hospitals and physicians, and all research material) was to be prepared and Page 896examined in the West Medical laboratory.
In 1938-39 the Neuropsychiatric Institute was constructed. To secure physical continuity with the main Hospital, it was necessary to cover the skylight which provided the only natural lighting for the necropsy amphitheater. Although retained as a lecture room, with its table left for the teaching of autopsy technique, the amphitheater could no longer be used for routine necropsies and was replaced by a more convenient room with two tables, providing more intimate instruction for smaller groups.
Consultation service in tissue diagnosis. — Physicians of Michigan, and, to a lesser extent, those of neighboring states, have looked to the Department of Pathology for diagnostic aid and for consultation service in tissue pathology. This was a natural and legitimate demand, since the services of pathologists have not been locally available. During the period in which Warthin was Director the demand for tissue diagnosis grew rapidly. From an occasional case in the early years, by 1928-29 the volume of this material had increased until it exceeded ten thousand cases per year, and more than six hundred physicians were making use of the consultation service.
In May, 1932, the Regents recognized this diagnostic service as a University function and adopted regulations for its operation. A Pathology Diagnostic Revolving Fund was established to facilitate the handling of financial matters in connection with this work. In June, 1937, the Regents authorized the transfer of the accumulated balance in the Pathology Diagnostic Revolving Fund to the Pathology Endowment Fund and provided that similar transfers could be made from time to time as circumstances might warrant. This has been done, and thus, through the use of the facilities of the laboratory for an essential public service, a permanent endowment for the department is being established.
To the nonmedical reader, the significance of this work may not immediately appear. Many of the tissues examined in the laboratory are "surgical biopsies," which have been removed by a minor procedure in order to obtain a more accurate diagnosis and thus gain information upon which further treatment may be undertaken and the ultimate prognosis gauged. Frequently, the clinical question is that of the presence or absence of cancer. For many years, it has been a departmental aim to make such tissue diagnoses available to every citizen of Michigan at a nominal cost. This has been accomplished without prejudice to private endeavor in the field of professional pathology. In fact, most of the pathologists in the state owe their positions to the fact that the Department of Pathology had taught the value of routine tissue examinations to the local physicians. Whenever a local hospital reaches a size which justifies the employment of a resident pathologist, the University assists in making the necessary arrangements and frequently sees one of its own graduate students installed. As the larger hospitals advance to this level, smaller institutions are added to the list of those which the University serves. Thus, the Department of Pathology continues to influence the practice of medicine over the state and to serve the citizens of the state.
Research activities. — As a matter of departmental policy each member of the professional staff has been expected to maintain a continuous program of research, with emphasis upon study and investigation rather than upon publication. Under this plan, and in spite of the routine service responsibilities of the department, there has been a fairly constant stream of contributions to medical periodical literature and to various Page 897handbooks. Those investigations which have been concerned with morphological pathology have very largely had origin in the routine diagnostic material, and this has been partly true of research in experimental pathology.
Grants from extramural sources have supported some of the more ambitious research programs. Among the more important grants have been those from the Pease Laboratories, Inc., for investigation of the toxicity of aluminum compounds, from the Committee on Research in Syphilis, Inc., in support of studies on the lesions of latent syphilis and on the demonstration of spirochetes in tissues, from the American Medical Association for a study of the fish tapeworm (Diphyllobothrium latum) in the Great Lakes region, and from the A. C. Barnes Company, Inc., for an investigation of argyria.
Three doctoral dissertations had been presented from the Department of Pathology by the end of June, 1940:
George R. Herrmann, "Electrocardiography and Cardiac Pathology with Especial Reference to Ventricular Preponderance," 1921-22.
Richard E. Olsen, "A Study of the Granular and Atypical Forms of Spirochaeta Pallida in Tissues," 1930-31.
Frank P. Mathews, "An Experimental Investigation of Lechuguilla (Agave lecheguilla) Poisoning," 1936-37.
Twenty-nine students had also received master's degrees in pathology from this department by 1940.
In 1902 reprints of all papers which had been published from the Department of Pathology since Warthin had joined the staff were bound as Volume I of a series entitled Contributions from the Pathological Laboratory. Subsequent volumes have appeared at irregular intervals as material has been available. Volume XIX contains the papers which were published in the period 1937 to 1940. Copies are distributed to the more important medical libraries over the world and also to other pathological institutes in exchange for their own contributions.
Institute for law-enforcement officers. — As might well be expected, those public officials who are charged with responsibility for the investigation and prosecution of criminal acts have frequently sought the aid of the staff of the Department of Pathology and have called on them to perform necropsies, to secure materials for submission to toxicologists, and to make microscopical examinations and photomicrographs of human tissue, and of objects thought to have possible evidential value. In addition, the staff has almost constantly acted in an advisory capacity, in medical matters, with the State Police and other official agencies. Thus, the staff of the Pathological Laboratories has been concerned in the investigation of many notorious homicides in this state.
As the value of scientific technology in the study of crime became more apparent to public officials, there developed a demand for instruction in this field with requests from individual judiciary and police officers reinforced by formal resolutions of various organizations. In March and April, 1934, the first Institute for Law-Enforcement Officers, organized under the auspices of the Extension Service of the University, was held in the East Amphitheater of the West Medical Building. A program of sixteen lectures and four discussion periods was provided. Professor O. W. Stephenson, of the Department of Education, and Dr. Herbert W. Emerson, of the Hygienic Laboratory, aided in the organization of this and the succeeding institutes, which were held in 1935 and 1936. Detailed programs with the personnel of the committees in charge were printed. With the development of increased Page 898facilities for instruction in East Lansing by the State Police and with the growth of the school organized by the Federal Bureau of Investigation, it was decided in 1937 to discontinue the institutes.
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Warthin, Aldred S."Medical Aspects of Gas Warfare." In: The Medical Department of the United States Army in the World War. Washington, D. C.: Govt. Print. Off., 1926. XIV: 512-661.
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