The University of Michigan, an encyclopedic survey ... Wilfred B. Shaw, editor.

The Period Since 1927

The present Director of the Department of Internal Medicine and Director of the Thomas Henry Simpson Memorial Institute for Medical Research is Cyrus Cressey Sturgis (Washington '13, M.D. Johns Hopkins '17). Before coming to Michigan in 1927 as Professor of Medicine and Director of the Simpson Memorial Institute he was a member of the faculty of the Harvard Medical School and physician of the Peter Bent Brigham Hospital in Boston.

The last year that Dr. Bruce was Director of the Department of Internal Medicine, there were twenty-eight members of the staff — a director, two professors, three assistant professors, eight instructors, one instructor in dietetics, four research assistants, one assistant, and eight interns. During the following year, 1928-29, the medical staff was increased to three professors, four assistant professors, fifteen instructors, eight senior interns, and eight junior interns, a total of thirty-eight. All members of professorial rank of the original staff were retained, with the exception of John Barlow Youmans (Wisconsin '15, M.S. ibid. '16, M.D. Johns Hopkins '17), who resigned to accept an assistant professorship in internal medicine at Vanderbilt University.

Among the additions to the professorial staff of the department in 1928 was Charles Leonard Brown (Oklahoma '19,

M.D. ibid. '21), who had been an instructor in the Harvard Medical School. He came to the University as Assistant Professor of Medicine.

The Department of Internal Medicine had previously been divided into several services, consisting of a service in metabolism headed by Dr. Newburgh, a cardiology service under the directorship of Dr. Wilson, a private medical service which had been directed by Dr. Bruce, and a tuberculosis service under the directorship of George Alexander Sherman (McGill '19, M.D. ibid. '24). During the year 1928-29 Sturgis combined the cardiology, metabolism, and private medical services with those of general medicine. This allowed Newburgh, Wilson, and their staffs ample opportunity to continue with the excellent experimental work that they had done in the past and which they had found difficult to continue because of the heavy clinical load they were required to carry.

John Blair Barnwell (Trinity College '17, M.D. Pennsylvania '23) was brought to the department as Director of the Tuberculosis Unit in November, 1928. He had been research instructor in pediatrics at the University of Pennsylvania, and a fellow and acting first assistant of the Trudeau Foundation.

With the addition of the special branches of medicine to general medicine it became necessary to reorganize teaching on the various medical wards. In order to facilitate handling the large number of students at that time, the medical service was divided into four general medical services, a medical outpatient service, a private medical service, a tuberculosis service, and a diabetic outpatient service. The work of the students was divided equally among the four services. They devoted half of their time to the medical section on the wards, and each group alternated between two instructors. The other half of the time in the medical section was spent in the private medical service, the tuberculosis service, the diabetic outpatient service, and the medical outpatient service. The new arrangement allowed more individual attention for each student and more cases for the student to examine than had heretofore been possible. The general medical services were also reorganized so that each attending man who taught the senior students was a member of the permanent staff and of professorial rank. His assistant was a third- or fourth-year staff member of the rank of instructor who also taught the junior section in the afternoon. Each ward was under the direction of an assistant resident and an intern. Better care of ward patients was possible, and teaching for both the student groups and the younger staff men was more comprehensive and individual.

The department by 1940 had a staff of fifty-one members — three professors, six associate professors, five assistant professors, seventeen instructors, three research fellows, one instructor in dietetics, nine senior interns, and seven junior interns. The large staff made it possible to provide postgraduate instruction for the younger members. Interns were selected, who, if they were satisfactory, could be given a total of four years' training in internal medicine. Such an opportunity for postgraduate training greatly increased the number and quality of men who applied for internship in the department. In the early period of Dr. Sturgis' directorship of the department it was difficult to obtain men of the first rank for appointment to the intern staff. The situation changed greatly, until in 1937 sixty-five applications were received for seven internships; many of the applicants were in the first 10 per cent of their respective classes, and most of the best medical schools in the country were thus represented.

During the first thirteen years Dr.

Sturgis was Director a number of the younger men were appointed to professorial positions elsewhere. Dr. Wilson, Dr. Newburgh, Dr. Paul Shirmer Barker (Westminster '15, M.D. Washington University '20), Dr. Henry Field, Jr. (Syracuse University '16, M.D. Harvard '20), Dr. Herman H. Riecker (Marietta College '17, M.D. Johns Hopkins '23), and Dr. Arthur Covell Curtis ('23, '25m), all members of the earlier medical staff, were still active in the department as of 1940.

In addition to providing the routine teaching of medical subjects the department has doubled the length of the courses in clinical microscopy and physical diagnosis, and numerous elective courses are offered to students interested in the various special phases of general medicine. The Department of Internal Medicine teaches more hours a year than does any other department in the Medical School. That such teaching has not been burdensome to students can be seen in a statement in "A Criticism of the Teaching at the University of Michigan Medical School by the Class of 1935": "In general, we feel from the standpoint of teaching, that the Department of Internal Medicine is outstanding in the Medical School…"

Several services of the department benefited during the thirties, either by new accommodations, marked growth, or special grants. Two additional floors costing $250,000 were erected on top of the Hospital to serve as a new unit for the care of patients with pulmonary tuberculosis. The floors were first occupied by patients in July, 1931. Accommodations were provided for ninety-eight patients in six single-bed rooms, ten two-bed rooms, and seventy-two four-bed rooms. Ample teaching rooms and workrooms for examinations, treatments, laboratory work, and fluoroscopy are also available.

The allergy service has slowly grown from a part-time interest of one man in 1927 until it occupies three rooms on the second floor of the Hospital and has a permanent staff of three men and, in addition, one man part time.

The diabetic service has likewise slowly grown until now it has entire care of all diabetic patients assigned to the department and also supervises the care of all diabetic patients on services other than the medical service.

It was found possible in 1936 to rotate the senior instructors who were members of the medical service, in periods of a month each, through the electrocardiographic service, the allergy service, and the Simpson Memorial Institute. This allowed these men to spend all of their time for the period in pursuing the special work given in the three divisions and greatly added to the training that they received.

In 1937 one million dollars was appropriated from the Horace H. Rackham Fund, the interest on which was to be used for a period of not less than five years and not more than ten years, for the study of arthritis. This work was organized in the University Hospital under the directorship of Dr. Richard Harold Freyberg ('26, '30m).

Arthur C. Curtis