THE MEDICAL SCHOOL
The Medical School operates as a closely related group of what might be called "sovereign" departments, 7 of which are concerned with preclinical teaching and research, 13 with teaching, research, and, in addition, the care of Page 191patients. While there are indications that from many points of view organization according to programs and project groups, rather than the 20 traditional departments, may be a more desirable arrangement on many counts, the solidity of the departmental structure has thus far resisted change.
Department of Anatomy. — Since 1940 there have been three chairmen — Dr. Bradley Patten, Dr. Russell Woodburne, and Dr. J.A. Rhodin.
To meet the needs of the rapid expansion of the entire Medical School, the departmental faculty grew from 10 to 20 members under Dr. Patten and has increased further to a present total of 31. In addition to coverage of the conventional fields of developmental, microscopical, neural, and gross anatomy, it has been necessary to provide faculty coverage for newly emerging specialized fields. These include organ culture, histochemistry, electron miscroscopy, endocrinology, radioautography, immunochemistry, electromyography, tissue regeneration, reproductive biology, and teratology.
The most outstanding research contribution of the department during the past thirty years has been the investigation of human and comparative neuroanatomy by Dr. Crosby and her many students and associates. Her laboratory of comparative neurology has been recognized as one of the world's leading centers for neuroanatomical research. Since retirement in 1959, Dr. Crosby continues to be active in research as consultant in neurosurgery at Michigan and consultant in anatomy at the University of Alabama. The department houses Dr. Crosby's collection of comparative anatomical preparations — one of the world's largest.
The research of Dr. Patten in the field of embryology has led to the accumulation of an extensive collection of over 1,000 human fetuses demonstrating congenital defects, particularly those of the heart and the nervous system.
In 1948 Dr. Wayne Whittaker and Dr. Burton Baker first demonstrated that adrenal cortical steroids can effect tissue structures by direct action on local areas of the body. The direct application of cortical steroids is now commonly used for the control of inflammation in dermatology, ophthalmology, and otology.
In 1957 Dr. Robert Hunter, collaborating with Dr. Clement Marquart of the Department of Zoology, developed Page 192a method for identifying enzymes, which is now widely used in general biological research, particularly in the matter of genetic control of enzyme synthesis.
In 1962 Dr. Maynard Dewey and Dr. Lloyd Barr of physiology, demonstrated by electronmycroscopy, the "nexus," a connection between smooth and cardiac muscle cells which provides for electrical cell-to-cell communication. Since 1962 Dr. Donald Huelke of Anatomy and Dr. Paul Gikas of Pathology have made an intensive study of fatal automobile accidents, which has led to many improvements in car design and modifications of highway construction.
The department has continued to maintain its position of leadership in American anatomy. Sixty-three graduate students have been awarded Ph.D. degrees since 1940, and many others have earned doctoral degrees in medicine and dentistry.
Department of Anesthesiology. — One of three Medical School departments to be established in the past thirty years, Anesthesiology in 1949 replaced a rather loosely organized section of anesthesia within the Department of Surgery. For two years, 1949-52, Warren Wilmer, Jr., served as the Acting Chairman followed by Dr. Robert Sweet, who was made Chairman in 1952. The professional staff consists of 14 members who conduct and supervise all anesthetic procedures within the Medical Center, engage in research in the field, and are extensively involved in teaching both medical students and students in nursing. In addition, the staff is active in the instruction of technical workers and in the programs presented by the Department of Postgraduate Medicine. The department operates the Medical Center's inhalation therapy unit, a rapidly growing feature of patient care.
The Department of Biological Chemistry. — Howard Lewis came to the University of Michigan as Chairman of the Department of Biological Chemistry in 1922. His tenure ended abruptly when he suffered a profoundly crippling stroke from which he never recovered. In 1956 Dr. Halvor Christensen of Tufts University was appointed as the new chairman of Biological Chemistry. At the same time the department, located for years in the West Medical Building on campus, was moved to spacious new quarters in Medical Science I, with space and facilities adequate for the teaching of medical students, graduate students in biological chemistry, and the many students receiving partial education in the Medical School, who belong to other schools and colleges of the University. The size of Page 193the departmental faculty was materially increased and there began a period of intense biochemical research.
Dr. Christensen resigned as chairman of the department as of June 30, 1970, in order to devote his full efforts to teaching and research activities. He was succeeded by a member of his own staff, Dr. Minor Coon.
Department of Dermatology. — The field of dermatology was accorded departmental status in 1912 under Dr. Udo Wile, long recognized as a leader of American dermatologists. Dr. Wile retired in 1946 and was succeeded by Dr. Arthur Curtis, formerly a Professor of Internal Medicine at Michigan. When Dr. Curtis retired in 1967 he was followed by the present Chairman, Dr. E. R. Harrell, Jr.
The department has extensive facilities available for its research activities which are centered in the fields of mycology, microbiology, immunology, serology, biochemistry, and radioisotopic medicine. These are located in the Kresge Research Buildings as well as in the School of Public Health.
Department of Human Genetics. — The Department of Human Genetics had its origin in 1941, when a Heredity Clinic was established under the aegis of the Laboratory of Vertebrate Biology and the University Hospital. The clinic owed its inception to the interest of Professor Lee Dice, Director of the Laboratory, in the field of human genetics, and his conviction that the time was right to initiate a clinic which could serve both to counsel persons with inherited disorders and as a basis for research into this subject. In 1950, the Laboratory of Vertebrate Biology was reorganized as an Institute of Human Biology, and in 1956, with Dr. Dice's retirement, those parts of Institute activity concerned with human genetics became the nucleus for the present Department of Human Genetics. Originally the department was housed in some of the older hospital buildings, but in 1961, in consequence of a gift from the Buhl Foundation of Detroit, matched in magnitude by the Department of Health, Education, and Welfare, the means were at hand for the construction of a building designed specifically for the needs of modern human genetics. This building, the Lawrence D. Buhl Research Center for Human Genetics, was completed in 1964. When Medical Science II was built, the Department of Human Genetics was allocated additional space immediately adjacent to the Buhl Building. The departmental facilities are among the most extensive in Page 194the United States today. Because of this early start in the field, the University has played a very significant role in the explosive development of the field of human genetics in recent years.
Department of Internal Medicine. — The Department of Internal Medicine, first officially so-called in 1908, was preceded in the history of the Medical School by professorship appointments variously designated as "The Theory and Practice of Medicine," sometimes including pediatrics, pathology, and other disciplines. Dr. Cyrus Sturgis served brilliantly and effectively as chairman for thirty-two years until his retirement in 1959. His last years were marked by failing health, necessitating the designation of one of his outstanding professorial colleagues, Dr. Paul Barker, as Acting Chairman until the chairmanship was filled by the appointment of Dr. William Robinson in 1958.
The Sturgis era in Internal Medicine was marked by splendid patient care, brilliant teaching at all levels, and research performance of high quality. The Simpson Memorial Institute for hematologic research, of which Dr. Sturgis was director, was well recognized nationally for its research in blood diseases, particularly pernicious anemia. Established individually in suitably equipped quarters Drs. Harry Newburgh and Frank Wilson endowed the Department of Internal Medicine with a research output unmatched by any other clinical department of the Medical School. Dr. Newburgh's field was nutrition, Dr. Wilson's was electrocardiography. Dr. Wilson's introduction of chest leads which made possible the discovery and localization of myocardial infarcts is in standard widespread use throughout the world today. His intensive mathematical study of the electrocardiogram led to complete reversal of the earlier-held understanding of the dextrogram and the levogram in man. Newburgh found experimental proof for nutritional concepts by placing hired volunteer human subjects within fully controlled environmental rooms for weeks at a time.
In the latter part of this thirty-year period the staff in Internal Medicine has been very materially increased in numbers, and the number and variety of research activities has undergone corresponding increase. Through representation on the Executive Committee, Internal Medicine has exerted strong influence in the development of Medical School policy and practice.
Page 195Department of Microbiology. — The three decades from 1940 to 1970 witnessed dramatic changes in the unit responsible for microbiological research and instruction. The number of faculty members increased from six full-time and one part-time in 1940 to 13 full-time, 7 part-time, and 6 postdoctoral fellows in 1970. This increase was brought about by (a) general post-World War II expansion; (b) the central role of microbial systems during this time in the great conceptual advances in cell biology, including biochemistry, genetics, and molecular biology; and (c) the continuing importance of microbiology in the professional preparation of allied health personnel.
The unit, which had been called the Department of Bacteriology since 1902 and had been until 1951 associated with the Hygienic Laboratory and until 1959 with the Pasteur Institute, was changed to the Department of Microbiology in 1963. Dr. Malcolm Soule replaced the first chairman of the Department (Dr. Frederick Novy) and served as a chairman from 1935 until his death in 1951. Dr. Walter Nungester was acting chairman from 1951-52 and chairman from 1952 until his retirement in 1970. Dr. Frederick Neidhardt was named chairman in 1970.
The department was moved from East Medical Building to Medical Science Building II in 1970. Approximately 38,000 square feet of space on the second, fifth, and sixth floors of this building house the department's offices, research laboratories, teaching laboratories, animal quarters, media room, computer terminal, general equipment rooms, graduate student room, and the F. G. Novy Library.
All full-time and most part-time faculty members have had active research programs during the past three decades. The four main areas of research are (1) the nature of the microbial cell, including biochemistry, genetics, regulation, systems analysis, and virus-cell interactions; (2) immunology, including the nature of the immune response, its regulation, suppression, and enhancement, and tumor immunology; (3) microbial ecology, particularly the microbial flora of the mouth and the intestinal tract, and the pathogenesis of selected infectious diseases; and (4) virology, particularly tumor viruses and basic aspects on the interactions of mammalian cells and viruses. Support for this research comes from various sources within the University, plus external funds from the National Science Foundation, various sections of the National Institutes of Health, the National Cancer Society, and several private individual companies and foundations. The Page 196F. G. Novy Fund continues to supply greatly appreciated help for research through student fellowships.
Department of Neurology. — The history of the Department of Neurology dates from the year 1888 when Dr. William James Herdman, at that time professor of practical and pathological anatomy and demonstrator in anatomy, was appointed professor of practical anatomy and diseases of the nervous system. In that year, also, Dr. Herdman taught the first course on "Disorders of the Nervous System" at Michigan. In 1906, Dr. Albert Barrett was named associate professor of neural pathology and in 1907, after Dr. Herdman's death, was made professor of psychiatry and nervous diseases. In that year, Dr. Carl Dudley Camp, was appointed clinical professor of diseases of the nervous system. At that time the department's functions in neurology and psychiatry were separated, but it continued to be called the department of diseases of the mind and nervous system and remained an administrative unit until 1920 when the Board of Regents divided it into two departments and Dr. Camp was named chairman of the Department of Diseases of the Nervous System. The next year the department's name was changed to that of neurology and Dr. Camp's title was changed to that of Professor of Neurology.
Dr. Camp continued to be in charge of the department until his retirement in 1950, when he was succeeded by Dr. Russell DeJong as chairman.
Interns were appointed in the department of diseases of the mind and nervous system as early as 1912, and there has been an organized residency training program in neurology since 1920. Since 1950 the department has grown from one of two or three faculty members and three individuals in training to one of 10 to 12 full-time faculty members and 12 to 14 residents in training. The department has awarded the degree Master of Science in Neurology since 1936, and organized postgraduate courses in neurology have been held periodically since 1950.
Department of Obstetrics and Gynecology. — Dr. Norman Miller followed Dr. Reuben Peterson as chairman of the department from 1931 to 1964 and the department grew steadily in size, multiplicity of activities, and the quality and volume of its investigative activities. In 1950 the department and its clinical facilities in "Old Mat," which had been built in 1910 as the eye and ear ward, moved into the long awaited, newly constructed "Women's Hospital." At the outset this building provided Page 197all available facilities for obstetrics as well as gynecology. In recent years the gynecologic segment of the clinical activities has been moved into the Main Hospital where it had previously been accommodated. On the retirement of Dr. Miller, Dr. Robert Willson was appointed as his successor. The affiliation in obstetrics and gynecology of University Hospital and Wayne County General Hospital has expanded yearly. It is now an essential part of the department providing an experience for residents and students which is impossible in Ann Arbor. The directors of this affiliation have been Drs. John Gosling, David Anderson, Charles Bollinger, and Crosby Eaton. The Affiliated Hospital Program has been expanded. Since 1965 representatives of the departments of Obstetrics and Gynecology of our group of affiliated hospitals have met each month as a study and planning group designed to improve better communication between the University and the community hospitals.
The department has had a strong division of endocrinology, starting with James Bradbury and Gardner Riley. The Endocrine Laboratory has been expanded and new assay methods have been introduced. The facilities of the laboratory have been made more available to physicians throughout the state.
A Steroid Research Unit was established in 1964 and has expanded progressively since. This program now includes increasing use of radioimmunoassay methods.
Fellowship training is available in endocrinology, reproductive biology, fertility control, and gynecologic oncology.
The Medical Director and the Director of Research of the local Planned Parenthood affiliate are members of the department.
A combined health-care-educational program for unwed pregnant school girls has been developed in conjunction with the Washtenaw County Intermediate School District. All pregnant school girls in the county are transferred to a special unit in which they continue their education. We provide health care, health education, and preventive and rehabilitative services.
Department members are active in community and University sex education programs.
A new unit designed for perinatal research, financed Page 198by a contribution from the Holden Foundation, has been constructed between the Mott Children's Hospital and Women's Hospital; the facilities of each of the latter two institutions are utilized. The new unit contains two labor-delivery rooms equipped for electronic monitoring of high-risk pregnant women, intensive-care newborn nurseries, research laboratories, and offices for public health nurses and social workers necessary for the care of high-risk obstetric patients.
Department of Ophthalmology. — From 1933 until 1968 the Chairman of the Department of Ophthalmology was Dr. Francis Bruce Fralick. He was succeeded on his retirement by Dr. John Henderson.
Since 1940 the resident students within the department have increased in number from 6 to 21. The permanent staff has grown from 3 to 12 members. Annual patient visits to the department have increased to 28,000. New departmental activities consist of a corneal bank, with the support of the Lions Clubs of Michigan, establishment of an ocular pathology registry, and a vision research laboratory; activation of an ophthalmic microsurgery program and the achievement of clinical and research developments in electroretinography, ultrasonography, and fluorescein angiography. The department's residency training activities have spread to the Ann Arbor Veterans Administration Hospital and to Wayne County General Hospital in addition to the main University institution.
Within the department a special retina service has been created dealing largely with retinal separation. A special service for glaucoma patients has also been established.
Department of Otorhinolaryngology and the Kresge Hearing Research Institute. — Dr. Albert Furstenberg served jointly as Chairman of Otolaryngology and the Dean of the Medical School from 1935 to 1959. He was succeeded as chairman by Dr. James Maxwell. Upon Dr. Maxwell's death, Dr. Furstenberg, then an emeritus professor, was made acting chairman until the appointment of Dr. Walter Work.
In 1963 the department name was changed from "Otolaryngology" to "Otorhinolaryngology." Sections of audiology and speech were established in 1961 and 1965, respectively. Resident training was expanded from 4 to 6 appointees in 1940 to 16, each resident serving 4 years. Otorhinolaryngology participates in the recently established Page 199affiliation with the Henry Ford Hospital as well as in the teaching activities at St. Joseph Mercy Hospital and the Veterans Administration Hospital. In 1969 a Ph.D. program in physiological acoustics was established in the Horace H. Rackham School of Graduate Studies, directed by a committee representing the University departments of Bioengineering, Zoology, Anatomy, Physiology, and Otorhinolaryngology.
Before 1952 departmental research was chiefly clinical. Dr. Merle Lawrence was appointed as research director in 1962. The original Kresge Research Medical Building contained the first otophysiology research laboratory and was opened in September 1952. It had facilities for histology, a dark room, an electrically-shielded soundproof room, and additional space for microscopic tables and accessory equipment. This laboratory functioned as the research center for the staff and residents of the Department of Otorhinolaryngology until September 24, 1962 at which time the new Kresge Hearing Research Institute was completed.
This new building was erected through the generous award of $1.75 million from the S. S. Kresge Foundation. In March of 1961, Dr. Merle Lawrence was appointed director of the Kresge Hearing Research Institute. At the time of occupancy of the new building there were four Ph.D. academic staff members in addition to the medical staff. By September of 1970 there were 16 members of the academic research staff of the Institute in addition to the medical staff of the department.
It is the policy of the Institute to emphasize research in all aspects of otorhinolaryngology. Although research in hearing is the most prominent, other areas of interest such as the larynx, the salivary glands, and the nonauditory labyrinth have not been neglected.
Department of Pathology. — Dr. Carl Weller, who assumed chairmanship of the department following the death of Dr. Aldred Warthin in June of 1931, directed departmental affairs until his retirement in 1956, at which time Dr. A. James French was made Acting Chairman. In October of 1956, French was formally appointed as chairman, and shortly thereafter, in 1957, the department moved into its new and spacious quarters in Medical Science I. Dr. Weller died shortly after retirement, and in 1956 the Galens Society established the Weller Award as a memorial to him.
With the transfer to the Medical Center area, activities and responsibilities of the department were Page 200considerably expanded. Operation of the Hospital's blood bank and the newly consolidated clinical laboratories, as well as direction of the instructional courses for laboratory technicians, were placed in the hands of Dr. French. The departmental library, a memorial to Drs. Warthin and Weller, became the repository for gifts of historical volumes from both of these individuals as well as from Professor Ruth Wanstrom, who retired from the faculty in 1958.
The new quarters contained long-needed student laboratories, as well as facilities for the research activities of the professional staff. The new research facilities were financed, to the extent of $150,000, by the Pathology Endowment Fund which had been accumulated during Dr. Weller's administration from consultation fees for services to other institutions and individual physicians. Upon the retirement of Dr. Constantine Sharenberg, Professor of Neuropathology in 1962, Dr. Samuel Hicks of Boston moved his research activities to this Medical School, where he was appointed Professor of Pathology.
The department has been actively engaged in research in a number of directions, including the study of automobile traffic fatalities. Under Dr. Robert Hendrix, the University of Michigan clinical investigation of cancer, begun by the medical staff of the institution in 1936, has been ably pursued. Codified, detailed data, from records of 53,000 malignant neoplasms encountered in this Medical Center, have been assiduously accumulated and made available to the National Cancer Institute for consolidation with similar data from other institutions.
Department of Pediatrics and Communicable Diseases. — Dr. David Cowie, who had been chairman since the formulation of the department in 1920, died on January 27, 1940. The W. K. Kellogg Foundation provided $100,000 to assist in financing complete reorganization of the department. Dr. Charles McKann was appointed chairman of the department. He assumed his new responsibilities in July of 1941. The revitalization of the department materialized during McKann's period of administration, and in 1944 James Wilson came to Ann Arbor from Boston to take over the chairmanship. In the twenty-three-year period under Wilson, 1944-67, the 1914 Contagious Hospital was abandoned and its patients transferred to isolation cubicles in the pediatric wards of the Main Hospital. Research activities were greatly expanded, utilizing space in the Kresge Clinical Research complex assigned to the department.
Page 201The long-standing desire of the Medical School faculty to have separate and adequate hospital facilities for the care of children was energetically supported by Wilson, who lost no opportunity to urge the necessity for the move and to seek the necessary financial support. Ultimately this goal was accomplished, but the modern pediatric hospital, the generous gift of Charles Mott of Flint, was not completed and occupied until after Dr. Wilson's retirement in 1967. The research laboratories in that building are named for him.
Dr. William Oliver was selected to be Dr. Wilson's successor as chairman of this now vigorously active department. The James L. Wilson Laboratories, the Charles S. Mott Children's Hospital, the Children's Cardiac Study Unit, and the Holden Perinatal Research Laboratories provide important segments of a "Children's Medical Center." Support of strong faculty representatives of other disciplines concerned with children continues to expand the potential of optimal patient care and of teaching of trainees in problems of the pediatric age group.
The departmental staff is active not only on the campus in Ann Arbor but also at Wayne County General Hospital and its outpatient clinic in Eloise.
Department of Pharmacology. — Pharmacology at the University of Michigan was ably directed by Dr. Charles Edmunds until his death March 1, 1941. Under Dr. Maurice Seevers, who became chairman in 1942, the department has grown in size of staff, extent of facilities, and diversity and quality of research.
The department has established an international reputation for research in the field of drug addiction and dependency. In support of its research efforts it has attracted outside budgetary support which, in the year 1969-70, amounted to $968,075, and in 1970 the Upjohn Center for Clinical Pharmacology, the gift of the Upjohn Pharmaceutical Company, became an important adjunct to pharmacologic activities in this Medical School.
Department of Physical Medicine and Rehabilitation. — Physical Medicine, at one time a section of the Department of Roentgenology, was reorganized as the Department of Physical Medicine and Rehabilitation in 1950 under the Acting Chairmanship of James W. Rae. He was made Chairman in 1953. The then existing quarters on what is now the second level of the eastern wing of the Main Hospital were extensively remodeled, with the abandonment of the Page 202therapeutic pool in order to accommodate new and expanded activities planned for this new department. The professional and technical staffs were enlarged and a training school for technical personnel was created. A residency program was begun which now accepts three 3-year trainees a year. The staff at the time the department was created consisted of four physical therapists and two occupational therapists. There are now 18 full-time physical therapists and 14 full-time occupational therapists. In the year 1970-71 there were 36,055 patient visits for medical evaluations and physical theraphy and 20,135 for occupational therapy. Over 300 patients go through the department per day.
The Division of Vocational Rehabilitation was established in 1952. This division is not a part of the department but the nature of its services demands that it work closely with Physical Therapy and Rehabilitation.
The Orthotics Research Division was established in 1956 and continues to expand into related fields as well as medicine. Orthotic Research is conducted in cooperation with a bioengineering program of the College of Engineering. In effect, the department provides a laboratory where engineering students can work with life scientists.
Electromyographic examinations have tripled in the last ten years and doubled in the past six. The income from this phase of departmental activities has exceeded $100,000 in the past decade. There were 157 electromyographic examinations in 1955 and 1,922 in 1970. A third fully-shielded room for this type of examination is now being equipped.
A ward of 13 beds, assigned to the department in 1962 for adult rehabilitation patients, continues to be fully occupied. At Parkview Medical Facility, acquired in 1968, the department has 26 inpatient beds for its psycho-social vocational program.
In 1963 the department was completely renovated and tripled in size to nearly 35,000 square feet. In these modern quarters the many rehabilitation services of the Medical Center are brought together in one area, including social work, psychological testing, prevocation testing, vocational counseling, orthotic and prosthetic appliance provision, orthotic research, speech and hearing evaluation and treatment. The speech and hearing science section of the department was added in July 1969. Clinical practice is provided in the Speech Clinic, a unit of the Page 203section which includes a children's division, an audiology division, and a student adult division. This latter supervises an aphasic unit which provides intensive speech therapy for 10 weeks during each trimester for 12 to 14 aphasic patients in residence. The Speech and Hearing Camp, provides postgraduate credit and intensive clinical experience for 16 to 20 students in a camp setting. It operates for eight weeks each summer at Camp Shady Trails, located at Northport, Michigan. The camp enrolls approximately 120 handicapped boys, ages eight to eighteen.
The Orthotic-Prosthetic Appliance Section became part of the department in 1970. This section is completely equipped and staffed to provide custom-designed and standard appliances and clinical services to Medical Center patients.
Department of Physiology. — Robert Gesell, who had been chairman of the department since 1923, died in April 1954. Dr. John Bean was acting chairman from 1954 to 1956. Dr. Horace Davenport became chairman in 1956. The department moved from East Medical to Medical Science II building in 1969.
In the period 1956 to 1966 the department increased in size approximately four-fold. Expansion was partly financed by increased federal funds for research and research training. Although the department was supported by University General funds only during the academic year, it was in fact operating for the whole calendar year.
Teaching programs were substantially expanded. The medical and dental classes increased in size. In addition, teaching was provided for many other degree programs, including nursing, surgical nursing, physical therapy, pharmacy, and others. The department was largely responsible for the success of the bioengineering program, and a considerable number of bioengineering Ph.D.'s have been earned in physiology.
Department of Postgraduate Medicine. — Since 1927 this department has provided both intramural and extramural educational opportunities to graduates of medicine throughout the state of Michigan as well as from other states and other countries. A prominent feature of the extramural activities of the department involves teaching sessions at 15 established centers throughout the state to which Medical School faculty members travel to hold clinical conferences and to lecture on new developments in medicine. In 1957 some 700 Michigan physicians enrolled Page 204in this type of teaching activity. Thirteen Michigan hospitals are affiliated with The University of Michigan through the Department of Postgraduate Medicine. Interns and residents at these institutions receive periodic instruction at their home bases by University faculty members as well as by medical staff members of their own hospitals. In addition, opportunity is provided for these same postgraduate trainees to make regularly scheduled visits to the University Medical Center for additional instruction. At the Medical Center, refresher courses are scheduled and are well attended. In the year 1958-59 about 1,200 physicians attended these intramural courses. The department works closely with the Michigan State Medical Society and with the postgraduate faculty groups at Wayne State University and at the new medical schools attached to Michigan State University.
Dr. James Bruce, the first chairman of the Department of Postgraduate Medicine, retired in 1942, to be followed by Dr. Howard Cummings who, in turn, was succeeded by Dr. John Sheldon in 1954. Following the death of Dr. Sheldon in February 1967, Dr. Towsley became chairman, serving until his retirement, June 30, 1971.
After many years of existence with inadequate facilities for administration and intramural teaching, the department moved into a splendid facility for continuing medical education made possible by gifts from the Margaret and Harry Towsley Foundation and the Herbert H. and Grace Dow Foundation of Midland. This building was occupied in 1969; since then its classrooms and auditoriums have been in constant and intensive use.
Department of Psychiatry. — Dr. Raymond Waggoner, who became chairman in 1937, directed the affairs of this department for thirty-four years until retirement on June 30, 1970. He was succeeded by Dr. Albert Silverman. Housed in the Neuropsychiatric Institute, built in 1938 and connected directly to the Main Hospital, the department acquired additional space and facilities in 1952 on the seventh level of the new Outpatient Clinic. In 1947 a separate building, the Veterans Readjustment Center, was built with state funds. Exservicemen from World War II were brought for protracted observation and psychiatric treatment to enable them to return to active, normal civilian life. Further expansion of facilities occurred in 1955 with the opening of the Children's Psychiatric Hospital. This facility has been intensively used in the development of a very active program of child psychiatry under the direction of Dr. Stuart Finch. In 1960 the Page 205Mental Health Research Institute, located directly across Forest Avenue from the Kresge Research complex, was opened under the directorship of Dr. James Miller. Dr. Miller was succeeded by Dr. Gardner Quarton in 1968.
In 1906 the first state psychiatric hospital was built on Catherine Street on University property. Dr. Albert Barrett was named superintendent of this hospital and shortly thereafter became Professor of Psychiatry and Diseases of the Nervous System on the University faculty. Neurology was separated from psychiatry and established as a separate department in 1920. For many years the initial Psychiatric Hospital and the Neuropsychopathic Institute of 1938 were provided with operating budgets directly from the legislature. They were not administered as a part of the Medical Center hospital group but rather by the chairman of the department of Psychiatry. This has been changed to make the Director of the University Hospital responsible for all of the Medical Center's hospital units.
In 1962 the state legislature discontinued the provision of operating funds for the Veterans Readjustment Center and the entire facility reverted, according to the terms of the original establishment, to the University to be reassigned for whatever purposes the administration saw fit. The building has now become the North Outpatient Building, an adjunct to existing Outpatient Clinic facilities.
The department has been extremely active in postgraduate psychiatric teaching with strong emphasis on psychoanalysis. Present goals and activities are being broadened to incorporate community concerns and neurobiological strengths.
Department of Radiology. — In July of 1965 Dr. Fred Hodges, chairman of this department, began retirement furlough and was succeeded by Dr. Walter Whitehouse. During the first semester of 1941 Dr. Hodges spent a sabbatical period as research associate in the Radiation Laboratory at the University of California. Through this contact Dr. Hodges brought back to Ann Arbor the first consignment of radioactive phosphorus, which was turned over to the Simpson Institute for experimental treatment of leukemia. This was followed by p32 shipments at regular two-week intervals until the outbreak of the war. At Berkeley Dr. Hodges completed experimental neutron exposures of animals, begun in Ann Arbor with Dr. Lampe, using the Michigan cyclotron.
Page 206In 1941 this country's first program of admission x-ray chest surveying was begun at Michigan, funded by the W. K. Kellogg Foundation. Dr. Hodges, on leave in Stockholm, participated daily in radiological activities at the Karolinska Hospital. This contact with Swedish radiology was the first step in the development of close relations between the departments in Stockholm and Ann Arbor. In 1956-57, Dr. Bjorn Nordenstrom, now chairman of radiology at the Karolinska, spent a year in the department in Ann Arbor. In 1954, funded by a sizeable research grant from the Atomic Energy Commission, and in part by the University Hospital, the General Fund of the University, and the Alice Crocker Lloyd Memorial Fund, a Center for Radiation Therapy was created, directed by Dr. Isadore Lampe. Utilizing carefully accumulated statistical data concerning the results of cancer treatment obtained with conventional 200KV x-ray equipment, Dr. Lampe was able to compare with those results subsequent accomplishments with isotope teletherapy (cobalt 60 and Cesium-137), comparable to x-rays produced with super voltage generators.
In 1950 the radiology staff developed and built a motor driven, roll-film camera for rapid sequential filming of the heart, following opaque injection. The shop also produced important modifications of equipment, unobtainable commercially, and x-ray film-numbering devices.
In 1956 an angiographic unit was developed within the main department in conjunction with thoracic surgery and the cardiovascular group in pediatrics. In 1957 the department installed mechanical film-processing equipment and, in 1961, fluoroscopic image intensifiers with television monitors.
Over the years the department has developed and maintained a workable system of filing and indexing to make accumulated radiologic diagnostic information available for clinical investigations and for teaching. Dr. Lampe has maintained a detailed system of recording results obtained with therapeutic radiation.
Since 1965 space remodeling has continued to achieve greater utility of existing space. Expansion into limited square footage previously assigned to blood chemistry and the transfer of pediatric radiology to the new Mott Hospital has been accomplished. Excellent and badly-needed technical facilities have been provided for peripheral angiography and for neuroradiology. Jointly, with the urology section of surgery, efficient new facilities for all aspects of urologic diagnosis were established on the third level.
Page 207Department of Surgery. — Section of General Surgery. The General Surgery Section was formed under Dr. Charles Child, III, Chairman of the Department of Surgery, in April 1967. Dr. William Fry was selected to be its chief. The General Surgical Services include two wards at the University of Michigan Hospital, two at the Ann Arbor Veterans Administration Hospital, and two at Wayne County General Hospital. In the affiliated hospitals both undergraduate and postgraduate students receive general surgical training.
The Section of General Surgery has an active research program. Clinical and laboratory investigations of tissue transplantation, vascular physiology, biochemistry of nutrition, endocrine abnormalities, and liver disease are subjects of particular interest.
Section of Orthopaedic Surgery. In 1940 the Orthopaedic Section consisted of a 100-bed hospital service chiefly concerned with the long-term care of patients with osteomyelitis, joint tuberculosis, and the deformities of paralytic poliomyelitis. It was directed by Dr. Carl Badgley until his retirement in 1963.
Traditionally, the research of this section has been of a clinical nature although there have been more basic contributions involving tetracycline labeling and bone repair, the preservation and storage of bone, experimental aspects of congenital hip dislocation, isotope labeling of bone, tensile strength of tendon materials, biomechanical function of the patella, and many other investigations.
During the 1940s a staff member made monthly visits to the state sanitorium at Howell to provide care for patients with bone and joint tuberculosis. From 1946 until 1964 residents made visits weekly to Jackson State Prison and Ypsilanti State Hospital to perform orthopaedic operations. A 35-bed orthopaedic service was established at the Ann Arbor Veterans Hospital in 1951. Since the affiliation with Wayne County General Hospital three orthopaedic residents have been assigned to this service under a full-time member of the staff.
Dr. William Smith succeeded Dr. Badgley in 1963. By 1971 the permanent staff had grown to five members. Approximately 2,600 operations are performed and 30,000 outpatients seen by the staff each year.
Section of Thoracic Surgery. The Section of Thoracic Surgery was well established by 1940 under the leadership Page 208of Dr. John Alexander. In 1932 he had instituted the first two-year training program in thoracic surgery. His trainees played a large part in the rapid development of thoracic surgery as a specialty during World War II when this branch of surgery came of age.
Following the war, even more dramatic changes occurred. A major part of thoracic surgery has always been the surgical treatment of infection, particularly tuberculosis. With the discovery of effective antituberculosis drugs, resection of pulmonary tissue infected with tuberculosis became safe, and pulmonary resection replaced the collapse procedures previously employed. Shortly, drug therapy of tuberculosis was found to be remarkably effective without resection of pulmonary tissue. The sanatoriums emptied, and new developments in thoracic surgery replaced the many operations for tuberculosis that had occupied so much of the section's attention. The same changes occurred in the treatment of other pulmonary infections.
Dr. John Alexander died in 1954 and was succeeded by Dr. Cameron Haight, who had pioneered during the 1940s in the treatment of esophageal atresia in the newborn.
The first open-heart operation at the University of Michigan was performed in 1956 and soon cardiac surgery became the most important part of the section's activity. The thoracic surgery staff soon established Michigan as one of the major centers in the country for the surgical treatment of heart disease, particularly congenital heart disease. With the field of cardiac surgery firmly established, members of the section turned their attention to heart and lung transplantation and, in 1968, Dr. Donald Kahn carried out the first of several successful heart transplantations.
Dr. Haight died in September 1970, and Dr. Herbert Sloan was appointed to replace him.
Section of Neurosurgery. Dr. Max Peet was the first section head. He was internationally famous for his operations for tic douloureux and splanchnicectomy for the treatment of hypertension.
When Dr. Peet died on March 25, 1949, Dr. Edgar Kahn was named as his successor. During World War II Dr. Kahn served as Colonel, Chief of Surgery, of the 298th General Hospital (University of Michigan). He is famous for his work on craniotomy for removal of subdural Page 209hematomas in infants and the first use of Thorotrast for localization of brain abscesses. He standardized open cordotomy for intractable pain and described the dentate ligament syndrome, emphasizing the clinical importance of mechanical stresses on the spinal cord.
In 1952 Dr. Kahn persuaded Dr. Elizabeth Crosby, internationally known comparative neuroanatomist, to participate in neurosurgical conferences at the University Hospital. Upon retirement as Professor of Neuroanatomy she became Head of the Kresge Neurosurgical Research Laboratory.
In 1969 Dr. Richard Schneider succeeded Dr. Kahn as Head of the Section of Neurosurgery.
Section of Urological Surgery. In 1940 the Section of Urology was a relatively small unit having only one full-time teacher, Dr. Reed Nesbit, Head of the Section. An average of one resident per year completed the urology residency training program until 1946 when larger numbers were appointed to accommodate men returning from the Armed Forces. In 1953 the section acquired a Urology Ward at the newly constructed Ann Arbor Veterans Hospital. In 1958, as a result of the increased number of beds and patients, the number of resident trainees in urology was increased to three.
In 1969 the previously independent Urology Residency Service at Wayne County General Hospital was incorporated into the University of Michigan program and the number of urology resident appointees at the University Medical Center was increased to four.
Dr. Nesbit retired as head of the Section of Urology in 1968, and was succeeded by Dr. Jack Lapides.
Section of Plastic Surgery. Before coming to Michigan as chairman of the Department of Surgery, Dr. Charles Child, III had worked closely with plastic surgeons and was cognizant of the contributions to be expected from plastic surgery in patient care and research. It was not until 1964, however, that a section of Plastic Surgery was formulated with Dr. Reed Dingman as section head.
Patients with congenital anomalies, traumatic and developmental deformities, and cosmetic defects are treated by three permanent staff members, six residents in plastic surgery, and interns and residents rotating from other surgical sections. Patients are referred to Page 210the section by the Michigan Crippled Children's Commission and by physicians in a large geographic area. Teaching is also carried on at St. Joseph's Mercy Hospital, the Ann Arbor Veteran's Administration Hospital, Wayne County General Hospital, and the Southern Michigan State Prison at Jackson.
In the seven years since its inception, the Section of Plastic Surgery has expanded services to patients with all types of acquired and congenital deformities, including special clinics in the correction of cleft lip and palate deformities, a maxillofacial prosthetic service, and a hand consultation service.
In 1970-71, over 1,700 plastic surgical operations were performed in our affiliated hospital program, and over 6,000 patients were seen in our clinics.
Unit for Laboratory Animal Medicine. — The use of animals for teaching and research has been of fundamental importance at the Medical Center and at the University generally for many years. In the 1950s the rapid growth of this use created an urgent need for better facilities. When the Kresge Medical Research Building and Unit I of the Medical Science Building were constructed, provision was made for modern departmental and central animal facilities. In 1962 Dr. Bennett Cohen was placed in charge of the animal care facility.
At the outset the facilities in the Kresge buildings, although occupying most of the seventh floor, did not provide adequate space for the numerous departments and investigators working in that building. This led to the construction of the Animal Research Facility and to the organization of the Animal Care Unit under veterinary direction in 1962.
In 1968 the Animal Care Unit was renamed the Unit for Laboratory Animal Medicine to reflect the growth and development of the Unit's academic program. Since the mid-1960s the Unit has had University-wide responsibility for the provision of adequate veterinary care for the animals used in teaching and research. The veterinary staff of the Unit presently consists of seven veterinarians, three members of the Medical School faculty, and four postdoctoral fellows who serve as residents in laboratory animal medicine. In addition animal husbandry and related services are provided by a staff of animal technicians headed by the Unit's Administrative Director and Supervisor.
Page 211Joint Activities with the School of Public Health. — Carrying on a tradition of more than eighty years, the Medical Center continues to be deeply involved in community and public health activities. When professional education in public health was separated from the Medical School in 1921, first to the Graduate School and then to the separate School of Public Health, close ties to the Medical School were maintained, and over the years the faculty of the School of Public Health have continued to provide instruction in public health for medical students.
Other forms of collaboration included use of the statistical resources of the School of Public Health, through formal course offerings in biostatistics as well as through consultation. This has been aided by a federally-sponsored grant to develop biomedical computing throughout the University. Particular note should be taken of the collaborative research in the Center for Research on Diseases of the Heart and Circulation, and Related Disorders, and in the Institute of Environmental and Industrial Health. The former was started by Dr. Thomas Francis, Jr., Professor and Chairman of the Department of Epidemiology in the School of Public Health and Professor of Epidemiology in the Department of Pediatrics and Communicable Diseases in the Medical School. The Center has drawn heavily on the expertise in the departments of Internal Medicine, Pediatrics, and Human Genetics for its progress in identifying precursors in heart disease. The Institute of Environmental and Industrial Health, established originally through a generous grant from the General Motors Corporation, carries out research in the field of occupational diseases and the effect of the environment on individual and community health. These two larger centers are supplemented by many individual projects involving Medical School and School of Public Health collaboration.
Formerly the School of Public Health had responsibility for the teaching of public health to undergraduate nurses in the School of Nursing. Just prior to the last decade the School of Nursing took over fundamental responsibility for the nursing part of this instruction with the School of Public Health, maintaining responsibility for the medical and professional input of this teaching program.