Obstetrics, Gynecology, and the University of Michigan by Stander

Transcription

OBSTETRICS, GYNECOLOGY
AND THE
UNIVERSITY OF MICHIGAN
RICHARD W. STANDER, M.D.
Professor and Chairman, Department of Obstetrics
and Gynecology, University of Cincinnati College of Medicine
and
WARREN H. PEARSE, M.D.
Professor and Chairman, Department of Obstetrics
and Gynecology, University of Nebraska College of Medicine
ABRAM SAGER
Chapter I
·
territories created by the Ordinance
... . leader in public education and, ultimately,
O
F THE
of 1787, Michigan was a
the first state to consider
medical education a public responsibility. In 1817, Michigan Territorial
Governor Cass charged Judge Augustus B. Woodward with formulating
..plans for a university. The pompous Woodward responded with an elaborately complex scheme for a Catholepistemiad
or University of Michigania
ich was to be composed of thirteen major divisions or didaxum. The
th didaxia was that of medicine. There was also provision for a far-flung
network of academies which were to supply the university with students.
':Fhe anachronous project never reached fruition, for the immediate concern
of>the territory's six thousand inhabitants was to wrest a living from the
newly settled land. Lack of support for the pedantic judge's quixotic plan
can also be attributed to his insistence that it be presented to the territorial
legislature as he composed it ...
in Greek, and it was twenty years later
that a more modest University of Michigan \'vas established in pastoral Ann
Arbor following the enabling act of statehood.
Abram Sager was born in Bethlehem, Albany County, New York,
December 22, 1810. He was educated at the Rensselaer Polytechnic Institute, Troy, New York, where he remained two years as pupil and instructor,
graduating in 1831. Here he came under the influence of Professors Torrey
and Eaton, undoubtedly accounting for his fondness of botanical and zoological studies. He attended medical lectures in the schools of New Haven, Albany and Castleton, Vermont, receiving his medical degree from the latter in
1835. Joining the stream of New Englanders pouring westward after the
opening of the Erie Canal in 1825, Sager established practice in Detroit in
1836. In 1837, he was appointed head of the botanical and zoological division of the Michigan Geological Survey. Two years later, a report on his
activities was accompanied by a catalog and a herbarium of twelve hundred
\/. species and some twenty-two thousand specimens, which he presented to the
University of Michigan laying the Ioundation for its present vast collection.
In 1842, Sager accepted the Chair of Botany and Zoology proffered by the
. University with the understanding
that he would aid in the formation of a
medical school and the selection of its faculty. In addition to his teaching
duties during the following years, he prepared a noteworthy collection of
specimens demonstrating comparative embryological development of the ner-
5
vous system in vertebrates. Although the University's inceptive plan envisioned development of a law department before that of medicine, a reversal of
precedence was ordained by the pressing need for medical education in the
young state. Popular concepts of Jeffersonian Democracy were inimical to
legislation governing medical licensure, resulting in a rapid increase in the
number of quacks and charlatans. Through the zealous efforts of Sager and
another physician, Zina Pitcher (University Regent 1837-52), the Medical
Department of the University of Michigan opened its doors in October, 1850.
Sager was appointed Professor of Obstetrics and Diseases of Women and
Children, but also continued to teach botany and zoology until 1854. Other
members of the original medical faculty were Silas Douglas (Chemistry,
Pharmacy and Medical Jurisprudence), Moses Gunn (Anatomy and Surgery),
James Allen (Physiology, Materia Medica and Therapeutics) and Samuel
Denton (Pathology and Theory and Practice of Medicine). Awaiting the new
students was a handsome porticoed structure built of sandstone at a cost of
nine thousand dollars. Although establishment of the new department had
been well-publicized, advance registration had not been required. To everyone's relief, ninety-five students appeared, were examined and matriculated
in the Medical Department. During the same semester, only sixty-four students were enrolled in the Department of Science, Literature and the Arts,
and the University's books showed a cash balance of $9.66. An economic
note of the times is found in the first official announcement of the "Medical
Department. In addition to listing faculty members and prescribed textbooks,
prospective students were notified that "Good board can be readily obtained
in private families and hotels of the village, for from $1.25 to $2.00 weekly."
Few of the original ninety-five students intended to expend the time or
energy necessary to acquire a medical degree, for thirty-three years were to
pass before any legislative restriction of medical practice appeared in the
state. Those who did announce their candidacy for a degree, however, were
required to be twenty-one years of age and to have attended two full courses
of lectures (each course lasted twenty-two weeks and the student's second
course was identical to his first). In addition, three years of practical experience under an approved preceptor was required and, of course, the candidate
must have passed the necessary examinations. Clinical instruction in the
modem connotation was unknown in the early days of the Medical Department and teaching was \vllolly didactic. The state's major population center
lay thirty-five miles to the east and transportation of patients to Ann Arbor
was often difficult and time consuming. Bedside teaching was already increasing in some of the metropolitan medical schools in the east and the
medical faculty of the University of Michigan felt compelled to announce,
"As noted in previous announcements, clinical instruction, it is believed, is
6
far better imparted in the walks of private practice, especially in that section
of the country where the student intends to locate himself, than can be done
even in the best regulated hospital. The hasty walks through the wards of a
hospital furnish at best but a sorry substitute for the close and accurate study
of cases as they occur in the professional rounds of the private practitioner."
In time, clinical facilities were developed in Ann Arbor and a later retrospective analysis by Victor Vaughn places the early deficiency in its true
light. "The University of Michigan Medical School was from its start, a
scientific, in contradistinction to a practical or clinical, institution. This was
not altogether due to the preference on the part of its founders or professors,
but was a necessity. For twenty-five years it had no hospital-not a building
which by any stretch of courtesy could be so denominated."
Thus in l850, Sager began instruction in Obstetrics and Diseases of
Women and Children, although attendance upon a single delivery was not
to be required of the medical student for another forty years. Except for a
rare patient demonstrated to the class, his materia] was presented bv lecture
four times weekly throughout the school year. Although not a brilliant lecturer, he was thorough and forceful, and his presentations were skillfully
compounded from medical knowledge of the day. From lecture notes of
November 21, 1856, we glimpse Sager's concepts of extrauterine gestation,
"which we have spoken of as a disorganization of nature." Following an
account of the pathology and statement that, "Hemorrhage sometimes occurs
endangering the life of the fetus," we find that "local blood-letting and saline
cathartics seem to have an important place in treatment."
More than one student, however, observed that Sager often tended to
become absorbed in general biology often to the neglect of the medical
subject at hand. Nevertheless, it was evident that he commanded the respect
of the students. A tall person with stern countenance and penetrating blue
eyes, he was never plagued by campus pranksters who delighted in victimizing other faculty members. From 1854 through 1860, Sager taught physiology and obstetrics, whi]e Alonzo B. Palmer included discussion of diseases
of women and children in a general medical course. This six year hiatus
represents the only departmental separation of obstetrics and gynecology in
the school's history, and the subjects were recombined under Sager in 1860.
As to Sager's clinical abilities, we have the evidence of a successful
practice in Detroit to which he returned between school sessions. His gynecologic surgical experience was confined to an occasional minor procedure,
for major gynecologic operations were few and still within the province
of the general surgeon. Lyster, Professor of Surgery, reported to the Michigan State Medical Society, in 1869, that in the six month period ending
March 31, 1869, the University Surgical Clinic had embraced one hundred
7
and four cases of general surgery, eighty cases of ophthalmic surgery, twentyeight cases of orthopedic surgery and three cases of uterine surgery.
In 1867, a faculty residence on the north edge of the campus was remodeled to accommodate a few patients, becoming the crude forerunner of
one of the first hospitals in the United States to be erected specifically as a
medical school facility. Surgical patients housed in the frame structure 'were
transported by litter to an upper chamber of the medical building. Here
operations were performed with the patient lying on a table, upon which,
perhaps an hour before, a cadaver had been demonstrated to the students.
At this time, Joseph Lister's work "vas known only to a few associates, and
the University Surgical Clinic's operative mortality was understandably
high. Under such conditions, the inexperienced Sager was called upon to
perform the first caesarean section in Michigan, a procedure carrying with it
fifty per cent mortality rate at that time. At least one historical note refers to
the venture as successful, but the patient's demise on the first postoperative
day would seem to render the description inappropriate.
The procedure
was occasioned by the admission to the "hospital" on November 2, 1869,
of a rachitic dwarf, three feet and six inches tall, grotesquely distorted by
intrauterine pregnancy. Such a severe degree of pelvic contracture existed
that an index finger could scarcely be placed between the symphysis and
sacral promontory. Deploring the circumstances which had prevented therapeutic abortion in the first trimester, Sager chose to improve the patient's
general condition "by the exhibition of mild aperients and chalybeates."
Labor began the morning of November IIth, and early that afternoon, the
terrified patient was borne across the chilled campus and up the narrow
stair of the medical building. Care had been taken to raise the temperature
of the usually cold amphitheater to about seventy degrees. After induction
of ether anesthesia, Sager performed the caesarean section, aided by Professors Ford, Cheever and Frothingham, delivering a living child of "average
size." It is noteworthy that Sager's closure of the uterine wound represented
a distinct departure from the technique of gastrohysterotomy of his day and
preceded Sager's pioneering monograph by thirteen years. In the United
States, onlv two instances of closure of the uterine wound were recorded
prior to Sager's case, but he ably defends this technique in his published
report. The patient's death eighteen hours after the procedure was thought
by Sager to be due to peritonitis, but description of the autopsy findings
would indicate septicemia to be a more likely cause. \V ord was received
later that the infant died at six weeks of age.
Neither a brilliant surgeon nor an inspired investigator, Sager's value
to the Medical Department was far beyond that of an able teacher. The
vicissitudes of the growing medical school were many during his tenure and
8
•
Sager often proved a cohesive force in a unit rife with controversy. His emergence as a faculty leader and spokesman was aided by a quiet demeanor and
impregnable dignity. That the qualities of leadership were appreciated by his
colleagues is attested hy his election to the presidency of the medical faculty
thirteen times during his twenty-five year association with the Medical Department and his continuous service in this capacity from 1868 through 1875.
From the inception of the medical school, many factions had advocated
its removal to Detroit for the purpose of amplifying clinical teaching. Proponents of the plan for partition among practicing physicians of the state and
within the medical faculty were convinced that the Medical Department
with its dearth of clinical material was little better than many of the proprietary schools of the day. Opposition to the campaign was unanimous among
university officials. Tuition was still a major source of income for the University and the Regents feared a loss of revenue if the flourishing Medical Department was moved to Detroit. *
The controversy reached a peak in 1868, culminating in editorial criticism of the university's administration,
an example of which reads, "And
now that the profession and, in a great measure, the public at large, have lost
their faith in the stability of the university, it is doubtful whether the most
prudent policy and the most persevering efforts on the part of the Regents
and Faculty will be able to restore to the Medical Department its rank even
as an elementarv school."
/
Although Sager's personal convenience would have been served by
transfer of the medical school to Detroit, he advocated its retention in Ann
Arbor. He recognized that the very lack of clinical material for which the
school was being criticized had stimulated a scientific approach to medical
studies foreign to proprietary schools. The Medical Department had been
the first in the country to require the student to work in the chemical laboratory. Sager felt that a high standard of medical education could best be maintained by continued proximity of the medical school to other university departments and facilities. He felt that perceptive planning and proper legislation would result in adequate clinical facilities and an increasing number
of patients in Ann Arbor. The Regents remained obdurate and the storm
abated.
Another crisis confronted
the Medical Department
during Sager's
presidential tenure. In 1870, a resolution was adopted permitting women
to attend the University. Sensing imminent invasion of a male domain, the
medical faculty cast about for a suitable solution. The instruction of mixed
classes in medical subjects was unthinkable
to even the pedagogic avant•. From 1850 through 1868, the Medical Department enrollees numbered 4339, while 4225
students registered in the Department of Sciences, Literature and the Arts during the same time.
9
garde of that time. With Sager as spokesman, the medical faculty presented
a memorial to the Reg~nts stating, "In their judgment the medical co-education of the sexes is at bt::t an experiment of doubtful utility and one not,
calculated to improve the digli;tv of man or modesty of women."
They indicated, however, th.,; they were "willing to ive a full course
of medical instruction to females at allY convenient time and for a uitable
compensation."
It was agreed that separal~ courses of medical in truction
would be provided for men and women for .vhich each faculty member
would receive an additional $500 per annum. The first attempt at medical
co-education in the United States resulted in the tabieau of the professor
concluding his lecture to a roomful of boisterous males. then striding to an
adjoining cubicle to relate the same information to a small group of timid
females.
Although the homeopathic movement was gaining strength in the
United States at the time the Medical Department opened its doors, it is
doubtful that Sager realized its portentous nature. That it would be little
more than a transient movement with an ignominiou
end would seem to
have been predicated by its very tenets, an example of which was repudiation
of the vaginal speculum. "And not only do all the soundest principles of
medical ex-ploration dissuade from the indiscriminate
introduction of the
speculum, -but the whole tenure of our Homeopathic therapeia leads to a
more excellent way, by substituting the subjective, the sensational, the constitutional and functional symptoms for the pathological details of structural
changes, as the basis for medical treatment."
As a matter of course, Sager joined other physicians in condemning
homeopathy and considered with suspicion anyone who countenanced such
an irregular medical practice. In 1849, the Regents were considering issuing
an invitation to Philip Tappan to accept the presidency of the University.
Sager, learning that Tappan had once called a homeopathic physician,
opposed the move and the matter was temporarily dropped. However, in
1852, an invitation was issued to Tappan who accepted the appointment.
Refusal to join in the invitation indicated continued disapproval on the part
of the medical faculty and a nucleus of opposition to Tappan was formed
even before he arrived in Ann Arbor.
That homeopathy achieved lay recognition far beyond that accorded
other cults of the time was partly the responsibility of an allopathic minority
given to bleeding of a dangerous degree and indiscriminate use of mercurials.
Many citizens abandoned regular physicians for the services of homeopaths
whose influence grew rapidly. Activity directed toward esrablishment of a
homeopathic school within the University was evident within five years of
inauguration of the Medical Department. Annoyance on the part of regular
10
•
:;:'=-:::':::::-ms-
became concern as legislative pressure slowly mounted. In 1868,
cial circumstances of the University forced President Haven to present
_ request to the state legislature for an increase in funds. The powerful exponents of homeopathy seized this opportunity to attach a rider to the requested appropriation
making it contingent upon establishment of a Professorship of Homeopathy within the Medical Department.
The physicians of the state and medical faculty, split over the question
~ removal of the Medical Department to Detroit, were quickly united by
on threat and the problem of relocation was relegated to secondary
ger advised the Regents that acceptance of the legislature's
uld result in wholesale resignation among members of the
='~"T","_-. Thus counseled, the Regents refused the appropriation reblic disapproval and necessitating reduction of faculty salaries
iod of national inllation. Ultimately, the rider was stricken
__ ropriation, but efforts to unite homeopathy with the University
~::::::::::e:" Health failing, Sager obtained a year's leave of absence from
-=fr~
1 73 and resigned the Chair of Obstetrics and Diseases of
, Children, in 1874, to devote full time to the leadership of the
_-""'- ,",,~~_,-_ In 1875, the legislature established the School of Horneope University with the intent that certain basic courses would
omeopathic students by the medical faculty. In protest, Sager
the University ending a thirty-three year association.
~~~~h
elected to the presidency of the State Medical Society in
_ -.-; me to his role in the development of medical education in
- death August 6, 1877, at the age of 66, prevented his taking
11
DEPARTMENT
OF OBSTETRICS
UNIVERSITY
AND GYNECOLOGY
OF MICHIGAN
1850-1963
Abram Sager
Edward S. Dunster
James N. Martin
James G. Lynds
Casper K. Lahuis
Clara A. O. Dedrick
John J. Mersen
Reuben Peterson
George R. Pray
T. S. Burr
William H. Morley
Ralph L. Morse
R. L. Parmeter
C. L. Patton
A. P. Reed
Christopher G. Parnell
H. S. McGee
Samuel R. Haythorne
Melvin K. Signor
E. P. Billings
Frank C. Witter
George Kamperman
Neil N. 'Vood
R. C. Leland
L. H. S. DeWitt
Howard H. Cummings
Ward F. Seeley
Frederic M. Loomis
Rudolph A. Bartholomew
Leslie L. Bottsford
John \iV. Sherrick
Harold Henderson
Roland S. Cron
1850-1874
1874-1888
1888-1901
1888
1901-1931
1901-1903
1901-1904
1901-1903
1902-1904
1903-1904
1903-1905
1903-1904
1904-1906
1904-1906
1904-1906
1905-]907
1906-]908
]906-]909
]904-1912
1908-1911
1909-1910
1910-1914
1910-1913
191]-1915
1912-1916
1913-1917
1914-1920
1915-1917
1916-1918
1917-1918
1905-1907
1919-1922
1919-1923
48
•
R. VV. Shelley
Lucy M. Elliott
M. D. Haag
Theodore W. Adams
Norman F. Miller
Lewis E. Daniels
William H. Rumpf
James M. Pierce
Lawrence E. McCaffrey
Harold A. Furlong
James V. Campbell
Harold S. Morgan
L. Grant Baldwin
Ralph G. Hubbard
Norman R. Kretzschmar
Robert W. Wilkins
John vv. Kemper
Glenn A. Carmichael
Carl P. Huber
Walter Belser
George H. Sehring
David C. Kimball
Robert G. Dalby
Woodburne K. Lamb
Paul W. Winder
James 1. Gillard
Ferdinand Gaensbauer
James T. Bradbury
F. \.\1. Tamblyn
Richard D. Reekie
Clair E. Folsome
Joseph Kurez
Oliver E. Todd
Russell Malcom
Sprague H. Gardiner
wnu, E. Brown
Russell R. DeAlvarez
Frederick W. Bald
Earl L. Hall
James o. H. Sirnrall
Charles B. Darner
1918-1920
1918-1919
1918-1921
1919-1924
1919-1926
1920-1925
1921-1926
1923-1931
1923-1927
1924-1929
1925-1929
1925-1930
1925-1930
1926-1928
1926-1931
1927-1931
1927-1929
1928-1931
1928-1936
1929-1931
1929-1931
1931-1935
1931-1935
1931-1935
1931-1935
1932-1936
1932-1937
1932-1940
1933-1934
1933-1937
1933-1941
1934-1935
1934-1938
1935-1936
1935-1939
1935-1940
1935-1944
1936-1936
1936-1940
1937-1940
1937-1941
49
1931-1964
J. Hobert Willson
Harry N. Jurow
Allan C. Barnes
Heynold L. Haas
David C. Baker
F. Jackson Stoddard
Charles W. Newton
Halph S. Steffe
Harry
A Lusk
George J. Andros
Charles 'vv. Henderson
Gardiner M. Riley
Janet M. Boog
Charles W. Aldridge
Charles H. Hendricks
Donald A Pollock
Joan C. Stryker
Tommy N. Evans
James S. Krieger
Charles E. Lemen
Charles E. Lewis
Alexander 'vv. Makepeace
Max A Parrot
Robert M. Campbell
S. Clifford
Henry L. Tieche
Donald J. Droulett
John McNichols
James 1. Collins
Robert W. Muenzer
George R. Thompson
\Valter R. Johnson
Norman L. Banghart
James B. Peery
Samuel J. Behrman
Robert L. Range
A Gordon Reynolds
Wallace C. Stout
George \V. Morley
Melvin D. Bivens
Edmond S. Botch
v:
1964-
1937-1942
1938-1942
1938-1942
1938-1955
1939-1943
1939-1944
1940-]945
1940-1942
1940-1942
1941-1945
1942-1946
1942-1965
1943-1944
1943-1945
1943-1946
1944-1946
1945-1948
1945-1946
1945-1946
1945-1946
1946-1947
1946-1947
1946-1949
1946-1949
1946-1950
1946-1950
1947-1948
1947-1948
1947-1948
1947-1951
1947-1952
1947-1952
1948-1953
1948-1951
1948-1949
1949-1952
1949-1950
1949-1954
1949-1954
1950-1953
1950-1951
1946-1947
1946-1948
1949-1951
1947-1949
1954-1956
1948-1966
1948-1950
1953-1954
19501952-1955
1956-
50
•
l
•.
Harry C. George
Warren H. Pearse
John R. G. Gosling
George S. Sayre
Richard W. Stander
Peter P. Ludovici
William A. Kretzschmar
David Standiford
Morris P. Wearing
Richard J. McMurray
Edward B. Leverich
Edwin E. Morev~
Frank Shubeck
David G. Anderson
Henry E. Malcolm
. John R. McAvoy
Jack L. Court
Richard A. Kutcipal
James H. Poppy
Theron D. Loughrin
Crosby J. Eaton
\iVi1Jiam R. Forsythe
Wallace G. Pearson
Hobert II. Messer
Louis Helder
F. Wallace Jeffries
Robert M. Kretzschmar
lames P. Youngblood
Robert P. Bushell
John C. Parker
Bernhardt Pederson
Edwin P. Peterson
Roger vV. Postmus
Harold E. Sanford, Jr.
Joseph F. Betts
Abbas Bolandgray
Andrew J. Krapohl
David H. Middleton
Frank J. Schrader
Charles D. Allen
Arthur S. Haight
1950-1955
1950-1953
1950-1953
1951-1953
1951-1957
1951-1965
1951-1953
1952-1957
1953-1954
1953-1955
1953-1957
1953-1955
1953-1958
1953-1955
1953-1956
1954-1957
1954-1959
1954-1959
1954-1959
1955-1958
1955-1960
1955-1960
1956-1961
1956-]961
1957-1961
1958-1962
1958-1962
]958-1962
1959-1963
]959-1963
1960-1964
]960-1966
1961-]964
1960-1965
1961-1965
1961-1965
1961-1965
19611962-1964
1962-1963
1962-1964
51
1955-1956
1955-
1955-1958
1957-1960
1957-
1961-1963
1967-
1968-
Buell A. Miller
Marvin E. Schrock
Jack Ford
Jan Schneider
Bern Marshall
Fredrick Bald
Bruce Work
David Youngs
Jack Caskey
1962-1966
1962-1966
1962-1966
19621963-1967
1963-1967
19631963-1965
1963-1967
52
•
ED\V AHD SWIFT DUNSTER
Sager's failing health prompted the Medical College to appoint Edward
Swift Dunster as Lecturer in Obstetrics and Diseases of Women and Chi1dren for the academic year of 1873. Upon Sager's resignation of the Chair
of Obstetrics and Diseases of Women and Children in 1874, Dunster was
quickly and unanimously appointed to fill the vacancy.
Dunster was born in Springvale, Maine, September 2, 1834. A direct
descendant of Henrv Dunster, the hrst President of Harvard College, he
received his primary education in the public schools of Providence, Rhode
Island, and entered Harvard in 1852. In contradistinction
to Sager's background of botany and zoology, Dunster pursued a classical education, receiving a Bachelor of Arts degree horn Harvard in 1856. Undoubtedly, this
facet of his education was responsible for the facility of pen and speech
1ht
which was to hiahlig
his medical career. Upon 0
oraduation from Harvard
o
with high honors, where he was also a member of Phi Beta Kappa, Dunster
studied medicine under the preceptorship of Dr. lV1. Stevenson of Newburg,
New York, deFraying his expenses the meanwhile by tutoring a young
man for college. In 1858, he attended medical lectures at Dartmouth College
and, in 1859, received a Master of Arts degree From Harvard, also graduating
from the Nevv York College of Medicine and Surgery in March of that year.
From the latter, he received the highest prize for proficiency in his medical
studies. It was also in New York that Dunster came under the inlluence of
three men who shaped his interest toward the special study of obstetrics and
gynecology later in his career.
Professor E. R. Peaslee was one of the pioneer gynecologists and abdominal surgeons of this country. When Dunster, then only twenty-four,
became one of his pupils, Peaslee's career as an ovariotornist had already
brought him international
recognition. IIis enthusiastic approach to his
work inspired his pupils with a high degree of respect and emulation. In
his later veal'S
at the Universitv ~ of Michizan.
Dunster was often to refer to
~
0
this man. Suhsequent to graduation from medical school, Dunster met both
Thomas and Sims, closely follO\Ning the latter's work until Sims' pro-southern
sentiments resulted in his voluntary exile to England at the outbreak of
Civil \Var.
Upon graduation from medical school, Dunster was appointed as intern
at St. Luke's Hospita] in New York,.but resicned
five months later to accept
0
13
the Demonstratorship of Anatomy at Dartmouth College, at the same time
opening practice in New York City.
Among the first to offer his services at the outbreak of civil conflict in
1861, he secured the position of Assistant Surgeon in the Army of the Potomac following a competitive examination. His administrative ability soon
came to the attention of his superiors, resulting in rapid advancement in
responsibility and rank in a brief five year military career. Serving as Medical Inspector, first under Rosencrans and then under McClellan in eastern
Virginia, Dunster supervised the erection of Army hospitals and later commanded hospital transports returning the wounded to northern hospitals.
Subsequently, he was placed in charge of Turner's Lane Hospital in Philadelphia only to be transferred from there to Washington, to become assistant
to Willarn A. Hammond, then Surgeon-General. At this time, he also served
on the Board of Examiners for candidates for admission to the Arn1y Medical
Service. From Washington, he proceeded to the Military Academy at West
Point, where he served as Chief Surgeon until his resignation from the
service in 1866.
Upon resumption of practice in New York, he was appointed editor
of the New York Medical Journal, a post he was to hold for five years. As
an editor, Dunster was a striking success. His alert mind quickly grasped
the needs of medical men and his journal became a model of its day and a
prototype for many current publications. He inaugurated and developed a
plan of giving his readers short abstracts of the current literature, a common finding in today's journal, but truly an innovation of that period. During
this time, he also conducted an active service as attending physician to the
Children's Out-Patient Department of Bellevue Hospital and, from 1868
to 1870, was Professor of Obstetrics and Diseases of Women and Children
at the University of Vermont. From 1869 through 1874, he held a similar
position at Long Island Hospital. It was not unusua] for medical faculty
members of that day to hold concurrent appointments in two or more schools,
the brevity of medical school terms allowing the appointee to fulfill his
multiple obligations at different times during the calendar year.
In 1869, Dunster was appointed Director of the Infants' Hospital,
Randall's Island, New York. The hospital's antecedent administration,
charged with laxity, had been held responsible for an appalling mortality
among the island's one thousand children. Dunster dramatically reduced the
mortality through institution of sweeping sanitary reforms and his accomplishments invoked high praise from his superiors. This success only added
to the burden of Dunster's many clinical and academic responsibilities, for
there was an increasing demand for his services as an after-dinner speaker
and participant in medical meetings. By his own declaration, the appoint14
•
the Demonstratorship
of Anatomy at Dartmouth College, at the same time
opening practice in New York City.
1861, he secured the position of Assistant Surgeon in the Army of the Potomac following a competitive examination. His administrative
ability soon
Virginia, Dunster supervised the erection of Army hospitals and later commanded hospital transports retuming the wounded to northern hospitals.
Subsequently, he was placed in charge of Tum~r's Lane Hospital in Philadelphia only to be transferred from there to Washington,
to become assistant
to Willam A. Hammond, then Surgeon-General. At this time, he also served
on the Board of Examiners for candidates for admission to the Army Medical
service in 1866.
of the New York Medical Joumal, a post he was to hold for five years. As
plan of giving his readers short abstracts of the current literature, a COllman finding in today's journal, but truly an innovation of that period. During
position at Long Island Hospital. It was not unusual for medical faculty
Randall's Island, New York. The hospital's antecedent
administration,
mortality through institution of sweeping sanitary reforms a~d his accomplishments invoked high praise from his superiors. This success only added
and participant in medical meetings. By his own declaration, the apoci::""'
14
•
the Demonstratorship of Anatomy at Dartmouth College, at the same time
opening practice in Nevv York City.
1861, he secured the position of Assistant Surgeon in the Army of the Potomac following a competitive examination. His administrative ability soon
Virginia, Dunster supervised the erection of Army hospitals and later commanded hospital transports returning the wounded to northern hospitals.
Subsequently, he was placed in charge of Turner's Lane Hospital in Philadelphia only to be transferred from there to Washington, to become assistant
to Willam A. Hammond, then Surgeon-General. At this time, he also served
on the Board of Examiners for candidates for admission to the Arn1y Medical
service in 1866.
of the New York Medical Journal, a post he was to hold for five years. As
plan of giving his readers short abstracts of the current literature, a common finding in today's journal, but truly an innovation of that period. During
position at Long Island Hospital. It was not unusual for medical faculty
Randall's Island, New York. The hospital's antecedent administration,
mortality through institution of sweeping sanitary reforms a~d his accomplishments invoked high praise from his superiors. This success only added
and participant in medical meetings. By his own declaration, the appoint14
•
..
l1eii'tasLecturer in Obstetrics and Diseases of \i\7omen and Children at the
University of Michigan, in 1873, was a welcome opportunity to escape the
accElerating pace of metropolitan life.
Since appropriation of a faculty residence, in 1867, for the purpose of
otlsil1g a small number of patients, the University Regents had been consideriIlg plans for a hospital worthy of the appellation. However, the homeopImproglio soon resulted in legislatorial disfavor of the Medical Departt. Deeming it inexpedient to approach the legislature with a request for
fu~ds {or the new building, construction plans were temporarily abandoned
. . 872. Upon establishment of a Department of Homeopathy within the
versity, in 1875, President Angell was able to persuade the legislature to
apl)ropriate $8,000 for construction of a state hospital in conjunction with
medical school, contingent upon contribution of an additional $4,000
. ecitizens of Ann Arbor. The meager appropriation necessitated revision
original plan for a completely new structure and addition of two wings
tOy the original hospital was decided upon. Because of Dunster's extensive
.
ience with military hospitals, he was called upon to supervise the new
, trucjion. Two pavilions, each one hundred and fifteen feet long and
tw~nty-eight feet wide, were attached to the former hospital building and
t
latter was then devoted entirely to administration.
Although hospital
itecture had not yet evolved as a specialty, the design and appointment
or ..e new wings resulted in an outstanding hospital of that era. Baths,
toilets and apparatus for central heating and ventilation were provided. Sit. :roOjJ1Sand reception areas for patients and visitors were included and
.'
ate'rooms were available for patients who could pay for better accomrno. da.~lOnsthan those provided on the general wards. Medical treatment was
s
ti tOlls; the only fee required from the patient was that for board and
cines which were given at cost. No provision was made for defraying the
cost of transportation of public patients to and from Ann Arbor. Although
patients with contagious diseases were not knowingly admitted to the
ital,Dunster's
experience with military installations led him to believe
the building would be such a nest of infection that it would have to be
burned within ten years of its opening in 1877. However, it continued to
serve as a hospital until 1890, and for an additional two decades as a class~aI)d laboratory.
,e
A special area for gynecologic patients had been envisioned by the
nts in their original plans for a new hospital, but the modified campus
.. ihospital
had no such facility and gynecologic patients continued
t
e''scen in pitifully small numbers throughout Dunster's fifteen year
association with the University. Although the pavilion hospital facilities
gaye impetus to clinical instruction in ophthalmology, surgery and medicine,
15
hospital records indicate that three gynecologic patients were admitted. in
1877, seventeen in 1878, and eleven in 1879. Dunster's personal records indicate that during the academic year of 1881-1882, he saw seventy gynecologic patients of whom only thirty-one were hospitalized. A total of thirteen minor operative gynecologic procedures were performed during the
same year. Major gynecologic procedures continued as a rarity and were
performed by the Professor of Surgery. Remodeling of the original campus
hospital had failed to provide for operating room facilities and for several
years, the amphitheater in which Sager had performed the historic caesarean
section was used for major surgical cases. Notions of antisepsis and asepsis
remained unclear. It was not unusual for gauze, which had been carefully
boiled to serve as surgical dressings, to be hung across the backs of the amphitheater seats to dry. Healing of a wound by first intention was the exception
rather than the rule. In the face of these handicaps, one does not wonder at
all that Dunster exhibited no special interest in the surgical aspects of his
chosen field, but turned his talents instead to lecturing and writing for
which he was eminentlv suited.
In 1880, the titles of the heads of other clinical departments 'were
changed to designate their expanding clinical duties, as well as their didactic positions. However, Dunster's title was changed to read, "Professor of
Obstetrics and Diseases of Women and Children and of Clinical Gynecology." The lack of reference to clinical obstetrics indicated a paucity of obstetric patients exceeding even that of gynecologic patients. The Regents' Proceedings, 1876-1883, substantiates the purchase of an obstetric mannequin, in
1879, the hrst in almost thirty years of teaching obstetrics in the Medical
Department. In support of the request for this expenditure, Dunster stated
that the need for teaching aids in obstetric area was particularly urgent
"Because, from our position, we are unable to have patients."
In contrast to Sager, Dunster was not a man of particularly commanding appearance. He was below average height and with a rather large head.
Yet few men in the annals of the l.lniversitv have equalled his ability as a
lecturer. Always intensely interested in his subject, he spoke slowly, developing his subject material with remarkable clarity and enriching it with his
precise grammar and seemingly limitless vocabulary .. Martin, his ultimate
successor, recalled that Dunster "wasthe most brilliant writer and lecturer
on the faculty at that time and that listening to him gave one the pleasure
derived horn the study of a fine painting.
That he was a favorite with the students is attested to by petition of
the Class of 1888 to have Dunster's name somehow placed on their diplomas,
since his death during the spring of that year, at the age of 54, occurred before the annual allixation of faculty signatures. The University Steward
;
16
•
had a copy of his signature electrotyped on the individual diplomas. An
additional testimonial to his speaking ability came from his medical colleagues. An article entitled: "How Public Speaking Can Help the Physician~'
appeared in the Wayne County Medical Bulletin in the early 1880's and
pointed out that "Dr. Dunster of Ann Arbor, is a very persuasive speaker,
particularly to medical students." The article indicated that he laid particular stress on etymology. A great deal of time and care went into the preparation of Dunster's student lectures. His ability to impart medical knowledge
to the neophyte constitutes an academic landmark on the annals of the
University.
Not /a prolific 'writer (only fifteen known publications have been located), Dunster nevertheless applied the same standards of excellence to his
medical writings as he did to his lectures. His articles were not only objects
of looical
construction and clarity,/ but his careful review of the literature nero
r
taining to the subject at hand allowed him to avoid announcing discoveries
which had been made before. As with speaking, his writing was error-free
and concise, an affirmation of his annual reiteration to medical students, "If
I could have but one book in mv medical library, it would be Dunglison's
Medical Dictionary." His literary talent and previous editorial experience
made Dunster a valuable member of the "Michigan Medical News" editorial staff from its inauguration, in January, 1878, until its merger with the
"Detroit Clinic" in 1883.
Nowhere was Dunster's inlluence more prominent than in attempts to
institute more stringent premedical requirements and promote a lengthened,
graded medical course. The initial requirement of two identical six month
terms of primarily didactic work, plus an approved preceptorship, had not
been changed during the first quarter century of the Medical Department's
existence.
Recognizing the need for improving the quality of medical education,
H. O. Hitchcock of Kalamazoo offered the following resolution at the
annual meeting of the Michigan State Medical Society in 1875.
"That the Regents of the University are hereby requested by the State
.ledical Society to make as soon as practicable a three full years graded
course of study and lectures obligatory upon all students graduating in the
Medical Department;
and that the requirements
for admission into this
department be made equal to those for admission into the Scientific Department."
Dunster eloquently endorsed the resolution and said that the University, "Was already moving forward in the matter of medical education and
that they will continue to advance as rapidly as they will be sustained by
public and professional opinion and the state and country." He held, 'That
/
/
17
our present system of medical education is inadequate, is more than inadequate, that it has been more senseless than superficial for it has been conducted without the slightest attention to the proper order of study and without any inquiry as to whether pupils are fitted by previous training to appreciate and appropriate the enormous mass of material that is laid before them."
He further pledged himself to the task of improving the quality of
medical education as a member of the young blood of the Medical Department. It is noteworthy, however, that Dunster concluded his remarks by disclaiming to be "authorized to speak for the faculty or state what their policy
. I b e. "
mlglt
This was diplomatic acknowledgment that many faculty members
opposed raising requirements for admittance or lengthening the medical
course on the grounds that either would result in decreased enrollment and
loss of tuitional income to the University.
Through the efforts of Dunster and others, the annual session was extended from six to nine months in 1877. Additional curriculum changes
provided gradation of material between the first and second years and a third
year was added in 1880. With these changes, Dunster's responsibilities were
concentrated in the second and third years. His presentation of theoretical
obstetrics consisted of a one semester course of sixty lectures offered both
semesters of the second year. His lecture course in the Diseases of Women
and Children consisted of forty-five lectures presented in both semesters of
the last year. In addition, throughout the third year, the seniors also met
twice weekly in the amphitheater for his course entitled, "Clinical Gynecology and Diseases of Children."
Surely Dunster's qualities as an articulate teacher of medical students,
an outstanding editor and author, and a pioneer of improved medical education must mark him as an outstanding member of the medical faculty. Yet
another contribution to the University, perhaps his most significant, took
place many miles from Ann Arbor.
At the meeting of the American Medical Association in Atlanta, Georgia, May 7, 1879, an amendment to the Code of Ethics was proposed that
would restrict the teaching of students of irregular or exclusive systems of
medicine. 111ere was little doubt that the medical faculty of the University of Michigan, with its uneasy relationship to students of homeopathy, was
the prime target of this proposal. As the afternoon wore c
the plan succeeded each other to the Iloor of rhe 2 sse:==: )~
barrage of hostile criticism and bitter den
Dunster listened, there must have stirred within him the same spirit
justice that caused Henry Dunster to s
centuries before in a gesture that cost him the Pr~aency -ot
or
18
•
•
unanimous consent, Dunster was chosen to present a rebuttal. As
mounted the podium the gathering fell silent. His reply to the Univer'iipersecutors was a monument to logic and eloquence, closing with these
tences.
"1)0 the opposite and adopt this amendment-then
it is a stride cenbackward in the historic mark of medicine, for it places us right along
hose old worthies, the Asklepiads, whose laws forbade the revealing of
things except to the elect and who exacted from students and strangers
ts of initiation before admitting them to share their knowledge. Finalall your discussions and in your decisions, forget me and forget the
University which I have the honor to represent, for if you can stand
isaster that must come with the adoption of this amendment we can
nly stand your censure."
he ringing applause was the knell of defeat for the University's
assailants and the amendment was never brought to a vote.
unster's death] May 3] 1888] after a year of failing health, closed a
remarkable chapter in the history of the medical school.
19
JAMES NELSON MARTIN
•
•
Chapter III
Upon Dunster's death, James Nelson Martin was placed in temporary
ession of the Chair of Obstetrics and Diseases of Women and Chil.1. Martin was born, in 1852, in Warren,
Rhode Island, obtaining his
y education in the district schools of Branch County, Michigan. IIillseCollege conferred upon Martin the degree of Bachelor of Philosophy
1880. In 1883, he was granted simultaneous degrees of Doctor of Medi(University of Michigan) and Master of Philosophy (Hillsdale College).
ereupon, Martin was immediately appointed Assistant to the Professor
Surgery and, in 1885, was appointed as Lecturer in Oral Pathology and
istant to the Professor of Obstetrics and Diseases of Women and ChilFollowing Dunster's death, Martin failed to receive immediate conhrtion as Professor of Obstetrics and Diseases of Women and Children.
fact, three annual appointments as an acting professor preceded his pernent appointment as Professor of Obstetrics and Diseases of Women in
At this time, instruction in children's diseases was formally transferred
Department of Theory and Practice of Medicine. However, the actual
. nsibility for teaching the diseases of children changed hands the preg year, when Walter S. Christopher, a distinguished pediatrician, was
harge of the Department of Theory and Practice of Medicine. The teachof pediatrics continued under the auspices of internal medicine until
establishment of a separate Department
of Pediatrics and Infectious
ases in 1921.
In February, 1888, the medical faculty received a petition from the
'01' medical
class to establish a lying-in ward for the improvement of
ling clinical obstetrics. The request was referred to Dunster, whose
h precluded a formal reply, but activation of a small obstetric unit within
vilion hospita] that year triggered a vigorous local campaign for raising
to erect a separate maternity hospital. In the summer of 1888, Judge
'man, E. B. Pond, A. W. Hamilton and O. Eberbach formed a com».representing the citizens of Ann Arbor and appeared before the
of Regents to discuss the possibility of establishing a local maternity
. Evidently the reaction of the Regents was a favorable one, for the
I Announcement
of 1888-1889 stated that "local citizens had initieasures looking to the erection at an early day of a well-equipped
21
hospital to be conducted by the faculty and utilized for dir."
mstruction.
In October, 1888, University President Angell stated that it Wall
most desirable to have a lying-in hospital. In December, 1888, the ci .
committee estimated that $25,000 could be raised locally to aid in the
struction of such a unit. Under these circumstances,
a separate lyi
hospital was close to reality until an unforeseen reversal of priority fa
abandonment
of the plans. At this time, another movement to transfer
Medical Department to Detroit was gaining momentum. Advocates of
change cited poor hospital facilities in Ann Arbor as one argument in fa, _
of the transfer. In light of these developments, the Regents recognized tha::
the need for new facilities for medical and surgical patients superseded rh
need for an obstetric unit. Their decision culminated in the erection anc
opening of the Catherine Street Hospital in 1891. However, the Regen
had been aware of the need for broadening clinical instruction in obstetri
for some time. In 1888, the Regents authorized the hospital superintenden
to locate obstetric patients who would consent to be used for instruction
if the University paid their maintenance costs. For this purpose, the Medical Department
was granted an annual University subsidy of $200.00 in
1888, 1889 and 1890. This procedure was adopted after observation of its
success under similar circumstances in the Homeopathic
Hospital. It was
also during this era that the state legislature enacted the first public law
authorizing the care and treatment of indigent adult patients in the University and Homeopathic
Hospitals and payment for their transportation
and maintenance
costs from public funds. In the Public Acts, No. 246,
1889, is found the provision "whenever obstetrical wards are established in
said hospitals, the said county superintendents
of the poor may make special
contracts with the Regents for the care and treatment of such obstetrical
cases as are a public charge in their respective counties."
Since only 70 gynecologic patients were hospitalized in l 888-89,
Martin was confronted with a paucity of gynecologic as well as obstetric
patients, and turned to the task of securing more gynecologic cases for
teaching purposes. By training and disposition, Martin's surgical talents
exceeded his abilities as a lecturer and investigator. Terminating
a vigorous
campaign, Martin succeeded in having all gynecologic surgical admissions
placed under his direct supervision, thus separating gynecologic surgical
procedures from general surgery. Under the new arrangement, the gynecologic inpatient census increased rapidly. In the academic year of 1892-93,
500 gynecologic patients were admitted to the hospital and 800 inpatients
were listed the following year. For the remainder of Martin's tenure, 600800 gynecologic patients were hospitalized annually. In part, the increased
lying-in
.
T<
r'
22
•
•
bf patients resulted from the opening of the new University
Hos891, but Martin's pioneering efforts in effecting the change in the
Tial management of gynecologic surgical disorders represented an
t change within the Medical Department. For the first time those
e responsible for the didactic teaching of female pelvic and abdomigery, could increase their own practical knowledge of this subject.
'w hospital had many problems with infection, however. Martin often
~0curtail his surgical activities during periods of quarantine following
,;ertent admittance of a patient with diptheria, scarlet fever or smallpox.
~hanges in didactic teaching also continued to occur during Martin's
association with the Medical Department.
The first four year curriculum
into effect in 1890-91. At this time, clinical work in obstetrics and
. gy was scheduled only for seniors, but both juniors and seniors
three lectures weekly in obstetrics and gynecology throughout the
1892, a special drill junior course in clinical obstetrics was instituted
hstruction bv means of models and manikins. The need for such a
-'
course was prompted by the scarcity of deliveries 00-12 annually), which
: tIle s~lclents were privileged to witness during the last decade of the 19th
cenfuty.
'tef the summer of 1888, Martin was aided continuously by James
" who was promoted, in 1892, from an Assistantship to the position
mstrator of Obstetrics and Gynecology. Because of poor health,
.as granted leaves of absence in 1895-96 and 1897-98. During the
ear, Lynds was Acting Professor of Gynecology. Other Assistants who
"
brieRy under Martin were Casper K. Lahuis, Clara A. O. Dedrick
Ild'John J. Mersen.
j~i*frhe first period of endowment gifts for the University of Michigan
he
follOWing the national £]nancial panic of 1893. In April, 1898, Dr.
th Bates of Port Chester, New York, upon her death, bequeathed
'1tersity $130,000 in gilt-edge securities. There is no record that Dr.
""d ever visited the medical school or had even seen Ann Arbor. Her
y apparently stemmed solely from her approbation of the medical
s. early, if reluctant, approval of medical co-education. It W3S Dr.
!,desire that income derived
from the bequest be utilized to endow a
sorship to be known as the Bates Professorship of Diseases of Women
hildren and was contingent upon perpetuation of University policy
'tting women to the Medical Department and providing them with
eeducational
advantages accorded male students. In May, 1898,
".ts voted to accept the gift and comply with the contingent con clilever, a legal struggle initiated by Dr. Bates' relatives cast an
•.uncertainty around the proposed gift until a court decision rendered
'j
23
in November, 1898, confirmed the validity of the will. The Bates Chair remained unoccupied during the year 1898-99. In 1899, Martin was appointed to the Bates Professorship of Diseases of Women and Children,
although the Regents made it clear that diseases of children would remain
under the control of the Professor of the Theorv and Practice of Medicine.
Martin's income from the bequest was $2,000 'a year. The Regents hoped
that part of the endowment could be utilized to construct a children's ward,
thus fulfilling in spirit, if not the letter, the original intent of the bequest.
However, the proposed Palmer Ward for children precluded the use of
income from the Bates endowment, leading to a Regents' resolution, in
1900, that income beyond that needed to subsidize the professorship be
used to defray expenses within the Department of Obstetrics and Gynecology. If such a resolution had not been passed, the greater part of the Bates
income might have been saved for the building and equipping of a maternity
hospital as soon as the idea of a Bates ward for children had been abandoned.
Although in 1901, the Regents did appropriate $500.00 of the Bates income
for additional equipment for a small hospital laboratory , established in 1897,
for investigation of obstetric and gynecologic cases, by and large it was
continuously dissipated meeting routine operational expenses. This method
of expenditure did little to improve Martin's department. As other departments expanded, they were awarded proportionately larger annual budgets,
while obstetrics and gynecology continued to operate largely under the
limited auspices of the Bates endowment. "rhus, for many years, the fund
proved a liability rather than an asset.
Although it was understood that the Bates Professorship should be
held by an obstetrician, official recognition was not accorded this concept
until 1923, until final adoption of the official title of Professor of Obstetrics
and Gynecology and Bates Professor of Diseases of Women and Children.
Already absent for two years because of ill-health, Martin began to
exhibit signs of emotional instability in 1900. At this time, Victor Vaughan,
then Dean of the Medical School, realized that soon a replacement for
Martin would have to be found. His search prompted him to write the
distinguished head of a clinical department at Johns Hopkins University.
The latter highly recommended one of his assistants as Martin's successor.
Vaughan, in turn, sent a letter to Franklin P. Mall, Professor of Anatomy at
Johns Hopkins and Michigan graduate. Mall advised Vaughan not to take
the man and stated that "Johns Hopkins professors are like fathers with
marriageable daughters-they wish to get rid of the oldest and homeliest
first." He added that the man to whom Vaughan had written had another
assistant who would be worthy of the position. Although neither of the men
24
•
· cal'neto Ann Arbor, Vaughan watched their development for the next few
yeats and was satisfied that Mall's judgment had been correct.
Martin's increasing disability culminated in his resignation in 1901,
upon which he moved to California where he lived until his death in 1913,
·at the age of 61.
25
REUBEN PETERSON
Chapter IV
tober I, 1901, the appointment
of Reuben Peterson as Bates
Diseases of Women and Children was announced. Time bas
ewisdom of the selection, for it provided a leader of strength
fcturino
an era marked bv• revolutionary / changes in medical
b
d iiiedical practice.
:0 was born in Boston on June 29, 1862, the son of Reuben and
Peterson. 11is mother was a teacher and an ardent abolitionist;
2l)leader among those supporting women's suffrage. His father
ieDuxbury
shipyards, but at the time of Reuben's birth, was a
Civil War veterans in the Boston area. Reuben's father was
. John Peterson who had come to Duxbury from England in
hn's grandson, the first Reuben Peterson, married the greatterof John Alden.
n Peterson, the fifth in direct descent, received his early educa'Public schools of Boston and prepared for college at the Boston
In 1885 he grClduated from Harvard University magna cum
achelor of Arts degree and received his medical degree from
dieal School in 1889. Although few opportunities for graduate
l}ing existed then, Peterson was appointed as house officer at
Hospital. His experiences there led to a primary interest in
gynecology. A year later he moved to Grand Rapids, Michiwas to practice for eight years.
ghPeterson's
initial professional efforts reflected a high level of
ohstetrics and gynecology, a review of his early publications
this specialty had not reached the narrower confines which
t today. Among his publications was one concerning puerperal
rich appeared in 1890. Although Peterson was only twentyiDle, his paper clearly emphasized that while the diagnosis may
here remains something yet undiscovered,"
an observation
even decades later. In 1893, he discussed tubal and peritoneal
ld detailed four patients upon which he had operated in only
ractice. Among other articles appearing during this period
al Oophorectomy with Case Report," "Hysterectomy
as an
t to Bilateral Removal of the Appendages," "The Prevention
s¢ase," "A Case of Beginning Tuberculosis of the Mesenteric
27
Lymph Nodes Revealed by Ex-ploratory Cceliotomy," and "AChnical and
Pathological Study of Five Recent Cases of Hysterectomy of Fibromyomata."
In 1895, Peterson read an article entitled "The Need for More Medical Reference Libraries and the Way in which They Can Be Established"
before the American Academy of Medicine. It is obvious that he harbored a
deep concern for adequate educational facilities even before he form any
embarked upon his career as a medical educator.
On May 13, 1898, Peterson presented his inaugural thesis before the
Chicago Academy of Medicine. Entitled "Peripheral Nerve Transplantation," it described successful transplantation of the sciatic nerve from a dog
between the severed ends of the median and ulnar nerves of a human. Included in the report was a review of seventeen similar cases collected from
the literature as well as two previously unpublished reports.
The scope and depth of Peterson's interests and abilities were most
unusual for a practitioner in a small midwestern community. It is hardly
surprising that his publications received wide recognition and culminated
in his appointment as Professor of Gynecology in the Chicago Post-Graduate Medical School in 1898. Two years later, while remaining at this post,
he accepted additional responsibilities as Assistant Professor of Obstetrics
and Gynecology at Rush Medical College. The following year he was
appointed as Martin's successor at the University of Michigan.
Upon his arrival in Ann Arbor, Peterson found an adequate gynecology
service located in the Catherine Street Hospital and serving approximately
eight hundred patients annually. On the other hand, obstetric patients numbered approximately thirty a year and were still cared for in a small lyingin ward in the remodeled but completely inadequate campus hospital. Such
meager facilities might well have discouraged many individuals, but Peterson's arrival saw him plunge vigorouslv into an ultimatelv successful earnpaign for improved clinical facilities and establishment of a graduate training program in obstetrics and gynecology.
Although Martin had retained four assistants for varying periods of
time, Peterson was the first to appoint two or more assistants concurrently,
and to arrange for these individuals, a program of graded responsibilities over
a two year period. Such was the beginning of the present residency program.
One of Peterson's assistants, Melvin K. Signor, was advanced to the rank of
Instructor in 1906. Examination of the academic structure of that time
indicates that this rank corresponded to the current status of senior resident.
Two similar appointments were made in 1907 and 1908. The average tenure
for appointees was gradually lengthened, and by 1917, it was customary for
an individual to remain for three or four years of training, and the number
of "instructors" had been increased to four. At an early date, Peterson recog-
28
ized the significant advances that had been achieved by microscopic studies
fdiseased tissue. In 1902, a cooperative interdepartmental arrangement
as made whereby an assistant in the Department of Obstetrics and Gynecolgy taught gynecologic pathology in the Department of Pathology. From
902 to 1904, this task fell to Ralph L. Morse. He in turn was succeeded
Samuel R. Hay thorne, Frank C. Witter, and Neil N. Wood. This pracicewas discontin ued in 1910.
In 1919, Leslie L. Bottsford was appointed as Assistant Professor of
bstetrics and Gynecology, the first to achieve this rank. Upon his depar}e in 1920, he was succeeded by John W. Sherrick who remained until
22, During the following year the position was held by Roland S. Cron.
fter Cron's departure, a vacancy existed at this level until the appointment
'Norman F. Miller in 1925. Again, Miller's departure in 1926 created
nether hiatus. James M. Pierce was appointed as Assistant Professor in
~·28,and in 1930 became the first staff member to achieve the rank of
ssociateProfessor.
."In Peterson's own words, his first task upon assuming his duties at the
niversity of Michigan was to increase the effectiveness of teaching gynecolgy; and his second task was that of building an obstetric clinic. Before
~terson's arrival, instruction in 2:vnecoloov
had been carried out larboely
0/
surgical demonstrations before large classes while "the students sat on
benches during long prescribed hours and watched; seeing little and
~rstanding less of what was done." Peterson was convinced that the
phnique of diagnosis and treatment of pelvic and abdominal disorders of
JOIn en must be taught to students in small groups. Upon this conviction,
ching focus was shifted from the classroom to the gynecologic clinic held
iCeweekly. Emphasis was placed upon differential diagnosis, outpatient
featment, surgical specimens, and follow-up care of patients recently disInissedfrom the hospital. Ward rounds were frequent and all aspects of each
i~1patientcase were discussed in detail.
The second task proved to be a monumental undertaking, fraught with
l~y)indecision, and long periods of frustrating inertia. It proved to be one
"bich Peterson made admirable headway, but he was forced to leave many
oIvedproblems to his successor.
;Ann Arbor remained a relatively smaJl community, and except for a
.hl1 of citizens represented by the men appointed by President Angell
88~)the townspeople remained indifferent to the establishment of an
'ic clinic and hospital. Few obstetric patients were hospitalized, and
)deliveries were the rule. Realizing that the immediate prospects for
f9~ant increase in the number of obstetric patients was very POOf,
·son·increased the emphasis upon teaching mechanisms of labor by a
y
LJ.I
q
29
variety of manikins with which the department was then supplied. Students,
meeting in small groups, were thoroughly drilled in this manner in an
attempt to provide some practical knowledge of scientific obstetrics for
those who would not have the experience of an actual delivery prior to
graduation. So thorough was this aspect of training that many graduates
found themselves to be better grounded in fundamental principles of normal
and abnormal obstetrics than were fellow interns who had delivered several
patients as students in other medical schools.
In 1905, inadequate physical facilities were an important factor in
limiting the size of the obstetric service. Physicians had shown a willingness
to refer patients to Ann Arbor where they were maintained during the last
month of pregnancy while awaiting the onset of labor. Peterson saw the
need for enlargement and improvement of facilities for obstetric patients.
He found an ally in Eugene S. Gilmore, Superintendent of University Hospital from 1900 until 1908. When a new addition to Catherine Street
Hospital, the Palmer vVard, was opened in 1903, it was intended to serve
primarily as a pediatrics unit. Gilmore prevailed upon George Dock, chairman of the Department of Internal Medicine, under whose jurisdiction
pediatrics "vas then taught, to consent to temporary use of a portion of the
new addition as an obstetric ward. This doubled the number of previously
available beds and brought the obstetric patient from the campus to the area
of developing hospital facilities. Although Peterson was grateful for this
improvement, he felt that his patients were on the Palmer Ward only by
sufferance, consequently in November of 1903, he persuaded the medical
faculty to submit a formal request to the University Regents to "grant a
separate house near the hospital for the use of obstetrical patients." The
Regents failed to take action in the matter.
At that time, there was little hope for any department of the University
to obtain improvements requiring financial expenditure without the approval
of James H. Wade, University Secretary, and to quote Peterson, "a watchdog of the University Treasury." Peterson went to Wade with a plea that
obstetric patients be admitted to the hospital free of charge. Wade was
astounded and branded the request as ridiculous, stating that it was quite
sufficient for each student to witness one delivery in the hospital amphitheater. During Wade's illness in 1905, Peterson made a direct appeal to Regent
Charles Lawton, who was at that time Chairman of the Medical Committee
of the Board of Regents. As a result, Peterson was granted authority to admit
certain obstetric patients at no cost to the patient. As soon as Wade recovered
from his illness, he persuaded the Regents to limit the number of free maternity beds to three.
.
A series of recurring epidemics in the hospital involving the gyneco30
•
•
logic patients as well as other surgical patients, prompted consideration of a
separate hospital for contagious diseases. To this end, the University pur'.chased the Penny House on North University Avenue, and the frame struc. 'ture was moved to a site at the rear of the medical ward westernmost of
. three main buildings of the Catherine Street Hospital. However, an alternate plan of erecting an entirely new building for the purpose of housing
_ patients with contagious diseases was also under study, and the Penny
1l...':.house remained vacant for six months after it joined the hospital building
.••.
-, complex. At Peterson's behest, it was remodeled for use as a maternity
.ward at a cost of $335, There was continued uncertainty as to the ultimate
purpose to be served by the building, and it remained unoccupied throughout
the winter and spring of 1905-06. In May, 1906, the Regents reaffirmed
their intent that the remodeled facility serve as a lying-in unit and authorized
purchase of furniture and equipment totalling $1,300. They stipulated,
however, that this sum was to be taken, if possible, from income derived
.from the Bates gift. The employment of four additional nurses was also
approved by the R.egents; however, they ruled that no more than ten
obstetrical patients would be hospitalized at anyone time,
.<
By 1908, the number of deliveries exceeded sixty annually. However,
'during that year, epidemics of scarlet fever resulted in quarantines preventing admittance of new patients to both the obstetric and gynecologic wards
for a protracted period of time. The quarantines, limitations of beds, and a
long waiting list caused many prospective patients to be turned away.
MATERNITY
HOSPITAL.
Used for deliveries and postpartum
1906-1925
31
patients,
Still seeking a solution to the problem of contagious diseases, the University purchased a second frame dwelling in 1908 and moved it to a location just west of the maternity ward. This structure, at the first, remained
empty while officials haggled over the merits and feasibility of erecting a
new building to serve as a contagious hospital. An aggressive Peterson again
took advantage of uncertainty and indecision and presented a plan to the
Hegents whereby the second building could be used to supplement the
maternity ward, providing more facilities for housing patients in earlier
stages of gestation. The plan was accepted, and the newly acquired building was designated as the Maternity Cottage, while the former maternity
ward was renamed Maternity Hospital. In the Maternity Cottage, eighteen
1\1ATERNITY COTTAGE.
Housed prenatal patients, 1908-1925
to twenty patients were always available for demonstrations of abnormal
fetal positions and presentation, and the building housed the University's
first classroom completely devoted to teaching of obstetrics. With acquisition
of the Cottage, the total number of obstetric beds rose to thirty. Success in
maintaining an adequate number of patients was primarily attributable to the
low cost of domiciliary care of prenatal patients. Room and board were $2.50
a week, and the cost could be reduced if the patient assisted in the preparation of bandages and repairing of bed linen. In June, 1910, the obstetric
service was able to report a total of one hundred and one deliveries for the
preceding year.
32
•
•
\iVhen viewed in the perspective of the preceding sixty years, the engement of the physical plant and increase in number of obstetric patients
st'have been viewed by many in a favorable light. From a modern point
view, conditions remained so unsatisfactory, that it hardly seems possible
. could have been endured. Lack of separate facility allowed contagious
ase to constantly threaten inpatients of all services. Peterson himself
cribed both maternity buildings as firetraps. Septic conditions prevailed
11esurgical ward and posed a constant threat to gynecologic patients.
ecame obvious to many that poor initial design and inadequate maintece n~ade infection difficult to control within the hospital confines. Con:9n~.were eased somewhat when a new hospital for contagious diseases,
.ftdfthe Ann Arbor townspeople, opened its doors in ] une of 1914. Gone
e t!!e epidemics and repeated quarantines which had plagued the general
fial wards.
Progress brought additional improvements
to the hospital complex,
t~eUniversity,
but one innovation proved more hindrance than help
'epartment
of Obstetrics and Gynecology. This took the form of a
-line of the Michigan Central Railroad connecting the main track along
Ijuron River to a new University power plant on Washington Street.
-ttackthreaded a path between the Maternity Cottage and the Maternity
spital, and engines pulling loaded coal cars often held up transfer of a
. tient from cottage to hospital. Both buildings were constantly bathed
" arid cinders while whistles, bells and noises peculiar to coupling and
Ul)ling of railroad cars proved highly disturbing to patients.
though the Public Acts had earlier provided a mechanism by which
c care could be purchased for indigent patients from public funds
county level, most obstetric patients came from within a radius of a few
~J.i'\11I1 Arbor. County officials were quite willing to send selected
a~nd
surgical cases to the growing medical center because of a
Ity of skilled physicians in many areas of the state. However, county
9~i,were held accountable for such medical expenditures, and few
pelled to send normal obstetric patients to Ann Arbor several weeks
ths prior to the estimated date of confinement. A slow but steady
CO$i of hospitalization
also acted as a deterrent to the referral of
. (,;)ther services, including gynecology, continued to benefit trec
~lx;"bythe
influx of patients
under
the county referral
system. A
'l~ig.thjn the number of medical and surgical patients resulted in
overcrowding of the hospital. The question often arose as to the
r limiting the number of gynecologic patients, but such restric~'!~r imposed.
15, President Hutchins and Dean Vaughan requested and re-
33
MATERNITY
lIOSPITAL,
1925-1950
ceived from the legislature $1,000,000 for the construction of a new University Hospital. The tenebrous days of \iVorld War I curtailed expansion
of the University's physical plant, and the hospital "vas eventually completed
ten years later at a cost amounting to four times the original appropriation.
When its doors finally opened August 10, 1925, the gynecology wards occupied the third and fourth Hoors of the east wing, while the gynecology outpatient service occupied an area on the first Hoor of the west wing. In the
same year, but prior to the opening of the new hospital, the Eye, Ear, Nose,
and Throat ward, a brick building erected in 1910, was remodeled at a cost
of $20,000 into a maternity hospital with thirty-five adult beds and an outpatient clinic for prenatal patients.
To those of the hosnital
staff associated with obstetrics and gvnecoloO'v,
r
'OJ
1925 was a banner year and morale was high. Years of strugg1e had finally
resulted in hospital facilities worthy of the name. 'To outsiders the gains
must have been even more impressive. In 1926, Peterson entertained members of the Travel Club of the American Gynecological Society. Tea at
Peterson's house was followed by a bus trip to the new hospital. Standing
with Peterson in the front of the bus was Dr. John O. Polak of Brooklyn,
national leader in obstetrics and gynecology. As the vehicle slowly made'its
way up Catherine Street, Peterson pointed out the two old frame buildings,
separated by a railroad track, which had housed the obstetric patients for so
l.//
34
•
•
many years, and recounted the difficulties of the past. Polak asked Peterson
how much the University paid him. Peterson replied, "Four thousand dollars a year. "
Polak snorted, "Reuben, you're a Goddam fool!
In 1903, Peterson established a private hospital at 603 Forest Avenue
in a remodeled fraternity house. Known as the Ann Arbor Private Hospital,
it was used primarily for gynecologic cases, although an occasional delivery
took place as well. By purchase of adjoining property, space was later available to accommodate forty patients, but by this time, the press of responsibilities at the University Hospital resulted in a voluntary curtailment of Peterson's private practice. Peterson also maintained a school of nursing in the
private hospital, and its activities were directed by Peterson and Miss Fantine
Pemberton. When facilities of the University nursing education program
reached a point at which all interested women of the Ann Arbor area could
be accommodated, Peterson and Miss Pemberton discontinued their program, but both continued to be active in education of nurses through University Hospital facilities.
Peterson's instructors assisted him with surgical cases in the private
hospital as well as the University Hospital. Since there was no elevator in
the building, patients were required to climb to the third floor operating
room, and after the procedure, they were carried, blanket-wrapped, back
down two flights of stairs on an assistant's shoulder. The pitch of the old
fashioned staircase was Significantly greater than those of today, and popular
rumor of the 1920's had it that height and strength were Significant advantages to one applying to Peterson for postgraduate training. Grant Baldwin
and Harold Morgan claim they were the first individuals of average size to
receive appointments in many years.
The private hospital, standing apart from the university medical facilities, nestled in a residential area of Ann Arbor. Then as now, some of the
lay people had rather vague notions of the functions and capabilities of specialists in the medical field. One day, as Peterson tied his horse to the hitching post of the Forest Avenue hospital, he was confronted by a breathless
girl with a tear-stained face who said, "Hurry, Dr. Peterson, hurry. My
mommy has tried to get a doctor because my little sister fell and cut herself,
and she's bleeding to death, but she can't find a real doctor, and she told
me to run and fetch Dr. Peterson. Perhaps he would do."
Peterson possessed a fine sense of humor and loved to retell stories
such as the following:
Some time after occupation of the brick maternity hospital, fire razed
one of the adjacent vacant frame buildings which had served as a medical
ward. Sparks from the conflagration showered upon the roof of the maternity
35
hospital, and the latter was evacuated as a precautionary measure. As patients
were moved into the pathology laboratory of the new hospital, confusion
reigned, and fortunately, only one delivery took place during the exodus.
While Peterson was standing in the hall of the maternity hospital, a wideeyed medical student, clutching something in his arms, rushed up to him
and explained in a horrified voice that someone had dropped one of the
babies. Peterson stared in disbelief, and then shook with laughter. The
student had retrieved a mummified fetus retained for the purpose of obstetric demonstrations. In the hasty evacution, it had fallen from its container
of green soap to the ground outside the entrance of the maternity hospital.
Peterson truly pioneered a graded residency program in obstetrics and
gynecology. His residents considered him to be an excellent teacher and a
fair and just individual. His concern for his trainees was deeper than concern for their professional accomplishments. Realizing the dire financial
straits of most postgraduate trainees, Peterson arranged for his senior resident
to participate to a limited extent in private practice to supplement his meager
income from the University. A bicycle was the resident's accepted means of
locomotion for attending home deliveries and making house calls. It was
customary for the senior resident, at the termination of his tenure, to sell
his bicycle to his replacement. Ability to negotiate the ice-coated hilly streets
of Ann Arbor upon a bicycle, rendered even more unstable by a heavy medical hag swaying from the handle bars, was a hallmark of Peterson's residents.
Of the nearly fifty individuals who received training under Peterson, most
became outstanding practitioners of obstetrics and gynecology; and more than
a fourth of his trainees achieved professorial rank in other medical schools.
Peterson emphasized research of a clinical nature and taught his students to learn all that the five senses could impart. He published more than
one hundred and thirty articles and an obstetrics text, A Manual for a Demonstration Course in Obstetrics. The latter had been revised and is in use
today. He was editor or co-editor of three additional textbooks of obstetrics
and gynecology in his earlier years and also wrote a five volume history of
the University Hospital. Even today in his Introduction to Obstetrical Practice, Beck states "the author wishes to acknowledge his appreciation of the
instruction he h8S received from the three great American teachers under
whom it has heen his privilege to have studied, Doctors Reuben Peterson,
J. \Vhitridge Williams, and John Osborne Polak."
Peterson was an outstanding surgeon and had almost uncanny clinical
judgment. For private patients, home delivery was the accepted arrangement
of that period, and when transfusion was necessary, it was carried out in
the hospital directly from donor to recipient through a paraffin-coated can36
•
I
t
I
1
nula. Despite such handicaps, Peterson's record for mortality and morbidity
was an enviable one.
Faculty colleagues recognized Peterson's qualities of vision and leadership. His wisdom and guidance were often sought in non-medical affairs,
and he served as Medical Director of the University Hospital as well as
Executive Officer of the Hospital's Executive Committee from 1913 to
1920, in addition to administering the affairs of his own department. His
rerception of trends in clinical practice and medical education are documented by statements made forty-three years apart. The first was occasioned
by his address on gynecology to the Michigan Medical Society in 1896.
Peterson asked, "Who can predict the mighty advances in gynecology and
abdominal surgery which the one hundredth anniversary of the American
Medical Association will reveal? During the past half century these two
branches of our science have been revolutionized chiefly, I am happy to say,
through the genius and industry of American physicians. It is not beyond the
realm of possibility that these same qualities, directed toward solutions of
problems in preventive medicine, will again revolutionize these departments
in the next fifty years."
Between this statement and the hundredth anniversary of the American Medical Association in 1947, truly remarkable progress was made in
many aspects of preventive medicine.
Separation of the basic sciences from the hospital facilities "vas of concern to Dr. Peterson and, nearing the end of his years in 1939 he asked, "Is
it too much to hope that the next step in advance (of the Medical School)
will be a complete medical unit situated on the bluffs overlooking the
Huron River?"
In those austere days of the University, it was indeed prophetic that
Peterson's dream "vas to be realized only twenty years later.
Peterson retired from academic life in 1931 at the age of sixty-nine.
f-Ie returned to his native Massachusetts to be at Powder Point, Duxburyby-the-Sea. He became town historian and was active in community affairs.
In 1936, he returned once again to Ann Arbor to receive an honorary degree
of Doctor of Science from the institution he had served for thirty years.
At this time, despite failing health, he retained his poise and sense of humor,
delighting listeners by recounting his earlier experiences. This was to be his
last visit. Failing health confined him to his home, and a proposed reunion
of former residents to be held in his native town had to be cancelled when
word was received of his death on November 25, 1942, at the age of eighty.
37
..........•.
_ _
.. ....•..
_------------------
NOR:rv1AN FRITZ MILLER
•
•
Chapter V
Peterson's successor as Chairman of the Department of Obstetrics and
Gynecology and Bates Professor of Diseases of Women and Children was
Norman Fritz Miller.
Miller was born in Iron Mountain, Michigan, August 14, 1894. He
attended the University of Michigan for undergraduate and medical education, receiving his medical degree in 1920. After four additional years of
training under Peterson, he was appointed as Assistant Professor in the Department, the fourth individual to achieve that rank. Peterson was quick to
recognize Miller's attributes, and saw in him the qualities of an academic
leader.
On one occasion, during the financially lean years of training under
Peterson, Miller received a call from an Ann Arbor practitioner requesting
that he see a patient for this physician and was offered the then munilicient
sum of $5.00. Miller saw the patient, but refused the fee knowing that
Peterson did not approve of this form of remuneration. In some manner, the
story reached Peterson who remarked on it at a much later date, stating that
among all the qualities of his staff, such loyalty was the most valuable. Miller
was to see the same loyalty returned many times by a host of individuals in
the following years.
In 1926, Miller was about to leave Ann Arbor to visit Rochester, New
York, where he had been offered an academic post. Just prior to his departure,
Miller received a visit from E. D. Plass of Detroit. Plass was soon to assume
new duties at the State University of Iowa Medical School and wanted
Miller to accompany him. Miller was appointed Associate Professor of Obstetrics and Gynecology in 1926 and was advanced to the rank of Professor
in 1928. He remained at Iowa until 1931, returning to Ann Arbor upon
Peterson's retirement.
Miller found the residency program well established, with most individuals remaining for three or four years after an internship. Carl P. Huber,
G. A. Carmichael, Walter Belser, and George Sehring were trainees spanning the Peterson-Miller era in 1931. The gynecology service was comfortably housed in the new University Hospital. However, the maternity hospital
to be known by all the staff in years to come as "Old Maty," was already an
inadequate facility at the beginning of Miller's tenure as department chairman.
39
Hidden behind the red bricks of West Hospital and accessible only
by an improbable road in constant need of repair, Old Maty became a
monument to the patience of the staff and the loyalty of the patients. The
poorly designed entrance allowed the Hoor of the front hall to became a
harbinger of the seasons. Bits of dried leaves scurried over the surface in the
fall, while traces of snow could be found on wintry days. In the summer,
small pools of water nestled in the sagging areas and gave rise to vapor in the
steaming heat. Spring resulted in caked mud from wall to wall. The temperature of the building, although as variable as the weather, seldom bore any relationship to it. The heating plant was unpredictable and recalcitrant. On
cold days it often failed to produce sufficient heat to warm the building, but
it had a penchant for working at peak efficiency during the hottest days of
summer.
The first Hoorhad a scattering of offices, examining rooms, a laboratory,
and a classroom. The smell of urine pervaded the area and defied any combination of window raising and lowering. The classroom provided the only
view from the first Hoor,its windows looking north across the river. In spring,
instructors were often discouraged to find students tending budding leaves
and green vistas while pearls of wisdom fell unnoticed.
The second Hoor "vas accessible to the timid by a circular iron staircase,
while a balky elevator served the bold and parturient. On the immediate right
were two labor rooms, two delivery rooms, and a battery of sterilizers, the
latter conspiring with the heating system to elevate temperatures in the
summer. A large portion of each delivery room was occupied by bleachers
of wood and pipe scaffolding which were commonly occupied by medical
students and student nurses. To the left was a large antepartum ward occupied by unwed mothers, fulminating toxemias, a septic postpartum patient
or two, and occasionally, by an overHow of uncomplicated postpartum patients. Between the large ward and the labor rooms was an extra hall with
four adjoining postpartum rooms for individual patients. These were reputedly so small that medical personnel could not enter the room unless the
patient was in bed.
.
The third Hoor contained the nursery and the postpartum Hoor, while
the intern lived on the fourth Hoor. There 'were many little cubbyholes
beneath the eaves containing beds, a table for infrequent caesarean sections,
and odds and ends of research equipment abandoned by residents of bygone
days.
Although a natural trend of many years had found a decreasing popularity of home deliveries, there was little in the physical accoutrements of
Old Maty to attract the patient from the Ann Arbor area. To make matters
worse, a state legislature act of 1933 shifted the medical responsibility for
40
•
•
many categories of patients from University Hospital to local units. Among
these 'were some types of obstetriC patIents.
The need for a new maternity hospital had been recognized by Peterson, but it fell upon Miller's shoulders to wage a protracted battle to provide
up-to-date facilities. The campaign was launched in the early 1930's. A
grant of $25,000 was obtained from the Kellogg Foundation to draw plans
for a new maternity hospital and a new children's hospital. The plans were
completed, but the death of Doctor Pritchard, at that time chairman of the
Foundation's Board of Directors, removed a sympathetic ally and no further
help was obtained from this source. Miller carried his efforts to the classroom, and for years made it a point to describe the need for a new hospital
to each group of junior medical students receiving instruction in obstetrics
and gynecology. A series of newspaper articles focused public attention upon
the problems of Old Maty. The campaign mounted in intensity and culminated in an evening meeting in Ann Arbor's Allene1 Hotel between Miller,
Octavius Furstenberg, then Dean of the Medical School, and Clarence Reed,
an influential state senator from Detroit. Miller had hoped to win legislative
sympathy by this direct appeal to a legislative representative. Although Reed
exhibited interest in the problems, word of the meeting reached University
administrative officials. Miller was reprimanded for bypassing the administration in his legislative contact, but the incident emphasized the needs within
university circles, and thereafter a new maternity hospital was included in
university planning. America's entry into \iVorld \iVaI II barred any hope
for immediate construction of a new hospital, but at the war's conc1usion,
Miller campaigned with even greater intensity.
In 1946, Governor Kim Sigler toured Old Maty with Miller and
Furstenberg. As the three entered the main entrance, they were met by a
flotilla of garbage cans being pushed from the elevator to the front door.
Although denied by Miller, many say that the encounter was not a result
of chance alone. During Sigler's tour, a male infant was born, and the
mother chose to name him Kim. It is somewhat more difficult to imazine
Miller's complicity in this. Shortly after the visit, Miller was invited to
Lansing to discuss the matter of a new maternity hospital. Thinking he
would be meeting only with the governor and a few legislators, Miller
was surprised to find the governor's office fiUed with newsmen and photographers. ~e!zing t~e .opp.ortunity, Miller dramatically described the deplorable con~ltlOns eXlstmg mOld Maty, even detailing the periodic necessity
for shootmg rats that scrambled across the driveway to the entrance.
In January, 194~ the legislature placed a new maternity hospital in
category B of construction priority, indicating that money was not available for construction at that time. A few weeks later, $100,000 was appro41
\VOMEN'S
HOSPITAL
priated to start the hospital, and steam shovels started breaking ground
March 21, 1947, at a site east of and below the main hospital building. It
was hoped that the new hospital would be completed during 1948. Work
progressed rapidly until April 19: On that day an order to cease construction was received. A shocked and saddened staff watched bulldozers fill the
excavations which were now deemed a hazard. Early in 1948, the State
Legislature voted a special appropriation of $1,650,000 fora new Women's
Hospital, and construction began anew in June of that year. The building
was completed in twenty months and was occupied on Valentine's Day, 1950.
The new unit was originally designed to serve completely as maternity
hospital. The second floor contained the labor and delivery suite as well as
facilities for thirty-one adult patients and fifty-two infants. The third floor
was constructed to harbor forty-six adults and thirty newborns. On the
fourth floor were sleeping and lounge facilities for staff use. The first floor
included offices for staff and administration as well as classroom, conference
room, student lounge, outpatient clinic, and a complete X-ray unit. In the
basement were housekeeping and food service facilities, locker rooms and
space for the development of the Reuben Peterson Memorial Laboratory.
The paint was hardly dry before transfer of patients from Old Maty
to the new hospital was begun. Even the wives and children of the staff
42
•
DEPARTMENT
OF OBSTETRICS
UNIVERSITY
AND GYNECOLOGY
OF MICHIGAN
1850-1963
Abram Sager
Edward S. Dunster
James N. Martin
James G. Lynds
Casper K. Lahuis
Clara A. O. Dedrick
John J. Mersen
Reuben Peterson
George R. Pray
T. S. Burr
William H. Morley
Ralph L. Morse
R. L. Parmeter
C. L. Patton
A. P. Reed
Christopher G. Parnell
H. S. McGee
Samuel R. Haythorne
Melvin K. Signor
E. P. Billings
Frank C. Witter
George Kamperman
Neil N. 'Vood
R. C. Leland
L. H. S. DeWitt
Howard H. Cummings
Ward F. Seeley
Frederic M. Loomis
Rudolph A. Bartholomew
Leslie L. Bottsford
John \iV. Sherrick
Harold Henderson
Roland S. Cron
1850-1874
1874-1888
1888-1901
1888
1901-1931
1901-1903
1901-1904
1901-1903
1902-1904
1903-1904
1903-1905
1903-1904
1904-1906
1904-1906
1904-1906
1905-]907
1906-]908
]906-]909
]904-1912
1908-1911
1909-1910
1910-1914
1910-1913
191]-1915
1912-1916
1913-1917
1914-1920
1915-1917
1916-1918
1917-1918
1905-1907
1919-1922
1919-1923
48
•
R. VV. Shelley
Lucy M. Elliott
M. D. Haag
Theodore W. Adams
Norman F. Miller
Lewis E. Daniels
William H. Rumpf
James M. Pierce
Lawrence E. McCaffrey
Harold A. Furlong
James V. Campbell
Harold S. Morgan
L. Grant Baldwin
Ralph G. Hubbard
Norman R. Kretzschmar
Robert W. Wilkins
John vv. Kemper
Glenn A. Carmichael
Carl P. Huber
Walter Belser
George H. Sehring
David C. Kimball
Robert G. Dalby
Woodburne K. Lamb
Paul W. Winder
James 1. Gillard
Ferdinand Gaensbauer
James T. Bradbury
F. \.\1. Tamblyn
Richard D. Reekie
Clair E. Folsome
Joseph Kurez
Oliver E. Todd
Russell Malcom
Sprague H. Gardiner
wnu, E. Brown
Russell R. DeAlvarez
Frederick W. Bald
Earl L. Hall
James o. H. Sirnrall
Charles B. Darner
1918-1920
1918-1919
1918-1921
1919-1924
1919-1926
1920-1925
1921-1926
1923-1931
1923-1927
1924-1929
1925-1929
1925-1930
1925-1930
1926-1928
1926-1931
1927-1931
1927-1929
1928-1931
1928-1936
1929-1931
1929-1931
1931-1935
1931-1935
1931-1935
1931-1935
1932-1936
1932-1937
1932-1940
1933-1934
1933-1937
1933-1941
1934-1935
1934-1938
1935-1936
1935-1939
1935-1940
1935-1944
1936-1936
1936-1940
1937-1940
1937-1941
49
1931-1964
J. Hobert Willson
Harry N. Jurow
Allan C. Barnes
Heynold L. Haas
David C. Baker
F. Jackson Stoddard
Charles W. Newton
Halph S. Steffe
Harry
A Lusk
George J. Andros
Charles 'vv. Henderson
Gardiner M. Riley
Janet M. Boog
Charles W. Aldridge
Charles H. Hendricks
Donald A Pollock
Joan C. Stryker
Tommy N. Evans
James S. Krieger
Charles E. Lemen
Charles E. Lewis
Alexander 'vv. Makepeace
Max A Parrot
Robert M. Campbell
S. Clifford
Henry L. Tieche
Donald J. Droulett
John McNichols
James 1. Collins
Robert W. Muenzer
George R. Thompson
\Valter R. Johnson
Norman L. Banghart
James B. Peery
Samuel J. Behrman
Robert L. Range
A Gordon Reynolds
Wallace C. Stout
George \V. Morley
Melvin D. Bivens
Edmond S. Botch
v:
1964-
1937-1942
1938-1942
1938-1942
1938-1955
1939-1943
1939-1944
1940-]945
1940-1942
1940-1942
1941-1945
1942-1946
1942-1965
1943-1944
1943-1945
1943-1946
1944-1946
1945-1948
1945-1946
1945-1946
1945-1946
1946-1947
1946-1947
1946-1949
1946-1949
1946-1950
1946-1950
1947-1948
1947-1948
1947-1948
1947-1951
1947-1952
1947-1952
1948-1953
1948-1951
1948-1949
1949-1952
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1949-1954
1949-1954
1950-1953
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1946-1947
1946-1948
1949-1951
1947-1949
1954-1956
1948-1966
1948-1950
1953-1954
19501952-1955
1956-
50
•
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•.
Harry C. George
Warren H. Pearse
John R. G. Gosling
George S. Sayre
Richard W. Stander
Peter P. Ludovici
William A. Kretzschmar
David Standiford
Morris P. Wearing
Richard J. McMurray
Edward B. Leverich
Edwin E. Morev~
Frank Shubeck
David G. Anderson
Henry E. Malcolm
. John R. McAvoy
Jack L. Court
Richard A. Kutcipal
James H. Poppy
Theron D. Loughrin
Crosby J. Eaton
\iVi1Jiam R. Forsythe
Wallace G. Pearson
Hobert II. Messer
Louis Helder
F. Wallace Jeffries
Robert M. Kretzschmar
lames P. Youngblood
Robert P. Bushell
John C. Parker
Bernhardt Pederson
Edwin P. Peterson
Roger vV. Postmus
Harold E. Sanford, Jr.
Joseph F. Betts
Abbas Bolandgray
Andrew J. Krapohl
David H. Middleton
Frank J. Schrader
Charles D. Allen
Arthur S. Haight
1950-1955
1950-1953
1950-1953
1951-1953
1951-1957
1951-1965
1951-1953
1952-1957
1953-1954
1953-1955
1953-1957
1953-1955
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19611962-1964
1962-1963
1962-1964
51
1955-1956
1955-
1955-1958
1957-1960
1957-
1961-1963
1967-
1968-
Buell A. Miller
Marvin E. Schrock
Jack Ford
Jan Schneider
Bern Marshall
Fredrick Bald
Bruce Work
David Youngs
Jack Caskey
1962-1966
1962-1966
1962-1966
19621963-1967
1963-1967
19631963-1965
1963-1967
52
•

Obstetrics, Gynecology, and the University of Michigan by Stander

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