The Armed Forces Institute
of Pathology
The Armed Forces Institute of Pathology
The Armed Forces Institute
of Pathology
Its First Century
1862-1962
by
Robert S. Henry, A.B., LL.B., Litt.D.
OFFICE OF THE SURGEON GENERAL
DEPARTMENT OF THE ARMY
WASHINGTON, D.C., 1964
THE ARMED FORCES INSTITUTE
OF PATHOLOGY
Advisory Editorial Board
Colonel John Boyd Coates, Jr., MC, USA, Chairman
Colonel James E. Ash, MC, USA (Ret.)
Brigadier General George R. Callender, USA (Ret.)
Brigadier General Raymond O. Dart, USA (Ret.)
Major General Elbert DeCoursey, USA (Ret.)
Howard T. Karsner, M.D.
Rear Admiral William M. Silliphant, USN (Ret.)
Library of Congress Catalog Card Number: 63-60060
For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402 - Price $4.25 (Buckram)
Foreword
As the Armed Forces Institute of Pathology approached its centennial year
in nineteen hundred and sixty-two, it seemed appropriate to pause for a brief
recapitulation of its accomplishments during its first one hundred years. To
this end, a fitting ceremony was held in November 1962 to mark this event.
The program was further enhanced by a 2-day scientific program that not only
summed up what had been accomplished in the past but attempted to glimpse
the future of the study of disease.
In addition to holding these programs, it was considered that the completion
of the first century of the Institute would also be an appropriate time to compile
a more detailed study of the people and events that had made the Institute
one of the Nation's leading scientific institutions from its very inception. With
the approval of the Board of Governors, the Surgeons General of the Army,
Navy, and Air Force, and with the assistance of the staff of the Institute, its
Scientific Advisory Board, and the Institute's many devoted consultants, a
project to compile a history was initiated. The assistance and support of The
Historical Unit, U.S. Army Medical Service, and of The Surgeon General of
the Army were requested, and they enthusiastically joined in the effort to assem-
ble this record. The role of The Historical Unit in the compilation of this
volume is but a continuation of the long and intimate association of this Unit
and the Institute. One of the two original missions of the Army Medical
Museum, the forerunner of this Institute, was to prepare the great "Medical
and Surgical History of the War of the Rebellion," the other being "to collect
and to forward to the Office of the Surgeon General, all specimens of morbid
anatomy, surgical or medical, which may be regarded as valuable; together
with projectile and foreign bodies removed, and such other matters as may
prove of interest in the study of military medicine or surgery." This first effort
of The Historical Unit, while it was still an integral part of the Army Medical
Museum, moved Rudolf Virchow, the great German pathologist and the father
of modern pathology, to comment, "From this time dates a new era in military
science. Whoever reads these publications will be constantly astonished at the
wealth of experience, the exactness of detail, the careful statistics and scholarly
Vi FOREWORD
statements embracing all sides of medical experience which preserve to pos-
terity the knowledge bought at so vast an expense."
With the passage of time, The Historical Unit became a separate organiza-
tion. The Army Medical Museum kept its original name until after World
War II when, in 1946, it was deemed appropriate to rename it the Army Insti-
tute of Pathology. At this time, the Scientific Advisory Board was organized.
Through the years since then, the dedication of the outstanding scientists who
have served on the Board has been a landmark of strength to the Institute in
the guidance of its professional developments.
In 1949, the U.S. Navy and Air Force joined forces with the Army, so that
the Institute became a total effort of the armed services under the executive
management of The Surgeon General of the Army and the Secretary of the
Army. It was redesignated the Armed Forces Institute of Pathology.
Through the years, many curators and directors and the staff of the
Museum-Institute had a continued interest in, and intuition of, the history that
they were making. Documents and records were carefully prepared and pre-
served. From the outset, the Institute played a leading role in national medical
developments as well as being an integral part of the Washington medical
scene. Its close association, throughout its history, with the medical schools
of George Washington University, Howard University, and Georgetown Uni-
versity attest to its leadership in medical affairs of the area. From its beginning,
the value of the Institute as a means of instruction of young military physicians
was apparent. A photographic department was added to the Museum in 1863,
and the pioneer work in America in medical photography and photomicrogra-
phy was accomplished by the Museum staff.
From its early days, the Museum-Institute had been housed with the Army
Surgeon General's Library, and the two remained under the same roof until
1955, when the latter, after a brief period as the Armed Forces Medical Library,
became the National Library of Medicine. At the same time, the Institute
acquired new quarters at the Walter Reed Army Medical Center. The location
of the Institute at this great medical facility seemed appropriate, since Walter
Reed had been for almost a decade, until his death in 1902, Curator of the
Medical Museum. It was during his tenure that the Army Medical School was
formed in the Museum building. In 1910, the School secured quarters of its
own and eventually grew to become the great institution known today as the
Walter Reed Army Institute of Research.
Out of World War I came the impetus for the training of pathologists
and the growth of pathology in the United States to the status of world emi-
FOREWORD VII
nence this country has in this field in the present day. World War II saw the
Museum as the leader in bringing about the standardization of diagnoses and
teaching methods in pathology that has enhanced the science of the study of
disease in the past two decades.
The Institute's close relationship with civilian medicine also has origins
in the very beginning of the Museum. The first formal arrangement between
the Museum and civilian medicine took place in 1895, when the American
Dental Association adopted the Museum as a repository for study materials in
the field of dentistry. The next great step was the founding of the American
Registry of Ophthalmology in 1921. The establishment of the American Reg-
istry of Pathology under the auspices of the National Academy of Sciences-
National Research Council and the Museum in 1933 gave signal impetus to the
registry movement, and by the end of the centennial year in 1962 the number
of Registries had grown to 27.
Following World War I, the Museum also became the repository for the
material from the Veterans' Administration hospitals. This was discontinued
in 1929, but after World War II the Veterans' Administration designated the
Armed Forces Institute of Pathology as its "Central Laboratory for Anatomic
Pathology and Research." Since that time, the Veterans' Administration has
played a key role in the affairs of the Institute. Its employees make up a portion
of the professional, technical, and clerical staff. This liaison between the Armed
Forces and the Veterans' Administration permits former patients to be fol-
lowed after they leave the service and greatly enhances the repository of case
material available to the Institute. Through the aegis of the American Registry
of Pathology, civilian pathologists also contribute cases to the Institute files
that are valuable in filling gaps in the overall knowledge of disease; this infor-
mation cannot be acquired from the military population alone. Beginning
with the work of Walter Reed and the Museum staff in the 1890's on yellow
fever, the Institute has had a continued interest in tropical diseases and other
disease entities that occur throughout the world. This collection of material
was invaluable in the beginning of World War II in the preparation of manuals
and textbooks used in the training of physicians who were to accompany our
troops to the remote corners of the earth during that conflict. The Institute
has continued this interest in global medicine, with members of its staff collect-
ing material from all corners of the world. Contributions of cases by patholo-
gists of other countries have added significantly to the collection of disease
entities, which now exceeds one million cases. From this vast storehouse of
Viii FOREWORD
cases, much teaching material is prepared and made available for loan to gov-
ernmental and nongovernmental pathologists.
Starting soon after World War II, the Institute embarked on the publication
of the fascicles of the "Atlas of Tumor Pathology," in conjunction with the
Division of Medical Sciences of the National Research Council and, specifically,
the Committee on Pathology and its Subcommittee on Oncology. To date,
some 33 of the 39 fascicles of the Atlas have been completed and are available
at nominal cost through the American Registry of Pathology. These fascicles
have been enthusiastically received by pathologists throughout the world. It
is through the fascicles that the Armed Forces Institute of Pathology is known
by practically every pathologist and other medical workers in all countries.
While the authors of these fascicles are outstanding authorities throughout the
United States and the United Kingdom, it has only been through the efforts
of the staff of the Institute, the American Registry of Pathology, the Institute's
Medical Illustration Service, and the National Research Council that the
publication and dissemination of the fascicles has been made possible.
With the designation of the Institute as an Armed Forces activity, the U.S.
Public Health Service also began to play an active role in the Institute and has
had pathologists assigned to the staff since that time. This Public Health
Service participation was endorsed during the centennial year with the estab-
lishment of the Radiation Pathology Registry ; additional financial and personnel
support was given to this important endeavor so vital within the framework
of the Institute's organization.
The greatest problem that confronted the Institute and The Historical
Unit in beginning the compilation of this history of the Museum-Institute was
securing an author who could sift through the mountain of records and other
historical material that would tell the story of the organization. It was desired
that the story be told in such a manner that it would have appeal to the lay
reader but still preserve the scientific content. In Robert Selph Henry, Litt.D.,
of Alexandria, Virginia, such a man was found. Dr. Henry is one of the
leading American historians and famed for his writings of the Mexican War
and the American Civil War. He is a man of varied interests who has served
many years as Vice President of the Association of American Railroads and has
prepared numerous treatises on railroading. In addition to being a member
of the Board of Regents of Vanderbilt University, his alma mater, Dr. Henry
was also one of the consultants in the preparation of the third edition of
"Webster's New International Dictionary." Within a brief period of 2 years,
Dr. Henry sorted through the voluminous document file of the Institute and
FOREWORD IX
many other varied sources, and this book is a testimony to his ability to recognize
the high points of the story of the Institute during its one hundred years of
existence. Of necessity, attention had to be given to routine coming and going
of personnel and other administrative changes that are a part of the story of
any organization. He has maintained reader interest with accounts of in-
dividual accomplishment, and with many vignettes that lend fascination to
the narration and make events of the past come alive.
This brief look back over the century seems a fitting milepost and spring-
board for this unique organization as it enters its second hundred years. With
its ever-expanding program of research, education, and consultation, the Institute
gives promise of being of even greater service to the Armed Forces and to the
Nation in the years to come. As the century from the 1860's to the 1960's can
be classified as the era of cellular pathology, so can the next few decades be
expected to see the development of studies within the cell, or so-called molecular
pathology. With its rich heritage from the past, the Institute today finds itself
in the forefront of these newer developments. A glimpse into the future is
revealed in the last chapter of Dr. Henry's history. One can be sure that the
record of the past will serve as an inspiration to those individuals responsible
in the future for the destiny of the Armed Forces Institute of Pathology and
its important role in advancing military medicine.
Leonard D. Heaton,
Lieutenant General,
The Surgeon General.
713-028'— 64-
Preface
In the preparation of this book, I have had so much assistance and so many
kindnesses from so many persons that I despair of making suitable acknowledg-
ment to all to whom it is due.
First and foremost, I am deeply obliged to the Director of the Armed
Forces Institute of Pathology, Col. Frank M. Townsend, U.S. Air Force, MC;
to the Deputy Directors, Col. Joe M. Blumberg, MC, U.S. Army, and Capt.
Roger H. Fuller, MC, U.S. Navy; and to the Scientific Director of the Institute,
Dr. Robert E. Stowell. They have provided every facility and all possible
assistance for the work.
Especially appreciated was the establishment of an Advisory Editorial
Board, with Col. John Boyd Coates, Jr., MC, USA, Director of The Historical
Unit, U.S. Army Medical Service, as chairman, and the following membership :
Col. James E. Ash, MC, USA (Ret.)
Brig. Gen. George R. Callender, USA (Ret.)
Brig. Gen. Raymond O. Dart, USA (Ret.)
Maj. Gen. Elbert DeCoursey, USA (Ret.)
Howard T. Karsner, M.D.
Rear Adm. William M. Silliphant, USN (Ret.)
Whatever merit this book has is due in no small degree to the counsel and
guidance received from the members of this Board.
All departments, divisions, and branches of the Institute have helped in the
preparation of the book, but special thanks are due Mr. Herman Van Cott,
Chief of the Medical Illustration Service, and his staff, including Mr. Herbert
C. Kluge, who rendered special service in going through the voluminous pic-
torial records of the Illustration Service and finding many of the photographs
which are used.
Special thanks are due, also, to the staff of the Medical Museum, where most
of the material for the volume was located and where most of the writing was
done. Col. Albert E. Minns, Jr., MSC, USA (Ret.), Curator of the Museum
when work on the book was started, and his successor, Col. John W. Sheridan,
MSC, USA, have done all in their power to facilitate the work.
X1I PREFACE
In the processing of the manuscript, the Executive Officer of the Institute,
Lt. Col. Vernon S. Oettinger, MSC, USA, and the Adjutant, Lt. Col. Russell Z.
Seidel, MSC, USA, and their staff have been most helpful, for which I am
grateful.
The services of the Institutes' Ash Library and its Librarian, Mrs. Ruth
Haggerty, have been numerous and varied, and are gratefully acknowledged,
as are the services of the secretarial pool and the Reproduction Division of the
Institute.
The Library of Congress, the National Archives of the United States, the
National Library of Medicine, and The Historical Unit of the U.S. Army
Medical Service have obligingly responded to every call for information and
assistance.
I am particularly grateful to Dr. Esmond R. Long, author of "A History of
Pathology," published in 1928, and "A History of American Pathology," pub-
lished in 1962, for permission to quote from his books, and for his interest in
the development of this book.
Thanks are also due to Dr. W. Montague Cobb, professor and head of the
Department of Anatomy of the College of Medicine of Howard University, for
information concerning Dr. Daniel Smith Lamb's connection with that
institution.
Among the many individuals who have been helpful in the writing of this
book, to all of whom I am grateful, there are a few whom I must mention with
special appreciation: Mrs. Gwendolyn M. Evans, Mrs. Ida P. Gaylin, Miss
Betty Krulack, Mrs. Genevieve Overmyer, Miss Helen R. Purtle, Mrs. Esther M.
Stone, Miss Cleo A. Warren, M. Sgt. Julia S. Williams, Mr. H. E. Demick, Mr.
Gordon T. Harrell, Mr. Myron Miller, Mr. James B. Smith, and Sgt. Bennett
W. Thompson.
Finally, I am deeply indebted to my associate in this work, Mr. Samuel
Kier, Research Historian of the Institute, who has been most helpful in the or-
ganization and writing of this book, and to Mrs. Cyrilla E. Hickey, Editor, of
the Editorial Branch, The Historical Unit, U.S. Army Medical Service, who has
shepherded the manuscript through the press.
Robert S. Henry
Contents
Pag,
FOREWORD V
PREFACE XI
Chapter
I. The Institute and Its Ancestry 1
The Threefold Mission 1
The American Registry of Pathology 2
"Unique in the World" 5
II. Background and Beginnings
Some Medical Problems of the 1860's 8
A New Surgeon General 9
The Scientific Approach 11
The First Curator 13
Collecting Specimens 17
New Quarters for the Museum 23
Grounds for Anxiety 26
Plans for an Army Medical School 28
The Museum's Collections Grow 29
Hammond in Exile 30
The Second Curator 32
Reorganization of the Museum 32
Pioneering in Microscopy 34
Woodward, Curtis, and the Camera 36
The Museum and the Lincoln Tragedy 41
III. Second Wind 51
Supply and Funding for the Museum 51
Increasing Activities of the Museum 53
The Museum's Fourth Home 54
Praise from Foreign Visitors 60
The Museum and the Medical Profession 63
The Museum and the Congress in the 1870's 63
Enlarging the Aims of the Museum 65
Varied Uses of the Museum 66
Scientific Skepticism as to Bacteria 66
The Third Curator 68
The Museum and the Garfield Tragedy 68
xnt
Xiv CONTENTS
Chapter Pagt
IV. Broadening the Base 73
Inadequate Quarters 73
Support From the Medical Profession 76
A New Surgeon General Presses for a New Building 77
Objections to Proposed New Building 78
John Shaw Billings Becomes Curator 79
The Museum Moves 82
A Shift in Emphasis 84
The "Old" and the "New" Museums 84
Dr. Billings' Appraisal 85
V. An Ending and A Beginning 89
The Museum and the Army Medical School 90
Walter Reed, Curator 93
Problems With Space 95
The Prime Source of Specimens 98
Bacteriology and Roentgen Rays at the Museum 100
Services of Dr. Billings 101
Animal Experimentation at the Museum 103
The Spanish-American War 105
VI. The Walter Reed Chapter 107
Yellow Fever Epidemics 107
Studies on Transmission 109
The Yellow Fever Board at Work 112
Dr. Finlay's Mosquito Theory 118
Human "Guinea Pigs" 119
The Death of Dr. Lazear 1 20
Studies at Camp Lazear 122
Soldier Volunteers 124
Testing the " Fomites" Theory 125
Transmission by Mosquitoes Established 127
Search for a Cause 130
Nil. Triumph Over Typhoid 133
Typhoid and the Medical Museum 134
The Typhoid Board's Report 135
A New " Villain"— The Fly 137
Changes in the Museum Command 139
Volunteers for Vaccination Against Typhoid 139
European Experience 142
Compulsory Vaccination Introduced 143
CONTENTS XV
Chapter P"gi
VIII. The "Pickle Factory" Period 147
The Army Medical School Moves Out 148
Changes at the Museum 150
Changes in Classification 153
The Devotion of Dr. Lamb 156
IX. The Museum in a World at War 159
Making Pathologists in a Hurry 160
Dr. James Ewing's Mission 161
The Autopsy Question 162
Procurement of Specimens 163
Two Museums in One 165
Launching the Movement for a New Building 167
Applying the Graphic Arts to Medicine 170
Motion Pictures 171
Pictures as Training Methods 174
Use of Animated Drawings 176
The Museum Goes Abroad 179
Necropsy Service in the AEF 180
Medical Photography in the AEF 183
The Museum's Major Aim 186
X. The Institute Idea 189
The First Practicing Pathologist to Become Curator 191
Space Problem Intensified 191
Plans for a Great Medical Center 194
American Registry of Pathology 197
Working in a New Direction 198
Varied New Activities of the Museum 201
Possible Courses of Action 203
XL The Registry Movement 207
Objective of the Registry 209
Organized Civilian Cooperation 212
Histopathology and the Museum 214
Inescapable Housekeeping 216
The Museum at Threescore Years and Ten 218
The Dental and Oral Registry 220
More Registries Formed 221
Publications of the Registries 222
Advantages of the Registry System 224
XVI CONTENTS
Chapter
XII. Between the Wars 227
Deterioration at the Museum 228
Inadequate Space, Insufficient Personnel 230
Working Under Handicaps 231
The Edgar Bequest 234
Gaining Ground 235
Prospects for a New Home 236
A New Building— Where and When? 239
Action Delayed 241
XIII. Pathology Worldwide 245
Regional Centers for Histopathology . 246
Increase in Personnel 249
A New Name for a New Organization 250
Scientific Investigations 251
The Attack on Tropical Diseases 254
Use of Materials for the Study of Pathology 256
Study Sets 257
The Army Medical Illustration Service 259
Storage of Museum Collections 264
Veterans' Administration and the Museum 265
Words of Appreciation 267
XIV. The Immediate, Imperative Objective 269
Continued Efforts To Get a New Building 270
Changes in Role of the Museum 271
Problems of Location 272
Building Plans Reviewed 277
Scientific Advisory Board of the AFIP 280
The Hawley Board 283
XV. New Name, New Home, New Responsibilities 287
Legislative Tangles 289
Congressional Hearings 289
A Bomb-Resistant Structure 292
Going Ahead on the New Building 293
Breaking Ground 295
Laying the Cornerstone 302
Dedication 307
XVI. Carrying On in the "Old Red Brick" 3J1
The Cooney Committee 315
Atomic Bomb Research Unit 318
Atlas of Tumor Pathology 320
CONTENTS XVII
Chapter Page
XVI. Carrying On in the "Old Red Brick" — Continued
The American Registry 324
The Medical Illustration Service 326
Rebirth of the Medical Museum 330
Research Programs 332
TriService Administration 334
XVII. Life in the New Building 337
Shortage of Space 344
Expanded Facilities and Services 346
Program of Education 351
The American Registry of Pathology 356
The Medical Illustration Service 357
Television 361
The Museum's Movements 366
International Efforts 369
Aerospace Pathology 371
XVIII. Into the Second Century 373
Organization 373
The Four Departments 377
Extramural Monetary Support 386
Scope of the Institute's Activities 390
Emphasis on Research 391
APPENDIXES
A. A Chronologic Synopsis of Events 395
B. Board of Governors, Armed Forces Institute of Pathology 403
C. Scientific Advisory Board Members, Armed Forces Institute of Path-
ology 405
index 407
Illustrations
"Figure
1. Brig. Gen. William Alexander Hammond, The Surgeon General, U.S.
Army, 1862-1864 10
2. Circular No. 2, Surgeon General's Office, 21 May 1862 12
3. Circular No. 5, Surgeon General's Office, 9 June 1862 14
4. Group of U.S. Army medical officers prominent in the history of the
Army Medical Museum and the Library of The Surgeon General . . . 15
5. Maj. John Hill Brinton, U.S. Volunteers, first Curator of the Army
Medical Museum, 1862-1864 16
xvm CONTENTS
6. Surgeon John H. Brinton, with a group of Union Army officers in the
field 18
7. A page from the first Catalogue of the Army Medical Museum. ... 21
8. The first home of the Museum
9. The second home of the Museum
10. The third home of the Museum
11. The "Incredible" General Sickles and his leg bones 31
12. Lt. Col. George A. Otis, the second Curator of the Army Medical
Museum, 1864-1881 33
13. Lt. Col. Joseph J. Woodward, MC 35
14. Maj. Edward Curtis, U.S. Volunteers 37
15- Photomicrography spreads
16. Pioneer photomicrography
17- Photomicrography by artificial light 42
18. Diatom, a form of unicellular life of microscopic size, magnified by 2,540
diameters 43
19. Bullet that ended President Lincoln's life, instrument used to locate i t, and
bone fragments which adhered to it 45
20. Hermann Faber 46
21. Sketch made by Hermann Faber 47
22. Reward poster, revised 48
23. Maj. Gen. Joseph K. Barnes, The Surgeon General of the Army, 1864-
1882 52
24. The fourth home of the Museum 55
25. Museum visiting rules 57
26. Main exhibit hall of the Museum, Ford's Theater building, 1866-1887 58
27. Early "dry" exhibits in comparative anatomy 61
28. Wet specimens on display enclosed in glass 64
29. Surgeon David Low Huntington, U.S. Army, third Curator of the
Museum, 1881-1883 69
30. Bullet from the body of President Garfield 70
31- Maj. Charles Smart, Surgeon, U.S. Army 74
32. Dr. John Shaw Billings, famed Librarian, fourth Curator of the Museum,
1883-1893 80
33. Fifth home of the Museum 82
34. Foundation and evolution of the microscope collection 86
35- Medical and Surgical History of the War of the Rebellion 91
36. Brig. Gen. George M. Sternberg, The Surgeon General of the Army,
1893-1902 92
37. Maj. Walter Reed, fifth Curator of the Museum, 1893-1902 94
38. Army Medical School laboratories, located in the Museum-Library
building in the first decade of the 20th century 96
39. Early X-ray apparatus at the Medical Museum 102
40. Early dental equipment 104
CONTENTS XIX
F'g"" Pag,
41. Dr. Carlos Juan Finlay Ill
42. Lt. James Carroll, a member of the Yellow Fever Board, became sixth
Curator of the Army Medical Museum, 1902-1907 114
43- Dr. Jesse W. Lazear, a member of the Yellow Fever Board 115
44. Dr. Aristides Agramonte, Cuban member of the Yellow Fever Board . . 116
45- Camp Lazear 123
46. Maj. Frederick F. Russell, seventh Curator of the Museum, 1907-1913 . 140
47- Maj. Frederick F. Russell vaccinating volunteers against typhoid . . . 144
48. World War I typhoid vaccination 145
49. Rented quarters of the Army Medical School in 1910 149
50. Maj. Eugene R. Whitmore, eighth Curator of the Museum, 1913-1915 . 151
51. Dr. Daniel Smith Lamb I55
52. Col. Champe C. McCulloch, Jr., ninth Curator of the Museum, 1915-
1916 158
53. Col. William O. Owen, tenth curator of the Museum, 1916-1919 . . . 168
54. Colonel Owen's "dream" of a new Museum and Library building, as
pictured by Lt. Morris L. Bower, October 1918 169
55. Laboratory of Dr. William M. Gray 170
56. Instruction Laboratory, World War I 172
57- Film dealing with venereal disease, produced by the Instruction Labora-
tory 173
58. Establishment of Anatomical Art Department is announced 177
59- Headquarters for medical art in the Army Medical Museum, World
War I 178
60. Samples of scenes and messages from lantern slide sets developed for
instructional use by the Army Medical Museum 181
61. Col. Charles F. Craig, eleventh Curator of the Museum, January-
September 1919 190
62. Maj. George R. Callender, twelfth Curator, 1919-1922, and fourteenth
Curator, 1924-1929, of the Museum 192
63- The "Great Hall" of the Museum in the 1890's 195
64. Gross pathological laboratory, Army Medical Museum 196
65- President and Mrs. Eisenhower congratulate Mrs. Helenor Campbell
Wilder 200
66. Maj. James F. Coupal, thirteenth Curator of the Museum, 1922-1 924 . . 208
67- Dr. Howard T. Karsner 210
68. Title page and an illustration from volume XII of "The Medical Depart-
ment of the United States Army in the World War" 213
69. Col. James E. Ash, fifteenth Curator, 1929-1931; twentieth Curator,
1937-1946; and first Director, Army Institute of Pathology, 1946-1947 . 215
70. Maj. Paul E. McNabb, sixteenth Curator of the Museum, 1931-1933 . . 217
71. Maj. Virgil H. Cornell, seventeenth Curator of the Museum, 1933-1935 • 219
72. Maj. T. C.Jones, VC, Registrar, Registry of Veterinary Pathology, Army
Institute of Pathology 223
xx CONTENTS
Figure Pa i'
73- Brig. Gen. Raymond O. Dart, eighteenth Curator of the Museum, 1935-
1936; second Director, Army Institute of Pathology, 1946-1949; and
first Director, Armed Forces Institute of Pathology, 1949-1950 ... 229
74. Capt. Hugh R. Gilmore, Jr., nineteenth Curator of the Museum, 1935-
1937 232
75- Maj. Harry A. Davis 2 37
76. Architects' drawing of a new home for the Library and Museum, author-
ized by Congress in September 1941 2 43
77. Schematic representation of the flow of pathological materials during
World War II 248
78. A unit of the Museum and Medical Arts Department of the Museum
photographing a diseased native of a tropical isle 251
79. Maj. Gen. Norman T. Kirk, The Surgeon General of the Army, presents
to Col. Balduin Lucke the Legion of Merit 253
80. Various methods used by the medical illustrator to present the picture of
trauma and disease 260
81. " Wounds" for training purposes 263
82. Main exhibit hall of the Medical Museum in the 1930's 272
83. Maj. Gen. Norman T. Kirk outlining, to a press conference, plans for a
new medical center 277
84. Colonels James E. Ash and Raymond O. Dart look over an exhibit pre-
pared for the American Medical Association Meeting in 1946 . . . . 278
85- Sixth home of the Museum, Chase Hall, 1947-1960 281
86. Materials awaiting inventory as the Medical Museum moved from
warehouse storage to Chase Hall 281
87. A corner of the exhibits of the Museum as shown in Chase Hall .... 282
88. Scale model of the new building as planned before the requirement that
the structure be blast-resistant 291
89. Brig. Gen. Elbert DeCoursey, second Director, Armed Forces Institute of
Pathology, 1950-1955 294
90. Lt. Col. Colin F. Vorder Bruegge 296
91. Programs for the three ceremonial steps in the erection of the AFIP
building 298
92. Turning of the sod 301
93. Clearing the site of the new building 303
94. Excavation troubles 304
95- Cornerstone laying ceremony 305
96. Typical floor plan of new Armed Forces Institute of Pathology building . 307
97. Coverage of the dedication ceremonies in the Service Stripe 308
98. President Dwight D. Eisenhower dedicates the new building 309
99. Quarters in the old red brick building in the 1940's 312
100. Mary Frances Gridley 314
101. Samples of the fascicles 321
CONTENTS XXI
Figure Page
102. Diagnostic consultation, under the direction of Dr. Hugh G. Grady,
Scientific Director, American Registry of Pathology, 1949-1957 . • • • 323
103- A sample study kit 325
104. President Harry S. Truman inspects an Institute exhibit on U.S. Govern-
ment hospital services, shown at an American Hospital Association
meeting 327
105. Antonio Cortizas 328
106. Roy M. Reeve 329
107. Aerial view showing the location of the Institute building in relation to
the Walter Reed Army Medical Center 335
108. Dr. Ernest W. Goodpasture, first Scientific Director, Armed Forces Insti-
tute of Pathology, 1955-1959 338
109. Capt. William M. Silliphant, MC, USN, third Director, Armed Forces
Institute of Pathology, 1955-1959 340
110. Col. Joe M. Blumberg, MC, USA, Deputy Director, 1957-1963, and
Director, Armed Forces Institute of Pathology, 1963- ; Scientific
Director, American Registry of Pathology, 1960- 341
111. Capt. Roger H. Fuller, MC, USN, Deputy Director, Armed Forces Insti-
tute of Pathology, 1959-1963 342
112. Col. Frank M. Townsend, USAF, MC, fourth Director, Armed Forces
Institute of Pathology, 1959-1963 343
113. Dr. Robert E. Stowell, second Scientific Director, Armed Forces Institute
of Pathology, 1959- 345
114. Specimens in storage and on display 346
115. Dr. Elson B. Helwig, Chief, Department of Pathology, Armed Forces
Institute of Pathology 349
116. Optical and electron microscopes 351
117. Educational sessions 353
118. Handling radioactive materials 356
119. The evolution of an emblem, for the Institute 359
120. Award-winning exhibits of the Medical Illustration Service 361
121. War surgery told largely in pictures 363
122. Printing the fascicles of the Atlas of Tumor Pathology 364
123. Modern photomicrography apparatus 365
124. Television camera mounted in ceiling of Armed Forces Institute of Pa-
thology autopsy room 366
125. Col. Joseph L. Bernier lectures with the use of visual aids 367
126. Threefold mission of the Institute 374
127. The Institute Organization, 1962 375
128. The three Surgeons General and The Director, AFIP, participate in the
unveiling of a plaque on 19 July 1962 376
129. Executive officer and administrative staff 377
130. Organizational chart, Department of Pathology, 1 February 1962 ... 378
131. Department of Pathology staff, Professional Divisions 379
XXII CONTENTS
F>i-rc Page
132. Administrative staff, Department of Pathology 380
133- Lawrence W. Ambrogi, Chief, Histopathology Laboratories 381
134. American Registry of Pathology staff 388
135- Medical Illustration Service staff 389
136. Curator and staff of Medical Museum, 1962 390
137. Building erected for the Army Medical Museum and the Army Medical
Library in 1887 391
138. The Institute's expanding research program 392
CHAPTER I
The Institute and Its Ancestry
On 21 May 1962, the Armed Forces Institute of Pathology entered upon the
second century of its life. It had started one hundred years before as an item
in Circular No. 2, of the Surgeon General's Office, in which Brig. Gen. William
Alexander Hammond, The Surgeon General, announced his intention to estab-
lish an Army Medical Museum, for which medical officers were directed to
collect specimens of morbid anatomy.
The collections with which the Museum started consisted of three dried
and varnished bones resting on a little shelf above the inkstand on the desk of
Brigade Surgeon John Hill Brinton, the young medical officer who was to be-
come the first curator of the Museum which was to be established.
The Museum thus launched evolved into the Army Institute of Pathology
which became the Armed Forces Institute of Pathology— a veritable treasure
house of medical knowledge and an active center for consultation, research, and
education in the effects of disease and injury upon the form and function of
living cells and tissue.
For back of the announcement in Circular No. 2 was an idea— the idea that
by careful collection, comparison, and study of the anatomical wreckage of
the great war in which the United States and the Confederate States were then
engaged, there might emerge a body of knowledge and understanding which
would, in time, lead to the lessening of human suffering and the saving of
human life.
To that end, the Museum and its successor Institutes have followed General
Hammond's admonition, "diligently to collect" specimens of morbid anatomy
and other materials of value and interest to the study of military medicine or
surgery until, at the opening of the second century of its life, the Institute
had in its collections more than 1,000,000 specimens— and is continuing to re-
ceive such specimens at the rate of 200 per day.
The Threefold Mission
The institution which has grown to such proportions in its first century
is unique in its organization and mission. It was founded and for 87 years
2 ARMED FORCES INSTITUTE OF PATHOLOGY
existed as an Army installation, and still is administered under the authority of
the Secretary of the Department of the Army, acting through The Surgeon
General of that Department, but it is not now an organization of and for the
Army alone. It is truly a triservice organization, established as such by the
joint action of the Department of Defense and the Departments of the Army,
the Navy, and the Air Force, with its broad policies determined by a Board of
Governors, the members of which are the Surgeons General of the three Armed
Forces.
It is thus a military organization, but one with so strong an infusion of the
civilian in its makeup and mission that the medical profession — the term
"medical" as here used being broad enough to include the dental and veterinary
professions as well — has come to accept and rely upon the Institute's work and
findings as a distinct, indeed a unique, contribution to the advancement of
medical science and practice, civilian as well as military, throughout the Nation.
Nor are the services of the Museum-Institute limited to the boundaries of
the United States, for they have followed wherever the American soldier, sailor,
and airman have gone — to the western plains in the 19th century Indian cam-
paigns; to Cuba, Puerto Rico, the Philippines, and the Canal Zone at the turn
of the century; to Europe in the first war, known simply as the World War
until a second world war of even greater dimensions took the American forces
back to Europe, and to the continents of Africa, Australia, and Asia, to Japan,
and the islands of the Pacific; and, at the halfway mark of the 20th century,
to Korea.
From all these campaigns, as well as from the American Civil War during
which the Museum was founded, lessons learned in the diagnosis and treatment
of disease and trauma have been reported to the Museum-Institute in the form,
principally, of specimens taken from surgical operations and from autopsies,
together with the relevant medical history and records of each case.
The American Registry of Pathology
In addition to this flow of materials from military installations in all parts
of the world, the Institute receives the organized cooperation of civilian medicine,
acting through the American Registry of Pathology, an arm of the National
Research Council of the National Academy of Sciences. The American Registry
of Pathology, which now includes 27 constituent registries sponsored by the
appropriate national societies of the various medical specialties, is both an arm
of the National Research Council and also one of the four main operating
departments of the Armed Forces Institute of Pathology. Thus, the Registry
THE INSTITUTE AND ITS ANCESTRY 3
constitutes a living link between the operations of the Institute and civilian
practitioners in regard to matters of pathology.
Pathology has been defined "as that specialty of the practice of medicine
dealing with the causes and nature of disease, which contributes to diagnosis,
prognosis and treatment through knowledge gained by laboratory applications
of the biologic, chemical or physical sciences to man, or material obtained
from man." '
Broad as it is, the definition is not broad enough to cover all the activities
and contributions of the Institute. Being limited to man, it does not cover
the work of the Institute in veterinary science, a field in which what is probably
the largest staff of veterinary scientists in the country is engaged. Nor does
it cover much of the work of the Medical Illustration Service, one of the four
departments which make up the Institute, and one which is called upon for
many services outside the perimeter of pathology.
The heart and core of the Institute is in its work of consultation, research,
and education, carried on largely by its Department of Pathology. To this
Department goes the daily intake of specimens sent in by medical officers in
the field, pathologists at military hospitals, and civilian practitioners seeking
light on some puzzling piece of pathological material. No matter whence it
comes, the sender is asked to designate the degree of urgency which attends
its sending by the use of code words which tell the staff at the Institute whether
the utmost in expedition is required, or whether the specimen may safely be
given ordinary expedited attention, or if it may go into the backlog of cases
awaiting opportunity to be worked over by the Institute's pathologists.
In numerous instances, review of the original diagnosis by the Institute
has profoundly altered the therapy applied. In other instances, materials have
been submitted to the Institute too late for treatment to be affected by the
revised diagnosis. Such was the case of a 22-year-old air cadet who developed
a growth, upon an eye, which though actually benign was mistakenly diagnosed
in the first instance as "malignant melanoma." The eye was removed, and
the enucleated eye, along with the benign nevus, was sent to the Institute—too
late to save the young cadet's eye. More fortunate in its outcome was a similar
case in which the nevus, mistakenly diagnosed as malignant, was submitted to
the Institute in time for a telegraphic report to save the patient's eye from
enucleation.
Review of diagnoses by the Institute staff has prevented unnecessary oper-
ations, including amputations of limbs, in a number of cases. Such cases are
1 Directory of Medical Specialists. Chicago: Marquis-Who's Who, Inc., I9<»- vo1 - X - P- 82 3-
4 ARMED FORCES INSTITUTE OF PATHOLOGY
an infinitesimal percentage of all cases reviewed, but to the individual whose
limb or whose sight is saved or lost, nothing could be more important.
Institute review of diagnosis is important, also, in preventing possible
imposition on the Government or injustice to the serviceman in cases involving
line-of-duty questions as to responsibility for death or disablement. Thus,
Institute review has forestalled the collection of compensation for nonexistent
disease and, on the other hand, has altered erroneous diagnoses of the causes
of deaths which, if allowed to stand, would have denied benefits due the
serviceman's family.
To many, and perhaps to most, of those outside medical circles, pathology
is vaguely recognized as a special sort of medical activity, and the pathologist
is a dim and remote background figure. This attitude was reflected in an
aside from President Dwight D. Eisenhower when he was called upon to
dedicate the new building of the Institute in May 1955. Turning to his friend
and physician, Lt. Gen. Leonard D. Heaton, just before making the dedicatory
address, the President said, "Leonard, what am I doing getting up to dedicate
a building for pathology, when I don't even know what pathology is?"
In telling of the incident, General Heaton adds the comment that however
little the President knew then what pathology is, "he would soon know" —
having in mind the medical and surgical experiences that lay ahead of him.
President Eisenhower, indeed, began to learn about pathology that same after-
noon of the dedication, "For the enlightenment of this audience," he said in his
opening remarks, "it is indeed fortunate that Dr. [Brig. Gen. Elbert] DeCoursey
saw fit (in his address of welcome) to tell us about pathology. Because for
myself, I can assure you that I have learned more in the last 5 minutes than I
knew in my entire life before."
The most common picture of the pathologist in the popular mind — insofar
as there is such a picture — is probably that of the specialist who advises the
surgeon as to whether the tissues to be removed are, or are not, malignant.
That, indeed, is an important part of what the specialist in pathology does,
but it is, after all, a part only.
As Dr. James Milton Robb, of Detroit — not himself a pathologist — put
it in his presidential address before the American Academy of Ophthalmology
and Otolaryngology, in 1952:
* the study of pathology in its relatively short life has grown from an investiga-
tion or the changes found in the human body after death and their correlation with the signs
of disease which had been observed during life to include almost anything which had to
THE INSTITUTE AND ITS ANCESTRY 5
do with disease, etiology, pathogenesis, morbid anatomy, microscopic histology, parasit-
ology, functional changes, chemical alterations, indeed any topic except treatment.-
Or, to put it more briefly and even more broadly, Dr. Esmond R. Long,
practitioner and historian of pathology, describes pathology as "the basic in-
formational science in the understanding of disease" and "a science that makes
use of all other biological and medical disciplines in its development." !
In arriving at this broader concept of pathology and the place of the
pathologist in the scheme of things medical, the Institute has played a major
part. During the first half-century of its life, while it still was the Army
Medical Museum, it contributed to medical research and education through
compiling and publishing the massive "Medical and Surgical History of the
War of the Rebellion," and through the introduction and development of such
techniques as photomicrography and the use of aniline dyes in staining slides
for microscopic study. Through its Curator, Maj. Walter Reed, it contributed
to the conquest of yellow fever, and through another curator, Maj. Frederick
Fuller Russell, it helped mightily in stamping out typhoid fever. Under the
curatorship of Maj. George Russell Callender, the Museum broadened its work
of education and research through its linkage with civilian medicine in the
Registry movement.
Through the work of more recent curators, the Museum, while retaining
its distinctive character as a place for exhibition of medical lore and historic
materials to a large and increasing number of visitors, has had its greatest
growth through the enlargement of its services of education and, increasinglv
of late years, of research.
''Unique in the World' '
Writing in 1946, when the Institute was still an Army organization and
had not taken on its triservice character, Dr. Howard T. Karsner, then of
Western Reserve University, described it as "unique in the world." He
continued: '
* * * Nowhere else has there ever been a concentration of pathological specimens
that is comparable. Nowhere else is the pathology of the entire Army of a great country
so concentrated. Nowhere else have the civilian pathologists and other interested physicians
taken such a great part in organization and operation. Nowhere else has there been, as
" Transactions of the American Academy of Ophthalmology and Otolaryngology, September-October
1952, p. 715-
3 Long, Esmond R.: A History of American Pathology. Springfield, 111.: Charles C Thomas, Publisher,
1962, pp. 133, 147.
karsner, Howard T.: The American Registry of Pathology and Its Relation to the Army Institute of
Pathology. The Military Surgeon 99: 368-369, November 1946.
6 ARMED FORCES INSTITUTE OF PATHOLOGY
continues to be true, such a close scientific liaison between medical officer and civilian
doctor.
In the years since this was written, the Institute has not only taken on its
triservice character; it has also become the central laboratory of pathology
for the Veterans' Administration, the Atomic Energy Commission, and the
U.S. Public Health Service, and has furnished informal consultation to the
Civil Aeronautics Board and the Federal Aviation Agency.
All in all, as Dr. Esmond R. Long says in his recent (1962) book, "A
History of American Pathology," the Armed Forces Institute of Pathology
has "become in fact the hub of activities in the nation's pathology," in a period
of activity since 1949 that "has never been matched by any organization for
research and instruction in pathology." °
The sweep and scope of these activities of the Institute are indicated by
the fact that its latest annual report, that for the last year of the first century
of its life, requires 254 pages in order to outline the working organization and
list in briefest form the activities undertaken and carried forward during the
year. These activities included 194 registered research projects, 91 publications
by staff members, n postgraduate courses with an attendance of 1,105, tne
distribution of 27,000 copies of fascicles published as part of the "Atlas of
Tumor Pathology," and the creation of 55 new visual exhibits— to mention
but a few items of work done in but one year out of the one hundred years
of the life of the Museum-Institute.
In the opening years of the second century of its life, the Institute is
carrying forward studies that range from the nature and behavior of the in-
finitesimally small subcellular particles that are revealed only in the stream
of electronic waves of the electron microscope to the inconceivable vastness
of outer space. For wherever man may go, and whatever he may see, pathol-
ogy — the scientific cornerstone of medicine — goes with him, and its evidences
are to be seen.
This volume does not undertake to treat in detail the history of the first
century of the Museum and its offspring, the Institute— a multi-volume task —
but seeks to tell in brief compass the story of the soil and the seed from which
a great medical service has grown, with some account of the men and women
who have made great the century-old Armed Forces Institute of Pathology.
'Long, op. cit., pp. 379, 381.
CHAPTER II
Background and Beginnings
In May 1862, the United States had been at war with the Confederate States
for a year and a month. After early defeats at Bull Run and Wilson's Creek,
the course of the war had been marked by great victories and wide conquests.
In the western theater, Fort Donelson had fallen to "Unconditional Surrender"
Grant, Nashville had been occupied by Buell, the battle of Shiloh had resulted
in victory for the Union, the great port of New Orleans had been taken by
Farragut. In the East, the mountain counties of western Virginia had been
detached from the Old Dominion, the defenses of the North Carolina sounds
had been breached, the deep water harbor of Port Royal in South Carolina had
been occupied to provide a safe base for the blockaders of the Atlantic ports,
and, most conspicuous of all, General McClellan's mighty Army of the Potomac
had advanced up the Virginia Peninsula, pushing the Confederate defenders
back almost into the outskirts of Richmond itself.
For the Union, the war had gone well in its first year, but it had been at
a cost in suffering and death from wounds and disease at which the people were
appalled. The Nation had gone to war in traditional hip-hip-hurrah fashion,
with little regard for the visible dangers of the battlefield and even less regard
for the invisible but more deadly dangers of the diseases that lurked in the
unclean camps.
Indeed, even if there had been a more realistic appreciation of these risks
and dangers, there was not in the existing state of medical knowledge and
military organization a great deal that could be done about them. Though
anesthesia had been introduced in America some 15 years earlier, methods were
still crude, and it was used with considerable misgiving. Bacteria were known
to exist but had not yet been accepted as a cause of disease. Antiseptic surgery
was still in the future, and asepsis was not yet even an ideal to be sought. The
occurrence of pus in wounds or as a result of surgery was looked upon as part
of the process of healing, a necessary suppuration.
8 ARMED FORCES INSTITUTE OF PATHOLOGY
Some Medical Problems of the 1860's
Medical men were still divided into dogmatic schools of thought, according
to the theoretical basis on which they practiced. The dominant school, the
allopaths, depended upon the administration of powerful dosages of drugs to
combat the suppositious causes of sickness or to neutralize its effects; the
homeopaths believed in small doses of medicine, operating on the theory that
"like cures like." The nature of the curative agents largely relied upon by the
medical profession led Dr. Oliver Wendell Holmes to observe, in an address
before the Massachusetts Medical Society in May i860, that "if the whole
materia medica, as now used, could sink to the bottom of the sea, it would be
all the better for mankind — and all the worse for the fishes."
Dr. Holmes granted that there were exceptions to his sweeping condemna-
tion, but his opinion as to the efficacy of much of the orthodox treatment of
disease was warranted by the fact that methods of treatment were derived more
from speculation and theory than from directed and controlled experimentation.
Even if there had been a more general recognition of the importance of
experiment and scientific observation, there was, in America in the early 1860's,
little of the apparatus or equipment for observation of even simple symptoms.
Even such familiar tools of the physician as the clinical thermometer and the
stethoscope were all but unknown and little used, and it was not until the
war was half over that the headquarters of the Medical Department of the
Army enjoyed the possession of an achromatic microscope, the basic working
tool of the pathologist.
Not because of these lacks — for at the time they were not recognized as
such— but because of the almost total lack of organized readiness for the removal
and treatment of the wounded, the Medical Department of the Army came
under criticism and condemnation. To many, the suffering of the sick, and
especially of the wounded, seemed unnecessarily severe because of the failure
of the Department to foresee the mounting needs of war and to organize to
meet them. The charge against the Department was "stiff adherence to anti-
quated forms and modes of action outworn even for peace conditions." l
Whether the deficiencies of the Medical Department were greater than
those of other staff departments of the Army may be questioned, and certainly
the framework of the governing law, under which the Medical Department
was compelled to rely on the quartermaster for transportation and hospital
construction and upon the Commissary Department for subsistence, was faulty.
'Duncan, Louis C: Evolution of the Ambulance Corps and Field Hospital, p. 4. In The Medical
Department of the United States Army in the Civil War. Washington, 1911.
BACKGROUND AND BEGINNINGS 9
But the fact that medical shortcomings, real or supposed, manifested them-
selves in the sensitive area of human suffering and death made all the more
glaring every instance of ineptitude, inadequacy, inefficiency, or just plain
indifference.
That there were such instances goes without saying. How could it have
been otherwise, when a department set up to care for the medical needs of an
army of 16,000 men, with all its methods geared to the slow tempo and small-
scale demands of peacetime, suddenly found itself called upon to care for an
army rapidly growing to the million mark and engaged in an active and hard-
fought war?
A New Surgeon General
On 15 May 1861, the 80-year-old Thomas Lawson, Surgeon General of
the Army since 1836, died. To succeed him, Clement Alexander Finley, veteran
of more than 40 years' service in the Department, was named Surgeon General,
to face the problems of an ever-expanding and hugely demanding war. In
the opinion of the United States Sanitary Commission, an unofficial body with
official recognition which was, in a sense, a forerunner of the American Red
Cross, the new Surgeon General was too much devoted to routine, and lacked
the flexibility of outlook, the largeness of concept, and the vigor in action
which the situation required.
The Sanitary Commission pressed for passage by Congress of a bill en-
larging and reorganizing the Medical Department of the Army, and likewise
sought to have the 64-year-old Finley replaced as Surgeon General. In March
of 1862, Finley fell afoul of the new Secretary of War, the imperious and
irascible Edwin M. Stanton, and was forced to resign. In April, Congress
passed, and President Abraham Lincoln signed, the bill reorganizing the De-
partment and, on the 25th of the month, a new Surgeon General, William
Alexander Hammond, was appointed (fig. 1).
The new Surgeon General, who was to become the father of the Army
Medical Museum and, through it, of the Armed Forces Institute of Pathology,
was less than 34 years old at the time of his appointment. His selection over
officers who were his seniors in age, rank, and experience was due in large
measure to the recommendation and persistent pressure of the Sanitary Com-
mission, which had been impressed by the tireless energy and high adminis-
trative ability he had exhibited in the organization and operation of hospitals
in Maryland and western Virginia. 2
2 Adams, George Washington: Doctors in Blue: The Medical History of the Union Army in the
Civil War. New York: Henry Schuman. Inc.. 1052, pp. 28-31.
10
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure i. — Brig. Gen. William Alexander Hammond, The Surgeon General, U.S. Army,
1862-1864.
Dr. Hammond was born in Annapolis, Md., on 28 August 1828, was reared
in Pennsylvania, and studied medicine in New York, where he received his
degree at the age of 20. He passed the examination for entrance into the Army
Medical Service and in 1849 became an assistant surgeon. In the next 10 years,
he served as medical officer at various frontier posts and also at West Point.
He took advantage of a sick leave spent in Europe to study in the medical
BACKGROUND AND BEGINNINGS II
centers there. Returning to duty, he submitted a report on a nutritional research
project of his own which won for him an American Medical Association prize
in 1857. In the report on this study, in which Dr. Hammond had used himself
as one of his "guinea pigs," he described himself as 6 feet 2 inches in height;
from 215 to 230 pounds in weight; of a rather full habit of body; and disinclined
to exercise for its own sake.
In the autumn of i860, the future Surgeon General resigned from the Army
to take the chair of anatomy and physiology at the medical school of the Uni-
versity of Maryland in Baltimore, but upon the outbreak of hostilities he had
resigned his professorship and re-entered the Army, coming in as a lieutenant
at the bottom of the promotion list, without credit for his 10 years of previous
service. 3
The Scientific Approach
The new Surgeon General faced a mountain of problems of medical supply
and administration, but he saw beyond these to the basic questions of the practice
of military medicine and surgery. Within less than a month after taking office,
therefore, the new Surgeon General, seeking more complete and accurate
knowledge of actual conditions, issued his Circular No. 2 on 21 May 1862 (fig. 2).
This circular prescribed in detail the requirements of the "remarks" which
were to accompany the monthly Reports of Sick and Wounded. Full informa-
tion was called for as to fractures, gunshot wounds, amputations, and exsections
by the surgeons. On the medical side, information was sought not only as to
symptoms and treatment of fevers, diarrhea and dysentery, scorbutic diseases,
and respiratory diseases, but also as to shelter and sanitary conditions, and as to
the character and cooking of the ration, rightly regarded as factors in the
causation and severity of sickness.
Almost as an afterthought, the circular announced in its closing paragraph
the intention to create a medical museum. "As it is proposed to establish in
Washington, an Army Medical Museum," the circular read, "Medical officers
are directed diligently to collect, and to forward to the office of the Surgeon
General, all specimens of morbid anatomy, surgical or medical, which may be
regarded as valuable; together with projectiles and foreign bodies removed, and
such other matters as may prove of interest in the study of military medicine
or surgery. These objects should be accompanied by short explanatory notes.
"Drayton, Evelyn S.: William Alexander Hammond, 1828-1900; Founder of Army Medical Museum.
The Military Surgeon 109: 559-565, October 1951.
713-028' — 64 3
12
ARMED FORCES INSTITUTE OF PATHOLOGY
SURGEON GENERAL'S OFFICE,
Washington Citt, May 21, 1862.
[ ll>cl'U> No. i ]
In the monthly Report* of Sick and Wounded, the following details will be briefly mentioned
in accompanying remarks :
SURGERY.
fractures. — The date of reception, the situation, character, direction, treatment and resvJt
in all cases.
Gunshot wound*. — The date of reception, the situation, direction, and character; the foreign
matters extracted ( if any ) ; and the result in all cases.
Amputations — The period and nature of the injury ; the character of the operation ; the
time, place, and result.
Eisections — All operations for, with a statement of the injury demanding them ; the date of
injury, the date of operation ; the joint or bone operated upon, and the result.
MEDICINE.
Fevers. — Their character and symptoms; an outline of the plans of treatment found most
efficient, with remarks on the location and sanitary condition of camps, or quartern, during the
prevalence of these disorders.
Diarrhoea and Dysentery. — Grade, and treatment, with remarks on the character of the ration,
and the modes of cooking.
Snrbutic Diseases. — Character and symptoms, with observations on causation, and a statement
of the means employed to procure exemption.
Respiratory Diseases.— Symptoms, severity, and treatment, with remarks on the sheltering of
the troops, and the atmospheric conditions.
Similar remarks on other preventible diseases.
Important cases of every kind should be reported in full. Where post-mortem examinations
have been made, accounts of the pathological results should be carefully prepared.
As it is proposed to establish in Washington, an Army Medical Musnm, Medical officers are
directed diligently to collect, and to forward to the office of the Surgeon General, all specimens of
morbid anatomy, surgical or medical, which may be regarded as valuable ; together with projectiles
and foreign bodies removed, and such other matters as may prove of interest in the study of
military medicine or surgery.
These objects should be accompanied by short explanatory notes.
Each specimen in the collection will have appended the name of the medical officer by whom
it was prepared.
WILLIAM A. HAMMOND.
Surgeon General
NOTE -Medie.1 Dmc,.,. .m ft™,. „„ CQfy of , w , cimUaI ,. mwy ^^ ^ fa ^ .^^ ^ ^^
"?T ' Dd "* 7 WU1 ""**"" '•"""' to ""• offi " wkh •* ■"""" ■ " — «* "P—. au .he monthly „J, of the
_*». -Seen under their Hpnl*a T*v .ill „,.. lou-dU-t, ...nsmu, aD Uck m<raUllv repOT „. „„„
**— "*■ * b °" "**"" ""*"- "* -W- "«* ~» »™ ««*M in their respective ofc,,^, *
commencement of the rebellion. we
Figuge 2. — Surgeon General Hammond announces his intention to establish the Army
Medical Museum, 21 May 1862.
BACKGROUND AND BEGINNINGS T ,
Each specimen in the collection will have appended the name of the medical
officer by whom it was prepared." *
Three weeks earlier, on i May, General Hammond had procured, from
the Adjutant General of the Army, orders for Assistant Surgeon Joseph Janvier
Woodward, on duty with the Army of the Potomac, and Brigade Surgeon John
Hill Brinton of the Volunteers, on duty with the Army of the Mississippi, to re-
port to the Office of the Surgeon General for special duty. The nature of this
duty was disclosed in part, on 9 June 1862, in Circular No. 5 (fig. 3). "It is
intended," the circular read, "to prepare for publication the Medical and
Surgical History of the Rebellion," with responsibility for the medical portion
of the work assigned to Dr. Woodward and for the surgical part to Dr. Brinton,
and with all medical officers called upon for cooperation (fig. 4)."
The First Curator
Meanwhile, The Surgeon General was maturing his plans for a medical
museum, and on 1 August 1862, he gave to Surgeon Brinton the go-ahead sign,
directing him "to collect and properly arrange in the 'Military Medical Museum'
all specimens of morbid anatomy, both medical and surgical, which may have
accumulated since the commencement of the Rebellion in the various U.S. hos-
pitals, or which may have been retained by any of the Medical officers of the
Army." Dr. Brinton was also directed to "take efficient steps for the procuring
hereafter of all specimens of surgical and medical interest that shall be afforded
in the practice of the different hospitals" and to report the name of any officer
who might decline or neglect to furnish such materials. 6
The 30-year-old Brinton had been a demonstrator of anatomy at the Jeffer-
son Medical College in Philadelphia and had served with General Grant in the
West. At Fort Donelson, under the direction of Surgeon H. S. Hewitt, he had
put together the first combination of regimental hospitals and ambulances into
brigade organizations, foreshadowing the broader and more comprehensive
groupings for evacuation and treatment of the wounded to be worked out
later in the same year of 1862 by Surgeon Jonathan Letterman, Medical Director
of the Army of the Potomac. 7
'Circular No. 2, Surgeon General's Office, Washington City, May 21, 1862. On file, National
Archives, Accession No. 421, Circulars/SGO/1862-1865.
5 (i) Special Orders Number 98, War Department, Adjutant General's Office, 1862. (2) Circular
No. 5, Surgeon General's Office, Washington, D.C., June 9, 1862. On file, National Archives, Accession
No. 421, Letter Book No. 30. March 7 to May 30, 1862/SGO, p. 319.
" Brinton, John Hill: Personal Memoirs. New York: The Nealc Publishing Co., 1914, pp. 180-181.
' (1) Duncan, op. cit., The Battle of Bull Run, p. 21. (2) Duncan, op. at., Evolution of the
Ambulance Corps and Field Hospital, pp. 2-4.
I4 ARMED FORCES INSTITUTE OF PATHOLOGY
Oit'eulai' No. .">.
Washington, D. 0., June It, 1862.
It is intended to prepare for publication the Medical and Surgical
History of the Rebellion.
The Medical portion of this work has been committed to Assistant
Surgeon J. J. Woodward, United States Army, and the Surgical part
to Brigade Surgeon John H. Brinton, United States Volunteers.
All medical officers are therefore requested to co-operate in this under-
taking by forwarding to this Office such sanitary, topographical, medical
and surgical reports, details of cases, essays, and results of investigations
and inquiries as may be of value for this work, for which full credit will
be given in the forthcoming" volumes.
Authority has been given to both the above named gentlemen to issue,
from time to time, such circulars as may be necessary to elicit the desired
facts, and the medical officers are defired to comply with the requests
which may thus be made of them.
It is scarcely necessary to remind the medical officers of the regular
and volunteer services that through the means in question much may be
done to advance the science which we all have so much at heart, and to
establish landmarks which will serve to guide us in future.
It is therefore confidently expected that no one will neglect this oppor-
tunity of advancing the honor of the service, the cause of humanity,
and his own reputation.
WILLIAM A. HAMMOND,
Surgeon Ucnrrah V. S. Army,
Figure 3. — Circular No. 5, Surgeon General's Office, 9 June 1862.
Dr. Brinton (fig. 5) warmly welcomed the order to collect, for study, speci-
mens of damaged or diseased tissues. Indeed, he had anticipated the order of
1 August by writing on 28 July to the medical officers in charge of hospitals at
St. Louis, Mo., Cincinnati, Ohio, Baltimore, Md., Philadelphia, Pa., Mound City,
111., and Winchester, Va., directing that all specimens be collected and for-
warded. Immediately after the issuance of The Surgeon General's order, he
addressed similar letters asking the cooperation of the officers in charge of
BACKGROUND AND BEGINNINGS
'5
Ficure 4. — This group of U.S. Army medical officers includes several who were to be
prominent in the history of the Army Medical Museum and the Library of The Surgeon
General. Standing (left to right): Lt. Col. William G. Spencer, Assistant Surgeon Alfred
A. Woodhull, Surgeon General Joseph K. Barnes, Assistant Surgeon Edward Curtis.
Seated (left to right): Assistant Surgeons George A. Otis, Charles H. Crane, John S.
Billings, and Joseph J. Woodward. (From an original glass negative dated 1864 in the
AFIP files.)
hospitals at Alexandria, Falls Church, and Culpeper Court House, Va., and
at Memphis, Tenn. s
"My whole heart was in the Museum," he wrote afterward, "and I felt that
if the medical officers in the field, and those in charge of hospitals, could only
be fairly interested, its growth would be rapid and the future good of such a
grand national cabinet would be immense. By it the results of the surgery of
this war would be preserved for all time, and the education of future generations
of military surgeons would be greatly assisted."
During his period of service as Curator, Dr. Brinton visited the field hospitals
after the great battles in the East — Antietam or Sharpsburg, Fredericksburg,
8 Record of John Hill Brinton's Action in the Matter of the Military Medical Museum. On file
in historical records of AFIP; letters of 28 July, 7, 9, 12, 18, and 19 August 1862.
i6
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 5. — Maj. John Hill Brinton, U.S. Volunteers, first Curator of the Army
Medical Museum, 1 862-1 864.
Chancellorsville, Gettysburg — seeking to enlist the interest of the surgeons with
the armies, to develop a "true professional interest" in the Museum as an
opportunity to contribute to the "common stock of surgical knowledge" and
BACKGROUND AND BEGINNINGS 17
to convince the skeptical that the formation of a "great National Surgical and
Medical Museum was not for the collection of curiosities, but for the accumula-
tion of objects and data of lasting scientific interest, which might in the future
serve to instruct generations of students, and thus in time be productive of
real use." 9
Dr. Brinton could hardly have foreseen that future generations of students
would come to look upon many of the medical and surgical practices of the
Civil War as curiosities carried over from the Middle Ages of medicine, but in
his prediction that the institution which he was launching would "in time be
productive of real use" he was abundantly correct— for the Medical Museum has
broadened into the Institute of Pathology, serving not only the Armed Forces
but, through its unique relation with the civilian specialist, serving the needs
and pacing the progress of all pathology.
Collecting Specimens
Many of the Army surgeons of 1862 "entered into the scheme of the
Museum with great zeal and earnestness," Dr. Brinton wrote afterward, "but
some few there were, and these mostly the least educated, who failed to see its
importance." In time, however, the project received "active and faithful
co-operation" from the medical staff generally.
The chief difficulty encountered at first was in the field hospitals where,
after battles, the medical forces were overwhelmed with the bloody work of
operating under conditions and pressures which did not permit the preparation
of specimens with their accompanying case histories.
"It really seemed unjust," Dr. Brinton noted, "to expect [under such cir-
cumstances even] the rough preparation necessary to preserve for the Museum
the mutilated limbs." Consequently, the Curator adopted the practice of visit-
ing the battlefields (fig. 6) where he had dug out of the trenches in which they
had been buried "many and many a putrid heap" of legs and arms on which
he went to work "amid surrounding gatherings of wondering surgeons and
scarcely less wondering doctors." All saw, he said, that he was in earnest and
as his infectious example spread from corps hospital to corps hospital, "active
co-operation was eventually established."
In his visit to the Army of the Potomac, after the battle of Fredericksburg,
Dr. Brinton was accompanied by Dr. William Moss, the Assistant Curator, the
purpose of the trip being to assist in caring for the wounded and also to "look
* Brinton, op. at., pp. 181, 186.
i8
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 6. — Surgeon John H. Brinton (front row, center), with a group of Union Army
officers in the field.
after the interests of the Museum." On the afternoon of 15 December, Dr.
Brinton "encountered Dr. Moss, my assistant, bringing with him an immense
number of surgical specimens for the Museum, some of these in boxes, which
we sneaked over in the wagons; the remainder were carried in great bags on
the backs of one or two very black negroes." Upon his return from the field,
the Curator sent his assistant back "down to the army for more" specimens.
"By this time," he said, "the surgeons generally were becoming interested in
the Museum project, and were taking pains to get and preserve what they could
for the collection." 10
To spare the field surgeons as much as possible in the preparatory work,
the Museum issued "Suggestions to the Medical Officers of the Army as to the
Preparation and Forwarding of Specimens to the Army Medical Museum, Sur-
geon General's Office, Washington, D.C." After a listing of the types of "speci-
mens illustrative of surgical injuries and affections" and the "specimens of
diseases" which were desired, the Suggestions continued: "It is not intended
to impose on medical officers the labor of dissecting and preparing the specimens
10 //'«</., pp. l86, 187-188, 214 220, 222.
BACKGROUND AND BEGINNINGS 19
they may contribute to the Museum. This will be done under the super-
intendence of the Curator."
Instructions for forwarding "such pathological objects as compound frac-
tures, bony specimens, and wet preparations generally, obtained after ampu-
tation, operation or cadaveric examination" included rough removal of all
unnecessary soft parts, wrapping in cloth so as to preserve all spicula and frag-
ments, attaching a tag of wood or sheet lead bearing the number of the
specimen and the name of the officer sending it, and immersing the object
in a keg or small cask of diluted alcohol or whisky. When filled, the cask
was to be forwarded to the Office of the Surgeon General by express, collect.
At the same time, a corresponding list or history of the cases was to be mailed
to The Surgeon General.
To facilitate the collection of specimens, the following medical officers
at major hospital centers were designated to receive and forward them:
Surgeon Lavington Quick, U.S. Volunteers, Baltimore
Acting Assistant Surgeon Edward Hartshorne, U.S. Army, Philadelphia
Acting Assistant Surgeon George Shrady, U.S. Army, New York
Surgeon M. Goldsmith, U.S. Army, Louisville
Assistant Surgeon F. L. Town, U.S. Army, Nashville
Surgeon John S. Hodgen, U.S. Army, St. Louis
Surgeon H. S. Hewitt, U.S. Volunteers, Army of the Mississippi "
In acknowledging receipt of specimens submitted in response to circular
letters and individual communications, Dr. Brinton, upon occasion, inquired
as to particular cases of which he had knowledge. For example, in a letter
of 17 December 1862, thanking Surgeon John S. Hodgen at St. Louis, Mo.,
for his contributions, Brinton mentioned that he had not seen among them
"one of a gunshot wound of the ear which occurred at Fort Donelson and
was treated in the Hospital under your charge last winter," and asked for the
specimen and also for "the round ball which inflicted the injury should it be
in your possession." Not every wounded man was willing to give up the
severed portion of his anatomy or the projectile by which he was struck. As
an instance of this occasional unwillingness, there is the case of Pvt. W. H.
Knaup of the 2d New Jersey, who was struck by a shell fragment in the left
cheek and lost the angle of his jaw. Brinton wrote the surgeon in charge of
the hospital at Chester, Pa., to which Knaup had been removed, to "make him
"Catalogue of the Army Medical Museum, Surgeon General's Office, Washington, January 1. 1963,
pp. 5, 6.
713-028'— 64 »
20 ARMED FORCES INSTITUTE OF PATHOLOGY
give up the shell by which he was struck and the loose angle of jaw for the
Army Museum," adding, "Keep every specimen you can."
Some of the operating surgeons, through ignorance or misunderstanding
of orders, believed that the specimens resulting from their operations were
their own to dispose of as they saw fit. One such instance was that of Surgeon
R. B. Bontecou, of the hospital at Beaufort, S.C., who, while on duty in the
Peninsula, collected between 70 and 80 preparations which he gave to Dr.
Thomas M. Markoe of New York. Brinton wrote to the recipient of the
gift, explaining that "all the specimens collected by medical officers belong
to the national museum" and calling for the return of those which had been
transferred to him by Surgeon Bontecou "under the mistaken impression that
he possessed the right to part with them." There is no record of the receipt
of anything from Dr. Markoe, but eventually Dr. Bontecou contributed 101
specimens. And then there was at least one case of outright theft of specimens
by "the men who had charge of the dead house" at a general hospital, and
the sale of the specimens to a New York physician. 12
In spite of early indifference and the very real difficulties of collection,
the specimens came in, even though the case histories which were to have
accompanied them were frequently lacking. Enough material had been re-
ceived by the end of 1862 to warrant the issuance of a small catalog in January
1863 (fig. 7). In a covering letter to Surgeon General Hammond, the Curator
noted that "all the contained specimens," numbering 1,349 objects, had been
collected since the Museum's establishment in August and the number was
"being daily augmented." Of the objects cataloged, 985 were surgical speci-
mens, 106 were medical, and 103 were missiles, "for the most part extracted
from the body." Through the cooperation of the Ordnance Department of
the Army, the Museum was enabled to display also a series of projectiles for
small arms, field and heavy guns, and a set of the bayonets in use in the
United States and foreign countries.
This first catalog of the Museum was "offered simply as a numerical list
of the objects" in the collection with no attempt to classify the various injuries
or to describe in detail the preparations included.
Of the nearly 1,000 surgical specimens listed, all but a handful were the
result of gunshot wounds, and the vast majority of those were from the
"(1) Record of John Hill Brinton's Action in the Matter of the Military Medical Museum, pp. tj
22, 52, 59. On file in historical records of AF1P; letters of 28 July, and 7, 9, 12, 18, and 19 August 1862.
(2) Lamb, Dr. D. S-: A History of the Army Medical Museum, 1862-1917, compiled from the Official
Records. Mimeographed copy in historical records of AFIP, pp. 8, 9.
BACKGROUND AND BEGINNINGS
21
12
No. or
Brsc'tr,
72 •
73 *
71
§
78
79 ■
60
CI
82 #
83 *
84
87 *
88 *
89*
90
91 "
92 •
93 "
94
95
96
97
98
99 *
Descripi ion.
Gunshol fracture of upper third s]i;ift of
Tibia.
Gunshot fracture, comminuted ; porforatiorj
of Humerus.
Shell contusion of Tibia; great suppuration.
Surg..T.H.Brinton,U.S.V.
A Asst. Surg. W. W. Keen,
l\H A .«., n'\ Horn No.
l. Fredvrick, Md.
A. Asst. Surg. D. W.Chee-
wr, l'. S. A., .In
Hosp., Washington, l>(".
Gunshot fracture, comminuted, of shafl of Dr. Bowles, Waters' Ware-
Femur, house, Georgetow d,D. <.'.
Gunshot fracture of Femur; perforation Surg. C. H. Pago, IT. S.A,
above condyles.
Gunshot fracture of condyles of Femur; de- 1
posit of callus.
" ot fracture of upper half and neck '
Humerus,
fracture of upper half Bhaft of Asst. Surg. B. A Storrow,
1 Fibula, L\S.A.,Eckiugtou Hosp.,
Washington, l>. C.
Gunslmt^kLhiiv of Tarsus and tower ex- Dr. Warner, Waters' Ware-
tremity Mp^tiljm auiUi^i^i^ mui. I >
Gunshot In
and Fibuli
Gunshot •fartfiic'^B ' S.V
tremity of Radio
Gunshot fracture of H H 8 \
with deposit of <:l I Hosp.
GlLllsln
Gunshot fracture of
of ball perpend ic
Gunshot fracture of
carpal bones and
( iinii-imi fracture of
Gunshol fracture o
with couoidal 1ml
Gunshol fracture of
carpal bones.
Gunshot fracture, <
U[<]»-r half Of I I il'
Gunshot fracture of
t lunshot fracture <■('
tors.
Gunshot fracture :
process an I head
Gunshot fracture;
inch of shaft ot ll|
Gunshol fracture
Ethmoid, and I'm
Gunshol fracture "il
Humerus.
tliird, fourth, and mTWTfflinirff^TWff^^^iTnrrrT^TTr^^WPl F. S \
Gunshot fracture of Carpus; amputation. Asst. Snrg. .1 .). Wood*
ward, f 8. A.
Gunshot fracture of lower half of Femur. Burg. J. if. Brinton, [TJ8.V.
Figure y. — A page from the first Catalogue of the Army
Medical Museum. The specimen shown is the one listed as
No. 76 in the catalogue.
conoidal bullets devised by Capt. C. E. Minie of the French Army and widely
adopted by both sides in the Civil War. Comparatively few American surgeons
had had experience with gunshot wounds, and fewer still had so much as
22
ARMED FORCES INSTITUTE OF PATHOLOGY
seen wounds made by Minie balls— hence the emphasis upon such specimens
in what soon came to be the largest collection of such specimens in the world.
Some 30 of the specimens other than gunshot wounds were from reampu-
tations or other secondary operations. Two were from victims of radroad
accidents; one was the result of a kick by a horse. Only two were saber
wounds, and there were no instances of wounds by the bayonet. One specimen
was from a case of gangrene of the face attributed to salivation— a condition
resulting from excessive dosage of calomel or other mercurial drugs. The
most numerous single disease listed as the cause of the lesions shown in the
specimens was typhoid fever, designated in 17 cases. The most frequently
mentioned disease was "Chickahominy diarrhoea," 10 cases. The Museum's
specimens, as they may be observed in its original catalog, were illustrative of
the effects of military action and camp conditions upon the life and health
of the soldier. 13
The work of preserving the specimens and preparing them for museum
purposes was done at the Museum by a professional anatomical "preparator,"
Frederic Schafhirt, assisted by his son, Adolph, and later, also by his son,
Ernst. The senior Schafhirt, who bore the courtesy title of "Doctor," was
born and trained in Germany and had been an assistant in anatomical work
for Dr. Joseph Leidy of the University of Pennsylvania.
The preservative commonly used was alcohol diluted in strength to 70
percent. This alcohol was secured by re-distilling the illicit liquors seized
and confiscated by the provost marshal of Washington, a source of supply
which was found adequate for Museum purposes for some years. Dr. Brinton
recalled afterward that the side lot of the Museum was "piled with kegs,
bottles, demijohns and cases, to say nothing of an infinite variety of tins, made
so as to fit unperceived on the body, and thus permit the wearer to smuggle
liquor into camp."
Among the more ingenious of these containers, according to the recollec-
tion of another officer assigned to the Museum, were false breasts, each holding
a quart or more, worn by women who were arrested as they sought to cross
the Long Bridge, carrying liquor to the camps. 14
13 Catalogue of the Army Medical Museum, Surgeon General's Office, Washington, January i, 1863,
passim.
" (1) Lamb, op. cit., pp. 4, 5, 25. (2) Krinton, op. cit., pp. 181-182, 191.
BACKGROUND AND BEGINNINGS
2 3
New Quarters for the Museum
During these early months of the Museum's life, its quarters were moved
twice. The first move was from the "top of my desk," as Brinton wrote, to
some "shelves put up for the purpose in my rooms in the Surgeon-General's
office," then located in the old Riggs Bank Building (fig. 8) at the corner of
President Place (now Pennsylvania Avenue) and 15th Street, NW., Washington,
D.C. From these shelves, on the second floor rear of the bank building, the
growing collection was soon removed to rooms in a building at 180 Pennsylvania
Figure 8.— The first home ot the Museum.
Avenue, NW., which stood on lots since numbered as 1719-1721 (fig. 9) . While
in this building, the first catalog was issued, but as increasing numbers of speci-
mens came in from the hospitals and the field, new and larger quarters were
imperatively demanded.
While he and Dr. Woodward were "pushing" on the medical and surgical
history of the war, and compiling lists of sick and wounded, Dr. Brinton was
scouting Washington, on the lookout for suitable quarters for the growing
Museum. The only place he could find that was both suitable and available
was a building on H Street, NW., between 13th and 14th Streets, opposite the
New York Avenue Presbyterian Church. The building, which belonged to
the Washington philanthropist, W. W. Corcoran, is variously described in con-
24
ARMED FORCES INSTITUTE OF PATHOLOGY
MWUUUWWUWWWJWW^^ » UWUWM*^
Figure 9. — The second home of the Museum.
temporary documents as a "mechanics' library," the "Library Building occupied
by Miss Middleton's School," and "the Art Gallery Building." It might have
been intended for use by the subsequently famous Corcoran Gallery of Art, but
BACKGROUND AND BEGINNINGS 25
it was in use as a school and was known as "Mr. Corcoran's School House"
when it was taken over by the Government. Mr. Corcoran agreed to put the
building in repair and rent it for $1,000 a year. The proposition was accepted
by the Curator, and on 16 May The Surgeon General asked permission of
Secretary Stanton to rent the building on these terms, the rent to be paid out of
an appropriation of $5,000 for the Museum which had been made at the closing
session of the Congress.
On 21 May, the Secretary of War directed that the Military Governor of
Washington, Maj. Gen. Ethan Allen Hitchcock, take possession of the building
and turn it over to the Medical Department of the Army for the use of the
Medical Museum, which was done in Special Orders No. 116, Headquarters,
Military District of Washington, on 22 May 1863.
Dr. Brinton stated in a letter of 24 August to Col. Joseph K. Barnes, Medical
Inspector and Acting Surgeon General, that Secretary Stanton had ordered
that "no rent will be paid for the building" owned by Mr. Corcoran, but re-
gardless of rent or no rent, the Medical Department took possession of "the
building known as Corcoran's School House near Dr. Gurley's Church, to-
gether with its outbuildings thereto, having been turned over to this department
by order of Secretary of War" and on 1 June assigned the quarters to the
Museum, directing Surgeon Brinton to "take charge thereof, and make such
alterations and repairs as may be necessary to fit it for the purpose of the army
Medical Museum." Brinton was cautioned, however, to "avoid all useless
alterations or expense." 15
Acting under this authorization, the Museum occupied the Corcoran build-
ing (fig. 10) as soon as the school term was over and put it in complete repair at
a cost, including new cases for exhibits, of nearly $2,000. On 24 August, the
Curator reported the building "as ready for the reception of the collection" which
by that time had grown to an estimated 3,500 specimens. Already, Dr. Brinton
reported to the Acting Surgeon General, "the collection of gunshot injuries
alone is the largest in the world, exceeding in number and value that of the
British Government at Netley (formerly at Fort Pitt, Chatham), and far sur-
passing the French Museum at Val-de-Grace, founded by Baron Larrey." '
15 (1) National Archives, War Department Records, Adjutant General's Office, Miscellaneous 204,
Accession Number 421, SG Letter Book Number 4, Surgeon General's Office, p. 108. (2) Rrinton. op. at.,
pp. 182-184. (3) Lamb, op. at., pp. 16, 17, 19-21. (4) Lamb, D. S.: Army Medical Museum. Washing-
ton, D.C. The Military Surgeon 53: 99, 101, August 1923. (5) W. W. Corcoran Papers. On file in
Manuscript Division, Library of Congress, Letter Press Copy Book, volume 22, pp. 269, 410.
M (1) Original letter, John Hill Brinton to Joseph K. Barnes, 24 August 1863. On file in historical
records of AFIP. (2) Lamb, op. at., pp. 19, 20. (3) Lamb, The Military Surgeon. 53 (1923). pp. IOI,
102. (4) Brinton, op. at., pp. 183, 184.
26
ARiMED FORCES INSTITUTE OF PATHOLOGY
— -~- — — -^t^— ~ == : B\ I .'-J f*T7\ T"-^ A ^*-»-
Figure io. — The third home of the Museum. Picture is from an engraving by H. H.
Nichols of the Museum staff.
Grounds for Anxiety
Apparently, judging from the anxious tone of Brinton's letter of 24 August
1863 to Col. Joseph K. Barnes, the Acting Surgeon General, there was some
apprehension that the Museum project might be caught in the backwash of
the increasingly bitter differences between Surgeon General Hammond and the
Secretary of War. These differences between two men of powerful personality
and clashing temperament had progressed to the point, by 2 July 1863, that a
special commission of three civilians was appointed to scrutinize The Surgeon
General's papers, seeking cause for his removal. The Surgeon General had
added to the ranks of his opponents by the issuance, on 4 May 1863, of his
Circular No. 6 striking calomel and tartar emetic from the list of Army medical
supplies — an action which outraged many physicians who were accustomed to
use calomel as a standard medication, if not as a sovereign remedy. Before the
month of August was out, Hammond was ordered out of Washington on a vague
and ill-defined mission of inspection in the South with headquarters at New
BACKGROUND AND BEGINNINGS 27
Orleans, whence he was to report to the Secretary every 10 days, while Colonel
Barnes acted as Surgeon General. 1 '
It was obvious that the Secretary of War was determined to be rid of tlie
innovating and independent Hammond, and it might well have been appre-
hended that this determination extended beyond the person of the unwanted
Surgeon General to all his works, as well. At any rate, Curator Brinton, while
disclaiming any need for such representations, urged upon Acting Surgeon Gen-
eral Barnes that the plan for the Museum be carried out. "It is unnecessary for
me, Colonel," he wrote, "to urge upon you the value of our National Medical
Museum. Its claims to usefulness are recognized by the civil profession through-
out the country and it is by them weekly and almost daily considered. The
cabinet as it stands is not a mere Museum of curiosities. It is a collection which
teaches."
"It is practical," he continued, "and has already powerfully influenced for
the better the treatment of the wounded soldier." In confirmation, he called
to mind the lessons to be deduced, from the study of the specimens of the
Museum, as to injuries of the joints from conoidal balls, "a class of injuries
previously almost unknown and the treatment of which, at the commencement
of the war, was unsettled."
The proposed arrangement of the Museum in its new quarters, he added,
would open the collection to the study of every surgeon, civil as well as military.
Only in this way, he said, could a true knowledge of the treatment of wounds
caused by modern projectiles be diffused. Concluding, he referred to the loss
which would occur if the plans for the Museum should be changed. "I know
of no other suitable building for the purposes of the Museum," he wrote, "and
even should one be found, the fund at command would be utterly insufficient
to make a second time the alterations and repairs which would be absolutely
necessary."
Dr. Brinton's argument against scuttling the plan for removal of the
Museum to its new and larger quarters was successful, for on 1 September
Colonel Barnes was notified that the Secretary of War had "authorized the
transfer of the specimens from the room in the Surgeon General's office to the
Museum newly selected." 18
" (1) Duncan, Louis C: The Strange Case of Surgeon General Hammond. The Military Surgeon 64:
107-108, January 1929. (2) Ashburn, Percy M.: Gleanings from Medical Department History. Military
Surgeon 64: 449, March 1929. (3) Drayton, Evelyn S.: William Alexander Hammond, 1828-1900;
Founder of Army Medical Museum. The Military Surgeon 109: 563, October 1951.
18 (1) Original letter, John Hill Brinton to Joseph K. Barnes, 24 August 1863. On file in historical
records of AFIP. (2) Lamb, op. cit., pp. 19-21. (3) Lamb, The Military Surgeon, 53 (1923), pp. 101-102.
2 8 ARMED FORCES INSTITUTE OF PATHOLOGY
Plans for an Army Medical School
Dr. Brinton was less successful in the attempt to establish a school of military
medicine and surgery in the Museum. On 24 September 1863, four young
Army medical officers then on duty in Washington, some of them being con-
nected with the Museum and "wishing to make that institution at once practi-
cally useful," asked Acting Surgeon General Barnes for "permission to deliver
a course of lectures on military medicine and surgery in the hall of the Museum."
Such a course would be particularly advantageous, they suggested, because of
the large number of medical cadets and junior medical officers on duty in the
hospitals in the Washington area. It was proposed to deliver the lectures in the
evening so that they "would in no way interfere with the official duties of any-
one concerned." The proponents of the course had all had experience in lectur-
ing on medical subjects. "These lectures of course will be delivered free," the
letter read, "and with the facilities afforded by the Museum would not be a source
of any expense whatever to the Government."
The officers who thus proposed what would nave been the first school of
the sort were: Doctors Brinton and Woodward, Dr. Roberts Bartholow, and
Dr. D. W. Bliss. Others who were to have lectured included Surgeons John A.
Lidell and A. C. Hamlin, Assistant Surgeon William Thomson, of the Volun-
teers, and Surgeon Richard H. Coolidge of the Regular Army, who was to
have taught the customs of the service and military medical ethics.
The Acting Surgeon General submitted the proposition to the Secretary of
War, who said he would decide the matter the next day. Surgeon Brinton
tells the story :
On the morrow, about nine o'clock, on his drive from his home to the war office, he
[the Secretary] stopped at the Museum Building, descended from his carriage, ran hastily
through the Museum rooms, looked angrily at the dear little lecture room, stamped his foot,
growled, "Ugh," drove to his office, sent for Acting Surgeon General Barnes and said
sharply to him, "Are these lectures to be given in the evenings?" To an affirmative reply,
he growled, "They will go to the theatre and neglect their duties. It shan't be," and thus
was the end of a favorite plan for doing some good for the Medical Corps of the Army,
and for disseminating a more correct and general knowledge of military medicine and
surgery. 19
And, it might be added, it was to be another 30 years before the idea of
an Army Medical School was to come to fruition.
19 (1) Original letter, John Hill Brinton to Joseph K. Barnes, 24 September 1863. On file in historical
records of AFIP. (2) Lamb, op. cit., pp. 23-25. (3) Lamb, The Military Surgeon, 53 (1923), pp. 103,
104. (4) Brinton, op. dr.. pp. 258—259.
BACKGROUND AND BEGINNINGS 29
The Museum s Collections Grow
However disappointed Brinton and Woodward may have been at Secretary
Stanton's brusque dismissal of their promising plan, they still enjoyed the sup-
port of Acting Surgeon General Barnes both in their work on the "History" and
on the Museum project. On 25 November 1863, and again on 24 June 1864,
Dr. Barnes issued circular letters to all medical officers in aid of the Museum.
In the first letter, he invited attention to the possibilities of illustrations and
representations of the results of surgical operations by means of plaster casts
which, it was said, could "in many instances be conveniently obtained — with-
out subjecting the patient to the slightest inconvenience." It was suggested
that cases in which the results of the operation had been unfavorable would
be as "instructive and valuable for future reference and study" as those which
had resulted favorably.
The 1864 circular of Acting Surgeon General Barnes directed medical offi-
cers in charge of hospitals "to diligently collect and preserve for the Army
Medical Museum all pathological specimens which may occur in the hospitals
under their charge." Listing the types of objects desired, the circular contained
directions for forwarding them to the Surgeon General's Office, substantially
repeating and reinforcing the "Suggestions" printed in the 1863 Catalogue of
the Museum. 20
Under the stimulus of these orders, and as a result of the missionary efforts
of the Museum staff, specimens continued to come in, particularly after the
great battles. Two barrels, filled with the gruesome materials resulting from
the work of the surgeons, were sent in by a member of the Museum staff after
Gettysburg.
One specimen from that battle which came in, without need of orders
from The Surgeon General or solicitation by Museum staff members, was an
amputated leg, received in a small coffin-like box, bearing the visiting card of
the donor with the message, "With the compliments of Major General D. E. S."
Gen. Daniel E. Sickles, whose leg it was or had been, combined a keen sense
of self-advertisement with a high estimation of the importance and interest
attached to the severed anatomy of the commanding general of the III Corps.
That he was correct in his estimate is evidenced by the fact that even today
20 (1) Circular Letter, Surgeon General's Office, June 24, 1864. On file in National Archives, War
Department Records. (2) Lamb, op. at., pp. 25A, 25B, 28, 20. (3) Lamb, The Military Surgeon, 53
(1923), pp. 105-109.
30 ARMED FORCES INSTITUTE OF PATHOLOGY
the fractured bones of the Sickles' leg attract the interest of visitors to the public
exhibits of the Museum (fig. n)." 1
Hammond In Exile
Throughout the last half of 1863, the Medical Department of the Army
was in the anomalous state of having two heads— the titular Surgeon General
Hammond, who was in official exile away from the seat of government, and
Acting Surgeon General Barnes, in charge of affairs at the Capital. Determined
to put an end to this situation, Hammond demanded reinstatement in his office
or trial by court-martial. Permitted to return to Washington, he arrived on
15 January 1864, to be placed in arrest on the 17th, and ordered to trial, be-
ginning the 19th, on charges of irregularities in the procurement of supplies and
falsehood. Hammond sought a postponement to allow preparation of his de-
fense, but it was denied him, and he was forced to proceed to trial in 48 hours
on charges and specifications which had required 6 months to prepare. The
ensuing trial ran for nearly 4 months, accumulated a record of 2,500 pages,
and resulted in a verdict of guilty and a sentence of dismissal from the Service,
approved by the implacable Secretary of War and promulgated on 18 August.
Dr. Hammond, far from being crushed by the sentence, retained the respect
of the medical profession, and went on to win new honors as one of the founders
of the developing specialty of neurology, with a large and lucrative practice
in New York City. Fifteen years after his dismissal, on 27 August 1879, by
Act of Congress and action of the President, he was restored to the retired
list of the Army with his rank of brigadier general, though, at his own re-
quest, without pay for the past, present, or future. In its report recommending
such action, the Senate Committee summed up the evidence as follows:
A careful, unbiased and searching scrutiny of the evidence * » * forces irre-
sistibly the conclusion that the gravamen of all the charges save one (that of falsehood)
was either disproved by the defense, abandoned by the prosecution, or eliminated by the
findings of the court.
The single charge of which the gravamen was not found wanting by the Court, was
in itself trifling, if not frivolous, and certainly insufficient in character and importance to
arraign, try, convict, and pronounce sentence thereon, in the manner and form set forth.
Referring to Hammond's request that he not be awarded pay but only
vindication, the Committee wrote:
Dearer and more precious to him than untold gold, the priceless treasure of reputation
restored and reparation made at the hands of his countrymen; he was asked that his name
n (1) Brinton, John Hill: Address to the Graduates of the Army Medical School, March 13, 1896.
Journal of the American Medical Association 26: 602, March 28, 1896. (2) Lamb, op. at., p. 18. (3)
Lamb, The Military Surgeon, 53 (1923), p. 100.
BACKGROUND AND BEGINNINGS
31
Figure ii. — The "Incredible" General Sickles and his leg bones.
32
ARMED FORCES INSTITUTE OF PATHOLOGY
be again inscribed upon the roll of honor in companionship with those brave men who
had fought the good fight and rested on their unstained laurels.- 2
The verdict of the Senate Committee, concurred in by the Senate, the
House of Representatives, and the President, that William Alexander Ham-
mond deserved well of his country, has been accepted by all who are acquainted
with the achievements of his 15 months in actual charge of the affairs of the
Medical Department and with the circumstances surrounding his dismissal. In
the face of indifference, and even obstinate opposition, he had initiated reforms
and launched institutions which were to be of lasting benefit, and even his
unfulfilled recommendations were to come to fruition in later years.
The Second Curator
The change in surgeons general was followed, a month later, by the relief
of Major Brinton from his duties in the Surgeon General's Office and also as
Curator of the Medical Museum, and by orders for him to report to Assistant
Surgeon General Robert C. Wood at Louisville, Ky., for assignment in the
West. On 3 October, Dr. George Alexander Otis (fig. 12), who had been
Brinton's assistant since July, was named as his successor and was to serve as
Curator longer than any other individual. 23
The new Curator, 34 years old, was from Massachusetts but had received
his M.D. degree from the University of Pennsylvania, had studied in Paris, and
had practiced for 2 years in Richmond, where he had founded and edited the
Virginia Medical and Surgical Journal. From 1854 to trie outbreak of the war,
he had practiced in Springfield, where he had joined a Massachusetts regiment
as surgeon. After 3 years' service, in which he had attracted the favorable
attention of Charles Henry Crane, Assistant Surgeon General, he was assigned
to the Museum." 4
Reorganization of the Museum
Upon his designation as Curator, the Surgical and Photographic Sections
of the Museum were assigned to Dr. Otis, while the Medical and Microscopic
a (i) Duncan, Louis C: The Strange Case of Surgeon General Hammond. The Military Surgeon
64: 98-110, January 1929, and 64: 252-262, February 1929. (2) Phalen, James M.: William Alexander
Hammond. Army Medical Bulletin, Number 52, pp. 42-46, April 1940.
B (i) Special Orders Number 245, Adjutant General's Office. On file, National Archives, Accession
Number 421. Letter Book Number 9, Military, Surgeon General's Office. (2) Brinton, op. at., pp. 307,
"Hume, Edgar Erskine: Victories of Army Medicine: Scientific Accomplishments of the Medical
Department of the United States Army. Philadelphia: J. B. Lippincott Co., 1943, p. 81.
BACKGROUND AND BEGINNINGS
B
Figure 12. — Lt. Col. George A. Otis, the second Curator of the Army Medical
Museum, 1 864-1 881.
34 ARMED FORCES INSTITUTE OF PATHOLOGY
Sections were continued under the exclusive control of Dr. Woodward, an
arrangement which, according to Otis's report of i July 1865, was to work with
"entire harmony and concert of action" between the respective departments.
This division of labor was not new, since during Brinton's curatorship, patho-
logical work, as distinguished from the collection and preparation of specimens,
had been largely assigned to Woodward. Like his associate, Brinton, Wood-
ward was a Philadelphian, born in 1833, and a graduate in medicine at the
University of Pennsylvania in 1853. He was a founding member of the Patho-
logical Society of Philadelphia, organized in 1857, and had published several
papers dealing with microscopic studies before entering the Army at the outbreak
of war. In connection with his duties at the Museum, he had written "The
Hospital Steward's Manual," published in 1862, a valuable guide for the work
of the forerunners of today's medical corpsmen, and "Outlines of the Chief Camp
Diseases of the United States as Observed During the Present War," published
in 1863. 25
Pioneering in Microscopy
It was in the study of "camp fevers and diarrheas" that Dr. Woodward
(fig. 13) made the pioneer use in America of the newly discovered aniline dyes
in staining tissue, so that certain parts become more visible under the microscope.
The idea of staining specimens so as to cause particular features to stand out
more clearly was as old as Van Leeuwenhock himself, but the unstable nature
and the limited range of colors of most of the vegetable and animal dyes available
had limited the use of the idea until the discovery, by the English youth, William
Henry Perkin, of aniline dyes made from coal tar. The new dye industry
flourished famously in Germany and it was there, in 1862 and 1863, that the
new colors were used to stain specimens for microscopic examination.
On 14 May, Dr. Woodward wrote to Rudolf Virchow, whose theory of
the cellular origin of cellular tissues had been announced in 1858, asking if he
had "used aniline or any of its derivatives for coloring microscopical specimens."
There is no record of a reply from the great German investigator, if indeed he
replied to his then virtually unknown American interrogator, but as early as
July 1864, Woodward was using "aniline in histological researches," as reported
in a paper in the American Journal of the Medical Sciences, published in 1865
under the title "On the Use of Aniline in Histological Researches With a Method
■ ( 1 ) 1 lume, op. at., pp. 141, 142. (2) Edmonds, Henry W.: Woodward and the Changing Concept
of Cancer, 1 858-1873. The Military Surgeon 109: 314, 315, October 1951.
BACKGROUND AND BEGINNINGS
35
Figure 13. — Lt. Col. Joseph J. Woodward, MC, who pioneered in America in the use
of aniline dyes for staining microscope slides and in photomicrography "using the highest
powers."
of Investigating the Histology of the Human Intestine and Remarks on Some
of the Points To Be Observed in the Study of the Diseased Intestine in Camp
Fevers and Diarrheas."
From the title of Dr. Woodward's paper and its opening statement that
"the use of these colors for the purpose of staining certain parts of tissues and
thus rendering them more visible appears to be unknown in this country and,
so far as I can learn from the journals accessible to me, is imperfectly understood
abroad," it appears that, working independently in the Army Medical Museum,
36 ARMED FORCES INSTITUTE OF PATHOLOGY
young Dr. Woodward had hit upon and developed one of the great basic
techniques of the pathologist. 26
Woodward, Curtis, and the Camera
Another of the indispensable tools of present-day pathology in which
Woodward did pioneer work was the photographing of objects visible only
under the microscope. In this work, he was assisted by Dr. Edward Curtis
(fig. 14), whom Woodward described in his letter to Virchow as a patient
and dexterous young man (Woodward himself was 31; Curtis was 5 years
younger) with preliminary training as a microscopist, who was capable of
independent investigation in pathology.
The work in photomicrography, first undertaken late in 1864 (fig. 15),
was described in a report to The Surgeon General, published on 1 November
1865 as Circular No. 6, and again in the second part of the Catalogue of the
Microscopical Section of the Museum, published in 1867." In these early
experiments with microscopic photography, the source of illumination was
the sun itself, ingeniously harnessed "to insure a perfectly steady and at the
same time an intense light," according to the account of the process as given
in the catalogue.
The room in which the photograph was to be taken, darkened so as to
dispense with a light-tight bellows, became the "camera" with a window fac-
ing south as the "shutter," through which the direct rays of the sun, caught
in the mirror of a heliostat mounted outside the window, were reflected upon
the plane mirror of a microscope mounted horizontally just inside the window.
From the mirror, the reflected rays of the sun were thrown upon the object to
be photographed, placed upon the stage of the microscope, whence the light
passed through the barrel of the instrument to the object-glass where it was
magnified. The magnified image was brought to a focus upon the sensitive
photographic plate, mounted upon a stand which was moved back and forth
along a 10-foot track provided with a scale for measurement of distances from
the microscope (fig. 16). When photographs were to be made at the higher
™ (1) Copy of letter, Joseph J. Woodward to Rudolf Virchow, 14 May 1864. On file in historical
records of AFIP. (2) Leikind. Morris C: Aniline Dyes — Their Impact on Biology and Medicine. From
the Report of the Smithsonian Institution for 1957, Publication Number 4330, p. 437. (3) Lamb, op. cit.,
p. 38. (4) American Journal of the Medical Sciences 49: 106-113, New Series, 1865.
"(i) Circular No. 6, Surgeon General's Office, War Department, November 1, 1865, p. 148. (2)
American Journal of Science and Arts, Second Series, Volume LXII, Whole Number XCII, New Haven,
September 1866, pp. 189-195. (3) Catalogue of the Microscopical Section of the United States Army
Medical Museum, Washington, 1867.
BACKGROUND AND BEGINNINGS
37
Figure 14. — Maj. Edward Curtis, U.S. Volunteers, who collaborated with Dr. J. J.
Woodward in photomicrography.
38 ARMED FORCES INSTITUTE OF PATHOLOGY
jMt/t^i / /Lf.*6n£<J, fsC&e^&ms, &&Cct*/ etrt-teO /l/c-i , ■ TjtaiUj
97tx 6n*o c^rfu; £/t6*i_ ijji<t4t(_ Art/ //a_ V /xyyajt^uy &*ij*r*i/tj
■OmwJ W&mqJL' yfl*v**o /3~ fe ■&$?/ c/<n^>ttAi^ awt
Mi (rt*(i-> ) /u >>ir>(w^t'>i> ttaj As / t* t iAf// h/ y y/ .
(JUL wiwautu J2.Jrtu»a*.'i (£0rcjiy fe fymic/t, i^Je^e^ntm-^
1 5 <*■ r j -4 '■*" / ^
>naAivr.
A
Figure 15. — Photomicrography spreads. A. The idea of
photomicrography had spread from the Medical Museum to
the general hospitals, as shown by this memorandum of its
use in the Douglas Hospital in Washington.
powers of magnification, or those requiring extended exposure, the beam of
light was passed through a pane of greased ground glass giving a diffused
"white cloud" effect or, where necessary, through an achromatic condenser
placed below the stage. Photographs were made with violet light, separated
from the mean white light of the sun by passing the beam through a blue
ammonio-copper solution, which also aided the operator by absorbing the heat
BACKGROUND AND BEGINNINGS
39
B
Ficurh 15.— Continued. B. The miscroscopc shown is one
of those issued by the Surgeon General's Office.
rays of the solar beam. Pictures were "snapped" by opening an aperture in
the light-tight shield with which the window was fitted.
The apparatus with which Surgeon Woodward and Assistant Surgeon
Curtis worked was, to a large extent, of their own devising. At that time, all
plates used in photography had to be sensitized, exposed, and developed while
wet with chemicals mixed and applied at the time and place where the picture
was to be taken. Projection printing had not been perfected, so that it was
still necessary to expose the bulky wet plates in the size desired for the final
print. With all these complications in photography, experience showed that
better pictures were obtained by the employment of a "practical photographer
* * * to manage the dark room" while the microscopist focused his "whole
attention to the optical arrangements." Despite difficulties and complications,
the pioneer photomicrographers made pictures which suffer not at all in com-
parison with those made today.
4°
ARMED FORCES INSTITUTE OF FATHOLOGY
1
B
Figure 16. — Pioneer photomicrography. A. By sunlight. B. The microscope is
wedded to the camera.
BACKGROUND AND BEGINNINGS 4 1
Despite the frustrating delays of overcast weather and the vagaries of pass-
ing clouds even on sunny days and determined to make the "process wholly
independent of the weather," experiments were undertaken in 1869, using
electric lights and magnesium lamps (fig. 17), such as were used for "magic
lantern" lectures. Both proved successful, but the electric light was superior.
In fact, Woodward reported to The Surgeon General on 5 January 1870, that
an electric lamp, powered by a 50-unit battery, gave better results with less
trouble than sunlight, and claimed for the Museum and for himself the credit
of having demonstrated the serviceability of artificial lighting as a source of
illumination for making negatives of high powers. The use of artificial light-
ing made it possible, as Dr. Woodward reported in 1870, "to sit down quietly
of an evening, and during 4 hours of work to produce from 12 to 30 negatives,
or more" — a casual reference to the working habits which, along with his zeal
and enthusiasm, accounted for his prodigious output. But even before his
successful demonstration of the use of artificial light, Dr. Woodward, assisted
by Dr. Curtis, made negatives which were clear and well defined at the mag-
nification of 2,344 diameters, and which retained their clarity and definition
even when enlarged photographically to 19,050 diameters (fig. 18). 28
Making photomicrographs, however, was but one facet of the work carried
on by Lieutenant Colonel Woodward and Major Curtis. There was always the
work on the massive medical volumes of the Medical and Surgical History
and on the voluminous and growing materials of the Record and Pension
Division, which had been committed to Woodward's care.
The Museum and the Lincoln Tragedy
The most melancholy mission assigned to Doctors Woodward and Curtis
was that of doing the autopsy upon the body of President Lincoln, who died
at 7:20 a.m., 15 April 1865. The pathologists were summoned to the White
House at n a.m. to perform the grievous task of finding and removing the
bullet fired into Mr. Lincoln's head by the assassin, John Wilkes Booth. Wood-
ward's laconic technical report, addressed to The Surgeon General, gives no
hint of the emotional tension under which he must have labored. After de-
scribing the bloodshot condition of the eyes and lids, and the condition of the
wound and surrounding tissue, swollen with blood, he traces the course of the
bullet, which entered through the occipital bone about an inch to the left of
18 (1) Woodward, J. J.: Report to the Surgeon General .... on the Magnesium and Electric Lights
as applied to Photo-Micrography, Washington, January 5, 1870. (2) Lamb, op. cit., p. 27.
42
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 17.— Photomicrography by artificial light. A. Using the electric light. B. Using
the magnesium light.
the median line, and just above the left lateral sinus, which it opened. It
then penetrated the dura mater (the outer sheath covering the brain), passed
through the left posterior lobe of the cerebrum, entered the left lateral ventricle,
BACKGROUND AND BEGINNINGS
43
K A B D B P k R THE NT,
Surgeon General'! Office, Army Medical Museum.
PLEUROSIGMA AXGULATOM.
I
Pliologrnphcd by D IABB i uni*. Aj
By Ouutii or 1. ] II n
J J. VYuobWARD.
Hit I.l- Orf. umI A— I. Swg, C. 9 A
Figure i8. — A diatom, a form of unicellular life of microscopic size, is magnified by 2,540
diameters.
and lodged in the white matter of the cerebrum just above the anterior portion
of the left corpus striatum where it was found. The ventricles of the brain were
full of clotted blood. A thick clot beneath the dura mater coated the right
cerebral lobe. There was a smaller clot under the dura mater of the left side.
713-028'— 64 5
44 ARMED FORCES INSTITUTE OF PATHOLOGY
But little blood was found at the base of the brain. Both orbital plates of the
frontal bone were fractured, and the fragments pushed up toward the brain.
The dura mater over these fractures was uninjured. The orbits were gorged
with blood. 29
A more colorful and emotion-packed account has been left by Dr. Curtis,
who wrote:
Eleven o'clock comes; the two designated pathologists are ushered into what was the
bedchamber of the deceased, a room furnished in simplest style. There sit in solemn silence
some officers in uniform and some civilians, while the Surgeon General paces nervously
to and fro beside another silent occupant of the chamber, a shrouded figure, cold and
motionless, lying outstretched upon two boards laid across trestles * * *.
The shroud is laid back, and see! A smooth clear skin fitting cleanly over well-rounded
muscles, sinewy and strong * * *. Next see at the back of the head, low down and
a litde to the left, a small round blackened wound, such as is made by a pistol-shot at
close range. There is no counter-opening, so the missile has lodged and must now be
found * * *. The part is lifted from its seat, when suddenly, from out a cruel vent
that traverses it from end to end, through these very fingers there slips a something hard —
slips and falls with a metal's mocking clatter into a basin set beneath. The search is
satisfied; a little pellet of lead.
So impressed was Dr. Curtis with the historical interest attached to the
autopsy on the martyred President, that when he found some drops of the blood
of the President upon his cuffs, Mrs. Curtis cut them off and saved them.
Ultimately, they were presented to the Medical Museum where they may be
seen today, along with a tiny sliver of bone which evidently had been driven
into Mr. Lincoln's brain by the bullet and had adhered to the surgical instrument
used by Dr. Curtis (fig. 19) . 30
Another connection between the Museum and the events surrounding the
death of President Lincoln was the preparation by Hermann Faber (fig. 20),
" (i) This account is taken from a true copy of the original, certified by Maj. George A. Otis, in the
collection of the Medical Museum. In Gilmore, Col. Hugh R., Jr.: Medical Aspects of the Assassination
of Abraham Lincoln. Proceedings of the Royal Society of Medicine, London, 47: 103—108, February 1954.
It is Dr. Gilmore's opinion that "it is doubtful if modern medical practice could have saved Lincoln's life."
(2) In a lecture at Walter Reed Army Medical Center on 25 May i960 (reported in the Washington Post
of 25 May), Lt. Col. George J. Hayes, M.C., Chief of Neurological Service, said that even with the best of
modern medical service, the President would have had no more than a 50-50 chance of survival, and even
if he had survived, he would probably have been completely paralyzed on the right side and possibly
unable to talk.
M (1) Personal Recollections of the War of the Rebellion: addresses delivered before the Commandery
of the State of New York Military Order of the Loyal Legion of the United States, Fourth Series, A. Noel
Blakcman (editor), New York, 1912, includes "Last Professional Service of the War," pp. 54-65, read
on 7 October 1908 by Companion Edward Curtis, Brevet Major, Late U.S.A. (2) From the bloodstains
on the cuffs preserved by Mrs. Curtis, Col. Joseph H. Akeroyd, MSC, U.S. Army (now stationed at Brooke
General Hospital) was able to type President Lincoln's blood as Type A.
BACKGROUND AND BEGINNINGS
45
m
Figure 19. — The bullet that ended President Lincoln's life, the instrument used to locate it,
and bone fragments which adhered to it.
medical artist at the Museum, of the earliest and most accurate sketch of the
scene at the deathbed of the President. Mr. Faber, a German artist enlisted as
a hospital steward and assigned to the work of what would now be called
medical illustration, entered the Petersen house, in which Mr. Lincoln had
died, immediately after the removal of the body. Nothing had been disturbed,
and the sketch made was approved for accuracy by Surgeon General Barnes,
who had been one of the physicians attending the President and who was
present at his death. The original of the sketch is among the exhibits at the
Medical Museum (fig. 21). 31
31 (1) Purtle, Helen R.: Lincoln Memorabilia in the Medical Museum of the Armed Forces Institute
of Pathology. Bulletin of the History of Medicine 32: 68-74, January-February 1958. Miss Purtle's
article discusses interestingly the various Lincoln items in the Museum, and gives an account of the
acquisition of each one, which was mostly by gift. (2) Original sketch was presented on 30 January 1933,
by Erwin F. Faber, son of Hermann Faber, to the Army Medical Museum. Letter on file in historical
records of AFIP.
46
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 20. — Hermann Faber, whose sketch of the Lincoln
deathbed scene gives some idea of the throng in attendance.
The pictorial resources of the Museum were also called upon in the search
for the President's assassin and his accomplices. "During the month of April,"
says a report of 1 July 1865 from Dr. Otis to The Surgeon General, "there were
printed 1,500 photographs of the assassins of the President, for the assistance of
the officers of justice." 3 ~ Presumably, these photographic prints were used to
illustrate the reward posters of the War Department, dated 20 April 1865. This
1 Lamb, op. cit., p. 35.
BACKGROUND AND BEGINNINGS
47
i*.
1
Figure 21. — This sketch, made by Hermann Faber immediately after the removal of
President Lincoln's body from the Petersen house in which he died, was approved for
accuracy by Surgeon General Barnes.
poster is illustrated with a familiar pose of Booth, but the picture of David E.
Herold is that of a schoolboy, while the one supposed to represent John H.
Surratt is of some other individual entirely. Later, after the conspirators had
been captured, tried, and executed, the War Department revised the photo-
graphic part of the poster, changing the Booth picture to another pose, the
picture of Herold to one made after his capture, and the Surratt picture to one
of Surratt made after his capture and return to the United States. 33 The poster
exhibited at the Medical Museum is one of the revised edition (fig. 22).
Still another contact of the Museum with the Lincoln tragedy was the
examination of the cervical vertebrae and section of the spinal cord of the
assassin, John Wilkes Booth. These specimens were removed from the body
officially identified as that of Booth after it was brought to Washington on 29
April 1865, and show the course of a conoidal bullet through the third, fourth,
"Roscoe, Theodore: The Web of Conspiracy. Englewood Cliffs, New Jersey: Prentice-Hall
'959- PP- 334. 335-
Inc.,
ARMED FORCES INSTITUTE OF PATHOLOGY
War Department, Washington, April 20, 1865,
'-»-ffi )0,000 REW ARD
TIE MURDERER
Of our late beloved President, Abraham Lincoln,
IS STILL AT LARGE,
$50,000 REWARD
Will bo Mid bj this Dop&rtniuDt Tor his appreh
Municipal Authorities or State Executives.
•.•ward offered by
$25.i
in
Will be paid for iho upprelie
$25,i
in
REWARD
I of JOHN H SURBATT, MU or Booth'* Accomplice*.
REWARD
Will be paid for the apprehension ot David C. Harold, another of Booth's acoomplioea,
U HI IBM "ill hi («<•! km jh> IpJtaMiBi u»< tal wfa ba angel ■■' «<»" w "" **">**>
Sfl p-r-ww hnri».rtns •" ir^ntkiat lh- -ai.l |f(v.,u- 01 vital i ■■! ili-m. ..( (Man*, •* i-i-im^ (h- i r .'..ii.valiii.tii Of
n--apr. vill I>r lri-nl.il ». arHiitiplin- in t*. m-itrUr at th* rVailkat •'■•! lae MIMMpM *"**'»■ ''"" " f "» ^■•W»a/T of
Ma, a** .ban he ->*>>•-( tu trial befi.r.- ■ Hlftii) "Tmi'^j nl the paafahiiiiH nl UMTH
l*t lar Mail .rf mnon-tjl I^omI be IfniwwJ <•""> tlw '*<"* '•> lfc» •"•i -""' f"J»!-hin.-i>l "' ,,,, ' MM * "* *"
\ll ifw.il ,-itiirn- ai» »ti.*1.J l<> aid paESr JMtfjcv '>n ihia nrrwiiili Brer* m-m hoaM roaaiaVf III- '"•» • •iti»"ioai»
<a*f*Mt >iUi 'hi-. -'■U-rnn detv, and r»~4 Beitbel nL-l.i hi dav until n be ■MMRfHaM
KIM* I * H. ST ASTO.V *4**rvtar) «f War.
- DHa"KIITlH5x. *HTH h Hw Keel : at - batea Ugh, -i'-l-r bald, kM faneeed Mm* hdr, UhI ■■•-. aad
<MH» a heart bleak laniahreji
JollV U .' jil'RRAT i. ab™t i fret, if iaoW llair ratiu-r ihui hh) Auk: "■- rather !i«bt. on beard. Wogtd
wele* 149 or 1M potman. t '^atrikw niter r pair anil <-lear, -ill. o..kw in be) iWk Wet* I i«hl clothe* i<f Bee
•Mil*, ?*™leVr» aqeatv reeM hone* rather promier nl : alb nartaw ; MU iTO|e«linK at il«- l"p fan-head rather
fee aad*eeerr. bat broad ParU hieJau? <>n dw rinhi alee: etci ™thw '""it- tii- lip- an- linuli ~et. V "liw meo,
ll.iHK ' MAKMf.fi ., fee fret aft in.-hr* hiffh. liaic ilark •'•'- -lara, I pfcjWW rather lire*?, full tare. BOM abort,
hand *b"»rt awl Beaky, fret -mall i„«,.|, hiL-l ratlt >|nlra ^if! aotlva, iUfftMl* "Iim« hi" ct™ whea
IkaUajt at a prnoa
!HTl(3t -In acUilHM :o th. above, StaU ami -Uhi aiilhttnu-- !«**•■ otfi-rtiJ i.-«af>la a
Figure 22. — Reward poster, revised.
BACKGROUND AND BEGINNINGS 49
and fifth cervical vertebrae and the perforated spinal cord, all of which are now
on exhibition in the Museum. 34
With the surrender at Appomattox and the collapse of the Confederacy,
the war which had been responsible for the birth and growth of the Museum
was approaching an end. Soon the grand armies of the Union would march
in review up Pennsylvania Avenue and would disband to their homes. Many
of the war-born institutions would come to a close — but not the Army Medical
Museum. It would continue its mission of showing, by specimens, preparations,
and illustrations, the nature and form of disease and injury, and teaching ways
and procedures to alleviate suffering and lessen mortality according to the
medical lights of the time.
M (1) Purtle, op. cit., p. 74. (2) Medical and Surgical History of the War of the Rebellion. Surgical
History. Washington: Government Printing Office, 1870, pt. I, vol. II, p. 453.
CHAPTER III
Second Wind
Fortunately for the future, while most other elements in the great complex
of military organizations which had just won the war were shrinking back
toward pre-war standards of size and activity, the Medical Museum was per-
mitted to go on its way undisturbed. It had won the respect of the new Surgeon
General, loseph K. Barnes (fig. 23), who declared in the Annual Report for
1864, wri il e tne war was stm being fought, that "the Army Medical Museum
continues to increase in value, and is already one of the most instructive patho-
logical collections in the world." Thus, early in its history, the ultimate
direction of the development of the Museum was foreshadowed by the use of the
word "pathological" to describe its collections. The term was repeated in The
Surgeon General's Report for 1865, with mention of the Museum's "patho-
logical collection," which had grown to 7,630 specimens.
Continued support of the project by Surgeon General Barnes was further
evidenced by Circular No. 6 of the Surgeon General's Office, issued on 26 lune
1865, directing that "when Hospitals shall be discontinued and their Libraries
disposed of, the most valuable works, Scientific, Historical, etc., shall be care-
fully selected, packed and turned over to the Quartermaster's Department for
transportation to Surgeon George A. Otis, U.S.V., Curator of the Army Medical
Museum."
Supply and Funding for the Museum
Besides books, The Surgeon General interested himself in supplementing
the financial support of the Museum by securing from the War Department
the authority to have all "slush funds" of discontinued hospitals turned over
to Major Otis for the use of the Museum. lust how much these funds amounted
to does not appear, but the transfer, ordered on 27 September 1865, did not
escape the attention of the Comptroller of the War Department, to whom
General Barnes addressed an explanation and an inquiry on 21 July 1866. "This
Fund," The Surgeon General wrote, "accrued during the war at the various
General Hospitals from the sale of soap, fat and swill, and upon their discon-
713-02S" — 04 6
52
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 23. — Maj. Gen. Joseph K. Barnes, The Surgeon General of the Army for 18 years,
1 864-1882, who carried forward much of the program initiated by General Hammond.
SECOND WIND 53
tinuance, was transferred to Dr. Otis by authority of the Honorable Secretary
of War, to be expended for the use of 'the Army Medical Museum.' As this
fund resulted from the sale of refuse subsistence supplies, it is believed to be
embraced in the exceptions to the Act of 1849, which are stated in the Act of
1850." Under the circumstances, The Surgeon General asked, were not the
"slush funds" exempt from the requirements of the Act of 1849 that "all moneys
received from the customs, and all other sources, are to be paid into the Treasury
without abatement or reduction" ? 1
Expenditures from the Museum fund, whether augmented by the "slush
funds" or not, were extremely modest. As reported by Curator Otis to The
Surgeon General on 1 July 1865, "* * * about two-fifths of the annual
appropriation" of $5,000 had been paid for new cabinets to contain the speci-
mens and $1,200 had been spent for "apparatus of a high order of excellence"
for the "commodious photograph gallery erected in the yard of the Museum
by the Quartermaster's department, and supplied with water, baths, screens,
shelving, etc."
Increasing Activities of the Museum
Over 50 of the more interesting specimens in the Museum had been photo-
graphed, and 40 complete sets of this series of pictures, each accompanied by a
history, had been prepared for issue to medical directors of armies and depart-
ments. This project had involved the making of more than 1,000 photographic
prints, this being before the day of the halftone process of reproduction. In
addition, 150 photographs were made to guide the wood engravers in making
a like number of woodcuts for use in illustrating catalogs or other oublications
relating to the surgery of the war.
Additional apparatus for Surgeon Joseph J. Woodwards microscopical work
had been purchased, and "for several months" Assistant Surgeon Edward Curtis
had been engaged in experiments in photomicrography, with results already
attained that had been favorably received. In the surgical department, 997
additional specimens had been mounted and cataloged since 3 October 1864,
while the medical side of the Museum had "very complete" illustrative materials
on the principal camp diseases, with many valuable additions on parasitic
diseases and morbid processes in general.
*(i) Lamb, Dr. D. S.: A History of the Army Medical Museum, 1862-1917, compiled from the
Official Records. Mimeographed copy in historical records of AFIP, pp. 34, 37. (2) On file, National
Archives, Accession Number 421 , Letter Book Number 42, SGO, p. 347.
54 ARMED FORCES INSTITUTE OF PATHOLOGY
Enough glass jars were on hand to meet the Museum's needs for a year to
come, and a sufficient quantity of alcohol had been distilled from confiscated
whisky turned over to the Museum by the major general commanding in
Washington to mount the wet preparations suitably. 2
The Museum, according to Dr. Otis's report, had not only enough glass
jars and alcohol; it had also an appropriation for the coming year that was
"ample." The fact that an annual appropriation of $5,000 was "ample" was
explained later by Dr. Woodward in an article in Lxppincott 's Magazine for
March 1871. "The building is already the property of the government, the
officers and attaches all belong to the army; no extra-duty pay, no special allow-
ances of any kind are awarded to any of them." Hence, as Dr. Woodward
put it, "the total additional outlay * * * in consequence of the existence
of the museum is so small that it may fairly be regarded as insignificant in
comparison with the good to be obtained." 3
The Museum's Fourth Home
In its 3 years of life, the Museum had been housed in three different build-
ings and now, in its fourth year, it was to be moved again. Its new quarters
were in the building (fig. 24) formerly occupied by Ford's Theater, on 10th
Street, NW., where, on Good Friday of 1865, President Lincoln was shot.
The building had been closed as a theater immediately after the assassination
and had been in the possession of the Government since 8 July 1865. The
purchase of the building "for the deposit and safekeeping of documentary
papers relative to the soldiers of the army of the United States and of the
Museum of the Medical and Surgical Department of the Army" was provided
for by Act of Congress approved 6 April 1866, and on 7 May 1866, the building
was assigned by Secretary of War Edwin M. Stanton to The Surgeon General. 4
Its interior fittings had been torn out and replaced with three floors, of
which the upper floor was assigned to the Museum, the second floor to the
surgical records of the Surgeon General's Office, and the ground floor to the
Record and Pension Division of the same office. There had been an effort to
fireproof the building by putting in brick floors resting on iron arches, sup-
~ (i) Lamb, op. at., pp. 35, 37. (2) Lamb, D. S.: Army Medical Museum, Washington, D.C. The
Military Surgeon 53: 109-111, August 1923.
3 Woodward, J. J.: The Army Medical Museum at Washington. Lippincott's Magazine, Philadelphia,
VII: 241, March 1871.
*(l) Statement of Gen. Joseph K. Barnes. On file, National Archives, War Department Records,
Letter Rook No. 14, SCO, 1878, p. 15. (2) U.S. Statutes at Large, volume 14, p. 23.
SECOND WIND
55
Figure 24. — The fourth home of the Museum.
ported by columns of iron. Stairways between floors were also of iron. The
building had a front of 71 feet on 10th Street, and a depth of 109 feet. Museum
workshops and a chemical laboratory were housed in small wings on each side.
Into this building, "the scene of the assassination of the lamented Lincoln,"
in the words of Dr. Woodward, the collections of the Museum were to be
moved. "What nobler monument could the nation erect to his memory," the
doctor asked, "than this sombre treasure house, devoted to the study of disease
and injury, mutilation and death?" 5
The movement of this "sombre treasure" from the building on H Street
began on 12 November 1866, and continued until 8 December. The removal
of the records, and that portion of the collection which had been housed at
180 Pennsylvania Avenue, followed between 11 December and the 21st of the
month. On the 22cl, General Barnes advised the Quartermaster General's
'Woodward, Lippincott's Magazine, VII (1871), pp. 233, 242.
56
ARMED FORCES INSTITUTE OF PATHOLOGY
office that the former quarters had been vacated, and transmitted the keys. 6
For the next 20 years, the life of the Museum was to be centered in the Ford's
Theater building.
From the beginning, the Museum had attracted an increasing number of
visitors. Within a year of its establishment, its usefulness had been recognized
by the civilian medical profession as well as by the military, and it was "weekly
and almost daily" consulted by them. 7 To the medical profession, there was
added another class of visitors with a special interest. In Dr. John H. Brinton's
phrase, "officers and soldiers who had lost a limb by amputation would come
to look up its resting place, in some sense its last resting place." Then, too,
as Dr. Brinton wrote, "the public came to see the bones, attracted by a new
sensation." While the Museum was still at the H Street address, Curator Otis
reported, more formally, "the number of visitors to the collection constantly
increases." 8
With the removal to the Ford's Theater building, and its tragic associations
with the great appealing figure of Lincoln, the number of visitors mounted to
such an extent that rules, approved by order of The Surgeon General and issued
on 25 April 1867, were posted (fig. 25) .*
Between mid-April of 1867 and the end of the year, some 6,000 persons, an
average of about 25 for each day the Museum was open, had been registered
in the visitor's book. Within the next 4 years, the number of visitors had
trebled, 10 and the Museum had become established as one of the "sights" of
Washington. When extra crowds came to the city, as upon the occasion of Lt.
Gen. Ulysses S. Grant's inauguration as President in 1869, the visiting hours
were extended — opening at 9 a.m. and closing at 4 p.m.; and at his second
inauguration, in 1873, from 8 a.m. until 4 p-m. 11
The collections viewed by these visitors were divided into six groups or
sections — surgical, medical, microscopical, normal human anatomy, compara-
tive or animal anatomy, and miscellaneous articles (fig. 26).
* (1) Lamb, op. cit., p. 41. (2) Lamb, The Military Surgeon, 53 (1923), pp. 112, 113. (3) National
Archives, Accession Number 421, Letter Book Number 13, Military, p. 452.
'Original letter, John Hill Brinton to Joseph K. Barnes, 24 August 1863. On file in historical records
of AFIP.
*(i) Brinton, John Hill: Personal Memoirs. New York: The Neale Publishing Co., 1914, p. 189.
(2) Lamb, op. cit., pp. 35-37. (3) Lamb, The Military Surgeon, 53 (1923), p. no.
* War Department Records, Office of the Surgeon General. On file in National Archives.
10 (1) Lamb, op. cit., p. 44. (2) Woodward, Lippincott's Magazine, VII (1871), p. 239.
"Original letters, George A. Otis to Charles H. Crane, 2 March 1869 and 28 February 1873. On
file in historical records of AFIP.
SECOND WIND 57
r
■ mo
Mu
5f bLo C$nwM oM^djLXLoL W'JJLUvntL
xr
;zzn
jU>A '^yv^^^db "tew *^a> jq^^o^uu j o^Zd ^ oU|o^a>ob
C^dU/J.^. rv^y-^o AaaJUL a-"yv<. sJajuJc^ tUY /ttvj- <AXa~-«^ .
Figure 25. — The Museum adopts visiting rules.
In addition, there was the beginning of a collection of crania, chiefly of
American Indians, together with specimens of Indian weapons, dress, imple-
ments, diet, and medicines, started in response to Circular No. 2 of the Surgeon's
General's Office, issued on 4 April 1867. The chief purpose of the collection,
officers of the Medical Department were informed by Assistant Surgeon General
58
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 26. — Main exhibit hall of the Museum, Ford's Theater building, 1 866-1 887.
SECOND WIND
59
Charles H. Crane in a memorandum of September 1868, was "to aid the progress
of anthropological science by obtaining measurements of a large number of
skulls of the aboriginal races of North America." For that purpose, it was
necessary "to procure sufficiently large series of adult crania of the principal
Indian tribes to furnish accurate average measurements." 12
The articles relating to Indian archeology and anthropology, received
along with the skulls and skeletons, belonged more appropriately in the Museum
of Natural History, administered by the Smithsonian Institution. Professor
Joseph Henry, Secretary of the Smithsonian, accordingly proposed to Surgeon
General Barnes an exchange of the Smithsonian's anatomical materials for the
Medical Museum's materials relating to the manners and customs and the
archeology of the Indian tribes. The Surgeon General agreed, and over the
next several years numerous exchanges were effected.
The craniological collection was to have been the most important feature
of a proposed catalog of the anatomical section of the Museum, to accompany
the catalogs of the surgical, medical, and microscopical sections. In a letter
of 18 January 1873, to the Honorable John Coburn, chairman of the House
Committee on Military Affairs, Surgeon General Barnes strongly urged such
a catalog as "simply a necessity" to make the collections accessible to students.
"Anthropologists in different parts of the world," he wrote, "are anxious for
the data * * * for comparison with similar data published in Sweden,
Russia, Germany, Italy, France, and England. The French Government,
through its Legation here, after making repeated applications for the tables
of cranial measurements, employed an artist to make casts and take photo-
graphs of a series of typical skulls; and a professor of Bonn made the study of
the collection the object of a trip across the Atlantic."
The Military Affairs Committee reported favorably on the bill authorizing
the publication of the catalog at a cost for 1,000 copies estimated at $26,200,
but the bill was not passed and the catalog was not published. 13
After some 30 years of medically unfruitful measurement of the cubic
capacity, the length and breadth, the facial angle, and other characteristics of
skulls, it was decided that such determinations pertained more properly to
anthropology than to medical study. On 8 May 1898, therefore, the Museum's
"(i) War Department Records, Office of the Surgeon General. On file in National Archives. (2)
Lamb, op. cit., pp. 43, 50, 51. (3) Lamb, The Military Surgeon, 53 (1923), pp. 117, 118.
"House of Representatives Report 56 (421! Congress, 3d session), 4 February 1873, "The Army
Medical Museum."
6 ARMED FORCES INSTITUTE OF PATHOLOGY
collection of crania, by then numbering 2,206 specimens, was transferred to
the Museum of Natural History."
Exchanges of duplicate and supernumerary specimens with other institu-
tions and individuals, and purchase of private collections increased the hold-
ings of the Museum. Among the former was the exchange of pictures and
models, suitable for class demonstration, which had been prepared for use in
the projected Army Medical School, vetoed by Secretary Stanton, for a cabinet
of pathological specimens collected by professors of the National Medical Col-
lege of Washington, which had taken over the buildings on H Street vacated
by the Museum and which, under its present name of the School of Medicine
of George Washington University, still occupies the site. Among the latter
was the purchase at Richmond, Va., on 22 April 1868, from the widow of
Prof. William Gibson, University of Pennsylvania, of a collection of 413
specimens, 54 casts and wax models of human anatomy, and 42 oil paintings
by Sully of various diseased conditions. 15
Still another source of specimens for the Museum's collection was the
medical staff of the Bureau of Refugees, Freedmen, and Abandoned Lands,
better known as the Freedmen 's Bureau. Col. L. A. Edwards, chief medical
officer of the Bureau, appealed on 6 June 1868 to "all Acting Assistant-Surgeons
in the employment of the Bureau, and especially those who are in charge of
Freedmen's Hospitals, [to] avail of every opportunity of contributing to the
Anatomical and Pathological collections of the Army Medical Museum." Offi-
cers were especially urged to make, or have made, autopsies and to forward
to the Museum "all pathological specimens of interest thus obtained." '
Praise From Foreign Visitors
By 1871, when Dr. Woodward's description of the Museum was published
in Lippincott's Magazine, the surgical section consisted of about 6,000 mounted
specimens and 350 plaster casts, the medical section of 1,150 specimens, and
the microscopical section of more than 4,000. The anatomical section included
nearly 1,000 human skulls and skeletons, of which 376 had been transferred
by the Smithsonian in exchange for Indian weapons, utensils, and other arti-
facts, while a still larger number had been contributed by medical officers. 17
The section of comparative anatomy (fig. 27) included more than 1,000 animal
" (1) Lamb, op. cit., pp. 52-54, 56, 57, 75, 76, 81, 89, 91, 97, 108, 114. (2) Lamb, The Military
Surgeon, 53 (1923), pp. 118, 119.
,s (1) Lamb, op. cit., pp. 48, 49, 56. (2) Lamb, The Military Surgeon, 53 (1923), pp. 116, 117.
'" War Department Records, Office of the Surgeon General. On file in National Archives.
17 (1) Woodward, Lippincott's Magazine, VII (1871), pp. 235-238. (2) Lamb, op. cit., p. 56.
SECOND WIND
61
Figure 27. — Early "dry" exhibits in comparative anatomy at the Medical Museum included
skeletal remains of a variety of mammals, birds, and reptiles.
62 ARMED FORCES INSTITUTE OF PATHOLOGY
skulls and skeletons, with special attention paid to the anatomy of the horse.
The majority of the 6,000 surgical specimens were, as was to be expected,
illustrative of military surgery, though other surgical cases were already well
represented. Over 400 missiles extracted from wounds were included, while
sabers and other cutting weapons were responsible for 22 specimens.
"Altogether," wrote Dr. Woodward, "it may safely be asserted that in the
illustration of military surgery this section not only exceeds any other surgical
museum in the United States, but surpasses any similar collection hitherto
made in the Old World — a fact that has been frequently and willingly admitted
by foreign savants well acquainted with the subject who have visited
Washington." 18
Dr. Woodward doubtless referred to statements by Dr. Berenger-Feraud
of Paris, published in the Gazette des hopitaux civils et militaires, Paris, and
Saint George Mivart, published in Nature, London, in 1870. In the Paris pub-
lication, Dr. Berenger-Feraud said that the United States had done as much
in the building of an anatomicopathological museum in 5 years as had been done
in Europe in a century, and that the three catalogs which had been published —
surgical, medical, and microscopical — contained more specimens than were in
all the like museums in Europe combined. In recognition of the fact that the
materials in the Museum had been chiefly collected during the American Civil
War, Mr. Mivart said in the London publication that "the Americans are a
wonderful people. There are few other nations which would have been capable
of so utilizing the results of a protracted internecine war as to make them
available in after years toward the advancement of medical science and alleviation
of human pain." 19
Some foreign visitors, according to Dr. Woodward, were not only impressed
by the scope of the collections of the Museum, but "seem to have been par-
ticularly struck with the free access given to the general public and to private
soldiers, who in less enlightened communities would be excluded from such an
institution."
While the majority of the 1,150 specimens in the medical section of the
Museum illustrated "morbid conditions of the internal organs in fever, chronic
dysentery and other camp diseases," Dr. Woodward reported, "the number of
preparations which exhibit the morbid anatomy of the diseases of civil life"
had been constantly increasing since the war. These included "pathological
'* Woodward, Lippincott's Magazine, VII (1871), p. 236.
"(i) Gazette des hopitaux civils et militaires, Paris, XLIII: 293, and Nature, London, 11 August
1X71., p. 290 (.is cited by Lamb, op. cit., pp. 57, 58). (2) Lamb, The Military Surgeon, 53 (1923), p. 120.
SECOND WIND 63
pieces" relating to the diseases of women and children — which, after all, were
not foreign to the practice of medicine by army doctors responsible for the
health of dependents as well as for that of military personnel.
The iSAuseum and the Medical Profession
Many of the post-war contributions to the Museum were from physicians
and surgeons in civil life who, as the institution became better known after the
war, gave specimens developed in their practice — the beginning of the close
relationship between the Museum and its successor, the Institute, and the medical
profession, the results of which have been so fruitful."
Among the more interesting of the early contributors to the collections
were former Confederate surgeons, including three presidents of the American
Medical Association, Dr. Henry F. Campbell of Augusta, Ga., Dr. Paul F. Eve
of Nashville, Tenn., and Dr. Hunter McGuire of Richmond, professor of surgery
in the Medical College of Virginia, but perhaps better known as the chief surgeon
of "Stonewall" Jackson's Corps in the Army of Northern Virginia. 21
The collections of the Museum, housed on the third floor of the building,
were lighted by windows front and rear and by a large central skylight. Beneath
the skylight was an oblong opening in the floor which let the light fall into
the space below. All available wall space was covered with display cases, which
also stood in ranks on the floor. In these cases, which were of pine and painted
white, the specimens were exhibited. Most of the surgical specimens were
mounted "dry," while almost all the medical specimens were "wet" preparations,
preserved in wide-mouthed jars, closed with ground glass stoppers to the
undersurfaces of which were attached glass hooks from which the specimens
were suspended in the preservative fluid (fig. 28)."
The ISAuseum and the Congress in the 1870' s
While supplies of alcohol distilled from confiscated whisky remained ample,
at least until 1876, with the growth of the Museum and its work, the annual
appropriation of $5,000 — which had seemed ample to Dr. Otis in 1865 — ceased
"° Woodward, Lippincott's Magazine, VII (1871), pp. 236, 237, 239.
21 (1) Otis, George A.: Notes on Contributions to the Army Medical Museum by Civil Practitioners.
Boston Medical & Surgical Journal 98: 163-169, 1870. (2) Lamb, D. S.: The Army Medical Museum —
A History. Washington Medical Annals 15: 9, January 1916. (A paper presented before the Medical
Society of Washington, 1 November 191 5.)
22 Woodward, Lippincott's Magazine, VII (1 871 ), pp. 234, 236.
64
ARMED FORCES INSTITUTE OF PATHOLOGY
W
s±
Figure 28. — Wet specimens on display enclosed in glass.
to be sufficient. The Surgeon General accordingly addressed a letter to the
Honorable James A. Garfield, chairman of the Committee on Appropriations
of the House of Representatives, on 6 January 1872, justifying an estimate of
$10,000 for the Museum and also the Surgeon General's Library. "No insti-
tution," he said, "has reflected greater credit upon its Government both at home
and abroad than the Army Medical Museum and its present size and steady
increase render the expense of keeping it in good order and preservation larger
than heretofore, although still small when compared with the cost of other
institutions of similar character." The request was looked upon with favor,
but the Senate Appropriations Committee cut the item from $10,000 to $5,000
whereupon, on 15 May, General Barnes wrote Chairman Cole, urging recon-
sideration and stating that the lesser sum was not sufficient to maintain the
growing collection and "to make some of the more valuable results known to
the profession of the country, a course which has been pursued so far as means
would allow." The appeal for restoration of the House figure was not success-
ful, and the next year's appropriation remained at $5,ooo. 23
An interesting sidelight is thrown on the problem of the congressional
relations of the Museum by a bit of correspondence between Curator Otis and
Brevet Lieutenant Colonel John Shaw Billings of the Surgeon General's Office,
preserved in the Armed Forces Institute of Pathology records. On 7 May 1870,
"On file, National Archives, Accession Number 421, Letter Book Number 50, SGO, pp. 37, 245.
SECOND WIND 65
Otis wrote, "I have on hand about thirty volumes of surgical photographs. Is
it practicable to have them bound at the Congressional Bindery ?", to which
inquiry Dr. Billings responded on the same day, "Dear Doctor: I do not think
it will be well to try to get any binding done at the Gov't, office until Congress
adjourns. It wouldn't be done I am sure and I doubt whether the attention
of the Committee on Printing would not be called to it— which thus far has
been avoided." 2i
Enlarging the Aims of the Museum
Despite limited financial support, the Museum continued to grow. By
1876, in its 10th year in the Ford's Theater building, the surgical section con-
tained 6,539 specimens, the medical section 1,279, the microscopical section
7,275, the human anatomical section 1,254, tne comparative anatomical section
1,522, and the section for miscellaneous articles 240. The primary emphasis
remained on preserving specimens illustrative of the wounds and diseases
which produced death and disability in the military forces, with the purpose
of reducing mortality and alleviating suffering among soldiers, but by 1876,
Dr. Woodward wrote, it had become "the desire of the Surgeon General that
so far as the means placed at his disposal will permit, the collection shall be
extended so as to embrace all forms of injuries and diseases, so that eventually
it shall become a general pathological Museum, accessible for study to all
medical men who are prosecuting original inquiries
That the original purpose remained uppermost is indicated by the reports
of foreign observers, who were struck by the richness of the collections in
gunshot and arrow wounds, and were impressed with the diligence and de-
votion which had permitted the making of such collections in the midst of a
great war. "Among the foreign visitors, whose wide experience made their
commendation peculiarly gratifying," said The Surgeon General in his annual
report for 1875, "were Baron Schwartz-Sanborn, Director of the Vienna World
Exposition of 1873, and Professor John Eric Erichsen, of University College,
London." Professor Erichsen, who visited the Museum in the fall of 1874, said
in a lecture on American surgery at the University College on 9 November
of that year:
There is one Museum which is so unique, so admirably arranged, and so interesting,
that I must direct your attention to it for a few minutes. It is the Museum of the
Army Medical Department at Washington. This magnificent collection, illustrating not
2t Original letters on file in historical records of AFIP.
* (1) Lamb, op. cit., p. 76. (2) Lamb, The Military Surgeon, 53 (1923), p. 125.
66 ARMED FORCES INSTITUTE OF PATHOLOGY
only every possible variety of gunshot and arrow injury, but also those diseases which
are more fatal than the bullet to an army in the field or in camp, has under the able
superintendence of Surgeon General Barnes, and of Drs. Otis and Woodward, been most
admirably arranged and catalogued * * *. Many of the specimens in this Museum are
quite unique * * *. 26
Varied Uses of the Museum
The Army Medical Museum became somewhat of a focus for the intellectual
and scientific life of the Washington of the 1870Y The fortnightly meetings of
the Philosophical Society, the leading intellectual group of Washington, were
held at the Museum, and the charter meeting of the now famous Cosmos Club,
and its first election of officers, was held at the Museum on 13 December
1878. 27 When the American Medical Association met in the Capital in 1868,
the Museum was the scene of a reception to its members given by The Surgeon
General. A like courtesy was extended to the members of the National
Academy of Sciences in 1870. Upon both occasions, as well as at other times,
Dr. Woodward showed transparencies of some of the remarkable photomicro-
graphs made at the Museum. Another notable visitor for whom The Surgeon
General had a reception at the Museum, on 11 December 1872, was Prof. John
Tyndall of London, whose studies in sterilization by heat had not yet reached
their culmination but who, already, had dealt mighty blows to the theory of
spontaneous generation. 28
Scientific Skepticism As to Bacteria
Just a month before the reception at the Museum for one whose careful re-
searches were to do so much toward establishment of the theory of bacterial in-
fection, Dr. Woodward paid his respects to the theory, in a letter to the editor
of the Washington Evening Star, published on 13 November 1872. "During
the last few years," the letter read, "it has been a favorite speculation in certain
quarters, that epidemic diseases are produced by the presence in the atmosphere
of vegetable germs, so minute as to be visible only with the microscope. Con-
siderable labor has been bestowed upon microscopical work in this direction,
but the results which have been confidently announced from time to time by
M (i) Annual Report, Surgeon General Barnes, 1875, p. 12. (2) The Lancet, London, 1874, II:
720 (quoted in Lamb, op. at., pp. 67, 68).
"' Cosmos Club Bulletin, Washington, volume 13, Number 3, March i960, p. 4.
38 Lamb, op. cit., pp. 49, 51, 54, 55, 57, 62.
SECOND WIND
6 7
enthusiasts have been either contradicted or so materially modified by subse-
quent observations that the question still remains in the domain of mere
speculation." Referring to the opportunities for "charlatanism" and for honest
mistake in this field, he added, "nevertheless I certainly regard the microscopical
forms which exist in the atmosphere and their possible effect on man as a
proper matter for scientific study, and by way of contributing my mite to the
difficult subject * * * I have collected the organic forms from a quantity
of air of a stable in this city where there are a number of sick horses, and sub-
mitted them to the highest power of the microscope, without finding any which
are not usually encountered when no epidemic is prevailing * * *.""
His opinion had undergone little change when, 7 years later, in part II of
volume I of the "Medical and Surgical History of the War of the Rebellion,"
he used with approval the derisive term "bacteriafanatics" and, speaking of the
persistence of the "general hypothesis that bacteria are in some way disease-
producers," said that Virchow's "splendid rhetoric has lent plausibility to argu-
ments which appeal almost as much to faith as to reason." Dr. Woodward
was well aware of the presence of inconceivable numbers of bacteria, but he was
doubtful of the disease-producing effects of what he referred to, somewhat
slightingly, as "those convenient bacteria which have played so conspicuous
a part in modern pathological speculation." 30
Ironically, the expressions of scientific skepticism on the part of Dr. Wood-
ward were published 2 years after Capt. A. C. Girard, stationed at Fort Randall,
Dakota Territory, had reported enthusiastically on the results of Joseph Lister's
technique in antiseptic surgery, which he had observed on a trip to Europe.
Captain Girard was willing to "leave to other pens the task of elucidating"
the nature of bacteria and how they acted upon the body, but he stoutly main-
tained "the indisputable fact that there are germs or ferments in the atmosphere
which will produce putrefaction in wounds, and that by preventing their ingress
we can in most cases avert the complications which cause the greatest fatality
in surgery * * *. This is the key to Lister's system." Captain Girard's
report was published to the Medical Corps in Circular Orders No. 3, Surgeon
General's Office, 20 August 1877, but, perhaps because the report and the Lister
system dealt with surgery while Dr. Woodward was concerned with medicine,
neither the Girard report nor Lister himself is mentioned in the 1879 volume
of the History.
29 (1) Lamb, op. cit., pp. 61, 62. (2) Lamb, The Military Surgeon, 53 (1923), pp. T20. lai, 123.
30 Medical and Surgical History of the War of the Rebellion. Medical History. Washington: Gov-
ernment Printing Office, 1 879, pt. II. vol. 1 , pp. 370, 374, 595.
68 ARMED FORCES INSTITUTE OF PATHOLOGY
The Third Curator
The stupendous task of compiling and writing the Medical and Surgical
History was drawing to its close when, in May 1877, Dr. Otis suffered a stroke
of paralysis, and in May 1880, Dr. Woodward was compelled by the state of his
health to go to Europe. On 23 February 1881, Dr. Otis died, at the early age
of 51, and was succeeded as Curator of the Museum by Surgeon David Low
Huntington, U.S.A. (fig. 29), who also took over the task of completing the
third and final part of the surgical volumes of the great History upon which
Dr. Otis was engaged at the time of his disability and death. 31
Back from Europe, Woodward suffered a broken leg on 1 January 1881,
when his horse slipped and fell on him, but he was able to resume work at the
Museum in time to be one of the physicians attending President James A.
Garfield, when the President was shot and fatally wounded by Charles J. Guiteau
on 2 July 1881. The shooting took place in the waiting room of the Baltimore &
Potomac railroad depot in Washington, where the President had gone to board
a train to join his wife on the New Jersey seashore. The first shot from Guiteau's
pistol grazed the President's arm; the second entered his back and was not
located until after his death on 19 September 1881. Probing failed to find it,
as did an "induction-balance" device of Prof. Alexander Graham Bell which
was supposed to locate metal objects by an electrically induced sound. Every-
thing known to the medical art of 1881 was tried, but in the prevailing state of
medical knowledge, there was nothing that could be done to save the President's
life.
The Museum and the Garfield Tragedy
Eighteen hours after his death, in a seaside cottage at Elberon, N.J., where
the President had been taken to escape the heat of Washington and the miasmas
of the swamplands south of the White House, an autopsy was performed by
Dr. Daniel Smith Lamb, pathologist of the Museum, with Dr. Woodward acting
as recorder (fig. 30). The autopsy disclosed the course and location of the fatal
bullet, which had entered the victim's back about 4 inches to the right of his
spine ; had broken the eleventh and twelfth ribs to the right of the spine ; passed
through the first lumbar vertebra, missing the spinal cord; grazed the splenic
artery; and stopped behind the pancreas, some 10 inches from the point of
31 (1) Lamb, op. cit., pp. 77, 80-82. (2) Lamb, The Military Surgeon, 53 (1923), p. 127.
SECOND WIND
6 9
Figure 29. — Surgeon David Low Huntington, U.S. Army, third Curator of the Museum,
1881-1883.
entrance. 1 " The President's vertebrae are preserved in the Medical Museum,
with the course of the bullet traced through them by a plastic rod.
Dr. Woodward's health failed early in 1882, and in February he left for
Europe — to return no more to the Museum. He did not participate in the
" (1) Lamb, D. S.: Official Record of the Postmortem Examination of the Body of President James A.
Garfield. American Journal of the Medical Sciences 82: 583-590, 1881. (2) Lamb, op. at., p. Si.
7"
ARMED FORCES INSTITUTE OF PATHOLOGY
/ ' \ 111
S • . ft, 0)
(J r ■ . V 6i
^ urn* ' 9j
Figure jo.— Bullet from the body of President Garfield, located at autopsy by Dr. Daniel
Smith Lamb, pathologist of the Museum.
SECOND WIND 7 1
autopsy performed by Dr. Lamb on Guiteau, the assassin, who was executed
on 30 June 1882. Special attention was given to the brain, sections of which
were parceled out to eminent alienists for examination, but no evidence of
unusual pathological change was found. 33
Thus it was, that in the first 20 years of its life, the Museum attaches were
called upon to participate in the activities growing out of the assassinations of
two Presidents of the United States, and the Museum itself became the repository
of the melancholy medical memorabilia of two great national tragedies.
33 (1) Lamb, op. cil., p. 83. (2) Lamb, Washington Medical Annals, 15 (1916), p. II. (3) Medical
News, Philadelphia, volume 41, p. 13, 1882.
CHAPTER IV
Broadening the Base
The Ford's Theater building was at best a makeshift home for the Museum,
the Library, and the historical records of the Surgeon General's Office, and
with the passage of time and the growth of the collections, it became less and
less suitable. By 1880, it has ceased to be adequate for the Museum alone, even
if all its space had been available for museum purposes. As it was, the Museum
was confined to the crowded and cluttered third floor, the books of the Library
were packed two and three rows deep on the shelves on the second floor, and
the hospital records of the Civil War, with the clerks at work on them, filled
the ground floor to overflowing. "In time," wrote Maj. Charles Smart, Surgeon,
U.S. Army (fig. 31), who was assigned to complete the work on the medical
volumes of the History after Dr. Joseph J. Woodward's disability, "there came
to be no room for even the storage of books and specimens, not to speak of facility
of reference or advantageous display." 1
There was, moreover, distinct danger of utter destruction of irreplaceable
records and materials by fire. The floors were of noncombustible materials,
it is true, but the roof was not, and the walls were so weak and so much out
of plumb as to threaten imminent collapse in case of fire. Indeed, the ordinary
use of the building was limited by a prohibition "against putting heavy articles
in the upper floor for fear of pushing out the west wall." "
Inadequate Quarters
In his annual report for 1880, Surgeon General Barnes "invited attention
to the overcrowded and unsafe condition" of the 10th Street building. Growth
of the collections, he wrote, had made "the space available for their preservation
quite inadequate, not merely for their proper display, but even for satisfactory
1 Smart, Charles: The Army Medical Museum and the Library of the Surgeon-General's Office. Journal
of the American Medical Association 24: 577, 20 April 1895.
2 Congressional Record, 48th Congress, 2d session, p. 1767. [That fears for the safety of the Ford's
Theater building were not exaggerated was demonstrated on 9 June 1893, when the floors fell through
to the basement with a loss of 22 lives and 68 injuries.]
74
ARMED FORCES INSTITUTE OF PATHOLOGY
Ficure 31.— Maj. Charles Smart, Surgeon, U.S. Army.
storage." The Surgeon General earnestly recommended an appropriation for
a building which should be "absolutely fireproof, but no expenditure for mere
architectural display is required."
Pursuant to The Surgeon General's recommendation, President Rutherford
B. Hayes, in his last annual message to Congress, urged such an appropriation.
The collection of books, specimens, and records constituting the Army Medical
Museum and Library are of national importance," the President said.
Their destruction would be an irreparable loss not only to the
United States but to the world * * *. These valuable collections are now in
a building which is peculiarly exposed to the danger of destruction by fire. It
is therefore earnestly recommended that an appropriation be made for a new
BROADENING THE BASE yc
fireproof building, adequate for the present needs and reasonable future expan-
sion of these valuable collections. Such a building should be absolutely fire-
proof; no expenditure for mere architectural display is required. It is believed
that a suitable structure can be erected at a cost not to exceed $250,000." :1
The movement for a new building was furthered by Surgeon General
Barnes in a letter of December 1881, to Secretary of War Robert T. Lincoln,
son of the President. The Library, he said, contained 51,500 volumes and 57,000
pamphlets, while the 22,000 specimens of the Museum were "unique in the
completeness with which both military surgery and the diseases of armies are
illustrated." These collections, he added, "although originally founded chiefly"
for purposes of military medicine, "have proved to have manifold uses in con-
nection with the general progress of medical science in the United States,
especially in relations to the public health, uses which are perhaps of equal
importance to the nation."
As to the worth in money to be placed on the collections, The Surgeon
General wrote that the value of that part of the Government property collected
in the old building "which could be replaced by money" could not be less than
$250,000, but that "much of it could never be replaced, either by time or money."
Surgeon General Barnes had the satisfaction of seeing his recommendation
approved by Secretary Lincoln on 6 January 1882, and made the subject of a
special message to Congress by President Chester A. Arthur, on die 19th of
the same month. 4
On 28 February 1883, almost at the end of the second and final session of
the 47th Congress, and too late for further action, the House Committee on
Public Buildings and Grounds reported favorably on the bill, H.R. 7681, ap-
propriating $200,000 for a building in the vicinity of the National Museum and
the Smithsonian Institution:
The collections of records, books, and museum specimens, * * * in imminent
danger of destruction, are of great national importance * * *. The Library now con-
tains about 70,000 volumes * * *. The museum is by far the best collection of materials
relating to military medicine and surgery in existence. They number over 20,000 speci-
mens * * *. Some 40,000 persons visited the museum during the year 1881 * * *.
The medical profession throughout the country have presented to the committee a
large mass of testimony commending the unequaled collections, both of the Library and
""Documents with Reference to Proposed Building for the Army Medical Museum and Library of
the Surgeon General's Office" — Copy of Report No. ioor, annex B, Committee on Public Buildings and
Grounds, on H.R. 7681, 47th Congress, 2d session, 28 February 1883.
4 Senate Executive Document 65, 47th Congress, 1st session.
713-02S>' — 64 7
76 ARMED FORCES INSTITUTE OF PATHOLOGY
Museum, and have earnestly requested that suitable provision be at once made for their
preservation * * *.
The building proposed is plain, fireproof, with a large amount of floor space
the building would cover an area of about 21,000 square feet, contain about 1,350,000 cubic
feet, and at a cost of $200,000, recommended by the bill, or about 15 cents per cubic foot. 5
Support From the Medical Profession
Before the new Congress, the 48th, opened its first session, the medical
profession made further representations favoring a new building for the Museum
and the Library. Professors Samuel D. Gross of Philadelphia, Austin Flint of
New York, and Oliver Wendell Holmes of Boston, three giants in American
medicine, addressed a letter to members of the American Medical Association
calling attention to the need for a new building as a subject of great importance
to the medical profession and to the public welfare. They wrote:
There has been formed at Washington, under the direction of the Medical Department
of the Army, a Museum of Military Medicine and Surgery, and in connection with this, a
Medical Library, each of which is believed to be the largest and best of its kind in the
world.
The building in which these invaluable collections are stored, collections which can
never be replaced if destroyed, is insecure, not fire-proof, in the midst of highly inflam-
mable buildings, and overcrowded. At the close of the last session of Congress, too
late for action, a bill appropriating funds for a fire-proof building * * * was reported
It appears to the undersigned in the highest degree desirable that this bill should become
a law at the next session of Congress, and to further this end, that the physicians of the
United States should explain to the members of Congress * * * the great importance
of these collections of books and specimens, the propriety of granting the funds necessary
for their maintenance and preservation, the inexpediency of separating them, or removing
them from the management under which they have so successfully been conducted, and
the necessity of a fire-proof building, that they may be handed down safely to coming
generations.
Responding to his communication, the American Medical Association,
meeting at Cleveland, Ohio, on 5-8 June 1883, adopted a strong memorial and
named a special committee to present the matter to Congress and to call the
attention of State medical societies to the importance of action. To the dis-
tinguished medical men who had originated the action, there were added on
the special committee Doctors D. W. Yandell of Louisville, T. G. Richardson
of New Orleans, and H. F. Campbell of Augusta — all three ex-Confederate sur-
geons and future presidents of the American Medical Association.
'' H.R. Report 1995 (H.R. 76S1), 47th Congress, 2d session.
BROADENING THE BASE
Action in support of the new building taken by local, county, and State
medical societies in at least 19 States was reported to the Congress by the special
committee of the American Medical Association, which also addressed its own
communication to Congress on behalf of the national association, stressing "the
urgent need to secure the preservation and full benefits" of the Museum and
Library. "These collections," the committee said, "already the largest and most
valuable of their kind in the world, are of the greatest importance, not only to
the physicians of this country but to all whose welfare and lives depend on
medical skill; and hence what we ask is emphatically for the general good." e
A New Surgeon General Presses for a New Building
Before further action toward a new building was taken, Surgeon General
Barnes, who had retired in 1882, died in April 1883. His successor in office,
Charles H. Crane, who had been Assistant Surgeon General since 1863, ^ so
died in October 1883, and was succeeded as Surgeon General by Robert Murray. 7
General Murray continued to press the movement for a new building, filing
with Congress a printed document setting forth the "imperative need of such
a building" and the "pressing necessity of placing in security these collections,
probably the most valuable of the kind in the world." 8
General Murray's submittal was in support of bills introduced in the Senate
by Senator Joseph R. Hawley of Connecticut (S. 403) and in the House by
Gen. William S. Rosecrans, Representative from California (H.R. 48), in
December 1883, in the early days of the first session of the 48th Congress. 9
On 13 December 1883, Secretary Lincoln, renewed his recommendation, re-
marking that he did so the more strongly because the appropriation of $200,000
6 (i) Congressional Record, 48th Congress, 2d session, p. 1768. Documents, Proposed Building,
loc. cit., pp. 3-6. (2) Scrapbook of clippings. On file in historical records of AFIP.
7 In announcing General Barnes' death, the Adjutant General's office ascribed to him the founding
of the Medical Museum and the launching of the History. Dr. Hammond called attention to the error,
which resulted in a change in the general order, which was made to read "Under the fostering care of
Edwin M. Stanton, Secretary of War, he (General Barnes) accomplished the successful establishment of the
Medical History of the War and the Medical Museum." Taking the word, " 'accomplished' in its primary
signification of 'completed'," Dr. Hammond was satisfied with the amendment. General Barnes, he said,
" 'completed' their successful establishment." (From the official correspondence between Surgeon General
William A. Hammond, U.S. Army, and the Adjutant General of the Army, relative to the founding of the
Army Medical Museum, and the inauguration of the Medical and Surgical History of the War of the
Rebellion, New York, 1883).
* Senate Executive Document 12, 48th Congress, 1st session.
"Congressional Record, 48th Congress, 1st session, pp. 37, 59. [General Rosecrans was in command
in West Virginia where the future General Hammond, founder of the Medical Museum, made his first
reputation in the Civil War.]
„g ARMED FORCES INSTITUTE OF PATHOLOGY
provided by the bill was $50,000 less than the amount originally proposed. On
the 17th, President Arthur again submitted the documents in the case to the
Congress, and the bills and the recommendations were referred to the respective
Committees on Public Buildings and Grounds of the two houses of Congress,
to which also went the numerous petitions and memorials of the medical
profession. 10
On 28 May 1884, William Mahone, late major general in the Confederate
service but then Senator from Virginia, reporting for the Committee on Public
Buildings and Grounds, submitted an amended bill for S. 403, carrying an
appropriation of $200,000, which the Committee recommended for passage
and which, on 3 June, was passed by the Senate and sent to the House. 11
It was not until the second and final session of the 48th Congress was
nearing its close, however, that final action was taken. On 16 February 1885,
H.R. 48, the bill introduced by General Rosecrans, came before the House of
Representatives. The bill, appropriating $200,000 recommended for passage
by the Committee, was submitted by its chairman, Representative Strother M.
Stockslager of Indiana.
Objections to Proposed New Building
Opposition was expressed on the grounds that the medical records of the
Civil War should be housed in the Pension Building or in the State, War, and
Navy Building, both of which were then under construction ; that the medical
library should be merged with the Library of Congress in the building then
in contemplation; and that the Medical Museum could be accommodated either
in the new State, War, and Navy Building or in the Smithsonian Institution.
One opponent, Mr. Potter of New York, went further, saying that he did not
believe in "preserving the relics and bones or wounds caused by the war at any
place in our capital" and expressing the wish that "they were all buried and
covered all over with green grass and hidden from sight forever."
To meet objections, proponents of the new building pointed out that the
buildings then being constructed for other purposes would not be adequate to
house the collections and the records of the Surgeon General's Office ; also, that
these features should be kept together, and that the present building, in the words
of Representative Stockslager, was a "mere tinder-box" and in an "absolutely
dangerous condition."
10 Senate Executive Document 1 2, 48th Congress, 1st session.
" Congressional Record, 48th Congress, 1st session, pp. 4603, 4766.
BROADENING THE BASE 79
In the course of the debate, Representative Lyman, of Massachusetts, ex-
pressed the views of an informed layman on the state of the medical art and
the contributions of the Museum to medical progress. "Most of the progress"
in medicine and surgery, he said, "has been made during the last half century,
and the next fifty years promise a great advance * * *. There is no subject
more baffling, and yet it is yielding to study. Already the studies of disease
have rendered it highly probable that these plagues are caused by the fertili-
zation of microscopic germs within the body; so that these diseases are a death
struggle between man and a parasitic fungus. But already we discern a hope
that these germs may be used for inoculation and may protect us from such
diseases, just as vaccination protects against smallpox."
"These profound studies, so essential to the welfare of our people, are
carried on under the fostering care of our National Medical Museum, whose
library, now the first in the world, and whose not less admirable collection
of military pathology are placed at the disposal of all investigators."
After an hour's vigorous debate, H.R. 48 was passed by a vote of 181 to
23. Transmitted to the Senate, the bill was recommended for passage by the
Committee, which reported its action through Senator Lott Morrill of Vermont,
and was passed without objection. On 3 March, the last day of the session,
President Arthur reported to Congress that, on the day before, he had signed
the bill, which thereby became law. 12
The bill, as finally passed, authorized the construction of a brick and
metal building upon the government reservation in the vicinity of the National
Museum and the Smithsonian Institution, the exact site to be selected by a
commission composed of the Secretary of War, the Architect of the Capitol,
and the Secretary of the Smithsonian. The building was to be in accordance
with plans and specifications submitted by The Surgeon General of the Army
and approved by the above Commission. Construction was to be under the
direction and superintendence of the Secretary of War, and at a cost not to
exceed $200,000."
John Shaw Billings Becomes Curator
During the years in which the matter of a new home for those institutions
was before Congress, a noteworthy change in the organization and personnel
of the Museum and Library took place when, on 28 December 1883, the two
were consolidated into one division to be known as the Museum and Library
12 Congressional Record, 48th Congress, 2c! session, pp. 1767-1770. 2117,2177, 25 6 9-
"(1) Public Law 62, 48th Congress. 2d session. (2) 23 VS. Statutes at Large, ch. 315.
8o
ARMED FORCES INSTITUTE OF PATHOLOGY
Ficure 32.— Dr. John Shaw Billings, lamed Librarian, fourth Curator of the Museum
(1883-1893), and father of its collection of microscopes.
Division of the Surgeon General's Office, and Maj. John Shaw Billings (fig.
32) was named as Curator of the Museum as well as Librarian."
Dr. Billings was 45 years of age when he was detailed for the double duty
of Librarian-Curator. Born in Indiana in 1838, he was educated at the "old"
Miami University at Oxford, Ohio, and received his M.D. degree at the Medical
College of Ohio in Cincinnati. Four years of wartime service as a brilliant
operating surgeon and medical administrator led to his detail in the Office of
the Surgeon General where, among other duties, he was assigned to the care
of the little library of that office. This library, started in 1836, had grown, by
1865, to fewer than 2,000 volumes. When, 30 years later, Colonel Billings relin-
quished his post as Librarian, the collection had grown to 115,000 bound volumes
and 184,000 unbound pamphlets and papers. 15 Moreover, this vast collection of
medical information had been made accessible and usable by the publication
"National Archives, Accession Number 421, SGO Circular, 1881-1885, p. 162.
,a Smart, Journal of the American Medical Association, 24 (1895), pp. 579-580.
BROADENING THE BASE 8l
of the "Index-Catalogue," started by Dr. Billings in 1880, in which both subjects
and authors are listed alphabetically and "every article from every issue of every
journal from every country" was indexed. 16
On 17 August 1884, Dr. Woodward died in a hospital near Philadelphia at the
early age of 51. In announcing his death, Surgeon General Murray outlined
the highlights of a distinguished professional and scientific career which had
culminated with his election as president of the American Medical Association
for 1882, being the first medical officer of the Armed Forces to be so honored.
The "confinement, anxiety and labor" to which he "was subjected in his attend-
ance upon the late President Garfield during his long illness proved too much
for a mind and body already over-strained by incessant labor," said The Surgeon
General, "and precipitated the illness which finally terminated his life." 3
As was anticipated when the enabling legislation was before Congress, the
Commission charged with responsibility for the erection of the new building for
the records, library and museum, on 25 March 1885, selected a site fronting 270
feet on the north side of B Street, SW. (now Independence Avenue), and ex-
tending back 170 feet on the west side of 7th Street. 18 Three weeks later, on 15
April, The Surgeon General was called upon to furnish plans and specifications.
The plans (fig. 33) were drawn by Adolph Cluss, architect, according to
the ideas of Dr. Billings, acting for The Surgeon General, and after Commis-
sion approval, the contract was let, on 18 August, to the firm of Bright & Hum-
phrey. Completion was, as usual, delayed beyond the contract date, making it
necessary for the Government to pay rent for 2 additional months on quarters
on F Street, occupied by 156 clerks of the Record and Pension Division, and to
threaten heavy penalties if the rented quarters were not vacated by August 1887.
In a letter to Col. John M. Wilson, the officer in charge of public building and
grounds for the Secretary of War, the new Surgeon General, John Moore, on
20 June 1887, outlined a proposed schedule of partial completions with appro-
priate moves of units into portions of the new building. He concluded with a
proposal for a 3-month extension if by 1 August Bright & Humphrey had "so
forwarded their work that there is a reasonable certainty" of carrying out the
schedule proposed. Otherwise, Surgeon General Moore recommended that
the Government take steps to have the work completed by others and be reim-
18 Hume, Edgar Erskine: Victories of Army Medicine: Scientific Accomplishments of the Medical
Department of the United States Army. Philadelphia: J. B. Lippincott Co., 1943, pp. 48, 49-
17 (1) Memoir of Joseph Janvier Woodward, 1833-1884, by J. S. Billings. (Read before the National
Academy of Sciences, April 22, 1885.) War Department Records, Office of the Surgeon General. On
file in National Archives. (2) Biographical Memoirs, National Academy of Sciences, volume 2, 1886.
1S Original letters in File 4938, Office (if the Surgeon General, National Archives.
82
ARMED FORCES INSTITUTE OF PATHOLOGY
-•*.
iqrr:
_i_L_Ui
Figure 33.— Fifth home of the Museum. The view of the building shown here is from the
architect's drawing.
bursed for losses and extra charges incurred. Apparently, the work was "so
forwarded" by the original contractors, and on 9 November Colonel Wilson
formally transferred the building to Surgeon General Moore. 19
The Museum Moves
From November 1887 until 15 February 1888, the Museum was in the
process of moving into the new building. The process was somewhat compli-
cated by the fact that the display cases were found to be a little too high to go
through the doors and had to be taken through a large window on the front end
of the second-floor Museum Hall.
In copy prepared by or for Colonel Billings for use in a guidebook which
was never issued, the building is described as "exceedingly plain, without orna-
mentation," while to Major Smart is was "severely simple in style." To a lady
writing for Godey's magazine in 1898, the building was a "plain red brick
structure." The profusion of brick and terra cotta embellishment on the ex-
" Idem.
BROADENING THE BASE
83
terior of the building raises a question as to how much ornamentation would
have been required in the 1880's and the 1890's to cause a building to be consid-
ered elaborate.
The structure, according to the proposed guidebook, consisted of a center
building 112 by 55 feet, with wings 60 by 131 feet on either end. Thus the
building had a front of 232 feet on B Street, with wings jutting back 81 feet be-
yond the rear line of the center building. In the courtyard thus formed, there
was an annex 52 by 24 feet, connected with the rear of the center building by a
covered passageway.
The central and western portions of the first floor were largely occupied by
the clerks of the Record and Pension Division, while the east wing was given
over to appanages of the Museum — a dissecting room, an anatomist's room, a
darkroom, a room containing the outfit for a post hospital, and a room for
genitourinary specimens considered unsuited for display in a museum open to
all comers.
The east wing on the second floor was given over to the specimens of the
Museum, the west wing to shelf stacks of the Library, while the central portion
of the floor was occupied by library offices and reading rooms. The Library and
the Museum wings were built so as to form fireproof compartments separated
from the other parts of the building. Both were open from the second story to
the roof, forming halls 31 feet high to the eaves and 47 feet to the ridge of the
lantern skylights by which they were ventilated and lighted. The Museum wing
also had, on the level of the third floor, a gallery 14 feet wide, extending clear
around the hall.
Rooms on the third floor were used as offices, a microscopy room, and a room
equipped for anthropometry. The fourth floor, found in the central building
only, contained the photographic gallery and several storerooms, two of which
were filled with appliances, for transporting the sick and wounded in the field,
for which no space could be found in the exhibit hall of the Museum. The
anatomical and biological laboratory was contained in the annex, in which were
found also the utilities and the limited and somewhat primitive sanitary
facilities. 20
20 (1) Lamb, D. S.: A History of the Army Medical Museum, 1862-1917, compiled from the Official
Records. Mimeographed copy in historical records of AFIP, pp. 93-95. (2) Lamb, D. S.: Army Medical
Museum, Washington, D.C. The Military Surgeon 53: 129, 130, August 1923. (3) Smart, journal of
the American Medical Association, 24 (1895), pp. 579-580. (4) Smart, Charles: The Army Medical
Museum and the Library of the Surgeon General's Office. Journal of the Military Service Institution of the
United States 19: 277-279, 1896. (5) Kyle, Joanna R. N.: The Army Medical Library and Museum.
Godey's Magazine 136: 408-418, 1898.
71.'i-028 v — 64 8
84 ARMED FORCES INSTITUTE OF PATHOLOGY
The office rooms were graced with fireplaces and mantels, while the large
library and museum halls were warmed by air passed over steam-coils in the
basement and supplied by ducts, in addition to steam radiators. Corridors and
stairways were heated by radiators.
Such was the building which was destined to be for nearly 70 years the home
of the Army Medical Museum and its successors, the Army Institute and then the
Armed Forces Institute of Pathology, and which after an absence of 7 years was
to be reoccupied by the Museum and the overflowing activities transferred from
the main building of the Institute.
A Shift in Emphasis
With a new home and a new curator, there was a shift in emphasis in the
work of the Museum. The new concept of that work attributed to Dr. Billings
in a dispatch of 18 September 1886, in the Medical News of Philadelphia, was
as follows:
1. To illustrate the effects, both immediate and remote, of wounds and of the diseases
that prevailed in the Army.
2. To illustrate the work of the Army Medical Department; models of transportation
of sick and wounded, and of hospitals; medical supplies; instruments; etc.
3. To illustrate human anatomy and pathology of both sexes and of all ages.
4. To illustrate the morphological basis of ethnological classification, more especially
of the native races of America, including anthropometry, and craniology.
5. To illustrate the latest methods and apparatus for biological investigations and the
various methods of preparing and mounting specimens. 21
Surgeon General Moore, in a circular letter issued 15 September 1888, after
the move to the new building was completed, "respectfully invited" the attention
of all physicians to the fact that the Museum was "now arranged in a convenient
fire-proof building which affords means for the proper preservation and display
of specimens" and requested their aid in making it "a complete representative
collection covering all branches of medicine." To that end, the circular outlined
in great detail the types of specimens especially desired and the methods of
"preserving them so as to make them most useful." 22
The "Old" and the "New" Museums
In keeping with this broader concept, there gradually developed a separation
in the exhibits of the Museum, with lessening emphasis on the "missiles, weapons,
■' Medical News, Philadelphia, volume 49, p. 330.
^Memoir of Joseph Janvier Woodward, 1833— 1884, by J. S. Billings. (Read before the National
Academy of Sciences, April 22, 1885). War Department Records, Office of the Surgeon General. On
file in National Archives.
BROADENING THE BASE 85
fractures, excisions, amputations, and other specimens of the Civil War," which
tended to be placed in the gallery. "In fact," Major Smart wrote (in 1895) "the
museum of the old Ford's Theater building may here [in the gallery] be recog-
nized, while that on the floor of the hall is relatively a new institution." 23
The central space of this "new institution" was occupied by flat-topped glass
cases in which were displayed various surgical instruments, including the begin-
nings of the collection of microscopes, started by Dr. Billings in 1884 with 17
instruments obtained in Europe— a collection which has grown to number
nearly 500 microscopes. These instruments date from the earliest times, in-
cluding a replica of the single-lens microscope through which Van Leeuwen-
hoek first saw the "little animals" in a drop of water— generally recognized as
the beginning of the microscopic era — and extending to the most elaborate opti-
cal types and the ultra-modern electron and phase-contact instruments (fig. 34).
In a series of display cases projecting from the walls, the Museum displayed
anatomical and pathological specimens so arranged as to tell, for each organ and
region of the body and for the human organism as a whole, the story of normal
development, abnormal deviations, disorders and diseases, and repairs and res-
toration, including that by surgery.
The displays of the Museum, together with the specimens held for study but
not on display, were designed to broaden and deepen the lessons learned in the
Library by adding to the reading of die printed word the impact of the tangible
and visible object, the thing itself.
Dr. Billings' Appraisal
The Museum, which was moved into the new building, contained nearly
27,000 specimens, probably more than there were in any other like museum in
the world. Comparison of the number of specimens, however, in the opinion
of Dr. Billings, "would give an exaggerated and erroneous idea of the value of
this collection" in relation to others. "The most important medical museum
in the world," he said in his presidential address before the Congress of Ameri-
can Physicians and Surgeons on 20 September 1888, "and the one which has
exercised the greatest influence in giving direction to anatomical and pathologi-
cal studies * * * is undoubtedly that of the Royal College of Surgeons of
London, the foundation of which was the collection made by Jolin Hunter,
purchased by the government in 1799 * # *. At first the Army Medical
Museum was limited to military medical subjects, but of late years its scope has
23 Smart, Journal of the American Medical Association, 24 (1895), p. 580.
86
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure
ments show
of London.
7a. — Foundation and evolution of the microscope collection. A. The instru-
n are from the original 17 sent by John Mayall of the Royal Microscope Society
been greatly broadened, and is now clearly the same as that of the Royal
College of Surgeons."
Speaking "On Medical Museums, with special reference to the Army Medi-
cal Museum at Washington," Dr. Billings declared that the "object of this
address is not to boast of what we have, but to indicate what we want." The
Museum, he said, had "only a beginning of such an anatomical collection as I
have indicated is desirable * * *. We are accustomed to think that human
anatomy is exhausted as a field for original research," a view to which the
speaker did not subscribe. "There is ample material and scope for original
work for half a dozen skilled anatomists for many years to come to supply the
demands of this museum for illustrations of human morphology * * *," he
added.
"The pathological section of a Medical Museum is its main feature," he
said. "No doubt much of the ancient pathology, and some of that which is
quite recent, is comparable to the looking in the dark for a black spot which
is not there, but those who despise pathology, and devote their entire time to
BROADENING THE BASE
87
Figure 34. — Continued. B. A part of the famous microscope collection displayed in the
Medical Museum.
symptoms and treatment, err as much on one side as those who talk and act
as if a knowledge of pathological anatomy could take the place of clinical ex-
perience do on the other."
Although Dr. Billings was the author of "A Report on the Hygiene of
the United States Army," published by The Surgeon General in 1875, and be-
lieved that "an ideal medical museum should be very complete in the depart-
ment of preventive medicine, or hygiene," the collections of the Army Museum
did not cover the subject except "in their immediate relations to the military
medical service." Partly accounting for this was the existence of the Museum of
Hygiene, under the direction of the Medical Department of the U.S. Navy.
"The objects of a medical museum are to preserve, to diffuse and to increase
knowledge," Dr. Billings said in his presidential address. "Its conservative
function is to form a permanent record of what has been demonstrated and
to fix the meaning of terms. Even in my brief experience of thirty years the
terminology of anatomy, physiology, pathology, chemistry, and of most of the
specialties has greatly changed * * *. To get useful results from the older
88 ARMED FORCES INSTITUTE OF PATHOLOGY
literature we must know the precise significance of the old words and, in some
cases, the best way to learn this is to examine the specimens prepared by those
who use such terms in their descriptions."
One of the advantages of the Medical Museum, which it enjoyed "in com-
mon with several of the largest, and most important museums, more especially
those of the Royal College of Surgeons and of the Faculty of Medicine of Paris,"
pointed out by Dr. Billings, was its close association with "a large medical
library which is in the same building, and at present under the same direction.
The increased utility and attractiveness which this gives to both library and
museum are very decided."
In the first place, in a "very condensed statement of the wants of our
National Medical Museum," Dr. Billings listed "the intelligent interest and
friendship of the medical profession * * *. To a very considerable extent
it has had that; were it otherwise it would not be what it is, nor where it is.
But it needs more of it, and it can never have too much."
Referring to the fact that a large proportion of the pathological specimens
"were gathered during a great war * * * when antiseptic surgery, as now
understood and practiced, was unknown," Dr. Billings predicted that this group,
showing the "effects of pyogenic microorganisms on gunshot wounds," would
never be duplicated. These and other Civil War relics, he said, "have an
interest beyond that which is purely professional * * *. The fact that we
are physicians does not imply that we look upon them from a medical or
scientific stand only. Those of the combatants who survive are now better
friends than ever, and the museum specimens coming as they do from the
sick and wounded of both armies, and contributed by both Union and Con-
federate surgeons, enforce the lesson of the unity of the profession and of its
interests, as well as that of our country."
And, with prophetic vision, the Curator saw ahead to the idea of an
institute of pathology cooperating with "earnest and well trained students"
working on the museum's collections "so as to advance knowledge * * #
To all such students we shall endeavor to afford opportunities for this work.
Precisely how this is to be effected is not yet clear, but here is abundance to
be done, and there are quite a number of men coming on the stage who want
to do such work for its own sake * * *. Sooner or later, we shall have
half a dozen or more of specially trained men busy in the laboratories and
work-rooms of the museum, each engaged on his own problems, and the whole
for the common good." 24
"Medical News, Philadelphia, volume 53, number 12, 22 September 1888, pp. 309-316.
CHAPTER V
An Ending and A Beginning
Shortly after the new building was occupied, in 1888, the sixth and final
"part," comprising the two "volumes" of the monumental "Medical and Surgical
History of the War of the Rebellion," was published. From its inception this
project had been, in all but name, an integral part of the Museum operation. The
first Curator of the Museum, Dr. John H. Brinton, had been the first editor of
the Surgical volume, and he was succeeded in the editorship by Dr. George A.
Otis, the second Curator, who brought out part I of that volume in 1870 and
part II in 1876, leaving part III to be brought out by still another Curator, Dr.
David L. Huntington, in 1883. The first and second parts of the Medical volume
were edited by Dr. Joseph Janvier Woodward, coming out in 1870 and 1879,
respectively, and the third and concluding part was edited by Dr. Charles Smart,
the Army surgeon detailed to complete the History.
Each of the six "parts" is a massive volume in itself, averaging nearly 1,000
quarto pages of text, with an average of some 40 full-page plates, many in color,
plus scores of black-and-white woodcuts. The volumes contain the reports of
thousands of medical and surgical cases, usually in the words of the doctors who
treated the wounds or diseases. In view of at least one unfriendly critic, indeed,
the work was a "mere compilation of other people's writings," l but it is far more
than that. The History contains an orderly arrangement and presentation of
vital statistics, while the body of the text summarizes, analyzes, and comments
on the specific cases in the light of the best medical literature and thought of the
times in which it was published. Thus, Dr. Woodward's skepticism as to the
bacterial origin of disease, expressed in the volume issued in 1879, was replaced
with a more tolerant view by Dr. Smart in the 1888 volume. He was not yet
ready to admit that the "causal relationship of a micro-organism to the disease"
of typhoid fever had "been established" but he discussed at some length the
researches supporting that view and concluded, "Although the typhoid germ
1 Sunday Herald, Washington, I April I i
90 ARMED FORCES INSTITUTE OF PATHOLOGY
has not been recognized its existence is generally allowed, and many of the
conditions needful to its development have been demonstrated." ;
All in all, the History merited the high praise which it received, even from
such an outstanding and keenly critical authority as the great Rudolf Virchow,
who wrote:
Whoever takes up and reads the extensive publications of the American medical staff
will be constantly astonished at the wealth of experience therein found. The greatest
exactness in detail, careful statistics even in the smallest matters, and a scholarly statement
embracing all sides of medical experience are here united, in order to preserve and transmit
to contemporaries and posterity in the greatest possible completeness, the knowledge pur-
chased at so vast an expense. 3
The Museum and the Army Medical School
With the completion of the Medical and Surgical History (fig. 35), there
ended the last major link tying the Museum to its Civil War origins. True, the
majority of its specimens were the result of Civil War wounds and sickness, and
the interest in Civil War specimens persisted, but there was the strong infusion
of more recent and different pathological material and, more importantly, there
was the new direction of thinking typified in the launching of the Army Medical
School.
The idea of a medical school for Army personnel had been put forward as
early as 1862, first informally by Brinton and his associates, and later by Surgeon
General William A. Hammond in his report of 10 November to the Secretary
of War, in which he recommended "an army medical school, in which medical
cadets and others seeking admission into the corps, could receive such special
instructions as would better fit them for commissions, and which they cannot
obtain in the ordinary medical schools * * *". 4
Like so many other of the excellent recommendations in this report, nearly
all of which were ultimately adopted, the idea was rejected at first, to remain
dormant for over 30 years until, in 1893, President Grover Cleveland appointed
Lt. Col. George Miller Sternberg (fig. 36) to succeed Charles Sutherland as
= Medical and Surgical History of the War of the Rebellion. Medical History. Washington: Govern-
ment Printing Office, 1888, pt. Ill, vol. I, pp. 492, 493.
3 Hume, Edgar Erskine: Victories of Army Medicine: Scientific Accomplishments of the Medical
Department of the United States Army. Philadelphia: J. B. Lippincott Co., 1943, pp. 152, 154, quoting,
Morgan, William Gerry: Contributions of the Medical Department of the United States Army to the
Advancement of Knowledge (With Particular Reference to Fields Not Directly Connected with the
Practice of Military Medicine). The Military Surgeon 66: 779-790, June 1930.
* Annual Report of the Surgeon General, U.S. Army, 10 November 1862.
AN ENDING AND A BEGINNING
91
In
B
GUNSHOT SCALP WOUNDS AND CONTUSIONS OF THE SKULL
Figure 35. — A. Medical and Surgical History of the War of the Rebellion. B. A page from
the History.
92
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 36. — Brig. Gen. George M. Sternberg, The Surgeon General of the Army for 9 years,
1893-1902, turned the thought of the Museum toward bacteriology.
The Surgeon General. The new Surgeon General was outstanding among
American bacteriologists. Working independently, he had discovered the
pneumococcus responsible for pneumonia in 1881, the same year in which,
earlier, Louis Pasteur had described the same microorganism. In 1882, Stern-
berg had photographed for the first time the tubercle bacillus, discovered in the
same year by Robert Koch. Ten years later, in 1892, he had published "A Man-
ual of Bacteriology," the first American textbook on the subject. He came into
the Office of the Surgeon General bearing the reputation of being the Army
Medical Corps' first man in scientific attainment.
Within less than a month after taking office, the new Surgeon General
secured authority of the War Department for the long-deferred Army Medical
School set forth in General Orders No. 51, A.G.O., dated 24 June 1893. "By
direction of the Secretary of War," the Orders read, "upon the recommendation
of the Surgeon General of the Army, an Army Medical School will be estab-
lished in the city of Washington for the purpose of instructing approved candi-
AN ENDING AND A BEGINNING 93
dates for admission to the Medical Corps of the Army in their duties as medical
officers."
"The course of instruction will be for four months, and will be given an-
nually at the Army Medical Museum, in Washington City, commencing on the
ist day of November."
As General Sternberg explained in his annual report for 1894, the new
school, although affording "all the advantages that could be derived from one
costing heavily for establishment and maintenance," would add nothing to the
expense of the Army. Professors were selected from among the senior mem-
bers of the corps stationed in or near the Capital, while the new Museum and
Library building provided the necessary lecture rooms and "the accumulation
of material for bacteriological and chemical study in the Army Medical Museum
which furnished everything essential for laboratory work."
Walter Reed; Curator
The Museum, indeed, furnished more than laboratory facilities and class
rooms, for one of the most useful members of the faculty of the school was
the newly appointed Curator of the Museum, Capt. Walter Reed (fig. 37), soon
to become Major Reed, who took over the office on 8 September. The appoint-
ment was, in a sense, symbolic of the lessening of emphasis on the Civil War as
the dominant theme of the Museum's activities. Born in Virginia in 1851, of
North Carolina lineage, he was the first Curator of the Museum who had not
served in the Union Army during the Civil War, and the first officer of Con-
federate antecedents to become Curator, serving under Maj. John Shaw Billings
who continued to hold the post of Director of both the Museum and the Library.
Both Major Billings and Captain Reed were members of the faculty of the
Army Medical School at its first session — Major Billings as professor of military
hygiene, including practical instruction in the examination of air, water, food,
and clothing from a sanitary point of view, and Captain Reed as professor of
clinical and sanitary microscopy and director of the pathological laboratory.
Other members of the faculty were: Col. Charles H. Alden, Deputy Surgeon
General and president of the faculty, who lectured on the military duties of
medical officers, including property responsibility, examination of recruits, cer-
tificates of disability, reports, rights and privileges, customs of the service, and
like topics; Lt. Col. William H. Forwood, attending surgeon at the Soldiers'
Home, who was professor of military surgery, including care and transportation
of the wounded; and Capt. Julian M. Cabell, instructor in Hospital Corps drill.
In addition to the regular courses taught by the members of the faculty, there
94
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 37. — Maj. Walter Reed, fifth Curator of the Museum, 1893-1902.
were lectures on bacteriology by General Sternberg; on military law by Mai.
G. B. Davis of the Judge Advocate's Office; on comparative anatomy by Capt.
J. C. Merrill; on medical jurisprudence by Dr. Robert J. Fletcher of the Library;
on parasites in man by Dr. C. W. Stiles of the Department of Agriculture; and
AN ENDING AND A BEGINNING 95
on head surgery by Dr. W. W. Keen, professor of surgery at the Jefferson
Medical College and one of the most active surgeons of the Union Army in the
Civil War. 5
The first annual session of the school closed with appropriate exercises
on 28 February 1894, attended by most of the officers of the War Department.
The distinguished Prof. William Osier of the Johns Hopkins University ad-
dressed the graduating class of five assistant surgeons, as did Maj. Gen. John M.
Schofield commanding the Army, briefly, and Colonel Alden more at length.
The address of the President of the Faculty doubtless was directed more to the
assembled spectators, which included ex-Surgeons General Hammond, Murray,
and Sutherland, than it was to the graduating class. In his address, he outlined
the many duties and responsibilities of the Army doctor which were outside
the work of the physician and surgeon as ordinarily understood, and described
the school's courses of study designed to fit the medical officer for these military
duties. Referring to the work of the Department of Clinical and Sanitary
Microscopy, the colonel said :
Perhaps it is proper to say here to our non-medical friends that the day when bacteria
were a scientific curiosity and their study a pastime or fad has passed. The investigation
of these microscopic organisms and their effects lies at the very foundation of modern
medicine and surgery, and of advanced medical and surgical practice. In this direction
lies today our strongest hope and brightest prospect of preventing and arresting disease. 6
Thus there was launched, in quarters provided by the Army Medical
Museum, and using facilities furnished by it, the school which was to grow and
develop into the Medical Department Professional Service Schools in 1923 and,
in 1947, into the Army Medical Department Research and Graduate School,
with its own quarters and facilities in the Walter Reed Army Medical Center
(fig. 38).
Problems With Space
Even before the inauguration of the School in the Museum quarters, and,
in fact, within a year of the occupation of the new building, the old question
of lack of space and overcrowding had already been raised. In his annual
report for 1888-89, Surgeon General John Moore said :
The question of space for the better accommodation of the present holdings of the
Museum and for the additions which experience shows are to be expected, is already ob-
5 Ashburn, P. M.: A History of the Medical Department of the United States Army, lloston: Houghton
Mifflin Co., 1929, pp. 149, 150.
*(i) Army Medical School: Closing Exercises of the First Session. Journal of the American Medical
Association 22: 352-354, 10 March 1894. (2) Ashburn, op. <•;>., pp. 149, 1 5".
96
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 38.— Army Medical School laboratories, located in the Mu
in the first decade of the 20th century. A. Bacteriological laboratory.
luseum-l-ibrary
build
ing
truding itself. Some special and valuable exhibits * * * already suffer from insuf-
ficient or unsuitable presentation * * *. In fact that is no avoiding the conclusion that
the whole of the office rooms on the first floor * * * now occupied by the Record and
Pension Division should pass into my control for the use of the growing Library and Mu-
seum for which the whole building was originally constructed * * *. I therefore
earnesdy recommend that provision be made elsewhere for the work of the Record and
Pension Division of the War Department and that justice may be done to the intent for
which this building was constructed. 7
In the report for the next fiscal year, 1889-90, the recommendation is
repeated with equal earnestness, and a like lack of success in securing the use
of the entire building for Library and Museum purposes. In support of his
request, The Surgeon General said, erroneously, that the building had been
erected at a cost of only one-half of the estimates, resulting in a reduction in
its dimensions and facilities.
'Lamb, Dr. D. S.: A History of the Army Medical Museum, 1862-1917, compiled from the Official
Records. Mimeographed copy in historical records of AFIP, pp. 103, 104.
AN ENDING AND A BEGINNING
97
Figure 38. — Continued. B. Chemistry laboratory.
In the use of the building, unanticipated needs were encountered and had
to be dealt with as part of the regular operation of the Museum. For example,
on 28 August 1888, within a few months after occupation of the building, Dr.
Billings found it necessary to ask for bids on the construction of a "cremating
furnace," sufficiently powerful to consume the body of an animal of the size of a
large Newfoundland dog without leaving obnoxious odors. s
Another lack of the building was a dependable source of electricity for the
light necessary to carry on continuously photomicrographic work without hav-
ing to depend upon the vagaries of the weather, and also for lighting the Library
hall on the "rare occasions when it is necessary to use this room at night." One
such occasion was the anticipated opening of the Museum at night during the
meeting of the American Medical Association, which was held in Washington
in the first week of May 1891. In a letter of 14 April to The Surgeon General,
8 Circular Letter, J. S. Billings. On file in historical records of AFIP.
98 ARMED FORCES INSTITUTE OF PATHOLOGY
Dr. Billings asked authority to purchase, for not more than $410, a dynamo to
be driven by an 8-horsepower steam engine, already connected with the boilers,
and urged action in time to have the lights working during the evenings when
1,500 members of the A.M.A. were expected to be in the city."
Special and specific authority had to be sought from the Office of the
Surgeon General for items of far less consequence than the dynamo needed to
replace one which had been borrowed from the National Museum and had
been recalled by its owner. "I have the honor to state that the following
articles are required for use at the Army Medical Museum and request authority
to buy them as emergency purchases to be paid for from the Museum appro-
priation: 5 gallons of Benzine, Estimated cost, $.75" read a typical formal letter
of the sort, duly signed by "Your obedient servant, John S. Billings, Major and
Surgeon, U.S. Army, Curator Army Medical Museum." Other such letters re-
quest authority to purchase items as minute as 30 cents' worth of flour, 10 cents'
worth of resin, and a half a dozen washers for a dime. 10
The degree of financial stringency involved in operating the Museum on an
annual appropriation of $5,000— and that not always forthcoming without a
struggle— is indicated by a letter of 30 December 1890 from Major Billings to
M. Jules Talrich, Officier de l'lnstruction Publique in Paris, from whom Billings
had purchased some anatomical models during a visit to Paris, and who had
offered others for sale.
I greatly appreciate your kind offer to let me have the two figures: "Une premiere
attaque d'hysterie chez une jeune femme de la race caucasique" and "une jeunne fille de
Zouzouland," for the sum of $4,000.00 but the means at my disposal will not allow me to
purchase them. The yearly appropriation made by Congress for this Museum is very
small, and after reserving the amount absolutely necessary for the current expenses of this
Institution, there remains less than a thousand dollars available for the acquisition of new
preparations and specimens. 11
The Prime Source of Specimens
How nearly complete was the reliance placed on contributions for speci-
mens is shown by the pamphlet catalog of the Museum's portion of the Army
Medical Department's exhibit at the World's Columbian Exposition in Chicago
in 1892-93. 12 In its "Description of Selected Specimens," the pamphlet lists 82
"Letter Book, J. S. Billings, October 1890 to June 1891, pp. 360, 361. On hie in historical records
of A I'll'.
10 Ibid., pp. 33, 200.
11 Ibid., p. 70.
- Pamphlel catalog, World's Columbian Exposition, Chicago, 1892-93. On file in historical records
AFIP.
AN ENDING AND A BEGINNING
99
medical and surgical specimens, contributed by 60 physicians and surgeons, with
only three specimens identified as having been purchased.
In a foreword to the pamphlet, Dr. Billings described the purposes and
collections of the Museum. Its primary object was, he said, to illustrate wounds
and diseases of armies as a "step in the study of the best means of diminishing
disease and mortality among soldiers," but it had soon been found necessary
to extend the scope of the collection to include all forms of injuries and
diseases, and also to form collections of means of transportation of the sick
and wounded, of surgical instruments, and of instruments for diagnosis and
research, including microscopes.
The Museum had, in 1892, a total of 29,486 specimens, including 3,439
of normal anatomy, 1,717 of comparative anatomy, 10,746 in the pathological
section, 12,270 in the microscopical section, and 1,584 instruments and pieces of
apparatus.
"Large as these numbers may appear," he said, "there yet remain many
gaps in each series * * *." And since Congressional appropriations left
little margin for the acquisition of additional specimens, The Surgeon General
appealed to all medical men to "aid, by contribution of specimens, an institu-
tion which is already of great value and interest, having an enviable reputation
both in Europe and in this country, and which, it is believed, is destined to
be of great importance in the advancement of medical science." Increasingly,
he added, contributions were being received from practitioners in civil life,
as the "facilities afforded by the Museum for the permanent preservation of
pathological specimens, and of the records connected with them, are more and
more appreciated" — a trend which Billings sought to strengthen by his earnest
appeals for cooperation from all medical men, civilian as well as military.
The appeal for civilian cooperation was not a one-sided seeking of help
without corresponding mutual benefits, for it had long been the settled policy
and practice to open the facilities and collections of the Museum to qualified
investigators and students — a policy which was made explicit by the passage
of a joint resolution of the Congress, approved 12 April 1892, declaring it to be
the policy of the Government to make available to students the facilities of
the Army Medical Museum and other scientific and literary institutions in the
Nation's Capital, as a measure for the promotion of research and the diffusion
of knowledge. 13 While this action was in the nature of a ratification of existing
policies and practices, it constituted congressional recognition of the scientific
character of the Museum.
13 27 U.S. Statutes 395.
100 ARMED FORCES INSTITUTE OF PATHOLOGY
Recognition of the character of the institution by others was abundantly
forthcoming. Thus, Dr. Henry W. Bettmann, Curator of the Cincinnati Hos-
pital, wrote the Curator of the Army Medical Museum on 13 July 1895, seeking
information as to the literature dealing with the best methods of preserving
and mounting anatomical and pathological material, or a detailed account of
the "methods employed in your own famous collections." Dr. Billings, who
replied on 20 July, observed that the literature on the subject was "very limited,
consisting principally of isolated hints scattered in various medical publications,"
but gave, in a nine-page memorandum, a "general summary" of the methods
employed at the Museum which "after many futile experiments, have to some
extent proved successful." "
The memorandum describes the steps in the process of cleaning, degreasing,
and mounting bones showing disease or injury, and in even greater detail the
processes of preparing wet specimens, preserved in ethyl alcohol or formalin.
Special precautions were taken with specimens intended for microscopic or
bacteriological work. For the latter, tissues were kept apart, handled as little
as possible and with every care to prevent access of foreign bacteria.
Bacteriology and Roentgen Rays at the Museum
With George Sternberg as Surgeon General and Walter Reed as Curator,
bacteriology was bound to expand in importance in the world of the Museum,
but the main emphasis of the laboratory work, if we may judge by the cor-
respondence files of the period, continued to lie in the pathological examination
of specimens sent in from Army posts and Indian agencies. Indeed, when the
Health Officer of the District of Columbia asked Major Reed if he could con-
veniently make bacteriological examinations of specimens of water from public
wells of which the health officer was suspicious, Major Reed was compelled to
reply that "with every desire to assist" it would be impossible to "give you at
present any material assistance," his own time and that of his assistants being
"so completely taken up with the routine Museum work." 15
Routine work of the Museum did not, however, keep Major Reed from
taking a keen interest in medical developments. For instance, Wilhelm Roent-
gen's discovery of X-rays was announced to the world on 6 January 1896.
Within 3 months, Reed had applied to The Surgeon General for authority
to obtain apparatus for the purpose of experimenting with the new rays, and
had been turned down on the ground that it was "not probable that any
u In correspondence files, AFIP.
* In correspondence files, AFIP, 30 January and 1 February 1895.
AN ENDING AND A BEGINNING I0I
experiments you would find time to make would add anything of importance
to our knowledge of these rays and their practical application in medi-
cine * * *. Later, when the exact practical value of photography by these
rays has been determined, we may want the necessary apparatus in order to
assist in the diagnosis of cases occurring in the District, to which the new method
may be applicable." 1G
That the Museum got its apparatus within 3 months after being turned
down, is indicated by a letter of Dr. Joseph S. Wall of Washington, in which he
describes an early clinical use of the X-ray. On 10 June 1896, as Dr. Wall recalls,
and as the admission records of the Garfield Hospital showed, "a girl of seven-
teen was admitted to the hospital because of a .22 calibre penetrating gunshot
wound of the hip, accidentally inflicted by her brother." It became the duty of
Dr. Wall, as a young "externe" of the hospital, "to accompany the patient in a
horse-drawn ambulance to the Army Medical Museum to obtain the services of
Dr. William Gray," who had been engaged in microscopic and bacteriologic
work for the Museum since 1884, and who, Dr. Wall said, had the only Roentgen
tube in Washington at that early date (fig. 39). "After the orderly-driver and
myself had struggled up four flights of stairs to Dr. Gray's laboratory," he con-
tinued, "carrying a rather plump young lady on the stretcher, she was exposed
to the X-ray for a period of one hour in order to secure a picture showing the
location of the bullet." A satisfactory plate was secured, "even though the tube
was activated by a kind of static grindstone," the girl was taken back to the
hospital, and the bullet was successfully extracted. 17
Services of Dr. Billings
Midway in the closing decade of the 19th century, in 1895, Dr. John Shaw
Billings retired from the Army, after 34 years of service, of which 30 years had
been spent in building up the Library, with 12 years of concurrent service to
the Museum. Dr. Billings, a mighty man of medicine, went on to a postretire-
ment career of rare distinction. From the University of Pennsylvania, where
he occupied a chair in the medical school for a year after retirement from the
"(1) Castiglioni, Arturo: A History of Medicine. Translated from the Italian and edited by
E. B. Krumbhaar, 2d ed. New York: Alfred A. Knopf, Inc., 1947, p. 1065. (2) Letter, George Stern-
berg to Walter Reed, 6 March 1896.
Letter, Dr. Joseph S. Wall to R. A. Sloan, Army Medical Museum, 13 January 1950. From a story
in the Washington Times Herald, 6 October 1954, it appears that there was an earlier use of the X-ray, in
the District of Columbia, to locate a bullet accidentally fired into the hand of Carl A. Loefflcr, as reported
in the Washington Post, 24 April 1896.
102
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 39. — Early X-ray apparatus at the Medical Museum. A. Roentgen
ray tube. B. Static electric apparatus.
AN ENDING AND A BEGINNING 103
Army, he was called to New York where he worked out the consolidation of the
Astor, the Lenox, and the Tilden Libraries to form the great New York Public
Library, of which he became the first director, heading not only the main library,
housed in a building erected in accordance with his ideas, but also the whole
library system with some 80 branches in Greater New York. 18
Among Dr. Billings' last official services to the Museum was his initiation
of a movement to have the dental profession adopt the Museum as a repository
for study materials in the field of dentistry (fig. 40), "just as other sections of
the Museum and Library are considered to be their national collections by the
physicians, surgeons, and specialists of the country," as Dr. Billings wrote Dr.
Williams Donnally, D.D.S., of Washington, on 10 December 1894. The sug-
gestion bore fruit when, in 1895, the American Dental Association accepted the
suggestion when offered by Dr. Donnally. This action, the first such formal
acceptance of the Museum as a national repository, may be regarded as a step
toward the system of national registries of pathological materials and case his-
tories of the various specialized medical groups which is such an important
factor of today's Armed Forces Institute of Pathology. 19
Animal Experimentation at the Museum
Upon the retirement of Lieutenant Colonel Billings, Col. David L. Hunt-
ington, Deputy Surgeon General, was placed in charge of the Museum and
Library Division, with Major Reed continuing as Curator of the Museum. As
Curator, he was called upon to deal with charges of unnecessary cruelty to
animals, said to have taken place in the Museum some years earlier. These
charges were contained in a letter from Dr. L. E. Rauterberg to the Senate
Committee on the District of Columbia, in connection with an investigation of
the practice of vivisection in the District. Dr. Rauterberg wrote :
It was my lot for a number of years to be engaged in the Microscopical Division of the
Army Medical Museum, and I saw practiced the most inhuman and barbarous mutilations
of the dumb animal, under the supervision and with the sanction of the United States of-
ficers in charge. A desired part or section of the animal would be removed, not under
anesthesia, and the poor beast would be then placed back in its cage or vessel until it suited
the convenience of the operator to help himself to another portion, so long as the animal
" Who Was Who in America, 1943 edition, "Billings, John Shaw."
"Lamb, op. cit., pp. 109-1 11. The invitation extended by Dr. Billings through Dr. Donnally was
published in Dental Cosmos, June 1895, p. 519- Dr. Donnally's eloquent and persuasive presentation of
the reasons for acceptance of the invitation appears in the Transactions of the American Dental Association,
1895, pp. I34-I49-
104
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 40. — Changes in the concepts of dentistry since the time when this type of
equipment was familiar have been quite as profound as the change in the equipment and
instruments used.
would survive these tortures. I have thus seen animals with eyes, section of brain and
other parts removed, and kept in reserve for future experiments for a number of days, and
all for the verification and repetition of results obtained and published years ago.
Since the practices alleged were ascribed to a time before he became Curator,
Dr. Reed asked Dr. J. C. McConnell, who had been connected with the Museum
AN ENDING AND A BEGINNING 1 05
from about 1870 to the end of 1895, about the truth of the charges. Dr. Mc-
Connell replied on 8 June 1896, "That a very wonderfully distorted, inaccurate
and false description has been given of work conducted at the Army Medical
Museum some twenty years ago." He continued :
Those who were practically engaged in the Microscopical Division should know better
than anyone else the character of the work that was performed, and that all animals ex-
perimented upon were under the influence of an anesthetic. One who was not in any
manner connected with the Microscopical Division of the Museum, as was the case with
Dr. L. E. Rauterberg, could draw upon his imagination very satisfactorily, and write a vivid
description of what might have been done with animals, the remains of which he saw
under alcohol in specimen jars. I, however, testify that at no time during my connection
with the Army Medical Museum, from about 1870 to the end of the year 1895, have any
experiments been performed upon animals in which an anesthetic was not used, unless
some of the ordinary inoculation experiments, which are practically painless, nor were
animals kept in a mutilated condition. 20
Dr. Reed did not appear before the Senate Committee, that function being
performed for the Army by General Sternberg, who vigorously opposed passage
of the bill which, in the opinion of most doctors, would have so restricted animal
experimentation as to have the practical effect of prohibiting the use of this
avenue to increased medical knowledge. Dr. Reed did, however, appear in
opposition to the bill at a preliminary hearing before the commissioners of the
District of Columbia, as is mentioned in an account in die Washington Post of
10 February, and reproduced in the transcript of the Senate Committee hearings.
The Spanish- American War
The major military event of the nineties, the war with Spain, seemed at
first to have passed the Museum by. Col. Dallas Bache, who had been ap-
pointed Director of the Museum and Library Division on 31 January 1898, as
the war clouds were thickening, made a report to Surgeon General Sternberg
on 17 October, after the brief war had been fought and won, in which he said:
The contributions to this Museum from the active theatre of the recent war with
Spain and from the extensive field of subsidiary operations, have been so few and unimpor-
tant that it seems desirable to renew the attention of Medical Officers to this important
subject. The hurry and peculiar military conditions of the Santiago campaign, and the
amount of work imposed upon Medical Officers in our large camps of instruction would
naturally obscure the more remote interests of the Museum; but from our large General
Hospitals and Hospital Ships, and the more deliberate methods of our forces of occupation
may well be demanded a return to the systematic collection of specimens illustrating the
M Senate Report 1049, to accompany S. 1552, 54th Congress. 1st session, 20 May 1896.
106 ARMED FORCES INSTITUTE OF PATHOLOGY
bone and tissue injuries produced by modern firearms and explosives, and a careful preser-
vation of such illustrations of disease as may be obtained upon cadaveric examination.
Colonel Bache's observations, with accompanying renewed directions as to
methods of preparation and preservation of specimens and their delivery to the
Museum, were published to the Medical Corps in the Surgeon General's Cir-
cular No. 10, 20 October 1898; 21 with what response does not appear. But the
Spanish-American War, with its record of nearly seven times as many deaths
from disease as from enemy bullets, with more than half the deaths from disease
from one cause, typhoid fever, and with the specter of yellow fever lurking in
the background, sounded a challenge to the best brains and the most devoted
dedication to medical advancement.
The history of the Spanish-American War was, in a way, a repetition of that
of the Civil War, in that a Medical Department, barely adequate for peacetime
and actually forbidden by law to store up reserve supplies, was suddenly called
upon to care for a tenfold increase in army numbers. Moreover, General Stern-
berg had been denied his request for allotment of a reasonable share of the
emergency funds voted for defense purposes before the start of actual hostilities,
and so was not permitted to anticipate his increased needs before the flood of
raw volunteer troops fell upon his slender medical resources.
Typhoid soon became epidemic in nearly nine out of ten of the new regi-
ments, and about one soldier in five contracted the disease. The reasons as-
scribed for these epidemics were numerous but, in the language of Col. P. M.
Ashburn, "fundamentally they are one, ignorance." " To the task of dispelling
the prevailing ignorance of the transmission of typhoid, and the equally un-
known method of transmission of yellow fever, and so to make a beginning in
the control of two of the major diseases of man, the Army Medical Museum
was called.
21 (1) Lamb, op. cit., pp. 112, 113. (2) Lamb, D. S.: Army Medical Museum, Washington, D.C.
The Military Surgeon 53: 131, 132, August 1923.
22 (1) War Department Records, Office of the Surgeon General. On file in National Archives. (2)
Ashburn, op. cit., p. 169.
CHAPTER VI
The Walter Reed Chapter
In three tremendous years of achievement, from 1898 to the end of 1900,
Maj. Walter Reed, Curator of the Army Medical Museum, and professor in
the Army Medical School, wrote imperishable pages in the history of medicine.
First, as president of an Army Board of medical officers set up to investigate
the typhoid fever epidemic in the camps within the United States, he helped
to broaden the understanding of the ways in which typhoid spreads — an essen-
tial step in the triumph of the next decade over that disease, to be dealt with
in a subsequent chapter of this story.
And then, after the field work of the Typhoid Board was completed but
before its report was compiled and published, Reed was called upon to head
another board of medical officers to investigate infectious diseases in Cuba,
which was to discover, and prove beyond a doubt, the method of transmission
of the most dreaded disease of the Tropics— yellow fever.
Yellow Fever Epidemics
Yellow fever, indeed, was more than a tropical disease. Endemic in the
American tropics, it had an unaccountable and disconcerting way of breaking
out in epidemic form in the cities and villages of the Temperate Zone of
North America. In at least 35 years of the 18th century, yellow fever invaded
the United States, extending as far north as Nantucket Island, where 259
persons died of it in 1763, and New York, where there were 2,300 deaths in
1798, and raching a climax of destructiveness in 1793, with 4,041 deaths in
6 weeks among the 40,144 inhabitants of Philadelphia, then the Capital City of
the Nation.
The 19th century was even worse, with invasions in at least 77 years, rising
upon occasion to great epidemics such as those of 1853, which took 7,848 lives
in New Orleans; of 1855, with 2,670 deaths in New Orleans and 2,000 in
Norfolk; of 1878, when 4,046 died in New Orleans and 5,150 in Memphis;
and as many more in smaller and scattered communities in the Mississippi
Valley.
713-028*— 64 !)
I08 ARMED FORCES INSTITUTE OF PATHOLOGY
Altogether, in the years since 1793, New Orleans had suffered more than
40,000 deaths, Philadelphia more than 10,000, Memphis more than 7,500,
Charleston more than 4,500, and New York almost 3,500, while the total for
the United States exceeded 100,000 deaths. 1
Perhaps worse than the sickness, which attacked from three to five persons
for every one who died of the disease, and certainly worse than the economic
disruption, was the sheer terror of the deadly infection which struck no one
knew how and against which no precautions, no defenses, seemed to avail.
Writing of the Philadelphia epidemic of 1793, eyewitness Mathew Carey
says in his "Short Account of the Malignant Fever Lately Prevalent in Phila-
delphia," that the "consternation of the people * * * was carried beyond all
bounds. Dismay and affright were in the countenance of almost every person."
Flight from the city was sought by many, including some of the representa-
tives of the Federal government while "of those who remained many shut
themselves in their houses and were afraid to walk the streets * * *."
The "marks of terror" seen on every hand included burial of "the corpses
of the most respectable citizens, even those who did not die of the epidemic
* * * unattended by a friend or relative, and without any sort of ceremony."
Pedestrians kept to the middle of the streets "to avoid being infected in passing
by houses wherein people had died." The custom of shaking hands was discon-
tinued, and it became common practice to try to keep to the windward of
persons met abroad in the streets."
Nearly a century later, when the great epidemic of 1878 struck the Mis-
sissippi Valley, causing a loss of 16,000 lives, J. M. Keating, who lived through
them, wrote of the scenes in Memphis. "Men, women and children," he said,
"poured out of the city by every avenue of escape * * * by every possible
conveyance — by hacks, by carriages, buggies, wagons, furniture vans, and street-
drays; by bateaux, by anything that could float on the river; and by the rail-
roads * * *. The aisles of the cars were filled and the platforms
packed * * *. The ordinary courtesies of life were ignored, politeness gave
way to selfishness, and the desire for personal safety broke through all social
amenities."
' (1) Yellow Fever: A Symposium in Commemoration of Carlos Juan Finlay. The Jefferson Medical
College of Philadelphia, 22-23 September 1955, pp. 4, 5. [Hereinafter cited as Symposium.] (2) Kelly,
Howard A.: Walter Reed and Yellow Fever, 2d edition. Baltimore: Medical Standard Book Co., 1906,
pp. 83, 84, 204, 210, 221, 233, 238. (3) Reed, W., and Carroll, J.: The Prevention of Yellow Fever.
Medical Record (New York) 60: 641, 26 October 1901.
"Carey, Mathew: A Short Account of the Malignant Fever Lately Prevalent in Philadelphia, Phila-
delphia. 1703, quoted in Kelly, op. cit., pp. 212-215.
THE WALTER REED CHAPTER
109
Twenty-five thousand persons, half the population, left the city and 5,000
more went into camp to escape the city's streets where "trade and traffic were
suspended" and "death was everywhere triumphant."
The terror of the time was heightened by the fact that "neither cleanliness
nor right living were a shield to stay the hand of the destroyer. He invaded
the homes of the most chaste and the den of the vilest. He took innocence and
infamy at the same moment and spread terror everywhere. Where sorrow was
so general there could be no parade of it. There were no funerals and but
little demand for funeral services * * *. Not infrequently bodies were left
in the cemetery unburied for a night, so hard pressed were the managers for
labor, and so numerous were the demands upon what they had * * *." 3
For every act of depravity or inhumanity there were, doubtless, deeds of
devotion and unselfishness, but the overall effect of an epidemic attack of yellow
fever — and any outbreak might develop into epidemic proportions— was the
utter demoralization of community life. The direat that hung over the cities
and villages of the United States was ample warrant for the creation of a special
commission to visit the West Indies and study yellow jack in its home haunts.
Such a commission was formed in 1879, with Maj. George M. Sternberg,
a future Surgeon General of the Army, as secretary. After 6 months' study in
Cuba and Brazil, the Commission reported, on 16 November 1879, that "yellow
fever is an epidemic, transmissable disease and the agent capable of transmitting
the disease must be in the air." 4
Studies on Transmission
The suggestion of an airborne agency of transmission of the disease found
lodgment in the mind of Dr. Carlos Juan Finlay of Havana (fig. 41). Dr.
Finlay was Cuban-born, of Scottish and French parentage, educated in France
and Germany, a graduate of the Jefferson Medical College of Philadelphia,
fluent in four languages, a student of the classics, and a man of scientific attain-
ments. He was first connected with the study of yellow fever when he was
named, by the Spanish Governor General of Cuba, to work with the United
States Commission of 1879 on the subject. The most meaningful consequence
of the work of that commission, as it turned out, was the idea implanted in the
mind of its Cuban collaborator.
3 Keating, J. M.: History of the Yellow Fever Epidemic of 1878 in Memphis. Tcnn.. quoted in Kelly,
op. cit., pp. 223-228.
* Symposium, p. 5.
II0 ARMED FORCES INSTITUTE OF PATHOLOGY
On 14 August 1881, Dr. Finlay read before the Royal Academy of Medico-
Physical and Natural Sciences in Havana a paper entitled "The Mosquito
Hypothetically Considered as the Agent in the Transmission of Yellow Fever."
This was not the first suggestion of the possibility of the mosquite as a carrier
of yellow fever — Dr. Josiah Clarke Nott, of Mobile, Ala., had speculated upon
the possibility as early as 1848 — but Dr. Finlay was the first to go beyond specu-
lation to the working out of a definite theory of the method of transmission,
based upon experiments with a particular species of mosquito, then called Culex
fasciatus, later known as Stegomyia fasciata, and now classified as Aedes aegypti.
Dr. Finlay 's theory was not ignored — he was too respected a figure for that —
but it met with almost universal disbelief, and even encountered ridicule as the
theory of "that crazy Cuban doctor." For this, there were more than the usual
reasons for nonacceptance of a new idea. Perhaps the most potent reason of
all was the lack of positive proofs resulting from Dr. Finlay's own continued
experiments in which he was never able to produce a clear-cut and undoubted
case of experimental yellow fever from the bite of a mosquito. '
In the very spirit of the time, there were reasons why the Finlay mosquito
theory did not receive the attention it merited. It was propounded in a period
when bacteriology, in the first flush of widespread acceptance of its basic
premise, was announcing with almost breathtaking frequency discoveries of
new bacteria as the specific causes of particular diseases — tuberculosis among
them, and tetanus, pneumonia, typhoid fever, anthrax, and diphtheria, to name
a few of the scourges for which a disease-causing microorganism was found.
Naturally, the eyes of the scientific world were focused on the minute
organisms which were being made visible by improved instruments and pro-
cedures, and inevitably, bacteriologists saw organisms which were taken to
be the cause of yellow fever. Such "discoveries" were announced in Brazil,
Mexico, and Cuba during the 1880's but further investigation by Dr. Sternberg,
outstanding among American authorities on the subject, demonstrated in each
instance that the supposed causative agent was not, in fact, related to yellow
fever. The specific agent of the disease, according to Sternberg's report, in
1890, of his investigations carried on in Havana, Vera Cruz, and Rio de Janeiro,
had not been discovered and demonstrated.
There matters stood until, in 1897, Dr. Giuseppe Sanarelli, an Italian
bacteriologist of the University of Bologna, who had worked in Montevideo
'*' ( 1 ) Symposium, pp. 96—IOI. Dr. Nott's suggestion as to mosquitoes was published in the New
Orleans Medical Journal, volume IV, pp. 563 ff., under the title "Yellow Fever Contrasted with Bilious
Fever: probably insect or animalcular origin." Dr. Finlay's theory first appeared in the Annales dc la Real
Acadcmia. volume LVIII. pp. 147-169.
THE WALTER REED CHAPTER
III
-
Figure 41. — Dr. Carlos Juan Finlay, whose theory of transmission of yellow fever by the
bite of mosquitoes was tested and proved by Walter Reed.
and Rio de Janeiro, announced his discovery of die cause of yellow fever as an
organism which he called Bacillus icteroides.
The announcement created great interest in America, where studies were
promptly undertaken to check and, if possible, to confirm the reported finding.
One such investigation, ordered by Surgeon General Walter W. Wyman of the
Marine Hospital Service — now the United States Public Health Service — resulted
in a report, in 1899, which accepted Dr. Sanarelli's claim in the fullest.'
Sternberg, by this time Surgeon General of the Army, assigned the task of
checking the Sanarelli discovery to two members of the staff of the Army Med-
ical Museum — Walter Reed and James Carroll — who performed the work in the
laboratories of the Museum. In a "Preliminary Report," published in the
Medical News of 29 April 1899, they reported that the Sanarelli bacillus was
apparently a strain of the bacillus of hog cholera rather than a cause of yellow
'Reed. Walter: The Propagation of Yellow fever: Observations Based on Recent Researches. (An
address given before the 103d Annual Meeting of the Medical and Ohirurgical Faculty "I the State "1
Maryland, held in Baltimore, 24-27 April 1901.) Published in the Medical Record (New York) 60:
201-209, I0 August 1901. I Hereinafter cited as Baltimore Address.]
112 ARMED FORCES INSTITUTE OF PATHOLOGY
fever. Dr. Sanarelli hotly resented the Reed-Carroll findings in a communi-
cation in the Medical News of 12 August, in which he charged his "obstinate
opponents" with "hiatuses of observation and inexactness in * * * ex-
periment," leading to "gross and inexcusable error." Reed and Carroll made
reply in the same journal of 9 September, refuting the charges and outlining
the careful procedures of the respected laboratories of the Museum. 7
By 1899, the subject of yellow fever was of all the more pressing interest
because on 1 January of that year the American Forces had formally taken over
from Spain the occupation of Havana, a city which had not been entirely free
of the pestilence for 140 years. Yellow fever, feeding on the non-immune per-
sonnel of the occupation forces, again broke out in epidemic form, in 1900.
The opportunity and the need for a fresh, thorough, and searching investi-
gation of the source and the spread of yellow fever had come together — and the
Army, fortunately, had the men who could make the most of the opportunity
and could meet the need.
The Yellow Fever Board at Work
The Surgeon General again turned to Major Reed, who had so ably directed
the investigations of the Typhoid Board, and to James Carroll, his second in
command at the Army Medical Museum, who had participated in the investi-
gation of the Sanarelli bacillus. These two, with Dr. Jesse W. Lazear and Dr.
Aristides Agramonte, were designated as a board to investigate infectious
diseases in Cuba, set up by War Department Special Orders No. 22, 24 May
1900. All four members of the Board were happy, one might say almost
inspired, choices.
Walter Reed was born on 13 September 1851, in Gloucester County, Va., s
where his father was a Methodist minister, and was reared in Farmville, Va.,
and Charlottesville, seat of the University of Virginia. After a year at the
University in the study of the classics, Reed, compelled by slender family
finances to curtail his education, managed to compress the 2-year course in
medicine into 1 year, graduating third in his class before his 18th birthday. A
year later, in 1870, he received a second M.D. degree from the Bellevue Hospital
Medical College in New York. After 5 years as a hospital intern and a health
department inspector in Brooklyn, he took the examinations for the Medical
Department of the Army, partly because he wished to ask Miss Emilie Lawrence
7 Medical News, Philadelphia, 74: 513-514, 29 April 1899; 75 : '93-199, 12 August 1899; 75: 321-
329, 9 September 1899.
8 A piece of one of the original logs of which the house at "Belroi," where Walter Reed was born,
was constructed, is exhibited at the Medical Museum, AFIP.
THE WALTER REED CHAPTER 113
of Murfreesboro, N.C., to marry him and felt that the prospects of establishing
a sufficiently assured private practice, which he said depended "more on his
beard than on his brains," were not sufficiently promising to sustain the venture.
He succeeded in passing the examinations, was commissioned a first lieutenant,
and won his bride.
There followed 4 years of frontier service in Arizona, and a year at Fort
McHenry, Baltimore, where he took advantage of the opportunity to study
physiology at Johns Hopkins. The next 5 years were spent in Nebraska, after
which he had a tour of 2 years at Mount Vernon Barracks in Alabama. In
1889, Reed was back in Baltimore as attending surgeon and examiner of re-
cruits, with permission of Surgeon General Jedediah H. Baxter to pursue such
courses at Hopkins as would be of practical benefit to any army surgeon, but
not to take laboratory courses. After General Baxter's death, Captain Reed
was permitted to take courses in pathology and bacteriology — subjects which
were to determine the direction of his future career.
After 2 years more of frontier service in the Dakotas, Reed was named to
the positions in the Medical Museum and the School which he held at the time
of his appointment to investigate yellow fever— the appointment which he was
to make of such shining service to medicine and mankind. 9
James Carroll (fig. 42) was born in England in 1854, emigrated to Canada
at the age of 15, and enlisted in the U.S. Army in 1874 at the age of 20. Twelve
years later, he took advantage of a tour of duty in New York to begin his medical
education, which he finished with the degree of M.D. from the University
of Maryland, earned while stationed in Baltimore in 1891. Postgraduate work
in bacteriology and pathology at the Johns Hopkins Hospital followed, in
1892 and 1893. In the latter year, he was assigned to the Museum, where he
served with the rank of Hospital Steward until 1898, when he became Acting
Assistant Surgeon. 10
Jesse William Lazear (fig. 43), the third member of the Yellow Fever
Board, was born in 1866 in Baltimore, where he graduated in academic studies
"Reed's career up to the time of the creation of the Yellow Fever Board is based on Kelly, op. at.,
chapters I, II, and HI, and upon Maj. Jefferson Randolph Kean's memoir, included in Senate Document
822, 61st Congress, 3d session, 1911, pp. 14-16 and 38-40. Maior Kean refers in these memoirs to a little
Indian girl who had been so badly burned in a campfire that she had been abandoned to die by her
people, but whom Dr. Reed had rescued and saved, taking her into his home for rearing. The story is
told in greater detail in an account of an interview, with Miss Blossom Reed, the major's daughter, at
her home at Blue Ridge Summit, Pa., on the 109th anniversary of his birthday, which appeared in the
Washington Daily News of 14 September 1960.
10 (1) Kelly, op. cit., pp. 262, 263. (2) Lamb, D. S.: A History of the Army Medical Museum.
1862-1917, compiled from the Official Records. Mimeographed copy in historical records of AFIP,
p. 114.
ii4
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 42. — Lt. James Carroll, a member of the Yellow Fever Board, who contracted
the disease in its experiments, became sixth Curator of the Army Medical Museum,
1 902- 1 907.
at the Johns Hopkins University in 1889. He took his medical degree at
Columbia University in 1892, served at the Bellevue Hospital in New York for
2 years, and studied in Europe for a year, including time in Italy and a period
at the Pasteur Institute in Paris. Back in the United States, he became bacteriol-
ogist on the staff of the Johns Hopkins University and assistant in clinical
microscopy in the medical school, until he was selected by the Surgeon General's
Office to go to Cuba as a bacteriologist at Camp Columbia, where he arrived
in February 1900."
Aristides Agramonte (fig. 44), the youngest member of the Board and
the only member who was an "immune" to the disease which was to be inves-
tigated, was born in Puerto Principe, Cuba, in 1868, the son of a Cuban patriot
"(1) Kelly, op. a:., pp. 281-283. (2) Truby. Albert E.: Memoir of Walter Reed: The Yellow
Fever Episode. New York: Paul B. Hcebcr. Inc.. 1943, pp. 61, 73, 82.
THE WALTER REED CHAPTER
"5
Figure 43. — Dr. Jesse W. Lazear, a member of the Yellow Fever Board, who lost his life
in its experiments.
insurgent against the rule of Spain. After the death of General Agramonte
in battle, in 1872, the family moved to New York, where Aristides graduated
from the College of the City of New York and received his M.D. in 1890, at
the College of Physicians and Surgeons of Columbia University. In May
1898, at the outbreak of the war with Spain, he was appointed acting assistant
surgeon in the U.S. Army, and participated in the Santiago campaign of that
summer. At the time of his appointment to the Yellow Fever Board, he was
in Havana, making bacteriologic studies of yellow fever cases. *
Major Reed was acquainted with all three of the other members of the
new Board. Carroll was his close associate at the Museum, Lazear he knew
through their connections with the Johns Hopkins school, and Agramonte
had done work in the laboratories of the Museum. When appointed, Doctors
Lazear and Agramonte were already at work on yellow fever in Cuba, where
Reed had renewed his acquaintance with them in the early spring of 1900,
12 Kelly, op. at., pp. 2KX-2<ji>.
713 028* 04 10
u6
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 44. — Dr. Aristides Agramonte, Cuban member of the Yellow Fever Board, was its
only "Immune.''
when he was there investigating the germicidal qualities of an "electronzone"
product being offered to the Army. The personalities and capabilities of the
Board which was to be created in late May were well known to its president. 13
The senior members of the Board, Reed and Carroll, arrived in Havana
on 25 June 1900, and work was undertaken immediately. Headquarters was
established at Columbia Barracks in the suburban village of Quemados de
Marianao, 6 miles west of Havana. Quemados, as it happened, was in the grip
of an outbreak of yellow fever, with 50 cases and 12 deaths, despite an almost
ideal situation from the standpoint of general sanitation.
The first work undertaken was a further investigation of the Sanarelli
bacillus, making use of the wealth of yellow fever materials available in Cuba.
Blood drawn from 18 yellow fever patients and autopsies performed on 11 who
13 (1) Truby, op. cit., pp. 73-77. (2) Lamb, op. cit., p. 118. (3) Senate Document 822, 61st Con-
gress, 3d session, p. 26 (Dr. Agramonte's statement).
THE WALTER REED CHAPTER 1 17
had died of the disease yielded no trace of the organism so, quite early in the
investigation, the Sanarelli theory as to the cause of the disease was discarded. 14
Reed, in fact, was to be criticized, in the clear light of knowledge after
the fact, for the time spent on disproving the Sanarelli theory. With the un-
solved problem before him, however, and especially with the knowledge that
the Marine Hospital Service accepted Sanarelli's claims, it is hard to see how
Reed could have done otherwise than make the most thorough test possible
of all approaches to the mystery of the cause and propagation of yellow fever.
At any rate, little time was lost, for even while the cultures were being
tested and the autopsies performed, preparations went ahead for trying other
approaches. The "search for the specific agent of yellow fever," in Dr. Reed s
words, was not to be abandoned but was "to be given secondary consideration,
until we had first definitely learned something about the way or ways in which
the disease was propagated from the sick to the well." It was regarded "as of
the highest importance that the agency of an intermediate host, such as the
mosquito, should either be proven or disproven." l0
Reed's attention had been drawn to the possibility of the mosquito as a
transmitter of disease by the then recent work of Ronald Ross, of the British
Indian Medical Service, in demonstrating that the Anopheles mosquito carried
the plasmodium causing malaria between birds, while Sir Patrick Manson
demonstrated that the bite of an infected mosquito could cause malaria in man.
To the "brilliant work of Ross and the Italian observers"— Grassi, Bastianelh,
Bignani, and others — Reed expressed his indebtedness. 10
Coming closer to the problem of an intermediate host for the cause of
yellow fever, Dr. Reed was impressed by the observations of Surgeon Henry
Rose Carter of the Marine Hospital Service, made during an outbreak of yellow
fever in Mississippi in 1898 and published in the New Orleans Medical Journal
"Reed, W., Carroll, J., Agramonte, A., and Lazear, J. W.: The Etiology of Yellow Fever. A Pre-
liminary Note. Philadelphia Medical Journal 6: 790-796, 27 October 1900.
a Baltimore Address, p. 203.
M (1) Reed ct al., Philadelphia Medical Journal, 6 (1900), p. 791. (2) Reed, W.: Recent Researches
Concerning the Etiology, Propagation and Prevention of Yellow Fever, by the United States Army Com-
mission. Journal of Hygiene 2: 107, April 1902. Ross had demonstrated the role of the mosquito as die
intermediate host to the plasmodium of malaria in 1897. The year before, 1896, Major Reed had reported
to The Surgeon General upon a malaria epidemic at Washington Barracks (now Fort Lesley J. McNair)
and Fort Myer, Va. By careful epidemiological investigation, he had ruled out the possibility of drinking
water as a cause and concluded that the fevers were due to "emanations from the Potomac flats. As
Col. Hugh R. Gilmore, Jr., Curator of the Medical Museum, put it, Reed "correctly implicated airborne
•emanations 1 — but the 'emanations' had wings!" In Gilmore, H. R., Jr.: Malaria at Washington Barracks
and Fort Myer: Survey by Walter Reed. Bulletin of the History of Medicine 29: 34^-351 (July-August)
'955-
n8 ARMED FORCES INSTITUTE OF PATHOLOGY
in May 1900. These observations showed that between the occurrence of the
first cases at isolated farmhouses and of the first succeeding groups of cases at
the same houses there was a lapse of 2 or 3 weeks, while subsequent cases de-
veloped in a shorter period of incubation of from 1 to 7 days. To Dr. Carter,
this indicated that there was in a life cycle of the infecting organism an inter-
mediate host, such as the mosquito, which harbored the cause of the disease for
a period before passing it on. 1T
To the work of Ross and of Carter, Reed added a perspicacious observation
of his own at Pinar del Rio, 100 miles west of Havana, where yellow fever broke
out in the American garrison. One of the victims was a general prisoner, under
confinement in the guardhouse since 6 June 1900, who fell sick on 12 July and
died on the 18th, and was autopsied by Dr. Agramonte on the 19th. The fact
that this guardhouse prisoner, effectively in quarantine insofar as yellow fever
exposure by ordinary means was concerned, should sicken and die of yellow
fever, led to the conjecture "that, perhaps, some insect capable of conveying the
infection, such as the mosquito, had entered through the cell window, bitten
this particular prisoner, and then passed out again." This, Dr. Reed added,
was only a supposition, but it was a supposition no doubt strengthened by the
reflection that iron bars at the windows and armed guards at the door could
keep the prisoner from visiting places of infection, but would not keep infected
mosquitoes from visiting the prisoner. ls
Dr. Finlay' s Mosquito Theory
And then there was Dr. Finlay and his long-held mosquito theory which
he had "ingeniously discussed," as Reed put it, as early as 1881 and had repeated
since, notably in papers published in 1891, 1894, 1895, and as recently as 1899.
Although the Cuban doctor had "no results in support of his theory" Reed
wrote, * * * the argument in favor of an intermediate host seemed so
strong * * * that investigation along this line was determined upon." '"
Already, around the 1st of July, members of the Yellow Fever Board had
called upon Dr. Finlay and had received his most cordial cooperation, for which
Reed expressed "sincere thanks." The doctor turned over larvae and eggs of
the suspected species of mosquito, which became the foundation of the breeding
stock used in the experiments. Dr. Lazear, who had had entomologic training
and experience with mosquitoes in Italy, was placed in charge of the work of
" Reed ct al., Philadelphia Medical journal, 6 (1900), pp. 791, 792.
18 Baltimore Address, pp. 202, 203.
" Reed et al., Philadelphia Medical Journal, 6 (1900), p. 792.
THE WALTER REED CHAPTER
II 9
breeding, rearing, and caring for Dr. Finlay's mosquitoes and those obtained
from other sources. Hospital Steward John S. Neate, of the staff of the Medical
Museum, who was sent to Cuba in June for service with the Reed Board, had
the hazardous and exacting task of the daily care and feeding of Dr. Lazear's
"birds." 20
To carry out the contemplated experiments, however, there had to be more
than a theory and a breeding stock of mosquitoes. There had to be money, for
one thing — precious little money by comparison with modern expenditures or
in relation to the results accomplished, but money just the same. And there
had to be experimental "animals" — and so far as anyone then knew, the only
animal subject to yellow fever was the genus Man, himself.
This disturbing fact led to another problem — not where to get the men
necessary for the experiments, for that problem was to be solved by ready volun-
teers, but whether to authorize experiments on human subjects. In the light
of the results accomplished, that question does not seem as thorny now as it
must have seemed to Dr. Reed, who had the responsibility for proposing such
a course to Surgeon General Sternberg, and to Maj. Gen. Leonard Wood,
Governor General of Cuba, who had the final responsibility for authorizing
human experimentation.
It happens that the experiment was brilliantly successful, and that the only
life lost was that of one of the experimenters, but it is easy to imagine, if things
had turned out differently, the outcry that would have assailed those responsible.
Fortunately, the United States was represented in Cuba in 1900 by a governor
general who, being a medical officer himself, had the understanding of the
problem and the courage to face it in his own responsibility — and Walter Reed
got the necessary authority ami backing.
Before all arrangements for the mosquito tests could be set up, Reed was
compelled, on account of the death of Dr. Edward O. Shakespeare of the
Typhoid Board, to hasten back to the United States to work on the preparation
of the report of that board for publication.' 1 He left Cuba on 2 August, and
did not get back to Quemados until 4 October. In his absence, there had been
developments both tragic and triumphant in the work on yellow fever.
Human e( Guinea Pigs"
One of the conditions upon which the Yellow Fever Board had recom-
mended the use of human "guinea pigs" in its work was that the members of
"" ( i) Truby, op. cit., pp. 92, 93. (2) Lamb, op. at., p. 1 [9.
" Ireland, M. W.: The Conquest of Yellow Fever. The Military Surgeon 64: 244-251, February 1929.
120 ARMED FORCES INSTITUTE OF PATHOLOGY
the Board should themselves be the subject of experiment. Consequently, in
the first group of eight inoculations by the bites of mosquitoes hatched from
Dr. Fin lay's eggs, administered between i August and 19 August, Dr. Lazear
was included as Case No. 6. The result in all eight cases, listed in the report
by number only, was negative — no yellow fever. The same thing was true of
Case No. 9, that of Dr. A. S. Pinto, bitten on 25 August by a mosquito infected
10 days earlier." 2
But on 27 August, Dr. Carroll was bitten by a mosquito infected 12 days
before — and on 31 August, Dr. Carroll sickened with a well-defined and very
severe case of yellow fever, the first such case traceable to the bite of an infected
mosquito under experimental conditions. Dr. Carroll's case came very near
to proving fatal and, in its aftereffects, undoubtedly shortened his life.
The second case of experimental yellow fever was that of Pvt. William H.
Dean of the Seventh Cavalry who, on 31 August, the day that Dr. Carroll was
taken sick, was bitten by the same mosquito which had infected him, and
also by three others which 12 days before had fed on the blood of yellow fever
patients. Dean, referred to in the original reports of the investigation as "XY,"
had a mild but definite attack of yellow fever. 23
Up to this time, there had been eleven "bitings" by the experimental mos-
quitoes, with but two cases of fever resulting — a circumstance which was after-
ward found to be due to the fact that only the female of the species could trans-
mit the disease, and she could not do so until at least 12 days after becoming
herself infected, and that the first nine "bitings" had been too soon after the
mosquitoes had been fed on yellow-fever blood. Moreover, there was a shadow
of doubt as to whether Major Carroll's case was of experimental or accidental
origin, since he had been in infected areas before and after being bitten. As
to the case of Private Dean, however, there was no doubt, since he had been
a patient in the post hospital at Columbia Barracks, and had not been
exposed to any source of infection other than the four experimental mosquitoes.
The Death of Dr. Lazear
In addition to the two cases of Carroll and Dean, there was the tragic case
of Dr. Lazear, who was stricken on 18 September and died a week later. After
his death, a notebook containing entries about his experiments was found in
the pocket of a uniform which he had been wearing. This little notebook,
when analyzed by Reed, furnished the clue to the secret of mosquito transmis-
23 (1) Rcec] ct al., Philadelphia Medical Journal, 6 (1900), p. 792. (2) Truby, op. cit., pp. 126, 220.
23 Rccd ct al., Philadelphia Medical Journal, 6 (1900), p. 792.
THE WALTER REED CHAPTER 121
sion of the disease— namely, that it was a matter of timing of the bites, both
of the original patient from whom the disease was transferred and also of the
transferee. To become infected, the mosquito must bite the sick patient within
the first 3 days of illness; to transfer the infection, at least 12 days must have
elapsed since the infection was acquired by the mosquito. The nine unsuccess-
ful attempts to produce the disease were explained by the recorded fact that
the original patient was bitten after the third day of his illness, or that the
attempt to convey the disease was made less than 12 days after the mosquito
was infected.
Dr. Lazear's own case presented a puzzle. Reed had no doubt that it was
due to the bite of a mosquito but could not be sure that the mosquito was one of
those reared in the laboratory. Dr. Lazear told Major Carroll and Maj. William
C. Gorgas that, while engaged in letting his experimental mosquitoes bite yellow-
fever patients at the Las Animas Hospital in Havana, a stray mosquito had
landed on his hand, and he had permitted it to drink its fill. Obscure and un-
finished notations in Lazear's pocket memorandum book, however, indicated
that he might have applied some of the laboratory mosquitoes to his own arm,
knowing by that time that there was every chance of infecting himself with a
possibly fatal disease.
This raised a question as to how the case of Lazear would be treated in the
report. There was no doubt in Reed's mind of his illness and death from the
bite of a mosquito, and there is persuasive evidence that he believed that the
mosquito was actually one of the purebred laboratory strain which Lazear had
deliberately applied to himself, and not the stray insect which Lazear hail men-
tioned during his illness to Carroll and Gorgas. The reason for the discrepancy,
it is surmised, was possibly an apprehension on the part of the sick man that
his life insurance might be forfeited if he deliberately infected himself with a
possibly fatal disease."' 4 Reed decided to list the cause of Dr. Lazear's lamented
death as the bite of the mosquito in Las Animas Hospital, as related by Lazear.
but he accepted the case as evidence of the validity of the mosquito theory, adding
strength to the Carroll and Dean cases.
While analyzing the evidence resulting from the preliminary experiments,
Reed was intensely occupied in setting up arrangements for further experiments
"(I) Trubv, op. at., pp. .23-127. (2) Hench, Philip S.: Conquerors of Yellow Fever. Hygeia
(The Health Magazine) October ,941, p. 5. Dr. Hench. of the Mayo Clinic, has found in the stud, ol
the Walter Reed epic an absorbing avocation. In 1940. he visited the rcma.ns of Camp Lazear, accom-
panied by John J. Moran. one of the original volunteers, who identified the "infected bedding and
clothing building," falling into decay. Efforts to have the building restored and preserved failed. .
York Times, 4 November 1951.
122 ARMED FORCES INSTITUTE OF PATHOLOGY
under controlled conditions designed to test the truth of the theory beyond any
question.
Meanwhile, Reed felt warranted in making a report of results as far as the
work had gone. This he did, in person, in a paper, "The Etiology of Yellow
Fever: a Preliminary Note," read before the American Public Health Associa-
tion, meeting at Indianapolis from 22 October to 26 October 1900, and published
in the Philadelphia Medical Journal of 27 October. The "Preliminary Note"
disposed of the bacillus icteroides of Sanarelli, and drew the flat conclusion that
"The mosquito acts as the intermediate host for the parasite of yellow fever."
Reed's preliminary report got a rather cool reception, and aroused some
opposition, notably from Dr. Eugene Wasdin of the Marine Hospital Service,
who was committed to the Sanarelli thesis, and who attacked Reed's conclusions
in the Medical Journal of November 17. 20
Studies at Camp Lazear
Before that time, Reed was back in Cuba and had plunged into the work
of planning and providing a camp— Camp Lazear, it was appropriately called—
where tests of the transmission of yellow fever could be carried on under con-
ditions controlled with certainty. A site was picked near Columbia Barracks
but far enough away from habitation to insure isolation. The distinguishing
feature of the camp, located at Quemados de Marianao, a suburb of Havana, was
two small frame buildings, each 14 by 20 feet, located on the opposite slopes
of a little valley about 80 yards from each other and the same distance from the
camp proper. One, the "Infected Mosquito Building," was designed to test
the mosquito theory; the other, the "Infected Clothing Building," was designed
to test the currently accepted theory of infection by contact with the clothing,
bedding, and other articles which had been in close contact with yellow fever
patients (fig. 45). 2G
Camp Lazear was put in operation on 20 November 1900, manned by a
service detachment of volunteers— two doctors, one an immune; one hospital
steward, an immune; nine privates of the hospital corps, one of whom was
immune; and an immune ambulance driver. A strict quarantine was estab-
lished, with no one except the four immunes permitted to enter or leave the
isolated camp.
K Dr. Wasdin's article appears in: Philadelphia Medical Journal 6: 951, 952, 17 November 1900.
"Reed, W., Carroll, J., and Ajrramonte, A.: The Etiology of Yellow Fever. An Additional Note.
Journal of the American Medical Association 36: 431-440, 16 February 1007.
THE WALTER REED CHAPTER
123
Figure 45.— Camp Lazear. A. The small cabins in the distance are
the "Infected Mosquito Building" and the "Infected Clothing Building."
The tents housed the detachment. B. Building in which the fomites
theory was disproved.
For subjects upon whom the experiment was to be carried out, the original
reliance was placed upon securing the services of some of the numerous new
Spanish immigrants to Cuba who, in the language of the agreement which
each one signed, understood "perfectly well that in case of development of
yellow fever in him, that he endangers his life to a certain extent but it being
entirely impossible for him to avoid the infection during his stay in this island,
j 24 ARMED FORCES INSTITUTE OF PATHOLOGY
he prefers to take the chance of contracting it itentionally in the belief that
he will receive * * * the greatest care and the most skillful medical service."
A further consideration was the payment of $100.00 in American gold
and, in case of contracting yellow fever, an additional $100.00, to be paid to
the subject if he survived; otherwise, to the person whom he designated. The
subject bound himself not to leave the camp during the period of the experi-
ments, forfeiting all benefits if he should do so. 27
Some of the Havana newspapers "have abused us soundly and have charged
us with all kinds of inhumanity and barbarity," Reed wrote General Sternberg
on 26 November, but, he added, "the Spanish consul, a most courteous and
intelligent gentleman, assures us that we shall have his support, as long as we
do not use minors and the individual gives his written consent * * *." '
Soldier Volunteers
Although no United States soldier was asked to submit to the inoculation
tests, Pvt. John R. Kissinger, of the hospital detachment, and John J. Moran,
a civilian clerk in the headquarters of Brig. Gen. Fitzhugh Lee, astonished
and delighted Reed by volunteering, upon the condition that they receive no
money. There is an apocryphal story that Major Reed, upon receiving their
unsolicited offer, which was renewed after the risks they ran had been carefullv
explained to them, rose, touched his forehead, and said, "Gentlemen, I salute
you." The story of the salute is probably not true in detail, but he did say in
his published account of the experiment that "in my opinion this exhibition
of moral courage has never been surpassed in the annals of the Army of the
United States." "
The remark was made of Private Kissinger, who was the first to become
the subject of experiment and to contract yellow fever, but the same remark
would apply to Moran, who volunteered along with him, and to the other
12 who volunteered to subject themselves to inoculation with fever — Dr. Robert
P. Cooke of Virginia, James A. Andrus of Pennsylvania, Thomas M. England
of Ohio, Levi E. Folk of South Carolina, Wallace W. Forbes of Illinois, James
F. Hanberry of South Carolina, James Hildebrand of Georgia, Warren G.
Jernegan of Florida, William Olsen of Wisconsin, Charles G. Sontag of
- An original contract, in Spanish, signed by Walter Reed and Vicente Presedo, with an English
translation, is displayed in the Medical Museum of the Armed Forces Institute of Pathology.
: " Truby. op. cit., p. [53.
"' Baltimore Address, p. zt>^.
THE WALTER REED CHAPTER 1 25
South Carolina, Edward Weatherwalks of New Jersey, and Clyde L. West of
Indiana. 30
The first inoculation by mosquito bite which produced yellow fever was
that of Kissinger, who was bitten on 5 December, and fell sick on the night
of the 8th. "As he had been in our camp 15 days before being inoculated," Reed
exultantly wrote his wife, "and had no other possible exposure, the case is as
clear as the sun at noonday, and sustains brilliantly and conclusively our con-
clusions." 31 Between the 10th and the 15th, the proof was strengthened by the
development of three more cases, after which there were no cases for 10 days,
due to a cessation of inoculations— a hiatus which demonstrated that the four
cases in 1 week did not mean that the camp itself was infected. ""
While continuing his experiments with mosquito bites, Dr. Reed was carry-
ing on a rigorous test of the theory that infected clothing and bedding was the
transmitting agent of the fever — a theory unquestioningly accepted by the
medical profession and acted upon in framing and enforcing quarantine regu-
lations. The very name given to these infected articles, supposed to be capable
of passing on the flame of infection— "fomites," a word derived from the Latin
term for "tinder" — indicates how seriously they were regarded as a means of
spreading the flames of the fever. The fomites theory, as Reed remarked, was
"not disputed by anyone." 33 To establish the mosquito-infection theory was
not enough so long as the theory of infection by fomites was left undisturbed.
Testing the "Fotnites" Theory
Consequently, on 30 November the testing of the infective power of fomites
was begun in the "Infected Clothing Building"— a tight little structure, proofed
against the entrance of mosquitoes, with a minimum of ventilation, and heated
■"'The names of the "Participants of Yellow Fever Investigations in Cuba" appear annually in a special
"Role of Honor" in the Army Register, in compliance with an Act of Congress approved by President
Calvin Coolidge on 28 February 1929. In addition to those who took part in the first series of experiments,
the Roll of Honor includes those who volunteered in 1901 to undergo injection of blood from infected
persons, as follows: Assistant Surgeon Roger P. Ames of Louisiana, John R. Bullard of Massachusetts,
Albert Coyington of North Carolina, Wallace W. Forbes of Illinois, and Paul B. Hammann of Illinois
(born in Germany). In special category was Gustaf E. Lambert, male nurse, born in Sweden, who cared
for the fomites in the infected clothing experiment.
Not to be forgotten also are the five Spanish volunteers, who stayed to the end of the first series of
experiments, four of whom developed yellow fever — Jacinto Mendez Alvarado, Antonio Bcnigno. MicanoT
Fernandez, Jose Martinez, and Vicente Presedo; and two others who participated in the 1901 experiments —
Pablo Ruiz Castillo and Manuel Guttcricz Moran.
31 Kelly, op. cit., pp. 140-142.
M Rced ct al., Journal of the American Medical Association, 36 (1901), p. 435.
33 Baltimore Address, p. 202.
126 ARMED FORCES INSTITUTE OF PATHOLOGY
above 90 ° F. Into this environment, there were introduced four large locked
boxes of sheets, blankets, pillowslips, and other articles "contaminated by con-
tact with cases of yellow fever and their discharge * * * purposely soiled
with a liberal quantity of black vomit, urine and fecal matter * * *." Dr.
Cooke and Privates Folk and Jernegan, all nonimmunes, entered the building,
unpacked the boxes, handled and shook out their contents so as to "disseminate
through the air of the room the specific agent of yellow fever, if contained in
these fomites * * *," used the fomites to make their beds, and lay down
to sleep upon the beds so made— and continued to do likewise for each of the
next 19 nights, after which they were quarantined while other soldiers— Eng-
land, Hanberry, Hildebrand, and Weatherwalks — repeated the horrible ex-
perience, even adding to it the macabre touch of sleeping in the shirts which
had been worn by yellow fever victims.' 14
Summing up the ordeal of the fomites, Major Reed said, in his address at
Baltimore, that these volunteers, sleeping every night in a building into "which
no sunlight ever came" and which was purposely designed to lack air ventila-
tion, "engaged in the morning in packing boxes with garments much soiled by
contact with the bodies and excreta of yellow fever patients, and at night
unpacking these same boxes in order to obtain articles for their beds and cloth-
ing for their bodies; in other words, sleeping in the very beds and garments
just vacated by cases of yellow fever * * * averaging each 21 nights amid
such surroundings, came out of this pesthouse * * * none the worse for
their exposure. Not one had contracted the disease." 35
"Yellow fever can no more be transmitted in that way than intermittent
fever," Dr. Reed wrote his wife, while the experiments were still underway.
Later, in an address before the American Public Health Association, meeting at
Buffalo on 18 September 1901— a year after he had presented his "Preliminary
Note" to the same organization— Reed declared that the doctrine of the spread
of yellow fever by fomites "burst like a bubble" at the first touch of "actual
experiment upon human beings." 3G
In clearing up theories, there was another that called for attention— the
theory of infection from a contaminated house. To test this, there was the
"Infected Mosquito Building"— well ventilated, tightly screened, with a mos-
quito-proof screen dividing its interior into two parts, differing only in that one
side of the building was free from mosquitoes, while infected insects were
released in the other side. In this side, Mr. Moran allowed 15 mosquitoes to
"Reed ct al.. Journal o/ the American Medical Association, 36 (1901), pp. 431-440.
" Baltimore Address, pp. 207, 208.
M (i) Kelly, op. cit., p. 149- (2) Reed and Carroll, Medical Record, 60 (1901), p. 642.
THE WALTER REED CHAPTER 1 27
bite him during three visits, while two other nonimmunes, acting as controls,
occupied the other side of the building, free of mosquitoes. Moran, who had
been in quarantine for 32 days before being bitten and had had no other chance
to catch yellow fever, sickened on Christmas morning. The controls, who spent
14 nights in the room protected by the wire screen, but who had breathed the
same air as Moran, remained well. The demonstration was complete that a
house is infected with yellow fever only if it contains infected mosquitoes.''
To insure that the particular species of mosquito which possessed this
infective potency should be accurately depicted for surer identification, Major
Reed asked General Sternberg, on 22 December, to have Dr. J. C. McConnell
of the Medical Museum sent to Cuba to "make drawings of the mosquito and
larvae from live specimens." Dr. McConnell, who had returned to the Museum
as anatomist and who acted, in addition, as a one-man Medical Illustration
Service, came down bringing his camera lucida and paper, and by the end of
the year was at work on his sketches. 38
Transmission by Mosquitoes Established
As the year ended, Reed had every reason for gratification. The fomites
experiment was still underway, as were experiments with the transmission of
yellow fever by direct infusion of infected blood from an active case to non-
immune volunteers. These experiments, mostly carried out in January and
February 190 1, proved that the presumptive "parasite" of yellow fever circulates
in the bloodstream and is directly transmissible from man to man without the
necessity of an intermediate host. These experiments, however, in no way
vitiated the conclusion that the only method of propagating yellow fever in
nature is by the bite of a mosquito which has drunk the blood of a yellow fever
patient— a conclusion which was to be presented by Reed, on behalf of himself,
Carroll, and Agramonte, and with a tribute to Lazear, before the Pan American
Medical Congress, meeting in Havana on 6 February 1901.
This, and the other conclusions of the report, backed by the unimpeachable
testimony of unassailable research techniques, were to be almost immediately
accepted by the medical world and the world at large. To Dr. Finlay, as Reed
said, "must be given full credit" for the original idea and for the persistence with
which it was maintained in the face of indifference and even ridicule. But to
Walter Reed, James Carroll, Aristides Agramonte, and the lamented Jesse W.
n> Baltimore Address, pp. 204, 205.
m Truby, op. at., pp. 166, 172. 177.
128 ARMED FORCES INSTITUTE OF PATHOLOGY
Lazear, and to the corps of intrepid and dedicated volunteers who offered them-
selves for experiment, must go the credit for demonstrating and establishing the
fact that explained the mysterious behavior of yellow fever and offered a method
of successfully combating it. As Dr. Agramonte wrote in his biographical
sketch of Dr. Finlay, speaking of the parts played by the Cuban doctor and the
U.S. Army Board, "the great credit due the one robs not the other of a particle of
his glory." '
Already, even before the experiments were concluded and the results pre-
sented, the findings had begun to be put into effect in the American Forces
occupying Cuba. At the suggestion of Maj. Jefferson Randolph Kean, Acting
Chief Surgeon, General Wood issued General Orders No. 6 on 21 December
1900, prescribing mosquito-control methods for application at all posts on the
island, "the Chief Surgeon of the Department having reported that it is now
well established that * * * yellow fever * * * (is) transmitted by the
bites of mosquitoes * * *." 40
Reed himself had been positive ever since Kissinger came down with yellow
fever that, as he wrote Lt. Albert E. Truby on the 10th, "the theory is all right." 41
The theory, as he wrote his wife on 9 December, was Finlay's, "and he deserves
great credit for having suggested it, but as he did nothing to prove it, it was
rejected by all, including General Sternberg. Now we have put it beyond
cavil * * *." 42
Writing to his wife again, in the closing minutes of the closing year of the
19th century, Reed expressed feelingly the glow of modest exultation at this
great accomplishment:
Only ten minutes of the old century remains. Here I have been sitting, reading that
most wonderful book, La Roche on Yellow Fever written in 1853. Forty-seven years later
it has been permitted to me and my assistants to lift the impenetrable veil that has surrounded
the causation of this most wonderful, dreadful pest of humanity and to put it on a rational
and scientific basis. I thank God that this has been accomplished during the latter days of
the old century. May its cure be wrought in the early days of the new! The prayer that
has been mine for twenty years, that I might be permitted to do something to alleviate hu-
man suffering has been granted! * * * Hark, there go the twenty-four buglers in
concert, all sounding "taps" for the old year. 13
" Agramonte, A.: Dr. Carlos J. Finlay: A Biographical Sketch. Transactions of the American Society
ot Tropical Medicine 10: 27-31, 1916.
" Truby, op. cit., pp. 187, 224, 225.
41 lhid. t figure 26.
'" Kelly, op. cit., p. 141.
" Ibid., pp. 152, 153.
THE WALTER REED CHAPTER
129
On February 9, 1901, 3 days after he had presented to the Pan American
Medical Congress the results of the experiments at Camp Lazear, Major Reed
sailed for home, leaving Carroll behind in Havana to finish up certain details,
including winding up the affairs of Camp Lazear, which was closed on
1 March 1901."
In Havana also were Dr. Finlay, the theorist whose theories had been
vindicated by experiment, and his friend— and Reed's— Maj. William Craw-
ford Gorgas, whose original skepticism as to the theory hat! been replaced
by acceptance, and whose acceptance and resulting action was to give the theory
its first practical application. Dr. Gorgas still was not convinced that the
mosquito was the only means of natural transmission of the disease, but realiz-
ing that the insects were effective carriers, he declared war on the Stegomyia
fasciata in Havana.
Yellow fever had claimed an average of nearly 500 lives in Havana an-
nually for the 20 years, 1880-1899. In 1899 and 1900, the city was "cleaned
up," with good effect as to general health, but still there were, in 1900, more
than 300 deaths from yellow fever. In January 1901, there were seven deaths,
and in February, five. In February, the new regulations as to mosquito control
were put into effect. In March, four new cases were reported, with one death.
In April, there were three cases and no deaths; in May, four cases and no
deaths; in June, neither a case nor a death. In July, the disease was re-
introduced into Havana from the interior, with three cases and one death.
August saw eight new cases and two deaths; September, five cases and one
death; October, two cases but no death— and thereafter, for the remainder of
190 1 and the entire year of 1902, neither new cases nor deaths from the scourge
that for over 140 years had never been absent from Havana's streets and
homes. 45
The task of mosquito control in a tropical city was prodigious in its diffi-
culties and infinitely vexing in its details, but it was accomplished by the vigor,
firmness, patience, and tact of the great health administrator, Gorgas. And
in its accomplishment, it provided the perfect proof of the correctness of the
conclusions of the great medical discoverer, Reed.
Back in Washington, Reed continued his work for the Yellow Fever Com-
mission, as well as his work as Curator of the Medical Museum and professor
of bacteriology at Columbian (now George Washington) University. He was,
2 CO Ibid., p. ,63. (2) Reed, Journal of Hygiene, 2 (1902), p. 108.
"(i) Reed, Journal of Hygiene, 2 (1902), pp . ioi, 102. (2) Kelly, op. cit., pp. 182-187. (3) Senate
Document 822, 61st Congress, 3d session, pp. 221, 235, 236.
!3o ARMED FORCES INSTITUTE OF PATHOLOGY
for the season, relieved of his work as professor of the Army Medical School
which had been suspended for the period of the Spanish War and was not to
resume its sessions until October 1901. Meanwhile, Reed, as he wrote to
Carroll, who was still in Havana, was "tied down to the Army Examining
Board." 4C
Search for a Cause
The Yellow Fever Commission had succeeded in demonstrating to the
satisfaction of the world the method of transmission of the disease, but the
discovery of the activating cause of the disease itself was unfinished business.
In 1898, Friederich A. J. Lomer and Paul Frosch had demonstrated that hoof-
and-mouth disease in animals is due to something called, for want of a better
name, a "virus." Prof. William H. Welch, who had taught Reed at Johns
Hopkins, and who had been a fellow-pupil of Loffler's under the great Robert
Koch, called Reed's attention to the LdfHer-Frosch findings in the early summer
of 1901.
To Reed and Carroll, it appeared possible that the same sort of substance
might be the cause of yellow fever. A brief outbreak of tht disease in Santiago
de las Vegas offered an opportunity to put the supposition to the test, so Carroll
was sent back to Cuba in August 1901 to carry on the experiments. The tests
showed that the infective agent was present in the blood and in the blood
serum of fever patients, and that the power to produce fever persisted even
after the serum had passed through "the pores of a filter which ordinarily
serves to prevent the passage of all known bacteria." 1T It was to be yet another
quarter of a century before it was finally established that the infecting agent
of yellow fever is not a visible "parasite" such as Reed and Carroll sought, but
is a virus which filters had not yet trapped nor microscopes revealed.
In the little more than a year which remained of what has been described
as the "fifty-one years of Walter Reed's industrious, blameless life," ,s Reed
lost no appropriate opportunity to give the medical world the lessons learned
in the work of the Yellow Fever Commission. Besides his appearance before
die Medical and Chirurgical Faculty of Maryland at Baltimore in April 1901,
and his second appearance before the American Public Health Association in
September, both of which have already been referred to, he appeared before the
Senate Document S22, fust Congress, 3d session, pp. 163, 164 (letter of 26 February 1901).
(1) Ibid., p. 165. (2) Reed, Journal of Hygiene, 2 (1902), p. 106.
"McCaw, Walter IX: Walter Reed: A Memoir. Washington: The Walter Reed Memorial Association,
1004. p. 1.
THE WALTER REED CHAPTER 131
American Association of Physicians, meeting in Washington in July,"' and
before the Society of American Bacteriologists, meeting in Chicago at the end
of the year. 50 In addition, he published in the Journal of Hygiene, a British
periodical, a summary article of recent researches concerning the etiology, propa-
gation, and prevention of yellow fever by the United States Army Commission. 51
In these various papers and publications, he outlined in detail the experi-
mental procedures followed and the results obtained, demonstrating to all who
heard and read that both in its occurrences and its nonoccurrences at Camp
Lazear, "yellow fever strictly obeyed the behests of the experimenters."
Dr. Reed resumed his teaching, while continuing as Curator of the Medical
Museum, but by the fall of 1902, it became evident that his strength was failing.
In November, he suffered an attack which was diagnosed as appendicitis.
On the 17th, at the Army General Hospital at Washington Barracks, he under-
went an operation for removal of a ruptured appendix. "Maior Reed received
the accepted treatment" of that period, according to Dr. Charles Stanley White,
and "was in most competent hands." 5S Everything was done for him that
medical experience dictated and the personal solicitude of affectionate associa-
tion could suggest— but on 22 November 1902, Walter Reed, who "gave to
man control over that dreadful scourge, Yellow Fever," 51 being but 51 years
of age, died, to live among the medical immortals.
"Reed, W.. Carroll, J., and Agramonte, A.: Experimental Yellow Fever. American Medicine. Phila-
delphia 2: 15-23, 6 July 190 1.
50 Reed, W., and Carroll. J.: The Etiology of Yellow Fever. A Supplemental Note. American
Medicine, Philadelphia 3: 3°i-305, 22 February 1902.
51 Reed, Journal of Hygiene, 2 (1902), pp. 101-110.
'•"- White Dr Charles Stanley: The Last Illness of Major Walter Reed. Medical Annals of the District
of Columbia '24: 396-398, August ,955- The surgeon in charge was Maj. William Cline Borden assisted
by Lieutenants Ford and Conner, with Dr. White as anesthesiologist. Others in attendance were: Surgeon
General O'Reilly, Mai. J. R. Kean, Cant F. P. Reynolds, and Doctors Wallace Ncff and Bovee. Dr.
Borden, who was Reed's devoted friend, was more than any other one individual responsible for the creation
of the Armv Medical Center which bears the name of Walter Recd-a project "known to his contemporaries
as "Borden's dream'." In Ramsey, Herbert P.: Washington Medical Institutions: Walter Reed Armv Medical
Center. Medical Annals of the District of Columbia 28: 225-231. A P nl ">5 9 -
53 (1) The quotation is from the citation accompanying the award of an honorar) MA. degree by
Harvard University in 1902. (2) In .9.,. the U.S. Senate published Document 822. 6,st Congress, } d
session, under the'title "Yellow Fever." The document includes tributes to Reed and his work among
them the declaration of President Theodore Roosevelt that Reed left "mankind his debtor and the state-
ment of Gen. Leonard Wood that "his was the originating, dieting, and controlling mind in this
work • * *" The document also reprints seven of Reed's papers and addresses on yellow fever and
three by Carroll on the same subject, together with cop.es of reports of the practical application of the
discoveries of the Yellow Fever Board, by Col. Valery Havard, Chief Sanitary Ofhcer of the Department
of Cuba, and by Maj. W. C. Gorgas, Chief Sanitary Officer in Havana.
CHAPTER VII
Triumph Over Typhoid
Writing in 1906, Maj. Jefferson Randolph Kean declared that "Typhoid
fever is today, on account of its wide dissemination, the persistent vitality of its
infecting organism, the duration and severity of its attack and its large death
rate, the most formidable infectious disease with which we have to contend in
military life." *
Of this fact, the Nation had had melancholy proof in 1898, during and after
the war with Spain. Hostilities with Spain ended with the signing of the peace
protocol on 12 August of that year, but there was no treaty of peace with a more
insidious enemy, the Bacillus typhosus, as it was then called, or Salmonella
typhosa, to give the microorganism its present-day name. Typhoid fever struck
one out of every five soldiers in the national encampments within the United
States, with a date rate of more than 7V2 percent of those stricken."
To the study of this epidemic, Surgeon General George M. Sternberg as-
signed Maj. Walter Reed of the Regular Army, Curator of the Army Medical
Museum, and two surgeons of the Volunteers— Maj. Victor C. Vaughan, dean of
the Medical School of the University of Michigan, and an epidemiologist and
microbiologist of note, with special experience in the examination of water
supplies, and Maj. Edward O. Shakespeare of Philadelphia who, as special
commissioner from the United States, had studied cholera epidemics in Spain
and India.
The new Board, set up by General Orders No. 194, Adjutant General's
Office, on 18 August 1898, lost no time in getting to work. On 20 August, they
were at Camp Alger at Dunn Loring, Va., near Washington. There they found
hundreds of cases of fever which they believed to be typhoid, but which most
of the medical officers in attendance had diagnosed as malaria.
1 Kean, Jefferson R.: The Prevention of Disease in the Army (The Seaman Prize Essay). The
Military Surgeon 18: 13, 1906.
2 Reed, W., Vaughan, V. C, ami Shakespeare, E. O.: The Origin and Spread of Typhoid Fever in
United States Military Camps During the Spanish War of 1898. Volume 1. Washington: Government
Printing Office, 1904, p. 674.
134 ARMED FORCES INSTITUTE OF PATHOLOGY
Typhoid and the Medical Museum
The question could be settled only by microscopic pathological examination,
and there was not a microscope in the camp. Authority to set up a diagnostic
laboratory in each camp was requested and was granted. Doctors William M.
Gray and James Carroll of the staff of the Army Medical Museum were assigned
to the laboratory at Camp Alger, the first to be established. Later, after the
troops left Alger, the activity was transferred to Fort Myer, Va., and afterward
to Jacksonville, Fla. 3
The Typhoid Board's first stop on its tour of inspection of campsites and
surroundings was at Fernandina, Fla., reached on 26 August. By the end of
September, the Board had visited camps at Jacksonville, Fla.; Huntsville, Ala.;
Chickamauga National Park, Ga.; Knoxville, Tenn.; Montauk Point, Long
Island; and Harrisburg, Pa.' On much of their journey, they traveled and lived
in an office car provided for their use by the Southern Railway."'
The early differences in diagnosis between the Board and the local medical
officers, first evident at Camp Alger, persisted. At Jacksonville, where the
VII Army Corps was encamped, the dominant diagnosis for the fevers was
malaria for the milder cases, and typhomalaria for the more severe. The Reed-
Vaughan-Shakespeare Board was convinced, from the clinical evidence, that
many such cases were typhoid. They persuaded Brig. Gen. Fitzhugh Lee, in
command of the camp, to order that 50 cases diagnosed by the camp medical
officers as malaria or typhomalaria be sent to Fort Myer, where Dr. Carroll had
set up his diagnostic laboratory, for microscopic tests. The tests, in every
instance, showed the true diagnosis to be typhoid fever.
Being still unconvinced by the tests of a microscopist working for the
Typhoid Board, further tests were made on a larger number of men, sent to
major civilian hospitals in Baltimore, Philadelphia, New York, Boston, and
Cleveland— and again the tests showed that the correct diagnosis was typhoid
fever.' 1
By September, the bacteriologic laboratory was in operation at Chicka-
mauga National Park, where 60,000 soldiers had been encamped during the
summer, and where camp fever had been so prevalent that there was a dis-
"(1) Reed et al„ op. at., p. xiii. (2) VaugBan, Victor C: A Doctor's Memories. Indianapolis:
Kobbs-Mcrrill Co., [926, pp. $69— 371.
Reed ct al.. op. cit., p. xvi.
" Vaughan, op. < it., p. 580.
'/*/</.. pp. 572, 373.
TRIUMPH OVER TYPHOID 1 35
position to term the disease "Chickamauga fever" and to ascribe it to "a miasma
that arises nightly from the river and permeates the camp." ' The laboratory
at this camp, in charge of Acting Assistant Surgeon Charles F. Craig, was
supplied with materials for its tests from pure cultures furnished by the Army
Medical Museum and the Johns Hopkins University. 8
In October 1898, the Board was back in Washington and at work on the
laborious task of studying the detailed medical records of 118 regiments which
were, or had been, in the national encampments. Leaving out of account the
records of 20 regiments, which were so defective that they were discarded, the
Board checked every man shown on sick report who might have been a typhoid
case, tracing him through the regimental, division, and general hospitals, and
even the civilian hospitals to which many men had been sent, in order to learn
the course and the outcome of the disease. In 48 regiments, the subsequent
medical history of every man with a short diarrhea or a supposed malarial
attack was checked, in order to see whether they afterward showed a greater
or a lesser susceptibility to typhoid fever. In all regiments studied, the analysis
of the start and spread of the disease was localized by companies; in many
regiments, it was carried down even to the squad, with the date and order of
occurrence of the disease listed by individual tents.
At the end of June 1899, the appropriation for the work of the Typhoid
Board ran out, and Doctors Vaughan and Shakespeare were relieved from
duty. They continued the work on their own account, however, dividing
the sick reports and taking them to their respective homes for further analysis.
On 2 June 1900, a meeting of the members of the Board was to have been
held, but on the day before the appointed meeting, Dr. Shakespeare died.
Three weeks later, Major Reed was on his way to Cuba to meet the menace
of yellow fever; Dean Vaughan, however, had prepared an abstract of the
findings of the Board, which was concurred in by Major Reed, and was pub-
lished in 1900.
The Typhoid Boards Report
The abstract, however, did not carry the convincing authority of the sup-
porting evidence, and in 1903, largely at the instance of Elihu Root, Secretary
of War, the Congress provided the funds for publication of the full report.
In the meanwhile, Major Reed had died, leaving the task of putting the full
'Ibid., p. 379.
* Reed et al., op. cit., p.
136 ARMED FORCES INSTITUTE OF PATHOLOGY
report into shape for publication to the surviving member of the Board, Dr.
Vaughan. 9
As finally issued in 1904, the report is in a massive volume of text and
tables, with a second volume of maps and charts, in the preparation of which
Major Reed testified that C. J. Myers, longtime Chief Clerk of the Museum,
had given "invaluable assistance for two years * * *." 10
From the data in the two volumes of the report, 57 conclusions were
drawn. The conclusions are a succinct and nearly complete compendium of
information on the course, transmission, and prevention of typhoid fever in
military camps or, for that matter, in civil life as well. As Major Kean wrote
in his Seaman Prize Essay of 1906, the report of the board "threw a flood of
light on the subject * * * and remains a permanent monument to the vast
labors and scientific acumen of the members of that board— Reed, Vaughan,
and Shakespeare." u
As to the cause of the disease, the report clears up several theories once
widely held— the "obsolete theory," as it is termed— that the disease is caused
by inhalation of gaseous emanations arising from certain soils, for one, and the
more sophisticated theory that the disease is due to germs which spontaneously
evolve, or "ripen," from microorganisms normally present in putrefying matter.
Instead, the report firmly supports the specific origin of the disease by trans-
mission, directly or indirectly, from an infected individual to a susceptible
person. With the wide dissemination of typhoid at the turn of the century, the
Board found that there were plenty of sources of infection, with 82 percent
of the regiments studied developing typhoid within 3 weeks after reaching
national encampments. Regardless of the section of the country from which
the soldiers came, and even if they were encamped under perfect sanitary
conditions, the chances were that one or more cases of typhoid would develop—
and every case was a potential focus of infection. 12
Indeed, because of the disposition to diagnose all but clear-cut cases as
malaria or typhomalaria— a term which the report recommended to be dis-
carded—typhoid fever was found to be much more prevalent than had been
supposed. In the camps, "Army surgeons correctly diagnosed about half of
the cases of typhoid fever," in the opinion of the Board after checking clinical
symptoms and bacteriologic findings. But even so, the Board added, the Army
' (r) Ibid., pp. xiii, xiv. (2) Vaughan, op. cit., pp. 391-394.
"'Lamb. Dr. D. S.: A History of the Army Medical Museum, 1 862-1917, compiled from the Official
Records. Mimeographed copy in historical records of AFIP, p. 119.
" Kean, The Military Surgeon. 18 (1906), p. 13.
12 Reed et al., op. cit., pp. 659, 662, 663.
TRIUMPH OVER TYPHOID T37
surgeon "in recognizing nearly half the cases of typhoid fever * * *
probably did better than the average physician throughout the country does
inh
is private practice
" 13
Typhoid fever, the report found, "is disseminated by the transference of the
excretions of an infected individual to the alimentary canals of others." Infected
individuals included those in the early and undiscovered stages of the disease,
and also convalescents who had passed through the attack but continued to
excrete typhoid bacteria." The existence of "carriers" who were not themselves
suffering from the disease was not known until 1907, when the report on the
original "Typhoid Mary" was published. 15
Contrary to the general belief— and a belief held by the Board itself at
the outset of its investigation — that typhoid was primarily a waterborne disease,
it was found that "infected water was not an important factor in the spread of
typhoid in the national encampments in 1898." Transmission through the air
in the form of dried dust carrying the bacilli of typhoid was regarded as "prob-
able * * to some extent" and it was looked upon as "more than likely
that men transported infected material on their persons or in their clothing" —
a likelihood rendered all the more likely by the fact that "camp pollution was
the greatest sin committed by the troops in 1898" and by the prevailing practice
of detailing men from the ranks on a day-by-day basis to act as orderlies in the
hospitals. 10
A New ''Villain" — The Fly
A new villain in the transmission of the disease was fount! in the flies
which served to convey the infected organisms from their source to a person.
To the modern generation, living in a wire-screened and stableless environment,
and trained from childhood to swat the fly, the idea of the fly as a carrier of
disease is commonplace. In 1898, however, when schoolchildren were exhorted
to emulate the fly in its supposed neatness, evidenced by constant rubbing of
its wings with its legs— "washing" itself, it was thought to be— the idea that
the common fly was a carrier of deadly disease was novel. General Sternberg,
in his Circular No. 1, issued on 25 April 1898, had suggested the possibility
of flies as a source of infection in typhoid, camp diarrheas, and perhaps yellow
fever. The statistics gathered by the Typhoid Board showed that men who
13 ibid., p. 674.
u Ibid., pp. 663, 667, 721, appendix 3.
15 Sopcr, George A.: The Work of a Chronic Typhoid Germ Distributor. Journal of the American
Medical Association 48: 2019, 15 June 1907.
" Reed ct. al., op. cit., pp. 666, 667.
j 38 ARMED FORCES INSTITUTE OF PATHOLOGY
ate in screened tents were less liable to typhoid than those whose mess tents
were open to the flies. The finding of the Board was explicit and convincing —
"Flies swarmed over infected matter in the pits and then visited and fed upon
the food prepared for the soldiers in the mess tents." "
The Reed-Vaughan-Shakespeare report takes on an even greater importance
when the conditions existing in the camps in 1898, constituting the background
into which the report was projected, are considered. Camp sanitation was still
virtually an unknown subject to most line officers and men and, for that matter,
was not well known even to many medical officers. Medical officers, moreover,
lacked authority and could do little more than recommend.
In some instances, the recommendations were vigorous, as in the case of
the Third Nebraska Volunteer Infantry, in camp at Jacksonville. "As we were
instructed to do," writes Dean Vaughan, "we found our way to the colonel's
tent and asked him to join us in the inspection of his regiment. I can only say
that we found the sanitary conditions no better than in other regiments. When
we were through with the inspection Major Reed said to the colonel: 'Shake-
speare and Vaughan are on this commission because they know something of
camp sanitation. I am here because I can damn a colonel,' and he proceeded
in plain terms to speak of the responsibility of a commanding officer in looking
after the health of his troops." The colonel of the Third Nebraska was William
Jennings Bryan. 18
The prevailing state of knowledge, or the lack thereof, is summed up by
Col.P.M.Ashbum:
There was ignorance of the epidemiology of typhoid, that it was conveyed in other
ways than by polluted water, ignorance of sanitation in general and of camp sanitation in
particular, ignorance of proper precautions to be taken in the preparation and handling of
food, ignorance of the danger of having sick men in kitchens, ignorance of the accurate
methods of diagnosis which are now employed as routine in camps and hospitals, ignorance
of the existence of typhoid carriers. For this ignorance no one person was to blame, it was
the characteristic of the day. 1 "
Most of this prevailing ignorance the Typhoid Report dispelled, even though
it did not suspect the existence of the carrier who is not himself at the moment
a victim of typhoid, and did not bring out sharply the danger of infection from
the convalescent or recovered typhoid patient.
" (1) Ibid., p. 666. (2) Vaughan, op. at., pp. 384, 385.
" Vaughan, op. at., p. 375.
" Ashburn, P. M.: A History of the Medical Department of the United States Army. Boston: Houghton
Mifllin Co., 1929, pp. 169-170.
TRIUMPH OVER TYPHOID 1 39
Changes in the Museum Command
In the interim between the accumulation of the data for the report and its
publication, there had been changes in the Surgeon General's Office and in the
Medical Museum. General Sternberg had reached the age of retirement in
1902, and had been succeeded by Brig. Gen. William H. Forwood who, after
a service of only 3 months as surgeon general, had also retired in the same year,
to be succeeded by Brig. Gen. Robert M. O'Reilly. Col. Alfred A. Woodhull
had succeeded Col. Dallas Bache as Director of the Museum and Library Division
in 1900, to be succeeded in the following year by Col. Calvin DeWitt, who in
turn was succeeded by Col. Charles L. Heizmann in July 1903.
On 1 November 1902, Maj. Walter Reed was put in charge of the Library
of the Surgeon General's Office, in addition to his duties as Curator of the
Museum, and Lieutenant Carroll was designated as Acting Curator. When
Major Reed died, later in the same month, Carroll was the natural choice for
his successor but, perhaps because he was already in performance of the duties
of the office, it was not until July 1903 that he was formally appointed to the
post. In 1906, Col. Valery Havard succeeded Colonel Heizmann in charge of
the Museum and Library Division, with Lieutenant Carroll continuing as Cura-
tor of the Museum. In March 1907, Carroll was promoted to the rank of major,
and 6 months later, on 16 September, he died. 20
Upon the death of Major Carroll, Capt. (later Maj.) Frederick Fuller
Russell (fig. 46) was named as Curator of the Medical Museum and professor
of bacteriology and clinical microscopy at the Army Medical School. The
new Curator, 37 years old, had done his premedical work at Cornell University,
and had taken his M.D. degree at the College of Physicians and Surgeons of
Columbia University in 1893. After serving an internship and a residency at
Bellevue Hospital in New York, and studying in Berlin, he had received a
commission in the Army as first lieutenant and assistant surgeon in 1898, being
promoted to captain in 1903. He had served in Puerto Rico and, briefly, at the
Museum in 1900.
Volunteers for Vaccination Against Typhoid
In the latter years of Major Carroll's tenure as Curator of the Museum,
he undertook an experiment in vaccination against typhoid fever which, in its
use of human volunteers as subjects, was reminiscent of the experiments with
' (1) Lamb, op. cit., pp. 122, 123, 133. (2) Senate Document 822, 61st Congress, 3d session, p. 20.
71 3-028* — 64 1 1
140
ARMED FORCES INSTITUTE OF PATHOLOGY
Figurl 46. — Maj. Frederick F. Russell, seventh Curator of the Museum, 1907-1913, who
introduced typhoid fever vaccination in the Army.
yellow fever in Cuba. The typhoid fever experiment, started in May 1904,
called for the oral administration of dead typhoid bacilli. After experiments
with rabbits and guinea pigs had succeeded in producing an immune reaction,
Dr. Carroll secured the permission of The Surgeon General to call for volun-
TRIUMPH OVER TYPHOID l . l
teers who would swallow doses of nutrient bouillon which had been inoculated
with typhoid bacilli killed by heat. Carroll himself swallowed the typhoid
dose, as did two officers detailed to assist— Lt. Edward B. Vedder !1 (later Col.,
MC, USA, and the discoverer of the cause and the prevention of beriberi) and
Lt. Harry L. Gilchrist (later Maj. Gen. and Chief of the Chemical Warfare
Service). Fifty soldiers volunteered for the experiment, from whom every
fifth man was accepted— Sgt. Joseph I. Howe, and Privates William E. Lumley,
George Dunn, George C. Williams, George S. Ward, Robert A. Eisemann,
Merl Clifford, William J. Epps, Claud W. Powell, and Robert E. Bowman.
Seven of the group developed undoubted cases of typhoid, and three others
suffered attacks of a febrile disease which may or may not have been typhoid.
This first attempt at a new technique in prevention failed in its purpose of
producing immunity, resulting instead in attacks of the disease against which
immunity was sought, but other and more successful experiments were to come.
Undismayed by the failure of the first attempt with oral typhoid vaccina-
tion, Dr. Carroll turned to a method of vaccination by hypodermic injection,
first used by Sir Almroth Edward Wright, in British India in 1896, and re-
ported in the British Medical Journal of 30 February 1897.
Typhoid was even more destructive among British troops in the Boer War
of 1899-1902, with 31,000 cases and 5,877 deaths, than it was among the Amer-
icans in the war with Spain. Sir Almroth's vaccination was tried on a voluntary
basis, with results so mixed that vaccination for typhoid was suspended in 1902
and, in 1903, its further use in the British Army was prohibited. The ban was
removed, however, when the Royal College of Physicians, after full investi-
gation, sustained the use of this method of prophylaxis.
Both the oral and the hypodermic methods of vaccination depended upon
killing the bacteria in the culture by heat raised to the death point for the specific
microorganism. This thermal death point had been determined by General
Sternberg for typhoid and many other bacteria. In determining these death
points, he had used small glass bulbs with the narrow necks sealed, thus pre-
venting evaporation. In making larger batches of vaccine, a i-liter flask
was used, with the mouth stoppered by cotton, which permitted some evapora-
tion. This left a ring of dried matter in the neck of the flask. Since it requires
a higher temperature to kill dried typhoid bacteria than is required to kill
them when moist, some of the dried organisms survived and, when the flask
was handled, were washed down into the liquid where they began to grow
Zl Vedder, Edward R., Col., MC (Ret.) : Typhoid Fever and Typhoid Inoculation in the United
States Army. Unpublished typescript, made available through the kindness of Lt. Col. Henry Vedder,
MC, USA.
I42 ARMED FORCES INSTITUTE OF PATHOLOGY
again, with the result that the vaccine was contaminated with living typhoid
bacteria. To prevent this, Russell added to each flask a small quantity of tri-
cresol disinfectant, sufficient to kill any bacteria left alive in the vaccine. 22
European Experience
On io February 1908, Captain Russell wrote Lt. Col. W. B. Leishman, pro-
fessor of pathology at the Royal Army Medical College at Millbank, London,
advising that it was proposed to inaugurate antityphoid vaccination in the
American Army and asking about the British experience. To this letter,
Colonel Leishman cordially replied on 29 February, offering "most gladly" to
give all the information he could on the subject, and sending him a culture
of the strain of Salmonella typhosa employed by the British.""
In the summer of 1908, Surgeon General O'Reilly sent Captain Russell to
Europe to study at firsthand the methods and the experience of the British and
German Armies. This assignment, carried out with "great industry and ability,"
as The Surgeon General put it, resulted in a report which The Surgeon General
described as a "very valuable treatise on the epidemiology of this disease to
date." ' 21 The experience of the German Colonial Army, which had tried vac-
cination for typhoid in 1904 on a voluntary basis, was that the vaccinated soldier
was only about one-half as likely to develop the disease as the unvaccinated
soldier, and that the death rate was cut to one-fourth. 25 In the British experience,
as described by Colonel Leishman, there had been among 6,610 unvaccinated
soldiers 187 cases of typhoid, with 26 deaths, while among the 5,473 men at the
same posts who had volunteered for vaccination, there had been only 21 cases
and 2 deaths. 20
The history of vaccination as a method of protecting troops against typhoid
fever, including the experience of the British and German Armies with voluntary
vaccination, was considered by a special board of officers of the newly created
Medical Reserve Corps. Members of the Board were eminent clinicians and
^dlThc explanation of the accident that left typhoid bacilli alive is that of Brig. Gen. Frederick
Fuller Russell, MC. USA (Ret.). (2) Memorandum of conversation with General Russell at Louisville,
Kv.. 28 April i960. (3) Letter, General Russell to Dr. Edward H. Vedder, George Washington Univer-
sity Medical School, 25 October 1935.
^Original letter, W. B. Leishman to F. F. Russell, 29 February 1908. On file in historical records
of AFIP.
: * Annual Report of the Surgeon General, U.S. Army, 1909, p. 44.
3 Russell, F. F.: The Experience of the German Colonial Army with Anti-Typhoid Vaccination. The
Military Surgeon 24: 53-56, 1909.
M Journal of the Royal Army Medical Corps 12: 166, cited in: Russell, F. F.: The Prevention of Typhoid
Fever by Vaccination and by Early Diagnosis and Isolation. The Military Surgeon 24: 484, June 1909.
TRIUMPH OVER TYPHOID 143
pathologists — Doctors William T. Councilman, distinguished for his researches
in amebic dysentery ; Simon Flexner, first director of the Rockefeller Institute
for Medical Research; Alexander Lambert, a distinguished internist of New
York; J. H. Musser, of the distinguished Philadelphia school of practitioners of
internal medicine; William S. Thayer of the Johns Hopkins faculty; and Victor
C. Vaughan, surviving member of the Reed-Vaughan-Shakespeare Board —
with Capt. F. F. Russell as recorder.
After studying the evidence, this Board concluded that "the practice of anti-
typhoid vaccination is both useful and harmless and that it offers a practicable
means of diminishing the amount of typhoid fever in the Army both in times
of peace and war." The Board accordingly recommended that in time of war
the practice be introduced in both the regular and volunteer forces, and that it
be introduced immediately on a voluntary basis in the medical units, with an
opportunity for volunteers from the Army as a whole to receive the protection
of vaccination. 27 The findings and recommendations of the Board were ap-
proved and published in 1909, in War Department General Orders No. 10.
Meanwhile, Major Russell (he was promoted in 1909) was busy with prepa-
rations for vaccinating the volunteers, the first of whom came from the Army
Medical Museum and the Medical School (fig. 47). A "special room in the
Army Medical Museum was fitted up as a vaccine laboratory," entirely separate
from the School. The new laboratory, with "complete equipment of entirely
new apparatus, specially planned for this particular purpose" of manufacturing
vaccine, was completed in February 1909, and in March, vaccination on a whole-
sale scale began. 23
Compulsory Vaccination Introduced
Eight hundred and thirty volunteers were vaccinated by the time the 1909
report of the Surgeon General was issued, without untoward incident. By the
end of the next year, 10,841 volunteers had received "shots." In March 191 1, be-
cause of troubles on the Mexican border, an entire division of the Army was
mobilized in Texas. For this mobilization, vaccination was made compulsory
for military personnel — and with more than 10,000 men in camp, the only death
from typhoid was that of a civilian teamster who had refused vaccination. "It is
hard to credit the accuracy of such a record," declared President William Howard
Taft, addressing the Medical Club of Philadelphia on 4 May 191 1. "But, as I
have it directly from the War Office," he added, "I can assert it as one more
instance of the marvelous efficacy of recent medical discoveries and practice —
27 Annual Report of the Surgeon General, U.S. Army, 19ml, pp. ^, 46.
28 Ibid., pp. 46—50.
i 4 4
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 47. — Maj. Frederick Fuller Russell (extreme right) vaccinating volunteers against
typhoid.
in which he included "modern health regulations" as well as vaccination against
typhoid.""
In his Annual Report for 1913, Surgeon General George H. Torney ex-
pressed the astonishment of a veteran Army medical officer. "It seems more
than marvelous," he wrote, "that among the number of men in the camps at
Texas City and Galveston, and among those in the numerous camps along the
Mexican border, constantly exposed to infection, not a single case has occurred."
On 30 September 191 1, vaccination for typhoid was made compulsory for
the entire Army, and by the end of 191 1, 85 percent of all personnel had received
the protection (fig. 48). The reduction in the incidence of the disease which
followed was dramatic. In 1909, with fewer than 1,000 men vaccinated, there
had been 3.35 cases of typhoid per thousand. In 1910, with 15 percent of the
strengdr vaccinated, there had been 2.43 cases per thousand. In 191 1, with 85
percent vaccinated by the end of the year, there were 0.08 cases per thousand.
In 1912, the rate was 0.03 per thousand, and in 1913, 0.004 cases P er thousand.
In the Navy, where vaccination did not become compulsory until 1912, there
were 361 cases of typhoid in 191 1; 92 cases in 1912; and 33 in 1913. "
"President Tart and the Medical Profession. Journal of the American Medical Association 56: 1399-
1404, 13 May 1911.
'"(1) Siler, J. F., and others: Immunization to Typhoid Fever: Results obtained in the Prevention of
Typhoid lever in the United States Army, United States Navy, and Civilian Conservation Corps, by the
TRIUMPH OVER TYPHOID
145
Figure 48. — In 1917, with the coming of World War I, typhoid vaccination scenes such
as this were commonplace.
Typhoid vaccination did not originate with the United States, but the
American Army was the first to make vaccination a required prophylaxis
against typhoid. For this step and the beneficial results which flowed from it,
credit is due to the mass experiments conceived by Major Russell and carried
out at the Army Medical Museum, and with vaccines at first produced in its
laboratories.' 1
For such results, there was a multiplicity of interacting causes. Faster and
more accurate diagnosis of cases helped to reduce the risk of infection, which
was further reduced by more thorough and efTective disinfection — a procedure
which Major Russell termed "really important" in his first article on "The
Prevention of Typhoid Fever by Vaccination and by Early Diagnosis and
Isolation." : '~
Use of Vaccines. The American Journal of Hygiene, Monographic Scries. No. 17. Baltimore: Johns
Hopkins Press, September 1941, pp. 12, 13. (2) Annual Report of the Surgeon General, U.S. Army, 1910,
p. 48. (3) Annual Report of the Surgeon General, U.S. Army, 1911, p. 51.
31 Afterward, the Army Medical School took over the preparation of antityphoid vaccine for the
Army, the Navy, and the Public Health Service. An interesting account of the process and tl» ex-
ponents of the vaccine used against typhoid and the two types of paratyphoid was published in: Callender,
G. R., and Luippold, G. F.: The Effectiveness of Typhoid Vaccine Prepared by the United States Army.
Journal of the American Medical Association 123: 319-321, 9 October 1943.
32 Russell, The Military Surgeon, 24 ( 1 909) , pp. 479-5 1 8.
146 ARMED FORCES INSTITUTE OF PATHOLOGY
Writing in answer to an inquiry as to the propriety of using typhoid vaccine
in civilian institutions, in November 1909, Major Russell said :
I do not think that it is the only thing to be considered in the prevention of typhoid
fever by any means; attention must be paid to all the usual sources of infection in addition
to the use of vaccine. This is for the reason that the protection gained by vaccination is
not absolute but only relative, and that if the infected material is present in sufficient
quantities some people might develop typhoid in spite of previous vaccination. 33
Greater knowledge of medical officers and greater authority for the Medical
Corps resulted in stricter sanitary controls. Broader knowledge of sanitation
and disease prevention among officers and men of the line made such controls
more readily enforcible. The combination of a lesser number of cases and
lesser chances of infection from such cases as there were, created a diminishing
spiral of morbidity. There was to be no repetition of 1898. By 1910, the
chances of typhoid infection in the Army had been reduced to the point that
the soldier was no more likely to suffer from the disease than the civilian. And
then, into this already diminishing incidence of the disease, there was introduced
the added safeguard of preventive vaccination, voluntary at first and then, for
the military forces, compulsory. In the 5-year period 1911-1916, the chances
of typhoid in the Army were further reduced to the point that the soldier was
only one-fifth as liable to the disease as the civilian. 34
The English physician, William Budd, writing in 1874, stoutly maintained
that typhoid was a "perfectly preventable plague" if pollution from alvine dis-
charges of infected individuals could be checked. The Reed-Vaughan-Shake-
speare study assembled overwhelming evidence to sustain the Budd theory, and
outlined methods of prevention. The application of these methods, together
with improved sanitary conditions generally, and the added protection of pro-
phylactic vaccination of both civilian and military personnel, has brought
measurably near Budd's prediction of perfect prevention.
For tliis triumph over typhoid, many causes are responsible, but no small
part of the responsibility rests upon three successive curators of the Medical
Museum — Reed, who organized and carried forward the great study of the
disease and its prevention; Carroll, who initiated experiments with the
prophylactic vaccine; and Russell, who carried the experiments to successful
conclusion and mass application.
M Correspondence with John I. Armstrong, Kirkwood, Atlanta, Ga. On file in historical records of
AFIP.
31 Siler ct al., op. tit., pp. 17, 18.
CHAPTER VIII
The "Pickle Factory" Period
Five medical officers of the Army— Colonels Valery Havard, W. H. Arthur,
and Walter D. McCaw, and Majors Carl R. Darnall and Frederick F. Russell,
all of whom had special acquaintance with the work, the problems, and the
situation of the Army Medical Museum or the Army Medical School, or
both — met on 31 March 1909, to discuss the need for a new and suitable build-
ing for the School.
Their conclusion, arrived at unanimously, was that there was such a need.
"The rooms which this school now occupy in the Museum and Library build-
ing are inadequate and unsuitable," they said in a memorandum of their
discussion. 1 "They have never been more than a makeshift * * * crowded
and insufficient * * *" as well as encroaching upon the space and facilities
desperately needed by the Library and the Museum.
Two possible remedies were agreed upon: renting a building in Wash-
ington or "simply the carrying out of the policy already decided upon" of
providing a suitable building for the school in proximity to the Walter Reed
General Hospital, then nearly completed. The conferees agreed that "the
second solution seems decidedly preferable," as the next step in the normal
development of the general plan, and strongly urged that $250,000, the esti-
mated cost, "be included in the next estimates to be submitted to Congress,
and that special efforts be made to induce Congress to appropriate it."
With a lively sense of the uncertainty of congressional action, however,
the conferees recommended that if it should be found that "there is no dis-
position on the part of Congress to appropriate the necessary sum for the
building" on the site already selected for it on the grounds of the Walter Reed
Hospital, inquiries should be made so that "a suitable structure may be found
and, if possible, rented."
Memorandum, Office of The Surgeon General, 31 March 1909. On file in historical records of A I IP.
713-028'— 04-
148 ARMED FORCES INSTITUTE OF PATHOLOGY
The Army Medical School Moves Out
Almost a year later, on 2 February 1910, Curator Russell "respectfully
invited" the attention of the officer in charge of the Museum and Library
Division of the Surgeon General's Office, who was then Col. Louis A. LaGarde,
to the history of the School's occupancy of quarters in the Museum and
Library building. 2
The School, he recited, was established in 1893 in "two rooms which
belonged to the Army Medical Museum, and Museum exhibits were put into
the store-room to make way for the School. Each year as the institution has
grown, the same encroachment on the exhibition and work rooms of the Muse-
um has followed, and the growth of the School has been entirely at the expense
of the Museum. This method * * * has reached its climax, since the Museum
has absolutely no more room of any sort to give it * * *. As the School has
grown the activities of the Museum have been more and more limited until
we have arrived at a state in which something must be done."
Something was done, and on 7 June 1910, Curator Russell informed The
Surgeon General, through Lt. Col. Walter D. McCaw, then the officer in
charge of the Museum and Library Division, that "the Army Medical School
equipment is now being moved out of this building into the building at No.
721 Thirteenth Street, N.W., which has recently been turned over to the Medi-
cal Department by the Quartermaster's Department." The move would be
completed, he added, "towards the end of the present month" (fig. 49).
The move of the School relieved somewhat the space pressure on the
Museum, but at the same time it created other problems. Major Russel was
in charge of, and did personally much of the technical work of, both the
teaching laboratory of the School and the laboratory of the Surgeon General's
Office, which carried on the work of the Museum in the fields of pathology
and bacteriology, including the new procedure of making typhoid vaccine.
Major Russell was also on the faculty of the Army Medical School and was to
be moved, with his teaching laboratory, to the new school quarters. Unless
both laboratories were under the same roof, he advised The Surgeon General,
it would be practically impossible for him to continue to do the work of ex-
amining water supplies, blood samples, and pathological materials required
of the Surgeon General's laboratory. Authority was sought, therefore, and
secured, for the removal to new quarters at the School of both laboratories,
along with two experienced men to do the "considerable" clerical work.
'Letter, F. I'. Russell to L. A. LaGarde, 2 February 1910. On file in historical records of AMP.
THE "PICKLE FACTORY" PERIOD
I 49
Figure 49. — After 15 years of operation in the Museum building, the Army Medical School
moved in 1910 to rented quarters on Louisiana Avenue.
Major Russell also recommended that a branch of the Museum be estab-
lished in the new building, "since a considerable part of the specimens, exhibits,
etc., of the Museum has been set aside for and are regularly used in the instruc-
tion of the classes of student officers" and it would be "impracticable to move
articles of this character back and forth between the two buildings." Dr. John
S. Neate, who had taken his medical degree since serving the Yellow Fever
Board in Cuba and was then microscopist of the Museum, was recommended
to have the custody and care of the branch. 1
1 Letter, F. F. Russell to The Surgeon General, 7 June 1910. On file in historical records of AFIP.
!50 ARMED FORCES INSTITUTE OF PATHOLOGY
Changes at the Museum
On 15 October 1913, Major Russell's service as Curator of the Museum
ended. His further Army service included distinguished work during the
First World War in the field of preventive medicine, as head of the Division
of Laboratories and Infectious Diseases of the Surgeon General's Office. In
1920, Colonel Russell, as he then was, resigned from the Army to be commis-
sioned a brigadier general in the Medical Reserve Corps, and to become direc-
tor of the International Health Board of the Rockefeller Foundation. He
closed his career in medical science and administration by years of service as
professor of preventive medicine at Harvard.
Succeeding Russell as Curator of the Museum was Maj. Eugene Randolph
Whitmore (fig. 50). The new Curator was an academic graduate of the
University of Wisconsin and had received his M.D. degree at the University
of Illinois in 1899. In 1910, while on duty in the Philippines with the Board
for the Study of Tropical Diseases, he had established the Pasteur Institute in
Manila.
For almost two decades, during the administrations of three curators who
had preceded Major Whitmore, the center of the Museum stage had been held
by work in bacteriology and its related subjects of epidemiology and immu-
nology. The resulting situation was recognized and described in a memoran-
dum of 21 November 1913, addressed by Colonel McCaw, the officer in charge
of the Museum and Library Division, to The Surgeon General of the Army. 4
"The Museum feature of the Museum and Library Division of the Surgeon
General's Office," he wrote, "has for many years past been almost at a standstill.
While the Army Medical School occupied a large part of the present building,
the energies of the Museum staff in practically all the laboratory work were
expended in teaching the class and in making original investigations, prin-
cipally bacteriological, into questions of great importance for the Army at large
and the Medical Corps in particular. The results have been so brilliant * * *
that no excuse is needed for having temporarily ceased to develop the Museum
feature proper — to wit, the collection, preparation and exhibition of specimens
illustrating medicine in all its branches. This feature was necessarily neglected
because of the preponderating importance of the brilliant work undertaken
and carried out successfully."
"Many new specimens have indeed been accumulated; the Museum has
been added to in some new directions and much obsolete material has been
' Memorandum, It. Col. \V. I). McCaw, to The Surgeon General. On file in historical records of AFIP.
THE "PICKLE FACTORY" PERIOD
I5 1
Figure 50.— Maj. Eugene R. Whitmore, eighth Curator of the Museum, 1913-1915.
taken from exhibition to give place to more valuable and up-to-date specimens.
The only room in the building especially adapted to exhibition and built for
that purpose is now much overcrowded and yet it contains only the pick of the
collections. As space was gained by the removal of the School two large rooms
were selected for exhibition purposes and promptly rilled * . In the space
152 ARMED FORCES INSTITUTE OF PATHOLOGY
gained from the School the Library also overflowed just in time to save it from
being choked in its own material * * *."
As a temporary solution, or rather palliative, of the space problem, Colonel
McCaw suggested the removal from the building of certain offices of the
Adjutant General's Department so that the entire building would be given
over to the Medical Department — a proposition reminiscent of similar proposals
of a quarter of a century earlier, when the "old red brick building" was new.
In spite of the difficulties imposed by the lack of space, and the lessened
emphasis on anatomy and pathology by reason of the overshadowing achieve-
ments in bacteriology, the Museum had continued to excite interest among the
professionals as well as the lay public. Calling "the attention of the profession
in a general way to the advisability of more frequently resorting to this store-
house of pathology," one Washington doctor declared that instead of the speci-
mens being looked upon "as so much 'embalmed beef,' they should be regarded
as treasures of great value," to be consulted by the "earnest student of disease."
Much remained to be done to fill the gaps, however, since "many phases of many
diseases are still unrepresented in this magnificent collection." 5
As seen by a visitor from Germany, Staff Surgeon Dr. Paul Ehrlich, of
Giessen, the collections were described as including "many rare pathological
preparations of man and the lower animals," with "serial sections of organs
displayed comprehensively between plates of glass, to give the spectator an
idea of their growth and structure." °
Dr. Ehrlich's "lively interest" was awakened by the preparations of tropical
diseases, but he found diem "unfortunately bleached out by being kept in alcohol,
and have lost their natural color. I called the attention of the pathologist to the
methods employed in Germany (e.g., Dr. Karl Kaiserling's method) of pre-
serving specimens in saline solutions, which, it seems, are not generally known
of in America."
As to knowledge in America of the Kaiserling process, the German visitor
was in error. Dr. Kaiserling announced his method, which included the use
"Smith, Thomas C: The . . . Treasures of the Army Medical Museum (Presidential address de-
livered before the Washington Obstetrical and Gynecological Society, 6 October 1899). In American
Journal of Obstetrics and Diseases of Women and Children 41: 57-63, January 1900. Although Dr.
Smith's address dealt with obstetric specimens, he declared that the "richness of the Museum" in this field
applied with equal force to other branches of medical and surgical pathology.
Ehrlich, Dr. Paul: A German View of the American Army Medical School, Library and Museum.
Translated by Dr. F. H. Garrison, Assistant Librarian, Army Medical Library from the Deutsche
mihtararztliche Zeitschrift, July 1904, p. 396, et seq.
THE "PICKLE FACTORY" PERIOD 1 53
of a solution of formalin followed by alcohol, in Berlin on 8 July 1896.' The
process, with some modification, was introduced into the Army Medical
Museum in June 1897, and had been used for wet specimens "with much satisfac-
tion" since that time. With the adoption of the Kaiserling method, the use of
alcohol, except as part of that process, was almost entirely discontinued. 8
The stature of the Museum and of its Curator, Maj. James Carroll,
was recognized by the election of Carroll as the first president of the Inter-
national Association of Medical Museums, a new organization whose truly
international character is evidenced by the election of professors at an American,
an English, and a German university as vice presidents, and of Dr. Maude E.
Abbott of McGill University, a Canadian institution, as secretary-treasurer.
Major Carroll was unable to attend the meeting, at which he was elected, because
of illness from which he never recovered sufficiently to enable him to serve
actively as president of the new association. At the second stated meeting of
the Association, deep regret was expressed at the death of "one of the heroic
figures in the history of this country" whose passing was a loss to the scientific
world. 9
Changes in Classification
In the last year of Carroll's curatorship, a new classification of the Museum s
materials was begun, under the direct charge of Dr. D. J. Healy, anatomist of
the Museum. The new system followed closely that adopted in 1899 by the
Pathological Museum of McGill University in Montreal. It superseded, largely,
the system of classification which had been developed by Dr. Daniel Smith
Lamb, the pathologist of the Army Medical Museum. 10
The advantages claimed for the McGill system of decimal numbers to
designate classes were that it followed an anatomical classification, with "the
different morbid processes affecting each organ subclassified under it, general
and regional pathology being provided for by cross cataloguing." In criticism
of the Army Medical Museum system, submitted with deference to that Insti-
tution's general excellence, it was said that the arrangement of descriptive num-
bers, made up of capital and lowercase letters and numerals, which was the
'Abbott, M. E.: On the Classification of Museum Specimens. (A paper read before the Canadian
Medical Association, Montreal, on 18 September 1902.) In American Medicine. 4 April I9°3. P- 54 1 -
"Lamb, D. S.: The Army Medical Museum — A History. Washington Medical Annals 15: 4, January
1916. (A paper presented before the Medical Society of Washington, 1 November 1915.)
"Bulletin Number 1, International Association of Medical Museums, Washington, D.C., 15 May 1907.
The death of Major Carroll was noted in Bulletin Number 2, Washington, D.C., 15 January I9°9-
10 Lamb, Washington Medical Annals, 15 (1916), p. 14.
J 54
ARMED FORCES INSTITUTE OF PATHOLOGY
basis of the system, was "not systematically carried out in its application, so that
it does not altogether answer the purpose for which it was intended * * *.
Not only is it difficult or even impossible to classify a specimen under the head-
ings that the catalog numbers furnish, but also it is impossible to observe the
numerical order in the different groups without disturbing the natural order
in which the specimens should stand." 1X
Before the new system could be fully installed, Major Carroll died, Dr. Healy
resigned, the new classification was abandoned, and the older system was
reinstated by Dr. Lamb, who was made custodian as well as pathologist. Under
this system, there were "collected together in one place all specimens illustrating
any one disease * * * the subarrangement being according to the organ
involved." Under this plan, as an example, it had been possible to select in a few
minutes specimens to be loaned to a Tuberculosis Congress meeting in Baltimore
without having to look for specimens in "twenty or more places." 12
More responsible than anyone else for the classification and cataloging of
specimens was Dr. Daniel Smith Lamb (fig. 51), who joined the Museum
staff as a hospital steward in 1865, took an M.D. degree from Georgetown
University in 1867, while still on duty at the Museum, was appointed Acting
Assistant Surgeon in 1868, served the Museum in that capacity until the rank
was abolished by Congress in 1892, and then became pathologist to the Museum,
and continued as such until his voluntary retirement in 1920 — a total span of
active service to the institution of 55 years, followed by occasional consulting
assistance during the remainder of his long life of 86 years.
Dr. Lamb commenced his service at the Museum under Dr. Joseph J.
Woodward and continued it under Dr. George A. Otis and Dr. David L.
Huntington. In 1883, when John Shaw Billings, the great administrator and
bibliographer, was put in charge of the Museum as well as the Library, Dr.
Lamb became, in effect though not in name, the active Curator of the Museum's
collections, and so remained under the administration of Walter Reed, whose
other responsibilities absorbed so much of his time and attention that the task
of keeping up the Museum's pathological collections was largely left to the
pathologist. 13
11 Abbott, American Medicine, 4 April 1903, pp. 541-544.
(1) Letter, D. S. Lamb to V. Havard. In Lamb, D. S.: A History of the Army Medical Museum,
1862-1917, compiled from the Official Records. Mimeographed copy in historical records of AFIP, pp.
'33-'35- (2) Lamb, Washington Medical Annals, 15 (1916), PP- M> '5-
(1) Callcndcr, Maj. George R.: Doctor Lamb's Association With the Army Medical Museum.
Copy of this memorial address on file in historical records of AFIP. (Hereinafter cited as Callendcr
Address.) (2) Kobcr, George M., Dean of Georgetown University Medical School: Doctor Daniel Smith
Lamb, A Man of Science. (An address delivered upon the occasion of Dr. Lamb's 50th anniversary as a
THE "PICKLE FACTORY" PERIOD
155
Figure 51. — Dr. Daniel Smith Lamb.
During die curatorship of Carroll, there seems to have been a slight change
in the assignment of responsibilities in the work of the Museum. In a circular
letter of 25 May 1905, the Curator informed sugeons of Washington, D.C., that
teacher in the Howard University Medical Department, 7 June 1923.) Published by the Howard University
School of Medicine, 1923.
156 ARMED FORCES INSTITUTE OF PATHOLOGY
the Army Medical Museum was "now prepared to accept * * * pathological
specimens of interest and preserve them after the method of Kaiserling, which
is intended to retain the natural coloring * * *. In the absence of the Curator,
any specimens turned over to Dr. Healy, the Anatomist, will be properly cared
for." With reference to this circular, Lamb observed with some asperity that he,
the pathologist of the Museum, had been using the Kaiserling process since 1899
"so that there was nothing really new in the circular, except the assignment of
the Anatomist instead of the Pathologist to receive pathological material." The
asperity was doubtless heightened by the fact that the anatomist had been on the
Museum staff only 6 months, while the pathologist had already served 40 years,
and had contributed more specimens to the Museum's collections "than any
other has, or ever will, so contribute." u
The Devotion of Dr. Lamb
The devotion of Dr. Lamb to the interest of medical science extended beyond
life into death. In his last will and testament, drawn in July 1928, in the last
year of his life, he left specific instructions for the performance of an autopsy,
even prescribing the formula for the solution in which his brain was to be pre-
served for transmission to the Wilder collection at Cornell University, and
directing that "such other organs as it may be desirable to preserve," including
the skeleton, be "donated either to the Army Medical Museum, where I gave
54 years of service, or to the Howard University Medical School where I gave
50 years," first as professor of materia medica, but for 45 years as professor of
anatomy. Dr. Lamb designated Maj. George R. Callender, then the Curator of
the Medical Museum, to perform the autopsy, with Dr. Ales Hrdlicka of the
National Museum as supervisor. Both were old and valued friends. To make
the autopsy and examination of the organs more meaningful, Dr. Lamb filed
with his will a complete statement of all illnesses and injuries from which he had
suffered, including the "many times" he had had "infection from post-mortem
examination" of which he had made "about 1,500 on nearly all diseased
conditions." "
The devotion and determination of Dr. Lamb helped to keep alive an inter-
est in anatomy and pathology in a period of 30 years after 1883, when interest in
microorganisms and parasite carriers of disease overshadowed that in morbid
anatomy. In the latter years of the 19th century and the opening decades of the
20th, the fields of bacteriology and related studies were filled with "ardent
11 Callender Address, op, cit.
Washington timing Star. 21 April 1929 aiul New York Times, 23 April 1929.
THE "PICKLE FACTORY" PERIOD 157
workers who * * * all but forgot that while parasitology is of fundamental
importance, certainly interesting, and approaches the exact in science, the orga-
nisms themselves do not constitute disease but must be coordinated with morbid
anatomical processes." In the prevailing neglect of morbid anatomy, Dr. Lamb
retained his interest and "preserved specimens essential to the study of diseases
including those caused by parasities." lb
Major Whitmore was followed as Curator of the Museum on 4 August 1915,
by Col. Champe Carter McCulloch, Jr. (fig. 52), who had been for 2 years
previously librarian, and who combined the duties of librarian and curator until
23 June 1916, when he was succeeded as Curator by Col. William Otway Owen.
Like Colonel McCulloch, the new Curator was a medical graduate of the Uni-
versity of Virginia. He had been retired from the Army for disability in line of
duty in 1905, after 23 years of service, but in 1916 was recommissioned and
assigned to duty at the Museum.
Through all changes of curators and all shifts of interest and emphasis, the
collections of the Museum continued to grow. In 1906, when the abortive
reclassification was undertaken, the collections numbered 34,338; 10 years later,
they had grown to 47,313 specimens.
But despite growth in the absolute size of the collections, the relatively
reduced interest in morbid anatomy led to a decline in status of the Museum
to such a point that it came to be called by the scornful appellation of "the pickle
factory" 17 — a name which it bore until the events and demands of the Nation's
next war demonstrated once more the vital need for a repository of materials for
the study of pathological anatomy, physiology, chemistry, parasitology, and
bacteriology in balanced relation to the prevention, diagnosis, and cure of disease.
10 Callender Address, op. cit.
17 Dart, Brig. Gen. Raymond O.: The Pathologist's Position in the Government Services. (An address
before the College of American Pathologists and the Section on Pathology of the Southern Medical Associa-
tion.) Typescript copy on file in historical records of AFIP.
i 5 8
ARMED FORCES INSTITUTE OF PATHOLOGY
Fi<;ure 52. — Col. Champe C. McCulIoch, Jr., ninth Curator of the Museum, 1915-1916.
CHAPTER IX
The Museum in a World at War
With the entry of the United States into what was then called simply the
World War, there being as yet no need to identify such conflicts by number,
there came a profound change in the affairs of the Army Medical Museum.
In his annual report for the fiscal year ending 30 June 1917— a report which
reflected for the most part conditions before the declaration of war on 6 April
of that year— Surgeon General William C. Gorgas noted that the Museum,
with its nearly 48,000 specimens, was "one of the largest, most instructive, and
valuable collections in existence." A year later, in a report prepared at about
the time the "bridge of ships" was beginning to move American combat outfits
into France in significant numbers, The Surgeon General reported that in the
past year the Museum had "taken on new life." *
At first, however, the rush of preparing for a war, which was to see the size
of the U.S. Army increased nearly fortyfold, seems to have bypassed the Museum
and left it in a quiet backwater, with its annual appropriation for the "preserva-
tion of specimens and the preparation and purchase of new specimens held
down to the $5 thousand-a-year figure which had come to be customary."
"With this meager sum," Dr. Charles H. Mayo of Rochester, Minn., said
in addressing the Surgery Section of the American Medical Association, the
officers in charge of the Museum had, over the years, "accomplished much,"
maintaining a record of the "progress of medicine of past ages" and accumu-
lating "many valuable historical specimens," while materials accumulated dur-
ing the war would "make the collection modern, and one of the best in the
world." These medical records of the war," he added, "will be of the greatest
value, not only to the glory of medical accomplishment, but also as a means of
interesting and educating the public in scientific matters pertaining to health
and disease." 3
1 Annual Reports of the Surgeon General, U.S. Army, to the Secretary of War, for fiscal years ending
30 June 1917, p. 325, and 1918, p. 434. TT . ,
2 War Department Bulletin Number 3", 22 May 1017. In The Medical Department of the United
States Army in the World War. Washington: Government Printing Office. 1923. vol. I. p. 532- I "
inafter cited as Medical Department History, World War I, volume I.]
"Mayo, Charles H.: Educational Possibilities of the National Medical Museum. Journal of the Amer-
ican Medical Association 73: 411-413,9 August 1919.
160 ARMED FORCES INSTITUTE OF PATHOLOGY
The accumulations to which Dr. Mayo referred were the result of strenuous
efforts to interest and instruct medical officers in the field, both in the camps
at home and in the American Expeditionary Forces overseas, in the exacting
work required in the proper preparation of anatomical and pathological speci-
mens and forwarding them to the Museum in Washington. Despite such ef-
forts, "most of the good material, and all the first-class specimens received at
the Museum, with few exceptions, were brought there by men sent from the
Museum to get them" — thus repeating, half a century later, the experiences of
the staff of the early Museum in the Civil War.
For this, there were plenty of real reasons as well as good excuses. Sum-
ming up the situation, the eminent Dr. James Ewing of the Cornell University
Medical School in New York, who is widely regarded as the "father" of oncology
in the United States, and who, serving the Army as a contract surgeon in 1918,
was assigned to the staff of the Medical Museum, said that this business of col-
lecting pathological material was "one of the least urgent matters claiming at-
tention in an army whose task was to win the war and win it quickly." A
succession of epidemics, both at home and in the AEF, and the care of the
wounded in the AEF overtaxed the laboratory forces and left "neither time
nor force to collect suitable pathological specimens and preserve them according
to modern methods." Furthermore, Dr. Ewing said, the "number of men in
the American medical profession trained in the methods of the pathological
laboratory, and especially in the methods of museum preparation, proved to be
extremely small, and few of these were available to the army." 4
Making Pathologists in a Hurry
The shortage of pathologists led to a certain amount of shortcut improvisa-
tion, such as the way in which Maj. C. Judson Herrick of Grand Rapids, Mich.,
found himself in charge of the pathology department of the Army Medical
Museum. As Dr. Herrick tells the story, he was commissioned as a major
on 18 January 1918, and charged with the business of assembling personnel for
assignment to Army hospitals to collect neuropathological materials for delivery,
with their accompanying records, to the Museum. In April, when he had
rounded up about 20 enlisted men with some training in histology and pathology,
his original order was rescinded and shortly thereafter he was ordered to report
for duty at the Medical Museum. Major Herrick continues:
' Ewing, James: Experiences in the Collection of Museum Material from Army Camp Hospitals. In-
let-national Association of Medical Museums Bulletin VIII, December 1922, p. 27. [Hereinafter cited as
Ewing.]
THE MUSEUM IN A WORLD AT WAR l6l
Upon reporting at the Museum to Col. W. O. Owen the only order I received was, "Go
see Capt. Cattell." Henry W. Cattell was then in charge of pathology at the Museum.
When Major Herrick reported for duty to Captain Cattell he was naturally disconcerted.
The Captain knew that I knew very little about pathology and I knew that he knew very
litde about neurology. Accordingly I suggested to him that he carry on exactly as before
except that he deliver to me all neurological material for processing as it came in. Shortly
after my arrival at the Museum, Col. Owen said to me, "Capt. Cattell has been transferred.
You will take over his space and all his duties." "Very well, Sir. You understand that
I am not a pathologist." "Perhaps you weren't yesterday," Colonel Owen replied. "You
are today." •"'
Dr. James E wings Mission
The task of collecting suitable material and getting it to Washington in
usable form was, in the opinion of Dr. Ewing, "almost insuperable," even
though, in 1917, "orders had been given that all pathological materials received
at camp hospitals should be sent to Washington. Under the existing conditions
it was practically impossible to carry out such orders, and they fell down at
nearly every point. At one time permission for the performance of autopsies
was suspended, but this situation was shortly relieved by the Surgeon General's
Office. Accordngly the only material from 1917 cases was sent by one or two
pathologists whose attention to the needs of the museum had been specifically
and urgently directed."
Failure of material to arrive from most of the camps prompted Colonel
Owen to send Dr. Ewing to visit some of the cantonments in the eastern part
of the United States in the early summer of 1918. "On these visits," said Dr.
Ewing, "it became apparent that the laboratories had been built, equipped and
manned chiefly for clinical microscopy, and not for pathology. There was
always an impressive array of test tubes, Wasserman trays, blood counters,
urinometers, etc., and a rather superabundant personnel trained in their use,
but I found the pathologist at only one of die seven hospitals visited, and he was
busily engaged as admitting officer of the hospital.
Autopsies had been performed, however, and at two camps efforts had
been made to collect a local camp museum of interesting cases, but frequent
transfers and changes of the acting pathologists had worked "against the effective
preservation and control of material."
The "most obvious" handicap to the success of Dr. Ewing's missionary
efforts was "lack of knowledge of the methods of museum preparation." " As
"Original letter, Maj. C. Judson Herrick, to Brig. Gen. Elbert De Coursey, 10 October 1953- On file
in historical records of AFIP.
8 Ewing:, p. 28.
1 62 ARMED FORCES INSTITUTE OF PATHOLOGY
a means of improving this situation, The Surgeon General issued a circular letter
of instructions on preparation and shipment of materials for die Museum.
Before such a circular of precise and detailed instructions was issued the question
of military authority for the making of post mortem examinations had to be
cleared up.
The Autopsy Question
In an opinion of the Acting Judge Advocate General of the Army, issued
on 6 October 1917, it was held "that there can be no question but that military
authority over all persons who are members of the Army of the United States
is sufficient to authorize the performance of a necropsy * * * if there is
sound military reason therefor." But, he added, "it is not within my province
to express my opinion upon the question whether such military reason exists."'
On 25 February 1918, The Surgeon General of the Army advised the War
Department that while it was "impracticable to state in detail the specific
circumstances which would justify post mortem examination in each case,"
he regarded such examinations as essential in the management of epidemics
and in cases where medicolegal questions were involved, and as desirable in
all cases. Even in cases where the cause of dealth was from well-recognized
processes of disease, The Surgeon General said, an autopsy "almost invariably
yields information which is instructive and of great value and importance in
the treatment of the living," and that "great good to the service and [to] medi-
cal science would result" if it were "practicable to hold post-mortem examina-
tion after all deaths."
In publishing this correspondence to the medical officers, on 1 March
1918, The Surgeon General added the requirement that commanding officers
of hospitals would be held responsible for the determination of the necessity
for performing post mortems, for the manner in which they were performed,
and for the proper preparation of the bodies thereafter, as required by Army
regulations. 3
The question of whether or not autopsies should be performed was dealt
with again on 12 June 1918, in a circular letter from the War Department in
which The Adjutant General, noting that there had been complaints that
"autopsies have been held on [the] bodies of deceased soldiers in various camps
and cantonments," ruled that while military authority was sufficient to au-
thorize them, "if there be sound military reason therefor, they should not be
' Medical Department History, World War I, volume I, pp. 1020, 1021.
'Ibid., p. 1021.
THE MUSEUM IN A WORLD AT WAR 1 63
resorted to, unless such reason exists." Commanding officers of hospitals or
the senior surgeons present were charged with responsibility for compliance
with the ruling. 9
On 18 June, 6 days after this promulgation from the War Department,
The Surgeon General sent this further appeal for greater activity in preparing
and shipping pathological specimens:
1. The Surgeon General expects that all medical officers will collect and ship pathological
specimens to the Army Medical Museum, as provided in paragraph 135, Manual for the
Medical Department, and in previous circulars from this office. The specimens should be
accompanied by histories, and officers will receive credit for their contributions.
2. A statement is desired as to:
(1) Whether your laboratory has already sent specimens to the museum.
(2) Whether you have collected specimens and have them ready to ship to the
museum.
(3) Whether you have material on hand for making Kaiserling solutions.
3. Have you collected large containers for storing and shipping specimens, such as
5-gallon oil cans, crocks, and kegs? 10
Apparently there was some uncertainty in the minds of the hospital com-
manding officers whose responsibility it was to authorize autopsies in individual
cases, for on 30 September, The Surgeon General issued another circular letter
which undertook to define more explicitly the "sound military reason" required
for authorization of the procedure. This, said the circular, was the "same as
the reason for performing an autopsy heretofore; that is, the study of the natural
history of the disease in question * * * even when the cause of death in that
particular case is known. It is essential from a military point of view that
autopsies be performed until the causes of the prevailing diseases are wel
understood and until suitable therapeutic and prophylactic measures have been
elaborated to cure and prevent the lesions found at autopsy."
Procurement of Specimens
With the nature of the authority for making autopsies thus clarified and
defined, and with the somewhat disappointing results of Dr. Ewing s mis-
9 Ibid., pp. 1021-1023.
'"Ibid., p. 1296.
11 Ibid., p. 1 02 1.
164 ARMED FORCES INSTITUTE OF PATHOLOGY
sionary journey to the camps in mind, it was decided to "issue a pamphlet
containing explicit directions for collecting, preserving and shipping gross
anatomical material." The resulting circular, which was reviewed and revised
with the help of leading pathologists, stated explicitly what material was wanted
by the Museum and how it should be prepared and shipped. It was undated,
but was not distributed to the hospitals whose autopsy methods it sought to
improve until December 1918, after the armistice. 1 "
In its efforts to procure suitable specimens, the Museum did not depend
wholly on either this definitive circular or the earlier promulgations of The
Surgeon General or the War Department. Appeals had been addressed to
"many camp pathologists personally known to members of the Museum staff,"
and such letters had produced some results. Dr. W. G. MacCallum, of the
College of Physicians and Surgeons, for example, had sent in "a large number
of pneumonic lungs which formed the sole representatives of the epidemic
of 1917-1918." 13
At the same time, therefore, that it was seeking to enlist the interest and
assistance of pathologists in the field, the pathology department of the Museum
was building up and training its own staff in the work of receiving and caring
for the specimens which were sought.
Dr. Daniel Smith Lamb, who had stood "as a lone sentinel guarding the
interests of pathological anatomy, crowded into two small rooms, but faith-
fully performing his function day by day as he has been doing year by year,"
no longer stood alone. "With rare generosity," Dr. Ewing wrote, Dr. Lamb
"placed at the disposal of the staff of new men his valuable museum collection
of microscopes and laboratory utensils." More rooms were secured and were
transformed into an active laboratory of pathology, a transformation due, says
Dr. Ewing, to the efforts of Major Herrick, who had been so summarily meta-
morphosed into a general pathologist by Colonel Owen. 14
In assembling and training a staff for the work in pathology, Major
Herrick was fortunate in being able to use the services of some of the men
whom he had previously enlisted for the Medical Department's section on
brain surgery. Ten of these university-trained histologists, who had entered
military service by voluntary induction for neuropathological laboratory work,
were assigned to the Museum, and by the time hostilities ended were giving
excellent service.
,J ( 1 ) Ewing, p. 28. (2) Surgeon General's Office: Review of War Surgery and Medicine, volume to.
Number i, December 1918, p. 72. [Hereinafter cited as Surgeon General's Office Review.]
' Ewing, p. 2m.
"Mem.
THE MUSEUM IN A WORLD AT WAR 1 65
One of the nonmedical members of the staff, detailed to Camp Wheeler,
Ga., during the period of the dread epidemic of influenza in 1918, "secured
through the cooperation of the pathologist at the camp hospital, most of the
really good specimens of influenza lungs that were in the Museum." This
man, wrote Dr. Ewing, "was permitted to remove the organs from the body
and preserve them before random incisions were made. He worked over
them day and night until fixation was perfect, packed them himself, rode on
the wagon that carried them to the station, and saw them off on the train."
With the help of such devoted members of the staff, the Museum's pathology
department was, in the opinion of the eminent Dr. Ewing, "in fair working
order" by the date of the armistice, with "a constant flow of materials of all
grades arriving." 1B
Two Museums in One
To take charge of the business of classifying and cataloging these accessions
to the Museum, Maj. Robert Wilson Shufeldt, a retired medical officer who
had served briefly on the staff of the Museum in the early i88o's while it was
still housed in the Ford's Theater building, was recalled to active duty in
January 1918. The major was a most prolific writer on a variety of subjects,
and accordingly was charged with the additional "duty of publishing in medical
and other journals of good standing articles describing those activities in the
museum about which the medical profession at large and the general public
may properly be informed." 1C
He took up his task of publicizing the problems and the accomplishments
of the Museum with enthusiasm as to the future but with a critical view and a
caustic pen in reference to the past. He had made known his views as to the
state of the institution in an article published in October 1917, in which he
declared that "from the standpoint of antiquity and history, this collection will
always be of enormous value, but from the viewpoint of a growing collection
and up-to-date exposition of modern medicine in all its varied departments, it
has, for only too long a time, been a supreme joke." '
This opinion of the Museum, as it existed before 1917, expressed before
Major Shufeldt's recall to active duty, was repeated in varied language in the
articles published by him while engaged in the work of classifying and catalog-
ing its incoming accessions. The pre-1917 museum, he wrote, "was still a
lj Ewing, pp. 29, 30.
18 Surgeon General's Office Review, p. 74.
" Shufeldt, R. W.: Army Medical Museums. Medical Record 92: 664, f'65. 20 October 1917-
1 66 ARMED FORCES INSTITUTE OF PATHOLOGY
teacher, to be sure, but a teacher of the past. It exemplified, with its many
thousands of specimens, our knowledge of military medicine and surgery as
practiced during the Civil War * * *. In the presentation of its specimens,
casing, labeling, lighting and in numerous other matters and details, it is
decidedly antiquated; and while it is, upon the whole, tidily kept, it is by no
means an exponent of what a live, growing functional museum of the
present time should be * * *. It required a World War to awaken this
museum * * *. This somnolent institution of yore gradually came out of
its lethargic state, and took on new life."
The source of this new life, according to Major Shufeldt, was the appoint-
ment to the Museum staff of several men who had had "long experience in
museum affairs and management." The effect of "three or four heroic doses
of vim injected into the vitals of this medical Morpheus, this sleepy old
Museum" he described as "a revolution, a mild upheaval, and a readjustment
with an increase in the Museum's staff in various old departments and the
establishment of the new ones." 1S
The sharp cleavage between the "new" and the "old" museums was exempli-
fied in the scheme of cataloging adopted by the new custodian of the collections.
All specimens in the Museum at the time of the declaration of war against
Germany were left undisturbed, with their accession numbers unchanged, and
were designated as Series A, while items received after 6 April 1917, were
accessions under new and separate numbers, designated as Series B. This
maintenance, in the same museum, of two separate series of numbers for
materials of essentially the same kind was deemed by Major Shufeldt to be
"radically absurd," but it was adopted as a temporary measure until such time
as it might be possible to revise and reclassify the older materials accumulated
over a period of more than half a century. When the time should come to
merge all the exhibition materials into "one homogeneous collection," he felt
that "no small part" of the Series A materials would have to be set aside and
that all of it would be reclassified along "divisional lines * * * very dif-
ferently drawn. Science will take a hand in the arrangement, and by the
application of true principles of museology, material will be exhibited in an or-
derly and scientific manner— properly cased, labeled, and classified * * *." 19
Shufeldt. R. W.: Value of the Army Medical Museum as a Teaching Factor. Proceedings of the
American Association of Museums, 1918, p. 209.
Shufeldt. R. W.: On the Classification Adopted for the Material Constituting the Collections in the
Armv Medical Museum of the Surgeon General's Office at Washington. Medical Review of Reviews
B, December [918.
THE MUSEUM IN A WORLD AT WAR 1 67
Launching the Movement for a New Building
This future reclassification, it was hoped, would be made in a new building
for the Museum and the Library, which Colonel Owen (fig. 53) had proposed,
first to The Surgeon General in 1916, and later to the medical profession at large
in an article published in the New Yorh\ Medical Journal?"
The time seemed ripe for such a project when it was launched. A special
Public Buildings Commission had been set up pursuant to a 1916 Act of Con-
gress, to "ascertain what public buildings are needed to provide permanent
quarters for all the government activities in the District of Columbia." This
Commission, reporting in December 1917, included in its plans a site on the
south side of the Mall between 4 14 and 6th Streets, SW., for a building of 175,000
square-feet capacity, to house the Museum and the Library. Cost estimates for
building and ground ranged from $2'/ 2 to $4 million. Preliminary plans for
such a building, of classical design, were approved by the Fine Arts Commission
as part of the move for a more beautiful Capital City.
The zeal of Major Shufeldt, seconded by Colonel Owen, led the major to
write letters to the deans of the principal medical schools of the country ; to state,
county, and city medical societies; and to individual physicians and surgeons of
prominence, soliciting their endorsement of the plan to provide, without delay,
suitable quarters for housing the materials to be collected on the battlefields of
Europe. With his letters, which went out in February and March 1918, he sent
reprints of an article from his pen, published in the Medical Record of 2 Febru-
ary, in which he described the existing Museum as a "mummy" stagnating in its
"sarcophagus" but retaining still the "essential life spark" which made possible
"revivification" and future usefulness." 1
The response to his letters was gratifying to him. The plan was endorsed
by more than a score of medical college deans and faculties, a like number of
medical societies, and three times as many individual practitioners, including
some of the leaders in the medical world, representing in Major Shufeldt s some-
what overly optimistic opinion, "the voice of practically all the profession in
America." The letters were bound in a handsome volume placed on the desk
of The Surgeon General, and were reproduced for wider circulation."
The new building was part of Colonel Owen's dream of the Museum of the
future, which should be not "merely a collection of medical history of the United
20 Owen, W. O.: The Army Medical Museum. New York Medical Journal 107: 1034-1036. ' J unc " ,8 -
a Shufeldt, R. W.: War Material at the Army Medical Museum. Medical Record 93: l8n ' 2 Fcb
22 (1) Mimeographed copies of letters on file in historical records of AFIP. (2) Shufeldt, R. W.: The
New Army Medical Museum on the Map. Medical Review of Reviews 24: S90-599. October 1918.
1 68
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 53. — Col. William O. Owen, tenth Curator of the Museum, 1916-1919.
States but should also be a teaching center in the truest sense * * * housed in a
building with a dignity commensurate with the service to be demanded of it."
"The Museum of 1861-1865, and later," he said, "was all that could have
been hoped for in that day. I am trying to make preparation for the study of
medical material of this war upon a modern, scientific basis * * *. I do not
THE MUSEUM IN A WORLD AT WAR
f 7JUL .
169
•(US-
Figure 54.— Colonel Owen's "dream" of a new Museum and Library building, as pictured
by Lt. Morris L. Bower, October 191 8.
believe that a mere collection of anatomical and pathological curiosities for
exhibit to the curious and the prurient should be permitted. A medical museum
should be, in my judgment, a great library of history and pathology, where the
student of medicine may come and study the history of disease and its pathology,
for the benefit of himself, his patients, and his nation." *
With a war to be won, however, and with money, materials, and manpower
in short supply, the time was not propitious for the construction of new perma-
nent buildings in Washington, and the project for a new home for the Museum
joined the other deferred dreams— not to be realized for yet another 40 years,
and then in an entirely different form and at a different place from the pro-
posals of 1918 (fig. 54).
The unrealized dream of a new building, however, in no way diminished
the drive of the Museum in expanding its activities to meet the demands of the
war of 1917-18. "The present war," said Major Shufeldt, "has had the effect
of waking up the old-time spirit in this erstwhile slumbering institu-
tion * * *. It is now an active medical concern, reaching out in all direc-
tions and absorbing every possible means to become a medical research and
teaching center in the broadest sense of those words." ;
23 Owen, New Yorl{ Medical Journal, 107 ( 1918), p. 1036.
"Shufeldt, R. W.: Vertebrate Types Below Man in the Collections of the Army Medical Museum.
Medical Review of Reviews 24: 274, May 1918.
ijo
ARMED FORCES INSTITUTE OF PATHOLOGY
Applying the Graphic Arts to Medicine
One of the new directions in which the Museum was "reaching out" in the
war years of 1917 and 1918 was in the extension of its informational services
through the wider use of the graphic arts — photographic, pictorial, and plastic.
Medical illustration in the Armed Forces of the United States was not some-
thing new in 1917. It had been developed during the Civil War period, when
the Museum staff included such medical artists as Hermann Faber and Edward
Stauch, and such clinical photographers as William Bell and E. J. Ward, whose
graphic plates are vividly reproduced in the "Medical and Surgical History of
the War of the Rebellion," in addition to Doctors Joseph J. Woodward and
Edward Curtis, who pioneered in photomicrography. The tradition of these
pioneers had been carried on by Dr. William M. Gray in photomicrography,
and by Dr. J. C. McConnell whose careful drawings of mosquitoes were useful
in the practical application to mosquito control of Walter Reed's discovery
(fig- 55)-
The World War I counterpart of these earlier illustration services was called
the Instruction Laboratory of the Medical Museum, a name bestowed to dis-
tinguish it from the division of the Museum devoted to work in pathology.
Figure 55. — This laboratory of the nineties was that of Dr. William M. Gray, who
carried on the tradition of achievement in photomicrography established by Dr. Woodward
and Dr. Curtis.
THE MUSEUM IN A WORLD AT WAR 171
The development of the new services may be dated from the employment,
in June 1917, of Roy M. Reeve as photographer— an employment which was
the beginning of a career of nearly four decades in the graphic depiction of
military medicine by the use of the camera. 25
In November 1917, Lt. Thomas L. W. Evans, head of a New York firm of
"commercial cinematographers" and a man of experience in the then young
motion-picture industry, was put in charge of the new Instruction Laboratory
(fig. 56). The operations of the Laboratory grew to include Mr. Reeve's section
of still photography ; a section of motion pictures, headed at first by Lt. Robert
Ross and later, after Lieutenant Ross had gone to France, by Lt. Charles W.
Wallach ; an anatomical art service headed at first by Lt. William T. Schwarz,
then by Lt. Morris L. Bower, and at the end of the war by Lt. Raymond O.
Ellis; and a section of wax modeling under Capt. James Frank Wallis." 6
Through these various graphic methods the Instruction Laboratory sought
to reach and inform a threefold audience — troops in training, medical officers,
and the civilian world, including especially civilian medical men.
Motion Pictures
A major activity of the Laboratory was the production, reproduction, and
distribution of motion-picture films. Altogether, 137 such films, including both
those produced by the Laboratory and those produced by other organizations
and distributed by it, were listed as available for showing in camps and canton-
ments and through civilian outlets." 7
The films offered for showing to the various "publics" ranged in length
from one-half reel to a nine-reel production on the diagnosis of tuberculosis.
The picture most widely shown and frequently discussed was a four-reeler,
"Fit to Fight," described as a "venereal disease photo play" which in three reels
of dramatic action told a story and, in one reel showing clinical consequences,
pointed a moral (fig. 57).
"Fit to Fight" was designed primarily for showing in the training camps
but was also shown, in a somewhat revised form, to selected civilian audiences.
Such showings were arranged by the Commission on Training Camp Activities,
by local departments of health and police authorities, by major industries, and
by the U.S. Public Health Service, among others.
E Creer, Ralph P.: Medical Illustration in the United States Army; Historical and Present Consider-
ations. Journal of Laboratory and Clinical Medicine 28: 651-661, February 1943.
M Memorandum, Colonel Owen to Lieutenant Colonel Fulton, 25 October 1018. On file in historical
records of AFIP: Evans, Ross, and Schwarz.
27 Medical Department History, World War I, volume I, p. 515.
713-02S-— 64 IS
172
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 56. — Instruction Laboratory, World War I. A. Drying racks for motion-picture film.
THE MUSEUM IN A WORLD AT WAR
173
Figure 56.— Continued. B. Cutting and polishing room for motion pictures.
SOUND
EDUCATION
AND
VARNINC
The motion picture
"FIT TO FIGHT"
tolls the stoty c«f
Vmereal Dtsoase
its results.
Figure 57.— The best known and most controversial production of the Instruction Labora-
tory was the film dealing with venereal disease.
'74
ARMED FORCES INSTITUTE OF PATHOLOGY
The film was shown before the convention of Rotary International held in
Kansas City in late June 1918, with the result that many of the constituent clubs
arranged meetings at which the film was shown in their communities, usually
for men and boys over 16.
A typical example of such showings and the reaction to them is the experi-
ence of the Rotary Club of Dallas, Tex. Showings were first planned for Sep-
tember or early October, but the spread of the appalling influenza epidemic in
city, country, and camps brought a ban on public gatherings and forced post-
ponement until late November. The reaction to the film when finally shown
is thus described in a report from W. C. Temple, secretary of the Dallas Rotary
Club, upon returning the film to the Army Medical Museum: 28
The first showing, by invitation only, was made to about one hundred and fifty men.
We did this to feel out the local situation, and after those invited had witnessed the film,
they were unanimous in their opinion that it should be shown to as many males as possible,
so we gave another showing of the picture, giving the matter publicity through the local
press, at which time the film was shown to something like two thousand men and boys over
fifteen years of age * * *. In my opinion this is just such education work as should
be carried on throughout this country.
Pictures as Training Methods
Most of the motion pictures made by the Instruction Laboratory, however,
were of an instructional nature, as the name of the organization implied, and
were aimed at perfecting procedures and standardizing training methods. For
example, Colonel Owen corresponded with both Brig. Gen. H. P. Birmingham,
in command of the great Medical Officers Training Center at Camp Greenleaf,
Fort Oglethorpe, Ga., and Col. W. N. Bispham, commanding the Medical Offi-
cers Training Camp at Fort Riley, Kans., advising them of the availability of
moving-picture production crews at the Museum and inquiring as to the desira-
bility of having them make pictures of such training features as an ambulance
company or a field hospital breaking camp, moving on the road, setting up a
dressing station or a field hospital, bringing in and caring for the wounded, and
making camp.
Colonel Bispham responded with a letter approving the project, and on
1 May 1918, wired Colonel Owen asking for a man to make the pictures about
the middle of that month. Lt. Robert Ross was sent to Fort Riley where, despite
weather and lighting difficulties, he shot a satisfactory picture which was com-
pleted by mid-June. 29
** Letters. 11 October and 29 November 191 8. On file in historical records of AFIP.
Correspondence between Colonel Owen and Colonel Bispham. On file in historical records o£ AFIP.
THE MUSEUM IN A WORLD AT WAR 175
Meanwhile, in May 1918, Colonel Owen received a reply from General
Birmingham in which he agreed that the moving picture suggested would be
of "great value in giving ideal demonstration and the technically correct methods
of foot drill, litter drill, with the loaded and unloaded litter, as well as the use of
improvised litters and the handling of the wounded without any apparatus
whatsoever, ambulance drill, Field Hospital dress, tent drill, gas defense, first-aid,
principally dressings and splints, sanitation in camp and in the field, surgery and
surgical treatment under field conditions, principally operating and preparation
of patients and materials for same, the giving of hypodermic injections, and the
use of the catheter."
To this thoughtful letter Colonel Owen replied immediately, saying that
the pictures covering base, evacuation, and field hospitals, and ambulance com-
panies were being made at Fort Riley, but that the other subjects referred to in
the general's letter would be made at Camp Greenleaf whenever the troops
which it was intended to photograph would be ready for the shooting of the
pictures. 30
Among the most successful and valuable of the films produced by the forces
of the Instruction Laboratory at the camps, and with the aid of the Medical
Department, was "Training the Medical Officer," directed at the thousands of
new medical officers taken from civilian life and passing through the medical
officers training courses.
Two films directed at the practical matter of insect control, and reflecting
the longtime preoccupation of the Museum with entomology, were "Mosquito
Eradication" and "Fighting the Cootie." Each U.S. military post had received
directions from The Surgeon General to collect mosquitoes in its vicinity, and
to forward the specimens collected to the Medical Museum for identification.
At the Museum, the mosquitoes— and other insect carriers of disease as
well— were examined by the Museum's entomologist, Dr. Clara S. Ludlow,
whose distinction in the field is indicated by the fact that two strains of anopheles
mosquitoes bear her name as A. ludlowi. Identification of the mosquitoes,
together with any information that might be useful in controlling the pests,
was reported to the surgeon at the post from which the specimen was received.
Compliance with the order was far from universal, and was not always in con-
formity with the directions for collecting and forwarding the specimens. Fleas,
'Correspondence between Colonel Owen and General Birmingham. On file in historic .il «
31 Directions for Collecting and Forwarding Mosquitoes, Office of the Surgeon General, -i Marc
Copy on file in historical records of AFIP.
AFIP.
176 ARMED FORCES INSTITUTE OF PATHOLOGY
lice, ticks and bedbugs" were asked for in one instance, but somehow only cock-
roaches and flies were received, while from some posts nothing at all came in,
but enough specimens were received to keep the entomology staff of the Museum
busy in identifying them and making recommendations for their eradication or
control. 32
Use of Animated Drawings
Among the films prepared by the Museum's force were several made with
what was described as "stop-motion pictures," producing the effect of animated
drawings in which every step in an operation was reproduced by sketches. "The
knife appears, without any hands, goes to the proper position and makes the
proper incision; the retractors appear, holding the wound apart. The needle
appears, armed with the thread, goes to the right place, puts the suture in the
right position; the suture rises up and ties itself and sloughs off its own ends.
Purely impersonal surgery, the patient being impersonal likewise * * * as
the schematized operation proceeds, legends are thrown upon the screen ex-
plaining the steps and pointing out the names of the essential structures as they
are successively exposed to view during the operation" — this being just before
the day of the motion picture with sound. 33
One of the skilled artists who worked on the production of animated pic-
tures was Sgt. (afterward Lt.) Paul H. Terry who, upon his discharge after the
armistice, opened an office in New York for the production of cartoon comedies
and, in time, originated the famous "Terrytoons," to the delight of millions. 3 '
A third branch of the Instruction Laboratory, the Anatomical Art Depart-
ment, grew out of this work of making sketches in series for use in animated
cartoon moving pictures, in which the artists were at first largely engaged. In
the spring of 1918, however, the brush and pencil came to be independent of the
camera, with the issuance of an attractive announcement, designed by Sgt. V. B.
Sisson, of "the establishment of an official department [in the Army Medical
Museum] for the handling of such surgical and anatomical illustration as is
required in the activities of the United States Army Medical Corps" (fig. 58). 35
^Letter, Dr. Ludlow to Curator, Army Medical Museum, 21 August 1922. On file in historical
records of AFIP.
M Surgeon General's Office Review, p. 70.
31 Letters, Lieutenant Evans to Lieutenant Ross, 4 September 1919 and Lieutenant Ross to Colonel
Owen, 18 December 1918. On file in historical records of AFIP.
ao Shufeldt, R. W.: The Art Department of the Army Medical Museum. Medical Review of Reviews 24:
39i,Iuly 1918.
THE MUSEUM IK A WORLD AT WAR l 77
ANATOMICAL
ART
DEPARTMENT
Amgi<toal€*n»
CING
THE ESTABLISHMENT OF AN
OFFICIAL DEPARTMENT FOR
THE HANDLING OF SUCH *
SURGICAL 222 ANATOMICAL
ILLUSTRATION AS IS REQlJIRr
ED IN THE ACTIVITIES OF THE
UNITED STATES ARMY MEDICAL
CORPS TTTTtTT t
Anatomical Art Deft.
IN THE ...
Army Medical Mu seum
Figure 58.— The Museum offers its services to those requiring assistance
in the development of illustrative medical art.
In charge of the Anatomical Art Department was Lt. William T. Schwarz,
who had had 5 years of experience in medical illustration at Syracuse University,
topped off by 2 years of study in Europe. He was assisted by Lt. Morns L. Bower,
who was to become well known as a magazine illustrator. Both officers receive
further training in the spring of 1918, under Prof. Max Brodel at Johns Hopkins.
They and others added to the staff, which by May came to number a dozen
artists, were given training in medical art on the job (fig. 59)- 11S
178
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 59.— Headquarters for medical art in the Army Medical Museum, World War I,
with staff members dutifully posing for the photographer.
included dissecting experience on cadavers in a dissecting room set up in the
Museum. "" Additional experience was had in the making of a large number of
drawings illustrating various stages in surgical operations at the Walter Reed
General Hospital and elsewhere, and participation in performing numerous
autopsies at the Government Hospital for the Insane (St. Elizabeths), in Wash-
ington, D.C., where the pathological service had been taken over for instruction
purposes by the Museum."
The output of the Museum's staff of artists found use in the program of
medical instruction of officers and men in the training camps, in the shape of
lantern slides, for projection on the screen, to illustrate lectures on medical topics.
Through these lectures, declared Major Shufeldt, the fitness and health of the
army was vastly improved." This was probably an exaggerated estimate of the
effectiveness of these educational efforts, 38 but there can be no doubt that the
" (1) Letter, Lieutenant Schwarz to Dean John Heffern, Syracuse University, 28 May 191 8. On file in
historical records of AFIP. ( 2 ) Shufeldt, Medical Review of Reviews, 24 (1918), pp. 391, 392.
37 (1) Annual Report of the Surgeon General, U.S. Army, fiscal year 1919, p. 1066. (2) Surgeon
General's Office Review, p. y 2 .
" Shufeldt. Medical Review of Reviews, 24 (1918), p. 392.
THE MUSEUM IN A WORLD AT WAR 179
attempt to add to the medical knowledge of officers and men through anatomi-
cally accurate medical art helped to make the army of 1917-18 the first in United
States history in which deaths from disease were fewer than those from battle-
field casualties (fig. 60).
A separately organized branch of medical art in the Instruction Laboratory
dealt with making casts and wax models of the lesions of wounds and disease.
Capt. James Frank Wallis, a Washington dermatologist and an experienced
modeler in wax, was in charge of the work and was assisted by Miss Eleanor
Courtenay Allen of Milwaukee, who had studied at the Chicago Art Institute,
and who joined the Museum staff in March 1918. 39
The Museum had had for many years a collection of several hundred
wax models, for the most part produced by the famous Baretta studios in Pans,
and part of the work of the new division was to rehabilitate some of the French
models which had deteriorated from prolonged exposure to direct sunlight.
The Museum Goes Abroad
With all the new developments and extensions of the service of the Museum
in the United States, the goal of the organization was to be of service overseas,
whether in pathology, photography, or anatomical art. First steps to that end
were taken in January 1918, when The Surgeon General at home sought from
the Chief Surgeon overseas authorization to send over a medical museum unit.
The oversea work of the Museum was to be in charge of Maj. (afterward
Col.) Louis B. Wilson, in civil life pathologist and director of laboratories for
the Mayo medical organization at Rochester, Minn. Dr. Wilson was ordered
to England— first to study what was being done along the line of collecting
specimens in the British and Colonial Forces, and then to France for duty with
the AEF as an assistant director of the Division of Laboratories.
In England, where he spent the last 3 weeks of April, Major Wilson con-
ferred with Sir Walter Morley Fletcher, secretary of the National Research
Committee; Prof. Arthur Keith of the Royal College of Surgeons; and Lt. Col.
J. C. Adami, in charge of the historical bureau of the Canadian Medical Corps,
with reference to methods of collecting pathological specimens. He talked
also with officers in charge of military orthopedics, concerning casts, models,
paintings, and drawings; with officers in charge of the cinema service; an
with those in charge of the indexing and filing of medical records and their
38 Shufeldt, R. W.: Wax Modeling Department of the Army Medical Museum. Medical Record 94:
663, 19 October 1918. , vn'tarv
"Wilson, L. B.: Museum and Art Service of the American Expeditionary Forces. The
Surgeon 46: 165, February 1920.
713-02S V — 64 14
180 ARMED FORCES INSTITUTE OF PATHOLOGY
statistical use. On i May 1918, he reported to Colonel Owen on his stay in
London, with a separate memorandum covering each subject discussed, and
proceeded on to France. 41
Before Major Wilson's arrival in France, the then Chief Surgeon of the
AEF, Brig. Gen. A. E. Bradley, had issued Circular No. 17, 2 April 1918,
"Instruction Concerning Autopsies," in which the attention of medical officers
was called to the importance of the post mortem examinations and under which
Major Wilson was to build up the necropsy service in the AEF. The circular,
issued in order to "secure proper records of causes of death of American troops
in France, and specimens of scientific value for the Army Medical Museum,"
gave directions as to procedures in autopsies, which "should be performed
whenever possible." With this encouragement to the adoption of the autopsy
as a routine procedure, to be done as a matter of course in all cases rather than
as a special procedure to be done only on express authorization, the number
of autopsies performed in the AEF rose from less than 25 percent of all deaths
in hospitals, which it had been in 1917, to 57 percent in the early months of
1918, and 92 percent in August and September. It held up to 85 percent even
in the peak month of the influenza epidemic, October 1918, when the laboratory
facilities and staffs, like every other hospital facility, were "overwhelmed by the
enormous number of deaths from influenza and the battle casualties of the
Argonne offensive." *"
Necropsy Service in the AEF
Writing shortly after the event, Colonel Wilson pointed out that in May
1918 there were, in the AEF to serve 72 hospitals and laboratories, but "fifteen
pathologists capable of making post-mortems and intelligently interpreting the
results" — a condition due in part to the "long neglect of autopsies in many
civil institutions in the United States" and in part to the "overshadowing status
of bacteriology in military laboratories." He continued:
The autopsy service in the Army in the United States had not been established as a
routine procedure, but, on the contrary, autopsies were made only on the written authority
of the commanding officer of the hospital. However, in the A.E.F. the need of a routine
autopsy service, amounting in fact to professional inspection of the diagnostic and thera-
Lctter, Maj. L. B. Wilson to Col. W. O. Owen, I May 191 8, with eleven memoranda attached. On
file in historical records of AFIP.
(1) Wilson, L. B.: The Pathologic Service of the American Expeditionary Force. The Military
Surgeon 45: 700, 702, December 1919. (2) Medical Department History, World War I, volume II, pp.
918-919.
THE MUSEUM IN A WORLD AT WAR
181
Figure 6o.-Samples of scenes and messages from lantern sl.de sets developed for in-
structional use by the Army Medical Museum, using material furnished by the Office ot
Surgeon General.
peutic measures of medical and surgical officers, became rapidly »PF»"« du ™« * C ^
mer of 1918. Surgeons were called upon to diagnose and treat, with little tunc fo stud
or reflection, many gunshot wounds with the like of which they had little or no prev ou
experience. Even those who were well grounded in the general principles of surgery
1 82 ARMED FORCES INSTITUTE OF PATHOLOGY
forced to make decisions and institute treatment thereon without sufficient basis or study.
As a result, there were errors in diagnosis and errors in treatment. The worst of these
could be determined only by the pathologist. In like manner, attending medical officers,
e.g., in cases of war gas poisoning and especially in the widespread epidemic of influenza
and pneumonia, were brought face to face with conditions with which they were totally
unfamiliar, and were frequently forced to make diagnoses and institute treatment with a
very meager knowledge of the facts. Here autopsies were of tremendous importance in
securing for the attending man a knowledge of the pathologic lesions, which knowledge he
could use in his diagnosis and treatment of subsequent cases. 43
The Director of the Division of Laboratories, AEF, Col. Joseph F. Siler,
requested in June 1918, that 10 competent pathologists be cabled for from
the United States, in addition to those coming over with organized hospital
units. The needed pathologists, or rather eight of them, came over in due
course and, with their help, centers for pathologic service were established at
Baccarat, Toul, Souilly, and Paris, staffed by medical officers who acted as
consultants in pathology for the surrounding areas. 44
Less successful was the request, made in May, for a museum unit of
photographers and artists to be sent to France. This request was approved
by General Bradley, Chief Surgeon of the AEF, but was turned down by the
General Staff, AEF, "in view of the existing tonnage situation," and because
it was believed that the "requirements of the Medical Corps could be met
successfully in this particular by the personnel and facilities already available,
in both the Signal and Engineer Corps." " 5
The interests of the Museum were not forgotten, however, for on 27 July
1918, Brig. Gen. Merritte W. Ireland, who had succeeded General Bradley as
Chief Surgeon upon his retirement for disability, issued Circular No. 42 "for
the information of those branches of the service whose cooperation and assist-
ance are necessary to enable the Army Medical Museum to discharge its duty
of collecting all those things which may be used for medical education and
research, or which may be of historic interest."
Circular No. 42 noted the responsibility of all medical officers to direct
into proper channels all desirable material coming to their notice; stressed
the duty of the pathologist in each unit to collect, preserve, and ship all such
Wilson, The Military Surgeon, 45 (1919), p. 701.
" (l) Ibid., pp. 701-702. (2) Letter, Maj. L. B. Wilson to Col. W. O. Owen, 5 October 1918. On
file in historical records of AFIP.
(1) Letter, Commander in Chief, G—i, to Commanding General, Services of Supply, 4 June 1918.
On file in historical records of AFIP. (2) Medical Department History, World War I, volume II, p. 222.
THE MUSEUM IN A WORLD AT WAR 1 83
material as was obtainable; and gave detailed directions for the fixation and
preservation of pathological specimens.
The circular covered a broad field, including microscopic materials as
well as gross organs and tissues; such pathogenic bacteria as might be isolated
in the American Expeditionary Forces; specimens of animal parasites, pref-
erably alive; helmets and other bodily protections; instruments and apparatus;
and paintings, drawings, and diagrams of medical interest.
"For the psychic effect, a missile removed from the body of a wounded
soldier may be given to him if he wishes to keep it," said the circular in para-
graph 12. In view, however, of the desirability of securing such material for
the Museum, the hope was expressed that when the scientific value of the
comparative study of such missiles was explained to them, soldiers might be
induced to give up these intensely personal souvenirs of service.
Medical Photography in the AEF
Reference was also made in the circular to General Orders No. 78, General
Headquarters, AEF, dated 25 May 1918, in which the earlier prohibition against
the use of cameras by anyone other than the Signal Corps was liberalized, and
the Medical Department was given responsibility for "technical photography
connected with the recording of photographic processes of surgical and patho-
logical matters." 40 The change in the orders as to the use of cameras had
little immediate effect. Only a few of the medical units in France had qualified
medical photographers in their ranks. Because of the earlier ban on making
photographs, still fewer units had suitable cameras among those which had
been brought over in spite of the bar to their use. These were put to work;
a few others were secured from the French; 3 were borrowed from the Signal
Corps; and 24 were secured from the X-ray Department of the Medical Corps
itself. This was enough to make a start on the business of securing a photo-
graphic record for information and study. 4.
Whether because of the relaxation of restrictions upon non-Signal Corps
photography, or because of some easing of the ship-tonnage situation, or because
of an increasing recognition of the value and importance of the Museum s
program, or because of a combination of all three, the ban on Museum Unit
No. i getting to France was lifted.
This was done in Courier Cablegram No. 7, 20 July 1918, from the Com-
" Ibid., pp. 961-964.
" (1) Ibid., pp. 222-223. (2) Wilson, The Military Surgeon, 46 (1920), PP- 165-168.
184 ARMED FORCES INSTITUTE OF PATHOLOGY
manding General, AEF, to The Adjutant General of the Army. Paragraph 2
of this message read:
Request that the Museum Unit, one Cinema Camerist, one photographer and four
artists with complete equipment and adequate supplies for at least six months be sent to
France. Item M 941 K. Consult Curator Army Medical Museum. 48
It was the end of August before the unit asked for could be assembled and
dispatched overseas, but by the middle of September, two groups sent from
the United States arrived in France. Captain Ross and seven photographers
reported to the headquarters of the Division of Laboratories, then at Dijon,
and Lieutenant Schwarz, Lt. W. H. French, and Miss Allen, illustrators and
modelers, who had come over attached to Base Hospital No. 115, were sta-
tioned at the hospital center in Vichy. 49
Before the General Staff, AEF, allowed Major Wilson to ask for talent
from the United States, he had "managed to scrape up in the Base Hospitals
some fifteen to twenty men who had had more or less training in medical
illustration," as he wrote Colonel Owen, on 5 October 1918. "A few of these,"
he continued, "such as Coleman and Jarrett, of whom you wrote, are good
Brodel-trained artists. Most of them have been landscape painters, interior
decorators or white-wash brush artists. A few of them we will be able to train
to do fairly good work. I propose to do this by ordering them to Vichy, where
Schwarz, French and Miss Allen will be permanently stationed."
As to the photographic work, Major Wilson wrote Colonel Owen that
"a number of units" had come to France with "fairly good amateur photog-
raphers" but that most of them, "having nothing to do, had been put into work
entirely foreign to photography" and "had to be blasted loose by slow and
diplomatic methods. Some are still grown fast to non-photographic jobs but
we are slowly getting the work in operation."
Colonel Owen was intensely interested in the use of moving pictures for
instruction purposes and doubtless had impressed his views upon Major Wilson.
It must have been with some degree of disappointment, then, that the major
reported, "up to date I have not been able to arouse any interest whatsoever in
moving pictures in the Medical Department of the A.E.F. * * *. Most of
the surgeons say they do not see any value in moving pictures of surgical
operations except to advertise the operator and that they do not want them
taken *. However, I am very far from disheartened, especially since
" Copy of cablegram, on file in historical records of AFIP.
"Medical Department History, World War I, volume II, pp. 224, 225.
THE MUSEUM IN A WORLD AT WAR ^5
Captain Ross and other motion picture men have arrived and believe that before
long this side of the work will be going satisfactorily." 50
Today's acceptance of moving pictures of operations as a familiar procedure
in medical training has vindicated the interest taken in this technique by Colonel
Owen and Major Wilson. Such pictures are shown as part of modern medical
training, and have even made their appearance on television. They still in-
escapably "advertise the operator," but this minor objection is more than
counterbalanced by the greater facility with which the observer can see and
understand what is done as it is done.
By the end of September, the photographers were at work in the zone of
the advance, covering the activities of the divisions at the front. With the
signing of the armistice of n November 1918, and the cessation of hostilities,
the Museum staff was concentrated at Dijon until 29 November, when Captain
Ross, with three photographers, was ordered to Paris to set up a photographic
bureau for the Medical Department of the AEF. The bureau was housed in
the Elysee Palace Hotel, where three large bathrooms were converted into
photographic darkrooms. 51
Despite difficulties and delays in securing sufficient supplies, some of which
had to be procured from the French, the photographic staff made, captioned,
filed, and cross-indexed about 10,000 still photographs and turned out some
40,000 feet of motion-picture film showing medical and surgical activities around
the hospitals, in addition to prints of 20,000 feet of film made by the Signal
Corps. In the same period, the artists and modelers produced 35 casts of surgical
subjects, about 200 drawings and paintings, and 1,000 photographs of technical
subjects. 52
Lieutenant Schwarz conceived the idea of making life masks of the prin-
cipal figures at the Peace Conference then in session. Working with Miss
Allen, he made a "bully mask" of Ambassador Sharp, who put him in touch with
Col. E. M. House who, in turn, introduced the lieutenant to M. Andre Tardieu,
the French High Commissioner for Franco-American affairs, whose mask was
also made. Through M. Tardieu, Lieutenant Schwarz was presented to Marshal
Joseph J. C. Joffre, who consented to have his mask taken on the evening of
7 January 1919, and who made arrangements for the taking of a mask of
Marshal Ferdinand Foch on 9 January, and of President Raymond Poincare
M Letter, Maj. L. B. Wilson to Col. W. O. Owen, 5 October 1918. On file in historical records of AF1P.
"Memorandum, Maj. Robert Ross, 17 April 1919. On file in historical records of AFIP.
S2 (i) Medical Department History, World War I, volume IF, p. 225. (2) Wilson, The Military
Surgeon, 46 (1920), p. 172.
1 86 ARMED FORCES INSTITUTE OF PATHOLOGY
and Premier Georges E. B. Clemenceau on the ioth. King Albert of Belgium
was slated to have his mask taken on 13 or 15 January, while Field Marshal
Douglas Haig, Prime Minister David Lloyd George, and Mr. Herbert H.
Asquith were to be taken sometime between the 13th and 17th of the month.
Whether any more of the masks were made, and what became of those which
were, does not appear in the Armed Forces Institute of Pathology files other than
the statement of Major Ross, in a letter of 21 January 1919, to Colonel Owen
that he understood that Lieutenant Schwarz had "been pulled off the plaster
masks proposition and it was turned over to an officer of higher rank to
handle." 53
The Museum s Major Aim
The major aim of the Museum was not, however, in the making of life
masks of notables, nor in graphic presentation of Medical Department activities,
nor even in the collection of weapons and other materials used by the armed
forces of allies and enemy nations — important as these were.
The major function of the Museum was the collection and preservation
of pathological materials. As to this, Major Wilson, after he had been overseas
for 6 months, wrote Colonel Owen that :
It is of course useless to talk about collecting pathological specimens except through the
men who are making the pathological examinations and there were very few such men over
here when I came. Most of the work was centered on bacteriology. At the same time
there was great need for the development of an autopsy service. One of the first steps,
therefore, was to cable back for a supply of pathologists # * * Since then we have
made a thorough combout of the A.E.F. for pathologists, placed good men in the most ad-
vantageous positions, and talked the necessity of autopsies not only to laboratory men but
also to clinicians and surgeons most insistendy, until today we have a very high grade
necropsy service in smooth working order. We still are very short of competent patholo-
gists but those that are here * * * are securing the fullest cooperation from the
attending physicians and surgeons. 54
The severe influenza epidemic, coinciding as it did with the great final
American offensive in the Meuse-Argonne, put such a strain on medical per-
sonnel and facilities that "only relatively slight attention could be given to the
collection of specimens." Nevertheless, despite the limited personnel and the
lack of equipment, of supplies, of containers, and in fact of everything except
"Letters, Lieutenant Schwarz to Colonel Owen, 23 December 1918, and Major Ross to Colonel Owen,
19 December 1918 and 21 January 1919. On file in historical records of AFIP.
" Letter, Maj. L. B. Wilson to Col. W. O. Owen, 5 October 191 8. On file in historical records of AFIP.
THE MUSEUM IN A WORLD AT WAR I°7
a multitude of specimens, upward of 6,000 pathological specimens were col-
lected, preserved, and shipped to the Army Medical Museum. 1 "'
With the signing of the armistice on 11 November, the tremendous flow
of men and materials across the Atlantic had to be reversed, with consequent
confusion and delays. Recognizing that the specimens being shipped home-
ward would be subject to unpredictable delays, Col. Walter D. McCaw, who had
succeeded General Ireland as Chief Surgeon of the AEF, when he had become
Surgeon General on 14 November 1918, upon the retirement of General Gorgas,
issued, on 2 December, his Circular No. 58 supplementing and reinforcing
Circular No. 42, and giving specific directions as to methods of packing and
shipping specimens so that they would not deteriorate even if they should not
be delivered for a couple of years. 50
The flow of materials collected in France had little more than begun to
reach the Museum, and most of the eager young men whom Colonel Owen
had sent overseas were still over there, when the colonel reached the statutory
age of compulsory retirement. Regretfully, in mid-January 1919, he yielded
the curatorship to become, after his retirement, professor of anatomy at the
Georgetown University School of Medicine.
Succeeding him as Curator was Col. Charles Franklin Craig, who was to
be called upon to deal with the problem of handling the incoming flood ot
specimens and materials with no increase in the space in which they were
to be processed and exhibited, and with a staff which, almost daily, was shrink-
ing toward pre-war levels as the wartime additions were demobilized.
M Medical Department History, World War I, volume II, pp. 223-224^
"(i) Ibid., p. 226. (2]
in historical records of AFIP.
Medical Department History, World War I, volume II, pp. 223-224.
(!) Ibid., p. 226. (2) Letter, Maj. L. B. Wilson to Col. W. O. Owen, 2. December 19.8. On file
CHAPTER X
The Institute Idea
"At no time during the war was there a sufficient number of trained pathol-
ogists in the service," said Surgeon General Merritte W. Ireland in his annual
report for the fiscal year ending 30 June 1919. "The same condition seems to
exist in civil life," he added, "for it proved impossible to find a sufficient number
of trained men."
A start toward correction of this situadon was made when the position of
the chief of the laboratory service in Army hospitals was made "coordinate in
standing and authority with the chiefs of the medical and surgical services,"
thereby opening the previously blocked path to promotion for practitioners of
pathology. During the year, also, special arrangements were made for the in-
struction of medical officers in pathology at the Government Hospital for the
Insane (St. Elizabeths), in Washington, D.C., at the Brady laboratories of the
hospital in New Haven, Conn., and at the Army Medical Museum, where special
instruction in neuropathology was given.
"Pathology, however," as The Surgeon General said in his report, "is a
subject in which a large experience is acquired slowly, and, in spite of efforts to
train additional men by the arrangement of special courses of instruction, the
number of qualified pathologists could not be greatly increased during the
war." x
Meeting the need for more and better-trained pathologists became, in the
period following the First World War, a prime purpose of the Museum. Col.
Charles F. Craig, the first postwar Curator (fig. 61), was not primarily a pathol-
ogist but was distinguished for his studies of dengue fever, filariasis, the dysen-
teries, and, most particularly, malaria and its control. The incidence of the last-
named disease in the Army was reduced in the first quarter of the 20th century
from more than 700 to less than 10 per 1,000. This control of malaria in the
Army was not the result of any one man's efforts, but Colonel Craig's contribu-
tion, through his "extensive investigations, writings, and advice" on the subject,
was outstanding. He was chosen by a board of officers appointed by Surgeon
1 Annual Report of the Surgeon General, U.S. Army, 1919, p. 1043.
190
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 61. — Col. Charles F. Craig, eleventh Curator of the Museum, January-September
1919.
General William C. Gorgas to prepare for the Army the compendious treatment
of the subject entitled "The Prophylaxis of Malaria with Special Reference to the
Military Service," published by the War Office of the Surgeon General as
THE INSTITUTE IDEA l 9 l
Bulletin No. 6, August 1914. This special interest, demonstrated ever since the
time of the Spanish- American War, was further evidenced by his post-retirement
career as professor and chairman of the Department of Tropical Medicine at
Tulane University."
The First Practicing Pathologist to Become Curator
His successor at the Museum, in 1920, was Maj. George Russell Callender
(fig. 62) , a native of Massachusetts and a graduate of Tufts Medical College, who
had served as Assistant Curator during Colonel Craig's administration. Major
Callender was the first practicing pathologist to head the institution which was
foremost in the Nation in the collection, preservation, and presentation of the
raw materials of pathology and which, a quarter of a century later, was to become
in name as well as in function an institute of pathology.
The problem which the Museum faced in the years after the First World
War was three-pronged, with an enormous increase in the quantities of materials
received, a diminishing work force to accession, catalog, and process the mate-
rials, and rigid limitations in the space available.
During and just after the First World War, the collections of the Museum
more than doubled, rising from fewer than 48,000 to more than 100,000 speci-
mens. The new specimens had to be accessioned and given numbers in a filing
system which contemplated bringing together and keeping with each specimen
all available pertinent information such as clinical histories, protocols of autop-
sies, photographs, X-ray plates, tissue blocks, microscopic slides, and anything
else which might shed light on the pathological condition of the specimen.
Keeping up with the routine of accessioning and cataloging these materials
as they came in "entailed a very large amount of work upon a very small clenca
force," which was "the more difficult because of the constant decrease of personnel
and the constant increase of work due to the material received from France,
as well as that which came in from the hospitals in the United States as they were
closed after the War. :1
Space Problem Intensified
More difficult to deal with than the problem of doing more work with
fewer people was the problem of finding space in an already overcrowd.
2 Ashburn, P. M.: A History of the Medical Department of the United States Army.
Mifflin Co., 1929. pp. 267, 268.
'Annual Report of the Surgeon General. U.S. Army. 1919, pp. 1<> 6 3. '"'' 4
Boston: Houghton
i 9 :
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 62. — Maj. George R. Callender, twelfth Curator, 1919-1922, and fourteenth
Curator, 1924-1929, of the Museum.
building for the display, or even storage, of the inflow of materials. This
problem was further complicated by a slow delivery of museum glass jars,
which made it necessary to store many specimens in 10-gallon stone crocks in
the basement of the west wing of the Museum and Library building. Not being
THE INSTITUTE IDEA J 93
fitted with airtight tops, the crocks allowed evaporation of the preserving fluids,
so that it was necessary to inspect and refill the crocks at intervals to prevent
spoiling of the specimens. 4
Some slight relief from the pressure for space was found in the discon-
tinuance, on i March 1919, of the production of moving pictures, because of a
lack of funds and personnel. This closing of the production end of the Mu-
seum's motion-picture activity did not stop the circulation and showing of films
already made, which was continued bodi by the Museum and by the U.S. Public
Health Service. Much of the demand for showings came from civilian sources,
including medical colleges, medical associations and societies, and educational
institutions.
Before 1 May 1919, exhibits in the Museum were open to all the public.
Feeling that the lay public would neither understand nor profit by viewing
many of these exhibits, the Museum began on that date a systematic rearrange-
ment of exhibitions, insofar as available space permitted, under which prepara-
tions and specimens not regarded as suitable for indiscriminate showing were
to be removed from the floor of the main museum hall to the gallery and to
rooms on the first floor which were to be open only to the medical profession,
including students and research workers. 6
"It is hoped eventually," Colonel Craig wrote, "to replace all pathological
material on the main museum hall floor with material of general public interest,
as specimens of ordnance, missiles, gas masks, sanitary appliances and apparatus
used in the Army in the prevention of disease."
By the middle of 1920, gross pathological specimens, wax models illustrat-
ing skin diseases, and anatomical models and sections, had been removed to
die first floor, as part of the plan of segregating material ot interest
rooms on
primarily to physicians and medical students. At the same time, but for reasons
involving the more effective use of available space, die exhibits illustrating the
method of transmission and treatment of the hookworm disease, and the collec-
tion showing the historical development of the microscope were also removec
from the main hall to the first floor.
The material removed from the main hall was replaced by material showing
diseases from which both military and civil communities suffered, inclu ing
malaria, typhoid fever, dysentery, and tuberculosis, displayed in such lasnion
•Memorandum o£ Maj. J. F. Coupal: Activities of the Patholo S ical Section of the .
Museum During the World War. On file in historical records of AFIP.
6 Annual Report of the Surgeon General, U.S. Army, 1920, pp. 246, 2 47-
6 Annual Report of the Surgeon General, U.S. Army, 1919, pp- ' o6 7. Io68 -
ARMED FORCES INSTITUTE OF PATHOLOGY
as to be "valuable in the instruction of the general public in hygiene and
preventive medicine." '
No amount of shuffling and reshuffling of exhibits within the confines of
the 30-year-old building occupied by both the Library and the Museum could
produce enough space to permit either a proper display of the exhibit materials
or an effective use of the study collections (fig. 63). It was estimated, indeed,
that proper display and exhibit of the World War materials alone would take
up the entire room of the building, while the whole of the Museum's materials
would fill a building twice the size of the one occupied by both the Library
and the Museum. Accordingly, The Surgeon General earnestly recommended
construction of a new building at as early a date as was possible. 8
Plans for a Great Medical Center
The first concrete step toward such a new building was the appropriation
by the Congress, on 11 July 1919, of $350,000 "for the purchase of land con-
tiguous to Walter Reed General Hospital, District of Columbia, 26.9 acres
more or less, for the final location of the Army Medical Museum, the Surgeon
General's Library, and the Army Medical School." Supplemental to this ap-
propriation, was an additional grant, on 22 September 1922, of $44,109.22 "for
the site of Medical Museum and Library." 9
The project contemplated a great medical center, with the School, the
Library, the Museum, and the Hospital in mutual support of one another.
The plan as projected was never to be carried out fully. The Army Medical
School moved from its rented quarters on Louisiana Avenue to its new build-
ing, in suburban Washington, in September 1923. The Museum, later trans-
muted into the Armed Forces Institute of Pathology, was to remain in its
downtown location for yet another 30 years before moving the greater part
of its activities to the Walter Reed site; while the Surgeon General's Library,
under its new name of the National Library of Medicine, was to stay on Inde-
pendence Avenue for still another decade and then move — not to Walter Reed,
but to the grounds of the National Institute of Health.
At the time of the purchase of the land contiguous to Walter Reed, how-
ever, there were plans for a new building for the Museum in which The
Surgeon General could carry out more effectively the idea of making available
'Craig, Charles F.: The Army Medical Museum and the Medical Profession. Modern Medicine 2:
542, August 1920.
* Annual Reports of the Surgeon General, U.S. Army, 1919, p. 1068, and 1920, p. 243.
*(i) 41 U.S. Statutes, 122. (2) 42 U.S. Statutes, 1029.
THE INSTITUTE IDEA
195
Figure 63.— The "Great Hall" of the Museum in the 1890's.
to research workers facilities for the study of the Museum's rich resources in
pathological materials (fig. 64). So long as the Museum was crowded into its
half of the old building, however, it was "impossible to furnish working rooms
for research purposes," and the Museum's materials could be used by others
than its immediate staff only by sending out available materials on loan, upon re-
quest by recognized research workers. 10 .
Nevertheless, and despite the handicap of limited space and facilities, the
Museum was, as The Surgeon General described it in his 1920 report, a very
valuable connecting link between the Medical Department of the United States
Army and the general medical profession of the United States, from the stand-
point of scientific medicine and surgery." Every feasible encouragement was
offered for the use of the Museum's collections by civilian physicians, it being
"believed that only in this way will the Museum fulfill its larger function ot
'Craig, Modern Medicine, 2 (1920), p. 542
196
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 64.— A 1920 photograph of the gross pathological laboratory of the Army Medical
Museum.
being not only a place for the exhibition of pathological and other material, but
a great instruction center in pathology and epidemiology." ]
This concept of the Museum as a connecting link between military and
civil medicine, expressed by The Surgeon General in 1920, was not new. It
was foreshadowed by Surgeon General William A. Hammond in the very
beginning of the institution and had been repeated by other medical men, both
military and civilian. It had been most eloquently voiced by Col. John Shaw
Billings in his address to the Congress of American Physicians and Surgeons,
meeting in Washington in 1888. Billings, in fact, had gone a step further
when, in 1895, he entered into an arrangement under which the Museum be-
came the repository of the dental and oral collections of the American Dental
Association. 12
"Annual Report of the Surgeon General, U.S. Army, 1920, p. 247.
12 Sec chapter V, pp. 89-106.
THE INSTITUTE IDEA I97
American Registry of Pathology
In June 1921, there was initiated another and more active form of cooper-
ation between the Museum and important segments of the medical profession.
The first such arrangement— there are now 27— was outlined in a joint letter
of Major Callender, representing the Museum, and Doctors Harry S. Gradle
and Ira Frank, of Chicago, representing the Academy of Ophthalmology and
Otolaryngology. In substance, this undertaking reflected the realities of a situ-
ation in which the Academy's members could furnish pathological materials
which the Museum did not have, while the Museum could supply the home
for the Academy's collections and the technical staff for the preparation of
specimens. The arrangement thus entered into was confirmed by the Academy
at its meeting in October 1921.
It was noted that the Army Medical Museum, at that time, did not have
on its staff anyone well versed in the pathology of the special fields covered
by the Academy and qualified to do the consultative diagnosis, which was to
be a major feature of the active cooperative work contemplated under the new
arrangement. It was necessary, therefore, to set up a committee of the Acad-
emy's specialists, to whom all specimens on which there was any doubt in
diagnosis were submitted. Most active in this work were Dr. Frederick Her-
man Verhoeff of Boston, the committee chairman, and Dr. Harry S. Gradle
of Chicago. Both men were prompt in reporting on the doubtful cases and
specimens submitted to them by Major Callender, who did much of the work
on the easier specimens himself. 13
At first without a name or title, the new arrangement finally came to be
called the Registry of Ophthalmic Pathology and became the first of the reg-
istries which make up the American Registry of Pathology. This great col-
laborative endeavor is housed and administered by the Armed Forces Institute
of Pathology, but draws its strength and substance from the memberships of
the 17 medical-specialty societies which sponsor the 27 individual registries now
in operation.
(1) The Atlases of Pathology. A symposium, presented at the Joint Session of the 57th Annual
Session of the American Academy of Ophthalmology and Otolaryngology, in Chicago, 12-17 October
1952, and reported in: Transactions of the American Academy of Ophthalmology and Otolaryngology 57:
13-26, January-February 1953. (2) Zimmerman, L. E.: The Registry of Ophthalmic Pathology: Past,
Present and Future. Transactions of the American Academy of Ophthalmology and Otolaryngology 65:
61-65, January-February 1961. (The 17th Jackson Memorial Lecture presented at the 65th Annual Session
of the American Academy of Ophthalmology and Otoaryngology.) Dr. Zimmerman's lecture is as broad
as its subject signifies and contains much of value, both historically and professionally.
Ig g ARMED FORCES INSTITUTE OF PATHOLOGY
The name "registry," which came to be applied to this form of cooperative
medical endeavor, probably grew out of a case of suspected bone sarcoma in a
patient of Dr. E. A. Codman of Boston. The patient's family wished to know
of cases of recovery from what was, or was supposed to be, bone sarcoma, and
the treatment which had resulted in a cure. Informally, Dr. Codman called
on his personal acquaintances in the profession for such light as they could
throw on cases, and their cures, if any. The first cases collected were placed in
the Registry in July 1920, less than a year before the Museum and the Academy
entered into their arrangement. Although the original patient for whose
benefit the information had been gathered had died, it was realized that the
information itself was too valuable to lose. Dr. Codman, therefore, took up
the matter with Dr. James Ewing of New York and Dr. J. C. Bloodgood of
Baltimore, with whose cooperation the Registry was informally organized.
Other surgeons and pathologists became interested in the project, which was
to be taken over, as part of its work, by the American College of Surgeons.
On 3 January 1922, Dr. Codman, using a bound, blank book with the
printed heading "Register," began the diary of "The Registry of Bone Sarcoma."
The primary object was to "keep an up to date list of all supposed-to-be sarcoma
cases" by registering "every case (1) of which we have a brief history and an
X-ray picture or a slide or tissue. (2) certain interesting or unusual bone tumor
cases which have been confused with sarcoma."
The objectives were not greatly different from those of the almost con-
temporary and still nameless arrangement between the Museum and the
ophthalmologists, and the basic idea of the operation was so nearly the same
and so well contained within the idea of a registry of pertinent information in
individual cases, that it was most natural to call the Museum-Academy arrange-
ment by the same name of a "registry." Particularly is this the case since Dr.
Codman was a friend and patient of Dr. Verhoeff, chairman of the cooperative
committee of the Academy, 14 to whom he might well have given the idea of
calling the new alliance between military and civilian medicine a "registry."
Working in a New Direction
At any rate, and regardless of the name, the new movement was destined
to give a largely new direction to the work of the Museum. At the first annual
meeting of the American Academy of Ophthalmology and Otolaryngology,
held after the new relationship between that organization and the Museum,
"Zimmerman. Transactions of the American Academy of Ophthalmology and Otolaryngology, 65
(1961 1. pp. 6a, 69-71.
THE INSTITUTE IDEA 1 99
the Museum exhibited some of its resources in the way of specimens of oph-
thalmic pathology, most of which had been collected from members of the
Academy during the year since the joint project was undertaken. The exhibit
received high praise from the doctors in attendance, and was the subject of
commendatory letters and expressions of appreciation from Dr. Walter R.
Parker of Detroit, president of the Academy during the first year of its spon-
sorship of the Registry. 15
The arrangement between the Museum and the professional sponsors of
the Registry was strengthened by the subsequent addition of Dr. Jonas Stein
Friedenwald of Baltimore and Dr. Georgiana Theobald of Chicago to its spon-
soring committee. It was further advanced during its first year in operation
by the gift, from Dr. James Moores Ball of St. Louis, of his entire collection of
historical and operative ophthalmic materials. The Ball collection became,
indeed, something of a cornerstone in the building of the Registry. It included
136 items of historical interest and value, which alone "would have been a
generous donation" to the Museum. But this was only a portion of the gift,
which included an interesting collection of ophthalmic instruments, large num-
bers of microscopic slides and other items, nearly 500 gross pathological speci-
mens, and more than 1,000 pictorial items."'
While the movement for what came to be called the Registry of Oph-
thalmic Pathology originated with the American Academy of Ophthalmology
and Otolaryngology, and that organization continued to be its major support,
it was soon strengthened by the affiliation of the two other groups of specialists
in this field, the American Ophthalmologic^ Society and the Ophthalmic
Section of the American Medical Association.
The Registry was fortunate both in its professional sponsorship and m
the Army personnel with which it had to deal. Surgeon General Ireland and
Curator Callender were of one mind in feeling that the Medical Museum
should, as Major Callender put it, "become a live activity in pathology in
addition to its function of collecting, studying and reporting on the injuries
and diseases of armed conflict." "
15 Ibid., pp. 65-67. . f pi,:],
» (X) Dr. BaU's gift to the Registry was made at the instance of Dr £*£» M - £*£
delphia. Other major donors to the Registry in its early years included Dr. Harris 1 . mo
who gave more than 600 specimens and Dr. E. C. Ellett of Memphis, whom General Callcn ^.^^ „
was "the largest single contributor and active supporter during the first ten years of the Registry s c
(2) Coupal, James F.: Special Report: The Ophthalmologic Collections from the * m «£ n * mQ ' &
Ophthalmology and Otolaryngology at the Army Medical Museum. American Journal ot p
853. 854, October 1923. . /)»o/«rvneo/ogv,
» Callender, George R., Transaction* of the American Academy of Ophthalmology and Otolary g
57 (>953).PP- 14-15-
200
ARMED FORCES INSTITUTE OF PATHOLOGY
And the movement was doubly fortunate in the member of the Museum
staff assigned to the operation of the first registry— Miss Helenor Campbell,
a young lady whose previous experience included 6 years as a technician in
pathology at the Johns Hopkins Hospital. Miss Campbell, afterward Mrs.
Wilder (fig. 65), joined the Museum staff in 1920 as a medical technician. In
1953, upon her marriage to Mr. Rudolf Foerster of San Francisco, she retired
as an ophthalmic pathologist— justly renowned as "the famous Mrs. Wilder."
Upon the occasion of her retirement, after more than 30 years of distinguished
Figure 65. — President and Mrs. Eisenhower congratulate Mrs. Helenor Campbell
Wilder (now Mrs. Rudolf Foerster) upon her achievements in ophthalmology which won
for her the designation as "Woman of the Year in Science" by the Women's National Press
Club in 1953.
THE INSTITUTE IDEA
201
service, Mrs. Foerster, as she then was, was presented by her associates at the
Armetl Forces Institute of Pathology with a bound collection of her published
contributions to an increasing knowledge of pathology and ophthalmology.
The collection covered a span of 32 years, from 1922 to 1954. It included 35
articles, appearing in 17 different publications. In 18 of the articles she was
the sole author; in 17 she had as collaborators some of the outstanding author-
ities in the field covered. Speaking in 1952 of the early days of what is now the
oldest ^medical registry in the United States, General Callender gave the "highest
credit" for its success to the woman who served it so brilliantly for so many
years, and whose scientific attainments were such as to lead to her election
to membership in professional medical societies, despite her lack of the college
degrees ordinarily required for entrance. Mrs. Wilder made "two of the most
eminent discoveries in ophthalmology of the past two decades" by her demon-
stration of toxoplasmosis in many cases which had previously been diagnosed
as tuberculous, and her finding that the larvae of nematodes are "a not infre-
quent cause of endophthalmitis" or inflammation of the inner structure of the
eye. By her outstanding achievements, she well merited the honorary degree
of doctor of laws conferred upon her in 1955 by Mills College, Oakland, Calif.
Varied New Activities of the Museum
Another new service of the Museum, evidencing its increasingly close
relations with the medical profession in general, was its designation as the
institution entrusted by the Society of American Bacteriologists with the cus-
tody and maintenance of its type cultures. Under this arrangement, which
went into effect in May 1922, the Museum became the depository of the
"purebred" strains of every differentiated bacterium of interest to medicine,
from which subcultures of particular strains were supplied upon request. This
arrangement, valuable alike to the medical profession and to the Museum, con-
tinued for 3 years until, adequate funds having been obtained, the activity was
transferred to the National Research Council, with the type cultures located
at the McCormick Institute for Infectious Diseases in Chicago. During the
time the cultures were maintained at the Medical Museum, the subcultures
distributed came to number as many as 4,000 a year, in response to 700 re-
" (0 Idem. (2) AFIP and Ophthalmology. Archives of Ophthalmology 67: 3>. M ^ ,<>61 - (i) AFIP
Centenmal. Archives o£ Ophthalmology 67: 177-178, May 1962. (4) Lebenson, J. E.: The Armed Forces
Institute of Pathology. American Journal of Opthalmologv 53: 695, April i'<<'- (5) Zimmerman,
Transactions of the American Academy of Ophthalmology and Otolaryngology, 65 ("/">' PP- 78. 79-
202 ARMED FORCES INSTITUTE OF PATHOLOGY
quests — a use which increased approximately eightfold while the work was
being done at the Museum. 19
Still another new activity of the post-World War I period, which helped
to intensify the turn taken by the Museum toward becoming an institute of
pathology, was the designation of the Museum as the location of the central
exchange for pathology specimens of the American and Canadian Sections of
the International Association of Medical Museums. This work had been car-
ried on, somewhat informally and in a limited way, as an addition to her other
duties, by Dr. Maude E. Abbott of McGill University who, over the years, had
been the mainspring of the work of the International Association. In the spring
of 1921, Prof. James W. Jobling of the College of Physicians and Surgeons in
New York, brought to a head the rather formless discussions of the subject
of a central exchange by a letter to The Surgeon General of the Army suggest-
ing the establishment of such an arrangement, to be housed and administered
by the Army Medical Museum. The subject was submitted to Major Callender
for his recommendation. Major Callender strongly urged the adoption of
Dr. Jobling's suggestion, saying in a memorandum of 13 April to The Surgeon
General, that the establishment of such an exchange at the Museum would be
of material benefit "by bringing the Museum into the closest contact with our
medical educational institutions" by rendering to them a most valuable service
and, at the same time, would enable the Museum to strengthen its collections.
The Surgeon General agreed, the Secretary of War approved and author-
ized the issue of a revocable lease for the necessary quarters at the Museum, and
1 he Surgeon General authorized the officers at the Museum to undertake the
administrative details. On 1 May 1922, the Museums Association authorized
the removal of the central bureau for the preservation of results of medical
research and the exchange for pathological specimens from Montreal to
Washington.
In an editorial in Bulletin VIII of the International Association of Medical
Museums, Major Callender said:
The central bureau for the preservation of the results of medical research will have a
permanent file of records entirely independent from those of the Museum as a whole, and
separate cabinets for slides and cases for specimens representing the result of original re-
search. It will be kept carefully under suitable safeguards to prevent loss and will be open
for consultation under adequate supervision to those qualified to consult it. 20
"Annual Reports of the Surgeon General, U.S. Army, for fiscal years 1922, p. 108; 1923, p 104-
1924, p. 161; 1925, p. 210.
30 (1) Letter, Major Callender to Professor Jobling, with memorandum to The Surgeon General 13
April .921. On file in historical records of AFIP. (2) Callender, G. R.: The Exchange of Museum
Specimens. International Association of Medical Museums Bulletin VIII, December 1922, p. 12.
THE INSTITUTE IDEA 203
Busy as he must have been with the launching of such a variety of new
and valuable prospects, Major Callender was faced, in 1922, with proposals for
combining the Army Medical Museum with the Smithsonian Institution. This
movement had what probably was its fullest and most elaborate exposition in a
letter from Dr. Arthur MacDonald of Washington, sent to many scientists
and inserted in the Congressional Record by Representative Melvin O. Mc-
Laughlin of Nebraska under the title "Consolidation of Government Science
Under the Smithsonian Institution." 21
Dr. MacDonald's letter was not directed solely at the Army Medical
Museum. His plan contemplated placing 33 bureaus of government organiza-
tions having to do with scientific matters under the jurisdiction of the Board
of Regents of the Smithsonian Institution. Among the agencies which would
have been affected were the Geological Survey, the Reclamation Service, the
Bureau of Mines, the Patent Office, the Census Office, the Bureau of Standards,
the Bureau of Fisheries, the Public Health Service, the Army Medical Museum
and Library, the Library of Congress, the Government Hospital for die Insane
(St. Elizabeths), the Coast and Geodetic Survey, the Naval Observatory, and
all the scientific bureau of the Department of Agriculture.
The advantages claimed for this wholesale transfer of government agencies
was that under it government science would develop to the highest efficiency,
by correcting illogical and haphazard arrangement of bureaus or departments,
and by reducing to a minimum political influence in scientific bureaus. The
plan was likened to the administration of a university, with the Secretary of the
Smithsonian Institution being analogous to the president of the university, and
the Board of Regents, consisting of die Chief Justice, the Vice President of the
United States, and three members each from the Senate and the House of
Representatives, corresponding to the university trustees.
Possible Courses of Action
The movement for consolidation of all governmental scientific activity does
not appear to have developed any great popular strength, but coming as it did,
just as the Army Medical Museum was changing its direction so as to expand
its services to medicine in general, as well as military medicine in particular,
such public discussion of the plan led Major Callender to give serious and con-
centrated thought to the position and the future course of the Museum.
Possible courses of action, as outlined in a memorandum of 13 February
1922, for The Surgeon General, were fourfold: (1) The Army Medical Musuem
21 Congressional Record, 67th Congress, 1st session, volume 405, pp. 8833-8835, 26 October 1921.
713-028' — 64 15
204 ARMED FORCES INSTITUTE OF PATHOLOGY
might continue "to be maintained as the only medical museum of national
character as it has been for the past sixty years," with exhibits "for the purpose
of educating the lay public in preventive medicine and hygiene" and an "en-
tirely separate collection of a scientific nature" or (2) that the Museum should
confine its activities to fields of general and preventive medicine as directly
applied to the Army, leaving the broader field of medicine to be dealt with by
another institution; or (3) that the Museum should "confine its activities to
diseases particularly affecting troops;" or (4) that the Museum, as a temporary
policy only, should continue to accept "temporarily the display of hygienic
and preventive medicine, awaiting further developments."
In analyzing the various plans, Major Callender put the cost of maintaining
and operating the Museum proper, exclusive of rental and repairs to the build-
ing, at about $40,000— an expense so small that the institution was being "run
below par." Costs under plan 1, he estimated, would be about $100,000 more
than the prevailing level of costs, in addition to the requirements of larger space.
Plans 2 and 3 would have little effect upon costs, while plan 4 would mean
that additional help from some source would be required, if exhibitions of
preventive medicine and hygiene were to be done by the Museum.
"The Army has had the only national museum worthy of the name in
the United States * * *" Major Callender wrote, which "is one of our most
valuable contacts with the civilian profession." Under Army control the facil-
ities of the Museum had been offered "to other government services which
might and should be interested in studying, particularly human pathology."
Specifically, the U.S. Public Health Service and the Veterans' Bureau had been
"apprised of our willingness to take care of their material for them."
"In a similar way," he continued, "we are now cooperating with all societies
who desire special representation in a museum of national character with the
idea that one medical museum is sufficient for all." Because Army medical
personnel are so mobile and are therefore subject to infection with diseases
to which they are not accustomed, he added, "medical museums are absolutely
necessary" for the education of medical officers in dealing with unfamiliar
diseases. The same thing was "becoming important to the civilian profession
because of the ease of travel throughout the world today" — truly a prophetic
note to strike in 1922, when transatlantic flight had been achieved by only
two stripped-down military planes, and the age of the jet airliner was not yet
even on the most advanced drawing boards.
Major Callender also pointed out that the Medical Department of the Army
was in far better position to conduct a medical museum than was any other
government service or an independent organization. "This is true," he said,
THE INSTITUTE IDEA 205
"for preventive medicine and hygiene, as well as for pathology. Army officers
have, since the advent of modern means of disease control, led the field in pre-
ventive medicine and hygiene. This work is largely a development of the last
25 years and was first brought to notice by Reed. It has since been ably continued
by Gorgas, Ashburn, Russell, Craig, and scores of others * * *." The compara-
tive richness of the results of Army medical research was attributed, in part, to
the fact that "the civilian profession, while frequently establishing the principles
used as a basis for disease control, lack the opportunity to prove their worth
which are offered the military by reason of the latter's contract with bodies of
troops under discipline."
The Medical Department of the Army, moreover, "by reason of its control
over 1,400 officers, including dental, veterinary and administrative corps, is in
a more favorable position to collect material illustrating disease conditions.
Thus, it can direct the collection of pathological and other material as it now does
disease bearing insects and thus obtain results impossible for an independent
institution without the expenditure of enormous sums of money and the sending
of details of scientific men to all parts of the globe."
Balancing various considerations, without closing the door on any of the
suggested plans, Major Callender concluded that under any plan of organization
there still would be need for a museum aimed at both educating the lay public
in preventive and hygienic measures and also at the further education of medical
personnel. "I believe that eventually there will be a large national medical
museum," he said in his memorandum for The Surgeon General, "and I am sure
that the military medical aspects of such a museum must be an integral part
of the Army Medical School. Otherwise it will be a curio shop appealing only
to morbid interest while its real value is purely educational for graduates in
medicine, more particularly officers of the Medical Department." 2
For yet another quarter of a century after Major Callender finished his first
tour of duty as Curator, the Museum would continue in its same quarters, com-
bining under one roof its functions as a place for professional study and research
and as a place for interesting and informing the lay public in matters medical.
But already, in the years just after the First World War, the differentiation in
objective and function was emerging. The Museum was becoming, more and
more, an Institute.
23 Memorandum, George R. Callender, Curator, for The Surgeon General, U.S. Army, 13 February 1922.
On file in historical records of AFIP.
CHAPTER XI
The Registry Movement
"The evolution of the pathology registries stands out as the most important
organizational development in American pathology," declared Brig. Gen. Elbert
DeCoursey, addressing the annual meeting of the American Academy of Oph-
thalmology and Otolaryngology in 1952. 1
When General DeCoursey, then the Director of the Armed Forces Institute
of Pathology, made his comment upon the importance of the registry movement,
there were 21 registries in successful operation, with many thousands of cases
registered and subject to the organized and systematic study of the manifesta-
tions of disease and trauma, with provision for regular periodic followup to
check on developments and responses to treatment.
In the 1920's, however, the registry movement was quite limited in scope,
being confined for the first 5 years to but two examples— the original arrange-
ment with the American Academy of Ophthalmology and Otolaryngology, set
up in 1921, and a second registry in lymphatic tumors, established in cooperation
with the American Association of Pathologists and Bacteriologists in 1925. Two
years later a third registry, in bladder tumors, was set up under the sponsorship
of the American Urological Association.
Succeeding Maj. George R. Callender as Curator of the Museum was another
native of Massachusetts and graduate of Tufts Medical College, Maj. James
Francis Coupal (fig. 66), who had been Assistant Curator under Callender.
He was to serve from 1922 to 1924, in which year he was appointed White House
physician during the administration of President Calvin Coolidge. Upon his
withdrawal from the Museum, Major Callender returned to serve as Curator
in the 5 years from 1924 to 1929.
During the administration of Major Coupal, a start was made toward a
reclassification of the contents of the Museum, using an adaptation of Dr. Maude
E. Abbott's modification of the Wyatt-Johnson museum classification.
1 DeCoursey, Elbert: The Atlases of Pathology. A symposium, presented at the Joint Session of the
57th Annual Session of the American Academy of Ophthalmology and Otolaryngology in Chicago, 12 17
October 1952, and reported in: Transactions of the American Academy of Ophthalmology and Otolaryngology
57: 15, 16, January-February 1953.
208
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 66. — Maj. James F. Coupal, thirteenth Curator of the Museum, 1922-1924.
Under the new system, the anatomical names and the pathological lesions
which produced disease and death were listed, with a number assigned to each
of the anatomical terms used. The numbers, listed in accordance with the
International List of Causes of Death, were used as a code. The code was cross-
filed, so that it was possible to locate specimens by their anatomical names, by
THE REGISTRY MOVEMENT 209
their pathological classifications, and by the names of their contributors. By
1924, the new system had been applied to 5,000 protocols, 4,000 gross pathological
specimens, and 4,500 miscellaneous items. 2
By the end of Major Calender's second tour of duty as Curator of the
Museum, in 1929, the original ophthalmic registry had accumulated 2,000
registered cases, while the two tumor registries had about 200 each. The regis-
tries, in Major Callender's opinion, were well established and had "reached that
stage of development and activity which makes necessary more professional,
technical and clerical work that can be given by the Army Medical Museum."
To find adequate support and to insure that there should be continuity
of policy in the registry movement, Major Callender took up with Dr. Ludwig
Hektoen, Chairman, Division of Medical Sciences of the National Research
Council, the matter of recognition of the registries as a joint activity of the
Council, the Museum, and the sponsoring professional societies. As a result,
and with the approval of the Council, the American Registry of Pathology was
formed, in 1930, by a committee headed by Dr. Howard T. Karsner (fig. 67)
of Cleveland as chairman and Major Callender as secretary. Other members of
the committee included : Dr. James Ewing of New York, Dr. Stanley P. Reimann
of Philadelphia, and Doctors Bowman C. Crowell, Harry S. Gradle, and Herman
L. Kretschmer of Chicago, all of whom had been active in promoting the
existing registries or were interested members of professional societies, such
as the associations combating cancer, who were naturally interested in the
project.
Objective of the Registry
The object of the American Registry of Pathology, which has grown to
include 27 specific specialty registries, as outlined by Major Callender, 3 is to
"collect data and specimens from patients, especially those with tumors, with
a view to accumulating a sufficient number of instances of each disease to
determine its characteristic course, the criteria for diagnosis, and to evaluate
methods of treatment * * *. The cases preferred are those living at the
time of registration, and that can be followed so that the outcome may be
ascertained. The following up of these cases will constitute a considerable and
important part of the Registry's activities."
= Coupal, James F.: Modification of the Wyatt-Johnson Museum Classification in Use at the Army
Medical Museum, Washington, D.C. International Association of Medical Museums Bulletin X, Apnl 1924,
PP ' ^CaUcnder, George R.: Report of Committee on Ophthalmic and Oto-Laryngic Pathology, 35th
Annual Meeting of the American Academy of Ophthalmology and Otolaryngology. Transaction;
American Academy of Ophthalmology and Otolaryngology, 193°. PP- 53 0_ 535-
210
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 67. — Dr. Howard T. Karsner, pre-eminent pathologist who throughout the
years, has been a discerning critic, a firm friend, and a staunch supporter of the Medical
Museum and its offspring, the Armed Forces Institute of Pathology.
Diagnosis in the early stages of disease "offers the best chance of cure,"
Major Callender said, but early and accurate diagnosis is not possible in the
absence of opportunity to observe enough cases to form a basis for reasonable
THE REGISTRY MOVEMENT 211
judgments. Except at large medical centers, there were too few cases of any one
kind to afford such opportunity for study. By combining cases from the coun-
try as a whole, Major Callender observed, "It will be possible to obtain con-
siderable numbers of cases and specimens in a much shorter time."
The Registry was not intended to replace the local pathologist and would
"never serve as a diagnostic laboratory." Rather, it was to be "a clearing house
in pathology to which will be sent cases already diagnosed and the obscure
cases about which more can be learned by obtaining the opinions of several
pathologists. In addition, by sending 'follow-up' letters to the physician regis-
tering cases, the Registry will be a means of helpful stimulation."
The success attained by the three registries already in operation when the
American Registry was formed, had "been obtained in spite of a minimum of
publicity effort because there has been insufficient personnel at the Army Medical
Museum to conduct larger collections. As the registries have become better
known, the 'follow-up' work alone is more than can be handled adequately in
the time of the Museum personnel available for it."
"The expense of these registries has thus far been borne entirely by the
Museum, whose entire budget, inclusive of all personnel and upkeep of plant,
is about $30,000. The expense for materials and equipment for the proposed
registry can be handled by the Museum," he added, "but it is necessary to have
additional help in the form of professional, clerical and technical personnel."
Other activities of the Museum personnel included the handling of the
tissues and histories of all cases of tumor or suspected tumor in the Army, and
the review of the protocols of all Army necropsies, numbering about 800 a year. 4
With a staff of but one medical officer, two medical technicians, one sten-
ographer, and one typist, it was obvious that additional help must be had if the
registries were to realize their full potential. Another obstacle to securing con-
tinuity of policy was the fact that the officer personnel on duty at the Museum
was shifted every 4 years, usually, and in many cases after even shorter periods.
In his outline of the operations and potentialities of the American Registry
of Pathology, Major Callender paid particular attention to the possibilities offered
by the registry in the earlier diagnosis of malignant growths. "It is generally
acknowledged by pathologists," he said in his 1930 outline > " that many neo P lasms
are difficult to diagnose. * * * The earliest changes which signify malignancy
are not sharply defined. In fact, there is serious doubt if we know by sight the
earliest malignant changes in any tissue. Unless cases are followed up we cannot
* Army Regulations No. 40-410, 18 January 1922. paragraphs 19. 2".
713-028*— 64 16
2I2 ARMED FORCES INSTITUTE OF PATHOLOGY
learn these changes. Even if a definite cause for cancer should be found, it will
still be necessary to recognize the earliest change indicating its presence."
In his outline of the American Registry of Pathology, he referred to the
project for a new building for the Museum and the Library at the Army Medical
Center, adjacent to the Walter Reed General Hospital as "being before the
Bureau of the Budget. In the new building, as contemplated, there will be rooms
available for research by scientists not on the Museum staff. Laboratory facilities
will be available and all collections of the Museum will be more accessible for
research."
The dream of the new building was not to come to fruition for yet another
quarter of a century after the American Registry of Pathology was set up by
the National Research Council, an agency of the National Academy of Sciences,
which was authorized to receive and administer any funds contributed to the
Registry. Through the channel thus opened, the medical specialty societies
could conveniently make financial contributions to the work of the Museum in
pathology.
Organized Civilian Cooperation
These contributions have continued over the years, but the greater contribu-
tion by far has been the active cooperation of the specialists in the registry work
in what has been aptly called an "effective synergism." 5 The way in which the
Museum and the civilian specialists worked together was well described in the
1927 report of Maj. Gen. Merritte W. Ireland, The Surgeon General of the Army,
as follows:
In the operation of a registry, case reports accompanied by specimens are sent in to
the registrar. Slides of the specimen are prepared, and when the diagnosis is in doubt the
entire case is circulated to a group of pathologists. The diagnoses furnished are studied
and the case is classified by the registrar in cooperation with a committee appointed by the
society conducting the registry. In so far as possible, only cases living at the time of regis-
tration are accepted and every case is followed to its conclusion. In this way large numbers
of cases are brought together, followed by subsequent reports to their decease, and classified
and studied to determine the character of the disease process, the course of the disease, and
to evaluate the methods of treatment.
The emphasis of the registries, it will be noted, was on living cases to be
followed to the end rather than on specimens resulting from post mortem cases
important as they are. "The registries," said the 1927 report of The Surgeon
5 Dart, Raymond O.: The Army Medical Museum. International Association of Medical Museums
Bulletin 27: 13, 1947.
THE REGISTERY MOVEMENT
2I 3
T5he
MEDICAL DEPARTMENT
OF THE UNITED STATES ARM?
IX THE WORLD WAR
VOLUME XII
n;\ hi- nil ACI IK RESPIRATORY
ISES, AND "i
LOWING WAR WOI NDS
Figure 68.— Title page and an illustration from volume XII of "The Medical Depart-
ment of the United States Army in the World War." The illustration shows the lung in
a case of pneumonia following influenza.
General, "are the source of the most valuable material now being received, and
the museum is fortunate in being chosen to conduct them." Since the registries
had been "accepted as offering the greatest aid in determining the best method
of reducing the mortality from malignant disease," it was confidently predicted
that "registries in other lines will follow as the years go by." (
Six years were to go by, however, before another registry was established-
years in which Major Callender was to complete his second tour of duty at the
Museum, in 1929, to be succeeded by Maj. James Earle Ash, whose first tour of
duty covered the years to 1931 and who, in turn, was to be succeeded by Maj.
Paul Edgar McNabb, who served until 1933 when Maj. Virgil Heath Cornell
became Curator.
The year 1929 was marked by the publication of volume XII of "The Medical
Department of the United States Army in the World War" (fig. 68), which
dealt with the two subjects chosen as the most important conditions of the war
from the standpoint of pathology. The first section of the work, "Pathology of
° Annual Report of the Surgeon General, U.S. Army, 1927. PP- 22, < 222 '
2I4 ARMED FORCES INSTITUTE OF PATHOLOGY
the Acute Respiratory Diseases" was written by Major Callender; the second
section, "Pathology of Gas Gangrene Following War Wounds," by Maj. James
F. Coupal, former Curator of the Museum. The richly illustrated volume, with
24 plates in lifelike color and 312 black-and-white pictures, was based to a large
extent on material in the Medical Museum, and made use of the photography
and artwork produced by the Museum staff, including Maj. Theodore Bitterman,
S.C., Capt. R. W. French, Inf., and Messrs. Roy M. Reeve, F. E. Prior, Garnet
Jex, L. W. Ambrogi, Walter Parker, and Edward V. McCarten, to whom grate-
ful acknowledgement was made.'
Major Callender's successor, Major Ash (fig. 69), was a native of Philadel-
phia and a medical graduate of the University of Pennsylvania. His 6 years of
postgraduate experience in various hospitals had been supplemented by study
in Vienna, where the young doctor and his slightly older colleague, Howard T.
Karsner, both men destined to distinction, worked at the State Therapeutic
Institute. Upon his return to the United States, Dr. Ash served 3 years on the
staff of the Harvard University Medical School. There he became interested in
tropical diseases — an interest which turned him to the Medical Department of
the U.S. Army, which was outstanding in that field. He was commissioned in
the Medical Corps in 1916.
On his second tour of duty at the Museum, from 1937 to 1947, he was to
become known as the principal protagonist of the spreading registry movement,
but during his first tour, 1929 to 1931, there was no further increase in the roster
of registries. This may be partially accounted for by the "greatly increased"
work of the Museum staff in the fields of diagnosis and consultation, following
the issuance of The Surgeon General's Circular Letter No. 2, on 12 February 1929.
Histopathology and the Museum
This circular called to the attention of all Medical Department officers the
fourfold functions of the Museum with reference to tissue pathology. These
were, the letter said, "to obtain material for instruction and research ; to preserve
material permanently for reference purposes; to act as a consulting service; to
examine and diagnose surgical, biopsy, and autopsy material for stations at which
adequate laboratory facilities and personnel for such diagnostic work are not
available." The cooperation of all medical officers in selecting and sending in
to the Museum "specimens presenting interesting pathological conditions" was
urged, but the greater stress was laid on the diagnostic and consulting functions.
7 The Medical Department of the United States Army in the World War. Washington: U.S. Govern-
ment Printing Office, 1929, volume XII, pp. v, vi.
THE REGISTRY MOVEMENT
2I 5
Figure 69.— Col. James E. Ash, fifteenth Curator, 1929-1931; twentieth Curator, 1937-1946;
and first Director, Army Institute of Pathology, 1946-1947.
The availability of this diagnostic service at the Museum "apparently is not fully
appreciated by the surgeons of all military hospitals," the letter said, in announc-
ing that certain hospitals had been designated as centers to which selected por-
tions of tissue might be sent for emergency diagnosis "when the best interests ot
2l6 ARMED FORCES INSTITUTE OF PATHOLOGY
the patient necessitate a microscopical diagnosis at the earliest possible moment
and local facilities for such diagnostic work are not available."
The hospitals so designated were Letterman General Hospital, for the IX
Corps area; William Beaumont General Hospital and the Station Hospital at
Fort Sam Houston, for the VIII Corps area; Fitzsimons General Hospital, for
the VII Corps area; and the Army Medical Museum itself for the I through the
VI Corps areas. The officer making the diagnosis was instructed to report by
telegraph or radio when, in his judgment, such a course was required. In all
cases, specimens were to be furnished to the Museum, together with a copy of the
report. Explicit instructions were given for the preparation and shipment of
specimens and the writing of autopsy protocols, all of which were to enter the
collections of the Medical Museum for final study, review, and preservation.
Inescapable Housekeeping
"There is an enormous amount of work that should be done in rearranging
exhibits and developing the material already on hand," said the annual report
of the Surgeon General for 1929, "but it must be put aside for the more urgent
current demands" of the consultation and diagnostic service which, as the
Museum's most important function, "has precedence over all other activities." 8
Although the diagnostic and consultation functions of the Museum had
first precedence, there were always inescapable housekeeping chores to be
attended to. The Museum's material, stored in the basement, was surveyed,
and the portions which had deteriorated and become useless were disposed of.
The cleanup was hampered by the chronic shortage of personnel. The task
of sorting material, and especially the "enormous amount of facio-maxillary
material which had accumulated during the few years after the war" was
perhaps made simpler by the adoption, in 1930, of straight alphabetical index-
ing, which was described as "much simpler and more efficient" than the numer-
ical system of coding adopted in the years just after World War I. Even though
there were no new registries set up, "active interest" in the three existing ones
was continued. In fact, nearly one-third of all accessions in 1930 were contrib-
uted through the route of the registries. 9
In the fall of 1931, Major McNabb (fig. 70) succeeded Major Ash as
Curator of the Museum. The new Curator, a native of Tennessee, received
his M.D. degree at the University of Pennsylvania. His Army service had
8 Annual Report of the Surgeon General, U.S. Army, 1929, p. 267.
'Annual Report of the Surgeon General, U.S. Army, 1930, pp. 271-273.
THE REGISTRY MOVEMENT
217
Figure 70.— Maj. Paul E. McNabb, sixteenth Curator of the Museum, i93i- : 933-
included tours of duty in the Canal Zone and the Philippines, where he had
been president of the Army Medical Research Board.
During Major McNabb's administration, the photographic section of the
Museum was particularly active in color photography of both gross and micro-
scopic specimens for museum display and also for lantern-slide demonstration.
2l8 ARMED FORCES INSTITUTE OF PATHOLOGY
There had been earlier efforts at the Museum to produce true color reproduc-
tions of pathological specimens, as reported by Major Callender, Major Coupal,
and Mr. F. E. Prior, in an article published in Bulletin No. X of the International
Association of Medical Museums. Effective results were produced by a method
which involved accurate photographic prints which were colored by hand, with
the resulting picture reproduced by lithography. The 1932 experiment, carried
on by Roy M. Reeve, photographer for the Museum, and Joseph Carter of the
U.S. Department of Agriculture, sought to secure correct coloring by making
three color separation negatives, from which prints were made in blue, red, and
yellow. The prints were superimposed upon one another, checked for accurate
registration, and true color values, corrected by differential printing of the three
images, and then mounted — yellow image first, red second, and blue third, to
complete the picture. The Reeve-Carter process produced effective color prints,
even though it required much patience and a high degree of manipulative
skills, and was a distinct advance in the development of today's simpler and
more rapid systems of producing photographs in color. 10
The Museum at Threescore Years and Ten
In 1932, the 70th year of the existence of the Army Medical Museum,
its exhibits were viewed by 67,689 visitors. Because of a lack of space, only
about half its collections could be placed on exhibition. The collections "com-
bined exhibits of historical value and interest to the Medical Corps of the
Army, to the medical profession at large, and to the general public." There
was, however, a "great volume of material of a purely pathological character"—
for it could never be forgotten that the Museum was, above all else, "the active
central unit of pathology in the Army." As such, it received, in its 70th year,
protocols and specimens from nearly 1,000 autopsies performed at Army hos-
pitals, representing more than 56 percent of all deaths in these hospitals. 11
Major McNabb was succeeded as Curator by Maj. Virgil H. Cornell in
IQ 33 (fig- 7 1 )- The new Curator was a native of Brooklyn and received his
medical degree at the Long Island College of Medicine in 1913. Thirty years
later, after serving as pathologist and chief of the laboratory service at major
10 (1) Callender, G. R., Coupal, J. F., and Prior, F. E.: True Color Reproduction of Pathological
Specimens. International Association of Medical Museums Bulletin X, April 1924, pp. 38-41. (2) Reeve
Roy M.: Color Photography in the Medical Museum. Journal of Technical Methods and Bulletin of the
International Association of Medical Museums 19: 12-19 October 1939. (3) Reeve, Roy M.: Color Prints
by the Carter-Reeve Color Process. The Journal of the Biological Photographic Association 4 - 132-136
1936.
11 Memorandum, Maj. P. E. McNabb, for The Surgeon General, U.S. Army, 1932. On file in
historical records of AFIP.
THE REGISTRY MOVEMENT
219
Ficure 71.— Maj. Virgil H. Cornell, seventeenth Curator of the Museum, 1933-1935-
Army posts, including service in both World Wars, Major Cornell received
from Harvard University the degree of doctor of public health. His Army
service is further memorialized in the name of the Cornell Laboratory, the
special section of the Medical Museum set aside for the use of medical research
workers.
220 ARMED FORCES INSTITUTE OF PATHOLOGY
The Dental and Oral Registry
Major Cornell's administration as Curator was signalized by the establish-
ment, in 1933, of the fourth of the registries and the first to be set up as a part
of the American Registry of Pathology. The Dental and Oral Pathology
Registry added in 1933 was, in a sense, a reactivation of the arrangement of
1895 under which the American Dental Association designated the Museum
as the national depository for its dental and oral specimens and materials.
Since this designation, there had been periods of activity, and also of inactivity,
in carrying out the plan for the deposit of material in the museum. The action
taken in 1933 contemplated a different and more active participation of the
dental profession in the development of a full-fledged registry, with the work-
ing support of a committee of the American Dental Association, headed by
Dr. Henry A. Swanson of Washington.
By the end of 1936, the Dental and Oral Pathology Registry had a total
of 483 accessions, many of which had been transferred to it from the materials
already collected in connection with the earlier registries. The dental registry,
however, was not yet "actually functioning" to the same degree of activity as
the other registries, even though there had been an official relationship between
the Museum and the organized dental profession for 40 years.
In a mimeographed statement, undated but apparently issued in 1939,
when there were 808 cases in the Registry, the purposes and intentions of the
committee of the Dental Association cooperating with the Museum were out-
lined along general lines. It was intended to "collect material from, and com-
pile data appertaining to, the pathological disturbances of the hard and soft
tissues of the oral cavity * * *. All cases of definite or suspected malignancy
* * * will be followed by annual inquiry addressed to the contributor for a
period of five years." The purpose of the Registry was to furnish consultation
service in such cases as could not be diagnosed locally, and to prepare loan
collections consisting of microscopic preparations, photographs, lantern slides,
and other material of illustrative cases for use in dental schools, societies, and
study clubs. It was the expressed desire of the committee to enlarge and
modernize the dental exhibit of the Museum "so that it will be of interest,
educational value and historic record second to none." 12
"Ash, James E.: Data for the Preparation of Statement Requested by Dr. E. H. Bruening, undated.
On file in historical records of AFIP.
THE REGISTRY MOVEMENT 221
More Registries Formed
Whether because of this appeal for more active cooperation on the part
of the profession, or because of the general pickup in military activity following
the near collapse of Allied defenses in Europe, the number of new cases received
in the Dental and Oral Pathology Registry went up from 95, which it was in
1938, 13 to 226 in 1939, and to 692 in 1940 — a sevenfold increase in 2 years.
While the dental and oral section of the American Registry was over-
coming the degree of indifference which it met at the outset, two other reg-
istries were being successfully launched. In 1935, the ear, nose, and throat
cases in the original combined ophthalmic and laryngic registry were separated
to become the Registry of Otolaryngic Pathology, under the sponsorship of the
Academy which had started the registry system at the Museum.
The addition of two more registries was reported in 1937— a Tumor Reg-
istry sponsored by the American Society of Clinical Pathologists, and one in
Dermal Pathology sponsored by the American Dermatological Association
and now under the sponsorship of the American Academy of Dermatology
and Syphilology. With these additions to the list, it appeared to Surgeon
General Charles R. Reynolds that "practically all the special fields are covered
except neuropathology, and it is possible that this will be taken care of in the
near future." "
The Surgeon General underestimated the extent to which subdivision of
specialties would be carried in the next two decades, as well as the range of
additional fields in which pathology would be found basically useful. Neuro-
pathology was indeed "taken care of" in the formation of a registry in 1942,
jointly sponsored by the American Association of Neuropathologists and the
American Psychiartic Association.
The registries in tumors, originally limited to the lymphatic tumors and
those of the bladder, evolved into a total of six tumor registries through the
addition of those on Kidney Tumors (1938), Prostatic Tumors (1943), and
Testicular Tumors (1959), all sponsored by the American Urological Associa-
tion; and that on Chest Tumors (1940), sponsored by the American Association
for Thoracic Surgery.
In the field of pathology of particular organs, areas, and systems there are,
in addition to the registries already mentioned, registries covering Orthopedic
Pathology (1943), the Female Reproductive System (i95 2 )> and the Gastr °-
"Annual Report or the Surgeon General, U.S. Army, 1938. P- l % 2 -
" (1) Idem. (2) Annual Report of the Surgeon General, U.S. Army, 1937. P- «7>
222 ARMED FORCES INSTITUTE OF PATHOLOGY
intestinal Tract (1952), all sponsored by the American Society of Clinical
Pathologists; Genitourinary Pathology (1947), sponsored by the American
Urological Association; Cardiovascular Pathology (1948), with the American
Heart Association as sponsor; Hepatic Pathology (1949), under the sponsorship
of the American Gastroenterological Society; Pediatric Pathology (1956), with
the American Academy of Pediatrics as sponsor; and one of Endocrine Pathol-
ogy, organized in 1948 and currently unsponsored.
In the broader fields of function and treatments, registries are found in
Gerontology (1945), sponsored by the Gerontological Society; Radiologic Pa-
thology (1947), jointly sponsored by the American College of Radiology, the
American Roentgen Ray Society, and the Radiological Society of North Amer-
ica; and Nutritional Pathology (1951), sponsored by the American Institute
of Nutrition.
The field of veterinary pathology is covered by a registry organized in
1944, with the American Veterinary Medical Association as sponsor (fig. 72).
The specific disease of leprosy is the field of a registry, formed in 1950, under
the sponsorship of the Leonard Wood Memorial. Most recent in the roster
of registries are the ones on Forensic Pathology, formed in 1958, with the
College of American Pathologists as sponsor and two formed in the centennial
year of 1962 — one on Radiation Pathology, under the sponsorship of the U.S.
Public Health Service, and another on Geographic Pathology, sponsored by
the International Academy of Pathology. Both new registries were formed
to meet the increasing need for accurate information as to radiation, in the one
case, and as to diseases which may be encountered in lands other than the
United States, particularly those in the Tropics.
The registries are a living link between the practitioners of the various
medical specialties and the staff of the Museum and its successor organiza-
tions — first the Army, and then the Armed Forces Institute of Pathology, in
the consultation, education, and research which are their common objectives.
Publications of the Registries
Brig. Gen. George R. Callender, in whose curatorship at the Museum the
first of these links was forged, paid tribute to the civilian pathologists who,
in the early days of the Registry, "taught the staff Ophthalmic Pathology, in
which at the start we were profoundly ignorant." 15 The teaching process
15 Callender, George R., Transactions of the American Academy of Ophthalmology and Otolaryn-
gology, 57 (1953). P- 15-
THE REGISTRY MOVEMENT
223
Figure 72.— Maj. T. C. Jones, VC, Registrar, Registry of Veterinary Pathology, Army
Institute of Pathology.
worked both ways, with the Museum staff providing study materials for loan
to responsible individuals and sets of lantern slides for group teaching. A
combination of group and individual instruction were the seminars conducted
for several years by the American Society of Clinical Pathologists for which
the Institute of Pathology furnished, upon occasion, as many as 37,000 micro-
scopic slides in sets of 25 slides to each of about 1,500 participants in the
program. 16
From these loan sets of slides, the Museum evolved the atlases which were
to become one of the strongest ties between the pathologists of the armed serv-
ices and the medical profession. In addition to the "Atlas of Tumor Pathology,"
the Registry has published an "Atlas of Angiocardiography" dealing with ob-
servation of the heart and great vessels after intravenous injection of an opaque
liquid, and an "Atlas of X-Ray Myelography" dealing with X-ray examination
"DeCoursev, Elbert, Transactions of the American Academy of Ophthalmology and Otolaryngology,
57 (1953). P- '6-
22 . ARMED FORCES INSTITUTE OF PATHOLOGY
of the spinal cord. Other publications of the Registry include syllabuses on
various disease conditions, issued in connection with courses of instruction.
Most of the publications have gone through more than one edition, with
revisions and reprinting. "Our original atlases were rather primitive," said
Colonel Ash in the course of reminiscent remarks at the 1952 session of the
American Academy of Ophthalmology and Otolaryngology. The pages of
the first editions were mimeographed and had as illustrations actual photographs
instead of printed reproductions. This limited the editions to about 100 copies
of each. "I remember so well the job it was to collate the pages," said Colonel
Ash. "We had the pages in a series of pigeonholes on the balcony of the old
Museum and it was the habit of the few of us who were then at the Museum
to stop and collate a book or two on our way back from the rest rooms on the
first floor."
Continuing, Colonel Ash said that "after this initial effort of using photo-
graphs, we did manage to acquire a little offset reproducing machine with
which the second edition was run off * * *. All the time, however, we had
in mind atlases that were more comprehensive professionally and technically
less amateurish."
Advantages of the Registry System
Speaking from his long experience with the Registry system, Colonel Ash
expressed the conviction that "registries, properly sponsored and properly ad-
ministered, can be very potent factors in education, in research, and in the
advancement of the various clinical specialties."
Speaking as a general pathologist, the colonel declared that "much of the
pathology of several of the specialties has been developed by clinical specialists
frequently not too well grounded in general pathology. On the other hand,
general pathologists have very little notion of the eye pathology and not too
much of skin, bone, teeth, and so on. Well, it is our idea that with these very
specialized activities at the Institute we have helped the specialist in the pathol-
ogy of his field, but at the same time have importantly stimulated the general
pathologist to an interest in these special fields."
Colonel Ash was speaking 30 years after the organization, by General
Callender, of the first of the Museum's registries. In those years, 22 registries
had been formed. Others were to be added in the decade which followed,
bringing the total to 27 at the close of the first century of the life of the Museum
and its successor, the Institute. The value of the Registry as an essential part
of the activities of the Institute has been abundantly proved by the better
THE REGISTERY MOVEMENT 225
understanding it has fostered between pathologist and clinical specialist and
between civilian and military medicine. "Medicine," as Colonel Ash con-
cluded, "owes a great debt to this Academy for being the pioneer in this activity.
We should honor Dr. Gradle and General Callender for fostering the idea in
its early stages. It has been a great privilege of the Institute and of the Army
to have participated in it." 17
"Ash, James E., Transactions 0} the American Academy of Ophthalmology and Otolaryngology, 57
(1953). PP- 18. 19-
CHAPTER XII
Between the Wars
Chronic difficulties of too little space and too small a staff continued to
plague the operation of the Army Medical Museum in the years between the
1918 armistice and Hitler's invasion of Poland, 21 years later.
"The rapid accumulation of materials * * * burdened the museum staff
with the labor of preparation" of specimens for several years after the First
World War, said Maj. Virgil H. Cornell, addressing the International Association
of Medical Museums at its meeting in Washington in May 1933. The combina-
tion of the volume of materials for display and the shortage of space had tended
to bring about overcrowding of the exhibits, particularly since, "anticipation of
the early erection of a new museum had led to the postponement of rearrange-
ment" of materials in the existing building. By 1933, it had become apparent
that the new building for which a site had been purchased 11 years earlier was,
like many another hopeful project, a victim of the great depression. "In view
of a rather indefinite postponement of any new construction," Major Cornell
added, "we are attempting to improve the material accumulated with what
facilities are at hand. Though no progress has yet been made in the new group-
ing of exhibits, it is none too early to begin the assembling of materials so that
it may be ready for transfer in group arrangement to the new museum when that
time comes."
The time when such a transfer and rearrangement was to be made was not
to come about until after two wars, three temporary homes, and four removals
of the Museum, so that it is no wonder that the idea of making ready in 1933 for
an anticipated move to a new building might, in Major Cornell's words, "sound
overoptimistic." But, he added, in extenuation of his seeming overoptimism,
"we have lived too long in an atmosphere of pessimism, so it is time to reverse
the trend." x
In the discussion which followed Major Cornell's presentation of the current
activities of the Museum, Dr. Howard T. Karsner of Cleveland, professor of
Cornell, V. H.: Current Activities at the Army Medical Museum. Typewritten memorandum for
remarks at International Association of Medical Museums Meeting, 13 May 1933. » °" file "> histor.cal
records of AFIP. Published in: International Association of Medical Museums Bulletin 13: 183-185. 1934.
22 g ARMED FORCES INSTITUTE OF PATHOLOGY
pathology at Western Reserve University, declared that it demonstrated what
could be done by the U.S. Army Medical Corps "in the face of most distressing
conditions."
The oral presentation by the Curator was backed up by a tour of the
Museum, in which the members of the Association had an opportunity to see
in actual use the methods of mounting, lighting, and display which had been
presented and discussed earlier in the day. The tour, according to the minutes
of the Association, afforded "an extremely interesting and valuable time * * *
in the examination of the treasures and resources of this great Collection." "
Deterioration at the DAuseum
The collections of the Museum were indeed great, but there can be no doubt
that by the early 1930's, as a result of restricted space and reduced staff, they had
deteriorated relatively, if not absolutely.
This was made plain in a special report to The Surgeon General of the Army
by Maj. (later Brig. Gen.) Raymond Osborne Dart (fig. 73), who had served
as Major Cornell's Assistant Curator and who succeeded him. The new Curator
was a native of Kansas, who received his academic education in the University
of that State and took his medical degree at Rush Medical College of the Uni-
versity of Chicago. He entered the Army in 1917, and started his first tour of
duty as Curator of the Museum in 1935. Before his second tour of duty with the
Museum ended, he was to affect profoundly its organization and direction.
The purpose of Major Dart's special report of 19 July 1935 was to point out
and make "recommendations for the correction of defects in the organization
which have seriously handicapped the successful operation of the institution in
the past." Continuing, he wrote:
It is an easily verified fact that the Army Medical Museum has slipped steadily back-
ward from the first rank of medical museums which it occupied immediately after the
World War until it is no longer regarded as an important place for the dissemination of
information concerning museum technique and display. Meanwhile the very fundamentals
of museum display have been changed and other institutions have assumed the leadership
in this field which was formerly held by the Army Medical Museum. The reasons for
this state of affairs are quite obvious when one considers the history of the organization
during the past few years. 3
"Ibid., pp. 184, 185.
3 Maj. R. O. Dart's report, 19 July 1935, Surgeon General's Office file number 024.9 (Army Medical
Museum and Library). On file in historical records of AFIP.
BETWEEN THE WARS
229
Figure 73.-Brig. Gen. Raymond O. Dart, eighteenth Curator of the Museum,
1935-1936; second Director, Army Institute of Pathology, m^W, and first Direc-
tor, Armed Forces Institute of Pathology, 1949-1950.
Taking up in turn the "four chief non-professional departments," he out-
lined their condition and described its effects upon the professional work of
pathology and scientific research.
2 , ARMED FORCES INSTITUTE OF PATHOLOGY
The "department of museum display and gross technique" was, he said,
the "most important non-professional department" and the one which had
"gravitated to the lowest level of all." He continued :
From 1919 to 1922 this department was in charge of Captain C. F. Silvester, Infty
(Res), an excellently trained technician and administrator. During this period he not only
supervised the preparation and display of a large amount of war material but published
many articles on museum technique of such importance that the Army Medical Museum
enjoyed an eviable position of leadership in this field. Since that time the work of this
department has been done by a succession of enlisted men from the detachment at Walter
Reed General Hospital or the Army Medical School who have been detailed temporarily
to the Army Medical Museum for this purpose. Desultory efforts to supervise this work
have been made by the Curator and his assistants when time could be spared from other
duties, but only the mounting of rare and important specimens could be given this atten-
tion and all others requiring more than the simplest technique have of necessity been
either destroyed or dumped in large vats in duplicate storage. 4
Inadequate Space J Insufficient Personnel
Even this attenuated attention to museum display had been further diluted
by reduction in staff from three enlisted men to one, who was due to retire for
age in a few weeks, with no trained replacement on hand. In the circumstances,
preparation of special exhibits for display in the building and at various scientific
meetings was "taking many hours of time from the more important duties of
the curator and his assistants" and the "undertaking of modernizing the general
museum exhibit" was "out of the question."
On the clerical and administrative side, the loss of Capt. Theodore Bitter-
man, principal clerk, through retirement in 1931 without replacement, "was
probably the most serious handicap to the successful administration of the
museum." The loss of this experienced administrator had imposed upon the
Curator multitudinous details requiring attention.
The Department of Photography, headed by Roy M. Reeve, was "inade-
quately staffed by a succession of enlisted men of the Medical Department who
as soon as they have become sufficiently trained to be of any real help in the
advancement of the department have either been transferred elsewhere or have
accepted more remunerative positions with civilian institutions." Mr. Reeve's
advances in the field of color photography, keeping up the tradition of leadership
in the photographic arts established by Dr. Joseph J. Woodward and Dr. Edward
'Among the published articles of Capt. Charles F. Silvester were: (i) Mounting War Collections at the
Army Medical Museum. International Association of Medical Museums Bulletin, pp. 49-53, December 1022
(2) Typewriting Labels on Museum Jars. International Association of Medical Museums Bulletin, pp. 83-86
December 1922.
BETWEEN THE WARS 23 1
Curtis, and carried on by Dr. William M. Gray, had been done, Major Dart
noted, "entirely after office hours and on Sundays and holidays," since routine
official duties had "occupied his entire government time."
The Department of Histology, except for the loss of personnel, had "main-
tained its former status," largely because of the publications and contacts of
Mrs. Helenor Wilder and the training which she had given the other members of
this unit.
Comparing the period of 1924-26 with 1932-34, and taking the average
number of accessions as a fair index of the volume of work accomplished, the
special report found that the average had been 2,666 per year in the later period
as against 1,990 per year for the earlier. The difference was widened by the fact
that approximately 1,200 per year of the earlier accessions were not new cases
but simply re-accessions from the old museum, requiring only the paperwork of
entering them in the modern system of classification, while in the later period,
lack of personnel had precluded the work of re-accessioning, so that the accession
figures represented new cases, the majority of which were specimens sent in for
diagnosis. The actual work in the 1930's was nearly double that in the period
in the 1920's, while the personnel had been reduced from 31 to 21 in all categories.
Major Dart continued:
This is an insufficient number to carry on more than the routine and consequently
the work on large projects essential to the orderly classification of the museum which have
been started in previous years from time to time have been stopped and a large part of the
vast museum collection still remains in a hopeless muddle. The very building has degen-
erated into a shambles of cobwebs and dirt, filled with antique furniture and the debris of
worn out equipment and broken exhibits.
Working Under Handicaps
The state of affairs in the Museum proper, characterized as a "breakdown,"
imposed such a handicap upon the work of the Curator and his professional
assistants that they were able to accomplish the routine padiology only with
difficulty and had "little time" for the "scientific research with which the officers
on duty at the museum are charged by regulation."
Major Dart's views on the state of the Museum were shared in large degree
by his successor, Capt. Hugh Richmond Gilmore, Jr. (fig. 74) » who served
as Acting Curator for a few months in 1935 and 1936. In a memorandum of 5
August 1936, for The Surgeon General, Captain Gilmore made the point
that between 1926 and 1936 the volume of work in the institution had increased
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 74. — Capt. Hugh R. Gilmore, Jr., nineteenth Curator of the Museum,
I 935" I 937-
50 percent while the size of the civilian staff had decreased by almost the same
percentage.
"Due to this decrease in civilian personnel the Museum exhibits have not
been kept up to date," he wrote. "Instead of being a leader in its field the Army
BETWEEN THE WARS 233
Medical Museum is rapidly becoming nothing but a storehouse of poorly ar-
ranged and poorly exhibited pathological specimens * * *. Also the
Museum's files and records are six months from being up to date."
The situation of Mr. Reeve, chief photographer and the only civilian em-
ployee in the department, was singled out. "If anything should happen to
him," the memorandum read, "the department would collapse." '
More restrained in their language, but much the same in import, were the
Annual Reports of The Surgeon General of the Army for this period in the
life of the Museum.
"The continued increase in routine pathological and administrative details
has again prevented renovation of the museum exhibits which has been needed
badly for a number of years," said Surgeon General Robert Urie Patterson
in his annual report for 1934. "The changes made in the main museum in
1933 have but accentuated the need for further work of this type * *.
An attempt to reduce and prevent overcrowding is continually being made but
the present quarters necessitate removal of some portion of present exhibits
when anything new is added." Personnel was not adequate, The Surgeon
General said, to permit the making of the studies which should be made.
In 1935, when the Museum was visited by 81,423 persons, the largest
number which had done so in any year up to that time, Surgeon General Charles
R. Reynolds spoke again of the great need for revision of the general museum,
but said that because of insufficient personnel it could not be done.'
The subject was discussed more at length in General Reynolds' report for
1936. "The routine pathology," he said, "is more than sufficient to fully occupy
all of the [time of the] officers regularly assigned to duty. However, in addi-
tion to the purely professional work, a large amount of time is required for the
administration of the museum, the proper conduct of the registries and in
teaching the course in pathology at the Army Medical School. All of the officers
are required to spend additional hours of duty in the institution and to take
part of the routine work to their homes to be done during the evenings and
on Saturday afternoons and Sundays. As a consequence, very little time can
be spent in the proper care and display of the permanent Museum exhibit."
Revision of the "entire exhibit on a modern basis" was "sorely needed," The
Surgeon General said, but shortage of trained technical personnel precluded such
a possibility.
•Memorandum, Capt. H. R. Gilmore, for The Surgeon General, 5 August 1936. On file in his
torical records of AFIP.
"Annual Report of the Surgeon General, U.S. Army, 1934. PP- '54. «57-
7 Annual Report of the Surgeon General, U.S. Army, 1935. P- '49-
2 , 4 ARMED FORCES INSTITUTE OF PATHOLOGY
The entire permanent exhibit, he said, "must be reviewed, relabeled, and
modernized as soon as funds and personnel are available * *. This
Museum must be rearranged so as to tell the story of disease as well as to display
its morbid processes. By so doing it would then become one of the greatest
teaching institutions in its field." s
The picture of the Museum, however, was not all dark. The photographic
department, which had been "functioning under the handicap of worn-out
equipment, leaky plumbing, and ineffective lighting" had been aided by the
installation of new sinks and the rearrangement of its layout.
The Edgar Bequest
New cases for better display of the Museum's great collection of microscopes
were procured, thanks to the William F. Edgar Bequest, a fund left to The
Surgeon General of the Army, to be expended for the benefit of the Medical
Museum and The Surgeon General's Library. The donor of the fund was
Dr. William F. Edgar who, in 1849, traveled overland by covered wagon from
the Missouri River to Oregon, and thence to California. There, in Los Angeles,
he prospered and accumulated a substantial estate. In a will drawn in July
1893, ne made the Museum and the Library co-sharers in the residue of his
estate, after the payment of numerous bequests to individuals and to charitable,
educational, and civic organizations. In 1894, by a codicil to his will, he had
changed the division of his bequest to The Surgeon General by providing that
the Museum should be the beneficiary of four-fifths and the Library of one-fifth
of the fund bequeathed. Dr. Edgar died in 1897, but his estate could not be
settled until after the termination of a life estate left to his widow. In 1931,
the trustees of the estate sought to make final settlement with the Army, but
this could not be done until after the Congress passed a joint resolution author-
izing acceptance of the bequest. This was not done until 1933, at which time
the bequest amounted to $18,309, and the four-fifths going to the Museum, to
$14,647. This amount was to be spent for equipment, supplies, and services
outlined in War Department General Orders No. 5, dated 8 May 1933, and
was to be "available until expended." The largest items of expenditure, by
far, were for new display cases, but the Edgar funds made it possible to meet
such peripheral expenses of the Museum-Institute as paying the inheritance
tax of the State of Pennsylvania on the portrait of Dr. John H. Brinton, the
first Curator, which was given to the Museum by Dr. Ward Brinton, his son.
Annual Report of the Surgeon General, U.S. Army, 1936, pp. 145, 147.
BETWEEN THE WARS
235
The fund dwindled over the years, as was inevitable, but it lasted for a quarter
of a century before its final extinction in 1958, after the last $42.51 had been
spent in December 1957."
Lt. Col. James E. Ash returned to the Museum in 1937 for a second tour
of duty as Curator — a post which he was to hold for 10 fruitful years. In the
first of these years, the Museum attracted more than 97,000 visitors, making it,
according to Surgeon General Reynolds' report for 1937, "one of the show
places of the Nation's capital" — to which he added the wry comment that it
was "about the shabbiest." The largest medical museum in the world "from
the standpoint of amount of material," the report said, "suffers considerably
by comparison with other museums in Washington, with their fine buildings
and modern equipment." l0
The status of the Museum as the Army's "clearing house for pathology"
and the "large number of cases sent into the various registries * * # ," said
the report, "require the constant application and considerable overtime effort
of the limited personnel to keep it moving at a reasonable pace. There is no
time for the study and investigation that this material warrants, and the
Museum itself can be given only perfunctory supervision." Many exhibits
needed revamping and a large percentage of the labels, some of them actually
illegible, needed replacing, but "with the present personnel it is possible to
make scarcely any appreciable progress in this rejuvenation."
Gaining Ground
Nevertheless, progress was made. The collection of microscopes, ophthal-
moscopes, hard-of-hearing aids, and stethoscopes — each collection as compre-
hensive as any to be found in the world — were exhibited to "much better
advantage than they have been heretofore," n using the new exhibit cases pur-
chased out of the Edgar Bequest. During 1938, the main museum room was
improved, the work being done by the staff using materials purchased from
the limited funds available. To relieve some of the overcrowding, several of
the old wooden exhibit cases were retired and the number of exhibits was
"Just what led Edgar to make the Army Medical Museum the principal beneficiary of his will does not
appear in the will and codicil thereto. Among his other bequests, however, there was one for ihe sons of
Surgeon General Robert Murray, which might indicate an interest on the part of Dr. Edgar in The Surgeon
General's office. Material on the Edgar Bequest is in the AFIP historical files, which contain legislative
and court proceedings, accounting records, and correspondence between The Surgeon General and the
trustees under the Edgar will. Uses made of the bequest are mentioned in the Annual Reports 'it the
Surgeon General, U.S. Army, for 1936, pp. 145, 146, and for 1937, P- >7°-
"Annual Report of the Surgeon General, U.S. Army, 193", PP- I7I-J7 2 -
11 Ibid., p. 170.
713-028'- — 64 17
6 ARMED FORCES INSTITUTE OF PATHOLOGY
reduced, it having been found that the display had a "greater appeal to the
laity if it is not confusingly overcrowded." The great bulk of the collections
were relegated to storage, but in such form that the material was always avail-
able for study. The Museum had taken its place "as one of the more popular
sights in Washington," having had, for the first time, more than 100,000 visitors
in a year. 12
Substantial evidences of ground gained were found in the number and
distinction of the medical collections given to the Museum in the years of its
resurgence (fig. 75). Important contributions during 1938 included a col-
lection of models, pictures, and actual specimens covering comprehensively
the history of appliances used in maxillofacial surgery, assembled by Dr. George
Morris Dorrance of Philadelphia, and described as "an unique collection of
great historic value"; a collection of historic and modern bronchoscopes and
esophagoscopes devised by Dr. Chevalier Jackson of Philadelphia and his son,
and of hundreds of foreign bodies removed by their use; a collection of models
and drawings developed in the postgraduate course in otolaryngology at the
Harvard Medical School under the supervision of Dr. Harris Peyton Mosher,
together with material representing Dr. Mosher's original research in diseases
of the esophagus; and several types of artificial larynxes, with which persons
who have lost their larynx can talk, presented by Dr. LeRoy Allan Schall of
Boston.
The most notable gift of this period was the world-famous Huntington
collection of anatomical material, perhaps the largest collection in the world in
its field. The collection had been gathered by Dr. George Sumner Huntington
of the College of Physicians and Surgeons of Columbia University, the first
full-time professor of anatomy in this country, in the years between 1889 and
his death in 1925. It includes some 5,000 specimens, illustrating the form, de-
velopment, and evolution of most parts of the body in many species, including
man. These specimens, presented to the Museum for display and study, were
an important educational resource of the Museum, particularly in the field of
comparative anatomy."
Prospects for a New Home
Still more encouraging for the days ahead was the passage by Congress of a
bill authorizing the Secretary of War to construct a new building to "replace
"Annual Report of the Surgeon General, U.S. Army, 1938, pp. 179, 181.
1:1 Memorandum. I.t. Col. J. E. Ash, for Colonel Harden, Surgeon General's Office. 5 January 1939,
Copy on file in historical records of AFIP.
BETWEEN THE WARS
^il
Figure 75 .-Maj. Harry A. Davis, after 28 years of military service, served the Museum
for 21 years, first as entomologist and later in historical work in the course of which he gave
special attention to the Museum's collections of medical instruments.
2 ,g ARMED FORCES INSTITUTE OF PATHOLOGY
the present Army Medical Library and Museum Building." The new building
was to be put up in the District of Columbia, on a site to be chosen after consulta-
tion with the National Capital Park and Planning Commission, and subject to
approval by the National Park Service. The total cost of the new building
was not to exceed $3,750,000, but the bill carried no appropriation for this or
any other amount."
The dream of a new building had persisted ever since Col. William O.
Owen's time as Curator, and even before. In earlier days, the dream was for a
building on the Washington Mall; in more recent times, as the great Army
Medical Center developed around the Walter Reed General Hospital, the
favored site had come to be one in the vicinity where, indeed, additional lands
had been purchased for the purpose of housing the Museum and Library.
This point of view was vigorously and thoughtfully presented by Dr.
Howard T. Karsner in letters to congressional and executive department leaders.
Writing in his capacity as secretary of the American Association of Pathologists
and Bacteriologists, and as chairman of the National Research Council's com-
mittee on the American Registry of Pathology, Dr. Karsner declared that even
in their present state the Museum and Library "have proved of the greatest
value to the medical profession of the United States" as "living, active, useful
collections rather than mere repositories. Numerous medical research projects
would have been sadly handicapped had it not been for the library and museum.
The same would be true of the future if the work of these institutions were in
any way limited."
As to cost, Dr. Karsner said that "These great institutions" were operated
at a "relatively much smaller cost than could be expected in any other circum-
stances." His familiarity with the Library and the Museum and his extensive
experience in university work convinced him that no possible combination with
other national libraries and museums, unless they were of identical objectives,
would result in any further economy, while it was his opinion that any such
combination would lead to "deterioration of the collections and of their
usefulness."
The doctor strongly favored the Walter Reed site, feeling that it would
form a highly desirable adjunct to the work of the hospital and would aid and
improve the teaching in the Army Medical School and associated schools
already located in the Walter Reed area.
" H.R. 10455, approved 15 June 1938, Public Law Number 611, chapter 384, U.S. Statutes at
Large, 75th Congress, 3d session, 1938, volume 52, p. 684.
BETWEEN THE WARS 239
In concluding, Dr. Karsner wrote, "No words can overemphasize the
importance to the Nation of the preservation of the integrity of these two
institutions as part of the Army organization and of their proper and adequate
housing at the Army Medical Center." 15
A New Building — Where and When?
In the work of securing favorable action by Congress on the bill author-
izing the new building, the medical profession of the country was foremost.
Dr. Karsner's letter was typical of the more than one hundred letters, from
distinguished doctors, which were submitted to the committees of the House
and the Senate when, in 1938, those bodies had hearings on the identical bills
introduced by the chairmen of the Committees on Military Affairs of the
Senate and House.
In addition to these individual recommendations, the American Medical
Association "officially endorsed the movement by authority of the House of
Delegates," a circumstance which recalled to the editor of the Journal of the
American Medical Association the fact that the Association had "played a great
part in obtaining the legislation for the old building" which had housed the
Museum and the Library for 55 years and had "contributed with equal force
in obtaining the new," — thereby treating the prospective new building as if it
were an accomplished fact and not a project which was to take another 15
years of struggle and delay so far as the Museum was concerned, and an even
longer time for the achievement of the new Library.
On 18 June 1938, in an editorial published only 3 days after the Presidential
approval of the authorization bill, the J.A.M.A. exulted that "at last the world's
mightiest collection of medical literature and one of the largest of medical
museums will be given adequate quarters. The medical profession," the edi-
torial went on to say, "may congratulate itself on the enactment of the bill to
authorize the new building."
"But," the editor added, "this is not enough. Under our legislative proce-
dure the appropriation called for by the authorization bills must be obtained.
The Committee on Appropriations of the Senate and House of Representatives
will shortly consider this. If we want the new building built now — and the
need is nothing less than urgent — we must let our representatives in both houses
of Congress know of our desire. The foundation for the building is already
15 Letters, Dr. Howard T. Karsner. various dates in August igj?. Copies on file in historical records
of AFIP.
ARMED FORCES INSTITUTE OF PATHOLOGY
laid; not the foundation of stones and mortar but that of Congressional
approval." 10
Efforts to build upon this foundation of congressional approval were
promptly forthcoming, when President Franklin D. Roosevelt included in his
budget for the fiscal year ending 30 June 1941, submitted on 4 January 1940,
an item of $600,000 for preliminary expenses in connection with the new
building.
Support for the adoption of this item in the appropriation bill included
an article by Joseph M. Lalley, in the Washington Post of 11 February 1940,
entitled "Neglected Treasures," which thus described "the plight of the Army
Medical Library and Museum":
* * * Two years ago Congress authorized the expenditure of $3,750,000 for the
construction of a new building for the Army Medical Library and Museum. This benig-
nant gesture was merely an imprimatur. The Secretary of War is now free, within the
limits of that sum, to have a new edifice built for the library and museum whenever and if
ever he gets the money. He has not got it yet. The new War Department budget, how-
ever, does contain, among the Surgeon General's estimates, a special item of $600,000 for
the acquisition of a site. But with Congress in its present temper, and with the estimates
for national defense tremendously swollen, the fate of this item appears precarious.
All the same, it is unlikely that many high officers outside the Medical Corps, give any
great attention to the concerns and difficulties of the library and museum. None of them,
of course, would dream of parting with it. But when, in the course of the hagglings with
the Congressional committee, it may mean the difference between a few extra tanks or
bombing planes there may be a temptation to let the library wait another year for a new
home. But it has already waited too many years, and can wait no longer.
Adoption of the budget item in the War Department appropriation bill
was urged by the Washington Post in an editorial of 10 February 1940, entitled
"Priceless and Unique." The estimate of $600,000 for the purchase of a site
and the preparation of plans for "a new building which will more adequately
house the Army Medical Library and Museum" was termed "modest" in
amount and pressing in importance.
"Whatever the needs of other forms of national defense, there is no part
of the current Army estimate more worthy of public support than this relatively
tiny item," the editorial said. "Nearly two years ago Congress authorized a
new building to replace the present antiquated Army Medical Museum, erected
in 1887. Economy of a glaringly penny-wise pound-foolish variety has hereto-
fore blocked action under this authorization. In view of the long delays and
"Editorial entitled, "Army Medical Museum and Library." Journal of the American Medical Associa-
tion 110: :<' 1 t8 June 1938.
BETWEEN THE WARS 24I
the urgent need in providing this new building, the least that can be done at
this session is to make a start in a matter so patently overdue." '
Between the time of submission of the estimate and action upon it, the
war in Europe passed from a period of comparative inactivity to the furious
"blitzkrieg," with the German invasion of Denmark and Norway in April
1940, the invasion of the Low Countries in May, the disaster at Dunkirk in
the last week of that month, all culminating in the fall of France in mid-June.
Against this background of rapidly moving events and precipitately deteri-
orating situations, the proposed appropriation was considered in the Congress.
Action Delayed
On 3 April 1940, the Appropriations Committee of the House of Repre-
sentatives recommended the adoption of $130,000 of the budget item, being
that portion of the expenditure proposed for the drawing of plans and pre-
paring of specifications, and recommended against the $470,000 included for
the purchase of a site for the new building.
In the 1938 authorization, Congress had assumed that the new building
was to be erected on Government-owned land, presumably adjacent to the
Walter Reed Army Medical Center. When it became generally known that
the site of the new building was to be in that region, then somewhat remote,
"great opposition developed from the rank and file of the civilian medical
profession of the country" and this influence, among others, led to "the aban-
donment of the plan to move * * * to the Army Medical Center and a return
to the idea of constructing it near its present location."
The National Capital Park and Planning Commission had to be consulted
under the terms of the act of authorization; it had other plans, however, and
recommended a location east of the Library of Congress, and Surgeon General
James C. Magee acquiesced in that decision. 18
The Appropriations Committee, however, felt that the whole question of
a site was out of order, since the preceding Congress, in passing the authoriza-
tion act, had not contemplated purchase of a site but had assumed that the
building was to be put on Government-owned land. The House accepted
the Committee's interpretation of the situation but the Senate, when the bill
17 The article and editorial are quoted in: Congressional Record, Appendix, 76th Congress, jd session,
volume 86, part 14, pp. 1336, 1337.
"Memorandum of Maj. Gen. James C. Magee. The Surgeon General, U.S. Army, 27 April 19 I
file in Record Group 112. Surgeon General's Office file number 631.1 (Arm) Medical Museum and Library),
from the records of the National Archives.
incidi
ARMED FORCES INSTITUTE OF PATHOLOGY
242
came before that body, restored the full $600,000 item by amendment 78. The
matter came before the House again on 10 June, when Representative Ross
Collins of Mississippi urged acceptance of the Senate amendment, while Rep-
resentative John Taber of New York opposed its adoption, taking the stand
that there were more pressing military needs. The House supported Mr.
Taber's view and "disagreed to the amendment of the Senate numbered 78." n
The bill, with its appropriation of $130,000 for getting on with the pre-
liminaries of construction, passed and was approved on 13 June 1940— by co-
knce, the day before the German armies entered Paris. 20
Acting under the authority granted, the Secretary of War and The Sur-
geon General selected as architects for the building the New York firm of Eggers
and Higgins, whose works included the National Gallery of Art, then nearing
completion. Preliminary plans, submitted in February 1941, were gone over
by a consulting board consisting of the incumbent Librarian, Col. Harold W.
Jones, the incumbent Curator, Lieutenant Colonel Ash, a former Librarian,
Col. James M. Phalen, a former Curator, Col. George R. Callender, and Lt. Col.
John R. Hall of the Surgeon General's Office. Early difficulties as to the division
of space between library and museum activities were ironed out and, at a
meeting of the consulting board on 11 August 1941, the plans in general were
approved. 21
As plans were developed and costs were rising, it became obvious that the
amount authorized in the 1938 legislation was inadequate. Consequently, H.R.
5146 to authorize the purchase of a site and to increase the total authorized
expenditure from $3,750,000 to $4,750,000 was introduced in and passed the
House, and was amended by and passed the Senate. On 15 September 1941,
the amended bill was brought up for action in the House, under the sponsor-
ship of the chairman of the Military Affairs Committee, Andrew J. May of
Kentucky. Representative Robert F. Rich of Pennsylvania asked whether it
was "absolutely necessary" to erect the building "now, when materials cost so
19 Congressional Record, 76th Congress, 3d session, volume 86, part 7, pp. 789s if.
" U.S. Statutes at Large, 76th Congress, 2d and 3d sessions, volume 54, part I, chapter 343, p. 363,
13 June 1940.
"(1) Letters, Robert P. Patterson, The Assistant Secretary of War, to Mai. Gen. James C. Magee,
2 December 1940; Colonel Birdscye, for The Quartermaster General, to Messrs. Eggers and Higgins,
12 December 1040; Daniel Paul Higgins to Colonel Birdseye, 16 December 1940: and drafts of letters
to Eggers and Higgins, approved by The Surgeon General, 3 January 1941. All on file in Record Group
112. Surgeon General's Office file number 631. 1 (Army Medical Museum and Library), from the records
of tin National Archives. (2) Letters, Lt. Col. J. E. Ash to Col. H. W. Jones, 10 February 1941 and Lt.
Col. I. V.. Ash to Mai. J- C. Magee, 13 May 1941; Office Order 119, Surgeon General's Office, 21
Ma} 1941: Report of Meeting of the Consulting Board, 11 August 1941. All on file in historical records
ol \I IP.
BETWEEN THE WARS
2 43
Figure 76. — Architects' drawing of a new home for the Library and Museum, author-
ized by Congress in September 1941, just before Pearl Harbor, an event which brought an
end to the plan.
much and labor is so scarce," suggesting that construction "ought to be post-
poned until some more appropriate time" after the national defense program
then underway was ended.
Mr. May urged the necessity of the new building but in effect accepted the
position taken by Mr. Rich, pointing out that the bill was merely an authoriza-
tion, without an appropriation, and expressing the belief that nothing further,
other than the preparation of plans then underway, was to be done about the
matter "until after the emergency is over." Unanimous consent was accordingly
given to consideration of the bill, which was passed and, on 24 September 1941,
was signed by the President (fig. 76). "
Representative May's estimate of the lack of effect of passage of the increased
authorization upon actual construction proved to be well founded. Work on
plans continued until in December, when the events at Pearl Harbor transformed
the "emergency" into active participation in full-scale, all-out, unlimited war—
a state of affairs in which, by tacit consent, the Nation's medical treasures of
the Library and Museum would continue to be housed in a "rather decrepit
old red brick building" to whose "dingy halls * * * the world's foremost
medical scholars" would continue to come — as they had been coming for
more than half a century."' 1
" Congressional Record. 77th Congress, 1st session, volume 87, part 7, pp. 7122. 7-'4. 7 -17**.
74 1 5' 757 1 - ( 2 ) Public Law Number 256, chapter 418.
a (l) Editorial: American Journal of Public Health and the Nation's Health 26: 930- 932, September
1936. (2) Editorial: British Medical Journal, 26 October 1935. (3) Editorial: The Military Surgeon.
volume 78, April 1936.
713 028' 64 IS
CHAPTER XIII
Pathology Worldwide
Decrepit the old building may have been, and dingy, too, but it was in its
crowded and cramped quarters that Col. James E. Ash and the Museum staff
somehow managed to carry the heavy wartime routine of pathology services for
an Army which was expanding explosively, not only in numerical strength but
also in geographic dispersion throughout the world, and at the same time to turn
out a program of productive research which, in view of the conditions, was
nothing short of prodigious.
The rapid expansion of the Army dates from 16 May 1940, when President
Franklin D. Roosevelt, addressing the Congress on the fast-deteriorating military
situation in Europe, recommended the appropriation of an extra billion dollars
for purposes of defense. The strength of the Army was then under 270,000.
By the time of the attack on Pearl Harbor, it had grown to 1,680,000, a sixfold
growth which continued until, at the end of hostilities in August 1945, it num-
bered more than eight million men and women. 1
Such an increase in the military population, which was the primary con-
stituency served by the Museum, was enough in and of itself to have called for an
increase in the Museum's peacetime staff. To this multiplication of the numbers
to be served, however, there was added another factor in the buildup of the
pathological workload— a change in the applicable Army regulations. Since
1922, these had been set forth in the War Department's AR 40-410, which
"solicited" the sending in of pathological materials and "requested" Medical
Department personnel to "make special efforts to procure and forward the
desired specimens." In August 1942, AR 40-410 was superseded by another
bearing the same number which was shorter, broader, and sharper than the
original 1922 regulation. The 1942 regulation did not "solicit" support or
"request" Medical Department cooperation. Instead, it spoke in the imperative,
'Figures for lunc 11)40. December 1941. and August 1945. on file in the Adjutant General's Offic
Department of the Army.
246
ARMED FORCES INSTITUTE OF PATHOLOGY
saying rather that autopsy, biopsy, and specified surgical materials "will be for-
warded" as directed. 2
The combined effect of a rapidly increasing Army and more positive direc-
tions for the submittal of pathological specimens was to increase the workload
of the Museum to 3,500 or 4,000 "cases" per month— as many as had been handled
in a full 12 months before the expansion began. By 1943, autopsy materials and
records were flowing into the Museum at the rate of 15 per day, a figure which
increased before the end of the war to the point where "we were receiving at the
Institute an average of over 50 autopsies a day and as many significant surgical
» 3
specimens.
In 1945, the year in which hostilities ended, records and tissues from nearly
19,000 autopsies were received at the Museum, along with more than 20,000
surgical specimens. 4 Colonel Ash spoke truly when he said, "the trickle of
materials of a decade ago has swollen into a torrent."
Regional Centers for Histopathology
The "torrent" might have overwhelmed the Museum staff if, during the
period of preparedness before the United States became an active belligerent,
there had not been thought out a planned decentralization of the pathological
facilities and activities of the Army.
On 11 December 1941 — 4 days after Pearl Harbor — the new system was put
into effect by The Surgeon General's Circular Letter No. 121, subsequently
mollified in Circular Letter No. 141, of 29 July 1943, and repeated in the War
Department's Technical Bulletin 99, issued 11 March 1944.
The new system deployed the limited number of trained pathologists at
the points where they would be able to serve most effectively. It was recognized
that there simply were not enough pathologists to go around among all the
medical installations, but there were enough to staff regional centers for his-
- ( 1 ) Army Regulations No. 40-410, paragraphs 6, 8, and 9, 18 January 1922. (2) Army Regulations
No. 40-410, paragraphs 3-7, 3 August 1942.
3 (i) Ash, James E.: The Army Medical Museum in This War. An address before the Section on
Pathology, Southern Medical Association, 37th Annual Meeting, Cincinnati, Ohio, 16-18 November 1943.
Published in Southern Medical Journal 37: 261-266, May 1944. (2) Ash, J. E.: Tumor Registries of the
American Urological Association. An address before the Association, Cincinnati, Ohio, 25 July 1946. Copy
on tile in historical records of the AFIP. (Hereinafter cited as American Urological Association Address.)
4 l.uckc, Balduin: The Army Institute of Pathology During World War II. The Military Surgeon 99:
365, November 1946.
'Ash. J. 1 ■..: The Army Institute of Pathology. (Tenth Annual Harrison S. Martland lecture delivered
before the Essex County Anatomical and Pathological Society, Newark, N.J.) Abstract published in
Bulletin of the U.S. Army Medical Department 4:718, December 1945.
PATHOLOGY WORLDWIDE 247
topathology. These centers — there were 18 of them altogether, with one or more
in each of the nine Service Commands into which the United States was then
subdivided — were set up mostly in the laboratories of named general hospitals."
To these centers, nearby posts and installations sent materials on which
diagnostic assistance was required. After screening out those cases on which
diere were no serious diagnostic doubts or difficulties, the regional centers for-
warded to the Medical Museum "such surgical cases as have a possible future
administrative or 'follow-up' value, particularly tumors and those cases requiring
final or confirmatory diagnosis." Also forwarded to the Museum were all
autopsy materials, including the protocols or records, as well as the tissues
involved. 7
As American Forces spread to theaters of active operations, the system of
channeling pathological materials and information spread with them, with
the chief surgeon of each oversea theater designating a medical general labora-
tory, usually at the principal general hospital in the area, to serve as its histo-
pathologic center. These centers were called upon to gather and forward the
same classes of materials as the regional centers at home, and in addition were
asked to send in materials and information about the disease encountered
among the peoples of foreign lands, "inasmuch as 'geographic pathology' has
become of great importance to the armed forces." The materials sought in this
connection included not only tissues from surgery and autopsies but also
"insect species that act as disease vectors or are suspected of doing so, poisonous
plants, poisonous snakes, and other material of medico-military interest" — a
term which covered the vast variety of conditions to be encountered by an Army
whose troops were serving in every sort of terrain and climate, all over the
world.
At the center of this worldwide network of channels, through which
pathological materials and records flowed in and diagnostic information flowed
out, was the Museum (fig. 77). "The U.S. Army is the only armed force
in the world that had this centralization of pathology," said Colonel Ash, "and
it has resulted in the largest single accumulation of material in the history of
"Histopathologic centers were established at: Lovell General Hospital, Fort Devcns, Mass.: the Second
Service Command Laboratory, Federal Office Building, New York City; Valley Forge General Hospital,
Phocnixville, Pa.; Lawson General Hospital, Atlanta, Ga.; Stark General Hospital, Charleston, S.C.: Station
Hospital, Fort Bragg, N.C.: Thayer General Hospital, Nashville, Tenn.: Hillings General Hospital, Fort
Benjamin Harrison, Ind.; the Sixth Service Command Laboratory, Fort Sheridan, 111.; O'Reilly General
Hospital, Springfield, Mo.; Fitzsimons General Hospital, Denver, Colo.: Brooke General Hospital. Fort
Sam Houston, Tex.; William Beaumont General Hospital, El Paso, Tex.: Army and Navy General Hospital,
Hot Springs, Ark.; LaGarde General Hospital, New Orleans, La.; Hoff General Hospital. Santa Barbara,
Calif.; Letterman General Hospital, San Francisco, Calif.; and Barnes General Hospital, Vancouver, Wash.
7 Circular Letter No. 141, Surgeon General's Office, 20 July 1043.
2 4 8
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 77. — Schematic representation of the flow of pathological materials during
World War II. A. Continental network, to and through Histopathologic Centers on the
way to the Institute. B. Worldwide flow to and from the Medical Museum.
medicine. It is particularly valuable because it has given us the opportunity to
study not only the pathology incident to warfare but also that arising from the
varied environments to which our soldiers were subjected — from the Arctic
to the tropics." 8
" American Urological Association Address.
PATHOLOGY WORLDWIDE 249
The basic idea, Colonel Ash said, was "to concentrate all the significant data
and material pertaining to pathologic processes occurring in the Army at the
Medical Museum, where it will be available for current professional use and
future scientific investigations, for teaching, and for historical purposes."
Still another value of this centralization of records and materials grows out
of the exceptional mobility of military life. Frequently, it is necessary or desir-
able to transfer military patients from one hospital to another— as for example,
from a post hospital to a more commodious and better-equipped general hospital,
or perhaps to a hospital with unusual facilities for the treatment of a particular
disease. In any such case, the Museum would have the tissues, the diagnosis, and
other pertinent facts, and could furnish from its files "a life history of such a
patient's condition, a record of his treatment, and of the outcome of the disease,"
all readily and quickly available in a single file. 9
Increase in Personnel
The tremendously increased workload at the Museum made necessary sub-
stantial increases in the staff. From the prewar number of three, the number of
professional pathologists at the Museum went up to more than 20. Twelve of
them remained at the Museum for more than 2 years; eight for more than 3 years.
The average number employed at any one time was 14. In addition to the staff
of professional pathologists, the work of the several departments of the Museum
required the services of some 30 enlisted men and Wacs, and about 60 civilians. 1 "
Reinforcing this full-time staff was a succession of distinguished resident
consultants who were invited by the Curator to participate in the work of the
Museum for brief periods. Seventeen such consultants were at the Museum,
first and last, staying for periods of from 2 weeks to 3 months, in which they acted
as advisers in the workup of pathological materials and participated in the
researches which were going forward. 11
Overwhelmingly, the greater part of the activities of the organization, still
entitled the Army Medical Museum, had come to center in the pathology service.
For example, in a list issued at the beginning of 1944, 37 out of 47 projects cur-
rently underway were in the field of pathology, while 11 of the 17 projects shown
9 Ash, Southern Medical fournal, 37 (19.14), pp. 261-266.
10 (1) Lucke, The Military Surgeon, 99 (1946), p. 367. (2) Brochure, Army Institute of Path-
Army Medical Museum, prepared by Technical Information Division, Surgeon General's Office, first printing
1 July i.j_|=5 : reprinted December 11)45 and 1 July 1946, p. 1. (Hereinafter cited as Brochure, AIP-AMM.)
11 (1) Correspondence, Colonel Ash to Surgeon General's Office, 21 August ic»4i and Surgeon General I
Office to Colonel Ash. 25 August 1943. (2) Lucke, The Military Surgeon, 99 (1946). p. $67.
ARMED FORCES INSTITUTE OF PATHOLOGY
as having been recently completed dealt with pathology. 1 " As Colonel Ash said,
the organization "suffered under the connotation museum, an institution still
thought of by many as a repository for bottled monsters and medical curiosities.
To be sure, we have such specimens. As is required by law, we maintain an
exhibit open to the public but in war time, at least, the museum per se is the least
of our functions, and we like to be thought of as the Army Institute of Pathology,
a designation recently authorized by the Surgeon General." 18
A New Name for a New Organization
This authorization, made informally in the closing weeks of 1943, is re-
flected in the printed heading of Office Order No. 18 of the Curator, dated
1 January 1944, which outlines the functions of the organization and assigns
responsibilities for the various segments of activities. On this heading, the new
name of "Army Institute of Pathology" appears as a subordinate division of the
Army Medical Museum— a relationship which was to be reversed 2 years later
when the "Army Institute of Pathology" was to become officially and formally
the general designation of the entire operation, with the Army Medical Museum
as a subordinate division. Under the new dispensation, the head of the whole
organization was known as the Director instead of the Curator.
The organization outlined in Office Order No. 18 of the Army Medical
Museum consisted of four divisions or "services"— Administrative, Professional,
Photographic and Medical Arts, and Museum and Medical Arts.
The Museum proper was relegated to the status of a subdivision of the
Photographic and Medical Arts Service, headed by Capt. Frank H. Netter.
Besides the Museum, this service included all forms of medical art, including
photography other than clinical and motion pictures. The latter types of
photography were assigned to the Museum and Medical Arts Service, headed
by Capt. Ralph H. Creer. Organization and training of units to be sent over-
seas were assigned to the Museum and Medical Arts Service — to be known for
short as the "MAMA's" (fig. 78).
Lt. Col. Balduin Lucke, in civil life a distinguished Philadelphia pathologist
and professor of pathology at the University of Pennsylvania, was named in
the office order as Deputy Curator and also as the officer heading up the Pro-
fessional Service, which was primarily the pathological division of the Museum-
'- Memorandum to Officers, Army Medical Museum, Army Institute of Pathology, anil Photographic
anil Medical Arts Service, t, January 1944. On file in historical records of AF1P.
" Ash, Southern Medical Journal, 37 (19-14), PP- 261-266.
PATHOLOGY WORLDWIDE
2 5 I
Figure 78. — A unit of the Museum and Medical Arts Department of the Museum, in World
War II, is photographed while photographing a diseased native of a tropical isle.
Institute. The division was responsible for reviewing and reporting on speci-
mens sent in currently, and also for research and education in the field of
pathology.
Scientific Investigations
Studies in progress and those recently completed, listed in a memorandum
to officers issued by the Army Institute of Pathology and the Photographic and
Medical Arts Service on 3 January 1944, indicate the wide range of the research
and educational activities of the staff of what was still known officially as the
Army Medical Museum.
By the end of the war, the results of 62 of these investigations had been
published — two of them in the new medical books, six in revisions and reissues
of the Museum's atlases of the pathology of particular organs, and the others
in articles in the scientific medical press. Fifteen of these published articles
appeared in the American Journal of Pathology; 11 in The Military Surgeon;
4 each in the Archives of Pathology and the American Journal of Orthodontics
and Oral Surgery; and the remaining 20 in 15 other medical journals. In
ARMED FORCES INSTITUTE OF PATHOLOGY
252
addition to the articles which had been published by 1 July 1946, 14 others had
been completed and were ready for publication, and 28 more were in progress. 1 *
These scientific investigations were not "mere academic research projects,"
Dr. Howard T. Karsner wrote in 1944, but were in large part such studies as
had "immediate application." " As an example of immediacy of application,
Dr. Karsner cited the part played by the Medical Museum in scotching the
subterranean rumor that the outbreak of hepatitis in the Army in the spring
and early summer of 1942 was actually yellow fever following vaccination
against that disease. Color of support for the rumor was found in the
undenied fact that troops were being given "shots" for yellow fever, and the
further fact that the most obvious and visible symptom of both yellow fever
and hepatitis was the jaundiced hue cast by both over the sufferers.
The diseases, however, were very different in their effects. Hepatitis,
while it is exceedingly debilitating and distressing to its victims, is not a disease
of high mortality, the death rate being less than three-tenths of 1 percent of
hospitalized cases. In disablement and deadliness, hepatitis was not to be com-
pared with yellow fever, but there was enough plausibility in the rumor that
"yellow jack" had returned to the Army through the hypodermic syringe of
the surgeon to make it damaging to morale.
Fortunately, before the alarmist rumor was well spread, the Medical Mu-
seum had completed its special study of three early fatal cases of hepatitis-
one each from Fort Belvoir, Va.; Camp Callan, Calif.; and Walter Reed Gen-
eral Hospital— and had circulated its findings to the laboratory chiefs of Army
hospitals for the information of "officers who may not have had an opportunity
to study at first hand the pathology of fatal hepatitis." The findings were
accompanied by clinical notes and microscope slides. 10
"Because of the current interest in yellow fever," there went with the
reports like information about an authentic case of yellow fever which had
caused the death of a young man in Brazil in 1937. As Colonel Lucke (fig. 79),
who had prepared the notes and materials on both diseases, pointed out, the
differences between them, when seen under the pathologist's microscope, are
so obvious that "it will be seen at once" that they are not the same. The putative
epidemic of yellow fever was demonstrated to be hepatitis — a demonstration
which was clinched by continued study, the results of which are embodied in
" Brochure, AIP-AMM, i July 1946.
,= Karsner, Howard T.: Army Medical Museum; Army Institute o£ Pathology. Journal of the American
Medical Association 124: 711, 11 March 1944.
'" Memorandum. Col. J. E. Ash, to Chief of Laboratory Services, 22 July 1942. Copy on file in historical
records of AFIP.
PATHOLOGY WORLDWIDE
2 53
Figure 79.— Maj. Gen. Norman T. Kirk, The Surgeon General of the Army, presents
to Col. Balduin Lucke the Legion of Merit for distinguished service to the Museum-Institute,
as Mrs. Lucke looks on.
Colonel Lucke's articles on "The Pathology of Fatal Epidemic Hepatitis,"
based on 125 fatal cases, and on "The Structure of the Liver After Recovery
from Epidemic Hepatitis," based upon post mortem examinations of 14 patients
who had recovered from the disease but had thereafter succumbed to some
other disease or accident. 1.
Yellow fever was but one of the tropical diseases which gave concern to
the U.S. Army in the war. Indeed, as Colonel Ash wrote, tropical medicine
IT (1) Lucke, B.: Pathology of Fatal Epidemic Hepatitis. American Journal of Pathology 20: 47i"593.
May 1944. (2) Lucke, B.: The Structure of the Liver After Recovery From Epidemic Hepatitis. American
Journal of Pathology 20: 595-619, May 1944- Publication of the 36 plates in « lur and black-and-white
was made possible by a grant to the Journal from the International Health Division of the Rockefeller Insti-
tute. The hepatitis was traced to certain batches of vaccine which used as a stabilizer human serum
containing the virus of hepatitis. The epidemic stopped after the use of human serum was discontinued.
In Medical Department, United States Army. Preventive Medicine in World War II. \ olume III.
Personal Health Measures and Immunization. Washington: U.S. Government Printing Office, 1955,
pp. 306-312, and Medical Department, United States Army. Preventive Medicine in World War
Volume V. Communicable Diseases Transmitted Through Contact Or By Unknown Means. Washington:
U.S. Government Printing Office, i960, pp. 411-432.
__. ARMED FORCES INSTITUTE OF PATHOLOGY
-M
"held a place of special importance, not only medical but military, with our
troops stationed in all quarters of the globe * *. Almost overnight, the
diseases of the tropics became an urgent specialty, where previously the general
pathologist had occasion for no more than superficial knowledge." "The
medical personnel of the armed forces," said Colonel Ash, "had to be instructed
in at least the basic features as quickly as possible."
The Attack on Tropical Diseases
To meet this emergency, Dr. Sophie Spitz, a brilliant young woman
pathologist serving as a contract surgeon, "prepared comprehensive study sets
from the large collection of material that had come to the Institute from wide-
spread tropical installations, which were distributed particularly to the Army
pathologists. In order to reach a wider circle, she prepared other collections
of tissues from tropical diseases which went out to nearly all medical schools
in the United States and Canada, as a means of alerting students to the possi-
bilities in this special field." 1S
This activity was undertaken by the Museum in mid-1943 at the request
of the Committee on Pathology of the National Research Council, with funds
supplied by the John and Mary Markle Foundation, through the American
Foundation for Tropical Medicine. The purpose was to collect and distribute
pathological material on tropical diseases to the undergraduate medical schools
of the United States and Canada, with the hope that it would stimulate interest
and facilitate teaching in tropical medicine. As part of a preliminary survey,
a circular letter was sent to the professor of pathology of every American
and Canadian school of medicine, listing the material available and asking
that only items actually needed should be selected. The materials offered con-
sisted of blocks of tissues of organs affected by a dozen diseases, ranging alpha-
betically from amebic dysentery to yaws, together with case records and lantern
slides or, in some cases, stained sections for microscopic examination.
The response to the letter was enthusiastically affirmative, with 82 schools
answering promptly and nearly every school stating that it had need for all
the items listed. Under the direction of Colonel Ash and Dr. Spitz, the Mu-
seum prepared and, during the last week of December 1943, sent ou t to the
medical schools 2,312 lantern slides, 1,049 tissue blocks, 324 stained sections of
tissue, and 794 sets of clinical records and autopsy protocols. Through these
"Ash, J. E.: In Memoriam: Sophie Spitz; An Appreciation; 1910-1956. American Journal of Clinical
Pathology 30: 553, December 1958.
PATHOLOGY WORLDWIDE 255
materials, it was hoped that the students might receive more thorough instruc-
tion in tropical medicine, and that future medical officers of the Armed Forces
would have more adequate training in the subject. 19
So great was the demand for pathological materials, and so valuable was the
concentration of such materials at a central point, that the flow of specimens anil
records from military sources was supplemented by contributions from the
civilian medical world. Action to this end was started at a meeting of a sub-
committee of the Advisory Committee of the National Research Council, held
in the same month as Pearl Harbor, at the suggestion of Col. George R. Callender,
and was carried forward by the Council of the International Association of
Medical Museums, and the secretaries of the American Association of Patholo-
gists and Bacteriologists and of the American Society of Clinical Pathologists.
These organizations approved a plan for the collection of pathological material,
including pictorial records of diseases and injuries, that might come to the
attention of civilian pathologists so that it might be added to the collections of
the armed forces. The civilian materials to which attention was particularly
called were those "arising from airplane crashes, civilian bombings, fires, gun-
shot wounds, and specific epidemics, particularly the virus diseases, encephalitis,
polio, Rickettsia, influenza and 'atypical' pneumonia." The Army Medical
Museum was approved as the collecting point for all such material, which could
there be "processed, correlated and studied with material from army activities
and possibly from the other armed services" and be "available for training,
teaching and scientific purposes."
Pursuant to this plan, Colonel Ash, in his capacity as secretary of the Associa-
tion of Medical Museums, on 5 March 1942, issued a circular addressed to civilian
doctors, in which he outlined the plan and specified in greater detail the types of
materials desired. 20
This appeal was reinforced by Surgeon General's Office Circular Letter No.
127 (1943), which read:
In view of the need for pathologic material in undergraduate and graduate education,
the Committee on Pathology of the National Research Council urges that all who have
suitable anatomic specimens forward them to the Curator of the Army Medical Mu-
seum * * * for correlation and distribution to other central agencies and to teaching
institutions. Material from the following is particularly wanted: the malarial diseases,
bacillary dysentery, endamebiasis, filariasis, the trypanosomiases, the relapsing levers, the
" (1) Circular Letter to Professors of Pathology, undated. (2) Letter, Col. J. E. Ash to The Surgeon
General, 30 June 1043, with 1st Indorsement, The Surgeon General, to Colonel Ash, 1 July 1943. (3) Re-
port of Army Medical Museum Activities to 31 December 1943. On file in historical records of AMP.
- 1 " Correspondence on file in historical records ol AMP.
6 ARMED FORCES INSTITUTE OF PATHOLOGY
leishmaniases, the rickettsial diseases, yellow fever, cholera, plague, and yaws. On applica-
tion to the Curator, arrangements for transportation will be made.
Use of Materials for the Study of Pathology
To take full advantage of the concentration of materials for pathological
study at the Museum, the Surgeon General's Office issued, on 23 July 1943,
temporary duty orders, for 10-day tours of duty at the Museum, on 34 medical
officers, distributed over the nine service commands. The purpose was to give
officers'in charge of the histopathologic centers and certain other key officers in
the various regions an opportunity to observe at firsthand the available facilities
and the procedures followed at the Museum and also at the laboratories of the
Army Medical School. A large amount of material was being sent in daily,
and the majority of the officers sending materials were conscientiously trying to
carry out instructions, the letter said, but there were still a "number who through
unfamiliarity were failing to comply. Hence, on the one hand, the facilities
provided by the Army Medical Museum and the other central laboratories are
not fully utilized, and on the other hand, much very valuable material is not
submitted and thus is lost to the Army." The hope was expressed that by
"thoroughly familiarizing a selected group of officers with the various activities,
facilities and problems of the central laboratories in Washington, present mis-
understandings may be corrected and future ones avoided." The officers to
whom the orders were directed were expected to pass on to other laboratory
officers in their respective service commands the information gained in the short
tour of duty in Washington.
The first group, 10 officers from the Third and Fourth Service Commands,
were to report on 16 August 1943. They were to be followed by 15 officers
The first group, 10 officers from the Third and Fourth Service Commands,
reporting on 30 August, and they, in turn, by nine from the Ninth Service
Command, reporting on 13 September." 1
Officers detailed for these temporary duty assignments had the opportunity
of attending and participating in the staff conferences held daily at the Medical
Museum, at which diagnostic problems were discussed and illustrative material
was screened. Each Saturday afternoon, there was a seminar at which an out-
21 (1) Correspondence, Col. J. F.. Ash to Lt. Col. E. S. Robinson, Laboratory Branch, Preventive Medi-
cine Division, Surgeon General's Office, 20 July 1943- ( 2 ) Memorandum, Lt. Col. E, S. Robinson to Chief,
Military Personnel Division, 23 July 1943, approved by Brig. Gen. James S. Simmons, Director, Preventive
Medicine Division, in which Service Commands were requested to issue temporary duty orders for the
officers whose attendance was desired.
PATHOLOGY WORLDWIDE 257
standing authority in pathology presented a topic, after which there was a free
discussion. All medical officers stationed in Washington and vicinity were
invited to attend the staff conferences and seminars." 2
The practice of having medical officers detailed for brief periods of obser-
vation and training at the Army's center for pathology continued through the
war period. Pressure of duties at their home stations and the worldwide disper-
sion of the Army, however, combined with the crowded conditions at the Mu-
seum itself to limit the number of laboratory officers who could receive such
training. Altogether, some 150 officers were detailed to see the organization and
operation of the Museum-Institute at firsthand, but other means had to be found
to make the results of continuing study and research in pathology more widely
available.
Study Sets
This was done, in part, through publication of articles of particular interest
in the medical scientific press. For more detailed and intensive study, however,
the printed word alone, even with photographic or photomicrographic illustra-
tions, was not enough. For such students of particular topics, the Museum-
Institute set up an extensive service, making study sets available to all Army
laboratories, to keep medical officers throughout the Army informed about the
pathology of the diseases prevalent during the war.
These study sets consisted of slides for microscopic study, reinforced by
printed syllabuses or atlases illustrated by photographs or photomicrographs
of the diseases with which they dealt. The sets were of two sizes, 100 slides
and 25 slides. The larger sets covered the pathology of major specialties
such as ophthalmology, otolaryngology, orthopedic surgery, neurology, derma-
tology, gynecology, serology, and dental and oral surgery— in general, the
specialties in which active registries had been established by the time of the
entrance of the United States into the Second World War.
The smaller sets dealt, for the most part, with specific diseases, among them
being lesions of the lymph nodes and the thyroid gland, tumors of certain
organs, interstitial pneumonitis or viral pneumonia, the various types of en-
cephalitis, and the several diseases traceable to different forms of fungus. During
1945, the last year of active hostilities, a total of 1,669 stud Y sets were sent out on
loan, approximately 90 percent of which went to Army installations and the re-
mainder to civilian doctors." '
"Editorial: Seminars at Army Medical Museum. Bulletin of the U.S. Arm} Medical Department ~y.
106, February 1944.
23 Brochure, AIP-AMM. 1 July I945.P-3-
2 _g ARMED FORCES INSTITUTE OF PATHOLOGY
Both types of sets were designed to make available to medical men the
information derived from the specimens and clinical records flowing into the
Institute from medical installations all over the world. The emphasis, of course,
was upon the pathology of the soldier— the military-age group roughly defined
as from 18 to 38 years. "Never before," said Colonel Ash, "has there been
an opportunity to learn so much about the pathology of this military age group;
only now as a result of the Army policy of centralization have significant data
been available to cover this presumably healthy span." In contrast with the
knowledge of diseases at other times of life— infancy, childhood, middle life,
and old age— information about young adults was scarce indeed.
The pathological findings were, in many cases, surprising. For example,
while it had long been known that fatal coronary disease is suffered by the young,
the number of fatalities from this cause was unexpectedly large. Study of the
first 80 cases received at the Institute showed that about one-third of these deaths
were in men under 30 years of age, and that overweight was a common condition
among those so stricken. Another unexpectedly large figure was that of malig-
nancies in the gastrointestinal tract. In fact, tumors of various types were found
to be more prevalent than had theretofore been realized."
Among the disease conditions which were the subject of special studies by
the Institute staff and its resident consultants were infections of the central and
peripheral nervous systems, and the group of diseases transmissible to man by the
bite of an infected louse, flea, tick, or mite, known generically as rickettsial
diseases, named for Dr. Howard Taylor Ricketts who lost his life to typhus.
Other special studies by the staff included malaria and the results of its
treatment with Atabrine; heat stroke, a subject of particular interest to an Army
which was to do much of its fighting in areas of high temperature; failure of the
kidneys to function as a result of crushing injuries to other parts of the body,
burns, or transfusions of incompatible blood; and tumors of various types and
localization. These studies were carried on in conjunction with, or at the same
time as, those of other agencies investigating like conditions, and all such
studies were greatly furthered by the collection, in one central location, of signifi-
cant numbers of cases of each type. 25
As an example of the prompt and expert diagnostic and consultative service
offered by the Institute, as an aid in the reduction of health hazards, there was
"''Ash, Bulletin oj the V.S. Army Medical Department, 4 (1945), pp. 718-723.
~'(i) Idem. (2) Brochure, AIP-AMM, 1 July 1945, pp. 4, 5. (3) Typescript of Memorandum,
"Armcil Forces Institute of Pathology: Status in a Future War," dated 8 September 1950. On file in
historical records at Al II'.
PATHOLOGY WORLDWIDE 259
the case of soldiers serving in Alaska who died unexpectedly and inexplicably,
insofar as the local medical officer could determine. Autopsy tissues sent to the
Institute indicated that death was due to severe damage to the liver following
inhalation of a toxic vapor. Investigation revealed that the soldiers had used a
cleaning fluid containing carbon tetrachloride to clean weapons. A directive-
was issued promptly to discontinue the use of the fluid indoors, anil pathologists
in the field were alerted to the danger of its use in confined quarters. From such
instruction, Army pathologists were enabled to explain the previously undeter-
mined causes of death among crews of allied submarines which docked at Pacific
ports. Studies of autopsy tissues revealed characteristic lesions, and investigation
showed that the sailors had used toxic cleaning solutions within the close confines
of submarines.
Along with the work on specimens received through military channels,
went the work done under the direction of the American Registry of Pathology,
through which materials of pathological interest arising in civil life were ana-
lyzed and studied. On account of wartime pressures, both upon the staff and
the cooperating civilian physicians, the followup system had to be suspended
for the duration of the war, and there was some slackening in the registration
of tissues and clinical records contributed from this source. Interest in the
registries continued, however. Five new registries were added during the war,
bringing the total number to 13. The total number of accessions received by the
Museum-Institute from this source by the end of the war had grown to more than
48,ooo. 20
The Army Medical Illustration Service
While the study of pathology was the principal business of the Museum-
Institute, it still was but part. Closely related was the graphic representation
of the results of such study through the media of drawings and paintings,
photography and photomicrography, and plastic medical art — all comprising
the Army Medical Illustration Service (fig. 80).
This Service included the Photographic Laboratory which, in an average
month, turned out from its collection of 100,000 negatives of medical interest
as many as 2,500 prints, prepared i,oco colored lantern slides, and made more
than 2,500 photostats and 25,000 offset prints. Not all of this work, by any
" (1) Draft of Report of Inspection. Army Medical Museum (Armv Institute of Pathology), with
covering letter. Col. J. E. Ash to Assistant Commandant, Army Medical Center, , January n)45- 1'hotostat
copy in AFIP files. (2) Karsner, H. T.: The American Registry of Pathology and its Relation to the Vrmy
Institute of Pathology. The Military Surgeon 99: 369, November 1946. (3) American Urological Association
Address.
260
ARMED FORCES INSTITUTE OF PATHOLOGY
Capsular Zi
f/eac/ of Femur-
r / /■* i / / /
■ HlJ
Figure 80. — Pencil, pen, brush and camera: The medical illustrator uses many media in
his task of presenting the picture of trauma and disease.
PATHOLOGY WORLDWIDE 26 1
means, was done for the Museum-Institute, as the Laboratory, presided over
by Roy M. Reeve, became, in effect, the photographers for the Surgeon General's
Office.
The work of medical illustration in the oversea theaters was provided for by
the detachments sent out by the other branch of the Medical Illustration Serv-
ice — the MAMA's — but until as late in the war as mid-1943, no P^ an f° r
central supervision of clinical photography in the hospitals in the Zone of the
Interior, or the "homefront," had been adopted. On 15 June of that year,
Colonel Ash proposed to The Surgeon General a plan for such supervision,
with centralization of the resulting materials in the Museum, where they would
be available for teaching, scientific, and historical purposes.
Upon inquiry, it appeared that only 6 out of the 22 general hospitals queried
had photographic equipment and supplies. In November, therefore, The
Surgeon General approved in its essentials the plan for centralized direction
of photographic activities in the Museum. This action was followed by a cir-
cular letter of 22 December, directing that, beginning with 1 January 1944,
monthly reports be made to the Museum, with prints of all photographs.
When prints were found to be worthy of preservation or wider circulation, the
Museum was to request the negatives for copying, after which the negatives
were to be returned to the hospital. Under this plan, the Institute was to
handle in an average month 5,000 still prints from 60 hospitals in the United
States." 7
Figure 80. — Continued.
O rrespondence on file in liistnric.il records ol All I".
2 5 2 ARMED FORCES INSTITUTE OF PATHOLOGY
To help meet the demand for medical artists and clinical photographers
both at home and abroad, The Adjutant General of the Army, in a telegram
of 2 August 1943, directed the commanding general of the Medical Replace-
ment Center at Camp Grant, 111., to submit to the Curator of the Museum the
name, serial number, and experience record of clinical photographers reporting
to the Center, and not to transfer such personnel elsewhere except upon instruc-
tions from The Adjutant General's Office.
As part of the education of Medical Department personnel, the Director
of Training, Army Service Forces, Maj. Gen. Clarence R. Huebner, asked the
Training Division of the Surgeon General's Office to prepare a graphic portfolio
illustrative of first aid in battle. The project was turned over to the Museum
in February 1943, and Captain Netter was assigned the job of producing 50,000
portfolios of 50 posters each. Sketches and a preliminary draft of the text were
approved by The Surgeon General and the Training Division, Army Service
Forces, by the end of March. Final photographs and paintings were completed
in July. After a period of study and review by various officers of the Surgeon
General's Office, the Training Division of the Army Service Forces, and the
Publications Division of The Adjutant General's Office, the material was
finally approved and turned over to the U.S. Government Printing Office for
publication. In October, the Government Printing Office, for more rapid
production, let the job on contract to five lithographic companies in New York.
To save time, Captain Netter was ordered to New York to supervise the litho-
graphing. On 6 November, the plant having the largest portion of the pro-
duction ran out of paper — six carloads were required to do the whole job — and
it was not until 9 December, more than 9 months after the project was started,
that the lithographs were completed and ready for distribution. Such were
the problems of production in wartime. 28
As an aid to more realistic teaching of emergency medical care and battlefield
first aid. the Museum and the Medical Arts Section were called upon to produce
sets of war-wound moulages, or models in synthetic rubber, of the types of
wounds which might be expected. Each set consisted of eight pieces — two masks
showing shell-fragment wounds of the forehead and gunshot wounds in the jaw,
to be worn by the men representing the "wounded," and six plaques to be at-
tached to the "wounded" men, showing wounds in the chest, the abdomen, the
arm and hand, and the leg. The purpose was to "impart greater realism to
casualties" in practice maneuvers, and to give better opportunity to demonstrate
correct methods of wound treatment, as set forth in War Department Technical
s * (1) Report of Army Medical Museum Activities to 31 December 1943. (2) Letters, Captain Netter
to Colonel Ash, 12 November and 9 December 1943. Photostats on file in historical records of AFIP
PATHOLOGY WORLDWIDE
263
1
A
^^^tfflMhft^l ^^r^^m
Figure 81. — "Wounds" for training purposes. A. Moulages, produced by the Medical
Illustration Service, represent types of wounds which might be expected.
Bulletin 116, issued on 18 November 1944. When applied to soldiers in the field,
the moulages were startlingly lifelike (fig. 81).
More than 4,000 pieces, representing n different wounds, were prepared by
the Medical Illustration Service, but none of the World War II moulages are to
be found in the Museum today. In late 1944, after the moulage-making job was
completed, the laboratory was cleaned up and turned to other uses, but appar-
ently no attempt was made to accession a set or two or to salvage the original
patterns or the plaster of paris molds. Instead, it is likely that all the excess
moulage materials were included in a general cleanup of the Museum, in which
nine truckloads of materials of various sorts were hauled off to nearby Army
posts in Virginia and dumped. Diligent search of the basement of the Institute
building and of Chase Hall — a temporary building into which the Museum
proper was moved in April 1947 — failed to turn up any of the missing moulages
of this particular lot. The use of moulages in training was continued, however,
and they are still being made by the Medical Illustration Service.""
= " (1) Typewritten memorandum in AFIP files dated 1 March 1949, signed R.A.S. (the initials ol M.ii.
Ruell A. Sloan, Curator, Army Medical Museum, in 1949). (2) The production of these moulages at the
Army Medical Museum is described in: Clarke, Carl D.: Rubber Moulages for First Aid Training, [ournal
of Technical Methods 25: 91-101, December 1945.
>64
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 8 i.— Continued. B. When applied to soldiers in the field, moulages were
startlingly lifelike.
Storage of Museum Collections
Even before the outbreak of the war, it had been necessary to store a major
part of the collections of the Museum proper. With the onset of the war and the
proliferation of new activities, still more material had to be withdrawn from
exhibit, and storage space had to be found in a southwest Washington waterfront
warehouse. Except for the main exhibit hall, all the exhibit rooms in the old
building were given over to offices and laboratories. The number of rooms was
increased by partitioning the large old-fashioned rooms into smaller cubicles.
With it all, however, the Museum proper was kept open, and continued to
draw visitors at the rate of 200,000 a year. Capt. Hans Schlumberger added to
PATHOLOGY WORLDWIDE 265
his duties as a professional pathologist the task of making the most that could be
made of the limited exhibit space remaining, and was successful to a remarkable
degree. In this, he was assisted by the installation of new alternating-current
lighting to dispel the "1885 gloom" of the decrepit direct-current lighting system
in the old building. Testimony to the effectiveness of the captain's efforts is to
be found in a staff letter at Christmas time, 1944, in which readers were told,
"You'd never know the crusty old place." More formal evidence to the same
effect is found in the draft of an inspection report, made in January 1945, which
noted that "the museum display has been reset so that it is now more informative
and instructive to the general public; it is still, however, of great interest to
medical students and to physicians."
The same 1945 inspection report pointed out that the present accession
rate in the Institute-Museum was on the order of 20,000 per year, but that
"because of the screening function of the histopathologic centers which elimi-
nate such routine materials as tonsils and appendices, almost all of these 20,000
cases present diagnostic problems." In consequence, the case load had grown
faster than the staff to handle it. Nevertheless, in spite of the fact that "the
load * * * now exceeds the capacity of the present personnel" and the inade-
quacy of a building which was "tremendously overcrowded," the "tissues re-
ceived for diagnosis or review" were "handled promptly," and reports were
sent out by mail, air mail, telegraph or radio, "in accordance with the emer-
gency of the situation." The service of the Army Institute of Pathology, the
report said, "has acted as a check on the correctness of diagnosis in all branches
of the medical service." 30
Veterans' Administration and the Museum
The end of hostilities in 1945 brought an uneasy peace to the world, but
it saw no great slackening of the work of the Army Institute of Pathology.
As the wartime hospitals were inactivated, and their laboratory material was
forwarded to the Institute for screening and review, there was a spurt in cases
handled. Before this was past, arrangements had been made to have the Army
Institute act as the central laboratory of pathology for the Veterans' Adminis-
tration in much the same way as it did for the Army.
30 (1) Christmas Message, Army Medical Museum, 1944, preserved by Mr. H. C. Klugc, Medical
Illustration Service. (2) Report of inspection, 3 January 1945. Photostat on file in historical records of
AFIP.
rs ARMED FORCES INSTITUTE OF PATHOLOGY
In a letter to The Surgeon General of the Army, written on 24 September
1945— less than 2 months after the surrender of the Japanese— Colonel Ash
suggested such an arrangement as being beneficial to both parties, and to the
Government as well. "We are now receiving daily requests from the Veterans'
Administration for slides and diagnoses on cases that have been transferred
to its facilities," Colonel Ash wrote, as evidence of the possibilities for a con-
tinuing "followup" of patients from their days in active service through their
periods of treatment in the facilities of the Veterans' Administration. "There
are now 97 Veterans' Facilities * * *" he wrote, and "no doubt this number
will be greatly augmented shortly." The additional load, he added, could be
handled by having the Veterans' Administration assign to the Institute two
pathologists, two technicians, and two clerks.
After consultations and correspondence between the Administration and
the Institute, Gen. Omar N. Bradley, Administrator of Veterans' Affairs, wrote
the Secretary of War, on 12 June 1946, that the veterans' organization was "in
need of certain forms of immediate assistance which it is believed could be
provided by the Army Institute of Pathology." These were consultation and
review as to pathological materials, assistance in training specialists in pathol-
ogy and in studies of disease processes. General Bradley advised that informal
conversations with The Surgeon General of the Army, Maj. Gen. Norman T.
Kirk, and the Director of the Institute, indicated that the Institute was willing
and capable of providing the assistance needed, if the Veterans' Administration
would furnish personnel to cover the added workload. "This," General Bradley
said, "we will be able to do." Use of the Institute's facilities, he added, would
avoid needless duplication of facilities, while the Institute would "benefit
through the accession of a great deal of additional material, much of which
would be correlated with previous specimens received while patients were in
military service."
On 8 July 1946, Secretary of War Robert P. Patterson approved a plan so
obviously desirable and in the best interest of both organizations, and of the
patients whom both served. 31
Only a month before the consummation of the plan to have the Institute
perform the central pathological service for the veterans' organization, Colonel
Ash saw another of his projects come to pass when, on 7 June 1946, a new
War Department Army Regulation was issued, amending AR 40-410 so as to
make the "Army Institute of Pathology" the official designation of the whole
operation, with four departments — the Department of Pathology, the Army
11 Copies of tin- correspondence on file in historical records of AFIP.
PATHOLOGY WORLDWIDE 2 g-,
Medical Illustration Service, the American Registry of Pathology, and the Array
Medical Museum. The head of the organization was to bear the title of
"Director"; the heads of the pathology department and the registry were to be
"Scientific Directors"; the head of the illustration service bore the title of
"Chief" ; and the head of the Museum section, the title of "Curator." A Scien-
tific Advisory Board of Consultants was provided for, with not more than 25
members, serving 5-year terms, to be appointed by The Surgeon General upon
recommendation of the Director.
Words of Appreciation
The year 1946, the last of the 10-year tour of Colonel Ash, saw an unusual
tribute to the retiring director in the publication of an entire issue of The
Military Surgeon devoted to Colonel Ash and the Army Institute of Pathology.
The issue opens with a Foreword from Surgeon General Kirk, in which he
wrote that Colonel Ash's "diligence, foresight, professional knowledge, and
undeterred devotion to duty have led to the organization of the most extensive
service in tissue pathology ever known in the world."
General Kirk's Foreword is followed by an Appreciation by Col. James
M. Phalen, long associated with the Library; by a sketch of the Institute thiring
World War II by Col. Bakluin Lucke; by an account of the American Registry
of Pathology and its relation to the Army Institute of Pathology, by Dr. Howard
T. Karsner; by a paper on the dental and oral pathology registry, by Dr. Henry
A. Swanson and Lt. Col. Joseph L. Bernier; and by 10 scientific papers pre-
pared by 16 scientists connected with the Institute and published as a tribute
to the retiring director.
After summing up the advantages favoring an institute located in the
National Capital as a site for the registries of national scope, Dr. Karsner
summed up the situation of the organization in 1946 in his Military Surgeon
article. "This Institute," he said "is unique in the world. Nowhere else has
there ever been a concentration of pathological specimens that is comparable.
Nowhere else is the pathology of the entire Army of a great country so con-
centrated. Nowhere else have the civilian pathologists and other interested
physicians taken such a great part in organization and operation. Nowhere
else has there been, as continues to be true, such a close scientific liaison between
medical officer and civilian doctor." 32
From a civilian source, the Journal of the American Medical Association,
comes confirmatory comment on the place of pathology in the accomplishments
JJ Karsner. The Military Surgeon, 99 (1946), p. -;'"*■
71:; 028' — 64 10
2 58 ARMED FORCES INSTITUTE OF PATHOLOGY
of medicine in wartime. "The startling accomplishments of surgery, medicine,
physiology, bacteriology and epidemiology as they partake in the war effort
tends to obscure the significant part played by pathologic anatomy," said the
Journal. "In man, and in animals with natural or experimentally induced
disorders, the final identification of disease, indispensable in investigation, de-
pends on pathologic anatomy. Through the medium of autopsies and surgical
specimens, pathologic anatomy serves the Army in its usual unpretentious
manner. The organization now operating in the Army is such that careful
examinations can be made in the field; central facilities provide for skilled
controls and permanent files. Surgeons are aided in their operative work,
internists in their investigation of patients and all medical officers in diagnosis,
treatment and prevention not only of internal diseases, but of injuries on land,
on sea and in the air." 33
'Karincr, Journal of the American Medical Association, 124 (1944), pp. 710-711.
CHAPTER XIV
The Immediate, Imperative Objective
Within a month after the guns of the Second World War were stilled,
Surgeon General Norman T. Kirk asked the National Research Council to study
the situation and prospects of the Army Institute of Pathology and recommend
the most advantageous use of its facilities, "both for the Army Medical Depart-
ment and for the medical profession as a whole."
Dr. Lewis H. Weed, chairman of the Division of Medical Sciences of the
National Research Council, to whom the request was addressed, turned the
assignment over to the Committee on Pathology of his division, of which com-
mittee Dr. Howard T. Karsner of Cleveland was chairman and nine other
distinguished pathologists were members. 1
On i December 1945— less than 3 months after receiving the assignment —
the Committee filed its report with The Surgeon General of the Army. Ap-
proximately half of its 37 specific recommendations were to the effect that the
Institute continue what it was doing, while the remainder represented new
activities, or modification and strengthening of those already undertaken.
These recommendations were divided equally between those having to do with
increases in staff and with innovations in methods, such as, for example, the use
of machine-accounting procedures in coding and filing.
"Today," said the report, "the Army Institute of Pathology is truly the
central laboratory of pathology and medical illustration for the entire United
States Army. The extraordinary amount and variety of material at the disposal
of the Institute is unmatched elsewhere in the world. This material offers un-
limited opportunities for the study of structural tissue changes and correlation
with clinical observations. With proper development of facilities and personnel,
the Army Institute of Pathology can become a guiding force in the furtherance
of pathology in this country and the world."
'Members of the Committee, in addition to Chairman Karsner, were: Doctors Marion A. Blankcnhorn,
University of Cincinnati; Paul R. Cannon. University of Chicago; William II. Fcldman, May.. Foundation,
Rochester, Minn.; Robert A. Moore, Washington University. St. Louis, Mo.; Alwin M. Pappenheimer,
Columbia University. New York; I. S. Ravelin. University of Pennsylvania; Arnold K. Rich. Johns Hopkins
University, Baltimore, M<l.: Henry A. Swanson, Washington, D.C.; and S. Hurt Wolbach, Harvard University.
\RMED FORCES INSTITUTE OF PATHOLOGY
270
Accordingly, the "first and most important recommendation" of the Com-
mittee was that the name of the Museum be changed to the Institute of Pathol-
ogy _ a change already in effect unofficially which, 6 months later, was to be
made official by appropriate Army regulation. The second recommendation,
that the Institute should become the central laboratory of pathology for the
Veterans' Administration, was likewise already underway and was to be con-
summated in a matter of months.
Continued Efforts To Get a New Building
A third recommendation for a new departure concerned itself with the need
of a new building. The building in which somehow the work of the war years
had been done, the Committee said, "was built in 1887, fifty-eight years ago, and
is no longer adequate * * * It is antiquated, overcrowded, obviously cannot
be modernized, and there is no provision for experimental research." The Com-
mittee recommended, therefore, that "the Surgeon General proceed at once to
secure authorization and funds for the construction of a building adequate in
size and arrangement for the expanding activities of a modern army institute
of pathology."
In this recommendation also, the Committee was putting its weight behind
an activity that was already underway— the effort to obtain a new building for
the Library and the Museum. This effort, which had been shelved in December
1941, in the face of the oncoming storm of war, had been revived in the planning
stage before the war ended. On 14 December 1944, Col. James E. Ash advised
The Surgeon General of the Army that it had just come to his attention that
"entirely new plans for the building had been prepared," dated September 1944,
but that no opportunity had been afforded the Museum to "express our ideas on
plans for the Army Medical Museum portion of the building," and that the new
plans had "omitted two of the floors that had originally been assigned to the
Museum."
"We fully recognize the great importance of the Army Medical Library,"
he said, "but we do not hesitate to state that the Army Medical Museum, as it
has developed over the past twenty years, has reached a point of equal importance,
not only to the Medical Department of the Army but to the medical profession
in general * * *. The enormous expansion of the pathologic and illus-
trative functions has justified our new designation as the Army Institute of
Pathology as more exactly representing our real purpose * * *. The Insti-
tute is acknowledged as the largest center of pathological and medical illustra-
THE IMMEDIATE, IMPERATIVE OBJECTIVE 2yi
tive material in the world. Its place in the professional life of the country is
limited only by the personnel and facilities allowed it * * *. We cannot
feel, therefore, that we are so near the tail of the dog that we cannot have
equal opportunity with the Library to plan for our new building, so long as
the two institutions are to be housed together."
Colonel Ash's letter to The Surgeon General closed with the recommenda-
tion that "a small committee of medical officers, who have the interests of both
institutions at heart, be appointed to assist in the development of final plans and
policies * * *." "
Apparently this letter bore fruit, for on 24 January 1945, The Surgeon Gen-
eral set up a board to review all matters relating to planning and construction
of a new Army Medical Library and Museum. Detailed for the board were
Maj. Gen. George F. Lull, the Deputy Surgeon General, as chairman, Col. A. G.
Love, and ex-officio the Directors of the Library and the Museum, and the
Chief of the Hospital Construction Branch of the Surgeon General's Office. 3
Changes in Role of the Museum
"The objectives and responsibilities of the Army Medical Museum have
changed radically in recent years," Colonel Ash informed The Surgeon Gen-
eral, "and several new divisions have been added. Hence the space planned
for this institution in the projected new building is no longer considered ade-
quate and must be increased from fifty to seventy per cent." In the Division
of Pathology, the principal division of the institution, the material examined
in the 3 years since Pearl Harbor had already amounted to "three-fourths as
much as had been received by the Museum during its entire previous existence,
which included three wars." The use of this material — over 50,000 cases a year
derived from either important surgical operations or autopsies — in research
and educational activities would require increased staff and more space. So it
was, also, with the registries, which gave to medical officers of professional
promise and qualified civilian physicians and specialists unexcelled opportunity
for training and research. More space was required, also, for the Army Illustra-
tion Service through which the Museum was receiving "vast quantities of sig-
nificant illustrative material." The Public Museum, while it was "by far the
largest museum of its kind," was described as "antiquated," with its exhibits
~ Letter, Col. I. E. Ash t<> The Surgeon General, 14 December W44. On file in historical records "I
AFIP.
8 Office Order 20, Surgeon General's Office, 24 January 1945.
72
ARMED FORCES INSTITUTE OF PATHOLOGY
I'k.ihi: 82. — Main exhibit hall of the Medical Museum in the lino's. These crowded
conditions continued and even worsened, until the Museum vacated its quarters in the old
building, making more space available for other activities of the Institute.
"poorly displayed" due to "lack of space and wholly inadequate housing facil-
ities" ' (fig. 82).
The postwar relationships and associations among the several Army or-
ganizations devoted to particular features of military medical activities, and
the prospective functions and development of each of them, became the sub-
jects of active consideration, both by correspondence and conference, through-
out 1945, before as well as after the cessation of hostilities.
Problems of Location
Much thought was given to the advantages and disadvantages of the sev-
eral arrangements which might be made. Should the Library and the Museum
Correspondence, Col. |. E. Ash to The Surgeon General, 7 February 11)45. On file in historical
records of AFIP.
THE IMMEDIATE, IMPERATIVE OBJECTIVE 2 y^
share a new building, as they had shared the old for almost 60 years? If so,
where should the new joint home be located— on the site southeast of the
Capitol which had been approved in 1941, or at the Army Medical Center
which had grown up around the Walter Reed Hospital ?
Or, should the long association of the Library and the Museum as joint
occupants of the same building be terminated by providing separate buildings,
either on adjacent blocks of land on Capitol Hill or with the Library location
in that area and the Institute and Museum in the Walter Reed group ? Or,
perhaps, the Institute and Museum should become part of an Army Medical
Research and Graduate Teaching Center proposed to be located at Forest Glen,
Md., where the buildings of the National Park Seminary for Women were
occupied as an annex to Walter Reed General Hospital, for convalescents.
On one point, there was virtually complete agreement: that the building
originally planned in 1941 would be entirely too small for the needs of the
Museum and the Library, because of the "tremendous expansion of both insti-
tutions and the establishment of the Army Institute of Pathology," as The
Surgeon General put it, in recommending to the Commanding General, Army
Service Forces, a change in the basic plans for the proposed building. As neces-
sary steps in orderly planning, it was requested that The Surgeon General be
authorized to endeavor to secure approval of the National Capital Park and
Planning Commission for an additional block of land in the proposed site on
Capitol Hill."'
Permission was granted to start revised plans for the proposed building,
ami the architects, Eggers and Higgins of New York, came to Washington to
meet with representatives of the interested Government agencies. The whole
group adjourned to meet with Maj. Gen. U. S. Grant III, chairman of the Park
and Planning Commission, who assured them that the Commission would
"earmark" in its plan a plot of land on Capitol Hill, adequate for the purpose.
On the same day, 20 April 1945, at a meeting called by General Kirk, The
Surgeon General, to discuss the status of the new building, the proposal to
concentrate the educational activities of the Army Medical Department was
introduced, and Colonel Ash urged that the matter should be referred to the
Army Medical Research Board for its consideration before proceeding further
with plans which would commit the Department to the erection of a building,
or buildings, separated from its central educational activities.
"Correspondence, The Surgeon General, to Commanding General, Army Service Forces, 19 February
1945. On file in historical records of AFIP.
-, 74 ARMED FORCES INSTITUTE OF PATHOLOGY
During the daylong series of meetings, three plans were considered —
separate buildings for the Library and the Institute-Museum, to be located on
adjacent blocks of land on Capitol Hill; or, in the alternative, to place the
Library near the Capitol, and to transfer the Institute-Museum to a site close
to the other educational and research organizations of the Army Medical De-
partment, either on or immediately adjacent to the Walter Reed reservation
or at the Forest Glen site, where it was contemplated that a great new medical
research and training facility would be set up.
At a meeting, held on 5 May 1945, of the special board created to deal with
the relocation of the Institute-Museum, and after consideration of the real
estate appraisals of the several sites under consideration, General Kirk decided
that the Library should be located on a square block southeast of the Capitol,
and that the Institute should be located on a site immediately south of the
Walter Reed reservation.'
The reasons for this decision were stated in a letter from General Kirk to
the Chief of Engineers, through Brig. Gen. J. S. Bragdon, Director of Military
Construction. "The Army Medical Library," said The Surgeon General, "will
continue to serve not only the Army but the medical profession of the world.
Its usefulness is in some part dependent upon its accessibility to the public
and to other major library collections. The building to house the facility
should, therefore, be located on the site * * * adjacent to the Library of
Congress which has previously been discussed * * *."
"The Army Institute of Pathology and the Army Medical Museum will
continue to serve both the Army and the civilian medical profession. Their
service to the Army will be closely related to the functions of the Army Medical
Center. Their service to the civilian profession will be handled to some degree
directly but in larger degree by mail. Their proper function requires im-
mediate access to hospital beds. It is, therefore, desired that the institute
of pathology and the museum be separated physically from the library and
studied in relation to the Army Medical Center."
The Surgeon General felt, however, that "additional major investment in the
Army Medical Center," such as would be involved in the proposed new build-
ing, "should be carefully considered in relation to future requirements." Study
was requested "looking to the development * * * on an unrestricted site"
of a new Army Medical Center, of which a new 1,000-bed hospital and the new
Institute-Museum building would "form a present nucleus." The site for the
'Office Memorandums, 19, 20, 21 April 1945. On file in historical records of AFIP.
Memorandum, Office of Chief of Engineers, 5 May 1945, Lt. Co!. L. C. Urquahart.
THE IMMEDIATE, IMPERATIVE OBJECTIVE
proposed center should be on the northern outskirts of Washington, where ready
communication with the new medical centers of the U.S. Public Health Service
and of the Navy would be available. Forest Glen was suggested as an "ex-
cellent site for this project." s
In connection with the studies for the future location of the Institute
and Museum, Colonel Ash suggested still another alternative— the physical
separation of the historical portions of the Museum's collections, which would
be turned over to the Library to be housed in its new building near the Capitol,
and the more strictly medical functions of the Museum, which should go with
the Institute of Pathology, to be located at either Walter Reed or Forest Glen.
The Army Medical Museum, Colonel Ash wrote in a letter to The Surgeon
General, "is a responsibility that cannot be lightly overlooked in spite of the
facetious onus that has been attached to it through the years, 'the pickle factory.'
It constitutes a part of the cultural background of medicine at least equal to
that of the incunabula and rare books of the Army Medical Library. It con-
tains the largest collection of historic microscopes in the world, and the col-
lections of medical coins, models and stamps, ophthalmoscopes, stethoscopes, and
so on, are equal, if not more comprehensive, than any others. This material
should have its place in the so-called cultural development in which the Library
is to share and not be transferred to a comparatively inaccessible place * * *.
At present there are about two hundred thousand visitors a year to the Museum,
and while it is true that many of these come out of curiosity, the possibilities
to the medical department of acquainting such a large group of civilians of
all walks of life with its activities cannot be taken lightly."
Just as he felt that much of the Museum was more closely related to the
new Library, Colonel Ash felt that the Institute of Pathology was more
"logically concerned with the teaching and research programs of the medical
department than it is with the activities of a hospital." After all, the colonel
pointed out, "the Institute at present serves the Twentieth General Hospital in
Assam, India, in the same way that it serves Walter Reed Hospital in Wash-
ington," since the Institute "should not have to be concerned with 'run of the
mill' pathology." The pathology of a i, coo-bed hospital, he said, would add
little to the teaching or research resources of the Institute, which had "the
material from all the army hospitals and the large amount from the civilian
specialists with which to work * * *." "
So matters simmered for 6 months, while consideration was being given to
the place of the new building in the scheme of things in a postwar world. In
"Letter, The Surgeon General, U.S. Army, to Chief of Engineers. 12 Ma; [945.
" Letter, Col. J. F.. Ash to The Surgeon General. U.S. Army. 22 Maj [945.
713 028"- <U 20
276 ARMED FORCES INSTITUTE OF PATHOLOGY
that time, a series of meetings relating to the future of Medical Department
research was held by the Army Medical Research and Development Board.
One such meeting, held on 20 December 1948, was "occasioned by the knowledge
that plans for the Army Institute of Pathology, which is and will remain an
important element in the medical research program, had progressed to the point
that it had become essential to establish a general plan into which the Army
Institute of Pathology may fit logically and effectively." Col. Roger G. Prentiss,
chairman of the Board, reported to The Surgeon General that it was unanimously
agreed that there should be an Army Medical Research and Graduate Teaching
Center, one of the major elements of which was to be the Army Institute of
Pathology, and that it should be located at Forest Glen. 1 "
The basic plan of the Board was approved by Surgeon General Kirk, but to
his approval there were added "reservations and understandings" that "plans
for the Army Institute of Pathology must go forward without delay and no
effort at implementation of plans for a Research and Graduate Teaching Center
shall be permitted to interfere with the more immediate and imperative objective
of a new Institute."
"Establishment of the Army Institute of Pathology at Forest Glen," he
added, "is contingent on authorization for the simultaneous construction of a
new hospital at that site. In the event of failure to obtain such authorization the
Institute will be constructed in the general vicinity of the present Army Medical
Center." ll
As things turned out, failure to secure authorization for the new hospital was
to cause the abandonment of the Forest Glen project, but for nearly 3 years the
proposed research and graduate training program, to be located at Forest Glen,
was very much to the fore in the plans of the Army Medical Department.
Speaking at a Washington preview of an exhibit prepared by the Army
Medical Illustration Service for showing at the convention of the American
Medical Association in San Francisco, Surgeon General Kirk made public
announcement of the project on 3 June 1946 (figs. 83, 84). The 12-year program
of construction at an estimated cost of $40,000,000 which was envisaged had yet
to secure War Department and congressional approval.' 2
In December 1946, while plans for the relocation of the Institute of Pathol-
ogy ami the Museum were still hanging fire, Colonel Ash reached the age of
" Memorandum, Col. Roger G. Premiss to The Surgeon General. U.S. Army, through Deputy Surgeon
General George F. Lull, 21 Deecmbcr 1945.
'' Sixth indorsement, dated 6 January 1946, to Memorandum of 21 December 1945, cited in footnote 10.
• New 1 nrk Times, 4 June 194ft.
THE IMMEDIATE, IMPERATIVE OBJECTIVE
277
•I III ,11. il a
1
Figure 83.— Maj. Gen. Norman T. Kirk, The Surgeon General, U.S. Army, outl
a press conference, plans for a new medical center.
retirement as Director of the Institute, but continued in a civilian capacity for
the National Research Council as the Scientific Director of the American Registry
of Pathology.
The new Director of the Institute was Col. (soon to be Brigadier General)
Raymond Osborne Dart, who in addition to having served as Curator of the
Museum in the mid-io^o's, had been Assistant Director of the Institute-Museum
during the last months of Colonel Ash's administration.
In addition to a new Director of the Institute, there was a new Surgeon
General, when Maj. Gen. Raymond Whitcomb Bliss was appointed in mid-1947
to succeed General Kirk who had reached the statutory age for retirement.
Building Plans Reviewed
The new Surgeon General shared the interest of his predecessor in the de-
velopment of the Forest Glen medical center. In a statement for the press, re-
278
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 84.— Colonels James E. Ash and Raymond O. Dart look over the message of
an exhibit prepared for showing at the American Medical Association Meeting in 1946, as
Maj. Ruell A. Sloan, Curator of the Army Medical Museum (left), looks on.
leased on 22 June 1947, he outlined the plan to make Forest Glen "the greatest
medical center in the world." It was contemplated that the group of picturesque
buildings in a sylvan setting, which had been the home of a school for young
ladies, would be used until buildings better adapted to the work of research and
graduate training could be secured. The first of these new buildings were to
be the ones used for the Institute of Pathology and its associated Museum, and
the new hospital which was to be a key facility in the project."
A year after General Bliss's announcement, and 18 months after that by
General Kirk, the congressional approval necessary for getting started was
secured when, on 12 June 1948, President Harry S. Truman signed the measure
which became Public Law 626, 80th Congress, 2d session, and which authorized
the spendin g of $600,000 for "complete plans and specifications of an Army
,: New York Times, Washington Post, Baltimore Sun, 22 June 1947.
THE IMMEDIATE, IMPERATIVE OBJECTIVE
279
Institute of Pathology building, including all necessary auxiliary facilities," to
be located at Forest Glen, Md.
The Chief of Engineers, whose office was responsible for the planning and
erection of the building for the Institute, assigned the work to the District
Engineer Commissioner who, on 13 October 1948, contracted with the firm of
Faulkner, Kingsbury, and Stenhouse, Washington architects and engineers to
draw preliminary plans, relying upon the availability of funds under the pro-
visions of Public Law 626.
By this time, the Forest Glen site had been abandoned, due to a ruling by
the Bureau of the Budget and other Federal agencies concerned that no addi-
tional hospital beds for the Army should be constructed in the Washington
area. Since the Institute could not conduct its program of research and teach-
ing without access to the clinical facilities of a hospital, the Director of the
Institute and its Scientific Advisory Board had, in December 1947, recom-
mended to The Surgeon General that the new Institute be set up as a "self-
contained unit" on the grounds of an existing hospital in the Washington
area. 14 The logic of the situation pointed directly to the Walter Reed General
Hospital as the hospital; to the area of the existing Army Medical Center as
the site; and to the $600,000 authorized by Public Law 626 as the fund for
planning the new building.
But such a simple solution ran against the specificity with which Forest
Glen had been designated as the site upon which the building was to be erected.
Public Law 626, the Comptroller General ruled, on 19 November 1948, pro-
vided funds for drawing plans and specifications for a building at Forest Glen,
Md., and nowhere else. 1 "
Extensive and detailed studies were made of the functions and needs of
the various segments of the Institute's operations; visits were made to a score
of the most modern laboratory and technical installations, military and civilian;
and, in the light of all these studies, preliminary plans— all that could be done
within the existing limitations upon availability of funds— were carried for-
ward. These plans were submitted by the firm of architects-engineers to the
responsible representatives of the Chief of Engineers and The Surgeon General
and by 1 June 1949 had received approval. 1 "
In the existing state of the statutes and the rulings of fiscal authority, this
was as far as the project could be carried at the time, but studies by the Institute
r 1. li.
"Annual Report. Army Institute of Pathology, 1948, pp.
lJ Annual Report, Army Institute of Pathology, 1949, pp. 2J. 25.
"Mem.
2 g ARMED FORCES INSTITUTE OF PATHOLOGY
staff and its Scientific Advisory Board continued in anticipation of legislative
relief.
Meanwhile, and in fact all through the period of agitation and disappoint-
ment in the attempt to secure a new building, energetic efforts were underway
to make conditions more tolerable in the "old, unsightly, and overcrowded"
building which still housed the Institute and the Museum, along with the
Library. Once more, there was a general shuffling and rearrangement of offices,
laboratories, file and record rooms, and other spaces, so as to bring related
activities closer together in the four stories and basement of the building without
an elevator.
In part, this rearrangement was made possible by the fact that in August
1946 the Institute had secured from the Public Buildings Administration the
use of Chase Hall (fig. 85), across Independence Avenue from its location.
Chase Hall was a temporary building which had been used during the war
as the barracks of the SPAR's, the women's Reserve contingent of the U.S.
Coast Guard. It was allocated for Museum use upon the condition that the
Museum materials which had been given wartime storage in the National
Guard armory warehouse on the waterfront be removed without delay — which
meant that the Museum had to begin moving in before the necessary altera-
tions were completed, with the result that much of the material had to be
moved more than once, and some exhibits had to be shifted about as many as
five times, as the task of rearrangement proceeded (fig. 86).
On 7 May 1947, the Museum, or rather some parts of it, was opened to
the public in its new location at the former SPAR barracks (fig. 87). On the
first day, the Museum received 137 visitors, and by the end of the month of
May, it had been visited by more than 8,500 persons, indicating that the insti-
tution had not lost its hold on the public interest. 17
Additional space was secured 18 months later in another somewhat dilapi-
dated building located on Independence Avenue, Tampa Hall by name, the
occupancy of which the Institute and Museum shared with other Government
agencies. 18
Scientific Advisory Board of the AFIP
In this period, also, the Scientific Advisory Board of the Army Institute of
Pathology, appointed by The Surgeon General, held its first meeting on 3 March
1947. Dr. Balduin Lucke, back in civilian status as professor of pathology at
11 Annual Report, Army Institute of Pathology, 1047, p. 23.
u Annual Report. Army Institute of Pathology, 1948, p. 6.
THE IMMEDIATE, IMPERATIVE OBJECTIVE
281
Figure 85. — Sixth home of the Museum, Chase Hall, temporary quarters which were
occupied for 13 years, 1947-1960.
Figure 86. — Materials awaiting inventory as the Medical Museum moved trom ware-
house storage to Chase Hall. Most of the items shown are part of the Huntington Collec-
tion of Comparative Anatomy.
282
ARMED FORCES INSTITUTE OF PATHOLOGY
-J ^- "- "' € «. ™
■I n
n : B i'i; B n n
■ ■'■■«_
2 i
^n e
Ficlre 87.— A corner of the exhibits of the Museum as shown in Chase Hall.
the University of Pennsylvania, was elected chairman, to serve 1 year, and Dr.
Robert A. Moore of Washington University, St. Louis, was named as secretary.
At a second meeting, held on 13 April 1947, the Board discussed the plans
for the new Institute of Pathology, its functions, and its administrative status,
and recommended to The Surgeon General that facilities be provided for
"research in pathology in the broadest sense," that the personnel of the Institute
be "free to conduct research on an individual basis, in addition to participation
in major problems of the Army Medical Department," and that the Director
of the Institute "should be responsible directly to the Surgeon General." l0
The reasoning behind these recommendations is expressed in the Annual
Report of the Institute for 1947, submitted by General Dart, as follows:
Research in morbid anatomy constitutes but one of the phases of pathologic investiga-
tion. If research problems in pathology are to be properly correlated with medical problems
as a whole, laboratory investigation and animal experimentation are indispensable. These
phases of investigation are not available to members of the staff on the present premises of
"Annual Report, Army Institute of Pathology, 1947. pp. 14, 15.
THE IMMEDIATE, IMPERATIVE OBJECTIVE
283
the Army Institute of Pathology This deficiency is keenly felt by members of the profes-
sional staff who are tnuned to think and work ,n broader terms, but who cannot exerc se
their ab.ht.es and tendenc.es ,„ this direction under the present circumstances. The sZ
T bTtT r tT " I' " CVer ' aChlCVed by " leth0ds em P ,(, > ed in —W -atomy
a one, helpful though they may be in pointing toward the right approach. The importance
or the Army Institute of Pathology as the nat.onal center of pathology would make it n
datory for this Institute to take the lead in pathologic research. Th.s, however, can only
be ach.eved by proving the necessary facilities for all phases of pathologic study and
investigation to members of a qualified staff. 20
The Hawley Board
An even broader concept of the place of the Institute of Pathology in the
general scheme of military medicine after passage of the National Security
Act of 1947 resulted from the appointment and deliberations of the Committee
on Medical and Hospital Services of the Armed Forces. This Committee
commonly known as the "Hawley Board," was named in December 1947 by
James V. Forrestal, the first Secretary of Defense, with Maj. Gen. Paul R
Hawley, who had served as Chief Surgeon, European Theater of Operations
and later as Chief Medical Director, Veterans' Administration, as chairman,'
and the Surgeons General of the three armed services as members. The com-
mittee was charged with the duty of making a "thorough, objective and im-
partial study of the medical services of the Armed Forces with a view of
obtaining, at the earliest possible date, the maximum degree of coordination,
efficiency and economy in the operation of these services." "
Early in its deliberations, the Hawley Committee approved and recom-
mended to Secretary Forrestal the relocation of the Army Institute of Pathology
in such a way as to make it of the greatest possible service to all three of the
Armed Forces. These recommendations reaffirmed the points, made by the
Scientific Advisory Board of the Institute, regarding the status of the Institute
as a self-contained independent unit, the need of facilities for experimentation,
and the direct responsibility of the Institute to The Surgeon General of the
Army, all of which were "urgently recommended" to the Secretary. The Com-
mittee, however, reserved decision on the thorny questions of the name and the
location of the proposed new Institute. 22
On 4 February, the Hawley Committee named a subcommittee to study
these questions of name, location, and organization. General Dart was chair-
2a Annual Report, Army Institute of Pathology, 1947.
"Memorandum, Secretary of Defense James V. Forrestal, 1 January 1948, subject: Memorandum
for Dr. PaulR. Hawley.
"Recommendations of members of the Hawley Hoard, to Secretary J. V. Forrestal, 5 Januarv 104S.
n ARMED FORCES INSTITUTE OF PATHOLOGY
man of the subcommittee, with Capt. William M. Silliphant, MC, USN, and
Maj. Robert A. Patterson, USAF, MC, as members. After eight meetings, the
subcommittee filed its report on 25 March 1948, together with seven inclosures,
discussing in greater detail the questions of organization, function, and opera-
tion of a pathology service for the Armed Forces. The report recommended
that the Army Institute of Pathology be located on the grounds of the Walter
Reed General Hospital reservation, as an independent command, directly under
the command of The Surgeon General of the Army, but with the control of the
broad administrative and professional policies lodged in a board composed of
the Surgeons General of the three forces; and that in recognition of the joint
responsibilities of all the services, the name be changed to either the Military
Institute of Pathology or the Armed Forces Institute of Pathology.
The subcommittee's report on name and location was not accepted by the
Hawley Board which, at its meeting on 9 April 1948, instructed the subcommit-
tee to confer further with representatives of other medical and hospital establish-
ments in the Government service. The result was a supplemental report of
the inability of the subcommittee members to agree on a location, resulting in
separate and dissenting reports, with the Army representative favoring the
Army Medical Center as a site; the Navy representative favoring the grounds
of the National Naval Medical Center at Bethesda, Md., and the Air Force
representative taking the position that a "new Armed Forces Institute of Pa-
thology * * * should not be compromised by secluding it on a post of any
one service" but that the organization should continue as an Army in-
stallation, furnishing service to all the armed forces and other interested
agencies. 23
On 4 October 1948, the Hawley Board filed its report on the Army Institute
of Pathology in which, "after long and thoughtful evaluation of all the matters
involved, and after further exploration of possible alternative solutions" the
Committee concluded that the recommendations of the subcommittee in its
original report constituted "the most acceptable and most practicable basis for
solution of the problem."
The report of the Hawley Board on this subject was approved by Secretary
Forrestal on 21 February 1949, with the request that its recommendations be
put into effect as rapidly as possible. Outstanding among the recommenda-
tions for joint action were the declarations that the Institute should become "the
central laboratory of pathology for all of the Armed Forces," with the appro-
priate change of name to the "Armed Forces Institute of Pathology"; that the
23 Supplemental reports to Committee on Medical and Hospital Services of the Armed Forces.
THE IMMEDIATE, IMPERATIVE OBJECTIVE 9 g
Institute be relocated on the Walter Reed reservation; that it should be an inde-
pendent unit directly under the command of The Surgeon General of the
Army, although "broad administrative and professional policies" would be de-
termined by a joint Board of Governors consisting of the three Surgeons Gen-
eral; that the Director of the Institute should be selected by the Board of Gover-
nors; that the major fields of training in the Institute should be in advanced
pathological studies; and that the "experimental facilities of the Institute be
adequate and sufficiently comprehensive to permit any type of investigation
which may be important in the study of morbid anatomy and disease
» 24
processes.
With the approval of the Secretary of Defense, the way was cleared for a
profound change in the status, organization, and functions of the Army Institute
of Pathology. To work out the mechanism of the change, on 17 May 1949,
Rear Adm. Joel T. Boone, MC, USN, Executive Secretary for the Interim
Medical Coordinating Committee for carrying into effect the recommendations
of the Committee on Medical and Hospital Services of the Armed Forces,
appointed General Dart, Captain Silliphant, and Major Patterson as the sub-
committee to deal with the recommendations relating to the Army Institute
of Pathology. 2 ' In effect, the subcommittee was designated to work out the
detailed "constitution and by-laws" of the new Armed Forces Institute, putting
into effect the change in its status— a change which was effected, insofar as the
Army was concerned, with the issue of the Department of the Army's General
Orders Number 32 on 6 July 1949, with an effective date of 1 July.
There remained another massive obstacle to the achievement of the new
Armed Forces Institute— congressional authorization and appropriation for the
new building which was so desperately needed. That obstacle, too, was to be
overcome— an accomplishment in which many men had a hand, but which
could not have been overcome as it was nor when it was, without the determina-
tion, the drive, and the persistence of General Dart whose "prime objective"
it was.
"Interim Report of Hawley Board, approved by Secretary James V. Forrestal in memorandum to
Secretaries of the Army, the Navy, and the Air Force, 21 February 1949.
-"Letter, Rear Adm. Joel T. Boone to General Dart, Captain Silliphant, and Major Patterson, 17
May 1940.
CHAPTER XV
New Name, New Home,
New Responsibilities
The 8oth Congress, it will be recalled, passed in June 1948 the bill which
became Public Law 626— a law intended to pave the way toward obtaining a
new home for the Army Institute of Pathology but which proved to be, instead,
a roadblock on the legislative path toward that long-sought objective.
The genesis of the legislation was in H.R. 4122, introduced in the House of
Representatives by Walter G. Andrews of New York on 9 July 1947, to authorize
construction at various military installations. As introduced, the bill made
no provision for the new Institute, an oversight which was corrected by an
amendment proposed in the report of the Committee on the Armed Services,
on 23 July 1947. In explanation of the amendment, the Committee reported
that the proposed building to be erected at Forest Glen, Md., which included
provision for a 1,000-bed hospital, would "be the nucleus of an Army medical
research and graduate teaching center * * *." Such a center, the Committee
reported, was an "urgent and immediate" need, due to the "comprehensive and
global nature of modern military medicine" if the Medical Department was
"to fulfill its mission of protection and care of troops, to keep pace with world-
wide developments of significance to military medicine and to maintain a
productive relationship with the medical profession at large * * *. The Army
Institute of Pathology and medical museum are presently housed in an anti-
quated building which seriously limits the important functions of this institution.
Plans for the replacement of this building were interrupted by World War II
anil further delay would limit the valuable work of the institution to both
Army and civilian medicine." '
Before Congress acted on this bill, it was decided that no additional hospital
beds for Army use were to be provided in the Washington area. In view of this
1 (1) House of Representatives bills, Both Congress, volume 20, Numbers 4000-4199. (2) H.R. Report
Number 1048, 80th Congress, 1st session, volume 5, H.R. File Number 11122. In Miscellaneous Reports,
Numbers 864-1 114.
288 ARMED FORCES INSTITUTE OF PATHOLOGY
decision, Surgeon General Raymond W. Bliss asked the Budget Officer of the
Department of the Army, and the Office of the Chief of Engineers to have the
language of the bill amended by omitting the authorization for the new hospital,
reducing the amount authorized for planning from $850,000 to $600,000, and
revising the language specifying Forest Glen as the location of the Institute
building to read "Forest Glen or vicinity"— language which was deemed to be
broad enough to apply to either the Army Medical Center on the Walter Reed
reservation, the National Naval Medical Center at Bethesda, Md., or the Forest
Glen location.
Legislative Tangles
The item in the enabling legislation which authorized the new Institute
building was redrawn, leaving out the hospital feature and reducing, by $250,000,
the amount authorized for plans of the smaller facility but, through some in-
advertence or misunderstanding, leaving the Forest Glen designation un-
changed. 2
With the legislation in this shape, it was decided to locate the new building
on the Walter Reed reservation, and preliminary plans were undertaken by
the architectural firm of Faulkner, Kingsbury, and Stenhouse, with the assist-
ance of a planning group which included Brig. Gen. Raymond O. Dart and
Col. A. L. Tynes, Chief of the Hospital Construction Branch of the Surgeon
General's Office. To this group, there was added Maj. Colin F. Vorder Bruegge
of the Medical Corps of the Army, who was transferred from Walter Reed
General Hospital to serve as Assistant to the Director of the Institute, and his
representative in matters pertaining to the new building. In this position
Colonel (as he came to be) Vorder Bruegge rendered outstanding service. 1
Planning, perforce of a preliminary character, was started in October 1948,
only a month before the Comptroller General ruled that the expenditures
authorized by Public Law 626 could not be made in relation to any site other
than Forest Glen. Nevertheless, progress was made in preliminary planning
through the use of fiscal year 1947 funds which were available up to 30 June
1949, and by 1 June of that year, these plans had been approved by the Govern-
ment agencies directly concerned— Chief of the Engineers and the Medical
Department of the Army. 1
-Letters, Gen. R. W. Bliss to Director of Logistics, General Staff, U.S. Army. 23 December 194*. and
1st indorsement thereto, 3 January 1949. On file in historical records of AFIP.
3 Annual Report, Army Institute of Pathology, 1948, p. 13.
*(i) Ibid., p. 14. (2) Annual Report. Armed Forces Institute of Pathology, 1949, p. 24.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES 2 8 Q
There matters stood for nearly a year, while studies were being made by
the Hospital Division of the Bureau of the Budget, particularly directed to the
relationship between the Institute and other Federal medical agencies, including
those already located at the Walter Reed Army Medical Center.
In the course of that year, the Department of Defense had come into
existence and, as one of the first fruits of that coordination of effort, the Army
Institute had become the Armed Forces Institute of Pathology, serving all the
Armed Forces— a change of status as well as a change of name, which was
recognized in the proposed amendment to Public Law 626. In addition to
the change of name, the proposed amendments called for location of the new
building at the Walter Reed Army Medical Center and a reduction in the
amount requested for planning from $600,000 to $350,000.
On 11 October 1949, the Bureau of the Budget gave its approval to the
submission of the amendment to the Congress, provided that the plans for the
new building should be changed so as to eliminate facilities which might
duplicate existing medical research work, and to bring about a closer coordi-
nation between the new Institute and the Army Medical Center.
One week after this clearance by the Bureau of the Budget, the desired
amendments were introduced in the House of Representatives by Representa-
tive Carl Vinson of Georgia, as H.R. 6478, and in the Senate by Senator Richard
B. Russell of Georgia (for Senator Millard E. Tydings of Maryland), as S.
2737. On the next day, 19 October 1949, the first session of the 81st Congress
ended, without action on the bills. 5
Congressional Hearings
The House moved first in acting on the amendment to the enabling act
when, on 3 February 1950, a subcommittee of the Armed Services Committee
held hearings on H.R. 6478. At these hearings, General Dart forcefully de-
picted the plight of the Institute, with its broad new responsibilities but its old
limited and insufficient space. "The greatest handicaps to the further develop-
ment of the institute," he said, "are the lack of space and the complete absence
of experimental facilities in the existing obsolete building. Researches are,
therefore, confined to pathologic anatomy and statistical analysis, which sharply
limits full utilization of the collection of pathologic material."
As to the relation between the Institute and other Federal medical agencies,
General Dart pointed out that the hospital capacity of the agencies which relied
5 (1) Ibid., pp. 25, 26. (2) Congressional Record, 8ist Congress, ist session. Senate, 18 October 1949,
p. 14828, volume 95. part 11. (V) Ibid., House, p. 14964.
290
ARMED FORCES INSTITUTE OF PATHOLOGY
upon the Institute as a "national pathology center" — the Armed Forces and the
Veterans' Administration — totaled 232,132 beds, while the corresponding figure
for Federal agencies not utilizing the Institute as a central laboratory of pa-
thology numbered only 23,469. "Since the greater proportion of the beds
operated by the Federal government," he said, "are occupied by military or
former military personnel, the responsibility of maintaining the collection of
pathologic material for training and research is definitely within the military
service.
Ten days later, on 13 February 1950, Mr. Lansdale G. Sasscer of Maryland,
chairman of the subcommittee which had considered the subject, filed his com-
mittee's report recommending passage of H.R. 6539, a bill, introduced by Mrs.
Frances P. Bolton of Ohio, which contained the amendatory material as H.R.
6478. One week later, on 20 February, Representative Bolton's bill was passed.
In an extension of remarks in the Congressional Record, Mrs. Bolton expressed
her appreciation to Chairman Vinson of the Committee on Armed Services for
his courtesy in considering her bill, and went on to say: T
In modern medicine the Department of Pathology, the laboratory of any hospital or
group of hospitals, is the heart of the facility. Accurate diagnosis and consequent treat-
ment is largely dependent upon perfection of laboratory work.
The benefits to be derived from the change of location of the contemplated building
have been recognized both by the Department of Defense and the Department of the Army.
The fiscal advantage of the savings made possible as well as the value of the broader
improvements involved has been given Bureau of the Budget approval. All three recom-
mend passage of this bill.
Passed by the House, H.R. 6539 was sent to the Senate, where further hear-
ings were held on 9 March 1950, with General Dart again appearing as the
principal witness.
In answer to a question, General Dart gave an estimate of the final cost of
the building, as revised and reduced, as "a little over $10,000,000." "This has
been reduced $i,ooo,coo," he added, "as the result of an agreement with the
Bureau of the Budget and the Director of Medical Services, in which we agreed
to reduce certain of the facilities that we had originally planned, to integrate it
into the program at Walter Reed that would have required an additional ex-
pense of $411,000 to expand facilities that are already overcrowded. So that
with this agreement, the original estimate has been reduced a total of $1,000,000
H.R. Report Number 160, 8ist Congress, 21I session, Congressional Record, House of Representatives,
: 3 February 1950, p. 1779, volume 96, pt. 2. In bound volume number 759, Proceedings and Debates,
1950.
' Ibid., p. 1980, 20 February 1950.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
291
Figure 88. — Scale model of the new building as planned before the requirement
that the structure be blast-resistant compelled a sharp reduction in floor space to stay-
within the appropriation.
in the building itself, and the saving of $411,000 by eliminating this extra
construction." s
At the close of the hearing, the Committee voted unanimously to recom-
mend the measure favorably and, on 19 April 1950, the House bill passed the
Senate and was sent to the White House where, on 29 April 1950, President
Harry S. Truman signed it to become Public Law 495, 81st Congress, 2d session. 3
Any thought that passage of the amendatory enabling act was all that was
required to permit the Institute and its architects to go ahead with final plans
and specifications was strictly illusory, for once more, overriding fiscal policies
intervened. On 4 May 1950, less than a week after the new law went into
effect, the Director of the Budget Bureau informed the Secretary of Defense that
funds for the new Institute building would be withheld, unless the cost of the
building should be reduced from the original estimate of $11,004,041 by 40 per-
cent, or to approximately $6,800,000. This meant, as a restudy of the plans
showed, the elimination from the plans of the entire public museum wing, a
500-seat auditorium, the public vestibule and lobby, two large bulk storage areas,
anc j — m ost serious of all — the elimination of space equivalent to two entire
floors in the laboratory services wing (fig. 88).
"Typewritten copy of. report, copied from Committee clerk's unpublished record. On file in historical
records of AFIP.
"U.S. Statutes at Large, volume 64. part 1, p. 96, Chapter 139 (12 S;.H~. }7*>)-
292
ARMED FORCES INSTITUTE OF PATHOLOGY
To achieve such reductions meant concentrating upon one floor the labora-
tories planned for three floors; eliminating the seminar-type teaching labora-
tories on two floors; cutting in half the space devoted to the American Registry
of Pathology; reducing the working library from 25,000 volumes to 15,000;
reducing the facilities for experimental animal research by 50 percent; reducing
the Medical Illustration Service by 40 percent; and eliminating the public
museum, though retaining the advanced teaching museum area and tbe
museum laboratories.
On 16 May 1950, the whole subject was presented at a formal Bureau of the
Budget hearing, at which Maj. Gen. George E. Armstrong, Deputy Surgeon
General of the Army, explained that with these revisions, although the new
building would have approximately double the area occupied by the Institute
in the old building at 7th and Independence Avenue, it still "would provide
space for only the basic activities of the Institute at the time of occupancy" and
should, therefore, be designed so that wings could be added to care for
expansion.
A Bomb-Resistant Structure
Representatives of the Bureau of the Budget "agreed to support the revised
plan and promised to release funds for final planning in the near future' " ] "—
but there were other obstacles to meet and overcome. On a Sunday morning
in June 1950, the North Korean Reds crossed the 38th parallel of North latitude
ami advanced against the Republic of Korea. The United Nations, led by
the United States, came to the aid of the Republic. Presumably, because of
a greater awareness of the possibilities of war, and doubtless, sharpened by
the fact that the Soviet Union had burst its first atomic bomb, a Presidential
directive, passed on by the Budget Bureau to The Surgeon General, required
that the new building must be designed to meet the specifications of the National
Security Resources Board for bomb-resistant structures.
Final and definite specifications for building bomb-resistant structures had
not at that time been completed by the National Security Resources Board
but, acting upon an estimate that conformity with the bomb-resistant require-
ment would add 10 percent to the cost of the Institute building, the Bureau of
the Budget increased its May allowance of $6,800,000 by that percentage, to a
total of $7,480,000, including the $350,000 for planning and the balance of
$7,130,000 for construction.
10 Annual Report, Armed Forces Institute of Pathology, 1950,
pp. 10, 11
NEW NAME, NEW HOME, NEW RESPONSIBILITIES ,
New plans had to be drawn to incorporate the bomb-resistant features
with the expectation that the plans, drawn in the final weeks of i 95 o, with
the cooperation of the Protective Construction Division, Office of the Chief
of Engineers, and the National Security Resources Board, would receive Board
approval early in 1951.
Efforts were made, without success, to have the full original estimate of
$11,004,041 included in the military budget for fiscal year 1951. Failing in
this, the proponents of the new Institute undertook to get the $7,130,000 for
construction, according to the revised plans of May 1950, included in the fiscal
year 1952 military budget."
Before this could be done, however, the impact of the Korean war called
for a revision of the entire military program and necessitated the filing of
a second supplemental fiscal year 1951 budget of high-priority items. The
$7,130,000 item was included in the Medical Department figures in two bills,
introduced in the House of Representatives by Mr. Vinson on 11 December
1950— H.R. 9893, an authorization, and H.R. 9920, an appropriation. The bills
passed the House on 15 December 1950, and the Senate on 21 December. Both
were signed by President Truman on 6 January 1951, to become Public Law
910 and Public Law 911, 81st Congress, 2d and closing session. 12
Going Ahead on the New Building
Before the legislative obstacles and delays were finally surmounted, General
Dart, the vigorous leader of the movement for the new building, had retired
on the last day of July 1950, and had been succeeded by another vigorous ad-
vocate of the new Institute, Col. (later Maj. Gen.) Elbert DeCoursey (fig. 89).
The new Director was a native of Kentucky, and a graduate of the Uni-
versity of Kentucky, with the M.D. degree from the Johns Hopkins University
School of Medicine. He joined the Medical Corps of the Army in 1929, had
served as pathologist at several major Army hospitals, and had been active in
research in the field of atomic energy and radiobiology.
The retiring Director, General Dart, was signally recognized by the publi-
cation of an entire number of The Military Surgeon in his honor. Issued in
October 1951, the issue contained forewords by Maj. Gen. George E. Arm-
strong, who had succeeded General Bliss as The Surgeon General of the Army;
by Rear Adm. H. Lamont Pugh, Surgeon General of the Navy; by Maj. Gen.
a Ibid., p. 12.
" Congressional Record, 8ist Congress, 2d session, House of Representatives, 6 I.inu.irv 1951, page
17139, volume 96, part 12. In bound volume number 769, Proceedings and Debates,
ARMED FORCES INSTITUTE OF PATHOLOGY
Ficl-re 89. — Brig. Gen. Elbert DeCoursey, second Director, Armed Forces Institute
of Pathology, 1950-1955.
Harry G. Armstrong, Surgeon General of the Air Force, and by Brig. Gen.
Elbert DeCoursey, successor to General Dart at the Institute; an appreciation
by Col. James M. Phalen, editor of the journal; and an acknowledgment by
Dr. Hans F. Smetana, head of the Pathology Division of the Institute and chair-
NEW NAME, NEW HOME, NEW RESPONSIBILITIES -> Q< -
man of the editorial committee which was responsible for the tribute to General
Dart.
The body of the issue contained 20 scientific papers, prepared by 54 authors
who were, or had been, connected with the Institute. Dr. Smetana assembled
these papers, "under the guidance of Doctors Howard T. Karsner and Balduin
Lucke." ' '
General DeCoursey, with the continuing help of Colonel Vorder Bruegge,
drove ahead on the final steps toward translating, from sheets of drawing paper
to the reality of concrete and steel, the building which had been authorized
and for which the appropriation had been made (fig. 90).
Release of the appropriated funds was held up for almost 4 months because
of administrative delays, but the time was not entirely lost. The delay afforded
an opportunity to submit the preliminary drawings, as revised, to a meeting
of the Scientific Advisory Board, held on 31 March 1951. At this meeting, Mr.
Slocum Kingsbury, of the architectural firm, outlined the essential features of
the bomb-resistant plan, and Colonel Vorder Bruegge, whose part in planning
the interior floor plans can hardly be overestimated, used visual aids to demon-
strate the arrangements, which became the subject of active ami keenly critical
review by the Board. Close attention was paid to the facilities for investigative
laboratories, which were to be grouped on both sides of a service space in which
the pipes, cables, and conduits were to rise, with outlets to each laboratory.
The Board recommended that these utilities should include piping for hot and
cold water, steam, compressed air and vacuum, and heavy-duty electrical lines.
These and other recommendations of the Board were included in the final set
of preliminary drawings, completed in April 1951. 1 '
On 8 May 1951, the Washington District Office of the Corps of Engineers,
under whose direction the construction was to proceed, employed the firm of
architects which had drawn the preliminary plans to complete the drawings
necessary for letting construction contracts — a task which involved making more
than 250 sheets of drawings, including more than 50 sheets for the electrical
installations alone, and which required more than 6 months to finish. 15
Breaking Ground
Meanwhile, preparation of the site for the new building was started on
10 July 1951, with the traditional ground-breaking ceremonies. General
13 The Military Surgeon, volume 109, number 4, October 1951.
"(1) Minutes, eighth meeting. Scientific Advisory Board. Exhibit f. (2) Annual Report. Armed
Forces Institute of Pathology, 1951.
13 Ibid., pp. 21, 22.
296
ARMED FORCES INSTITUTE OF PATHOLOGY
Fid k, 9o.-Lt. Col. Colin F. Vorder Bruegge, who was of immense assistance in develop-
ing the details of the new building.
DeCoursey, who presided, presented to the group of some 600 in attendance
the curators and the director who, since 1918, had sought a new building-
Brig. Gen. George R. Callender, "who started the American Registry of
NEW NAME, NEW HOME, NEW RESPONSIBILITIES 2 Q7
Pathology"; Col. Virgil H. Cornell, "who modernized the Museum exhibits";
Col. James E. Ash, "who transformed the organization into an Institute of
Pathology" and who upon that day had telephoned from Buffalo, N.Y., to
express his disappointment at being unable to attend; and Brig. Gen. Raymond
O. Dart, "who extended the Institute's services to all the Armed Forces, and
who successfully laid the groundwork that obtained the new building."
Among the other distinguished guests presented by General DeCoursey
were Fred A. McNamara, Chief of the Hospital Branch, Bureau of the Budget,
introduced as "the sympathetic man who learned of our plight, saw the need,
and obtained the necessary executive support"; Dr. Arnold Rich of the Johns
Hopkins University, the current chairman of the Scientific Advisory Board ; and
the three deputies for the Surgeons General who formed die Board of Governors
of the AFIP— Col. Hugh R. Gilmore, Jr., for the Army; Rear Adm. John Q.
Owsley for the Navy, and Col. John F. Dominik for the Air Force.
Maj. Gen. Paul H. Streit, Commanding General of the Walter Reed Army
Medical Center, welcomed the assemblage to the ground-breaking ceremony.
Of the three ceremonies customary in connection with the construction of new
buildings — the breaking of ground, the laying of the cornerstone, and the day
of dedication — he described the ground-breaking as the "least spectacular" but
the most "soul-satisfying occasion," as it "represents, at last, a beginning— a
first evidence that dreams and hopes and plans have crystallized into reality"
(fig. 91).
Yet, General Streit said, "we are not uncovering the sod on a new idea; we
are celebrating the ripening — the coming-of-age — of an old one. The 'Army
Medical Museum,' as the institution was first called, was authorized by the
young and forward-thinking Surgeon General Hammond, in the early days of
the Civil War. The plan to include the Museum as an integral part of a medical
center was proposed by Lt. Col. William Cline Borden in the early post-Spanish-
American War period. Surgeon General Ireland, one of the great Army sur-
geons general, secured the necessary land in 1919 and made it a part of the
hospital grounds."
Voicing "our great pride in the past accomplishments of the late Army
Medical Museum," he declared that with the additional support of the other
services "together we can forge an even more illustrious future."
Speaking for one of the "sister services," Rear Adm. C. J. Brown, Deputy
Surgeon General of the Navy, struck a keynote when he said :
It is, to me, an important and most interesting happenstance that the first permanent
edifice to be built under the aegis of the unification of the Armed Forces should he. not an
298
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 91.— Programs for the three ceremonial steps in the erection of the AFIP
building.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
2 99
arsenal, not a tank factory nor an airplane plant, but an institute equally useful in peace
Medil" " ""' t0 ^ "^ ° f *"""*'' ^^ advan — f > and international
Speaking for Surgeon General Harry G. Armstrong of the Air Force
Brig. Gen Earl Maxwell emphasized the point that the Air Force had been
able to utilize the services of the Institute and would "continue to enjoy that
privilege * *. There is no other repository anywhere which can supply
us with so much valuable information on the causes, effect, and treatment of
many epidemic and tropical diseases."
Continuing, the Air Force spokesman said :
Infectious jaundice, typhus, malaria, cholera, high altitude frost bite and various other
exposure problems are but a few of the host of diseases and conditions which confront our
military personnel in varying environments in all parts of the world. In its aims and
purposes, the Institute represents the hard core of our attack on disease and war injuries
which ordinarily take such a terrific toll of military effectiveness * * *. In these days
of increasingly devastating conflicts, this institution will become of even greater importance
than during the past. New types of warfare, including atomic weapons, make additional
pathological facilities mandatory for the prevention and treatment of casualties.
Vice Adm. Joel T. Boone, MC, USN (Ret.), and Medical Director of the
Veterans' Administration, spoke of the deep interest and intense pride taken
by that administration in the achievements and advances by the AFIP. General
Callender, he noted, was now Chief of the Pathology Division of the Veterans'
Administration, which took "pride and pleasure in the very real part it is
playing in this important example of medical teamwork."
Maj. Gen. George E. Armstrong, Surgeon General of the Army, the
principal speaker for the occasion, emphasized "the splendid achievements of
several who have played a part in today's culmination of these years of dreaming
and working," mentioning General Callender, Colonel Cornell, General Dart,
and Colonel Ash. "It is through these individuals," he said, "together with
the Surgeons General of the Army of the past several decades, some of whom
are here this afternoon, that finally after years of effort we come to the fruition
of our vision."
Emphasizing the part played by the Hospital Branch of the Bureau of
the Budget, General Armstrong expressed appreciation of the contributions of
Mr. McNamara and his associates— "because, believe it or not, in the final
sessions that we have been through no professional person, or persons, have
fought any harder than these individuals representing the Executive portion
of our Government."
713-02S r — fi4-
^00 ARMED FORCES INSTITUTE OF PATHOLOGY
Disclaiming any intent to recite the progress of the Institute through its
"four-score and nine years" of life, General Armstrong contented himself with
a brief account of General Hammond and his "far reaching, and, I am sure, at
that time considered visionary, recommendations" and invited attention "to
the steps which took us from the Museum stage, which, in the minds of the
public both lay and professional, tended to emphasize the dead and the dead
past" to the newer and broader institute whose "primary concern is the living,
and not the dead."
At the conclusion of General Armstrong's address, Colonel Vorder Bruegge
handed the ceremonial shovel to General Dart, who explained its symbolism.
"It is," he said, "from the traditions of the past in the old Museum," — the
blade was "made from the hinges of cases in the old museum, some of which
go back to the days when the Museum was located in Ford's Theater; the
mold was made in the Institute; the casting made by the Naval Gun Factory in
Washington; the shaft was turned from wood saved from the old cases when
they were replaced by newer and sturdier ones; and the handle was made from
a microscope in the old Museum."
"Most important of all," he said, "and the symbol of the part that this
Institution is going to play in American medicine in the future, is a microscope
slide that was prepared by one of the first members of the staff of the Museum,
Dr. J. J. Woodward, one of the earliest photomicroscopists in the United States.
This slide, now inlayed in the shaft of the shovel, has been preserved since before
1880."
Handing the shovel to General Armstrong, General Dart stressed the
fact that he was "merely the agent of many, many individuals, men and women,
in the military service and in civilian life, who have worked so hard for so many
years to bring this occasion about."
The occasion was climaxed by the turning of a clod by General Armstrong,
after which the elaborately symbolic shovel and the first clod were turned over
to the Museum for preservation (fig. Q2). 1S
The breaking of ground and work of preparing the site for the building —
work which involved moving bodily five large frame residences (fig. 93) to
another part of the Walter Reed reservation — did not bring an end to the
planning of detailed features. Rather, it was discovered that "throughout the
design period plans for a building of this type never become static." Particu-
larly was this true of the new home for the Institute, not only in the period of
design but also in the period of construction, and even in the finished building,
"Annual Report, Armed Forces Institute of Pathology. 1951, exhibit 9: Ground Breaking Ceremony.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
A'
Figure 92.— The turning of the sod. A. Maj. Gen. George E. Armstrong wields the
ceremonial spade.
because of the in-built flexibility of its plan, a feature for which Colonel Vorder
Bruegge was in a large degree responsible.
The building is essentially a grouping together of units of space, in a
repetitive modular arrangement under which advance preparation was made
for the quick, easy, and inexpensive rearrangement of partitions between units.
The module of space which was to determine the overall size was taken to be
11 by 20 feet for a laboratory unit in the central core of the building, and 11 by
^02 ARMED FORCES INSTITUTE OF PATHOLOGY
B
Figure 92. — Continued. B. The symbolic spade.
18 feet as a unit of office space along the outer walls. All necessary utility
outlets were to be available in each unit, while larger units could be created
by the ready removal of partitions. As part of the planning, the District En-
gineer built a mockup of an individual laboratory module in which it was
possible to pretest ideas for the placement of equipment and fixtures, including
laboratory benches for both sitdown and standup use, and also to try out floor-
ing materials and different color schemes.
With excavation underway (fig. 94), the planning group turned its attention
to the equipment for the new building — an activity which was to become a
major undertaking in 1952. On the first working day of that year, the District
Engineer placed sets of the contract drawings in the hands of construction
companies who desired to bid on the job, allowing 60 days for study of the
plans and specifications. Bids were received from nine prime contractors,
ranging from $4,924,000 to $5,787,000— figures which did not include several
features, such as elevators, structural steel purchased in advance, and electrical
switchgear, amounting to a total of $865,000. The low base bidder was the
firm of Cramer and Vollmerhausen, of Washington, to which the contract was
let on 7 March 1952. 17
Laying the Cornerstone
The outer walls of the building were halfway up when, on 20 October
J 953> tne second ceremonial occasion in its progress was observed with the laying
"Annual Report, Armed Forces Institute of Pathology, 1952, section III.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
3^3
Figure 93. — Clearing the site of the new building.
of the symbolic cornerstone. Welcoming the assembled group of some 1,500
persons to the Walter Reed Army Medical Center, Maj. Gen. Leonard D.
Heaton, Commanding General of the Center, expressed the pleasure and pride
5 "4
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 94. — Excavation troubles.
with which he viewed the addition to the medical installations on the Walter
Reed grounds of "this great center of pathology, unique and unparalleled in the
field of medicine."
The principal address at the cornerstone laying was delivered by Dr. Melvin
A. Casberg (fig. 95), Assistant Secretary of Defense (Health and Medical),
who, in a reminiscent mood, traced the development of "this great new Armed
Forces Institute of Pathology as the culmination of the dreams of a host of dis-
tinguished men of American medicine." The removal from the "old red brick
building," with all its associations and atmosphere, stirred many vivid recollec-
tions — of John Shaw Billings whose "professional prestige, influence and fore-
sight did much to obtain the close cooperation of these military establishments,
medical schools * * * and other scientific institutions"; of Walter Reed
who "in that same building completed his work on typhoid fever," and "there,
he and Carroll formulated plans for the famous yellow fever studies."
World War I, Dr. Casberg said, "saw a resurgence of activity at the
Museum," and, in 1920, the "more recent era" was initiated by General Cal-
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
Ficire 95. — Cornerstone laying ceremony. Dr. Melvin A. Casbcrg addresses the
audience and spreads the mortar for the cornerstone.
306 ARMED FORCES INSTITUTE OF PATHOLOGY
lender, striking out in a direction in which his successors had continued, with
ever-enlarging responsibilities. Notable among these enlargements was the
designation of the Institute as the central laboratory of pathology for the "rap-
idly expanding medical program of the Veterans' Administration."
"This, then, is the cornerstone of American medicine of today," Dr. Casberg
said, "representing the united aims and efforts of civilian physicians as well as
those in the Armed Forces."
Giving instances of the Institute's accomplishments in its three basic
activities— consultation and diagnostic services, teaching and investigation — Dr.
Casberg continued : 1S
Some may have considered the Armed Forces Institute of Pathology as a repository
of museum specimens and tissues dusty with age; specimens deposited to satisfy the morbid
curiosity of the visiting populace. Nothing could be further from the truth, for housed
within the walls of this institution are the scientific keys which have and will continue
to unlock the secrets of disease. Here is demonstrated the close collaboration between
Armed Forces and civilian medicine, a joint effort so smoothly woven that the identity of
individual civilian and military threads are lost in the warp and woof of the composite
produce * * *.
As I spread the mortar which will unite the cornerstone with this building, it shall
be my prayer that all our medical resources, civilian as well as military, similarly shall be
cemented in a united fight against disease and for the preservation of our country.
The building which was thus treated as a symbol of collaboration in medi-
cine was so nearly completed by September 1954, wnen f he International Con-
gress of Clinical Pathology and the triennial meeting of the International
Society for Geographic Pathology were held in Washington, that the delegates
from foreign countries were able to visit it and inspect its features, inside and
out. 19
Roof and floor slabs, also of heavily reinforced concrete, furnish internal
bracing of the mass, as do transverse concrete walls and the greater depth of the
mass due to the double-corridor design of the interior. Necessary openings in
the outer walls of the central mass are closed with blast-resistant doors. The
heart of the building is in the central block of research laboratories, located on
both sides of a 3-foot-wide "mechanical core," extending lengthwise of the
building, through which each laboratory is supplied with such essentials as
electricity, water, gas, and compressed air. Surrounding this rectangular block
of laboratories is a passageway, separating the laboratories from the offices which
are ranged against the windowless outer walls. At the ends of the building up
" Annual Report, Armed Forces Institute of Pathology, 1953.
" Annual Report, Armed Forces Institute of Pathology, 1954, p. 1.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
307
A. F. I. p.
THIRD FLOOR PIAN
STUDY DENTAl ft
OUAl
kkm mwxoov r^ WN
■ I
U I ! U I ,
HISTOCH EMISTRY LABCBATORIES , Zl g ■*
r " ,n ' HISTOCHEMISTRY LASCMtATORIES ( Jj-'j
iOFHCES T ~ I ' I ftv ^ I " BIOCHEMISTRY IMMUNOCHEmISTRY
I ■ I BIOPHYSICS , -
ELECTRON MICROSCOPY
I U
I MECHANICAL CORE I
fERINARY PATHOLOGY
CLERICAL
TOCX
i!
BIOPHYSICS Z 2^ p *
PATHOLOGIST'S '.
O'flCES J
8f--X
c«i2>
Figure 96.— Typical floor plan of new Armed Forces Institute of Pathology building.
to the height of four stories above ground are windowed "blisters" containing
offices. Blast-resistant doors on each floor afford communication between the
main mass of the building and the offices in the two outer projections (fig. 96) . 20
By the time the building was inspected by the international visitors, installa-
tion of equipment and furniture had begun and, on 20 January 1955, the monthly
meeting of the Medical Service Corps of the Army was held in the new AFIP
building auditorium. At this first meeting in the hall, which had not yet
received its name of Dart Auditorium, Col. Byron L. Steger, MC, of the Institute
staff, presented a paper on "Field Medical Services in Korea." 21
By mid-February 1955, the Institute had begun to move into its new quarters.
The movement, skillfully planned by General DeCoursey, was completed with
a minimum disruption of work in mid-March, but it was not until May that
the building was formally dedicated."
Dedication
Two days, 26-27 May i955,were devoted to the dedicatory exercises (fig. 97).
On the afternoon of the first day, President Dwight D. Eisenhower delivered
20 Vorder Bruegge, Colin F.: New Building Facilities for the Armed Forces Institute of Pathology,
Scientific Monthly 79: 81-89, August 1954.
21 Announcement, in files of AFIP.
21 Annual Report, Armed Forces Institute of Pathology, 1955, p. 3.
71 3-02S* — 64 22
3 o8
ARMED FORCES INSTITUTE OF PATHOLOGY
IKVKi: STIMIfi:
Waltei Reed \nm M (1 |h.iI i tim-t. Washington. D. ' -
President Speaks at AFIP Dedication
lUffiiilurh's \\ iliu'ss
Colorful C <»r<»liioitM
:■
s^
la m
■ ■
;;;:;:
.p.. i ,
■
' bap Iiiicm Sp«>ukn
>IHi(l;i\ ul ( li;||H-|
■ ■
■
Figure 97. — Service Stripe, the Walter Reed Army Medical Center newspaper,
devotes the first page of its 27 May 1955 issue to coverage of the dedication ceremonies
ot the preceding day and the scientific program to be given on the day of issue.
NEW NAME, NEW HOME, NEW RESPONSIBILITIES
Figure 98.— President Dwight D. Eisenhower dedicates the new buildi
the address of dedication, before an outdoor audience of 3,000 persons (fig. 98).
That evening, Dr. Wendell M. Stanley of the University of California, noted
biochemist and Nobel laureate, gave the principal scientific address. Appro-
priately entitled "New Horizons," Dr. Stanley's address dealt with what is
known and what is not yet known in the "borderline between the living and
the nonliving" in the world of the virus.
"About the turn of the century," he said, "there was a something discovered
that acted like a cell * * *. This something or other that acted like a cell would
pass filters which were known to hold back all of the cells then known and this
something would cause disease when applied to certain other susceptible cells.
During the disease producing process it would be multiplied many millions of
times over * * *. This mysterious something turned out to be a virus * * *
smaller than the accepted living cells," but with characteristics "recognized as
those of living cells."
In an inspiring lecture, outlining what has been discovered as to these very
real materials and posing some of the challenges to further search, Dr. Stanley
concluded :
I do not know the answer to this structure of nucleic acid at the molecular level. It
is one of the unanswered questions. If this can he answered, if certain other problems
310 ARMED FORCES INSTITUTE OF PATHOLOGY
of the manner of reproduction of viruses can be answered, I think we will have gone a long
way towards explaining the nature of life itself.
On the second day of the dedicatory exercises, 10 scientific papers prepared
by 14 current and former members of the Institute staff were presented and
discussed.
For the nonscientific generality of the public, these papers, written in tech-
nical language and addressed to a technically trained audience, were impressive
but not altogether comprehensible. Better understood were the earlier remarks
of the President of the United States, who said that he "did not come here to
talk scientifically" but to dedicate a "great building" which, he was told, was
"arranged better and more efficiently for the conduct of the work here to be
done than any other that this country has erected."
In introducing the President, Secretary of Defense Charles E. Wilson spoke
of the new building as an example of unification. The President carried the
idea further, saying, " * * * some years ago those of us who were advocating
unification of the services saw something of this kind in the offing, even though
we were ignorant of the exact form these developments would take. For that
reason I couldn't be happier that all of the services are combined in this
effort * * *.
"And so I dedicate this building to the conquest of disease so that mankind,
more safe and secure in body, may more surely advance to a widely shared
prosperity and an enduring and just peace." ~ 3
23 Dedication, Armed Forces Institute of Pathology, Walter Reed Army Medical Center, 26-27 Ma y 1955-
Military Medicine 117: 176-306, September 1955.
CHAPTER XVI
Carrying On in the "Old Red Brick"
During the decade of determined effort to procure and occupy the new
building, there had been no cessation or slackening of the work which went on
in the cramped and crowded corridors and rooms of the building, which for
nearly 70 years had been the home of the Museum and its offspring, the Institute
(fig. 99). On the contrary, sharp increases in the output of the staff were
necessary to meet the rising demand for the fundamental services of consulta-
tion, education, and research in pathology.
In 1947— the first year in which the change of emphasis from "Museum"
to "Institute" became fully effective— newly accessioned cases numbered 21,764.
Two years later, after the field to be covered had been broadened from the
Army to the Armed Forces, the number of new cases rose to 36,029— and the
real rise in the flow of materials into the Institute had just begun. 1 Already,
however, the "heavy and unrelenting pressure of the daily routine" was im-
posing a "serious hardship on all members of the professional staff." As the
Director of the Institute said, in his report for 1949, it was "barely possible to
keep up with the incoming material during the working day when ancillary
personnel is available, study and scientific research must be relegated to nights
and week ends."
In the year 1950, the first full year of operation as the Armed Forces Institute,
the number of cases received went up to 49,518, despite the fact that 13 histo-
pathology centers had been established for the dual purpose of facilitating diag-
nosis and consultative services by providing them "in closer geographic relation-
ship to Armed Forces Hospitals" and reducing the pressure upon the Institute
by screening out commonplace specimens before submittal. Under the new
regulation, materials from all completed autopsies were still to be sent in, but
surgical specimens sent in were to be limited to those which had "future ad-
ministrative, scientific, or follow-up value." 2
Instructions were made more specific in a special regulation issued on 8
June 1950, which required that all specimens derived from surgery on tumors
1 Annual Report, Armed Forces Institute of Pathology, 1947, p. 11.
2 Annual Report, Armed Forces Institute of Pathology, 1950, p. 23.
312
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 99. — Close quarters. A. Personnel of the Histopathology Labora-
tory worked under great difficulties in the old red brick building in the 1940's.
B. File cases were not only stacked 11 high, but were frequently located in
halls or corridors.
CARRYING ON IN THE "OLD RED BRICK" , j .
or tumor-like conditions and other surgical specimens as to which final or
confirmatory diagnoses were called for, be sent in to the Institute. Other surgi-
cal specimens did not need to be forwarded to the Institute unless they contained
noteworthy lesions. As a guide to the kind of materials which were not re-
quired to be forwarded, the special regulation listed n classes of such specimens,
including such commonplace items as appendices, tonsils, and adenoids, and
such comparatively rare items as arms and legs amputated for injury or infec-
tion. Even as to these excepted groups, specimens were to be forwarded if
there was any doubt as to their importance. 3
For a time, it seemed that despite the effort to apply restrictions, nothing
would diminish the flow of materials into the central laboratory of the three
armed services and the Veterans' Administration. In 1951, the year after the
new regulations went into effect, the cases accessioned numbered 52,378. In
1952, the flow reached its high water mark with 118,704 cases, of which 29,008
came from deactivated naval hospitals and 89,099 from current operations (fig.
100). Accessioning was completed that year for only 67,909 cases, the re-
mainder of nearly 50,000 cases going to swell the massive backlog of work.
"Lack of adequate laboratory and office space continues to be a most distressing
situation," the Director reported. "Relief must await movement into the new
building in 1954." 4 Slight relief was found in 1953, when 79,212 cases were
received — nearly 10,000 fewer than those from current operations in the previous
year. There was a further reduction to 64,836 cases in 1954, and it appeared
that efforts to bring about a more manageable flow of materials into the Institute
were showing results.''
Even so, the daily inflow of pathological materials requiring attention
averaged some 200 cases a day — a situation which made necessary some system
for sorting out the incoming cases which required expedited handling. Since
no one could be quite so well acquainted with the requirements of each case
as the doctor submitting the specimen, contributors were asked to indicate
the handling desired under the proper one of four classifications. The code
word "Telegraph" called for immediate attention and the fastest service which
could be given, with reports made to the contributor by cable, radio, telegram,
or telephone. The code word "Rush" called for handling as speedily as
possible, second in priority only to requests under "Telegraph," with answers
sent out by airmail. "Comment" requests were answered with staff findings
"Special Regulations No. 40-410-10; Bureau of Medicine and Surgery Circular Letter No. 50-50;
Air Force Regulation No. 160-55, pp. 2-6.
4 Annual Report, Armed Forces Institute of Pathology, 1952. p. 43.
6 Annual Reports, Armed Forces Institute of Pathology, 1951, p. 6; 1952. p. 5: 1953, p. iii; 1954- I', t-
3M
ARMED FORCES INSTITUTE OF PATHOLOGY
F IG ure loo.— Mary Frances Gridley, compiler of a manual of Histologic and
Special Staining Technics issued in 1952. After her death in December 1954, her
fellow workers had the manual reissued in a memorial edition.
concerning autopsies, surgical materials, or a questionable change in the tissues
submitted, with reports going out by ordinary mail. Material submitted under
the code word "Routine" was acknowledged with any comment which was
warranted by the material, but handling was not expedited.
* Annual Report, Armed Forces Institute of Pathology, 1950, pp. 23, 24.
CARRYING ON IN THE "OLD RED BRICK" , I5
Such increases in the work of the Pathology Department were matched
in greater or lesser degree by rising workloads in the other departments— the
American Registry of Pathology; the Medical Illustration Service; the Medical
Museum ; and the Administrative Service, set up in 1947 to perform those func-
tions which were essential to the operation of the four basic departments but
were not exclusively related to any of them.
With such increases in the work to be done, there had to be increases in
the staff which had the work to do. The staff, including commissioned and
enlisted military personnel and civilian employees, numbered 172 at the end
of 1946; 230 a year later; 251 in 1949; and 282 in 1950. In 1951, the staff num-
bered 338, including 15 officers attached for training in padiology as one step
toward meeting the general shortage of pathologists, to which was ascribed
the Institute's inability to fill all its authorized positions for medical officers and
the failure to secure applicants for all the Institute's openings for residencies.
By the end of 1952, the staff had increased to 338, and a year later had gone
up to 365. The figure rose again to 438 by the end of 1954, the last year in the
old building. 7
The Cooney Committee
In anticipation of the removal of the Institute from its old quarters to the
new building which was beginning to rise on the grounds of the Walter Reed
Army Medical Center, Surgeon General George E. Armstrong recommended
that "studies be made of the missions and operational procedures of the
Armed Forces Institute of Pathology." This recommendation was supported
by the Armed Forces Medical Policy Council of the Department of Defense and,
on 12 December 1952, Dr. Melvin A. Casberg, chairman of the policy council,
sent to General Armstrong a memorandum requesting the establishment of
an ad hoc committee to study the "scope and effectiveness" of the program of
the Institute.
The Committee, set up on 14 January 1953 by Maj. Gen. Silas B. Hays, Act-
ing The Surgeon General, consisted of Brig. Gen. James P. Cooney, representing
the Surgeon General of the Army; Capt. John H. Ward, representing the
Surgeon General of the Navy; Brig. Gen. Earl Maxwell, representing the
Surgeon General of the Air Force; Brig. Gen. Elbert DeCoursey, representing
the Institute; and Robert A. Moore, M.D., dean of the Washington University
Medical School at St. Louis, and chairman of the Scientific Advisory Board of
'Annual Reports, Armed Forces Institute of Pathology, 1947, Exhibit A; 1948. p. 2; 1949. P-
'950, PP- 2-5; I95I. PP- I2 > '3; '952. P- "■ 1953. P- 5; '954.P-57-
316 ARMED FORCES INSTITUTE OF PATHOLOGY
the Institute. General Cooney was chairman of the ad hoc committee, which
accordingly was known informally as the Cooney Committee.
The Committee's conclusions and recommendations were asked for as
to the services of the Institute to the Armed Forces, other Government agencies,
the civil professions, and foreign governments, and also as to its educational
program. Special attention was directed to possible changes in the missions
of the Institute, in the next few years, with consequent expansion or curtailment
of activities.
In a report submitted on 9 March 1953, the Cooney Committee recom-
mended that the services of the Institute to the three Armed Forces be con-
tinued under the terms of the charter embodied in Army Regulations No.
40-410, Navy Bureau of Medicine and Surgery Circular Letter No. 50-8, and
Air Force Regulation No. 160-38, issued jointly by the three services on 15
February 1950, and enlarged upon in detail in a descriptive circular "Central
Facilities Provided for Department of Defense by Armed Forces Institute of
Pathology," issued on 8 June 1950, as Special Regulations No. 40-410, Bureau
of Medicine and Surgery Circular Letter No. 50-50, and Air Force Regulation
No. 160-55.
In addition to the services of the Institute to the Armed Forces, the Com-
mittee approved the arrangement with the Veterans' Administration as "an
essential part of a vast plan of collective research whereby former military per-
sonnel may be followed through the various medical vicissitudes of their lives
to old age and death," to the end that medical services for the military might be
improved. The Committee likewise approved the cooperative arrangements
between the Institute and the U.S. Public Health Service, the Atomic Energy
Commission, and the medical, dental, and veterinary professions.
The Committee further approved the Institute's instruction in advanced
pathology as part of a general program of residencies, postresidency on-the-job
training, special pathology seminars, and review studies in pathology for medi-
cal officers preparing for examinations by the specialty boards in pathology or
other medical or surgical specialties. The practice of the Institute in sending
out loan sets to those unable to come to the Institute for study, was approved by
the Committee. These sets consisted of microslides with related data, clinico-
pathological materials, duplicate gross specimens from the museum collections,
lantern slides, photographs, filmstrips, and motion pictures when available.
In general, the Committee gave its approval to the organization and opera-
tions of the Institute, including plans for a broader scope of work in the eagerly
awaited new building. It was the opinion of the Committee, however, that
CARRYING ON IN THE "OLD RED BRICK" 7
the production of original motion pictures should be discontinued as soon as
each of the Armed Forces had opportunity to provide for such services on its
own account. The Committee felt, also, that "no useful end is served by requir-
ing all pictures and films be sent to the AFIP" but did believe that "a central
file of pictures and films of general educational value should be maintained at
the AFIP." Accordingly, it recommended that the requirement of sending in
all pictures and films should be limited to those of "general educational value."
In its closing remarks, the Cooney Committee recognized the Institute as
a "unique institution" for consultation in pathology and for the investigation of
disease, filling a "need both of military and civilian medicine." Because of the
"better approach to medical care" inherent in its educational facilities and
methods, the Committee said, "the Armed Forces Institute of Pathology has
been called 'the Postgraduate School of Pathology' for the United States and
even for the world." 8
Maj. Gen. Silas B. Hays, the Deputy Surgeon General, concurred in the
recommendations of the Cooney Committee, and agreed that the functions and
level of operations set forth in the report were desirable. In the light of recent
trends toward curtailment rather than expansion, however, he asked the advice
of the Committee on the "functions to be performed and the level of operation"
which should be sought under each of four assumptions— a continuation of sup-
port at the current level, and reductions of 10, 20, or 30 percent under that level.
The Committee accordingly reconvened and, on 26 March 1953, answered
the general's inquiry. The "practice of pathology," it said, constituted more
than 70 percent of the activities of the Institute and curtailment of this service
would interfere with the development of the Institute as the central laboratory
for the military services. Furthermore, the Committee said such portions of
this work as were not done by the Institute would of necessity have to be done
elsewhere by each of the Armed Forces, "or else the patient would suffer."
In the light of these considerations, and the further fact that the Institute
was organized "to provide at the least cost possible a maximum of pathology,"
the Committee felt that this service "must be kept intact" and that whatever
cuts might have to be made should be in the activities of the Institute which
"might be considered as ancillary." Even if available funds should remain at
the current 1953 level, the Committee said to "keep up with the normal increase
of the pathology workload, there would have to be substantial curtailment of
"(i) "Study of Armed Forces Institute of Pathology." Report of the Cooney Committee to The
Surgeon General, Department of the Army, 23 January 1953. (2) The characterization of the Institute
as "The Postgraduate School of Pathology" was in an address by Dr. Robert A. Moore, Dean of the
Washington University School of Medicine, at a Pathologists' Luncheon in Chicago, 16 October 1952.
318 ARMED FORCES INSTITUTE OF PATHOLOGY
other activities," while a cut of as much as 30 percent in funds and personnel
would mean the abolishment of all services other than that of pathology con-
sultation, and serious curtailment of even this remaining central feature of the
work of the Institute. 9
Fortunately, no such drastic cuts proved to be necessary, and the demands
for consulting service in pathology did not go up to the extent anticipated.
This was due, in part at least, to the more selective screening of cases in the
histopathological centers, resulting in a reduced flow of pathological materials
to the Institute. In 1952, the year before the Cooney Committee made its
report, nearly 119,000 new cases were received, including the 29,000 cases from
deactivated naval hospitals. With these figures before them, the Committee
estimated a workload of 101,000 new cases in 1955, and 106,800 in i960. Actual
requirements in those years, as it turned out, were fewer than 63,000 new cases
in 1955 and only slightly more than that figure in i960. 10
Atomic Bomb Research Unit
These figures do not include the cases received by the Atomic Bomb Research
Unit set up in 1948 under an arrangement with the Atomic Energy Commission
by which the Army Institute of Pathology made its facilities available "for the
filing and custodial care of pathologic material and related records of interest
to the Atomic Energy Commission." u
The group assigned to this special work, known as the "A-Bomb Unit," was
charged with processing "all pathologic material and case histories collected by
the Atomic Bomb Casualty Commission in Japan in a fifty-year follow-up study
of the victims of the atomic bomb and descendants of irradiated victims." The
unit had received, by the end of 1954, specimens and case histories for 26,735
cases originating in Hiroshima and Nagasaki, in furtherance of its mission of
assembling in one place in the United States the information pertaining to the
effects of radiation on human beings. Included in this information are the
early Japanese reportings of the overall effects of nuclear explosions, and over
200 translations of the Japanese scientific reports dealing with radioactivity,
injury, hematology, and pathology. In addition to information from Japan,
•2d indorsement, General Cooney, dated 27 March 1953, to The Surgeon General of the Army 27
March 1953, subject: Study of the Missions and Functions of the AFIP. On file in historical records of
AFIP.
'° Annual Reports, Armed Forces Institute of Pathology, 1952, p. 5; 1955, p. 4; lo6o> annex No 3
Letter, Kenneth G. Royal, Secretary of the Army, to Carroll L. Wilson, General Manager, Atomic
Energy Commission, 3 February 1948, in response to letter of 23 January 1948. Copy on file in historical
records of AFIP.
CARRYING ON IN THE "OLD RED BRICK" ~ JQ
the Radiation Unit of the Institute collects data, from the atomic and nuclear
tests conducted in this country, for the Atomic Energy Commission.
The materials received from Japan have been found of use in a score of
special researches, including studies by General DeCoursey and statistical an-
alyses by Francis X. Lynch, supervisor of the unit, and Mardelle L. Clark, Chief
of the Statistics Branch of the Institute.'"
Before the studies could be undertaken, it was necessary to correlate the
specimens and case histories with the named individuals from whom the speci-
mens had been taken and to whom the histories applied— a painstaking proce-
dure made more complicated by language differences and especially by un-
familiarity with the sound and the spelling of Japanese names which had to be
transliterated into some sort of American equivalent for filing purposes.
Studies of radiation effects were not the only medical problem plagued by
differences in language and medical nomenclature. Difficulties in diagnosis,
made more difficult by the growing confusion in the naming of neoplastic
diseases, led to the publication by the Institute of its "Atlas of Tumor Pathology,"
as a contribution to the broadly based efforts of health organizations to combat
cancer. This project had its genesis in discussions at the Fourth International
Congress for Cancer Research, meeting in St. Louis, Mo., in 1947, out of which
there grew the suggestion that "renewed attempts be made to simplify and
standardize the nomenclature of neoplastic diseases and to devise means toward
aiding graduate and undergraduate teaching of oncology" — the medical term
for the body of knowledge pertaining to tumors.
This suggestion led to the calling of a conference of specialists held in
Washington under the joint auspices of the National Research Council and the
Scientific Advisory Board of the Army Institute of Pathology, at which it was
recommended that a subcommittee on oncology be set up by the National
Research Council's Committee on Pathology, as part of the Committee's overall
program. In November 1947, the subcommittee was formed with Dr. Shields
Warren of Boston, Mass., as chairman; and Doctors Balduin Lucke of Phila-
delphia, Pa., Arthur Purdy Stout and Fred W. Stewart of New York, N.Y.,
Milton Winternitz of New Haven, Conn., and Harold Stewart of Bethesda, Md.,
13 (1) Clark, Mardelle L., and Lynch, Francis X.: Clinical Symptoms of Radiation Sickness, Time to
Onset and Duration of Symptoms Among Hiroshima Survivors in the Lethal and Medical Lethal Ranges
of Radiation. The Military Surgeon 3: 360-368, November 1952. (2) Reynolds, Mardelle L., and Lynch,
Francis X.: Atomic Bomb Injuries Among Survivors in Hiroshima. Public Health Reports 70: 261-270,
March 1955. (3) DeCoursey, Elbert: Pathology of Ionizing Radiation. Minnesota Medicine 34: 313-318,
April 1951. (4) DeCoursey, Elbert: Injury from Atomic Bombs. Radiology 56: 645-652, May 1951.
(5) Annual Report, Armed Forces Institute of Pathology, 1950, p. 28.
320 ARMED FORCES INSTITUTE OF PATHOLOGY
as members; and Dr. Howard T. Karsner, Chairman of the Research Council's
Committee on Pathology, as a member ex officio.
Atlas of Tumor Pathology
This Subcommittee on Oncology was the moving force in the launching
of a new "Atlas of Tumor Pathology" to be issued at the Institute of Pathology
with the support and sponsorship of the American Cancer Society; the Anna
Fuller Fund; the Jane Coffin Childs Memorial Fund for Medical Research;
the Veterans' Administration; the National Cancer Institute of the Public
Health Service; and the Armed Forces Institute of Pathology.
The first unit of the Atlas to be published recites, on the title page, that
the publication was "prepared at" the Institute of Pathology under the auspices
of the Subcommittee on Oncology. Subsequent units recite, on the title page,
that they are "published by" the Institute, under the same auspices, and that
they are for sale by the American Registry of Pathology of the Institute.
The Atlas, it was decided, was to give "preeminently a pictorial representa-
tion of the many structural variants which characterize the many kinds of neo-
plasms." Along with the illustrations, which were to be its outstanding feature,
there were to be "adequate explanatory legends," as Dr. Lucke put it, in his
introduction to the first of the 39 units or fascicles into which the proposed
Atlas was to be divided.
Thirty-two distinguished pathologists accepted the invitation of the Sub-
committee on Oncology to prepare the illustrative and text material on tumors
of the various organs or anatomical regions which were to be dealt with in the
several fascicles. In the preparation of these studies, the authors could draw not
only from cases encountered in their own practice but also from cases on file in
the American Registry of the Institute.
Indeed, the great facilities and resources of the Armed Forces Institute of
Pathology were placed at the disposal of the Subcommittee and of the collabo-
rators, authors of the fascicles, who served without recompense other than the
satisfaction of having a part in the massive marshaling of the forces of light
and understanding directed against the darkness and mystery surrounding the
topic of tumors.
The spirit in which the task of publishing the Atlas was undertaken is
well stated in a signed foreword printed with the first fascicle. "Only through
a continuing coordinated effort of all doctors, civilian and government," the
statement said, "can the available specialized knowledge be welded into an
CARRYING ON IN THE "OLD RED BRICK"
■ <#&
'""»'>*>
Figure ioi. — Samples of the fascicles.
effective resource for all pathologists and medical personnel. The Subcommit-
tee on Oncology has brought together the experience of eminent doctors and
the resources of the Armed Forces Institute of Pathology to produce this Atlas
to aid in the definition and diagnosis of those diseases grouped together under
the term 'cancer'." l3
The method of publication in separate units, or fascicles, has many advan-
tages for such a project as the Atlas. The first of the fascicles appeared in 1949
(fig. 101). Twelve years later, in December 1961, seven units were still in
various degrees of readiness for the press; 31 1 / 2 fascicles have been issued and
made available to the medical profession as they were readied for publication.
The earliest chapters were edited by Dr. Isabella Perry, Executive Secretary of
the Subcommittee on Oncology, who was succeeded in 1950 by Dr. Mary Ruth
Oldt. Since 1958, Dr. Catherine W. Blumberg, professional associate of the
National Academy of Sciences, National Research Council, has been editor of
the "Atlas of Tumor Pathology."
13 Signers of the statement were: R. W. Bliss, The Surgeon General, Department of the Army; C. A.
Swanson, The Surgeon General, Department of the Navy; Malcolm C. Grow, The Surgeon General. De-
partment of the Air Force; Charles S. Cameron, Scientific Director, American Cancer Society; Lewis 11.
Weed, Chairman. Division of Medical Sciences, National Research Council: Leonard A. Scheele, The
Surgeon General, U.S. Public Health Service: and Paul B. Magnuson, Medical Director. Veterans' Admin-
istration.
322 ARMED FORCES INSTITUTE OF PATHOLOGY
The first chairman of the Subcommittee, Dr. Shields Warren, resigned in
1951, to be succeeded by Dr. Lucke who, as chairman, performed the last of
his many services to the Institute until his death in 1954, when Dr. Ardiur
Purdy Stout of the Institute of Cancer Research of Columbia University became
chairman. Dr. Paul Steiner of the University of Pennsylvania and Dr. Lauren
Ackerman of Washington University, a member of the International Committee
on Oncological Nomenclature, were added to the membership of the committee
before the move into the new building.
Acceptance of the Atlas has been worldwide, with from 12 to 25 percent
of the distribution in foreign lands. The fascicles have met with hearty
acclaim abroad as well as at home, although there was some feeling abroad
that "perhaps not enough attention has been paid to the nomenclature and
opinions of nonAmerican pathologists," as Dr. Stout put it in an editorial
article in the American Journal of Clinical ' Pathology. Xi
The degree of acceptance of the Atlas by the medical profession is indicated
by the growing demand for the fascicles as they have appeared. The original
print orders were for 5,000 copies of each, a figure which has been increased
to 7,500 copies, then to 10,000, and now to 15,000 copies.
In 1949, the year in which the first fascicles appeared, the American
Registry of Pathology was designated as the department of the Institute through
which sales of the fascicles would be handled. Four years later, in October
1953, Dr. Hugh G. Grady (fig. 102), who had succeeded Col. James E. Ash
as Scientific Director of the Registry in 1949, reported that the first four
fascicles had been "completely sold out." This "tremendous sale," he added,
has been done with nothing resembling a sales organization or any worth-
while advertising." 15 In 1954, the last year in the old building, 17,623 copies
of fascicles were sold, still without a sales organization in the usual sense, and
still without advertising other than word-of-mouth reporting of the merits of
the publications. 18
The fascicles which were sold out have been reprinted, whenever it has
been possible to do so without holding up the printing of those as yet unissued,
and others which are now out of print will doubtless be reproduced as oppor-
tunity offers.
Another arm of the Institute which has a part in the enterprise of publish-
ing the "Atlas of Tumor Pathology" is the Medical Illustration Service, which
^ Stout, Arthur P.: Editorial. American Journal of Clinical Pathology 25: 175, i 7 6, February 1955.
^ Annual Report, Armed Forces Institute of Pathology, 1953, Exhibit 2, p. 7.
Annual Report, Armed Forces Institute of Pathology, 1954, p. 20.
CARRYING ON IN THE "OLD RED BRICK"
Figure 102.— This group is carrying out one of the three prime responsibilities of the
Institute, diagnostic consultation, under the direction of Dr. Hugh G. Grady (upper right),
Scientific Director, American Registry of Pathology, 1949-1957.
is responsible for the physical production of the fascicles. Because of the
highly specialized character of the illustrations which are the distinguishing
feature of the Atlas, the negatives used in offset printing are prepared in the
Medical Illustration Service's plant, where the closest cooperation between the
pathologist and the printer can be assured. Presswork, in the ticklish business
of reproducing accurately the photomicrographs which are the heart of the
fascicles, likewise can best be done in the Institute's own plant. For these and
other reasons, the printing division of the Institute qualifies as an "approved
field printing agency" under the standards and rulings of the congressional
Joint Committee on Printing. When it came to setting type for the text of
the fascicles, however, the situation was different. The type-setting equipment
in the Institute's plant was antiquated and inadequate, "necessitating hours of
hand setting" which delayed all other operations. Rather than attempting to
set type with the equipment it had, arrangements were made to have this done
by the U.S. Government Printing Office— an arrangement which is still in
effect. 17
''Annual Report, Armed Forces Institute of Pathology, 1948, p. 27.
324 ARMED FORCES INSTITUTE OF PATHOLOGY
The American Registry
While both the American Registry and the Medical Illustration Service
are integral parts of the Institute of Pathology, both have responsibilities that
extend beyond the primary purposes of their parent organization. Thus, the
several registries are so many links between the medical services of the Armed
Forces and the civilian medical, dental, and veterinary professions. At the
beginning of the last decade of the Institute's occupancy of the old building,
there were 12 such links; at the time of the move into the new building, the
number had grown to 22, each one with a registrar chosen from the Institute's
staff of senior pathologists. The separate registries, each working with its own
sponsoring organization in medical, dental, or veterinary specialties, are bound
together in the American Registry of Pathology.
An important service of the American Registry to the medical profession,
civil as well as military, is the circulation of histopathological study sets (fig.
103). These sets are especially appreciated by those who are preparing for
examination by the certifying boards of the various organized medical, dental,
and veterinary specialties. Before 1949, distribution of these study sets had been
on a rental basis, with the fees paid to the National Research Council. This
was changed, effective 1 January 1949, to a loan basis, with no charge other than
paying the transportation both ways. When the Army Chief of Finance was
approached with an inquiry as to the method of property accountability to be
adopted under the new system, its legality was questioned. The Logistical
Division of the Army General Staff, to whom the question was referred, ruled
that the plan was "both authorized and desirable," and directed that the language
of the pertinent Army Regulations No. 40-410 be amended so as to make it clear
that "the Army Institute of Pathology may supply teaching material, such as
sets of prepared microscopic slides to Army installations and qualified profes-
sional persons as approved by the Director." ,s
Approximately 50 different study sets, each one containing from 25 to 100
slides, accompanied by a syllabus and other materials, were kept in circulation,
with no more than one set at a time loaned to a borrower. More than 10 sets a
day were loaned in the last year of occupancy of the old building. 1 "
The value of the work of the American Registry was further recognized
by the action of the American College of Surgeons which, in July 1953, donated
'-(i) Annu.il R<,p, )rt . Armed p orces Institmc „f p at h l ogyj ro49] ,,. I0 . ( 2) Army Rcj , u | ati „ ns
No. 40-410. (3) Department of the Army Circular Letter No. i, 1949.
"Brochure, "AFIP: Armed Forces of Pathology," appendix III, 1952.
CARRYING ON IN THE "OLD RED BRICK"
325
Figure 103. — A sample study kit.
to it the Codman Bone Sarcoma Registry— the first to be formed in the United
States. The collection included 2,374 cases, with specimens and medical histories,
on the basis of which much of what was known of the behavior and classification
of bone tumors had been developed. The collection became part of the Registry
of Musculo-Skeletal Pathology, but retained its name so as "to preserve the
identity of the first such Registry created, and to honor Dr. Codman who first
conceived the idea of a Registry and follow-ups as an essential feature of medical
investigation." General DeCoursey, the Director, expressed the happiness of
the Armed Forces Institute of Pathology at receiving "this historical and valuable
collection." 20
* Annual Report, Armed Forces Institute of Pathology, 1951, pp. ii. 23, 40
326 ARMED FORCES INSTITUTE OF PATHOLOGY
The TAedical Illustration Service
In much the same way as the activities of the American Registry extended
beyond the strictly military aspects of the Institute into fields of civilian medicine,
so the Medical Illustration Service had responsibilities which were broader than
the limits of the Institute. These responsibilities were placed on the Illustration
Service by the Surgeon General's Office in August 1947, when "certain functions
of The Surgeon General's Office pertaining to the preparation and coordination
of all Medical Department exhibits were transferred to the Army Institute of
Pathology," and all "Medical Department installations and individuals invited
to prepare or desiring to prepare an exhibit for a medical meeting, convention
or other similar gathering" were called upon to "coordinate the matter with the
Director, Army Institute of Pathology, prior to taking any action on a given
project." The purpose and effect of the order was to "improve the appearance
of all exhibits [of Medical Department functions and activities], eliminate
duplication and prevent the presentation of activities and materials not approved
by The Surgeon General." 21
In 1947, the first year in which this broader concept of the Institute's
Medical Illustration Service was in effect, 25 exhibits were constructed and
shown at a like number of meetings. In 1948, the number of exhibits built
was 47, for showing at the same number of meetings. The number of exhibits
built increased to 81 in 1954, the last year in the old building. In the same year,
there were 267 showings of Medical Department exhibits at 121 meetings. In
the 8 years ending with 1954, the Illustration Service of the Institute constructed
457 exhibits; attended 393 meetings at which exhibits were displayed; and
showed its exhibits 1,217 times. Medals, awards, and official commendations
received numbered 52."
The first exhibit which expressed the triservice character of the Institute
was one representing all United States hospital services (fig. 104)— Army, Navy,
Air Force, Veterans' Administration, Public Health Service, and Bureau of
Indian Affairs— shown at the 1951 annual meeting of the American Hospital
Association in St. Louis, Mo." 3
Illustrative of the way in which "mileage" was made by multiple showings
of the exhibits, as well as the way in which the various departments of the
:1 (i) Circular Letter No. 127, Surgeon General's Office, U.S. Army, 8 October 1947. (2) Whitehurst,
E. R.: The Evolution of the Armed Forces Institute of Pathology and Related Problems of Administration.
The Military Surgeon 106: 302, April 1950.
" Compiled from Annual Reports, Armed Forces Institute of Pathology.
Annual Report, Armed Forces Institute of Pathology, 1951, p. 57.
CARRYING ON IN THE "OLD RED BRICK"
3*7
Figure 104. — President Harry S. Truman inspects an Institute exhibit on U.S. Government
hospital services, shown at a meeting of the American Hospital Association.
Institute worked together, was the exhibit on malaria prepared by the staff
of the Medical Museum in conjunction with Dr. Ernest Carroll Faust of New
Orleans, La., consultant on tropical diseases, and constructed by the Illustration
Service. This exhibit was shown at the 1952 annual meeting of the American
Medical Association, where it received the Billings Silver Medal, and afterward
was set up and shown at the American Public Health Association meeting
in Cleveland, Ohio; at Tulane University in New Orleans, La., at the meeting
of the American Society of Tropical Diseases at Galveston, Tex.; and was
finally placed at Brooke General Hospital at Fort Sam Houston, Tex."'
Building and showing of medical exhibits, however, was but one phase
of the activities of the Medical Illustration Service (fig. 105). Its "primary
object" as stated by Maj. Carroll F. Naidorf, Chief of the Service for the greater
" Annual Report, Armed Forces Institute of Pathology, 1953, p. 54.
328
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 105.— Antonio Cortizas, Cuban-born medical sculptor, at work on a heart-lung
model. Sergeant Cortizas, a master specialist, died in 1956.
part of the year 1946, was "to make documented medical pictures available
for study, research, teaching and publication"— an assignment which, he added,
"requires more than a passive acceptance and filing of inadequately documented
pictures." 25
Major Naidorf's successor as Chief of the Service was Dr. Edward M.
Gunn, who had served in the Pacific in World War II, and was at the time of
the reorganization of the department a civil service administrative employee
of the Surgeon General's Office. Two years later, in 1949, Dr. Gunn described
the reorganized Service as the "most complete and well balanced organization
of its kind."
The organization thus described included Roy M. Reeve (fig. 106) as
Deputy Ch ief of the Service and Herman Van Cott as Chief of the Scientific
20 Final Report, Maj. Carrol] F. Naidorf, 26 October 1946. On file in historical records of AFIP.
CARRYING ON IN THE "OLD RED BRICK"
Figure 106. — Roy M. Reeve, who went to work for the Museum in 191 7, and for 37 years
was its official — and sometimes only — photographer.
Illustration Division. Joseph Carter was Chief of the Photography Division;
Don Carlos Ellis, of the Audiovisual Aids Division; and Herbert C. Kluge, of
the Illustration Library. In 1950, the Technical Duplication Branch and Photo-
330 ARMED FORCES INSTITUTE OF PATHOLOGY
stat Division was headed by Maj. Floyd C. Egger, and in 1951, a new General
Service Division was formed with Lt. Cdr. G. T. Moss as Chief. In the
spring of 1952, after 5 years of service, Dr. Gunn resigned to enter private
industry, to be succeeded by Mr. Reeve as Acting Chief of the Department, with
Mr. Van Cott as Deputy Chief. William E. Macy became Chief of Scientific
Illustration. Later in the year, Commander Moss was relieved, due to a change
of station, and was replaced by Joseph Q. Conroy. Joseph Carter retired and
was succeeded by Julius Halsman as Chief of the Photography Division. The
recently renamed Printing Division was headed by Walter Harders, in place
of Major Egger, who was transferred. 20
In March 1953, Don Carlos Ellis, Chief of the Training Aids Division, died
from injuries received in an automobile accident and was succeeded by Morris
Goldberg.
In December of the same year, Mr. Reeve retired, after 36 years of service,
in which he had done much to enhance the position of the Museum-Institute
as a leader in the field of medical photography, particularly in photomicrography.
He was succeeded as head of the Medical Illustration Service by Herman Van
Cott, a graduate in fine arts of Yale University and an artist of distinction in his
own right. 27
Rebirth of the Medical Museum
During the last decade of the occupancy of the old brick building by the
Institute, the Medical Museum— the mother which "had been overshadowed by
its offspring" 2S — began a comeback from the low estate into which it had
drifted during and just after World War II. Wartime demands for space had
all but squeezed the Museum out of the main building. Museum materials, for
which no room was available, had been stored and, as it turned out, not well
and safely stored. Rehabilitation started when on 9 August 1946, Chase Hall, a
temporary building put up during the war to house the SPARS— the Women's
Reserve Corps of the U.S. Coast Guard— was assigned to the Museum, which
began to gather itself together again.
The small part of its collections which had remained in the main building
were moved across the street, Independence Avenue, into the newly available
space. Thither, also, the vans brought materials from storage space on Maine
Annual Reports, Armed Forces Institute of Pathology, 1940, p. 40; 1950, pp. 33, 45; 1951, pp. 37, 45 -
1952. PP- 44.45-
Annual Report, Armed Forces Institute of Pathology, 1953, pp. iii, 4.
Annual Report, Armed Forces Institute of Pathology, 1947, p. 22.
CARRYING ON IN THE "OLD RED BRICK" „j
Avenue in Washington, and from a warehouse on Columbia Pike in nearby
Virginia.
A year after the occupation of Chase Hall, the Director reported that "the
initial post-war stage of chaos with hundreds of boxes of items of unknown
type, number, location or condition has given way to a stage of concentrated
storage of items of generally known type, condition and location." For the
Museum to get "started on its return to its rightful place as an unparalleled
working body of scientific and historical medical data in the Western Hemi-
sphere," he added, would require "time, patience, and persistent attention to
innumerable details * * * coupled with an adequate staff ." 29
At the end of another year, it was possible to report that reorganization of
the Museum was completed for practical purposes with "transporting, cleaning,
repairing, sorting, preliminary cataloguing, temporary storage, final cataloguing,
cross referencing, indexing, filing, accessioning, wrapping, packing and final
storing of over 126,000 museum items and the salvage or discard of damaged
medical items and a great bulk of unrelated or distantly related material." 30
Three years after the move into Chase Hall, the Director's report for 1950
noted that "the Museum proper has changed from a large vacant recreation hall
and assorted smaller rooms to an organized exhibit area with over 300 displays
which reflect broad medical interests of value to the public, junior medical
officers and specialists."
Back of the transformation, there was devoted and intensive work by the
Museum staff, headed by Dr. Ruell A. Sloan, whose outstanding service to the
Museum-Institute was soon to end with his untimely death on 17 June 1951.
Between 21 March 1947, when Dr. Sloan became Curator, and the submittal of
the Annual Report for 1950, the staff had grown from "one physician and a few
inexperienced enlisted men to a staff of 21," forming the nucleus of the pro-
fessional, technical, and administrative personnel necessary to the basic operation
of a comprehensive medical museum. 31
The Pathology, Anatomy, and Embryology Division was headed by Dr.
Henry W. Edmonds. A new Information Section was formed with Mrs.
Evelyn Drayton as its Chief. The General Service Division, of which Miss
Helen R. Purtle was Chief, had reviewed, physically inventoried, partially
indexed, and filed over 250,000 museum items of widely assorted types. After
storage of some and disposal of other items seriously damaged by hasty war
^Annual Report, Armed Forces Institute of Pathology, 1948, pp. 34. 35.
3,1 Annual Report. Armed Forces Institute of Pathology, 1949, p. 61.
31 Annual Report, Armed Forces Institute of Pathology, 1950, p. 57.
332
ARMED FORCES INSTITUTE OF PATHOLOGY
storage and "items useless to current and future development of the Museum"
there remained nearly 80,000 items in the working collection. 32
Upon the death of Dr. Sloan, Dr. Henry W. Edmonds served as Acting
Curator until October 1952, when he resigned and was succeeded by Miss
Purtle, also as Acting Curator, until the end of the year. At that time, Col.
Hugh R. Gilmore, Jr., former Curator, returned to the Museum in the same
capacity. 33
He continued in that position until after the main body of the Institute
had moved away, leaving the Museum in the renovated temporary quarters
in which it was to be housed for more than a decade.
With all the attention paid to the auxiliary departments of the Institute,
the fact remained that it was primarily an Institute of Pathology and that its
primary purposes were consultation, education, and research in pathology.
In line with this purpose, the members of the staff were active in the preparation
and publication of scientific papers on medical topics — the term "medical" as
used here and elsewhere in this work being broad enough to cover dental and
veterinary subjects as well. In furtherance of such publication, an Editorial
Branch was set up in 1951, with a membership which included the Director
of the Institute, the Chief of the Pathology Division, five senior pathologists, the
Chief of the Medical Illustration Service, and an editor, who acted as recorder
for the Board. The Board was to review manuscripts prepared for publication
by staff members of the Institute, and to edit the Institute's own publications. 3 '
Research Programs
With somewhat the same objective of seeing that limited facilities were
put to the best use, a screening committee was set up to evaluate applications
for research projects to be carried on at the Institute. Although the nature
of the facilities in the old building limited the range of research to "morphologic
and statistical aspects of disease" the committee processed 36 applications in
1952, the first year of its existence, and added 42 in the following year. With
projects previously initiated and new projects approved, the total number
underway in 1954, the last year in the old building, came to 150. 36
M (i) Memorandum, Ruell A. Sloan, for Col. E. DeCoursey, 9 December 1950. (2) Annual Report,
Armed Forces Institute of Pathology, 1950, p. 60.
Annual Reports, Armed Forces Institute of Pathology, 1952, p. 53; 1953, p. 36.
(1) Annual Reports, Armed Forces Institute of Pathology, 1949, p. 35; 1951, p. 41. (2) Special
Orders No. 67, n July 1951.
M (i) AFIP, Special Orders No. 27, 20 March 1952. (2) Annual Reports, 1952, Exhibit 28, p. 35;
1953. P- 22; 1954, P- 3-
CARRYING ON IN THE "OLD RED BRICK"
One project of direct and personal interest to the combat soldier and the
medical officer had to do with the development of practical and effective body
armor— a medicomilitary goal long sought. Much basic information about the
behavior of bullets in wounds had been accumulated, particularly in the series
of experiments conducted in 1935 by Col. George R. Callender and Maj. R. W.
French of the Army Medical Museum staff. 30 More recent studies, made at
the Naval Medical Field Research Laboratory at Camp Lejeune, N.C., led to
the development of a sleeveless vest of laminated layers of synthetic fibers, cover-
ing the thorax and abdomen.
In June 195 1, a joint Navy- Army mission, whose senior members were
Cdr. John S. Cowan, MC, USN, and Lt. Col. Robert H. Holmes, MC, USA, was
sent to Korea to see how effective this body armor would be under combat con-
ditions. The vests were first issued to medical corpsmen and to troops of the
1st Marine Division and the 2d Infantry Division. Experience in 1951 and in
1952 showed that the 8-pound vests were not unduly cumbersome, and that three
out of four hits by shell fragments failed to penetrate the vest and injure the
soldier, while two out of three of all hits were likewise defeated by the armor.
Such results "determined beyond doubt that the field soldier could wear, would
wear, and desired to wear the body armor afforded him." 37
Serving the four basic departments of the Institute in such vital particulars
as supply and finance was the Administrative Service. In the last years of
occupancy of the old building, this Service was headed by Lt. Col. E. R. White-
hurst, MSC, USA, from the time when the Institute took on its triservice charac-
ter until 1950 and again from January 1952, until the new building was occupied.
These chiefs of the Administrative Service were responsible to the directorate for
the smooth operation of a complex organization. This organization, as de-
scribed by Colonel Whitehurst, "really functions neither as a military nor a
civilian installation, but endeavors to coordinate six different types of personnel,
governed by the broad policies of the three Surgeons General and a civilian
Scientific Advisory Board, and maintains close coordination not only with the
"Callender, G. R., and French, R. W.: Wound Ballistics: Studies in the Mechanism of Wound
Production by Rifle Rullets. The Military Surgeon 77: 177-201, October 1935.
37 (1) An analysis of the results of the mission to Korea was given in a paper entitled. "Wound
Ballistics and Body Armor," by Lt. Col. Robert H. Holmes, MC, USA, read before the Section on Military
Medicine at the 101st Annual Session of the American Medical Association, Chicago, on 11 June 1952, and
published in the Journal of the American Medical Association 150: 73-78, 13 September 1952. (2) Addi-
tional information is given in: Holmes, Robert H., Enos, William F., and Beyer, James C: Medical Aspects
of Body Armor Used in Korea. Journal of the American Medical Association 155: 1477, 1478, 21 August
1954. The three men who prepared this article, from which the quoted sentence is taken, were all members
of the AFIP. Colonel Holmes was awarded the Legion of Merit for his part in the study and analysis.
334 ARMED FORCES INSTITUTE OF PATHOLOGY
three uniformed services, but also with the Public Health Service, the Veterans'
Administration, and the National Research Council." 3S
Triservice Administration
The first Director under the triservice arrangement was Brig. Gen. Raymond
O. Dart, who was succeeded on i August 1950, by General DeCoursey, with
Capt. Arthur W. Eaton, MC, USN, as a Deputy Director. Nearly a year later,
in June 1951, the three-man directorate was completed when Col. Ralph M.
Thompson, of the U.S. Air Force Medical Corps was named as the Deputy
Director from the Air Force. On 15 February 1952, Capt. William M. Silliphant,
MC, USN, was named Deputy Director, in the place of Captain Eaton. This
triumvirate continued as the directorate of the Institute until mid-1955, after
the move into the new building.
Preliminary to the move was a meeting called by Maj. Gen. Leonard D.
Heaton, Commanding General of the Walter Reed Army Medical Center, for
the purpose of clarifying the various logistical relationships between the Medical
Center and its several components, and the newest member of the Center, the
Armed Forces Institute of Pathology. The meeting, held on n August 1954,
was attended by key staff personnel of the Medical Center, the Military District
of Washington, the Office of The Surgeon General of the Army, and the Armed
Forces Institute of Pathology.
In convening the meeting, General Heaton "made it plain at the onset that
the AFIP is basically a tripartite organization — Army, Navy, and Air Force.
It is a separate, distinct class 2 organization under administrative jurisdiction
of The Surgeon General of the Army and under command of the Director.
Although the AFIP will be physically located on the Post at Walter Reed, the
only command responsibility that will be exercised by the Center will be of
necessity in those areas of administration and logistical support, the responsibility
for which has been laid down in SGO Administrative Letter 1-6. Insofar as
those areas are concerned, the Director of AFIP will coordinate his activities
with the Center Command." :i "
General Heaton proposed that the various questions raised be taken up
"item by item * * * to assure that the proposed solutions are mutually
agreeable to all of us." His opening remarks set the tone of a friendly and
fruitful meeting which dealt with practical questions as to matters of personnel,
official orders, transportation and travel, protection and surety services, cus-
' Whitelmrst. The Military Surgeon. mC< (11)50). p. 309.
" Minutes <>f cited Meeting, 13 August 1954. On file in historical records of AFIP.
CARRYING ON IN THE "OLD RED BRICK"
335
Figure 107. — Aerial view showing the location of the Institute building (upper left corner)
in relation to the Walter Reed Army Medical Center.
todial and "housekeeping" services, supply, finance, records administration,
postal service, civilian employees, commissary facilities, repairs and utilities,
military training, and others of the thousand and one complications bound to
arise in fitting the new member into the pattern of work and life at the Army
Medical Center.
On 13 February 1955, the move from the old building to the new was
started. Already, 5,000 items of new equipment had been purchased and placed
in the new building. The move from the old building, carried out by General
Service Administration forces, according to plans laid down by the Institute
staff, was accomplished in a month, during which time 10,200 tagged items were
moved to new quarters— 40 vanloads, mostly specimens sealed in plastic bags
going to outside storage at Franconia, Va., and 150 vanloads going to the long
sought and eagerly awaited new building on the Walter Reed reservation (fig.
107).-
' Annual Report, Armed Forces Institute of Pathology, 1955, p. 79.
CHAPTER XVII
Life in the New Building
Occupancy of the new building made it possible, for the first time, said
Brig. Gen. Elbert DeCoursey, to formulate and carry through "a comprehensive
program of pathology" '—which the Institute lost no time in undertaking.
The first step in this new program was to complete the organization and
staffing of the Department of Pathology, which previously had been limited to
the Pathology Division. Under the new organization, effective in March 1955,
this division was joined by the Basic Laboratories Division and the Dynamic
Pathology Division, to make up the new department. 2
To head the expanded department, the Institute secured Dr. Ernest W.
Goodpasture (fig. 108), professor of pathology at Vanderbilt University, who
joined the staff as the first Scientific Director of the Institute on 1 July 1955, and
forthwith "engaged in planning the professional program so as to take full
advantage of the facilities of the new laboratories." 3
The new Scientific Director was one of pathology's greats. A native
Tennessean, he had taken his academic work at Vanderbilt, and had graduated
in medicine from the Johns Hopkins University School of Medicine. He had
taught at Hopkins and Harvard; had served on the faculty of the School of
Medicine of the University of the Philippines; had studied in Vienna; and had
returned to Vanderbilt where, for 31 years, he had been professor of pathology,
and for 5 years, dean of the Medical School.
In May 1931, Dr. Goodpasture and his associate, Dr. Alice Miles Woodruff,
published a report on the results of 3 years of research and experiment in the
inoculation of chick embryos with a virus, inserted through a tiny window in
the shell of an unhatched egg. The virus was that of fowlpox, a poultry disease
commonly called "sorehead." The tiny droplet of virus grew and multiplied,
producing abundantly the pure and uncontaminated virus from which a pro-
tective vaccine could be derived. Such a virus, the report suggested, should be
"valuable in immunological experiments."
'DeCoursey, Elbert: Editorial. American Journal of Clinical Pathology 25: 554-555, May 1955.
= Annual Report, Armed Forces Institute of Pathology, 1955, p. 3.
'1,1 cm.
338
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 108. — Dr. Ernest W. Goodpasture, first Scientific Director, Armed Forces Institute
of Pathology, 1955-1959.
The Goodpasture-Woodruff team had done more than to suggest further
interesting experiments. They had found in the incubating egg a living tissue
on which a virus would feed and from which it could not be contaminated, and
had opened the way to the production of vaccines quickly, inexpensively, safely,
LIFE IN THE NEW BUILDING „g
and in quantity. The methods devised, it was thought, "might prove advan-
tageous in the study and development" of other virus infections. 4
As further researches did indeed determine that other viruses could be
produced by the impregnated egg method, Dr. Goodpasture's successful experi-
ment with fowlpox began to be recognized for what it meant — a revolution in
one vast field of immunology and preventive medicine through the production
and use of pure, plentiful, and potent vaccines derived from the incubated egg.
Appointment of Dr. Goodpasture as Scientific Director of the Institute
and head of its major Department of Pathology was not the only change in the
organization and staffing that took place in the Institute's "shakedown cruise,"
as Capt. William M. Silliphant (fig. 109), in naval vernacular, termed the first
few months in the new building. The captain, who had served as the Navy-
nominated Deputy Director for 3% years, succeeded General DeCoursey as
Director in July 1955, when the latter left the Institute, after 5 years of service,
to become Commandant of the Army Medical Service School at Brooke Army
Medical Center, Fort Sam Houston, Tex.
Captain Silliphant, the new Director, a native of Prince Edward Island,
Canada, was graduated with honors from Prince of Wales College at Charlotte-
town, Prince Edward Island, and afterward was graduated cum laude from the
University of Southern California. He obtained his medical degree from the
Stanford University School of Medicine, and had 2 years' postgraduate study in
pathology at the U.S. Naval Medical School in Washington. He was captured
by the Japanese in the Philippines and for 37 months was interned in Bilibid
Prison, where he served his fellow prisoners as ward medical officer, sanitation
officer, and laboratory officer, simultaneously. For 5 years before his assignment
to the Institute as Deputy Director, he was Director of Laboratories, U.S. Naval
Medical School, National Naval Medical Center, Bethesda, Md.
In August, Col. Dwight M. Kuhns, MC, USA, became Deputy Director,
serving to the end of the year 1955, when he retired for physical disability, and
was succeeded by Col. Francis E. Council as the Army-nominated Deputy
Director.
Meanwhile, Col. Ralph H. Thompson, the Air Force-nominated Deputy
Director, retired at the end of August, and was succeeded by Col. Frank M.
Townsend, USAF, MC.
Adjustment of personnel, space, and activities, to take full advantage of the
new building and its facilities, went forward in the latter months of 1955 and in
' Woodruff, A. M., and Goodpasture, E. W.: The Susceptibility of the Chorio-Allantoic Membrane of
Chick Embryos to Infection With the Fowl-pox Virus. American Journal of Pathology 7: 209-222, May 1 93 ■ ■
713-02S 1 ' — 04 24
34°
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 109.— Capt. (later Rear Adm., Ret.) William M. Silliphant, MC, USN, third
Director, Armed Forces Institute of Pathology, 1955-1959.
1956, the first full year in the new quarters, under the direction of this
triumvirate.
In April 1957, Colonel Council retired, to be succeeded by Col. Joe M.
Blumberg, MC, USA, as Deputy Director (fig. no). Colonel Blumberg, a
LIFE IN THE NEW BUILDING
Figure iio. — Col. Joe M. Blumberg, MC, USA, Deputy Director, 1957-1963, and
Director, Armed Forces Institute of Pathology, 1963- ; Scientific Director, American Regis-
try of Pathology, i960- .
Georgian, is a medical graduate of Emory University in Atlanta, and has served
as chief of pathology and commanding officer of Army laboratories, including
the 406th Medical General Laboratory in Japan.
34^
ARMED FORCES INSTITUTE OF PATHOLOGY
Ficure in.— Capt. Roger H. Fuller, MC, USN, Deputy Director, Armed Forces Institute
of Pathology, 1959—1963.
The directorate remained unchanged for more than 2 years until, in August
1959, Captain Silliphant retired and joined the staff of the Cancer Research
Institute of the University of California Medical Center in San Francisco. His
successor as the representative of the Navy on the directorate was Capt. Roger
H. Fuller, MC, USN (fig. m), who had taken his academic training at Yale and
his medical degree at Tufts, and who came to the Institute from the post of Chief
of Laboratory Service at the Naval Hospital, Camp Pendleton, Calif.
Succeeding Captain Silliphant as the Director of the Institute was Col.
Frank M. Townsend, USAF, MC (fig. 112). The new Director had been, since
1954, the Consultant in Pathology to the Surgeon General of the Air Force,
and a Deputy Director of the Institute for 4 years. A Texan by birth and rear-
ing, he had done his premedical work at San Antonio College and the Univer-
LIFE IN THE NEW BUILDING
Figure 112. — Col. Frank M. Townsend, USAF, MC, fourth Director, Armed Forces Insti-
tute of Pathology, 1959— 1963.
sity of Texas, and had taken his M.D. degree at Tulane University. He has
served on the medical faculties of three universities — Washington University,
St. Louis, Mo.; Nebraska University, Omaha; Texas University, Austin — and
ARMED FORCES INSTITUTE OF PATHOLOGY
has been especially active in the newly developing field of aviation pathology,
and the even newer field of bioastronautics.
Two months earlier, in June 1959, Dr. Goodpasture had resigned as
Scientific Director of the Institute, and returned to Tennessee. His successor
was Dr. Robert E. Stowell (fig. 113), one of the Nation's leaders in pathology,
who came to the Institute from the University of Kansas Medical Center, Kansas
City, Kans., where he had been, for n years, professor and chairman of the
Department of Pathology and Oncology, and director of Cancer Research.
Through all changes in the directorate and professional staff, in the new
building, as in the old, there was no change in the fundamental mission of the
Institute to serve the needs of pathology through consultation, education, and
research. Within the first year of occupancy of the building, space problems
arose, and it became "apparent that the cut made in the original plans was a
doubtful economy." In other respects, however, the new building and its
equipment proved to be satisfactory, and the Institute staff expressed apprecia-
tion "to all those responsible for its planning and equipment." Special appre-
ciation was expressed to those who had secured congressional approval of the
new plant, and also the commanding general at Walter Reed Army Medical
Center and his staff. "Everything possible has been done to welcome the AFIP
as a part of the Center and to extend to the AFIP all the services available,"
the Director said, in his 1955 annual report. 5
Shortage of Space
Not even the most cordial cooperation from Walter Reed Army Medical
Center, however, could relieve a space problem that became apparent as the Insti-
tute settled into its new quarters. The problem that "engrossed the attention
of the Directorate" was to find room for essential facilities for expanding profes-
sional studies, storage space for the ever-increasing flood of specimens, and space
to store exhibits between the times when they were shown in public. To meet
such needs, plans for a wing of some 103,000 square feet were prepared for in-
clusion in the Army Medical Services budget for fiscal year 1958, but such
plans did not meet with favor in the processes of budget making and approval. 6
One consequence of the space shortage at the main building of the Institute
is the maintenance of warehouse space at Franconia, Va., where a large part of
the more than one million specimens in the Institute's collection is stored.
Annual Report, Armed Forces Institute of Pathology, 1955, pp. 3, 5, 6.
' Ibid., pp. 53, 54 .
LIFE IN THE NEW BUILDING
Figure 113. — Dr. Robert E. Stowell, second Scientific Director, Armed Forces Institute
of Pathology, 1959- .
Storage of wet-tissue specimens in 20-gallon crock jars has been largely super-
seded by storage in sealed plastic bags, containing a small amount of formalin
(fig. 114). The plastic bags offer many advantages in saving of space, ease of
handling, and freedom from formalin fumes. By April 1959, storage of speci-
346
ARMED FORCES INSTITUTE OF PATHOLOGY
Ficure 1 14. — Specimens in storage and on display. A. Large crock jars for storage of
specimens are being replaced by plastic bags.
mens in the main building had been converted to plastic bags, and work was
well started on conversion of the storage at Franconia. The difficulties in-
herent in the 25 miles between the place of storage and the place of use were
such that in the spring of i960 a study was started looking to the possibility
of finding space at or near Walter Reed Army Medical Center. Maj. Charles
B. Broadway, Chief of the Professional Records Division, who played a large
part in the development of the plastic bag technique, represented the Institute
in a careful but fruitless search, and the 50-mile round trip continues to handi-
cap the work of the Institute, and particularly that of the Department of
Pathology. 7
Expanded Facilities and Services
The expansion of professional services with consequent changes in the
organizatio nal structure of the Institute emphasized the fact that through all
'Annual Reports, Armed Forces Institute of Pathology. 1955, p. 3; 1959, pp. 34, 36; i960, p. i 4 .
LIFE IN THE NEW BUILDING
347
__.
H*5
^^AjmLw 1.
■mp
in ftfi •«
i
■■! \fl !■ 1 ""^
/; ;
!-*J&™
j«f« i
_ .
■
B 1
Figure i 14.— Continued. B. Sealed plastic bags for storage of specimens require less
space and preservative fluid and are handled more conveniently. C. Wet specimens on
display embedded or enclosed in unbreakable plastic (compare fig. 28, p. 64).
348 ARMED FORCES INSTITUTE OF PATHOLOGY
changes it continued to be primarily an Institute of Pathology, with the heart
and core of its operation in the Department of Pathology, which numbered on
its staff some two-thirds of the entire professional staff of the Institute, and
accounted for a like proportion of expenditures. To head the pathology services
within the Department, Dr. Elson B. Helwig (fig. 115) was named as Chief,
Division of Pathology, a post in which he was to serve under Scientific Directors
Goodpasture and Stowell. The new division chief is an academic and medical
graduate of Indiana University, with experience in pathology services at Western
Reserve University, the New England Deaconess Hospital, the Washington
University School of Medicine, and the Army of the United States.
The expanded and improved research facilities of the Institute were found
to be of use not only in projects of immediate interest to the Institute itself, but
also in projects of value to other agencies of government and to voluntary health
organizations. One of the earliest of the numerous projects which the Institute
has undertaken for other organizations on a cooperative or cosponsorship basis
had to do with the sterilization of foods by irradiation. As part of this project
of the Research and Development Command of the Department of the Army,
the Institute undertook to furnish guidance to the study of the effects of feeding
animals with irradiated foods, in an extensive program carried out in several
laboratories. The Institute's services included receipt and review of all micro-
scopic material and pathological reports, providing a central repository for all
such materials, and preparing and analyzing statistical data as to pathological
lesions found in animals that had been on irradiated diets for 2 years or more. s
In addition to the evaluation of pathological findings in animals fed on food
sterilized by irradiation, and other projects receiving special support from such
military organizations as the Research and Development Command of the Office
of The Surgeon General of the Army, the Institute received financial support
outside its regular budget for carrying on studies and investigations from non-
mditary organizations, such as the American Cancer Society, the Alfred P. Sloan
Foundation, the Squibb Laboratory, and the National Institutes of Health. By
i960, additional supplements to the Institute budget, derived from direct con-
tracts and subcontracts with other Federal agencies and from grants from volun-
tary health organizations, totaled $351,930. Of this sum, approximately 60 per-
cent went for basic research, with the balance of 40 percent approximately
equally divided between investigations of direct military interest and applied
studies in human and veterinary pathology. By the end of i960, the developing
research pr ogram of Dr. Stowell, the Scientific Director of the Institute, had
'Annual Reports, Armed Forces Institute of Pathology, 1955, p. 15; 1956, p. 22; 1957, pp. 28, 65.
LIFE IN THE NEW BUILDING
349
Figure 115. — Dr. Elson B. Helwig, Chief, Department of Pathology, Armed Forces Institute
of Pathology.
350 ARMED FORCES INSTITUTE OF PATHOLOGY
resulted in research support from outside sources, nongovernmental as well as
governmental, amounting to more than $700,000, or double the amount of
outside support the year before."
The Institute's program of research covered not only the descriptive mor-
phological and statistical investigations to which research had been largely
confined in the old building, but also included projects that were made possible
for the first time by the facilities afforded by the new building. In the more than
200 investigations carried out in the first 5 years of occupancy of the new build-
ing, there were studies of the biological and biochemical effects of microwaves;
the response of cells to acute radiation; the neuropathology of nuclear and cosmic
radiation; the structure and functions of various tissues; the effects of toxic
agents upon various organs; the performance of motor end-plates where motor
nerves join muscle fibers; and studies in leprosy and a variety of tumors.
Much of the enlarged scope of the Institute's program was made possible
by advances in the instruments available and their application to research pro-
grams. The use of the electron microscope (fig. 116) with its magnifying
power on the order of 250,000 diameters enabled the observer to "see" into the
interior cellular structure farther than man had seen before with the optical
microscope. With such instrumentation and methodology, the pathology of
diseases could be "traced beyond the cell to the intracellular and molecular
level," as the Director of the Institute put it. 10
One of the vital areas of research which the new building opened up was in
experimental pathology, using laboratory animals. In the first year of occupancy
of the new building, the Laboratory Animals Branch of the Department of
Pathology was set up, with the dual mission of looking after the housing, diet,
and health of the animal population maintained within the Institute, and of
providing facilities, assistance, and consultation to the staff on matters pertaining
to experimental surgery. The population of the animal quarters at the end of
1955 exceeded 3,000. Of these, 1,900 were mice, nearly 400 were rats, more than
600 were guinea pigs, and nearly 300 were rabbits. Dogs numbered 8, swine 16,
and cats 24. The average number of animals maintained in the 12 months of
1961 was 2,800 per month. The total number of animals issued during the
entire year was over 14,000, of which more than 13,000 were mice, hamsters, and
rats, and more than 600 were rabbits and guinea pigs. 11 The Veterinary
Pathology Division, responsible for these functions, as well as for studies in
' Townscnd, Frank M.: The Armed Forces Institute of Pathology. U.S. Air Force Medical Digest
July i960.
"Idem.
11 Annual Reports, Armed Forces Institute of Pathology, 1955, p. 21; 1961, p. 168.
LIFE IN THE NEW BUILDING
351
Figure 116. — Optical and electron microscopes. A. How
they work.
comparative anatomy and physiology, included in i960 eleven doctors of vet-
erinary medicine, perhaps the largest aggregation of veterinary pathologists in
the United States. This section of the Institute has for many years performed
autopsies in the National Zoological Park of the Smithsonian Institution, in the
course of which Institute veterinarians have performed or attended necropsies
on a variety of animals ranging from an elephant to a 20-foot python. 1 "'
Program of Education
Closely related to the research function of the Institute is its program of edu-
cation, both within and without the confines of the Institute itself (fig. 117).
13 (1) Annual Report, Armed Forces Institute of Pathology, 1961, p. 24.
Force Medical Digest ( i960).
(2) Townsend, US. Air
35 2
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 116. — Continued. B. Electron microscope in use.
The effort is restricted only by the limitations on the physical space and staff
time that can be devoted to it. The program includes postgraduate short courses,
individual training on a residency or fellowship basis, lectures to and by members
of the staff, seminars for the consideration and discussion of pathology topics,
active-duty training for Reserve officers, and related intramural activities. Ex-
tramural activities include publication of professional scientific papers in biolog-
ical and medical journals, attendance at and participation in meetings of scien-
tific societies, and the preparation and distribution of study sets on a loan basis.
These services are in no manner restricted to the medical profession in the
United States but include nationals of foreign countries who are welcomed to the
Institute. The extent to which these foreign nationals seek the educational
opportunities offered by the Institute may be gaged by the fact that in the first
LIFE IN THE NEW BUILDING
353
Figure 117. — Educational sessions. A. Lectures are conducted for and by members of the
Institute staff. B. Opportunity is afforded for more intensive study by smaller groups.
354 ARMED FORCES INSTITUTE OF PATHOLOGY
6 years in the new building, nearly 1,000 foreign nationals from over 40 coun-
tries attended courses or received training at the Institute. 1 '
So great is the interest in the Institute's intramural educational program that
the number of "student days" — a method of measurement that reflects both the
number of students attending and the length of time attended — increased from
6,coo in 1958, to more than 27,000 in 1961.
"Because of the demands upon the professional time of the staff, space
and support personnel," the i960 annual report said, "the educational program
appears to have reached the saturation point within the present Institute
capabilities." 14
A major feature of the extramural educational effort of the Institute con-
tinues to be lending study sets for the use of physicians both within and without
the ranks of the Armed Forces. The growing demand for these loan sets
for study purposes called for making up new sets, increasing the number and
variety of those offered, and repairing old and wornout sets, even though
this meant that an "inordinate amount of time and effort" had to be spent
in this activity. The demands for the sets was so great, however, and their
use was so much appreciated, that it was deemed impossible to reduce their
circulation of approximately 5,000 sets a year. 15
The outreach of the Institute is further strengthened by its active program
of encouraging the utilization of its research riches in the preparation and pub-
lication of articles for publication in the scientific press. There are few fields
of scientific investigation so prolific in publication as are the medical, dental, and
veterinary disciplines, and few institutions of scientific investigation have been
so active in the dissemination of research findings as the Armed Forces Insti-
tute of Pathology. This applies both to work done by members of the staff
and also by others who have been associated directly or indirectly with the
Institute.
The result has been a program of publications noteworthy in quality and
volume. In 1949, the year the Institute became representative of the three
armed services, publications numbered 29. In 1955, the year the new building
was occupied, the number of articles published was 35. Forty-one articles ap-
peared in 1956, and 43 in 1957. In 1958, publication reached a new high of 77
items, with 76 in the next year, 82 in i960, and 91 in 1961. The sharp increase,
it will be noted, did not come about until the third year in the new building,
reflecting the time lapse involved in the process of research, writing, and edi-
" Annual Reports, Armed Forces Institute of Pathology, 1955-1060, passim.
'' Annual Rt|*.rt. Armed Forces Institute of Pathology, ig6o.p. 18. annex 2.
Annual Report, Armed Forces Institute of Pathology, 1958, p. 30.
LIFE IN THE NEW BUILDING 355
torial processing of scientific articles for publication in the numerous learned
journals that make up the medical press. 10
The noteworthy increases in the research and educational output of the
Institute following the move into the new building were not achieved at the
expense of the Institute's functions of diagnosis and consultation. True, the
number of cases received did not materially increase between 1954, when 75,000
cases came into the old building, and 1958, when the number received in the
new quarters reached its high point of 76,000, and actually it declined to 54,000
in 1959; 60,000 in i960; and 57,000 in 1961. The declines were largely due to
the effect of budgetary limitations on the Veterans' Administration, which
caused a reduction in the number of cases from that source, and also to a
trend to refer to the Institute, for consultative services, only the more difficult
cases, thereby requiring that more time be spent by the pathologist on the
average case. "The corresponding supportive help and reports were becoming
still more specialized than in the previous years," said the annual report for
i960. "Numerous instances were recorded during the year whereby the findings
of our staff influenced an alteration in the course of therapy." '
Cases received by the Radiation Injury Branch, more familiarly known as
the A-Bomb Unit, constitute a special category. The number of these cases
sent from Japan by the Atomic Bomb Casualty Commission laboratories at
Hiroshima and Nagasaki in the years 1955-1961 exceeded 27,000, virtually the
same number that had been received in the preceding 7 years since 1948. The
Institute in Washington thus has become the repository for surgical and post
mortem specimens of materials from more than 54,000 persons who were exposed
to the blast of the first atomic bombs. The function of storage alone, however,
does not give a proper picture of the Institute's participation in the scientific
analysis and utilization of these materials (fig. 118).
In furtherance of its functions of education, research, and consultation,
whether for immediate application or for future study and evaluation, the re-
sources of the Institute are available for study by qualified investigators. These
resources, in addition to the 54,000 specimens, include the largest collection in
this country of early Japanese reporting of the overall effects of nuclear explo-
sions, along with more than 200 translations of Japanese scientific reports dealing
with radioactive injury, hematology, and pathology.
From years of experience in the management of large collections of the
raw materials of pathology, the Institute has developed methods for their
18 Annual Reports. Armeil Forces Institute of Pathology, 1958-1960. passim.
" Annual Report. Armed Forces Institute of Pathology, i960, p. 1 7.
356
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 118— Handling radioactive materials.
utilization in study and investigation. In keeping with these concepts, the col-
lection of materials from Japan has supplied much of the fundamental facts for
studies of the effects of radiation, some of which have been published with
Japanese and American text in parallel columns. 18
The American Registry of Pathology
Closely related to the Department of Pathology in the structure of the
Institute is the American Registry of Pathology. The association of the two
departments is all the more intimate by reason of the fact that the registrars of
the individual registries that make up the American Registry of Pathology are
senior pathologists who also head up the specific branches and sections of the
Department of Pathology. At the time of the occupancy of the new building
i n 1 955. the re were 22 individual registries, with a total of 119,000 cases in their
" Memoranda in tilc^. Radiation Injurv Section, AFIP.
LIFE IN THE NEW BUILDING ^7
files. By 1962, the number of registries had grown to 27 and the number of cases
in the files to more than 200,000.
The American Registry is an important arm of the Institute in its research
and education functions. Several of the sponsoring medical specialty societies
provide fellowships at the Institute for study in such fields as radiology, urology,
dermatology, ophthalmology, otolaryngology, and veterinary pathology, while
other fellowships are supported by private funds, foundations, or institutions.
In addition to these sponsored fellowships, physicians of the military services,
including those of the Reserve components and civilian doctors, avail themselves
of the facilities of the Registry, particularly in lines of investigation requiring
followup activity.
The Registry continues to act as sales agent for the fascicles of the "Atlas
of Tumor Pathology," with sales running up to as many as 40,000 copies in a year.
Of these sales, approximately one-fourth are made outside the United States,
going directly to physicians in 55 countries.
Dr. Hugh G. Grady, who had served as Scientific Director of the American
Registry of Pathology since 1949, resigned in mid-1957 to become the first pro-
fessor and organizer of the Department of Pathology in the newly founded Seton
Hall College of Medicine and Dentistry at Jersey City, N.J. He was succeeded
by Dr. Fathollah K. Mostofi. After 2 years of service, Dr. Mostofi resigned this
administrative post but continued to serve as registrar of the Genitourinary
Pathology Registry.
He was succeeded as Scientific Director for the Registry by Colonel Blum-
berg, who combined the duties of this post with those of Deputy Director of the
Institute. As Scientific Director of the Registry, he turned his particular atten-
tion to the increase in financial support from sources outside the Institute, so that
the educational and research potentialities of the Registry, with its intimate
association with civilian medicine, might be more fully realized. 19
The Nledical Illustration Service
The aim of the Medical Illustration Service is, as its name implies, to serve
the medical departments of the Armed Forces through the application of the
graphic arts of pencil and brush, of photography and print, and of three-dimen-
sional modeling. The field of service is, therefore, broader than that of pathol-
ogy, and involves an exchange of information and an area of cooperation with
the education and training divisions of the offices of the several surgeons general.
Annual Reports, Armed Forces Institute of Pathology, 1957, p. 37; 1959, p. 71.
358 ARMED FORCES INSTITUTE OF PATHOLOGY
In the earlier years of occupancy of the new building, the illustrative materials
produced by the Service were not greatly used by the Navy and the Air Force,
except as they participated in the materials used by the three-service Institute
itself. As time went on, however, the direct use of Illustration Service materials
by Navy and Air Force increased, although the Army, as might have been
expected, continued to be by far the largest user of these products other than the
Institute itself.
The breadth of the contacts of the Illustration Service is indicated by the
fact that in i960, by no means an unusual year, it collaborated with more than
[65 U.S. Government, civilian, and foreign agencies in matters pertaining to
exhibits, the loan of films, lantern slide teaching sets, training aids, and illustra-
tions. In another year, 1957, it cooperated with 19 Federal agencies in exchang-
ing information and services in the field of medical illustration, and its personnel
participated in the activities of a dozen civilian societies and associations that
have like interests. 20 In recognition of this breadth of contact, Mr. Herman Van
Cott (fig. 119), Chief of the Service, was appointed to represent the Institute on
the Interdepartmental Committee, now known as the Advisory Council on
Medical Training Aids. The Council is composed of officially appointed repre-
sentatives of the Army, Navy, and Air Force, the Veterans' Administration, the
Public Health Service, and the Bureau of Indian Affairs. Its object is to review
critically all training projects of the governmental agencies that are represented
on the Committee.
A major activity of the Service is the preparation and showing of exhibits
featuring medical information. In the years 1955-1961, 543 such exhibits were
constructed, and 2,102, including those constructed in earlier years, were shown
at local, State, and national meetings of medical associations and at other scien-
tific gatherings. Seventy-nine, or more than one-sixth of those constructed in
the years covered, won awards and official commendations (fig. 120).
From 20 prototyped wound moulage kits, developed by the Training Aids
Division of the Illustration Service, the Office of the Surgeon General of the
Army had 525 individual moulages depicting a variety of wounds made up, and
tried them out in several maneuvers and field exercises. The moulages were so
graphic in effect and so accurate in reproducing the appearance of wounds that
they were standardized for Army use and, as a step toward uniformity in nomen-
clature of wounds among the Allies in the North Atlantic Treaty Organization,
copies of the kit were sent to Great Britain, France, and Canada. In the light
of the possible interdependence of the NATO nations for medical care of their
•"Annual Reports, Armed Forces Institute of Pathology, 1957, p. 44: i960, p. 25.
LIFE IN THE NEW BUILDING
359
A«.ftt «'*
>W
Figure i 19. — The evolution of an emblem. A. Sketches showing steps in the develop-
ment of the idea for the Institute seal by Herman Van Cott, Chief of the Medical Illustra-
tion Service.
respective personnel in time of emergency, the Medical Illustration Service pro-
posed that a graphic training aid, based on the 1958 Emergency War Surgery,
NATO Handbook, be prepared and circulated (fig. 121). This proposal was
approved, and the Illustration Service was asked to develop the necessary 300
overhead projector transparencies, designed to reinforce the Handbook in the
instruction of Allied doctors and ancillary medical personnel. In the develop-
ment of these visual aids, Lt. Col. Kathleen Phillips, ANC, USA, assigned to the
Medical Illustration Service, had an important part. Preliminary sets were dis-
tributed to major medical installations in the United States and oversea com-
mands by October i960. After field testing and minor revisions, the set of 304
transparencies was standardized by the Army as an official graphic training aid. 1 ' 1
(1) Annual Report, Armed Forces Institute of Pathology, 1959, p. 80. (2) Office Memorandum,
AFIP, undated.
S 6 °
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 119.— Continued. B. Mr. Van Cott at work.
In addition to this vivid depiction of war wounds, the Illustration Service
continues its pictorial part in the war against disease. In this, it is greatly aided
by the new equipment which came with the new building (fig. 122). This in-
cludes a new offset press, a hand proving press, a 24-inch processing camera,
and other new items to speed up and improve the quality of reproduction of die
plates in the "Atlas of Tumor Pathology." Its publication is further aided by
a new collating rack in the bindery, which makes it possible for one person
to collate the pages of an entire volume without lost motion. Such a rack,
designed by those who were to use it in "picking up" some 5- or 6-million
pages a year, is a far cry from the pigeonholes on the stairway of the old build-
ing, in which the pages of early publications of the Medical Museum were
placed to be collated, a few at a time, by members of the staff en route to and
from the rest rooms in the old building.
Another segment of the Illustration Service which was enabled to increase
and improve its output upon removal from cramped quarters on the topmost
floor of the old building is the Photography Division, which normally turns
LIFE IN THE NEW BUILDING
3 6l
HOSPITAL SERVICES
M 1 *'
Figure 120. — Award-winning exhibits of the Medical Illustration Service. A. Full-size
exhibit which is shipped to the place of showing.
out a quarter of a million pieces of its work in a year and has, upon occasion,
turned out more than 350,000 items (fig. 123). This output includes photo-
micrography and color reproduction, as well as what might be called normal
black-and-white representations of pathology subjects. 22
Television
Another interesting installation in the Institute of Pathology building is
the main studio and control center for the television facilities of the Walter
Reed Army Medical Center. These facilities include also studios in Walter Reed
General Hospital, and the Walter Reed Army Institute of Research, and are
hooked up in the hospital network of the Washington area. Programs of
scientific interest, broadcast by closed-circuit transmission, are seen and heard
at the National Institutes of Health, the National Naval Medical Center, the
hospital at Andrews Air Force Base, the James C. Kimbrough Hospital at Fort
Meade, Md., and the Wallace DeWitt Hospital at Fort Belvoir, Va., as well as
on some 170 receiving sets in the Walter Reed area.
The broadcasting range is further extended by the ability to transmit pro-
grams on commercial facilities for closed-circuit showing at a distance from
Annual Report, Armed Forces Institute of Pathology, 1961, pp. 215-225.
3 fc
ARMED FORCES INSTITUTE OF PATHOLOGY
THE BIOLOGICAL AND
BIOCHEMICAL EFFECTS OF
MICROWAVES
IF MICROWAVES
Figure i 20.— Continued. B. Light, portable type exhibit which can be carried by one man.
Washington. It is feasible, indeed, to have programs originating in the Walter
Reed studios distributed over the facilities of nationwide broadcasting net-
works, as has been done upon occasion.
The assignment of space in the Institute of Pathology building for the
installation of television facilities for the Medical Center was planned from the
beginning, and contracts with the Radio Corporation of America for the in-
stallation were made in June 1955, within weeks after occupation of the new
building. The installation, completed in late 1956, includes facilities for
producing both black-and-white and color programs. One unusual feature
of the equipment is a color-television camera, mounted in the ceiling of the
hospital operating room, arranged for 360-degree viewing from any part of the
LIFE IN THE NEW BUILDING
363
Figure 121.— For uniformity in war surgery, this material, based on the NATO Hand-
book, is designed to lessen the language barrier among the medical officers of the NATO
nations by telling its story largely in pictures.
room, with remote control so that the cameraman need not be in the operating
room itself (fig. 124). A similar overhead camera is mounted in the McNabb
Autopsy Suite in the Institute building. With such equipment, an audience
of any desired number may view the details of a surgical or autopsy procedure,
without the necessity of straining and craning of necks in trying to see what
goes on from the limited seating area of an operating theater.
The use of television to facilitate consultation between the surgeon in the
operating room and the pathologist in the laboratory, while theoretically
feasible, has not been used as widely as was anticipated, presumably because
of the practical difficulty in sending and receiving meaningful specimens and
slides suitable for simultaneous viewing and diagnostic discussion at a distance.
As a means of broadening and sharpening the teaching of medicine, how-
ever, the television camera and receiving sets are finding more and more uses.
This is due, in part, to the presentation of televised operations to medical student
audiences, but in larger part, to the possibilities for recording and rebroad-
713-02S''— 64-
2.-,
364
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 122. — Printing the fascicles of the Atlas of Tumor Pathology.
casting significant segments of medical subjects through the medium of motion-
picture films or kinescopes of operations and techniques (fig. 125).
The possibilities inherent in such additional uses of the television camera
have been enormously enlarged by the development of video magnetic tape.
This development, which is compatible with the equipment at Walter Reed,
records the living program, both picture and sound, on magnetic tape, from
which it can be transferred to motion-picture film, available for showing on any
16-mm. projector, or can be reproduced directly from the tape wherever com-
patible equipment is available. Thus, a program recorded on video tape is
multiplied many times over as an educational medium, reaching by sight and
sound many audiences besides the original viewers of the program. Indeed,
the potential audience is as vast as diat afforded by the nationwide network
of television cables, microwaves, broadcasting stations, and receiving sets that
make up the great system of visual and sound intercommunication, included
in the one word — television.
Of more immediate application, however, is the practice of exhibiting
programs, through closed-circuit facilities, to audiences assembled in Dart Audi-
LIFE IN THE NEW BUILDING
365
Figure 123. — Modern photomicrography apparatus.
torium of the Armed Forces Institute of Pathology; Sternberg Auditorium
in the Walter Reed Army Institute of Research; or the post theater of Walter
Reed Army Medical Center. To such audiences, it is possible to transmit by
sight and sound, in black and white or in color, significant operations, "live" or
by delayed broadcast; microscopic studies for simultaneous viewing, rather than
having the viewers wait their turns at the microscope; lectures and discussions,
with accompanying illustrative materials; or other demonstrations of educa-
tional interest — all viewed on a picture screen of 6 by 8 feet, if in color, or 9 by 12
feet, if in black and white.
As part of the educational aspect of its threefold mission, the Armed Forces
Institute of Pathology, particularly through the efforts of Dr. Robert E. Stowell,
its Scientific Director, contributes to the Medical Center's television program-
ming, with discussions, demonstrations, and illustrations of pathology material
by members of die Institute staff and consultants. 23
1957
" 3 Illustrated brochure, Radio Corporation of America, Walter Reed Army Medical Center, 1 November
3 66
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 124. — Television camera mounted in ceiling of Armed Forces Institute of Pathology
autopsy room.
The Museum s Movements
The department of the Institute least affected by the move into the new
building in 1955 was the Museum, the ancestor organization which had, in 1947,
already vacated its quarters in the old building. When the Institute moved,
it took with it those sections with which the Museum shared Chase Hall, leaving
to the Museum the entire building. In addition, the Cornell Museum, open only
to the medical profession, was taken out of Chase Hall and removed to the new
building. Col. Hugh R. Gilmore, Jr., MC, USA, who had been Curator of the
Museum since 1953, continued to head the entire Museum, dividing his attention
between the professional museum quartered in the new building, and the two
branches that continued in Chase Hall — the Lay or Public Museum and the
Museum Laboratory.
LIFE IN THE NEW BUILDING
367
Figure 125. — Lectures, with and without the use of visual aids, are an important part
of the Institute's educational mission. In this instance, Col. Joseph L. Bernier (later Maj.
Gen. and Chief of the Dental Corps, U.S. Army), is backed up by television images on four
receiving sets.
With the increased room available in Chase Hall, it became possible to take
many specimens out of the footlocker storage to which they had been consigned
when the wanderings of the Museum had begun, 15 years before. Funds were
found, moreover, for the purchase of 36 new-type exhibit cases for the display of
specimens under more advantageous conditions. 21
This slight easing of space pressures, however, and the improvement of
display materials, did not end the vicissitudes and wanderings of the Museum.
Chase Hall was squarely within the area of the Southwest Washington Urban
Renewal Project, and was known to be doomed at an early date. The question
was, therefore, one of finding new quarters before the present ones were taken
over by the wreckers as part of the rebuilding of a section of the city.
Nevertheless, doomed to destruction as the building was, the curators and
staff of the Museum attempted, with quite a remarkable degree of success, the
task of refurbishing and enlivening the quarters in which the Museum was
located. Colonel Gilmore retired from active service in June 1955, and was
Annua! Report, Armed Forces Institute of Pathology, 1955, pp. 35-37.
368 ARMED FORCES INSTITUTE OF PATHOLOGY
succeeded by Dr. Alfred Plaut, of the Institute staff, as Curator, with Lt. Col.
Harvey W. Coddington, MSC, USA, as Assistant Curator. In the few months
during which this arrangement was in effect, Dr. Plaut devoted most of his
attention to the Cornell Museum, which was housed in the AFIP building, and
Colonel Coddington attended mostly to the affairs of the rest of the Museum.
In March 1957, Colonel Coddington became Curator of the Museum, the
first Medical Service Corps officer to do so. His task was described as "main-
taining two unique collections, both devoted to the * * * preservation and
display of selected medical material of historical and scientific worth." Among
the new exhibits shown were those of "Space Biology," "Psychiatry in Operation
Deepfreeze," "Medical Aspects of Aircraft Investigations," and "Women in
Medicine." During the year, 15 guest exhibits were shown.
l n IQ 57> also? the task of cataloging the Museum's collection of nearly 500
microscopes (fig. 34, pp. 86-87)— probably the world's largest and most repre-
sentative collection of the basic tool of the pathologist — was completed. In 1957,
also, the number of visitors to the Museum exceeded 200,000 persons for the first
time, reaching 221,000.
Early in 1958, Colonel Coddington returned to his duty in the Office of The
Surgeon General, and was succeeded at the Museum by Col. Albert E. Minns,
also of the Medical Service Corps of the Army. The new Curator was a graduate
of the School of Pharmacy of the University of Buffalo, and the University
College of the University of Maryland. In a service of 3^ years as Curator, he
sought to give the Museum a "living atmosphere" by the rotation and refurbish-
ing of 218 out of a total of 715 exhibits shown in that period.
In April 1959, the Cornell Museum was moved out of the Institute building
and installed intact in a suitable room, access to which was limited to the medical
profession, in the Chase Hall quarters of the Museum. In this year, also, the
number of visitors to the Museum rose to 363,000 — by far the highest number
in any previous year.
Even this record, averaging 1,000 visitors daily— the Museum being open
to the public 365 days a year — was broken in the next year, i960, when the num-
ber of visitors reported went up to 587,000. For the first 11 months of the year,
visitors came to the temporary quarters in Chase Hall which had been home to
the Museum for 13 years, but which was scheduled for demolition early in 1961.
In November and December i960, therefore, the Museum moved into
quarters shared with other Government agencies in another temporary building
designated as "Tempo S" and located only a block away, at Jefferson Drive
between Sixth and Seventh Streets, SW. The move was well planned and
smoothly performed, with the laboratory and exhibit materials moved out of the
LIFE IN THE NEW BUILDING 369
old quarters and into the new in such fashion that the Museum was never closed
down and remained open to visitors throughout the move.
International Efforts
Colonel Minns, the Curator under whom this successful move was made,
reached the statutory age of retirement in June 1961, and after some delay, was
succeeded as Curator by Col. John W. Sheridan. The new Curator was also of
the Medical Service Corps of the Army, the third Curator in succession to be
chosen from this source. As had been the case of his predecessor, he was to be
called upon to move the Museum — this time from Tempo S to the "old red
brick" that had been its home for 60 years prior to 1947."'
While the Museum had from its early years attracted a degree of inter-
national attention — winning the praise of Virchow himself for the contributions
of the "Medical and Surgical History of the War of the Rebellion" — its lack
of facilities for advanced experimentation had severely limited its participation
in international study efforts. Occupancy of the new building by the Institute
opened up new avenues for such participation in the worldwide war against
disease which knows no national boundaries. Such a war calls for a common
medical language for international communication of the results of research
in both the clinic and laboratory.
The Museum and its successor, the Institute, had participated in this inter-
national effort, notably through the publication of the fascicles of the "Atlas of
Tumor Pathology," devoted to developing a nomenclature of tumors in the
communication of the results of medical research which could surmount the bar-
riers of ordinary language differences.
A further step in this direction was taken on 2 December 1958, when the
World Health Organization, the National Research Council, and the Armed
Forces Institute of Pathology signed a three-way agreement for the establishment
of the International Reference Center for Soft Tissue Tumors. Pursuant to the
agreement, the Institute selected from its collection a general histologic reference
set of tumors of the soft tissues, with an accompanying syllabus and classification
of tumors of these tissues.
This material was sent to the headquarters of the World Health Organiza-
tion at Geneva, Switzerland, where a meeting of an Expert Committee on
Cancer was held in the last week of June 1959. This meeting, attended by
pathologists from various parts of the world, agreed upon a tentative classifica-
tion of soft tissue tumors, and plans for future operation of the Reference Center.
26 Annual Reports, Museum sections, Armed Forces Institute of Pathology, i 055-1 ofii. passim.
370 ARMED FORCES INSTITUTE OF PATHOLOGY
The latter half of 1959 was given over to the collection of soft tissue tumors of
various types from the Institute files and their classification in accordance with
the tentative classification agreed upon at Geneva. Microscope slides, paraffin
blocks, tissues, and records were collected, and the first histological reference set
of fibrous tissue tumors, with an accompanying syllabus, was prepared. This
material was widely circulated for review and comment. The revisions indicated
were made and, in the spring of i960, 50 sets of material on tumors of fibrous
tissues were made up. Each set consisted of 25 representative sections of tumors
of fibrous tissues, with a syllabus which contained a general discussion of the
diagnostic difficulties involved, and with a description and discussion of each
type of tumor and a clinical history and comment on each case. In addition to
the 50 sets sent to the World Health Organization at Geneva, for distribution
to the health centers of cooperating nations, 30 sets were turned over to the
American Registry of Pathology to be loaned to individual pathologists.
A second international reference set of 25 cases each, dealing with tumors of
adipose tissue was prepared early in 1961, in an "edition" of 100 sets, and received
a similar distribution. 20
An earlier instance of international cooperation is the Joint Committee on
Aviation Pathology — a group which is "joint" in a double sense in that it is
jointly representative of the three armed services of the United States, as well as
being representative of the medical departments of the armed forces of Canada
and the United Kingdom. The Committee dates from 1955, when it was
established by a directive of the Department of Defense, amplified by jointly
issued regulations of the Armed Forces.
The Committee grew out of discussions, in 1954 and 1955, among pa-
thologists interested in the application of pathology to aviation accidents. The
group included Wing Commander (later Air Commodore) Bruce Harvey,
Medical Service, RAF; Capt. S. I. Brody, MC, USN; Dr. Howard T. Karsner,'
Medical Research Adviser, U.S. Navy, Bureau of Medicine and Surgery ; Col.
Frank M. Townsend, then Deputy Director and later Director, Armed Forces
Institute of Pathology; and Dr. F. K. Mostofi, of the Institute. As a result of
several meetings of this group, the Department of Defense issued, on 14 Novem-
ber 1955, a directive setting up the Joint Committee on Aviation Pathology, with
headquarters at the Institute, where permanent files of the findings and other
records of the Committee are maintained.
The Committee is charged with the duty of collecting information on the
correlation between pathological evidence and the factors which cause aircraft
J " Annual Report, Armed Forces Institute of Pathology, 1950, p. 65.
LIFE IN THE NEW BUILDING 371
accidents, making detailed pathological studies to help determine the cause of
unexplained aircraft accidents, improving flight safety by taking into account
pathological conditions, and investigating factors which may result in pathologi-
cal changes in flight personnel.
A prime purpose of the Committee is to insure, insofar as it may be possible
to do so, that medical officers shall have full opportunity to participate in the
investigations of aircraft accidents. From examinations made on the scene and
pursued further in the laboratory, the pathologist may determine what part was
played by human or environmental factors in causing the accident. He can
weigh the evidence pointing to some medical condition, such as shortage of
oxygen, presence of carbon monoxide, explosive decompression or pre-existent
disease in the pilot, or he may note a pattern and sequence of injuries that point
to some failure or improper design of the aircraft itself. For example, it was
medical investigation of a commercial airliner crash near Bolivia, N.C., on
6 January i960, by representatives of the Joint Committee, that led other investi-
gators to find that the accident was due to the explosion of a bomb smuggled
aboard by a passenger.
Aerospace Pathology
Closely related to the work in aviation is that of aerospace pathology which,
in the AFIP organizational setup, is one of three branches of the Division of
Military Environmental Pathology. Aerospace pathology deals with the path-
ological conditions encountered in the flights into outer space by biopack mice
and monkeys, and animals of various kinds, preparatory to flights by men, and
the increasingly numerous flights by men themselves. 2.
Not all of the adventure in such flights, by any means, is that of those who
ride the vehicles into space, or at least into the extreme heights of rarefied
atmosphere. There was, for example, the flight of the Air Force balloon to
investigate the risks to future travelers in the stratosphere from cosmic rays,
sent up from International Falls, Minn. The balloon carried a cargo of live
mice and tissue cultures that would have to be examined immediately, or with-
in a very few hours, after the return of the balloon from stratosphere to earth.
For this reason, it was imperatively necessary that the pathologists who were
to make the examination should reach the place where the balloon came down
promptly after its descent. In an engagingly humorous account of "Operation
"(i) Army Regulations No. 15-97, Bureau of Medicine and Surgery Instruction 6510.6, Air Force
Regulation No. 160-127, "Joint Committee on Aviation Pathology," Departments of The Army, The NlTXi
and The Air Force, 3 September 1957. (2) Office Memorandum, AFIP, 28 March 19*0, Summary of
Activities through February 1961.
71 3-028'— 64 26
37-
ARMED FORCES INSTITUTE OF PATHOLOGY
Stratomouse," published in Military Medicine in 1956, Dr. Webb Haymaker
of the Neuropathology Section of the AFIP, tells of the adventures and mis-
adventures of the reception crew as they chased an unpredictable balloon in an
ancient and vibratory C-47 plane, a truck, and a taxicab across North Dakota,
into Montana, and back to Minnesota — to find that 90 out of 93 precious
mice were alive and well, while autopsies of the three that were dead disclosed
no effects of cosmic rays. 2S
The investigation as to the effects of cosmic rays upon the central nervous
system of animals was continued for several years, the latest experiment having
been conducted at Fort Churchill, Canada, in the summer of 1961. In this
experiment, 8 monkeys and 24 mice were sent aloft nearly 24 miles, where
they floated for about 10 hours.
Another area of the activities of the National Aeronautics and Space Ad-
ministration in which the support of the Institute's Animal Care Branch was
used, was in the animal flights into space which were an essential preliminary
to the manned flights of Project Mercury. Personnel of the Institute who had
received special training in handling chimpanzees were deployed in the antic-
ipated landing areas to care for the animals after they had landed from their
flights. The skeleton of one of the animals, "Able" whose death did not result
from his flight, but from a subsequent operation, is an exhibit of interest in
the Medical Museum.
Like everything else connected with space exploration, bioastronautics,
as space medicine is beginning to be known, is growing in interest and im-
portance. In connection with man's entry into space, the Institute has conducted
studies of radiation, decompression, rapid acceleration and deceleration, and
hypoxia, and the correlation of basic sciences with such specialized studies.
The results are made available to Project Mercury, particularly through the
membership of the Director of the Institute on the team of medical specialists
that support the manned flights of the project. Thus, Colonel Townsend
participated in the arrangements and conduct of the suborbital flight of Cdr.
Alan B. Shephard, Jr., USN, on 1-5 May 1961 ; the like flight of Capt. Virgil
I. Grissom, USAF, on 17-21 July 1961 ; the orbital flight of Lt. Col. John H.
Glenn, Jr., USMC, on 12-21 February 1962; and the second orbital flight, that
of Lt. Cdr. Malcolm Scott Carpenter, USN, on 23-26 May 1962. Colonel
Townsend was represented in the six-orbital flight of Cdr. Walter M. Schirra,
Jr., USN, by Lt. Col. David Auld, USAF, MC, who was detailed to serve on
the team at Cape Canaveral, Fla., from 29 September to 5 October 1962.
"Haymaker, Webb: Operation Stratomouse. Military Medicine 119: 151—171, September 1956.
CHAPTER XVIII
Into the Second Century
In the 99th year of its life, the Institute was partially reorganized to bring
into sharper focus the contribution of its various activities to the accomplishment
of the threefold mission of consultation, education, and research (fig. 126).
It was recognized that the three were inextricably interwoven in the pattern
of the everyday work of the departments, divisions, and branches of the Institute,
but it was felt nevertheless that the multifarious activities of the Institute
should be under continuing examination as to their educational, consultative,
and research aspects.
To this end, three members of the staff were designated as secretaries of
Education, Research, and Consultation, respectively. In their capacity as Secre-
taries, the three staff members work under the direct control of the Director,
and are charged with the responsibility of keeping the directorate and the
Scientific Director of the Institute advised as to the bearing of the work of its
several departments upon the three main missions. As expressed in the memo-
randum outlining the duties and responsibilities of the Secretary of Education,
the secretaries are "to maintain constant and close coordination with all Insti-
tute activities to determine the latest trends and accomplishments in the educa-
tion mission." 1
Organisation
The organization with which the secretaries were to maintain "constant
and close coordination" was that with which the Institute entered the second
century of its life (fig. 127). It consisted of the four principal departments —
the Department of Pathology, the American Registry of Pathology, the Medical
Illustration Service, and the Medical Museum — and the administrative services
applying to all four departments. The entire operation was under the direction
and control of The Director (Col. Frank M. Townsend, USAF, MC), assisted
by the two Deputy Directors (Col. Toe M. Blumberg, MC, USA, and Capt. Roger
*(l) General Orders No. 18, Hq., AFIP, 23 May 1961. (2) Memorandum Number 63, 25 October
1961.
374
ARMED FORCES INSTITUTE OF PATHOLOGY
MISSION
EDUCATION
E5 GRADUATE INS
CED PATHOLOGY
A. INDIVIDUAL STUDY
B. FORMAL COURSES
C. RESIDENCIES AND FELLOWSHIPS
D. LOAN AND STUDY MATERIAL
E. DEVELOPMENT OF TRAINING AIDS
F. PREPARATION AND DISSEMINATION
OF SCIENTIFIC AND TECHNICAL PUBLI-
CATIONS
CONSULTATION
CONSULTATION GIVEN YEARLY ON
PATHOLOGIC SPECIMENS FROM AP-
PROXIMATELY 70,000 PATIENTS.
PATHOLOGISTS COMBINE IMPARTIAL
REVIEW WITH FOLLOW-UP INFORMA-
TION IN DIAGNOSIS.
ARMY - NAVY - AIR FORCE - VA -
OTHER FEDERAL AGENCIES - CIVILIAN
MEOICAL INSTITUTIONS.
RESEARCH
EQUIPPED FOR AND ENGAGED IN THE
STUDY OF BOTH ANALYTICAL ANO
EXPERIMENTAL PATHOLOGY
1. HISTOCHEMISTRY
2. X-RAY
3. ELECTRON MICROSCOPY
4. BIOCHEMISTRY
5. AVIATION CASUALTIES
6. EFFECTS OF COSMIC RAYS ON
MAMMALS.
7. FLUORESCENT ANTIBODY IDENTI-
FICATION OF PATHOGENIC ORGAN-
ISMS.
fl, EFFECT OF IONIZING RADIATION ON
CELLS.
9. QUALITY OF FOODS PRESERVED BY
IRRADIATION.
10. EXPLOSIVE DECOMPRESS K-
Figure 126. — Threefold mission of the Institute.
H. Fuller, MC, USN), and by the Scientific Director (Dr. Robert E. Stowell),
and advised by a scientific advisory board of 18 eminent practitioners of pathol-
ogy. The affairs of the Institute are conducted in accord with policies deter-
mined by the Board of Governors — Lt. Gen. Leonard D. Heaton, The Surgeon
General of the Army; Rear Adm. Edward C. Kenney, MC, USN, The Surgeon
General of the Navy; and Maj. Gen. Oliver K. Niess, The Surgeon General
of the Air Force. The members of the Board of Governors (fig. 128) are,
upon occasion, represented by designated alternates — Brig. Gen. Howard W.
Doan for the Army; Rear Adm. Allan S. Chrisman for the Navy; and Maj.
Gen. Richard L. Bohannon for the Air Force.
Under the immediate control of the directorate is the Executive Officer
(Lt. Col. Vernon S. Oettinger, MSC, USA), and five administrative services
(fig. 129). These include the Adjutant (Lt. Col. Russell Z. Seidel, MSC, USA),
under whose direction is the Ash Library (Mrs. Ruth Haggerty), which issued
more than 13,000 books and journals to patrons, and served nearly 15,000 readers
INTO THE SECOND CENTURY
375
SCIENTIFIC DIRECTOR
H
THE DIRECTOR
DEPUTY DIRECTORS
IOARD Of GOVERNORS
L.
SCIENTIFIC ADVISORY
BOARD
EXECUTIVE OFFICER
CONSULTATION SECTY
EDUCATION SECTY
RESEARCH SECTY
LEGAL COUNSEL
MEDICAL MUSEUM
DEPARTMENT
OF PATHOLOGY
MEDICAL ILLUSTRATION
SERVICE
AMERICAN REGISTRY
OF PATHOLOGY
WHO CENTRE
LEGEND
JCAP ■ Joini Cornmitlee on Aviotion Poihology
WHO World Heollh Organ nolion lni«motto«ol
reference cent., tor toll t.itu* lumen
Figure 127. — The Institute Organization, 1962.
during the year 1961; the Mail Room, which handled nearly 350,000 letters
and 33,000 parcels, and mimeographed nearly 1,900,000 sheets in the year;
the preparation of reports and forms, and the reception of foreign nationals, of
whom 90, representing 34 countries, were at the Institute as trainees and 704,
representing 79 countries, were there as visitors in the year 1961."
Other administrative units reporting to the directorate through the Execu-
tive Officer are the Budget and Management Office (Cdr. Hey ward E. Hall,
MSC, USN), and the Personnel Division (Lt. Col. Walter F. Maybaum, MSC,
USA) ; the Supply and Services Division (Maj. Bryce L. Moschel, MSC, USA),
which reported that "shortage of funds for procurement of equipment plagued
the Division during the entire year," to such an extent that the equipment re-
placement program was "practically nonexistent"; and the Technical Liaison
Office ( 1st Lt. John L. Bryant, Jr., USAF, MSC). The Technical Liaison Office
issued the monthly "AFIP Letter" to a mailing list of more than 2,300 members
of the medical, dental, veterinary, and allied scientific professions, while the
! Annual Report, Armed Forces Institute of Pathology, 1961, pp. 240-247.
376
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 128.— The three Surgeons General and the Director, AFIP, participate in the
unveiling of a plaque on 19 July 1962. Left to right, Lt. Gen. Leonard D. Heaton, Maj.
Gen. Oliver K. Niess, Col. Frank M. Townsend, USAF, MC, and Rear Adm. Edward C.
Kenney. The plaque, containing the heart of President Eisenhower's 1955 dedication
address, was placed at the main entrance of the Institute.
Editorial Office (Miss Laura A. Gibbs) edited 145 manuscripts for publication
or oral presentation; processed 41,000 reprints of articles by members of the
Institute staff; and issued a bibliography of their articles and books published
in 1961, numbering 91 titles.
INTO THE SECOND CENTURY
377
Figure 129.— Executive officer and administrative staff. Front row (left to right):
Lt. Col. L. J. Neurauter, USAF, VC, Lt. Col. R. Z. Seidel, MSC, USA, Lt. Col. V. P. Ver-
fuerth, MSC, USA, Lt. Col. W. F. Maybaum, MSC, USA, Maj. B. L. Moschel, MSC, USA.
Back row (left to right): Maj. O. L. Norrell, Jr., MSC, USA, Lt. T. O. Jordan, MSC,
USN, 1st Lt. J. L. Bryant, Jr., USAF, MSC, J. L. Evans, Maj. W. R. Rule, USAF, MSC,
Capt. B. P. Chambers, USAF, MSC, Capt. J. R. Green, USAF, MSC. Missing from this
photograph is Lt. Col. V. S. Oettinger, MSC, USA, who retired and was replaced by
Colonel Verfuerth.
The Four Departments
Of the four departments of the Institute, the largest by far is the Department
of Pathology (fig. 130), headed by Dr. Elson B. Helwig as Chief, with Col. Paul
C. LeGolvan, MC, USA, as Assistant Chief. As it was organized at the start of
the second century of the life of the Institute, the Department consisted of eight
professional divisions (fig. 131) and an Administrative Office, under Lt. Col.
Nathan Cooper, USAF, MSC, the mission of which was "to give the professional
staff the utmost administrative support" (fig. 132). This is accomplished
through the Professional Records Service (Maj. Charles B. Broadway, USAF,
MSC), the Histopathology Laboratories (Mr. Lee G. Luna), and the Education
Office, which provides continuous on-the-job training for staff personnel, and
trains technicians from other installations, both civilian and military, in special
techniques developed at the Institute. The degree of success that attends these
training efforts may be gaged by the fact that, in 1961, 13 members of the labora-
tory staff applied for and took the examination for certification in histopathology
given by the American Society of Clinical Pathologists, and all 13 passed and
were certified.
378
ARMED FORCES INSTITUTE OF PATHOLOGY
DtPAITMENT OF PATHOLOGY
Msg£M
G*ee>apMc fc>*olog,
Gaegiaphic Zoonetn
tanwjiwJoj/ & locrarioloer
Figure 130. — Organizational chart, Department of Pathology, 1 February 1962.
Among the techniques used at the Institute is one applied by the late Law-
rence W. Ambrogi (fig. 133), Chief of the Histopathology Laboratories, who
served the Institute for all but 4 of the 40 years before his sudden death in
December i960. In the last year of his life, Mr. Ambrogi adopted a new tech-
nique which makes possible the distribution of microscopic sections by first-class
mail at nominal expense and without fear of breakage. The sections are mounted
and sealed inside plastic sheets which can be folded, creased, or crumpled without
harm to the sections. Upon arrival at destination, the sections may be cut out
of the plastic sheet, mounted between glass slides, and examined by microscope
in the usual fashion. 3
The Professional Records Service of the Department of Pathology includes
sections for Receiving and Accessions, Tissue Processing, Professional Files,
Machine Records, Medical Statistics, and a Library of Medical Records. The
Service maintains "vast and voluminous" files of diagnostic information, both
in the form of specimens and on diagnostic cards, of which there are in the files
literally millions. The system is designed for ready reference to any case, with
cards crossfiled and indexed to the etiology or cause of the disease, and to the
topography or location of its lesions. There are thus not less than two diagnostic
cards crossfiled and indexed to the etiology or cause of the disease, and to the
*(l) Annua! Report, Armed Forces Institute of Pathology, pp. 79-85. (2) Transactions of the
American Academy of Ophthalmology and Otolaryngology, January-February 1961, pp. 79-80, 100.
INTO THE SECOND CENTURY
379
3 8o
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 132. — Administrative staff, Department of Pathology. Left to right, seated:
Lt. Col. D. C. Auld, USAF, MC, Maj. C. B. Broadway, USAF, MSC, Lt. Col. N. Cooper,
USAF, MSC, B. L. Parnell, D. G. Koelle. Left to right, standing: S. G. Corbett, G. M.
Evans, M. S. Attaway, M. Y. Robeson, N. M. Beasley, L. G. Luna.
there being as many as half a dozen cards, or perhaps even more. Under serious
consideration, as the second century of life of the Institute began, was discon-
tinuance of the use of punchcards, and adoption of a system by which the millions
of "memories" which make up the professional records of the Museum-Institute
would be stored and made more readily available by the use of magnetic tape.
Many of these recorded memories are related to the tissues that are handled
by the Tissue Processing Section. These specimens are being removed from
cumbersome 20-gallon earthenware crock jars and placed in plastic bags. In
1961, despite the collapse of the roof of the Franconia, Va., warehouse wherein
many of the specimens are stored, which caused a time loss of 2 months, more
than 60,000 specimens were transferred from crocks to bags.
Space, or the lack of it, handicapped the Professional Records Service in
several directions. The Professional Files Section, for example, which had
paraffin blocks filed in two parts of the main Institute building beside those
stored at Franconia, was compelled to seek more space. This was found, with
the help of the Walter Reed Army Medical Center, in the basement of Delano
Hall, the headquarters and home for the Walter Reed nurses. The Histopathol-
ogy Laboratories also were plagued by a shortage of space, with 54 persons
INTO THE SECOND CENTURY
3 8l
Figure 133.— Lawrence W. Ambrogi, Chief, Histopathology Laboratories, who served for
36 years.
working in a space originally designed for not more than 35. Under these con-
ditions, the laboratories turn out a load of work which is indicated by the prepa-
ration of some 350,000 microslides and the processing and cutting or 00,000
paraffin, celloidin, and frozen blocks per year.
382 ARMED FORCES INSTITUTE OF PATHOLOGY
The purpose of these supporting services was, primarily, to relieve the pro-
fessional staffs of the divisions and branches of the Department of Pathology of
detailed custodial and statistical duties, as far as possible. 4
Three of the eight professional divisions of the Department of Pathology
had to do with the general and special pathology of groups of diseases — Division
A, under Dr. William C. Manion ; Division B, headed by Dr. Lorenz E. Zimmer-
man; and Division C, by Dr. F. K. Mostofi.
Group A (Dr. Manion, Chief) includes the Cardiovascular Pathology
Branch, of which Dr. Manion was also Chief; the Orthopedic Pathology Branch,
headed by Dr. Lent C. Johnson; the Hepatic and Pediatric Pathology Branches,
of which Dr. Hans F. Smetana was Chief; and two Branches, those of Dermal
and Gastrointestinal Pathology, headed by the Chief of the entire Department,
Dr. Helwig. 5
Division B was headed by Dr. Lorenz E. Zimmerman, who was also Chief
of the Ophthalmic Pathology Branch. The Hematologic Pathology Branch
Chief was Dr. George Th. Diamandopoulos, while Dr. Samuel H. Rosen, who
had played a leading part in the identification and description of a new disease
entity, pulmonary alveolar proteinosis, served as Chief of the Branches of Pul-
monary Pathology, and also Mediastinal Pathology, and Ear, Nose, and Throat
Pathology. Division B also included the Neuropathology Branch, of which Dr.
Kenneth M. Earle was Chief, having succeeded Dr. Webb Haymaker upon his
resignation, in 1961, to join the staff of the Ames Research Laboratory in Cali-
fornia. Dr. Earle came from the University of Texas School of Medicine at
Galveston, where he was a neuropathologist and dean. 6
Dr. F. K. Mostofi was Chief of Division C of General and Special Pathol-
ogy, and also Chief of the Genitourinary Pathology Branch of that division.
The Endocrine and Soft Tissue Pathology Branch was headed by Dr. G. H.
Klinck, who took notice of the increasing trend toward sending in specimens
from unusual and highly selected cases, only a small minority of which could
be handled by form letters of receipt and acknowledgement. The third Branch
of the Division, that of Obstetric, Gynecologic, and Breast Pathology, was
headed by Dr. Herbert B. Taylor, who had succeeded Dr. Robert D. Neubecker
at the end of August 1961/
The Division of Basic Sciences was the charge of Dr. Frank B. Johnson,
who also headed its Histochemistry Branch. Dr. Gunter F. Bahr was Chief
' Annual Report, Armed Forces Institute of Pathology, 1961, pp. 182-203.
'■Ibid., pp. 86-97.
"Ibid., pp. 98-114.
7 'Ibid., pp. 1 15-126.
INTO THE SECOND CENTURY 383
of the Biophysics Branch, and Dr. Vaman S. Waravdekar headed the Bio-
chemistry Branch. The Chief of the Immunobiology Branch was Dr. Arthur
M. Silverstein. s
Much of the work of these branches is devoted to investigations in life
processes which may not relate immediately to some disease but which pro-
vides basic knowledge and understanding. Reminiscent of the pioneering of
the Medical Museum in the combination of the camera and the microscope is
the work of the Biophysics Branch with the electron microscope and a photom-
eter in determining the mass of biological particles so small that it can be
expressed only in terms of a negative fraction of a gram raised to the 12th or even
the 18th power — if such words as "mass" and "raised" can be meaningfully
applied to anything so infinitesimally small.
Experiments underway in the Immunobiology Branch in the nature of the
immunologic response of the mammalian fetus give promise of enlarging the
understanding of the response to immunization, improving the comprehension
of the pathogenetic features of the processes of fetal infection, and changing
the concept of the beginning of the immunologic capability of the infant,
which would seem to be at an earlier age than that commonly accepted.
The Radiation Pathology Branch, headed by Lt. Col. David C. White, MC,
USA, reported in 1961 on more than 6,500 cases submitted for consultation,
the main concern in most instances being a determination of the extent to which
radiation contributed to, or was a significant factor in, the cases reviewed. The
Radiation Pathology Branch also was a moving force in the creation of the
26th Registry, that of Radiation Pathology, which went into operation in the
centennial year of the Institute.
The Division of Military Environmental Pathology was headed by Lt. Col.
Edward H. Johnston, MC, USA, who also doubled as chief of its Forensic
Pathology Branch. Maj. William R. Rule, USAF, MSC, Legal Counsel to the
Institute, was active in the work of this branch, which conducted courses, held
seminars, and provided residency training dealing with the many and varied
ways in which problems of the law arise in the practice of pathology, ror
example, as part of the Medical Education for National Defense program, famil-
iarly known as MEND, the Institute sponsored a 3-day symposium on the
"Pathology of Trauma," with an attendance of 160 professional registrants
from medical schools throughout the United States, and 24 professional regis-
trants from Government agencies other than the Institute. 9
"Ibid., pp. 127-139.
'ibid., pp. 140-153.
384 ARMED FORCES INSTITUTE OF PATHOLOGY
The Aerospace Pathology Branch, under Capt. W. Harley Davidson, USAF,
MC, is closely allied in its operations with the Joint Committee on Aviation
Pathology. The two organizations have similar missions in the pathological
investigation of the human factors involved in aircraft accidents — to which is
added, in the light of recent developments, pathology in space flight as well.
Since the formation of the Joint Committee, the Aerospace Pathology
Branch of the Institute has acted as its headquarters staff. Maj. V. A. Stem-
bridge, the first Chief of the Branch, received the Legion of Merit for his out-
standing contribution to aviation pathology. Staff members of the Branch
have served as secretaries of the Joint Committee, beginning with Dr. Mostofi,
followed by Capt. Murray Ballenger, MC, USN, and then by Maj. F. W. Lovell,
who was both Branch Chief of the Aerospace unit and Secretary of the Joint
Committee. The same combination of positions was held by Captain Davidson
at the beginning of the Institute's second century of life. 10
In the first 6 l / 2 years of its operation, Aerospace Pathology Branch per-
sonnel assisted in the investigation of 22 military aircraft accidents. In the
years 1959-61, 23 civilian accidents were investigated at the request of the Civil
Aeronautics Board. Altogether, the Branch has reviewed more than 3,000
cases from fatal aircraft accidents, both civilian and military.
Essential in the accomplishment of the mission of the Branch was the work
of the Toxicology Laboratory established in 1956, which has done research in
the pathology of the effects of carbon monoxide, hypoxia, alcohol, and drugs
upon aircrew members. In November 1961, the Toxicology Laboratory was
given the status of a branch under Col. Thaddeus J. Domanski, USAF, MC, as
Chief. In the last 2 months of 1961, the first 2 months of its existence as a
full-fledged Toxicology Branch, it received for toxicological examination 68
cases growing out of fatal aircraft accidents. 11
Maj. Pierre A. Finck, MC, USA, doubled as Chief of the Wound Ballistics
Branch of the Military Environmental Pathology Division, and also as the
education officer for the Division, in which capacity 7 lectures and 30 division
staff meetings were arranged. Among the guest speakers who gave lectures were
Lt. Cdr. John H. Ebersole, first medical officer on the submarine U.S.S. Nautilus,
and Capt. Joseph W. Kittenger of the Air Force, first man to jump from a
height of more than 100,000 feet.
The Division of Dental and Oral Pathology was headed by Capt. Louis S.
Hansen, DC, USN, who had succeeded Col. Joseph L. Bernier when the latter
"IH., pp. 143-148.
" Annual Report, Armed Forces Institute of Pathology, 1961. pp. 1 51-153.
INTO THE SECOND CENTURY 385
became a major general and head of the Army Dental Corps. Besides giving
attention to consultation sought in about 250 cases per month, the Division
carried on an active program in research and education. The use of loan ma-
terials in the form of microscope study sets and lantern slides was virtually
doubled in 1961, as compared with i960, while response to the Division's post-
graduate short course on the pathology of the oral regions was such that 60
civilians who applied for the course had to be turned down because of lack of
space. 12
The Veterinary Pathology Division was headed by Lt. Col. M. A. Ross, VC,
USA, who had succeeded Col. F. D. Maurer upon the latter's transfer in June
1961. The Division consisted of three branches, one on General Veterinary
Pathology, of which Colonel Ross was Chief, and the others, on Animal Care
and Surgery and X-ray, combined, with Capt. Keith L. Kraner, USAF, VC, as
Chief. The work of this Division is ample proof of the error in the opinion that
an army without horses would have no need for veterinary services. When it is
considered that there are at least 80 diseases which are communicable from the
lower animals to man, and that the laboratory animal is a necessary part of
research dealing with human diseases, the importance of veterinary knowledge
and services becomes apparent. Indeed, research into the maintenance in health
of the colonies of laboratory animals becomes the more important since the
validity of the results of experimentation may be impaired if the animals used
are not healthy specimens. More recently, there have been other calls for vet-
erinary science in the space tests of animals which were an essential preliminary
to space flights by man. 13
Newest of the eight divisions of the Department of Pathology is that of
Geographic Pathology, of which Dr. Chapman H. Binford is Chief. The assign-
ment of the Division is the study of the peculiarities of disease as affected by
topography, climate, food habits, and population of various regions of the
earth, with special attention to infectious diseases that might be encountered by
persons going into unfamiliar environments. To this end, the Division not only
carries on research studies on selected diseases, but also seeks to stimulate the
exchange of information among different countries by establishing closer rela-
tions with their pathologists.
The Geographic Pathology Division included six branches. Two of these —
the Branches of Infectious Diseases and Virology— had been transferred from
other divisions in 1961. Under the new organization, Infectious Diseases was
'Ibid., pp. 154-160.
3 Ibid., pp. 161-169.
^86 ARMED FORCES INSTITUTE OF PATHOLOGY
assigned to Group Captain R. M. Cross, Royal Air Force, as Chief, and the
Virology Branch to Col. T. C. Berge, MC, USA. Two other branches of the
Division — those of Geographic Pathology and of Leprosy — are headed by Dr.
Binford, Chief of the Division. The other branches of the Division are those of
Nutritional Pathology, of which Dr. Richard H. Follis, Jr., is Chief, and of
Immunology and Bacteriology, of which Maj. (later Lt. Col.) Joseph F. Metzger,
MC, USA, is Chief.
Extramural Monetary Support
The main emphasis of the program in Geographic Pathology is support
of investigations of diseases of military importance which are encountered in
other countries, an activity which is supported financially by the U.S. Army
Medical Research and Development Command. 14
Monetary support of Institute research projects from sources outside the
Institute increased from $700,000 in i960, to $880,000 in 1961, and was further
increased in the centennial year of the Institute to $1,055,000, with an additional
$143,000 in prospect. The greater part of this extramural support came from
governmental agencies such as the Research and Development Command of
the Army, the Veterans' Administration, and the National Aeronautics and
Space Administration, but contributions came also from such sources as the
National Research Council-National Academy of Sciences, and a variety of
societies and foundations devoted to research and education in problems of
health and disease for cooperative projects with universities and others.
Scientific and professional aspects of the activities of the Institute and
stimulation of, and assistance in, research and education were the principal
functions of the Scientific Director (Dr. Robert E. Stowell). The range and
extent of the interests of the office are indicated by the degree of participation
of the scientific director not only in the work of the Institute, but also in the
activities of numerous agencies of governmental and civilian medicine. Thus,
he was Chairman of the Advisory Committee of the American Cancer Society
on Research on the Pathogenesis of Cancer; editor of the series of monographs
of the International Academy of Pathology; and member of the editorial board
of the journal Laboratory Investigation.
For practical purposes, and in keeping with his educational, research, and
consultation functions, the Scientific Director supervised the activities of the
offices of the Secretaries — Capt. Binning P. Chambers, USAF, MSC, Education
' I hill., pp. I70-181.
INTO THE SECOND CENTURY 387
Secretary; Lt. Col. Lloyd J. Neurauter, USAF, VC, Research Secretary; and
Maj. Charles B. Broadway, USAF, MSC, Consultation Secretary.
In the Institute's centennial year, the office of the Education Secretary issued
the first unit of a planned catalog of the educational aids and activities of the
Institute. Ultimately, the completed catalog will include listings of lantern
slide and microscopic slide teaching sets, loan sets prepared for the clini-
copathologic conference, video tapes, moving pictures, audio-aids such as mag-
netic tapes and long-playing records, and exhibits produced not only by the
Department of Pathology and the Office of the Scientific Director, but also by the
American Registry of Pathology, the Medical Illustration Service, and the
Medical Museum. 15
The American Registry of Pathology (fig. 134) entered the 40th year of
the registry movement, and the centennial year of the Institute, with 25 regis-
tries, to which there were added, before the year's end, two others, that of
Radiation Pathology and Geographic Pathology. The unique organization
of the registries, with their facility for followup study of die natural history
of disease processes, made it possible in 1961 to conduct over 50 research projects,
involving more than 6,000 cases, over 80 percent of which were contributed
through the registries. 16
The Medical Illustration Service (Herman Van Cott, Chief; Morris Gold-
berg, Assistant Chief), entered the centennial year of the Institute with an or-
ganization of four divisions — Scientific Illustration (William E. Macy. Chief) ;
Photography (Julius Halsman, Chief); Printing (Frank Dillon, Chief); and
Training Aids (William W. Nicholls, Chief) (fig. 135). In the course of a
year, the Scientific Illustration Division produced more than 6,000 illustrations
for use in manuals and graphic aids, and for supplying the Medical Illustration
Library with pictorial material. Much of this material originates with the
Photography Division, which turns out some 250,000 items in a year. The
Printing Division produces the fascicles of the "Atlas of Tumor Pathology,"
the demand for which is so great that it has been necessary to add a nightshift
in the printing plant. The Training Aids Division uses pictorial and three-
dimensional materials in the production of prototypes of materials to be used
in training personnel. 1.
The centennial year of the Medical Musuem with Col. John W. Sheridan,
MSC, USA, as Curator (fig. 136), was marked by another move — from Tempo-
rary Building S across 7th Street to the same "old red brick" which had been
16 Ibid., pp. 226-233.
18 Ibid., pp. 226-231.
" Ibid., pp. 215-225.
3 88
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 134. — American Registry of Pathology staff. Left to right, seated: Capt. E. L.
Howes, Jr., MC, USA, Maj. H. H. Shamdin, MC, USA. Left to right, standing: Capt.
H. M. Price, MC, USA, R. DiPretoro, Capt. A. W. Lazar, USAF, MC, Capt. A. B. Cooper,
USAF, MC.
its home for 60 years up to 1947. This time, however, there was a very real
difference in conditions from those which had prevailed when the Museum
moved out 15 years before. Then, the building, in anticipation of its coming
evacuation by the Library of Medicine and the Institute of Pathology, received
very limited expenditures for maintenance and virtually nothing for improve-
ments. In 1962, with the decision that the Museum should reoccupy its old
home, there went the decision to preserve the building for its historic and archi-
tectural interest. The General Services Administration, which is responsible
for its upkeep, has undertaken an immediate program of limited rehabilitation
to make the building suitable for the Museum, and a longer range plan for in-
terior improvements, such as elevators and plumbing, adequate to permit the
installation of some of the histopathology laboratories now housed in the main
building. Neither the short-range repairs nor the long-range program of
INTO THE SECOND CENTURY
389
Figure 135. — Medical Illustration Service staff. Left to right, seated: Herman Van
Cott, Morris M. Goldberg. Left to right, standing: Julius Halsman, William E. Macy,
Frank J. Dillon, Jr., William W. Nicholls.
improvement comtemplates alteration of the fundamental architecture of the
building, which in and of itself is a true museum piece.
The Museum will occupy the two main exhibit halls on the second floor,
with their balconies and their two-story-high ceilings, and one main exhibit
hall on the first floor. Office space in the building will be occupied by parts
of the Professional Records Service and other offices which will be moved from
the main building of the Institute. It is anticipated that when the moves are
completed, approximately 100 of the total Institute staff of 650 will be located
in the rehabilitated Museum building, with a corresponding decrease in the
population pressure on the facilities of the main building.
In distance, the move back into its oldtime quarters (fig. 137) was lne
shortest of the several moves of the Museum in its hundred years of life, dis-
tance, however, is no measure of the difficulties involved in scheduling such a
move, packing the thousands of items that are to go, moving exhibits and
display cases, setting them up in their new locations, unpacking specimens,
and restoring them to their proper places — and doing all this in a building
39°
ARMED FORCES INSTITUTE OF PATHOLOGY
Figure 136. — Curator and staff of Medical Museum, 1962. Left to right, seated: Col.
J. W. Sheridan, MSC, USA, H. R. Purtle. Left to right, standing: G. T. Harrell, 1st Lt.
W. R. Schafer, MSC, USA, H. E. Demick.
still undergoing renovation without shutting down the Museum which, in 1961,
received 685,000 visitors. 13 This attendance reached its peak on 26 February
1962, the day on which Washington welcomed Col. John H. Glenn, Jr., after
his triple orbit around the earth, and when more than 14,000 persons visited the
Museum.
Scope of the Institute' s Activities
In the broad sense, the whole work of the Institute is educational in purpose
and character, but some of the activities aimed specifically at education are
shown in figures 117 (p. 353) and 125 (p. 367). Among these activities were the
' Ibid., pp. 234-239.
INTO THE SECOND CENTURY
39 1
Figure 137. — This building, erected for the Army Medical Museum and the Army
Medical Library in 1887 was in part occupied by the Museum and its successor, the Institute,
until 1955. The Museum and certain offices of the Institute returned to this home in the
centennial year 1962.
11 postgraduate short courses offered by the Department of Pathology and
attended in 1961 by 1,105 qualified students. The courses were continued in
1962-63, with such subjects as an introduction to research methods, the pathology
of tropical and other exotic diseases, the application of histochemistry to pathol-
ogy, the pathology of diseases of laboratory animals, forensic dentistry, the
pathology of the oral regions, orthopedic pathology, ophthalmic pathology, and
forensic pathology.
The most widely attended feature of the program was the week of annual
lectures by Institute staff members, 42 of which were given in 5 days, with a
daily attendance of 256.
Other education activity in 1961 included the loan of nearly 900 sets of
clinicopathological conference sets and more than 4,000 microscopic slide teach-
ing sets, and the circulation of nine lectures on tapes to reach wider audiences.
Emphasis on Research
Without in any way diminishing its education or consultation missions, the
Institute is placing greater and greater emphasis upon its mission of research.
This is particularly notable in the extramural segment of its program, receiving
39 2
ARMED FORCES INSTITUTE OF PATHOLOGY
SUMMARY OF RESEARCH PROJECTS
1955 - 1962
1955
1956
Ca
1957
lendar
1958
rear
1959
I960
1961
Number of Publications
35
38
43
77
83
82
88
Number of Intramural Projects
164
118
127
131
134
143
157
Number of Extramural Projects
1
4
13
IS
21
37
40
Money Value of Extramural Projects
NOT
AVAILABLE
32,000 1
109,000 1
127,000
336.000
700.000 1
879.978
Figure 138.— The Institute's expanding research program. The table closes with 1961 but
1962 saw a further increase in the value of this outside support to more than $1 million.
financial support from sources outside the Institute, as is shown in figure 138.
Where there was but one such project in 1955, the year in which the new building
was first occupied, and but four in 1956, the first full year of occupancy, there
were 40 such projects in 1961. The number and scope of such activities give
promise of further growth as more funds are made available and as the widening
field of knowledge affords an expanding area of contact between the known and
the unknown— the area which is the hunting ground for research.
In one of the Armed Forces Institute of Pathology lectures, recorded on tape,
Brig. Gen. Stanhope Bayne-Jones, MC, USA (Ret), discussed "Research Fron-
tiers for Future Investigations." Looking forward to what might be the ultimate
in research into the structure and composition of matter, General Bayne-Jones
said:
The ultimate particles which enter into combination to make hydrogen and iron also
enter into the construction of bone and muscle, blood, and nerve, and brain. In studying
the constitution of atoms we are studying the fundamental stuff of the universe, of suns
and mountains and seas— the black carbon of coal, the green chlorophyll of grass, the red
hemoglobin of blood. Indeed, nature knows no such specializations as physics, chemistry,
INTO THE SECOND CENTURY 393
biology, and other categories into which we fit our fragments of knowledge. She knows
only the particles and their incessant interactions as expressed in phenomena such as
magnetism, radiation, life, and death. 19
In search for broader knowledge and deeper insight into the nature of diese
"ultimate particles," the century-old Institute is one of the forward observation
posts— an organization rarely equipped for the pursuit of the elusive bits of
information which can, in time, lead to a better understanding of the causes and
course, and the prevention and cure, of disease.
Writing in 1928, Dr. Esmond R. Long, author of a standard history of
pathology, and himself a pathologist of distinction, ventured the opinion that
"there is no present warrant for predicting any change so revolutionary as the
cellular doctrine of the nineteenth century * * *. There is much to indicate
that the modern spirit of pathology is expressed in organization and that present
advance is being brought about more through well designed administration than
that individual capacity which proved so fertile in the preceding century *
Capable administration and the recognition of fruitful projects, although less
dramatic, have thus apparently become as important in the furtherance of
knowledge in pathology as individual investigative originality."
Writing one-third of a century later, in his "History of American Pathol-
ogy," published in the centennial year of the Insdtute, Dr. Long paid tribute to
the Institute in terms that are reminiscent of his earlier description of the kind
of organization which would become increasingly important in augmentation
of knowledge of pathology. 21
In like recognition of the value of the Institute, the American Journal of
Clinical Pathology, official publication of the American Society of Clinical
Pathologists, devoted a special issue to the Institute as it began its "second century
of distinguished service." The special centennial commemoration issue con-
tained seven scientific papers prepared by 16 members of the Institute start and
scientists who had worked at the Institute. 22 This recognition of the Institute
was typical of that of other publications in the medical field, including Inter-
national Ophthalmology Clinics which dedicated its June 1962 issue to the
Institute's 100th Anniversary. The issue, edited by Dr. Lorenz E. Zimmerman
" AFIP tape recording of lecture by Brig. Gen. Stanhope Bayne-Jones.
20 Long, Esmond R.: A History of Pathology. Baltimore: Williams & Wilkins Co., 1928, pp. 2;
21 Long, Esmond R.: A History of American Pathology. Springfield, 111.: Charles C Thomas. Publ.snc
1962, pp. 378-380. . »__:.
23 American Journal of Clinical Pathology, Special Issue in Commemoration of the Centcnnia
versary of the Armed Forces Institute of Pathology, volume 38, July 1962.
394 ARMED FORCES INSTITUTE OF PATHOLOGY
of the Institute staff, contains 16 articles dealing with tumors of the eye and
adnexa. 23
A further international note in the recognition of the Institute's centenary
was supplied by a special commemorative issue of what is probably the oldest
internationally recognized journal in the field of pathology- — Virchows Archiv,
founded in 1847 by Rudolf Virchow, edited by him until 1902, and continued
thereafter as a journal of general pathology, anatomy, physiology, and clinical
medicine. In its June 1962 issue, dedicated to the "hundert Jahre" of the Institute,
this famous Archiv published nine papers by 16 authors of the Institute staff,
together with a brief summation of the history of the Museum-Institute by
Prof. Dr. E. Uehlinger of Zurich, Switzerland, co-editor of the journal, and a
Foreword by Col. Frank M. Townsend, The Director of the Institute. 21
"It is with a sense of anticipation that we enter the second century of the
Armed Forces Institute of Pathology," the Director wrote. "The sum of knowl-
edge gained from the study of pathology will continue to enhance the welfare of
men and make it possible for those of the Medical Fraternity of the world to
unite their many efforts for the well-being of all."
The Museum-Institute has done much in the first century of its life to add
to "the sum of knowledge." As the frontiers of medical knowledge continue
to expand, as opportunity for fruitful research is enlarged, as the apparatus of
investigation and the techniques of research and communication improve, there
is every reason to anticipate even greater contributions in the second and succeed-
ing centuries.
23 International Ophthalmology Clinics, volume 2, June 1962.
Virchow's Archiv fur pathologische Anatomie und Physiologie und fur klinische Medizin, volume 335,
Springer-Verlag: Berlin; Gottingen; Heidelberg, June 1962.
APPENDIX A
A Chronologic Synopsis of Events
1862
25 April:
1 May:
21 May:
9 June:
1 August:
1863
1 January:
25 August:
24 September:
1864
18 August:
3 October:
William Alexander Hammond appointed Surgeon General,
U.S. Army.
Brigade Surgeon John Hill Brinton and Assistant Surgeon
Joseph Janvier Woodward ordered to report to Surgeon Gen-
eral for special duty.
Surgeon General Hammond issued Circular No. 2, establish-
ing the Army Medical Museum.
Hammond issued Circular No. 5 which provided for publi-
cation of "The Medical and Surgical History of the War of
the Rebellion."
First home of the Museum in the Riggs Bank Building.
Hammond ordered Brinton to collect and arrange in the
"Military Medical Museum" all specimens of morbid anatomy,
both medical and surgical.
Second home of the Museum — Pennsylvania Avenue.
First catalog of the Army Medical Museum issued by the
Curator.
Third home of the Museum— Corcoran School House, 1325
H Street, NW.
Brinton's plan for an Army Medical School rejected by Secre-
tary of War Stanton.
Surgeon General Hammond dismissed from the Service by
Secretary of War Stanton.
Dr. George Alexander Otis named Curator, to succeed
Brinton.
71 3-028 v — G4 27
39 6
ARMED FORCES INSTITUTE OF PATHOLOGY
1865
15 April:
29 April:
1 November:
1866
22 December:
1867
25 April:
1881
23 February:
19 September
1882
30 June:
1883
28 December
1884
11 October:
/««5
25 March:
1887
9 November:
7#92
12 April:
1893
24 June:
Drs. Woodward and Curtis performed the autopsy upon the
body of Abraham Lincoln.
Immediately after the removal of the body, Hermann Faber
sketched the deathbed scene.
Autopsy upon the body of John Wilkes Booth performed by
Museum's pathologists.
Surgeon General Joseph K. Barnes issued Circular No. 6,
describing Woodward's work in photomicrography.
Museum settled in Ford's Theater building, its fourth home.
First visiting rules issued for the Museum.
Dr. Otis died; succeeded by Maj. David Low Huntington as
Curator.
President James A. Garfield died; autopsy performed by
Dr. D. S. Lamb, Museum pathologist, with Dr. Woodward
as recorder.
Dr. Lamb performed autopsy of Guiteau, the assassin.
Museum and Library consolidated into one division.
Maj. John Shaw Billings named Curator of Museum as well
as Librarian.
Billings started microscope collection; first 17 arrived in
Museum.
Site for new building (fifth home) selected.
Museum moved into "new red brick," its fifth home.
Congress recognized scientific status of Museum.
Army Medical School established in Museum building by
Surgeon General George Miller Sternberg.
APPENDIX A
397
1893
8 September:
1895
16 September:
1896
10 June:
1898
18 August:
1900
24 May:
7 September:
18 September:
22-26 October:
20 November:
1901
6 February:
1902
22 November:
1907
16 September:
1909
1 March:
/9/0
7 June:
1911
30 September:
79/3
15 October:
Capt. (later Maj.) Walter Reed appointed Curator of the
Museum; succeeded Billings.
American Dental Association designated Museum as national
repository.
First record of use of X-ray in Museum.
General Orders No. 194, AGO, designating Typhoid Fever
Board.
Special Orders No. 22, AGO, designating Yellow Fever
Board.
Report of Reed-Vaughan-Shakespeare Board on Typhoid
Fever completed at Museum.
Dr. Lazear died of yellow fever.
Reed presents "preliminary note" on transmission of yellow
fever.
Yellow Fever experiments continued at Camp Lazear.
Reed presents findings on transmission of yellow fever before
Pan-American Medical Congress in Havana.
Walter Reed died; Lt. James Carroll designated Curator.
Carroll died; Capt. Frederick Fuller Russell named Curator.
First volunteers of Museum staff vaccinated against typhoid
by Major Russell.
Army Medical School moved out of Museum's "red-brick"
building.
Vaccination for typhoid made compulsory in Army.
Maj. Eugene Randolph Whitmore succeeded Russell as
Curator.
398
ARMED FORCES INSTITUTE OF PATHOLOGY
1915
4 August:
1916
23 June:
1917
December:
1918
21 March:
20 July:
1919
15 January:
11 July:
1 September:
1921
17-21 October:
7922
1 May:
July:
1924
1929
12 February:
1930
Col. Champe Carter McCulloch, Jr., in dual post of Librarian
and Curator, succeeded Whitmore.
Col. William Otway Owen succeeded McCulloch as Curator.
Public Buildings Commission recommends new building on
Mall for Museum and Library.
Surgeon General ordered forwarding of mosquitoes to Mu-
seum for identification.
AEF in France requested services of Museum Unit No. 1.
Col. Charles Franklin Craig succeeded Owen as Curator.
Congress makes appropriation for purchase of land for new
building.
Maj. George Russell Callender succeeded Craig as Curator.
First registry established.
International Association of Medical Museums relocated its
central bureau from Montreal, Canada, to Army Medical
Museum.
Museum became depository of Society of American Bacteri-
ologists.
Maj. James Francis Coupal succeeded Callender as Curator.
Major Callender returned to serve as Curator; succeeded
Coupal.
Coupal appointed White House Physician by President
Coolidge.
Maj. James Earle Ash succeeded Callender as Curator.
Surgeon General's Circular Letter No. 2 defined Museum's
four functions pertaining to tissue pathology.
American Registry of Pathology established.
APPENDIX A
1931
'933
399
'935
19 July:
1937
9 February:
i 93 8
15 June:
1940
4 January:
13 June:
1941
11 August:
24 September:
11 December:
'943
November :
Maj. Paul Edgar McNabb succeeded Ash as Curator.
Maj. Virgil Heath Cornell succeeded McNabb as Curator.
Registry of Dental and Oral Pathology established; reacti-
vated the arrangement of 1895 between the American Dental
Association and Museum.
Maj. Raymond O. Dart succeeded Cornell as Curator.
Registry of Otolaryngic Pathology established.
Major Dart's special report to Surgeon General on the state
of the Museum.
Capt. Hugh Richmond Gilmore, Jr., succeeded Dart as Act-
ing Curator.
Lt. Col. James E. Ash returned for a second tour of duty as
Curator ; succeeded Gilmore.
Important contributions to Museum of models, pictures,
specimens, and instruments.
New building for Museum authorized by Congress.
President Franklin D. Roosevelt earmarks funds for new
building in his budget.
Appropriation of $130,000 for preliminaries of construction
approved by Congress.
Consulting Board approved new building plans.
President Roosevelt signed H.R. 5146; authorized expendi-
ture increased from $3,750,000 to $4,750,000.
Surgeon General's Circular Letter No. 121 decentralized
pathological facilities and activities of the Army; 18 histo-
pathological centers established.
Surgeon General informally authorized designation, "Army
Institute of Pathology."
26-31 December: Widespread distribution of pathological material on tropical
diseases.
400
ARMED FORCES INSTITUTE OF PATHOLOGY
1944
1 January:
W5
24 January:
24 September:
1 December:
1946
7 June:
12 June:
8 July:
December:
1947
3 March:
13 April:
7 May:
1948
5 January:
12 June:
13 October:
19 November
Curator issued Office Order No. 18; functions and responsi-
bilities assigned. New name of "Army Institute of Pathol-
ogy" appeared as a subordinate division of Army Medical
Museum.
Office Order 20, SGO, sets up new board to plan new library
and museum building.
Scientific value of pathological "followup" of Veterans' Ad-
ministration patients recognized.
Report of Committee on Pathology of National Research
Council.
Army Regulations 40-410 officially designated the Institute as
the Army Institute of Pathology.
Scientific Advisory Board established.
Veterans' Administration requested Army Institute of Pathol-
ogy assistance.
Army Institute of Pathology became central laboratory of
pathology for Veterans' Administration.
Col. (later Brig. Gen.) Raymond Osborne Dart succeeded
Ash as Director.
Scientific Advisory Board of Army Institute of Pathology held
its first meeting.
Second meeting of Scientific Advisory Board; important
changes recommended.
Museum opened to the public in its new location at "Chase
Hall."
Hawley Board submitted report to Secretary of Defense.
President Truman approved Public Law 626, 80th Congress,
2d session ; authorized spending of $600,000 for plans.
Architects and engineers for new building named.
Comptroller General ruled Public Law 626 applied to Forest
Glen only.
APPENDIX A
401
1949
21 February:
1 June:
6 July:
1950
15 February:
29 April:
May:
31 July:
1951
6 January:
10 July:
1953
14 January:
9 March:
20 October:
'954
September :
^955
20 January:
13 February-
March:
26-27 May:
June:
Secretary of Defense Forrestal approved major recommenda-
tions of Hawley report.
Preliminary plans for new Institute building at Walter Reed
Army Medical Center approved.
General Orders No. 32, Department of the Army, designated
the Institute as the Armed Forces Institute of Pathology,
effective 1 July.
Army Regulations 40-410; Bureau of Medicine Circular
Letter 50-8; and Air Force Regulation 160-38 jointly desig-
nated "AFIP" as the Armed Forces Institute of Pathology,
"TriService."
President Truman signed H.R. 6539 to become Public Law
495, 81st Congress, 2d session.
"Bomb-resistant" structure required by "National Security
Resources Board specifications."
Col. Elbert DeCoursey succeeded General Dart as the Di-
rector, AFIP.
President Truman signed H.R. 9893 (authorization) and
H.R. 9920 (appropriation) to become Public Law 910 and
Public Law 911, 81st Congress, 2d session.
Ground-breaking ceremonies for new Institute building.
Cooney Committee appointed to study AFIP.
Report by Cooney Committee.
Cornerstone-laying ceremonies.
International visitors inspected building.
First meeting in new auditorium.
Move to new building, "Sixth Home," completed in 1 month.
Dedication ceremonies.
Contract for television installation.
402
ARMED FORCES INSTITUTE OF PATHOLOGY
'955
i July:
i August:
14 November:
i 95 8
2 December:
'959
13 April:
1 August:
7962
Dr. Ernest W. Goodpasture, first Scientific Director, ap-
pointed.
Capt. William Merrill Silliphant, MC, USN, succeeded Gen-
eral DeCoursey as the Director.
Joint Committee on Aviation Pathology established with
headquarters at AFIP.
World Health Organization-International Reference Center
for Soft Tissue Tumors established at AFIP.
Dr. Robert E. Stowell, second Scientific Director, appointed.
Col. Frank Marion Townsend, USAF, MC, succeeded Cap-
tain Silliphant as the Director.
Extramural research support exceeds $1 million.
APPENDIX B
Board of Governors,
Armed Forces Institute of Pathology
Surgeons General, U.S. Army :
Maj. Gen. Raymond W. Bliss, 1947-1951
Maj. Gen. George E. Armstrong, 1951-1955
Maj. Gen. Silas B. Hays, 1955-1959
Lt. Gen. Leonard D. Heaton, 1959-
Surgeons General, U.S. Navy :
Rear Adm. Clifford A. Swanson, 1946-1951
Rear Adm. Lamont Pugh, 1951-1955
Rear Adm. Bartholomew W. Hogan, 1955-1961
Rear Adm. Edward C. Kenney, 1961-
Surgeons General, U.S. Air Force:
Maj. Gen. Dan C. Ogle, 1954-1958
Maj. Gen. Malcolm C. Grow, 1949 (July-November)
Maj. Gen. Harry G. Armstrong, 1949-1954
Maj. Gen. Oliver K. Niess, 195&-
713-028" — 64 28
APPENDIX C
Scientific Advisory Board Members,
Armed Forces Institute of Pathology
Joseph L. Appleton, M.D i94&- 1 949
Theodore S. Beecher, M.D I9 62 "
Ivan L. Bennett, Jr., M.D I9 61 "
K. M. Brinkhous, M.D i957~
Austin M. Brues, M.D i947- J 957
Charles H. Burnett, M.D i95 2 " I 956
Brig. Gen. G. R. Callender i949~
Keith R. Cannon, Sc. D 1953"
Gustave J. Dammin, M.D 1961-
Edward W. Dempsey, Ph.D 1955"
John F. Enders, Ph. D i955" I 96o
William H. Feldman, D.V.M 194^-
Harry Goldblatt, M.D 194^195°
A. McGehee Harvey, M.D 1956-1961
Howard T. Karsner, M.D I94 6 "
Richard A. Kern, M.D I 9 62 ~
James W. Kernohan, M.D J 947"
John G. Kidd, M.D I 9 6l ~
Cyril N. H. Long, M.D i947~ I 956
Balduin Lucke, M.D.* I946-J954
James B. McNaught, M.D* i955- x 959
Karl F. Meyer, M.D l^ 1 ^
Carl V. Moore, M.D I 9 62 "
Robert A. Moore, M.D I 94 6 "
Alan R. Moritz, M.D x 955"
John J. Morton, M.D J 95 2 -
Ralph S. Muckenfuss, M.D I 9 6l_
*Deceased
406 ARMED FORCES INSTITUTE OF PATHOLOGY
C. Barber Mueller, M.D 1962-
J. Lowell Orbison, M.D I957 -
Eugene Pendergrass, M.D 1955-1960
Maurice C. Pincoffs, M.D.* 1946-1950
Isidore S. Ravdin, M.D 1946-1950
Arnold R. Rich, M.D 1946-1957
Edward B. Smith, M.D 1957-1961
Robert E. Stowell, M.D 1957-1959
Henry A. Swanson, D.D.S I949 -
Jerome T. Syverton, M.D.* 1960-1961
Cornelius A. Tobias, Ph. D 1960-
Shields Warren, M.D 1946-
William B. Wartman, M.D 1962-
Lewis Weed, M.D.* 1946-1949
Carl V. Weller, M.D.* 1951-1956
Milton C. Winternitz, M.D.* 1950-1953
Robert W. Wissler, M.D 1962-
S. Burt Wolbach, M.D.* 1946-1953
David A. Wood, M.D 1956-1961
*Deceased
INDEX
Abbott, M. E., 153, 202, 207
"Able," 372
A-Bomb Unit. See Atomic Bomb Research Unit;
Radiation Injury Branch.
Ackerman, L., 322
Act of 1849, 53
Act of 1850, 53
Activities, scope of Institute, 6, 390—391
Adami, Lt. Col. J. C, 179
Administrative Office, AF1P, 377
Administrative Service, AIP, 250, 315
Advisory Council on Medical Training Aids, objec-
tive of, 358
AEF. See American Expeditionary Forces.
Aerospace pathology, 371—372
Aerospace Pathology Branch, Military Environ-
mental Pathology Division, 371, 384
"AFIP Letter," 375
Agramonte, A., 112, 114, 115, 118, 127, 128
Air Force Regulation(s):
No. 160-38, 15 Feb. 1950-316
No. 160-55, 8 June 1950 — 316
Alden, Col. C. H., 93, 95
Alfred P. Sloan Foundation, 348
Allen, E. C, 179, 184, 185
A. ludlowi, 1 75
Ambrogi, L. W., 214, 378
American Academy of Dermatology and Syphilol-
ogy, 221
American Academy of Ophthalmology and Oto-
laryngology, 197, 198, 199, 207, 221, 224
American Academy of Pediatrics, 222
American Association for Thoracic Surgery, 221
American Association of Neuropathologists, 221
American Association of Pathologists and Bacteri-
ologists, 207, 255
American Cancer Society, 320, 348
American College of Radiology, 222
American College of Surgeons, 198, 324
American Dental Association, 103, 196, 220
American Dennatological Association, 221
American Expeditionary Forces, 160
autopsy service in the, 180—183
medical photography in the, 183-185
American Foundation for Tropical Medicine, 254
American Castroenterological Society, 222
American Heart Association, 222
American Institute of Nutrition, 222
American Journal of Clinical Pathology, tribute in,
322,393
American Journal of Orthodontics and Oral Surgery,
251
American Journal oj Pathology, 251
American Medical Association, 66, 77, 239
Ophthalmic Section of, 199
support of Museum and Library from, 76, 77
American Ophthalmological Society, 1 99
American Psychiatric Association, 221
American Public Health Association, 122
American Red Cross, 9
American Registry of Pathology, 2-5, 197-2°'. *«>
212, 220, 221, 259, 266, 267, 292, 315. 32".
322, 324-325, 326, 356-357, 37°, 373, 387
advantages of, 224-225
as sales agent for "Atlas of Tumor Pathology,"
357
establishment of, 209
functions of, 324, 357
growth of, 324, 356
objective of, 209-2 1 1
publications of, 222-224
relationship of Pathology Department to, 356
responsibilities of, 324, 3 2 "
See also specific registries by name; Registry
(ies).
American Roentgen Ray Society, 222
American Society of Clinical Pathologists. 221, 223,
255
American Urological Association, 207, 221, 222
American Veterinary Medical Association, 222
Anatomical Art Department, Instruction Laboratory,
176, 160
Anatomical Art Service, Instruction Laboratory, 17.
Ancestry of Institute. 1-6
Andrews, W. G., 287
Andrus, J. A., 1 24
Aniline dves, use of, 5, 34~3 6 .
Animal Care and Surgery Branch, Ve.er,nar>
Pathology Division, 385
Animal experimentation, 103-105
See also Experimental surgery on animals.
Animated drawings, 176
Anna Fuller Fund, 320
Anopheles mosquito as malaria vector, 1 17
Appropriations for building, 74~75, 77"7
Archives oj Pathology, 25"
4"7
408
INDEX
AR 40-410, War Department, 18 Jan. 1922 — 266
AR 40-410, 3 Aug. 1942 — 245, 266, 341
AR 40-410, 15 Feb. 1950 — 316
Armed Forces Medical Policy Council, Department
of Defense, 315
Armed Services Committee, 289
See also Committee(s) on the Armed Services.
Armstrong, Maj. Gen. G. E., 292, 293-294, 299,
300.315
Armstrong, Maj. Gen. H. G, 299
Army Chief of Finance, 324
Army General Staff, Logistical Division of, 324
Army Institute of Pathology, 250, 251
Army Medical Center. See Walter Reed Army
Medical Center.
Army Medical Department Research and Graduate
School, 95
Army Medical Illustration Service, 259-264, 266-
267, 271
Army Medical Library, 154, 270, 271, 272, 273
Army Medical Museum, 5, 9, II, 18, 20, 29, 35,
49. 51. 73, 74, 78, 82, 83, 84, 85, 86-88, 93,
95. 98, 99, 100, 267, 300, 315, 373, 383, 387
ancestry of, 1-6
between the wars, 227-243
changes at the, 148-152
changes in organization and personnel of, 79, 154,
250-251,331
changes in responsibilities of, 155
changes in role of, 271-272
classification system at, 153
combining Smithsonian with the, proposal of,
203
government organizations affected by, 203
Congress and the, 63-65, 76
Cornell laboratory of, 219
during and after World War I — 159-187, 191,
205
during and after World War II — 245, 330
effects of the Armistice, 11 Nov. 1918, on, 185,
.87
efforts to get a new building for, 270-271
effect of Korean war on, 293
enlarging the aims of, 65-66
first catalog of, 20-22
General Service Division of, 331
growth in personnel of, 245, 249-250, 331
increasing activities of, 53-54, 246, 265
Information Section of, 331
Kaiserling process used at, 152
major aim of, 186-187
Medical ami Microscopic Sections of, 32, 34
medical profession and the, 63
Army Medical Museum — Continued
Pathology, Anatomy, and Embryology Division of,
33i
plans for "old red brick" home of, 387—389
problems in location of, 272—277
rebirth of, 330—332
Surgical and Photographic Sections of, 32
varied uses of, 66, 201—203
Army Medical Research and Development Board
276
Army Medical Research and Graduate Teaching
Center, proposed, 273, 276
Army Medical Research Board, 273
Army Medical School, 60, 139, 194, 238, 256
authority for, 92
faculty members of, 93—95
first annual session of, 93-95
Museum and the, 90-93
plans for, 28
proposals for, 90—93
space problems of, 95—98, 147-148
Army Regulations. See AR and specific number.
Arthur, President C. A., 75, 78, 79
Arthur, Col. W. H., 147
Ash, Col. J. E., 213, 214, 216, 224, 225, 235, 242,
245, 246, 247, 249, 250, 253 254, 255, 258, 261,
266, 267, 270, 271, 273, 275, 276, 277, 297, 299,
322
Ashburn, Col. P. M., 106, 138
Ash Library, 374
Asqltth, H. H., 186
"Atlas of Angiocardiography," 223
"Atlas of Tumor Pathology," 6, 223, 319, 320-323,
369,387
role of Medical Illustration Service in producing,
323. 360
"Atlas of X-Ray Myelography," 223
Atomic Bomb Casualty Commission laboratories,
318.355
Atomic Bomb Research Unit:
establishment of, 318
mission of, 318
See also Radiation Injury Branch.
Atomic Energy Commission, 6, 319
Auld, Lt. Col. D., 372
Autopsy procedures, directives on, 180
Autopsy question, 162-163
Autopsy service in the AEF, 180-183
Baccarat, pathologic service center in, 182
Bache, Col. D., 105, 106, 139
Bacillus icteroides, discovery of, 1 1 1
See also Sanarelli, G.
INDEX
409
Bacillus typhosus, 133
Background and beginning, AFIP, 7-49
Bacteriology and the Museum, 100
Bahr, G. F., 382
Ball, J. M., 199
Ball collection, the, 199
Ballenger, Capt. M., 384
Baretta studios, Paris, collection of wax models
from, 179
Barnes, Surg. Gen. J. K., 25, 26, 27, 28, 29, 30, 45,
51, 55.59.64,73, 75.77
Bartholow, R., 28
Basic Laboratories Division, 337
Bastianelli, 117
Baxter, Surg. Gen. J. H., 113
Bayne-Jones, Brig. Gen. S., 392
Bell, A. G., 68
Bell, W., 84
Berencer-Feraud, Dr., 62
Berge, Col. T. C., 386
Bernier, Col. J. L., 267, 384
Bettmann, H. W., 100
BlGNANI, 117
Billings, Col. J. S., 64, 65, 79-81, 81, 82, 84,
85, 86, 87, 88, 93, 97, 98, 99, 100, 101, 103,
154, 196, 304
Billings Silver Medal, 327
BlNFORD, C. H., 385, 386
Bioastronautics, role of the Institute in, 372
Biochemistry Branch, Division of Basic Sciences, 383
Biophysics Branch, Division of Basic Sciences, 383
Birmingham, Brig. Gen. H. P., 174, 175
Bispham, Col. W. N., 174
Bitterman, Maj. T., 214, 230
Bladder Tumors Registry, 207
Bliss, D. W„ 28
Bliss, Maj. Gen. R. W., 277, 278, 288, 293
Bloodgood, J. d 198
Blum berg, C. W., 321
Blumberg, Col. J. M., 340, 357, 373
Board of Governors, AFIP, 2, 297, 374
Body armor studies, 333
Boer War, typhoid in the, 141
Bohannon, Maj. Gen. R. L., 374
Bolton, F. P., 290
Bomb-resistant structure, reasons for, 292-293
Bone Sarcoma Registry, 198
Bontecou, Surg. R. B., 20
Boone, Vice Adm. J. T., 285, 299
Booth, J. W., 41, 47
Borden, Lt. Col. W. C, 297
Bower, Lt. M. L., 171, 177
Bowman, Pvt. R. E., 141
Bradley, Brig. Gen. A. E., 180, 182
Bradley, Gen. O. N.. 166
Bragdon, Brig. Gen. J. S„ 274
Bright & Humphrey, 81
Brinton, Mai. ]■ H., I, 13. M. '5. '7. >9. 2". 11,
23, 25, 26, 27, 28, 29, 32, 34, 56, 89, 90, 234
Brinton, W., 234
British and Colonial Forces, 179
Broadway, Maj. C. B., 346, 377, 387
Brodel. M., 177
Brody, Capt. S. I., 370
Brown, Rear Adm. C. J., 297
Bryan, W. J., 138
Bryant, 1st Lt. |. L., Jr., 375
Budd, W., 146
Budget and Management Office, 375
Budget Bureau. See Bureau of the Budget.
Buell,7
Bulletin No. 6, War Office of the Surgeon General,
August 1914 — 191
Bureau of Indian Affairs, 358
Bureau of Refugees, Frecilmcn. and Abandoned
Lands (Freedmen's Bureau 1. 60
Bureau of the Budget, 279, 289, 291, 292
Hospital Branch of, 297, 299
Hospital Division of. 289
Cabell, Capt. J. M., 93
Callender, Brig. Gen. G. R.. 5- '5 r ». «9«i '97. "99.
201, 202, 203, 204, 205, 207, 2("/. 210, 211. 21).
214, 2l8, 222, 224, 225, 242, 255, 296, 299,
304-306, 333
Campbell, H., 200
See also Wilder, H.; Foerster. H.
Campbell, H. F., 63, 76
Camps. See Military installations.
Capitol Hill, as site for Museum building. 27 1
Cardiovascular Pathology Branch, Department of
Pathology, 382
Cardiovascular Pathology Rcgistn. 222
Carey, M., 108
Carpenter, Lt. Cdr. M. S.. yji
Carroll, Maj. J., Ill, i«, l«3> "5. "''■ 120 ' «*»•
127, 129, 130, 134, i}9. ML M 6 . '5J. 154- US
Carter, Surg. H. R.. 1 1 7
Carter, J., 218,329,330
Casberg, M. A., 304, 306, 3 1 5
Catalog of Museum specimens, 23, 29' 59
Cataloging system, 166
See also Classification and cataloging of Museum
specimens.
Catalogue of the Microscopical Section of the
Museum, 36
410
INDEX
Cattell, Capt. H. W., 161
Chambers, Capt. B. P., 386
Charleston, yellow fever epidemic in, 108
Chase Hall, 263, 280, 281, 366, 367, 368
Chest Tumors Registry, 221
"Chickamauga fever," 135
Chickamauga National Park, 134
Chief of Engineers, 279
Cholera epidemic(s) —
in India, 133
in Spain, 133
( Ikkmm in. Rear Adm. A. S., 374
Circular —
No. 1, Surgeon General's Office, 25 Apr. 1898 —
137
No. 2, Surgeon General's Office, 21 May 1862 —
I. n-13
No. 2, Surgeon General's Office, 4 Apr. 1867 —
57
No. 5, Surgeon General's Office, 9 June 1862 — 13
No. 6, Surgeon General's Office, 4 May 1863 — 26
No. 6, Surgeon General's Office, 26 June 1865 — 51
No. 6, Surgeon General's Office, 1 Nov. 1865 — 16
No. 10, Surgeon General's Office, 20 Oct. 1898 —
106
No. 17, AEF, 2 Apr. 191 8 — 180
No. 42, Office of the Chief Surgeon, AEF, 27 July
1918—182,183,187
No. 58, Office of the Chief Surgeon, AEF, 2 Dec.
[918—187
Circular letter —
Curator, Army Medical Museum, 25 May 1905 —
'55
No. 2. Surgeon General's Office, 12 Feb. 1929 —
214-216
No. 50-8, BUMED, 15 Feb. 1950—316
No. 50-50, BUMED, 8 June 1950 — 316
No. lit. Surgeon General's Office, 11 Dec. 1941 —
246
N'n. 127. Surgeon General's Office, 1943 — 255
No. 141, Surgeon General's Office, 29 July 1943 —
246
Surgeon General's Office, 24 June 1864 — 29
Surgeon General's Office, 30 Sept. 191 8 — 163
\VI>. A.G.O., I2junci9i8— 162
Circular Orders No. 3, Surgeon General's Office,
20 Aug. 1877 — 67
Civil Aeronautics Board, 6
Civil War, the, 90, 95, 106
hospital records of, 73
medical illustration in. 170
medical records of, 2, 78
specimens from. 2. 90
Clark, M. L., 319
Classification and cataloging of Museum specimens,
'53-154
Abbott's modified system of, 207
after World War I, 216
Army Medical Museum system of, 153, 154
D. S. Lamb's role in, 154
McGill University system of, 153, 154
Wyatt-Johnson system of, 207
See also Cataloging system.
Clemenceau, Premier G. E. B., 186
Cleveland, President G., 90
Clifford, Pvt. M., 141
Cluss, A., 81
Coburn, Hon. J.. 59
CODDINGTON, Lt. Col. H. W., 368
Codman Bone Sarcoma Registry, 325
Codman, E. A., 198, 325
Cole, Chairman, 64
Collection of specimens, 17—22
Collections, Museum :
growth of, 1,29-30,51, 157
source of, 17, 18, 29, 57-60, 63, 90, 236
storage of, 264-265
College of American Pathologists, 222
Collins, R., 242
Color photography, Rceve-Cartcr process of, 218
Columbia Barracks, 122
Columbian University. See George Washington
University.
Commission on Training Camp Activities. 171
Committee(s) on —
Appropriations of the Senate and House of Repre-
sentatives, 241
Medical and Hospital Services of the Armed
Forces. See Hawley Board.
Military Affairs of the Senate and House, 239
Pathology of Division of Medical Sciences, Na-
tional Research Council, 269, 270, 319
the Armed Services, 287, 290, 291
See also Armed Services Committee.
Congressional hearings, 289—292
Congressional Record, 203
Conrov, J. Q., 330
Cooke, R. P., 124, 126
Coolidce, President C, 207
Coolidge, Surg. R. H., 28
Cooney, Brig. Gen. J. P., 315, 316
Cooney Committee, 315-318
establishment of, 315
purpose of, 315
Cooper, Lt. Col. N., 377
Corcoran Gallery of Art, 24
INDEX
4 II
Corcoran, W. W., 23, 25
Cornell, Col. V. H., 213, 218, 220, 227, 228, 297,
299
Cornell Laboratory, 219
Cornell Museum, 366, 368
Cornerstone-laying ceremony, AFIP, 302-307
Corps of Engineers, Washington District Office of,
295
Cosmos Club, 66
Council, Col. F. E., 339, 340
Council of the International Association of Medical
Museums, 255
Councilman, W. T., 143
Coupal, Maj. J. F., 207, 214, 218
Courier Cablegram No. 7, CG, AEF, 20 July 1918 —
183
Courses in pathology for medical officers, 189
Cowan, Cdr. J. S., 333
Craig, Col. C. F., 135, 187, 189, 190, 191, 193
Cramer and Vollmerhausen, 302
Crane, C. H., 32, 57, 77
Creer, Capt. R. H., 250
Cross, Group Captain R. M., 386
Crowell, B. C, 209
Curtis, Maj. E., 36, 39, 41, 44, 53, 170, 231
Darnell, Maj. C. R., 147
Dart, Brig. Gen. R. O., 228, 230, 231, 277, 282,
283, 285, 288, 289, 290, 293, 294, 295, 297,
299. 300, 334
Davidson, Capt. W. H., 384
Davis, Maj. G. B., 94
Dean, Pvt. W. H., 120, 121
DeCoursey, Maj. Gen. E., 207, 293, 294, 295, 296,
297. 3°7> 315. 3J9. 3 2 5> 334. 337. 339
Dedication ceremony, AFIP, 4, 307-310
Delano Hall, 380
Dental and Oral Pathology Division, role of, 384-
385
Dental and Oral Pathology Registry, 220, 221, 267
Department of Clinical and Sanitary Microscopy, 95
Department of Defense, 2, 289
Armed Forces Medical Policy Council of, 315
Department of Histology, 231
Department of Pathology, 3, 266, 315, 337, 346,
348,356,373,377,382,387
postgraduate cources offered by, 391
Department of Photography, 230
Department of the Air Force, 2
Department of the Army, 2
Department of the Navy, 2
Dermal and Gastrointestinal Pathology Branches,
Department of Pathology. 382
Dermal Pathology Registry, 221
Deterioration at the Museum, 227-230
DeWitt, Col. C, 139
Diagnosis and consultation services, 3, 4, 258-259
on Hiroshima and Nagasaki cases, 355
Diamandopoulos, G. T., 382
Dijon, Museum Unit at, 184, 185
Dillon, F., 387
District Engineer, 302
District Engineer Commissioner, 279
Division of Basic Sciences, 382
Division of Laboratories, AEF, 179, 182. i«4
Division of Medical Sciences, Committee on Path-
ology of, 269
Division of Medical Sciences, National Research
Council, 269
Division of Pathology, 271
Doan, Brig. Gen. H. W., 374
DoMANSKI, Col. T. J., 384
Dominik, Col. J. F., 297
DONNALLY, W., 1 03
Dorrance, G. M., 236
Drayton, E., 331
Dunn, Pvt. G, 141
Dynamic Pathology Division, 337
Ear, Nose, and Throat Pathology Branch, Depart-
ment of Pathology, 382
Earle, K. M., 382
Eaton, Capt. A. W., 334
Ebersole, Lt. Cdr. I. H.
Edgar Bequest, 234, 235
Edgar, W. F., 234
Editorial Office, 376
Edmonds, H. W., 331, 33 2
Education Office, 377
Education program of the Institute, 35'~3 I 5' 1
extramural activities of, 35 2
intramural activities of, 354
media of, 352
participation by foreign nationals in. 354
use of study sets in, 354
Edwards. L. A.. 60
Egger, Maj. F. C. 330
Eggers and Higgins, 242, 273
sTcongre'r See Public Uw(,); ^
VII! Corps area, hiswpatbologj
centers lor. 2'"
8,'sicongress77« Public Uw(l)i Legist'""
Kisimaw. Pvt. R. A.. 14 1
ElSENHOWEX, President !>• I>- 4- V'7- <"'
Ellis. D. C, 329, 330
I11 iv I.t. R. ().. 171
412
INDEX
Elysee Palace Hotel, 185
Emergency War Surgery, NATO Handbook, 1958 —
359
Endocrine and Soft Tissue Pathology Branch, Gen-
eral and Special Pathology Division, 382
Endocrine Pathology Registry, 222
England, T. M., 124, 126
Epps, Pvt. W. J.. 141
Erichsen, J. E., 65
"Etiology of Yellow Fever; a Preliminary Note,"
122, 126
Evans, Lt. T. L. W., 171
Eve, P. F., 63
Ewing, J., 160, 161, 163, 164, 165, 209
mission of, 161-162
Exhibits, Medical Department, 326, 327
awartl-vvinning, 327, 358
number of, 326, 358
responsibility for preparation of, 326
Experimental pathology, 350
Experimental surgery on animals, 350
See also Vivisection.
Expert Committee on Cancer, 369
Faber, H., 44, 45, 170
Facilities and services of the Institute, expansion of,
346-35>
Farragut, 7
Fascicles, the. See "Atlas of Tumor Pathology."
Faulkner. Kingsbury, and Stenhouse, 279, 288
Faust, E. C, 327
Federal Aviation Agency, 6
Female Reproductive System Registry, 221
"Fighting the Cootie," 175
Finck, M.11. P. A., 384
Fine Arts Commission, 167
Fini ay, C. J., 109, no, 118, 120, 127, 128, 129
Finlay's mosquito theory, no. n 8-1 19
Finley, C. A., 9
I Corps area, histopathology center for, 216
First World War. See World War I.
"Fit to Fight." 1 71 -1 74
reactions of groups to, 174
Fletcher, R. J.. <>?
Fletcher, Sir W. M., 179
Flexner, S., 143
Flint. A., 76
Fly. the. as a possible carrier of —
camp diarrheas. 137
typhoid. 1 (7
yellow fever, 137
Foch, Marshal F., 185
Foerster, H., 201
See also Campbell, H.; Wilder, H.
Foerster, R., 200
Folk, Pvt. L. E., 124, 126
Follis, R. H., Jr., 386
Fomites theory, 125-127
Forbes, W. W., 124
Ford's Theater, 54
Ford's Theater building, 56, 65, 73
Forensic Pathology Branch, Military Environmental
Pathology Division, 383
Forensic Pathology Registry, 222
Forest Glen, Md., as site for Museum, 273, 274, 275,
287, 288
Forrestal, J. V., 283, 284
Forts. See Military installations.
48th Congress, 76, 77
47th Congress, 75
Forwood, Brig. Gen. W. H., 93, 139
Franconia, Va., warehouse, 335, 344, 346, 380
Frank, I., 197
Freedmen's Hospitals, 60
French High Commissioner for Franco-American
affairs, 185
French, Maj. R. W., 214, 333
French, Lt. W. H., 1 84
Friedenwald, J. S., 199
Frosch, P., 130
Fuller, Capt. R. H., 342, 374
Funding, extramural monetary support in, 386, 392
Gareield, President J. A., 64, 68, 81
assassination of, 68—69
autopsy on, 68
Garfield tragedy, role of Museum in the, 68-71
Gastrointestinal Tract Registry, 221—222
Gazette des hopitaux civils et militaires, 62
General and Special Pathology Division, Department
of Pathology, 382
General Orders —
No. 5, War Department, 8 May 1933 — 2^4
No. 6, 21 Dec. 1900 — 128
No. 10, War Department, 1909 — 143
No. 32, Department of the Army, 6 July 1949 —
285
No. 51, A.G.O., 24 June 1893 — 92
No. 78, General Headquarters, AEF, 25 May
1918-183
No. 194, Adjutant General's Office, 18 Aug.
1898—133
General Services Administration, 335
responsibility of, 388
INDEX
413
General Staff, AEF, 182,184
General Veterinary Pathology Branch, Veterinary
Pathology Division, 385
Genitourinary Pathology Branch, General and Spe-
cial Pathology Division, 382
Genitourinary Pathology Registry, 222, 357
Geographic Pathology Branch, Geographic Pathology
Division, 386
Geographic Pathology Division, Department of
Pathology :
organization of, 385
role of, 385, 386
Geographic Pathology Registry, 222, 387
George, Prime Minister, D. L., 186
George Washington University School of Medicine,
60
Gerontological Society, 222
Gerontology Registry, 222
Gibbs, L. A., 376
Gibson, W., 60
Gilchrist, Lt. H. L., 141
Gilmore, Col. H. R., Jr., 231, 297, 332, 366, 367
Girard, Capt. A. C., 67
Glenn, Col. J. H., Jr., 372, 390
Godey's magazine, 82
Goldberg, M., 330, 387
Goldsmith, Surg. M., 19
Goodpasture, E. W., 337, 338, 339, 344, 348
Gorgas, Surg. Gen. W. C, 121, 129, 159, 187, 190
Government Hospital for the Insane (St. Elizabeths),
178, 189
Gradle, H. S., 197, 209
Grady, H. G., 322, 357
Grant, Lt. Gen. U. S., 7, 13, 56
Grant, Maj. Gen. U. S. Ill— 273
Graphic arts and medicine, 170-171
Grassi, 117
Gray, W. M-, 101, 134, 170, 231
Grissom, Capt. V. I., 372
Gross, S. D., 76
Ground-breaking ceremonies, AFIP, 295-302
Guiteau, C. J., 68
autopsy on, 71
Gunn, E. M., 328, 330
Gunshot injuries, collection of, 20, 25
Haggerty, R., 374
Haig, Field Marshall D„ 186
Hall, Cdr. H. E., 375
Hall, Lt. Col. J. R., 242
Halsman, J., 330, 387
Hamlin, A. C, 28
Hammond, Surg. Gen. W. A., 1, 9, 10, 13, 20, 26,
27.90.95.196,300
exile of, 30-32
Hanberry, J. F., 124, 126
Hansen, Capt. L. S., 384
Harders, W., 330
Hartshorne, E., 19
Harvard Medical School, specimens from, 236
Harvey, Wing Commander B., 370
Havana:
Slegomyia fascitita in, 129
yellow fever epidemic in, 112
yellow fever in, 129
Havard, Col. V., 139, 147
Hawley, Senator J. R., 77
Hawley, Mai. Gen. P. R., 283
Hawley Board, 283-285
Hawley Committee, subcommittee, the, 283, 284
Hayes, President R. B., 74
Haymaker, W., 372, 382
Hays, Maj. Gen. S. B., 315, i'7
Healy, D. J., 153, 154
Heaton, Lt. Gen. L. D., 4. 3°3> 334. 374
Heizmann, Col. C. L., 139
Hektoen, L., 209
Helwig, E.B., 348, 377. 382
Hematologic Pathology Branch, Department of
Pathology, 382
Henry, J., 59
Hepatic and Pediatric Pathology Branches, Depart-
ment of Pathology, 382
Hepatic Pathology Registry, 222
Hepatitis, 252-253
Herold, D. E., 47
Herrick, Maj. C. J., 160, 164
Hewitt, Surg. H. S„ 13. 1 9
Hildebrand, J., 124, 126
Hiroshima, follow-up studies of irradiated victims.
in, 318
Histochemistry Branch, Division of Bas!C Sc.ences,
382
Histological reference set of fibrous tissue tumors.
370
Histopathologkal study sets, 324
Histopathology and the Museum, 214-216
Histopathologycenter(s), 256, 311
at Service Commands. 247. 256
establishment of, 31 1
for I Corps area, 216
for VI Corps area, 216
for VIII Corps area. 216
for IX Corps area, 216
414
INDEX
Histopathology center (s) — Continued
purposes of, 311
regional, 246-249
selective screening of cases in, 3 1 8
Histopathology Laboratories, 377-378
new techniques developed at, 378
space problems of, 380
"History of American Pathology," 6, 393
Hitchcock, Maj. Gen. E. A., 25
Hodgen, Surg. J. S., 19
Holmes, O. W., 8, 76
Holmes, Lt. Col. R. H., 333
Hoof-and-mouth disease, 130
Hospital Branch, Bureau of the Budget, 299
Hospital Division, Bureau of the Budget, 289
"Hospital Steward's Manual, The," 34
Hospitals, general:
named:
Fitzsimons, 216
Letterman, 216
Walter Reed, 177, 194, 212, 361
William Beaumont, 216
Hospitals, various:
Freed men's 60
Las Animas, 121
Station Hospital, Fort Sam Houston, Tex., 216
House, Col. E. M., 185
House Committee on Public Buildings and Grounds,
75- 77. 78
Howe, Sgt. J. I., 141
H.R. 48, 2 Mar. 1885—77, 78, 79
Il.R. 4122, 9 July 1947 — 287, 288
H.R. 5146 — 242
H.R. 6478—289, 290
I I.R. 6539 — 290
H.R. 7681, 28 Feb. 1883— 75
H.R. 9893, 1 1 Dec. 1950 — 293
H.R. 9920, 11 Dec. 1950 — 293
Hrdlicka, A., 156
I Iuebner, Maj. (Jen. C. R., 262
Hunter, J., 85
I luntington collection, 236
Huntington, Col. D. L., 68, 89, 103, 154
Huntington, G. S., 236
Illustration service. See Medical Illustration Serv-
ice.
Immunobiology Branch, Division of Basic Sciences,
382.383
Immunology and Bacteriology Branch, Geographic
Pathology Division, 386
"Index-Catalogue," 81
Infectious Diseases Branch, Geographic Pathology
Division, 385
Influenza epidcmic(s) —
at Camp Wheeler, 1918 — 165
in Dallas, Tex., 191 8 — 174
inFrance, October 1918 — 180, 186
Institute of Pathology:
Administrative Service of, 333
auxiliary departments of, 331, 332
Department of Pathology of, 346, 348
organization and staffing of, 337
Editorial Branch of, 332
Pathology Division of, reorganization of, 337
primary purposes of, 332, 344
research programs at, 332—334
Instruction Laboratory, Army Medical Museum,
170, 174, 175
anatomical art service of, 171
motion-pictures section of, 171
still photography section of, 171
wax modeling section of, 171
Interdepartmental Committee. See Advisor)' Coun-
cil on Medical Training Aids.
International Academy of Pathology, 222
International Association of Medical Museums,
American anil Canadian Sections of, 202
International efforts, 369—371
International List of Causes of Death, 208
International Ophthalmology Clinics, 393
International Reference Center for Soft Tissue
Tumors, 369
Ireland, Surg. Gen. M. W., 182, 187, 189, 199,
212
Jackson, C, 236
J. A.M. A. See Journal of the American Medical
Association.
Jane Coffin Childs Memorial Fund for Medical
Research, 320
Jernegan, Pvt. W. G., 124, 1 26
Jex, G., 214
JoBLING, J. W., 202
Joefre, Marshal J. J. C, 185
John and Mary Markle Foundation, 254
Johnson, F. B., 382
Johnson, L. C, 382
Johnston, Lt. Col. E. H., 383
Joint Committee on Aviation Pathology, 370-371,
384
establishment of, 370
mission of, 370, 371
Jones, Col. H. W., 242
INDEX
415
Journal of Hygiene, 131
Journal of the American Medical Association:
endorsement of building legislation by, 239-240
support from, 267
Kaiserling, K., 152
Kaiserling process of preserving specimens, 152, 156
Karsner, H. T., 5, 209, 214, 227, 238, 239, 252,
267, 269,320, 370
Kean, Maj. J. R., 128, 133, 136
Keating, J. M., 108
Keen, W. W., 95
Keith, A., 179
Kenney, Rear Adm. E. C, 373
Kidney Tumors Registry, 221
King Albert of Belgium, 186
Kingsbury, S., 295
Kirk, Surg. Gen. N. T., 266, 267, 269, 273, 274,
276, 277
Kissinger, Pvt. J. R., 124, 125, 128
KlTTENGKR, Capt. J. W., 384
Klinck, G. H., 382
Kluge, H. C, 329
Knaup, Pvt. W. H., 19
Koch, R., 92, 130
Kraner, Capt. K. L., 385
Kretschmer, H. L., 209
Kuhns, Col. D. M., 339
Laboratory Animals Branch, Department of Pa-
thology, 350
LaGarde, Col. L. A., 148
Lalley, J. M., 240
Lamb, D. S., 68, 71, 153, 154, 156-157, 164
Lambert, A., 143
Lantern slides, 178
Lawrence, !■'... 1 1 2
Lawson, T., 9
Lazear, J. W., 112, 113-114, 115, 118-119, 120,
121, 127-128
Lee, Brig. Gen. F., 124, 134
Legislation:
H.R. 48, 2 Mar. 1885—77. 78, 79
H.R. 4122, 9 July 1947 — 287, 288
H.R. 514^ — 242
H.R. 6478—289, 290
H.R. 6539 — 290
H.R. 7681, 28 Feb. 1883—75
H.R. 9893, 11 Dec. 1950 — 293
H.R. 9920, 11 Dec. 1950 — 293
Public Law 495, 81st Congress, 2d scss., 29 Apr.
1950 — 291
Legislation — Continued
Public Law 626, June 1948—287, 288, 289
Public Law 910, 81st Congress, 2d sess., 6 Jan.
1951—293
Public Law 911, 81st Congress, 2d sess., 6 Jan.
1951—293
S. 403, December 1883 — 77
amendment to, 28 May 1884 — 78
S. 2737—289
LeGolvan, Col. P. C, 377
Leidy, J., 22
Leishman, Lt. Col. W. B., 142
Leonard Wood Memorial, 222
Leprosy Branch, Geographic Pathology Division, 386
Leprosy Registry, 222
Letterman, Surg. J., 13
Library of Congress, as site for Museum building,
241
Library of Medicine. See National Library of
Medicine.
Library of the Surgeon General. See Surgeon
General's Library.
Lidell, Surg. J. A., 28
Life masks at Peace Conference, 185, 186
Lincoln, President A., 9, 41, 44. 45. 47. 54. 5°
assassination of, 54, 55
autopsy on, 41-44
Lincoln tragedy, role of Museum in, 41-49
Lincoln, R. T., 75, 77
"Lippincott's Magazine," 54. °°
Lister, J., 67
Loan sets, 3 1 6
Loffler, F. A. J., 130
Logistical Division, Army General Staff, 324
Long, E. R., 5, 6, 393
Love, Col. A. G., 271
Lovell, Maj.F. W., 384
Lucke, Col. B., 250, 252, 253. 267. 2»o, 319. 320.
322
Ludlow, C. S., 175
Lull, Maj. Gen. G.F., 271
Lumley, Pvt. W. E., 14 1
Luna, L. G, 377
Lyman, Representative, 79
Lymphatic Tumors Registry, 207
Lynch, F. X., 319
MacCallum, W. G.. 164
MacDonald, A., 203
Macy, W. E., 330, 387
Macee, Surg. Gen. [. C. 241
Mahone. W., 7 S
416
INDEX
Mail Room, 375
Malaria, control of, in the Army, 189
MAMA's. See Museum and Medical Arts Service.
Maniom, W. C, 382
Manson, Sir P., 117
"Manual of Bacteriology, A," 92
Marine Hospital Service, 117
See also U.S. Public Health Service.
Markoe, T. M., 20
Maurer, Col. F. D., 385
Maxwell, Brig. Gen. E., 299, 315
May, A. J., 242, 243
Mavbaum, Lt. Col. W. F., 375
Mayo, C. H., 159, 160
McCarten, E. V., 214
McCaw.CoI. W. D., 147, 148, 150, 152, 187
McClellan, General, 7
McConnei.l. J. C, 104, 127, 170
McCormick Institute for Infectious Diseases, 201
McCuli.och, Lt .Col. C C, Jr., 1 57
McGill University, Pathological Museum of, 153
McGuire, H., 63
McLaughlin, M. O., 203
McNabb, Maj. P. E., 213, 216, 218
McNabb Autopsy Suite, television facilities in, 363
McNamara, F. A., 297, 299
Mediastinal Pathology Branch, Department of
Pathology, 382
"Medical and Surgical History of the War of the
Rebellion," 5, 13, 29, 41, 67, 68, 73, 89, 90,
17". 369
"Medical Department of the United States Army in
the World War," 213
Medical Department Professional Service Schools, 95
Medical Education for National Defense program,
j8 3
Medical illustration —
in the Civil War, 170
in World War I— 170
Medical Illustration Library, 387
Mk1ic.iI Illustration Service, 3, 263, 292, 315, 322,
523, 326-330, 357-361, 373. 387
activities of, 327, 358
Audiovisual Aids Division of, 329
award-winning exhibits of, 326-327
breadth of contacts of, 358
General Service Division of, 330
graphic training aid prepared by, 359
Illustration Library of, 329
Photography Division of, 329, 360
Photostat Division of, 329—330
primary objective of, 427, 357
Printing Division of. 530
Medical Illustration Service — Continued
reorganization of, 328
responsibilities of, 324, 326
role of, in war against disease, 360
Scientific Illustration Division of, 328—329
Technical Duplication Branch of, 329
Training Aids Division of, 330, 358
Medical Museum. See Army Medical Museum.
Medical News of Philadelphia. 84, 1 1 1
Medical photography in the AEF, 183—186
Medical problems, 1860's, 8-9
Medical Record, 1 67
Memphis, yellow fever epidemic in, 107, 108, 109
MEND. See Medical Education for National De-
fense.
Merrill, Capt. J. C, 94
Metzger, Maj. J. F., 386
Meuse-Argonne offensive, 186
Microscope collection, 85
cataloging of, 368
Microscope, electron, 350, 383
Microscopical Division, Army Medical Museum, 103,
105
Microscopy, 34—41
Military Environmental Pathology Division, 371,
383,384
Military installations:
Camp Alger, 154
Camp Lazear, 122, 129, 131
Columbia Barracks, 122
Fort Myer, 134
Military Institute of Pathology, as proposed name,
284
Military Surgeon , 251, 267
editorial tributes by, 293
Minie, Capt. C. E., 21
Minns, Col. A. E., 368, 369
Mission of Institute, 1-2
Mississippi Valley, yellow fever epidemic in, 107, 108
Mississippi, yellow fever in, 117
Mivart, Saint George, 62
Moore, Surg. Gen. J., 81, 84, 95
Moore, R. A., 282, 315
Moran, J. J., 124, 126, 127
Morrill, Senator L., 79
Moschel, Maj. B. L., 375
Mosher, H. P., 236
"Mosquito Eradication," 175
"Mosquito Hypothetically Considered as the Agent
in the Transmission of Yellow Fever, The," no
Moss, Lt. Cdr. G. T., 330
Moss, W., 17
Mostofi, F. K., 357, 370, 382, 384
INDEX
4'7
Motion-picture section, Instruction Laboratory, 171
Motion pictures, 171-176
as training methods, 174-176
Moulages:
standardization of, for Army use, 358
war-wound, 262
World War II, 263
Murray, Surg. Gen. R., 77, 81, 95
Musculoskeletal Pathology Registry, 325
Museum and Library Division, Surgeon General's
Office, 79, 103, 105, 139
Museum and Medical Arts Section, 262
Museum and Medical Arts Service, 250, 261
Museum of Hygiene, Medical Department, U.S.
Navy, 87
Museum of Natural History, 59, 60
Museum Unit No. 1 — 183
Musser, J. H., 143
Myers, C. J., 136
Nagasaki, follow-up studies of irradicatcd victims
in, 318
Naidorf, Maj. C. F., 327, 328
Nantucket Island, yellow fever epidemic in, 107
National Academy of Sciences, 66
National Aeronautics and Space Administration, 372,
386
National Cancer Institute, Public Health Service, 320
National Capital Park and Planning Commission,
238,241, 273
National Guard Armory warehouse, 280
National Institutes of Health, 194, 348
National Library of Medicine, 194, 388
See also Surgeon General's Library.
National Medical College of Washington, 60
National Medical Museum. See Army Medical
Museum.
National Museum, 75, 79, 98
National Naval Medical Center, as site for Museum,
284, 288
National Park Service, 238
National Research Council, 201, 269. 319. 324, 369
Advisory Committee of, 255
Committee on Pathology of, 254, 319
Subcommittee on Oncology of, 319, 320
National Research Council-National Academy of
Sciences, 386
National Security Act of 1947 — 283
National Security Resources Board, 292
National Zoological Park, autopsies at, 351
NATO Handbook, Emergency War Surgery, 1958 —
359
Namre, 62
Neate, J. S., 119, 149
Netter, Capt. F. H., 250, 262
Neubecker, R. D., 382
Neurauter, Lt. Col. L. J., 387
Neuropathology Branch, Department of Pathology,
382
Neuropathology Section, AFIP, 372
Neuropathology Registry, 221
New Orleans Medical Journal, 1 1 7
New Orleans, yellow fever epidemic in, 107, 108
New York Avenue Presbyterian Church. 23
New Yorl{ Medical Journal, 1 67
New York, yellow fever epidemic in, 107. 108
NlCHOLLS, W. W., 387
Niess, Maj. Gen. O. K., 373
IX Corps area, histopathology center for, 216
Norfolk, yellow fever epidemic in, 107
North Atlantic Treaty Organization, 358
Nott, I. C, no
Nutritional Pathology Branch, Geographic Path-
ology Division, 385
Nutritional Pathology Registry, 222
Obstetric, Gynecologic, and Breast Pathology Branch,
General and Special Pathology Division, 382
Oettinger, Lt. Col. V. S., 374
Office of the Scientific Director, 387
Office of The Surgeon General, p-II, 13. 73. 7*>.
80, 92, 98- "4. 139. 175. 194, «i, 242, 256,
261,358
Office Order No. 18, 1 Jan. 1944—250
Oldt, M. R., 321
Olsen, W., 124
"Operation Stratomouse," 37 I_ 37 2
Ophthatak Pathology Branch. Department of
Pathology, 382
Ophthalmic Pathology Registry, 197. "98, "99- 209
O'Reilly, Brig. Gen. R. M., 139- M*
Organization, AFIP, I, 2, 374"386
Orthopedic Pathology Branch, Department of Path-
ology, 382
Orthopedic Pathology Registry, 221
Osler, W., 95 ,
Otis, Ma). G. A., 32. 34, 46. 5». 53. 54- 5°. 63.
64,68,89,154
Otolaryngic Pathology Registry, 221
Owen, Col. W. O., 157. l6 '- '^ lf>7 ' "* '"'
180,184,185,186,187,238
Owsley, Rear Adm. J. Q-. 297
Parker, W. R., 199.214
Pasteur, L., 92
Pathologic service centers, 1 82
4i8
INDEX
Pathological Society of Philadelphia, 34
Pathologists, training of, in World War I — 160-
162, 189-191
Pathology, definition of, 3, 4, 5
"Pathology of Fatal Epidemic Hepatitis," 253
Patterson, Maj. R. A., 284, 285
Patterson, R. P., 266
Patterson, Surg. Gen. R. U., 233
Pearl Harbor and the Museum, 243, 245, 246, 271
Pediatric Pathology Registry, 222
Pension Building, 78
Perkin, W. H., 34
Perry, I., 321
Personnel Division, 375
Phalen, Col. J. M., 242, 267, 294
Philadelphia Medical Journal, 1 22
Philadelphia, yellow fever epidemic in, 107, 108
Phillips, Lt. Col. K., 359
Philosophical Society, 66
Photographic and Medical Arts Service, 250, 251
Photographic bureau, Medical Department, AEF,
establishment of, 185
Photographic Laboratory, Army Medical Illustra-
tion Service, 259
Photography Division, 387
Photometer, use of, 383
Photomicrography, 5, 97, 170, 330, 361
experiments in, 36-41, 53
"Pickle factory" period, 147-158
Pinar del Rio, yellow fever in, 118
Pinto, A. S., 120
Plastic bags, for specimen storage, 345, 346
Plaut, A., 368
Pneumonia pneumococcus, 92
Poincare, President R., 185
Powell, Pvt. C. W., 141
"Preliminary Report," in
Prentiss, Col. R. G., 276
"Prevention of Typhoid Fever by Vaccination and
by Early Diagnosis and Isolation," 145
Printing Division, 387
Prior. F. E., 214. 218
Problems of location, 272-277
Professional Records Service, Department of Path-
ology, 377, 378, 380, 389
Professional Files Section of, space problems of,
380
Professional Service, 250
Project Mercury, 372
"Prophylaxis of Malaria with Special Reference to
the Military Service," 190
Prostatic Tumors Registry, 221
Public Buildings Commission, 167
Public Health Service. See U.S. Public Health
Service.
Public Law(s):
495, 81st Congress, 2d sess., 29 Apr. 1956 — 291
626, 80th Congress, 2d sess., June 1948 — 278, 279,
287, 288, 289
910, 8isl Congress, 2d sess., 6 Jan. 1951 — 293
911, 81st Congress, 2d sess., 6 Jan. 1951 — 293
Public Museum, 271
Pugh, Rear Adm. H. L., 293
Pulmonary Pathology Branch, Department of Pathol-
ogy, 382
PURTLE, H. R., 33I, 332
Quarters, Museum, 23-25, 54-60
Quemadosde Marianao, yellow fever in, n6, 122
Quick, Surg. L., 19
Radiation Injury Branch, 355
See also Atom Bomb Research Unit.
Radiation Pathology Branch, Department of Pathol-
ogy, 383
Radiation Pathology Registry, 222, 383, 387
Radiological Society of North America, 222
Rauterberg, L. E., 103
Record and Pension Division, 41, 54, 81, 83
Reed, Maj. W., 5, 93, 100, 103, 104, 105, 107, in,
112, 113, 115, 116, 117, 118, 119, 120, 121, 122,
124, 125, 126, 127, 128, 129, 130, 131, 133, 135,
136,139, 146, 154, 170,304
Rced-Vaughan-Shakespeare Board 134, 138, 143,
146
Reeve-Carter process, 218
Reeve, R. M., 171, 214, 218, 230, 233, 261, 328, 330
Registry movement, 207—214
Registry(ies):
Bladder Tumors, 207
Bone Sarcoma, 198
Cardiovascular Pathology, 222
Chest Tumors, 221
Dental and Oral Pathology, 220, 221, 267
Dermal Pathology, 221
Endocrine Pathology, 222
Female Reproductive System, 221
Forensic Pathology, 222
Gastrointestinal Tract, 221-222
Genitourinary Pathology, 222
Geographic Pathology, 222, 387
Gerontology, 222
Hepatic Pathology, 222
Kidney Tumors, 221
Leprosy, 222
Lymphatic Tumors, 207
INDEX
419
Registry (ies) — Continued
Musculoskeletal Pathology, 325
Neuropathology, 221
Nutritional Pathology, 222
Ophthalmic Pathology, 197, 198, 199, 209
Orthopedic Pathology, 222
Otolaryngic Pathology, 221
Pediatric Pathology, 222
Prostatic Tumors, 221
Radiation Pathology, 222, 383, 387
Radiologic Pathology, 222
Testicular Tumors, 221
Tumor, 221
Veterinary Pathology, 222
Registry. See American Registry of Pathology.
Reimann, S. P., 209
Reorganization of Museum, 32-34
"Report on the Hygiene of the United States Army,
87
Research and Development Command, Dept. of the
Army. See U.S. Army Research and Development
Command.
Research program, publications as part of, 354
Research studies —
in comparative anatomy and physiology, 351
in leprosy and tumors, 350
on biological and biochemical effects of micro-
waves, 350
on effects of toxic agents on various organs, 350
on experimental pathology, 350
on experimental surgery on animals, 350
on feeding animals with irradiated foods, 348
on fowlpox virus, 337, 339
on neuropathology of nuclear and cosmic radia-
tion, 350
on performance of motor end -plates, 350
on production of vaccines, 338
on response of cells to acute radiation, 350
on structure and functions of various tissues, 350
sources of financial support for, 348
Reynolds, Surg. Gen. C. R., 221, 233, 235
Rich, A., 297
Rich, R. F., 242, 243
Richardson, T. G., 76
RlCKETTS, H. T., 258
Rickettsial diseases, 258
Robb, J. M-, 4
Roentgen tube, 101
Roentgen', W., 100
Roosevelt, President F. D., 240, 245
Root, E., 135
Rosecrans, Gen. W. S., 77, 78
Rosen, S. H., 382
Ross, Lt. Col. M. A., 385
Ross, Lt. Robert, 171, 174, 184, 185, 186
Ross, R., 117
Royal College of Physicians, 141
Rule, Maj. W. R., 383
Russell, Col. F. F., 5, 139. M». >43. '45. M*.
147, 148, 149. 150
Russell, Senator R. B., 289
St. Elizabeths Hospital. See Government Hospital
for the Insane.
Salmonella typhosa, 133, 142
Sanarelli bacillus, 112, 116, 122
Sanarelli, G., no, in, 116, 117, 122
See also Bacillus icleroides, discovery of.
Sanitary Commission, 9
Santiago de las Vegas, yellow fever in, 130
Sasscer, L. G., 290
SCHAFHIRT, A., 22
Schafhirt, E,. 22
SCHAFHIRT, F., 22
Schall, LeR. A., 236
Schirra, W. M., Jr., 372
Schlumbercer, Capt. H., 265
Schofield, Maj. Gen. J. M., 95
Schwarz, Lt. W. T., 171, 177. l8 4. > 8 5
Schwartz-Sanborn, Baron. 65
Scientific Advisory Board, AIP, 279. 280, 283, 295.
2 97.3i9 .
Scientific Illustration Division, services ot, 3»7
Scientific investigations, 251-256
Second World War. See World War II.
Secretary of Consultation, duties and responsibility
of, 373. 387
Secretary of Defense, 285 , ■ c
Secretary of Education, duties and responsibilities ot,
Secretary of Research, duties and responsibilities of,
Secretary of the Department of the Army, 2
Secretary of War, 9. «. *«. 27, 28, 30, 53. 54,
90, 202, 236, 242
Seidel, Lt. Col. R. Z., 374
Seminars in pathology, 256, 257
Senate Appropriations Committee, 64
Senate Committee on the District of Columbia, 103
Service Commands, h.stopathology centers at, 247,
256
VII Army Corps, 134 .
VII Corps area, histopathology center for, 216
S. 403, December 1883 — 77
S. 403. amendment to, 28 May 1884—78
S. 2737—289
420
INDEX
Shakespeare, Maj. E. O., 119, 133, 135
Sharp, Ambassador, 185
Shepard, Cdr. A. B., Jr., 372
Sheridan, Col. J. W., 369, 387
"Short Account of the Malignant Fever Lately Prev-
alent in Philadelphia," 108
Shrady, Acting Asst. Surg. G., 19
Sir 1 1 ldt, Maj. R. W., 165, 166, 167, 169, 178
Sickles, Gen. D. E., 29
Siler, Col. J. F, 182
Silliphant, Capt. W. M., 284, 285, 334, 339, 342
Silverstein, A. M., 383
Silvester, Capt. C. F., 230
Sisson, Sgt. V. B., 176
VI Corps area, histopathology center for, 216
Sloan Foundation, Alfred P., 348
Sloan, R. A., 331, 332
Smart, Maj. C, 73, 82, 85, 89
Smetana, H. F., 294, 295, 382
Smithsonian Institution, 59, 60, 75, 78, 79, 203
Society of American Bacteriologists, 201
SONTAG, C. G., I24
Souilly. pathologic service center in, 1 82
Southern Railway, 134
Space and personnel problems, 230-234
Space problems, 73, 95-98, 152, 187, 191-194, 344-
Spanish-American War, 105-106
Special Orders No. 22, WD, 24 May 1900 — 1 12
Special Orders No. 116, Hq., MDW, 22 May 1863—
25
Special Regulations No. 40-410, 8 June 1950 — 316
Specimens:
methods for utilization of, in study and investiga-
tion, 355-356
methods of preparation and preservation of, 18,
19, 22, 106
pathological :
directives on handling and types of, 18, 19, 311,
313
number of accessions of, 20, 313
screening methods for expedided handling of,
313
prime sources of, 98-100
procurement of, 163-165
wet-tissue, storage of, 345, 380
See also Collection of specimens; Collections,
Museum.
Spitz, S., 254
.Squibb Laboratory, 348
Stanley, W. M., 309
S I AN TON. E. M.. 9, 25, 29. 54. 60
Si vi 1 ii. I-.. 170
Steger, Col. B. L., 307
Stegomyia jasciata, 129
Steiner, P., 322
Stembridge, Maj. V. A., 384
Sternberg, Brig. Gen. G. M., 90, 92, 93, 94, 100,
105, 106, 109, no, in, 119, 124, 127, 128, 133,
137, 139, 141
Stewart, F. W., 319
Stewart, H., 319
Still photography section, Instruction Laboratory,
I7t
Stockslager, S. M., 78
"Stop-motion pictures," 176
Storage of Museum collections, 264-265
Stout, A. P., 319, 322
Stowell, R. E., 344, 348, 365, 374, 386
Streit, Maj. Gen. P. H., 297
"Structure of the Liver After Recovery from
Epidemic Hepatitis," 253
Study sets, 257-259
on tropical diseases, 254-356
Subcommittee on Oncology, National Research
Council, 319. ^211
Supply and funding, 51-53
Supply and Services Division, 375
Surgeon General, The, 25, 26, 27, 30, 53, 59, 64,
74, 75, 77, 79, 81, 87, 92, 96, 97, 99, III, 112,
140, 142, 143, 148, 162, 163, 164, 179, 194,
195, 196, 202, 261, 262, 267, 271, 273, 274,
277, 279, 280, 283, 284, 285
Surgeon General's Library, 64, 73, 76, 79, 83, 139,
194,234
See also National Library of Medicine.
Surgeon General's Office. See Office of The Surgeon
General.
Surratt, J. H., 47
Sutherland, Surg. Gen. C, 90, 95
Swanson, H. A., 220, 267
Symposium on "Pathology of Trauma," 383
Taber, J., 242
Taft, President W. H., 143
Talrich, M. J., 98
Tampa Hall, 280
Tardieu, M. A., 185
Taylor, H. B., 382
Technical Bulletins. See War Department Techni-
cal Bulletin (TB MED).
Technical Liaison Office, 375
Television, 361-366
role of, in educational mission, 363, 365
uses of, in medicine, 364
Temple, W. C. 174
INDEX
421
"Tempo S.," 368, 369
Terry, Sgt. P. H., 176
"Terrytoons," 176
Testicular Tumors Registry, 221
Thayer, W. S., i 43
Theobald, G., 199
Thompson, Col. R- M-, 334. 339
Thomson, Asst. Surg. W., 28
Tissue Processing Section, 380
Torney, Surg. Gen. G. H., 144
Toul, pathologic service center in, 182
Town, Asst. Surg. F. L., 19
Town-send, Col. F. M., 339, 342, 370, 372, 373,
394
Toxicology Branch, Military Environmental Path-
ology Division, 384
Toxicology Laboratory, 384
Training Aids Division, 387
Training Division, Army Service Forces, 262
Training Division, SCO, 262
Training films, 171, I74 _I 76
"Training the Medical Officer," 175
Tropical diseases, studies on, 254-256
Truby, Lt. A. E., 128
Truman, President H. S., 278, 291, 293
Tubercle bacillus, 92
Tumor Registry, 221
Tydings, Senator M. E., 289
Tyndali.. J.. 66
Tynes, Col. A. L... 288
Typhoid Board, 107, 12, 119, 133, 134, 135, 136,
137
findings and recommendations of, 137, 143
inspection tours of, 133, 134
report of, I35~i37
Typhoid fever, 5, 89, 106
at Camp Alger, Dunn Loring, Va., 133
compulsory vaccination against, 143-145
in Texas, 143
results of, 144-146
death rate of, 133
diagnosed as malaria or typhomalaria, 133, 134,
136, 137
diagnostic laboratories for, 134
epidemic in the United States, 133
experiments in vaccination against, 139, 140
results of, 141
in the Boer War, 1 899-1 902 — 141
in the Spanish-American War, 106, 133, 146
use of vaccine in civilian institutions against, 146
vaccination against:
hypodermic injection method of, 141, 145
oral method of, 141
Typhoid fever — Continued
volunteer vaccination against, 139-142
experience of British Army in, 1 42
experience of German Colonial Army in, 142
wholesale scale of, 1909 — 143
"Typhoid Mary," 137
Uehlincer, Prof. E., 394
United States Commission of 1897 — 109, 128
United States Sanitary Commission, 9
U.S. Army Medical Research and Development
Command, 386
U.S. Army Research and Development Command,
348
U.S. Government Printing Office, 262
U.S. Public Health Service, 6, 171, 193. 222, 275,
358
Van Cott, H., 328, 330, 358, 387
Van Leeuwenhoek, 34, 85
Vaughan, Maj. V. C, 133. ! 35. '36, 138, M3
Vedder, Lt. E. B„ 141
Verhoeff, F. H., 197, 198
Veterans' Administration, 6, 265-267, 270, 290, 320,
355.358,386
Veterinary Pathology Division, Department of Path-
ology, 385
responsibility of, 350
role of, 385
Veterinary Pathology Registry, 222
Vinson, C, 289, 290, 293
Virchow, R., 34, 36, 67, 90, 369, 394
Yin how's Archiv, 394
Virology Branch, Geographic Pathology Division,
385
Visitors to the Museum:
number of, 56, 218, 233, 280, 368, 390
rules for, 56
Vivisection, 103, 104, 105, 350
Vordeh Bkueoce, Col. C F., 288, 2 9 5. 300, 3<»
Wall, J. S., 101
Wallach, Lt. C. W., 17'
Wallis, Capt. J. F.. 171. "79
Walter Reed Army Institute of Research, television
facilities 31,361,365
Walter Reed Army Medical Center, 95. 289. 3°o,
303, 3' 5 „ ,. R
as possible site for Institute, 279. 284. »5. ™<
289
as possible site for Museum and Library. 2^. 241.
273, 274, 346
television facilities at. 361. 3 n2 ' 3 6 -l' 3h5
422
INDEX
Walter Rccil General Hospital, 238, 361
as possible site for Museum and Library, 147,
272-273, 275, 279, 284
War Department, 92
assassin's reward posters of, 46, 47
War Department General Orders No. 10, 1909 —
'■43
War Department Special Orders No. 22, 24 May
1900 — 112
War Department Technical Bulletin (TB MED) —
99, it Mar. 1944 — 246
116, 18 Nov. 1944 — 262-263
War wounds. See Moulages.
Waraydekar, V. S., 383
Ward, E. J., 170
Ward, Capt. J. H., 315
Ward, Pvt. G. S., 141
Warren, S., 319, 322
Wasdi\,E., 122
Washington District Office of the Corps of Engi-
neers, 295
Washington, Evening Star, 66
Washington Post, 105
support of building plans by, 240
Wax modeling section. Instruction Laboratory, 179
Weatherwalks, E., 125, 126
Weed, L. H., 269
Welch, W. H., 130
West, C.L., 125
Wm.te.C.S., 131
White. Lt. Col. D. C, 383
Whitehlrst, Lt. Col. E. R., 333
Wimtmore, Maj. E. R., 150, 157
Wilder, H., 200, 201, 231
See also Campbell, H.; Foerster, H.
Wilder collection, Cornell University, 156
William F. Edgar Bequest, 234
See also Edgar Bequest.
Wit ,1 i\ms. Pvt. G. C, 141
Wilson, C. E., 310
Wilson, Col. J. M., 81
Wilson, Col. L. B., 179, 180, 184, 185, 186
WlNTERNITZ, M., 319
Wood. Maj. Gen. L.. 119. 128
Wood, Asst. Surg. Gen. R. C, 32
Woodhlll, Col. A. A., 139
Woodrui 1. A. M.. \\-, 338
Woodward, Lt, Col. J. J., 13, 23, 28, 29, 34, 35, 36,
J9, 41, 53, 54- 55, 60, 62, 65, 66, 67, 68, 69, 73,
81.89. 154, 170, 230
World Health Organization. 369
World War I:
Army Medical Museum in, 159—187, 191-193,
205, 216
medical illustration in, 170
specimens from, 160
training pathologists in, 160-162
World War II:
Army Institute of Pathology in, 269-285
Army Medical Museum in, 245-268
World's Columbian Exposition, 98, 99
pamphlet catalog of Museum items for, 98, 99
Wound Ballistics Branch, Military Environmental
Pathology Division, 384
Wound moulage kits, distribution of, 358
Wright, Sir A. E., 141
Wyatt-Johnson museum classification, 207
Abbott's modification of, 207
Wyman, Surg. Gen. W. W., 1 1 1
X-ray apparatus at the Museum, 100-101
X-ray Branch, Veterinary Pathology Division, 385
X-rays, discovery of, 101
Yandell, D. W., 76
Yellow fever, 5, 106, 107, 252, 253
vaccination against, as cause of 1942 serum
hepatitis epidemic, 252
Yellow Fever Board, 113, 115, 116, 118, 120, 149
Yellow Fever Commission, 129, 130
Yellow fever epidimic(s), 1 07-1 09
in Charleston, 108
in Havana, 1 12
in Memphis, 107, 108, 109
in Mississippi Valley, 107, 108
in Nantucket Island, 107
in New Orleans, 107, 108
in New York, 107, 108
in Norfolk, 107
in Philadelphia, 107, 108
Yellow fever in —
Cuba, 115, 135
Havana, 129
Mississippi, 1 17
Pinar del Rio, 1 1 8
Qucmados de Marianao, n 6
Santiago de las Vegas, 130
Spanish-American War, 106
Yellow fever studies —
at Camp Lazear, 122—125
in Havana, 115
in West Indies, 109
on transmission, 109— 112
"Yellow jack." See Yellow fever.
Zimmerman, L. E., 382, 393
U.S. GOVERNMENT PRINTING 0FFICE:I9S4
Live Music Archive
Librivox Free Audio
Metropolitan Museum
Cleveland Museum of Art
Internet Arcade
Console Living Room
Books to Borrow
Open Library
TV News
Understanding 9/11