Armed Forces Institute of Pathology: Its First Century 1862-1962/Chapter VIII

by Robert S. Henry

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 building 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 building are inadequate and unsuitable," they said in a memorandum of their discussion. 1^[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 Washington 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 estimated 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 disposition 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."

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 Museum 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 Medical 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 examining 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.

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 established 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 instruction 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.^[3]

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 commissioned a brigadier general in the Medical Reserve Corps, and to become director 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 immunology. The resulting situation was recognized and described in a memorandum 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 ^[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, principally 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

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 filled * * * . In the space 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 achievements 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 specimens 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^[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." 6^[6]

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 preserving 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 of a solution of formalin followed by alcohol, in Berlin on 8 July 1896.7^[7] The process, with some modification, was introduced into the Army Medical Museum in June 1897, and had been used for wet specimens "with much satisfaction" 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 ^[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 International 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^[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^[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 Institution's general excellence, it was said that the arrangement of descriptive numbers, made up of capital and lowercase letters and numerals, which was the 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 headings 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." 11^[11]

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 ^[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 ^[13]

Figure 51.—Dr. Daniel Smith Lamb.

During the 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

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." 14^[14]

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 preserved 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. Aleš Hrdlička 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." 15^[15]

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 workers who * * * all but forgot that while parasitology is of fundamental importance, certainly interesting, and approaches the exact in science, the organisms 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." 16^[16]

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 University 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^[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.

Figure 52.—Col. Champe C. McCulloch, Jr., ninth Curator of the Museum, 1915-1916.

teacher in the Howard University Medical Department, 7 June 1923.) Published by the Howard University School of Medicine, 1923.

1. 1 Memorandum, Office of The Surgeon General, 31 March 1909. On file in historical records of AFIP.
2. 'Letter, F. I'. Russell to L. A. LaGarde, 2 February 1910. On file in historical records of AMP.
3. Letter, F. F. Russell to The Surgeon General, 7 June 1910. On file in historical records of AFIP.
4. 4 Memorandum, Lt. Col. W.D. McCaw, to The Surgeon General. On file in historical records of AFIP.
5. 5 Smith, Thomas C: The . . . Treasures of the Army Medical Museum (Presidential address delivered 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.
6. 6 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 militararztliche Zeitschrift, July 1904, p. 396, et seq.
7. 7 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 I903. P- 541.
8. 8 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.)
9. 9 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 I909-
10. 10 Lamb, Washington Medical Annals, 15 (1916), p. 14.
11. 11 Abbott, American Medicine, 4 April 1903, pp. 541-544.
12. 12 (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. 133-135- (2) Lamb, Washington Medical Annals, 15 (1916), PP- 14,15.
13. 13 (1) Callender, 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 Callender Address.) (2) Kober, 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
14. 14 Callender Address, op, cit.
15. 15 Washington Evening Star. 22 April 1929 and New York Times, 23 April 1929.
16. 16 Callender Address, op. cit.
17. 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 Association.) Typescript copy on file in historical records of AFIP.