The Warrens and Other Pioneering Clinician Pathologists of the Massachusetts General Hospital During its Early Years

An Appreciation on the 200th Anniversary of the Hospital Founding

Robert H Young; David N Louis

Disclosures

Mod Pathol. 2011;24(10):1285-1294. 

In This Article

The Beginnings of Pathology at the MGH and HMS: John Collins Warren and JBS Jackson

John Collins Warren (Figure 4) was a member of a distinguished New England family[5] dating back to one of the earliest English settlers of the region. A tradition of medicine in the Warren family had been established by Dr Warren's father, also John Warren, and grandfather, Dr Joseph Warren, the latter being killed in the Battle of Bunker Hill. Dr Warren's father was one of the founders of HMS in 1782 and the first Professor of Anatomy and Surgery of HMS. He authored the first paper published in the Boston Medical and Surgical Journal (now the New England Journal of Medicine), which was on cardiac disease and included speculation on the pathological basis of the diseases he discussed.

Figure 4.

(Left) Dr John Collins Warren. (Right) Frontispiece of Dr Warren's 1837 book on tumors.

John Collins Warren graduated from HMS in 1797, and studied medicine at Guy's Hospital, London (with Astley Cooper) and later in Edinburgh and Paris (with Dupuytren and Corvisart among others), before returning to Boston after 3 years abroad. He brought anatomical specimens back with him and continually added them to his collection thereafter, based on materials obtained from the many operations he performed as the first surgeon at the MGH. These were added to specimens his father had collected and in 1847 when the HMS building on North Grove Street near the MGH was completed, he donated the collection to the school. The Harvard Corporation stated that 'the collection of anatomical specimens now presented by Dr Warren to the President and fellows, should be known and designated as the Warren Anatomical Museum.' The museum still exists under the auspices of the Countway Library of HMS.

Although Warren's fame rests largely on his first public demonstration of ether anesthesia at the hospital on 16 October 1846, and his role in the founding of the hospital, two of his works are particularly notable in the context of the history of pathology. In 1809 he published a monograph entitled 'Cases of Organic Diseases of the Heart,' likely related to the interest his teacher, Corvisart, had in cardiac disease. More noteworthy from the perspective of pathology is his 1837 book 'Surgical Observations on Tumors, with Cases and Operations.' This book (Figure 4), dedicated to Sir Astley Cooper, is 607 pages long and has 16 plates, many in color. There are 14 chapters covering various subtypes of neoplasia and a final short section entitled 'Distinguishing Characters of the Most Common Tumors.' The coverage of gross aspects of pathology is impressive.

Although gross pathology had been a major interest of John Collins Warren, he was primarily a surgeon and it almost certainly did not consume as much of his time as it did for Dr John Barnard Swett Jackson (1806–1879) (Figure 5).[6] Jackson was also a member of a medical family, being a nephew of the aforementioned Dr James Jackson. As JBS Jackson's father died when he was less than a year old, his uncle probably filled a paternal role for him. From 1829 to 1831, Jackson studied in Paris (with Dupuytren, Roux and Lisfranc), Edinburgh (with Syme) and London (with Bright, Addison and Hodgkin). Upon his return to Boston in 1831, he had a limited general practice, devoting most of his time to pathology at the MGH and HMS. He was a great collector of specimens, first for the 'Cabinet of the Society for Medical Improvement' and from 1847 as Curator for the Warren Anatomical Museum (Figure 5), when this museum was inaugurated after the donation of specimens from the collection of Dr JC Warren to the 'Cabinet'. In 1854 he became the first Shattuck Professor of Morbid Anatomy at HMS (and thereby the first professor of pathology in the United States) when his friend, George Cheyne Shattuck, Hersey Professor of the Theory and Practice of Physic, donated $14,000 to endow the professorship.

Figure 5.

(Left) Dr John Barnard Swett Jackson. (Right) Cover of the catalogue of Warren Anatomical Museum prepared by Dr Jackson (1870).

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