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 Start of Microscopy at the MGH: Oliver Wendell Holmes, John Bacon and Calvin Ellis

Despite the introduction of the microscope into pathology in the mid-nineteenth century, Jackson preferred gross pathology. In 1847, the MGH trustees voted that 'the admitting physician be authorized to purchase one of Oberhauser's microscopes at a cost not exceeding fifty dollars' with the stipulation that one of his duties was to 'examine microscopically and analyze all growths, tumors and diseased parts that may be removed from patients by operation or otherwise.' Jackson, however, restricted his pathological observations to gross findings. Oliver Wendell Holmes wrote in his eulogy of Jackson[6] 'what he knew he knew thoroughly but he never pretended to have the slightest knowledge beyond what his honest naked eye could tell him…his look penetrated like an exploring needle, and many a tympanitic fancy of careless observers has collapsed under its searching scrutiny.' Jackson prepared detailed catalogs of the initial collection he oversaw in 1847 and then for that of the Warren Museum in 1870 (Figure 5). He is credited with recognizing that decidua was derived from normal tissue, a new concept at the time.

A famous physician at the MGH at this time was the eminent literary figure Dr Oliver Wendell Holmes (Figure 6), who was officially affiliated with the hospital from 1840 to 1849. Holmes made an important contribution in 1843 when he published an essay on the contagiousness of puerperal fever.[7] This was a revolutionary concept at the time and was met with hostility from many leading obstetricians; it was only the work of Semmelweis a few years later that led to the acceptance of this concept. It has been stated in a number of sources that Holmes' contribution on the etiology of puerperal fever was not more publicized because it appeared in an 'obscure journal' that did not last long. It is pleasing from the historical perspective that 100 years after his contribution there was a Centennial celebration of it at the New York Academy of Medicine and a tribute to Dr Holmes presented there by Dr Reginald Fitz (son of Dr Reginald Heber Fitz, see below) was published.[8] In addition to his literary prowess, Holmes is usually given credit for the introduction of the microscope at HMS. As HMS was adjacent to the MGH on North Grove Street by 1847 (Figure 2), it is likely that his introduction of the microscope at HMS had an impact on its introduction at the hospital around that time. Given the hospital's decision to purchase a microscope as early as 1847, one wonders if Holmes had a role in lobbying for its purchase; however, we have been unable to find evidence of such a connection. Interested readers can refer to an excellent essay focusing on Dr Holmes' work as teacher and microscopist.[9] Brief note should also be made that another important branch of medicine, anesthesiology, owes its very name to Dr Holmes inasmuch as he is credited with introducing the word 'anesthesia'.

Figure 6.

Dr Oliver Wendell Holmes, with early microscope (courtesy of the Boston Medical Library in the Francis A. Countway Library of Medicine).

The first person to take up microscopy officially at the MGH was Dr John Bacon Jr (Figure 7), who held the new position of Chemist and Microscopist from 1851 to 1855 and then the position of Chemist from 1855 to 1863. Bacon's interest in chemistry was an early one, since he taught chemistry and toxicology to medical students and his recommendation in 1855 to separate the position of Chemist from that of Microscopist presumably related to the increase in clinical chemistry responsibilities. Nonetheless, he was an avid microscopist but apparently in relation to clinical fluid examination rather than in analysis of anatomical specimens; an obituary in a local paper remarked that 'He took especial delight in microscopy.'

Figure 7.

(Left) Dr John Bacon Jr (Harvard University Archives, call # HUP Bacon, John[1]). (Right) Acceptance letter from Dr Bacon to the MGH Trustees, 1851: 'Dear Sir, The notice of my election as Chemist & Microscopist to the Mass. Gen. Hospital for the current year is duly received. You will please communicate to the Board of Trustees my acceptance of the appointment which they have done me the honor to confer upon me. Respectfully yours, John Bacon Jr.'

Dr Calvin Ellis (1826–1883) (Figure 8) took over the role of Microscopist at the MGH after Dr Bacon, and held the titles of Shattuck Professor of Pathological Anatomy, Curator of the Pathological Cabinet and Microscopist for the hospital from 1855 to 1865. He had studied medicine and pathology in Vienna, France and Germany. Upon his return he became Assistant to JBS Jackson. He was the first MGH physician to use the microscope in evaluating anatomical specimens. He published over 40 papers and won the Boylston prize in 1860 for his essay on 'Tubercle', considered in one remembrance as the best paper on the subject prior to Koch's discovery of the bacillus.[10] Dr Ellis was appointed the Jackson Professor of Clinical Medicine in 1866 and served in that capacity until 1869 when he became Dean of HMS. In the latter capacity he cooperated with Harvard President Charles Eliot in the latter's sweeping reform of medical education at HMS. According to Eliot, 'he actively furthered all the many improvements made by the Faculty during his long term of service, and the changes made in 1870-71 could not have been effected without his (Ellis') support—a support which was as sturdy and strong as it was indispensable'.

Figure 8.

Dr Calvin Ellis.

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