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Pediatrics and Communicable Diseases Pediatrics and Communicable Diseases Pediatrics and Communicable Diseases Medical School The University of Michigan: An Encyclopedic Survey Copyright © 2015 by the Regents of the University of Michigan The University of Michigan: An Encyclopedic Survey was first published beginning in 1942. For its 2017 Bicentennial, the University undertook the most significant updating of the Encyclopedia since the original, focusing on academic units. Entries from all versions are compiled in the Bicentennial digital and print-on-demand edition. Contents 1. Pediatrics and Infectious Diseases (1942) 1 D. Murray Cowie 2. Pediatrics and Communicable Diseases (2016) 20 Valerie P. Opipari, MacDonald Dick, and Faye Silverstein [1] Pediatrics and Infectious Diseases (1942) D. Murray Cowie THE first regular course in pediatrics in the Medical School was given in the year 1905-6 by Dr. David Murray Cowie (’96m), who had been appointed Instructor in Pediatrics in the Department of Internal Medicine. Prior to this time, however, the subject of children’s diseases had not been neglected. It was included in the course on the Theory and Practice of Medicine. The title of Dr. Alonzo Benjamin Palmer (M.D. College of Physicians and Surgeons [West. Dist., N. Y.] ’39, A.M. hon. Nashville ’55, LL.D. Michigan ’81) in 1854 was Professor of Materia Medica, Therapeutics, and Diseases of Women and Children. This was later changed, on the death of Dr. Samuel Denton (M.D. Castleton Medical College [Vt.] ’25) in 1860, to Professor of Pathology, of Materia Medica, and of the Theory and Practice of Medicine. His successor, Dr. Henry Francis LeHunte Lyster (’58, ’60m, A.M. ’61) was Professor of Theory and Practice of Medicine and Clinical Medicine from 1888 to 1890; but up to this time no emphasis had been placed on diseases of children. 2 Pediatrics and Communicable Diseases There is no mention of children or infancy in the index of the two 900-page volumes of Palmer’s excellent and then very popular text, The Science and Practice of Medicine. It is noteworthy that Dr. Walter Shield Christopher, who followed Dr. Lyster, was a pediatrician, and in his courses on internal medicine, he must have more or less continuously pointed out the differences between childhood and adult types of disease. It was his interest in pediatrics that led Dr. Christopher to resign his chair at the University in 1891 and to take up the practice of that specialty in Chicago, where he became professor of diseases of children at the Chicago Polyclinic. After graduating from the Medical College of Ohio in 1883, Dr. Christopher was elected Demonstrator of Chemistry at his alma mater, and consulting chemist to the Rookwood Pottery, where he perfected some of the glazes which have since given world-wide fame to Rookwood ware. Soon after his graduation he was made clinician to the children’s clinic of the Medical College of Ohio, in Cincinnati. Dr. Christopher was elected to membership in the American Pediatric Society in 1889 and served as its president in 1902. He was greatly interested in “the perversions of the chemism of the body,” and was one of the first to see the importance of such studies in diseases of infancy: “It is in these conditions of perverted chemism of infancy,” he said, “that we find many of the difficulties of infant feeding.” Dr. Christopher died in Chicago, March 2, 1905, “one of the best known and best beloved physicians of this country.” In 1891 Dr. George Dock (M.D. Pennsylvania ’84, A.M. hon. Harvard ’95, Sc.D. hon. Pennsylvania ’04) was appointed Professor of Theory and Practice of Medicine. He had been an associate of Osler, and he continued to be an ardent follower and exponent of this great teacher and clinician. Osler was particularly interested in pediatrics and was a member of the American Pediatric Society, being its president in 1896. Medical men of that time were particularly interested in the childhood types of disease, and it should be pointed out that Dock did not neglect pediatric training while he was abroad. He made every effort to encourage doctors to send sick children to the University Hospital. He taught a simple milk dilution method of Pediatrics and Infectious Diseases (1942) 3 infant feeding, which soon went out of vogue, overshadowed as it was by the newly developed “percentage method,” but since reinstated with a better understanding and appreciation of its merits. Sterilized and pasteurized milk dilutions, cereal and vegetable additions, yolks of hard-boiled eggs, milk and cane sugar, were all that were needed then as now, if intelligently employed, to carry the infant successfully through the then more perilous period of infancy. Because of the alarming increase in the infant mortality rate about this time, general interest was aroused in the conservation of infant life. Few medical schools had instituted required courses in the diseases of infancy and childhood, and pressure was being brought to bear on their faculties to establish such courses. Dr. Cowie was particularly interested in the field of gastroenterology and infectious diseases. When, in 1905, it became advisable to develop the subject of pediatrics as a permanent course in the Medical School, because of the frequency of these two types of disturbance in infancy and childhood, he was selected to teach this branch in addition to his other work. The staff had been trying for several years, without much success, to increase the admission of children to the University Hospital. Parents who could afford to pay for their children’s medical attention would, of course, not send them to a charity hospital which possessed no special equipment for their care. There was no state children’s fund and no way whereby the indigent medically sick child could enter the hospital unless a cash deposit was made or the child’s expense in some way guaranteed. This was done insofar as possible by the organization of King’s Daughters, the Palmer fund, and by private donations. The interest on the Palmer fund amounted to $750 a year and was used for surgical as well as medical child patients and for some time for the defraying of the expense of glasses for children. The opportunity to develop a clinic under these conditions was discouraging. A bill had been passed by the legislature some years previously providing hospital care for children with congenital deformities, but the medically or acutely sick child was discriminated against. Only children with certain states of 4 Pediatrics and Communicable Diseases mental deficiency could be admitted to the clinic under this provision. This helped to increase the number of children at the Hospital. Where children are gathered the disturbances to which they are heir sooner or later show themselves, and, developing under the eyes of the staff, they were sooner recognized and more properly handled. The staff, however, began to think that these children, in spite of popular belief to the contrary, were more resistant to the vicissitudes of childhood than those not so afflicted. Medical material for teaching purposes did not perceptibly increase with their attendance, but they proved excellent cases for the study of this ever-increasing and important form of juvenile disturbance. Children with “epilepsy” could also be admitted under the provisions of this act. They are always of great interest and importance as medical problems, and much could be done for them. There was some technical difficulty in bringing about the establishment of this separate division of internal medicine, since there was already a chair of diseases of women and children, the Bates professorship, first given to Dr. James N. Martin. An adjustment was soon made, and the subject of pediatrics was permanently established as a required course for graduation — one of the first in the nitedU States. As early as 1902-3 in the description of the Department of Medicine in the yearly Calendar there appeared a statement of the teaching of diseases of children: “The peculiarities of medical diseases in childhood are discussed in the lectures and recitations. Clinical instruction is given in the various hours mentioned above. Most of the infants born in the Obstetric Clinic are artificially fed, and furnish abundant material for instruction in this important branch … Contagious Diseases are demonstrated in an Isolation Ward.” This latter statement was perfectly correct. In 1901 Mrs. Love M. Palmer, widow of the late Alonzo B. Palmer, made a bequest of $20,000 to the University for the building of a memorial ward, to be known as the Alonzo B. Palmer Ward. She also established an endowment fund of $15,000 to be used for the medical care of patients brought there. The building was completed in 1903. It was decided by Pediatrics and Infectious Diseases (1942) 5 the Board of Regents to dedicate the ward to the service of children. The urgent need for quarters for obstetrical patients, however, persuaded the Hospital staff, with the permission of the Regents, to use the first floor of the building for that purpose. Another pressing need determined them to use the second and third floor for a nurses’ home. Accordingly, there was no special place in which to house the patients of the children’s division of clinical medical study. The children’s clinic grew very slowly. The greatest number of yearly registrations during the first eight years was 228 (1912). Much pressure was being brought to bear on the Regents to transfer the clinical years of medical study to Detroit, and the need for more adequate teaching material in pediatrics was being stressed. Dr. Cowie decided to organize a campaign for a revision of the congenital deformity act (No.
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