Internal Medicine

Internal Medicine Internal Medicine 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. Internal Medicine (1942) 1 Cyrus C. Sturgis, Frank N. Wilson, and Arthur C. Curtis 2. Internal Medicine (1975) 22 Fred J. Hodges 3. Internal Medicine (2016) 24 Joel D. Howell [1] Internal Medicine (1942) Cyrus C. Sturgis, Frank N. Wilson, and Arthur C. Curtis The Period Ending in 1908 THE first step in organizing the Department of Medicine was the appointment in 1848 of Abram Sager (Rensselaer Polytechnic Institute ’31, M.D. Castleton Medical College [Vt.] ’35, A.M. hon. Michigan ’52) as Professor of the Theory and Practice of Medicine. He had been Professor of Botany and Zoology since 1842, but apparently never conducted classes in medicine, as in January, 1850, Samuel Denton (M.D. Castleton Medical College [Vt.] ’25) was appointed to the professorship in medicine as well as to that in pathology, and Sager was assigned to the professorship of obstetrics and diseases of women. In 1874 Sager was made Emeritus Professor, but he continued to act as Dean until June, 1875, when he resigned as a protest against the proposed establishment of a department of homeopathy in the Medical School. The first active head of the Department of Medicine was Samuel Denton, who had been appointed Professor of the 2 Internal Medicine Theory and Practice of Medicine and Pathology in 1850. In 1837 he had been appointed one of the first Regents and he had served for three years; later, his interest in state politics led to service in the state Senate from 1845 to 1848. According to Dr. William Fleming Breakey, Denton was very dignified in manner and always wore a high hat. He had a large general practice and was much sought in consultation, for he had an excellent reputation for sound judgment and skill in diagnosis and treatment. A great advocate of the use of alcohol in many types of illness, he especially recommended it in “consumption” and in the later stages of protracted fevers. The discrepancy between his views and those of Dr. Alonzo B. Palmer, who bitterly opposed the use of alcohol in all forms, was quickly noticed by the students, who sometimes submitted written questions in class calling attention to the opposing opinions. According to Dr. Victor C. Vaughan, Denton “possibly had something to do with the inauguration of the Medical School, but so far as I can learn he contributed but little to its reputation” (Vaughan, A Doctor’s Memories, p. 195). He died in Ann Arbor, August 17, 1860. To succeed him Samuel Glasgow Armor (M.D. Missouri Medical College ’44, LL.D. Franklin ’72) was, in 1861, appointed Professor of the Principles of Medicine and Materia Medica, although the title was changed at once, by his request, to Professor of the Institutes of Medicine and Materia Medica. He had held teaching positions in several middle western medical colleges and was in private practice in Dayton, Ohio, when he accepted the appointment, which he retained until the close of the session of 1867-68. Dr. Armor, a man of great personal charm, was characterized as an able teacher and lecturer, although he will not be remembered as one who contributed importantly to the advancement of medicine. He made his home in Detroit and was in practice there, for a part of the time, in professional partnership with Dr. Moses Gunn, who was then Professor of Surgery in the University. Alonzo Benjamin Palmer (M.D. College of Physicians and Surgeons [West. Dist., N. Y.] ’39, LL.D. Michigan ’81) became associated with the University in 1854, when he was appointed Professor of Materia Medica, Therapeutics, and Diseases of Internal Medicine (1942) 3 Women and Children. Appointed Professor of Anatomy two years before, he was listed as “not on duty,” presumably because of his desire to accumulate more funds before beginning an academic life. For a time Palmer attempted to maintain a residence in Chicago, but soon gave this up and came to Ann Arbor to live. On the death of Denton in 1860 he assumed the professorship of the theory and practice of medicine and of pathology and materia medica, becoming, a year later, Professor of the Theory and Practice of Medicine and of Pathology, in 1864 Professor of Pathology, the Practice of Medicine, and Hygiene, and in 1869 Professor of Pathology and the Practice of Medicine. His title from 1880 until his death was Professor of Pathology and of the Practice of Medicine and Clinical Medicine. Thirty-three years of his life were devoted to teaching medicine in the University; the last twelve of these he served as Dean. During the years of his residence in Ann Arbor Dr. Palmer was an active member and vestryman of Saint Andrew’s Church, where as a lay reader he often conducted services and taught a students’ Bible class. With Mrs. Palmer he gave a substantial sum toward the erection of the church tower. After his return from Europe in 1879 he became a warm friend of Bishop Harris of the Detroit diocese and took the deepest interest in the founding of the Hobart Guild. In 1859, when he was forty-four, he made his first European trip. His diary shows that in London he attended clinics and lectures at Guy’s Hospital, Saint Bartholomew’s Hospital, the London Fever Hospital, King’s College Hospital, Saint Thomas Hospital, Middlesex Hospital, and the Children’s Hospital. He met many prominent medical men, among them Charles Murchinson, famed for his studies on fevers and for emphasizing the importance of milk in the spread of typhoid fever. He spoke of having met Sir Benjamin C. Brodie, then seventy-six years of age, the president of the Royal College of Surgeons, and Sir Alfred B. Garrod, well known for his studies on gout. After three months in London he spent five weeks in Paris. There he visited Charles Eduard Brown-Séquard, who succeeded Claude Bernard as the professor of experimental medicine in the Collège de France in 1878 and who is chiefly 4 Internal Medicine remembered for his experimental investigations of the nervous system. He also saw Auguste Nelaton, one of the surgeons to Napoleon III, and Alfred Armand Louis Marie Velpeau, surgeon at the Charité, well known for his work on surgical anatomy and his New Elements of Operative Surgery. Palmer was especially interested in the clinic of Pierre-Adolph Piorry, inventor of the pleximeter and a pioneer in mediate percussion. In his diary he recorded: “Piorry [is] famous for his percussion; pretends to tell more by percussion than anyone else, and probably can do it.” This is of interest because Palmer was a master of physical diagnosis himself and drilled his students thoroughly in its methods. He also visited the clinic of Armand Trousseau, one of the leading clinicians and medical teachers of France. In Dublin he spent a morning with William Stokes, regius professor of medicine, who, as early as 1825, had published an Introduction to the Use of the Stethoscope. He had also written on cholera, having observed the Dublin epidemic of 1832, and was well known for his description of the Stokes-Adams syndrome and for his contributions to the literature dealing with diseases of the chest, heart, and aorta. As a delegate of the American Medical Association, Palmer attended the meeting of the British Association for the Advancement of Science at Aberdeen, where he met and heard the most illustrious scientific men of Great Britain. Later, at Edinburgh, he called upon Sir James Young Simpson, one of the most remarkable personalities of his time, who was the first to employ chloroform as an anesthetic. He also made many contributions to obstetrics and gynecology and was greatly interested in improving the status of hospitals. The European trip was doubtless a great inspiration to Palmer, for he came in contact with the finest type of physicians and medical teachers of Great Britain and France and visited most of the important hospitals and medical schools. Why he did not visit Germany is not known. The French, however, had contributed most of the advancements in medicine until about 1850. On his return Palmer entered into his work with enthusiasm. Apparently he was an inspiring teacher; he sincerely enjoyed lecturing and was always ready to substitute for other lecturers Internal Medicine (1942) 5 in emergencies, or to add new lectures of his own if he thought there was a need for them. The memorial to him stated: His lectures were at first fully written out but latterly he took briefer notes into the lecture room, carefully and systematically arranged. He never appeared before his class without looking over his notes and getting his subject well in hand; he was constantly rewriting and rearranging his lectures, to keep them abreast of scientific advancement. (Memorial of … Palmer, p. 167.) That he was thorough and meticulous in the examination of patients may be surmised by his comments on Dr. Walshe, whose clinic he visited in London: I have been particularly interested in Dr. Walshe’s clinical exercises in the hospital. I have never witnessed more searching, exact, and intelligent examination of patients, particularly in all cases of diseases of the chest. Nothing could exceed the minute care exercised in physical explorations, and, so far as I could judge from witnessing his procedures, and hearing his remarks, with occasional examinations of particular sounds, he is unusually discriminative and precise in his observations, and very just in his conclusions.

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