Washington University Medical Alumni Quarterly, April 1951

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WASHINGTON UNIVERSITY MEDICAL ALUMNI QUARTERLY

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» ,*■: Published in the Interest of the University and the Alumni

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• The Challenge of Cancer Chemotherapy Alfred Gellhorn, M.D. (Second M. G. Seelig Lecture)

• David P. Wohl, Jr., Memorial Hospital Under Construction

• 1951 Alumni Reunion — June 1

Vol. XIV APRIL, 195 1 No. 3 OFFICERS OF THE ALUMNI ASSOCIATION OF WASHINGTON UNIVERSITY SCHOOL OF MEDICINE

President: James Barrett Brown, M.D. '23

Vice-President: A. N. Arneson, M.D. '28 Vice-President: Wendell G. Scott, M.D. '32 Secretary-Treasurer: George W. Ittner, M.D. '37

EXECUTIVE COMMITTEE Term Expires 1951 Term Expires 1952 Term Expires 1953 Sim F. Beam, M.D. '32 Walter Baumgarten, Jr., Grace E. Bergner, M.D. '43 Delevan Calkins, M.D. '31 M.D. '39 Charles W. Duden, M.D. '26 Guy M. Magness, M.D. *28 Joseph C. Jaudon, M.D. '33 Arthur T. Esslinger, M.D. '40 Oscar C. Zink, M.D. '21 David N. Kerr, M.D. *40 Virgil 0. Fish, M.D. '30 A. Victor Reese, M.D. '28

EDITORIAL BOARD WASHINGTON UNIVERSITY MEDICAL ALUMNI QUARTERLY

Representing the University: Representing the Alumni: Robert J. Terry, M.D. '95 Louis H. Jorstad, M.D. '24 Alexis F. Hartmann, M.D. '21 James W. Bagby, M.D. '33 Paul 0. Hagemann, M.D. '34 Leo J. Wade, M.D. '38 Robert A. Moore, M.D., Editor

Office of the Washington University Medical Alumni Quarterly, Euclid and Kingshighway, St. Louis 10, Missouri

Published quarterly by Washington University School of Medicine, St. Louis 10, Mo. Entered as second class matter December 14, 1937, at the Post Office at St. Louis, Mo., under the act of August 24, 1912. The Washington University Medical Alumni Quarterly

VOL. XIV APRIL, 1951 No. 3

THE CHALLENGE OF CANCER CHEMOTHERAPY Alfred Gellhorn, M.D. (From the Medical Service, Francis Delafield Hospital, and the Department of Medicine, College of Physicians and Surgeons, Columbia University, New York) This address was delivered at Washington University School of Medicine, St. Louis Mo on March 7, 1951, as the second M. G. Seelig Lecture, in honor of Dr. Major G. Seelig professor emeritus of clinical surgery. Dr. Gellhorn is a 1937 graduate of Washington University School of Medicine. It is a privilege to participate with broad economic, social, and health you in this expression of affection and problems of this city. As a tireless respect for Dr. Major Seelig. Dr. worker on the Board of the People's Seelig's boundless energy, keen insight Hospital, Dr. Seelig made a major con- and broad experience brought him to tribution to the improvement of com- preeminence in both clinical surgery munity relationships. This only partial and scientific research. Dr. Graham has list of Dr. Seelig's activities is an im- reviewed some of the medical contribu- pressive measure of the man, and the tions made by Dr. Seelig, and many of work that he has done is a living memo- us in a variety of medical disciplines rial to him. have made use of the knowledge that Dr. Seelig recognized many chal- tie added. Besides the well-deserved rec- lenges in his professional and commu- 3gnition that Dr. Seelig has won in his nity life and met them successfully. To- jrofession, it is also to be recalled that night I wish to discuss with you one his stature was great as a citizen of this phase of a problem which bristles with community. To mention but a few of challenges. Dr. Seelig's extrascientific activities, we can remember that he was a founder of THE CHALLENGE OF CANCER the Liberal Forum, an important me- CHEMOTHERAPY dium of adult education in St. Louis; The chemotherapy of cancer is ages and he was a long- time and construc- old. Long before the development of tive member of the Public Library the techniques of radical surgery and Board. As a member of the Social the methods of irradiation, malignant Planning Council and founder of the disease was treated by drugs in a variety Blue Cross Hospitalization Insurance of forms. The approach was character- Dlan, he gave generously and skillfully ized by the application of naive and of his talents toward the solution of erroneous concepts and the therapeutic 84 WASHINGTON UNIVERSITY results were uniformly bad. When it other hand, is qualitatively indistin- was demonstrated that certain malig- guishable from the normal cells of the nant diseases could be cured by surgery body and no innate restrictive defenses and/or radiotherapy and when critical are mobilized against it. A distin- laboratory and clinical evaluations were guished scientist who had devoted his made of cancer remedies such as crab life to experimental cancer research soup, purgation, blood-cleansing po- took cognizance of the basic difficulties tions, heavy metals externally and in- which theoretically raise the odds im- ternally administered and black or red pressively against successful chemother- pastes, cancer chemotherapy fell into apy of malignant disease when he said well justified disrepute. that the problem of treatment with chemical compounds is "almost — not During the past half-century, how- quite, but almost—as hard as finding ever, the accumulated experience with some agent that will dissolve away the conventional surgical and irradiation left ear, yet leave the right ear un- treatment has taught the medical pro- harmed : so slight is the difference be- fession that there still is a desperate tween the cancer cell and its normal need for additional therapeutic weap- ancestor." ons in the management of human ma- lignancy. With this realization atten- In spite of the obvious obstacles to tion is once again focused on the poten- a chemotherapeutic solution of cancer tialities of chemotherapy and vast ef- and in spite of the understandable skep- forts in this field are in progress. ticism of many, the challenge presented by the practical problem of the med- A powerful stimulus to research in ical management of disseminated malig- cancer chemotherapy has been the dra- nant disease is so great that all efforts matic successes achieved by anti-micro- must be made to meet it. Tonight I wish bial chemotherapy. The demonstration to evaluate with you some phases of that a chemical compound can selec- modern cancer chemotherapy to deter- tively destroy an invading micro-organ- mine whether there are as yet any ism has spurred the hope that a similar auspicious signs for the future. effect on the neoplastic cell may be achieved. Sober reflection of the com- At this time it must be recognized parative difficulties posed by the ther- that there are no drugs now available apy of infection and of cancer leads to which completely eradicate any malig- the realization that there are a number nant disease. There are, however, chem- of fundamental differences in the two ical compounds which modify the problems. Probably the most striking course of certain malignant tumors and difference is that in microbial infections which are indicated in the clinical care the offending invader is foreign to the of patients with these tumors. host and efficient defense mechanisms The important observations of Hug- provide strong support to supplement gins and his associates, which led to the and complement the effects of thera- recognition that malignant prostatic epi- peutic drugs; the malignant cell, on the thelium requires male sex hormone for ■■

MEDICAL ALUMNI QUARTERLY 85

its survival, have firmly established es- Let us consider first the nitrogen mus- trogens as a part of androgen-control tards which were introduced into the therapy of disseminated cancer of the therapeutic management of malignant prostate. Both estrogens and androgens disease by Gilman and Goodman at have found application in the palliative Yale and Jacobson and Spurr at the treatment of metastatic breast carci- University of Chicago in 1942. The de- noma and the relief of bone pain, velopments which led to the clinical improvement in appetite and sense of study of this agent are closely linked to well-being which may follow their ad- the history of dichloroethyl sulfide, the ministration is of significant importance dreaded "mustard gas" of World War I. to the patient. The pituitary adrenal In 1886 a German chemist, Victor cortical stimulating hormone and corti- Meyer, described the properties of this sone have been found to produce re- latter compound. Meyer appreciated missions in acute leukemia, particularly the highly toxic local actions of the sul- of children, with some regularity and fide because he and his associates in have also been reported to benefit pa- the laboratory sustained severe skin tients with lymphomas and multiple contact-burns from working with the myeloma. Urethane may substitute for chemical compound; in addition, Meyer radiotherapy in the treatment of chronic noted that following the administration leukemias and perhaps more impor- of small doses parenterally to rabbits, tantly it can be used to modify the the material produced death rapidly. course of multiple myeloma in a signif- The toxicological properties of this icant proportion of cases. The judicious compound were disregarded until the use of the nitrogen mustards in conjunc- first World War. tion with radiotherapy offers significant During the spring of 1917, however, palliation to patients with Hodgkin's the Germans carried out secret field diseases, lymphosarcoma and broncho- tests with such satisfactory results that genie carcinoma. Finally, the folic acid they adopted dichloroethyl sulfide as antagonists have the distinction of being an artillery shell filling and accumu- the first therapeutic weapons ever to lated a large quantity of these (yellow alter the course of acute leukemia. cross) shells without the knowledge or It is neither feasible nor pertinent to at least understanding of Allied intelli- discuss the laboratory and clinical data .'. gence. On the night of July 12, 1917, on each of these chemotherapeutic com- the Germans bombarded the British po- pounds. Rather I will present a brief sitions near Ypres in Flanders with summary of the biological actions on these shells. The devastating effects normal and tumor cells produced by produced by this unexpected chemical two of the drugs, followed by the story offensive warfare are indicated by the of a chemical compound which we are statistics of 14,276 casualties processed studying in the laboratory. This, it is through British casualty stations in the hoped, will provide orientation to the first three weeks of mustard gas use. present status of cancer chemotherapy. Descriptions of sulfur mustard intox- 86 WASHINGTON UNIVERSITY

ication soon appeared in the medical ing their absorption. As had been noted literature, with initial attention focused in the studies with sulfur mustard, on the local actions as manifested by lymphoid structures were especially skin vesication progressing to deep susceptible to damage by the nitrogen ulceration, conjunctivitis, photophobia mustards. These observations, coupled and lacrimation; irritative laryngitis, with the fact that the hydrochloride bronchitis with intractible cough and salts of the nitrogen mustards were crys- aphonia; secondary bronchopneumonia talline compounds, thereby facilitating associated with severe damage to alve- their handling, led the groups at Yale olar epithelium, massive pulmonary and Chicago to explore the therapeutic edema and death. Somewhat later, how- possibilities of these agents in the ma- ever, serious systemic toxicity was rec- lignant lymphomas. ognized as a major complication of The biological actions of the nitrogen mustard intoxication and descriptions of mustards are impressively demonstrated profound hemopoietic depression, dis- following the administration of mini- solution of lymphoid tissues and gastro- mum lethal doses to dogs. The delayed intestinal ulceration were recorded. lethal syndrome thus produced is of Laboratory studies to define the mecha- real pertinence to the clinician usinsr nism of cytotoxic action were under- nitrogen mustard. The events which taken, but the termination of World War characterize this syndrome are encom- I led to the discontinuation of these passed within three to seven days and investigations before a careful evalua- either result in death of the experimen- tion of the problem had been com- tal animal or uneventful recovery. Ano- pleted. rexia is evident in the first day follow- In the interim between World Wars ing the injection of the drug and per- I and II only scattered studies on the sists throughout the period. Associated biological effects of sulfur mustard with this there is loss of weight which were reported; however, there was con- exceeds, however, the effect of starva- tinued activity in the chemical warfare tion alone. Usually profuse vomiting laboratories of the French and Germans occurs within several hours after intox- directed toward the discovery of more ication and continues for two or three toxic agents. With the advent of the days. On the third day there is the Second World War new compounds onset of diarrhea which progresses to were proposed as potential offensive ulceration of the gastrointestinal tract agent. Sulfur mustard shared interest with large losses of fluid, electrolytes with a series of nitrogen analogs, bis- and blood. The syndrome is compli- and tris-(B-chloroethyl)-amines. It was cated by marked depression of hema- rapidly demonstrated that the nitrogen topoiesis manifested by progressive mustards were also contact vesicants lymphopenia, granulocytopenia and and careful pathological studies re- thrombopenia. Complex disturbances vealed the cytotoxicity of these com- of electrolyte and water metabolism are pounds on a number of tissues follow- also in progress with loss of intra- MEDICAL ALUMNI QUARTERLY 87

cellular potassium and cellular dehy- observations of the susceptibility of dration. Terminally, there is hypother- lymphoid tissues to this chemical com- mia and shock, followed in several pound, the most successful therapeutic hours by coma and respiratory failure. application has been in the management The precise cause of death in nitro- of the malignant lymphomas. In pa- gen mustard intoxicated animals is un- tients with these tumors, and most strik- derstandably obscure. The disruptions ingly in cases of disseminated Hodg- of physiological function produced by kin's disease, dramatic reversal of the the hemorrhagic necrosis of the gastro- lesions can be achieved by the admin- intestinal tract, by aplasia of the bone istration of nitrogen mustard. There can marrow, and by alterations of electro- be no doubt of the fundamental effects lyte and water distribution due to toxic of this drug on neoplastic cells when effects on cells, as well as possibly on one observes patients with high fever, renal transport systems, are great and marked weakness and anorexia, gen- interrelated. The entire problem of the eralized Iymphadenopathy, and enlarge- mechanism of lethal nitrogen mustard ment of the liver and spleen who, forty- toxicity is further complicated by the eight hours after an intravenous course fact that correction of the obvious ab- of nitrogen mustard, have normal tem- normalities by appropriate substitution peratures, subjective improvement, a therapy in the form of transfusions, voracious appetite and then a more electrolyte solutions and so on fails to gradual regression of tumor infiltra- prevent the lethal outcome. This sug- tions. Unfortunately the remissions so gests that subtle toxic efforts on the induced are only temporary. Why is it cells are produced which irreparably not possible to eradicate these suscep- damage their function. tible tumors? The limitation to effective therapy rests on the fact that nitro- The toxic manifestations and patho- gen mustard has no true selectivity of logical changes produced by nitrogen action on neoplastic cells. This drug mustard resemble in many details the has a devastating effect on the cellular effects of total body x-irradiation. The function of normal and malignant tis- radiomimetic actions of the chemical sues in direct proportion to the rate of compound accounts, in part, for the proliferation of these cells. Thus, be- great efforts that have been put forth to alii discover its intimate mechanism of ac- cause of the high turn-over rate of the ini tion because it has been hoped that the cells of the hemopoietic system, even understanding thus gained would shed when therapeutic doses of nitrogen mus- light on cellular effects produced by tard are given, depression of bone mar- ionizing radiation. row function is manifested by lymphopenia, granulocytopenia and thrombo- Turning to the actions of nitrogen penia. Complete destruction of a tumor mustard in man it may be broadly stated that therapeutic doses produce by nitrogen mustard would also destroy effects comparable to total body ir- the host. radiation. As was anticipated from the Here, then, we meet the basic 88 WASHINGTON UNIVERSITY problem of cancer chemotherapy head- Brilliant cytological experiments at the on. The nitrogen mustards interfere Chester Beatty Institute in London and with a mechanism of the malignant cell at the Wilmer Institute in Baltimore but this mechanism is also vital to the have demonstrated mitotic inhibition of function of normal cells. Under these cells exposed to extremely low concen- circumstances* it is obvious that only trations of nitrogen mustard and spe- limited therapeutic objectives can be cific alterations of chromosomal struc- attained. But what are these fundamen- ture could be detected and characterized tal cellular mechanisms and what can in these cells. Since it has been estab- we learn about them which may be of lished that the chromosome is a com- value in further chemotherapeutic re- plex nucleoprotein in which the desoxy- search ? pentose nucleic acid is the chief poly- During World War II extensive inves- nucleotide, the morphological evidence tigations were conducted on the mecha- suggests that the mustards may react nism of action of nitrogen mustard with with these latter important nuclear con- the objective of devising rational anti- stituents. The induction by the mus- dotal measures. A major contribution tards of heritable mutations in the fruit fly and in certain fungi also provides was made by chemists who demon- ■ strated that the chemical compound convincing proof that the drug alters underwent an intramolecular transfor- chromosomal function. The inactivation mation when placed in solution at the of viruses, particularly those rich in I pH of body fluids. The compound thus desoxypentose nucleic acid, the change formed was shown to be highly reactive in viscosity of DNA from thymus and chemically. Biochemists then found that the evidence from dynamic studies, a large number of compounds of biolog- which indicates suppression of desoxy- ical importance reacted with nitrogen pentose nucleic acid synthesis all pro- mustard in the test tube. These included duced by the mustards, provide addi- such varied substances as amino acids, tional support to the tentative conclu- proteins, vitamins and a number of sion that the drug destroys cells by enzymes. The concentrations of the interfering with the functions of the drug required to alter these entities, nucleic acids. however, were far greater than oc- Before trying to draw any lesson curred in vivo, even following the ad- learned from the clinical and basic in- ministration of lethal doses, and there- vestigations of the nitrogen mustards fore it was considered unlikely that let us review briefly the current status inactivation of any of these substances of knowledge about another group of accounted for the observed biological cytotoxic agents, the folic acid analogs. actions. Increasing evidence from bio- These compounds, which are very chemical, histochemical, genetic and closely related chemically to pteroylglu- morphological studies has focused at- tamic acid, or folic acid, are noteworthy tention on the nucleic acids as the pri- because they can produce remissions in mary site of action of the mustards. acute lukemia and because studies of i MEDICAL ALUMNI QUARTERLY 89 their mechanism of action have illumi- denum to the anus is edematous, swol- nated some fundamental aspects of cel- len, and in part, hemorrhagic. lular physiology. There are a number On the third day of acute intoxica- of folic acid analogs which have been tion, the bone marrow of the experi- synthesized and studied in the labora- mental animals is found to be grossly tory and in the clinic. Although they abnormal. The peripheral blood showed vary in potency, their biological actions marked granulocytopenia retriculocyto- are qualitatively identical and therefore penia, and moderate lymphopenia. Se- we will typify them all in discussing rial examination of the bone marrow just one of them, aminopterin. reveals progressive depletion of all cells The toxicity of the folic acid analogs in the erythroid and myeloid series. in experimental animals has been care- Apart from the lesions of the bone fully studied in order to throw light on marrow and the intestines, no outstand- the mechanism of action of the drugs ing pathological changes have been and in order to anticipate the hazards noted. Decrease in the size of lymph in their clinical application. Animals nodes and spleen has been described but receiving single, fatal doses of aminop- histological studies have not revealed terin, survive for at least 48 hours and striking cytotoxicity to lymphoid cells. usually succumb between the third and In humans the biological actions of fifth day. The characteristic syndrome aminopterin can be excitingly demon- of toxicity is manifested by progressive strated when a remission is induced in a weight loss, anorexia, bloody diarrhea, child dying from acute leukemia. In leucopenia, depression, terminal col- those patients who respond, the abnor- lapse and coma. mal immature leucocytes in the pherph- As could be anticipated from the clin- eral blood and bone marrow may ical course of fotal intoxication with the completely disappear to be replaced by drug, the chief pathological changes normal mature forms. Associated with have been found in the intestinal tract this change, the anemia and thrombocy- and the bone marrow. Microscopic ex- topenia may be corrected by a spon- amination of the small and large intes- taneous rise of the erythrocytes and tine reveals swelling and cytoplasmic platelets. Hermorrhagic manifestations vacuolization of the epithelium as early cease, the hectic temperature curve re- as six hours after the parenteral admin- turns to the baseline, the child begins istration of the drugs. The initial to eat with relish and to react to his changes are followed by desquamation surroundings and associates with re- of the epithelial calls, plasma extravasa- newed vigor and pleasure; bone pain tion into the intestinal lumen and inten- and other objective signs of the leu- sive leucocytic infiltration of the sub- kemic process such as peripheral mucosa. Within three days after acute lymphadenopathy and gross visceral in- poisoning or within a somewhat longer filtrations disappear. Within a period period after chronic intoxication, the of two weeks a critically ill child may whole mucous membrane from the duo- once again be in good health. 90 WASHINGTON UNIVERSITY

As you well know, the story can not effect can be detected. Recent experi- be ended here. The response just de- mental studies by Law and by Burch- scribed is observed in only about one enal have demonstrated that the devel- third of the cases. Another group, com- opment of refractoriness to the folic prising about 20 per cent of the total, acid analogs is an inherent response of show only a moderate hematologic re- the leukemic cell. Whether this is the sponse but are nevertheless markedly acquisition or enhancement of a cellu- improved symptomatically. The remain- lar detoxifying mechanism or whether ing half of the patients suffer a severe an alternate metabolic pathway is de- initial bone marrow depression follow- veloped which bypasses the function ing the administration of aminopterin affected by the folic acid analogs is not and hemorrhagic phenomena occur yet known. which, along with the depredations of Finally, clinical studies have empha- the disease, contribute to death early in sized the important toxicity of the folic the course of treatment. acid analogs on normal cells. The cells There are several points which have of the hematopoietic system and the emerged from the clinical studies with epithelium of the alimentary tract are the folic acid analogs which merit atten- particularly susceptible. Severe bone tion. As has been stated, only about 50 marrow depression, ulcerative stomatitis percent of children with acute leukemia and hemorrhagic enteritis are not infre- show a favorable response. It is im- quent concomitants of therapeutic doses possible a priori to predict which pa- of these powerful drugs. tient will have a remission; this sepa- Again we must recognize that ami- ration of acute leukemias into those nopterin fails to provide the solution to which are and those which are not con- a therapeutic problem of malignant dis- trolled by aminopterin presents a fas- ease. The drug does have some pro- cinating problem in the biology of the found effect on malignant cells, how- disease. Another striking observation ever, and therefore it is important to along this line is that the results of know how it acts. aminopterin therapy in acute leukemia When the folic acid analogs were of adults are far less satisfactory than first synthesized their biological action in the childhood disease. It is possible was studied on bacteria which required that the therapeutic drug will also serve folic acid for growth. In these micro- as a tool for investigating these biolog- biological experiments aminopterin was ical enigmas when its mechanism of found to inhibit the growth of appro- action is more fully understood. priate bacteria and its action could be It has been implied that the folic acid reversed by the addition of more folic analogs do not cure acute leukemia. acid to the medium. This led naturally This is true, and further, experience has to the conclusion that aminopterin and taught us that with each exacerbation of related compounds were folic acid an- the disease, the response to therapy is tagonists. This concept began to be less evident until sooner or later no seriously questioned, however, when it MEDICAL ALUMNI QUARTERLY 91

was found that both in experimental sized. The nucleic acids are built up animals and in man, folic acid had only from combinations of purines and pyri- limited success in preventing the tox- midines to each of which there is added icity of its analogs. If toxic manifesta- a 5-carbon sugar moiety, either a pen- tions had already appeared following tose or a desoxypentose, and phos- the administration of aminopterin, then phorus. It is known that the nucleic i) folic acid was completely ineffective in acids are complex polynucleotides, i.e., reversing them. These observations sug- molecules of purine plus sugar and f f k gested that aminopterin was an antag- pyrimidine plus sugar joined together onist of folic acid, but in addition through phosphoric acid ester linkages. caused cytotoxicity through some un- The formation of the high molecular related mechanism. As we shall see, weight nucleoprotein, is accomplished recent advances in our knowledge of the by the addition of a protein to the biochemical function of folic acid and nucleic acid. Exact definition of the of its metabolism indicate that the puz- protein component and the mechanism zling discrepancies just mentioned can of its condensation with nucleic acids be adequately explained on a single are areas which are being investigated basis. in many laboratories here and abroad. From exciting observations made on How does aminopterin enter into this microbiological systems and in bio- picture? In figure 2 there are indicated chemical experiments using radiocarbon three metabolic functions which are and heavy nitrogen tagged molecules, blocked by folic acid deficiency either

■ t evidence has been accumulated which due to inadequate dietary intake of the points to the nucleic acids as the cellular vitamin or to administration of the anti- ■ !

■ ■<. components affected by the folic acid vitamin, aminopterin. In the first ex- analogs. Since our knowledge of the ample is pictured the reversible reaction mechanism of action of these drugs is in which the amino acid serine is synthe- more precise than in the case of nitro- sized from glycine plus a single carbon gen mustards, it will be profitable to fragment, or in which serine is broken review briefly and schematically some down into glycine and an active carbon ,1 aspects of nucleic acid metabolism. fragment. Folic acid is a part of the enzyme system which catalyzes the re- In figure 1 there is represented dia- it action, and the reaction can be blocked grammatically the sequence of events by aminopterin. As you will remember, which lead to the synthesis of nucleo- glycine is one of the precursors of the proteins. This is an over simplification, purines and pyrimidines so that inter- but it will facilitate the presentation of ference with its availability would seri- the probable sites of action of the folic '■\ ously hamper nucleic acid synthesis. acid analogs. As can be seen, from the simple precursors glycine, ammonia and The second illustration of a site of active single carbon fragments such as aminopterin action requires a little am- formate, the far more complex purine plification. During the past few years and pyrimidine molecules are synthe- evidence has been accumulated which 92 WASHINGTON UNIVERSITY

PRECURSORS GLyciNE.NH3.Ct T

Figure 1. Diagrammatic representation of nucleoprotein synthesis. PUDINES PYRIMIDINES V f+SUGARl "VH3P04

NUCLEIC ACIDS r -{+PROTEIN NUCLEOPROTEINS

METABOLIC REACTIONS (1! BLOCKED 6/ AMINOPTERIN

A. SERINE ^ GLyCINE + d lit B. FoucAciD 1—- FoLINiC Aci D Figure 2 it; (PGA) (CITPOVORUM FACTOO OS

IT: C. PRECURSORS —-' H

N = -C-OH = COH I I H«N-C C—N-H H.N-C II II > II N(j Figure 3. Structural formulae of guanine and N C—N N- -C—N its carcinostatic analog 8-azaguanine. GUANINE 8-AZAGUANINE ir

it: MEDICAL ALUMNI QUARTERLY 93

indicates that folic acid is converted in of action of aminopterin in the nucleo- the animal organism to a related form protein synthetic chain is not yet which is biologically active. This al- known. Certainly the available evidence tered folic acid is called the "citrovorum adequately demonstrates that the drug factor" because a bacterial species, Leu- strikes at fundamental cellular mecha- '■'■«•: conostoc citrovorum, requires it for nisms. growth. More recently, chemical char- From the stories just presented on acterization of the "citrovorum factor" the mechanisms of action of nitrogen indicates that it is a reduced form of mustard and aminopterin, it is not sur- folic acid which has been named folinic prising that interest of many labora- acid. When folic acid is given to hu- tories working in the field of experi- mans there is a proportional excretion mental cancer chemotherapy turned to in the urine of folinic acid or the citro- the nucleic acids. The difficulties of vorum factor. Welch has shown that interfering with nucleic acid function in when rat liver slices are incubated with neoplastic cells without affecting nor- folic acid, the citrovorum factor ap- mal cells has been highlighted in the pears in the medium. This in vitro con- preceding discussion. I would like to version of folic acid to folinic acid is tell you, therefore, about a chemical blocked by the addition of aminopterin. compound which, as of this time at When it was found that the citrovorum least, appears to circumvent the di- factor or folinic acid could prevent the lemma. toxicity of aminopterin and also could Some years ago Roblin synthesized a reverse toxic manifestations produced number of purine analogs and tested by the drug, a reasonable explanation their anti-bacterial activity. Although for the inability of folic acid to accom- several appeared promising, the advent plish these ends was apparent. Thus of penicillin discouraged further studies aminopterin, by blocking the conversion along these lines. Two years ago of folic acid to the active folinic acid, Kidder, at Amherst, found that an ani- effectively stifles the formation of its mal microorganism, Tetrahymena gelei, own inhibitor. which he was studying, required the Finally, as shown in C. of the figure, purine guanine for its growth. When evidence has been obtained which im- he added, to the medium, a guanine plicates folinic acid as a part of the analog which Roblin had previously enzyme system necessary for the syn- prepared, the growth of the Tetrahy- thesis of the purine nucleus. The par- mena was inhibited. Kidder then studied ticular step consists of the introduction the action of the guanine analog on the of a carbon atom between two nitro- growth of a number of other micro- gens, thus completing the purine nu- organisms and also on several experi- cleus. Aminopterin blocks this impor- mental tumors. He reported that the tant synthetic process, thereby further guanine analog inhibited the growth of interfering with nucleic acid metab- these tumors. At that time our labora- olism. Whether there are further sites tory was also exploring the chemothera- 94 WASHINGTON UNIVERSITY peutic action of purine and pyrimidine of a variety of experimental epithelial analogs against experimental tumors. tumors including squamous cell carci- We confirmed and extended Kidder's noma and several mammary adenocar- observations and have become increas- cinomas in mice, but failed significantly ingly interested in the compound. to affect sarcomas, lymphosarcomas or leukemias. Because the drug was car- In figure 3 are represented guanine cinostatic, rather than carcinolytic, we and 8-azaguanine, the analog which in- had no inclination to give it clinical hibits neoplastic growth. The type of trial; however, the fact that it seemed to response which this chemical produces have selective action for tumor cells in is illustrated in figure 4, which shows contrast to normal cells, and also be- the growth of an undifferentiated squa- cause it had a selective action on a mous cell carcinoma (the Brown-Pearce morphologically separate group of ma- Carcinoma) growing in the anterior lignant tumors, suggested that the chem- chamber of the eyes of treated and control rabbits. We were particularly in- ical compound would be a splendid tool for studying biochemical differences be- terested to note that the therapeutic effect was achieved without apparent tween normal and certain neoplastic host toxicity. This gross impression re- cells and between cells of 8-azaguanine ceived additional support from studies susceptible and resistant tumors. For of the effect of 8-azaguanine on the this reason, a program of research on mitotic activity of normal and tumor the mechanism of action of the drug has tissue. This is shown in Table 1. Here been initiated in our laboratory. it can be seen that the mitotic rate in This work is in progress and I am the intestinal crypts and in the testes is unable to give a complete story. How- the same in untreated and 8-azaguanine ever, the results thus far illustrate a treated animals, whereas the mitoses of hopeful aspect for future cancer chemo- the tumor have been markedly de- therapy, and therefore may be justifi- pressed in treated rabbits. This indica- ably mentioned. Evidence which we, tion of tumor specificity was sufficient and also Skipper in Birmingham, have stimulus to learn more about the chem- obtained, indicates that 8-azaguanine ical compound. A further spur, how- interferes with nucleic acid synthesis ever, was our finding and that of others, and nucleic acid function. The precise that 8-azaguanine inhibited the growth mechanisms involved are not yet known.

THE EFFECT OF 8-AZAGUANINE ON THE MITOTIC RATE OF NORMAL AND NEOPLASTIC TISSUES IN RABBITS*

Tumor Intestine Testis (mitoses per 100 cells) (mitoses per 100 cells) (mitoses per 100 cells) Control 8.8 6.3 13.1 8-azaguanine 1.1 6.3 14.7 * Abstracted from: Shapiro, Weiss and Gellhorn. Cancer 3: 896, 1950. MEDICAL ALUMNI QUARTERLY 95

Figure 4. The effect of 8-azaguanine treatment Treated Control on the Brown-Pearce carcinoma transplanted to the anterior chambers of rabbits' eyes. The small numbers refer to periods after transplantation. The arrows indicate the tumor. Number 2 is immediately after transplantation. Number 3 is two days later. Treatment started on the third day. Number 4 is 5 days after transplanation. Number 5 is 7 days after transplantation. Number 6 is 8 days after transplantation. Number 7 is 10 days after transplantation. Note that there is little growth of the tumor in the treated animals, whereas the tumor completely fills the anterior chamber of the control animals. (From Shapiro, Weiss and Gellhorn, Cancer 3: 896, 1950.) 96 WASHINGTON UNIVERSITY

We* do believe, however, that we have case of 8-azaguanine is that the car- uncovered an important factor to ex- cinostatic action of the chemical com- plain the observed differences in action pound can be directly related to the of 8-azaguanine on normal and neo- low concentration of a deaminating en- plastic cells. An enzyme is present in zyme in susceptible cells; in normal normal tissue cells which deaminates cells and in certain tumor cells both of 8-azaguanine to the corresponding xan- which have a relatively higher concen- thine analog, 8-azaxanthine. This re- tration of the enzyme, no effect of the action is illustrated in figure 5. When drug is demonstrable. we determined the cellular concentra- The biochemists have shown that tion of this enzyme in susceptible tu- metabolite inhibition by an antimetabo- mors we found it to be low, whereas in lite depends to a large degree upon the resistant tumors thus far examined the concentration of the metabolite; the it was very much higher. These com- relationship between enzymes and en- parisons are shown in figure 6, in which zyme inhibitors also follows this pat- the concentration of the enzyme in the tern. From the experience we have had tumors is related to the level in the with 8-azaguanine and from other ex- liver. This observation takes on signif- perimental observations in progress in icance from toxicological and experi- our laboratory, we feel that the observed mental chemotherapeutic studies in quantitative differences between normal which we have shown that 8-azaxan- and neoplastic cells may provide vul- thine, the end product of the reaction nerable points for chemotherapeautic catalyzed by this enzyme, is neither agents to attack cancer cell mechanisms. toxic nor does it have any growth-inhib- iting action on tumors. This leads us to In summary, it has been noted that the interpretation that 8-azaguanine in- the impressive biological actions of the hibits those tumors which are unable to nitrogen mustards and the folic acid convert the drug to the inactive form; analogs are intimately related to their normal cells and resistant tumors are effects on nucleic acid metabolism and protected by an efficient mechanism. function. This reemphasizes the impor- Obviously, the observations discussed tance of these cellular constituents and just now are not on the main road to explains the interest of experimental the discovery of effective cancer chemo- cancer chemotherapeutists in this field. therapy weapons. They do emphasize It has been indicated that these cytotoxic the application of an important fact. drugs do modify the course of certain The fact is that there are many quanti- malignant tumors and that they are use- tative differences between normal and ful in clinical medicine if their indica- malignant cells even though qualitative tions and limitations are clearly recog- differences have not yet been discov- nized. The nitrogen mustards and ami- ered. The application of this fact in the nopterin fail, however, to be truly effective agents because they also are toxic * Drs. E. Hirschberg, J. Kream, I. Jaffe, M. to normal cells. This typifies the major Gertler and J. Gang are all associated in this research work. problem of cancer chemotherapy. MEDICAL ALUMNI QUARTERLY 97

=C-0H N= =C-0H I DfAMlNAH I I HjM-C C—N-H HOC C-NrH i'Jn Figure 5. The intracellular enzymatic diami- II II > nation of 8-azaguanine. -c—vt N- :::a 8-AZAGUANINE 8-AZAXANTHINE

DEAMINASE ACTIVITX

SA. 180 755 BROWN-PEARCE

In the discussion of a chemical com- illuminated by these quantitative, compound which is only of interest in ex- parative, biochemical characterizations, perimental cancer chemotherapy, evi- thereby providing guidance to the de- dence was presented which demonstrates velopment of more effective anti-cancer the importance of quantitative differ- drugs. ences between normal and neoplastic cells in the attainment of a chemothera- The challenge of cancer chemother- peutic effect. It was suggested that the apy is formidable but the progress of weakness of the neoplastic cell and the the past ten years offers auspicious signs strength of the normal cell might be that it will be met triumphantly. 98 WASHINGTON UNIVERSITY REFERENCES GENERAL Burchenal, J. H., Babcock, G. M., Broquist, Gellhorn, A., and Jones, L. O., Chemother- H. P., and Jukes, T. H., Prevention of Chemo- apy of Malignant Diseases. Am. J. Med., 6: therapeutic Effects of 4- amino-N 10-methyl- 188-231, 1949. pteroyl-glutamic acid on Mouse Leukemia by Karnofsky, D. A., Chemotherapy of Neo- Citrovorum Factor. Proc. Soc. Exper. Biol. plastic Disease. New England J. Med., 239: and Med., 74: 735-737, 1950. ■ 226-231, 260-270, 299-305, 1948. Law L. W., and Boyle, P. J., Development Reinhard, E. H., Good, J. T., and Martin, E., of Resistance to Folic Acid Antagonists in a Chemotherapy of Malignant Neoplastic Dis- Transplantable Lymphoid Leukemia. Proc. eases. J.A.M.A. 142: 383-390, 1950. Soc. Exper. Biol. and Med., 74: 589-602, 1950. Nichol, C. A., and Welch, A. D., On the Mechanism of Action of Aminopterin. Proc. NITROGEN MUSTARDS Soc. Exp. Biol. and Med., 74: 403-411, 1950. Auerbach, C, Robson, J. M., and Carr, J. G., Sauberlich, H. E., and Baumann, C. A., A The Chemical Production of Mutations, Sci- Factor Required for the Growth of Leuco- ence, 105: 243-247, 1947. nostoc Citrovorum. J. Biol. Chem., 176: 165- Berenblum, I., and Schoental, R., Action of 173, 1948. Mustard Gas on Nucleoproteins. Nature, 159: Sauberlich, H. E., The Effect of Folic Acid 727-729, 1947. upon the Urinary Excretion of the Growth Bodenstein, D., and Kondritzer, A. A., The Factor Required by Leuconostoc Citrovorum. Effect of Nitrogen Mustard on Nucleic Acids J. Biol. Chem. 181: 467-473, 1949. during Embyronic Amphibian Development. Skipper, H. E., Mitchell, J. H., Jr., and J. Experimental Zool., 107: 109-121, 1948. Bennett, L. L., Inhibition of Nucleic Acid Chanutin, A., and Gjessing, E. C, The Synthesis by Folic Acid Analogs. Cancer Re- Effect of Nitrogen Mustards upon the Ultra- search, 10: 510-512, 1950. violet Absorption Spectrum of Thymonucleate, Uracil and Purines. Cancer Research, 6: 599- 8-AZAGUANINE 601, 1946. Gellhorn, A., Engelman, M., Shapiro, D., Goldacre, R. J., Loveless, A., and Ross, Graff, S., and Gillespie, H., The Effect of W. C. J., Mode of Production of Chromo- 5-amino-7-hydroxy-lH-v-triazolo (d) Pyrimi- some Abnormalities by the Nitrogen Mus- dine (Guanazolo) on a Variety of Neoplasms tards: The Possible Role of Crosslinking. Na- in Experimental Animals. Cancer Res., 10: ture, 163: 667-669, 1949. 170-177, 1950. Herriott, R. N., Inactivation of Viruses and Kidder, G. W., and Dewey, V. C, Parks, Cells by Mustard Gas. J. Gen. Physiol. 32: R. E., Jr., and Woodside, G. L., Purine Metab- 221-239, 1948. olism in Tetrahymena and Its Relation to Ma- Koller, P. C, Experimental Modification of lignant Cells in Mice. Science, 109:511-514, Nucleic Acid Systems in the Cell. Symposia 1949. Soc. Exp. Biol. I, 270-290, 1947. Roblin, R. O., Jr., Lampen, J. O., English, Philips, F. S., Recent Contributions to the J. P., Cole, O. P., and Vaughan, J. R., Jr., Pharmacology of bis (2-haloethyl) amines and Studies in Chemotherapy VIII Methionine and sulfides. Parm. Rev. 2: 281, 1950. Purine Antagonists and Their Relation to Sul- fonamides. J. Am. Chem. Soc, 67: 290-294, FOLIC ACID ANALOGS 1945. Bardos, T. J., Bond, T. J., Humphreys, J., Shapiro, D. M., Weiss, R., and Gellhorn, A., and Shive, W., Relationship of the Folinic The Effect of 8-azaguanine on Mitosis in Nor- Acid Group and the Leuconostoc Citrovorum mal and Neoplastic Tissues. Cancer, 3: 896- Factors, J. Am. Chem. Soc, 71: 3852, 1950. 902, 1950. WOHL HOSPITAL CONSTRUCTION STARTED Ten-Story Building to Add 82 Beds

Construction on the $2,000,000 David cine and Surgery will occupy the second P. Wohl, Jr., Memorial Hospital in the floor of the new hospital, with class- Medical Center was started during the rooms and a lounge for students on the last week of March. The architect's ground floor, and dining room and drawing of the hospital is reproduced additional offices on the first floor. The above. third, fourth and fifth stories will be The ten-story Wohl Hospital will be devoted to patient care, while the top adjacent to the Nurses' Home and will five floors are to house offices and re- Hii connect with the Mallinckrodt Institute search laboratories for the surgery and of Radiology and other nearby build- medicine departments. ings. Designed for a maximum of 82 Named in memory of Lt. David P. hospital beds and facilities for teaching Wohl, Jr., the hospital is being built and research, it is to be constructed so with funds provided in part by Mr. that three additional floors may be David P. Wohl, St. Louis shoe manu- Ml added in the future. facturer and philanthropist. Lt. Wohl Recent completion of the steel and was killed in a bombing raid over Ger- > concrete bridge across the Wabash Rail- many in 1944. road tracks made possible the begin- Mr. and Mrs. Wohl, the Wohl Foun- ning of construction on the hospital. dation, and the Wohl Shoe Company The double-span bridge will provide a contributed generously to finance the front entrance to the hospital from Au- hospital, and the United States Public dubon Avenue, and also will fill the Health Service made a grant for the long-felt need for a northern approach construction. to the Medical Center. Completion of the structure is ex- Offices for the Departments of Medi- pected late in 1952. 100 WASHINGTON UNIVERSITY W. U. to Admit First Negro Markle Foundation Awards Third to Medical School in Fall Scholarship to W. U. Researcher For the first time, a Negro has ful- The John and Mary R. Markle Foun- filled the necessary qualifications and dation announced in New York on accepted admission to the regular four- March 4 the awarding of the third year course in the School of Medicine. Markle Foundation scholarship to a The student is Edgar R. Thomas of New research man at Washington University York City and Kingston, Jamaica, Brit- School of Medicine. The recipient is ish West Indies, and he will enter with Dr. Robert B. King, fellow in neurolog- the 1951 freshman class in September. ical surgery now on leave of absence to do neurosurgical work at Walter The School of Medicine was author- Reed General Hospital in Washington, ized by the Board of Directors of the D. C. University in July, 1947, to admit Ne- The School will receive a total of groes on the same basis as all other $30,000, to be made available at the students. There have been several Ne- rate of $6,000 for the next five years, to groes in recent years who have taken support Dr. King's research in neuro- postgraduate work in the Medical Cen- surgery. Dr. King interned at Barnes ter. Hospital following graduation from the Thomas is 30 years old, was born University of Rochester School of Med- in New York City, and lived for several icine in 1946, and was a fellow and years in Jamaica, British West Indies, assistant resident in neuro-surgery on where he received his secondary educa- the staff here before leaving for army tion. He was employed by the Medical service in July, 1949. Department of Jamaica and was secre- Dr. King is the third Washington tary to the senior medical officer of the University man to be named a "scholar Kingston Public General Hospital. in medical science" by the Markle Foun- In 1946 he entered Washington dation. Dr. C. Barber Mueller '42, Square College of New York Univer- assistant in surgery, received such an sity, and will receive his bachelor of appointment in 1949, and Dr. Ralph arts degree from there in September. Smith in 1948. He has been working as a laboratory assistant in the chemistry department, W. U. Commencement Changed and for two years has been president Washington University commence- of the student affiliates of the American ments hereafter will be held on the Chemical Society at NYU. Wednesday of the second week in June. Active in many University organiza- The Calendar Committee voted to tions, Thomas was elected to the honor- change the date permanently to avoid ary pre-medical society, Caducean, and conflict with exercises of St. Louis Uni- to the honorary German fraternity. Mrs. versity. Thomas will accompany him to St. This change places the 1951 com- Louis. mencement on Wednesday, June 6. MEDICAL ALUMNI QUARTERLY 101

W. U. to Be Host to International The exhibits will include 20 to 30 of a Gerontology Meeting in September scientific nature and 60 in the commer- 11 ; Plans are well under way for the cial field. ill .| meeting of the Second International The Congress is being sponsored by Gerontological Congress, which will the International Association of Geron- < It K meet in St. Louis at Hotel Jefferson, tological Societies, the Gerontological J'ilSji September 9 through 14. Dr. Edmund Society, Inc., and the American Geri- Bs\ V. Cowdry, research professor of anat- atrics Society. Four sections have been

. ..:■ omy, is president of the Congress and established for discussion of the phases i several other staff members of the Med- of old age study. These are: biology fiil ical School are serving as chairmen of and medicine; sociology, psychology, various committees. education and religion; economics and Washington University will act as the welfare; and medical services, hygiene official host to the Congress. and housing.

■ 'i Activities will start on Sunday, Sep- More than one thousand delegates are tember 9, with setting up of exhibits expected to attend the Gerontological and a radio broadcast of the University Congress, including representatives and I of Chicago Round Table from St. Louis. diplomats from many foreign countries. i::.!

I 1951 MEDICAL ALUMNI REUNION Friday Evening, June 1

Guest Speaker: THE HONORABLE WALTER H. JUDD, M.D. Representative in United States Congress from the Fifth District, State of Minnesota. Dr. Judd returned to the United States in 1937 after several years as a medical missionary in China. He is a graduate of the Uni- versity of Nebraska School of Medicine, class of 1923.

Place: STARLIGHT ROOF, CHASE HOTEL Kingshighway at Lindell, St. Louis

Time: Cocktails, 6:30 P. M. Dinner, 7:00 P. M. The 1951 graduating class of the School of Medicine will be our guests on this occasion, so come and help give them a good send off! Please send your reservation to the Medical Alumni Office NOW! Your class will have its own table 102 WASHINGTON UNIVERSITY Report of the Dormitory Fund Marvin Cornblath, St. Louis William C. Dunckel, Charlottesville, Va. Campaign Helen Hofsommer Glaser, St. Louis Burnet W. Peden, St. Louis Our immediate goal of $100,000 from Virginia H. Peden, St. Louis the medical alumni is coming closer, 1946—Living Graduates, 86 but there is still some $35,000 outstand- Drennan Bailey, Clayton, Mo. ing before we can approach private R. Robert Bates, Tucson, Ariz. philanthropy for contributions and Gladden V. Elliott, Richmond Heights, really start work on the Medical Stu- Mo. Lawrence W. O'Neal, Webster Groves, dent Dormitory. Mo. The grand total of contributions and James O. Owen, Jr., Skiatook, Okla. pledges is now $65,284.10, including Theodore J. H. Smith, Temple, Tex. $6500 in volunteer gifts from St. Louis Robert S. Spain, McKinney, Tex. friends of the Medical School, as men- Frank Vellios, St. Louis Leonard J. Wiedershine, Aurora, Colo. tioned in the January QUARTERLY. The 1945—Living Graduates, 105 average gift from 707 donors stands at John T. Farrar, Boston, Mass. $92.00. Jay O. Gibson, French Camp, Calif. There are still more than 2200 grad- Samuel B. Guze, Newington. Conn. uates of the Medical School who have John T. Johnstone, Jr., St. Louis not responded to our appeals. If you Donald E. Kilker, St. Louis Louis 0. Lambiotte, Salt Lake City, U". have not contributed yet, please send Ceylon S. Lewis, Jr., Salt Lake City in your check now to show that you Roscoe Maxwell, Punta Gorda, Fla. support this important project. George W. Prothro, Clovis, N. Mex. Eugene T. Taylor, Mocksville, N. C. Samuel B. Grant, Chairman John W. Ubben, Staunton, 111. Gary B. Wood, St. Louis 1950—Living Graduates, 85 Betty Ben Geren, Boston, Mass. Edward T. Emura, St. Louis Charles Wolfson, Amarillo, Tex. Joseph D. O'Keefe, Nashville, Tenn. 1944—Living Graduates, 95 Robert I. Pfeffer, St. Louis Guy D. Callaway, Jr., Seattle, Wash. Richard L. Swarm, St. Louis Albert B. Eisenstein, St. Louis 1949—Living Graduates, 96 J. K. Frost, Centralia, 111. Roger Bumgarner, Kansas City, Kans. Robert D. Lange, Kirkwood, Mo. Eugene W. Pearce, Washington, D. C. Ervan Levine, Vandalia, Mo. Russell D. Sheldon, Kansas City, Mo. Clayton H. Manry, Syracuse, N. Y. George S. Woodard, Jr., Washington, Francis E. Pennington, St. Louis D. C. H. H. Perman, Forest City, la. 1948—-Living Graduates, 89 John J. Rupp, Tucson, Ariz. Virgil R. Bleisch, Boston, Mass. David E. Smith, St. Louis Walter A. Fernau, Jr., Cincinnati, O. Roy A. Walther, Jr., Overland, Mo. David A. Guterman, Elgin, 111. Virgil Loeb, Jr., St. Louis Hugh R. Harting, St. Louis Marvin T. Pursell, Dinuba, Calif. Richard F. Huck, Jr., St. Louis Louis Weisfuse, Brooklyn, N. Y. Juro L. Shintani, Perry Point, Md. 1943—(Dec.)—Living Graduates, 113 1947—Living Graduates, 98 John F. Blinn, Jr., Stockton, Calif. Charles G. Clay, Rantoul, 111. J. P. Myles Black, Olive View, Calif. MEDICAL ALUMNI QUARTERLY 103 C. Read Boles, St. Louis George L Watkins, Farmington, Mo. William P. Callahan, Wichita, Kan. Hiraku Ishida, Los Angeles, Calif. Joseph B. Clay, Van Nuys, Calif. 1941—Living Graduates, 93 Terrell Covington, Jr., McKinney, Tex. Robert J. Cook, St. Louis Edward W. Czebrinski, St. Louis Harold Grant, McKinney, Tex. Jane Matthews Day, Montgomery, Ala. Mary Jordan, Ridley Park, Pa. Charles E. Fildes, Poplar Bluff, Mo. B. W. Finkel, St. Louis Walter J. Kennedy, Yakima, Wash. Peter 0. Fleming, Topeka, Kan. Edward H. Kowert, St. Louis Anne T. Goetsch, Berkeley, Calif. Elaine K. Lince, Pasadena, Calif. Samuel W. Gollub, St. Louis Torrence A. Makley, Jr., Columbus, 0. Leon Kahn, Beverly Hills, Calif. Walter A. Rohlfmg, Fresno, Calif. Geo. Bruce Lemmon, Springfield, Mo. Ernest Schwartz, San Francisco, Calif. Harold E. McCann, E. St. Louis Burton Shatz, St. Louis V. A. Mueller, Wichita, Kan. Donald E. Smith, Salt Lake City, U. C. A. Nielsen, Seattle, Wash. Tom G. Stauffer, Scarsdale, N. Y. Joseph W. Noah, St. Louis Herbert C. Wiegand, St. Louis Carol H. Rehm, Los Angeles, Calif. Frances C. Wilson, Tampa, Fla. Allan M. Rossen, Los Angeles, Calif. Carl T. Woolsey, St. Louis William L. Topp, Seattle, Wash. Alfred H. Sudholt, St. Louis Mitchell Yanow, Clayton, Mo. Harold E. Walters, St. Louis Cecil H. Blackburn, Selma, Ala. 1943—(March—Living Graduates, 105 Bruce L. Canaga, Drexel Hill, Pa. DeWayne C. Anderson, Stanhope, la. Jane A. Erganian, Glen Rock, N. J. Grace E. Bergner, St. Louis J. I. Moreland, Salem, Ore. Raymond M. Charnas, St. Louis Bernice A. Torin, St. Louis David Feldman, St. Louis 1940—Living Graduates, 92 Harlan I. Firminger, Bethesda, Md. Robert R. Anschuetz, Alton, 111. Melvin L. Goldman, St. Louis Donald S. Bottom, Alton, 111. H. Clagett Harding, Portland, Ore. Seymour Brown, St. Louis F. C. Lawrence, Bartlesville, Okla. Russell J. Crider, St. Charles, Mo. Ira W. Liebner, Brooklyn, N. Y. Roland R. Cross, Hines, 111. Eichi Masunaga, T. H. A. T. Esslinger, St. Louis Roberts B. Pappenfort, New York, N. Y. L. R. Fernandez, Laupahoehoe, T. H. Ernest S. Rogers, San Francisco, Calif. James M. Foerster, Wausau, Wis. Carvel T. Shaw, Hermann, Mo. Otto H. Grunow, St. Louis David A. Stadtner, Stockton, Calif. R. N. Hirst, Ogden, Utah H. A. Uhlemeyer, Jr., St. Louis Robert H. Johnson, Tulsa, Okla. Gerald J. Conlin, Denver, Colo. Robert E. Koch, St. Louis Albert N. Lemoine, Jr., Mission, Kans. James Mann, Boston, Mass. James L. Petry, Port Arthur, Tex. Gordon F. Moore, Alton, 111. Daniel G. Santer, Milwaukee, Wis. Charles G. Obermeyer, St. Louis 1942—Living Graduates, 92 Willard D. Rowland, Portland, Ore. William M. Anderson, Richmond, Va. Llewellyn Sale, Jr., St. Louis Ewald W. Busse, Denver, Colo. John S. Skinner, St. Louis Frances M. Love, Richland, Wash. Robert M. Smith, St. Louis French H. McCain, Birmingham, Mich. W. L. Tomlinson, St. Louis C. Barber Mueller, St. Louis Leo A. Sachar, St. Louis Harry W. Sawyer, San Francisco, Calif. William G. Reese, Perry Point, Md. Herman Rice, Temple, Tex. 1939—Living Graduates, 96 Frank 0. Shobe, St. Louis Alfred K. Baur, St. Louis 104 WASHINGTON UNIVERSITY Irving L. Berger, Cleveland, Ohio H. L. Townsend, Louisville, Ky. Vilray P. Blair, Jr., St. Louis Bernard C. Trowbridge, Kansas City, Leo J. Blum, Jr., Warner Robins, Ga. Mo. Joseph Borenstine, Kansas City, Mo. J. A. Fiorito, New Haven, Conn. Sidney S. Boyers, W. New York, N. J. William H. Gray, Yakima, Wash. Mark J. Brockbank, Petaluma, Calif. Carroll W. Huffman, Los Angeles, Calif. Heinz E. Cron, San Francisco, Calif. Arthur A. Kaplan, Utica, N. Y. William B. Hildebrand, Menasha, Wis. Robert C. Kingsland, St. Louis Leonard H. Jacobson, Miami Beach, Fla. Carl E. Lischer, St. Louis Benjamin Milder, St. Louis Edgar H. Little, New Orleans, La. Edward H. Reinhard, St Louis Lewis E. Littmann, St. Louis Minton D. Ritter, Margate City, N. J. Elizabeth Lowenhaupt, San Francisco R. J. Roscow, Evansville, Ind. M. S. McGrath, Weiser, Idaho Gerald A. Slusser, Silver City, N. Mex. Ralph C. Petersen, Glendale, Calif. O. W. Towers, St. Charles, Mo. Charles M. Polan, Huntington, W. Va. John W. Dix, Miami, Fla. William J. Quinn, Alturas, Calif. Leon J. Fox, St. Louis Henry N. Reid, Rome, N. Y. Lloyd Rosenbaum, Anderson, Ind. 1938—Living Graduates, 92 Harvey S. Smith, Boise, Idaho Harry A. Baers, North Hollywood, Calif. Walter Stevenson, Jr., Quincy, 111. G. W. Blankenship, Anderson, Mo. H. L. Townsend, Louisville, Ky. Robert D. Brookes, St. Louis David R. Wall, Wichita, Kan. Margaret A. Carter, St. Louis Ellsworth A. Westrup, Webster Groves, Adolph H. Conrad, Jr., St. Louis Mo. Marion J. Dakin, Los Angeles, Calif. Marie H. Wittier, Wheaton, 111. Lawrence M. Kotner, St. Louis Harry Mantz, Alton, 111. 1936—Living Graduates, 102 Robert G. Moles, Hanford, Calif. James H. Bryant, St. Louis Anthony Piraino, Oberlin, Ohio F. R. Crouch, Farmington, Mo. Joseph H. Pollock, Los Angeles, Calif. Norman W. Drey, St. Louis Philip Rosenblatt, New York, N. Y. Stephen Ellis, Coffeyville, Kan. Samuel Schultz, Clayton, Mo. Curtis H. Epps, Springfield, Mo. Roy W. Thomas, Redding, Calif. John L Horner, St. Louis J. L. Doenges, Anderson, Ind. W. H. Jacobson, Canton, Ohio H. R. Gilbert, Wyandotte, Mich. Nathan R. Kahn, Brooklyn, N. Y. Alexander A. Mueller, Los Angeles, George M. Klingner, Springfield, Mo. Calif. Vernon Lundmark, Seattle, Wash. Frank McDowell, St. Louis 1937—Living Graduates, 93 James D. Morrison, Billings, Mont. Samuel Brady, Gary, Ind. R. A. Nussbaum, St. Louis Paul A. Brenner, Owensville, Mo. Samuel Schneider, St. Louis G. L. Calvy, Cleveland, Ohio William L Sellers, Jr., Mobile, Ala. R. G. Carter, Austin, Tex. E. H. Trowbridge, Jr., Kansas City, Mo. Martin A. Compton, Richmond, Va. Michael S. Wepprich, Washington, Mo. John R. Connell, Denver, Colo. Warren B. West, Ogden, Utah Samuel M. Day, Jacksonville, Fla. Robert A. Wise, Houston, Tex. J. M. Dougall, Houston, Tex. Charles A. Brasher, Mt. Vernon, Mo. Thomas S. Boozer, Montgomery, Ala. Lawrence Breslow, Chicago, 111. Edward A. Harris, Birmingham, Ala. Hyman Jaffe, Beverly Hills, Calif. Lester E. Haentzschel, Appleton, Wis. A. E. Meisenbach, Jr., Dallas, Tex. 1935—Living Graduates, 88 : John E. Miksicek, St. Louis K. M. Amlin, Honolulu, T. H. MEDICAL ALUMNI QUARTERLY 105 I. J. Fiance, St. Louis James W. Bagby, St. Louis Heinz Haffner, St. Louis Russell J. Blattner, Houston, Tex. Alfred W. Harris, Dallas, Tex. Cecil M. Charles, St. Louis A. Herman Hutto, St. Louis Lee W. Dean, Jr., St. Louis Norman M. Johnson, Clarinda, Iowa Truman G. Drake, St. Louis Jacob Katzeff, Brooklyn, N. Y. Wallace D. English, Cardwell, Mo. Bruce Kenamore, St. Louis Charles H. Flynn, Clarinda, la. Kenneth V. Larsen, St. Louis George E. Grim, Kirksville, Mo. Ellen S. Loeffel, St. Louis Carl G. Harford, St. Louis Edward Massie, St. Louis John R. Haslem, Terre Haute, Ind. Sidney Messer, Venice, Calif. W. W. Herman, Cleveland, Ohio Clark G. Porter, Three Rivers, Mich. Joseph C. Jaudon, St. Louis Laurence G. Pray, Fargo, N. D. F. Craig Johnson, Denver, Colo. David Rothman, St. Louis A. A. Loverde, Chicago, 111. Bernard Schwartzman, St. Louis R. R. Merrell, Pocatello, Idaho Ben H. Senturia, St. Louis Alvin R. Miller, Seattle, Wash. A. J. Steiner, St. Louis Louis A. Motchan, Beverly Hills, Calif. David 0. Weiner, Brooklyn, N. Y. Charles Oderr, New Orleans, La. Irvin Weisman, Granite City, 111. Lyman K. Richardson, New Orleans, La. Elmer G. Graul, St. Louis J. F. Roufa, St. Louis Arthur P. Echternacht, Fort Dodge, la. Richard Y. Sakimoto, Honolulu, T. H. John W. Williams, Oak Grove, Mo. Robert S. Smith, Boise, Idaho Robert T. Terry, Nashville, Tenn. 1934—Living Graduates, 88 Oreon K. Timm, Danville, 111. Helen M. Aff, St. Louis R. M. Van Matre, Oklahoma City, Okla. Edmund B. Alvis, St. Louis Wirt A. Warren, Wichita, Kan. James M. Baker, Columbia, Mo. Lawrence M. Wilson, Olympia, Wash. Garvey Bowers, Kokomo, Ind. J. J. Wimp, Kirksville, Mo. Eugene M. Bricker, St. Louis Frank G. Zingale, St. Louis L. F. Bush, Danville, Pa. Everett S. Caldemeyer, Washington, George E. Zukovich, San Diego, Calif. Lawrence M. Wilson, Olympia, Wash. D. C. George J. L. Wulff, Jr., St. Louis T. C. Campbell, New Orleans, La. David Friedman, Granite City, 111. 1932—Living Graduates, 85 Ben I. Frissel,, Phoenix, Ariz. Harry Agress, St. Louis Paul O. Hagemann, St. Louis Sim F. Beam, St. Louis Stanley Hampton, St. Louis Brian B. Blades, Washington, D. C. Louis G. Jekel, Phoenix, Ariz. Louis T. Byars, St. Louis Dorothy J. Jones, St. Louis B. S. Clark, Spearfish, S. D. Ralph R. Jones, Boise, Idaho William Ehrlich, Newark, N. J. Morris D. Marcus, St. Louis Leo Gottlieb, St. Louis M. Norman Orgel, St. Louis Kikoshi Inouye, Honolulu, T. H. H. D. Rosenbaum, St. Louis D. H. Kaump, Detroit, Mich. John A. Saxton, St. Louis Paul H. Lefkowitz, Spring Valley, N. Y. Edna Schrick, Oakland, Calif. William H. Meinberg, St. Louis James G. Telfer, Chicago, 111. Carl V. Moore, St. Louis William W. Gist, Kansas City, Mo. Paul B. Nutter, Spokane, Wash. Martin P. Hunter, Kansas City, Mo. Sydney S. Pearl, Elizabeth, N. J. Fred C. Reynolds, St. Louis C. O'Neil Rich, Salt Lake City, Utah 1933—Living Graduates, 89 Wendell G. Scott, St. Louis Henry C. Allen, St. Louis Don J. Silsby, Springfield, Mo. 106 WASHINGTON UNIVERSITY

Barrett L. Taussig, St. Louis A. Ford Wolf, Temple, Tex. Dwight H. Trowbridge, Fresno, Calif. Grace Edwards Barar, Allahabad, India Sam R. Wallis, Kauai, T. H. F. L. Harms, Salisbury, Mo. Helman C. Wasserman, St. Louis V. L. Peterson, Charleston, W. Va. John C. Wilson, San Jose, Calif. Arthur E. Varden, San Bernardino, Irving Wyle, Brooklyn, N. Y. Calif. Virgil E. Jeans, Joplin, Mo. 1928—Living Graduates, 69 Donald M. Paton, Houston, Tex. A. N. Arneson, St. Louis 1931—Living Graduates, 73 William Brewer, Hays, Kans. Delevan Calkins, St. Louis Edward Burns, Toledo, Ohio E. W. Cannady, E. St. Louis, 111. Justin J. Cordonnier, St. Louis Joseph Cieri, Piedmont, Calif. Roland F. Elkins, Springfield, Mo. D. B. Elrod, Cape Girardeau, Mo. John S. Harter, Louisville, Ky. A. W. Hankwitz, Milwaukee, Wis. H. R. Hildreth, St. Louis W. E. Keiter, Kinston, N. C. Laurence L. Howard, Great Falls, Mont. Morris Krutchkoff, San Francisco, Calif. J. Ted Jean, St. Louis Mary Louise Newman, Jacksonville, 111. R. D. Kepner, Honolulu, T. H. Max Magnes, Paterson, N. J. Guy N. Magness, St. Louis H. R. McCarroll, St. Louis L. A. Malone, Terre Haute, Ind. Robert F. Monroe, Louisville, Ky. Earl L. Mills, Wichita, Kan. Ben Friedman, McKinney, Tex. John F. Patton, St. Louis W. Wallace Green, Kansas City, Mo. A. Victor Reese, St. Louis Edwin C. Schmidtke, Columbia, Mo. Paul R. Rollins, Seattle, Wash. John A. Schindler, Monroe, Wis. Verne Ross, Stockton, Calif. R. B. Wray, Nevada, Mo. W. A. Ruch, Memphis, Tenn. 1930—Living Graduates, 76 0. G. Schneidewind, New Athens, 111. Harold S. Bowman, Wichita, Kan. B. Wright Shelton, Miami Okla., M. A. Brennecke, Waimea, Kauai, T. H. David M. Skilling, St. Louis J. Paul Burgess, Hyrum, Utah A. Lloyd Stockwell, Kansas City, Mo. M. A. Diehr, St. Louis Jacob Stolar, St. Louis Donald E. Eggleston, Macon, Mo. Vincent T. Williams, Kansas City, Mo. Virgin 0. Fish, St. Louis George H. Wood, Carthage, Mo. Herbert H. Gass, India 1927—Living Graduates, 70 Joseph J. Gitt, St. Louis Stanley Harrison, St. Louis Everett C. Drash, Charlottesville, Va. A. C. Fortney, Fargo, N. D. Alfred H. Hathcock, Fayetteville, Ark. Walter M. Howard, Joplin, Mo. Paul H. Guttman, Sacramento, Calif. Alfred G. Henrich, Los Angeles, Calif. James D. Horton, Springfield, Mo. Irene A. Koeneke, Halstead, Kans. I. D. Newmark, Chester, 111. C. H. Leslie, Kirkwood, Mo. 1929—Living Graduates, 71 W. R. Merrell, Brigham City, Utah Carl S. Bickel, Wheeling, W. Va. Alfred J. Metscher, Enid, Okla. Leslie C. Drews, Clayton, Mo. Kazuo Miyamoto, Honolulu, T. H. A. W. Freshman, Denver, Colo. Eugene O. Parsons, Kansas City, Mo. Guerdan Hardy, St. Louis Willard C. Schwartz, Manhattan, Kan. Craig B. Johnston, Philadelphia, Pa. Abigail E. Smith, Lexington, Mass. Louis Kovitz, Kansas City, Mo. Frances H. Stewart, St. Louis Sidney Pakula, Kansas City, Mo. Richard T. Taylor, Los Angeles, Calif. Frank B. Queen, Portland, Ore. Louis L. Tureen, St. Louis A. P. Rowlette, Moberly, Mo. Franklin Walton, St. Louis Jay Marvin Salzman, Springfield, 111. W. B. Wilcoxen, Bowling Green, Mo. MEDICAL ALUMNI QUARTERLY 107

George S. Wilson, Enid, Okla. Perry E. Duncan, Springfield, 111. Louis F. Aitken, St. Louis George H. Garrison, Oklahoma City, A. G. Klein, St. Louis Okla. 1926—Living Graduates, 73 H. V. Gibson, Great Falls, Mont. Reno A. Ahlvin, Kankakee, 111. William B. Gnagi, Monroe, Wis. Herbert Anderson, Los Angeles, Calif. Scott Johnson, New York City Willard Bartlett, Jr., St. Louis Louis H. Jorstad, St. Louis James L. Benepe, St. Paul, Minn. Elizabeth E. Koppenaal, Elmhurst, 111. H. M. Chandler, Waipahu, T. H. A. E. Meinert, Winona, Minn. Erich A. Cunningham, Louisiana, Mo. E. B. Pfefferkorn, Oshkosh, Wis. Max Deutch, St. Louis Reuben M. Smith, St. Louis Andy Hall, Jr., St. Louis 0. Earl Whitsell, St. Joseph, Mo. William M. James, St. Louis Eugene S. Auer, Denver, Colo. William B. Kountz, St. Louis 1923—Living Graduates, 47 John G. Manning, McMinnville, Ore. Oliver Abel, Jr., St. Louis G. Wendell Olson, Fullerton, Calif. William G. Becke, St. Louis Walter R. Peterson, Trenton, N. J. William L. Bradford, Rochester, N. Y. Bernard Rand, New York City James Barrett Brown, St. Louis Henry A. Romberg, Oshkosh, Wis. Ben M. Bull, Ironton, Mo. J. C. Schmidtke, Elgin, 111. 1. Z. Davidoff, Milwaukee, Wis. E. H. Theis, Granite City, 111. Walter J. Decker, Westfield, Pa. Charles W. Duden, St. Louis George V. Feist, Kansas City, Mo. 1925—Living Graduates, 67 Ben D. Senturia, Chicago, 111. George P. Bailey, Lakewood, Colo. Charles Teel, Bellingham, Wash. Robert J. Crossen, St. Louis J. Wm. Thompson, St. Louis H. M. Denny, Union, Mo. Clair 0. Vingom, Madison, Wis. James J. Donohue, E. St. Louis, 111. Elias H. Schlomovitz, Milwaukee, Wis. B. Y. Glassberg, St. Louis 1922—Living Graduates, 44 A. E. Hiebert, Wichita, Kan. K. S. Chouke, Philadelphia, Pa. Richard K. Kimmel, St. Louis Calvin Clay, St. Charles, Mo. James I. Knott, San Diego, Calif. James B. Costen, St. Louis S. D. Soule, St. Louis Aphrodite J. Hofsommer, Webster Jerome S. Levy, Little Rock, Ark. Groves, Mo. Joseph Magidson, St. Louis Armin C. Hofsommer, Webster Groves, Carl H. Matthey, Davenport, Iowa Mo. Loren D. Moore, Wellesley Hills, Mass. Kirby A. Martin, New York, N. Y. Sam. J. Roberts, Miami, Fla. F. E. Sultzman, Hannibal, Mo. Melvin A. Roblee, St. Louis 1921—Living Graduates, 42 Roland A. Slater, Peoria, 111. Lester J. Evans, Jackson Heights, N. Y. Winton T. Stacy, Fort Sill, Okla. J. C. McKitterick, Burlington, Iowa R. 0. Stickler, Kirksville, Mo. Harvey S. Rusk, Pueblo, Colo. Gershom J. Thomson, Rochester, Minn. Oscar C. Zink, St. Louis Hugo O. Wagner, Great Lakes, 111. James O. Nail, Marion, Ky. 1920—Living Graduates, 39 Robert L. Andrae, Louisiana, Mo. 1924—Living Graduates, 68 Alfred O. Adams, Spokane, Wash. Clifton H. Briggs, Pasadena, Calif. Roy F. Baskett, Texarkana, Tex. Warren H. Cole, Chicago, 111. J. William Beckmann, New York, N. Y. Alfred Goldman, St. Louis Harry J. Davis, Topeka, Kans. Samuel B. Grant, St. Louis Charles Drabkin, Los Angeles, Calif. Guy H. Hopkins, Pueblo, Colo. 108 WASHINGTON UNIVERSITY

William A. Hudson, Detroit, Mich. 1912—Living Graduates, 30 W. N. Jenkins, Port Gibson, Miss. C. F. DeGaris, Oklahoma City, Okla. Frederick E. Jostes, St. Louis Roy G. Empson, Valmeyer, 111. P. H. Kennedy, Hubbard, Ohio Edwin C. Ernst, St. Louis Herman M. Meyer, St. Louis George S. Gilpin, Cleveland, O. L. J. Owen, Lincoln, Neb. W. N. O'Bannon, New Madrid, Mo. M. G. Peterman, Milwaukee, Wis. Wells C. Reid, Goodrich, Mich. Royal W. Rudolph, Tucson, Ariz. A. P. Erich Schulz, St. Charles, Mo. H. W. Wellmerling, Bloomington, 111. George L. Watkins, Farmington, Mo. Harvey Lester White, St. Louis 1911—Living Graduates, 20 1919—Living Graduates, 45 Thomas M. Davis, St. Louis Duff S. Allen, St. Louis Clyde P. Dyer, St. Louis S. P. Funkhouser, Lake County, Calif. William H. Fickel, Denver, Colo. Howard H. Heuston, Bolder, Colo. Charles H. Hecker, Palo Alto, Calif. Fred J. Hodges, Ann Arbor, Mich. Arthur J. Wagers, Philadelphia, Pa. Carl 0. Kohlbry, Duluth, Minn. 1910—Living Graduates, 40 Marriott T. Morrison, Mt. Horeb, Wis. Stanley S. Burns, St. Louis E. H. Munro, Grand Junction, Colo. Frederic Hagler, Springfield, Mass. Raymond L Murdoch, Oklahoma City, Robert M. Hardaway, Wheatridge, Colo. Okla. John P. Keim, St. Louis Howard A. Plank, New York, N. Y. Peter G. Moskop, St. Louis A. B. Raffl, Syracuse, N. Y. Claude D. Pickrell, St. Louis R. P. Roantree, Elko, Nev. Frederick O. Schwartz, St. Louis A. L Walter, Sedalia, Mo. 1909—Living Graduates, 29 1918—Living Graduates, 26 James W. Barrow, Carbondale, 111. Glover H. Copher, St. Louis Carey B. Elliott, Raton, N. Mex. Wilbur G. Gillett, Wichita, Kan. W. N. Pugh, Salt Lake City, Utah Elmer N. Liljedahl, Hollywood, Calif. Richard S. Weiss, St. Louis Arthur G. Mahle, Chicago, 111. 1908—Living Graduates, 29 J. F. Pessel, Trenton, N. J. W. A. Olds, Colville, Wash. O. Sundwall, Murray, Utah O. J. Raeder, Boston, Mass. James A. Tesson, Kansas City, Mo. W. D. Moore, San Pedro, Calif. 1917—Living Graduates, 25 1907—Living Graduates, 28 Archie A. Skemp, La Crosse, Wis. C. C. Nash, Dallas, Tex. J. E. Wattenberg, Cortland, N. Y. Grandison D. Royston, Hope, Ark. Llewellyn Sale, St. Louis 1916—Living Graduates, 13 Raymond M. Spivy, St. Louis E. L. Dallwig, Milwaukee, Wis. Earl C. Sage, Omaha, Neb. 1906—Living Graduates, 33 Ray T. Woolsey, Salt Lake City, Utah Martin J. Glaser, St. Louis Arthur Gundlach, St. Louis 1915—Living Graduates, 20 T. A. Lawler, Taylorville, 111. D. K. Rose, St. Louis S. P. Martin, East Pairie, Mo. J. E. Strode, Honolulu, T. H. S. B. McPheeters, Goldsboro, N. C. W. T. Wilkening, Fort Scott, Kans. William H. Smith, Colfax, Calif. 1914—Living Graduates, 8 1905—Living Graduates, 30 O. F. McKittrick, Linglestown, Pa. Jerome E. Cook, St. Louis John T. McLarney, Brookfleld, Mo. Walter Fischel, St. Louis 1913—Living Graduates, 20 Harry M. Griffith, Pasadena, Calif. F. 0. Kettelkamp, Colorado Springs, J. M. James, Henning, 111. Colo. O. W. Knewitz, East St. Louis MEDICAL ALUMNI QUARTERLY 109 1904—Living Graduates, 31 1886—Living Graduates, 3 Paul Baldwin, Kennett, Mo. 1885—Living Graduates, 2 W. Q. Conway, Kalispell, Mont. E. F. Ellis, Fayetteville, Ark. N. M. Freund, St. Louis 1884—Living Graduates, 2 Harry L. Jones, Kansas City, Mo. Roy P. Scholz, St. Louis 1883—Living Graduates, 2 J. H. Woodridge, Pueblo, Colo. W. A. Fries, St. Louis 1903—Living Graduates, 20 1882—Living Graduates, 1 A. H. Myerdick, Mt. Pleasant, Iowa 1881—Living Graduates, 3 Clive D. Scott, Louisiana, Mo. James A. Dickson, St. Louis 1902—Living Graduates, 22 Willis Hall, St. Louis 1901—Living Graduates, 14 1880—Living Graduates, 2 John M. Bradley, St. Louis OTHER DONORS W. C. Forder, St. Louis Mrs. T. R. Akin, Clayton, Mo. Walter C. G. Kirchner, St. Louis Mr. William M. Akin, St. Louis M. K. Wyler, Albuquerque, N. Mex. Harry L. Alexander, M.D., St. Louis 1900—Living Graduates, 2 Robert W. Bartlett, M.D., St. Louis 1899—Living Graduates, 34 Leon Bromberg, M.D., St. Louis J. C. Caldwell, Wellington, Kans. J. J. Bronfenbrenner, Ph.D., St. Louis C. L. Lawless, Marshall, Mo. Samuel S. Bukantz, M.D., St. Louis R. O. Raymond, Flagstaff, Ariz. Martin M. Calodney, M.D., St. Louis >elden Spencer, St. Louis Benjamin H. Charles, M.D., St. Louis Julian B. Woodson, Lowesville, Va. Drs. Carl F. and Gerty T. Cori, St. Louis 1898—Living Graduates, 27 Gustave J. Dammin, M.D., St. Louis J. G. W. Fischer, Alma, Mo. Morris Davidson, M.D., St. Louis R. B. H. Gradwphl, St. Louis Hallowell Davis, M.D., St. Louis John Q. Roane, Carlyle, 111. Joseph E. Edwards, M.D., St. Louis A. L. Stuttle, Williamsville, 111. Ben Eiseman, M.D., St. Louis Robert Elman, M.D., St. Louis 1897—Living Graduates, 21 Lee T. Ford, St. Louis Theodore Greiner, St. Louis Robert J. Glaser, M.D., St. Louis Frederick E. Woodruff, St. Louis Harry N. Glick, M.D., St. Louis 1896—Living Graduates, 21 Drs. Evarts and Helen Tredway Graham, 1895—Living Graduates, 21 St. Louis H. A. Geitz, Monterrey, N. L., Mexico G. E. Gruenfeld, M.D., St. Louis Sandor Horwitz, Peoria, 111. Miss Helen D. Harkness, St. Louis Robert J. Terry, St. Louis Leopold Hofstatter, M.D., St. Louis William A. Tolleson, Eufala, Okla. Mr. W. W. Horner, St. Louis 1894—Living Graduates, 13 Alex H. Kaplan, M.D., St. Louis 1893—Living Graduates, 12 J. Albert Key, St. Louis Andrew Darling, St. Louis John Esben Kirk, M.D., St. Louis R. Clarence Stephens, Plymouth, Ind. Paul E. Kubitschek, M.D., St. Louis 1892—Living Graduates, 4 K. Cramer, Lewis, St. Louis 1891—Living Graduates, 15 Grover Liese, M.D., St. Louis Robert G. Loeffel, St. Louis 1890'—Living Graduates, 6 Sedgwick Mead., M.D., St. Louis 1889—Living Graduates, 6 Albert I. Mendeloff, M.D., St. Louis 1888—Living Graduates, 2 Ivan N. Mensh, Ph.D., St. Louis 1887—Living Graduates, 3 William H. Olmsted, M.D., St. Louis 110 WASHINGTON UNIVERSITY Ernest H. Parsons, M.D., St. Louis Arthur E. Strauss, M.D., St. Louis Joseph C. Peden, Sr., M.D., St. Louis A. C. Stutsman, M.D., St. Louis Lawrence T. Post, M.D., St. Louis Robert Votaw, M.D., St. Louis M. Hayward Post, M.D., St. Louis Theodore Walsh, M.D., St. Louis Herman J. Rosenfeld, M.D., St. Louis Carl R. Wegner, M.D., St. Louis Theodore B. Rosenthal, Ph.D., St. Louis Park J. White, M.D., St. Louis Harold Scheff, M.D., St. Louis Ralph B. Woolf, M.D., St. Louis MEDICAL ALUMNI QUARTERLY 111 DEPARTMENTAL NEWS Anatomy Internal Medicine Dr. Edward W. Dempsey, professor Dr. Harry A. Schroeder, associate of anatomy, attended a meeting spon- professor of medicine, delivered the an- sored by the Ciba Foundation in Lon- nual Alpha Omega Alpha lecture at don, England, April 9-12. He presented McGill University, Montreal, Canada, a paper on "The Experimental Induc- on March 1, speaking on "Congestive tion of Sexual Behavior by Steroid Hor- Failure." He spoke at the initiation mones," during this conference on the dinner. While in Montreal, he also ad- influence of steroid hormones on psy- dressed the Montreal Medico-Chirurgi- chological and behaviourial reactions. cal Society, March 2, on "The Patho- The keynote address of the Confer- genesis of Hypertension." ence on Aging sponsored by Smith, On Feb. 1-3, Dr. Schroeder addressed Kline and French Laboratories in Phil- the Recess Commission on Hyperten- adelphia on Feb. 15 was given by Dr. sion of the Commonwealth of Massa- Edmund V. Cowdry, research professor chusetts in Boston on "The Evidence of anatomy. He spoke on "The Im- That Essential Hypertension Is Not a portance of Research on Aging in the Single Disease Entity," and led the dis- National Emergency." cussion which followed. An exhibit entitled "The Separate The United States Public Health Ser- Neural Arch—A Study of the Incidence vice has renewed a grant to Dr. Harry from the Fetus to Maturity," was L. Alexander, professor of clinical med- awarded the silver medal for second icine, for continuation of research on place and a certificate of merit at the the metabolism of lipid antigens by Dr. American Academy of Orthopedic Sur- Samuel Bukantz on a joint project with geons meeting in Chicago, Jan. 27 to Drs. Gustave Dammin and Frank J. Feb. 1. Dr. Maurice B. Roche, instruc- Dixon. tor in clinical orthopedic surgery, pre- Dr. Alexander is chairman of a com- sented the exhibit, which was prepared mittee appointed by the American Acad- by him and Dr. George G. Rowe, former emy of Allergy, at the requests of the instructor in anatomy. They presented surgeon general of the army, navy, air a selected series of some 36 lumbo- force and Public Health Service, to re- sacral columns from the Terry Anatom- view standards for the induction of men ical Collection. suffering from allergic disorders into First prize in the exhibits at the the service. Dr. Stanley Hampton is a meeting went to Dr. T. J. Stewart, cur- member of the committee. ator of physical anthropology at the Dr. Samuel C. Bukantz, assistant pro- Smithsonian Institute in Washington, fessor of medicine, has been appointed and former staff member of the Medi- chairman of the committee on clinical cal School. Dr. Stewart was visiting investigation on food allergy of the professor of anatomy during 1943. Research Council, American Academy 112 WASHINGTON UNIVERSITY

of Allergy. The committee is in organi- ogy, left Feb. 5 for an extensive lecture zation and drawing up plans for investi- and inspection tour through Europe un- gative work. der auspices of the Office of Naval Re- •< A reseach grant of $7350 has been search. awarded to the School of Medicine for Officially classified as a navel techni- work in heart disease by the Life Insur- cian on the trip, Dr. Davis visited labo- ance Medical Research Fund. ratories and gave lectures in France, The grant is for research by Dr. Rob- Switzerland, Sweden, Denmark, Hol- ert J. Glaser, assistant professor of med- land, Belgium and England. Purpose icine, for work on the pathogenesis of of this tour was to exchange informa- experimental streptococcal infections tion with scientists in the democratic and their relation to rheumatic fever. countries of Europe on research prob- Other fellowships have been awarded to lems about neurophysiology of the ear. Dr. Joseph Larner, fellow in biological In Sweden, Dr. Davis delivered a chemistry, and Dr. H. Mitchell Perry, series of three lectures describing re- research fellow in medicine. search work at Central Institute. He spoke before the Karolinska Institutet Neuropsychiatry of Stockholm and the medical faculties Dr. Edwin F. Gildea, professor of of the Universities of Upsala and Lund, psychiatry, will address the third an- and gave informal lectures in Switzer- nual neuropsychiatric meeting held at land, England and Holland. North Little Rock Veterans Administra- Dr. Davis is in charge of special tion Hospital, March 1 and 2. His topic naval research projects being conducted is "Research in Psychiatry, Particularly at C.I.D., and is chairman of the Com- as Exemplified by the Milbank Founda- mittee on Hearing of the National Re- tion Symposium on Biological Aspects search Council. He is also part-time of Mental Health and Disease." professor of physiology on the Medical School staff. Otolaryngology Dr. Theodore E. Walsh was guest Pathology speaker at several sessions of the During the week of April 8, Dr. Rob- postgraduate course sponsored by the ert A. Moore, Dean and professor of Oregon Academy of Ophthalmology pathology, was at the University of and Otolaryngology. He presented six Pennsylvania in Philadelphia to take papers for the course. On Feb. 27, Dr. part in meetings of the committee on Walsh was guest speaker for the teach- the survey of medical education, a ing day session of the Otolaryngology group formed jointly by the American Department at Syracuse University Medical Association and the Association Medical College in New York. of American Medical Colleges, which Dr. Hallowell Davis, director of re- recently completed an extensive survey search at Central Institute for the Deaf of medical schools in this country. and research professor of otolaryngol- Dr. Frank J. Dixon, Jr., assistant pro- ■■■■■'■

MEDICAL ALUMNI QUARTERLY 113

fessor of pathology, has resigned to ical Use of Cardiovascular Angiog- accept the position of professor of raphy." pathology at the University of Pitts- Surgery burgh, Pa., on May 1. A graduate of The Henry Jacob Bigelow Medal of the University of Minnesota in 1943, he the Boston Surgical Society was has been on the Washington University awarded to Dr. Evarts A. Graham, staff since the summer of 1948, when Bixby professor of surgery, during a he came here as an instructor in pathol- meeting of the Society in Boston on ogy. Dr. Dixon served with the Navy April 20. On March 15, Dr. Graham ■:-iraf during World War II and attained the addressed the fifth annual Michigan ami' rank of lieutenant. Postgraduate Clinical Institute on oi Dr. David W. Talmage of the Depart- "Common Errors in the Diagnosis of ment of Medicine, also will leave the Bronchiogenic Carcinoma." staff to accept a position as assistant re- At the annual meeting of the Society search professor in the department of of University Surgeons, held this year ill \ pathology at the University of Pitts- at Durham, N. C, from Feb. 8 to 10, burgh. His appointment is also effective Dr. Eugene M. Bricker, '34, associate on May 1. professor of clinical surgery, was chosen president-elect of the Society for Preventive Medicine the year 1952. He presented a paper on "The Role of Pelvic Evisceration in Dr. Robert E. Shank, '39, professor Surgery," during the meeting. of preventive medicine and public Drs. Henry G. Schwartz, George E. health, spoke at the meeting of the Food Roulhac, and Leonard T. Furlow at- Industries Advisory Council of the Nu- tended the meeting of the Southern trition Foundation at Skytop Lodge, Neurosurgical Society in New Orleans Pa., on April 25. •J on Feb. 9 and 10. Dr. Schwartz is secretary of the Society. Radiology Dr. Hugh M. Wilson, '27, professor Gerontology of radiology, was elected president of Participating in a panel discussion the St. Louis Society of Radiologists at on "Better Health for Older People" on a recent meeting. Feb. 27, were Dr. William B. Kontz, Dr. Wendell G. Scott, '32, associate Dr. John Esben Kirk, Dr. Margaret ;i|K ft professor of clinical radiology, gave Chieffi of the Division of Gerontology, two papers before the Post-Graduate and Dr. Sedgwick Mead, assistant pro- Medical Study Course in Radiology at fessor of physical medicine. The topic the University of Kansas Medical Cen- of forced retirement of employees at ter, Kansas City, Kansas, on January 9. an arbitrary age was discussed before He spoke on "Developments in Cerebral a meeting of the St. Louis Academy of Angiography" and "Technical and Clin- General Practice. ALUMNI NEWS 1883 1905 William A. Fries, one of the oldest R. Manton Wilson sends word that he practicing physicians in St. Louis, cele- is now health officer for Henrico County, brated his 90th birthday on January 12 Virginia, and celebrated his 71st birthday by making his regular rounds of patients. in January. Prom 1908 until 1947, Dr. His office now is at his home, 3209 Shen- Wilson was a medical missionary in andoah Avenue, but for 66 years, until a Korea, where he worked with lepers and year ago, he had his office at 1544 S. established a large colony near Soonchun Broadway. The only reason he moved which was named after him. Returning then was that the roof was blown off in a to this country when the second World storm. Dr. Pries lives a quiet life fol- War began in 1941, he was health officer lowing regular habits and getting exer- for the city of Richmond, Va., from then cise by ignoring elevators in hospitals until 1946, when he went back to Korea. and using the stairs. He was advisor on leprosy to the U. S. 1893 Army in Korea and directed a program of gathering lepers and establishing a Arthur R. Stover has changed his address from Kingman, Ariz., to Box 96, colony in an old Japanese fort near Pusan. This latter colony now has 1200 Holbrook, Ariz. He writes that he views with pleasure the progress being made cases of Hansen's disease and is being by the School of Medicine. supplied with food by the V. S. Army. He has had word that the R. M. Wilson 1895 colony recently fell into the hands of Forty "old timers" of the School of the Communists and the patients there Medicine and the University gave a party have been mistreated and scattered. Dr. in honor of Robert J. Terry's 80th birth- Wilson came back to this country and day on January 25. The group included since December, 1948, has been in Hen- maintenance men and secretaries from rico County. He has five sons, four of the School of Medicine, as well as pro- whom are M.D.'s, and two daughters. fessional staff members and friends. A birthday cake with 80 candles and a spe- 1911 cial copy of the Medical Alumni Quarterly J. C. Drake, who practiced medicine at for January, which was autographed by Kerman, Calif., for 30 years before re- .. all those present, were given to Dr. tiring in August, 1948, has accepted a Terry. Among those attending the party position as assistant county health officer were: Dr. Robert Schlueter '95, Dr. Bor- of Fresno County "for the duration." He den S. Veeder, Dr. Philip Shaffer, Dr. conducts 15 child health clinics each Joseph Erlanger, Dr. Sherwood Moore, month, three in the city of Fresno and '05, Dr. E. V. Cowdry, Dr. Robert A. 12 in the county. He now lives at 134 t< Moore, Dr. Mildred Trotter, Miss Agnes W. McKinley Ave., Fresno. O'Gorman, Mr. Erik Carlson, Mr. Paul 1917 Bauer, Mr. Albert Gigi, and many associates from the Department of Anatomy. Robert Mueller has been named chair-

man of the Missouri Advisory Committee ■ 1905 on the Selection of Doctors, Dentists and Robert A. (Dr. Bob) Schlernitzauer has Allied Specialists under the Selective been retired from practice for several Service Act. Dr. Mueller served as head years and is now in the private order of the Physicians' Procurement and As- fruit business with his son at Cocoa, Fla., signment Service in Missouri during in the Indian River fruit country. World War II. His committee duties are MEDICAL ALUMNI QUARTERLY 115 to apportion Missouri physicians, dentists 1929 and allied specialists properly between Craig B. Johnson has moved from the the civilian population and the armed U. S. Naval Hospital in Philadelphia to forces. the Naval Hospital at Bainbridge, Mary- 1923 land, effective March 10. K. W. Steubner recently moved his 1931 office to 35 N. Central Ave., in Clayton, Ben Friedman is at the Veterans Hos- Mo. pital in McKinney, Tex. Elmer 0. Breckenridge can be reached in care of general delivery at Mason, 1932 Texas. Paul Lefkowitz lives in Spring Valley, 1928 N. Y., and his address is 25 S. Main St. Col. Earl Maxwell recently was named 1934 Acting Director of Professional Services, Jane E. Frisch now lives at 5736 Mc- Office of the Surgeon General, U. S. Air Pherson Ave., in St. Louis. Force, in Washington, D. C. Col. Max- Charles E. Stindel has moved recently well was Theater Surgeon in the South to 341 Violet Ave., in Webster Groves, Mo. Pacific from July 1942 to 1944, and for the following nine months was Task 1935 Force Surgeon for the Okinawa cam- Walter K. Langston has offices in the paign in World War II. After a period of Professional Bldg., Springfield, Mo. occupation duty in Japan, he was staff Arthur P. Echternacht has an address member at Letterman Army Hospital at 728 Crest Ave., Fort Dodge, Iowa. from June, 1946, until he took over his John W. Williams is living and prac- present assignment. He was chief of ticing in Oak Grove, Mo. ENT service, has been certified by the 1937 American Board of Ophthalmology, and The address of Lester E. Haentzschel accept^d by the American Academy of is 228 W. College Ave., Appleton, Wis- Ophthalmology and Otolaryngology. COnsln Wilford F. Hall has been promoted to - 1938 to the rank of brigadier general, and Kenneth L. Carter is in Beloit, Wis- now is air surgeon for the Military Air consin, where he is associated with the Transport Service. His specialty is Beloit Clinic as surgeon. E.N.T., and he has studied extensively on Joe Parker is now located at 2516 N. aerotitis. Dr. and Mrs. Hall have two Hudson, Oklahoma City, Okla. children, Ronald Dexter, five, and Carol Robert K. Robinson, Jr., is engaged in Lynne, one year old. They live at 1213 the private practice of maxillo-facial and N. Evergreen St., Arlington, Va. plastic surgery in the Brockbank Profes- Paul I. Kobinson has been promoted to sional Bldg., in Salt Lake City at 141 E. the rank of brigadier general, and his 2nd South St., and reports that he likes new title is Chief of Army Medical and Salt Lake City very much. He and Mrs. Civilian Personnel. His duties include Robinson have four sons. procurement and placement of medical Winfield S. Wilder is director of Mon- personnel; doctors, nurses, dentists, and tana's Mental Hygiene Clinics, with of- medical specialists. The largest division fices at Great Falls and at Butte. His in the Medical Corps also is under Gen. address is 1401 Second Avenue, North, Robinson. In addition to his work at the in Great Falls. He writes that he fre- Surgeon General's office in Washington, quently saw Cornelius Meeker, '38, who Gen. Robinson is on the Medical School was practicing pediatrics in Butte, before staff and teaches eight hours of hospital Dr. Meeker left for navy duty in July, administration each year. 1950. 116 WASHINGTON UNIVERSITY

1939 time basis. As you know, Jim Growden Raymond F. Kuhlmann is living at 21 is professor of oncology here. Last fall Elson Parkway, South Burlington, Ver- Dr. Hayden C. Nicholson, formerly secre- mont. He is a member of the Crippled tary of the National Research Council, Children's Division of the Vermont De- came here as dean. In general the fu- partment of Health. ture of the school looks bright, particu- 1910 larly since the legislature finally provided funds to begin construction of a Mary E. Bowen has a new address at model 400-bed Medical Center, as the 7449 Cottage Grove Ave., in Chicago, Illi- core clinical facility. I believe that Dr. nois. Her practice is limited to obstet- E. P. Gildea has given much consultative rics-gynecology. help to the establishment of our depart- James H. Robertson recently announced ment. the opening of his new offices at 1405 San "At the moment we are looking par- Marino Ave., in San Marino, California. ticularly for a full-time neurologist and He is a diplomate of the American Board would welcome applications. of Otolaryngology, and limits his practice "Betty, Billy, Bob and I are already to ear, nose and throat. comfortably settled into this congenial 1911 city, and would welcome any of you who The office of D. Cramer Reed is located wish to see us at 5501 Grandview Road, in the First National Bank Building in Little Rock. Drop us a line, Sincerely Wichita, Kansas. yours, Bill Reese." Cecil H. Blackburn's office is in the Swift Building, Selma, Alabama. 1913 Henry Schwarz is on the staff of the Edward H. Dunn has been transferred Veterans Administration Hospital in As- to A.N.S. Hospital in Tanana, Alaska. pinwall, Pa. Hans-Karl Stauss can be reached at Mitchell Yanow recently moved his of- 1200 N. State St., Jackson, Miss. fice to 35 N. Central Ave., in Clayton, Mo. Glenn L. McElroy is now at Shriner's Hospital for Crippled Children in St. 1912 Louis, where he will be until he enters Hiraku Ishida is practicing in Los private practice this coming December. Angeles, with his office at 2630 W. Jeffer- son Blvd. 1911 James R. Herz has moved from Kansas Marvin T. Pursell was a visitor to St. City to 508 Humboldt, Reno, Nev. Louis early in April and stopped by the Sven L. Melsraard now lives at 6831 Alumni Office. He is doing general prac- Cherry St., in Kansas City, Mo. tice in Dinuba, California. Glenn 0. Turner is now located at 920 E. Elm St., in Springfield, Mo. 1915 Walter P. Granl has moved from Phila- Samuel B. Guze is a fellow in psy- delphia to St. Louis, where his office is chiatry in the Division of Psychosomatic in the Beaumont Medical Building, 3720 Medicine at W. U. School of Medicine. Washington. Edmund V. Cowdry, Jr., is a fellow in Bill Reese writes the following: "Dear psychiatry on the Medical School staff Alumni (particularly of '42): I recently and lives at 14 N. Kingshighway Blvd. assumed the duties of professor and head William F. Andrew recently moved to of the department of neuropsychiatry at 3410 Tulane Dr., University Hills, West the School of Medicine of the University Hyattsville, Md., from Richmond, Mo. of Arkansas, Little Rock, Ark. The clin- Marshall B. Conrad has moved to 7018 ical departments are now all on a full- Southland Ave., St. Louis. MEDICAL ALUMNI QUARTERLY 117

The address of Betty Ben Geren is 372 Jack A. Gregory is at Huntington Me- Longwood Avenue, Boston, Mass. morial Hospital in Pasadena, Calif. 1946 H. Glenn Kellogg is stationed at U.S. Theodore J. Smith is now a captain in Naval Hospital, San Diego, Calif. On the IT. S. Air Force and is stationed at January 13, he was married to Ensign Station Hospital, Randolph Field, Texes, Dorothy Zulick of Philadelphia, who is a where he is chief of medical service. navy nurse and also is at the Naval Before entering service in January, he Hospital. was on the staff of Scott and White Clinic 1948 in Temple, Texas, in the department of Robert Friedman now lives at 4616 internal medicine. Lindell Blvd., in St. Louis. Garrett Deane is resident in pediatrics at University Hospital, Baltimore, Md. Robert W. Petty is on active duty as He stopped in the alumni office recently senior medical officer on a naval trans- during a visit to St. Louis. port ship plying the Pacific. His home address is 1305-27th St., Ogden, Utah. 1947 Paul F. Brown is at Pfeiffer Memorial Duane R. Taylor is in his second year Hospital, Clinica Americana, Cajon 9, of residency at Jefferson Barracks Vet- La Paz, Bolivia. Before moving to La erans Hospital. His home address is 815 Paz, he was in training at Fresno County Dugan, Jefferson Barracks 23, Mo. (Calif.) General Hospital.

Jn iHemnrtam

1883 associate on the medical school staff Brice Edwards of Richmond Heights, until 1934, when he became emeritus pro- Mo., passed away recently. fessor. Dr. Crossen was author of several textbooks which are still widely 1889 used in medical schools. In 1940, he was John D. Kessenger of Salt Lake City, honored at a testimonial dinner for his Utah, passed away last fall at the age 40 years of service with Washington Uni- of 85. versity, and the oil painting of him which 1891 now hangs in the Medical School Library T. C. Richards of Fayette, Mo., passed was presented to the University at that away recently. time. 1892 1893 Harry Sturgeon Crossen, widely-known Cornelius A. Mann of Glendale, Calif., St. Louis gynecologist, died March 10 at passed away recently at the age of 79. the home of his son, Dr. Robert J. Cros- 1895 ■.-:;; sen, at the age of 82 years. Dr. Crossen, who was professor emeritus of obstetrics- Albert H. Thornburgh died August 15, gynecology on the Medical School staff, 1950, at the age of 80, in West Plains, Mo. had been ill for a long while. He joined 1897 the Washington U. medical staff in 1901 and was chief of the gynecological dis- William 1). Francis of Lampasas, Texas, pensary at the old Washington Univer- passed away recently at the age of 97 in sity Hospital from 1901 to 1911. He was Austin, Tex. He was 92 years old and 118 WASHINGTON UNIVERSITY had served as city and county health 1910 officer of Lampasas. T. P. Gronoway of Macon, Mo., died 1898 March 4, 1951. William H. Hays, of Hannibal, Mo., 1911 Mo., passed away recently. John F. Beatty of Everett, Wash., passed away December 15, 1950, at the 1903 age of 61. Carl Althans, who had practiced in St. Louis for 46 years, passed away April 1920 1 of a heart ailment at his home, 3248 W. Roger Moore, a pediatrician prac- Lafayette Ave. He was 69 years old and ticing in St. Joseph, Mo., died August 16, had maintained offices in his home since 1950, at the age of 54. He was past presi- entering private practice 46 years ago. dent of the Buchanan County (Mo.) Medi- cal Society. 1904 1935 Harry L. Jones, who was associate pro- Robert H. Swinney of Portland, Oregon, fessor of medicine at the University of was drowned in a fishing accident on the Kansas, died in Kansas City December Lewis River, February 8, 1951. Dr. Swin- 13, 1950, at the age of 73. ney had practiced surgery in Portland 1905 since 1941, and is survived by his widow, Arthur M. Gregg of Joplin, Mo., passed Mrs. Ruth Erlanger Swinney, and two away December 14, 1950, at the age of 66. daughters, Peggy, 7, and Patsy, 5. WASHINGTON UNIVERSITY

Arthur H. Compton, Ph.D., Sc.D., LL.D., Bridge Chancellor Charles Belknap, B.S., Vice-Chancellor Leslie J. Buchan, Ph.D., Acting Dean of Faculties Thomas Edward Blackwell, Ph.B., M.S., J.D., Director of Business Administration

The College of Liberal Arts Thomas S. Hall, Ph.D., Dean The School of Engineering Lawrence E. Stout, Ph.D., Ch.E., Dean The School of Architecture Joseph D. Murphy, Dean The School of Business and Public Administration Leslie J. Buchan, Ph.D., Dean The George Warren Brown School of Social Work Benjamin E. Youngdahl, A.M., Dean The Henry Shaw School of Botany Henry N. Andrews, Jr., Ph.D., Dean The Graduate School of Arts and Sciences Carl Tolman, Ph.D., Dean The School of Law Wayne L. Townsend, A.B., LL.B., J.S.D., Dean The School of Medicine Robert A. Moore, M.D., Ph.D., Dean The School of Dentistry Otto W. Brandhorst, D.D.S., Dean The School of Nursing Louise Knapp, R.N., B.S., A.M., Director The School of Fine Arts Kenneth E. Hudson, B.F.A., Dean University College Willis H. Reals, Ph.D., Dean The Summer School Stephen C. Gribble, Ph.D., Director The Henry Edwin Sever Institute of Technology Lawrence E. Stout, Ph.D., Ch.E., Director