'olume 5 FALL 1948 Number 1PROGRAM OF GRADUATE MEDICAL EDUCATIONBelieving that information about the opportunities available foraduate medical training at The Clinics would be of considerable.terest to our members, we are presenting in this issue statements'out the facilities for postgraduate work in the various clinical'partments.In all the departments there are excellent programs for trainingJding to certification by the several specialty boards. In addition,e opportunities at the University of Chicago Clinics for learninge techniques of medical research and for engaging in productive7Yk in clinical and laboratory investigations are unique. They constitute the keystone for the organization of the graduate medicaleducation program.This emphasis on medical research has long been a part of theofficial policy of our school. It has been remarkably fruitful in im­portant contributions to medical knowledge both at the Universityof Chicago and by those who had their training here and have nowgone elsewhere to work. Consequently, every effort is being made toimprove and expand this aspect of the graduate program in keepingwith the improved clinical facilities soon to be available with the com­pletion of the Goldblatt Hospital unit in the late summer of I949.Department of MedicineThe Department of Medicine of theniversity of Chicago offers a three-yearrogram of training in internal medicineid its subdivisions following an intern­.ip of one year. In unusual circum­ances the period of training may benger. Appointments during this period'e on an annual basis, and reappoint­ent is contingent upon acceptable per­rmance.Stress is laid on clinical investigation; an important part of the training of anternist throughout the three-year pe­ad. A relatively short period of orienta­on at the beginning of the assistant-sidency, usually not to exceed sixonths, is permitted but is not requiredefore a research program is settled upon.he amount of time spent in active in­estigation during the assistant residencyay vary widely in individual cases, butrangements for doing some specificark of this kind are completed early.At the time of appointment to the sec­id year of the program, the general na­.re of the research is decided upon, and. e faculty member who is to collaboratethe work or supervise it must haveiproved it.The clinical rotation during the first.ar consists of four services of threeonths each with emphasis on the care ofitients in the hospital. During the sec­rd and third years considerable flexibil­Y' is allowed in the rotation, but usuallynphasis is primarily on work in the out­uient clinics. Rotation throughout the.ree-year program is so arranged as to'ovide a sound training in internal medi­ne. Work may be done in any of theirious out-patient clinics, and trainingavailable in a number of special diag­Istic procedures.(Cont. on page 2) Department of Obstetricsand GynecologyA complete program of residencytraining is offered by the Department ofObstetrics and Gynecology in the ChicagoLying-in Hospital and Dispensary of theUniversity of Chicago.The hospital contains full clinical andlaboratory facilities for obstetrics andgynecology. It has an adult bed capacityof 166, plus 134 bassinets. During the year1947 there were 5,969 in-patient admis-DIECKMANsions, 4,649 obstetric, and 1,320 gyneco­logic. There were 4,II7 deliveries, slightlyless than half of which were clinic casesmanaged by the resident staff under thesupervision of the full-time Universitystaff. The house staff also assists in thecare and delivery of all private patients.There is no home delivery service. A small(Cont. on page 3) Department of SurgeryThe Department of Surgery comprisesgeneral surgery, chest and plastic surgery,orthopedic surgery, genitourinary sur­gery, neurosurgery, anesthesia, ophthal­mology, and otolaryngology. All thesesections are operated as a unit for thetraining of house officers.Twelve rotating internships are of­fered each year beginning July I. Theseappointments provide six months of sur­gery, four months of medicine, and twomonths of obstetrics and gynecology. Insurgery the intern changes services everytwo months, receiving four months oftraining in general surgery and twomonths in one of the specialties. None ofthe interns is assigned to surgical pathol­ogy, ophthalmology, or otolaryngology.Half of the interns rotate through theemergency service for a period of onemonth, during which time valuable ex­perience is gained in the handling of ma­jor and minor surgical problems. Re­search opportunities are provided forthose interns who wish to do investigativework .One straight surgical internship is of­fered annually. This intern shifts everytwo months through three general surgi­cal services and three specialties.Each year one to two of the internswho show outstanding qualifications arechosen for advanced surgical training.These men are appointed' as nonresidentassistants and devote a year or more toresearch in the various laboratories of theDepartment. All the assistant-residentappointments are made from the non­resident assistants.There are six assistant residents in thesection of general surgery who are rotatedirregularly through the various generalsurgical services and surgical pathology at(Cont. on page 5)2 MEDICAL ALUMNI BULLETIN3Jn jIltmoriam. Drell's illness was discovered whenhe was qualifying for duty in theU.S. Naval Medical Corp in 1941.Dr. Drell left The Clinics inJuly, 1946, to practice ophthalmol­ogy in Seattle. At the time of hisdeath he was a member of the KingCounty Medical Society, attendingphysician at Harborview Hospital,and visiting staff physician at theVirginia Mason Hospital. Arrange­ments were also being made for anappointment on the medical staffof the University of WashingtonSchool of Medicine.In addition to his clinical andteaching responsibilities while atThe Clinics, Dr. Drell with Dr.C. P. Miller and associates carriedon an active program of investiga­tion of experimental gonococcalinfection in the rabbit's eye. Hewas a diplomate of the AmericanBoard of Ophthalmology and afellow in the American College ofSurgeons.Dr. Drell was an active memberof the Medical Alumni Associationand will always be remembered byhis associates for his co-operativeand friendly personality. Dr. Drellis survived by his mother, sister-in­law, and brother.DRELLOn May 20, 1948, Dr. MauriceJ. Drell,aged thirty, former instruc­tor in ophthalmology at The Clin­ics, died at his home in Seattle,Washington, of malignant hyper­tension. Dr. Drell was a graduateof the School of Medicine of theUniversity of Illinois in 1939. Afteran internship at Cook County Hos­pital he spent a year in industrialpractice. He came to the Univer­sity of Chicago Clinics as an as­sistant resident in ophthalmologyin July, 1942, and was advanced tothe rank of instructor in 1944. Dr.Department of PediatricsDuring the war when few young doc­tors could obtain specialty training theproduction of qualified pediatriciansslowed almost to a standstill. At the sametime the demand for pediatric skills fromthe public, from educational institutions,and from government and private or­ganizations increased progressively. Tomeet the current shortage, the Depart­ment of Pediatrics has tried to create allthe training positions which its clinicaland laboratory facilities will permit.Feeling that its main energies shouldbe directed toward those who soughtpediatric careers, the Department haswithdrawn from the rotating internshipprogram of The Clinics and now appointsseven straight pediatric interns. No quali­fications other than graduation from med­ical school are required. Each appointeeduring the year rotates through threegeneral pediatric services, the pediatricneurology service, the out-patient depart­ment, a newborn service at the ChicagoLying-in Hospital, and, if he so elects, acontagious disease service at the Syden­ham Hospital in Baltimore.An equal number of assistant residentsis appointed from applicants who havehad at least one year of hospital experi­ence in pediatrics. Their rotation coversthe services enumerated above exceptthat a service at the La Rabida Sani- tarium III Chicago for children withrheumatic fever is substituted for thecontagious disease service at SydenhamHospital.The chief resident, currently Dr. DukeChoy, is responsible for the out-patientdepartment and for integrating the ac­tivities of the resident staff and of theseveral services within the Department.A limited number of fellowships is avail­able for the pursuit of research projects.Dr. Walter Ray Hepner, as Benjamin ].Rosenthal Fellow, is launching a study ofthe newborn infant in collaboration withthe Department of Obstetrics andGynecology.Although their major opportunitiesand responsibilities are centered aboutpatient care, interns and residents haveaccess to clinical and laboratory investi­gation through the attending staff andtheir fields of special interest. The diver­sity of interests encompassed by the pres­ent staff offers an entree to most of thesubdivisions of pediatrics.During service with Dr. DouglasBuchanan the house staff concentratesupon clinical neurology. In addition to thematerial available within the BobsRoberts Memorial Hospital, they visitthe Children's Memorial Hospital weeklyand also observe the sequelae of neuro­logic disease in children through theorthopedic and adult neurology clinics inBillings Hospital. The Lying-in service with Dr. DonaldCassels gives each pair of interns and as­sistant residents responsibility for theexamination and care of about five hun­dred newborn infants- normal, abnor­mal, and premature. During this periodthey observe or participate in prenataland postnatal instruction of mothers, ininvestigations on newborn physiology un­der Dr. Cassels and Dr. Hepner, and inthe studies of newborn pathology anderythroblastosis being conducted by Dr.Edith Potter of the Lying-in staff. Dr.Cassels' interests in pediatric cardiologyalso offer contact with research in cardio­vascular physiology and clinical experi­ence with children suffering from rheu­matic and congenital heart disease atBobs Roberts and at La Rabida.The general pediatric services are con.ducted by Drs. Dorfman, Gezon.i PierceSeckel, and Wright. Dr. Dorfman is ircharge of the clinical biochemical Iabora.tory of the Department and provides bio·chemical advice and technical assistan«to several investigative projects withirthe Department. His major investigation!concern hyaluronidase and its relation t<rheumatic fever. Dr. Gezon, in charge o.the clinical bacteriology laboratory, functions in a similar capacity in his speciafield. His research program centers abouthe action of antibiotic agents upon th,common bacterial pathogens. Dr. Pierce'special interests are in hematology, neoplastic disease in children, and the usc aradioactive isotopes in the study an,treatment of various pediatric conditionsDr. Seckel concentrates upon normal an,abnormal growth and the influence ahereditary and endocrine factors. In addition to the administration of the Department, Dr. Wright has unrelated interestin well-baby care and in experimental infection with neurotropic viruses.Within the Department physically buunder the administration of the Psychiatry Section of the Department of Medcine, Dr. Vander Veer and Dr. Haug corduct a child guidance clinic. Although nformal rotation through this c!inic is previded, the pediatric house staff is kept itouch with its activities through consult:tions, conferences, and student teachiniSpecial work in the clinic is possib.through individual arrangements. .similar arrangement obtains for Mi:Elonen, whose staff for the psycholog:study of children is housed in BotRoberts but administered by the deparments of Psychology and Psychiatry.The enlargement of staff, extension (interests, and accompanying reorganiz.,tions have not been achieved withergrowing-pains. Though further changtare probable, the Department of Pediarics now possesses most of the staff anfacilities necessary to provide both exteisive and intensive training in its field.Medicine-(Cont. from page I)By special arrangement, it is possibfor assistant residents to do some workM EDICAL ALUM NI BULLETIN' 3.her departments of the University,inical or preclinical.In addition, there are a limited num­!r of places for trainees who are not partthe residency program. Some of these'e on a voluntary basis and some onirious fellowships. The experienceLined is similar to the above except for.e hospital service.Dermatology.-Postgraduate trainingdermatology and syphilology is limitedfull-time appointees of the Universityho commit themselves to undergo three-ars' training leading to qualification for.e American Board of Dermatology andzphilology. In the first year they are ap­linted assistant residen ts; in the second.ar, residents; and in the third year, ifey have done satisfactory work, theye promoted to the rank of assistant.The trainees participate continuouslybasic science training courses duringeir period of study. Clinical dermatol­:y and syphilology run through the en­'e three-year period-twenty-two hoursweek being devoted to the former andght hours a week to the latter. The totalImber of patients seen in one year varies'tween 6,000 and 8,000.The training in the clinical subjects isfollows: The day begins with hospitalard rounds from 8: 00 to 9: 30 A.M.uients hospitalized because of derma­ses or syphilis are seen as well as pa­mts for whom consultations have been'quested. From 9:30 A,M. to noon the'sidents take part in the cut-patientrvice. In the first year they take his­ries, perform physical examinations,en present the patient to the attendingan with whom the case is discussed. Ate same time they learn practicallabora­ry methods, including microscopic, his­logic, and serologic techniques. In thecond year, according to progress made,e residents see patients independently.d consult attending men only in case of»ubt. Most candidates do rather inde­ndent work in the third year, seeing.tients on their own responsibility and.ing on consultations to other servicesdependently of the attending man.'isic science study continues through theree years, with two pathology seminars. -ekly, weekly lectures in physiology and. emistry and in bacteriology and irn­unology, and bimonthly lectures in.arrnacology. Each trainee completes'0 to five research studies in the threears.Neurology,-A one-year residency is'ered each year in clinical neurology. Iteludes both out-patient work and re­onsibility for the in-patient neurologyrvice as well as training in neuropathol­y. Joint rounds with the neurosurgeryrvice are held weekly. Opportunities forrrying on research and for more ad­need training in neurology are availablequalified pers�ns.Psychiatry.-A three-year approvedsidency which provides opportunities; both intramural and extramural psy- chiatric experiences, under supervision ofthe senior members of the division, isavailable to graduates in medicine whohave completed a rotating internship.The psychiatric ward contains eleven bedswhich are used chiefly for the evaluationand temporary management of patientswith psychoneurotic, psychosomatic, andpsychotic disorders. The out-patient de­partment is a combined teaching andservice organization in which residentshave opportunities to become acquaintedwith the wide variety of psychiatric prob­lems. Residents also assist in the psy­chiatric consultation service which is pro­vided for all the divisions of a general hos­pital. Psychoanalytic training under thedirection of the staff of the Institute forPsychoanalysis (Chicago) composes anintegral part of the residency. The appli­cants are chosen after interviews with thechief of service and members of the As­sociated Psychiatric Faculties of Chicago.Assistant residents in medicine whodesire to acquire psychiatric experiencemay arrange, subject to the approval ofthe Department of Medicine, to work inthe out-patient department three morn­ings a week for at least one quarter. Twosenior medical students may elect, sub­ject to the approval of the Division ofPsychiatry, to spend one quarter inpsychiatry on a full-time basis. They areexpected to attend all the courses givenby the division as well as its seminars in­cluding weekly Journal Club meetings, towork up and follow selected patients onthe ward and in the out-patient depart­ment, and to pursue a prescribed readingprogram.ROENTGENOLOGYIn connection with its other activities,the Division of Roentgenology of the Uni­versity of Chicago provides graduate in­struction for physicians desiring to qual­ify as radiologists. The period of study isfour years. House officers must have anM.D. degree from an approved institutionand except under unusual circumstancesmust possess United States citizenship(this requirement is necessitated by theLos Alamos service and similar restrictedactivities on the campus in which theDivision of Roentgenology participates) .All the house officers share the respon­sibiities of evening, week-end, and holi­day emergencies. In addition, they assistthe permanent staff in routine diagnosis,therapy, undergraduate teaching, andresearch. Eventually they assume respon­sibility for independent fluoroscopy andfilm' reporting, the timing depending uponthe exigencies of the service and particu­larly on the ability and industry of theindividual.For not less than six months and notmore than twelve, depending on thewishes of the individual and the needs ofthe service, student radiologists are as­signed to radiation therapy, during whichtime they are required to attend autop­sies, clinical pathological conferences, andpathology seminars. From six to nine Resident Staff NewsDr. Gail R. Broberg, former resident inanesthesiology, is now located at St. Mary'sHospital, Evansville, Indiana.Dr. Joaquin Coto writes that he and Dr.R. A. Milia have been appointed directors ofthe Department of Anesthesiology, OperatingRooms, Blood Bank, and Oxygen Therapy ofthe largest charity hospital in El Salvador.They also have a busy anesthesia service in anew hospital for private patients. Equipmenthas arrived from the United States so theyare able to employ modern methods andapparatus.Dr. Allan B. Crunden, Jr., former internin obstetrics, has opened his office at 2 I Plym­outh Street, Montclair, N.J., for the practiceof obstetrics.Dr. Robert E. Green is now an assistantresident in neurosurgery with Dr. EarlWalker at Johns Hopkins Hospital. .Dr. Joel R. Husted, former intern at TheClinics, is at present a resident in medicine atthe University of Michigan.Dr. Lester Jacobs, formerly of the WalterG. Zoller Memorial Dental Clinic, opened anoffice in Chicago for the general practice ofdentistry.Dr. Douglas Morton is out of the armyand has accepted an assistant residency withDr, George Curtis at the Ohio State Univer­sity Hospital.Dr. Francis L. Rook has been associatedwith Dr, Ralph L. Hoffman at 1206 Medico­Dental Building, San Diego, California, sinceJuly I in the practice of gynecology andobstetrics,Dr. J. Saldamando-Cota from the Univer­sity of Guadalajara, Mexico, on April I be­came an Assistant Resident in Anesthesiol­ogy.Dr. Jack Woolf of Dallas, Texas, and Dr.Francis J. Phillips of Temple, Texas, visitedThe Clinics in June.Dr. Martin Paul Woolf, former resident inanesthesiology, has opened an office at 3004South Harris Boulevard, Austin, Texas, forthe practice of medical anesthesia,months are spent at Los Alamos, wherethe routine work is exclusively diagnosisbut where very extensive opportunitiesexist for co-operation in research in thefield of radiobiology. The remainingtwenty-seven to thirty-six months aredevoted to X-ray diagnosis.Throughout the entire forty-eightmonths students are encouraged to attendseminars and conferences in various areasin the University and at least to col­laborate in research that is going on in theDivision of Roentgenology or preferablyto engage in independent investigation.Obstetrics and Gynecology-(Cont. from page 1)amount of the gynecologic work of theDepartment is conducted at BillingsHospital.The out-patient department, a unit ofthe Max Epstein Clinic, received 39,602patient visits during 1947, The house staffparticipates in the care of these obstetricand gynecologic patients. The Hospitalalso maintains a clinic in the Stock Yardsdistrict.tCont. on page 5)4 MEDICAL ALUMNI BULLETINSCIENTIFIC SECTIONRoentgen Irradiation inPeptic UlcerBy WALTER LINCOLN PALMER, WILLIAME. RICKETTS, ANNA HAMANN, JOSEPHB. KIRSNER AND ERWIN LEVINIn the last eleven years the effect ofroentgen irradiation upon the stomachand upon the course of peptic ulcer hasbeen studied. The use of this procedure isbased, first, upon the concept that acidgastric juice constitutes the sine qua nonfor peptic ulcer and, second, upon the factthat radiation depresses the secretorycapacity of the stomach.Four different radiation techniqueshave been used, although several factorshave remained the same: the quality ofthe radiation of H.V.L. 1.5 mm. cu. pro­duced by 200 PKV and r mm. Al filtra­tion, and an intensity of the radiation ofapproximately 33 r in air per minute ob­tained with 20 M.A. at 50 ern, F.S.D.The techniques varied in number of treat­ments, duration of radiation, and size ofthe portals. The total depth dose wasr600 to 2500 r in Technique I, r600 r inII, r roo to rsoo r in III, and 666 to rooor in IV. The value of the procedure wasfound to be proportional to the reductionin the gastric secretion. There was no cor­relation between the effect of treatmentand the age of the patient or the durationof the disease. The incidence of post­irradiation achlorhydria in patients withgastric ulcer was higher than in thosewith duodenal or jejunal ulceration. Thehigher doses (Technique I) in' cases ofgastric ulcer produced o r per cent ofachlorhydria as compared with 48 percent in Techniques III and IV. In duo­denal ulcer, Technique I produced SO percent of achlorhydria and Technique IVonly 9 per cent. The achlorhydria variedin duration from a few days to as long asseveral years.In a gastroscopic and histologic studyof the gastric mucosa after irradiation in aseries of a hundred cases, the anatomicbasis was found to be an acute inflamma­tory reaction. Irradiation gastritis is char­acterized gastroscopically by hyperemia,hemorrhage, edema, and adherent exu­date; histologically, by degenerativechanges in the epithelial cells and lymphfollicles, increased cellular infiltration,and relatively minor changes in the bloodvessels. Atrophy of the mucosa oftenensues; it is uniformly present in patientswith prolonged postradiation anacidity.The patients known to have had achlor­hydria for several years remained wellclinically in spite of the atrophy seengas troscopi cally.In one-third of our cases of gastriculcer the level of the acidity did not re­turn to the previous level; in some, per­manent achlorhydria developed. Per- manent depression of secretion was muchless common in duodenal ulcer. In noinstance was ulcer pain present in thephase of achlorhydria regardless ofwhether the ulcer had healed or not; in­deed, the pain almost always disappearedon ulcer management long before achlor­hydria developed. Healing of the ulceroccurred in variable periods of time,usually within a few weeks; in one in­stance six months were required for theprocess to become complete. Healing oc­curred in from 87 to 93 per cent of thepatients given r roo r or more. Achlor­hydria of three months' duration in­variably resulted in healing. Recurrencewas always preceded by reappearance ofacid gastric secretion. If the acid did notreturn, the ulcer did not r�cur. If acid re­turned the ulcer sometimes recurred.These' observations constitute furtherevidence of the essential role of hydro­chloric acid in the pathogenesis andcourse of peptic ulcer.Our patients were treated with theconventional Sippy program, radiationtherapy being added. By comparing theincidence of recurrence in patients treatedwith radiation with others not receivingsuch treatment, it seems evident thatradiation significantly lowers the fre­quency of recurrence. This is particularlytrue of gastric ulcer and is presumablydue to the lower secretory rate, as Levinet al. have shown, and also to the fact thatin this group the secretion is more easilydepressed by radiation..It is not possible at present to appraiseexactly the permanent effect of radiationupon secretion or upon the course of theulcer be it gastric, duodenal, or jejunal.Furthermore, the most effective and yetconservative technique of radiation re­mains to be determined. It appears thatthe best results are obtained with thelargest doses, but these must be keptwithin the limits of safety.The Enzymatic Oxidation ofFatty AcidsBy ALBERT L. LEHNINGERDepartments of Surgery andBiochemistryThe enzymes and chemical intermedi­ates involved in the oxidation of fattyacids in the tissues of the body have notbeen very well understood in the past be­cause the enzymes responsible for catalyz­ing this process were found to be sounstable that they could not be studiedin the test tube in cell-free tissue extracts.Work done in this laboratory has dis­closed that these enzymes can be acti­vated by the addition of certain necessaryconfactors so that the enzymatic activitycan be readily studied independent of theintact cell. The enzyme system which catalyzes the oxidation of fatty acids tcacetoacetic acid and ultimately to carbordioxide and water in the liver and othetissues requires the presence of adenimnucleotides, Mg++, certain other neutyasalts, catalytic traces of oxalacetate, Inorganic orthophosphate, and cytochromec. In the absence of anyone of these components the enzyme system is inactiveThe enzyme system oxidizes the highefatty acids, both saturated and unsaturated with either odd or even number 0carb�ns in the chain. The main product iacetoacetic acid. For instance, palmitiacid is oxidized to form four molecules (acetoacetate. However, if sufficieroxalacetic acid is also present, the reartion proceeds to complete com.bustion. tCO2• This occurs by enzymatic reactroof 2-carbon intermediates, formed durinfatty acid oxidation, and oxalacetate tform citric acid and eventually carbodioxide via the Krebs tricarboxylic acicycle.The function of inorganic orthophophate and adenine nucleotide in enz�matic fatty acid oxidation is to serve;an energy-transmitting mechanism. Jthe fatty acid is oxidized, energy is libeated and is conserved by the formationthe so-called "high-energy" phosphabonds of adenosine triphosphate. Thwas established by the use of p32 astracer.The enzyme system depends on tlpresence of certain neutral .salts for ativity. This led to the finding that t.enzyme systems which are responsibl� fthe oxidation of fatty acids in the ltvand for oxidation of carbohydrate ov.the Krebs tricarboxylic acid cycle are atually localized in small granules of clular cytoplasm called mitochondrThese particles were found to POSSfmost if not all, of the organized respiitory machinery of the liver cell and migtherefore be regarded as cellular "poV'plants."These investigations represent onlybeginning toward a complete understaring of the enzymatic mechanisms of fat"acid oxidation, but with the finding tIthis process can be studied free of thetact cell the way is open to isolationindividual enzymes and interrnediainvolved in this process.A Specific Therapy forVaginal MycosisBy H. CLOSE HESSELTINE, M.D., MEDMUND S. BECKETTE, M.D.(From the Department of Obstetrics,Gynecology, The University of Chica.and The Chicago Lying-in HospitalVaginal mycosis is encountered,most instances, in the gravid stateuncontrolled diabetic patients. TlMEDICAL ALUMNI BULLETIN 5rg�nis�s can be cultured from theagma In 25-41 per cent of pregnantatients=-while a fair percentage will de­elop symptoms of severe pruritus. The-ganism can. be found in the gastro­itestinal tract of normal college men andomen. The distribution is thus evident.esides producing sleeplessness and dis­'ess in the pregnant and diabetic indi­iduals, the newborn is exposed by con­unination at or after birth to an oral.fection which can be fatal.The placing of glucose or most of theimrnon sugars (lactose is a usual excep­on) in the vagina harboring these funginonilia albicans or candida albicans)ould result in a mycosis. The diabetic,irticularly the uncontrolled one, has theost favorable circumstances for vaginal.ycosis. In pregnancy the vaginal epithe­rm rich in glycogen-like material pro­rces a favorable medium just as occursthe postmenopausal patient on exces­ve estrogen therapy.Gentian violet in 1- 5 per cent concen­ation in aqueous or glycerine vehicle hassen used generally but is not entirely.tisfactory. Some patients were sensitive, this dye. After laboratory tests of arge number of compounds, the more.omising were given more careful study.Of the various agents, ricineolic acidas selected finally for the crucial analy­s on a large number of patients. Thisaterial is colorless, nonirritating to theigina and vulva, inexpensive, and non­jurious to garments. In the group re­irted 72 per cent of the obstetric and 89�r cent of the gynecologic patients be­ime asymptomatic within one week orloner. The material was dispensed in aagacanthacacia jelly. It cured those whoIlowed directions and practiced properilvar and perineal hygiene.By controlling the mycosis of preg­mcy, oral thrush in the newborn at thehicago Lying-in Hospital has been re­iced greatly. This control eliminates:actically all danger of spread to otheribies in the nurseries.ibstetrics and Gynecology­(Cont. from page 3)The work in the residency program isrgely clinical, but opportunities arerailable in the departmental laboratoriesr those qualified for research in the fieldobstetrics and gynecology and forudy in the fundamental branches ofedicine.Prospective candidates for appoint­ent to the resident staff serve a six­onth period of straight internship in ob­etrics. At least one previous year ofternship, preferably of the rotating typenajor in medicine), is prerequisite totch an appointment, of which six areade each quarter. Special work in anythe basic sciences, medical sciences, oraching experience is regarded favorably.Three of the six months are spent inre clinic and in hospital care of normalid abnormal pregnant and puerperal patients, in the care of newborn babiesunder direction of the staff of the Depart­ment of Pediatrics, and in giving emer­gency anesthetics. The remaining threemonths are served in the birthrooms.Here each intern is trained in the diag­nosis and conduct of normal and abnor­mal labor, in the use of forceps, in thetechnique of episiotomy, and in the ad­ministration of spinal (saddle block) anes­thesia. He also assists with the major op­erative deliveries of abnormal patientsand with private patient deliveries. Thereis some nonoperative gynecology in theclinic, and a portion of the interns rotateon the gynecology wards and operating­rooms.One appointment to the resident stafffor specialization in obstetrics and gyne­cology is made every six months fromtwelve second-year interns. The appoint­ment is for one year and is renewed forsubsequent periods if the individualshows ability.The services for the residents are di­vided as follows:A twelve- and an eight-month period asfirst assistant to two of the senior staff. Dur­ing this period the resident is first assistant onall the private cases and is the assistant resi­dent on the ward service of his chief.Four months in the laboratories: chemis­try, bacteriology, endocrinology, and pathol­ogy.Four months as resident in charge of theobstetric floors.Four months as resident in charge of thegynecologic service.Four months as resident in charge of theobstetric service.During these last two periods the resi­dent is responsible for the supervision andteaching of the students, interns, and as­sistant residents on his service, and iseither the operator or first assistant on allstaff patients. Subsequent to this servicean appointment as an instructor may bemade.There are also positions open for quali­fied persons as nonresident research as­sistants, who may receive compensationfrom departmental or special fellowshipfunds.Surgery-(Cont. from page I)yearly intervals. The assistant residentacts as first assistant at all operations onhis service, supervises the work of theinterns both on the wards and in theemergency room, and attends the out­patient clinic where he has an oppor­tunity to see new patients and follow oldones. He carries out minor surgical proce­dures, and, as his ability and experiencedevelop, he is given more responsibilityuntil he is able to perform independentmajor procedures. He helps in the teach­ing program and is encouraged to carryonoriginal investigative work.Each of the assistant residents spendsat least one year in the surgical pathologylaboratory which is under the Depart­ment of Pathology. He is closely super- vised by a full-time member of that De­partment. He takes a major part in theteaching of surgical pathology and is re­sponsible for the . surgical portion of theweekly pathology conferences.The resident surgeon is chosen fromamong the assistant residents who havecompleted a five-year period of trainingin surgery and is appointed to serve oneyear. He holds an appointment as an in­structor in surgery of the University ofChicago and attending surgeon of theAlbert Merritt Billings Hospital. In addi­tion to taking an active part in the teach­ing program and being responsible for thepatients on his service, he supervises thework of the resident staff and has chargeof the surgical emergencies.In orthopedic surgery the resident staffconsists of two assistant residents and oneresident. The period of training is fiveyears and includes bone pathology, frac­tures, and child and adult orthopedic sur­gery. The resident may hold a concurrentappointment as instructor in the Depart­ment of Surgery.The urology section offers two assist­ant residencies and one residency. Theperiod of training is three years. The firstyear (junior assistant resident) is devotedto investigative work. The second year(senior assistant resident) is spent in clini­cal training. The third year is the resi­dency. The resident supervises the internand assistant resident, works in the urol­ogy clinic, assists at all operations, andmay perform independent operative pro­cedures.The training in neurosurgery covers aperiod of three years. The first year the as­sistant resident works on the clinical serv­ice supervising pre- and postoperativecare, taking charge of minor procedures,and acting as second assistant in the op­erating room. The second year is spent inthe laboratory doing investigative work.He also receives instruction and trainingin neuro-ophthalmology, neuroanatomy,neuropathology, and electroencephalog­raphy. The third year he serves as resi­dent, acting as first assistant at opera­tions, supervising the work of the as­sistant resident, interns, and medical stu­dents, in pre- and postoperative care ofthe patients. He carries out minor surgicalprocedures, opens and closes the majorcases, and carries out independent majorprocedures as his ability develops.The University of Chicago Clinics wasone of the first to be approved for a resi­dency in anesthesia. There are four as­sistant residencies and four residenciesavailable. The period of training is twoyears. A few third-year appointments areavailable to those who show outstandingqualifications. The training program isgraduated, commencing with the periodof initial observation and close supervi­sion. Experience is gained in all types ofapproved anesthetic. agents and methodsfor general surgery and all the specialties,including inhalation therapy. In additionto the clinical work, a period of time is(Cont. on page 6)6 MEDICAL ALUMNI BULLETINALUMNI NEWS'37. Charles C. Scott, formerly head of theDepartment of General Pharmacology, EliLilly and Company, has joined the InlowClinic, Shelbyville, Indiana, where he is prac­ticing internal medicine. His brother, V.Brown Scott, '35, has been associated with theInlow Clinic for several years.'38. Henrietta Herbolsheimer, formerlychief of hospital construction and services inthe Illinois State Public Health Department,has been named Medical Administrative As­sistant to Dr. Roland R. Cross, State PublicHealth Director of Illinois.'38. David S. Pankratz, Dean of theSchool of Medicine at the University of Mis­sissippi, attended the cancer co-ordinators'meeting held at The Clinics in October.'42. Marjorie White Hill and Lyndon M.Hill recently announced the opening of theiroffice in Jamaica, New York.William S. Hunter, having completed hisresidency training in internal medicine at theMassachusetts General Hospital in Boston, isnow associated with the staff of the MasonClinic in Seattle.William F. Renner completed his resi­dency at Union Memorial Hospital in Balti- more in July and opened his office for thepractice of internal medicine at II WestTwenty-ninth Street, Baltimore 18, Mary­land.'43. William H. T. Murray was appointedADAMSON, NEIL, JIM,GIBSON, CARPENTER, NAPTON a Fellow in Psychiatry at The Clinics in July.Joseph A. Parks is a Kellogg Fellow inRoentgenology at The Clinics as of July I.William R. Wicks, former resident inanesthesia, is now Chief of Anesthesiology atSt. Joseph's Hospital, Alton, Illinois.'45. Ralph F. Carlson, Peter V. Moulder,Jr., and Edward H. Storer were appointedresearch assistants in Surgery at The Clinicson July I.'46. Duval Jaros is in charge of the Dis­pensary, Eleventh Naval Headquarters, SanDiego, California. He plans to be out of theservice next April and hopes to specialize inophthalmology.'47. Sam S. Barkulis is now a ResearchFellow in Surgery at The Clinics, and RobertG. Frazier is an Assistant Resident inPediatrics, both as of July I.'48. Robert Adamson, Robert Jim, andRichard Neil, who are interning at HighlandAlameda County Hospital, sent in the abovephotograph of themselves and William Nap­ton, Elmo Carpenter, and Harland Gibson,who are graduates of the Hospital Adminis­tration given at Billings and are now adminis­trative interns at the same hospital.FACULTY NEWSDr. Wright Adams is now president of theJackson Park Branch of the Chicago MedicalSociety.Dr. Alf S. Alving was among ten Chicagoscientists who were presented with the Presi­dent's certificate of merit at a meeting of thePublic Affairs Committee of the Chicago As­sociation of Commerce in the La Salle Hotel,July 14. Other University of Chicago facultymembers honored were: Dr. Weldon G.Brown, Dr. Thorfin R. Hogness, Dr. WarrenC. Johnson, Dr. Morris S. Kharasch, Dr.Lawrence Murray Graves, and Dr. DarrellWayne Osborne, Argonne National Labora­tory.Dr. Paul R. Cannon was awarded theWard Burdick gold medal given by the So­ciety of Clinical Pathologists for his outstand­ing contributions to clinical pathology at theannual meeting of this group in October.Dr. Lowell T. Coggeshall received anhonorary degree in June from the Universityof Indiana for his contributions to humanwelfare.Dr. William H. Fishman, formerly as­sistant professor of biochemistry and surgeryat the University of Chicago, on July I be­came research professor of biochemistry inthe departments of surgery and biochemistryat Tufts College Medical School in Boston.Dr. Fishman will also serve as associate direc­tor and chief biochemist of the Cancer Re­search and Cancer Control Unit in theZisk.ind Research Laboratories of the NewEngland Medical Center.Dr. Ralph W. Gerard, Professor of Physi­ology, recently spent a month in Greece as amember of the Medical Mission of the Uni­tarian Service Committee. This trip includedperiods spent at the medical schools inAthens and Salonika.Dr. H. C. Hesseltine has been elected anAlternate Councilor-at-Large of the ChicagoMedical Society. Dr. Charles B. Huggins, Professor ofUrology, has been awarded the FenwickPrize, a gold medal, by the Societe Inter­nationale d'Urologie for work on the en­doctrine control of cancer of the prostate.Dr. Dallas B. Phemister is president of theInstitute of Medicine of Chicago.Dr. Stephen Rothman on June 20 waselected president of the Society for Investiga­tive Dermatology.Surgery-(Cont. from page 5)spent in research and instruction in theDepartment of Pharmacology. Oppor­tunities are available for obtaining a com­bined Ph.D. in anesthesiology andpharmacology.The resident staff in ophthalmologyincludes a resident and three assistantresidents. The period of residency is threeyears-Two additional positions which areequivalent to that of assistant residentare available for full-time voluntary as­sistants for a term of one year. In thetraining of junior residents, clinical andmedical ophthalmology is emphasized. Acourse of study in ocular anatomy, his­tology, and pathology is covered in thesecond year of residency. The resident ismade a responsible member of the Divi­sion of Ophthalmology.The section of otolaryngology has oneresident and two assistant residents. Inaddition, a voluntary assistant may beappointed for one year either as a clinicalor as a research assistant. Residency can­didates who have taken an organizedcourse in basic science in preparation forthe specialty are given preference. Theresidency is for a period of two years fol- lowing a basic science course, otherwis€for three or more years depending uponrequirements of the American Board fOlcertification. Members of the residen1staff work in the out-patient departmen1and on the hospital service where thenduties at the beginning are closely super­vised by the senior staff. As they pro­gress, they are given more and more reosponsibility. In addition, training is giverin endoscopy, anatomy, histopathologyand the diagnosis and treatment of speeddisorders. Opportunities are available fa:investigative work. A special electroacoustical laboratory is equipped for investigation of special problems connecterwith audition.The resident training program in eadsection of the Department of Surgery idesigned to qualify men for their respective specialty boards, stimulate interesin investigative work, and develop highl;competent physicians who will be a tribute to surgery of the future.First Phemister LectureThe first Dallas B. Phemister Lecturwas given by Professor James F. Brailsford, the Hunterian Professor of Radialogy of the Royal College of Surgeons­London, on November 10, at 7: 00 P.M. iPathology 117. Professor Brailsford spokon "Sclerosing Conditions of Bone."Society of Clinical Surgery Meetat BillingsThe Society of Clinical Surgery meat Billings Hospital on October 29, wher.they were guests at operations and lee:tures presented by our staff.MEDICAL ALUMNI BULLETIN 7.ppointed Head of ClinicalBacteriology and SerologyMr. Ross S. Benham has been put in.arge of Clinical Bacteriology and·rology at Billings. He replaces Misselen Van Sant, who was in charge ofedical Bacteriology and Serology frome opening of The Clinics until her resig­.tion this July. Mr. Benham, a native ofrlgary, Canada, has had all his profes­mal training at the University of Chi-BENHAMgo. He was for a number of years inarge of the clinical laboratories of theuskoka Hospital, Muskoka, Ontario.Iring the war he came to Chisago to.rk under Dr. William Burrows in Bac­.iology for O.S.R.D. This was followedan Eli Lilly Fellowship in Bacteriol­y. He will soon complete his work for! Ph.D. degree .. Mr. Benham has al­idy begun the work of reorganizing theioratories so that they may betterve the constantly increasing work load.3ULLETINf the Alumni Association'he University of Chicago�CHOOL OF MEDICINE·OL.S FALL 1948 No.1CHARLES L. DUNHAM, EditorHUBERTA LIVINGSTONE, Associate EditorHENRY T. RICKETTS, Associate EditorROBERT H. EBERT, Assistant EditorALLAN T. KENYONFRANCIS B. GORDONHILGER P. JENKINSMembers oj the Editorial BoardMARIE ECKERT, SecretaryII rice of yearly subscription for nonmembers, $1.00;-ice of single copies, 25 cents. BecomesProfessor of Pathology andCancer Co-ordinatorDr. Paul Steiner, for sixteen years amember of the Department of Pathologyhas been made Professor of Pathologyand cancer co-ordinator. Dr. Steiner re­ceived his M.D. degree from Northwest­ern University in 1932, and his Ph.D. de­gree from the University of Chicago in1933. He has been interested in neoplasticdiseases ever since he came to the Mid­way as a National Research Council Fel­low in Medicine. His first work here wasdone under Dr. H. Gideon Wells on theetiology of Hodgkins disease. Since thenhe has made many important contribu-STEINERtions to oncology. Dr. Steiner's specialfield of interest is naturally occurringcarcinogens. During World War II heserved in the Navy as lieutenant com­mander andcommanderfrom 1943 to 1946.As cancer co-ordinator, Dr. Steinerwill administer a U.S. Public HealthService grant of $25,000 yearly for fiveyears. This money is made available forthe improvement of teaching and re­search on cancer. In this capacity Dr.Steiner will have contact with all work incancer in the various departments andwill be in a position to stimulate studentsand junior staff members to take an ac­tive part in research projects in this gen­eral field. During the first week of Octoberhe was host to seventy newly appointedcancer co-ordinators representing medicalschools from all over the country.Dr. Steiner is a member of the follow­ing professional societies: American As­sociation of Pathologists and Bacteriolo­gists, American Association for CancerResearch, American Society for Experi­mental Pathology, American Associationfor the Advancement of Science, ChicagoPathological Society, Society for Experi­mental Biology and Medicine. He hasjust been appointed editor of the journalCancer Research and will take officeJanuary I, 1949. BIRTHSDr. and Mrs. E. L. Laden-Martha, Feb. I,1947Dr. and Mrs. E. R. Woodward-adoptedSusan Louise, born May 26, 1947Dr. and Mrs. C. F. Williams-Charles E.,June 26, 1947Dr. and Mrs. Nels Strandjord-David Chris­tian, July 19, 1947Dr. and Mrs. Frank Evans-Michele Mach­rae, Aug. 8, 1947Dr. and Mrs. Robert Snapp-Alan Harvey,Sept. ro, 1947Dr. and Mrs. R. L. Watterson-Jean Marie,Sept. 20, 1947Dr. and Mrs. W. D. Hawk-e-ChristopherAlan, Sept.' 25, 1947Dr. and Mrs. F. W. Johnson-Neil Philip,Oct. 20, 1947Dr. and Mrs. P. J. Clark-Peter Conger,Nov. II, 1947Dr. and Mrs. A. H. Vander Veer-PeterJames, Nov. 26, 1947Dr. and Mrs. R. L. Nichols-Russell Law­rence, Jr., Nov. 26, 1947Dr. and Mrs. James Goldinger-RichardWilliam, Dec. IS, 1947Dr. and Mrs. Judd Uhl-Mary Anne, Dec.16, 1947Dr. and Mrs. Alfred Kahn-James Martin,Dec. 30, 1947Dr. and Mrs. Vernon Jim-Sandra Vat Ngo,Dec. 30, 1947Dr. and Mrs. Otto Trippel-Stephen Bow­man, Jan. 25, 1948Dr. and Mrs. W. C. Halstead-adoptedBeecher, February 3Dr. and Mrs. E. J. Fredrickson, Jr.-WilliamTirnm, February 4Dr. and Mrs. C. L. Spurr-Charles Louis,Jr .-February 9Dr. and Mrs. J. W. Carpender-StephenBleecker, February 9Dr. and Mrs. Ralph Victor-Joyce Emily,February 12Dr. and Mrs. N. B. McCullough-RobertNorman, February 17Dr. and Mrs. Jacob Zuidema-Linda Jayne,May 2Dr. and Mrs. L. O. Jacobson-adoptedJudith Ann, born May IIDr. and Mrs. Winslow Fox-Lorraine Marie,May 14Dr. and Mrs. Edward Horner-Martha June,May 16Dr. and Mrs. Robert Smitter-Robert, Jr.May 16Dr. and Mrs. Joseph Parks-Kathleen, May17Dr. and Mrs. J. A. Rider-Charles Alfred,May 19Dr. and Mrs. Frederick Kittle-BradleyDean, May 19Dr. and Mrs. Jerome Feldman-Jill Elaine,June 2Dr. and Mrs. Pompeyo Chavez-Jeffrey,June 7Dr. and Mrs. John B. Fuller-Lynn Jeanette,June 17Dr. and Mrs. Jay Jacoby-Carolyn Sue, June18Dr. and Mrs. Charles McKeen-Charle,Richard, July 8Dr. and Mrs. W. D. Garrard-Linda Mau­rine, August 11Dr. and Mrs. Ralph F. Carlson-SusanElizabeth, August 16Dr. and Mrs. Peter V. Moulder-MaryElizabeth, September IDr. and Mrs. Wilbur L. Flesch-KarenElizabeth, September 4Dr. and Mrs. Norris L. Brookens-MarilynElaine, September 88 MEDICAL ALUMNI BULLETINASSOCIATION ACTIVITIESDr. Loosli Retires as Presi­dent and EditorThe officers of the Alumni Associationwish to express their appreciation for thesplendid job performed by Dr. ClaytonG. Loosli during the past year in his dualcapacity as president of the MedicalAlumni Association and editor of theBULLETIN. Under his leadership the or­ganization has become financially sol­vent and reached an all-time high in ac­tive membership. The June Reunion Ban­quet was Dr. Loosli's idea, and it waslargely through his enthusiastic efforts ingaining the support of the alumni andfaculty that the banquet was a completesuccess. As for the BULLETIN, the lastfour issues speak for themselves.Annual Appeal for Duesand GiftsEach autumn annual dues are payable,and a drive for gifts is made. The low rateof dues ($2.00 a year) does not providesufficient revenue to support the publica­tion of the BULLETIN and other activitiesof our association. Additional contribu­tions, therefore, are necessary from thoseable to make them. It is hoped that theresponse this year will be great enough sothat the present dues rate can be con­tinued, since it permits our alumni withlow incomes to participate.Last year an appeal of desperation was IN THIS ISSUEThe clinical departments present theirresidency and postgraduate training pro­grams. Albert Lehninger, AmericanChemical Society Paul Lewis Awardwinner (see summer, 1948, BULLETIN),summarizes his work on fatty acidmetabolism. Palmer, W. Ricketts,Hamann, Kirsner, and Levin summarizea dozen years' observations of the effect ofX-ray therapy on peptic ulceration.Hesseltine and Beckette describe thelatest method for the control of vaginalmycoses. Steiner is promoted to Professorof Pathology and appointed Cancer Co­ordinator for the University of Chicago.The Clinics Guild continues to carryonits active program of voluntary assistancein the work of The Clinics. The BULLETINfinally catches up on the added responsi­bilities assumed by its membership (see"Births").Don't fail to read and to act generous­lyon the annual call for dues and gifts.made by a nearly insolvent organization.The response was highly gratifying. Ourfinancial position is about $800 betterthan last year. There is still very littlereserve, however, and our costs have in­creased somewhat. With the help of thegenerous support of the membership, Dr. Loosli, president and editor of the BUL­LETIN, was able to increase the size ofsome of the issues and to publish regu­larly. Continued generous support will berequired if our new officers are to carry onin the pattern of last year and further ex­pand activities. Our appeal this yearcomes from a successful organization, butsupport is nonetheless necessary, for ourreserves are very low.During the period when our financialposition was bad, the University contrib­uted the salary of our part-time secre­tary. The Association will meet this ex­pense during the current year, as we wishto be as self-supporting and independentas possible.This means that support from ourmembership, as good as or better than wereceived last year, is required, or our pro­gram must be curtailed. Last year we re­ceived $871 in dues and $1,240 in gifts.The average contribution was $5.00. Ifeach of us will contribute as much as he isable, the continued success of the Associa­tion will be assured.Medical Alumni Office inNew LocationThe office of the Medical Alumni Asso­ciation secretary, Miss Marie J. Eckert,is now located on the first floor of Billingsin Room M-130 (Blood Bank). All alumniand former members of The Clinics staff'are urged to send news and changes ofaddress to Miss Eckert.Mrs. Leon O. JacobsonHeads U. of C.Clinics GuildAt its last meeting the UniversityClinics Guild, which is in its second year,elected the following officers for the com­ing year: Mrs. Leon O. Jacobson, chair­man; Mrs. Clayton G. Loosli, first vice­chairman; Mrs. Lester R. Dragstedt, sec­ond vice-chairman; Mrs. Paul D. Voth,treasurer; and Mrs. Henry B. Periman,secretary.In November, 1946, invitations weresent to the wives of the men on the hos­pital staff and in the Biological SciencesDivision to attend a tea for the purpose oforganizing a women's auxiliary in TheClinics. The aim of the auxiliary was toafford an opportunity for the wives to getacquainted with each other and with thework of The Clinics and to help in anyway in which they might be needed.More than a hundred women indicateda desire to take part in such a project, andthe University Clinics Guild was organ- ized. Mrs. C. Phillip Miller was electedchairman, with Mesdames C. HowardMRS. JACOBSONHatcher, Walter L. Palmer, WrightAdams, and William Burrows serving as the other officers (see October, 1947,BULLETIN).During this year and a half, the Guildhas made a place for itself in variousways. It has furnished about forty vol­unteers who read to patients, do wardwork, help in physiotherapy and X-ray, .do clerical work, and make surgical dress­ings. It has responded to many requeststo furnish workers for various assign­ments, ranging from trimming Christmastrees to acting as guides or hostesses formedical meetings.Mrs. Hatcher has conducted threecourses for training hospital aides, thusproviding for many hours of service to thehospital. Mrs. Robert Weiner has had,charge of a mending group, which ha�made a genuine contribution to the workof the Housekeeping Department. Undeithe sponsorship of the Guild, a number 01faculty homes have been opened to memobers of the resident staff and their wive:for Sunday afternoon teas. In additionthe Guild keeps its members and theihusbands informed as to what is going 01'in the Division by the publication of ;monthly newssheet, Inside InformatiMI