Volume 9 WINTER 1953 Number 2ATOMIC HOSPITALBy LESTER SKAGGS, PH.D.Associate Professor of Medical Physicsand Director of Health Physics Serv­ice, section of radiology, Argonne Can­cer Research HospitalCOMPLETED at last after nearlythree and one-half years of building,the Argonne Cancer Research Hospitalstands as the latest addition to the Uni­versity of Chicago's center of medicaland biological research. The date of open­ing is a different day to different people.To many of you the most significant dateis January 10, 1953, when the first pa­tient was admitted to the third floor ofthe new hospital. The official openingdate, with dedication ceremonies, isMarch 14.'This new hospital was built by theAtomic Energy Commission on landleased from the University of Chicago.The purpose of the Commission in estab­lishing this hospital was to provide supe­rior facilities for treatment and study ofneoplastic diseases with radiation, in­cluding both radiations produced arti­ficially by man-made machines and thoseproduced by radioactive materials. Thehospital is to be regarded as a researchhospital in every sense of the word andis not to be used for the treatment ofcommon diseases or even for the treat­ment of cancer by methods already es-tablished. .The hospital is operated by the Uni­versity under a contract similar to butnot part of the contract for the opera­tion o-f the Argonne National Labora­tory. Nevertheless, there will be closeco-operation with the Argonne Labora­tory, and the participating institutionsof the Argonne Laboratory will have theprivilege of sending qualified physiciansand scientists to the hospital to engagem selected research problems. However,the responsibility for individual patientswill rest with the faculty of the Schoolof Medicine of the University.Responsibility for the scientific pro­gram and the efficient operation of thehospital rests with the dean of the Divi­sion of the Biological Sciences, LowellT. Coggeshall. The responsibility for theday-by-day administration of the hospi- THE VAN DE GRAAFF GENERATORThe rwo-miltion-volr Van de Graaf generator recently installed for cancer research andbiological investigations in the subbasement of the Argonne Cancer Research Hospital.This machine will be used to compare the efficacy of two-rnilhon-volr Xvrays with that ofthe gamma rays from radioactive cobalt.2 MEDICAL ALUMNI BULLETINJACOBSONtal has been delegated to the director,Leon Jacobson, professor of medicine inthe University. Dr. Jacobson is specif­ically responsible for the selection andplanning of the research program, ap­pointments to the professional staff, as­signment of space and facilities, and de­velopment of the budget. He is also re­sponsible for the development and en­forcement of the regulations for controlof radiological and other hazards to pa­tients and staff and for direct control ofclassified documents. The director is as­sisted in his duties by the associatedirector, Robert J. Hasterlik, assistantprofessor of medicine. In addition, Dr.Hasterlik has responsibility for researchprograms conducted jointly with the Ar­gonne National Laboratory and for therelations with participating institutionsof the Argonne Laboratory. Responsibil­ity for furnishing such administrative,nursing, housekeeping and dietary, engi­neering, and other allied services. as arerequired for operation of the ArgonneHospital rests with the superintendent ofthe University Clinics, Ray Brown, andwith the administrative assistant to thedirector, Richard Wittrup.The new hospital is located on EllisAvenue and adjoins Goldblatt Hospitalon the south. It extends northward to apoint even with the north side of BillingsHospital. It was designed by the firm ofSchmidt, Garden and Erikson, well­known hospital architects, with the assist­ance of J. Lee Jones, consulting archi­tect for the University. The exterior isof Indiana limestone, and the Gothicstyle of The Clinics has been main­tained in the architectural design. Thereare seven floors above ground, includingthe mechanical equipment attic, and twofloors underground. Total floor area isapproximately 100,000 square feet. Thebuilding was built at a cost of $2,720,-000. The equipment will add approxi­mately $1,100,000 to this figure. From Top to BottomProbably at this time a floor-by-floordescription of the facilities will give you. the best understanding of what may beexpected from this newest addition tothe University Clinics. The seventh-floorattic is filled from end to end with blow­ers, ducts, filters, and other equipmentrequired for the many hoods usedthroughout the building.Radioactive Animal FarmThe sixth floor is the only completelyair-conditioned floor in the building. Onthis floor, Eric Simmons, assistantprofessor in the Institute of Radiobiol­ogy, will operate the animal farm, main­taining a stock of mice, rats, rabbits, andguinea pigs. He will supply animals toresearch people as needed and will main­tain the animals for observation afterinjection with radioactive materials,treatment by X-ray, or other researchoperations. Largest use will be made ofmice, and approximately a thousandLAF 1 hybrid mice will be produced eachweek. These mice are used very widelyin radiation experiments because the uni­form hereditary factors make their re­sponse much less variable than that ofordinary mice. This floor also containssuch special facilities as two 250-kilovoltX-ray therapy machines built by Gen­eral Electric and supplied with specialfloor-to-ceiling mounts, making possiblea large uniform field of radiation. Diag­nostic X-ray machines will also be in­stalled for animal experimentation. Allanimal operating room is located on thisfloor, and special facilities are providedfor the injection and maintenance of ani­mals receiving radioactive materials. Lat­est and most up-to-date facilities areprovided for maintaining and washingcages and handling a large supply of ani­mals.Radiology, Physics, BiophysicsA number of activities are centeredon the fifth floor. James W. J. Carpen­der, associate professor of radiology,will have his mold-preparation labora­tory here, where he will prepare specialmolds for use in radiation therapy. Nearby is a radiation physics laboratorywhich will be used both as a facility forresearch in radiation physics and as ateaching laboratory. Residents in radiol­ogy will have an opportunity to brush upon their physics in this laboratory andalso to learn the latest techniques inmeasuring high-energy radiation and inevaluating the quantity of radioactivematerials.Other research programs located on thefifth floor are devoted to studies usingradiocarbon (carbon-I-t), radiohydrogen(hydrogen-S, or tritium), and radon.Most of the studies will be concernedwith the metabolism of patients andanimals with cancer of one sort or an- other. The radioisotopes will be used tlabel and trace chemical substances thaare concerned with either the growth 0the destruction of tumor tissue. A POItion of the fifth-floor space is used folaboratories for organic synthesis of calbon-14 and tritium-labeled compoundfor use in the program: Specialized equipment for advanced biochemical and biophysical research is located on this flooand will be used jointly by the researcgroups. Four groups are working therat the present time. Professor WeldoBrown of the chemistry department iresponsible for a group concerned witthe synthesis program; George V. LeRoy, associate professor of medicine anassociate dean of the division, witGeorge Okita, research associate in phaimacology, and Harold Werbin, researcassociate in medicine, will conduct thmetabolic studies; Eugene Coldwasseiresearch associate in biochemistry, anhis group are concerned with biochemicsproblems; and Dr. Hasterlik's group wistudy patients with radium poisoninand with other sorts of radiation injurjThe laboratories handling radioactivmaterials on this floor, as well as iother parts of the hospital, are speciallequipped. All laboratory benches, cupboards, cabinets, etc., are of stainlessteel. Special hoods designed and developed by Argonne National Laboratorare installed for handling radioactivmaterials where there is danger cair contamination. The floors are coverewith a vinyl sheet which is easily decontaminated. All laboratories in t'hiarea are air-conditioned.Health PhysicsOutside this area are the health physics laboratories, Dr. Hasterlik's officethe medical physics office, and the special counting laboratories. The countinlaboratories are located at the north en,of the building, removed as far as possible from sources of radioactive materials. They are equipped with all thlatest devices for detecting and measurHASTERLIKMEDICAL ALUMNI BULLETIN 3ng radioactive materials. The healthlhysics laboratories serve as a base oflperation of the group charged with pro­ecting University personnel as well as:he general public from dangers of exces­iive radiation. This group establishesJrocedures for handling radioactive ma­:erials, surveys the laboratories for con­:amination, supervises decontamina­:ion where necessary, and assists in thelisposal of radioactive wastes. It also:hecks on the weekly exposure to radia­:ion of University personnel, generallylY means of film badges, but sometimeslY special. ionization chambers.56 Beds and 285 ColorsThe third and fourth floors are hos­oital floors and together have fifty-sixieds, thirty on the third floor and twen­:y-six on the fourth. These two floorsire practically the same except that on:he fourth floor there is a small operat­ng room and a dietary kitchen, and on:he third floor a special shielded roomfor surveying patients with tracerloses of radioactive materials. Most of:he rooms are semiprivate, each with itsiwn bath and lavatory. Each room isorovided with a small closet for the pa­.ient's personal clothing. The rooms areiecorated in pastel shades, each with twodifferent contrasting colors. It is said:hat 285 separate shades of colors wereused to decorate the entire hospital. Cur­cains are different in each room, andthey, with the bedcovers, are chosen toharmonize with the walls. The beds onthese floors will all be electrically oper­ited.Clinical Use of Radioactive MaterialsThe floors are covered with vinylsheeting to aid in decontamination; andthe rooms are shielded from each otherby 8 inches of concrete, the shieldingbeing desirable to prevent the build­up of radiation from a number of pa­lients. Under the present plans, thelhird floor will be used for those pa-LeROY CLARK and CARPENDERtients who receive radioactive materials;the fourth floor, for those who are beingtreated with the machines in the sub­basement.Special procedures are necessary inthe handling of patients receiving radio­active materials. These patients arecared for by a special nursing staff un­der the direct supervision of Miss Rose­mary Haughey, who has had experienceat Memorial Hospital in New York andat Oak Ridge with patients receivingradioactive materials. Patients selectedby the medical staff for admission arehandled routinely. Actual administrationof radioactive isotopes is, of course, bythe physician handling the case or hisstaff. Twenty-four hours' notice of intentto administer radioactive materials is re­quired in order to give the nursing staffand health physics opportunity to makeproper preparations. Baths and as muchcare as possible are given the patientjust before the administration of radio­active material so that nursing care dur­ing the critical period after administra­tion may be reduced to a minimum.Elaborate precautions are taken toprevent the spread of contaminationthrough the building. Great care is takento protect the health of the medical andnursing staff. For instance, the lengthof time the same personnel may treatpatients with gamma-ray emitters hasbeen carefully determined, so that thestaff will not be exposed to an accu­mulated dosage beyond the point oftolerance. Film badges are, of course,used to check the amount of radia­tion received by each person, and, insome cases, ionization chambers are alsoprovided. Control of contamination isimportant both from the standpoint ofhealth and from the standpoint of theresearch activities which are carried on in other parts of the building. Wherethe spread of contamination is likely, allpersons entering the room are requiredto wear gowns and rubber gloves. Inspecial cases, plastic overshoes are alsorequired. All linen used on isotope pa­tients is collected separately, placed inpaper bags, and labeled with the nameof the patient and the isotope used. Thislinen is then taken to the basementwhere it is checked for possible contami­nation before going into the regularlaundry. Wherever practical, instrumentsare washed and then set aside until theradioactivity has decayed. Food isbrought up to the floor from the maindietary kitchen in large electricallyheated carts and served there. Dishwash­ing facilities are provided on the floorin order to prevent spread of contamina­tion to the central facilities. All radio­active wastes are collected separatelyand disposed of by health physics. Thefloor is monitored daily by health phys­ics, and every spot of contamination isremoved immediately. So far, it has beenpossible to keep the corridors clear ofcontamination, thus making it possiblefor the staff to move about freely.Visitors are normally not allowed dur­ing the first forty-eight hours after ad­ministration of a radioactive isotope.This regulation is not so much for theprotection of the visitor, since he willnot receive repeated exposure over along period of time. Rather we are con­cerned about the possible spread of con­tamination through the hospital.So far, radiogold (gold-198), radio­iodine (iodine-t Jt), radiochromium(chromium-51), and radiophosphorus(phosphorus-32 ) have been used on pa­tients on this floor. Radiochromium hasbeen used in tracer doses and has not[Continued on page 5)4 MEDICAL ALUMNI BULLETINRUSH ALUMNI NEWSLANEOLDEST LIVING RUSHGRADUATELeslie Coulter Lane was graduated fromRush Medical College in 1877 and now, inhis ninety-eighth year,. is its oldest livinggraduate.Dr. Lane's early practice, in the daysof no telephones, no automobiles, few roads,and a very small body of medical scienceas we know it today, called for constantingenuity and inventiveness. Kitchen-tableoperations were common-there were nohospitals near by, and most cases wereurgent or desperate. He tells of curing diph­theria when, as a forlorn hope, he followedthe suggestion of a young man riding withhim on a call. The young man had heardof the use of champagne for blood poisoningand asked Dr. Lane if diphtheria was not aform of blood poisoning. Dr. Lane tried theremedy on himself first and then on severalof his patients with complete success.In the 1880's he removed epitheliomas ofthe lip by making the incision parallel withthe edge of the lip, along the color line,thus avoiding an unsightly scar-a proce­dure well ahead of contemporary surgicalpractice.Dr. Lane built his first office in Orton­ville, Minnesota, with lumber hauled fifty­five miles by ox team: And he publishedthe town newspaper until his practice be­came so large that he had to give it up.In 1882 he married Mathilda Rice Em­mett, daughter of Minnesota's first chiefjustice of the Supreme Court, LafayetteEmmett. She died in 1890, and one son sur­vives of this marriage. He is L. EmmettLane, a civil engineer in Willmar, Minne­sota.Soon after his wife's death, Dr. Lanega ve up general practice, and for the restof his professional career he specialized inlife-insurance practice. In 1898 he returnedto Minneapolis and married Adla Carlson, '01. W. E. Lamerton has retired frompractice at seventy-nine and he says, asRiley did, "I have rounded her once andcan do her again." He considers that he hasbeen very fortunate in his fifty-two yearsof practice to have had excellent health. Hehad a good practice, but, like most doctorsof the old days who had to practice withoutmany of the gadgets that are used now indiagnosis, he yields to the young men fullof new ideas.'13. Ralph H. Kuhns, district medicalofficer and N.P. specialist for the Veterans'Administration, has an article in the Quar­terly of Phi Beta Pi on the subject of "50thAnniversary of Xi Chapter." The 1913 classis preparing for its fortieth reunion nextJune, with Dr. Kuhns as class secretary.Rey Vincent Luce is retired and en­joying California at its best in Santa Rosaafter thirty-odd years in Akron, Ohio, inthe practice of bone-and-joint and trau­matic surgery. His son, now in Stanford,will carryon for him.'17. Frank A. Williams is senior ortho­pedic surgeon at Elizabeth General Hospitalin Elizabeth, New Jersey.'18. Harry 1. Huber has recently beennamed chairman of the Section on Allergyfor the May, 1953, meeting of the IllinoisState Medical Society. His daughter, NancyLee, is a member of the freshman class atthe Southern Methodist University of Dal­las, Texas.'21. Harry A. Oberhelman has been pro­fessor and chairman of the Department ofSurgery, Stritch School of Medicine, LoyolaUniversity since 1941.'25. Upon reading the news item in ourlast issue about Libby Pulsifer, in whichwe referred to him as "she," a friend wrotehim: "I knew you before. Have you beento Denmark for surgery?"'26. Jessie Bierman has been professor ofmaternal and child health at the School ofPublic Health of the University of Cali­fornia since 1947.Harry A. Gussin teaches proctology atthe Chicago Medical School and is on thestaff of Chicago Physicians and SurgeonsHospital and Mount Sinai Hospital (presi­dent). His daughter, Vivian, is a graduateof the University of Chicago (1947), andhis son, Zave, is a premedic here now.of that city. They have three daughters:Mrs. Merrill B. Folsom of White Plains,New York; and Mrs. Dana C. Eckenbackand Mrs. Glen Sawyer, both of Minneapolis.All his life Dr. Lane has had vigorousgood health-in his prime he stood six feettwo and weighed over two hundred pounds.He was remarkably erect and active. Atninety he was required to be re-examinedfor his driver's license and passed with nodifficulty-easily the oldest licensed driverin Minnesota.Sometimes now he will talk for hours ofpioneer days in Minnesota, and he hassome wonderful tales to tell. But mostly heis content to watch the world go by fromthe window of his home at 3101 SecondAvenue, South. His needs are attended withloving care, and he has no worries. We wishhim the best! Esmond R. Long is still holding dowtwo jobs: director of the Henry PhiPJInstitute for the Study, Treatment, ar:Prevention of Tuberculosis and director •medical research of the National Tubercilosis Association. He was much concernewith the plans for the Fiftieth Anniversaiof the Henry Phipps. Institute in Februar'27. Alexander Brunschwig, formerprofessor of surgery at The Clinics arnow professor of clinical surgery at Conell University, will leave soon for Autralia, where he will deliver a series of Ietures on cancer.Hilger Perry Jenkins was recently eleced to the Board of Governors of the Arneican College of Surgeons and is chairmsof the Motion Picture Committee. Febnary 10-13, at the Mid-South PostgraduaMedical Assembly in Memphis, Dr. Jenki:discussed both "Acute Surgical Diseasesthe Intestine" and "Diagnosis and Managment of Lesions of the Face, Head, atNeck."Capt. 1. Keith MacClatchie, after behcalled to the Navy as a reserve officin 1941, transferred to the regular Na­as a captain (MC) in July, 1946: Iwas chief of dermatology at USNHSan Diego in 1947-50 and since has be.chief of dermatology at the USNH in �Albans, New York. Both hospitals are aproved by the American Board for tvyears of residency training and have lufrom two to four residents annually. CalMacClatchie married Ada Tarvin Sebastsin 1949. They have no children. He expeca transfer this spring-foreign or back·California.'28. Arthur E. Diggs is on the surgicfaculty of the University of Illinois atis on the staff of Presbyterian and 'Ohdren's Memorial hospitals. He is surgergeneral of the Illinois National Guard.Capt. John P. Wood (MC) USN, afttwo years' duty in the Office of Naval Rsearch in London, returned to the Unit.States in September, 1952, to become drector of the professional division, Buresof Medicine and Surgery, Navy Deparment, Washington, D.C.'30. R. Kennedy Gilchrist 'has belelected secretary of the Board of Governoof the American College of Surgeons.'34. Bernard M. Blum has been direct.of the Fife-Hamill Memorial Health Centand professor of public health at JefferscMedical College in Philadelphia since 194Jefferson is the school which productDaniel Brainard, the founder of Ru:Medical College. Dr. Blum says, "Is rrALUMNI BULLETIN useful? I didn't knountil I read this latest that my classrnatChuck Dunham, is with the AEC in Was)ington. I am interested because I was rsponsible for organizing and directing tlDepartment of Health of Oak Ridge, Telnessee, beginning in 1944."'35. R. H. K. Foster entered privapractice last July in Franklin, Indiana. 1-resigned as director of the Departmeiof Pharmacology of St. Louis UniversiiSchool of Medicine. He is doing G.P. aranesthesia.MEDICAL ALUMNI BULLETIN 5'37. Robert G. Mindrup is enjoying avery busy practice of medicine and surgeryin Jerseyville, Illinois. He is presently veryactive in building a new forty-bed hospitalin Jersey County.Cdr. Felix H. Ocko (Me) USN hasmade a career of the Navy Medical Corps.He was certified by the American Boardof Psychiatry in 1949 and is a candidateat the Chicago Institute for Psychoanalysis.He is currently chief of N.P. service at theU.S. Naval Hospital, Great Lakes.'38. Nicholas George Amato is in thepractice of anesthesiology in Cincinnati. Heand his wife are very happy with theirfour "J's"-Joanne, 11; Jimmy, 6; Jerry,4; and John, 2.Louis Shattuck Baer is back in practiceafter six months spent tussling with polio.He was promoted to clinical assistant pro­fessor of medicine at Stanford last year.'40. Virginia M. Ferrara has been doinggeneral practice for eleven years in Detroit.She has two daughters, ages two and three.'42. Frank W. Johnson is entering hisfourth year of private practice of ophthal­mology- in partnership with five G.P.'sknown as the Klamath Medical Clinic inKlamath Falls, Oregon. Last October he re­ceived certification by the American Boardof Ophthalmology. He says, "This areain the Cascade Mountains has wonderfulscenery and ideal sport opportunities tofish, hunt, and ski, although the last is alittle too difficult to learn at my stage inlife."WILBER E. POSTWilber E. Post is one of the most illustri­ousgraduates of Rush Medical College. Hebelongs now to the older group, but he' re­mains young in his interests and activity.He still attends the meetings of the juniorstaff every month at Presbyterian and isas ardent a golfer as he was in the dayswhen he and Basil Harvey and JosephCapps kept a rendezvous in Tryon or onthe Gulf Coast every winter.Dr. Post was born in Lowell, Michigan,March 20, 1877. At fifteen he taught in thedistrict school near his home. He graduatedfrom Kalamazoo College (at that time af­filiated with .the University of Chicago) in1898; then for two years he was superin­tendent of schools in August, Michigan. Hereceived the Ph.B. degree at the Universityof Chicago in 1900.As a result of being present at a confer­ence where William Rainey Harper, FrankBillings, and Ephraim Ingalls were makingplans for a medical school on the campus,he decided to take his medical work at Chi­cago. He was a member of the first classto take the full two years of preclinicalwork on the South Side. This group in­cluded Dallas Phemister, David J. Davis,Ralph C. Brown, Ernest Irons, and KelloggSpeed. In 1901, as an assistant in pathologyand bacteriology, he taught bacteriology tothe students of the West Side school. Hewas assistant to Ludwig Hektoen for one'year and received his M.D. in 1903. He in­terned under Dean Bevan 'and Frank Bil­lings at Presbyterian Hospital from Janu­ary, 1904, to October, 1905, then becameassistant to Dr. Billings for the succeedingten years.In 1910 he went abroad for a year ofstudy in Vienna and Freiburg. He studiedthere under Aschoff on the pathology of POSTthe sinus node of the heart. From 1912 hebecame interested in nephritis, especiallyin the study of edema, and was associatedwith the work being done by Frank Billings,D. J. Davis, and E. H. Rosenow on focalinfection, particularly with regard to ar­thritis and endocarditis. He was on theattending staff of the Cook County Hos­pital from 1912 to 1918.In 1917 he was a member of the Amer­ican Red Cross Mission to Russia underDr. Billings with the purpose of surveyingthe medical needs of that country. In 1918he was a member of the Commission forRelief in the Near East, especially for fa­mine relief in Persia, under Harry PrattJudson, then president of the University ofChicago. In 1919 he was elected to theBoard of Trustees of the University of Chi­cago, in which position he was active inplanning the full-time medical school nowso successfully established at the University.He was also instrumental in obtaining 'theLouis B. Kuppenheimer Fund for the eyedepartment, the fund of three million dol­lars for the Zoller Dental Clinic, the A. D.Thompson Fund, and the Anna Louise Ray­mond Fund. He resigned from the Board ofTrustees in 1939 but has maintained an ac­tive interest in the medical school and theUniversity as a whole.He became chief of a medical service atthe Presbyterian Hospital in 1919 and in1941 was elected president of the medicalstaff. He became president of the ChicagoInstitute of Medicine of Chicago in 1943.In addition to maintaining a busy practiceof internal medicine, which he continues to­day, he has devoted much time and interestto teaching. He has been particularly help­ful ill advising and helping young physiciansto study and become proficient in particularsubjects or diseases.Argonne-[Continued from page 3]presented any problems. Radiophos­phorus and radioiodine are given inlarger therapeutic doses and have re­sulted, in some minor cases, in contami­nation. Radiogold has been used in mas­sive therapeutic doses, being injected in- to the pleural or the peritoneal cavities.As much as 150 millicuries have beengiven at one time. Material is receivedfrom Abbott Laboratories packed as in­dividual doses in serum bottles and prop­erly shielded for shipment. Injection isthrough a plastic tube and needle in­serted into a serum bottie, the gold solu­tion being displaced by normal saline.So far, this method has given very goodresults, only a minor amount of contami­nation resulting from the normal pro­cedure. One accident was experienced inwhich the plastic tube burst and con­taminated the bed clothing. We are, ofcourse, far from having any conclusiveclinical results, but we are gaining ex­perience in handling patients on a largescale who are receiving this type of treat­ment.Ground ForcesOn the second floor are the offices andlaboratories of Dr. Jacobson and DwightClark, professor of surgery. Dr. Jacob­son's staff is concerned with hematologicinvestigation, both clinical and research,and problems pertaining to radiation in­jury and protection. Tracer studies withradioiron (iron-59) and radiophosphorusare in progress. Dr. Clark's group isstudying thyroid chemistry and physiol­ogy with radioiodine and by chromotog­raphy.Some of the administrative offices arelocated on the first floor. A large con­ference room is provided which can bedivided into three smaller rooms byfolding partitions. The electronics shopand the machine shop are also located onthis floor. These shops are provided to,develop and build special instrumentsand devices required in research beingconducted in this building. The electron­ics shop is under the direction of DonaldCharleston; the machine shop underJohn Stupka. These men are familiarenough with the construction and func­tion of equipment in their' particularfields to assist physicians and biologicalscientists in the design of apparatus fortheir particular projects. The electronicsshop provides space for up to six elec­tronics technicians, and the machineshop up to' eight machinists. Adjacent tothe machine shop is the radiology shop,under the direction of Paul C. Hodges,professor of radiology. It is used 'forthe development of new equipment forresearch in diagnostic and therapeuticX-ray.Basement, Cave, and theThree Maclfines 'The basement contains laboratoriesfor the chemical processing of largequantities of radioactive materials. It isexpected that eventually a cave will beinstalled on this floor providing for thehandling of 10-100 curies of radioactivematerials by means of remote manipu-:[Continued on page 7]6 MEDICAL ALUMNI BULLETINGRADUATE NEWS'32. Bernard E. Kane has again enrichedour diet and spread good cheer amongalumni and medical students with his giftof tangerines from his Crescent City, Flori­da, grove.'37. Everett I. Evans, professor of surgeryand director of the Surgical Research Lab­oratories of the Medical College of Vir­ginia, gave the McArthur Lectures at theUniversity of Edinburgh and the HunterianOration before the Royal Academy of Sur­geons, London. He also spoke before theSwedish Surgical Society and conductedconferences on the treatment of burns inFrance, Belgium, Holland, and Denmark be­fore returning to the United States in No­vember.'38. H. Todd Stradford is still in theNavy. He has been head of the departmentof orthopedics in two naval hospitals andis now assistant to the head of the depart­ment at Philadelphia, the East Coast centerfor orthopedics and amputations. He saysthe work is very interesting. His family nownumbers four: his wife, Charlotte, two girls-Charlotte, seven, and Orlene, five-and aboy, twenty-one months.'40. Helen Heinen is president of theAmerican Medical Women's Association,Branch No.2, in Chicago.'42 Isadore Rossman has recently beenmade executive director of the MontefioreHospital Home Care Program in New York.Lillie Curlew Walker is working withthe Department of Maternal and ChildWelfare of the City and County HealthDepartment in Memphis. She recently mar­ried John E. Farrior, professor of Englishat Memphis State College.'43. Joseph M. Dondanville has resignedhis position as director of anesthesia atHenry Ford Hospital and has become asso­ciated with William R. Wicks in the pri­vate practice of anesthesia at St. Joseph'sHospital in Alton, Illinois.John Findley has moved from Phoenix,Arizona, to San Mateo. California, wherehe has joined the San Mateo Clinic.Harold R. Reames is in the Departmentof Clinical Investigation in the MedicalDivision of the Upjohn Company. Aftergraduation he spent three years at CampDetrick with Dr. Dack and a year as resi­dent in medicine at Blodgett MemorialHospital. After two years' training in pedi­atrics at St. Louis Childrens' Hospital hepracticed pediatrics for three years inGrand Rapids, where he saw Dick Ras­mussen and the Sidell brothers frequently.The Rearneses have two children-Jill, ten,and Hal, Jr., eight.Roy F. Stanton, Jr., and his wife, Peggy,are well established in a residential suburbof Birrninghirn, Alabama. They have threechildren-Roy, eight; Betty Jean, five;and Patricia Ann, fourteen months. Dr.Stanton is doing general practice with em­phasis on pediatrics. They see a lot of theWinston Henrys, who have recently had ason. The Stan tons would be happy to wel­come any visitors on their way to Florida.'44. Robert I. Barickman, Jr., is resi­dent in ophthalmology in the Boston CityHospital. After leaving the Army in 1947he spent two years at the University Hos- pita I in Columbus, Ohio, and practiced inTulsa, Oklahoma, until the first of J anu­ary, 1953.Arthur T. Evans is instructor in urologyat the University of Cincinnati College ofMedicine. In September Albert J. Farrell,who interned at The Clinics in 1944-'-45,became associated with Dr. Evans in pri­vate practice and has been appointed clin­ical assistant in urology at Cincinnati.Robert Jampolis left his residency insurgery at the Mayo Clinic in Decemb.erto enter the Navy and is now at TreasureIsland, San Francisco.Rudolph Janda is in the private prac­tice of general surgery in La Grange, illi­nois.J. Alfred Rider became a diplomate ofthe American Board of Internal Medicinelast November.T. A. Staskiewicz has just completed afellowship in internal medicine at the LaheyClinic in Boston and expects to be inductedinto the Army very soon.'45. James and Mary Ahern and theirson, Stephen, have established permanentresidence in Seattle and Jim is now in theprivate practice of internal medicine. JimCrosbie is in private practice in Seattle,in the same office building as Dr. Ahern.His specialty is internal medicine.Edwin G. Eby has been recalled into theNavy. He is stationed on the USNS "Gen­eral Nelson M. Walker" T.A.P.-125. Hisfamily is staying in South Haven, Michi­gan. There are three Eby children: RobertGeorge, seven; Margaret Ann, four; andJohn Edwin, two.Edward N. Horner is now associatedwith the Alhambra Clinic in Alhambra,California, for private practice and wasappointed instructor in obstetrics and gyne­cology at Los Angeles County Hospital.Warren F. Wilhelm and his family (hiswife, Tozia, formerly from S-4, and threesons: six, three, and one and a half') leftRochester, Minnesota, in October and areliving in Kansas City, Kansas. Dr. Wilhelmfinished his fellowship in internal medicineat the Mayo Clinic last April and stayed onsix months for some extra work. He hastaken over the position of medical directorof the Research Clinic in Kansas City,where his chief duties will be in clinicalmedicine with somewhat the same arrange­ments as we had in the out-patient depart­ment when he was in Billings in the mid­forties. Dr. Wilhelm would be glad to hearfrom any alumni in the Kansas City area.'46. Daniel M. Enerson gave a paperon "Pulmonary Pathology of Histoplas­mosis" on February 9 before the ChicagoPathological Society.'47. Leon A. Carrow is now chief ofobstetrics at Eglin Air Force Base, Florida.He expects to be in service until January,1954.Lt. Robert M. Chanock expects soon tobegin work in the virus laboratory at Wai­ter Reed Hospital in Washington, D.C.Gerald Hill has been accepted in theDetroit Psychoanalytic Institute to startanalytic training. He has been a lecturerin the school of social work of MichiganState College. William L. Lorton (Major, M01921329) returned from overseas in Nvember. He is serving out the rest of I'time at- the U.S. Army Hospital in FeRiley, Kansas, as chief of the neuropsydatric service. He and his wife live in Juntion City.Donald F. McBride has left the Arn.and has assumed the practice of Dr. EvaW. Pernokis in Chicago. His practicelimited to internal medicine.Harry A. Oberhelman, Jr., remains st,tioned at Goodfellow AFR.· He has be,chief of surgery and acting flight surge.since November 15 at Station Hospital. Iexpects to be discharged at the end' of J ur'48. Ernst R. Jaffe left the USAF Meccal Corps on December 26 after two yeaservice at Carswell AFB. He and his wiwill live in Fort Worth until he returto New York to resume his residency traiina in internal medicine at the PresbyteruHospital.'49. Norman I. Graff will finish I­psychiatric residency in July and expecto enter the USPHS then for service. TIGraffs are expecting their third childMarch.William E. Hummel recently retumrfrom overseas and was discharged frothe. Navy. The Hummels are again livirin 'Portland, Oregon, where Bill has be.able to resume his residency training ,orthopedics at the University of OregoThey have bought a home and are lookiiforward to a more settled life.V. P. Simmons is now Lt. (j.g.) MIUSNR, at Great Lakes, Illinois. He h:not yet received any assignment. Rog,Shapiro is also at the Lakes in psychiatrC. Harold Steffee, after a bout of trberculous pleuritis, is now back at WOIhalf time and hopes to return to full tinthis winter at the National Cancer Insttute in Bethesda, Maryland. His wor.which he finds very challenging, deals witprimary lung tumors in humans and ianimals, and he is also involved in a studof cancer of the uterus.William H. Wainwright is most happto be back in the United States after manlong months in Korea. He is to be di:charged from the Air Force in March anwill begin psychiatric residency at the Ne­York Hospital in July.'50 . .T. A. Filos-Diaz reports the arriv:of a baby boy, weighing 7 pounds, 1ounces, by Cesarean section at the AIm:rante Hospital in Panama on August 2'The boy now weighs nineteen pounds. Thmother and father are very pleased wittheir first offspring.Roberto Fortuno is a first lieutenant ithe Army, at present in Korea.J. Sutherland is enjoying Cincinnati aChildren's Hospital. He plans to spenanother year there as chief resident.'51. Roland P. Brown is in his first yeaof surgical residency at Harper Hospital iDetroit.Mary Elizabeth Evans is serving asresident in pediatrics at the University aKansas Medical Center after having completed her internship there.[Continued on page 10]MEDICAL ALUMNI BULLETIN 7Argonne-[Continued front page 5]lators. Directly adjacent to the spacereserved for the cave is the tube-storagefacility for radioactive isotopes. Hereforty stainless steel tubes 8 inches indiameter extend 8 feet below the floorin a solid block of concrete. Radioactivernaterials to be stored here will be placedn lead containers approximately 2 feetlong with a diameter to fit the tubes.Ihe lead containers will be sufficiently:hick to shield the individual lot of ra­iioactive material. The concrete shielduirrounding the tubes will prevent theradiation from many containers fromiuilding up to dangerous levels. A largeaboratory on this floor will be provided.0 receive radioactive materials andiandle their distribution. This laboratoryIfill be in the charge of a registerediharmacist under The Clinics pharmacy.\11 materials for clinical use will belispensed by this laboratory in the exactunount required. Certain materials in:ommon use will be stocked and willrlso be available for research purposes.;everal other laboratories are availablem this floor as well as a counting labo­atory. Locker rooms are provided foriersonnel requiring a change of clothing,md stockrooms are located here. Ainen-sorting room is also located on thisloor. Here linen from the hospital floorsmd from the laboratories will be in­pected by geiger counters for evidence,f contamination. Where contaminations found, proper measures will be takeno remove the contamination and theirticle will be run through an automaticvashing machine and drier before it isent to the central laundry. Where con­amination cannot be removed. the arti­:le will be stored until its active mate­ial decays or until it has to be destroyed.The subbasement of the Argonne Hos­,ital is located 19 feet below the street.l'his is 12 feet below the permanentvater table, and special methods of con­truction were necessary to keep thisirea dry. Much of the mechanical equip­nent for heating the building, providinglot water, compressed air, etc., is 10-ated on this floor. There are twelve,200-gallon glass-lined retention tanks,n this floor. These are provided for eachIf the floors where radioactive isotopes.re used. These tanks may either bemptied into the normal sewer orlumped into a tank truck for transpor­ation to the Argonne National Labora­ory in the event that the contents ofhe tanks are so radioactive that theyannot be discharged into the city sew­rs. At the Argonne Laboratory theiaterial will be concentrated by eva po­ation, and the resulting solid radioactiveiaterial will then be buried. On thisoor, two constant irradiation rooms arerovided for the constant irradiation ofnimals and the study of chronic effects This is the cobalr therapy room. It shows the half-scale model of the cobalt-60 rotationaltherapy machine and (in the foreground) the initial construction of the framework for theactual machine. The zinc-bromide window gives the physician a complete view of theroom while fully protecting him from radiation. The men in this picture are Lester Skaggs,director of health physics, and Lawrence H. Lanzi, one of the designers of this machine.of radiation. Also located on this floorare the large machines for the treatmentof patients with radiations.First to be installed of these machinesis the Van de Graaff generator. This isa 2-million-volt electrostatic generatorof X-rays. It will be used to study theeffects of supervoltage X-rayon can­cer and also to study the advantages ofrotational therapy. Rotational therapy isa type of therapy using an externalsource of radiation which, by rotationabout an axis through the tumor, buildsup radiation destruction throughout theregion of the tumor to 'a maximum whileregions outside, due to their intermittentirradiation, receive a smaller amount.Also, it will be possible to bring theelectron beam to be used in biologicalexperiments out of the Van de Graaff.These electrons may turn out to be di­rectly useful in the treatment of cutane­ous cancers, since the penetration oftissue is approximately one centimeter.Second to be installed will be a cobalt-60 rotational therapy machine. This ma­chine will use an 1,800-curie source ofcobalt-60 and will rotate the sourceabout a horizontal axis. A reclining pa­tient can then be placed with his tumoron this axis and receive rotational ther­apy. The advantage of this machine overthe Van de Graaff generator is that thepatient can be irradiated in a recliningposition, making it easier to locate thecenter of the tumor. Also, accuracy oflocation will be improved by placing thepatient in a half-cast and taking X-rayradiographs of the tumor region beforeirradiation starts. Then, from a studyof these radiographs, it will be possibleto locate the patient accurately in the cobalt-60 machine. Besides rotationaltherapy of a reclining patient, two otherfeatures of this machine are unique.First. it is the only machine to useuranium as a shield. This reduces theweight of the shield from approximate­ly 4,000 pounds to 950 pounds. It alsoreduces the over-all size of the machineand gives a larger output of radiation tothe tumor from the same size source.The other unique feature is the size ofthe cobalt source. This will be three­quarters of a centimeter in diameter and3 centimeters long, and this small size willbe made possible by the fact that thesource will be activated in one of thenewest f\lomic Energy Commission reac­tors at Arco, Idaho. The use of this verysmall source is advantageous because itreduces the region of penumbra to aminimum. With this source. the penum­bra, that is, the distance from essentiallyfull irradiation of the tumor to essen­tially no irradiation of the surroundingtissue, will 'be approximately 1 centi­meter. This machine is now being de­signed by Lawrence Lanzi and Don Da­vison and is being built in our shops andthose of the Argonne National Labora­tory.The third machine to be installed inthe subbasement is a linear accelerator.This machine will accelerate electrons toan energy of 50 million volts, at whichenergy they will have sufficient penetra­tion to pass entirely through the body.These particles will be used directly inthe treatment of cancer. They are ad­vantageous because they give a morefavorable distribution of ionization andtherefore of destructiveness. with depth.[C ontinued on page 11]8 MEDICAL ALUMNI BULLETINSCIENTIFIC SECTIONAcute Nephritis*By CHARLES H. RAMMELKAMP, JR., M.D.Research Laboratories, Cleveland CityHospital; Department 0 j PreventiveMedicine, School oj Medicine, WesternReserve University; Streptococcal Dis­ease Laboratory, Cheyenne, WyomingAcute glomerulonephritis and acuterheumatic fever are both complicationsof Group A streptococcal infections. Al­though both diseases share a commoninitiating illness, the mechanism of pro­duction of the specific tissue changes isnot understood and may be different. Anexplanation of these differences mightaid in the study of the mechanism ofboth complications and might lead tomethods for their prevention and treat­ment. The present report is concernedwith the interpretation of the attackrates of rheumatic fever and nephritisfollowing streptococcal infections.Rheumatic fever develops in approxi­mately 3 per cent of all individuals in­fected with Group A streptococci.'Data collected from published reportsindicate that the attack rate followingstreptococcal infections is independentof factors such as geographical area, age,clinical manifestations of the strepto­coccal infection, and the serological typeof Group A streptococcus responsible forthe initiating illness. Thus rheumaticfever, whether occurring sporadically orin epidemics, bears a relatively constantrelationship to the incidence of GroupA streptococcal infections.Information concerning attack ratesof acute nephritis following streptococcalinfections is meager. Although it hasbeen stated that the incidence of ne­phritis following scarlet fever has de­creased during the past several decades,collected statistics show that there is amarked variation in the incidence ofthis complication. Thus in one epidemicof scarlet fever 18 per cent developedhemorrhagic nephritis. whereas in an­other study, of 2,169 patients, nephritiswas observed in only 0.4 per cent. Occa­sionally the attack rate of nephritis isexceedingly low. In a population of 1,206men infected with typeable Group Astreptococci and observed thereafter forthree weeks there was only 1 case ofacute nephritis and 32 cases of rheu­matic fever.Because of the differences betweenthe attack rates of rheumatic fever and* Abstract of paper read at the twenty­fifth anniversary of the University of Chi­cago Clinics, October 4, 1952.1 The attack rate may be altered by re­peated streptococcal infections or by a pre­vious attack of rheumatic fever. acute nephritis following streptococcalinfections, a study was undertaken todetermine whether or not certain strainsof Group A streptococci were associatedwith the initial attack of nephritis. Cul­tures of the oropharynx have been ob­tained from 31 sporadic cases of initialattacks of nephritis. These patients havebeen observed since 1949 in Pennsy 1-vania, Ohio, New York, Florida, Mary­land, Wyoming, and Hawaii. Of the totalgroup, Type 12 streptococci were iso­lated from 24, Type 4 from 4, Type 18from 2, and Type 25 from 1. These dataindicate that certain strains of strepto­cocci may be more nephritogenic thanothers, since many streptococcal infec­tions due to other serological types wereobserved which were not followed by ne­phritis. Conclusive evidence that certainstrains of Type 12 streptococci were es­pecially nephritogenic was obtained re­cently when an outbreak of nephritiswas observed. Type 12 infections re­sulted in an attack rate of at least 7 percent. whereas infection with other typesof streptococci was not followed by thiscomplication.The nature of the substance respon­sible for the nephritis and the mecha­nism by which the kidney is damaged arestill to be explained. The relationship ofacute episodes of glomerulonephritis tochronic nephritis must be determined.The concepts presented here provide thebasis for studies now in progress onthese aspects of the problem.Chromate Hazards in Industry*By EDMUND NELSON WALSH, M.D.**Attending Dermatologist, City-CountyHospital, Harris Methodist Hospital,St. Joseph's Hospital, Fort Worth, TexasChromium in metallic form and in itstrivalent and hexavalent forms is impor­tant in many manufacturing and indus­trial processes. Some of these are elec­troplating, anodizing, and other anticor­rosive metal treatments, tanning ofleather. manufacturing of pigments andanticorrosive paints, preserving of wood,mordanting of wool, fur, and leather,and photoengraving and lithography.Workers come in contact with chro­mates in the form of mist or dust whichis inhaled and in solution or solid form.Inhalation may produce acute pulmo­nary symptoms, chronic hepatic intoxi­cation, or, in some rare instances of longexposure to dust, carcinoma of the lung.Perforation of the lower nasal septum* Presented at the American Academyof Dermatology and Syphilology, Chicago,1952.** '36; Resident in dermatology, 1937-40. may also result from inhalation of mistsor dust.Chrome ulcers are produced by thecontact of the material with an abrasionor any break in the epidermis. Experi­mental chrome ulcers were produced byvery dilute solutions (1 :20,000 Na2Cr207)This reaction was not associated with ahypersensitivity or allergic reaction.Dermatitis due to contact of chrome­sensitive individuals with -these sub­stances is the most important of the in­dustrial hazards encountered. Apparentlyonly the hexavalent compounds are sen·sitizing. The incidence of such sensitivityvaried between 0.1 and 1 per cent irseveral large series of industrial groupsHowever, patch tests with 0.5 per centdichromate in small groups of nonindus­trial patients indicated a sensitivity rateof about 3 per cent. In the industria.groups most sensitivity reaction ap­peared within the first nine months ojexposure, but there were no definite timeor concentration factors discovered irthis study.Chromate dermatitis is often patch)in distribution and more prolonged irits course than the usual contact dermatitis. Prophylactic measures include protective clothing, proper designing of rna­chinery, and industrial engineering to reoduce or avoid contact with the materiaand contamination of the work areaEducation of the workers as to the na­ture of the danger and the early detection, investigation, and management 01any eruption occurring in exposed workers are of great importance.Milker's Nodules and PyogenkGranulomas*By F. T. BECKER, M.n.**Head, Department oj DermatologyDuluth Clinic, Duluth, MinnesotaMilker's nodules are an infectiousgranuloma occurring about the hands 0:dairy workers. These develop abouiseven days after contact with the in­fected cattle and vary in number frorrone to forty. The virus usually enter!through minute skin abrasions. At theonset an erythematous papule formsslowly increases in size, until it become!a firm elastic bluish-red nodule, 1-2 ernin diameter. The surface flattens with �central depression; the epidermal covering loosens, under which granulation tis­sue is present. These slowly absorb irfour to six weeks, but secondary infection frequently occurs. The causative* Presented at the American Academyof Dermatology and Syphilology, Chicago1952.** Resident in dermatology, 1933-35.MEDICAL ALUMNI BULLETIN 9agent is a virus which has no relation­ship to true cowpox.Histologically there is hyperkeratosis,acanthosis, and reticular degeneration ofthe upper cells of the epidermis with theformation of multilocular vesicles. Thedermis consists of granulation tissue witha multicellular infiltrate in which eosino­phils are prominent. These lesions areself-limited, and treatment is only in­dicated for secondary infections.Pyogenic granulomas occur most fre­quently at sites of trauma on either themucous membranes or the cutaneoussurface. They are usually 1 ern, in diam­eter, and they vary in shape. beinground, mushroom-like or peduncular.The color is dark red as in a vascularlesion, often being covered with a puru­lent crust. They bleed with the slightesttrauma and are otherwise symptomatic.Microscopically, the tumor is well cir­cumscribed, not invasive, and is usuallyelevated. There are numerous newformed blood vessels, and the lesions re­semble an infected angioma. Many poly­morphonuclear and round cells are pres­ent, and staphylococcus aureus is fre­quently found by culture.Diagnosis is made by the presence ofa red raspberry-like noninvasive tumorthat develops following trauma andbleeds easily. Treatment is usually somedestructive procedure such as freezingwith carbon dioxide snow, cautery, orradiation therapy. A few respond to lo­cal and systematic administration of an­tibiotics.Varieties of PostpartumAmenorrhea*By ARTHUR B. HUNT, M.D.**Sections oj Obstetrics and Gyneco!ogyMayo Clinic, Rochester, MinnesotaExamination of the records of ap­proximately two thousand women ofchildbearing age afflicted with amenor­rhea from causes other than pregnancyand seen at the Mayo Clinic during theyears 1935-52 inclusive revealed thatseventy-eight of them had acquired theamenorrhea immediately post part urn.This was exclusive of eleven typical in­stances of postpartum pituitary necro­sis (Sheehan's disease). The chief con­cern of this study was one of etiology:to determine whether one or two impor­tant organic or physiologic abnormalitiescaused most of the amenorrhea orwhether there existed a fairly large groupof pathologic states that precipitated it.Table 1 shows the results of such at­tempted diagnosis.* Abstract of paper read at the twenty­fifth anniversary of the University of Chi­cago Clinics, Chicago, Illinois, October 4,1952.** Resident in obstetrics and gynecology,1931-33. The commonest diagnosis of the causeof postpartum amenorrhea was pituitaryfailure. This diagnosis was made in thepresence of a "silent" type of amenor­rhea associated with the absence of bothpituitary gonadotropin and estrogen inthe urine. Ovarian failure, on the otherhand, was diagnosed in the presence ofamenorrhea associated with hot flashesand normal or excessive amounts ofurinary gonadotropin. Of these twogroups, the patients with pituitary fail­ure frequently manifested some depres­sion of the basal metabolic rate. Sixpatients presented various findings ofSheehan's disease, but in none was thecondition typical..Atretic or traumatic amenorrhea dueto partial or complete cervical stenosisafter uterine manipulation was presentin five cases. The treatment for this isrelatively simple and consists only ofcervical dilatation. The prognosis forsubsequent menstruation and pregnancywas the best of any group. Three of fourpatients resumed menstruation and borechildren.Primary deficiency of the thyroid wasrepresented by only four cases. In manyother cases in which there was markeddepression of the basal metabolic rate,the amenorrhea was felt to be due tothyroid failure secondary to postpartumpituitary damage or anorexia nervosa.Four instances of tumors of the endo­crine glands, all chromophobe adenomasof the pituitary gland, were encountered,representing 5 per cent of the cases ofamenorrhea. The curious form of starva­tion known as anorexia nervosa coincid­ing with the time of delivery and there­after also explained 5 per cent of thecases.In the remainder' of the series theamenorrhea was attributed to miscella­neous causes. Chiari's syndrome (thetriad of postpartum amenorrhea, uterineatrophy, and prolonged secretion fromthe breast) occurred in several differentgroups cited above; this suggests that itis not a separate entity. Uterine atrophyand lack of any luteal effect on the en­dometrium were encountered almost uni­versally. In 22 per cent of the casesprimary menstrual dysfunctions hadbeen present or had developed second­arily before conception occurred. In theremainder of the cases the women wereapproximately normal prior to the con­ception which resulted in postpartumamenorrhea. In a fifth 'of the cases, thefluctuation in body weights ranged be­tween 50 and 100 pounds. Obesity andmalnutrition were treated with a high­protein, high-vitamin diet, plus a high­caloric diet for the malnourished and alow-caloric diet for the obese.The use of such therapeutic agents asdesiccated thyroid, estrogen and proges­terone given cyclically, and low-voltageroentgen irradiation was outlined. For a variety of reasons only thirty­three patients could be followed aftertherapy. Fifteen of these regained amenstrual status that could be termedquite normal, and eight had a partial re­turn of menstruation. Among these twen­ty-three women who had more or lessreturn of menstrual function there oc­curred fourteen pregnancies resulting ine.even live births.TABLE 1ETIULOGY OF POSTPARTUM: AMENORRHEA.Cases21161365Pituitary failure .Cause not classified .Ovarian failure .Atpyical Sheehan's disease .Atretic amenorrhea ..Primary low basal metabolic ratewithout myxedemaPituitary tumor (chromophobeadenoma) .Anorexia nervosaProlonged lactationObstetric traumaDenuded endometriumEnd-organ failureEndometriosisTotal 4441111178Plasma Cells in HumanBone Marrow*By MATTHEW BLOCK, M.D.MedicineAlthough plasma cells are found inevery normal and abnormal human mar­row, there is no information availableregarding their exact location. Sectionsof about a thousand marrows in a widevariety of diseases as well as in oc­casional hematologically normal indi­viduals have been studied to clarify thispoint. Plasma cells vary from about 1per cent of the cells in the more normalto almost 100 per cent in multiplemyeloma. At least 90 per cent of patientswith elevated serum globulin have anincreased number of plasma cells.These cells are located almost entirelyinside the reticular fiber sheath of themost distal segment of the arterial capil­lary. Since this sheath must be rupturedto allow the plasma cells to be smearedout in recognizable form, they are un­evenly distributed in smears. When pres­ent in abnormally large numbers. themost marked increase is around thearterial capillaries, although the cellsmay be increased to a lesser extentthroughout the marrow. Even when thebasic architecture is distorted or themarrow is overwhelmed by malignantcells, plasma cells are always found inat least normal number in their usuallocation.Evidence will be presented suggestingthat plasma cells are formed from peri­vascular mesenchymal cells of the ar­terial capillary distal to the terminationof the smooth muscle coat.* Supported by an institutional grantfrom the American Cancer Society.MEDICAL ALUMNI BULLETIN10FACULTY NEWSAmong those participating as guest in­structors in the interim meeting of theKansas chapter of the American College ofSurgeons in Kamas City on January 19-23 were William E. Adams, AlexanderBrunschwig, Everett I. Evans, and C.Howard Hatcher. Lecturers from the Uni­versitv of Kansas included C. FrederickKittle and Paul W. Schafer.Delbert M. Bergenstal spoke on the"Therapeutic Value of Adrenalectomy inCancer" February 5 before the North SideBranch of the Chicago Medical Society.Douglas Buchanan is editor of a sectionon pediatric neurology in the journal Neu­rology.M. Edward Davis spoke on "Manage­ment of Third Stage of Labor" at thesecond annual obstetric-gynecologic forumsponsored by the Los Angeles ObstetricalGynecological Society on February 14-15.lester Dragstedt was made an honor­ary member of the School of Medicine atthe University of Guadalajara and receivedthe degree of Doctor Honoris causae (tiensay t rabaja) at a special convocation in Feb­ruary of the International Society of Tho­racic Surgeons.Dr. and Mrs. A. M. Dunlap have de­cided to remain in Hong Kong, China, forsix months where Dr. Dunlap will serveas a visiting professor at the Universityof Hong Kong. They plan to sail for theUnited States early in May and hope tostop in Chicago after a visit on the PacificCoast.Robert H. Ebert spoke on "Chemo­therapy in Tuberculosis" at the clinicalconference of the Chicago Medical Society,March 3-6. Dr. Ebert is now a diplomateof the American Board of Internal Medi­cine.lillian Eichelberger addressed the Amer­ican Medical Women's Association meetingof Branch No.2 in Chicago on January 14on "Histochemical Characterization of Hy­aline Cartilage."Ward C. Halstead spoke on "Psycho­logical Reaction to Organic Disease" in theChicago Medical School Lecture Series onJanuary 27.Charles B. Huggins is one of ten phy­sicians chosen out of a field of two hun­dred candidates to receive the 1953 ModernMedicine Awards for Distinguished Achieve­ment. The candidates were nominated bvdeans of American medical schools and b)'readers of Modern Medicine. Dr. Hugginsspoke on "Hormone Treatment of Cancer"before the German Medical Society of Chi­cago on January 26.Eleanor Humphreys spoke on "Rheu­matic Heart Disease in Children andAdults" at the February 11 meeting of theAmerican Medical Women's Association,Branch No.2, in Chicago.Richard Jones has been certified by theAmerican Board of Internal Medicine.Joseph B. Kirsner spoke on "Incidenceof New and Recurrent Rectal Polyps: AProctoscopic Survey," which was madewith the assistance of Alfred Rider, '44,Hugo Moeller, '48, and Walter Palmer,at the January 26 meeting of the ChicagoSociety of Internal Medicine. Robert M.Potter (Rush '39) reported on "Radiologi- cal Demonstration of Lesions of the Colonbv High Penetration Technique."A symposium on retrolental fibroplasiawas held on February 13 at the ChicagoOphthalmological Society Clinical Confer­ence. Arlington C. Krause discussed "Ex­perience with Therapy," and Walter R.Hepner, '-/4, of Galveston, spoke on "Pedi­atric Aspects."Clayton G. Loosli, '37, has been ap­pointed member of an ad hoc Committeeon Space Allowances and Troop Housingof the Armed Forces Epidemiological Board.He has also been appointed a member ofthe Committee on Biological Warfare De­fense of the Illinois Civil Defense Agency.In November he and William lester, jr.,participated in a conference of professorsof preventive medicine and public healthin Colorado Springs. In January Dr. Loosli.was a member of a panel discussing "TheRole of Specialized Agencies" in a UnitedNations Workshop in Chicago.Jules Masserrnan, now professor of nerv­ous and mental diseases at NorthwesternUniversity, has been elected president ofthe Illinois Psychiatric Society. On Decem­ber 19-20 he lectured to the Mexican Neu­ropsychiatric Society and the PsychiatricCorps of the Mexican Army and on De­cember 30 to the Cuban Society of Neuro­psychiatry.Walter 1. Palmer is chairman of theAmerican Board of Internal Medicine. OnMarch 20. Dr. Palmer will be the speakerat the dinner meeting of the regionalmeeting of the American College of Phy­sicians in Kamas City, Kansas, His subjectwill be, "Medicine: Historical and GlobalReflection."Henry T. Ricketts has been re-electedchairman of the Beard of Governors of theInstitute of Medicine of Chicago.Stephen Rothman was elected to honor­ary membership in the Deutsche Derma­tolozische Gesellschaft in December. Dr.Rothman was guest lecturer at a specialclinic sponsored by the Alembert WinthropBravton Skin and Cancer Foundation ofthe 'Department of Dermatosyphilology atthe Indianapolis General Hospital on Janu­ary 28. His title was "Premalignant Lesionsof the Skin and Mucous Membranes."Sidney Schulman, '46, spoke on "FurtherObservations on the Use of Octamethyl­pyrophosphorarnide in the Treatment ofMvasthena Gravis" before the ChicagoNeurological Society on February 10.Robert W. Sperry, assistant professor ofanatomy, has joined the combined researchprogram of the National Institute of Neu­rological Diseases and Blindness and theNat-onal Institute of Mental Health,USPHS. He will be chief of the Sectionon Developmental Neurology in the Labo­ratory of Anatomical Sciences.Ruth Taylor has returned to the Uni­versity as a physician in Student Health.Peter J. Talso is now assistant profes­sor of medicine at Stritch Medical Schoolof Loyola University, Chicago. He holds afull-time clinical research appointment.A. Earl Walker of John Hopkins spokeon "Surgical Treatment of Epilepsy" at theInterurban Neurosurgical Society meetingin Chicago on February 14. \MORCHNEW APPOINTMENTErnst Trier March has come to TluClinics from the University of Kansaas professor of surgery to be the nevhead of the Division of AnesthesiologyDr. March received his M.D. fronthe University of Copenhagen, a Ph.Dfrom the University Institute for HumaiGenetics in Copenhagen, and a diplom:in anesthesiology from the Royal Colleg­of Surgeons, England.During the war he worked with th.underground resistance movements ilDenmark, for which he was decorated b;the kings of Denmark, Norway, aniSweden.Mrs. March and their four childreiplan to move to Chicago soon.Graduate News­[Continued from page 6]Harold Marcus is a second-year residenin psychiatry at the Kingsbridge VeteranHospital and a first-year student at th.Columbia University Psychoanalytic Clini.for Training and Research. The Marcusehave a son who was a year old in NovemberDr. Marcus reports that Henry Edelheiand Manny Peterfreund are residents ilpsychiatry at Hillside Hospital in NevYork and that they are both married.Clyde G. Miller completed his internship at the Veterans Administration Hospital in Los Angeles last July ·and immediately started psychiatric residency at thrVeterans Administration Neuropsychiatri.Hospital there. In November he moved t(Pacific Colony, a state hospital for mentadeficiency and a psychiatric out-patienclinic for adults and children.'52. Donald J. Glorzer is finding thrMassachusetts General Hospital as good a.it is reputed to be.Lawrence P. Maillis will finish his internship at Michael Reese in Chicago ifJune and has a residency in internal medicine at the Veterans Administration Hospital in Los Angeles, where he hopes tcstay as long as his draft board will let himMEDICAL ALUMNI BULLETINRESIDENT NEWS 11Major Samuel Abramson of the USPHS5 working for a year with William Lester.Bruce N. Balding is practicing obstetricsmd gynecology in Ventura, California. Re­:ently he delivered a great-nephew of MissKabel Carmon (formerly delivery-roomiupervisor at Lying-in). Her nephew, NealKoquin, is a resident at the Ventura Coun­:y Hospital. Miss Carmon is living in Los'ngeles, and he says she looks as hale andiearty as she did in 1935 when he knewler at Lying-in.J. Ed Campbell has been released fromhe Air Force and has established privatelractice in Knoxville, Tennessee.Miguel Castellanos, fellow in chest sur­:ery, presented lectures on "Experiencevith Subscapular Paraffin Pack as an Aidn Thoracoplasty for Pulmonary Tubercu­osis" and "The Use of a Subscapular Pros­hesis for Obliteration of the Pleural Spacelollowing Pulmonary Resection" at the[ational Congress on Chest Diseases held.t the University of Guadalajara, Mexico,n January.Duke Choy is enjoying his practice ofediatrics in Honolulu. He is chief ofervice at Children's Hospital and medicallirector of Demonstration Premature Cen­er at St. Francis Hospital. His family nowneludes Diane, six; Peggy Ann, four and aalf ; and Glen, three.Edwin S. Clarke is assistant lecturer inhe Department of Medicine (neurology),f the Postgraduate Medical School of theJniversity of London, where he combineshe care of patients with teaching and re­earch. He would be happy to see anylumni who may be in England this year.William Drennan, '43, has entered thenivate practice of medicine in San Jose,:alifornia. Robert Hockwald has replacedlr. Drennan as chief resident in medicine.Among those on the program for theanuary meeting of the American College,f Surgeons in Cincinnati are Joseph P.ivans, director of the Division of Neuro­urgery at the University of Cincinnati:ollege of Medicine; Carl P. Huber, chair­nan of the Department of Obstetrics and;ynecology at Indiana University School'f Medicine and president of the Americanicademy of Obstetrics and Gynecology;nd Robert 1. Schmitz, assistant clinicalrofessor of surgery at the Stritch School,f Medicine, Loyola University, Chicago.Arnold Goldberger is associate in ob­tetries and gynecology at Jefferson Medi­al College in Philadelphia.Ernest Kraft is director of radiology at.incoln Hospital, New York City. He istarried and has one daughter.Edwin Tutt Long has completed overwo years with the Air Force and has re­umed to his residency in surgery here.Carlos Mena is in charge of the Depart­lent of Anesthesia, Pierce County Hos­ital, Tacoma, Washington.Richard 1. Miller has just opened hisffiee to begin the practice of obstetricsnd gynecology in Waterloo, Iowa.William Neal has joined the surgicalaff at the University of Alabama in Bir­,ingham.HerzI Ragins has been called to servicethe Air Force.Stuart Ryerson, of Detroit, became a BIRTHSDr. and Mrs. Joseph 1. Jernegan­Joseph III. September 25,1950; Michael F.December 30, 1951.Dr. and Mrs. Carlos Collignon-MariaElena. February 17, 1952.Dr. and Mrs. David Clark-LucindaReddell. March 28.Dr. and Mrs. Clyde G. Miller-JessicaAnn. April 10.Dr. and Mrs. Myron G. Chapman­Carol Marie. May 19.Dr. and Mrs. George Kasai-ElizabethJoan. May 31.Dr. and Mrs. Frederick Kittle-LeslieJeane. June 15.Dr. and Mrs. John Raper-JonathanArthur. June 15.Dr. and Mrs. Philip Ambuel-BruceHoward. June 19.Dr. and Mrs. Frank Orland-JuneRose. June 23.Dr. and Mrs. David Brockman-Pam­ela Ann. July 10.Dr. and Mrs. John Green-Mark Chris­topher. July 10.Dr. and Mrs. Giles Libersat-Suzanne.July 16.Dr. and Mrs. Carl von Essen-KamalChristina. July 18.Dr. and Mrs. Sidney Schulman-Pa­tricia Tilane. July 20.Dr. and Mrs. Roger Baker-LeslieGreenberry. July 27.Fellow of the American College of Surgeonslast September.After completing his internship at TheClinics, George 1. Sivils spent three yearsas resident in internal medicine at HenryFord Hospital. In July, 1951, he startedprivate practice of internal medicine inChattanooga but has just been recalled tothe Army. As of February 9 he is at BryanAFB in Texas.William E. Sullens has been doing gen­eral surgery with the Northwest MedicalGroup of Great Falls, Montana, for thelast three years. He became a diplomateof the American Board of Surgery in 1950and Fellow of the American College in1952. The Sullenses have two girls and aboy and enjoy living in that relatively newbut rapidly developing part of the country.At the Tenth National Assembly of Sur­geons held in Mexico City, November 9-15,Alfonso Topete was given the award ofthe year for experimental work in Mexico.Dr. Topete is professor and chairman ofthe Department of Surgery at the Univer­sity of Guadalajara.On this occasion also Rene Leriche, Hu­berta Livingstone, Shields Warren, andJames Watts were decorated and presentedwith diplomas as "visitante Distinguido" byofficials of the Federal District of Mexico.Huberta Livingtone opened the scientificprogram with a paper on recording ox­imeters and was presented with a diplomaas "Asarnbleisto de Honor" by PresidentJose Alvarez Amezquita.Guillermo de Ovando was president ofthe section on anesthesiology, and JesusSaldamando presented a paper at the As­sembly.Robert M. Wiener has been a lecturerin general pathology and oral surgery atMcGill Dental School, his alma mater, since1948 when he left the Zoller Clinic here. Dr. and Mrs. Joseph Leek-Joseph H.Jr. August 6.Dr. and Mrs. Cyrus E. Rubin-Wil­liam David. August 6.Dr. and Mrs. James Dougherty-JamesMason. August 11.Dr. and Mrs. William Lester, Jr.­Stephen William. August 18.Dr. and Frank Loewus-David Ivan.August 22.Dr. and Mrs. Gordon Q. Vancil-Mar­cia Elizabeth. August 24.Dr. and Mrs. Richard M. Bernard­Mary Virginia. August 25.Dr. and Mrs. J. A. Filos-Diaz-e-Son.August 29.Dr. and Mrs. Aaron Novick-David.September 3.Dr. and Mrs. Theodore Rasmussen­Mary Catherine. September 3.Dr. and Mrs. Walter D. Hawk-Eliza­beth. September 11.Dr. and Mrs. Iohn P. Plunkett-Tom­my. September 14.Dr. a-id Mrs. Byron Berlin-MichaelJoseph. September 22.Dr. and Mrs. Frederick Malkinson­Philip Roth. September 24.Argonne-[Continued from page 7]No unusual biological effects are ex­pected with electrons, since the actualagent of tissue destruction in the case ofX-rays are the electrons which are ex­pelled from the atoms of tissue by thephotons as they pass through that tissue.Contracts have been entered into for thedesign and construction of the linearaccelerator, and it is expected that themachine will be completed in approxi­mately a year.Medical work on another machine isalso being supported by the ArgonneHospital. This is the 4S0-million-voltproton synchrocyclotron located in theAccelerator Building. Work on this ma­chine is being supported by the ArgonneHospital because it, together with re­sources to be provided in the hospital,will give practically a complete coverageof all types of radiation which are nowknown and thought to be useful in can­cer therapy. Protons will be used directlyand are expected to be advantageous be­cause of the very favorable distributionof dose. However, their biological effectsare as yet only incompletely known, andconsiderable study will be necessary be­fore they can be applied to the treat­ment of cancer in humans.The Argonne Cancer Research Hospi­tal offers the University of ChicagoClinics yet another chance to pioneer ina new field of medicine. It offers thestudent of the University of ChicagoSchool of Medicine yet another oppor­tunity not only to see the various newmethods of treatment but also to under­stand the value of research. And it offersthe Atomic Energy Commission thechance to demonstrate that the atomcan be applied to the service as well asto the destruction of mankind.12 MEDICAL ALUMNI BULLETINASSOCIATION NEWSLETTER FROM KOREAEight days from the time he was recalledto the Navy, Richard B. Hull found him­self in Korean waters. Only then he learnedthat a mistake in classification had beenmade which put him in priority II insteadof IV. He was given the chance to get out,but, since he had arranged his affairs for atwo-year absence, he decided to take thingsas they came.He is supposed to be the internist onthe U.S. Navy Hospital Ship "Haven" inInchon Bay, but since the work is surgicalhe finds his duties mainly administrative.His ship has served the First Marines forthe major battles of Bunker Hill, SiberiaHill, Triangle Hill, and Capitol Hill, andthe volume of emergency care has beenterrific. When they have space, they try tocarry out treatment to the end; but, withonly 800 beds, they frequently have toevacuate casualties shortly after emergencytreatment. Whenever possible, however, hehas pursued a very interesting medicalproblem. They see very young healthyboys progressing nicely with severe, butwhat they consider uncomplicated, injuries.They are reasonably sure that the patientshave had no blood transfusion reactions,but suddenly they develop terrific hyper­tensions, convulsions, coma, uremic frost,extreme elevation of NPN's but alwayshave excellent urinary output of good spe­cific gravity without albumin or micro­scopic findings. They routinely survive withtreatment based on the modern concept ofanuria of a lower nephon syndrome. Theold potassium argument is always at hand,but Hull thinks it is a prerenal azotemiaaffair-reminds him of an eclampsia-pre­eclampsia syndrome.Hull was a resident in medicine herefrom 1948 to 1950 and immediately there­after became associated with a medicalgroup in Springfield, Illinois. While herehe worked on some ACTH investigationswith Dr. Loosli and was delighted to comeacross a reference to their work in WilliamBean's Monographs on Medicine. He says,"It made me more appreciative of what youand the University of Chicago have donefor me .... I would give anything to beback in your basic academic work."Andrew Canzonerri, '44, is one of thesurgeons in the same unit, and so compe­tent, Hull says, that he is very proud to befrom the same place.ALUMNI AID MEDICALEDUCATIONContributions to the National Fund forMedical Education are being received inincreasing numbers. We are notified by theAmerican Medical Association of the giftsthat are intended for the University of Chi­cago, and each donor's name is mentioned.The University is greatly benefited by thefunds made available through the gener­osity of its alumni. CORRIDOR COMMENTOnly someone who had the Argonne Hos­pital in his head and his heart and hisfingers could have written as complete andinteresting a story as Lester Skaggs hasfor this BULLETIN. He has the rare gift ofsaying complicated things simply, and hehas been concerned with the Argonne can­cer research project from the very be­ginning.Mr. Skaggs is an alumnus of this Uni­versity, having received the Ph.D. degreefor work done under Samuel K. Allisonin the Department of Physics in 1939. Sub­sequently he participated in the develop­ment of the radio proximity fuse for theCarnegie Institution on a contract with theOSRD in Washington, D.C. He workedfor a year and a half at Los Alamos andfor four years as consultant for MichaelReese Hospital on the design of a betatronfor the treatment of cancer. He returnedto the University of Chicago in 1949 towork on the Argonne cancer researchproject. He is director of the Health Phys­ics Service for the entire University; he isin charge of the program involving thethree machines in the Argonne Hospital­the Van de Graaff generator, the cobalt-60therapy machine, and the linear acceler­ator-and he is responsible for the devel­opment of the synchrocyclotron for use inhuman therapy.DUES AND GIFTSWe are now well established in a cen­trally located office, next door to the stu­dent lounge, where we can maintain aclearing-house of information on all alumni-geographic, professional, and domestic.For the past year we have sent theBULLETIN to all seven thousand alumniof the Association whether they were mem­bers or not. Five hundred graduates ofRush Medical College have become newmembers. And from a revived list of for­mer members of the resident staff we havereceived over a hundred more.We consider it an important functionof the Association to keep all alumni in­formed of activities here, and we shouldlike to continue to send the BULLETIN toour entire list, but, in order to do so, wemust be assured of the continued supportof established members of the Associationas well as the income from new member­ships.Our expenses ·increase every year-print­ing costs are higher, and we are publishinga larger BULLETIN than we ever have be­fore. Our Scientific Section is enlarged, ourcoverage of University affairs that concernthe medical school is greater, we have addedthe "Rush News Section," and we have anoffice to maintain.So you see that we need the co-oper­ation of all of you-we need your giftsas well as your dues, but first of all weneed dues. Don't put aside the reminderinclosed with this issue: fill it out now andreturn it to us with your check. A.M.A. LUNCHEONJUNE 4If you are going to New York in Jtfor the A.M.A. meetings, you will wantknow about our plans for a UniversityChicago Medical Alumni luncheon. Thuday, June 4, is the date, and Glen T. Smhas been able to schedule the meetingthe A.M.A. headquarters hotel, the Wdorf-Astoria,Alf Haerem arranged an impromjluncheon in San Francisco when the A.Mmet there in 1950, and those of us wwere able to attend remember it with gnpleasure. By making our plans early,expect to see a great many of you at 1.year's reunion luncheon. We wish to Etend a special invitation to all new melbers, particularly to the graduates of RuMake your reservation now-with usdirectly with Glen Smith at St. BarnalHospital, New York.LOUNGE-WARMINGThe Seniors entertained the faculty althe resident staff at a reception in the stdent lounge on the last day of the AutunQuarter, December 19.It was a real house-warming withChristmas tree hung with ingenious decrations, soft music in the background, alsomething rising from the punch bovthat looked but didn't taste like stea:Everyone seemed to be there, and :agreed that the Seniors were superb hotand that the party was a fine thing.CORRECTIONIn the autumn issue of the BULLETon page 6 under the picture of Dr. Pherister's chief residents, we neglected to narWilliam E. Adams, who was the thirdDr. Phemister's chief residents. CertainDr. Adams' name was on the original lisbut through some unfortunate error it Viomitted from the final copy.BULLETIN Iof the Alumni AssociationThe University of ChicagoSCHOOL OF MEDICINEVOL. 9 WINTER 1953 No.2\\'ILLIAU LESTER, JR" EditorHUBERTA LIVINGSTONE, Associate EditorMembers oj the Editorial Board:CLAYTON G. LOOSLIROBERT H. EBERTJESSIE BURNS MACLEAN, SecretaryPrice of yearly subscription $2.00