Volume 14 SPRING 1958 Number 3LESTER DRAGSTEDT2 MEDICAL ALUMNI BULLETINPEPTIC ULCER-AN ABNORMALITYIN THE MECHANISM OF GASTRIC SECRETIONBy LESTER R. DRAGSTEDT, M.D., PH.D.Thomas D. Jones Professor and Chairman, Department of SurgeryThe concept of the mechanisms ofgastric secretion and the pathogenesisof gastric and duodenal ulcers presentedin this informal report have developedas a result of many years of experimen­tal studies in the laboratory, checkedand amplified by observations in the op­erating rooms and clinic. In all of thiswork I have enjoyed the enthusiasticcooperation of very able and industriousassociates.! without whose assistancethe experiments could not have beenperformed.The great English surgeon and physi­ologist, John Hunter, was one of thefirst to raise the question, "Why doesnot the stomach digest itself?" and ad­vanced the idea that living tissue resistsgastric digestion by virtue of the livingprinciple itself. At first I believed thatHunter was right. In an early experi­ment we made windows in the stomachwall of dogs and implanted into thosedefects organs such as the spleen, pan­creas, and kidney, so that the paren­chyma of these organs would be exposedto gastric digestion. When, to my sur­prise, they remained intact I drew theerroneous conclusion that these livingtissues were able to resist the digestantaction of gastric juice. It was only someyears later that I realized that I had ex­posed these tissues to the digestant ac­tion of the usual gastric content andi I am particularly indebted to the follow­ing associates who worked with me for vary­ing lengths of time on the physiology of gas­tric secretion: Arkell M. Vaughn, Silber C.Peacock, James C. Ellis, Warren B. Mat­thews, Edward H. Storer, E. Bruce Tovee,Paul V. Harper, J r., James S. Clarke, Ed­ward R. Woodward, Harry A. Oberhelman,Jr., Robert R. Bigelow, Edward H. Camp,William B. Neal, J r., D. M. Enerson, CurtisA. Smith, Jose M. Zubiran, Allan E. Kark,Antonio J. Montalbetti, Clemente J. L.Morel, Jack D. McCartby, Shirl O. Evans,Herzl Ragins, Stanley P. Rigler, Edward S.Lyon, John Landor, Lester R. Dragstedt II,Peter H. Brasher, J. L. Bravo, J. Barcena,C. M. Baugh, C. F. Mountain, Herbert B.Greenlee, Enrique H. Longhi, Jose Delgadi­llo Guerrero, Thomas S. Nelsen, S. Kohatsu,K. Nagano, and J. Gwaltney. The path fol­lowed in these researches was not the simplestraight one indicated in this paper, but thecontribution of each of these associates wassignificant in the development of the picturehere presented. not to pure gastric juice. Gastric contentis made up not only of gastric juice se­creted by the fundus of the stomach,but also swallowed food, saliva, mucusfrom the pyloric antrum, and regurgi­tated bile and pancreatic juice. Theseare buffering and neutralizing agents andreduce the corrosive properties of thepepsin hydrochloric acid of the fundicsecretion.Gastric Juice versusGastric ContentWhen later on we diverted the puregastric juice from a Pavlov pouch intothe ileum instead of to the exterior, wefound that typical appearing peptic ul­cers developed in the intestine adjacentto the region of anastomosis with thePavlov pouch. Since the mucosa of theintestine was entirely normal before itwas subjected to the contact with puregastric juice, we must conclude thatpure gastric juice has the power to di­gest and destroy the normal living mu­cosa of the intestines. The destructiveeffect of the gastric juice is manifestedby the development of a punched-outulcer in the mucosa, rather than by adiffuse erosion of all of the mucosa com­ing in contact with the gastric secretion.How gastric 'juice produces this curiouseffect remains unknown. Pure gastricjuice can also digest away the wall ofthe normal stomach, again producing asharply punched-out lesion, resemblingthe ulcers seen in patients. These ob­servations developed as a by-product ofa study on the mechanism of gastricsecretion and the effect of the total lossof gastric juice.Dogs without Gastric JuiceDogs were prepared with completelyisolated, vagus-innervated, stomachpouches with anastomosis of the esopha­gus to the duodenum. When these ani­mals were fed, food passed directlyfrom the esophagus into the duodenum,but, nevertheless, the isolated stomachsecreted large volumes of highly acidgastric juice which flowed to the exteri­or and could be collected for examina­tion by suitable cannulae. The escape ofthis gastric juice produced progressiveimpairment of weight and strength, anddeath in a period of ten to fourteen days. Coinciding with these symptoms, thenappeared a progressive decrease in thtconcentrating of chloride in the blood, 1shift in the reaction of the blood to thealkaline side, a marked increase in thecarbon-dioxide combining power of theplasma, and, as a terminal event, a pro·found increase In non-protein and uresnitrogen.Signposts to VagotomyAll of these changes could be reoversed or prevented and the animalsrestored to a normal state by the simpleexpedient of injecting adequate amountsof physiological salt solution into theveins. When this was done, the animalssurvived for long periods of time, butthen usually developed typical appear­ing ulcers in the isolated stomach. Theseoccasionally perforated or caused deathof the animals from hemorrhage. Sincethese isolated stomachs took no part indigestion, we were led to conclude thatthe agent producing the ulcers musthave been the corrosive digestant effectof the pure gastric juice. At this timewe were impressed by the fact thatwhereas ulcers regularly developed insuch isolated stomachs where the nervesupply was intact, they rarely, if ever,appeared in similar isolated stomachswhere the vagus nerves had been di­vided.The question, "Why does not thestomach digest itself?" should probablybe changed since the stomach does di­gest itself in part and in some peopleand an ulcer results. It might be betterto ask, "What are the factors that per­mit the stomach to be digested, or sinceit is evident that pure gastric juice candigest away the mucous membrane ofthe stomach and intestinal tract, underwhat conditions, if any, does a gastriccontent, resembling pure gastric juice inits corrosive properties, ever accumu­late in the stomach?"Peptic Ulcer: Theoryand ObservationFor many years gastroenterologistsand surgeons have held the view thatgastric and duodenal ulcers are pro­duced by the digestive action of thegastric juice. The widespread adoptionof the term "peptic ulcer" for these le-MEDICAL ALUMNI BULLETIN 3sions is an expression of that point ofview. It was realized, of course, thatunder normal conditions the stomach isnot digested away, so an additional hy­pothesis was considered necessary andit was postulated that ulcers are causedby a local decrease in the resistance ofthe mucous membrane to the digestiveaction of the normal gastric content.This decrease in resistance was thoughtto be produced by local thrombosis orembolism of the gastric and duodenalarteries, to vascular spasm, deficiency ofmucus, deficiency of anti-enzymes in thecells, mechanical trauma or other causes.When resection of the stomach for thetreatment of duodenal ulcers becamewidely adopted, examinations were madeof the resected specimens. Evidence ofarteriosclerosis in the gastric blood ves­sels of duodenal ulcer patients was notfound and the occurrence of these le­sions in young and otherwise healthyadults without other systemic disease orarteriosclerosis constitutes strong evi­dence against this point of view. In lab­oratory studies also, it was promptlyfound that the collateral circulation ofthe stomach is very adequate and nolesions result even from extensive liga­tion of the blood vessels to the stomach.When the critical point is exceeded,large parts of the stomach become gan­grenous, but typical chronic ulcers donot appear. Surgeons had noted that lo­cal excision of peptic ulcers was not agood operation since it was promptlyfollowed by the appearance of similarulcers elsewhere in the stomach. If thedisease were dependent upon some localdefect in the mucosa, this operationought to have given better results.In considering a problem of this kind,it is necessary to think not only of theresistance of the mucous membrane, butalso of the extent of the corrosive prop­erties of the gastric content. With thedemonstration that pure gastric juice candigest away the mucosa and produce alesion indistinguishable from ulcers seenin man, the concept developed that pep­tic ulcers are not due to a local decreasein resistance of the mucosa but ratherto a hypersecretion of gastric juice as aresult of which the buffering effect offood, intestinal secretions, and mucus isovercome and there accumulates in thestomach a content approximating puregastric juice in its concentration of hy­drochloric acid and pepsin.Peptic Ulcer: Experimentand TheoryEvidence that an abnormally greatsecretion of gastric juice occurs in duo- L. R. D. and A. J. CARLSONdenal ulcer patients had been secured bythe early gastroenterologists, of whomDr. D. W. Sippy of Chicago was per­haps the most distinguished. Duodenalulcer patients were known to secretemore gastric juice in response to thestimulus of food or histamine than donormal people. However, when studiesof the fasting continuous secretion dfgastric juice were made, a very strikingdifference between duodenal ulcer pa­tients and normal people became ap­parent. These studies recall an old con­troversy between Dr. A. J. Carlson andDr. A. B. Luckhardt of Chicago on onehand, and Pavlov and his pupils on theother. Pavlov believed that in the ab­sence of food taking or the stimulus offood the gastric glands were quiescent.Carlson and Luckhardt maintained, how­ever, that the gastric glands continuedto secrete even during prolonged fast­ing. Our own studies support the viewof Carlson and Luckhardt. Normal peo­ple secrete about 500 cc of gastric juicewith a free acidity of 30 clinical unitsduring a twelve-hour period at nightwhen the gastrointestinal tract is emptyof food and the patient is shielded fromthe sight, odor or taste of food. Thiscontinuous secretion is largely neuro­genic in origin as it disappears almost completely if the vagus nerves to thestomach are divided.Henning in Germany and Bloomfield,Winkelstein and others in this countrynoted that this continuous secretion inthe fasting empty stomach of patientswith duodenal ulcer is usually markedlyincreased. We were impressed with thisobservation and in 1940 substituted ameasurement of the fasting nocturnalsecretion in peptic ulcer patients forother types of gastric analysis. If thevolume of fluid aspirated from the fast­ing stomach in a twelve-hour period atnight is expressed in liters and the freeacid in clinical units, the product of thetwo represents the output of free hydro­chloric acid expressed in terms of milli­equivalents. Normal people put out be­tween ten and twenty milliequivalents,whereas duodenal ulcer patients put outfrom 50 to 100 or even 150 milliequiv­alents of free hydrochloric acid undercomparable conclitions. It is readilyapparent that in the presence of such ahypersecretion during fasting, the buf­fering effect of swallowed saliva, gastricmucus, and regurgitated duodenal secre­tions would be easily overcome so thatthe mucosa would actually be exposedto pure gastric juice for relatively longperiods of time.4 MEDICAL ALUMNI BULLETINAbout this time a most significant ex­periment was reported from the Uni­versity of Minnesota. Wangensteen andhis associates found that if a hyper­secretion of gastric juice was maintainedin experimental animals by the implan­tation of pellets of histamine and bees­wax into the subcutaneous tissues, typ­ical duodenal ulcers regularly appeared.This accumulating evidence led us tosuspect that peptic ulcers were due to ahypersecretion of gastric juice ratherthan to a local decrease in the resistanceof the mucous membrane, a theory forwhich we could find little clinical orexperimental support.Neural Reflexes andGastric SecretionUnder normal conditions, the inges­tion of food stimulates gastric secretionboth by way of nervous reflexes overthe vagus nerves and through the re­lease of humoral agents or hormonesfrom the gastrointestinal tract. The re­peated observation that duodenal ulcersare prone to develop in individuals sub­jected to long continued stress and'strain and that exacerbations in symp­toms often coincide with emotional cri­ses had led physicians to speak ofduodenal ulcer as a psychosomatic dis­ease or the wound stripe of civiliza­tion. We jumped to the surmise that thehypersecretion of gastric juice observedin the fasting stomach of duodenal ul­cer patients was probably of nervousorigin and brought about in some wayby the tensions and anxieties of modemlife. We knew from the experiments ofPavlov that division of the vagus nerveswould eliminate completely the nervousphase of secretion. However, we werein some doubt about the ability of hu­man patients to tolerate the procedure.This was resolved for us when Dr.Phemister and Dr. Adams successfullyremoved the lower portion of the esoph­agus and upper portion of the stomachin a woman with carcinoma in thatarea. The vagus nerves had to be sacri­ficed, and it was interesting to observethat 'when the patient recovered fromthe operation, she regained her formerweight and continued in good health formany years. Subsequently, other resec­tions of the esophagus were made inmany clinics in all parts of the worldand we know for certain that man aswell as lower animals can survive aftera complete vagotomy.Vagotomy for Duodenal UlcerThe first vagotomy operation wasperformed in February, 1943, on a man with intractable duodenal ulcer, whowas invalided by his disease, but re­fused to have a gastric resection. Hewas willing to have a vagotomy, how­ever, even though it was explained tohim that the operation had not beendone before in man, although there wasgreat probability that it would relievehim of his trouble. He agreed and theoperation was performed by enteringthe left chest and dividing the vagusnerves approximately two inches abovethe diaphragm. Fortunately, this firstpatient got an excellent result. His painpromptly disappeared, the hypersecre­tion of gastric juice in the fasting, emp­ty stomach was reduced below normallimits, and the ulcer crater healed. Otherpatients were then operated upon in thesame manner, and within the first yeartwelve such operations were done. Thefirst report was made before the Ameri­can Gastroenterological Association inJune, 1944, and the controversy began,which has continued to the present time.Ob jections were raised that vagotomywould produce a fatal failure of diges­tion, a cessation in the secretion ofurine, paralysis of the stomach and in­testines, insufficiency in pancreatic di­gestion, death from putrefaction ofstagnant food in the stomach, and other direful events. Time has proved thesefears to be unfounded and at the presenttime approximately twelve hundred andfifty vagotomy operations have beenperformed in this clinic for varioustypes of peptic ulcer and some otherdiseases. After a recent survey of somethirteen hundred duodenal ulcer patientstreated by vagotomy and gastroenteros­tomy in Great Britain, Burge and Pickreport in the March 15, 1958, issue ofthe British M edical Journal that "vagot­omy and gastroenterostomy is the opera­tion of choice in either sex and at anyage when surgery is indicated for chron­ic duodenal ulceration."Gastric Ulcer-Another ProblemHowever, while favorable results werebeing secured by vagotomy and gastro­enterostomy in duodenal ulcer patients,the operation was not so effective inpatients with gastric ulcer. Indeed, someof the patients with duodenal ulcer inwhom vagotomy alone was done subse­quently developed gastric ulcers, al­though the duodenal ulcers healed andremained healed. Stasis of food in thestomach due both to pyloric stenosisand gastric atony was a striking featurein these cases. These observations ledus to speculate that in some ulcer pa-Tea for ten at 4:00 P.M. in S539: SHOICHI KOHATSU, LESTER R. DRAGSTEDT II,JAMES ABNER GWALTNEY, EDWARD S. LYON, '53, HARRY A. OBERHELMAN, JR.,'46, SHIRL O. EVANS, JR., '51, DR. DRAGSTEDT, KAZUO NAGANO, JOHN H.LANDOR, '53, and THOMAS SLOAN NELSEN.MEDICAL ALUMNI BULLETIN 5tients a hypersecretion of gastric juicedue to other than nervous factors mightbe operating. As a result of a long seriesof experimental studies in the labora­tory, our attention had become focusedon the antrum of the stomach as thesource of a humoral agent which mightbe responsible for a hypersecretion ofgastric juice in patients where the nerv­ous mechanism was not at fault. Withthe development of quantitative meth­ods for the collection of gastric secre­tion from the stomach or from isolatedstomach pouches, it became possible tosubject Edkins' gastrin theory to a cru­cial test.Antrectomy and Gastric SecretionWe prepared Heidenhain pouches indogs which are devoid of vagus innerva­tion and found that the secretion ofgastric juice from these pouches waspractically abolished by excision of theantrum of lower fifth of the stomach.Subsequently, we found that transplan­tation of the antrum into the colon asa diverticulum would produce an exces­sive secretion of gastric juice and thatwhen this occurred ulcers regularly de­veloped in the tissues exposed to thissecretion. The cause of this hypersecre­tion was revealed when it was foundthat when the antrum is in its normallocation, it is stimulated both by con­tact with food and by gastric peristalsisonly so long as the gastric content isneutral or faintly acid in reaction. Whenthe food becomes thoroughly acidifiedby the gastric juice, the antrum no long­er liberates its hormone, gastrin. Whenneutral or faintly acid food escapesfrom the pylorus into the duodenum,gastric secretion is stimulated by a hor­mone resembling gastrin, produced bythe duodenal mucosa. When, however,the chyme leaving the stomach is acidin reaction, a hormone is released fromthe duodenal mucosa which inhibits fur­ther secretion of acid gastric juice. Thishormone may be pancreatic secretin, orsome substance closely associated withit since preparations of pancreatic se­cretin prepared by the Lilly Companyand suitable for human use cause aprofuse secretion of pancreatic juice indogs and a simultaneous marked inhibi­tion of gastric secretion.Neural and Humoral Phases ofGastric SecretionWe are now in a position to under­stand the mechanism of gastric secretionsomewhat more completely. The aug­mentation in secretion produced by foodtaking is mediated in part by secretory Patient Rounds: DR. DRAGSTEDT, GWALTNEY, and KOHATSUimpulses in the vagus nerves arousedreflexly by the sight, odor, and taste offood. Gastric peristalsis and contact offood with the antrum continues this se­cretory stimulation by means of thehumoral agent or hormone, gastrin, andpossibly in part by a gastrin-like hor­mone liberated from the duodenal mu­cosa during the early part of gastricdigestion. When, however, the food be­comes thoroughly acidified, gastrin failsto be liberated from the antrum mu­cosa, and when the acid food reaches theduodenum, a hormone is liberated intothe blood stream which inhibits furthergastric secretion. This mechanism ob­viously provides for an abundant secre­tion of gastric juice when it is neededfor peptic digestion and a cessation ofthis secretion when the corrosive prop­erties of the gastric content becomesufficiently great to damage the mucosa.The discovery that a hypersecretionof gastric juice of hormonal origin couldbe produced by transplanting the antruminto the colon and the further observa­tion that this hypersecretion could produce typical ulcers in the stomach,duodenum, or jejunum, of course led usto speculate on the possibility that sucha mechanism might be operative in somecases of peptic ulcer in man. The mostobvious abnormality that might be ex­pected to produce a hypersecretion ofgastric juice of hormonal origin in manis stasis of food in the stomach. Physi­cians have long been aware of the factthat patients with duodenal ulcers thathave produced obstruction at the py­lorus not infrequently develop gastriculcers as a secondary complication. Hereit might be argued that prolonged con­tact of the retained food with the an­trum mucosa and the hypermotilityinduced by the narrowing at the pyloricoutlet cause an exaggerated and pro­longed formation and liberation of gas­trin and consequent hypersecretion ofgastric juice. The buffering effect of thestagnant food would be shortly over­come and the gastric mucosa exposed toa content equivalent in its corrosiveproperties to the pure gastric secretion.Only twenty per cent of gastric ulcer6 MEDICAL ALUMNI BULLETINpatients, however, have a previous duo­denal ulcer-producing pyloric stenosis.For the remainder, stasis of food in thestomach must be produced by decreasedgastric motility or atony. Evidence thatstasis of food on this basis is graduallyaccumulating, and the finding that thesepatients display a fasting nocturnal se­cretion less in amount than that of·normal people suggests that decreasedactivity of the vagus nerves may be theresponsible factor, since the night secre­tion in the empty stomach is chiefly ofnervous origin.The Surgical Test: Vagotomy forDuodenal Ulcer; Antrectomy forGastric UlcerThese concepts that duodenal ulcersare usually due to a hypersecretion ofgastric juice of nervous origin and thatgastric ulcers are usually due to a hyper­secretion of gastric juice of humoralorigm are supported by experiencegained from the surgical treatment ofpeptic ulcer. When low gastric resectionis done in the treatment of duodenalulcer, a relatively high incidence ofstoma ulcers result. This is probablydue to the fact that the hypersecretionis of nervous origin in these cases,persists after removal of the antrum,and causes the formation of the newulcer. When, however, a low gastric re­section is done in patients with gastriculcer, stoma ulcers rarely or never form,presumably because the cause of thehypersecretion has been abolished withremoval of the antrum. Other causes ofgastric hypersecretion with ulcer forma­tion undoubtedly occur in addition tothose outlined in this discussion. It isalready known that certain types ofislet cell tumors of the pancreas pro­duce a hypersecretion of gastric juiceof humoral origin, sufficient in degreeto produce intractable ulcers. These arerelieved by removal of the tumor butnot by severing the vagus nerves or ex­cising the antrum. It seems evidentthat the surgical treatment of pepticulcers will become more precise andeffective when more is known concern­ing the factors that are operative in theindividual case. Heretofore, it has beensurgical practice to treat all ulcers byexcising a large amount of the acid­secreting part of the stomach. Bettertreatment may be secured if the causeof the gastric hypersecretion in the indi­vidual case is determined and corrected.Less dangerous and less mutilating op­erations, equally effective, are then pos­sible. merle <irohle <ioulter189t-1958On Monday, March 17, 1958, MerleCoulter, Professor of Botany and Asso­ciate Dean of the Division of BiologicalSciences of The University of Chicago,passed away in Billings Hospital.Born in Lake Forest, Illinois, on June13, 1894, Merle Coulter was the son ofthe first and distinguished Professor ofBotany at the University. Merle himselfwas awarded his Bachelor of Sciencedegree by the University in 1914 andhis Ph.D. degree in Plant Genetics in1919. He joined the faculty of the Uni­versity in 1921 and became Professorof Botany ten years later. At the timeof his death, in terms of length of serv­ice to the University, he was dean ofthe faculty members.Merle Coulter's interest in researchcentered about plant genetics and longafter his administrative duties com­manded most of his time he still taughta course in plant genetics every year.Throughout his entire career MerleCoulter was deeply interested in teach­ing science courses in the area of gen­eral education. He was author of thechapter on plant life in the book, TheN ature of the World and Man, whichwas the basic text of The University ofChicago's first course of general educa­tion taught more than a quarter of acentury ago. He also had published TheStory of the Plant Kingdom, one of thebooks used in the Biological Sciences 3course, a basic science course taught inthe college in the 1930's and '40's.As chairman of the Biological Sci­ences 3 course from 1931 to 1948, heguided a staff of young, vigorous, andyouthfully impatient instructors judi­ciously and tactfully in the developmentof a stimulating and exciting one-yearcourse of biology. This course intro­duced all of our college students notonly to the wide spectrum of disciplineswhich constitute the biological sciences,but also to world-renowned biologistswho were members of the Universityfaculty. Physiologists Carlson, Luck­hardt and Gerard; zoologists Romer,Emerson and Moore; the surgeon Drag­stedt, and many others of similar aca­demic stature participated in the teach­ing of this introductory course, to thedelight and benefit of the young collegestudents. Moreover, during the period1930 to 1931 Merle Coulter also servedas the Dean of the College.His genuine and understanding inter- est in students led to his appointmentas pre-medical advisor to countless pre­professional students. He served in thiscapacity from 1925 to 1948 except forone year, 1945, when he went to Shriv­enham, England, to teach in the Army'sUniversity Study Center. His interestin pre-medical education led to his se­lection by the National Committee onSurvey of Medical Education in 1949to serve on the Committee of Ten. Thiscommittee conducted a three-year sur­vey of preprofessional education ofmedical students in the United Statesand published a classical report on thesubject.In 1948 Merle Coulter was appointedAssociate Dean of the Division of Bio­logical Sciences, a post he held for thelast ten years of his life.Merle Coulter the individual wascharacterized by a strong and fearlesscharacter, a friendly and pleasant dis­position, and a truly subtle sense ofhumor. The illness which finally claimedhim undermined his physical strengthsteadily during his last year but neverwas able to stifle his spirit or to dull hiskeen mind.Those of us who were fortunate tohave been associated with Merle Coulterin his many capacities recognized himto be an inspiring teacher, an able ad­ministrator, and a wise counselor aswell as a true friend and worthy scholar.Mr. Coulter is survived by his wife,Prudence, and two children.JOSEPH J. CEITHAML, PH.D.CHARLES E. OLMSTED, PH.D.GRAND TOURThe Lester Dragstedts and the PaulCannons will spend the summer to­gether in Europe.MEDICAL ALUMNI BULLETIN 7)B gsi( <iol(man ��gtt�ar\1(�1875-1958Dr. Harvey was born in WatfordOntario, and received the A.B. and M.B:degrees from the University of Toronto.His interest in teaching and researchbrought him to the University's Depart­ment of Anatomy in 1901, and his in­terest and skill with students led to hisappointment as Dean of Medical Stu­dents in 1923 and as Dean of Studentsin the Division of Biological Sciences in1931.After his retirement in 1940 he con­tinued to live in Hyde Park and to bean active member of the Universitycommunity.Dr. Harvey died in Billings Hospitalon February 15 at the age of eighty-three.He is survived by his daughter, Mrs.T. G. Kindel, of Grand Rapids.The memorial service was held inBond Chapel on April 7. Dean Cogge­shall spoke of him as an administratorDr. DeBruyn of him as an anatomist'and Percival Bailey of him as a closefriend who had befriended generationsof medical students. We quote from Dr.Bailey's personal reminiscences:Basil Coleman Hyatt Harvey was abeacon to me. I entered medical schoollonely, frightened and more than a littlenauseated on the first contact with thedissecting room. I doubt that I shouldh�ve continued were it not for a smilingkindly man who wandered around to mytable and asked, "What is your name?""Bailey," I replied. "Bailey," hechuckled, "Some ancestor must havebeen a jailor in Scotland." "No, sir," Iprotested, "my grandfather's name wasBoehler. He was born in the GrandDuchy of Baden." The kindly man'sface fell. He looked so disappointed thatI quickly added, "But my mother wasan Orr. Her people came from Kirkcud­bright." "I knew it," he triumphed,again in good humor, "You can't foolme. I knew you were Scotch. Why notcome to my home for tea about fouro'clock this Sunday."Thus I acquired a haven of rest andrestoration as did generations of medicalstudents after me. I did not fail to ap­pear at the appointed time with myshoes shined and my worn clothesbrushed. Apparently they looked suffi­ciently intact because no others ap­peared anonymously in my closet later, HARVEYas happened more than once to otherimpecunious students. I was warmlywelcomed. I felt immediately that herereigned love and understanding.Mrs. Harvey was very different inmany ways but had the same transpar­ently sincere kindly spirit. Within anhour I had told them more about my­self than anyone before or since hasever heard. They understood instinc­tively what I needed and drew it out ofme so deftly and naturally that I didnot realize what was happening to me.My sweet Scotch grandmother was ap­proved, even my dour grandfather Orr.I must have been more eloquent than Irealized, for Dr. Harvey chortled, "Mc­Andrew! McAndrew to the life!" Andhe went to the bookcase, pulled downa volume of poems and read to mefrom McAndrew's hymn which begins,"Lord, Thou hast made this world belowThe shadow of a dreamAn', taught by time, I tak' it so -Exceptin' always Steam." ,So the old Scotch engineer sings his lovefor his engines and draws from themillustration of his Calvinistic creed."Now, a' together, hear them lift theirlesson-theirs and mine:Law, Orrder, Duty an' RestraintObedience, 'Discipline."I know that Kipling is supposed to bea second-rate author but, in this poem, he draws a picture which my Orr ances­tors, who built the first mills in myhome town and founded the Cumber­land Presbyterian Church, would haveloved and understood. It has remaineda favorite with me. I suppose Dr. Har­vey and I must have second-rate souls.At any rate he taught me to love Kip­ling.On other visits he read to me fromBobby Bums and other Scottish poets.I do not know how authentic was hisScottish accent nor do I care. I knowonly that he loved Scotland and allthings Scotch. Years afterward I hadthe pleasure to cross the Atlantic Oceanon the same ship with him and Mrs.Harvey. I had with me my young wife.They adopted her as they had adoptedme. Never have I had so agreeable avoyage. As we approached Scotland Dr.Harvey became more and more excited.His enthusiasm was infectious. Westood at the rail and strained our eyesfar into the night. He knew every islandand rock and recounted endless storiesand legends of the people who had livedon them. My wife and I were very sadthat our paths parted soon after ourlanding. Of course we loved Scotland.Who does not? But, with such a guide,our visit would have been greatly en­riched.In later years I saw him seldom. Wedelude ourselves into thinking that weare too busy to cultivate the greatesthappiness in life-the communion withour friends. But it was just as well inthis case, for I did not distract him fromdevoting himself to generation aftergeneration of students who all lovedhim and were the better for knowinghim.He was no professional do-gooder.Doing good came naturally to him. Hav­ing known him I can understand EmilyDickinson's poem:"If I can stop OI�e heart from breaking,I shall not live m vain;If I can ease one life the aching,Or cool one pain,Or help one fainting robinUnto his nest again,I shall not live in vain."Dr. Harvey lives still in the hearts ofhis pupils and he does not live in vain.My own life has been immeasurably en­riched from knowing him. I regret onlythat I shall not see his like again.PERCIVAL BAILEY, M.D.Professor of Neurology and Neurosurgery,The University oj Illinois8 MEDICAL ALUMNI BULLETINSENIOR SESSIONSCIENTIFICThis year, the twelfth for the SeniorScientific Session, the program will begiven in two parts-in the afternoonand evening of June 11. Between thetwo sessions, the Phemister Lecturewill be heard at 5:00 P.M., and adinner in the Doctors' Dining Roomis arranged for the participants andalumni.Corneal Epithelization in Ex­planted Eyes with ElevatedIntraocular PressureBy CHARLES M. ALEXANDERSurgery (Ophthalmology)It has been observed clinically thatinjuries to the corneal epithelium healmore slowly in eyes with elevated intra­ocular pressure than in normal eyes.This study was performed to learn therelationship between an elevated intra­ocular pressure and the healing of smallwounds of the corneal epithelium.It was reported as early as 1891 thathealing of wounds in the corneal epithe­lium results from a migration of adja­cent epithelial cells. Mitosis does notkeep pace with the migration and doesnot playa major role in the healing ofsuch wounds.Experimental wounds were made witha fine-pointed needle in the corneae of250-gm albino rats. The eyes, kept aspairs. were then enucleated, immersedin a Sorensen's phosphate buffer at pH7.2 at a constant temperature of 37° Cand continually oxygenated. A 27-gaugehypodermic needle was inserted into thevitreous body of one of each pair ofeyes, and was connected to a waterreservoir arranged to maintain hydro­static pressure to the eye. The other eyepreparation served as the control. Theexperiment was terminated three hoursafter the initial injury. The corneaewere then fixed, stained with hematoxy­lin and examined microscopically tocompare the healing of the epithelialwounds in the treated and the controleyes.The injured cells are initially alignedtangentially in relation to the wound.Within the first hour after injury vari­ous biochemical and biophysical reac­tions occur which cause the adjacent vi­able cells to reorient radially and to mi­grate centrally, thereby covering thedefect. Small epithelial wounds, initial­ly 40-50 micra in diameter, are com­pletely healed in four to six hours in thenormal intact animal. In the isolated eyehealing is delayed. Furthermore, retarda­tion was found to be more marked ineyes in which the intraocular pressurewas higher than 75 mm Hg. Cortisone Modification ofRabbit-Skin Responseto X-RadiationBy WILLIAM ROBERT BRUCEMedicineThe antiphlogistic property of corti­sone has been found to ameliorate theeffect of localized irradiation on rabbitskin. Observations have been made bygross examinations and multiple biop­sies of rabbit skin exposed to doses of1000, 3000, 5000, 10,000 and 30,000 rdelivered acutely. At certain of theselevels in vivo observations have beenmade using a modified Clark rabbit ear­chamber. After a latent period of twoto four weeks, exposures above 3000 rnormally lead to massive inflammatoryreaction and necrosis. Animals exposedto the same amounts of radiation buttreated continuously with parenterallyadministered cortisone did not show themarked inflammatory reaction of theskin when exposed to as much as 10,000r. The most effective regimen was foundto be the highest dose of cortisone thatcould be administered constantly fortwo to three months, approximately 1mgjkg/day.Studies of the Mechanism ofInflammation Following In­tradermal Inoculation ofH. Pertussin in the RatBy JERRY G. CHUTKOWObstetrics & GynecologyPresented by title.ISOPCOz Technique for Study­ing the Ventilatory Responseto Metabolic AcidosisBy DARIO B. DOMIZIPhysiologyWhen fixed acid is added to the bloodto permit evaluation of its effectivenessas a respiratory stimulus, there is a con­comitant fall in the tension of carbondioxide, a potent respiratory stimulantin itself. Since two variables have thusbeen affected, one does not have ameasure of the stimulating effect of me­tabolic acidosis alone. In order to avoidthis difficulty, a technique was devisedwhereby alveolar CO2 tension (PAC02)could be held constant during metabolicacidosis. The procedure involves con­tinuous recording of PdC02 by an auto- matic infrared analyzer, and addition ofsufficient CO2 to the inspired air tomaintain PACOZ, and thus arterial PC02which is equal to it, at any desiredvalue.The ventilatory response of anesthe­tized dogs to acidosis produced by intra­venous infusion of 0.5 M HCI was meas­ured when the PACO., was held constantat the value (near 40 mm Hg ) , as wellas when the animals breathed room airand the CO2 tensions were allowed tofall. 'The "ISO-PC02" response to acidosiswas found to be 10 to 15 times as greatas when the animals were allowed tocompensate by blowing off CO2, How­ever, this response was not as great aswhen the same degree of acidosis wasproduced by CO2 inhalation, reaffirmingthe fact that CO., has an effect in addi­tion to its tendency to increase bloodacidity. The data permit comparison ofthe relative potencies of the two stimuli,hydrogen ions and CO2 tension, andthey are similar to the relative valuesgiven by Gray.A one and one-half- to three-fold in­crease in sensitivity to a 5-mm incre­ment in CO., tension was found as thepH was lowered by fixed acid to 7.10,indicating some degree of interactionbetween the two stimuli. The responseto CO2 was found to be approximatelylinear at tensions ranging from 15 to 60mm Hg, which excludes the possibilitythat there is a threshold below whichCO2 is ineffective.Studies on the DynamicEquilibrium of theErythronBy WALTER FRIEDMedicine (Argonne)The existence of a humoral sub­stance(s) regulating erythropoiesis waspostulated more than fifty years ago.However, until recently relatively littleprogress was made in determining itsrole in maintaining the dynamic equilib­rium of the erythron, probably becauseonly tedious and insensitive methods ofassay were available.Plasma rich in erythropoietin (anemicplasma) was harvested from rats previ­ously bled until their hematocrit was25% or less. Three consecutive dailyintravenous injections of anemic plasma(2 ml daily) significantly increased theincorporation of Fe,,9 into the red bloodcells of normal rats above that of ratsthat received normal plasma. The re­sponse of hypophysectomized rats to theMEDICAL ALUMNI BULLETIN 9injection of anemic plasma was several­fold greater than their response to nor­mal plasma using Fe"� incorporation in­to the red cells as an index of erythro­poietic activity.In the young adult rat, erythropoiesisis reduced by a factor of ten within twoweeks after hypophysectomy and thered cell mass falls slowly to one-half itsoriginal value by 60 to 90 days. On theother hand, erythropoiesis falls abruptlyby a factor of 10 within two weeks afterhypophysectomy and then rises slowlyto about one-half its original rate asequilibration with the new red cell massis established.We postulated that shortly after hy­pophysectomy, the tissue demand foroxygen decreased due to an over-all re­duction in the metabolic rate of the ani­mal. Since the oxygen supply remainsunchanged and the red cell mass hadnot yet fallen appreciably, a relativered cell plethora existed. Consequently,erythropoietin production is reducedsharply and erythropoiesis declines. Thissuggested that erythropoietin produc­tion, and thus erythropoiesis, is regu­lated by the relationship of tissue oxy­gen demand to oxygen supply.The hypothesis has been subjected tofurther testing. Our fi.ndings have con­fi.rmed the model proposed for the mech­anism controlling production of the hor­mone and have provided us with othersensitive and simple assay methods.The Steady State of TritiatedWater in the Anterior andPosterior Aqueous andin the VitreousBy SEYMOUR B. GORENSurgery (Ophthalmology)Earlier experiments in this laboratorywith tritiated water showed that the av­erage half-life of the water in the an­terior chamber was 7.4 min., which cor­responds to a steady-state turnover rateof 9.4% of the volume of the anteriorchamber per minute. Previously, studiesusing deuterium oxide as a tracer sub­stance indicated that the half-life of an­terior aqueous water was 2.7 min. whenmeasured from anterior chamber toblood and 5.4 min. when measured fromblood to the anterior aqueous.The steady-state rate of exchange ofwater between the blood, posteriorchamber, aqueous humor, and vitreoushumor has not been reported previously.A tracer dose of 1 mc of HTO was in­jected intramuscularly into male albinorabbits, and serial samples of bloodwere withdrawn from the central arteryof the ear. A single paracentesis of theanterior chamber, posterior chamber, orvitreous chamber was performed on each eye at varying intervals after the admin­istration of HTO. Adequate relaxationwas obtained so that procedures couldbe done without anesthesia. A total of190 rabbits was used in this study. Allsamples were assayed in a liquid scintil­lation counter in a toluene system using2,5-diphenyloxazole (DPO) as the phos­phor.The experimental data were analyzedby numerical integration of a differen­tial equation between limits and by ap­plication to the "slope" method. Theaverage rate of turnover in the anterioraqueous humor was found to be be­tween 12.2 and 16.3% per min. That ofthe posterior aqueous was 21.9 and24.3% per min. The average rate of ex­change of HTO of the vitreous humorwas 4.2% per min.Studies on the Coagulationof SemenBy GERALD S. GOTTERERBen May LaboratoryThe nature of the enzymatic reactionsresponsible for the coagulation of ro­dent semen was studied. The enzyme,vesiculase, is present in the coagulatinggland, a lobe of the rodent prostate.This enzyme clots the proteins presentin the secretions of the seminal vesicle,forming an insoluble material that hasbeen shown to be protein in nature.Vesiculase was partially purifi.ed andseparated from a highly active enzymein the coagulating gland which hydro­lyzes tosyl-L-arginine methyl ester. Thishydrolyzing activity is a property of thrombin, paralleling its clotting activ­ity. Bovine thrombin will not coagulatethe seminal vesicle proteins of rodentsand vesiculase will not coagulate eitherbovine or human fi.brinogen with orwithout Ca + + present. Attempts to in­duce coagulation with various proteoly­tic enzymes, with hyaluronidase, andwith takadiastase were uniformly unsuc­cessful.The reaction was found to be marked­ly influenced by ionic strength, regard­less of ionic species, and by the concen­tration of the seminal vesicle proteins.At low ionic strength and/or seminalvesicle protein concentration, the forma­tion of insoluble protein was delayed,though the rate of formation, once ini­tiated, remained unchanged. The coagu­lation process was shown to involve twodistinct steps. The first of these is in­hibited by the metal chelating agent,versene. This inhibition can be entirelyreversed by equimolar or greater con­centrations of Mn + + and by an excessof Ca + +. Either the second or bothsteps are inhibited by heavy metal ions,e.g., Hg + +. This inhibition can be over­come by the addition of cysteine.These studies have demonstrated thatthe coagulation of semen involves anenzymatic process of protein denatura­tion which is apparently quite distinctfrom that of the thrombin-fibrinogenand the trypsin-casein systems.Organ Weight and CytologicChanges during AntibodyFormation in theRat SpleenBy CARL H. GUNDERSONPathology (Argonne)Previous work from this laboratoryhas emphasized the importance of therat spleen in the formation of antibodyfollowing a single intravenous injectionof particulate antigen. Investigationshave been carried out concerning funda­mental problems related to the develop­ment of "antibody forming" cells fromreticular cells and their maturation intosmall round cells concurrently with therelease of antibody.On day one after a single intravenousinjection of typhoid or Friedlander'svaccine, the rat spleen increases signif­icantly in weight. By day four it reachesa maximum and then begins to de­crease. Hemoglobin and water deter­minations show that these weightchanges are not related to hyperemia oredema. By day four the red pulp isfilled with cells that contain abundantRNA and that probably make antibody.Most of these cells appear to develop(Continued on page 16)10 MEDICAL ALUMNI BULLETINTHE SENIORACKERMAN, BRUCE DAVIDBorn Mar. 12, 1934; New York U., B.A., 1954;Intern.: Geisinger Mem. H., Danville, Pa.; Pedi­atrics; Married; 14 S. Park Dr., Tenafly, N,J.ALEXANDER, CHARLES MEREDITHBorn Nov. 23, 1933; Intern.: Lankenau H., Lan­caster, Pa.; Ophthalmology; Unmarried; 2120 Glen­wood Ave. Toledo, Ohio.ANDERSON, DONALD PAULBorn Nov. 19, 1933; Intern.: Colorado Gen. H.,Denver; Internal medicine; Married; 614 N. Denver,Hastings, Nebraska.BARBEE, ROBERT ALLENBorn Jan. 10, 1933; Yale U., B.A. 1954; Intern.:University H., Cleveland; Internal Medicine; Mar­ried; 743 E. 84th Place, Chicago 19.BOKAT, PETER AKULINBorn May 4,1932; Brandeis U., B.A. 1954; In­tern.' Kings County H., New York City; Psychia­try; Unmarried; 1950 Andrews Ave., New York 53,N.Y.BRIEFER, CAESAR, JR.Born Dec. 4, 1929; Allegheny College, B.S. 1950;Intern.: Massachusetts Gen. H., Boston; Internalmedicine; Married; A.O.A.; Hillcrest Blvd., Warren­ville, N.J.BRUCE, WILLIAM ROBERTBorn May 26, 1929; U. of Alberta, B.Sc., 1950, U.of Saskatchewan, M.Sc., 1954, Ph.D., 1956; Intern.:Billings; Specialty undetermined; Married; 1102990th Ave., Edmonton, Alberta, Canada.CARDER, BRYAN JAMES, JR.Born Aug. 12, 1933; 'Johns Hopkins U., A.B.,1954; Intern.: MacNeal Mem. H., Berwyn, III.; Gen­eral practice; Unmarried; 3413 Clarence Ave., Ber­wyn, III.CHIMENE, DONALD ROBERTBorn Apr. 6, 1933; Cornell U., A.B., 1954; Intern.:Bronx Municipal H. Center; Specialty undetermined;Married; One child; 108-40 70th Ave., Forest Hills75, N.Y.CHUTKOW, JERRY GRANTBorn June 14, 1933; U. of Chicago, A.B., 1952,B.S., 1955; Intern.: Presbyterian H., New York;Internal medicine; Married; A.O.A.; 121 S. Colo­rado Blvd., Denver 20.CONRAD, HAROLD THEODOREBorn Jan. 25, 1934; U. of Chicago, A.B., 1954,S.B., 1955; Intern.: U.S.P.H.S. H., San Francisco;Psychiatry; Unmarried; A.O.A.; 1571 S. 62nd St.,West Allis, Wis.DOMIZI, DARIO BATEBorn May 27,1932; Harvard U., A.B., 1954; U.of Chicago, M.S., 1958; Intern.: Kings County H.,Seattle; Surgery; Unmarried; 11 Bittersweet Lane,Darien, Conn.DRAKE, CHRISTOPHER TERZAKEBorn Dec. 4, 1932; U. of Chicago, A.B., 1954, B.S.,1956; Intern.: Highland-Alameda County H.: Sur­gery; Married; 6235 N. Kedvale Ave., Chicago.FRENKEL, MARCELBorn Apr. 17, 1933; U. of California (Los Angeles),B.A., 1954; Intern.: Billings; Specialty undetermined;Unmarried; 20355 Stagg St., Canoga Park, Calif.FRIED, WALTERBorn Mar. 21, 1935; U. of Chicago, A.B., 1954,B.S., 1955; Intern.: Philadelphia Gen. H.; Internalmedicine; Unmarried; 6241 N. Francisco Ave., Chi­cago 45.MEDICAL ALUMNI BULLETIN 11CLASS OF 1958GELLERT, THOMAS MATTHEWBorn July 20, 1927; U. of Chicago, B.S., 1958;Intern.: Roosevelt H., New York; Internal medicine;Married; One child; 565 McKinley Terrace, Hunting­ton, New York.GIER, RICHARD HOWARDBorn Jan. 15, 1932; U. of Kansas, A.B., 1954; In­tern.: U. Kansas Med. Center; Obstetrics & Gyne­cology; Unmarried; 2727 W. 21st St., Topeka, Kan­sas.GINSBERG, DAVID JESSEBorn Nov. 19, 1933; U. of Chicago, A.B., 1953,B.S., 1955; Intern.: University H., Cleveland; Inter­nal medicine; Unmarried; 7023 S. Jeffery Blvd.,Chicago 49.GOLDEN, MICHAEL FRANCISBorn July 23,1931; Intern.: Blodgett Mem. H.;Specialty undetermined; Married; Two children;2432 Toronto St., Philadelphia 32.GOREN, SEYMOUR BERNARDBorn Apr. 8, 1934; U. of Rochester, B.A., 1955;Intern.: Philadelphia Gen. H.; Ophthalmology; Un­married; 2427 E. 29th St., Brooklyn, N.Y.GOTTERER, GERALD SAULBorn Oct. 17, 1933; Harvard U., A.B., 1955; In­tern.: Grace-New Haven Com. H.; Internal medi­cine; Married; c/o Mrs. S. Kramer, 3457 E. TremontAve., Bronx, N.Y.GUNDERSON, CARL HARMONBorn Nov. 6, 1933; U. of Notre Dame, B.S., 1954,U. of Chicago, M.S., 1958; Intern.: PhiladelphiaGen. H.; Specialty undetermined; Married; A.O.A.;Hotel Hoffmann, Apt. II-A, South Bend, Ind.HABER, SETH LESTERBorn Oct. 8, 1932; Cornell U., A.B., 1954, U. ofChicago, M.S., 1958; Intern.: Billings; Pathology;Married; 21 W. Mosholn Pkway, New York 67,N.Y.HANKE, MARTIN EDWARD, JR.Born Apr. 17, 1926; U. of Chicago, B.S., 1949;Intern.: Los Angeles County H.; General practice;Unmarried; 8424 Rhodes Ave., Chicago 19.HERMAN, GERALD PAULBorn Nov. 20, 1934; Western Reserve U., B.A.,1955; Intern.: Jackson Mem. H., Miami; Thoracicsurgery; Married; One child; c/o Mr. Jack Buck­lan, 2281 Traymore Rd., University Heights 18, Ohio.HILLIER, ATTIE YVONNE WERNERBorn Aug. lO, 1923; American U., S.B., 1944, StateU. of Iowa, Ph.D., 1952; Intern.: Philadelphia Gen.H.; Pediatrics or internal medicine; Unmarried;A.O.A.; 808 Cox Ave., Hyattsville, Md.HUFFER, JAMES MORSEBorn Jan. 20, 1934; U. of Chicago, B.A., 1953,B.S., 1955; Intern.: Strong Mem. H.; Surgery; Mar­ried; A.O.A.; 2119 Regent St., Madisor, 5.JACOBSON, MYRON JULIUSBorn June 19, 1932; McGill U., B.S., 1954; In­tern.: Bellevue 3rd Surg., New York City; Surgery;Married; 21 Spencer Ave., Lynbrook, N.Y.KING, FRANK KARLBorn Feb. 14, 1930; Intern.: Cook County H.;Specialty undetermined; Married; R.F.D. #4, Nash­ville, Ind.KISKEN, WILLIAM ALBERT, JR.Born June 2, 1932; Hope College, A.B., 1954; In­tern.: Blodgett Mem. H.; Surgery; Married; Nopermanent address.12 MEDICAL ALUMNI BULLETINTHE SENIORKNEPFER, ARNOLD LLOYDBorn Jan. 28, 1931; U. of Michigan, A.B., 1952,M.A., 1954; Intern.: San Francisco H.; Psychiatry;Unmarried; 80 Belvedere Dr., Yonkers 5, N.Y.KURLAND, KENNETH ZELDONBorn Nov. 16, 1930; Tufts College, B.A., 1954;Intern.: San Francisco H.; Specialty undetermined;Married; 336 Shirley St., Winthrop, Mass.LANCASTER, JOSEPH ROY, JR.Born June 14, 1931; Shepherd College, B.S., 1954;Intern.: Billings; Surgery; Married; One child; 208N. West St., Charles Town, W. Va.MAGES, NORMAN LOUISBorn May 17, 1935; U. of Chicago, A.B., 1953;Intern.: Beth Israel H. ; Psychiatry; Married;A.O.A.; 6335 N. Springfield Ave., Chicago.McENERY, JOHN THOMASBorn June 15, 1929; U. of Ill., B.S., 1951; Intern.:San Francisco H., Stanford Service; Pediatrics or in­ternal medicine; Unmarried; 945 N. Linden Ave.,Oak Park, Ill.MITCHELL, STEPHEN ARNOLD, JR.Born Feb. 28, 1932; Cornell U., A.B., 1954; In­tern.: St. Vincents H., New York City; Neurology;Unmarried; 1130 Lake Shore Dr., Chicago 11.MUDRY, JOHN PAULBorn Aug. 9, 1932; Rutgers U., B.S., 1954; Intern.:lllinois Research & Educational H.; Specialty unde­termined; Unmarried; 235 Hudson PI., Cliffside Pk.,N.J.NATOVITZ, BENJAMINBorn Nov. 21, 1932; U. of Pennsylvania, B.A.,1954; Intern.: Mount Sinai H., New York City; In­ternal medicine; Married; 324-47th St., Union City,N.J.NICHOLS, ROBERT L.Born Nov. 15, 1926; Southern Methodist U., B.S.,1949; Tulane U., M.S., 1952, Ph.D., 1954; Intern.:Gorgas H., Canal Zone; Tropical medicine; Unmar­ried; 30 Frankford Ave., New Kensington, Pa.P ARZEN, ZANE DRIBINBorn July 26, 1933; Indiana U., B.A., 1954; In­tern.: Cook County H.; Psychiatry; Married; Onechild; 1617 E. La Salle St., South Bend, Ind.PATING, ROGERBorn Mar. 9, 1931; U. of California (Berkeley)A.B., 1953; Intern.: Illinois Research & EducationalH.; Otolaryngology; Married; 462-44th St., Oak­land, Calif.PAVEL, ALANBorn July 2, 1933; Yale U., B.S., 1955; Intern.::'\ ell' York H.; Obstetrics & Gynecology; Married;One child; A.O.A.; 17 Charles-Mary Lane, Stam­ford, Conn.PLZAK, LOUIS FRANK, JR.Born Feb. 21, 1934; U. of Chicago, A.B., 1954,B.S., 1955; Intern.: Peter Bent Brigham H.; Sur­g;ery; Unmarried; 560 N. Washington St., Hinsdale,Ill.PROSHAN, NEILBorn Dec. 29, 1933; Brooklyn College, B.A., 1954;Intern.: Montefiore H., New York City; Specialtyundetermined; Unmarried; 2658 E. 28th St., Brook­lyn 35, N.Y.RASMUSSEN, COLETTE ULLMANBorn Mar. 5, 1932; U. of Chicago, A.B., 1951,Roosevelt U., B.S., 1953; Public Health; Married;5658 Drexel Ave., Chicago 37.MEDICAL ALUMNI BULLETIN 13CLASS OF 1958ROSE, LAWRENCEBorn Feb. 1, 1928; San Francisco State College,M.A., 1952; Intern.: San Francisco H.; OrthopedicSurgery; Married; Two children; 44 Manzanita St.,San Francisco.ROSSE, WENDEL FRANKLYNBorn June 5, 1933; U. of Omaha, B.A., 1953, U. ofNebraska, M.S., 1956; Intern.: Duke H., Durham,N.C.; Internal medicine; Unmarried; A.O.A.; 5827Burdette St., Omaha, Neb.ROTHBERG, RICHARD MARTINBorn July 15, 1933; U. of Rochester, B.A., 1955;Intern.: Billings; Pediatrics; Married; 2314 DitmarsBlvd., Long Island City 5, N.Y.ROTHSCHILD, HENRYBorn June 5, 1932; Cornell U., B.A., 1954; Intern.:Billings; Medicine; Unmarried; 622 Columbus Ave.,New York, N.Y.SAMAL, BOHUMIL A.Born June 8, 1933; Western Michigan College,B.S., 1954; Intern.: Illinois Research & EducationalH; Specialty undetermined; Unmarried; 5501 W.23rd St., Cicero 50, Ill.SCHREIBER, SANFORD JAYBorn June 6, 1931; Amherst College, B.A., 1952,U. of Michigan, M.A., 1953; Intern.: San FranciscoH.; Psychiatry; Unmarried; 1920 Osborne PI.; NewYork 53, N.Y.SCHULMAN, THEODOREBorn Feb. 14, 1933; U. of Rochester, B.A., 1954;Intern.: Buffalo Gen. H.; Obstetrics & Gynecology;Unmarried; 43 Wilton Pkwy., Kenmore 23, N.Y.SINGER, EZRA RICHARDBorn Oct. 10, 1933; Yale U., B.S., 1955; Intern.:Billings; Surgery; Married; 8 Smith St., Danbury,Conn.SOLOMON, FREDRICBorn Aug. 8, 1936; U. of Chicago, A.B., 1954, B.S.,1955; Intern.: Illinois Research & Educational H.;Psychiatry or Endocrinology; Unmarried; 7111 S.Paxton Ave., Chicago 49.STAR, FRANKLIN JULIANBorn Sept. 29, 1933; U. of Chicago, A.B., 1953,B.S., 1955; Intern.: King County H., Seattle; Sur­gery; Unmarried; A.O.A.; 7753 S. Yates Ave., Chi­cago 49.SURVIS, JAMES ADLERBorn Sept. 3, 1932; U. of Michigan, A.B., 1954;Intern.: Presbyterian H., Chicago; Pediatrics; Mar­ried; 14 Aberfoyle Rd., New Rochelle, N.Y.SVOBODA, ALBERT CARL, JR.Born July 27, 1931; U. of Chicago, A.B., 1951,B.S., 1955, U. of Southern California, M.S., 1954;Intern.: University H., Ann Arbor; Internal medi­cine; Married; 1110 N. Aarlen, River Forest, Ill.TAN, TOH-LEONGBorn May 16, 1932; North Central College, B.A.,1954; Intern.: Illinois Research & Educational H.;Surgery; Unmarried; Ipoh, Perak, Malaya.TAUBMAN, JOANNE HELENABorn May 1, 1930; U. of Chicago, A.B., 1953,S.M., 1955; Intern.: Illinois Research & EducationalH.; Medicine; Unmarried; 3508 Labyrinth Rd.,Chicago.TEMPLE, DONALD ERNESTBorn May 21, 1933; Harvard U., A.B., 1954; In­tcrn.: Michael Reese H.; Internal medicine or Der­matology; Marricd ; 6257 N. Talman Ave., Chicago45.14 MEDICAL ALUMNI BULLETINTHE SENIOR CLASS OF 1958THIESSEN, EUGENE UWEBorn Feb. 5, 1931; U. of Chicago, A.B., 1951;Intern.: Bellevue 3rd Medicine, New York U.; Pedi­atrics; Unmarried; 721 Pleasant Lane, Glenview, Ill.THURSH, DONALD ROBERTBorn Nov. 19, 1932; New York U., B.A., 1954;Intern.: King County H., Seattle; Surgery; Married;A.O.A.; 415 E. 52nd St., New York, N.Y.TIDBALL, CHARLES STANLEYBorn Apr. IS, 1928; Wesleyan U., B.A., 1950, U.of Rochester, M.S., 1952, U. of Wisconsin, Ph.D.,1955; Intern.: Madison Gen. H.; Physiology; Mar­ried; 1023 Clymer Pl., Madison 5, Wis.URIU, STANLEY ASAOBorn Jan. 3, 1933; U. of California, A.B., 1954;Intern.: Illinois Research & Educational H.; Specialtyundetermined; Unmarried; 20841 Fremont Rd., Sun­nyvale, Calif.WEILER, ROBERT JOSEPHBorn May 18, 1932; U. of Notre Dame, B.S.,1954; Intern.: Billings; Internal Medicine; Unmar­ried; 1651 Grace Ave., San Jose 25, Calif.W.eINBERG, RICHARD ALLENBorn Aug. 3, 1932; Brooklyn CoHege, B.S., 1954;Intern.: Philadelphia Gen. H.; Specialty undeter­mined; Married; 869 New Jersey Ave., Brooklyn 7,N.Y.WHITMAN, JOHN MICHAELBorn Oct. 4, 1923; U. of Chicago, M.S., 1953;Intern.: Cook County H.; Psychiatry; Unmarried;662 N. 12th St., Reading, Pa.WOLFSON, SIDNEY KENNETH, JR.Born June 14, 1931; U. of Pennsylvania, A.B.,1951, Temple U., M.A., 1958; Intern.: U. of Penn­sylvania H., Philadelphia; Surgery; Unmarried; 5202Church Rd., Philadelphia 31, Pa.ZINNER, NORMAN ROBERTBorn Sept. 20, 1934; Purdue U., B.S., 1955; In­tern.: New York H.; Urology; Unmarried; 5810Beverly Rd., Brooklyn 3, N.Y.Whump's disease �1�� J1 [ftJ%1'"•o 0\Merry Chr ishtmash cccMEDICAL ALUMNI BULLETINCLASS HISTORY 15As we now add our class history tothose of years gone by, it seems almostyesterday that we all met for the firsttime in Abbott 101 for our freshmanorientation. There we heard DeanCeithaml tell us that we were a veryselect group and that grades were un­important (though some of us wonderedabout that later), marvelled at Dr.Dragstedt's hands, and wondered whatwas going to happen to that poor un­fortunate Ken Kurland who arrived twodays late.From there it was only a short hop to"Coach" Kabisch's anatomy class andthe coffee breaks at Commons whichseemed to grow longer and longer untilHank (Deals) Rothschild was politelyasked to leave the lab sans Coca-Cola.Freshman's Syndrome: Amaurotic IdiocyFew of us will forget the "Rod" askingwho gave us permission to destroy thecadaver or the bored voice of Dr. Gershresponding to a question with, "Justturn the page." That hectic first quarterculminated in those fateful three hoursbetween the gross and microscopic finalswhen many of us gulped down quartsof milk to stop that peculiar burningepigastric pain. Tom Gellert wasn't ableto give up his Tums until months after­ward.The following quarter we were intro­duced to physiology, and Dr. Perkins'respiratory equations will remain asource of amazement to many of us.In the spring the pressure eased offsomewhat as some of us began dabblingin research or taking elective coursessuch as the Saturday afternoon softballgame at Stagg Field. Then as suddenlyas it had started, it was over and wefound ourselves sophomores.We returned the following fall infi­nitely more sophisticated than the in­coming freshmen as we were introducedto the fascinating world of worms andbugs. Dr. Steiner was at least partiallysuccessful in his goal of causing ouradrenals to become hyperplastic. In Sophomore's Syndrome: HypochondriasisFulminans.some of our more susceptible classmatestwo very SUSpICIOUS retroperitonealmasses may be seen on close inspection.That spring with shiny stethoscopes andblood equipment purchased from theseniors (who were unaccountably happyabout selling it) we became cliniciansand it was every patient for himself.With the clinics a whole new crop ofpersonalities arose and all of us willremember with nostalgia the antics ofNorm the Storm, Stainless Steel, andMr. Medicine. It took Dick Gier fouryears to learn that we didn't hate himand indeed were so much the wiser forlearning from him the definitions ofsuch things as dyspareunia. In that yearof blood counts, urinalyses, detailedJunior's Syndrome: Hyperscribia Agitans presentations, and little sleep we shallall remember that much prized notationon our work-ups, "OK-R. Blaisdell."There were mighty few of us whodidn't measure up to Dr. Alving's cri­teria for a "dummy," and even the moststoic among us were known to quailwhen the "Squire" peered at them overhis half-glasses to ask, "But where inthe brain?" Marcel Frankel soon learnedto cut his eight o'clock lecture to scrubin with Dr. Huggins and Larry Rose,after a few false starts, finally learnedto find out the patient's name beforeworking him up.As seniors we got to know the staffmore intimately as we learned the in­tricacies of the "Big Six," of Dr. Ken­yon's propensity for doing repeat pel­vies, and of the "Pro's" rather uniquetechnique for doing a rectal. With theincrease in leisure, we all had more timefor reading and consolidating theknowledge we had acquired so that onerarely had to miss Ann Landers' dailycolumn. Extracurricular activities suchas the Thursday night poker game andthe Wednesday night eponym club aswell as a whole raft of new babies andmarriages did much to take up the slack.Senior's Syndrome: Mania TerminalisThe senior Christmas party was a"smashing" success. As comps came andwent, even the most spastic among uswas finally convinced that he was actu­ally to become a doctor.And so we come to the close of an­other class history. Not too differentfrom preceding classes or classes thatwill follow, but unique and full of mean­ing to those of us who were a part of it.As we all go our separate ways we shallremember more of the laughter than thelabor and this is as it should be.To the class of '58, to those whomade it and those who didn't, this hx isdedicated.CAESAR BRIEFER16 MEDICAL ALUMNI BULLETIN(C ontinued from page 9)into small dark bodies and leave thespleen between day four and day eight.A few become adult plasma cells. Anti­body-containing cells, indistinguishablefrom small lymphocytes, presumablyfrom the spleen, have been demon­strated in blood smears by adherence ofantibody to their cell walls.When washed carbon particles mixedwith the typhoid vaccine are injectedthey localize principally in the marginalzone around the lymphoid follicles andto a lesser extent in small islands in theloose red pulp, but never in the pyro­ninophilic cells. During the first threedays the marginal zone thins, most ofthe carbon-laden macrophages migrateinto the loose red pulp, and the pyro­ninophylic cells apparently proliferatearound but do not originate from thesephagocytes.These observations help to explainhow cells are stimulated to form anti­body. They indicate that cellular prolif­eration and mobilization correlate withthis reaction.The Effects of Surface-ActiveSolvents and Dietary AlphaTocopherol on the Car­cinogenic Activity of In­jected Methylcho­lanthreneBy SETH L. HABERPathology & ArgonneConsiderable evidence indicates thatcarcinogenesis is a two-stage phenom­enon consisting of an initiating phase inwhich the previously normal cell is con­verted into a dormant tumor cell, and apromoting phase in which these dormanttumor cells multiply into visible tumors.It follows that the number of tumorsdeveloping is a function of the initiat­ing process, while the latent period is afunction of the promoting action.Several solvents, such as Tween 60,have been implicated as tumor-promot­ing agents because high tumor yields canbe obtained with a sub-threshold doseof a carcinogen, if it is followed byapplication of this agent. Although theseagents have been used extensively inskin painting and dietary experiments,there is little data on their activity insarcoma production with subcutaneousdepots.Dietary factors are also said to inftu­er ce the carcinogenic response. Severalinvestigators have reported that wheat­germ oil inhibits carcinogenesis, butprevious experiments have not linkedthis with the high vitamin-E content ofthe wheat-germ oil. In the first experiment, two hundredC-57 mice were placed on a diet of Pu­rina Laboratory Chow with or withoutthe addition of alpha tocopherol. Theythen received interscapular subcutaneousinjections of the carcinogen, methylcho­lanthrene, in mineral oil or Tween 60,with a control group receiving pureTween 60. Vitamin E reduced the tumorincidence and increased the latent pe­riod. The Tween 60 completely inhibitedlocal tumor formation when it was usedas a solvent for the methylcholanthrene.This may have been due to a spreadingeffect of the Tween 60, analogous tothat of hyaluronidase, which increasedthe rate of diffusion of the carcinogenaway from the depot, so that there wasnot sufficient time for it to act locally.In a second experiment one hundredthirty mice were placed on Purina Labo­ratory Chow diets with or without theaddition of alpha tocopherol. They thenreceived interscapular subcutaneous in­jections of methylcholanthrene dissolvedin tricaprylin or a mixture of 10%Tween 60 and 90% tricaprylin; the con­trol group received the Tween-tricapry­lin solvent without the carcinogen. Theinhibitory effect of vitamin E was againconfirmed. Under the conditions of thisexperiment the solvent effect of theTween 60 was apparently altered suffi­ciently to retard the diffusion of the car­cinogen from the depot and to demon­strate the tumor-promoting action ofthis surface-active agent.To clarify the stages of carcinogen­esis, the sequential histopathologicalchanges antecedent to tumor formationwere investigated in a third experiment.Methylcholanthrene retarded the fibro­plasia usually seen about the subcuta­neous depot. Abnormal giant fibroblaststhat may represent the tumor-promotionphase began to appear about twentydays after the carcinogen was injected.At forty days an occasional depotshowed nests of these cells which resem­bled small sarcomas. This approach maylend itself to further detailed analysis ofthe nature of the histochemical processby which a carcinogen, acting first as aninhibitor of cell proliferation, laterstimulates neoplastic growth. The Reversibility of ChronicAtelectasisBy GERALD P. HERMANSurgery & PhysiologyChronic atelectasis may be secondaryto bronchostenosis of traumatic, tuber­culous, or congenital origin. A series ofexperimental studies were undertakento ascertain whether such a chronicallyatelectatic lung might be reexpandedwith improvement in pulmonary func­tion.Atelectasis of the entire left lung wasproduced in 15 dogs by the transbron­choscopic application of 35% silver ni­trate to the wall of the left main-sternbronchus. Complete bronchostenosis andresulting atelectasis were demonstratedby bronchoscopy, roentgenograms, andbronchography. Physiologic studies,utilizing a continuous recording oximeterwere performed two and one-half weeksto nine months after production of ate­lectasis to permit determination of ar­terial saturation in the awake un sedatedanimal, and to provide data for the plot­ting of oxygen-saturation tension curves.The amount of blood shunted throughthe atelectatic lung as a percentage oftotal blood flow was calculated. Aftervarying periods of time of atelectasis,the stenotic portion of the bronchus wasresected, and the lung re-expanded.Studies in the group of animals hav­ing an atelectatic lung for two and one­half to ten weeks was 26% of totalblood flow; in the ten- to twenty-weekgroup, the shunt was 11 %. Followingbronchoplasty and re-expansion, the de­gree of shunting was reduced to 1 %,and the return toward normal functionwas demonstrated. Conclusive evidenceof the capacity of the chronically atelec­tatic lung to regain function was ob­tained by resection of the opposite lungwhich left the animal with only the re­expanded lung.Peripheral Blood-Flow in Chil­dren, Ages Seven toEighteenBy YVONNE HILLIERPediatricsThere are meager data on peripheralblood-flow in children and these refer todistal leg-blood in children over tenyears of age. Temperature was notrigidly controlled in the room and in theplethysmograph.In this study forearm blood-flows weremeasured in 189 children; 159 were stu­dents at the University LaboratorySchools, the remainder were normal pa­tients seen in pediatric clinics. Forearmblood-flow was measured by means of aMEDICAL ALUMNI BULLETIN 17constant-temperature (34.0° ±0.1 ° C)water-filled venous occlusion plethysmo­graph. Studies were performed on a su­pine subject in a room with constanttemperature controlled at 23°-25° C.The arm was placed into the plethysmo­graph at heart level and twenty-five in­flow tracings were recorded.Forearm blood-flow of males and fe­males up to age twelve averages 6.3 ml/100 gm tissue./min., which is slightlymore than twice adult male blood-flow.Blood-flow of males and females overfifteen years of age has decreased to anaverage of 4.3 ml/100 gm tissue/rnin.,one and one-half times the level ofadult males. The majority of the chil­dren were in the age groups of seven totwelve and fifteen to eighteen years.More children in the group twelve tofifteen years need to be studied in orderto determine the pattern of the decreasein blood-flow with aging. Up to twelveyears of age, male blood-flow averages0.9 ml greater than female blood-flow;at fifteen, 0.5 ml greater.A group of children studied at ambi­ent temperatures of 28°-31 ° C showeda blood-flow three to three-and-one-halftimes that of previously describedgroups at 23°-25° C. Similar room tem­perature increase in the studies on adultmales doubled the blood-flow measure­ments. This would suggest that in a vas­cular bed which is primarily muscle,children experience greater vasodilata­tion than do adults.Enterotoxin Enteritis-Experi­mental Induction of theDisease in AnimalsBy MYRON J. JACOBSON andCHRISTOPHER DRAKESurgeryIn the clinical study of pseudomem­branous enterocolitis, studies in this lab­oratory have indicated that the diseasemay actually be produced by the entero­toxin generated by Staphylococcusaureus successfully established in the in­testine of man.Six cats were used in the first seriesof three experiments. Each receiveddaily 10 cc of enterotoxin by mouth.Animals were sacrificed beginning onthe twelfth to the last on the thirty­fourth day. All showed enteritis. Theprincipal gross pathologic changes foundin all the animals at necropsy consistedof marked edema of the duodenum andjejunum and the mucosa of the jejunumwas granular with patchy hemorrhagicareas. The microscopic changes observedwere edema, hyperemia, leukocytic infil­tration of the mucosa and muscularis,partial sloughing of the mucosa andoccasional ulceration. In the second series, a Roux-Y feed­ing jejunostomy was executed in threecats. Ten cc of enterotoxin were intro­duced through a catheter directly intothe upper jejunum daily for periods offrom five to 23 days. At necropsy thegross and microscopic pathological find­ings were similar to those found in theanimals receiving the enterotoxin bymouth.In the third experiment seven kittenswere used. They were offered 5 to 10 ccof enterotoxin in milk. Sacrifices beganon the twelfth day and the last was doneon the twenty-third day. Enteritis wasfound in all the animals except one.It may be concluded that staphylo­coccal enterotoxin without viable organ­isms given orally with or without milkor introduced directly into the jejunumof cats produces pathologic changes inthe bowel similar to that seen in human"pseudomembranous enterocolitis."Effect of Impaired Metabolismon Cochlear PotentialsBy ROGER PATINGSurgery-OtolaryngologyThe responses of the cochlear recep­tor (cochlear microphonics and actionpotentials) to sound stimuli werestudied under different conditions ofimpaired metabolism.The survival time for both potentialsafter blocking the internal auditory ar­tery was between 40 and SO seconds.This measurement was considered to bean index of (1) the oxygen reserve inthe cochlea, (2) energy provided byother reactions such as glycolysis, and (3) the metabolic rate of the generatorsof cochlear microphonics and action po­tentials. Under other conditions of oxy­gen lack such as asphyxia (by clampingthe trachea), anoxia (respiration of purenitrogen) and hypoxia (respiration ofgas mixtures with low concentrations ofoxygen), the survival time of cochlearresponses increased significantly. Theincrease was attributed to the presenceof oxygen in the circulating blood. Theseexperiments demonstrate that action po­tentials are more sensitive to anoxiathan cochlear microphonics and thattheir generation depends on oxidativemetabolism.The same qualitative results were ob­tained when the metabolic rate of thegenerators was reduced by means of hy­pothermia. A drop in the body tempera­ture of guinea pigs from 37° C to 20° Creduced the amplitude of cochlear mi­crophonics by one half while action po­tentials were barely visible.Iodoacetic acid at a concentrationsufficient to inhibit anerobic glycolysishad no effect upon the cochlear re­sponses. This result is compatible withthe present concept of alternate path­ways of glycolysis when the inhibitorsare given aerobically.Hypoglycemia induced by insulin ad­ministration and/or functional eviscera­tion also had no effect upon the cochlearresponses until hypoglycemia reachedthe medullary stage. At this levelchanges in cochlear microphonics andaction potentials followed the changesin blood pressure. Several possible ex­planations are given for these findings.The Site of ErythropoietinProductionBy LOUIS F. PLZAKMedicine (Argonne)Ever since the existence of a humoralmediator of erythrocyte production waspostulated, attempts have been made todetermine its site of formation. Afterdeveloping sensitive and simple methodsof assay for this humoral substance(erythropoietin), experiments were de­signed in an attempt to find its site ofelaboration.Normal rats and rats subjectedeither to hypophysectomy, orchiectomy,oophorectomy, splenectomy, adrenalec­tomy, removal of seven-eighths of theliver, or lethal amounts of irradiationretain the capacity to produce high plas­ma titers of erythropoietin in responseto repeated phlebotomy. On the otherhand, after bilateral nephrectomy, nodetectable elevation in erythropoietintiter is observed in response to hemor­rhage. whereas an increased titer is ob­tained routinely in rats with bilateral18 MEDICAL ALUMNI BULLETINureter ligation that are subjected tophlebotomy even though the degree ofuremia (BUN) is comparable in bothexperimental conditions.The plasma erythropoietin titer ofnormal rats given cobaltous chloridesubcutaneously rises above the controlvalue about four hours after injectionand reaches a peak titer at approximate­ly ten to 12 hours. Bilateral nephrec­tomy eliminates this response to cobaltion.These data suggest that the kidneymay be the primary site of erythropoi­etin production.The Pelger-Huer Anomaly inThree Families and Its Usein Determining the Sur­vival Time of Trans­fused NeutrophilsBy WENDELL F. ROSSEMedicine (Argonne)Thirteen cases of the Pelger-Huet nu­clear anomaly of the leucocytes werefound in three families. In this anomalythe nuclei of granulocytes are hyposeg­men ted (50% or more nonsegmented;the nuclei seldom with more than twolobes), pyknotic, and smooth androunded in contour. The "pince-nez"cell, which has two symmetrical, roundlobes connected by a thin chromatinstrand, is characteristic. The anomaly iscongenital and inherited as a non-sex­linked Mendelian dominant. Estimatesof incidence range from 1: 1000 to1: 6000 but it has been reported in onlythree other families in the UnitedStates.Asymptomatic elliptocytosis of theerythrocytes was found in one familyin the present series but was probablyunrelated to the leucocyte anomaly.This is the second Negro family in whichthe Pelger-Huet anomaly has been ob­served.The anomaly is apparently harmless.It must be distinguished from a "regen­erative shift to the left" and from leu­kemia. Familial incidence and carefulexamination of cells will serve to dis­tinguish the anomaly from these condi­tions.The morphologic distinctiveness ofPelger-Huet cells permits one to followthe course of disappearance of exoge­nous neutrophils following their injec­tion. Five hundred ml of blood from apatient with the anomaly was injectedinto a patient with normal cells, andvice versa. Serial total white-cell anddifferential counts were performed, withspecial care being taken to distinguishthe exogenous cells. Over half of the in­jected cells in both experiments weregone from the peripheral blood by sixto eight hours after injection and none was found later than 49.5 hours follow­ing injection. These experiments demon­strate the short survival time of injectedneutrophils in the peripheral blood.Enhancement of Muscle Con­tractility by MechanicalStimulationBy HENRY ROTHSCHILDMedicineAbbott, Aubert and Hill have pre­sented evidence that skeletal musclesmay absorb energy from a mechanicalstretch. They suggest that this energyis converted to some form of potentialenergy, probably in chemical form. Theefficiency of this transformation is inpart dependent on the speed of stretch.A new method of introducing me­chanical energy into vascular smoothmuscle has been devised by vibratingthe muscle system. Reasonably parallelbundles of smooth muscle were obtainedby cutting a rabbit aorta in a spiral.This bundle of smooth muscle wasplaced under a predetermined tensionwhich could be released and reappliedisometrically to the muscle at rates from20 to 20,000 times per second. Thestored potential energy of the mechani­cal stimulation can be recovered aswork by using the strain gauge tomeasure the isometric contraction ofthe muscle in response to a chemicalstimulus.When the tension cycle was appliedfrom 40 to 70 times per second a stimu­lation of the muscle by norepinephrinegave a greatly augmented response ascompared with that of a control muscleunder a constant tension and the re­sponse was also greater than that of amuscle with the tension altered at a fre­quency above and below these levels.It is postulated that mechanical vibra­tion of the intact in vivo vascular sys­tem can change the contractibility ofthe vascular muscle in the same way.Clinical evidence supports this hypoth­esis; e.g., Gurdjian and Walker foundthat the vibration of pneumatic ham­mers had to be 50 to 60 cycles persecond to produce vasospasm and Ray­naud's phenomenon in man.Relationship of CirculatingAntibodies to Anaphy­laxis in the MouseBy RICHARD M. ROTHBERGMedicine (Argonne)The purpose of this project was tostudy the capacity of the mouse to pro­duce specific circulating antibodiesagainst a single protein antigen (bovineserum-albumin emulsified in Freund'sadjuvent ), and the relationship of theseantibodies to anaphylaxis. Three differ- ent inbred strains of mice were used ancantibody titers were determined by botlthe standard precipitin test and the Fansalting-out method. Varying concentra­tions of sensitizing doses, times of ad.ministering challenging dose, and .con­centration of challenging dose were useeand resultant antibody titers and de·grees of anaphylaxis were observed. Theexperiments indicated first, that anaphy­laxis in the mouse can be related to cir­culating antibody titers as determinedby the Farr test. Anaphylaxis and ana­phylactic deaths were noted only in theCF No.1 strain which was the only oneto produce appreciable antibody titers(1 :400 dilutions). Second, precipitatingantibody is not related directly to ana­phylactic sensitivity. Severe anaphy­laxis, anaphylactic death, and antibody.measurable by the Farr test, appearedbefore precipitating antibody appearedin the serum. Weiser et al. have shownthat anaphylactic sensitivity lasts longafter precipitating antibody disappearsfrom the serum. Using calculations de­rived by Farr and Talmage to measurethe average strength of the antibody­antigen bond, it was found that as theaverage bond became stronger, anaphy­laxis to the higher challenge doses be­came more severe, but the opposite orno change occurred in response to thelower challenge doses. Furthermore,sensitivity to anaphylaxis and anaphy­lactic death increased in a manner simi­lar to the increase in antibody asso­ciated with a weak antibody-antigenbond. The precipitating antibody asso­ciated with a strong antibody-antigenbond appeared and began to increase atabout the time the decreased anaphylac­tic sensitivity to the lower dose chal­lenges appeared. Interpretation of thesefindings suggests a new mechanism foranaphylaxis.Embryomegaly and IncreasedFetal Mortality in PregnantRats with Mild AlloxanDiabetesBy FREDRIC SOLOMONObstetrics & GynecologyFor unknown reasons pregnancy indiabetic women is associated with ahigh stillbirth rate and increased size ofthe newborn. Attempts to reproduce ex­perimentally these clinical observationshave yielded conflicting and unsatisfac­tory results.Diabetes of various degrees of sever­ity was induced by the administrationof alloxan to rats at various stages ofgestation. Mildly diabetic rats deliveredoffspring with an average birth weightsignificantly higher than that of off­spring of normal rats (6.30 gm com­pared with 5.75 gm). A statistically sig­nificant increase in stillbirth rate alsoMEDICAL ALUMNI BULLETIN 19was observed (20.8% compared with3.7%). The stillborn young were notnecessarily larger than their littermates.Gestation time, number of fetuses perlitter, and net maternal weight incre­ment did not differ significantly fromcontrol values. The elevations in fetalbirthweight were most marked whenmild alloxan diabetes was induced at thebeginning of the third trimester of preg­nancy.Severe diabetes caused early inter­ruption of pregnancy in most cases,often preceding maternal death. Thoseanimals which did not abort producedonly living young, of slightly less thannormal weight. The mothers failed tolactate.Gross chemical analysis was per­formed on two litters from rats withmild alloxan diabetes and on two littersfrom control animals. Virtually identicalproportions of water, protein and fatwere found in both groups. Such datawould suggest that the embryomegaly ofmild alloxan diabetes is associated withtrue growth of the fetus rather thanedema or excessive fat deposition.Experimental Induction ofPseudomembranous En­teritis in the AnimalBy TOH-LEONG TANSurgeryThe purpose of this paper is to de­scribe the production of pseudomem­branous enterocolitis in chinchillas withthe oral administration of strains ofstaphylococcus isolated from the stoolsof patients with this disease, and the re­isolation of the same staphylococcus andits enterotoxin from the intestines ofthese animals. The experiment that wasdone is in conformity with the four pos­tulates of Koch.In the first study, three chinchillasreceived daily oral administration of anantibiotic mixture. Starting on the sixthday a suspension of a pure culture ofstaphylococci was given daily by mouthuntil the time of death. All three ani­mals died within 14 days. Necropsy re­vealed severe enterocolitis. The culturesof the intestinal content revealed a purecolony of staphylococcus.In the second study the administra­tion of the antibiotic mixture to twochinchillas was discontinued on thesixth day, at which time the oral feedingof a suspension of staphylococci wasgiven until death took place from se­vere enterocolitis in six to eight days.Pure cultures of staphylococcus were re­isolated at necropsy. The reisolatedstaphylococcus again produced a pro­nounced enterotoxin reaction in themonkey.Three chinchillas in the third studywere treated in the same manner as those in the second. At first, theyshowed the characteristic symptoms, butlater developed resistance. They were,therefore, rested for two weeks and adifferent strain of staphylococcus wasadministered. Severe enterocolitis wasagain observed. Staphylococci were re­isolated in pure cultures and they re­produced a strong enterotoxin reaction.It may be concluded that Staphylo­coccus (var. au reus ) isolated fromknown cases of pseudomembranous en­terocolitis or from cases of food poison­ing produces the disease in chinchillas;at necropsy, the Staphylococcus may bereisolated in pure culture from the in­testinal tract of the diseased animaland that the etiologic agent of pseudo­membranous enterocolitis is enterotoxin­producing Staphylococcus.Mechanism of the EnzymaticConversion of Thiophos­phates to CholinergicDrugsBy DONALD R. THURSHP harmacolo gyThis investigation was undertaken inan effort to elucidate the mechanism bywhich organic thiophosphates are con­verted to anticholinesterase agents invivo. The compound employed for thestudy was the dimethoxy ester of ben­zotriazine dithiophosphoric acid (DBD).Measurements of acute toxicity in­dicated that DBD exhibits a relativelyhigh toxicity to rats and mice as evi­denced by LD-50 values in the range of3 to 12 mg /kg. Guinea pigs are some­what more resistant. The symptoms pro­duced by this compound are similar inall species and are typical of thosecaused by cholinergic drugs. Atropine iseffective as an antidote for DBD.In vitro tests demonstrated that DBDhas a rather weak anticholinesterase ac­tion, but the injection of sublethal dosesof the compound produced marked inhi­bition of the enzyme activity of brainand submaxillary glands. The differencesbetween the in vitro and in vivo ef­fects of D BD on cholinesterase may beexplained by the finding that the com­pound is converted to a highly activeanticholinesterase agent by an unstablediphosphopyridine nucleotide-linked en­zyme located in the microsome fractionof liver. The metabolic conversion con­sists of replacement of the sulfur ofthiophosphates by oxygen and the activemetabolite is, therefore, the oxygenanalog of the parent compound.A quantitative method for measuringthe activity of this enzyme was devel­oped and applied to a study of species,sex, and age differences in the suscepti­bility of animals to cholinergic thio­phosphates.The results of this investigation pro- vided evidence for the presence of anenzyme in liver microsomes that is capa­ble of converting physiologically inertchemical agents to highly toxic metabo­Ii tes.The Effect of .B-3-Thienylal­anine on Antibody Syn­thesis in VitroBy STANLEY A. UaruPathology and Anatomy (Argonne)The spleen is virtually the sole anti­body-producing organ in the rat. Itscellular response to intravenous particu­late antigens begins on day one to twoand reaches a peak on day four. Theserum antibody begins to rise on daythree and reaches a peak on day six.,B-3-thienylalanine, an amino acid ana­log of phenylalanine, has been shown toinhibit antibody production in rats whenit is fed at a level equivalent to threetimes the amount of phenylalanine pres­ent in the diet beginning two days be­fore antigen injection.Minced spleen fragments, taken 48 to72 hours after an intravenous injectionof S. typhi vaccine and maintained intissue culture for 48 to 72 additionalhours, show active antibody synthesis.This can be measured by uptake oflabeled glycine and by agglutinin titra­tion.When ,B-3-thienylalanine at a levelequal to three times the amount ofphenylalanine is added to the tissue cul­ture medium, no effect on antibody syn­thesis is shown by a normal uptake ofradioactive glycine in antigen-boundmaterial from the medium.A diet that maintains a rat's weightand nitrogen balance and which con­tains an equimolecular amount of,B-3-thienylalanine in place of phenylala­nine was fed to rats from one to threetimes in the interval between antigeninjection and the time of sacrifice.Spleens were removed and cultured for18 to 72 hours. A gradual inhibition ofantibody synthesis occurred under theseconditions. This inhibition is maximalwhen ,B-3-thienylalanine feeding isstarted on the day of antigen injection.There is less inhibition if feeding startson day one. Antibody synthesis is in­hibited only slightly when the com­pound is fed to the rats a few hours be­fore their spleens are taken for culture.These findings seem to indicate thatthis analog of an essential amino acidis capable of interfering with antibodysynthesis during the period when rapidcell-division or differentiation and in­creasing cytoplasmic RNA occur. Thequestion arises whether the metabolicdysfunction induced concerns only mi­totic activity and cell differentiation orthe formation of the antibody-producingmechanism itself.20 MEDICAL ALUMNI BULLETINThe Inhibition of LabeledAntigen Precipitation asa Measure of SerumGamma GlobulinBy ROBERT J. WEILERMedicineBy comparing the amount of precipi­tation inhibition produced by humanserum in a Coombs serum-labeled gam­ma globulin system with the amount ofinhibition produced in the same systemby a known amount of purified gammaglobulin, human serum levels of gammaglobulin can be determined precisely andin a relatively simple manner. When theresults so obtained are compared withthe results obtained by means of con­ventional starch fractionation, it is seenthat "normal" serum proteins which donot migrate electrophoretically as gam­ma globulins exert no significant inhibi­tory effect.With slight modifications this tech­nique can be used in conjunction withroutine hemoglobin determinations toscreen patients for hypogammaglobulin­emia. It may also be possible to meas­ure other serum protein fractions bysubstituting appropriate protein prepa­rations for the plasma gamma globulinused here and thereby use this techniquein the study of various dysproteinemias.Instrumentation for Trans­Sphenoidal Hypophysec­tomy with RadioactiveYttrium Oxide SeedsBy J. MICHAEL WHITMANSurgery (Otolaryngology)Trans-sphenoidal hypophysectomy byimplantation of radioactive yttriumoxide seeds has been performed with aspecial set of instruments designed forthis purpose. The operation is performedunder local anesthesia and the actualimplantation takes approximately twen­ty minutes.The instruments are long reinforcedhypodermic syringe needles and trocharswith small stainless steel containers andstands, each container carrying oneseed. The tip of a needle is introducedinto the hypophysis and a seed con­tainer screwed to the needle hub; theseed is then pushed from the containerthrough the needle into the hypophysis.The needle and seed positions arechecked by image amplifier fluoroscopyand X-ray pictures. All instruments aremade of stainless steel to close specifi­cations, They are easily cleaned andsterilized, and are interchangeable. Thisinstrumentation aids the simplicity ofthe operation without impairing accu- racy and constancy of implantation ofthe seed and, in addition, are designedto protect completely the operator fromradiation by the yttrium oxide.Serum Pyridine N ucleotide­Linked Dehydrogenases inLiver Disease and in Ex­perimental LiverDamageBy SIDNEY K. WOLFSON, JR.Ben May LaboratoryAlthough a number of enzymes em­ploying diphosphopyridine nucleotide(DPN) as a hydrogen acceptor havebeen described in blood serum, dehydro­genases using triphosphopyridine nucleo­tide (TPN) have not been observedhitherto in mammalian extracellularfluids. It was discovered that humanand rodent sera contained active, TPN­specific dehydrogenases for glucose-6-phosphate, 6-phosphogluconate (PGD)and isocitrate (ICD). Simple and sensi­tive spectrophotometric methods for thedetermination of serum ICD and PGDwere developed. The levels of both en­zymes were similar in the serum of ap­parently healthy individuals (50-250millimicromoles of substrate oxidized/ccserum/hour) and could not be correlatedwith age, race, sex, or serum-proteinconcentration. They were normal inpregnancy.Serum ICD was not found to be ab­normal in individuals with a wide vari­ety of infections, pulmonary, gastroin­testinal, urological, neoplastic, and car­diovascular diseases, including myocar­dial infarction. Elevations of serumICD as great as 40-fold occurred in pa­tients with acute viral hepatitis, and toa lesser extent in about 50% of patientswith liver metastases from malignancies.Patients with portal cirrhosis and ex­trahepatic obstructive jaundice had nor­mal serum ICD. Serum PGD was in­creased in viral hepatitis, but to a lesserextent than ICD. Abnormalities ofserum PGD were not observed in pa­tients with other disease states. The seraof patients with viral hepatitis oftencontained two DPN-linked enzymes notdemonstrable in the serum of normalsubjects, namely, alcohol (AD) andpolyol dehydrogenases (PD).The half-life of injected ICD in therat was found to be about one hour.Marked increases in serum lCD, PGD,AD, and PD were found in rats withacute liver damage following carbontetrachloride administration, simulatingalterations in the activity of the en­zymes in human viral hepatitis. Liga­tion of the common bile duct and par­tial hepatectomy resulted in relativelylittle alteration in these serum enzymes. Preventive Medicine andTesticular Neoplasms:A ReviewBy THOMAS M. GELLERTPreventive MedicineTesticular tumors comprise a smallpercentage of all malignant growths.They assume disproportionate impor­tance because they usually are highlymalignant and because they often occurin males of the younger age groups.A study was made of the prognosis oftesticular neoplasms as affected by thepatient's delay in seeking medical ad­vice and by the varying practices andattitudes toward examination of the tes­ticles. In particular the experience inThe Clinics has been reviewed as wellas physical diagnostic procedures forexamination of the testes as outlined inthe health service forms of Americanschools and colleges and in those of in­surance institutions. The reports of themilitary services during and sinceWorld War II emphasize the impor­tance of early diagnosis in increasingthe cure-rate. The mortality is lower inthese reports than in most civilian com­pilations.Early diagnosis is an importantparameter in prognosis and recent re­ports indicate that there is a delay ofsix to fourteen months from the onsetof symptoms to the time medical ad­vice is sought. This delay may be re­flected in the finding that 30% to 60%of all testicular tumors have metasta­sized when the patient is first medicallyexamined. In fact many cases are dis­covered only after symptoms producedby the metastatic lesions appear.Many factors other than the precisenature of the neoplasms are concernedin the early diagnosis and successfultreatment of testicular tumors. Theseinclude the initial selectivity of thepatient-group; the training and orienta­tion of the physician; tabus of societyand of particular social groups; psy­chosociological problems of the individ­ual. Far too many patients have ob­served testicular swelling long beforethey seek medical treatment. Publiceducation may decrease the size of thisgroup. For the rest, the completeness ofthe physical examination performed bythe individual physician is the final an­swer. Adequate palpation of the testesis mandatory and should be as much apart of the routine physical examina­tion of the male patient as adequatepalpation of the abdomen.MEDICAL ALUMNI BULLETIN 21,_ G_R_A_D_U_A_T_E_N_E_W_S _,II RES IV ENT NEWSDavid W. Anderson ('52-'56) is practic­ing orthopedics with the Mason Clinic inSeattle. He reports seeing George Hadden('52-'56) at King County Hospital there.Saul P. Baker ('56-'57) is assistant pro­fessor of medicine at Chicago Medical Schooland research associate in the Hektoen In­stitute at Cook County Hospital.Andre Barbeau, assistant resident in neu­rology, addressed the Society of MedicalHistory of Chicago in March on "Historyof Involuntary Movement."Dr. and Mrs. Alfonso Topete ('46-'48)have two sons: Alejandro, born June 30,1956, and Eduardo, born December 8, 1957.Frank E. Whitacre ('29-'35) of Vander­bilt University, was a guest speaker at theannual meeting of the Panhandle DistrictMedical Society in Amarillo, Texas, inMarch.Harwell Wilson ('32-'39) of the Univer­sity of Tennessee, was a guest speaker at theannual assembly of the Kentucky Chapterof the American Academy of General Prac­tice in Louisville in April.'34. D. Omah Maharajh has been ap­pointed by the Governor General to the FirstSenate of the new nation of the West Indies.William B. Tucker, director of the Tu­berculosis Service of the Veterans Admin­istration in Washington, D.C., spoke on"The Treatment of TB in the General Hos­pital" and William Lester, Jr., '42, chief ofstaff of the Suburban Cook County Tu­berculosis Sanitarium District, discussed"Administration and Interpretation of theTuberculin Test" at the ninth annual con­ference on tuberculosis held in Chicago inMarch.James F. Regan has been elected secre­tary-treasurer of the Los Angeles SurgicalSociety.'37. David Bodian, Johns Hopkins Uni­versity, was one of eleven living scientistshonored by the National Foundation forInfantile Paralysis recently. He proved thatpoliomyelitis can be blocked by antibioticsin the blood before it reaches the centralnervous system.Eli Borkon is chairman of medicine inthe Carbondale (Illinois) Clinic, four ofwhose members are certified in internal med­icine and the fifth is board-eligible. Theclinic is composed of eighteen men repre­senting seven specialties. They are mightyproud!'37. Clayton Loosli spoke on "EpidemicInfluenza Due to the Asian Strain in a Mili­tary Population" at the January meeting ofthe Chicago Society of Internal Medicine.Donald Stannus is chief of medicine atSt. Francis Hospital in Miami Beach.'38. Robert L. Schmitz participated in apostgraduate conference in Mattoon, Illinois,in April arranged by the Illinois State Medi­cal Society. The discussion dealt with thecare of highway accident victims.James L. Whitten berger has been ap­pointed the first James Stevens SimmonsProfessor of Public Health at Harvard Uni­versity.'39. Victor E. Johnson will be a deputypresident and chairman of the program com­mittee of the Second World Conference onMedical Education to be held in Chicago inSeptember 1959.'40. James D. Majarakis was a speaker atthe postgraduate medical conference inRichland County, Illinois, in February underthe auspices of the Illinois State MedicalSociety's Committee on Postgraduate Medi­cal Education and Scientific Service.'41. John M. Beal and J. Garrott Allen(Faculty '43-) were among the speakers atthe Southeastern Surgical Congress held inBaltimore in March.Owen Berg is now associated with a twen­ty-five man clinic group in Wichita Falls,Texas. His fifth child, Mary Lou, was bornJanuary 17.Arnold Lazarow, of the University ofMinnesota, was a guest speaker of the Clini­cal Society of the Washington Diabetes As­sociation at their fourth annual symposiumon metabolic and endocrine diseases held atthe University of Washington in Seattle inApril. '42. Robert H. Ebert, of Western Reserve,spoke at the annual meeting of the Cali­fornia Tuberculosis and Health Associationin San Mateo in April. His subject was "NewHorizons in Research."'43. Michael Bonfiglio, State Universityof Iowa, spoke on "Congenital Anomalies ofthe Skeleton: Surgical Considerations" atthe sectional meeting of the American Col­lege of Surgeons at Des Moines in March.'44. Henry McWhorter, Toledo, was cer­tified by the American Board of Plastic andReconstructive Surgery in San Francisco inNovember.'45. Justin A. Aalpoel is chief resident inthoracic and cardiovascular surgery at theUniversity of Oregon.E. H. Storer, Francis Murphey (Intern,'33-'34), and Harwell Wilson (Resident,, 32-' 39) were speakers on the April programpresented by the University of Tennessee inhonor of the visiting New Orleans SurgicalSociety.Jerry Sryrr is busy in private practice(psychiatry) with some teaching at Hopkinsand supervision at Sheppard Pratt. Thedaughters are now six and two and brightand lively. David McDougal, '47, was arecent Baltimore visitor from WashingtonUniversity, St. Louis.'47. John T. Grayhack spoke on"Changes with Aging in Human SeminalVesicle Fluid, Fructose Concentration andSeminal Vesicle Weight" before the ChicagoUrological Society in May.'49. Evelyn Adams, Cairo, Egypt, was aClinics visitor recently.'50. Jean L. Hirsch and Robert E. Priest,'54, will be married June 14. They will livein Seattle where Bob is on the pathologystaff at the University of Washington.John H. Hummel was married in June,1956 to Betty Wadsworth. Their daughter,Amy, arrived May 9,1957.'51. William J. Browne is the psychia­trist on an alcoholic research program in theGraduate School of Public Health at theUniversity of Pittsburgh.Herbert Rothenberg is an instructor atthe University of Colorado and in part-timepractice of internal medicine in Denver.'52. Robert B. Gordon was married Feb­ruary 15 to Lois P. Kalins.Seymour Halleck will become assistantprofessor of psychiatry at the University ofWisconsin on July 1.L. V. Radkins is practicing obstetrics andgynecology in Fort Myers, Florida. He man­ages to get back to the University of Chicagoonce or twice a year.'55. Howard R. Engel will start a medi­cal residency at Barnes Hospital, St. Louis,in July. He was married on March 2 toSondra Friend, a former University of Chi­cago student.Floyd Gilles is completing his neurologytraining at Johns Hopkins and BaltimoreCity Hospitals. He reports the arrival of adaughter, Elizabeth Ellen, on September 9.Kenneth R. Wilcox will return to Cleve­land City Hospital on July 1 for pediatricresidency.'56. Robert Day hopes to be granted aM.P.H. degree in epidemiology from the REUNION AT A.M.A.MEETINGSSHERATON-PALACE HOTEL-JUNE 26Al Rider, '44, has arranged a roast-beefdinner for alumni and their wives who willbe in San Francisco for the A.M.A. meetings.A Dutch-treat cocktail party is scheduledfor 6: 30 and the dinner will be at eighto'clock. If you have not already made yourreservations, mail your check for as manyplaces as you want at $6.00 each toDR. J. ALFRED RIDER% Western Regional Alumni Office717 Market StreetSan Francisco 3, CaliforniaGraduate School of Public Health of theUniversity of California in Berkeley in June.He was married to Jane Boynton on Sep­tember 6.Eugene Halpert has been assigned to theMental Hygiene Consultation Service at Ft.Hood, Texas.Carl Kaplan is serving a two-year tourof active duty in the U.S. Navy. He is atpresent division medical officer for DestroyerDivision 212.'57. James Magidson was married in NewYork on January 25. He didn't say to whom.Robert Moore has completed all his workexcept the thesis toward a Ph.D. degree inpsychology under Howard B. Hunt and willtake a rotating neurology internship at theUniversity of Michigan in July.Ted Peterson and Joseph Kiser entersurgical residency at Minneapolis GeneralHospital in July.22 MEDICAL ALUMNI BULLETINFACULTY NEWSJohn D. Arnold, '46, spoke on "RenalBiopsies in Internal Medicine," CharlesMcCartney, '43, discussed "Renal Biopsiesin Toxemias," and Benjamin Spargo, '50,reported on "Etiology and Pathogenesis ofRenal Disease as Studied by Renal Biopsies"at the February meeting of the Jackson ParkBranch of the Chicago Medical Society.William R. Barclay's subject at the NewYork Tuberculosis and Health Associationmeeting in April was "Tuberculosis Re­search in the Atomic Age."Ernest Beutler, '50, presented "ClinicalEvaluation of Iron Stores in the Diagnosisof Iron Deficiency States" before the Chi­cago Pathological Society and "HemolyticEffect of Primaquine and Related Com­pounds" at the Milwaukee County Hospital-both in March.Douglas N. Buchanan was a guest speak­er at the pediatric symposium held at BaylorUniversity in March.Hugh Carmichael ('35-'43) is director ofthe American Board of Psychiatry and Neu­rology and since 1952 has been a member ofthe Council on Mental Health of the Ameri­can Medical Association.J. W. J. Carpender is a member of theBoard of Trustees of the American Board ofRadiology and is second vice-president ofthe Radiological Society of North America.Lowell T. Coggeshall is chairman of anad hoc committee to make recommendationsfor the reorganization of the Cook CountyCoroner's office. By appointment of Presi­dent Eisenhower, he has been made a mem­ber of the United States delegation to thetenth anniversary commemorative session ofthe World Health Organization and theeleventh World Health Assembly whichmeets in Minneapolis May 26 to June 14.Dean Coggeshall has also been made a mem­ber of the Board of Directors of the Ameri­can Medical Education Foundation.Dwight Clark has been elected by theFellows of the American College of Surgeonsto the Board of Governors for a three-yearterm as a representative of the state of Illi­nois.M. Edward Davis, '22, was a speaker atthe annual scientific assembly of the Penn­sylvania Academy of General Practice inMay.Lester R. Dragstedt, '21, gave the 1.Ridgeway Trimble Lecture at the annualmeeting of the Medical and Chirurgical Fac­ulty of Maryland in April.Alfred Emerson has been elected presi­dent of the Society of Systematic Zoology.Frank W. Fitch, '53, received the LederleMedical Faculty Award for three years be­ginning in October.Clifford Gurney, '51, has been awardedthe 1957 Joseph A. Capps Prize by the Insti­tute of Medicine of Chicago for his paper on"The Dynamic Equilibrium of Erythropoie­sis: Studies of its Theoretical and ClinicalSignificances. "Paul V. Harper, Jr., discussed "ImplantRadiation Therapy for Carcinoma of thePancreas" before the Chicago Surgical So­cietv in March.The second annual postgraduate course infractures and other trauma given by the Chi- SCIENCE '58The University of Chicago andWBKB cooperated in producing athirteen-week television program de­voted to explaining the principles ofmodern science. The series ran fromMarch 17 through June 13 five morn­ings a week from 7:00 to 7:30 A.M.More than forty-five members of thefaculty participated. Those from theDivision of Biological Sciences were:Daniel Harris, "The Origin of Life"Paul Vorh, "Algae from the Sea"Hewson Swift, "What Cells Are"John Hutchens, "What Cells Do"Earl Evans, Jr., "How Cells Do It"William Burrows, "Microorgan-isms"Robert Wissler, "Abnormal Func-tioning of Cells"lloyd Roth, "The Effects of Drugs"Aaron Novick, "How Cells Change"Rachmiel Levine, "Contributions ofBiology to Human Welfare"John Perkins, Jr., "Man in Space"John Hutchens, "What Next in Bi­ology?"cago committee on trauma of the AmericanCollege of Surgeons in April was dedicatedto the memory of Dallas B. Phernister,C. Howard Hatcher gave the first Dallas B.Phemister Memorial Lecture.In a ceremony at Bonn, Germany onJuly 7, Charles B. Huggins will become amember of the Order of Pour Ie Merite ofthe German Federal Republic. Founded byFrederick the Great as a military honor, itnow provides recognition in the sciences andarts, with membership limited to thirty. Theonly other American members are ThorntonWilder and Arthur H. Compton.Elwood Jensen was appointed chairmanof the U.S. Public Health Service's subcom­mittee on evaluation of hormones for clinicaltrial.Eugene Kennedy received the Paul LewisA ward of the American Chemical Society inApril, at San Francisco. He addressed thesociety on "Biosynthesis of Phospholipides."Joseph B. Kirsner and Walter L.Palmer, '21, are members of the medicaladvisory board of· the Ulcerative ColitisFoundation, a new medical research founda­tion formed to promote research in this field.John Lindsay and A. Earl Walker ('31-'47) are members of the Council of the Na­tional Institute of Neurological Diseases andBlindness of the U.S. Public Health Service.Philip M. Margolis talked on "AnacliticTherapy in a Case of Extreme Anorexia" inMarch before the Illinois Psychiatric Society.Leonidas Marinelli was recently made amember of the Advisory Committee for Bi­ology and Medicine of the Atomic EnergyCommission. C. Phillip Miller, 19, has been elected aFellow of the New York Academy of Sci­ences.Robert D. Moseley, Jr., spoke on "BoneChanges in Radium Poisoning" before theChicago Roentgen Society in April.Clifton Mountain discussed "A Case ofMalignant Carcinoid" before the ChicagoSociety of Internal Medicine in March.Thomas Park has been re-elected to theBoard of Directors of the American Asso­ciation for the Advancement of Science fora four-year term.Dorothy Price will give the address atthe Sigma Xi initiation meeting at the Uni­versity of Oklahoma on May 15.John J. Prock now, '50, presented "Clinicof Histoplasmosis" in Cincinnati in Febru­ary at a symposium on histoplasmosis spon­sored by the Jewish Hospital Association.In April he spoke on "The Early Pathogene­sis in Experimental Histoplasmosis" beforethe Chicago Pathological Society.Henry T. Ricketts has been elected chair­man of the Board of Governors of the Insti­tute of Medicine of Chicago.Stephen Rothman gave the first DohiMemorial Lecture at the fifty-seventh annu­al meeting of the Japanese DermatologicalAssociation in Niigata, Japan, in May. Thelectureship is in honor of Professor KeizoDohi (1866-1931) the founder of Japanesedermatology. His subject was "Keratiniza­tion and Keratinization Anomalies." He willalso speak at the Universities of Tokyo,Kyoto, and Osaka.Rudolf Schindler ('37-'42) has acceptedan appointment at the University of MinasGerais in Belo Horizonte, Brazil, beginningin July. He has been in the practice of gas­troenterology in Los Angeles.lloyd Roth, '52, has been appointedchairman of the medical exhibits section ofthe Second International Conference onPeaceful Uses of Atomic Energy to be heldin Geneva, Switzerland, in September.John Paul Scott, chairman of the Divi­sion of Behavior Studies at the Roscoe' B.Jackson Memorial Laboratory, Bar Harbor,Maine, was visiting professor of psychologyin the spring quarter.H. Burr Steinbach was elected chairmanof the divisional committee on biology andmedicine of the National Science Founda­tion.Peter J. Talso ('45-'51) spoke on "ACerebrospinal Fluid Bank" at the Marchmeeting of the Chicago Neurological So­ciety.Ilza Veith gave the annual D. J. DavisMemorial Lecture on Medical History at theUniversity of Illinois in April. Her subjectwas "Oriental Medicine and Its Concept ofthe Soul."Robert Wissler has been appointed amember of the National Research Council'sCommittee on Pathology. He is also pres­ident-elect of the Chicago chapter of theAmerican Association of Cancer Research.F. Howell Wright has been appointed anofficial examiner for the American Board ofPediatrics.MEDICAL ALUMNI BULLETIN 23� __R_U__S_H__N_E__W_s 11� D_E_A__T_H__S�'12. Josiah J. Moore, serving his fifteenthyear as treasurer of the A.M.A., was recentlyelected president of the Institute of Medicineof Chicago. He was also made honorarychairman of the Chicago alumni group ofthe University of Montana.'13. Ralph H. Kuhns is making finalplans for the forty-fifth anniversary of hisclass in June. Headquarters will be at theHilton Hotel and the University Club andthe time will be during the weekend of the21st. A second reunion will be held in SanFrancisco the following week during theA.M.A. convention.'15. Frank Menne has retired to his na­tive Wisconsin after practicing and teachingpathology at the University of Oregon since1916. He was assistant to Edwin R. LeCountand studied under Ludvig Hektoen at Rushand when he first went to Oregon was oneof only two trained pathologists in the state.He headed the Department of Pathologyfrom 1929 until 1944 when he became chiefpathologist of St. Vincent's Hospital, Port­land, but continued at the University asclinical professor. He is nationally knownfor his contributions to medical educationand his great interest in legal medicine. Hisnew address is Fond du Lac, Wisconsin.'17. Michael H. Ebert has retired fromhis practice of dermatology in Chicago andis living in Cleveland Heights with his son,Robert, '42.'20. Waltman Walters of Rochester, Min­nesota, gave the tenth Julius FriedenwaldMemorial Lecture at the University of Mary­land in October.'24. William J. Baker, Chicago, is pres­ident of the American Urological Associa­tion.Howard Wakefield is president of theChicago Society of Internal Medicine.'27. Jessie M. Bierman is professor ofmaternal and child health at the Universityof California. She recently served abroadwith the World Health Organization of theUnited Nations.Alexander Brunschwig, New York, wasa guest speaker at the thirteenth annualmeeting of the Ogden (Utah) Surgical So­ciety in May.Ralph W. Gerard of the University ofMichigan, is chairman of an advisory com­mittee on problems of aging connected witha new division of the Department of Med­icine and Surgery of the Veterans Admin­istration in Washington, D.C.'2B. Col. Paul A. Campbell, M.C.,U.S.A.F., conducted symposiums on currentdevelopments in manned space flight at thetwenty-ninth annual meeting of the Aero­medical Association in Washington, D.C., inMarch.'29. John I. Brewer, professor of obstet­rics and gynecology at Northwestern Uni­versity, is serving as president of the medicalstaff of Passavant Memorial Hospital, Chi­cago.'31. Joseph H. Schaffer was chairman ofan international symposium on mechanismsof hypersensitivity sponsored by the HenryFord Hospital, Detroit, in March. '99. Oscar Theodore Roberg, Chicago,January 16, age 81.'01. Edward W. Marquardt, Elmhurst,III., March 7, age 82.'03. Edwin Bruce Bradley, Spencer,Nebr., November 23, age 78.Andrew Gansevoort, Chicago, February24, age 86.'OB. Lynn van Horn Gerdine, Los Ange­les, December 22, age 83.'13. Lyman Keith Gould, Fort Wayne,Ind., December 31, age 68.Clara Jacobson, Chicago, April 13, age 70.'14. Elven James Berkheiser, Chicago,January 3, age 70.Harold McMurdo Helm, Rockton, Ill.,January 3, age 69.Ralph Wilbur Hardinger, East Moline,Ill., February 9, age 67.'15. Melbourne Jabez Pond, New YorkCity, December 24, age 70.'16. Roland George Mayer, Aberdeen,South Dakota, January 8, age 66.'19. Peter Milton Mattill, Oak Terrace,Minn., January 12, age 70.'20. Frederick Arnold McMurray, Vash­on, Wash., December 16, age 65.'22. Matthew Winter, Bloomington, Ind.,February 14, age 67.'26. Nelson Paul Anderson, Los Angeles,December 1, age 58.Meyer Jerome Steinberg, Chicago, Janu­ary 6, age 54.'2B. Louis C. Morris, Chicago, February23, age 57.'30. Julius Twente, Tallahassee, Fla.,February 4, age 59.Matthew Arnow, Eustis, Fla., December29, age 45.'32. jamesRandolph Webster, Chicago,February 28, age 51.'37. John Donald McAtee, Tuscaloosa,Ala., January 26, age 45.John Ross Ralyea (Res. '53-'55), High­land Park, Mich., January 29, age 41.'32. Evangeline E. Stenhouse is presidentof the medical staff of the Mary ThompsonHospital, Chicago, which has just built anew diagnostic center.Myron M. Weaver is clinical professorof medicine at Albany Medical College, NewYork.'37. Robert B. Greenman is chief of ob­stetrics and gynecology at the U.S. NavalHospital in St. Albans, New York.'3B. Lewis L. Robbins has left the Men­ninger Foundation of Topeka with which hehas been associated since 1940, to becomedirector of professional services at HillsideHospital, Glen Oaks, Long Island, NewYork. Dr. Robbins is currently secretary ofthe American Psychoanalytic Association.Capt. Horace D. Warden, M.C., U.S.N.,has been transferred to the U.S. Naval Hos­pital in Philadelphia to head the thoracicsurgery service.'39. William M. Lees is president of theChicago Tuberculosis Society.'42. Holger Spaabeck Mouritsen is prac­ticing general surgery in Richmond, Cali­fornia. PRACTITIONER OFTHE YEARArthur Kirby Baldwin, Rush '16,was named "General Practitioner of theYear" by the Illinois State Medical So­ciety.Dr. Baldwin was born on a farm inWarren County, Illinois, and was grad­uated from Monmouth High School. Heinterned at Michael Reese Hospital andserved in the Army in Siberia in 1919-20. He began his practice in Elmwood,Illinois, and four years later moved toCarrollton where he still lives. He di­rected the construction of a hospital inCarrollton, headed the local schoolboard, and has been active in churchand civic work.ALPHA OMEGA ALPHAELECTIONSEleven members of the class of 1958and three of the class of 1959 are mem­bers of A.O.A. The seniors are: CaesarBriefer, Jerry Chutkow, Alan Pavel,and Donald Thursh, elected in theirjunior year, and Harold Conrad, CarlGunderson, Yvonne Hillier, JamesHuffer, Norman Mages, Wendell Rosse,and Franklin Star. The juniors: JamesDahl, Garry Friedman, and FrankThorp.Joseph P. Evans and Henry T. Rick­etts were elected from the faculty.Dr. William B. Bean, professor andchairman of the Department of Medi­cine of the State University of Iowagave the annual Alpha Omega Alpha lec­ture. His subject was "The PatientThrough the Ages."RICKETTS AWARDRene Jules Dubos, bacteriologist ofthe Rockefeller Institute for MedicalResearch, received the Howard TaylorRicketts Award for 1958 on May 12.Dr. Dubos' lecture was on "Nutrition,Emotion and Infection."Correction for DIRECTORY*BRANHAM, SARA E. (MRS. PHILIPSTEVEN MATTHEWS), Ph.D. '23,M.D. '34, Path (CM)-AB'55, Chief, Sec.on Bact. Toxins, Div. Biol, Stds., Nat!.Insts. of Health, Bethesda, Md. (4514Dorset Ave., Chevy Chase 15), L.M., Gift.24 MEDICAL AL UMNI BULLETINFROM DEANCOGGESHALL-Last year I spoke to the alumni throughthe Bulletin about the major changeswhich had occurred in the medicalschool during the preceding decade. Ibelieve the events of the past year willalso be of interest to the alumni.On the debit side, we have taken someheavy losses. Cannon, Dragstedt, Geil­ing, and Hodges are' retiring as de­partmental chairmen and death hastaken such stalwarts as Barron, Carl­son, Coulter, Dieckmann, Harvey andLuckhardt. Although recent graduateshave had relatively little contact withsome of these men, all are familiar withtheir contributions to our Universityand to many these losses may seem ir­replaceable, although most of the deathsoccurred near or after retirement. Ifone examines the roster of the youngmen in the departments who will serveas replacements, however, there is rea­son for optimism. Forecasting theircareers one cannot but believe that theywill always bear comparison, step bystep, to their illustrious predecessors.On the educational side, a committeefor the clinical years has examined thecurriculum with great intensity andsome major changes have been insti­tuted. Students now have greater op­portunity to observe patients over long­er periods, pathology has been improvedin the junior year, and a solid programin psychiatry has been established.This is just a beginning. A similarcommittee is working with equal vigoron non-clinical areas so that our over-allprogram will be one of the finest edu­cational experiences possible.Just how good it is at present can bejudged from the report of representa­tives from the American Medical Asso­ciation and the Association of AmericanMedical Colleges who have just com­pleted a critical survey of our educa­tional program. In their report to theChancellor, they commented specificallyon the high calibre of our students andpraised the educational program. Forthe quality of our students we are par­ticularly grateful to the hard-workingadmissions committee headed by Dr.Richter. They have been in virtuallycontinuous session, interviewing, dis­cussing, and reviewing candidates in or­der to select the best talent, and onevery hand we are hearing good reportsabout our graduates that should makeall of you proud, and certainly makesus proud of you. COGGESHALLWe also continue to move ahead inthe construction of new facilities. Plansare well advanced for a new large cen­tral animal quarters just west of AbbottHall and for a two-story bridge con­necting Lying-in and Billings. The pos­sibility of a basic science building pri­marily for consolidated teaching and re­search is being explored intensively. Amajor alteration program is under way.The lecture halls in Abbott, Zoologyand Anatomy have been completelyrenovated and refurnished. Laboratoriesfor the gastoenterology and dermatologystaffs have been refurbished by match­ing government funds' with private gifts.And by matching government funds withthe Block Fund, laboratories in zoology,anatomy and physiology have been mod­ernized. And a great deal more isplanned.The school and division have a vigor­ous research program costing in excessof three million annually and its investi­gators are being honored on everyfront. Perhaps what I wish to say isbest conveyed by repeating what thechairman of the four-day visiting com­mittee said last week, "The Universityof Chicago's medical care, teaching andresearch program is outstanding. This isall due to the fine staff and faculty andthe superb quality of students." Thisconfirmed the action of the Ford Foun­dation Granting Committee which placedyour university high among the top sixmedical r chools of the country.LOWELL T. COGGESHALL, M.D.Dean, The Divisionof Biological Sciences CLARK HEADS SURGERYOn July 1 Dwight E. Clark, pro­fessor of surgery, will become chairmanof the department.Lester R. Dragstedt, who will retirein 1959, has asked to be relieved of thechairmanship so that he may devotenext year to his research.STIJDENT EXHIBITSFive exhibits were presented by ourstudents at the Student A.M.A. Con­vention in May. They will be on dis­play in the Pathology corridor June 11-13. They are: "Study of PeripheralBlood-flow in Normal Children andChildren with Congenital Heart Dis­ease" by Yvonne Hillier, '58, andGerald Margolis, '60; "Analysis ofSerum Proteins by Use of TemplateFilms" by Charles Y. C. Pak, '61;"Erythropoietin" by Louis F. Plzak,'58, and Walter Fried, '58; "The Effectof Urinary Pressor Substances and LowFrequency Stretch Stimulation on Rab­bit Aorta" by Henry Rothschild, '.58;and "Carbon and Hydrogen in Biomedi­cal Tracer Research" by James L.Spratt, '61.PHEMISTER LECTUREFrederick A. Coller, Professor Emer­itus of Surgery of the University ofMichigan, will give the Phemister Lec­ture on June 11.His title is "Surgery and Science."BULLETINof the Alumni AssociationThe University of ChicagoSCHOOL OF MEDICINE950 East Fifty-ninth Street, Chicago 37, IllinoisVOL. 14 SPRING 1958 No.3EDITORIAL BOARDPETER V. MOULDER, ChairmanWRIGHT ADAMS ROBERT J. HASTERLIK1. T. COGGESHALL ELEANOR M. HUMPHREYS. ALBERT DORFMAN HUBERTA LIVINGSTONEWALTER 1. PALMERJESSIE BURNS MACLEAN, SecretarySubscription with membership:Annual, $4.00 Life, $60.00