Volume 15 SPRING 1959 Number 3BASIC RESEARCH IN DERMATOLOGYIn the last eighteen years the dermatology research staff has been mainlypreoccupied with the mysteries of howand why the skin produces a highly complex mixture of fatty substances whichare excreted to the surface and lubricateskin and hair. We became interested inthis seemingly esoteric subject for ratherpractical reasons.Free Fatty Acids and TheirBiological SignificanceIn 1941 an epidemic of a highly unpleasant ringworm infection of the scalpof children swept through the majorcities of the United States. The epidemicstarted in New York, and soon after itsarrival in Chicago involved about thirtythousand children here. The peculiarityof this infection, caused by the fungusMicrosporon audouini, is that it clearsspontaneously in adolescence and thatthe scalp hair of adults is immune to itwith very few exceptions. There weregood reasons to believe that some changein the surface lipids during adolescenceis the reason for this peculiarity, becausein adolescence the sebaceous glands, themain source of the fatty surface film,undergo a spectacular growth. We foundthat human hair fat contains a largeamount of free fatty acids (up to 30per cent of the total weight of surfacefats consists of free fatty acids) andthat the free fatty acids inhibit thegrowth of fungi, especially that of Microsporon audouini.We were able to analyze in detail thisfree fatty-acid fraction after we collected 100 pounds of cut hair of adultsfrom downtown barber shops and secured the help of an outstanding lipidchemist, A. W. Weitkamp, associatedwith Standard Oil Company of Indiana.For the extraction of 100 pounds of hairwith 100 liters of warm refluxing ether, By STEPHEN ROTHMAN, M.D.Professor and Head, Section of DermatologyROTHMANwe were relegated to the warming roomof the ice-skating rink under the NorthStands of the football field by authorities in the Department of Buildings andGrounds. But we got through withoutmajor explosions and found that hairfat contained an amazingly complete ho- mologous series of free normal (straightchain, saturated) fatty acids from chainlengths C7 to C22. In sugar and fat metabolism we encounter most often evennumbered carbon chains because naturesynthesizes most organic compoundsfrom two-carbon fragments. In human2 MEDICAL ALUMNI BULLETINDR. ROTHMAN in conference with second-year residents' ARNOLD GOMBINER '56RICHARD GOODMAN, CHARLES BOARDMAN, '55, and YELVA LYNFIELD. ' ,hair-fat, however, we found also the fatty acids with odd-numbered carbonchains, such as the C7, c; Cll' CH, C15'and C17 straight-chain saturated fattyacids.Testing the fungistatic effect of allisolated and identified acids, we foundthat the acids with chain lengths fromCn to Cl:l were the most effective, withodd-numbered carbon chains being moreeffective than their even-numbered neighbors. These odd-numbered carbon acidsin the medium chain-length range hindered the growth of Microsporon audouini if added to the nutrient mediumin a dilution of 1: 500,000.The spontaneous cure of" this infection during adolescence can be explainedas follows: With the puberal development of sebaceous glands, the amount ofsebum poured on the surface of the scalpincreases threefold. Thereby the freefatty-acid concentration per surface areais raised beyond the critical level atwhich M icr osporon audouini is able tothrive. The fungistatic sebum enters theloose parts of the superficial horny layerand the hair canals. Once there, it sterilizes all the pathways of the infection.It does not kill the fungi inside theinfected hairs because, unlike the fungi,the fatty acids are unable to penetratethe hair shafts. However, the infectedhairs are lost in the course of naturalshedding, and the newly growing hair is no longer infected because all pathwayshave been sterilized. Thus a spontaneouscure takes place about two years afteradolescence has set in, and thereafterthe scalp is immune to this infection.We found that Microsporon audouiniis about ten times more sensitive to fatty acids than all other comparable ringworm fungi, and this is the reason thatthis is the only infection to which thescalp of adults is immune. Still, thefungistatic potency of sebum can berecognized also in infections with fungiless sensitive to fatty acids. The ringworm infection of the feet, commonlyknown as "athlete's foot," is localizedexactly in those areas of the skin whichhave no sebaceous glands and thereforeno free fatty acids on the surface. It isremarkable how seldom it happens thatthe fungi of this common infectionspread to other parts of the body, although there is plenty of opportunity forthem to be carried elsewhere with thehands. When such spread does occur, itis because the fungi have adapted themselves to a higher fatty-acid level. Intest-tube experiments we have found thata limited resistance of "athlete's foot"fungi to the Cn acid can be achieved ifone forces this adaptation by very gradual and gentle training.As time has passed and with the advent of research grants, radioisotopesappeared on the scene, equipment be- came more elaborate and more expensive, and we could take in our ownPh.D.'s; and, naturally, our work onskin fats became fancier.Mainly on the basis of work in ourlaboratory with isotopes, Nicholas Nico-'laides has shown that the free fatty acidson the skin surface are secondary splitproducts of triglycerides. The mouths ofsebaceous glands harbor a lipolytic enzyme, as was shown by George Wells,who, after he returned to his nativeEngland, continued to collaborate onour lipid projects. We also found thatfurther splitting of triglycerides takesplace after the arrival of the sebum tothe surface mainly by the activity ofthe resident bacterial flora.Nowadays, in the age of gas chromatography, we no longer need 100 poundsof hair to get sufficient amounts of surface fat for analysis. A few dropletssuffice to obtain significant data. Exactlysuch significant data appeared after Victor Wheatley, of London, joined us oneand a half years ago. He started to studythe anomalies of skin surface fats inpatients who suffer from an unpleasantfungus infection of the trunk calledtinea versicolor. In this condition thesaprophytic fungus, M alassezia furfur,colonizes and thrives on the skin of thetrunk, causing rapidly growing and unsightly scaling patches. These fungi canbe easily eradicated from the skin butwhen the patient stops treating himself,the scaly patches soon appear again. Thedisease is not contagious. The patientscarrying M alassezia furfur must havesome special nutrient on their skin surface (or they must lack some inhibitor)which enables these more or less ubiquitous fungi to colonize and to thrive onlyon their skins. In other words, the deccisive factor in this infection is a susceptibility factor. Wheatley, who hasgreatly contributed to the developmentand perfection of gas chromatographyin collaboration with William H. Gilles·pie, has taken off some ether-solublematerial from the normal skin of M alassezia furfur carriers and, after obtaininga few milligrams of fatty material, discovered that the sebaceous glands ofthese carriers produce abnormal unsaturated C14 and CIG acids which are neverfound on the skin surfaces of normalindividuals. Thus it seems that now wehave found the "susceptibility factor"of tinea versicolor.Synthesis of CholesterolThe skin as a tool of general biochemical research.-Another angle ofMEDICAL ALUMNI BULLETIN 3WHEATLEYour research has been study of the synthesis of cholesterol by the skin. In 1949it was found that the fatty film-surfacein man contains squalene. Thirty yearsearlier squalene was first isolated fromthe liver oil of sharks (squalidae). Itschemical structure suggested that itcould be an intermediate in the synthesisof cholesterol from acetate and othertwo-carbon fragments. The presence ofsqualene on human skin, which is alsoan efficient producer of cholesterol,greatly strengthened this suggestion. Idiscussed this matter with KonradBloch, and soon afterward, in a brilliantseries of experiments, he proved thatactually squalene is an intermediate incholesterol synthesis in all animal cells.At about the same time Nicolaides, inour laboratory, experimented with samples of different skin fragments, someof which did and some did not containsebaceous glands. He incubated suchsamples with radioactive acetate. Hefound that samples of isolated epidermissynthesized radioactive cholesterol withgreat ease but made hardly any squalene, while samples with sebaceousglands in them did also. manufacture alarge amount of radioactive squalene.This result led us to the conclusion thathuman epidermis possesses the wholeseries of enzymes required to synthesizethe final product cholesterol from twocarbon fragments, whereas human sebaceous gland cells, in a more primitiveor rudimentary fashion, carry the synthesis only to the intermediate stage ofsqualene.Nicolaides also found that the hairfat of children contains considerablymore cholesterol and considerably lesssqualene than the hair fat of adults. Thisis because in children the cornifyingepidermis contributed relatively muchmore to the production of the oily surface film than do their tiny sebaceousglands.More recently, Wheatley noticed that, in different mammalian species, skincells carry the process to different intermediate steps of cholesterol synthesis.For instance, sebaceous glands of sheepcarry the synthesis a step farther thanthose of man, namely, to lanosterol,which is a cyclized squalene with anadded alcohol group. One of the mostimportant intermediates was recentlyshown to occur in human epidermis byReinertson and Wheatley in our laboratory. This intermediate is ll.-7-dehydrocholesterol, the precursor of vitamin D3.It is activated in the epidermis by theultraviolet rays of the sun to vitamin D,which, in turn, is absorbed into the general circulation. This finding has givenus, at long last, a satisfactory understanding of the exact mechanism bywhich rickets of man can be cured byultraviolet irradiation alone.Arranging the different intermediatesoccurring in skin cells of different mammals, Wheatley arrived at a sequencewhich may very well represent subsequent intermediate steps of cholesterol synthesis by cells in general. It seemsthat all these compounds can be foundin the skin and its surface film becausein different species some sebaceous glandcells and some epidermal cells have incomplete enzyme systems, incomplete todifferent degrees so that the synthesismay stop at different stages before theend product, cholesterol, has formed.Hormonal Influences on SebaceousGlandsIn connection with the work on ringworm of the scalp we also became interested in the hormonal mechanism ofthe puberal development of sebaceousglands, particularly because the appearance of acne depends on this development.It has been known for a long timethat castrated boys and eunuchoids donot develop seborrhea and acne obviously because their sebaceous glands do notundergo puberal growth. If prepuberalcastrates are given testosterone, theywill develop seborrhea and also acne if"Does it eetch?'4 MEDICAL ALUMNI BULLETINLORINCZthey have the familial predisposition forthis disorder. Also sexually normal adults,males and females of any age group,may develop seborrhea and acne whengiven large doses of male sex hormones.Thus, in the case of males, there can belittle doubt that the male sex hormoneis the· moving force behind the puberaldevelopment of sebaceous glands.Girls, of course, do not produce testicular hormone. Yet they still developseborrhea and acne with equal frequency as boys. On the basis of systematicanimal experimentation and after havingworked out an accurate method for measurement of sebaceous gland volume, ourgroup found that in female rats progesterone exerts a growth stimulus on thesebaceous glands which is almost aspowerful as that of the testicular hormone. That this is the case also in humans has recently been shown by 1.Zeligman at the Johns Hopkins University. Zeligman produced oiliness andacne with large doses of progesterone inwomen who previously had had no acne.In experiments supervised by AllanLorincz, it was found that in hypophysectomized rats the growth-stimulatingeffect of testosterone and of progesteroneon sebaceous glands was abolished or atleast greatly diminished. It was of interest to find out what pituitary factorcould be responsible for the responsiveness of sebaceous glands to sex-hormonestimulation. To our surprise it was foundthat none of the known pituitary hormones was able to restore this responsiveness. Lorincz initiated a fractionationof pituitary glandular tissue to isolatethe responsible factor. After using several chemical procedures and after laboriously testing the effectiveness ofeach new fraction in restoring responsiveness of sebaceous glands to sex hormones, he and his associates succeededin isolating a highly effective fraction.Purification and chemical analysis ofthis "sebotropic factor" are now in progress. It has been definitely establishedthat this factor differs from gonado- tropic hormones as well as from all otherknown pituitary hormones. The preparation of this sebotropic factor in pureform and in sufficient quantities hasmany clinical implications, includingpossible rational treatment of ringwormof the scalp and (by its possible suppression with specifically antagonisticsteroids) of acne.Percutaneous AbsorptionThe human skin contains a superficially situated cellular layer which actsas a rather powerful barrier to the penetration of foreign substances from theoutside into the skin. In the last fewyears, Frederick D. Malkinson has takenadvantage of the immense possibilitiesof working with radioisotopes in thisfield, since the qualitative and quantitative penetration of radioisotope-labeledsubstances can be measured with greatprecision. One of the major problemswhich Malkinson has studied has beenthe question of why topical use of theadrenal steroid hydrocortisone is so effective in the treatment of some eczematous dermatoses, while the local use ofthe closely related compound, cortisone,is without benefit. Topical applicationof an ointment containing very smallquantities of hydrocortisone labeled withcarbon 14 demonstrated for the firsttime that this hormone actually penetrated the skin in small amounts, sinceradioactive metabolites could be recovered from the urine. Analogous studieswith cortisone labeled with carbon 14yielded almost identical findings. It wasnow apparent that the disparity in topical effectiveness of these hormones wasnot related to differences in their absorption through the skin. Later experimentsof Malkinson investigating the in vitrometabolism of these hormones by isolated skin slices have shown that differences in metabolic pathways and in thespeed of metabolic inactivation of hydrocortisone and cortisone probably account for the different therapeutic effects of these compounds when usedlocally.Recently, Malkinson has been able toconduct further absorption studies withradioisotope-labeled compounds by theuse of a light-weight gas-flow cell whichmeasures radioactivity directly on theskin surface. The effectiveness of thesuperficial skin barrier against absorption of foreign substances depends in alarge part on certain chemical propertiesof the substance in question. Penetrability of the barrier can be measured bythe gas-flow cell by first assaying ab- sorption of a compound from the normal skin surface over a given period oftime and by then repeating the procedure over the same time period afterremoval of the barrier layer. Removal ofthe barrier can be accomplished by successive applications of adhesive cellophane tape to the skin surface. An electrically powered device to perform thisrapidly has been designed by Lorincz.By the application of testosterone-a-Ct+,which passes through intact skin slowlywhen first applied but which enters theskin far more rapidly when the barrieris absent, we have now been able tomeasure barrier regeneration time afterremoval in humans. Knowledge that a:period of two to four days is requiredfor complete restitution of barrier-layerfunction is of great importance to us inconducting further physiological studies.It also is of considerable practical inter-MALKINSONest in the management of patients withdermatoses or skin injuries, who areemployed in the handling of potentiallypoisonous compounds in laboratoriesand in industry, since these substancesmight penetrate broken skin in amountslarge enough to produce severe systemictoxicity.Other StudiesSpace does not permit detailed consideration of numerous other current research activities in the Section of Dermatology, such as: (1) study of cutaneous carbohydrate metabolism by meansof perfusion of isolated dog skin withradiocarbon-labeled intermediates (Kenneth Halprin): (2) investigations on themechanisms of delayed-type contact allergic reactions and the possibilities forselectively abolishing such allergies(Lorincz and Roger Pearson); (3) analysis of the nature of a powerful, nonprotein, antifungal factor in serum discovered recently by Lorincz and associates; and (4) basic immunoallergicstudies in syphilis and cancer (Pearsonand Lorincz).MEDICAL ALUMNI BULLETIN 5SENIOR SESSIONSCIENTIFICThe thirteenth annual SENIOR SCIENTIFIC SESSION is to be held on Tuesdayevening, June 9, in Pathology 117. Abstractsof the eleven papers to be presented by members of the 1959 Class are given below.Adenine TransaminaseBy STEVEN ARMENTROUTBiochemistryThe enzyme adenase is produced byTorulopsis utilis in a growth mediumwith adenine as the sole nitrogen source.The specific activity of this enzymecould be increased at least one hundredfold by ammonium sulfate, protamine,and ethanol precipitation. When the active fraction was dialyzed for 12 hours,it lost essentially all its activity. Activitywas rest_ored by adding concentrated dialysate. The cofactor activity of the dialysate could be absorbed on a columnof Dowex-1 at pH 7.0 and eluted withdilute HCI. However, two fractionswere required for full activity. Brewer'syeast extracts could also supply the cofactors. It was found further that theactivity of the dialyzed enzyme could befully restored by the addition of a mixture of pyridoxal phosphate, an a-ketoacid, and cupric ions (1 X 10- 4 M.).Incubation of the enzyme system withadenine, a-keto acid (a-ketoglutaric),cupric ion, and pyridoxal phosphateyielded hypoxanthine and amino acid(glutamic). Following incubation withDowex-1 for 24 hours the enzyme preparations were again essentially inactive.Addition of reduced diphosphopyridinenucleotide (DPNH) restored full activity to the treated enzyme preparation.Further ammonium sulfate fractionationindicated that at least two enzymes areprobably involved in his reaction. Alphaketoglutaric acid and oxaloacetic acidserved equally well as amino acceptors.No other purine or purine derivativeexcept adenine served as an amino donorunder the conditions of assay. It is proposed that the name "adenase" be reserved for the true deaminase and thatthis enzyme system be called "adeninetransaminase. "The Electrophoretic Mobilityof Soluble Antigen-AntibodyComplexesBy JAMES L. BENNINGTONM icrobiolo gyThis study has dealt with the electrophoretic analysis of soluble antigen-antibody complexes containing radioactivelyiodinated bovine-serum albumin (BSA)antigen and rabbit gamma-globulin anti- body. The soluble complexes were prepared by dissolving antigen-antibody"precipitates in varying amounts of excess unlabeled BSA.Supernatants containing only solublecomplexes were subjected to electrophoresis, and radioactivity was determined on similar aliquots. Activity inthe supernatants increased as antigenwas added in increasing excess. Radioautographs prepared from these electrophoretic patterns revealed three distinctbands that appeared between the loci ofgamma-globulin antibody and the fastmigrating BSA antigen.The radioautographs were scanned ina densitometer, and the optical densityof each band was expressed in the percentage concentration of the total soluble complexes. The concentration ofthe faster-migrating complex, rich inantigen, was found to increase at theexpense of the slowly migrating antigenpoor complex as increasing amounts ofunlabeled antigen were added to thesystem.This type of analysis suggests achanging framework of the antigen-antibody molecule in the precipitate systemas dissociation takes place-from the insoluble aggregate rich in antibody tothe more soluble complexes richer inantigen.Gastric Ulceration inExperimentally InducedPolycythemiaBy JAMES R. DAHLMedicine (Argonne)The increased incidence of peptic ulcer in patients with polycythemia rubravera has never been explained satisfactorily. The theoretical concept of vascular thrombosis with mucosal infarctionand subsequent ulceration was proposed25 years ago but has never been substantiated. As a first step in an investigationof this problem, an attempt has beenmade to demonstrate a similar relationship between polycythemia and ulceration in the experimental animal.Rats were rendered polycythemic bythe intravenous administration of washedand packed rat erythrocytes to a totaldosage of 8 per cent of the body weight.Included in the group receiving erythrocytes were normal, adrenalectomized,hypophysectomized, and sham-operated animals. In two control groups normalrat plasma and isotonic saline were substituted for the packed erythrocytes.Hematocrit levels greater than 75 percent were observed in all the animalsthat received erythrocytes, whereas thehematocrit levels of the other groupsshowed no consistent change from preinjection values.All animals were autopsied 3 days following the final infusion. Apart fromgeneralized hyperemia, abnormalities inthe polycythemic animals were confinedto the stomach. The stomachs of 26 ofthe 29 animals, including all the adrenalectomized and hypophysectomized animals, showed ulceration of a type thatresembled human peptic ulcers bothgrossly and microscopically. The stomachs of the three remaining rats of thisgroup were also abnormal, demonstratingmultiple small areas of superficial hemorrhagic gastritis. In only 1 of the 29specimens was there evidence of associated vascular thrombosis. No lesionswere present in any of the animals ofeither of the control groups.It has been demonstrated, therefore,that gastric ulceration, without significant associated thrombosis, can be produced in the rat by transfusion-inducedpolycythemia. These findings suggest anintriguing parallel between this experimental system and the patient withpolycythemia rubra vera and its associated increased incidence of pepticulcer.Inhibitory Effects ofCarcinogen 3-Methylcholanthrene on a Chloromain RatsBy HUGH c. GRAHAM, JR.MedicineIn 1935 Haddow first reported thatsome polycyclic hydrocarbon carcinogens retarded the growth of certain experimental neoplasms. Administration of3-methylcholanthrene over prolonged periods has produced a high incidence ofmammary and other cancers in miceand rats and leukemia in rats. Hugginsand Pollice recently showed that 3-methylcholanthrene retarded the growthof transplanted mammary tumors inrats. A study of the effects of 3-methylcholanthrene on a leukemia of rats wasundertaken.The experiments were carried out ona chloroma tumor derived from a myelogenous leukemia of albino rats andtransplanted by subcutaneous injection.6 MEDICAL ALUMNI BULLETIN3-methylcholanthrene was dissolved insesame oil and injected intramuscularlydaily for the duration of each experiment. Controls received an equal volume of sesame oil. Weight and tumorgrowth were measured at weekly intervals.The repeated administration of 3-methylcholanthrene resulted in retardation, regression, and, in many cases,complete disappearance of the tumor,decreased body growth, and histologicevidence of tumor degeneration and fibrosis. No changes were observed IIIbone marrow, spleen, liver, kidney, orlymph node. The antitumor effects ofthe drug could not be attributed to undernutrition, because animals that werepair-fed with those receiving 3-methylcholanthrene showed no tumor inhibition. Animals receiving sesame oil and3-methylcholanthrene did not demonstrate any hematologic abnormalitiesduring a 6-week period.These experiments demonstrate con.clusively the tumor inhibitory and tumoricidal effects of 3-methylcholanthrene on the chloroma. The mechanismof action of the drug is not known butappears to be a specific rather than ageneralized phenomenon.Anryllus, His Works, and theMedicine of His DayBy RICHARD L. GRANTHistory of MedicineAntyllus, a Greco-Roman physician,who probably lived in the first half ofthe second century A.D., is renowned forhis wise and accurate surgical writings.Nothing is known of the life of AntylIus, but it was probably analogous tothat of other physicians, such as Celsus,Soranus, and Galen in the first two centuries after Christ.His original writings appear to havebeen lost. Fortunately, his thoughts arepreserved, at least in part, in the encyclopedias of medical knowledge compiled by such well-known authors asOribasius of the fourth century A.D.,Paulus of Aegina of the seventh centuryA.D., and Rhazes of the tenth centuryA.D.Les Oeuvres d'Oribase, translated fromGreek to French in 1951 by Bussemakerand Daremberg, contain almost all ofAntyllus' preserved fragments. It wasfrom this compilation that I did an English translation of Antyllus' ideas. Inaddition, a survey was made of themedical philosophies extant at the timeof Antyllus in order to explain AntylIus' philosophy in relation to the practice of medicine of his day.His operation for aneurysms of vesselsof the extremities was used until thetime of John Hunter in the eighteenthcentury. A portion of the translationreads: "Thus the whole aneurysm is be- tween the two ligatures. We open thenthe middle of the tumor by a small incision: in this manner all which it contains will be evacuated, and there willbe no danger of hemorrhage."It is not, however, just in the practiceof surgery that Antyllus excelled. Hewas also an accomplished physician and,indeed, practiced medicine in its fullestsense. Study of the writings of severalmedical historians of recent times andanalysis of Antyllus' preserved fragments reveal with a fair degree of certainty that Antyllus was a truly eclecticphysician of unusual perspicacity, drawing from the works of others and fromhis own experience only that whichproved correct and useful.The Effect of X-Radiation onthe Healing and Acceptanceof Bone TransplantsBy AVRUM GRATCHOrtho pedicsThe purpose of this work is to studythe effects of repeated total-body Xirradiation on the healing of both autogenous and homogenous bone transplants.Previous work with parabiotic animalsshowed that the rejection of bone homotransplants is suppressed in the X-irradiated member of the pair. It is notclear whether healing in the irradiatedanimal is affected by the presence of thenon-irradiated animal, which may provide cellular or humoral factors that aredeficient in the irradiated member ofthe pair.The rejection of bone homotransplantsbecomes histologically evident 7-15 daysafter transplantation. The healing andacceptance of bone transplants after a20-day interval was compared in fourgroups of animals, that is, autogenousand homogenous bone transplants in irradiated and in non-irradiated rats.Histologic criteria used in the interpretation of acceptance and rejectionare based on previous sequential studiesof transplant healing and on acceptanceas well as observations of this material.The most important criteria of rejectionare signs of death and destruction ofproliferations of new bone in the graft.It is concluded that, in the circumstances of the experiment, repeated total body X-irradiation does not impairhealing of bone transplants but suppresses the rejection of homogenous transplants. This supports the previousobservation with parabiotic animals.Healing and inflammation may be considered activities of the connective tissue. By blocking inflammation, irradiation provides a means of separating,healing and inflammation.Studies on the Control ofIron AbsorptionBy SANFORD KRANTZMedicine (ACRH)A rapid and direct determination ofthe amount of iron absorption throughthe intestinal mucosa has been developed. When mice are given Fe59 byforced feeding and the whole animal isthen counted in a well-type counter atseveral intervals, the fate of the administered isotope with regard to absorption or excretion can be determined.Iron is excreted for 24--48 hours, afterwhich time the total radioactivity of themouse falls to a constant value that represents absorbed iron. Blood levels ofFe::ig in all cases paralleled total bodycount, whereas none was retained in theexcised gastrointestinal tract. Phlebotomy, hemolysis from acetyl phenylhydrazine, or hypoxic hypoxia will resultin increased absorption of ingested iron,and this has been confirmed by thismethod. Since all three of these stimuliwhich increase iron absorption cause anincreased plasma erythropoietin titerand since it has been shown that cobaltous ion can induce a rise in plasmaerythropoietin, the effect of cobalt oniron absorption was tested. Cobalt injected subcutaneously significantly increases iron absorption. Depression oferythropoiesis and the level of circulating erythropoietin by means of artificially induced polycythemia lowerediron absorption. Iron loading by meansof iron-dextran (Imferon) markedly reduced the absorption of iron. Absorptionwas increased in iron-loaded mice tonormal or above-normal levels withacetyl phenylhydrazine or cobalt treatment or with hypoxic hypoxia. The hypothesis that erythopoietin may exert adirect effect upon iron absorption wastested by using anemic plasma extractsthat were rich in erythropoietin. Whilethose conditions that elevate the amountof circulating erythropoietin increaseiron absorption and while the converseis also true, the direct test of the effectof this hormone by use of plasma richin erythropoietin, or concentrated extracts of such plasma, clearly demonstrated that it does not cause an increase in the transport of iron across thegastrointestinal mucosa. Nevertheless,iron absorption appears to parallel therate of erythropoiesis, and investigationis proceeding into other possible humoral controls of absorption of iron bythe intestinal mucosa.MEDICAL ALUMNI BULLETIN 7The Dancing Mania: A Twentieth-Century TheoryBy JANE F. PASCALEHistory of MedicineThe dancing mania, known also as St.Vitus' dance and chorea sancti viti, isan instance in medicine in which a disease is known by a name whose originalsignificance has been lost. It was firstencountered in A.D. 1374 at Aix-la-Chapelle. On the streets and in the churches,men and women, appearing to have losttheir minds, haunted by visions, conjuring up spirits, danced for hours in wilddelirium until finally they fell to theground exhausted. In Strasbourg, in1418, the afflicted were sent to the chapels of their patron saint, St. Vitus. Bythe seventeenth century this "demonical"disease had become rarer and modified.In the sixteenth century Paracelsusexpressed the idea that the dancing possession was not inflicted by supernaturalpowers and divided chorea sancti viti into chorea imaginativa, chorea lasciva,and chorea naturalis. Sydenham, in 1636,used the term "chorea sancti viti" to describe cases of the disease now given hisname but which had nothing to do withthe epidemic disorder of motion described by Paracelsus. The name "chorea sancti viti" will forever cling to thetwo forms known, respectively, aschorea minor and chorea major.In the first quarter of the twentiethcentury epidemic encephalitis occurred.Descriptions of some of its forms (hyperkinetic, choreiform, epilepto-maniacal, acute psychotic) are reminiscent ofthe dancing mania. Crowds and diminished resistance favoring epidemic disease were seen in the dancers, the pilgrimages, and the famine and pestilence following the Black Death. Thosesurviving the latter found consolation inreligion during a time of legends ofsaints and satan.Amid religion and epidemic disease,the dancing possession broke out in1374, with a hysterical element addedin the imitation, compassion, and terrorthat had an effect on the susceptible.What probably began as a real disease,an epidemic encephalitis, with thosereally affected being in the minority, became a dancing epidemic of diabolicalpossession.Review of RoentgenologicDiagnosis of GastricCarcinomaBy RAY SCHWEINEFUSRadiologyFrom 19 SO through 1957, approximatey 32,000 examinations of the uppergastrointestinal tract were conducted bythe Department of Radiology. Duringthese years the Registry of Neoplastic Diseases recorded a total of 368 diagnoses of gastric carcinoma. Eightyeight of these were recurrent carcinomafor which initial therapy had been performed elsewhere or for which roentgenographs had not been made at TheClinics prior to surgery or autopsy.These diagnoses are excluded from thissurvey, leaving 280 for statistical analySIS.Of the 280 patients, 213 were diagnosed as carcinoma without reservationon the basis of roentgenographs. Thisgives a positive diagnosis of 78 per cent.In 17 of the remaining 62 patients, theroentgenologist was unable to differentiate between benign and malignant lesions. Review of the films confirmed thejudgment of the roentgenologist.The remaining 45 patients, 16 percent of the total. are considered failuresas determined by roentgenologic means.It is this group with which we are primarily concerned. The review indicatesthat many of these were failures to interpret the films properly. An extensivestatistical review of the 280 records withregard to type of lesion, location, exfoliative cytology, and gastroscopic diagnosis has been made.Lipid Analyses in Rats FedVarious Vegetable Fats withand without Cholesteroland Bile SaltsBy COLEMAN R. SESKINDPathologyRecent experiments designed to giveinformation about atherogenesis suggestthat there are many variables contributing to the final pathologic condition.These experiments were designed to testthe effect of the degree of saturation ofdietary fat on atherogenesis and alsothe contribution of added cholesteroland bile salt. Diets equivalent in calories, vitamins, and minerals were prepared containing SO per cent fat, 23 percent carbohydrate, and 5 per cent protein. Different levels of dietary lipidhardness were obtained by employingdifferent vegetable oils or the same oilhardened in varying degrees. Male albino rats were fed the different diets bystomach tube three times daily. Analysesof serum factors believed related to thedevelopment of atherosclerosis, such ascholesterol, phospholipids, and lipoproteins, were done at intervals during theexperiments. The results showed thatthe serum lipid fractions associated withatherogenesis increased when "hard"fats were fed as opposed to "soft" oils.Moreover, for the "harder" fats, addeddietary cholesterol augmented this effect.Dietary bile salt and cholesterol fed together also contributed to an increase inthe deleterious serum-lipid factors. Furthermore, separation of serum choles- terol esters by silicic acid columns andgas chromatography analysis of the individual ester fatty acids revealed patterns that appeared to vary with the different dietary conditions.Conversion of 17-(a)-Hydroxyprogesterone 17 -n-Caproateto Estriol in PregnancyBy GERD STRUVERObstetrics and GynecologyThe purpose of this study was to investigate metabolic pathways of 17-(a) -hydroxyprogesterone 17 on-caproate(HPC), a long-acting and highly effective progestational agent, first preparedfrom 17 -(a)-hydroxyprogesterone (HP),which has weak and ineffective progestational activity. Investigations of urinarymetabolites of HPC gave no consistentpattern but differed from that of progesterone. Excretion of pregnanediol orpregnanediolone, the usually acceptedprogesterone metabolites, was unchangedfollowing HPC administration. Neitherwas there an increase of pregnanetriol,etiocholanolone, or neutral 17 -ketosteroids, known to be elevated in the urineafter administration of HP.CH-labeled HPC was administered intramuscularly to a pregnant patient. Radioactivity in urine and feces was determined. Analysis showed 65 per cent ofthe radioactive excretory products in thefeces in contrast to an average of 20 percent activity in feces after the administration of C14-4-progesterone. The crudestool extract, containing 35 per cent ofthe original total radioactivity, was partitioned into phenolic, acidic, and neutral fractions containing, respectively,81, 1l.1, and 6.9 per cent of recoveredradioactivity. The phenolic fraction wasfurther separated by paper chromatography, yielding estriol. Estriol was recrystallized, and acetate and benzoate derivatives were formed. Radio-assay, ultraviolet absorption spectra, and meltingpoints confirmed the radiochemical purity of estriol. The remaining activitywas largely present in pigments.Very little is known about metabolicpathways of HPC; the isolated estriolof the investigation accounts for only asmall fraction of the administered chemical dose. However, the results are inagreement with clinical findings in somecases of amenorrhea, where largeamounts of HPS will induce bleedingwithout endometrial priming by endogenous or exogenous estrogens, usuallynecessary to produce bleeding when progesterone is administered.This investigation has shown that, inpregnancy, HPC, a long-acting progestational agent, is partially converted to estriol, an estrogen, and is largely excretedthrough the gastrointestinal rather thanthe urinary tract.8 MEDICAL ALUMNI BULLETINTHE SENIORARMENTROUT, STEVEN ALEXANDERBorn Aug. 22, 1933; U. of Chicago, A.B., 1953;Intern.: University H., Cleveland; Internal medicine;Unmarried; A.O.A.; 383 Rotary St., Morgantown,W.Va.BALDWIN, LOUIS WILLIAMBorn Dec. 24, 1934; Intern.: Cook County H.;Obstetrics & gynecology; Unmarried; 8231 S. ThroopSt., Chicago.BALLIN, NORMANBorn Feb. 28, 1930; Cornell U., B.A., 1952; Intern.:Philadelphia Gen. H.; Ophthalmology; Unmarried;A.O.A.; 5 Wychview Dr., Westfield, N.J.BARHAM, FRANCIS LIONELBorn June 16, 1935; U. of Chicago, A.B., 1955, B.S.,1956; Intern.: Illinois Research & Educational H.;Psychiatry; Married.BARTH, BERLE IRABorn Apr. 11, 1929; State Teachers College, N.J.,B.A., 1950, U. of Denver, M.A., 1954, U. of Colorado,B.S., 1955; Intern.: Letterman Army H., San Francisco; Anesthesia; Married; Two children.BENNINGTON, JAMES LYNNEBorn Apr. 29, 1935; Intern.: Presbyterian-St. Luke'sH.; Pathology; Unmarried; No.9 Valley Rd., Beloit,Wis.BRAY, ROBERT ALDENBorn Feb. 2, 1924; Montana State College, B.S.,1957; Intern.: King County H., Seattle; Specialty undetermined; Unmarried; Big Timber, Mont.DAHL, JAMES RUSSELLBorn Oct. 30, 1933; Intern.: King County H., Seattie; Internal Medicine; Married; A.O.A.; Taylor'sFalls, Minn.DEGOWIN, RICHARD LOUISBorn May 14, 1934; Intern.: Billings; Internal medicine; Married; A.O.A.; 201 Black Springs Circle, IowaCity, Iowa.DUKES, MYRNA THELMA KATZBorn Nov. 10, 1930; U. of Chicago, A.B., 1948, B.S.,1956; Intern.: Illinois Research & Educational H.:::-\eurology; Unmarried; A.O.A.; c/o Lazard, 30 E. ElmSt., Chicago.EIGENBRODT, EDWIN HIXSONBorn Mar. 21, 1933; North Central College, Naperville, Ill., B.A., 1955: Intern.: Billings; Surgery; Unmarried; 619 E. North, Naperville, Ill.EVANS, RICHARD HARVEYBorn Mar. 12, 1935; U. of Chicago, A.B., 1954, B.S.,1955; Intern.: Billings; Pediatric surgery; Unmarried;A.O.A.; 2652 Rosemont Ave., Chicago 45.FELDMAN, SIDNEYBorn May 14, 1935; U. of Chicago, A.B., 1954, B.S.,1955; Intern.: Cook County H.; Specialty undetermined; Unmarried; 6237 N. Mozart Ave., Chicago.FREEDMAN, LA WRENCE DAVIDBorn Mar. 8, 1934; Hobart College, Geneva, N.Y.,B.A., 1954; Intern.: Los Angeles County H.; Specialtyundetermined; Unmarried; 2235 Ocean Parkway,Brooklyn, N.Y.FRIEDMAN, GARY DAVIDBorn Mar. 8, 1934; U. of Chicago, B.S., 1956;Intern.: Boston City H.; Internal medicine; Married;A.O.A.; 24460 Greenwich Lane, Beechwood Village 21,Ohio.MEDICAL ALUMNI BULLETIN 9CLASS OF 1959FROST, ROBERT WILLIAMBorn Aug. 12, 1929; U. of Chicago, A.B., 1949, U. ofCalifornia at Los Angeles, Ph.D., 1957; Intern.: LosAngeles County H.; General practice; Married; 10940S. Green St., Chicago.GIVEN, EVERETT HERDMAN, JR.Born Dec. 1, 1928; U. of Minnesota, B.S., 1950;Intern.: Blodgett Mem. H.; Radiology; Married;Three children; c/o Given, Sr., 800 N. Hamlin, ParkRidge, Ill.GLASSER, HARVEY WILLIAMBorn July 2,1935; U. of Illinois, B.S., 1957; Intern.:Michael Reese H.; Psychiatry; Married; 63 W. SchillerSt., Chicago.GOLDSTEIN, MORTON HILLBorn Apr. 21, 1934; Alfred U., Alfred, N.Y., A.B.,1955; Intern.: Billings; Surgery; Unmarried; 800 Avenue H., Brooklyn 30, N.Y.GRADOLPH, IDA HEINTZBorn Aug. 19, 1927; U. of Texas, B.A., 1946; Intern.:Cincinnati Gen. H.; Psychiatry; Married; 3241 N.Troy St., Chicago 18.GRADOLPH, PHILIPBorn June 30,1927; U. of Chicago, Ph.B., 1949, B.S.,1955; Intern.: Cincinnati Gen. H.; Internal medicine;Married; 3241 N. Troy St., Chicago 18.GRAHAM, HUGH CORNELIUS, JR.Born Nov. 23, 1933; Harvard U., A.B., 1955; Intern.:University H., Oklahoma City; Pediatrics; Married;3123 S. Atlanta, Tulsa, Okla.GRANT, RICHARD LOCKEBorn Dec. 3, 1933; DePauw U., B.A., 1956; Intern.:University H., Portland, Ore.; Internal medicine; Married; 10931 S. Trumbull Ave., Chicago 43.GRATCH, AVRUM VREMMIEBorn Sept. 4, 1934; U. of Chicago, A.B., 1954, B.S.,1955; Intern.: Beth Israel H., Boston; Orthopedics;Married; A O.A.; 528 Surf St., Chicago 14.HEYWOOD, JOHN DAVIDBorn Mar. 14, 1933; Earlham College, Richmond,Ind., A.B., 1955; Intern.: University H., Ann Arbor;Internal medicine; Married; A.O.A.; Dublin, Ind.HIRSCH, DAVID MICHAEL, JR.Born Dec. 7, 1933; Harvard U., A.B., 1955; Intern.:Billings; Specialty undetermined; Unmarried; 2508Broadway, New York 25, N.Y.HOLTZMAN, JORDAN LOYALBorn July 12, 1933; U. of Chicago, A.B., 1952, M.S.,1955; Intern.: Illinois Research & Educational H.; Internal medicine; Married; 108 Sargent, Joplin, Mo.KAHN, WALTER J.Born June 21,1934; Intern.: Philadelphia Gen. H.;Ophthalmology; Unmarried; Box 70A, Hooper Ave.,Toms River, N.J.KATZ, FRANKLIN ALEXANDERBorn June 13, 1934; U. of Connecticut, A.B., 1955;Intern.: Los Angeles County H.; Specialty undetermined; Unmarried; 3740 Washington Blvd., University Heights, Ohio.KELLY, FRANK JOSEPHBorn Jan. 8, 1934; U. of Pennsylvania, B.A., 1955;Intern.: Illinois Research & Educational H.; Orthopedic surgery; Married; One child; 130 N. 18th St.,Ph ilarlr-Inh ia "I10 MEDICAL ALUMNI BULLETINTHE SENIORKEOUGH, THOMAS FRANCISBorn Oct. 13, 1929; U. of Chicago, B.S., 1956; Intern.: Blodgett Mem. H.; Internal medicine & pediatrics; Married; A.O.A.; 310 N. Buffalo St., Warsaw,Ind.KINSLER, DONALD BENEDICTBorn Apr. 9, 1933; Queens College, B.S., 1955; Intern.: Los Angeles County H.; Specialty undetermined; Married; 2786 Bainbridge Ave., New York 58,N.Y.KOENIGSBERGER, RICHARD MERTONBorn June 7,1933; Stanford U., B.S., 1955; Intern.:Billings; Pediatrics or radiology; Unmarried; 2019Lyon St., San Francisco.KOIVUN, CHARLES WILHARTBorn Aug. 27,1932; Dartmouth College, A.B., 1954;Intern.: Presbyterian-St. Luke's H.; General practice;Married; 1702 30th Ave., Moline, Ill.KRANTZ, SANFORD BURTONBorn Feb. 6, 1934; U. of Chicago, A.B., 1955, B.S.,1956; Intern.: Billings; Internal medicine; Married;4166 Clarendon Ave., Chicago 13.KRONICK, ELWOOD LENWORTHBorn Mar. 24, 1931; U. of California at Bcrkeley..B.A., 1953; Intern.: San Francisco County H.; Obstetrics & gynecology; Unmarried; 3006 College Ave.,Berkeley, Calif.LECK, RICHARD CHRISTIANBorn Feb. 12, 1931; U. of Chicago, A.B., 1952, B.S.,1955; Intern.: Billings; Specialty undetermined; Married; 7316 N. Winchester Ave., Chicago 26.LEVINE, RICHARD SAUNDERBorn Mar. 22, 1931; U. of Bridgeport, Bridgeport,Conn., B.S., 1952; Intern.: Kings County H., Brooklyn; Psychiatry; Unmarried; 3015 Riverdale Ave.,Bronx 63, N.Y.LEVINE, SUSAN PLASKOWBorn July 12, 1934; U. of Chicago, A.B., 1955;Intern.: Cook County H.; Child psychiatry; Married;Karl Meyer Hall, Cook County H., Chicago.LLOYD, WILLIAM BROSS, IIIBorn Apr. 3, 1935; U. of Chicago, A.B., 1955, B.S.,1956; Intern.: Cincinnati Gen. H.; Pediatrics; Unmarried; 806 Rosewood Ave., Winnetka, Ill.McGANN, BARBARA LLYNBorn Sept. 7, 1931; Vassar College, A.B., 1952;Intern.: Bobs Roberts H.; Pediatrics; Married; c/oLechtman, 2440 Sedgwich Ave., New York 68, N.Y.NYGREN, ROBERT CHESTERBorn Oct. 25, 1933; Carleton College, B.A., 1955;Intern.: Los Angeles County H.; Pediatrics; Unmarried; Braham, Minn.ODA, YOSHIOBorn Jan. 14, 1933; Cornell U., A.B., 1955; Intern.:Billings; Specialty undetermined; Unmarried; 99186Puakala St., Aiea Oahu, Hawaii.PASCALE, JANE FAYBorn May 20, 1932; Mount Holyoke College, B.A.,1954; Intern.: Grace-New Haven H.; Pathology; Unmarried; 1366 Boulevard, New Haven, Conn.PAVILACK, PAULBorn July 3, 1932; West Virginia U., B.S., 1954,A.B., 1955; Intern.: San Francisco County H.; Specialty undetermined; Unmarried; 1024 National Rd.,Wheeling, W.Va.MEDICAL ALUMNI BULLETIN 11CLASS OF 1959PEARSON, DONALD HALLBorn Feb. 28, 1934; Reed College, A.B., 1955;Intern.: Royal Victoria H., Montreal; Neurology &neurosurgery; Unmarried; 192 Lela, Crescent City,Calif.PELLAR, DONALD HOBARTBorn Aug. 2, 1931; U. of Miami, B.A., B.S., 1954;Intern.: Charity H., New Orleans; Neurosurgery;Married; One child; 35 E. San Marino Isle, MiamiBeach, Fla.PINC, ROGER DAVIDBorn Dec. 28, 1928; Northwestern U., B.S., 1950,U. of Illinois, M.S., 1952; Intern.: Martin Army H.,Fort Benning; Radiology; Married; 1943 S. Gunderson, Berwyn, III.RAMBAUD, JACQUES JEAN EDMONDBorn Jan. 2, 1934; Cornell U., B.A., 1955; Intern.:Walter Reed Army H.; Internal medicine; Married;250 Taft Crescent, Centerport, N.Y.ROBERTS, JAMES ALLENBorn May 31, 1934; U. of Chicago, B.S., 1955;Intern.: Billings; Urology; Married; 1123 N. 26th,Billings, Mont.ROSENBLATT, STANLEYBorn May 17, 1932; New York U., B.A., 1955;Intern.: Los Angeles County H.; Internal medicine;Unmarried; 2958 W. First St., Brooklyn 24, N.Y.RUTGERS, CAROL FAYBorn Dec. 22, 1933; Calvin College, Grand Rapids,Mich., A.B., 1953; Intern.: Billings; Internal medicine; Unmarried; 17032 Bixby Ave., Los Angeles, Calif.SCHAFER, JOHN RAYBorn Apr. 23, 1933; U. of California at Los Angeles,B.A., 1954; Intern.: Highland-Alameda County H.,Oakland; General practice; Married; One child; 51440th St., Sacramento, Calif.SCHWEINEFUS, RAYMOND LeROYBorn June 6,1929; U. of South Dakota, B.A., 1957;Intern.: U.S. Navy, San Francisco; Radiology; Married; Three children; 712 Second Ave., S.E., Watertown, S.D.SESKIND, COLEMAN ROBERTBorn Sept. 22, 1936; U. of Chicago, B.A., 1955, B.S.,1956, M.S., 1959; Intern.: San Francisco Gen. H.;Pathology; Unmarried; 7500 N. Ridge, Chicago.SHAPIRO, MARTIN LEEBorn Feb. 10, 1934; Cornell U., B.A., 1955; Intern.:Illinois Research & Educational H.; Ophthalmology;Married; A.O.A.; 159-07 14th Ave., Beechhurst 57,N.Y.SHUSTER, FREDERICKBorn Sept. 12, 1933; Rutgers U., B.S., 1955; Intern.:University H., Ann Arbor; Internal medicine; Married; A.O.A.; 636 Lyons Ave., Irvington, N.J.SLOTWINER, PAULBorn May 13,1935; U. of Chicago, A.B., 1955, B.S.,1956; Intern.: Billings; Neurology; Married ; 193882nd St., Brooklyn 14, N.Y.SMITH, SUE ALBERTSONBorn June 19, 1934; U. of Chicago, A.B., 1955, B.S.,1956; Intern.: Billings; Psychiatry; Married; 5122 N.Gomez Ave., Tampa, Fla.SPAULDING, JOHN SCOTTBorn Aug. 23, 1929; Swarthmore College, B.A.,1951 ; Intern.: Presbyterian-St. Luke's ·H.; Pediatrics;Married; 6110 N. 52d Pl., Phoenix, Ariz.12 MEDICAL ALUMNI BULLETINTHE SENIOR CLASS OF 1959STEIGLITZ, JEAN ANNBorn Mar. 4,1931; U. of Illinois, B.S., 1952; Intern.:Presbyterian-St. Luke's H.; Medicine; Unmarried;5543 Kimbark Ave., Chicago 37.STRUVER, GERD PAULBorn Sept. 1, 1929; U. of California at Berkeley,B.A., 1954; Intern.: St. Mary's H., San Francisco;Internal medicine; Married; Two children; 1242 26thAve., San Francisco.TERMAN, DAVID MATTHEWBorn May 23, 1935; U. of Chicago, A.B., 1955, B.S.,1956; Intern.: Philadelphia Gen. H.; Psychiatry; Unmarried; 615 Clinton Pl., Evanston, III.THOMAS, THOMAS ROHANBorn Apr. 3, 1930; Purdue U., B.S., 1952; Intern.:Colorado Gen. H.; Medicine; Married; 823 173d Pl.,Hammond, Ind.WAST ALU, ALEKSANDERBorn July 30, 1932; Iowa Wesleyan, B.S., 1955;Intern.: Evanston H.; Internal medicine; Unmarried;6156 S. Kenneth Ave., Chicago.WEBER, WENDELL WILLIAMBorn Sept. 2, 1925; Central College, Fayette, Mo.,B.A., 1945, Northwestern D., Ph.D., 1950; Intern.:Moffitt H., San Francisco; Psychiatry or neurology;Married; Gerald, Mo.WEISS, ETHEL MAYBorn Jan. 21, 1929; U. of Chicago, Ph.B., 1947, B.S.,1956; Intern.: Cook County H.; Specialty undetermined; Unmarried; 4300 N. Marine Dr., Chicago.WISE, WARREN ALLENBorn Nov. 24, 1931; Intern.: Wayne County H.,Eloise, Mich.; Surgery; Married; Three children;1306 N. Hickory St., Champaign, III.WONG, WU-TSUANBorn May 4, 1932; U. of Chicago, M.S., 1955;Intern.: Cincinnati Gen. H.; Medicine; Unmarried;3114 Oliver St., N.W., Washington 15, D.C.CLASS FIRSTS1. Ten new female physicians-five married to doctors or doctors-to-be.2. 65 per cent united in wedded blissnurses and teachers predominate asmates.3. A male with dysmenorrhea-relievedby FUGO-mycin ointment.4. Perhaps the most unhealthy-$150for health fees, mainly benefiting Seskind and Leek, victims of usual childhood diseases.5. A textbook dedicated to the noonlecture nappers by Dr. Mullan.6. The use of Chinese interpreters as anadjunct to neurophysiology.Noo,", Lec+ureMEDICAL ALUMNI BULLETIN 13OUR HISTORY(Abridged)1955-Bona fide freshmen!-Most lectures were but opening remarks to confuse the reading of severalhundred pages of assignment, but evenat this early date the instructors knewenough not to begin before the entranceof Ethel Weiss.-Dick Tracy thought how nice it wouldbe to see the whole squid, not just anaxon, and maybe we really don't see livepeople-patients.-Getting Frank Kelly to buy a biochemistry book and not rely on noteswas probably Paul Hinenburg's achievement for the year.-Dr. Ruth Rhines, one of our favoritepeople, began her first year with ourclass; she made Betz's cells exciting.-To valiant Dave Heywood we owethanks for increased knowledge in Dr.Perkins' pulmonary studies class. Thoughhe gave us a scare when the bicycle gearsslipped, his brave heart and lungs produced beautiful curves, and to him weregiven the best copies.1956-Sophomore year, year of disease, year of patient contact, year ofpathology, year of work.-Third quarter-C.C.C.-we inspected,palpated, percussed, and auscultatedeverything and anything.-We learned the surgical motto, "Whenin doubt, cut it out," and became acquainted with the shiny new equipmentpurchased wholesale by Coleman Seskind, M.M.M. (Medicine's MysteryMerchant).-We learned how, artfully, to partakeof lunchtime lectures. Of course, we hadHarvey Glasser to emulate.'Glasser, 1957-Juniors! Doctors (maybe)!-It was perhaps Dr. Pullman who didthe most to round out our education. To I�add even more stimulation to the al- �.:tready interestingly disturbed states weassumed during his rounds, he one daysuddenly fired out: "What is a boatnail?" (and right in the middle of a discussion of the caloric content of anolive!) Target Gary Friedman, drawingon his medico-nautical knowledge, notonly knew what but how many calories.-Paul Slot winer made his testimonyconcerning the cause of the withdrawalof his belching. It was the two soothing -weeks spent on Dr. Palmer's service, or, =a new interpretation of P IB-PalmerBenevolence.-Our favorite arsonist, George Humphrey, will not soon forget the smouldering skeleton and the telltale cigarettestill clutched in his hand while Dr. Pullman helplessly laughed an aneurysm intohis Circle of Willis and two interns relayed paper cups full of water from adistant water fountain, drenching everything but the target-Dr. Hodges' roarof "What idiot did this?" and, finally,Dr. Carpender's crisp, "And your name,please?"-If that weren't enough to immortalizeGeorge, there are the 7: 15 A.M. GEORGEBENNETT HUMPHREY SURGICAL ROUNDSfounded by him and Franklin Katzwhich appear to have become a permanent fixture.1958-Seniors and Seniorettes!-The year of 72 schedules and 1,000variations, though seemingly complex, isorganized around a simple principlethe Ouija Board in Dr. Page's office. We,the pioneers of the new program, hopethat those to come will benefit from ourtrials.-Because of the added twelve weeks,we were deprived of the opportunity ofworking during our off-quarter. In orderto satisfy our habits of eating, etc., theadministration created jobs within TheClinics which provided on-the-job experience as well as a stipend. The stipend of $20 per night for EmergencyRoom service was, after a few months,considered to be overcompensatory inview of the direct evidence of Jim Dahl'srapid weight increase. The fee was reduced to $5, and the side benefitsseemed to decrease with it.1959-"Final year"!-We finally graduate, make final decisions about internships and specialties.Many of us will remain here to continue 8know}IS 61 � 61 flo�"our studies (who knows but that Dr.Vermeulen may some day have to compete with our own Jay Roberts!)-George Humphrey, Frank Thorpe, BobMoody, and Dick Tracy took leaves ofabsence to pursue research frontiers andwill complete their senior year in 1960.Jim Hill, who also had a leave of absence to overcome a personal frontier,will graduate with the researchers in1960. To emphasize a historical fact, welay claim to Jim as our own, but won'tdeny the group behind us the benefit ofhis inspiration.-Warren Wise and Gig Given are perhaps the only two who are happy to seethe off-quarter disappear from the senioryear. Warren has raised our class-fertility-index 3 points, and probably holdsthe record of any class by fatheringthree sons since his entrance into medical school. Gig has three children, twoboys and one girl. Both have wives (it'sjust good policy not to leave any doubt).We have in the neighborhood of twentyoffspring, not counting what furtherprogress has been made to date.-And, while we're surveying, we havemore cigar smokers (speaking of which,Lou Baldwin will be our Class Speakerat the Alumni Banquet), more psychiatrists (something we've always needed),and more pediatricians than any previous class.TOM KEOUGH14 MEDICAL ALUMNI BULLETINDEATHSFrank Boyd, Paducah, Ky., Septembe9' 2 7, age 90../93. Oscar Reilly Wright, Huron, S.D.,Ncjvember 8, age 90.�'6. James Edwards Skinner, Tacoma,W h., January 12, age 9l.orner Percy Dredge, Sandstone, Minn.,ember 27, age 88.7. Ollie W. Rice, McAlester, Okla.,iJbruary 3, age 87.J'98. Alfred Lewy, Chicago, December 14,m 85.99. Thomas Ira Motter, Oak Park, Ill.,ovember 20, age 86.Charles Luther Patterson, Westside,I wa, September 14, age 89.'00. Porter Bruce Brockway, Toledo,hio, October 28, age 83.Rupert A. Davies, Arlington, Neb., March2 ,age 84.'01. Felix Edward Ashcroft, Glendale,alif., December 30, age 87.James William Barnebee, Kalamazoo,Mich., December 19, age 80.) erberr Milo Trankle, Chippewa Falls,. , September 21, age 78.2. John Raymond Barber, Santa Cruz,f., September 21, age 80.osiah Ralph McKirahan, Des Moines,a, November 6, age so.Walter R. Rhodes, Toledo, Ill., Novem�er 29, age 80.\) J. Albert Schultz, Albert Lea, Minn., Oct�ber 31, age S1.JJoseph Benjamin Sonnenschein, Chicag�, January 30, age S2.'03. Thomas William Parsche, OceanS rings, Miss., December 9, age 77.�'O.f. James Dunn, Davenport, Iowa, Oct ber 11, age 79.George William Koch, Anaheim, Calif.,o tober 22, age 79._ Anson LeRoy Nickerson, Kankakee, Ill.,Dfcember 25, age S1.'" , acob Myers, Chicago, January 19, age 75.anford A. Winsor, Pompano Beach,F a., September 2, age 75.'06. Claude Vernard Russell, Lansing,ich., September 25, age 77.'07. Max Louis Mendel, Vicksburg, Miss.,ctober IS, age 76.'09. Emmett Lehr Lee, Aurora, Ill., No-�mber 14, age 76.Walter L. Wentzel, Corpus Christi, Tex.,o tober, age 77.'10. William W. Peter, Port Republic,l\Id., March 31, age 76.�'11. John Vincent Barrow, Los Angeles,Ijecember 17, age S1..J'12. Roy J. DeMotte, Chicago, February\'6, age ir.-l Clinton George Stewart, Circleville,Qhio, November 1, age 85.J Oren Henry Wright, Chicago, December¥O, age 73.j '16. Lester Alvin Smith, Indianapolis,'nd., December IS, age 68.�'17. Lee Roy Woodward, Mason City,Iowa, December 9, age 73..J '18. Charles Edward Watts, Seattle,I,fash., October 12, age 6S._} '20. James Houloose, Los Angeles, J anuary 11, age 69. J�rle Alexander Pittenger, Aberdeen,S. ., September 24, age 66.'fArnest Elwood Tippin, Sr., Wichita,n., October 30, age 68.21. William Joseph Matousek, Glenda/e, Calif., November 21, age 69.'/;24. J. Bailey Carter, Evanston, Ill., Dec"Jnber 9, age 61.J Ernest Lemon Jewell, Logansville, Wis.,N�vember 22, age 62.jWyant LaMont, Beverly Hills, Calif.,Fepruary 7, age 59.Jrwin Dave Siminson, Mineral Point,W/ts., January 26, age 63.�6. Dwight Tedcastle Van Del, KansasC y, Mo., August 12, age 5S.27. Howard McKinley Walker, Dodgevilie, Wis., November 21, age 57../' 29. Isee L. Connell, Jacksonville, Fla.,F1bruary 14, age 66.";'31. Raymond B. Baer, Grosse Pointe�rk' Mich., February 7, age 59.William M. Stauffer, Allentown, Pa.,Yober 20, age 62.32. Lealdes McKendree Eaton, Roches-je , Minn., November IS, age 53.'34. Robert Leo Stern, Beverly Hills,liL, December 17, age 50.'35. Robert D. Perkins, Moline, Ill., Dember 31, age 49., 36. Matsukichi Kanai, Albuquerque,N/M., November 22, age 53 .j'40. Roger S. Morris, Ludington, Mich.,December 30, age 47.S.A.M.A.Allen Dekelboum, '60, was chairmanand Richard Evans, '59, co-chairman ofthe S.A.M.A. Convention in Chicago thefirst of May. Nine hundred students fromoutside Chicago attended.Ten final papers were presented at theScientific Session of S.A.M.A., and thesecond prize went to Coleman Seskind,'59, for his paper on "Serum Lipid Levelsin Rats Fed Vegetable Oils with and without Cholesterol."BULLETINof the Alumni AssociationThe University of ChicagoSCHOOL OF MEDICINE950 East Pif ty-n in th Street, Chicago 37, IllinoisSPRING 1959 No.3VOL. 15EDITORIAL BOARDPETER V. MOULDER, Chairman'\'RIGHT ADAl'.'IS ROBERT J. liASTERLIKL. T. COGGESHALL ELEANOR �I. HUMPHREYSALBERT DORFMAN HUBERTA LIVINGSTONE'VALTER L. PALllERJESSIE BURNS MACLEAN, SecretarySubscription with membership:Annual, $4.00 Life, $60.00 RUSH NEWS'12. Maude Hall Winnett is on the regular attending staff of Mary Thompson Hospital in Chicago and keeps office hours dailyin the Marshall Field Annex. She is a fellowof the American College of Surgeons and ofthe American Board of Obstetrics and Gynecology.'14. M. M. Kulvin has retired from theVeterans Administration after thirty-sixyears and is now in the private practice ofophthalmology in Miami. His son, Stephen,is nineteen and a second-year premed student at Duke University, and his daughter,Dale June, sixteen, will enter Sophie Newcomb College in New Orleans in the autumn:'18. F. W. Burcky has retired from hismedical practice in Pasadena and is at presen t on an extensive trip.L. I. Oppenheimer has been retired sinceJanuary, 1955. He says that his classmate,John Simpkin, is still in active practice inSan Leandro and is "one of the best-thoughtof men in the San Francisco East Bay area."'20. Karl M. Nelson of Princeton, Illinois, is not retiring-"not fading away."'24. Manuel E. Lichtenstein has beenelected chairman of the Department of Surgery of Cook County Hospital and appointed to membership on the Board ofTrustees of the Cook County GraduateSchool of Medicine.'25. From Ernest H. Clay, Montebello,California, we get the news that AngusMcDonald is now vice-president of the LosAngeles County Medical Association.'28. Noel G. Shaw is president of theChicago Pediatric Society and has been elected to a four-year term on the ExecutiveCommittee of the Annual Clinical Conference of the Chicago Medical Society. Heserved on the program committee for the1959 Clinical Conference in March.'31. Gladys Kindred Dolan moved toTulsa, Oklahoma, in 1948. Until 1954 shewas in the Maternal-Child Health Department; she has since been clinic staff physician at the Children's Medical Center.'34. F. A. Musacchio has returned toLaredo, Texas, to become director of the.Health Department., 35. Richard H. Baugh completed hisformal training in obstetrics and gynecologyat Providence Hospital in Detroit in 1954.He has since been in private practice inDearborn, Michigan.'37. H. C. Gunderson was the 1955 president of the Academy of Medicine of Toledoand Lucas County. He is a specialist inotolaryngology with the Toledo Clinic.Caroll M. Silver is chief of orthopedicsurgery at Miriam Hospital in Providence,Rhode Island, where he has been since 1946.He has three children-June, sixteen; Susan,twelve; and Paul, nine.Philip J. Stein placed first in the recentexaminations for the new six-year term forattending men of the Cook County Hospital.'38. Louis Shattuck Baer, Burlingame,California, has been promoted to associateclinical professor of medicine at Stanford.Arthur Robinson has been granted thefirst combined appointment on the facultyof the University of Colorado School ofMedicine: assistant professor of biophysicsand assistant clinical professor of pediatrics,MEDICAL ALUMNI BULLETIN 15A.O.A.GRADUATE NEWS James R. Dahl and Gary Friedmanwere elected to A.O.A. membership lastyear as Juniors.The Seniors elected this spring are:Steven Armentrout, Norman Ballin,Richard DeGowin, Myrna Dukes,Richard Evans, Avrum Gratch, DavidHeywood, Thomas Keough, MartinShapiro, and Fred Shuster.The Juniors elected this year are:Lloyd Ferguson, Alfred Heller, andLawrence Lichtenstein.'44. Edward G. Ference announces anaddition to his family-Peggy Ann, bornOctober 15.'45. Justin Aalpoel is chief of thoracicsurgery at the VA Hospital in Portland,Oregon. He was certified by the AmericanBoard of Surgery in 1957 and by the Boardof Thoracic Surgery in 1958.'47. The Thomas Tourlentes' son, Teddy,was a year old on February 12. The Galesburg State Research Hospital, where Tomis superintendent, is the fifth mental hospital to be fully accredited in the UnitedStates.'48. N. J. Galluzzi was certified by theAmerican Board of Internal Medicine inMay of 1957. He continues as chief of medicine at the Detroit P.H.S. Hospital. CharlesBurhow is chief of radiology there.'49. Sherwood P. Miller left Californialast December and is on the attending staffof Maimonides Hospital in Brooklyn and inthe practice of internal medicine on StatenIsland.'50. Jack B. McClure (Capt.) has returned from a thirteen-month tour of dutyin Korea, where he was commanding officerof the l l th Evacuation Hospital. He is nowstationed at Fort Sam Houston.'51. Myron G. Chapman is in privatepractice of internal medicine and cardiologyin Claremont, California, and is associatedwith the Health Service of Claremont Colleges.'52. Fred V. Gwyer has opened a newoffice in La Grange, Illinois. His practice islimited to psychiatry (child and adolescent).Harold Lischner was married in December to Kyong Ok Kim, a Korean nurse. Heis finishing his residency in pediatrics at theU.C.L.A. Medical Center.'53. Alexander Breslow will become instructor in pathology at the University ofWashington in July. The Breslows' thirddaughter, Rachel, arrived last September 20.James I. Gabby has finished his residencyin adult and child psychiatry and is in halftime private practice in San Francisco andis in charge of the Adult Intake Service ofthe Mount Zion Psychiatry Clinic.Edward S. Lyon is now the father of threedaughters and two sons. The most recentboy, Roger Morton, was born on March 15.'54. Lois A. G. Scheimann has a son,Richard William, Jr., born December 4, tokeep company with her daughter, AnneMarie, age two.Dorothy Windhorst is doing a little private dermatology as well as working for theSt. Louis County health department andthe VA. The latter and clinic work at BarnesHospital give her an opportunity to teachstudents and residents as well as to continueher own education. The whole family enjoys St. Louis, especially in the spring.'55. Lloyd L. Brandborg will start histhird year of a research fellowship in gastroenterology at the University of Washingtonin July. He recommends this university andKing County Hospital for internship andresidency for graduates who are not stayingat Chicago. He says the Chicago people archighly thought of and consistently do well. Martin H. Flax looks forward to an appointment as clinical fellow in pathology atMassachusetts General Hospital upon completion of his tour of duty with the Air Forcein July.Floyd H. Gilles reports the arrival of histhird daughter, Susan Kay, on March 24.He will begin active service in the Navy inJuly after completing his third and last yearof neurology residency at the Johns Hopkins.E. Jack Harris is in the last year of hisOb-Gyn residency at the Brooklyn JewishHospital. Andrew, the Harrises' first, arrivedMarch 1.Richard Osband is now completing hisobstetric and gynecologic residency at theUniversity Hospital in Birmingham, afterwhich he plans to practice there. His residency was begun at the University of Rochester and interrupted by two years in theAir Force. He says the Alabama residency ismagnificent-more men ought to comeSouth.Leonard Sagan is leaving the Army inJuly to resume his medical residency at theUniversity of California in San Francisco.'56. Ronald E. Myers is involved in basicresearch in the area of mind-brain interrelationships in the neuropsychiatry departmentat Walter Reed Hospital under David Rioch.His program has been so successful that heplans to extend his tour of duty by at leasta year before entering a neurological residency. The Myerses would be delighted tobe hosts to any Chicago visitors in Washington.'57. The Herbert Gellers became theparents of a son on May 11, 1958.Theodore Jacobs is a resident in psychiatry at the Albert Einstein Medical Centerin New York City.Myron Karon will begin his appointmentas chief resident in pediatrics at the University of Wisconsin in July. A son, MichaelScott, was born last July.Theodore A. Peterson has a son, Todd,born August 23. Ted calls your attention tothe new surgical mask perfected by JoeKiser and described in the American] ournalof Surgery.'58. Donald R. Chimene will stay on atBronx Municipal Hospital next year as assistant resident in surgery.'59. Coleman R. Seskind has been awarded the Sheard-Sanford prize for $100 for hismanuscript, "Serum Lipid Levels in RatsFed Vegetable Oils with and without Cholesterol" by the American Society of ClinicalPathologists. Come to the Banquetto find out WHO• graduates with honors• wins the Borden AwardJune 10REUNION BANQUETHotel ShorelandJune 9SENIOR SCIENTIFIC SESSIONMost of the original drawings in thisissue as well as the design of the backpage were done by Ed Eigenbrodt, '59.We are happy to acknowledge his ablehelp. June 11SENIOR SKITJune 12COMMENCEMENTTHE EDITORS16 MEDICAL ALUMNI BULLETIN