Early Radiology and the National Medical Association

Early Radiology and the National Medical Association

h i s t o r y Early Radiology and the National Medical Association Alan E. Oestreich, MD Both the discovery of the x-ray and the founding of t...

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Early Radiology and the National Medical Association Alan E. Oestreich, MD

Both the discovery of the x-ray and the founding of the National Medical Association (NMA) occurred in 1895. Radiologists have participated importantly in the NMA since the lecture of Dr Marcus F. Wheatland at the 1909 Annual Meeting in Boston, Massachusetts, which led to his election as president of the NMA for the following year. More recently, Dr Tracy M. Walton was president of the NMA in its centennial year. This article details early and continued participation in the NMA by radiologists, including the founding of the Section on Radiology in 1949, with its first chairman, Dr William E. Allen, Jr, longtime leader in radiology, the section, and the NMA. Keywords: radiology n National Medical Association n history J Natl Med Assoc. 2011;103:46-49 Author affiliation: Cincinnati Children’s Hospital Medical Center, Ohio. Correspondence: Alan E. Oestreich, MD, Radiology 5031 CCHMC, 3333 Burnet Ave, Cincinnati, OH 45229-3039 ([email protected]).

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he remarkable career of Marcus F. Wheatland, MD, 11th president of the National Medical Association (NMA) and the f irst African American specialist in radiology, included receiving his MD degree from Howard University in Washington, DC, in 1895, the same year that the NMA was founded. 1 His first known NMA lecture, entitled “The Diagnostic Value of the X-ray in General Practice, with lantern slides,” at the 11th Annual Meeting of the NMA, Boston, Massachusetts, August 24 to 26, 1909, is the first documented formal radiology paper in the history of the organization. It was the next day that he was elected to the presidency for the following year. The program for the following annual meeting, August 23 to 25, 1910, in Washington, DC, further announced “Dr. Marcus F. Wheatland of Newport, Rhode Island, will exhibit X-ray plates during the session.” This statement also reminds us that in the early days, radiographs appeared on glass “plates,” which many years later were replaced by “films,” and in today’s world, most of us use electronic “images.” At the 1919 Newark, NJ, annual meeting, he made comments, preserved in the Journal 46 JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION

of the National Medical Association (JNMA), on both of the radiology papers presented there.2 X-rays appeared in the pages of the JNMA for the first time in 1911 with an article published by Chicago, Illinois, African American Radiologist Claudius DeWitt Bell, MD, of Provident Hospital.3 That article was basically a “show and tell” with 4 illustrations from plates, but remarkably included the normal hand of Dr Booker T. Washington (Figure 1). Dr Bell himself states that the accompanying cuts of his article were far from being as clear as the original plates, but served to show the inestimable value of the x-ray.3 An article emphasizing the use of detailed radiology in 1917, entitled “The Relationship of Roentgenology to Gastrointestinal Diagnosis,”4 also appeared from Chicago from the pen of Carl Glennis Roberts, MD (NMA president, 19261927), a general practitioner and gynecologist, who also eventually served on the Board of Directors of the Chicago Radium Corp. During World War I, he organized the first African American sanitary corps of the Red Cross. In his article, Dr Roberts emphasized that details of the technique (tube, exposure time, tube patient distance, etc) are exclusively the domain of the roentgenologist, while the clinician should understand the process so that he (or she) may correlate with clinical history and physical examination. In addition to barium, bismuth (which, of course, is now obsolete) was described as a contrast material for the gastrointestinal radiologic exam.4 During the 1916 national meeting of the NMA in Kansas City, Charles R. Humbert, MD, while still an intern at Kansas City’s Old General Hospital, played an active role as lecturer and demonstrator of many cases.5 Dr Humbert became the first African American x-ray specialist in the midwest outside Chicago and a leader in his medical community. Philadelphia pioneer Radiologist Robert William Henry, MD, gave 1 of the next 2 formal radiology lectures—“The X-ray, A Potent Factor in Determining Important Decisions,” illustrated by lantern slides—to an NMA national meeting, namely to a joint session of the medical and surgical sections at the 1919 Newark meeting.6 Dr Henry emphasized that the x-ray was just as dangerous as ever but radiologists in 1919 better VOL. 103, NO. 1, JANUARY 2011

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understood how to protect themselves. Moreover, he declared the value of the radiograph as an “unbiased witness” in jury trials.6 Discussants included Dr Wheatland. Dr Henry was chief of the x-ray department at Philadelphia’s Frederick Douglass Hospital; he also served as treasurer of the General Executive Committee of the NMA 1926 Philadelphia meeting. At the same 1919 meeting, Chicago General Practitioner and Pediatrician Herbert Turner, MD, lectured on “X-ray as an Aid to Diagnosis,” illustrated with plates,7 with discussion opened by Dr Wheatland. At the 1921 Louisville meeting, Chicago Radiologist Floyd W. Willis, MD, lectured on a radiotherapy topic: “Carcinoma of the Breast—Preoperative and Postoperative X-ray Treatment of.” Discussants included Howard Radiologist B. Price Hurst, MD (Harvard 1916), who was the first full-time African American head of radiology at a major teaching hospital (Freedmen’s).8 Dr Willis (Figure 2) was also a landscape and portrait artist who chaired from 1949 (and probably founded) the Section on Medical Art of the NMA. When he died in 1951, he was on the way to the Philadelphia NMA annual meeting with an exhibit of his paintings.9 His widow later married Chicago’s Leonidas H. Berry, MD, who long possessed one of Dr Willis’ paintings. Also in attendance at the 1921 meeting was pioneer New Orleans Radiologist Foster T. Jones, MD. Also in 1921 in the JNMA appeared an illustrated article on “The Roentgen Diagnosis (Illustrated) [in] the Early Diagnosis of Pulmonary Tuberculosis” by C. B. Powell, MD.10 Dr Powell compared radiographic manifestations to changes in physical examination and spoke of the advantages and disadvantages of each method in early diagnosis. The radiographs that he illustrated (Figures 3 and 4) were far less sharp and clear than in modern publications, but he attempted through the captions to explain

what was seen. He stated the importance of the x-ray examination in almost all cases of pulmonary tuberculosis.10 Dr Powell, for whom the former Freedmen’s Hospital building at Howard was later named, was intern and then– staff member in radiology at Bellevue Hospital in New York City before opening his own x-ray practice in Harlem and later embarking on a major nonmedical public career, including being editor and publisher of the New York New Amsterdam News. At the 1922 Washington, DC Meeting of the NMA, Dr Hurst lectured on x-ray and laboratory diagnosis of gastric carcinoma, including x-ray plates.11 That same year, he gave the first-known radiology lecture at the John A. Andrew Clinical Society in Tuskegee. Jesse Jerome Peters, MD, was assistant roentgenologist at City Hospital No. 2 in Saint Louis, Missouri, when he published the original paper, “Pneumoperitoneum as an Aid in Diagnosis,” in the 1923 JNMA.12 In that unillustrated paper, Dr Peters describes the then-new radiographic technique of induced pneumoperitoneum for abdominal diagnoses not obtainable by other means (clearly, these were the days before ultrasound and CT). He speaks of overenthusiasm for the method but felt it was useful for diagnosis of liver and gallbladder, kidneys, postoperative adhesions, and retroperitoneal tumors. In 1923, he considered pneumoperitoneum radiographs the best method of examining the gallbladder,12 and, at that time, it likely was. Dr Peters was radiologist at the Veterans Administration Hospital at Tuskegee from 1926 to 1958 and was the second African Figure 2. Floyd W. Willis, MD, of Chicago poses peeping through the fluoroscope in his x-ray office.

Figure 1. Reproduction3 of the normal hand of Dr Booker T. Washington from the article in the JNMA of Dr Bell

Reproduced from Simms JN, Simm’s Blue Book. Chicago, IL: Simms; 1923:105-106.

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American radiologist to pass his specialty boards (American Board of Radiology, 1937; William E. Allen Jr, MD became certified in roentgenology in 1935). Also in 1923, pioneer Philadelphia Radiologist James Lemuel Martin, MD, lectured at the NMA national meeting on dyspituitarism;13 he led radiology at Freedmen’s and Howard during 1936-1944 after having been on the faculty of the University of Pennsylvania Graduate School of Medicine and chief of x-ray at Philadelphia’s Mercy Hospital. Both Dr Peters (“Pulmonary Tuberculosis from the Radiographic Viewpoint”) and Dr Powell (“Some Phase of X-ray Findings in the Chest”—discussion opened by Dr Hurst) spoke at the 1924 Hampton NMA meeting.14 In Chicago at the 1925 Annual Meeting, Dr Peters (“The Use of the X-ray in Tuberculosis Glands”) and Dr Martin (“Hyperthyroidism”)15 spoke, and Dr Willis was a discussion leader.16 The same year, Dr Powell spoke on “Roentgen Ray Diagnosis of the Diseases of the Thoracic Viscera” to the John A. Andrew Society in Tuskegee and was elected an officer of that society.17 In 1926, the NMA met in Philadelphia. Dr Martin was in charge of the NMA’s first formal x-ray clinics and discussed “X-ray Findings—the Pituitary Gland;” Dr Willis lectured on “Some High Spots in Physiotherapy”18 (discussion opened by Clyde Donnell, MD, who had studied radiology at Massachusetts General Hospital of Harvard University 1922, 1924, and 1926); and H. M. Collier, MD, of Savannah, Georgia, lectured on “The Part Played by X-ray in Diagnosis” (discussion opening by Dr Henry).19 By the mid-1920s, radiology had become,

thus, an important regular part of the NMA annual meeting and the JNMA. The first formal annual refresher course on x-rays and radium was held at the 1939 New York City annual meeting, organized by William E. Allen Jr, MD as chairman of the new (since 1936) NMA Commission on X-rays and Radium.20 The revered and energetic Dr Allen21 served the NMA for nearly 50 years, including a vice presidency of the NMA and a 1967 NMA Distinguished Service medal; he was gold medalist of the American College of Radiology and trained Rose J. Pegues-Perkins to be the first African American registered x-ray technologist. Speakers at that 1939 refresher course were Drs Robert W. Henry, Russell Minton (of Philadelphia [lived 1900-1997]), Benjamin W. Anthony (of Chicago), Foster T. Jones, Lawrence D. Scott (of Meharry, then Chicago), and William E. Allen, Jr.21 The Section on Radiology of the NMA was founded as an official constituent of the association in 1949 and presented its first refresher course at the 1949 Detroit, Michigan, NMA annual meeting.22 Dr.Allen was (naturally) the first chairman of the section. Attending the Detroit refresher course were Drs Rembert Jones (Elberton, Georgia), Darnell P. Mitchell (Cleveland, Ohio), Willis (Chicago), Harold Thornell (Detroit), Robert Greenidge (Detroit), John Jackson (Portsmouth, Virginia), Allen, and A. W. Mitchell (Detroit). Listed as supporting the section as well were Drs Peters, Scott, Lincoln W. Shumate (Los Angeles, California), Henry Figure 4. Reproduction10 of radiograph of pneumothorax

Figure 3. Reproduction10 of radiograph of military tuberculosis, in black-bone format and as if viewed from behind.

The military nodules are difficult for the reader to see. They are described as numerous nodular areas of absent illumination corresponding to tubercles.

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The descriptive caption mentions collapse of the right lung with brilliant illumination in the right pleural cavity due to air, with adhesion of upper lobe preventing complete collapse, together with cavities in that upper lobe.

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Figure 5. William E. Allen Jr, MD FACR, at the microphone at the first Allen Lecture of the Section on Radiology of the NMA in 1978. With him is Lecturer Leslie L. Alexander, MD, FACR

Adapted from Oestreich AE. A Centennial History of African Americans in Radiology 1996, Section on Radiology, NMA.

M. Collier (Savannah), and Dr William P. Quinn (Chicago—in 1962 Dr Quinn would be general chairman of NMA’S Chicago annual convention).23 Contributions of radiologists to the NMA have been numerous through the years. Dr Allen was vice president in 1963; Leslie L. Alexander, MD (Brooklyn, New York), has been treasurer; Henry W. Wiggins Jr, MD (Chicago), has been speaker of the House of Delegates; and Tracy M. Walton, MD (Washington, DC), was the centennial year president. A special honor paid to Dr Allen by the Radiology Section is the William E. Allen Jr, Annual Lecture at the NMA annual meeting, established in 1978 (while Dr Allen was still alive). First lecturer at the 1978 Washington, DC, meeting, was Leslie L. Alexander, MD, FACR, on “The Treasures of Tuberculosis: Pearls from the Past”24 (Figure 5).

References

1. Oestreich AE. Marcus Fitzherbert Wheatland, MD J Natl Med Assoc. 1995;87:829-835. 2. anon. News items. J Natl Med Assoc. 1909-1910;1-2 and 1921:12. 3. Bell CD. The value of X-rays. J Natl Med Assoc. 1911;3:229-232. (reprinted in J Natl Med Assoc 1995;87:505-507). 4. Roberts CG. The relationship of roentgenology to gastro-intestinal diagnosis. J Natl Med Assoc. 1917;9:57-61. 5. anon. News item. J Natl Med Assoc. 1916;8:221-222. 6. Henry RW. The x-ray, a portent factor in determining important decisions

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(the subject illustrated by lantern slides) and anon, news item. J Natl Med Assoc. 1920;12:11-12 and 38-40. 7. anon. News items. J Natl Med Assoc. 1920;12:30-31 and 40-41. 8. anon. News items. J Natl Med Assoc. 1921;13:241-242 and 260. 9. anon. News item. J Natl Med Assoc. 1952;44:73. 10. Powell CB. The roentgen diagnosis (illustrated) [in] the early diagnosis of pulmonary tuberculosis. J Natl Med Assoc. 1921;13:84-87 and anon, news item. 1922;14:129. 11. anon. News item. J Natl Med Assoc. 1922;14:267. 12. Peters JJ. Pneumoperitoneum as an Aid in Diagnosis. J Natl Med Assoc. 1923;15:33-35. 13. anon. News item. J Natl Med Assoc. 1923;15:199. 14. anon. News item. J Natl Med Assoc. 1924;16:208-209. 15. anon. News item. J Natl Med Assoc. 1926;18:6-10. 16. anon. News item. J Natl Med Assoc. 1925;17:142-143. 17. anon. News items. J Natl Med Assoc. 1926;18:73-75 and 179. 18. anon. News item. J Natl Med Assoc. 1926;18:204-206. 19. anon. News items. J Natl Med Assoc. 1926;18:30 and 144-146. 20. Alexander LL. Section on radiology celebrates its thirtieth year. J Natl Med Assoc. 1980;72:277-279. 21. Oestreich AE. William E. Allen Jr, MD, FACR. J Natl Med Assoc. 1999;91:414-418. 22. Holton JB. Fifth Annual William E, Allen, Jr, Lecture, San Francisco NMA Annual Meeting, 1982. Appears in History of the radiological section— NMA: revisited, In: Oestreich AE. A Centennial History of African Americans in Radiology 1996, Section on Radiology, NMA, pp 29-53. 23. Allen WE Jr. History of black radiologists (1970). In: Oestreich AE. A Centennial History of African Americans in Radiology 1996, Section on Radiology, NMA, pp 1-19. 24. anon. News item. J Natl Med Assoc. 1962;54:514. n

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