Armed Forces Institute of Pathology: Its First Century 1862-1962/Foreword
Foreword
As the Armed Forces Institute of Pathology approached its centennial year in nineteen hundred and sixty-two, it seemed appropriate to pause for a brief recapitulation of its accomplishments during its first one hundred years. To this end, a fitting ceremony was held in November 1962 to mark this event. The program was further enhanced by a 2-day scientific program that not only summed up what had been accomplished in the past but attempted to glimpse the future of the study of disease.
In addition to holding these programs, it was considered that the completion of the first century of the Institute would also be an appropriate time to compile a more detailed study of the people and events that had made the Institute one of the Nation's leading scientific institutions from its very inception. With the approval of the Board of Governors, the Surgeons General of the Army. Navy, and Air Force, and with the assistance of the staff of the Institute, its Scientific Advisory Board, and the Institute's many devoted consultants, a project to compile a history was initiated. The assistance and support of The Historical Unit. U.S. Army Medical Service, and of The Surgeon General of the Army were requested, and they enthusiastically joined in the effort to assemble this record. The role of The Historical Unit in the compilation of this volume is but a continuation of the long and intimate association of this Unit and the Institute. One of the two original missions of the Army Medical Museum, the forerunner of this Institute, was to prepare the great "Medical and Surgical History of the War of the Rebellion," the other being "to collect and to forward to the Office of the Surgeon General, all specimens of morbid anatomy, surgical or medical, which may be regarded as valuable; together with projectile and foreign bodies removed, and such other matters as may prove of interest in the study of military medicine or surgery." This first effort of The Historical Unit, while it was still an integral part of the Army Medical Museum, moved Rudolf Virchow, the great German pathologist and the father of modern pathology, to comment, "From this time dates a new era in military science. Whoever reads these publications will be constantly astonished at the wealth of experience, the exactness of detail, the careful statistics and scholarly statements embracing all sides of medical experience which preserve to posterity the knowledge bought at so vast an expense."
With the passage of time. The Historical Unit became a separate organization. The Army Medical Museum kept its original name until after World War II when, in 1946, it was deemed appropriate to rename it the Army Institute of Pathology. At this time, the Scientific Advisory Board was organized. Through the years since then, the dedication of the outstanding scientists who have served on the Board has been a landmark of strength to the Institute in the guidance of its professional developments.
In 1949, the U.S. Navy and Air Force joined forces with the Army, so that the Institute became a total effort of the armed services under the executive management of The Surgeon General of the Army and the Secretary of the Army. It was redesignated the Armed Forces Institute of Pathology.
Through the years, many curators and directors and the staff of the Museum-Institute had a continued interest in, and intuition of, the history that they were making. Documents and records were carefully prepared and preserved. From the outset, the Institute played a leading role in national medical developments as well as being an integral part of the Washington medical scene. Its close association, throughout its history, with the medical schools of George Washington University. Howard University, and Georgetown University attest to its leadership in medical affairs of the area. From its beginning, the value of the Institute as a means of instruction of young military physicians was apparent. A photographic department was added to the Museum in 1863, and the pioneer work in America in medical photography and photomicrography was accomplished by the Museum staff.
From its early days, the Museum-Institute had been housed with the Army Surgeon General's Library, and the two remained under the same roof until 1955, when the latter, after a brief period as the Armed Forces Medical Library, became the National Library of Medicine. At the same time, the Institute acquired new quarters at the Walter Reed Army Medical Center. The location of the Institute at this great medical facility seemed appropriate, since Walter Reed had been for almost a decade, until his death in 1902. Curator of the Medical Museum. It was during his tenure that the Army Medical School was formed in the Museum building. In 1910, the School secured quarters of its own and eventually grew to become the great institution known today as the Walter Reed Army Institute of Research. Out of World War I came the impetus for the training of pathologists and the growth of pathology in the United States to the status of world eminence this country has in this field in the present day. World War II saw the Museum as the leader in bringing about the standardization of diagnoses and teaching methods in pathology that has enhanced the science of the study of disease in the past two decades.
The Institute's close relationship with civilian medicine also has origins in the very beginning of the Museum. The first formal arrangement between the Museum and civilian medicine took place in 1895, when the American Dental Association adopted the Museum as a repository for study materials in the field of dentistry. The next great step was the founding of the American Registry of Ophthalmology in 1921. The establishment of the American Registry of Pathology under the auspices of the National Academy of SciencesNational Research Council and the Museum in 1933 gave signal impetus to the registry movement, and by the end of the centennial year in 1962 the number of Registries had grown to 27.
Following World War I, the Museum also became the repository for the material from the Veterans' Administration hospitals. This was discontinued in 1929, but after World War II the Veterans' Administration designated the Armed Forces Institute of Pathology as its "Central Laboratory for Anatomic Pathology and Research." Since that time, the Veterans' Administration has played a key role in the affairs of the Institute. Its employees make up a portion of the professional, technical, and clerical staff. This liaison between the Armed Forces and the Veterans' Administration permits former patients to be followed after they leave the service and greatly enhances the repository of case material available to the Institute. Through the aegis of the American Registry of Pathology, civilian pathologists also contribute cases to the Institute files that are valuable in filling gaps in the overall knowledge of disease; this information cannot be acquired from the military population alone. Beginning with the work of Walter Reed and the Museum staff in the 1890's on yellow fever, the Institute has had a continued interest in tropical diseases and other disease entities that occur throughout the world. This collection of material was invaluable in the beginning of World War II in the preparation of manuals and textbooks used in the training of physicians who were to accompany our troops to the remote corners of the earth during that conflict. The Institute has continued this interest in global medicine, with members of its staff collecting material from all corners of the world. Contributions of cases by pathologists of other countries have added significantly to the collection of disease entities, which now exceeds one million cases. From this vast storehouse of cases, much teaching material is prepared and made available for loan to governmental and nongovernmental pathologists.
Starting soon after World War II, the Institute embarked on the publication of the fascicles of the "Atlas of Tumor Pathology," in conjunction with the Division of Medical Sciences of the National Research Council and, specifically, the Committee on Pathology and its Subcommittee on Oncology. To date, some 33 of the 39 fascicles of the Atlas have been completed and are available at nominal cost through the American Registry of Pathology. These fascicles have been enthusiastically received by pathologists throughout the world. It is through the fascicles that the Armed Forces Institute of Pathology is known by practically every pathologist and other medical workers in all countries. While the authors of these fascicles are outstanding authorities throughout the United States and the United Kingdom, it has only been through the efforts of the staff of the Institute, the American Registry of Pathology, the Institute's Medical Illustration Service, and the National Research Council that the publication and dissemination of the fascicles has been made possible.
With the designation of the Institute as an Armed Forces activity, the U.S. Public Health Service also began to play an active role in the Institute and has had pathologists assigned to the staff since that time. This Public Health Service participation was endorsed during the centennial year with the establishment of the Radiation Pathology Registry; additional financial and personnel support was given to this important endeavor so vital within the framework of the Institute's organization.
The greatest problem that confronted the Institute and The Historical Unit in beginning the compilation of this history of the Museum-Institute was securing an author who could sift through the mountain of records and other historical material that would tell the story of the organization. It was desired that the story be told in such a manner that it would have appeal to the lay reader but still preserve the scientific content. In Robert Selph Henry. Litt.D., of Alexandria. Virginia, such a man was found. Dr. Henry is one of the leading American historians and famed for his writings of the Mexican War and the American Civil War. He is a man of varied interests who has served many years as Vice President of the Association of American Railroads and has prepared numerous treatises on railroading. In addition to being a member of the Board of Regents of Vanderbilt University, his alma mater. Dr. Henry was also one of the consultants in the preparation of the third edition of "Webster's New International Dictionary." Within a brief period of 2 years. Dr. Henry sorted through the voluminous document file of the Institute and many other varied sources, and this book is a testimony to his ability to recognize the high points of the story of the Institute during its one hundred years of existence. Of necessity, attention had to be given to routine coming and going of personnel and other administrative changes that are a part of the story of any organization. He has maintained reader interest with accounts of in- dividual accomplishment, and with many vignettes that lend fascination to the narration and make events of the past come alive.
This brief look back over the century seems a fitting milepost and spring- board for this unique organization as it enters its second hundred years. With its ever-expanding program of research, education, and consultation, the Institute gives promise of being of even greater service to the Armed Forces and to the Nation in the years to come. As the century from the 1860's to the 1960's can be classified as the era of cellular pathology, so can the next few decades be expected to see the development of studies within the cell, or so-called molecular pathology. With its rich heritage from the past, the Institute today finds itself in the forefront of these newer developments. A glimpse into the future is revealed in the last chapter of Dr. Henry's history. One can be sure that the record of the past will serve as an inspiration to those individuals responsible in the future for the destiny of the Armed Forces Institute of Pathology and its important role in advancing military medicine.
Leonard D. Heaton,
Lieutenant General,
The Surgeon General.