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5 Division of Gastroenterology PROGRESS THROUGH MULTIDISCIPLINARY collaboration has been a watchword of Mount Sinai throughout its existence. Nowhere is this in greater evidence than in the Division of Gastroenterology. J. Hugh Baron and Henry D. Janowitz have recently edited a very complete history of the Divisions of Gastroenterology and Liver Disease.1 In three theme issues of The Mount Sinai Journal of Medicine, they and their co-authors reviewed in great detail the development and productivity of these groups. In almost every article, the authors stress the cooperation among the gastroenterologists, hepatologists, and the physicians of the Departments of Surgery, Radiology, Pathology, Urology, and other divisions of the Department of Medicine. Medical specialization did not exist in the early years of the Hospital . Many practitioners performed their own surgery, and almost all surgeons had general practices, as well. Before the advent of aseptic surgery, abdominal surgery was nonexistent. As the first attending and resident physician in the 1850s, Mark Blumenthal cared for all medical and surgical patients. He certainly had his share of patients with abdominal and gastrointestinal disorders. Case No. 27, admitted on August 24, 1855, suffered from “quotidian fever” and jaundice. In one of the shortest lengths of stay recorded in the early casebooks, the patient was discharged as “cured” on the tenth hospital day.2 Several patients with a similar illness were admitted during the first year of hospital operations . Patients who in retrospect almost certainly had appendicitis and/or gallstone disease were likewise admitted. On July 16, 1857, Patient No. 333 was admitted with symptoms classic of a peptic ulcer with posterior penetration and was treated empirically with bismuth and bicarbonate of soda by mouth and a plaster to the back. The patient improved and stated that she “had doctored for many, many years before entering the hospital, and nowhere did they ever do her any good except here.”3 This must surely have been one of the first testimonials given to the Hospital. 65 Edmund Aronson, in the early twentieth century, was the first physician at Mount Sinai to limit his practice to diseases of the gastrointestinal tract.4 Morris Manges was, however, far better known for his expertise in gastroenterology. A founding member of the American Gastroenterological Society, Manges wrote extensively on many medical subjects but did not limit himself to diseases of the gastrointestinal tract. His translation of Ewald’s two-volume Diseases of the Stomach from German to English introduced a major European text to America.5 In 1913, an outpatient Division of Gastroenterology was established , with Aronson as the Chief. In the Clinic, physiologic analyses on gastric and pancreatic secretions in health and disease were carried out, and therapeutic responses to available drugs were studied. One year later, in a reorganization of the Surgical Service, an intestinal service was created, with Albert A. Berg as the Chief. At Berg’s urging, gastroenterologists , surgeons, physiologists, radiologists, and other specialists came together in the Clinic and on the wards to begin a collaboration that still continues and has led to many of Mount Sinai’s major contributions over the intervening years.6 When Aronson died in 1922, he was succeeded by Burrill B. Crohn. When the words “gastroenterologists” and “Mount Sinai” are articulated , the name Burrill B. Crohn immediately comes to mind. A graduate of Columbia University’s College of Physicians and Surgeons, Crohn began his internship in 1907 and was affiliated with Mount Sinai until his death in 1983 at the age of ninety-nine years. He published his first paper on Glanders7 in 1908 but then entered the emerging field of gastroenterology. Following the completion of his training, he opened an office for practice and soon developed a substantial following of patients with gastrointestinal disorders. In 1925, Crohn and Herman Rosenberg, in a publication entitled “The Sigmoidoscopic Picture of Ulcerative Colitis,”8 documented the first case of a carcinoma developing in a patient with ulcerative colitis. In this paper, they also described a case in which the colon and rectum were thickened and rigid and contained multiple discrete ulcers. Although unrecognized at the time, this was almost certainly a case of granulomatous colitis. In 1927, Crohn published the single-authored text Affections of the Stomach.9 When Crohn, Leon Ginzburg, and Gordon D. Oppenheimer published “Regional Ileitis” in the Journal of the American Medical Association (JAMA) in October 1932 and proposed “to describe, in pathologic and clinical details, a disease of the terminal ileum, affecting mainly 66 THIS...

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