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THE FECUNDITY OF AGGREGATES: THE AXONOLOGISTS AT WASHINGTON UNIVERSITY, 1922-1942 LOUISE H. MARSHALL* A Flexner Report Consequence The recommendations of the well-known Flexner Report of 1910 for improvement of medical education in the United States and Canada were implemented to various degrees by U.S. medical schools. The Washington University School of Medicine in St. Louis reacted promptly and purposefully. This is not surprising, because the Carnegie Foundation , which sponsored the report, gave Washington University $2,000,000 (1910) to reorganize the School of Medicine [I]. The entire faculty resigned to give the new heads of departments a free hand in restructuring the faculty and curriculum. Among the basic medical sciences , physiology was conspicuous in the resulting improvement, and the department became preeminent in the field of electrophysiology. The person responsible was Joseph Erlanger (1874-1965), and the evidence comes in part from the high representation of Washington University among the axonologists. Joseph Erlanger went to St. Louis in 1910 from the University of Wisconsin where he had been founding chairman of physiology. He weighed the offer from St. Louis very carefully, for he was satisfied at Madison, and delayed responding until the last moment, hoping to learn if Harvey Cushing, whom he knew from his medical training at The Expanded from a paper read before the Medical History Club, Washington University School of Medicine, St. Louis, May 14, 1980. The work was supported in part by grant LM 03069 from the National Library of Medicine. The author is indebted to Margaret Clare, Hallowell Davis, Carleton Hunt, and William Landau for helpful discussions and to Estelle Brodman and Paul Anderson for facilitating her work in St. Louis. * Neuroscience History Resource Project, Brain Research Institute, University of California, Los Angeles, California 90024.© 1983 by The University of Chicago. All rights reserved. 0031-5982/83/2604-0359$01.00 Perspectives in Biology and Medicine, 26, 4 ¦ Summer 1983 | 613 Johns Hopkins, was going to accept a similar offer; too late, Erlanger learned that Cushing had elected instead to move to Harvard.1 For several years after he arrived in St. Louis as chairman of the department of physiology, Erlanger's efforts were largely absorbed by reorganization of the medical school along the lines of the Flexner recommendation and the Executive Faculty system at Hopkins.2 He was also kept busy planning new quarters for the departments of physiology and pharmacology. Joseph Erlanger Some influences that shaped Erlanger's career are described in his autobiographic chapter in Annual Review of Physiology [2]. He was the only one of seven siblings who went beyond the eighth grade, in spite of their German-born parents' encouragement to do so·. As a native ofCalifornia , he was an undergraduate at the University of California, Berkeley , and was early drawn into research, which he continued between his first and second medical years at Hopkins. "My results did not warrant publication of a paper, but [Lewellys] Barker, in his massive tome, entitled 'The Nervous System and Its Constituent Neurons,' mentions my name six times in the text and reproduced as figures three of my histological preparations . . ." [2, p. S]. The impression conveyed by the autobiography is of a highly motivated son of German immigrants who was imbued with the importance of unimportant detail. His attention to salary offers and claiming credit for small things reveal a person determined to come out on top. This paid off, for after his internship at Hopkins, he had what must be a rather rare opportunity—he was offered positions in two Hopkins departments , by William H. Welch in pathology and William H. Howell in physiology. He chose the latter because of his greater interest in the subject and worked very hard supervising the laboratory courses for medical and graduate students and preparing the demonstrations for Dr. Howell's lectures. Erlanger's entire research during the Hopkins period concerned the circulation: pulse pressure changes and renal function, stroke volume and pulse pressure, and especially the electrophysiology of that strip of specialized muscle, the auriculoventricular bundle. Within 6 years of committing himself to Howell's department, Erlanger was offered the chairmanship of physiology at the new medical school of the University of Wisconsin...


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