History of Pathology & Cell Biology at Columbia

A History of Anatomy at Columbia from Genesis to Merger

By Michael Gershon, MD, Professor of Pathology and Cell Biology

Photo of Dr. Michael GershonThe histories of biology and medicine begin with anatomy.  Early humans observed the living machinery with some care because it was necessary for them to do so.  Cuisine and faith each required it.  Whether animals were butchered for food or sacrifices were made for gods, it was important that practitioners knew, at least in relative terms, what they were doing.  The earliest anatomists were diviners who forecast the fates of kings and nations from the shapes of the liver of a ram.  That necessitated a working knowledge of the hepatic location, relations, and gross morphology.  Mummification in Egypt involved considerable dissection of organs and, as early as 1920 BCE, regulations of what might, with some charity, be called the medical profession appeared in the Code of Hammurabi.  All of this activity, however, was driven by a belief in gods, capricious demons, and the supernatural.

Nobody who was anybody seems to have thought that natural events might be significant until Thales of Miletus (624 BCE-546 BCE), the man to whom Bertrand Russell attributes the origin of western philosophy, began to do just that in Ionia (the western coast of what is now Turkey).  Thales introduced “rationalism”, which proposed the then novel idea of causality, a concept that had not previously colored the reasoning of ancient minds.  Under rationalism, events were attributed to a natural cause, whether or not that cause was known or understood; moreover, a particular cause was thought to reproducibly produce the event to which it was linked without change by the intervention of a capricious will.  To rationalists, there was a law that governs the universe, but it was a natural law that human minds could ultimately, if not immediately, understand.

Rationalism, after Thales, was quite popular in the ancient world and peaked in then contemporary medicine with the works of Hippocrates about 400 BCE.  Because the fame of Hippocrates was so transcendent, many authors, no doubt out of deference to the master signed his name to their work; therefore, whether or not Hippocrates was actually responsible for his oath is not clear.  Another man with the same name might have written it.  The success of rationalism, however, was transient.  Both rationalism as an ideal and observation of anatomical detail were eventually suppressed.  Greeks, and later Romans, became more concerned with warfare, conquest, and its moral philosophical rationalizations than with natural philosophy. Anatomical observation was condemned in Judeo-Christian tradition because dissection desecrated the human body, which was, the bible maintains, created in the likeness of G_d.  Egyptians agreed, although they thought it was necessary to avoid dissection in order to keep the body fit and trim for life after death.

Rationalism staged a comeback in the seventeenth century, beginning in Flanders, the fields of which became notorious for other reasons in 1914-1918.  Andreas Vesalius was born in Brussels in 1514 into a family with a medical tradition.  Vesalius acquired an interest in anatomy during the beginning of his medical education in Paris, where he was often observed contemplating bones at the Cemetery of the Innocents.  At that time, barber-surgeons conducted dissections, the practice of which had been revived, but lecturers directed the dissections and students watched.  The goal of the exercise was not to observe and describe what one saw, but to find what Galen, the ancient Roman, had written should be seen. A problem, unsuspected prior to Vesalius, was that faith in Galen, which was absolute, had been misplaced.  Human dissection was forbidden in ancient Rome, so Galen worked and described Barbary apes, which he thought were close enough (perhaps a precocious inkling of the coming of Darwin).  Apes, however, are not humans, a difference that Vesalius noticed and thought was significant.  When Vesalius did his own dissections, therefore, his observations naturally differed from those of Galen.  Vesalius’ former teachers became formidable enemies, which was fine in the sense that in order to refute Vesalius, they too had to dissect and observe.  It is one thing to read a book (by Galen or anyone else) and ask people to see what does not exist on the grounds that the book claims that it exists; it is yet another to search and find it.  The story of Vesalius can be understood as a precocious example of a critical anatomical maxim, as valuable to modern cell biologists as to early anatomists; it is the principle of Yogi Berra, “Never can tell what you might see just by looking”.  Vesalius’ enemies may have been after his scalp, but they went a long way toward validating his work.  Unfortunately for Vesalius, however, science in his day was hard.  Peers did not conduct peer reviews, but religious and secular authorities conducted reviews. Vesalius was driven to make a pilgrimage to the Holy Land, which led, in 1564, to a shipwreck and his death as a pauper on the island of Zakynthos in the Ionian Sea.  The death of Vesalius did not end rational anatomical science because a flowering of microscopy followed it.

Thomas Hooke used the word “cell” in 1665, describing chambers he observed in cork.  Anton von Leewenhoek polished lenses of short focal length to get microscopy going and described bacteria and protozoa.  These developments were eventually to transform medicine and come to underlie the fields of pathology and cell biology; however, they affected virtually nothing in New York on June 10, 1760 when the first law regulating medicine was passed in this city.  On that day, a certain Cadwalder Colden, a physician who was repeatedly elected the Lieutenant Governor of the New York province (colony), pushed through a law that stated that: “No person whatsoever shall practice as a physician or surgeon …before he shall first be examined in physick or surgery and approved of and admitted ..." Those legal regulations implied that some form of training and coursework was going to be necessary.  Examination, approval, and admission provide a fine rationale for a college, the establishment of which soon followed.  The right people were available and Vesalius had set a precedent that traveled across the Atlantic, even to what appeared to European contemporaries as a land that was distant, somewhat strange, and very fierce.  New York had recently been engaged with the British and French in their customary activity, war.  Colonial physicians were therefore gaining practice in the surgical treatment of wounds; moreover, the absence of sterile technique, sewers, or an adequate supply of clean water in cities provided an endless supply of sick patients.  Doctors had to be trained and that meant that anatomy, which was the one form of medical knowledge at the time that was linked to reality, was in demand.

neuronal elementsPeter Middleton, M.D., who had been trained at St. Andrews University of Dundee, Scotland teamed with a local doctor, Samuel Bard (of Hall fame) to give anatomical demonstrations and lectures to interested New Yorkers.  They used the bodies of convicted and executed murderers that they had injected with dye to enable blood vessels to be visualized.  These lectures, which evidently were very popular, were supplemented by clinical training given at the “House of Correction”.  It is best to keep the morality of that age and not the current age in mind while considering these historical events.  One cringes to imagine what constituted clinical training after the French and Indian War and why the House of Correction was deemed a suitable place for it to occur.  In any case, while these activities were in full sway, an impressed James Jay, the older brother of John Jay (who was to graduate with a degree in law from New York’s King’s College and become first Chief Justice of the United States Supreme Court) took it upon himself to medically improve the colony.  Jay, who was a physician who had been trained in Edinburgh, went abroad in 1762 to raise funds and lift the profile of King’s College.  George III took to Jay and made him a knight in 1763, which gave Jay standing to petition the governors of King’s college.  Jay urged the governors to make King’s College a university, which included a college of medicine “…which will add such reputation as will give it preeminence in every respect above every institution in America”.   This was an appealing suggestion, preeminence being then the same desirable trait that it is today.  Jay thought that 5 professors would be needed.  Because 5 professors, however, seemed overly expensive, Jay thought that King’s College could start with 3.  The fields of the new medical school would be anatomy and midwifery, the theory and practice of physick, and chemistry and materia medica.  On June 23, 1763 the governors of King’s College approved Jay’s plan in principle, but stated that the project could not be launched until the funds became available.  In an age that predated the NIH, Medicare, and Medicaid, raising funds for teaching and medicine presented a challenge, but it was one that enthusiasm for anatomy helped to solve.

Samuel Clossy, M.D. emigrated to New York City from Dublin in 1763.  Clossy had trained in medicine at Trinity College in Dublin and published meticulous works of dissection in which he correlated anatomical findings with disease.  The politics of the hospital at Trinity College, however, drove him out of Dublin.  He began teaching in New York at King’s College soon after his arrival and he very quickly began to give anatomical lectures.  He wrote back on August 1, 1764 to a former colleague, George Cleghorn, the anatomist who had taught Clossy back at Trinity College, that “…You would be amazed with what delight ...." his lectures were received (this delight has passed on through multiple successors to Paulette Bernd today).

Clossy was appointed a Professor of Natural Philosophy at King’s College in 1765 and established a course in anatomy under the official countenance of the President and Board of Governors.  This was the very first course in Anatomy given as part of the curriculum of any college in America.  Two years after Clossy began to “delight” New Yorkers with his anatomical lectures, King’s College was petitioned on August 4, 1767 to launch a real medical school in the winter term.  On August 14, 1767 King’s College decided to comply and one-upped the penurious James Jay by exuberantly appointing 6 Professors, which kept King’s College, at least in respect to faculty numbers, competitive with Edinburgh.  Among the stalwart 6 was Professor Samuel Clossy, who held down the chair of Anatomy, joining Peter Middleton in Physiology and Pathology, Samuel Bard in Physick, John Jones in “Chirugery”, John Tennant in Midwifery, and James Smith, in “Chymistry”, Materia Medica.  Peter Middleton gave the opening lecture on Monday, November 2, 1767, with considerably more fanfare than is currently our practice.  Students, of course, must have attended, but the New York “Mercury”, which may not have noticed them, reported that the Board of Governors, all of the professors, the president of the college, members of the Supreme Court in full robes and regalia, as well as his “Excellency, the Governor, Sir Henry Moore”, were all present to hear, and presumably learn, about the history of the “…ancient and present state of medicine”.  Clossy followed Middleton in the afternoon and introduced the human body.  King’s was the second medical school to be established in colonial America but it worked quickly; King’s was the first school to graduate a medical class, Robert Tucker and Samuel Kissam, which it did in 1769.  Robert Tucker went on to receive America’s first doctorate in medicine, from King’s College in 1770.  Transformative events were brewing in New York, however, which would soon end, in 1776, the initial burst of medical energy at King’s College.

Samuel BardSamuel Clossy may have come from Dublin, but he was a devoted Tory.  His students were something else.  Classes became tumultuous as ties with England became tenuous.  Controversial wars, like a later one fought by Americans in Vietnam, complicate the calm and concentration needed to study academic subjects, like anatomy.  Clossy’s lectures might once have been greeted with “delight”, but with the coming of the Redcoats, he found lectures impossible to present and he was forced to cancel classes while he raged in his diary about radicals (not the Red Sox) descending on his adopted city from Boston.  In 1776, the old King’s College of medicine suspended activity for the duration as British troops occupied New York.  The school re-opened in 1784, now as Columbia College, and in December of that year, classes in the medical school re-started.  Samuel Bard was named dean in 1791 but no more was heard, at least in the Columbia context, of Samuel Clossy.

I was the last Professor of Anatomy at Columbia and had no idea that I was to assume that status when I  moved to Columbia from Cornell.  Moving across town was easy, but that was the only easy part.  My immediate predecessor had been fired from his role as Chairman but stayed on as a disgruntled professor.  Curricular changes had been imposed on an un-accepting faculty and teaching was not going well in any of the courses assigned to the department.  Hours devoted to the teaching of anatomy, histology and neuroanatomy had drastically been curtailed, but the material presented was not.  Teachers spoke faster.  No one was happy; students blamed the faculty in surveys and the faculty blamed the students, who they thought had lost interest in learning.  Research within the department was moribund and anything other than description was suspect.  The search committee discovered that replacing an angry leader with a new Chair was not easy; a succession of distinguished candidates came, looked, and left.  The department drifted in its discontent but by the time it was my turn to be interviewed, the former Chair had died and the major impediment to rebuilding the department was no longer present.  The Chair had become an attractive one.  I understood that whatever I did would be a success; virtually anything that changed would have to be for the better, worse was not possible.

The tenured faculty met with me upon my arrival at Columbia and assured me  that while they all thought I might be quite stellar, I was the wrong person for this job.  Dean Tapley disagreed with this assessment and let me make changes, the most important of which was to introduce Cell Biology to Anatomy at Columbia and to alter the composition of the faculty.  New people, both junior and senior were recruited, research began in earnest, grants were obtained, the graduate program was revived and the material taught was made to correspond to the time available to teach it.  Faculty and students ceased to be at odds with one another.   Joint appointments facilitated collaborations with cell biologists across departmental boundaries, particularly with the new and very different Department of Pathology rebuilt by Michael Shelanski.  Cell biology was thriving at Columbia and disciplinary boundaries were blurring.

While the first Professor of Anatomy at the school that was to become Columbia University P&S, Samuel Clossy, went out with the bang of the American Revolution, the last Professor, Michael Gershon, went out without a whisper as the Department that started the school merged out of a free-standing existence.  Before the merger, Cell Biology had become integral to Anatomy, which was reflected officially when department’s name was changed from Anatomy to Anatomy and Cell Biology.  Cell Biology had also been incorporated into Pathology albeit not into the name of that department. The merger thus made sense, two departments with cell biology as a common activity became one, Pathology and Cell Biology. In union, moreover, there is strength.  The merger leaves the original vision of Samuel Clossy intact; he searched for the anatomical basis of disease and thus would have been quite comfortable had he been a member of today’s Department of Pathology and Cell Biology.  The Department’s teaching of the tradition of Vesalius can “delight” students today just as Clossy’s lectures in that tradition used to delight students in his time.  Microscopic research within the newly merged Department produces images that Leewenhoek would have appreciated. Columbia may now lack a department of Anatomy but anatomy is still alive and well at Columbia.

 
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