There will be a year of festivities as the Department of Pediatrics celebrates its centennial April 1 to honor the milestones. Currently ranked eighth in the nation by U.S. News & World Report, the Department of Pediatrics has become a world leader in pediatric patient care, teaching and research with its many groundbreaking discoveries and for its excellence in all divisions.
Here are a few highlights from the department’s colorful past.
• 1910: The department launched, 19 years after the School of Medicine was founded. That same year, St. Louis Children’s Hospital, founded in 1879 and the sixth oldest children’s hospital in the country, affiliated with Washington University, moved next to Barnes Hospital and built a modern children’s hospital facility. Leaders decided the new chair of pediatrics would also serve as chief physician at St. Louis Children’s Hospital.
• 1918: The first three female pediatric interns were appointed. One of them, Martha May Eliot, was the granddaughter of Washington University founder William Greenleaf Eliot and went on to teach in the pediatrics department at Yale University and to help found the United Nations International Children’s Emergency Fund (UNICEF) and the World Health Organization (WHO).
• 1920: Washington University scientists Philip A. Schaffer, PhD, professor of biochemistry; Alexis Hartmann, MD, a medical student who later became chief of pediatrics; Edward Doisy, PhD, who later won a Nobel Prize; and Michael Somogyi, PhD, professor of biochemistry, developed a technique to measure sugar in patients’ blood. This was an important step toward the discovery of insulin by scientists in Toronto.
• 1922: The department was the first to use digitalis, a medication made from the foxglove plant, to treat children with heart disease. At that time, children’s heart disease was often the result of rheumatic fever, diptheria and infectious conditions. Hugh McCulloch, MD, the first pediatric cardiologist at St. Louis Children’s Hospital, used digitalis to successfully treat children. He also was one of the six cofounders of the American Heart Association.
Later that year, the department was the first in the United States to administer insulin to a child with diabetes. W. McKim Marriott, MD, then chief of pediatrics, attended a meeting at which a scientist discussed using insulin in children with diabetes. Shortly after, a child came to St. Louis Children’s Hospital in a diabetic coma and was likely to die. Dr. Schaffer extracted insulin from a cow pancreas to treat the child, who survived. It was the first time in the United States insulin was used to treat diabetes.
Also in the 1920s, Daniel Darrow, MD, shed light on the biology of potassium in health and disease.
• 1930s: Marriott pioneered studies of infant nutrition and metabolism. His textbook titled Infant Nutrition was very successful and became the standard textbook on infant nutrition in many medical schools.
• 1940s: Alexis Hartmann, MD, studied metabolic control and salt-water balance. He later developed Hartmann’s solution (now termed Lactated Ringer’s), used intravenously to replace body fluid and mineral salts.
• 1950s: Two labs formed in the department: the clinical chemistry lab and the bacteriology and virology labs. More than 30 years later, they would combine to become the Division of Laboratory Medicine.
Also, Gilbert Forbes, MD, used radioactive tracers, and later stable isotopes, to study metabolism in children in vivo.
• 1960s: Alexis Hartmann Jr., MD, son of the former chair of pediatrics, was the first to recognize the double-chambered right ventricle in the heart, a form of septated right ventricle caused by the presence of abnormally located or hypertrophied muscular bands.
Also in the 1960s, during the department chairmanship of Phillip Dodge, MD, the Division of Infectious Diseases was founded. During that era, many children were hospitalized with Haemophilus influenzae type b (Hib) meningitis. Dodge assembled a team of investigators who would carry out pioneering studies on treating some of these diseases and publish seminal works on bacterial meningitis.
The department established and opened a formally designated pediatric intensive care unit and under the guidance of James Keating, MD, and Larry Cobb, MD.
Physicians performed the first pediatric kidney transplant at St. Louis Children’s Hospital in 1965.
•1970s: Pediatric faculty developed an aggressive strategy for Reye’s syndrome, a major cause of death at pediatric centers. Their approach led to a five-fold reduction in mortality for the disease and was widely adopted nationwide.
William Sly, MD, discovered that beta-glucuronidase deficiency is the biochemical basis for a syndrome designated MPS Type VII, or Sly syndrome.
Dennis Bier, MD, explained glucose homeostasis in the newborn using novel stable isotope techniques.
Larry Shapiro, MD, elucidated placental sulfatase deficiency.
In addition, Brad Thach, MD, developed an animal model of obstructive sleep apnea that laid the groundwork for understanding risk factors for Sudden Infant Death Syndrome (SIDS), and later, the Back to Sleep campaign to prevent infant suffocation.
• 1980s: The launch of the Division of Allergy, Immunology and Pulmonary Medicine under Robert Strunk, MD. Strunk and his colleagues developed the largest prospective trial studying the long-term effects of inhaled corticosteroids on lung growth in children with asthma. Findings from this trial, as well as several other nationwide asthma studies, have advanced the care and treatment of children with asthma.
Teresa Vietti, MD, formed the Pediatric Oncology Group in 1980 with Washington University as the headquarters for 12 years. Among the major advancements were success in using chemotherapy to treat osteosarcoma; classifying acute lymphoblastic leukemia by cytogenic features and tailoring therapy to different risk groups; showing that chemotherapy could delay radiation therapy in very young children with brain tumors, reducing long-term side effects; and establishing the feasibility of performing Phase I clinical trials in children. Those efforts contributed to the increasing cure rate of childhood cancer.
Garrett Brodeur, MD, revealed the biology of N-MYC in neuroblastoma.
In 1984, a team of Washington University investigators, including Ralph Feigin, Penny Shackelford and others, published a landmark paper in the New England Journal of Medicine describing sensorineural hearing loss as a result of Hib and pneumococcal meningitis. Their work still guides modern management of these infections, which are still seen in developing countries.
• 1990s: The department exploded in growth, adding the divisions of adolescent medicine, pediatric rheumatology and immunology, emergency medicine, the Pediatric Diagnostic Center under Keating, and adding hospitalists at community hospitals.
The first freestanding pediatric lung transplant program in the United States was established at St. Louis Children’s Hospital. Cardiothoracic surgeons performed the first pediatric lung transplant at St. Louis Children’s Hospital on an 18-month-old girl. The hospital now has the largest and the most active pediatric lung transplant program in the world, providing new lungs for more than 330 children since 1990.
Lawrence Nogee, MD, and Harvey Colten, MD, discovered surfactant protein-B deficiency as the cause of lethal respiratory distress in a full-term newborn in the Neonatal Intensive Care Unit. In 1994, lung transplants for newborns with this deficiency were first performed and provided a foundation to find genetic mutations that cause respiratory dysfunction in newborns.
• 2000s: Physicians continue to make new discoveries through the Children’s Discovery Institute, a partnership between Washington University School of Medicine and St. Louis Children’s Hospital launched in 2006 to treat, cure and ultimately prevent childhood diseases and illnesses. The Children’s Discovery Institute is the engine that drives the focus on pediatric research, promotes collaboration between clinicians and investigators and leverages new intellectual resources into the effort through funding specific programs and projects.
Mark Manary, MD, proved the use of peanut-based ready-to-use therapeutic food for severe malnutrition. That product has now become the standard of the World Health Organization.
Robert Heuckeroth, MD, PhD, showed that the mother’s vitamin A status and the genetic complement of the fetus define the development of the enteric nervous system of the newborn.
The Division of Hospitalist Medicine was officially launched with nearly 40 faculty.
See posters of the Department of Pediatrics’ first 100 years
Adolescent Center [ PDF – 998 KB ]
Allergy-Immunology [ PDF – 908 KB ]
Cardiology [ PDF – 560 KB ]
Cardiology [ PDF – 956 KB ]
Critical Care Medicine [ PDF – 1 MB ]
Diagnostic Center [ PDF – 1 MB ]
Emergency Medicine [ PDF – 1.1 MB ]
Endorinology [ PDF – 956 KB ]
Gastroenterology & Nutrition [ PDF – 1 MB ]
Genetics & Genomic Medicine [ PDF – 984 KB ]
Hematology/Oncology [ PDF – 904 KB ]
Hospitalist Medicine [ PDF – 952 KB ]
Infectious Diseases [ PDF – 620 KB ]
Laboratory Medicine [ PDF – 984 KB ]
Nephrology [ PDF – 952 KB ]
Newborn Medicine [ PDF – 2.9 MB ]
Pulmonology [ PDF – 920 KB ]
Residency Training [ PDF – 1 MB ]
Rheumatology [ PDF – 1 MB ]