A History of Urology at Northwestern

Northwestern's Medical School began before the Civil War when a group of young faculty at Rush Medical College sought to reform the curriculum. Inspired by Nathan Smith Davis, in 1859 they started a new school and became pioneers in medical education. Their innovations included admission requirements, an expanded and sequential curriculum, and grading of students by the faculty. They also introduced bedside clinical instruction. Gradually, similar changes began elsewhere. They were adopted at Harvard 12 years later and were not in place nationally until the end of the 19th century. By then the young school had merged with Northwestern University, discarding the interim name of Chicago Medical College. 

The beginnings of urology at Northwestern can be found in the careers of the early surgical faculty, one of whom, Edmund Andrews, became the founder and the first Chairman of Surgery at the school. While urology was only one of his interests, he performed stone surgery and conducted experiments in ways of providing illumination of cystoscopy. He introduced aseptic techniques in the West, and learned the surgery of trauma on Civil War battlefields. He was succeeded by Christian Fenger who originated a pyeloplasty and collaborated in intestinal substitution for the ureter with Weller Van Hook who, as the century closed, became the third Chair in Surgery. Another member of the early faculty having urologic interests was Charles Smith, a member of the original staff of Cook County Hospital's Department of Venereal and Cutaneous Diseases. He was Professor at the allied Northwestern Women's Medical School, as was Isaac Newton Danforth who may have done the first nephrectomy in Chicago and who wrote Nathan Smith Davis' biography.

Louis E. Schimdt, MD, Chairman, 1900-1948
The Department of Urology was born in the fertile environment of the early twentieth century. Much of the department dealt with venereal and dermatological conditions, but became more diverse as the electric lamp was adopted for cystoscopy. Louis E. Schmidt, then a 30-year-old Chicagoan, had returned from study abroad after his graduation from Northwestern Medical School in 1895. In 1900, he interested his alma mater in adding a Urology Department and making him its Chairman. Earlier, he had inaugurated one of the nation's first urology services at Alexian Brother's Hospital. In 1902, as the American Urological Society (AUA) was forming, Ramon Guiteras asked Schmidt to help start a branch in Chicago. Among the potential members invited to join was William Belfield, who later became president of this first AUA section. For years the society met in Schmidt's offices in an old theater building and usually adjourned to the Union Restaurant for discussions and beer. Schmidt developed a national reputation and was president of the AUA and the American Association of Genitourinary Surgeons (AAGUS). He helped start urology services in many Chicago area hospitals.

Dr. Schmidt attracted notable faculty to Northwestern, including Harry Rolnick, co-author of a widely used medical textbook; Harry Culver, who built a service at the County Hospital; and James Farrell, who had collaborated in Huggin's laboratory at the University of Chicago. Schmidt wrote a number of articles on "skiagraphic" examinations using radio-opaque, floppy wires to delineate the course of the ureter and the vas. He described experience in cystoscopic diagnosis and surgery using galvanocautery in the prostate and the bladder. However, he was perhaps best known as a crusader for making the treatment of gonorrhea available to the poor and for leading a national fight to adopt blood tests for syphilis. These issues often found him in opposition to organized medicine.

Schmidt's fellow Chairman at Northwestern was the world famous John B. Murphy. This was in a day when much of the open surgery in urology was performed by general surgeons. Murphy was especially noted for teaching clinics at Mercy Hospital which often featured a perineal prostatectomy. His publications included the surgical anatomy of the kidney and genitourinary tuberculosis. Victor Lespinasse, a frequent collaborator of Dr. Schmidt and faculty member for over 45 years, published innovative articles on organ transplantation including techniques in vascular surgery and transfusion. 

Vincent J. O'Conor, Sr., MD, Chairman, 1948-1960
Vincent J. O'Conor, Sr. succeeded Dr. Schmidt as Chairman at Northwestern in 1948. He was born in nearby LaSalle, Illinois in 1893, graduated from Michigan University, and then received his MD from Rush Medical School in 1917. He was reportedly the first urological resident at the Peter Bent Brigham Hospital in Boston under Dr. William Quimby and served as a lieutenant in the Medical Corps toward the end of World War I. Dr. O'Conor's practice in Chicago began in 1920, initially at the University of Illinois, where he became an Associate Professor before his Northwestern appointment. His interests and great energy produced many articles on diverse subjects including vesicovaginal fistula, pelvic trauma, vasectomy reversal, pyeloplasty, electrosurgical treatment of bladder tumors, prostatectomy techniques, chlorpactin, and radioisotopes. He established the Northwestern residency program in 1945, was awarded the Keyes medal in 1960, and was actively working at the time of his unexpected death in 1963. Dr. O'Conor was a nationally prominent and popular figure, and he was often referred to as one of the real gentleman among Chicago urologists. 

John T. Grayhack, MD, Chairman, 1961-1989
In 1956, Northwestern was most fortunate in recruiting Dr. John T. Grayhack to return to his native Illinois after two years in the Air Force. A recent bequest by a Northwestern alumnus and prominent Chicago Urologist, Herman Kretschmer, had provided the potential for a laboratory and Dr. Grayhack was engaged to direct the new urologic research facility.

John Grayhack was born in Kankakee, Illinois in 1923. He graduated from the University of Chicago as Phi Beta Kappa in 1945 and remained there to receive his medical degree and Alpha Omega Alpha membership in 1947. He served as an intern at the Billings Hospital on the medical service and then at the John Hopkins Hospital in surgery. He remained at Johns Hopkins to complete his urological residency in 1953. While at John Hopkins and with intentions of a career in general surgery, Dr. Grayhack came under the influence of William W. Scott, and as a result of this interaction he transferred his efforts to urology and research. During those years, Dr. Grayhack became a fellow of the American Cancer Society and of the Damon Runyon Fund. In collaboration with Dr. Scott, he published ten papers based on research on prostatic growth. He was invited to remain at Hopkins as an Assistant Professor but entered the Air Force in 1954 and served for two years.

In 1956, Dr. Grayhack arrived to build a urologic research laboratory at Northwestern. By 1961, he was promoted to Associate Professor and named to succeed Dr. O'Conor as Chairman. In 1963, he was named the Herman Kretschmer Professor, a post which he held for 28 years. He has published over 120 journal articles and 55 book chapters, and his investigations have continued to focus upon underlying mechanisms in prostate hyperplasia and malignancy. His papers and presentations have gained him world fame and innumerable honors, including the Hugh H. Young award, the Presidency of the American Board of Urology, the Presidency of the Clinical Society of Genitourinary Surgeons (CSGUS), the John Hopkins University Society of Scholars, the Fuller Award from the AUA, the Russell and Mary Hugh Scott Award from the AUA, the Presidency of the AAGUS, the Valentine Award from the New York Academy of Medicine, and the Ramon Guiteras Award from the AUA. Dr. Grayhack served as editor of the Yearbook of Urology for 15 years until 1978. He was associate editor of the Journal of Urology after 1982 and its editor from 1985 through 1994. He has also served upon the editorial boards of Urology, Surgery, Journal of the American Medical Association, Investigative Urology, Urology Digest, Gynecology and Obstetrics, Urology Update Series, Clinical Endocrinology and Metabolism, The Prostate, and Current Opinions in Urology.

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Department of Urology
Northwestern University, Feinberg School of Medicine
303 East Chicago Avenue, Tarry 16-703
Chicago, IL 60611-3008
(312) 908-8145/ Fax (312) 908-7275 E-mail: m-grant@northwestern.edu