WELCH, WILLIAM HENRY

(b. Norfolk, Connecticut, 8 April 1850; d. Baltimore, Maryland, 30 April 1934), pathology, bacteriology, public health, medical education.

Welch was born into a family of physicians who for two generations had practiced medicine in Connecticut. His mother died when he was six months old, and he and his slightly older sister, Emma, were raised with the help of their paternal grandmother. The elder William Welch, a busy family practitioner, was a kind but somewhat distant father. The son prepared for college at a boarding school in Winchester Center and entered Yale in 1866, at the age of sixteen. By the time he graduated in 1870, third in his class, Welch had become interested in the classics and hoped for a position as tutor in Greek.

Not successful in obtaining a post at Yale, Welch accepted a teaching job at an academy in Norwich, New York, for 1870-1871. He then returned home to apprentice himself to his father, thereby beginning medical studies. In the fall of 1871, a very brief exposure to the medical lectures at the College of Physicians and Surgeons in New York City convinced him of the need for science courses. Welch therefore returned to New Haven to spend the academic year 1871-1872 at the Sheffield Scientific School of Yale University. where he concentrated on chemistry. Resuming medical studies at the College of Physicians and Surgeons in the fall of 1872. Welch found little more than a series of didactic lectures. He therefore eagerly accepted a prosectorship in anatomy in 1873, so that at least he could learn by firsthand investigation. Welch’s dissertation on goiter was awarded a prize: and several months prior to receiving the M. D. in 1875. he began duty as an intern at Bellevue Hospital. where he had an excellent opportunity to observe and study a large variety of patients. Under the direction of Francis Delafield. Welch soon developed a keen interest in pathology. He also was greatly stimulated by two teachers who had emigrated from Europe. E. C. Seguin and Abraham Jacobi. Welch followed their advice to make a European study tour beginning in the spring of 1876.

During this sojourn of two years Welch visited and studied at the major medical centers of Strasbourg, Leipzig, Breslau, and Vienna. Two of his research endeavors had special influence in shaping his career. With the physiologist Carl Ludwig at Leipzig, Welch learned to handle living tissue. He investigated the nerve distribution in the auricular septum of the frog heart and visualized the nerve network that later was fully described by Louis Ranvier. At Breslau, under Julius Cohnheim’s direction, Welch studied the pathogenesis of pulmonary edema, showing, contrary to Cohnheim’s presuppositions. That the condition is primarily mechanical in origin. With the publication of his findings in Virchows Archiv in 1878. Welch was launched in the scientific. laboratory-based study of pathology that Varchow, Cohnheim, and other German physicians were developing so fruitfully. For Welch there was no turning back, and he rejected a career in country practice with his father.

Returning to New York in 1878. Welch set out to bring the laboratory tradition in pathology to American medical students. His own school, the College of Physicians and Surgeons, was willing to let him teach a summer course but offered inadequate facilities and no salary. Bellevue Hospital and its medical school, on the other hand, offered to renovate three small rooms and to supply very modest equipment. Here Welch inaugurated the first teaching pathology laboratory in the United States. The student response was heartening but the financial returns meage. To support himself Welch performed autopsies and examined specimens for his medical colleagues. held a popular private class for medical students. wrote a section of the sixth edition (1886) of Austin Flint’s Principles and Practice of Medicine. and saw a few private patients. It is therefore not surprising that in six years he failed to complete a single piece of pathological research. It was this frustration,as well as the dream of bringing a real science of pathology to America, that had intrigued Welch about the new Johns Hopkins University. From 1876, if not before, Welch had hoped that he might be offered a chair in the proposed medical school faculty. When the offer was made in 1884, Welch accepted the professorship of pathology.

Prior to moving to Baltimore, Welch took an additional year of study in Europe, concentrating on the rapidly emerging field of bacteriology, a subject he had entirely bypassed six years earlier. Study with Carl Flügge, Robert Koch, and Max von Pettenkofer gave Welch the groundwork he needed to bring another aspect of the study of disease to America. When Welch arrived in Baltimore at the end of 1885 to assume his duties at Johns Hopkins, no hospital or medical school existed. It fell to Welch, with John Shaw Billings; Daniel Coit Gilman, president of the university; and H. Newell Martin, the professor of biology, to recruit the rest of the medical faculty. Welch moved into Martin’s laboratory and, with the assistance of William T. Councilman, began a series of pathological and bacteriological studies on thrombosis, embolism, hog cholera. diphtheria. and a number of other projects. In contrast with New York. Welch now had both able assistants and adequate laboratory facilities. Which enabled him to bring a number of projects to a successful conclusion. The most renowned discovery coming from Welch’s laboratory (opened in 1886) was the correct identification of the gas gangrene bacillus. In 1892, with the help of G. H. F. Nuttall, Welch published his findings regarding the isolation of Clostridium perfringens.

With the opening of the Johns Hopkins Hospital in 1889, William Osler, Howard A. Kelly, and William Halsted began residency programs patterned on the German system of postgraduate medical training. This was doubtless one of the most important contributions of the hospital to American medicine. Although not involved directly in clinical training, Welch played a key role in setting the climate for these developments. When the medical school, after overcoming financial difficulties, finally opened in 1893, Welch became its first dean, a post he held until 1898. The students were taken to the wards and were given clinical responsibility. The outstanding basic science chairmen, Franklin P. Mall in anatomy and John J. Abel in pharmacology, had been recruited by Welch. With him, they and the clinical chairmen were instrumental in making basic science and laboratory work, as well as study of patients on the wards, the norm for medical education in America. As much as any individual, Welch made the Johns Hopkins Hospital a new kind of hospital in America. one devoted to science as much as to charity.

It fell to Welch and a handful of colleagues who also had been in the European bacteriological laboratories to alert the American medical profession to the practical applications of the germ theory of disease in relation to medicine and public health. His address to the Medical and Chirurgical Faculty of Maryland in 1887, “Modes of Infection,” stressed what he had learned in such cities as Munich. Cholera and typhoid, he pointed out, were caused by specific microorganisms, not a vague miasma. The bacteria could be found in the open sewers still prevalent in Baltimore; and Welch subsequently worked to improve the city’s health conditions, serving for many years on the Maryland State Department of Health.

In the spring of 1888 Welch was asked to deliver the Cartwright lectures in Nes York City. His speech, “On the General Pathology of Fever,” presented one of several general reviews for which he became well known. In later years he wrote similar essays on the immune mechanism, thrombosis, and wound infections. Although this work was not derived primarily from his own research, Welch here evidenced his great gift for expression and for cogent summary.

His general summations of current scientific work, his editorship of the Journal of Experimental Medicine (1896-1906), and the numerous scientific and civic organizations to which he belonged, more than his own scientific investigations, increasingly made Welch one of the most influential spokesmen for American medicine. Many sought his counsel and he served in some key policy-making positions. He headed the Board of Scientific Directors of the Rockefeller Institute and served as a trustee from 1910 until 1933. At the same time Welch was a member of the board of the Carnegie Institution of Washington. He also served, for shorter periods of time, on the boards or councils of the Milbank Memorial Fund, the Rockefeller Sanitary Commission, and the International Health Board of the Rockefeller Foundation. In 1910 he was president of the American Medical Association and, from 1913 to 1916, president of the National Academy of Sciences.

Long active in the public health movement in America. Welch agreed in 1916 to leave his chair at the school of medicine to become dean of the new School of Hygiene and Public Health at Johns Hopkins. This was the first full-scale school of its kind, although Harvard and M.I.T. had begun a joint effort a few years earlier to train health officers. Welch continued as dean until 1925, when the trustees persuaded him to take the newly established chair in medical history.

Welch’s eightieth birthday was celebrated by friends, students, and colleagues. In Washington, President Herbert Hoover called him “our greatest statesman in the field of public health,” Welch himself, with characteristic modesty, agreed to accept the accolades only insofar as “I stand here to represent an army of teachers, investigators, pupils, associates, and colleagues, whose work and contributions during this period have advanced the science and art of medicine and public health to the eminent position which they now hold in this country,”

BIBLIOGRAPHY

I. Original Works. A bibliography of Welch’s publications was prepared by Walter C. Burket,Bibliography of William Henry Welch (Baltimore,1917); Burket also edited the collected Papers and Addresses by William Henry Welch, 3 vols. (Baltimore, 1920). Those few items that appeared after 1920 are listed in the bibliography appended to Simon Flexner’s memoir (see below).

The Welch MSS, consisting of many file boxed of letters, diaries, and clippings, indexed and arranged by Simon Flexner and James T. Flexner, are deposited in the William H. Welch Medical Library of Johns Hopkins University, Baltimore.

II. Secondary Literature. The most thorough biography is Simon Flexner and James T. Flexner, William Henry Welch and the Heroic Age of American Medicine (New York, 1941; repr. 1966). A shorter and more interpretive study is Donald Fleming, William Henry Welch and the Rise of American Medicine (Boston, 1954). Two collections of articles are The Eightieth Birthday of William Henry Welch (New York, 1930) and a series describing Welch’s influence on pathology. public health, medical history, and medical education in a special supp. to Bulletin of the Johns Hopkins Hospital, 87 no. 2. pt. 2 (1950), 1–54.

See also the following listed chronologically: Fielding H. Garrison, “In Memoriam: William Henry Welch (1850-1934),” in Scientific Monthly, 38 (1934), 579– 582; Harvey Cushing, “The Doctors Welch of Norfolk,” in Connecticut State Medical Journal, 5 (1941), 557–560; Simon Flexner, “Biographical Memoir of William Henry Welch 1850-1934,” in Biographical Memoirs National Academy of Sciences, 22 (1943), 215–231; Owsei Temkin, “The European Background of the Young Dr. Welch,” in Bulletin of the History of Medicine,24 (1950), 308–318; Barnett Cohen, “Comments on the Relation of Dr. Welch to the Rise of Microbiology in America,” ibid., 319–324; and carl J. Salomonsen, “Reminiscences of the summer Semester, 1877, at Breslau,” C. L. Temkin, trans., ibid., 333–351.

On Welch’s role in the development of the medical institutions of Johns Hopkins University, see Alan M. Chesney, The Johns Hopkins and the Johns Hopkins University School of Medicine; a Chronicle, 3 vols. (Baltimore, 1943-1963); Richard H. Shryock, The Unique Influence of the Johns Hopkins University on American Medicine (Copenhagen, 1953); and Thomas B. Turner.Heriotage of Excellence, the Johns Hopkins Medical Institutions, 1914-1971 (Baltimore, 1974).

Gert H. Brieger