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International Association of Medical Museums/International Academy of Pathology (For the IAP Centennial Congress: Montreal 2006 - September 16-21, 2006)  Welcome Home!! Maude, we are back home again. And your spirit bids us "welcome". Its been a hundred years, Maude: The Century of Pathology... The Century of the IAMM/IAP 
What started in May, 1906 here, in Montreal, in a preliminary meeting with a
collection of individuals one hundred years ago, has culminated in us today, here, now, in this
way.....
It is said that the history of a successful institution is often the history or a man (or a woman). This is particularly true of the International Association of Medical Museums, which evolved into the International Academy of Pathology as we are today. From its inception it was a truly international organization. This unique organization was essentially a product of the imagination and industry of one person: Maude Abbott of Montreal. She was called: "the Moving Spirit", the Chief Pillar" of the IAMM. 1.) Maude et al. Maude Abbott received her undergraduate degree (B.A.) from McGill in 1890 being one of the first women to graduate (the very first woman graduated from McGill in 1888). Maude obtained her M.D. degree from Bishop's College at the Montreal campus. She had petitioned but could not get into McGill medical school, her long-lasting love, because they did not accept women at that time in medical school, 1889. She then studied in London, Heidelberg, Berne, Zurich and Vienna. She had always been an outstanding student winning many honors and an outstanding leader of her classes and organizations being President of many of her classes. 
On her return to Montreal this superhumanly energetic woman worked with J.G. Adami. She presented,
the first for a woman, at several national and international medical and pathology societies, her work on
pigment cirrhosis. Indeed her presentation of this was the first case in the English language, and the
first in any literature by a woman. Hers was the first article presented by a woman to the Pathological
Society of London (also celebrating its Centenary this year), and subsequently published in its journal.
Thus, there was also probably an association between its establishment and Maude's setting up of the
IAMM. Following her paper on "Functional Heart Murmurs" at the Montreal Medical Chirurgical Society, a
vote was taken and women were unanimously henceforth allowed to attend and present; Maude continued to
lead the way in its future membership.
The Pathological Society of London was amalgamated with a newly formed society-the Pathological Society of Great Britain and Ireland in 1906 by James R. Ritchie from Oxford. Maude would become the first woman and the first world-renowned woman physician of McGill University and one of Canada's first internationally respected medical figures. Her unshaken devotion to McGill was extraordinarily intense. In fact she had three loves: throughout most of her life, she supported and cared for her invalid sister, her only close family, other than the IAMM and McGill. She became Curator of the McGill Museum of Pathology, and despite a major fire in 1907, its resuscitation stands to her everlasting credit. Her principal inspiration came from Wyatt Johnston in Montreal, and William Osler, whom she first met after making a trip to the Army Medical Museum in Washington DC. Johnston had suggested that she and the chiefs there might find it advantageous to form a society of curators of pathological museums. She found a kindred spirit in James Caroll, the Museums' curator, and out of that became the IAMM. Osler indicated to Maude what a great opportunity she had with the McGill Museum. He indicated that it was the greatest place he knew for teaching students: pictures of life and death together in clinicopathologic correlations and teaching. Incidentally and interestingly, her initial meeting with William Osler was marred by a finger crushed in a door, but this would lead to Osler's immediate personal interest in her, inviting her to dinner that evening; Maude met Osler in his library and she ventured to ask for one reprint; she was overwhelmed by a great pile of them. ( Maude was extremely short-sighted and suffered a series of minor accidents throughout her life, mainly involving automobiles and streetcars (once caught between two streetcars, breaking ribs). 
Maude was charming but persuasive, who always seemed to want her friends and acquaintances to do
something for her–like joining the IAMM and giving papers at the meetings. Her circle of friends around
the world was huge. She worked continuously without regard for meals, never refused to see a visitor,
and worked on several problems all at the same time. She could never say no to a request, and therefore
was constantly involved in multiple efforts at the same time.
The concept of an International Association of Curators originated later in 1906 when Maude, James Caroll and William MacCallum met at the Army Medical Museum in Washington DC and later in Baltimore, Maryland and formed an organizing committee to establish the IAMM. A letter of invitation was sent to the leading medical museums throughout the world requesting them to join in forming an international association, and the importance of its function as a medium for the interchange of museum materials for teaching and research. It was further stipulated that "The business of the Association was to be conducted chiefly by means of correspondence , and the meetings were to be held triennially at Washington, in connection with the Congress of Physicians & Surgeons unless otherwise specially arranged; in this way it was thought to forestall and obviate the objections likely to be raised to the formation of a new association with obligate annual meetings in those days of an over-organized profession". The first documented meeting of the IAMM was held at the Army Medical Museum in Washington DC on May 6, 1907. Dr. James Caroll was President but absent due to illness; he was the first person to show virus as a cause of human disease after volunteering to submit to the bite of mosquitoes to prove the transmission of the disease-Yellow fever. Unfortunately he contracted yellow fever, but fortunately recovered, only to die of the heart injury seven years later. Presiding in Carroll's absence at that first IAMM meeting was William MacCallum(US). Present at this meeting were Drs. Osler, Frederick Fuller Russell, F.F. Westbrook, JJ MacKenzie, R.M. Pearce, D.S. Lamb, Edmond Souchon, D.J. Healy, White, Maude Abbott, and Henry Albert. The first officers elected were: W.G. MacCallum, J. Ritchie (UK) and Ludwig Aschoff (Germany), and of course Maude Abbott, Secretary-Treasurer. Dr.William Osler, the first pathologist at Montreal General Hospital, suggested that the IAMM issue a yearly or half-yearly bulletin of museum information similar to an existing German periodical pertaining to the exchange of specimens between museum collections. And it starts! What a famous cast of characters as Presidents followed: William Carroll, William MacCallum, A.S. Warthin, R.M. Pearce, J. Ludwig Aschoff, O. Klotz, W.M.L. Coplin, James Ewing, Frank .B.Mallory, James F. Coupal, H.E. Robertson, George R. Callender, Victor Jacobson, William Boyd, V.H. Cornell, Carl V. Weller, James E. Ash, Tracy B. Mallory, William H. Feldman, Samuel R. Haythorn, Ralph D. Lillie, Everett L. Bishop, G. Lyman Duff, Granville A. Bennett, James B. McNaught, Averill A. Leibow, Jesse Edwards, Ed Smith, W.O.Russell, Chapman Binford, Robert E. Stowell, F.W. Wigelsworth, Benjamin Castleman, John B. Hazard, L. Lowell Orbison, David Smith, Henry Moon, A. James French, Robert H. More, Jesse Edwards, Edward A. Gall, T.C. Jones, William Christopherson, F.K (Kash) Mostofi, Nate Kaufman, Peter Gedigk, Erkki A. Saxen, Roger Cotton, Jack Layton, Adonis de Carvalho, Jack Strong, Antonio Llombart-Bosch, David Hardwick, Phillip Allen, Cecilia Fenoglio-Preiser, Anna Kadar, Shinichiro Ushigome, Francis Jaubert, and others ... Other members of the IAMM/IAP include names such as William Osler, Hans Chiari, Paul Courmont, Forsman Lund, Josselin de Jong, Kretz, Herxheimer, H. Lubarsch, J. Ritchie, Dr. Muir, S. Burt Wolbach, George N. Whipple, Martha Wollenstein, William Welch, Sir Jonathan Hutchinson, Pierre Marie, Bernard Fischer, J. Fibiger, Dr. Askanazy, Charles Minot, C.H. Bunting, Horst Oertel, Harry Goldblatt, Howard T. Karsner, Pierre Masson, Alwin M. Pappenheimer, Paul White, Ernest Goodpasture, Arnold Rich, Milton C. Winternitz, Joseph F.A. McManus, Ruell Sloan, Harold Stewart, Murray (Gus) Abell, Kenny Earle, Nate Kaufman, Florabel Mullick, Robin Cooke, and many others. Constitution and bylaws were written, scientific programs were developed, initially concerned with techniques for the preservation of museum specimens and the need for a uniform system of museum classification. The IAMM Bulletin became a valuable journal of pathologic anatomy, with special reference to technical methods of preparation and procedures for exhibit and display for education and research, and classification and cataloguing of specimens, and interchange of specimens. Consideration was also given for the feasibility of establishing an Index Pathologicus for the future. It became one of the principal periodicals in its field. Maude demonstrated a series of specimens with anomalies of the heart, and became the North American authority on congenital heart disease, obtaining specimens from many of her pathologist friends around the world. Multiple Divisions of the IAMM were formed including Austria, Belgium, Brazil, Canada, Denmark, France, Germany, Holland, Ireland, Italy, United Kingdom, Japan, Scotland, and the United States officially joining. The First Meeting held outside of the USA was in 1913 in London, England: Amendment in Bylaws: Every third year where a meeting was accessible to more members became the harbinger of the International Congress, now held every 2 years. The first concept of the formation of separate Divisions was proposed in 1913: "a central International Body with international officers, and local or sectional societies with local officers". In 1914: Lord Strathcona (Donald Smith), Resident Governor of the Hudson's Bay Company, and one of the chief builders of the Canadian Pacific Railway, (He drove the last spike into the Canadian Pacific railway) High Commissioner of Canada and Chancellor of McGill, a financier and philanthropist gives $5000 to "establish and maintain the proceedings of the Association at a higher standard of efficiency" and to fund the IAMM Bulletin. (Perhaps he was "taken to the Club" by the English Pathologists to have his arm gently twisted) Some of this money paid for the first Presidential Chain and Medal. World War I disrupts the activities of the IAMM, and sections in various European countries dissolve. The IAMM is maintained as the American (Later US-Canadian) section through the efforts of Maude Abbott. In 1915 an Editorial written almost certainly by Maude Abbott in the IAMM Bulletin states: "This Bulletin contains the proceedings of the last International Meeting of the Association which was held in London in August 1913...Since to recall these proceedings is to remember London as it was during the concourse of nations of that great congress, and to bring sharply before the mind the changed conditions of today, when the very men who met each other so cordially in the friendly interchange of scientific thought, are now engaged in an encounter of deadly hostility. So serious has the situation become and so terrible the loss of life, that all other matters sink into insignificance in comparison with the overpowering need for the amelioration of the belligerents. Nevertheless, the duty remains for such an Association as this, to preserve its integrity, and to cherish the memory of the international amity in which it originated, in the hope that in a happier day, when a just peace may at last be proclaimed, it may act as one of the links that must bridge across the chasm that divides those who are now bitter foes. It is with this thought and in the hope that we introduce the Bulletin to our membership–to whom it has been long pledged. " 1924: Bulletin Number 8 of the IAMM is issued as a memorial for the death of William Osler. (It was said that the cost of this issue of the Bulletin virtually "bankrupted" the association.) 1925: Symposium held on the "problems of securing autopsies" (some things never change). 1930: A grant from the Carnegie Foundation ($5000) was obtained about six years after this event: about six years). This presumably repaid the cost of Bulletin Number 8! 1940: Maude Abbott, died as a woman of international medical fame with a record of honesty, good will, kindness and benevolence, who had acted as S/T from the beginning of the Association and editor of its bulletin from 1907 to 1938–producing 17 editions. The Curator of the Army Medical Museum –Colonel James Ash, becomes S/T and Robert A. Moore (USA), bulletin editor (the latter succeeded by Sidney Farber). During WW II the Association met only once (1942) and for a time after that meetings were restricted to gatherings of the Council. 1947: British Division reactivated under Dr. C.J. Hackett. With resumption of the meetings of the entire section in 1948, the need for changes to keep up with the times was evident. The international aspects of the parent society had virtually ceased during the war. A burst of activity developed into the field of histochemistry, studies reporting the application of newly developed coloring techniques to histopathologic sections where read at our annual meetings and subsequently published in the Bulletin. 1952: A Turning Point in IAP History:: Kash Mostofi, a Persian, becomes S/T (and what a S/T he became!): According to Nate Kaufman: "Young Kash Mostofi was the imaginative, energetic, dedicated and bold individual who led, and at times, drove the Academy in the direction to what it is now". In 1952 the Bulletin was replaced with a new journal: Laboratory Investigation: A journal of Experimental Methods and Pathology"; first editor Thomas Kinney and Nathan Kaufman, Associate Editor. (Vol 1 No. 1 was sold out. In Vol 1 No 3 the Editor was offering to pay $1 for copies of Vol 1 No 1). 2.) Mostofi et al. : Timing, as they say, is everything: 
When Kash (Dr. Mostofi) got to the AFIP, he went to the Director, Colonel Dart, to enquire about his
job description. He was asked "What do you like to do?" Breast (no got someone doing that); Pulmonary
(got someone doing that); Well, what Col. Dart do you want me to do? GenitoUrinary (GU)-maybe GU
although it seems like its pretty well worked out and after awhile do something else.(cf. This is akin
to the method of allocating jobs in Christian "religious orders" whose members are bound by vows of
Poverty, Chastity and Obedience. Similarly, some teachers/professors are lined up each year and the
subjects are allocated, regardless of the person's qualifications or training. Perhaps talent just
"shines through" and people make the most they can out of whatever they are "asked" to do). Kash
certainly did this.
We'll Kash did do GU, but also after awhile he did something else: He became the most recognized pathologist in the world: "During his 18 years as Secretary-Treasurer of the IAP, the character of the Society emerged as the pattern of a Persian rug emerges from its myriad details. Perhaps recollecting how a whole village together worked to make a beautiful rug, he worked indefatigably with many others, and they fashioned the IAP as it grew up from the old IAMM". In January 1952, the journal Laboratory Investigation was started and within a few months the first issues were exhausted; the first volume contained the first mention of pathological effects of new chemotherapeutic agents, and subsequent seminal papers on "immunocompromised hosts", etc . 1953: At the 42nd meeting a Special Course on the Anatomy, Physiology and Pathology of one organ–The Kidney (I might add) presented by a number of speakers met with great success. This was the genesis of the Long Course; one of Dr. Mostofi's many contributions. Two years later (1955) the IAMM name is changed to the International Academy of Pathology: used to stress the connotation of a learned society united for the advancement of the sciences. The IAP was incorporated in Washington DC on November 14, 1955. The decade from 1950-1960 was thus an exciting period of development for the IAP. The second phase of the IAP News Bulletin began with the publication of "International Pathology" in 1960: the Editor was Chapman Binford. He was ably followed by Howard Hopps, Kash Mostofi, Roger Mortimer, Geoffrey Farrer-Brown, Vincent McGovern, Roger Cotton, to name a few, and of course, presently the wonderful Robin Cooke for the last 12 years. 1961: The IAP Academy Seal is developed and unveiled initially on the cover of the Journal of Laboratory Investigation (Vol 10, number 1, 1961). A representation of the Marshall-Hooke microscope (c1704) was used because of the beauty of the line, a lamp of learning to represent the educational, teaching and investigative aspects of the Academy, and the Earth, to indicate its international aspect. Resumption of the International Presidents in 1969. In 1969 a new Constitution and Bylaws formalized both the Divisional and the International organization of the IAP. Divisions evolved in various countries throughout the world. 1971: Many new Divisions formed with the Thai Division the first of these: 17 by 1971: As a result of the increasing number of Divisions, an International Council was formed with Professor G.J. Cunningham of the British Division, the first President. Many great Presidents have followed (See the Hall of Presidents). Lots has happened in the last three decades: in summary, there are now.... Approximately 50 Divisions throughout the world have been formed...over 18,000 members worldwide, representing the largest organization of physician-pathologists in the world (see the "Time Line" on the IAP Centennial Website). 3.) Kaufman et al. 
Dr. Nathan Kaufman made major contributions to the IAP in myriad ways over many years. They include
founding Associate Editor of Laboratory Investigation, establishment of Bylaws and separate incorporation
of the USCAP while maintaining traditional close ties with the IAP, etc.
4.) Societies/Meetings/Museums and Journals: A.) Societies/Meetings: Science is the mode of cognition of our societies/a gift. Enquiry into science is a social activity (an enterprise of shared contributions/participation of all those interested), as started by the Italians in the 1500 and 1600's (Rome's Academia dei Lincei; Bologna, Naples, Florence, to the Academie Francaise, to the Royal Society of London in 1667, and then Berlin by Leibniz in the 1700's. A Shared and communal effort with people congregating and cooperating in advancing our science. These seasonal calender of ritual, as it was called, became an essential figure of our modernity. A place of report, it incited and rewarded independent scientific work; and avenue of communicating results of the scientific work. A forum to meet and discuss, where controversies are aired, alliances forged, criticisms vetted. From its inception it was an international effort with camaraderie and conviviality of its members. As Hardwick is fond of saying: "A free flow of information": open and accessible. This led to social harmony/cohesion of a society and allowed the mentoring of younger scientists. Museums: Medicine and Science moved from a translation of manuscript documents of previous generations to organ specimens: descriptions/commentary. These museums, these temples of nature and learning served dual purposes: research collections/research and educational tools. The History of Natural History, including geology, paleontology, zoology, botany, and medicine, was largely caught up with the development of museums. One of the largest in Canada was in Montreal and McGill University in the 1800's. A place to edify those who had not seen other lands/experiences/diseases. Indeed the motto of the Naturale History Society of Montreal in 1827 was "Tandem fit surculus arbor": Great accomplishments by bringing together the modest efforts of individuals". Journals: The worlds' first scientific journals came about in about 1665 (Journal des Scavans; Philosophical Transactions) as well as Andreas Vesalius's De Fabrica Humani Coporis (1543). This was the first printed medical book. National societies, like the IAMM/IAP established permanent records of their collective identities; a quick accessible medium for publication of their findings; information that might escape their attention. This facilitated the flow from scientist to scientist of information and stimulated consensus and criticism. With it came the decision to focus on a particular area, like disease. It kept us all on our toes. 
5.) Summary: The Past, the Present, the Future: So to Review as Hardwick
suggests: "The IAMM, about the time of the Flexner Report (which would change all medical education),
was created to provide State of the Art Educational processes and information to academics. About the
same time the IAP was created to provide the same thing. Assessing the vision projected by the
initiators of the IAMM, it is apparent that their motives related to teaching the latest understanding of
the Foundations of Medicine." "As goes your Pathology so goes your Medicine" a quote from Sir William
Osler sums up the raison d'etre for the educational emphasis of the IAMM/IAP. Utilizing museum specimens
as a highly relevant teaching medium was appropriate given the technology of the day and the
audience–medical students being taught.
In the 70's CE was emphasized, and the IAP adopted the expanded meetings to enhance the Science & Practice of Pathology. Providing access to the vast store of valid, currently authenticated and trusted knowledge is a fundamental role for the Academy. The IAP continues to enhance its Continuous Professional Development offerings and provides on-line documentation of CPD, evaluation and arms-length documentation of Academy Technology permits expanding the teaching forum beyond slide/Em or microaray-based pathology presentations and courses to now include internet webbased transition of knowledge globally. Presentations as well as documentation of enhanced learning are now on websites/CD-ROMS/to now The Pathology Information Knowledge Hub/Pathology Portals on our websites, etc: The Academy provides real time access through electronic search capability to this storehouse of knowledge. This is freely available to all pathologists world-wide. The USCAP/ IAP Knowledge Hub/Pathology Portal ( www.uscap.org) provides a forum the presentation of advances in the understanding of pathologic processes and for the presentation and critical evaluation of the application of scientific, technological and methodological advances in the study of pathology. Knowledge developed for diagnosis, etiopathogenesis, therapeutic interventions, and response to therapy are under constant and iterative flux. In Pathology, as in Medicine, a putative base of provisional knowledge has been accumulated and archived. There is a constant evolution of technologies, and the known and accepted is constantly tested, amended or discarded, and when found wanting, updated and rearchived. This process of providing access to the vast store of valid, currently authenticated and trusted knowledge for questioning minds continues to be a fundamental role for the IAP. ALL SINGULAR EVENTS IN MEDICAL EDUCATION AND THE RESPONSE BY THE IAMM/IAP.... 
In summary, a free flow of information to all Pathologists worldwide will stimulate a flowering of
interest in Pathology leading to more innovation, better refinement of diagnosis and thus better human
health. Each Pathologist writer, lecturer, presenter or specialist makes his or her material available.
Wide distribution of ideas to a waiting, informed Pathologist Public worldwide will form a type of
Enlightenment with consequent further knowledge creation and analysis.
About the IAMM/IAP: As Edith Wharton says: "There are two ways of spreading light; to be the candle or the mirror that reflects it". Our members are the candles, and our Academy is the mirror. At this meeting: Hall of Presidents IAMM Museum Replica (circa 100 years ago) Lectures, presentations, etc (approximately 100)... Time capsule to be opened in 100 years. "Substance is enduring Form is ephemeral Know the difference" (Quoted by the Head of the USA ACGME)...
Well, its been a one hundred year story.... A Brief History, of Everything: As they say, its not the beginning of the end, but instead the end of the beginning. We've come "Full Circle"...back to Montreal...our founding and our future... T.S.Eliot: "We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time" (Four Quartets. Little Gidding, II).
And now as she - Maude would have wished, carry on with the job. Good Congress. Thank you Maude. by Fred Silva, Nate Kaufman, Robin Cooke, and David Hardwick, and materials from Kenny Earle for the IAP Centennial Congress/Montreal/Sept. 06 April 9, 2006. |