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Chapter 25

Julius Hess, M. D.

Alwin C. Rambar, M. D.

 

Dr. Julius Hess was born in Ottawa, Illinois on January 26, 1876. He received his medical degree from Northwestern University in 1899, interned at Alexian Brothers Hospital in Chicago and had postgraduate training at Johns Hopkins University Hospital, as well as at hospitals in Germany and Austria. He married Clara Merrifield, in 1902, and they had two daughters: Mrs. Jean Merrifield Spencer and Mrs. Carole Lucile Saphir. He practiced in Chicago from 1902 on. He was a member of the American Medical Association, the Illinois State Medical Society and the Chicago Medical Society in the last of which he was President in 1934-5. He was active in the American Pediatric Society and the Chicago Pediatric Society, and he received the American Academy of Pediatrics Borden Award in 1952. Dr. Hess was a consulting pediatrician at the Municipal Contagious Hospital of Chicago and a member of the advisory committee of the Children's Bureau of the Department of Labor. He had many publications and belonged to The Standard Club and the Adventurers' Club.

Here are my recollections of him:

I came to Chicago in 1926, after graduating from Syracuse University Medical College, to intern at Michael Reese Hospital. In my junior year of Medical School, I had spent a number of months on the Columbia Service of ear, nose and throat at Bellevue Hospital and the Friesner service at Mount Sinai in New York City, and I fully intended to make that my specialty. However, my first service as an intern at Reese was Pediatrics, with Dr. Hess as my attending man, and I knew immediately that pediatrics was my field.

Whenever I think of him, he was and always will be "Dr. Hess." I never heard any but his very closest friends call him Julius, and absolutely no one called him "Doc." That was a far cry from modern times where house officers and patients alike address doctors by their first names or nicknames.

Dr. Hess had an austere air. He was not tall-nor was he pompous, but he was a commanding presence and, when you were with him, you felt the aura of importance which emanated from him. He was kind and gentle to patients, although he could be very firm when the need arose. As a teacher and critic, he was never abrasive and he was a superb instructor who shared his knowledge generously.

In that first month, when I was a new intern, I looked upon Dr. Hess with awe and respect. When he asked me to be his assistant, I felt that I had received a great honor. I asked him about my taking further training as a resident but he felt that my spending a couple of years with him (after an extra year of pediatric internship) would give me as much graduate training as a residency would have done.

At that time in Chicago the leading pediatricians were Dr. Hess, Professor and Chairman at the University of Illinois; Dr. Isaac Abt, Professor and Chairman at Northwestern University; and Dr. Joseph Brenneman at Children's Memorial Hospital. There were other fine pediatricians, of course, but I think of those three as the masters of Chicago Pediatrics.

While I was an intern, Dr. Hess once took me to a meeting of the Chicago Pediatric Society which was held at the Tip Top Restaurant on Michigan Avenue, one of Chicago's leading restaurants at that time. I counted those present; there were 29 including myself. We were all seated at a long mahogany table. I do not know how many members there actually were in 1928, but there are undoubtedly 20 or 30 times that number now.

Dr. Hess' office was at 104 South Michigan Avenue. He had a number of associates at that time: Dr. Joseph Calvin, Dr. Philip Rosenblum, Dr. Iris Chamberlain-and Dr. Louis Robins and myself as assistants. He had a large practice for those days, but the most interesting feature of the work was his consultation practice. He had developed a following of patients with strange and unusual diseases and those patients and their parents were so devoted to him that he could round them up at will, and they were proud to be displayed for teaching purposes in his lecture classes and for the house officers.

As I write, I recall many interesting times when Dr. Hess spoke to me of his early years in practice. The changes were as great between his first years and mine as they have been between 1928 and now. When he started in practice in Chicago, his office was at 55th Street and Prairie Avenue. Dr. Hess had a horse and buggy to get around to see his patients at that time. I believe he was in general practice for a while. He was especially proud that within a few years he was so successful that he had two horses pulling his buggy. When I met him, and for the rest of the years that he lived, he had a devoted chauffeur named Bill, whom we all knew and liked.

One of my duties was to make a house visit once a month to Dr. Hess' Aunt Mary Hess, a very old and very interesting lady. The visit had to last at least half an hour and she regaled me with descriptions of her early life in Chicago. I was especially interested in her recollection of the train that carried Abraham Lincoln's body from Washington to Springfield, for my own mother had seen that train, too -- albeit from her mother's shoulder when she was only eight months old.

Dr. Hess was a prolific writer -- his articles were mainly descriptions of children's diseases and the care of infants. Infant feeding then consisted of difficult (for me, at least) mathematical ratios of "top milk" (cream), "bottom milk" and a carbohydrate (usually Mead Johnson's brand of DextroMaltose, #1, #2 or #3.) Only trained pediatricians could figure out the necessary magical numbers which produced the proper proportions of carbohydrate, fat and proteins. There was widespread use of barley water, Eagle Brand milk-as well as Pet and Carnation evaporated milks -- and a commercial preparation, SMA, devised by Dr. Gerstenberger at Western Reserve. In 1922, Dr. Hess wrote a series of articles for the journal of the American Medical Association, at their request, explaining how to simplify infant feeding. This revolutionized the method of writing formulae, and was later printed as a handbook. The handbook had a wide circulation and was reprinted in six editions.

Dr. Hess' international reputation resulted from his study of premature infants, which was his main interest. He developed the premature infant station at Sarah Morris Hospital, the children's hospital of Michael Reese. As I remember, it had room for 28 incubators and living quarters for five to eight wet nurses. He had designed an incubator in the early 1920's, with the help of an engineer. It was known as the Hess Incubator and was in general use then, just as the Isolette incubators are now. He interested the Infants' Aid Society of Chicago in financing the premature station at Michael Reese and he trained two intensely devoted nurses to be in charge of the tiny patients there. Miss Evelyn Lundeen, who co-authored several books with Dr. Hess on the care of premature infants, was totally in charge of the station. She managed the feeding and care of those delicate babies and she trained nurses who came there from all over the world to learn from her. She was the epitome of the devoted nurse -- she lived only to save the lives of those premature infants. She was also an autocrat who knew more about the care of the premature than the doctors did, and woe unto them who dared to write orders. There were no antibiotics and her diagnoses and treatment were vital; she saved many infants with her expert judgment. One of her interesting observations was that severely jaundiced babies did better in the incubators near the windows and she always placed the most jaundiced infants there. It was years later that the bilirubin light came into use.

The other nurse, Roberta Stannard, assisted me in the premature clinic where all the non-private patients were seen.

One of Dr. Hess' friends was Dr. Martin Couney, who for many years had a premature station for the hospitals of New York City at Coney Island Amusement Park. The babies were displayed in Hess incubators and admission was charged to see them. Naturally, when the Chicago World's Fair, The Century of Progress, opened in 1933 on the lakefront, a premature station was one of the scientific displays. Dr. Hess and Miss Lundeen were in charge, showing the well prematures who needed no special care. The station at the Fair was very near the hospital and it was practical (in 1933 traffic) for all of us to work both places concurrently.

One of the interesting facts of the premature station at Reese was the very small number-and percent-of our smallest prematures who developed retrolental fibroplasia. At Lying-In Hospital, only 30 blocks away, they had the usual 5-25% morbidity, but our surviving babies who weighed less that 1500 grams rarely had this dread complication. It took Patz's work on oxygen concentration much later to uncover the reason for our success. Hess incubators were not air tight. They leaked a great deal of oxygen being given and, as a result, the babies were not subjected to the high concentration of oxygen which produced this condition. Lying-In was using the Isolettes, which were much more modern and streamlined -- and airtight.

When Dr. Hess retired from the Department of Pediatrics at the University of Illinois, he brought in Dr. Henry Poncher to succeed him. Dr. Poncher was the first full-time Professor of Pediatrics at Illinois and quite possibly the first in Chicago.

Dr. Hess encouraged young doctors to be pediatricians and he trained many who became leaders in the field. Some were: Dr. Norman Clein of Seattle, Dr. Dennis Kovan of Detroit, Dr. Ray Armstrong of Urbana, Dr. Ralph Kunstadter of Chicago (his nephew), Dr. Edmund Hess of Evanston (another nephew) and Dr. Lawrence Breslow of Northbrook. Dr. Michelin came to Dr. Hess from Paris for postgraduate training, as did Dr. Alexander Minkowsky, who is head of the Hospital de Periculture, the premature hospital of Paris.

Dr. Hess died suddenly in Los Angeles at the age of 79 during a family visit to the home of his elder daughter. He had been active in practice to the end.


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Created 8/10/2002 / Last modified 8/17/2002
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