Surgical Pathology in the Era of the Civil War: The Remarkable Life and Accomplishments of Joseph Janvier Woodward, MD

Archives of Pathology & Laboratory Medicine, Oct 2005 by Rapkiewicz, Amy V, Hawk, Alan, Noe, Adrienne, Berman, David M

In this era, natural dyes were used to stain tissue sections. However, Woodward was not satisfied with the dyes because they were unstable and did not provide enough contrast. Through experimentation, he popularized in America the use of synthetic red and yellow aniline dyes developed in Europe.4 Eosin, a synthetic aniline dye, is now routinely used in all anatomic pathology labs.

Woodward's inspiration for photography came from the physicist Lewis M. Rutherfurd, who had invented a telescope that could be used for astronomic photography. Woodward met in May 1865 with Rutherfurd, who advised him how to convert a microscope into a camera.2,3,10,11 Woodward, with Curtis, then created the apparatus. Illumination came from sunlight reflected by a heliostat placed outside of a window on the fourth floor of the Ford Theatre building, location of the Army Medical Museum. The light passed through a copper ammoniosulfate solution light filter before passing through the specimen, which was mounted on a sideways Zentmeyer Grand American Microscope. The image was projected through the microscope, the eyepiece of which had been replaced by a concave lens, onto a movable plate holder situated approximately 9 feet away (Figure 3).2 In Circular No. 6: Reports on the Extent and Nature of the Materials Available for the Preparation of a Medical and Surgical History of the Rebellion, published in 1865, Woodward described how he intended to use the photomicrographs to illustrate cases in the proposed medical section of the MSHWR. Because photolithography provided inadequate detail, Woodward had museum artist Hermann Faber make detailed drawings of the images that were used to generate the steel engravings that ultimately illustrated the MSHWR. Approximately 7500 copies of Circular No. 6 were published.3,11,12 To overcome the unpredictable sunlight source, Woodward later pioneered the use of artificial light sources, using both magnesium and electric lights.5 Artificial light not only allowed nighttime experiments but also allowed greater magnification.3

Woodward's collection of glass slides is currently archived at the National Museum of Health and Medicine at the Armed Forces Institute of Pathology in Washington, DC. These slides are remarkably well preserved and provide a fascinating view of 19th-century pathology. One example demonstrates a section labeled "Negro skin" (Figure 4, A) and is noteworthy for the superb histologie technique. Although Woodward authored the sections on the "colored" Union troops in the MSHWR, one can only speculate about whether this specimen was derived from an autopsy or amputation from one of these soldiers. An example of a tumor is labeled "carcinoma of the mamma gland" (Figure 4, B) and stained with red aniline. The lesion consists of normal breast tissue highlighted by paler-staining stroma and vibrant red glands. In the lower portion of the slide, a dense infiltrating population of cells consistent with carcinoma is present. Figure 4, C, shows a section of trachea taken from a patient with diphtheria. The section beautifully illustrates the classic tracheobronchitis, demonstrating transmural acute inflammation and an adherent necrotic mucosal pseudomembrane containing sloughed respiratory epithelium. This specimen was procured at autopsy. Figure 4, D, demonstrates a section of colon taken from a soldier with "chronic diarrhea" and stained with yellow aniline dye. The presence of flaskshaped ulceration present in the mucosa raises the interesting differential diagnosis of infectious colitis (eg, amoebic colitis, Salmonella or Yersinia) versus inflammatory bowel disease.