No apology needed, Dr. Johnston!

McGill Libraries offers access to more than 70 digital projects covering a wide array of subjects. The perusal of the old journals and newspapers that have been made available online can lead to some serendipitous findings. For example, on page 14 of the McGill University GAZETTE Monday, December 1, 1885 there is the following report:

Dr. W. G. Johnston, we are surprised to see, has neither been made to apologise for anything or send in his resignation for nothing, though he has been House-Surgeon in the M. G. H. [Montreal General Hospital] since May last.

Johnston succeeded William Osler as Pathologist at the Montreal General Hospital after the latter left for Philadelphia. Johnston had an important influence in the development of the McGill Medical Museum. For more information on Johnston see Physicans.



Guest post by Dr. Chantal Atallah, Pathologist, Hôpital Régional de Saint-Jerôme



Wyatt Galt Johnston and the Montreal General Hospital Autopsy

At the Montreal General Hospital (MGH), an imposing brass plaque dedicated to Dr. Wyatt Galt Johnston flanks the door of the pathology grossing room leading on to the autopsy suite. Following his appointment as a pathologist at the MGH in 1884, Johnston performed over a thousand autopsies during his short career – he died at thirty-nine years of age from the complications of a cut sustained while performing an autopsy.1

Johnston shared with Maude Abbott an interest in the Museum. He suggested a classification scheme based on the Dewey Decimal System which Abbott developed and used for the McGill Museum and which was exported to other centers. He also suggested that she should organize a society with other curators to share museum specimens and knowledge, leading to the establishment of the International Association of Medical Museums in 1907 (later to become the International Academy of Pathology).2

Although the total number of specimens he donated to the Medical Museum is unknown, a review of the museum log books, produced after the 1907 fire which destroyed most of the original Medical Museum, yielded 48 specimens attributed to Johnston. Forty-two of these were accessioned between 1890 and 1903, while the remaining six were not dated. Roughly half of those specimens originated from the gastro-intestinal or respiratory tract and a wide variety of disease was illustrated, including the spleen in malaria and echinococcosis. Only three of Johnston’s specimens remain today: “atrial ball thrombus” (1890), “bulging fossa ovalis“(1896) and “scirrhous carcinoma of the stomach” (1895).

 

 

 

 

 

 

 

 

 

Atrial ball thrombus (1890)

This specimen shows a smooth surfaced thrombus occupying most of the left atrium. It originates from the autopsy of a 42 year-old female who suffered from rheumatic fever. Sir William Osler published articles on “ball thrombi” in 1891 and 1897. Both include mention of a specimen at the “Museum of the Medical Faculty of McGill University”. This specimen was lost and replaced by Johnston’s, likely by Maud Abbott to illustrate this cardiac pathology described by Osler. 3,4

 

 

 

 

 

 

 

 

Scirrhous carcinoma of the stomach (1895?)

This specimen shows marked thickening of the pylorus and loss of the rugal folds. Although definite confirmation is lacking, it likely originates from the autopsy of a 35 year-old male conducted in 1895. Johnston performed nineteen autopsies between 1886 and 1900 in which “carcinoma of the stomach” was a main diagnosis. Of these, three were “scirrhous carcinoma of the pylorus”; two in 1886 and one in 1895. Given the state of preservation, the latter case is the most likely candidate.

 

 

 

 

 

 

 

 

 

Bulging fossa ovalis
This specimen shows a fossa ovalis with multiple fenestrations bulging into the right atrium. It originates from the autopsy of a 47 year-old male who presented a dilated heart showing stigmata of rheumatic heart disease (mitral and aortic stenosis) along with pulmonary embolus and deep vein thrombosis. The latter were probably related to a hypercoagulable state secondary to a “fungating polypoid and necrotic” lesion of the stomach, likely an adenocarcinoma.  3

References:

  1. Report of the Committee on Resolutions on the Death of Dr. Wyatt Johnston Public Health Pap Rep 29, 416-418. 1903.
  2. https://www.mcgill.ca/medicalmuseum/introduction/history/physicians/johnston
  3. “Pathological Reports (Montreal General Hospital) no. IV” published in 1904.
  4. https://www.mcgill.ca/medicalmuseum/exhibits/maude-abbott-medical-museum-osler-collection/specimens/miscellaneous-cardiac-disease/27-heart-ball-thrombosis

 

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