THE HISTORY OF THE DEPARTMENT
P. Neifeld, M.D.,
F.A.C.S. | Stuart
McGuire Professor and Chairman
The history of the
Department of Surgery and the Medical
College of Virginia go hand
1837, Dr. Augustus Warner, a graduate
of the University of Maryland who was
on the surgical faculty at the University
of Virginia, became disillusioned with
the clinical material available and felt
that Richmond would provide a much broader
patient base. He organized a petition
to have Hampden-Sydney College put a
medical college in Richmond.
Dr. Warner became
the first Professor of Surgery, as
well as Dean when the institution opened
in 1838. He was known for being a superb
surgeon, performing a partial mandibulectomy
in nine minutes! The first permanent
building was the Egyptian Building,
which opened in 1845 and is still being
used as a building for the Medical School.
This was the first permanent hospital
of the Medical College of Virginia
and had well ventilated wards and private
Dr. Warner died in 1847
(probably of appendicitis) and was succeeded
by Dr. Charles Bell Gibson. Dr. Gibson
was also a well known surgeon and was
one of the first surgeons to use anesthetics.
He wrote on femoral artery ligation,
treatment of femur dislocations,
and resection of a maxillary sarcoma.
In 1861 the Commonwealth of Virginia
organized its military forces with a
medical department under Dr. Gibson as
Surgeon General. He died in 1865.
the time of the secession of the South,
there were many Southerners attending
medical schools in the North. A large
group was in Philadelphia. Hunter
Holmes McGuire led a group of 150
medical students to Richmond, many of
whom transferred to the Medical College
of Virginia. Through the Civil War many
of these people made major contributions
to the Confederate cause.
was well known and thought to have been
a major figure for the southern medical
establishment during the Civil War, but
he was actually quite junior. His wartime
notoriety derives from the amputation
of the arm of Stonewall Jackson and his
subsequent demise (probably from pneumonia).
Dr. James McCaw, who served MCV for about
50 years, planned and organized the largest
hospital that ever existed in the western
Hospital was located just east of
the Medical College of Virginia campus
and was said to have had as many as 7000
beds. It had one of the lowest mortality
rates of any hospital in the Civil War.
The buildings were ventilated and accommodated
40 to 60 patients. There were also approximately
100 tents with eight to ten soldiers
or convalescent patients per tent. Over
76,000 patients passed through this hospital
and 7000 died, an exceptionally good
record for the time.
MCV was the only southern medical school
to remain open throughout the Civil War.
The fire that burned much of Richmond
at the end of the war did not affect
Learn more: Civil War Hospitals in Richmond.
After the war,
Dr. McGuire practiced in Richmond and
became closely associated with MCV.
He became the third Professor of Surgery
in 1865. He was one of the first surgeons
to practice Listerism, the first to
perform a suprapubic cystostomy, and
he reported ligation of the abdominal
aorta. Despite a busy private practice
he was always willing to treat charity
cases and treated Confederate soldiers
without charge. He is one of the very
few to be President of the American Surgical
Association, Southern Surgical Association,
and American Medical Association. He
was Professor of Surgery until 1881 but
resigned following a fight with the Board
of Trustees. After his resignation, he
founded St. Luke’s Hospital and
in 1892 his interest in teaching led
him to help found a new medical school,
the University College of Medicine. This
medical school developed a faculty better
than MCV’s and the curriculum was
extended to three years.
The fourth Chairman of Surgery at MCV
was appointed in 1881: Dr. John Dorsey
Cullen. He had been assigned to General
Robert E. Lee during the war. He was
said to have been a skillful surgeon
and an excellent teacher. He published
on hepatic abscess, traumatic tetanus,
and diseases of the bones. After his
death in 1893, George Ben Johnston became
the next Professor of Surgery. He was
also an advocate of Listerism and published
on nephrectomies, imperforate anus, renal
and hepatic diseases, and biliary surgery.
He became President of the Southern Surgical
Association and the American Surgical
Association. During his time as Chairman,
MCV became the first medical school in
Virginia to require a four-year term.
Following the Flexner Report, Dr. Johnston
and Dr. Stuart McGuire, then President
of the University College of Medicine,
merged the two medical schools in 1913
to form the new Medical College of Virginia.
Dr. Stuart McGuire, son of Dr. Hunter
McGuire, was an eminent surgeon in his
own right and was chosen Dean of the
Faculty. Dr. Johnston died in 1916 and
Dr. McGuire took over as Chair of Surgery.
He became known for his publications
on toxic goiter, cholecystitis, and appendicitis.
He was said to be an outstanding organizer
During this period of time World War
I was raging in Europe and it was decided
to organize a Red Cross Hospital in Richmond
based on MCV. Dr. Stuart McGuire helped
organize this unit. He was the first
Director of this unit, was replaced on
a temporary basis by Major Alexander
Williams, but after the unit went to
France, Dr. McGuire resumed his position
as Director. Base Hospital No. 45, as
it was known, was supposed to be far
behind the front lines but it actually
was within a few miles of the front lines
and served not just as a base hospital
but as a triage and evacuation hospital.
Within two weeks of a major United States
offensive in September, 1918, 8000 casualties
arrived. The mortality rate was one of
the lowest of any of the military hospitals
of that time; Dr. McGuire was awarded
the French Medal of Honor as well as
the Distinguished Service Cross from
the United States Government.
Following the war, Dr. McGuire became
President of MCV. In that position he
had to give up being Professor of Surgery
and Dr. Murat Willis succeeded him. Dr.
Willis had a busy clinical practice,
apparently was rarely at MCV, and most
of the teaching was done by Dr. Paul
LaRoque. Dr. LaRoque arrived in Richmond
in 1905 to join the faculty of the University
College of Medicine. He was a prolific
writer on many subjects including pelvic
surgery, vascular surgery, and intestinal
obstruction, but his major contribution
was in the field of hernia surgery. He
died suddenly in 1934.
One of the critical
problems the Medical School faced was
the lack of a full time faculty. Dr.
Isaac A. Bigger was appointed as the
first full-time Chair of Surgery in
1930. He was one of the most beloved
men of his time. His primary contributions
were in thoracic and cardiovascular surgery.
He was the first to resect a pulmonary
bleb, which is responsible for spontaneous
pneumothorax. The repair of tracheo-esophageal
fistulae was another major interest of
his and he accomplished one of the first
major series of successful heart wound
repairs. He co-edited a very successful
operative surgery textbook into a sixth
edition with Dr. Guy Horsley. Dr. Bigger
was President of the Southern Surgical
and was instrumental in the formation
of the Virginia Surgical Society. During
Dr. Bigger’s 25 years as Chairman
of the Department of Surgery, research
laboratories, a better defined residency
program, and excellence in clinical care
all developed. Dr. Everett Evans was
a brilliant faculty member recruited
by Dr. Bigger to develop burn wound care.
The Burn Unit was the first civilian
intensive care unit in the United States
and the first burn formula for fluid
replacement was developed under Dr. Evans’ leadership.
World War II was imminent, military hospitals
were again based on individual university
and large private hospitals. Dr. McGuire
was asked to reorganize Base Hospital
No. 45 as the 45th General Hospital but
due to age and poor health he asked Dr.
Carrington Williams to take over. The
surgical services were organized into
General Surgery and other services under
the overall leadership of Dr. Guy Horsley.
The Unit served with distinction in North
Africa and Italy and a large number of
MCV physicians and nurses made names
for themselves. The Unit established
the first blood bank in a military hospital
in March, 1944, and soon averaged about
430 units transfused per month. Secondary
wound closure (at day four to five) was
pioneered in this unit, fibrin sealant
was first used for brain surgery and
hepatic hemorrhage, primary nerve repair
was developed as was a method of rapid
blood acquisition. These advances were
soon used throughout all military hospitals.
After World War II,
people returned home and the Department
of Surgery continued to flourish under
Dr. Bigger until his death in 1955. In
1956, a young surgeon from Boston, David
Hume, was named Chairman of the Department
of Surgery. Dr. Hume became the beneficiary
of one of the largest NIH grants ever
awarded to that time, over six million
dollars, and developed a transplant program
at MCV. His research included work in
transplantation, endocrinology, vascular,
and bariatric surgery. He mapped the
hypothalamus and published seminal papers
on pheochromocytomas and parathyroid
disease. He helped describe the use of
azothioprine, steroids, and total body
irradiation for immunosuppression. Dr.
Hume was a revered figure, superb teacher
and developed an incredible faculty.
Dr. Jim Brooks, a pioneer in thoracic
surgery, Dr. Arnold Salzberg, a pioneer
in pediatric surgery, and Dr. Richard
Lower, who developed the technique of
heart transplantation in animals, were
members of the faculty. Dr. B. W. Haynes
became Director of the Burn Unit and
Dr. Walter Lawrence, Jr., an eminent
surgical oncologist, founded the first
Division of Surgical Oncology at any
university hospital. Many leaders in
transplantation and other leaders in
American surgery were trained under Dr.
In 1973, Dr. Hume died in a plane crash
in Southern California. Dr. Lawrence
was the Interim Chairman until the arrival
of Dr. Lazar Greenfield in 1974. Dr.
Greenfield headed the Department for
12 and one-half years. He provided a
great deal of stability, had a major
interest in thrombo-embolic disease,
and worked closely with Thoracic Surgery,
Vascular Surgery, and Cardiac Surgery.
Dr. Greenfield hired a large number of
faculty and both research and clinical
care continued to flourish. In 1986,
Dr. Greenfield left to become Chair of
Surgery at the University of Michigan
in Ann Arbor.
Dr. Andrew Wechsler was recruited from
Duke in 1988, and brought very much of
a business atmosphere to the Department.
Dr. Ronald Merrell was recruited from
Yale in 1999, and during his brief tenure
the Hume-Lee Transplant Unit and the
Evans-Haynes Burn Unit became realities.
In 2003, Dr. Merrell resigned as Chairman
and the current Chairman, Dr. James Neifeld,
became Chairman of the Department of
Surgery. During the next three years,
many faculty were hired in the Department
both in clinical and research positions,
teaching was revamped, and the administrative
aspects of the Department were enhanced
to meet current requirements. The Department
has jumped from 42nd to 27th nationally
in NIH funding. The institution continues
to develop the campus to expand clinical
and research activities, and the future
information about these historic
To view a historical
timeline of MCV