Between 1850 and 1875, largely due to the flood of westward migration,the population of Chicago leapt from 28,000 to 400,000. The influx of private enterprise, wealth, and civic pride fostered the establishment of a wide variety of medical services that eventually developed into specialization programs in neurology. As in other American cities, early neurological care in Chicago began with efforts to attend to the insane. In 1847, Edward Mead, an English immigrant who settled in the Chicago area, set up the first private sanitorium for nervous patients in Chicago, including a wide variety of disorders. Walter Hay moved to Chicago from Washington DC in 1853, founded St. Luke's Hospital in 1864, and developed the Department of Nervous and Mental Diseases at Rush Medical College in 1871. He was one of the founding members of the American Neurological Association (1875). His two close Chicago colleagues were JS Jewell, the first president of the American Neurological Association, and HM Bannister, another charter ANA member.

EDWARD MEAD

E. Mead, born in 1819, was an English immigrant to the United States and settled west of Chicago in St. Charles, Illinois. He worked ardently to establish the Illinois State Hospital for the Insane and established the first private Chicago sanitorium for nervous patients in 1847.

WALTER HAY

W Hay was one of the original founders of the American Neurological Association and was responsible for the original organization of the Chicago Department of Health. He developed the Department of Mental and Nervous Diseases at Rush Medical College and succeeded JS Jewell as Professor of Nervous and Mental Diseases at Northwestern.

HENRY M. BANNISTER

HM Bannister moved to Chicago in 1874 from Washington DC. With JS Jewell, he organized the Chicago Journal of Nervous and Mental Disease that later became the Journal of Nervous and Mental Disease.

JAMES S. JEWELL

JS Jewell was the first president of the American Neurological Association, and served from 1875 until 1879. He was the first Professor of Nervous and Mental Diseases at the Chicago Medical College, predecessor of Northwestern Medical School. A man of wide interests, he developed an extensive library that became part of the Newberry Library and later the Crerar Library.

Between 1875 and 1900, the dichotomy between wealth and poverty in Chicago magnified, and against the backdrop of the World's Columbian Exposition, strikes and civil unrest punctuated the city's history. In 1859, City Hospital was established to deal with the indigent of the city and later this institution was renamed Cook County Hospital. Large wards accommodated acute and chronic neurological conditions of particularly high prevalence among the indigent and workers enduring substandard factory conditions, including traumatic injuries, heat exhaustion and infectious diseases. In addition to studying these diseases, Chicago neurologists published extensively on railway injuries and neurobehavioral disorders like neurasthenia that were occupationally associated with job stresses and the pressured lifestyle of industrialized America.

NEUROLOGY IN THE WORKPLACE

Meat packers and factory workers in proximity to high power machinery were prone to numerous traumatic injuries. Those handling food in crowded sub-standard conditions participated in transmission of infectious and toxic neurological syndromes.

FREE DISPENSARY FOR THE POOR

Services to the City's poor were centralized as shown in this early photograph (c1875) of the Free Dispensary. The dispensary catered to outpatients and especially immigrants during the early period after their arrival in Chicago.

THE WORLD'S COLUMBIAN EXPOSITION

The World’s Fair of 1893 focused international attention on Chicago with particular emphasis on scientific, technological and medical advances.

OCCUPATIONAL NEUROLOGY

Living in the railway center of the US, Chicago neurologists like J.S. Jewell and Hugh Patrick became familiar with conditions like “railway spine” and neurasthenia among workers who endured dangerous and emotionally-stressful conditions in this new industry.

ERICHSEN'S SPINE

Chicago neurologist, SV Clevenger, wrote the widely circulated "Spinal Concussion" in which he described the syndrome otherwise known as "railway spine" or "Erichsen's Disease." The topic was embraced by some and disputed by others who favored the diagnosis of malingering for many such patients. Among his critics, CM Dewey wrote this derisive poem.

MEDICO-LEGAL ISSUES IN NEUROLOGY

As with many early neurologists, HM Lyman became involved in Medico-Legal issues, in this case writing on injuries of the spinal cord. (Courtesy of Rush Medical Archives, Rush-Presbyterian-St. Luke's Medical Center).

NARCOTICS CASE

At the time of the Spanish-American War, Chicago nurses were recruited by the US Navy and Military divisions to handle war wounds and injuries. This narcotics case with vestiges of medication still intact dates from this period.

(Narcotics case: courtesy of the Natalie A. and Louis D. Boshes MD Library of the Neurosciences, University of Illinois at Chicago. Nurse photograph: courtesy of Rush Medical Archives, Rush-Presbyterian-St. Luke's Medical Center).

Throughout most of Chicago's history, three medical schools, their neurological programs and a variety of hospitals housed themselves in close geographical proximity on the near west side of Chicago, termed "Illinois Medical District". These structures were built after the earliest medical schools were largely destroyed by the Chicago Fire in 1871. Here the University of Illinois at Chicago, Rush Medical College, Chicago Medical School, Cook County Hospital, the VA Hospital and all ancillary services co-existed on the largest medical agglomeration in the United States. Conferences, teaching activities, and libraries were largely open to all interested participants regardless of program. Decentralization and the development of large suburban populations have since shifted the concentration. Currently two medical schools, Loyola and Chicago Medical School, have their primary medical campuses outside of Chicago on suburban sites. The downtown location of Northwestern and far south side campus of the University of Chicago have traditionally drawn on these populations, but now extend to a wider city-based and national network of neurological referral patterns. (See section Hospitals and Universities.)

HUGH T. PATRICK

HT Patrick was Chicago’s first neurologist to enter the field without prior training in state hospitals for the insane. Choosing to study in the neurological centers of Europe, he developed a wide array of international neurological contacts and welcomed European neurologists to Chicago.

HENRY M. LYMAN

HM Lyman was born in Hawaii and graduated from the College of Physicians and Surgeons in 1861. He moved to Chicago in 1863 and became Professor of Physiology and Nervous System Diseases at Rush Medical College in 1876. Allied closer to general medicine than psychiatry, Lyman authored Treatise on the Theory and Practice of Medicine (1892) and was instrumental in separating neurology from psychiatry in Chicago.

THE CHICAGO FIRE

The Great Chicago Fire occurred October 8, 1871. In its 36 hour duration, it destroyed one third of the city including important medical facilities. The map below shows the extent of the fire. No photographs of the fire are known to have survived. Although the painting by artist James Session depicts the fate of the “fire-proof” Tribune building, the paper resumed publishing the next day.

THE CITY'S PUBLIC HOSPITAL - COOK COUNTY HOSPITAL

The original public hospital of the City of Chicago was named City Hospital but was later renamed Cook County Hospital. Shown here are two early depictions of the hospital's facilities located on Harrison Street: early Cook County Hospital (below c1895) and a scene of a hospital building prior to 1920 (second photo below). This building was vacated in 2003 but still stands.

Though designed as a charity hospital for the urban poor, the architectual facade of Cook County Hospital (shown here when first built in 1912-13) was grand and combined classical and barroque motifs.

The tradition of a volunteer Hospital in Chicago was embodied in Cook County Hospital, where physicians from multiple medical centers participated in clinics. James B. Herrick is shown here conducting a medical clinic in the amphitheater (1900).