The Hektoen Institute was founded by a group of dedicated physicians and public minded citizens and incorporated in 1943 to support research and educational programs designed to train physicians and other health professionals in the County of Cook. It was named in honor of Ludvig Hektoen, who was then the director of the John McCormick Institute and professor of pathology at Rush Medical College, and who was considered to be one of the first to devote himself prominently and consistently to medical science. He interned at Cook County Hospital in 1887.
The Institute was originally housed in the old Durand Building of Cook County Hospital, relocated in 1963 to the newly constructed Hektoen building, and in 2002 to its present address at 2100 W. Harrison Street. Over the years the Institute has encouraged investigators to pursue research in basic sciences as well as carrying out clinical investigations, particularly in leukemia, tuberculosis, nephritis, heart disease, and liver, gastrointestinal and surgical research. Hundreds of papers were published by Hektoen investigators, including more recent publications in the fields of trauma, cellular biology, and acquired immunodeficiency syndrome (AIDS). Funds from private contributions and from competitive grants have allowed Hektoen to support the activities of a large number of programs designed to advance the epidemiology and treatment of various diseases, further medical education, and provide support to afflicted patients and their relatives. Its board of trustees has consistently abided by its mission of extending the frontiers of science and developing better methods for the diagnosis and treatment of the sick. In 1998, the Hektoen Institute, L.L.C. was established as the operating entity to conduct the Institute’s activities.
Dr. Hektoen and Cook County
By Patrick Guinan, M.D.
In a real sense, the Hektoen Institute is the direct result of the humanitarian efforts of the doctors who trained and were staff attending physicians at one of the great hospitals in the United States, Cook County Hospital. Opened in 1866, the hospital’s charge was to care for patients in the county who lacked the means to pay for their medical care. Of necessity, the hospital was the product of the medical-education and health-care system of the 19th century. In the 1800s, before the release of the Flexner Report, many medical schools were mere diploma mills. Medical education, such as it was, was by preceptorship or by internship in such large charity hospitals as Chicago’s Cook County, New York City’s Belleview, Philadelphia’s General, or New Orleans’ Charity Hospital.
These public hospitals, because of their large volume of patients and unregimented atmospheres, attracted medical men of unusual talent and personality. To County Hospital came such giants as Drs. Nicholas Senn, John Murphy, Gideon Wells, Frank Billings, and Christian Fenger. These physicians cared for patients and taught students, but they also made original clinical observations, studied disease processes, and developed new medical and surgical treatments. In a word, they conducted medical “research.”
Of these pioneers, perhaps the greatest was Dr. Ludvig Hektoen, who interned at Cook County Hospital in 1887. His mentor was Dr. Fenger, acknowledged as the “father of pathology” in Chicago. Dr. Hektoen succeeded Dr. Fenger as the hospital’s pathologist in 1895, and for the next 30 years, he encouraged and guided most of the clinical research at the hospital.
Born in Wisconsin in 1863, Dr. Hektoen earned his medical degree from the College of Physicians and Surgeons in Chicago in 1887. He placed first in the Cook County Hospital intern examination and was an 18-month intern from 1887 to 1889. After succeeding Dr. Fenger in 1895, he remained active until his death in 1951.
Dr. Hektoen was an outstanding clinical investigator who appreciated the need to integrate the basic sciences into the study of the pathophysiology of disease. He also understood that the pursuit of the science of medicine would be protected from the pressures of day-to-day clinical care and administrative duties.
With support from the John McCormick Foundation, Dr. Hektoen founded and became the first director of the John McCormick Institute for Infectious Disease. A facility was constructed in 1910 for the institute at 625 South Wood Street, the site of the present Hektoen Institute. In 1917, the Durand Hospital was built for Dr. Hektoen’s patients at a site immediately south of the institute.
Dr. Hektoen was a systematic and orderly investigator, and the institute provided him and his associates with an atmosphere to apply the scientific method in the investigation of human disease. He remained director until 1937. In 1940, the institute closed because of financial problems following the Great Depression.
Incorporation of the Institute
Because Cook County Hospital was a tax-supported institution, the county commissioners appropriated money for direct patient care, but not for education or research. The void left by the closure of the John McCormick Institute became more pronounced with the medical needs created by World War II.
In 1943, a group of prominent physicians, including Drs. Karl Meyer, Morris Fishbein, Raymond McNealy, Hans Popper, Frederick Steigmann, Samuel J. Hoffman, and Morris T. Friedell, founded the Hektoen Institute for Medical Research. Its bylaws clearly express its aim; and its mission has resulted in a significant contribution to medical science in many areas, including the publication of more than 2,700 scientific papers.
The early years were driven by the energies of such early investigators as Drs. Steigmann, Howard Armstrong, Friedell, Steven Schwartz, Maurice Lev, Alvin Dubin, and Paul Szanto. During that period, its budget increased from $430,000 in 1958 to $1,937,000 in 1968. The high point may well have been the construction of the new Hektoen Building in 1964, with the help of $5 million from the federal government.
Some highlights of the early years are as follows:
- Dr. Steigmann and his gastroenterology group investigated hepatic coma and the use of live function tests, pioneered work in peritoneoscopy, and conducted research on peptic ulcers. He often collaborated with Dr. Meyer on diseases of the stomach.
- Dr. Armstrong conducted research on various aspects of renal diseases, especially the immunology of glomerulonephritis, often in collaboration with Dr. Abraham Mark.
- The hematologic group, under the direction of Dr. Schwartz, studied various aspects of the leukemias and anemias, especially sickle cell disease.
- Dr. Szanto and the division of pathology collaborated with other groups on many projects, especially liver disease and the effect of alcohol on various organ systems.
- Dr. Lev pursued numerous investigations in the area of congenital heart disease, particularly its effect on the conduction system.
During the 1960s, funding for clinical research projects was generous, particularly from the federal government as part of the Great Society programs. In the mid-1970s, however, during the Nixon era, this support diminished. The institute became less able to support all clinicians and directed its efforts mainly in the department of research biochemistry. Institute funding declined, but individual investigators continued the research work of the Hektoen Institute, including:
- A bridge between the two eras was provided by surgical research. Dr. William Shoemaker, with the support of Drs. Robert Freeark and Robert Baker, pursued research into the hemodynamic effects of dextran.
- More recently, under the direction of Dr. Harry Richter III, the division of surgical research investigated the pathophysiology of the gastroenterologic tract.
- Dr. George Dunea and the nephrology group have continued investigations on dialysis and renal problems. In collaboration with research biochemistry, they have worked on uremic toxins and mechanisms of uremia.
- Dr. Irving Bush has worked on problems of urologic oncology, especially prostate cancer.
- Dr. Marvin Rubenstein has added an immunologic dimension to these investigations by evaluating the immune responses to tumors and the role of sensitized lymphocytes.
- The Burn Group, led by Dr. Takayoshi Matsuda, has evaluated the effect of administering large doses of vitamin C to reduce fluid loss in extensively burned patients.
- Dr. Samuel J. Hoffman, who had directed the institute since its founding in 1943, died in 1989 and was succeeded by Professor Dubin, who died suddenly in 1991.
In the 1990s the focus of the Institute began to change. Educational activities and support for laboratory research continued, but grant management expanded considerably.
The HIV/AIDS epidemic provided an opportunity to promote community care, with grants, clinics, symposia, and clinical research. In time the HIV- related programs became a major activity of the institute. Later grants addressed domestic violence, child welfare, drug addiction, prison medicine, and women’s’ health.
Throughout the decade Hektoen also funded a mentorship program in which promising pupils from inner city high schools spent their summer vacations working and being tutored by Hektoen researchers. This successful program resulted in several of the mentored pupils being later admitted to higher education institutions in science, medicine, and veterinary sciences.
The first decade of the 21st century saw a significant expansion of Hektoen’s educational activities, with regular programs and lectures given under the auspices of the . Chicago Society of Medical History & Humanities, the Gasul Club of Pediatric Cardiology, and the Nurses & the Humanities group.
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