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The Children’s Hospital, Boston
Abelardo A. Retureta, MD; Oscar Papazian, MD; Julia M. Retureta-Soler, MD; Graciela C.
Retureta, PharmD
The Children’s Hospital, Boston was founded in 1869, fourteen years after the
foundation of the first children’s hospital in the United States, the Children’s
Hospital of Philadelphia, which opened its doors in 1855. Thereafter, children’s
hospitals were established in Washington DC (1870), New York City (1870), Albany (1875),
San Francisco (1875), St. Christopher’s Hospital for Children, Philadelphia (1875),
Detroit (1877), St. Louis (1879), and Cincinnati (1883).1,2
The Children’s Hospital, Boston was founded by Dr. Francis Henry Brown, Reverend
Chandler Robbins, D.D., Mr. George H. Kuhn, Mr. J. Huntington Wolcott, Dr. William
Ingalls, Dr. S. G. Webber, and Dr. S.W. Langmaid. It had twenty beds.3
The Children’s Hospital, Boston was largely influenced in its origin by the
founding of the Hospital for Sick Children, Great Ormond Street of London (1852) and the
Children’s Hospital of Philadelphia (1855).3-5
Before the nineteenth century, children were indiscriminately treated along with adults
in general hospitals.2 Evidence of neglect, cruelty, and infanticide were abundant, and
the mortality within the first five years of life was higher than 75%.6 The Massachusetts
General Hospital cared for children since its opening in 1811, but children were treated
mixed with adults both in the hospital and in outpatient dispensaries. Very young children
used to remain with their mothers.2
From 1846 to 1851 more than 65 000 people entered Boston from Ireland, compared to 10
000 during the preceding 30 years.7 In the 1860s living and sanitary conditions in Boston
must have been as bad, if not worse, than those in London. The circumstances were even
more dreadful for less fortunate families. In 1865, babies and children in Massachusetts
cities other than Boston had a better chance for survival.3 By the 1870s, Boston had a
population of 200 000 to 300 000. By 1875, the mortality rate in Boston was 96.2 deaths
per 1000 children less than 5 years of age.3
Among the diseases which caused death in Boston were smallpox, scarlet fever, measles,
cerebrospinal meningitis, whooping cough, diphtheria, croup, typhoid fever, diarrheal
diseases, bronchitis, pneumonia, consumption or phthisis (or "tubercular
disease"). In 1872 to 1873, smallpox had reappeared in its most severe epidemic since
vaccination was introduced in 1800.3
There was little to offer the parents of infants and children whose illnesses had not
been prevented. Harvard Medical School, founded some 70 years before, offered training in
medicine and surgery but little about diseases of children in what was later called
pediatrics.3
In 1871, Dr. Francis Minot first mentioned diseases of children when he became
"Clinical Lecturer on the Diseases of Women and Children" and began teaching
about "a few lectures on the eruptive fevers," as described by Dr. John Lovett
Morse.3,8
The Archives of Pediatrics first appeared in New York in 1884. There were few
textbooks, most of them reprinted, like Charles West’s 1848 Lectures on the Diseases
of Infancy and Childhood. In 1869, the Treatise on the Diseases of Infancy and Childhood
by Job Lewis Smith, curator to the Nursery and Child’s Hospital, New York, appeared.
Physicians and surgeons of a children’s hospital, in general, would have to be
self-taught.3
Children’s Infirmary in Boston (1846-1848)
The Children’s Infirmary in Boston was founded in 1846 by Mr. Amos Lawrence
(1786-1852) in a large house on Washington Street. It had 30 beds. The announcement of its
opening appeared on page 65 of the Boston Medical and Surgical Journal for February 17,
1847. The facility was located near the Lying-in Hospital, and it was for the reception of
sick children between 2 and 16 years of age. Dr. William R. Lawrence (Mr. A.
Lawrence’s son) and Dr. John Ware were appointed to the facility and nurses were
provided.3
During the first 10 months, 174 patients were admitted to the facility—142 Irish,
21 American, and 11 others. Of these 174 patients, 117 were less than 15 years of age.
Common admitting diagnoses to the facility were: fevers, "Ship fever," and
"extreme prostration" from the privation of a long sea voyage. The children were
cared for by the matron and the chief nurse, but they received very little medicine. There
were no eruptive diseases of childhood nor communication of disease to other patients
reported. But Dr. J. B. Alley, Admitting Physician, in the hottest part of the summer
contracted a long and dangerous fever from which he recovered.3
On November 1, 1847, the facility moved from Washington Street to the corner of West
and Mason Streets. Only one year later, on November 29, 1848, Dr. W. R. Lawrence closed
the Children’s Infirmary. During its 18 months of existence, the Children’s
Infirmary had admitted 192 patients under 15 years of age.3
Between the closing of the Children’s Infirmary and the proposal for a
Children’s Hospital 20 years later, little if any change occurred that might improve
the health of the children, except kindly sentiments toward "the little
sufferers."3
The Children’s Hospital, Boston
The First Hospital (1869-1870)
The Children’s Hospital, Boston was founded as the results of the ideas and acts
of: (1) four physicians, who since late 1868 and January of 1869, were calling for its
development, (2) a board (trustees) of twelve managers and their four officers, and (3)
the approval by the Commonwealth of Massachusetts (Legislature) for its incorporation by
February 26, 1869. The first announcements of the creation of the Children’s
Hospital, Boston appeared in the Evening Transcript of Boston on July 21, 1869.3
The original building was located on 9 Rutland Street, about 200 feet from Washington
Street. The first floor of the house contained the reception room, manager’s room,
dining room, kitchen, bathrooms, and dispensary. The other three floors were used for
wards which contained 20 beds. There was also a room for the superintendent or matron of
the hospital and another room for two other nurses.3 The objectives of the founders of the
hospital were: (1) the medical and surgical treatment of children; (2) the diffusion of
knowledge regarding the diseases of children, and (3) the training of young women in the
duties of nursing.3
The Four Founding Physicians
The four founding physicians of the Children’s Hospital included Dr. Francis H.
Brown, Dr. William Ingalls, Dr. S.G. Webber, and Dr. S.W. Langmaid. The original 4-man
staff included Drs. Brown and Langmaid as surgeons, and Dr. Ingalls and Dr. Francis B.
Greenough as physicians.3
Dr. Francis Henry Brown is considered the founder of the Children’s Hospital. He
was also its first secretary and its indefatigable and very effective public relations
officer. He was born in Boston on August 8, 1835. He received his medical degree in 1861
from Harvard Medical School. He opened an office for medical practice in Cambridge. By
1864 he was assistant surgeon (under Dr. Ingalls) to the United States General Hospital at
Readville, Massachusetts. After a few months, he returned to civilian practice in Boston.
His wife died in 1865 after four years of marriage. In 1867, he traveled to Europe to
study the opening of European hospitals. In 1868, he accepted an assignment from the
committee planning Harvard’s Civil War Memorial Hall project. He recorded more than
900 names of men from Harvard classes. He also worked as editor of the Boston Medical and
Surgical Journal and helped to establish the Medical Register of New England annual
volumes.3
Dr. Brown served as secretary of the Children’s Hospital Board until 1915, a total
of 46 years. He was also a member of the surgical staff and Board of Managers of the
Children’s Hospital until his death at 82 years of age on May 16, 1917, when a
streetcar accident ended his life. Two days before the accident, on May 14, 1917, Dr.
Brown took a prominent part in graduation exercises held at the Harvard Medical School by
the Children’s Hospital’s Training School for Nurses.3 As written in the Boston
Medical and Surgical Journal’s obituary editorial, "Dr. Brown had been for many
years a familiar, quiet, and benign figure. . . pleasant and sociable to meet. . . a most
kindly and benevolent friend."3,9
Dr. William Ingalls was born in 1813 and graduated from Harvard Medical School in 1836.
He was the oldest of the four founding physicians. He served in the Civil War. After the
war and for 21 years he practiced in Boston, much of the time on the surgical staff of
Boston City Hospital. He also delivered about 2000 consecutive obstetric cases with no
instance of puerperal sepsis, and only three deaths. He published "A Case of
Progressive Muscular Sclerosis" together with Dr. Samuel G. Webber. He died in 1903
at the age of 91 years. He was still a consulting surgeon to the Children’s Hospital
he had helped to found more than thirty years before. The Boston Medical and Surgical
Journal’s obituary editorial described him as "a doctor of the old school. . .
in fullest sympathy with young men. . . pressing forward upon the threshold of entrance to
the profession. . ."3,10
Dr. Samuel Gilbert Webber was born in 1838. He was the youngest of the four founding
physicians. In 1862, while attending Harvard Medical School, he enlisted in the Union Navy
as Assistant Surgeon and served in the Civil War. In 1865, at the end of the war, he was
given his M.D. degree without further study. In 1893 he became the first Professor of
Neurology at Tufts Medical School where he served until his retirement in 1902. He was
well published and was known as the first real "nerve specialist" in Boston. Dr.
Webber was the only physician of the four founders whose name was never listed among the
staff of the Children’s Hospital, Boston.3 Boston Medical and Surgical Journal’s
obituary in 1926 described him as "a man of short stature [with] a full beard and
kindly smile, a familiar figure on the streets of Boston for many years."3,11
Dr. Samuel Wood Langmaid was a year older than Dr. Webber. He graduated from Harvard
Medical School. As a medical student and surgical house-pupil to Dr. R. M. Hodges at the
Massachusetts General Hospital in 1863, Dr. Langmaid published a number of surgical case
reports to the Boston Medical and Surgical Journal. Upon his graduation in 1864 and
volunteering for military service, Dr. Langmaid was soon transferred to the army hospital
at Readville where Drs. Brown and Ingalls were also serving. In 1865, Dr. Langmaid, like
Dr. Brown, studied for a few months in Europe. He served on the surgical staff of the
Carney Hospital from 1868 to 1880, and in the same capacity at the Children’s
Hospital from its opening in 1869 and for the next sixteen years. In 1886, Dr. Langmaid
was named as the first surgeon for diseases of the throat in the Children’s Hospital.
He was also President for many years of the Harvard Musical Association. He had a
beautiful tenor voice and liked to promote good singing. Dr. Langmaid lived long enough to
see the purchase of the first and second Children’s Hospital buildings and the
erection of the third and fourth.3
He died in 1915 at the age of 78 years. Boston Medical and Surgical Journal’s
obituary described him as a man who "thoroughly enjoyed the life in the open, the
intelligence of his dog, and the fine art of angling.3,12
Dr. Francis B. Greenough graduated from Harvard Medical School and did his postgraduate
studies in Vienna. He served the Children’s Hospital for 4 years.3
By 1870, the Children’s Hospital’s professional staff had expanded from four
to six, with the additions of physician Benjamin Eddy Cotting, MD (1812-1897) and surgeon
John Homans, MD (1836-1903). Dr. Homans was a consultant in surgery until his death.3
The first superintendent or matron at the Children’s Hospital, Boston was
deaconess of the Episcopal Church, Mrs. Adeline Blanchard Tyler (1805-1875). Mrs. Tyler
served gratuitously for 3 years.3
During its first year, the hospital treated 69 children, 49 boys and 20 girls. Medical,
surgical, and orthopedic conditions were then common diagnoses at the "cozy little
institution..." within the "neat, apt and thorough general appearance of the
house."3,13
The Second Hospital (1870-1882)
As Dr. Francis H. Brown had predicted, the hospital soon became "somewhat
crowded."3 On July 28, 1870, the hospital was moved to its second location to the
"Fine Brick House" at Rutland and Washington Streets, one year after the
dedication of the original hospital building. This new building was a large mansion which
provided space for 30 beds which were arranged and convenient with light, sun, air, water,
and all the conveniences. But larger quarters meant more patients and more work for the
Superintendent and the Medical Staff.3
Dr. Joseph P. Oliver (1845-1903) replaced Dr. Ingalls in 1872.3 In March 1872, Mrs.
Adeline Blanchard Tyler resigned due to health problems and Sister Theresa of the English
Sisterhood of St. Margaret was appointed as the new Superintendent to the Hospital.3 By
1873, Dr. William Lambert Richardson occupied the position on the Medical Staff vacated by
Dr. Cotting.3 Two other surgeons, Dr. Edward Hickling Bradford and Dr. Arthur Tracy Cabot
replaced Drs Brown and Ingalls’ surgical work in 1878 and 1882, respectively. Dr.
Allen Melancthon Sumner (1844-1901) replaced Dr. Greenough in 1874.3
By 1882, a pathologist, Dr. W. F. Whitney, two assistant physicians, and an assistant
surgeon were appointed. One of the new assistant physicians was Dr. Thomas Morgan Rotch
(1849-1914). He was age 34 when appointed. Dr. Rotch was to play an important role to the
further development of the Children’s Hospital.3 Dr. Samuel Wood Langmaid was the
only active staff member of the four founding physicians remaining at the Hospital when
its Washington Street years ended in December 1882.3
The Third Hospital (1882-1914)
On December 26, 1882, the hospital was relocated to a land on the north side of
Huntington Avenue, just beyond the future (and present) Symphony Hall. The central portion
and the west wing of the building provided beds for 60 children—twice the number of
the previous hospital. In 1890, an east wing was added to the building giving the hospital
a total of approximately 96 beds. This area of the new building was considered "the
best in Boston." A new Harvard Medical School was erected there in 1906.3
The brick facade of the new hospital building was of the high Renaissance style. Most
of the 60 beds were in the two west wing wards; others were in rooms on the second and
third floor of the central administration block, the fourth floor could also accommodate
two or more beds. Five rooms were designated for private patients and three for special
cases. The wards in the Huntington Avenue Hospital had high ceilings, good light, and
adequate circulation.3
The Children’s Hospital, throughout its 32 years at Huntington Avenue, steadily
increased the amount and quality of its medical care. Outpatient visits jumped from 421 in
1882 to 1488 the following year. Medical and surgical admissions increased from 862 in
1883-1885 to 2417 in 1896-1898, to 5062 in 1911-1913. In 1888, a separate adjacent
outpatient building opened, which received nearly 6000 visits in its first year.3
Superintendents to the Children’s Hospital during this period were: Sister Maria
in 1888 (who succeeded Sister Theresa), Sister Caroline in 1893, Sister Katherine in 1907,
Sister Susanna in 1909, and Sister Caroline in 1913. In 1917, Sisters of St. Margaret
withdrew from the Children’s Hospital after 45 years of "loving care."3
Major causes for admission to the Children’s Hospital during the Huntington Avenue
years were medical, surgical, and orthopedic conditions. There was a constant predominance
of children with tuberculosis in its manifestations to the skeleton, spine, hips, and
knees, as well as tuberculous meningitis. Many medical, surgical, and orthopedic
physicians and administrators worked at the Children’s Hospital between 1882 and
1914.3 In 1900, the first pediatric radiology department in the country was organized at
the Children’s Hospital.14 In 1903, the Children’s Hospital became a teaching
hospital after formalizing its ties with Harvard Medical School.14
Among the pioneers in bone and joint surgery were Drs. Edward Hickling Bradford, Robert
Williamson Lovett, Elliott Gray Brackett, Joel Earnest Goldthwait, and Arthur T. Legg.3 By
1914, one of the first independent physical therapy departments in the country was
organized at Children’s Hospital.14 Among the general surgeons at Children’s
Hospital were Drs. Arthur Tracy Cabot and Herbert Leslie Burrell.3
On the medical staff, three physicians held senior staff positions during this period:
Dr. Ferdinand Gordon Morrill, who was concerned with passive immunization to diphtheria;
Dr. Edward Marshall Buckingham, who was involved in 23 cases of malaria seen at the
Children’s Hospital between 1870 and 1892, did studies on the sterilization of milk
in 1898, and was Vice-President of the American Pediatric Society in 1900; and Dr. Thomas
Morgan Rotch (1849-1914), who held the senior staff position from 1884 until his death and
was a key figure in American pediatric history.3
Dr. Rotch graduated from Harvard Medical School in 1874 with honors. He became very
interested in the diseases of infants and children and was an early advocate of the
modification of cows’ milk with water, cream, proteins, and various sugars, to make
its composition more similar to that of human milk. As a result of his pioneering
research, in 1891 the first laboratory for the modification and production of
bacteria-free milk was organized at the Children’s Hospital.3,14 In 1895, Dr. Rotch
published a textbook entitled Pediatrics: The Hygiene and Medical Treatment of Children,
and in 1910, he published The Roentgen Method in Pediatrics.3 Dr. Rotch was "amongst
a few, who in America raised pediatrics to the rank of a genuine science and humane
practice," as quoted by Abraham Jacobi in 1914.3,15
In 1902, following the death of Dr. Rotch’s only son due to pneumonia at the age
of 23 years, the hospital was renamed the Thomas Morgan Rotch, Jr., Memorial Hospital for
Infants. The name was shortened to Infant’s Hospital in 1907, and later to
Children’s Hospital. In 1904, a building fund campaign was launched to build a new
and modern building for the Hospital.3
The Fourth Hospital (1914-present)
On March 3, 1914, Children’s Hospital, Boston relocated to its fourth building at
300 Longwood Avenue. With plenty of land to build upon, new ward buildings or pavilions
were built gradually. They were connected by long covered passageways but separated enough
to have abundant light and air as recommended 60 years before by Florence Nightingale. In
the Central Administration building were offices, reception rooms, examining rooms,
kitchen and serving rooms, superintendent’s suite, x-ray department,
house-doctors’ quarters, ladies’ aid rooms, and servants’ quarters.3
To the west were the dispensary; receiving, waiting, examining, treatment, and plaster
rooms; an isolation suite; and a gymnasium. There were a few rooms for private patients on
the top floor.3 The Nurses’ Home, to the east, was built for 70 nurses, with five
rooms for the sisters in charge of the hospital.3
The first ceremony held in the new building was the funeral service for Professor
Thomas Morgan Rotch, MD. The Boston Transcript for April 15, 1914, described the
"formal dedication of the new and adequate buildings of the Children’s Hospital
on Longwood Avenue," with President Lowell of Harvard, Dean Bradford of the Medical
School, and Mayor Curley of Boston as speakers.3
The Infants’ (Children’s) Hospital staff in April 1914 included Medical
Director Dr. George S. Derby; four pediatricians: John Lovett Morse, William Howell,
Arthur A. Howard, and Charles Hunter Dunn; surgeon Beth Vincent; consulting surgeons John
Collins Warren and Edward H. Bradford; pathologist William T. Councilman; radiologist
Percy Brown; and neurologist George T. Waterman. Other pediatric subspecialties were also
covered and available for consultations at the hospital.3
After the departure of the sisters of St. Margaret in 1917, and until 1933, Ida C.
Smith, RN, was the Hospital’s superintendent. She was succeeded by Mr. George von L.
Meyer who was an excellent director and administrator especially during the World War II
years.3
By 1944, the board of the hospital announced "a general plan for the development
of the hospital. . ." and "to establish a Children’s Medical Center
covering all phases of pediatrics."3
Since 1914 and after Dr. Rotch’s death, a succession of medical authorities and
professors of Pediatrics at Harvard Medical School was promptly settled at the
Children’s Hospital. Among those physicians were: John Lovett Morse, Oscar Menderson
Schloss, Kenneth Daniel Blackfan, James Lawder Gamble, Bronson Crothers, Elizabeth Evans
Lord (psychologist), Edward Vogt, R. Cannon Eley, Franc Ingraham, Randolph K. Byers, and
Edith Meyer (psychologist).3
In 1920, Dr. William Edward Ladd (1880-1967) devised surgical procedures for correcting
various congenital defects such as intestinal malformations. Dr. Ladd joined the
Children’s Hospital staff in 1910, and treated many other conditions and
abnormalities such as hare lip, biliary atresia, esophageal atresia, malignant tumors, and
exotrophy of the bladder.3,14,16 Since 1938, Dr. Robert Edward Gross surgically treated
many congenital cardiovascular defects.3,14,16
On May 26, 1930, the Gardner House was opened as a new building for the Children’s
Hospital School of Nursing.3 Since 1932, Drs. Kenneth Daniel Blackfan (1883-1941) and
Louis Klein Diamond studied and published on cases of erythroblastosis fetalis.3,14 In
1947, Dr. Sidney Farber (1903-1973) was responsible for the first successful pediatric
remission of acute leukemia in children treated with the folic acid antagonist
aminopterin.3,14
In 1949, Dr. John Franklin Enders and his colleagues successfully cultured the polio
virus. Later Dr. Enders and his team cultured the measles virus and worked on other
viruses such as influenza A virus. In 1954, Dr. Enders and his team won the Nobel Prize
for their 1949 polio work.3,14
In 1949, Dr. Alexander Sandor Nadas developed the Children’s Hospital Division of
Cardiology.3 In 1966, Dr. Joseph E. Murray and his team first operated and corrected a
case of Crouzon’s craniofacial deformity.14
In 1988, a 9-month-old boy became the region’s first recipient of a segmental
liver transplant, in which a donor liver was trimmed to a smaller size.14 In 1990, Dr.
Joseph E. Murray won the Nobel Prize for his pioneering work in organ transplantation.14
In the 1980s and 1990s many other developments have been made in cystic fibrosis and
chromosome studies in muscular dystrophy and sickle cell disease. Complex lung, liver, and
heart transplants were performed by Drs. Craig W. Lillehei, Joseph P. Vacanti, and Redmond
Burke.14
The Children’s Hospital, Boston has made remarkable progress, but "the work
is far from complete. Ongoing research efforts are continuing. . ."14
Long live Children’s Hospital, Boston!
Acknowledgments
We acknowledge Marco Danon, MD, Director, Medical Education, Miami Children’s
Hospital, for providing us with a copy of the book The Children’s Hospital of
Boston3; the literature review prepared by the staff of the Miami Children’s Hospital
Library; and the preparation of the manuscript by Ms. Sandy Allen. Without their help,
this work would never have been completed.
References
1. Huff DS. The oldest children’s hospital building still in use in the
United States? J Pediatr. 1983;102:165-166.
2. Radbill S. A history of children’s hospitals. Am J Dis Child. 1955;90:411-416.
3. Smith CA. The Children’s Hospital of Boston. "Built Better Than They
Knew." 1st ed. Boston, Mass: Little, Brown & Co; 1983.
4. Retureta A, Papazian O, Retureta-Soler J, Retureta G. The Hospital for Sick Children,
Great Ormond Street. Int Pediatr. 1997;12:124-127.
5. Retureta A, Papazian O, Retureta-Soler J, Retureta G. The Children’s Hospital of
Philadelphia. Int Pediatr. 1997;12:253-256.
6. Hunt A. On the hospitalization of children: an historical approach. Pediatr.
1974;54:542-546.
7. Handlin O. Boston’s Immigrants. Cambridge, Mass: Harvard Univ Press; 1959. Cited
by Smith CA. The Children’s Hospital of Boston. "Built Better Than They
Knew." 1st ed. Boston, Mass: Little, Brown & Co; 1983.
8. Morse JL. The history of pediatrics in Boston. N Engl J Med. 1931;295:169. Cited by
Smith CA. The Children’s Hospital of Boston. "Built Better Than They Knew."
1st ed. Boston, Mass: Little, Brown & Co; 1983.
9. Francis Henry Brown. BMSJ. 1917;176:814. Cited by Smith CA. The Children’s
Hospital of Boston. "Built Better Than They Knew." 1st ed. Boston, Mass: Little,
Brown & Co; 1983.
10. Obituary, William Ingalls, MD. BMSJ. 1903;144:661. Cited by Smith CA. The
Children’s Hospital of Boston. "Built Better Than They Knew." 1st ed.
Boston, Mass: Little, Brown & Co; 1983.
11. Obituary, Samuel Gilbert Webber, MD. BMSJ. 1926;195:1173. Cited by Smith CA. The
Children’s Hospital of Boston. "Built Better Than They Knew." 1st ed.
Boston, Mass: Little, Brown & Co; 1983.
12. Obituary, Samuel Wood Langmaid. BMSJ. 1915;172:422. Cited by Smith CA. The
Children’s Hospital of Boston. "Built Better Than They Knew." 1st ed.
Boston, Mass: Little, Brown & Co; 1983.
13. Children’s Hospital. BMSJ. 1869;4:29. Cited by Centennial of the founding of the
Children’s Hospital in Boston. New Engl J Med; 1969;280:898-899.
14. http://web1.tch.harvard.edu/1998.
15. Jacobi A. Thomas Morgan Rotch. Am J Dis Child. 1914;8:245. Cited by Smith CA. The
Children’s Hospital of Boston. "Built Better Than They Knew." 1st ed.
Boston, Mass: Little, Brown & Co; 1983.
16. Glick PL, Azizkhan RG. A genealogy of North American Pediatric Surgery. From Ladd
until now. St. Louis, Mo: Quality Med Pub, Inc; 1997.
© 1998 by Miami Children’s Hospital.
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