Inventor & Mentor: Dr. Leonidas H. Berry and the Gastroscope

The National Library of Medicine announces new public access to more than 1,600 materials selected and digitized from the Leonidas H. Berry Papers, 1907–1982 manuscript collection including letters, photographs, and ephemera documenting the career and personal life of the trailblazing physician and civil rights advocate. His work is recognized in the NLM traveling banner exhibition For All the People: A Century in Citizen Action in Health Care Reform; the online adaptation of the exhibition features 1,686 digitized items in a digital gallery. Stay tuned this week as Circulating Now features materials from the collection in honor of what would be Dr. Berry’s 116th birthday—July 16, 2018.

By Nicole Orphanides ~

Dr. Leonidas H. Berry’s (1902–1995) career in gastroenterology began at Provident Hospital, an all-black hospital in Chicago, in 1933. Just one year prior, a new model of the gastroscope—an instrument that allows doctors to view the upper digestive system with a flexible tube and camera, appeared on the market in Germany. Designed by Dr. Rudolf Schindler (1888–1968), a German gastroenterologist, with Berlin instrument maker Georg Wolf, the Wolf-Schindler semi-flexible gastroscope improved upon the rigid gastroscopes of the past by offering flexibility in 1/3 of the length of the tube. This new design allowed for safer procedures and a decrease in instrumental perforations.

It was during Dr. Berry’s second year as the gastroenterologist at Provident Hospital that he became fascinated with the idea of viewing the stomach through this gastroscope. A desire for training in the instrument influenced Dr. Berry to study under Dr. Schindler to learn gastroscopy technique and procedures, gastroenterology, and endoscopy.

By 1937, Dr. Berry began his own gastroscopy clinic at Provident Hospital and procured a Wolf-Schindler scope for use in his own procedures. It is likely that Dr. Berry was the first African American to practice gastroscopy with this model during this time of segregated medicine. While other model scopes would appear on the market in the 1950s, Dr. Schindler’s semi-flexible scope was a major advancement in the field and remained widely used until 1957.

In 1955, Dr. Berry invented the Eder-Berry biopsy attachment for the Eder-Palmer gastroscope, which was produced by the Eder Instrument Company in 1953. The Eder-Berry biopsy attachment made the gastroscope the first direct-vision suction instrument used for taking tissue samples during gastroscopic examination. Although this was not the only attachment that allowed doctors to biopsy the inside of the stomach without surgery, it was unique in that it operated via suction and offered good visualization. The suction type instrument was especially useful for widespread stomach lesions characteristic of conditions such as gastritis, granulomatous lesions of the stomach, and sarcoidosis.

As described in Diagnostic Procedures in Gastroenterology, the Berry biopsy attachment is comprised of a cylindric, metal, capsular sheath on the end of a semi-rigid plastic and metal sheath. To take biopsy specimens with direct vision, the sheath slides down partially covering the objective window. During a procedure, the instrument works by suctioning and maneuvering the knobs for the cutting plunger (A) and flanged bushing (B) in tandem to take a tissue sample.

During the 1950s–1970s, endoscope technology progressed as developments in optical fibers, lenses, and electronics continued, with Dr. Berry often at the forefront of advances. In 1957, Basil Hirschowitz and colleagues developed the first flexible fiberoptic gastroscope manufactured by American Cystoscope Makers Inc (ACMI). Soon after, the Olympus Optical Company in Tokyo, Japan would produce its version of the scope, and by 1963 had developed a model using a gastrocamera and fiberoptic technology. Dr. Berry was the first American physician to use this model.

Dr. Berry cultivated connections with colleagues and former students, many of whom kept in touch, and reached out for information and his opinion. In a letter from Dr. Gerald L. Glaser to Dr. Berry, Dr. Glaser asks Dr. Berry for advice and information on the Tomenius type of biopsy gastroscope. The Tomenius type was quite similar to his own invention in that it also provided visualization and aspiration biopsy—in Dr. Berry’s response to Dr. Glaser, he regards the Tomenius tool as “one of the best on the market.”

As an expert in the field—having performed more than 5,000 gastroscopic procedures in his lifetime—Dr. Berry developed innovative techniques for procedures. In a letter to Dr. Harkins, Dr. Berry highlights his experiences and research in field, noting the types of procedures used for early detection of gastric cancer and his biopsy invention. Dr. Berry was influential in introducing gastroscopic examinations and technique in six hospitals. By 1963, Dr. Berry had trained more than 175 gastroscopists from all over the world in a 17-year period.

Dr. Berry took pride in teaching his skill to medical students and gastroenterologists not yet trained in gastroscopy. In a 1963 letter from Dr. Arthur M. Freeman to Dr. Berry, Dr. Freeman says that the two weeks studying under Dr. Berry were the most useful and practical two weeks he ever had in any course. Dr. Freeman references his work with both the Eder gastroscope and the Hirschowitz flexible fiberscope made by the American Cystoscope Company. The work of performing gastroscopy requires technical skills and dexterity in working with a range of instruments. In a letter to Dr. Belch, Dr. Berry shares his views of the Olympus and ACMI esophagus gastroscopes, noting the ease with which the Olympus scope is manipulated as opposed to the ACMI instrument.

These letters portray a man who was both intent on developing and using the best tools for endoscopic procedure and a man who was deeply appreciated by colleagues and students. The Leonidas H. Berry Papers collection at the National Library of Medicine includes over 3,379 items. In an effort to honor, share, and make accessible Dr. Berry’s legacy, we have digitized a selection of more than 1,600 items. Find out more about Dr. Berry by browsing on your own, or use the “Refine by…” drop down categories to search by topic, creator, date, and item type. An insider’s pro-tip for you: on the browse page, go to the right hand side and select view all. This will display all 1,686 items alphabetically on one page so you can use Ctrl + F to quickly search and find text on the page.

Read the first post in this series: Leonidas H. Berry and the Fight to Desegregate Medicine

Nicole Orphanides is a public historian and independent contractor working as an exhibition coordinator for the Exhibition Program in the History of Medicine Division at the National Library of Medicine. Ms. Orphanides earned her Master’s of Arts in Public History at American University. When she is not in the office, she enjoys touring historical sites in Washington, D.C. and around the world.