With World War II raging abroad and the country focused on supplying men and matériel, William Felix Mengert, M.D., became the first permanent chair of the Department of Obstetrics and Gynecology at Southwestern Medical College on November 1, 1943.

He replaced Elbert Dunlap, M.D., who had served as chair since the School’s founding on May 5th of that year.

Dr. Mengert also became the first full-time faculty member in a clinical department at the new medical school — and the only compensated faculty member in the Department.

All other faculty members were volunteers from the community. Many of them — Elbert Dunlap, M.D., included — had been affiliated with Baylor College of Medicine prior to its move from Dallas to Houston.

With medical supplies rationed and doctors drafted into the military after internship, the challenges were huge. Many of the community physicians had gone off to war, and those that remained were left to care for patients who now found themselves without a doctor.

The new medical school also depended on these community physicians for clinical training of medical students and residents as well as care of patients at Parkland Hospital — which in 1943 included delivery of 1,352 women. It was in this environment that Dr. Mengert set about to organize the first Department of Obstetrics and Gynecology.

Like his mentors — Everett Dudley Plass, M.D., and J. Whitridge Williams, M.D., from Johns Hopkins — Mengert believed obstetrics and gynecology belonged in the same department. This organization was accepted by about 70 percent of medical schools by the mid-1940s. But there were still prominent institutions such as Harvard and Johns Hopkins that kept the two disciplines separate. Dr. Mengert opposed this organization.

“… is it not absurd to attempt separation of the physiology (obstetrics) and the pathology (gynecology) of these organs into two separate specialties? Pregnant women have fibroids; those with malignant tumors become pregnant, and to pursue further … the artificial division, who will treat the surgical emergencies of pregnancy and labor?”

Mengert’s persistence in championing the unity of obstetrics and gynecology probably would not have surprised anyone at Southwestern Medical College. In her book about the first 25 years at Southwestern, Catharine Schulze describes him as “… a dynamic and methodical individual, who immediately set to work to organize his program.” 

Dr. Mengert was assisted in this endeavor by a part-time secretary, Myrtle Muraske. Four years later, she was joined by Juanita Epperson. Juanita would go on to assist the chairs of obstetrics and gynecology for 38 years (1947–1985), rising from Secretary to Administrative Services Officer, the highest classified position at that time. 

In 1944, an additional part-time faculty member, Dr. William Guerriero, was appointed to assist Dr. Mengert. There is no record of how long Dr. Guerriero remained on the faculty. However, throughout Mengert’s tenure, the compensated faculty remained small — reaching its peak when Assistant Professor Stewart A. Fish, M.D., joined Associate Professor Douglas M. Haynes, M.D., and Dr. Mengert in 1954. Interestingly, this faculty complement matched that of the University of Iowa where Dr. Mengert had been a resident and faculty member for 14 years.

The three-year Parkland obstetrics and gynecology residency program received full approval in 1947. But, the new medical school struggled financially in the post-war environment, and there was fear that it would not survive. In 1949, Southwestern Medical Foundation reached an agreement with the University of Texas System, and the assets of the medical school were transferred — making Southwestern Medical College the second medical school in the UT System.

Following the transfer, the business practices became more formalized and annual budgets emerged. Thanks to Juanita, those first budgets have survived and provide insight into the early departmental organization and personnel complement.

As Chair of the Department of Obstetrics and Gynecology, Dr. Mengert was also Chief of Obstetrics and Gynecology at Parkland Hospital and a member of the Parkland Medical Advisory Council. Catharine Schulze described him as a pioneer in developing medical school–hospital relationships. 

And in 1945, he faced his first big crisis as Chief when five women died of the pregnancy complication, eclampsia. This disorder — characterized by high blood pressure and high levels of protein in the urine, followed by seizures, coma, and death in its final stages — is sometimes referred to as toxemia of pregnancy.

At the time, the standard treatment was to hydrate eclamptic women to prevent low urinary output and to sedate them with morphine to control the convulsions. Once the convulsions ceased, patients were fed a high protein, low salt diet, and sedated with Phenobarbital. If the patient survived, labor was induced two to three days after the last convulsion. 

Autopsy results on the five women cited pulmonary edema as the cause in four deaths and a factor in a fifth. These findings led Mengert to conclude that excess water intake was responsible for the edema that resulted in the deaths. He instituted a protocol to prevent what he termed water intoxication. Daily fluid intake and output were measured and an additional 1,500 cc were added to account for unmeasurable losses like respiration.

Twenty-three women were treated for convulsive toxemia during the 26 months following institution of this new protocol. There were no maternal deaths due to eclampsia and no cases of pulmonary edema. Of the 27 infants that were delivered, 21 survived the effects of prenatal morphine and Phenobarbital. Mengert took this as confirmation that his assessment was correct, and the treatment was effective. While acknowledging that controlling edema was important, other physicians were less convinced. And, the debate over the appropriate treatment for toxemia of pregnancy continued. (Standardizing the most appropriate treatment would be one of the defining accomplishments of Dr. Mengert’s successor, Dr. Jack Pritchard — the second Chair of Obstetrics and Gynecology at UT Southwestern.) 

While Chair at Southwestern, Dr. Mengert played an active role in shaping the medical school and influencing medical administration at Parkland. Interested in identifying effective ways to “re-integrate” soldiers into civilian medicine and provide practicing physicians with postgraduate education, in 1945 he chaired the Committee on Postgraduate Education of Southwestern Medical College. In 1946, he was acting dean prior to Brigadier General Dr. W. Lee Hart’s arrival. In 1952, he chaired the search committee for a chair in the Department of Surgery. And, in 1953, he became vice chair of the Parkland Medical Advisory Council. 

Dr. Mengert was also actively involved nationally. In 1947, he became Chair of the Section on Obstetrics and Gynecology of the American Medical Association, editor-in-chief of the Quarterly Review of Obstetrics and Gynecology, and general program chair for the Third American Congress on Obstetrics and Gynecology.

In 1951, he was among 11 physicians who founded the American Academy of Obstetrics and Gynecology in Homestead, Virginia; and he served as the fifth president of that organization (1954–1955). The American Academy of Obstetrics and Gynecology later became the American College of Obstetrics and Gynecology (ACOG). ACOG is now known as the American Congress of Obstetrics and Gynecology. 

In 1947, Dr. Mengert published the first medical textbook by a full-time faculty member while on the faculty at Southwestern Medical College. According to a review by T.N.A. Jeffcoate, Post-graduate Obstetrics was written for the general practitioner “who does a certain amount of midwifery.” The illustrations were created by Ruth Maxwell Sanders, a member of the Visual and Medical Arts Department at Southwestern.

In 1948, Mengert teamed up with Professor Lewis Waters of the Department of Visual and Medical Arts on the first Southwestern venture into film making. The 45-minute, color film, Simplified Obstetric Care, was directed and narrated by Dr. Mengert.

Aimed at getting women with uncomplicated deliveries back on their feet and home sooner than was the practice in the mid-1940s, the film featured Parkland patients and care givers and documented the approach practiced at Parkland since 1944 on more than 6,000 deliveries. Instead of spending three weeks in bed and another month convalescing, the new mother bathed herself in bed on day 2, walked to the shower on day 3, and went home in just seven days — upright in a car, not prone in an ambulance. Intended as a documentary to be shown at society meetings, the film was publicized in a Dallas Morning News article, “Pampering New Mothers Usually Not Necessary,” by H. Bullock. Sadly, the film has been lost.

Advice for practicing physicians was a theme that Mengert returned to throughout his career. He is perhaps best known for developing a system for physicians to assess whether to attempt vaginal delivery. The Mengert index — as some came to call it — was a methodology for estimating maternal pelvic size to determine the ability of the baby’s head to pass through during vaginal delivery.

Dr. Mengert first became interested in this problem — known as cephalopelvic disproportion — while at Iowa where he conducted a clinical study of rural women. In 1944, he began a clinical study using manual and radiographic methods to assess pelvic size in 935 pregnant Parkland women. This is the first documented Ob/Gyn study to be conducted at Parkland. Later, Mengert went on to publish a formula to use in assessing pelvic capacity. The success of the system depended largely on the obstetrical experience of the physician and was never widely adopted. 

Another clinical study, sponsored by the Texas Division of the American Cancer Society, used a new cytological test (the PAP smear) to examine 6,818 Parkland women between August 1, 1947 and September 1, 1950. It led to early detection of unsuspected cervical carcinoma in 36 patients. Although successful, the test required a trained technician to interpret and was expensive. Dr. Mengert thought these two factors made the PAP test impractical for community gynecologists to use routinely. 

The ability to detect early-onset cervical cancer led Mengert to re-examine the protocol for handling the disease which, for the previous 20 years, had almost exclusively been treated by irradiation. As head of both gynecology and obstetrics at Parkland, Mengert had the authority to change the treatment protocol for all gynecological maladies affecting women — including cancers of the reproductive system. 

Predictably, a debate emerged between Mengert and Parkland radiologist, Ralph Clayton, M.D., over who should treat cervical cancer. Community physicians, who were responsible for staffing and clinical training at Parkland, joined in as the conflict escalated. According to Dr. Jack Pritchard (Mengert’s successor), the effect on “town–gown” relations was devastating. Although this was not the first debate Mengert had fought over an issue of women’s reproductive health while Chief of Obstetrics and Gynecology, the ramifications were potentially more crippling. With deliveries now close to 4,000, “mutiny” among community physicians was no small matter. 

Whether the conflict over treatment of cervical cancer influenced Mengert’s decision to leave Southwestern, no one really knows. The news of the conflict between Drs. Mengert and Clayton and the community brouhaha, evidently did not reach medical students. And, according to one member of the Class of 1955, they assumed that Mengert, like others before him, left for a more prestigious position.

Having brought the Department of Obstetrics and Gynecology through its first 11 years, William F. Mengert announced his decision in a January 25, 1955, letter to members of the staff.

“It is with much regret and a great deal of emotional ambivalence that I announce my resignation from the staff of the Southwestern Medical School and the staff of Parkland Memorial Hospital to be effective June 30, 1955. You may be sure that this (to me) momentous decision was not made without a great deal of soul searching. …I do not lightly or by choice leave behind so many friends and so many years of creative work and effort.”

Associate Professor Douglas M. Haynes, M.D., also resigned to take the position of Professor and Chair at the University of Louisville School of Medicine. This left Assistant Professor Stewart Fish, M.D., as the sole remaining faculty member in the Department. And, he was named acting chair.

Before leaving Southwestern, Dr. Mengert received the Marchman Award from the Southern Clinical Society “in recognition of his outstanding contributions to better healthcare in his field in Parkland and the community.”

During his tenure as the first chair, Dr. Mengert saw the protocols for pregnancy confinement, eclampsia, and cervical carcinoma change dramatically. He witnessed the reduction of maternal deaths due to eclampsia and watched deliveries at Parkland rise from 1,352 in 1943 to a record 4,055 by the end of 1955. 

He defined the leadership role of the Chief of Obstetrics and Gynecology at Parkland Hospital and forged relations between the medical school and Parkland. He outlined the challenges of post-war medical education, and achieved certification for the first residency in obstetrics and gynecology at Parkland. He lobbied civic leaders and encouraged the building of a new hospital. When Parkland Memorial Hospital opened on September 25, 1954, he “christened” the new state-of-the-art, air conditioned operating rooms with the first surgical procedure.

Clearly, Dr. Mengert left his mark on the triumvirate of education, research, and patient care; and influenced the advancement of his specialty. But perhaps his most important and lasting contribution was his blueprint for the organization of the Department of Obstetrics and Gynecology at Southwestern Medical College. It became the foundation upon which his successors would build.

The biography, The Life and Times of William F. Mengert, M.D., traces Dr. Mengert’s life from the early years through his days at Southwestern Medical College and examines his views on women’s health care and obstetrics and gynecology.