Surgeons' College

Three thousand surgeons drifted into Manhattan's new Waldorf-Astoria Hotel last week. It was easy to see that they were surgeons, not physicians. The physician is apt to be benign, a trifle careless of his dress, slow in speech. The surgeon, on the other hand, tends to talk swiftly, dress meticulously, gesture boldly. There are always more evening clothes at a surgeons' meet than at a physicians'. This was the American College of Surgeons, at its 21st annual clinical congress.

One & all had subscribed to the protection of the specialist: "Upon my honor as a gentleman, I hereby declare that I will not practice the division of fees, either directly or indirectly, in any manner whatsoever." When they had composed themselves, when their regents and officers bar ranged themselves on the ballroom stage, Dr. Charles Gordon Heyd of Manhattan gave an address of welcome.

Dr. Charles Jefferson Miller of New Orleans, the College's president, in red-collared academic robe and gold-tasseled mortarboard cap, upbraided lay critics of medical men. He denounced "those articles in magazines whose standards, one used to believe, were rather higher than the publication of half truths and misrepresentations and downright falsehoods. I confess that a rather unworthy suspicion has crossed my mind that it has perhaps been easier for our traducers to gain a hearing than it has been for our defenders Here & there a physician has raised his voice, not always, I am sorry to say, with very profound wisdom, but lay defenders are notably absent, and I find it rather hard to believe that an occasional satisfied layman, an occasional grateful patient, has not tried to say something in our favor."

Not "rathering" was his denunciation by name, as uninformed medically and unjust ethically, of Magazine Critics T. Swann Harding, F. C. Kelly, H. L. Mencken, the late J. A. Mitchell.

When Dr. Miller ended his speech he took off cap and gown, helped them on to Dr. Allen Buckner Kanavel (pronounced Kuh-nave'-ul) of Chicago. By robing, Dr. Kanavel assumed the presidency of the College. He is a smaller man than retiring President Miller. The official sleeves hung over his wrists as he swung into an official flaying of social and industrial medicine not guided by responsible doctors.

Followed an explanation of urinary surgery, by Dr. Arthur Henry Bitrgess of Manchester, England. An important point: catheterization for urinary retention is a dangerous procedure The retention causes a back pressure against the kidneys, which adjust themselves to the abnormal condition. Perspiration removes sufficient water from the body to maintain a satisfactory state of invalidism. Catheterization suddenly relieves the kidneys of back pressure, causes kidney injuries and, usually, a fatal kidney bleeding. In aged persons is this fact especially so.

Later in the week Dr. John Bentley Squier, Manhattan urinary surgeon, gave a dinner in honor of Dr. Burgess, Sir Charles Gordon-Watson of London, Dr. Hans von Haberer of Cologne (all three were made honorary fellows of the College) and the officers of the College. It was a happy evening for Dr. Squier. That afternoon the College had elected him its next president. He is just about as much smaller in height and build than President Kanavel, as President Kanavel is smaller than retired President Miller.

Publicity. Dr. Miller's animadversions upon lay critics had nothing to do with his desire for laymen's help in educating the public to its medical needs. The American College of Surgeons was a pioneer in opening its meetings to everybody, in translating medical effort into commonplace terms. During last week's sessions a dozen important fellows of the College-- Francis Carter Wood, Joseph Colt Bloodgood, John Carl Arpad Gerster, et al.-- dined with journalists as guests of the American Society for the Control of Cancer. Doctors distrust reporters, fearing inaccuracy and exploitation. Reporters are impatient of doctors, knowing they rarely can get a frank disclosure of news. This is an old impasse which the cancer men are again trying to hurdle. The public, after a few years of cancer consciousness, has again become apathetic. Surgeons are seeing more cases in late stages, fewer in early stages. The sooner a cancer is attacked, the better the prospects of cure. Unusual bleeding, strange lumps, unhealing sores are all danger signals. Chief cause of this recurrent negligence of early cancer was laid to Depression. Cancer causes little pain or inconvenience until it becomes mortal. Impoverished victims let their ailments wait.

Upshot of the surgeon-journalist conference on cancer was that the surgeons would find a writer who knows medicine or (more difficult) a doctor who knows journalism to bombard the public with cancer warnings.

Cancer. In treatment of cancer the new contributions offered were refinements in diagnosis and treatment. Dr. George Washington Crile, for instance, reported that cancer tissue conducts electricity more easily than normal tissue, that here was a method of differential diagnosis. Dr. Donald Church Balfour urged more operations for cancer of the stomach and of the intestines. These cases are among the hardest to save. But Dr. Balfour finds that nine out of ten patients can sur- vive the operation. If lymph nodes are not involved, five out of ten live for five years or more.

The electrical knife perfected by Dr. George Austin Wyeth of Manhattan received great tribute as a cancer tool. It reams out tiny holes wherein the cut of a scalpel would be brutal.

Again the surgeons insisted that there is no evidence that cancer is caused by a germ. They reapproved Dr. James Swing's suggestion of several great cancer research institutions spotted over the U. S. (TIME, Jan. 12).

More Years. Dr. Charles Horace Mayo, his eyebrows bristling, flayed frantic oldsters: "The radios of young people are tuned to rhythmic motion. Those of old people get mainly static. There are too many 'drop-deads.' The 'drop-deads' occur in the city. They may die on the golf links, trying to show they are all right, but they really occur in the city. Farmers haven't the time to drop dead. We overdo the subject of exercise unless we have had the advantage of training early in life. Unless you have been brought up to work in early life, do not get out and try to do stunts after you are 50 or 60 years old. . . .

"Today it may be said that we are dying as individuals and not in droves. The world, through science, has been made a safe place in which to live. All the mass destroying diseases have largely come under control, and now each adult must fight his own individual battle. Usually he does not brook any interference with his own mode of living."

Dabbles in the Occult, Dr. Charles Horace Mayo would "rather die when my brain fails than live on." His brother William James Mayo has a more vigorous contempt for addled minds. To flay students of the psychic, he wrote:

"Anyone dabbling in the occult, deliberately depriving himself of vision, man's chief means of obtaining information, injures himself mentally. I have known a number of men of great promise in medicine, who, in the springtime of their lives, became interested in a cult or in occultism of the old-fashioned spiritualistic type, which led them to blind alleys.

"Sir Conan Doyle, Sir William Crookes and Sir Oliver Lodge are three outstanding men of science who interested themselves in psychic phenomena and believed in reincarnation of the dead. This interest, however, came in the autumn of an intense scientific life. Their great days were over."

Body's "Power Station." Preoccupation with mental and nervous phenomena pervaded the surgeons' meeting. Many diseases which require knifing result from disordered nerves. But surgery may improve many nervous disorders. Dr. George Washington Crile has concentrated lately on the adrenal glands and their body influence. He considers the adrenals the "power station" of the sympathetic nervous system, the frontal lobe of the brain as the "slave driver." When the adrenals are over-busy they cause abnormal nervous excitation, abnormal palpitation of the heart ("soldiers' heart"), abnormal nervous fatigue, peptic ulcer, etc., etc. Dr. Crile is curing such ailments, he said, by disconnecting the adrenals' nerves, thus interrupting their powerful body control.

Social Medicine. The Congress proceedings began with an attack on State control of Medicine. Retiring President Miller instanced as a horrid example of such control the often poorly trained, politically ruled doctors who have jobs as coroners and health commissioners. The Congress ended with President James Rowland Angell of Yale declaring: "I am by no means unaware of the narrow-minded and exclusively self-seeking attitude of a good many practitioners who see in every social movement affecting medicine simply one more effort to rob them of a livelihood and forthwith devote all their energies to digging in where they are. Their position is like that of Labor, which has traditionally opposed all labor-saving machinery--and always in the long run, in vain. . . .

"[A new social] philosophy conceives the social order as under binding obligation to give its members wholesome conditions of life, protection from needless exposure, whether to climate or disease or moral depravity. It conceives human life as indisputably superior to money or physical property in any form, and it is disposed to suppress or radically modify any agency to practice which appears to be exploiting men for the promotion of merely financial and material gain."

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