A. M. A. at New Orleans

At Warm Springs, Ga., whither Governor Franklin Delano Roosevelt of New York goes for the lessons in walking which he has needed since infantile paralysis attacked him eleven years ago, he last week clambered onto a wooden table fastened to the bottom of his glass-enclosed bathing pool. Helen Lauer, his physiotherapist, clad like him in a bathing suit, helped him onto the table where he lay supine, partially submerged and buoyed up by a foot of water. Miss Lauer, 35, 5 ft. 5 in., hazel of eye, strong of fist, proceeded to massage one by one the 116 muscles in Governor Roosevelt's toes, feet, legs, thighs, counting 10 as she manipulated each. Then he sat up, swayed his heavy torso forwards and backwards. That was to keep his abdominal muscles in tone.

While Miss Lauer stood by to guard against accidents and too much activity by her patient, he slid himself off his table, caught hold of a horizontal bar affixed to the side wall of the pool. Supported partly by the bar, partly by the deep water, he thrust out his legs alternately as though he were riding a bicycle. Tired of "bicycling," he "abducted" and "addicted" his legs (raised & lowered them sideways), creating great swirls of water. A swim and a walk in four feet of water unsupported by brace, crutch or attendant, are included in his daily 45 minutes of underwater calisthenics, or hydrogymnastics "Vastly improved," commented Physiotherapist Helen Lauer. With braces and cane and leaning upon someone's arm, Governor Roosevelt now can take short promenades.

The re-education of Governor Roosevelt's muscles interested every one at the New Orleans meeting of the American Medical Association last week. Infantile paralysis was a major topic of discussion. Alice Lou Plastridge, director of physiotherapy at Warm Springs, lectured on her chief client's treatments. She averred: "He's as strong as you and I. He just doesn't walk as well as we do. But I can assure you that despite that impediment in his walk he is in splendid physical shape."

Other topics, other reports at the A. M. A. meeting:

Asthma Cooked. Knowing that malaria fever was proving an excellent treatment for paresis, and that fever caused by scarlet fever, pneumonia or an abscess usually gave temporary relief to people suffering from asthma, Dr. Samuel Maurice Feinberg & associates of Chicago tried out artificial fevers on their asthmatic patients, got good results. Their method is to anoint the patient thoroughly, wrap him in blankets and electric heating pads, cook him for about eight hours at 104DEG F.

Eyes Reset A frequent effect of goiter is protrusion of the eyes. Usually the eyes recede and cease staring upon the removal of the goiter. When this does not happen, it is because the muscles sur- rounding the eyeballs remain swollen to from three to eight times their normal size Dr. Howard Christian Naffziger of San Francisco relieved the pressure by enlargement of the passages through which the optic nerves and the arteries of the eyes reach the eyesocket from the interior of the skull. The popping eyes then reset themselves.

Eyelids Mended. When an eyelid is damaged by injury or disease it can be mended satisfactorily by grafting a bit of skin from another lid, from the inner surface of the arm, or from behind the ear. Skin from those places approximates the thickness of an eyelid. Lids thus mended may blink,' wink, close. If his patients insist, Professor Vilray Papin Blair, St. Louis lid-mender, transplants a strip from the eyebrow. Eyelashes from eyebrows usually look straggly. Professor Blair also makes eyebrows with grafts from the scalp. These tailor-made eyebrows require frequent barbering.

Bananas & Diarrhea, There is a stubborn, debilitating form of diarrhea called celiac disease. It is most common in children under 5. They cannot digest sugars, starches or fats. Dr. Sidney Valentine Haas of Manhattan found that ripe bananas, for some not fully understood reason, have the power to break up starches and convert cane sugar into more easily tolerated fruit sugar. With carbohydrate (sugar, starch) assimilation taken care of, digestion of fats takes care of itself. Ripe bananas contain all the essential vitamins, except bone-forming D. For times & places where ripe bananas are not available, there are now available preparations of dried, powdered banana.

Yellow Fever Testees, Dr. Wilbur Augustus Sawyer of the Rockefeller Foundation offered a method of immunizing against yellow fever, tropical scourge. Dr. Bolivar Jones Lloyd of the U. S. Pubblic Health Service suggested that criminals be pardoned if they submitted to Dr. Sawyer's method and then to bites of the yellow fever mosquito. Thus the Sawyer principle of prevention would be proved indubitably. Dr. Lloyd offered himself as a testee, if he can get enough life insurance to protect his family "in case of any untoward result."

Last week John H. Andrus, 50, of Camden, N. J., who has a Congressional Medal of Honor for letting the late Dr. Walter Reed infect him and 15 other soldiers with yellow fever in 1900 to prove that mosquitoes carry the disease, was admitted to Walter Reed Army Hospital at Washington. He is partially paralyzed.

Appendicitis. Dr. Frank Kells Boland of Atlanta re-emphasized the fact that purgatives and delayed operations are the outstanding causes of death from appendicitis. More men have the disease than women. More men die from it than women. Negroes show comparatively few cases of appendicitis until they abandon simple foods and eat more meat, sugar and "things that have been polished, pickled, frozen, thawed and sterilized." Some whites have learned not to take a physic for every stomachache, observed Dr. Boland. But not many Negroes. Favorite purgatives of Negroes are castor oil and epsoni salts.

Birth Control Shelved, To the satisfaction of every opponent of Birth Control, notably Episcopal Gynecologist Howard Atwood Kelly of Johns Hopkins, who keeps snakes in his bathtub and graces every meal with a verse from his ponderous Bible--Mrs. Margaret Higgins Sanger Slee was in an exasperating fix last week. After several years' effort Mrs. Sanger had persuaded the Ways & Means Committee of the House of Representatives and the Judiciary subcommittee of the Senate to consider duplicate bills which would permit physicians, hospitals & clinics complete freedom to learn about contraceptives. Fortnight ago the House committee --at the insistence of Massachusetts' Representative John M. McCormack (Knight of Columbus, Elk, Moose, Forester, Hibernian) -- pigeonholed Mrs. Sanger's bill. Her angry clarion stirred Birth Controllers throughout the land to telegraph their displeasure to their Congressmen last week, while the Senate committee was diffidently hearing other of her supporters. After listening to advocates of the movement the Senators postponed the hearings a week.

Meanwhile in New Orleans the physicians of the nation, for whose professional discretion in the matter of contraceptives Mrs. Sanger has made herself champion, were flabbergasted when Dr. Jacob Daniel Brook, 56, county health officer of Grandville, Mich., rose up in the House of Delegates and proposed a resolution on Birth Control. Let the A. M. A., urged Dr. Brook, appoint a committee to spend one year pondering the effects of contraception on health, wealth, morals, happiness. Dozens of physicians leaped from their seats to shout pro & con on the long suppressed topic. Retiring President Edward Starr Judd cleverly put discussion over to the next day.

Next day the physicians made Mrs. Sanger appear foolish in Washington and gave the Senators a good excuse to put her off. The doctors decided that not yet did they want anything to do officially with Birth Control.

U. S. Medicine Today. Dr. Edward Starr Judd of Rochester, Minn., outgoing president of the A. M. A., and Dr. Edward Henry Gary of Dallas, Tex., incoming president, left a survey of "present-day trends of private practice in the U. S." to Dr. Morris Fishbein, editor of the A. M. A.'s scientific Journal and popular Hygeia. Of 160,000 physicians in the U. S., Dr. Fishbein observed, 40,000 list themselves as specialists in the American Medical Directory. Among medical students the situation is now reversed. Three out of four medical school graduates go into one of the specialties. The specialist's income is greater than the general practitioner's. Yet "90% of all disease seen by physicians represents the type of disease that any good general practitioner can diagnose suitably and treat suitably with the amount of equipment that he can carry in a handbag.

"Such cases as tumor of the brain, acute hemorrhagic pancreatitis, hypertrophy of the prostate of Raynaud's disease may demand consultation with specialists or their technical services. . . . But to the wage earner who is attempting, with his family, to subsist on $30 a week, a pain in the epigastrium is just cramps and not allergic abdominal migraine."

To the public Editor Fishbein submitted: "Good medical care differs greatly from the best medical care. In view of the advances of modern medical science, it is questionable whether or not the best medical care can ever be furnished to all the people at a price they can afford to pay. It would seem rather that we must work toward the period when all of mankind in this country will receive the best medical care that they can be furnished for what they can afford to pay."

Health insurance seems to promise adequate medical attention for everybody and adequate livelihood for the physician. Exclaimed Dr. Fishbein, spurting to the end of his long discourse: "People know that death is inevitable. In teaching preventive medicine, we have emphasized that sickness may be prevented. Today we know that some sickness for every family is just as inevitable as death, and unless obstetrics continue to be inevitable there will be no population for the future. Let us, therefore, teach the worker that 2,000,000 people are sick every day in 120,000,000 population, and that this number is not likely to change greatly in the future. . . ."

New President, elected to succeed Dr. Gary next year, is Dr. Dean De Witt Lewis, professor of surgery at Johns Hopkins University, surgeon-in-chief to Johns Hopkins Hospital. When Dr. Lewis, 57, was a Kewanee, Ill boy his great ambition was to be a professional ball player. He became a proficient pitcher. While he studied medicine at Rush Medical College he spent almost every free afternoon at ball games. The great pleasure of his interneship was the free passes which he received for tending the minor injuries of Chicago players.

Professionally he is rated a speedy, crackerjack general surgeon operating on "anything below the throat." The cliche is misleading. He has done notable re search on the pituitary gland (in the skull) as well as on the elastic tissues of the larynx and on bone cysts. For his re constructive surgery on mutilated War veterans he was awarded the Distinguished Service Medal. Surgery, he remarked last week upon his election as president of the American Medical Association, "is a long, hard grind."

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