A.M.A. Meeting

The annual meeting of the American Medical Association in Chicago was steeped in penicillin, politics and progress. About 7,500 doctors jammed the halls of four hotels to saw up a two-year backlog of medical science and gossip.

Politics and Personalities. Killed in committee was the California Medical Association's proposal that A.M.A. Journal Editor Morris Fishbein be ousted. Dr. Fishbein gave out the news himself at one of his daily press conferences.

Dr. Herman Louis Kretschmer, incoming president of the Association, repeated organized medicine's objections to the Wagner-Murray-Dingell Bill (semisocialized medicine), which for twelve months has been in Congressional committee. Said he: "I believe it is incumbent on every physician in this country to devote at least two hours a day to educating the people in his community as to the significance of such legislation"--i.e., against it.

Pressure for some improvement in the distribution of medical care--not necessarily the Wagner-Murray-Dingell Bill--came from the military doctors present: 1) Colonel Leonard George Rowntree pointed out that 30% of all Service registrants examined turned out to be 4-Fs; 2) Major General George Lull added that U.S. physical fitness has actually deteriorated since World War I, largely as a result of poor distribution of medical care; 3) Vice Admiral Ross T. Mclntire requested that the A.M.A. draft a "sound plan for medical care." To cope with this problem, a five-man committee (included: General Lull, Dr. Fishbein) was appointed.

Also dealt with, but probably not for keeps, was Sister Elizabeth Kenny's method of treating infantile paralysis. After two years of research, a special committee reported that: 1) just as many people recover from polio without Kenny treatment as with it; 2) Sister Kenny's concept of the disease (TIME, Sept. 27) is wrong; 3) her treatment is neither new nor unique. Retorted Sister Kenny, who was also in Chicago last week: "[The A.M.A. report is] the most criminal thing that ever happened in [any work] . . . a terrible thing to put out . . . the most cruel thing that ever happened to America."

Penicillin. The meeting's most popular feature was the lectures on penicillin. Dr. John Hinchman Stokes of Philadelphia reported excellent results with penicillin in late syphilis, showed slides of the handwriting of paretics to illustrate their dramatic improvement from illegibility to Spencerian clarity as treatment progressed. Other penicillin notes:

P: The Navy now authorizes the use of penicillin in all cases of gonorrhea. The few cases which do not respond to it are still treated with sulfa drugs and/or with artificial fever.

P: Penicillin cured 68 out of 69 cases of several kinds of meningitis at a Navy hospital.

Progress in Surgery. Radical splanchnicectomy (removal of long segments of the nerves which serve the viscera) is a lifesaver for certain types of high-blood-pressure patients. Dr. Reginald Smithwick of Boston has now perfected the technique so that deaths from the operation are rare. Some of his patients are in normal health six years after operation.

To prevent fatal blood clots from stopping up heart and lung arteries after operations, Boston's Dr. Arthur Wilburn Allen watches the big leg veins where the clots form and, when necessary, opens the veins, draws the clots out by suction before they can move on and do any harm, then ties off the veins. He uses this method on hundreds of cases a year, has greatly reduced deaths from embolism.

Progress in Medicine. For patients whose high blood pressures cannot be remedied by surgery, Dr. Walter Kempner of Duke University uses a unique palliative: a low protein diet composed chiefly of rice. His reason: high-blood-pressure patients have poor kidney function and the low protein diet is easy on impaired kidneys. Doctors were incredulous. But Dr. Kempner retorted that only time would tell whether he was right, that meanwhile, so long as the diet helps his patients, he will continue to use it.

About half of barren marriages can now be made fertile, compared with one-fifth 20 years ago. Strangely low metabolism often goes with sterility, and thyroid extract sometimes results in babies.

Progress in Military Medicine. Lieut. Colonel Francis Raymond Dieuaide's paper on malaria was censored for security reasons. A hint of what Colonel Dieuade had to say was given by Brigadier General Hugh Jackson Morgan, who presided at the meeting. He read an A.P. dispatch to the effect that malaria among U.S. troops in New Guine? has been cut 95% in the past year.

Modified globin, one of the newest substances used in transfusions, was described by Dr. Max Maurice Strumia of Bryn Mawr, Pa. It is made from red blood cells, keeps well in salt solution, is so successful in preventing blood fluid from leaking into the tissues (as in wound shock) that, if globin were made along with plasma, each blood donation would go four times as far as at present.

A gram of sulfadiazine a day last year protected a quarter of a million Navy men for months from a dangerous streptococcus infection which was going the rounds of the Navy, causing sore throats, scarlet fever, even meningitis. Only about one man in 1,000 had a bad reaction.

Two disorders described last week were in the curiosity class:

P: Epidemic diarrhea and vomiting of unknown cause is what Dr. Hobart Ansteth Reimann and associates of Philadelphia call widespread epidemics of the familiar 24-to-48-hour diarrhea and vomiting (commonly known as intestinal flu, gyppy tummy, the trots, molly-grables), which almost everyone has had at some time or other. Since the disorder cannot always be traced to food (TIME, June 19), the doctors think it may be a virus infection, possibly transmitted through the nose as well as the mouth.

P: The infectious jaundice which plagued the army in Africa is contagious, can be given to canaries for experimental purposes, but a jaundiced canary is hard to detect.

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