Big Meeting

Mayor Harry Arista Mackey of Philadelphia assured the American Medical Association convention there last week that Philadelphia was perfectly safe for them. The doctors did not investigate. They industriously streamed between the convention hall and their hotels. The hotels were overcrowded. The A. M. A. had forecast 5,000 doctors and their wives would attend the convention. About 7,500 appeared. The wives visited places and collected free samples. The husbands talked and listened to a practically unassimilable number of medical facts, of which some held attention, viz:

Unhappy Wives stimulated Robert Latou Dickinson, Manhattan gynecologist, to study marital discontent. He asked 1,000 married women certain impudent questions. As women will, they answered him. The women were "what may be called the cultural type . . . urban, of good family background, married to professional men of moderate income [e. g. physicians], each with one or two children. They were considered socially normal in the ordinary relationships of work and life."

The marital tales of 230 widows, divorcees and newly-marrieds he put aside as not being characteristic. Of the rest, 365 said they were not dissatisfied with married life; 30 said they did not know; 375 said they were downright dissatisfied.

The unhappy blamed their condition on early education and religious sexual taboos, on relatives-in-law, money, children (but most declared they wanted more), and on housekeeping. Some had had "a shock in childhood related to the sex side of life." But most of all, they complained of unsatisfactory marital sex-life, often due to faulty courtship of husbands. Said Dr. Dickinson: "Teaching men and women the medical art of love is one of the most important steps toward preventive medicine and better social adjustments."

The unhappy wives compensate themselves for their connubial discontent by going on shopping sprees; by taking up art, religion, morals, culture, society, politics; by being cute, girlish and kittenish, by nagging, by yammering.

Dementia Praecox. That extreme condition of dull wits and sluggish brain called dementia praecox (adolescent insanity) affects so many people in the U. S. that all the hospitals of the country could not contain them. Roy Graham Hoskins of Boston counted 140,000 in mental hospitals alone. The need for solution of the dementia praecox problem "is exigent," yet it "is being grossly neglected." Signs of this mental disease are constant melancholy and self-absorption. Bad cases behave like very young, helpless children.

Walter Freeman of Washington, brilliant young (36) chairman of the A. M. A. section on Nervous & Mental Diseases, suggested that dementia praecox may be a deficiency disease, comparable to scurvy or rickets. The brain may become unable to use the oxygen it requires. Supporting Dr. Freeman's suggestion is the fact that lack of oxygen in the brain causes more or less evanescent dementias, as mountain sickness, carbon monoxide poisoning, partial suffocation, circulatory failure. If so, keeping the nitwit in the open air or in a chamber full of excess oxygen ought to help. Artificial fevers may stimulate oxygen absorption. Psychoneurologists are beginning to experiment along these lines. What gives them hope is that in epilepsy, although what initiates the fits is not known, there is a disturbance of the body's water balance. Regulating the epileptic's diet has kept him measurably free from seizures.

Vitamins, Yeast, Orange Juice, Bran-- "Everybody seems to be going crazy over vitamin D. . . . Some folks are going nuts on processes of irradiation," broadcast Morris Fishbein, editor of the A. M. A. Journal, expert in grocery store jargon as well as in scientific argot. Dr. Fishbein is chairman of the A. M. A.'s Committee on Foods, which offers to give a seal of approval for food manufacturers to use. The committee has been examining such branded foods for a year, has approved less than a fourth, has advised the manufacturers to alter their claims. Thus "Grape Nuts," to get the A. M. A. seal, will have to be renamed because it contains no grapes, no nuts.

The public's current interest in food stirred up typically sound & dogmatic Fishbein pronouncements: "The best diet of man includes adequate quantities of all the well-known food substances. Such a diet will provide adequate quantities of the vitamins. The use of insulin for diabetes, of liver extract for pernicious anemia, of whole liver, heart and kidneys for anemia in general indicates the folly of vegetarianism.

"Every new discovery in medical science is promptly exploited beyond reason by commercial interests. Yeast is merely a food rich in vitamin B with some laxative effect. It is not a panacea for pimples or dyspepsia.

"Orange juice is simply a pleasant drink rich in vitamin C, with a slightly alkaline effect eventually in the body. It is not a cure for acidosis nor will it prevent either falling hair or falling teeth.

"Bran is a good food for horses but may be severely irritating to a delicate stomach and intestinal tract.

"Whole wheat bread is somewhat richer in vitamins and roughage than white bread. It has not been shown that it will prevent cancer and there is no evidence that a modern, civilized diet causes cancer."

A. M. A. trustees are making Dr. Fishbein take his first vacation in 17 years this summer. He and his family will wander over Europe.

Whooping Cough is a far more dreadful disease than the public realizes. The characteristic whoop sounds terrific. The real danger of the cough is the sudden and pervasive strain on the body. Adults frequently become infected. To them whooping is more dangerous than to children. The victim suffocates. His muscles go into spasms. Blood vessels are apt to break, muscles to tear, secondary infections to take root. Such attacks occur sometimes 100 times a day, but 20 times is the average. The main thing to do is to quiet such spasms by sedatives. Useful in carefully prescribed amounts are paregoric, codein, heroin, antipyrin, chloral hydrate, benzyl benzoate. Perhaps the best was that suggested last week by W. Ambrose McGee of Richmond, Va.-- douching the rectum with a mixture of ether and olive oil.

Rickets-- About half the children doctors are called to examine show some signs of rickets. Signs of advanced rickets include: big, fatty head; loose, flabby skin (it resembles an oversized, ill-fitting glove); pinched, chicken breast; puffed belly; bow legs; little lumps on the joints, especially the wrists and ankles. Outdoor play, artificial sun lamps, codliver oil, animal fats and other foods which contain vitamin D prevent rickets. At Philadelphia Alfred Fabian Hess of Manhattan and associates advised milk from cows fed with irradiated yeast or viosterol as an excellent general preventive.

Naughty Brain-- George Washington Crile of Cleveland said that the frontal lobe, the thinking part of the brain, is the naughty contributing cause of stomach ulcer, exophthalmic goiter, irritable heart, and possibly diabetes--all diseases to which high-strung, emotionally and physically active persons are prone.

His reasoning was as follows:

The thyroid controls the accumulation of energy in the body. The brain, the sympathetic nervous system and the adrenal glands jointly control the expenditure of this energy. "Because the entire organism is capable of just so much oxidation--hence so much energy--natural selection endowed the brain and the nervous system with the oower of driving one group of organs and inhibiting all the others. . . .

"The professional man, the banker, the businessman, the statesman, the soldier, although achieving their survival by the control of nature's energy in the infinitely complicated web of life, fear and worry and hate in every tissue and organ of their bodies. . . ."

Thus the brain, particularly the comparatively new frontal lobe, is shunting energy from other vital parts of the body by draining the powers of the sympathetic system and the adrenals.

Dr. Crile has prevented this in 84 cases by simply cutting certain nerves which hook up the brain with the adrenals. Thus the adrenals were cut off from the naughty brain's influence, and the vegetative parts of the body could function unhindered. Stomach and intestinal ulcers cleared up with amazing speed. Exophthalmic goiter subsided. High strung individuals quieted down.

Addison's Disease. Perhaps the greatest medical discovery of the past year was that a hormone from the cortex of the adrenal glands relieved the almost invariably fatal Addison's Disease (TIME, Dec. 15). In Addison's Disease the skin becomes bronze colored. There are other constitutional changes. The trouble originates with destruction of the cortex of the glands which are situated just above the kidneys. The adrenals more and more are coming to be considered the "brains" of the living processes.

When Addison's Disease and its treatment came up for report at Philadelphia, a fight for glory impended. Wilbur Willis Swingle and Joseph John Pfiffner with money from Parke, Davis & Co. and laboratory facilities at Princeton and the Long Island Biological Laboratories, isolated a cortical hormone. Leonard George Rowntree and associates at the Mayo Clinic used the Swingle-Pfiffner hormone on 20 cases of Addison's Disease. Four cases, too far gone for relief, died. The others showed remarkable recuperation as long as they received injections of the hormone. The present cost of keeping an Addison's Disease patient in good health is now about $3,000 a year. But now that the method of extracting the hormone from the adrenal glands of cattle is known, the yearly cost may soon be cut to $500.

Before Drs. Swingle and Pfiffner announced their hormone, Frank Alexander Hartman, professor and head of the physiology department of the University of Buffalo, had isolated a similar, if not identical substance from the adrenals. He calls his cortical extract cortin. He lacks money and facilities to carry out experiments. He was not on the Philadelphia program. No glory quarrel flashed; but he had a champion, Clayton Wellington Greene of Buffalo, who carefully reminded the A. M. A. of his friend's efforts.

Doctors' Health. Among remarkable observations of the 7,500 doctors at Philadelphia was the fact that while most of them abstain from smoking and drinking, most of them show nervous strain in their faces, postures, gaits. Young doctors die of accidents and acute infections, but by far the greatest number of those who have passed 45 die of some kind of heart disease. To contemporary young men Reginald Fits of Harvard advised precaution in their activities. To medical schools and hospitals he advised devices for physical recreation for the intensely working students and internes. (Harvard medical students have annual physical examinations, a new dormitory, a gymnasium, and a playground.)

Regarding personal care by the older men Dr. Fitz, 46, was cynical: "Those of us past the 45-year-old mark no doubt will continue on our way regardless of what we should do, putting on more weight than we ought, neglecting vacations and exercise, gambling with fatalistic optimism that we shall not fall ill, overworking, overworrying and developing arteriosclerosis with the same cheerful in- difference as have our predecessors."

Miscellany. And then there were a great number of miscellaneous items: nasal sinuses displayed by Warren Beagle Davis of Philadelphia. Harrison Stanford Martland of Newark's pieces of radium-rotted bones. How mites which live on rats transmit typhus fever, by Jesse Bedford Shelmire Jr. and Walter E. Dove of Dallas. The description by Fred DeForest Weidman of Philadelphia of the skin infection technically called dermatophytosis, popularly ringworm, and in certain advertisements "athlete's foot." Xanthomatosis, which makes children look like frogs, squatty and popeyed, and which Merrill Clary Sosman of Harvard found X-rays will relieve and sometimes cure. The scolding which Harvard's George Richards Minot gave lazy physicians because they think liver extracts will cure every kind of anemia. The scorn with which Arthur Joseph Cramp of Chicago flayed sellers and buyers of patent medicines. The plan of Theodore Louis Squier of Milwaukee's A. 0. Smith Corp. (FORTUNE, Nov. 1930) to preserve the life-long medical record of every person in a community. The criticism by Harrison H. Shoulders of Nashville of the free Government medical attention to war veterans for illnesses not due to war injuries. The refusal of Ray Lyman Wilbur of Stanford and the Department of the Interior to comment on Federalized or State Medicine. The suggestion by retiring President William Gerry Morgan of Washington that the A. M. A. president get $5,000 a year and the president-elect $2,500 for necessary travel expenses.

Scientific Exhibits were unusually informative. Putting them up cost the A M. A. $50,000. Notable were the fresh pathological exhibit which looked and smelled like a tidy butcher shop; the exhibit on fractures with demonstrations of their proper setting and immobilizing with plaster of paris bandages or splints; the exhibit on varicose veins with local patients getting their swollen veins plugged by a solution of glucose and salt. A couple of pet Belgian hares lay comfortably tied in cradles so that an ear of each could be held under a microscope. In the lightly clamped ear was a tiny window through which an observer could see blood cells flowing and flesh growing.

The A. M. A.'s first prize for exhibits, a gold medal, went neither to the biggest, nor the neatest, nor the cleverest, nor the most learned presentation. Jacob Furth, an immunologist at the Henry Phipps Institute of the University of Pennsylvania, a onetime worker at the Rockefeller Institute, won the gold medal for his demonstration of experimental leucemia. Leucemia is a blood disease closely resembling cancer. The blood contains abnormally vast numbers of white blood cells. Usually the spleen and liver are hugely enlarged. Bone marrow is usually affected. Dr. Furth isolated a virus from leucemic chickens. The virus stimulated leucemia in other chickens. He got a virus from leucemic mice, which affected other mice deleteriously. Presumably a virus causes human leucemia. Chicken virus does not affect mice, nor vice versa. Dr. Furth demonstrated all that with charts and figures. He, 35, graduate of the German University of Prague (1921), thought that he was obliged to work up his exhibit all by himself. Largely for his industry was he given the first prize.

Presidents. When William Gerry Morgan, 63, of Washington straightened the green ribbon with its gold pendant around his neck, he became demonstrably the retiring 1930 president of the A. M. A. That was immediately after Edward Starr Judd, 52, of the Mayo Clinic, had delivered the speech which signified his installation as 1931 president.

Dr. Judd is often called, though this is but a matter of expert opinion, the greatest practicing U. S. surgeon. He is a stocky, diffident homebody,* somewhat given to philosophizing. "I believe that it would not be out of place to establish departments in medical schools for the purpose of giving courses that would teach common sense methods in the practice of the art of medicine. . . . There are many ways in which information concerning medical facts may be given to the public that are certain to be helpful in establishing a more confident and intimate relationship between the public and the profession: public health and other medical lectures . . . the daily press . . . the radio. ... A physician is not qualified to take up special work until he has spent some time in general practice."

Two days after Dr. Judd's inauguration as 1931 president, the medical power of the southwest, Edward Henry Gary, 59, was chosen president for 1932. Dr. Canis a rich man. He started his wealth with medicine, increased it by marriage, multiplied it by business. An Alabaman who worked his way through Manhattan night schools and through Bellevue Hospital Medical School, he became first dean of the medical school of Baylor University and its professor of ophthalmology & otolaryngology (1902). His private eye, ear & throat practice became large. Twenty years ago he married Georgia Fonda Schneider, of an old, wealthy Texas family. (At Philadelphia Mrs. Gary in a black & eggshell chiffon & lace gown was reckoned the best-dressed doctor's wife. Georgie, eldest of her three daughters, was along with her.) He built and gave Baylor its Gary Hall. Two years ago he surrendered his many university connections, except the professorship and became medical dean-emeritus.

He was by that time a busy business man and Dallas' foremost constructor. He owns the twin 20-story Medical Arts Buildings which, although not Dallas' tallest, are its biggest. On their top floors is the Gary Clinic, one of the country's best. The Gary Clinic now constitutes his chief contact with practical medicine. He is nominally eye & ear man for three railroads. He is head of the A. P. Gary surgical supply house which his brother established, and of the Cary-Schneider Investment Co. which looks after the family's general business interests. Right now he is guiding Dallas in the expenditure of $25,000,000 on civic improvements. His varied interests go further: fraternal work (32DEG Mason, Shriner), religion (Baptist), politics (Democrat). A strong argument for his election as A. M. A. president was his large scale building experience. He will supervise the construction of a new A. M. A. headquarters building in Chicago. The diversion which enthralls him most is golf, and once golf awarded him its most coveted prize: four months ago he lammed out a hole in one. He let out a joyous whoop which was heard "all the way to Alabama."

*Mrs. Judd is a niece of the Mayos.

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