Doctors in San Francisco

Last week the American Medical Association convened in San Francisco and for the first time in that professional body's 92 years the attending members (6,000) showed more interest in the business than in the science and art of medicine. Hard times for doctors and patients, changing social attitudes have caused doctors to consider new ways of distributing medical care. Traditionally, the American Medical Association, now representing 109,435 of the country's 165,163 licensed doctors, stands for decentralized administration and private initiative. The political and economic tendency of the times, however, is toward larger-scale corporate activity, and many a U. S. doctor--with about a sixth of the population living on relief and another sixth also unable to support private medicine--would agree to some sort of medical socialization.

Ponderers of this dilemma argued at length with one another in San Francisco last week. Assistant Surgeon General Warren Fales Draper of the U. S. Public Health Service hinted that the Federal Government, which already runs a tremendous medical establishment for soldiers, sailors and war veterans, was ready to expand further.

Others pointed out that 2,000,000 U. S. citizens pay two cents or more a day to insure themselves against hospital bills; that 15,000,000 citizens who work for railroads, public utilities and industries are already accustomed to having company doctors look after their accidents and ills; that insurance company agents are itching to sell health insurance to the populace.

A large majority of the A. M. A.'s delegates last week held firm to this tenet: that the health of all the people of this country will be protected best if: 1) each locality is permitted to adapt one of several endorsed social-economic-medical procedures to its own local needs; 2) doctors are put in charge of all governmental and corporate medical systems. Greatest desideratum to them is a medical Secretary of Health in the President's Cabinet. Great fear is a nonmedical Secretary of Welfare.

Hero. In spite of their preoccupation with strictly professional problems, the delegates paused this year for the first time to salute a colleague for high general medical achievement. To Surgeon Rudolph Matas of New Orleans went their first annual Distinguished Service Medal, given for "meritorious service in the science and art of medicine." Stout, little Dr. Matas, 1895-1927 Tulane professor of surgery, was one of the world's first doctors to use local anesthetics. He invented a splint for broken jaws and aluminum binders for bulging arteries. He discovered safe ways of operating in cavities of the chest and sure ways of testing for blocked circulation in fingers and toes. Probably his boldest procedure (the Matas Operation) is to slit the paper-thin wall of an artery which is about to burst, stitch the walls together like a seamstress taking in a pleat, and leaving the artery with a normal size bore. Last week's was the most recent of many honors for Dr. Matas.

For Patients & Practitioners the convention, assembled in various special groups, listened to some 275 member physicians reveal what tricks of the profession the past year had turned up:

P: "The allergic salute," rubbing the nose, is a child's way of showing that he is allergic to some substances and needs medical attention, according to Dr. W. Ambrose McGee of Richmond, Va.

P: Brains need oxygen, which they get from the blood. At the time of birth, a child's breathing may be disturbed and his brain starved of oxygen because his mother took too much drug to allay the pains of childbirth. Said Dr. Frederic Schreiber of Detroit: the difference between a living infant with a brain damaged from this cause and one that is born dead is probably only a matter of degree.

P: Drs. Hiram Houston Merritt & Tracy Jackson Putnam of Boston announced that a little used drug, diphenyl hydantoin, completely prevents, or reduces the frequency of attacks of epilepsy in 77% of patients with the severe type. It soothes, does not cause drowsiness.

P: The following notable drugs may poison the marrow in the bones, decrease the production of white blood cells, may cause death, and should be taken as medicine only with specific instructions from a well-informed doctor, said Dr. Roy Rack-ford Kracke, Atlanta blood specialist: amidopyrine, dinitrophenol, novaldin, antipyrine, sulfanilamide, sedormid, salvarsan.

P: Warm air for sinuses is what Dr. William Walter Wasson of Denver advises if the sinuses are chronically diseased. He has patients sleep in rooms "well ventilated with warm air of the proper humidity."

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