Medicine: Surgeons

Prohibition was also the aperitif at the Boston clinical congress of the American College of Surgeons last week. Franklin N. Martin of Chicago, president of the College, interrupted his formal inaugural talk to say: “More than two-thirds of our people morally and spiritually favor the 18th Amendment to the Constitution. In spite of the injudicious administration, which has resulted in an orgy of lawbreaking, of self-indulgence and ridicule on the part of the other one-third of our citizens, the foundation has been laid for a demonstration of race betterment and extension of life that will astonish the world.”

His audience shifted in their seats. On the platform back of him a dozen foreign surgeon-guests looked inquisitive, puzzled, amused. All waited for Dr. Martin to support his statement with statistics; he supplied none. After the day’s session the surgeons buzzed at each other with pompous cynicism. Quotable comments:

“Americans as a nation suffer from indigestion because body poisons are not burned up by the moderate use of wines and beer. I am impressed by the difference in the looks of Australians and you Americans. Our folks look so much more healthy and vigorous.” (Herbert Schlink of the Royal Prince Alfred Hospital, Sydney, Australia.)

“After a visit to America I have always noticed the healthy look of my countrymen. The secret drinking in this country is far worse than moderate open drinking.” (President Sir George Syme of the Australian College of Surgeons.) Just a month ago New South Wales, Australian state, on a referendum vote defeated Prohibition four to one.

But of more concern than drinking to the surgeons were the qualifications of hospitals and professional men.

The U. S. has 2,761 hospitals good enough for the American Medical Association to bother inspecting. Of those 1,919 (or 70 out of 100) are good grade (on the “approved list”); they have fair to excellent equipment for treatment and research. The situation is not perfect. But it is pleasing to doctors. Ten years ago only 12 out of 100 U. S. hospitals were fit for praise.

During those 10 years medicine has improved too, in practice as well as in science. In 1918 patients remained in hospitals 20 to 24 days on the average, now they stay only 12 to 14 days for the same diseases. Then 70 to 90 out of 1,000 hospital patients died; now 20 to 30. Then 18 out of every 100 major operative cases died; now 3 or less. Surgery is more competent, anesthetics better.

To boost hospitals higher on their toes the College of Surgeons last week insisted that hospitals follow up their patients for six months after discharge. This is to make certain what good, or ill, the hospital does to its clients. Another bolster is the requirement that all approved hospitals hold staff meetings at least once a month and make doctors explain just why any of their patients died.

President-elect (for 1929) of the American College of Surgeons is Surgeon General Merritte Weber Ireland of the Army.