Search

This article explores the medical condition and treatment of Babe Ruth, a renowned baseball player. Ruth experienced diverticulitis, a condition likely caused by his overeating. He underwent surgery to drain an abscess and recuperate from the illness. The procedure was performed by Dr. George D. Stewart, a respected surgeon who was also a poet. Ruth's recovery was successful, and he did not require additional treatment or surgery. The article also touches on Ruth's baseball career and his subsequent achievements following his recovery. [Extracted from the article]

Musicians with physical disabilities who achieved stardom are part of the lore of popular music. Guitarist Django Reinhardt contrived alternate fingering patterns necessitated by burn contractures of his left hand. Les Paul, a legend in the development of the solid body electric guitar and multitrack recording, mangled his right arm in a car wreck so severely that his elbow was set permanently at 90° so he could continue to play guitar. Michel Petrucciani suffered from osteogenesis imperfecta, a condition that stunted his growth to the point where he used a special attachment to reach the sustaining pedals of his piano. Their stories show the force of human genius in music. [ABSTRACT FROM AUTHOR]

When 13-year-old Teruichi Nakayama, my grandfather, came to San Francisco from Osaka in 1906, he was assured of an education in a public school by an 1894 treaty between the United States and Japan that gave the latter most-favored-nation status. In 1906, racist mobs forced a decision by the school board to assign 41 school aged Japanese children, including him, to a segregated school for Asian children in violation of the pact. In 1907, he escaped street violence to work as a migrant laborer on inland farms. Settling in the state's Central Coast, he started a confectionary, the family business he knew from his childhood in Japan. He eked enough money to raise a family with a wife arranged for him in the traditional manner by a go-between in Japan. The school board action opened a diplomatic rift between the 2 countries that never resolved and ended in war in 1941. Just days ahead of the imprisonment of Japanese living in California in 1942, he and his family fled to Colorado, a sanctuary state where he reestablished the confectionery. He faced every misapprehension of the current immigration crisis: racism, unfair labor competition, the impossibility of assimilation, and suspicion of a fifth column. Now 5 generations later, none of the fearful predictions when he first arrived came true. His legacy proves immigration as an essential rejuvenating force in America. [ABSTRACT FROM AUTHOR]

The Opium Wars of 1839-1843 and 1856-1860 revealed the devastating effects of narcotic addiction on the health of the body politic of China. The defeated Qing dynasty lost effective sovereignty to the British, leaving it helpless against more than 100 years of exploitation by the European powers, the United States, and Japan. Today we see the same risk posed by prescription narcotics and illegal opioids imported from China that can be seen as retribution for the "Century of Humiliation" nearly two centuries ago. [ABSTRACT FROM AUTHOR]

Asian migration to America began with Chinese railroad workers on the transcontinental railroad (1862-1869). Their labor saved the foundering Central Pacific Railroad, challenged by building a rail line through the Sierra Nevada. By mid- 1864 only 50 miles of track had been laid, grueling work that dissuaded its white workforce from going any further. To save the railroad 50 Cantonese workers were hired in early 1864 from neighboring mines to lay rail through forests, canyons, and granite mountains. High explosives, rockslides, cave-ins, and winter avalanches were constant dangers. The trial worked so well that thousands of Chinese joined the effort, many from the rural districts surrounding Guangzhou (Canton). The wages, less than half of that paid to white workers, were beyond the imaginations of subsistence farmers escaping abject poverty, plague, and famine. A good proportion of their earnings were remitted to families back home. As many as 20,000 may have worked on the railway. The death toll was staggering, estimated in the thousands. After Promontory Summit in 1869, Chinese were in great demand, building scores of rail lines throughout the country and Canada. Just 13 years later rising anti-Asian sentiment led to the passage of the Chinese Restriction Act of 1882 that for the first time barred a racial group from American shores. But they opened America to Asian immigrants that includes today's Asian surgical community, which owes its present-day success to the hardworking forebears that created a global country with ribbons of steel rail. [ABSTRACT FROM AUTHOR]

The Great Migration, the movement of 6,000,000 black Americans from the South to the great urban centers of the eastern seaboard, the industrial Midwest, and West Coast port cities from roughly 1915-1970, was one of the defining demographic events in American history. It dwarfed the 100,000 49ers who swarmed westward in search of gold, the incarceration of 110,000 Japanese to concentration camps in the American interior during World War II, and the 300, 000 Okies who escaped the Dust Bowl to California. In the words of writer Isabel Wilkerson, "[It] swept a good portion of all the black people alive in the United States at the time into a river that carried them to all points north and west." Blacks crammed into urban districts rife with crime and communicable disease, subjecting them to risks of death far higher than their proportion of the population. Without access to adequate inpatient hospital facilities, they received care in public hospitals run by hospital staffs that excluded black physicians from their membership and medical schools that refused admission to black students. The untenable health station of Black America was one of the leading causes of the civil rights movement of the 1950s and 1960s, activism that succeeded in integrating the hospitals and medical schools by federal acts passed in 1964 and 1965 that transformed American medicine. [ABSTRACT FROM AUTHOR]

The origins of today's surgical societies are the guilds of medieval London. The Company of Barbers and the Guild of Surgeons vied for dominance no different from the scores of conflicts between rival artisans and merchants whose trades overlapped. The Company dates from 1308, when the council of London passed ordinances that installed its first master, Richard le Barber. When the surgeons received ordinances of their own in 1368, the barbers had the Council reassert theirs in 1376, 1390, 1415, and 1424. Faced with a vigorous organization with greater numbers the surgeons aligned with the physicians in 1423 to form a short-lived ruling "commonalty" with an elite membership based on educational achievement and proven ability that excluded the barbers. The surgeons were thereby granted authority over all of surgery, including that practiced by barbers, an arrangement that failed after only a year. The surgeons formed a guild in 1435 but could not compete with the barbers. The barbers' primacy became complete in 1462 when Edward IV chartered them to govern all aspects of surgery, along with the power to fine and imprison. From then barbers and surgeons amiably coexisted, likely because the rapidly growing population and the democratization of the practice of physic provided plenty of work. Henry VIII formally united the barbers and surgeons in 1540 under the Worshipful Company of Barbers and Surgeons, an amalgamation that lasted for two centuries until the surgeons broke away in 1745. [ABSTRACT FROM AUTHOR]

Chinese immigration in America in the mid-nineteenth century incited violence and governmental sanctions to restrict Asian immigration and reject citizenship rights. In 1870, Chinese strikebreakers in Massachusetts ignited nationwide demonstrations against Chinese immigration, which ended altogether with the Chinese Exclusion Act (1882). Japanese schoolchildren in San Francisco public schools sparked rioting in 1907, leading Japan to unilaterally limit emigration to the United States (Gentlemen's Agreement, 1908). Congress responded to anti-Punjabi riots (Bellingham, WA, 1907) by refusing naturalization rights to Asians (Barred Zone Act, 1917), policies supported by the Supreme Court (Ozawa, 1922; Thind, 1923). All immigration from Asia was soon prohibited (Johnson-Reed Act, 1924). Anti-Asian measures peaked in 1942 with imprisonment of Japanese in concentration camps, including those with birthright citizenship. Anti-Asian policies unwound in the last half of the 20th century, culminating in sweeping changes in US immunization policy. Naturalization rights were granted to wartime allies against Japan (China, 1943; the Philippines and India, 1946) and the Japanese themselves (1952). Asian women marrying American servicemen were allowed entry into the country (1945, 1950). Prohibitions against Asian immigration were lifted in 1965 (Hart-Celler Act), with preference for those trained in science, technology, and medicine. The refugee crisis that followed the fall of Saigon (1975) drove humanitarian policies that brought evacuees from Southeast Asia and others from throughout the world seeking freedom from persecution (Refugee Act, 1980). Hundreds of thousands from China, South Asia, the Philippines, and Southeast Asia thus settled in the United States, changing American society and medicine. [ABSTRACT FROM AUTHOR]

An editorial is presented the traditions of the morbidity and mortality conference (M&M), tracing its origins to surgeon Ernest Amory Codman in the early 20 century, and highlighting the principles of personal accountability and continuous improvement in medical practice. Topics include Codman's "End Result" system, the nosology of errors guiding M&M discussions, and the historical significance of M&M conferences in addressing maternal mortality.

The stories of Asian immigrants have both shared themes and ones that are unique to the histories of their homelands. Their labor was essential to the settlement and economic development of America, yet their presence incited riots and official restrictions to their rights to immigration and citizenship. Chinese laborers mined the Gold Country, built the transcontinental railroad, and reclaimed tillable land in the Central Valley. Yet they were denied the immense bounty they created, and their immigration was blocked by the Chinese Exclusion Act of 1882. Japanese, Asian Indians, and Filipinos replaced them on farms as migrant laborers. As foreign nationals they were not allowed to own land, but they thrived as independent farmers on leased plots. Their success attracted discrimination and racist violence. They, too, were barred from immigration and citizenship (Johnson-Reed Act, 1924). World War II was a watershed event for Asians in America. Japanese Americans, ethnically identical to the enemy, were imprisoned in concentration camps in the American interior. China, the Philippines, and India, all allies of the US, were rewarded with naturalization rights for their nationals. In 1965 Congress liberalized immigration quotas and reversed the 1924 restrictions, with priority given to those with advanced technical ability in science, including medicine. Asians from Taiwan and India took advantage of the new regulations and predominated among the newcomers. After the fall of Saigon in 1975, America accommodated yet another Asian population in the country, the tens of thousands of refugees from Southeast Asia. [ABSTRACT FROM AUTHOR]

The quality movement in 21st century healthcare—quality, patient safety, and the value equation (value equals quality divided by cost)—had their start with Ernest Amory Codman (1869-1940), the quixotic surgeon who started it all a century before. He was on track for prosperity and success, given a Boston Brahmin pedigree and his impeccable credentials from Harvard College, its medical school, and the Massachusetts General Hospital. In 1910, nearing 40, Codman instead detoured toward a revolutionary idea that he called the End Result system, the seemingly unachievable goal of reaching "perfection" in surgery: complete recovery without death, complications, or lasting disability. He scrutinized any case that fell short, seeking honest explanations and improvements so that his next case would more likely reach a perfect outcome. The system that was so clear to him was audacious to his colleagues, who summarily rejected it. When Codman suspected greed and self-interest, he was ostracized from the Boston medical community. To apply his concepts, he opened a proprietary hospital called the End Result Hospital that drove him to insolvency. His career never recovered from the debacle even when he later reached prominence as an authority on bone malignancies and shoulder pathology. When he died, his resting place went unmarked. As quality became central to healthcare at the end of the 20th century, Codman's prescient End Result system was recognized as a fundamental contribution to medicine. [ABSTRACT FROM AUTHOR]

One of the heroes in American history, Associate Supreme Court Justice Thurgood Marshall (1908-1993) sought legal remedies against racial discrimination in education and health care. As director of the Legal Defense Fund (LDF) of NAACP from 1940 to 1961, his success in integrating law schools in Texas led to the first black medical student admitted to a state medical school in the South. Representing doctors and dentists needing a facility to perform surgery, the LDF brought cases before the courts in North Carolina that moved the country toward justice in health care. His ultimate legal victory came in 1954, Brown v. Board of Education of Topeka, the decision that declared racial segregation in public schools unconstitutional. In 1964, the LDF under Jack Greenberg, Marshall's successor as director, won Simkins v. Moses H. Cone Memorial Hospital, a decision that held that hospitals accepting federal funds had to admit black patients. The two decisions laid the judicial foundation for the laws and administrative acts that changed America's racial history, the Civil Rights Act of 1964 and the Social Security Act Amendments of 1965 that established Medicare and Medicaid. His achievements came during the hottest period of the American civil rights movement of the 1950s and 1960s. Well past the middle of the twentieth century, black Americans were denied access to the full resources of American medicine, locked in a "separate-but-equal" system woefully inadequate in every respect. In abolishing segregation, Marshall initiated the long overdue remedy of the unjust legacies of slavery and Jim Crow. [ABSTRACT FROM AUTHOR]

The foundation story of immunology is the Christmas miracle of Emil von Behring, whose diphtheria antitoxin was first used to save the life of a child on Christmas Day 1891. Modern scholarship has dismissed it as historically and scientifically implausible: Behring's lab did not have enough antitoxin serum for use in humans, and Ernst von Bergmann had prohibited its use at the Charité. But antitoxin was tried that December by their assistants, Erich Wernicke, who processed injected rams and horses and harvested the serum for Behring, and Heinrich Geissler, who was one of Bergmann's house physicians. Especially during the Christmas season, it is easy to imagine Wernicke and Geissler bypassing protocol and giving the serum a try as a last-ditch effort to save a dying child. Derek Linton, a Behring biographer, wrote: A harried nurse confronted by a dying infant belatedly remembers that a doctor with a promising remedy for diphtheria urged her to bring hopeless cases to his attention and has him roused from his slumber on the other side of Berlin in the middle of the night on December 20, 1891. The injection of his wonder serum then rapidly resuscitates the comatose infant. Five days later, the parents celebrate the most joyous Christmas of their lives with their fully recovered daughter. [ABSTRACT FROM AUTHOR]

David V. Feliciano, a highly respected figure in academic surgery, passed away at the age of 79. He made significant contributions to trauma and surgical education, particularly in the management of abdominal vascular injuries, liver injuries, peripheral vascular injuries, and vascular damage control. Feliciano was known for his devotion to his patients and his role in organizing a renowned trauma service at Grady Memorial Hospital in Atlanta. He was also a skilled teacher, using a direct and incisive approach to educate others in the field. Feliciano's impact on surgical education and his dedication to improving patient care will be remembered. [Extracted from the article]