Appendicitis At 100

In a classic medical paper, Dr. Reginald Fitz identified the disease, named it, showed how to diagnose it, and prescribed an operation that would save tens of millions of lives

On Sunday, January 17,1886, a twenty-four-year-old Boston woman experienced searing, excruciating pain in her right lower abdomen. Her doctor prescribed applications of moist heat to her abdomen, an enema of warm water, and a dose of morphine, all to be repeated “as needed.” Two days later the pain had subsided, but by afternoon it returned, this time afflicting the entire abdomen. The doctor increased the dosage of morphine, and the pain again let up.Read more »

Vietnam: Helicopter Evacuation


A MARINE GUIDES a medevac helicopter to a landing to a near Du Co, South Vietnam, where it will pick up the victims of an ambush and fly them to a nearby hospital. Helicopter evacuation began in Korea, but in that war, land-based ambulances still carried 80 percent of the wounded. In Vietnam, “dust-off” helicopters touched down on the battlefield itself and removed the wounded to air-conditioned fixed-facility hospitals as sophisticated as those in the United States.

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The Korean War: MASH And Vascular Surgery


DOCTORS OPERATE on a wounded soldier at a Mobile Army Surgical Hospital. Korea’s MASH units were adaptations of systems devised in World Wars I and II, in which surgical teams were sent forward to clearing stations to stabilize the condition of severely wounded men before sending them to the rear for definitive care. At first Korea’s MASH units moved with the Army; as the war settled down, they tended to remain stationary.

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World War II: Plasma, Penicillin, And Insecticides


WITHIN MINUTES of being hit, a wounded soldier in Sicily receives blood plasma from an Army medical corpsman. Some 80 percent of injuries in World War II were caused not by bullets but by bombs or mortar and shell fire, resulting in grave wounds accompanied by shock. Doctors in the First World War had learned that transfusions were useful in treating shock, but they had no system of collecting and transporting sufficient quantities of blood.

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World War I: Tetanus And Plastic Surgery


VICTIMS OF mustard gas, American soldiers of the 82nd and 89th divisions lie in a field north of Royaumeix, France, too numerous to be cared for in the nearby field hospital. New weapons like gas and the increasing efficiency of conventional weaponry meant ever larger numbers of wounded men: this war saw dramatic improvements in the number and quality of hospitals and in triage—the method of sorting the wounded.

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Military Medicine

How our wartime experience conquered a wide range of problems from hemorrhagic shock to yellow fever

WHEN HIPPOCRATES wrote in the fifth century B.C. that “he who would learn surgery should join an army and follow it,” he illuminated the central irony of military medicine. Destructive as war is, it makes possible quantum leaps in the art of healing. And it is the surgeon who benefits most directly: war has been described as an “epidemic of trauma,” and the vast supply of wounded men provides opportunities for experimentation and innovation unthinkable in a world at peace.Read more »

The Genealogy Of Mass General

How a favorite local charity of Boston’s Brahmins—parochial and elite—grew into one of our great democratic medical institutions


HE WAS A sixth-generation American, white and Protestant, educated at Princeton and the University of Pennsylvania Medical School, which, at the time, was the best in the country. Even in 1912, hiring David Linn Edsall would hardly seem to be a blow for equal-opportunity employment. But the place was Boston, the job was to lead the medical staff of the Massachusetts General Hospital.Read more »

The State Of Medical Care, 1984

Americans have never been so healthy, thanks to advances in medical technology and research. Now we have to learn to deal with the staggering costs.


FEW PEOPLE ARE as well qualified to assess the U.S. medical scene as David E. Rogers. Formerly chairman of the Department of Medicine at Vanderbilt University and then dean of the Johns Hopkins University School of Medicine and medical director of Johns Hopkins Hospital, he has since 1972 been president of the Robert Wood Johnson Foundation. The foundation was established on a modest basis in 1936 by Robert Wood Johnson, head of the pharmaceutical concern of Johnson & Johnson.Read more »

What It Was Like To Be Sick In 1884

American medicine in a crucial era was at once surprisingly similar and shockingly different from what we know today. You could get aspirin at the drugstore, and anesthesia during surgery. But you could also buy opium over the counter, and the surgery would be more likely to be performed in your kitchen than in a hospital.

IN 1884 ALMOST three-quarters of America’s fifty million people lived on farms or in rural hamlets. When they fell ill, they ordinarily were treated in their own homes by someone they knew, someone who might not be a trained physician but a family member, neighbor, or midwife. Only a handful of smaller communities boasted hospitals, for they were still a big-city phenomenon.Read more »

A Short History Of Heart Surgery

“A wound in the heart is mortal,” Hippocrates said two thousand years ago. Until very recently he was right.

IN MAY OF 1975, when I was fortyseven, I developed angina (heart pain due to an insufficient supply of blood to the heart muscle), and about two months later, after a stress test, a coronary angiogram, and various blood tests, I underwent an operation. The operation was a coronary artery bypass in which veins from my leg were used to bypass the obstructed arteries of my heart.Read more »