Tobacco Documents Online

The Harmful Effects of Tobacco Chairman: CLAUDE E. FORKNER, M.D., Professor of Clinical Medicine, Cornell University Medi- cal College; Attending Physician, New York Hospital. Panel Members: GREYDON BorD, M.D., Associate Professor of Surgery, New York University; Sur- geon, New York Eye and Ear Infirmary; Con- sultant Surgeon, Veterans Hospital, Brooklyn. NORNfAN WILSON, M.D., Assistant Clinical Pro- fessor of Surgery, Tufts College Medical School; Thoracic Surgeon, New England Deaconese Hospital, Boston, Mass. IRVING S. WRIGHT, M.D., Professor of Clinical Medicine, Cornell University Medical College; Attending Physician, The New York Hospital. ERNEST L. WYNDER, M.D., Chief Resident at Memorial Center; Assistant at Sloan-Kettering Institute. CHAIRMAN CLAUDE E. FORKNER: Today we are having a conference on the harmful effects of tobacco. I have one or two statements to make. In a'paper by R. B. Scott in the British Medical Journal, March 29, 1952, is a historical note that I thought would be of interest. He says that so far as Western civilization is concerned, the history of tobacco begins on October 13, 1492 when Christopher Columbus landed on the island he named San Salvador. The natives sought to propitiate their visitors with rare gifts including among them some dried leaves which the Spaniards later threw away with smiles at the artless generosity of the savages. Nevertheless, within fifty years these leaves were eagerly' sought in Europe and recommended for their medicinal prop- erty by the Ambassador in Lisbon, Jean Nicot, who later gave his name to nicotine. Within the century the habit of pipe smoking had been firmly established in England. It survived the formulations of James I who published his counterblast to tobacco within a year of com- ing to the throne, stigmatizing smoking as a Edited by CLAUDE E. FORKNER, M.D. Presented at the Practitioners' Conference, New York Hospital- Cornell University Medical Center December 2, 1953 custom loathsome to the eyes, hateful to the nose, harmful to the brain and dangerous to the lungs. In continental countries where deterrents were more vigorous, the habit of smoking spread less. In Russia smokers were discouraged by amputation of the nose, and in the Swiss canton of Berne the• offense was ranked only one degree less odious than adultery. The pro- hibition of smoking in the streets was rigidly enforced in the streets of Berlin up to 1849. I have asked a patient to tell you in thirty seconds why he stopped smoking. Would you, sir, tell us why you stopped smoking? PATIENT: Dr. Forkner, I have no prescribed speech. I didn't give up smoking because of fear of cancer. I gave it up because I had an irritation of the throat. I noticed the difference almost immediately. The next day my breath- ing was eagier and I seemed to be more alert. I found that sometimes I seemed to be in a fog. I became convinced that this mental dull- ness was due to cigarettes. To me it seemed they were a form of sedative which was no longer active after I ceased smoking. The only thing wrong now is that I am getting too fat. I don't know whether I can afford it or not. CHAIRMAN FORKNER: Thank yOU. Dr. Sut- ton, would you tell us -why you stopped smok- ing? DR. JOHN E. SUTTON: I smoked cigarettes and I smoked many of them-a pack and a half or two packs a day. On the 9th of August, Sunday morning, I awakened with my left arm asleep. That was not unusual because for years I slept with a thin pillow or no pil- low and used my arms instead. For a number of years we have had a custom of taking black coffee in a thermos up to our bedroom and having it the first thing in the morning. It was a very comfortable habit and I smoked 356 NEW YORK MEDICINE

V 1 1 one, two, three, sometimes four cigarettes with my black coffee. I did that on the morning of the 9th of August, not thinking anything of it at all until I found that my left arm had not come to life. In fact, it had become com- pletely dead up to my elbow. I could not move a finger. My thumb, fingers, hand and arm were white. The finger nails were cyanotic. I loafed around. I said nothing to my wife and she did not think it anything too unusual that I loafed around on Sunday morning. For about two and one-half hours I did no smok- ing but during that time I thought it wise to call up some friends of mine. I telephoned a neurosurgeon and a neurologist and told them my symptoms and what had happened and my habit of sleeping on 1117 arms and something about smoking and the black cof- fee. They concluded that I had been sleeping on my arm. That was a natural conclusion. During the morning I had considerable time to think about things and I came to the con- clusion that the symptoms were not entirely due to sleeping on my arm. I began to get a little sensation back in my hand but I could not use it. I could not shave. I could not dress. I could not tie my necktie. I could not but- ton a button. So I said to my wife that I was going to try an experiment and that it may prove what was wrong with me. I had been smoking cigarettes for 30 years. So I picked out one of my favorite cigarettes and began inhalin; it as I usually did. The tip of my thumb and a1T of my fingers began to tingle. They became dead and white and that tin- gling and dead feeling went up to my elbow and I was right back where I started from, with a perfectly paralyzed hand and arm. I was admitted to the hospital and had a course of anticoagulants,administered. Gradu- ally improvement occurred. I went south and had some good baking in a tropical climate. I g~t back to New York and started operating again on the 28th of September. CHAIRMAN FORKNER: Have you smoked again? DR. SL•TTON : Not on your life. CHAIRMAN FORKNER: I have asked Dr. Wynder to open this conference, if it is not already open, by making a few remarks. Then MAY 5, 1954 we are going to show you two cases briefly. Dr. Wynder! DR. ERNEST L. WYNDER: Dr. Forkner, first of all, I think we must be aware that there are two sides to this problem and I think we should not take either extreme. One extreme that I recall was written by Dr. Abbott in the eighteen hundreds when he wrote about the effects of tobacco and he stated that he has never seen a man smoking a cigarette who is trustworthy or honorable. I have too many friends of my own who smoke so I would hate to agree with such statements. On the other hand, the state- ments that we read today in advertisements go to the other extreme saying that there are no harmful effects at all in smoking. We are convened here today to decide what is fact and what is fancy in regard to the effect of smoking on various diseases. There are a number of diseases which have been considered in the medical literature to be associated with tobacco smoking. Among these are vascular diseases, gastric ulcers, some allergic disorders, certain throat conditions and finally, and perhaps what has brought this entire subject into the great limelight today, is the possible association of smoking to cancer. In the evaluation of these diseases we must think along two lines. One is the effect of tobacco on vascular diseases. This effect prob- ably is related to the nicotine content. The other effect is related to its possible irritating nature which we believe is due to the tars in tobacco. These two facts _we must keep separate. We are discussing this subject today as sci- entists and as physicians and as such we want to know the part tobacco may play in the eti- ology of various diseases and how by controlling the effect of tobacco, if we determine that it has an etiological effect, can we control some of these diseases. Our only concern is the wel- fare of our patients. We have nothing to sell. Our job as physicians is to fight disease. If in this task we find evidence of harmful effects on the health of patients by any given agenzs, then we must try to modify these agents or their use. We are now opening the discussion to de- termine, as I said in the beginning, what is 357

1 fact and what is fancy. Some of the things we read today in regard to tobacco coming from our own medical profession may be ex- aggerated but much is truth and that truth we would like to ascertain this afternoon. CHAIRMAN FORKNER: Thank you, Dr. Wyn- der. I agree entirely with everything that Dr. Wynder has said. I don't want to leave the impression that we are trying to attack the tobacco companies. We are aware that some of the great tobacco fortunes of this country have contributed to medicine. They have built a great university, Duke University, and I be- lieve Wake Forest University, and have con- tributed to the medical schools. We fully believe that the tobacco industry wants - to- continue to be philanthropic and of benefit to the people, but I feel that in their eager- ness to sell their products that they have mis- led the people and themselves. Now we are going to show two cases. The first case will be presented by Dr. Barakat. DR. RussEL BARAKAT: This is the first New York Hospital admission of a 56-year-old white, male, widower, chauffeur, who came into the hospital because of cough. Six weeks prior to admission he had a cold which lasted for two or three days. This respiratory infection left him with a chronic cough. Three weeks prior to admission he acquired another cold. At this time he consulted his family doctor, who took a chest x-ray, and found a "spot" on the lung.. He was advised to come to the hos- pital. Two weeks prior to admission, he ex- perienced some dyspnea. He has been known to smoke for 40 years, about 30 cigarettes a day, plus an occasional cigar or pipe. He usually inhales the smoke. He has no history of tuberculosis or chronic bronchitis or asthma. He had no chest pain or hemoptysis. The family history, past history and review of systems are non-contributory. On physical examination the vital signs were essentially normal. Rectal temperature 37.8 degrees C., pulse 80, respirations 24, blood pressure 135/75. The only positive finding was found to be clubbing of the fingers. The routine laboratory examinations were within normal limits except for a white blood cell count of 11,600 per cu. mm. Further routine screening 358 studies were done as you see on the chart. The results all were negative, urine, Mazzini, BUN, fasting blood sugar, prothrombin time, sputum culture and intravenous pyelogram. The sputum was studied by Dr. Papanicolaou and was Class II which is ne;ative. X-ray i lms of the cheat wei-e taken and the results v,-il1 be shown. CHAIRMAN FORKNER: Dr. Barakat, will you tell us about the films? DR. BARAKAT: There is a density here at the upper lobe of the right lung. That is the only positive finding. It was decided to do a right pneumonectomy. This was done and carci- noma was discovered with metastases to the hilar lymph nodes. The operation was done on the 23rd of November. The condition of the patient is good and he is tip and around. Shall I show the patient? CHAIRMAN FORKNER: Yes. (Patient comes in.) Dr. Barakat, have you anything to dem- onstrate on this patient? DR. BARAKAT: I would like to show you the clubbing of the fingers which was the only positive finding found. CHAIRMAN FORKNER: Will that clubbing disappear, Dr. Wilson? DR. NORMAN WILSON: I would like to know how long it has been present. Da. BARAKAT: It has been present for thirty years. PATIENT : I used to bite my finger nails. CHAIRMAN For.KNER: How long have they been bent over, bigger on the end? PATIENT: About thirty years. CHAIRMAN FORKNER: They probably will not disappear. DR. WILSON: I don't think they will change. CHAIRMAN FORKNER: If it were recent in origin, the clubbing would disappear. Are you smoking now? PATIENT : No, sir. CHAIRMAN FORKNER: Are you going to re- sume smoking? PATIENT: I am afraid not. CHAIRMAN FORKNER: Are there amy ques- tions you would like to ask this patient' DR. WILSON: I would like to ask him about his cough that took him to his family doctor. How did your cough change? NEW YORK MEDICINE

. i PATIENT: I caught a cold. DR. V!'II,sON : You started a head cold? PATIENT: Running nose, watery eyes, etc., kind of depressed me. I went over to the doc- tor. He gave me an antihistamine or so. I got rid of the cold but I never did get rid of the cough. That lagged for 3 or 4 weeks. Then I caught another cold on top of that. CHAIRMAN FORKNER: Did you have a cough before you had the cold, a smoker's cough? PATIENT: Occasionally in the mornings. I( I had a heavy night the night before I would get a throat clearing out the next day. CIIAIRMAN FORKNER: We hear about smok- er's cough, smoker's larynx, smoker's angina, smoker's asthma, smoker's lung, smoker's throats; did you have any of these? PATIENT: I'Vell- CHAIRMEIN FORKNER: Thank you very muclt. (Patient leaves.) DR. LAWRENCE SONKIN: I brought an- other patient down who has the identical his- tory of this patient. I though we might just bring him in to show that the woods are full of them. (Patient comes in.) CHAIRMAN FORKNER: How long have you been smoking? PATIENT: About 40 years. CHAIRMAN FORKNER: How many cigarettes a day? PATIENT: An average of 3 packs a day, CHAIRMAN FORKNER: Do you smoke a pipe or cigars? PATIENT: Just cigarettes. CHAIRMAN FORKNER: Three packs, 40 years. You are a little hoarse now. Have you always been that way? PATIENT: No, since the bronchoscopy. CHAIRMAN FORKNER: What did they find on the bronchoscopy? PATIENT: They did not tell me. CIIAIR-MAN FORKNER: Have you had a cOUgh? PATIENT: Not much since my operation but I have had a smoker's cough, yes. CHAIRMAN FORKNER: What do you spit up with It? PATIENT: NOthing at all. MAY 5, 1954 CHAIRMAN FORKNER: Have you ever stopped smoking in 40 years? PATIENT: Yes, since my operation. CHAIRMAN FORKNER: Thank you very much for coming in. Are you going to start smoking again? PATIENT: Definitely not. CHAIRMAN FORKNER: The next patient will be presented by Dr. Dame. DR. RICHARD DAME: The second case this evening is that of a 26-year-old white male Czechoslovakian draftsman who entered The New York Hospital for the second time on the 16th of September 1952 with the chief com- plaint of gangrene of the right fifth finger mani- fested by a discoloration and extreme pain. His present illness dates back to about Nu- vember of 1948; at that time he had been in a displaced persons' camp. For about fivt months prior to this, he had been smoking quitt heavily, up to a pack and one-half a day, buL when he entered the displaced persons' calnl., cigarettes became less available to him and hc restricted himself to two, three or four ciga- rettes a day. In November of 1948 he devel- oped pain in the left second toe which bothered him considerably. Soon after that he devel- oped discoloration and severe pain in the fourth toe of his left foot. In December of 1948, a month later, left lumbar sympathectomy was done, apparently as a result of the diagnosis of thrombo-angiitis obliterans. However, fol- lowing that the patient continued to smoke cigarettes to the extent of five or ten a day, never having been told to stop. However, he was asymptomatic until about March of 1940 when the left fourth toe, on which he had the gangrene previously, was amputated. Again he was well and asymptomatic, although he con- tinued to smoke until January 1950, when he developed gangrene of his right third and fifth toes, and a right lumbar sympathectomy was done. At this time he was still in Germany. Am- putation of the third and fifth toes of the right foot was also performed. He continued to smoke never having been told to stop. In De- cember 1950, he developed a paronychia on the first toe of the left foot, which responded well after the nail was removed. In June of (Continued on page 369) 359

c Colendar of Medlcal Meetfos-May 1954 MONDAYS I TUESDAYS I WEDNESDAYS THURSDAYS FRIDAYS SATURDAYS Page Page Page Page Page Page May 5 May 6 May 7 N.Y. Soc. of Physical NYAM-Stated NYAM-Surgery; N.Y. Medicine 363 Meeting 362 and B'klyn Com. *J.Y. Hospital- NYAM-Postgraduate on Trauma 362 Prac. Conf. 363 Radio Program 368 Montefiore Hospital 363 N.Y. Allergy Soc. 363 Medical Circle 363 May 10 May I I May 12 May 13 May 14 May 15 Soc. of Medical Juris- N.Y. Neurological iVYAM-Historical & The Mt. Sinai Hosp.- N.Y. Society for Columbus Hospital 366 prudence 363 Society & NYAM 362 Cultural Medicine 362 Ophthalmol. Conf. 364 Thoracic Surgery 365 Beth David Hosp. 363 The M.. Sinai Hosp.- N.Y. Hospital- U.S. Veterans Hosp. 365 American-Hungarian The Mt. Sinai Hosp.- Gzslroca:-erology 364 Prac. Conf. 363 N.Y. Cardiological Medical Assn. 366 Neurological 364 ~ The Mt. Sinai Hosp.- Society, Inc. 365 Diabetes & Nutrition 364 NYAM-Postgraduate High Point Hospital 364 Radio Program 368 Columbus Hospital 364 The N.Y. Hospital- N.Y. Surgical Society 365 Plastic Surgery 365 N.Y. Soc. for, Speech & Voice Therapy, Inc. 365 Adelphi Hospital 365 May 17 May 18 May 19 May 20 May 21 NYAM-Ophthalmol. East Side Clinical N.Y. Hospital- The Hospital for The Assoc. for the & Obstetrics 362 Society 366 Prac. Conf. 363 Spec. Surgery 367 Advancement of N.Y. Roentgen Society 362 Harlem Hospital 366 Gouverneur Hospital 367 Psychotherapy 367 Madison Ave. Hosp. 366 Medical Arts Center 366 The Harvey Society 368 NYAM-Orthopedic 368 The Clinical & Alumni NYAM-Genito- NYAM-Postgraduate Soc. of Morrisania Urinary Surgery 367 Radio Program 368 City Hospital 366 NYAM- Ofolaryngology 368 May 24 May 27 N.Y. County Society i•JYAM-Postgraduate Stated Meeting Radio Program 368 I

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Programs NEW YORK ACADEMY OF MEDICINE All meetings are open to the medical profession and to medical students. 2 East 103 Street, New York 29, New York THE NEW YORK ACADEMY OF MEDICINE STATED MEETING Thursday evening, May 6, at 8:30 o'clock The Ninth James Ewing Memorial Lecture Attacking cancer in a community. WALTER B. QUISENBERRY Director of Preventive Medicine, Territorial Health Department, Honolulu, Hawaii Combined Meeting SECTION ON SURGERY with the NEW YORK AND BROOKLYN COMMITTEE ON TRAUMA Friday evening, May 7, at 8:30 o'clock PAPER OF THE EVENING Overall care of hand injuries. ERIK MOBERG Sahlgrenska Sjukhuset Hospital, Goteborg, Sweden Discusszon: J. WILLIAM LITTLER PRESTON A. WADE Combined Meeting SECTION ON NEUROLOGY AND PSYCHIATRY with the NEW YORK NEUROLOGICAL SOCIETY RESIDENTS' PROGRAM Tuesday evening, May 11, at 8:30 o'clock PAPERS OF THE EVENING Bellevue Hospital Acute cerebral venous occlusion manifested by spontaneous subarachnoid hemorrhage STEFAN SZANCER - New York Hospital-Payne-Whitney Clinic Psychopathological indications and contra- indications for the use of subcoma insulin treatment DONALD C. GREAVES Bellevue Hospital Schizophrenic children under the age of six MANUEL FURER New York Hospital-Westchester Division A survey of general surgical procedures in a group of emotionally disturbed women patients WILLIAM A. TRIEBEL The Mount Sinai Hospital The creative drive-a case history RICHARD S. BLACHER General Discussion: S. BERNARD WORTIS OSKAR DIETHELM M. RALPH KAUFMAN BERNARD C. MEYER SECTION ON HISTORICAL AND CULTURAL MEDICINE Wednesday evening, May 12, at 8:30 o'clock PAPER OF THE EVENING "Our heritage from William Osler-1954" STANLEY E. DORST Dean, University o f Cincinnati College of Medicine; Chairman, Directing Staff, Cincinnati General Hospital Discussion : MR. HERBERT WOHL College of Physicians and Surgeons, Columbia University MR. RALPH C. WILLIAMS, JR. Cornell University Medical College MR. HENRY N. CLAMAN William Welch Society, New York Univ. College of Medicine MR. HAROLD STEINBERG New York Medical College, Flower and Fifth Avenue Hospitals MR. AARON'R. RAUSEN Medical History Club, State University of New York, College of Medicine at New York City General Discussion Combined Meeting SECTION ON OPHTHALMOLOGY with the SECTION ON OBSTETRICS AND GYNECOLOGY Monday evening, May 17, at 8:15 o'clock SYMPOSIUM: Ocular manifestations in normal and abnormal. pregnancy': Ocular diseases occurring during pregnancy. ELLEN F. REGAN Retinal findings in pregnancy. STUART S. SNYDER The value of retinal and conjunctival vascular findings in normal and toxemic pregnancies. ROBERT LANDESMAN General Discussion NEW YORK ROENTGEN SOCIETY in af}iliation with THE NEW YORK ACADEMY OF MEDICINE RESIDENTS' PROGRAM Monday evening, May 17, at 8:30 o'clock PAPERS OF THE EVENING a. Special studies on the lateral soft tissue: Roentgenogram of the neck. DORIS BATE, OSCAR RUIZ Francis Delafield Hospital (Continued on page 367) 362 NEW YORK MEDICINE

Programs LOCAL SOCIETIES AND HOSPITALS : i MEDICAL SOCIETY OF THE COUNTY OF NEW YORK There will be no meeting of the MATERNAL MORTALITY ANALYSIS GROUP of the SPECIAL COMMITTEE ON MATERNAL WELFARE in May. RALPH L. BARRETT, Chairman NEW YORK SOCIETY OF PHYSICAL MEDICINE STATED MEETING Wednesday evening, May 5, 1954, 8:30 p.m. New York Academy of Medicine Building, 2 East 103rd Street, New York, N. Y. Members of the medical profession are cordially invited. SCIENTIFIC SESSION The problems of the service for handicapped children, the Board of Health, New York City. Panel Introduction (12 minutes each) HELEN WALLACE JEROME TOBIS ROBERT SIFFERT MISS MARGARET LOSTY, R.:V'. MISS HELEN GOSSETT, Social Service Panel Discussion (30 minutes) EXECUTIVE SESSION MORTON HOBERMAN, President 175 East 79th Street, N. Y. 21, N. Y. MADGE C. L. McGUINNESS, Secretary 48 East 62nd Street, N. Y. 21, N. Y. NEW Y ORK HOSPITAL PRACTITIONERS' CONFERENCE 525 East 68th Street, New York City Wednesday, May 5, 1954 Osteoporosis. Wednesday, May 12, 1954 Thrombophlebitis and embolism. Wednesday, May 19, 1954 Vitamin B12 and folic acid: assets and liabilities. CLAUDE E. FORKNER, Chairman NEW YORK ALLERGY SOCIETY Wednesday evening, May 5, 1954, 8:30 p.m. Room 440, N. Y. Academy of Medicine 1. Asthmatic attacks in children caused by bacterial strains in carriers. (6 min.) FRANKLIN A. STEVENS _ 2. The use of injectable anti-histaminics in herpetiform lesions. (10 min. ) MAURY D. SANGER 3. Mucolytic detergent therapy in bronchial asthma and other respiratory diseases. (45 min.) JOSEPH B. MILLER (by invitation) FREDERICK R. BROWN, President LEONI N. CLAMAN, Secretary MONTEFIORE HOSPITAL, DIVISION OF NEOPLASTIC DISEASES Friday afternoon, May 7, 1954, at 3:00 p.m. Social Hall, Main Bldg, Montefiore Hospital, MAY 5, 1954 100 East Gun Hill Road, New York 67, N. Y. The internal distribution of body sodium, potassium and water; its implications on the interpretation of metabolic balance and tracer dilution data. I. S. EDELMAN Established Investigator o f the American Heart Association; Assistant Professor of Medicine, School of Medicine, Univ. of California, San Francisco, California MEDICAL CIRCLE Friday evening, May 7, 1954, at 8:30 o'clock The Academy of Medicine, 2 East 103rd Street A contribution to the sterility pro'alcm. E. FARBER Common errors in rectal diagn,)s:s. F. VOGEL PAPER OF THE EVENING Present concepts of allergy. E. HELLREICH M. GROLNIK F. VOGEL, Secietary THE SOCIETY OF MEDICAL JURISPRUDENCE Monday, May 10, 1954 70th ANNIVERSARY DINNER Honoring DR. LEON THEODORE LEWALD'S 35 years of service Hotel Statler-Penn Top Room 6:00 p.m., Reception; 6:30, Cocktails, 7:00, Dinner Speakers: HON. EDMUND H. LEWIS Chief Judge of The Court of Ap,heals of The State of New York Ho:.. ANDREW A. EGGSTON, M.D., D-PA, FCAP President of The Medical Society of The State of New York Send in your reservations to Joseph Carl Thomson, Secretary, 217 Broadway, New York 7, at $7.50 per person. HOWARD C. HUTTER, President JOSEPH C. THOMSON, ESQ., Secrerary BETH DAVID HOSPITAL CLINICAL SOCIETY CONFERENCJ Monday, May 10, 1954 at 9:00 p.m. Beth David Hospital, 161 East 90th Street, New York City 1. Synovial Sarcoma JULES D. GORDON Discussion : JOSEPH BUCHMAN THEODORE M. SANDERS 2. Case of Hyperparathyroidism ELLIOTT HOCHSTEIN Collation Members of the medical profession cordially invited. ARNOLD KOFFLER, Chairman 363

THE MOUNT SINAI HOSPITAL GASTROENTEROLOGY Tuesday evening, May 11, 1954, 8:30 p.m. Lecture Room 3-B. Entrance: North Side of 100th St., between Fifth and Madison Aves. SYMPOSIUM Reports from the gastroenterology research laboratory. FRANKLIN HOLLANDER, PH.D., Chairman An investigation into the Etiology of cardiospasm. JOSEPH BANDES in collaboration with VICTOR WILLNER The influence of steroid hormones on the healing of experimental gastric ulcers. VERNON WEINSTEIN in collaboration with HENRY D. JANOWITZ A new approach to ulcer therapy through inhibition of intracellular enzymes. HENRY D. JANOWITZ Effect of a carbonic anhydrase inhibitor on pancreatic secretion in man. DAVID DREILING in collaboration with HENRY D. JANOWITZ Effect of subtotal gastrectomy upon external pancreatic secretion in dogs. ALEXANDER RICHMAN in collaboration with LOUIS J. LESTER ASHER WINKELSTEIN, Presiding HARRY YARNIS, Secretary 1075 Park Ave., N. Y. 28, Pd. Y. LAST CONFERENCE OF THE SEASONI THE MOUNT SINAI HOSPITAL MONTHLY NEUROLOGICAL CONF. Monday evening, May 10, 1954, at 8:00 p.m. Lecture Room 3-B. Entrance: North Side of 100th Street, between Fifth and Madison Aves. 1. Neuropathology: a case of embolic occlusion of the middle cerebral artery. I. FEIGIN I. SILBERMAN 2. Two case presentations: Wilson's disease. I. SILBERMAN M. BORti STEIN 3. Metabolic studies in Wilson's disease. A. G. BEARN 4. Personality factors in patients with intractable pain: effect of electro-convulsive therapy. E. A. WEINSTEIN P. S. BERGMAN R. L. KAHN MORRIS B. BENDER, Chairman SEMINARS ON DIABETES AND NUTRITION Wednesday, May 12, 1954, 8:30 p.m. Lecture Room 3-B. Entrance: North side of 100th Street, between Fifth and Madison Avenues. 1. Case Presentation STEROID DIABETES TREATED WITH LENTE INSULIN ROBERT H. ,TOELSON The Mount Sinai Hospital 2. COMPARISON OF LENTE INSULIN, A NEW MODIFICATION, WITH OTHER INSULINS IN THE TREATMENT OF DIABETES MELLITUS W. R. KIRTLEY Physician-in-Charge, Diabetes Research Lilly Laboratory for Clinical Research, Indianapolis, Indiana . HENRY DOLGER, Chairman JOHN BOOKMAN, Secretary Next Seminar: Wednesday evening, Novem- ber 10, 1954. OPHTHALMOLOGICAL CONF. Thursday evening, May 13, 1954, 8:30 p.m. Lecture Room 3-B. Entrance: North Side of 100th St., bet. Fifth and Madison Avenues 1. Behcet's disease. DAVID SILVER 2. The use of gelfilm in filtration surgery for glaucoma. JOSEPH LAVAL ROBERT S. COLES 3. Review of service cases. HENRY MINSKY, Chairman SYLVAN BLOOMFIELD, Secretary 1010 Fifth Avenue, N. Y. 28 LAST CONFERENCE OF THE SEASON HIGH POINT HOSPITAL MONTHLY CONFERENCE Wednesday, May 12, 1954, at 8:30 p.m. New York Academy of Sciences, 2 East 63rd Street, New York Speaker: STEPHEN W. KEMPSTER Attending Psychiatrist, High Point Hos- pital, Port Chester, New York. Topic: Special Techniques in the Treatment of Schizophrenia Chairman: MERVYN SCHACHT Attending Psychiatrist High Point Hos- pital, Port Chester, New York Director: ALEXANDER GRALNICK High Point Hospital, Port Chester, New York (The profession is cordially invited) COLUMBUS HOSPITAL SCIENTIFIC CONFERENCE Wednesday, May 12, 1954, at 8:30 p.m. Amoroso Conference Hall 227 East 19th Street, New York 3, New York Carcinoma of the Breast FRANK E. ADAIR Memorial Hospital, New York City Discussion by Staff Collation 364 NEW YORK IMEDICINE

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