Evening star., 1938-06-25
OF STARS
MEN AND ATOMS
Notebook of Science Prosress
in Field, Laboratory
and Study.
BY THOMAS r. HENRY.

and Study.
By THOMAS r. HENRY.
Perhaps the best way to keep out Of
the way of the surgeon is to be poor.
If you have an income of 5000 a year
he is approximately twice as likely to
catch you than If your annual wage is
less than 81 900.
The relative need of surgery, Of course,
Is another matter. The difference, &C.
cording to economic status OF q cross
section of the population Of the United
States, is based on three-year survey
conducted by the Public Health Service,
the results Of which have Just been pub
lished.
But, rich or poor, the survey shows,
treatment with the knife is rapidly on
the increase. Records of the Army and
Navy show that there are now more than
twice as many operations among soldiers
and sailors than in 1910, three times as
many operations for appendicitis and
approximately 10 times as many appen.
dectomieS per thousand. This is due
to the fact that the benefits of surgical
treatment are becoming more generally
recognized, there are more surgeons and
they are not looked upon with the same
dread.
Fifty years ago. the report stresses,
anything but the simplest sort Of opera
ton was only undertaken as a last re-
sort. Without an operation the patient
would die, anyway. There was the Slim
NEST sort OF a chance that the surgeons
treatment might be successful Opera
tions now considered matters of routine
were then last-chance procedures. It
has been difficult for the surgeon to live
down his bad reputation.
But, the report stresses surgery by
and large is still very expensive, both
because of the surgeons fee and the
long period OF recuperation necessary.
Consequently persons in the lower In
come classes who do not want to be
objects of public charity put of surgical
treatment as long as possible-often, it
is feared, until it is too late to do any
good
The survey included S,758 families, in
cluding 39,l85 individuals, in l8 States.
Anything falling under the head of sur
gerry, from cutting out an appendix to
lancing boil, was classed as an Opera
ton" There are between 60 and 10
year for each 1000 persons, it turns out
For women the figure is 68 per 1000 per
year and for men 62-but the difference
is largely due to contingencies arising in
childbirth. When these are eliminated
the sex incidence turns out to be ap-
proximately equal. There are two age
peaks-from 5 to Q, when tonsils and
adenoids are giving trouble, and from 80
to "a, when distinctly feminine operations
are most frequent. Removal of tonsils
accounts for slightly less than a third
of all operations. Next in order of fire.
quency are bone-setting. appendectomy
and removal of benign tumors About
one-fifth of all operations are made nee
essary because of accidents When ap-
pendectomy. tonsilectomy, bone setting
and distinctly feminine troubles are
combined they account for more than
thirds of all surgery
There are wide differences between the
two sexes in the frequency of certain
operations, the survey showed Women
are much more likely to develop ap-
pendicitis. Bone setting is much more
frequent among men, as are also opera
tions for sinus troubles and hernia
Surgery for gall bladder, cancer and
thyroid are considerably more frequent
among women. The similarity for both
sexes in total number of all operations
in various age groups Is apt to be mis-
leading, the report points out There
is very high rate of appendectomy
among young women. 1t is balanced by
high rates for operations in connection
with injuries among males of the same
ages. Young married men. it was found
are less likely to be operated upon than
single men of the same ages. This is
probably due to two reasons it is pointed
out. First, the single men are better able
to pay the surgeon. Second, many of
them are in college, where all surgical
services are free.
The survey showed that operations
are about twice as frequent among both
men and women in the professional and
business classes as among unskilled la
borers. The rates vary from 50 per
1000 persons per year in families with
average incomes below 81 200 to "a in
families with average incomes of 5000
or more. Between these extremes there
is a gradual increase with income in the
frequency of surgical treatments. AS
might have been expected, the larger
the city the more frequent the opera
tions. This is due largely, but not en-
tirely, to the fact that most surgeons
are located in cities and specialists only
in the very large cities.
The rate for most emergency opera
tions, such as appendicitis, is about the
same for country and city. The tonsils
of the city child are much more apt to
be removed. A curious exception is
found in operations for mastoiditis
This is an emergency procedure. but is
rare among country children. The ex-
planation is that it is an emergency
often overlooked by country doctors.
About 81 per cent of all operations,
the survey showed, are done in hospitals
or have some hospital service. The
other 80 per cent.are performed in homes.