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 Breast Cancer: Revisiting Accepted Wisdom in the Management of Breast Cancer - Part 2 
 

2. Greater cohesion and homogeneity of the pro&scion were also achieved by the deliberate segregation of Jews, Catholics, women, blacks, and the foreign-born. consolidating the rise of a genteel Protestant medical aristocracy. Medical school admission and operating privileges at hospitals were granted to a closed fraternity of surgeons, qualified more by social caste than by professional achievement Discrimination underlay the building of hospitals with names like Saint Vincent, Saint Mary, Saint Joseph, Beth Israel, Mount Zion, Mount Sinai-places that welcomed Catholic and Jewish patients and doctors.10(pp173-177)

3, Establishing Johns Hopkins as the model for all others to follow was consolidated by the Flexner Report of 1910, which Arced the massive closure of schools that did not conform to the new standards. By 1936, S91 million was steered primaniv from the Rockefeller General Education Board into a select group of schools, Johns Hopkins being among the seven that received more than two thirds of the funds.10(p121)

4. Curiously, his parents were both the offspring of business partners (his father was a Halsted and his mother was a Haines) and cousins (his mother and father were the children of sisters) (Rutgow 1, William Halsted, his family, and 'queer business methods.' Arch Surg. 1996;131:125),

5. In London, Charles Moore formulated the principles of mastectomy in 1867; Joseph Pancoast, prom Philadelphia, recommended removal of the breast and glands all in one piece as early as 1844; Richard von Volkmann in Germany and Theodor Billroth in Vienna both removed the entire breast in the 1870s: and William Handley in London and Willie Meyer were contemporaries of Halsted, who supported his efforts with their own.

6. Halsted demonstrated the use of cocaine as local anesthesia to Koller's friend, Anton Wolfler, who had been the Viennese surgical giant Theodor Billroth's first assistant. Later, Wolfler published on the subject (Penfield W. Halsted of Johns Hopkins. JAMA. 1969;210112l:2214-2218). (Reprint of Halsted's letter to Osler, dated August 23,1918.)

7. In a private letter to Osler, Halsted wrote that three of his associates "acquired the cocaine habit in the course of our experiments on ourselves--injecting nerves. They all died without recovering Prom the habit" (/AMA. 1969:2101121:2217).

8. A lump was the initial symptom in 83% of the women, which by the time of hospitaCzation had become a large mass for many. Ulceration, sometimes extensive. was seen in 68%: only 7% of the women came to the hospital within 6 months of the symptoms. Seventy-one percent delayed for more than 12 months. In 24% of the women, more than 3 years elapsed; in 12%, more than 5 years. The longest delay was 16 years. This contrasts with later practices, in which patients present within 6 months to 1 year after symptoms are noticed. A high percentage of the Middlesex women therefore had advanced disease (Bloom H. Richardson W. Harries E. Natural history of untreated breast cancer 11805-19331, Br Med / Jul 1962:219). According to Diana Fischer, research scientist at Yale School of Medicine, the 50 women who received mastectomies reported upon in Halsted's study between 1889 to 1894, when compared with the 250 cases at Middlesex Hospital in London between 1805 to 1930, showed no statistically significant survival difference between the surgically managed and untreated women (written communication, March 1996).

(Excerpted from Alternative Therapies in Health and Medicine)
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 About The Author
Harriet Beinfield LAcHarriet Beinfield, L.Ac. and Efrem Korngold, L.Ac., O.M.D. have pioneered the practice of Chinese medicine in America for the last 28 years as educators, writers, and practitioners. They are the co-authors of the......more
 
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