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ws Volume 38 MAY, 1955 
il General Practice Symposium 
ns Printed in U.S.A. (Table of Contents—Page iii) 40c a copy—$3.00 a year 
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a bacterial infections 
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respiratory infections 
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sensitivity of common pathogens to CHLOROMYCETIN 

and three other major antibiotic agents 


more effective against more strains... 


for today’s problem pathogens 


Because of the increasing emergence of pathogenic strains 
resistant to commonly used antibiotics, judicious selection of the 
most effective agent is essential to successful therapy. In vitro 
sensitivity studies serve as a valuable guide to the antibiotic 
most likely to be most effective. Both clinical experience and 
sensitivity studies indicate the greater antibacterial efficacy of 
CHLOROMYCETIN (chloramphenicol, Parke-Davis) in the treat- 
ment of many common infections. 


CHLOROMYCETIN is a potent therapeutic agent and, because certain blood 
dyscrasias have been associated with its administration, it should not be used 
indiscriminately or for minor infections. Furthermore, as with certain other drugs, 
adequate blood studies should be made when the patient requires prolonged or 
intermittent therapy. 

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Adapted from Altemeier, W. A.; Culbertson, W. R.; Sherman, R.; Cole, W.; Elstun, W., 
& Fultz, C. T.: J.A.M.A. 157:305 (Jan. 22) 1955. 


Volume 38 



Neurodermatitis Carcinoma in situ of the Uterine Cervix ener 
Louis A. Brunsting, M.D., Rochester, Minnesota .... 291 David C. Dahlin, M.D., Rochester, Minnesota .......... ¥ 

Differential Diagnosis of Tumors of the Neck 
Oliver H. Beahrs, M.D., Rochester, Minnesota ......... 293 CASE REPORTS 

Fractures of the Upper Extremity in Children os 0 
John C. Ivins, M.D., Rochester, Minnesota ................ 296 Hemobilia Following Blunt Trauma to the Liver sahet 

Management of Recent Injuries of the Hand 
Paul R. Lipscomb, M.D., Rochester, Minnesota ........ 299 

Precautions in the Use of Cortisone for Treatment of 

Rheumatic Diseases 

L. Emmerson Ward, M.D., Rochester, Minnesota .... 

H. M. Broker, M.D., and L. J. Hay, M.D., Minne- How I 
PONS, TIMES O Ay 525.25. Arsensccscdsas tesco cevesecesewecuscsvessthes 1 

Association of Intracranial Meningioma with Pituitary 
304 Adenoma ce 
J. Grafton Love, M.D., and Charles M. Blackburn, 

Digestive Ailments of Older Patients M.D., Rochester, Minnesota ........:.ccesceeeseseeeesesseeeen ea 
Albert M. Snell, M.D., Palo Alto, California ............ 309 ax D 

Management of Acute Abdominal Diseases 
William H. ReMine, M.D., Rochester, Minnesota .... 315 


Hematuria Case Presentation 
John L. Emmett, M.D., Rochester, Minnesota .......... 320 A. C. Aufderheide, M.D., Duluth, Minnesota ............ 3 

The Technique and Interpretation of the Vaginal atroge 
Examination Char 
Edward A. Banner, M.D., Rochester, Minnesota ........ 323 PRESIDENT’S LETTER 

The Treatment of Anemia 

Charles H. Watkins, M.D., Rochester, Minnesota .... 327 

In Appreciation 
Arnold O: “Swenson; WMD. a. cciisiccccciccescctesicvcssssvcscscecetses j 

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Contents. for May, 1955 

eneral Practice Symposium ...............c:cccccccccessceescceeceeeee 341 International Health Organization, Part I 
Lsessssees ER BERT SESIEE EROM Cee Rer noe er neuen Te 341 Bes. ED. BP. Walthquist 1..o-.osssesesesssnsssnvscanserieecsneesinoconenes 
i my Praming in: Alletgy ....2.:...:0..<..s0ss.e0sedsencsesexsceeee 342 Cilarhficld Blois HleaBibe Wey ccosecccocscccsccsccceccoceccsossossee 
MEE IN EG 2 5525520255, Seen eds cc sales caee Coco Saves dachabecaseen anion 342 Ramsey Auxiliary Reports Activities 
os of Hearing in Children cccccecceseeeeeeeees 343 a ee ne ee oe ee ee 
r jabetes Detection Programs. ..................:ccccceccessceeeeeeeeeees 343 
Minne- [Mow Long Should One Keep Valuable Papers? ............ 343 
mie , , " IN MEMORIAM 
ituitary Wadia is As Vitae 2205 otek tee 
ICAL ECONOMICS hubené:-Rowriseme Sheen aiie cc. ctis. ccsnceedicecsceeereen tune: 
ickburn, fi Pum ~ iemanneas C lala CRAIN 52a nce ceca aines cent reece 
ieee qgpMA Reviews Legislation Status..................ccccccscsscssssseree S49 
ax Deferment Bills Make Slow Progress ......................+ 346 
ational Board Notes Exam Requirements .................... 347. OF GENERAL INTEREST 
NCE TRCUAMMIMEETINO@ WES «<< cace ccs cxcssoxescvasexrosesaceetassaiis eee eas 
1 OC JOSS | oS ee ee en ROR Race ete a atone OPE eer oy sr 
oe pRRENT CARDIAC CONCEPTS Minnesota Blue Shield-Blue Cross Plans ..........:::0c0-000 
atrogenic Heart Disease 
sei th. Resse: Wi Sea. tly PO ice asa cra 
A 4@PORTS AND ANNOUNCEMENTS ........--:0::-5 349 ASSOCTATION, 1955 «......--:cc-cscsssssserscssscrsrssosesenseeses 
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e Bronchial Asthma 

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General Practice Symposium 


HE commonest disease of the skin is eczema, 

and the commonest form of eczema is neuro- 
dermatitis, which is merely a word to express the 
relationship between the nervous system and the 
skin. Various forms of neurodermatitis occur, 
such as the exudative form characterized by blis- 
ters on the fingers or oozing widespread plaques, 
which may occur in childhood as well as in older 
persons. The commonest form, however, is the 
circumscribed thickened plaque called “lichen 
simplex chronicus.” These plaques, single or 
multiple, may occur in various places or they may 
become a diffuse process to the extent of exfolia- 
tive dermatitis. The patient may be entirely in- 
capacitated and be miserable day and night be- 
cause of the outstanding symptom of itching, 
often paroxysmal in nature; many patients are 
driven to distraction and almost to suicide. 

Lichen simplex chronicus occurs in certain 
types of persons who may have hay fever, asthma 
or urticarial tendencies. Thickening of the skin 
results from scratching. This thickening brings 
on exudation and nonspecific cellular reaction; 
the tissues are thus changed so that itching results 
and a vicious cycle is established. 

The most familiar site for the appearance of 
lichen simplex chronicus is along the lateral sur- 
face of the thighs, on the shins, about the ankles 
and on the elbows or knees, where the lesions 
tesemble those of psoriasis. A peculiar form 
occurs in the nuchal region of women almost ex- 
clusively, as well as behind and in the ears; an 
extremely common form of neurodermatitis, or 

Read at the meeting of the Minnesota Academy of 
eneral Practice, Rochester. Minnesota, October 20, 1954. 
From the Section of Dermatology, Mayo Clinic and 
Mayo Foundation. 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the Universitv of Minnesota. 

May, 1955 


Rochester, Minnesota 

lichen simplex chronicus, produces the symptoms 
of pruritus vulvae or ani. 

The presence of neurodermatitis around the 
ankle always brings up the question of whether 
or not varices are present. One must distinguish 
neurodermatitis of the lower portion of the legs 
from so-called stasis dermatitis. Whenever any 
disturbance occurs in the lower part of the legs, 
hydraulic factors come into play, and any time the 
skin is injured, the circulation becomes stagnant 
in that region. It is rare to relieve these patients 
of their symptoms by treatment of varicose veins, 
although the use of an ace bandage is helpful 
for two reasons, namely swelling is prevented and 
the site is covered so that scratching is not 

When the disease reaches the proportions of 
exfoliative neurodermatitis, it is extremely diffi- 
cult to arrive at a satisfactory diagnosis. The 
contiguous lymph nodes are invariably enlarged 
and present an almost irresistible demand for 
biopsy. Other diagnostic facilities should be 
utilized first, for in such patients the site from 
which the specimen has been removed for biopsy 
frequently becomes infected. The microscopic 
picture of the nodes is usually one of reticulum 
cell hyperplasia, plus the presence of pigment and 
fat. Pathologic diagnoses such as lipomelanoretic- 
uloendotheliosis may be returned, although the 
condition is nothing but a scavenger reaction in 
the lymph nodes as the result of extensive chronic 
dermatitis. Biopsy of the skin shows a rather 
nonspecific picture that may be almost impossible 
to distinguish from that of psoriasis. A patient 
who has dermatitis of this magnitude is entirely 
incapacitated. As already indicated, some patients 
who have this syndrome have had asthma, eczema, 
hay fever and urticaria off and on since infancy. 


In not a few of them, opacities in the lenses will 
develop that are typical of allergic cataracts. 
Therefore, one test in these patients should be 
routine screening by slit-lamp examination to 
detect such changes in early stages. If such lesions 
are found, serious restrictions are placed on the 
patient’s activities. 

The localized plaque of neurodermatitis may be 
treated by topical measures. Protective pads, 
such as an elastoplast cutout, placed over the 
plaque are sometimes helpful. Tying the hands 
at night is of aid in some of these conditions, as 
is any artificial device to break the cycle of the 
scratching reflex. Systemic measures, such as 
allergic surveys and dietary restrictions to remove 
supposedly allergenic foods, are practically worth- 
less. A mistake is often made in prescribing oint- 
ments containing a local anesthetic agent, such 
as dibucaine hydrochloride (nupercaine) or ben- 
zocaine, for the relief of itching. Sooner or later, 
sensitivity to these agents develops and the origi- 
nal condition becomes aggravated and widespread. 
The same is true in the presence of slight infec- 
tion, when the prescribing of sensitives, such as 
nitrofurazone (furacin) is to be condemned. The 
use of roentgen therapy in moderate doses is 
helpful; however, excessive amounts of such 
treatment produce actinodermatitis, which leads to 
no end of complications. 

Dietary control is prescribed for patients who 
have gained weight; patients who have hyperten- 
sion should have proper restrictions from the 
standpoint of their general health. Sometimes in 
women this condition first appears during the 
menopausal years; under these conditions, some 
estrogenic support is helpful. When neuroder- 
matitis becomes widespread and the patient is 
extremely unstable, some restrictions should be 
made on the excessive activity. These people usu- 
ally are hyperactive and like to improve every 
shining minute. The typical woman who has 
neurodermatitis never sweeps anything under the 
rug. She may be on a committee; soon she is 
chairwoman and soon there are no other members 
on the committee but this woman—she’s the chair- 
woman and the entire committee. It is useless 
to attempt to find an ointment in this jar or that 
to correct the symptoms which are trying to tell 
us that such a patient is about to blow a fuse. 
Phenobarbital is helpful but it is also sometimes 
capable of provoking allergic reactions. Some 



favorable results have been attained by use of 
reserpine (serpasil), even in the absence of hyper- 
tension, because of the tranquilizing effect of this 

agent. Chloral hydrate is a useful bedtime sed- 


Topical applications in the acute stage include 
use of moist compresses of boric acid (saturated 
solution) or aluminum subacetate. The latter is 
prescribed as an 8 per cent solution that is to be 
diluted 1 fluidounce to a pint. It is not used as 
a wet poultice but as a moist dressing ; it is useful 
in relieving the irritation. 

One of the most successful but rather messy 
treatments is the use of tar. It can be prescribed 
as an ointment containing 1 or 2 per cent each 
of crude coal tar and salicylic acid. If tar is used 
in the hair, it should be incorporated in a water- 
soluble base. 

Dermatitis of the ear canal is often neuroder- 
matitis, and fungi are not involved. It is neces- 
sary to clean out the canal frequently. A small 
wick of moist dressing may be helpful. The most 
characteristic reaction in this location is intense 
itching, and the patient perpetuates the condition 
by scratching. In the treatment of ear conditions, 
nuchal eczemas and pruritus vulvae et ani, use 
of an ointment containing 1 per cent hydrocorti- 
sone is helpful. The effect of this steroid applied 
locally wears out in time unless the underlying 
disturbances are corrected, but it has been a most 
significant advance in treatment. I have no brief 
for those who would use cortisone or corticotropin 
(ACTH) systemically for the treatment of neuro- 
dermatitis, even when the condition becomes 
generalized, because the patient becomes depend- 
ent on it and it is difficult to discontinue treat- 
ment without a rebound reaction. Occasionally, 
when the condition is uncontrollable, it is useful 
to give 15 to 25 mg. of ACTH intravenously as 
an eight-hour drip in a 5 per cent solution of 

As already emphasized, patients who have wide- 
spread neurodermatitis are incapacitated and 
really need hospitalization for immediate relief. 
In long-range treatment they need readjustment 
of their habits of living and sometimes a change 
of environment. Some of the mafiana influence of 
the Southwest is helpful and the sunlight there 
is also beneficial. 


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Differential Diagnosis of Tumors 
of the Neck 

: eh tumor of the neck, as is one in any other 

place in the body, is potentially dangerous 
and should be treated accordingly. The only way 
to establish a definite diagnosis is by histologic 
study, which requires biopsy or removal of the 
lesion. The best time to carry out primary treat- 
ment of a tumor in the neck, especially if it is 
malignant, is at the time of biopsy. Therefore, it 
is important to use every possible means to estab- 
lish a preoperative working diagnosis so that the 
physician can better explain to the patient and his 
relatives what might be expected in the way of 
definitive treatment. 

It is for these reasons that one always should 
keep in mind the differential diagnosis of tumors 
in the neck when a patient is being examined. 
For instance, if a lesion should prove to be a 
squamous cell epithelioma metastatic from a pri- 
mary tumor in the mouth, there is no better time 
to do the necessary radical dissection of the neck 
than when the primary lesion is removed. If one 
strongly suspects that a lesion is squamous cell 
epithelioma, possibly primary dissection of the 
neck should be done in preference to biopsy, be- 
cause biopsy in squamous cell epithelioma may 
increase the chance of recurrence because of 
“seeding” at the operative site or persistence of 
the carcinoma because of incomplete removal of 
the tumor. Thus in the course of examination of 
the neck, one should always inspect the lip, the 
endoral cavity and the larynx, because of the 
potential danger of metastatic involvement of 
lymph nodes in the neck arising from primary 
carcinoma in these regions. 

General Aspects of Examination 

The examiner must consider a tumor of the 
neck from the standpoint of the history and the 
results of inspection, palpation and auscultation 


Read at the meeting of the Minnesota Academy of 
eneral Practice, Rochester, Minnesota, October 20, 1954. 
From the Section of Surgery, Mayo Clinic and Mayo 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the University of Minnesota. 

May, 1955 


Rochester, Minnesota 

of the tumor. If the tumor has been present for 
many years without any evidence of recent change, 
that means one thing to the examiner; if the 
tumor has been present for ten or twenty years 
and in the past month has shown a sudden in- 
crease in size, that means something else; if the 
tumor was first noted a month ago and is painful 
and tender, that means yet another thing. One 
should also note whether or not there has been 
any difficulty in swallowing, or any recent evi- 
dence of hoarseness. One factor that is sometimes 
misleading is whether or not the tumor varies in 
size. The patient may say that the lesion increases 
and decreases in size. It is difficult to judge this 
because with change of the position of the neck, 
as in moving the head from side to side, the ap- 
pearance of the tumor will change; it appears best 
to ignore this particular symptom. 

For inspection, it is helpful to have the patient 
stand directly in front of the examiner, perhaps 
2 or 3 feet away. This establishes whether or not 
asymmetry of the neck is present; if it is, the 
tumor is obvious and merely from inspection one 
should get some idea of its nature. Motion of 
the tumor up and down as the patient swallows 
gives certain information, perhaps indicating a 
nodular goiter. A tumor that is not easily appar- 
ent on inspection sometimes becomes prominent 
when the patient swallows. Also, movement of 
the head from side to side occasionally makes the 
tumor more prominent. Any dimpling or attach- 
ment of the skin over the tumor should be noted. 

Palpation should not be attempted until after 
thorough inspection. The physician should feel 
the neck rather carefully, as some people are 
rather sensitive to such palpation. The tumor 
preferably should be grasped between the thumb 
and the fingers. Occasionally, however, one is 
unable to feel the tumor between the fingers and 
then it must be palpated against the deeper struc- 
tures of the neck. At times, one can depress the 
structures of the neck with the opposite thumb, 
causing the tumor to become more prominent and 
more palpable. One should note whether the 


tumor is firm or soft, encapsulated or infiltrative, 
solid or cystic, tender or nontender, fixed to sur- 
rounding tissues or freely movable, in which di- 
rection it moves and, if possible, from which struc- 
tures of the neck it arises. When the lesion is 
in the upper cervical region, especially the sub- 
maxillary triangle, bimanual palpation with the 
fingers in the mouth is of value. One should also 
determine the degree of hardness or firmness. A 
tumor that is calcified is like a rock and usually 
is benign, in contrast to a firm tumor that feels 
as though it is infiltrating adjacent tissue; the 
latter type of tumor frequently is malignant. One 
should feel for attachment to surrounding tissues. 

In the course of palpation, one should notice if 
there is any pulsation of the tumor. Occasionally, 
an aneurysm or a vascular tumor might arise from 
structures in the neck. It is extremely important 
to know this before exploration of a tumor. 
Auscultation of the lesion may aid in this 

Regardless of how expert the examiner is and 
how certain he may be that a lesion is of this type 
or that, the only way to prove the point is to 
excise the lesion for histologic diagnosis. Then 
the lesion can be forgotten or the indicated defini- 
tive treatment can be carried out. 

Tumors of the neck may be divided into con- 
genital lesions, primary tumors, metastatic tumors, 
tumors of the salivary glands and inflammatory 
lesions. This presentation is primarily concerned 
with the characteristics of these lesions that might 
be of diagnostic value. 

Congenital Lesions 

Among congenital lesions occurring in the 
midline of the neck are cysts of the thyroglossal 
duct. This tumor occurs in the midline and lies 
either over or below the hyoid bone. If it is much 
below, the cystic mass may move slightly to the 
right or the left of the midline. Most often this 
lesion is definitely cystic; however, if it is tense 
it is somewhat difficult to establish its cystic na- 
ture. If one grasps the tumor and creates pres- 
sure on it downward and then feels above the 
tumor, between the tumor and the hyoid bone, one 
frequently can feel the cordlike structure that 
represents the tract from the cyst through the 
hyoid bone to the base of the tongue; palpation 
of such a tract renders it fairly certain that the 
tumor is a cyst of the thyroglossal duct. If the 
lesion has been previously incised, or if it has 



previously drained, the character of the discharge 
is important. A discharge from a cyst of the 
thyroglossal duct is mucoid in type. A cyst of the 
thyroglossal duct may not have been noticed in 
childhood and may be initially discovered in pa- 
tients sixty or seventy years of age. 

Among the lesions in the lateral aspect of the 
neck are branchial cleft cysts, which occur in the 
submaxillary triangle, usually just anterior to the 
anterior border of the sternocleidomastoid muscle. 
The cystic nature of a branchial cleft cyst can 
usually be determined. It is superficial, has a 
smooth surface, is freely movable, unless it is 
large or has been previously infected, and is not 
attached to any of the underlying tissues. Sinuses 
sometimes are assdéciated with branchial cleft 
cysts if the cysts have been previously operated 
on and not completely removed. One should 
always inspect for a branchial cleft sinus or fistu- 
lous opening, which occurs along the anterior 
border of the sternocleidomastoid muscle usually 
just above the clavicle. The characteristic dis- 
charge is mucoid in type. A branchial cleft fistula 
has no cystic component as a rule. When the 
course of the tract is put under tension, a cord- 
like structure can be felt along the edge of the 

Another lateral cystic lesion is a cystic hy- 
groma, which often occurs in the lower portion 
of the cervical region, especially if it is small. 
If it is large, it may involve the entire neck. Such 
a lesion is cystic, soft and multilocular. A ranula 
is possibly a similar structure occurring in the 
upper portion of the neck. A ranula frequently 
can be identified by inspection of the floor of 
the mouth, where it shows as a watery bleb that 
disappears when punctured. Such lesions also 
can be felt in the submandibular region as cystic 
structures, usually bilateral. 

Tumors of the Thyroid 

Adenomas of the thyroid are frequently en- 
countered. One should always be suspicious of a 
thyroid adenoma and should palpate the lateral 
aspects of the neck in all cases of nodular goiter 
for possible metastatic lesions. My colleagues and 
I consider that a nodular goiter is frequently 
enough malignant so that all nodular goiters 
should be removed. Whenever a node is found in 
the neck that has the characteristics of a meta- 
static lesion, the thyroid always should be care- 
fully palpated. In our experience, about 4 per cent 



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of nodular goiters that are not producing symp- 
toms will contain unsuspected carcinoma. 

Occasionally confused with a cyst of the thyro- 
glossal duct is an adenoma of the pyramidal lobe 
of the thyroid gland. An adenoma may or may 
not be firm but rarely does it feel cystic. There 
is no palpable tract above an adenoma as is often 
noted with a thyroglossal duct cyst. Adenomas 
usually move up and down when the patient 
swallows and frequently the presence of other 
adenomas of the thyroid gland supports the diag- 
nosis of this midline tumor as an adenoma. 

Also to be confused with an adenoma of the 
thyroid gland or a cyst of the thyroglossal duct 
is a delphian node, which also occurs in this re- 
gion. A delphian node is a metastatic lesion from 
a primary carcinoma in the thyroid. When the 
carcinoma is located in or near the isthmus, one 
of the first areas of spread is to a lymph node 
located over the thyroid cartilage; such meta- 
static lesions, however, are firm, usually small, 
and freely movable. 

Tumors of the Salivary Glands 

Tumors of the salivary glands are important in 
examination of the neck. A mixed tumor of the 
parotid gland will have been present for a long 
period; it is hard but yet as a rule it is freely 
movable unless it is in the deep portion of the 
gland. If a tumor that has been present for many 
years shows sudden growth, one has to be sus- 
picious of malignant degeneration. The facial 
nerve is rarely involved regardless of the size of 
the tumor unless a malignant tumor is super- 
imposed on the mixed tumor. However, a cylin- 
droma, an adenocarcinoma, or another type of 
malignant tumor of the parotid gland is not only 
hard but is usually fixed within the tissue; such 
tumors frequently cause paralysis of the facial 
nerve, which is extremely important in evaluating 
a tumor and advising the patient regarding the 
treatment that should be carried out. Warthin’s 
tumor, which is cystadenoma lymphomatosum, 
occurs in the parotid gland; it is soft, usually 
presents itself below or slightly behind the parotid 
gland and appears to be encapsulated on palpa- 
tion. One should not confuse this lesion with a 
mixed tumor, 

Miscellaneous Tumors 

Among the primary tumors of the neck are 
tumors of the carotid body. These lesions occur 
in about the same area as do branchial cleft cysts 

May, 1955 


but are deeper in the neck and are not cystic. 
Tumors of the carotid body may be elongated, 
extending upward and downward; because of 
their fixation to the carotid vessels, they can be 
moved laterally but not up and down, which is an 
important diagnostic finding. Lymphosarcoma 
occurs in a similar region in the upper part of 
the neck and in the lower portion of the neck in 
the internal jugular lymph nodes, Usually lympho- 
sarcoma in the neck involves multiple nodes, 
frequently matted together. These nodes are 
usually rubbery in consistency. 

A parathyroid cyst has to be considered occa- 
sionally, although this is a rare finding. A neuro- 
fibroma might occur along the lateral aspect of the 
neck under the sternocleidomastoid muscle. It is 
an elongated tumor in contrast to a lymphosar- 
coma, which is round or associated with a matted 
group of nodes. Neurofibromas frequently are 
bilateral. Lipomas are seen usually in the supra- 
clavicular region and the posterior cervical tri- 
angle. They are soft and multinodular. 

Inflammatory Lesions 

Inflammatory lesions of the neck include acute 
lymphadenitis associated with respiratory and 
oral infections; this condition does not create a 
diagnostic problem since the enlargement of the 
nodes is of recent origin and usually bilateral. 
lf, however, such lymphadenopathy does not 
disappear within two weeks, it should be regarded 
with suspicion. The chronic lesions of tuber- 
culosis, sarcoidosis or other granulomas occa- 
sionally.are confusing ; biopsy is required to estab- 
lish the diagnosis but one should be suspicious 
of this type of lesion from the history. 

Metastatic Tumors of the Neck 

Metastatic tumors in the neck are usually of 
recent origin and are firm and nontender. They 
may be movable but, if large, may be fixed to the 
surrounding tissues. Again, when one is suspi- 
cious that a tumor may represent metastasis to a 
node, careful search should be made for a primary 
lesion on the lip, in the oral cavity, or in the 
larynx, as well as on the skin of the face or scalp. 
Lesions of the lip spread in an orderly fashion 
to the submaxillary nodes in the neck. A node 
that is the seat of metastasis may be misleading 
if it has a necrotic center and feels soft. If a 

(Continued on Page 303) 

Fractures of the Upper Extremity 

in Children 

RACTURES in children are different than 
similar ones in adults. Ordinary good treat- 
ment produces better results in children than it 
does in adults. The heavy periosteum that sur- 
rounds the bone in children may help to prevent 
displacement ; most of the time it makes for sat- 
isfactory manipulation and easier closed reduc- 
tion. In preadolescent children, the potential for 
rapid growth will produce an excellent end result 
even after mediocre reduction. This same growth 
potential is responsible for the usual speedy 
union and the rarity of nonunion in children. 
This generally optimistic outlook must be tem- 
pered by the knowledge that with improper treat- 
ment the complications of fractures in childhood 
can be disastrous. The general principles of treat- 
ment are not complex. Alignment is the chief 
requirement. While it is desirable to produce 
restoration of length and anatomic apposition, 
such restoration certainly is not necessary and 
failure to produce such a result is no indication 
for open reduction and internal fixation in chil- 
dren. As a rule, completely satisfactory results 
can be obtained by traction or by closed manipu- 
lation and immobilization in plaster. This rule, 
however, has the usual exceptions. Some frac- 
tures, notably certain types about the elbow, often 
require open reduction. In this discussion, I wish 
to consider the commoner major fractures of the 
upper extremity in children and to emphasize 
those that may be attended by complications or 
that require open reduction. 

Fractures of the Humerus 

Fractures of the humerus occur through the 
condyles, through the shaft, below the tubercles 
or through the upper epiphysis in about that 
order of freqency. Fractures of the shaft are 

Read at the meeting of the Minnesota Academy of 
General Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Orthopaedic Surgery, Mayo 
Clinic and Mayo Foundation. 

The Mayo Foundation, Rochester, Minnesotz, is a part 
of the Graduate School of the University of Minnesota. 



Rochester, Minnesota 

rarely accompanied by palsy of the radial nerve 
and may be satisfactorily treated by application 
of a hanging cast. If the general alignment and 
rotation are good, one need not worry about 
end-to-end apposition or overriding and shorten- 
ing of up to a half inch; sound union will occur 
and the proper length will be restored by sub- 
sequent overgrowth. 

Separation of the upper humeral epiphysis may 
be treated the same way. Restoration of function 
and normal bony contours is usually rapid. If 
the epiphysis is completely displaced, manipula- 
tion with the patient under general anesthesia will 
be required, but even then one need not insist 
on strict anatomic reduction, and open reduction 
is rarely required, 

Supracondylar fractures are common. Ac- 
curate reduction is difficult to achieve and even 
more difficult to maintain. Neural and vascular 
complications are more common than the physi- 
cian usually suspects. Because of the close prox- 
imity of major nerves and arteries, in a typical 
supracondylar fracture the artery or one of the 
nerves may be impaled on the end of the proximal 
fragment or actually may be caught between the 
ends of the fractured bone. Once the diagnosis 
is established by initial roentgenograms, prompt 
treatment can be effective. Of prime importance 
is accurate evaluation of the patient’s condition. 
Simple sensory and motor testing should be done 
to determine the status of the major nerves. The 
presence or absence of radial pulsation should be 
established ; if it is present, one should note its 
quality. Closed reduction is then carried out 
with the patient under general anesthesia by trac- 
tion in the long axis of the arm combined with 
flexion and pronation. It was formerly taught 
that these fractures should be put up in supina- 
tion, but I believe the rotary components can 
be reduced best by putting the forearm up in 
pronation. Satisfactory reduction can be main- 
tained only by means of a posterior plaster splint 
that holds the arm in flexion. If this causes dis- 












f the 
1 the 
Id be 
re its 
- can 
ip in 
s dis- 


appearance of radial pulsation, the elbow must 
be extended until pulsation reappears. 

One can deal with these fractures by either 
continuous traction in bed or open reduction and 
fixation of the fracture by crossed Kirschner 
wires. Traction in bed will produce just as good 
results as will surgical intervention. The greatest 
danger is Volkmann’s ischemic contracture, which 
presents pain as its most significant symptom. 
Never disregard the complaint of pain in the 
hand associated with these fractures. If this pain 
is accompanied by swelling, coldness, cyanosis 
or pallor of the fingers, prompt action must be 
taken regardless of the hour and regardless of 
the interval of time since the fracture. If exten- 
sion of the elbow and removal of all circular 
dressings do not result in a prompt satisfactory 
return of circulation, block of the stellate gan- 
glion by means of procaine might be considered. 
However, it is preferable to deal with this situa- 
tion directly by opening the antecubital fossa and 
exploring the artery. The artery may be contused, 
transected or caught between the ends of the 
bone. Segmental resection of the damaged portion 
of the vessel relieves the reflex vasopasm and 
usually results in adequate circulation. Vascular 
grafting is not indicated in such cases. 

Epiphysial Injuries at the Elbow 

Epiphysial injuries at the elbow usually are 
more serious than the clinical picture or the roent- 
genograms would indicate. Three main centers of 
ossification are present at the inferior end of the 
humerus. One is for the lateral condyle, or capi- 
tellum, one is for the medial condyle, or trochlea, 
and one is for the internal epicondyle. At times, 
there may be a fourth center for the lateral epi- 
condyle. A fall on the point of the flexed elbow 
may displace the entire epiphysis forward. Usu- 
ally, however, the fall is on the outstretched hand 
and one of these centers of ossification is pulled 
away from the others by muscular traction. When 
the joint is forced into the varus position, the 
origin of the common extensor muscles on the 
back of the forearm may avulse the lateral part 
of the epiphysis, the capitellum, together with 
some of the adjacent portion of the trochlea and 
the end of the shaft. If the aponeurosis is incom- 
pletely torn, the condyle simply may be displaced 
laterally and not rotated. Such a fracture will 
unite firmly, with good results. 

However, if the aponeurosis is completely torn, 

May, 1955 


the condylar fragment may be rotated completely 
out of the joint and turned upside down. If the 
fracture is allowed to heal in this position, there 
will be an increase in the carrying angle and 
sooner or later ulnar palsy will appear because of 
stretching of the ulnar nerve. Open reduction is 
usually required. After the condylar fragment 
has been anatomically reseated in its bed, it usu- 
ally can be held there firmly by suture of the sur- 
rounding soft tissues of the aponeurosis. Internal 
fixation of such a fracture is not required. 

The epiphysis for the internal epicondyle does 
not unite until about the age of eighteen; thus, 
injury to this structure can occur until late in 
adolescence. Until that time, the origin of the 
common flexor muscles, which attaches to the 
internal epicondyle, may avulse this structure 
when a strain in the valgus position is applied to 
the elbow. This is an opposite strain from the 
one that has just been considered. At least four 
grades of such a displacement may occur. The 
least serious is a slight separation, with minimal 
displacement. The most serious is avulsion of the 
epicondyle associated with complete outward dis- 
placement of the elbow. The more serious dis- 
placements usually are associated with some dam- 
age to the ulnar nerve. Less extensive displace- 
ments may be adequately treated by closed manip- 
ulation, with immobilization of the elbow in the 
flexed position. However, when the avulsed epiph- 
ysis has been drawn into the joint it is neces- 
sary to do an open reduction, securing the frag- 
ment in its bed by means of a few sutures. An 
important point about the roentgenograms in 
epiphysial injuries is that the films may not tell 
the story at all as these structures are composed 
mainly of cartilage and are not well portrayed 

Children who fall on the outstretched hand may 
impact the head of the radius against the capitel- 
lum, causing displacement of the upper radial 
epiphysis. An important consideration here is that 
the head of the radius in children must never be 
excised. To do so will result in radial shorten- 
ing, radial deviation of the hand and disruption 
of the radio-ulnar joint at the wrist. The usual 
displacement of the radial epiphysis can be treated 
by closed manipulation. When the displacement 
is more pronounced, it may be necessary to make 
a short incision and restore the parts under direct 
vision. In most cases, the epiphysis is perfectly 
stable after such a procedure. Occasionally, when 



it is not stable and will not stay in position, a 
Kirschner wire can be introduced from the back 
of the elbow through the capitellum into the shaft 
of the radius to hold its position for two or three 
weeks until early formation of callus occurs. 

Fractures of the Forearm 

Fractures of both bones of the forearm occur 
at the distal third, at the middle third and at the 
proximal third in about that order of frequency. 
Open operation is not justified for such fractures 
regardless of their level. It must be emphasized 
that no trace of angulation should be present in 
fractures of the proximal or middle third, for 
this will not correct itself with growth. Instead, 
permanent limitation of pronation and supination 
will result. Greenstick fractures at these levels 
frequently will be troublesome because of persist- 
ing and recurring angulation. In such situations 
it may be necessary to extend the greenstick frac- 
ture and convert it into a complete simple fracture 
in order to prevent recurring angulation. Some 
overriding is permissible if good alignment is 

Fractures of the upper third of the forearm 
should be immobilized in full supination and 
those of the middle third should be immobilized 
in midposition due to contraction of the muscles. 
It may be necessary to maintain alignment by 
using traction on the fingers and one need not 
fear doing this in children. Perfect restoration 
of the contours will be obtained in a few months 
and function as a rule will be normal. 

Fractures about the distal third of the fore- 
arm may be left unreduced if the angulation is 
less than 30 degrees. The hazard of leaving such 
fractures alone is far less than the hazard of 
giving the patient an anesthetic agent and manip- 

ulating the fracture in any way. The distal 
fragments usually are displaced dorsally. In such 
fractures, there is a strong tendency for angula- 
tion to return even in a well-applied cast. Immo- 
bilization of such a fracture should be in a long 
cast with the elbow at a right angle and the fore- 
arm pronated. Molding of the cast is a more 
effective way of controlling the angulation than 
trying to put the hand way down in pronounced 
flexion. There is no justification at all for open 

Fractures of the Hand 

Space allows discussion of only one fracture of 
the hand. One of the common athletic injuries in 
adolescence is fracture of the neck of the fifth 
metacarpal. Such a fracture cannot be handled 
with the finger extended, because with such exten- 
sion the ligaments are relaxed and the small 
distal fragment cannot be controlled. If the 
fracture is allowed to heal in this position, the 
end of the metacarpal will be down in the palm 
just like a marble. This type of fracture can be 
easily reduced, however, by flexion of the meta- 
carpophalangeal joint to an angle of 90 degrees; 
after its reduction, it can be held that way by 
means of a plaster slab. 


A plea is made for conservatism in treating 
fractures in children. Nature will do a wonderful 
job in healing these fractures and normal func- 
tion will be restored, as a rule, if physicians will 
simply assist nature to the extent of restoring 
alignment and providing proper immobilization 
for an adequate length of time. In some cases, 
it is almost unbelievable to what extent nature 
will afford correction of extremely severe frac- 
tures in spite of minimal correction obtained at 
the time of manipulation, 


Sunlight may be a major cause of skin cancer. Five 
fields of evidence point to sunlight as a possible caus- 
ative factor: “(1) Cancer of the skin of laboratory ani- 
mals (mice and rats) can be induced by exposure to ul- 
traviolet radiation; (2) cancer of the skin is more com- 
mon among outdoor than indoor workers; (3) cutaneous 
cancer is less prevalent in Negroes than in the white 

races, presumably because the former are less susceptible 
to sunlight; (4) the incidence of cancer of the skin is 
greater in regions of the earth that receive high insola- 
tion; (5) cancer of the skin occurs principally on parts 
of the body most exposed to sunlight.”—KETTERMAN, 
H. L.: Sunlight and cancer, Journal of Kansas Medical 
Society, 41:12 (Jan.) 1955. 


kin is 
| parts 



Management of Recent Injuries 

of the Hand 

ANY excellent articles have been published 

about the injured hand. Much of the mate- 
rial included in this presentation was derived from 
articles published by the great pioneer in recon- 
structive surgery of the hand, Dr. Sterling Bun- 
nell,»? from a series of bulletins produced by the 
American Society for Surgery of the Hand* and 
from a recent article by Godfrey.* The accom- 
panying sketches outline a plan of procedure that 
is applicable in the early management of the 
majority of injuries of the hand. 

Wounds of the hand comprise 36 per cent of 
all industrial accidents. Although no accurate 
statistics are available, it is probably safe to esti- 
mate that a similar incidence is present in injuries 
around the farm and the home. If an injured hand 
is to regain useful function, it must be protected 
from infection and from additional damage to 
tissues, both of which may be instrumental in 
converting the hand into a rigid club. This pro- 
tection is furnished initially by avoidance of 
meddlesome interference with the wound, clean- 
liness of the surrounding area, application of 
sterile protective dressings and immobilization in 
the position of function. Probing, examination, 
cleansing and treatment of the wound itself should 
not be undertaken until adequate surgical facili- 
ties are available. 

Bunnell noted after examining thousands of 
crippled hands that six main types of crippling 
are encountered. These are (1) stiffening of the 
hand in poor position, (2) flexion contractures, 
(3) skeletal malalignment, (4) dysfunction from 
injuries to tendons and nerves, (5) ischemic con- 
tractures and (6) trophic or vasomotor conditions. 
Although the latter two types of crippling usually 
but not always are due to the initial injury, the 

Read at the meeting of the Minnesota Academy otf 
General Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Orthopaedic Surgery, Mayo 
Clinic and Mayo Foundation. 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the University of Minnesota. 

May, 1955 


Rochester, Minnesota 

first four types are often due to sins of omission 
as well as commission in the treatment of the 
injured hand. 

Stiffening in Poor Position 

Edema, together with immobility, is the com- 
monest cause of stiffness. When these two factors 
are combined with a position of nonfunction after 
injuries to the hand, it will stiffen in its poor posi- 
tion. Edema results from many causes but espe- 
cially from infection. In the presence of edema, 
fibrin is precipitated about the tendons, muscles 
and joints. Soon the fibrin is converted into rigid 
fibrous tissue and the hand becomes a club rather 
than a finely co-ordinated and delicate piece of 
machinery. Edema is prevented soon after the 
injury by elevation and use of compression dress- 
ings. These dressings must be voluminous and 
snug but not too tight. Active motion must be 
started as soon as it is feasible. The part that is 
fractured, burned or otherwise damaged must be 
splinted, but the remainder of the hand must not 
be immobilized but kept active and moving. The 
position of function of the hand is that of moder- 
ate dorsiflexion of the wrist, moderate flexion of 
the fingers and moderate abduction and opposition 
of the thumb. When injuries of the hand are 
treated, this position must be borne in mind con- 
stantly. If for some unpreventable reason the 
hand should partially stiffen in this position, all 
function is not lost, whereas if the wrist is flexed, 
the fingers are straight or clawed and the thumb 
is adducted, function is lost. 

There is no place in the treatment of injuries 
of the hand for a splint that holds or allows the 
fingers to be maintained in the extended position. 
Even in mallet or baseball fingers. although the 
distal joint is hyperextended in treatment, the 
midjoint must be flexed so as to tighten the central 
slip of the extensor tendon and thus approxi- 
mate the avulsed extensor tendon to the distal 
phalanx. In an extended finger, its intercapsu- 



lar ligaments are relaxed and soon become fibrotic 
in this shortened position. In a flexed finger, the 
ligaments are tight. 

Fig. 1. Wounds of the hand should be covered im- 
mediately by a large protective sterile dressing. The 
nose and mouth of the physician or first-aid attendant 
and the patient should be covered in an attempt to 
prevent further contamination of the wound. 

Infection as a Cause of Stiffening in Poor 
Position.—Infection produces edema, pain on 
motion and thus immobility and a poor position, 
which is assumed for protection. Therefore, all 
possible precautions should be taken to prevent 
infection. A mask should be worn by all who 
come in contact with an open wound of the hand 
(Fig. 1). A large protective sterile dressing 
should be applied to the hand immediately after 
injury. The wound should not be probed or fully 
examined until this large first-aid dressing is re- 
moved and all arrangements have been made to 
proceed with the necessary surgical care (Fig. 2). 
The patient must be taken to the hospital imme- 
diately, as time is an important factor in pre- 
venting infection. 

It is unsafe to repair deep structures in a wound 
of the hand if bacteria have had an opportunity 
to multiply for more than 8 to 10 hours after 
injury. The wound should be gently but thor- 
roughly cleansed with soap and water and then 
completely excised or débrided; tendons, nerves 
and bones should be carefully preserved (Fig. 3). 
Fresh wounds have nonvirulent contamination 
and heal well if circulation, closure, compression 


dressings and rest are adequate. Tendons and 
nerves should not be repaired primarily in crush- 
ing, explosive or grinding injuries. 

Fig. 2. The first-aid dressing is not removed nor 
is the wound thoroughly inspected until the patient is 
in the operating room and plans have been made to 
proceed as necessary. Careful evaluation of the injury 
is then made and recorded and a plan of reconstruction 
is decided on. The hand and forearm are shaved, washed 
with soap and water and the wound is thoroughly ir- 
rigated with normal saline solution. A pneumatic-cuff 
tourniquet is applied. 

Every effort should be made to attain effective 
and early closure of the wound. The rotation of 
flaps of skin and grafting of the donor site, 
using the skin of a filleted finger or an immediate 
pedicle flap from the abdominal wall, may be 

necessary (Fig. 4). Thus, months of drainage 
from infection and its concomitant crippling may 
be avoided. Especially is it important to cover all 
vulnerable parts such as joints, bones, tendons 
and nerves, which are so suspectible to infection. 
On the other hand, the closure must not be under 
tension. If a wound is too dirty to close, it may be 
packed open for five to seven days and closed 

Flexion Contractures 

Flexion contractures are due to contracted scar 
tissue resulting from a burn or an open infected 
wound. Prevention, therefore, involves utilization 


on of 

ry be 
x may 
rer all 
ray be 

d scar 



of all available means to close the wound. In 
burns, the deep bed is usually in good condition 
for grafting. Often the burn has become demar- 

Fig. 3. Definitive treatment requires a well-equipped 
operating room, good lighting, adequate instruments, 
sufficient assistance, complete anesthesia and a bloodless 
field as supplied by the pneumatic tourniquet. Strict 
asepsis, with use of masks, gowns and gloves, helps 
prevent contamination of the wound with more virulent 
organisms. The wound is thoroughly débrided but all 
usable parts are saved, especially nerves and tendons. 
Fractures are reduced, the digits being placed in the 
position of function so they will be opposable. 

cated to such an extent that the destroyed skin can 
be excised four or five days after injury and a 
split-thickness skin graft can be applied at the 
same time or a few days later. Granulation tissue, 
if present, should be scraped off so as to apply the 
skin on a good bed that will not contract later. 
The borders of either a free or a pedicle graft 
should be zigzag and should not cross a flexion 
crease in a straight line. The hand and wrist must 
be splinted in a position of function if contrac- 
tures are to be avoided (Figs. 5 and 6). 

Skeletal Malalignment 

Skeletal malalignment must be prevented by 
restoration of normal function of the bony struc- 
tures at the earliest possible time. Restoration of 
normal position is accomplished by manipulation, 

May, 1955 

skeletal traction or open reduction. Regardless 
of whether a fracture or a dislocation is being 
manipulated, full relaxation, preferably induced 

Fig. 4. A cover of skin is supplied if at all possible, 
and usually it is, by swinging a flap as illustrated and 
applying a split- thickness graft to the resultant defect, 
by application of a split-thickness graft directly to the 
defect in selected instances or by use of a direct pedicle 
graft from the abdominal wall. If a finger has to be 
discarded, its skin with vessels and nerves may be 
utilized for cover. 

by having the patient under general anesthesia, is 
desirable. Manual traction, pressure and molding 
should be performed gently and deliberately to 
avoid further injury to soft tissues. If reduction 
is not promptly successful, operative (open) treat- 
ment is in order, since less harm is done by gentle 
surgical procedures performed through a correct 
incision than by rough and forceful closed 

To maintain reduction, particularly of oblique 
or comminuted fractures of the phalanges or 
metacarpals or fractures into joints, control by 
skeletal fixation may be required. The hand and 
the injured finger or fingers should be supported 
in the position of function. Not much traction is 
needed for fractures of the metacarpals and 
phalanges. The pull must be applied with the 
finger held semiflexed and never straight. Use of 
banjo splints is to be condemned. Rotary malunion 
of digits is avoided by checking to see that the 
plane of motion of each finger passes through the 
navicular tubercle and by observing the plane of 
the nail. Stiffening of adjoining fingers is avoided 
by splinting only the one that is injured. All 
uninjured parts must be kept moving. The cast 
should hold the wrist in dorsiflexion; it must be 
molded to the metacarpal arch and should termi- 
nate at the distal flexion crease and the thenar 



crease in the palm so that the proximal finger 
joints are free to flex. 

lor many metacarpal fractures, temporary pin- 
ning with Kirschner wires cut off beneath the skin 

Fig. 5. Swelling is avoided by fluff compression dress- 
ings that are applied just tightly enough, but not too 
tightly, to the hand, which is in the position of func- 
tion with the finger tips exposed so that circulation may 
be evaluated. Straps for elevation are incorporated in 
the dressing. 

to avoid infection is an excellent method of fixa- 

‘tion; the hand does not stiffen, as it is not in a 
cast. The wiring or plating of fractures of the 
bones of the hand generally is unsatisfactory. 
Healing of fractures of the long bones of the 
hand requires immobilization for three to five 
weeks; healing of fractures of carpal bones re- 
quires twelve to fourteen weeks. Fractures of the 
navicular may require four months for union. If 
immobilized consistently for these periods, most 
of these fractures will not require surgical inter- 

Injuries to Tendons and Nerves 

The dysfunction from injuries to tendons and 
nerves is best prevented by repairing these struc- 
tures early, within a few hours, and establishing 
a good cover of skin. Success depends on obtain- 
ing primary healing. In wounds more than eight 
to twelve hours old or in badly contaminated, 
dirty or explosive wounds, primary repair of 
tendons and deep structures must be omitted or 
serious infection will follow. The surgical repair 
must be done through proper incisions, with mini- 
mal trauma. The best conditions for healing are 
accomplished by avoidance of dead spaces, hema- 
tomas, buried sutures, especially catgut, and tight 


suturing. Tor the average surgeon it is best to 
unite the ends of nerves with one suture of stain- 
less-steel wire or silk to prevent retraction of the 
ends, thus facilitating secondary resuture under 


Fig. 6. The bandaged hand is elevated and rest is en- 
forced until the acute reaction of the injury is past, 
which usually takes about three days. 

the best of conditions later. However, when pri- 
mary suture of a nerve is performed expertly, the 
regeneration is sooner and better than that ob- 
tained after late repair. Nerves can and should 
be successfully repaired down to the distal flexion 
crease in the finger, including even the tiny motor 
branches within the hand. Injury to the nerves in 
the arm or brachial plexus is just as crippling as 
is injury to the hand itself and repair of these 
nerves should take precedence over that of bones 
and joints. When this is not done, the paralyzed 
muscles and distal portions of the nerves undergo 
such irreversible fibrous atrophy that restoration 
of function is impossible. A paralyzed hand needs 
to be kept mobile and in the position of function 
or it becomes a useless claw in a position of non- 
function. The patient should be instructed to keep 
the paralyzed hand in the position of function by 
gently manipulating it with the good hand. Pain- 
ful and tender neuromas are avoided by mini- 
mizing formation of scar tissue. Amputation 
should be done in noninfected fields and the end- 
ings of nerves placed in good tissue. 

Ischemic Contractures 

Ischemic contractures, both of the Volkmann 
type and the local type in the hand, usually are 
preventable by avoidance of tight casts or dress- 
ings. If the patient continues to complain of 



. of 


severe pain a few minutes after the cast or dress- 
ing is loosened and if there is evidence of im- 
paired circulation in the hand, emergency surgical 
treatment is necessary if the severe crippling that 
results from prolonged ischemia is to be avoided. 

Fig. 7. Supervised active, not passive, motion not 
only of the uninjured parts but also of the injured part 
must be started as soon as healing will permit. 

Trophic or Vasomotor Conditions 

Some patients appear more inclined to experi- 
ence so-called Sudeck’s atrophy and the tendency 
to causalgia than do others. These persons usu- 
ally have unstable sympathetic.nervous systems. 

Early recognition of such patients and encourage- 
ment in whatever activity may be required to make 
these people use their hands during every waking 
moment usually will abort the development of 
this extremely painful and disabling complication 
(Fig. 7). 


Review of the six main types of crippling of 
the hand, namely stiffening in poor position, flex- 
ion contractures, skeletal malalignment, loss of 
motion and sensation from injuries to tendons 
and nerves, ischemic contractures and trophic or 
vasomotor conditions, leads to the conclusion that 
many of these complications can be ascribed to 
treatment and, therefore, are preventable. 


. Bunnell, Sterling: The injured hand—principles of 

——-* Indust. Med. & Surg., 22:251-254 (June) 

. Bunnell, Sterling: The early treatment of hand in- 
juries. J. Bone & Joint Surg., 33-A :807-811 (July) 

. American Society for Surgery of the Hand: Prin- 
ciples of Early Management of Hand-Injuries and 
the Care of Hand Injuries. From a series of ar- 
ticles published in bulletin form, prepared by the 
American Society for Surgery of the Hand and 
distributed by the Committee of Trauma, Ameri- 
can College of Surgeons, through its Regional Com- 
mittees, 1948, 1949, 1950, 1952. 

. Godfrey, J. D.: Early management of the injured 
hand. J.A.M.A., 155 :1484-1486 (Aug. 21) 1954. 


(Continued from Page 295) 

tumor is invading surrounding structures, it may 
be tender and make the examiner think of an 
inflammatory lesion. 

If a patient has a hard, nontender node or 
nodes in the lower deep jugular region or supra- 
clavicular region (Virchow’s, or sentinel, node) 
on the left, one must be suspicious that these are 
secondary toa primary tumor of the lung, stomach 
or kidney. 

Incision for Lesions of the Neck 

In removal of a tumor of the neck for exami- 
nation, it is extremely important always to use 
a transverse rather than a vertical incision. A 
transverse incision heals nicely and is not a 
cosmetic problem later. Any incision that is made 

May, 1955 

vertically in the neck crosses the natural cutaneous 
lines and results in a puckered scar. For a large 
tumor in the neck or when an extensive resection 
is being done, such as a radical dissection of the 
neck, a vertical component to the horizontal inci- 
sion is usually necessary. 


Regardless of how careful the examiner may 
be, his impression of a tumor of the neck is just 
a guess until he proves the diagnosis by biopsy. 
Since many of these tumors are malignant, cos- 
metically deforming and potentially infected, all 
should be surgically investigated when discovered. 
The attitude, “The tumor is not bothering 
you, why bother it?” should not prevail. 


Precautions in the Use of Cortisone 

for Treatment of Rheumatic Diseases 

ORTISONE and related hormones, such as 

hydrocortisone and corticotropin, are the most 
potent antirheumatic agents known at present.* 
Unfortunately, these hormones also are capable 
of producing metabolic effects that often are 
undesirable and, indeed, sometimes temporarily 
harmful, especially if excessive doses are em- 

For optimal results, the use of these hormones 
in the treatment of rheumatic diseases must be 
attended by certain precautions, which can be 
divided into three convenient categories: (1) 
selection of the proper disease for treatment, (2) 
selection of the proper patient having one of these 
diseases, and (3) selection of proper dosage and 
attention to other details of management during 

General Precautionary Measures 

Selection of the Rheumatic Disease —Cortisone 
is most commonly indicated in selected cases of 
the following rheumatic diseases : 

1. Rheumatoid arthritis and its variants, such 
as rheumatoid spondylitis, Still’s disease, Felty’s 
syndrome, Reiter’s syndrome, psoriatic arthritis 
and the arthritis associated with chronic ulcera- 
tive colitis. 

2. Acute rheumatic fever. 

3. Systemic lupus erythematosus. 

4. Periarteritis nodosa. 

In a second group of diseases cortisone occa- 
sionally may be helpful but its systemic admin- 
istration is usually not indicated, since other and 
simpler measures ordinarily suffice. These diseases 
include : 

Read at the meeting of the Minnesota Academy of 
General Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Medicine, Mayo Clinic. 

*Reference will be made primarily to cortisone in 
this presentation, although the remarks apply generally 
to hydrocortisone or corticotropin. 



Rochester, Minnesota 

1. Arthritis of hypersensitivity states, such as 
serum sickness, in which antihistaminic drugs, 
epinephrine, salicylates, local application of heat, 
and rest for the affected joints usually are 
adequate. ; 

2. Acute gouty arthritis, for which colchicine 
is the drug of choice. 

3. Acute nonspecific bursitis, tendinitis and the 
shoulder-hand syndrome; for these conditions, 
physical medicine, salicylates and, in certain cases, 
roentgen therapy or local injection of hydrocor- 
tisone generally are sufficient. 

Cortisone should not be employed for: 

1. Specific infectious (septic) arthritis. 

2. Osteoarthritis. 

3. Primary fibrositis. 

4. Psychogenic rheumatism. 

In osteoarthritis of peripheral joints, intra- 
articular injection of hydrocortisone may pro- 
duce temporary symptomatic relief and is often 
useful, especially for acute or subacute flare-ups, 
but prolonged systemic administration of corti- 
sone should be avoided. 

Selection of the Patient.—If it has been estab- 
lished that a co-operative patient has a disease 
for which cortisone may be indicated, the next 
decision concerns the suitability of its use in the 
particular patient. Two principal considerations 
arise in this regard. The first is whether the 
disease in this particular instance is of sufficient 
activity and severity to warrant the use and 
expense of hormonal therapy or whether the 
patient would respond equally well to simpler 
treatment. For example, many patients who have 
mild rheumatoid arthritis can be managed satis- 
factorily by a general program, such as physical 
therapy, salicylates, extra rest, protection of joints 
and other supportive measures. Secondly, does 
the patient have some other condition that might 
be aggravated by cortisone and that, therefore, 









might contraindicate its use? Absolute contra- 
indications to prolonged usage are psychoses, 
Cushing’s syndrome, and tuberculosis and certain 
other infections not readily susceptible to control 
by currently available therapeutic agents, as acute 
poliomyelitis. Relative contraindications include 
renal and cardiovascular insufficiency, peptic 
ulcer, psychoneuroses, osteoporosis, diabetes mel- 
litus, convulsive disorders and certain severe in- 
tercurrent infections. 

The decision of whether or not to employ corti- 
sone in the presence of one of these relative con- 
traindications requires balancing the possible 
benefits of cortisone against its possible hazards 
in each particular patient. For example, one 
might elect to avoid use of cortisone if a patient 
has a moderate degree of rheumatoid arthritis 
but a peptic ulcer that is difficult to control, 
whereas one might employ cortisone for severe, 
incapacitating active rheumatoid arthritis in the 
presence of a peptic ulcer that could be controlled 
by careful medical management. Occasionally, 
the pros and cons are so evenly balanced that 
only cautious trial of treatment may allow a 
definite decision. 

Selection of Dosage and General Management. 
Studies Prior to Treatment.—Before cortisone 
is used, the patient should receive a complete 
medical examination, a roentgenogram of the 
thorax, serologic tests for syphilis, urinalysis, 
determination of hemoglobin and leukocytes in the 
blood and other tests pertinent to evaluation of 
the disease or complicating conditions. The physi- 
cian should discuss thoroughly with the patient 
the potentialities and limitations of treatment with 
cortisone and should stress the necessity for fre- 
quent rechecks and co-operation in following 
directions carefully. 

Choice of Hormone.—Doses of cortisone, hy- 
drocortisone or corticotropin required to produce 
equivalent antirheumatic effects differ somewhat. 
On the average, the required amount of hydro- 
cortisone given orally may be about 20 per cent 
less than that of cortisone, although in practice 
individual variations are considerable.’ It is even 
more difficult to estimate comparative doses of 
corticotropin owing to differences that result from 
such factors as the preparation used, the route of 
administration and the variable activity of the 
adrenal cortices. However, increased antirheu- 

May, 1955 


matic activity of these hormones is accompanied 
by increased metabolic activity, affecting electro- 
lytes, water, protein, fat and carbohydrate. No 
one of these three hormones has proved con- 
sistently superior to the others in the avoidance 
of hypercortisonism. 

Examination During Treatment——During ad- 
ministration of the hormones, the patient should 
be examined periodically with regard to the effect 
of treatment on control of the disease and to the 
presence or absence of hypercortisonism. The 
frequency’ of periodic rechecks depends on the 
disease and the individual circumstances. The 
patient who is treated for acute systemic lupus 
erythematosus with large doses of cortisone needs 
to be checked clinically at least daily ; laboratory 
tests, such as urinalysis and measurement of 
serum electrolytes, sedimentation rate and hemo- 
globin, may be required frequently. On the other 
hand, the rheumatoid patient treated with small 
doses of cortisone may need to be seen only at 
weekly intervals initially, then later at intervals 
of two to four weeks, at which time the clinical 
status should be evaluated carefully.and weight 
and blood pressure recorded ; necessary laboratory 
tests may be minimal, such as urinalysis and 
measurement of hemoglobin and leukocytes every 
two or three months, and roentgenograms of the 
thorax every six to twelve months. 

Careful clinical observation of the patient is of 
more importance than are laboratory tests in the 
management of the patient receiving cortisone, 
especially in the detection of hypercortisonism. 
Such evidence of hypercortisonism as mental 
stimulation, increased appetite, gain in weight, 
facial rounding, retention of fluid and appearance 
of supraclavicular fat pads usually occurs long 
before any laboratory signs of hypercortisonism. 

Regulation of Dosage.—Regulation of dosage 
is the most important phase of careful treatment. 
Attitude toward dosage should be conditioned to 
a great extent by the disease under treatment and 
the anticipated duration of hormonal therapy. 

For acute self-limited but potentially damaging 
diseases, such as acute rheumatic fever, relatively 
large doses are employed to accomplish quick 
suppression of the inflammatory reaction; then 
a gradually lowered but completely suppressive 
dose is maintained for the relatively brief course 
of the disease. For example, one might give to a 



young adult with acute rheumatic fever 200 or 
300 mg. of cortisone daily for a few days until 
clinical signs of acute rheumatic fever have dis- 
appeared, after which the dose might be reduced 
to about 100 to 150 mg. daily for the next two or 
three weeks. Then slightly lower doses, perhaps 
50 to 100 mg. daily, might be employed for the 
next few weeks. Thereafter the dose might be 
tapered off in a period of another week or two 
or longer if necessary. Recurrence of activity 
may call for temporary increase in doses. Signs 
of hypercortisonism in the presence of apparently 
complete suppression of the disease would indi- 
cate the probable desirability of some reduction 
in dosage. Obviously, dosages and duration of 
treatment should be adjusted to the needs of the 
individual patient; the variation in severity and 
duration of the disease does not permit a routine 
schedule of treatment. When such large doses as 
just outlined are employed, a low-salt diet and 
the administration of potassium chloride (for 
example, 2 gm. three times daily) are advisable. 

For subacute and chronic diseases typified by 
occasional acute, potentially fatal flares, as for 
example in systemic lupus erythematosus, ex- 
tremely large doses of 300 to 1,000 mg. or more 

per day may be employed temporarily during the 
acute stages; subsequently the dose is tapered off 
so that during the chronic stages little or no corti- 
sone is employed. If the use of cortisone is neces- 
sary during the less acute stages, the dosage 
should be regulated to avoid hypercortisonism in 
much the same manner as will be described in the 
discussion of rheumatoid arthritis. 

lor chronic diseases requiring indefinitely long 
treatment, as in chronic rheumatoid arthritis, the 
dose should be kept low enough to avoid hyper- 

Dosage in Rheumatoid Arthritis 

The objective in the treatment of rheumatoid 
arthritis with cortisone or related hormones should 
be to achieve as much antirheumatic effect as 
possible without producing hypercortisonism. 

Problems of Chronic Hypercortisonism.—lf 
large doses of cortisone, hydrocortisone or cor- 
ticotropin are administered to a rheumatoid pa- 
tient, antirheumatic effects may be maintained 
whether or not signs of hypercortisonism appear. 
However, in some patients maintenance of 


excessive doses producing hypercortisonism 
eventually leads to serious complications, such 
as osteoporosis with fractures, peptic ulcers, pro- 
nounced emotional disturbances and excessive 
retention of fluid. Extreme fatigability, emotional 
lability and depression and diffuse aches and 
pains unlike but often confused with rheumatoid 
symptoms may be noted.‘ Reactions simulating 
systemic lupus erythematosus or periarteritis 
nodosa have occurred in several cases.° At 
present, one cannot predict in which patients 
significant complications will develop if hyper- 
cortisonism is permitted to persist. Therefore, 
doses should be regulated to avoid hypercortison- 
ism in all patients. 

Policy on DosageA policy of restriction of 
dosage so as to avoid hypercortisonism implies 
that doses will be smaller than those employed 
previously by many physicians. As a conse- 
quence, less than complete antirheumatic effects 
may result in many cases. Necessary com- 
promises in dosage may permit suppression 
of only 50 to 75 per cent of symptoms. Relief of 
this or greater magnitude generally can be 
achieved in at least 50 per cent of cases, often 
more easily in men than in women. In about 35 
per cent of cases satisfactory regulation of dosage 
may be more difficult, while in about 15 per cent 
continuous adequate control of rheumatoid arthri- 
tis with tolerable doses is difficult or tnsatis- 

Initial Doses —My colleagues and I virtually 
have eliminated the use of large initial priming 
doses in our present treatment of rheumatoid 
arthritis. Starting doses are the approximate 
amount estimated as reasonable for prolonged 
maintenance, governed by the activity of the in- 
flammatory reaction and the patient’s expected 
susceptibility to hypercortisonism. The following 
daily doses of cortisone often are employed ini- 
tially: for men, 40 to 60 mg.; for postmenopausal 
women, 20 to 30 mg.; for other women, 25 to 40 
mg. Doses of hydrocortisone are slightly less. 
Sometimes the chosen initial dose may prove 
insufficient, in which case a small increment 
(5 to 10 mg.) may be made temporarily. 

Reduction of Dose.—As soon as antirheumatic 
response is definite, gradual reduction of dose is 
attempted. Decrements generally are from 2.5 to 
5 mg. when the dose is 50 mg. or less, or from 




f of 

t 35 

2 in- 
- ini- 
0 40 

se is 
,.5 to 



5 to 10 mg. when the daily dose is more than 50 
mg. If a previous reduction has been well 
tolerated, the dose may be reduced again within 
a week or so. In some patients, reduction must 
be made less often. If the response to the pre- 
vious reduction has been less favorable, another 
decrement may be delayed for several weeks or 
as long as necessary for the patient to readjust 
to the new dose, unless further reduction is 
dictated by other circumstances, such as the pres- 
ence of hypercortisonism. 

Maintenance Doses.—The maintenance dose is 
not a fixed dose. Ideally, it is that variable and 
usually decreasing amount required to maintain 
relief without producing hypercortisonism. Thus 
maintenance refers to relief, not dose. The proper 
dose for maintenance of relief varies from patient 
to patient and from time to time in the same 
patient; hence, frequent individual attention is 
required. Occasional and repeated attempts at 
reduction should be made even though the patient 
appears to be well stabilized at a given dose, 
since a smaller dose may accomplish as much. If 
the reduced dose proves insufficient, the former 
dose can be reinstated, perhaps for one to three 
weeks or so, before reduction is again attempted. 
Eventual discontinuation of medication by gradual 
reduction should be the aim. 

For mild or moderate flares, the dose often can 
remain unchanged; extra amounts of acetylsali- 
cylic acid, physical therapy and rest may suffice. 
If necessary the dose may be increased by 5 mg. 
for mild or moderate flares and 10 mg. for more 
severe flares; a second increment may be given 
later if required. The dose is reduced again as 
soon as the flare begins to recede. 

Experience suggests that daily doses for pro- 
longed treatment generally should not exceed the 
following limits: for men, 50 to 60 mg.; for post- 
menopausal women, 30 to 35 mg.; for other 
women, 40 mg. Hypercortisonism develops in 
some patients who receive less than these doses; 
others can tolerate slightly larger doses. In case 
of increased stress or pronounced articular flare, 
temporary use of larger doses may be required. 

Division and Spacing of Daily Oral Doses — 
For most patients the daily oral dose of cortisone 
should be divided into four more or less equal 
parts and one part should be given every six 
hours; a typical schedule might be 10 mg. at 

May, 1955 

6 a.m., noon, 6 p.m., and midnight. The duration 
of antirheumatic effect of cortisone sometimes is 
sufficiently long to permit the patient to take the 
last dose of the day at bedtime rather than having 
to be roused from sleep to take the final dose 
at a later time. 

Other patients may be treated more satisfac- 
torily by varying the size of individual doses dur- 
ing the twenty-four-hour period so as to provide a 
little more cortisone for times when symptoms are 
likely to be worse. Thus, for a man whose symp- 
toms are particularly severe during the morning 
but much less severe in the afternoon and evening, 
a program of 20 mg. at 6 a.m. and 10 mg. at noon, 
6 p.m. and midnight may achieve better results 
than a program of 12.5 mg. every six hours, 
although the total dose would be the same in each 

Flexible Program of Dosage-——Many rheuma- 
toid patients experience varying degrees of symp- 
toms from day to day during an average week. 
For some such patients it may be better to 
employ a flexible program in which the patient 
takes a slightly different amount for “average” 
days, “good” days and “bad” days. Thus, instead 
of a daily maintenance dose of 45 mg. during the 
week (total weekly dose of 315 mg.), such a 
patient might more effectively take 40 mg. daily 
for three average days, 35 mg. daily for two good 
days and 45 mg. daily for two bad days (total 
weekly dose of 280 mg.). Such a program not 
only supplies more cortisone when needed but also 
reduces the amount given at times when less is 
required. In this way smaller total doses may be 
successfully employed. This plan requires espe- 
cially intelligent co-operation by the patient, as 
well as careful check by the physician to insure 
that supplemental doses are not employed exces- 
sively or unnecessarily. The patient is not per- 
mitted to regulate his own dosage but rather is 
permitted a choice within a slight range of dosage 
predetermined by the physician. 

Supplementary Measures.—Appropriate sup- 
plementary treatment, such as physical therapy, 
salicylates, adequate rest, protection of involved 
joints and other supportive measures, should be 
continued during administration of cortisone. 

Management in Case of Stress — 

The pituitary-adrenocortical mechanism is in- 
hibited by long-term treatment with cortisone or 



corticotropin and, therefore, it cannot react nor- 
mally to produce increased quantities of needed 
adrenocortical hormones in case of stress. Thus, 
in order to prevent the serious consequences of 
adrenocortical insufficiency in severe stress, suff- 
cient additional hormone must be administered.**7 
For minor stress, such as a mild intercurrent 
infection or a minor surgical procedure per- 
formed with the patient under local anesthesia, 
the maintenance dose of cortisone should be con- 
tinued or rarely increased slightly, perhaps by 
25 to 50 mg., for the duration of the stress; 
careful clinical observation should reveal any 
need for additional cortisone. 

In major stress, such as a major surgical 
operation, serious injury or severe intercurrent 
infection, even more additional cortisone must 
be given. In elective major surgical treatment, 
my colleagues and I give 200 mg. of cortisone 
intramuscularly forty-eight hours, twenty-four 
hours and one hour before operation. On the day 
after operation, 100 mg. is usually given if the 
patient’s condition is satisfactory ; within the next 
two to three days the dose is gradually reduced 
to the preoperative maintenance level or its use 
is discontinued. Oral administration is resumed 
postoperatively conveniently 

whenever it is 

For more urgent surgical procedures or other 
emergencies, 200 mg. or more of cortisone is given 
intramuscularly as soon as possible; this dose is 
repeated after operation and as needed thereafter. 
In addition, a dose of 100 to 200 mg. of hydro- 
cortisone in solution is given intravenously in 
250 cc. of isotonic solution of sodium chloride 
during operation or for rapid effect in other 
emergencies, to be repeated as needed during or 
after operation. 

Other precautions also are advisable to mini- 
mize the effects of major stress in these cases. 
Operation should be performed early in the day 
to avoid prolonged fasting and other stress inci- 

dent to waiting. If intravenous administration 
of fluids is required, the use of glucose alone in 
distilled water should be avoided; isotonic solu- 
tion of sodium chloride or such a solution con- 
taining 5 per cent glucose should be used instead. 
Morphine is poorly tolerated by patients who have 
adrenocortical insufficiency ; the use of meperidine 


hydrochloride (demerol hydrochloride) appears 

During and after operation or other stress, the 
patient should be watched closely. Blood pressure 
and pulse are checked at least hourly for twenty- 
four to thirty-six hours. If signs of adrenocor- 
tical insufficiency develop, such as weakness, 
tachycardia, hypotension, vascular collapse or 
respiratory failure, 100 to 200 mg. of hydrocor- 
tisone should be promptly administered intra- 
venously in 250 cc. of isotonic solution of sodium 
chloride; this injection should be repeated as 
often as necessary to maintain normal blood 
pressure. A dose of 200 mg. of cortisone should 
also be given intramuscularly for later supportive 
effect. Oxygen, blood transfusions and vasopres- 
sor drugs, such as norepinephrine, 4 mg. in iso- 
tonic solution of sodium chloride, may be em- 
ployed as indicated if shock develops. 

The afore-mentioned precautions are employed 
not only for patients currently under treatment 
with cortisone but also for those who have re- 
ceived significant amounts of the hormone 
within the past three to six months, or even 
within the past year if hypercortisonism has 
been present. In patients treated with cortisone 
less recently, prophylactic use of cortisone 
often is deemed unnecessary. However, in 
such cases the other precautions just described 
are observed just as in the case of the patient who 
receives cortisone, and a solution of hydrocorti- 
sone is kept available for emergency intravenous 

Patients treated with cortisone or related hor- 
mones should carry cards similar to those carried 
by diabetic patients to inform those who might 
care for them in an emergency that special care 
and additional doses of hormone may be required. 


This presentation purposely has stressed the 
possible hazards and necessary precautions dur- 
ing administration of cortisone in the treatment 
of certain rheumatic diseases. In viewing these 
hazards, one must not overlook the benefits that 
result from use of cortisone in certain carefully 
selected, properly managed patients who have one 
or another of the rheumatic diseases for which 

(Continued on Page 322) 





Digestive Ailments of Older 


N AGING population is rapidly developing 

and more patients are living longer and re- 
maining in better health at present than at any 
time in history. Among this group, gastroin- 
testinal complaints are extremely common and 
varied. The literature bearing on the field of 
geriatric gastroenterology is scanty and individual 
experience is limited. Since degenerative cardio- 
vascular renal disease and cancer loom so large 
as causes of death, it is natural that the bulk of 
the literature on the aging process has concerned 
itself with these two problems while the gastro- 
intestinal tract has been almost forgotten. Only 
in recent years have gastroenterologists become 
interested in this problem. Those who have writ- 
ten about it have agreed in emphasizing (1) the 
fact that many of the gastrointestinal complaints 
are due to curable or correctable lesions, (2) the 
variation in symptomatology from the usually 
accepted classic clinical syndrome of the disease 
in question and (3) the opportunity which the 
family physician has in dealing with this group 
of patients. 

The Pathologic Physiology of Aging 

The changes which occur in various organs of 
the body as a result of the aging process have 
been fairly well documented, the exception being 
the gastrointestinal tract. There are minor de- 
generative changes of the salivary glands with 
a reduction of ptyalin secretion. Since digestion 
of starch begins in the mouth, these changes may 
be reflected in the development of fermentative 
diarrhea, The esophagus itself is usually seen 
to resist the passage of time but in some very 
old persons there may be either atony or un- 
co-ordinated peristalsis with resulting dysphagia. 
The lowering of gastric acidity with age has been 
well studied and it is probable that about 10 to 
12 per cent of older persons have permanent 

Read at the meeting of the Minnesota Academy of 
General Practice, Rochester. Minnesota, October 20, 1954. 
From the Palo Alto Clinic. 

May, 1955 

Palo Alto, California 

anacidity. Some atrophy of the gastric mucosa 
has been reported but this finding has been con- 
tradicted by recent gastroscopic biopsy studies 
that show essentially normal mucosal structure in 
the stomachs of many older people. Radiologists 
tell me that there is little evidence of a loss of 
gastric tone or motor activity in the aged. So 
far as the small intestine is concerned, the little 
that is known about it would indicate that no 
significant changes take place in it as a result of 
aging. The same statement cannot be made of 
the colon, in which loss of muscle tone and pro- 
pulsive activity is frequently seen. This problem 
is frequently compounded in older persons by the 
development of rectal lesions that interfere fur- 
ther with normal intestinal function. 

So far as the accessory organs of digestion are 
concerned, some falling off in organ weights may 
occur but little else has been observed. The liver 
may show some abnormal pigmentation of its 
cells and fibrosis around the portal spaces but the 
cell mass as a whole appears to be normal and 
such liver functional data as exist would indicate 
that the physiologic capacity of the liver is not 
greatly disturbed. Much the same statement can 
be made with regard to the pancreas. 

With regard to the abdominal vasculature, ag- 
ing may be a basis for such lesions as mesenteric 
thrombosis. However, existing evidence appears 
to indicate that degenerative vascular disease of 
the abdominal aorta and its branches lags some- 
what behind the same changes in other portions 
of the body. 

I shall have relatively little to say about cancer 
and will, in the main, deal with the benign gas- 
trointestinal diseases, for many of which there 
are satisfactory and acceptable forms of treat- 

Case-taking in Geriatric Gastrointestinal Disease 

As in pediatrics, diagnoses in old patients must 
be based largely upon objective evidence and 
upon a sound general knowledge of what is likely 



to be wrong. The histories in older patients, al- 
most all of whom have some digestive complaints, 
may be grossly misleading. Many elderly in- 
dividuals are willing to blame their complaints 
on “something I ate,” upon supposed allergies and 
upon other ailments that they have been known to 
have for a long time. Many of them probably 
minimize their symptoms because they are afraid 
of what might be found. Finally, many of them 
are unwilling to discuss the personal, social and 
economic difficulties which may play a large part 
in the production of their symptoms. For this 
reason one may recommend the general practice 
of first getting acquainted with the patient, then 
seeing what else is wrong with him (since mul- 
tiple diagnoses are the rule in the aged), and 
finally considering the gastrointestinal complaints. 

The well-established practice of obtaining a his- 
tory of the complaints for a single typical day is 
helpful; of even greater value is the presence of 
a relative or friend who may often supply the 
pertinent details. Finally, it is wise to make an 
attempt to see any acute episodes of distress 
which these oldsters may have. A visit to the old 
man or woman in the patient’s own home and the 
observation of an episode of the illness at first 
hand may be of greater value than even the most 
detailed studies in the hospital. The advantages 
that the family physician has in respect to these 
factors are obvious. 

Common Gastrointestinal Diseases of the Aged 

I shall attempt to refrain from statistics so far 
as is possible. However, I have drawn freely 
upon Monroe’s experiences at the Geriatric Clinic 
of the Peter Bent Brigham Hospital, upon some 
observations kindly made for me by Dr. Roger 
Egeberg and his colleagues at Wadsworth Hos- 
pital in Los Angeles and upon the personal ex- 
periences of some of my own colleagues. It 
seems well to begin at the entrance to the digestive 

Diseases of the Esophagus.—There are prob- 
ably more erroneous diagnoses made in respect to 
esophageal disease than any other field of gas- 
troenterology, the reason probably being that it 
is not often recognized how frequently esophageal 
disorders will produce symptoms referable to the 
abdomen. Cardiospasm is a relatively rare condi- 
tion in older persons, but carcinoma is common 
enough and should be the first consideration in 


any elderly person with a short history of dyspha- 
gia. Both of the former are overshadowed in im- 
portance by one common ailment, namely, hiatus 
hernia, with or without peptic esophagitis. Such 
hernias are common in old people; in fact, evi- 
dence indicates that there may be a relative re- 
laxation of the esophageal hiatus which increases 
with age. The diagnosis frequently can be made 
from the history alone, the most common feature 
of which is nocturnal or postural pyrosis and 
regurgitation of food, along with varying degrees 
of transitory dysphagia and of pain in the epi- 
gastrium and left upper quadrant. The diagnosis 
is clinched by roentgenologic study. If one is to 
get maximal help from the radiologist, however, 
one must tell him what is suspected. 

It is remarkable how often older patients with 
hiatus hernias are admitted to the hospital with 
a history of bleeding; probably at least a third 
are anemic when first seen. Actual esophageal 
ulcers are not infrequently seen when they are 
sought for, usually in the herniated portion of the 
stomach or in the distal portion of the esophagus. 
Probably patients can bleed from esophagitis and 
gastritis alone without gross ulceration. 

Diverticula of the esophagus are not especially 
rare. It is noteworthy that they infrequently 
cause symptoms until the later years of life. The 
important diverticula to identify are those at the 
pharyngo-esophageal juncture. Such diverticula, 
when filled with food, may set off a chain reaction 
of aerophagia and belching ; hyperventilation may 
be associated with the condition as well. Ausculta- 
tion of the neck during the act of deglutition may 
be of diagnostic value. 

Traction diverticula of the middle third of the 
gullet are of lesser importance, while those of its 
distal portion are extremely rare. It is important 
to exclude esophageal lesions in patients who 
have supposed cardiac disease. Barium studies, 
so widely used by radiologists in studying the out- 
lines of the heart and aorta, have in many in- 
stances served to establish an entirely different 
diagnosis, namely, that of esophageal disease. 

Diseases of the Stomach and Duodenum.— 
Since gastric acidity decreases with advancing 
age, it was the general belief about 30 years ago 
that ulcers of the stomach and duodenum would, 
therefore, disappear or become quiescent. The 
situation is different today and it is now recog- 
nized that either acute or reactivated ulcerative 



disease of the stomach and duodenum is relatively 
common in patients more than 60 years of age. 
In his afore-mentioned studies, Monroe found 
that 6.4 per cent of the more than 8,000 admis- 
sions to the Geriatric Clinic were for peptic 
ulcer; in only about half these cases was the 
usual long and classic history obtained. In one 
home operated by the Veterans Administration, 
60 per cent of all gastrointestinal admissions from 
the home to the hospital are because of ulcer 
problems involving obstruction, bleeding or pene- 
tration and almost universally requiring surgical 
consultation and study. 

Some interesting points are found with regard 
to the location of peptic ulcers in older patients. 
In the population as a whole there are probably 
ten duodenal ulcers to every gastric ulcer. In 
the aged, this ratio falls to about 3.5:1. Some 
correlation may exist between gastric ulcer and 
degenerative arterial disease, which may be of 
clinical importance, especially in connection with 
the cause of gastric ulcers and the seriousness 
of bleeding from them. 

The patient with a long-standing ulcer history 
who experiences reactivation of his ulcer diathesis 
in later years presents no particular problem. 
There is a sizable group of old patients, however, 
who present their first ulcer symptoms in the sev- 
enth decade of life. In such -patients bizarre 
symptoms appear to be the rule rather than the 

The usual sequence of pain with an empty 
stomach and ease with food often does not appear, 
being replaced by symptoms having little rela- 
tionship to those usually described by ulcer pa- 
tients. A common story is that of isolated attacks 
of severe pain unrelieved by anything short of 
narcotics and not infrequently associated with 
vomiting and bleeding. Other patients may com- 
plain of pain aggravated by the taking of food 
or of periodic vomiting. 

Complications, as already indicated, are al- 
most the rule in the aged. Of these the most 
serious is bleeding, which not infrequently comes 
out of a clear sky. Duodenal ulcers apparently 
bleed a little less often than do ulcers on the 
gastric side. Men have more hemorrhages than 
women. Both the incidence and gravity of hem- 
orrhage appear to increase with age, with a cor- 
responding effect upon mortality. The true in- 
cidence of hemorrhage is difficult to determine, 
figures of from 5 to 30 per cent appearing in the 

May, 1955 

literature; in Monroe’s series, the latter per- 
centage obtained. It is difficult to estimate the 
severity of hemorrhage in the aged, and a high 
incidence of cardiac and cerebral thrombosis 
follows hemorrhage, even that of moderate de- 

Obstruction is noted in about 10 to 15 per 
cent of old patients with ulcer, slightly more 
often with gastric than with duodenal lesions. 
Many of these patients have symptoms and roent- 
genologic findings suggestive of cancer. Obstruc- 
tion may appear suddenly and with little in the 
way of antecedent history. Persons who have 
acute obstruction area particular problem and may 
need hospital study with repeated checks of gas- 
tric retention and radiologic studies before a 
final diagnosis can be made. It should be pointed 
out that imbalance of electrolytes and azotemia 
develop with extreme rapidity in older patients 
after either hemorrhage or obstruction and that 
neglect of fluid balance for as little as a day or 
so may result in serious complications. Most of 
these older patients with pyloric obstruction can 
be handled well by simple surgical procedures, 
such as gastroenterostomy with or without ex- 
cision of the ulcer. Fortunately, perforation oc- 
curs only about half as often as obstruction. A 
pronounced sex difference is noted, perforation 
being five times as common in men as in women. 

What impresses gastroenterologists in dealing 
with the older ulcer patient is the bizarre symp- 
tomatology, the high incidence of complications 
and the relatively high mortality and morbidity 
rates; the persistence of the ulcer diathesis be- 
yond the seventh decade of life is also impressive. 
Obviously, we should make roentgenologic studies 
of the stomach on more old patients even if the 
history is bizarre; we must be particularly quick 
to investigate a history of gastrointestinal bleed- 
ing, even if the amounts of blood lost are small. 
Finally, if the patient is seen for the first time 
with hemorrhage or other complications which 
might be attributed to ulcer, immediate investi- 
gation is compulsory. 

One final point is stressed by gastroenterol- 
ogists who have dealt extensively with ulcer in 
older patients. Treatment should never be con- 
tinued for any length of time on the basis of 
symptomatology alone without confirmatory 
roentgenologic studies. Even after examination 
has revealed a lesion that appears to explain the 
complaint, and even if symptoms are benefited 



by medical management, further roentgenologic 
studies after a lapse of time are necessary. The 
high incidence of neoplastic disease in the stomach 
should warn us not to be misled by a solitary 
roentgenogram that shows a supposedly benign 

Diseases of the Gallbladder.—Thirty years ago, 
when disease of the gallbladder was suspected in 
all middle-aged patients who had any sort of 
dyspepsia, a good many unnecessary cholecystec- 
tomies were done. Over the years the pendulum 
has swung in the opposite direction and today 
even cholecystography is often omitted unless the 
patient has had fairly classic symptoms referable 
to the biliary tract. As a result, a great many 
persons are going into the later years of life 
carrying gallstones which are not suspected until 
a catastrophe of some sort occurs: 

The increasing incidence of gallstones with 
age requires only brief mention. Women ap- 
parently form most of their gallstones between 
their middle twenties and the menopause. In 
men the process starts later and continues into 
the eighth and ninth decades of life. The end 
result is that the incidence of stones in the two 
sexes becomes nearly equal in the very old. 
Many of these stones remain completely asymp- 
tomatic for life; others produce their first and 
only symptoms in advanced age. It is well to 
remember that gallstones are probably the com- 
monest single cause of serious abdominal pain 
in patients more than 65 years of age and that 
neither the location nor the exact character of the 
pain is of much diagnostic value. 

Should the accidentally discovered calculous 
gallbladder be removed in older patients? Is a 
single bout of pain sufficient indication for radi- 
cal treatment? These questions are practical and 
the answer is not always simple. When statistical- 
ly considered, the answer must be in the affirma- 

If one checks present hospital mortality rates 
from gallstones against the generally accepted 
surgical risk, it will be found that the mortality 
rate of stones in older patient is much higher 
than the least optimistic figures on surgical risk. 
In old patients the complications of gallstones and 
associated disease are jointly responsible. In Mon- 
roe’s series there were many patients with chole- 
cystenteric fistulas, gallstone ileus, common-duct 
stones and obstructive cirrhosis, to say nothing 


of associated pancreatitis; in the same series, the 
incidence of vascular complications was high. 
About 44 per cent of the patients who had gall- 
stones had associated nonvalvular heart disease 
and 10 per cent had had previous cerebrovascular 

Thus, gallstones are a distinct hazard to life 
which increases rapidly with age. Surgical mor- 
tality rates run a parallel course, although as a 
tule the old patient with gallstones stands oper- 
ation well and there are few contraindications. 
The mortality rate of all patients with gallstones, 
according to Monroe, is materially increased 
above the hospital mortality rate of all old pa- 
tients by at least 10 per cent. In his series, 4.5 
per cent of the “medically treated” patients with 
gallstones died in the hospital solely as a conse- 
quence of their biliary disease and 8.5 per cent 
died from gallstones with complicating disease 
elsewhere in the body. 

Diseases of the Small Intestine —Regional 
ileitis is rare at all ages and decidedly uncommon 
among the old. The disease appears to present 
no special features in the later years of life. 
Whether healed ulcerative or granulomatous dis- 
ease in early years leaves any residues that per- 
sist into the later years of life is not known. | 
recall three instances of intestinal strictures from 
my own experience ; one caused obstructive symp- 
toms of some severity while the others caused 
difficulty of a relatively mild degree. In two the 
origin was unknown; the third was associated 
with polyarteritis. 

Diverticula in the small intestine, not uncom- 
mon in the aged, interest the radiologist but are 
rarely productive of serious symptoms. Duodenal 
diverticula in particular are probably of no great 
clinical importance, although a few are known 
to have produced mechanical difficulties chiefly 
because of their large size. Meckel’s diverticula 
are rarely considered in diagnosis, yet I know 
of a recent case in which one produced obstruc- 
tion in a 92-year-old man. This lesion was suc- 
cessfully resected and the obstruction relieved. 

Diseases of the Colon.—lf one arbitrarily ex- 
cludes cancer from the discussion, only a few or- 
ganic conditions involving the colon remain to be 
considered in the older age group. Ulcerative 
colitis is rare in geriatrics, yet an occasional case 
is found even in the aged. 


in tl 
not 1 
ed o1 
old | 

vane | 
» the 





One sees on histories a great many diagnoses 
of diverticulitis of the colon. Diverticula them- 
selves are as common after 50 years of age as 
gray hair or wrinkles; they rarely produce symp- 
toms until they are called to the patient’s at- 
tention. In private practice a really significant 
attack of diverticulitis is something of a rarity. 

One sees frequently on radiologic examination 
of older persons a narrowed cicatricial strip of 
intestine beginning in the descending colon and 
extending into the sigmoid. These lesions are prob- 
ably truly the consequences of previous diverticu- 
litis. They may simulate cancer, although their 
length and the rather indefinite terminal margins 
they present argue against such a diagnosis. In 
a few patients, cicatricial obstruction of the region 
may occur which can be relieved only by surgical 
excision of the diseased segment of intestine. It 
has been said that lesions of this type do not 
bleed, yet I am sure that some must do so. One 
woman, aged 83, with this radiologic picture 
bled from the intestine for years in quantities 
such as to require frequent transfusions. In spite 
of many roentgenologic studies and two laparot- 
omies, no other cause for the bleeding point was 
ever found. 

Much has been said and written about polyps 
in the colon. The small multiple polyps so fre- 
quently seen during sigmoidoscopy are easily ful- 
gurated and removed. Larger single, adenomatous 
polyps, which produce symptoms by mechanical 
blockage of the intestine or by ulceration and 
hemorrhage, are not uncommon in older patients. 
Since many of them are potentially malignant, 
their removal must be advised, but in my ex- 
perience the expected cure of the vague abdominal 
complaints so commonly associated with them does 
not materialize. 

Some special mention must be made of ap- 
pendicitis in the aged. Dr. Egeberg has comment- 
ed on the frequency of appendiceal rupture in 
old patients associated with only moderate in- 
lammatory reaction. These ruptures are appar- 
ently caused by distal obstruction incidental to 
cancer, the cicatricial residues of diverticulitis, 
volvulus or perhaps even constipation. There is 
no more difficult diagnosis than that of appendi- 
itis in an old person. The symptoms are bi- 
zarre and the peritoneal reaction minimal; sus- 
picion frequently is the only possible basis for 
diagnosis. All too frequently a diagnosis is not 
suspected until an abscess develops. 

May, 1955 

The major problem referable to the colon in 
No bulk formers, 
lubricants or antispasmodics will get much of 
a performance out of the old colon. What one 
should attempt to do is persuade the patient that 
the intestine need not be emptied every day and 
that no physical harm will result from an overdue 
stool. Such arguments leave most old people un- 
moved, and it is a rare person who has not worked 
out his own salvation by means of various laxa- 
tives, suppositories or enemas. It takes a hardy 
physician to attempt to correct some of these no- 
tions and no amount of talking can divert some 
oldsters from their preoccupation with their bowel 

old patients is constipation. 

The diarrheas of old people are troublesome. 
In some instances, they are associated with achlor- 
hydria and probably also with deficient intestinal 
absorptive capacity. Such difficulty may be re- 
lieved in part by parenteral administration of 
liver extract and use of vitamin concentrates. 
Orally administered antibiotics may be responsi- 
ble for setting the stage in many such patients. 
In others, no apparent explanation is. available 
and one has little to offer except purely sympto- 
matic measures. The nature of such diarrheas is 
obscure; much further study of the subject is 

Hepatic and Pancreatic Disease.—Cirrhosis of 
the liver does not frequently present itself as a 
clinical problem in the later years of life. This 
is probably due to the fact that the peak incidence 
of cirrhosis as a cause of death is past at age 60. 
Also, many types of cirrhosis are inconsistent 
with long life. Hemochromatosis and biliary cir- 
rhosis (often described as xanthomatous) usually 
have run their course long before the seventh 
decade. Somewhat the same statement may be 
made in regard to chronic hepatic atrophy, an 
especially lethal ailment in postmenopausal wom- 
en. What remains, therefore, is chiefly nutritional 
cirrhosis and the cause is, in most instances, al- 
cohol plus malnutrition. The incidence of the 
disease varies with the location and dietary habits 
of the community. 

As might be expected, the complications of cir- 
rhosis, chiefly hemorrhage from varices and epi- 
sodes of hepatic necrosis, are highly fatal in old’ 
persons. Some fortunate patients, however, ap- 
pear to achieve a balance between cellular destruc- 
tion and repair, with the result that the aged pa- 



tient may carry on successfully. I recall a num- 
ber of older patients with cirrhosis who presented 
every evidence of gross hepatic damage and yet 
survived for years in a reasonable state of health. 
One man to whom a fatal prognosis was given 
at the time of his admission to the hospital lived 
for 10 years, dying of arteriosclerosis. One should 
not despair of the older cirrhotic; he deserves as 
vigorous treatment as the younger patient and not 
infrequently will reward these efforts by a long 
and reasonably comfortable life. 

Viral hepatitis is no respecter of age. Epi- 
demiologic study appears to indicate that persons 
in middle life and beyond have a fairly solid im- 
munity to the naturally acquired disease but this 
conveys no immunity to the serum-borne type. 
Probably because of this fact and the likelihood 
that hepatitis in the aged may be due to virus 
SH, by far the more dangerous type, the prog- 
nosis in the old patient with hepatitis should be 
guarded. The state of the patient’s nutrition and 
the presence or absence of associated disease else- 
where in the body may be determining factors in 
the outcome. It is wise to study the old person 
with jaundice with great care, since the difficulty 
of diagnosis between obstructive and parenchym- 

atous jaundice apparently increases with age. 
The patient who has a definitely obstructed biliary 
tree cannot be explored too promptly, whereas 
the patient with primary hepatic cellular disease 
must be kept out of the operating room. 

Chronic relapsing pancreatitis appears to be 
relatively rare in older persons but it does occur 
often enough to keep one constantly reminded of 
its presence. Pancreatic edema associated with 
common-duct stone is, of course, frequently seen 
and is relieved when the offending calculus is re- 
moved. Two patients recently seen with episodes 
of hemorrhagic pancreatic necrosis were in the 
seventh and eighth decades of life. Both recovered 
after a long and stormy illness characterized by 
imbalance of electrolytes and azotemia. It is en- 
couraging to be able to tell these patients that 
only about half of those who have this syndrome 
will have a recurrence. Surgery in such patients 
is probably better avoided, but one must make 
an exception for the patient with a pancreatic 
cyst. The suspicion of cancer is ever present in 
this group of individuals but it appears well 
established that the more violent episodes of 
illness are most often associated with the benign 
form of pancreatic disease. 


Functional Complaints of the Aged.—These 
are legion even in persons who have an under- 
lying organic disorder. In these patients one 
has to pick up the trail of an organic disorder 
out of the maze of bizarre symptoms. One must 
beware of the alleged functional complaint in 
patients more than 45 years of age; this statement 
is doubly true for patients more than 60 years 
of age. One learns to be cautious in commitments 
made to these patients and to advise re-examina- 
tion if the character of the symptoms changes. 

There are, however, innumerable older persons 
who always have had digestive disturbances that 
simply grow in number and magnitude with the 
passing of years. Among these, certain types 
stand out, such as fhe bolters of food and the 
swallowers of air, who usually can be distinguished 
by their ability to belch at any time and as fre- 
quently as desired; another type is the confused 
oldster who has himself imagined or has been 
led to believe that he has food allergies or sensi- 
tivities and who as a result has restricted his 
diet severely. To convince these people of the 
error of their ways and to get them back on a 
full and proper diet require diplomatic skill of 
the highest order. A third group, and perhaps 
the commonest of all, are persons with so-called 
mucous colitis. It is a fortunate physician who 
does not have a group of these unfortunate pa- 
tients under his care. To the best of my knowl- 
edge there is no dietetic program nor any com- 
bination of drugs which will restore peristaltic 
activity to normal in the colons of these individ- 
uals. With persuasion and guidance, some of 
them improve, but more often they drift dis- 
consolately from one physician to the next, ob- 
taining little relief from any. 

Finally, some comment must be made about 
the organic psychoses of old age and their tend- 
ency to produce digestive symptoms. Minor 
cerebrovascular accidents, encephalomalacia of 
arteriosclerotic origin and even simple reactive de- 
pression may produce somatic digestive symp- 
toms of a most bizarre type. The depressive 
episode may pass and the digestive complaints 
disappear, but with organic cerebral damage, 
prognosis for recovery is not good. If any help 
is to be obtained for these older persons with 
functional digestive complaints, it is usually at 
the hands of the wise family physician who knows 

(Continued on Page 330) 


Management of Acute Abdominal 


T HE diagnosis and management of acute dis- 
eases of the abdomen continue to be among 
the most perplexing problems that confront the 
surgeon today. Regardless of the tremendous 
strides in modern medicine, considerable room 
for improvement exists in this field. It must 
be remembered that the first successful closure 
of a perforated peptic ulcer was done less than 
50 years ago and that removal of a diseased ap- 
pendix has been a practical surgical procedure 

only for about the same time. Laparotomy for 

intestinal obstruction was regarded until com- 
paratively recently as a procedure of last resort. 

Needless to say, the most important and also 
one of the most difficult problems is that of ar- 
riving at the correct diagnosis. While it is not 
within the scope of this paper to discuss the 
taking of a history and the performance of the 
physical examination, it should be emphasized that 
extreme care is needed at this crucial stage. 
Among the several diseases that simulate an 
acute surgical condition of the abdomen are 
cardiac derangements, chronic interstitial nephrit- 
is, pneumonia, porphyria, hydronephrosis, typhoid 
fever, tuberculous peritonitis and tabes dorsalis. 
The latter three diseases are not seen nearly so 
often as formerly. For some time it has been 
the policy of my surgical colleagues and me to 
require as routine on all candidates for emergency 
surgical treatment a certain minimum of labora- 
tory studies, including a complete blood count, 
urinalysis, thoracic roentgenogram, a scout (pre- 
liminary survey) film of the abdomen when in- 
dicated, and determination of the blood group 
and Rh factor. Other studies may be done de- 
pending on the particular problem at hand; these 
include such things as roentgenograms of the 
abdomen with the patient upright or in the lateral 


Read at the meeting of the Minnesota Academy of 
eral Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Surgery, Mayo Clinic and Mayo 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the University of Minnesota. 

May, 1955 

Rochester, Minnesota 

decubitus position to determine the presence of 
free air, and chemical determination of values for 
serum amylase and lipase. Such studies are of 
considerable value when used in the proper situ- 
ation, but they should not be ordered indiscrimi- 
nately as they are time-consuming and expensive. 

Stomach and Duodenum 

Acute hemorrhagic peptic ulceration, either gas- 
tric or duodenal, is a most formidable problem. 
Constant observation of the pulse, blood pressure 
and value for hemoglobin is necessary in addition 
to the usual administration of blood and other 
supportive fluids. Massive bleeding must be 
brought under control without delay. The patient 
who has such hemorrhage presents a considerably 
different problem than does the usual type of 
bleeder. The mere induction of anesthesia may 
prove fatal as a result of aspiration of large 
quantities of regurgitated blood. During the past 
two years my surgical colleagues and I have worked 
in close co-operation with the anesthesiologists 
and have established a routine method of man- 
agement in these difficult situations. Since its 
inception, the surgical mortality rate has been 
greatly reduced. 

Our present method of surgical management of 
bleeding peptic ulcer is as follows: two 15-gauge 
needles are inserted into the veins even if it is 
necessary to cut down on the veins to accom- 
plish this. It is thought that complete and ade- 
quate control of two veins is of utmost importance 
in the maintenance of an adequate circulating 
blood volume. The systolic blood pressure should 
be maintained at more than 80 millimeters of 
mercury in order to be well above the minimal 
pressure for renal filtration and thereby fore- 
stall development of lower nephron nephrosis. 
The abdomen is opened after local infiltration 
with procaine has been accomplished. The stom- 
ach will be greatly distended and filled with blood 
and clots; therefore, the stomach is opened and 
evacuated immediately so that the patient can- 



not regurgitate large quantities of blood. The 
anesthesiologist then puts the patient to sleep and 
inserts an intratracheal cuffed tube. Thus, with 
complete control of both the circulatory system 
and the airway, the surgeon can proceed with the 
operation with relative ease and considerably less 
risk to the patient. 

The next problem is to bring the bleeding 
point under control by either suture or ligature ; 
once this is accomplished, the condition of the 
patient will become stabilized fairly well. Of 
course, blood is being replaced all the time, and 
after the bleeding has been stopped the surgeon 
can proceed with an adequate and satisfactory 
gastric resection of whatever type is preferred. 

Perforated peptic ulcers have had considerable 
attention recently due to the advocacy of con- 

servative methods of management by some work- 

ers. For the most part, my colleagues and | con- 

tinue to treat perforated ulcers surgically. At - 

present no attempt is made to close a perforated 
gastric ulcer, since it cannot be determined im- 
mediately whether such a lesion is an ulcer or 
a carcinoma. Therefore, these lesions should be 
resected whenever possible. 

Perforated duodenal ulcer presents a somewhat 
different problem. The diagnosis of an acute 
perforated duodenal ulcer is made from the cri- 
teria of previous ulcer history, sudden onset of 
acute abdominal distress, free air in the abdomen 
and an increased value for serum amylase. The 
serum amylase is increased usually to 500 or 
1,000 units in perforated duodenal ulcer; this 
finding is often important in differentiating this 
disease from acute pancreatitis, in which the 
value for serum amylase is considerably higher, 
often ranging from 3,000 to 4,000 units. As 
soon as the diagnosis of perforated peptic ulcer 
is made, the patient should be prepared for oper- 
ation unless very definite localizing signs are de- 

Such preparation consists of immediate gastric 
intubation to rid the stomach of its contents and 
prevent further leakage into the abdomen. In 
addition to this, the patient receives parenterally 
large doses of atropine or methantheline bromide 
(banthine) to further inhibit gastric secretion and 
also to inhibit pancreatic secretion. The patient 
should receive large doses of antibiotics, with 
morphine or some similar narcotic to allay ,the 
pain ; intravenous administration of fluid or blood 
tranfusions are given as necessary to treat shock 


or to restore proper hydration. The perforation 
is then promptly closed, 

Many times the abdominal cavity will be great- 
ly soiled with contents from the stomach and 
duodenum, and severe chemical peritonitis will 
be present as a result of the gastric acid, bile 
and pancreatic juice liberated into the peritoneal 
cavity. Under such conditions, the peritoneal 
cavity should be lavaged profusely with large 
quantities of saline to remove such material and 
reduce the extent of chemical peritonitis. A 
mixture of penicillin and dihydrostreptomycin is 
left in the abdomen to combat the growth of any 
bacteria that might have been introduced into 
the cavity. As the result of use of this method, 
there have been no deaths at the Mayo Clinic 
in the last two years from perforated peptic ulcer. 

In addition to this regimen, more perforated 
duodenal ulcers are now being resected than 
closure of a perforated duodenal ulcer will return 
later because of reperforation, obstruction or 
hemorrhage. If primary resection will spare the 
patient a second major surgical procedure, the 
surgeon probably is obligated to do this when- 
ever possible. However, primary resection should 

Many patients who have had _ simple 

not be used indiscriminately, and candidates for 
the procedure should be picked with great care. 

A number of factors enter into the selection 
of patients for primary resection of a perforated 
duodenal ulcer. The age of the patient should 
come into consideration, but no hard and _ fast 
rule can be set; a 65-year-old patient may be in 
unusually good condition for his age. The gen- 
eral condition of the patient is important; the 
physician must use his clinical judgment in eval- 
uating the condition of each patient. The amount 
of soilage in the abdomen should be considered. 
If the patient is having a great amount of shock 
resulting from severe chemical peritonitis, the 
surgeon should not add to that shock by attempt- 
ing a long procedure, such as gastric resection. 
The duration of the perforation is also to be 
considered. If the perforation has been present 
for some time, much contamination has occurred 
and the patient’s condition may not be good; un- 
der such conditions, mere closure of the ulcer 
should be done. The condition of the duodenum 
is of prime importance. This will determine 
whether or not adequate closure of the duodenal 
stump can be done. If the tissues are in poor 
condition, friable, or edematous, if much fore- 




in is 
1 or 
» the 
_ the 
s for 
be in 
- the 
o be 
> un- 



shortening is present, or if the perforation is 
extremely large and occupies a major portion 
of the wall of the anterior surface of the duo- 
denum, then it is not wise to attempt resection and 
run the risk of a draining duodenal stump in 
addition to the many other associated problems. 


Difference of opinion continues as to when oper- 
ation should be performed in acute disease of the 
gallbladder. Patients with this disease must be 
carefully individualized. Emergency surgical in- 
tervention does not have to be considered for 
patients who are merely having minor attacks. 
Patients having attacks severe enough to necessi- 
tate admission to a hospital or repeated injection 
of narcotics for relief of pain present a consid- 
erably different problem. Such patients may be 
evaluated on the basis of several factors, among 
the most important of which are (1) the duration 
of the present attack, (2) the severity of the 
present attack, (3) the number of previous at- 
tacks and (4) the association of pancreatitis. 

If the duration of the present attack has been 
as short as twenty-four hours or so, it is advis- 
able to observe the patient for a while longer, per- 
haps an additional twelve to twenty-four hours. 
This allows time to show improvement, and 
in the meantime proper medical-management can 
be instituted. At the end of this period if the 
pain and other symptoms are less and the tem- 
perature is on the decline, then the program 
should be continued. If, however, the condition 
of the patient has not improved or has become 
worse, then surgical intervention is indicated. At 
the end of this period, the attack has not been of 
sufficient duration for the surgical procedure to 
be technically difficult because of inflammatory 
reaction. On the other hand, if the attack has 
lasted five or six days, the affected tissue by this 
time has become so brawny and ligneous that 
cholecystectomy is extremely hazardous and dif- 
ficult and should not be attempted if it can pos- 
sibly be avoided. Thus a duration of five or six 
days is the upper margin of safety beyond which 
operation is not recommended until after the at- 
tack has subsided. 

The number of previous attacks may play an 
important’ role in determining the best form of 
treatment for a particular patient. If the patient 
is seen in a severe attack and has not had pre- 
vious gallbladder disease, that patient should be 

May, 1955 

operated on immediately. It is largeiy among 
this group that free perforation of the gallbladder 
is found, associated with bile peritonitis. This 
is due primarily to the fact that the adjacent 
abdominal structures have not yet had an oppor- 
tunity through repeated minor attacks and re- 
sultant inflammation to wall off the area around 
the gallbladder and thus prevent so-called free 
perforation. Approximately 4 per cent of all 
acutely inflamed gallbladders will perforate. 

In the event of associated pancreatitis, which 
is evidenced by pain penetrating through to the 
back and by an increase of serum amylase, sur- 
gical intervention should be postponed if at all 
possible. This is especially true since these pa- 
tients may have a stone in the common bile duct, 
which would necessitate exploration of the duct. 
This is technically difficult in the presence of 
severe inflammation; therefore, operation should 
be delayed if at all possible until after the attack 
has subsided sufficiently to allow the inflammation 
to subside, which usually takes two or three 
weeks after onset of the disease. 


Acute pancreatitis continues to be a most diffi- 
cult and often lethal problem. A rigid abdomen, 
a shocklike picture and greatly increased values 
for serum amylase and lipase, in the absence of 
free air in the abdomen, lead to the diagnosis of 
acute pancreatitis. In the past, several procedures 
have been offered for use in surgical manage- 
ment of this disease. Among these are drainage 
of the common bile duct, drainage of the region 
around the pancreas and splitting of the capsule of 
the pancreas. These methods have not proved 
to be of sufficient value to recommend their rou- 
tine use. Instead, a properly managed conserva- 
tive regimen appears to offer considerably more 
than does surgical intervention in this disease 
and does not add to the already existing shock 
of the patient. ; 

As soon as the diagnosis of pancreatitis is 
made, all efforts should be directed toward the 
suppression of pancreatic function, general sup- 
port of the patient and the relief of pain. The 
patient should receive nothing by mouth and con- 
tinuous gastric suction should be instituted. This 
removes the gastric acid as a source of pancreatic 
stimulation. Use of morphine and codeine should 
be avoided as these drugs frequently may cause 
spasm of the sphincter of Oddi, thus hindering 



pancreatic drainage. Other drugs for the relief 
of pain should be used, however, in sufficient 
doses to give adequate relief. Large doses of 
atropine or banthine given parenterally should be 
used to suppress gastric as well as pancreatic 
function. Massive doses of broad-spectrum anti- 
biotics should be given, as sterile abscesses fre- 
quently form from necrosis of tissue and pan- 
creatic digestion and these may be secondarily 
infected by bacterial invaders. Adequate amounts 
of fluid and blood should be given parenterally as 
indicated. This program has proved to be satis- 
factory and has greatly reduced mortality rates 
in the management of this disease. 

Small Intestine 

Emergency problems of the small intestine may 
be divided into three main groups, namely (1) 
those related to Meckel’s diverticulum, (2) those 
resulting from mesenteric vascular occlusion as 
the result of either thrombosis or embolism and 
(3) obstruction from such conditions as adhe- 
sions, congenital bands, volvulus, tumors (either 
benign or malignant, such as polyps, lipomas, 
myomas, adenocarcinomas and carcinoids), and 
foreign bodies, such as ingested articles and gall- 

Meckel’s diverticulum may give symptoms from 
bleeding, obstruction or perforation. The diag- 
nosis usually is made by exclusion, as there are 
no good pathognomonic signs to indicate the 

Mesenteric thrombosis may be acute or insidi- 
ous in onset depending on the causative situation. 
The existence of ventricular fibrillation often 
may give a clue but this is not necessarily a 
prerequisite for mesenteric vascular occlusion. 
Venous thrombosis may be a more frequent cause 
of mesenteric vascular occlusion than is arterial 
embolism ; the former may occur on the basis of 
cardiac failure with resultant decompensation and 
diminished venous return. The affected tissue 
must be resected; otherwise the outlook is ex- 
tremely poor. 

The diagnosis of intestinal obstruction may be 
made on the following criteria: intermittent 
crampy pain, borborygmi at the height of the 
pain, nausea, vomiting, interference with bowel 
movements, abdominal distention, localized ab- 
dominal tenderness and roentgenologic evidence. 
Certain factors contribute to a late diagnosis in 
acute intestinal obstruction. These include failure 


to recognize intestinal colic, failure to auscultate 
the abdomen, frequent lack of local findings, con- 
fidence in enemas, apparent effect of laxatives 
and premature use of morphine. 

Whenever possible it is always well initially 
to try conservative methods in the management of 
simple intestinal obstruction. Such methods in- 
clude giving nothing by mouth, intestinal in- 
tubation, parenteral administration of fluids, hot 
abdominal stupes, inhalation of oxygen, blood 
transfusion when necessary, warm gentle rectal 
irrigation and close observation, including blood 
chemical determinations and roentgenograms of 
the abdomen. 

Obstruction of the small intestine presents 
many varied problems. Adhesions and congenital 
bands are the cause in the great majority of 
cases. In the case of adhesions, medical decom- 
pression by means of a Miller-Abbott tube or 
some other type of long intubation tube, if 
possible, is preferable to surgical procedures be- 
cause the latter only produce more adhesions. 

Volvulus of the small intestine presents an ex- 
tremely serious problem. Often an indication to 
the correct diagnosis may be noted on a scout 
film of the abdomen. A characteristic roentgeno- 
logic picture is the so-called almond-shaped de- 
formity, which is pathognomonic of a closed- 
loop obstruction of the small intestine, or so- 
called volvulus. Once this picture is seen, the 
patient should be operated on immediately ; other- 
wise gangrene of the intestinal loop will develop, 
necessitating a much more extensive procedure, 
with resection of a segment of the small intes- 

Tumors that produce obstruction must be re- 
moved surgically. It is best, however, to decom- 
press the intestine as much as possible before- 
hand, as this will make the operative procedure 
considerably easier for both the surgeon and 
patient. Resection of the small intestine may be 
unusually dangerous, especially when one is 
forced to attempt anastomosis in a distended 
edematous friable segment. In order to put the 
tube into the small intestine as far down and as 
rapidly as possible, it is often necessary to push 
the tube into the small intestine through the 
pylorus with the aid of fluoroscopic examination. 
Tubal decompression may greatly improve the 
integrity of the tissues with which the surgeon 
is forced to work. 

Foreign bodies occasionally may cause intestinal 



obstruction; many of them can be noted on a 
scout film of the abdomen. Ileus produced by a 
gallstone, however, is an extremely difficult prob- 
lem to diagnose preoperatively at times, yet to 
the careful observer the diagnosis frequently may 
be made from the scout film. The stone itself 
seldom may be seen; however, the presence of 
free air in the biliary tree is pathognomonic of 
gallstone ileus. This finding means that the patient 
should be operated on immediately, because it is 
indicative of air that has escaped into the biliary 
tree through the fistula between the gallbladder 
or the common bile duct and the small intestine. 
The stone usually will lodge in the distal 5 or 6 
cm. of the ileum, with a marked amount of inflam- 
matory reaction around it and a considerable 
degree of distention above it. When the stone is 
found it should be milked proximad away from 
the inflamed and edematous intestine up to a nor- 
mal segment, where a small incision can be made 
through the wall of the intestine, the stone re- 
moved and the incision closed with minimal diffi- 
culty. One per cent of all obstructions of the 
small intestine are due to gallstones. 

Large Intestine 

Acute emergencies involving the large intestine 
may be generally divided into three main groups, 
namely (1) those resulting from appendicitis, (2) 
those resulting from diverticulitis and (3) those 
resulting from obstruction from other causes. 
Appendicitis will not be considered in this pres- 
entation because relatively little recent change has 
occurred in the management of this disease. 

Diverticulitis is primarily a disease of middle 
and old age. Five to 10 per cent of persons more 
than forty years of age have but do not suffer 
from diverticulosis. Of these persons, one in 300 
experiences diverticulitis. Diverticulosis is twice 
as common among males as among females but 
diverticulitis has an equal sex incidence. Divertic- 
ulitis is located in the sigmoid in 75 per cent 
of cases. Emergency surgical procedures for this 
condition are indicated only in the presence of 
free perforation or obstruction. A transverse 

loop colostomy to divert the fecal stream is usually 
all that should be done initially, and more defini- 
tive surgical treatment should be planned for a 
later date. Rarely the affected region may be 
exteriorized. Primary resection of the perforated 
obstructed segment is difficult because of the 
severe inflammatory reaction and seldom can be 
accomplished. Other conditions of the colon that 
necessitate emergency surgical procedures are 
volvulus and closed-loop obstruction. 

Carcinoma of the sigmoid and rectosigmoid ap- 
pears to be the commonest cause of closed-loop 
obstruction in the presence of a competent ileo- 
cecal valve. A closed-loop obstruction may be 
readily recognized on a scout film of the abdomen 
by the severe distention of the colon, with appar- 
ent absence of gas in the small intestine. These 
patients should be followed with extreme care 
since perforation of the cecum may be imminent. 
Impending cecal perforation may be diagnosed by 
the following criteria: progressive cecal enlarge- 
ment as evidenced by roentgenologic studies, pain 
and tenderness over the cecal region, rebound 
tenderness over the cecal region and an increase in 
pulse rate. Many times in the presence of closed- 
loop obstruction, the first symptom may be pain 
in the right lower quadrant, which will draw 
attention away from a lesion in the sigmoid or 
rectosigmoid and may cause it to be overlooked. 
The reason for such pain with an obstructing 
lesion in the sigmoid or rectosigmoid is that the 
cecum is the thinnest and most easily distensible 
part of the intestine, which is why it also is the 
commonest point of perforation. 

When the afore-mentioned findings are noted, 
immediate surgical decompression is compulsory. 
In our experience the procedure of choice in this 
instance is transverse loop colostomy. Some sur- 
geons favor use of appendicostomy or cecostomy. 
It has been our experience that an appreciable 
number of the stomas established by these latter 
procedures do not function in a satisfactory man- 
ner and failure to function at this crucial time 
may prove fatal. 

Thousands of people are abroad in the country with 
tuberculosis which is arrested or inactive following 
treatment. Antibiotics have played a large part; and we 
hope these people will remain well for many years, but 
how many will relapse,-we do not know. How many may 
at some time produce tubercle bacilli, which may be 
a danger to the community, we do not know. Will the 

May, 1955 

antibiotics lose their effectiveness as the number of re- 
sistant cases increases in the community? Again, we do 
not know. It is such uncertainties that lead the pessi- 
mists to say that tuberculosis, like the poor, will be al- 
ways with us.——Georce J. WuHerrett, M.D., National 
Tuberculosis Association Transactions, 1954. 



ODERN physicians are fully aware of the 

potential seriousness of hematuria and ad- 
vise patients who have such a condition to under- 
go prompt and thorough examination. The trag- 
edies that occur from delayed diagnosis of ma- 
lignant lesions of the genitourinary tract often 
can be ascribed to the patient, who either does 
not seek advice immediately after hematuria ap- 
pears or ignores the counsel of his physician. The 
public must be educated to the seriousness of 
hematuria. : 

Hematuria always demands a qualifying ad- 
jective, namely either gross or microscopic. Gross 
hematuria always means an abnormal or patho- 
logic situation. On the other hand, the finding of 
microscopic hematuria’ always brings up the un- 
answered question with.regard to whether or not 
a few erythrocytes may be present in the urine 
of normal persons. The bulk of evidence accu- 
mulated over the years would .indicate that, with 
ordinary techniques of urinalysis, the presence 
of more than two erythrocytes per high-power 
microscopic field in a centrifuged specimen is 
abnormal. Of course, many variables enter into 
this conclusion, such as the accuracy of the tech- 
nician, the speed of the centrifuge and the spe- 
cific gravity of the urine. Dilute urine contains 
fewer erythrocytes than does an equal volume 
of concentrated urine. 

Sites of Origin of Hematuria 

There are three main possible sites of origin 
of hematuria, namely lesions occurring as part 
of a systemic disease, lesions in organs adjacent 
to the genitourinary tract and lesions in the geni- 
tourinary tract itself. Among the systemic dis- 
eases that may cause erythrocytes to appear in 
the urine are (1) acute or chronic nephritis; (2) 
diseases of the blood-forming organs, such as 

_ Read at the meeting of the Minnesota Academy of 
General Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Urology, Mayo Clinic and Mayo 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the University of Minnesota. 



Rochester, Minnesota 

thrombocytopenic purpura, leukemia, Hodgkin’s 
disease, hemophilia and polycythemia vera; (3) 
cardiac disease, as in congestive cardiac failure 
or renal infarction resulting from rheumatic car- 
ditis and auricular fibrillation; (4) acute exan- 
thematous diseases and (5) deficiency diseases, 
such as deficiency of ascorbic acid or vitamin K. 
Drugs and chemicals, such as methenamine, car- 
bolic acid, turpentine and sulfonamides, may pro- 
duce hematuria, as may administration of anti- 
coagulants, such as dicumarol or heparin. 

Lesions in organs adjacent to the urinary tract 
can be disposed of briefly by simply stating that 
the possibilities are unlimited. Among such le- 
sions that may produce hematuria by irritation 
or invasion of the genitourinary tract are ap- 
pendicitis, salpingitis, diverticulitis and carcinoma 
of the colon. 

The remainder of this presentation will be 
devoted to a consideration of lesions of the geni- 
tourinary tract itself. 

Microscopic Versus Gross Hematuria 

The presence of asymptomatic microscopic he- 
maturia is perhaps more troublesome to the phy- 
sician than is gross hematuria because it is en- 
countered more frequently and is associated with 
a much smaller incidence of serious disease; yet 
the physician does not dare neglect such a finding. 
Significant lesions will be found in approximately 
5 per cent of such cases; thus the clinician would 
like the urologist to furnish a rapid and simple 
screening procedure that would eliminate the 95 
per cent of cases in which such minimal hema- 
turia is insignificant. To date such a procedure 
is not available and it is necessary to subject 100 
patients to such procedures as excretory urog- 
raphy, cystoscopy and retrograde pyelography to 
discover the five or six who have significant 
lesions. In some of the cases in which no lesions 
are discovered to explain the hematuria, the con- 
dition simply may be normal erythrocyturia. In 
some cases hematuria may originate from trauma 
as a result of digital rectal or pelvic examination 



- Car- 
n K, 

h le- 
- ap- 

ll be 





In other cases, 

before the urine was obtained. 
subclinical nephritis or a small angioma of the 
kidney may be present. It is apparent that asymp- 
tomatic microscopic hematuria is a worrisome 
problem whose solution is not always satisfactory. 

Gross hematuria is a less troublesome problem, 
at least to the physician, simply because it is as- 
sociated with such a high incidence of significant 
and serious lesions that a complete urologic ex- 
amination is compulsory. 

The commonest cause of gross hematuria in a 
woman is inflammation, usually cystitis or pyel- 
onephritis. The commonest cause of gross hema- 
turia in a man is a tumor of the bladder, with 
hypertrophy of the prostate in second place. An 
important point to emphasize is that benign en- 
largement of the prostate causes hematuria much 
more frequently than does carcinoma of the 

General Clinical Aspects of Hematuria 

When the physician is confronted with a pa- 
tient who has gross hematuria he first considers 
the age of the patient. Hematuria is rare in in- 
fancy and childhood; usually it is the result of 
infection in such instances. Such infections usual- 
ly are produced by stasis, which usually is caused 
by congenital obstruction. The latter is ordinarily 
at one of three chief points, namely the ure- 
teropelvic juncture, the vesical neck or, in the 
male, the urethral meatus. Tumors of the geni- 
tourinary tract in infancy are rare and are chiefly 
Wilms’ tumors and sarcomas. Such lesions rare- 
ly cause hematuria; they are diagnosed because 
they present themselves as abdominal masses. 

With regard to gross hematuria in adults up 
to 40 years of age, the common causes include in- 
fection, cystitis, pyelonephritis, tuberculosis and 
calculi. Tumors are relatively uncommon in this 
age group. However, in patients more than 40 
years of age, the incidence of neoplasms and 
prostatic lesions, both benign and malignant, be- 
comes increasingly common. 

The type of hematuria may give some clue as 
to its origin. Initial and terminal hematuria usu- 
ally is conSidered to indicate a lesion in the neck 
of the bladder or the prostatic portion of the 
urethra. If it is present in the same degree 
throughout urination and if the blood is dark, 
the lesion is thought to be in the upper part of 
the urinary tract, whereas if the blood is fresh 
and bright, it supposedly comes from the bladder. 

May, 1955 

However, it is not wise to place too much reli- 
ance on this finding. Blood that emerges directly 
from the urethra and soils the clothes of either 
a man or a woman originates distad to the ex- 
ternal sphincter. It is well to be cautious about 
a story of bleeding in a woman. The physician 
must take a careful history and be extremely pa- 
tient with a woman in order to ascertain whether 
she is talking about vaginal bleeding, about ure- 
thral bleeding or about cystitis; this is because of 
embarrassment and because many women do not 
understand the terms used. Sometimes a com- 
plete urologic and gynecologic examination is re- 
quired to uncover the true situation. 

The general physical examination may not be 
too productive in the diagnosis of hematuria but 
it should not be overlooked. Palpable renal en- 
largement may indicate neoplasm, hydronephrosis 
or a cyst of the kidney. Tenderness in the flank 
may indicate a stone, infection or hydronephrosis. 
Enlargement of a supraclavicular lymph node 
may herald hypernephroma. Acute left varicocele 
in a man past 40 years of age often means a 
left hypernephroma with invasion of the left 
renal vein, because the spermatic vein empties 
into the left renal vein. Digital rectal examination, 
which is so important, can aid in the diagnosis of 
carcinoma of the prostate, benign hypertrophy 
of the prostate or prostatic calculi. Vaginal ex- 
amination may reveal infiltration at the base of 
the bladder from a tumor. 

Excretory Urography 

Emphasis should be placed on the value of 
excretory urography, including the plain roent- 
genogram of the kidney-ureter-bladder region 
that accompanies this procedure. This examina- 
tion is of great importance in the diagnosis of 
urologic lesions because it is one of the greatest 
tests of renal function, indicating the compara- 
tive function of the two kidneys. The other 
factor of importance with regard to excretory 
urography is that it focuses attention on the part 
of the urinary tract that is involved, which is 
of great aid in cystoscopy. 

Excretory urography can be of assistance in 
the localization of urinary obstruction, demon- 
strating whether such obstruction may be at the 
ureteropelvic junction or lower in the. urinary 
tract. It can accurately localize calculi in the kid- 
neys, pelves or ureters. It may demonstrate fil- 
ling defects at the base of the bladder as the re- 


sult of prostatic hypertrophy. Other filling de- 
fects may indicate infiltrating tumors of the blad- 
der. Pedunculated tumors of the bladder may 
be outlined by the way in which the opaque me- 
dium surrounds them. Hypernephromas may be 
indicated by characteristic distortion of calyces. 
Tumors of the renal pelvis may produce typical 
filling defects. 


It is usually necessary to perform cystoscopy 
to complete a urologic diagnosis because it is 
easier and more accurate to study lesions in the 
bladder under direct vision than to rely on 
urography entirely. Also, it is often necessary 
to do retrograde pyelography to supplement ex- 
cretory urography. It is of importance to examine 
the patient urologically while bleeding is still 
present. So often a patient bleeds grossly for 
2 or 3 days and by the time he gets ready for 
urologic examination the bleeding has stopped, 
making it difficult to determine the source of the 

Another element of importance in cystoscopy 


is to examine the ureteral orifices and watch the 
urine as it spurts from them. That is the only 
way to determine whether or not blood is coming 
from a kidney. Examination of a specimen of 
ureteral urine taken from a ureteral catheter will 
not necessarily indicate whether or not blood is 
coming from the kidney in question because the 
trauma caused by passage of a ureteral catheter 
in most cases will cause either microscopic or 
gross hematuria. However, the appearance of 
bloody urine flowing out from a ureter that has 
not been catheterized will localize the kidney that 
is bleeding. 

In conclusion I wish to emphasize that the 
Bladder Tumor Registry indicates that 50 per 
cent of tumors of the bladder are not diagnosed 
within one year after the first attack of hematuria. 
This is a tragic situation; it means that all phy- 
sicians must be on the alert in their practice and 
community to educate patients and the public to 
the seriousness of hematuria and the advisability 
of seeking medical advice immediately when it 

(Continued from Page 308) 

such treatment is indicated. Until better thera- 
peutic measures are developed, cortisone and re- 
lated hormones will continue to be important and 
valuable agents in the management of such 


Since this paper was prepared, another potent 
antirheumatic steroid, namely metacortandracin, 
or 1-dehydrocortisone, has been synthesized. Al- 
though this steroid has less tendency than does 
cortisone to cause retention of sodium, chloride 
and water, and to produce excretion of potassium, 
it does cause many other cortisonelike metabolic 
effects. The dose of 1-dehydrocortisone (meta- 
cortandracin) necessary to produce an equivalent 
antirheumatic effect appears to be only a third 
or a fourth that of cortisone, perhaps even less 
in some cases. The use of this steroid should 
be attended by the precautions indicated during 
treatment with cortisone; however, restriction of 
intake of sodium and supplementation of potas- 
sium usually have not been required, at least not 
in rheumatoid ‘patients treated for periods up 


to several months with doses of 5 to 20 mg. per 

1. Boland, E. W.: Hydrocortisone (Kendall’s Com- 
pound F): Experiences with the free and acetated 
forms in rheumatoid arthritis. J. Am. Pharm. A. 
(Pract. Pharm. Ed.), 13:540-544 (Aug.) 1952. 

2. Hench, P. S., and Ward, L. E.: Rheumatoid 
arthritis and other rheumatic or articular diseases. 
In Lukens, F. D. W.: Medical Uses of Cortisone: 
Including Hydrocortisone and Corticotropin. p. 208. 
New York: The Blakiston Company, Inc., 1954. 

3. Salassa, R. M., Bennett, W. A., Keating, F. R., 
Jr., and Sprague, R. G.: Postoperative adrenal cor- 
tical insufficiency : Occurrence in patients previously 
treated with cortisone. J.A.M.A., 152:1509-1515 
(Aug. 15) 1953. 

4. Slocumb, C. H.: Relative cortisone deficiency simu- 
lating exacerbation of arthritis. Bull. Rheumat. Dis., 
3:21-22 (Oct.) 1952. 

5. Slocumb, C. H.: Rheumatic complaints during 
chronic hypercortisonism and syndromes during 
withdrawal of cortisone in rheumatic patients. 
Proc. Staff Meet., Mayo Clin., 28:655-657 (Nov. 
18) 1953. 

6. Slocumb, C. H., and —_, z. S.: The use and 

abuse of cortisone in ry. S. Clin. North 

America, PP. 1105-1107 thers 1952. 

Ward, L. Polley, H. F., Slocumb, C. H., and 

Hench, ty S.: Cortisone in treatment of theu- 

oe arthritis. J.A.M.A., 152:119-126 (May 9) 



d is 
- the 
: of 


c to 
1 it 










of the Vaginal Examination 

M°! of us learn best by doing, and so it is 
fortunate indeed that the technique of the 
pelvic examination can be attained more by doing 
than by reading or hearing about it. What I have 
to say, therefore, is directed chiefly toward actual 
performance of this examination, with some at- 
tention to interpretation of what the examiner 

The conditions to which the physician’s atten- 
tion is called most often by women include inflam- 
matory and infectious disease, new growths, 
sequelae of labor and endocrine dysfunctions 
which produce aberrations of menstrual function. 
Often the patient will seek your counsel because 
of abnormal vaginal secretions, genital bleeding or 
pelvic pain. Less often, she may come to you 
because of protruding masses or generalized pelvic 
or abdominal discomfort. Still others may visit 
your office because the persistent “cancer drives” 
have made them apprehensive, and they wish to 
reassure themselves by such routine measures of 
investigation as you are able to provide. What- 
ever the cause, it is certainly true that the number 
of such patients in the office of the gynecologist 
is increasing. The net result is to place greater 
responsibility on the physician, for if mass edu- 
cation sends more patients to him, he will be 
expected more and more often to detect malig- 
nant.processes in earlier stages, where treatment 
can be swift and effective, and lives can be saved. 

The Physical Examination 
A general physical examination should follow 
the history and should, whenever it is possible, 
precede the pelvic examination. 

What to Look For.—in the general examina- 
tion of the patient much can be learned: her 

Read at the meeting of the Minnesota Academy of 
General Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Obstetrics and Gynecology, Mayo 
Clinic and Mayo Foundation. 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the University of Minnesota. 

May, 1955 

The Technique and Interpretation 

Rochester, Minnesota 

habitus, whether masculine or feminine, robust or 
frail, hirsute or balding—all may be noted with 
a glance. The temperature, pulse rate and blood 
pressure should be recorded. The breasts should be 
examined, for they are secondary sex characters 
and as such they share in many changes and 
physiologic conditions within the pelvis. In the 
abdominal examination the physician should note 
the presence or absence of striae indicative of 
rapid loss of weight, and evidence of past preg- 
nancies or endocrine dysfunctions. Tender areas 
should be carefully palpated, and distinction 
should be made between rigidity and normal 
muscular defense reaction. ‘ 

Much can be learned from an adequate abdom- 
inal examination, and although it is neglected 
by many, it may actually bring to the fore the 
primary difficulty at hand, especially if the patient 
is acutely ill or apprehensive. In passing, let us 
remember that a full bladder at times has de- 
ceived the shrewdest of examiners. For this rea- 
son, some gynecologists have suggested that the 
patient void immediately before examination to 
forestall such a diagnostic pitfall. 

The Pelvic Examination 

Whatever is learned after the history and the 
physical examination must be gained tactually, 
and must be correlated with information gained 
from those two procedures. The only way I know 
of to develop the tactile sense is to do enough 
pelvic examinations to acquire the faculty of 
instant recognition not only of the normal ana- 
tomic relationships but also the minor aberrations 
which are the hallmarks of pelvic disease. One 
should become familiar with the nodular tender 
areas involving the uterosacral ligaments and 
posterior uterine surface so characteristic of endo- 
metriosis; also the thickened, tender and bulbous 
swelling of the tubes portraying the aftermath of 
pelvic inflammatory disease. 


Equipment.—All the necessary equipment for 
the proper performance of a pelvic examination 
should be at hand before the examination is 
begun. This would include drapes, hand protec- 
tion, lubricants, light, material for taking smears, 
and a table which will offer the examiner every 

Since the speculum is an indispensable instru- 
ment to the gynecologist, a word should be said 
regarding the various types available. For most 
purposes, the bivalve speculum is perfectly satis- 
factory. It is made in several sizes, and the 
examiner selects that size which can be introduced 
easily and does not cause discomfort to the 
patient. In children, the most satisfactory specu- 
lum is the tubular cystoscope, which is used 
with the patient in the knee-chest position. The 
tubular speculum likewise is available in a variety 
of sizes. For some patients the flat Sims speculum 
may be used to advantage. The physician should 
become familiar with the various speculums and 
their sizes to facilitate and insure maximal com- 
fort to the patient. 

Rapprochement With the Patient.—Establish- 
ing the patient’s confidence is the greatest single 
factor in promoting ease of examination. Uncon- 
sidered remarks or chance actions which engender 
fear, resentment or anxiety may result in a tense, 
disturbed or apprehensive patient. Such a patient 
is rigid and ill at ease, and in a state that may 
make a pelvic examination impossible or seriously 
unproductive. In creating confidence, gentleness 
is the first essential. Relaxation may be encour- 
aged by asking the patient to breathe through her 
mouth. Constant reassurance is helpful. No vio- 
lation of modesty should enter the pelvic examina- 
tion, but exposure should be consistent with 
thoroughness. The presence of a nurse or an 
assistant may aid in this respect, although it is not 
entirely necessary. Most of all, the physician 
should maintain an attitude of kindly and imper- 
sonal thoroughness. A pelvic examination is not 
a pleasant experience for any woman, and the 
success with which it is conducted will depend as 
much on the attitude of the physician and his 
assistant as upon the actual situation in the pelvic 

What to Look For.—Inspection of the external 
genitalia is done with the patient in the lithotomy 
position, with the physician standing between the 



patient’s knees. The vulva is inspected for dermal 
lesions, excessive secretions and tumor masses. 
Since vulvar neoplasms frequently metastasize 
to the inguinal glands, these glands should be 
palpated for tenderness or enlargement. Small, 
shotty inguinal glands are not unusual, especially 
in young women, and should cause no concern 
unless they are associated with definite lesions. 

After examination of the vulva, the labia should 
be gently parted, and the size, shape and dermal 
changes, if present, should be noted carefully. 
Inspection for kraurosis vulvae, lichen sclerosus 
et atrophicus and leukoplakia should be made. 
If it is suspected that one such condition is 
present, the counsel of a dermatologist is of 
inestimable help in identification. If a discharge 
is present, the examiner should determine whether 
it is bloody, serosanguineous, purulent or mucoid. 
Normally, Bartholin’s glands should not be pal- 
pable and Skene’s glands should not be tender. 
If the hymen is intact, examination of the pelvic 
organs may be completed rectoabdominally. Care- 
ful note should be made of the caliber of introitus. 
By pressure exerted downward against the peri- 
neal body, more space may be obtained with less 
discomfort to the patient. 

The condition of the pelvic floor is then deter- 
mined. To determine the presence or absence of 
rectocele is not difficult, but may be rendered 
easier by pressure exerted upward on the pos- 
terior vaginal wall, through the rectum. The 
size, shape, consistency and position of the cervix 
should then be determined by palpation. A normal 
cervix is said to have the consistency of the end 
of the nose, whereas a cervix invaded by a malig- 
nant process generally has a hard or gritty 

At this point, examination with the speculum 
is begun. It is well to recall at this point that the 
axis of the vagina is directed posteriorly, while 
the long axis of the introitus is anteroposterior. 
It is well, then, to introduce the speculum of the 
bivalve type with its long axis vertical, to conform 
to the shape of the vaginal orifice. This is pre- 
ceded by separating the vulva and pressure on the 
perineal body. When it is well past the entrance 
of the vagina, the speculum is turned so that the 
blades lie transversely, with the tip of the specu- 
lum pointed posteriorly toward the vaginal floor 
when the blades are opened. The common practice 
of using soap or lubricants is not advisable, since 
soap alters the chemical reaction of the vaginal 











secretions and interferes with staining and cul- 
tural reactions. Lubricants also frequently make 
interpretation of Papanicolaou smears for malig- 
nant cells more difficult or even impossible. 
Rather, it is better to wet the gloved hand and 
speculum with warm water, thereby decreasing the 
shock to the patient and offering adequate lubri- 

With the aid of a strong light, the cervix is now 
visualized directly. Size, position and length of 
the cervix, as well as the nature of its secretions, 
are noted. This is the moment at which an old 
adage becomes most significant: “Examine the 
cervix with a strong light and with a suspicious 
mind.” A smear for study by the Papanicolaou 
technique may be taken; secretion should be 
taken from both the internal os and the vaginal 
pool. Samples may be taken with the use of either 
a wooden spatula or a cotton applicator. The 

secretion is spread on a clean glass slide which is 
dropped immediately into a solution of 95 per 
cent alcohol. Because of the danger of explosion, 
ether should not be added to the solution of 
alcohol stored about the offices. 

Next, the cervix is inspected for evidence of 
cystic change, lacerations or erosions. A speci- 

men of tissue can be taken for biopsy, if biopsy 
is indicated. A specimen of any abnormality that 
is seen should be taken for biopsy before definitive 
therapy is offered. Such a specimen should be 
obtained in the presence of all cervical erosions, 
and care should be exercised to obtain adequate 
tissue from the squamocolumnar junction. This 
should always be done before cervical cautery is 
attempted. The application of Lugol’s solution 
will demarcate those areas most applicable for 

You will recall that normal cervical and vaginal 
epithelium contains glycogen, whereas abnormal 
epithelium, such as that found in erosions or a 
malignant lesion, contains little or none at all. 
Hence, by applying a weak solution of iodine 
(%4-strength tincture of iodine) to these areas, a 
marked differentiation may be seen rapidly; nor- 
mal tissue taking a deep mahogany brown, the 
pathologic’a pink. It is from the pink or light 
areas that specimens for biopsy should be taken. 
One must be cognizant of the fact that the Schiller 
or iodine test is not specific for any type of lesion, 
nor does it distinguish malignant from benign 
tissue. All it does is to demarcate the areas from 
which specimens of tissue for biopsy should be 

May, 1955 

taken. There is no special time in the menstrual 

“cycle when the specimen for biopsy should be 

taken; the important factor is to do it when the 
patient is seen. In this regard, the endocervix 
should not be neglected, because the introduction 
of a small sound or cotton applicator within the 
cervical canal (the so-called Clark test) will many 
times disclose a pathologic process which other- 
wise might have been missed. 

Many women present themselves with bleeding 
after subtotal hysterectomy. Under such circum- 
stances, a small endocervical curet may be used 
to obtain tissue for examination. If small endo- 
cervical polyps are the cause of the bleeding, this 
curettage may be therapeutic as well as diagnostic. 
It is always well to submit all such material to a 
competent pathologist for careful examination and 

It is also a wise practice to remove all polyps 
which may be found extruding from the cervix. 
Polyps can be removed easily by torsion; this 
should be followed by fulguration of the bases of 
the polyps. All polyps should be examined by a 
competent pathologist. Before the speculum is 
removed, the condition of the pelvic walls should 
be observed, with attention to the presence or 
absence of excoriations or new growths. 

The bimanual examination, which would better 
be known as the “vaginal-abdominal examina- 
tion,” can be done with either the left hand or the 
right within the vagina. From a practical stand- 
point, and especially in the case of those physi- 
cians who practice obstetrics, I believe it is useful 
to develop ambidexterity in the performance of 
this examination. With the examiner’s fingers 
resting against the pelvic floor, the cervix is 
palpated, while the examiner’s other hand is 
placed flat on the lower part of the patient’s abdo- 
men. By elevating the palm and using the tactile 
sense in the balls of the fingers rather than in the 
tips, the various organs are located, steadied and 
evaluated. The size, shape and consistency of each 
structure can be determined, and if tumors project 
into the superior strait, their outlines can be noted. 

After the cervix has been palpated, the presence 
or absence of pelvic pain on motion is determined. 
The position of the uterus is ascertained by locat- 
ing the body of the uterus. When the uterine 
fundus lies in its normal relationship, it is usually 
in an anteflexed position. Retrocession or retro- 
flexion occurs normally in a high percentage of 
women. The mobility of the uterus may be then 



thoroughly tested. Immobility or excessive pain 
on uterine motion may be indicative of chronic 
infection, acute exacerbation of chronic infection, 
adhesions or endometriosis. ‘When the median 
part of the pelvis has been palpated and the condi- 
tion of the uterus has been determined, the 
examining fingers are now slid into one of the 
fornices lateral to the uterus. The abdominal hand 
is directed in a like plane, and is moved slowly 
and deliberately. 

Next, the examiner’s fingers in the vagina are 
pushed out into the lateral fornix, while the hand 
resting on the abdomen is directed in a like plane. 
The ovary is then palpated between the tips of 
both fingers. A normal ovary is sensitive and 
mobile. Ovaries which are retrocessed within the 
pelvis are best examined later by rectoabdominal 
approach. The physician should become familiar 
with the normal size of an ovary and should keep 
in mind its tendency to enlarge after contralateral 
oophorectomy and hysterectomy. The normal 
ovary feels like an almond; it is about 4 cm. long 
and 2 to 3 cm. wide. Normally, it will move within 
a limited range. Occasionally, its mobility may 
become abnormal and it may be situated imme- 
diately lateral to the cervix, within the cul-de-sac, 
or high on the lateral pelvic wall. 

Normal fallopian tubes usually cannot be pal- 
pated through the vagina; however, if they are 
thickened or are the sites of chronic residual 
changes from infection, they may be sensed as 
masses of hornlike shape which occasionally are 
fluctuant, and many times are tender, firm and 

Occasionally, it is possible to palpate the ureters, 
lying as they do on the lateral pelvic wall. If 
pyelonephritis is present, the ureters may be 
thickened ; if tuberculosis is present, they may be 
nodular. Ureteral calculi occasionally can be pal- 
pated ; inflammatory conditions within the ureters 
may provide their own clues by making the ureters 
unusually tender. 

Rectal examination should be done for all 
patients who complain of difficulties referable to 
the pelvis, and it is especially indicated for young 
women with an intact hymen. When a pelvic 
malignant process is present, the rectoabdominal 
examination gives perhaps more information than 
any other. The necessity for an empty bowel is 


clear. Care should be taken not to exert too much 
pressure against the anterior wall of the bowel, 
for that structure may be extremely tender. 
Should any abnormalities be noted, proctoscopic 
examination is indicated. 

Lesions within the vagina and cervix occa- 
sionally may be seen best by examination with the 
patient in the knee-chest position. The vagina is 
easily distended with air, making the vaginal 
rugae disappear, and allowing the walls of the 
vagina to be seen clearly. Examination of chil- 
dren and young girls is best done with the patients 
in this position, and with the aid of a Kelly 

At times, it may be necessary to carry out 
pelvic examination with the patient anesthetized. 
This is indicated only after repeated pelvic exami- 
nations have been entirely unsuccessful, sometimes 
with several days intervening. We should be 
aware not only of the usefulness of this procedure, 
but also of its limitations. Naturally, examination 
of the pelvis with the patient under anesthesia 
has no value under conditions in which the co- 
operation of the patient is needed; for example, 
to locate areas of pain or minimal discomfort. 
In general, the more complete and accurate the 
pelvic examination is, the less frequently need 
one resort to anesthesia in gynecologic diagnosis. 

Laboratory Aids——A paper on the pelvic exam- 
ination of course is not complete without brief 
mention of some of the laboratory facilities which 
aid in the diagnosis. These should include uri- 
nalysis, complete blood counts, determination of 
the sedimentation rate, serologic tests for syphilis, 
smears and culture of specimens of urethral and 
cervical secretions, and finally, the taking of 
special smears for the Papanicolaou technique of 
detection of malignant cells. Specimens of cervi- 
cal tissue should be taken for biopsy if the exami- 
ner believes this laboratory procedure is indicated. 

It is well to emphasize again that all laboratory 
procedures should be supplemental to clinical ob- 
servation and carefully performed bimanual 
examination. Preceded by a carefully taken his- 
tory, the value of any laboratory test is dependent 
upon the clinician’s ability to interpret the findings 
and correlate them with what he has found by 
direct examination of the patient. 




a is 








The Treatment of Anemia 

N ANY consideration of the treatment of 

anemia, it is important to recognize that 
anemia is not a disease in itself but merely a 
symptom resulting from some underlying cause. 
Therefore, one must establish the etiologic factor 
involved in the anemia prior to therapy. 

Hypochromic (Iron-Deficiency) Anemia 

The great majority of anemias are of the 
iron-deficiency type and usually are secondary to 
chronic loss of blood, to inadequate intake or 
inadequate absorption of iron, or to the so-called 
physiologic deficiency of iron. Morphologic ex- 
amination of the erythrocytes reveals a decrease 
in hemoglobin within the cell, with resultant hy- 
pochromasia. The erythrocytes are usually nor- 
mal in size, although some regenerative macro- 
cytes may be present ; in some instances the eryth- 
rocytes may be smaller than normal. Regenera- 
tive macrocytosis with increased polychroma- 
tophilia may be noted, particularly if the loss of 
blood has been severe. A proportionate reduction 
in the number of erythrocytes usually occurs in 
acute hemorrhage ; however, in this case the cells 
rarely show a loss of hemoglobin unless an as- 
sociated hypochromic anemia of some duration 
has been present prior to the onset of the acute 

It is important to ascertain, insofar as possible, 
whether any loss of blood has occurred in a per- 
son who has hypochromic anemia. Loss of blood 
with menses frequently may produce a rather pro- 
nounced hypochromic anemia. Bleeding from the 
gastrointestinal tract is relatively common. Such 
bleeding may originate from ulcers, carcinoma, 
polyps, varices or hemorrhoids; various hemor- 
rhagic diseases may be manifested initially by 
bleeding ‘from the gastrointestinal tract. In a 
patient who has an obscure anemia, one should 

Read at the meeting of the Minnesota Academy of 
General Practice, Rochester, Minnesota, October 20, 1954. 

From the Section of Medicine, Mayo Clinic and Mayo 

The Mayo Foundation, Rochester, Minnesota, is a part 
of the Graduate School of the University of Minnesota. 

May, 1955 

Rochester, Minnesota 

examine the stools for evidence of occult blood 
and a thorough gastrointestinal investigation 
should be done. 

Under modern conditions, anemia associated 
with an inadequate intake of iron is relatively 
rare. A well-balanced diet in the northern part 
of the United States contains approximately 10 
mg. of iron daily. The gastrointestinal tract is 
able to absorb approximately 0.5 to 1.5 mg. of 
iron daily; this absorption occurs at a constant 
rate even when there may be unusual demands 
for iron by the body. The normal excretion of 
iron is approximately 1 mg. daily. In certain in- 
stances it is well to obtain a detailed description 
of the patient’s diet if other etiologic factors can- 
not be elicited in the investigation of hypochromic 

Anemia due to, physiologic deficiency of iron 
may occur in several conditions. In infancy there 
is usually an inadequate intake of iron as well as 
a period of rapid growth with a rapid increase 
in blood volume; consequently, the relative de- 
ficiency of iron results in hypochromic anemia. 
This same condition may prevail during periods of 
rapid growth in later years, particularly at the 
time of puberty. At such times the great increase 
in blood volume may be accompanied by a rela- 
tive decrease in the amount of iron available, 
with development of hypochromic anemia. At the 
onset of menstrual flow, blood may be lost at a 
time when rapid growth is still occurring, pro- 
ducing a double demand for iron; in such in- 
stances, rather severe degrees of hypochromic 
anemia may appear. The so-called physiologic 
anemia of pregnancy is due in part to the fact 
that within a relatively short period a great in- 
crease in blood volume occurs with a relatively 
constant intake of iron; thus, iron-deficiency 
anemia may occur. 

Practically all persons can absorb iron from 
the gastrointestinal tract. The iron is: absorbed 
in the form of ferrous salts and the chief site 
of absorption is the duodenum. As already in- 
dicated, an extremely small amount of the iron in- 


gested is actually absorbed and, after hema- 
tologic vaiues have been restored to normal by 
administration of iron, it is well to continue the 
treatment for a month or so in an attempt to 
supply the body with sufficient stores of iron. 
Protracted treatment after that time is usually 
not advisable. 

When an anemic patient takes iron, the peak 
of the response of reticulated erythrocytes occurs 
in about eight to twelve days, which is about the 
same time at which it occurs in the treatment of 
pernicious anemia with effective fractions of liver 
or vitamin B,2. Since administration of iron is 

the treatment of choice in iron-deficiency anemia, 

the use of liver extract, vitamin B,., folic acid and 
other similar substances is not indicated. 

Practically all patients respond to the oral use 
of iron. However, an occasional patient cannot 
tolerate iron given by mouth. Also, in certain 
severe hypochromic anemias it may be desirable 
to obtain a rapid increase in the value of hemo- 
globin. In such situations, the intravenous in 
jection of iron is of value. Several formulas for 
the calculation of the amount of iron needed in- 
travenously to bring the hemoglobin to a normal 
level can be found in the literature. The simplest 
one is based on the fact that approximately 25 
mg. of metallic iron is required to increase the 
value for hemoglobin by 1 per cent. This pro 
vides an easy method of calculating the amount 
necessary. The preparation used is a solution 
of saccharated iron oxide in a dose of 100 mg. in- 
jected intravenously once or twice daily. Care 
should be taken to determine that the material is 
not unduly toxic for a given patient and a small 
initial dose should be used. If an untoward reac- 
tion does not occur, the patient usually will tol- 
erate larger doses. Actually it is rarely necessary 
to resort to intravenous therapy, as practically 
all patients respond satisfactorily to iron given 

Macrocytic Anemia 

Among the various types of macrocytic anemia, 
often termed “megaloblastic anemia,” the com- 
monest is pernicious anemia. Fortunately this form 
of anemia responds well to adequate therapy. The 
clinical findings in pernicious anemia may vary 
but in general they include anemia, glossitis with 
atrophy of the mucous membrane of the tongue, 
a history of pernicious anemia in the family, early 
gray hair, evidence of combined system disease, 



absence of free hydrochloric acid in the gastric 
contents, and intestinal manifestations, which may 
be characterized by loose watery stools or by con- 
stipation alternating with loose stools. As a rule, 
patients who have pernicious anemia do not lose 
weight and may have a relatively abundant amount 
of subcutaneous fat. They often display a sur- 
prising amount of energy for the degree of anemia 
that is present; this is probably due to the fact 
that, because of the gradual onset of anemia, the 
body becomes accustomed to the anoxemia. 

Examination of blood smears in pernicious 
anemia reveals generalized macrocytosis, with 
the erythrocytes usually containing normal 
amounts of hemoglobin. There is usually an in- 
crease in poikilocytosis or the appearance of 
pear-shaped erythrocytes, which is thought to 
be due to loss of elasticity of the cellular mem- 
brane. The leukocyte count is usually normal but 
may be decreased or even increased. Megalo- 
blasts or normoblasts may be present in severe 
degrees of pernicious anemia and thrombocyto- 
penia occasionally may be noted. More rarely, 
a leukemoid reaction may occur in severe de- 
grees of pernicious anemia. An occasional pa- 
tient who has pernicious anemia in crisis may 
have a leukocyte count as high as 40,000 or more 
cells per cubic millimeter of blood, with a great 
increase in immaturity, so much so that the pres- 
ence of acute leukemia may be suspected in an 
occasional case. Examination of the bone marrow 
reveals the presence of megaloblasts, which, to- 
gether with the clinical findings, usually enables 
one to establish the diagnosis of pernicious ane- 
mia. The polymorphonuclear neutrophils usual- 
ly exhibit thinning of the individual lobes, with 
stranding between the lobes. Hyperlobulation 
may occur, with as many as six to twelve lobes, 
or even more, being present. This type of neu- 
trophil, although not absolutely diagnostic, is the 
so-called pernicious-anemia neutrophil and its ap- 
pearance, with other findings in the peripheral 
blood, would make one suspicious of the presence 
of this disease. 

After the diagnosis of pernicious anemia is 
established, the treatment is relatively simple. 
The most important factor is to give effective 
doses of liver extract or vitamin By. Depend- 
ing somewhat on the degree of anemia, I prefer 
to start treatment with fairly large doses. If con- 
centrated liver extract is used, an initial dose of 
3 cc. (45 units) is given; if vitamin Biz is used, 




On - 

the initial dose is 60 micrograms. This dose 
is given intramuscularly once daily for three 
successive days. Then 1 cc. of liver (15 units) 
or a dose of 30 micrograms of vitamin Bi2 given 
once a week usually restores the blood to a nor- 
mal level, after which time a maintenance dose 
may be worked out. In the uncomplicated case, 
this dose averages about 15 units of liver extract 
or 30 micrograms of vitamin B,. every two to 
four weeks. Some persons require more than 
others. In the presence of combined system dis- 
ease, a larger dose of an effective fraction may 
be necessary, such as 30 units of liver extract or 
60 micrograms of vitamin B,, twice a week, which 
may be continued for a number of months de- 
pending on the degree of improvement in the 
combined system disease. 

Proper maintenance therapy consists in giv- 
ing a sufficient amount of an effective fraction 
to keep hematologic values at normal levels, to 
avoid macrocytosis and to prevent any advance- 
ment of neurologic symptoms or to improve 
them, if it is at all possible. Sometimes a patient 
may be receiving maintenance doses of liver ex- 
tract and getting along satisfactorily; in spite of 
this, the symptoms and findings of combined scler- 
osis will develop. In such instances, larger doses 
of the effective agent are required. 

There is practically no difference between the 
response obtained from vitamin By. and _ that 
obtained from liver extract. One slight difference 
is that liver extract exerts a slight effect on the 
coagulation of blood that is not produced by 
vitamin Bj. This is relatively unimportant and 
is of no consequence with regard to the manage- 
ment of pernicious anemia. The main factors are 
to give sufficient material for control of the neu- 
rologic symptoms and to keep the patient on sus- 
tained and steady treatment for the rest of his 

Parenteral administration of liver extract or 
vitamin By2 is in general the treatment of choice. 
As a rule this method is cheaper, it permits the 
physician to keep the patient under observation 
so that he can determine whether or not the treat- 
ment is adequate, it impresses on the patient the 
importance of regular therapy and it assures that 
the material is absorbed. Vitamin B,. has what 
might be considered some advantages over liver 
extract in that it is a purified crystalline substance 
of constant potency, it may be used in patients 
who are sensitive to liver extract and it produces 

May, 1955 


a minimal local reaction. Oral therapy for per- 
nicious anemia produces a satisfactory remission 
and patients may be maintained satisfactorily by 
such treatment. However, at present it is usually 
expensive, absorption may vary greatly ‘depend- 
ing on the condition of the gastrointestinal tract 
at a given time and in general it is difficult to 
maintain adequate control of the patient by such 

Folic acid is known to be important in the 
maturation of erythrocytes. It will convert a meg- 
aloblastic bone marrow to a normoblastic state 
and will correct the hematologic abnormalities as- 
sociated with pernicious anemia. However, glos- 
sitis and the symptoms of combined sclerosis may 
develop in many patients while folic acid is being 
given. Consequently its use is not advisable al- 
though it is not contraindicated. Essentially the 
same is true for citrovorum factor, or so-called 
folinic acid, another substance that has been 
shown to be necessary for the conversion from 
a megaloblast to a normoblast. Folic acid and 
citrovorum factor are effective either orally or 
parenterally but neither of them exerts any 
beneficial effect on combined system disease. They 
usually have no effect on the gastrointestinal 
symptoms in pernicious anemia. Citrovorum 
factor, however, is important in that it is of great 
value in combating the toxic reactions to anti- 
folic substances that have been used in the treat- 
ment of certain leukemias. Combination therapy 
with liver extract and iron is rarely needed be- 
cause in most instances the stores of iron in per- 
nicious anemia are at a high level. Administration 
of hydrochloric acid as a rule is not necessary 
in the management of pernicious anemia. 

The treatment of other types of megaloblastic 
anemia is often extremely difficult. It usually 
may be summed up as a method of trial and 
error, utilizing various substances that are es- 
sential for hematopoiesis. Megaloblastic anemia 
other than pernicious anemia may occur as the 
result of gastrointestinal disease, total gastrec- 
tomy, intestinal strictures and fistulas, or short- 
circuiting operations; nutritional macrocytic ane- 
mia is seen in the tropics and with sprue, either 
tropical or nontropical. Megaloblastic anemia also 
may be associated with pregnancy ; this is the so- 
called pernicious anemia of pregnancy, which is 
usually due to a deficiency of folic acid. Use of 
liver extract or vitamin B,. may produce improve- 
ment; otherwise, folic acid may be of value. The 



megaloblastic anemia of infancy usually can be 
corrected by use of folic acid, although in some 
instances liver extract or vitamin Biz. may prove 
effective. The megaloblastic anemia associated 
with infestation by the fish tapeworm shows a 
variable response to the administration of vita- 
min By, or folic acid. 

The treatment of megaloblastic anemia other 
than pernicious anemia is probably best begun 
by use of vitamin B,. in the same dosage as 
would be used in treatment of pernicious anemia. 
If no response occurs after two or three weeks, 
use of folic acid may be tried. If there is still 
no response, folinic acid or citrovorum factor 
can be used. Transfusion may be necessary in 
some cases because of lack of response to any 
of these substances. Occasionally, a rare macro- 
cytic anemia may occur with a relatively aplastic 
bone marrow that will respond to administration 
of cortisone, following which the blood responds 
to use of folic acid or vitamin Bis. In refrac- 
tory anemias, such treatment might be tried. 

Anemia in Systemic Diseases 

Anemia is a frequent finding in many systemic 
conditions for which treatment is of practically 
no value. Examples of such anemias are those 
associated with metastatic malignant lesions in- 
volving the bone marrow, nephritis with azotemia 
and the anemia associated with infection. In azo- 
temia, if it is possible to decrease the blood urea, 
the patient’s blood usually will respond auto- 
matically. In true hypoplastic or aplastic anemia, 
treatment is of little or no value. The same is 
true of the leukemias and lymphoblastomas. The 
anemia associated with rheumatoid arthritis rarely 
responds to any of the usual hematinics. The 
anemia associated with myxedema responds to 
administration of desiccated thyroid but usually 
fails to respond to any other substance. 

In conclusion, it is important to establish the 
diagnosis and the etiologic factor responsible for 
the anemia before treatment is started. In cer- 
tain instances, treatment of anemia may mask 
an underlying serious disease whose early diag- 
nosis would save the patient’s life. 


(Continued from Page 314) 

the background of the patient, his habits and 
his way of life, and who can, by persuasion and 
advice, do much to ameliorate these symptoms. 


An attempt has been made to show the fre- 
. quency, distribution and severity of benign di- 
gestive disorders in the aged. In many instances, 
the complaints, however bizarre and atypical, are 
likely to have an organic background. The diag- 
nosis of the organic disease is often far from 
easy, chiefly because the usual clues which lead 
to diagnosis are absent or distorted. If the history 
is brief, full investigation is compulsory. If it 
is a continuation of one which has plagued the 
patient all his life, investigation is still essential, 

if only to provide the necessary reassurance and 
support essential to treatment. Symptomatic 
treatment without full investigation is at its best 
a risky business and temporizing on such a basis 
is the cause of much disability and many fatalities 
in the aged. It should not be forgotten that per- 
sons who reach the eighth decade of life are 
of a rather special pattern and mold, and not 
infrequently are made of better biologic materials 
than their juniors. Their tolerance to surgery may 
be amazingly good and their recovery from even 
major procedures rapid. Here is a field in which 
all physicians can participate in reducing mortality 
and morbidity rates, and in making life more 
bearable for many people who have passed their 


Laboratory Aids 

Sponsored by 
The Minnesota Society 
of Clinical Pathologists . 
George G. Stilwell, Editor 


Carcinoma in situ is a lesion in which epithe- 
lium in its normal anatomic location possesses the 
cytologic criteria for malignancy. It has not 
broken through the anatomic barrier that sepa- 
rates the epithelium from the underlying connec- 
tive tissue. Such preinvasive or intraepithelial 
carcinoma has been observed in many sites, in- 
cluding the skin, the mammary ducts and acini, 
colon, stomach, bronchi, larynx and uterine cer- 

Intraepithelial carcinoma of the cervix has 
been recognized for more than thirty years. How- 
ever, large series of cases have accumulated only 
during the past decade, as a result of develop- 
ment of intensive programs for the early detec- 
tion of cancer. Investigators have established 
some facts concerning this phase of cervical car- 
cinoma and have emphasized some other prob- 
lems relating to it that as yet are unsettled. 

Knowledge of the established facts is necessary 
to an understanding of the controversies. Carci- 
noma in situ is ordinarily invisible. Most of these 
early malignant lesions are discovered when a 
smear or a specimen for biopsy is procured from 
a grossly normal cervix or one that has an erosion, 
an eversion, leukoplakia or “cervicitis.”” Applica- 
tion of Lugol’s solution may outline the neoplastic 
lesion when it is otherwise invisible; normal 
cervical mucosa stains dark brown owing to a 
high glycogen content of the cells, whereas little 
or no staining occurs in the malignant cells, which 
are deficient in glycogen. 

Carcinoma in situ nearly always begins at the 
squamocolumnar junctional zone. This line is 
usually at the external cervical os but may lie 
well out on the portio vaginalis or up in the cer- 

From the Section of Surgical Pathology, Mayo Clinic. 

This is the twenty-seventh in a series of editorial re- 
ports sponsored by the Minnesota Society of Clinical 
Pathologists and designed to foster closer relationships 
between clinicians and pathologists. 

May, 1955 

Rochester, . Minnesota 

vical canal. Those in situ carcinomas associated 
with leukoplakia may arise any place on the cer- 
vix and even in the vagina. Downgrowth of this 
surface carcinoma into the mucous glands of the 
cervix is common and may be extensive. Such 
spread does not impart a metastasizing potential 
in the absence of true stromal invasion, because 
the basement membrane of replaced glands acts 
as a barrier to lymphatic and hematogenous dis- 

In situ carcinoma may be as small as a square 
millimeter and involve only a minor portion of 
the circumference of the squamocolumnar junc- 
tional zone. However, it may spread to involve 
large regions of the portio vaginalis and even, 
though rarely, the upper part of the vagina. This 
surface lesion also may extend 2 or 3 cm. up to 
the endocervical canal. 

The accessibility of the uterine cervix to in- 
spection and for procurement of specimens 
adapts it well to cytologic techniques for early de- 
tection of cancer, Jn situ or early infiltrating cer- 
vical malignant tumors that are invisible can be 
unmasked with a high degree of accuracy by 
study of stained smears of scrapings from the 
exocervix and endocervix. Tissue for biopsy that 
includes the squamocolumnar junctional zone 
taken from each quadrant of the cervix provides 
a similarly great accuracy of detection. 

Cervical carcinoma in situ appears to be present 
in about 1 per cent of adult females. Practically 
equal numbers of these lesions can be detected by 
good cytologic screening, by careful biopsy tech- 
niques or by a combination of the two. Sizable 
variations from this usual rate of prevalence in- 
dicate differences in the criteria for carcinoma 
accepted by some pathologists or in the efficiency 
of the detection program. 

Debates concerning some of the controversial 
phases of this subject can hardly add real knowl- 



edge, although they do bring known facts into 
focus.. Scientific statistical evaluations of the type 
contributed by Dunn?’ likely will supply the ulti- 
mate answers. Unwillingness to submit human 
béings to periods of observation of intraepithe- 
lial carcinoma hampers acquisition of knowledge. 
Evaluation of recorded studies is clouded by the 
fact that biopsy sometimes eliminates the entire 
lesion, as can local cautery. 

Does uterine carcinoma in situ usually progress 
to infiltrating carcinoma and is the latter ordinari- 
ly preceded by the former? More than forty in- 
stances of such progression have been document- 
ed, and a lesser number of these preinvasive car- 
cinomas reputedly have regressed.? Limited data 
suggest that a preinvasive phase usually precedes 
clinical carcinoma of the cervix. 

How long is the latent period, the time from 
which intraepithelial carcinoma is histologically 
recognizable until it produces clinical carcinoma? 
The average difference in age of patients at the 
time of detection of each form of lesion indi- 
cates an interval of about eight years. Since de- 
tection of the asymptomatic and invisible carci- 
noma in situ is a matter of chance, the average 
lesion in a screened population is found at about 
the midpoint in its evolution from histologic 
recognizability to clinical invasiveness. Accord- 
ingly, it is likely that the preinvasive phase lasts 
about twice as long as the ages at detection would 
indicate, or about fifteen years. 

The likelihood that preinvasive carcinoma in- 
cubates for more than a decade lends credence 
to its significance. Statistically, the average prev- 
alence of the im situ lesion and the recorded in- 
cidence of development of clinical cervical malig- 
nancy are consistent with the view that the form- 
er is the precursor of the latter. Additional valid- 
ity for the concept of carcinoma in situ is afford- 
ed by other facts. Jewish women enjoy the same 
relative immunity for this incipient lesion that 
they are known to have for clinical carcinoma of 
the cervix. Recognizable malignant cells appear 
in smears in both stages of the disease. Typical 
intraepithelial carcinoma is frequently found at 

the periphery of ulcerating cervical carcinoma. 
The full-blown picture of carcinoma in situ 
probably is valid diagnostically during pregnancy, 
although some investigators caution against over- 
diagnosis of epithelial hyperplasia in the pregnant 

Controversial criteria have been suggested for 
establishing that a given carcinoma is still in situ. 
The experience of my associates and me** in- 
dicates that study of a section made from each 
of about twelve serial blocks of the entire squa- 
mocolumnar region at right angles to the junc- 
tional zone is adequate. Minimal evidence for 
true invasion includes obvious vascular invasion 
or stromal permeation, the latter often accompa- 
nied by a scrirrhous reaction to the penetrating 
cells. ; 

What treatment should be given for carcinoma 
in situ? Hysterectomy alone is curative except 
for the rare case in which surface spread past 
the line of excision in the upper part of the vagina 
has occurred. Some physicians consider that coni- 
zation of the junctional region or extensive 
cautery is adequate. Extensive surface spread 
to the: exocervix or vagina or up the cervical 
canal imposes obvious limitations on either of 
these procedures. The more radical procedures, 
including Wertheim hysterectomy with dissection 
of the pelvic lymph nodes and conventional radi- 
ation therapy, are unnecessary. 


. Dunn, J. E., Jr.: The relationship between carcino- 
ma in situ and invasive cervical carcinoma: A con- 
sideration of the contributions to the problem to 
be made from general population data. Cancer, 
6 :873-88 (Sept.) 1953. 

. Jones, H. W., Jr., Galvin, G. A. and Te Linde, 
R. W.: Intraepithelial carcinoma of the cervix and 
its clinical implications. Internat. Abstr. Surg., 92:- 
521-524 (June) 1951. 

. Dahlin, D. C., Mussey, Elizabeth, and Dockerty, 
M. B.: Cervical smears in the detection of pre- 
clinical carcinoma. Minnesota Med., 35 :305-312 
(Apr.) 1952. 

4. Dahlin, D. C., Randall, L. M., Soule, E. H. and 
Dockerty, M. B.: Smears in the detection of pre- 
clinical carcinoma of the uterine cervix: Further 
studies with emphasis on the significance of the 
negative “repeats.” Surg., Gynec. & Obst., 100 :463- 
468 (Apr.) 1955. 


Case Reports 


Hemobilia is a term used to designate hemorrhage 
into the biliary tract as a result of trauma to the liver. 
Fourteen cases are reported in the collected literature 
which has been reviewed by Sandblom,? by Sparkman,‘ 
and by Sparkman and Fogelman.5 We wish to report 
two additional cases. 


Fig 1. Case-1. Postoperative chest 
roentgenogram taken on December 10, 
1953, showing a right pleural effusion 
with an air fluid collection under the 
right diaphragm. 

Case Reports 

Case 1—D. U., a twenty-five-year-old white man was 
admitted to the Minneapolis Veterans Hospital on No- 
vember 22, 1953, sixteen hours after having been in an 
automobile accident. The patient suffered no apparent 
injury at the time of the accident and was taken home 
by a passing motorist. Shortly after arriving home, 
he developed abdominal pain and a physician was called. 
When examined by the doctor the patient was in shock. 
A transfusion of 1000 cc. of whole blood was given at 
the local hospital and he was transferred to this hos- 
pital for definitive treatment. 

Dr. Hay, formerly Chief of the Surgical Service, 
Minneapolis Veterans Hospital, Minneapolis, is now 
Director of Surgical Research, Mount Sinai Hospital, 

Ma x, 1955 

H. M. BROKER, M.D., and L. J. HAY, M.D. 
Minneapolis, Minnesota 

Physical Examination.—On admission, the blood pres- 
sure was 90/60 and the pulse was 120 beats per minute. 
Examination of the head, neck and chest was normal. 
The abdomen was moderately distended and generalized 
rebound tenderness and spasm were present. There were 
no abrasions of the thorax or abdomen. 

Laboratory Examination—The hemoglobin was 12 

Fig. 2. Case 1. Postoperative roent- 
genogram of the abdomen after choledo- 
chostomy. This view shows the develop- 
ing area of emphysematous tissue under 
the right diaphragm and a large air 
bubble present in that region. 

Gm./100 cc. blood. The urine was normal. The flat 
and upright roentgenograms of the abdomen were not 

Hospital Course—Shortly after admission, the patient 
vomited 2000 cc. of grossly bloodly fluid. A transfusion 
of 1500 cc. of whole blood was given rapidly, after 
which the hemoglobin was reported as.11.7 grams. The 
blood pressure rose from 90/60 to 130/80 but. the pulse 
remained at 130. 

The patient was operated upon. Approximately 3000 
ce. of blood was present in the peritoneal cavity. The 
capsule was torn free from an area of the dome of the 
right lobe of the liver. The laceration was estimated as 
8x12 cm. in dimension. Liver tissue and blood clots were 
scooped out to a depth of 3 or 4 cm. The wound was 



packed with gelfoam. Two large rubber tube drains to 
the area were brought out in the right flank posteriorly 
under the margin of the twelfth rib. Postoperatively, the 
patient’s temperature remained at 100-101 degrees F. 
There was a large amount of bile drainage (Fig. 1). 
It was suggested that, since most of his bile was draining 

Fig. 3. Case i. The large cavity is 
seen On roentgenogram in Figure 2 as an 
emphysematous area. The cavity is filled 
with necrotic liver tissue which is shown 
in Figure 4. 

through the posterior drain, a decompression of the bili- 
ary tract be performed. On December 18, 1953, a chole- 
dochostomy was performed. This was followed by a 
marked decrease in the bile drainage from the wound. 

On December 24, 1953, a peculiar emphysematous 
mass with a fluid level was noted under the right dia- 
phragm on the roentgenogram (Fig. 2). This mass was 
explored through an incision traversing the tenth rib 
bed and diaphragm, and a sequestrum of necrotic liver 
tissue, 10 cm. in diameter was removed. The sequestrum 
was separated from the viable liver tissue by a fibrotic 
layer. It was removed by finger dissection. Brisk bleeding 
was controlled by a gelfoam pack. It was estimated at 
the time of surgery that about 30 per cent of the right 
lobe of the liver had sequestrated(Figs. 3 and 4). 

Postoperatively, the patient developed a_ stenosing 
esophagitis involving all the esophagus beyond the aortic 
arch. This was satisfactorily controlled by dilatation. 
Healing of the liver defect was slow but progressive 
and was complete after four months. 

This patient has been followed for one year. Liver 
function tests were within normal limits on December 
13, 1954. The patient is completely asymptomatic and is 

Case 2.—P. H., a twenty-year-old white woman was 
admitted to the Minneapolis General Hospital on June 
19, 1954, following an automobile accident. On admis- 
sion, she was irrational and uncooperative. 

Physical Examination —Blood pressure was 94/54, the 
pulse was 100 and the temperature was 98 degrees F. 
Findings included a large hematoma of the forehead, 
tenderness over the right lower chest, and abdominal 
rigidity with marked tenderness present in the right 
upper quadrant. Bowel sounds were absent. 


Laboratory findings were essentially normal with the 
exception of a hemoglobin of 10 Gm./100 cc. blood. 

Hospital Course.—A peritoneal tap performed on ad- 
mission was negative. After the patient had received 
1000 cc. of whole blood, her blood pressure stabilized 

Fig. 4. Case 1. The resected specimen 
of necrotic liver tissue from the right 
lobe. This tissue is seen on the roent- 
genogram in Figure 2, represented by 
the area of emphysematous reaction, 

at 130/80, and a laparotomy was performed. The peri- 
toneal cavity contained approximately 2000 cc. of blood. 
Examination of the liver revealed a 5x10 cm. stellate 
laceration of the dome of the right lobe. 

The laceration of the liver was packed with gauze and 
a large Penrose drain was placed to Morison’s pouch 
and to the area of laceration. 

The drains and pack were removed and the patient 
was asymptomatic by July 4, 1954. 

On July 12, 1954, the patient became febrile and com- 
plained of right upper quadrant pain. This was followed 
by one episode of hematemesis, after which the hemo- 
globin was 8.8 Gm. A transfusion of 1000 cc. of whole 
ED was administered, and the hemoglobin was_then 

2 Gm. The pain in the right upper quadrant continued 
ae Me until July 20, 1954, when it became severe 
and radiated to the back. On that day the hemoglobin 
dropped to 8.0 Gm. 

On July 21, 1954, after the patient had been given a 
transfusion, a laparotomy was performed. The gall 
bladder was filled with clotted blood. The subphrenic 
space was explored and contained a “deep purplish” 
exudate. Brisk bleeding occurred from the lacerated area 
of the liver and was controlled by repacking with gauze. 
A cholecystostomy was performed and the abdomen 
was drained. 

The pack was gradually removed over a two-week 
period. The patient was asymptomatic until August 10, 
1954, when mild right upper quadrant pain occurred. 
Three hours later the pain had become severe and the 
patient began to bleed profusely from the site of the 
previously removed subphrenic drain and through the 
cholecystostomy tube. In a two-and-one-half-hour period, 
the patient received 7500 cc. of whole blood. The patient 
died in the operating room from shock before definitive 
surgery could be accomplished. 

(Continued on Page 336) 




Report of Successfully Treated Case 

N SPITE of our present-day accuracy of neurologic 

and ophthalmologic diagnosis, a neurologic surgeon 
must be prepared for unexpected developments when 
he opens a patient’s skull. 

The diagnosis of a chromcphobe adenoma of the 
pituitary gland usually is not difficult. The visual loss 
which causes the patient with such a lesion to consult 
a neurosurgeon ordinarily is rather classic, and the 
roentgenologic finding of an enlarged and eroded sella 
turcica is most often pathognomonic of a pituitary tu- 
mor, yet occasionally the surgeon uncovers a lesion that 
is entirely unexpected. The following report is illus- 
trative of the unexpected situation that may be en- 
countered once in a while. 

Case Report 

A sixty-five-year-old woman came to the Mayo Clinic 
complaining chiefly of poor vision in her right eye. 
The decreased vision on the right had been noticed for 
about five months. A local ophthalmologist had pre- 
scribed “drops”; these had been used without improve- 
ment. Two weeks before coming to the clinic this pa- 
tient saw another ophthalmologist, who examined her 
eyes and advised roentgenologic examination of her head, 
which was done. The patient said he told her she had 
a “boil” in her head, and that it needed to be “dried out” 
with x-ray treatments. A neurosurgeon saw her and 
was said to have concurred in the diagnosis and treat- 
ment. During the two weeks prior to the patient’s visit 
to the clinic the husband had noted a slightly increased 
prominence of her right eye. 

In addition, the patient complained of mild bitem- 
poral and biparietal headache. There had been no 
symptoms to suggest endocrine dysfunction. 

The patient was 59%4 inches tall and weighed 14814 
pounds without her clothes. There were no physical 
signs of pituitary insufficiency. The blood pressure was 
178 systolic and 108 diastolic, measured in millimeters 
of mercury. The uterus was surgically absent (hysterec- 
tomy had been done in 1930). Vision was recorded as 
6/20 on the left and 1/60 on the right. There was 1 mm. 
of proptosis of the right eye. The palpebral fissure was 

mm. wider on the right than on the left. Extra-ocular 
motions were generally restricted in all directions in the 
tight eye. The tension in the right eye was 27, whereas 
in the left eye it was 20. The ocular fundi revealed a 
moderate degree of pallor, and the arterioles of the 
retina showed the changes of chronic hypertension. 

Dr. Love is in the Section of Neurologic Surgery and 
Dr. Blackburn is in the Section of Medicine at the Mayo 
Clinic and Mayo Foundation. The Mayo Foundation in 
Rochester, Minnesota, is a part of the Graduate School 
of the University of Minnesota. 

May, 1955 


Rochester, Minnesota 

The fields of vision when plotted revealed bitemporal 
hemianopsia, with involvement of the right optic nerve 
and right side of the optic chiasm. 

Neurologic examination did not disclose any additional 
abnormalities. Roentgenologic examination of the 

Fig. 1. Lateral roentgenogram showing enlargement 
and erosion of the sella turcica, such as is seen in the 
presence of a pituitary tumor. 

head demonstrated erosion and enlargement of the sella 
turcica, which condition was interpreted as being due 
to a large intrasellar tumor (Fig. 1). Roentgenograms 
of the optic canals showed them as normal. The su- 
perior orbital fissure on the left was slightly larger 
than that on the right. This was thought to be of no 
clinical significance. 

The basal metabolic rate was within normal limits 
(+6), as were results of blood counts and urinalysis. 

We knew we were dealing with a progressive lesion 
involving the sella turcica and the visual apparatus. We 
felt the lesion was neoplastic and not an aneurysm of 
the carotid artery or the circle of Willis. In an attempt 
to explain all the ophthalmic signs and the eroded sella 
turcica we considered three different neoplasms which 
might be conceived to be present, and we ‘assigned the 
following percentages, in terms of likelihood, to each: 
meningioma, 50 per cent; pituitary adenoma, 40 per 
cent; pituitary adamantinoma, 10 per cent. 

Operation for the removal of a tumor involving the 
visual apparatus was advised and accepted. 



Although there was no clinical evidence of pituitary 
insufficiency, the patient was given 200 mg. of cortisone 
intramuscularly forty-eight, twenty-four and two hours 
prior to craniotomy. It was thought advisable to supply 
the patient with such a depot of cortisone in the event 
that operation resulted in acute anterior pituitary in- 
sufficiency, either temporary or permanent. After the 
operation the administration of cortisone was gradually 
reduced over a period of several days. 

Right transfrontal craniotomy was performed with 
difficulty with a malleable needle. It was necessary to 
convert two of the perforator openings into burr open- 
ings, but we still were unable to turn the flap without 
lacerating the dura. There was sharp bleeding at the 
anterior temporal opening, and ultimately we realized 
why. After the flap had been turned, and as we were 
inspecting the lacerated dura, we noted a hard, firm, 
nodular mass in the anterior temporal hole and a thick- 
ened dura; this mass proved to be a typical meningioma 
of the Sylvian fissure, and it was of very respectable 
size. For a moment, it was thought that this process 
might be a lateral extension of a meningioma of the 
sphenoid ridge. However, this entire tumor mass was 
removed in one piece after the nutrient artery had been 
closed with silver clips and there seemed to be no deep 

Yet it was obvious that this tumor was not producing 
the defect in the visual fields or causing the erosion 
of the sella turcica. We then stripped the adherent dura 
from the roof of the right orbit and exposed the visual 
apparatus. As we did so, we saw a large, thick-walled, 
nonpulsating tumor projecting above the sella and ex- 
tending under the right optic nerve and internal carotid 
artery, both structures being displaced upward. The 
tumor presenting between the optic nerves and anterior 

to the chiasm was aspirated without obtaining blood. 
Then it was incised and typical pituitary adenomatous 
tissue was obtained. A considerable amount of tissue 
was saved for microscopic examination. Most of the 
tissue within the capsule was removed with a sucker. 

A large adenomatous extension under the right optic 
nerve and internal carotid artery was pulled within the 
sella and removed. Extensive resection of the capsule 
was carried out; a piece along the floor was left. The 
bleeding was under control. The lacerated dura was 
covered with a sheet of animal membrane. The bone was 
wired in place with two pieces of wire. The wound 
was closed in layers without drainage. The 30 cc. of 
fluid which had been removed through the malleable 
needle was replaced in the spinal canal. 

The pathologist’s report identified these lesions as 
(1) a meningioma of the Sylvian fissure, and (2) a 
chromophobe pituitary adenoma which was intrasellar, 
suprasellar and extrasellar (supratentorial) in extent. 

The patient received 500 cc. of blood during these 

The patient’s postoperative convalescence was unevent- 
ful and very gratifying.” For one twenty-four-hour pe- 
riod (the second) after operation the intake and output 
of fluids was markedly increased (4,800 cc. intake and 
5,300 cc. output). However, this condition spontaneously 
subsided without the employment of posterior pituitary 

The patient was dismissed from the hospital on the 
eighth day after operation, and from the care of the 
Mayo Clinic four days later. At the time of dismissal 
there had been some improvement in vision in the tem- 
poral field of the right eye and ocular motions were 

(Continued from Page 334) 

Autopsy revealed an area of liver necrosis measuring 
5x6 cm. There was an erosion of a branch of the right 
hepatic artery deep in the substance of the right lobe of 
the liver. 


The sparsity of reports in the literature would suggest 
that bleeding into the gastrointestinal tract as a result of 
liver injury is a rare condition.1 It is more likely that 
bleeding is often mild or masked by the associated 
problems presented by other injuries.2}Hemobilia may 
be an early or, late complication of liver injury as in the 
two cases reported. 

Central rupture of the liver occurs by compression 
of the inelastic and fragile liver parenchyma. When a 
tear occurs, arteries, veins, and bile ducts are ruptured 
and the cavity fills with blood and bile. This process 
produces necrosis which in turn produces secondary 
hemorrhage. The only exit of drainage in central lacera- 
tion is into the bile ducts or the blood vessels. Autolyzing 
ferments at the site of injury, sequestration of damaged 
liver tissue and infection of devitalized tissue are other 
causative factors in the etiology of hemobilia. 

Usually, hemobilia is an insidious process since the 
central portion of the liver has no sensory nerve endings. 
Only after the liver enlarges enough to distend the cap- 
sule or after a tear occurs in the capsule will pain be 
present. Shortly after the occurrence of bleeding into 
the bile ducts, the symptoms of typical biliary colic 
become manifest. This occurred in the second case 


Sparkman gives the symptoms of hemobilia as a triad 
of abdominal injury, pain, simulating biliary colic and 
gastrointestinal hemorrhage. In the second case reported, 
the patient experienced pain prior to the onset of hemor- 
rhage and could predict the episodes. 


Two cases of hemobilia are reported. In the first 
patient, the hemobilia occurred at the time of the injury, 
and in the second it occurred twenty-one days after 

Knowledge of this entity and the possibility of seg- 
mental necrosis of the liver substance should permit 
earlier debridement and decrease the chances of second- 
ary hemorrhage. 


. Mikal, S., and Papen, G. W.: Morbidity and mor- 
tality in ruptured liver. Surgery, 27 :520, 1950. 

. Owen, H. K.: Case of lacerated liver. London M. 
Gaz., 7:1048, 1848. 

. Sandblom, Philip: Hemorrhage into the biliary tract 
following trauma-traumatic hemobilia. Surgery, 
24 :571, 19 

. Sparkman, R. S.: Massive hemobilia following trau- 
= rupture of the liver. Ann. Surg., 138:899, 

. Sparkman, R. S., and Fogelman, M. J.: Wounds of 
the liver. Ann. Surg., 139:690, 1954. 



Sponsored by 
The Minnesota Society 
of Clinical Pathologists 
Donald F. Gleason, Editor 


The patient, a white nun, was originally admitted to 
St. Mary’s Hospital in 1945 at the age of sixty-one for 
multiple contusions suffered when she fell while hanging 
curtains. Except for a fracture of a metacarpal bone, 
there were no other significant findings or complaints. At 
that time, the hemoglobin was 12 gm. per cent, red blood 
count 4,210,000/cu. mm. and white blood count 6,600/cu. 
mm. Recovery was uneventful. 

The second admission was in 1946, at the age of sixty- 
two, for “strain of lumbar spine.” While cleaning win- 
dows, she strained her back. She was admitted with 
severe pain in the lower back over the lumbar and sacral 
spine. There was local tenderness to deep pressure. 
Except for hyperactive tendon reflexes throughout, neu- 
rologic examination gave negative findings. The hemo- 
globin was 12.8 gm. per cent, white blood count 8,700/ 
cu. mm., red blood count 4,320,000/cu. mm. Complete 
urinalysis showed no abnormalities. The spinal fluid 
showed 7 white cells/cu. mm., 64 mg. per cent sugar, 
740 mg. per cent chlorides and 25 mg. per cent total 
protein. The colloidal gold curve and serology were 
normal. X-rays of the area were not remarkable except 
for slight wedging of the first and fourth lumbar verte- 
brae with hypertrophic changes which might represent 
old compression type fractures. The spinogram was 
negative for herniated intervertebral disc. The patient 
was fitted with a lumbosacral support and recovered 

The final admission in February, 1954, occurred when 
the patient was sixty-nine. While sitting in a chair, 
she bent over, fell and struck the right hip, suffering 
immediate, severe pain in that area. Past history included 
pulmonary tuberculosis in 1907 for two months and a 
few minor surgical operations. System review revealed 
no abnormal findings except for blindness in the left eye 
for two years. Physical examination showed an obese 
white woman with severe pain in the right hip. A 
mature cataract was present in the left eye. The tongue 
was in the midline, and the pharynx showed no unusual 
changes. The chest was examined only anteriorly but 
showed no abnormalities. The blood pressure was 
156/86 mm. of mercury. No other cardiac physical find- 
ings were present. The abdomen showed no abnormali- 
ties. There was an obvious fracture of the neck of 
the right femur. X-ray examination confirmed the frac- 
ture. A portable chest x-ray on the second hospital day 
was unsatisfactory, suggesting possible atelectasis on the 

From the files of the Department of Pathology, St. 

gh Hospital, Duluth, Minnesota. Discussed on June 
9, 1954, 

May, 1955 

Duluth, Minnesota 

right and an elevated right diaphragm. An electrocardio- 
gram was normal. On the third hospital day, the hemo- 
globin was 16 Gm. per cent, the white blood count 
14,500/cu. mm. with 73 per cent neutrophiles, 24 per 
cent lymphocytes. On the fourth hospital day, the 
hemoglobin was 14 Gm. per cent, platelets 135,300/cu. 
mm. A preoperative physical examination on the second 
hospital day showed a blood pressure of 150/80 mm. of 
mercury, pulse of 96, respirations 20/minute and tem- 
perature 100.2°; otherwise, there had been no change. 
The urine, which showed a specific gravity of 1.026, 
was otherwise normal. On the fourth hospital day, a 
hip-nailing procedure was carried out without difficulty. 
The patient progressed satisfactorily, and on the seven- 
teenth hospital day she began to be up in a chair. On 
March 19, 1954, (thirty-third hospital day), the patient 
complained of a thick feeling in the tongue and difficulty 
in speaking. No other changes were found on examina- 
tion. On March 22, she developed slurred speech as 
well as trouble in chewing and swallowing. The tongue 
deviated to the left. On March 24, she had two sudden 
episodes of dyspnea lasting about ten minutes each. The 
lungs were dry and the heart rhythm regular. On March 
25, panting respirations were noted. An electrocardio- 
gram repeated on this day was again normal. Neurologi- 
cal examination showed a nasal voice tone. Hypalgesia 
was present in the fifth finger and less in the fourth 
finger of the right hand. Deep reflexes were moderately 
hyperactive. Speech was difficult. Regurgitation of 
liquids occurred through the nose. No cerebellar signs 
were found. On March 26, a spinal puncture showed 
a pressure of 410 mm. water, and 4.5 cc. of clear color- 
less spinal fluid was removed. This contained no cells, 
but 45 mg. per cent sugar, 14 mgm. per cent total protein 
and 755 mg. per cent chlorides were present in the fluid. 
Pandy’s test was negative, as were the gold curve and 
Wassermann tests. On this day the white blood count 
was 7,750/cu. mm., the hemoglobin 11.8 mg. per cent. 
On March 26, there was little change with no facial 
weakness detectable and an active gag reflex was present. 
On March 27, examination of the ear, nose and throat 
gave essentially negative findings. Pharyngeal muscle 
function was difficult to evaluate but all muscles moved 
as did the vocal cords. On March 29, the previous symp- 
toms increased. On March 30, physical signs of diaphrag- 
matic paralysis bilaterally were confirmed by fluoroscopy. 
The tongue became uncontrollable, and there was much 
respiratory distress. A tracheotomy was performed. 
‘Thoracic muscle action was poor. The patient was placed 
in a Drinker respirator. On March 31, her condition 



was grave with obvious signs of insufficient oxygenation. 
Slight nystagmus was apparent with the gaze to either 
side. The left palpebral fissure was narrower than the 
right. The left corneal reflex was less active than the 
right, and there was slight deviation of the tongue to 
the left. Her condition progressed to complete coma and 
death that night. The white blood count the day of death 
was 21,500/cu. mm., with 82 per cent neutrophiles. The 
temperature was normal throughout her illness until the 
day of death when it rose to 101 degrees. 

Differential Diagnosis 

Dr. L. R. Gowan: Review of the protocol as well as 
the nurse’s notes indicate a rather marked fluctuation in 
the severity of symptoms from hour to hour. The past 
history also includes several falls with resultant frac- 
tures (ribs, ankle, wrist, hip). The x-rays served 
primarily to corroborate the clinical impression of 
diaphragmatic paralysis and also show no bone signs of 

A broad view of the problem would demand considera- 
tion of many entities including: 

. Anterior horn disease 
Bulbar palsy (arteriosclerotic) 
Pseudobulbar palsy 
Basilar artery thrombosis 
Vascular anomaly (aneurysm of basilar artery) 
Tumor (pontine) 
Myasthenia gravis 

. Guillian-Barre’s syndrome 

. Bulbar multiple sclerosis 
Multiple CNS metastases 
Toxic encephalitis (CO, As, etc.) 

All of these conditions may produce bulbar signs. In 
the process of elimination, the negative spinal fluid find- 
ings rule out poliomyelitis, or encephalitis or other 
anterior horn-cell disease not already ruled out by the 
history. The absence of fibrillation and vacillation of the 
clinical course are not characteristics of bulbar palsy. 
Basilar artery thrombosis causes quadriplegia and death 
in about twenty-four hours, if complete; if incomplete, 
I would expect more neurological signs as a result of 
brain stem and cranial nerve nuclear involvement; the 
same arguments apply to aneurysms. Pontine tumors 
are rare at this age; furthermore, the patient had no 
headaches, dizziness or visual disturbance. Hyperpara- 
thyroidism must be considered, especially with the long 
history of bone aches, demineralization and leg weak- 
ness; the x-rays show no cystic changes, but these are 
not invariably present. Guillian-Barre’s disease is a diag- 
nosis which, if made at all, should be considered only 
in a patient with a fairly characteristic picture. The 
patient’s age is the biggest argument against multiple 
sclerosis, although this disease could begin at this age. 
I would expect more neurological findings in the extremi- 
ties, however; furthermore, even apoplectic onsets of 
multiple sclerosis usually produce a history of previous 
symptoms upon specific questioning. There is nothing to 
suggest a primary tumor, and multiple metastases would 


not have produced such a fluctuating clinical picture. No 
exposure to: a toxin makes toxic encephalitis untenable 
as well as lack of more widespread evidence of brain 

Myasthenia gravis and pseudobulbar palsy must be 
considered seriously. There is a past history of hyper- 
tension; therefore, vascular disease is possible. There 
is no atrophy; pyramidal tract involvement is common 
in pseudobulbar palsy, absent in this case. Past history 
of a stroke is also common, again lacking here. 

Myasthenia gravis may appear in older people. The 
clinical vacillation in severity of symptoms is quite con- 
sistent with this diagnosis. Respiratory muscle weak- 
ness is common in myasthenia gravis. Clinically, myas- 
thenia gravis usually falls into three groups: (a) bulbar, 
(b) ocular, (c) myasthenia of the extremities. This 
case was primarily bulbar in type with minimal ocular 
signs. Of course, most cases are much more gradual 
in their onset than was this case, but such sudden onsets 
occur and may be an exacerbation of a subclinical form 
of the disease. Unfortunately, we have no therapeutic 
test (prostigmine) recorded in this case. I believe this 
patient died of an acute form of myasthenia gravis but 
cannot definitely rule out pseudobulbar palsy. The other 
possibilities are improbable for the reasons mentioned 

Dr. I. T. Criark: The chest x-ray shows high 
diaphragms and right lower lobe atalectasis. No evidence 
of thymoma is seen. 

Doctor Gowan’s Diagnosis 

Myasthenia gravis 
Possible pseudobulbar palsy 

Anatomic Diagnosis 

1. Benign Thymoma 
2. Acute myasthenia gravis 

Dr. A. C. AUFDERHEIDE: The heart weighed 380 
grams. It was otherwise normal; except for lower lobe 
atelectasis on both sides, the lungs were not abnormal. 
The gastrointestinal tract showed no: pathologic lesion. 
A small benign fibroma was present in the right ovary. 
A benign cortical adenoma (3 cm. in diameter) was 
found in the right adrenal gland. Osteoporosis of the 
lumbar vertebrae was apparent. Four parathyroids were 
grossly and microscopically normal. The parenchymal 
and vascular tissue of the brain and spinal cord showed 
no gross or microscopic changes. Microscopically, the 
skeletal muscle of the diaphragm was not abnormal. 
Situated in the superior anterior mediastium in the region 
of the thymus gland was an encapsulated, lobulated, 
hard tumor measuring 4x3x3.5 cm., which on cut 
section was white, trabeculated with a few hemorrhagic 
areas. Microscopically, the tumor consisted of larger 
epithelial-appearing cells mixed with smaller cells indis- 
tinguishable from lymphocytes (Fig. 1). The picture is 
that of a benign thymoma. 

The absence of central nervous system lesions, the 
presence of a benign thymoma and the clinical history 
led us to conclude that this was a case of acute 
myasthenia gravis. 



Dr. H. Fiskett1: Are malignant tumors of the thymus 
ever associated with myasthenia gravis? 

Dr. A. C. AUFDERHEIDE: Rarely, a few cases have been 
reported, but with these few exceptions, thymomas 
accompanying myasthenia gravis are benign. 

Dr. A. C. AUFDERHEIDE: About 50 per cent of 
myasthenic patients have a thymoma or hyperplasia of 
the thymus on x-ray examination. 

Dr. J. Cott: Johns Hopkins University has reported 
up to 80 per cent at autopsy, if a careful search is made. 

INTERN: What is the current status of thymectomy 
in myasthenia gravis? 

Fig. 1. (A) Low power photomicrograph of the thymic tumor. Note the cellularity. 
(B) High power photomicrograph of the thymic tumor showing the two types of 

much larger and stain less deeply. 

Dr. J. K. Butter: What is the treatment of choice? 

Dr. J. B. Mover: Neostigmine tablets are the most 
popular; the methyl sulphate form of neostigmine is 
available in ampule form for emergencies. Other prod- 
ucts are also available; I haven’t had much experience 
with them but I understand they are quite toxic. It is 
important that enough drug be given; too many myas- 
thenic patients are undertreated by their physician. 

Dr. N. E. A. Leppo: What is the incidence of thy- 
moma in myasthenia gravis? 

The smaller, dark-staining cells resemble lymphocytes while the others are 

Dr. Gowan: Debatable at present. The Lahey Clinic 
staff feels that their series shows definite benefit from 
thymectomy; the Mayo Clinic staff felt otherwise but 
recently supported the eastern school after re-evaluating 
their results. Thymectomy usually produces a severe 
postoperative transient exacerbation of the disease so 
that treatment must be vigorous during that phase. 

I think this patient had had subclinical myasthenia 
gravis which probably caused enough muscle weakness 
to result in her frequent falls and that the present 
episode represents an acute exacerbation of the disease. 


Although having surgical patients ambulate soon 
alter their operation has been widely practiced since 
World War II, Palumbo believes it should be followed 
ven more extensively than it is today. He feels that 
hesitancy on the part of many surgeons is due to fears 
that certain undesirable effects such as wound disrup- 

tion may occur. The author disagrees and notes that 
Through disturbances in metabolism, prolonged bed 
rest produces weakness and loss of tone of both smooth 
and skeletal muscles, loss of calcium and nitrogen from 
the body, reduced vital capacity, decreased cardiac out- 

May, 1955 

put, slowing of circulaticn, and a delay in wound healing. 
These changes may result in an increased incidence of 
complications of the gastrointestinal tract, as evidenced 
by ileus, constipation, nausea, vomiting, and/or decrease 
or loss of appetite.” Conversely, “Early ambulation en- 
hances wound healing and reduces other complications 
which may occur in the gastrointestinal tract, in the 
cardiopulmonary and in the peripheral-vascular system:” 
—Pa.umpo, L. T.: Early postsurgical ambulation, Jour- 
- of the Iowa State Medical Society, 45:12 (Jan.) 

President’s Letter 


This issue of MINNEsoTA MEDICINE should reach you about the time of the state 
meeting, and the impact of the work of your state association, plus the work of your 
local arrangements committees in bringing to you this excellent annual meeting, 
should be fresh in your mind. 

On occasion, I have been asked by members of local units of medical societies, 
“What does my county medical society do for me?” At such times, even though 
I could talk indefinitely on the subject, I have often felt completely tongue-tied 
and frustrated. Perhaps I have felt somewhat as you would feel if, after you had 
successfully seen a patient through a critical illness, he were to say to you, “I 
guess I would have done just as well if I had gone to bed and seen it through 
without you, eh, Doctor?” 

That the physician can ask such a question about his medical society, is evidence 
that he is not even a member of the society in his own heart. If he had helped to 
cook the meal, he would inevitably have tasted some of the bounties of society 
membership in the process. 

So many members have participated in the work of our state association that 
to single out any one man or group would be an injustice. The work of the 
Hennepin County Medical Society, our hosts at the state meeting; the Insurance 
Liaison Committee; the Committee on Malpractice; the committee studying our 
functions in civil defense ; Maternal and Child Health Committees ; and the editing, 
publishing, and editorial boards of MrinNEsota MEDICINE, to name only a few, 
have been so outstanding that our membership owes them a debt of gratitude 
beyond their ability to repay. 

It is, indeed, a source of satisfaction to your officers and Council that when 
help and advice is needed, it is freely given. Time and efforts seem of little 
consequence to these devoted members of our Association when they are asked 
to contribute to the profession of our state. 

In the light of the accomplishments of the committees, on both scientific and 
non-scientific work, can any one of our members seriously ask, ““What does my 
society do for me?” Rather let us ask, “How can I aid in the dedicated work of 
our Association, whose object is the improvement of public health, the advance- 
ment and dissemination of scientific knowledge, and the protection and advance- 
ment of our profession in the accomplishment of these objectives ?” 

President, Minnesota State Medical Association 






This number of MINNEsoTA MEDICINE con- 
tains material presented on October 20, 1954, at 
the Fourth Annual Refresher Course of the 
Minnesota Academy of General Practice in Roch- 

This meeting was representative of what I feel 
to be one of the richest heritages of American 
medicine. Five hundred general practitioners reg- 
istered and attended the meetings wherein four- 
teen specialists gave of their time and knowledge. 
The meeting demonstrated a co-operation for 
the good of the patient that is typical of the 
medical profession. Nothing could so well belie 
those vocal few who would have us believe that 
the specialist and the general practitioner are 
continually at each other’s throat. The attendance 
and attention of the general practitioners earned 
them the respect of the speakers. 

Members of the Minnesota Academy of Gen- 
eral Practice have seen these meetings grow and 
have watched the enthusiasm mount each year. 
This annual meeting, along with the regional 
meetings that are held throughout the state, gives 
general practitioners an opportunity to get post- 
graduate instruction that will qualify them for 
continued membership in the Academy. It also 
provides nonmembers with an opportunity to 
“refresh” themselves. 

The papers included in this symposium are not 
meant to be a basic contribution to the medical 
literature but do review some of the basic con- 
siderations in diagnosis and treatment of the con- 
ditions discussed. It is considered that their in- 
clusion in MINNESOTA MEDICINE might be of 
value to physicians unable to attend the meeting. 

H. A. Wente, M.D., Secretary-Treasurer 
Minnesota Academy of General Practice 


The last twenty-five years have flooded us with 
alphabetic agencies, and he is indeed a dolt who 
doesn’t understand UN, WHO, UNESCO, et 
cetera. The Armed Forces gave us a goodly num- 
ber of useful alphabetics ; e.g., SOP for Standard 
Operating Procedure (quite reminiscent of the 
s.0.b. that appears on clinical histories to indicate 

May, 1955 

Joun F. Briccs, M.D. 
ArtHuR H. WE tts, M.D. 
Henry G. Moenurinec, M.D. 

short of breath—beware of capitalizing these let- 
ters, though), and SNAFU for Situation Normal, 
All Fouled Up. The tendency to reduce com- 
munications to a series of letters has even carried 
into domestic life. We know an efficient head- 
of-a-family who used to telephone home just as 
he left his office to deliver the command, “PMC,” 
and the wheels would begin to turn at home in 
anticipation of his arrival. This worked fine as 
long as he drank only coffee, because even his 
youngest child could comprehend this cryptic com- 
mand, “Pour My Coffee.” As he rose in the 
world, his tastes became more expansive and 
expensive, and an alternate translation appeared, 
“Pour My Cocktail(s).” Finally, when he went 
on a reducing diet and “Peel My Carrots” was 
added to the reasonable interpretations, things 
became so chaotic that he had to revert to impera- 
tive sentences rather than initials—like ordinary 
inefficient folks. Thus ends one success story. 

Now this BMD business, which insidiously 
entered our lives via an innocent conversation, 
has to do with success in another way. It is a 
criterion of success. You remember how in order 
to pick the man-most-likely-to-succeed in our 
class, we first strove for a definition of success. 
We settled for health, wealth and happiness, with- 
out thinking that we still had not arrived at an 
objective definition. In any event, many of us 
were sure that we were successful when we could 
go around with roseate cheeks, a smiling face, 
and a new Buick for house calls. This rotund, 
bourgeois concept of success was soon elbowed 
out by the unsettling information that a man was 
successful only when he had the prerogative of 
choosing the interior decorator who would do 
his office—at least junior partnership in the firm. 

Now this BMD came to us as a subheading of 
the interior decorative criteria of success when 
a friend of ours declared he was working for his 
BMD. We were unable to equate this with any 
degrees we’d heard of and were wondering wheth- 
er it had to do with a new telescoped type ,of 
Bachelor-Doctor of Medicine when he gave us the 
literal translation: Big Mahogany Desk. 

H. G. M. 


Allergy must now be considered as a clinical 
entity with its various phases integrated by known 
factors or implications. It is a specialty which 
must be correlated with all other specialties of 
medicine. There is a growing appreciation that 
allergy is wholly or partially responsible for so 
many diseases or symptom-complexes that it is 
expected to be met in the practice of the internist, 
pediatrician, dermatologist, otorhinolaryngologist, 
and general practitioner. They cannot escape from 
the responsibility of at least its recognition so that 
the patient may be referred to a properly trained 
allergist or they must become trained in the 
specialty themselves. 

The primary allergic diseases, asthma and hay 
fever, afflict approximately 10 per cent of the 
total population, making this category of chronic 
diseases third in prevalence in the United States. 
We must also recognize that the mechanism of 
hypersensitivity is responsible for plant derma- 
titis, urticaria, eczema, allergic headache, allergic 
evidence of infectious diseases, rheumatic fever, 
serum sickness and drug allergies, thus making 
the incidence of allergy much higher. 

Allergy in industry is becoming a serious prob- 
lem, and many manufactured products now cause 
important allergic diseases. Allergic reactions to 
our modern drugs, particularly to antibiotics, are 
mounting to alarming proportions and becoming 
a very serious problem. Allergy today is a social 
problem, extending from birth to old age. 

Certification, in itself, in internal medicine and 
pediatrics does not indicate that a physician is 
qualified for the diagnosis and treatment of 
allergic disease. The extremely small number of 
physicians subcertified in allergy attests to this. 
There are only seventeen AMA-approved institu- 
tions in the United States which train residents 
and fellows in allergy. A well-organized Ameri- 
can Foundation for Allergic Diseases is now 
carrying on these functions of teaching and re- 
search. The impact of allergy on medicine must 
be strengthened by the education of physicians 
and the public alike. 

Frep W. Wirtticyu, M.D. 


The medical profession should be very familiar 
with the American concept of profitable produc- 
tion; namely, that the units of production mul- 



tiplied by the price per unit produced, less the 
cost to produce, means the eventual profit. 

Farmers, like doctors, live and progress on 
profits. They do not live off just price or produc- 
tion. Farm production is subject to the vagaries 
of the weather, varies from year to year and from 
locality to locality. Farm prices should be allowed 
to flex in line with needed production, in order 
to keep down price depressing surpluses on the 
one hand and to stimulate needed production on 
the other hand. This is the basic concept of our 
free enterprise system. 

Since in the late 1930’s, the government has 
been trying artificially to peg prices to farmers 
in order to insure a measure of farm stability. 
In times of full farm production and reasonable 
costs, artificially pegged high farm prices bring 
high prosperity to farmers. On the other hand, if 
artificially pegged high prices create surpluses 
which force production cuts and higher costs, the 
farmers actually receive less net income. This is 
what has happened in agriculture within the last 
several years. 

Cotton producers and tobacco producers voted 
and accepted high government prices and took 
acreage cuts in return. These cut-out acres went 
into wheat, corn and feed which in some cases 
were also price-supported too high, and the results 
were surplus produce and acreage cuts. 

Today, we are witnessing the confusion of 
government interference in agriculture. Some 
commodities are artificially high priced above 
market demand and are causing ceiling prices and 
restrictions. Other commodities are supported 
flexibily and are feeling the effects of the spill- 
over of acreage cuts of high supported crops. 
Feeders and dairymen are feeling the effects of 
governmentally determined high feed costs, while 
their products are allowed to drop. Butter must 
drop because it is too high for its competition or 
continue to loose its market. If the socializers 
and communizers wanted to create confusion in 
agriculture, they couldn’t have done a better job. 
Or maybe the boys that wrote and policed the 
bills did know what they wanted to do. 

I hope physicians won’t buy such government 
paternalism. Perhaps we can all work together to 
get back to the real system. 

J. DELBERT WELLS, Secretary 
Minnesota Farm Bureau Federation 




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Loss of hearing in children is of two main 
types: (1) middle-ear dysfunction, which is often 
preventable, and (2) nerve dysfunction, for 
which no prevention or cure exists at present. 

The Committee on Conservation of Hearing of 
the Minnesota State Medical Association con- 
ducted a survey of school children in the state. 
As a result, 1,028 children were reported to have 
loss of hearing sufficient to be a handicap in school 
and later life. Only 175 of these were under 
treatment or in special schools. 

The committee prepared a brochure that has 
been mailed to all physicians in Minnesota. This 
brochure presents a concise digest of present 
opinion in the fields of treatment for loss of 
hearing, training of the deaf child and selection 
of a hearing aid. It should be filed in an available 
location by all physicians. 

The Minnesota Department of Health is co- 
operating in the project by mailing letters to the 
parents of children discovered by the survey. 
Parents are advised to seek medical advice for 
diagnosis and for therapy or rehabilitation of the 
handicapped child. 

This program demonstrates the close co-opera- 
tion between organized medicine and public health 
agencies. Further co-operation by individual phy- 
sicians is required to carry the project to a suc- 
cessful conclusion. With the information pro- 
vided, every physician can give valuable advice 
to the parents of children handicapped with 
respect to hearing. 

K. M. Stmonton, M.D. 


dt is axiomatic that the earlier the diagnosis 
of an ailment, the better the prognosis for great- 
er comfort, for prolongation of life and for 
cures. It is unfortunate that in some diseases, 
such as cancer, a diagnosis is quite impossible 
until the condition is fairly well advanced. 
Diabetes is one disease in which a correct diag- 
nosis can be made quite simply. It can be sus- 
pected without the patient’s even visiting the 
doctor, by having the urine examined for sugar. 
If glycosuria is present, then more careful tests 
can be made to establish definitely the presence 
or absence of the disease. Because of this sim- 
plicity for mass detection, diabetes detection 
drives have been instituted all over the country. 

May, 1955 


Through this procedure, a possible one million 
diabetic persons might be found and placed under 
proper supervision and control. 

The more recent introduction of the St. Louis 
Dreypak strip has simplified the entire procedure. 
The strips, after having been immersed in the 
urine and dried, can be sent through the mail to 
the laboratory with practically no inconvenience 
to the patient. Every community should arrange 
for the simple facilities necessary to carry out 
this procedure. From this center, the results may 
be transmitted to the patients. Such an arrange- 
ment should prove very simple and inexpensive. 
The co-operation of the medical profession in the 
Diabetes Detection Week conducted by the Ameri- 
can Diabetes Association will help establish excel- 
lent public relations between the medical profes- 
sion and the community. 

In the Diabetic Detection Drive in Minneapolis 
in November, 1952, 32,063 specimens were ex- 
amined, of which 657 (about 2 per cent) were 
found to be positive for sugar. Of these persons, 
further tests proved that 40 per cent were truly 
diabetic, and they were advised to consult their 
doctors for management and control. 

Moses Barron, M.D. 
Governor, Minnesota District 
American Diabetes Association 


These days all of you have to contend with the 
problem of deciding how long records and other 
valuable documents should be retained. You are 
concerned with keeping not only those records, 
documents and papers necessary for the protec- 
tion of your interests in the ordinary administra- 
tion of living but also those which are necessary 
as a result of your professional practice. 

Quite apart from the maintenance of files with 
respect to the treatment of patients, as to which 
you may have some kind of moral obligation, 
there is the possibility that at a future date you 
may be called upon in a proceeding in court or 
elsewhere to present your records for the purpose 
of verifying and establishing what has or has not 
been done. It is impossible to enumerate all of 
the instances in which a physician’s records may 
be required. There may be occasions where it 
will be of value for you to use records merely to 
refresh your recollection as to whether you were 



in or out of the city on a particular date. It is 
quite possible that at some time you will be called 
upon to explain and even justify the method of 
treatment employed in a particular instance. Al- 
most surely, you will be called upon at some time 
to explain the extent and nature of your income 
and of your deductions for income tax purposes. 

As a rule of thumb, it seems desirable that 
account books and all other records reflecting 
income and expenditures should be kept until 
January first of the eighth year after the year to 
which they pertain. If a creditor attempts within 
that time to assert that a bill has not been paid, 
you will have your records available to dispute 
him. Or if the tax collector has some question 
as to the proper tax liability for a given year, the 
correct data will be available for his perusal and 
for use in court, if necessary. 

Deeds, mortgages, leases and other documents 
pertaining to real estate are seldom of burden- 
some volume and should be retained indefinitely. 
A minimum tax file should be kept for an indef- 
inite period. This should contain not only the 
returns but also sufficient supporting evidence to 
establish your income and your deductions. Papers 
having no particular present interest may be 
destroyed when their usefulness has been served. 
In this class fall expired policies of insurance 
where no loss has occurred (other than liability 
insurance), cancelled savings account books, con- 
tracts which have been fully performed, and 
similar documents. As to checks and records 
pertaining to items which do not have tax conse- 
quences, the eight-year period seems to present 
only reasonable risks, if any. 

Of course, in any unusual situation, you will 
want to consult your lawyer because of the obvi- 
ous danger that the general rule may not cover 
the particular situation. 

Rovanp J. Faricy, Attorney 
Saint Paul, Minnesota 


Initial treatment of the primary lesion in cancer of the 
tongue and floor of the mouth seems to be best accom- 
plished by radiation therapy, Dr. C. L. Ash, of Toronto, 
Canada, has concluded. 

Dr. Ash presented his conclusions, based on a five- 
year study of thirty-nine patients with cancer of the 
tongue and ninety-five patients with cancer of the 
mouth floor, in a recent (April, 1955) issue of the 
American Journal of Roentgenology, Radium Therapy 
and Nuclear Medicine. 


The Canadian radiation specialist is associated with 
the Ontario Institute of Radiotherapy and the Depart- 
ment of Radiotherapy in the Toronto General Hospital. 

“In general, the secondary lesions of the oral cavity 
developing in the lymph nodes of the neck are most 
adequately treated by radical surgery,” Dr. Ash said. 

He admitted, however, there are certain exceptions to 
this rule. 

“The patients we treated represent all the various 
forms of radiation therapy—radium in the form of 
molds, needles, radon seeds, teleradium therapy, or 
roentgen rays of 200 to 400 kv., as well as intraoral 
roentgen rays generated at &8 to 200 kv.” 

His overall results showed a 49.9 per cent “control’”— 
that is, a total of five years with the lesion healed—for 
cancer of the tongue and 38.7 per cent control in cancer 
of the mouth floor. 

However, in the early cases of tongue cancer, there 
was 67.0 per cent control—as compared with 32.3 per 
cent control among the late cases. 

In mouth-floor cancer, there was 49 per cent control 
in the early group and 26.2 per cent in the late. 

“Better results appear to attend the use of radium, or 
a combination of interstitial radium and roentgen rays, 
than is the case when external therapy is used alone,” 
Dr. Ash said. His conclusion: 

Studies at present are being made as to the value 
of extending the field of surgery in the so-called radia- 
tion “failures’—particularly when initial treatment has 
failed and the lesions remain localized. 


The wide differential in temperature between summer 
climates and some air-conditioned interiors poses a pos- 
sible health question. “The chief difficulty centers about 
the ‘comings and goings’ of occupants of this artificial 
climate.” In winter, the human body becomes adjusted 
so that persons leaving interiors heated to about 80 de- 
grees (Fahrenheit) can enter a near-zero environment 
with only the addition of an overcoat and hat. In sum- 
mer, however, moving from air-conditioned environments 
with relatively low temperatures into exteriors of high 
temperatures may result in a condition of “thermal 
shock.” The ideal solution of a three to four stage tran- 
sition is unfortunately impractical. “Under the circum- 
stances described, much may be accomplished by cloth- 
ing adjustments. In many air-conditioned spaces, par- 
ticularly if there is excessive air motion, added gar- 
ments are necessary, especially among women. The 
divestment of these garments aids the physiological state 
on re-entering the hot outer air. Humidification of the 
air is less important to health than was earlier con- 
tended. As to comfort, the degree of humidity may be 
more important but still is not fundamental. Some in- 
vestigators, with respect to air conditioning in summer, 
advise merely dehumidifying the air to a low point with- 
out effort to lower temperatures, but this may give 
rise to an unpleasant sense of chilling owing to increased 
evaporation. In any event, a humidity between 40 and 
60 per cent is regarded with favor.”—QUERIES and 
Minor Notes: Air conditioning, Journal of the Amer- 
ican Medical Association (157:1265 (April 2) 1955. 


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Medical Economics 


After three months of the 84th Congress, the 
American Medical Association has published a 
summary of the status of federal legislation of 
interest to the medical profession. More than 200 
medical-interest bills are being followed by the 
Washington Office of the AMA, and also con- 
sidered are pertinent testimony before commit- 
tees, committee actions, and all available informa- 
tion on future plans and objectives of the Ad- 
ministration and Congress. An early April issue 
of an AMA Washington Office Special Report 
reviews current status of legislation under several 
categories : 


Legislation provides an initial $25 million to 
start a trust fund that would be maintained by 
percentage payments from premiums of partici- 
pating health insurance plans. The fund would 
reimburse voluntary health insurance plans (com- 
mercial and nonprofit) for abnormal losses in 
extending coverage and expanding benefits. This 
is on the “must list” of the Administration’s 
health and medical care program. No hearings 
had yet been scheduled in early April. 

According to the Report: 

“While endorsing the stated purposes of the bills (to 
promote the best possible medical care on reasonable 
terms), the American Medical Association again op- 
poses the proposal on the grounds that (1) extensive 
private funds are available within the insurance indus- 
try for such purposes, (2) reinsurance doesn’t provide 
a means for making insurable what otherwise would be 
an uninsurable risk, (3) it will not fulfill its intended 
Purpose and might even inhibit the satisfactory progress 
made to date by voluntary plans, and (4) it is a poten- 
tial subsidy.” 

Mortgage Guarantee 

For a fee, this legislation would guarantee up 
to 95% of private mortgages for construction 
of non-government health facilities, to be owned 
and operated for profit or on non-profit basis. 

May, 1955 

Edited by the 
Committee on Medical Economics, 
Minnesota State Medical Association 

George Earl, M.D., Chairman 

The mortgage could not exceed 80 per cent of 
the estimated value of the project and equip- 
ment, and maturity could not exceed thirty years. 
The guarantee would apply to refinancing, as 
well as to new construction and modernization. 
Hearings are to be scheduled. 

The AMA Report states: 

“The Association (AMA) is actively opposed to this 
legislation on grounds that (a) private financing is meet- 
ing the need, and (b) the proposal represents intrusion 
by the federal government into a field where government 
help is not required.” 

Mental Health 

The Administration wants a new five-year pro- 
gram of increased grants to states on a need- 
population-per-capita-income formula to help 
maintain and improve mental health facilities, 
to stimulate special projects, and to train more 
personnel. Several bills for grants to finance a 
three-year survey have been introduced, and an- 
other to create a permanent federal commission 
on mental health, which would study the problem, 
make recommendations and attempt to co-ordinate 
all work in this field, private as well as govern- 
ment. These proposals have made the most 
progress of all health bills, and the former, both 
in the House and Senate, are expected to reach 
the floor. 

AMA policy on this matter is: wholehearted 
support of the survey bill, also favoring the Ad- 
ministration bill, but only as a temporary measure 
until Congress has been able to redefine the fed- 
eral and local areas of responsibility in public 
health matters. The Report states: “This interest 
in mental health problems dates back to the found- 
ing of the AMA more than a century ago.” 

Federal Aid to Medical Education 

Plans for federal aid to medical education 
range from “one-shot” construction grants to 
outright operating aid for schools increasing en- 
rollment. Most prominent in this Congress are 
identical bills in the House and Senate, providing 
a five-year $250 million program of construction, 



expansion, modernization, and maintenance grants 
to new and existing schools. Hearings should be 
scheduled shortly. 

According to the Special Report: 

“The Association favors one-time construction, reno- 
vating and equipment grants to medical schools on a 
matching basis similar to the Hill-Burton formula, but 
opposes federal grants for instruction or continuing 
grants for operation or maintenance. It approves the 
Hill-Priest bill, providing some specific changes are 
made in line with the above policy. It opposes the Burn- 
side bill, until he accepts changes that have been sug- 
gested to him.” 

Doctor Draft and Military 
Medical Scholarships 

The Doctor Draft extension bill would con- 
tinue the present act for another two years be- 
yond July 1, 1955. Under the scholarship bill, 
the government would pay up to $133 a month, 
plus tuition and fees. Students would be obligated 
for three years’ active duty if the scholarship 
was for a year or less, and four years if for more 
than one year. 

The Doctor Draft provision is expected to come 
up this session, but hearings had not been sched- 
uled in early April. The scholarship bill is an 
official Administration measure, and is planned 
for consideration before the Doctor Draft act. 

The AMA policy on the above is described as 
follows : 

“When there was a proven need for it at the start 
of the Korean War in 1950, the Doctor Draft was sup- 
ported by the AMA. The AMA also supported one 
extension of the law. Now, in the face of the Defense 
Department’s request for another (and peacetime) ex- 
tension, the AMA’s policy is unchanged. If it can be 
demonstrated that there is a continuing need for the 
act, the AMA will support the extension. Evidence 
so far presented has not established the need. The De- 
fense Department admits the regular draft obligation 
will supply it with the young physicians it needs, but 
says that the Doctor Draft is required to bring in more 
experienced men with special skills and administrative 
ability. Without these, the Department insists, the mili- 
tary medical services cannot be maintained during the 
next two years. The AMA believes the services could 
do a great deal more to build up their regular Medical 
Corps and to make more efficient use of the experienced 
men now in uniform.” 

Regarding the military scholarships, the AMA 
supports the scholarship idea, provided that (1) 
a student not be approached by the military until 
he is fully matriculated in the medical school, 


(2) no student so selected receive any preferen- 
tial treatment, and (3) number of military 
scholarships in a school not exceed 5 per cent of 
any year’s class or the total enrollment. 

Military Dependents 

The present program of medical care for mili- 
tary dependents is irregular, Legislation would 
substitute a plan that would (a) apply a uniform 
definition of dependents to all services, (b) make 
all dependents eligible for the same amount of 
treatment, and (c) offer relatively the same de- 
gree of care regardless of residence of the depen- 
dents. Uniformed physicians and military hospitals 
would take care of all dependent patients within 
limitation of resources. The Secretary of Defense 
could set a token fee schedule to be charged de- 
pendents in military facilities. 

No hearings had been scheduled at the re- 
lease of the AMA Special Report. Two identical 
bills have been introduced in the House and 
Senate, and it is felt that the Administration will 
support some kind of change in the present law. 

The AMA has no argument with the military 
services on most provisions of the Defense De- 
partment bill, but is unalterably opposed to one 
part of it: “Whereas the Administration thinks 
the military medical departments should care for 
all the dependents they can handle, the AMA 
feels that dependents, like other civilians, should 
be treated by private physicians and in private 
hospitals unless these private facilities are inade- 
quate. In the latter case it would be the military's 
responsibility to care for dependents.” The AMA 
is working on a set of guiding principles to pro- 
pose for amendment when the bill is brought 


There seems to be little evidence that Congress 
will act on the Jenkins-Keogh-Ray type of bills 
this session. The Treasury Department has 
studied some of the proposals, but the Adminis- 
tration is not supporting any. 

The purpose of the Jenkins-Keogh and Ray 
bills is broadly the same: “namely,” according 
to a recent issue of the AMA Journal, “to en- 
courage but not compel saving for retirement by 
the self-employed and by employed persons whose 
employers have not established pension and/or 
profit-sharing plans for them . . . Both bills make 


cent of 

r mili- 
) make 
unt of 
ne de- 
ed de- 

he re- 
e and 
mn will 
it law. 
se De- 
to one 
ire for 
O pro- 

f£ bills 
t has 


1 Ray 
to en- 
ent by 
nd /or 
, make 



special provisions—past service credits—for those 
older self-employed and pensionless employed 
persons who have not had the benefit of tax de- 
ferment during the early and middle parts of 
their working lifetimes.” 

The American Medical Association supports 
all these bills, including medical expense deduc- 
tion bills, but among the tax deferment proposals 
it prefers the Jenkins-Keogh approach. 


The National Board of Medical Examiners has 
released general information on taking national 
board examinations, which should be of value to 
many physicians. The National Board is a volun- 
tary and unofficial examining agency, the purpose 
of which is to “prepare and to administer qualify- 
ing examinations of such high quality that legal 
agencies governing the practice of medicine with- 
in each state may at their discretion grant success- 
ful candidates a license without further examina- 
tion,” their publication states. 

The National Board certificate is accepted as a 
suitable qualification for the practice of medicine 
by forty-one licensing authorities in the states, 
the District of Columbia, Hawaii and Puerto 
Rico, Minnesota is one of these states. 

The examinations are divided into three sepa- 
rate parts, I, II and III which must be taken and 
completed in numerical sequence. Examinations 
are held in February and June at medical schools 
in the U. S. and Canada; an additional examina- 
tion in Part IT is held in April and an additional 
examination in Part I in September. 

Who Is Eligible? 

The National Board admits to its examinations 
any student in or graduate of approved medical 
schools in the United States and Canada. A can- 
didate is eligible for Part I when he has com- 
pleted the first two years of work in an approved 
medical school; eligibility for Part II calls for 
successful completion of a four-year medical 
course in an approved medical school; a candi- 
date is eligible for Part III if he has passed 
Parts I and II, received a degree of doctor of 
medicine, and served at least one year in an ap- 
proved hospital internship. 

May, 1955 

Advantages Named 

In its recent publication, the National Board 
examination advantages are outlined as: 

“Because the answer sheets are machine scorable, the 
grading can be accomplished rapidly, accurately, and 
impartially. With this type of examination, it becomes 
possible to determine the level of difficulty of each 
test and to maintain comparability of examination 
scores from test to test and from year to year for any 
single subject. Moreover, of even greater long-range 
significance is the facility with which the total test 
and individual questions can be subjected to thorough 
and rapid statistical analyses, thus providing a sound 
basis for comparative studies and for continuing im- 
provement in the quality of the test itself.” 

Further advantages result from the fact that 
these examinations are set up in three parts, the 
Board states, and may be taken during the course 
of training in the medical school when the stu- 
dent is fresh from his preparation in the various 
subjects included in the medical curriculum. 

Preparation of Examinations Noted 

The summary of examinations by the National 
Board publication states that approximately a 
year goes into the preparation of each examina- 
tion. Each committee member thoughtfully and 
laboriously writes test questions selecting that type 
best suited to a particular point. Each question is 
then subjected to the critical review of the other 
members of the committee; any doubtful item is 
revised or discarded. It concludes: “Hence, each 
examination contains only material that has been 
thoroughly worked over and agreed upon as ap- 
propriate, free from ambiguity and representative 
not only of important aspects of a subject, but 
also of high standards of medical education.” 

In 1902, Charles Richet, a French physician, theorized 
that an inoculation of a given protein in animals would 
produce a hypersensitivity to that protein. He termed 
this process “anaphylaxis,” derived from the Greek ana, 
meaning “backward,” and phylaxis, meaning “protec- 
tion.” The term, then, refers to the reverse of “prophy- 
laxis,” or a state of increased susceptibility to a drug 
protein or toxin following administration of the drug.— 
Wain, H.: The story behind the word, Ohio State 
Medical Journal 51:362 (April) 1955. 



The word “iatrogenic” comes from two Greek 
words meaning “physician and producing”—actu- 
ally generated by the physician. It is a term ap- 
plied to disorders induced in the patient by auto- 
suggestion, resulting from the manner in which 
the physician conducts his examination, and what 
he tells the patient. 

Today, when there appears to be such a great 
increase in the incidence of coronary arterio- 
sclerosis with coronary occlusion and myocardial 
infarction, everyone is aware of this growing 
menace to life and health. 

Consequently, more than ever before, people 
with any pain or abnormal feeling in the left chest 
seek medical advice to learn how serious this 
symptom may be. If the doctor, after a brief his- 
tory and physical examination, finds a regular 
heart of normal size and a normal blood pressure. 
and tells the patient, “I find nothing wrong, but 
you'd better be careful at your age,” or, “I find 
nothing wrong, but you'd better take a little 
digitalis and avoid doing anything strenuous,” 
then he is is likely to generate “iatrogenic heart 

Actually, when a doctor gives such advice, he 
is “straddling.” He is not entirely sure himself. 
and so, should this patient later develop actual 
organic heart disease, he wants to be able to say, 
“You see I was right. I warned you.” 

When any person first comes to a physician 
complaining of a pain or an ache in his left chest 
that physician is charged with a very grave re- 
sponsibility for making the right diagnosis and 
for telling the patient, at once, he has or he does 
not have heart disease. 

The first contact with such a patient is most 
important, because how the doctor conducts him- 
self may determine success or failure in handling 
the case. He must sit quietly with the patient 
and take plenty of time to obtain a complete 
history of his chest pain or ache. When did 
it begin—day or night? What was its relation 
to exertion, to rest, to anxiety? Was there any 
antecedent exhausting illness? Was there a recent 
bereavement, or grief over the death of a loved 
one? If such a death were sudden and from a 
heart attack, does this patient fear that he, too, 
may be so stricken? 

Has there been a series of strains and anxieties 
in the mother of a large family, with many ill- 
nesses and many nights of broken sleep? Has 



Saint Paul, Minnesota 

there been a recent “bout” of upper respiratory 
tract infection or a tonsillitis or a pleurisy? 

Inquiry into all of these factors will point to- 
ward the diagnosis of either organic heart disease 
or a functional heart disturbance, such as a ner- 
vous heart. 

The next step is a complete physical examina- 
tion with clothes removed. This should include 
pupillary reactions, examination of the oral 
cavity, palpation of the thyroid gland, examina- 
tion of the lungs, determination of the heart 
borders and auscultation of the heart, determina- 
tion of blood pressure, examination of the abdo- 
men, rectal examination, study of the reflexes, 
a check for edema of the shins, temperature of 
the body, and examination of urine and blood. 

Next follows the examination of the heart after 
exercise, using such a simple test as twenty hops 
on one foot and twenty hops on the other foot, 
noting the height of the pulse and the blood pres- 
sure and the time of their return to normal. 

Then, and not till then, comes the observation 
of the heart and lungs under the fluoroscope, 
study of the heart silhouette from a 6-foot heart 
film, and reading of the electrocardiogram. 

If all of these examinations and tests have pro- 
duced normal responses, then and only then, can 
the examining physician be justified in telling the 
patient that he does not have any heart disease at 
all, that the dull ache in his left chest and the 
palpitation of his heart when he gets into bed at 
night are “fear reactions,” because fear tends to 
pour extra adrenalin into the blood stream, and 
it is this extra adrenalin that makes his heart 
slam and bang against his ribs. 

Tell him that the symptoms of organic heart 
disease are relieved by the horizontal position. 
that the pain of organic heart disease is not a 
dull ache, but a sharp stabbing pain, which passes 
with rest or standing still. 

Tell him that a dull ache in the left chest is 
frequent in people with a nervous heart. 

Look for other associated nervous signs, such 
as light headedness, trembling, sweating and an 
abnormal tendency to sigh. 

Tell him that exercise is good for people with 
nervous hearts and that they should walk erect 
and breath deeply. 

Do not ever hedge—tell him yes or no. And 
if he has no organic heart disease, tell him to do 
normal things and to lead a normal life. But 
whatever you tell him, be definite. 


} M.D. 


nt to- 
1 ner- 




Reports and Announcements 



TION, annual meeting, Minneapolis, May 23-25, 1955. 

Minnesota Academy of Occupational Medicine and 
Surgery, annual meeting, Minneapolis Athletic Club, 
May 2, 1955. 


American Association of Blood Banks, eighth annual 
meeting, Palmer House, Chicago, Illinois, November 
19-21, 1955. 

American Cancer Society, Board of Directors and 
special committee meetings, Hotel Radisson, Minne- 
apolis, June 2, 1955. 

American Medical Association, annual meeting, At- 
lantic City, New Jersey, June 6-10, 1955. 

American Proctologic Society, annual meeting, Hotel 
Statler, New York, New York, June 1-4, 1955. 


International College of Surgeons, twentieth anniver- 
sary congress, Palais Du Conseil General, Geneva, 
Switzerland, May 23-26, 1955. 

International Hospital Congress, Lucerne, Switzer- 
land, May 30-June 3, 1955. 

International College of Surgeons, Cape Cod regional 
meeting, Chatham Bars Inn, Chatham, Massachusetts, 
July 1-4, 1955. 

International Symposium on Enzymes: Units of Bio- 
logical Structure and Function, Henry Ford Hospital, 
Detroit, Michigan, November 1-3, 1955. 


The American Academy of General Practice is allow- 
ing twenty hours of informal credit to its members who 
attend the medical sessions of the annual meeting of the 
National Tuberculosis Association and its medical sec- 
tion, the American Trudeau Society. The sessions will 
be held in Milwaukee, Wisconsin, May 22 through 27. 

Further information may be obtained from the Min- 
nesota Tuberculosis and Health Association, 614 Port- 
land Avenue, St. Paul, Minnesota. 


At the sixty-eighth annual session of the American 
Association of Anatomists, held at the Jefferson Medical 
College, Philadelphia, April 6 through 8, Dr. Edward 
A. Boyden, University of Minnesota professor emeritus 
of anatomy, was named president-elect of the organiza- 
tion. He will take office in April, 1956. 

Dr. Boyden, who retired as head of the University of 

May, 1955 

Minnesota’s anatomy department in 1954, is currently a 
visiting professor of anatomy at the University of Wash- 
ington, Seattle. 


The formation of the Minnesota Chapter of the 
Arthritis and Rheumatism Foundation was completed in 
Minneapolis on April 13 with acceptance of a charter 
from the national foundation. Elected as officers of the 
organization were Dr. Charles Slocumb, Rochester, presi- 
dent; Dr. Macnider Wetherby, Minneapolis, first vice 
president, and Dr. Cecil J. Watson, University of Min- 
nesota Medical School, second vice president. 

Executive secretary of the chapter is R. V. Stevenson, 
with offices at 89 South Tenth Street, Minneapolis. 

Purpose of the foundation is to fight arthritis and 
rheumatism by working for establishment of free clinics 
for treatment and to provide for research through estab- 
lishment of scholarship and laboratory grants. 


The St. Louis County Medical Society held a meeting 
at St. Luke’s Hospital, Duluth, on April 14. Principal 
speakers at the meeting were Dr. William B. Martin 
and Dr. Kenneth A. Storsteen, both of Duluth. They 
discussed the diagnosis and treatment of hyperthyroid- 
ism, using radioactive substances. 


Recently elected as officers of the Minnesota Ob- 
stetrical and Gynecological Society were Dr. Leonard A. 
Lang, Minneapolis, president; Dr. Rodney F. Sturley, 
St. Paul, vice president, and Dr. Edward A. Banner, 
Rochester, secretary-treasurer. 


The Minnesota Society of Neurology and Psychiatry 
will meet at the Mayo Clinic, Rochester, Minnesota, on 
May 21. 

Surgical clinics will be held at St. Mary’s Hospital 
at 8:00 a.m., followed by presentation of papers at 
10:00 am. Papers to be presented are as follows: 
“Chloropromazine and Reserpine in the Treatment of 
Chronically Ill Mental Patients,’ by Dr. M. C. Petersen 
and Dr. C. W. Baars. “Hormones and Psychoses,” by 
Dr. Howard P. Rome. “Investigation of Environmental 
Factors in Schizophrenia,” by Dr. Peter Beckett and 
Dr. Jane Watson. 

Luncheon will be served at the Foundation House at 
12:30 p.m. Principal speaker at the luncheon will be 
Dr. J. H. Tillisch, who will discuss “The History of 
the First Minnesota Regiment in the Civil War.” 


oun a, ee 


Medical Foundation 

beds Your , / 

1) To promote the welfare of the medical School 
of the University of Minnesota 

2) To improve the undergraduate, graduate ‘and 
research functions of the Medical School 

To establish scholarships, lectureships, 
professorships, research and student loan funds 

To publish a weekly bulletin 

To advance the interests of the University of 
Minnesota Medical School and its alumni 

The Minnesota Medical Foundation is desirous of obtaining the support of all 
members of the medical profession in this area. The Weekly Bulletin is a major 
project of the Foundation. It is an expensive undertaking and a fund must be 
accumulated to insure continued publication. All members of the Foundation 
automatically receive the Weekly Bulletin of the University of Minnesota Hos- 
pitals and The Minnesota Medical Foundation. 

Annual. ... . . .$ 10.00 per year Minnesota Medical Foundation 
Contributing . . . . . 25.00 per year 1342 Mayo Memorial Building 
Sustaining. . . . . . 100.00 per year University of Minnesota 
Patron. . . . . . . 1000.00 or more Minneapolis 14, Minnesota 

(Membership dues and contributions are tax deductible) 



Woman’s Auxiliary 


Mrs. H. F. Wahlquist 

A needless cause of embarrassment to many wives of 
physicians is not knowing how to explain to many people 
just what World Medical Association and World Health 
Organization mean. Each of us has a vague idea of 
what these two organizations represent—we know they 
are organized for health purposes, but we lack knowledge 
df their basic principles, and their differences. Perhaps 
circumstance has really never made it imperative that we 
study and ferret out facts about their organizational 
structure and purposes. 

Constantly, I am hearing some one refer to WMA 
when she means WHO and vice versa. As wives of 
physicians, we must know more about these two organi- 
zations. They are both related to medicine, and yet both 
are basically different. Perhaps one of the most basic 
differences is that WMA is made up of physicians; 
WHO of technical representatives of member states. 
As wives of physicians, we need to know more than this! 

In these few brief paragraphs, I shall attempt to 
clarify the purpose of each organization and in later 
comments describe the organizational structure and 
functions of each. 

The World Medical Association (WMA) and World 
Health Organization (WHO) are two international 
organizations. The WMA is non-governmental; it is an 
organization of national medical associations and its 
members are solely physicians. I say “solely,” for in the 
United States a WMA U. S. Committee, Inc., of which 
other citizens may become a member, has been formed. 
The WHO is inter-governmental; it is a branch of the 
United Nations and represents the governments of the 
world in the field of health. It is a specialized technical 
agency of the United Nations system, but under a sepa- 
rate treaty with membership independent of membership 
in the United Nations and with its own governing 
assembly. The WHO is supported entirely by govern- 
ment funds. The WMA is supported by dues and volun- 
tary contributions. 

When the Constitution of WHO was written in 1946, 
specific functions were assigned in three general cate- 
gories : 

l. Functions relating to international sanitary regula- 
tions, causes of death, nomenclature of diseases, new 

2. Coordination of health activities of governments 
for the eradication of epidemic and endemic diseases, the 
Promotion of research in fields of public health and the 
Promotion of improved standards in the medical and 
telated professions. 

3. Assistance to governments in strengthening national 
health services, furnishing technical assistance, promo- 

May, 1955 

tion of improved housing, nutrition and sanitation and 
the promotion of maternal and child health. 

Its real objective is to aid in the long term solution 
of a country’s health problems through strengthening 
the national health service, rather than developing 
Specific programs. 

The World Medical Association aims to promote 
closer ties among the national medical organizations and 
thus among the physicians of the world. It seeks to serve 
as a forum for discussion of mutual problems. Its aim 
is to disseminate information and to raise the standards 
of health, medical education and medical care throughout 
the world. Through its officers, it can present the points 
of view of the medical profession before other interna- 
tional bodies; as WHO, UNESCO, giving physicians 
a voice in international affairs when matters of medicine 
and health are discussed. Perhaps the most significant 
of its aims is to work toward world peace. 

(Parts II and III will appear in succeeding issues.) 


Sponsored by the Clarkfield Community Hospital 
Auxiliary, a successful “Health Day” was held on Satur- 
day, April 2, in the High School Auditorium in Clark- 

Mrs. M. I. Hauge, first chairman of the hospital auxili- 
ary and state chairman of Today’s Health for the 
Woman’s Auxiliary to the Minnesota State Medical 
Association, served as chairman of a very active health 
day committee. 

The afternoon and evening programs included a talk 
on “Child Accidents” by Dr. A. B. Rosenfield, Minne- 
sota Department of Health, a talk on mental health by 
Rev. Fred Norstad, President, Citizens’ State Mental 
Health Association, and panel discussions on child health, 
the aging population and the new wonder drugs. Music 
and numerous information booths helped round out an 
excellent program to a large crowd from Clarkfield and 
the vicinity. 


Mrs. L. T. Simons 

Mrs. W. P. Gardner, president, called a board meeting 
on April 18 in the Medical Arts Library. Members made 
cancer dressings during and following the meeting. An- 
nual reports of all committee chairmen were presented 
and plans for the May meeting were discussed. 

Mrs. Duane Ausman and Mrs. E. R. Sterner, hos- 
pitality chairman and co-chairman, took reservations for 
the monthly luncheon meeting, held in the Commodore 
Hotel on April 25. Mrs. S. M. Loken, program chair- 
man, presented Dr. Clarence Rowe, assistant teaching 
professor in psychiatry at the University of Minnesota 
and director of the Hamm Memorial Psychiatric Clinic, 
who was the main speaker on the program. 


In Memoriam 


Dr. Rudolph A. Beise, Brainerd physician, died April 
4, 1955. He was seventy-eight years old. 

Dr. Beise was born in Medo, Minnesota, in 1877. He 
attended school in Mankato before going to the Univer- 
sity of Minnesota and Rush Medical School. He interned 
at Cook County Hospital in Chicago and started his 
practice in Brainerd soon afterward. 

During his active life, Dr. Beise participated in many 
civic affairs. He was mayor of Brainerd from 1915 to 
1919. He was a member and secretary of the Brainerd 
Park Board. In 1953, Governor C. Elmer Anderson 
selected him to represent Minnesota at the First Western 
Hemisphere Conference of the World Medical Asso- 

Dr. Beise was a vestryman of St. Paul’s Episcopal 
Church. He was a charter member of the Brainerd 
Rotary Club and served as its president from 1923 to 
1924. In 1951, the club held a testimonial dinner honor- 
ing him for his fifty years as a practicing physician. 

Dr. Beise was chief of staff at St. Joseph’s Hospital 
in Brainerd. He was a member of the Upper Mississippi 
Medical Society, the Minnesota State Medical Association 
and the American Medical Association. He was a Life 
Member of the State Association and a member of the 
“Fifty Club” ‘for doctors who have been in practice for 
fifty years. 

He is survived by his wife, the former Minnie Keller ; 
a daughter, Mrs. Ruth Louise Quanstrom, Brainerd; 
and a sister, Ida Beise, of Ada. 


Dr. Hubert T. Sherman, long in practice in southern 
Minnesota, died March 23, 1955, in Cambridge. He had 
been a medical staff member at the Cambridge state 
school and hospital since 1944. 

Dr. Sherman was born at Wykoff, Minnesota, in 1879. 
He attended high school at Minneapolis Central and 
continued his education at Hamline University and the 
Minneapolis College of Physicians and Surgeons, grad- 
uating in 1904. 

Dr. Sherman practiced in several Minnesota locations, 
spending brief periods of time at Becker, Minneapolis, 
Grand Meadow, Bellingham and Echo. He spent many 
years in practice at Big Lake, Franklin, and Plainview. 

While at Plainview, Dr. Sherman served as President 
of the Wabasha County Medical Society. He was a Life 
Member of the Minnesota State Medical Association 
and was a member of county societies where he was 


He is survived by his wife, Rachel; three daugliters, 
Mrs. Will McCoy, Rock Falls, Ill, Mrs. Clifford Kast, 
Aitkin, Minn., and Mrs. Roy Peterson, Mahtomedi: three 
sons, John and Hubert, both of Minneapolis, and Roy, 
of Albuquerque, New Mexico; a sister, Mrs. H. E. Hart, 
Long Prairie, Minn.; eleven grandchildren, and three 


Dr. James C. Ferguson died April 17, 1955, at the age 
of seventy-nine. He had practiced medicine for over 
fifty years. ; 

Dr. Ferguson was born at Fort Totten in what was 
then the Dakota territory. He attended school in Coop- 
erstown, New York, the home town of his mother. He 
came west to attend the University of Minnesota, grad- 
uating in 1901. 

He combined his internship with work as a pathologist 
for St. Joseph’s Hospital in Saint Paul for several years 
and became a member of its staff. 

Dr. Ferguson served with the army during World 
War I, both in this country and overseas. He was a 
Life Member of the Ramsey County Medical Society, 
the Minnesota State Medical association, and a member 
of the American Medical Association. He was a charter 
member of the Minnesota Pathological Society and a 
member of the Association of Military Surgeons. In 
1951, Dr. Ferguson became a member of the “Fifty 
Club” of the Minnesota State Medical Association. 

He was active in Masonic affairs and was a life 
member of the Minnesota Historical Society. 

He is survived by his wife, Emily K.; three sons, 
James Cory of Lake Minnetonka and Robert Bruce 
and William Frederick of Saint Paul, and six grand- 

A sample survey of some 12,000 industrial firms, in- 
cluding manufacturers of chemicals and_ professional 
and scientific equipment, has been started by the Na- 
tional Science Foundation. Director Alan T. Waterman 
said the findings should be valuable to companies in 
planning and appraising their own research programs, 
“besides contributing greatly to the formulation of na- 
tional policies for research.” He estimated industry’s con- 
tribution to the total $3.5 billion national research and 
development effort at around $1 billion a year. The 
federal government, in addition, spends about $1 billion 
annually to support research and development in indus- 
trial laboratories. Survey plans were worked out in con- 
sultation with National Association of Manufacturers, 
Industrial Research Institute and other industry groups. 


| Kast, 
; three 
1 Roy, 
. Hart, 


he age 

it Was 
‘r. He 



was a 
and a 
is. In 


a life 


s, in- 
es in 
f na- 
; con- 
1 and 


Of General Interest 

Dr. Karl Lundeberg, Minneapolis health commis- 
sioner, has announced that Minneapolis ranks lowest 
in cities of 400,000 or more for reported cases of 
venereal disease in 1954. Minneapolis had a rate of 
18 cases of syphilis per 100,000 population. The high- 
est rate in the nation, reported in Washington, D. C., 
was 517 cases per 100,000. Similarly, Minneapolis had 
only 84 cases of gonorrhea per 100,000 population, 
compared to 1,400 per 100,000 in Washington. 

* *k * 

Among the speakers at a meeting of the fifth dis- 
trict of the Minnesota Society of X-Ray Technicians 
at Mankato on March 13 was Dr. J. W. Burnett of 
New Ulm. Dr. Burnett spoke on “Urinary Tract 

x ok * 

Dr. Henry W. Meyerding, Rochester, who retired 
in November, 1949, as professor of orthopedic sur- 
gery in the Mayo Foundation, has been elected an 
honorary member of the Turkish Surgical Associa- 
tion and an honorary fellow of the Philippine Col- 
lege of Surgeons. 

Dr. Meyerding recently completed an around-the- 
world tour by airplane. Countries he visited included 
Hawaii, the Philippines, Japan, China, India, Thai- 
land, Pakistan, Lebanon, Turkey, Israel, Greece, 
Italy, Iceland and France. Chapters of the Interna- 
tional College of Surgeons were installed and lectures 
were given at various universities and surgical meet- 

x ok Ok 

Dr. Henry E, Michelson, Minneapolis, has been 
invited to address the 1955 annual session of the 
Michigan State Medical Society in Grand Rapids, 
Michigan, on the subject, ‘““Dermatological Diagnosis 
and Treatment.” 

* * OK 

Dr. Wendell L. Downing, Le Mars, Iowa, a gradu- 
ate of the University of Minnesota Medical School in 
1919, has been named president-elect of the Iowa 
State Medical Society. Dr. Downing has been a 
member of the organization’s board of trustees and 
was chairman of it last year. In February he was 
elected president of the Sioux Valley Medical Society. 

K * * 

Principal speaker at a clinical conference at the 
Community Memorial Hospital, New Prague, on 
March 15 was Dr, Stuart W. Arhelger, assistant pro- 
fessor in the department of surgery at the Mayo 
Memorial Hospital, University of Minnesota. He dis- 
cussed the diagnosis and treatment of cancer. The 
clinical conference was one of a series sponsored by 
the Minnesota Department of Health, Minnesota 
State Medical Association, University of Minnesota, 
Minnesota Heart Association and Minnesota Cancer 

May, 1955 

Guest consultant at a clinical conference at the 
Kanabec Hospital, Mora, late in March was Dr. Paul 
Winchell, staff member of the Variety Club Heart 
Hospital at the University of Minnesota. He dis- 
cussed diseases of the heart. 

x k * 

Dr. H. H. Russ, Blue Earth, was guest speaker at 
a meeting of the Kiester Parent-Teacher Association 
at Kiester late in March. He spoke on cerebral palsy 
and showed a motion picture on the same subject. 
* * * 

Dr. Tray G. Rollins, formerly of Elmore and now 
located at Cass Lake, has been awarded a fellowship 
in dermatology at the Mayo Clinic, Rochester, effec- 
tive January 1, 1956, 

* * * 

Dr. E. L. Penk, Springfield, has been appointed to 
a three-year term as Springfield’s health officer. He 
replaces Dr. W. G. Nuessle, whose term of office 
has expired. Dr. Penk also heads the Springfield 
board of health. 


Fathers and expectant fathers heard Dr. Milton L. 
Kaiser, New Ulm, discuss the anatomy and physiol- 
ogy of reproduction and the responsibilities of 
fathers at a parent education meeting in New Ulm 
late in March. Two motion pictures on the subject 
were also shown. The session was the last in a series 
of parenthood classes sponsored by the Union Hos- 
pital at New Ulm. 

x * * 

Dr. Dale Cameron, medical director of the Min- 
nesota Department of Public Welfare, was the prin- 
cipal speaker at a meeting of the Minneapolis and St. 
Paul sections of the National Council of Jewish 
Women in St. Paul on April 4. Dr. Cameron spoke 
on mental health problems in Minnesota and the 
work of volunteers in mental health programs. 

* * * 

Dr. S. J. Raetz, Maple Lake, attended a meeting 
of the International Academy of Proctology in New 
York City during the last week of March. While at 
the meeting he also attended lectures and surgical 
clinics at the Jersey City Medical Center. 

* ok x 

Childhood accidents were discussed by Dr. Thomas 
Murn, Thief River Falls, at a meeting of the Oklee 
Parent-Teacher Association in Oklee late in March. 

* * * 

Dr. E, H. Rynearson, Rochester, has been named 
by the board of managers of the Gamehaven Founda- 
tion as general chairman of the Camp Building Fund 
Campaign, a drive to raise funds for improvement of 
scout camps near Rochester and Lake City. 



Dr. G. W, Clifford, Alexandria, was guest speaker 
at a meeting of the Woman’s Club in Alexandria on 
April 4. Dr. Clifford spoke on the subject, “Under- 
standing Old Folks.” 

* * * 

Dr. and Mrs. Robert N. Bowers, Lake City, spent 
an eleven-day vacation trip in Haiti, Jamaica and 
Cuba during the middle of March. They made the 
journey by air. While in Cuba they were entertained 
by friends, Dr. and Mrs. Carlos Menendez of Havana. 

ae ee 

An auxiliary of Doctors Memorial Hospital, Min- 
neapolis, has been organized by Dr. Olga S. Hansen 
to assist the hospital and its patients. 

* * * 

The engagement of Suzanne Elizabeth Scott, St. 
Paul, and Dr, Thomas H. Kirschbaum, Minneapolis, 
has been announced. A graduate of the University 
of Minnesota Medical School, Dr. Kirschbaum in- 
terned at University Hospitals. At present he is on 
active duty with the Navy at San Diego. 

* * * 

Principal speaker at a meeting of the Kiwanis 
Club at Alexandria late in March was Dr. L. F. Was- 
son of Alexandria, who spoke on the topic, “Does 
Cigarette Smoking Cause Cancer?” He discussed the 
opinions of groups on both sides of the somewhat 
controversial question. 

* * * 

Fifty-four members of the Chicago Surgical So- 
ciety visited Rochester on March 25 and 26 for 
scientific sessions, observations of operations and 
tours of the Medical Sciences Building. Dr. John 
M. Waugh of the Mayo Clinic was in charge of 
the two-day affair. During the scientific sessions 
papers were presented by fellows in the Mayo Foun- 
dation and by members of the clinic staff. 

* * * 

Dr. A, O. Swenson, Duluth, president of the Min- 
nesota State Medical Association, has been named 
a member of the advisory board of the Minnesota 
Poll, a public opinion survey conducted by the Min- 
neapolis Tribune as a public service. 

*x* * * 

Dr. and Mrs. S. W. Harrington, Rochester, re- 
turned home in mid-March after spending almost two 
months in South America. During their tour Dr. 
Harrington, a retired staff member of the Mayo 
Clinic, presented lectures at several colleges and uni- 
versities. He received an honorary award from the 
University of Buenos Aires. 

* * * 

June 26 has been designated as Dr. McKaig Day 
for the residents of Pine Island and surrounding 
communities. On that date they will celebrate the 
birthday of Dr, Carle B. McKaig and honor him for 
his half-century of medical service. Committees have 


been formed, and the citizens of Pine Island are 
busily preparing for the event. 

* *k * 
Dr. C. E. Anderson, who became resident physi- 
cian at Stillwater Prison on February 15, has resigned 
from the post because of illness. 
x ok * 

Dr. and Mrs. O. K. Behr and their two sons have 
returned to Crookston after a six months’ absence, 
during which time Dr. Behr had a senior residency 
in urology at the San Diego County Hospital in 
California. While Dr. Behr was in California his 
practice at Crookston was conducted by Dr. Norman 
R. Haugan, who is now in practice at Park Rapids. 

* * * 

Among the speakers at the Upper Midwest Busi- 
ness and Industrial Forum on Problem Drinking, 
held in Minneapolis°on April 12, was Dr. Charles 
W. Mayo, Rochester. Dr. Mayo spoke on “People 
Who Overdrink.” The meeting was conducted by 
the Upper Midwest Foundation on Problem Drink- 
ing, assisted by the Minneapolis Chamber of Com- 
merce and the Salvation Army. 

* * * 

Dr. Donald E. Dille, Litchfield, left for Fort Sam 
Houston, San Antonio, Texas, on April 3 to report 
for a two-year tour of duty in the Army. Dr. Dille 
has been associated with the Litchfield Clinic since 
1946. While he is in service his duties as Meeker 
County coroner will be carried out by Dr. Harold 
Wilmot, previously deputy coroner. 

* * * 

Two staff members of the University of Minne- 
sota were the principal speakers at a one-day institute 
for private duty nurses held at the Midway YMCA, 
St. Paul, by the Minnesota Nurses Association on 

April 21. Speaking on the cross-circulation tech- 
nique for intra-cardiac surgery was Dr. Raymond 
Reed, while Dr. P. H. Soucheray discussed the psy- 
chosomatic aspect of illness in older persons. 

* * * 

A biographical sketch of Dr. Samuel G, Balkin, 
Minneapolis, appeared in the Town Toppers column 
in the Minneapolis Star on April 6. The article de- 
scribed Dr. Balkin’s civic and professional activities. 
Town Toppers features brief biographies of leading 
citizens of Minneapolis each day. 

* * * 

The Minnesota department of the Veterans of 
Foreign Wars recently presented the University of 
Minnesota with a certificate announcing that the 
organization had raised over $100,000 in its campaign 
to get $450,000 for a cancer research institute to be 
built at the University. Accepting the certificate for 
the University were J. L. Morrill, president, and 
Dr, Owen H. Wangensteen, chairman of the depart- 
ment of surgery. The VFW group voted at its annual 
meeting in 1953 to raise the money needed to build 
an eleven-bed nine-laboratory center without public 


1d are 


s have 
tal in 
ia his 

-d by 


solicitations for donations. It passed the $100,000 
mark in less than eighteen months. 

* * x 
Dr. Kenneth H. Peterson, Hutchinson, left for 
Fort Sam Houston, Texas, on April 3 to report for 
a two-year tour of duty in the Army. He holds the 
rank of captain in the reserve. Dr. Peterson has 
practiced at Hutchinson for the past ten years. 
* *k * 

Dr. E. V. Allen, Rochester, was chairman of a 
symposium on hypertension at a postgraduate course 
conducted by the American College of Physicians in 
New York City late in March. 

x ok * 

The prevention and treatment of ski injuries was 
the topic discussed by Dr. Vernon D. E. Smith, St. 
Paul, at a meeting of the American College of Sur- 
geons at Sun Valley, Idaho, April 18 to 20. 

* * * 

Dr. R. B. J. Schoch, St. Paul health officer, was 
guest on “The Doctors’ Round Table,” a television 
show on WCCO-TYV, on the last Sunday in March. 
Dr, Schoch discussed a case study made in St. 
Paul on the spread of tuberculosis in a family. 

* * * 

Dr. Donald R. McFarlane, associated with the 
Oliver Clinic in Graceville, reported at Fort Sam 
Houston, Texas, on May 8 to put in a two-year tour 
of duty in the Army. 

* * * 

Dr, Thaddeus J. Litzow, Rochester, has been ap- 
pointed to the staff of the Mayo Clinic as a con- 
sultant in plastic surgery and laryngology. Dr. 
Litzow entered the Mayo Foundation in 1951 and 
was an assistant to the staff from 1953 to April, 1954. 

*x* * * 

Among Minnesota physicians attending the seventh 
annual scientific assembly of the American Academy 
of General Practice at Los Angeles, California, dur- 
ing the last week of March were the following: 
Dr. J. A. Cosgriff, Sr., Olivia; Dr. H. L. Huffington, 
Waterville; Dr, O. B. Fesenmaier, New Ulm; Dr. 
C. A. Wilmot, Litchfield; Dr, William E. Johnson, 
Morgan; Dr. H. E. Drill, Hopkins; Dr. B. F. Pear- 
son, Shakopee; Dr. E. J. Tanquist, Alexandria, and 
Dr. E. W. Lippmann, Hutchinson, 


Winner of second place by popular ballot at the 
1955 Rural Art Show in the Agricultural Library at 
the University campus, St. Paul, was a painting by 
Dr, Paul F. Brabec, Hastings. Dr. Brabec’s painting, 
entitled “Captain Bill,” was entered in competition 
among painters from towns of under 10,000 popula- 
tion. Over 400 entries were received for the show, 
which was attended by 2,000 visitors. 

* * * 

Dr. T. M. Seery, Austin, attended a series of lec- 
tures on “Pathology and Pathologic Physiology in 

May, 1955 

Internal Medicine” at the Frank E. Bunts Educa- 
tional Institute in Cleveland late in March. The lec- 
tures were presented by the Cleveland Clinic Foun- 

dation. neo 

Dr, and Mrs, Frank E. Mork, Anoka, returned in 
mid-March from a trip through the South. During 
the journey Dr. Mork attended the annual meeting 
of the Graduate Medical Assembly in New Orleans, 

* * * 

Several section changes at the Mayo Clinic, Roches- 
ester, became effective April 1. Dr. R. K. Ghormley 
became senior consultant in orthopedic surgery, with 
Dr. H. H. Young as chairman of section. Dr. F. A. 
Figi became senior consultant in the section of plas- 
tic surgery, with Dr. J. B, Erich as head of section. 
Dr. W. McK, Craig became senior consultant in the 
section of neurosurgery, with Dr, J. Grafton Love 

as head of section. 
* * * 

Dr. R. H. Puumala attended a three-day course in 
radiology at the University of Minnesota Continua- 
tion Center on April 11, 12 and 13. 

* * * 

Dr. Douglas L. Johnson, Little Falls, began a fel- 
lowship in ophthalmology at the University of Min- 
nesota on March 28. On completion of the graduate 
study he plans to return to Little Falls and limit his 
practice to ophthalmology. 

* * * 
Principal speaker at a meeting of the Lions Club 
in Mabel late in March was Dr, Joseph F. Schaefer, 
Owatonna. The meeting was held in honor of the 

local Boy Scouts. 
* * * 

Three Minnesota surgeons participated in a sec- 
tional meeting of the American College of Surgeons 
at Winnipeg, Canada, April 25 and 26. They were 
Dr. Morley Cohen and Dr. W. Robert Schmidt, 
Minneapolis, and Dr. John C. Ivins, Rochester. 

te & 

Guest consultant at a clinical conference at the 
Municipal Hospital at Wells on March 28 was Dr. 
Alan P, Rusterholz of the department of medicine at 
the University of Minnesota. He discussed heart 
disease at the conference, which was sponsored by 
several Minnesota medical organizations. 

* * x 

Dr. and Mrs. S. T, Kucera, Northfield, returned in 
late March after a three-week tour of the southern 
states. While on the trip Dr. Kucera attended the 
eighteenth annual meeting of the New Orleans 

Graduate Assembly. 

Dr. Thomas L. Pool, Rochester, associate professor 
of urology in the Mayo Foundation, was a consult- 
ant in medicine at a Career Conference at Knox Col- 



lege, Galesburg, Illinois, recently. Experts from 
twenty-six vocational fields attended the conference 
for a day of counseling and meeting with students. 

er kk 

A biographical sketch of Dr. Ivar Sivertsen, Min- 
neapolis, in the Town Toppers column of the Min- 
neapolis Star on April 14 emphasized the physician’s 
early affiliation with Fairview Hospital. Dr. Sivertsen 
admitted the first patient to the hospital in 1916 and 
performed the first operation in the hospital’s old 
operating suite. 

Dr. Jack A. Guy, New London, now with the U. S. 
Public Health Service, expects to return to his prac- 
tice at New London about June 1. He recently com- 
pleted a two-week course in fractures and traumatic 
surgery at the Cook County Postgraduate School of 
Medicine in Chicago. 

Dr. and Mrs. C. J. Olson, Belle Plaine, returned 
on April 7 from a vacation trip to California and 
Texas. While in San Diego, Dr. Olson attended an 
institute in heart disease at the naval hospital. 


Dr. R. G. Ziegler has announced that he will dis- 
continue his practice at Welcome about May 22 and 
will move to Brush, Colorado. Beginning July 1, 
he will be affiliated there with the Brush Clinic. He 
has practiced at Welcome since 1951. 

* x ok 

Dr. John W, Schut opened offices for the practice 
of medicine in Anoka on April 1. A graduate of 
Northwestern University Medical School, he was a 
resident at the University of Minnesota for two years 
and served as a psychiatrist at the Anoka State 
Hospital for another two years. Until recently he 
was doing research at the Galesburg State Research 
Hospital, Galesburg, Illinois. 

a a 

Dr. Wallace E. Anderson has announced that he 
will leave Lakeville in July to become associated in 
practice with Dr. Stanley Stone, Minneapolis. Dr. 
Anderson has practiced at Lakeville since July, 1952. 

a ie 

Dr. Norman Haugan, formerly of Crookston, 
opened offices for the practice of medicine in Park 
Rapids on April 1. After graduating from the Uni- 
versity of Minnesota Medical School in 1953, Dr. 
Haugan practiced in Watertown before moving to 
Crookston where he was associated with the Crook- 
ston Clinic. 



Blue Shield 

At a Blue Shield professional relations meeting held 
in Chicago on February 24 and 25, 1955, over 100 repre- 
sentatives of Blue Shield Plans throughout the country 
were present to review and evaluate methods used in 
professional relations programs. Arthur J. Doherty, of 
Minnesota Blue Shield, found that the whole program 
was devoted to consideration of means of providing 
greater service to the doctor, bringing information about 
‘Blue Shield directly to the doctor, and creating a closer 
relationship between the doctors and the Blue Shield 

At the conclusion of these sessions, it was the opinion 
of those present that developing closer liaison between 
the doctor and Blue Shield through personal visits is 
the most effective feature of any such program. This 
method of improving professional relations is being 
used by many of the Blue Shield Plans in other states 
and has proved successful in securing the necessary 
close relationship and understanding between the doctor 
and Blue Shield. 

Minnesota’s Blue Shield program of professional re- 
lations is strikingly similar to that carried on in other 
states. In October, 1954, the Minnesota program became 
fully active. Since then, three Blue Shield field repre- 
sentatives have made over 1800 personal calls to doc- 
tors’ offices. In more than 25 per cent of these calls, 
the doctor has been personally visited. When the doc- 
tor has not been available, various features of Blue 
Shield have been discussed with the members of his 
office staff. In each instance, the Blue Shield contract 
and procedures are explained to the doctor and his staff 
ffor clarification of Blue Shield objectives of subscriber 
benefits, claims reporting, and payment of claims. 

During the first two months of 1955, maternity cases 
ranked first in frequency of occurrence for hospitaliza- 
tion of Blue Cross subscribers, respiratory _ illnesses 
ranked second and accidents third. 

Blue Cross 

The number of maternity cases paid during the first 
two months of this year totaled 4,302, a slight increase 
over the 4,277 cases paid during the same period of 
1954. Maternity benefits of $463,106.08 were provided 
by Blue Cross during the first two months of 1955. 

Although respiratory illnesses ranked second in fre- 
quency of occurrence during the first two months there 
was a slight decrease in the number of cases over the 
previous year. There were 3,857 respiratory cases for 
the first two months of 1955 with Blue Cross respira- 
tory benefits totaling $309,102.19. 

Accident cases numbered 3,599 for the first two 
months of 1955 and the Blue Cross accident benefits 
allowance amounted to $190,888.17. 

Since 1933, $113,979,811.15 has been provided by 
Minnesota Blue Cross for hospital care of subscribers. 

During the month of February, 1955, 4,056 contracts 
representing 10,171 participant subscribers were en- 
rolled in Blue Cross bringing the net enrollment as of 
February 28, 1955 to 1,003,104 participant members. 


r held 
sed in 
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sits is 
. This 



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Books listed here become the property of the Ramsey, 
Hennepin and St. Louis County Medical Libraries when 
reviewed. Members, however, are urged to write re- 
views of any or every recent book which may be of 
interest to physicians. 


Professor of Medicine, Department of Medicine, Uni- 
versity of North Carolina. 262 pages. Illus. Price 
$6.00, cloth. Boston: Little, Brown & Co., 1955. 

CLINICAL SURGERY. 12th Edition. Hamilton Bail- 
ey, F.R.C.S. (Eng.), F.A.C.S., F.R.S.E., Emeritus 
Surgeon, Royal Northern Hospital, London; General 
Surgeon, Metropolian Ear, Nose and Throat Hospital ; 
Consulting Surgeon, Italian Hospital; Hunterian Pro- 
fessor, Royal College of Surgeons; formerly External 
Examiner in Surgery, University of Bristol. 456 pages. 
ea Price $8.00, cloth. Baltimore: William & Wilkins, 

BRUCELLOSIS. M. Ruiz Castefieda. Director del De- 
partmento de Investigaciones Médicas, Hospital Gen- 
eral, México, D. F. Miembro del Comité de Expertos 
en Brucelosis de la Organization Mundial de la Salud. 
302 pages. Illus. Mexico, D. F.: La Prensa Med- 
ica Mexicana, 1954. 

Bernard G. Sarnat, M.S., M.D., D.D.S., F.A.CS. 
Professor and Head of the Department of Oral and 
and Maxillofacial Surgery, College of Dentistry; 
Clinical Assistant Professor, Department of Surgery 
(Plastic Surgery), College of Medicine, University 
of Illinois, Chicago, Ill.; Diplomate of the American 
Board of Plastic Surgery. 148 Pages. Illus. Price 
$4.75. Springfield, Ill.: Charles C Thomas, 1951. 
This small volume by five faculty members of the 

dental schools of three universities in Chicago dis- 
cusses the anatomy, physiology, and pathology of the 
temporomandibular joint with emphasis on the dental 
aspects. The Costen syndrome, attributing numerous 
auditory and vestibular symptoms to dysfunction of the 
temporomandibular joints, is thoroughly evaluated with 
the conclusion that it is not supported by facts and 
should be abandoned. The book is strictly limited in its 
objectives and makes no pretense at covering all the 
clinical features of the temporomandibular joints. 

ExLMer C. PAutson, M.D. 

BONE TUMORS. By Louis Lichtenstein, M.D., Senior 
Pathologist, General Medical and Surgical Hospital, 

Veterans Administration Center, Los 

pages. Illus. Price $10.50. St. Louis: 

Mosby Company, 1952. 

The introductory chapter stresses the importance 
of biopsy in conjunction with roentgenographic exam- 
ination of suspected bone tumors before treatment is 
attempted. Since many new skeletal lesions, both neo- 
Plastic and non-neoplastic, have recently been described, 

Angeles. 315 
Fhe€.. “V. 

‘the necessity for open-mindedness is emphasized. 

A classification of bone tumors is presented for con- 
sideration as a helpful working hypcthesis, along with 
Pertinent comment in support of proposed categories. 

May, 1955 

The chapters on bone tumors describe the clinical 
features, pathology, radiograms and therapy of various 
bene tumors. An appendix discusses some lesions of 
bone often mistaken for tumors. 

The text is adequate and readable. The illustrations 
include radiograms, gross photographs, and photomicro- 
graphs of good quality. There is an adequate bibliog- 
raphy with each chapter. This book will prove itself 
useful to pathologists, surgeons, and radiologists alike. 

J. W. James, M.D. 

Vaughan, M.S., M.D., Richmond, Va. _ Illustrations 
by John P. Tillery, 4th edition, revised by J. Harvey 
Black, M.D., Dallas, Texas. 191 pages. Price $4.25. 
St. Louis: C. V. Mosby Co., 1954. 

This book has fulfilled its primary purpose. It is an 
interesting book on allergy which will be read by the 
intelligent patient and enable him to co-operate with 
his dcctor. It is written in a style which stimulates the 
patient to do his best in treating his allergies. Every 
practicing physician will do the patient and himself a 
favor by introducing the patient with an allergic disease 
to this short book. The language of the doctor will 
no longer be just a lot of words after the patient has 
read this book. 

The secondary purpose of this book, that of giving 
concise information to the physician doing a minimum 
of allergy work, has also been fulfilled. However, this 
reading should be expanded by reading a larger book 
in the field of allergy as soon as the physician’s time 

Donato W. Koza, M.D. 


A completely revised Fourth Edition of “Professional 
Films” is now in compilation. (The frequency and num- 
ber of future insert pages necessary to assure a compre- 
hensive index that is continuously current over a period 
of years will be determined by the volume of forth- 
coming productions.) It will include new sections pro- 
viding biographical data on authors, and information 
on the audio-visual activities of medical schools, dental 
schools and graduate teaching centers. 

Over 28,000 copies of previous editions are in use 
by medical and dental schools, program chairmen of 
state and specialty societies, and others here and abroad. 
Academy-International of Medicine provides this valu- 
able audio-visual information to the profession-at-large, 
without profit, as one of its contributions toward elevat- 
ing the standards of medical and dental services by ex- 
pediting the dissemination of professional knowledge. 

You are urged to directly assist by (1) informing film 
authors of this announcement so that they can write 
for questionnaires, or (2) providing the film title and 
(full name and address of any film author. Write to 
the Academy-International of Medicine, 601 Louisiana 
Street, Lawrence, Kansas. 


Minnesota State Medical Association 


PAD BANA SIO IN NED, sa scnsasscascesen.neonssevsgossensdeeveovan eae President 

F. W. BeHMteErR, M.D...... 
Kart E. JouHnson, M.D...... 

First Vice President.... 
Second Vice Prestdent 

Bee er NNT RODD sc ss scescssescssexsestsctscssansssesesscooessoveesacel Secretary 

W. H. Conoprr, M.D 

R. R. RoseEti 


CRS BP PARD, DED. vcs ssssccsscessnses sosesesenecd Speaker, House of Delegates 
PASM GROW UNNEID 5. cccscsesonessscveiescsssovespovesooounscsess Vice Speaker 
Executive Secretary. 

Saint Paul 


(Terms expire December 31 of year indicated) 

First District 

J. M. Stickney, M.D. (1956) 
Second District 

R. C. Hunt, M.D. (1956) 
Third District 

P. E. Hermanson, M.D. (1955) 
Fourth District 

H. J. Nitson, M.D. (1957) 


North Mankato 

Ninth District 



M.D. (1957) 

Fifth District 

L. R. Crircurietp, M.D. (1955) 
Sixth District 

H. B. Sweetser, M.D. (1957) 
Seventh District 

W. W. Witt, M.D. (1955) 
Eighth District 

C. L. Oprrcaarp, M.D. (1957) Chairman....Crookston 

Saint Paul 



House of Delegates, American Medical Association 


J. ARNOLD Barcen, M.D. (1956) 
O. J. CAMPBELL, M.D. (1955) 
GerorcE Earz, M.D. (1955) 

F. J. Extras, M.D. (1956) 

Saint Paul 


Paut C. Leck, M.D. (1956) 

W. W. Witt, M.D. (1955) 
E.M. Hammes, Sr., M.D. (1955) 
A. O. Swenson, M.D. (1956) 

Scientific Committees 


A. O. Swenson, M.D., General Chairman Duluth 
POSTUE OAC, NID. osscsssscsssessen<cscsvceescovsecesvesconss St. Paul 
IB a OCB TER EID iin csbeseussoequsvesersssoncsecseucsesvesaes St. Paul 
R. R. Rosey St. Paul 

Section on Medicine 

D. W. WHEELER, M.D., Chairman 
R. O. Satuer, M.D., Secretary 

Section on Specialties 
. T. WENNER, M.D., Chairman 
. B. Hunt, M.D., Secretary. 
Section on Surgery 

. MircHELL, M.D., Chairman 
. Lannin, M.D,, Secretary 

Local Arrangements 


BR. AAAS, I osc snk cececacescaeessesesceesvescasseveass Rochester 
MarGARET C. ANDERSON, M.D............c:ccceeeeee Mankato 
J. We SBA, GD oo scscssciscsscncscssvcscesenseeoossits Minneapolis 
J. H. CRowLEY, IRM cc vccsasissvodus sane sadaovenstsvevent Saint Paul 
R. C. Gaarp, ‘M.D Ree seaa ieee ces sats covey Mencesesnoan Minneapolis 
RoBerT C. KNUTSON, M.D..........::ccesceesceesteeeeees Saint Paul 
WD. MES SELDON: MOD 0. cscessssescscsseccesesscsssasiseccseees Rochester 


TP INN, IN svc s seca dees saavacsp sescccees cacdeonsvaners Rochester 
PAUE FODWAN, DAUD io. .cicscciccsscsssecscosaccssssetesesses Minneapolis 
J. W. Epwarps, IRAEM os cscs cack cocsetsedeuotvensyeomnees Saint Paul 
E. V. Gotrtz, MD ayers Saint Paul 
Wo. V. KNOLL, M.D...... 

R. WW; KoOuery, MiDiiic...cciscccsesccsoscesss ...Minneapolis 
M. T. MircHett, 1.13 Se nea ree ee Minneapolis 
N. C. PLIMpTON, M.Da..........ccccscccserceseceeeseesees Minneapolis 
Howarp M. WikorF, Do casaaocesescosnasssascteevect Crookston 



UmHzr zoey 

Bsr SOmneoa 


SOS =e 


SAM Som weno 




(Three-year appointment) 

Davw P. ANDERSON, Jr., M.D. (1955) 
Hersert Boysen, M.D. (1955) 
MerRIAM Frepricxs, M.D. (1956) 
G. F. HartNaGEL, M.D. (1956) 

C. R. Hrrcucocx, M.D. (1956) 
N. K. Jensen, M.D. (1958) 
LeonarD A. Lane, M.D. (1958) 
N. Locan Leven, M.D. (1956) 

T. B. Macatu, M.D. (1956) 

F. M. Owens, Jr., M.D. (1958) 
D. E. Stewart, M.D. (1958) 


G. B. Locan, M.D Rochester 
Etpon BerGLuND, M.D Minneapolis 
Pees. CHIBHOLM, MLD. ......0::i.0..csescsessesescsenecese Minneapolis 
Je J. GALLIGAN, MUD.............cscccccrssscccecsscnsesseres Saint Paul 
MEE TONES, NOD) i ocncsssasescoscsesssersosenscosevesnssnsoees Mankato 
WUD: RICHARDS, MID). .cccscscecssceescsvsssccsszssesssessse St. Cloud 
A. B. ROSENFIELD, M.D................ccccecccceeeeses Minneapolis 
OY, WHRE GON: RODD v5 cc cccsccsseusssevscsssocossecsnassesseents Rochester 
BAWARD ZUPANG, MED)iniccccsceccsccececsesccccscsssiecessovesened Duluth 


vk. AUNDMBGON TMU y ooscssccacsenccccocssssesscesonscacéscessese Hector 
ET, (CONEMY. NIB) occccscccssscacssesteecssseseesasisconessess Mankato 
Joun LEo DELMORE, JR., M.D..........ccccssscesceeseeeees Roseau 
OM. FREIBERG, MiB).....0cccsecspscsccoscesessscznesese Worthington 
NOHN A. EEPAR, MD) .......ccscsesssccscasceaseccssssescesss Saint Paul 
E. L. Tuony, M.D............000 ...Duluth 


K. M. Simonton, Rochester 
L. R. Bores, M.D Minneapolis 
JoHN H. CAMERON, M.D.u.......:ccsccsesscesseessesees Crookston 
WE CON NGM NED iiivsvcsicsscccesessvscconsssscsscccecenceness Saint Paul 
WER CATIVAS WOM DP occ iccencessccnsesscascuctsqedessonatiaceassse St. Cloud 
ANDERSON EREDING, MiiDD......000s0-cscscocsssescsessssesesseases Duluth 
ConraD J. HOLMBERG, M.D............csscescsseseeeees Minneapolis 
J. DonaLp Syopinc, M.D Mankato 


Pehee: NORAD, De occ ccssscezssncecossassssccsteucsiaciseed Saint Paul 
Moses BARRON, M.D.........::ccesscssscsecesseeenseeees Minneapolis 
j. J. BozHREerR, M.D Minneapolis 
al ROC CARR 2 2 SER ee Pe Sn Duluth 
J.J. EustermMann, M.D 

D. R. Gittespre, M.D... 

W. S. Nerr, M.D 


RANDALL G. SPRAGUE, M.D............sccsecesseeseeseeeees Rochester 


ee AUP EERNRS NMP aig cnace ccccuecesecccsadedesadetousstcntaed Rochester 
F. BricHam, Jr., M.D.... ...5t. Cloud 
W. Epwarps, M.D....... 
F. Fettows, M.D 

Ais EBSOHE, MED c.0cccesccctsecssccascesssessesscecceed Lake City 
Vs CROs NM Bi ec cs ocasas.coccseceeaacuduseccteccccecenes Saint Paul 
I OE Bees | soc e hascaaccctenavoessececuuacccessss Faribault 
4 INCHRESIO AN. WDD: oicesesscescecesuctessvessccnonessensceseesess Mora 

Saint Paul 

... Saint Paul 

O’PHELAN, Minneapolis 
« TPEDMEPTON, MED). .cccccsscssscessccscsscsscscsiens Minneapolis 
VERNON, “Does caccssicscescpenrcancsasctesavevestese Mapleton 


i, i I oicruectvisbbaiesieasceiviien Minneapolis 
N. H. Baker, M.D Fergus Falls 
ee er Saint Paul 
Rozsert B. ENcstrom, M.D Mankato 
V. P. Hauser, M.D 

May, 1955 

Joun C. Ivins, Rochester 
W. J. McDonatp, M.D Crookston 
J. H. Moz, M.D Minneapolis 
EUAGIEY: Bie FUMIE 5 Wee ccencse5asoccassccsussascedcscanesgs Albert Lea 
17 A EAS 1) SE RRTOn SE Biante ree Minneapolis 
A. B. RogzHuxe, M.D.......... Elk River 
W. A. SwEepBERG, M.D u 

Vi ee Aes Ye oa bccscascccsecsrasscscccescancecancetertes Brainerd 


James A. Cosorirr, Sr., Olivia 
EB. ©. BAvERW MEiDyie. 52ccsscsscsccsssass 

Pasa Ao Garam oi sasc oss csesccscaacaccanecseceaccecsadesece Hopkins 
De i a lindas ccnensnccsccacenadsacasocsees Saint Paul 
Cuas. C. Cooper, M.D 

H. E. Coutter, M.D 

Dona.p C. Deters, M.D 

C. S. DonaLpson, M.D 

R. J. Eckman, 

ND SS 7 8 |) RR ieee meer eperecr errr er Monticello 
WOW, Hammes ED a5 ocssenicanccsccsicas caecascestacensntece Wayzata 

(Three-year appointment) 

F. J. Hirscusoeck, M.D. ( 

J. F. Borc, M.D. (1958) 

J. F. Briccs, M.D. (1956) 
Henprik DeKruir, M.D. (1955) 
Pau. F. Dwan, M.D. (1955) 
C. N. Hensext, M.D. (1955) 
M. M. Hurwrrz, M.D. (1956) 
R. O. Satuer, M.D. (1958) 

H. L. Smiru, M.D. (1958) 
CHESTER TurEM, M.D. (1956) 
D. W. WHEELER, M.D. (1958) 
ASHER A. WuirteE, M.D. (1955) 


Roper? ROSentTHab, MDi nn .ccicciecicccsssccccecsssséuse Saint Paul 
TRIGEIAMED HARBORS, DE occ cssice ie cccsiecascacsccacevescadacsaced Duluth 
WheOP. CRAARCEE, Beans viccicsicicssseistsiceactsteences Rochester 

....Fergus Falls 

Saint Paul 

A. G. LrepLorr, M.D 

Tuos. A. PEpparD, M.D 

G. E. SHERWOOD, M.D...... 
Harotp R. TuyseE.u, M.D.... 
A. M. Watson, M. 

W. E. Witson, M.D 


H. S. Dixit, M.D Minneapolis 
fe OT SS 0 3) Ey einen eter Saint Paul 



A. C. Kerxuor, M.D Minneapolis 
Henry A. Onna, MED... cccccssscccscsscctsccesess Pelican Rapids 
ARNOED 'LARGON, MED... ccascess sccccesecesesecciaces Detroit Lakes 
Joun P. MEepELMAN, M.D Saint Paul 
De ah coarse cha ccenacesdecéscccsagegansenaes Faribault 
H. J. WAtpER, M.D 

E. E. Wo.uarecer, M.D 

Bee Be WOR UGG I ooo coos cai eceasccscedececactancccaceacsad Winona 


| Fe Pa, 81 2 Sd. =) ) Eee ncn EDS Fe Minneapolis 
‘Tracy-E.. Banewm: Vrs, Mb oinccscccecccccicscsvadiscccciarsee Austin 
JOuaN DD. AMM, nace cc ccsscciccsncsscccsaconssanievaccetsts Duluth 
Or Cr em WS oe sists hs ckcanscnecdsedatececssededecee Saint Paul 
Be Orr Am a i hee re St. Cloud 
ea SOV |) Sa ne ee tene ee: South Saint Paul 
Rosert F. McGanpy, M_LD...............cccccccceees Minneapolis 
O. L. McHarriz, M.D : 

W. E. Parx, M.D Minneapolis 
Joun ‘W. Raarrama, MLD....:.:::..:062<..c0.i00.cc00s000. Nashwauk 
BEWARE SOHONG MID. o. onc csesccecectcseccdecccevasesseces Saint Paul 
H. H. Younc, M.D Rochester 




J. J. Swenpson, M. Saint Paul 
tyes NS ee ee re Seen Duluth 
R igh co) Ca RS 0 2 Sauk Centre 
G. F. HartnacE., M.D............ 
Joun A. Haucen, M.D Minneapolis 
BaP ION NCI i esc ssnsescandasbeoesbicsiedsacssocccaneeeascoe Echo 
J. L. McKetvey, M.D Minneapolis 
SRS ANAM: INNIS 5572. < 025<oxtstisvaesovse Genectuscoeetth Crookston 
A. B. RosENFIELD, M.D Minneapolis 
F. L. ScHape, M.D Worthington 


BO AAMAS SR, NED os ccss cvsceccssieseccin ce Saint Paul 
Marx B. Coventry, M.D 
A. J. LEEMuHutIs, M.D 
L. H. RutLepce, M.D 
W. G. Workman, M.D 


K. E. JoHNson, 

E. G. BENJAMIN, Minneapolis 
FLoyp M. Burns, M.D Milan 
PUA iy RARER INLD 6c gcsiessssceesvssossscepsesasonveatoel ‘Mankato 
N. H. Lurxin, M.D . Minneapolis 
DonaLp McCartuy, M.D Saint Paul 
W. P. Ritcure, M.D Saint Paul 
NOSEPEOM: TRGAN, GMD) onicscncsvessesesssudssosessosveours Saint Paul 
Joun T. Smitey, M.D Minneapolis 
A. K. Stratte, M.D 

J. H. Tmurscu, M.D Rochester 


je sg, Co ce I D en ee ere Saint Paul 
OWA ROW N NUD 52522 s00.055sssucystedvendsesieastacesoveets Rochester 
W. S. CHatcreN, M.D 

Bis UNG BBM SIO: «525 csscsecatsdendodscxescenssyessnorices Faribault 
J. E. T. Haavix, M.D 

E. M. Hammes, Jr., M.D 
H. B. HANNAH, M.D H. Noran, 

W. L. Patterson, M.D 


ae tite) 1 .\, LB Se oe New Ulm 
AP ADAIR SRS IMD os o5cc50cicsessoses .. Saint Paul 
ArtTHuR V. GarLock, M.D Bemidji 
EE RE CN: OC 5 a ee Saint Paul 
ESMWN 5 MAGNE N ONO. 525 os 5505 csonscesseacsé suse ascecceeed Minneapolis 
Hosart C. Jonnson, M.D 

FM MRNA FUNNIES 5 sic ces ox'oscosisss sei enecdssbsssscencenticceeme Duluth 
C. W. Rucker, M.D Rochester 

Detroit Lakes 

Saint Paul 
Fergus Falls 


E. M. Hammes, 8r., 
T. A. Pepparp, M.D 
H. L. Utricu, M.D 
A. H. WEtts, M.D. (Ex officio) 

A. H. WEtts, M.D., Editor 
STUART W. ARHELGER, MiD:........60c.cceeccovecsexe Minneapolis 
Joun F. Briccs, M.D Saint Paul 
PRE TG AROWN DUD cn cssscccsivcctesosdessecestcvcessvers Rochester 
S. F. Cerptecua, M.D Redwood Falls 
Tacug C. CuisHotm, M.D Minneapolis 


Saint Paul 
Saint Paul 

ANDREW SinAMaARK, M.D Hibbing 
C. E. STanrorp, M.D Minneapolis 
WY TD, VENER, GID ss cis con ceccacesiesoiceceacececeastenese St. Cloud 

M. McC. FiscHer, M.D..............sscesccsssesssccessessees Duluth 
Ree AMAT ONG oo cise scacien cach sccsenssevessdeveonsesavsvsaseseay Saint Paul 
W. C. CHAMBERS, M.D Blue Earth 
Ae ADAMI NI cog 50i ccevcsececssesoustesicevadioecapscostigeue Wadena 
Heten L. Knupsen, M.D Minneapolis 




1g OR CPi 5 55 | 9 RP ae Minneapolis 

Joun A. Butzer, M.D 

W. E. Hatcu, M.D 

Gerorce W. Hauser, M.D Minneapolis 

BW SYNGE MED coca 5csicedesscesscssessocossnessescsenes Saint Paul 

H. E. MIcHELson, Minneapolis 

Ci We MOBERG, MUD. ..:..:05:0.:.ccccccsccsssssnsecssesens Detroit Lakes 
e Rochester 


A) AR) SERIGGS SMUD) si sncisscsscscosacenszscnessssirctvescasevcveted Saint Paul 
J. A. Myers, M.D., Vice Chairman Minneapolis 
R. N. Barr, M.D Minneapolis 
Rutu E. Boynton, Minneapolis 
F. F. CALLAHAN, Saint Paul 
S. S. CoHEN, M. Oak Terrace 
DEAN 'S. FLEMING, M:D............00scssessssoosseessioscszes Hopkins 
Rospert E. Hansen, M.D.......... ibbi 
G. A. Hepserc, M.D 

Corrin H. Hopcson, 

L. S. Jorpan, M.D : Granite Falls 
TDP OMRINGEELA, ONIGID) 505 .c02scccsecesssqennscescssooscccned Minneapolis 
E. A. MEYERDING, M.D Saint Paul 
W.. (OLB, UNEDSON, (MED). <ccccscccsssccecesseenesosneee Fergus Falls 
W. E. Peterson, M.D 


S. A. SLatTER, M.D 

Lyte A. ToncEN, M.D...... 
W. H. Ube, M.D 

Saint Paul 

R. N. Barr, M.D Minneapolis 
E. E. Barrett, M.D 
LuTHER Davis, 
| RS Re STO ERS) Ci 0 a Rochester 
Cc. O. Kouusry, M.D 

R. L. Witper, M.D 


Rosert B. Howarp, M.D Minneapolis 
HEnrY C. MOEHRING, M.D....0.....cccccceeseeeceeeeeneeeeeeee Duluth 
GLENN J. MourITSEN, M.D..........ccccceecseesseeees Fergus Falls 
Olive V. Seibert, B.A............ccccsccssssccssscseeeeeeed Saint Paul 
GrorceE G. STILWELL, M.D Rochester 
E. M. Hames, Sr., M.D. (Ex officio) 

C. ALLEN Goop, M.D Rochester 
W. C. BERNSTEIN, Saint Paul 
W. T. GREENFIELD, M.D.oo.i....eccecsescessccesessesceseseeees Cokato 
IRANO CIIEDA, NID io cs socesssssscccsececscsestssacsosecctsees Saint Paul 
Bi. 1G, ACOBSON, WED. ocsescenscscncccseacssvssesscotossosensannes Duluth 
THomas Lowry, M.D...........cccccccccccsessseeseeeeees Minneapolis 
GLENN MouritTsENn, M.D Fergus Falls 


ee he eee 

S FSS 3 a, oO 

Pr Rm==E 

Poe OM MO 


. Cloud 

int Paul 
e Earth 
. Cloud 

lea polis 
nt Paul 
t Lakes 

it Paul 
t Paul 
- Falls 
t Paul 
t Paul 



Corrin H. Hopeson, M.D 
R. P. Buckley, M.D 
Joun Dorpat, M.D 

p, W. Harrison, M.D Worthington 
hl MOCGANDY;, MED..........-.:..0::-:cs.cecesess00 Minneapolis 
Horatio VAN CLevE, RN BW oc cicweauccciuaceaceccadeseeeesiees Austin 
CLARENCE W. WALTER, ME csciacsscccscssctcetseaed Saint Paul 

(Chairman to be appointed) 

a ANDERSON;  MEBD:........::0...<cs0--cescstssssseoscssess Rochester 
We ORE AND: WEDD eos ccesccecsccnedesssenssiccvssexeasvecses Willmar 
R. Fawcett, M.D 

RANSON oo esccs cise caccce canta ceatestctetsiceeveanes Clarkfield 

EBIDENG, “WD oi.0525:...sescecssescascesssonseneseass Fergus Falls 
LMER LIPPMANN, M.D............:ccccsseeseeceeeceeeees Hutchinson 
J.C. Manxey, M.D Minneapolis 
R. F. SturteEy, M.D Saint Paul 
R. H. WILSON, M.D Winona 

GzorGE Eart, M.D., General Chairman 


Saint Paul 

Executive Committee 
GzorGE EArt, M.D Saint Paul 
AISI, EI coe cc sc occcr ta osivsndenssssédeecandnsctecsecenes Duluth 
W. H. HENGsSTLER, M.D Saint Paul 
CorrIn H. Hoposon, M.D. ..............cccceeeeeeceeees Rochester 

Harry KLEIN, 

. E. : Minneapolis 
PM NB nc ca te sccccteoccacsacaccaiesecssowaccvacssdds Windom 
Editorial Committee 
PORCE TARE. MED)... 5. cscsccciesssessocecvacsnecodersecesenes Saint Paul 
F, BRAASCH, M.D Rochester 
L. PATTERSON, Fergus Falls 
F. , Minneapolis 
H. Duluth 

Medical Advisory Committee 

EFL. EIENGS TEER, MAID) 20006 ccscssncoscansescosssseesencs Saint Paul 
Pe: BEUNING, MD i is.i.ccs0ccs.csecsseccoosescssonectoqnesece St. Cloud 
Mark B. Coventry, M.D Rochester 
P. G. E. Horper, M.D 


G. C. MacRae, M.D 
Harvey NELSON, 

Medical Ethics 
1,1) 0 BERR Pe et teil Ben ee PRE rs eye ore Duluth 
Saint Paul 
ene (INGRDEA, NED Minneapolis 
GHORGE BE. PENN, MOD:.....20.:020ccsscccscessscccvecceseesses Mankato 
Harry M. WeserR, M.D Rochester 

Medical Service 
Witu1aM Prorritt, M.D 
F. S. Bass, M.D 
C. M. BactEy, M.D 
Tacuze C. CuisHotm, M.D 
Lester N. Date, M.D Red Lake Falls 
Frank J. Hecx, M.D Rochester 
C. H. Houmstrom, MRM oo cs ee Seiiahasdescaxeseyceneetasechers Warren 
jr") Saint Paul 
R. A. Murray, M.D 
James P. O’KeerE, M.D 
H. F. R. Piass, M.D Minneapolis 
tds SEMONSs MGDDi....csecssassecesscsnetessssescacecsnenceters Saint Paul 

State Health Relations 

GE, PROGHER,. ME DYcsscsc.cccsoscesscnceserensnssovserss Minneapolis 
. C. Bayley, | —_—ee ONe eme e Lake City 

ES, DONAEDSON, MD)%......:..:..ccsscssscecseesssceeesees St. Cloud 
Joun TTR EN Saint Paul 
J. J. Eusrermann, M.D 

D. L. Jounson, M.D 

May, 1955 

Harry Ktern, 

Saint Paul 


SAMUEL N. Litman, M. 

C. N. McCown, Jr., 

Paur Heep, MEB..........:-.<...... 
CARL Smison, 

C. E. Witson, M.D 

Membership Committee 

H. F. R. Prass, M.D Minneapolis 
Pie Se Wem NA ess sare aces con cosas eewaccontardectnccarssoees Hallock 
H. M. Carryer, M.D Rochester 
Joun W. Grivtey, M.D 

L. D. Hitcer, es eee Saint Paul 
Cart LuNDELL, M.D Granite Falls 
M. O. WALLACE, M.D Duluth 


Mario M. FiscuHer, M.D 


W. R. Humpurey, M.D 
James A. Biaxe, M.D 
Paut G. Boman, M. Duluth 
Joun Dorpat, M.D Sacred Heart 
Mary C. GuHostLey, M.D 

RrcHarp B. Graves, M.D 

BReeoew Fic wies,, anna assassin acne cs onneaqeatose Winthrop 
L. W. Jounsrup, M.D Hibbing 
HERMAN M. JuErGENS, M.D Belle Plaine 
E. A. Kitsriwe, M.D Worthington 
W. E. Mackuin, Jr., M.D i 

Wa ttace P. Ritcuir, M.D 

E. R. SatHer, M.D 

CS GC Sime, Re ose sscccissccsacsseacnige tenets Hutchinson 
M. D. StarEKow, M.D Thief River Falls 
R. H. Witson, 



F. J. Exias, M.D., General Chairman 
Executive Committee 

F. J. Extas, MLD.............ccccecscssccecsnserssceescssesceeecssees -Duluth 

R. M. Burns, M.D 

H. M. CARRYER, 1) 




A. H. WELLs, MD 
(And Chairmen of all Scientific Committees) 

A. H. Wetits, M.D 


G. W. CurFrrorp, M.D 

T. J. Epwarps, M. 
Gorpon M. ErskINE, M.D 
H. W. Scumwt, M.D 

Radio and Television 

RR i Dice ce oes ci secs Saint Paul 
Bepmanmrre ©), WAGE mY. Web yocccccincescasccecccscscccencasaes Duluth 
James Rocers Fox, M.D.........2::csssesesesseseees Minneapolis 
C. N. Harris, M.D Hibbing 
O. M. Herserc, M.D Worthington 
R. N. Jones, MD 

Ts We peers RM oo occa sak cgvannvaadsexaxaaenagacagetaseeat Albert Lea 
Ben A arena occ cosines ecqvteasacssedeenes Mankato 
R. H. Witson, Winona 

Saint Paul 
Grand Rapids 

Speakers’ Bureau 
He. ME Cannwans MOR. 5eonccenc essen Rochester 
W. C. Dopps, M.D Detroit Lakes 
J. W. Duncan, M.D 
BEN R. Gevrs, 1! |). Rene ters, eer ree ee Mankato 
P. A. Lommen, M.D Austin 
©) E. Ne Needenes BOE <i cetesccies Minneapolis 
Cuar_Les Rea, M. 
W. B. WeEtts, M.D 
Harotp E. Witmot, M.D 




| i Oe | nee EOE cr rE Windom 
Rae i OS oan Ef ee ee Brainerd 
Bo PAS NSA DEN ST URNSID Sb si sccistvcsessseccessostetescvesabeece att Rochester 
gamrs A. BLame, JR... MD ....00ccesssscecosessscconecesesi Hopkins 
We ks PU MRMINE EID 525 ssc ncssncscvegesvsnaseovenesstatece te Dawson 
Be Fo GEA RE ssssiscivccsccssesoecessssoneconsvesscscce’ Appleton 
WR Bis Aas ACN EMER, IOS coincscccescostersssesoooseoecsseees St. Peter 
Dee SAME WORMED, tos capicdsceesveceninaereciacosssbecs cosees St. Cloud 
Bs AL EAUMOPROM, MLD......5..0ccseesscssisscccasssecssoss Virginia 
BR ise RI NTE 5s sccpeseovcesccocsvessscvesasteaecncoves aack St. Paul 
RUNS SRE GID ocnsconcscch cece conscnvasaccevesccenseeine Fosston 

First District 
Paut C. Leck, M.D., Chairman 
Second District 
WANG AD OMAN SO IMOID ss scsncecvcodbaceapicansevasshenseveuceseste Lakefield 
Third District 
DEAGNUS WES TBY,; (MID si ccicccccnisscosseaeessiccscscsacsseess Madison 
Fourth District 
LAWRENCE SJOSTROM, M.D...........csccssecesssssecsseees St. Peter 
Fifth District — 
AI RATE NEA ss sesucsescscsesssvescssesenevecsceesooeses Pine City 
Sixth District 
BE WN ABNER IID oo cisa vencevecsoshciistetiseseascesvanncoted Wayzata 


Seventh District 

DD, <L,, JOHNSON; MID i vcdicicdsciccssessseessoccccossssceacs Little Falk 
Eighth District 

C. W. JACOBSON, M.D............sccssscssscsecssscseed Breckenridge 
Ninth District 

SS ABO NED osc decveseectetsctvesstictoresseveseseveavsvaesed Cloquet 


F. J. Exvtas, M.D.............0000 --Duluth 
C. G. SHEPPARD, M.D...........ccccsccscsssssssoccseseees Hutchinson 
E. J. Stmons, M.D................. ae Saint Paul 


JUSTUS. OHAGE) MD io i.ccncscccccssssecssscosssecessesosseves Saint Paul 
©.- J. ‘CAMPBREL, MED) .cicescscsssseisscessessesevesseness Minneapolis 
CHAS. C. Cooper, M.D.u........eeceeecsecessstereeeeeeeeees Saint Paul 
BS PRMGIAB  ONMUDD sc ccnosescsccscvecsacsavessseicsissesutedsutsttarscores Duluth 
Ree J. RENNEDY, MED... .5csccscscocdsscscessssivesecsvensss Rochester 


Ratpw H. CreiGHToN, M.LD.......0 ee Minneapolis 
ALVIN ERICKSON, M.D. ..........cccccssceeseeeseeeeee Long Prairie 
J. J. SEUSTERMANN, MLD.............0:cscsceccsssoveseusseze Mankato 
J. E. Murpuy, M.D ‘ 

E. I. Parson, M.D................. 

AtvaAN SacH-Rowitz, M.D............c::ccc008 Moose Lake 
P: TR GOUCHERAY, MED.....5...55sicesse..sescccesesecessserees St. Paul 
TEE, OUPATEREENS EID aos cs siccis covcccnsnsecosscssasccocts Rochester 

Councilor Districts 


FNL PRICEY, ORs NNO os ccesctscgiecavseecmensacel Rochester 
Counties—Dodge, Fillmore, Goodhue, Houston, Mow- 
er, Olmsted, Rice, Steele, Wabasha, Winona 


R. C. Hunt, Sr., M.D Fairmont 
Counties—Cottonwood, Faribault, Freeborn, Jackson, 
Martin, Murray, Nobles, Pipestone, Rock, Watonwan 


DP) Bh: ERE RORA NEON INE ss ssesccs cscs sccdsccsessccesounced Hendricks 
Counties—Big Stone, Chippewa, Kandiyohi, Lac Qui 
Parle, Lincoln, Lyon, Meeker, Pope, Redwood, Ren- 
ville, Stevens, Swift, Traverse, Yellow Medicine 


FA. 3 PURE BON SGD soo co sscssissvcssesesscetemnerce North Mankato 
Counties—Blue Earth, Brown. Carver, Le Sueur, Mc- 
Leod, Nicollet, Scott, Sibley, Waseca 


1. R. CRITCHFIELD, MED......ss0ccccssesesssssssevasnssevses Saint Paul 
Counties—Anoka, Chisago, Dakota, Isanti, Kanabec, 
Mille Lacs, Pine, Ramsey, Sherburne, Washington 


H. 1B. SwWEETSER, (MED ssicisccsccccscssveeseessessesseeeses Minneapolis 
Counties—Hennepin, Wright 


WV STWW PUN REE: SOAP ssc ees ens stessccscdsecuseoscecavevssveczesasted Bertha 
Counties—Aitkin, Beltrami, Benton, Cass, Clearwater, 
Crow Wing, Hubbard, Koochiching, Morrison, Stearns, 
Todd, Wadena 


GC. EL. ‘OPPRGAARD:. ‘MED... .<.5..cesecccicsnsscecssoosseaee Crookston 
Counties—Becker, Clay, Douglas, Grant, Kittson, Lake 
of the Woods, Mahnomen, Marshall, Norman, Otter 
Tail, Pennington, Polk, Red Lake, Roseau, Wilkin 


CLARENCE JACOBSON, M.D.u..u00.. cece ceeeteeeeeee Chisholm 
Counties—Carlton, Cook, Itasca, Lake, St. Louis 


County Medical Advisory Committees 

e Falls 

ane Rottanp H. Wixson, M.D., Chairman................ i J. Bi Wieear ae, ME once case sixcecsseccitacccsecseaes Saint Paul 
HADDON CARRYER, MLD................:ccccccccsecsceseeees Rochester E. W. LarppMann, MLD................ccccsccccssecees Hutchinson 
7 Oy. MM. FERMBERG, MD... .c000:<ccccersscssecsecncaceees Worthington C. W. MOoBERG, M.D. .........cccccccsscccceseeeesseees Detroit Lakes 
roan Douctas L. JOHNSON, M.Du.......ccccccccceseseeeseeee Eittle- Balls, KE. Chenoa Mea oasis cccccticcocsscctssccdateaoe Graceville 
TEE MARE, GG, JOUNSON, MCD.......c0cccccssccstasssssoccsssccseonsss Brubtte «=F. IE. rm reaeig WEDD. c...cccccsssscccececiaccesensca Minneapolis 
' LEO G. RIGLER, M.D.....0.......:ccsscessesseeseeeeesseeee- Minneapolis 
MO teh CIE AIUIYE oi ss sic cdevscceddesassaasesdsdnesiaeneesbaceddadeesves Aitkin 1A) Seer tone RSS eR DEES REE APIO PERE Rush City 
Bh Ei PE CARON 5 ova sasd5ccacacevnssssvctenawdarvaadaciscciverncessts ils Abs. Es DR osc ccicascsccocepesceeensceomiwsectenas i 
—. | 2.22 ee <  RE EITC 
Duluth Bee IOAN 55a socchacdsduestessccsauaccdeseccwaseehsveseiasestes Anoka CLAY COUNTY 
chester RIN PUNNBIN UNM oe oo, cue sc caelauldsiid uniwecwacwateeceadedsaseodécds Anoka UR eee AO ee re Hawley 

PERN EEN coc cciscsc cscs ca siccbatcasustwsiaasdebsacioasecasteiataccsceh Anoka 


eapolis MMO rs OREO acc gs skadkcostidscsatuaceseuessducsuisaastvecWancevecieets Frazee CLEARWATER COUNTY 
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— DPE SY: SLATESOON. 5 5i<ccnasss<csnncncsecccesessstacssodenss Detroit Lakes We. Ee. AMBMGO: iiscciciscecticesccccccccicstiteecnsenee! Clearbrook 
: e by 
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chester BM ROGRNMGOM «5 giciosss0ssscciessessigsccsstnnsscsncasacecsaets Bemidji 
Ard RUN ooo ois nace vans dutacsdsaaravsedveicssaccoate Blackduck COTTONWOOD COUNTY . 
Ee: Ce, WABI cence cet a cevasaie ‘alge 
Bec. Gi nc ciccescricnctccrstrnecnstenens ountain Lake 
BIG STONE COUNTY J. Vu. CARES ON a ccsicccscs0 nid eraaidtandrecentd Westbrook 
MES MOMS 25 oars asks caice dakcedavsnnccvacecsdesetaisegadesvosws Graceville 
URC N RETAINS ooo yac.cap sinks ivascadsccennccassdacaseavosaeh excunsad) Clinton CROW WING COUNTY 
Wie As. PRRDE MABE. . c.ccscccsccececsseeseacssesssorceseasssotaces Ortonville Vv QUANSTROM ER TR ON ey Seem PS Brainerd 
Co he APR ocnses caeccdinescteieeieaneceee Brainerd 
BLUE EARTH COUNTY Be INE eoisec cca cei cacexcicnegecencee Geecieee ncaa Crosby 
G i MEINEM ois Sccevcavihs st cccau syste wetteeeg ee Mank 
at Paul He tton Moroan.. a DAKOTA COUNTY 
anabec, i CNC oS ee een n rate BamNice THORRSON £....0c.c..cccccscsceccccetecensscs 
igton POUeeeErCTOCTOOCOCOOCer CeCe errr ee eer ri i) eee 
OLR SIT) 1) 0 ee 
i E. J. WoHLRABE...... Ce GEO a sos cese dea cetnitecsccarendacenc eee) Dodge Center 
oO. B. FESENMAIER Ws PRIN dasa cducaconceesauaacddccquiauaetadeeteete Kasson 
A. P. GOBLIRSCB.oocecccccecccccccccoceececceccecceececccccesees ae Be CHE IO cic catceendsscataeactataaaet mers West Concord 
Bertha a 
rwater, UFO Bios edacso cc cncc acc cacceesedee ddeoewetesecesucsececd Cloquet E. E. EMERSON............ssssssesesssesesssesesntenteneenssneneessassed Osakis 
Stearns, MEME, PPAR ocesec.seseecsoeceecedsccccecescesvececcecececceccd Cloquet G. W. CLIFFORD...........:.:csssesseesesseeseeseneeneentaneseens Alexandria 
OD ERANSOINE oc ccroccocsseccocsncesocsocceocseccessocssssonseead Gixcltcrr Wee a SARI secs sce cocncsd cscs teeeostacseraccunsemeereen Alexandria 
soitaaiie Ep ge epenaneleiemmemammne <A . L RR RINE: 
n, Lake EB. PoGug. A cetopa - RICHARD VIRNIG....004...--s0sssssssensessssesssoserencenssrenctsennesees 
Potter Ye POUR evsesseeesesseeessseeensssernsstennnnsteenenene 

Bp ics cu esSea dh (suse sacavatcresd eaten Albert Lea 

ee AON Teen . E. J. NELSON Albert Lea 
M. A. Burns......... . SHERMAN ...Albert Lea 
L. A. Krystosex Or os 2ikicccnadésbaiccadtéciandseadsenese He -.Albert Lea 

May, 1955 363 



ie Be ET CIRO OR RHE ort fee ee oA Ee DSR eR Red Wing 
RN MEIER oes cass dicsaptvnkescheconsohacosenetssacunesseih Red Wing 
STi ME MMMOMDIAIIIE: 5. (555550505 cchsciecssensissecebacsoeceesees Red Wing 
Dee RUAN 5 cas os Sa5 cscs ses Szasceswacen tea besetesenouee’ Elbow Lake 
NR EME oo cog hs occ snssbesiavseaccvessercotentvcd web aanose eee Hoffman 
WUC UN TAN Sos sss Sib va scutes wdeepbecesa tne loaaeiiueiet Wayzata 
US hc. C= eee ee crea eer,” Hopkins 
Ms Uc Me AREAS EDE soos cs Sees seks ceSiohscsensc sh csassescevense ome Robbinsdale 
PNG om MOIRA EES OOS Sires ta os As Soca nokconcassuibieocdeisoeee Caledonia 
Bn a Ee Houston 
Mis FR NTO 5506s sc Spsvsntscveessvseusevecnoseusc0s lectee Spring Grove 
MPONAED TIGUBTON 5 50.55 0scisieesecesisecsceccisesvessecesseet Park Rapids 
WY MONI oo Ss oo ish sssscseecesegabsvascavebovasiccvaone Park Rapids 
IRA RR oo 5S 5. cas deg svatsncs sai <ovestieesciebessest-csstth Park Rapids 
BY = ek MASI IN 55 sv esas sccsevee Necihaesseteeest Te. Braham 
Pe A MR RIRMEN eyo ssc Csi cosy sssedcaclod eserasacety J.sseeeeeeee Cambridge 
Ray AAR PERRO Nc sion csiap scabies caseeseck as toeckueve Su lestetnes Cambridge 
Fe cA TR ND NMI ESF oo Se oad con in ccacuesceeuceeceaeeee Coleraine 
ACs ae SR REINS 5065 5a casisses canseseccosstvecesivaceees Grand Rapids 
INAS) RGIS ININA (on stesccccecscasssicasesesanstessteepstl Grand Rapids 
i OMI one core fiend OS Someone Lakefield 
WN PRES POR ERSNIO BIN 5555s 650c ess z095seeioacs case oasceeceseasseaed Jackson 
CR ee Ll 5 RR Geen ere gee Mora 
bese 5, FOUL, TS EA eA A ROR Mora 
AANAUR 501.0 MRREIGE 3005555550554; 005<asackct ennsacouviniiuanetontcen Mora 
ACTA POM ERNED ers 55 0.8 Oe hen leew usu elin ose Willmar 
Pace NTeIRIRRIE SS 3 Cicily he hak el ee Willmar 
| ae) ORE Oct. eae se et ane a eRe Willmar 
Pte pM SRN 20 255 e KET eS yey scucboore cence exter esau weet cee Hallock 
tee Sg LC) 0) a Ry eRe. Karlstad 
a ee EC: CC C0 Sa Littlefork 
RES SUNS OR a Aa PSE International Falls 
MSR MOND REIB Soc ccciccccecssconcinatvcvantovecdoce’ International Falls 
i Sa bess LS 0°) S ALR one RE eR eae ae Re Dawson 
MSHESTER ANDERGON: 5.065055. ¢00sssc5eccsseseesscscsssosssaacscee Madison 
RALPH PAPERMAS TER .<.0..065055ccccccscccssesccscsscce Two Harbors 
PA RS MEINE ohn wcasetle eth a, cues pean th ae Baudette 
1 Cage, [Ao 0) Sd y ae neer ee Peer ie en aPEN Baudette 
Be sy MMM BION oi vsscco ss asestecosseascesecee Nese eee Hendricks 
DA id cP BRIM ENIOM ers os csa Pode eeck 5 Licss \ceiax seh coun eco SoS eeeee a Tyler 
ARE ION a oe ics ks dots ca daicdonsa cere eesiek Lake Benton 




TUES OFS cen ie Rn i dt ee Marshall 
N= FUN cE ericsson ase cb ck sa avsudeedevceguececaevacseses Marshall 
WH: UG, SUMORICMORING coos eee. co cops sccesesSsctessscoctscevssosssscenszuce Tracy 
eI  ORMIOD, - Piaren nai ugsceccons eeocte dec eacdbnipiadicans Mahnomen 
Pe EIVET EMOU BANA, io550 Soshcdstsesosssentursiconcoscdenenteess Mahnomen 
CARER TIOLMBTROM: .. 26.56.5055) -csccccas..ccassaceescsaeeccessesee Warren 
PEs RN) MMII 055 68 5s isos g sas cakuicsenucicexswocivecgandnanownee Warren 
BRAG WEI co con chev bese tocds ead wae weeds norte danbauesessooe Fairmont 
MOD NaI ors cho acscsccctuacessasecacdiccascecoxtensdstecssaced Fairmont 
MS IN AE SBC ancl dv en xcdschaSecereviecnacs ave aN RUE Fairmont 
BA. AL  WWIETASEGON oso co oscascseedeccecnsssersdossscvensaveoe Fairmont 
AS FINA OMIENGION 6 ca cicors szcussnesecesedoss iu snus accsestaxecenyeessiest Brownton 
Ir, RUN MGRERRAIS. oc 5ccsscesscrisessssoncscsaooesesssenacsscsecd Hutchinson 
TPOSBR ET SBEMON. 5 cccsscvssscahoreccecksctoosessterssaatsacoueeeus Norwood 
TUAROETy WHELIMEOIE ooo dicccseesccvesevascenescchceceecccgentsncavesed Litchfield 
LENNOX DDANIELSON «60.50c0ccscccsesccissccssesessticacevsasess Litchfield 
PAGINA DIGOON oe. oscci ossse0s soccsicesseseteeccass avasscoeed Litchfield 
WFR BOMB ERG 5 oie doc sche cobs cess cocsvancesnsvetcasseasncionse’ Princeton 
Pin Ut MEMBER SINNER coos foc ccdes boas yes seve ce seneccsevencevessneseee Princeton 
HNN, PO PMT on ss ic.css ev -scaicco cas cisco assutuabubeeccovoces Princeton 
D. L. JOHNSON............00066/ Bee ak Nusaaa st eacesteeont ees Little Falls 
Bi SMO VAT BONG oo cnccisocclendssoevaesesentvednasioenssevaesecd Royalton 
| Die CRU) (Sc 1 eR Swanville 

| Rg: UA Ec! Ch Ne ae tr cre RIN ee Austin 

MY RG IAIN en ache tes ccc acen vvcinsees as eekcusneseapaearerneess Austin 

Be oI SEEN GOIN 2a cA coc cncs cost Sec deus taca eases Ieotseeieapiuveees Fulda 

R. F. Prersow.......... Slayton 

H. D. PATTERSON Slayton 


Bs (G OABAINGON 5 os cscs c.ccccieseceekcssvaessepensavardivesevivecs St. Peter 

DS Hee, MOG BGING 502 os ccs ceciioecadsnts voce hve lestastonstcavesnteees Gaylord 

BB A UMM oo cece ds casas catcccenseesoacecsksliomseasensnrveeds St. Peter 

Bic. ANN NG RS IAD 0s sock cacs cio sy.d cecdeosseeosiencctseteeasreeees Adrian 

Be As, MISSION ass sg cc oes su eaee xa sansa vasseweeuceedseves Worthington 

“ge | Spe SCS me AR Worthington 

WUSMIT) MRICS ON So oc2 cc cco casusccaccosesgeacceecssbessesteis meee Halstad 

BBO IE TINICAIIE 6605 50cc) 6s casceasdectnasavseesesenvsecedesvascoccenesssovel Ada 

WPERODORE TGORIN 3.06 ccsccccccesssescsccecssscssssvarvoncescvonssevacees Ada 

15 AE, pa 200) C11) 5 a ep ca ee Rochester 

(Oke RS (ol) fc EO Pine Island 

OT HO BR vac os Sch ac dccnc Susser s vosecueesiKacdansserbavers Rochester 


CREA RES IR WAS 2 oc cdessncksecdcpscescescccansasvoncessvsnsesacones Henning 

RANI NAR ORIN 552055 ccnsseccscecseaseessssuceesoarsssesees Fergus Falls 

ED WR IB SEED? ocsscecsicsocsccessvascesstssnonsscverdeem Pelican Rapids 


Qs sr > 

. aan 






















Mea), STAREROW.............ccsccesseccsoacsnscnseese Thief River Falls 
GorGE T. VAN ROOY...............:ccseceeeees Thief River Falls 
FRM Fe SRA E oe «ons die sa ans sascsdeatateseigeestecscarsveven Pine City 
Rr PROBING 62055, <6 53. cc. <osSareastdecetisccosiieiee-npaveeeet Sandstone 
MMM PARED Be sasvacc.sdvecnss.ccice wacsnsceaciticercoateecelt Sandstone 


W. oy a INURE Sos i ccacensavscassouscanesssdecsancsrsicasucoes oe 
SE RIE i cnscnsssncecansensasatanetaronesntsesnaceneccal ipestone 
PMO DUNG 505. cee sposecensipasecevanderevcevadeckcnsecnseh seats Edgerton 

MRIS AMIENS 5 oa 22028 00052 cscckncedvodsnevecasccisbontaecesead Fosston 
OY ERE oc oases calescccccunes cuyecccontaacaowreaseconcices Crookston 
Ca OT CC en ei nn RRS veer McIntosh 


Det SWEDEN DERG: . 05.5.0 scseseseedievecoscccdccsausscosccccened Glenwood 
I ENNIO oo 20 cFoac 2 ov hcde cso, daavecndcccinalcavssudeecn Starbuck 
MI UN oo 505. 2a cles. < cas exsedccartceussatvdeenexigiaigesne St. Paul 
PERE NE 5c305 21 ed Ra pcs aut aikindse Rusa eeavskiuakD UNG: St. Paul 
PMI OEE 62 ovcccsceccensvtecewsecascvexevecedssverese%os: No. St. Paul 
JS 5 a Red Lake Falls 
OSE GTS Sg Red Lake Falls 
"| ends TEST. eae ee AP Wabasso 
OWN DIB SONGR....<5...:<cc0+-ceovescctesscsssessecssesien Redwood Falls 
MM MPM PENLUNS CON oo 2055 055 sd50ysacseandscscectccdsleaxceosece soit Morgan 
vA \@OSGRIBE. (Sie. coca ccce se viciciesdelcccscsesscsencwuaccacs Olivia 
HEIN IV ORDAL  <.00.55cc0ssostssesessccesdsvevsacexcsccsced Sacred Heart 
PMT PANU OHIDD: «csc ccnasccessesunnccestssnncessaveaccevesccvee! Renville 
MEA, NU BAMGANG ce cccacccesdcondcscessustsldsasesccoccesss Faribault 
MMEREZG We SBAURSERE 2; o2- <5 0523:5) coczesbesss,cceceteeiececstcsen: Faribault 
BERNARD STREET)......<....0sccccccccorcscssnccotsstececsessoess Northfield 
Cal SHR MEAN 2 occ.n50-.cescksecadianedctsecdesststeislleeee Luverne 
PO PIU RI TEN ccs toss coc cc doahdat ees creecsccoae oes Luverne 
He Wr BOREN KADER: «. <....csececececessccceecsaseccocesecedoecseese, Luverne 
PEN E. DEEMORE, Jit. ..o-cschs-cecoeedeccelseaetisdedens Roseau 
|. AO ai): 5 a ln Roseau 
ERNEIDES! NEE SON <5 .00:c+0<escccecsicesndecesidsscicieccactacce Warroad 
SO MMIII i csccviisiniviensnnicccuresncivsesarsonscarencactd Greenbush 
RECO ETT Te ae. Duluth 
I a ee as cera Duluth 
EA CTE, Duluth 


nnn CER Oe te a eee Belle Plaine 

ESS ANSARI Shakopee 

I, RN asc cvescnondaesesecsccsccs dees Elk River 

= RRR eae: Elk River 

May, 1955 


RGR NEMOURS Sy 28 (ayia tad Rae Satan ed eee Winthrop 
I Ne AE as fo Ad a ea ee Arlington 
BPS GR. QRES ONG resect ahaa Ee Gaylord 
Cl. Be AIS Tose cccaesa cence St. Cloud 
To WING 5 a2 oss coe ee hacia cache St. Cloud 
1 MON SRR O11: SRR ea ape oben em 98 Sect EO es ne St. Cloud 
INS, We NIACIN bo coho cc Restrnt alms Foley 
We Bil RAR UANEN oos sscacse sc scaesansctcaacacnsyeavaenl St. Cloud 
Ble Te COE RON en cscs cachnasoepecetcaadseannscesancnaladenace Owatonna 
TE Ae Wass ccs atee cassette Owatonna 
WOE. TRANGON 003k eee Hancock 
Pi SONOS ck doscawngiecatesnndorer erates i Morris 
PR TE, PONE oso ccsec cs oak eden ae Morris 
| A Age 71)” 7). Seana ee nen teenie Sea a ee Appleton 
ys Gy, CUR Ge. ccs ceedessicse hen eh eaeee Kerkhoven 
Rs CNUs ods occa cece vgstataracetimee ee Benson 
MEE, MOsBe.o.oi.ctciccsirc een aad Long Prairie 
NAS Cala, screen taeda ee Staples 
Oe Re Was cesses cheeses htc ade ae ee Bertha 
de i. “Baa os sons Sheena 
Bien We RADAR ORIG soos ccc cwaasexestea saraateieasetetedaeeetaae 
WW he MMII sodas a <coccnsaccncsnd Quacuvesasdecaneancnsseease 
C. GC. . COCHAGBI 5 6icg esciciniieieeee Wabasha 
De Oy RM WW ose tsd cs coccwacacsccoccacsaicassneesaceseseenceated Lake City 
BE GWA ochre eine Plainview 
ia We AW 8 ico thac eek re eee Wadena 
Oy. ER amen os cc oc fo dccsevacicstigs aera Wadena 
WB A occ sciceie ee oe eee Sebeka 
CS Eis i Cia oon aes Ae New Richland 
Wh CARR Aa Rais esc s eden cctpccececesacactacitenantesies Waseca 
NM FOURGENS 4.3 <i tei tc emeequiae Stillwater 
©. His SERRA oo ia < ccc cinece cect ee eases Bayport 
TE. By CARES Ok. ok... cisecciccaccirieeec etc Stillwater 
OG}: By RRGW@AN ices osc ernie Saint James 
POMEROY SUING aesccadecccccdccacsascaistcacccess iorecsen ees Madelia 
C. We JACORSON.....65.465-hi cee Breckenridge 
We . ‘WHESON:...24 eee eee Winona 
S.. > aati. ees eee ee eee Maple Lake 
BR WR SANDEE. csn chat spac nen eeveranesectcaseecccatinaspeiees Buffalo 
Cae ERR se a casecziecdecesocetatcoe ee Granite Falls 
0)! GC 5°75") San ene eee aR ER oe ey Granite Falls 
Wee RG. “UN a socac cs scdes scuascanssideetsactanecat Rate Echo 


to the 


Mrs. Peter S. Rupiz 
Mrs. H. H. FEsLer 
Mr.. JoHN Dorpba 
Mrs. V. J. ScHwartz 
Mrs. L. P. Howeiui 
Mrs. Justus OHAGE 
Mrs. Davip HALPERN 

Mrs. CHARLES W. Froats 

Mrs. G. H. Goreurs 
Mrs. S. N. Litman 
Mrs. A. J. BIANco 
Mrs. LEo FINK 

. O. M. HeErserc.... 

. J. C. BuscHer 
. C. W. Moserc 
J. L. McLEop 

Henry W. Quist, SR 



St. Paul 

Recording Secretary 

Corresponding Secretary 

Fifth District 
Sixth District Minneapolis 

Saint Cloud 
Detroit Lakes 

Eighth District 
Grand Rapids 

Ninth District 

Chairmen of Committees 

Advisory—Mnrs. HENRY W. Quist, SR Minneapolis 

Allied Medical Careers— 


American Medical Education Foundation Fund— 
Mrs. J. A. CoscrirF 

Archives—Mrs. J. L. BENEPE 
Bulletin—Mrs. C. E. CaRLson 
Cancer—Mrs. W. G. BENJAMIN 
Civilian Defense—Mrs. D. G. MAHLE 

Mrs. L. RaymMonp SCHERER 

Saint Paul 



Finance—Mrs. Marx RyAn Saint Paul 

Health Days— 

Mrs. Haroitp F. WAHLQUIST Minneapolis 

In Memoriam—Mkrs. JouHN J. Ryan Saint Paul 
Legislation—Mrs. Pui K. Arzt Saint Paul 


Medical and Surgical Relief— 

News Letter—Mnrs. M. F. FeLttows 
Organization—Mrs. H. H. FEsier 

Press and Publicity— 

Mrs. A. B. RoSENFIELD. Minneapolis 

Printing—Mrs. WiLt1aM GJERDE Lake City 

Program and Health Education— 

Public Relations—Mrs. G. A. HEDBERG 
Resolutions—Mrs. P. J. PANKRATZ 
Revisions—Mrs. D. V. BoaRDMAN 
Roster—Mrs. R. F. Erickson 

School of Instruction— 

Mountain Lake 



County Society Roster 

Key to Symbols: *Deceased, }Affiliate, Associate or Life Member; {In Service; 
§Wife is Member of Woman’s Auxiliary. 

Regular meetings, last Monday of each month. 
Annual meeting, last Monday of December 
Number of Members—57 

President $ Hammar, Lawrence M............ Mankato § Morgan, Hugh O................::00+----Amboy- 
EusTERMANN, JOHN J Mankato Hankerson, Robert G.....Minnesota Lake § Olive, John ; ee ..Mankato. 
Secretary + Hassett, Roger G Mankato § Penn, George E.... = 
McNear, Georce R., Jr Mankato § Heller, Edgar E.... .Mankato § Roth. Frederick 
$ Hoeper, Philip G... -Mankato § Samuelson, L. Gordon.. 

§ Anderson, James Mankato § Howard, Marshall I J § Sanford, Raymond A... ), 
Anderson, Margaret C.. es 7 + Schmidt, Paul A -Aurora, Ill. 
#$Andrews, Roy N § Huffington, Herbert L., Jr.....Waterville § Schmitz, Anthony A.. ~Mankato 
§ Baird, Raymond L.. § Jones, Orville THe ni.n...:.:...c.c00 Mankato § Sjoding, J. Donald... 
§ Batdorf, B. Niles... + Juliar, Richard O...Los Angeles, Calif. § Smith, Harry J 

Duluth § Butzer, John Ss § Kaufman, Walter § Smith, Paul M 

: te § Butzer, John F § Kearney, Rochfort Wynn.. + Sohmer, Alphonse E.. 

neapolis § Chalgren, William S... § Kemp, Alphonse F § Stillwell, Walter C.... 

it. Paul § Conley, R § Koenigsberger, Charles.. § Thiem, Chester E.. 

1 Heart Dobson, M. § Langhoff, Arthur H... § Troost, Henry 

: § Engstrom, Robert + Liedloff, Adolph G... § Vezina, 

leapolis § Eustermann, John § Lindblom, Alton E. § 

chester t§Franchere, Fredk. Lake Crystal + Luck, Hilda 

t. Paul {Fugina, George R...............000 Mankato § McNear, George - ye. .M + Williams, gh O ...Lake Crystal 

me u § Geurs, Benjamin R. ...Mankato § Mickelson, John : § Wohlrabe, St. Clair 

rewster @hlaes, Jolius B..........2...:..cccccesscosed Mankato T§$Miller, Wistar icine Mankato 

t. Paul 




Duluth ; : 

ani (Martin—Watonwan—Faribault Counties) 

Regular meetings, third Thursday of each month. 
Annual meeting in November 

Number of Members—44 

President § Hanson, Lewis.... ea ¢ Rollins, Troy G 
Winnebago : mga Julius , : in, + A 
Secretary ruza owe, illiam 
Boysen, HERBERT Madelia +$Hunt, i § Russ, Homer H 
chester Kraemer, George } § Smith, Don V.... 
ington § Armstrong, Ralph S... Winnebago § Krause, C. W § Snyder, Clifford D. 
Echo Barr, James EB § Lester, } § Thayer, Ellsworth 
Ke § Bergman, Oscar B § Lindahl, § Vaughan, Victor M 
w Ulm § Blumberg, Henry B... Louisell, § Virnig, Mark P.... 
it Paul § Boysen, Herbert.... + Mctnoarty, John § Virnig, Richard 
eapolis § Bratrude, + Mills, John L.. § Wandke, Otto E. 
+§Chambers, Winslow C. t Moulton, K. B... § Watkins, John A 
Cloud + Cooper, Maurice D... § Nickerson, John R... § Williamson, Harold A. ; 
Lakes § Coulter, Harold § Nickerson, Neil D. + Wilson, Clyde “Blue Earth 
Rapids § Drexler, George W... ...Blue Earth § rada, ae ied § Zemke, Erhart E... .Fairmont 
§ Gamble, Elbert J ....Bricelyn § Parsons, R. fe Ziegler, Robert G ..Welcome- 

§ Gardner, Victor H Fairmont Parsons, Ralphs Ee. 


Regular meetings, quarterly. Annual meeting, in January 
Number of Members—34 

‘okato President § Fritsche. Albert Muesing, William _................. New Ulm 
Seirert, Orro J § Fritsche, Carl J .N J Nuessle, Walter G... e 
inkato Secretary $ Fritsche, Theodore R. t+ O'Leary, John B 
Kaiser, MILTON New Ulm Goblirsch, Andrew P... ‘Sleepy Eye § Penk, —— Le 
duluth Hedlund, Charles J. -Owatonna Peterson, Roy A 
§ Black, William A... New Ulm Hovde, Winthrop Rayner, Ralph R 
Paul Burnett, Joseph W.. Vew Ulm Inglis, William.... -Redwood Falls ea. George F.... 
§ Cairns, Robert J.... ...Redwood Falls © Mawer, Milton E..........ccc.s0 New Ulm § Saffert, Cornelius A.. 
; Carthey, Frank _J.... New Ul § Keithahn, Elmer E.. Sleepy Eye _ Schroeppel, John E... 
apolis § Dubbe. Fredk. H.... .N Kitzberger, Peter J.. ..New Ulm » Scifert, Otto J 
: § Dysterheft, Adolf F.. seat & Kruzick, S. J Sleepy Eye : Vogel, Howard A. L.. 
City 3 Fesenmaier, Otto B... ¢ § Kusske, es .New Ulm Wisness, Osmund A.. 
Flinn, James Mattson, Albert D St. James } Wohlrabe, Edwin J 
A (Chippewa, Lac qui Parle and Yellow Medicine Counties) 
Lake Regular meeting, first and third Thursday of April, May, September and October 
inona Annual meeting, third Thursday in October 
: Number of Members—33 
President § Allen, John H § Burns, 
- Barr, Montevideo Anderson, Chester A... § Burns, M. Alpheus 
polis Secretary $ Barr, Ronald W i § Camp, Ray Junior 

ALLEN, JoHN Montevideo Boody, George, Fallon, Virgil 

May, 1955 



t Flom, Robert © Columbus, Ga. 
Guilbert, G. M 1 

Hartfiel, aes A Montevid 
Hauge, Clarkfield 
' — A 0 Canby 
udec wyn 
ustad, Edward G 
2 Johnson, Curtis M 
§ Johnson, Vilhelm M 


t Jordan, Kathinwe Smith....Granite Falls 

Granite Falls 
H aufman, William C... 

Krystosek, Lee on Clara 
t Lee, Walter I N... aeealenr = itd 

Lima, ie. 
Granite Falls 

t Maus, Philip New Orleans, La. 

Nelson aoe m, 
Odland, M... 
Owens, Wills A.. 
Pertl, "Albert _L... 
§ Roust, Henry A 
§ Schmidt Paul D au Jr. ‘Granite Fall 
eon Montevideo 
§ Westb y, M: -Madison 
$ Westby, Norval M.......c:csccsssse. Madison 

Granite Falk 
Granite Falk 


Regular meeting, spring, fall and winter. Annual meeting, November 30 

pps, Witiiam C... 

§ Carlson, Vernon J... 
$ Dodds, William C 

Number of Members—26 

3 Duncan, James W 
Gacusana, Jose M 

$ Geib, Marvin J... 

y Hagen, Olaf J 

§ Houglum, Arvid 

§ Humphrey, h.. a ie W.. 

..Detroit Lakes 
Lake Park 

§ Lorentzen, Ernest S. 
$ Midthune, A. S 

3 Ooped Maz gt Ww -Detroit Lakes 
kE et Lakes 

Oliver, ” 
Otto, Henry 

§ Rice, Hagbart 

3 Rutledge, Lloyd 
axman, Gertrud 

§ Simison, Carl 

+ Thysell, Fred A... 

$ Thysell, Vernon D 


(Anoka, Chisago, Isanti, Kanabec, Mille Lacs, Pine and Sherburne Counties) 
Regular meetings, first Tuesday of every other month of the year 

Secreta ry 
TescH, Gorpon H 

Adkins, oo a 

Albrecht, H. Chisago City 
Baars, Co Camp Cook, Cot. 
Berge, Harry L Mora 
Beyer, Eugene F 
Blomberg, Wm. 
Bossert, Clarence Ss 
Bunker, Bevan 
Burseth, Edgar C 
Dredge, Homer P. 
Gully, ‘Raymond J 

Number of Members—40 

Halpin, Joseph E 
He a og Paul 



McManus, William F 
~ Magnuson, R. C 
$ March, Kenneth A.. 
Metcalf, Norman B 

Annual meeting, first Tuesday in December 


$ Nordman, Willard F 
Nygren, William T 
Pasek, Edward A 

Rudolph, Frank A... 
*+§Sherman. Hubert :; 
Spurzem, Raymond z 
t Stahn, Louis 
§ strate, 

§ Swensen 
3 Tesch, 


t Waller, st D 

Woyda, William C 

Pine City 
Elk River 


Regular meetings, third Thursday of even months 

Ecce, S. G 
E.iertson, L. M 
§ Barr, Lowell C 
Burns, Catherine. 
8 Butturff, Carl R... 

Ha San hen y 
ertson, Leonard M 


SHERMAN, Roya. V. 
Secretary ° 

Haw.ey, Georce M. B. 

§ Akins, Willard ~ 

§ Allen, George S 

t Bagby, George W...Ft. Len. Wood, Mo. 

t Sol, . ‘hornton... ‘Portsmouth, Va. 

§ Bridge, Ezra V..................Cannon ’ Falls 

§ Brusegard, James F... ..Red Wing 
Claydon, Howard F Red Wing 


Annual meeting, December 
Number of Members—30 

§ Erdal, Ove A 

§ Folken, Frank G... 
{+ Freeman, John P... 
+ Gullickson, Andrew 
§ Hansen, Theodore 
§ Holian, Darwin K. 
* Kaasa, Lawrence 
*tKamp, Byron A. 
§ Keil, Marcus A.. 
+ Leopard, Brand 

§ Neel, Harry B 

sville, Texas 
Albert Lea 

Regular meeting, none 
Annual meeting, December 

Number of Members—29 

§ DeGeest, 
t Dovenmue e, Robt. 
§ Falls, John L 
Flom, Martin G 
§ Graves, Richard B... 
§ Halvorson, ames 
§ Hartnage 
§ Hawley, 
§ Hedin, 
¢t Jones, i 
§ Juers, Edward H..........:::ccce Red Wing 

Nelson, Clayton E 
Nesheim, Martin O 

: Whitson, Sidney A. 
§ Wilcox, 'G. Charles 


§ Kimmel, George C 
: are. William W.... 
§ Miller, Winston R 

§ Molenaar, Robert _E.. 
i Sen Royal me 

“Cannon Falls 
..Red Wing 
Smith, Myron W.... 

Steffens, eon A... 

Walter, William E. 

Wasmund, Clarence W.. 

§ Williams, Marland R......... 


or Reon COR OR 2 LR — AO om _ CR ER ROP? 
i, i Sn, Oh an i, Pe Se: Se, Se, Se: Oe, i, ee ee, 6 6[ClUlC CC 


See, Oe FL Ae ee ee, ee ae ey a 

002 08 

c, ee ee 


—b +e —F 

Onto C0802 = 008008008 Ft 08 

‘ite Fall 
‘ite Falk 


it Lakes 
it Lakes 
it Lakes 

lk River 

ed Wing 
od Wing 
ed Wing 
on Falls 
od Wing 
ed Wing 
ed Wing 
ed Wing 
on F; 



Aunc, CuHartes A......... 

Hotmperc, Conrap J 

Executive Secretary 


Regular meetings, first Monday of each month October through May 

ee Minneapolis 


Mi lis 

Cook, THomas P. 

Abramson, Milton 

Adkins, Charles D 
§ stsson, Hreidar. 

Mi li 
Min Li 

ern, Eugene E 

§ Alexander, Harlan A 
§ Aling, Charles A 

M Yr 
Mi Iie 

Althausen, Theo. L., 
7 Altnow, Hugo Oye 
Amatuzio, Donald S 

Orsi Gables, Fla. 
Mi: a 


§ Andersen, Silas 



‘Mi is 
St. Louis Park 
‘Mi lis 

§ Anderson, 

+ Anderson, | 

Mi Li 

§ Anderson, 
§ Anderson, 
§ Anderson, J 

Mi ae 

§ Anderson, 



§ Anderson, 

§ Anderson, 

§ Anderson, 
Andreassen, Einar 

§ Andreassen, Rolf _L. 

§ Andresen, Karl D’A.. 

§ Andrews, Robert S 

§ Ankner, Frank J 

* Archer, Willard E 
Arends, Archabald L 
§ Arey, S. Lane 

Mi oe 


Arhelger, Stuart W 
§ Arlander, Clarence E 
§ Arling, 
§ Arms, 


Arnold, Anna W 
Arvidson, Carl G 
#§Aune, Martin 


+ Aurand, William H 

in 1 

§ Baggenstoss, Osmond J 
Bagley, Russell W 
§ Baird, Joseph W 

M r 


Mi ee 

$ Baken, Melvin P. 
Bak A. B 

i lis 




§ Baker, M 

§ Baleisis, Peter.. 
§ Balkin, 


M; He 


Balogh, Charles J 
Bank, Harry E 
§ Barno, Alex 

San Francisco, Calif. 

St. Louis Park 
Mi lis 

§ Barr, Maxwell. 

Barr, Robert N.............. 

Barron, Jesse J 

cacevaed Minneapolis 


Barron, S. Steven.. 

*§Baxter, Stephen H... 

§ Beach, Northrop.... 

+ Becker, 

§ Bedford, Edgar W. 

§ Beirstein, Samuel 

§ Beiswanger, Richard H. 

+ Bell, E. T 

§ Bellville, Titus P... 

§ Belzer, Meyer S 

enesh, Louis A 

§ Benjamin, Edwin G... 

§ Benjamin, Harold G. 
Benson, Ellis 
Berg, Clinton C. 
Berger, Alex G... 

§ Bergh, George S. 
Bergh, Solveig M... 
Berglund, Eldon B.... 
Bergquist, James R.. 

§ Berkwitz, Nathaniel J.. 
Berman, Reuben 
Bernstein, Irving C 
Bessesen, Alfred N., Jr 

—, —— ae 

ieter, Raymond N.. 

§ Bilka, Paul J 

§ Binder, Manuel R.... 
Bjornson, Robert G. B 

§ Blake, Allen J 

§ Blake, James A 

May, 1955 

La ee 

Esatees Minneapolis 


Election in February 

Annual meeting, first Monday in October 

Number of Members—960 

§ Blake, Hopkins 
§ Bloedel, T. J. G.... seo 

Blomberg, Robert D.. Minneapolis 
§ Bloom, ecen B .../Minneapolis 
§ Blumenthal, Jacob S Minneapolis 
*+Bockman, Michael W. H. 

Hot Springs Nat’l Park, Ark. 
Bodelson, A. Little Rock, Ark. 
Boehrer, John J ..Mi polis 
Bofenkamp, Benjamin.......... Minneapolis 
§Bohn, Donald G Minneapolis 
Boies, Lawrence R..............-.- Minneapolis 
Booth, Albert E Mi polis 
+ Boreen, Clifton A................. Minneapolis 
§Borgeson, Egbert J.. t. Paul 
Borman, Chauncey N Minneapolis 
Borowicz, Leonard A Minneapolis 
Bowers, Gordon G Mi polis 
Boynton, Ruth E Minneapolis 
§ Bratrud, Arthur F.. ....Minneapolis 

Bratrud, Theodore E. Minneapolis 
t Breitenbucher, R. B.....Columbia, S. C. 
$ Minneapolis 

am, -Minneapolis 

Bushard, Wilfor .Minneapolis 

Buzzelle, Leonard inneapolis 

Cable, Morris L .Minneapolis 

Cabot, Clyde M. /Minneapolis 

ady, Laurence H. /Minneapolis 

Cameron, Isabell L... .Minneapolis 

Campbell, Lowell M ‘Minneapolis 
§ Campbell, Orwood inneapolis 
§ Caplan, Leslie. 

§ Card, William H... 
§ Carey, James B 
§ Carlander, Lester 
§ Carlson, Lawrence 

Carlson, Leonard T.. 

Caron, Robert P... 

Carr, Willi 

+ Brooks, Charles N. 

+ Brown, Edgar D... 
Brown, Ian 
Brown, William D 


Challman, Samuel Alan........ 

§ Chavez, Demetrio A.... a 

§ Chesler, Merrill D.. 

+ Chesley, A 

§ Chisholm, Tague C 

$ Christensen, Llewellyn E 
Clark, Malcolm D 
Clarke. Eric K 

M; - 



§ Cochrane, 
Coe, John 

§ Cohen, Bernard A.... 
Cohen, Evhraim B.... 
Cohen. Maynard M St. Paul 

§ Cohen, Sumner Oak Terrace 
Cole, James S ..Minneapolis 
Colp. Edward Adams... ..Minneapolis 
Condit, William H ..Minneapolis 
Cooper, ...Excelsior 

§ Cooper, . Minneapolis 
Corniea, Albert D... ; 

§ Correa, Dale H 

§ Corrigan. Cyril J... 

Cowan, Donald W... 

Craig, M. Elizabeth... 

Cranmer, Richard R. 

Cranston, Robert W... 

Creevy, Charles D 

Creighton, Ralph H... 

Culligan, Leo 

Cundy, Donald T... 

Cutts, George 

Dady. Elmer E 

Daggett, Donald R. 


Rn ++ LRA 

§ Danyluk, Michael... 

§ David, Reuben...... 

§ Davis, Jay C 

$ Davis, Witham: I........2.0.0.:0000..4... Mound 


C—O — bmn 



§ F 




mun Mmm Aun mm 

rr tes 

del Plaine, Carlos W 
Devereaux, Thomas J. 
DeWall, Richard 
Dickman, Roy W 
Diefenbach, Bu e 
Diehl, Harold S 
Dierker, Heinrich 
Diessner, Henry D.... 
——,, Edward P.. 
lorge, ..Minneapolis 
Dornbach, Robert A ane 
ogg Harry B...Los Gatos, Calif. 
orsey, George Minneapoli 
Doxey,’ Gilbert L 1 am a 


§Drake, Charles R.... 
Drill, Herman 

uff, Edwi 

Dummer, Donald J 
Dunlap, Earl H 
Dupont, Joseph A 
Duryea, ilis M 
Dutton, C. E 


me J., Jr. Minneapolis 


... Hopkins 
Mi li 

- a 



Eder, W. P. 

Mi lis 
Ehrenber ; 

g, ee: Mi poli 
{a = 

: on 

: vi 
Eisenstadt, William S 
Eitel, George 
Ellison, David E Minneap 
Ellison, Ellis. Mi 
Emond, Albert 
Emond, Joseph 
Engel. Joseph P. 
Engelhart, Peter C 
Eagiuad, Elvia F Minneapolis 
ngstrand, Oscar J Minneapoli 
Engstrom, Denton P... ~“Sieneopelie 
| ae ane —— O.............Minneapolis 
rickson, urence F, ../Mi i 
Erickson, Myron E Minneapolis 
Erickson, Reuben F 
Ericson, Reinhold M.. 
Esensten, Sidney 
Evans, Edward T. 
Evans, Robert D 
Fahr, George 
Fansler, Walter A 
Feeney, John M 
§Feigal, David W 
Feinberg, Philip 
Feinstein, Julius Y. 
Fenger, Ejvind P. 
Field, Charles W. 
Fingerman, David 
Fink, Leo Wm. 
Fink, Walter H 
Fisher, Isadore 
Fitzgerald, D. F.. 
§Fjeldstad, Christia 
leeson, William H.... 
*Fleming, Aloysius S 
Fleming, Dean S... 
Fliehr, Richard R 
i per B 
Omer, Leslie W.......c0cc...0<::! Minneapolis 
Folsom, Louis B.. ee 
Ford, William H.... ...-Minneapolis 
Foster, Orley W Minneapolis 
Fowler, Lucius Haynes. Minneapolis 
Fox, Ponald P -Minneapolis 
Fox, James Rogers. /Minneapolis 
Frane, Donald B Minneapolis 
Frear, R y Mi Li 
Fredericks, George M 
Freeman, Craig 
Freeman, Donald W. 
French, Lyle A 




pt Ree ~anmenpes 

dison, N. J. 
hai Hopkins 

€ -Minneapolis 
Friberg, Joseph B Minneapolis 
Fried, Louis A Mi i 
Friedman, Jack 
Friend, Charles A Mi 
Frost, John B Mi 
Frost, Russell H 

: Minneapolis 
Louis Park 
Mi os 


Mi li 

§ Frykman, Howard M........... Minneapolis 

Fuller, Alice H........ -Minneapolis 
§ Funk, Victor K. Oak Terrace 

Furman, Lucie Chr -Minneapolis 
§ Gaard, Richard C.. .Minneapolis 
§ Gallett, Lester E....... .Minneapolis 
+ Galligan, Margaret M. -Minneapolis 
*§Galloway, John B....... Minneapolis 
§ Gammell, John H -Minneapolis 
§ Garske, George L.. -Minneapolis 
Garten, Josep -Minneapolis 
Garvey, James T. -Minneapolis 
Gaviser, David... ‘Minneapolis 
Gibbs, Robert W.... ...Minneapolis 
Giebenhain, John N.. Minneapolis 
Giere, Joseph Rotesscsecs Minneapolis 
Giere, Richard W Minneapolis 

Gilbert, Maurice G.. Minneapolis 
Gingold, Benjamin A.. ....Minneapolis 
+ Girvin, Richard B... ....Minneapolis 
§ Glaeser, John H..... Minneapolis 
§ Goldberg, Isadore M Minneapolis 

Goldman, Theodore I.........Minneapolis 

Goldner. Meyer ...Minneapolis 
Goltz, Robert W... e ‘Minneapolis 
§$ Good, Hoff D........... ...Minneapolis 
Goodchild, William R. ...Minneapolis 
Gordon, Philip Minneapolis 

. Louis Park 

Gordon, Sewell S. 
. Springs, Colo. 

t§Grais, Melvin 

Grant, Suzanne...............0000000 Minneapolis 
§ Gratzek, Frank R. E. ...Minneapolis 
Gray, Royal C hase ...Minneapolis 
Green, Robert ea see ..St. Louis Park 

§ Greenberg, Albert J... 
§ Greenfield, Irving........ 
+ Greishiemer, Esther M.. 
Grimes, Marian............. 
Grimm: ell, Francis J... 

.Phila., Pa. 

§ Gronvall, Paul R....... Minneapolis 
Grotting, John K... ...Minneapolis 
Gullickson, Glenn, ‘Ir asia Minneapolis 
‘oe on, Frederick G.. /Minneapolis 
Gushurst, Edward Guu... Minneapolis 
Gustason, Harold T.. ..Minneapolis 
Haberer, Helen inneapolis 

Py Richfield 

Hagen, Kristofer... 
Hagen, Wayne 
Haggard, G. D... 
Hall, Harry B... 
Hall, Wendell H... 


Hallberg, Charles A Minneapolis 
fannah, Hewitt ..Minneapolis 
Hansen, Cyrus O... ..Minneapolis 
$ Hansen, ..Minneapolis 
Hansen, Minneapolis 
t$Hansen, ‘alls Church, Va. 
Hanson, Harlow _J..............3 Minneapolis 
anson, Mi polis 
Hanson, Svaxeerarcoeeen Minneapolis 
Hanson, sh ./Minneapolis 
Hanson, ..Minneapolis 
Happe, Lawrence J............... Minneapolis 
Harris, Leon D Minneapolis 
Hartman, Evelyn E............... Minneapolis 
$ Hass, Frederick M..... -Minneapolis 
§ Hastings, DeForest R. -Minneapolis 
§ Hastings. Donald W... -Minneapolis 
§ Hauge, Erling T......... -Minneapolis 
§ Haugen, George W.... (Minneapolis 
Haugen, John A..... -Minneapolis 
Hauser, Donald C... -Minneapolis 
Hauser, George /Minneapolis 
Havel, Robert J........ /Minneapolis 
§ Haven, Walter K.... .Minneapolis 
§ Hawkinson, Raymond -Minneapolis 
§ Hay, Lyle J.. -Minneapolis 
T Banyes, James’ M...0ssescccsoses Btiansapolis 
§ Hays, Albert T Mi 
§ Head, Douglas P.................0.0. Simaeapelis 
§ Hebbel, Robert.........0.0..0...0.0. Minneapolis 
t§Heisler, John J Mi poli 
Hempel, Dean_J..............:.:0004 (Minneapolis 
+ Hendrickson, John F.. -Minneapolis 
§ Henrikson, Earl C.. ....Minneapolis 
+ Henry, Clifford E.... ‘Kirksville, Mo. 
Herbert, Willis L... Minneapolis 
§ Hermann, _— W.. Minneapolis 
+§Higgins, John H sVbabvecceskssueteee Minneapolis 
ill, Earl Minneapolis 
$ Hill, Elmer M........c00e0ciessesssess Minneapolis 
T§Hillis, Samuel J.....East Bradenton, Fla. 
Hinckley, Robert G............... Minneapolis 
§ Hirshfield, oes R. Minneapolis 
§ Hitchcock, Claude R.. Minneapolis 
Hoffbauer, Frederick Minneapolis 
§ Hoffert, Henry E........ ....Minneapolis 
§ Hoffman, Roy A....... Minneapolis 
§ Hoffman, Walter L. Minneapolis 
§ Holmberg, Conrad J.. Minneapolis 
§ Holzapfel, Fred C... Minneapolis 
t Horns, Howard L..... ...-Minneapolis 
§ Horns, ‘Richard G........0sssc.s000: Minneapolis 



+ Houkom, Bjarne.. 

§ Houle, Rollin  & 
Hovland, Melvin L... 
Howard, Robert B..... 
Howard, Solomon E... 

§ Howell, Carter ws 
Hudson, vee 

§ Huenekens, = 

§ Hultkrans, i «4 E. 

~ Hurd, Annah 

Hymes, Ch arles 
Hynes, John E...... 
Ide, Arthur W., Jr.. 


rs i East Africa 

FRIES Minneapolis 
Hutchinson, Dorothy W.....Oak Terrace 

Johnson, Norman P. 

Johnson, Youbert T. 

§ Idstrom, Linneus G -Minneapolis 
$ Ingalls, Edgar Gases -Minneapolis 
+ Irvine, Harry G... ...-Minneapolis 
§ Iverson, Rolf M.. /Minneapolis 
§ Jacobson, Loren J.. ..Minneapolis 
§ Jacobson, +“ eamel E........St. a Park 
§ Jay. Alan R 4 

Jefferies, “Minneapolis 
t Jensen, ; ‘oslindale, M Mass. 
§ Jensen, Harry (Minneapolis 
*§ Jensen, Marius J minneapolis 
§ Jensen, Nathan K... slis 

Jensen, Reynold A................/ Minneapolis : 

erome, Bourne 

Jerome, Elizabeth ne 
t Jeub, Robert P......... San Antonio, Texas 
§ Johnson, PROEHNT T cvsnsesseseced Minneapolis 
§ ohnson, August E... ....Minneapolis 
§ Johnson, Emil W..... ....Minneapolis 

Johnson, Frank E. ../Minneapolis 
§ Johnson, Harry A. ...Minneapolis 
*§Johnson, James A. ...Minneapolis 
§ Johnson, John W. ...Minneapolis 
*§Johnson, Julius. ........ ./Minneapolis 
§ Johnson, Malcolm R... Minneapolis 

§ Johnson, Norton T... ‘Minneapolis 
§ Johnson, Reinald G. Minneapolis 
§ Johnson, Reuben A. Minneapolis 
§ Johnson, Robert E... ...Minneapolis 

Johnson, Roger S...... ...... Wayzata 

§ Kelly, John 
+§Kennedy, Claude C.. 
+ Kennedy, Jane F...... 
§ Kerkhof, Arthur C. 

Kiesler, Frank, Sri. 
+ King, Edgar 7 

King, Frances W..... 
§ Kinsella, Thomas J... 


Kistler, Alvin J....... .-Minneapolis 
SB Kline, Mictiard’ B.....ssscssssoscoossscset Wayzata 
§ Knapp, Miland E... -Minneapolis 
§ Knight, LS Ad RE ree 

Knight, Ray R..... polis 

Knudsen, Helen L................. Minne eots 
§ Koepcke. Gerald M... /Minneapolis 
Koller, Hermann M... inneapolis 
Koller, Louis R.... inneapolis 
Koller, Robert L.. ‘Minneapolis 
Korchik, John P.. -Minneapolis 
Kosiak John, ae -Minneapolis 
Kottke, Frederic ae -Minneapolis 
§ Koucky, Rudolph W. -Minneapolis 
§ Kovack, Freeman D... a 
Kremen, Arnold J.....New York, 

Krieser, Albert E..........:ccssssssssssssees te 
§ Kucera, Frank J........ .... Hopkins 
§ Kucera, William J., Sr... ‘Minneapolis 
§ Kucera. William J., Jr.........Minneapolis 
§ Kusz, Clarence ....Minneanolis 
§ LaBree, Johm W....... “St. Louis Park 
+§Lagaard. Sheldon M............. Minneapolis 

Lajoie, John M... Min 
§ Lamb, H. Douglas............... Minneapolis 
§ Lang, Leonard A.... ... Minneapolis 
t Lange, Robert D.....Washington, D. C. 
§ Lapierre, Arthur P. Mi poli 

§ Jones, Davi 
t§ Jones, Herbert W., Jr...Brookline, Mass. 
§ Jones, Richard H Minneapolis 
§ Jones, William R..... ...Minneapolis 
Josewich, Alexander ...Minneapolis 
BPG. AMON Sis. cssescsssisosicscicosts Minneapolis 
§ Judd, Walter H.......... Washington, D. C. 
junl. John H Mi polis 
§ Jurdy, Mitchell J............0..../ ‘Minneapolis 
Kadesky. Harold B ..Minneapolis 
§ Kalin, Oscar T.......... Minneapolis 
§ Kallestad, Leonard L................... Wayzata 
Kantar, Bruce L........ -Minneapolis 
§ Kaplan, Harold A -Minneapolis 
§ Kaplan, John J...... Minneapolis 
§ Karleen, Conrad I Minneapolis 
§ Karlen, Markle . Minneapolis 
+ Katz, Yale : Minneapolis 
Kaufman, Herse .-Minneapolis 
§ Kelby, Giert Muu... Minneapolis 
§ Kelly, Charles F polis 

| anys. | Mines 
- Minneapolis 

*+Lazar, Henry Biase 
t Leavitt, oe 
7 Lebowske, Joseph A. 
§ Leemhuis, Andrew J. 



; Larson, Leonard M.. 

Lapierre, Jean T Minneapolis 
Larsen, Frank W............0:000+: Minneapolis 
Larson, Clarence M .-Minneapolis 
Larson, Donald ; Minneapolis 
Larson, Lawrence M -Minneapolis 

Oak T Terrace 
Larson, Loren _J..... .-Minneapolis 
Larson, Paul N... Minneapolis 
Larson, Ralph H.................c.sssesss0... Anoka 
Larson, Roger C. Minneapolis 
LaVake, Rae T... inneapolis 

§ Laymon, Carl W. 

— pe lis 
finneay apolis 
inne apo! is 
-Minneat polis 

Leiferman, Robert J. 
Leland, Harold R... 

Lenz, ‘Otto A........ 
Leonard, Lawrence J. 
Leonard, Samuel... 

Lerner, A. Ross... 
Lewis, F. John... 

Lillehei, C. Walton ‘Minneapolis 

pergr: Bier 0: iséccccsvcscoxt Robbinsdale 
t Lind, C. J., Jr...Ft. Sam Houston, Tex. 
54 Lindberg, Arvid Crocs Minneapolis 
§ Lindberg, Vernon L... -Minneapolis 

§ Lindemann, Charles E... 
g Lindner, 

: Linner, Gunnar ....... 
no hd 

: Lipschultz, Oscar. ... * 




Lindberg, Winston R. 

Lindblom, ‘Maurice L... 


Lindgren, Russell C... 
Lindquist, Richard H... 
§Linner, Henry P. 

Lippman, Emanue Minneapolis 

§Litchfield, John T.. inneapolis 
Litman, pAbraham DD sscsecssiesaned ‘Minneapolis 
Lober, Minneapolis 
So al y am | nee ee: St. Paul 
§Logefeil, Rudolph C.. Minneapolis 
Loomis, Earl A........ Minneapolis 
Lott, Frederick H. ....Minneapolis 

Lovett, Beatrice R... 
Lowry, Elizabeth C... 
Lowry, P T 

Lowry, Thomas .... 


§ Lueck, Wallace W... Minneapolis 
§ Lufkin, Nathaniel H... Minneapolis 
Lund, “George WY vies Minneapolis 
Lundber; or Minneapolis 
Lundblad, Roy A..... /Minneapolis 
Lundblad. 7 W... (Minneapolis 
Lundeberg, -Minneapolis 
§ Lundquist, Minneapolis 
+ Lynch, M Minneapolis 
Lyons, James H Minneapolis 
*§Lysne, Henry . Minneapolis 
§ Lysne, Myron Minneapolis 
Lysyj, Anatol ......... Minneapolis 
Lyzenga, Anton G... Minneapolis 
§ McCaffrey, F. John. ...Minneapolis 
§ McCann, Eugene J..... ...Minneapolis 
§ McCannel, Malcolm A.......Minneapolis 
McCarthy, Donald...............0........ St. Paul 
McCartney, James 6.............Minneapolis 
$ McCormick, Donald P.........Minneapolis 
+ McDaniel, Orianna .... ...Minneapolis 
McFarland, Arthur H. Minneapolis 
McGandy, Robert F.. Minneapolis 
McGeary, George E..... inneapolis 





McInerny, Maurice W... 
McKelvey, John L........ 
McKenzie, Charles H.. 
McKinlay, Chauncey A... 
McKinney, Frank 


McLaughlin, Byron H........... ne 
McMurtrie, William B......... Minneapolis 
McNeil, John _J.............. ./Minneapolis 

McPheeters, Herman O.. 
McQuarrie, Irvine ....... 
MacDonald, Daniel A.. 
MacDonald, cae 
MacKinnon, Donald Cc 
Mach, Frank B 


Maeder, Edward C Li 
§Maland, Clarence O............ Ainnespole 
Mandel, Sheldon L Mi poli 
Mankey, James C...........cesooo0s Minneapolis 
Marking, George H... ..Minneapolis 
Martin, George .Minneapolis 
Martinson, RO Yiassccicdecsssesetseonoaes Wayzata 
Martinson, Elmer AB a scseccesstcssesone Wayzata 
Mattill, Peter M......... ..Oak Terrace 
Mattson, Hamlin A. -Minneapolis 
Maxeiner, Stanley R. inneapolis 
Maxeiner, Stanley R., ‘Minneapolis 
Meller, Robert Minneapolis 
Merkert, Charles E............... Minneapolis 


bor + con 

mm ~ 

SSeS S3 23-22 222 222222222 


eee ne —beton em 


Kh hh od oh dd td od 



apolis is 

§Merkert, George L................. Minneapolis 
+ Merrick, Charlotte T... St. Paul 
§ Meyer, Alvin J....... Minneapolis 
#§Meyer, Ette L..... Minneapolis 
Meyer, Robert J. ..Minneapolis 
Michael, Joseph C. ..Minneapolis 
§ Michel, Henry Bi... Minneapolis 
§ Michelson, Henry E Minneapolis 
+ Mickelsen, Emma F Minneapolis 
§ Miller, Arden L..... Minneapolis 
§ Miller, Harold E. Minneapolis 
§ Miller, Hugo E....... Minneapolis 
§ Miller, John Carleton... Minneapolis 
§ Millett, D. _— ..Minneapolis 
§ Milton, John S. ..Minneapolis 
Minsky, Armen A... Minneapolis 
§ Mitby, Irving ......... Minneapolis 
$ Mitchell, Berton D.. Minneapolis 
Mitchell, Edward C.. ..Minneapolis 
§ Mitchell, Mancel T............... Minneapolis 
+§Mixer, Harry W t. Hood, Texas 
Moberg, Thomas D............... Minneapolis 


$ Moe, John H....... 
§ Moehn, John T... 
§ Moen, "Johannes oe Jr 
+ Monahan, Elizabeth S.. 
§ Monson, Einer M...... 
§ Moore, Irvin _H...... Mi i 
Moorhead, Marie . ./Minneapolis 
§ Moos, Daniel J...... ..Minneapolis 
§ Mork, PEST Woes issn cnceocesassespacccseens Anoka 
§ Mork, Frank E...... teow Anoka 
Morrison, Charlotte J. 
§ Mosser, Donn 
§ Moyer, Leonard B 
§ Mulholland, William M. 


Murphy, dmund P......... inneapolis 
+ Murray, Elisabeth Merrill....Minneapolis 
Muske, Marvin M........... inneapolis 
§ Musty, a dp. inneapolis 
§ Myers, Jay A....... Minneapolis 
§ Myhre, James A. Minneapolis 
§ Naslund, Ames W.. Minneapolis 
Nauth, Bernard S.. Minneapolis 

§ Neal, Joe | SAR UB EU Ors S St. Paul 
§ Neary, Richard P...... 
Nelson, Bernette G.. 

Nelson, Bernice A...... inneapolis 
Nelson, C. Barton..... Minneapolis 
Nelson, Carleton A.. nneapolis 
§ Nelson, Edward N Minneapolis 
§ Nelson, Harvey... Minneapolis 
§ Nelson, Lloyd S.. Minneapolis 

Nelson, Maxine O.. Minneapolis 

Nelson, Maynard C..... Minneapolis 
Nelson, O. L. Norman........Minneapolis 
Nelson, Wallace I...... Minneapolis 


Nerenberg, Samuel 
Nesbitt, Samuel ......... 
Nesset, Lawren B.. 
Nesset, William D 
Neumaier, Arthur .... 
Neumeister, Charles A... 
Nice, Charles M....... 
Noonan, William J 
Noran, ‘Axel S. N.. 
Noran, Harold H.. 
Nord, Robert E...... 
Nordin, Gustaf T..... 
Nordland, Martin, Sr. 
Nordland, Martin, Jr. 

Nudell, Gerald ..... 
3 Nydahl, Malvin J.. 
$ Nylander, Emil G..... 
O'Donnell, James E. 

§ O’Phelan, E. Harvey 
* Oberg, Carl Mu... 
lavs, Ol 
$ Olsen, > de George 
§ Olson, Alton C......... 
$ Olson, Carl J...... 
Olson, C. Kent. 
Olson; Detlof 
+ Olson, Olof A........ 
Olson. Rolland A.. 



pen, E. Gerhard.. 

Oppen, Melvin G. 

Opstad, Earl T... Oak Terrace 
Palen, “Benjamin J -Eeeverrerrre! Minneapolis 
Papermaster, Theodore C.....Minneapolis 
Park, Wilford E ..Minneapolis 
Pattee, James cis Minneapolis 
Peluso, Charles Rov..scssssss- en 
Peppard, Thomas A polis 
erlman, Everett C..... eo eee os 
Perlman, Herschel Minneapolis 
Peteler, Jennings C. L......... Minneapolis 
Petersen, Deane A Minneapolis 
Petersen, Glenn I Mi 

etersen, Peter C Mi lis 

May, 1955 



GEL. SL Lhe She Os 

ab es 

is Pollock, David K.. 








mn ~s 




Ammummm mumrynr 

Petersen, William E... 
Peterson, Alice H..... Minneapolis 
Peterson, Henry ...... i i 
Peterson, Herbert W... 

Peterson, Nordahl P.............Minneapolis 
Peterson, Oliver H....... Minneapolis 
Peterson, C3: A SSB Minneapolis 
Peterson, Palmer A................ Minneapolis 

Peterson, Peter E..... 
Peterson, Willard C. 
Petit, Julien V...... 
Petit, Leon | ae 


‘Feyton, * William T... 
Phelps, Kenneth A... 
Piasha, A i Anoka 
‘Plass, Herbert F. R. i i 
;$Platou, Erling S... 
Pleissner, Karl 

§ Plimpton, Nathan. 
Pohl, John PB. MM... 

Polzak, Jacob A....... 
‘Poppe, Frederick H. 
Potek, David ........ 
Dotter, Moher: Wesicscssicsscicsuene Hopkins 
Pratt, Fred J., Sr... i i 

Pratt, Fred J., Jr... Minneapolis 
Preston, Paul J..... Minneapolis 
Price, William E.....................Minneapolis 
Priest, Robert E Minneapolis 
§Prim, Joseph A..............:004 Minneapolis 

Proffitt, William 
Proshek, Charles E... 
Quello, Robert O..... 
Quiggle, Arthur B... 
§Quist, Henry W., Sr... 
Quist, Henry W., Jr... 
Ransom, H. Robert.. 
Reader, Donald R... 
Regnier, Edward A. 
Reif, Harold A..... 
Reiley, Richard E. 




Reitmann, John H............ ee Anoka 
Remole, William D. Minneapolis 
Resch, Joseph A. Minneapolis 
Rice, Carl O....... Minneapolis 
Rice, Frank B Minneapolis 
Rice, Fred A............. Minneapolis 
Richdorf, Lawrence F. Minneapolis 
Rieke, Wellington W................... Wayzata 
Rigler, Leo G............. Minneapolis 
Riordan, Elsie M. ...Minneapolis 
Risch, Ronald E... ...Minneapolis 
Rizer, Dean K.. ...Minneapolis 
Rizer, Robert I.. Minneapolis 

Robb, Edwin F..... 
Robbins, Owen F. 
Roberts, Byron H. 
Roberts, Lewis J... 
Roberts, Stanley W. 
+$Roberts, William B... 
Robinson, Cartland 

Rocknem, Robert E.... Minneapolis 
Rockwell, Curtiss V. Minneapolis 
Rodda, Fredk. C..... Minneapolis 
Rodgers, Richard S... Minneapolis 
Romness, Kenneth Boies Mound 
Rosander, Phyllis ....... Minneapolis 
Rosenbaum, David L............. Minneapolis 

Rosendahl, Frederick G Minneapolis 
Rosenfield, sg a B......... Minneapolis 
Rosenow, "John H Minneapolis 
Rosenwald, Reuben M.........00.00.. Anoka 
Ross, Alexander | = i i 
Rossen, Ralph X...... 
Rotenberg, Robert J.. 
Rothnem, Morris S...... 
Rucker, William H 
Rud, Norman E..... 
Rudell, Gustaf L... 
Russeth, Arthur } 
Rusten, Elmer M. 
Rydburg, Wayne C.. 
t. Cyr, Harry M., 
St. Cyr, Kenneth J... 
Sadler, Wm. P., Jr 
Safirescu, Sorin R........ 
Saliterman, flv I 
Samuelson, Samuel ..... 
Sandt, Karl E........... 
§ Sawatzky, William A.. 
Sborov, Abe M 

Schaaf, Frederick H. K... 




haar, Frances ....Minneapolis 
Schaefer, Kenneth F............. ae 
Schaefer, Wesley G 
Scheldrup, Ni. H........c.ccssss000. Minne aie 
Scherer, Leslie Raymond.....:Minneapolis 
Scherling, Sidney S.... inneapolis 

Schiele, Bertrum -Minneapolis 
Schissel, Gregory A M poli 


§ Schmidt, W. Robert.............. Minneapolis 
t Schmitt, S. C........... Los Angeles, Calif. 

Schneck, Jack I.... ..Waukesha, Wis:- 
§ Schottler, Max E.... ....Minneapolis 

§ Schroeder, Albert J Minneapolis 
Schultz, Alvin L..............000« Minneapolis 
Schultz, J. Harold.................. Minneapolis 
Schultz, Peter J...... 

Schulze, William M 
Schumacher, John W.. 
Schwartz, E. Robert... 

Schwartz, Virgil J... 


Scott, Horace G... Minneapolis 
Seaberg, 1 1g, ee Minneapolis 
Seham, Max Minneapolis 
Seifert, Milton H Mi poli 
Seljeskog, Sigsbee R.............. Minneapolis 
Semsch, Robert D Minneapoli 


Shandorf, James F.. Minneapolis 

Shaperman, Eva -Minneapolis 
§ Shapiro, Sidney K.................. Minneapolis 
§ Sharp, David inneapoli 
§ Shaw, Howard A............002 Minneapolis 
§ Shea, Andrew W 

Sheldon, Warren Ne .nccccancaed Minesbots 

§ Sher, Lewis. seeses....-- 
§ Sherman, Lloyd F...... 
Shillington, Maurice A. 
Shronts, John | 
Sidell, Franklin D... 
§ Siegmann, William C.. 
Silas, Ralph M........ 
Silver, John D... 
+§Simons, Jalmar ....... 

‘Butte, Mont. 

Simonson, Donald B.. ..Minneapolis 
+ Simpson, *Ellery De. Phoenix, Ariz. 
§ Sinykin, Melvin B... Minneapolis 

Siperstein, David M -Minneapolis 

§ Sisterman, Thomas J. Minneapolis 
+ Sivertsen, Andrew .... ....Minneapolis 
+§Sivertsen, Ivar. Minneapolis 
§ Skjold, Arthur C....................; Minneapolis 

Smiley, John T......... 
§ Smisek, Frank M. E. 
Smith, Adam M...... 


§ Smith, Archie M......... -Minneapolis 
§ Smith, Baxter A. * -Minneapolis 
§ Smith, Graham G... -Minneapolis 
7 Smith, Homer R... ....Minneapolis 
+ Smith, Margaret :.. .Gardena, Calif. 
§ Smith: Norvin Rs... Willmar 

§ Smith, Theodore S$ 
Smith, William T..... 
Soderlind, Ragnar T. 
Solhaug, Samuel B... 
Solvason, Harold M. 
Spain, W. Thomas... 
Spano, Joseph P...... 
Spencer. Bernard J 
Spink, Wesley W.... 
Sponsel, Kenath H 

Princeton, N. 3. 
as Minneapolis 

mm my 


+ Spratt, Charles N ‘Minneapolis 
ae, Hopkins 
§ Stanford, Charles E... .Minneapolis 

Staub, Henry | Je -Minneapolis 

§ Stelter, Lloyd A.... ‘Minneapolis 
§ Stennes, John L ....Minneapolis 

Stenstrom, Annette E. T..... Minneapolis 
§ Sterrie, Norman A............... Minneapolis 

Stewart, Marvin J. 

§ Stewart, Rolla J..... me 


+§Stiegler, Farrell S... St. Paul 
§ Stoesser, Albert V.. ‘Minneapolis 
§ Stoltz, Robert €............. Minneapolis 
+ Stomel, Joseph... Blackfoot, Idaho 
Stone, Stanley Ri ee Minneapolis 
+ Strachauer, Arthur C. .Minneapolis 
§ Strickler, Jacob H..... -Minneapolis 
§ Strom, Gordon W..... -Minneapolis 
Stromgren, Delph T... -Minneapolis 
§ Stromme, William B. ‘Minneapolis 
Strunk, Clarence A...... ‘Minneapolis 
§ Sturses, Robert L Minneap 
*§Subby, — Walter. Mi polis 
ukov, Marvin Mi lis 
Sullivan, Ra —- Me... “Minneapolis 
Sullivan. R is 
Swain, hee vi Diccssscetsvseoedl Minne pots 
Swanson, Roy E..... -Minneapolis 
§ Sweetser, Horatio B.... Minneapolis 

§ Sweetser, Theodore H., Sr...Minneapolis 

Sweetser, Theodore H. Jr...Minneapolis 
+ Sweitzer, Samuel E inneapolis 
+§Swendseen, Carl G... ... Starbuck 
§ Syverton, Jerome 3 { Minacapelis 

Tam, Ernest C 
§ Tangen, George M 

LY eae 

Taylor, Joseph H... ..Minneapolis 
§ Tenner, Robert J... ..Minneapolis 
t Thomas, George E. Minneapolis 

Thomes, A. Boyd.... ..Minneapolis 

Thompson, Arthur Mi poli: 


Thompson, Willis H 
Thorsen, David 
Thorson, Stuart V 
Thysell, Desmond M 
Tichy, Fae Y 
Tingdale, August C 
Tinkham, R 
Titrud, Leonard A 
Tobin, John D... 
Trach, Benedict B 
Trow, James E Mi 
Trow, William H Mi 
Trueman, Harold Mi p 
Tsai i} Oak Terrace 
§ i Minneapolis 
§ Tudor, Richard B.... -Minneapolis 
+§Turnacliff, Dale D St. Paul 
Twomey, Joh hn E Mi lis 
§ Ude, Walter H 
#§Ulrich, Henry L. 
§ Ulvestad, Harold S 
§ Undine, Clyde A 
Vermund, Halvor 
Vik, A. Elliott... 
§ Vitols, -: 

M Minneapolis 

§ Wahlquist, Harold F. -Minneapolis 
Waldron, Carl W... Hopkins 
§ Wall, Tt. eae Minneapolis 


§ Walonick, Albert L St. Louis Park 
§ Walsh, Francis Mi polis 
§ Walsh, William T Mi poli 
Wangensteen, Owen H 
ard, Percy A 
§ Watson, C. Gordon 
Watson, Cecil J 
+ Weaver, Myron Mc.... 

§ Re Edgar A 
Roscoe C 
; Webber, Richard J... 
er, "Lowell W 
Weisberg, Rapheal J... 
Wendland, John P 
erner, George 
Wesolowski, Stanley P 
West, Catherine C 
Wetherby, Macnider meno 
Wheeler, Robert W ee 
§ White, Asher A polis 
White, S. Marx Mi poli 
§ White, Willard D Mi polis 
§ Whitesell. Lloyd A... sMinneapolis 
§ Widen, Wilford F... Minneapolis 
Wilder, Kenneth W ‘Minneapolis 
§ Wilder, Robert I Mi polis 

St. ae Park 



+§ Wilder, M., Jr Minneapolis 
§ Wilken, Poul A ....Minne anolis 
+ Willcutt, Clarence E... Phoenix, Ariz, 
+ Williams, Robert New York, N. Y, 
Winchell, Paul Minne: apolis 
Winther, Nora M. C ...-Minneapolis 
§ Wippermann, Frederic F ‘Minne apolis 
+$Witham, Carl A inneapolis 
§ Wittich, Frederick W.......... -Minne: apolis 
Wohlrabe, Arthur =" -Minneapolis 
§ Wohlrabe, Cabo -Minneapolis 
Wolf, -Minneapolis 
Wolter, Frederick H. -Minneapolis 
§ Wright, Thomas D inneapolis 
§ Wright, Wale S.... ‘Minne apolis 
$ Wright, William -Minneapolis 
Wyatt, Oswald S -Minneapolis 
Wynne, Herbert M. N. -Minneapolis 
Yivisaker, Ragnvald S... -Minneapolis 
Yoerg, Otto W i 
Yue, Wen 
Zahrendt, O. Lewis.. 
Zarling, V. Richard. 
Zierold, Arthur A.. 
Zinter, Ferdinand A. 
Ziskin, Thomas. ........0.0.000.... Minneapolis 





Jacoss, Douctas L 

OpsaHL, LAwreNCE J 

Allison, David D 
Anderson, Richard E 
Austrian, Sol 

§ Bosland, Howard 

+ Chadbourne, Wayn 
Chunn, Stanley S 

¢ Daignault, Oscar 

+ Danielson, Karl A.. Litchfield 
Danielson, Lennox Litchfield 
Dille, Donald E Litchfield 
Douglas, Kenneth W Sandstone 
Eberley, Tobe S 

§ Ellinger, Willmar 
Frederickson, Alice Willmar 

Regular meetings, third Thursday 

Annual meeting, third Thursday in November 

Number of Members—51 

§ Gaebe, Clara City 
Giere, Silas W Benson 
§ Gilman, Lloyd C 
Griffin, R. 
Guy, Jack A... 
§ Hinz, Walter E.. 
§ Hodapp. Robert 
§ Holm, Donald F 
Houts, Joseph C 
Jacobs, Douglas L.... 
§ Jacobs, Johannes C.. 
Kaufman, Edward J... 
Lundblad, Robert M... 
McCarthy, Austin M.. 
Macklin, William E., Jr. 
§ ‘Michels, Roger P.. 
Nash, Eldore B 

*§O’Connor, Daniel C Eden Valley 
Olson, Gregory M Litchfield 
§ Opsahl, Lawrence J.. .... Willmar 
Ostling, Burton C —— 
¥ Penhall, Fletcher W.. ; 
§ Peterson, Willard E 
Porter, Oliver M 
Proeschel, Ray K. 
§ Rorem, Joseph A. 

Rygh, Harold N.. 
hnell, Frederick S... 
+§$Solsem, Fredk. N. S 
rum, F, T 
Sutheriand, W. 
Thompson, A. Henry. 
Wagner, Norman W.. 
Wilmot, i 
Wilmot, Harold E 


BODABKS, (ALBERT: A .0.ic.c:.5.000sssscens0000- Tyler 
Purves, Georce H 
Bodaski, Albert A 
Eckdale, John E 
Ferguson, William C.. 
Ford, Burton C 

k ; 
Hedenstrom, Philip C................. Marshall 

Regular meetings, last Tuesday of each month 
Annual meeting, last Tuesday of October 

Number of Members—26 

Helferty, John K Boise, Idaho 
Hermanson, Peter ..Hendricks 
Hoidale, Andrew D.. ... Tracy 
Johnson, C. Percy.... ... Tyler 
Kreuzer, Titus ...Marshall 
Larson, Milo H.. Lake Benton 
Lee, Norman J 

Monson, Leonard J 

Murphy, Joseph E 

Peterson, Kenneth A..................- Marshall 


Purves, G. Harland 
Remsberg, R. R... 
Smith, Lloyd A 
Thill, Leonard J.. 
Thompson, Carl O.. 
+§Vadheim, "Alfred L.. 
+§Valentine, Walter H.. 
olstan, Simon D... 
Workman, Warner 
Yaeger, Wilbert WG hesecccine snes Marshall 

Regular meeting, third Thursday of each month 

SmytH, Joun J 
Hvuesert, Dan W 
Bretzke, Carl O.. 
§ Brink, Donald M 
Carroll, John J.... 
T Clement, John B 


Annual meeting, third Thursday in December 

Number of Members—20 

§ Floersch, Adrian J 

§ Griebie, Grant L 

§ Howell, Milton ..... 

§ Huebert, Dan W... 

§ Jensen, Alvin M... ...Brownton 
§ Klima, William W... Stewart 
§ Lippmann, Elmer W.... Hutchinson 
§ (Peterson, Kenneth H Hutchinson 

Sahr. Walter G 

+ Scholpp, Otto W... 

§ Selmo, Joseph D 

§ Sheppard, Charles G. -Hutchinson 

§ Smith, G R Hutchinson 
Lester Prairie 

§ Struxness, David F. 

§ Truesdale, Clark W Glencoe 



eoveccecs © cavtonecnconeos 
at -1--tant--he ee ee ee | Laok 

i ae: 

ee es 

600202 conto ©=—- Gon CONCORD 


concorconcon— HCO” 


ne: 1polis 
x, Ariz, 
ps oe 








Regular meeting, last Thursday of every month 

Pererson, STANLEY C 

RosENTHAL, F. Harowp 

§ Anderson, David P., Jr. 

§ Anderson, Harold i. 

§ Anderson, Wallace R 

§ Barber, Tracy 

§ Cronwell, Retkad J 
Elliot, Harold J 

§ Fisch, Herbert 

§ Flanagan, Leonard G.. 

§ Grise, William B 

Annual meeting, December 
New officers elected in November 
Number of Members—36 

+ Havens, John G. W 
+ Hegge, Olav H 
+$Hegge, Rolv S 
+ Hertel, Garfield E 
§ Hesla, "Inman A Austin 
§ Leck, Paul C. Austin 
3 Lommen, Peter A ae 
McKenna, Elizabeth M 
§ McKenna, Jay K 
+ Melzer, George R... 
§ Miller, Herman................G 
Morse, Morton P 

§ Nesse, J. A 

Osborn, Donald O 
Peterson, Stanley C. 
Robertson, Paul A 
Rosenthal, F. Harold 
Sargent, E. C., Jr 
Schneider, Paul a. 

Seery, Thomas M. 
Sheedy, Chester L. 

Stahl, George 

Thomson , M. 
Twiggs. Leo F 

Van Cleve, © om P., Jr 
Wilson, Franklin C.......Ft. Belvoir, Va. 
Wright, Robert R Austi 


Otson, DuaNe O 

Griptey, Joun W 

+§Aitkens, Herbert B. 

§ Canfield, Wayne W. 

§ Covell, Walter W 

§ Curtis, Rauen 

t Ericson, Swan Le Sueur 
Gridley, John W Arlington 

Regular meeting, not scheduled 
Annual meeting, December 
Number of Members—27 

§ Grimes, Burton P 
Henry, Martin R... 

§ Hiniker, Peter J 
Johnson, Hobart C 
Kabrick, Ola A 
Kath, Reinhard H 

§ Lenander, Mellvin E. 
Limbeck, Donald A.... 
Maertz, William F.. 

§ Nilson, Helmer J 

§ Olmanson, Edmund G 

§ Olson, Duane O 
t Orwoll, Harold S.. 
§ Rudie, Clifford N 
Schulberg, Verne A 
§ Sjostrom, Lawrence E 
§ Sonnesyn, Nels N 
§ Strathern, oe a S.. 
+§Strathern, Fred P... 
Traxler, J. Felix 
§ Wohl hlrabe, Clarence F..North Mankato 


Annual meeting, first Wednesday in November 

Regular meeting, first Wednesday every second month starting with January 

JacKMAN, Raymonp J 


Abbott, Albert R 
heer, aes W. P... 

§ Aitelde, “Daniel E 

g Abts, 75 Jacob Caledonia 
§ Allen, Rochester 
t Amberg, Ry Rochester 
§ Andersen, Howard -Rochester 
§ Anderson, Mark J... -Rochester 
Anderson, Markham Rochester 
Anderson, Milton W. -Rochester 
Ardan, Nicholas I., J -Rochester 
§ Atmore, William 
§ Baggenstoss, Archie 
Bain, Robert C 
Bair, Hugo 
§ Baker, Georse S 
+$B; aker, 
$ Baker, Hilier L, Jr x 
Baker, Russell L int avlicld 
t§Balfour, Donald C Rochester 
§ Balfour, William M Rochester 
§ Banner, Edward Arthur Rochester 
§ Bargen, J. Arnold .... Rochester 
§ Barker, Nelson W ....Rochester 
Barlow, Loren C.. ....Rochester 
Barnes, Arlie R .... Rochester 
Barry,” Maurice J., Jr... ....Rochester 
Bartholomew, Lioyd G. -Rochester 
§ Bastron, James A Rochester 
t§Bayard, Edwin D 
Scott a Force Base, Illinois 
§ Beahrs, Oliver H Rochester 
Beddow, Ralph M.. -Rochester 
t Benedict, William L Rochester 
erge, Kenneth G Rochester 
+ Berkman, David M 
§ Berkman, John _ 
§ Bernatz, ‘Philip E 
Betts, Charles S... 
§ Bickel, William Harold. 
+ Bige low, Charles E 
Black, B. M. ochester 
t Bonnet, John D....Clovia, New Mexico 
Bossard, “John Wesley.......-.-..- Rochester 

May, 1955 




Number of Members—517 

, Botham, Richard James 

7 Bowers, Dorrance 
Bowes, Donald Earl... 

§ Boyd, David A., Jr 

§ Braasch, John WwW 

+§Braasch, William F 
Brackett, Ralph D 

§ Brandenburg, Robert O 
raun, Robert A 
Broadbent, James C 
Broders, Ww 

§ Brown, 

§ Brown, : 

§ Brown, Rochester 

Rrown, ili a Rochester 

Brown, Roland G Rochester 

Brunsting, Louis A Rochester 

Buie, Louis A Rochester 

 Bumpes Frank Thatcher Rochester 

Burchell, Howard B.... ..Rochester 

Burke, Edmund C 








ORR COR Oe we 

Comal, "Donal i Cc 
§ Carr, David T 
§ Carryer, Haddon McC... 

§ Childs, Donald S., Jr.. 
§ Christensen, Norman 
§ Clagett, Oscar T 

Clark, Edward C 
§ Clark, Leslie ar a 

Clifton, © cg ie 

Colby, M shea 

Collins, Ca 
§ Comfort, Mandred W Rochester 

Compton Russell F Rochester 

Cook, Edward N... Rochester 


Counts, Rober rt N ..Rochester 
§ Coventry, Markham B Rochester 
¢ Craig, Richard M Rochester 
§ we Winchell McK 

rumbley, J James J., Jr... 
on Ormond S 

§ Dahlin, David C 

pring Valley 
.... Rochester 



t Daly, David 
§ Daugherty, Guy Wilson 
avis, Austin 
vis, Charles Truman Rochester 
§ Davis, Rochester 
avis, H. L Rochester 
Davis, Rochester 
Dawe, le J Rochesti 
ies William H 
§ Devine, Kenneth D. 
§ DeWeerd, James _H.... 
§ Diessner, Cm Roy. 
f Dines, David E 
ixon, Claude F 
Doane, Joseph C 
§ Dockerty. Malcolm “ 
Dodge, Henry W. 
Doehlert, Charles a2 ". 
Donin, J. Winnip: g, Man., Canada 
§ Donoghue, Francis Edmund... ‘Rochester 
Douglass, E 
Doyle, James R 
+ Drips, 




West Point, 
N. Y. 

+ Dyer, john’ Allen 
t Dykstra, Peter Calvin 

§ Eaton, Lealdes M 

Edwards, J Rochester 
§ Elkins, Earl C Rochester 
§ Ellis, F. Henry Rochester 

Elstner, Howard L Rochester 

Emmett, John L ochester 
+ Ensrud, Earl Richard Rochester 
§ Frich, To hn Rochester 

Erickson, Doraid J Rochester 

Erickson, John G... ....Rochester 
.... Rochester 









+ Evarts, Arrah B 
Ewen, Ed 
§ Faber, ohn E E 

; Fabi, Mario Nestor. 
Faucett, Robert ~ 
Faulconer, Albert 
Feldmann, Floyd va 
Fergeson, James 

§ Ferris, DeWard 3 




Keith, Haddow M 
Keith, Norman M.. 

O’Leary, Paul A 
O’Neil, Richard L 
Kennedy, Roger L. J.. ....Rochester t§O”’ Shaughnessy, Edward J 

§ Rochester 

Rochester ; Kent, George B oenix, Ariz. amp Kilmer, N, he 
§ K 

Fieldman, E. Jay. Rock 

Figi, Fredk. A 

Fly, Orceneth A 

Foss, Edward pie 
§ Fricke, Robert E. 
+$Gambill, Carl M 

Gambill, Earl E 

Garrett, Charles M., 

. ochester 

Rochester Kernohan, James W Rochester § Odel, Howard Mo... Roche ter 
Rochester ye John R Rochester § Olsen, Arthur M.. -Roch ester 
Rochester Rochester Olson, Ernest A.. a sland 
Rochester ... Joliet, Illinois Olson, Gran »ncord 
Rochester t Onifer, Theodore M. 

iely, James Patrick 
Kiely, Joseph 
Kierland, Robert R 

t§Gastineau, Clittord F N York, 
ee | 

+ Gatchell, Frank G 


a William D 
Gee, Vernon Ray. 
Geraci, Joseph Emil 


§ Ghormley, Ralph K 
+§Giffin, ning Z 
Giffin, Mary E 


§ Gifford, R. W., Jr 
t§Ginsberg, Robert I 

Silver Soring, 


7 Glew, ogg Bainbridge 

Goff, Joh 


yp gee Norman P.....Bethesda, Md. 


Grattan, Robert T 


§ G 
t sea Joseph B 

Gray, Howard 
Green, Paul A 
Greene, Laurence 


§ Griffin, George D. im Jr.....Rochester 

Grindlay, John H 
Groch, Sigmund N.... 



t$Hagedorn, Albert Berner. 

§ Haines, Samuel F 

New Rh 


§ Hallberg, Olav Erik 


t§Hallenbeck, Dorr F 
Hallenbeck, George A. 
Hanlon, i 

§ Hanson, Norbert Orrin, 
Hardy, William M.. 
Hare, Robert Lewis. 

§ Harrington, Stuart 

§ Harris, Lloyd E 
Hartman, Howard R.. 

§ Havens, Fred Z 

Hayles, Alvin Beasley 
Healy, John 
eck, Frank 

Heilman, Dorothy M. H 
~~ Diego, California 

Heilman, Fordyce 
Heimark. John J 



*+Helland, Gustav M 

+ Helland, John W 

t+§Helmholz, Henry F.. 

Hench, Phili 

Spring Grove 
Spring Grove 

§ Henderson, Baraca DS apsesacecs 

§ Henderson, John W.. 
Henderson, Lowell.. 
*+§Henderson, Melvin 
+ Henderson, Robert Earl. 
Hepper, Norman G.. 
+ Hewitt, Edith 
+$Hewitt, Richard M.. 
ig pl wr ©... 
, John Roger.. 



Holt, Allen Howard.. 
Horton, Bayard T... 
Howell, Llewelyn P... 

Hunt, Arthur 
Hunter, James 

Jackman, Raymond 
acks, Quentin D.... 
Jackson, es L 
§ Janes, Joseph M 


‘ ohnson, Carl 

Johnson, Ralph B 
Jordan, Stanley 
Joyce, George L 

i Judd. Edward i Laws 
* Juergens, John L... 

Huizenga, Kenneth A... 

fohnson, a yg McF 
Johnson, Einer W., Jr... 


.... Rochester 


} Keating, Francis Raymond Jr. 



Kilby, Ralph A Rochester 

Kirby, Thomas J., Jr Rochester 

§ Kirklin, B. R 

§ Kirklin, John W 
Klakeg, Clayton H... 

t Klass, Donald W 

¢ Knight, James Harry.. 
Knutson, Lewis A 

§ Koelsche, Giles 

§ Kroboth, Frank J. 

a Harry G 




Krout, alii 

Krusen, Frank H... 
+ Kuhn, * Arthur B | 

Kunkel, Melvin G ..Rochester 
§ Kunkel, William M., Jr Harrisburg, 

§ Kvale, Walter F 

Lacy, Paul E 
§ Lake, Clifford F. 
Taw, William M 
Lazarte, Jorge A Rochester 
§ Leddy. Eugene T Rochester 
_ hee, *Ph hilip R Rochester 
ifton Forge, Va. 



§$ Lipscomb, Paul R. 

§ Litin, Edward M 
Lofgren, Karl A. 

*§Logan, Archibald H 

§ Logan, George B 

t Lommel, Jerome G. 

§ Love, J: Grafton... 

§ L 


oche ter 

Lundsten, Lloyd R. 
undy, John Ss. 
Lynn, Thomas E. 
McBean, J. B Rochester 

t McClure, Rensselaer W. Jr., 

Lawrence, “Kansas 

(McConahey, —_— M. ., Rochester 
McDonald, John R 
McFarlane, John 
McKaig, Carle B 

t McKee, Robert E.... 

§ MacCarty, 

t§MacCarty, William C. 

+ Madalin, Herbert E 

§ Madison, Mitchell S.. 

§ Magath, Thomas B 
Manger, William M. 
Mankin, Harold T -Rochester 
Mankin, Haven W Rochester 
Mann, Frank D Rochester 

§ Martens, Theodore G Rochester 

§ Martin, George M -Rochester 

§ Martin, William J.. -Rochester 
Masson, Duncan M.. -Rochester 

+§Masson, James C.. -Rochester 

Masson, James K.. -Rochester 

Mathieson, Don R.. -Rochester 
ayne, John G -Rochester 
Mayo, Charles William -Rochester 

Menges, Charles G. H.. -Rochester 
Merritt, Wallace A.. -Rochester 
Meyerding, Henry W Rochester 
Miller, Roland D Rochester 

Miller, William J 

Mills, Stenhen D... 

Moersch, Frederick P.. 

Moersch, Herman J...... 

Montgomery, Hamilton 

Moore, Chris H Rochester 

Moores, Kenneth D Rochester 

Morlock, Carl G Rochester 

Mortensen. J. D Rochester 

Mulder, Donald W 

Mussey, Mery E 

Mussey, Robert D... 

Myers, Cortland III.. 

Myers, Richard L 

Myers, Thomas T... 

Myre, Theodore T 

Nehring, Jesse P 
Neuman, Harold W... 
Nichols, Donald R... 
Norris, Neil T 

“Bryan, Texas 
Austin, Texas 

Mm SR rawr wm 





Onsgard, L. Kenneth.. 

Opfell, Richard W 
§ Osborn, John E 

Owen, Charles A. J 

t Paris, Jaime 

Miamisburg, Ohio 
‘ -Rochester 
Parkhill, -Rochester 
Parkin, “Themes -Rochester 
t§Parsons, William B., Jr 

Coronado, Calif. 
Patrick, Robert T ochester 
§ Paulson, John A ...Rochester 
$ Paynter, Camen R 
Great Falls, Montana 
Peake, Charles O Rochester 
Pearce, Francis M. ochester 
Pease, Gertrude 
Pemberton, Albert H.. 
t Pemberton. 

$ Peters, Gustavus 
Petersen, Arthur B... 
Petersen, Magnus C 
Peterson, Willard H 
Pettersen, George R 
Pettet, John 
Piper, Monte C... e 
Place, Virgil Alan.. ..-Rochester 
Polley, Howard F... ..-Rochester 
Pool, Th Rochester 
Powelson, Myron H. 
Great Lakes, Illinois 

Powers, Fred Rochester 
Prangen, Avery DeH... 
Pratt, George 

San Francisco, California 
Pratt, Joseph Hyde, Jr Rochester 
Price, Mary L 
Prickman, Louis E 
Priestley, James T... 

a. Donald E.... 
Randall, Lawrence M... 
Randall, Raymond V 
Rasmussen, Waldemar C 
Rawls, Thompson T 
Reifsnyder, William Henry III 
Reitemeier, Richard J Rochester 
ReMine, William H., Jr Rochester 
Rice, Roberta G.....Grand Island, Nebr. 
Rigler, Robert Rochester 
Ringer, Merritt Rochester 
Risser, Stewartville 
Rodenbaugh, Fredrich Hase, Rochester 
Rogne, William Gustav... ‘Spring Grove 
Rome, Howard P... Rochester 
Rooke, E. Rochester 
Rothwell, Walter S Rochester 
Rotnem, Orville M.....lowa City, Iowa 
Rovelstad, Randolph Rochester 
Rucker, Charles W ..Rochester 
Ruggieri, Bartholomew A ..Rochester 
Rushton, Joseph G ..Rochester 
Ryan, Robert Frank... ..Rochester 
§ Rynearson, Edward ..Rochester 
Sabanas, Alvina O Rochester 
Sabin, Frederick paepenee.. Rochester 
§ Salassa, Ro M...... ochester 
+§Sanford, j ed H. ..Rochester 
Sauer, William G.. -Rochester 
Sayre, George P Rochester 
§ Scheidel, Alois McK. Rochester 
Scheifley, Charles H. -Rochester 
+ Schirger, Alexander Rochester 
§ Schmidt, Herbert William Rochester 
Schwartz, Carl A Rochester 
Schwarz, Bert E -Rochester 
Schweiniurth, J. D Rochester 
§ Scudamore, Harold H. -Rochester 
t aoa. James Elbert III -Rochester 
t Selby, John B Rochester 
§ Seldon, Thomas H.. Rochester 
7 Seybold, Herbert M.. -Rochester 
Shick, Richard M.. Rochester 
Shields, -Rochester 
Shocket, -Rochester 
Sibley, John Adams. Rochester 
Siekert, R. G Rochester 
t Silver, “Arthur W Rochester 


mun hth ee 






Ce le 

Ser © © 

r+  conecreceecocoseostorecs cos ++ 

eg nes res ey 9 ed Se) ed EI > > > > > Se 



ochester § Simonton, Kinsey M Rochester Svien, Hendrik J Rochester § Weed, Lyle A Rochester 
ochester Skaug, Harold M Chatfield Symmonds, Richard E Rochester + Weeks, Richard E Rochester 
ce + Skrdla, Willard B.. Rochester Tani, George T Rochester Wehr, B 
r, N. J § Slocumb, Charles H Rochester Taub, Robert G Rochester 
Ochester Smid, Arthur C Rochester Thompson, Gershom J Rochester 
ye tHSmnith, a. Rochester ¢ ce —* a 
> Asian arry ochester 5 illisch, Jan ochester 
Concord ith, Lucian A Rochester § Uihlein, Alfred Rochester as 
ochester i Meredith P. Rochester Underdahl, Laurentius O Rochester § Wente, Harold A Rochester 
Houston ith, Reginald A Rochester Utne, R -Rochester § Westrup, John E 
ochester i OR a Rochester ; vi 2 -Rochester + Wilder, Russell M......... re Md. 
g, Ohio ‘ . ; Rochester Rochester t Wilkinson, George R., J Rochester 
ochester H Rochester Van Patter, | 1 eattle, Wash. Williams, "George E Rochester 
ochester ever, New Haven, Conn. § Vaughn, Louis D Rochester Williams, Henry L Rochester 
ochester Spencer, Jean A Rochester Verby, John E Rochester *+Williams, 
ochester Sperl, Michael P., Jr.. Rochester Virnig, Hildegard J Rochester § Wilson, Robert B Rochester 
ochester Spittel, John A., ‘Ir. R § Wagener, Henry P -Rochester Wilson, Theodore W. Rochester 
ochester Sprague, Randall G. J Was , James M.... .. Harmony § Wilson, V. O Rochester 
: E Starr, Grier F e n Z -Rochester Winter, Malcolm D., Jr Rochester 
, Calif, —_—, es H *+§$Wakim, Khalil G. -Rochester Wollaeger, Eric E Rochester 
ochester + Stein, Harold § Walters, Waltman... Rochester § Woltman, Henry Wm. F Rochester 
ochester ao Richard M t ba — wees — +§$Wood, Harry G Rochester 
tevens, } ard, Bert ochester : ? ai 
fontana $ Stickney, J. M § Ward, Louis ; t being George F... oe 
ochester bettwell, George G... § Watkins, Charles : § Woolner, ochester 
»chester Stillwell, George K.. : Watson, Eleanor J. “ t Wuest, ? : 
chester § Stroebel, Charles F., Jr.. Watson, John R : , California 
chester Struthers, A. Morgan. s Waud. Robert E.. : § Young, Henry H Rochester 
chester Stuhler, Louis G § Waugh, John M.. fe ‘ Zimmer, J. Rochester 
chester 5 Weber, Hany NM-.............:.5. Rochester 
—— (Douglas, Grant, Otter Tail and Wilkin Counties) 
chester ° 
chester Regular meeting, last Wednesday even numbered months 
— Annual meeting, December 
Illinois Number of Members—64 
Xtc President § Hanson, LeRoy W Pelican Rapids § Nelson, Roy Fergus Falls 
S Esme, Roser Di Fergus Falls + Harris, Evelyn va Seattle, Wash. § Nelson, Wilburn O. B. 7 _ 
. . ecretary eegaard, illiam ...Alexandria § e reckenridge 
— SHaver, Warp Fergus Falls § Heiberg, Emmett A.. ..Fergus Falls Ostergaard, ing... Evansville 
chester ; § Helseth, Hovald K.........Pelican Rapids Palmerton, Ernest S Fergus Falls 
neste Arndt, Harry W Detroit Lakes t Hom, Leong, Y. W ; Parson, Lillian B.. .Elbow Lake 
acta Baker, Jeannette iL... ..Fergus Falls North Chicago, Illinois Parson, Lester R a 
= sien Baker, Norman H... ..Fergus Falls § Hunt, William Fergus Falls + Patterson, William L. 
haste + Blakey, Adam R.... Osakis § Jacobson, Clifford W Breckenridge + Paulson, Theodore S. 
estar § Boline, Clifford A... § Kevern, Jay L Henning Rockwood, Philo H. 
aia + Boysen, Peter. Kippen, 1 Be enri § Sanderson, David J ...Fergus Falls 
chester { Cain, James H. § Korda, Henry A i i } Satersmoen, Theodore....Pelican Ravids 
heat § Carlson, Carl E.... Leibold, Herbert H. ‘Parkers Prairie § Sather, Edgar R Alexandria 
© ara Clifford, George W cas § Lewis, Henning § Schamber, Walter F.. 
pnester § Combacker, Cc ...Fers ; wis 3 Henning Schoeneberger, P. 
t§Daehlin, . si ye, Fredk. A Carlos § Shaver, Ward 
§ DeKruif. ..Fergus § ; = “Fergus Falls § Sommerness, a 
§ Doms, Vernon A... ....Elbow Lake Daniel, S. P... _.-Fergus Falls § Stemsrud, Harold Alexandria 
Emerson, Edwin E. Osak § Mahowald, Aloys ...Fergus Falls Sutton, Harris R .... Hoffman 
§ Estrem, Ralph L.... fe ‘ Miller, William Anthony § Tanquist, Edwin J.. Alexandria 
i Estrem, — og ae be m si Nes Bs = ; boy — oes re . 
Geiser eter J ortensen, Nels Minneapolis § Wasson, Loren F.. .Alexandria 
§ Hamlon, John S.. ..Fergus Falls § Mouritsen. Glenn J.. ..Fergus Falls + Wray, William E Campbell 
ad Hanson, Everett C.........New York Mills + Naegeli, Frank Fergus Falls 
— Regular meetings, last Monday each month except June, July, August 
hester Annual meeting, last Monday in January 
hester Election in November 
— Number of Members—485 
hester President § Beech, Raymond H § Brodie, Log D Pau 
hester Franacan, Harotp F . Paul § Beck, Harvey O... + Brown, John C. .Los ean Calif. 
hester Secretary § Beer, John J... Buckley, J. J St. Paul 
hester Gisss, . Paul § Bell, Charles C. § Bulinski, Theodore J. St. Paul 
hester Executive Secretary § Bellomo, James. § Burch, Edward | yas ‘ St. Paul 
hester Otson, Mrs. ELEANOR . Paul Bellomo, John 7 Burch, F .St. Paul 
— $ Adair, Albert F. Jr... _ § Benepe, James L.. 3 § Burklund, Edwin D. St. Paul 
— : t§Ahrens, Albert E.. . Paul + Bennion, P. H .....Isway, Montana § Burlingame, David A... St. Paul 
vane Ahrens, Robert M Paul § Bentley, Norman P.. : St. Paul § Burmeister, Richard O. St. Paul 
tenia t$Alden, J. F., J St. Paul Bernier, M. J North St. Paul +$Burns, Robert M St. Paul 
a § Arnquist, Andrew S... St. Paul § Bernstein, William C St. Paul Burton, Carl G St. Paul 
auch § Arny, Frederick P . Paul § Bicek, Joseph F $B St. Paul 
ce § Art, Philip K Paul 7 Binger, Henrv E.. Phoenix, Ariz. § jn Herbert H... 
— § Aurelius, J. Richards Paul Black, Earl J § Cain, Clark 2 
cre § Auman, Duane R... Se) Paul +§Bock, Rolland A. St. Paul Callahan, Francis F. 
ester § Babb, Frank S St. Paul + Boeckmann, Egil.. St. Paul Canine, James L... 
row § Bacon, Donald K.. Se Dant § Bolender, Harold_L.. St. Paul § Carley, Walter A... 
reste § Baer, Walter Se Baal Bonnello, Frank J.. St. Paul *§Carroll, William C... 
— § Balcome, Milton M. St. Paul § Borg, Joseph F St. Paul Cedarleaf, Cherry B.... 
rester Barnett, Joseph M... ...St. Paul Bouma, Lewis R.... St. Paul § Chadbourn, Charles R 
ester t Baronofsky, Ivan D St. Paul ma ge Florence , St. Paul § Chatterton, Carl 
rester + Barsness, Nellie O. St. Paul § Brand, George D.... . Paul § Christiansen, Andrew... 
nester Bauer, St. Paul + Bray, Elwyn R . Paul § Clark, Henry B., Jr 
ester "Heals, Hugh.... LaJolla. Calif. § Briggs, John F..... St. Paul Cochrane, Byron B... 

lester Beck, Charles x RN ey ‘aoe St. Paul § Broadie, Thomas E St. Paul Coddon, Walter D 
CINE May, 1955 375 

Cohen, Ellis N 
§ Colby, Woodard L.. 
. Wallace H 
Coleman, John B.. 
+ Collie, Henry G 

t§Connoliy, C 

St. Petersburg, 

Fort Belvoir, 

Connor, Charles E S 

§ Cook, Carrol 

§ Cooper, Charles C 

§ Countryman, Roger S... 

§ Craig, David M 

$ Critchfield, nie R... 
Crowley, James H... 

§ Crado, Vincent D... 

§ Crump, James W.... 

§ Culligan, John M 

ulver, G 

Davis, Edward V 
Dawson, James . 
Decker, Charles H... 

§ Derauf, Benjamin I 

§ Deters, Donald 

+ Dickson, Thomas H 

§ Drake, Carl B.... 

§ Dunn, James N 

§ Earl, 

§ Earl 

§ Edwards, 
§ Eginton, Charles 
+ Ely, 
Emerson, Edward C 

§ E : 

§ Endress, 

§ Enroth, Oscar E 

t+ Ernest, George C. H 

St. Petersburg, 
§ Ersfeld, Murray P St. 
+ Eshelby, E. C 

t Evert, John A., Jr 

Farkas. John V.... 

*+§Ferguson, James C... 
§ Fesler, Harold H.... 
Field, Anthony H 

t Fifer, 
§ Fisher, 
§ Flanagan, Harold 
§ Flannery, Hubert F 
Flom, R. P 
§ Flynn, L. L.. J 
+ Fogarty, Charles W.. 
§ Fogarty, Charles W., 
§ Fogelberg, Emi 
§ Foley. Frederic E. B 
Forsythe. J: 
Fox, LeRoy 
§ Freeman, Charles D., 
Freeman, Geral 
§ Freidman, Louis L.... 
§ Fritz, Wallace L.... 
§ Froats, Charles W.... 
§ Fuller, Benjamin F 
Galligan, John J........... 
§ Garbrecht, Arthur W... 
§ Gardner, Walter 
Garrow, Douglas M... 
§ Gehlen, Joseph N.... 
*§Ghent, Charles H.... 
Gibbs, Edward C.... 
§ Gillespie, Delmar R..... 
t Gilsdorf, Donald A.... 
§ Gleason. Wallace A... 
Goldsmith, Joseph Ww 
+§Goltz, Edward V. 
§ Grant. Hendrie W 
§ Gratzek, Thomas 
§ Grau, PR. : 
Gray, Edward F 
**#Gruenhagen, Arno 
Hagen, Paul 
Hakanson, Erick Y 
§ Hall, Barnard 
§ Hammes, Ernest M., Sr... 
§ Hammes, Ernest M., Jr... 
*+Hammond, James F 
Hannon, Donald W.... 
§ Hanson, Harold B.... 
Harbaugh, John T 
§ Harmon, Gaius E.... 
§ Hartfiel, William F.. 
Hartig, Marjorie 



. Paul 
. Paul 
t. Paul 
. Paul 
. Paul 
St. Paul 
t. Paul 

. Paul 

. Paul 

. Paul 
St. Paul 
St. Paul 
. Paul 
t. Paul 
St. Paul 
. Paul 

. Paul 

. Paul 

. Paul 

. Paul 
t. Paul 
. Paul 
St. Paul 
. Paul 
St. Paul 
St. Paul 
. Paul 

. Paul 

. Paul 

. Paul 

. Paul 

. Paul 


St. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 
. Paul 


§ Hartley, Everett C. 
§ Hauser, Victor P. 
§ Hayes, 
§ Heck, William W 
Hedenstrom, Frank G.. 
Heili ig, Willi im va 
Henderson 3G... 
at gp’ "Wien i... 
Hensel, Charles N 
Herman, Samuel M 

Herrmann, Edgar T 
— Myron 
§H al Andrew W.. 
Hil er, 
Hochfilzer, John 
Hodgson, Jane 
Holcomb, Oo. W 
Hollinshead, W. 
Holmen, Robert W.. 
Holt, John E 

H Heron, Roy C 

Anm—- Mm 

Hopkins, George W 
Howard, Merrill A.. 
Howard, Willard S.. 
§ Howe, Newell 
§ Hullsiek, Harold E.. 
§ Hullsiek’ Richard B.. 
§ Hunter, Murray H... 
§ Hurwitz, Milton M.. 


+ Ingerson, 

William C.. 
§ Ellery 


Carolyn A.. 

§ Herbert _W.. 

St. Paul 

§ Kamman, Gordon R 
Kaplan, David H 
Karon, Irvin M 

§ Kasper, Eugene M.. 
Katz, Louis J L 
Keefe, Rolland 
Kelly, James H.. 

My peat John V.. 

§ Kelse Chauncey 

§ — ck, Emmett V.. 

§ Kenyon, Thomas 

§ Kesting, Herman 

St. Paul 

+ King, George L 
§ Knutson, 


§ Kugler, 

§ Kuske, Albert 
Kusske, Rradlev W 

§ Kusske, Douglas R 
Kvitrud, Gibert 

§ Lannin, Bernard G.. 

§ Lannin, Donald 
Larrabee, Walter F 
Larson, Eva-Jane 

Larson, Kenneth R.. 
Martin L.. 
Morris H 
+$Leahy. co ate 
§ Leavenworth, R. O., 

r <e 
Leavenworth, Richard O;. jr. 
M St 

§ Leick, Richard 
Leitch, Archibald 

§ Lepak, John A 
+ Lerche, William.... 
§ Leven, N. Logan....... 

§ Leverenz, Carleton W.. 

Levin, Bert G 

Levitt, George X.. 
§ Lick, "Charles L 

Lick, William J., Jr.. 
§ Lien, Richard 

t Lightbourn, Edgar _L.. 

Lilleberg, Norbert A 

§ Lindell, 

§ Lynch, Francis W 
§ McCabe, James S 
§ McCain, 

McCarthy, Joseph J 
+ McClanahan, James H 

White Bear 

McClanahan, Thomas S 

§ McCloud, Charles N 

§ McGroarty, Brian J 
a Eva Elaine... 

§ McNeill, 

F Mackoff, Sam M... 

*§$Madden, John F.... 
Madland, hgree S. 

§ Malerich, . Anthony. 

§ Malerich, 

olis, hilip M 

Man » Roger 

§ Martin, Dwight L 

§ Martineau, Joseph L. 
Mateo, Guillermo. 
Matthews, ames H... 
nag illiam F 

§ Meade, John R 

§ Mears, Burtis J 

§ Medelman, John 
Melancon, Joseph 

§ Menold, — 


Miller a G 
t Miller, William T 

Anthony. Jr.. 

Miller, Z. R 
§ Milnar, Frank J 
Mintz, Charles M. 
H ‘Mishek, Charles J. 
§ Monahan. 
§ a 
+ Moquin, A. 
+ Moren, J. Adelaid 
Moriarty, Berenice 
Moriarty, Cecile 
§ Muller, Albrecht E 

¢ Nelson, Louis A., Sr 
Nelson, Louis A., Jr.... 
Nimlos, Kenneth 

7 Nimlos, eee O... 

§ Noble, 

§ Noble, 

+ Nollet, Donald J. 
Nuebel, Charles i: 
Nye, Katherine 
Nye, Lillian L 
O’Brien, J. C 

+ O'Connor, Loren J 
O’Kane, omas 
§ O’Reilley, 
§ =. 
§ Ogden, 

§ Olsen, Ralph L 
Charles A.... 

§ Ostergren, Edward W 

§ Ouellette, Alfred J 

§ Owens, Frederick M., Jr 
Paulson, Elmer 
Paulson, Wallace J... 

§ Pearson, Malcolm M 
Pedersen, Arthur H.... 
(Peltier, Leonard F. 
Peterson, David B... 

§ Peterson, 

§ Peterson, 


—, 4 

lotke, Harry 
Polski, Paul G 

§ Ralph, James R 

t Ramsey, Walter 
Rasmussen, Ramby 

§ Ravits, Harold G 

§ Rea, Charles E. 
Reid, James a 

§ Reif, Robert W.. 
Richards, Albert 

§ Richards, Ernest T. 
Richardson, Edward J., 

§ Richardson, Robert J... 

. Paul 




An nn 





Rick, Paul F. W . Paul + Skinner, Harvey O . Paul Van Bergen, Frederick H.....Minneavolis 
Rinkey, Eugene St. Paul § Smisek, Elmer A ...St. Paul Varco, Richard L St. Paul 
§ Ritchie, Wanace P . Paul § Smith, Vernon D. E. ..St. Paul Veirs, Dean M....... St. Paul 
§ Ritt, Alb Paul § Sn der, e é St. Paul Veirs, Ruby J. St. Paul 
Roach, . Paul § Sohlberg ..St. Paul § Venables, Alexander . Paul 


= St 

§ Rogers, Sydney F... St. Paul Sommerdorf, Vernon _L.. ... at. Paul t§von Amerongen, W. : at. 
¢ Rogin, Norton ——t Ben ..9t. Paul § Waas, Charles = 


Rolig, David H. St. Paul St. Paul § Walker, Arthur E. 
Rollie, Orris O St. Paul a ..St. Paul Wall, James O.... 
St. Paul $s E . Paul t§Wallinga, Jack.... Antiene, Galt 
R gi .St. Paul § i" Paul § Walsh, Edward F 
sRothschild, Harold J.... .St. Paul New vores 'N. ¥. § Walter, Clarence W. 
_ Clarence J., . Paul L St. Paul Warren, Cecil A 
Cc . Paul Sprafka, J ..St. Paul Watson, P. Theodore.... 
Mg George N Calif. § Steinberg, Charles L. . St. Paul § Watson, William H. A... 
sarinks, Alan P. St. Paul Sterner, Donald C St. Paul § Watson, William 
Ryan, John J St. Paul +§Sterner, Ernest G. .5t. Paul Watz, Clarence E 
Ryan, Joseph M... .St. Paul § Sterner, E. R ..St. Paul § Webber, Fred L... 
Sarnecki, M. M St. Paul § Sterner, John J... St. Paul ; Weis Benjamin A. 
Satterlund, Victor L.. St. Paul Stewart, Alexander ..St. Paul § Weisberg, preoriee. es 
t§Savage, Francis J St. Paul § Stolpestad, Armer H. ..St. Paul § Wenzel, Gilbert P. 
§ Schmidtke, Reinhardt L St. Paul § Stolpestad, Herbert L... ..St. Paul Westover. E.. 
eapolis Schoch, Robert B. J St. Paul § Strand, Jack W ..St. Paul Wetzel. 
t. Paul schons, St. Paul § Strate, . Paul *+Wheeler, Merritt W. 
t. Paul Schroeckenstein, Hugo F St. Paul Straus, M. I Paul + Wilkinson, Stella L 
t. Paul §Schuldt, Fredk. C St. Paul § Strem, Edward L . Paul + Williams, Arthur B... 
t. Paul §Schulze, Albert G St. Paul § Sturley, Rodney = .. St. Paul § Williams, Clayton K... 
+. Paul Schwyzer, Hanns C. .St. Paul + Swanson, John A ..St. Paul § Williams, John A 
t- Paul Schwyzer, Mar: .St. Paul Swanson, Lawrence J. ..St. Paul Williams, Richard A. 
ribault § Scott, Eugene .St. Paul § Swendson, James J ..St. Paul Wilson, J. 

Paul Sekhon ohan_ S. . Paul Swenson, "Donald B. ..St. Paul § Wilson, James V.... 
+. Paul Sells, Richard Bien . St. Paul § Teisberg, John E ..St. Paul Winnick, Joseph B.... 
. Paul + Senkler, George E.. . Paul Thompson, Floyd A . Paul Witthaus, Melvyn E. 
§ Setzer, Hobert J St. Paul Thoreson, M. C. Bernice... So. St. Paul § Wolff, Herman 1 ae 
. Paul § Tifft, St. Paul Wolkoff, H. J 
+ Shell Joh § Tongen, Lyle A.... ..St. Paul Word, Harlan L.. 
i , Calif. § Tracht, Robert R... ..St. Paul t Yamamoto, Joe 
Short, St. Paul Travis, es S - Youngren, Everett R 
Siegel, Clarence Paul § Tregilgas, ..So. St. Zachman, Leo L 
§ Simons, Leander T . Paul Tregilgas, Richard B. St. Zagaria, James F 
Singer, Benjamin J... St. Paul t Tucker, Jolyn S........ a § Zimmermann, Harry B 
§ Skinner, Abbott. . Paul Ubel, Frank A 


(Kittson, Mahnomen, Marshall, Norman, Pennington, Polk, Red Lake and Roseau Counties) 
Regular meeting—four each year 
Annual meeting, December or January 
Election in January 

Number of Members—61 

President § Greene, Daniel E Thief River Falls *§$Norman, John F 
THysELL, Haron R Crookston § Haugan, Norman R Crookston § Oppegaard, C. I 
Secretary *+$Henney, William H.. ....McIntosh Parker, Philip J 
SatHER, Russet, O Crookston § Hirsh, ...Crookston Pumala. Erven E 
*+Adkins, C. M Thief River Falls + Hollands, illi Reff, Alan R... Crook 
Anderson, Wallace E. Clearbrook § Holmstrom Carle is Roholt, Christian... McIntosh 
Behr, Orlo K .Crookston Janeck ‘Baudette Rydland, Arne D... Foley, Alabama 
Berge, David oO § Kinkade. Byron R. Ada Sather, Edgar E... F 
Berlin, Anthony S. Hallock *+Kirk, George P ...East Grand Forks Sather, George A... 
Biedermann, Jacob Klefstad, Lloyd H Greenbush Sather, Richard N. 
Boyer, George pl do Kostick, William R. i Sather, Russell O 
Bratrud, Edward. .Thief River Falls Loken, Theodore Schossow, George W. 
Brink, Adlai A Baudette Lund, Anthony J.. Skozerboe. Rudolph... 
Cameron ohn H. Crookston Lynde, Orrin G Stadem, Clifford 
Clapp, Hubert D Fister § McDonald, William J Starekow, Milton......... 
Covey, Kenneth W McHardy, Bryson R s Stensgaard. Kermit L... Thief River Falls 
Dale, Lester N McKaig, Alan M......... Red Lake Falls Stewart, 
§Delmore, John L.. Rosez Martin, George B.....Thief River Falls Thysell, 
Delmore, | ee | 2 Mercil, illi —— Uhley, Charles G es 
Downing, William $ Mueller. Donald R... Van Rooy. George T...Thief River Falls 
Erickson, _Eskil Halstad $ Murn, Thomas Wendt, H. Paul Thief River Falls 
Feigal, William M.....Thief River Falls +t Nelson, Henry E Wikoff, Howard M.. 
Flancher, Leon H Crookston Nelson, Kenneth L Wiltrout, Irving 

t+ nm 




Regular meeting, third Tuesday of each month 
Annual meeting, November 

Number of Members—24 

President § Ceplecha, Stanley F Redwood Falls § Johnson, William E 
Pierce, Rosert B ivi § Cosgriff, James A., S Oli § Knoche, Harvey A 

Secretary _ Cosgriff, i h 

IESSNER, ARDELL W § II Redwood Falls 
§ Alcorn, William J § ... Sacred Heart 
§ Anderson, Chester A a § A ; — 

sesen, Daniel H.... ...-Olivi inn, s . 
§ Billings,’ Ralph E... i Leo O + a ™ Joseph W. 
Brand, William A § ey Fairfax § Strauchler, Jonas 

§ Hinderaker, Harris Bird Island 

May, 1955 



Regular meeting, third Tuesday of each month 
Annual meeting, third Tuesday in October 

Mever,. Pau, F 


§ Beaton, J. Northfield 
§ Bruhl, pinz H... Faribault 
{$Dungay, Neil S ...Northfield 
§ Engberg, Edward J... .....Faribault 

Francis, David W... -Morristown 
§ Furlow. William L. Faribault 
*§Hanson, Adolph M... Faribault 
+ Huxley, Fredk. R Faribault 

Number of Members—33 

§ Kennedy. George L Faribault 
§ Kolars, James J Faribault 
¢ Kucera, Louis B...Colo. Springs, Colo. 
§ Lende, Norman Faribault 
t Lexa, F. | 
§ Mears, Robert F... 

Meyer, Fred’k C... 

Meyer, Paul F.... 
t Meyer, Robert P. 
§ Moses, Royal 
§ Nelson, Ernest J... 
§ Nielsen, Alvin M 

§ Nuetzman, Arthur ..Faribault 

§ Orr, Burton A 
Peterson, D. H 

§$ Roberts, Stanley 

§ Robilliard. Charles M. 
Rumpf, Carl W 
Rysgaard, George M. 

§ Stevenson, Frank W... 
Street, Bernard 
Studer, Donald J 

§ Traeger, Carl A.. 

§$ Weaver, Paul H.. . 

§ Wilson, Warren E.................... Jor 

ae Faribault 
Fe ar’ ~~ 

(Carlton, Cook, Itasca, Lake and St. Louis Counties) 
Regular meeting, second Thursday except July and August 

Fawcett, KeitH R Duluth 

Secretary . 
Haavik, Joun E Duluth 

Exec. Secretary 
Gilbert, Mrs. Margaret B Duluth 

§ Ahrens, Curtis F 
Andrew, William F... 
Antonow, Arthur M. 

Asta, J 

§ Athens, 

§ Aufderheide, 

§ Backus, Reno 

§ Bagley, Charles M... 
Bagley, Elizabeth C. 

§ Bagley, William R. 
Baich. Velemir M.... 

§ Bakkila, Henry E 

§ Bardon, Richard.. 

§ Barker, | 
Barnes, Richard E... 

+ Barney, Leon A... 

§ Barrett, Earl E... 
Bartzen, Peter J. 

§ Becker, Fredk. 

§ Benell, Otto E 
Bepko, Marie K.. 

§ Bergan, R. O 

§ Bianco, Anthony J., 

+§Bianco. Anthony J., 

+ Binet, Henry E 

§ Rlackmore, Sidney C 

§ Bloom. Joseph 

¢ Bolz, J. Arnold. 
Boman, Paul G 
Bonner. John 
Bouchelle, McLeo 
Bowen, Robert L. 

+ Boyer, Sam H. 

§ Boyer, Sam H. Jr. 

§ Braun, Ohrmundt 

§ Bray. Philip N 
‘Brockway, Roger 

§ Brooker, Warren J. 

§ Buckley, Robert Peers... 
Burleigh, we cS: 

§ Rutler, Tohn K 
Cantwell, William F...International Falls 
* Chapman, Theodore L Duluth 

§ Chermak, Francis G...International Falls 

§ Christensen. Clarence H 
Ciriacy, Edward 

§ Clark, Clarence L 
Clark: Elizabeth A. 

§ Clark: Ivan T. 

§ Coll, James J 

¢ Collins, Arthur N...... 

Colosey, Frederick J 

t§Conley. Francis W 

+ Cope, Hershel E 

§ Coventry, William D 


sue OChester 

Annual meeting, second Thursday i in January 
Election, second Thursday in December | 

Number of Members—279 

Cowan, George M 
Detien, Edward D 

§ Dickson, Franklin H., Jr... 
Doxsee, George C 
Doyle, George C.... 

§ Dwyer, John J 

Eppard, Raymond 
Erickson, George P....... 
Erickson, Vernon D 
Erskine, Gordon 
Evensta, John B 
Farley, Frank G 
§ Fawcett, Keith R... 
§ Fellows, Manley F... 
t Ferrell, Clarence R.. 
§ Feuling, | 
Fifield, Malcolm 
§ Fischer, Mario McC 
§ Fisketti, 
§ Flynn, { 
§ Fredericks, Merriam G... 
French, Bayard T 
§ Fuller, Josiah 
8 Gillesnie, Malcolm G 
8 Goldish, Daniel R, 

§ Goldish, Robert , 
Goodman, Charles... 
§ Gowan, Lawrence R 
+ Graham, Archibald W 
§ Grahek, Jack P. 
Granauist, Richard D 
§ Grinley. Andrew 
rohs. William H. 

+ Halliday. # 
Halper, Rernard.. 
+ Haney, Claude 
Hansen, Robert F. 
anson., Ernest O 
Harrington, Verno 
§ Harris, Carl N... 
+§Hatch, Walter E 
*+Haves. Michael F.. 
§ Hedberg. Gustaf A... 
Heiam, William C... 
§ Hildine, Anderson 1 C.. 
+ Hill, Fredk. E.... 
Hill, | 
Hirschboeck, Frank J.. 
§ Hoff, Herbert O 
Hoover, Norman W. 
§ Honkom. Samuel S... 
Hult. John E... 
Hutchinson, Henry 
t Indihar, Tohn E.... 
Treland. Gerald W. 
Trwin, Homer R..... 
J lacobson, Clarence 
§ Tacobson. Ferdinand C.. 
Jensen, Thorvold 
Jeronimus, Henrv J. 
Tessico. Charles M... 
Joffe, Harold H 

Johnsen, Henry A., a Virginia 
P Johnson, Edward A... Vena 
: Johnson, Karl E 

ohnsrud, Luverne W. 
Johnston, Henry W 
§$Tohnston, Rufus O.... 
Jolin, Francis M.. 
Tuntunen, Roy R.. 

§ Kelley, Walter. 

§ Kelly, Albert C.... 

. Kelly. Robert T.... 


: Klein, William A 

§ Knanp, Frank N 

§ Knoll, W. V... 

§ Kohlbry, Carl O 
Koskela, Lauri E...Shaker Heights. Ohio 

§ Kotchevar, Frank R 

§ Krueger, 

§ LaBree, 

*+§Laird, Arth 

§ Latterell, Kenneth E... 
Law, Harrison E 

¢ Leek. Joseph H 
Lepak, Francis J.. 
Leppo, N. Erkki A. 
pal Stanley W. 

§ Litman, Samuel N 

*tLovshin, William C 

+ McCarty, Paul D.... 

oy, Mary 

+ McDonald, hehdiaii 

§ McDonald, Owen G. 

§ McHaffie, Orval L 

§ McKenna, Maurice J. 

§ McNutt, John R.......... 


§ MacRae, Gordon C... 

§ Magney, Fredolph H. 

§ Malmstrom, John A... 
Marcley, Walter J 
Marrone, Patrick H 

§ Martin, ili 
Martin, Webster C. 

§ Mayne, Roy M 
Mead. Charles H. 

§ Merriman, Lloyd L 
Miettunen, John B. 
Moe. Thomaz.......... 

§ Moehring. Henry 
‘Mollers, Theodore 
Monroe, Paul B... 

§ Monserud, Nels 

§ Morsman. L. Willia 

§ Moyer, John B... 
Munson, Martin S 
Murray, Robert A... 
Nakamura, James Y 

§ Neff, Walter S 

§ Nelson, Robert L 

§ Nicholson, Murdoch 

§ Nisius, 

Norberg, Carl E 

§ Nutting, Roland E. 

$ O'Neill, John C... 
Olvon’ pan - 

son rchiba u 

: Owens, ... Hibbing 

‘o Harbors 



ene oe 
SSeS Omid = 


. Virginia 

... Duluth 
its. Ohio 
ose Lake 
sta, Ga. 

se Lake 
or River 




*;Parker, Owen W 
§ Parker, Wilbert H 
§ Parson, E. Irvine.................0.--Duluth 
§ Pasek, Antone W Cloquet 
§ Patch, Orien B... ..-Duluth 
+ Pearsall, R. P .Virginia 
§ Pedersen, Roy C. ..Duluth 
7 Pennie, Daniel F... ...Duluth 
Peterson, Edward N .Virginia 
§ Peterson, John _H.... ...Duluth 
§ Pierce, Virginia 
Puumala, Reino 
Raadquist, Charles S.. 
Raattama, John Keewatin 
Arnold I Grand Rapids 
* Paul Virginia 
i Virginia 
0 Barbara, Calif. 
Olin W Duluth 
Rowles, Everett K ..Coleraine 
§\Rudie, Peter S.... Duluth 
Rudie, William A.. ...Duluth 
§ Runquist, 
Ryan William J 
§ Sach-Rowitz, 

Chi hal. 

Moose Lake 


Om = mw 

ma Mua 





Sax, Milton 

Sax. Simon G... 

Schirber, Martin J. .Grand Rapids 
mid, Joh Duluth 

Echneider, Laurence E 

Schroder, C. H 

Schweiger, Theodore 

Seashore, R. T ee 

Sher, David A Virginia 

Shirai, Shohei Coleraine 

Siegel, Joh Virginia 

Sinamark, Andrew Hibbing 

Sisler, Clifford E. ...Grand Rapids 

Smith, Cyril M 

Smith, Wallace R... 


§ Snang, Anthony J... 

§ Spang, | 

§ Spang, William M... 

Stein, William A 

Storsteen, Kenneth A.. 

§ Strandjord, Nels M. 

+§Strathern, Moses L... 

§ Strauss, Eugene C 
§ Strewler, Gordon J 




Strobel, William G 
Sutherland, Harry N 
Swedberg, "William A 
Swenson, Arnold O 
Teich, Kenneth W.. 
Terrell, Bernard J.. 
Tetlie, James 
Thomas, John V.. 
Tingdale, Carlyle... 
Tomhave, Wesley G... 

§ Tosseland, Noel E.. 

Tuohy, Edward L.... 

Urberg, Sofus E 

Van Ryzin, Donald J. 

Walder, Harold J 

Walker, A. 


Walter, Frederick H...International Falls 
Wells, Arthur H 

Wheeler, Daniel W.. 

$Williams, Bruce F. P.. Fort Knox Ky. 

Wolff, *John M 

#$Ylitalo, William H. 
§$ Young, Thomas O.. 

Zemmers, Roberts.... 
Zick, Luther H.. ... 

§ Zupanc, Edward............. : 

Regular meeting, second Wednesday of every month 


Ponterio, James E 

RiescHL, EvizasetH K 

Bratholdt, pre W 
+ Buck, Fredk. H 

§ Cervenka, Charles F. 
Clarke, John Ww 

§ Doherty, Elmer M... 
§ Hebeisen, Milton B.. 
Heinz, Ivy 

: ... Shakopee 
einz, Lawrence H 


Annual meeting, second Wednesday in June 

Number of Members—32 

§ Juergens, Herman M.............. Belle Plaine 
§ Kucera, Stanley ..Northfield 
Larson, ¢ Waconia 
Lukk, Olaf /Montgomery 
*§Martin, Thomas Philip Arlington 
Nagel, Hlarold D.......:00<c.s«.: Minneapolis 
Navratil, Donald R..........Baltimore, Md. 
Ninneman, Newton N... 
Novak, Edward 
Olson, Chester J.. 
§ Pearson, Bror F 
Pearson, Roy T.. 
Philp, David R 

§ Ponterio, James 


Pogue, Richard E 

Rieschl, Elizabeth K. 

§ Rynda, Edwin R 
*+Sanford. James oe 

Sawaryniuk, Iwan.. 
Schimelpfenig, George 
Simmonds, Harry N...... 

§ Simons, Bernard H 

Stahler, Paul A....... 

+$Westerman, Alvin. 

Westerman, Fred...............- "Montgomery 

(Cottonwood, Jackson, Murray, Nobles, Pipestone and Rock Counties) 

Harun, Rocer P. 

Herperc, Orar M 

§ Arncld, Elmer W... 
ader, J. I 
§ Basinger, Harold P. 
Basinger, Harvey R... 
Basinger, Homer P. 
Beckering, Gerrit... 
Benjamin, Walter 
Bofenkamp, Ferdinand | 
Boone, Ervin 
§Bouma, John H............. Topeka, Kansas 
Brown, Alexander Pipestone 
Buresh, Kenneth L.........Aurora, Colo. 
Carlson, John V 
Christiansen, Harold A.. 
tDe Boer, 
Doman, Victor W 

Regular meetings, on call 
Annual meeting, October 
Election, October 
Number of Members—62 

Hallin, Roger P 
Halloran, Walter H 
Halpern, David J.... 
Harada, Thomas T... 
Harrison, Percy W... 
Heiberg. Olaf M.... 
Hoyer, Ludolf J 
Karleen, Bernard N...........0.0.0.... Jackson 
Keyes, ...Pipestone 
Kilbride, .Worthington 
Koenecke, .... Lakefield 
Kotval, Russell J Pipestone 
Laikola, Leslie A... .....Adrian 
Lohmann, John G Pipestone 
Maitland, Edwin T w. Jackson 
Manson, Frank M..... ‘Worthington 

Minge, Raymond K. 

Nealy. Donal 

Nicholson, Richard W.........Heron Lake 

Odland, Donald Mo.eccccccccssvss Luverne 


..Lake Wilson 


§ Pankratz, Peter J........... Mountain Lake 
§ Patterson, Hugh D 
§ Pierson. 

Piper, William A. 
Plucker, Milton W.. 
Ritzinger, Fredk. R... 

/Mountain Lake 

§ Robinett, Robert W... 
§ — ‘Christian A 

Rose, John T 

§ Sawtell, Robert R. 
§ Schade. Fredk. L. 
§ Schutz, 

§ Sherman. Charles 

§ Slater, Sidney A...... 2 
§ Sogge, Ludwig L... 
§ Stam, 

Stanley, Court R.. 
Stevenson, Basil M. 

§ Stratte, Harold C.... 

§ Wells, 
§Zeller, Ni 



EIF, Henry J 
Cosrriu, Vasite G St. Cloud 

Alden, W. Charles. Kimball 
BIGErS ORI, OES NM, cissaciccsecccosssssse St. Cloud 

May, 1955 

St. Cloud 

Regular meeting, third Thursday of month 

Election in December 
Annual meeting, December 
Number of Members-—69 

Andrews, Bernice F............ 
§ Autrey, William A.......... 

§ Baumgartner, Florian H 
§ Beuning, John B 
+ Brigham, Charles F., Sv.... 

§ Brigham, Charles F., Jr.. .......St. Cloud 

+ Broker, Henry M... 

§ Buscher, Julius C.... 

t§Cesnik, Robert J 

§ Clark, Harry B 
Cleaves, William D. 

§ Coseriu, Vasile G 



DeWeese, Robert C... St. Cloud Keith, Paul J (Milaca § Petersen, Robert T 
§ Donaldson, Charles i Kelly, John F.......................Cold Sprin: § Phares, Otto 
§ Dredge, Thomas E... ; Koenig, Robert P.... Re Y § Raetz, 
DuBois, juan F F., Kohler, Delphin W Tacoma, Wash. § Reif, Henry 


DuBois, Julian F EO SN Kuhlmann, Lawrence B "Melrose Richards, Willi iam B... 
§ Evans, Leslie Sauk Rapids { Lewis, Claude B St. Cloud Salk. Richard | 
t Fidelman, Norman E. ..Foley Libert, John N.... Sandven, Nels O.... 
§ Fleming, Lic N. - Loes, Louis A...... ; + Schatz, Francis J... 
§ Gaida, Joseph St. d t§Luckemeyer, Carl . Ri § Schmitz, Everett ; 
s t8$McDowell, John P... St. Cloud , Sherwood, George E. 
Meyer, Anthony A.... on Sisk, Harvey E 
Speen Aes St. § Stangl, Philip E 
usachio, Nicholas F... Thuringer, Carl B... 
Halenbeck, Philip 1 4c! Myre, Clifford R i Veranth, Leonard A... 
t Henry, i Fi § Neils, Vernon E.... § Walfred, Karl A 
Hoehn, i § Nessa, Curtis B.... § Wenner, Waldemar T.. 
Tohnson. i Milaca Nietfeld, Aloys. 3 § Wittrock, Louis H... 
§ Jones, Richard N St. Cloud § O’Keefe, James P ; Zachman, Albert H..........0.......... Melrose 


Regular meetings, called by the officers 
Annual meeting, February 

Number of Members—23 

President Halvorsen, Daniel K Owatonna §$ McIntyre, John A 
ARNESEN, Hartung, Elmer H ..(Claremont +§$'Melby, i Blooming Prairie 
Henry. Kenneth G. ea + Morehead, D Owatonna 
Dewey, Donarp H Honath, Donald H. a § Olson, Albert J 
§ Anderson, Franklin C.. e Kulstad, Oscar S ea ‘ § Roberts, Oliver ses ..... Owatonna 
§ Arnesen, John F e Kurtin, Henry §J........... § Schaefer, Owatonna 
§ Dewey, Donald H J : Kurtin, Joseph J.........} oes + Senn, Ov 
+ Ertel, Edward OQ: . § Lundquist, § Stransky, Theodore W Owatonna 
§ Fischer, John R i iri § McEnaney, Clifford T § Wilkowske, Owatonna 


(Aitkin, Beltrami, Cass, Clearwater, Crow Wing, Hubbard, Koochiching, Lake of the Woods, 
Morrison, Todd and Wadena Counties ) 

Annual meeting, January 
Number of Members—95 

President Halme, William B... Menahga 
Quanstrom, Vircit E Brainerd San. “Francisco, “Calif. § Mosby, M: Long Prairie 
Secretary S owe, Base D International Falls § Mulligan, “Ar ws = enon 
. ansen, Milo Little Falls Nelson, Nesmit Minneapolis 
Baveaux, Georce I Brainerd Hartien. Jas Nelson, Robert H.....International Falls 
Anderson, Werner W Brainerd Healy, Raymond T. neseotte ININGI, VAUMCS BB. cies csssececsoisenssesecosoas Crosby 
§ Radeaux. George I.... ... Brainerd Heine, George W.... = Olson, Lillian A Ah-gwah-ching 
*§Beise, Rudolph A.... Brainerd Hendricks, Esten J.. St. Paul Palmer, Harry A... Blackduck 
Bender, James _ H...... .... Brainerd Higgs, . ids Parker, Charles W. Wadena 
§ Benson, Little Falls Hildebrand, |} ....Bemidii Parker, 
.... Little Falls Hoganson, 0 4) Pedersen, Robert 
§ Borgerson, ne .Long Prairie House, Zachariah E i § Petraborg. Harvey 
Brown, Hector M... wss..sWalker Houston, Donald M.. ...Park Rapids Pierce, Charles H 
Cardle. George E.... ‘Brainerd Hubbard, Otto E Brainerd Ouanstrom, Virgil E 
Closuit, Frederick C. § Hughes, Bernard J.... Brainerd § Ringle, Otto F 
Cook, Ja ay M 2 § Johnson, Douglas _L.. .. Little Falls Rozvcki, Anthony T 
Johnson, Einer W .... Bemidji Sanderson, Anton G.. 
” Craig, Clair C.... .._ International Falls Johnson, Rudolph E Mankato Schmitz, 
Crow, Earl R...............South Bend, Ind. Johnstone, William W.....Ah-gwah- — Schwyzer. Arnold G. 
Cushing, Robert L Brainerd § Kanne, Earl R Brainer: Simons, Edwin J....... 
Davis, ..Wad Kelley, Roger E Crosby Skaife, William F 
§ Davis, Luther F A Kinports, Edward B...International Falls Spurbeck, George R.. 
* Davis, Thomas L., Jr.. w § Knight, Edwin G Swanville § Stein, Raymond 
Deweese, Wilford J.. idji Larson, LeRoy J Bagl Stoy, 
§ Eiler, h ! i Lee, Hubert W a Thabes, John A., Jr.... 
§ Erickson, i Leinonen, Wendla E... Wade Vandersluis, Charles W.. 
Fitzsimons, William E... § Lenarz, Albert We sis : -Browerville § Watson, Alexander M.. 
§ Fortier, George M. A. Li Longfellow, Helen W B d Watson, Percy T 
Garlock, Arthur V Bemid Lund, Werner J Staples Watson, Sydney W. 
Garlock, DeWitt W ; Lundsten, sli Bemidji Witenes Dede bi 
Ghostley, Mary C.... ‘Bemidji § McLane, William O.. ..Brainerd Will. Charles B a 
+ Gilmore, Rowland *. Crookston MacDonald, Roger A.. .Littlefork ‘ Wi oe 
Griffin, John W., Jr... Macheledt, Neil L ..Wadena § Will, W. 
Groschupf, Theodore P.. : idii § Marshall, Clark M. Williams, M. M.... Ah-gwah-ching 
§ Grose, Frederick N............:00+ ‘Clarissa Meller, Maurice Brainerd Zeigler, Charles M.............-+ Pine River 

Annual meeting, first Thursday after first Monday in October 
Number of Members—13 

President § Bouquet, Bertram J I § Gjerde. William P Lake City 

Exus, Eart W i § Bowers, Robert N... . Glabe, Robert A.... Plainview 

te + Collins, Jovogh a H Mahle, ee ‘ ..Plainview 
. } nce 

FLESCHE, siti PRS schecteets Lake City ; Eritrand, — * + Replogic, WH Los Angeles, Calif. 

§ Bayley, E. Covell i § Flesche, Bernard A i Wellman, Thomas G Clinton, Iowa 



ang Regular meetings, as decided 

Annual meeting, January 
Number of Members—10 

st. Cloud 

st. G 

Davis, Raymond D 
Florine, Martin C. 

President ; : 
[SGallagher, Bernard 3 oe George H 
§ § 


§ Hottinger, Raymond Swenson, Donald 

McIntire, Homer M.... Swenson, Orvie J 


(Washington and Dakota Counties) 

Regular meetings, second Tuesday in each month 
Annual meeting, December 

Number of Members—18 

President § Holcomb, Joel T....:Marine-on-St. Croix § McCarten, Francis M Stillwater 

Cartson, Russet E Stillwater Humphrey, Stillwater Mensheha, Nicholas... Forest Lake 
: Secretary . § Jenson, James E + Poirier, Joseph A... Forest Lake 
Pane Juercens, MANLEY F Stillwater ay Stillwater Racer, Harley J Stillwater 
Watnnue Brabec, Paul F Beate Josewski, Raymond J Stillwater Ruggles, George M. Forest Lake 
watonna § Carlson, Russel E... wees Stillwater § Juergens, Manley F Stillwater § Sherman, Carnot H.. 
watonna Fasbender, Herman T... ..... Hastings Just, Herman J Hastings § Stuhr, John W.... 
watonna *+$Haines, "James H Stillwater Kulzer, Norbert J....................... Hastings Van Meier, Henry. 

(Big Stone, Pope, Stevens and Traverse Counties) 
Regular meetings, one Tuesday in March, May, September and November 
Annual meeting, November 
Number of Members—25 

President 7 §Eberlin, ee A 

ag Alfred L 

Ewe, O. A Hancock § Lide, +§Linde, rman 
+ Elsey, Tames R. § Magnuson, Allen E 
fenahga Secretary *+Fitzgerald, E. T § Merrill, Robert W. 
Prairie Watson, ROBERT M........0....0c0cc0eee Morris § Giesen, Allan F. <i k ‘Muir, Browns Valley 
rainerd Good, Roy H ae *$O’Donnell, Ortonville 
neapolis § Arneson, Arthur I Hedemark, Homer H.. § Oliver, : 
val Falls { Echmiler, Fred’k Wm. Hedemark, Truman A.. + Ransom, Matthias L.... 
Crosby t$Bergan, Otto § Rossberg, Raymond A. 
h-ching t Bolsta, Charles .. a § Swedenburg, Paul A.... 
ickduck t§Bucher, | A) See ee N. § Watson, Robert M 
. Atkin 
Walker Regular meeting, first Monday in January, April, July and October 
e fon Annual meeting, first Monday in January 
le Falls Number of Members—32 
, 2. 
.-Edina President § Heise, Paul vR § Roemer, Henry a SARA Winona 
le Falls Heise, Pumir vR § Heise, Philip vR. § Rogers, Charles vesceuseeee Winona 
h-ching Secretar Heise, William v! § Rollins, Pat Charles 
....Pierz Wuson, Louis J Hughes, Sidney O § Satterlee, Howard W ‘Lae 
le Falls § Johnston, Leonard F.. ; § Schmidt, Hilmar R... 
rainerd **Benoit, Frank T Keyes, Wi *§Steiner, 
3emidji Boardman, Dalmon V.. § Loomis, G. L --Wi § Tweedy, 
ovalton § Christensen, Eh. E...... + McLaughlin, Edmund M.. Wi Tweedy, Robert B... 
rthfield § Finkelnburg, William O § Mattison, Percy A Vollmer, Fredk. J... 
oyalton Haesly, Warren § Meinert, Albert E... Wilson, Louis J 
semidji epeeweh, Roger F. Neumann, Conrad § Wilson. Rolland H. 
Bertha Heise, Carl vR § oe Raymond L § Woltjen, Myron J.. 

» River 

§ Heise. Herbert vR 

§Robbins, Charles P 


§ Younger, Louis I 

Regular meeting, first Tuesday of every third month 

Pre sident 
SaNDEEN, Buffalo 

t Abullarade, Jose A Cokato 
Anderson, Waldo P ..Buffalo 
§ Bendix, Lester H... nnandale 

May, 1955 

Annual meeting, first Tuesday in October 

Number of Members—17 

+§Catlin, John J Buffalo 
§ Catlin, Theodore J.. .... Buffalo 
i ..Monticello 

: Michael 

§ Guilfoile, Pierre F. 

§ Hall, William E..... Maple Lake 
§$ Hart, William E Monticello 
§ Sandeen, Robert M 

§ Shragg, Robert I 

§ Smorstek, Matthew B.. 
§ Thielen, Robert D 

§ Thomas, William H........... 

-Howard Lake 

....St. Michael 
Howard Lake 


‘anes, Almer M 
Abbott, Albert R... 


Alphabetic Roster 

Key to Symbols: 

*Deceased; }Associate, Junior Associate, Residency, Affiliate or Life Member; {In Service 

-Red Wing 


Arden 18 

‘Abullarade, Jose A 
Achor, Richard W. P 
Adair, Albert F., Jr. 
Adams, Bertram S$ 


+ Ahrens, 
¢ Aitkens, 

Richard C 

Charles M 
Galen H.... 
Daniel E 

Aga, John H 

Kenneth E 
Curtis F... 

«Thief River Falls 


M —— 

Alcorn, William J.. 

t Alden, J. 


a | Re 
W. Charles.. 

Harlan A 

Aling, Charles A.... 

Allen, E 

7 Altnow, 

¢t Amberg, Samuel 

t Anderson, 
+ Anderson, 

Anderson, | 


tdgar V 

Allen, George S.. 
Allen, John H.... 
Allison, David D 

Cannon Falls 

Jr....... Minneapolis 
Coral Gables, Fla. 

Theo. L., 
Donald §. 

Howard A 
Silas C 
Arnold S... 
Chester A 
Chester A... 
David M 
David P., Jr... 
Donald C 
Edward D.... 
Ernest M.. 
Ernest R.. 
Frank _J.... 
Franklin C... 

St. Louis Park 



William H. 

William T. et 


Andreassen, Einar C.. 
Andreassen, Rolf L. 


K. D’A... Minneapolis 

Andrew, William F... 

Andrews, Bernice F... 


t Andrews, 




k J 
Arthur M. 

* Archer, Willard . 

+ Ardan, 

y = Wl Stuart 
Arlander, Clarence 
Arling, Leonard 


, Harry Wm... 
Arnesen, John F 
Arthrr I. 


Nicholas I 
Archabald L 

Minnea lis 
Min ae 
Detroit Lakes 
Sanna Morris 


Arnold, Anna W........:...:0000.0: Minneapolis 


Arnold, Elmer Wm 
Arnquist, Andrew S 
Arny, Frederick P.... 
Arvidson, Carl 
Arzt, Philip K 
Asta, Joseph J 
thens, Alvin G 
Atmore, William G 
Ayfderheide, Arthur C 
une, artin pol 
Aurand, William H Minneapolis 
Aurelius, J. Richards.. St. Paul 
Ausman, Duane R.... ..St. Paul 
Autrey, William A 

Conrad W 



Babb, Fran 
Backus, Reno W... 
Bacon, Donald K 
Badeaux, George I 
Bader, | 
Baer, Walter St. Paul 
Bagby, George W. 
Ft. Leonard Wood. Mo. 
Baggenstoss, Archie H Rochester 
Baggenstoss, Osmon «-s.+.-..Minneapolis 
Bagley, Charles M 
Bagley, Elizabeth C. 
Bagley, Russell 
Bagley, William R... 
Baich, Velemir M.... 
Bain, Robert 
Bair, Hugo L 
Baird, Joseph W... 
Baird, Raymond L... 
Baken, re re. 
t Baker, 
t Baker, 
Baleisis, Peter .. 
Balfour, Donald 
Ralfour, William 
Balkin, Samuel G. 
Bank, Harry E 
Ranner, Edwar 
Barber, Tracy E 
Bardon, Richard ... 
Bargen, TI. Arnold.. 
Barker, John D 
Barker, Nelson W. 
Barlow, Loren C... 

Rarnes, Richard E 
Rarnett, Toseph M 
Barney, Leon 
Barno, Alex 
Baronofsky, Ivan D 
Barr, Tames S 
Barr, i p 
Barr, Minneapolis 
Barr, Ronald (Montevideo 
Barrett, Earl E — 
Barron, Tesse J 
Barron, cal gemma: 
Barron, S. Steven... 
Barry, Maurice J.. 
Barsness, Nellie O. 
Bartholomew, ‘oyd G 
Bartzen, Peter J 
Basinger, Harold P.. 
Basinger, Harvey R.. 
Basinger, Homer P.. 
Bastron, Tames A. 
Batdorf. B. Niles... 
Bauer, Eugene L 
Baumgartner, Florian H. 
Rayter, Sterhen H 
Bayard, Edwin D 

Scott Air Force Base, TI. 
Beach, Northrop Minneapolis 


oe Si. 
Hillier es “Tr. .West Point, N 

Teannet te ergus Falls 

Russell L.. 
Henry E.. 

Beahrs, Oliver H 

+ Beals, 
Beck, Charles J 

+ Becker, Arnetta M 
Becker, Frederick T. 
Beckering, Gerrit... 
Beddow, Ralph M.... 
Bedford, Edgar Wm... 
Beech, Raymond H. 
Beek, Harvey O 
Beer, John 

.-LaJolla, Calif, 

No. St. Paul 
‘Minne: apolis 


Beiswanger; Richard H. cet olis 
Bell, Charles C t. Paul 

WW Me Micssssscccncccs-aescscccisaovead ieee 

‘4 Bellomo, J James St. Paul 
Bellomo, John St. Paul 
Bellville. Titus P Minneapolis 
Belzer, Meyer S... -Minneapolis 
Bender, James H. Brainerd 
Bendix, Lester H... 

+ Benedict, William L. 
Benell, Otto E 
Benepe, James L. 
Benesh, Louis A 
Benjamin, Edwin G... 
Benjamin, Harold G. 
Benjamin, Walter G.. 

+ Bennion, P. H 

*tBenoit, Frank T. 
Benson, Alfred H... 


-Isway, Mont. 

Little Falls 
m: Paul 

Berg, Arnold 
Berg, Clinton C "Exce isior 


Berger, Alex G... 
Bergh, George S 
Bergh, Solveig M... 
Berglund, Eldon B 
Bergman, Oscar B. 

* Bergquist, Karl E 

+ Berkman, David M 
Berkman, John M 
Berkwitz. Nathaniel J... 
Berlin, Anthony S 
Berman, Reuben 
Bernatz, Philiv E... 
Bernier, M. J.......... 
Bernstein, Irving C 
Bernstein, William C.... 
Bessesen, Alfred N., Jr. 
Bessesen, Daniel ni 

*+Bessesen. William A... 

Bianco, Anthony J. 

+ Bianco, Anthony J., 
Bicek, Josevh 
Bickel, William H... 

t Biedermann, Jacob. 
Bieter, Ravmond N... 

t Bigelow.” Charles E. 
Bigler, Earl E 
Bieler, Ivan E.. 
Bilka, Paul J 
Billings, Ralph E... 
Binder, Manuel R. 

Binger, Henry E 
Biornson, Robert G... 
Black, B. Marden.. 
Rlack, Farl J 

Black, William A.... 
Blackmore, Sidney C. 
Blake, Allen J....... 
Blake, James A. 

+ Blakey, Adam R. 
Bloedel, Traugott J. G. 
Blomberg, Robert D 
Blomberg, William R. 
Bloom, Joseph 


St. James 
Battle Lake 
.... Oronoco 
o. St. Paul 
St. Paul 


Thief River Falls 
Dodge Center 

“here Rapids 
, Ariz. 

a, inneapolis 

, Calif. 
wr thfield 
t. Paul 
it. Paul 
t. Paul 
t. Paul 
st. Paul 
st. Paul 
st. Paul 
t. Paul 
le Falls 
it. Paul 

le Lake 
t. Paul 
t. Paul 
_ Cloud 
t. Paul 
or Falls 
x, Ariz. 
t. Paul 
w Ulm 


Bloom, Norman B.................Minneapolis 
Blumberg, Henry B 
French ae, Calif. 
Blumenthal, Jacob S 
Boardman, Dalmon V... _ Wien 
+ Bock, Ronald A St. Paul 
* Bockman, gy er W. H 
Hot Springs Nat’l. Park, Ark. 
Bodaski, aa A Tyler 

Little Rock, lek. 
+ Boeckmann, Egil St. Paul 
Boehrer, John ™ 
Bofenkamp, Benjam 
Bofenkamp, F. Willia 
t Bohn, Donald G... 
Boies, Lawrence R.. 
Bolender, Harold L 
Boline, Clifford A 
+ Bolsta, Charles. 
t Bolz, J. Arnol 
Bonello, Frank - 
Bonner, John L 
t Bonnet, John D 
Boody, George. 5, Je 
Boone, Ervin S 
+ Booth, Albert E 
+ Boreen, Clifton A. 
Borg, Joseph F 
Borgerson, Arthur H.. 
+ Borgeson, Egbert J 
Borman, Chaunce 
Borowicz, Leonard A.. 
Bosland, "Howard G 
Bossard, John 
+ Bossert, Clarence S Mora 
t Boswell, J Thornton....Portsmouth, Va. 
+ Botham, Richned J 
Bottolfson, Bottolf T.. 
Bouchelle, McLemore 
Bouma, John H 
+ Bouma, Lewis R.... 
Bouquet, Bertram J.... 
Bouthilet, Florence J 
Bowen, Robert I ibbing 
t Bowers, Dorrance. Rochester 
Bowers, Gordon G i polis 
Bowers, Robert N......................Lake City 
Bowes, Donald E Rochester 

Boyd, ‘David A., Jr. 
one Pa. 


veer. George K 
Boyer, George S 
Viorer, & Samuel ae. Sr 
aereton, Ruth EB Racacsesossicioscssd ‘Minneapolis 
Boysen, Herbert. Madelia 
¢ Boysen, Peter. Bemidji 
Braasch, John W Rochester 
t Braasch, William F... ....Rochester 
Brabec, Paul F ... Hastings 
Brackett. Ralph _D.. Rochester 
Brand, George D.... 

t Brand, William A... “Redwood Falls 
Brandenburg. Robert O. Rochester 
Bratholdt, James W. 

Bratrud, Arthur F 

t Bratrud, Edward. 
Bratrud, Theodore E 
Bratrude. Earl J............. 
Braun, Ohrmundt C.. 
Braun, Robert A 

, ~ 
...Grand Rapids 

St. Paul 

Co eS 
Brekke, Harvey J Mi lis 

Briggs, John F St. Paul 
+ Brigham, Charles F., a Cloud 
Brigham. Charles F., St Cloud 
Brill, Alice K 
Brink, (og SORE .Baudette 
Brink. Donald M... -Hntchinson 
Broadbent. James C Bee 
Broadie, Thomas E..... 
Brockway, Roger W rand Rapids 
Broders, C. W... Rochester 
Brodie, Walter |) aE: St. Paul 
t Broker, Henry M.. 
Brooker, Warren ¥. 
+ Brooks, Charles N.. 
Brown, Al Rochester 
+ Brown, Al r i Pi 
t Brown, Edgar 5 Paynesville 
Brown, Hector M Walker 
Brown, Henry A Rochester 
Brown, Tan A Mi poli 
Brown, Joe R Rochester 
t Brown, John C Gatos, Calif. 
Brown, Philip W Rochester 

May, 1955 


Brown, Roland G Rochester 

Brown. William D ‘Mir 

Bruhl, Hei Pactoealt 

Brunsting, Louis A Rochester 

Brusegard, James F 

Bucher, Foster D 

— Harold F... 
Frederick H 

Buckley. J Ly 

Buckley, Robert P 

Buie, Louis 

Buirge, Raymond E 

Bulinski, Theodore J. 

Bulkley, Kenneth.... inneapolis 

Bumpus, Frank T Rochester 

Bunker, Bevan W.. 

Burch, Edward P. 

Burch, Frank E.. 

Burchell, Howard B.. 

Buresh, Kenneth L.... 

Burke, Edmund C...... 

Burklund, Edwin C.... 

Burleigh, Edward G.. 

Burlingame, David A... 

Burmeister, Richard O. 

Burnett, Joseph Ww i 

Burnham, Wesley H.. ‘inneapolis 

Burns, Catherine Albert Lea 

Burns, Floyd M Milan 

Burns, LM! ee Milan 

Burns, Robert M... 

Burseth, Edgar é.. 

Burton, Carl G 

Buscher, Julius C. 

Bush, Robert 

Bushard, Wilfred J. 

Busher, Herbert H 

Butler, John K... 

Butt, Hugh R........ 

Butturff, Carl R. 


Butzer, F 

Buzzelle, Leonard K............. Minneapolis 

St. Paul 

Cable, i Sinamepele 
Cabot, Clyde M 
Cady, Laurence H. 
Cain, Clark 
Cain, James C. 
Cain, James H. 
Cairns, Robert J. 
¥ Calhoun, F. W.... 
Callahan, Francis 
Cameron, Isabell L 
Cameron, John H 
Camp, Ray Junior. 
¢ Campagna, Mario J 




Canine, ” James L So. 

Cantwell, William F...International Falls 
plan, Leslie Mi 

Card, William H i I lis 



Carey, James 
Carlander, Lester W 
Carley, Wal ary A... 
Carlson, Ble cccss 
Carlson. Lawrence 
Carlson, Leonard T. 
Carlson, Russel 
Caron, Robert P 
Carr, David T 
Carr, William J 
oll, John J 
* Carroll, William C... 
Carryer, Haddon McC.. 
Carthey, Frank J 
Caspers, Carl G Minneapolis 
¥ Catlin, John J Buffalo 
Catlin, Theodore J 
t Cavanor, Frank T 
Cedarleaf, ay B 
Ceder, Elmer T 
Ceplecha, Stanley F 
Cervenka, = F. 
t Cesnik 
Chadbourn, Charles R. 
+ Chadbourn, Wayne A 
Chalgren, William S 
Challman, Samuel A 
t Chambers, Winslow C 
Chapin, Lemuel 
* Chapman, Theodore L 
Chatterton, Carl a 2 
Chavez, Demetrio A Minneapolis 
Chermak, Francis G.. International alls 
Chesler, Merrill D inneapolis 
+ Chesley, Albert J Minneapolis 

A. kas. 




Childs, Donald S., Jr 
Chisholm, Tague C 
Christensen, larence H 
Chri Eli E Winona 
Christensen, Llewellyn E 
Christensen, Norman 
Christiansen, Andrew 
Christiansen, Harold A 
Chunn, Stanley S 
Ciriacy, Edward 
Clagett, Oscar T 
Clapp, Hubert D 
Clark, Edward C 
Clark, Elizabeth A 
Clark, Harry B 
Clark, Henry B., Jr. 
Clark, Ivan T 
Clark, Leslie Wm 
ark, Malcolm D 
Clarke, Eric K 
Clarke, John W 
Clay, Lyman B 
t Clayburgh Bennie J 
Claydon, Howard F.. 
Cleaves, William D.. 
5 Clement, John B 
Clifford, George 
Clifton, The 
Cochrane, Byron B 
Cochrane. Ray F 
Coddon, Walter D 
Coe, John I 
hen, Bernard A poli 
Cohen, Mi polis 
Cohen, Ephraim B Minneapolis 
Cohen; Maynard M.. St. Paul 
Cohen, Sumner S.. 
Colby, M. ¥.. Je.. 
Colby, Woodard L. 
Cole, James S 
Cole, Wallace H 
Coleman, John B 
Coll, James 7 
t Collie, Henry G 
+ Coll ins, Arthur N 
t Collins, Joseph S 
Collins, Loren E 
Colosey, Frederick J 
Combacker, Leon C... 
Comfort, Mandred ....Rochester 
Compton, Russell F.... ....Rochester 
Condit, William H... Minneapolis 
¢ Conley, Francis W Ft. Hood, Texas 
Conley, Robert H Mankato 
¢t Connolly, eae cong J.....Ft. Belvoir, Va. 
Connor, Charles E.. St. Paul 
Cook, om “St. Paul 
Cook. Rochester 
Cook, Jay M Staples 
Cooley, Rochester 
Cooper, Excelsior 
+ Cooper, Winnebago 
Cooper, Rochester 
Cooper, Robert R i Li 
7 Cope, 
Corbin, Kendall B 
Corniea, Albert D 
Correa, Dale H 
Corrigan, Cyril J 
Coseriu, Vasile & 
Cosgriff, James A cg ees 
Cosgriff, James A., Jr... 
Costello, Addis Rochester 
Coulter, Harold E Madelia 
Counseller, Virgil S 
Countryman, Roger 
Counts, Robert 
Covell, Walter W 
Coventry, Markham B 
Coventry, William D 
Covey, Kenneth W 
Cowan, Donald W 
Cowan, George M 
Craig, Clair C 
Craig, - M St. Paul 
Craig, M. Elizabeth ‘Minneapolis 
t Craig, Richard M Rochester 
Craig, Winchell McK Rochester 
Cranmer, Richard R.. Minneapolis 
Cranston, Robert W Minneapolis 
Creevy, Charles D Mi 1 
Creighton, Ralph H 
Critchfield, Lyman R. 
Cronwell, Bernhard J. 

Lester Prairie 
..... Alexandria 

..Fergus faik 

Crowley, James H 
Crudo, Vincent D 
Crumbley, James J 
Crump, James W 


Culligan, John M 
Culligan, Leo C p 
Culp, Ormond S Rochester 
Culver, L. G ..St. Paul 
Cundy, Donald T M 1 
Curtis, Rauen 
Cushing, Robert L 
t Cutts, George 

Dady, Elmer E 

...St. Paul 


Daggett, cage R 
Dahl, Elmer 
t Dake ames C 
Dahl, John A 
Dahlin, David C f 
Dahlstet, John P........San Ysidro, Calif. 
Daignault, Oscar. B 
Dale, Lester N Red Lake Falls 
Daly, David Rochest 

t Daniel, Donald H Minneapoli 

T Danielson, Karl A Litchfield 
Danielson, Lennox Litchfield 
Danyluk, —, Minneapolis 
Daugherty, Guy W... ‘Rochester 
David, Reuben Minneapolis 
Davis, Austin C... -Rochester 
Davis, R 

Davis, Thomas L 
Davis, William I 
Dawe, Clyde J 
Dawson, James R 
Dawson, orin D 
Dearing, William H... 
*+DeBoer, Hermanus. 
Decker, Charles H 
Decker, David G 
DeGeest, James H 
DeKruif, endrik 
t Delmore, a i * Roseau 
Delmore, Roseau 
Del Plaine a W. Minneapolis 
Demo, Robert A a Lea 
Derauf, — a. t 
Deters, Donald C 
Detjen, Edward D... 
Deveraux, Thomas J. 
Devine, Kenneth D Rochester 
DeWali, Richard A lis 
DeWeerd, ames H Rochester 
Deweese, Wilford J 
Dewey, Donald we 
Dickman, Roy W 
Dickson, Franklin H., Jr. 
Dickson, Thomas H 
Diefenbach, ape J: i ats 
Diehl, Harold ol 
Dierker, Heinrich. 
Diessner, Grant R 
Diessner, aid E D 
Dille, Donald 
Dines, David E 
Dixon, Claude F 
Doane, Joeerh Cc 
Dodge, eae | ae 
Doehlert, Charles A., Jr... 
Doherty, Elmer M 
Dokken, James H 
man, Victor Wm. 
Doms, Vernon A 
Donaldson, Charles S.. 
Donatelle, Edward 
t Donin, Winnipeg, Man. 
Donoghue, Francis Rochester 
Donovan, Daniel L Albert Lea 
Dordal, "John Sacred Heart 

Dornbach, Robert A.. i 
¢ Dornblaser, Harry B.....Los Gatos, Calif. 
Dorsey, George C inneapolis 
Douglas, Kenneth W.. .. Sandstone 
Douglass, Bruce E Rochester 
t Dovenmuehle, Robt. H...Durham, N. C. 
Downing, William 
t Doxey, Gilbe 
Doxsee, George C 
Doyle, George C... 
Doyle, — R 
Doyle, Lawrence O. 
Drake, Carl B 
+ Drake, Charles R 







+ Dredge, Homer P Sandst 
Dredge, Thomas E 
Drexler, George W = ok 
rill, Herman opkins 
t Drips, Della G 
ry, Thomas J 
Dubbe, Frederick H 
DuBois, J Sr. 
ter Sadi 
Duncan, James 
Dungay, Neil S 
Dunlap, Earl H 
Dunn, Jack, 6 
Dunn, James N 
Dupont, Joseph A 
Duryea, illis M 
DuShane, James W 
Dvorak, Benjamin A 
Dwan, Paul F 
Dworsky, Samuel D 
Dwyer, John ulut 
+ Dyer, John i Rochester 
kstra, Peter C est aie N. 
Dysterheft, Adolf F... ...Gaylord 


Earl, George A 
Earl, John 
Eaton, Lealdes M 
Eberley, Tobe S 

t Eberlin, Edward A 
Eckdale, & 
Eckman, hilip F.. 
Eckman, Ralph J. 
Edelmann, Robert 
Eder, Walter P 

* Edlund, seal 
Edwards, — E 
Edwards, oseph W.. 
Edwards, Lloyd G. 
Edwards, Thomas J.. 
Eelkema, Harriso} 
Esge. Sanford G... 
a Chasies T.. 

renber aude 

Ehrlich, SP 

Eich actions A I 

Eichhorn, Edmund P Minneapolis 

Eide, O. A Hancoc 

Eiler, John Park Rapids 

Eisenstadt, David H Minneapolis 

Eisenstadt, William S. Mi i 


Ellinger ’ Albert J 
rag arold J 
Earl Wm 
Ell F. Henry. 
Ellison, David E 
Ellison, Ellis 
Ellison, Frank E 
t Elsey, James R 
Elstner, Howard L 
¢ Ely, Orriman S 
Emanuel, Karl Wm... 
Emerson, Edward C.. 
Emerson, ve 
Emmett, John L 
Emmons, R. 
Emond, Albert | 
Emond, Joseph S... 
Eodress, Edward K... 
Engel, 7 
Engelhart, “a Cc 
Englund, Elvin 
Engstrand, Oscar J 
Engstrom, Denton P 
Engstrom, Robert 
Enroth, Oscar E 
Ensrud. Earl Richard... 
Eppard, Raymond M. 
Erdal, Ove 
Erich, ihe B 
Erickson, Alvin O Long Prairie 
Erickson, Clifford O Minneapolis 
Erickson, Donald J Rochester 
Erickson, Eskil Halstad 
Erickson, George P Hibbing 
Erickson, John G ..Rochester 
Erickson, Laurence F. ‘Minneapolis 
Erickson, Myron Minneapolis 
Erickson, Reuben F............... Minneapolis 
Erickson, Vernon D... ‘Grand Rapids 
Ericson, Reinhold M Wayzata 
+ Ericson, Swan Le Sueur 

R — 

So. _ aoa 


+ Ernest, Geo. C. H...St ean Fla. 
Ersfeld, Murray P St. Paul 
Erskine, Gordon 

+ Ertel, Edward Q 
Esensten, F a wl 

+ Eshelby, 
Estes, J. ee 
Estrem, Ralph L.. 

Estrem, Robert D.. 

+ Eusterman, George B. 

Eustermann, John J... ed 
Evans, Edward T. inneapolis 
Evans, Leslie. Sauk Rapids 
Evans, Robert D Mi 

+ Evarts, Arrah B 
Evensta, John B... 

t Evert, jo n A. 

Ewen, Edgar 

Faber, John E 
+ Fabi, Mario Nestor. 
t Fahr, George E 

Fallon, Virgil T 

Falls John L 

Fansler, Walter A 



Fasbender pays ae 

Faucett, Robert L 

Faulconer, / Albert r. 

-Fawcett, Arthur M. 

Fawcett, Keith R 

Fee, John G 

Feeney, John M 
t Feigal, David W.......A. F. B., Wyoming 

Feigal, William M.......Thief River Falls 

Feinberg, Milton St. Paul 

Feinberg, Philip Mi li 

Feinstein. Julius . « 

Felder, Davitt A. 

Feldmann, Floyd 

Felion, Arthur J. 

Fellows, Manley 

Fenger, E. P. K. 

Fergeson, James O 
* Ferguson, James C.. 

Ferguson, William C... 
t Ferrell, 

Ferris, Dewar 

Mi li 

Fay aaa 


¢ Fetzek, Albert * 
Feuling, John C 
t Fidelman, N. E.... 
Field, Anthony H 
Field. Charles 
Fieldman, E. 
+ Fifer, William ” 
Fifield, Malcolm M. 
Figi, Frederick A 
Fingerman, David 
i SB eee 
Fink, Leo M 
Fink, Walter H 
Finkelnburg, William O 
Fisch, Herbert 
Fischer, Blooming Prairie 
Fischer, Marion McC Duluth 
Fisher, Dan W St. Paul 
Fisher, Isadore I i 1 
Fisketti, Henry. 
t Fitzgerald, Don F... 
*+Fitzgerald, Edward iT 
+ om William E... 
a Christian A.. 
Flanagan, Harold F. 
Flanagan, Leonard G 
Flancher, Leon H 
Flannery, Hubert F 
Fleeson, William H 
Fleming, Dean 
Fleming, Thomas N. 
Flesche, Bernard 
Fliehr, Richard R 
Flink, Edmund B Mi 
Flinn, J Redwood, alls 
+F linn, Remer 
Floersch, Adrian J Glencoe 
Flom, M ...Moorhead 

Columbus, Ga. 

. Sheridan, Ill 

Orceneth A., Jr... 
Sime, Bernard 

t Fogarty, Cc. 
Fogarty, C. Wm., J 
ee. Emil J 

er, Leslie 
Foley, Frederick E. B. 
Folken, Frank 
Folsom, Louis B 
Ford, Eh (0a — 
Ford, William H ‘Minneapolis 


Albert Lea 

— + 

Les he > hes be > he > he > he > he > har he > he > har bao ha har kao lack LeeLee LeeLee L _ Le  eeee 

B, Fla. 
t. Paul 
t. Paul 
is Falls 
s Falls 
t. Paul 


“ olis 
» Paul 
t. Paul 
r Falls 
t. Paul 

t. Paul 
v Ulm 
. Paul 
lan, Ill 


. Paul 


Forsythe, James R 
Fortier, George M. A. 

Foss, Edwar 
Foster, Orley W 
Fowler, Lucius Haynes 


Fox, Donald P. 
Fox, James — 
Fox, 0’ 

+ Franchere, roa. Wm.. 
Francis, David 
Frane, Donald B 


Mi a 


Frear, y 
a ng George M 
Frederickson, Alice 
Fredricks, Merriam ~ 

‘Niinn Paul 



t Freeman, 

St. Paul 






Mi lis 

Friedel, i 


Fritz, Wall 
Froats, Charles W 

t Frost, John B 
Frost, Russell H 
Frykman, Howard M. 

Fugina, George * ame 

Fuller, *Alice 

Fuller, Benjamin F 

Funk, Victor K 
Furlow, William L 
Furman, Lucie C. 

Furr, Leo O 
Gaard, Richard C 


Gaebe, Mi 
Gaida, Joseph 
f Gallagher, 
Gallett, Lester 

Galligan, John J....... 
+ Galligan, mag 
« Galloway, 

+ Gambill, 
Gambill, Earl E 





Gardner, Victor H., Sr... 


Garlock, Dewitt H 
Garrett, Charles 
Garrow, David 
Garske, George L 


St. Paul 

Garten, Joseph I 

Garvey, James T. 

} Garchel 

+ Gatchell, 



Gee, Vernon - 
Gehlen. Joseph_ N 
Geib, Marvin J 
Geiser, Peter M... 
Geraci, Joseph E 
eurs, Benjamin R... 

*Ghent, Charles H.... 
Ghormley, Ralph K. 
Ghostley. Mary C 
Gibbs, Edward C... 
Gibbs; Robert W 
Giebenhain, John N 


mi Paul 


in Bemidji 
..St. Paul 


Giere, Joseph Cc 

Giere, Richard W 


= Allan F... 

iman, ial 
ilmore, Rowland... 
t Gilsdorf. Donald A 
Gingold: Benjamin A. 
t Ginsberg, R. 

May, 1955 

...St. Paul 

San Antonio, Texas 


+ Girvin, Richard B 
Gjerde, William P 
Glabe, Robert A......... eeiciesaccasueal Plainview 
Glaeser, John H Mi 1 
Gleason, Wallace A 

t+ Glew, Wm. Bainbridge. 

Goblirsch, Andrew P 
Goehrs, Gilman H 

+ Goehrs, Henry W... 
Goff, h 
Goldberg, Isadore M 
Goldish, Daniel R 
Goldish; Robert J 
Goldman, Theodore I 
Goldner, Meyer Z i 
Goldsmith, Joseph W - Paul 
Goldstein, Norman P 

ood, C. Allen, Jr 
Good, Hoff D 

Good, Roy H 
Goodchild, William R 
Goodman, Charles E... 
Gordon, Philip E... 
Gordon, Sewell S 
Gowan, Lawrence R. 
Grace, Joseph 
Graham, Archibald W. 
aaa Jack P. ly 
Grais, Melvin L.....Colo. Springs, Colo. 
Granquist, Richard D Chisholm 
Grant, Hendrie W St. Paul 
Grant, Suzanne 

Grattan, Robert T.... 

Gratzek, Frank R. E... 

Gratzek, Thomas 

Grau, . we 
Graves, Richard B 
Gray, Edwar 

+ Gray, Frank D 
Gray, Howard K 
Gray, Royal C 
Green, Paul A ochester 
Green, Robert A St. Louis Park 

+ Green, Robert C., Jr.....LaGrosse, Va. 
Greenberg, Albert’ J ...Minneapolis 
Greene, Daniel E.... River Falls 
Greene, Laurence 
Greenfield, Irving.. 

Greenfield, William T. 

t Greishiemer, Esther M. 

Philadelphia, Pa. 
Gridley, John W... . Ari 
Griebie, Grant L 
Griffin, George D., 
Griffin. pes W., 

Min or 



Grimmell, Francis 
Grindlay, John H... 
Grinley, Andrew V... ..Grand Rapids 
Grise, William B Austin 
Groch, Sigmund N... ...Rochester 
Grohs, William H.. 

Gronvall, Paul 

Groschupf, Theodore 

Grose, Frederick 

Grosh, John Livingston 

Gross. B Rochester 
Grotting, John K Minneapolis 
*+Gruenhagen. Arnold P. as 
Grundset, le J 

Gullickson, Glenn, Jr 
+ Gullickson, Andrew....Longmont, 
Gully, Raymond | Cambridge 
Gunlaugson, Frederick C.....Minneapolis 
Gushurst, Edward .‘Minneapolis 
Gustason, Harold T... ..Minneapolis 
S Gey, Teele Ain. .nsecsicsissiccicscis New London 

ee OM Fairfax 
Haavik, John E...... -Duluth 
Habein, Harold C., Sr Rochester 
¢ Habein, H. C., Jr.....Wiesbaden, Ger. 
Haberer, Helen R Mi Li 
+ Haberman, Emil Osakis 
Haes, Julius E Mankato 
t Haesly, Warren W 
t Hagedorn, Albert B...New York, N. Y. 
Hagen, Kristofer Richfield 
7 Hagen, Olaf J Moorhead 
agen, Paul 
Hagen, Wayne S Mi p 
+ Haggard, G. D i 
+ Haigler, Frank H., Jr 
*tHaines, James iH 
Hakanson, Eck Y 

R L + 

St. Paul 

Halbert, John J 
Halenbeck, Philip L 
Hall, Barnard 
Hall; Harry B p 
Hall, Wendell H ‘Minneapolis 
H William E... ...Maple e 
* Hallberg, Charles A Minneapolis 
Hallberg, Olav E Rochest 
¢ Hallenbeck, Dorr F 
Hallenbeck. George A... 
+ Halliday, Philli 
Hallin, Roger p 
Halme, Ww. B 
Halpern, David 
Halpin, Joseph 
Halvorsen, Daniel K. 
Halvorson, James W. 
Hamlon, Jo 
Hammar, Lawrence M............. 
Hammes, Ernest M3; 
Hammes, Ernest 
*+Hammond, James 7 
+ Haney, Claude _L....... 
Hankerson, Robert G 
Hanlon, vid G 
Hannah, Hewitt B Minneapolis 
Hanover, Ralph D.....International 
Hansen, Cyrus Mi 
Hansen, Erlin 
Hansen, Milo » Blasio 
Hansen, Ol S 
Hansen, Robert E Hibbing 
¢ Hansen, Rollin M.....Falls Church, Va. 
Hansen, —— M Albert Lea 
t Hanson, Adolph M 
Hanson, Ernest O... 
Hanson, Mi 
Hanson, Pelican Rapids 
Hanson, Frost 
Hanson, Maleela : Racnsenel Minneapolis 
Hanson, Mark C. ‘Minneapolis 

i Rochester 

Rush City 
.. Owatonna 


Hanson, Norbert on : ter 
Hanson, William A. H Minneapolis 

“Lake Wilson 
St. Paul 

Happe, Lawrence J 
a Rae on E 
arbaug' ohn 

7+ Hardy, Wil Joe 
Hare, Robert L 
Harmon, Gaius E 
Harrington, Stuart 
Harrington, Vernon A., 
Harris, Carl 

t Harris, Evelyn S.. 

arris, Leon 

Harris, Lloyd E. 
Harrison, Percy W 
Hart, William E... ...Monticello 
Hartfiel, Herbert A. Montevideo 
Hartfiel, William F... ..St. Paul 
Hartig, Marjorie ee 
Hartjen, Jason K.. 
Hartley, Everett C 

Hartman, Evelyn E 
Hartman. Howard R 
Hartwich, Roger F 
Hass, Frederick M 
+ Hassett, Roger G 
Hastings, DeForest R Minneapolis 
Hastings, Donald W. ‘Minneapolis 
+ Hatch, Walter E Duluth 
Haugan, Norman R 
Hauge, Erling T. 
Hauge, Malvin I 
Haugen, George W 
Haugen, John 
Hauser, Donal 
Hauser, George 
Hauser, Victor P. 
Havel, Pp 
Haven, Minnea) 
Havens, Fred Z Riversi if. 

+ Havens, John G. W -Austin 
Hawkinson, Raymond P.....Minneapolis 
Hawley, George M. B., IL...Red Wing 
Hay, Lyle J Mi lis 
Hayes, Albert F 

+ Hayes, oe M 

Hoy Albert T. 






Heck, Frank J 

Heck, William W 
Hedberg, Gustaf A 
Hedemark, Homer H. 
Hedemark, Truman A. 
Hedenstrom, Frank fs 


Hedenstrom, Paul 
Hedenstrom, — 
Hedin, Raymond F 
Hedlund, Charles 7; 
Heegaard, William G.. 
Hegge, Olav H 
Heiam, William C.... 
Heiberg, Emmett A.. ..Fergus Falls 
Heiberg, Olaf M ...Worthington 
Heilig, William R . Paul 
Heilman, Dorothy M. H 
San Diego, Calif. 
Heilman, Fordyce R Rochester 
Heimark, John J Rochester 
Heimark, Julius .s..-F airmont 
eine, George WwW Little, Falls 
Heinz, Ivy 
Heinz, elke H eee 
Heise, Philip vR... 
Heise, William vR ; 
t Heisler, John J ‘Minneapoli 
Helferty, John K Idaho 
*+Helland, Gustav M. 
¢ Helland, John W 
Heller, Edgar E 
t Helmholz, . t 
Helseth, Hoval Pelican Rapids 
Hempel, Dean Minneapolis 
+ Hempstead, B. E Rochester 
Beach, Philip S. Rochest 
Henderson, Arthur J. G.....No. St. Paul 
Henderson, d D. Rochester 
Henderson, .....Rochester 
Henderson, % Rochester 
*+Henderson, i Rochester 
+ Henderson, Robert Earl ‘Rochester 
Hendricks, Esten J ..St. Paul 
+ Hendrickson, John F. ner olis 
Hengstler, William H... St. Paul 
*+Henney, William H 
Henrikson, Earl C I 
Henry, Clarence J 
+ Henry, Clifford E... ..Kirksville, _ 
t Henry, Benton 
¢ Henry, Sl 
T Hensel, 
Hepper, Norman G ] , 
Herbert, Willis... Minneapoli 
Herman, Ss M St. Paul 
Hermann, Haecid W..............Minneapolis 
Hermanson, Peter E....:, .... Hendricks 
Heron, Roy C St. Paul 
Herrmann, Edgar T... “ Paul 
+ Hertel, Garfield E... 
Hertz, Myron 
Hesla. Inman A... 
+ Hewitt, -Rochester 
+ Hewitt, ow BM sss sscoeccesscsste Rochester 
4 Hei 1 Rochester 
Park Rapids 
ee ae Bemidji 
Hilding Anderson C 
t ad Andrew W: 
Hilger, Laurence D... 
Hilker, Marcus D 
Hill, Earl Mi 
Hill, Minneapolis 
t Hill, i . ..Riverside, Calif. 
Hill, John P Virginia 
Hill, John R ‘Rochester 
..... Rochester 
Bradenton, Fla. 


inckley, Robert 
Hinderaker, Harris 
Hines, Edgar A., Jr 
Hiniker, Louis P 
Hiniker, Peter J... 
Hinz, alter 
Hirsh, Stanton secaeeats 
Hirshfield, Frank R. 
Hitchcock, Claude R. 
Hochfilzer, J 
Hodgson, Corrin H 
Hodgson, Jane E... 
Hodgson, John R.. 
Hoehn, i 
Hoeper, Philip G 
Hoff, Herbert O 




Hoffbauer, Frederick 
Hoffert, ey, E 
Hoffman, Ro 
onenee, ak S I 

Hoe ros tos 
Holcomb, Joel T 
Holcomb, Ww 
Holian, Darwin K 
Hollands, William 
Hollenhorst, Robert W... 
Hollinshead, <a 
Holm, Donald F 
Holman, Colin B Rochester 
Holmberg, Conrad J Minneapolis 
Holmen, Robert W.. St. Paul 
Holmstrom, Carle H... 
Holt, Allen H 
Holt, John E 
Holzapfel, Fred C 
Honath, Donald H 
Hoover, Norman 
Hopkins, George W i a 
Horns, H._ L....-Colo. Springs, Colo. 
Horns, Richard C inneapolis 
Horton, Bayard T Rochester 
Hottinger, Raymond C Janesville 
ouglum, Arvid J Park 
Houkom, Bjarne........ T. T., East Africa 
Houkom, Samuel S$ Duluth 
+ House, Zachariah E re, Calif. 
Houston or M........../Park’ Rapids 
Houts, Joseph C Dassel 
Hovde, Rolf Winthrop 
Hovland, i Minneapolis 
Howard, Marshall ....Mankato 
Howard, Merrill A.. 
Howard, Robert Boon Minneapolis 
Howard, Solomon E M 
Howard, Willard S 
Howe, Newell W 
Howell, Carter Wi 
Howell, Llewelyn P. 
Howell, Milton M... 
Hoyer, Ludolf J 
ruza, William J 
* Hubbard, Otto E 
Hubin, ‘Edwin G 
Hudec, Elwyn R 
Hudson, George E 
Huebert, Dan W 
{ Huffi ngton, H. 
Huffington, Herb L., Jr. 
Hughes, Bernard J 
Hughes, Sidney O.... 
Huizenga, Kenneth A... 
Hullsiek, Harold 4 coed 
—, 4 aelin . Snelling 

Humphrey, E. Sr 
Humphrey, Wade R Stillwater 
Hunt, Arthur B Rochester 
+ Hunt, a. Fairmont 
Hunt, Willi Fergus Falls 

Hutchinson, Dorothy W. 
Hutchinson, Henry. 

+ Huxley, Frederick R.. 
Hymes, Charles 

+ Hynes, John E 

¢ Ide, Arthur W. 
Ide, Arthur W., = 
Idstrom, Linneus G 
Ikeda, Kano 

Inglis, William.. 
¢ Irvine, Harry 
Irwin, Homer - 
Iverson, Rolf M 
Ivins, John 

Jackman, Raymond J... 
acks, Quentin D 
Jackson, Richard L... 
Jackson, William _— 
Jacobs, Douglas a. 
Jacobs, J 
Jacobson, Ferdinand C. 
Jacobson, Loren J 
Jacobson, Wyman E 
James, Ellery M 
James, John 


anecky, Baudette 
anes, h M.. Rochester 
anssen, Martin E m - 
arvis, Bruce W 

Jarvis, Marilyn A. 

Jay, Alan R 
Jeffries, William L. 
Jensen, Adrian R 
ensen, Alvin 

ensen, Harry C... 
Jensen, Marius J.. 
Jensen, Nathan K 
Jensen, Reynold A 

Jensen, Thorvold J. 

enson, seemed E 

erome, Bourne. 

Jerome, Elizabeth E 

Jeronimus, Henry J 

Jesion,. Joseph W.... id 

essico, Charles Duluth 
Jeub, "Robert P.....San Antonio, Texas 
Joffe, Harold H Virginia 
Johanson, Waldemar G... Be 
Johnsen, Henry A., 

ohnson, Adelaide 






. Johnson; Carolyn A 

Johnson, Curtis M.. 

ohnson, C. Percy. 

Johnson, Douglas L.. 

Johnson, Edward a 

Johnson, Einer Y 

Johnson, Einer » ie nat 
johnson. Emil we Minneapolis 
johnson, Minneapolis 
J johnson, St. Paul 



johnson, ulius. 

Johnson, Karl E 

johnson, Malcolm R.. 

Johnson, Marvin W.... 

Johnson, = 

Johnson, Norman P.. Minneapolis 

Johnson, ...Minneapolis 

x as ..-Moorhead 

J Lanesboro 

Johnson, Ray G Stillwater 

johnson, Reinald G.. Minneapolis 

johnson. Reuben Minneapolis 

ohnson, Robert E Mi li 

Johnson, Roger S 

ohnson, Rudolph E 

ohnson, Vilheim M 

Johnson, William E.. 

Johnson, Youbert T... 

ohnsrud, Luverne W... 

ohnston, Henry W... "Virgins 

chnston, Leonard F 

‘Johnston, R. O.....Fort Lauderdale, Fla. 

Johnstone, William W Ah-gwah- ‘ching 

olin, Francis M 

ones, Alva 

ones, i. 

ones, E he eg ee St. Pa 

ones, W., W B ine, Mass. 

ones, Orville Mankato 

Jones, Richard A i 

ones, Richard ‘,, 

ones, William R it 

Jordan, Kathleen Sait. Granite Pots 

ordan, Lewis 6..... ranite Falls 

ordan, Stanley. Rochester 

osewich, Alexander. 

Josewski, Raymond J. ... Stillwater 

oyce, George I Rochester 

udd, Allen S i li 

udd, Edward S., 



juergens, John 

uergens, vary F.. .... Stillwater 
uers, Edward Red ote 
Juliar, Richard 3 

juntunen, Roy R 
urdy, Mitchell J 
ust, Herman 

~anies Peter 

Kaen i ‘New Ulm 
Kalin, Os oP is. ‘Minneapolis 
Kallestad, Leonard L.. Minneapolis 
Kamman, Gordon R St. Paul 
*+Kamp, Byron A bert Lea 
Kanne, Earl R Brainerd 


st. Paul 
st. Paul 
t. Paul 
» Mass, 

t. Paul 
st. Paul 

~ Paul 
t. Paul 
. Tyler 
> Falls 
t. Paul 
t. Paul 
_ Paul 
e, Fla. 

D. C. 





arleen, Bernard } 
conan. Conrad I. 
Karlen, Markle... 
Karn, Jacob F.. 
K — ‘*“"" 
Kasper, tLugene ae 
Kath, Reinhard H 
Katz, Louis J ; 
Katz, Yale 


Kaufman, Herschel J. 
Kaufman, Walter 
Kaufman, William C... 
Kearney, Rochfort W 


ot. Paul 
St. Paul 

-Long Beach, Calif. 


Kearns, Thomas P 

Keating, Francis R., Jr...........Rochester 

Keefe, Rolland E 
Keil, Marcus A 
Keith, Haddow M. 
Keith, Norman M. 
Keith, Paul J 
Keithahn, Elmer E 
Kelby, Gjert M 
Kelley, Roger E... 
Kelley, Walter M 
Kelly, Albert C.... 
Kelly, Charles F. 
Kelly, James H... 

st. Paul 
..Albert Lea 

Sleepy Eye 

St. Paul 
Cold Spring 

— F.... 

+ Kelsey, Carleton 
Kelsey, Chauncey 
Kemp, Alphonse F 
Kenefick, Emmett 

+ Kennedy, Claude C. 
Kennedy, George L... 
+ Kennedy, Jane F 
Kennedy, Roger L. J 
t Kent, George B 
Kenyon, Thomas J... 
Kerkhof, Arthur C... 
Kernohan, James W 
Kesting, Herman 


St. Paul 

Kevern, Jay L 

Keyes, John D. 

Keyes, Robert W 



Kilby, Ralph Allen... 
Kimmel, George C.. 
+ King, Edgar A 
King, Frances W... 
+ King, George L 
Kinkade, Byron R 
Kinports, Ed. B 
Kinsella, Thomas J.... 

Joliet, Ill. 

..Oak Terrace 
-Hudson, Wis. 


International Falls 


Kirklin. John Woescscccsccs.e 

Kistler, Alvin J 
Kitzberger, Peter J.. 
Klakeg, Clayton H.... 

» Donald W 
Klefstad, Lloyd H 
Klein, Harry. 

..... Rochester 
New Ulm 

+ Klein, Henry N 

Klein, William A... 
Klima, William W 
Kline, Richard F.. 
Knapp, Frank N... 
Knapp, Miland E.... 
Knight, Edwin _G... 
+ Knight, James Harry... 
Knight, Ralph T 

night, Ray R 

.. Swanville 


Knoche, H A 
Knoll, W. —" 


Knudsen, Helen L 

nutson, Gerhard E. 
Knutson, Lewis A... 
Knutson, Robert C 
Koelsche, Giles A 


.Spring Grove 
St. Paul 

..Tacoma, Wash. 


May, 1955 


Koller, Robert L 
Kooda, Jennings C. 
Korchik, John P Minneapolis 
Korda, Henry A.. ..Pelican Rapids 
Kosms, Joka, Jc:.................. Minneapolis 
Koskela, Lauri E.....Shaker Heights, O. 
Kostick, William R Fertile 
Kotchevar, Frank R... a 
Kottke, Frederick J. 
Kotval, Russell J 
Koucky, Rudolph W... 
Kovack, Freeman D... 
Koza, Donald W 
Kozberg, Oscar. 
Kraemer, George N.. 
Kragh, Lyle O 
Kremen, Arnold J.. 
Kreuzer, Titus 
Krezowski, Thomas K. 
Krieser, Albert E 
Kroboth, Frank J., Be 
¢t Kroli, Harry G Rochester 
Krout, Robert M Rochester 
Krueger, Victor K..........:.:...0:0 Nopeming 
Krusen, Fran Rochester 
Kruzick, Josesscssesessssesssee.. eepy Eye 
Krystosek, Lee Clara City 
Kucera, Frank Hopkins 
t Kucera, Louis B.....Colo. Springs, Colo. 
Kucera, anley orthfield 
Kucera, William J., i 
Kucera, William J., 
Kugler, Alex A , 
Kuhlmann, Lawrence B... a 
+ Kuhn, Arthur J ochester 
Kulstad, Oscar S ..Dodge Center 
Kulzer, Norbert J. Hastings 
Kunkel, Melvin G Rochester 
Kunkel, Wm. M., Jr.....Harrisburg, Pa. 
+ Kurtin, Brey 1, ..Tuscon, Ariz. 
t Kurtin, Joseph J... v 
Kuske, Albert W. 
t+ Kusske, Arthur L.... Yew Ulm 
Kusske, Bradley, W. St. Paul 
Kusske, Douglas R. 
Kusz, Clarence V 
Kvale, aM 
Kvitrud, Gilbert... 

LaBree, John W . Louis Park 
LaBree, Robert H 

+ LaGaard, Sheldon M... 
Lacy, Paul E 
Laikola, Leslie A.. 

+ Laird, Arthur T.. 

+ Lajoie, John M... 
ioe Clifford F... 2 : 
Lamb, H. Douglas.. Minneapolis 
Lang, Leonard A... ...Minneapolis 

t Lange, Robert D.....Washington, D. C. 
Langhoff, Arthur Mankato 
Lannin, Bernard G. 
Lannin, Donald R. 
Lapierre, Arthur 
Lapierre, Jean T 
Larrabee, Walter 
Larsen, Frank Wm 




Larson, Gerald E. 

Larson, Kenneth R 
Larson, Leigh 
Larson, Lawrence M 
Larson, Leonard M.... 





Larson, P. 

Larson, : 

+ Larson, Roger 
Latterell, Kenneth E. 

+ LaVake, R 


Oak Terrace 

Law, Harrison E Virginia 
Law, William M Rochester 
Lax, Morris H St. Paul 
Laymon, Carl W M 1 

*tLazar, Henry L 
Lazarte, Jorge A 

+ Leahy, Bartholomew. 
Leavenworth, R. O., Sr... 
Leavenworth, R. O., Jr 

+ Leavitt, H. H 

+ Lebowske, Joseph A 
Leck, Paul C Austin 


Leo, bert W.... Brainerd 
Lee, Gordon E Glenwood 



Lee, Norman J 
Lee, Philip R.. 
+ Lee, Walter N 

laremont, Calif. 
A + G 

, Ga. 

Parkers Prairie 

Leick, Richard M St. Paul 
Leiferman, Robert J. Minneapolis 
Leinonen, Wendla E..................... Wadena 
Leitch, Archibald St. Paul 
Leland, Harold R Minneapolis 

*+Lemon, Willi Clifton Forge, Va. 
Lenander, Mellvin E St. Peter 
Lenarz, Albert J s 
Lende, Norman 
Lenz, Joseph R 
Lenz, Otto A..............000+-.-Minneapolis 
Leonard, Lawrence J............. Minneapolis 
Leonard, Minneapolis 

+ Leopard, Brand A.....Brownsville, Texas 
Lepak, Francis J. 
Lepak, John A.... 
Leppo, N. Erkki A. 

+ Lerche, William 
Lerner, A. Ross 
Lester, Malcolm J., Jr. 
Leuallen, Ed dC 
Leven, N. Logan 
Leverenz, Carleton W 
Levin, Bert G St. Paul 
Levitt, George X - Paul 
Lewis, Arthur J Henning 
Lewis, Rochester 
Lewis, Henning 

+ Lewis, 
Lewis, F. J 

+ Lexa, Frank J 
Libert, John N 
Lick, Charles L 
Lick, Louis 
Lick, William J., Jr........... 

7 Liedloff, Adolph G... 
Lien, Richar 
Liffrig, William 

¥ Lightbourn, Edgar L.. 
Lilleberg, Norbert J... 
Lillehei, C. Walton. 

+ Lillie, § 
Lillie, John C.. 
Lima, Ludvig 
Limbeck, Donald 

¢ Lind, C. J. 
Lindberg, Alfred 

t Lindberg, 
Lindberg, Winston R. 
Lindblom, Alton E.... 
Lindblom, Maurice 

7 Linde, Herman 
Lindell, Robert 
Lindemann, Charles E 
Lindgren, Russell C............ 
Lindner, Janus C i poli 
Lindquist, Richard H.............. ‘Minneapolis 
Linner, Gunnar Mi poli 

¥ Linner, Henry P Mi is 
Linner. John H Minneapolis 
Linner, Paul W Minneapolis 
Lipinski, Stanley W.. ibbi 
Lippman, Hyman 6... 
Lippmann, Elmer W 
Lippmann, E 1 Mi polis 
Lipschultz, Minneapolis 
Lipscomb, Paul R. Rochester 

t Litchfield, John T. -Minneapolis 
Litin, Edward M Rochester 
Litman, Abraham B Minneapolis 
Litman, S 1 Duluth 
Lober, Paul H.......0.............Minneapolis 
Loes, St. Cloud 
Lofgren, Karl A ..Rochester 
Lofsness, Stanley V...... ..St. Paul 

t+ Logan, Archibald H_................Rochester 
Logan, George B ee ..Rochester 

+ Logefeil, Rudolph _C............ Minneapolis 
Lohmann, John G Pipestone 
Loken, Selmur M........... ..........St. Paul 
Loken, Theodore : Ada 

+ Lommel, Jerome G.................Rochester 


etroit Lakes’ 
R ter 


St. Paul 




Longfellow, Henry W.. 

t Loomis, Earl A . 

t Lorton, William L 
Lott, Frederick H 
Louisell, Charles. 
Love, Frederick A.. 
Love, J. Grafton... 
Lovett, Beatrice R 

Lowe, E 
Lowe, Thomas A 
Lowry, Elizabeth C 
Lowry, Paul 
Lo Thomas 

t can, Hilda Mankato 

t Luckemeyer, C. J.....Ft. Riley, Kansas 

+ Ludwig, Clarence John Rochester 
Lueck, Wallace 
Lufkin, Nathaniel H 
Lukk, Olaf... 

t Lund, Anthony J 
Lund, Carl J. T.... 
Lund, George W... 
Lund, Werner J 
Lundberg, Ruth I...... 
Lundblad, Robert M.... 
Lundblad, Roy A 
Lundblad, Stanley W.. 
Lundeberg, Karl R 
Lundell, Carl L 
Lundholm, Arthur 
Lundquist, Curt x 
Lundquist, Virgil J. 
Lundsten, Leslie C 
Lundy, John S 
Lynch, Francis W 

+ Lynch, Matthew J 
Lynde, Orrin G 

¢ Lynn, Thomas E 
Lyons, —_ H 
Lysne, Henry. 
Lysne, Myron 
Lysyj, Anatol 


Los Gatos, Calif. 

(Mi 1 



Lyzenga, Anton G M polis - 

McBean, J. B Rochester 
McCabe, . : . Paul 
McCaffrey, Fabian J 
McCain, Don L ..St Paul 
‘McCann, Eugene Mi poli 
McCannel, Malcolm _A Minneapolis 
McCarten, Frances M.. Stillwater 
McCarthy, Austin M.... Be 

McCarthy, Donald ..... 

McCarthy, Joseph J 

McCartney. James S 
t oer D 

anahan, James H. 

oe White Bear Lake 

oe | 

McCloud, Charles N., Jr St. Paul 
t McClure, Rensselaer, Jr. 

awrence, Kansas 
McConahey, W. M., 
McCormick, Donald ’P.... 
+ McCoy, Mary K 
+ McDaniel, 
+ McDonald 
McDonald “ 
¢t McDowell, John P... 
McEnaney, Clifford 
cEwan, Alexander.. 
McFarland, Arthur H 
McGandy, Rob 
McGeary, George E 
McGroarty, Brian J.... 
McGroarty, John J.. 
McHaffie, Orval L.. 
McHardy, Bryson R... 
McInerny, Maurice W 
McIntire, Homer M 
McIntyre, John A.... 
McKaig, Alan M 
McKaig, Carle B 
McKee, Robert E...... ..Bryan, Texas 
McKelvey, John L Minneapolis 
McKenna, Austin 
McKinlay, Chauncey A... 
McKinney, Frank S 
McLane. William O. ....Brainerd 
McLaughlin, Byron ..Minneapolis 
+ McLaughlin. Edmund ..Winona 
McManus, William F. 
McMurtrie, William B 
‘McNear, George R c 
McNeil, John nneapolis 
McNeill, J. A St. Paul 
McNutt, John ; ! 
McPheeters, Herman O.......Minneapolis 
+ McOuarrie, i Minneapolis 
McWhorter, Henry E Rochester 




* Madden, cn F 



MacCarty, Collin S 

+ MacCarty, William C 

MacDonald, Daniel A... 
MacDonald, John W... 
MacDonald, Roger A... 

* MacFarlane, P. Harvie.. 
MacHeledt, Neil L 
MacKinnon, Donald C. 
MacRae, Gordon C 
Mach, Frank B 
Macklin, W. E., Jr 

t Mackoff, Sam M 

+ Madalin, Herbert E.. 

Madison itchell S 
Madland, Robert S 
Maeder, Edward C.... 
Maertz, William F.... 
Magath, Thomas B.. 
Magney, Fredolph H. 
Magnuson, Allen E 
Magnuson, Raymond C. 
Mahle, Donald G 
Mahowald, Aloys.... 
Maitland, Edwin T.. 
Maland, Clarence ‘) .. 
Malerich, J. Anthony. 
Malerich, J. Anthony, Jr.. 
Malmstrom, John 
Mandel, Sheldon L 
ae er, pong 
ankey, James ‘Minneapolis 
Mankin, Harold T.....Cambridge, ‘Mass, 
Mankin, Haven W Rochester 
Mann, Frank D Rochester 
¢t Manning, Phil R.....Los Angeles, Calif. 
+ Manson, Frank M.. «Worthington 
March, Kenneth A. .....Cambridge 
t Marcley, Walter J. ..Minneapolis 
Marking, George H Mi Li 
Marks, Roger W.. St. Paul 
arrone, Patrick 
Marshall, Clark M. 
Martens, Theodore 
artin, ..Luverne 
om See St. Paul 
artin, Thief Ri 
Martin, G R isan = 
Martin, * 
Martin, ; ee 
Martineau, Joseph L. 
Martinson, Carl J..... 
Martinson, Elmer J. 
Masson, Duncan M.... 
Masson, James 
Masson, James 
Mateo, Guillermo... 
Mathieson, Don R.... 
‘Matthews, James H.. 
— wd |, Soe 
Mattison, Percy A... . Wi 
Mattson, Albert D St. sen 
Mattson. Hamlin A. N........:.Minneapolis 
t Maus, Philip New Orleans, La. 
Maxeiner, Stanley R., Sr...Minneapotis 
Maxeiner, Stanley R., jr...Minneapolis 
Mayne, John Gregory.............Rochester 
Mayne, Roy M. sessoveeaNE i 
Mayo, Charles W...... 
Mazzitello, William F 
Mead, Charles H 
Meade, J 

Fergus Falis 
seseeeeeee Jackson 


... Virginia 
- neapolis 

Oak Terrace 

Medelman, John P. 
ener — t... 
Melancon, Joseph F St. P. 
Melby, Benedik Prairie 
eller, aurice. i 
Meller, Robert L ee 
Melzer, George R 
Menges, Charles G. H. 
Menold, William F.... 
Mensheha, Nicholas... 
Mercil, William F 
Merkert, Charles 
Merkert, George L 
Merner, Thomas B 
Merrick? Robert L 
Merrill, Robert W 
Merriman, Lloyd L. 
Merritt, Wallace A.. 

Forest Lake 
Mi li 

sees Olivia 

+ Mesker, George . 

Metcalf, Norman B.. 
Metz, Donald D............0...... 
Meyer, i M: 

+ Meyer, E 

Meyer, Paul F 
Meyer, Robert J. 

t Meyer, Robert P... 

+ Meyerding, Edward A... 

+ Meyerding, Henry Wm 
Michael, Joseph C.. 
Michel, Henry H. 
Michels, Roger P... 
Michelson, Henry 
Michienzi, Leonard 

+ Mickelsen, E F.. 

Midboe, Gilbert T. 
Midthune, A. S... 

Milhaupt, E. N 
Miller, Albe: 


t Miller, 

+ Miller, 

+ Miller, 

t Miller, 
Miller, Z 
Millett, D. 
Mills, Ste 
Milton, J 

inge, fk 
Minsky, Armen A. 
Mintz, Charles M. 
Mishek, Charles J. 
Mitby, Irving I 
Mitchell, Berton D 
Mitchell, Edwards C. 
Mitchell, Mancel T. 
Mixer, Harry W... 
'Moberg, Clarence W 
Moberg, Thomas D. 
Moe, » Pe H 
Moe, Thomas 
Moehn, John T 
Moehring, Henry G 
(Moen, J. K., Jr. 
- Moersch, Frederick P.... 
oersch, Herman J 
Moga, John A 
Molander, Herbert A.. 
Molenaar, Robert E.. 
Mollers, Theodore P... 
Monahan, Elizabeth S. 
Monahan, Robert H.... 
Monroe, Paul B 
Monserud, Nels O 
Monson, Einer M 
Monson, Leonard J. 
Montgomery, Hamil 
Mooney, Robert P.... 
Moore, Chris H 
Moore, Irvin H 
Moores, Kenneth D 
Moorhead, Marie. 
Moos, Daniel J 
Mogquin, Marie A 
Morehead, Dewey E 
Moren, J. Adelaide 
Morgan, H Oo 
Moriarty, Cecile R 
Mork, Arthur 
Mork, Frank E 
Morlock, Carl G 
Morrison, Charlotte J. 
‘Morse, Morton 
Morsman, L. 
Mortensen, J. D... 
Mortensen, Nels G. 
Mortenson, Howard O 
Mosby, Maurice E.. 
Moses, Royal R 
Mosser, Donn G 
Moulton, K._ &........ 
Mouritsen, Glenn J. 
Moyer, John B.... 
Moyer, Leonard B 
Mueller, Donald R. 
Muesing. William J 
Muir, Walter F.... 
‘Mulder, Donald W. 
(Mulholland, William 
Muller, Albrecht E 
Mulligan, Arthur M 
Mundahl, Harold R 
Munson, Martin S... 
eel Thomas ie 
urphy, mun 
Murphy, Jack _T.... 
Murphy, Joseph E 




Mi is 
R L +; 



Naegeli, Frank 
1 ace, Harold D > 
Ni ura, James Y Deer River 
Nash, Eldore B Eden Valley 
Nash, Leo A ...St. Paul 
Naslund, Ames Minneapolis 
Nauth, Bernard S Mi 1 
Navratil, Donald R 

Neal, Joe 
Nealy, Donald E 
Neary, Richard P 
Neel, Harry B rt Le 
Neff, Walter S... ws Virginia 
Nehring, Jesse P. Preston 
Neibergs, Lidija St. Paul 
Neibergs, Pauls St. Paul 
Neils, Vernon E Sauk Rapids 
Bernette G M lis 
Bernice A.............. 
Carleton A 
C. Barton 

Fergus Falls 

Mi _ 

Albert Lea 


Ct (sis 

, Kenneth L 
Lloyd S. Mi 
Louis A vw St. Paul 
Louis A., Jr.. 
Maxine 0... Minneapolis 
Maynard C.. ./Minneapolis 
Melvin S... Granite Falls 
Nesmith P ..Minneapolis 
O. L. Norman Minneapolis 
International Falls 
..Fergus Falls 
. Minneapolis 
Fergus Falls 


. Samuel 
Nesheim, Martin O 
Nessa, Curtis 
Nesse, J. A Austin 
Nesset, Lawren B Minneapolis 
Nesset, William D Mi i 

Neuman, Harold W.. 
Neumann, Conrad A.... 
Neumeister, Charles A 
Nice, Charles 
i , Donald R 
icholson, Murdoch _A.. 
icholson, Richard W 

Nickerson, 0 R 

ickerson, Neil D. 

Nielsen, Alvin M... 

Nietfeld, Aloys B 

ilson, Helmer J... 

Nimlos, Kenneth O. 
* Nimlos. Lenore O.... 

Ninneman, Newton 

isius George 
Nixon, James B 
Noble, John F 
Noble, John I 
* Nollet, Donald J 
Noonan, William J p 

oran, Axel S. Minneapolis 
Noran, Harold H. ..Minneapolis 
Norberg, Carl E Cloauet 
, Robert E Edina 
in, Gustaf T. Mi poli 
rdiand, Martin, Sr Minneapolis 
Nordland, Martin, Jr.............Minneapolis 
lordman, Willard F Mora 
Norman, John F kst 
Ormann, Stephen T., Jr. 

orris, Neil T 
Nudell, Gerald 
Nuebel, Charles J 
uessle, Walter G.. 
Nuetzman. Arthur W. 
utting, Roland E 

May, 1955 



Nydahl, Malvin J 
Nye, Katherine A 
Nye, Lillian I 
Nygren, William T 

Nylander, Emil G Minneapolis 
Nywall, Dean D Slayton 

O’Brien, I. Cc St. Paul 
O’Brien, Louis T..................Breckenridge 
+ O’Connor, i Eden Valiey 
t+ O’Connor, St. Paul 
* O’Donnell, D. ....Ortonville 

O’Donnell, James E 
O’Hanlon, John A 
O’Kane, Thomas W 
O’Keefe, J 
t O’Keefe, Rochester 
t O'Leary, i polis 
O’Leary, Paul A Rochester 
O’Neil, Richard IL 
O’Neill, John C 
O’Phelan, E. Harvey. 
O’Reilley, Bernard E.... St. 
t O’Shaughnessy, E. J...Cp. Kilmer, N. J. 
+ Oberg, Carl M Min Li 

-Detroit Lakes 
..Granite Falls 
Oeljen, Siegfried C. G. 
g den, Warner. 
age, ustus. 
Olaxs, Fo Mi is 
Olds, George H New Richland 
Olive, John T., J Mankato 
Oliver, Irwin Graceville 
Oliver, James 
Olmanson, Edmund G 

Gregory M Litchfield 
Lillian A.... Ah-gwah-ching 
. Olof A... ...Minneapolis 
Olson, Rolland A.. Wayzata 
+ Onifer, Theodore Michael.. 
Onsgard, L. Kenneth 
Opfell, Richard 
Oppegaard, C. L. 
Oppen, E. Gerhar 
Oppen, Melvin G... 
Opshal, Lawrence 
Opstad, Earl T 
Orr, Burton A.. 

t Orwoll, Harold 
Osborn, Donald O 
Osborn, John E.. 
Ostergaard, Erling 
Ostergren, Edward 
Ostling. Burton C 
Otto, Hen 
Ourada, Anthony L... 
Owen, Charles A., J 
Owens, Ben 
Owens, Frederic 

Owens, William A 

Page, Raymond L St. Charles 
Palen, Benjamin J M polis 
Palmer, Clinton Albert Lea 
Palmer, Harry ...Blackduck 
Palmerton, Ernest S.. ...Fergus Falls 
Pankratz, Peter J -Mountain Lake 
Papermaster, Ralph Two Harbors 
‘Papermaster, Theodore C.....Minneapolis 
t Paris, Jaime Rochester 
Park, Wilford E Minneapolis 
Parker, Charles W. Wadena 
Parker, Harry L ....Rochester 
*+Parker, A ...Minneapolis 
Waeber; (VR Jo scicccscscssssisescosoners Hallock 
Parker, Robert L Rochester 
Parker, Warren E Sebeka 
Parker, Wilbert H.....................Chisholm 
Parkhill, Edith M Rochester 
Parkin, Thomas Rochester 
Parson, E. i Duluth 
Parson, E. Lillian B.. Elbow Lake 
Parson, Lester R Elbow Lake 

Parsons, R. A 
Parsons, Ralph IL M ey 
t Parsons, W. B., Jr.......Coronado, Calif. 
Pasek, Antone Cloquet 
asek, Edward A Li: 
Patch, Orien B 
Patrick, Robert_T 
Pattee, James J 
Patterson, Hugh D 
7 Patterson, William L 
Paulson, Elmer p 
Paulson, Rochester 
t+ Paulson, ..Fergus Falls 
Paulson, J Minneapolis 
Paynter, R...Great Falls, Mont. 
Pearce, Francis M., 
+ Pearsall, R. P 
t+ Pearson, Roy 
Pease, Gertrude L 
Pedersen, Arthur H 
Pedersen, Robert L 
Pedersen, Roy C 
Peltier, Leonard F.. 
Pemberton, Albert H 
Pemberton, John 
Penhall, Fletcher W. Willmar 
Penk, Engward L Springfield 
Penn, George E Mankato 
t Pennie, Daniel F. V. 
Peppard, Thomas A 
Perlman, Everett C 
Perlman, Herschel L 
Perry, arold 
Person, John 
Pertl, Albert L Canby 
Peteler, Jennings C. L Minneapolis 
Peters, Gustavus A Rochester 
Petersen, Rochest 
Petersen, D. H Northfield 
Petersen, Mi li 
eterson, Henry 
Peterson, Herbert W. 
Peterson, Joel L. E... 
Peterson, John H 
Peterson, Kenneth A.. 
Peterson, Kenneth H. 
+ Peterson, 
Peterson, Willard H.........Spring Valley 
Petit, Julien V .Minneapolis 
Petit, Leon J -Minneapolis 
Petraborg, Harvey T Aitki 
Pettersen, George R.. 
Pettet, John R 
Pewters, John T. 
Peyton, William T. 
Phelps, Kenneth 
Philp, David R... 
Pierce, Charles 
Pierce, Jack 
Pierce, Robert B 
Pierson, Roy F F 
¢ Piper, Monte C , Calif. 
Piper, William A. .-Mountain Lake 
Place, Virgil A Rochester 
Plasha, Matthew K 
Plass, Herbert F. R 
¢ Platou, Erling S Mi 
Pleissner, Karl W i 
Plimpton, Nathan C., Jr. 
+ Plondk d 
Plucker, Milton 
Pogue, Richard E 

* on 

Fe all: 
Miaka, rom 





Forest Lake 
Polski, Paul G So. St. Paul 
Polzak, Jacob A Mi li: 
one, John 

Cambridge - 

Ponterio, James E Shal 

Pool, Thomas L. Rochester 
+ Poppe, Frederick H Minneapolis 
Porter, Oliver M.... Atwater 
Potek, David M pol 
Potter, Robert B Hopkins 
‘Pougiales, Mary L. Rochester 
t Powelson, ochester 

Power, John E., Sr 
Power, John E., Jr 
* Prangen, Avery De 
+ Pratt, re 
Pratt, Fred J., Jr 
¢ Pratt, George F 
Pratt, Josep 
+ Preisinger. Joseph 

Preston, Pau 
Price, William 'E 
Prickman, Louis E 
Priest, Robert E 
Priestley, James T Rochester 
Prim, Josep Minneapolis 
Prins, Leo R sin Lea 
Proeschel, Ray K.. 

Proffitt, William E 
Proshek, Charles E 
Pruitt, Raymond D 
Pugh, David G 
Pumala, Erven 
Purnell, Don C 
Purves, George H. 
Puumala, Reino H 



Quanstrom, Virgil E 
uattlebaum, Frank 
—_— ge o. B 
uiggle rthur 

t on enry W., Sr 

Quist, Henry W., Jr 


Raadquist, Charles S............+-0:: Hibbing 
Raattama, John Keewatin 
Racer, Harley J.. .. Stillwater 
Raetz, Sylvester J.. 

j Arnold 
Ralph, J 
Ralston, Donald E 
Ramsey, Walter R St. Paul 
Randall, Lawrence M.. -Rochester 
Randall, Raymond V.... R 
Ransom, H. Robert 
Ransom, Matthias L.... 
Rasmussen, Ramby 
Rasmussen, Waldemar C... 
Ravits, Harold G 
Rawls, Thompson T 
Rayner, Ralp 
Rea, Charles E 
Reader, Donald R «Mi lis 

I 1 
: Virginia 

Reff, Alan R Crookst 

Regnier, Edward A Mi i 

Reid, James W So. St. Paul 

Reif, Harold A i i 

Reif, Henry 

Reif, Robert 

Reifsnyder, Wm. Henry, III..Rochester 

Reiley, Richard E i i 

Reineke, George F 

Reitemeier, Richard J... 

Reitmann, John H 

Re Mine, William_H., Jr...... 

Remole, William Mi 

Remsberg, R. R 

Replogle, William H...Los Angeles, Cal. 

Resch, Joseph M poli 

Rice, Carl i poli 

Rice, Mi polis 

Rice, F Mi li 

Rice, Moorhead 

Rice, R 

Richards, Albert M 

Richards, Ernest T. F... 

Richards, William B 

Richardson, Edward J., Jr.. 

Richardson, Robert 

Richdorf, Lawrence F... 

Richter, David 

Rick, Paul F. 

Rieke, Wellington W.. 

Rieschl, Elizabeth K 

Rigler, Leo G 

Rigler, Robert G 
¢t Ringer, Merritt G., Jr 

—— Otto F 

Rinkey, Eugene... 
Riordan, Elsie M. 

t Ripepi, James D... 
Risch, Ronald Be. 
Risser, Alden F 
Ritchie, Wallace P. 
Ritt, Albert E 

+ Ritzinger, Frederick R 



Rizer, Dean K 
Rizer, Robert I 
Roach, Donald E..............+++: 
Robb, Edwin F 
Robbins, Charles P 
Robbins, Owen F 
Roberts, Byron H 
Roberts, Lewis J 
Roberts, Oliver W 
Roberts, Stanley E 
Roberts, Stanley W 
Roberts, William B 
Robertson, Paul 
Robilliard, Charles M.. a 
Robinett, Robert .Worthington 
Robinson, Cortland O Crystal 
Rocknem, Robert E ‘Mi poli 
Rockwell, C. V Mi i 
Rockwood, Philo H Fergus Falls 
+ Rodda, Frederick C Minenapolis 
+ Rodenbaugh, Fredrich Hase....Rochester 
Rodgers, Richard S Mi poli 
Roehlke, Arthur B...........4........Elk River 
Roemer, Henry : ...Winona 
Rogers, Charles # ...Winona 
Rogers, Sidney F.. 
+ Rogin, Norton... 
Rogne, William G. 
Roholt, Christian 
Rohrer, Christian 

< SE 

a eg Park 
pring Grove 

.. Virginia 

..St. Paul 

St. Paul 

..St. Charles 
.Cass Lake 


Rome, Howard 
Romness. Kenneth B 

*+Rood, Dana C....Santa Barbara, Calif. 
Rooke, E. D Rochester 
Rorem, Joseph A 

+ Rosander, Phyllis. 
Rose, John 
Rosenbaum, David L ‘Minneapolis 
Rosendahl, Frederick G.....Minneapolis 
Rosenfield, Abraham B Minneapolis 
Rosenow, John ‘Mi i 
Rosenthal, F. 
Rosenwald, Reuben M 
Ross, Alexander J i 
Rossberg, Raymond A........:ss.0+ 
Rossen, Ralph Mi 
Rotenberg, Robert J 
Roth, Frederick D 
Roth, George C 
Rothnem, Morris 
Rothschild, Harold J 
Rothwell, Walter S 
Rotnem, Orville M....Iowa City, Iowa 
Roust, Henry A Montevideo 
Rovelstad, Randolph A. : 
Rovelstad, Roger. 
Rowe, Clarence J., Jr 
Rowe, Olin 

*+Rowe, William H... 
Rowles, Everett K 
Roy, Phil C 
Rozycki, Anthony. 
Ruchie, Warren H. 
Rucker, Charles W.... 
Rucker, William H 
Rud, Norman E 

+ Rudell, Gustave IL 
Rudie, Clifford N 
Rudie, Peter S 
Rudie, William D 
Rudolph, Frank A 
Ruggieri, Bartholomew... 
Ruggles, George M 

+ Ruhberg, George M.. 
Rumpf, Carl 
Runquist, John M 
Rushton, Joseph G Rochester 
Russ, Homer H Blue Earth 
Russeth, Arthur N Mi poli 
Rusten, Elmer Minneapolis 
Rusterholz, Alan P.. 
Rutledge, Lloyd H 
Ryan, John 
Ryan, Joseph M 
Ryan, Robert F 
Ryan, William J 
Rydburg, Wayne C 
Ryding, Vincent 

t Rydland, Arne 
Rygh, Harold N.. 
Rynda, Edwin R 
Rynearson, Edward H. 
Rysgaard, George M 


Pine River 

St. Cyr, Harry M., Jr.......... Robbinsdale 
St. Cyr, Kenneth J Robbinsdale 
Sabanas, Alvina Rochester 

+ Sabin, Frederick Chapman 
Sadler, William P., Jr.. 
Saffert, Cornelius A.. 
Safirescu, Sorim R.. 
Sahr, Walter G 

Salassa, Robert M .... Rochester 

Saliterman, Bernard I.........Mi P 
Salk, Richard ] aa 
Salter, Reginald A 

Samuelson, Leonard G 

Sandeen, ‘Robert M 
Sanderson, Anton G. 

Sandt, Karl E 
Sandven, Nels O 
+ Sanford, Arthur H 


t — 
anfor bs 
Sarff, Ol ee 
Sargent, Edward C ...Austin 
a i, <a M St. Paul 
atersmoen, eodore i i 
Per agg Pelican Rapids 
Sather, Richard N... 
Sather, Russell O.... 
Satterlee, Howard W. 
Satterlund, Victor L.. 
Sauer, William G 
Savage, Francis J... 
Sawaryniuk, Iwan.... 
Sawatzky, William A. 
Sawtell, Robert R 
Sax, Milton H 
Sax, Simon G. 


Mi tu i. 
Schaar, Frances E Minna 
Schade, Frederick L 
Schaefer, Joseph F 
Schaefer, Kenneth F. 
Schaefer, Wesley G 
amber, Walter F 
Schatz, Francis W. 
Scheidel, Alois McK.. 
Scheifley, Charles H 
Scheldrup, N. H i li 
Scherer, Leslie Raymond...... Minneapolis 
Scherling, Sidney S Mi Li 
Schiele, Burtrum C............... (Minneapolis 
Schimelpfenig, George.. 
Schirber, Martin J 
Schirger, Alexander... 
Schissel, Gregory A 
Schmid, John FE. 
+ Schmidt, | 
Schmidt, W. Robe 
Schmidtke, Reinh 
a Ss. C 
mitz, Anthony A 
Schmitz, Senet 3... 
Schmitz, Glenn P... 

... Owatonna 
Parkers Prairie 

¢ Schoch, Robert B. J. 
Schoeneberger, P. B 
t Scholpp, Otto W. 
Schons, Edward. 
Schottler, Max E 

Pottstown, Pa. 
St. Paul 

Schumacker, John W... 
hutz, Elmer S 
Schwartz, Carl A... 
Schwartz, E. Robert 
Schwartz, Virgil J 
Schwarz, Bert E 
Schweiger, Theodore R 
Schweinfurth, J. D 
t Schwyzer, Arnold. G..........+ 
San Juan, Puerto 
Schwyzer, Hanns C St. Paul 


Noose Lake 


d Rapids 
rora, Ill, 

nite Falls 

es if. 
t. Cloud 
ttle Falls 

ha, Wis. 

St. Pel 

in Lake 

to Rico 
St. Paul 


hwyzer, Marguerite..................4 St. Paul 
ew: George W... Erskine 
Scott, Eugene 
Scott, Horace G 
Scudamore, Harold K 
seaberg, John 
seashore, R. T 
Seay, James Elbert, IIT 
seery, Thomas 

Iby, Joh 
ee, "Thomas H Rochester 
Seljeskog, Ss. R Min 1 
Sells, Richard S. No. St. Paul 
Selmo, Joseph N od 
Semsch, Robert 
Senkler, George E... 
+ Senn, Edward W 
Setzer, Hobert J 

+ Seybold, Herbert 
Shandorf, James F.. 

Shannon, William R.. 
Shaperman, Eva P 
Shapiro. Sidney K 
Sharp, David D 
oS eee 
haw, Howard A 
Shea, Andrew W 
Sheedy, Chester L 

Sheldon, Warren_N...............4 Minneapolis 

f Shellman, John I 
Pacific Palisades, Calif. 
ye G Hutchinson 

Sherman, Charles L... 
Sherman, Hubert 
Sherman, Lloyd F.... 
Sherman, Royal V... 
Sherwood, George E.. 
Shick, Richard M 
Shields, Jack W 
hillington, Maurice A 
Shirai, Shohei 

St. Paul 

Howard Lake 

I Minneapolis 
Sibley, John A Rochester 
Siegel, Clarence . Paul 
Siegel, John S Virginia 


L Rochester 

Silas, Ralph M i polis 
t Silver, Arthur W Rochester 

Silver, John D Minneapoli 
Simison, Carl Barnesville 

Simmonds, Harry N Prior Lake 

Simon, Howard B... -Rochester 

Simons, Bernard H. mt 

Simons, Edwin J 
t Simons, Jalmar H.. 

Simons, Leander T 

Simonson, Donald 

Simonton, Kinsey MacL 
* Simpson, Ellery D 
Sinamark, Andrew... 
singer, Benjamin J. 
Sinykin, Melvin B.... 
Siverstein, David M.. 
Sisk, Harvey F.......... 
Sisler, Clifford E 
Sisterman, Thomas J.. 

Siekert, R 

Phoenix, Ariz. 

+ Sivertsen, Andrew... 

¥ Sivertsen. Ivar. 
Sioding, J. Donald 
Siostrom. Lawrence E 
Staife. William F 
Skaug, Harold M 
Skinner, Abbott. 
kinner, Harvey O 
pold, Arthur Cc Mi i 
Skogerboe, R. Karlstad 
Skrdla, Willard B. Rochester 
later, Sidney A Worthington 
locumb, Charles H... Rochester 
mid, Arthur C Rochester 
smiley, John T.... i li 
Smisek, Elmer A 
Smisek, Frank M. E 
Smith, Adam M 
Smith, Archie M 
Smith, Baxter A., Jr.. 
Smith, Cyril M 
Smith, Don V 
t Smith, Frederick L. 
Smith, George R 
Smith, Graham G 

May, 1955 

..Blue Earth 

* Steiner, Irving W 



+ Smith, 
* Smith, 

Smith, Rochester 
Smith, Meredith P Rochester 
+ Smith, Margaret I........../ Gardena, Calif 
+ Smith, Myron Red Wing 
Smith, Norvin R.. Willmar 
Smith, Paul 
Smith, Reginald A 
¢ Smith, Ross H., Jr Rochester 
Smith, Theodore S /Minneapolis 
Smith, Vernon D. E. St. Paul 
Smith, Wallace R Grand Marais 
Smith, William G Rochester 
Smith, William T Minneapolis 
Smorstok, Matthew B... Monticello 
Smyth, John J Lester Prairie 
Snyder, Clifford D 
Snyder, George W 
Snyker, Omer E 
Soderlind, Ragnar T 
Sogge, Ludwi 



Solhaug, Samuel B 
Solhaug, S 1 B., Jr 
Solsem, Frederick N. S 
Solvason, Harold M......... 
Sommerdorf, Vernon L 
S s, Ben... 
Sommerness, M. Duane 
Sonnesyn, Nels N 
Sorem, Milton B 
Sorum, F. T 
Soucheray, Philip 
Soule, Edward H 
Souster, Benjamin B 
Sowada, E 
Spain, Ww. 
Spang, Anthony J 
Spang, James " 
Spang, William M. 
Spano, Joseph P.... Minneapolis 
Spear, Harold C w Haven, Conn. 
Spencer, Bernard J................. Minneapolis 
Spencer, Jean A ochester 
Sperl, Michael P., Jr Rochester 
Spink, Wesley W ‘Minneapolis 
Spittel, John A., Jr.. ..Rochester 
Sponsel, Kenath H.... 
t Sprafka, Gregory A... 
+ Sprafka, Joseph L 
Sprafka, Joseph M..... 
Sprague, Randall G.. 
¥ Spratt, Charles N 
Spurbeck, George H. 
Spurzem, Raymond J... 
Stadem, Clifford J.... 
Stahler, Paul A 
Stahl, George W 
Stahn, Louis ..El Paso, Texas 
Stahr, Aubrey C. opkins 
Stam, Joh .Worthington 

Fergus Falls 
..Le Sueur 

Stangl, 3 
Stanley, ....Worthington 
Starekow. Milton D.....Thief River Falls 
Starr, Grier F Rochester 
Staub, Henry P (Minneapolis 
Stauffer, Maurice H Rochester 
Steffens, Leon A 

+ Stein, Harold A 
Stein, Raymond J 
Stein, William A 
Steinberg. Charles L 


t Steiner. Leon E iPhiladelphia, Pa. 
Steinhilber, Richard M 
Stelter, Lloyd A .-Minneapolis 
Stemsrud, Harold L.. ....Alexandria 
Stennes, John L ‘Minneapolis 
Stensgaard, Kermit L...Thief River Falls 
Stenstrom, Annette inneanolis 
Sterner, Donald 

* Sterner, Ernest G 
Sterner, E. R 
Sterner, John J 
Sterrie, Norman A 

+ Stevens, Grant M 
Stevenson, Basil M.. 
Stevenson, Frank W. 
Stewart, Alexander. 

+ Stewart, Allan H.... 4 
Stewart, ‘Crookston 
Stewart, i Minneapoli 
Stewart, Minneapolis 
Stickney, J. M a 

¥ Stiegler, 
Stilwell, George G.... 
Stillwell, George K 

+ Sweitzer, 

+ Swendseen, Carl G 

Stillwell, Water C 
Stoesser, Albert 
Stolpestad, Armer H... 
Stolpestad, Herbert 
Stoltz, Robert C 

Stomel, Joseph 

Strand, Jack W 
Strandjord, Nels M..... 
Stransky, Theodore W.. 
Strate, Gordon 
Strathern, Carleton S. 
Strathern, Fred 
Strathern, Moses L. 
Stratte, Alf K 

Stratte, Harold C 
Strauchler, Jona 

-Little Falls 

Straus, M. L 
Strauss, Eugene C... 
Street, Bernard 
Strem, Edwar 
Strewler, Gordon J 
trickler, Jacob H 


Stroebel, Chas. F., Jr.......... 

..... Rochester 
Mi lis 

Strom, Gordon W 
Stromgren, Delph T 
Stromme, William B 


Strunk, Clarence A 
Struthers, A. Morgan 
Struxness, Davi 
Studer, Donald J 



Stuhler, Louis G 
Stuhr, John W 


Sturges, Robert L 
Sturley, Rodney F 

ubby, Walter 

Sukov, Marvin 

Sullivan, Raymond M 

Sullivan, Robert E 
Sutherland, Harry N.. 
Sutherland, W. H 

Sutton, Harris R 
Svien, Hendrik J.. 
Swain, Francis M 

+ Swanson, John A 

Swanson, Lawrence 
Swanson, Roy E 

Swedberg, William A.... 
Swedenburg, Paul A 
Sweetser, Horatio B 

Sweetser, Theo. H., 
Sweetser, Theo. H. 


Swendson, James J..... 
Swenson, Arnold 

+ Swenson, 
+ Swenson, 

Swenson, Roy 
Symmonds, Richard E 

Syverton, Jerome 


Tam, Ernest C. 


Tangen, George M 


Tani, George T 
Tanquist, Edwin J 


Taub, Robert G 

~ on 

Taylor, Joseph H 
Teich, Kenneth W. 
Teisberg, John E.. 
Tenner, Robert J 
Terrell, Bernard J 
Tesch, Gordon 
Tetlie, James P 
Thabes, J. A., Jr 


Thayer, Ellsworth A 
Thielen, Robert D 
Thiem, Chester E 

St. Michael 

Thill, Leonard J 


Thomas, George E 
Thomas, John V 
Thomas, hig H 

Thomes, A 


Thompson, A. Henry. 
Th Carl O 


Thompson, Floyd A 
Thompson, Gershom J 
Th , Willis H 


Th , James 


Thoreson, M. C. Bernice...So. St. Paul 

Thorsen, David S 


Thorson, Stuart V. 

Thuringer, Carl B 
Thysell, D d 

Thysell, Fred A 
Thysell, Harold R 

Thysell, Vernon D 
Tichy, Fae Y 

Tifft, Cyril R 
Tihen pone’ N 
Tillisch, J 

t Tingda “= ha 
Tinkham, Robert 
Titrud, Leonard 

Tregilgas, “Harold R 
Tregilgas, Richard B.. 
Troost, Henry 
Trow, James E 
Trow, illiam H 
Trueman, Harold S 
Truesdale, _— hes 
Tsai, Shih H 
ow Nagy Fang s. 
Tucker, Richard Cc 
Tudor, Richard B 
Tuohy, Edward L 
¢ Turnacliff, Dale D. 
Tweedy, job 
Tweedy, Robert B. 
Twomey, John E 

Ubel, Frank A 
Ude, Walter H 
Uhley, Charles G 
Uihlein, Alfred 

Ulrich, Henry L 
Ulvestad, Harold S 
Underdahl, Laurentius O 
Undine, Clyde A 


Utne, John R 
Utz, "David C 


t Vadheim, Alfred L 

+ Valentine, Walter H 
Van Bergen, Fredk. H 
Van Cleve, Horatio P., aE. 
Vandersluis, Charles W... 

‘an Herik —~ 

Van Meier, Henry.... 
Van Patter, Ward 
Van Rooy, George T...Thief River Falls 
Van Ryzin, Donald J Duluth 
Varco, Richard L sad 
Vaughan, Victor M 
Vaughn, Louis D 
Veirs, Dean 
Veirs. Ruby J. 
Venables, Alexand 
Veranth, Leonard A... 
Verby, john E., Jr 
Vermund, Halvor 

i p lis 


Virnig, Hildegard J 

Virnig, Mark 

Virnig, Richard aes 

Vitols, T. Minneapolis 

Vogel, dines A. ...New Ulm 

‘ollmer, Frederick ra Winona 

¢ von Amerongen, W. W...Chandler, Ariz. 
¢ Von Drasek, Joseph ankato 

Waas, Charles W 
Wagener, Henry P 
Wagner, Norman W 
Wagoner, James me 
Wahlquist, Harold F.. 
Wakefield, Elmer G... 

+ Wakim, Khalil G... 
Walder, Harold J... 
Waldron, Carl W 
Walfred, Karl A.. 

t+ Walker, 


Walsh, Francis M Minncapolis 
Walsh, William T 
Walter, Clarence Wm St. Paul 
Walter, Frederick H.. International Falls 
Walter, William E W: mingo 
Walters, Waltma R 
Wandke, Otto E 
Wang, Jun-Chuan 
Wangensteen, Owen 
Ward, Bert B 
Ward, Louis E 
Ward, Percy A 

arner, James 
Warren, Cecil A 
Wasmund, Clarence 
Wasson, Loren F 
Watkins, Charles H. 
Watkins, Joha A 
Watson, Alexander 
Watson. C. Gordon 
Watson, Cecil J p 
Watson, Eleanor J Rochester 
Watson, . R Rochester 
Watson, Theodore... 
Watson, Percy hag 
Watson, Robert M... 
Watson, Sydney Wm... 
Watson, William H. A.. 
Watson, William J 
Watz. Clarence E 
Waud, Robert E 
Waugh, John M 
+ Weaver, Myron Mc 
sana ™ bi Canada 
Weaver, Paul H...... Faribault 
wore Edgar A 
Roscoe C 

Webber, Fred L 

Webber, Richard - 

Weber, “Harry Mi... c.eseseeeseeeeeese ROChEster 

Weber, Lowell W.. Mi poli 

Lyle Au... eseeseeeeeeeeee ROCHESter 

Wome, Richard E. a 
ehr, B 

Weiner, Alan D. 

Weir, james F 

Weis. Benjamin A 

Weisberg, Maurice... 

Weisberg, Raphael J 

Weiss, arl A 

Welch, John S 

Wellman, Thomas ae 

Wellman, William E... 

"Red : Wing 

Clinton, Iowa 


Wente, Harold A... 

+ Wentworth, Albert 
Wenzel, Gilbert P 

t Werner, George 
Wesolowski, Reniey P 

+ West, Catherine C 
Westby, Magnus. 
Westby, Norval M 

+ Westerman, Alvin E 
Westerman, Fred Cc 
Westover, D. 
Westrup, By E 
Wetherby, Macnider. 
Wetzel, Earl V. 

3 Weyhrauch, Robert A. 
Wheeler, Daniel W 
*+Wheeler, Merritt W.. 
Wheeler, Robert W Minneapolis 
White, Asher A ..Minneapolis 
+ White, S. Marx... Minneapolis 
White. Willard D. aaneapens 

Whitesell, Lloyd A (M 
Whitson,” Sidney A Albert "Lea 
Whittemore, Dexter D 
Widen, Wilford F i 
Wikoff, Howard M kst 
Abe Lea 
Wilder, Minneapolis 
Wilder, ob: L ‘Minneapolis 
+ Wilder, : Bethesda, Md. 
t Wilder, Russell M. Minneapotis 
Wilken, Paul A 
t Wilkinson, George R., Jr 
t Wilkinson. Stella L St. Pau 
Will, Charles B 
Will, W. W Bertha 
+ Willcutt, Clarence E.......... Phoenix, Ariz. 
+ Williams, Arthur B St. Paul 

re ‘Minneapolis 


¢ Williams, 
Williams, H 

¢ Williams, 

¢ Williams, 
Williams, M. M 



Tt Williams, erm 
Williamson, Harold 
Wilmot, Cecil A 
Wilmot, Harold 

+ Wilson, Clyde E. 

$ Wilson, Franklin 
Wilson, . All 

Rolland H.. 
Viktor O.. 
Warren E. 

¢t Wiltrout, Irving G 

+ Winnick, — B. 
Winter, jenn A 
Winter, Malcolm D., Jr.. 
Winther, Nora M. G 

Wittrock, Louis H. 
Wohlrabe, Arthur A 
Wohlrabe, A. Cabot. 
Wohlrabe, Clarence F... 

dwin J 

Wolkoff, J 
hve Magy Eric. 
Wolstan, Simon 
Wolter, Frederick 

- Woltjen, Myron 
Woltman, Henry Wm. 
Wood, Harry G 
Woodington, George F..... 

oolner, Lewis B 

Word, Harlan L 
Workman, Warner 
Woyda, William C 

+ Wray, William E 
Wright, Robert R.. 
Wright, Thomas D. 
Wright, Wale S 
Wright, William S. 

t Wuest, "John H., Jr 
Wyatt, Oswald § 
Wynne, Herbert M. N 

Yaeger, Wilbert W 
t Yamamoto. Joe... 
7 Ylitalo, William H 

Yivisaker, regal 


Young, ond H 

Young, Thomas O. 

Younger, Lewis I... 

Youngren, Everett R. 

Yue, W 

Zachman, pool H 

Zarling, 'V. ‘Richard. 
Zaworski, Leo 
t Zeigler, Charles M. 
Zeller, "Nicholas H 
Zemke, Erhart E... 
s, Roberts... 
Zemt Luther H... 
Ziegler, Robert Ge, 
Zierold, Arthur A 
Zimmer, J. F 
Zimmermann, Harry B 
Zinter, Ferdinand A 
Ziskin, Thomas 
Zupanc, Edward A