Monday, Jan. 22, 1934

Sterilization in Michigan

All Michigan was stirred last week when Edward H. Williams, new Wayne County auditor, lashed out hotly with the charge that at a training school for mental defectives near Detroit trickery was used to enforce the State sterilization law. Cried he: ''Mrs. Ainsworth violated all sense of justice and decency. . . . The father [ of a 19-year old] was violently opposed to having his boy subjected to this mutilation. She tricked the father into signing a consent order on the pretext that he was signing his son's release from the Wayne County Training School." Other cases which horrified Mr. Williams: a girl 20, a girl 18, a boy 16, all of whom "objected to being sterilized, to no avail." More data which shocked Michigan: During the past four years 14 boys and 47 girls of the Wayne County Training School have been rendered incapable of passing on their defects to a new generation. At the larger Lapeer Home & Training School 216 males and 688 females have similarly been sterilized. Practically all this has happened under Michigan's 1929 law permitting sterilization in certain cases.* Parents may ask that their children be thus handled. Or the superintendent of a tax-supported institution may do so. Accused with Mrs. Mildred H. Ainsworth, chief social worker of the Wayne County School, was Dr. Robert Henry Haskell, school superintendent. Last week Dr. Haskell and Mrs. Ainsworth vigorously denied that they ever used trickery, insisted that they got the consent of the parents in every instance, and "not only that but the consent of every other adult member of the family, which is more than the statute requires." Legally Dr. Haskell seemed to be secure last week./- But not communally. Excited Auditor Williams called for a public hearing. Papal sentiment urges Roman Catholics to oppose sterilization. Jews, because of Old Testament injunctions, presume an interest. So Auditor Williams invited "spokesmen for several Catholic and Jewish organizations" to the accusatorium.

New Deal Cold Cure

The New Deal pressure of work on Federal employes in Washington is so great that the Government is taking extraordinary measures to keep everyone fit for the job. Doctors and nurses make regular rounds. At the sign of a cold, chief cause of disability, the Federal worker must take one of two treatments. Last week the Public Health Service released its formu lae:

Federal Cold Treatment No. 1: a) one fever-chasing tablet (aspirin, phenacetin, or the like) dissolved in a small quantity of warm water; b) swab throat with a mixture of one part iodine and five parts glycerine; c) spray nostrils.with 1% solution of ephedrin sulphate, or with a diluted solution of atropine sulphate if cold is very severe; d) castor oil or citrate of magnesia purge; e) saturated solution of baking powder.

Federal Cold Treatment No. 2: two aspirin tablets, a teaspoon of baking soda, a dash of aromatic spirits of ammonia and a few drops of spirits of camphor shaken with two ounces of hot water. Swallow the mixture.

Senile Appendicitis

One out of ten cases of acute appendicitis died 20 years ago. One out of ten cases of acute appendicitis died last year. The failure of advancing surgery to re duce this mortality rate prompted Dr. Urban Maes, able New Orleans appendectomist. chief of the department of surgery of Louisiana State University Medical Center, to search for explanations. His conclusions he last week presented in the American Journal of Sur gery*: "Categorically speaking, the mortality in appendicitis is not usually the mortality of appendicitis itself; it is usually the mortality of unwise treatment, the mortality of delay, and the mortality of the complications that follow upon and are induced by these two things." But for childhood and old age this generality does not hold. Appendicitis is then dangerous per se. Thus although only one-third of the cases of appendicitis occur at the extremes of life, two-thirds of the deaths from the disease occur before 10 and after 40. Why this is so Surgeon Maes explained last week. The character of the appendix changes as people grow older. In the young the organ contains an abundance of lymphoid tissue, which renders it a particularly good harborer for germs. In the old the appendix largely loses its lymphoid character. Its risks then grow from diseases of its blood vessels. "In the young patient, therefore, local infection predominates, and the resulting disease is fundamentally suppurative, with perforation and abscess formation the usual sequelae." This is easy for the surgeon to clean up. Children and infants present difficulties because they cannot explain their com plaints and because parents too often give destructive cathartics. As people grow older, progressively smaller is the likelihood of their developing appendicitis. In their appendicitis, however, "suppuration is the exception rather than the rule, and the primary pathologic change tends to be a massive variety of gangrene, a true tissue death." In the old the disease tends to spread and cause general infection. This means that "senile appendicitis ... is a disease in which the only hope of safety lies in prompt surgery, and yet a disease in which operation is frequently late because the diagnosis is very frequently not made until late. . . . The safety of our patients depends upon . . . resorting to surgery without delay. . . ."

*Michigan first legalized eugenic sterilization in 1913. Currently 26 other States have similar laws. /-However, in Oceana County, Mich, a young: man got a $3,250 verdict against three county officers whom he accused of coercing him to submit to sterilization (TIME, July 24). Retrial is pending. *In a joint paper with Frederick Boyce, M. D. and Elizabeth M. McFetridge, M. A.

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