Presidential
addresses
Foreword : The issues Sheldon G. Cohen Historian, American Academy of Allergy (1963-1969), Bethesda, Md. Upon taking on an assignment requiring the sorting out of appropriate material from files, correspondence, and notes for use in the development of an orderly categorized historical document, it soon became apparent that expert guidance was very much in order. “Look to the presidential addresses,” was the advice of a medical historian; it is from the remarks of the leadership that the tempo of the times and reality of the issues can be sensed. This eagerly pursued lead, however, presented its own built-in problem. Apparently, in the beginning there had not been a counterpart consultant historian to suggest to the founding groups of the American Association for the Study of Allergy (AASA) and the Society for the Study of Asthma and Allied Conditions (SSAAC) that a record of their thoughts would be searched some 50 years later. Though titles of Presidential addresses on scientific topics, beginning with William Duke’s on “Physical Allergy” in 1925 (AASA), occasionally appeared on programs, those on timely issues were few and far between until later years of the American Academy of Allergy. Further, without an official organ to document Western Association and Eastern Society proceedings until the appearance of the JOURNAL OF ALLERGY in 1929, addresses did not find their way into the record until that of the sixth SSAAC President, J. Alexander Clarke, in 1931. Unfortunately, for the next few years there was no regularity to the entries. However, following the emergence of the American Academy of Allergy, the pattern of recording Presidential messages had become fairly well established. Clarke’s message (The future policy of this society. J ALLERGY 2:381, 1931) was concerned with the plight of asthmatic and allergic patients resulting from a lack of understanding by physicians, the unavailability of adequate facilities for patient care, and a chaotic state of nonstandardized individual efforts in the preparation of diagnostic and therapeutic materials, methods of treatment, and setting up of asthma and allergy clinics. At the SSAAC meeting 2 years
later, Albert Vander Veer (J ALLERGY 4:428, 1933) urged the membership to consider the nondiscerning general practitioner and thus take care to make accurate observations, exercise conservatism in reporting, guard against extravagant claims, and “combat the general attitude that allergy consists in scratching the skin with a few food tests and putting the patient on a wierd and impracticable diet which usually accomplishes no results.” The first record of an AASA President calling the membership’s attention to a timely issue is that of Alfred Caulfeild, who took time to digress from his scholarly discussion on the chemical character of antigenicity (Some comments upon antigens and the practice of allergy. J ALLERGY 5: 1, 1933). Caulfeild noted that the practice of allergy was being menaced by two factors. First was “the reporting of allergic manifestations in the individual or diseases group when actually or probably they do not exist,” and second, “the overlooking of some other conditions of more importance to the welfare of the health of the patient than any symptoms referable to the detected atopen. ’ ’ Acknowledging failure of accepted methods, he believed, should have two important results: “an increase in the care with which we take our histories and make our physical examinations and an attempt within our means of experimental studies . . to put the practice (of allergy) upon more satisfactory foundation. ’ ’ As the American Academy of Allergy emerged from the amalgamation of the Western Association and the Eastern Society, a fresh start and a new approach was offered, but to the same old problems; none seemed to have gone away. The first President of the Academy, Robert Chobot (Our Society--Its past, present, and future. J ALLERGY 15:291, 19441, reviewed the course of events and circumstances by which allergy’s suffering from “want of esteem” had come about from its own shortcomings: varying schools of thought each rotating about a central
OOgl-6749/79/110467+02$00.20/0 0 1979 The C. V. Mosby Co.
figure-a bewildering nomenclature. a lack of unanimity even on the simplest matters bitter differences often
Vol. 64, No. 5, pp. 467-468
466
Fiftieth anniversary issue: Presidential addresses
based on inconsequentialities . and permitted entrance into the field of some men who took the attitude that allergy consisted of a needle. syringe and the patient’s extremity.
Answers were still needed for standardization of extracts
and procedures,
unity,
properly
organized
and supervised instruction in allergy, and inequities in certification. As both the field of allergy and the Academy were evolving, subsequent Presidents discussed many new issues as new circumstances arose, e.g., support for
the Allergy Foundation, the influence of new developments in immunology to broaden the scope of the specialty of allergy, the effects of government regulatory policies and peer review on the socioeconomics of practice,
manpower
distribution,
amalgamation
with other professional allergy societies, and recertification. From time to time, however, the Academy membership still continued to hear about skin test abuses, problems of certification, controversial and unproven diagnostic and treatment methods, needs for uniformity of nomenclature and standardization of materials and methods, and educational needs for allergy at all levels of instruction and training. In the course of this search, Steams Bullen had told me of two presidential addresses that he personally had sent to the Academy flles. On reclaiming and reviewing these it was obvious that by the escape of
these manuscripts from publication, more recently arrived members were deprived of an opportunity to view meritorious contributions to Academy archives. There they were, the messages of J. Harvey Black
(AASA, 1935) and Stearns Bullen (AAA, 1946), discussing the persistent issues and problems but in entertaining literary styles and the clever use of symbolism and satire. In a letter dated October 2 1, 1954, Bullen gives this background to the Academy Historian. Dr. Black’s presentation was delivered in Atlantic City in
June, 1935 (the only joint meeting of the AASA and the SSAAC). Dr. Richard Kern was the president of the Society for the Study of Asthma and Allied Conditions which was in some sense the host. The meeting at that time was a one day affair and Dr. Harvey Black. as president of the Society [sic]
J. ALLERGY
CLIN. IMMUNOL. NOVEMBER 1979
for the Study of Allergy was asked to preside at the afternoon session. Most of us in the East knew Dr. Black only by name and 1 believe I reflect the impression of many during that afternoon session. Throughout the whole period Dr. Black had hardly a change of expression and it was my impression that here was a sour individual who could by no chance ever see any of the lighter side of life. The program listed a banquet for that evening and the sole speaker was Dr. Black who was slated to deliver an address on -‘The State of Allergy.” I am sure that many of us felt sorry for him that he should have to discuss such a dry subject at the end of a hard day and I believe that all of us who did not know him felt rather more sorry for ourselves that we should have to listen to such a dissertation. When it came time to introduce the speaker I and some of the Easterners who sat near me were a little shocked at the levity of Dr. Kern’s introductory remarks because they seemed rather out of place in an introduction for one who was obviously so dignified and straight laced. If you take the time to read Dr. Black’s presentation, you will soon see why our impression was quickly changed. Even he had to give a faint smile when some of us laughed so hard that we almost fell out of our chairs. His presentation made such a great impression on me that when I had the honor of being President of the Academy and it was necessary for me to prepare a presidential address, I tried to imitate him. This was presented in 1946. At that time certification of allergists had suddenly become a very burning issue so that it seemed not inappropriate to use the word “sanctification” in reference to this subject. I assume that the only procedure available to you will be to store these in the archives of the Academy. I have always wanted something of mine to be in an archive although I do not know what an archive looks like so I am taking this opportunity to ride in on Harvey Black’s coat tails.
But now there is another option, bringing these essays to light. Though somewhat delayed by 44 and 33 years, respectively,
the long-overdue
and deserv-
ing publication of these two addresses follows. On reflection, my consultant medical historian was quite right. A review of 48 years of presidential addresses gives just reason to take pride in appreciating how far the Academy had come. However. while noting genuine progress, we may at the same time ask, in the case of some issues, if times have really changed,
addresses
Foreword : The issues Sheldon G. Cohen Historian, American Academy of Allergy (1963-1969), Bethesda, Md. Upon taking on an assignment requiring the sorting out of appropriate material from files, correspondence, and notes for use in the development of an orderly categorized historical document, it soon became apparent that expert guidance was very much in order. “Look to the presidential addresses,” was the advice of a medical historian; it is from the remarks of the leadership that the tempo of the times and reality of the issues can be sensed. This eagerly pursued lead, however, presented its own built-in problem. Apparently, in the beginning there had not been a counterpart consultant historian to suggest to the founding groups of the American Association for the Study of Allergy (AASA) and the Society for the Study of Asthma and Allied Conditions (SSAAC) that a record of their thoughts would be searched some 50 years later. Though titles of Presidential addresses on scientific topics, beginning with William Duke’s on “Physical Allergy” in 1925 (AASA), occasionally appeared on programs, those on timely issues were few and far between until later years of the American Academy of Allergy. Further, without an official organ to document Western Association and Eastern Society proceedings until the appearance of the JOURNAL OF ALLERGY in 1929, addresses did not find their way into the record until that of the sixth SSAAC President, J. Alexander Clarke, in 1931. Unfortunately, for the next few years there was no regularity to the entries. However, following the emergence of the American Academy of Allergy, the pattern of recording Presidential messages had become fairly well established. Clarke’s message (The future policy of this society. J ALLERGY 2:381, 1931) was concerned with the plight of asthmatic and allergic patients resulting from a lack of understanding by physicians, the unavailability of adequate facilities for patient care, and a chaotic state of nonstandardized individual efforts in the preparation of diagnostic and therapeutic materials, methods of treatment, and setting up of asthma and allergy clinics. At the SSAAC meeting 2 years
later, Albert Vander Veer (J ALLERGY 4:428, 1933) urged the membership to consider the nondiscerning general practitioner and thus take care to make accurate observations, exercise conservatism in reporting, guard against extravagant claims, and “combat the general attitude that allergy consists in scratching the skin with a few food tests and putting the patient on a wierd and impracticable diet which usually accomplishes no results.” The first record of an AASA President calling the membership’s attention to a timely issue is that of Alfred Caulfeild, who took time to digress from his scholarly discussion on the chemical character of antigenicity (Some comments upon antigens and the practice of allergy. J ALLERGY 5: 1, 1933). Caulfeild noted that the practice of allergy was being menaced by two factors. First was “the reporting of allergic manifestations in the individual or diseases group when actually or probably they do not exist,” and second, “the overlooking of some other conditions of more importance to the welfare of the health of the patient than any symptoms referable to the detected atopen. ’ ’ Acknowledging failure of accepted methods, he believed, should have two important results: “an increase in the care with which we take our histories and make our physical examinations and an attempt within our means of experimental studies . . to put the practice (of allergy) upon more satisfactory foundation. ’ ’ As the American Academy of Allergy emerged from the amalgamation of the Western Association and the Eastern Society, a fresh start and a new approach was offered, but to the same old problems; none seemed to have gone away. The first President of the Academy, Robert Chobot (Our Society--Its past, present, and future. J ALLERGY 15:291, 19441, reviewed the course of events and circumstances by which allergy’s suffering from “want of esteem” had come about from its own shortcomings: varying schools of thought each rotating about a central
OOgl-6749/79/110467+02$00.20/0 0 1979 The C. V. Mosby Co.
figure-a bewildering nomenclature. a lack of unanimity even on the simplest matters bitter differences often
Vol. 64, No. 5, pp. 467-468
466
Fiftieth anniversary issue: Presidential addresses
based on inconsequentialities . and permitted entrance into the field of some men who took the attitude that allergy consisted of a needle. syringe and the patient’s extremity.
Answers were still needed for standardization of extracts
and procedures,
unity,
properly
organized
and supervised instruction in allergy, and inequities in certification. As both the field of allergy and the Academy were evolving, subsequent Presidents discussed many new issues as new circumstances arose, e.g., support for
the Allergy Foundation, the influence of new developments in immunology to broaden the scope of the specialty of allergy, the effects of government regulatory policies and peer review on the socioeconomics of practice,
manpower
distribution,
amalgamation
with other professional allergy societies, and recertification. From time to time, however, the Academy membership still continued to hear about skin test abuses, problems of certification, controversial and unproven diagnostic and treatment methods, needs for uniformity of nomenclature and standardization of materials and methods, and educational needs for allergy at all levels of instruction and training. In the course of this search, Steams Bullen had told me of two presidential addresses that he personally had sent to the Academy flles. On reclaiming and reviewing these it was obvious that by the escape of
these manuscripts from publication, more recently arrived members were deprived of an opportunity to view meritorious contributions to Academy archives. There they were, the messages of J. Harvey Black
(AASA, 1935) and Stearns Bullen (AAA, 1946), discussing the persistent issues and problems but in entertaining literary styles and the clever use of symbolism and satire. In a letter dated October 2 1, 1954, Bullen gives this background to the Academy Historian. Dr. Black’s presentation was delivered in Atlantic City in
June, 1935 (the only joint meeting of the AASA and the SSAAC). Dr. Richard Kern was the president of the Society for the Study of Asthma and Allied Conditions which was in some sense the host. The meeting at that time was a one day affair and Dr. Harvey Black. as president of the Society [sic]
J. ALLERGY
CLIN. IMMUNOL. NOVEMBER 1979
for the Study of Allergy was asked to preside at the afternoon session. Most of us in the East knew Dr. Black only by name and 1 believe I reflect the impression of many during that afternoon session. Throughout the whole period Dr. Black had hardly a change of expression and it was my impression that here was a sour individual who could by no chance ever see any of the lighter side of life. The program listed a banquet for that evening and the sole speaker was Dr. Black who was slated to deliver an address on -‘The State of Allergy.” I am sure that many of us felt sorry for him that he should have to discuss such a dry subject at the end of a hard day and I believe that all of us who did not know him felt rather more sorry for ourselves that we should have to listen to such a dissertation. When it came time to introduce the speaker I and some of the Easterners who sat near me were a little shocked at the levity of Dr. Kern’s introductory remarks because they seemed rather out of place in an introduction for one who was obviously so dignified and straight laced. If you take the time to read Dr. Black’s presentation, you will soon see why our impression was quickly changed. Even he had to give a faint smile when some of us laughed so hard that we almost fell out of our chairs. His presentation made such a great impression on me that when I had the honor of being President of the Academy and it was necessary for me to prepare a presidential address, I tried to imitate him. This was presented in 1946. At that time certification of allergists had suddenly become a very burning issue so that it seemed not inappropriate to use the word “sanctification” in reference to this subject. I assume that the only procedure available to you will be to store these in the archives of the Academy. I have always wanted something of mine to be in an archive although I do not know what an archive looks like so I am taking this opportunity to ride in on Harvey Black’s coat tails.
But now there is another option, bringing these essays to light. Though somewhat delayed by 44 and 33 years, respectively,
the long-overdue
and deserv-
ing publication of these two addresses follows. On reflection, my consultant medical historian was quite right. A review of 48 years of presidential addresses gives just reason to take pride in appreciating how far the Academy had come. However. while noting genuine progress, we may at the same time ask, in the case of some issues, if times have really changed,
