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First published in 1891 in Kansas City, MO, by W.P. Cleary, the journal was recognized at that time as The American Journal of Surgery and Gynaecology. [...]Dr. Polk has significantly enlarged international circulation and diversified editorial board membership with American and international scholars.
Presented at the Festschrift for Dr. Hiram C. Polk, Jr, University of Louisville, Louisville, KY, February 5, 2005
January 2005 marked the 114th year of consecutive publication of The American Journal of Surgery . First published in 1891 in Kansas City, MO, by W.P. Cleary, the journal was recognized at that time as The American Journal of Surgery and Gynaecology . Fourteen years later, the journal changed its name to its present title; this title and its publication of surgical science have remained uninterrupted to date. For many years after its founding issue, the entire journal comprised approximately 30 pages of reading material that included surgical text, contemporary science, education, and multiple advertising quotations. A transition occurred (circa 1920) in which the journal grew rapidly with insightful evolving science, education, technology, and experimentation; thereafter, its publisher allowed growth to approximately 1200 text pages per year. In the early 1930s, the text page number was doubled and special issues would be inclusive of over 350 pages of reading matter. The American Journal of Surgery currently represents a premier journal ranked in the top 20 in surgical publications and has circulation to every US state and every civilized country in the world.
The purpose of this festschrift is to acknowledge the fifth Editor, Dr. Hiram C. Polk, Jr, who ended his 18th year as Editor in December 2004. Dr. Polk has provided major contributions and leadership for the editorial board of the journal while serving as its Editor-in-Chief. He was first an Associate Editor (1982-1986) and served as Editor-in-Chief from 1986 to 2004. His leadership has provided durable continuity of editorial policy for publication of excellent science, education, and technology.
Historical Perspectives
In 1891, with evolution of the first published edition of The American Journal of Surgery and Gynaecology (Fig. 1), medical schools, as they were called, were simply apprenticeship havens that were randomly distributed throughout the northeast and midwest United States. In Louisville, KY, alone (circa 1880s-1890s), there were 7 such schools, few of which had interest in teaching the art and science of medicine and inquiry; principally, these were proprietary schools that were conducted and maintained for financial success and gain. The faculty of such schools judged the success of these medical schools, its faculty, and its teaching philosophies primarily by the net profit generated at the end of each calendar year. Ironically, it was Abraham Flexnor, also of Louisville, who published his landmark report and recommendations vilifying these proprietary schools' philosophic and monetary missions; Flexner is acknowledged as the sole dissenter who was largely responsible for closure of these "grade B" schools [1].
For many years thereafter, and with the initiation of publication of The American Journal of Surgery and Gyneacology , the course of instruction for medical degrees in what became "grade A" institutions was but 2 years in the majority of these medical schools. In the late 1890s, it was not uncommon for a young male who had not yet attained the age of 21 years to be a graduate from a medical school. In the majority of states at that time, each new medical doctor had to be in compliance with state laws. Most states required an individual to be at least 21 years of age before being licensed to practice medicine.
I will focus on the brief history of the first 4 editors of the journal, but this festschrift for Hiram Polk must be centered on his salient contributions to the quality and substance of its publication.
Formulative editorial leadership of The American Journal of Surgery
The first Editor-in-Chief of The American Journal of Surgery and Gynaecology was Emory Lanphear, M.D., Ph.D., Professor Lanphear (Fig. 2) served as Editor from 1891 to 1905 and worked with the originator of the journal, W.P. Cleary of New York, to publish the same in his home state of Missouri. Lanphear was born in 1859 and received his medical degree at the Missouri Medical College, St. Louis, MO, in 1881, completing postgraduate work and obtaining his Ph.D. in Chicago and New York. Considered a prominent academician, he was appointed professor and chair of operative surgery at the Kansas City Medical College and the St. Louis College of Physicians and Surgeons. Thereafter, he was appointed professor of surgical gynecology and clinical surgery, thus, perhaps the genesis for attachment of the name "gynaecology" to the surgical thrust of the journal. Thereafter, Lanphear was appointed professor of surgical gynecology and clinical surgery in the medical department of the National University of Arts and Sciences, St. Louis, MO. Professor Lanphear was a distinguished academic surgeon of his era and was president of the St. Louis Academy of Medicine and of the Tri-State Medical Society of Iowa, Illinois, and Missouri. He died at the age of 60 on February 6, 1920, in Citrus Park, FL [1].
In 1905, the ownership of the journal changed hands and its publication site was moved from Kansas City to New York when Dr. Walter M. Brickner became its second Editor-in-Chief (Fig. 3). With transfer to New York, the journal was placed under the operational management of Dr. Joseph MacDonald, Jr, a nationally prominent surgeon and gynecologist who was renowned principally by reason of his success as a medical publisher. Moreover, the editorship was offered to Dr. Brickner because of his extensive experience in publications and his knowledge of contemporary surgery. Brickner had extensive military experience in World War I. He worked as a valuable and effective surgeon in the war and provided patriotic service on the frontlines of battle. This surgeon apparently exhibited exquisite personable attributes and respect; upon return from the war, his heroic acclamation assisted his appointment as the chief surgeon of the Hospital for Joint Diseases at Mount Sinai Hospital of New York City. In addition, he was honored with an appointment as skeletal surgeon to Morisania Hospital. It was principally Brickner who provided the essential framework for organization of the journal's publication philosophy and excellence; this Editor laid a firm foundation for future growth to expand its circulation. Brickner served as the Editor from 1905 to 1928 and is credited with the realization of the importance of separation of the journal title and with termination of copublication of gynecologic diseases. Thereafter, in 1906, soon after Brickner assumed the Editor-in-Chief position, the journal bore the title of The American Journal of Surgery (Fig. 4) and was principally dedicated to scientific and educational articles related to surgical diseases [1].
The third Editor, Thurston S. Welton, M.D., was ironically an obstetrician-gynecologist who assumed the editorship in 1928; he functioned as Professor of Clinical Obstetrics-Gynecology at the Long Island College of Medicine (now the State University of New York). Welton (Fig. 5) served as Editor for 30 years (1928-1958) during a tumultuous interval of geopolitical strife that included the depression, World War II, and the Korean conflict. He provided strong leadership for developing the solidarity of educational and scientific commitment of the journal to surgical science. With his editorship tenure, scientific papers presented before the Pacific Coast Surgical Association, the Southern Surgical Association, the Society of Head and Neck Surgery, the Society for Surgery of the Alimentary Tract, and the Southwestern Surgical Congress were published in the journal.
A brief courtship of The American Journal of Surgery with the Southern Surgical Association
Under Welton's leadership as Editor, the prominent surgeons of America and world surgery were included on the editorial Board. Welton's influence on the editorial board established a new paradigm in the claim that the journal was a "truly independent" journal that ultimately bore consequences for the withdrawal of the Southern Surgical publication rights with the journal. In his position as the new Editor of the journal, he was evidently highly influential with the prestigious editorial board who agreed to adopt in March 1930 a statement that appeared on the cover page of the journal and was printed in bold type just below the listing on the masthead for members of the editorial board and stated: "The American Journal of Surgery is truly independent and enters into no 'entangling alliances.' It publishes many papers read before the leading surgical societies of the country, but it is not 'the official organ' of any organization. Every manuscript is selected by the Editors, as noteworthy of publication--nothing is published merely because 'it was read at the meeting.'"
This disclaimer, which appeared on all mastheads of future journals for several years thereafter, provided the reader this acknowledgment of its apparent independence (Fig. 6).
A debacle grew as Welton and the secretary of the Southern Surgical Association began earnest negotiations between 1929 and 1930 to ensure that the journal published the annual scientific presentations of the association. In 1932, Welton contracted with the secretary of the association to enter into the publication of its prospective papers, memorials, and membership in an "annual volume of transactions" that the association had published since 1888 [2]. Meetings of the Southern Surgical Association were held in December of each year, and contractual arrangements with the journal were to provide publication of scientific presentations the following May and June with annual publication of "Transactions" later in the year. This arrangement was to become effective immediately and to include the annual presentations delivered at the association meeting in December 1932 [2].
Scientific papers of the association thereafter appeared for the first time in May and June 1933 (volume 20). For whatever reason, all but 2 papers presented at the December 1932 meeting of the Association were published and "Transactions" also appeared in the 2 spring 1933 issues of the journal. A conspicuous omission was that of a senior author, Vilray P. Blair of St. Louis, who played a dominant role in the development of the specialty of plastic surgery and was to become the association's president. In the second year of the relationship between the association and The American Journal of Surgery , the journal published the 1933 meeting in its May and June 1934 issues (volume 21). A notable omission of the 39 papers presented at the meeting was the presidential address of Vilray P. Blair, who presented a scholarly and introspective view of the qualifications and training of a rural surgeon that was entitled, "Ruminations of a Journeyman Surgeon" [3]. Careful study and reflection of this notable historical event for the association by the late Robert Sparkman did not provide disclosure in the journal or the association's minutes any explanation for the omission of both of these articles from the 1933 and 1934 journal volumes [2].
In the third year of publication arrangements between the association and the journal, few would recognize that 1935 would be the final year the journal would publish the "Transactions" of the association. The presidential address of Frank K. Boland [4] for 1934 included a brief preliminary editorial. Although all papers and the presidential address were published in "Transactions," council minutes of the association for 1934 do not include the possibility of termination of the contract with P.B. Hoeber, Inc, publisher of The American Journal of Surgery . The secretary at the time, Dr. Alton Ochsner, began negotiations to quietly terminate the contract and to move the association's publications to a different journal. Subsequent minutes of the Southern Surgical Association Council meeting do not discuss this change or provide explanation for removal of The American Journal of Surgery as its publisher; furthermore, there is no mention in the journal of the termination of the contract with the association [2]. It is perhaps this rift with the association and the faux pas of omission of a presidential address and other key publications that created this conflict, which led to termination of the contract. Nonetheless, soon after (1936) the journal had a change in editorial policy (Fig. 7). The new position of the journal was that it would "drop" the aforementioned editorial policy to function as an independent journal without entering into any "entangling alliances." However, the previous editorial position was maintained in that the journal would not function as the "official organ of publication" for any organization: "The American Journal of Surgery is the leading independent surgical Journal. It publishes many papers read before the outstanding surgical societies, but it is not the official organ of any organization. Every manuscript is selected by the editors, as noteworthy of publication--nothing is published because 'it was read at the meeting'" (April 1936).
The use of the term "the entangling alliance" had also initiated the split between the association and the journal. These events represented valuable maturation experiences for both the association and the journal's editorial staff.
The fourth Editor, Dr. Robert M. Zollinger of Columbus, OH, provided a dynamic change in editorial leadership. An internationally renowned general surgeon credited with the first description of the Zollinger-Ellison syndrome in 1955, Zollinger was recognized as a gastrointestinal clinical and experimental surgeon-scientist poised to assume the role of Editor-in-Chief in 1958. Dr. Zollinger (Fig. 8) remained the active editor for the next 28 years until 1985. His principal contributions included strong stewardship, significant enlargement of the scientific content and circulation of the journal, and the addition of international scholars to the editorial board. Under Zollinger's leadership, a diversification of scholarly experimentation in clinical and basic sciences was evident. The addition of prominent contemporary symposia, robustly edited editorials, and a preeminent elegance to writing style became the trademark of the journal. His elegant stewardship of The American Journal of Surgery allowed the transition to Hiram Polk's leadership and further success.
Hiram C. Polk, Jr, M.D.: fifth Editor-in-Chief of the journal
In 1982, Dr. Zollinger's wisdom foresaw the need for future transition of the journal to that of an outstanding surgical scholar. His influential choice for an Associate Editor at that time was Dr. Hiram Polk, who together with Dr. John S. Najarian of Minnesota provided major intellectual support, ideology, and perseverance to allow transition of the journal to its currently recognized scholarly activity.
Dr. Polk (Fig. 9) remained an Associate Editor until 1986 when the publisher named him Editor-in-Chief, a position he retained for 18 years until December 2004. With change of editorial policy, Dr. Zollinger had been successful in retaining 3 societies that used the journal as their "official organ of publication" and included the Southwestern Surgical Congress, the North Pacific Surgical Association, and the Association for Surgical Education. Hiram Polk was thereafter successful in recruiting 3 additional societies to contract with the journal as their publication source and include the Association for Women Surgeons, the American Society of Breast Surgeons, and the Association of VA Surgeons. More recently, Dr. Polk has begun and completed successful negotiations with the Midwest Surgical Association to use the journal as its official organ of publication as well.
A review of the history of the journal acknowledges that there have often been changes in publishers approximately every 5 years; importantly, the continuity of editorial policy and dedication to the publication of excellent science by the journal has never waivered. As previously acknowledged by this author [6], the publisher has provided different approaches to enhancing quality of the journal; however, all publishers have invariably emphasized that the content of the journal is the sole responsibility of the Editor. This dedication for service to the surgical community and the journal's readership has been scrupulously maintained by Dr. Polk with an adroit management style allowing him as Editor-in-Chief to provide masterful stewardship of manuscript publication with proper oversight of the journal's content. The information for authors section has provided recommendations for categorization by the publisher of The American Journal of Surgery , which invites concise original articles that are inclusive of 5 categories: (1) clinical and experimental surgery, (2) descriptions of modern operative techniques ("How I Do It"), (3) review articles, (4) surgical pharmacology, and (5) brief reports. The fourth category (surgical pharmacology) was added by Dr. Polk in 1986 upon assuming the editorship, as this section emphasizes drug interactions and their effectiveness in the management of surgical diseases. These categories have remained extant and continue to provide continuity of publication emphasis for the journal.
The success of all publishers rests clearly with their diligence and perseverance to publication detail and visionary ideals that recognize evolution and progress in surgical science. Furthermore, the success of any Editor will only be ensured with the assimilation of novel manuscript selection together with the publisher that provides emphasis on "new" knowledge. Hiram Polk has provided Elsevier proper guidance and support from his editorial office in Louisville and has ensured the maintenance of continuity and quality of these scientific submissions. Although these relationships have been nurtured by Dr. Polk, he would be the first to acknowledge that for every great Editor-in-Chief, a responsible and diligent Administrative Editor is requisite. Such is the case with his working relationship with his Senior Administrative Editor, Mrs. Anne T. (Cunningham) Weimer, who has provided oversight to societal publications and daily attention to the details for organization in the journal's editorial office.
Hiram Polk's prior leadership continues to allow growth in circulation and in text page numbers of the journal. He is as much responsible as any of the 4 preceding Editors to enlarge the journal's scientific contributions and quality. Moreover, Dr. Polk has significantly enlarged international circulation and diversified editorial board membership with American and international scholars. His diligence for overseeing these tasks can only be expressed as profound acknowledgment from the surgical community and from Elsevier for these enduring contributions.
With the current evolution and progression of surgical research from cellular to subcellular and the current, molecular-based science, our research environment has gained modern descriptions of organ physiology, dysfunction, and therapeutic interventions. As The American Journal of Surgery has progressed with its attitude toward surgical science, it is this Editor's wish that we continue to embrace submissions of the finest experimentation in bench and clinical science. It is via these measures that surgical scientists provide explanation to fundamental mechanisms of disease, physiologic dysfunction, genetic mutations, and subsequent organ failure. I am particularly appreciative of Dr. Polk's leadership; he has provided the journal with a balance of evolving state-of-the-art bench research that answers hypothesis-driven inquiry. These scientific contributions ensure that prospective and retrospective clinical trials of high quality are seminal studies representative of contemporary translational science. It is the expressed intent at Elsevier and the Editor's office to continue Dr. Polk's policy of continuity of publication of methodological and statistical outcomes that ensure translational progress that is representative of cellular and molecular research conducted in the finest international surgical laboratories. It is the Editor's view that these tenets will sustain the journal and ensure its future while providing the surgical community readership an assurance for continuation of publication of meritorious, high-quality research that properly depicts mechanisms of disease and management of a multiplicity of surgical illnesses.
Although a chronological closure has occurred regarding Dr. Polk's tenure as the fifth Editor of the journal, his enthusiasm and imprimatur for the journal's development to its current state of excellence is evident. Many members of the editorial board have often queried "Will Hiram Polk retire?" The answer most assuredly will be that it is most improbable that Dr. Polk will fully dismiss all of his editorial chores but will shift them largely from the journal to other noteworthy academic pursuits, principally focused on surgical investigation and clinical outcomes research. The editorial staff of the journal and Elsevier, its publisher, will miss his masterful touch on the journal's monthly production sequence of manuscripts. However, Dr. Polk is highly deserving of altering his academic and personal focus, a move that hopefully will allow him more time for his passion--teaching of surgical residents and students and the management of his racing portfolio. We will not say goodbye to Dr. Polk; we will only express our profound appreciation for his leadership and stewardship of The American Journal of Surgery for the past 18 years. We wish him well. Godspeed to Hiram Polk!
Welton TS: Editorial : Fiftieth birthday . Am J Surg 51 1-6, 1941.
Sparkman RS: Official organs and entangling alliances : The brief association of The American Journal of Surgery and the Southern Surgical Association (1932-1935) . Am J Surg 161 305-308, 1991.
Blair VP: Ruminations of a journeyman surgeon . Trans South Surg Assoc 46 1-11, 1933.
Boland FK: Progress in surgery . Am J Surg 28 193-200, 1935.
Masthead . Am J Surg 32 1- 1936.
Bland KI: A salute to Hiram C. Polk . Am J Surg 189 2005.
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