From the Division of Cardiology (C.F.W.) and Prior Health Science Library
(D.S.), The Ohio State University, Columbus, Ohio; and The New York Hospital,
Cornell Medical Center (A.A.L.), New York, NY.
Correspondence to Charles F. Wooley, MD, The Ohio State University, Division of Cardiology, 6th Floor Means Hall, 1654 Upham Dr, Columbus, OH 43210. E-mail wooley-1{at}medctr.osu.edu
Lewis Atterbury Conner, one of the founding group of the
American Heart Association in 1924 and its first president in 1924 to
1925, is honored by the Lewis Conner Memorial Lecture at the annual
American Heart Association Scientific Sessions.
Conner was born in New Albany, Ind, and received the degree of bachelor
of philosophy from the Sheffield Scientific School of Yale University
in 1887.1 He then attended the College of
Physicians and Surgeons of Columbia University, where he received the
MD degree in 1890. Conner was appointed as a house officer at
New York Hospital from 1890 to 1892. From 1892 to 1894, he was in
Vienna, Munich, and Heidelberg as a postgraduate student. He returned
to clinical practice in New York City in 1894 (Figure 1
The Department of Medicine: Professor and Chairman
Most of Conner's career was devoted to the New York Hospital and
Cornell University Medical College. The New York Hospital was granted a
royal charter in 1771 and opened in 1791; in 1877, the hospital moved
to a new site that extended from Fifteenth to Sixteenth Streets, west
of Fifth Avenue. The Cornell University Medical College, founded in
1898, associated with the New York Hospital in 1927.
Conner had been appointed as an Instructor in Medicine in the original
faculty at Cornell in 1898 and became Professor of Clinical Medicine 2
years later. At that time he was also an Attending Physician to the New
York Hospital's House of Relief on Hudson Street and an Assistant
Pathologist to the New York Hospital (Figure 2
Military Experiences
Conner's military experiences extended from service as a
private in 1898 during the Spanish-American War to serving as a senior
medical officer in the US Army Medical Corps during World War
I. The US Army physical examination process during World War I required
the US Army to update the 1910 version of its "Rules for Examination
of Recruits" and to revise and clarify cardiovascular
physical examination standards and terminology. This was the first
experience in the United States with an organized and systematic
examination of almost 4 million young men. The conventional physical
diagnostic wisdom, based on 19th century clinical
pathological correlates derived from patients with late-stage disease,
was of limited value in these activities.
Conner was chief of the Army Medical Corps Division of Internal
Medicine, with the rank of major in 1917. He was involved in the
selection and training of cardiovascular specialists
whose responsibilities involved the interpretation and clarification of
cardiovascular signs and symptoms, reconciling
cardiovascular physical findings with the military
criteria for fitness for duty. Later in the war, Conner
represented the Surgeon General's office in the
implementation of the first Cardiovascular Medical
Center at US Army Hospital #9 at Lakewood, NJ. Discharged with the rank
of colonel in 1919, he was appointed a brigadier general in the Reserve
Corps in 1919.
Conner took "stock of what has been accomplished by all this
elaborate effort" in the United States when he presented
"Cardiac Diagnosis in the Light of Experiences With Army Physical
Examinations" at the Association of American Physicians meeting in
Atlantic City in June 1919.3 Clarification of the
vague, preexisting cardiovascular physical examination
standards and terminology was a major concern. His translation of the
wartime lessons learned about cardiac diagnosis, the pathogenesis of
cardiac disorders, functional disorders of the heart, and
valvular heart disease, in particular mitral
regurgitation,4 was directed to
the problems physicians faced in civil life. Many of his observations
and conclusions surfaced in his later publications and in his
discussions of papers presented at the American Heart
Association meetings.
Public Health and Rehabilitation: The New York Heart Association
and the American Heart Association
Early in his career, Conner's attention was directed to heart
disease as a public health problem and to the rehabilitation of cardiac
patients. His participation in the development of the heart
associations was an expression of his commitment to the "heart
movement." This involvement extended to the establishment of the
cardiac convalescent home, cardiac classes, the Trade School for
Convalescents, and specialty outpatient clinic programs. Conner's 1927
rehabilitation article quotes Frederic Brush on the appropriation of
public and private funds for the care of cardiac patients, emphasizing
the differential cost of care of the cardiac patient in the hospital
($30 per week) compared with the convalescent home ($12 per week) and
the special cardiac clinic ($1 per week).
Fye used the term "public health cardiologists" to describe a
select group of physicians who were concerned with the provision of
both medical and social services to cardiac patients and who played a
major role in the establishment and the direction of the US
organizations devoted to cardiac disease.5
Prevention of heart disease, cardiac disability and rehabilitation, and
the social and economic consequences of heart disease were topics added
to the traditional concerns about diagnosis and treatment.
Conner was a central figure in these deliberations and activities, and
Fye traces Conner's role within the heart movement from the cardiac
clinic to the convalescence of working men with cardiac disease and to
the creation of the Association for the Prevention and Relief of Heart
Disease in 1915. Conner served as the first president of this group,
which brought together physicians and laypersons concerned "about the
frequency and social consequences of cardiac disease."
Introduction of the ECG and the World War I medical experiences
accelerated the development of specialists who became "heart men,"
and Conner's wartime observations contributed to the growing
epidemiological awareness about the causes and frequency of heart
disease in specific age groups and in the population at large. A group
of distinguished men and women were involved in the next formative
steps, first of the New York Heart Association, and then of the
American Heart Association (1924). These were important steps in the
development of US cardiology in the early 20th century.
Throughout the story, Lewis Conner was present at the
beginning.
The American Heart Journal
Conner was the first editor-in-chief of The American
Heart Journal, the "official organ of the American Heart
Association," from 1925 until his resignation in 1936 (Figure 3
The Conner Legacy
Conner's legacy extended beyond his academic, writing, and
editorial activities. David Barr recalled Conner's "...
preeminence as a teacher can be attested by all graduates of Cornell
who came ... into contact with his remarkable example and method.
His learning, his clinical judgment, and above all, his integrity, made
him the idol of the students and particularly of those chosen young men
who were permitted to work with him as interns or residents in the
wards of the New York Hospital."7
One of "Those Chosen Young Men"
William Paul Thompson was one of these "chosen young men" who
worked with Conner as an intern at the "old" New York Hospital
before the opening of the New York Hospital–Cornell Medical Center on
East 68th Street.
Thompson was born in Iowa in 1907, began medical school at the
University of Iowa, and spent the last 2 years at Harvard, where he
received his MD degree in 1931.9 He was in the
last group of interns with Lewis Conner at the "old" New York
Hospital, made the move to the medical center when it opened, served
there as an assistant resident in medicine, and then worked with
cardiologist Dr Harold J. Stewart as the first
cardiology resident at the medical center.
Thompson went on to a research fellowship at Harvard from 1934 to 1935,
where he was assigned to work with Dr Samuel A. Levine at the Peter
Bent Brigham Hospital, and then spent 2 years with Dr Paul Dudley White
at the Massachusetts General Hospital. Thompson moved to Los Angeles,
Calif, in 1937 and had a distinguished career in the private practice
of cardiology with faculty appointments at Loma Linda
University from 1938 to 1966 and at the University of Southern
California from 1966 to 1974. The American College of Physicians
honored him in 1982 as the Dean of Cardiologists in the Los Angeles
medical community and one of the outstanding clinical cardiologists in
the United States. (Figure 4
William Paul Thompson Recalls Lewis A. Conner
Dr Thompson responded to my request for his recollections of his
time with Lewis Conner with the following vignette, dated 10 April,
1990.
Lewis A. Conner and the New York Hospital
The "old" New York Hospital was indeed old when I started my
service as an intern on January 1, 1932. The hospital building, located
at 8 West 16th Street in New York City, was in fact so old that one was
inclined to be suspicious it was the same building in which it began
its existence when it was "Founded in 1771 in the Reign of George
III," as its logo proclaimed. The New York Hospital was the second
hospital founded in the Colonies, the Pennsylvania Hospital having
preceded it.
The Medical Service was located in two large open wards, one for women,
the other for men. As an intern, I did my own laboratory work, urine
examinations, blood counts, and such, but had no real laboratory,
simply a desk in the waiting room between the two wards.
The medical floor was reached by way of an ancient elevator,
activated when the passenger within pulled on ropes. It
traveled so slowly that the intern, always pressed for time, usually
elected to reach his destination by way of the stairs.
The ambulance service, which was then a required part of the
internship, consisted of a single electric-powered vehicle with hard
rubber tires and an open back in which the intern, in uniform, sat
while clutching an upright (Figure 5
The inexperience of the intern, freshly out of medical school, was
balanced by that of the driver, an old hand who always knew what to
tell the intern to do and what disposition to make of the case.
But the service was not as primitive as all this may appear. The
rewarding part of the service, and rewarding it was, was the chief, Dr
Lewis A. Conner. Rounds with him were a delight, especially when he
came from church each Sunday morning dressed in his wing collar,
long-tailed jacket, and striped pants.
Dr Conner was tall, straight, with a bald head and red fringes,
exceedingly dignified, a scholarly gentleman with never an unkind word
toward patients or staff. His physical examinations were meticulous,
always ending when he asked the head nurse, who always accompanied him
on rounds, for the sounding towel. This was placed by the nurse over
the chest of the patient for the purpose of immediate auscultation
(Figure 6
I had the privilege of being Dr Conner's last intern. The "old"
New York Hospital closed its doors on July 31, 1932. The house staff
until the opening of the "new" New York Hospital on September 1,
1932, was forced to shift for itself without the vital pay of board,
room, and laundry, not an easy task at the depth of the Great
Depression.
The new hospital at 525 East 68th Street in New York City provided a
profound change, housed in a glittering new building of 27 stories on
the East River. Our first lunch was in the Doctors' Dining Room on the
18th floor overlooking the river. We were seated by the hostess and
asked to choose steak or soft-shell crab! Our unheard of bounty, for
interns at least, did not last long as the Depression caught up with
the Hospital, and we ended sharing the employees' cafeteria in the
basement.
The new hospital was a shiny new environment that made us all happy to
feel we "had arrived" in a research atmosphere, but with the
retirement of Dr Conner from active teaching on the move uptown, we all
lost that superb clinical teaching that made service with Dr Conner
such a joy.
Conner Recalled
A wonderful description of the man, his times, and the legend came from
J. James Smith, MD, Cornell class of 1938, who knew Conner as a
"physician and teacher of consummate
skill."11 After his retirement from practice,
Conner acted as medical director of the Burke Convalescent Home. Conner
was a friend and advisor of John Masterson Burke and had been
instrumental in the development of the home. Smith picks up the story
at this point:
Educated at a time when the unaided senses still
represented the only resource in the clinical study and
recognition of many diseases, Dr Conner's mastery of physical
diagnosis must have frequently astonished the uninitiated house
officer. One such young physician, while presenting a case
of lung abscess following pneumococcal pneumonia at Grand Rounds,
reported incredulously that the correct diagnosis had been made at the
Burke Convalescent Home by a very aged physician who didn't even have
a stethoscope. This man had never seen Dr Conner palpate for the
cardiac apex with his gnarled fingers, after which he announced a
"high degree of mitral stenosis." This was before he
listened, which of course was with sounding towel and naked ear, for
his hearing loss defeated the use of the stethoscope [Figure 6
It seemed that during a tour of Europe in the 1890s, which in those
days was an important finishing-off process in medical education, he
had visited the clinic in Kiel of Heinrich Quincke, who was then
developing the technique of lumbar puncture. Quincke describes that in
two papers published in Berlin Klinische Wochenschrift,
28:929, 1891, and 32:889, 1895. In that latter paper, he reports the
needles were fabricated for him by "instrumentenmacher Assman."
With rare foresight, apparently well aware of the importance of the
technique, Lewis Conner brought a supply of these needles back with
him... .
It was in the House of Relief, probably in the reception ward, where
Lewis Conner performed the lumbar puncture with his German-made needle.
His introduction of this technique could not have been more timely
[as] ... "epidemic meningitis was an important disease at the
turn of the century."11
Conner has not had a biographer to date. However, his many
contributions to the study, treatment, and prevention of heart disease,
the "heart movement," and the formation of heart associations (in
particular, the American Heart Association) provide us with important
chapters in 20th century US medicine.
Those who knew him and worked with him left us with varied titles and
descriptions: clinician, teacher of medicine, professor and chairman,
master of the art and science of physical diagnosis, leader in the
heart movement, public health cardiologist, president, editor-in-chief,
a man of integrity. The language and descriptions contribute bits,
pieces, and fragments to the Conner mosaic. In the end, however, it is
Thompson's salute that brings us closest to the essence of the man:
the revered "Chief," the superb clinical teacher with whom service
was "such a great joy."
Appendix 1
The Conner Bibliography
Duplicate publication is present in several instances; this
involved papers presented at meetings of organizations that
then published transactions of the proceedings; publication in multiple
journals, each with a different audience, did not carry the stigma
about duplicate publication that developed later in the century. The
bibliography was assembled from the Conner files in the archives at the
New York Hospital–Cornell Medical Center, the Index
Medicus, the American Heart Journal, the
publications of the Association of American Physicians, and several
history-of-medicine bibliographies and relevant databases.
His earliest articles involved use of the "new" technology of
lumbar puncture in children and adults, his objections to a method of
treating thoracic aneurysms with a subcutaneous injection of
gelatin, and his observations on the near-fatal cardiac depressive
effects of quinine contained in "cold" medicines. Conner's
interests in clinical and pathological correlates are presented
in articles dealing with bile pigments, the causes of bronchopneumonia,
syphilis of the trachea and bronchi, and status lymphaticus.
His concerns about the acoustic limitations of the stethoscope dealt
with the use of immediate auscultation—the ear applied directly to the
chest wall—as contrasted with mediate auscultation using the
stethoscope, whereas the clinical study of heart cases in 1908
presents a broader approach to physical examination, with the
venous pulse, percussion, auscultation, and the use and limitations of
the new imaging technology, the chest radiograph and cardiac
fluoroscopy.
Graphic recordings of the disordered respiration associated
with central nervous system disease; the causes and immunologic therapy
of pneumonia; complications of typhoid fever; rheumatic fever and
rheumatic heart disease; cardiovascular syphilis;
coronary artery disease; cardiac neurosis; and
pulmonary thromboembolic disease are recurrent themes.
His concerns were frequently well ahead of the time. Conner recognized
the value of the laboratory in medical practice and suggested
requirements for minimal standards of commercial clinical laboratory
accuracy in 1923. He also recognized the need for a "truer
perspective" between laboratory aids and the older bedside methods of
clinical observation and careful deductive reasoning.
His later publications dealt with focal points in the development of
cardiology during the first half of the 20th century.
The 1930 paper on the "Natural History of Coronary
Thrombosis" was an early and extensive study of morbidity, mortality,
and survival in patients with coronary artery disease, with
attention to the effects of age, sex, hypertension, and diabetes.
A state-of-the-art review of rheumatic fever and rheumatic heart
disease in 1937 and an extensive review article in 1939, "The Heart
and Its Disturbances," are concise presentations
of the cardiology of the day. He returned to the
subjects of thrombophlebitis and pulmonary embolic
complications in 1940 and the cardiac neuroses in 1945.
Circulation became the official journal of the American
Heart Association in 1950, the year that Conner died. The February 1951
issue of Circulation was dedicated to Lewis A. Conner as an
"expression of the respect of his colleagues."
Bibliography: Lewis A. Conner
Conner LA. A report of three cases of thoracic aneurism
treated by subcutaneous injections of gelatin. Med News.
1901;78:412–414.
Conner LA. On the causes, variations and significance of
the color of the feces. Med News. 1902;81:400–403.
Conner LA. Report of a case of almost fatal poisoning by
six grains of quinine. Med Rec (NY). 1903;63:535–536.
Conner LA. Syphilis of the trachea and bronchi: an
analysis of 128 recorded cases and report of a case of
syphilitic stenosis of the bronchi. Am J Med
Sci. 1903;126:57–95.
Conner LA. The aetiology of bronchopneumonia. N Y
Med J. 1903;78:1213–1217.
Conner LA. Acute dilatation of the stomach, and its
relation to mesenteric obstruction of the duodenum. Trans Assoc
Am Physicians. 1906;21:581–617.
Conner LA. Acute dilatation of the stomach, and its
relation to mesenteric obstruction of the duodenum. Am J Med
Sci. 1907;133:345–373.
Conner LA. The clinical diagnosis of status lymphaticus.
N Y State J Med. 1906;6:282–284.
Conner LA. Review of the bacteriology of acute articular
rheumatism. JAMA. 1907;48:379–381[discussion:
391–393].
Conner LA. On certain acoustic limitations of the
stethoscope and their clinical importance. N Y Med J.
1907;86:56–59.
Conner LA. On certain acoustic limitations of the
stethoscope and their clinical importance. Trans Assoc Am
Physicians. 1907;22:113–123.
Conner LA. A case of typhoid spine. Med Rec
(NY). 1908;73:668.
Conner LA. The occurrence of epileptiform attacks in
diabetes mellitus. Med Rec (NY).
1908;73:801–807[discussion: 835].
Conner LA. The clinical study of heart cases.
Am J Med Sci. 1908;135:90–96.
Conner LA, Roper JC. The relations existing between
bilirubinemia, urobilinuria and urobilinemia. Arch Intern
Med. 1908;2:532–552.
Conner LA, Roper JC. The relations existing between
bilirubinemia, urobilinuria and urobilinemia. Trans Assoc Am
Physicians. 1908;23:222–245.
Conner LA. Multiple pulmonary abscesses of obscure
origin. Med Rec (NY). 1909;75:784.
Conner LA. Biot's breathing. Am J Med
Sci. 1911;141:350–360.
Conner LA. Pulmonary symptoms as premonitory signs
of venous thrombosis. Med Rec (NY). 1911;79:753–757.
Conner LA, Stillman RG. A pneumographic study of
respiratory irregularities in meningitis. Trans Assoc Am
Physicians. 1911;26:464–485.
Conner LA, Stillman RG. A pneumographic study of
respiratory irregularities in meningitis. Arch Intern Med.
1912;9:203–219.
Conner LA. A contribution to the symptomatology of
thrombophlebitis in typhoid fever. Trans Assoc Am
Physicians. 1912;27:198–236.
Conner LA. A contribution to the symptomatology of
thrombophlebitis in typhoid fever. Arch Intern Med.
1912;10:534–559.
Conner LA, Downes WA. Spontaneous rupture of the spleen in
typhoid fever, with report of a case cured by operation. Trans
Assoc Am Physicians. 1913;28:103–116.
Conner LA, Downes WA. Spontaneous rupture of the spleen in
typhoid fever, with report of a case cured by operation (splenectomy).
Am J Med Sci. 1914;147:332–344.
Conner LA. Intravenous injections of sodium
salicylate in the treatment of rheumatic affections. Med Rec
(NY). 1914;85:323–325.
Conner LA. A type of pulmonary attack simulating
primary lobar pneumonia seen in apparently healthy persons and caused
by pulmonary embolism and infarction from a latent venous
thrombosis. Transactions of the International Congress in
Medicine, London. 1914;section 6, medicine part 2:45–58.
Conner LA. A pulmonary attack simulating primary
lobar pneumonia, caused by pulmonary embolism and infarction
from a latent venous thrombosis. Arch Intern Med.
1914;13:349–360.
Conner LA. Intravenous use of sodium
salicylate in rheumatic fever. Med Rec (NY).
1915;87:710–701.
Conner LA. A case of recurrent fever from rheumatic
infection without articular manifestations. Med Rec (NY).
1915;87:755.
Conner LA. Trade training and employment for cardiacs: the
"Sharonware" shop and its workers. Am J Care
Cripples. 1917;5:203–205.
Conner LA. Cardiac diagnosis in the light of experiences
with army physical examinations. Am J Med Sci.
1919;158:773–782.
Conner LA.. Cardiac diagnosis in the light of experiences
with army physical examinations. Trans Assoc Am Physicians.
1919;34:141–153.
Conner LA. The symptomatology and complications of
influenza. JAMA. 1919;73:321–325.
Conner LA. Heart disease as a public health problem.
JAMA. 1920;74:1564–1566.
Conner LA. Thrombosis. In: Nelson Loose-Leaf
Medicine. London/New York: Nelson; 1920;4:559–589.
Conner LA. Embolism. In: Nelson Loose-Leaf
Medicine. London/New York: Nelson; 1920;4:590–608.
Conner LA. The value to the community of organized effort
to control heart diseases. Trans Coll Physicians Phila.
1921;54:53–63.
Conner LA. Experiences in New York Hospital with the
treatment of lobar pneumonia by a serum-free solution of pneumococcus
antibodies. Trans Assoc Am Physicians. 1922;37:387–404.
Conner LA. Experiences in New York Hospital with the
treatment of lobar pneumonia by a serum-free solution of pneumococcus
antibodies. Am J Med Sci. 1922;164:832–846.
Conner LA. Cardiovascular section. In:
Lynch C, Weed FW, and McAfee L. The Surgeon General's
Office: The Medical Department of Unites States Army History in World
War. 1923;1:377–381.
Conner LA. The relation of laboratory aids to the practice
of medicine and surgery. JAMA. 1923;81:871–873.
Conner LA. The prevention of cardiac diseases.
Health News (Albany, NY). 1923;18:293–304.
Conner LA. The American Heart Journal.
Am Heart J. 1925;1:115–116. Editorial.
Conner LA. Framboesia Tropica. In: Osler W, ed.
Modern Medicine. Its Theory and Practice. Philadelphia/New
York: Lea & Febiger; 1925;2:462–475.
Conner LA. On the diagnosis of pericardial effusion with
special reference to physical signs on the posterior aspect of the
thorax. Am Heart J. 1926;1:421–433.
Conner LA. Note on the occurrence of an unusual form of
gallop rhythm. Am Heart J. 1927;2:514–517.
Conner LA. Note on the occurrence of an unusual form of
gallop rhythm. Trans Assoc Am Physicians.
1927;42:66–69.
Conner LA. The rehabilitation of cardiac patients through
organized effort. JAMA. 1927;89:496–500.
Conner LA. Atypical clinical forms of trichiniasis.
Ann Intern Med. 1929;3:353–359.
Conner LA. The psychic factor in cardiac disorders.
JAMA. 1930;94:447–452.
Conner LA, Holt E. The subsequent course and prognosis in
coronary thrombosis: an analysis of 287 cases. Am
Heart J. 1930;5:705–719.
Conner LA. Presentation of a case. Am
Heart J. 1931;7:117–118. Abstract.
Conner LA. An historical sketch of the Cornell University
Medical College. Cornell University Medical Center Opening Day Address;
1931.
Conner LA. A discussion on the role of
arterial thrombosis in the visceral diseases of middle
life, based upon analogies drawn from coronary thrombosis.
Am J Med Sci. 1933;185:13–21.
Conner LA. Development of knowledge concerning role of
syphilis in cardiovascular disease (Frank Billings
Lecture). JAMA. 1934;102:575–581.
Conner LA. Comments upon certain aspects of rheumatic
fever and rheumatic heart disease. N Engl J Med.
1937;217:503–507.
Conner LA. The heart and its disturbances. In:
Lanza AJ, Goldberg JA, ed. Industrial Hygiene. New York, NY:
Oxford University Press; 1939:111–171.
Conner LA. Thrombophlebitis and its pulmonary
complications. N Engl J Med.
1940;222:125–130.
Conner LA. An intern fifty years ago. Cornell Univ
Med Coll Q. 1941:7–8;14–15.
Conner LA. Cardiac neuroses. In: Stroud WD, ed.
Diagnosis and Treatment of Cardiovascular
Disease. 2nd ed. Philadelphia, Pa: FA Davis Co;
1941;1:196–207.
Conner LA. Charles Nicoll Bancker Camac, 1868–1940.
Trans Assoc Am Physicians. 1941;56:13. Obituary.
Conner LA. The heart in fat embolism. J Mt Sinai
Hosp N Y. 1942;8:454–458.
Conner LA. James Ewing, 1866–1943. Trans Assoc Am
Physicians. 1944;58:21–23. Obituary.
Conner LA. Cardiac neuroses. In: Stroud WD, ed. Diagnosis
and Treatment of Cardiovascular Disease. 3rd ed.
Philadelphia, Pa: FA Davis Co; 1945;1:225–236.
Conner "In Discussion"
Conner LA. In discussion of: Weiss S, David D. Rheumatic
heart disease: embolic manifestations. Am Heart J.
1933;9:114–116(45–52).
Acknowledgments
This report was supported by the Overstreet
Cardiovascular Teaching and Research Laboratory,
Division of Cardiology, The Ohio State University
College of Medicine. The author wishes to acknowledge Mary Sprague,
Assistant Professor of The Ohio State University Health Science
Library, for verification of the Conner bibliography and Bari Yardley,
Medical Secretary, for manuscript preparation.
References
© 1998 American Heart Association, Inc.
Current Perspective
Lewis Atterbury Conner
Appreciation and Bibliography
Key Words: American Heart Association • Conner, Lewis Atterbury
).
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Figure 1. The Conner chronology. ). W. Gilman Thompson, also a graduate
of Sheffield Scientific School at Yale, with an MD from Columbia
University College of Physicians and Surgeons in 1881, had been
Professor of Medicine at Cornell from 1898 until 1916. When Conner
succeeded Thompson as Professor and Chairman of Medicine in 1916, the
Department of Medicine also included the Russell Sage Institute of
Pathology affiliated with the second medical service of Bellevue
Hospital, the Cornell Division. As described by
Harvey,2 the faculty roster included a cross
section of fine clinical investigators who contributed to the excellent
research productivity of the department in the 1920s. With the
opening of the "new" New York Hospital–Cornell Medical Center in
1932, Eugene F. DuBois replaced Conner as Chairman of the Department of
Medicine.
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Figure 2. The young Lewis Conner. Courtesy of the National
Library of Medicine. ). His editorial entitled "The
American Heart Journal" appeared in the first issue of that
publication in October 1925, expressing his views of the role of the
new journal, with a focus on the "newly awakened" widespread
interest in circulatory diseases and the preventative aspects and
public health relations of heart diseases.7 He
cited 2 distinct motivating forces for a new journal. One was the need
for a periodical covering the diseases of the heart and the
circulation. The other was the conviction that such a journal would be
a potent factor in the furtherance of the aims and goals of the
American Heart Association, "for the better education of the medical
profession in matters relating to the diagnosis, treatment and
prevention of heart diseases is the first essential step in the
campaign against these diseases."7 Clinical
studies, special research, and public health aspects were important
subjects to be covered in the American Heart Association
publication.
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Figure 3. The mature Lewis Conner. Courtesy of the Medical
Archives, New York Hospital–Cornell Medical Center. ).
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Figure 4. William Paul Thompson. Personal collection of
Charles F. Wooley, MD. ).
Traffic was cleared by the clanging of a gong mounted on the outside of
the ambulance and activated by the driver by pumping a lever
back and forth. The speed achieved was probably 10 miles per hour, less
going uphill.
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Figure 5. New York Hospital Ambulance. Courtesy of Medical
Archives, New York Hospital–Cornell Medical Center. ). Dr Conner always heard more
than his staff. In my more mature years, I have often suspected he may
have been more influenced by tactile than auditory sensations, much as
was the case of Helen Taussig, also quite deaf.
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Figure 6. Lewis Conner: Immediate auscultation. Courtesy of
the Medical Archives, New York Hospital–Cornell Medical Center.
Dickinson W. Richards, distinguished American physician,
cardiopulmonary physiologist, and Nobel Laureate, gave the
Conner Memorial Lecture in 1953, and recalled Conner: "... he
was, throughout his long life, primarily a clinician and a teacher of
medicine ... a master in the art and science of physical
diagnosis ... held firm to the belief that new advances should
support and add to our simpler forms of knowledge, rather than replace
them; that in the analysis and treatment of disease, laboratory
findings, whatever their nature, should be our servants and not our
masters."10 
]. One
of the few details about his career that Dr Conner ever told me
personally was said hesitatingly, almost sheepishly. He said he thought
he had performed the first lumbar puncture on a living man on this
continent.
Conner's written legacy was modest compared with his influence
on colleagues, students, institutions, and organizations. The
bibliography, an admixture reflecting Conner's wide range of medical
interests, mirrors the development of a US-educated clinician with the
benefit of postgraduate experiences in Vienna, Munich, and Heidelberg.
It progresses through early 20th century clinical practice and academic
medicine in New York City and Conner's assumption of positions of
leadership in US internal medicine and cardiovascular
medicine. Several observations on his publications follow.
Conner LA. The technique of lumbar puncture. N Y
Med J. 1900;71:723–725.
Conner LA, et al. Society transactions: American Heart
Association meeting of May 26, 1925. Am Heart J.
1925;1:117–123. Discussion 120.
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