Stephen H. Weeks, MD,
an 1864 medical
graduate of the University of Pennsylvania, Philadelphia,
had a long and distinguished career. He was a man of many
and varied surgical interests. Like Warren Greene, he was
a member of the early surgical staff at the Maine General
Hospital from 1874 until 1905. He was a professor of
anatomy at the Medical School of Maine and a professor of
surgery at the Bowdoin Medical College in Portland.
He became a member of the American Surgical
Association in 1889, along with Drs Arthur T. Cabot, and
John Homans, both of Boston, Mass. He was very active in
the association and served as its vice president in 1904.
His presentations and discussions of papers at this
organization reflect wide surgical interests, a keen
intellect, and intelligent scientific curiosity. In 1907,
in a discussion on the treatment of breast carcinoma (and with
most of the participants, including Dr Halsted, advocating the
radical operative procedure), Dr Weeks "took issue with this
statement that even the Halsted operation with a
supraclavicular extension was a complete operation." He
noted that his own results with mastectomy and node
excision without removing the pectoral muscles were
better, and that he only "sometimes removed the muscles."
This would have been a most bold assertion for a surgeon
from Maine, and possibly a man ahead of his time.
Dr Weeks advocated in 1899, when
appropriate, interval appendectomy, which was not a
popular or accepted concept then. In
the 1890 proceedings discussiong long bone fractures, he
suggested "fixation of joints above and below the seats
of fractures"—an observation referred to as "the modern
sounding statement" by Hayes Agnew, MD.
That he was a thoughtful surgeon is suggested by his
comments at the 1900 meeting regarding the treatment of
carcinoma of the stomach. He argued that palliative
gastroenterostomy rather than resection was more appropriate
as "the time might come when diagnosis would improve and early
operation would result in cure, but that time had not yet
come."
Dr Weeks' interests and bibliography
extended to a variety of other surgical problems,
including gallstone disease and choledocholithiasis,
renal calculi, femoral artery
aneurysm, osteomyelitis, and
even tic douloureux. He wrote 2 papers on the surgery of the
Gasserian ganglion.
In a 1901 presentation of "Fractures and Dislocations of
the Spine," he advocated that cervical spine anterior
dislocations should be treated with prompt laminectomy
"in all such cases for the benefit of the few who might be improved"
by cord decompression.
Dr Weeks presented a paper to the American
Surgical Association in 1907 entitled, "Some Considerations
in Regard to Brain Surgery," which included the follow-up of
a craniotomy patient operated on successfully by him in 1898
at the Maine General Hospital—surely an early foray into
the infant specialty of neurosurgery.
In a symposium led by Drs Chas Mayo and A.
J. Ochsner in 1904 regarding "thyroidism" (or Grave's
disease) and the role of surgery, it is recorded "there
was a good deal of discussion, but only S. H. Weeks of
Portland introduced a new note stating there were many
cases in which medical treatment is the only plan we can
adopt," using neutral bromide of quinine, which was
"found to be a valuable remedy" in controlling the symptoms
of Grave's disease based on the observations of R. Shattuck,
MD, of Harvard Medical School in Boston.
Again, this is an early observation that
has stood the test of time. At the same meeting,
commenting on surgery for osteomyelitis of the tibial
shaft, the discussion relates that, "S. H. Weeks of
Portland, Maine seemed to understand the disease best of
all." The discussion proceeded with his comments regarding adequate
drainage.
Like many of the famous surgeons of his
day, Dr Weeks was slow to embrace Dr Lister's concepts.
In this, he diverged from his colleague at the Maine
General Hospital, Frederic Gerrish, MD. In 1889 in a
discussion of the use of drains for wounds, he said, "it
is not the province of this paper to discuss the germ
theory of disease," then further stated that he was "not a complete
convert to Listerism."
Despite this, a catholicity of surgical
interests, an inquiring and inquisitive mind, and a
willingness to question the prevailing surgical wisdom
earned for him a place in Maine's surgical pantheon. An
example of his commitment and compassion is noted in the
opening remarks on the "Sanitary Condition of the Almshouse
and the Poor of the City of Portland," read at the 1870
meeting of the Maine Medical Association:
It is certainly gratifying to know
that the members of the medical profession are
coming to realize that the preservation of health
and the prevention of disease are as important a part of
their duty as the treatment and cure of disease.
. . . No worthier object can engage the mind and
heart of the philanthropist than that which
relates to the promotion and preservation of health.
. . . If health is justly deemed an inevitable
possession to those surrounded by all the
comforts of home and friends, and all that wealth
can procure, of how much more consequence must it
be to the poor, who, homeless and friendless, seek shelter
within the walls of our public charities. . . . Too
often it is the poor, half starved poor, half
clothed unfortunate shunned, loathed, and if
sick, even viewed as a culprit; while, in many
cases at least, his poverty and sickness are the result of
his misfortune and not his fault. It is a wise
charity, therefore, that seeks to improve the
physical and moral condition of this unfortunate
class of our population.
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