In search of the first head and neck surgeon.

I have picked a topic quite different from those selected by previous presidents of our Society. In the past, my predecessors have chosen training, socioeconomic, political, developmental, and research aspects of our profession. It seems appropriate on this international occasion to pause to review our accomplishments in the struggle against head and neck cancer and to search for those pioneers who led the way. Ours is a relatively new specialty, formed to concentrate surgical efforts against a growing problem. As tobacco use has increased, the incidence of squamous carcinoma in the head and neck has progressed to alarming levels. Before the introduction of tobacco in Europe in the late 16th century, oral cancer was seldom mentioned in medical writings. When Henry VIII proclaimed the Act of Union between the barbers and the surgeons in 1540, the disease was apparently quite rare. Though banned for a time as a noxious weed by King James, this new product gained rapid acceptance and mouth cancer became commonplace. However, this disease was thought by many to result more from syphilis than tobacco, which was a theory that persisted into the 1940s [I], although Butlm [2], in 1900, stated that “we believe that smoking is a decided cause of the occurrence of cancer [of the tongue], not so much directly as indirectly.” As this relatively new problem increased in severity, innovative surgical pioneers appeared in succession, each adding to a growing armamentarium. The very term, surgery of the head and neck, is a relatively new one, first used by Lane [3] in 1888 for a textbook of that name, covering neurosurgery, otolaryngology, and ophthalmology. Modern refinements of this term were delayed