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ObituaryWALTER EDWARD DANDY

M.D., F.A.C.S.

THE death is announced of waiter Dandy, protessorof neurological surgery at Johns Hopkins University,Baltimore. Born in 1886 of parents who came froihLancashire, he qualified in 1910 and became assistantto Harvey Cushing in the Old Hunterian Laboratoryat Johns Hopkins. At that time he worked on the bloodand nerve supply of the hypophysis, but it was not until1913-19 that he showed his powers as a surgical experi-mentalist by his observations, partly with KennethBlackfan, on intemal hydrocephalus, in which he provedin dogs that the cerebrospinal fluid was formed at thechoroid plexus, and boldly attacked infantile hydro-cephalus by excision of the choroid plexuses of thelateral ventricles. At this time also he was assessing withGeorge Heuer the value of radiography in the diagnosisof brain tumours, of which they were able to collect100 cases.The discovery of ventriculography was made in 1917,

and in the Annals of Surgery for September, 1919,Dandy has related the incident which was the starting-point of his most important work. In January, 1917,as a member of Halsted’s staff he was asked to see

a case of suspected intestinal perforation in the medicalwards at Johns Hopkins Hospital. The diagnosis hadfluctuated between typhoid fever and acute miliarytuberculosis with intestinal involvement. An operationwas (characteristically enough) " agreed upon " ; butthere were some who were not satisfied ; so on the wayto the operating-theatre they examined an X-ray filmof the chest which had been taken a few hours before,and this showed the dome of the diaphragm clearlyoutlined from the liver by a zone of free gas, whosepresence was subsequently confirmed by operation.Dandy saw at once the diagnostic advantages to beexpected from injecting air into body cavities and

photographing the X-ray appearances. In July, 1918,he published his first paper on ventriculography, and thiswas followed quickly by papers on encephalography,on the diagnosis of hydrocephalus from stricture ofthe aqueduct of Sylvius, and on the use of ventricularestimation in localisation of intracranial tumours inpatients who were too ill for ventriculography. As iswell known, ventriculography added greatly to theprecision of localisation of expanding intracraniallesions : indeed it played a major part in opening upthe field of intracranial surgery. Dandy applied it tothe diagnosis of pineal and third-ventricle tumours andwas the first surgeon to remove successfully a pinealtumour and a benign colloid cyst of the third ventricle.In each case he designed an operative approach.

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He was a dexterous and bold surgeon. He advocatedtotal removal of acoustic tumours (1922), as opposedto the more conservative intracapsular enucleation ofCushing which could usually be carried out withoutproducing facial palsy. He introduced the operationof removal of the anterior part of the frontal lobe toobtain access to basal meningiomas, and the operationof complete removal of the right cerebral hemispherefor malignant glioma producing hemiplegia. He workedout an approach to the cranial nerves in the cerebello-pontine angle through which he divided the 5th nervefor trigeminal neuralgia, the 8th nerve for aural vertigo,and the 9th nerve for glossopharyngeal neuralgia.He described prolapse of the intervertebral disk, withoperations in two cases, in 1929, and suggested thatit offered a pathological basis for sciatica; but heevidently did not follow this up at the time and thoughhe became a whole-hearted devotee of the operationlater in his life it remained for Ayer and Mixter toestablish the frequent relationship of prolapsed disk andsciatica. -

Besides devising -other operations Dandy made im-portant contributions to the study of angiomatousmalformations and other lesions of the brain. Indeed,there are few fields’ in the surgery of the central nervoussystem on which this brilliant experimenter did notleave his mark, and his volume on intracranial surgeryin Dean Lewis’s Practice of Surgery is a monument to

his originality and his power of grasping the essentials ofa problem.

In the clinical side of his work Dandy appearedto be less interested, and his writings on clinical subjectswere sometimes too dogmatic to carry conviction.He was the very antithesis of Harvey Cushing, and thisat times obtruded itself in their relations with one

another, though not in their later years. Neurosurgeonsare wont to compare the two and their contributionsto neurosurgery-the one a comparatively lonely workerinfluencing the subject mainly by his ideas developedby operative experiments ; the other always a cautiousdoctor, using the experimental method with less powerbut greater thoroughness, and irradiating his personalityover pupils in many lands. The usual conclusion isthat both types are essential to the progress of medicine.

Medical DiaryMAY 12-18

Monday, 13thMEDICAL SOCIETY OF LONDON, 11, Chandos Street. W’.1

8 P.M. Mr. J. Johnston Abraham : The Two Fothergills. (Annualoration.)

Tuesday, 14th .

ROYAL SOCIETY OF MEDICINE. 1, Wimpole Street, W.15.30 P.M. Erperimental Medicine and Th,crrspeuti,c.s. Dr. Sheila

T. Callender, Dr. J. F. Loutit : Life and Death of theRed Blood Corpuscle.

5.30 P.M. Psychiatry. Dr. C. P. Blacker, Dr. Thomas Beaton:Organisation of a Psychiatric Outpatient Service.

Wednesday, 15th -

MEDICO-CHIRUHGICAL SOCIETY OF EDINBURGH -

1.30 P.M. (Bangour Hospital.) Prof. Charles Cameron : Demon-’stration of cases.

Thursday, 16thROYAL COLLEGE OF SURGEONS, Lincoln’s Inn Fields, W.C.2 -

5 P.M. Mr. B. W. Rycroft: War Wounds of the Eye and theirTreatment. (Hunterian lecture.)

ROYAL SOCIETY OF MEDICINE5 P.M. Dermatology. Dr. R. G. Cochrane : Significance of

Cellular Changes in the Corium in the Pathology and-

Diagnosis of Leprosy. (Cases will be shown at 4 P.M.)ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 26, Portland

Place, W.18 P.M. Colonel Thomas T. Mackie : Observations on Tsutsuga-

mushi Disease (Scrub Typhus) in Assam and Burma.Friday, 17thROYAL SOCIETY OF MEDICINE

8 P.M. Obstetrics and Gynœcology. Clinico-pathological meeting.8 P.M. Radiology, Dr, S. Cochrane Shanks : Place of the

Radiologist in a National Health Organisation.TUBERCULOSIS ASSOCIATION

5 P.M. (26, Portland Place, London. W.I.) Dr. Brian Thompson:Primary Pleurisy with Effusion-Clinical and Epidemio-logical Features and After-history of 190 Cases.

8 P.m. Mr. W. T. Russell, D.sc., Dr. Norman England : Morbidityof Tuberculosis.

Births, Marriages, and DeathsBIRTHS

DAVIES.—On March 24, in Abadan, Southern Iran, the wife of Mr.E. R. Davies, F.R.C.S.—a son.

EDWARDS.—On April 30, at Leamington Spa, the wife of Lieut.-Colonel G. F. Edwards, M.B.F., R.A.M.C.—a daughter.

LING.—On April 2, at Roffey Park, Horsham, the wife of Dr. T. M.Ling-a son.

NEWSOME.—On April 27, at Tonbridge, the wife of Dr. JohnNewsome-a son.

NICHOLSON.—On April 27, in Manchester, Dr. Olive Nicholson (néeElkin), the wife of Mr. Alan Nicholson, F.R.c.s.-a daughter.

RICE.—On May 3, in London, the wife of Surgeon Lieut.-CommanderDavid Rice, R.N.V.R.—a son.

SHEPHERD.—On April 28, at Oxford, the wife of Mr. John A.Shepherd, F.R.C.S.E.—a son.

SLOAN.—On May 3, the wife of Dr. D. R. Sloan-a son.TODD.-On May 5, at Leicester, the wife of Dr. R. Nlelaren Todd-

a son.

TURNER.—On May 5, at Woking, the wife of Dr. R. W. D. Turner,O.B.E.—a son.

WATKINSON.—On April 28, in London, the wife of Dr. GeoffreyWatkinson—a, daughter.

MARRIAGES

BALL—WOODHOUSE.—On April 27, in London, Dr. Keith Ball toFrancesca Woodhouse.

CULLIS—COLLETT.—On May 4, at Charlton Kings, Hugh Cullis toDorothy Lawrence Collett (nee Millar), M.B.

DUNKLET—MOORE.—On April 26, in Edinhurgh, Ernest WeightmanDunkley, M.B., to Edith Moore.

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MIULLER—LOCHÉE BATNE.—On April 27. at Bexhill, Joseph EsmondMiller, M.C., major R.A.M.C., to Kathleen Veronica LocheeBayne.

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DEATHSDAY.-On April 27, William Frank Lydstone Day, M.B. Camb., of

Truro, Cornwall.TURNER.—On April 27, in London. Rosa Turner, L.R.C.P.E., formerly

of Gower Street, W.C.1.