Stan Musial and his frozen appendix

Last Updated on July 30, 2018 by Dave Farquhar

Cardinals beat writer Derrick Goold (who also happens to be a former classmate) dug out an interesting story about Cardinal great Stan Musial.  In 1947, he was diagnosed with appendicitis. Team doctor Robert Hyland was reluctant to recommend immediate surgery, as it would sideline Musial, the team’s best player, for nearly a month. So instead, he froze Musial’s appendix, Musial sat out five days, and played the rest of the season before having the appendix removed.

This curious, um, cure caused a lot of head shaking and questions. So I did a little digging.

I’ve spent time digging through ancient medical journals. My great great grandfather was a doctor, as were several of his brothers and brothers in law. Some of his brothers wrote in them a lot, so this sounded interesting. Maybe I’d even find something by them, I thought.

I didn’t. But searches in Google Books for words like “appendix,” “ice,” “frozen,”  and “appendicitis” turned up some interesting things. Indeed, this once was a common treatment, but when it fell out of favor, it fell hard.

In the 1890s, physicians sometimes treated appendicitis with heat or with ice, as well as anything else imaginable. Mercury, for one. Leeches and olive oil, for another. Of course, those last two things have been used to treat just about every malady, even going back to ancient times. The reference to mercury was in a harsh rebuke, so that practice wasn’t widespread at least. I suppose that, technically, cyanide would cure appendicitis too, and for the same reason as mercury.

Surgical removal was in play at the time too. Even in 1894, the Journal of the American Medical Association called appendectomy a simple, low-risk surgery. Among some doctors, that was the favored treatment, even 117 years ago.

As time went on, use of heat fell out of favor. In the first decade of the 20th century, about the time Dr. Hyland would have been in medical school, I found very few doctors talking about using heat to treat appendicitis. By then, it generally came down to ice or surgery, and sometimes they would supplement the ice with another form of treatment. Olive oil more frequently than leeches, fortunately.

The proper use of ice was a frequent topic of discussion. Some advocated prolonged exposure to the ice and some advocated using ice only in 20-30 minute increments, much like we use ice packs today to treat burns and prevent swelling.

The other tricky part was isolating the treatment area. You didn’t want to freeze everything; just the area of the appendix. I found descriptions of doctors cutting openings in various types of heavy fabric or paper, drawing a mark on the abdomen with a marker where the opening should be placed, then placing ice bags over the paper to localize the chilling effect and minimize frostbite to the surrounding area.

Given that 1940s accounts of Musial’s treatment discussed “freezing,” this suggests that Dr. Hyland utilized the prolonged approach.

Even a half-century before the treatment, there were doctors who would have taken issue with it. And by the time Musial was born, even some advocates of using ice admitted it was just a temporary treatment, though I found one doctor saying “temporary” sometimes meant 5 years, and he argued that a patient treated with ice first responded to surgery better.

After 1910, there are fewer and fewer articles advocating the use of ice. In the 1918 book A Treatise on Clinical Medicine, William Hanna Thompson says using an ice bag is effective on the first attack only.

By 1922, the American Association of Obstetricians, Gynecologists and Abdominal Surgeons was saying ice treatments didn’t cure anything, they only alleviated the pain.

So what were they saying at the time Stan Musial received this odd-sounding treatment?

It’s exceedingly difficult to find anyone saying anything positive about ice treatments for appendicitis in the 1940s. In the 1947 book Surgical treatment of the Abdomen, Frederic Wolcott Bancroft and Preston Allen Wade wrote, “The ice bag has been a time-honored remedy in treating appendicitis and peritonitis, and has done untold harm by masking symptoms through its anesthetic effect. There is no evidence that it has any favorable action…” Frank Gill Slaughter, writing in The New Science of Surgery in 1946, agreed. “A customary remedy for appendicitis has long been the application of ice caps to the abdomen, in the mistaken assumption that the appendix could be ‘frozen.’ Surgeons in general deplore this treatment…”

In a 1948 issue of the Journal of the American Medical Association, I find a review of a book dismissing the entire book because it advocated the use of ice bags to treat appendicitis. I found another book from 1948 titled A Treasury of American Superstitions that contained a description of freezing the appendix with ice bags to treat appendicitis.

So it was, at best, a controversial treatment in 1947. The consensus in the late 1940s seemed to be that this treatment was old-fashioned and risky.

Today it’s just a curiosity.

Musial survived and had a respectable (but below his career average) season. He underwent surgery in the off season to have his appendix removed, then went on to have an outstanding year in 1948, and played until 1963, before retiring to become a successful businessman.

You have to be careful when making judgments to use the standards of the day, since they didn’t know then what we know now, necessarily. But in this case, the standards of 1947 aren’t too different from today. We can recover more quickly from the surgery today, but that’s about all that’s changed.

For some reason, this worked. By “worked,” I mean Musial was able to resume his daily activities and he didn’t die. I don’t have the background to speculate about why. Perhaps those early 20th-century doctors were right, that a temporary cure can be prolonged, lasting months or years. Maybe they caught it early enough.

Maybe it was a placebo effect. Sometimes placebos work. My dad and my grandfather both used them sometimes, when they had no other choice. And so does pretty much every parent, when they kiss their children’s boo-boos.