4. Groningen, The Netherlands 1924-1940

PROFESSOR OF ORL AT GRONINGEN UNIVERSITY

In 1924 Charles Emile was appointed professor in ear-nose and-throat diseases at Groningen University. He gave his Inaugural Address on the subject of “Overgevoeligheids Ziekten der Bovenste Luchtwegen”-Hyper sensitivity diseases of the upper respiratory tracts- on Saturday 20 September 1924

Activities as a professor:
Charles Emile’s activities as ORL professor were manifold and included:

1. Conducting research, his main task.
2. Lecturing: General introduction courses on ORL diseases for medical students.
3. Training residents in becoming ORL specialists and coaching PhD students working on their dissertations.
4. Managing the ORL clinic of which he was the head, seeing patients who were referred to  him and conducting surgery when needed.
5. Reviewing ORL publications by other authors.

1. Conducting research
The result of his research during the period 1924-1939 is summarized in 291 papers, including research conducted under his supervision by his assistants and students preparing to become ORL specialist or working on their dissertations.
His clinical research was by nature directly linked with the medical problems of the patients referred to him, while his physiologic research was more fundamental of nature.

The main subjects of his clinical research were summarized by Egbert H.Huizing and Paul van den Broek (3) as follows:

• Clinical research in allergology
• Labyrinthine function based on animal experiments with Eelco Huizinga, his senior assistant
• Acoustic subjects together with the physicist H.C. Huizing.
• Bronchoscopy
• Bony tumors of the nose and sinuses

To illustrate his broad interests and wide range of activities, the following table shows the titles of a selection of the publications he had been associated with, including:

• His Inaugural Address;
• Clinical lessons: ten public lectures addressed to his peers, including ORL specialists and medical researchers in related fields;
• Dissertations of the ten PhD students who studied under him;
• Nine papers on research conducted when he was resident in Semarang, Java;
• Nine papers on acoustical subjects. In addition three of his students choose an acoustic subject for their dissertation:-Huizing H.C. Hacquebord P. and Pannekoek F.J.M

NB. H.C.Huizing, a physicist actually did his dissertation with Prof F. Zernicke, the professor in Physics at Groningen University and later Nobel price winner, with Charles Emile as co- promoter. It is to be noted that the papers written by the physicist H.C.Huizing were written under his own responsibility, while Charles Emile‘s responsibility was obviously restricted to the ORL aspects of the research conducted in the acoustical laboratory.

Overview of selected research papers, written or supervised by Charles Emile, 1924-1939  

In addition Charles Emile was involved in:

• 22 papers which he wrote originally in Dutch and which papers were afterwards submitted in a second language, either in French, German or English

• 42 papers in which he shared authorship with one or more colleagues and

• 139 papers were written by other authors under his guidance, among which:

• 79 papers by E. Huizinga, his senior medical assistant and his successor as ORL professor.

2. Lecturing: General introduction courses on ORL diseases for medical students.                      
An instruction film about the ORL training for medical students in his clinic shows that apart of following lectures, the students had to participate in a one month practical training period.

3.Training residents in becoming ORL specialists and coaching PhD students working on their thesis.
A total of 17 ORL specialists and ten PhD students graduated under his supervision. The basic ORL specialization scheme was that a resident physician joined a specialized ORL  university clinic for a two-year period. Those of the students interested in research used this period to simultaneously work on their dissertation on an ORL subject.

Below is a list of the residents who became an ORL specialist under Charles Emiles’ guidance
Seven students of the following list simultaneously worked on their PhD dissertations* during their ORL training period:

It has been reported that Charles Emile had a special gift to involve his assistants and senior students in his research activities which covered many new subjects, methods and approaches. Students found him an inspiring teacher.

Related medical issues and interests

1. Establishment of a new ORL clinic.
Soon after his appointment the University’s Managing Board allowed him to build a new clinic. This gave him an opportunity to design lecture rooms, surgery theaters and laboratories especially adapted to support the clinical and physiological research he was planning. He also designed workshops in support of these activities, in particular for developing surgery- and research tools and was fortunate to hire two very skilled amanuenses: Volckman & Kuitert, whose excellent work very much supported his research activities.

2. The development of new surgery tools. 
One of the outputs of his workshop was the development of new surgery tools. In this context therefore another of grand mother’s stories:
“Around the 1960s, twenty years after he passed away, one of his cousins Benjamins had to undergo an ORL operation. After the surgeon successfully completed the operation he asked her if she was related to the late Professor Benjamins, the ear-nose-throat surgeon. After our cousin confirmed that Professor Benjamins was her uncle, the surgeon told her that the surgery tools he had used for the operation had been designed by her uncle”.
At that time, Charles Emile’s tools were the most efficient surgery tools available. One may assume that grandfathers’ surgery tools stayed in use till the development of laser surgery for ORL.

3. Acoustic laboratory
One of the laboratories he established in his new clinic was an acoustic laboratory.
Charles Emile was one of the first ORL specialists to be interested in hearing problems. He realized that to solve some of these problems, the knowledge of the physics of sound of medical specialists was insufficient. Physicists would have to assist medical science to solve such problems. He therefore requested his colleague Dr F. Zernicke, the professor of physics at Groningen University and later Nobel price winner, to send him his brightest Ph D students. Following this Charles Emile established an acoustic laboratory with Henk.C. Huizing for this research, whereby Huizing was responsible for the relevant research in the physics of sound, while Charles Emile stimulated the research and saw to the related ORL aspects. The result of this work was presented in four dissertations- Huizing H.C.; Pannekoek F.J.M.; Haquebord P.; and Weersma P. and nine other papers on acoustic research topics.

4. Hearing deficiencies
Charles Emile was the promoter of specialized education for children people with severe hearing problems or deaf born as is shown in his paper ”The need for specialized education for children with poor hearing” (Meer bijzonder onderwijs voor het slechthoorende kind August 1935 Opera Omni No 272)
He was an active board member of the Groningen Doofstommen Instituut, a society running a school for children deaf born or with severe hearing problems.  After his death the Journal of this Institute memorized his considerable contributions in this field.

5. Promotion of the quality of swimming pool water
In Groningen Charles Emile was also promoting swimming and improving the hygienic quality of swimming pool water. He was co-initiator and commissioner of the Society “the Helper Zwembad”, a Society which operated and owned a public swimming pool in South Groningen in combination with providing central heating for the Helper quarter of Groningen town. His thoughts on this subject were summarized in a number of news paper articles on the medical significance of swimming. He was also editor and wrote introductions for text books on swimming education with his co-author R.Hoogland, 1926, which publication was reprinted in 1930. It was an update of his 1920 publication: “Swimming: A guide for swimmers and swimming education with co-author F.C.G. Duverge. In 1939 he further wrote a report on “Requirements of swimming water” for the Association of directors of public swimming pools in the Netherlands.

6. Anti-noise campaign 
Charles Emile was very concerned about the damage to hearing caused by excessive noise, in particular noise produced by vehicles and industrial equipment. He established a committee for the reduction of noise for the town of Groningen, of which he was the chairman.
To establish an objective measurement he ordered with assistance of Henk.C. Huizing a Bell & Howell Sound Level Meter from the USA, recommended by Zwikker, a professor in physics of Delft University. This equipment was used in the campaign to reduce noise. Image no 146 shows Charles Emile on his motorcycle, while Henk C. Huizing, his physicist assistant, operated the Sound Level Meter assisted by P Weersma, a resident in training for ORL

7. Medical textbooks
Charles Emile was also the author/co-author and editor of several national and international text books for medical students:

Text books in Dutch:     

• An introduction to physiology with co-author/editor: J.H.O. Reys – 1924, 2nd print 1929; 3rd print 1934; supplementary exercise book 1935

• The bronchoscope as diagnostic and therapeutic tool: 1931;

• The sense organs, part VI in: The Netherlands physiological text-book  by G. van Rijnbeek, editor: 1st edition 1940, 2nd edition 1946

Text books in German:

• Diseases caused by infections and parasites-

• Dermatosen, tropical diseases and bleedings-in Volume 4: The diseases of the air passages and the mouth. Two sections of the standard text book on: Neck, nose and ear diseases by J.F. Bergmann,  published by Springer in Berlin in 1928,  “Die Krankheiten der Luftwege und der Mundhöhle  Deel: Tl. 4: Infektionskrankheiten, pflanzliche und tierische Parasiten,   Erkrankungen bei verschiedenen Dermatosen, Tropenkrankheiten, Blutungen / bearb. von C.E. Benjamins … [et al.]  1928: Springer, Berlin Editor:  J.F. Bergmann  Handbuch der Hals-, Nasen-, Ohrenheilkunde ; Bd. 4: 774 p”

Text books in French:
Bony tumors of the nose and the sinuses, Part 31 of the monograph Oto-rhino-laryngologiques published in 1938 in Bordeaux by Delmas. “Les tumeurs osseuses du nez et des sinus: analyses en allemand et anglais / C.E. Benjamins
1938, publisher [Bordeaux] : Delmas Series Monographies oto-rhino-laryngologiques internationals no 31, 314 p”