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Become a member and receive career-enhancing benefits
Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.
How the ACS Shaped Surgical Cinema and Preserved a Century of Medical Films
Michael C. Trotter, MD, FACS
September 2, 2026
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Dr. Hilger Perry Jenkins, 1960
The phrase “movies for surgeons” may evoke classic medical dramas such as 1937’s Internes Can’t Take Money, 1970’s M*A*S*H, or 2004’s Something the Lord Made.1-4
Although these films portray real people or events, this article focuses on motion pictures produced specifically for medical education, including Diagnosis and Treatment of Infections of the Hand, Gangrene Bowel Resection, and Gallstone Ileus.5-7
The history of the ACS film program encompasses its leadership in the medical film community, an initial preservation success, and current efforts to digitize the remaining works from the former ACS motion picture library.8-13
The use of motion pictures to teach surgery dates to 1898, when French surgeon Eugène-Louis Doyen had himself filmed performing a craniotomy and a hysterectomy. In July of that year, he screened the films in Edinburgh, Scotland, for the British Medical Society. In October, he held public screenings in France, reportedly marking the first public presentation of surgical films.14-18 A competing claim involves a below-the-knee amputation performed by German surgeon Ernst von Bergmann and filmed by German cinema pioneer Oskar Messter.17
The following year, Argentine surgeon Alejandro Posadas filmed the removal of a pulmonary hydatid cyst, a milestone for which one author recently claimed historical priority.19 Historical consensus, however, generally favors Dr. Doyen rather than Dr. Posadas as the first to use film for this purpose.
In 1912, Rudolph Matas, MD, FACS, an ACS founder and former vice president of the organization, endorsed the medium in his presidential address to the Southern Surgical and Gynecological Association. During the address, he showed several films by Dr. Doyen that he had obtained in Paris.20 By 1914, Dr. Doyen was advocating for a “great museum of surgical art” that would preserve films of unique or difficult operations that might otherwise be lost.21
ACS Medical Motion Pictures Program
ACS Founder Franklin H. Martin, MD, FACS, recognized cinema’s potential for surgical education. Cinematographic exhibitions of operations began at the Clinical Congress in 1916 and continued the following year, with films appearing intermittently through the 1920s.8
After viewing well-produced films in Paris in 1925, Dr. Martin secured approval from the ACS Board of Regents to develop a formal program. A plan was created with support from Will H. Hays, the first president of the Motion Picture Producers and Distributors of America, and ACS cofounder J. Bentley Squier, MD, FACS, the 16th President of the ACS.8-9,11,22
The ACS Board on Medical Motion Pictures was approved on October 26, 1926.8,11 Its goals included surveying existing films, identifying appropriate subjects, establishing production standards, and creating a noncommercial clearinghouse at the ACS.8
Hays enlisted George Eastman, president of the Eastman Kodak Company, to support the initiative, leading to a collaborative arrangement between the ACS and the company.8-10 The first film developed through the program, Diagnosis and Treatment of Infections of the Hand, was produced by Allen B. Kanavel, MD, FACS, an ACS cofounder and later President, in association with Sumner L. Koch, MD, FACS. The film premiered at the 1927 Clinical Congress.
Through rigorous review, approval, and cataloging processes, the ACS quickly assumed a leadership role in surgical film education. Its endorsement became highly sought after. Following Eastman Kodak’s departure from the program in 1931 and George Eastman’s death in 1932, longtime ACS Secretary Eleanor K. Grimm assumed responsibility for coordinating the program.8-9,11
“Approved, Issued, and Passed” – Seals of Approval
The College then shifted away from film production and concentrated on reviewing, approving, and cataloging films. Medical film production companies emerged, as did film departments within pharmaceutical companies, surgical equipment manufacturers, and other organizations. Most sought ACS endorsement.5
The number of films shown at Clinical Congress increased during the 1930s and 1940s, largely replacing live “wet clinics.”11 During World War II, the ACS partnered with the US Department of State to provide teaching films to South America. The ACS also produced two nursing recruitment films during this time, White Battalions and R.N.—Serving All Mankind, with support from the military and industry.8-9,11
In 1948, Grimm announced that she planned to retire in 1951 and recommended reorganizing the Motion Picture Department. H. Perry Jenkins, MD, FACS, was appointed chair of the Committee on Medical Motion Pictures in 1950 and served until 1966.8-10 Dr. Jenkins has been credited with contributing more to the program than any other individual.11
Under his leadership, and with support from Davis & Geck, a medical device and surgical suture manufacturer founded in 1909, several prominent film initiatives were introduced: Cine Clinic in 1950, the Motion Picture Symposium in 1952, and Spectacular Surgical Problems in 1954.5,11 By 1961, the approved film list contained 884 titles across 18 major categories.5
Michael E. DeBakey, MD, FACS, became the committee’s archivist and bibliographer in 1962 because of his interest in archival materials held in the ACS Film Library and his interest in providing cardiovascular surgery films from Baylor University to the library.5 No major effort to preserve the library’s historic films, however, appears to have been undertaken at that time.
In 1963, Dr. Jenkins updated the program’s policies. The ACS discontinued its approval program and film lists and cooperated with the American Medical Association (AMA) on cataloging the films. In 1970, C. Rollins Hanlon, MD, FACS, who later served as ACS President, presented 22 Cine Clinic films produced from 1951 to 1969 to the National Library of Medicine. He described the collection as “a superb historical treasure” of “incalculable value.”5
By the mid-1970s, ACS archivist George W. Stephenson, MD, FACS, recognized that the films were deteriorating and faced the possibility that they would need to be discarded. No preservation action was taken. The historic value of the collection prompted further discussion in 1986, but preservation efforts were again sidelined as video technology advanced.5
Davis & Geck became the distributor for the ACS Film Library in 1972 and merged its library with that of the College. Cine-Med assumed management in 1992, and US Surgical Corporation became the sole sponsor in 1996.5 Although the technology has changed, “visual education in surgery” and “learning by seeing” remain ACS priorities.
The ACS, Dr. Nichtenhauser, and the Medical Film Institute
The ACS led surgical teaching film efforts in the US by combining cinematic standards with surgical expertise, qualities the commercial film industry could not independently replicate. This combination positioned the College as a gatekeeper for high-quality surgical teaching films.
The College’s interactions with the broader and less-organized medical film community are illustrated by its relationship with a little-known but highly regarded physician.
Born in Vienna in 1903, Adolf Nichtenhauser, MD, developed a profound interest in film during the 1920s. He studied motion-picture technology before receiving his medical degree from the University of Vienna in 1931. Following a rotating internship, Dr. Nichtenhauser served as a staff and attending physician at several hospitals in Vienna while also working as a film reviewer, critic, correspondent, producer, editor, and educational film programmer. Persecuted under Nazism, he fled Austria and arrived in New York in 1939.23-24
Dr. Nichtenhauser applied for US citizenship, which he obtained in 1944. During this period, he dropped “Adolf” and began going by “Nick.” His parents remained in Europe and died at the Treblinka death camp in 1942.24
He subsequently undertook a series of short-term contracts and consulting assignments with government agencies involved in health and medical films. Through this work, he had three notable interactions with the ACS.
In November 1941, during the ACS Clinical Congress in Boston, Dr. Nichtenhauser reviewed 102 ACS-approved films for the American Film Center. He identified cinematic shortcomings, including poor image quality, insufficient animation, and failures to show pathology and patient outcomes. As a nonsurgeon, he declined to evaluate surgical technique or propose operative modifications.23
Eleanor K. Grimm and Dr. Malcolm MacEachern, 1950
The following year, Dr. Nichtenhauser served as secretary of an AMA planning group focused on the development, production, and use of medical films. Malcolm MacEachern, MD, FACS, a former ACS Co-Executive Director, also participated.
During one planning meeting, Dr. Nichtenhauser presented a detailed assessment of the medical cinema field, while Dr. MacEachern described the scope and comprehensiveness of the ACS program. The group viewed the ACS film program favorably for surgical subjects but considered it less applicable to nonsurgical material. No definitive action emerged from the meeting. During the remaining war years, however, the need for—and perceived value of—medical training films expanded dramatically.23
In 1946, the federal government established the US Interdepartmental Committee on Medical Training Aids. The committee included representatives from the Army, Navy, Veterans Administration, and US Public Health Service and reportedly had a budget of $3 million.8
Dr. Nichtenhauser was involved early in developing the rationale, prospectus, and budget for a centralized medical film center. In 1947, the Association of American Medical Colleges (AAMC) was invited to join the committee and establish the Medical Film Institute (MFI).
As a member of an AAMC workgroup, Dr. Nichtenhauser proposed a plan addressing film use, cataloging, distribution, medical film training, and international outreach. He also produced much of the documentation needed to govern the new organization. He emphasized that the MFI “is a film agency serving medicine rather than a medical agency dealing with films.” In early 1948, the AAMC selected David S. Ruhe, MD, to direct the MFI when the organization was formally established.23
As Johnson & Johnson’s support of the ACS film program ended, Dr. MacEachern and Grimm became interested in the government initiative. Grimm was authorized to represent the ACS in the exploratory venture.
A few months later, she spent a week in Washington, DC, meeting with committee members and discussing potential ACS collaboration. Upon returning to Chicago, she reported that “the ACS will, in my opinion, be in the foreground of the medical motion picture production program and will receive as much credit in every film in which it has a part on the cooperative basis (with the government assuming all production responsibility).”
ACS advisors, she reported, would be compensated “on the basis of a consultant’s fee of from $40 to $50 per day, plus $6 per day maintenance, plus any travel expense that may be involved”—approximately $590 to $740 per day in today’s dollars.8
By 1948, Dr. Ruhe was actively advocating for the MFI’s launch. The organization also represented a potential employment opportunity for Dr. Nichtenhauser. In correspondence between Drs. Ruhe and Nichtenhauser, Dr. Ruhe described time spent at the AMA discussing the MFI “both above and below the board.” He also wrote about cataloging work that would provide income for the institute, suggesting they “make them [‘potential foes’] do the scut work of the cataloging job while we preempt the cream.” Regarding the ACS collection, he proposed that they “force Grimm to review again from scratch the ACS films.”23
A year later, the AAMC’s Medical Film Institute opened at the New York Academy of Medicine. Dr. Nichtenhauser first served as a temporary consultant and became an MFI staff member in 1950.23 Although he possessed exceptional knowledge of medical films and was respected for his wide-ranging expertise, he also gained a reputation among some employers and colleagues for being difficult and alienating.24
Throughout 1949, ACS leaders engaged in considerable discussion about the College’s potential role in the MFI. By October, the institute’s funding was uncertain, and it was seeking grants to produce a comprehensive medical film catalog. The catalog, which would be sold by subscription to medical schools, hospitals, medical societies, and other professional organizations, was expected to become the MFI’s primary source of income.
The ACS ultimately declined to participate.8 The College would have been limited to an advisory role on selected projects, and its leaders decided not to place the organization’s considerable experience, knowledge, and capabilities at the disposal of an institute with uncertain finances.
Between 1948 and 1949, Grimm devoted considerable time to defining and developing a possible ACS role in the MFI. She also would have been familiar with the views of the surgeon leaders with whom she worked. Whether these circumstances influenced her decision to step away from the ACS film program is unknown.
During this period, Dr. Nichtenhauser was researching and writing a manuscript titled “A History of Motion Pictures in Medicine,” which he hoped to publish as a book.23 His work on the manuscript brought him into direct contact with Grimm.
In March 1949, while both were in Washington, DC, Dr. Nichtenhauser discussed with Grimm “the first film project of the American College of Surgeons, of 20 years ago.” Their correspondence over the following months provided him with the information needed to produce the first historical study of the ACS film program, which became part of his manuscript.23
His “story of the College of Surgeons films” noted that “the film project of the College and Eastman Kodak was the first large-scale attempt at teaching film production by a medical organization.”23
Dr. Nichtenhauser did not live to see his manuscript published. He died in November 1953, “after a short, violent illness,” at age 50. Three months before his death, Dr. Ruhe had described him as “the most knowledgeable reference person in medical films today.”
His wife, Margaret, donated his papers to the Armed Forces Medical Library in 1954 and worked through 1955 to secure publication of the manuscript, but her efforts were unsuccessful.23 Today, the unpublished manuscript—which many consider an authoritative document—and the Nichtenhauser Papers are housed at the National Library of Medicine and are fully digitized and accessible.25
At the time, the ACS possessed considerable resources and influence. Dr. MacEachern and Grimm were familiar with Dr. Nichtenhauser and his work, but a sustained professional collaboration between the College and this medical film pioneer never came to fruition.
Dr. Hugh A. Gamble, (1876–1954)
Gamble Films
One of the clearest examples of ACS film preservation involves the collection of Hugh A. Gamble, MD, FACS (1876–1954), a general surgeon from Greenville, Mississippi, and an original Fellow of the ACS.
From 1937 to 1951—primarily during the 1940s—Dr. Gamble collaborated with a local professional photographer to produce educational surgical films, which he presented at professional meetings.26-27
In 2004, Hugh A. Gamble II, MD, donated his grandfather’s collection to the ACS. Because the films had been stored in closets and an attic for several years, it was unknown if they were salvageable. Once the films arrived at the ACS, the high cost of archival preservation prevented moving ahead with the project.
An opportunity emerged in 2010, when University of Chicago PhD candidate Caitjan Gainty was working as a research assistant on the ACS Centennial project. She also was involved in a separate project examining medicine and science in film and was collecting archival films in Chicago for digitization.
Gainty included Dr. Gamble’s films in the project and collaborated with Andy Poulos, a colleague in the university’s audiovisual department. Poulos digitized the films at no cost, completing the work in 2012. Item-level descriptions of the films were added to the ACS Archives bibliographic database, and the digital files are available for scholarly research at ACS Headquarters in Chicago.28
Original 16-mm Gamble Films
ACS Film Digitization Project
Digital technology has rendered motion-picture film and videotape largely obsolete. Yet the visual records they contain (of anatomy, open surgical techniques, and historic procedures) retain immense educational and historical value.
Preserving content that otherwise would deteriorate and become inaccessible allows these films to inform the broader history of surgery, document the contributions of the ACS, and sustain the legacies of prominent surgeons.
In 2022, Davis & Geck sent 674 films to the ACS, most of them on U-matic, an analog cassette-based videotape format. The materials were placed in off-site storage.
The ACS Film Digitization Project began in January 2025. With support from the ACS History and Archives Committee, Michael Beesley, Archivist in the ACS Division of Member Services, managed the conversion of 100 tapes. Discussions are ongoing about incorporating the remaining tapes into a larger project that would preserve their educational and historical value.
The ACS has a rich history in medical film. Its program began as a noncommercial initiative that provided a highly sought-after indicator of quality through the College’s seal of approval. Dr. Nichtenhauser was the first historian to document the ACS’s important role in the development of medical cinema.
Digitizing surgical films preserves unique resources for historical study, education, and research. The ACS already has demonstrated that such preservation is possible through its work with the Gamble collection and the first phase of its current digitization initiative.
Building on these successes, the century-old legacy of surgical cinema offers the College another opportunity to safeguard historically significant materials and make them available to future generations.
Dr. Michael C. Trotter is a retired cardiothoracic and vascular surgeon. He was the recipient of the 2024–2025 ACS Archives Fellowship in surgical history.
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McCabe K. Like something the Lord made. Washingtonian. August 1989.
American College of Surgeons. Medical Motion Pictures Collection. RG5-SG2-SS2-S2. American College of Surgeons Archives; Chicago, IL.
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Stephenson GW. American College of Surgeons at 75. American College of Surgeons; 1990.
O’Shea J. Motion pictures and the College: A history of “learning by seeing.” Bull Am Coll Surg. 2003;88(8):17–23.
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Nahrwold DL, Kernahan PJ. A Century of Surgeons and Surgery: The American College of Surgeons, 1913–2012. 2012. American College of Surgeons.
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Nichtenhauser A. A History of Motion Pictures in Medicine. Unpublished typescript. Circa 1950. Adolf Nichtenhauser History of Motion Pictures in Medicine Collection, MS C 380. Archives and Modern Manuscripts Collection, History of Medicine Division, National Library of Medicine; Bethesda, MD.
Almada TN. First filmed surgery sparks new era of medical cinema. Bull Am Coll Surg. 2026;111(3):40–45.
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Cantor D. Adolf Nichtenhauser and the history of medical film. Med Hist. 2026; 70(1):94–119.
Bonah C, Cantor D, Laukötter A. Introduction. In: Bonah C, Cantor D, Laukötter A, eds. Health Education Films in the Twentieth Century. University of Rochester Press; 2018.
Trotter MC. Hugh Agnew Gamble, MD, FACS: A legacy to the College. Bull Am Coll Surg. 2014;99(12):44–48.
Trotter MC. The Colored King’s Daughters Hospital of Greenville: A history. J Miss State Med Assoc. 2024;65(2):56–85.
Barber D. Arch Desc Number 165: Hugh A. Gamble Surgical Operation Films: Administrative/Biographical History, Scope and Content, Arrangement/File Inventory, Non-Paper Formats, Physical Condition, and Notes. American College of Surgeons Archives; 2013:1–5.
