AMERICAN SURGERY remarkably "flowered" during the years leading up to World War I, and "internationalization" became one of this era's underlying themes. Whereas streams of American physicians had once traveled to the great German centers of surgical learning, the trend was clearly beginning to reverse itself. It became very evident, by the increasing number of European surgeons who were visiting American medical centers, that our state of dependence on European surgical know-how was rapidly changing to one of autonomy. Between 1900 and 1914, an array of outstanding figures in European surgery made the long and what was increasingly viewed as an obligatory trip to America to encourage, envy, observe, and take part in the great surgical debates of the day.