Skip to main content

Full text of "Animal experimentation and medical progress"

See other formats


This is a digital copy of a book that was preserved for generations on library shelves before it was carefully scanned by Google as part of a project 

to make the world's books discoverable online. 

It has survived long enough for the copyright to expire and the book to enter the public domain. A public domain book is one that was never subject 

to copyright or whose legal copyright term has expired. Whether a book is in the public domain may vary country to country. Public domain books 

are our gateways to the past, representing a wealth of history, culture and knowledge that's often difficult to discover. 

Marks, notations and other maiginalia present in the original volume will appear in this file - a reminder of this book's long journey from the 

publisher to a library and finally to you. 

Usage guidelines 

Google is proud to partner with libraries to digitize public domain materials and make them widely accessible. Public domain books belong to the 
public and we are merely their custodians. Nevertheless, this work is expensive, so in order to keep providing tliis resource, we liave taken steps to 
prevent abuse by commercial parties, including placing technical restrictions on automated querying. 
We also ask that you: 

+ Make non-commercial use of the files We designed Google Book Search for use by individuals, and we request that you use these files for 
personal, non-commercial purposes. 

+ Refrain fivm automated querying Do not send automated queries of any sort to Google's system: If you are conducting research on machine 
translation, optical character recognition or other areas where access to a large amount of text is helpful, please contact us. We encourage the 
use of public domain materials for these purposes and may be able to help. 

+ Maintain attributionTht GoogXt "watermark" you see on each file is essential for in forming people about this project and helping them find 
additional materials through Google Book Search. Please do not remove it. 

+ Keep it legal Whatever your use, remember that you are responsible for ensuring that what you are doing is legal. Do not assume that just 
because we believe a book is in the public domain for users in the United States, that the work is also in the public domain for users in other 
countries. Whether a book is still in copyright varies from country to country, and we can't offer guidance on whether any specific use of 
any specific book is allowed. Please do not assume that a book's appearance in Google Book Search means it can be used in any manner 
anywhere in the world. Copyright infringement liabili^ can be quite severe. 

About Google Book Search 

Google's mission is to organize the world's information and to make it universally accessible and useful. Google Book Search helps readers 
discover the world's books while helping authors and publishers reach new audiences. You can search through the full text of this book on the web 

at |http: //books .google .com/I 

!\ " ..V... V>\v\ . ^ 










WiiOJAM v/iLdJ-OJiia jsJiiCiiy, Ja.i>., lLjd, 




(If HftiRfflc 9ttU tutMbft 






ntoTBMOB mxKmiB of auaamxr, nrwEuon u 






21 UUHI937 

»4 ^.5>'\^\'V-2 - 


Publishgd Novemb4r IQ14 


I HAVE been so frequently asked by earnest inquirers 
after truth for information as to animal experimentation, 
and especially for my own publications, that I have con- 
cluded to publish these papers in a more permanent and 
accessible form than in medical and other journals. My 
thanks are due to the editors and publishers of the journals, 
etc., in which these papers first appeared, for permission 
to republish them in this volume. 

The papers appear in chronological order. Hence it is 
important that all their statements of methods, results, 
and statistics should be considered in connection with the 
date of the publication of each paper. In some cases I have 
given in footnotes later information and statistics. 

One rather serious objection to rq)ublishing these papers 
in full and just as th^ were written is that there is consid- 
erable repetition. But it must be remembered that th^ 
were published or delivered at various times in many 
years and that they were read or heard by very different 
sets of readers or hearers. Naturally I wished each address 
or paper to be complete in itself. Moreover, a potent reason 
for the repetitions is that they were intended to meet the 
constantly repeated misstatements by the opponents of 
experimental research in spite of public exposure of these 
misstatements. This is well illustrated by the case of 
Dr. Wentworth, which is fully stated on pages 274-878. 

I have frequently used the word ''vivisection.'' It is 
very objectionable, however, for its meaning is usually 
extended to cover experiments on the effects of the varied 
and difficult problems connected with nutrition and 
physiological chemistry; experiments to determine the 
effects of ''drowning," whether the submersion be of longer 


or shorter duraiion, fatal or non-fatal» and the value of 
various methods of resuscitation; hypodermic injections of 
various drugs, etc. None of these involve any ** cutting 
of a living animal'* as ''vivisection'* actually means. Only 
about six per cent of all the experiments on animals in 
England (and the same percentage would hold good of 
America) are strictly ''vivisections," and over one half of 
these animals were kiUed before regaining consciousness. 

Every surgical operation is literally a "human vivisec- 
tion." In such operations we always take it for granted 
that an anesthetic has been used, even though no mention 
of it is made by the operator. 

But the "antivivisectionists" constantly quote descrip- 
tions of operations on animals omitting all mention of the 
anesthetic, and, therefore, lead their readers to believe that 
they were done wUhoiU an anesthetic. Yet in the very 
papers from which these descriptions are taken the authors 
distinctly state that an anesthetic vxia given. 

In their leaflet entitled "The Anesthetic Delusion," for 
example, experiments by Crile are thus quoted: — 

Other experiments are described such as "tearing and twisting 
the sciatic nerve"; "extirpation of an eye and rude manipulation 
and bruising of the socket"; "forcing air and then water into the 
stomach, causing its gradual complete dilation, and its final 
bursting." — Prom " Surgical Shock," by Dr. Crile. 

No mention is made of any anesthetic. Yet every one 
of these animals was anesthetized. 

A still more flagrant instance occurs in a letter by Mrs. 
Henderson, vice-president of the American Antivivisection 
Society,* in whidi she asserts that "Dr. Crile*s book . . . 
repeatedly describes experiments followed by the words 
'no anesthesia.' " Dr. Crile answered this charge by saying 
that in not a single instance do these words appear in his 

^ Philadelpliia Ledger, December 19, 1918. 


After a careful examination d( the book mysdf > I could 
find no such words anywhere. On the contrary, I found 
that Dr. Crile alluded some forty times to the anesthetic 
given to the animals, and on pages 187 and 140, two sec- 
tions appeared covering a page and a half with the heading, 
in capitab, "ANiESTHESIA.'' 

Besides this, on page 14 of the same book, it is distinctly 
stated that ''In idl cases the animals were anesthetised, 
usually by the use of ether, occasionally by chlcnof orm, 
either alone or with ether. In a few cases curare and mor- 
phine were used.^' 

I have four times written Mrs. Henderson and dial- 
lenged her to give me the pages on which these words 
appeared, but though these pages were explicitly promised, 
she has failed to send them. ''Harper's Weekly'' tat May 
16, 1914 (page 18), states that Mrs. Henderson had prom- 
ised the editor "months ago" to specify these pages, and 
had been reminded of the promise several times, but no 
such information had been furnished him. 

How the profession esteems Dr. Crile b shown by his 
most recent honor — the award to him of the American 
Medicine Gold Medal for 1914, as the American physician 
who, in the judgment of the trustees, has performed the 
most conspicuous and noteworthy service in the domain of 
medicine and surgeiy. 

In my paper on "The Influence of Antivivisection on 
Character" in this vdume, I have shown how false is the 
assertion that "light anesthesia" means "sensibility to 
pain." Eveiy bui^ surgeon, in countless operations on 
human beings, knows that patients often strug^e when the 
first incision is made, showing that the anesthesia is not 
de^ enough to prevent muscular response. Yet, even 
though the struggles may have been veiy vident, the pa- 
tient on returning to consdouaness has been in entire 
ignorance even that an operation has been done. 

Operations done on animals before even the discovery of 


anesthesia by ether (first publicly used on October 16, 
1846) are described by the antivivisectionists without 
stating the date or the fact that anesthesia was then un- 
known, and the reader, unversed in medical history, sup- 
poses that these operations are done at the present time. 

In no illustration by drawing, photograph, painting, or 
model shown at the antivivisection exhibitions have I ever 
seen the representation of an etherizer administering an 
anesthetic. Such illustrations are utterly untrustworthy 
and misleading. Even impossible operations are shown as 
though they were commonly done, instead of being simply 

One of the commonest assertions of the antivivisection- 
ists is that all experiments are done behind ''dosed doors," 
locked and barred, and guarded against the intrusion of 
any outsider. Dr. R. M. Pearce, of the University of 
Pennsylvania,^ has fully answered this. I can only quote 
one paragraph: — 

At an exhibit of the American Antivivisection Society two 
years ago. Dr. Allen J. Smith, then Dean of the Medical School, 
in conversation with Mrs. Easby, offered to allow her the freedom 
of the University laboratories and animal house, and later 
(February 21, 1912) wrote Mrs. Easby reminding her of this offer. 
These invitations were of no avaQ, for no member of the Society 
has ather officially or in a private capacity visited the University 
laboratories. Despite this effort on our part, Mrs. Easby, at the 
recent exhibit, assured one of the sight-seers that entrance to 
experimental laboratories was impossible, and with this coupled 
the statement that anesthesia was not used in any of the opera- 
tions. As it happened, the young woman to whom these state- 
ments were made was our (^>erating-room nurse, who not only 
has charge of every operation, but administers the anesthetic 
and knows how frequently strangers come not cmly into the 
laboratory, but as wdl into the operating-room itself. 

It is highly diverting that the statement of Mrs. Easby, 
''that anesthesia was not used in any of the operations,*^ 

> Old Penn, January 9, 1014. 


was unknowingly made to the very young woman who was 
constantly anesthetizing these very animals! 

Dr. W. B. Cannon, Professor of Physiology in the Har- 
vard Medical School, writes me as follows: ''None of the 
doors in my laboratoiy are locked. Any one could come in 
at any moment/' 

The constantly reiterated cry of ''human vivisection" 
to rally the public against experimental research has of late 
been the chief resource of the antivivisectionists. 

In Dr. R. M. Pearce's article, ''The Charge of Human 
Vivisection as Presented in Antivivisection Literature," in 
the series of pamphlets issued by the American Medical 
Association^ there is a full consideration of the American 
cases of alleged human vivisection, and in my own papers on 
"The Misstatements of the Antivivisectionists"* the for- 
eign cases will be found. 

I may especially, however, allude to the evidence of the 
cruelty of the antivivisectionists as shown in the attack 
that has been made upon the researches of Drs. Mitchell, 
Morehouse, and myself as set forth on page 236. Ap- 
parently these cruel persons would have forbidden us to 
seek any relief for those suffering soldiers during the Civil 
War by testing the effects of any drugs upon them. For 
these humane efforts to alleviate their horrible sufferings, 
Drs. Mitchell, Morehouse, and myself are to this day held 
up to the execration of our fellows as guilty of "human 

Now let us look the facts squarely in the face. 

While animals have benefited enormously from experi- 
mental research, the chief object has been to benefit the 
human race, to diminish suffering, baffle death, and save 
the bread-winner to his family or the loved children and 
others to their relatives. In some cases a whole nation and 
the world have experienced the benefits. No better m« 
stances could be cited than the abolition of yellow fever, 

1 See list on pp. xiz, zx. . > Seei^. llOand 185. 


the total disappearance of '^hospital gangrene/' and the al- 
most total abolition of tetanus (saving in neglected cases). 
The Panama Canal has beaa made a possibility; from 
our Southern cities have beaa banished the frightful epi- 
demics of yellow fever which impoverished them by thou- 
sands of lives and millions of doUars; malaria bids|air to be 
conquered; typhoid fever, one may say, has disappeared 
from our armies and is being conquered in civil Ufe.^ 

In the papers published in this volume, I have shown 
some of the victories which have been won. How has this 
marvelous progress he&x made? I answer, *^By experi- 
ment." Go back to my early professional life fifty years 
ago. Yellow fever, malaria, hospital gangrene, tetanus, 
and typhoid were national scourges. Only three ways are 
open to lessen or abolish these and other diseases: — 

1. Try a new remedy or method or operation and try 
it^r^ on man. God forbid! 

Yet Mrs. White, the most prominent Philadelphia anti- 
vivisectionist, is a pronounced advocate of human vivisec- 

2. Try them first on the lower animals and then on man, 
provided that the trials on animals showed that th^ 
would be an improvement upon existing methods. If such 
trials on animals proved that th^ were ineffective or dan- 
gerous, then they would not be tried on man at alL 

3. Try no experiments at all either on animals or man, 
that is to say, never make any progress. 

Remember that the least deviation from the usual prac- 
tice, whether in using a new drug or even a larger or a 
smaller dose, or in a different way, is an *^ experiment." 
For instance, hypodermic injections, which were unknown 
till about fifty years ago; puncturing the spinal canal, — 
**lumbar puncture," — in order to make a diagnosis and 
later to inject a remedy, was unknown until a little over 

^ See footnote, p. 260. 

* See text. pp. £ffl-26S, and 254 and footnote,p. 252. 

ratEFACE xi 

twenty years ago and has only become a routine practice 
within the last few years; and many new and valuable 
drugs have been thus introduced into our ordinaiy practice. 
Every one of these at first was an *' experiment/' 

I am sure that every person of common sense could only 
choose the second of these three possibilities. 

** Clinical observation" is constantly vaunted by the 
antivivisectionists as the proper and best method of prog- 
ress. As a clinical teacher for over forty years, I would 
be the last to decry this method of progress. But the mo- 
ment YOMocton your '^clinical observation" by any new 
method of treatment, any new dose or drug, any new or 
even slightly varied operation, ycu are making an experu 
merU and on a human being, 11 your treatment, dose, drug, 
or operation is so slight a variation that you may rightly 
venture to use it without testing it on an animal first, very 
well. But if you do so, you have nevertheless done an 
experiment upon a human being. If the departure from 
prior practice is so great as to involve possible serious 
results, then I hold that you have no right to try it upon a 
human being first if it is possible first to test it on an 

Look for a moment at the difference between the results 
of clinical observation and of experimental investigation 
in i^3^hilis. Of course, no experiments on human beings 
were allowable. Metchnikoff in 1903 first succeeded in 
inoculating the disease in apes and later in other animab. 
Experiments, impossible before that time, were immedi- 
ately b^^un on animals. In 1905 Schaudinn and Hoffmann 
thus discovered the germ. In 1910, after a most extraordi- 
nary series of experiments with six hundred and five other 
remedies, which had to be discarded as ineffective or too 
dangerous, Ehrlich discovered his Salvarsan, or ** 606," since 
which time we have had the whip-hand over this desolat- 
ing plague. Many of the victims of this dreadful disease 
are innocent women; many others are innocent children. 


some already dead when bom; others destined happily to 
an early grave; still others, less fortunate, doomed to drag 
out a miserable existence. 

In seven years experiment an animals did more for aUe- 
mating huTnan misery from this one disease than clinical 
observation on man had done in over four centuries. 

The objection is constantly made that animals are so 
differently constructed from man that inferences from 
results on animals are of no value in the case of man. That 
there are a few and even sometimes marked differences is 
perfectly true, as, for example, the effect of belladonna or 
of opium on man and on some of the lower animals; but 
as a matter of fact, barring these few exceptional cases, 
the organs and functions of man and animal correspond 
exactly in health and in disease, and the effects of drugs 
and operations are parallel and in most cases are iden- 

The antivivisectionists claim the support of a large 
number of doctors. Undoubtedly, they have a moderate 
number, but they are chiefly unknown in the profession. 
A veiy few are or were really men of distinction. Profes- 
sor Henry J. Bigelow, who was bom nearly a century ago 
(1818), the early part of whose professional life was past 
before anesthesia was known, was familiar with the dread- 
ful sufferings of the animals at Alfort in France, and his 
veiy proper protest against it is constantly used by the 
antivivisectionists. In his later life, however, when anes- 
thesia was well established, he published, in the same 
volimie from which their quotations are taken, an in- 
dorsement of experiment by research which the antivivi- 
sectionists always fail to quote.^ 

Lawson Tait was undoubtedly a good surgeon and dis- 
tinguished in his early life. But the reliability of his sta- 
tistics was seriously questioned. He was much, of an 
Ishmaelite in his profession, and the last years of his life 

1 See pp. ms, 29S. 


closed in pitiable obscurity. He is constantly quoted by 
the antivivisectionists as a vigorous opponent of experi* 
mental research. In fact he is their '^trump card.'' But, 
for evident reasons, they never allude to his recantation ^ 
six years before his death in 1899. 

On Fdbruaiy 2, 1898, at a conjoint meeting of the Mid- 
land Medical Society and the Birmingham Branch of the 
British Medical Association, to consider the objects of the 
British Institute of Preventive Medicine (now the Lister 
Institute) and to further the same, the following resolution 
was passed: — 

Resohed, That the members of the medical profession in 
Birmingham [Mr. Tait's hcMne] and district cordially approve of 
the objects of the British Institute iA Preventive Medicine. 

Mr. Tait spoke in favor of the resolution, saying that he 
fully assented to the resolution, feeling that, while he 
objected to a certain class of surgical investigations, ^^bac- 
ieridogical experiments on animale had prooedcf great value ** 
(italics mine). Yet the antivivisectionists still flatly deny 
that bacteriology is true or has proved of any value what- 
ever. The report adds that *'this declaration of Mr. Tait 
was received with amusement and i^plause." 

Another oft-quoted authority against experimental re- 
search is Sir William Fergusson, of London. He was an 
eminent surgeon in his day. He died in 1877, just as the 
new era in medicine (that of modem experimental research 
and antisepsis) was beginning, — an era which has wit- 
nessed the most wonderful progress ever seen in every 
department of medicine. 

To quote the opinions of these men — Tait (especially 
in view <^ his recantation), Bigelow, and Fergusson — men 
who died fifteen, twenty-four, and thirty-seven years ago 
— against the opinions of similar leaders in medicine 
to-day, is like citii^ the opinions of eminent engineers of 

1 British Medical Jaumal, 1888, toL i, p. S17. 


the last centuiy as to the methods and even the possibility 
of constructing the Panama Canal, against the opinions 
and achievements of Colonel Goethals and Colonel Sibert. 

The recent prosecution of six professors of the Univer- 
sity of Pennsylvania for cruelty to animals was a notable 
event, especially by reason of the charge to the jury by 
Judge Br^gy. The learned judge ruled that **the law of 
Pennsylvania does not allow pain and suffering or torment 
or torture to be inflicted upon dogs for any purpose except 
fortherelief of the suffering of the dog itself." Byimplica- 
tion the word 'Mog" is used in a general sense for ** ani- 
mal" or "living creature." 

In the opinion of Samuel Dickson, Esq., the Nestor of the 
Philadelphia Bar, furnished to the Trustees of the Univer- 
sity, it is pointed out (1) that this opinion "is in conflict 
with what has beaa the common understanding of the 
people of this Commonwealth for centuries and with the 
implications, at least, if not the express language, of 
the Acts of Assembly upon the subject and the decision of 
the Supreme Court " of Penn^lvania. (Commonwealth vs, 
Lewis, 140 Pa. ^1.) (2) Mr. Dickson then points out 
some of the consequences which would follow this construc- 
tion of the law. Thus the gelding of the calf, colt, dog, 
pig, or chicken to increase its size and value for food, or to 
make the animal more tractable as a beast of burden; the 
playing of a game fish on the hook in some cases for hours; 
the shooting of birds — unless th^ are instantly (i.e., 
painlessly) killed — would be ill^^ and punishable as a 
"crime"; for all this is done not for the "relief of the dog 
itself," but for the convenience of man. 

Nay, more, if followed to its logical end, would it not be 
ill^al even to net fibsh as a business, for th^ are suffocated 
by their removal from water and are thus "tortured," not 
for their benefit, but for our food. Would it not also be ille- 
gal to poison or trap a rat — even if the plague were at our 
doors — or a mouse if the house is invaded; to starve the 


typhmd-canying fly in a tn^ or on ''tan^kfoot*^ piqier; to 
poiscHi ev&i a roach, though its instant death underfoot 
would be allowable? 

This trial resulted in a disagreemoit <^ the jury. It is 
understood that the prosecution has abandoned any fur- 
ther proceedings. 

The prosecution has produced two good results: — 

(1) A special ccmimittee of the Board of Trustees of the 
University made a careful and detailed ezaminaticm of the 
Departmoits of Medicine involving animal experimenta- 
tion, their methods, rules, care» and food of the animals, con- 
dition of the Animal House, etc., and in their rq[>ort com- 
pletely exonerate the teachers from all charges of cruelty. 

(2) The press, especially of Pomsylvania, and the think- 
ing public have been awakened to the serious danger to the 
lives and health of the community if the antivivisectionist 
view prevails; for, as Mr. Dickson points out, not only 
'*must all further experiment be stepped and future re- 
search be brought to an end, but it will not be possible to 
obtain and test vaccine for protection against smallpox by 
the inoculation of calves, or the antitoxins, from the inocu- 
lation of horses, against diphtheria, lockjaw, or the epi- 
demic form of cerebro-spinal meningitis.'* It would also 
prevent the inoculation of guinea-pigs to aid us in diagnos- 
ing the early stages of tuberculosis; in testing the strength 
of preparations of ergot on animals, and would thus endan- 
ger the lives of many women in cases of hemorrhage in 

What the organized medical profession believe is shown, 
for example, in the following quotations. 

In 1892» the British Medical Association, numbering over 
15,000 members and almost all of the leading men of the pro- 
fession in Great Britain, ttruunnumdy passed the following 
resolution: — 

" Resohedt That this general meeting iA the British Medical 
Assodaticm records its (pinion that the results of eq[>eriments on 


living animals have been of inestimable service to man and to the 
lower animals, &nd that the continuance and extension of such 
investigations is essential to the progress of knowledge, the relief 
of suffering, and the saving of life." ^ 

The recent International Medical Congress in London, 
composed of the most distinguished members of the pro- 
fession from eveiy civilized country in the world» at a 
general meeting August 12, 1918, unanimously approved 
the following resolution: — 

That this Congress records its convicticai that experiments on 
living animals have proved of the utmost service to medicine in 
the past, and are indispensable to its future progress. That, 
accordingly, while strongly deprecating the infliction of unneces- 
sary pain, it is of opinion, alike in the interests of man and <^ 
animals , that it is not desirable to restrict competent persons in 
the performance of such experiments.* 

At the meeting of the Federation of American Societies 
for Experimental Biology held in Philadelphia on Decem- 
ber 31, 1918, the following declaration was unanimously 
adopted:' — 

1. We, the members of the Federation of American Societies for 
Experimental Biology, — comprising the American Physiological 
Society, the American Society oi Biological Chemists, the Ameri- 
can Society for Pharmacology and Experimental Therapeutics, 
and the American Society for Experimental Pathology, — in 

• convention assembled, hereby express our accord with the decla- 
ration of the recent International Medical Congress and other 
authoritative medical organizations, in favor of the scientific 
method designated properly animal experimentation, but some- 
times vivisection. 

2. We point to the remarkable and innumerable achievements, 
by means of animal experimentation in the past, in advancing 
the knowledge of biological laws and devising methods of pro- 

1 BriHsh Medical Journal, August 6, 1892, p. 806. 

* BriHih Medical Journal, 1918, vol. n. p. 429. 

* Science, February 6, 1914, p. 217. 


cedure for the cure of disease and for the preyention of suffering 
in human beings and lower animals. We emphasize the necessity 
of animal experimentation in continuing similar beneficent work 
in the future. 

8. We are firmly q[>pofled to cruelty to animals. We heartily 
support all humane efforts to prevent the wanton infliction of 
pain. The vast majority of experiments on animals need not be 
and» in fact, are not accompanied by any pain whatsoever. 
Under the regulations already in force» which reduce discomfort 
to the least possible amount and which require the decision of 
doubtful cases by the responsible laboratory director, the per- 
formance of those rare experiments which involve pain is, we 
believe, justifiable. 

4. We regret the widespread lade of information regarding the 
aims, the achievements, and procedures of animal experimenta- 
tion. We deplore the persistent misrepresentatioii iA these aims» 
achievements, and procedures by those who are opposed to this 
scientific method. We protest against the frequent denimda- 
tions of self-sacrificing, high-minded men of science who are 
devoting their lives to the welfare oi mankind in efforts to solve 
the compHcated problems of living beings and their diseases. 

In 1906, the two largest scentific bodies of the United 
States, the American Medical Association^ and the 
American Association for the Advancement of Science,* 
tmaninumsly adopted the following resolutions:' — 

Whbbbas, from time to time, attempts, fostered largely by 
erroneous statements and accusations and false sentiment and 
prejudice, are made in some parts of this country to enact specific 
l^islation, prescribing the omditions under which experiments 
on animals may or may not be performed; be it 

A. Resokfedf by the Association, That animal experimentation 
has been of incalculable benefit to medical science and art, the 
progress iA which b as absolutely dependent on experimental 
methods as are all the physical and natural sciences. 

^ Journal, American Medical Aeeociation, June 18, 1906, p. 8001. 

s Ibid., January 9, 1909, pp. 144, 145. 

' Very sli^^t verbal variations exist in "B." 

xviii FBEFACE 

B. i20«olf^. That no abuse of the practice of aninudezperime^^ 
taticoi in this countiy has been shown to exist to warrant specific 
legislation, nor is there any probability of such abuse arising. 

C. Resolved, by the Association, That the unrestricted perform- 
ance by proper persons of scientific experiments on living ani- 
mab is essential to the maintenance and progress of medicine 
and biology. 

These resolutions represent the coUecHve opinion of the 
medical profession^ not only of Great Britain and America, 
but of the whole civilized world. 

Per contra^ there is not^ so far as I hnoWy a single resoltUion 
of any scientific body expressing the opposite opinion. 

In addition to all this the following quotation from the 
unanivums Report of the English Boyal Commission on 
Vivisection, composed of the advocates and opponents of 
ammal experimentation^ is published in their final Report 
in 1912, on page 20. 

We desire to state that the harrowing descriptions and illus- 
trations of operations inflicted on animals, which are freely 
circulated by post, advertisement, or otherwise, are in many 
cases calculated to mislead the pubHc, so far as they suggest that 
the animals in question were not under an anesthetic. To repre- 
sent that animals subject to experiments in this country are wan- 
tonly tortured would, in our (pinion, be absolutely false. 

The Bureau on Protection of Medical Research, ap- 
pointed by the Council on Health and Public Instruction 
of the American Medical Association, has published a 
series of twenty-six pamphlets, a list of which is appended. 
The pamphlets in this smes set forth from different as- 
pects the value and importance of experimental research 
very clearly. The price is only a few cents each. 

Ib^ to express to the distinguished President Emeritus 
of Harvard University, Dr. Charles W. Eliot, my warm 
thanks for his kindness in f lunishing the Introductory 
Note. His indorsement hall-marks any book. 



Pamphubt L — Vaodnatioo and its Relation to Animal Ezperimeiita- 
tioii» by Dr. J. F. Schambefg, Fluladclphia. M pages. Illustrated. 

Pamfhubt n. — Animal Experimentation and Tubefculoais, by Dr. 
E. L. Tnideau, Saranac Lake» N.Y. 16 pages. 

Pamfhiat EDL. — The R^ ci Animal Experimentation in the Diag- 
nosis olDisease, by Dr. M. J. Rosenau, Washington, D.C. Spages. 

Pamfhubt IV. — Animal Experimentation and Cancer, by Dr. Jamea 
Ewing, New York. 12 pages. 

Pamfhubt V. •— The Ethics d Animal Experimentation, by Professor 
J. R. AngdU Chicago. 8 pages. 

Pamfhut VI. ^ Animal ExperimenUtion: The Protection it AflPords 
to Animals Themselyes and its Value to the live-Stock Industry, by Dr. 
V. A. Moore, Ithaca, N.Y. 90 pages. 

Pamfhudt Vn. — Rabies and its Relation to Animal Experimenta- 
tion, by Dr. L. Frothingham, Boston. 16 pages. 

Pamfhudt Vlll. — Importance ci Animal Experimentation in the 
Development ci EnoiHedge ci Dysentery, Cholera and T^rplioid Ferer, 
by Dr. M. W. Richardson, Boston. 8 pages. 

Pamfhubt IX. — Fruits ci Medical Research with Aid ci Anesthesia 
and Aseptidsm, by Dr. Charles W. ^iot, Boston. 16 pages. 

Pamfhubt X. — Animal Experimentation in Relation to Our Knowl- 
edge ci Secretions, Especially Internal Secretions, by Dr. S. J. Meltaer, 
New York. 82 pages. 

Pamfhubt XI. — Animal Experimentation and Phitoaoan Tropical 
Disoues, by Dr. Harry T. Marshall, Charlottesville, Va. 90 pages. 

Pamfhubt Xn. — Modem Antiseptic Smgery and the RMe ci Experi- 
ment in its Discovery and Development, by Dr. W. W. Keen, Phila- 
delphia. 90 pages. 

Pamfhiat Xm. — Animal Experimentation in Ration to Practical 
Medical Knowledge ci the Grculation, by Dr. Joseph Erlanger, Madison, 
Wis. iOpagea. 

Pamfhubt XIV. — What Vivisecticm has Done for Humanity, by 
Dr. W. W. Keen, Philadelphia. 16 pages. 

Pamfhubt XV. — The Relation ci Animal ExperimentatiMi to Our 
Knowledge ci Plague, by George W. McCoy, San Fhmcisco. 12 pages. 

Pamfhiat XVI. — Medical Control ci Vivisection, by Dr. Walter B. 
Cannon, Boston. 8 pages. 

Pamfhuit XVn. — Immunology: A Medical Science Developed 
through Animal Experimentation, by Dr. Fredakk P. Gay, Beric^ey, 
Cal. go page s. 

Pamfhudt XViii. — Obstetrics and Animal ExperimentatioOt by 
Dr. J. Whitridge Williams, Baltimore. 86 pages. 


Pamphlet XES. — Some Characteristics of Antivivisection LHenr 
ture, by Dr. Walter B. Cannon, Boston. 16 pages. 

Pamphlbt XX. — The Value of Animal Experimentation as Illiis- 
trated by Recent Advances in the Study of Syphilis, by Dr. J. W. Church- 
man, Baltimore. 24 pages. 

Pamphlet XXI. — Animal Experimentation and Epidemic Cerebro- 
spinal Meningitis, by Dr. C. H. Dunn, Boston. 28 pages. 

Pamphlet XXII. — Animal Experimentation and Diphtheria, by 
Dr. W. H. Park, New York. 19 pages. 

Pamphlet XXIII. — Animal Experimentation and its Benefits to 
Mankind, by Dr. Walter B. Cannon, Boston. 24 pages. 

Pamphlet XXIV. — The Influence of Antiviyisection on Character, 
by Dr. W. W. Keen, Philadelphia. 43 pages. 

Pamphlet XXV. — Antivivisection Legislation: Its History, Aims, 
and Menace. By Dr. W. B. Cannon, Boston. 11 pages. 

Pamphlet XXVI. — The Charge of "Human Vivisection" as Pre- 
sented in Antivivisection literature, by Richard M. Pearee, M.D., 
Philadelphia. 82 pages. 

Pamphlets I, yiTT and XXIV: Other pamphlets of the series: 

iCopy $.08 

5 Copies .85 

10 Copies 65 

25 Copies 1.25 

IC^opy $.04 

5 Copies 15 

10 Copies 25 

25 Copies M 

Orders should be sent to the Amkbican Medical AaaocuTioN, 585 
N. Dearborn St., Chicago, Illinois. 


Inibod uotion ••• • .xziii 


Bbcbnt Pbocoubs in Subobbt 22 

ViTiBBcnoN AHD Brain-Sxtbosbt 45 

THBPBOcnB» OF Subobbt ABlNTLuiiNcxDBTViyiaBCTioN 72 






Thb Nbw Sxtboebt 171 


What Viyibbction has donb fob Humanitt • • • • 220 
Thb Influbncb of ANmnvisBCTioN on Chabacteb • . 284 
The Antiyiyisection Exhibition in Fbiladblphia 

IN 1914 286 

Selbcted Quotations 291 

A Letteb to ''Life" 296 

Index 299 


Db. Keen describes in this book, in a very interesting 
and convincing manner, the new surgery <^ the last forty 
years and its extraordinarily beneficent results. He shows 
that the progress of surgeiy has takoi effect in all parts of 
the human body, including the brain, spine, chest, stomach, 
intestines, liver, gall bladder, appendix, pancreas, spleen, 
and kidn^rs, and the arteries, veins, and nerves; that many 
operations which were impossible, or had a hi^ mortality, 
before aseptic surgery was invented, have become not only 
possible but safe; and that innumerable lives have been 
saved, and are continually being saved, by operations new 
within forty years. He also demonstrates that the new 
surgeiy has reduced veiy much the period required for re- 
covery, as well as the death-rate, after a large variety of 
operations, — such as those for compound fractures, 
ovariotomy, hernia, goiter, and the removal of cancers and 
tumors, — and that the proportion of complete and rapid 
cures after q[>eration has been greatly increased. Hepoints 
out that lockjaw has been almost abolished; that the direct 
transfusion of blood has been achieved; that the mortality 
from diphtheria and cerebro-spinal meningitis — two 
formidable diseases now successfully treated by antitoxins 
— has been greatly reduced; that yellow fever has been 
abolished as a destructive epidemic; and that child-birth 
fever, formerly very destructive, has become rare. 

The new surgery has been made possible by the combi- 
nation of anesthesia and asepticism; but asepticism owes 
to animal experimentation, guided and furthered by the 
new science and art of bacteriology, its origin and its suc- 
cessful applications. Through animal experimentation, 
also, numerous valuable drugs have been tested before being 


used on man; and the beneficent use of each has been 

The immense benefits which modem surgeiy and serum- 
therapy have conferred on mankind are therefore due to 
animal experimentation. 

Since experiments on the living human being are seldom 
possible, or indeed justifiable, except by request of the 
patient in desperate cases, and since all scientific knowledge 
comes by the way of experiment, the progress of medicine 
and surgeiy was very slow, so long as the only means of 
advancing them was by the study of sick or injured human 
bodies and the post-mortem examinations. Animal experi- 
mentation has aheady made progress rapid, and will be 
even more fruitful in the future. 

In the manufacture of the serums now used in the treat- 
ment of diseases, as in diphtheria, tetanus, and cerebro- 
spinal meningitis, the serum has to be tested on animals 
before it is used on human beings; and therefore some rab- 
bits, guinea-pigs, or other small animals are sacrificed 
during the process of manufacturing serums of good qual- 
ity. In learning how to sew together two bowel ends or the 
two ends of an artery, vein, or nerve which has been 
severed, a few dogs and cats were sacrificed. In learning 
the localization of function in the different parts of the 
human brain, many animals had to be sacrificed before the 
human skull could safely be entered at the right spot for 
relieving a hemorrhage, or removing a tumor. 

Through these sacrifices of animal life or happiness, 
always made as painless as possible, suigeons and physi- 
cians have been able to save innumerable human Uves 
which, without the help of the new surgery and therapy, 
would have been lost, and to relieve or remedy innimierable 
cases of human suffering and injury. Is it justifiable to use 
animals in this way? 

The human race daily devours animals, large and small, 
by the million, cuts off animal life by eating innumerable 


^gs from which animals would develop, makes the animals 
capable of domestication work for them in multifarious 
ways, and thereby deprives them of their liberty and of 
their natural joys. The number of animals used for the 
benefit of the human race in making possible the recent 
advances of surgeiy and medicine is insignificant, indeed 
infinitesimal, compared with the number used for human 
food and human service; but the benefits to mankind which 
result from animal experimentation are immeasurable m 
quantity, and very precious in quaUty. 

How many rabbits or guinea-pigs is it justifiable to 
incommode or kill, in order to save the life of a child 
attacked by diphtheria? How many monkeys would a 
competent experimenter be justified in sacrificing, in order 
to find a sure treatment for infantile paralysis? How many 
rats is it justifiable for men to kill, in order to protect a 
city from an epidemic of bubonic plague? Dr. Keen sug- 
gests at many points the reasonable answer to all such 
questions as these. 

One third of the book is devoted to the exposition of the 
unreasonableness, inaccuracy, and indifference to truth 
and justice manifested by the antivivisectionists in select- 
ing the premises of their argument against animal experi- 
mentation. He points out over and over again that the 
antivivisectionists would be the cruel people, if they could 
have their way, cruel to their own kind; and that the sur- 
geons and physiologists, and the men who devote them- 
selves to medical and surgical research are carrying on the 
most humane work now done in the world. Dr. Keen thus 
sets before his readers in a striking way the evil conse- 
quences which may flow from the morbid perversion of a 
humane, kindly, or altruistic sentiment. In this case, the 
conunon sense of mankind ought to be able to prevent the 
victims of a perverted sentunent from doing serious harm 
to the human race. 

One must always remember that when by a course of 


experiments on a few animals a scientific discoverer arrives 
at knowledge of the mode of transmission of a dangerous 
pestilence, at a new means of preventing the spread of a 
disease, or at a new medical or surgical treatment of a 
disease or a wound, the benefits of the discovery go on 
generation after generation, multiplying as they go. There 
lies an immense hope for the future! To propose that such 
a hope shall be blighted by stopping animal experimental 
tion argues an extraordinary infatuation in the proposer. 
Dr. Keen is a competent witness to the progress of sur- 
geiy during the past fifty years. His surgical career began 
in 1862, when aseptic surgery was unknown; so that he has 
personally seen the whole development of modem surgery, 
and indeed has actively participated in its achievements. 
His career proves him to be a dear-sighted, alert, and 
diUgent student, and a wise and skillful practitioner. He 
is also, like most good surgeons, a humane and sympathetic 

Chables W. Eliot. 

7 October, 1914. 




It is to oneof the medical issues of the day to which I pur- 
pose to direct your attention at present, — one as to which, 
especially among women, intense feeling has been aroused, 

— namely, the question of experiments upon animals. 
Epithets and invective have been freely used, but, as 

befits the audience and the occasion, I shall endeavor to 
approach it in a perfectly calm and fair spirit, seeking to 
lay before you only one aspect of a many-sided question, 

— namely, the actual practical benefits it has conferred 
upon man and animals, — a fact that is constantly denied, 
but which medical evidence proves to be incontestable. 

I shall not consider the important older discoveries it 
has given us, but only those since 1850, almost all of which 
are within my own personal recollection. ^ Even of these 
I must omit nearly all of its contributions to physiology and 
to pathology, though so much of our practice is based upon 
these, and confine myself to the advances it has enabled us 
to make in medical and surgical practice. I shall endeavor 
to state its claims with moderation, for an extravagant 
daim always produces a revulsion against the claimant, 
and is as unwise as it is unscientific. 

Again it must be borne in mind that, as in nearly eveiy 
other advance in civilization and in society, so in medicine, 
causes are rarely single, but generally multiple and inter- 

^ The address to the graduates at the Thirty-third Commencement of 
the Woman's Medical College of Pennsylvania, Mardi 11, 1885. Re- 
printed by permission from the Popular Science Monthly for May, 1885. 


woven. While vivisection has been a most potent factor 
in medical progTess» it is only one of several factors, the 
disentanglement of which and the exact balancing of how 
much is due to this or to that are often difficult and some- 
times impossible. Let me add one word more. All that I 
may say is purely upon my own responsibility. I commit 
the opinion of no one else to any view or any statement of 

Medicine in the future must either grow worse, stand 
still, or grow better. 

To grow worse, we must forget our present knowledge 
— happily, an inconceivable idea. 

To stand still, we must accept our present knowledge 
as a finality, complacently pursuing the well-worn paths; 
neither hoping nor trying for anything better — happily, 
again, an impossibility. 

To grow better we must try new methods, give new 
drugs, perform new operations, or perform old ones in new 
ways; that is to say, we must make experiments. To these 
experiments there must be a b^^inning: they must be tried 
first on some living body, for it is often forgotten that the 
dead body can only teach manual dexterity. They must 
then be tried either on an animal or on you. Which shall 
it be? In many cases, of course, which involve little or no 
risk to life or health, it is perfectly legitimate to test prob- 
able improvements on man first, although one of the grav- 
est and most frequent charges made against us doctors is 
that we are experimenting upon our patients. 

But in many cases they involve great risk to life or health. 
Here they cannot, nay, they must not, be tested first upon 
man. Must we, then, absolutely forego them, no matter 
how much of promise for life and health and happiness they 
possess? If not, the only alternative we have is to try them 
on the lower animals, and we would be most unwise'— 
nay, more, we would be cruel, cruel both to man and to 


animals — if we refused to pain or even to slay a few ani- 
mals, that thousands, both of men and of animals, might live. 
Who would think it right to put a few drops of the hydro- 
chlorate of cocain (a year ago almost an unknown drug) 
into the eye of a man, not knowing what frightful inflam- 
mation or even loss of sight might follow? Had one dared 
to do it, and had the result been disastrous, would not the 
law have held him guilty and punished him severely, and 
all of us have said Amen? But so did Christison with Cala- 
bar bean, and well-nigh lost his own life. So did Toynbee 
with prussic add on himself, and was found dead in his 
laboratory.^ Accordingly, KoUer, of Vienna, properly and 
wisely tried cocain first on animals,' and then, finding its 
beneficial effects, tried it upon man with like results, and 
one of the most remarkable drugs of modem times was thus 
made available. We are only on the threshold of its use- 
fulness. It has been used in the eye, the ear, the nose, 
the mouth, the larynx, and all other mucous membranes, 
in the removal of tumors, and as an internal medicine. 
When its physiological action has been still more thor- 
oughly and systematically investigated, its poisonous dose 
ascertained, when we know how it works, what its effects 
are upon the blood-pressure, the heart, the nerves, the 
blood-vessels, — effects that cannot be accurately studied 
upon man, — its usefulness may be increased to an extent 
as yet but little dreamed of. Should it only soothe the last 
painful hours of our great hero. General Grant, a nation 
will bless it and the experiments which gave it effect. More- 
over, had the experiments of Dr. Isaac Ott, of Easton,' on 
this very drug, borne their due fruit, America would have 
had the honor and the human race the benefits of cocain 
ten years ago — ten years of needless suffering! 

^ See also Sir Lyon Playfair's statement on p. 258. 

> Arckwet qf Opkikalmology, September and December, 1884, p. 402; 
New York, Putnam's. 

> Ott, Coomn, VmOrine, and GeUemiwn, Ffailadelpliia, 1874. 


This is but one illustration of the value of experiments 
upon animals in the reahn of new drugs. In fact, substitute 
for cocain other drugs, or new operations, or new methods 
of medical treatment, and the argument repeats itself for 
each. Within the last thirty years a multitude of new drugs 
have thus been discovered, and their effects have been either 
first tested upon animals, or their properties studied ex- 
haustively in a manner impracticable upon man. I will 
only enumerate some of them, since time will not allow me 
to enter upon each in detail. Thus have been introduced 
lily-of-the-valley in heart disease, yellow jasmine in dis- 
eases of the heart and nervous system, paraldehyde and 
chloral hydrate, so valuable for sleep, caffein for headache, 
eucalyptus as an antiseptic and in medicine, nitroglycerin 
for nervous maladies. Calabar bean for disease of the eye 
and nervous system, naphthalin and iodoform in surgery, 
quebracho as an antispasmodic, antipyrin and kairin in 
fever, jaborandi in dropsy, salicylic acid in rheumatism, 
nitrite of amyl in epilepsy and intermittent fever, jequirity 
in ophthalmic surgery, piscidia as a substitute for opium, 
the hypodermatic method of using drugs, and so on through 
a long list. And, as to the old drugs, it may be truly said 
that we have little exact — that is, scientific — knowledge 
of any one except through experiments upon animals.^ 

^ For three hundred years digitalis, for instance, has been given as a 
depressant of the heart, and, when a student, I was taught to avoid it 
carefully when the heart was weak. But the accurate experiments of 
Bernard and others have shown that it is, on the contrary, actually a 
heart tonic and stimulanL So long as I live I shall never forget the intense 
joy of myself and the agonized parents, when one bright young life was 
brought back from the very grave, some five years ago, by the knowledge 
of this fact, and this is but one of many such cases. Thus have the 
action and dangers of our common anesthetics been positively and accu- 
rately ascertained; thus the action of ergot on the blood-vessels, explain- 
ing alike its danger as an article of food and its wonderful use in certain 
tumors of the uterus and diseases of the nervous centers; thus, too, every 
one who gives opium in its various forms is a debtor to Bernard, and 
every one who gives strychnin a disciple of Magendie. 

"As ergot is a drug that varies greatly in physiological activity in its 


Let us now see something of what America has done in 
advancing practical medicine by vivisection. In passing, I 
may say that the assertion that America has contributed 
but little, so far from being an argument for the restriction 
of vivisection, is a strong argument for its further cultiva- 
tion, in order that greater good may result from remark- 
able discoveries here, equal to those that I shall show have 
been made in Europe. 

Wounds of the abdomen, especially gunshot wounds, are 
among the most fatal injuries known to surgery. A small, 
innocent-looking, external pistol wound may cover multiple 
and almost inevitably fatal perforations of the abdominal 
viscera. The recoveries from 8717 such wounds during 
the late Civil War only numbered 444, and of those with 
escape of the intestinal contents the recoveries, says Otis, 
may be counted on one's fingers. The prevailing treatment 
as laid down in our textbooks has been purely conserva- 
tive, treating symptoms as they arise. The brilliant results 
achieved in other abdominal operations have led a few bold 
spirits, such as our own Sims, Gross, Otis, McGuire, and 
others, to advocate the opening of the abdomen and the 
repair of the injuries found. 

In May of last year, Parkes, of Chicago, reported to the 
American Medical Association ^ a series of systematic ex- 
periments on thirty-seven dogs, that were etherized, then 
shot, the abdomen opened, and the wounds of the intestines, 

crude state and cannot be chemieaUy assayed with advantage, the phy- 
ndan should always use a preparation which has been phynologically 
tested by the manufacturer before it is placed on the market." (Hare*s 
Practical Therapetdics, 11th ed., 1905, p. 286.) 

The physiological test of ergot is by giving it to animals and observ- 
ing the effects on the caliber of the small blood-vessels. Unless so physio- 
logically tested, the physician, surgeon, and especially the obstetrician, 
may be ignoranUy using a wholly inert preparation, thus seriously en- 
dangering human life. 

^ Medical News, May 17, 1884. I shall refer readers frequently to this 
Journal, as it is often more accessible than foreign jounujs, and it will 
refer them to the original papers. 


arteries, mesenteiy, etc., treated by appropriate surgical 
methods. The results confirmed the belief awakened by 
earlier experiments and observations that surgeiy could 
grapple successfully with multiple and formidable wounds, 
by sewing them up in various ways, or even by removing a 
piece of the bowel and uniting the cut ends. Hard upon the 
heels of this important paper, and largely as its result, comes 
a striking improvement in practice. And remember that 
this is only the first fruit of a rich harvest for all future time, 
in all countries, in peace and in war. 

November 2, of last year, a man was brought to the 
Chambers Street Hospital, in New York, with a pistol- 
shot wound in the abdomen. Under careful antiseptic 
precautions, and following the indications of Parkes, the 
abdomen was opened by Dr. Bull,^ coil after coil of the in- 
testines was drawn out, the bullet was found and removed, 
and seven wounds of the intestines were successfully dis- 
covered and properly treated, and the patient made an 
uninterrupted recovery. A recovery, after so many wounds, 
any one of which would necessarily have been fatal under 
the old methods of treatment, shows that we have now 
entered upon a proper and successful method of treatment 
for such frightful accidents.' 

This is but one of the remarkable achievements of late 
years in abdominal surgery. The spleen has been removed, 
part of the stomach has been cut out for cancer,' part of the 
bladder ^ has been dissected away, the entire gall-bladder 
has been removed, and several inches of the intestine have 
been cut out,^ all with the most remarkable success. To all 

1 Medical NevM, February 14, 1885. 

' Since 1885 hundreds of such wounds have been successfully treated 

and recovery has followed after as many as nineteen wounds of the bowels. 

' Since 1885 the entire stomach has been repeatedly removed. (1914.) 
^ Since then the entire bladder has been repeatedly removed. (1914.) 
' Much larger portions have been removed since then, even as much 

as eight feet eight inches, with success. (1914.) 


of these, experiments upon animals have dther led the way 
or have tau^t us better methods. To recite each in 
detail would occupy too much time, but one illustration I 
must not omit, tor the improvement produced by it and 
other experiments, affects every abdcmiinal <^)eration« 
When I was a student, the peritoneum was avoided by knife 
and needle wherever possible. After the death of his fourth 
case of ovariotomy , Mr . (now Sir Spencer) Wells, ^ in making 
the poH-mortenif was led to believe that the then received 
treatment of the peritoneum was incorrect, and that he 
ought to bring its surfaces in contact in order to obtain 
secure union. According, instead of testing his ideas 
upon women, he experimented upcn a few dogs, and found 
that his suspicions were correct. Since then it has been ac- 
cepted as a cardinal point in all abdominal operations. 
Following this came improvements in the ligatures used, in 
the method of treating the pedicle, in the use of anti- 
septics, etc, all more or less the result of experiments upon 
animals, and what are the results? Taking successive hun- 
dreds of cases. Sir Spencer Wells's percentage of mortality 
has decreased steadily from thirty-four per cent to eleven 

Since then, others have reduced the percentage of deaths 
after ovariotomy to three in the hundred; and Martin, of 
Berlin, has lost but one patient from blood-poisoning in his 
last one hundred and thirty cases. 

It cannot be claimed, of course, as to oB this wonderful 
histoiy of abdominal surgeiy — and remember that in 
1862, when I was a medical student, I heard ovariotomists 
denounced from a professor's chair as murderers! — that 
experiments upon animals have done the whole work. No 
one man, no one series of experiments has sufficed, and 
experiment alone would not have done it. But had such ex- 
periments not been made on animals, as to the peritoneum, 
the pedicle, the sutures, the ligatures, etc., we should be far 

^ Wells, Ovarian and Uterine Tumort, 1882, p. 197. 


behind where we now are» and still be ignorantly sacrificing 
human life and causing human sufiPering. 

But to return to America. The first condition to success- 
ful treatment is an accurate knowledge of what any disease 
is — its cause and its course; then we may guide it» and in 
due time» it may be, cure it. 

Before Dr. H. C. Wood's ^ accurate experiments on the 
eJBFects of heat on animals, the nature and effects of sun* 
stroke were almost matters of mere conjecture. Every one 
had his own theory, and the treatment was equally varied. 
Even the heat-effects of fever itself — the conmionest of 
all symptoms of disease — were ill understood. Wood ex- 
posed animals to temperatures of 120^ to 180^ F. and stud- 
ied the effects. These experiments ha ve often been alluded 
to as ''baking jMiiiniLlg alive.'' You will note that the heat 
was no greater than that to which laborers are frequently 
exposed in our hot summer days, when working in the sun 
or in many industrial works. His experiments showed that 
the effects of sunstroke — or, as he happily termed it, 
thermic or heat fever, a scientific name now widely adopted 
— were solely due to the heat, death following from coagu- 
lation of the muscular structure of the heart, or by its 
effects on the brain. They explained also many of the 
phenomena of ordinary fever as the result of heat alone. 
They have established the rational and now generally 
adopted treatment of sunstroke by reduction of the body- 
temperature; and the same method is now beginning to be 
appreciated and employed in ordinaiy fever.* 

The same observer, with Dr. Formad, has made impor- 
tant experiments on the nature of diphtheria, and when we 
learn, as we probably soon shall, how to deal with the 

1 Wood, Thermic Fever or Swtsbroke, Philadelphia, 1872. 

* Eighteen out of Wood's experiments were on the general effects of 
heat, as above alluded to. In six others the local effects of heat (135® to 
190® F.) on the brain, and in four others the local effects (up to 140® F.) 
on the nerves were studied and gave most valuable results, entirely and 
evidently unattainable on man. 


microsoopical forms of life which seem to be its cause, it 
will not be too much to hope that we may be able to cope 
far more successfully with a disease now desolating so 
many homes.^ 

In India alone twenty thousand human beings die annu- 
ally from snake-bite,' and as yet no antidote has been dis- 
covered. How can we 9eareh irUeUigenUy for an antidote 
until we know accurately the eflPects of the poison? This 
cannot be studied on man; we must resort to animals, or 
else let the holocaust go on. Accordingly, Dr. (now Sir) 
Lauder Brunton began such a series of experiments in 
London, but was stopped by the stringent antivivisection 
laws there in force. But Drs. Weir Mitchell and Reichert,' 
in this dty, have recently undertaken experiments on 
cobra and rattlesnake venom, the cobra-poison being fur- 
nished, be it observed, by the British Government, whose 
own laws have prevented investigations for the benefit of 
its own subjects! The results are as yet only partly made 
known, but they ha ve been brilliantly successful in lowing 
that there are two poisons in such venom, each of which 
has been isolated and its dBFects studied. The first step has 
been taken — the poison is known. Who will raise a finger 
to stc^ progress toward the second — the antidote?^ 
Can the sacrifice of a few scores of animals each year in 
such research weigh for a moment against the continuous 
annual sacrifice of twenty thousand human beings ? ' 

^ The remarkable results in lessening the mortality from diphtheria 
by the use of the antitoxin discoyered since this address was first pub- 
lished are now uniyersally known. Thousands of human lives* espedally 
of children, are saved annually in this country alone. (1914.) 

* Fayrer, Tkanaiio>phidia c/ India, p. 82. 

* Medietd New, April 08, 1888. 

^ Since then Calmette and Nogudii have both announced an anti- 
venene or antidote to the venom of snakes, but they still leave much to be 
desiied. (1914.) 

* IampermittedbyRev.R.M.Luther,of this city, to state the follow- 
ing fact in illustration of the practical value of vivisection in snake-bite: 
When a missionaiy in Burmah, he and his brother-in-law. Rev. Bir. Vinton 
(two missionary vivisectionistsi), made a number of experiments to dis- 


The modem histoiy of anesthetics is also of interest. To 
say nothing of ether and chlorof orm» whose safer use Bert 
has investigated in France, nor of cocain, to which I have 
abeady alluded, let us see what experiments on animals 
have ^own us as to bromid of ethyl — an anesthetic lately 
revived in surgery. Its revival has quickly been followed 
by its abandonment on account of the frequent sacrifice of 
human life — that is to say, experiments on human beings 
have proved it to be deadly. Now, Dr. H. C. Wood,* soon 
after its reintroduction, made a study of its effects on 
animals, and showed its physiological dangers. Had his 
warnings been heeded, not a few human lives would have 
been saved. 

The ideal anesthetic, that will abolish pain without 
abolishing consciousness, and do so without danger, is 
yet to be found. Cocain is our nearest approach to it. 
Now, in all fairness and common sense, would it be real 
kindness or real cruelty to obstruct the search for such an 
anesthetic — a search which will surely be rewarded by 
success, but which, if not carried on by experiments on 
animals, must be tried by deadly experiments upon man, 
or else be entirely given up? 

In 1869 I was called to see a man suffering to the last 
degree from an abscess in the loin. I recognized the fact 
that it arose from the kidney, but I was powerless. All 
that I could do was to mitigate his pitiless sufferings and 
that, alas! but little, till death came to his relief, after 
nearly a year of untold agony. I have never forgotten his 

cover an antidote to the pcnson of the "brown viper" — a snake but little 
less venomous than the cobra. Th^ found a substance which is an anti- 
dote in about sixty per cent of the cases if applied at once. Thah Mway» 
one of their native preachers, when bitten by the brown viper, had some 
of this antidote with him, and by its use his life was saved when on the 
verge of death. This one life saved, it is estimated, has been the means 
of leading two thousand Karens to embrace Christianity. Was not this 
one life worth all the dogs used in the experiments — to make no men- 
tion of the many other lives that will be saved in all the future? 
1 Philadelphia Medieol Times, April 24, 1880. 


sufferings, nor the sharp pain I felt when I learned, two 
years later, how I might possibly have saved his life. In 
the very same year (1869), Simon, of Heidelberg,^ had a 
woman under his care suffering from urinary fistula' from 
a healthy kidney — a surgical accident he in vain tried to 
heal. That she could live with one kidn^ had the other 
gradually been disabled by disease was probable, for one 
such diseased Iddn^ had been already removed three times 
when mistaken for ovarian disease. But no one had 
removed a healthy kidn^, and then studied the effects on 
the remaining kidney and upon the heart; no one had 
tested what was the best method of reaching the kidney, 
whether by the abdomen or the loin, or how to deal with 
its capsule, or the hemorrhage, or the surgical after-effects. 
Of course, Simon could have tried the experiment on his 
patient, blindly trusting to Providence for the result. But 
he chose the wiser course. He studied the previous litera- 
ture, experimented on a number of dogs, and watched the 
points above noted, tried various methods of operating 
upon the dead body, and, after weighing all the pros and 
conSt deliberate)^ cut down upon the kidn^ of his patient 
after a carefully formulated plan, not by the abdomen, but 
throu^ the loin, and saved her life. She died in 1877, after 
eight years of healthy life, free from her loathsome dis- 

Now, what have been the results of these experiments 
upon a few dogs? One hundred and ninety-eight times the 
kidney has been removed, and 105 hmnan Uves have been 
saved; 83 times abscesses in the kidney have been opened, 
and 66 lives saved; 17 times stones have been removed from 
the kidn^ without a single death — or, m all, in the bst 
fifteen years, 298 operations, and 188 human lives saved. 
Besides this, as an extension of the operation in 17 cases, in 

^ Simon* Ckirurgie der Nieren, 1871» preface. 

' An opening in the skin through which the urine constantly escapes 


which the kidney, having no such attachments as ought to 
anchor it in place, was floating loosely in the abdomen and 
was a source of severe pain, it has been cut down upon and 
sewed fast in its proper place ; and all of these patients 
but one recovered.^ 

Looking to the future, when not hundreds, but thou- 
sands, of human beings will enjoy the benefits of these 
operations, and in increasing percentages of recoveries, are 
not the sufferings inflicted on these few dogs amply justified 
as in the highest sense kind and humane?* 

Not long since Dr. (later Sir David) Ferrier, of London, 
was prosecuted for the alleged performance of certain 
experiments on the brains of the lower animals. With 
Fritsch, Hitzig, Goltz, Yeo, and others, he had destroyed 
or galvanized certain limited areas of the brain (and it must 
not be forgotten that the brain is wholly without the sense 
of pain), and so determined the exact nervous centers for 
certain limited groups of muscles. As a result of their 
labors, the brain is now mapped out with reasonable ac- 
curacy, so that, given certain hitherto ill-understood or 
obscure localized sjrmptoms, we can now say that there is 
certainly a tumor, an abscess, or other disease in precisely 
this or that locality. True, we can doubtfully infer some- 
what of the same from the cruel experiments of disease on 

* In the twenty-nine years since tbis address was delivered these figures 
have been multiplied many fold. (1914.) 

' Very erroneous views prevail as to the sufferings of animals from 
experiments upon them. Many persons suppose that ''vivisection'* 
means ddiberate " cutting up " of an animal without using any anesthetic, 
little by little, till not enough is left to live. So far is this from the truth, 
that Professor Gerald Yeo, from the actual reports of vivisectionists in 
England (Fortnighily Renew, March, 1882), estimates that of one hun- 
dred such ezperimentB, there are: — 

Absolutely painless 75 

As painful as vaccination 20 

As painful as the heaHng of a wound 4 

As painful as a surreal operation 1 

Total 100 


man. But nature's experiments are rarely ever limited in 
area or uncomplicated; they are never systematic and ex- 
haustive; it takes years to collect a fair niunber of her 
clumsy experiments, and the knowledge is diffused through 
many minds instead of being centered in one that will i^s- 
tematize the results* 

Said Ferrier, a year ago, in the Marshall Hall Oration, 
''There are already signs that we are within measurable 
distance of the successful treatment by surgery of some of 
the most distressing and otherwise hopeless forms of intra- 
cranial disease, which will vie with the splendid achieve- 
ments of abdominal surgery/' 

Note the fulfillment! Last fall, within a year of the fore- 
going prophecy, a man, aged twenty-five, entered the 
London Hospital for Epilepsy and Paralysis.^ From the 
i^ymptoms, which I need not detail. Dr. Hughes Bennett, 
basing his conclusions on Ferri^'s experiments, diagnos- 
ticated a tumor of small size, involving the center of motion 
for the muscles of the hand. On November 15, 1884, at his 
instance, Mr. (later Sir Rickman J.) Grodlee trephined the 
skuU over the selected spot, and a quarter of an inch 
below the surface of the brain found a tumor as big as a 
walnut, and removed it. For three weeks the man did well, 
but died on the thirty-eighth day from blood-poisoning, 
such as might follow any operation, especially a new one* 
Macewen, of Glasgow,^ has similarly trephined a woman, 
the victim of slow paralysis of body and mind, and opened 
an abscess a little distance below the surface, letting out 
two teaspoonfuls of pus, and followed by entire mental 
and physical recovery. 

By these experiments and operations a wide door is open 
to surgery in the treatment of diseases within the skull — 
diseases heretofore so obscure and uncertain that we have 
hardly dared to attack them. The question is not whether 

1 MedieaL Newi, Januaiy 17, 1885. 
^Medical Newe, Januaiy 8, 1885. 


death or recovery followed in these particular cases. The 
great, the startling, the encouraging fact is that, thanks to 
these experiments, we can now, with well-nigh absolute 
certainty, diagnosticate, and with the greatest accuracy 
locate such diseases, and therefore reach them by opera- 
tion, and treat them successfuUy.^ Would that I had been 
bom twenty-five years later, that I might enjoy with you 
the full luxury of such magnificent life-saving, health- 
giving discoveries! 

It is, howeva*, by the experimental study of the effects of 
minute organisms — microbes, as th^ are now called — 
that some of the latest and most remarkable results have 
been achieved. The labors of Koch, Pasteur, Klein, Cheyne, 
Tonmiasi-Crudeli, Wood, Formad, Sternberg, and others 
are now known even to the daily press. Let us see what 
they have done. 

It is but three years since Koch announced that con- 
sumption was caused by the '* bacillus tuberculosis.'* 
Later he had studied cholera and found the *'conm[ia 
bacillus," to which he ascribes that dreaded disease. In 
spite of the opposition of prominent scientists, his views 
have been in general accepted, and seem to be reasonable. 
[How odd all these words sound after 80 years!] 

The method of experiment is simple, though difficult. 
The suspected expectoration or discharge is placed in a 
suitable soil, and after cultivation some of this growth is 
placed in another culture-soil, and so on till generation 
after generation is produced, the violence of the poison 

^ In 1899 — only fourteen yean after this address was delivered — 
Knapp collected 491 operations for brain tumors in which the result was 
known. In 64 operations for palliation — Le., relief of pain, etc — only 4 
died; in 875 completed operations 82 died (30 per cent) ; in 152 inoperable 
and incompleted cases 86 died (56 per cent). (1905.) 

A larger experience has developed difficulties unknown thirty years 
ago, in the exact localization and therefore in the operability of such 
tumors. But the main fact to be remembered is that before these investi- 
gations every case of brain tumor was f ataL Hence every case of recovery 
is one life saved. (1914.) 


being modified by each culture. A small portion of any 
one of these cultures is then injected under the skin of a 
mouse or other animal, and in time it dies or is killed» and 
the results are verified by the poH^mortem. 

So exact is the knowledge in tuberculosis now that Kodi 
can predict almost to an hour when the mouse will die of 
consumption, or that it wiU escape, according to the culture 

It is far too eariy as yet to say that these studies have 
borne the immense practical fruit that the next few years 
will show;^ but th^ have already enabled us to recognize 
by the microscope doubtful cases of consumption in their 
earlier and more remediable stages, and have made certain 
what has hitherto been only a probability — that consump* 
tion is distinctly contagious. 

By Gerlach's experiments on animals with the milk from 
tuberculous cows, also, it has been shown that consumption 
may be contracted from such milk. How imi>ortant this 
conclusion is, in so universal an article of food to young 
and old, I need not do aught than state. 

The experiments of Wood and Formad on d^htheria I 
have already alluded to. Those of Tommasi-CrudeU also 
have shown that probably the i>oisonof malaria is due to 
like organisms, while a large number of other diseases are 
being similarly investigated.* 

As to cholera, the classic experiments of Thiersch, in 
1853,' are weD known. He inoculated 56 mice with cholera 
discharges. Of these, 44 sickened and 14 died from chol- 
eraic diseases. In the same year two water companies in 
London experimented on 500,000 human beings, one of 

^ Ab a result of this difloovery and the methods of sanitation based upon 
it, the death-rate of tuberculosis has been reduced in various dties by 
from thirty to fifty per cent. (1914.) 

' Later experiments by Laveran and others have definitdy settled the 
microbial origin of malaria and also that only one species of mosquito 
is responsible for the spread of the disease. (1914.) 

• John Simon, Proeeed%ng$, IntematioDal Medical Congress^ Loiidon» 


them inoculating its patrons with cholera discharges 
through its impure water-supply. This one sickened 
thousands and killed 8476 human beings, most of whom 
might have escaped had the lessons of Thiersch's 14 mice 
been heeded. To ask the question, which was the more 
cruel, is to answer it.^ 

At present our strenuous efforts are all in one direction — 
namely, to study these microbes by the microscope, by 
clinical observation, and by experiments on animals, in 
orda* to find out their origin, causes, growth, and effects, 
and to discover by what means their deadly results may 
be avoided, or by what remedies, without harm to the 
patient, th^ may themselves be destroyed. Evidently 
these studies cannot be tried on our patients. Th^ must 
either be tried on animals or be abandoned. 

The inoculation experiments of modem times have 
recently borne rich fruit in still another pestilential disease 
— yellow fever — whose ravages in this country are fresh 
in our minds. November 10, 1884, M. Bouley reported to 
the Paris Academy of Sciences^ that, since 1880, M. Freire, 
of Rio Janeiro, had experimented on guinea-pigs with the 
virus of yellow fever, and believed that he had been 
able to produce such attaiuation of the virus that by vac- 
cination he could secure immunity from this dreadful 
scourge. Following the experiments, he and Rabourgeon 
tested the results on themselves, some students of medicine, 

^ The population supplied by the Southwark and VauzhaU Company, 
in the ^idemie of 1848-49»died at the rate of 118 m each 10,000, and, 
in that of 1858-54, at the rate of ISO per 10,000. Those supplied by the 
Lambeth Ck)mpany died in 1848-^ at the rate of 125 per 10,000, but 
having improved its water-supply meantime^ the death-rate^ in 1858-54, 
f eU to 87 per 10,000. 

If Thiersch lived in En^^and to-day, he would have to take out a license 
to kill his fourteen mice in the interests of humanity — a license possibly 
refused, or only to be obtained alter the most vexatious delays. But 
any housemaid might torture and kill them with arsenic or phosphorus, 
or Thiersch might give them to a favorite terrier without the idi^test 
interference, provided only it be not for a scientific or a humane objecti 

> Mediod News, November 20, 1884. 


and ^nployees. Later the Emperor Dom Pedro authorized 
two hundred wharf-laborers to be inoculated. All these, 
after a three days' mild attack, remained free from the 
pestilence, while their fellow laborers, similarly exposed 
to the fey tf, were dying on eveiy hand. If , in an epidemic, 
this still prove true, as there seems every probability it will, 
from the five hundred lives already saved, we can hardly 
estimate either the medical or the cmnmerdal advantages 
to this country alone. Is this cruelty? Let Norfolk, and 
Memphis, and Pensacola, and New Orleans answer.^ 

We are all familiar now with the numerous deaths from 
eating pork infested with trichina. While I was in Berlin, 
in 18d5--66, a terrible epidemic of the then new disease 
broke out at Hedersleb^i, a small town in Prussian 
Saxony. I well remember with what zeal Virchow and his 
assistants immediately investigated the disease, inoculated 
jwirniftU with the parasitic worm, studied its natural his» 
toiy, found out that heat killed it, and to-day, as a result 
of these and other experiments, we all know how to avert 
its dangers by proper cooking, or to avoid it altogether by 
the microscope. The value of these experiments, both to 
human life and to commerce, you know even from the daily 

You will find it difficult to make the non-medical public 
understand — nay, you yourselves as yet hardly under- 
stand — the enormous advance in medicine and surgery 
brought about by recent researches on inflammation, and by 
the use of antiseptics. My own prof essional life only covers 

* ^noe then the bxilHant researdieB of Major Reed, Colond (now 
Biigadier^eneral) Gorgas, and other American army offioeis in Cuba 
have shown that the mosquito is the only source of propagation of yellow 
fever. The cause of yellow fever is stfll unknown, but mosquito bars 
guard against the fever, as our knowledge has been augmented, and Cuba 
and the United States have been freed from this pestilence and its ravages 
among human beings and its commercial disasters. 

So completely has yeUow fever been eliminated that mnoe May 17, 
1900, — <3foer eight yean! — not a single case of yeUow fever has arisen in 
the Canal Zone! (1914.) 


twenty-three years^yet in that tune I have seen our knowl- 
edge of inflammation wholly changed, and the practice of 
surgery so revolutionized that what would have been im- 
possible audacity in 1862 has become ordinaiy practice in 

It would seem that so old a process as inflammation 
would long ago have been known through and through, 
and that nothing new could be adduced. In 1851, however, 
Claude Bernard, by a slight operation, divided the sym- 
pathetic nerve in a rabbit's neck and showed its influence 
on the caliber of the blood-vessels. In 1858 Virchow pub- 
lished his ''Cellular Pathology." In 1867 Cohnheim pub- 
lished his studies on the part that the blood-cells played in 
inflammation as shown in the frog, followed by further 
papers by Dr. Norris, of this dty, Stricka*, Von Reckling- 
hausen, Wald^er, and many others. Already in my lec- 
tures I have i)ointed out to you in detail the advances made 
by these studies, both in theory and practice. They have 
brought about an entire reinvestigation of disease, and 
given us wholly new knowledge as to abscesses, ulceration, 
gangrene, the organization of dots in wounds, and after 
operations and ligature of blood-vessels for aneurism, as to 
thrombosis, and embolism, and paralysis, and ai>oplexy, 
and a score of other diseases through the diagnosis and 
treatment of which now runs the silver thread of knowledge 
instead of ignorance. 

With this the brilliant results of the antiseptic system 
have joined to give us a new surgery. Sir Joseph (later Lord) 
Lister, to whom we chiefly owe this knowledge, has done 
more to save human life and diminish human suffering than 
any other man of the last fifty years. Had he only made 
practicable the use of animal ligatures, it would have been 
an untold boon, the value of which can only be appredated 
by doctors; but he has done far more, he has founded a new 
system of surgery. We may reject the spray and carbolic 
add, but the surgical world, regardless of details, with few 


exceptions follows the principles upon which his method is 
founded and humanity is the gainer, by the nearly total 
abolition of inflammation, suppuration, secondary hemor- 
rhage, blood-i>oisoning, gangrene, erysipelas, lodcjaw, and 
** hospital gangrene,*' as sequels of accidents and opera- 
tions; by the relief from suffering and death, by operations 
formerly impossible; by rendering amputations and com- 
pound fractures safe and simple instead of deadly. Re- 
flect on what each one of these brief, but momentous, 
statements means! ^ 

But we have by no means reached perfection. Lister 
himself, no tyro, but the great master, is still searching for 
further improvements. But when lately he desired to make 
some experiments on animals, still further to perfect our 
practice, so many obstructions were thrown in his way in 
England that he was driven to Toulouse to pursue his 
humane researches. 

I had intended also to speak of many otha* practical 
benefits to man directiy, but can only mention such im- 
portant matters as the surgery of the thyroid gland, the 
seat of goiter; the surgery of the lungs, parts of which have 
been removed; the surgery of the nerves; removal of the 
entire larynx; the remarkable researches of late years as 
to the periosteum in the reproduction of new bone after 
removal of dead or diseased bone; Bernard's important ob- 
servations as to diabetes; Brown-S^uard's experiments on 
epil^sy; the modem extraordinary advance in nearly all 
the diseases of the nervous system, and a number of other 
discoveries, as to all of which experiments ui>on ftTiiTnii.lft 
have added largely to our knowledge, and therefore to our 
means of diminishing suffering and saving human life. For 
many of these, as well as for the most judicial discussion of 
the vivisection question I have yet seen, I must refer you 
to that remarkable book, *' Physiological Cruelty."* 

^ These splendid results are described in later papers in this Toliime. 
* See also the Life and Labors qf Patieur, by Vallery-Radot ^ 


I had also intended to refa* in detail to the splendid 
results of vivisection in relieving the sufferings of animals, 
and in preventing enormous pecuniaiy loss to man. We 
are only beginning to see that vivisection is as humane to 
animal life and suffering as it is to human, and that for 
fiyiftTipiftl reasons as well as humane motives it is of the 
utmost importance to the State that such diseases as cattle 
plague, splenic fever, chicken cholera, swine plague, and 
others, should be eradicated. Vivisection has shown us 
how this may be done, and has so conferred upon animals, 
too, the boon of life and health. For all this, however, I 
must ref a* you to the recent admirable lecture by Professor 
Robert Meade Smith, of the University of Pennsylvania.^ 

One subject, however, is so recent and of such interest, 
both to man and animals, that I must not pass it over — I 
mean that justly dreaded disease hydrophobia. Thanks to 
vivisection, its abolition in the near future seems no longer 
to be a matter of doubt. 

Within the last three years Pasteur has annoimced that, 
by passing the virus through the monk^, he has been able 
to protect dogs from hydrophobia by vaccination with this 
weakened virus. The French Grovemment recently ap- 
pointed an eminent scientific commission to report on the 
alleged discovery.* Pasteur furnished them with 23 vac- 
cinated dogs. These 23, and 19 others unprotected, were 
all inoculated from rabid animals. Of the 19 unprotected, 
14 died. Of the 23 protected dogs, 1 died of diarrhea, and 
all the others escaped. It has yet to be tried on a man 
suffering from hydrophobia, but, should our reasonable 
hopes be realized, what a boon it will be! * 

^ Therai)euiic OateUe, November, 1884. 

' Medical Newt, August 30, 1884. 

* "Pasteur Institutes" for the treatment of hydrophobia and some 
similar diseases have been established in nearly every civilized country in 
the world. Of posons bitten by animals bdieved to be rabid, heretofore 
about sixteen per cent developed hydrophobia, and every one died. In the 
thousands of such cases treated by Pasteur's method even those bitten by 
ammalsibunoii to be rabid the mortality is ^ (Aon orMjMf cent (1914.) 


With this brief summary of a few of the recent practical 
benefits from vivisectiony I must dose. I have given you 
only ascertained facts for your future use in the communi- 
ties in which you may settle. They may assist you in form- 
ing public sentiment on a basis of fact, of reason, and of 
common sense. The sentiment of our own profession, so 
constantly and so conspicuously humane, is always against 
inflicting pain; but if in yielding to sentiment we actually 
increase disease, and pain, and death, both among animals 
and men, our aversion to pres^it pain is both unwise and 
actually cruel. 


In no department of medicine has there been more rapid 
and in many respects more astonishing progress in recent 
years than in surgery. This progress is due chiefly to two 
things — the introduction of antiseptic methods, and to 
what we have learned from laboratory work and experi- 
ments upon animals. 

It has long been known that a '^simple*' fracture, in 
which the skin is unbroken, and a ''comi>ound" fracture, 
in which the skin is broken and the air has ea^ access to 
the fractured bone, were vastly different in their dangers; 
but why the communication with the air was so dangerous 
was a mystery. Of late years, however, the germs existing 
in the atmosphere, and on every material coming into con- 
tact with the wound, such as dirty clothing, ordinarily 
clean instruments, the skin of the patient, the hands of the 
surgeon, and the dressings, have been investigated by a 
large number of observers, and it has been abundantly 
proved that infection comes not from the woimd itself, but 
from the exterior, and that this infection from without is 
the cause of inflammation and of its speedy sequel, the 
formation of "pus" (that is, "matter"). Once that the 
pus begins to form, fever, abscesses, blood-poisoning, gan- 
grene, erysipelas, one or all, may start up into ominous 
and fatal activity. Inflammation and suppuration (that 
is, the formation of pus), then, are the causes of all these 
evil processes. They are all called briefly "septic" (that is, 
"poisonous") processes. Hence "antiseptic" methods are 
those that prevent inflammation and suppuration. 

Now we see why a compound fracture, or any other 

^ Rq>rinted from Harper** Magazine, October, 1889, by the kind con- 
sent of Messrs. Harper & Brothers. 


*'opeii '' wound (that is» one in which the protective defense 
of the skin is destroyed), is so much more dangerous than a 
simple fracture, or a subcutaneous wound. It arises from 
the fact that these septic germs, or '^microbes," have easy 
access to the tissues, and, once there, multiply with almost 
incredible rapidity, and quickly set up inflammation and 
suppuration and thdr consequences. At first it was thought 
that the chief danger lay in atmospheric germs, but later 
investigations have proved that the skin of the patient, 
and especially the hands of the surgeon, and his instru- 
ments and sponges, and even his dressings, are far more 
frequent sources of infection* 

Perhaps I cannot better illustrate the difference between 
the old, or "septic,** and the new, or "antiseptic," surgery 
than by describing two amputations, one such as was com- 
monly done, for instance, during the Civil War, and the 
other such as is done now by every good surgeon. In fact, 
it is only within the last ten or fifteen years that antiseptic 
surgeiy has become generalized in the profession. 

Let us suppose an amputation above the elbow, and the 
operator the best surgeon of the Civil War. The arm was 
not specially prepared, except that it would be cleaned of 
its coarse dirt arising from the accident, but that would be 
all. The instruments were taken out of an ordinary case 
and placed on a table, and during the operation were fre- 
quently placed upon the patient's clothing, soiled often by 
the accident necessitating the operation, as well as by more 
or less wearing. If the instruments or sponges feD upon the 
floor, they would be picked up, dipped into water, and then 
used with innocent equanimity. The sponges, washed and 
dried from the last operation, were simply thrown into a 
basin of ordinary water. The hands of the surgeon were as 
clean as a gentleman would always keep his hands. The 
amputation having been done, the arteries were tied with 
silk threads (called "ligatures"), one end of each being left 
long. These long ends were left hanging out of the wound 


at any convenient place, and in an amputation of a musco* 
lar thigh might number a score or more. Hemorrhage 
having been checked, the two flaps were sewed together 
with wire or silk threads, called *' sutures/' In threading 
the needle, the silk thread would often be shaped into a 
point by the lips, or, after being wetted with septic saliva, 
would be rolled between septic fingers. A piece of lint, or 
often a piece of soft, old linen **rag,'' spread with some 
grease, was placed upon the stump, and a suitable bandage 
applied. The nest day the dressings were removed, and 
the woimd was redressed in a similar manner. At the end 
of twenty-four or forty-eight hours a {ever would set in» 
called in our textbooks ** surgical fever," thus assuming 
that a surgical operation always resulted in such a fever; 
nor was the assumption erroneous at that time. This would 
continue for several days, the temperature ranging from 
IW*' to 104** or 105*' F. In a few days, when suppuration 
became established (and this was always expected by the 
surgeon), the fever would gradually subside, and later the 
suppuration also would diminish. At the end of a week or 
ten days the surgeon would pull gently on each silk liga- 
ture, to see if it had rotted loose from the blood-vessel and 
could be removed. If the wound became unduly inflamed, 
I)oultices would be applied; and finally, after three or four 
weeks, the ligatures would all have been removed, and 
the wound soon be healed. Very rarely, indeed, would a 
wound heal without suppuration. If it did, it always excited 
remark, and would be recounted as a surgical triumph. 
Veiy often, on the other hand, grave complications arose by 
the formation of abscesses; erysipelas and gangrene were 
fertile sources of danger, and veiy often of death; while 
secondary hemorrhage — that is, hemorrhage following pre- 
mature rotting of the ligatures on the blood-vessels — was 
always a possible, and frequently an actual and formidable, 
danger to life. A serious operation from which the patient 
recovered in less than a month was a ** remarkable case." 


Contrast this with a similar operation performed to-day 
by any ordinarily weD-instructed surgeon. The day before* 
hand the skin in a wide area around the site of the proposed 
operation will first be scrubbed by a nail-brush with soap 
and water, then with etha*, then with some antiseptic 
solution, — most frequently at the present day a solution 
of corrosive sublimate, one part to one thousand of water, 
— and then covered with an antiseptic dressing until the 
operation is begun. The object of this is to free the skin 
from dirt and fatty matter, making it surgically dean and 
free from germs. The instruments will have been boiled 
in a covered vessel for fifteen minutes, or disinfected by 
carbolic acid or some equivalent germicide, and are then 
placed in a tray filled with an antiseptic solution. In the 
cleaning of them after the last operation all rough and more 
or less inaccessible places where germs may accumidate 
(especially, for instance, the joints) will have been scrupu- 
louusly disinfected. If during the operation an instrument is 
laid down, it is never placed on the clothing of the patient, 
but either is replaced in the tray, or laid ui>on towels or 
sheets which have been disinfected and spread all over the 
patient's person and dothing all around the field of 

After an operation the sponges are thrown away if they 
have become infected from pus; but if not, they are very 
carefully disinfected, and then kept permanently in a 
carbolic solution.^ At the next operation they are placed 
in a tray containing some antiseptic, or at least water which 
has been boiled, for heat has been found to be one of the 
best antiseptics. If a sponge or an instrument fall on the 
floor, it is laid aside, or before being used again is thoroughly 
disinfected. The hands of the surgeon will next receive 
especial care. First they are scrubbed with soap and water 
and a nail-brush. Then the nails are deaned anew, for the 

1 Later gauze "sponges'' have practically displaced these "marine'^ 


dirt which accumulates unda* them is found to be one of 
the most fruitful sources of infection. Then the hands are 
washed in pure alcohol, and last, while wet, are again 
scrubbed with the antiseptic solution, the nails again 
receiving gr^it care. If during the operation the hands 
touch anything not itself already disinfected, th^ must 
again be disinfected. 

These precautions being complete, theoperation is b^un. 
The blood-vessels are tied with catgut or silk which has 
been disinfected, and boih ends are cut short. These liga- 
tures are not irritating like the non-disinfected silk formerly 
used. As no end hangs out, they are never pUlled upon, 
but are slowly absorbed, and nothing is ever heard of them 
again. In consequence of this the blood-vessels are never 
afterward disturbed, and secondary hemorrhage is now one 
of the rarest complications following an operation. A dis- 
infected rubber tube, with holes in it for draining away 
the wound fluids, which ooze from the raw surfaces for 
some time, is then inserted between the flaps, with a bundle 
of horse-hairs alongside of it. The flaps are now united by 
sutures of catgut, disinfected as before, or sutures of wire 
or of silk similarly prepared. A large, soft dressing of many 
layers of dry cheese-cloth is next applied by a bandage. This 
dressing has been thoroughly impr^nated with corrosive 
sublimate or some other antiseptic solution. The finest 
linen or lint, clean as the driven snow to the ordinary eye, 
is dirty to the ^e of an antiseptic surgeon, since it is not 
cleansed from the microscopical germs that will surely 
cause infection. At the end of twenty-four hours the drain- 
age tube is removed, the horse-hairs being sufficient for 
the slight later drainage, and another similar dressing of 
dry antiseptic cheese-cloth is applied. The horse-hairs are 
entirely removed after four or five days.^ 

The temperature of the patient after the operation 

^ Since 1889 this "ritual" has been much amplified and at the same 
time is more efficient. (1914.) 


scarcely rises above the normal. Apart from the discomfort 
of the ether-vomitings from shock, and from loss of blood 
(from all of which the patient generally recovers in twenty- 
four hours or less), he will suffer but little pain. It is not 
an infrequent thing to see a patient recover, even from a 
severe operation, without having suffered much pain. By 
the fifth or the tenth day, when the second dressing will be 
applied, the wound is well. No complications ought to 
occur, saving in exceptional cases. Secondary hemorrhage 
is unknown. Primary union of the flaps is now always 
expected. Theformationof pus is a rare accident; if it does 
occur, the surgeon asks himsdf, *'What mistake did I 

Let us now see what the results have been in amputa- 
tions. In Prof essor Billroth's clinic in Vienna^ in the seven- 
teen years from 1860 to 1877, there were 815 major ampu- 
tations done (i.e., excluding fingers and toes) in the most 
approved methods of the days before antiseptics were 
introduced. Of these, 178, or 54 per cent, died. From 1877 
to 1880, 91 such amputations were done by the same sur- 
geon with antiseptic precautions, and the mortality fell to 
18, that is, 19.7 per cent — nearly one third of the former 
rate. Of the 91 cases, M were uncomplicated cases, of 
wh<»n not one died. The general rates of mortality in 
amputations in different hospitals in the days before anti- 
septics were employed have ranged from 28 to over 5S per 
cent* Since the introduction of antiseptics some idea (rf the 
saving of life, to say nothing of the immense decrease of 
pain and suffering, may be gathered from the following 
additional figures: In Von Bran's clinic, 47 major amputa- 
tions were done antiseptically, and not one died. Busch 
reports 57 similar amputations, with a mortalily of S.5 per 
cent; Schede, 81 amputations with a mortality of 4.87 per 
cent; Socin, 48 amputations, and a mortality of zero; and 
Volkmann, 220 amputations, with a mortality of but S,5 
per cent. I have purposely quoted the statistics ci six 


operators so as to show that it is not the man, but the 
method, which has yielded such splendid results. 

This perfection has been reached by an immense deal of 
labor on the part of many observers, first and foremost, 
jynmri8 inter pares^ Sir Joseph (later Lord) Lister, now of 
London. The experiments have been made chiefly in two 
directions. First, on animals, to discover what was the 
best method of treating wounds, and especially to select 
the best material for ligatures and sutures by which to tie 
the bleeding vessek and unite the flaps, the object being to 
obtain that material which would not carry infection, and 
which, at an early date, would be entirely absorbed — yet 
not at too early a date lest the blood-vessels should not be 
firmly closed and therefore secondary hemorrhage should 
occur. These experiments upon animals have been at- 
tended with but little pain, and in many cases practically 
none, for th^, too, have been done antiseptically. The 
results shown above attest the inmiense value of the in vesti- 
gations. Yet the antivivisection laws in England are so 
hostile to all humane progress in surgery that when, a few 
years since. Lister desired to carry on some experiments 
with a view to still greater perfection, he was obliged to 
leave London and go to France in order to perform them. 
After experimenting in animals with ligatures, with 
sutures, and with disinfectants in the various modes of 
the antiseptic treatment of wounds, then followed the 
crucial test in man — a test only justified by the good 
results first obtained in animals. These trials have from 
time to time been followed by modifications in detail, but 
practically none in principle. 

Secondly, this result has been attained by a painstaking 
study of the entire life-history of the many varieties of 
microbes or bacteria now known to exist: what distinguishes 
one from another, and what favors and what hinders the 
development of each. Next the effects of their intentional 
inoculation in animals were observed; and then the results 


of their oocurrenoe in man in various diseases and aoddents* 
In facty this study of bacteria is now a distinct science, 
known as bacteriology, and has among its students some 
of the most noted names in medicine. One of the practical 
results of such scientific study of bacteriology is seen in the 
recent immense improvement of our treatment of that 
dangerous accident already alluded to — compound frac- 
tures. The statistics of compound fractures from a half- 
dozen of the best hospitals of America and Europe for 
varying periods from twelve to twenty years before the 
introduction of antiseptic methods gave a mortaUty vary- 
ing from £6 to 68 per cent, the majority of deaths being 
from serious complications due to blood-poisoning. The 
introduction of antiseptics caused a f alling-off of the death- 
rate of Billroth*s cases in Vienna to one tenth of what it 
formerly was, and in the other hospitals in similar though 
varying proportions. Still more remarkable are the results 
recently reported by Dennis of New York. Of 446 com- 
pound fractures of all grades, from the most severe down, 
of which 385 belonged to the class of severe fractures, only 
ft died, the mortality being less than one ha^ of one per cent 
— less than 2 in 400 in contrast to the rate previous to the 
introduction of modem surgical methods of from 104 up to 
£72 in 400! At present his list of cases extends to about 
900 without a single death from blood-poisoning. Nothing 
can add force to such a statement. 

Besides these very remarkable results in the almost 
certain and painless healing of severe accidents and of 
operation wounds within the last few years, as a result of 
the scientific studies just noted, many other achievements 
have been made possible by them in modem surgery, to 
which I must now allude. 

The two regions of the body in which the most marvelous 
advance has been made are the abdomen and the head. 
Twenly-five years ago, to open the cavity of the abdomen 
and explore the peritoneum (a thin membrane which lines 


the entire cavity and covers all its contents) was a step 
from which every prudent surgeon shrunk. If it were 
opened by accident, there was nothing left for us but to do 
the best we could, and usually the best meant, in the 
absence of antiseptic methods, to look on until the patient 
died, helpless to do aught except administer a few anodynes 
until death came to his relief. 

During the War of the Rebellion there were 64 cases of 
wounds of the stomach, and only 1 recovered. Otis esti- 
mated the mortaUty at 99 per cent. In over 650 cases of 
wounds of the intestines there are recorded in the literature 
of the war only 5 cases of recovery from wounds of the 
small intestine (and there is even some doubt as to 
whether the intestine was really wounded in these 5) 
and 59 from wounds of the large intestine. A gunshot 
wound in the abdomen was looked upon as almost 
necessarily fatal. Surgeons scarcely dared to open the 
abdomen either to search for the ball, to close a fatal 
perforation of the boweb, or to check hemorrhage. 

America can rightly boast of playing the chief rdle in 
effecting the change that has taken place. The elder Gross 
long since led the way by his experiments on dogs, but we 
owe our present boldness and success chiefly to the experi- 
ments of Parkes, Bull, and Senn, — all Americans, — who 
have first shown in animals that it was safe and right, with 
antiseptic methods, to interfere actively for the health and 
healing of our patients. While it is true that a small rear- 
guard in the surgical army would fold their hands and give 
opium until the patient died, there is scarcely a man abreast 
with modem ideas who in such a case would not open the 
abdomen, tie bleeding vessels, sew up a rupture or wound 
of the stomach or bowels, remove a lacerated kidn^, and 
in general repair any damage done. Of course, large num- 
bers of such patients, either from immediate hemorrhage, 
or from the severity of the wound inflicted, must always 
die. But, to say nothing of the numerous other cases in 


which recovery has followed operative interference in such 
wounds, even though multiple, the possibilities of modem 
surgery are well shown in a case reported by Senn, in which 
eleven perforations of the bowel were sewed up, and another 
case of Hamilton's in which there was so extraordinary a 
number as thirteen wounds of the intestines, besides wounds 
of the omentum and the mesentery, and yet both of these 
patients made uninterrupted recoveries! In a recent table 
by Morton of 19 cases of stab wounds (all, of course, by 
dirty knives, and one even by a ragged splinter of dirty 
wood) with hemorrhage and protrusion of the bowels, 12 
recovered and but 7 died, and even of 110 gunshot wounds 
of the intestines in which the abdomen was opened, 86 lives 
were saved.* 

If this be the admirable showing in wounds attended by 
infection from dirty knives, from the dirt on the clothing* 
and from the ground on which wounded persons would fall, 
it is no wonder that, with dean hands and instruments, 
surgeons have dared not only to open the abdominal cavity 
to verify a probable diagnosis, or to perform an operation, 
but to go still farther and to open the abdomen to make a 
diagnosis. It is often impossible to make an absolute diag- 
nosis from eztanal examination alone, not only on account 
of the inherent di£Sculty from the dose grouping of so many 
organs within the abdominal cavity, but even in cases 
apparently not obscure we may be in error. At the present 
day it is not only considered justifiable and not unreason- 
ably dangerous to open the abdomen for the removal of 
tumors that are dearly fit for operation, but in a very large 
number of doubtful cases it is the duty of the surgeon to 
make a small opening directly into the abdominal cavity, 
and to insert two fingers in order to determine by touch 
what the nature of the tumor or other disorder is, and, 

^ Eeyes, Journal Ameriean Medioal AMoeiaHofit November 9S, 1012; 
p. 1886, records a recovoy after twenty-two gunshot perforations of the 


having determined its nature^ to proceed to its removal, if 
the facts warrant it; if not, the abdominal wound is closed, 
and the patient practically always recovers from the 
incision. So slight is the danger from such ** exploratory 
operations,'' as th^ are rightly called, that it is not to be 
weighed for a moment against the advantages derived from 
positive knowledge. 

The most remarkable statistics recently published are 
those of Mr. Tait, and a mere statement of his percentages 
will go far to convince the non-medical public of the correct^ 
ness of the above statements, startling as they appear to 
one unfamiliar with modem surgical progress. Mr. Tait has 
completed a second series of 1000 cases in which he opened 
the abdomen for the removal of tumors, for abscesses, for 
exploration, etc In his first 1000 cases only 02 patients 
died (9.2 per cent), and in the second 1000 only 53 died 
{5.S per cent). In ovariotomy alone the percentage fell from 
8.1 in the first 1000 to 3.8 in the second. Only a quarter 
of a century ago the mortality of ovariotomy was but Uttle, 
if at all, under 50 per cent. I have heard the first obstetri- 
cian of his day, when I was a student, say that any man 
who dared to open the abdomen to remove an ovarian 
tumor should be indicted for murder! Sir Spencer Wells, 
even with the far larger mortality of his earlier days, added 
twenty thousand years to human life as the net result of 
one thousand ovariotomies! He has lived to see even his 
great success far surpassed by the best surgeons; and all 
over the civilized world, even the average surgeon is fol- 
lowed by benedictions for recovery in ninety out €st every 
hundred of such operations. 

Surgeons have even successfully removed tumors that 
after removal weighed more than all the rest of the 
patient's body. But we go further than the mere removal 
of abdominal tumors. In a considerable number of cases of 
cancer of the stomach the diseased part of the stomach 
itself has been removed, and the patient has made a good 


recovery. Of course, however, the disease often returns, 
and is eventually fatal. In cases of cancer and obstruction 
of the bowels, or of extensive wounds, even three or four 
feet of the bowel have been completely removed, the ends 
sewed together, and the patients have recovered. In other 
cases, instead of removing the diseased parts, openings 
have been made in the bowel, one above and one below 
the disease, the two openings being then placed opposite 
each other and united by their margins, and the continuity 
of the bowel has been thus successfully reestablished, the 
intestinal contents following the ** short<nit " thus provided. 
This veiy new operation has only been done in man in a 
veiy smallnumberof cases, but the mortality in dogs is only 
7.69 per cent, and as our procedure will improve by experi- 
ence, it will probably be even less in the human subject. 

When the spleen is enlarged, it also has been successfully 
removed in 90 cases, followed by 51 recoveries. Occasion- 
ally the spleen, instead of being fixed in its place, is loose 
or ^^floating'' in the abdominal cavity. In 10 cases these 
have been removed, with 8 recoveries. 

Another remarkable achievement of abdominal surgery 
is in operations on the gall-bladder. Occasionally a numb^ 
of gall-stones^ are formed in the gall-bladder or its duct and 
produce dangerous and often fatal disease. In 78 cases 
now recorded the gall-bladder has been opened, the gall- 
stones removed, and 64 of the patients have recovered. 
Not satisfied even with this, in 22 cases the entire gall- 
bladder itself has been removed to prevent any recurrence 
of the disease, and 19 of the patients have demonstrated 
the fact that they could get along quite as well without 
such an apparently useless appendage as with it; in fact, 
in their cases at least, a good deal better. In 100 operations, 
therefore, on the gall-bladder the mortality has been only 

^ These stones arise fram the bile^ and aie often as large as marbles. 
Sometimes only one exists^ but sometimes there are even hundreds of 


17 per cent. Mr. Tait himself has performed 54 such opera- 
tions, and has lost but 2 patients, a mortality of less than 
4 per cent. Considerable portions of the liver have also 
been removed with success, one of the operations being 
neces^tated as a direct result of the use of corsets, in the 
opinion of the operator.^ 

Operations on the kidn^ are among the most remarkable 
trimnphs of abdominal surgery. In 1869 Simon, of Heidel- 
berg, had a patient suffering from various troubles with the 
duct of the kidn^. After many experiments on dogs to 
determine whether it was possible for them to live with one 
kidn^, after the sudden removal of its fellow, he ventured 
to remove this otherwise healthy organ, and the patient 
lived for eight years in perfect health.^ Since then very 
many such operations have been done, and the latest results 
are as follows: In 875 cases of entire removal of one kidney 
in consequence of its being hopelessly diseased, 197 lives 
were saved. In 95 cases of abscesses and other diseases, 
in which the kidney was cut down upon in the loin or abdo- 
men, and the kidney opened and drained, 76 lives were 
saved. In 102 cases in which stones were removed from the 
kidney, 76 lives were saved, and in 25 cases in which the 
kidney (as in the case of the spleen above referred to) was 
''floating'* around loose in the abdomen, and a source of 
discomfort and pain, it had been cut down upon, sewed 
fast in its proper place, and all but one got well, and even 
this one death was from injudicious surgery. A total of 
597 operations on the kidn^ shows, therefore, recovery 
and, in general, complete restoration to health in 878. Had 
the patients been let alone (as they would have been prior 
to Simon's experiments in 1869), almost every one would 
have died^ and that, too, after weeks, or years it might be, 
of horrible pain and loathsome disease. 

1 Tie statistics of all these operations have been greaUy bettered 
in the twenty-five yean since this was written. (1914.) 
* See pp. 10-12. 


But the most extraordinaiy achievement of modem sur- 
gery lemains to be told. In the ''Lancet'' for December 
20, 1884» Dr. Bennett and Mr. Qater Sir Rickman J.) 
Godlee published an article which startled the surgical 
world. Dr. Bennett had diagnosticated not only the 
existence, but the exact locality of a tumor in the brain, 
of which not the least visible evidence existed on the exte- 
rior of the skull, and asked Godlee to attempt its removaL 
The head was opened and the brain exposed. No tumor 
was seen, but so certain were th^ of the diagnosis that 
Godlee boldly cut open the healthy brain and discovered 
the tumor the size of a walnut and removed it. After doing 
well for three weeks, inflammation set in, and the patient 
died on the thirty-eighth day. But, like the failiue of the 
first Atlantic cable, it pointed the way to success, and now 
there have been twenty tumors removed from the brain, of 
which seventeen have been removed from the cerebrum 
with thirteen recoveries, and three from the more dangerous 
region of the cerebellum, all of which proved fatal. Until 
this recent innovation every case of tumor of the brain was 
absolutely hopeless. The size of the tumors successfully 
removed has added to the astonishment with which 
surgeons view the fact of their ability to remove them at 
all. Tumors measuring as much as three and four inches 
in diameter and weighing from a quarter to over a third 
of a pound have been removed and the patients have re- 

Another disease formerly almost invariably fatal is 
abscess of the brain. In the majority cS. cases this comes 
as a result of long-standing disease of the ear, which after a 
while, involves the bone and finally the brain. So long ago 
as 1879 Dr. (later Sir William) Macewen, of Glasgow, diag- 
nosticated an abscess in the brain, and wished to operate 
upon it. The parents declined the <q>eration, and the pa- 
tient died. After death Macewen <q>erated precisely as he 
would have done during life, found the abscess and evacu- 


ated the pus^ thus showing how he could probably have 
saved the child's life. Since then the cases treated in such 
a manner amount to scores^ and more than half of them 
have recovered without a bad symptom. 

In injuries of the skull involving the brain* the larger 
arteries are sometimes wounded, and the blood that is 
poured out between the skull and the brain produces such 
pressure as to be speedily fataL In some cases, even without 
any wound, the larger arteries are ruptured by a blow or 
fall, and a similar result follows the hemorrhage. Nowa- 
days, in both of these injuries, any well-instructed surgeon 
will open the head, secure the bleeding vessel, and turn out 
the dot witha good chance of recovery in a large number of 
cases. Even gunshot wounds of the brain are no longer 
necessarily fatal. Among a niunber of other successful 
cases one has been recently reported in which the ball went 
all the way from the forehead to the back of the head, and 
after striking the bone rebounded into the brain. The back 
of the skull was opened, the ball removed, and a rubber 
drainage tube of the caUber of a lead pencil passed in the 
track of the ball completely through the head, and the 
patient recovered. So little danger now attaches to opening 
the skull, with antiseptic precautions similar to those 
already described, that the latest writer on trephining 
(S^del) estimates that trephining per se is fatal only in 
1.6 per cent of the cases. Mr. (later Sir Victor) Horsley has 
recently published a most remarkable paper, including ten 
operations on the brain, in which, without anything on the 
exterior to indicate its situation, the site of the disease was 
correctly located in all, and nine of them recovered after 

Almost equally astonishing are the results of brain 
surgery in certain cases of epilep^; for the surgical treat- 
ment of the cases justifying such interference has been 
attended with the most brilliant results. In these cases the 
spasm begins in a particular part of the body; for example. 


the hand or the thumb* or it is limited to one arm, or to one 
side of the body. Some of them have been operated upon 
without any benefit, but a large number of other cases have 
been operated on and either benefited or, in not a few cases, 
have been completely restored to health. That the words 
''brilliant results" are not inappropriate will certainly be 
granted when we look at Horsley's table of cases. One 
patient had 2870 epileptic convulsions in thirteen days, 
and completely recovered, not only from the operation, 
but also from his terrible malady, after the removal of a 
diseased portion of the brain, the result of an old depressed 
fracture of the skull. Besides this, a few cases of headache 
so inveterate as to make ordinary occupations impossible 
and life itself a burden have been cured by trephining the 
skull. Even insanity itself has been cured by such an opera- 
tion in cases in which it has followed injuries to the head. 
What the ultimate result of these recently inaugurated 
operations will be it is impossible to tell as yet, but thus 
far th^ have been so beneficent and so wonderful as to 
arouse not only our greatest astonishment, but also our 
most sanguine hopes.^ 

The question will naturally arise, how is it that the neu- 
rologists can determine so exactly the location of such tum- 
ors, abscesses, hemorrhages, scars, and other alterations 
of tissue giving rise to epilepsy and other disorders men- 
tioned, without the slightest indication on the exterior of 
the skull to point to the diseased spot. That this is of 
supreme importance in the brain will be evident upon a 
moment's reflection. In other parts of the body, even if we 
make an error of an inch or two, it is of comparatively 
littie importance, as the incision can be easily prolonged, 
and heals readily. But in the skull, from the very nature of 
the bony envelope, an error of an inch or two means almost 

1 Larger and longer experience has modified these expectations. Most 
cases of epilepsy are not amenable to operatioD, but in many cases the 
lesnlt has been "brilliaot" (1014.) 


certain failure to find the disease, and means, theref ore» 
possibly the death of the patient. 

It is impossible within the limit of this paper to state in 
detail the method, but the following brief sketch may give 
some idea of it. Whatever can be advanced against vivi- 
section, there is this to be said in its favor, that without it 
the exact localization of cerebral tumors and other such 
lesions, which is one of the chief glories of the present day, 
would be impossible. We owe our knowledge of the loca- 
tion of cerebral functions to many observers, chief of whom 
are Ferrier and HorsI^, of England, and Fritsch, Hitzig, 
and Goltz, (rf Germany. Horsl^'s method will suffice as a 

The brain of a monk^ having been exposed at the part 
to be investigated, the poles of a battery are applied over 
squares one twelfth of an inch in diameter, and all the vari- 
ous movements which occur (if any) are minutely studied. 
One square having been studied, the next is stimulated, 
and the results are again noted, and so on from square to 
square. These movements are then tabulated. For exam- 
ple, all those adjacent squares which, when stimulated, 
produce movements of the thumb are called the region for 
representation of the thumb, or, shortly, ''the thumb 
center''; and to all those squares which produce movements 
of the hand, the elbow, the shoulder, or the face, etc., are 
given corresponding names. In this way the brain has 
been mapped out, region by re^on, and the same minute, 
patient study given to each. 

These animals, I should add, are etherized so that they 
do not suffer the least pain. I may also say in passing that 
such operations^ with few exceptions, even without ether, 
are not painful. The brain itself can be handled, com- 

^ Operatioiui on the bnun itsdf were meant. Of oouise the indsian in 
the scalp would be very painful and would require an anesthetic Hand- 
hng, cutting, and even burning the brain tissue (as is occasionally neces- 
sary to chedc hemorriiage), it must be emphasised produces mdtheleoH 
pom. I have had patients chat and joke with me while doing so. (1014.) 


pressed, cut, or torn without the least pain. A number of 
cases have abeady been reported in which a considerable 
portion of the human brain has been removed by operation 
and the patients have been out on the street within a week, 
without pain, fever, or a single dose ci medicine. 

Studying in this way the brain of the lower animals, we 
now have a very fair knowledge of the localization of many 
of its functions. With the functions of the front part we 
are as yet not familiar. The part which lies, roughly speak- 
ing, behind and in front of one of the chief fissures of the 
brain (the fissure of Rolando), which runs downward and 
forward above the ear, is known as the ** motor region.*' In 
this region the different centers have been mapped out in 
the monkey's brain, and have been verified in the brain of 
man many times. Most of that part of the brain above and 
behind the ear has no special functions that we know of at 
present, except one region, which is the center for sight. 
Injury to this produces blindness of the half of each retina 
on the same side as the injuiy to the brain. But it is ex- 
tremely di£Seult to obtain in the lower animals any evi- 
dence of the special senses other than that of touch, the 
abolition of which produces loss of feeling, of which we can 
get exact evidence. Motion and sensation, therefore, are 
the two things that can be most readily determined. 

Having now ascertained in animals the location of the 
particular centers, the next step is to apply this knowledge 
to the human brain in judging of the processes of disease. 
But it will be easily seen that the experiments that disease 
performs in a human brain are clunu^, spread over a wide 
area, and therefore often difficult of interpretation. In- 
stances affecting a single little area of brain surface one 
twelfth of an inch in diameter are almost unknown, and a 
tumor has been removed of such size that it produced direct 
pressure upon more than twelve hundred such squares, and 
indirectly produced pressure upon many distant parts of 
the brain. This is, of course, very dumi^ experimentation. 


The familiar game of ''shouting proverbs'' will well iUus- 
irate the di£Sculty of interpreting the answers of disease 
to our question, "Where is it located?*' Imagine twelve 
hundred persons, each assigned a single word of a proverb 
of twelve hundred words. At a given signal each shouts 
his own word. What a Babel of sound! How utterly im- 
possible of disentanglement and proper arrangement! This 
is the answer of disease as represented by such a tumor* 
Take each of the twelve hundred persons in the proper 
order and question him separately and repeatedly, write 
down the answers accurately and in their proper sequence, 
and behold the proverb! This is the answer of scientific 
investigation as seen in vivisection. 

Instead of there being a tumor, a blood-vessel will some- 
times break in the brain, and produce a clot, affecting sim- 
ilarly a large area; or softening of the brain will in the same 
way invade an equal or a greater niunber of centers. It is 
therefore eirtxemely rare that we can find a small area, such 
as that for speech, or for the hand, or for the arm, or for 
the face, or for the leg, or for sight, that is involved entirely 
by itself. But such cases do occasionally occur, and they 
are extremely valuable in fortifying the conclusions 
derived from the exact experiments of the laboratory. 
While some of the cases have introduced confusion and 
uncertainty from the character of nature's experiments, 
it can be broadly asserted that generally they have abso- 
lutely confirmed them. The results obtained by the surgeiy 
of the brain have more than confirmed them; for, as indi- 
cated already, the brain has been exposed, and that portion 
which, according to experiment, is believed to be the center 
for the wrist, or for the shoulder, etc., has been cut out, 
and paralysis of the corresponding part (a paralysis which, 
however, is usually only temporary) has proved positively 
the accuracy of the inference from animals. 

We are still a little uncertain as to the exact functions of 
large portions of the brain, but we have made a reasonable 


begnming; we have found firm ground to stand upon, and 
the results abeady obtained i n the relief of human miff ering 
and the cure of disease are such as readily encourage the 
hope that in the near future we shall be able to do vastly 
more. The exponents of vivisection have stoutly contended 
that it has shown no useful results. Let us wholly ignore 
the researches of Sir Charies Bell* of Harvey or Hunter* or 
other eiperimenters of the past. Here is a field in which the 
last UaoL years have opened wholly new ground tar modem 
surgeiy, in which already the operations of the last four 
years have been marveloudy successful, and have startled 
even surgeons themsdves. Had vivisection done nothing 
else than this, it would be amply justified, and to obstruct 
researches so rich in beneficent results would be a disaster 
to humanity. 

But not only has the brain been exposed and compelled 
to give up its secrets, and to yield itself to the successful 
assaults of the surgeon, — the spine has also of late been 
the field of some remarkable work. About a year ago 
Horsley repcnrted a remarkable case, in whidi a tumor by 
pressure on the spinal cord had been the source of most 
frightful pain for a long time, and of paralysb of all the 
lower half of the body. Once that an accurate diagnosis, 
not only of its existence, but of its actual locality was made, 
he made an incision in the back, exposing the backbone, 
cut away the bone down to the membrane, and even to the 
spinal marrow itself, and removed the tumw. When last 
reported the patient was able to walk three miles, and even 
to dance. Since then there have been numerous successful 
operations upon the spine in this country, in England, and 
in France, and the near future will doubtless show even 
better results. Already severe fractures of the spine have 
been operated upon by removal of the fragments sticking 
into the spinal marrow, and recovery has followed instead 
of a lingering and certain death. 

We are only just b^pnning to interfere surgically with 


the lungs; to open abseesses in them» and to remove por- 
tions successfully; and several ribs have been removed in 
cases of chronic pleuri^ and deformed chests. 

Formerly one of the most dangerous operations known 
was the removal of goiters. Hemorrhage, inflammation, 
and blood-poisoning destroyed a very large number of such 
cases, and when Kocher, of Berne, in 1882, reported 58 
operations, with a mortality of only 14.8 per cent, it was 
deemed a triumph. But improved methods of operation 
reduced the mortality until, in 1884, he reported 48 more 
operations, with a mortality of only 0.9 per cent, and in 
1889 he has just reported 250 additional operations, and all 
but patients recovered — a mortality of but 2.4 per cent, 
or, if we exclude the 25 cases of cancer, which gave 4 of the 
deaths, we have 225 cases and only 2 deaths, a mortality 
of but 0.8 per cent.^ 

We see few cases of severe knock-knee and bowlegs in 
this country, but among the ill-fed lower classes of Europe 
they are conunon. Formerly almost nothing could be done; 
but a few years ago surgeons began to operate upon them 
in this way: A small cut is made through the skin and mus- 
cles down to the bone, and by a saw or a chisel the bone 
is divided. The limb is then straightened, and the case 
treated predsely as if it were an ordinary fracture. It 
heals without fever or serious pain, and the patient is welL 
With modem methods this is not a dangerous operation, 
as will be seen by the remarkable paper read by Macewen, 
of Glasgow, at the International Medical Congress of 1884, 
in Copenhagen, when he reported 1800 operations on 1267 
limbs in 704 patients, and only 5 died, in spite of the fact, 
too, that most of them, from deformity in several limbs, 
had to have multiple operations. Even these deaths were 

* Charles H. Mayo, in 1913, reported five thousand cases (including 
all varieties) of goiter operated on in the Mayo clinic in twenty-five 
years, with a mortality of only one to three per cent. (Journal of the 
Americaa Medical AsMciatioih July ^» 1918.) - 


not due to the operation, but followed from pneumonia, 
typhoid fever, consumption, and diphtheria. 

We have learned, too, that portions of the body can be 
entirely severed, and, if suitably preserved, can be replaced, 
and they will adhere and grow as if nothing had happened. 
When a wound is slow in healing, we now take bits of skin, 
either from the patient's own body or provided by generous 
friends, or even from frogs, and "graft" them on the sur- 
face of the wound. They usually adhere, and as they 
enlarge at their margins, they abridge by one-half the time 
required for healing. Even a large disk of bone, one or two 
inches in diameter, when removed from the skuU, can be so 
treated. It is placed in a cup filled with a warm, antiseptic 
solution. This cup is placed in a basin of warm water, and 
it is the duty of one assistant to see that the thermometer 
in this basin shall always mark IW to 105'' F. The bone 
may be separated from the skull so long as one or two hours, 
but, if properly cared for, can be replaced, and will grow 
fast and fulfill its accustomed, but interrupted, duty of 
protecting the brain.* 

The remarkable progress of surgeiy which I have so im- 
perfectly sketched above has been, as I have shown, the 
result chiefly of experimental laboratory work. To Mr. 
Carnegie, of New York, is due the credit of establishing the 
first bacteriological laboratory in this country, and from 
studies in this laboratory arose the brilliant and beneficent 
results in the treatment of compound fractures which I 
have quoted. If one laboratory can give such beneficent 
results in one single surgical accident, what will not majiy 
do, each vidng with all the rest in investigating different 
important surgical and medical questions as yet unsolved? 
Could wealthy private citizens erect more useful monu- 

' Carrel's extraordinary success in transplanting tissues even after 
being for days in ''cold storage," his successful transplantations of the 
entire Iddney and an entire leg in animals, are among the latest achieve- 
ments of surgery. (1914.) 


ments of enduring fame? In Europe the government es- 
tablishes and supports such laboratories. In America we 
must look to private munificence, and never yet has hu- 
manity made such an appeal to my countrymen in vain. 


To ''Harper's Magazine" for October, 1889» I contrib- 
uted a paper in which I demonstrated the fact, and to 
some extent the causes, of the recent marvelous progress of 
surgery. In this, as in an earlier publication, I attributed 
it to a large extent to vivisection. Both publicly and pri- 
vately my statements have been called in question. 

The seven years which have elapsed since my first publi- 
cation on this subject have demonstrated, far more than I 
even hoped or expected, the truth of what I then stated, 
and it would seem right that some of these demonstrated 
facts should be laid before the public. Moreover, the re- 
cent revival of the discussion of the subject before the 
Churdi Congress at Folkestone, England,* and at the recent 
meeting of the Humane Society in Hiiladelphia in October, 
1892, makes it especially timely. 

I shall omit many topics which would be suitable, such 
as the wonderful results of Pasteur's treatment of hydro- 
phobia, the discoveries of bacteriology, the wholly new 
class of remedies which medicine owes to vivisection, such 
as the antidotes to lockjaw and several other diseases, de- 
rived from the blood cl animals inoculated with the virus 
of these diseases — remedies to which we already owe 
astonishing cures. In the present paper I propose to limit 
myself to brain-surgery alone, and to give a glimpse of what 
has been done up to the present time. I shall show espe- 
cially that without the exact knowledge of the functions of 
the brain, derived almost wholly from experimentation 
upon animals, it would be simply impossible to do what 

^ Reprinted by tlie kind permiasion of Haiper & Brothers from 
Harper'i Magcuine for June, 1898. 
> Church Times, October 14, 1892, p. 1081. 


has been accomplished. I shall not restrict myself to gen- 
eral assertions which may easily be denied* but I shall 
relate actual cases> with their definite results* and the 
authority for each case. 

In order to understand modem progress in cerebral sur- 
gery it is necessary first to understand what has been 
achieved by experimentation upon the brain. When I was 
a student of medicine* thirty years ago, the brain was re- 
garded as a single organ* and its various functions were not 
thought to have any especial localized centers of action.^ 
When the brain acted it was thought that the whole of it 
acted, just as the liver or the kidney acts, as a whole. Now 
we know that instead of the brain being a unit* it is really 
a very complex organ. Just as in the abdomen* besides the 
other organs in its interior* we have the stomach, the liver* 
the pancreas, and the bowel, each of which has its part in 
digestion, so correspondingly in the brain, besides the por- 
tions concerned in sight* smell, thought, etc., we have four 
adjacent portions which are concerned in motion. One 
produces motion of the face; another, motion of the arm; 
a third, motion of the 1^; and the fourth* motion of the 

How* it may be asked* have these facts been deter- 
mined? Has it not been by observing the effects of injuries 
and diseases in man? To a small extent* yes. But very* 
very rarely does disease or injiuy involve only one of these 
very limited regions of the brain; and the moment two or 
more of them are involved our inferences become confused 
and misleading. As a matter of fact which cannot be gain- 
said* nine tenths of our knowledge has been derived from 
exact experiment upon animals* and in this way: A mon- 
key is etherized, a certain area of its brain is exposed, and 
an electrical current is applied. This stimulation of most 

^ The ** bumps" or localized centers of phrenology were always dis- 
credited by the medical profession, and experiments upon i^nimjila and 
observation in man have entirely overthrown them. 


portions of the brain is followed by no motion in any part 
of the body. These parts of the brain, therefore, have noth- 
ing to do with motion, but are the centers for general sen- 
sation (touch), or for certain special senses, as sight, hear- 
ing, etc., or for mental processes. But in one definite region 
of the brain, called the ** motor area," the moment the brain 
is stimulated by the electrical current motion is produced. 
Moreover, it was soon found that stimulating different 
parts of this motor area produced motion in different parts 
of the body, and that this was not haphazard, but that 
stimulation of one part of it always produced motion in the 
arm, and in another part always motion in the leg, etc. 
Thus have been mapped out the various portions of the 
motor area, as will be presently described in detaiL 

It is evident that by experiment upon animals the motor 
area can be more easily and more exactly determined than 
can those regions which are the seat of the faculties of 
smell, taste, sight, and hearing, the presence or absence of 
these senses in animals being difficult to determine with 
absolute accuracy* Stillmoreisthistrueof the parts of the 
brain which have to do with mental processes. Yet dis- 
ease and in j uiy in man, if they alone could answer the ques- 
tions what part of the brain has to do with motion, what 
part with sight, what part with the intellect, ought to have 
answered them long ago. No better evidence could be 
given of the superiority of experiment upon animals over 
observation of accident and disease in man in determining 
facts of this character than this, that those centers are best 
and most accurately known which can be determined by 
vivisection, and that those in which vivisection can aid us 
but little are still only vaguely located. Thus the motor 
area is positively and definitely located; the area for sight 
approximately well; those for hearing, smell, and taste 
and general sensation (touch) are still uncertain, though 
guessed at. As to those for mental processes, except per- 
haps one which will be alluded to later, we are almost 


wholly in the dark. Moreover, (Useaae and acddoit have 
nude their cruel and rude experiments ever since the worid 
bc^an. But as a matter of fact the last fifteen years of ez- 
perunentatiiHi have taught us more than the previous fif- 
teen hundred yean of careful observation and of poit~ 
morUm examination. 

Let me now briefly explun this "localization of func- 
tion" in the brain, and then show its value and certitude 
by cases which arouse our interest not only by thcar il- 
lustrating the practical applications of science, but by 
the cheering and 
humane results 
in the relief of 
human sufFering 
and the saving 
. of human lite. 
Fig. 1 repre- 
sents the motor 
area as ascer- 
tained by many 
c^Mximents such 
Vio.l. BldCTtawottlwiiirfMeofkmoiikq'^Imtn, as I have de- 
MotMoenum. (.aonifv «>d soMVor.) acnoea Upon tne 

biuns of mon- 
keys. On its surface will be observed cert^ broad 
black lines labeled, from in front backward, "Precentral 
sulcus, Assure of Rolando, Intraparietal fissure. External 
parieto-ocdpital fissure, IHssure of Sylvius, Parallel fissure," 
and others without names. In the middle, running down- 
ward and forward toward the left hand of the figure, no- 
tice especially the fissure of Rolando. This and the fissure 
(A Sylvius are the most important fissures of the entire 
brain. The fissure of Rolando is, so to speak, the "axis" of 
the motor area of the brain. At its upper end will be ob- 
served the center for the leg, with certain minor divisions 
marlffid in smalls letters. In its middle lies the arm center; 


and it should be remarked that the part wheate the word 
''retraction" is is the shoulder center^ a little lower down 
is the elbow center, and where ''wrist and fingers'' occurs 
is the hand center. At the lower end of the fissure of Ro- 
lando lies the center for the face, and at other points will 
be observed the centers for the trunk and head. By the 
word "center" is meant that, for examine, if you expose the 
part of the brain marked "arm," and apply the poles of an 
electric battery to that portion of the surface of the brain, 
you will produce muscular mov^nent in the arm. If at the 
upper end, you will move the shoulder; at the middle, the 
elbow; lower down, you will move the hand, etc This dia- 
gram shows the fissures and centers as ascertained in the 
brain of the monkey, but it must be remembered that th^ 
have an exact parallel in the human brain. The same fis- 
sure of Rolando exists there, the same fissure of Sylvius, 
the same intraparietal fissure, etc., as is seen in Figs. S, 0, 8, 
and the same centers for the arm, leg, trunk, and head. 
When I state that these exist in the human brain I am not 
stating what is theoretical, butthat which, in common with 
scores of surgeons, I have verified in many cases in which I 
have exposed the human brain, applied the battery exacts 
at the places shown in this diagram of the monkey's brain 
(with sudi modifications as would follow the slightly al- 
tered relations al the same parts in the human brain as 
compared with the monkey's), and have obtained in man 
exactly the same resulting moti<Mis as have been thus exper- 
imentally determined in the monk^. 

Naturally the first question that will occur will be, "This 
diagram shows the fissures and centers on the brain, but 
how are you going to tell from the outside of the head, with- 
out opening the skull, where th^ lie?" This has been de- 
termined by careful study of the human brain and skull, 
and their relations to each other. I will give only one illus- 
tration, and that by far the most important, namely, how 
we locate the fissure of Rolando, and therefore practically 



the whole motor area. Measure any head in the middle 
line, from a point between the eyebrows to that bony prom- 
inence which any one of my readers can feel at the back of 
the head just above the border of the hair. These points 
are called respectively the "glabella" and the "inion." 
Divide this distance into two equal parts, and thus obtain 
the mid-point between them, llie fissure of Rolando starts 
half an inch behind this mid-point between the glabella and 
the inion, and runs downward and forward at an angle of 
67^ There have been constructed various simple and other 
complex apparatuses for the purpose of determining just 
this angle of 67^, but it was reserved for Mr. Chiene, of 

Edinburgh, before the Congress 
of American Physicians and Sur- 
geons in Washington, in Septem- 
ber, 1891, to point out the Amplest 
possible method of determining 
this angle, which any one of my 
readers can use. If a square of 
paper be folded diagonally, it is 
obvious that the right angle of 
90® at two of the comers is divided 
into two halves, or two angles of 
45® each. If the paper be then again folded so as to di- 
vide one of these angles of 45® into two angles of 22.5® 
each, it is evident that one angle of 45® and another of 22.5® 
make an angle of 07.5®, which varies only half a degree 
from that of the fissure of Rolando. (Fig. 2.) If the middle 
line of the head be marked with an aniline pencil on the 
shaven scalp, if its mid-point be then fixed, and if the strip 
of paper just described be so placed that its edge indicating 
the angle of 07.5® runs downward and forward from a point 
half an inch back of the mid-point, the edge will correspond 
to the line of the fissure of Rolando, and can be marked by 
the aniline pencil on the scalp. If this line be measured for 
a distance of Sf inches from the middle line of the head, the 
length of the fissure of Rolando is also shown. 

Fio. 2. Professor Ctaiene*8 
method of finding the angle 
of the fissure of Bolaodo. 


It is not necessary for me to go further into det^Is. I 
propose now, after having thus explained the *' localization 
of function" in the brain, and the means of locating the 
motor area from the exterior, to show not only that, as a 
matter of fact, it has been verified in actual surgical experi- 
ence, but also that it is so accurate that from the exterior of 
the head, without any scar or other evidence of injury (or 
even in the presence of an otherwise misleading scar), with- 
out any fracture of the skuU, without any lump, promi- 
nence, or other means to guide us, cerebral localization is a 
reality, and as reliable as the needle of the compass itself to 
guide us exactly to the correct spot, so that we can open the 
head and expose the brain with an accuracy which is truly ^ ^ 

marvelous. If the last fifteen years of experimentation m | 

have done so much, what may we not expect in the next c 9 ^ 

fifteen? Does not humanity as well as science protest S n c 

against any hindrance to the further prosecution of work 9^1 

which has accomplished such results? Is this the work of ^ x 

'* inhuman devils," as Canon Wilberforce has been pleased ^ ^ 

to term those engaged in it , or is it the work of humane men ^ 

of science anxious to mitigate human suffering and prolong 
human life? 

Now let us see what results practical surgery has given 
us by the application of the doctrines of cerebral localiza- 
tion of function to special cases, otherwise beyond our 
power exactly to diagnosticate and to relieve. In each case 
I give the published authority, or, if the case has not yet 
been published, the records are accessible in the hospitals 
named. The cases are not of the time of John Hunter or of 
Sir Charles Bell, but of the last few years, and can be inves- 
tigated and verified now. 

The first case shows that it is possible not only to diag- 
nosticate in general the fact that an abscess exists in the 
brain, but to locate it exactly, and to open it with the same 
precision as in opening an abscess on the hand. What is 
more to the point, in about one half of such cases we can 


now cure the patients who* befOTe vivisection had taught 
us modem cerebral localization, would all have gone to 
their graves. 

Case I. Abscess in the brain. In the ** British Medical 
Journal'* of April 21, 1888, Mr. Darner Harrisson records 
the following case. A boy aged fifteen had received a blow 
on the right side of his head from a pair of tcmgs eight days 
before his admission to the hospital. Three days after the 
accident a convulsion suddenly set in, involving the right 
side of the body, beginning in the arm and qn^ading to the 
leg and face, and followed rapidly in four days by eight 
oth^ convulsions and paralysis of the entire right side of 
the body. Most of my readers would imhesitatingly attrib- 
ute the convulsions and the paralysis to this blow from the 
tongs. But it must be remembered that the right side of 
the brain supplies the kft side of the body, and vice versa. 
Hence Mr. Harrisson suspected that the paralysis of the 
right dde of the body indicated trouble in the kft half of 
the brain. Examining his head, he found on the left side a 
small scar at the junction of the arm and leg centers. In- 
quiry elicited the fact that, ten years before^ he had received 
a severe blow there, which, however, had not been followed 
by any serious ^rmptoms. Could this old injury, after so 
long a time as ten years, possibly be the cause of his present 
serious trouble? Further inquiry brought out the fact that 
for about a year before his admission the boy had had re- 
peated twitching of his right arm. So convinced was Mr. 
Harrisson that modem cerebral localization was right that 
he opened the boy's skull, not where most people would 
suppose would be natural, namely, on the right side of the 
h^td, where he had received the blow from the pair of 
tongs eight days before, but on the left side, at the site of 
the blow ten years before, and at a definite point, namely, 
over the fissure of Rolando, at the place corresponding to 
the motor center for the arm as established by experiments 
on animals. Although the first injury was received so long 


before, yet the paralysis showed that it was the left side of 
the brain that was involved, and the twitching of the arm 
showed that this was the particular part of the left side of 
the brain where the injuiy probably existed. Mr. Harris- 
son punctured what seemed on the surface to be a normal 
brain, and opened an abscess, and this boy, otherwise abso- 
lutely doomed to death, made an uninterrupted recovery. 
This is only one instance out of probably more than one 
hundred and fifty cases of abscess in the brain which have 
been reported within the last seven or eight years which 
have been diagnosticated with the same accuracy and by 
the same means. 

Case IL In the '^British Medical Journal" for Au- 
gust 11, 1888, Dr. Gater Sir William) Maoewen, of Glas- 
gow, relates the case of a 
patient who, among other 
symptoms of abscess of the 
brain, had partial paralysis 
of the right side of the face 
and right arm, and paralysis 
of the nerve supplying the 

Mt pvphall Fop reamns ^<^'^ Ca«i n. Side Tiew of 
leil eyeoau. ror reasons the hmnMibralii. Tbe shaded aroa 

stated in the paper he con- titcmn the looatton o£ the abeoeM 

produoiiig^ pressme on the lower 
duded, with great acuteness iMurtofthemotorarea. (SeeFlg.1.) 

of reasoning, that the ab- 
scess could not be in the motor area for the face and arm 
on the left Ade of the brain, but in the projecting part of 
the brain just below these centers, but producing pressure 
upon them. (Fig. 3.) He confidently operated at this pre- 
cise spot, and opened an abscess inside of the brain in the 
exact position described, and gave exit to six tablespoor^ids 
of pus, when the symptoms vanished, and in three weeks 
the patient was well I 

Brain tumors. Nothing could be easier than to locate a 
tumor of the brain which showed itself externally. In a 
case in which the tumor is as large as that shown in Fig. 4 


(which is the natural size of a tumor removed from a man 
who is still living, five years after the operation) ' it might 
be thou^t easy to locate it, though, as a matter of fact, it 
is very difficult, owing to the large area of brain involved. 
But when I say that the existence of a tumor about the 
size of the end of the forefinger can be diagnosticated, and 

Fio. i. KKtDial slie of a tumor remoTed from the bialn. The pkUent II 
llTlng attar tweiit7'WTeD fsan. (lut.) 

-that before touching the head it should be said (and I was 
present vrken the statement was made), that it was a small 
tumor, that it did not lie on the surface of the brain, but a 
little underneath it, and that it lay partly under the center 
for the face and partly under that for the arm in the left 
side of the brun, and that the man was operated on, aod 
the tumor found exact^ where it was believed to be, with 
perfect recovery of the patient, it is something which ten 
years ago would have been deemed the art of a magician 
rather than the cold predsion of science. 

Case III. In the "American Journal of the Medical 

Sciences" for July, 1888, this case is detailed by Drs. Se- 

guin and Weir, as follows. A gentleman thirty-nine years 

of age had been perfectly healthy until August, 1882, when 

I He ia «liU olive in l&t4, twen^-seven yeua after tlie opavtion. , 



he had malarial fever, accompanied with a good deal of 
pain. One day, as he rose to go to the window, his wife no- 
ticed a spasm of the right cheek and neck, which did not 
involve the arm, nor was consciousness lost. In 1886, two 
or three similar attacks having occurred in the interval, he 
fell, unconscious, and bit his tongue. These attacks were 
all accompanied with twitching of the right arm and hand 
and right side of the face. His memory became impaired 
and his speech thick. No injury had ever been received on 
his head, nor was anything abnormal observed even when 
his head was shaved. Gradually his right hand and arm 
became weak, and, as a result, his handwriting became bad. 
This weakness of the right arm slowly increased, and along 
with it a weakness of the right leg, and, as a consequence of 
the increasing paralysis of his face, drooling at the right 
side of the mouth set in. 

Dr. Weir examined him at Dr. Seguin*s request, and 
both of them reached a diagnosis, chiefly based upon the 
facts already given, that 
the man had a small tu- 
mor situated as above 
described, and on No- 
vember 17, 1887, the skull 
was opened at the junc- 
tion of the arm and face 
centers. This operation I 
had the pleasure of wit- 
nessing personally. Noth- 
ing abnormal was seen on 
the surface of the brain. 
Yet so confident was Dr. 
Weir of the correctness 
of the diagnosis that he 
boldly cut into the brain 
substance, and from its interior removed a tumor of the 
size indicated by means of a small surgical spoon. The 

Fia.6. CASBin. AcroM-sectlonof the 
brain (only a part of the left side is 
shown.) The round shaded spot rep- 
resents the brain tomor. (Weir and 


man made a perfect recovery. When examined microscop- 
ically, the tumor was f omid to be of a malignant charac- 
ter. It returned in about four years, and finally destroyed 
his life. Fig. 5 shows the tumor represented as a little ball 
in the substance of the brain. 

In one sense, as a surgical feat, the removal of a tumor 
as large as that shown in Fig. 4 is a much more difficult and 
extraordinary operation (and one neariy twice as large, 
weighing over half a pound, has lately been successfully 
removed by Bramann!) ; but as a matter of diagnosis and 
of surgical skill, locating and removing so small a tumor 
from the brain so successfully, and without the slightest 
indication on the exterior to guide one, is a much more bril- 
liant and remarkable operation. 

In an address which I published in 1885^ I alluded to the 
first and then the only case known of removal of a brain 
tumor, and I said: — 

By these experiments and operations a wide door is opened to 
surgery in the treatment of diseases within the skull, diseases 
heretcrfore so obscure and uncertain that we have hardly dared 
to attack them. The question is not whether death or recovery 
followed in this particular case. The great, the startling, the 
encouraging fact is that with this experience we can now, with 
well-nigh absolute certainty, diagnosticate the existence of, and 
with the greatest accuracy locate, such diseases, and therefore 
reach them by operation* and treat them successfully. 

That my prophecy has been verified, let me quote the 
statistics gathered by Dr. Knapp, of Boston, in 1891. He 
collected forty-six cases of operations for tumors of the 
brain, operated on in the last six years, of which thirty re- 
covered (!), fifteen died, and the result was unknown in 
one. It must be remembered that these thirty which re- 
covered would every one of them have died had not vivi- 
section given us the means of accurately locating the dis- 
ease. That we have not yet reached the accuracy which is 

^ "Our Recent DdbtB to Yivisectioii," ante, p. 13. 


to be desired is shown by the fact that in fifteen other cases 
no tumor was found at the point of operation, and of these 
thirteen died. Most of these tumors lay not in the motor 
r^on of the brain, but in other parts of it, in which our 
means of diagnosis are as yet very imperfect for the very 
reason that vivisection has thrown but little light on the 
function of these regions. There were also four cases of 
tumors which were found, but were so large as to be irre- 
movable, and of these three died. To these statistics I can 
add three other cases. In one of these the tumor was not 
rightly located (it was not in the motor r^on), and there- 
fore was not found at the operation, and the patient died. 
In the other two cases the tumor was found, but was irre- 
movable. One patient died, and the other recovered from 
the operation, but died from the disease four months after- 
wards. He had, however, been relieved from the atrocious 
headaches which rendered life a burden, and his delusional 
insanity had almost wholly disappeared — results whidi 
fully justified the operation by the comfort of his few re- 
maining days.^ 

CabbIV. Hemorrhage inside the skull. Let me next give 
a case of a different character, but equally accurate and 
astonishing. An artery about as large as the lead in an or- 
dinary lead-pencil runs in the membranes of the brain on 
the inside of the skull, in the region called ^^the temple," 
and grooves the bones quite deeply. In some cases in which 
a heavy blow is received on the surface of the skull, without 
fracture, or it may be even without leaving any mark what- 
ever on the skull, this artery is ruptured, and a large dot is 
poured out on the surface of the brain. Formerly it was 
not only almost impossible to make a diagnosis of such an 
injury, but, even if the rupture of the artery was suspected, 

* Another renuu^able case* in which a growth of the under surface of 
the bone pressing on the arm center was exactly located and successfully 
removed, is rdated by Dr. A. B. Shaw, of St. Louis. (Ainencan Jounud 
cf ihs Medical Sciences, December, 1892, p. 691.) 


before antiseptic surgeiy (itself the child of vivisection) 
arose, such patients were only treated with a little opium, 
rest, and regulated diet. Most of them died, but occasion- 
ally one got well. Of 147 cases collected by Ti^esmann 
which were not operated on, 181, or over 89 per cent, died. 
The symptoms of such an injury are fairly dear, but, until 
the doctrines of cerebral localization were accepted, were 
often misleading. The patient is stunned by the blow, but 
usually recovers consciousness, only to relapse again into 
unconsciousness when the amount of blood poured out is 
sufficient to compress the brain, this compression of the 
brain producing also paralysis. Generally the artery on the 
same side of the head as the blow is ruptured, and the par- 
alysis will be on the opposite side of the body. But some- 
times, instead of the artery being ruptured on the same 
side as the blow, it will be ruptured on the opposite side; 
or, again, if the blow be in the middle line, as in a case re- 
cently under my care, it may be difficult to tell which side 
has been involved. Moreover, as the artery splits into two 
branches, one of which runs in the direction of the motor 
region and the other back of it, it may be difficult to know 
where to open the skull in order to reach it. Now it is very 
evident that if we make an incision into the forearm to 
reach an abscess or a tumor, and it is found that the trouble 
lies one or two inches further up or down, the incision can 
be easily prolonged in the right direction, and will heal 
readily. But in the skull our diagnosis must be correctly 
located within a very small limit of error, for it is evident 
that we cannot enlarge the opening in the bone at will to 
almost any extent, as we can in the flesh. Wiesmann has 
also collected 110 cases which were thus operated on, of 
whom 36 died, or only 83 per cent!^ What a contrast to the 
89 per cent of deaths when no operation was performed! 
In the majority of these 86 who died the clot was not found, 

' *■ See " Midwhipman Aiken and Yiviaection*" pott, p. 140, whose life 
was saved by operatkm. 


and was therefore not removed, because in the earlier days 
we lacked the boldness and therefore the exactness of 
modem times. 

CabbV. Let me now give the case furnished me by Dr. 
Dench, by permission of Dr. Bull, of New York.^ A young 
man had been shot in the head, the ball entering above the 
ear, two and a half inches to the left of the middle line of 
thehead. When first seen his right arm was paralyzed, and 
shortly afterward the paralysis had extended to the right 
leg and right face. A diagnosis was made of hemorrhage 
from one of the arteries of the brain, by reason of the fact 
that the paralysis had extended so rapidly from the arm cen- 
ter to the leg and face centers, for no other cause excepting 
hemorrhage could be so rapidly progressive. The wound was 
exposed, and a considerable dot gushed out, when motion 
immediately returned in the leg. The bone was then tre- 
phined, not at the bullet opening, but a quarter of an inch 
below and in front of the wound, when this bleeding me- 
ningeal artery was exposed and tied. It was found that a 
large branch of an artery in the brain itself had also been 
severed. This was tied, and in two months the man was 
well, no fever following, and no '^matter'' having formed. 
He could speak perfectly well, and could use his arm, but 
not his hand. The ball was never found. 

Case VI. It may be objected that here there was a 
wound to point out exactly the situation of the injury. Let 
me therefore give a somewhat similar case in which no 
such guide existed: M. Michaux* reports a case of trephin- 
ing, followed by cure, for a case of meningeal hemorrhage, 
probably of spontaneous origin. A man was brought to the 
hospital in a state of complete apoplexy, with paralysis of 
the left face and right arm. There was no sign of fracture 
or other injury. During the next few days the paralysis 

^ Budf 8 lUference Handbook cf (he Medical Seienees, vol. Tin, p. 227. 
* Medical Newtp Blay 2, 1891, p. 504, from Rmie de Ckirurgie, 1891, 
vd. XI, p. 870. 


extended to the right leg. Epileptic convulsions set in, at 
first limited to the paralyzed regions, then becoming gen- 
eral Occurring at intervals in the beginning, they became 
continuous at the end of three or four days. The patient 
was addicted to absinthe, and his head had troubled him 
for several months. The trephine was applied over the fis- 
sure of Rolando on the left side, over the ''motor area'' for 
the arm and leg, and an opening six centimeters long was 
made, through which the membranes of the brain were in- 
cised. This was followed immediately by the escape of 
four tablespoonf uls of large blackish clots After the oper- 
ation the patient improved rapidly, and in a month most 
of the symptoms had disappeared. 

Drs. Bremer and Carson, of St Louis,^ and Drs. Rom- 
ans and Walton, of Boston,' have published cases in which, 
also without external signs, such clots have been accur- 
ately located and removed with success. In the latter case 
there was evidence of an injury, but the clot was on the 
opposite side of the head. 

Mental disorders. I shall now add a case involving the 
centers for mental processes, in the establishment of which 
vivisection has done but little, for reasons already ex- 
plained, but the case is one of great interest and value. 

If the reader will look at Fig. 1, find the fissure of Sylvius 
and follow it to its upper end, he will see that this end ter- 
minates in a A-shaped convolution between the intraparie- 
tal and the external parieto-occipital fissures. In this por- 
tion of the brain have been located certain mental processes, 
including the ability to recognize objects and their uses. 
The location of this convolution of the brain can be made 
with almost the same accuracy as that of the fissure of 

Case VII. The following case of Macewen of Glasgow* 

^ American Journal cf the Medical Sciences, February, 1808, p. 184. 
* Boston Medical and Surgical Journal, February 12, 1891. 
> Britieh Medical Journal, August 11, 1888, p. 806. 


wiUiUustrate the accuracy of this localizaticni. A year be- 
fore Macewen saw him the patient had received an injury 
which had resulted in melancholia. Though formerly a 
happy husband and f ather» he now repeatedly contem- 
plated the murder of his wife and children. There were no 
phenomena connected with motion in any part of the body 
by which the injury could be located; but it was discovered 
by that careful, dose investigation for which this surgeon 
is so well known that, immediately after the accident, for 
two weeks he had suffered from what is called ^'p3ychical 
blindness,'' or '^mind blindness''; that is to say, his physi- 
cal sight was not at all affected, but his mind was not able 
to interpret what he saw. I presume he was a stanch 
Scotch Presbyterian. He knew that, as was customary, his 
New Testament was lying by his side, but when he looked 
at it he was utterly unable to recognize it. While, however, 
his mental sight was thus affected, his sense of touch was 
perfect, and when he passed his hand over the smooth 
leather cover of his well-known book and felt the deep- 
indented letters on the back he recognized it as his familiar 
friend; but when he opened 
it, the printed words were un- 
known symbols to him. This 
gave to Macewen the k^ to 
the injury. He located on the 
outside of the skull this A- 
shaped convolution (Fig. 6, Fio.e. ca«b vn. side view of 

shaded area), known as the ^^ bmnan bnln. The shaded 

.. - •« 1 • 1 1^1^* shows wheie the bone 

angular gyrus, and found, pressed on the A-shapedMignlAr 

on removing a button of bone, ^^^'^^ (Maoewen.) 
that a portion of the inner layer of the bone had become 
detached and was pressing on the brain, one comer of it 
being imbedded in the brain substance. After removing 
the splinter, the button of bone was replaced in its proper 
position. The man got weU, and, although still excitable, 
lost entirely his homicidal tendencies and returned to work. 


Epilepsy. It I were to gather together the operations 
which have been done for epilep^ since we have been able 
to locate the centers, especially for motion, I should per- 
haps have to record one hundred and fifty or more. The 
great majority of these patients have recovered from the 
operation, or, in surgical parlance, have made an ^^opera- 
tive recovery,** but in a very large proportion the disease 
has returned, generally, however, with a lessened intensity. 
In a small proportion recovery has taken place from the 
disease itself. But it is evident that as cerebral surgery 
covers practically only the last eight or ten years, it is 
much too early to formulate definitely a statement of what 
the results may be when a longer time has elapsed. 

Case VIII. In the *' American Journal of the Medical 
Sciences** for December, 1891, Dr. Charles K. Mills, of 
Philadelphia, has reported the case of a young lady twenty- 
seven years of age, who suffered for some time from numb- 
ness and a sense of weight in the left arm, hand, and foot. 
After about five years these attacks developed into distinct 
epileptic fits, and had become extremely frequent at the 
time when Dr. Mills first saw her, in November, 1890. The 
attacks occurred both in the daytime and at night, and 
were as frequent as ten to fifteen in the twenty-four hours. 
Dr. Mills himself often saw them. The left arm was first 
raised, the motion beginning in the shoulder, and includ- 
ing also the elbow. The attack quickly extended over the 
entire body. On the outside of the head, after it had been 
shaved, absolutely nothing was found which could be a 
guide to the site of the trouble. The diagnosis was some 
source of irritation, the character of which was unknown, 
but which was located on or in the center for the left shoul- 
der. Accordingly the fissure of Rolando was mapped out 
on the shaven head, and a button of bone an inch and a half 
in diameter was removed, the center of which was an inch 
and three-quarters to the right of the middle line. Fig. 7 
shows the button of bone, the inner surface being upper- 


most. The bone was very thick, from five to seven riz- 
teentlis ot an inch, and was also very dense. As soon as tlte 
bone was removed, a small 
tumor resembling in shape a 
minute btmch of grapes was 
found, the apex of the tumor 
being within one aixteenih cff an 
inch of the pmnt v>here it vxu 
belieoed to exist. By its pres- 
sure it had produced several 
pita on the inner surface of the 

bone, UKi these l.oI«, a. weU JSl'iSS^T'CSi" 
as the KToove for a large blood- *"• bono were ptodrnwd ny tba 

, , , , »- 1 1 ttUDOT. Tliey w«rre klntoat pre- 

vessel which supplied the tu- oIhIj in Uu oanter or the button, 

morwith blood, are weU shown t^^tZ^T^^' *^ 

in the middle of the button. 

The tumor, with the membrane of the brain to whidi 

it was attached, was removed, and the battery waa 
then applied to 
the brain imme- 
diately under- 
neath it. ■ Kg. 8 
shows the fissure 
of Bolando as 
a line r unning 
downward and 
forward across 
the circle. The 
urde represents 
the button of 
___ bone removed, 

no, & Thebnln tnCMeVUL Itasamisihowi , , , 

«iwTat)wtnitbnofbona«uramoT*d,uditi«Kniwtb and the numbers 
ft^^«ta<»t .uctiy u tto omta of tb. tmbm. j ^^ ^ represent 

the points at 
which the poles of the battery were applied to the brain. 
On stimulating the brain at the point marked 1, and 


again at point 2, movements of the arm at the shoulder 
and elbow were reproduced; precisely the movements of 
her attacks. This point was the portion of the brain 
pressed upon by the tumor. Along with the mo vements of 
the shoulder at point 1 the elbow was involved, and at 
point 2 it was found that the hip and knee were both flexed, 
and the entire leg carried away from its f eUow, the toes and 
foot being extended. It was very evident, then, that point 
1 corresponded to the shoulder and elbow centers, and 
point 2 corresponded to the upper edge of the shoulder 
center and also to the edge of the leg center. Excitation 
at point 8 was followed by more decided movements of the 
lower arm, and at point 4 the leg alone moved, the shoulder 
not being involved. 

Could any better illustration be found of the accuracy of 
localization? The 1^ center here, when compared with the 
leg center in Fig. 1 of the monkey's brain, is found exactly 
where it ought to be, the arm center directly below it, with 
the shoulder, elbow, wrist, and hand movements precisely 
in the same relative positions as in the monk^'s brain. 
Unfortunately the lady has not been cured. But the fits 
have been greatly moderated, so that when the case was 
reported, nearly a year after the operation, she had usually 
only about three attacks in the twenty-four hours instead 
of ten or fifteen, and the attacks had never attained the 
same severity as before the operation. Moreover, after the 
operation, in about half the attacks she did not lose con- 
sdousness, and so was far less exposed to the danger of fall- 
ing the downstairs, into fire, and other similar perils to 
which epilepqr with unconsciousness exposes a patient. 

Casb IX. Another case, which is fortunately more fa- 
vorable in its result, is published in the ^'Medical News '' of 
April 12, 1890. A little boy, six and a half years old, at the 
age of fourteen months fell about ten or twelve feet from a 
haymow upon a plank flooring. He was unconscious for 
some time. . No decisive evidence of injury could be found 


rither on his head or other parts of his body, but from his 
prolonged unconsciousness it was presumed that he had 
struck his head. Soon after this accident his disposition 
changed materially for the worse. He became irritable, ob- 
stinate, and ill-tempered, and very frequently kicked, bit, 
and scratched, and offered other violence to his plajrmates. 
His room had to be padded, his clothes had to be sewed on 
him every morning, and he would kill any small animals, 
such as cats or chickens, that came in his way. When two 
and a half years old his first epileptic fit occurred. He had 
from three to six attacks a day, with some intervals of com- 
parative freedom. His father, an intelligent clergyman, 
estimated that in the four years since his epilep3y began he 
had had over five thousand fits! Of these about eighty per 
cent began in the right hand. The attacks were observed 
with great care in the Jefferson Medical College Hospital 
by a special nurse, and the statement of his father that they 
usually began in the right hand was verified. When the 
attacks began the child had a "vocabulary of about forty 
words, but gradually these were reduced, word by word, 
until his speech consisted only of three words and a little 
jargon, the words being ^^papa," ** mamma," and, charac- 
teristically *'no," rather than *^yes.'' Examination of the 
head revealed nothing that could locate any injury; but as 
the attacks began so constantly in the right hand, it was 
resolved to remove the center for this part of the body, in 
the hope that if the fits were prevented at thdbr initial spot 
they would not begin elsewhere. The fissure of Rolando 
was first located, then the position of the hand center was 
marked, and a disk of bone an inch and a half in diameter 
was removed. The membranes of the brain were then 
opened, and the brain itself exposed. Nothing abnormal 
was perceptible either by ^e or by touch. The battery was 
applied to the portion of the brain exposed, producing 
movements of the hand, showing that the center had been 
correctly mapped from the outside of the skull. Excitation 


of the bram further upward produced elbow movements 
(elbow center). These centers were therefore exactly where 
th^ ought to lie, as shown in the monkey's brain (Fig. 1). 
The portion of the brain that moved the hand was then 
removed, and when the battery was applied to the parts 
around it» it was found that all the center for the hand and 
wrist had been removed. 

The boy made a speedy recovery from the operation. 
Three years have now elapsed since the operation. Most 
of the time he has been and still is in Misses Bancroft and 
Cox's School for Feeble-minded Children, at Haddonfield, 
New Jersey. He has had there very painstaking care, and 
to this is to be attributed very much of his mental improve- 
ment. During the last six months of 1892 he has had only 
one attack for about every sixty before the operation. This 
improvement can be attributed only to the good effects of 
the operation. 

CaseX. The last case to which I shall refer has not been 
published, but can be found in the records of the Ortho- 
pedic Hospital and Infirmaiy for Nervous Diseases in Phil- 
adelphia, Record Book S. 9, p. 12S. A yoimg girl of about 
twenty-one was admitted to the infirmaiy in October, 1891. 
She said that her attacks of epilep^, from which she had 
suffered for two years and a half, always began in the right 
thumb. This fact having been verified, it was decided to 
remove the center for the thumb, for the same reason as in 
the last case, i.e., to stop the very beginning of the fit. It 
was especially desired to remove only the center for the 
thumb, and not that for the hand, in order not to interfere 
more than was necessaiy with the usefulness of her hand, 
upon which she depended for her support, as she was a mill- 
girL This was an unusual and minute attempt at localiza- 
tion, and a very severe test of the accuracy of the mapping 
of the brain by vivisection. On October 6, 1891, the fissure 
of Rolando was first located, and a disk of bone an inch and 
a half in diameter was removed, the center of it being two 


and five eighths inches to the left of the middle line. Both 

the bone and the brain, when exposed, seemed to be nor- 

mal. The fissure of Rolando was seen crossing the middle 

of the opening, downward and forward (Fig 9). By the 

battery the brain was stimulated at certain definite points 

until the thumb center was 

recognized, and also the face 

center, which lay somewhat 

below it, and the wrist center, 

which lay — as it ought by 

experiments on the monkey's 

brain — a little above it. Each 

of these centers was recognized 

by the movement of the part 

SUppUed by it (thumb, face, ^^ ^^^ Thecirclerep- 

wrist) when the center was waents the opening in the sktdl 

. 1 J 1 .1 1 J j.1. dlBcloBlng the thumb center al- 

tOUCned by tne poles of tne moet at its nUddle. The shaded 

battery. Stimulation of the SL'S'^^'^"' ** 
thumb center produced a typi- 
cal epileptic fit, such as she had suffered from since her 
admission, beginning in the thumb, as she had asserted. 
The portion of brain corresponding to the thumb center, a 
piece about half an inch in diameter, was removed, and by 
the battery it was determined that the portion removed 
was the whole of the thumb center. She recovered promptly 
and without disturbance from the operation. 

It was necessary in this case to be unusually accurate, 
and not to remove any portion of the brain other than the 
center for the thumb, and for three reasons: First, if too 
much were removed upward and backward, the wrist and 
fingers would be paralyzed; second, if too much were re- 
moved forward, the muscles of the face would be involved; 
third, a little further down lies the center for speech, and 
had this part of the brain been injured, this important fac- 
ulty would have been destroyed, thus producing serious and 
unnecessary trouble. 


Note now the accuracy of experimental cerebral localiza- 
tion. As soon as the patient had recovered from the ether 
and was in a suitable condition, her ability to move the face 
and hand was tested. All the muscles of the face were en- 
tirely intact* and could be moved with absolute ease. Her 
speech also was unaffected. She had absolute and perfect 
control of all the muscles of the shoulder, elbow, wrist, and 
hand, vnth the single exception of the muscles of the thumbs 
every one of which wcls paralyzed. In order to understand 
how curious this paralysis is in relation to the thumb center 
in the brain, the reader must observe that only a small piece 
of the brain, half an inch square, was removed, whereas the 
muscles of the thumb lie as follows: some of them in the 
ball of the thumb on the hand, one between the thumb and 
forefinger, one on the front of the forearm reaching almost 
to the elbow (the great flexor of the last joint of the thumb) , 
and three of them on the back of the forearm, extending 
half-way from the wrist to the elbow; and yet the removal 
of so small a portion of the brain paralyzed these muscles 
of both widely different situation and widely differing func- 
tions (flexion, extension, abduction, adduction, and cir- 

By June, 1892, she had entirely recovered the use and 
strength of her thumb, as shown by the dynamometer, 
both sides then registering the same number of degrees. 

This history illustrates one of the most curious problems 
of cerebral surgery. The removal of any portion of the 
motor region of the brain is, of coiu^e, followed by palsy of 
the part of the body supplied by that brain center; but 
though I have frequently removed portions of the brain, 
I have never yet seen this paralysis permanent. I have seen 
a right hand wholly paralyzed after such an operation, and 
in three months it had regained its strength and dexterity 
sufficiently to enable its owner to play baseball. But while 
this is true of the careful removal of small parts of the 
brain by operation, the widespread injuries which result 


from accident are not seldom followed by extensive palsies 
which remain throughout life. In the case just related not 
only has strength returned equally, but such delicate move- 
ments as are involved in the use of a needle have been pre- 
served, or rather restored. Usually, however, weakness, to 
a greater or less extent, will remain in the part of the body 
controlled by the portion of brain removed. Whether there 
is actual reproduction of brain tissue or not is as yet uncer- 
tain, because after such operations there have been almost 
no deaths at a period sufficiently remote to enable us by 
post-mortem examination to determine whether such a re- 
production has occurred or not. It is possible that the sim- 
ilar center on the opposite side of the head is capable of do- 
ing double duty; for although normally the right side of the 
brain controls and moves the left side of the body, and trice 
versGy yet apparently there is a latent power which when 
necessary is called into play, and enables the right side of 
the brain to innervate and control the same side of the 
body as weU as the opposite side, just as, for inirt;ance, the 
left hand, which is unused to writing, can acquire the fac- 
ulty of writing if the right hand is lost. 

There has also been performed a very remarkable opera- 
tion on animals which may hereafter produce important 
results. Several experimenters have opened the heads of 
two dogs (both under an anesthetic, and both as carefully 
and as tenderly cared for as any human being could be, the 
operations being attended with but little pain,^ as they 
were done with the most careful antiseptic precautions), 
have taken a bit of the brain from the head of each dog and 
transferred it to that of the other dog. The pieces so trans- 
ferred have grown in place, and have caused at least no 
mischief. Whether it will ever be possible to transfer brain 

* Most operatioiis on tbe broin are f oUowed by very little pain, and 
tometimefl it may truthfully be said by none. It is not an uncommon re- 
sult for the patient to take no medicine, or at most a sin^e small dose of 
an anodyne on the first day , be out of bed in three to five days, and entirely 
wdl in a we^ or ten days. 


tissue from the lower animals to man, and whether if so 
transferred it will properly perform its function, are prob- 
lems as yet unsolved. It would be, I think, unwise to test 
its effects in man except as applied only to the motor re- 
gions at first, for we have every reason to believe that the 
motor cells in an animal's brain subserve precisely the 
same function as the motor cells in the human brain. More- 
over, nothing of this kind would ever be done excepting 
perliai>s in case of an accident where a considerable portion 
of the human brain was destroyed, when possibly this loss 
could be made good from an animal's brain. It is unneces- 
sary, however, to discuss this question at present, for all 
the facts in the case, the needful precautions to be taken, 
and all the possible results, must first be determined in 
much greater detail and by much larger experimentation on 
animals than has yet been done before it will ever be con- 
sidered in man. But it is not at all impossible that in this 
way we may see hereafter one of the most brilliant achieve- 
ments of modem cerebral surgery.^ 

But we must return again to our last patient, for her sub- 
sequent history as to her epilepsy is quite as interesting as, 
and to her no doubt even more important than, the con- 
dition of her thumb. On December 17, 1891, seven weeks 
after the operation, she had one slight attack. Januaiy 18 
and 30, 1892, there were two; then none until March 12; 
a very slight one came on May 19; and the last to date 
were two on July 8 (slight) and 10, making in all seven 
attacks in eight months. Thus the intervals were growing 
longer, and the attacks as a rule less severe, while before 
the operation the attacks were growing more severe and 
far more frequent, for when she entered the infirmary they 
were tending to become daily.* 

^ So far (1914) no progress has been made in this direction. The value 
of the experimental researdi in animals in preventing such dangerous 
attempts in human beings is evident. 

* Since this was written her attacks have become somewhat more fre- 
quent, but are still far less frequent and severe than bef we the operation. 


The anti-vivisectionists constantly parade the few phy- 
sicians who are in accord with their views, and by frequent 
reappearances make an apparent army upon the stage. As 
a matter of fact, Mr. Lawson Tait is the only one who has 
an international reputation; the rest are but little known. 
Even Mr. Tait recently changed his views, and in a speech 
in favor of the objects of the British Institute of Preventive 
Medicine, which are largely attained through vivisection, 
has declared: *' bacteriological experiments on animals 
have proved of great value.** What the real opinion of the 
medical profession of Great Britain is as to the value of 
vivisection is seen by the following resolution, which was 
passed in August, 1892, at the Nottingham meeting of the 
British Medical Association, and passed unanimously. 
The weight of such an authority can best be measured when 
I state that it is the largest and most important association 
of physicians in the world, and numbers over fifteen thou* 
sand members, including most of the distinguished men of 
the profession in Great Britain. 

* Resohed^ That this general meeting of the British Medical 
Association recardB its opinion that the results of experiments on 
Uving ftn™<»^^« have been of inestimable service to man and to the 
lower animals, and that the continuance and extension of such 
investigations is essential to the progress of knowledge, the relief 
of suffering, and the saving of life. 

I have thought it worth while not to content myself with 
broad assertions that experimentation on animals has en- 
abled us to locate with absolute accuracy the various motor 
functions and to some extent the other functions of the 
brain; but to any doubting Thomas I would simply say. 
See any brain operation of this character, and you cannot 
fail to be convinced of its humanity and propriety. 


I HAVE been asked by the editor of the Philadelphia 
"Record" to write a brief r6sum6 of the influence of vivi- 
section on the progress of modem snrgeiy. I shall do so as 
briefly as I possibly can» stating only facts which are gener- 
ally well known to surgeons, but of which the general pub- 
lic of necessity must be ignorant to a great eirtent. Most 
of the facts below stated are known to me personally, aa 
they have occurred diuring my professional lifetime; and I 
can, therefore, vouch for their accuracy. 

If a physiologist were asked to contribute a similar paper^ 
he would be able to tell a similar story as to the revelations 
of the functions of various organs in the himian economy 
obtained through vivisection; if a professor of pharmacol- 
ogy (i.e., the action of drugs upon the living body) were to 
write a similar paper, he would be able to show an equal 
debt owing to animal experimentation, first, in giving us an 
exact knowledge of the action of drugs, and, secondly, in 
the introduction of a large number of new drugs. In this 
way cocain was introduced into medicine and the proper 
use of such a powerful drug as digitalis was shown. 

If a medical man were to write a similar chapter, he 
would scarcely know where to begin. The whole life his- 
tory, for example, of the trichina has been studied in ani- 
mals and the results applied to man, so that if every one 
would heed the warning, no one need die from the trichina 
worm in pork. This has had also an enormous commercial 
value, since all our hog products are exported on condition 
that the trichina be excluded by microscopical examina- 

^ Reprinted by permission from the Philadelphia Record of Sq^tember 
14 and 21. 1901. -- 


tion. In diphtheria the percentage of deaths has been re- 
duced in Baltimore from about seventy per cent to about 
five per cent. The saving of human life in a single year in 
New York has been 1500. All this is due to the antitoxin 
of diphtheria, which has been evolved solely as a result of 
animal experimentation. • • • 

On the border line between medicine and surgery is the 
new science of bacteriology. In surgery this has shown the 
cause of inflammation, of erysipelas, of tetanus or lockjaw^ 
of glanders, of tuberculosis (not only of the lungs, but of 
the brain, the bones, the joints, the bowels, etc.) and of 
many other disorders. 

Let me give one illustration of the method by which the 
cause of one disease — tuberculosis — was proved. Simi- 
lar methods are employed in tracing the causes of others. 
In a case of consumption of the lungs the expectoration 
is examined by the microscope after applying a staining 
material. Without staining, the tubercle bacilli are so trans- 
lucent (like little rods of jelly) that we can scarcely see 
them. Having found this peculiar germ in the expectora- 
tion, some of the material is injected under the skin of a 
guinea pig. After a certain time the animal either dies or is 
killed, and a posUmorlem examination is made. If there 
are found in the body of the guinea pig little nodules,— 
i.e., tubercles (little tubers), — these are examined by the 
same method, and the same germs will be discovered and 
can be obtained in a pure culture. But the circle of proof 
is not yet complete. A small portion of this pure culture of 
the germs obtained from the inoculated guinea pig is again 
injected into another animal, and if the secondanimalsuflfer 
from a similar disease and the same germ be found again, 
the conclusion is irresistible that the cause of the tubercu- 
losis is the peculiar germ always found in such cases.* 

I well remember the incredulity with which I first read 

1 Yet the antivivisectioDiBts deny in Mo this And all other findings of 



of the origin of lockjaw from the soil, but very soon'this 
incrediility was changed to belief in the face of absolute 
demonstration after this fashion: It had been well known 
for years that hostlers^ cavahymen, farmers, and persons 
who were engaged in any occupation about horses were 
peculiarly liable to lockjaw. After the discovery of the 
bacillus of lockjaw in 1884» by I^colaier, when a case of 
lockjaw occurred, the ground on which the patient had 
fallen, or the instrument by which he had been hurt, was 
examined, and a certain bacillus was found in or on it. 
This was inoculated into animals, and was found to pro- 
duce the same disorder; and the same bacillus was recovered 
from the animal's body, and was successfully reinoculated. 
The circle of proof, therefore, was complete. This explained 
the popular belief that treading on a rusty nail is a fre- 
quent cause of lockjaw; not because it was a nail or old or 
rusty, but because the germ of lockjaw was on it and in the 
ground in which it was lying. No such exact experiments 
are justifiable on man. The sacrifice of a few rats quickly 
gave us all the desired information. This has almost 
totally abolished lockjaw as a result of surgical operations, 
and enabled us to cure it in many cases even after acci- 
dental inoculation. Before 1884 it was both frequent and 
fatal; now it is almost a surgical curiosity, except after 
neglected accidents. 

The two most important surgical discoveries of the nine- 
teenth century were, (1) anesthesia, especially by ether (in 
1846) and by chloroform (in 1847) ; and (2) antisepsis, by 
Lord lister, who b^an his work soon after the middle of 
the nineteenth century and had distinctly formulated it 
about the end of the sixties. His remarkable paper in 
^'The Lancet" of April 8, 1869 (when he was simply Mr. 
Lister, Professor erf Surgery in the University of Glasgow), 
was one of those papers which marked a new era in surgery . 
Several years before^ he had announced that he believed 
that inflammation and most of our surgical disorders were 


due to genns» and that if we could exclude these germs, we 
would be able to secure the healing of wounds without in- 
flammation and without the formation of pus (matter); 
yet it was not until 1881 that Ogston and Rosenbach dis- 
covered the germs which produce the terrible results of 
inflammation, such as erysipelas, hospital gangrene (what 
irony in the name!) abscesses, blood poisoning and even 


One of the most important contributions by Lister to the 
progress of surgery was the introduction of antiseptic 
threads (ligatures) of catgut, with which to tie blood- 
vessels. One of the earliest Philadelphia surgeons, Philip 
Syng Physick, tried to get rid of JJie dangers following silk, 
which had been used to tie arteries ever since Ambroise 
Par6 introduced it in the sixteenth century as a happy sub- 
stitute for the horrible hot pitch and hot iron which then 
were the only means for arresting hemorrhage. Physick 
sought to use buckskin, on the ground that it was an ani- 
mal substance and would, therefore, disappear by absorp- 
tion. Dors^ used catgut. Hartshome used parchment 
cut in fine threads, and Bellinger and Eve the tendon of the 
deer. But none of these surgeons succeeded in giving us 
harmless ligatures until Lister taught us how to use them. 
Li the paper which I have referred to he showed that the 
old idea of a ligature was that it was a foreign body which 
was to be got rid of by its rotting through the walls of the 
blood-vessel. The result was that in a very large percent- 
age of cases the blood-vessel was not stopped by a clot; sec- 
ondary hemorrhage took place (usually during the second 
week after an operation), and many a patient bled to 

I shall never forget one night in the Satterlee Hospital, 
of West Philadelphia, about ten days after the battle of 
Gettysburg, when I was called five times to check just 


such secondary hemorrhage from the rotting through of 
silk ligatures. As a consequence of the introduction of anti- 
septic ligatures by Lister I do not recall in the last thirty 
years five cases similar to these five that I then attended in 
one night. In other words, secondary hemorrhage has al- 
most disappeared from surgical experience. 

How did Lister find out the proper method of tying an 
artery? On December 12, 1867, he tied the great carotid 
artery in the neck of a horse with a piece of pure silk satur- 
ated with a strong watery solution of carbolic acid, cutting 
both ends of the thread short and dressing the wound anti- 
septically. Healing took place without any inflammation. 
Thirty-nine days after the operation he investigated the 
parts by dissection, and found that if the thread had not 
been appUed with the antiseptic precautions, secondary 
hemorrhage would unquestionably have occurred, and in 
all probability the animal would have bled to death. On 
January 29, 1868, he applied this principle in the case of a 
woman of fifty-one with an enormously dilated sac (an 
aneurism) in the upper part of the great artery supplying 
the thigh and leg. She, like the horse, recovered without 
inflammation, and lived for ten months. On November SO 
she suddenly died as the result of a rupture of a similar 
dilatation of the aorta in the chest. This gave Lister the 
unusual opportunity of examining in a human body the 
result of his application of an antiseptic thread to the ar- 
teries. The case emphasizes one of the great difficulties in 
studying such questions on human beings. The opportu- 
nity for a post-mortem examination after such an application 
of a new principle can only be occasional. If this woman at 
the time of her death had been under the care of some other 
surgeon than Lister, no such careful examination of the con- 
sequences of the tying of the artery would have been made, 
and no further progress would have followed. The result 
of Lister's examination showed that, in spite of his care, an 
incipient abscess was developing at the point at which he 


had tied the artery. This was In consequence of the presence 
of the thread, and especially of the knot. 

As a result of this investigation, on December 81, 1868, 
he tied the carotid artery in the neck of a calf with catgvi 
which had been prepared with carbolic acid, and all anti* 
septic precautions were used during the operation. The 
calf recovered perfectly, and in thirty days was killed and 
the parts dissected. He found that at the site of the thread 
of catgut there was a band of living tissue surrounding the 
thread and closing the artery, and that, therefore, instead 
of the thread rotting through, as was the case with the silk» 
it had become a part and parcel of the tissues. The artery, 
instead of being so weakened as to allow of secondary 
hemorrhage, was really stronger at this point than at other 
points. The Ugature and the knot had entirely disappeared. 

I have narrated this somewhat in detail for this reason: 
It illustrates admirably the method of scientific progress by 
experiment upon animals. Neither of these animals suf- 
fered any material pain, both operations having been done 
with the same antiseptic care as in a human being. Both 
of them were killed at such a time as would facilitate our 
knowledge of the results. 

Since then other experimenters have tied the blood-ves- 
sels in A^nimftla and have killed them at varying intervals 
and made microscopical examinations of the blood-vessels. 
In this manner our knowledge of the way in which hemor- 
rhage is stopped is now complete. The knowledge which 
was attained within a short time by the sacrifice of a few 
fLTiiniftla would have been attained only after many years 
by occasional post-mortems^ and would then have been 
very much less perfectly attained and only by the loss of 
many himian lives instead of a few animals* Uves. 

Contrast, now, the result of the old and the new surgery 
in the mere matter of stopping hemorrhage after opera- 
tions or accident by tying blood-vessels with the old ordin- 
ary silk and the modem antiseptic catgut, or with silk itself 


as now used by improved metliods. In the old way the 
blood-vessels were tied with silk, which was as clean as an 
ordinary housewife would have it. One end was left long, 
and it was no uncommon thing after an amputation of the 
thigh to have as many as twenty or thirty of these ligatures 
or threads hanging out of the wound. After two or three 
days, when those on the smaller blood vessels would, pos- 
sibly have rotted through, each ligature was pulled upon, 
and those that were already loosened by putrefaction came 
away. Finally, at the end of ten days, two weeks, or three 
weeks, the ligature on the great blood-vessel of the arm or 
thigh came away, not uncommonly followed, as has been 
stated, by profuse and often fatal hemorrhage. Sometimes, 
as in Lord Nelson's case, such a ligature did not rot away 
for years, and required dressing of the arm all of this time 
on account of the constant discharge. 

What happens to-day in a surgical operation where 
either properly prepared silk or catgut is used? We tie all 
the blood-vessels needing it, cut off both ends of the threads 
short and dose the wound entirely; and, instead of having 
discharge and horrible inflammation for days and often 
weeks and sometimes months, it is now a rare thing for 
such a wound not to be entirely healed within ten days, and 
sometimes less, and secondary hemorrhage is almost un- 
heard of. If vivisection had given to surgery only the mod- 
em means of stopping hemorrhage, it would be worth all 
the labor it has required and all the suffering it has inflicted 
on all the animals ever experimented upon. 

Of late a new problem in hemorrhage has been presented. 
When an artery is wounded — as, for instance, if the blade 
of a pocket knife has been thrust into the thigh and wounds 
the great femoral artery — the only way to prevent the 
patient's bleeding to death has been to expose the artery 
and tie it above and below the point where it was cut. Of 
late several surgeons (especially Murphy, of Chicago) have 
made some very ingenious experiments on such wounded 


blood-vessels. They have carefully exposed the artery of 
an animal (under an anesthetic, of course), have wounded 
it, and then, instead of tying the arteiy, have sewed up the 
wound in the wall of the arteiy to see whether this could 
not be done successfully. The reason for this series of ex- 
periments is this: When we cut off the supply of blood to a 
leg or an arm by tying the blood-vessels, gangrene not un- 
commonly occurs, because the chief blood-supply of the 
limb is cut off by tying the artery. If instead of tying the 
vessel we can sew up the wall and it will heal, the current 
of blood is uninterrupted and there is no danger of gan- 
grene. One thing is perfectly manifest — it would never 
be proper to make such experiments on human beings. 
Human life would be endangered, and no surgeon would 
adopt or would be justified in adopting such a novel pro- 
cedure until it had been tried and proved successful on 
animals. Several successful cases of suture (sewing) of the 
large blood-vesseb have now been done in man.^ 

The Brain 

When I first taught anatomy, thirty-five years ago, the 
various portions of the brain were not supposed to have 
separate functions. We knew, of course, that disease or an 
injury on one side of the head produced paralysis on the op- 
posite side of the body. Broca also discovered by observa- 
tions on man in actual cases of disease that when that part 
of the bnun corresponding to the left temple was affected 
the power of speech was lost. But if a man had a fracture 
of the skull or a gunshot wound in the region above the ear 
or in the front of the bnun or the back of the brain, there 
was no well-recognized difference in the results. This was 
largely due to the fact that such injuries are widespread, 
and not limited to small areas. In Germany, Fritsch, Hit- 
zig, and Goltz, and in England, Horsl^, Ferrier, Schaeffer, 

* ^ Now some hnndredi of cases luive been snooessfully operated on and 
patients doomed to kse kg or life have had both preserved. (1914.) 


and others, pursued the following plan: The monkey's 
brain is the nearest in similarity to man's. A known por- 
tion of the brain — for instance, the r^on above the ear — 
being exposed, the brain was mapped out in small squares^ 
and each one of these squares in succession had the pole of 
a battery applied to it. The phenomena which occurred — 
whether opening and shutting the eyes, turning the head 
right or left, contraction of the muscles of the arm or leg — 
were all carefully noted down. In this way a distinct map 
of the brain was made, so that we know definitely that a 
certain area of the surface of the brain governs the move- 
ments of the eyes, of the head, of the arm, forearm, hand, 
thumb, thigh, leg, great toe, etc. In the same way at the 
back of the head the area which governs sight has been 
found, and it was discovered that the area on the right side 
if destroyed made the right half of each ^e blind, and that 
if the area of the left side was destroyed, the left half of 
each eye became blind. This description is, probably, suffi- 
cient to indicate how physiologbts and surgeons have in- 
vestigated the brain. 

The following is an instance which shows how accurately 
this method has enabled us to locate the motor centers in 
the brain. A girl, who suffered from epilepsy, and in whom 
the convulsions always began in the right thumb, and then 
spread to the arm and the body, was operated upon. A 
piece of the gray matter on the surface of the brain, as 
large as the last joint of the forefinger, was removed from 
the place determined upon animals as the center govern- 
ing the movements of this thumb. When she awoke from 
the ether that thumb but no other part of the body was en- 
tirely paralyzed. When we remember that the muscles 
which move the thumb arise in the ball of the thumb, 
between the thumb and the forefinger, and on the front 
and the back of the forearm nearly as high as the elbow, 
this is seen to be most remarkable. I do not know a sin- 
gle case ever recorded of so minutely located disease. By 


no other means than vivisection could this small thmnb 
center have been determined. She has entirely recovered 
from the paralysis, and her epileptic fits instead of being 
almost daily were reduced to one or at the most two a 

Those experiments have made possible the modem sur- 
gery of the brain, which would not exist to-day were it not 
for vivisection. . . • 

It is a source of sincere gratification on the part of nu- 
merous surgeons that by this same knowledge of cerebral 
localization derived from animal experimentation they 
have been able to recognize hemorrhage inside the skull, 
open the skull at the right point, even when there was no 
fracture of the skull, and save th^ patients. Before exper- 
iments on animals showed us how to interpret the symp- 
toms this was an impossibility, and nearly all such patients 
died. Now we save, roughly speaking, two out of three! 

Time and space would fail me to tell of the abscesses of 
the brain, of the foreign bodies in the brain (such as nails 
driven into it by accident or design, rifle-balls which had 
lodged in it), and of many other similar surgical disorders 
the modem successful treatment of which depends di- 
rectly upon the localization of cerebral functions, which 
is the result almost wholly of experiments upon animals. 

The Spinal Cord 

Up to the present time the belief of surgeons has been 
that in case the spinal cord was completely cut in two, 
either by gunshot wounds, fracture of the spine or other- 
wise, no reunion of the two ends would take place, and, 
therefore, there was no possibility of relief for the paralysis 
below the point of division of the cord which is almost 
always fatal. Only this winter, at the Pennsylvania Hos- 
pital, Dr. F. T. Stewart had a patient whose spinal cord 
was cut in two by a bullet. He removed the bone suffi- 
ciently to get access to the spinal cord, and found it com- 


pletely divided. He immediately stitched the two ends to- 
gether, and, strange to say, this patient has recovered both 
feeling and motion to some eirtient in both legs. I think 
it would be evident to any person that such a totally unex- 
pected result deserves the most careful investigation. In 
man cases of such complete division followed by recovery 
are almost unknown; and if they had to be studied in man, 
this would be imperfectly done, and probably would require 
fifteen or twenty years before we would know what ought 
to be done. It is one of those cases in which it is our duty 
to investigate by experiments upon animals what is the 
best method of sewing the two ends of the spinal cord to- 
gether; at what date after division of the cord it will be 
hopeless to do so; how much of the cord can be lost (that b 
to say, a half inch, or more) and yet by stitching the two 
ends together it will be possible to restore the function of 
the spinal cord. One can see very readily that in animals 
all these problems can be studied minutely, in a sufficient 
number of cases; various procedures can be tested and the 
results determined accurately by killing such animals at a 
suitable date, and a definite conclusion can be reached in a 
short time. 

In 1888 Mr. (now Sir Victor) Horsl^, the distinguished 
London surgeon, and Dr. Growers, equally distinguished as 
a neurologist, for the first time in the history of surgery 
made a diagnosis of a tumor of the spinal cord, definitely 
located it and the former removed it, the patient making an 
absolute recovery. A number of other cases have been suc- 
cessfully operated on since then. Just as in the case of tu- 
mors of the brain, this would not have been possible had it 
not been for experiments upon animals, which have given 
us practically most of our present knowledge of the minute 
anatomy and physiology of the spinal cord and have, there- 
fore, enabled us to deal with it siu'gically. 



Among the most fruitful branches of research which have 
been so valuable in results are the animal experiments upon 
the different nerves of the body. The methods by which 
nerves could be sewed together; the possibility of taking a 
portion of a nerve or even of the spinal cord from a rabbit 
or other animal to replace a piece of the nerve when it has 
been destroyed by accident or disease; the possibility of 
sewing one nerve to a neighboring nerve in order to rei^ 
tablish its function — all of these and other similar oper- 
ations have been studied in animals, and could only be 
studied in animals with exactness. 

In order to study such conditions it is not enough that 
the two ends of the nerve should be sewed together and 
then, after the wound has healed, that we should simply 
determine the fact that the functions of the nerve are rei^ 
tablished. It is necessaiy to know by the microscope the 
various steps of the process of union of the nerves — to 
investigate various methods of sewing them together; 
whether they can be overlapped, or must be applied ex- 
actly end to end; whether one end of the nerve can be split 
and the other inserted into it, or turned over as a flap, and 
so on. Evidently numerous methods can only be studied 
on animals. Then, when the results are known, we can 
apply them for the benefit of man. 

The Thyroid Gland 

One of the commonest diseases in Europe, and one that 
is occasionally seen here, is goiter. This forms a large tu- 
mor in the neck, for which formerly little could be done, as 
an operation was nearly always fatal. Such patients were 
obliged to go through life with a dreadful deformity, in the 
greatest discomfort, and were sometimes suffocated by pres- 
sure on the windpipe. In consequence of the introduction 
of the antiseptic method of Lister, which we owe to vivi- 


section more than to any other agency, operations on the 
thyroid gland are now so common that at the German Sur- 
gical Congress in April of this year Professor Kocher, of 
Berne, has reported two thousand operations done by him- 
self, with a mortality of only four per cent. 

Very soon it was discovered that removal of the entire 
gland produced a curious effect. The face became bloated; 
the expression greatly changed, and the patient became 
more or less idiotic — that is, the condition known as myx- 
edema followed. This led to improvement in operations in 
several directions. First, in all those cases in which the tu- 
mor could be shelled out, as an English walnut is turned 
out of its shell, leaving a portion of gland tissue behind, 
this was done. The similar effects of the removal of the 
thyroid in animals were studied especially by Horsley. 
Surgeons then removed the thyroid gland from the neck 
of an animal and placed it imder the skin of the same ani- 
mal, and it was found that the disastrous results were 
avoided. After a number of experiments on animals there 
was good reason to believe that the disastrous effects of 
the operation which sometimes followed goiter could be 
avoided in man by the same procedure. Accordingly the 
thyroid gland of a sheep was transplanted in a number of 
instances under the skin, or in some cases into the abdom- 
inal cavity. In both cases there was improvement for a 
time; but eventually the majority of the cases suffered 
from cretinism or myxedema, which may be described as a 
less severe form of the same disease. Finally, in animals a 
study was made to determine how much of the gland must 
be left in order to prevent myxedema, and now we are able 
to relieve patients from goiter and yet, by leaving enough 
of the gland, prevent any bad results following the opera- 

These results led also to a careful study of the effects of 
^ving an extract of the thyroid gland to human beings. 
Some of the most brilliant results that have ever been ob- 


tained in medicine have followed the administration of the 
thyroid extract to cretins in whom the disease had not been 
produced by operations for goiter, but arose naturally. In 
certain forms of goiter it has enabled us to relieve or even 
to cure without operation. In insanity and many other 
mental states it is used as a well-established remedy » which 
in even a large percentage of cases is followed by great 
benefit and even by cure. In many other diseases also the 
thyroid extract has been used with the best results.^ 

Removal of the Larynx 

Cancer of the larynx, or that part of the windpipe back 
of and just below the Adam's apple, is not at all uncom- 
mon. The only hope for such patients is in removing the 
entire larynx or voice box. Before attempting this for the 
first time on man, Billroth, of Vienna, and his assistant 
Czemy, now the distinguished Professor of Surgery at 
Heidelberg, tested the operation on several dogs. Billroth 
then removed the larynx from his patient and saved his 
life. This operation has now been successfully repeated 
scores and scores of times as a result of these few experi- 
ments on dogs. 

The Lungs 

A b^inning has been made in the surgery of the lungs, 
but as yet we have not reached the point where we can say 
that we have attained entire success. In a number of ani* 
mals parts of the lungs have been cut out with a view of dis- 
covering the possibility of cutting out diseased portions of 
lung, the seat of tumors, consumption and other disorders, 
and a few operations have been done upon man, with a fair 
percentage of success. Not uncommonly abscesses of the 
lungs which were perfectly inaccessible a few years ago 
have been reached and opened. Sometimes coins and other 

^ For the later diacovery of the use of the ''parathyroid ^ands," see 
''Recent Surgical Progress," jH)$t, p. 166. 


f ordign bodies get into the bronchial tubes, and can only be 
reached through most difficult and dangerous operations. 
Several surgeons have experimented upon animals to de- 
termine the safest method of removing such bodies, but 
with only partial success. Is it not evidently our duly to 
devise new operative procedures and test them on animals 
first, and, when a reasonably promising one has been found, 
to apply it to man?^ 


In 1890, Ponfick, of Germany, showed that in rabbits the 
removal of a quarter of the liver caused a slight deteriora- 
tion in the condition of the animal; removal of one half 
was followed by much more serious i^ymptoms, which, 
however, passed off within a few days. Even removal of 
three fourths of the whole liver could be recovered from, 
but removal of more than this was always fatal. By killing 
the animal in which a small part had been removed at a 
suitable time, and studying microscopically the liver tissue 
at different periods of time after operation — a procedure 
manifestly only possible in animals — he showed that there 
was a reparative power in the liver, which before then was 

Up to that date less than a dozen surgeons had operated 
on tumors of the liver. In only two of them was any con- 
siderable portion of the liver removed. After the paper by 
Ponfick, which showed how much could be removed, sur- 
geons immediately operated with much more confidence, 
and removed considerable portions of the liver. Up to 
1899 seventy-six tumors of the liver had been removed. 
Of these cases the termination of two was unknown; of the 
remaining seventy-four, sixty-three recovered and eleven 
died — a mortality of less than fifteen per cent. One who 
is not a surgeon can scarcely appreciate how differently 

* See the papers on "The New Surgery " {post, p. 171) and "The In- 
floenoe of Antivivisection cm Character " (!poH, p. 284) for the remark- 
able recent progresa m the surgery of the cheat. 


the operation for tumor of the liver was regarded before 
and after Ponfick's experiments. Before that everything 
was marked by timidity; after that everything was marked 
by confidence, and all to the benefit of the patient. 


The same story that has been toldof the liver can be told 
of the spleen, thon£^ with much less good results. As a re- 
sult of studies, partly by accident, in man (as when in con- 
sequence of a stab-wound or other injury a spleoi would 
protrude throu£^ the waU of the abdomen, and would have 
to be removed), but chiefly as a result of the careful studies 
of removal of the spleoi in animals, beginning practically 
with Schindeler's experiments in 1870, we are now in a posi- 
tion definitely to say that in man the entire sjpieeD. can be 
removed, and he can not only survive the operation, but 
can get along comfortably williout any spleen. A veiy con- 
siderable number of such operations have now been suc- 
cessfully performed. 

The Kidney 

On August 2, 1809, Professor Simon, of Heidelberg, laid 
the foundation of the modem surgery of the kidney by re- 
moving a healthy kidn^ from a healthy woman. The rea- 
son for it was that in removing an ovarian tumor some time 
before he had been obliged to remove a part of the ureter 
(the tube leading from the Udney to the bladder), and to 
fasten the cut end to the skin. As a consequence of this the 
woman was in a most deplorable condition from the con- 
tinual escape of urine over her person. After a number of 
unsuccessful attempts to dose this external opening, it 
finally occured to him that the only way to cure her was to 
remove the kidn^ on that side. Whether a human being 
woidd recover aiul could live with only one kidn^ was 
practically unknown. It is true that disease had destroyed 
one kidney in some patients and the other had gradually 


developed ability to do the work of both. Injury also had 
destroyed parts or all of one kidney» but deliberately to 
take out a healthy kidney from a healthy human being was 
an operation not only fraught with danger, but one before 
whidi all the surgical world up to that time had recoiled. 
No one had studied the effect on the remaining kidney and 
upon the heart. No one had carefully determined what was 
the best method of reaching the kidn^ — whether through 
the abdomen or through the loin from the back; what to do 
with adhesions and many other technical questions. All 
these had to be settled. Accordingly he experimented on a 
number of dogs; decided that from these indications a hu- 
man being could live with only one kidney; studied on the 
cadaver the best way of doing the operation, and on August 
^9 1869, removed this healthy kidn^ through the loin, 
saved the patient's life and made her perfectly comfortable. 
She died in 1877, after ei^^t years of healthy life. 

As I have said, these new experiments laid the founda- 
tion of the modem surgeiy of the kidn^. Now hundreds 
of kidneys have been removed successfully. Finding this 
operation so feasible, surgeons were led to practice other 
operations; some hundreds of abscesses in the kidn^ have 
been opened; stones have been removed from scores of kid- 
n^s; floating (i.e., loose) kidney has been sewed fast in 
hundreds of cases; manycasesof tuberculosis of the kidn^ 
have been relieved or cured; tumors of the kidn^ are suc- 
cessfully attacked; even the cut ureter has been spliced; 
stones also have been removed from it. In a word, Simon's 
experiments on a few dogs opened to us a new domain in 
surgery which until then was wholly unknown. Would 
it not be gross cruelty to man to prevent such benefi- 
cent researches? 

The Stomach 

Were I limited to the progress of the surgery of the stom- 
ach alone by vivisection there would be quite enough ma- 


terial for this entire paper. Until 1875 practically there was 
no surgeiy of the stomach. As occasional Csesarean sec- 
tions have been done in the past, so occasional operations 
on the stomach were done when the surgeon was obliged to 
do them. Now, however, it is a matter of routine proced- 
ure, to the vast benefit of the human race. Had vivisection 
contributed nothing else to the progress of surgeiy than its 
services in the surgeiy of the stomach, this alone would be 
sufficient to justify it. I may quote from the Cartwright 
lectures which I gave before the College of Physicians and 
Surgeons in New York in 1898: * — 

In 1875, Tschertneisky-Barischewsky cut out a piece of the 
intestines in thirty-five dogs, with twenty-nine recoveries — a 
startling result when compared with the former fatality of such 
operations. This was the starting pdbt in the new gastro-intes* 
tinal surgery. The next year Gussenbauer and Winiwarter cut 
out a piece of the stomach in only seven dogs. We scarcely can 
appreciate at this day, though these experiments are so recent, 
how many new questions had to be answered. After their first 
unsuccessful experiment they naively remark that certain facts 
were established by the experiment, among them, ''that the sur- 
faces of the stomach have a real tendency toward union by first 
intention, • . • just as do wounds of the skin.*' (I) Whether this 
would be correct of man as well as of animals they admitted was 
as yet uncertain. Another point settled by the experiment was 
''that there was no digestion of the mucous membrane in the 
neighborhood of the wound." Their second experiment was fol- 
lowed by recovery, and showed not only that such an operation 
could be successfully done, but that the narrowing caused by the 
scar did not interfere with the functions of the stomach, either as 
to its movement or its secretion of the digestive juices, and that 
the removal of the pylorus (the opening from the stomach into 
the intestine) was not f oUowed either by the too early escfi^ of 
the food into the intestines, or by the reflux of the intestinal con- 
tents into the stomach. The dog was killed five months later and 
the post-mortem showed no contraction, by reason oi the scar, and 
no digestion of the edges, and his perfect health after the <q>era- 
tion showed that the movements of the stomach and its digestive 

1 In quoting this I hsve pc^ulariied some of tlie medical terms there 


functions had not been interfered with. Then, again, the ques- 
tion whether catgut or other suture material was the best, and 
what kind €i a knot and what kind of a suture would best answer 
were subjects of debate. 

Our antivivisection friends, who so often declare that experi- 
ments upon animals have never contributed anything to the 
progress of surgical science, may well be challenged to account 
for the remarkable progress in the surgery of the stomach which 
immediately followed these fruitful experiments. The dogs that 
died did not die in vain. Th^ showed the correct methods and 
indicated errors in technic, and directly led up to the modem sur- 
gery of the stomach and the intestine in man, as follows: In the 
very same year, 1876, Hueter cut out a part of the bowel, though 
without success. In 1877 Csemy for the first time sewed up the 
intestine, and dropped it into the abdominal cavity, with recov- 
ery; followed almost immediately by Billroth, who did the first 
successful suture of the stomach and total removal of a portion 
of the bowd. In 1878 Forelli operated for a wound of the stom- 
ach, and in 1879 Cavazsani removed a portion of the stomach for 
tumor. In the same year P4an did the first removal of the py- 
lorus. In 1880 Rydygier did the second, and in 1881 Billroth did 
the third and firot successful one, without a knowledge of the 
preceding operations. 

Then followed various operations on the stomach to 
which I will allude later, and finally the successful removal 
of the entire stomach. It is quite impossible to give the de- 
tails of all the various operations now done on the stomach 
and indicate minutely the part that vivisection has had in 
developing this extraordinarily successful branch of modem 
surgery. Suffice it to say that among them are the follow- 
ing, all of which owe more to vivisection experiments than 
to any other single agency: — 

In cancer of the esophagus or in the constriction of the 
esophagus, which so often follows the accidental or inten- 
tional swallowing of lye or acids, etc., so that no food can 
get into the stomach, we now open the abdomen, open the 
stomach, introduce a tube or construct a passageway into 
the stomach, and feed the patient through this outside 
esophagus, as it were. In case the narrowing of the esoph* 


agus is not from cancer the patient can live his natural span 
of life. In case of cancer his remaining days are rendered 
relatively comfortable, since the operation prevents his 
starving to death. When we have cancer at the opposite 
end of the stomach (the pylorus), so that the food, though 
it can be swallowed, cannot get ovi qf the stomach, one of 
two courses is followed, both of which have been carefully 
studied in the Iowot animals and then adapted to man. 
First, the portion of the stomach and bowel involved in the 
cancer is cut out and the bowel united to the stomach di- 
rectly, or, in other cases, an opening is made in the stom- 
ach and one in the bowel lower down, and the two openings 
are sewed tc^ther, thus allowing the food to pass from the 
stomach directly into the bowel beyond the cancer. The 
mere question of how the stomach and bowel can be most 
successfully united in these cases, particularly the best 
method to prevent fatal leakage, has required very many 
series of experiments, especially in this country, by Senn, 
Abbe, Brockaw, Ashton, Murphy, and others. As a result 
of their labors sometimes we have learned how not to do 
the operation because of unexpected difficulties; sometimes 
how to better our procedure, until now we are in possession 
of satisfactory methods, as has been proved by the success- 
ful operations on man many times over. Even the sewing 
together of the stomach and bowel alone had been done 
up to 1808 in 550 cades which have been published. I have 
no doubt that since then this number has almost been 
doubled. The mortality of this operation from 1881 to 
1885 was 65.71 per cent; from 1886-00, the mortality had 
fallen to 46.47 per cent; from 1801 it had again fallen to 
88.01 per cent, and recently in twenty-seven cases an 
Italian surgeon (Carle) has had a mortality of only 7.4 per 

Moreover, the experiments on animals, having shown 
how safe various operations are, have emboldened us to 
enlarge the inhere of our operations and do others that 


were before not dreamed of — a good instance of the partly 
indirect good results from vivisection. 

A brief enumeration of some of the various operations 
done upon the stomach, together with their mortality, is 
as follows: — 

(1) Where the stomach is bound down by adhesions 
(which often produce the most serious digestive disturb- 
ances, destroying comfort and even threatening life), we 
now open the abdomen, cut or tear the adhesions, and prac- 
tically all of the patients recover. 

(i) Where there are f ordgn bodies in the stomach (or in 
some cases foreign bodies that have stuck in the esophagus 
low down, near the stomach), we open the stomach, remove 
the foreign body (inserting, if need be, the arm to reach 
it in the esophagus), sew up the stomach and the abdom- 
inal wall, and the patients generally recover. In some cases 
as many as 192 staples, buttons, screws, horseshoe nails, 
etc., weighing over a pound and a half, have been re- 
moved, and the patients have recovered. 

(3) Where the esophagus has been narrowed by the swal- 
lowing of lye, etc., instead of making a permanent opening 
in the stomach (as before described), sometimes by having 
the patient swallow a perforated shot which will cany a 
string down into the stomach, we can open the stomach 
temporarily, seize and draw out the shot, attach a conical 
dilator to the string, and, after having dilated the con- 
striction of the esophagus, remove the string, sew up the 
stomach and the abdominal wall and cure the patient 

(4) We now open the stomach purely to explore it and 
find out whether or not there is serious disease. This has 
enabled us in many cases to relieve illness which otherwise 
was incurable. Nearly all of these patients recover from 
the operation. 

(5) The permanent opening in the stomach through 
which we can feed a patient I have already described. It 


was first proposed in 1837. It was first done in 1849. 
From then until 1875 twenty-eight cases were operated on» 
with twenty-eight deaths! It seemed ahnost as though the 
operation must be abandoned when, in 1875, the first oper- 
ative recoveiy occurred. From then until 1884 in 163 cases 
there were 133 deaths — a mortality of 81.66 per cent. At 
the present time the mortality is only about twenty-five 
per cent in cases of cancer, and in the non-malignant cases 
not over ten per cent. 

(6) As I have indicated, in certain conditions we make 
an opening in the stomach and another in the bowel and 
sew the two openings together. In some cases of ulcer of 
the stomach, which cannot be cured by medical means, this 
gives wonderful results, both as to comfort and cure. The 
operation was first done in 1881, with a mortality decreas- 
ing from 65.71 to 33.91 per cent in general, and in the sta- 
tistics of single surgeons to only 7.4 per cent. 

(7) The first removal of the pylorus with union of the 
bowel and stomach was done in 1879. The mortality was 
veiy great, and is still large, ranging from 9!7St per cent in 
simple cases to 72.7 per cent when there are extensive ad- 

(8) When the pylorus is simply narrowed, but is not the 
seat of cancer, we make an incision in its long axis, seize the 
edges of the incision at the middle, draw them out at right 
angles to the line of the incision, and by sewing them in 
this position we widen the opening of tiie pylorus. This 
was first done in 1886. Up to 1894 the mortality was 20.7 
per cent. Recently Carle has reported fourteen cases, with 
a mortality of only seven per cent. 

(9) In not a few disorders the stomach is dilated to 
nearly two or three times its normal size. In these cases we 
now take a *'tuck*' in it, as was first done in 1891. Up to 
three years ago fifteen such operations had been done, with 
only one death. 

(10) When the stomach, instead of being dilated, is dis- 


placed, we sew it fast, and practically in all cases recoveiy 

(11) Sometimes the stomach is divided into two parts, 
like an ^'hour-glass" or a dumb-bell with a very short 
handle. The first operation for relieving this condition was 
done in 1893 by making an opening in each half of the 
stomach and sewing the two openings together. Up to 
this year over forty operations have been done for this 
condition, with only nine deaths. 

(12) Tumors of the stomach other than cancer are rare, 
but since 1887 at least seven cases of tumor have been cut 
out, of which six have recovered. 

(13) Partial removal of the stomach finally led to its 
complete removal, of which over a dozen instances have 
been reported, with a recoveiy of somewhat more than half. 
Nearly all, however, have died from recurrence. 

Some of the above operations are not the direct result of 
experiment upon animals (as, for instance, the taking of a 
tuck in the stomach) ; but they are the indirect result, first, 
through the antiseptic method, which itself is the child of 
vivisection, and, secondly, because throu£^ our experience 
in other operations we have been led to perform totally new 
ones. It is the same in other sciences. If we were still de- 
pendent upon the old ''air-pump" worked by hand, we 
should have no lighting by the incandescent bulb of to- 
day, for this is dependent upon a cheap method of making 
an almost complete vacuum. This b a wholly unexpected 
and indirect result of improvement in air pumps as one of 
the chief factors of progress. 

The IrUesHnes 

Very much the same story can be told of the surgery of 
the bowel. Indeed, the surgeiy of the stomach involves 
largely that of the bowel. I need, therefore, only recall a 
veiy few points* When a tumor or cancer exists in the 
bowel, of course, in a little while it obstructs the passage of 


the intestinal contents; and if this obstruction becomes 
complete and is not quickly removed, the patient must 
necessarily die* As a result of many experiments upon ani- 
mak (more especially by Senn,Parkes,and other American 
surgeons) we now know how to deal with this ccmdition. 
First, if the tumor or cancer can be removed, it is cut out 
entirely, and the two ends of the bowel are united. Our 
present successful means of uniting them are a result of 
most laborious researches by experimentation upon ani- 
mak to discover the best method of doing this otherwise 
perilous operation. The slightest leakage c^ intestinal con- 
tents produces a fatal peritonitis. Where the cancer can- 
not be removed, in order to prolong the patient's life and 
lessen his terrible pains, we make an opening above the ob- 
struction and another one below and sew the two openings 
together. Here again many experiments were needed to de- 
termine whether an animal could live with the intestinal 
contents thus ^* side-tracked/' and if life could be main- 
tained, what was the best method of doing the operation. 
In gunshot wounds of the intestines, which formerly 
were among the most fatal of all accidents, we now can 
rescue a very large percentage of the patients. During the 
Civil War practically almost every case of perforation of 
the intestine by gunshot died. To see whether something 
could not be done to remedy this frightful mortality. Gross 
many years ago performed some experiments to determine 
the best treatment of such wounds. Later Parkes etherized 
a number of dogs, shot them, opened the abdomen and 
treated the wounds in various ways; and in consequence of 
this and other series of experilnents, at the present time 
many instances of recovery have been reported in which 
multiple wounds even to the number of seventeen have 
been found closed by methods determined by vivisection 
to be the best, and the patients have recovered. To reach 
this result it had to be determined by accurate observa- 
tion on animals what was the best method of closing such 


woimds; what material is the best for use as a thread; iinder 
what conditions it would be needful, instead of closing the 
wound, to cut out the injured portion of the bowel and 
unite the two ends; how long after perforation occurred was 
the best time to operate, and many other such questions 
too technical to mention here. 

In typhoid fever and in ulcer of the stomach also some- 
times a perforation similar to the hole made by a bullet 
occurs, and the contents of the intestines or of the stom- 
ach are poured out into the abdominal cavity. Of course, 
eveiy one knows that if this went on for a brief time death 
would necessarily follow. In the lower animals we cannot 
produce exactly the conditions following gastric ulcer and 
typhoid fever; but, in consequence of the knowledge ac- 
quired by experimenting upon gunshot and incised wounds 
of the stomach and bowel in the lower animals, in 1884, 
we finally woke up to the fact that a perforation after such 
an ulcer, either in the stomach or in the bowel from typhoid 
fever, ought to be closed. In 150 cases of such perforation 
of the stomach operation has been done, and the recoveries 
have been 46.80 per cent. But in the last 54 of these oper- 
ations done from 1890 to 1898 the percentage of recoveries 
had risen to 04.82 per cent. In 158 such operations done for 
perforation of the bowel in typhoid fever collected in 1898 
the recovery rate was 2S.41 per cent. Since then it has 
risen to over one in three, and ultimately, I believe, one 
half of such patients will be saved. It must be remembered 
that in such perforations of the stomach and bowel every 
patient would die were no pperation done. To save one 
half or even one third b a surgical triumph. 

I have several times alluded to cutting out a portion of 
the bowel and uniting the two ends. This involves a num- 
ber of problems which ought not, and, in fact, cannot, be 
studied in man because of the fact that it is wholly inad- 
missible to test such operations (which always involve life) 
on man when they can be tested accurately and more 


quickly by experiments on animah without involving 
human life. 

I have stated that by many experiments on animals we 
have now reached a satisfactory solution of the problem 
how the two ends of the bowel are best sewed together. 
But one other question was still unanswered — how much 
of the bowel could be removed and yet life be preserved. 
A similar question, we have seen, has been answered in 
respect to how much of the liver could be removed by 
Ponfick's experiments. How much of the bowel could be 
removed was a most important question. We would all pre- 
sume that a few inches, possibly even a foot or two, might 
be removed without danger; but when we remove a larger 
portion we cut down the digesting and absorbing surface 
to such an extent that it is a question whether the patient 
can still live. This has been determined upon animals, and 
then, as occasion required us to decide the question, in man . 
As a result of the knowledge derived from animal experi- 
mentation I saw four years ago in Montreal a man from 
whom Shepherd had removed ei^^t feet (over one third of 
the entire length of the bowel) which was involved in a 
large tumor; and yet the patient was in capital health a 
long time after the operation. 


The search for the germ of this dreadful disease has as 
yet been fnutless; but happily the search for the means of 
prevention has been crowned with success. Before Pas- 
teur, of every hundred persons bitten about fifteen con- 
tracted hydrophobia and every one died. Of those bitten 
on the head and face at least eighty per cent contracted 
hydrophobia and again every one died. The Pasteur 
treatment, which is entirely the result of animal experi- 
mentation, by preventing its occurrence, has reduced the 
mortality to less than one per cent; and yet the establish- 
ment of Pasteur Institutes for the benefit of the human 


race has been resisted most strenuously by those opposed 
to vivisection.* 

Transplaniation of Bone 

In 1867, OUier, a celebrated French surgeon, who re- 
cently died» by experiments on animals showed that the 
membrane which covers the bones (the periosteum) could 
be peeled off a bone and transplanted to a distance into 
the tissues of the same animal, or even of anoth^ animal, 
and that it would there live and produce new bone. Tliese 
experiments, very crudely described in these few words, 
have been extraordinarily fruitful in several directions. 

First, in certain cases it is necessary to remove diseased 
or dead bone. These experiments showed us that if in re- 
moving the bone the periosteum was carefully guarded and 
left behind it would reproduce the bone. In some cases in 
which the lower jawbone has died as a result of phosphorus 
poison in the employees of phosphorus match factories, the 
dead bone has been removed, but the periosteum has been 
preserved and a new jawbone has been reproduced. An- 
other result has been that, instead of amputating, for ex- 
ample, an arm when the elbow is diseased, we can remove 
the bone and by preserving the periosteum can preserve a 
more or less useful joint. 

In other cases a certain area of bone, as, for instance, in 
the skull, is chiseled loose or otherwise separated from the 
surrounding bone excepting for an inch or two at the por- 
tion where the chief blood supply enters the flap. The bone 
is then forcibly broken at this unchiseled portion and 
turned back, the periosteum and scalp acting as a hinge. 
When the tumor has been removed, the abscess opened, or 
other needful operation done, the trap door is simply closed 
by replacing the flap of bone, the scalp sewed in place and 

^ In spite of the wearisome reiteration of Dr. Charles W. Dulles that 
there is no such disease as hydrophobia, the actual germ of the disease has 
just been discovered at the Bockefeller Institute. (1914.) 


the integrity of the skull is restored. One can see that this 
is an immense advantage over having a great hole left in 
one's skull. 

In some cases, in which, in consequence of accident or 
abscess, a large hole already exists in the skull, we either 
chisel off bits of adjacent bone or take pieces of bone 
from one of the lower animals and successfully fill this 

Again, in certain cases, for example, in which the jaw 
has been fractured, a bit of the bone has been chiseled loose 
from the patient's jaw and has been grafted in place as a 
bridge between the two fragments, so relieving the deform- 
ity or remedying an otherwise incurable fracture. 

Again, a certain small number of children are bom with- 
out any bone at the back of the spine in the neck or the loin 
(spina bifida). Through this opening the membranes of 
the spinal cord protrude and form a tumor which, if un- 
treated, in most cases proves fatal. We now operate most 
successfully on many of these cases, and in suitable cases 
either chisel loose a bit of adjacent bone and transplant it, 
so as to dose the opening, or in other cases take a bit of 
bone from one of the lower animals to fill the opening and 
cure the patient. 

Again, in certain cases of fracture of the arm bone (hu- 
merus), the nerve going to the muscles on the back of the 
forearm, which winds dose around the bone on a spiral, is 
torn in two; these muscles are paralyzed, and the patient 
has what we term *^ wrist drop," so that the hand is useless. 
In such cases the knowledge derived from two different 
series of experiments comes to our aid to enable us to rem- 
edy the trouble. First we expose the two ends of the broken 
nerve, freshen these ends, unite them, and in many cases 
can change a useless hand into a useful one; but if so much 
of the nerve has been destroyed that the two ends cannot 
be brought together we now deliberately remove an inch 
or two of the arm bone, thus shortening the arm so as to 


bring the two ends of the nerve together, unite them, wire 
the two ends of the bone together, and in a good percentage 
of cases we can again restore the hand to usefidness after 
months and occasionally even after years. 

A still more remarkable transplantation of the bone is 
accomplished in some operations on the skull. In some cases 
it is necessary to remove a button of bone which may be 
an inch and a half or two inches in diameter in order to do 
an operation on the brain. The operation which has neces- 
sitated this removal of bone may require an hour and a half 
or two hours. If we want to replace the bone so as not to 
leave an opening in the skull throu£^ which the brain may 
easily be dangerously injured, we put the button of bone 
in a basin of hot salt solution or weak antiseptic solution, 
and by keeping it at a proper temperature, at the end of the 
operation, when it has been totally detached from the body 
for so long a time, we replace it and its vitality is not lost* 

All of these various operations (and others which I have 
not time to describe) done on bone, to the immense ad van- 
tage of our patients, are the direct or remote results of the 
experiments of Oilier and others on the transplantation of 
periosteum and of bone. The indirect results are quite as 
valuable as the direct results of such experiments, and 
sometimes more valuable. 

An illustration of the indirect results of OUier's experi- 
ments is shown in the transplantation of the skin. One of 
the oldest operations in surgery is the making of a new nose. 
When the nose had been lost a suitable shaped flap was cut 
on the forehead, leaving a sufficient uncut base for a proper 
blood supply so that the flap would not undergo gangrene. 
The flap was then turned by twisting it on its base and was 
sewed in place where the nose had been. The experiments 
of Oilier and his successors showed, however, that perios- 
teum, and even so dense a structiue as bone, could be en- 
tirely detached from the body for a long time and yet not 
lose its vitality. Hence we now transplant bone as well as 


skin to make firm instead of flabby noses. This has led us 
of late years to apply the same procedures to the skin, and 
enables us now to do far more extensive and more successful 
operations than would otherwise have been possible. The 
first method tried in man was that of Reverdin, of Geneva. 
He cut little bits of skin only as big as a pin's head from the 
arm or the thigh» not quite skin deep» and planted them on 
any raw surface which did not heal readily. These grafts 
under proper treatment adhere and form new centers from 
which healing of the wound takes place. Emboldened by 
this, Krause and other surgeons have taken very large 
pieces of skin> including often the whole thickness of the 
skin, detached them entirely, and transplanted them. For 
example, in some cases of extensive cancer in which a very 
large portion of skin must be removed, now, while the pa- 
tient is under the influence of the anesthetic, we take strips 
of skin an inch wide and several inches long from the thigh 
of the patient diunng the operation, or, in other cases, 
from another person who is willing to give up a portion of 
his skin. These pieces are immediately placed on the raw 
place left by the removal of the cancer,and as they do not 
lose their vitality but grow fast to the tissues under them, 
the woimd is healed almost immediately, instead of taking 
a long time for the slow formation of a scar. 

One of the most difficult of all wounds to heal is an ex- 
tensive bum, such as is produced by the clothing catching 
fire. In these cases large surfaces of the skin on the chest 
or the abdomen slough off, resulting in great ulcers. These 
sometimes take months, sometimes years to heal, and in 
not a few cases never heal, no matter what is done. Now, 
as a result of our experience, first with the periosteum and 
bone and then with small bits and then larger bits of skin, 
we transplant strips of skin as just described, and such 
wounds heal in a very short time. One sees in the news- 
papers every now and then accoimts of some woman whose 
long hair has been caught in machinery and almost all of 


tlie scalp torn away. These woonds are healed hy trluoa- 
planting skin in a similar manner. 

The Blood 

We are at present only just beginning to iq^nedato how 
mndi we can leam from examination 6i the blood, eq>e- 
cially l^ new methods lately introduced. Almost every 
intelligent person knows that the blood consists, rou^ily 
speaking, (rf a fluid in which float small drcular disks, about 
one three4housandth part (rf an inch in diameter , called the 
red blood cells. In addition to these there is in the Uood an- 
other kind of cell caUed the white blood cdl. Theredblood 
cells are made up chiefly of a substance caUed hemo^obin, 
which gives the color to the blood. Some of the investiga- 
tions, which are really only at pres^it at the beginning of 
their usefulness, are as follows. They are good illustrations 
of how inductive science begins by ascertaining facts. If 
they are valueless they are disregarded; if of value they 
are studied still further. It is not unlikely that the blood 
may soon be one of the most fruitful sources of the knowl- 
edge by which surgery may profit greatly.* 

Firsts the number of white blood cells. It is found that 
in case inflammation results in an abscess the number of 
white blood cells is increased several times. Ordinarily in 
a little cube of blood one millimeter (the twenty-fifth part 
of an inch) on each of its sides the number of red blood cells 
is about four tofive millions, and the number of white blood 
cells is eight thousand to ten thousand. 

If one has an abscess, the white blood cells as a rule 
will rise to fifteen thousand, twenty thousand, twenty-five 
thousand, or more to the cubic millimeter — a condition 
that we know scientifically as ''leucocytosis.'' In certain 
cases when it is a question whether an abscess exists (as, 
for instance, in the brain, in the liver, and other parts of 

1 Immense progress in the study of the blood has been made in the 
thirteen years since this was written. (1914.) 


the body in which the diagnosis is very difficult to make), 
if the leucocytosis or its absence will show us absolutely 
that there is or is not an abscess present, it would be of the 
greatest help. 

Again, in typhoid fever the pain and tenderness exist j ust 
above the right groin. In appendicitis the pain and tender- 
ness exist in the same r^on, and in not a few cases it is ex- 
tremely difficult to distinguish between these two diseases. 
Especially is this true at the b^^inning of such an illness, 
just when it is most important to make the right diagnosis 
and institute the correct treatment. If the presence of leu- 
cocytosis will show us distinctly that it is appendicitis, and 
the absence of leucoc^rtosis that it is typhoid fever, an im- 
mense gain in accuracy of diagnosis, and, therefore, of the 
proper treatment, will result. To open the abdomen, if it is 
typhoid fever (without perforation), would be a dreadful 
mistake; not to open it, if it is appendicitis, would be, as a 
rule, equally wrong treatment. If the leucocytosis is a sure 
guide we cannot leam it too quickly. It seems to me very 
reasonable, therefore, that experiments should be made in 
the lower animals by producing abscesses and determining 
whether under many vaiying conditions leucocytosis is 
always present when there is an abscess and always absent 
when there is no abscess.^ 

Seocmd. Hemoglobin. The hemoglobin, which makes up 
the bulk of the red blood cells, is the means by which oxy- 
gen is carried to all parts of the tissues. Whenever an anes- 
thetic, such as ether or chloroform, is given, the amount of 
hemoglobin is distinctly diminished, and by this means the 
oxygenation of the blood is hindered. In certain conditions 
of the system the percentage of hemoglobin is diminished 
to sixty, fifty or even as low as twenty-five per cent of the 
normal. If an anesthetic is given to a person with an al- 
ready diminished percentage of hemoglobin this percentage 
is still further diminished, and the oxygenation of the blood 

1 This b now a constant and valuable meana of diagnosis. (1914.) . 


still ftirther hindered. If» then, the percentage of hemo- 
globin is very small before an operation, the danger of giv- 
ing an anesthetic is very marked; if the hemoglobin is as 
low as thirty per cent, it is very likely that the patient may 
die upon the table irrespective of the operation, simply be- 
cause the anesthetic reduces the hemoglobin to such a point 
that the blood does not absorb enough oxygen to carry on 
life. Some authorities have stated that we ought never to 
give ether or chloroform to a patient whose hemoglobin is 
below fifty per cent. Others ha ve placed the limit as low as 
thirty per cent. Surely this subject, which is very recent 
and about which we know up to this time very little, ought 
to be investigated with the greatest care in animals rather 
than to decide the question by sacrificing life by venturing 
to give an anesthetic to patients whose hemoglobin is at so 
low a point as to be inconsistent with safety. 

Other recent researches are those on the temperature at 
which the blood freezes and the lapse of time after the 
blood is drawn from the body before it coagulates — that 
is, clots. A small portion of blood drawn by aprick of the 
finger enables us to determine these four conditions — 
i.e., (1) the presence or absence and degree of leucoc^rtosis; 
(2) the percentage of hemoglobin; (8) the freezing tempera- 
ture of the blood, and (4) the coagulation time of the blood. 
We are banning to see that these last two as well as the 
first two will probably prove of the greatest value in refer- 
ence to surgical operations. Hence we ought to learn accur- 
ately and quickly all the facts in the case by experiments 
upon animals, and so avoid dangers to human life of which 
until lately we have been quite ignorant. 

These would include experiments upon animals fasting, 
or after feeding; after being bled; i^ter surgical operations 
have been done upon them; after an anesthetic is given to 
them; when the anesthetic is administered for a short time, 
for a longer time, for a very long time, or for a time long 
enough to kill them, in order to determine what the effect 


of the anesthetic is in fatal and non-fatal doses. It is of the 
utmost importancethat we should know exactly and speed- 
ily the result of all these conditions. If we are debarred 
from learning them by experiment on animals, then the hu- 
man race must go without the knowledge we seek, saving 
as it is revealed to us from time to time by studying slowly 
and inexactly the results in man. With certain modifica- 
tions due to the slight differences between man and animab 
the conclusions drawn from experiments on animals i^ply 

Let me give one instance which confronts the surgeonnot 
infrequently. An abdominal section is occasionally fol- 
lowed by very great and, it may be, dangerous and alarm- 
ing depression. One of the most difficult things to deter- 
mine in some cases is whether this condition is due to the 
shock of the operation or to internal hemorrhage. This 
hemorrhage differs from that which may follow an ampu- 
tation or removal of a tumor from the neck, etc., by the 
fact that it is concealed within the abdomen, and its exist- 
ence can only be inferred. If the patient is suffering from 
shock, stimulation, heat, quiet, certain drugs, etc., will be 
resorted to to enable him to recover. If it is due to internal 
hemorrhage, we must instantly reopen the abdomen and 
tie the bleeding vessel. To do the latter operation when 
the patient is only suffering from shock might prove fatal; 
not to do it, if hemorrhage b the cause of the depression, is 
certainly fatal. No one not a surgeon can appreciate the 
anxiety, the careful weighing of evidence, the intense long- 
ing for some positive means by which a correct diagnosis 
may always and surely be made, which every surgeon feels 
in such an emergency. 

It is possible that by examining into the presence or ab- 
sence of leucocytosis, by determining the percentage of the 
hemoglobin, or possibly even the coagulation time and 
the freezing temperature of the blood in a number of oper- 
ations in human beings, we might be able positively to de- 


termine the difference between shock and internal hemor- 
rhage, but only after making many blunders, each of which 
would cost a human life: every life so lost would be a 
needless sacrifice upon the altar of antivivisection. In 
an animal we can open a blood vessel in the abdomen and 
let it bleed for a longer or shorter time, and determine 
positively the leucocytosis, the hemo^obin, etc., the ani- 
^ mal meantime suffering nothing because it would be un- 

5 der an anesthetic. Which is the right, which the kindest, 

X which the most humane way of finding out the truth? 

^ This is an illustration of the harmlessness to animals of 

^ S such experimeiits and their priceless value to human 


> r 

3 < 
■D Ul 

~1 5 


Experiment to enable tut to make a Reliable and 

Speedy Diagnosis 

^ ^ In some cases in which the diagnosis is difficult, or may 

2 require considerable time, experiment upon animals aids 

us greatly, and so is of inunense value to man. Thus in 
supposed anthrax, or wool-sorter's disease, a most danger- 
ous malady, by inoculating a guinea pig with the discharge 
the diagnosis can be cleared up quickly and proper treat- 
ment instituted. If a case suspected to be one of bubonic 
plague arises, the diagnosis can be established within 
twenty-four or thirty-six hours by a similar injection into a 
rat or a guinea pig, the apprehensions of a community (to 
say nothing of the patient and his friends) relieved and the 
greatest damage to its commerce averted by discovering 
that it is not the dreaded pestilence, or, if it is the plague, 
by showing the necessity for most stringent measures to 
prevent its spreading. I do not think any conununity will 
or ought to allow sympathy with the unavoidable suffer- 
ing of a few rats or guinea pigs to weigh in the balance for a 
moment against the safety of many human lives and the 
ruin of large business interests. 
An amusing instance of how sentiment gives way before 


affection and facts occurred not long since in England. The 
brother of the Duke of Newcastle was bitten by a dog sup- 
posed to be rabid. The Duke was president of the Anti- 
vivisection Society, but knowing that whether the dog was 
rabid or not (and, therefore, whether his brother was in 
danger or not) could only be settled by inoculation experi- 
ments upon animals, he took the dog to Horsley, in Lon- 
don, and had the experiment done. He was promptly de- 
posed from his presidency. 

By similar means anthrax and actinomycosis (or lumpy- 
jaw, which spreads to man as well as to herds) among cattle 
are diagnosticated and eradicated; glanders in horses is 
recognized and stamped out and tuberculosis in cows is 
eradicated, not only preventing its spread to healthy cattle, 
but through the milk to many human beings, especially 
young children, whose chief diet must be milk. 

By similar experiments on animals the causes of chicken 
cholera, hog cholera, Texas fever, and many other diseases 
of cattle, sheep, horses, hogs, poultiy, and other animals 
have been discovered and the means of prevention or of 
cure demonstrated. The Reports of the Bureau of Animal 
Industry at Washington enter into these in detail. Surely 
the poor animals who have benefited so greatly from such 
experiments should pray to be saved from their friends if 
these beneficent researches are to be prohibited.^ 

I often wonder what would have been the influence on 
surgery if the young man who first took ether in the Massa- 
chusetts Greneral Hospital on October 16, 1846, had died. 
Morton, it is true, had experimented on some dogs first, 
but, as we now view it, very inadequately. Had this patient 
died, would not the use of ether have been deferred for 
years, possibly even till now, and meantime the human 
race all over the world have gone on suffering the horrible 
tortures of the pre-anesthetic days and all our modem 
progress in surgery have been prevented? I hardly ever 

^ ^ See Pamphlet No. in the List on p. xix. 


look on my patients in the blessed ether sleep without be- 
ing impressed with the confident audacity of the earlier 
operators who dared to induce a sleep so like that of death 
when they must often have asked themselves whether the 
patient would ever waken or whether this was not the first 
stage of the never-ending sleep. 

If the sacrifice of the lives of even a considerable number 
of animals enables us to reach the benevolent purposes, a 
few of which I have described, is it not plainly a moral duty 
to perform them so as to obtain this knowledge? Is it not 
wrong to hinder such benevolent researches? Especially is 
it not wrong so to hinder research when, in the vast major- 
ity of instances, animals suffer little or nothing? In almost 
all experiments not only can an anesthetic be used, but in 
all involving difficult and delicate operations it is essential 
to do so; for it is impossible to do such an operation on an 
animal struggling from pain. Not only, therefore, does sen- 
timent lead the vivisectionist to spare the animal all the 
suffering that is possible, but scientific accuracy points in 
the same direction. A very few experiments, principally 
those on the nervous system which require us to determine 
the presence or absence of sensation, cannot be done with 
an anesthetic; but these experiments are few and far be- 
tween. Some experiments also (for instance, those on lock- 
jaw, to which I have already alluded) by producing the 
disease, necessarily make the animal suffer; but if by the 
suffering of a few animals, human beings suffering from 
lockjaw can be cured, or, still better, if we can learn the 
cause of the disease and so can prevent it from attacking 
human beings, is it not worth the suffering? The infliction 
of suffering is not cruelty. If one dear to us meets with an 
accident far away from surgical aid and we spur a horse 
to the utmost so that finally it drops dead in our frantic 
effort to bring surgical assistance, I am sure no one would 
accuse us of cruelty, although we had inflicted torture upon 
the horse. So this infliction of pain on a small percentage 


of ftninrnk experimented on is not cruelty, but is the great- 
est kindness to other animals and to a much higher animal 
— man himself. 

I have been able in this paper to select only a few illus- 
trations of the progress that surgery has made by experi- 
mentation on animals. Practically, as I said at the be- 
ginning, nearly all of these have occurred during my own 
professional life, and I speak, therefore, of what I know. 
Although I myself am not a vivisectionist, yet I could not 
do the work I do every day and accomplish results I obtain 
were it not for just such work, of which I take advantage. 
In view of these facts, therefore, how unwise it would be 
to restrict and still more to abolish such life-giving and pain- 
saving results of vivisection, especially when the animals 
themselves benefit from these experiments fully as much as 
man. I have not referred to any of the older experiments, 
such as those remarkable experiments of Jones on the meth- 
ods of tying blood-vessels in the early part of the last cen- 
tury, nor of Sir Charles Bell's experiments, by which he 
determined the functions of the two different roots of the 
nerves just as they emerge from the spinal cord, nor of the 
circulation of the blood as discovered by Harvey. All these 
are fundamental; and without the knowledge derived from 
them we should be a century or more behind where we are 
now. I have preferred rather to take modem instances 
with which I am personally familiar in order to illustrate 
the subject which I have been asked to describe. I cannot 
believe that any unprejudiced, fair-minded reader will not 
agree with me that such humane purposes should be fos- 
tered and not hindered; should be encouraged and not 






Toledo, Ohio, Oct. 4, 1900. 

Professor William W. Keen, late President of the Amer- 
ican Medical Association, Jefferson Medical College, 
Dear Sir, — My attention has just been called to a 
passage in the published ''Report of the Hearings" before 
the Senate committee, held at Washington last February, 
on the bill for regulation of vivisection. In this volume 
the following conversation between Senator Gallinger and 
yourself is recorded: — 

Senator Gallinoeb — What knowledge have you of the ad* 
vanees made by vivisectionists that have led them to progress 
from the brute creation to the human creation in making these 
so-called vivisection experiments? 

Dr. Keen — I presimie that you refer to a pamphlet issued by 
the American Humane Society. I have only to say in reference 
to it that there were a number of experiments which I would ut- 
terly condemn. Of the experiments narrated in that pamphlet, 
I have looked up every one that I could. Only two are alleged 
to have been done in America. Many of them are so vague and 
indefinite that I could not look them up, but as to those that I 
could, some are garbled and inaccurate; not all of them, observe. 

Senator GaIiLinger — Some of them? 

Dr. Keen — Some of them. 

1 Reprinted by permission from the 'JowmcA cf the Ameriean Medi- 
dal Association for February 23, 1901. 
* Printed by permission. 


A statement of this character, based upon such author- 
ity, it is impossible to ignore. Proceeding from one less 
eminent than yourself in that profession which you repre- 
sent and adorn it might pass without notice, but coming 
from you, sir, such a charge must be investigated and 
probed to the fullest extent. Its importance is evident, and 
in testing its accuracy you will give me, I trust, eveiy assist- 
ance within your power. 

First: Regarding the cases of experimentation upon hu- 
man beings recorded in our pamphlet, ** Human Vivisec- 
tion," you informed the Senate committee that **many of 

We challenge the accuracy of that statement, and ask for 
proof. Of the various series of experiments upon human be- 
ings, made for the most part upon women and children in 
hospitals and infirmaries, the authorities given in this 
pamphlet are as follows: — 

1. Bulletin of the Johns Hopkins Hospital, July, 1897. 

2. Boston Medical and Surgical Journal, August 6 and 18, 
1896 ; PkOadelpkia Polyclinic, September 5, 1896. 

8. New York Medical Record, September 10, 1892. 

4. BriiUh Medical Journal, July S, 1897; New Er^fiand Medi- 
cal Monthly, March, 1898. 

5. Medical Press, December 5, 1888; British Medical Journal, 
August 29, 1891; London Times, June 27, 1891; and other jour- 

6. Medical Brirf, June, 1899. 

7. Ringer's Therapeutics, pp. 498,503; 585, 588, 590, 591, The 
Lancet, London, November 8, 1893. 

8. Newcastle Daily Ckronide, September 21, 1888. 

9. Medical Press and Circular, March 29, 1899; The Lancet^ 
London, May 6, 1899, p. 1261. 

10. AUg. Wiener med, Zeitung, nos. 50 and 51. 

11. Deutsche med. Woch,, nos. 46-48, 1894. 

12. Ibid., February 19, 1891. 

13. Lecture before Medical Society of Stockholm, Sweden, 
May 12, 1891. 

14. British Medical Journal, October 15, 1881; Medical Re- 
prints for May 16, 1893; Nineteenih Century, December, 1895. 


For one series of experiments in the above list, those 
made by Dr. Jansen upon children of the ^'Foundlings* 
Home,'* — with the "kind permission" of the head physi- 
cian, Professor Medin, — because, as he said, "calves were 
so expensive/* it appears that the only authority given was 
a reference to his lecture delivered before a Swedish medical 
society upon a certain date. Although, so far as known, the 
facts there stated have never been denied, yet the reference 
may, perhaps, be called indefinite. But one case is not 
"many.** To what other of the references above given did 
you refer when you informed the Senate conmiittee that 
**many of them are so vague and indefinite thai I could not 
look them up?** Had you stated that your library — ample 
as it is — did not contain, and could not be expected to 
contain, all of the foreign authorities to which reference was 
made, there would have been nothing to criticize. I must 
assume, sir, that you have not put forth an aspersion of 
another's reliability merely to have acknowledgment of the 
faiadequacy of your sources of reference; that the proofs of 
your statement, covering **m4my^* cases, are available, and» 
in the interest of accuracy, I ask you to produce them. 

Second: There is yet another point to which I ask your 
attention. You made the statement before the Senate com- 
mittee that in regard to our published account of cases of 
human vivisection, **m4my qf them are so vague and indefin- 
He thai I covld not look them up; bui^ as to those thai I ccndd, 
some are garbled and inaccurate; not all of them^ observe.** 

This, sir, b a most serious charge. You distinctly de- 
clared that of the cases personally investigated by yourself, 
as quoted in the pamphlet on "Human Vivisection,'* some 
are "garbled and inaccurate." We deny the charge, and 
again challenge production of evidence upon which it is 

A "garbled" quotation is one which, by reason of omis- 
sion and perversions, is essentially unfair. Sometimes it is 
a statement from which parts are omitted or transposed for 


the purpose of conveying a false impression. To omit quo- 
tation of parts not directly bearing upon the question for 
the sake of brevity — this is not ** garbling/' for all quo- 
tations would then be impossible. We assert that in quot- 
ing accounts of the cases of human vivisecton no omissions 
of essential facts have been made sufficient to impair the 
accuracy or fairness of the quotation. Let us put the mat- 
ter to the test. Point out, if you can, the **some cases'' 
which you found ** garbled and inaccurate," and in proof 
of the charge quote the omitted sentences or words wkich^ had 
they been inserted^ would cause you and the general jniblic to 
justify and apTptoce the experiments on human beings which 
we haive so severely condemned. 

Third : You stated, sir, before the Senate committee that 
only two experiments upon human beings '*are alleged to 
have been done in America." I question, sir, whether that 
remark is quite in accord with the highest ideals of truth; 
it is the language of doubt; it seems to signify and imply 
that even you are aware of no other experiments upon hu- 
man beings than two cases which are thus*' alleged." lam 
very confident, sir, that you will not venture formally to 
assert — what you have seemed to imply — that you Imo w 
of but two experiments upon human beings made in this 
country and recorded in the medical literature of the 
United States. There is, indeed, need of further enlight- 
enment if the medical profession of this country, so worth- 
ily represented by yourself, is ignorant of what has been 
done by men without pity and without conscience. 

Trusting to have response from you at an early date, 
I am» 

Yours most truly. 

Jambs M. Bbown, President. 


DB. keen's BEPLT 

1729 Chestnut Stbsbt, 
Philadblphu, Pa., Jan. 21, 1901. 

James M. Bbown, Esq., President American Humane 
Association, Toledo, Ohio. 

Deab Sir, — Your letter of October 4 reached me 
promptly, but as I then notified you would be the case, 
very pressing engagements, absence, etc., prevented an 
earlier reply. Now that I have a little leisure, I can answer 
your letter and furnish you in detail the proofs for which 
you ask. 

There are two pamphlets, both entitled ** Human Vivi- 
section." First, one of thirty pages, " printed for the Amer- 
ican Humane Association, 1809 ** ; the other of seven pages, 
"published by the Humane Society, Washington, D.C.,'* 
without date, but from its contents published a little later, 
as it is chiefly a synopsis of the same instances reported 
more fully in the larger pamphlet. Hereafter, when I speak 
of "the pamphlet,'' I mean the larger one, unless I spe- 
cifically mention the smaller one. 

This larger pamphlet consists of two parts: first (pages 
S-12), a reprint of a portion of Senate Document No. 78, 
and the rest of it of various quotations, translations, and 
comments. No name is attached to either part to indicate 
who is responsible for the accuracy of the references, the 
translations, or the quotations. As the whole is preceded 
by an open letter signed by the president and secretary of 
the American Humane Association, and as you refer to the 
pamphlet as "ours,'' I presume the association holds itself 
responsible for such accuracy, especially as you as its new 
president challenge me for proof. 

The pamphlet purports to furnish a reprint of a portion 
of Senate Document No. 78 and refers to this document 
in a way that would lead uninformed readers to suppose 
that this is a document expressing the sentiments of the 
United States Senate. It is, therefore, important to call 


your attention to the fact that Senate Document No. 78 is 
simply a collection of statements and papers by various 
persons, printed by order of the Senate, but in no sense ex- 
pressing the opinions or convictions of that body. The last 
paper in Document No. 78 is one on *' Human Vivisection/' 
by "A. Tracy." 

In two respects *' A. Tracy" has a right to complain that 
the reprint is inaccurate: First, it omits to print the name 
of the author, **A. Tracy." ^ Surely he — or she(?) — 
should receive whatever credit there is attaching to his 
work. Secondly, on page 80, line 8, of Senate Document 
No. 78, I read, "A. Tracy's comment." ["This patient, 
therefore, was sdentificaUy murdered."] This statement 
the reprint very wisely omits — but there are no indica- 
tions of the omission. Of this, more hereafter. 

Your letter challenges the accuracy of my statements in 
three particulars: (1) I stated that many of the references 
in the pamphlet are "vague and indefinite"; (2) I said that 
some of the accounts of the experiments are "garbled and 
inaccurate"; (8) I stated that of the experiments narrated 
in the pamphlet only two were allied to have been per- 
formed in America. 

You will pardon me if I indignantly resent your imputa- 
tion of untruthfulness in regard to this last statement. You 
entirely misinterpret my statement, which had no reference 
to my knowledge or ignorance of any other American ex- 
periments. I said that the pamphlet only contained two 
instances of such experiments which were allied to have 
been done in America. These are recorded on pages 4 and 
5 of the pamphlet. All the rest were done in Europe, South 

^ In Watson*8 Physicians and Surgeons qf America, Dr. Albert Le£Biig- 
wdl'fl full name is given as "Albert Tracy Leffingwell." In the same 
arUcle it is noted that a book of his, "Rambles through Japan without 
a Guide," came out in London in 1892 under the pseudonym of "Albert 
Tracy." In the Catalogue of the Surgeon-General's Library Dr. Leffing- 
well's name is given as "Albert (Tracy) LeflSngwell." In his own book 
on ^visecUcm his name is only "Albert LeflSngwell.*' (1914.) 


America, and Hawaii,' years before it came into our pos- 
session. If you still question the accuracy of my statement 
and believe that there is a third instance of experiments 
done in America, and described in the pamphlet, point it 
out by page and paragraph. 

Turning to the other two really important matters re- 
ferred to in your letter, let me again state clearly the question 
at issufi. It is not whether the experiments mset with my ap- 
provaly but solely whether the reports of them in the pamphlet 
issued by the American Humane Association are reliable and 
accurate both as to their sources and substance. 

1. Many qf the References are Vague and Ind^nite 

The references are so vague and indefinite in many cases 
that the statements and quotations made cannot be veri- 
fied by consulting the originals. The preface of your presi- 
dent and secretary states that " in each case the authority is 
given," and what sort 'of "authority" do you depend 
upon? Newspaper medicine and surgery are notoriously 
inaccurate. I ha ve personally had so much experience and 
observation of this that I am always certain that at least 
one half or more of the statements in newspapers in refer- 
ence to medical matters are inaccurate, not purposely, but 
only because the writers are not medical men. Yet you 
depend for the accuracy of your statements upon news- 
papers as follows (I follow the inaccurate spelling of foreign 
names in your pamphlet) : — 

1. The Vienna correspondent of the London Morning Leader^ 
January 26, 1899 (p. S), of whom more hereafter. 

2. The Deutsche VolksblaU, January 25, 1899 (p. 8). 

8. The Washington correspondent of the Boston Transcript, 
September 24, 1897 (p. 9), of whom more hereafter. 
'•4. The New York Independent, December 12, 1895 (p. 11). 

5. The London Times, June 27, 1891 (p. 16). •^ 

6. The Tagliche Rundschau of Berlin (p. 17); no year, month, 
or day being given. 

7. The Vossische ZeUung, of Berlin, no year, month, or day being 
given (p. 18). 


8. The Vorwart^ no year, month, orday being gken (p. 18). 

9. The Damnger Zeiivng, July 23, 1891 (p. 18). 

10. The Schiesische VoUcszeUung, July i4» 1891 (p. 18). 

11. The HamJbwrger Nacknchien, July» 1891, no day staled 

(p. 19). 

12. A correspondent of the Newcastle (England?) Daily Chronr 
ide, Sq>tember 21, 1888 (p. 22). 

18. Dr. B. £. Dudgeon, in the AboliHoniit, April IS, 1899 
(p. 24). 

14. A letter by Dr. Ed¥rard Berdoe to the London CktonicU» 
wUhovt year, month, or day (p. 29). 

Few of these f ouite^i newspaper leferenoes can be con- 
sulted in this country; five of them (numbers 6, 7, 8, 11, 
and 14) are impossible of consultation for want of any date 

In no case would I be willing to admit a newspaper parar 
graph, a non-professional and usually unsigned statement, 
— even if correctly quoted, — as a sufficient authority for 
a grave charge against an individual or the profession. 

Look for a moment what stuff Senator Gallinger stated 
at the "'Hearing'' he had himself caused to be printed. It 
is published on page 31 of the ""Hearing" and on page 3 of 
the pamphlet. It consists of cable dispatches printed in 
some newspaper — Senator Gallinger did not even remem- 
ber its name. The author of the dispatch from London is 
utterly unknown. The dispatch states that ""the Vienna 
correspondent of the [London] "Morning Leader' says " so 
and so. WhoandhowreliableistheViennacorrespondent? 
He says that ""the physicians in the free hospitals of Vi- 
enna" do so and so. Who are the physicians? Inwhathos- 
pitals were these deeds of darkness done? 

And upon such evidence it is seriously pr(^>o8ed to indict 
the medical profession! Whether these dispatches are 
""garbled and inaccurate" in their alleged facts, who can 
find out? 

If a lawyer tried to convict a man of petty larceny on 
such testimony, he would be laughed out of court. And 



yet a Senator of the United States and the American Hu- 
mane Association actually adduce such statements as evi- 
dences of the gravest charges and spread them broadcast! 
I now add six other * Vague and indefinite'' references 
not to newspapers. 

15. On page 13 there is a quotation from TertuUian. 
The reference in the footnote is *'Tertullian» De Animas 
vol. n, pp. 430, 433, Tran. by Holmes." I have compared 
the quotation with Clark's Edinburgh edition of the Trans- 
lation of Tertullian by Holmes, the date of the edition be- 
ing 1870. No such quotation exists on pages 430-433. 
Possibly it may be that the quotation is from another edi- 
tion. No edition is named in the pamphlet; another in- 
stance of a * Vague and indefinite" reference. 

16. On page 17 a formal accusation is quoted as made by 
a Dr. Eugen Leidig against certain surgeons. No reference 
whatever to any book or journal is given by which the accur- 
acy of the quotation can be tested. Is not this again* Vague 
and indefinite"? 

17. On page 24 is a reference to a paper by "Professor E. 
Finger, of Vienna (AUg. Wiener med. ZeUung^ nos. 50 and 
51 ") . No year is given, a somewhat essential part of the ref- 
erence, as there are over forty volumes of this journal, each 
with the weekly numbers 50 and 51. No such paper by 
Finger is published in that journal, at least from 1890 to 
the present time. The reference is quoted from a paper by 
Dr. R. E. Dudgeon in the "Abolitionist" — an English 
journal — of April 15, 1899. I have been unable to consult 
this journal. If Dudgeon gave the year, then the Humane 
Association pamphlet has misquoted him. If he did not, 
then both the association's pamphlet and he have been 
"vague and indefinite." 

18. On page 25 again is a reference to a statement in a 
"lecture before the Medical Society of Stockholm," by Dr. 
Jansen, of the Charity Hospital, reporting certain experi- 
ments. No reference whatever is given even to a news- 


paper, much less to any medical journal. As the statement 
is in quotation marks it purports to be the exact words used 
and ought to have had some source to which a reference was 
possible, especially as the preface of the pamphlet says: 
'^IneocAco^^ the authority is given." I am glad to see that 
in your letter you recognize this as one in which the refer- 
ence 18 really inadequate. I notice, however, that even in 
your letter you do not supply this missing reference. You 
say the facts asserted in the Jansen paragraph have never 
been denied. Of course not. The first requisite is to know 
whether th^ are correctly quoted. 

Turning now from the larger pamphlet to the smaller 
one, which was spread broadcast by house-to-house distri- 
bution in Washington at the time when the hearing on this 
matter took place last winter, I find repeated in this a num- 
ber of the same vague and indefinite references and garbled 
and inaccurate quotations already or to be described, to 
which are to be added the following: — 

19. On page 3, an extract from a report referring to ex- 
periments upon insane patients is printed in quotation 
marks. The only reference is to a ** published report" in 
1890 of the ''Medical Staff of the Public Insane Asylum in 
Voralberg, Austria." The librarian of the Surgeon-Gen- 
eraFs office informs me that there are two small insane 
asylums in the Voralberg, namely, at Hall and Valduna. 
Some reports of the former are in the library, and in them 
no account of the experiments referred io can be found. 
No reply has been received to a letter addressed to this 
asylum as named in the pamphlet, and written over a year 

20. On the same page is an account of some experiments 
on bacteria from boils, and the reference is to the ''Deut- 
sches Volksblatt"; no day^ no months no number, no page, 
nor even the year is given. If this is not '' vague and indefin- 
ite," what is? 

* This letter wu written by myself and not by the librarian. 


21. On page 24 there is an account of Kroenig's experi- 
ments, to which I shall recur later. No reference whatever 
is given to the source from which the account is taken. 

2. Some of the Statements are Oarbled and Inaccurate 

To be vagueand indefinite in charges a£fectingthemorab 
and the reputation not only of individuals, but, in fact, of 
a whole profession is bad enough, but to make statements 
that are *' garbled and inaccurate*' is, as your letter recog- 
nizes, a much more serious matter. Let me consider the 
instances in detail. 

1. *' Vivisection Experiments upon the Insane,'' pages 4 
and 5 : In the following quotation, the words of the original, 
which I inclose in brackets, are omitted. '*To these pa- 
tients the thyroid tablets [each pill representing five grains 
of the fresh sheep's gland] were administered," etc. This 
omission is of moment, because any one familiar with the 
administration of thyroid extract knows that the doses 
used by Dr. Berkl^ are frequently given to human pa- 
tients, including the insane, without producing symptoms 
dangerous to life, but, on the contrary, with ben^t. I 
have myself given such tablets to patients with goiter for 
weeks together in larger doses than Dr. Berkley used. 

In the following paragraph the quotation is garbled by 
omitting the words which I inclose in brackets: **Two pa- 
tients became frenzied and of these one died before the 
excitement had subsided [the immediate cause of the exitus 
being an acute disseminated tuberculosis]." And again in 
the next paragraph giving a report of the same case, the 
pamphlet quotes: *'The thyroid extract was now discon- 
tinued, but the ^ccitement kept up . . • for seven weeks, 
at the end of which time she died." One would think this 
was the end of the sentence and that she died from the 
effects of the thyroid tablets. Not at all. The original con- 
tinues as follows: She died *'with the clinical evidences 
of acute miliary tuberculosis" — galloping consumption. 


Does this not oome within the definition of garbling given 
in your letter? *'A 'garbled' quotation is one which, by 
reason of omission and perversions, is essentially unfair/' 
To say that this patient, who actually died of galloping 
consumption, died from the effects of the thyroid extract, 
which had not been given for seven weeks before death, is 
as absurd as it would be to say she had died from the effects 
of moderate doses of laudanum given seven weeks before. 
Yet **A. Tracy's'' comment on this case is: [**This patient 
was, therefore, scientifically murdered."] Your Association 
mutilates its r^rints by wisely omitting this piece of ab- 
surdity, though the omission is not indicated. Moreover, 
the pamphlet states: **There is no intimation that the ad- 
ministration of the poisonous substance was given for any 
beneficial purpose to the patients, for he took care to select 
patients that were probably incurable." On the contrary, 
Berkley's original paper expressly states that instead of 
being incurable, one (case 1) was cured and another (num- 
ber 8) was improved. Besides this, though the pamphlet is 
dated 1899, it omits aU reference to Dr. Berkley's letter to 
the ''British Medical Journal" for October SO, 1897, in 
reply to your friend Dr. Berdoe, which shows that, as a re- 
sult of the administration of the thyroid tablets to these 
eight patients — a well-recognized remedy for insanity,^ 
not one died from the effects of the drug, but that, on the 
contrary, two of those alleged ''incurables" were cured — 
twenty-five per cent. 

In his admirable letter to "life," — December 6, 1900, 
— Dr. Berkl^ says: "The purpose for which the article 
was written was to show to the medical profession that a 

* I quote the following from the eighth edition of Hare's Therapeutics^ 
as to the use of thyroid extract: '*In the dosed from five to twenty grains 
(0.85-1^) three times a day p.e., fifteen to sixty gruns a day] according 
to the degree to which it produces its effects, it has proved of value in 
acute mania and mdandiolia, puerperal and climacteric insanities, and in 
stuporous states with primary dementia." Berkley's maiimum dose was 
fifteen grains a day. 


certain medicament in common use was not free from objec- 
tion, and should not be given in unsuitable cases. In proper 
ones the results are among the most resplendent attained 
by modem medicine, converting the drooling dwarf into 
an intelligent, well-grown man or woman; or in other in- 
stances, as in myxedematous insanity, affording the other- 
wise hopelessly insane with almost a specific to recover 
their reason.'* (See the addendum at the end of this let- 

2. The "Cases of Lumbar Puncture," by Dr. Went- 
worth, of Boston (p. 5) : * "" Lumbar puncture," I may re- 
mind you, is the simple insertion of a hypodermic needle 
between the vertebrse into the sheath of the spinal cord, 
but below the cord itself, to obtain a few drops of the cere- 
bro-spinal fluid for diagnosis. 

The pamphlet gives what is called a "brief abstract" of 
five of the experiments related. The abstracts are indeed 
brief, so brief as to give a wholly erroneous impression as to 
the causes of the patients' death. The omissions are glaring 
instances of what the logicians call a suppressio veri equiv- 
alent to a suggestio falsi. Let me point this out in detail. 

Case 2. It is correctly quoted that the last puncture 
(where there were several punctures I only give the last 
date) was made "February 16, on the day of the patient's 
death." The pamphlet fails to add, however, the important 
fact stated by Dr. Wentworth that the postr^mortem showed 
an empyema [abscess in the chest] which had burst into the 
lung, pneumonia, and inflammation of the brain with pus 
as the causes of death. 

Case 8. The pamphlet correctly says: "Puncture Jan- 
uary 17, 1896; patient died January 22." TVhat Dr. Went- 
worth adds is omitted, namely: "No symptoms attended 
or followed the operation." Moreover, the post-mortem 

1 For a further discussion of the cases of Dr. Wentworth, due to later 
and still worse misstatements, see "The Influence of Antivivisection on 
Character," post, pp. 27i-278. 


showed that the patient died from the widespread changes 
common to infantile wasting. 

Cash 5. The pamphlet says: "Puncture February 8, 
1896; patient died February 4." It omits to state what im- 
mediately afterward follows^ that the post-mortem showed 
"primary tuberculosis of the intestines. Double pneu- 
monia," as the causes of death. 

Case 6. The pamphlet quotes: "Puncture February 1; 
patient died in convulsions three weeks later.'* It neglects 
to state what Dr. Wentworth particularly mentions, "no 
reaction on the part of the patient attended the operation/* 
and it also fails to state that the child was seen only once, 
and that the diagnosis then made was tuberculous menin- 
gitis, which was clearly the cause of the child's death, 
three weeks later. 

Case 7. The pamphlet quotes: "Punctured February 
27; patient died February 28." It omits the fact that the 
post-mortem showed that the child died from defective de- 
velopment of the brain and other causes; and that the his- 
tory showed that the child, who was seven months of age, 
had " frequent convulsions, which began when he was about 
three months old. While in the hospital the convulsions 
occurred not less than twenty times a day. Oftentimes he 
had several in an hour." 

The inference from the pamphlet's "brief abstracts" of 
these cases is clearly, and it seems to me by these omissions 
was meant to be, that the deaths were due to the lumbar 
punctures, whereas the evidence is that the deaths were due 
to other causes, and in two instances the operation is ex- 
pressly stated not to have done any harm. Are not these 
abstracts "garbled and inaccurate"? 

S. On page 7 the pamphlet refers to some experiments on 
the inoculation of lepers with S3rphilis, made in Hawaii, but 
published in the "New York Medical Record" of Septem- 
ber 10, 1892. It is stated that the patients "were already 
suffering from one incurable disease and the object of the 


experiment was to asoertain whether with another^ and 
even worse, disorder, they might not be infected." This 
statement is incorrecL Most writers recognize only three 
stages of S3rphilis, primaiy, secondaiy, and tertiary. The 
writer of the article in question believed that leprosy was a 
fourth and final stage of syphilis and not an ind^>end^it 
disease. It is a well-recognized fact by all scientific writers 
that a patient suffering from syphilis in any stage is im* 
mune to an inoculation of the virus; that is to say, the in- 
oculation will not ""take** if he is already a S3rphilitic. It 
was for the pmpose of determining whether leprosy was a 
fourth stage of syphiUs that the attempt was made. None 
cf those inoculated lock the disetue. 

4. SanaieUi's **Ei^>eriments on the Inoculation of Yd- 
low Fever,** page 8: The references here are to the "Brit- 
ish MedicalJoumal** for July S, 1897, and the ''New Eng- 
land Medical Monthly,** Majx^h, 1898. The extracts 
marked with quotation marks are from the ''New Eo^and 
Medical Monthly.** Between the first and the second sen- 
tences of the quotation there should be some stars to note 
an omission, but none such appear. The omitted words 
state that not the germs of the disease, but the carefully 
filtered and sterilized germ-free fluid was used. Besides 
this and many other minor inaccuracies many of the scien- 
tific terms are changed into non-medical terms, which is 
not objectionable in itself . But such changes and inaccur- 
acies should exclude quotation marks, for when used they 
mean that the words quoted are the ipsiseima verba of the 
author, if in the same language, or an exact translation if 
from a foreign language. 

But this is the least of all. The pamphlet says that the 
injection produced certain symptoms, among which are 
mentioned "the jaundice, the delirium, the final cdUapsey* 
the last three words being in italics in the pamphlet to call 
special attention to them. In the "British Medical Jour- 
nal,** and in the "New England Medical Monthly** the 


warda**tiie&Dal** arenottobe found. We see not a few pa- 
tients suffering from ** jaundice, deliriuni» and collapse'* 
who recover, but when the expression is changed to **the 
final *' oolIiq[>se, it means to every one that the patient died. 

Moreover, the end of the quotation is as follows : ** I have 
seen [the symptoms of ydlow fever] unrolled before my 
eyes thanks to the potent influence of the yellow fever 
poison made in my laboratory/' This entire sentence does 
not occur either in the ^'British Medical Journal" or in the 
**New England Medical Monthly." Yi^ether it is quoted 
from some other source not indicated, or has been deliber- 
ately added, I leave you or ** A. Tracy" to explain. 

Moreover, immediately afterward, on the authority of 
the Washington correspondent of the Boston ** Transcript," 
it is stated: '*It is understood that some, if not all, of the 
persons inoculated died of the disease"; and then seven 
times afterward are repeated '*the final collapse," the **un- 
roUing before the qres," ** scientific assassination," *'death," 
and ** murder," quoted from a public speech before the 
American Humane Association. Let us see if these tvere 

In the two references given there is no indication whether 
any of these patients died or not. How, therefore, "it is 
understood that some, if not all, of them died," I do not 
know. As a matter of fact none of the human beings inocu- 
lated by SanareUi died^ as any one desirous of learhing the 
truth could have ascertained by consulting Sanaielli's 
original publication reporting his experiments with full 

What hysterical oratory about "the final collapse," 
which was not final; "scientific assassination," which did 
not assassinate; and "murder" of those who were so dis- 
obliging as still to Uve! And this on the authority of the 
Washington correspondent of the Boston "Transcript," 

^ AnntM d^Igiene SpmmmtaU, 1807, voL vn, Faflcic: m, pp. 845 
and 438. 


who, the pamphlet assures us, is a person **who would 
seem to be unusually well informed in matters of science '' ! 
An excellent example of ** newspaper medicine ** and a good 
reason for my refusal to accept it as evidence, esi>ecially 
from other correspondents who may not be as ** unusually 
well informed/* May I ask whether "the Vienna corre- 
spondent of the London * Morning Leader' " is also one of 
those who, in your opinion, is "unusually well informed in 
matters of science," and whether his testimony is as wholly 
false as the one under consideration? 

5. On page 23, the pamphlet quotes an account of some 
experiments of Dr. Neisser from the "Medical Press and 
Circular [England], of March 29, 1899." This is an in- 
stance again of misquotation and omission which can 
scarcely be other than intentional. The last sentence of the 
first quotation states: "Of these eight girls, four developed 
syphilis." No stars indicate that any words have been 
omitted. The original reads: "Of these eight girls [five 
were prostitutes, and of these five] four developed syphilis." 
The words in brackets are entirely omitted in the pamphlet. 
They make a deal of difference, for what is more probable 
than that four out of five prostitutes should develop syphr 
ilis? Whether it makes any difference or not, however, is at 
present not the question. The issue is whether the quota- 
tion is " garbled and inaccurate." Does it not fulfill another 
of the definitions of "garbling" given in your letter, 
namely, "omissions of essential facts . . . sufficient to im- 
pair the accuracy or fairness of the quotation" ? 

Moreover, the pamphlet's comment upon this case is as 
follows: — 

"Does the London journal which reports these awful 
experiments denounce them as a crime against every law 
of morality? Not at all. It simply says that 'it would be 
difficult to acquit Dr. Neisser of a large measure of re- 
sponsibility in respect of the causation of syphilis in these 
cases ' ! Could reproof be more gentle? " 


Is that really all that the "Medical Press and Circidar** 
^simply says*'? On turning to that journal, after the above 
sentence, which is correctly quoted, the editorial continues 
thus: "We, however, are less concerned in establishing the 
culpability of Dr. Neisser than in condemning the spirit 
which prompted such experiments* All measures, even if 
novel, which may reasonaJt^ly be expected to assist in bring* 
ing about the recovery of the patient without injuiy to his 
health may legitimately be resorted to with the consent of 
the patient, but measures, whether by drugs or by opera- 
tion, which have not for direct object the cure of the patient 
and which may prove inimical to his health or condition, 
are inadmissible under any circumstances and must expose 
the perpetrator to professional ostracism and to penal re- 

Is "professional ostracism and penal rebuke'* a reproof 
than which nothing could be "more gentle*'? If this state- 
ment is not "garbled and inaccurate," what do words 
mean? How could this misrepresentation be otherwise 
than intentional? 

6. On page£4 again, reference is made to theexperiments 
of Menge.^ The extracts being in quotation marks would 
purport to be exact translations. This is not the case. The 
collocation of the paragraphs, also, — especially in the 
smaller pamphlet, — is such that it would be supposed 
even by a careful reader that the babies experimented upon 
were inoculated with the germs taken "from the pus in the 
abdominal cavity of a person who had died of peritonitis,'* 
without any precautions or preliminary experiments, and 
that, therefore, these babies were exposed to a fatal infec- 
tion. This is not true. Four columns of text in the original 
intervene between the first and the second paragraphs 
alleged to be quoted, and these detail experiments which 
proved that the inoculations which he then carried out 
would almost certainly be harmless. The result showed 

^ Deutsche medicinisehe Wodtenechrift,, 1894, nos. 46 to 48. 


that he was right, for not the slightest ill effects followed. 
I have only words of condemnation for Menge*s experi- 
ments, but to misrepresent these experiments is scarcely 
less culpable than to perform them. 

7. Then follows a brief accoimtofKroenig's experiments. 
The objects of these, the pamphlet sajrs, were **to observe 
the surest way of breeding purulent bacteria.*' This is not 
true. On the contrary, his object, like Menge's, was to de- 
termine how these bacteria are normally destroyed in the 
part of the body in which the experiments were made. In 
only a single instance did any ill effects follow, and in this 
case the inflammation was brief and not dangerous either 
to life or health. In fact, the very ^t^ of these two papers 
proclaim the destruction of the bacteria and not the surest 
way of breeding them. Menge's title reads: *'0n a quality 
{Verhalien) of the vaginal secretion in non-pregnant fe- 
males, which is hostile to bacteria*'; and Kroenig*s is on 
the same peculiarity in pregnant women. 

In the comment on these two series of experiments, they 
are spoken of as inoculations "with loathsome diseases,'* 
which would suggest to any one that the patients were suc- 
cessfully inoculated with syphilis or other similar diseases. 
This was not the case. Only inflammation would follow 
even had the inoculations been successfuL 

Moreover, to show the vague looseness of the alleged 
quotations, the two paragraphs on the experiments of 
Menge are in quotation marks and are introduced by the 
words, "He says: The bacteria I used," etc., as if they were 
exact continuous translations. "He says" nothing of the 
kind. Instead of being exact translations, the fibrst para- 
graph is made up of partly correct and partly incorrect 
translations from page 891, near the top of the second 
column and near its middle; and the second paragraph of 
partly correct and partly incorrect translations from page 
907, near the bottom of the first column. 

No reference whatever is given to Kroenig's paper either 


by number, date, or page. Is not this *Vague and indef- 
inite *7 As a matter of fact, it is the same journal (no. 
43, p. 819) as Menge's paper, but published three weeks 

8. On page 25 is one of the most outrageous instances of 
garbling, and mistranslation, or worse, which I have ever 
known to be perpetrated, even in antivivisectionist publi- 
cations. It relates to observations and experiments of Pro- 
fessor Schreiber, reported in the '^Deutsche medidnische 
Wochenschrift'' of February 19, 1891. The subject is m- 
troduced with the startling caption: '^InoculaticHis with 
Tuberculin and Germs of Consumption.'' In the smaller 
pamphlet the caption is simply: '* Injected Grerms of Con- 
sumption.'' What was injected was no< the **germs of con- 
sumption" at all, but tuberculin, a substance which at the 
date erf Prof essor Schreiber's publication was engaging the 
attention of physicians throughout the civilized world as a 
therapeutic and diagnostic agent. To describe inoculations 
with tuberculin as ** inoculations with the germs of con- 
sumption" can be attributed only either to gross ignorance 
or to willful disregard of the truth. 

In the first pan^raph occurs the sentence: **He b^an 
with one decimilligram and continued to inject the tuber* 
culin in ever-increasing quantities, until he at last injected 
as much as five centigrams, about fifty times as much as 
Koch said was the maximum dose for children of three to 
five years old." Any fair presentation of these experiments 
would have included Professor Schreiber's sentence, which 
he prints in bold-face type: ''But even with so large a dose 
injected at one time, the children showed no trace qf a 
reaction** It would, perhaps, be too much to expect your 
society to have indicated on what grounds Professor 
Schreiber was led to the employment of such large doses, 
and that his observations demonstrated for young infants 
an exceptional tolerance of tuberculin, a phenomenon for 
which there are analogies with other drugs. 


But the worst falsification is the succeeding account, in 
the form of what purports to be an exact translation of 
Schreiber's inoculation of a boy with tuberculin. The al- 
leged quotation b^ins: **I am sony to say that it is very 
difficult to obtain subjects for such e3q>eriments. There are, 
of course, plenty of healthy children in consumptive fam- 
ilies, but the parents are not always willing to give them 
up." The words, **I am sorry to say that," and the entire 
next sentence, **There are, of course, plenty of healthy 
children," etc., are not in the original^ but are addUions made 
out of the whole doth. The next following sentences contain 
many inaccuracies, such as the translation of the Gennan 
words betrSchtlich anechiooUen as ** swelled up enormously," 
instead of ** swelled up considerably." But the worst is the 
deliberate insertion of the following sentence, italicized in 
the pamphlet, which also does not occur in the original: **I 
cannot yet say whether the boy will be consumptive in con- 
sequence of my treatment." The correct translation of 
Schreiber's words at the point where this closing sentence 
appears in the pamphlet is as follows: **I could discover no 
other alterations in the otherwise apparently healthy boy." 
["Andere Verdnderungen konnte ich an dem sonst genmd 
scheinenden Knaben nicht entdecken.*'] 

While I have said enough about this case to substantiate 
my charge of garbling and inaccuracy , I cannot refrain from 
utilizing it also to show the utter misapprehension which 
the citation of detached sentences and paragraphs from 
medical articles is calculated to create in the mind of anon- 
medical reader. Even when the words are quoted correctly, 
th^ are likely, when detached from the context, to give 
rise to entirely false impressions. This is a criticism which 
applies not only to other examples cited in this pamphlet, 
but to a very large number of reports of experiments and 
of quotations from medical journals and books current in 
antivivisectionist writings, and the resulting dissemination 
of erroneous conceptions is often greater even than that 


caused by inaccurate or garbled quotations. A brief ex- 
planation of the present example will show the justification 
of this charge. 

For what purpose did Professor Schreiber inoculate the 
boy with tuberculin? His article leaves no doubt as to the 
answer. He points out the importance of the earliest pos- 
sible recognition of tuberculosis in a patient in order to 
secure the best curative results. The boy's mother had 
consumption and the author calls attention to the fre- 
quency of unrecognized tuberculosis in the offspring of 
tuberculous parents. The boy received a small dose — one 
milligram — of tuberculin, which, if he were free from tu- 
berculosis, would produce no effect, but which, if he had 
unsuspected tuberculosis, would produce a transient — 
thou^ possibly a severe — fever, and a local reaction 
indicative of tuberculosis. Such reaction followed the in- 
jection of tuberculin, and the diagnosis of tuberculosis, 
which had not been, and very likely could not have been 
made in any other way, was established. I do not know 
what could have been more fortunate for this boy than 
the recognition in its incipiency of a disease previously 
unsuspected and which, recognized thus eariy, should in all 
probability be cured by proper treatment. This tuberculin 
test is constantly employed to prevent the spread of tuber- 
culosis in our cattle. In our children it enables us to dis- 
cover the same disease in an early, curable stage. Shall we 
care for our cattle better than for our children? 

The use of tuberculin is not properly to be called an 
*' experiment'* at all. As I write this, I find in the *' Jour- 
nal of the American Medical Association" for January 12, 
1901 (p. 75), three cases of the use of tuberculin in human 
beings by Professor J. M. Anders, who points out its value 
in enabling us to diagnosticate consumption *'in latent 
forms and dubious cases, however incipient," long before 
percussion or the stethoscope will reveal the disease. I 
can imagine his surprise if he were charged with making 


three horribly cruel '"ezperiments'* and mjecting the 
** germs of consumption**! 

It is a euphemism to call such an alleged quotation, in 
which words and one entire sentence are interpolated and 
another wholly changed in meaning* a *^ mistranslation** or 
even a ** garbled and inaccurate** account. Does it not 
amount to literary forgery? It is another illustration of the 
fact that when an antivivisectionist attempts to say any- 
thing about scientific experiments either the moral sense is 
blunted or the truth-telling faculty is in ab^ance. A good 
English example are the misstatements in Miss Frances 
Power Cobbe*s book, laid bare by Victor Horsley, and 
Schreiber*s and Sanarelli*s cases will serve as excellent ex- 
amples of American misrepresentation — if so long a word 
is needed to describe them. 

I am Sony my reply is so long, but in fewer words I could 
not explain the many and gross errors to be pointed out. I 
have given you, indeed, ^^many** instances in which the 
references are ''vague and inaccurate,** and '"some** in 
which the accounts are ** garbled and inaccurate.** These 
adjectives are, I submit, very mild ones to apply to such a 

You can hardly be surprised, after the extraordinary and 
repeated interpolations, mistranslations, and worse which 
I have demonstrated in this letter, that I am unwilling to 
accept any alleged quotation or translation emanating 
from the American Humane Association as accurate and 
truthful unless I can compare it with the source from which 
it is derived. 

In conclusion, let me commend to the ^'Humane** Asso- 
ciation the closing words of President Eliot's letter, to be 
found on pages 218-19 of the *' Hearing**: ''Any attempt 
to interfere with the necessary processes of medical inves- 
tigation is, in my judgment,' in the highest d^ree inex- 
pedient and is fundamentally inhuman.** 

I shall take the liberty of publishing my reply . I suppose 


tliat you will not object to the publication of yoiur letter 
with it in order to explain the reason for the reply. 

Very respectfully yours, 

William W. Keen. 


Since this letter was written I have seen an article in 
** Gould's Year-Book of Medicine and Surgery,'* 1901 
(Medical volume, p. S27), from the '"Archives of Pedi- 
atrics" for June, 1900 (p. 431), by H. Oliphant Nicholson, 
of Edinburgh, Scotland, reporting the case of Annie C, 
a girl of two years and eight months old, with pictures, 
which, with a brief statement of the case, well illustrates 
what Dr. Berkley has asserted, that ""in proper cases, the 
results [of the treatment by thyroid extract] are among 
the most resplendent attained by modem medicine, con- 
verting the drooling dwarf into an intelligent, well-grown 

man or woman." 

This child was first seen by Dr. Nicholson on October 28, 
1894, and the picture shows the *' swollen, myxedematous- 
looking face and body, a markedly curved back, and a pen- 
dulous abdomen." The child *' could not walk without 
support and dragged her limbs slow^ after her." Hervo* 
cabulaiy was confined to calling her mother and father 
*'mum" and ^*ah," and *^her wishes were wholly made 
evident by signs." Very naturally, therefore, with this 
low grade of intell^nce, she was uncleanly in her 

The treatment was begun on October 80, with £.5 grains 
of thyroid powder, once daily. This was reduced on No- 
vember £ to 1.25 grains once a day, and was continued for 
several weeks. As early as November 7, improvement was 
noticed. On November 17 the pulse at the wrist, which was 
scarcely perceptible through the swollen tissues at the be- 
ginning of the treatment, was distinctly felt, and by the 
S4th, the puffiness of the ^elids and forehead were dimin- 


ishing and the expression of the face becoming more intelli- 
gent. The dose of the extract was now increased again to 
2.5 grains. The results I quote as follows: — 

In about three months* time very few traces of cretinism re- 
mained and the child was able to waUc about easily without assist- 
ance and was making use of the short words and gestures of early 
childhood. . . . After four months of the thyroid treatment, 
the improvement seemed so complete that the second photograph 
was taken and the likeness produced is that of a bright, happy, 
pretty child, to all appearances normal, both physically and men- 
tally. The improvement continued till the middle of June, 1895, 
when, unfortmiately, she contracted an attack of malignant 
measles and died on July 16, after three days' illness. 

If Dr. Berkley's use of the th3rroid extract, which cured 
two out of eight patients was an experiment, and its admin- 
istration by Dr. Nicholson also was an experiment, the 
more of such happy "' experiments" we could have the 

P.S. (1914). At the recent Antivivisection Congress 
in Washington, Mr. E. H. Clement, of Boston, stated 
categorically (according to the Washington "Post,*' De- 
cember 9, 1918), that ''Three of the most prominent 
physicians in Boston — Drs. J. Collins Warren, Richard 
C. Cabot, and Maurice H. Richardson — have assured 
me personally that they do not believe in vivisection." 

Now I knew the late Dr. Richardson personal^ and in- 
timately ever since 1886, and I know positively that this 
was not his opinion, and both Dr. Warren and Dr. Cabot 
assure me that it is not their opinion. 



San Fbancibco» July 8, lOOl, 

On January 21, 1901» I sent a reply to James M. Brown, 
president of the American Humane Association, in response 
to a letter from him challenging me to produce proof of 
inaccuraqy in the references to a number of certain alleged 
experiments and of garbling of the reports of the same.' 
My reply was published in ""The Journal of the American 
Medical Association'* and the Philadelphia "'Medical 
Journal" of February 28, 1901. 

In reply I received a letter from Mr . Brown saying that he 
expected to spend the month of February in C alif omia» and 
could not give attention to my letter until his return. 

Mr. Brown seems to have been detained in California 
much longer than expected, for up to the present moment 
— nearly six months — I have received no further reply 
whatever from him. Indirectly, however, a certain reply 
has been published in the form of an anonymous pamphlet 
entitled '*The Reality of Human Vivisection," which is 
called a "review" of my letter. 

Not long since I had the pleasure of attending a lecture to 
one of his classes in moral science by Rev. Dr. Faunce, the 
accomplished president of Brown University. Among the 
virtues which he discussed was "Courage," and he pointed 
out the moral cowardice of anonymous letters. While such 
a letter is an instance of private moral cowardice, an anony- 
mous pamphlet such as this is an instance of public moral 
cowardice. An honorable open foe I at least respect; one 

^ Reprinted by permission from the Journal cf the Ammcan Medical 
Association for August 16» 1901. 
* Ante, p. 110. 


who skulks behind anonymous pamphlets I despise. The 
antivivisectionists seem to delight in such secrecy and 
anonymous attack. 

There are four publications on this subject up to the 
present moment, to which I shall hereafter refer by num- 
ber» except the last, which I shall call the ^'review." 

1. In Senate Document No. 78, 55th Congress, 8d Ses- 
sion, the last of a collection of certain antivivisectionist 
papers is one entitled ^* Human ^visection," signed '*A. 
Tracy.*' I should like to know who this mysterious '*A. 
Tracy*' is.» 

S. There is a pamphlet entitled '^ Human Vivisection," 
third edition, printed for the American Humane Associa- 
tion in 1900, which reprints this paper (with the omission 
of '* A. Tracy's" name) and adds to it a long continuation 
of the misstatements of the first. This is anonymous. 

8. There is a small pamphlet entitled ^'Human Vivisec- 
tion," published by the Humane Society, Washington, 
D.C., chiefly a rehash of the misstatements of pamphlet 
No. £. This is also without the name of any author. 

4. Now comes the last pamphlet, the ** review" of n^ 
letter. This is not only without the name of any author, 
but without even that of a publisher. It b simply dated 
"Boston, 1901." 

Thecharacter of every oneof thesepubUcations, however, 
is such that I do not wonder that the author wishes to con- 
ceal his identity. 

The "review" (No. 4) reprints Mr. Brown's letter to me, 
and at the end adds: "No suflScient rejoinder to his [my] 
letter [in reply to Mr. Brown] would be admitted to the 
columns of tiiese medical periodicals " ("The Journal of the 
American Medical Association" and the Philadelphia 
"Medical Journal"). The duplicity of this sentence is evi- 
dent. The ordinaiy reader, for whom it is evidently in- 
tended, would understand that a reply had been sent to the 

^ See footnote! ante, p. 115. 


editors of these me(Hcal journals and that th^ had dedi^^ 
to print it. This is absolutely untrue. No sudi communica- 
tion has ever been received by the editor of dther of these 
journals. The critical reader will see that the sentence just 
quoted does not definitely state that such a communication 
has been rejected. But for one critical reader a thousand 
casual readers will get the impression which the sentence 
was evidently intended to conv^* 
• It is in^K>ssible for me to take up all the misstatements 
and misrepresentations contained in the thirty-two pages 
of this last anonymous *^ review/' nor is it necessaiy to do 
so. That I should be honored from such a source by vilifi- 
cation and misrepresentation, I expected, of course, but I 
did hope at least that there would be an honesty of state- 
ment to which no exertion could be taken. 

The author, however, is a veiy curious person who does 
not seem to be limited by the ordinaiy laws of either fair 
dealing or truthful statement. 

Moreover, he would be a veiy poor lawyer. Most of the 
evidence cited by him is derived from published reports by 
certain medical men. Having, therefore, chosen his wit- 
nesses and put them on the stand, he would not be allowed 
in any court of law to discredit his own witnesses by select- 
ing part of their testimony as trustworthy and rqecting 
part as unworthy of credence. And yet, throughout thia 
** review," while the anonymous author is eager to accept 
the statements of the various authorities as to what th^ 
c2u2, he declines to admit thdr statements as to their re^ul^ 
or else misstates them, going so far as to assert that the 
statements of the physicians cited, concerning the recovery 
of their patients, are "utterly valueless." 

In my reply to Mr. Brown, I used the following language.; 
''Let me again state clearly the question at issue. Itisnot 
whether the experimenis meet toiih my approval^ but solely 
whether the reports of them in the pamj^et issued by the 
American Humane Association are reliable and accurate 


both as to their somoes and tobatanoe.'* At the hearing 
bef ofe the Senate i M^ w 'W'ft ^ ^ I dialine^ twice over ex- 
pfeased mg uUer Utappromd of maogr of the cq>eriinenta 
referred to in the original pamfdikt (No. 8). This con- 
liffiwiyt*^ is quoted both on page 1 and page 5 of the 
anonymous ^review''; yet, in qpite of these two statementa 
and the third in my letter to Mr. Kown, jnst quoted, the 
anthor rqnesents me throo^ioat Us ''review'* as the 
wspohptat and the advocate of sodi eq>eriments, thus 
publishing, yet at the same time wiDfoIty igncning, my 
rqpeated statements to the contraiy. 

In my letter to Mr. Brown, in support of my aocnsatkm 
that many of the references in the pamphlet on ''Hnmaa 
Vivisection" are ''vague and indefinite,** I dted fourteen 
instances of quotations from new^Mpers, five of vdiidi were 
withoiitdate,aiidIadded six other instances of "vague and 
indefinite'* references not to newspapers. I commented 
qpcm the imrrfiahility of newq)^)ers as a somroe of author* 
ity in medical matters. 

Let us see how the anonymous reviewer attenqsts to meet 
this issue. The facts he does not and cannot deny. In the 
first phu^ he claims that I have changed the issue from 
"the question of 'vague and indefinite quotation* to that 
of vague and indefinite ' nsf^nwicsf.* ** When I stated at the 
Senate hearing (stenographer's iqxyrt), "Many of them 
are so vague and indefinite that I could not look them up»** 
it must have been dear to any one of common sense that I 
referred to the references to the experiments, and there was 
no misunderstandiiig on this pcnnt in the letter of Mr. 
Brown, ^dio asks, "To "sdiat other of the references above 
l^en did you refer when you informed the Senate commit- 
tee that 'ifumtf qf them were eo vague and indifiniie thai I 
eoM fudlook them up*i** I was challenged by Mr. Brown 
to adduce examples of "vague and indefinite references,** 
and this challenge I successfully met. 

On page Se, the anooymous reviewer says: "(M the foui^ 


teen journals referred to, every one convesring a statement 
of fact — save one — had its name and date ot publication 
plainly given.'* Here it will be observed that a distinction 
is drawn between references to articles *' conveying a state- 
ment of f act**' and those which do not relate to statements 
of fact. My indictment against the pamphlet on ^^Human 
^visection ** (No. 2) was and is that many of the references 
are so ^'vague and indefinite *' that the original sources of 
alleged quotations cannot be consulted, and that some of 
the reports are *^ garbled and inaccurate.'* It may be just 
as imi)ortant to determine the accuracy of a reference to an 
expression of an opinion as to learn the facts upon which 
the opinion is supposed to be based, and to charge me with 
an evasion of the issue because I did not restrict myself 
solely to one particular class of references, but pdnted out 
the vague and indefinite character of all classes of refer- 
ences in the pamphlet, is too absurd to require further 

As a matter of fact, as pointed out in n^ letter to Mr. 
Brown, there are no less than five citations or reports of 
experiments in pamphlet No. 2 for which either no refer- 
ence whatever is given, or the one inserted is wrong or so 
vague and indefinite that the original cannot be consulted. 

On page 9, the anonymous reviewer says: **It was 
pointed out by the president of the American Humane As- 
sociation that, with one ezcepti<m, every phase of experi- 
mentation specifically mentioned had some reference to a 
medical authority.*' It is incredible that the reviewer 
should not have known the f aLdty of the statement attri- 
buted by him to the president of the American Humane 
Association, or he may think that in this strangely worded 
sentence he has constructed some looph<de of escape 
through such avenues as may be afforded by throwing the 
responsibility for a false statement upon another, or by 
such equivocal phrases as ^'eveiy phase of experimenta- 
tion," "'specifically mentioned," ''some reference." There 


aie» in fact, in the pamphlet of the American Humane 
Association seven instances in which reference to a medical 
authority for the experiments mentioned is lacking, and in 
addition the sole authority for an important part of the 
statements regarding Sanarelli's experiments are the corre- 
spondent of a daily newspaper and a speaker at a conven- 
tion of the American Humane Association. 

Let us see how the reviewer tries to meet my demonstra- 
tion of numerous instances of ''garbled and inaccurate" 
quotations in pamphlet No. 2. Here again the facts cannot 
be denied, but an attempt is made to minimize their 

1. "Brevity of quotation is often absolutely necessary" 
("review," p. 9). Why, then, as I pointed out in my letter, 
are whole sentences added which do not i^pear at all in the 

£. Errors are described in the "review" as a "transla^ 
tor's exaggeration" (p. 6), "blunders of a copyist" (p. 6), 
''errors of a translator " (p. 7) . So, then, it is now conceded 
that the pamphlet does contain "exaggerations," "blun- 
ders," and "errors." It contains not merely "errors of a 
translator," but deliberate falsification and misrepresenta- 
tions. When a translator says what the author did not say; 
when the word "collapse" is translated "final collapse," 
and an oration is made upon the death of patients who did 
not die; when the American Humane Association in refer- 
ence to these very cases quotes on the cover of its pamph- 
let, "Is scientific murder a pardonable crime?" in spite of 
the published fact that the patients referred to did not die; 
when the translator again and again interpolates words, 
phrases, and sentences which do not exist in the original; 
when essential phrases and paragraphs are omitted, — 
these I submit are not the mere "errors of a translator," 
but deliberate misrepresentations. Instances of all of these 
I fiunished Mr. Brown in reply to his challenge. 
. The pamphlet, moreover, contains, as I have pointed 


out, false or misleading quotations which could not be 
attributed to "errors of a translator," as they were from 
English sources. One can only hope that hereafter the 
"translators" and "copyists" employed by the antivivi- 
sectionists may be more accurate, or rather that the men 
and women back of these poor employees may be willing 
not to distort and suppress the truth in order to effect their 
purpose. It is a safe rule, I repeat, not to befieve any state- 
ment of an antivivisectionist until its accuracy is estab- 
lished by reference to the original source from which the 
alleged statement or quotation is derived. 

8. My charge of garbling and inaccuracy of quotation is 
practically admitted, but the reviewer states (p. 15) : "For 
none of them [the translations] was the American Humane 
Association responsible in any way whatever." It is now 
rather late in the day to advance this disclaimer, after the 
insertion on the inside of the cover of the pamphlet of the 
sentence, "The facts are indisputable," and in the preface, 
over the signature of the president and secretary of the 
Association, the words, "In each case, the authority is 
given." It is a favorite trick of antivivisectionists to at- 
tempt to throw off in this way responsibility when con- 
fronted with incontrovertible evidence of false statements, 
as is illustrated in the controvert between Miss Cobbe and 
Mr. Horsley. 

I shall be curious to see the fourth edition of this pamph- 
let. For it I now furnish one more instance of false state- 
ment, the evidence of which was not in my possession last 
January. Even Mr. Brown admits that to this "the refer- 
ence may, perhaps, be called indefinite." I submit that 
"periiaps" it may, for no book, journal, or any other publi- 
cation was named. The instance I refer to is Jansen's lec- 
ture purporting to be quoted on page 26 of pamphlet No. 2. 
The lecture was published, I have since f oimd, in a well- 
known journal, the "Centralblatt f. Bakteriologie u. Par- 
asitenkunde" (1891, vol. x, p. 40). So gross is the falsifica- 



tion that the leference was ^'perfai^'' wbdy omitted. The 
first phrase of the quotation is as follows, *' When I b^an 
my eiq>eriments with smallpox pus," etc. This is an ab- 
solute untruth. What Jansen used was not smallpox pus 
at all, but sterilized, diluted vaccine lymph, and sterilised 
blood a&cum from vaccinated calves, which could do no 
more harm than injecting so much water. The entire 
extract is inaccurate as a translation. Tha:e can be no 
question but that the substitution in this alleged quota- 
tion of *^ smallpox pus'* for ''sterilized vaccine lymph 
cannot be attributed to the mere ''error of a translator, 
but is a deliberate falsification, and this in a pamphlet in- 
troduced with the statement to the reader, "The facts are 

Much has been made of my statement that I could only 
find in the pamphlet references to "two eiq>eriments" in 
America. My reason for this statement was veiy simple 
and perfectly evident to any honest-minded reader. 

In the pamphlet "Human ^visection" (No. 2) there are 
a number of experiments related, the numbered ones b^^- 
ning with the following on page 4: " 1. Vivisection Experi- 
ments upon the Insane." Under this title several experi- 
ments, aJl of the same nature and by the same individual, 
are reported, eight being referred to in all. On page 5, 
appears, "2. Vivisection of Children in Boston"; and 
under this a number of experiments, all by the same person, 
are referred to. Anybody with common sense would see 
that when I referred to "two" instances, I did not mean 
two individual experiments, but using the classification of 
their own pamphlet, I referred to Nos. "1" and "2" on 
pages 4 and 5. In fact, I specifically referred to these pages 
and mentioned various experiments under each caption. 

I presume, however, that it is useless to expect fairness 
from an ambushed enemy. 

The anonymous "reviewer's" suggestion that as I was 
president ct the American Medical Association last year. 


therefore I am lesponinble for eveiy paper read before that 
body* — ifdien there were hundreds of pi^iers read mover a 
doeen secttons before several thoasaod members, — is so 
aTnnsmg that I pass it by with a smile at the author's 

One sentence 6t my letter I wrote p«4ii^ better than I 
knew. In the account of Sanarelli's ezpmments a certain 
sentence, '*I have seen unrolled befcne my eyes," etc. was 
quoted by **A. Tracy"' in the original paper (No* 1). In 
that pamphlet two references were given, one to the "Brit- 
ish Mediod Journal,'' the other to the ^ New En^^d Med- 
ical Monthly." I stated that this entire sentence occurred 
in neither of these journals and I added: **Whether it is 
quoted from some other $ource not tndioatod at has been 
deliberately added, I leave you at A. Tracy to explain." 
The "reviewer" explains that this quotation was from 
another source not indicated (surdy this was "vague and 
indefinite")* namdv. Sanarelli's oriidnal Italian Daoer* 
though no reference to it was given. 

Inasmudi as in my letter to Mr. Brown I gave the refer- 
ence to Sanarelli's original paper, the anonymous author of 
the "review" pays me the compliment of supposing thati 
am a facile Italian scholar, and, theief <»e» that I was per- 
fect^ aware that Sanarelli himsdf wrote this sentence. 
"\^th the vdume in his hands, the CMriginal article open 
before his eyes," says the "reviewer," "would he have us 
believe that he did not take the trouble to compare and 
verify the (mly quotatbn from it which a|q)ears in the pam- 
phlet? He did not see it? Credat Jud«us Apdla! There 
are limitations to credulity. But how queer must be that 
sense of honcnr idiich would permit a man to make a dis- 
graceful imputation knowing all the while that every word 
ctf it was false!" 

The simple facts of the case are these. Unfortunately, I 
am not an Italian scholar, and have nsiwf even seen Sana- 
relli's cmginal article. In order to find out the fMt fact,' I 


wrote to a friend who reads Italian well, to learn whether 
these five patients really died» as the American Humane 
Association pamphlet Qio. i) asserted. He repKed giving 
me the original reference, and stated that not one of them 

As the '* reviewer" points out that this quotation by '"A. 
Tracy ** was from Sanarelli's original paper, a veiy interest- 
ing inquiry arises, namely, if ** A. Tracy'* in Senate Docu- 
ment No. 78, as is now claimed, quoted from this original 
paper of Sanarelli, it b in order for him now to explain how 
it is, when Sanarelli's original paper states that all of these 
patients recovered, that he states that «ome, if not all cf 
ihem died, and how he dares to quote ueejiy a page of ora- 
tory about *' scientific murder" and "assassination," based 
upon this false statement. 

On page 26 of the anonymous "review" the author dis- 
putes the value of tuberculin as a test for incipient con- 
sumption in children. Were it worth my while I could give 
him references to disprove this statement, but in view of 
his amazing ignorance of modem medical progress, as 
evinced by the next statement, I do not propose to take 
the trouble. He says, "Dr. Keen knows perfectly well, in 
the first place, that phthisis, however early discovered, is not 
in all probabUUy a curable ailmeni.** Has he never made a 
post-mortem examination and found a cured phthisis? Has 
he never visited, or even read of, the Adirondacks, or Den- 
ver, or Colorado Springs, or Minnesota, or Arizona, or New 
Mexico, or a score of other such places? EUus he never read 
of the many books and pamphlets on sanatoria for con- 
sumptives? Does he know nothing of these modem move- 
ments? Koch's discovery of the bacillus of tuberculosis by 
experiment upon animals in 1882 has done more to help in 
curing consumption and other forms of tuberculosis than 
any other one means and especially by early recognition of 
the disease. If he will consult the recent prize essay on 
^ Tuberculosis as a Disease of the Masses and how to Com- 


bat it/' by Dr. S. A. Knopf» of New York, he will be made 
aware of the facts. This essay was awarded the prize by the 
Intemational Tuberculosis Congress last year in Berlin in 
a competition in which eighty-five prize essays were pre- 
sented from all over the world. 

I When I see the statement that phthisis is not curable 
even when discovered at an early stage, put forth seriously 
by my anonymous reviewer, I throw down the pamphlet in 
despair. One cannot argue further with such dense ignor- 
ance. It is equal only to the assertion of another medical 
light among the antivivisectionists, that brain tumors 
cannot be located outside the motor area. 


An Open Letter to Hon. Jacob H. OaUingeTf Chairman qf 
the Senate Committee far the Dietnd qf Cdumhia^ 
Washingtan^ D.C. 

Mt Dbab Sib, — As you have repeatedly introduced 
bilk into the Senate for the purpose nominally of regulating 
e]q>eriments upon animals in the District of Columbia^ 
which billst however, if they had become laws, would in 
fact have prohibited many, if not all, of them, I deem it my 
duty to call your attention to the case of Midshipman 
Aiken, of the United States Naval Academy, who was 
recently injured in a football game*^ My reason for doing 
so is to show you by a single concrete example that knowl- 
edge gained by animal experimentation is an immense boon 
to humanity and that, therefore, such experiments should 
be heartily encouraged. 

The facts of Mr. Aiken's case are as follows: When I 
first saw him, three days after the accident, I found that 
he had been unconscious for a half-hour after the accident 
and ever since then had complained bitterly of headache, 
which he located always in the forehead. Mentally he was 
veiy dull, though not comatose. His pulse was slowed 
down to 52 instead of being 7£, the normal. Soon after the 
accident he began to develop convulsions, first in the 
right leg, afterward in the right arm also, the right arm 
being finally the chief seat of the convulsions. When they 
were veiy severe they involved the left side also. The face 
was never involved. In six and one half hours after I first 

^ Rq>rinted from tlie Phflade^hia Medieal Journal, December IS, 

' The facts had been already obtained without my knowledge by the 
r ep or t ers and puUished in the daily newspapen; hence I felt at liberty to 
the case publidy. 


saw him he had twenly-f our of these attacks* all linuted to 
the right ann. They were not attended with any loss of 
consciousness. They exhausted him veiy greatly » especially 
when th^ were excessively severe. Several times it was 
necessaiy to give him chlonrfcmn. 

There was no fracture of the skulL The only phymcal 
evidence of any injury was a very sli^t bruise at the outer 
end of the left eyebrow. 

Had I seen this case before 1885» I should have been 
unable to explain why the spasms were chiefly manifested 
in the right arm, and from the evid^oce of the slow pulse, 
the headache, the stupor, the bruise in the left temple, 
etc., I should have been justified in inferring that probably 
the front part of the brain was injured at the site of the 
bruise. Had I opened his skull at that point, I should have 
found a perfectly normal brain and should have missed the 
dot. The young man, therefore, would have died iKdiether 
his skull had been opened or not. 

In 1902, observe the difference. Asaresultof theknoid* 
edge derived from experiments upon animals which have 
located precisely the center for motion of the right arm on 
the left side of the brain near the tofp and a little in front 
of a vertical line drawn through the ear, and disregarding 
entire^ the site of the headache and the bruise, I reached 
the conclusion that there had been a rupture of a blood* 
vessel within the head, which had poured out a quantity 
of blood, and that the situation of the clot should cone- 
sp<md to the ^^arm center.'* The location of this arm cen- 
ter was far away (about three inches) from the location of 
the bruise, and its position was fixed absolutely as a result 
of experiments upon animals, ocmfirmed later by many 
operations on human beings and also by posl morUma. 
The operation was done on November 19, 1902. 

As soon as the skull was opened at this point, the clot 
was found, its thickest point being exactly over the arm 
center, and nine tablespoonfuls of blood were removed* 


with the result that the patient's life has been saved. The 
blood had first been poured out over the "1^ center," 
which is located a little higher up than that for the arm. 
This explained the early spasms in the right 1^. The clot 
did not extend, however, further down than the arm center. 
This explained why the face was never convulsed, for 
the '"face center" lies just below that for the arm. [See 
Kg. 1, p. 48.1 

I think if you were to ask the parents of this young man 
how many animals th^ would be willing to have sacrificed 
in order that their son might have his life saved, there 
would be no doubt of the answer. Indeed, had it been your 
own son, I cannot doubt the answer. But this is only one 
of hundreds of cases in which a similar exact localization 
has been made by many surgeons, both in Europe and 
America. Yet, by a curious coincidence, in the veiy same 
issue of a Baltimore newspaper containing a reporter's 
account of the successful operation on Midshipman Aiken, 
there is a letter signed by an active antivivisectionist agita- 
tor, which, among other misstatements and misrepresenta- 
tions usually found in such publications, asserts that 
'^brain surgery is disregarded." 

If the laws which you and your friends advocate were in 
force, the conditions for scientific investigation in medicine 
in this country would be quite as deplorable as those in 
England. For example, when Lord Lister, who has revolu- 
tionized modem surgery, largely as a result of such experi- 
ments, wished to discover possibly some still better way 
of operating by further experiments, he was obliged to go 
to Toulouse to carry them out, as the vexatious restrictions 
of the law in England practically made it impossible for 
him to continue there these preeminently humane experi- 

Again, when Sir T. Lauder Brunton, in London, started 
a series of experiments on animals to discover an antidote 
for the cobra and other snake poisons of India, where every 


year twenty thousand human lives are sacrificed by snake 
bitesy these beneficent researches were stopped by the 
stringent British laws to protect animals. Meanwhile half 
a million of human beings have perished. 

Who, I may ask, is the more humane; he who» doubtless 
with the best and sincerest motives of love for dumb 
beasts, would prohibit experiments upon ftTiimAla and 
thereby prevent the acquisition of such knowledge and so 
compel surgeons to stand with folded arms and see in- 
numerable Uves thus needlessly sacrificed; or he who, by 
properly instituted experiments, would discover such new 
truths and apply them to the service of humanity? 

The antivivisectionists have frequently denied that sur- 
geons have learned anything from such experiments. I 
presume that I may be considered a competent witness as 
to the source at least of my own knowledge, and I state 
with the greatest positiveness that, without the knowledge 
derived from experiments upon animals which have demon^ 
strated the facts of cerebral localization, I should never 
have been able to locate the clot in Mr. Aiken's head and to 
remove it, nor should I have been able in the last fifteen 
years to locate numerous timiors and other brain troubles 
and relieve many of them. What is true of myself is 
equally true of other surgeons. 

In view, therefore, of the evident and positive benefit of 
such experiments, I trust that you will be willing to desist 
from further efforts at such repressive and, as I r^^ard it, 
most inhumane and cruel l^islation. 

As this matter is of vital importance to the well-bdng of 
the entire conmiunity, I shall take the liberty of giving this 
letter to the press as soon as you have received it* 

Veiy respectfully yours, 

W. W. Keen. 

(This fine young man's later histoiy is of great interest. 
In spite of my injunctions to drop back one year in the 


Naval Academy he studied extra hard, made up all hb lost 
time, graduated with his dass, and entered the navy. 

On Januaiy 10, 1909, over six years after the accident, he 
was examined for life insurance and was passed as ^a first- 
dass risk*' and the policy was issued. 

Six months later, July 11, 1909, he was killed by an 
explosion in a coal bunker on his ship, the North Carolina, 
lying in the harbor of Naples. He gallantly refused to let 
his men enter the bunker, where there was supposed to be a 
fire, until he had explored it himself . He saved their lives at 
Hie expense of his own.] 


In October, 1880, and June, 189S, in '^Harper's Maga- 
one,*' I gave some account of the progress of suigeiy. In 
the sixteen years that have elapsed since my last paper was 
written there has been much further progress in various 
directions. I can only consider a veiy few of these advances, 
and even those in a veiy incomplete manner. 

Surgery cf the Heart 

Up to the publication of Ilscher*s piq)er in 1867, scarcely 
any surgeon took the surgeiy of the heart seriously. That 
paper was based on a study of four hundred and fifty-two 
published cases of wounds of the human heart, and he 
showed that a patient might live for hours or even days 
with a wounded heart. 

In 1881, Dr. John B. Roberts, of Philadelphia, made the 
bold proposal deliberately to sew up a wound of the heart, 
in spite of the fact that Billroth, the then most distin- 
guished Continental surgeon, had declared that no one who 
wished to preserve the respect of his colleagues would ever 
attempt to operate on the heart. In 1896, after a number of 
experiments upon animals, two unsuccessful attempts to 
sew up a wound of the heart were published, f oUowed hap- 
pily in 1897 by Rehn*s famous piq)er recording the first 
successful case. How quickly surgeons followed this happy 
lead is seen by the statistics ^ven me by Dr. Francis T. 
Stewart (who himself has had a successful case), that up to 
June, 1908, one hundred and forty-one cases of wound of 
the heart had been operated on, and sixty-four of them had 

^ Beprinted by tlie kkid permission of Haiper k Bros, from Harper'$ 
MagoMM for ApriL liM)9. 


recovered. When one considers the difficulties of such an 
operation, — the speed with which the heart must be ex- 
posed by making a trap-door through the chest wall» then 
dividing two or three ribs> without, if possible, injuring the 
left lung, opening the sac in which the heart lies (the peri- 
cardiimi), clearing it of blood, seizing the heart, and while 
it is actively pulsating, with a jet of blood from the wound 
at every pulsation obscuring the field of operation — when 
one considers these difficulties, and yet notes that over 

forty-five per cent have recovered, and that this percentage 
of recoveries is steadily increasing, it b a matter of both 
surprise and gratification. 

In a good many operations, when chloroform and even 
sometimes when ether is given, the patient suddenly 
passes into collapse, the heart ceases to beat, the respira- 
tion stops a few minutes afterward, and death quickly 
follows. Whether the pulsation of the heart could be re&- 
tablished was first investigated by Schiff ^in 1874, and in 
animals, by means of rhythmical compression of the heart 
by the hand, he succeeded in starting the heart beating. 
It is impossible for me to state in detail the experiments of 
Pruss in 1889 and Battelli in 1900, both of whom were able 
in a considerable number of animals and by various meth- 
ods to reestablish cardiac pulsation. The most extraordi- 
naiy experiments, however, were made by Kuliabko in 190£ 
on hearts which had been removed from the body; all prior 
experiments having been made on hearts remaining in the 
body of the animal. Kuliabko showed that after the heart 
had been removed from the animal and kept in ice for 
twenty-four or even forty-four hours, by filling the heart 
with certain fiuids pulsation was reestablished and con- 
tinued for over three hours. He was able also to take the 
hearts from rabbits that had died a natural death instead 
of having been killed, and on even the second, third, and 
fourth day after death, by filling them with this fiuid the 
isolated heart was started pulsating and continued to beat 


for several hours. He also tried the experiment in a number 
of instances in which the human heart was removed, post 
mortem^ even as long as thirty hours after death, and pro- 
duced temporaiy pulsation. In a dog's heart which had 
been in snow for eighteen hours, and again after having 
been frozen in salt solution for twenty-four hours, Velich 
obtained slight contractions, but full pulsation was not 


Veiy naturally such experiments aroused the hope that 
some similar result might be reached in man. Attenq)ts 
were made in desperate cases of sudden death, especially 
from chloroform. Ricketts has collected thirty-nine cases, 
of which twelve recovered! In other cases the circulation 
has been reestablished for a number of hours, so that the 
surgeons were justified in expecting the lecoveiy of the 
patients, but after a time the pulse and respiration failed, 
and recoveiy did not f oUow. 

As can easily be seen, all this is so new that it is impos- 
sible at present definitely to fix on the best method of 
reaching the heart, whether (as in cases of wounds of the 
heart) by making a trap-door over it in the wall of the 
chest, or by quicldy opening the abdomen and reaching the 
heart through the diaphragm, or by other means which are 
too technical for me to describe. The report of the thirty- 
nine cases alluded to gives a recoveiy rate of thirty-one 
per cent. That this will .be increased in time there is no 

The most recent researches in the surgery of the heart 
are experiments on animals to determine whether it is 
possible not only to expose the heart and operate on its 
exterior, but -deliberately to open its cavities and operate 
on the valves. The results so far seem to show that it is no 
dream of a surgical Utopia, but that some day ^'valvular 
disease of the heart,'* hitherto an absolutely incurable dis- 
sease, may be dealt with surgically and with the possibility 
of success. Happy the surgeon who, after suitable experi- 


ments upon animals have taught him exactly how to do it» 
may be able to cure such a hopeless malady I ^ 

But the happy histoiy of progress is not yet all told. 
Three years ago I saw Dt. Crile, of Cleveland, chl<Hx>f orm 
a dog to death. By a suitable apparatus he was able accu- 
rately to record the veiy last pulsation of the heart and the 
last attempt at breathing. I stood by the dc^» watch in 
hand, and when he had been dead — having neither pulsa* 
tion of the heart nor breathing — for fifteen minutes. Dr. 
Crile injected toward the heart in the carotid artery a 
mixture of salt solution and adrenalin (the extract of a 
^and lying just above the kidn^), compressed the dog's 
chest a few times, thus starting the heart and lungs going, 
and in less than three mmutes the dog, though, of course, 
still unconscious from the anesthetic, was just as much 
alive as he had been a half-hour before. Partial but not 
permanent recoveiy has been obtained by Dr. Crile in 
animals even twenty-five minutes after actual death. If 
further experience confirms these results, we may have a 
better methodof resuscitation in collapse of the heart than 
by exposmg it as above described. 

Without the experiments which had been made upon 
animals and proved the efficacy of the adrenalin, which 
was added to the salt solution, no one would have thought 
that the extract of a gland lying above the kidn^ would 
be of the least value in saving dther animal or human life. 
We know now, as a result of such experiments, and with 
positive certainty the effect of the adrenalin and its im- 
mense value in these cases as well as in others. 

Surgery qf the Arieriei and Veine 

From the heart naturally we pass to the arteries, which 
conduct the blood from the heart to all parts of the body. 

^ Further progress has been made by Cand in operating on the valves 
in animals, but it is not yet an operation so safe and certain as to warran t 
its use in man. (1914.) 


Wounds of the arteries by gunshot, by stabs, by accidents, 
etc., are not at all uncommon. Until veiy lately when a 
large aiteiy or a large vein was wounded our on^ remedy 
was to cut down upon the blood-vessel and tie it above and 
below the wound. If it were an artery leading to the arm, 
and still more if it were one leading to the leg, as the prin- 
cipal supply of blood was cut off» gangrene was a very 
conmion result. 

In case of aneurysm (a disease in which the walls of the 
artery become weakened at a certain point, bulge, and 
finally rupture, producing death), till recently, as in the case 
of a wounded artery, our only resource was to expose the 
artery and tie it. Here again, for the same reason, the chief 
danger was gangrene. In the treatment of aneurysm, 
Matas, of New Orleans, has made the greatest improve- 
ment since the days of John Hunter, over a century ago. 
Instead of tying the artery above the aneurysm and arrest- 
ing the current of blood in the artery, he opens the sac 
(that is, the dilated portion of the artery or aneurysm), 
and, if I may so describe it, sews the opposite walls of the 
sac together on the inside, leaving, however, a small tun- 
nel through which the circulation is continued. 

Up to June, 1908, eighty-five operations of this kind have 
been done, with seventy-eight recoveries. This method of 
operating obviates almost entirely the dang^ of gangrene. 
Thus far apparently European surgeons have neglected it, 
only two operations having been done in Italy and four in 
Spain, while the remaining seventy-nine have been done in 

But it is in cases of wounds of arteries and veins that 
perhaps the most remarkable progress has been made, and 
the story shows how widespread are the benefits derived 
from a single discovery — how to sew together the two ends 
of an artery which has been cut across. When a blood-ves- 
sel was wounded, we were obliged to tie the artery or vein 
to prevent the patient from bleeding to death. As I have 


explained, this cutting off of the blood-supply often pro- 
duced gangrene. In 1894, Dr. Robert Abbe, of New York, 
made a number of remarkable experiments upon animals; 
among them two are especially noteworthy. Opening the 
abdomen of a cat, he cut across the aorta (the great blood- 
vessel passing directly from the heart to the lower limbs) 
and inserted a thin sterile glass tube, tying the aorta over 
flanges made at the two ends. After four months the cat 
was shown at the New York Academy of Medicine, '^fat 
and strong, with the glass tube still in his aorta." Again, he 
almost amputated a dog's foreleg, leaving the limb at- 
tached to the body by nothing but the artery and vein. He 
then wired the two ends of the bone together, sewed muscle 
to muscle, nerve to nerve, etc., and after dressing the limb, 
encased it in plaster. After four months this almost ampu- 
tated limb was perfectly imited, and Dr. Abbe drew the 
inference that a completely amputated limb might be suc- 
cessfully grafted. How fruitful these experiments were in 
practice we shall see later. 

When an artery is partially divided or completely cut 
across, naturally the proper course would be in the former 
case to sew up the wound, or in the latter to sew the two 
ends of the blood-vessel together, and so reestablish the 
dnnilation. To describe all of the technical difficulties of 
such an operation would be impossible in a brief paper. 
Th^ have been investigated experimentally by Murphy, 
of Chicago; Payr, of Graz; Crile, of Cleveland; Carrel, of 
New York; Guthrie, of St. Louis, and others. 

The great difficulty has been to find a suitable method of 
sewing the two ends of a completely divided artery together 
in such a way that the blood wM not form a dot at the neces- 
sarily somewhat rough and irregular line of union and 
totally obstruct the vessel just as if it had been tied. At last, 
within the past few years, especially by the labors of Carrel, 
Guthrie, and Crile, a suitable method has been devised by 
which now any surgeon, who will familiarize himself with 

2 > 

I- O 33 

i z '^ 

« m c 


the process and obtain skill in its application by a few ex- 
periments upon animals, can operate in such cases with 
confidence. This method has not only found its chief appli- 
cation when the blood-vessels have been completely di- 
vided> but has made possible another veiy remarkable 
achievement; namely, direct transfusion of blood. 

The older method of transfusion was to connect the ar- 
tery of a healthy person with the vein of the patient by 
means of a rubber tube. The great danger here, as in the 
case of wounds of the artery, was that the blood would clot. 
If this clot passed into the vein, whether of arm or leg, it 
went upward till it finally reached the heart, and was then 
driven into the lungs, where it would act like a cork and ^ 

block up a larger or smaller artery of the lung, cutting off ^ ^ 

the circulation in that part and producing a dangerous and " 

in most cases a fatal pneumonia. So great was this danger 
and so frequent the disaster following indirect transfusion ^ z i 
by this means that for a number of years it has been prac- ^ ~ 

tically abandoned. Instead, therefore, of transfusing blood ^ 

itself, surgeons have for some years relied upon supplying ^ 

the loss in volume of the blood by means of salt solution, g 

and this in veiy many cases has answered very well. As a g 

result, however, of these recent experiments on the suture 
(sewing) of blood-vessels end to end, we now are in a posi- 
tion to pass the blood from the arteiy of a healthy person 
into a vein of the patient without any danger of its clotting, 
provided the operation is properly done.^ This has had a 
veiy striking climax in certain cases in which there has been 
severe loss of blood. Let me give but one very briefly — 
the case of the baby of a well-known young medical man. 
Immediately after the birth of this baby, there set in severe 
hemorrhages from the mouth, nose, stomach, and bowels, 
the so-called *' hemorrhage of the newborn.'* The various 

^ As a result oC these and many other remarkable researches by animal 
experimentation* Carrd, in 1912, was awarded the Nobel Price ($40,000) 
in Medicine. 


remedies which were tried all f uled, and on the fourth day 
the baby was dying. I am suie that eveiy woman, espe- 
cially, will sympathize with the grief of these parents over 
the impending death of their firstborn. In the middle of the 
night the father called Dr. Carrel, of the Rockef eUer Insti- 
tute, to his assistance, lay down alongside of his baby, an 
arteiy in the father's arm was laid bare and sewed end to 
end to a vein in the baby's leg, and the blood was allowed to 
flow from father to child. The result was most dramatic. 
A few moments after the blood began to flow into the 
baby's veins its white, transparent skin assumed the 
ruddy glow of health. The hemorrhage from every part of 
the body ceased instantly and never returned, and, as the 
published account ^ so vividly puts it, there was no period 
of convalescence — immediately before the operation, the 
baby was dying; immediately after the operation, it was 
well and strong and feeding with avidity. That baby 
to-day is a strong, healthy child. 

The same method of direct transfusion has been used by 
Crile, Downes, of New York, and others, in a still difiFerent 
way. Many patients come to surgeons so weak, either from 
loss of blood or from the dreadful e£Fects of cancer, tumors 
and other diseases, that to operate upon them with the 
coincident shock and loss of blood is almost sure to be fatal. 
In such cases very frequently prudent surgeons, to their 
great grief, are obliged to say *'no," and allow the patient 
to die rather than attempt an operation. 

In a child two years and two months old, Downes found 
a tumor of the kidn^ which filled the entire left half of the 
abdomen, and in whom the quality of the blood (the hemo- 
globin) was reduced to forty-five per cent of the normal ; the 
child's face was drawn, the pulse rapid and feeble, and the 
appetite very poor. Operation was delayed for a few days 
in order to see whether good care and good food would not 
cause improvement. On the contrary, the child was no 

1 New York Medical Record, May SO, 1908. 


better, and there was a meagurable increase in the size of 
the tumor, so rapidly was it growing. On September 11, 
the father's arteiy and the child's vein were united and the 
blood allowed to pass from father to child for forty minutes. 
Eveiy five minutes the quality of the blood of the child was 
tested by taking a few drops of it, and it was found that at 
the end of forty minutes the quality of the blood had risen 
from forty-five per cent to ei^ty per cent. The pulse was 
full and strong, and the child's color and general condition 
showed equal improvement. On the following day the tu- 
mor, weighing a pound and two ounces, together with the 
left kidn^, was removed, and the patient was discharged 
perfectly well on October 18, having already gained three 
pounds in wei^t. 

Crile has even, if possible, in a more striking way demcm- 
strated the use of this method in eleven successful cases in 
human beings. Tnst4^ of effecting the transfusion a day 
or two before the operation, he has placed the patient and 
her husband akmgside of each other at the time of the <^r- 
ation, connected the husband's aiteiy with the wife's vdn, 
and as soon as, from the inflowing blood, her condition has 
improved sufficiently to withstand the etherization, the 
shock, and the loss of blood, has proceeded with the <^ra- 
ation. During the operation the loss of blood by the patient 
has been more than made up by her gain from her hus- 
band's blood, and she has been aiabled to withstand the 
shock incident to the ether as well as the operation; and at 
the end of the operation she has been in better ccmdition 
than before it was b^gun. As Crile has declared, ''In some 
cases the results seem nothing short of a resurrecti<m from 
the dead." 

Bec^itly a nephew of Bishop Lawrence, of Massachu- 
setts, was thus rescued by direct transfusion of blood. To 
quote the Bishop's exact w<»ds, ''The boy was at death's 
door, and b now in perfect health." 


TfOfuplatiiaiiim cf Parts cf the Bodif 

Our abOhy 8iiooes8fii% to sew severed Uood-vesseb 
together has borne stfll farther frtnt. It has enabled us to 
tran^lant whole OTgans — for exaiiq>le, ixae or, m other 
cases, both kidneys, or an entire leg tmm ooe animal to 
another. Tlieseposobilities, however, have <xi]7 been real- 
ized step by step, not cmfy by devising soocessfiil methods 
of sewing the ends of large vessds together, bot by discov- 
ering that natore can mspgiy a tran^>lanted part fip<mtane- 
oos^ with small blood-vessds and thus enable it to retain 
its vitality. 

Eveiybody, fcnr instance, knows about ** skin-grafting.'* 
Beverdin, of Geneva, first snipped off little pieces of skin 
from the arm or leg and deposited these pieces on the sur- 
face of an ulcer, protecting them by suitable dressings from 
being displaced. He found that these little pieces whai 
placed <m the ulcer adhered to it, that they Kved, that 
small blood-vessds nourished them, and around each little 
island of tran^>lanted skin the ulcer began to scar over 
(cicatrize), and finally healed. This emboldened Krause, of 
Berlin, to take much larger pieces of skin, so that at present 
after removing a tumor, if we cannot bring the margins of 
the skin together, we cut from the thi^ of the patient l<»ig 
strips of thin skin an inch wide and several inches long by 
means of a sharp razor and transfer them to the raw spot. 
As a rule, they adhere, preserve their vitality , are nouri^ed 
by new small blood-vessds, and in a short time we can thus 
^skin-graft" a large raw surface and have it heaL The 
thing quickly heab. 

But this kind of ^'grafting'* is not limited to the skin. 
Many years ago Oilier, of Lyons, showed that by taking 
from the bone of a living animal a bit of the membrane 
which covers all bones (the periosteimi), he could trans- 
plant it to another place on tiie same animal, or even into 
another animal, and the periosteum would produce new 


bone. Following that discove]y» which was the result of 
laborious experiments, we constantly now make what are 
called ^'subperiosteal'* removals — for example, of a part 
or the whole of a lower jaw — preserving the periosteimi» 
and from it a new more or less perfect bone is developed. 

Recently Lexer, of K5nigsberg» has gone much farther. 
Li the case of a man who had a stiff knee-joint bent at an 
angle and immovably fixed by firm bony union, he removed 
the bones forming the knee-joint and took from an ampu- 
tated leg the healthy knee-joint and put it in place of the 
bone that he had removed from the stiff knee. The trans- 
planted bones both above and below united firmly with the 
bones of the patient, and the strange knee-joint from the 
amputated leg served a perfectly normal function. In 
another case he removed the upper end of the shin bone, 
taking away, therefore, the lower half of the knee-joint (a 
much more difficult and dangerous operation, as it opened 
the knee-joint), and replaced this with a similar portion of 
bone from an amputated leg with entire success. 

The last achievement that I have seen of this ingenious 
surgeon was reported to the German Surgical Congress in 
April, 1908. Most of my readers are familiar with the fact 
that when a patient, through disease or accident, has lost 
his nose a new one can be made for him. This is a veiy 
ancient operation. The new nose is usually made by cut- 
ting a flap from the forehead, leaving it attached by a f oot- 
stalk between the ^ebrows. This flap is then twisted on its 
footstalk and sewed in place. But it has serious disadvan- 
tages. Sometimes the twist in the footstalk is too tight; 
this compresses the blood-vessels, and the flap becomes 
gangrenous. In that case not only has the patient lost his 
nose, but he is left with a face disfigured by a great scar in 
the middle of his forehead. Even if the attempt to give him 
a new nose is a success, the scar on the forehead always 
tells the stoiy, and, moreover, the new nose, having no 
bone, is flabby and unsightly. Lexer records a case which is 


not only surprising, but one may say also amusing. Having 
a patient requiring a new nose, and having amputated a leg 
for some disease which did not involve the thigh bone, he 
took a bit of the lower end c^ this thigh bone, whittled it 
into the shape of a nose, and bored out two nostrils in it. 
He then made an incision in the skin of the forearm of the 
patient, on the front, or hairless surface, loosened the skin 
to some extent from the underlying muscles, placed the 
new bony nose under the skin, and closed the wound. 
After three months, when the skin of the forearm had 
become firmly attached to the bony nose (which was only 
intended to be a temporary tenant of his forearm) the skin 
and the new bony nose were cut out in one piece and trans- 
planted to the face. This gave the patient a good, firm, 
bony nose, which at the same time was covered with the 
healthy skin of the forearm, and avoided any disfiguring 
scar on the forehead. 

Even more surprising things have been done by Carrd 
and Guthrie in the transplantation of soft parts which had 
been preserved by various means, and yet grew fast and 
fulfilled their function. For example, in November, 1906, 
Carrel removed from the neck c^ a dog a portion of the 
carotid artery, and put it into cold storage, where it was 
kept at an even temperature of 32^ to S3^ F. After twenty 
days in cold storage he transplanted this into the aorta of a 
cat, and after two years and one month the cat was per- 
fectly weU. Again, in May, 1907, a portion of a dog's aorta 
was removed, and a similar portion of the artery behind the 
knee removed from the amputated leg of a man was put in 
its place, and eighteen months later the dog was still in 
thoroughly good condition. 

Guthrie also reports that he removed from a dog a por- 
tion c^ the great v^ alongside the aorta (the vena cava), 
preserved it by formalin (a chemical preservative) for sixty 
days, then removed a corresponding portion of the carotid 
artery from the neck of another dog and replaced it by this 


portion of vena cava, and the animal was living and well 
when the report was made three weeks later. 

Still more extraordinary experiments have been done by 
Carrel and Guthrie in the transplantation of entire legs or 
<rf entire organs. Carrel amputated the thighs c^ two dogs, 
A and B, and united the thigh from dog A to the stump of 
the thi^ c^ dog B, wired the ends of the bones together, 
sewed artery to artery and vein to vein, etc. (it will be seen 
now how essential was the discovery of a successful method 
oi sewing the arteries end to end), and implied a suitable 
dressing and a plaster cast. The new leg grew fast to the old 
stump, and when I personally saw it there was firm union. 

This experiment, which has also been done by Guthrie, 
is only a further step, it will be observed, beyond the oper- 
ation ci Abbe in 18M, when he amputated the entire leg 
with the exception c^ the blood-vessels, which he dared not 
cut, for with the imperfect knowledge we poseesssd fifteen 
years ago he could not possibly have suocessf u% sewed 
them together. 

Quite as noteworthy also are some experiments of Carrel 
and Guthrie in which they have taken the two kidneys with 
their blood-vessels and the corresponding part of the aorta 
and the vena cava, the two ureters, and the part of the 
bladder into which the ureters entered, from one cat, and 
transplanted them into another cat from which the same 
parts had been removed. I saw this operation done a few 
months ago in an hour and a half. An hour after the opera- 
ation the cat was in very much better shape than most of 
my patients are an hour after I am through with them. 
She recovered perfectly, and the transplanted kidneys 
worked as weU in the second cat as they had done in the 
body of the original one. 


The surgical record of cancer consists of a happy achieve- 
ment and a temporary failure. The achievement is the 


practica]^ pennanent cure of forty to fifty per cent (and 
some surgeons have had even a larger percentage) of the 
cases operated upon: that is to say» patients who have had 
cancerous tumors removed have lived for five, ten, fifteen, 
and even twenty years without any recurrence. This has 
been gained by the most painstaking study of the modes of 
extension of the disease and by more thorou^ and earlier 
extirpation. I presume even now, with our imperfect 
knowledge of cancer, if eveiy patient who found a lump in 
any part of the body would seek the best available surgeon, 
it would be within the bounds of truth were I to say that, 
taken at this early stage, the cures would probably amount 
to sixty-five or even seventy-five per cent of the cases oper- 
ated on. But what all surgeons are seeking is (1) the cause 
and (2) the means of cure of cancer without operation — a 
professional altruism which I never cease to admire. 

That cancer is mildly contagious is shown by the un- 
doubted existence of the so-called ^* cancer houses'' in 
which, for want of proper disinfection, repeated cases of 
cancer have arisen. Moreover, animal experimentation 
and a few cases in human beings have shown that if the 
cancer cells of the tumor come in contact with a fresh raw 
surface during operation, the disease may easily be spread 
in this way. Hence eveiy modem surgeon is extremely 
careful to protect the raw surface of the wound from touch- 
ing, even momentarily, the cancerous tissues or being 
moistened with their dangerous juices. For the same rea- 
son our operative methods, too, have been changed, so that 
now we take out the entire mass of infected glands as well 
as the original tumor in a single piece, and never put a knife 
into any of the cancerous tissues. If we are obliged to do so, 
this knife is cast aside and a new one substituted. 

The cancer problem is being attacked vigorously in can- 
cer laboratories in Buffalo, Boston, London, Heidelberg, 
New York, and elsewhere with extraordinary zeal. Many 
men are devoting their lives wholly to the study of this 


one great and perplexing problem. It is being attacked on 
the clinical side to see if we can learn anything by such ex- 
perience; by the microscopists to find if the minute study 
of the tissues will reveal the cause; by the bacteriologists 
to see if they can discover any germ which may originate 
the tumor; and finally by animal experimentation to study 
the life history of such tumors from start to finish by inoc- 
ulating with the cancerous tissue and tracing the 
effect of the inoculation, destroying one animal at the end 
of a few days» another in two or three weeks, another in 
months, and so on; and in a multitude ci other ways too 
technical to relate, in order to obtain the most intimate 
and exact knowledge possible. But so far the cause of 
cancer has eluded us. 

I have called this a temporary failure because I look 
forward with confidence to the future. At any moment I 
am expecting to learn that some pathologist will really 
discover the cause of cancer (for many have cried, Lo here ! 
or, Lo there! only to find they were in error), and thus con- 
fer a boon on the human race second only to the discovery 
of the bacillus of tuberculosis. 

Let us now turn to anotiier subject, in which, once more, 
the question of transplantation ci organs will come up for 


This disease is weU known, of course, to all who have 
traveled in Switzerland and Savoy, where such an immense 
nimiber of cases occur. That it is not very uncommon in 
America is shown by the fact that the Mayo brothers have 
done over one thousand operations for goiter. In my paper 
in October, 1889, 1 referred to what was an amazing report 
in that year by Kocher, of Berne, of two hundred and 
fifty operations for goiter, with a mortality of but 2.4 per 
cent. The last statistics which have been published by 
Kocher cover three thousand operations for goiter, with the 


marvdously low mortality c^ only three deaths in each one 
thousand cases. 

When we began to operate on goiters, the whole of the 
thyroid gland (the enlargement of which produces the 
goiter) was removed. It was soon found, however, that in a 
certain percentage of cases the patients underwent a dread- 
ful change; namely, th^ looked as though they were 
bloated; their hands and features became thickened and 
enlarged; their intellects became dulled, so that some of 
them even passed into the state c^ cretinism. Others, on 
the other hand, became greatly excited, and died with what 
is known as tetany, a disease which derives its name from 
its resemblance in many respects to tetanus or lockjaw. In 
order to obviate these dangers the first change that was 
made was to leave a portion of the gland behind. If this 
was done, the patient was not attacked by the general 
change (myxedema or cretinism), though fatal tetany still 
sometimes followed. 

In 1880, Sandstr5m discovered in the human subject 
some small glands about the size of grains of wheat, situ- 
ated behind the thyroid gland, but in immediate connec- 
tion with it, and therefore called the parathyroid glands. 
Human beings and many animals usually have four, some- 
times three, and sometimes only two. Moreover, their situ- 
ation varies veiy much, and at first it was impossible to 
recognize them at operation. What their function was, and 
what would be the effect of their removal, nobody knew. 
Accordingly, experiments were begun upon the lower ani- 
mals by removing some or all of these frauds in order to 
discover their function. It was quickly learned that when 
they were all removed, the animals died from tetany, just 
as human beings occasionally did after operations for 
goiter. Then it was suspected that the cause of the hiunan 
tetany was not the removal of the thyroid gland itself, but 
of these little parathyroids, and that the good effect c^ 
leaving a part of the thyroid gland was due not only to 


leaviii^ the thyroid itself » but to accidentally leaving at 
least one of these little glands. Numerous experiments 
upon animals, as well as the terrible experiments which we 
had been ignorantly making upon hiunan beings, from 
whom many surgeons, toithmit knowing ii^ had removed 
these parathyroid glands, have shown that, small as they 
are, th^ are essential to life, and that if th^ are aU re- 
moved, the withdrawal of the secretion th^ furnish to the 
body always causes death. 

At the German Surgical Congress in April, 1906, Kocher 
reported that he had transplanted these glands for certain 
reasons into the upper end of the shin bone just below the 
knee. This he did first in animals, and found that when, at 
a later operation, he removed the whole of the thyroid 
gland and the parathyroids from the neck, the animals did 
not suffer from tetany. He has now gone a step farther, as 
his animal experimentation justified him in doing, and has 
done a similar transplantation in the human subject. The 
results of this operation have not yet been published, but 
I judge from his report to the Surgical Congress that it 
was favorable. If so, a new means of security is provided 
for us in operations for goiter. 

There is another form of goiter, however, which is much 
more fatal than the ordinary goiter with which most people 
are familiar. It is called exophthalmic goiter, or Graves's 
Disease, the latter after Graves, of Dublin, the former be- 
cause the eyes protrude very markedly. Along with these 
two symptoms there is a very fast pulse, running up to 160 
or 200. The disease very frequently destroys life. It has 
been operated on by a number of surgeons with a good 
degree of success, but recently an antidote has been pre- 
pared by Rogers and Beebe of New Yoric which seems to 
promise much in the way of cure and may possibly obviate 
operation. One of the gentlemen most interested in the 
development of this antidote was purred on in his experi- 
ments by the fact that his own wife was suffering dread* 


fully from the disease and rapidly nearing the grave. The 
idea of preparing this anti-serum or antidote had come to 
him while watching the action of another anti-serum, the 
whole effect of which was spent upon the kidney, no other 
organ of the body being affected. This suggested to him 
the idea that an anti-serum mi^t be prepared from dis- 
eased thyroids which would have its sole effect upon the 
thyroid gland. Soon after this fruitful idea had developed 
in his mind, a patient with Graves's Disease died, and at 
the post mortem he obtained the thyroid gland from this un- 
fortunate patient. )^th this a number of rabbits were in- 
oculated, but in consequence of his total ignorance of the 
proper method of using it, all but one of these rabbits died. 
From this one rabbit there was prepared an extraordinarily 
good serum which absolutely cured three human beings 
and partially cured two others. The second of the three 
who were cured was the wife of the doctor himself. Her 
attending physician, one of great eminence, had declared 
to her husband that how long she would live was only a 
question of hours. By reason of the fact that its instant use 
was imperative before it could be thoroughly tested on 
animals so as to learn its dangers and how to avoid them, 
he nearly killed his own wife in the attempt to cure her; but 
she is to-day a perfectly well woman, thanks to the experi- 
ments upon this small number of rabbits. 

Beckoned in rabbits, what is the value of your wife, your 
husband, or your child? 

All of this animal surgery I mention for two reasons: 
first, because with minor exceptions the methods and the 
results of animal surgery and of human surgery are identi- 
cal; and therefore, secondly, because it b a necessary pre- 
liminary and precautionary step to similar surgery in 
human beings. All of the recent surgery in animals above 
described will surely be applied, with suitable modifications, 
to man, immensely adding to his comfort and saving 


Iife» with all which that implies for himself and his 

This paper is a record of only a few of the wonderful 
achievements of modem surgery in human beings which 
have resulted chiefly from experiments on the lower ani- 
mals. That clinical investigation — that is, investigation 
by observation at the bedside — has been of value, no one 
doubts; but had we been restricted to clincial observation 
only, not a tithe of the progress recorded would have been 
made. I scarcely know anything more touching than the 
stoiy told me by Dr. Carrel of a boy who wrote to him, 
offering himself for experiments of any kind, if by so doing 
he could obtain a pension for his mother. Not long since I 
received a similar letter from a doctor who was afflicted 
also with a disease which he knew was mortal. He wrote 
me saying that he was willing to submit to any opera- 
tion, however piunful, wUhout any aneethetiCf if it could be 
of any use to humanity. 

Moreover, this progress is not only in surgeiy , but in medi- 
cine; and doctors have been in the forefront in sacrificing 
their Uves, sometunes by accident, sometunes voluntarily, 
in order to achieve these splendid results. Doctors have 
died by diphtheria, by plague, by infection of various 
kinds, have slept in the clothes and in the beds of yeUow- 
f ever patients in order to discover whether the fever was 
spread by these means, and have offered up even their 
lives in order to prove that yeUow fever was caused solely 
by the mosquito, and thus clinch the proof that was needed 
in order that this dreadful scourge might be eliminated; a 
scourge which has cost a holocaust of lives and millions of 
dollars even in the United States alone. 

As a result of the sacrifice c^ human lives Cuba has been 
freed from yellow fever for the first time in nearly two cen- 
turies, and in the Canal Zcme not a case of yellow fever has 
occurred for over four years. Colonel Grorgas is the one 
man who has made the building of the Panama Canal a 


possibility. No lower animal being sub ject to yeOow fever, 
experiments eould not be tried upon them, and hence 
Lazear and others lost their Uves. In the fine words on 
Lazear's tablet in the Johns Hopkins Hospital, written by 
President Eliot : ** With more than the courage and devotion 
c^ the soldier he risked and lost his life to show how a fear- 
ful pestilence is communicated and how its ravages may be 

I am old enough, perhaps, to relate without reproach the 
following personal incident. While writing this paper a 
friend gave me the ''Journal of Zo5phily'' for January, 
1909. On page 21 found in an editorial note on a large gift 
by its founder to the Rockefeller Institute the following: 
''But the gift only fanned into fuiy the opposition of wo- 
men to experiments on living animals, no matter how great 
(he anticipated henefii** Three days later, between noon 
and bedtime, I happened to meet four former patients, all 
of whom thanked me warmly for having saved their lives. 
Three of these four patients owed their lives chiefly to the 
knowledge derived from experiments upon animals. No 
further comment need be made on those cruel words — 
"No matter how great the anticipated benefit.'* W\\3i a 
thrill of delight I fervently thanked God for what modem 
surgery could do. 

For what the friends of experimental research have done, 
and for what the foes of experimental research have done, 
see "The Influence of Antivivisection on Character/' 
p. 284. 


In "Harper's Magazine'' for April, 1009, 1 gave a brief 
account of the newer surgery of the heart, the arteries, and 
the veins, and of the transplantation of different parts of 
the body, with some remarks on cancer and goiter. 

Further transplantations of bone, such as Lexer's, which 
I there described, have been reported during the past year. 
Streissler, of Gratz, has publi^ed eighteen such cases; some 
of deformed noses made straight and comely by pieces 
transplanted from the shin bone of the patient, after being 
whittled into proper shape and size ; others in which an inch 
or more of the arm bone has been removed for various rea- 
sons and the gap filled also by pieces of the shin bone. In 
fact, this bone seems to be the usual quarry from which can 
be had all the necessary building material for such opera- 
tions. Of the eighteen cases all but one were successful, the 
limb becoming as strong and useful as before the operation. 

In the present paper I propose to describe what has been 
accomplished in some other realms of surgery, which will 
show the remarkable progress made possible, especially 
with the aid of anesthesia, antisepsis,^ and experiment. 


Anesthesia is produced in several different forms. (1) 
General anesthesia — i.e., insensibility to pain of the entire 
body; (9) local anesthesia, similar insensibility of a part of 

^ Reprinted by the kind permission of Harper k Bros, from Harper's 
Magadne for July» 1010. 

s Consult the remarkable paper by President Charies W. Eliot, " The 
Fruits of Medical Researdi with the Aid of Anesthesia and Asepti- 
cism," delivered October 16, 1909 (Ether Day), at the Massachusetts 
General Hospital. Pamphlet No. ix, American Medical Association, 
Chicago. (See p. xiz.) 


the body; and (S) spinal anesthesia, insensibility produced 
by injecting an anesthetic around the spinal cord. 

Firsts general anesthesia. On October 16» 1846, the first 
public demonstration of the use of ether for producing gen« 
end insensibility to pain was made by Morton and Warren 
at the Massachusetts General Hospital, Boston. On No- 
vember 17, 1847, chloroform was first used in surgery by 
Simpson of Edinburgh. On December 11, 1844, Wells had 
inhaled nitrous-oxid gas and had a tooth painlessly ex- 
tracted, but it was not until 1867 that Colton brought the 
method into general favor by a report of twenty thousand 
successful inhalations. 

The relative danger of these general anesthetics b about 
as follows: chloroform produces one death in two thousand 
five himdred cases; ether, one in sixteen thousand; and 
nitrous oxid, one in two himdred thousand. There are 
several other general anesthetics, but all of them have a 
larger death-rate than ether and chloroform. Nitrous oxid 
is by far the safest anesthetic, but the difficulty has been 
that one cannot perform long operations with it on account 
of the danger from asphyxia. To a certain extent this can 
be remedied by administering oxygen with the ether. Re- 
cently some surgeons have performed even very long oper- 
ations by this method. Possibly this may prove to be a very 
important advance in practical anesthesia.^ 

Secondy local anesthesia. In 1884, as a result of experi- 
ment upon animals (for what prudent man would be willing 
to have a new drug which might blind him appUed to his 
eye without such a proof of its harmlessness?), Koller first 
introduced cocain in the surgeiy of the eye. From this 
beginning its use has become greatly broadened. We now 
inject a solution first into the skin itself and then into the 
subcutaneous tissue, and, by means of this ^* infiltration'' 
method, can perform even large operations. About 1891, 

^ Crile and others have since perfected this method so that it is now 
(1014) extensively used. 


Schleich in Germany showed the possibility of infiltrating 
the tissues with a very weak solution of one tenth of one per 
cent instead of two to ten or even twenty per cent as had 
been used at first, thus avoiding all the dangers of the 
stronger solutions. 

In 1902, Braun conducted a series of experiments with a 
mixture of cocain and adrenalin. This added greatly not 
only to the duration, but to the safety of local anesthesia. 
Adrenalin is derived from a little body called the adrenal 
or supra-renal gland, which is situated immediately above 
the kidney. Adrenalin was first discovered by Takamine, a 
Japanese physiological chemist, in New York in 1901. 
Accurate experiments upon animals have shown that the 
effect of this powerful agent when administered in a very 
dilute solution is to contract the small blood-vessels in dif- 
ferent parts of the body. But, strange to say, the blood- 
vessels of the lungs are not at all contracted, and therefore 
the supply of blood to the lungs and the function of respira- 
tion are not affected by the adrenalin. By its effect upon 
the blood-vessels elsewhere, however, the anesthetic action 
of cocain is greatly prolonged and also intensified. Hence 
its frequent use. 

Another local use of cocain and several other similar 
drugs has been brought to the notice of surgeons in the last 
few years by Crile and Gushing; namely, the injection of a 
solution of cocain directly into the large nerves of the body 
before dividing them, in the case of an amputation. For 
example, in any amputation above the knee, or at or above 
the shoulder joint, we have to divide nerves which are as 
large as a lead-pencil, or even a little finger. Accurate ob- 
servation both in animals and man has shown that when 
these nerves are divided a great fall takes place in the blood 
pressure, to such an extent in some cases as even to 
threaten life veiy seriously. This dangerous shock is pro- 
duced even when the patient is fully etherized. But it has 
been found that if a solution of cocain is injected into the 


nerves suppljring the arm or the leg dbooe the point at 
which the nerves are to be severed* these large nerves may 
then be divided with impunity and without the least shock, 
since the cocain ''blocks " the sensoiy impulses going to the 
spinal cord and brain when the nerves are cut. 

Third, spinal anesthesia. Lately spinal anesthesia has 
attracted great attention, and has been widely exploited 
by the press, and many inaccurate notions have been pub- 
lished. The facts are as follows: From the initial trials, by 
Coming in America in 1885, there has been developed the 
method which we now know as spinal anesthesia. In 1891 
Quincke, of Kiel, first introduced what we know as ** lumbar 
puncture'*; that is to say, the introduction of a long hypo- 
dermic needle between the vertebrae into the sheath which 
includes the nerves at the lower end of the spinal cord, for 
the purpose of withdrawing some of the cerebro-spinal fluid 
which surrounds the spinal cord and is continuous with that 
within the skull. The object that Quincke had in view was 
that of diagnosis. By this procedure, now constantly used, 
we are able to determine whether, in cases of brain tumors 
and some other conditions, this fluid exists under a higher 
pressure than is normal; whether the fluid contains blood, 
and therefore indicates hemorrhage either around the 
spinal cord or even within the skull; and again, by micro- 
scopic and bacteriological examination, whether the fluid 
contains any bacteria which are capable of producing dis- 
ease. This has now become a well-established method of 
investigating and diagnosticating a number of diseases, the 
most noteworthy, perhaps, being cerebro-spinal and tuber- 
culous meningitis. From the use of the method for diag- 
nosis, however, it was a very easy step to treatment, for by 
the same needle by which one withdraws the cerebro-spinal 
fluid it would be possible to inject various remedies. Thus 
the mortality of cerebro-spinal meningitis has been dimin- 
ished from sixty per cent or even ninety per cent down to 
twenty-five per cent or less by the injection of the serum 


discovered by Flezner and Jobling at the RockefeUer 

Naturally one of the obvious questions would be whether 
the injection of cocain directly into the sheath of the spinal 
cord, thus bringing it into direct contact with the nerves 
from the cord» would not produce anesthesia c^ all the body 
below the point of injection. The answer given by experi- 
mental research was that it would. 

Spinal anesthesia has now reached a stage of practical 
utility. The injection is made into the lumbar region (the 
small of the back) between the vertebrae. Cocain now is 
rarely used, because of its danger. Stovain was used for a 
considerable time. Since then novocain and tropacocain 
have replaced it, as they are found to be much less dan« 

Recently Jonnesco has advocated applying this method 
even as high as between the shoulders, and has thought 
that the danger of stovain was much diminished by the 
addition of a small amount of strychnin to the stovain. 
But experience in a large number of cases has shown that 
Jonnesco's method is far from being devoid of danger. 

One can easily understand that there are dangers pecu- 
liar to this method of anesthesia. A tubular needle is a 
very difficult thing to disinfect thorouj^ily, and infection of 
the cerebro-spinal fluid would be a very serious danger. In 
some cases the needle itself has broken off, requiring a seri- 
ous operation to remove the broken point. Palsy of the 
lower extremities and, curiously enou^, palsy of the mus- 
cles of the eye have followed in a few cases. But the chief 
danger is that of collapse, and especially failure of the 
respiration. The nervous center which governs breathing is 
situated in the spinal cord immediately below the base of 
the skull. The cerebro-spinal fluid, as a rule, circulates 
freely up and down around the spinal cord and into the 
cavity of the skuU. With the patient lying down, and es- 
pecially if the shoulders and head are lower than the rest 


ci the body, the solution of stoviun or cocain, etc.» gravi- 
tates toward this respiratory center, and when the drug 
reaches this center and anesthetizes it, it may easily pro- 
duce collapse and failure of the respiration, which are very 
serious dangers. Even in Jonnesco's own hands, in several 
cases operated on recently in this country, death was only 
averted by the prolonged use c^ artificial respiration. 

In view of all these possible dangers and complications, 
prudent surgeons restrict the use of spinal anesthesia in two 
ways: (1) Hiey are unwilling to inject it at a point above 
the small of the back (Le., the lumbar region) for fear that 
it may reach the respiratoiy center, and (2) they limit its 
use to the exceptional cases in which the use of ether, chlo- 
roform, or nitrous oxid is attended with unusual danger, and 
therefore contra^indicated. Within this limited field spinal 
anesthesia has a distinct value. B^ond this field it may 
hereafter be made less dangerous and therefore more widely 
ai^licable, but that can only be as a result of further ex* 
periment and observation. 

Alluring as it unquestionably is to be able to have an 
operation performed on one's self without the loss of con- 
sciousness — a condition to which there is often a very 
natural repugnance — the preservation of consciousness 
during an operation is a distinct disadvantage in most 
cases. As I said in 1907, ^^to have the patient aware of sur- 
gical emergencies, which frequently arise and which often 
test a veteran operator's skill and resources to the utmost, 
would frequently invite death by the terror which it might 
occasion. Even the usual emergencies of hemorrhage, 
etc., which attend almost every operation and which are 
easily conquered by the surgeon, would frighten most 
patients. The ideal anesthetic, hereafter undoubtedly to be 
discovered by experimental research, vnll abolish pain by 
the abolition of conmousness, biU without danger to life.** 


Surgery cf the Nerves 

I have already alluded above to the blocking of sensation 
in nerves in cases of amputation by the injection of a local 
anesthetic directly into the tissue of the nerve. Twenty 
years ago operations on nerves were very few. At present 
th^ are constantly performed. As long ago as 1863 Phil- 
lipeaux and Vulpian by experiments upon animals proved 
that by uniting nerves which had been divided the function 
of the nerve might be re^tablished. Until these experi- 
ments had proved it, there would be a natural fear that if 
we sewed the two ends of a severed nerve together, the 
needle puncture and the thread, which must remain in the 
nerve for a considerable time, might inflict serious or even 
lasting injury. Indeed, it was supposed at that time that 
very possibly lockjaw might follow; for that lockjaw was 
only caused by a special germ was then unknown. It has 
been proved, however, on animals, that these supposed 
dangers did not follow, but that severed nerves could be 
sewed together without harm. In case a patient in falling 
puts his arm through a pane of glass and the broken glass 
divides the sinews (tendons) and the nerves at the wrist, 
where they lie just under the skin, in view of our present 
knowledge it is the bounden duty of the surgeon who first 
sees the case to sew the divided sinews end to end, and, 
what is quite as important, if not more so, to sew the di- 
vided nerve ends together in order to avoid permanent 
paralysis. If this is done promptly, success is almost the 
rule. Even if this has not been done and the severed nerve 
has remained ununited for weeks, months, or in some cases 
for years, it is possible in not a few cases to restore the 
function of the nerve and ciure the paralysis by sewing the 
ends together. 

One nerve in the arm, the musculo-spiral, so called be- 
cause it winds among the muscles in a spiral fashion around 
the upper arm bone, is peculiarly liable to injury, for in- 


stance, by a stab wound by a pocket-knife or a gunshot 
wound* But the most frequent source of injury to this 
nerve as it winds around the bone itself is fracture ci the 
arm bone about midway between the elbow and the shoul- 
der. In some cases the nerve is torn to such an extent that 
the two ends when they are dissected loose at operation are 
separated by a considerable interval. If this interval is not 
too large, by stretching the nerve above and below the 
point of injury we can bring the ends into contact and sew 
them tc^ther. In other cases, however, the gap between 
the two ends is too wide for approximation of the two ends. 
In this condition there are various ways of accomplishing 
union of the nerve. Among them, in a number of cases, 
surgeons have deliberately laid bare the bone, sawed out an 
inch or more of the bone, and wired the ends of the bone 
together. This shortens the upper arm to such an extent 
that, with stretching, the two nerve ends can be brought 
into contact and held in this position by sewing them to- 
gether; after the wound is dressed splints are then applied 
to the arm as in any ordinaiy fracture. This operation, 
especially if done early enough, is followed by a consider- 
able, and in some cases practically a perfect, recovery of 
function — a useless arm is made useful again. 

The bundle of nerves which originate from the spinal 
cord in the neck and are distributed to the arm are also 
specially liable to injury. Occasionally, in fracture of the 
collar bone, these nerves are seriously injmred. In other 
cases, by a fall on the shoulder — for instance, from a 
bicycle — one or more of these nerves are completely torn 
across. This is the condition which we now know occurs in 
a great many cases of the so-called ** birth palsies,*' in which 
one arm from the time of birth hangs flabby and useless. 
Unless the condition is remedied, it means a useless arm 
during the entire life of the patient. Only within the last 
few years has this condition been recognized as due to rup- 
ture of the nerves, and attempts have been made to remedy 


the serious disability following the injuiy. The nerves have 
been exposed, and where they have been torn apart the 
ends have been sewed together with the veiy gratifying 
result in a number of cases of a partial or, in some cases, 
practically of complete restoration of function of the arm. 

Of course in all of these cases of wound or other injuiy, 
as a rule, the earlier the operation is done the greater the 
prospect of success, but in a number of cases not only sev- 
eral months but sometimes years have elapsed before the 
operation has been performed, and yet restoration of func- 
tion has followed. After the operation, subsequent treat- 
ment by massage and the use of the various electrical cur- 
rents are quite as important as the operation itself, and 
should be persisted in for a year or even two years before 
giving up all hope of success. 

The muscles of the face are all supplied by what we know 
as the seventh or facial nerve. This comes through a canal 
in the base of the skull veiy close to the mastoid process 
(the bony lump behind the ear), emerges from the bone 
just behind the lobe of the ear, and then spreads out fanlike 
over the face, supplying all of its muscles. A stab wound 
or gunshot wound just below or just in front of the ear not 
uncommonly paralyzes one side of the face by destroying 
this nerve trunk. OccasionaUy, unavoidably, in the well- 
known mastoid operation for ear disease, the same nerve 
is injured. Only within fifteen years, by a happy thought, 
first, Ballance, of London, then Kennedy, of Glasgow, Bar- 
denhauer, of Cologne, and a number of surgeons in America 
and elsewhere, have treated this condition surgically, and 
the unsightliness of a face with the usual expression on one 
side, but motionless and expressionless on the other, has 
been remedied. This relief has been made possible in con- 
sequence of the studies of the union of divided nerves in 
animals and the means of their r^^eration — i.e., restora- 
tion to their normal power. 

In the neighborhood of the facial nerve run two other 


nerves of about equal size; one (the hyx>oglossal) going to 
the tongue; the other (the spinal accessory) going to certain 
muscles of the neck. In cases in which the destruction of 
the facial nerve has been so extensive that the two ends 
could not be united, one of these two uninjured nerves just 
mentioned is partly or completely divided, and the end of 
the facial nerve which goes to the muscles of the face 
hitched on to the facial or hypoglossal nerve. In quite a 
number of cases the face has recovered its expression and 
the muscles their ability to contract. 

Surgery cf the Chest 

The surgery of the great cavities of the body — i.e., of 
the head, of the chest, and of the abdomen — has advanced 
at very different rates of progress. The surgery of the abdo- 
men was the first of these three regions to show immense 
progress as a result of the introduction of anesthesia, anti- 
sepsis, and experiment. Only a little over twenty years ago 
did the surgeiy of the head begin to make any serious prog- 
ress. The surgery of the chest, until within the last veiy 
few years, has been almost at a standstill. One reason for 
this is the character of the contents of the chest. They are, 
the esophagus on its way from the mouth to the stomach; 
the lungs covered by the pleura; the heart in its sac (the 
pericardium) ; and the enormous blood-vessels, some con- 
veying the blood from the heart to all parts of the body by 
the arteries (the aorta and its branches), some bringing it 
back to the heart by the great veins (forming the greater 
circulation), and others going from the heart to the lungs 
and coming back to the heart from the lungs (the lesser cir- 
culation). These are the largest blood-vessels in the body; 
they are nearly as large as the thumb, and any interference 
with them is so dangerous that until very recently it has 
never been attempted. 

Moreover, there is another peculiar feature about the 
chest which makes it very dangerous and difficult for sur- 


geons to operate within that cavity. The chest, by means 
of the motion of the ribs and the diaphragm, practically 
acts like a bellows, drawing the air into the lungs through 
the mouth and nose (corresponding to the nozzle) when the 
diaphragm descends and the ribs rise, and expelling the air 
in the reverse way when the diaphragm and the ribs reverse 
their action. If one made an opening in the chest wall, it 
was like ma.king an opening in the side of a pair of bellows, 
but with one serious difference. The air would rush into the 
cavity of the chest through this artificial opening, would 
surround the lungs in the pleural cavity, biU would not get 
inside the lungs to dikate the bloody and the lung itself would 
collapse because suction by the diaphragm and ribs was no 
longer possible. Moreover, pleurisy of a violent and often 
fatal form was always a possibility. And yet there was ur- 
gent need for remedial surgeiy in this region. Patients, 
especially children, very frequently inhale "foreign bod- 
ies," which pass down the windpipe into the great bron- 
chial tubes, going each to its respective lung. They often 
lodge so far down as to be inaccessible through the mouth, 
or even through an opening into the windpipe (trach- 
eotomy). If the foreign bodies are swallowed, they pass 
down the esophagus and may be arrested at any level in 
the chest. Then again frequently pleurisy passes into that 
form in which a large amount of pus (matter) accmnulates 
in the pleural cavity around the lung and should be evacu- 
ated. Abscesses form in the lungs as a result of pneiunonia 
or of other causes. Gangrene of the limg occasionally 
occurs. In consumption great cavities are formed in the 
lungs, which ought to be drained or otherwise dealt with. 
Besides all these there are gunshot wounds, stabs, and other 
accidental injuries. Yet the surgeiy of all these conditions 
was in the most backward state tiU very recently. 

At the meetings of the American Surgical Association 
and the American Medical Association in 1909, several 
papers were read dealing with the surgery of the chest, such 


as sewii^ up the lungs when they have been wounded, 
removing diseased parts of lungs, removing large portions 
of the wall of the chest, etc., with extraordinaiy ease, com- 
pared with a few years before, and with surprising success. 

Urged by the necessity of removing foreign bodies that 
lay in the bronchial tubes, various experimenters at- 
tempted to reach them by direct operations either through 
the chest wall from in front, from behind, or at the side of 
the chest. Experiments were made upon lower J^-nip^ftU to 
see which of these modes of approach was the least danger- 
ous, the most expeditious, and most satisf actoiy, but all of 
them were found to be exceedingly dangerous, and were 
only resorted to when the dangers of not doing anything 
exceeded the dangers of attempting to do something. 

Within a few years, however, what is called "broncho- 
scopy "has been practiced with the greatest success. When 
a tack or other foreign body has been inhaled, we now can 
introduce a long straight tube between the vocal chords 
down the windpipe to the point where the windpipe divides 
into the two bronchi to the right and left lungs, and by 
means of powerful electric Ughts can then see the foreign 
body, and can even pass the tube into the right or the left 
bronchus, and by means of suitable delicate instruments 
passed down through the tube can seize and extract this 
foreign body. This is a vastly less dangerous and vastly 
more successful method than the older one of tracheotomy, 
but as yet relatively few surgeons are masters of the 

When the foreign body, however, is beyond the reach 
even of such an instrument, then the only possible way to 
extract it is through the limg by an opening in the chest. In 
1904, Sauerbruch in Breslau constructed an air-tight cham- 
ber from which the air could be exhausted or compressed 
to any extent. Only the body of the animal was placed in 
the chamber; the head protruded through an opening with 
a rubber collar around the neck so that the animal could 


be etherized from the outside. Inside the chamber there 
was room for the surgeon and his assistants, instruments, 
etc. Control of the amount of exhaustion or compression 
of the air was obtained through an electric motor operated 
from within the chamber, and a telephone gave ready 
means of communicating with those outside. Various mod-^ 
ifications of this have been made, the last by Dr. Willy 
Meyer, of New York. He has shown that the pressure 
of the atmosphere as indicated by the barometer in New 
York varies normally between that at sea-level and that 
which corresponds to an elevation of one thousand seven 
hundred to two thousand feet; but in the chamber he 
has devised to open the chest safely it is only necessaiy 
to exhaust the air to what corresponds to an elevation 
of two hundred and fifty or three hundred feet, about the 
height of many modem ''sky-scrapers.'' In this chamber 
he has removed part or all of one lung in twenty-six dogs> 
with twenty-two recoveries — 84.6 per cent. 

Last year, also, Meltzer and Auer at the Rockefeller 
Institute devised still another method of respiration that 
may possibly render even such a chamber in many cases 
unnecessary. By ''ventilating the lungs," or "tracheal 
insufflation" as it has been called — i.e., by introducing a 
tube into the windpipe and forcing a gentle current of air 
charged with a certain amount of ether vapor into the 
lungs — they have found that all the necessaiy respiratory 
changes of oxygen, carbonic acid, etc., go on, and the ani- 
mal can be kept alive for hours tvUhout any movement 
whatever of the chest in breathing. Utilizing this method. 
Carrel has done some extraordinary work on the aorta, the 
great blood-vessel which carries all the blood from the heart 
to the entire body and in man is as large as the thumb. He 
has divided it at different levels, clamping the aorta above 
and below the point of division to prevent hemorrhage, 
long enough to sew the ends tc^ther, has incised and even 
cut away portions of the aorta, and done other remarkable 


gurgical operations, from which the animals in most of the 
eases reported recovered. 

In February last I saw him thus freely open the entire 
chest from side to side, operate upon the aorta, and man- 
ipulate hearty lungs, and other organs in the chest with the 
same facility and safety as we handle the various organs 
in the abdomen. The operation lasted an hour and a half, 
and an hour later the dog had entirely recovered from the 
ether, and was doing better than a human bdng after most 
capital operations. 

Thus a wholly new chapter in the surgeiy of the chest 
and its great blood-vessels has been opened. 

These advances in the surgeiy of the chest in animah 
will lead quickly to veiy great advances in the surgeiy of 
the chest and its contained organs, the heart, the lungs, 
the esophagus, and even the aorta, in man. In fact, already 
more than a score of cases have been operated on, usuaUy 
in a Sauerbruch chamber. A most extraordinaiy case was 
reported at the German Surgical Congress in April, 1909, 
by Von Eiselsberg, of Vienna. A man stabbled himself 
repeatedly in the chest with a pur of sharp scissors. He 
was brought to the hospital and operated upon in a Sauer- 
bruch chamber within an hour after the accident. He was 
already unconscious, so that no anesthetic was needed, 
was pulseless — in fact, was dying. The chest was opened 
widely, the lungs drawn aside; the heart and its great 
blood-vesseb could be readily seen and manipulated. It 
was discovered that the scissors had made a considerable 
rent in one of the great blood-vessels carrying the blood 
between the heart and the lungs. This was sewed up with 
six stitches, and the man survived for fifty-four days — 
almost eight weeks. This is the first operation on man of 
this kind ever recorded. Had the operation been done 
deliberately, with all the necessaiy antiseptic precautions, 
there is little doubt that the man would have survived; 
but when life is ebbing away with the lapse of eveiy 


moment, one is between the Scylla of too great haste and 
therefore possible infection, and the Chaiybdis of too great 
delay for proper didnf ection while the patient is dying from 

Occasionally the blood suddenly forms a clot in the 
great arteiy carrying the blood from the heart to the lungs, 
thus arresting more or less completely the aeration of the 
blood. This accident is necessarily fatal, sometimes so 
quickly that nothing can be done. But in most of the cases 
death does not follow for fifteen to forty minutes, and occa- 
sionally for an hour or more. After experiments upon 
animals, which he reported in 1907, Trendelenburg, of 
Leipzig, believed it to be possible to rescue some of these 
relatively slow-dying cases. The next year one of his 
patients, a woman of seventy, suddenly collapsed, and was 
evidently dying. Fortunately he lived only eight minutes 
away. He was called by telephone, and in eighteen minutes 
after the first symptom the operation was b^^un, and in 
five minutes more the chest had been opened, the artery 
exposed and opened, and the clots removed. This was the 
firat case of this kind ever operated upon« But the patient 
was too old and too far gone for recovery. 

The second operation was done by Trendelenburg's 
assistant, this patient living for fifteen hours. Kruger has 
recently reported a third case, who lived for five and a 
quarter days. 

With constantly improving tedmic, success is sure to 
follow before long, just as it has followed many early 
failures in operations for typhoid perforation, goiter, cancer 
of the stomach, and many other operations. Thus from 
1849 to 1875 the stomach had been operated on for cancer 
twenty-eight times with twenty-eight deaths. The twenty- 
ninth case, in 1875, was successful. The operation has 
gradually become more and more successful as our technic 
has improved, till now the great majority of the patients 


That valvular disease of the heart may in time come 
within the domain of surgery I have little doubt. 

Some cases^of cancer cf the esoi^iagus, also, heret(tfore 
absolute abandoned to death, have been operated on» 
but with only fair success thus far.^ 

Ulcer and Cancer cf the Stomadi 

To attempt to i^ve any idea of the advances made in the 
surgery of the various organs contained in the abdomen in 
the short ipace at my d]q[>06al is hqpdess. I can only 
coDfflder a few special points. 

Among the most important are ulcer and cancer of the 
stomach. It is now well established that most cases of 
cancer of the stomach originate from a chronic ulcer. This 
ulcer has two distinct dangers besides that of a posdble 
cancerous degeneration. Not seldom the ulcer eats into 
one of the large blood-vessels, just as in consumption the 
same process in the lung qpens one of the large blood- vesseb 
ofthelung. In either case a more or less prof use and always 
dangerous hemorrhage takes place. 

In cases of chronic trouble with the stomach, surgeons 
are not now disposed to wait until a profuse hemorriiage 
announces the presence of an ulcer, but they open the 
abdomen and then open the stomach, search for the ulcer 
and treat it. This avoids or remedies, as the case may be, 
not only hemorriiage, which is so dangerous, but another 
danger, namely, that the ulcer will eat its way entirely 
through the wall of the stomach and suddenly allow the 
contents of the stomach to escape into the general cavity 
of the abdomiKi. This is invariably followed by a fatal 
peritonitis unless operation is undertaken at once. The 
number of cases in which, after such a perforation, opera- 
tion has been done is now veiy large, and when it is done 

^ See the p^>er on "The Influence of Antivivisection on Character" 
(p. 284) for a later and fuller account of the recent progress on the surgery 
ol the chest by means of experiments upon animals. 


promptlyy within say a few hours, the percentage of recov- 
eries is veiy large. 

Cancer is veiy apt to attack the stomach at the orifice of 
exit called the pylorus, where the food passes into the upper 
intestine. When cancer develops here, this opening is grad- 
ually narrowed until no food can escape from the stomach. 
All that the patient swallows remains in the stomach, 
undergoes decomposition, and creates the greatest possible 
distress in addition to the pain of the cancer. In these 
cases, if we cannot remove the cancer, we make an opening 
in the stomach and an opening in a nearby loop of the upper 
bowel, sew the two openings together, and in that manner 
side-track the food past the obstruction precisely as the 
Welland Canal passes around the obstruction to naviga- 
tion by Niagara Falls. 

If we could only make a diagnosis of cancer in the very 
earliest stages, it would be possible in most cases to remove 
the cancer and have patients recover. In a very consider- 
able number of cases parts, and in a few cases all of the 
stomach have been removed, the esophi^us and the intes- 
tines have been sewed together, and while many of the 
patients have died, a number have recovered and lived for 
months and in some cases for a much longer period. In the 
past few years the percentage of recoveries has increased 
veiy encouragingly. 

The diiSculty is in making a diagnosis before the disease 
has advanced to the stage when^ by adhesions to neighboring 
organs and infection of the glands, removal of the cancer vnth 
any hope of permanent success is practically past. When a 
case of marked indigestion has been rebellious for a niun- 
ber of weeks, surgeons are more and more inclined to open 
the abdomen and by actual inspection and palpitation of 
the stomach to determine whether it is cancerous or not. 
In these early stages the removal of the cancer is not an 
extremely dangerous operation. Such an ^^exploratoiy" 
operation is fully justified, for if no cancer exists, prac- 


tically all of the patients recover, and not seldom the 
surgeon, even if he finds no cancer, does find adhesions, 
ulcer, or other difficulty which can be remedied. Ulcer 
precedes cancer in about two cases out of three, and prob- 
ably even more; perforation of the stomach by an ulcer 
occurs in about one case in five. The average of recoveries 
after perforation, if operated on veiy promptly, is about 
three out of four; later it b reversed — three out of four 
die by reason of the delay. 

Surgery cf ihe Intestines 

Cancer is not by any means limited to the stomach. 
It not uncommonly attacks the intestine. Here again an 
"exploratory" operation is often necessaiy. If we can 
catch the disease in its early stages, we can remove large 
portions of the intestine and by various devices can restore 
the continuity of the intestinal canal and save the patient's 
life. The only safety for the sufferer in these cases lies in 
early operation. When operation is deferred, we are almost 
sure to find that it is impossible to remove the disease, and 
we have to resort again to the device above spoken of, to 
side-track the intestinal current by making one opening 
above the cancer and another below it and sewii^ the two 
openings together. As in the similar operation between the 
stomach and the upper bowel, life is not permanent^ 
saved, for the cancer remains, but life is prolonged for 
months and sometimes even for years, and the immense 
comfort that is given to the patient fuUy justifies the pro- 
cedure, which is not very dangerous. 

In not a few cases of accident, when, for example, the 
wheel of a wagon runs over the abdomen, though the 
abdominal wall may not be ruptured, rupture of the intes- 
tine takes place, allowing its contents to escape into the 
general abdominal cavity. So, too, when a stab wound or a 
gunshot wound is received, a similar escape of intestinal 
contents may take place. In these cases, where the evi- 


deuce from the symptoms is fairly dear, so safe is abdom- 
inal surgeiy in these antiseptic days, we do not hesitate to 
open the abdomen, seek for the point of rupture, or of the 
wound, and either, if it be small, sew it up in the proper 
way, or, if too large for this procedure to be safe, we cut 
out the torn portion of the intestine and unite the two ends. 
In fact, it is surprising that of twenty-five feet of the intes- 
tine almost one-half has been successfully removed. In 
gunshot wounds, as many as eighteen perforations have 
been closed and the patient has recovered. 

One of the most desperate, frequent, and fatal compli- 
cations of typhoid fever is perforation of the bowel. In 
typhoid fever ulcers form in the intestines, and in a large 
percentage of cases, as in ulcer of the stomach, an ulcer 
eats into a blood-vessel, producing profuse hemorrhage 
which may destroy life, or if it eats a hole entirely through 
the intestinal wall, the deadly intestinal contents then 
escape. It is serious enough to operate on a healthy patient 
who has had a hole torn in his intestine, but when in addi- 
tion to the perforation we have to operate on a patient who 
is desperately ill with typhoid fever, even the stoutest heart 
might well shrink from it. 

The first operation for such a perforation ever done was 
by lifikulicz, of Breslau, in 1884. The mortality originally 
was about three out of four. Several hundred cases oper- 
ated on have now been published, and the mortality has 
gradually fallen to about sixty-five per cent. Inotherwords, 
one out of three recovers instead of one out of four. This 
seems a terrible death-rate, and at first blush one might 
almost believe that no operation ought to be done if two 
out of three or three out of four die; but remember the alter- 
native — if no operation is done, practically a hundred out 
of every hundred die. Operation, therefore, distinctly saves 
every case that recovers. A few hospital surgeons, very 
favorably situated as to facilities, have been so fortunate 
as to save about one half of the cases operated on. In 


seventy cases of operation in children under fifteen, col- 
lected by Jopson and Gittings, there were only thirty-one 
deaths — a recovery rate of fifty-six per cent. With speedy 
operation (always if possible within a few hours) and suit- 
able methods, the next few years will undoubtedly show a 
general mortality of only fifty per cent or less, and every 
case that recovers owes his life to modem antiseptic 

Heretofore, in searching for perforations or ruptures, 
surgeons have constantly drawn part or often all of the 
intestines temporarily outside of the abdominal cavity, 
without a thoi^t that the patient would suffer any harm 
by such a procedure. We used no especial care in manipu- 
lating the intestines, particularly when haste was needful 
on account of hemorrhage. 

But Crile has studied on animals the deleterious shock 
produced by any rough handling of the bowel or by pres- 
sure upon it, and Cannon, of Harvard, has recentiy rein- 
forced Crile's conclusions. They have shown that mild> 
moderate, or rough handling of the bowel (always under an 
anesthetic of course) produces very pronounced shock 
proportionate to the roughness of such handling. 

Hence in all abdominal operations nowadays — e.g., for 
appendicitis, etc. — surgeons are most careful to handle 
the intestines with the greatest gentieness, and never dis- 
place them outside the abdomen if it can possibly be 
avoided, with the result that the mortality of abdominal 
surgeiy is always steadily decreasing. 

Surgery of the Liver and OaU-Bladder 

The liver is liable to stab wounds, gunshot wounds, and 
also to be torn when a patient is run over by a wagon, cart, 
etc. Besides the danger of infection by bullets, dirks, etc., 
which is veiy great, the danger of death from hemorrhage 
always exists. Hence if there is good reason to believe 
that the liver has been wounded or torn, the abdomen 


should be opened very quickly, the hemorrhage arrested, 
and the abdommal (i.e., the peritoneal) cavity cleansed. 
If done promptly, a very large percentage of the patients 
recover. To show how in this as in other operations in- 
creasing experience, by disclosing errors and establishing 
better methods, results in a diminishing rate of mortality, 
in 1887 the mortality was as high as sixty-six per cent; 
in operations done between 1805 and 1905 it has fallen to 
forty-four per cent. 

Non-cancerous tumors of the liver have been very suc- 
cessfully removed in the last few years, sixty-three out of 
seventy-six early cases having recovered, while in later 
cases the results are even better. Cancer of the liver, how- 
ever, is practically always fatal. 

The gall-bladder, which is simply a receptacle for the 
bile, has now been successfully removed in so many cases 
that it is rather puzzling to know why we have any such 
organ. The bile in this storage reservoir is often infected 
by bacteria. Such an infection is probably the rule in 
typhoid fever, and even many years after the patient has 
recovered from such a fever the bile is stiU infected and not 
seldom becomes a serious menace to life. In addition to 
other causes, typhoid and other germs frequent^ cause 
gall-stones to form in the gall-bladder. These are concre- 
tions formed from the solid constituents of the bile. Often 
th^ are only one, two, or three in nimiber, but in some 
cases they number hundreds and even thousands of very 
small stones. Women are far more liable to gall-stone dis- 
ease than men — in the proportion of three or even four to 
one. Tight lacing has been accused of bdng one of the 
most potent causes. 

If gall-stones cause trouble, they should be removed by 
operation. In competent hands this is now attended with 
a mortality of from one and a half to say five per cent, 
depending on existing complications. 



Rupture or perforation of the stomach or intestine, from 
whatever cause, unless speedily operated on, always sets 
up a general peritonitis. Until within the last few years, 
when this diagnosis was made, it was equivalent to a 
verdict of death. Even if operation was done the patients 
almost all died. But in the last few years, thanks especially 
to the American surgeons. Murphy, of Chicago, and the 
late Dr. George B. Fowler and his son. Dr. Bussell S. 
Fowler, of Brooklyn, this almost hopeless picture has been 
changed to one of great encouragement. It is needless to 
enter into details of the treatment, but it may be sum- 
marized for popular knowledge in this way: It has been 
found that the poison of pus (matter) in the abdomen is 
much more readily absorbed in the upper part of the abdo- 
men next the diaphragm, and much less readily absorbed 
in the lower part of the abdomen. Hence we raise our 
patients suffering from peritonitis in bed, sick as they gen- 
erally are, to two thirds or three fourths of the sitting 
position, and then slowly for hours flush the interior of the 
intestine with salt solution delivered very gradually but 
almost continuously. As much as two or three gallons of 
the salt solution may be absorbed within the twenty-four 
hours. At the present time, therefore, even when the 
specter of general peritonitis is present, the case is by no 
means hopeless, but, thanks to the greatly improved treat- 
ment of modem days, and also to American surgeiy, it is 
full of hope.^ 

Hernia cr Rupture 
One of the commonest surgical conditions in the human 

^ Dr. R. S. Fowler writes me tliat by this method and by earlier oper- 
ating, his mortality has gradually fallen from thirty-ei^t per cent to 
seven per cent in his last one hmubed cases as against about seventy-five 
per cent before this treatment was adopted. (1914.) 


body b hernia or rupture. In the wall of the abdomen 
there are a few openings to let arteries and veins and other 
structures pass out of or into the abdominal cavity* When 
these apertures — or ^^rings," as we call them — are not 
secure^ closed aknuckle of bowel often protrudes through 
the opening. This is a hernia or rupture. For many years 
after I graduated, in 1862, qx>radic attempts were made 
to remedy this condition by operation, so as to spare the 
patient not only the life-long annoyance of a truss, but the 
ever-present danger that more bowel would be forced sud- 
denly throu^ the opening in the wall of the abdomen as a 
result of sudden muscular strain in lifting something heavy, 
and become gripped by the opening, or what we know in 
surgery as '* strangulated"; that is to say, so constricted 
that gangrene of the bowel and death were inevitable unless 
relief was afforded. 

Until the antiseptic method was thorouj^ily grounded 
and established in the profession, no really successful 
methods to cure this condition had been devised, for the 
reason that until the advent of antisepsis every surgeon 
was afraid, and rightly afraid, of opening the abdominal 
cavity on account of the exceedingly great danger, or, in 
fact, almost certainty of peritonitis. About twenty-five 
years ago, however, attempts began to be made to remedy 
the condition, innumerable new methods were devised, 
until finally we are now in a position to advise almost every 
sufferer from this condition, unless too old or suffering from 
some complication which would make it undesirable, to 
havea radical operation done. How little danger now at* 
laches to the operation is seen in the fact that in a series 
of twenty-two himdred operations by Coley there have 
been only four deaths. Three of these occurred in the 
twelve himdred children; in the one thousand cases in 
adults, only one patient died — a mortality of only one 
tenth of one per cent. Well did Lord lister at the Royal 
College of Surgeons on March 29, 1897, say of a similar 


result: ^'An achievement like that is enough to cause 
gladness in the heart of any man who loves his fellow 

All this is a result of the antiseptic method, which in 
turn is the result of animal experimentation. 

Surgery of the PiiuUary Body or Hypophysis 

About at the crosang of two lines, one drawn horizon- 
tally backward between the eyebrows, and the other 
horizontally across between the temples, is a cup-shaped 
depression in the base of the skull a little smaller than the 
tip end of the little finger. In this is lodged a peculiar gland 
or body called the hsnpophyffls or pituitary body. It is one 
of that strange class of *Muctless glands" which exist in 
different parts of the body, among which are the thymus 
gland at the very lowest part of the neck in front; the 
thyroid gland, which when it becomes enlarged is called a 
goiter; the parathyroid bodies, three or four little bodies, 
each the size of a grain of wheat, situated behind the thy- 
roid; the adrenal or suprarenal bodies at the upper end of 
each kidney, from which adrenalin is derived, and several 
other glands which have no tube or duct which can deliver 
their secretion into the drculation. The ''internal secre- 
tions" which they are believed to produce, and which 
reach the blood current throu^ the absorbents, formerly 
were thought to be of no importance, but now we know 
that these secretions, in some cases at least, are of supreme 

If in animals the pituitary gland is removed, death fol- 
lows in the course of a short time. If all four of the littie 
parathyroids are removed, death takes place before long. 
If all of the thyroid is removed, we have a condition which 
gradually develops into cretinism. In disease of the adrenal 
gland the skin becomes of a bronze color, etc., and disease 
of the thymus f requentiy results in sudden death. More- 


over, the pancreas (which in animals we call the sweet- 
bread) may be involved, and through that in turn the 
liver, so that this whole series of glands, small as most of 
them are, forms a most complicated system which we have 
only very recently b^^un to imderstand. What little we 
have learned has been chiefly by animal experimentation, 
and this little emphaazes the need for more and more 
knowledge, till we shall know thoroughly their functions, 
and what we can do to cure or, still better, to prevent their 


This little gland, the pituitaiy body, though so very 
smaU, consists of a front and a back part, which are appar- 
ently wholly different in function. When an extract of the 
back part, which is supposed to be the most active, is 
injected into animals, it does harm, yet when the same 
part is entirely removed from the brain of an animal, no 
harm apparent^ results. The front half, however, has 
been foimd to be essential to life. Certain changes in the 
gland, if th^ arise in childhood, are followed by tremen- 
dous overgrowth of the body (giantism), together with a 
deposit of much fat over the body. If the condition arises 
in an adult, there follows clumsy thickening of the hands, 
feet, features, etc. (acromegaly), and in other parts of the 
body an infantile condition is produced. 

Surgery, it is astonishing to say, has dealt successfully 
with timiors of this small but important organ hidden in an 
almost inaccessible qx>t. In a few cases such tumors have 
been successfully removed in man with great relief, if not 
real cure of the ^mptons.^ 

Almost the same stoiy may be told of all the other duct- 

^ A large number of operations have been done — one hundred and 
seven by Dr. Harvey Gushing alone with only eleven deaths, less than ten 
per cent (February, 1914). The results have been most encouraging, 
especially the restoration of sight, if the operation is not too long delayed. 
Strange to say, its extract or active {winciple has been found to be of the 
greatest value in chfldlurth — an unexpected boon. (See the BriUsk Med" 
ieal Jaunwl, April 85, 1904, p. 90.) 


less glands which are so closely mterrelated. GraduaUy, 
by experiment upon animals, we are learning what the 
functions of these important structures are, and by removal 
of parts or all of these glands, or by other experiments upon 
them, we are getting a glimmering knowledge of their 
interrelation, their importance, and the possibility of deal- 
ing with them medically and surgically. I believe that in 
the near future our ignorance about these various structures 
will be dispelled and the surgery of these glands will 
develop with rapid strides, greatly to the advantage of 
many patients. 

Tetanus or Lockjaw 

Among the many other subjects crowding upon me for 
description, I can only select one more — tetanus or lock- 
jaw. In 18S4, 1 remember my surprise and almost incredu- 
lity when I saw it asserted that Nicolaier, by experiments 
on mice, rabbits, and guinea-pigs, had discovered that the 
germ or bacillus of tetanus was found in the earth, and 
especially in that around stables and on highroads trav- 
eled by horses. It was such a novel idea that I was little 
inclined to accept this as a possible origin of lockjaw, but 
time has proved that ^colaier was right. For many years 
we had known clinically that stablemen, above all others, 
8u£Fered from lockjaw, but why this was so we did not 
understand. Now we know that this little microbe 
finds its chief abiding-place in and around stables, high- 
roads, etc. 

The popular belief that a wound from treading on a 
rusty nail is very likely to cause tetanus is quite correct. 
This is not because it is a nail or is rusty, but because by 
^jring on the groimd it has become infected with the germs 
of lockjaw. Moreover, as the punctured woimd caused 
by the nail bleeds but little and this blood dries up and 
excludes the air, the most favorable conditions for the 


development of tetanus exist, f ot« as Eitasato, the Japan- 
ese bacteriologist, proved, the absence of oxygen is most 
favorable to the growth of this germ. 

The germ itself looks very much like a tack. So virulent 
is it that its toxin in doses of l-200,000th of a teaspoonful 
will kill a mouse. It has been found by experiment that the 
poison is carried up to the spinal cord, not by the absorb- 
ents or the blood-vessels, as are other poisons, but through 
the motor nerves themselves. Fortunately, an anti-poison 
or antidote has been developed, but so prompt is the action 
of the poison that in an animal, two minutes after the 
injection of a fatal dose of the poison, twice as much of the 
remedy is required as if it had been administered with the 
poison; after eight minutes ten times the amount, and after 
ninety minutes forty times the original amoimt is neces- 
sary. This antitoxin is entirely harmless. 

As a result of antiseptic methods lockjaw is now almost 
unknown except after neglected wounds, instead of being 
terribly frequent as it formerly was. When it is feared, the 
antitoxin is used as a preventive, and when it has devel- 
oped, as a cure. 

In animals — for naturally horses su£Fer enormously 
more frequently than man — the same antitoxin is used. 
In one hundred and sixty-three horses that had operations 
performed on them, but were protected by the antitoxin, 
not one developed tetanus, whereas of eight cases impro- 
tected by the antitoxin, five developed tetanus. The re- 
sult of all these experiments has been that what is known 
as '*Fourth-of-July tetanus*' has been enormously dimin- 
ished, chiefly by the antitoxin used as a preventive. 

It is well known now to every intelligent person that a 
large number of cases of tetanus develop from injuries, 
especially those received from toy pistols and blank car- 
tridges in celebrating the Fourth ci July. The following 
table from the ^'Journal of the American Medical Associa- 
tion'' gives the number of persons injured, the number of 


deaths, and the number of deaths from tetanus alone for 
several years past: — 





: (Mai) 



































The popular movement for a ^^sane Fourth of July 
was b^^un by the doctors, and fortunately is spreading 
vigorously. Too long we have had an ^insane'' Fourth 
with its thousands of victims. Even the small Chinese 
"fire-cracker" has caused 10,781 serious injuries in the last 
seven years! ^ 

^ The splendid lesulto of this campaign — conducted above all by doc- 
tors, mark you — is shown by the fact that the total number d injuries 
over the entire country, which was 5808 in 1896 was only 947 in 1912; and 
instead of 415 deaths from lockjaw alone in 1998 there were but seven in 
1912 and 4 in 1918. 



The subject naturally divides itself into tluee parts: 
(1) the conditions before the introduction of the anti- 
septic method by Lister; (2) the means by which his 
system was discovered and developed, and (S) the condi- 
tions existing after the introduction of the method, i.e., 
at the present time. 

My surgical life covers all three of these periods since I 
graduated in medicine in 1862, some years before Lister 
b^an his work. I have, therefore, fought my way from 
the horrors of the preantiseptic days up to the delights of 
the present antiseptic days.* 

7. The Preantiseptic Period 

In my early surgical experience every accidental wound 
and every surgical operation (that is, an intentional 
wound) was followed by inflammation and suppuration, 
i.e., the discharge of ''pus" or ''matter." This was not 
only constantly expected as an unavoidable process of 
nature and beKeved to be needful for healing, but was 
constantly reali2sed. Hence the pus was called "laudable" 
pus! How well I remember forty years ago at the begin- 
ning of each winter's session when I was the asdstant of the 
late Professor Samuel D. Gross, his turning to the orderly 
and saying to him, "To-morrow, Hugh, I shall lecture on 

^ Reprinted by pernuBsion of the Council in Defense of Medical Re- 
search of the American Medical Association. It is Pamphlet No. xn in 
their series. See list on p. xnc 

> In this article I use the word *' antiseptic" as the more p<^ular one to 
indude also the as^tic method. 


suppuration. Gro over to the hospital in the morning and 
get a cupful of pus for my lecture." Pus» mark you, was 
always '^on tap/' so to speak, though the Uttle hospital 
contained only a dozen beds! 

Perhaps the best way to ^ve the reader an idea of wound 
conditions at that time will be to describe an ordinaiy 
operation and its results. We will suppose that it is an 
amputation. The surgeon approached the operation with 
the clean hands of a gentleman. He usually wore an old 
coat covered with dried blood spots from previous service. 
His finger-naUs very likely were long and no special atten- 
tion was given to them. The instruments were taken out 
of a velvet-lined case and were as clean as ordinaiy table- 
knives would be. The operation was done without any 
preliminary cleansing of the skin other than to remove 
any visible dirt. If the knife happened to fall on the floor 
it was picked up, rinsed in a basin of ordinaiy water, and 
used as it was. The marine sponges then always used were 
washed clean in ordinaiy water and used over and over 
again even after being saturated with foul pus. The blood- 
vessels were tied with ordinaiy silk; one end was cut short, 
the other one hung out of the wound. After an amputation 
6t a fleshy thigh I have often seen twenty-five or thirty 
such "li^tures," as they are called, gathered into two 
bundles, one at each end of the wound. The flaps were then 
sewed together with an ordinaiy needle and thread and the 
stump dressed first with an old rag (which, however, would 
be ordinarily clean) or scraped lint spread with some ample 
grease. Over that would be placed some other rags, lint, 
cotton, or other dresdng, and finally a bandage. During 
the Civil War these greasy dresdngs gave place to simple 
cold-water dressings. 

By the second day the patient would begin to have 
considerable fever. By the third or fourth the temperature 
would rise to what we now know (for medical thermome- 
ters were not in general use in that early day!) to about 


103^ 104*" or 105*" F. Then we would poultice the wound. 
Every few hours the patient would be disturbed, a new 
poultice put on to replace the old one, now cold, foul and 
ill-smelling, and by this time bathed with pus. I have 
often seen the pus escaping by the tablespoonful and the 
wounds alive with squirming maggots resembling chestnut 
worms. By this time also it was hoped that the silk liga- 
tures, with which the arteries had been tied, had literally 
^* rotted " loose, and each one of them was gently pulled on 
to the discomfort of the patient. Care was taken that the 
ligatures with knots tied on them (in order to distinguish 
those that secured the large blood-vessels) should not be 
pulled on severely until probably the tenth or twelfth day. 
Meantime the patient was tossing about the bed with pain, 
with thirst, without f^petite, without sleep except such as 
morphin would secure. This drug at the same time dried up 
all the secretions, producing constipation and other evils. 
By about the tenth to the fourteenth day, suppuration 
having been fully established and quantities of pus pouring 
from the wound, the fever would subside and the wound 
would begin slowly to heal. Of course, the healing could 
not be complete so long as the silk ligatures were still 
protruding from the wound. Sometimes they did not 
become detached for even months or years, but more com- 
monly all of them would rot loose in from ten days to three 
weeks. When the silk ligatures on the large blood-vessels 
came away, if the healing process had formed in the blood- 
vessels a firm dot, which had become adherent, and, so to 
speak, "^corked" it up, all went well. But, as veiy fre- 
quently happened, when the ligature and the rotten end 
of the artery were pulled off and there was no clot to act 
as a stopper, ''secondary^ hemorrhage" followed. This 
often came on after the patient's wound had been dressed 
and the surgeon had left, and, if so, very likely the first 

^ So called to distinguish it from ''primary hemorrhage," Le., the 
bleeding occurring at time ct the accident or operation. 


notice that the nurse had that anythmg was wrong would 
either be the gasping for breath of the patient or his moans 
and cries> or sometimes by the blood which had not only 
saturated the mattress, but had even appeared in a pool 
on the floor. How fatal were such hemorrhages may be 
seen from the fact that in ^9S5 cases of hemorrhage in the 
Civil War 61.7 per cent of the patients died.^ 

I shall never forget one night about ten days after the 
battle of Gettysburg, when it was my bunness as ''officer 
of the day" to attend to all emergency cases. That night 
I was called to five cases of secondary hemorrhage. To 
indicate what a difference there is between modem and 
ancient conditions, in the thirty-four years since October, 
1876, when I b^an the practice of the antiseptic method, 
I have not seen as many cases of secondary hemorrhage 
as I treated in that one night. 

It was a rare thing for any patient after such an opera- 
tion to get well under three or four weeks, and it was 
not uncommon for healing to be delayed for three or 
four months, so that, in spite of the great mortality, the 
wards of the hospitals were cimibered with convalescent 
patients. The rare case in which healing took place by 
''first intention," i.e., at once, was recoimted as a triimiph. 
To-day it is precisely the reverse. The case in which heal- 
ing does not occur primarily and at once is regarded as a 

But a prolonged convalescence was the least of the 
evils to which a patient was subject. A large majority of 
the woimds were followed by eiysipelas, by lockjaw, or by 
blood poisoning, and hospital gangrene sometimes became 
a veritable plague. Gangrene in various forms during the 
Civil War was rife and often fatal. In 12563 cases 11412 
patients died, a mortality of 45.6 per cent.' In one variety 
which was frequent, hospital gangrene, a simple flesh 

^ Med. and Surg. HiH, War of the Rebellioth part m, Surg, vol., p. 765. 
* Ibid., p. 824. 


wound scarcely larger than the bullet which made it, 
became larger and larger till a hand would scarcely cover 
it and it would eat into the tissues until one could put half 
his fist into the sloughing cavity. 

Of 505 cases of lockjaw (tetanus), 451 were fatal, a 
mortality of 80.3 per cent.^ I^emia or blood poisoning 
was terribly frequent and almost as fatal as it was frequent, 
for of 2818 cases in the Civil War 2747 patients died, or 
97.4 per cent! * When a joint was opened or wounded, the 
result was frequently either amputation or death, or not 
uncommonly amputation and death. Of 2382 woimds of 
the knee-joint alone for which amputation was performed 
1212 patients died, a mortality of 51 per cent, and of 973 
similar woimds for which amputation was not performed 
591, or 61 per cent, of the patients died.' 

Fractures, as most people know, are divided into two 
kinds: simple fractures in which the skin is unbroken, 
and compoimd fractures in which the broken bone pro- 
trudes through the skin. Simple fractures nearly always 
heal with relatively little pain and slight fever; but in 
the preantiseptic days when the skin was broken and the 
bone protruded two out of three patients with these 
compoimd fractures were sure to die. 

Moreover, certain r^ons of the body were forbidden 
ground unless the surgeon were absolutely compelled to 
invade them. No one would open the head if he could 
possibly avoid it. No one would dare to make an incision 
through the abdominal wall into the cavity of the abdomen 
unless a bullet or a dirk had gone before him and opened 
the way. The reason for our hesitation was that death 
stalked behind us. 

How eloquent is the statement of Sir Samuel Wilks,^ 
that '"the change came home to me in an almost startling 

^ Med, and Surg, HiiL War of the ReheUion, part m, Surg, vol., p. 819. 

* Ibid,, p. 858. * Ibid,, p, 887. 

* RayalL Com. on ViyiaectioD, 1907-H)8, Q. 7750. 


manner from what I witnessed in the pati^mortem room. 
Some time before [i.e., before Lister's discoveries], when 
reading a paper on pyemia [blood poisoning], I had no 
difficulty in collecting one hundred cases which had 
occurred within a veiy short time previously, when sud- 
denly this terrible malady disappeared — it was gone never 
to return." So, too, lockjaw (tetanus), except in accidental 
cuts that have been n^lected and have not received proper 
surreal care, has almost completely disappeared. Again, 
at the present day one practically never sees erysipelas 
after hospital operations; and in order to find illustrations 
of hospital gangrene to show to my classes for the last 
thirty years I have had to rely on pictures from the 
'"Surgical Histoiy of the Civil War'* and other similar 
sources, for I have not seen a single case in private or hos- 
pital practice since I first adopted the antiseptic method 
in 1876. 

//. The Discovery and DevdopmerU of the Antiseptic Method^ 

Neither time nor space will allow me to describe the 
many earlier steps. Schwann, in 1887, in studying putre- 
faction, reached the conclusion that it was not the gases 
of the w, especially the oxygen, as was then universally 
believed, that caused putrefaction, but organic particles 
which floated in the air and which could be destroyed by 
heat. In 1854 SchrOder and Dusch showed that putrefac- 
tion did not occur in organic fluids in flasks if the air enter- 
ing the flasks was simply filtered through cotton wool. 
Pasteur, in 1864, showed that it was necessary neither to 
heat the air nor thus to filter it, for if the sir merely entered 
through a tortuous tube in which the dust could settle 

*■ See Lord Lister's Collected Papers, Oxford. 1909 (l&ter reference to 
these Collected Papers will be indicated simply by ''Lister, vol. — , 
p.—"), the Lister number of the Brii. Med. Jour,, December 13, 1902. 
celebrating the fiftieth anniversary of his receiving his degree. Lister's 
**Haxley Lecture" in the same journal, October 6, 1900, and Cameron's 
''Lister and the Evolution d Wound Treatment, etc.," Glasgow, 1907. 



before it reached the flmd no change took place in the 
fluid, or if flasks containing a material which would putrefy 
were left open in a place where the air had been undisturbed 
sufficiently long to allow the dust to settle, as, for example, 
in a cellar, no decomposition took place and no growth 
api)eared in such fluids. 

Lister naturally was profoundly impressed by these 
studies of Pasteur and he proceeded to make many experi- 
ments to confirm or disprove them. Among them I will 
only relate the following: ^ Lister filled four glass flasks 
one third full of urine and 
drew out the neck of each 
flask with a spirit lamp into 
a tube less than one twelfth 
of an inch in diameter. Three 
of these long open tubes were 
then bent at various angles 
downward, while the fourth, 
equally narrow, was left short 
and vertical. Each flask was 
then boiled for five minutes, 
after which th^ were left 
with the ends of the small 
necks still open. Throu^ 

these open mouths the air, including its oxygen, would 
pass out during the heat of the day and pass in during the 
colder n^ht. The boiling was to kill any organisms in the 
liquid or on the sides of the glass. The object of the bend- 
ing of the three necks downward was to allow the air to 
pass in and out, but to intercept the particles of dust, 
which, according to the germ theory, caused putrefaction. 
The germs, being heavier than air, could not rise in the 
bent necks and reach the urine. The fourth neck, however, 
being short and vertical, not only allowed the air to pass 
in and out, but gave a very narrow but real opportunity 

^ lifter, vol. n, p. 173; Brit. Med. Jour., 1871, vol. n, p. ftSUk 

FUBk with Flaak wltb the 

the open tabe open tube bent 
TertioaL downwarda. 


for dust and germs to fall into the liquid. If any of these 
were living organisms, they could produce putrefaction. In 
a short time the vessel with the short vertical neck showed 
growths of mold and the liquid changed its color, showing 
chemical changes; but in the three flasks with bent necks 
the urine after jour years was entirely unaltered. A year 
after the commencement of the experiment a little of the 
urine in one of the flasks with a bent neck was poured into 
a wine-glass; it had not lost its original acidity and normal 
odor and a microscope showed not the minutest organism. 
In two days it was most offensive, and under the micro- 
scope already teemed with organisms. The three flasks 
with bent necks were subjected to a further severe and 
rather amusing test. Two years after the beginning of the 
experiment Lister had to transport them from Gla^ow to 
Edinburgh on the railway when he was appointed to the 
chair of surgeiy in Edinburgh. He took charge of these 
flasks himself, "'nursing them carefully," as he says, *'to 
the amusement of my fellow travelers." In the drive from 
the station to his house the violent rocking of the carriage 
churned up the contents of the flasks till the upper part 
was full of a frothy mixtiu^ of this proved putrescible 
liquid with the atmospheric gases; yet after two years more 
no decomposition had taken place. 

The explanation of this convincing experiment was 
simply this: The germs in the atmosphere could not rise 
against gravity in any of these tubes bent downward and 
so could not gain access to the urine. This easily preserved 
a decomposable fluid for four years, although the air passed 
in and out freely every day. But the urine in the flask with 
the straight but very narrow neck in a few days had under- 
gone decomposition. The only difference between the 
flasks was that the three bent tubes prevented the en- 
trance of the germs, though not of oxygen or other 
constituent of the air, while the straight but equally nar- 
row tube allowed the germs to enter Uirough in very 


small quantities^ and yet these few grew and produced 

In order still further to confirm this experiment, how- 
ever. Lister tested these bent tubes by the condensed beam 
of li^t which Tyndall had used and found that they were 
optically empty.* 

These experiments convinced him that it was not the 
oxygen or any other gas in the air that caused inflamma- 
tion and suppuration, but that these were caused by 
minvie organisms stispended in the air. In dressing a wound, 
then, the problem was how to exclude not the air or its 
oxygen, which was impossible, but how to exclude the 
organisms in the air. This could be done by applying a 
dressing saturated with some material capable of destroy- 
ing the life of these germs. This was the basis of the anti- 
septic method.* It must be remembered that at that time 
we were wholly ignorant of what now everybody knows, 
that there are hundreds of different kinds of germs or 
bacteria. Even the greatest scientists were then groping 
in the dark seeking for the li^t by observation and 
especially by experiment. 

About that time Lister was much struck with an account 
of the effect of mingling phenol (carbolic acid) with the 
sewage of the town of Carlisle, England.* He proceeded, 
therefore, to experiment with it in compound fractures. 
I have already stated how fatal a compound fracture was in 
those days. Indeed, Mr. Syme, the great Edinburgh 
surgeon, predecessor and father-in-law of Lister, was 
inclined to think that, on the whole, "it would be better if 
in every case of compound fracture of the leg amputation 
were done without any attempt to save the limb.** The 
marked success which followed Lister's dressing these 

* See l^dall's channing lecture on " Dust and Diseaae," in FragmenU 
€f Science, 1871» p. 275. D. Appleton & Co. 

s Lister, vol. n, p. 87; Brii, Med. Jour., 18(rr» vol. n, p. 246. 

' lister, yol. n, p. 8; Lancet, 1867, vd. i, pp. 826, 857, 887, 507, vol. n, 


compound fractures ^* with carbolic acid led him then to 
experiment with its uses in abscesses.^' '»' This was fol- 
lowed again by such remarkable success that he was led 
to try it in accidental wounds and finally to intentional 
and extensive wounds> i.e., surgical operations.^ 

Practically the progressive introduction of the antiseptic 
^stem from compound fractures up to deliberate surgical 
operations was one vast experiment in the human living 
body — an experiment justified^ as all the world well 
knows» by its splendid and continuing results. Yet when 
in 1880 or 1881 Lister wished to make additional experi- 
ments on animals to perfect his method still further^ so 
stringent was the law in England that he was obliged to 
go to the Veterinary School at Toulouse» France.* 

Like many surgeons> Lister had noticed the fact that a 
needle or a bit of glass would often Ue for an indefinite 
period in the body without producing inflammation or 
pus, but that a bit of silk or linen thread was sure to pro- 
duce pus. He belie ved the reason was that the thread was 
porous and that its interstices contained these germs which 
no one had then seen and identified, and that they gave 
rise to decomposition and produced the pus. So, Lister, 
from his previous experiments with phenol (carboUc acid) 
believed that if the thread with which an artery was tied 
were steeped in phenol and both the ends of the silk were 
cut short, it might be left in the wound without producing 
any inflammation or suppuration. The woimd could then 
be closed at once — an immense gain, for it would heal at 
once. *' Before applying these principles on the human 

* Lister* vol. n. p. 8; Lancgt, 1867, vol. i, pp. 828, 857, 887, 507; vol. 
n, p. 95. 

* Lister, vol. n, pp. 8, 8«, 87; Brft.Med. Jour,, 1887. vol. n, p. 246. 

» Lister, vol. n. pp. 88, 86, 42; Brit Med. Jour,, 1867, vol. n, p. 246. 

< Lbter, vol. n, pp. 188, 199, 256, ete.; Brii. Med. Jour., 1871, vol. n, 
p. 225; Edinburgh Med. Jour., 1871-72, vol. xvn, p. 144; ibid., 1875-76, 
vol. XXI, pp. 193, 481. 

» Lister, vol. n, p. 281; Lancet, 1881, vol. n, pp. 868, 901; Tram. Inter' 
not. Med. Cong., London, 1881, vol. u, p. 869. 


subject^" he says» ^'I thought it right to test them on one 
of the lower animals/'^ Accordingly^ December 12, 1867» 
he tied the great blood-vessel in the neck of a horse, having 
steeped the silk for some time in a solution of phenol. 
Both ends were cut short, the wound was entirely sewed 
up and treated with phenol dressings. Ten days after the 
operation the dressings were removed, the woimd was 
healed, and there was no pus! Thirty-nine days after the 
operation he carefully examined the arteiy which he had 
tied. The operation was a complete success, the blood 
current had been entirely arrested and the thread had been 
covered in by dense fibrous tissue. ''Thus encouraged,'* 
he says, ''I felt justified in canying a similar practice into 
human surgeiy."' Januaiy 29, 1868,' he saw a woman, 
fifty-one years old, with an aneurysm as lai^ as a large 
orange in the upper part of the left thigh. (An aneuiysm, 
I should explain, is a dilated portion of an arteiy, the yield- 
ing of the wall being due to disease of the wall of the blood- 
vessel. This dilatation continues to increase in size till 
finally the wall of the arteiy is so thin that it bursts and the 
patient dies from hemorrhage.) On the following day he 
tied the woman's arteiy with a piece of silk which had 
been steeped for two hours in phenol. 

The woimd was treated like that in the horse's neck, 
i.e., both ends of the ligature were cut short, the woimd 
agfdn entirely closed and a phenol dressing applied. The 
patient was immediately relieved of the pain she had pre- 
viously experienced; she had no fever, the pulse was 
practically normal the entire time, and ''her appetite, 
which had been absent during the four weeks of agony that 
preceded the operation, returned two days after it."* She 
made a perfect recovery. November SO, ten months after 

* Lister, vol. n, p. 64; Laneet^ 1867, vol. n, p. 668. 

* Lister, vol. n, p. 65; Lancet, 1867, vol. n, p. 668. 

* Lister, vol. n, p. 88; Lancet, 1869, vol. i, p. 451. 

* Lister, vol. n, p. 89; Lancet, 1869, vol. i, p. 451. 


the operation, she suddenly expired. Fortunately, Lister 
himself had the opportunity of making the pod mortem. 
He found that her death was due to the bursting of a 
similar aneurysm inside of the chest. Examining the art^y 
which he had tied, he f oimd that the silk had almost all 
disappeared, but that there was a little fluid aroimd the 
remnant of the ligature, which probably would have 
developed into a small abscess and might have caused great 
mischief had she Uved longer. This, therefore, suggested 
to him the expediency of substituting for the silk some 
other substance which would be more readily absorbed.^ 

In Philadelphia, years before. Dr. Physick had already 
tried animal ligatures made of buckskin, Dors^ those of 
kid. Hartshorn had used parchment, and Bellenger and 
Eve the tendon of the deer, but for various reasons these 
had all been abandoned. Lister determined to try catgut. 
Although he had great confidence in the use of catgut 
steeped in a solution of phenol, yet he says^ *'in order to 
put the antiseptic animal ligature to the test, I made the 
following experiment," for only by experiment in an 
actual living body of animal or man could the question 
whether it was actually safe or not be surely answered. 
December SI, 1868, he tied the right carotid artery in the 
neck of a healthy calf at several places with different kinds 
of animal ligature, including catgut. All were cut short 
except one end of the catgut, which was purposely left 
three quarters of an inch long to determine what would 
become of this foreign material. The woimd was com- 
pletely closed and dressed. After ten days the dressings 
were removed and the wound foimd quite dry. Thirty 
days after the operation Lister says, on dissection, he was 
struck with the entire absence of any infection or inflam- 
matoiy thickening in the vicinity of the blood-vessel. On 
exposing the artery itself he was greatly disappointed at 

^ Lbter» vol. n, p. 89; Lancet^ 1869, vol. i, p. 451. 
* Lister, vol. n, p. 93; Laned, 1869» vol. i, p. 451. 


first to find the ligature to all appearance still there and as 
large as ever. On more careful examination, however, he 
f oimd that this apparent ligature was not the catgut liga- 
ture at all, but that this ligature had been transformed into 
bands of Uving tissue, making the artery not weaker, as 
silk often did, but stronger than ever at the point where it 
was tied. The knots had disappeared and also the three- 
quarters inch of catgut piurposely left. Everything had 
been absorbed. 

Even one not a surgeon can see what an enormous differ- 
ence in rapidity of healing without inflammation, pain or 
other serious disturbance of the body this use of catgut 
with inunediate total closure and healing of the woimd 
provided. Before Lister, the old ligatures hanging out in 
bimdles were always inviting infection, suppuration, 
erysipelas, lockjaw, blood poisoning, hospital gangrene 
and death. No patient was absolutely safe till the wound 
was absolutely healed and this often required weeks or 
months. With the catgut ligature, both ends being cut 
short, the wound closed at once, and, the ligature being 
absorbed, the woimd healed in less than a week, not un- 
commonly in three or four days, with little, if any, immedi- 
ate suffering and without any ultimate danger of those 
many serious complications above mentioned. But no one 
not a surgeon can appreciate to the full the meaning of these 
brief words. While the patient made a smooth and speedy 
recoveiy without complications, the surgeon slept the 
uninterrupted sleep of the just, seciure against wearing 
anxiety on accoimt of sudden hemorrhage or insidious 
infection. The heart-breaking tragedies which often made 
the surgeon wish he were a hod-carrier or even in his grave 
are now but specters of a horrid past. 

As I have said, we had no idea at first of the enormous 
variety and different characters of the germs. In his early 
studies on putrefaction, Lister spoke of them in a general 
way as "'germs," because the various species of plants (for 


they are plants and not animalculfie) had not been dis- 
tinguished. Now there are scores and even hundreds of 
known varieties. Many of these simply cauise putrefaction 
or decomposition and are not in themselves capable of 
giving origin to any particular disease. Other varieties^ 
each one of which causes a special disease and can cause no 
other disease, have been isolated and identified. Some of 
these germs cauise medical diseases, with which I have 
nothing to do here. The germs of lockjaw, tuberculosis, 
anthrax (wool sorters' disease), erysipelas, glanders, etc., 
are among the most virulent foes with which the surgeon 
has to contend. 

How have these been identified and how do we prevent 
their entrance into the system of the patient? The process 
is very simple to describe, but very complicated and diffi- 
cult practically. Letus take the case of lockjawf or instance. 
A peculiar kind of germ, looking a good deal like a tack 
with a straight body and a large head at one end, was dis- 
covered by animal experiments by Nicolaier in earth and 
dust in 1884.^ In 1889 Kitasato, the Japanese bacteriolo- 
gist,* first obtained it in pure culture (i.e., free from all 
other germs), former experimenters having failed because 
they did not know that it only grows well when oxygen 
is excluded. 

But how do we know that this tack-like germ and it alone 
is the cause of lockjaw? 

I^t, in a patient ill with lockjaw, this particular 
bacillus or germ must be discovered. 

Second, a pure culture of it must be produced; that is 
to say, the tetanus bacillus must be separated from all 
other germs and cultivated by itself. 

Third, some of this pure culture of tetanus immixed 
with any other germs whatever must be injected into an 
animal to see point-blank whether this particular bacillus 
will produce lockjaw. 

1 Deut$eh. med. Woek., 1884, no. 5ft, p. 842. * Ibid.. 1889, no. 81. 


Fourth, from the body of this animal the same germ 
that was injected must be recovered. 

fifth, with a pure culture of this recovered bacillus the 
cycle must be begun over again and completed sufficiently 
frequently to assure the experimenter that the connection 
between the disease and the germ is not accidental, but 
^»ential and invariable. 

Sixth, no other germ used in the same way must pro- 
duce lockjaw. 

In this same manner the germs that produce inflanmia- 
tion and suppuration, which are the ever-present danger to 
the surgeon, have been identified, and also, what is equally 
important, the places where they and many others exist. 
In this way we have determined the fact that, while there 
are some in the air, they are few in number and so constitute 
a small though a real danger. But the places where they 
are f oimd and are most dangerous are on the skin and 
clothing of the patient, the hands of the surgeon and 
especially under his finger nails and at the roots of his 
finger nails, on instruments, dressings, silk, cal^t, and 
other things used for ligatures; in fact, practicaUy every 
material that one can think of. We know now how all- 
pervading they are. We know, too, that phenol (carbolic 
acid), corrosive sublimate and other chemicals, or that 
boiling for a certain time, or heating to a certain degree 
and for a certain time, will kill these germs. Thousands of 
such painstaking researches in test-tubes and by many 
other bacteriologic methods have been carried out all over 
the world by men either wholly unpaid, working for the 
love of truth and love of their fellow creatures, or paid but 
mei^r pittances. Then when a discovery seems to have 
been made comes the needful, the finally convincing, the 
unavoidable experiment — in a living body itself . The only 
question is should Lister have made this final test first on a 
horse and a calf, or on two human beings? Can any one 
with a sane, well-balanced mind hesitate as to the answer? 


in. The Remits 

The results of the establishment of the antisq)tic method 
have been so extraordinary as to be incredible were it not 
for ample testimony the world over. They have been 
already stated in part> but a few words more must be 

At present before an operation is b^un the patient's 
skin, the surgeons' and the nurses' hands are scrupulously 
disinfected, sterile gloves are usually worn and every person 
is clothed in a disinfected gown. The instruments, dress- 
ings, ligatures, everything that is to come in contact with 
the woimd, is carefuUy disinfected. Disinfected gauge 
'^sponges" are used once and then discarded. 

It is almost impossible for any one not a surgeon to 
understand how different are the results from this radical 
change of methods. No change of climate from fierce mid- 
winter storms to lovely summer breezes or autumn golden 
harvest could be greater. Most woimds now heal within a 
few days, often one might almost say without the patient's 
being sick. Compound fractures and opened joints heal as if 
there had been no break in the skin. Arteries can be tied 
anywhere without fear of secondary hemorrhage. The ab- 
domen is now fearlessly opened. 

A woman with an ovarian tumor no longer has an opera- 
tion postponed imtil it is veiy dangerous but inevitable, 
but by early operation is relieved almost without danger, 
even from tumors so large as to weigh twice as much as the 
patient herself. When I was assistant to Dr. Washington 
Atlee in the late sixties, before the antiseptic period, two 
out of three of his ovariotomy patients died, yet he was the 
then most famous operator in America. Now any siu'geon 
who loses more than five out of one hundred is looked at 
askance by his coUei^ues, and many, many hundreds of 
cases have been operated on with a mortality falling even 
below one per cent. There is not an organ in the abdomen 


that has not been attacked; organs which formerly when 
diseased could not be touched because death was almost 
sure to follow are now operated on eveiy day. In fact as I 
once described it> the abdominal cavity is almost the sur- 
geon's playgroimd! The stomach, the intestines, the liver, 
the gall bladder, the pancreas, the spleen, the kidney, every 
organ is operated on, and with extraordinary success. Did 
space permit, a more detailed statement could be given, 
but it could scarcely be more convincing. 

In obstetrics the same happy results have followed the 
introduction of the antiseptic method. Puerperal or 
''childbed" fever, which not imcommonly used to kill one 
half or two thirds or even three fourths of the women in 
the maternity wards of a hospital, now is practically un- 
known except in the neglected cases brought into the hos- 
pital at a late date, and the pre-antiseptic general mortality 
in maternity cases has been reduced from ten per cent or 
more to one per cent and less. Brain tumors, abscesses 
and other diseases of the brain formerly inevitably caused 
death, for we never dared to touch them. Now the number 
of recoveries is very large. Compoimd fractures now have 
a mortality of two or one per cent or less, instead of over 
sixty per cent, and now very rarely require amputat;ion; 
and amputations formerly followed by death in one half 
the cases have a mortality of ten per cent or less. In 
general, both the soldier and the sailor are provided with 
the first-aid packet, which contains an antiseptic dressing. 
This has enormously diminished the mortality of wounds 
received in battle. 

Perhaps no better evidence of the value of the anti- 
septic method in civil life can be adduced than the results 
in three hospitals. In Munich^ the General Hospital was 
excessively unhealthy. Blood poisoning was very frequent 
and hospital gangrene, which had appeared in 1872, had 
become annually a more and more frightful scourge imtil 

^ Lister, vol. n, p. 248; Brit. Med. Jour., 1875» vol. n, p. 769. 


1874» when eighty per cent of all wounds that occurred in 
the hospital^ whether accidental or inflicted by the surgeon, 
were attacked by it! At the beginning of 1875 Nussbaum 
introduced the antiseptic treatment. From then on till 
Lister's visit, presumably in the summer of 1875, not one 
single case of hospital gangrene had occurred and only one 
case of blood poisoning, and that a doubtful one. Erysipe- 
las was rare and mild instead of being very prevalent and 
severe, and the convalescent wards, which formerly had 
been filled to overflowing, stood practically empty. In 
Halle,^ Volkmann was operating in an extremely unhealthy 
hospital in small, overcrowded wards, with the toilet rooms 
opening directly into them and a large drain running 
directly underneath. It was so bad that it had been con- 
demned to demolition. After his introduction of the anti- 
septic method in 187£, no single patient suffering from com- 
poimd fracture in which conservative treatment was 
attained had died dther from the fracture or from a neces- 
sary amputation, nor was there a single death from second- 
ary hemorrhage or gangrene. No case of blood poisoning 
had occurred for a year and a half, though sixty amputa- 
tions had been done. Hospital gangrene had entirely dis- 
appeared and erysipelas was extremely rare and mild. 

Perhaps, however, the most extraordinary success was 
obtained by lister' in his own wards in Glasgow. Lister 
was professor of surgery in Glai^w from March, 18^, 
till the autimm of 1869, but in that brief period he intro- 
duced measures that were absolutely revolutionary. The 
Royal Hospital in Glai^w was overcrowded, and in some 
parts of the building the conditions were so frightful that 
the wards had to be entirely shut up for a time. Lister's 
own account of this is interesting. He says: — 

A crisis of this kind occurred rather more than two years ago 
in the other male accident ward on the ground floor, separated 

^ lister, vol. n, p. 250; BriL Med. Jovr,, 1875, vol. n, p. 769. 
* Lister, vol. n, p. 124; Lancet, 1870, vol. i, pp. 4, 40. 


from mine merely by a passage twelve feet broad, where the mor* 
tality became so excessive as to lead, not only to closing the ward» 
but to an investigation into the cause oi the evil, which was pre- 
sumed to be some foul drain. An excavation made with this view 
disclosed a state of things which seemed to explain sufficiently 
the unhealthiness that had so long remained a mystery. A few 
inches below the surface of the ground, on a level with the floors 
of the two lowest male accident wards, with only the basement 
area, four feet wide, intervening, was found the uppermost tier 
of a multitude of coffins, which had been placed there at the time 
of the cholera epidemic of 1849, the corpses having undergone so 
little change in the interval that the clothes they had on at the 
time of their hurried burial were plainly distinguishable. The 
wonder now was, not that these wards on the ground floor had 
been unhealthy, but that th^ had not been absolutely pestilen- 
tial. Yet at the very time when this shocking disclosure was 
being made, I was able to state, in an address which I delivered to 
the meeting of the British Medical Association in Dublin,^ that 
during the previous nine months, in which the antiseptic ^stem 
had been fairly in operation in my wards, not a single case of 
pyemia [blood poisoning], erysipelas, or hospital gangrene had 
occurred in them; and this, be it remembered, not only in the 
presence of conditions likely to be pernicious, but at a time when 
the unhealthiness of other parts of the same building was attract- 
ing the serious and anxious attention of the managers. Supposing 
it justifiable to institute an experiment on such a subject, it 
would be hardly possible to devise one more conclusive. 

Having discovered this monstrous evil, the managers at once 
did all in their power to correct it. . . . But besides having along 
one of its sides the place of sepulture above alluded to, one end of 
the building is coterminous with the old cathedral diurchyard, 
... in which the system of ''pit burial" of paupers has hitherto 
prevailed. I saw one of the pits some time since. . . . The pit, 
which was standing c^n for the reception of the next corpse, 
emitted a horrid stench on the removal of some loose boards from 
its mouth. Its walls were formed on three sides of coffins piled one 
upon another in four tiers, with the lateral interstices between 
them filled with human bones, the coffins reaching up to within a 
few inches of the surface of the ground. This was in a place imme- 
diately adjoining the patients* airing ground, and a few yards 
only from the windows of the surgical wards! And the pit which 
I inspected seems to have been only one of many simOar recep- 

' Lister, vol. n, p. 45. 


Udet, for the '^LftDcet** of September 25 ^■«-**"- a 
copied from one of the Glaagow newqwpcrB* that ^the Deaa «j| 
Guild is taid to have oonqmted that five thooaand bodies were 
taring in pits, holding eighty eadi* in a state of deeompositioii, 
around the '"^^ " 

When to all this is added the fact that the laige fever 
hospital was separated from the soripcal hoqntal by only 
ei^t feet, that Lister's hospital ci near^ six hundred beds 
was cramped in area and almost always fall to ovoflow- 
ingy and that he was operating, it mi^t almost be said, 
in a chamal house, yet that those wards were continnooaty 
and conspicuously healthy and enjc^ed for ^thiee years 
immunity from the ordinary evils ci surgical hoq[>itals 
under circumstances which but for the antiseptic qrstem 
were specially calculated to produce them," ^ we stand 
convinced by such a huge unintentional experiment on 
man himself. 

Were not results such as these su£5cient to justify the 
experiments on animals as related by Lister himself and 
here quoted, by which such blessed relief has been brought 
to mankind? 

What was seen in Glai^w has occurred all over the 
world. The surgical revolution of the last thirty years 
is the most momentous in the entire history of surgeiy. 
In every science — chemistry, engineering, botany, phys- 
ics, electricity — the era of precise experimerUs has been 
the era when enormous and constant prepress has been 
made. Medicine is no exception. We have closely studied 
disease by various observational methods, and clinical 
observation for two thousand years had slowly advanced 
our knowledge up to a certain point. Then experimental 
research, which employed methods of precision, varying 
conditions at will, noting the different results, and multi- 
plying the experiments at will instead of waiting, it might 
even be years, imtil Nature's second experiment occurred, 

* Lister, vol. n, p. 126; Lancet, 1870, vol. i, pp. 4, 40. 


began its work; and in the past thirty years experimental 
research has produced a more fruitful harvest of good to 
animals and to mankind than the clinical observation 
during thirty preceding centuries. 

But we are far from having attained perfection. In 
medicine and in surgery many problems of disease and 
death are still awaiting solution and can only be solved 
by the experimental method. A number of organs in the 
body are as yet inaccessible and others have f imctions of 
which we know little or nothing. Many operations ought 
to be bettered in method and in results. The cause of 
many diseases^ such as cancer, scarlet fever, measles, 
whooping-cough, etc., are as yet unknown. To dispel all 
this ignorance and discover a cure for all these and other 
diseases is the earnest wish of wise and humane experi- 
menters the world over. Shall the community aid these 
humane life-saving efforts, or shall they by restrictive 
legislation call a halt and let death slay our fellow creatures 
and especially our dear children? The answer is clear. It 
will never be other than an emphatic no to the latter cruel 



In 1905 I had made all my arrangements to do an 
operation on a Thursday morning. Among my assistants 
was Dr. C. On Wednesday morning he telephoned and 
said he was not feeling very well and that I had better 
engage some one to take his place. This I did, giving no 
special thought to the matter, supposing it was an unim- 
portant passing illness. At ten o'clock that same night I 
was startled by a telephone message that if I wished to 
see Dr. C. alive I must come at once! In a few minutes I 
was there, but he was already unconscious. As I sat beside 
him and his weeping young wife, who soon expected to 
become a mother, how I longed for some means by which 
the hand of death could be stayed; but he died in less than 
thirty-six hours from the time that he was seized with 
epidemic cerebro-spinal meningitis. 

On June 16, 1909, Charles E. Hughes, Jr., son of the 
Governor of New York State, and president of his class» 
was graduated at Brown University. A few weeks earlier 
he had been suddenly seized with a violent attack of the 
same disease — epidemic cerebro-spinal meningitis. When 
some of the fluid around his spinal cord was removed by 
^'lumbar puncture" — that is, pimcture of the spinal 
canal in the small of the back by a hypodermic needle — 
there settled to the bottom of the test-tube a half inch 
of pure pus ("matter"). No medical man famiUar with 
this terrible disease would have thought it possible that he 
could recover when such a condition existed. But in 1907, 

^ Reprinted, by pennissionfrom the Ladies* Home Journal, April, 1910, 
and of the Council on Defense of Medical Research of the American 
Medical Association. It is Pamphlet no. xrv in their series. (See p. xiz.) 


midway between the death of Dr. C. and the case of young 
Hughes, Drs. Flexner and Jobling, of the Rockefeller In- 
stitute, had discovered by researches on animalft alone a 
serum against this disease. Three doses of this serum 
were administered also by "" lumbar puncture" to young 
Hughes. Within twenty-four hours after the first dose his 
temperature fell to normal. The pus disappeared after the 
second dose and he soon recovered and was able to take 
his degree in the presence of his proud father. The trag- 
edy in the case of Dr. C. was averted, a useful life was 
fifpared, and a family made happy. 

In discovering this serum Dr. Flexner experimented 
on twenty-five monkeys and one himdred guinea-pigs. 
Many of these animals themselves had been cured by the 
use of the serum. Having, therefore, found it effective in 
ftniTTifLla he proceeded to test it on human beings. Before 
the introduction of the serum, medicine was almost help- 
less. Whatever treatment was adopted seventy-five to 
ninety patients out of one himdred were sure to die. In 
two years this serum has been used in this coimtry and in 
Europe in about one thousand cases. In these one thousand 
cases the mortality has dropped, in different series each 
under the care of the reporter, to thirty, twenty, ten, and 
even to seven in a himdred. If we take the mortality of 
the days before the serum treatment was used at seventy- 
five per cent, and the mortality since it was discovered, say, 
at twenty-five per cent, there is a clear saving of five hun- 
dred human lives! Not only have five hundred human 
lives been saved in these first one thousand cases, but for 
all time to come in every thousand five hundred more 
human lives will be saved. 

Moreover, we must not forget that these thousands 
who would die were it not for Dr. Flexner's serum had 
families and friends who would have been filled with 
sorrow, and, in case it was the bread-winner of the family 
whose life was lost, would have had to suffer the depriva- 


tions and pangs of poverty and the community have had 
to assume their support. 

Let me now put |t plain, straightforward, common-sense 
question. Which was the more cruel : Doctor Rexner and 
his assistants who operated on twenty-five monkeys and 
one himdred guinea-pigs with the pure and holy purpose 
of finding an antidote to a deadly disease and with the 
result of saving hundreds, and, in the future, of thousands 
on thousands of human lives; or the women who were 
"fanned into fuiy" in their opposition to all experiments 
on living animals at the Rockefeller Institute, "no matter 
how great the anticipated benefit"? 

If these misguided women had had their way, they 
would have nailed up the doors of the Rockefeller Institute, 
would have prevented these experiments on one hundred 
and twenty-five animals, and by doing so would have 
ruthlessly condemned to death for all future time five 
hundred human beings in every one thousand attacked by 
cerebro-spinal meningitis! 

If your son or daughter falls ill with this disease, to 
whom will you turn for help — to Flexner or to the anti- 

Of these one hundred and twenty-five animals, as a rule 
those which died became unconscious in the course of a 
few hours and remained so for a few hours more till they 
died. They suffered but little. When they died they left no 
mourning families and friends. They left undone no deeds 
of service or of heroism to either their fellows or to the 
human race, as the human beings whose lives were rescued 
by their death may do. But these deluded women had their 
minds so centered on the sufferings of these one hundred 
and twenty-five animals that their ears were deaf and their 
hearts steeled against the woes and the sufferings of thou- 
sands of human beings, their families, and their friends. Is 
this common sense? Are not human beings " of more value 
than many sparrows"? 


Less than two years ago their first baby was bom to 
a young doctor and his wife in New York City. Scarcely 
was the child bom before it b^an to bleed from the nose, 
the mouthy the gums, the stomach, and the bowels. It was 
a case which we know as ** hemorrhage of the newborn/* 
which attacks about one baby in every thousand. It is 
very frequently fatal» and in treating it up to that time 
physicians practically groped in the dark, trying one rem- 
edy after another, but, alas, too often in vain! 

The bleeding continued. This poor little baby soon 
showed the pallor which accompanies severe loss of blood. 
It lost all appetite, was suffering from high fever, and, 
finally, by the fourth day the physician in attendance told 
the parents frankly that the child could live only a few 
hours. Then, in the dead of the night, the father wakened 
Dr. Carrel, one of the assistants in the Rockefeller Insti- 
tute. The father lay down alongside of his firstborn. The 
artery of the pulse in the father's arm was laid bare and 
sewed end-to-end to a vein in his baby's leg, and the blood 
was allowed to flow from father to child. The result was 
most dramatic. A few minutes after the blood b^an to 
flow into the baby's veins, its white, transparent skin 
assmned the ruddy glow of health, the hemorrhage from 
every part of the body ceased instantly and never returned, 
and, as Dr. Samuel Lambert, who reports the case, puts it, 
there was no period of convalescence; immediately before 
the operation the baby was dying; immediately after the 
operation it was well and strong and feeding with avidity. 
That baby to-day, after two years, as I know personally, 
is a splendid specimen of a healthy child. 

Perhaps my readers may see nothing very wonderful 
in this, but we surgeons know that it is one of the most 
remarkable recent achievements in surgery. For many 
years we have been trying to devise a method by which 
we could sew severed blood-vessels end-to-end without 
danger to the patient. The difficulty has always been 


that» no matter what were the methods employed, the 
blood nearly always formed dots at the roughened ring 
idiere the two ends <rf the divided blood-vesselswere sewed 
together. These dots passed up to the heart and into the 
lungs of the patient and produced pneumonia, so that the 
old method ot transfusion <rf blood has been practically 
abandoned for years. Dr. Carrd woriced out his new 
method on the blood-vessels ot dead human beings, and, 
when it seemed to him to be satisfactory, put it to the proof 
on two living dogs, and then used it in living human beings. 
It is now in use everywhere. 

Moreover, Dr. Crile, ot Cleveland, who has so splen- 
didly enlarged our means of coping with disease, has used 
the same method in another way. When patients come 
to him too weak to be operated on and ordinary tonics and 
food do not strengthen them, he has transfused the blood 
from husband, father or son, and thus given the patient 
sufficient strength to bear the operation. He has used even 
a more striking method. For example when a woman has 
to be operated on — say for cancer of the breast — and 
is so weak that the shock, the anesthetic and the loss of 
blood would probably turn the scale against her, he has 
had the husband lie down alongside of her, has sewed the 
artery of the pulse of the husband to a vein in his wife's 
leg and allowed the blood to flow. In a few minutes, when 
she has become strong enough, he has etherized her and 
proceeded with the operation, starting or stopping the 
flow of blood according to the varying needs of the patient. 
At the end of the operation, through the new life-blood 
that has been given her, the patient has been in better 
condition than when the operation began. These methods, 
too, are now in successful use by other surgeons. 

Let me again put the plain, straightforward, common- 
sense question: Who is the more cruel: Dr. Carrel, in 
devising this life-saving method of transfusion of blood 
by experimenting on two living dogs, and saving through 


himself and other surgeons scores of lives already » and even 
thousands in the future; or the women who would shackle 
him, shut up the Rockefeller Institute and thrust these 
poor patients into their graves? Does not the work of 
Drs. Flexner» Jobling and Carrel and their assistants not 
only justifiy the existence of the Rockefeller Institute, but 
also bid us tell them Grodspeed in their mission of mercy, 
and give them and those engaged in similar blessed work 
all over the world our confidence, encouragement and aid? 
Is it just, is it fair, is it Christian to call such an institution 
a *'hell at dose range," as the Rockefeller Institute is called 
in a pamphlet written by a woman and distributed by anti* 

I suppose that in this day of general intelligence scarcely 
any person, obliged to submit to an operation, would 
be willing to have it done by a surgeon who did not 
use antiseptic methods. These methods we owe to Lord 
Lister, of London, still living in his eighty-third year. Few 
of my readers, however, know how enormous the contrast 
is between the days before Lister's discoveries and the 
present. I was graduated in medicine in 18G2. The anti- 
septic method was adopted by various surgeons, we may 
say roughly, between the years 1875 and 1880. Prior to 
1876 I practiced the old sui^iy, but ever since then the 
new antiseptic method. I x>Assed through the horrible 
sui^ry of the Civil War, when blood poisoning, erysipelas, 
lockjaw, hospital gangrene, and all the other fearful septic 
conditions were eveiyday affairs. In five hundred and 
five cases of lackjaw during the Civil War four himdred 
and fifty-one patients died. In wounds of the intestines 
the mortality was ninety-nine out of a hundred. In sixty- 
six cases of amputation at the hip-joint, fifty-five patients 
died. In one himdred and fifty-five cases of trephining, 
ninety-five patients died. After the war for some years I 
was an assistant of Dr. Washington L. Atlee. A more 
careful surgeon I never saw, but two out of every three of 


his patients died. There are now many surgeons who can 
show series of hundreds and even thousands of cases of 
ovariotomy and other abdominal operations with a mor- 
tality of only five in a himdred, and some of only one in a 
hundred. After "clean" operations — that is, with no 
"matter** present — blood poisoning, lockjaw, and erysip- 
elas are wdl-nigh unknown, and I have not seen a single 
case of hospital gangrene in the thirty-five years since I 
adopted the antiseptic method. 

One of the most common operations is amputation of 
the breast for cancer, in which now we do far more exten- 
sive operations than formerly. These operations are fol- 
lowed by permanent cure in more than one half of the 
patients operated on early, and rarely more than one or 
two women in every hundred die. Recovery also follows 
in a few days and not seldom with but little pain, instead 
of several weeks or even months of great suffering as 
before the days of antisepsis. 

All of this wonderful improvement we owe to Lord 
Lister and the new science of bacteriology which treats 
of "bacteria'* or "germs.** Both Lister's work and that 
of the bacteriologist are and must be absolutely founded 
finally on e3q>eriments on animals. The laboratory was 
of use, but, in order to be absolutely certain that he was 
right he had to experiment on a few animals — the only 
possible way of achieving positive knowledge.^ 

Who, I ask, are the more humane: Lord Lister and 
other siu^eons who have made these life-giving, pain- 
saving experiments on animals, or those who — if they 
had succeeded in the past in prohibiting such experiments 
— would have compelled surgeons in 1910 to continue to 
use the same old, horrible, dirty methods of surgery as in 
the days before Lister, and thus to offer up hecatombs of 
human lives to the Moloch of antivivisection? Which 

^ For an account of how lister discovered and developed his antiseptic 
method see the next preceding paper, p. 199. 


method will any man of common sense or any woman with 
a human heart choose? 

Even in sui^iy it is doubtful if a more wonderful im- 
provement has been realized than in our maternity hospi- 
tals and in private obstetric practice as a direct result of 
the work of Pasteur and Lister. Well do I remember as a 
young man every now and then an outbreak of that fright^ 
ful and fatal puerperal or *' childbed " fever in our maternity 
hospitals. Almost every woman who then entered such a 
hospital was doomed to suffer an attack of the fever, and its 
mortality sometimes ran up to seventy-five, or even more, 
out of eveiy hundred mothers. Often such hospitals had 
to be closed till the then unknown poison disappeared. 
Not a few obstetricians had to quit practice entirely for 
weeks because every woman they attended fell ill of the 
disease and many, many died. Finally Pasteur appeared on 
the field. In 1879, in a discussion on puerperal fever at the 
Paris Academy of Medicine, after a member had eloquently 
discussed various alleged causes of these epidemics, Pasteur 
interrupted him and said: *^ All this has nothing to do with 
the cause of these epidemics. It is the doctors who trans- 
port the microbe from a sick woman to a healthy woman.'' 
When the speaker responded that he feared they would 
never find this microbe, Pasteur immediately advanced to 
the blackboard, drew the picture of what we know as the 
'* streptococcus" and said: **This is the cause of the 
disease.'' This recognition of the streptococcus as the cause 
of puerperal fever and the consequent adoption of anti- 
septic methods have practically abolished puerperal fever 
and reduced the mortality in maternity cases to less than 
one in a himdred.^ 

All this we owe absolutely to experiment on animals. 
Nothing else could have given us the knowledge. Even 
the horrible experiments that were being made by doctors 

^ For a fuller account of the results in childbed fever see the paper 
(m "The Influence of Antivivisection on Character/' poti^ p. 856. 


who were igninraiitly spreading the pcHson all around them, 
even these were not sufficient to op^i our eyes to the real 
cause <rf the disease. Hie laboratcMy test-tubes and experi- 
ments on animals were the chief means by which this 
scourge of motherhood has been banished. 

In addition to all these, another fearful disease, yellow 
fever, has also been abdished by eiqperiment which was 
necessary for the final convincing proof . I need not repeat 
at length the fri^tful ravages of this terrible pestilence in 
days gone by. Cuba was never free from it for neariy two 
centuries until the American CommissiiHi showed how to 
get rid of it. The Panama Canal Zone had peihaps the 
worst reputation in the world as a graveyard for strangers, 
and now for four years not a single case ot yellow fever has 
originated there! Colonel Gorgas has made the Panama 
Canal a possibility. 

I wish that eveiy one mi^t read that most interesting 
little book, "Walter Reed and Yellow Fever,*' by Dr. 
Howard A. Kelly, and see the wonderful methods by which 
this scourge of humanity has been abolished. When one 
thinks of the enormous difficulties of the problem, the 
wonder is that it was ever solved. There are about four 
hundred varieties of mosquito. Only one of them carries 
the poison of yellow fever. Of this variety only the female 
carries the poison, and this female mosquito must have 
bitten a patient sick with yellow fever during the first three 
' days of his illness, or she could not become infected. 
Moreover, after infection, the poison, whatever it is, does 
not develop in the body of the female mosquito for about 
twelve days. Some of these facts were thought to be true, 
but there was no positive proof. A very large number, 
perhaps the majority, of yellow-fever experts still believed 
that the disease was carried in clothing, bedding, etc. To 
disprove this experiments were tried first of all by doctors 
on themselves. They slept in the beds in which yellow- 
fever patients had died, and in their very clothes, night 


after night — clothes soiled with their black vomit, urine, 
and feces. At other times doctors have actually swallowed 
the black vomit, tried to inoculate themselves by putting 
some of it into their eyes, by hypodermic injections, etc., 
in the vain attempt to discover the cause of the disease 
and the means by which it was spread, hoping in this way 
to discover the means of preventing it. Surely self-sacrifice 
could go no farther. Yes, it could go farther. One more step 
was requisite. The anfy way to give the absolute final 
proof was for a well man to be bitten by a mosquito known 
to be infected. Dr. Carroll, of the United States Army, was 
the first one who offered himself. Other men followed — 
doctors, soldiers, and others. Several lost their lives, 
amoi^ them Dr. Lazear at the beginning of a most promis- 
ing career. His tablet in the Johns Hopkins Hospital, in 
the fine words written by President Eliot, records that 
"With more than the coun^e and the devotion of the 
soldier he risked and lost his life to show how a fearful 
pestilence is communicated and how its ravages may be 

It is often said that such experimental work brutalizes 
men. Let us read a letter from Dr. Reed to his wife, 
remembering, also, that the same high and holy purposes 
animate Drs. Flexner, Carrel, Crile, and other experi- 
menters: — 

QuraiADO, Cuba, 
11.50 P.M., December 31, 1000. 

Only ten minutes of the old centiuy remain. Here have I been 
sitting, reading that most wonderful book, ''LaRoche on Yellow 
Fever," written in 1853. Forty-seven years later it has been per- 
mitted to me and my assistants to lilt the impenetrable veil that 
has surrounded the causation of this most wonderful, dreadful 
pest of humanity and to put it on a rational and scientific basis. I 
thank Grod that this had been accomplished during the latter days 
of the old century. May its cure be wrought out in the early days 
of the new I The prayer that has been mine for twenty years, that 
I might be permitted in some way or at some time to do something 
to alleviate human suffering, has been granted! 


This prayer of Reed — that its cure might be wrought 
out in the new, the twentieth centuiy — has been abun- 
dantly realized and yellow fever is now a vanquished foe. 

Unfortunately, the lower animals cannot be infected 
with yellow fever. If they could be, Lazear and the other 
victims would have been saved. But they, yielding up 
their lives as leaders of a forlorn hope in the battle against 
disease, have made it possible to free the world from this 
dreadful scourge. Never was there a finer exhibition of 

The antivivisectionists have never dared to attack these 
experiments upon man. If they had dared to do so, pub- 
lic opinion would have made short work of them. 

A few years ago I was called to Annapolis to see a young 
man who had been injured in a football game. He was 
evidently swiftly going to his grave. He had certain 
peculiar i^ymptoms, which, in the light of cerebral localiza- 
tion — that is, the fact that certain definite portions of the 
surface of the brain have each a certain definite function — 
I believed to be due to a dot of blood inside of his head 
above his left ear. There was a bruise, not above the ear, 
but at the outer end of the left eyebrow. Before 1885 I 
should have opened his skull under the bruise, — appar- 
ently the almost certain point of injury, — would have 
fiuled to find the clot, and he would surely have died. 
Instead of this I made a trap-door opening three inches 
away from this bruise, removed nine tablespoonfuls of 
clotted blood, closed the wound so that his skull was as 
firm as ever, and he recovered, continued his studies, was 
graduated from the Naval Academy. Lately he has 
heroically given up his life at the call of duty. Had it not 
been for experiments on animals which had definitely fixed 
certain spots in the brain as the centers for movements of 
the hand, arm, shoulder, head, face, etc., it would have 
been utterly impossible for me to save his life. This is but 
one of hundreds of similar cases in which modem surgery 


deals with tumors of the brain, hemorrhage inside of the 
skull and many other disorders, and deals with them 

I have heard the following pitiful stoiy from one of my 
colleagues. He and a young mother stood by the bedside 
of her only child. The child, in the throes of diphtheria, 
was clutching at its throat and gasping vainly for breath. 
Suddenly the mother flung hersdf on the floor at the doe- 
tor's feet in an agony of tears, entreating him to save her 
child. But alas! it was impossible. Had this case occurred 
a few years later, however, when the blessed antitoxin for 
diphtheria had been discovered (solely by animal experi- 
mentation), this remedy would have been given early; and 
almost certainly within a few hours the membrane would 
have Boitened and disappeared, and that life, precious 
b^ond rubies, mi^t have been saved. 

In those early dreadful days the only comfort we could 
give such distracted mothers — possibly some of them may 
read these veiy lines — was that "it was Grod*s will." Yes! 
Then, possibly, it was Grod's will; but now, thank God, it is 
not His will. One mi^t as well say it is Grod's will that 
thousands should die from smallpox when vaccination will 
protect them; that other thousands should die from typhoid 
fever when a pure water-supply and the banishment of the 
fly will prevent it; that thousands of women should die 
from puerperal fever when sterile hands and sterile instru- 
ments will save them! 

Let me give a table of some o£Scial reports showing in 
nineteen American and European cities the mortality in 
every one hundred thousand inhabitants from diphtheria 
in 1894 — that is to say, before the use of the antitoxin of 
diphtheria — and in 1905, when its use had become gen- 
eral. Being o£Scial and from nineteen cities in America 
and Europe, its accuracy can hardly be assailed* 

^ See "Midshipman Aiken and Viyisection," ante, p. 146, for a fuller 
aooount of this case. 


Table of Mortality from Diphtheria 

Per 100,000 InkabUanU 
1894 1906 

New York 158 88 

Philadelphia 128 82 

Baltimore 50 20 

Boston 180 22 

Brooklyn 178 48 

Pittsburg 64 26 

London 66 12.2 

Paris 40 6 

Vienna 114 19 

These ninie and ten other large cities taken together 
average as follows; in 1894, 79.9, and in 1905, 19, per 
100,000 inhabitants — that is to say, in these nineteen 
cities the avenge death-rate in 1905 was less than one 
fourth of the rate before the introduction of the serum 

The alleged atrocities so vividly described in antivivi- 
section literature are fine instances of "yellow journalism," 
and the quotations from medical men are often misleading. 
Thus, Sir Frederick Treves, the eminent English surgeon, 
is quoted as an opponent of vivisection in general. In 
spite of a denial published seven years ago, the quotation 
still does frequent duty. I know personally and intimately 
Horsley , Ferrier, Carrel, Flexner, Crile, Gushing and others, 
and I do not know men who are kinder and more lovable. 
That they would be guilty of deliberate cruelty I would no 
more believe than that my own brother would have been. 

Moreover, I have seen their experiments, and can vouch 
personally for the fact that they give to these Animalg 
exactly the same care that I do to a human being. Were 
it otherwise their experiments would fail and utterly 
discredit them. Whenever an operation would be painful 
an anesthetic is always given. This is dictated not only 
by humanity, but by two other valid considerations: first. 


uid delicate operations cannot be done properly on 

gglingy fighting animal any more than they could be 

an a struggling fighting human being, and so again 

experiments would be failiues; and second, should 

le try an esperiment without giving ether he would 

liscover that dogs have teeth and cats have daws. 

>ver, it will surprise many of my readers to learn that 

> total niunber of experiments done in one year in 

nd ninety-seven per cent were hypodermic injections 

ily three per cent could be called painful! 

ny one will read the report of the recent British 

Commission on Vivisection, ^^he would find,'* says 

yromer, **that there was not a single case of extreme 

mecessary cruelty brought forward by the Antivivi- 

I Society which (hd not hopelessly break down under 


In view of what I have written above — and many 

times as much could be added — is it any wonder that 

I believe it to be a common-sense, a scientific, a moral, 

and a Christian duty to promote experimental research? 

To hinder it, and, still more, to stop it would be a crime 

against the human race itself, and also against ammals, 

which have benefited almost as much as man from these 


What do our aniivivisection friends propose as a substi- 
tute? Nothing except clinical — that is, bedside — and 
2)o«f-morfo77i observations. These have been in use for two 
thousand years and have not given us results to be com- 
pared for a moment with the results gained by experimental 
research in the last fifty, or even the last twenty-five years. 
For a tabular contrast between the beneficent results of 
experimental research and the utter futile results of the 
years of agitation by the antivivisectiomsts, see fost^ p. 280. 

^ See the statements and Resdutions on pp. xv-xvin. ^ 



**In this controversy [vivisection] there should be no bitter- 
ness. ... Do not let us attempt to browbeat or call names. . . • 
Vivisection tends to weaken character. . • • Nothing which hurts 
the character can be right." (Bev. Dr. Floyd W. Tomkins, P^^- 
dent of the American Antivivisection Society, in the LadM Home 
Journal, March, 1910.) 

I ACCEPT the test proposed by Dr. Tomkins, and quoted 
in the above motto, ^'Nothing which hurts the character 
can be right.^' Let us, therefore, study what is the effect 
of antivivisection on the character of its advocates. 

L Violent Pcusuma aroused by AntivmsecUon Agitation 

The most violent and vindictive passions have been 
aroused and fostered, especially among women — the very 
flower of our modem civilization. Let us see whether th^ 
have shown ^^ bitterness'' or ^* called names.'' I have 
rejected much oral testimony I could use and have drawn 
my evidence from only a very small itortion of the literature 
at my disposal. 

Herewith I reproduce (Ilg. 1) the photograph of a 
remarkable letter which contains an asserted prayer to 
the Deity calling down curses by ^^a dozen women" on 
my long-since sainted mother. It needs no conunent from 
me save that the *^ horror" mentioned in this letter was 
excited by an article which I published in the ^'Ladies' 
Home Journal" for April, 1910, in which I recited a few of 
the bemfiU to humanity which had resulted from vivisec- 

^ An address read before the Surgical Section of the Suffolk District 
Medical Society, Boston, March 80, 1912. Reprinted by the kind per- 
misnon of the editor and the publisher from the Boston Medical and 
Surgical Jowmal, May 2 and 9, 1912. 

























CO ^ 

























tion. The only clue even to tlie place from which the letter 
comes is the postmark, *'Los Angeles." 

Let me quote another earlier anonymous letter I have 
before me. This is from Philadelphia. Instead of the usual 
address, "Dear Sir," it begins, "You Fiend." I had not 
then been promoted to "Arch-fiend" in Satan's hierarchy. 
The writer exclaims, " Oh, that you all could be put through 
the same torture that you inflict on these helpless ones." 
As I am notavivisectionist this ardent wish fails to terrify. 
I am an advocate of vivisection because I know how greatly 
it has helped me during all my professional life in saving 
life and lessening suffering.^ 

^ In the American Journal cf the Medical Sciences for July, 1865, p. 67, 
Dr. S. Weir Mitchell, the late Dr. Morehouse, and I published a paper on 
the "Antagonism of Atropia and Morphia," based cm observations and 
experiments in the Army Hospital for Injuries and Diseases of the Nerv- 
ous System. The reason which caused us to make this investigation was 
that we desired to find better means for "soothing the pain oi those ter- 
rible cases of neuralgia" following gunshot wounds of large nerves. These 
are accurately described in the paper as causing "anguish** and "agony" 
— no word could be too strong. "A Hell of Pain*' was the accurately 
descriptive title one patient gave to our hospital. These patients often 
wore cotton ^oves and hi^ boots and always carried in their pockets a 
bottle (A water which they poured from time to time on their ^oves and 
into their boots, since the least dry friction was simply intolerable. 

Accordin^y, in our efforts, we tried a number of conmion and some 
uncommon drugs, and finally found that morphin (the active principle of 
opium) was the best remedy and yet had many disadvantages. Ulti- 
mately we found that by combining with it a certain amount (A atropin 
(the active principle of belladonna) we obtained the best results. The 
facts discovered in our investigations have long since become merged in 
the common knowledge of the profession, and standard tablets with differ- 
ent proportions (A the two drugs are manufactured and used all over the 
worid. Most of our patients operated on (entirely by hypodermic injec- 
tions) were sorely in need of relief . A few were convalescents. In all cases 
we avoided telling them what drug was being used, for every one knows 
how imagination, fear, or other emotion would alter the rate of the pulse 
or of the breathing. Not one man was injured in the least. Not one ever 
complained. Since then many thousands of human beings have been 
greatly benefited and many lives have been saved through the knowl- 
edge ihva obtained. 

I have expressly mentioned these facts in some detail because we have 
been attacked in their pamphlets by the antivivisectionists for these 


If two letters will not convmce> here is a tliird. Tliis» 
from Baltimore^ also the result of the same article, was 
from a writer who had the courage to sign her name and 
address: — 

You would appear even the more fiendish on account of your 
superior intelligence. • . . The future of a vivisectionist is a veri- 
table hell. You> I understand, are a man advanced in years [the 
calendar, alas I seems to justify this shocking statement] soon to 
go before the bar of justice. Can you meet your God with the 
terrible cries ringing in your ears of these creatines, our helpless 
brothers, made by his hand, that you have drawn and quartered? 
How they must haunt you. • • • When your time comes to die, 
every cry of pain and anguish that you have been the cause of 
producing in these hdpless creatures will follow you to the depths 

Yet I have ''drawn and quartered" not even so much as 
a mouse. 

But this same lady tells me that she had survived one 
of the most serious abdominal operations that could be 
done — a hysterectomy.* This oi)eration was so perilous 
that imtil Lister had devised the antiseptic method it 
was never even thought possible^ and its success at the 
present day is due chiefly to experiment on animals. The 
writer of the letter, therefore, is herself a witness to the 
benefit of vivisection. 

Later on she says, "If they would only use vivisectors 
for their experiments, it would soon be considered unneces- 
saiy." Her gentlest wish, therefore, is for human vivisec- 
tion, and doubtless ''without anesthetics." Per contra, 
in the newspai)ers of May 6, 1911, a dispatch states that 
seventeen medical students had offered themselves for 
experimental inoculation with cancer, an offer which was, 
of course, refused, as animals can be used. 

experiments, which are described as *' Human Virisection." What would 
they have had us do? Sit idly by and let these poor fellows suffer tor- 
ments because if we tried various drugs we were "experimenting" on 
human beings? 

1 Removal of the entire womb. 


A curious statement in the letter is, **1 understand the 
Rockefeller Institute has had four or five of its laboratories 
burned, the animals destroyed, rather than have them fall 
into the hands of these wretches, and if this thing were 
more widely known, eveiy medical college in the country 
would be razed to the ground and the doctors tarred and 
feathered." The insiirance companies, I am quite certain, 
have never heard of the one laboratoiy which the Rocke- 
feller Institute possesses having been burned. But what 
a strange exhibition of kindness it is to gloat over the fact 
that the poor animals in these supposed laboratories had 
been roasted to death '* without anesthetics.'* 

If three instances are not sufficient, here is a fourth — 
a signed letter from Chicago. Referring to one case which 
I had published as an illustration of the value of vivisection 
in saving human life, she says, **My sympathy for the 
parents of that young man • • . would have been deep, 
but not so keen as for a mother dog who saw her puppy 
tortured to death on a dissecting table. . . . Even if you 
did save a man's life, was U worth whUef** (Italics in the 
letter!) This lady wrongly assumes that the puppy was 
^'tortured to death," i.e., without anesthetics. This, I am 
glad to say, is not true, as I shall show later on. To her 
question, "Was it worth while?" I can only say, "Ask 
his father and mother." 

And this is the ennobling influence of antivivisectioni 

A fifth communication is from a lady who was i)erson- 
ally acquidnted with myself and my family. She sent me a 
pamphlet with some good advice, ending with the terse 
injunction, "Do God's work, not the Devil's," and had 
the courage to sign her name. 

A sixth lady sent me (anonymously) an article from one 
of our magazines, with many marginal annotations and 
much imderscoring. From this I select a few sentences. 

Millions of people regard him [the vivisector] with loathing, and 
shudder with horror at his name. . • . Frightful as the suffer- 


ings of this tortured dog must be, I would rather be in its place 
than yours when your soul is summoned to its final judgment to 
receive judgment without mercy. [This seems to be a favorite 
threat of my correspondents.] May Grod so deal with every fiend 
incarnate who has thus tortured defenseless creatures. ... All 
the demons and fiends do not dwell in Hades. Some are made in 
the image of God, but have hearts blacker and more cruel than 
the arch-fiend himself. These are the vivisectors who *' benefit" 

I have received very many more such letters — usually 
anonymous. These six may serve as samples. 

I would willingly acc^t the supposition of unbalanced 
minds as an explanation and palliation for such letters 
but for their number and for the fact that they so entirely 
coincide with almost all the ''repulsive literature" (to use 
Lord Coleridge's words) published by the various antivivi- 
section societies. 

A brief search throu^ only a part of my file of this 
antivivisection literattire enables me to cull the following 
evidences of a similar debasing violence and vindictive- 
ness. The list could easily be extended. 

The art of torture has been carried to a perfection which the 
devildoms of Spain in the old days of the Inquisition could not 
equal in ingenuity or pitilessness. 

Vivisection is the anguish, the hell of science. All the cruelty 
which the human or rather the inhuman heart is citable of 
inflicting is in this one word. Below it there is no depth. This 
word lies like a coiled serpent at the bottom of the abyss. 

Animals are dissected alive — usually without the use of anes- 

The vivisector keeps his victim alive while he cuts it up. 

Vivisection founded on cruelty, supported by falsehood, and 
practiced for selfish ends. 

The vivisector is less valuable to the world than the animals he 

A thing I know to be danmable whatever the results. 

An organized system of barbarity. 

Vivisector and criminal become interchangeable terms. 

Cowards who peipetrate hideous crimes. 


Experiments on living animals is a system of long-protracted 
agonies, the very recollection of which is enough to make the soul 
sick as if with a whiff and an after-taste of a moral sewer. 

Impious barbarity of the vivisector. 

All other forms of sinful cruelty are comparatively trifling com- 
pared with the horrors of vivisection. 

Deliberate dabbling in blood and agony. 

Cruelty the inevitable and odious spawn of secret vivisection. 

Blood-stained hands of the grim tormentors. 

Bloody mass of agony. 

Devilish inventions of unbalanced mentality. 

At a hearing before a committee of the L^islatuie of 
Pennsylvania, I heard myself and others who were advo- 
cating the humane woric of vivisection called ^^ hyenas'* by 
a woman. 

Briefer descriptive tenns are as follows: — 

scientific hells temples of torment 

torture-house cruelty of cruelties 

orgy of cruelty infernal work 

halls of agony hellish wrong 

inhiimRii devil devil's work 

devils incarnate lust of cruelty 

scientific murder scientific assassination 

abominable sin torture of the innocent 

devilish science black art of vivisection 

fiends incarnate satanic 

damnably mean fiends 

arch-fiend human monsters 

master demon demons 

diabolical vivisection working model of hell 

Antivivisection writers nearly always state, assume, or 
imply that all experiments are ^* tortures," i.e., that anes** 
thetics are not used. This is wholly erroneous. 

In Great Britain, where all experiments are returned to 
the Government, the following table for 1906 (the latest I 
happen to have) will show how utterly indefensible is such 
an assumption. It is a fair presumption that about the 
same average exists in the United States. 



Inoculations, etc., not involving any operation 93.96 

Animals killed under anesthetics 3.44 

Animals allowed to recover from anesthetic but nothing likely to 

cause pain and no further operation allowed without anesthetic g.60 


In other words, only twenty-six animals out of one Ihov^ 
sand could by any possibility have suffered any pain> and 
veiy few of these any serious pain. Is this the torture and 
agony so constantly harped on? 

[Since this address was delivered the report of the British 
Royal Commission on Vivisection, on which the antivivi- 
sectionists were represented, has appeared. One of their 
unanimous conclusions (page 20) is as follows: — 

**We desire to state that the harrowing descriptions and 
iUiistrations of operations inflicted on animals, which are 
freely circidated by post, advertisement, or otherwise, are in 
many cases calculated to mislead the public, so far as they 
suggest that the animals in question were not under am* 
anesthetic. To represent that animals subjected to experi- 
ments in this country are wantonly tortured would, in our 
opinion, be absolutely false.** 

This clear statement should end this calumny.] 

Many of the instances cited in antivivisection literature 
are taken from researches — such as Magendie's — which 
were made before anesthetics were discovered, over sixty- 
five years ago. 

The rest in which real cruelty was inflicted, and which if 
done now would be condemned by all modem research 
workers as freely as by the antivivisectionists themselves, 
were done almost wholly on the Continent, and often by 
I)ersons who are now dead. In discussing vivisection to-day, 
these should be excluded, or their dates and countries 
indicated, for the public, ignorant of medical history, is 
misled into supposing that these persons are living and 
practicing these methods to-day and in America. 


In one of the anonymous replies to my paper on the 
** Misstatements of Antivivisectionists»" ^ I am represented 
as the apologbt and advocate of experiments of which 
twice over at the Senate Committee hearing and again in 
my letter to Mr. Brown I had expressed my utter dis- 
approval. I am always willing to face a truthful charge, 
but it is a hopeless task to meet untruthful charges, 
especially when the author is ashamed of his own name. 

''Hell at Close Range" is the title given by Miss Ellen 
Snow to a leaflet dealing with the work of the Rockefeller 
Institute. One could scarcely expect such fierce heat from 
so frosty a name. 

At this institute, by experiments on twenty-five monkeys 
and one hundred guinea-pigs, most of which animals re- 
covered, has been discovered a serum that has brought 
the former death-rate of cerebro-spinal meningitis of 
seventy-five or ninety per cent down to twenty i)er cent 
and less. Is it because of this beneficent work that it is 
called "hell"? 

At this institute has been discovered a means of trans- 
fusion of blood that has already saved scores of human 
lives. Is this the reason for calling it "hell"? 

At this institute a method of criss-crossing arteries and 
veins, which almost always run alongside of each other, 
has been discovered by which impending gangrene has 
been prevented. Does this make it a "hell"? 

At this institute the cause and the cure of infantile 
paralysis are being sought. Are such investigations carried 
on in "hell"? « 

Miss Snow in this same leaflet expresses in italics her 
horror at the idea of the proposition of the institute "to 
build a hospital where the experiments may be continued 
on human beings." It may be of interest to her and also 

^ Ante, p. 110. 

* Since this was written the genns of infantile paralysifl and of hydrcK 
phobia have been difoovered at thb same institute. 


to others to know that this hospital was opened in October, 
1910, and that the pubUc, undeterred by her horror, have 
thronged to it in such numbers that there have not been 
beds enough for the several hundreds of disappointed 

An editorial in the '^Journal of Zo5phily '' ^ records a gift 
to this Rockefeller Institute, *'an institution in New York 
where vivisection should be practiced with the idea of 
achieving as great an advance as possible in the war of 
science against human suffering," and adds, *'but the gift 
only fanned into fury the opposition of the women to 
experiments on hving animals, no matter how great the anticir 
paied ben^.** Could cruel passion be better expressed? 

Can a cause which so seriously injures the character 
of its advocates that they indulge in this prolific vocabu- 
lary of vituperation by any possibility have an uplifting 
influence? It eminently fulfills Dr. Tomkins* proposed test 
— it "hurts the character and, therefore, cannot be right." 

Are those who give loose rein to such passion fitted to 
form a sound and sane judgment on the subject about 
which they write? This is especially true when the matter 
is one so technical as anatomic, physiologic, chemical, 

^ Jour, qf Zo&phUy, January, 1909, p. 2. 

In my opinion other antivivisection joumak are not worth the time or 
the money, but this one — the Journal qf ZoOphily — b my stand-by. 
Of course its columns, like those of all its tribe, are filled with much fic- 
tion, but it often reminds me of the good-humored epigram of a witty 
husband to his wife, "My dear, you are usually wrong, but you are 
never dull." Its annual tome of somewhat over two hundred pages re- 
quires the combined energies of four editors, beginning with the hyphen- 
ated "Editor-in-Chief/* It outshines the "Outlook" now for it still has 
a "Contributing Editor,'* who, with becoming dignity, contributes only 
on special occasions. Its price is " one dollar per annum '* — only twenty- 
five cents per editor! For shame t 

Its office is just around the comer from my house. Among a swarm of 
florists' and opticians' and other shops, it is our sole literary attraction. 
Appropriately also it is very neighborly. It raps on my door each month 
(thou£^ generally sadly belated) and whenever I wander too far from the 
path of virtue, it also raps on my head. I find it very entertaining. 


pathologic and surgical investigations as to which they 
cannot be expected to know and> in fact, do not know 
anything. Even relatively few medical men are fitted 
by temperament and training to act as censors of such 
researches, much less those ignorant of medicine. 

I believe that much of the passion shown in the above 
quotations is the result of ignorance. Most of the attacks 
on vivisection, as I have said, assmne or even state cate- 
gorically that anesthetics are not used. Saving in the very 
rare cases in which the use of anesthetics would entirely 
frustrate the experiment, anesthetics are always used. 
This is done not only for reasons of humanity, but also 
because the struggles of a suffering animal would make 
delicate and difficult operations absolutely impossible, to 
say nothing of the danger of injury to the oi)erator. 

The always-quoted opinion of Professor Bigelow was 
founded on what he had seen at the Veterinaiy School at 
Alfort, France, in the pre-anesthetic days. (See p. £78.) 

Many absolutely false statements are made that anes- 
thetics were not used in certain specified experiments, 
whereas the experimenters have expressly stated that 
anesthetics were used. Of such misstatements by antivivi- 
section authors I shall give some startling instances later. 
It is no wonder that the public has been thus misled. 
'* Cutting up men and women alive " is an accurate descrip- 
tion of every surgical operation, but we all know that while 
in comparatively few reports of surgical operations it is 
expressly stated that an anesthetic was used, such use 
"goes without saying.** 

One of the most frequent antivivisection statements 
is that "incomplete" or "slight** or "light** anesthesia 
means that the animal is fully able to feel pain and that 
when the eye resents a touch or there is muscular move- 
ment following any act which would be painful when one 
is not anesthetized, pain is actually being inflicted. 
Mr. Coleridge says (Question 10,887 in his testimony 


before the Second Royal Commission on Vivisection), 
''What does 'anesthetized* mean? It means 'without 
feeling/ You cannot be slightly without feeling. You 
either feel pwn or you do not/* 

Veiy recently when I had nitrous o:2dd gas given several 
times to a lady to bend a stiff elbow she struggled and 
writhed so hard as almost to throw herself out of the den- 
tist's chair on to the floor. Yet she was never conscious of 
the slightest pain. In other words, while the motor nervous 
centers responded to my forcible bending movements and 
caused violent muscular struggles, the perceptive nervous 
centers felt no pain. But any spectator would surely have 
said that she was being "tortured." This is only one of 
hundreds of similar cases I have had; all other surgeons 
have had similar experiences. 

In modem laboratory researches, ether or other anes- 
thetics are almost always given. Extremely few exceptions 
occur, and then only with the consent of the director in 
each specific case. The actual conditions at the present 
day are well shown by the rules in force in practically all 
American laboratories of research. These rules have been 
in operation for over thirty years in one case and for more 
than ten years in others. In most laboratories in which 
students work, and where they are absolutely under the 
control of the director, the only animal used is the frog, 
and by "pithing" or decapitating it, it is made wholly 
insensible to pain. 

The idea that students privately "tortiwe" animals, 
often, it is stated, out of mere curiosity, is absolutely 
false. I have been intimately associated with students 
ever since 1860, first as a student and since 1866 as a 
teacher. I state, therefore, what I am in a position to 
know. Moreover, private experimental research takes 
time which our overworked students do not have, and 
money which they cannot afford. It means the rent of 
a laboratory, the purchase of very expensive and delicate 


instruments* the rent of an animal room, the cost of the 
animals, and of their food and care» a man to look after 
them, — for all modem surgical work on animals must 
be done with the same strict antiseptic care as on man 
or the experiment will surely fail and discredit the author, 
— a total expense amounting to a very large sum. 

I quote in full the rules which, as I have sidd, are in 
force in practically all American laboratories of research : — 

Rules Regarding Animala 

1. Vagrant dogs and cats brought to this laboratory and pur- 
chased here shall be held at least as long as at the city pound, and 
shall be returned to their owners if claimed and identified. 

2. Animals in the laboratory shall receive every consideration 
for their bodily comfort; they shall be kindly treated, properly 
fed, and their surroundings kept in the best possible sanitary con- 

8. No operations on animals shall be made except with the 
sanction of the director of the laboratory, who holds himself 
responsible for the importance of the problems studied and for 
the propriety of the procedures used in the solution of these 

4. In any operation likely to cause greater discomfort than that 
attending anesthetization, the animal shall first be rendered 
incapable of perceiving pain and shall be maintained in that con- 
dition until the operation is ended. 

Exceptions to this rule will be made by the director alone, and 
then only when anesthesia would defeat the object of the experi- 
ment. In such cases an anesthetic shall be used so far as possible 
and may be discontinued only so long as is absolutely essential for 
the necessary obs^vations. 

5. At the conclusion of the experiment the animal shall be 
killed painlessly. Exceptions to this rule will be made only when 
continuance of the animal's life is necessary to determine the 
result of the experiment. In that case, the same aseptic precau* 
tions shall be observed during the operation, and so far as possible 
the same care shall be taken to minimize discomforts during the 
convalescence as in a hospital for human beings. 


Director rf the Laboratory, 


I may add that at the Rockefeller Institute regular 
trained nurses are employed and are on duty not only 
during the day» but at night when necessary. 

Self-confessed total ignorance of a subject on which 
one ^ves extensive evidence is not often known, but 
Dr. Herbert Snow, of London, an authority among the 
antivivisectionists, is a case in point. Dr. Snow's evidence 
before the Royal Commission on Vivisection (1906) covers 
ten pages quarto and he answers three hundred and twenty- 
six questions. In 1911, Dr. Snow visited America. In a 
letter to the Philadelphia ^'Ledger" ^ he makes the almost 
incredible statement that he gave all this evidence ''in 
utter ignorance of the vivisection question.*' 

Moreover, when asked by the Conunission (Question 
2242), ''Do you find any fault with the present gentlemen 
who are licensed under the act''? he replied, "I do not"; 
and again (Questions 2227 and 2228) he admits that both 
painful and painless experiments may sometimes be 

In other cases ignorance of physiology and anatomy is 
shown which would only excite a smile did it not gravely 
mislead the reader. I shall give only a single illustration 
here. Others will be found elsewhere in this paper. 

"The Nine Circles," with its sulphurous subtitle, "Hell 
of the Innocent," is an English book originally issued by 
the late Miss Frances Power Cobbe, in 1892. This edition 
had to be withdrawn on account of its false statements, 
especially as to the non-use of ether.' A second and revised 
edition was issued in 1893. This was "carefully revised and 
enlarged by a subcommittee especially appointed for the 
purpose," as the preface states. 

On page 15 of the revised edition, it is correctly stated 
that Professor Henry P. Bowditch, of the Harvard 
Medical School, in some experiments on the circulation, 
etherized a cat and that "then its sciatic nerve was 

^ Phfladdphia Ledger, March 6, 1911. * See paeU pp. 265, d66. 


divided/* etc. The sciatic nerve is the largest nerve in 
the body of man and aniinals and passes down the back 
of the leg« After division of the nerve the portion going 
down the leg bdow the place where the nerve was divided 
was stimulated by an electrical current. As this part of 
the nerve was wholly cut off from the spinal cord and 
brain, by no possibility could any pain befell. Yet a Boston 
lawyer, in a leaflet published by the New England Anti- 
vivisection Society, comments on a similar experiment as 
follows: *'It will be readily seen even by the casual reader 
that it involves an amount of agony beyond which science 
is imable to go." Just how the ^'casual reader" would be 
so well informed as to physiology when a lawyer and two 
doctors — not casual but intelligent and careful readers 
— got things totally wrong, is not stated. Dr. Bowditch 
published a correction ^ of this misstatement in 1896. In 
spite of this, the New England Antivivisection Society in 
1909, thirteen years after this public correction, was still 
distributing this lawyer's statement. 

But in "The Nine Circles" (second edition, carefully 
revised by Dr. Berdoe and the committee) these experi- 
ments are referred to as "experiments on the spinal cord**l 
(Italics mine.) Yet Bowditch did no operation on the spinal 
cord. Miss Cobbe, not being an anatomist, might be par- 
doned for confusing the thigh and the spine of the cat, 
but surely Dr. Berdoe ought to have seen to it that 
"sciatic nerve" and "spinal cord" were not used as inter- 
changeable terms. 

Many years ago, after amputating a leg near the hip, 
I tried to see now long electric stimulation of the sciatic 
nerve would cause the muscles of the amputated leg to 
contract. After four hours, during all of which time 
the muscles continued to react, I had to stop as I could 
give no more time to the experiment. According to the 
canons of antivivisection as voiced above, I should have 

^ Heniy P. Bowditch, Advancement cf Medicine by Beeear^ p. 43. 


continued to etherize the patient whose leg had been 
amputated, for he» just as much as Bowditch's cat» could 
feel "agony beyond which science is unable to go." 

Let me give only two other surprising statements. 
Dr. Hadwen^ criticizes my reference in "Haiper's Mag- 
azine'*' to "an astringent named ^adrenalin."* I had 
shown how valuable adrenalin had been in saving human 
life in certain surgical conditions, and also described the 
resuscitation, by means of adrenalin and salt solution, 
of a dog which had been "dead" for fifteen minutes. Dr. 
Hadwen concludes his paragraph thus: "But it does 
seem a pity that these New World vivisectors will not be 
able to perform the resurrection miracle without first 
killing somebody to get at his kidn^s." The presumable 
object of "getting at his kidneys" would be in order to 
make adrenalin from them. Now adrenalin is not made 
from the kidneys at aU, least of all from human kidn^s» 
but from the adrenal glands of animals. 

Li the same article he vaunts the use of salt solution 
instead of the direct transfusion of blood, and rightly 
says that he has "seen the most marvelous effects follow 
the injection of an ordinary saline solution into the venous 
system in cases of loss of blood." But he seems to be 
ignorant of the fact that this veiy saline transfusion was 
begun and perfected by experiments on animals. I com- 
mend to him Schwarz's essay (Halle, 1881) with its twenty* 
four experiments on rabbits and dogs, and Eberius's essay 
(Halle, 1883) with its ten experiments on rabbits and the 
record of eleven cases in which Schwarz's method had 
already been used in man. These essays were practically 
the beginning of our knowledge of the advantages of the 
use of salt solution over the old dangerous methods of 
transfusion of blood. 

^ Hadwen, Jour, rf Zodphily, January* 1910. 

* W. W. Keen. "Recent Surgical Progress," Harper's Magadne, April, 
1909; reprinted in this volume anie, p. 151. 


The antivivisectionists deny the truths of bacteriology. 
Yet we practical physicians, surgeons, and obstetricians 
know by daily experience that Pasteur's and Lister's re- 
searches are the basis of most oi our modem prepress. 
Are Hadwen, Harrigan, Snow» and their colleagues right, 
and have all medical coU^es all over the world, in estab- 
lishing chairs of bacteriology, and all medical men, in 
believing bacteriologic diagnosis of such importance and 
in basing on the germ theory their antiseptic treatment, 
which has so revolutionized modem surgery, been wholly 
wrong? The germ theory b as well established as the 
doctrine of the circulation of the blood.^ 

77. Fostering a Spirit of Cruelty to Human Beings 

My second reason for believing that antivivisection 
injures character is that, by putting a greater value on 
the well-being and the lives of monkeys, guinea-pigs, 

^ In Mrs. White's answer to this address (Boston Med, and Surg. Jour.^ 
July 25» 1918, p. 148)» as the editor on p. 131 points out, her reference to 
the "fever inseparable from the healing of abdominal wounds'* shows her 
ignorance of the results of modem progress in surgery. Thanks to bac- 
teriology and the antiseptic method of Uster and his foQowers, thousands 
of surgeons and patients the world over can confirm my own experience* 
both as a surgeon and as a patient, that no fever usually follows a dean 
abdominal operation. Before Lister's day, not only was there the terrible 
fever and suffering of peritonitis, but the mortality was so great that we 
never dared to do many operations which are now commonplace and 
rarely fatal. Another iUustration of ignorance of surgery is found in Mrs. 
White's reference (p. 148) in the same paragraph to the "pain caused by 
the presence of gall-stones in the gall-bladder," a pain which she says " is 
generally considered the most violent pain known." Now, it is true that 
sometimes "gall-stones in the gall-bladder" do cause some or even consid- 
erable pain; but many potUmortem examinations reveal " gall-stones in the 
gall-bladder" iduch have never given the patient the slightest pain, and 
the patient, therefore, was totally ignorant of thdr presence. The "vio- 
lent pain" to which she refers is not due to their presence in the gall- 
bladder, but to the terrible " gall-stone colic " caused by the passage of the 
gall-stones out of the gall-bladder into its duct, or tube, opening into the 
bowd. Modem antiseptic surgery prevents these constantiy recurring 
attacks by safdy removing the gall-stones from the gall-bladder or from 
the gall-duct. 


rabbits, dogs, cats, mice, and frogs than on the lives of 
human beings, it fosters a spirit of cruelty to himian 

Is it not a cruel passion which will lead men and women 
to write such letters and to print such epithets as I have 
quoted? Is it a right thing to misstate the facts of opera" 
tions, and after the falsity of the charge has been proved, 
still continue for years to hold up men with human feelings 
and sensitive to abuse before the community as vile mon- 
sters of cruelty? Nay, more than this, is it not an extra- 
ordinaiy thing that those who so vehemently denounce 
hiunan vivisection are even among its advocates? 

When I was professor of surgeiy in the Woman's 
Medical College of Pennsylvania, I took as the topic of 
my address at one of the commencements, '"Our Recent 
Debts to Vivisection."* Mrs. Caroline Earle White pub- 
lished ''An Answer to Dr. Keen's Address entitled, 'Our 
Recent Debts to Vivisection.'" At the bottom of page 4 
I find the following: — 

I take issue with Dr. Keen in the second place where he says, 
*'These experiments cannot, nay, must not, be tested first upon 
man." I assert, on the contrary, that in the majority cf eases they 
must be tested first upon man [italics my own] or not tested at all, 
because no important deductions can ever be drawn with any 
degree of certainty from experiments upon animals, since in some 
inexplicable way their construction is so different from that of 

The statements in the latter portion of the concluding 
sentence will much amuse anatomists, physiologists, and 
biologists, or, in fact, any one who really knows anything 
about science. With minor modifications, man and the 
lower animals are alike in almost all particulars, both in 
structure and function, in health and disease. 

The extraordinary fact is that Mrs. White asserts that 
experiments must be tested first on men or not tested at all. 

^ See the first paper in this volume. 


That is to say, we miut rither ezp^iment on bmnan 
beingB or else cootmue in exactly the same <Jd mt as before 
and never make any progress, for eveiy departure from 
prior practice, however sli^t, is an "experiment.'* 

If this basic doctrine ci antivivisecti<m had hdd good, 
for the last fifty years Lister would not have been able, 
after carefully testing his antiseptic method on animals 
and having found it successful, tha[i, and not before 
then, to tiy it on man.^ By this means he became, as the 
''British Medical Journal" has just caDed him, ''the 
maker of modem surgeiy." 

On page 10 of Mrs. White's "Answer** is found the 
following flat-footed advocacy of human vivisection: — 

Dr. Keen mentions that in India alone twenty thouwmd human 
beings die annually from snake bites and as yet no antidote has 
been discovered. How can we search intelligently for an antidote, 
he says, until we know accurately the effects of the poison? I 
should reply that in order to find out the effects of the pcHscm and 
to search also for an antidote, the best plan would be for the experi- 
menters to go to India where they could find as large a fidd for * 
investigation as they require in the poor victims themselves. 
Here is an opportuniiy evch as is not cften qferedfof experimenHng 
upon hvman beings^* since as they would invariably die from the 

1 W. W. Keen. "Modem Antisqytic Surgeiy and the R^ of 
ment in its Discovery and Development," Jour, Awi, Med. AsstUp April % 
1010, p. IIM. Reprinted in the series of pamphlets on Defense of Re- 
search (see p. ziz), and in the present volmne, ante, p. 190. 

' In her answer to this address (Bostcm Med. and Svrg, Jour,^ July 85, 
1012, p. 14S), Blrs. White, after twenty-seven years for reflection, de- 
fends her proposal for "experimenting on human beings," saying that 
"it does not seem to me that this is a crud suggestion, as my only object 
in it was to benefit the poor natives who die by the thousand every 
year." Such a defense places her dearly and definitdy among the ad- 
vocates of vivisection, whose only "object" is to prevent death "by 
thousands every year." This object, moreover, has already been obtained 
in a score of diseases and will be obtained hereafter in many others, not, 
however, by "experimenting on human beings," as she advocates, but 
on dogs, cats, rabbits, guinea-pigs, mice, frogs, etc. 

And now the associate editor of the Jotima/^^ZoSpAt^, in the last issue 
of her journal I have received (July, 1914, p. 101), horribUe dietu^ enters her 
plea for vivisection! She holds with her London hero. Dr. Snow, that 


snake bites, there can be no objection to trying upon them every 
variety qf antidote that can be diecovered. Nothing seems to me less 
defensible than these experiments on the poison of snake bites 
upon ftnimftla since it is the one case in which they could be 
observed with so much aatirfaetion and certainty upon man! 
[Italics my own.] 

Such a proposal is as absurd as it is cruel. Even if the 
experimenter could afford sufficient time and money to 
go to India for months or rather for years, how could he 
arrange to be present when such unexpected accidents 
occurred? How could he have at hand in the jungle the 
ether, chemicals, assistants, tables, tents, food and drink, 
and the necessary yet intricate and delicate instruments? 
And even if he had all of these, how could he work with the 
calnmess and the orderly deliberation of the laboratory 
when a fellow human being's life was ebbing away and 
every minute coimted in such a swift poison? The proposal 
is cruel and revolting and would never be accepted by any 

But Mrs. White is not the only one who is guilty of 
making such a proposal. Many antivivisection leaflets 
and pamphlets express the wish that the vivisectors 
should be vivisected. In a pamphlet^ freely distributed S 

in the United States I find the following in a letter from E 

a man who was at that time a Senator of the United 
States: — 

It would be much better to dissect men alive occasionally 
for the general welfare because the attendant phenomena and 
demonstration of the victims being of our own particular form 
of animal would be far more valuable than the result of our 
observation upon the physical structure illustrated in the ago- 
nies unto death of the helpless creatures around us. 

**re$eaireh among the lower organiems is the main path to be followed in the 
ogee yel to be,** True it is claimed that "it would not inflict a pang on 
any sentient creature." Yet it is also asserted that the health of these 
lower organisms ''primarily depends on the condition of its [their] nerves. ** 
Pray what are nerves for? 

^ Frances Power Cobbe, and Benjamin Bryan, VivieeeHon in Ameriea^ 
p. 15. 


The English is as distressing as theproposal is astounding. 

Let me give one more illustration of the effect of anti- 
vivisection in encouraging cruelty. 

To-day the plague, cholera, and yellow fever no longer 
terrify Europe or America. What is the reason for this? 
Primarily and chiefly the discovery of the germs of cholera 
and of the plague by bacteriologic methods, which in turn 
are very largely the result of experiment on animals, and 
of the means of the transmission of yellow fever, though 
as yet not of its cause. In the latter case experiments on 
animals were out of the question because it is impossible 
to transmit yellow fever to animals. They are not suscepti- 
ble to the poison. So a number of noble medical men and 
others volunteered to have experiments tried on them. The 
very first experiments were tried on medical men. These 
men slept in a stifling atmosphere for twenty nights in the 
beds in which yellow fever patients had died, and in their 
very clothes, — clothes soiled with their black vomit, urine 
and feces; tried to inoculate themselves by putting some 
of the black vomit into their eyes, or by hypodermic injec- 
tions, etc., but all in vain. By none of these methods were 
they able to inoculate themselves with the fever. One step 
more was requisite — to learn whether a well man bitten 
by an infected mosquito, but having been exposed to no 
other possible source of infection, would contract the 
disease. Dr. Carroll, of the army, was the first to offer 
himself, and nearly lost his life. Others followed. Several 
lost their lives, among them Dr. Lazear, at the beginning 
of a most promising career.^ 

Contrast with this a cruel letter* written by a woman: 

Science is based on such firm foundation, indeed, that it 
can at a moment's notice be tumbled down and become a 
wrecked mass by a mosquito! Not only this, but these lifelong 
vivisectors could not even prolong their own lives. Undone by a 
mosquito! I shall always have unbounded admiration for thai 
clever insect, [Italics mine.] 

» Sec ante p. 229. « New York Herald, August 2, 1909. 


This self-sacrifice for humanity has made us masters 
the world over of yellow f ever» has made possible the 
Panama Canal» has saved many thousands of human lives 
and millions of dollars in our own Southern States alone, 
and yet a woman can feel ^* unbounded admiration for the 
clever insect" which slew these heroes and had devastated 
cities and countries for centuries! Does not such antivivi- 
section zeal *'hurt character"? 

Two men are especially obnoxious to the antivivisec- 
tionist: Pasteur, whose demonstration of the cause of that 
form of infection known as puerperal or childbed fever 
alone would have made his name immortal; and Lister, 
whose application and extension of the principles laid 
down by Pasteur have revolutionized all modem surgeiy. 

I need not argue the case for Pasteur, Lister, and mod- 
em antiseptic surgeiy. Excepting the antivivisectionists, 
eveiy intelligent man and woman the world over knows 
that modem surgeiy has been made safe by their researches. 
Let me give a single instance. 

In the charming '^Life of Pasteur" by Ren6 Valleiy- 
Radot, it is stated^ that, hoping to overcome the almost 
invariably fatal results of ovariotomy in the hospitals, 
the authorities of Paris '^hired an isolated house in the 
Avenue de Meudon, a salubrious spot near Paris. Lx 1863 
ten women in succession were sent to that house. The 
neighbors watched those ten patients entering the house, 
and a short time afterward their ten coffins being taken 

To-day, thanks to Pasteur and Lister and modem sur- 
gery, based on experiment on animals more than on any 
other f oimdation, not more than two or three in a hundred 
die after ovariotomy. Yet, if the antivivisectionists had 
prevailed, the horrible mortality of the earlier days and 
even the tragedy of the ten women and the ten coffins 
would still exist. Is not this cruelty? 

^ Vallery-Radot, Life of Pasteur, vol. ii» p. 16. 


Let me take another illustration of a similar cruelty, 
a form especially interesting to women. Professor J. 
Whitridge Williams»^ professor of obstetrics in the Johns 
Hopkins University, states the following facts: In 1866 
Lefort showed that in 888,812 obstetric cases in the 
hospitals of France up to 1864, 80,8M women had died of 
puerperal fever; that is to say, SM per cent, or about eveiy 
twenty-seventh mother. From 1860 to 1864 the mortality 
in the Maternity of Paris had risen nearly fourfold, to 12.4 
per cent. In December, 1864, it rose to 57 per cent; that is 
to say, more than one half of the women who bore children 
in that hospital in that month died of childbed feverl 
In Prussia alone, in the sixty years from 1815 to 1875, 
Boehr showed that 868,624 women had died of the same 
fever and estimated that eveiy thirtieth prospective mother 
was doomed to death from that cause. In the United 
States, Hodge, of Philadelphia, showed that in the Penn- 
iqrlvania Hospital, from 1803 to 1838, there had been a 
mortality of B.6 per cent; i.e., eveiy eighteenth mother 
was doomed. Lusk reported an epidemic in 1872 with 18 
per cent; that is, almost eveiy fifth mother perished from 
the same fever! 

As late as March, 1879, only thirty-three years ago, at 
the Paris Academy of Medicine, when the leading men in a 
debate on childbed fever were at a loss to account for it, 
Pasteur drew on the blackboard what we now know as the 
streptococcus and declared this Uttle vegetable organism 
to be its cause. Our own Oliver Wendell Holmes, in 1843, 
was the first who declared on clinical grounds that the 
doctors and the nurses carried the contamination, but how 
and why he could not know, for bacteriology did not then 
exist. He was followed by Semmelweis, of Vienna, who, 
in 1861, still further reinforced the reasoning of Holmes, 

* J. Whitridge Williams, ''Obstetrics and Animal Experimentation," 
Jour, Am, Med, Aon,, Api^ 22, 1911, p. 1159, and no. xvm in the series ol 
pamphlets on Defense ol Research. (See p. xix.) 


and for his pains was tabooed by his professional colleagues 
and ended his life in a madhouse. 

The result of Pasteur's researches and the practical 
application of Lister's antiseptic method to obstetrics as 
well as to surgeiy have borne the most astounding and 
gratifying fruit. For instance, in 1909, Markoe reported 
in the New York Lying-in Hospital in 60,000 births a 
maternal mortality of only 0.S4 per cent, and Pinard, in 
1909, in 45,683 births recorded a mortality of only 0.15 per 
cent, while in 1907 Mermann had been able to report a 
mortality of only 0.08 per cent in 8700 patients! Lx other 
words, these reports show in round numbers that, taking 
in the two extremes, the deaths from childbed fever fell 
from the eztraordinaiy rate of fifty-seven in a hundred 
mothers, or the former usual rate of five or six in every 
hundred mothers, to one mother in 1250. 

If for fifty years past the antivivisectionists had had 
their way, all these marvelous results in obstetrics would 
have been prevented and women would still be dying by 
the hundred and the thousand from puerperal fever — an 
entirely preventable disease. Would it not have been the 
height of cruelty to stop these experiments? But according 
to the ''Journal of Zo5phily" such wonderful life-saving 
experiments should be prohibited, **no matter how great the 
anticipated berufit.** 

In surgeiy, erysipelas, blood poisoning, lockjaw, hospital 
gangrene, etc., would still be killir^ our patients right and 
left; weeks of suffering, to say nothing of danger, would 
confront eveiy patient operated on; the modem surgeiy 
of the head, of eveiy organ in the abdomen and pelvis, of 
tumors and of cancer, amputations and many other opera- 
tions, instead of being almost painless and so safe as th^ 
are to-day, would be the cause of prolonged illness, pain 
and death; in fact, most of them would be deemed entirely 
imx)ossible of performance — th^r were impossible before 
Pasteur and Lister — and animals themselves would still 


be suffering as of old from animal maladies whose causes 
are now known and whose ravages have been enormously 

Call you not the desire to arrest such experiments 
cruelty to man and animals alike? 

In a speech in the House of Commons, April 4» 1883, 
Sir Lyon Playfair, the Deputy Speaker, said: — 

For myself, though formerly a professor of chemistry in the 
greatest medical school of this country [Edinburgh], I am respon- 
sible only for the death of two rabbits by poison, and I ask the 
attention of the House to the case as a strong justification tisir 
experiments on animals; and yet I shoidd have been treated as a 
criminal under the present act [the British vivisection law] had it 
then existed. 

Sir James Simpson, who introduced chloroform, • . . was then 
alive and in constant quest of new anesthetics. He came to my 
laboratory one day to see if I had any new substances likely to suit 
his purpose. I showed him a liquid which had just been discov- 
ered by one of my assistants, and Sir James, who was bold to 
rashness in eiq)erimenting on himself, desired inunediately to 
inhale it in my private room. I refused to give him any of the 
Uquid unless it was first tried on rabbits. Two rabbits were 
accordingly made to inhale it; they quickly passed into anesthesia 
and apparently as quickly recovered, but from an after-action of 
the poison they both died a few hours afterward. Now was this 
not a justifiable experiment on animab? Was not the sacrifice of 
two rabbits worth saving the life of the most distinguished physi- 
cian of his time? 

As this experiment was not for the good of the two 
rabbits, but in fact, killed them, in the eye of present-day 
antivivisectionists it would be wrong, and, if th^ had 
their way, illegal and punishable, and Simpson would have 
lost his Ufe. Would not this be cruelty? 

Let me state briefly two of the most recent discoveries 
in medicine and surgery: — 

1. Vaccination against typhoid fever. Starting from 
Pasteur's researches on animal diseases and continued 
l^ various observers, and especially in the last few years 


by Sir Almroth Wright, of London, there has been devel- 
oped, chiefly by experiments on animals, a ^Vaccine" to 
jyreverU t3q>hoid fever. When by such experiments the 
method was found to be sufficiently safe, it was tried on 

Lx the Boer War, and among the German troops in 
their African colonies, tentative trials of its value were 
made. Now it has been tried in the United States Army 
on a larger scale and with more astonishingly good results 
than in any previous trials. 

During the Spanish War there were 20,738 cases of 
typhoid and 1580 deaths; nearly one fifth qf the entire army 
had the disease. It caused over 86 per cent of the entire 
mortality of that war! In some re^ments as many as 400 
men out of 1300 fell ill with it. How this would handi- 
cap an army in the field — to say nothing of deaths — is 

Lately in our army on the Mexican border, for months 
under war conditions, except as to actual hostilities, there 
has not been a single soldier ill wUh typhoid. This is due 
partly to better sanitation (which in turn is due largely 
to bacteriology), but chiefly by reason of wholesale anti- 
typhoid vaccination. This is evident from the fact that 
during the year Jime 30, 1908, to 1909, when this vaccina- 
tion was purely voluntary and the army was not in the 
field, proportionately sixteen times as many imvaccinated 
soldiers fell ill with the disease as compared with the 
vaccinated. On the Mexican border there has been only 
one single case of t3q>hoid, not in a soldier, but a teamster 
who had not been vaccinated. So evident are the benefits 
of this preventive inoculation that Dr. Neff , the director 
of health of Philadelphia, has issued a circular proposing 
its municipal use, and also to prevent typhoid in our sum- 
mer resorts. In many large hospitals it is extensively used 
to protect the physicians and nurses from catching the 


Would it not have been cruel to prevent such life-saving 

2. In surgeiy let me instance the surgery of the chest. 
This has been the region in which progress has lagged 
far behind that of all the other parts of the body till 
within the last five or six years. The reason was that 
the moment you opened the chest cavity to get at the 
heart, the lungs, the esophagus, the aorta or the pleura, 
it was like making an opening in the side of a bellows. 
The air, instead of being drawn in and forced out through 
the nozzle (corresponding to the mouth in the case of a 
patient), passed in and out through the opening in the side 

^ The Reports of the Surgeoii-€reneral of the Army for 1909 to 1912 
show the foUowing number of cases and deaths from typhoid fever: — 

Ywt Com* Diotib 

1009 178 10 Protective Tacciiiation wm entirelj Tohmtaiy bat 

1010 149 10 WM graduaUy winning its wiy. 

1011 00 8 September SO, 1911, it wm enforoed imiyena]ly in 
1018 87 4 the Army. 


f^ci a single ease in the United States, Hawaii, Porto Rico, Panama* 
Alaska, or the Philippines t Meantime the army had increased in numbers 
from about 69,000 to over 88,000! 

The condurion of the Surgeon-General is that, as a result of the pro- 
tection a£Forded by the anti-tjrphoid " vaccination,'* "typhoid fever will 
cease to be a scourge to the army in the future." 

In the Brit Med. Jour, tor August 22, 1914, p. 869, is an "Appeal by 
the War Office " urging typhoid vaccination of the British soldiers en- 
gaged in the present European war. One fact is most impressive and 
exactly corresponds to the experience of our own American army. 
Though this protective vaccination is still only voluntary in the Eng- 
lish army, " about 98 per cent of the British garrison of India have been 
protected by inoculation, and typhoid fever, whieh used to cost us from 
three hundred to six hundred deaths annually was last year responsible for 
less than twenty deaths.** 

Doubtless our antivivisection friends will object, as they do in the case 
of diphtheria, smallpox, etc., to the introduction of such a "vile poison.'* 
What does common sense reply? 

Since writing this I find in the Open Door (a New York antivivisection 
organ), in its issue for March, 1914, an article entitled "Typhoid Vaccine 
Fraud again punctured"! If we could find a similar "fraud" agiunst 
scarlet fever, measles, whooping-cough, etc., what a blessing to humanityl 


of the bellows or the chest. If only one side of the chest 
was opened, breathing was embarrassed, if both sides were 
opened, the patient's lungs collapsed, breathing was impos- 
sible, and death ensued. 

Sauerbruch, then of Breslau, first devised a large air- 
tight box or chamber in which the pressure of the air could 
be increased or diminished at will. The body of the 
patient, the surgeons, nurses, and instruments were all 
inside the box, and a telephone enabled them to give direc- 
tions to those outside, especially to the etherizer. The 
head of the patient with an air-tight collar around his neck 
protruded outside of the chamber where the etherizer also 
was placed. In such a chamber the chest could be safely 
opened. But while this was an immense improvement, 
such a chamber is clumsy, not easily transportable, and is 
veiy expensive. The method has done good service, how- 
ever. It has been improved by others and is in use to-day 
by many surgeons. 

At the Rockefeller Institute, Meltzer and Auer, by a 
number of experiments on animals, have lately developed 
a new, simple, and safe method of anesthesia with ether 
which is revolutionizing the surgeiy of the chest and to 
a considerable extent may even displace the ordinaiy 
inhalation method of anesthesia. As soon as the patient 
has been etherized in the ordinaiy way, a rubber tube is 
inserted into the windpipe through the mouth. By a foot 
bellows ether-laden air is pumped into the lungs through 
this tube, the foul breath escaping between the tube and 
the windpipe and out through the mouth. Experiments 
on animals showed that the rubber tube used for so long a 
time would not injure the vocal chords and so alter or 
destroy the voice of a patient, or cause injury to the limgs, 
and that the method was most efficacious in the surgeiy of 
the chest. 

I saw Carrel thus keep a dog under ether for about an 
hour and a half; open both sides of the chest by one wide 


sweep of the knife; displace the heart and lungs this way 
or that; expose and divide the aorta between two clamps 
(the clamps were applied in order to prevent immediate 
fatal hemorrhage) ; do a tedious and difficult operation on 
the aorta; imite its two cut ends; replace the heart and 
limgs, and close the wound. An hour later the dog, which 
showed no evidences of suffering, was breathing naturally, 
and in time recovered entirely.^ What this method means 
in injuries and diseases of the heart, in gangrene, abscess 
and tumors of the lungs, in cancer of the esophagus, and 
foreign bodies locked in the esophagus or in the bronchial 
tubes, and in diseases of the aorta, one can hardly yet even 

These experiments have done more for the surgeiy of 
the chest in three or four years than all the ^* clinical 
observation*' of cases in a thousand years. The method 
has already been tried successfully in several hundreds 
of cases in man, and the future has in store for us a new and 
most beneficent chapter in the surgeiy of the chest. 

Yet, if the antivivisectionists had prevailed, all these 
experiments would have been prevented, the doors of the 
Rockefeller Institute nailed up, and men, women, and 
children have been deprived of the benefits of these splen* 
did discoveries. Call you not that intensely cruel? 

Moreover, these veiy same people, in their own house- 
holds and without the slightest pity, will kill rats and mice 
by turning them over to the tender mercies of cats, by 
drowning them, by stranglii^^ them in traps, by poisoning 
them with stiychnin or phosphorus, or by any other means 
of "torture"; but they hold up their hands in holy horror 
when any proposal is made to terminate the lives of other 
rats and mice almost always without pain and with im- 
mense benefit to humanity. They are cruel and callous to 

^ For these and other experimental reseaiches Carrel has just been 
awarded the Nobel Prize in medicine — a splendid testimony to his genius 
from the first scientists of the world. 


human suffeiii^ so long as dogs and cats, mice and guinea- 
p^ escape! And yet, as I have shown, only twenty-six 
animals in a thousand can possibly ever suffer at all! 

That sentiment rather than principle is at the bottom 
of the antivivisection crusade is shown l^ what I in 
common with many others believe to be true, that if 
experimental research could be carried on on other animals 
without using dogs and cats there would scarcely have been 
any antivivisection movement* 

III. Lessened Reverence for Trvihfvlness 

The third way in which the influence of antivivisection 
injures character is by diminishing the reverence for 
truthfulness. In 1901 I gave many instances^ of the mis- 
statements of the antivivisectionists. These misstatements 
were contained in two anonymous pamphlets, and I have 
two more similar publications which are also anonymous. 
I have before me also three publications purporting to be 
replies to that publication of mine, all again anonymous. 
Is a foe who attacks from ambush worthy of the respect 
and confidence of the public? 

These misstatements, so far as I know» are still dis- 
tributed in leaflets and pamphlets without correction 
nearly eleven years after their incorrectness was shown. 
In fact, several of them reappear uncorrected in the 
"Journal of Zo8phily " for July, 1911. 

Let me give a few new instances. 

The most prominent antivivisectionist in England is 
Mr. Stephen Coleridge. On page 183 (April to July, 1907), 
in the minutes of his evidence before the Royal Conmiis- 
sion on Vivisection, I find the following: — 

Question 10952: We may have inspection, but still we may 
ask a person of character when he saw the experiment what his 
opinion of it was. Will you not accept that? 

^ W. W. Keen, "MisstatementB of Antiviyiaectionists," Jovar. Am, 
Med, As9n,, February 28 and August 10» 1901, and onto, pp. 110 and 135 
of this volume. 


Answer: Certainly not, because I think that all these expeii* 
menters have the greatest contempt for the Act of Parliament. 
Th^ would deny a breach of this act just as I should deny a 
breach of the Motor-Car Act. I drive a motor-car, and when I go 
beyond the speed limit and the policeman asks me, I say, "No, 
I am not going beyond the speed limit ^ [italics mine]. Nothing 
would keep me from going beyond the speed limit except the 
presence of a policeman in the car; and nothing will keep the 
experimenter within the four comers of the act except an inspec* 
tor in the laboratory. 

Question 10958: Surely, if you were asked about the speed 
limit and gave your word that you had not exceeded it, you 
would not expect to be disbelieved? 

Answer: No, X did not say so. I said last year that of course I 
did, and I exceed it every time. 

Question 10954: You are apparently not very ethical ahovi 
motor-cars [italics mine]. If you apply your principles as regards 
motoring to the physiologists, you have very little to say against 

Answer: What I have to say is that they r^^ard the Vivisec- 
tion Act of 1876 with the same contempt that I regard the 
Motor-Car Act as regards the speed limit. 

In quoting also a letter from the Home Office, ISfr. 
Coleridge admits mutilating it, for in reply to Question 
1 1015, he says, '* I seem to have left out the important item 
of it.'' See also Questions 10301, 11011, 11024 and 19067 
to 19978. 

Comment on Mr. Coleridge's testimony is superfluous. 

Again in the *' Black Art of Vivisection," Mr. Coleridge 

1 In a letter referring to this address (Boston Med, and Surg, Jottr.^ 
July 11, 1912, p. 71), Mr. Coleridge says that I seem "quite shocked that 
he should admit that he constantly breaks the law and exceeds the speed 
limit of twenty miles an hour in his motor-car," and that "a quarter of a 
million motorists" do the same. If the reader will agdn peruse Mr. 
Coleridge's testimony, as quoted in the text, he will find that theie are 
two admissions: (1) that he constantly breaks the law, i.e., the "statute 
law," of England as to the speed limit; and (2) that when he goes beyond 
the speed limit, and the policeman asks him, he says, **No, I am nol 
going beyond the speed limit. The last statement is what gives special 
p<nnt to the quotation from his evidence, but in his letter he omits any 
reference to this more important admission of confessed falsehood. 


gtates, '"The Pasteur institutes in Paris and elsewhere 
have entirely failed to prevent people dying of hydro- 
phobia." Yet the fact is that formerly from twelve to 
fourteen per cent of persons bitten developed the disease 
and eveiy one of them died» whereas the result of the 
Pasteur treatment in 55»000 cases has diminished the 
mortality to 0.77 per cent of those bitten. 

I cite another English mstance. In ''The Nine Circles''^ 
is published a r^ly to a letter by Sir Victor (then Mr.) 
Horsley, published in the London "Times," October 25, 
1892, a copy of which I have before me. A oc^y of the now 
rare first edition and these quotations from the London 
"Times" are in the Library of the College of Physicians 
of Philadelphia. The book, as the London "Times" points 
out in an editorial, was 

Compiled under his [Dr. Berdoe's] direction. He was en- 
trusted with the task of reading the proofs and was supposed to 
safeguard the accuracy of ''the compiler." He now admits that 
he overlooked in Miss Cobbe's preface a passage in which she 
''was careful to say, ... so far as it has been possible, the use or 
absence of anesthetics has been noticed in regard to all the 
experiments cited in this book." Mr. Horsley, in the appendix 
to his letter, which we publish this morning, shows by reference 
to some twenty cases cited in "The Nine Circles" how entirely 
inconsistent with the truth this guarantee b, and Dr. Berdoe's 
reluctant acknowledgment completes the proof. 

A still more remarkable letter appears in the same 
number of the "Times" from Professor C. S. Sherrington, 
of Liverpool. He says: — 

I find in the book, "The Nine Circles," three instances in 
which I am by name and deed held up to public abhorrence. 
From each of the three statements made about me the employ- 
ment of anesthesia in my experiments is studiously omitted, 
although expressly mentioned in each of the published papers on 
which these statements are professed to rest. In two out of 
three statements I am accredited with inflicting on living ani- 

^ Second edition, pp. 88-88. 


mals, and without the employment of anesthetics, a dissection 
and procedure that I purtued only on animaU which were dead. 

AccordingIy» the society withdrew the book from the 
market, but later published a revised second edition* 

In his reply to Professor Horslqr*8 letter calling atten- 
tion to the misstatements in the first edition, the excuses 
that Dr. Berdoe gives in this second edition are veiy 
extraordinary. Among them, for example, one is, *^The 
sentence about testing the right after recovery from the 
anesthetic was overlooked." Another excuse is, ^^This was 
taken at second hand from another report where the ques- 
tion of pain was not under discussion." In a third he says^ 
*' We have not always access to ^original papers* and can 
only rely on such reports and extracts as are given in the 
medical and other joumab." 

I ask whether it is fair, square dealing to base grave 
charges of cruelty on sentences ^^ overlooked" and on 
''second-hand" misinformation? 

But Miss Cobbe was by no means satisfied with mis- 
r^resenting English medical men. In the pamphlet 
''Vivisection in America," I find on page 9 a letter by a 
Boston lawyer in which he says of American experiments: — 

In other words, animals are dissected alive, ustiotty wMoui 
ihe use cf anetthetica, for the supposed (but illusory) gain to 
science [italics mine]. 

I have already given a table showing that only twenty-dx 
animals out of a thousand could by any possibility have 
suffered any pain, and that even these were anesthetized. 
Is it correct, then, to say that animals are "dissected alive 
usually without anesthetics"? 

Near the top of page 45 Miss Cobbe's pamphlet reads 
as follows: — 

Dr. Ott, in the "Journal of Physiology," vol. n, p. 42, de- 
scribes a number of experiments on a number of cats noi etherized 
[italics my own], for the purpose of making observations on the 
physiology of the spinal cord. 


I find that on reading the original paper there were four 
series of experiments: — 

In the first series, there were twenty experiments. In 
the first experiment the animal was killed before the experi- 
ment began. In eleven other instances it is expressly 
stated in each experiment that the animals were etherized. 
Dr. Ott informs me that the other eight were so etherized 
and that he invariably etherizes the animals. 

In the second series there were eight experiments. On 
page 52 of the ** Journal of Physiology'' it is stated that 
the animals were etherized. 

The third series consisted of ten experiments, and on 
page 54 it is expressly stated that the animals toere 

The fourth series consisted of ten experiments and again 
on page 60 it is stated that the animals were etherized. 
We see, therefore, that Miss Cobbe's statement "not 
etherized" is imtrue, for of forty-eight animals, one was 
killed before the experiment was begun; in thirty-nine it 
is expressly stated that they were etherized; leaving only 
eight out of forty as to the etherization of which nothing is 
said, though it was done. 

On pages 45 to 48 I find a series of experiments on the 
surgery of the pancreas by the late Dr. Senn, of Chicago. 
This was in July, 1886, at a time when the surgery of \he 
pancreas was just beginning. Two pages and a half of 
Miss Cobbe's pamphlet are devoted to describing in detail 
experiments which, as no mention is made in her pamphlet 
of ether, one would certainly suppose were done without 
ether and would surely be very painful. On looking at 
page 142 of the original paper I find that it is expressly 
stated that the animals were etherized. 

In a series of experiments by Halsted, imder experiment 
No. 6, p. 51, Miss Cobbe's pamphlet says, "Died under 
the ox>eration, which was carried on for two hours on a 
young, small brindle dog," which would imply two hours 


of "agony." The origmal expressly states the fact that this 
dog died /rom the effects of the ether. 

So much for Miss Cobbe's idea of reproducing accurate 
accounts of the experiments to which she refers. 

An amusing instance of misrepresentation is seen in an 
antivivisection comment made on one of Carrel's experi- 
ments on a cat. "How intense the suffering must have 
been to cause a cat (an animal usually so quiet and repose- 
ful) to spend the day jumping on and off the furniture!'' 
As a matter of fact, the kitten was only "playing with a 
ball of paper." 

Another illustration of the way in which sentences are 
detached from their context and made to mean quite 
different things and repeatedly published years after the 
falsity of the statement has been demonstrated is shown by 
the constant inclusion of Sir Frederick Treves among the 
opponents of vivisection. He stated of one single investiga- 
tion that operations on the intestines of dogs in his opinion 
— other surgeoiLs do not hold the same opinion — were 
useless as a means of fitting the surgeon for operations on 
the human bowel. Ever since this utterance^ Sir Frederick 
Treves has been constantly quoted in the manner men- 
tioned, yet in a letter to the London "Times" of April 18, 
1902, he says: — 

The fallacy of vivisection can hardly be said to be established 
by the failure of a series of operations dealing with one small 
branch of practical surgery. No one is more keenly aware t>m.n I 
am of the great benefits conferred on suffering humanity by cer- 
tain researches carried out by means of vivisection. 

•• • 

This was noticed editorially in the " 
Journal" of April fi6, 1902. So late as 1909, in the May 
number of the "Journal of ZoOphily," the editor-in-chief, 
Mrs. Caroline Earle White, reprints from the "North 
American" of April 12, 1909, her signed letter, and implies 
1 Sir Frederick Treves, Lancet, London, November 5, 1908. 


that Sir Frederick Treves is an opponent of vivisection, 
seven years after this correction had appeared. In the 
number of the same journal for July, 1909, the associate 
editor of the journal prints a letter of denial from Sir 
Frederick Treves, and yet so late as the number for March, 
1911, p. 177, the same old quotation from Sir Frederick 
Treves is published in the same journal which twenty-two 
months before had printed his own letter of denial.^ 

At the annual meeting of the Research Defense Society, 
Sir Frederick Treves, in referring to the great progress 
made in the science of medicine, said: ''This progress has 
in the main been accomplished by experiments on animals." 
Ought not his name hereafter to be omitted from the list 
of the opponents of vivisection? 

A postal card issued by the American Antivivisection 
Society in Philadelphia (there are several others of the 
same sort) presents a picture of a large dog with his mouth 
gagged wide open and his paws tied ''without anesthetic." 
The object of the gag, of course, is to prevent the animal 
from biting before and while it is being etherized. It is 
absurd to state that this produces any pain, but a guide 
at the traveling antivivisection exhibition explained to 
two of my friends that it was used to break the jaws of the 
dogs! and that this was done "without anesthetics." But 
in nearly all our surgical operations within the mouth, on 
the tonsils, cleft palate, the tongue, etc., we employ gags 
of various kinds to keep the mouth wide open. To show 
how Uttle annoyance this causes, here is a picture (Fig. 9) 
of a Uttle girl, four years old, my own granddaughter, with 
a mouth-gag which I have used many times over with 
children and adults in ox>erations about the mouth. This 

^ Just as I had corrected the proof d this paper, April 29, 1912, I 
received through the mail from Mrs. Caroline Earie White a reprint of 
her letter of April 12, 1909, with the same mial^A/ling quotation, tlurty- 
three months after Sir Frederick Treves's letter of denial had been 
printed in her own journal. 

Sir Frederick Treves, Brit, Med. Jour., July 8, 1911, p. 82. 


particular photi^aph, it will be observed, was taken also 
"without an aoesthetic." It was not necessary to tie her 

Fra. 2. HoDth-gag as QBed In operatioiu about tbe moDtb. 

hands and feet as is done with dogs, for the child regarded 
the whole proceeding of photographing her with her mouth 
wide open as a "lark," and sat as still as a mouse. Is it 
neoessaiy to add that her jaw was not broken? 

Miss Britton, in her three-hundred-dollar antivivisec- 

tion prize essay,' vividly describes an operation (removal 

* Our Dumb AnimaU, January, 1010. 


of the breasts of a nursing mother dog) which was neifm 
done at all. This fictitious operation is described in *^The 
Nine Circles,"^ again it appears in Dr. Albert Leffingwell's 
essay, ^'Is Science Advanced by Deceit/' published in 
1900. In 1901, Professor Bowditch called Dr. Leffingwell's 
attention to the fact that no such operation was ever done. 
In Dr. Leffingwell's collected essays entitled ''The Vivisec- 
tion Question/' on page 169 of the second revised edition 
(1907), there is, in a footnote, a correction admitting that 
no such operation was ever done, but on page 67 of the 
same edition, a description of this same operation still 
appears uncorrected, six years after Bowditch's letter had 
been received and the misstatement acknowledged. 

In the Antivivisection Exhibit which was shown in 
New York, in the winter of 1909-10, Professor Lee states 
that there was ^'an oven heated by gas-burners which 
contains the stuffed body of a rabbit and which the attend- 
ant tells you is used for the purpose of baking live ftnimRla 
to death, and this also is performed without anesthetics." 
Then to add still further pathos, the note at the end of the 
label on the oven said '* gagging, muffling, or severing of 
vocal organs prevents tortured animals giving voice aloud 
piteously to such terrible suffering." As a matter of fact, 
''the oven is an apparatus intended for the indneration qf 
{he . * . refuse of a laboratory T* I might add that it is a 
constant practice in medicine and surgeiy now to use vari- 
ous forms of apparatus for the purpose of "baking" alive 
an arm, leg, or other part of the body, and lately a patient 
of mine has had her arm "baked" almost daily for weeks 
at a temperature up to 800^ F. with great benefit.' 

In the exhibit of the American Antivivisection Society 
in Philadelphia in November, 1911, a portrait of a dog 
was shown with a large placard stating correctly that the 
dog had been stolen from its owner and sold to the Univer- 
sity of Pennsylvania for experiment. It omitted to state 

^ Second edition, p. 2S. ' See ante, p. 8. 


the further fact, which is perfectly well known* that the 
dog was kept for identification under Rule 1 (pag^ 245)» 
was claimed, identified, and turned over to its owner and 
not used fct experimerU. Such a placard, stating half the 
truth, but not the whole truth, inevitably leads the public 
to draw a false conclusion. 

The bodies of three dogs were also exhibited, each la- 
beled, ''The Vivisected Product of a Philadelphia Lab- 
oratoiy." All show gaping wounds; one, in fact, has the 
entire abdomen and pelvis wide open. Such a condi- 
tion is utterly incompatible with any research. Surgeons 
and physiologists, when experimenting on animals, are 
necessarily as scrupulously careful in thdr antiseptic 
technic as in operations on human beings. Wounds are 
accurately dos^ and carefully dressed. Any esperimenter 
leaving wounds wide open and undressed as are those in 
these dogs would invite failure in every case, and when he 
published his results and had to confess to a high and 
needless mortality, he would discredit himself. 

One of these dogs shows an absurd operation in the 
neck. The great blood-vessels from the ri^t and left sides 
of the neck have been drawn together in front of the wind- 
pipe and then tied — a procedure that is unimaginable to 
anysuj^eon. Moreover, from the wide-open abdomen and 
pelvis the following organs have be^i removed: the 
stomach, all the large and small intestines, except aportion 
a few inches long, the spleen, the pancreas, both tiie kid- 
neys and the bladder. The liver, however, is left. Cannot 
even any non-medical person of ordinary intelligence see 
that if all these organs were really removed and, in addi- 
tion, the great blood-vessels of the neck on both sides were 
really tied, thus cutting off almost all of the blood-supply 
to the brain, and then the neck and the abdomen were left 
wide open, the death of the animal on the table would be 

About a dozen medical men, all teachers in medical 


schools, after caiehil inspection of these. dogs, unite in 
believing that all or nearly all of these mutilations must 
have been done pod mortem and not during life. More- 
over, there is no eindence that these animals were really 
*' vivisected/' that is, operated on during life. 

Still further, granting that all these operations were 
done for research and during life, if the animak were 
etherized no pain would have been felt and no cruelty 
perpetrated. The significant omission to say anything as 
to any anesthetic, like the omission as to the restoration 
to its owner of the stolen dog, entirety misleads the pubKc. 

Dr. Henry P. Bowditch^ quotes an extraordinaiy state- 
ment of the late Heniy Bergh, an ardent antivivisectionist. 
Mr. Bergh says: — 

Robert MacDonald, M J>., on being questioned, declared that 
he had opened the veins of a dying person, remember, and had 
injected the blood of an animal into them many times and had 
met with brilliant success. In other words, this potentate has 
discovered the means of thwarting the decree of Providence 
when a person was dying, and smitching away from its Maker 
a soul which He had called away from earth. 

I have happily been able to rescue quite a number of 
dying persons who but for my timely aid would have 
been dead persons. Instead of supposing that I had 
^'thwarted the decrees of Providence and snatched a soul 
from its Maker," I have always been under the impres- 
sion: (1) that it was not in my feeble power to thwart 
the decrees of the Almighty, and (2) the very fact that 
I was able to save a dying person from death was the best 
evidence that the decree of Providence was that the 
patient at that time should Eve and not die. 

But it seems that in the catechism of antivivisection it is 
an impious crime to save the life of a dying person, though 
I suppose it is proper to save the life of a patient who is 
only "sick." 

^ Henry P. Bowditcli, Amnmd Exprnmentatian, p. 78. 


In the ''Journal of ZoOphily'' for April, 1010, p. 44, 
under the caption ''Still More Barbarity,'' is an editorial 
signed "C. £. W.," the initials of the editor-in-chief. In 
this editorial it is stated as to certain experiments of 
Dr. Wentworth, of Boston, that they were "upon between 
forty and fifty little children in the Children's Hospital 
of that dty, every one of whom died after the performance 
of his operation." The "casual reader" would certainly 
understand that every one of these forty to fifty children 
died as a resuU of the operation. 

Let us see what the real fads are.^ In 1805, in a case of 
possible tuberculous meningitis. Dr. Wentworth did lum- 
bar puncture in order to make a positive diagnosis. Lum- 
bar puncture consists in introducing a rather long hypo- 
dermic needle between the vertebrse in the small of the 
back (lumbar region) and withdrawing some of the fluid 
from around the spinal cord. This fluid circulates freely 
to and fro both within the brain and its membranes and 
within the membranes of the spinal cord. The needle is 
inserted below the end of the spinal cord, rarely with gen- 
eral anesthesia, sometimes with local anesthesia of the 
skin, but generally without even this, as the pain is slight 
and only momentary. 

In 1805 this method of diagnosis was very new. Its 
value was uncertain, its dangers, if any, were not deter- 
mined. The appearance of the fluid and the nature of its 
microscopic contents in human beings were imperfectly 
known. Dr. Wentworth in this case used the method for 
diagnosis. Alarming symptoms appeared, but passed 
away. The child was proved not to have menin^tis and 
" left the hospital shortly afterward perfectly welL" 

In order to determine whether this case was exceptional, 
and the dangers only accidental, or always to be feared 
(which if true might compel the entire abandonment of 
lumbar puncture), he repeated the operation most can- 

^ Boston Med, and Swg, Jour,, August 6 and 13, 1896. 


tiously at first and finally with surer faith in its safety and 
value in twenty-nine other cases. In fifteen of the thirty 
cases the puncture was expressly done in order to make a 
diagnosis — meningitis or other diseases of the brain and 
spinal cord being suspected. In the other fifteen cases, 
while there probably was no cerebral or spinal disease, it 
was of great importance to know whether examination of 
the cerebro-spinal fluid might throw any unexpected side- 
light on these diseases, and if not, it would at least disclose 
what the normal condition, appearance and microscopic 
contents of the fluid were. 

Forty-five punctures in all were made on the thirty 
children. In three cases the puncture was made after 
death. Of the twenty-seven living children, fourteen died. 
Not one of ihe fourteen died from the operatwriy but, as the 
post mortems showed, from meningitis, tuberculosis, pneu- 
monia, water on the brain, convulsions, etc., as is ex- 
pressly stated in each case in the i>aper. 

But the editorial says ''between forty and fifty little 
children . . . every dfie of whom died after the performance 
of the ox>eration.'' I have before me several antivivisection 
pamphlets published in New York, Philadelphia and Wash- 
ington in which Wentworth's cases are narrated as cases of 
''human vivisection," and it is usually stated that "many 
of them died," but the reader would still suppose that it 
was as a result of the ox>eration. In two of these pamphlets, 
"brief abstracts" of five cases are given, usually only one 
to three lines long. The poH-mortem reports published in 
Wentworth's i>ax>er showed that these five patients died 
from meningitis (two cases), infantile wasting, tuberculosis 
and defective development of the brain and convulsions. 
Yet the "casual reader" would inevitably suppose that 
they died from the lumbar puncture as no other cause of 
death is stated in these pamphlets. 

When Dr. Cannon pointed out the inaccuracy of the 
editorial of April, 1010, in the "Journal of Zo5phi]y," that 


same journal in the issue for July» 101 1» p. 210, in a paper 
signed *'M. F. L."*(the initials of its associate editor) not 
only did not acknowledge the error, but practically re- 
peated it by sa3ang that Dr. Cannon is ^^severe on the 
^Journal of ZoOphily ' for having referred last year to Dr. 
Wentworth's forty-five experiments on children and for 
having mentioned the fact that the children died qfter the 
operation** [italics mine]. 

Is it fair dealix^ to give such veiy brief abstracts and 
omit the most important facts as is done here? In 1901 
I pointed out^ these misstatements and what the truth 
was> but the same pamphlets have been constantly dis- 
tributed without any correction. In November, 1910, 
nearly ten years after I had exposed the matter. Dr. 
Cannon states that one of these pamphlets was sent to 
a friend of his with a letter from the president of the New 
York Antivivisection Society, saying, *^You may rely on 
them as being absolutely accurate and authentic!'* Still 
worse: In April, 1910, ^'C. E. W.'' enlarges the number 
from thirty to ^'between forty and fifty'* and actually says 
that **eveiy one" of them died, and ^'M. F. L.'* practically 
repeats the misstatement by saying that **the children 
died after the operation.'* ' 

Suppose thirty friends dined together at the Bellevue- 
Stratf ord, then took a train and as a result of a collision 
fourteen were killed; would a reporter, and still less an 

1 ''Mintatements of Antiviviaectiomsts," Jour. Am. Med. A$9'n., Feb- 
ruary S3 and August 10, 1901. (See ante, pp. 110 and 185 of this volume.) 

* In Mn.White'8 rej^ to this address (p. 144). she ''pleads guilty** to 
the charge of misstating; as to these children* "that they all died," and 
says she " unconsciously exaggerated." On page liS she states that she is 
''most particular to avoid not only falsehood, but even exaggeration." 
It is hardly correct to say that the statement that there vrere "between 
forty and fifty children" and that "they all died" is an "exaggeration** 
of the real fact, namely, that there were only twenty-seven living children 
operated on, and of the fourteen who died,9io( ofi« of them died from the 
operation, but from well-known causes revealed by the poH^mortem 
cxaminatioDs and fully stated, in each case, in Dr. Wentworth's paper. 


editor, be justified in stating in print» '^Between forty 
and fifty friends dined last night at the Belleyue-Stratf ord. 
Eveiy one died shortly after partaking of the dinner,'* 
entirely omitting the collision as the real cause of death? 

Now, after fifteen years, what has been the result of 
these investigations by Dr. Wentworth and others? 
Lumbar puncture is a thoroughly well-established means 
of diagnosis. That it isattend^ with practically no danger 
is shown by the fact that it is now a routine practice in 
certain diseases, even much more important than recording 
the pulse and the temperature. Holmes^ states that he 
has done the operation *^over four hundred times and has 
never met with an accident." 

It is not only always done in some diseases, but is 
repeated two, three or more times in the same patient in 
cases of cerebro-spinal meningitis. As I showed in my 
pax>er in the "Ladies' Home Journal" (April, 1910),* the 
son of then Governor, now Mr. Justice Hughes, of the 
United States Supreme Court, a student at Brown Uni- 
versity, stricken with a violent attack of the epidemic form 
of the disease, had lumbar puncture done three times; 
the first time in order to make a diagnosis and also for 
the injection of Flexner's serum, the second and third 
times for two other injections of the serum, which snatched 
him from otherwise practically certain death. 

In this disease, Boyer* says, "It is absolutely necessary 
to do a lumbar puncture" to make a diagnosis, and Dimn^ 
says emphatically, "Without lumbar puncture a diagnosis 
of cerebro-spinal meningitis is absolutely without value 
for scientific, statistical or therapeutic purposes." 

As there are half a dozen different forms of meningitis, 
and the remedy for the deadly epidemic form is of no use 

^ Holmes, Arch. Peditd., October, 1908, p. 788. 

' "What Vivisection has done for Hmnanity," amUf p. 890. 

* Rqyer, Arch. PedUd., October, 1908, p. 729. 

^ Charles Hunter Dunn, Am, Jour, Dis, Ckiidrent February, 1911, p. 98. 


in the other forms, lumbar puncture, the only absolute^ 
positive means of differentiating them, cannot be dispensed 

Moreover, its use has been broadened, as shown in the 
case of young Mr. Hughes. No longer are we content to 
use it merely as a means of diagnosis, but it is the only 
means of successful treatment of that terribly fatal malady. 
It is also used for diagnosis in several surgical diseases and 
injuries. Moreover, the method of spinal anesthesia, which 
is most useful in cases in which other methods of anesthesia 
are too dangerous, is exclusively by means of lumbar 
puncture, the cocain or other local anesthetic being injected 
around the spinal cord by the hypodermic i^yringe.^ 

When a witness is called, it is not allowable for the party 
calling him to accept a i>art of his testimony and refuse 
to accept the rest, yet this is precisely what the opponents 
of research do. Th^ always cite, for example, the late 
Professor Bigelow, printing his earlier utterances based 
on the suffering he saw at Alf ort in the pre-anesthetic days, 
but th^ carefully omit the following later expression of 
opinion:* — 

The dissection of an animal in a state of inseiifflbilify is no 
more to be criticized than is the abrupt killing of it, to which 
no one objects. The confounding of a painful vivisection and 
an experiment which does not cause pain — either because the 
animal is under ether, or because the experiment itself is pain- 
less, like those pertaining to the action of most drugs, or because 
it is a trivial one and gives little suffering — has done great 
damage to the cause of humanity, and has placed the opponent 
of vivisection at a great disadvantage. ... A painless experi- 
ment on an animal is unobjectionable. 

^ Those who wish to consult by far the best statement for general use 
of the steps by which epidemic meningitis has been conquered, and the 
results of the new but now thoroughly well-established serum treatment 
by lumbar puncture, can obtain a copy of Dunn*s paper on this subject. 
No. 21 of the series in Defense of Research. (See pp. zix, xx.) 

' Henry J. Bigelow, Anedkena: Addresses and Other Papers, Boston* 
1900, p. 871. 


So, too, when the statements of HorsI^, Ott, Crile, 
and others that the a.nimals were anesthetized and suffered 
no pam are shown to antivivisectionists, th^ reply, ** We 
do not believe it, for the only testimony to this insensibility 
to pain is that of the vivisectors themselves." Th^ greed- 
ily accept as true all their other statements as to the opera- 
tions th^ did, etc., down to the minutest details, but they 
refuse to accept those as to anesthesia. No court of law 
would sanction such a course. 

In reviewing the preceding misstatements and those 
quoted in my former papers,^ I have been compelled to 
conclude that it is not safe to accept any statement which 
appears in antivivisection literature as true, or any quota- 
tion or translation as correct, until I have compared them 
with the originals and verified their accuracy for myself. 
Not seldom this is impossible, as no reference to the volume, 
month, day or sometimes even the year of publication is 

Lest the reader think this too severe a statement I 
will refer to only one instance in the anonymous pamphlet, 
'* Human Vivisection," in addition to others already ^own 
to be grossly inaccurate. 

On page 9 in the account of Sanarelli's five experiments 
in the endeavor to inoculate yellow fever, the phrase ''the 
final collapse" appears as an allq^ translation of the 
original Italian. The word ** final** does not occur in the 
original. Moreover, the collapse was not ''final," for eveiy 
one of the five patients recovered, yet the pamphlet says 
that "some if not all of them died." The phrases "scien- 
tific murder" and "scientific assassination "are also freely 
used. Even the cover and the titie-page of this pamphlet 
have as a motto, "Is scientific murder a pardonable 
crime?" As not a single patient died, were they really 
"murdered" or "assassinated"? 

^ "Mintatementsof Antivivisectiomsts," Jour. ilm. If «i.iiMii., Febru- 
ary 23 and August 10, 1901. (See 011(0, pp. 110 and 185 in this Wame.) 



In thirty years the sixteen British antivivisection socie- 
ties have received more than £100,000 ($500,000) ac- 
cording to Mr. Stephen Coleridge's testimony before the 
Royal Commission on Vivisection (Questions 10256 to 
10260). The American societies have had many bequests 
given to them, and in the aggregate must have also spent 
a large sum of money. 

On the other side, the friends of research and progress 
have had little mon^, have had to stop research and 
waste a deal of precious time in defending their be- 
neficent researches from the attacks of the antivivisec- 
tionists; the rest of the time they have quietly gone about 
their business, adding to the sum of our knowledge and 
forging new and more efficient weapons against disease 
and death. 

What, then, is the net result? What have the friends 
of research accomplished, and what achievements can the 
foes of research show? Let me put it in a contrasted tabu- 
lar form and confine it to what has occurred during my 
own professional life. 

The Aehieoemenis of the Friends cf Research 

1. They have discovered and devel(^)ed the antiseptic 
method and so have made possible all the wonderful results 
of modem surgery. 

2. They have made possible practically all modem 
abdominal surgery, including operations on the stomach, 
intestines, appendix, liver, gall-stones, pancreas, spleen, 

8. They have made possible all the modem surgery 
of the brain. 

4. They have recentiy made possible a new surgery of 
the chest, including the surgery of the heart, lungs, aorta, 
esophi^us, etc. 


5. Th^ have almost entirety abolished lockjaw after 
operations and even after accidents. 

6. They have reduced the death-rate after compound 
fractures from two out of three, i.e.» sixty-six in a hundred, 
to less than one in a hundred. 

7. Th^ have reduced the death-rate of ovariotomy 
from two out <^ three, or sixty-six in a hundred, to two 
or three out of a hundred. 

8. They have made the death-rate after operations like 
hernia, amputation of the breast, and of most tumors a 
n^;ligible factor. 

9. Th^ have abolished yellow fever — a wonderful 

10. Th^haveenormouslydiminishedtheravagesof the 
deadly malaria, and its abolition is only amatter of time. 

11. They have reduced the death-rate <^ hydrophobia 
from twelve or fourteen per cent of persons bitten to 0.77 
per cent. 

12. They have devised a method of direct transfusion 
of blood which has already saved veiy many lives. 

18. Th^ have cut down the death-rate in diphtheria 
all over the civilized world. In nineteen European and 
American cities it has fallen from 79.9 deaths per hundred 
thousand of population in 1894, when the antitoxin treat* 
ment was begun, to nineteen deaths per hundred thousand 
in 1 905 — less than one quarter of its death-rate before the 
introduction of the antitoxin. 

14. They have reduced the mortality of the epidemic 
form of cerebro-i^inal meningitis from seventy-five or even 
ninety odd per cent to twenty per cent and less. 

^ Mrs. "Whitet in her letter (p. 144), argues that this statement is in- 
correct because* forsooth, yeflow fever "is still flourishing in a number 
of places in South America, Central America, and Blezico." Of course it 
is, but all the world knows that if they adopted the methods of Colo- 
nd Grorgasin the Canal Zone, yellow fever would soon be banished from 
these other places. Since May 17, 1906, — over eight years, — not a sin- 
^ case of yellow fever has originated on the Isthmus! 


15. They have made operating tor goiter almost per^ 
f ectly safe. 

16. Th^ have asasted in cutting down the death-rate 
of tuberculosis l^ from thirty to fifty per cent, for Koch's 
discoyeiy €jt the tubercle bacilhis is the cornerstone al all 
our modem sanitaiy adiievements* 

17. In the British Army and Navy th^ have abolished 
Malta fever, which, in 1905, before their researches, 
attacked neariy thirteen hundred scddiers and sailors. In 
1907 there were in thearmy only devencases; in 1908, five 
cases; in 1909, one case. 

18. They have almost abolished childbed fever, the 
chief former peril of maternity, and have reduced its 
mortality from five or ten iq> even to fifty-seven in eveiy 
hundred mothers to one in twelve hundred and fifty 

19. Th^ have veiy recently discovered a remedy 
which bids fair to protect innocent wives and unborn 
childroi, besides many others in the community at large, 
from the horrible curse of syphilis. 

20. Th^ have discovered a vaccine i^ainst typhoid 
fever, which among scddi^s in camps has totally abolished 
typhoid fever, as President Taft has so recently and so 
convincing]^ stated. The improved sanitation which has 
helped to do this is itself largely the result of bacteriol<^c 

21. Th^ are gradually nearing the discovery 61 the 
cause, and then we hope of the cure, al those dreadful 
scourges of humanity, cancer, infantile paralysb^ and 
other children's diseases. 

Who that loves his fellow creatures would dare to stay 
the hands of the men who may lift the curse of infantile 
paralysis, scarlet fever, and measles from our children 

1 Since tlus was written (1918), the germ of infantile puralysis ktu 
been disoovered at the Rockefeller Institute — that Institute so hated 
of all Antivivisectionists. 


and of cancer from the whole race? If there be such cruel 
creatures, enemies of our children and of himiani1y> let 
them stand up and be counted. 

22. As Sir Frederick Treves has stated, it has been by 
experiments on animals that our knowledge of the path- 
ology, methods of transmission, and the means of treat- 
ment of the fatal ** sleeping sickness'' of Africa has been 
obtained and is being increased. 

23. They have enormously benefited animals by dis- 
covering the causes and, in many cases, the means of pre- 
venting tuberculosis, rinderpest, anthrax, glanders, hog 
cholera, chicken cholera, limipy jaw> and other diseases of 
animals, some of which also attack man. If the suffer- 
ing dimib creatures could but speak, they, too, would pray 
that this good work should still continue unhindered. 

In April, 1914, when Mr. Rockefeller gave $1,000,000 
to extend the work of the Rockefeller Institute, to the 
study of animal diseases in a laboratory to be established 
in New Jersey, the antivivisectionists persuaded the 
Governor to veto the bill authorizing this eminently 
humane work! 

The Achievements of the Foes of Research 

1. Not a single human life has been saved by their efforts. 

S. Not a single beneficent discovery has been made by 

8. Not a dngle disease has been abated or abolished by 
them either in animab or man. 

4. All that they have done is to resist progress — to 
spend $500,000 in thirty years in Great Britain alone* 
and very large amounts of money in the United States 
— and to conduct a campaign of abuse and gross misrep- 

5. They apparently care little or nothing for the contin- 
ued suffering and death of human beings, the grief and 
not seldom the ensuing poverty of their families, provided 


that tweniy-six out ct every thousand dogs and cats, 
monkeys and guinea-pigs, mice, and frogs eiperimented 
on shall escape some phyacal suffering. 

6. Th^ insist, therefore, that all experimental research 
on animals shall stop and — astounding cruelty — that 
thousands of human beings shall continue year after year 
to suffer and to die. 

The Age of Experiment is the Age of Progress. This is 
true in mechanics, in ^igineering, in electricity, in every 
department of human knowledge in which experimental 
investigation is possible. 

Medicine is no exception. Stop experiment and you 
stop progress. But while stopping progress in other depart- 
ments only means that we shall have no further develop- 
ment in the external comforts and conveniences of Uf e, the 
arrest of the experimental method in medicine means that 
progress in the knowledge of the cause and cure of disease 
shaU stop and that our present sufferings and sorrowful 
bereavements from the onslaught of cancer, scarlet fever, 
measles, whooping-cough, and all the other foes of health 
andlife — especially of our dear children — must con- 

In the last fifty years, by experimental methods, we have 
made more progress than in the preceding fifty centuries. 
I believe that if experimental research is continued and 
aided, the next fifty years will be still more prolific of 
benefit to mankind than even the past fifty. 

I have absolute confidence in the humanity, the in- 
telligence, and the common sense of this nation that 
they will see to it that this progress shall not be halted 
by the outcries and misstatements of the antivivisec- 

Dr. S. Weir Mitchell, when visiting the Antivivisection 
Exhibition in Philadelphia, put the matter in a nutshell 
when he said to one of the guides, ** Your exhibition is not 


quite complete. You should place here a dead baby and 
tiiere a dead guinea-pig with the motto> ^^Choose between 
them." 1 

^ Of course* not all antivivisectioiiiflts are to be grouped with tliose 
who are regponsible for the letters, the einthets, and the persistent mis- 
statements mentioned in this paper. I have, for example, s<nne most es- 
teemed personal friends who are more or less opposed to research by 
means ol experiments on animals. But I believe that most ol the reason- 
able persons who take this stand are not well informed, either as to the 
character of such researches, to their profound importance to the human 
race and to animals, or to thdr wonderfully beneficent results. They are 
misled by the misstatements of the chief antivivisectionists, and their 
kindly hearts are so shocked by the asserted "torture" of dogs, cats, etc, 
that they lose sight of the real and horrible torture continuously inflicted 
on human beings by diseases which the advocates of research are endeav- 
oring to banish. Had they ever stood as in the past I have stood, knife 
in hand, by the bedside of a gasping, livid child struggling for breath, 
ready to do a tracheotomy when the surely tightening grip of diphtheria 
made it necessary to interfere, they would hail with delight the Uessed 
antitoxin which has abolished the knife and enormously diminished the 
mortality of that curse of childhood. They would surely Uess God that 
such a discovery as this antitoxin could be made solely by experiments on 
animals. The sufferings of a few such animals are as nothing compared 
with the lessening of suffering and saving of life for multitudes of human 
bdngs (to say nothing of the saving of sorrow and suffering to their fami- 
lies and friends), not only now, but for all time to come. 


It is difficult to write with calmness and moderation 
about the Antivivisection Exhibition, dnce it is such a mass 
of omissions and misrepresentations. 

I protest against an exhibit which misleads the public 
into believing that operations on animals are generally 
done without anesthetics. This is untrue. Anesthetics are 
universally employed in painful operations with the excep- 
tion of the extremely rare cases in which their use would 
vitiate the results. Moreover, they are so used as to pro- 
duce total insensibiUty to pain. To animals under their 
influence no operation can cause any suffering. All persons 
who have had surreal operations know this. The omission 
of the etherizer, theref ore» in pictures or descriptions of 
operations on animals is not a truthful representation* 
It wholly misleads the public. 

I protest against the impossible operations represented 
as the ^Mvisected products of Philadelphia laboratories.'' 
About a dozen teaches in medical schools, after inspecting 
the same or similar specimens in the exhibition a year ago> 
agreed with me that they had been probably done poH 
mortem and not during life. There is not the slightest 
evidence that they were done during life. They are mutila- 
tions the like of which I have never seen in any laboratory. 
When wounds are made in animals by surgeons, physiolo- 
gists or pathologists, th^ are closed with the most minute 
care. In this exhibit the wounds have been left wide open, 

^ Reprinted from the PubUo Ledger of December 9, 1918, by tlie 
kind permission of the editor. 

medical: progress 287 

and from the abdomen of one dog nearly all the internal 
organs had been removed — an absurdity in itself. 

I appeal to the knowledge and common sense of the 
vast majority of people who are not deluded l^ the gross 
misstatements of the antivivisectionists. If the latter had 
had their way for the last forty years, there would have 
been almost no progress in medicine and surgery and we 
should be practicing the old fatal sui^ry in vogue before 
Lister's day. Then two out of three compound fracture 
cases died. Now less than one in a hundred. Then ovarian 
tmnor operations also had a mortality of two out of three. 
Now only one or two in a hundred. Then five to ten and 
sometimes as many as fifty-seven mothers out of eveiy 
one hundred died in childbirth from childbed fever. Now 
only one in twelve hundred and fifty. 

To-day, in spite of the overwhelming testimony of really 
competent medical men, the antivivisectionists actually 
declare that diseases are not caused by germs! Of course, 
therefore, they decry the use of the antitoxins in diph- 
theria, lockjaw, epidemic cerebro-spinal meningitis, and 
as a preventive of typhoid fever. Yet every well-informed 
physician and intelligent layman knows positively the 
^lormous benefits of these remedies. 

To show how serious a menace to progress, to life and 
health the antivivisectionists are, one of the leaflets in this 
exhibition attacks one of the most extraordinarily benefi- 
cent of recent researches, that upon the hyx>ophysis or 
pituitary body. This little body, the size of a pea, lies at 
the base of the brain and is not rarely the seat of disease 
oroftumors. Up to only dx to eight years ago its functions 
were not known. By experiments upon animals these 
functions are now known to some extent and found to be 
of vital importance. Blindness is a frequent symptom of 
such timiors and eventually life is destroyed unless an 
C9)eration is done. 



It is true that the dogs experimented upon suffered 

paxa and doubtless felt wretched, for though the operations 

done upon them in order to ascertain the functions of this 

gland were done under an anesthetic, yet th^ could not 

be killed at once or the function of the gland would not be 

discovered. The only alternative is to watch the clumsy and 

confusing experiments of disease in human beings. This 

had been done for years without any definite results. The 

health and the lives <d the former sufferers from disease 

of this gland had been sacrificed in vain. Many of them 

j£ became cretins (idiots). Many ovei^rew and became loath- 

^ some in appearance and wretched in health. Many became 

^ blind, and many died. 

Note now the benefits from the experiments upon ani- 
mals. Already more than one hundred cfperations have 
been done, with a mortality of less than ten per cent. While 
writing this paper. Dr. Rodman E. Sheen, a most grateful 
young man of twenty-four, from Atlantic City, has called 
to see me to tell me of his remarkable case. In October, 
1909, the sight of his left eye began to fail. By August, 
1912, this eye was completely blind and the sight of the 
ri^t eye was rapidly failing. Only by the kindness of his 
fellow medical students could he complete his medical 
course. On March 8, 1918, Dr. Harvey Gushing removed 
a tumor of this gland. Immediately his vision began to 
improve. He can now read large print and his sight is 
steadily growing still better. Without operation death 
would certainly have overtaken him. Ask him if he thinks 
that his life and usefulness were not worth more than the 
sufferings and the lives of the four dogs whose pictures are 
shown in the antivivisection leaflet attacking these re- 
searches, and of all the other dogs experimented upon. 
Do not forget also that in the future hundreds of other 
patients also will be saved. 

Would it not be cruelty beyond belief if the search for 
the causes and means of cure of cancer, scarlet fever. 


measles, mumps» etc., should be stopped? And yet this is 
exactly what the antivivisectionists aie determined to do. 
A card on the wall of the exhibition reads: — 

We indorse Intimate surgery but deny it has been advanced 
through vivisection. 
(Signed) Ths Amxbican Antivivibsctiox Socibtt. 

Whose knowledge, opinions, and statements as to the 
value of vivisection will you trust? Shall it be those 
of Miss Lind-af-Hageby, Mrs. White, Mrs. Lovell, Mrs. 
Easby, and Miss Nicholson, the most active members of 
the American Antivivisection Society, women who have 
never studied medicine thoroughly if at all, or those of 
such life-long students and leaders in medicine as S. Weir 
Mitchell, Sir William Osier, William H. Welch, of Johns 
Hopkins; John B. Deaver, and men like them? The veiy 
question is an absurdity. 

I have heard myself called a ** hyena'' before a legislative 
committee at Harrisburg. I have rec^ved letters address- 
ing me as ^^yon fiend'' and even ** arch-fiend" and cursing 
my sainted mother for ever giving me life. These are not 
pleasant incidents. I would far rather have the esteem 
than the hatred of these persons, but for one thing — a 
profound sense of the duly I owe to my profession, and 
above all to present and future generations of my fellow 

For more than half a century I have spent my days 
and nights in the constant study of surgeiy. I have taught 
it to many thousands of students. I am nearing the end of 
a long and laborious life. I have had some small share in 
the wonderful progress of surgery during the last thirty 

I appeal to my fellow citizens and fellow countrymen to 
believe me when I say that while clinical observation, 
sanitary engineering, etc., have done much to make this 
progress possible, the chief means by which medicine and 


surgeiy have won their beneficent triumphs has been 
experimental research. To abolish all such research, as is 
the declared aim of the antivivisectionistSy would be a dis- 
aster to animals themselves. Millions of animals have 
benefited by our knowledge derived from experiments on 
animals, by which hog cholera, chicken cholera, rinderpest, 
anthrax, lumpy jaw, and other diseases of animals have 
been checked, cured or abolished. 

It would also be a disaster to the whole human race by 
preventing future researches which will equal if not sur- 
pass in value those of past years. Our descendants must 
not be abandoned to devastation and death from diseases, 
the cause, prevention, or cure of which are now unknown. 
The antivivisectionists in my opinion are enemies of 
animals and of the whole human race. 




Lawflon Tait: — 

''Bacteriological experiments on animali have pioYed of great 
value." * 

Professor Henry J. Bigdow: — 

''The dissection of an animal in a state of insensibility is no 
more to be criticized than is the abrupt killing of it» to which no 
one objects. The confounding of a painful vivisection and an 
experiment which does not cause pain — either because the 
animal is under ether, or because the experiment itself is painless, 
like those pertaining to the action of most drugs, or because it is a 
trivial one and gives little suffering — has done great damage to 
the cause of humanity, and has placed the oj^wnent of vivi- 
section at a great disadvantage. • • • A painless experiment on an 
animal b unobjectionable." * 

Sir Frederick Treves: — 

" No one is more keenly aware than I am of the great benefits 
conferred on suffering humanity by certain researches carried 
out by means of vivisection." * 

Sir Frederick Treves: — 

"This progress [in the science of medicine] has, in the main, 
been accomplished by experiments on animals." ^ 

Professor C. S. Sherrington* of Liveii>ooI: — 

"I find in the book» "The Nine Circles," three instances in 
which I am by name and deed held up to public abhorrence. 
From each of the three statements nuide about me the employ- 

^ fifduft If Altbal /ottffialL February 11, 1888, p. 817. See onia^ p. xiii 
of this volume. 

' Anetihena: Addre$8e$ and OOur Papen, Boston, 1900^ pi. 871. 

s London Times, April 18, 1902. 

« BriHak Medical Journal, July 8, 1911, p. 88. 


ment of anesthesia in my experiments is studioudy omitted, al- 
though expressly mentioned in each of the published papers on 
which these statements are professed to rest. In two out of three 
statements I am accredited with inflicting on living animals, and 
without the employment of anesthetics, a dissection and pro- 
cedure that I pursued only an atdmala which were deai.** ^ 

Mrs. Caroline Earle "White: — 

*'The best plan would be for the experimenters to go to India 
where they could find as large a field for investigation as they 
require in the poor victims themselves. Here is an opportumiy 
such 08 ie not qften qferedfor experimenting upon human beings ^ 
since, as they would invariably die from the snake-bites, there can 
he no objecHon to trying upon them every variety qf antidote that can 
he dieeovered. Nothing seems to me less defensible than these 
experiments on the poison of snake-bites upon animals, since it ia 
the one case in which they could be observed with so much eatie^ 
faction and certainty upon man!** (Italics my ownJ * 

Mrs. Caroline Earle "White: — 

*'I take issue with Dr. Keen . . . where he says, * These experi- 
ments cannot, nay, must not, be tested first upon man.' I assert, 
on the contrary, that in the majority of cases they must be 
tested first upon man or not tested at all." ' 

Unanimous report of the Royal Commission on Vivisection* 
On this commission the antivivisectionists were represented and 
joined in this unanimous report : — 

*'We desire to state that the harrowing descriptions and illua- 
trations of operations inflicted on animals, which are fredy circu- 
lated by post, advertisement, or otherwise, are in many cases cal- 
culated to mislead the public, so far as they suggest that the 
animals in question were not under an anesthetic. To r^resent 
that animals subjected to experiments in this country are wan- 
tonly tortured would, in our opinion, be absolutely false." * ' 

^ London Time*, October 25, 1898. 

* An Answer to Dr. Keen's Address, entiOed "Our Recent DtbU to Fm- 
seetion," p. 10. 
> Ibid., p. 4. « Report, 1912, p. 20. 


Dr. Herbert Snow, of London, as quoted by Mrs. M. F. 
Lovell: — 

'^Research among the lower organisms is the main path to be 
followed in the ages yet to be.'' ^ 

Dr. Herbert Snow, of London, in his evidence before the Royal 
Commission on Vivisection answered 826 questions in 1906. Li 
1911, he stated that he gave all this evidence '*in utter ignorance 
of the vivisection questiim.*' ' 

The Honorable St^hen Coleridge, of London: — 

**I drive a motor-car, and when I go b^ond the speed limit, 
and the policeman asks me, I say » ' No, I am not going b^ond the 
speed luniC* 

W.W. Keen:— 

*' These resolutions — t.^., in fatvor of Experimental Research 
(vide pp. zv-zviiO — represent the coUecUce opinion qf the medi' 
eal prqfeseionp not only of Great Britain and America, but of 
the whole civilized worid. 

** Per contra, there i$ not, eo far as I know, a tingle reeolvtion 
qf any scientific body expreeeing the opposite opinion.*^ * 

1 Journal qf ZcdphHy, July, 1914, p. 101. 

< Dr. Snow's letter. PiMe Ledger, Philadelphia, Mazdi 6, 1011. 

* Report qf Royal Commieeion en Vieisection, Answer no. 10^ 95fL 

* Prkace, p. zviii. 




(Thib letter [by a kyman, be it observed] was sent to ''life 
in criticism of the attitude of that paper toward the use of vac- 
cines, sera, and vivisection. It was kter returned to the writer 
as unavailable. . • . The document is so human, however, and ia 
such a powerful i^peal against the maudlin sentimentality of the 
antivivisectionist and antivacdnationist, that the ** Journal *' has 
asked Mr. Fahs's permission to publish it. The recent attadcB 
of these propagandists against the use <^ tuberculin as ''human 
vivisection" makes the publication of this letter the more timdy. 

— This Editob.) 

Dbab "Lipb": — 

You take your fling, and you must. That's your mission. But 

When Death first struck near me, I was but four years old, and 
it was my little sister that went — spinal meningitis. Serum 
therapy was yet to be. Last year my only boy lay in convulsions 

— spinal meningitis. A fast auto ride to a Brooklyn hosfntal. 
Antimeningitis serum used. Not another convulsion thereafter. 
I thanked God for Kmon Flexner and his ilk and took courage. 
What would you have done? How would you have felt? 

When Death struck near me the second time, it was a baby 
brother that went — diphtheritic sore throat. Antitoxins were 
unheard of as yet. When I took my family abroad f cht a winter 
three years ago, I felt easier when I discovered that the German 
town we had chosen for our stay had a high-grade laboraUny 
where the diphtheria antiUndn had been developed. How would 
you have felt? 

When Death struck near me the third time, again it was a 
younger brother who was claimed — infection following vaodna- 

* Reprinted l^ the kind permission of the author and of the editor 
of the Journal of the Outdoor Life for September, 1914. 


lion against smallpox which was active near by. We learned 
later that the alleged doctor who did the vaccinating had neither 
legal nor moral right to hang out a shingle, and bitterness was in 
my heart. Two years ago I was about to start for a long journey 
through Asia where smallpox was to be met with on every high* 
way. In spite of sad memories, I had myself vaccinated before I 
sailed. What would you have done? 

During the Spanish War I saw Death when its name was 
Legion. A score of times on a single afternoon I heard the muf- 
fled drums and saw the reversed arms as the melancholy pro- 
cessions left the fever hospitals. Inoculation for typhoid was 
unknown. On that Far Eastern trip of two years ago I was to 
face possible typhoid infection at almost every meal time. I was 
inoculated for typhoid before I started. What would you have 

Seven years ago, physically undone, I lay in a hospital while 
capable and faithful physicians sought to ascertain the ob- 
scure cause of it all. Finally I was asked whether I was willing to 
undergo the tuberculin test (hypodermic) for diagnostic pur- 
poses. I consented. The reaction was severe, but it pointed the 
way, and the subsequent treatment for tuberculous peritonitis 
brought me back to health. Would you have consented ? 

As a lonesome boy on the farm I had a collie as a servant, 
companion, and pet. Because of disease he had to be shot, and 
my heart was broken. Never have I had a pet since. But I have 
children, and I am willing for all the dogs and cats and guinea- 
pigs to be sacrificed if these precious ones can be better protected 
against the hostile microbes of various kinds that have cost my 
home the life of one child and severe if not desperate illnesses for 
each of the other three within a single year. 

The profession of medicine has not succeeded in isolating 
itself entirely from carelessness, inefficiency, selfishness, or even 
from hardness of heart with respect to suffering on the part of 
animals or folks, but I know too many physicians of a noble type, 
men of high worth in head and hand and heart, to subscribe to 
any broad indictment of the profession's personnel or processes. 

In a word, "Life,'' I think you're honest, but I don't think 
you're fair. 



Abbe, Dr. Robert, his experiment 
on the aorta, 156. 

Abdominal operations, 5-8, 29-S4, 
105, 189, 215; fever after, 250 n. 

Abdominal tmnors, 81, 82. See 

Abscess, in the loin, 10; of the kid- 
ney, 11, 84; of the brain, 85, 52, 
69, 215; of the lunfls, 42, 85, 181; 
condition of blood in, 102, 103; 
Lister's experiments on, 208. 

Abusive, literature of antivivisec- 
tionists, 289, 240; epithets used 
by antivivisectionists, 240. 

Achievements, of friends of research, 
280-88; of foes of research, 288- 

Acromegaly, 105. 

Adrenal gland, 194. 

Adrenalin, value of, 154; and oocain, 
mixture of, 178; Dr. Hadwen's 
criticism of Dr. Keen's reference 
to, 249; source of, 249. 

Aiken, Midshipman, and vivisec- 
tion, 146-50, 280. 

Air, not the cause of inflammation, 

America, contributions to medicine 
through vivisection in, 5, 6, 8. 

American Antivivisection Society, 
postal cards issued by, 269; card 
of, in eidiibition, 289. 

American Association for the Ad- 
vancement of Science, resolutions 
of, xvii, xviii. 

American Humane Association, cor- 
respondence and controversy 
with, 110-45. 

American Medical Association, reso- 
lutions of, xvii, xviiL 

Amputated 1^, contraction of, 248. 

Amputation, mustrations of, before 
antisepsis, 28-27, 200-04; illus- 
tration of, after antisepsis, 25-27; 
mortality of, 27, 215; mjection of 
oocain into nerves before, 178, 

174; of hip-joint, 225; of breast, 
for cancer, 286. 

Anders, Prof. J. M., use of tuber- 
culin by, 181. 

Anesthesia, meaning of "li^t anes- 
thesia," vii, 2M; experiments 
done before discovery m, vii, viii; 
important surgical discovery of 
nineteenth centuiy, 74; general, 
171, 172; k>cal, 172-74; spinal 
174-76, 278; Mdtzer and Auer's 
method of, 188, 261. 

Anesthetic bromid of ethyl as, 10; 
ideal, 10, 176; effect of, on hemo- 
globin, 103, 104; use of, in animal 
experimentation, 108, 282, 288; 
used in animal experimentation, 
but non-use claimed by antivivi- 
sectionists, vi-viii, 244-46, 265- 
68, 278, 278, 279, 286. 

Anekhetio Ddueion, The, vi. 

Anesthetised, meaning ol the word, 

Anesthetixer of animals and Mrs. 
Easby, viii. 

Aneurysm, 155, 209. 

Animal experimentation. See Vivi- 

Animals, not different from man in 
structure and function, xii; bene- 
fited by vivisection, 20, 109, 288, 
289, 290; diseases of, 107; statis- 
tics of painfulness of experiments 
on, 108, 241, 244, 245, 262, 268, 
266; experiments on, performed 
with anesthetics, vi-viii, 108, 282, 
288, 244-46, 265-68, 278, 278, 

Anthrax, 106, 107. 

Antidote, for snake-bites, 9, 148, 
149, 252; for exophthalmic goiter, 
167, 168; for tetanus, 197. 

Antidotes, due to vivisection, 45. 

Antisepsis, Lister's services to, 18, 
19,28,74-77, 225-27, 255; prog- 
ress in surgery partly due to, 1^ 



45; recent* generalizaiioii of, 28; 
illustration of operation before, 
23, 24, 200-04; illuatration of op- 
eration under, 25-27; mortality 
in amputations before and after, 
27; mortality in operations before 
and after, 225, 226. 

Antiseptic method, the period pre- 
ceding, lOlHMM; discovery and 
development of, 204-13; results 
of. 214-19; in three hoq>itals, 215- 

Anti-serum. See Antidote, Anti- 

Antitoxin* lessening of mortality 
from diphtheria by use of, 9 n., 
73, 282; for tetanus, 197; for 
diphtheria, 231. 

Antivivisection, influence of, on 
character, 234-85. 

Antivivisection, exhibits, no etheri- 
zer shown in, viii; laws in Eng- 
land, 9, 12, 19, 28, 148, 149, 208; 
exhibit in New Yoric, 271; exhibit 
m Phikdelphia, 271, 272, 286-90; 

. societies, bequests to, 280. 

Antivivisectionists, misstatements 
and misrepresentations c^, vi-ix, 
110-45, 120Hk5, 244, 263-90; non- 
use of anesthetics falsely claimed 
by, vi-viii, 244-46, 265-68, 273, 
278, 279, 286;propo8e poet-mortem 
examinations, 233; deny truths of 
bacteriology, 250. 

Aorta, Dr. Abbe's experiment on, 
156; transplantation of, in dogs, 
162; Carrd's work on, 183, 184. 

Appendicitis, condition of blood in, 

''Arch 6end" letter, 234-36. 

Arm, bone, transplantation c^, 171; 
musculo-spiral nerve in, 177, 178; 
birth palsies in, 178, 179. 

Army, typhoid fever abolished in 
our, X, 259, 260; vaccination in 
British, 260 n. 

Arteries, gunshot wounds of, 5, 6; 
surgery of, 154^59; divided suture 
of, 156; transplantation of, after 
cold storage, 162; Lister's experi- 
ments on, 208-11; method of 
criss-crossing discoveredat Rocke- 
feller Institute, 242. 

Aseptic, 199 n. 

Asphyxia, danger frcmi, in use of 
nitrous oxid, 172. 

Assassination, scientific, 125, 279. 

Association, British Medical, reso- 
lution of, XV, xvi, 71; and Mid- 
land Medical Society, resolution 
of, and Lawson Tait, xiii. 

Atlee, Dr. Washington L., 225. 

Auer. Ss^Meltser. 

Authorities, newspapers as, 116-18» 

Bacteria, purulent, 128. 

Bacteriology, of tuberculosis, 14, 15, 
73; its contribution to treatment 
of com^und fractures, 29; value 
of, admitt4*H by Lawson Tait, xiii, 
71; what it has shown, 73; of lock- 
jaw, 74; services c^, 2^; truths of, 
denied by antivivisectionists, 250, 

Baking animals alive, 8, 271. 

Bennett, Dr. Hu^^es, 13, 35. 

Bequests to antivivisection soci^ 
ties, 280. 

Berdoe, Dr., accuracy of , 248, 265; 
his excuses for misstatesoents, 

Bergh, Henry, extraordinary state- 
ment of, 278. 

Beridey, Dr., his experiments on 
the msane, 120, 121, 133, 134. 

Bigelow, Dr. Henry J., his two 
views of vivisection, xii, 244, 278; 
his view of painlnss vivisection, 

Bile, the, 191. 

Birth palsies, 178. 

Black Art qf Vineeelwn, 264. 

Bladder, removal c^, 6. 

Blood, examination c^, 102; leuoo- 
cytosis, 102, 103; hemoglobin, 
103, 104; freesing temperature of, 
104; coagulation time of, 104; 
dot, 156, 157, 185; transfusion of, 
157-59, 223, 224, 242. 

Blood poisoning. See Pyemia. 

Blood vessels, dots in, 156, 157, 228, 
224; suture of, 158, 223; in chest, 
wounds of, 184. 

Bone, transplantation of, 98-102, 
160-62, 171. 

Boeton Tranecripl, The^ the Wash- 
ington correspondent of, 125, 126. 

Bowditdi, Heniy P., 247, 248, 273. 



Bowel, flfeg Intertines. 

Bowlegs, 42. 

Brain* result of ezperiments of 
Ferrier and others on, 18, 18; 
tumors of, diagnostication and 
removal of, 13, 14, 85, 58-57, 68, 
64,174,215;absce88of, 85,52, 58, 
215; hemorrhage of, 86, 57-60, 81, 
146-48, 230; gunshot wounds of, 
86; surgery in cases of epilepsy, 
86, 97; localization of its centers, 
87-89, 46-50, 62-70, 80; cannot 
feel pain, 88, 69; motor area, 87- 
89, 46-50, 79, 80; surgery of, and 
yivisection, 45-71; fissures of, 48- 
50; fissures of, how located on 
skull, 49, 50; statistics of tumors 
of, 56, 57; question of transfer-, 
enoe €^ tissue of, 69, 70. 

Breast, amputation of, for cancer, 

Br6^, Judge, ziv. 

British Memcal Association, resolu- 
tion of, ziii, zv, xvi, 71. 

BriHik Medical Journal, 268. 

British Royal Conmiission on Vivi- 
section, r^Kirt of, zviii, 288, 241, 

Britton, Miss, describes operation 
which was never done, 270, 271. 

Bromid (^ ethyl, 10. 

Bronchoscopy, 182. 

Brown, James M., President of 
American Humane Association, 
correspondence and controversy 
of, with Dr. W. W. Keen, 110- 

Brunton, Sir T. Lauder, 9, 148. 

Bumps of the brain, 46. 

Bums, healed by skin grafting, 101. 

Cabot, Dr. Richard C, his attitude 
toward vivisection, 184. 

Cancer, abdominal, 82, SS, 185-88; 
of the larynx, 85; of the esopha- 
gus, 90, 91 ; of the pylcxus, 91, 187; 
of the bowd, 95, 188; ratio of , per- 
manent cures, 168, 164; mudly 
contagious, 164; houses, 164; 
study of, 164, 165; an4>utation of 
breast for, 226. 

Cannon, Dr. W. B., is, 275, 276. 

Carbolic add, to prevent suppura- 
tion, 207-11. 

Carnegie, bacteriological laboratory 
founded by, 48. 

Carrel, Dr., 229; his services in 
transfusion of blood, 156-58, 228- 
25; Nobd Prize given to, 157 n.* 
262 n.; his work on the aorta, 188, 
184; experiment of, misrepr^ 
sented, 2(98. 

Carroll, Dr., 229, 254. 

Catgut ligatuies, 75-78, 210, 211. 

Centers of the brain, 87-89, 46-50; 
what is meant by, 49; accuracy of 
localization of, 62-70, 80. 

Cerebral kKalization, 87-89, 46-M; 
aocura<7 of, 62-70, 80. 

Ccarebro-q;>inal meningitis, 174; two 
cases contrasted, 1M, 221; mor- 
tality of, before and after Flex- 
ner's serum, 221, 242; lumbar 
punctures for, 220, 221, ?77. ^ 

Character, influence of antivivisee- 
tion on, 284-85. 

Chest, surgerv of, 180-86» 260-68; 
contents of, 180; difficulties of 
operation on, 180, 181; wounds of 
great blood vessels in, 184; dot in 
great blood vessds in, 185. 

Cmene, Professor, his method of 
finding the an^e of the fissure of 
Rolando, 50. 

Childbed fever, before and after 
antisepsis, 215, 227, 255-57, 287. 

ChkMroform, 74, 108, 104; when first 
used in surgery, 172; relative 
danger of, 172. 

Cholera, experiments on, with mice 
and weDs, 15, 16. 

Christison and Calabar bean, 8. 

Circulation reestablished after 
death, 154. 

Citations from medical artides, de- 
tached, 180. See Quotatic»is» 

Civil War, surgery of, 203, 225. 

Clement, E. H., 134. 

Clinical observations, experimental 
researdi, xi, xiL 

Qots, 156, 157, 228, 224; in great 
blood vessds of chest, 185. 

Coagulation time of blood, 104. 

Cobbe, Frances Power, misstate- 
mento in her book, 132, 247, 248, 

Cocain, 3, 10, 72; in the surgery of 



the eye, 172; infiltration of, 172, 
173; and adrenalin, mixture of, 
173; injection of, into nerves, be- 
fore dividing, 173, 174; injection 
of, into sheath of spinal cord, 

Cold storage of tissues for trans- 
plantation, 162. 

Coleridge, Stephen, and the speed 
limit, 263, 264; false statement of, 
in regard to Pasteur institutes, 
264, 265. 

Colic, gall-stone, 250 n. 

Compound fractures, 20, 23, 29, 
203. 207, 215, 287. 

Consumption, galloping, 120, 121; 
germs of, and tuberculin inocula- 
tions, 129-32, 144. See Tubercu- 

Cretinism, thyroid extract in, 133, 
134; as result of operation for 
^iter, 166. 

Cnle, Dr., 229; experiments of, 
anesthetics used in, vi, vii; and 
Mrs. Henderson, vi, vii; awarded 
American Medicine Crold Medal 
for 1914, vii; services in transfu- 
sion of blood, 156, 159, 224. 

Cromer, Lord, 233. 

Cruelty to human beings, fostered 
by antivivisection, 250h83. 

Cuba, 17 n., 169, 229. 

Cushing, Dr. Harvey, 195 n. 

DeuUches VolkshlaU, 119. 

Diagnosis, of brain tumor, 14, 53-57; 
of abscess in the brain, 51-53; of 
hemorrhage inside the skull, 59, 
60, 146-48, 230; of mental dis- 

* orders, 60, 61; of causes of epi- 
lepsy, 62-70; experiments to aid, 
1 06-09 ; of consumption, by tuber- 
culin, 131, 144; lumbar puncture 
for, 174, 274-77; of cancer, 187. 

Dickson, Samuel, opinion by, xiv, 


Digitalis, effects of, discovered by 

experiment, 4 n., 72. 
Diphtheria, eariy experiments on, 8, 

9; reduction in deaths from, due 

to antitoxin, 9 n., 73, 231, 232. 
Diseases, among animals, 107; 

germs as causes of specific^ how 

proved, 211-13. 

Doctors, who are opposed to vivi* 
section, xii, 71; experiment on 
themselves, 16, 17, 169, 228, 229, 

Dog stolen, misleading placard ooq' 
ceming, 271, 272. 

Dogs from a "Philadelphia Labo- 
ratory," 272, 286, 287. 

Drugs, value of new, discovered by 
experiments on animals, 4. 

Ductless glands, 194. 

Dudgeon, Dr. R. £., 118. 

Duke of Newcastle and hydropho- 
bia, 107. 

Dying person ought not to be saved* 

Eliot, C. W., quoted on interference 
with necessary processes of medi- 
cal investigation, 132; inscription 
on Lazear's Ublet, 170, 229. 

England, antivivisection laws in, 9, 
12, 19, 28, 148, 149, 208; real 
opinion of medical profession of, 
as to value of vivisection, xv, 71. 

Epilepsy, 36, 37, 62-70. 

Ergot, effects of, discovered by ex- 
periment, 4 n. 

Eiysipelas, 24, 202, 204, 216. 

Esophagus, cancer of, 90, 91 ; sur- 
gery of, 90-92. 

Ether, 74, 103, 104; sleep of, 107, 
108; first demonstration of, 172; 
relative danger of, 172. 

Exophthalmic £[oiter, 167. 

Exhibition, antivivisection, in New 
York, 271; in Philadelphia, 271, 

Exhibitions, antivivisection, no 
etherizer shown in, viii. 

Experiment, what is an, x, xi; age of, 

Experimental research w, dinical 
observation, xi, xii. 

Experiments, performed with anes- 
thetics, vi-viii, 108, 232, 233, 244- 
46, 265-68, 273, 278, 279, 286; on 
animals, feasible method of prog- 
ress, X, xi; necessary to progress, 
X, xi, 2, 284, 289, 290; by doctors 
on themselves, 16, 17, 169, 228, 
229, 254; to aid diagnosis, 106;-09; 
recent surgical progress chiefly 
result of, 22, 45, 151-70, 199-219; 



era of predae, 218, 219; painful- 
ness of, statistics, 241, 244, 245, 
262, 263, 266; by students, 245; 
on sciatic nerve, 247, 248; to be 
tested first on man, according to 
Mrs. White, 251-58; on human 
beings, advocated by United 
States Senator, 258. See Progress, 

Exploratory operations, 81, 82. 

Eye, cocain in surgery of, 172. 

Face, paralysis of, operation for, 179. 

Facial nerve, 179. 

Fahs, Mr., letter to L^e, 296, 297. 

Federation of American Societies 
for Experimental Biology, reso- 
lution of, xvi. 

Fergusson, Sir William, ziiL 

Ferrier, Sir David, 12, 18. 

Fever, 8; heat, 8; typhoid, 108, 258- 
60; puerperal, 215, 227, 255-257, 
287; after abdominal operations, 
250 n. 

Final cdlapse, 124, 125, 140, 279. 

Finger, Prof. E., 118. 

Fischer, his paper on wounds of the 
heart, 151. 

Flexner, 229; his serum for cerebro- 
spinal meningitis, 221, 242. 

Foreign bodies in windpipe, 181, 

Fourth of July tetanus, 197, 198. 

Fowler^s position in peritonitis, 192. 

Fractures, simple imd compound, 
22, 23, 203; compound, mortality 
of, 29, 215, 287; (^ the spine, 41; 
Lister's experiments on com- 
pound, 207. 

Gag. See Mouth gag. 

Gt^-bUdder, removal of, 6; opera- 
tions on, 88, 191. 

Gall-stone colic, 250 n. 

Gall-stones, 83, 191, 250 n. 

Gallinger, Senator Jacob H., 110, 
111. 117; letter to, 146-49. 

Galloping consumption, 120, 121. 

Gangrene, hospital, x, 24, 202-04, 
215, 216, 226; from tying of arter- 
ies, 79, 155, 156; of the lung, 181. 

Garbling of quotations, 110, 112, 
113, 115, 119-32, 139-48. 

General anesthesia, 171, 172. 

Gentleness, need for, in handling the 
intestine, 190. 

Geriach, his experiments on tubeiw 
culosis, 15. 

Crerm theory, weU established, 250. 

Germs, of consumption, and inoco* 
lations with tuberculin, 129-82; 
cannot rise against ^vity, 205- 
07 ; suppuration and mflammation 
caused b^, 207, 218; as causes of 
specific diseases, how proved, 211- 
13; how lolled, 213. 

Gettysburg, battle of, secondary 
hemorrhage after, 202. 

Gigantism, 195. 

Glands, ductless, 194. 

Glasgow, antisepticmethod in Ro^ 
Hospital in, 216-18; description 
of conditions in Royal Hospital 
in, 216-18. 

(rodlee. Sir Rickman J., 85. 

Goiter, mortality of, 42, 84, 165, 
166; operations for, 83, 84, 166; 
use of thyroid extract for, 85; and 
parathyroid glands, 166, 167; ex- 
ophthalmic, 167. 

Gorgas, Colonel, 17 n., 169, 228. 

''Grafting" of severed parts, 4$, 
156; of skin, 100-02, 160. 

Graves's Disease, 167, 168. 

Gross, Prof. Samuel D., 199. 

Guthrie, Dr., 156, 162, 168. 

Hadwen, Dr., 249, 250. 

Halle, antiseptic method in hospi- 
tal in, 216. 

Halsted, his experiments misrepre- 
sented, 267. 

Hand, right, center for, 65, 66. 

Heart, surgery of, 151-54; suture of, 
151, 152; pulsation of, reestab- 
lished long after death, 152, 153; 
valvular disease of, 153; opera- 
tions on valves of, 153, 154. 

Heat fever, 8. 

HeU at Close Range, 242. 

Hdl of the Innocent, 247, 248. 

Hemoglobin, 103. 

Hemorrhage, secondary, 24, 201, 
202; withm the skull, 36, 57-60, 
81, 146-48, 230; Lister's experi- 
ments in, 75-77; one night of, 75; 
how arrested, before and after 
antisepsis, 77, 78; sewing of 



artery to avoid, 78, 79; internal, 
vs. shodc, 105, 106; of the new- 
bom, 157, «23. 

Henderson, Mrs., on Crile*s experi- 
ments, vi, vii. 

Hernia, operation for, 192-94. 

Hip-joint, amputation at, 225. 

Holmes. O. W., St56. 

Hondey, Sir Victor, and brain sur- 
gery, 36; his method of localizing 
cerebral functions, 88; and spinal 
surgery, 41; his experiments mis- 
represented, 265. 

Hospital for experiments on human 
beings, 242, 243. 

Hospital gangrene, x, 24, 202-04, 
215, 216, 226. 

Hospitals, antiseptic method in 
three, 215-18. 

Hughes, Charies E., Jr., case of, 220, 
221. 277. 

Human beings, cruelty to, fostered 
by antivivisection, 250-63. 

Human vivisection, cry of the anti- 
vivisectionists, ix; Drs. Mitchell, 
Morehouse, and Keen accused of, 
ix, 236 n. ; correspondence regard- 
ing, 110-45; advocated by Mrs. 
White, 251^3, 294; advocated 
by Mrs. Lovell and Dr. Snow, 
252 n.; advocated by United 
States Senator, 253. 

Human Viviaection, ix, 136-42, 236 n, 

Humanity, what vivisection has 
done for, 220-33. See Progress. 

Hydrophobia, 20, 97; discovery of 
germ of, 98 n.; and Duke of New- 
castle, 107. 

"Hyena," 289. 

Hypoglossal nerve, 180. 

Hypophysis, surgery of, 194-96, 
1^7; an operation on, 288. 

Hysterectomy, 287. 

Inaccuracy of statements, 110, 112, 
115, 119-32. 139. 

India, mortality from snake-bites 
in, 9; antidote for snake poisons 
in, 9, 148, 149; experiments from 
snake-bites in, advocated, 252, 

Infantile paralysis, 242, 282. 

Infection, to what due, 22, 23. 

Infiltration of cocain, 172, 173. 

Inflammation, 22, 23, 199; re- 
searches on, 17, 18; discovery d 
germs of, 75; the cause of, 207» 

Inoculation, of ydlow fever, Sana- 
relli*s experiments on, 124-26; 
with tuberculin, 129-32^ 

Insane, Dr. Berkl^s experiments 
on, 120, 121; vivisection experi- 
ments upon, 142. 

Insane Asylum at Voralberg, 119. 

Insufflation, tracheal, 183. 

Internal secretions, 194. 

International Medical Congress^ 
resolution of, xvi. 

Intestines, wounds of, 5, 6, 30, 95; 
suMcry of, 33. 94-«7, 188-W; 
and stomach, united, 91, 93; 
tumor of, 94, 95; typhoid per- 
foration of, 96, 189; how much 
can be removed, 96, 97; cancer of» 
188; rupture of, 188; need for 
gentleness in handling, 190; mor- 
tality of wounds of, in Civil War» 

Jansen, Dr., lecture of, 118, 119, 
141, 142. 

Jobling, Dr., 221, 225. 

Joints, transplantation of, 161. 

Journal of Zodphily, 243, 243 n., 257, 
263, 268, 274-76; advocates vivi- 
section, 252 n. 

Keen, Dr. William W., accused of 
human vivisection, ix, 236 n. ; cor- 
respondence of, with the Ameri- 
can Humane Association, 110- 
45; open letter c^, to Senator 
GaUinger, 146-49; false diarse 
against, 242; on opinion of medi- 
cal prof ession and of societies on 
vivisection, 295. 

Kelly, Dr. Howard A., his book, 
Walter Reed and YdhwFeoer,i9S. 

IQdney, Simon's experiments on, 
11, 87; surgery of, 11, 12, 34, 87, 
88; removal of, results in saving 
life, 11, 34, 88; tumor of, 158, 159; 
transplantation of, in cat, 163. 

Knee-joint, transplantation of, 161. 

Knock-knee, 42. 

Knopf, Dr. S. A., prize essay of, 145. 



Koch, his discovery of germ of 

tuberculosis, 14, 15, 144. 
Krause and sldn-grafting, 160. 
Kroenig, experiments of, 120, 128. 

Laboratories, visitors not excluded 
from, viii, ix; dosed doors of, viii, 
ix; conditions under which re- 
searches are made in, 245, 246; 
rules of, 246; Philadelphia, vivi- 
sected products of, 272, 286. 

Larynx, surgery of, 85. 

Laudable pus, 199. 

Lawrence, Bishop, 159. 

Lazear, Dr., death and tablet, 170, 

Leffingwell, Dr. Albert, 115 n., 271. 

Leg, transplantation of, in dog, 

Leidig, Dr. Eugen, 118. 

Letter, of Mr. Brown to Dr. Keen, 
110-13; of Dr. Keen to Mr. 
Brown, 114-32; of Dr. Keen to 
Hon. Jacob H. Gallinger, 146-49; 
from Los Angeles, 23Jh36; of Mr. 
Fahs, 296, 297. 

Letters of abuse, 234-89. 

Leucocytosis, 102, 103. 

licxer, his operations, 161. 

Zi/e, Berkley*s letter to, 121; Mr. 
Fahs*s letter to, 296, 297. 

Ligatures, silk and catgut, 23, 75- 
78, 200, 201, 208-11; of carbolized 
silk, 208-11. 

laght anesthesia, vii, 244. 

Lister's services to antisepsis, 18, 
19, 225-27, 255; obliged to go to 
Toulouse to experiment, 19, 28, 
148, 208; his experiments in hem- 
orrhage, 75-77, 148; quoted on re- 
sult of operation for hernia, 193, 
194; his experiments with urine, 
205-07; his experiments on sup- 
puration, 207, 208; his experi- 
ments on arteries, 208-11; suc- 
cess of antiseptic method in 
Royal Hospital m Glasgow, 216- 
18; the maker of modem sur- 
gery, 252; application of his anti- 
septic method to obstetrics, 257. 

Liver, operations on, 34, 86, 87, 190, 
191; tumors of, 191. 

Local anesthesia, 172-74. 

Localisation of function in the> 

brain, 37-39, 46-50; accuracy of, 

62-70, 80, 146-48. 
Lockjaw. iSss Tetanus. 
Los An^es, letter, 234-36. 
Lovell, Mrs., advocates vivisection, 

252 n. 
Lumbar puncture, 122-24, 174, 220, 

221, 274-77; results of, 277, 278. 
Lungs, surgery of, 41, 42, 85, 86, 

180-86; ventiktion of, 183. 

Malaria, experiments to determine 
origin of, 15. 

Mastoid operation, 179. 

Matas's operation for aneury8m,155. 

Medical articles, detached citations 
from, 130. 

Medical Press and Cireidar, quoted, 
126, 127. 

Medical profession, collective opin- 
ion oif on vivisection, xv-xviii, 

Medicine, progress in, how attained, 
X, xi, 2, 284; contributions to, in 
America through vivisection, 5, 
6, 8. See Progress. 

Meltzer and Auer's method of anes- 
thesia, 183, 261. 

Menge, experiments of, 127, 128. 

Meningitis, several forms of, 277, 
278. §00Cerebro-spinal meningitis. 

Mental disorders, operation for, 60, 

Mesentery, gunshot wounds of, 5, 6. 

Meyer, Dr. Willy, his chamber for 
surgery of chest, 183. 

Midluid Medical Society and Law- 
son Tait, xiii. 

Ii£srepresentations due to antivivi- 
sectionists, vi-4x, 120-45, 26»-90. 

Missionaries and snake-bites, 9 n. 

vi, 110^45, 244, 263-90. 

Mitchell, Dr. Weir, 9; accused of 
human vivisection, ix, 236 n.; at 
Antivivisection Exhibition in 
Philadelphia, 284. 

Morehouse, Dr., accused of human 
vivisection, ix, 236 n. 

Morton, and ether, 172. 

Mosquito, admiration for, 254, 255. 

Mouth-gag, used "to break the 
jaws," 269; in a child's mouth, 
.269, 270. J 



Munich, General Hospital in, anti- 
septic method in, 215, 216. 

Munier, scientific, 125, 279. 

Murders not murders, 125, 140. 

Muscuio-spiral nerve, in arm* 177, 

Myxedema, 84. 

Nature, clumsy experiments by, in 
disease, 89, 40. 

Neisser, experiments of, 126, 127. 

Nerve, muscuio-spiral, in arm* 177, 
178; of face, operation on, 179; 
the hypo^ossaf, 180; the spinal 
accessory, 180. 

Nerves, surgery of, 88, 177-80; in- 
jection (3 cocain into, befwe 
dividing, 178, 174; suture of, 177; 
of arm, and birth palsies, 178, 

New England Antivivisection So- 
ciety, 248. 

Newcastle, Duke of, and hydro- 
phobia, 107. 

Newspapers as authorities, 116-18, 

iVtne Cirdei, The, false statements 
in, 247, 248, 265, 271. 

Nitrous oxid, 172. 

"No matter how great the benefit," 
243, 257. 

Nobel Prize, given to Dr. Carrel, 
157 n., 262 n. 

Nose, the making of a new, 100, 161 ; 
made from shm bone, 162, 171. 

Novocain, 175. 

Obstetrics, before and after antisep- 

as, 215, 227, 255-57, 287. 
Oilier, and transplantation of bone, 

Operation described which was 

never done, 270, 271. 
Organs, transplantation of, 160-63. 
Ott, Dr. Isaac, 8; his experiments 

misrepresented, 266, 267. 
Ovariotomy, mortality of, 7, 82, 

214, 255, 287. 

Painfulness, of experiments, statis- 
tics, 12 n., 108, 241, 244, 245. 262, 
263, 266; of gall-stones, 250 n. 

Pamphlets on vivisection, xix, xx. 

Panama Canal Zone, 17 n., 169, 228. 

Paralysis, due to removal of brain 
center, not always permanent* 68» 
69; mfantile, 242, 282. 

Parathyroid glands, 166, 167, 194. 

Pasteur, his experiments, 20, 97; 
and childbed fever, 227, 255, 257; 
Life of, 255. 

Pasteur Institutes, 20, 97; false 
statement of Stephen Coleridge 
regarding, 264,265. 

Pearoe, Dr. R. M., viii, ix. 

Pennsylvania, University of, prose- 
cution of six professors of, xi v, xv. 

Perforation of mtestine in typhoid* 
96, 189. 

Periosteum, production of new bone 
from, 9&-102, 160, 161. 

Peritoneum, operations on, 7, 29. 

Peritonitis, 192. 

Phenol. Sm Carbolic acid. 

Philadelphia, Antivivisection Exhi- 
bition in, 271, 272, 286-90; labo- 
ratories, vivisected products of, 

Phthisis. See Consumption, Tuber* 

Pituitary body, surgery of the, 194- 
96, 287; an operation on, 288. 

Playf air. Sir Lyon, 258. 

Pleurisy, 181. 

Postal cards issued by the American 
Antivivisection Society, 269. 

Pre-antis^tic surgery, 28, 24, 19^ 

Pre-Iisterian surgery, 28, 24, 19^ 

Professors, six, of University of 
Pennsylvania, prosecution of, 
xiv, XV. 

Progress, experiments on animals a 
feasible method of, x, xi; and ani- 
mal experimentation, 2, 22, 48, 
45, 72-75. 151, 168-70, 219, 220- 
83, 289, 290; age of, 284. 

Prosecution of six professors of Uni- 
versity of Pennsylvania, xiv, xv. 

Puerperal fever. <8m Childbed fever. 

Puncture, lumbar, 122-24, 174, 220, 
221. 274-77; results of, 277, 278. 

Purulent bacteria, 128. 

Pus, 199, 200. 

Putrefaction, 204-06, 212. 

I^emia, in Civil War, 203; disap- 
pearance of, since antisepsis, 204* 



J^lonis, cancer cf, 91» 187; surgery 
of, 91, 93, 

Quotations, in pamphlet of Ameri- 
can Humane Association, garbled 
and inaccurate, 110, 112, 115, 
119^2, 139; selected. 29d-95. 

Rabbits, Sir James Simpson's life 
saved by experiments on, 258. 

Reality of Human VwisecUon, The, 

Reed, Dr., 17 n. ; letter to his wife, 

References in pamphlet of American 
Humane Association, vague and 
indefinite, 110-20, 188-40. 

Reichert, Dr., 9. 

Remedies, new, discovered by exper- 
iment, 4, 25. 

Repetitions, reasons for, v. 

Research, achievements of friends 
of, 280-83; achievements of foes 
of, 283-85. 

Resolutions, of British Medical As- 
sociation and Midland Medical 
Society, xiii; of British Medical 
Association, xv, xvi, 71; of Inter- 
national Medical Congress, xyi; 
of Federation of American Socie- 
ties for Experimental Biology, 
xvi; of American Medical Asso- 
ciation and American Association 
for the Advancement of Science, 
xvii, xviii; against vivisection, 
notonefrom any scientific society, 

Respiration, Meltser and Auer*8 
method of, 183, 261. 

Reverdin, and skin-grafting, 160. 

Richardson, Dr. Maurice H., his 
attitude toward vivisection, 184. 

Roberts, Dr. John B., 151. 

Rockefeller Institute, discoveries at, 
221-25, 242, 247, 261, 282 n., ob- 
ject of antivivisectionists' wrath, 
238, 243, 283. 

Rolando, fissure of, 48-50. 

Royal Commission on Vivisection, 
denial by, of torture in vivisec- 
tion, xviii, 233, 241, 247, 294. 

Rules of laboratories, 246. 

Rupture, operation for, 192-94. 

Rupture of intestine, 188. 

Sah solution, injection of, 154, 249. 
Sanarelli, his experiments on the 

inoculation of yeUow fever mis- 
represented, 124-26, 143, 144, 

Sauerbruch's chamber for surgery 

of chest, 182, 184, 261. 
Schreiber, Professor, experiments 

of, 129-32. 
Sciatic nerve, experiments on, 247, 

248; and spinal cord, 248. 
Scientific assassination, 125, 279. 
Scientific bodies, attitude of, toward 

vivisection, xv-xviii, 295. 
Scientific murder, 125, 279. 
Secondary hemorrhage, 24, 201, 202. 
Senn, Dr., his e^>eriments misr^re- 

Septic processes, 22; illustration of, 

23, 24; mortality in amputations 

under, 27. 
Seventh nerve, 179. 
Sheen, Dr. Rodman E., case of, 288. 
Sherrington, Prof. C. S., operations 

of, on dead animals, misr^re- 

sented, 265, 293, 294. 
Shin bone, transplantation of, 161, 

Shock v$. internal hemorrhage, 105, 

Silk, ligatures of, 23, 75-78; car- 

bdized, ligatures of, 208-11. 
Simon, his experiments on the kid- 
ney, 11, 87, 88. 
Simple fractures, 22, 28, 203. 
Simpson, Sir James, and chloroform, 

172 ; his life saved by Playfair*s 

two rabbits, 258. 
Skin grafting, 10(M)2, 160. 
Skull, hemorrhage within, 57-60, 81. 

Sm Brain. 
Sleeping sickness, 283. 
Smallpox pus, 142. 
Smith, Prof. Robert Meade, 20. 
Snake-bites, mortality from, in 

India, 9; need of an antidote for, 

9, 148, 149; and missionaries, 9 n.; 

experiments on sufferers from in 

India advocated, 252. 
Snow, Ellen, 242. 
Snow, Dr. Herbert, his ignorance 

on vivisection question, 247, 250, 

295; advocates vivisection, 2isi2 tl, 




Societies, scSentific their attitiicle 
toward viviaectioii. ziii-zviii, 71, 
295; antiviviiectioiit bequests to, 

Society, American Antiviyisection, 

Speed limit and Stephen Coleridge, 

Spina bifida, 99. 

Spinal accessory nerve, 180. 

Spinal ancstbwiia, 174-7«, 278. 

Spinal cord, total diyision of, 81, 82; 
tumors of, 82; and scuttic nerve, 

Spine, surgery of, 41. 

Spleen, removal of, 6, 88, 87. 

Stewart, Dr. Francis T., 151. 

Stomadi, removal of, 6, 82, 90, 94, 
187; wounds of, 80; cancer of, 82, 
88, 18^^-88; surgery of, 88^M; 
mortality of sewing of, 91; and 
bowd, united, 91, 98; operatkuis 
on, for adhesions, 92; foreign bod- 
ies in, 92; permanent opening 
into, 92, 98; dilated, taking a 
"tu<^" in, 98; displaced, 98, 94; 
like an "hour-glass," 94; tumors 
of, 94; perforation c^, by ulcer, 
96, 186; ulcer of, 186-88. 

Stovain, 175. 

Streptococcus, 227. 

Students, experiments by, 245. 

Subperiosteal removals, 161. 

Sunstroke, nature and effects of, 8. 

Suppuration, 22, 28^ 199, 200; the 
cause of, iH)7, 21 8; Lister's oqperi- 
ments on, 207, 208. 

Suprarenal ^and, 194. 

Surgery, recent progress in, 22-^; 
of the brain, 45-71; the progress 
of, as influenced by vivisection, 
72-109;^ recent progress in, a re- 
sult chiefly ci experimental re- 
search, 151-70; the new, 171-98; 
modem antiseptic, and experi- 
mentation, 199-219. See Heart, 
Lungs, etc 

Surgical fever, 24. 

Suture, defined* 24; of the heart, 
151, 152; of artery, 155-57; of 
nerves, 177; of blood-vessds, 158» 

Sylvius, fissure of » 48. 

Syme, Mr., 207. 

Syphflis, clinical observatioB ss. ex- 
periments, xi, xH; experiments 
on, 128, 124.. 

Tait, Lawsoo, recantation of, xii, 

Ten ooffinp, tragedy of, 255. 

Tertullian» 11& < 

Tetanus, germ of, 74, 196, 197, 212; 
since antisepsis, 197, 204; on 
Fourth of July, 197, 198;inava 
War, 208, 225. 

Tetany; 106. 

Thermic fever, 8. 

Thiersdi, lus eq;>erimeiits on chol- 
era, 15, 16. 

Thigh, nose made from IxMie of, 162; 
transplantation of, 168. 

Thumb, center for, 66-68, 80. 

Thymus gland, 194. 

Thyroid extract, 84, 85, 120, 121; 
in cretinism* 188, 184. 

Thyroid gland* 194; q;>erations on, 

Tomkins, Rev. Dr. Fiayd W.* 
quoted, 284. 

Tommasi-Cnideli, lus experiments 
on malaria, 15. 

Torture of animals, denial of, by 
Royal Commission of Viviwction, 
241, 294; by students, denial of, 

Toulose, Lister obliged to go to, to 
experiment, 19, 28, 48, 208. 

Toynbee, lost his hfe by experi- 
menting, 8. 

Tradieal msufflation, 188. 

Tracy, A., 115, 121, 186, 148, 144. 

Transfusion of Uood* 157-59, 228, 

Transplantation, of bone, 98-102, 
160-62, 171; of skin, 101-02, 160; 
to form new nose, 100, 161, 162; 
of parts of body and organs, 160- 
68; d joints, 161; of arteries after 
cold storage, 162; of leg of dog, 
162; of kidney of cat, 168; of para- 
thyroid glands, 167. 

Trephining, 225. 

Treves, Sir FrederidE, misrepre- 
sented, 282, 268, 269; his testi- 
mony to value of vivisection* 298. 

Trichina, 17, 72. 



Trathfuliien, lenened levereiioe f or» 

Tuberculin inoculatioiifl, 129-82, 

Tuberculosis, ducoTciy of germ of, 
14, 16; bacteriology ol, 78; tuber- 
culin test lor, 181, 144. iSee Con- 

Tuberculous meningitis, 174. 

'*Tuck," taken in the stomach, 98. 

Tumors, of the brain, diagnostica^ 
tion and removal cKf, 18, 14, 85, 
6S-57, 68, 64, 174, 215; abdomi- 
nal, 81, 82; of the spine, 41; of the 
brain, statistics of, 56, 57; of 
spinal cord, 82; of the liver, 86, 
87; oi the stomach, 94; of the 
bowed, 94, 95; of the kidney, 158, 
159; and skin-grafting, 160; of the 
liver, 191 ; of pituitary body, 195. 

l^phoid fever, condition of blood 
in, 108; vaccination against, 258- 
60; abolished in our army, 259, 
260; vaccination in British Army, 
260 n. 

T^hoid perforation of intestines, 

Ulcer, perforation of stomach by, 
96; and skin-grafting, 160; of the 
stomach, 186, 188. 

University d Pennsvlvania, prose- 
cution of six professors of, xiv, 


Urine, lister's experiments with, 

Vaccination, for yellow fever, 16; 
against typhoid fever, 258-60. 

Valleiy-Radot, Renl^ his Lffe qf 
Pasteur, ft55. 

Valves of the heart, <^>erat]ons on, 
158, 154. 

Veins, surgery of, 154-59. 

Ventilation ol the lungs, 188. 

Virdiow, his experhnents on 
trichina, 17. 

Vivisected products ai Philadelphia 
laboratories, 272, 286. 

Vivisection, objections to the word, 

V, vi; use of anesthetics in, vi-viii, 

106, 282, 288, 244-46, 265-68, 

278, 278, 279, 286; human, ix, 

' 110^15, 236 n., 251-58, 294; doo- 

ton who are o pp osed to, xii, 71; 
resolutions ol societies regarding, 
xiii-xviii; pamphlets on, xix, xx; 
our recent d^ts to^ 1-21, 45, 72- 
109, 220-88; new remedies dis- 
covered through, 4; painfulne^ 
of, 12 n., 108, 241, 244, 245, 262, 
268, 266; its contribution to treat- 
ment of amputations and frac- 
tures, 19, 28; animals benefited 
by, 20, 109, 288, 289, 290; its con- 
tribution to localization of brain 
centers, 87-41, 146-^; brain sur- 
^erv and, 45-71; opinion of med- 
ical profession ol Great Britain as 
to value of, 71; and Midshipman 
Aiken, 146-50; Royal Commis- 
sion's denial ol torture in, 241, 
294; no resolutions against, by 
any scientific society, xviii, 295. 
See Experiments, Progress, Hu- 
man vivisection. 
Voralberg, Insane Asylum at, 119. 

Warren, Dr. J. Collins, his attitude 
toward vivisection, 184. 

Warren, John C, and ether, 172. 

Wells, Sir Spencer, 7, 82, 172. 

Wentworth, Dr., case of, 122, IftS, 
274-76; results of his researdies, 

White, Mrs. Caroline Earle, her 
ignorance of surgery, 250 n.; ad- 
vocates human vivisection, x, 
251-58, 294; and Sir Frederick 
Treves, 268, 269; "unconscious 
exaggeration" of, 276 n.; argues 
that veUow fever has not been 
abolifliied, 281 n. 

Wilks, Sir Samuel, 208. 

Windpipe, foreign bodies in, 181f 

Womb, removal of, 287. 

Women, opposition of, to experi- 
ments on animals, 170, 222, 225; 
bitterness of, 284-89. 

Wood, Dr. H. C., his experiments on 
the effects of heat on animalB, 8; 
his experiments on the effects of 
bromid of ethyl on animalB, 10. 

Wounds, of the abdomen, 5, 6, 189; 
of the intestines, 5, 6, 80, 95; of 
the abdominal organs, 80, 81 ; ol 
the brain, 86; of the heart, 151; 



ot the aiteriet and todb, 155; of 
the luag, 181; ot gretA blood 
▼CMels in cfaeit, 184; hnmediatr, 
oomplete dofuie of, 206» 909. 

Wright, Sir Afanioth, 250. 

Wriftrdrop^ M. 

YeDow f erer, ahoGdanait ol, b; z, 
S81; experiments on, and diaoor- 
ery of source, 1 «, 17. tS»-90, 254. 
855. 281; Walter Reed's letter to 
Ilia wife as to, 229; ezperimenta 
on iDocqIation oC 124-20^ 279. 

U . S . A