JO The Red Cross and the Antivivisectionists By W. W. KEEN, M.D. Emeritus Professor of Surgery, Jefferson Medical College ; Major Medical Reserve Corps, United States Army y p ^ [Reprinted from The American Museum Jouknal, Vol. XVIII, No. 3, pp. 219-225, 1918] Reprinted from the March, ig/S, American Museum Journal The Red Cross and the Antivivisectionists AN APPEAL TO THE FAMILIES AND FRIENDS OF OUR HEROIC TROOPS AND TO THE COMMON SENSE OF THE AMERICAN PEOPLE By W. W. KEEN, M.D. Emeritus Professor of Surgery, Jefferson Medical College; Major Medical Reserve Corps, United States Armv FIRST of all let me make two facts clear. 1. This paper has been written entirely on my own responsibility and not at the suggestion directly or indi- rectly of the Red Cross. I have been moved to write it solely in the interest of our brave soldiers, and especially be- cause their sufferings and lives are in- volved in the suit against the Red Cross by the antivivisectionists to prevent the use of $100,000 of the Red Cross funds in such beneficent life-saving re- searches. 2. The Red Cross as an organization is neither an opponent, nor an advocate, nor a defender, of vivisection. It states officially that the supreme aim of the Red Cross is to relieve human suffering [and it might well have added "and to save thousands of human lives"]. "The War Council was advised from the ablest sources available that an immediate appropriation for medical research would contribute to that end. The War Council could not disregard such advice." They then refer to the many un- solved medical and surgical problems that have arisen from wholly new con- ditions and methods of warfare. Let- ters from a number of my own surgical friends in France emphasize and the medical journals teem with papers on these new problems. They relate to the treatment of the horribly infected wounds — and practically all wounds are of this kind — never met with in civil surgery; to the treatment of "trench fever"— a peculiar form of fever never 1 Quoted from Science, February 22, 19 before seen ; of "trench heart" ; of "trench foot," often followed by lock- jaw; of "trench nephritis" (inflamma- tion of the kidneys); gas gangrene; tetanus; shell shock; poisonous gases; fearful compound fractures, especially of the thigh, etc. Every man enabled to return to active duty as a result of solving these problems helps to win the war. Every man who dies, or is per- manently disabled because of our igno- rance, hinders our winning the war. It must be remembered that our sur- geons, physicians, and physiologists over there are the very flower of the American medical profession. These fine men, under the supervision of the Medical Staff of the United States Army, superintend all the work. Noth- ing is done that has not the direct ap- proval of Brigadier General A. E. Bradley, Medical Corps, IT. S. Army. Experiments on animals form a nec- essary but a minor feature of the re- searches. "The animals used are principally guinea pigs, rabbits and white rats. If operations causing pain to animals are performed, anesthesia is used." This certainly does not suggest "cru- elty*' or "torture." I appeal to the common sense of the American people and especially to the families and friends of our brave sol- dier boys: Which do you prefer, (1) That our soldiers shall be protected from attacks of these new (as well as of the familiar) diseases, their suffer- ings lessened or even prevented, and 18, with slight additions by Dr. Keen. 219 220 THE AMERICAN MUSEUM JOURNAL their lives saved, or (2) will you insist that not a single guinea pig, rabbit, or rat shall suffer the slightest pain or lose its life, in researches to lessen the suffering and save the lives of our sol- diers ? Eemember, if you choose the second you deliberately condemn your son, brother, or husband to sufferings far beyond any suffering of these animals. In many cases, as I shall show, you will condemn your dear one to death, and in some cases a horribly painful death. In the "Bill of Complaint" of the antivivisectionists, seven grounds of opposition to vivisection are mentioned. The sixth reads as follows : "That although it [vivisection] has been practised for many years, nothing has been discovered by means of it that is at all bene- ficial to the human race." This is the crux of the whole matter. If this were true I would vigorously op- pose vivisection myself. I entered upon my medical studies in 1860. I took part in the horrible sur- gery of the Civil War— as we now know it was. I have taught anatomy and surgery to not far from 10,000 students. I taught and practised the old dirty surgery— the only kind we then had — up to October 1, 1876. Since that date I have practised and taught the new antiseptic surgery, which has been cre- ated by researches similar to those now proposed. Since the Great War began I have diligently studied the newest sur- gery. I submit, therefore, that I may be presumed to be fairly familiar with these three stages of surgery. Let me give now a few examples of some of the things that have "been discovered by it [vivisection]" and that are "beneficial to the human race." I may remark in passing that ani- mals themselves have benefited by the same means, almost, and possibly quite as much as the human race. 1. Typhoid Fever. — This has been one of the historic scourges of armies. In 1880 the bacillus — the cause of the fever — was discovered. It was soon proved that the disease was spread through infected milk, infected water, and very largely by the house fly. The last, after walking over the excrement of a typhoid patient, and then walk- ing over our food, conveys the disease. Prevention of contamination by these three means — sanitary measures based on the discoveries of bacteriology — pre- vents the disease to a large extent. But our real triumph over the disease was not achieved until lately. I may here call attention to the fact that the antivivisectionists entirely re- ject bacteriology, a science which has disclosed to us the causes of many dis- eases, and has enabled us to prepare antitoxins to neutralize the poisons de- veloped by these bacteria. Without bac- teriology the physician and the surgeon today would be as helpless as a mariner without a compass. Cases Deaths During the Civil War ty- phoid fever resulted in. 79,462 and 29,336 In the Boer War there were 58,000 " 8,000 (In that war the total number of deaths was 22,000. Typhoid alone, therefore, was respon- sible for more than one third of all the deaths ! ) In our war with Spain there were 20,738 " 1,580 Our Army numbered 107,973 men. Therefore every fifth soldier fell ill with typhoid in 1898 ! Over 86 per cent of all deaths in this war were due to typhoid ! ! During the Boer War imperfect at- tempts were made to control typhoid by an antitoxin similar to that against diphtheria, which has saved such mul- titudes of children. Gradually the method has been improved so that in our army it was at first recommended as a voluntary protection (1909). The THE RED CROSS AND THE ANTIVIVISECTIONISTS 221 results were so favorable that in 1911 it was made compulsory. It has been said that it should still be voluntary. But as every case of typhoid imperils the health and life of multitudes we surely have a right to make it compulsory so as to protect all the rest. All that is necessary to prove this is to look at these tables of cases and deaths in our Army and Navy. TYPHOID FEVER IN THE UNITED STATES ARMY Year Cases Deaths 1906 210 12 1907. 124 7 1908 136 11 1909 173 16 1910 142 10 [vaccination made compulsory] 1911 70 8 1912 27 4 1913 4 1914 7 3 1915 8i TYPHOID FEVER IN THE UNITED STATES NAVY 1909 189 17 1910 193 10 1911 222 15 [vaccination made compulsory] 1912 57 2 1913 I 22 4 1914 13 1915 15 1 On the Mexican border, though the fever was rife near the camps, only one man out of 20,000 troops, a civilian, who unfortunately escaped vaccination, fell ill with it. Now let us see the results in the armies in the present war. In the British armies, on March 1, 1917, Mr. Forster, Under Secretary for War, stated in the House of Commons that The last weekly returns showed only twen- ty-four eases in the four British armies in France, Salonica, Egypt and Mesopotamia. He added that the total number of eases of typhoid fever in the British troops in France 1 Four in the United States ; 4 in Hawaii. down to November 1, 1916, was 1,684, of paratyphoid 2 2,534, and of indefinite cases, 353, making a total of 4,571 of the typhoid group. Now the English armies number at least 5,000,000. If they had suffered as our Army did in 1898 there would have been 1,000,000 cases ! In fact there have been less than 4,600 ! Be- sides that, the percentage of fatal cases in the inoculated men was 4.7 per cent, in the uninoculated 23.5 per cent; and perforation of the bowel, the most dan- gerous complication, occurred six times more frequently among the unvacei- nated than among those who had been protected. In the British armies the antityphoid vaccination is still volun- tary but more than 90 per cent have sought its protection. If it had been compulsory, hundreds of the 4571 who died would have been saved! In our own Army in more than four months (September 21, 1917, to Janu- ary 25, 1918), a period one month longer than our war with Spain (the Surgeon General's Office gives me the official figures ) , we have had an average (i. e., every day of these four months) of 742,626 men in our cantonments and camps. These men have come from all over the country, in many cases from where autumnal typhoid was reaping its annual harvest, in practically all cases unprotected by vaccination. Between these two dates there have been 114 cases of typhoid and 5 of paratyphoid. Had the conditions of 1898 prevailed there would have been ll/.l/.,506 cases in- stead of 119 in all! The reason is clear. The men were all immediately vacci- nated against typhoid, paratyphoid and smallpox. 3 Besides this as soon as the anti- typhoid inoculation was completed the number of cases rapidly fell and from December 14 to February 15 — 9 weeks - A form of fever caused by a bacillus somewhat similar to the typhoid bacillus but causing a much milder infection. 3 Of the last disease, there have been only 4 cases, all unvaceinated. 222 THE AMERICAN MUSEUM JOURNAL —there have been only 6 cases of ty- phoid and one of paratyphoid among probably now nearly 1,000,000 men ! Truly marvelous ! Now all this is the direct result of bacteriological laboratory work. Was it not worth while ? Has it not "benefited the human race" ? Are you not glad that your son is thus protected? I may add that the German armies show a similar absence of typhoid. I have seen no figures but only general statements. Tetanus or "Lock-jcm" — Few people realize what terrible suffering this dis- ease causes. The mind of the patient is perfectly clear, usually to the very end, so that his sufferings are felt in their full intensity. All of my readers have had severe cramps in the sole of the foot or calf of the leg. The pain is some- times almost "unbearable." In tetanus not the muscles of the jaw alone are thus gripped, but the muscles all over the body are in cramps ten or twenty- fold more severe, cramps so horrible that in the worst cases the muscles of the trunk arch the body like a bridge and only the heels and head touch the bed ! Never shall I forget a fine young soldier during the Civil War who soon after Gettys- burg manifested the disease in all its dread- ful horror. His body was arched as I have described it. When at intervals he lay re- laxed, a heavy footstep in the ward, or the bang of a door, would instantly cause the most frightful spasms all over his now bowed body and he hissed his pitiful groans between tightly clenched teeth. The ward was emptied, a half -moon pad was hung be- tween the two door-knobs to prevent any banging; even the sentry, pacing his monot- onous steps just outside the ward, had to be removed beyond earshot. . . . The spasms became more and more severe, the intervals shorter and shorter ; it did not need even a footfall now to produce the spontaneous cramps, until finally a cruelly merciful at- tack seized upon the muscles of his throat and then his body was relaxed once more and forever. He had been choked to death. Do you wonder at the joy unspeak- able which we surgeons have felt of late years as we have conquered this fearful dragon? In 1884 the peculiar germ, shaped like a miniature drumstick, was discovered. Its home is in the intes- tines of animals, especially of horses. The soil of France and Belgium has been roamed over by animals and ma- nured for over 2,000 years, even before Julius Caesar conquered and praised the Belgians. The men in the trenches and their clothing are besmeared and be- mired with this soil, rich in all kinds of bacteria, including those of tetanus, gas gangrene, etc. When the flesh is torn open by a shell, ragged bits of the muddy clothing or other similarly infected foreign bodies are usually driven into the depths of the wound. Now the tet- anus bacilli and the bacilli of "gas gan- grene" are the most virulent of all germs. It takes 225,000,000 of the ordinary pus-producing germs to cause an abscess and 1,000,000,000 to kill, while 1,000 tetanus bacilli are enough to kill. This readily explains the fright- ful mortality from tetanus during the Civil War. It killed 90 patients out of every hundred attacked. In the early months of the Great War the armies suddenly placed in the field were so huge that there was not a suf- ficient supply of the antitoxin of tet- anus. Hence a very considerable num- ber of cases of tetanus appeared. Now it is very different. At present every wounded soldier, the moment he reaches a surgeon is given a dose of antitetanic serum. As a result, tetanus has been almost wiped off the slate. I say "al- most," because to be effective the serum must be given within a few hours. The poor fellows who lie for hours and even days in No Man's Land cannot be reached until too late. All the surgeons on both sides concur in saying that tetanus, while it still occurs here and there, has been practically conquered. Every step of this work has been ac- complished by the bacteriologists and THE BED CROSS AXD THE AXTIVIVISECTIOXISTS ■m the surgeons working together in the laboratory and the hospital. Would you seriously advise that no such experi- mental researches should have been car- ried on and that your boy should suffer the horrible fate of my own poor Get- tysburg boy ? Confess honestly, are not these and other similar researches to be described as humane? — as desirable? — nay. as imperative? Nay, more. "We feel." say forty-one of our medical officers on duty in France, "that any one endeavoring to stop the Red Cross from assisting in its humani- tarian and humane desire to prevent American soldiers from being diseased, and protecting them by solving the pe- culiar new problems of disease with which the Army is confronted is in reality giving aid and comfort to the enemy.'" But the antivivisectionists de- clare that bacteriology is false — that such vaccination is "filling the veins with 'scientific filth' called serum or vaccine"* ! They are doing their best to persuade our soldiers not to submit to any such "vaccination" ! Smallpox. — The word vaccination leads me to say a word about smallpox. I confess that I was amused by a recent paper in an antivivisection journal en- titled "Vaccination as a Cause of Small- pox" ! During the last year hundreds of thousands of soldiers have been vac- cinated against smallpox. Surely there should have been some cases of that dis- gusting disease if it were caused by vaccination. But what are the facts ? I have just received the Report of Surgeon General Gorgas for 1917. The section on Small- jinx reminds one of the celebrated chap- ter on "Snakes in Ireland.*' On p. 81 on .Smallpox in the Army in the United States, I read "No cases of smallpox occurred within the United States proper during the year." On p. 175, I read "No cases [of smallpox or vario- loid] occurred in the islands" [among the American troops in the Philip- pines]. On p. 188, 1 read under Small- pox that "nine cases occurred during the year" [among the Philippine Scouts]. My friend and former student, Dr. Victor G. Heiser. as director of health in the Philippine Islands for years, vac- cinated over 8,000,000 persons without a death — and with what result ? In and around Manila the usual toll of small- pox had been about 25.000 cases and 6000 deaths annually. In the twelve months after his vaccination campaign was finished there was not one death from smallpox. Per contra, in 1885 in Montreal, as stated by Osier, one Pullman porter in- troduced smallpox into a largely un- vaccinated city. There followed 3164 deaths and enormous losses to the Mont- real merchants. But why say more? We all know that a single case in any community causes every intelligent person to be protected by vaccination. Gas Gangrene. — One of the terrible and new surgical diseases developed by this war is called "gas gangrene." It has no relation to the poisonous gases introduced by the barbarous Germans at Vpres. About twenty-five years ago Professor W. H. Welch, of the Johns Hopkins Hospital, discovered a bacte- rium which produced gas in the inter- stices between and in the muscles. This bacillus does not occur in Great Brit- ain. I never saw a case of gas gangrene in the Civil War. and but one case since then in civil practice. On the contrary in Belgium and France in the soil and. therefore, on the clothing and on the skin of the soldiers these bacilli abound. From what Bashford calls the "cesspool of the wound** the germs travel up and down in the axis of the limb. If the gas escapes from a puncture it will take fire from a match. Gas has been observed within five hours. An entire limb may become gangrenous within sixteen hours. If the whole limb is amputated the gas may be so abundant that the limb will float in water ! Death is not lone delayed. 224 THE AMERICAN MUSEUM JOURNAL jSTow your son in France runs a very serious risk of becoming infected with this deadly germ. Would you be will- ing positively to forbid any experiments on animals which could teach us how to recognize this infection as early as pos- sible ? Would you forbid any experiments which might teach us how to conquer or better still to prevent this virulent infection and save his life? Which would you prefer should suffer and very possibly die, a few minor animals or your own son? If a horse or a dog or even a tiny mouse can help in this sacred crusade for liberty and civiliza- tion, if it even suffers and dies, is it not a worthy sacrifice? Should they be spared and our own kith and kin give up their lives? I need not wait for a reply ! I am sure you would say "My boy is worth 10,000 rabbits or guinea pigs or rats ! Go on ! Hurry, hurry ! and find the remedy." That is true humanity which will save human lives even at the ex- pense of some animals' lives. Now see the result. By careful ob- servation and experiments with differ- ent remedies the surgeons have discov- ered valuable methods of treatment. But very many still die. Prevention is always far better than cure. At the Rockefeller Institute Drs. Bull and Ida W. Pritchett have discovered a serum which in animals prevents this gas gan- grene and yet does no harm to the ani- mal. It is now being tried on the sol- diers in France. Again I ask : Is it not our duty even to insist on such experiments so that our troops may be spared the dreadful suffering and even death following this virulent infection? If the Bull-Prit- chett serum proves ineffective should not our efforts be redoubled ? The com- mon sense of the American people will reply : "Yes, by all means. You will be recreant to humanity and to your duty if you do not." Modern Surgery. — "Lister," in How- ard Marsh's fine phrase, "opened the gates of mercy to mankind." Pasteur and Lister are the two greatest bene- factors of the human race in the do- main of medicine. I am not sure but that I might even omit the last five words. The revolution which Lister pro- duced in surgery is so well known to every intelligent person that I need say only a few words. Forty years ago a wholly new surgical era was inaugu- rated by Pasteur and Lister. In the Civil War there were recorded 64 wounds of the stomach and only one re- covered. Otis estimated the mortality at 99 per cent. In more than 650 cases of wounds of the intestines there were only 5 cases of recovery after wounds of the small bowel and 59 from wounds of the large bowel — together only 64 out of 650 recovered, i. e., more than 90 out of every 100 died ! The complete statistics of the present war cannot be tabulated and published for some years. I give, however, the result of one series of abdominal gun- shot wounds as a contrast, on a far larger scale and in far worse wounds. Out of 500 such operations, 245 recov- ered! and only 255 died. Contrast 51 per cent of deaths in these wounds with mutilation and infection unutter- ably worse than in the Civil War, with 99 per cent of deaths, according to Otis. Is not this a triumph of bacteriologi- cal and surgical research? Would you prohibit similar researches now when your boy's life may be saved by them? Is not this one of the things that have "been discovered" by vivisection and has not such change in surgical treatment been of "benefit to the hu- man race"? In all honesty would you be willing to have your son treated as I myself (may God forgive me!) igno- rantly treated hundreds during the Civil War? This advance I not only think and believe, but also I KNOW is due to THE RED CROSS AXD THE ANTIVIVISECTIONISTS 525 Pasteur and Lister and their followers. I know it by personal experience just as you know the high cost of living, the shortage of sugar, and the scarcity of coal. The bacteriology which the antivivi- sectionists scorn and reject I know is the corner-stone of modern surgery. Before Lister's day out of 100 cases of compound fracture 66 died from infec- tion. Now the percentage of deaths is less than one out of 100. Before Lister my old master in surgery, Dr. Wash- ington L. Atlee. one of the pioneers in practising ovariotomy, lost 2 out of every 3 patients — now only 2 or 3 in 100 die. Before Lister we never dared to open the head, the chest or the abdo- men unless they were already opened by the knife, the bullet or other wound- ing body. Now we open all of these great cavities freely and do operations of which the great surgeons of the past never dreamed in the wildest flights of their imagination. Could they return to earth they would think us stark crazy until they found that the mortality was almost negligible and the lives saved numbered hundreds of thousands. I have given but a few instances of the many wonderful benefits which have resulted from medical research in every department of medicine. But I believe they are sufficiently convincing. I should have been glad to tell the story of tuberculosis, syphilis, the bubonic plague, yellow fever, malaria, the hook- worm disease, diphtheria, typhus fever, cerebrospinal meningitis, Malta fever, leprosy, and many other diseases, every one of which has had its progress stayed, its victims rescued, its toll of human lives cut down enormously, sometimes to one half or less, by re- searches similar to those which will be conducted in France. Most important and life-saving researches on surgical shock already have been made by Por- ter, Cannon, and others. Ought these to be abandoned and our soldiers left to perish when we can save their lives? I can sympathize with the deep feel- ings of those who wish to spare pain to animals, but is it not a higher and more imperative, a holier sympathy that has spared and will spare pain eventually to human beings and also to other ani- mals in uncounted numbers? Do you wonder that after more than forty years of steady practice, teaching and writing I assert, conscious of the great responsibility of my words, that "I regard experimental research in medicine as a medical, a moral and a Christian duty toward animals, toward my fellow men. and toward God." There is so much yet to be learned, chiefly by experimental research ! So many devoted lives to be saved to our country and to mankind if we only knew how ! Do you wonder that I am in dead earnest ? Finally. What have the antivivisec- tionists themselves done to diminish sickness and save life ? A. In animals? Absolutely nothing. In spite of the enormous ravages of animal diseases causing enormous suf- fering to animals and costing this coun- try $215,000,000 every year, not a single disease has had its ravages dimin- ished or abolished as a result of any- thing they have done. They have not even tried. But medical research is sav- ing every year thousands of animals from anthrax, hog cholera, chicken cholera, Texas fever, and other diseases. B. In human beings? Absolutely nothing. I do not know a single disease of human beings which has had its rav- ages checked, abated or abolished by any work ever done by the antivivisection- ists. Again, they have not even tried. The only thing they have done has been to throw as many obstacles as pos- sible in the path of those who are striv- ing to benefit both animals and men. This present suit is characteristic. Digitized by the Internet Archive in 2012 with funding from Duke University Libraries http://www.archive.org/details/redcrossantiviviOOkeen CUKE MED. CENTER LIB. HISTORtCAL COLLECTION. UUKE MED. CENTER LIBj HISTORICAL COLLECTION