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 QP45 .K253 The progress of surg 
 
 RECAP 
 
 The Progress of Surgery 
 
 as Influenced by 
 
 Vivisection 
 
 BY 
 
 W. W. KEEN, M. D., LL. D., 
 
 Professor of the Principles of Surgery and of Clinical Surgery, 
 Jefferson Medical College, Philadelphia. 
 
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The Progress of Surgery as Influenced by 
 
 Vivisection 
 
 BY 
 
 W. W. KEEN, M. D., L. L. D., F. R. C. S. (Hon.) 
 
 Professor of the Principles of Surgery and 
 
 of Clinical Surgery, Jefferson Medical 
 
 College, Philadelphia. 
 
 *\ 
 
 
 Reprinted from "The Philadelphia Record" of September 14 and 21, 1901, 
 
C" 
 
 Kiss 
 
THE PROGRESS OF SURGERY AS INFLUENCED BY 
 
 VIVISECTION 
 
 PART 1 
 
 I have been asked by the editor of 
 "The Philadelphia Record" to write a 
 brief resume of the influence of vivisec- 
 tion on the progress of modern surgery. 
 I shall do so as briefly as I possibly can, 
 stating only facts which are generally 
 well known to surgeons, but of which 
 the general public of necessity must be 
 ignorant to a great extent. Most of the 
 facts below stated are known to me per- 
 sonally, as they have occurred during my 
 professional lifetime; and I can, there- 
 fore, vouch for their accuracy. 
 
 Tf a physiologist were asked to con- 
 tribute a similar paper he would be able 
 to tell a similar story as to the revela- 
 tions of the functions of various organs 
 in the human 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 pa- 
 per 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, second- 
 ly, in the introduction of a large num- 
 ber of new drugs. In this way cocaine 
 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 sim- 
 ilar chapter he would scarcely know 
 where to begin. The whole life history, 
 for example, of the trichina has been 
 studied in animals and the results ap- 
 plied to man, so that if &very 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 ex- 
 cluded by microscopical examination. In 
 diphtheria the percentage of deaths has 
 been reduced in Baltimore from about 
 70 per cent, to about 5 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 almost solely as a re- 
 sult of animal experimentation. 
 
 Two water companies in London in 
 1853 experimented on 500,000 human 
 beings, and. as a result of the cholera, 
 one of them killed 847" > human beings. 
 In that same year Thiersch, in Leipzig. 
 .'Xj erimented on tifty-six mice. Had 
 the lesson of these few mice been heed< d 
 the lives of these human beings might 
 have been saved. More than that, even 
 at the present day. as a result of Koch's 
 discovery of the cause of cholera. Haff- 
 kine, in India, is making protective inoc- 
 ulations which are proving of the great- 
 est value. By the same method we have 
 recently discovered that the bubonic 
 plague is spread by rats, and that effica- 
 cious vaccines can be used against this 
 dreadful disease: that the malarial para- 
 site is spread by mosquitoes, as proved 
 by studies both in birds and in human 
 beings; and the preventive inoculations 
 against typhoid (as yet in the early stage 
 nf their usei have been discovered by the 
 same means. 
 
 On the border line between medicine 
 and surgery is the new science of bac- 
 teriology. In surgery this has shown the 
 cause of erysipelas, of inflammation, of 
 tetanus or lock-jaw. of glanders, of 
 tuberculosis (not only of the lungs, but 
 of the brain, the bones, the joints, the 
 bowels, etc.) and of many other disor- 
 ders. 
 
 Let me give one illustration of the 
 method by which the cause of one dis- 
 ease — tuberculosis — was proved. Similar 
 methods are employed in tracing the 
 causes of others. In a case of consump- 
 tion of the lungs the expectoration is 
 examined by the microscope after apply- 
 
 ing a staining material. Without stain- 
 ing the tubercle bacilli are so trans- 
 lucent (like little rods of jelly l that Ave 
 <an scarcely see them. Having found 
 this peculiar germ in the expectoration, 
 some of the material is injected under 
 the skin of a guinea pig. After a cer- 
 tain time the animal either dies or i- 
 killed, and a post-mortem examination 
 is made. If there are found in the body 
 of the guinea pig little nodules — i. e.. tu- 
 bercles (little tubers i— these are exam- 
 ined by the same method and the same 
 germs will lit discovered ami can be ob- 
 tained in a pure culture. But the cir- 
 cle of proof is not yet complete. A 
 small portion of this pure culture of the 
 germs obxained from the inoculated 
 guinea pig is again injected into another 
 animal, and if the second animal suffer 
 from a similar disease and the same 
 germ be fcund again the conclusion is 
 irresistible that the cause of the tuber- 
 culosis is the peculiar germ always 
 found in such cases. 
 
 I well remember the incredulity with 
 which I first read of the origin of 
 lock-jaw from the soil, but very soon 
 this incredulity was changed to belief 
 in the face of absolute demonstration 
 aft.-r this fashion: It had been well 
 known for years that hostlers, cavalry- 
 men, farmers and persons who were en- 
 gaged in any occupation about horses 
 were peculiarly liable to lock-jaw. 
 After the discovery of the bacillus of 
 !' <k-jaw in 1S84. by Nicolaier, when a 
 case of lock-jaw 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 inoc- 
 ulated into animals, and was found to 
 produce the same disorder: and the same 
 
bacillus was recovered from the ani- 
 mal's body, and was reinoculated. The 
 circle of proof, therefore, was complete. 
 This explained the popular belief that 
 treading on a rusty nail is a frequent 
 cause of lock-jaw; not because it was 
 a nail or old or rusty, but because the 
 germ of lock-jaw 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 quick- 
 ly gave us all the desired information. 
 This has abolished lock-jaw as a result 
 of surgical operations, and enabled us 
 to cure it in many cases even after 
 accidental 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 dis- 
 coveries of the Nineteenth Century 
 were, (1) anesthesia, especially by 
 ether (in 1846) and by chloroform (in 
 1847); and (2) antisepsis, by Lord Lis- 
 ter, who began his work soon after the 
 middle of the Nineteenth Century and 
 had distinctly formulated it about the 
 end of the 60's. His remarkable paper 
 in The Lancet of April 3, 1869 (when he 
 was simply Mr. Lister, Professor of 
 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 be- 
 lieved that inflammation and most of 
 our surgical disorders were due to 
 germs, and that if we could exclude 
 these germs we would be able to secure 
 the healing of wounds without inflam- 
 mation and without the formation of 
 pus (matter); yet it was not until 1881 
 that Ogston and Rosenbach discovered 
 the germs which produce the terrible 
 results of inflammation, such as ery- 
 
 sipelas, hospital gangrene (what irony 
 in the name!) abscesses, blood poison- 
 ing and even death. 
 
 HEMORRHAGE. 
 
 One of the most important contribu- 
 tions by Lister to the progress of sur- 
 gery was the introduction of antisep- 
 tic threads (ligatures) of catgut, with 
 which to tie blood vessels. One of the 
 earliest Philadelphia surgeons, Philip 
 Syng Physick. tried to get rid of the 
 dangers following silk, which had been 
 used to tie arteries ever since Ambroise 
 Pare introduced it in the Sixteenth Cen- 
 tury as a happy substitute 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 animal substance and would, there- 
 fore, disappear by absorption. Dorsey 
 used catgut. Hartshorne used parch- 
 ment cut in fine threads, and Bellin- 
 ger and Eve the tendon of the deer. But 
 none of these surgeons succeeded in giv- 
 ing us harmless ligatures until Lister 
 taught us how to use them. In 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 per- 
 centage of cases the blood vessel was 
 not stopped by a clot; secondary hemor- 
 rhage took place (usually during the sec- 
 ond week after an operation), and many 
 a patient bled to death. 
 
 I shall never forget one night in the 
 Satterlee Hospital, of West Philadel- 
 phia, 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 liga- 
 
tu res. As a consequence of the introduc- 
 tion of antiseptic ligatures by Lister I 
 do not recall in the last twenty years five 
 cases similar to these five that I then 
 attended in one night. In other words, 
 secondary hemorrhage has almost disap- 
 peared from surgical experience. 
 
 How did Lister tind out the proper 
 method of tying an artery V On Decem- 
 ber 12, 1867, he tied the great carotid 
 artery in the neck of a horse with a 
 piece of pure silk saturated with a strong 
 watery solution of carbolic acid, cutting 
 both ends of the thread short and dress- 
 ing the wound antiseptic-ally. Healing 
 took place without any inflammation. 
 Six weeks after the operation he investi- 
 gated the parts by dissection, and found 
 that if the thread had not been applied 
 with the antiseptic precautions secon- 
 dary hemorrhage would unquestionably 
 have occurred, and in all probability the 
 animal would have bled to death. On 
 January 29, 1868, he applied this prin- 
 ciple in the case of a woman of fifty-one 
 v\ith 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 in- 
 flammation, and lived for ten months. 
 On November 30 she suddenly died as 
 the result of a rupture of a similar dilata- 
 tion of the aorta in the chest. This gave 
 Lister the unusual opportunity of exam- 
 ining in a human body the result of his 
 application of an antiseptic thread to 
 the arteries. The case emphasizes one 
 of the great difficulties in studying such 
 questions on human beings. The oppor- 
 tunity for a post-mortem examination 
 after such an application of a new prin- 
 ciple can only be occasional. If this 
 woman at the time of her death had 
 been under the care of some other sur- 
 
 geon than Lister no such careful exam- 
 ination of the consequences of the tying 
 of the artery would have been made, and 
 no further progress would have followed. 
 The result of his 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 31, 1868, he tied the carotid 
 artery in the neck of a calf with catgut 
 which had been prepared with carbolic 
 acid, and all antiseptic 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 al- 
 low of secondary hemorrhage, was really 
 stronger at this point than at other 
 points. The ligature and the knot had 
 entirely disappeared. 
 
 I have narrated this somewhat in de- 
 tail for this reason: It illustrates ad- 
 mirably the method of scientific prog- 
 ress by experiment upon animals. Neither 
 of these animals suffered 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 vessels in animals and 
 have killed them at varying intervals 
 and made microscopical examinations of 
 
the blood vessels. Iu 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 
 animals would have been attained only 
 arter many years by occasional post-mor- 
 tems, and would then have been very 
 much less perfectly attained and only 
 by the loss ur many human lives instead 
 of a few' animals' lives. 
 
 Contrast, now, the result of the old and 
 the new surgery in tne mere matter of 
 stopping hemorrhage after operations or 
 accident by tying blood vessels with the 
 old ordinary silk and the modern anti- 
 septic catgut, or with silk itself as 
 now used by improved methods. 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, 
 possibly, be rotted through, each liga- 
 ture 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 lig- 
 ature on the great blood vessel of the 
 arm or thigh came away, not uncom- 
 monly 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 con- 
 stant 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 th-5 threads short and close 
 the wound entirely; and, instead of hav- 
 ing discharge and horrible inflamma- 
 tion for days and often weeks and some- 
 times 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 unheard 
 of. If .vivisection had given to surgery 
 only the modern means of stopping hem- 
 orrhage 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 pa- 
 tient'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 Mur- 
 phy, of Chicago) have made some very 
 ingenious experiments on such wounded 
 blood vessels. They have carefully ex- 
 posed the artery of an animal (under an 
 anesthetic, of course), have wounded it, 
 and then, instead of tying the artery, 
 have sewed up the wound in the wall 
 of the artery to see whether this could 
 not be done successfully. The reason 
 for this series of experiments is this: 
 When we cut off the supply of blood to 
 a leg or an arm by tying the blood ves- 
 sel, gangrene not uncommonly occurs, be- 
 cause the chief blood supply of the limb 
 is cut off by tying the artery. If in- 
 stead 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 gangrene. One thing is per- 
 
feclly manifest— it would never be prop- 
 er to make such experiments on human 
 beings. Human life would be endan- 
 gered, and no surgeon would adopt or 
 would be justified in adopting such a 
 novel procedure until it had been tried 
 and proved successful on animals. Sev- 
 eral successful cases of suture (sewing) 
 of the large blood vessels 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 
 opposite side of the body. Broca also 
 discovered by observations on man in 
 actual cases of disease that when that 
 part of the brain 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 gun-shot 
 wound in the region above the ear or in 
 the front of the brain or the back of the 
 brain, there was no well recognized dif- 
 ference in the results. This was largely 
 due to the fact that such injuries are 
 widespread, and not limited to small 
 areas. In Germany Fritsch, Hitzig and 
 Goltz. and in England Horsley, Ferrier, 
 Schaeffer and others, pursued the fol- 
 lowing plan: The monkey's brain is the 
 nearest in similarity to man's. A known 
 portion of the brain — for instance, the 
 region above the ear — being exposed, the 
 brain was mapped out in small squares 
 and each one of these squares in suc- 
 cession 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, contrac- 
 tion 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 movements 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 eye blind, and that if the 
 area of the left side was destroyed the 
 left half of each eye became blind. This 
 description is, probably, sufficient to 
 indicate how physiologists and surgeons 
 have investigated the brain. 
 
 The following is an instance which 
 shows how accurately this method has 
 enabled us to locate the motor centres 
 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 of the brain, as large as 
 the last joint of the forefinger, was re- 
 moved from the place determined upon 
 animals as the centre governing the move- 
 ments of this thumb. When she awoke 
 from the ether that thumb was entirely 
 paralyzed, and no other part of the 
 body. 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 single case ever recorded of so minute- 
 ly located disease. By no other means 
 than vivisection could this small thumb 
 centre 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 year. This has made 
 possible the modern surgery of the brain, 
 which would not exist to-day were it not 
 for vivisection. 
 
 Here and there an unexpected post- 
 mortem examination, as in the case of 
 Lister's woman patient, has given us 
 some special information, but nine-tenths 
 if not ninety-nine-one-hundredths of our 
 knowledge of cerebral localization is the 
 result of exact experiment on animals. 
 As a consequence of this in 1884, for 
 the first time in the history of surgery, 
 the existence of a tumor of the brain, 
 which was not indicated by anything on 
 the outside of the head, was diagnosti- 
 cated, its location determined and the 
 tumor removed. When the skull was 
 opened do tumor was visible: but so 
 confident was Mr. Godlee, the surgeon, 
 that he cut boldly into the substance of 
 the brain and there found the tumor 
 which had been so accurately diagnos- 
 ticated. Since then this first achieve- 
 ment has been repeated not only scores, 
 but hundreds of times, and the 
 net result up to 1898 was that 273 
 brain tumors had been operated on. Of 
 the patients 169 (61.9 per cent.) had re- 
 covered and 104 (38.1 per cent.) had died. 
 At present it can be said that two out of 
 every three recover! This localization of 
 cerebral functions, together with anti- 
 sepsis, has so revolutionized (or, rather, 
 created) modern cerebral surgery that 
 the principal facts are a matter of com- 
 mon knowledge. Tumors are now at- 
 tacked not only in what is called the 
 motor area (that is, that portion of the 
 brain governing movement, which, 
 roughly speaking, may be described as 
 lying above the ear), but many times 
 
 in the front part of the brain, and at the 
 back of the brain, far outside of the 
 motor area. In case tiie tumor is at the 
 base of the brain, or at certain other 
 parts this knowledge has prevented use- 
 less operations which otherwise might 
 have been performed. 
 
 It is a source of sincere gratification 
 on the part of numerous surgeons that 
 by this "same knowledge of cerebral local- 
 ization derived from animal experimenta- 
 tion they have been able to recognize 
 hemorrhage inside the skull, open the 
 skull at the right point, even when there 
 was no fracture, and save their patients. 
 Before experiments on animals showed 
 us how to interpret the symptoms 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 braiu (such as 
 nails driven into it by accident or de- 
 sign, rifle balls which had lodged in it) 
 and of many other similar surgical dis- 
 orders the modern successful treatment 
 of which depends directly upon the lo- 
 calization of cerebral functions, which 
 is the result almost wholly of experi- 
 ments 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 otherwise, no reunion of the 
 two ends would take place, and, there- 
 fore, there was no possibility of relief 
 for the paralysis below the point of di- 
 vision of the cord which is almost al- 
 ways fatal. Only this winter, at the 
 Pennsylvania Hospital, Dr. Stewart had 
 a patient whose spinal cord was cut in 
 
two bv a bullet. He removed the bone 
 sufficiently to get access to the spinal 
 cord, and found it completely divided. 
 He immediately stitched the two ends 
 together, and, strange to say, this pa- 
 tient has recovered both feeling and 
 motion to some extent in both legs. I 
 think it would be evident to any person 
 that such a totally unexpected result de- 
 serves the most careful investigation. In 
 man cases of such complete division 
 followed by recovery are almost un- 
 known; 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 together; at 
 what date after division of the cord it 
 will be hopeless to do so; how much of 
 the cord can be lost (that is to say, a 
 half inch, inch or more) and yet by 
 stitching the two puds together it will 
 be possible to restore the function of 
 the spinal cord. One can see very read- 
 ily 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 1S8S Mr. Horsley, the distinguished 
 London surgeon, and Dr. Gowers, 
 equally distinguished as a neurologist, 
 for the first time in the history of sur- 
 gery made a diagnosis of a tumor of the 
 spinal cord, definitely located it and 
 the former removed it, the patient mak- 
 ing an absolute recovery, A number of 
 other cases have been successfully oper- 
 ated on since then. Just as in the case 
 
 of tumors 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 pres- 
 ent knowledge of the minute anatomy 
 and physiology of the spinal cord and 
 have, therefore, enabled ns to deal with 
 it surgically. 
 
 NERVES. 
 
 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 ani- 
 mal 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 
 re-establish its function — all of these 
 and other similar operations 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 re- 
 established. It is necessary to know by 
 the microscope the various steps of the 
 process of union of the nerves — to in- 
 vestigate various methods of sewing 
 them together; whether they can be 
 overlapped, or must be applied exactly 
 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. 
 
 10 
 
THE THYROID GLAND. 
 
 One of the commonest diseases in Eu- 
 rope, and one that is occasionally seen 
 here, is goitre. This forms a large tu- 
 mor in the neck, for which formerly lit- 
 tle 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 dis- 
 comfort, and were sometimes suffocated 
 by pressure on the windpipe. In con- 
 sequence of the introduction of the anti- 
 septic method of Lister, which we owe 
 to vivisection more than to any other 
 agency, operations on. the thyroid gland 
 are now so common that at the German 
 Surgical Congress in April of this year 
 Professor Kocher, of Berne, has reported 
 2000 operations done by himself, with 
 a mortality of only four per cent. 
 
 Very soon it was discovered that re- 
 moval 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 myxcedema 
 followed. This led to improvement in 
 operations in several directions. First, in 
 all those cases in which the tumor could 
 be shelled out, as an English walnut 
 is turned out of its shell, leaving a por- 
 tion of gland tissue behind, this was 
 done. The similar effects of the removal 
 of the thyroid in animals were studied 
 especially by Mr. Horsley. Surgeons then 
 removed the thyroid gland from the neck 
 of an animal and placed it under the skin 
 of the same animal, and it was found 
 that the disastrous results were avoided. 
 After a number of experiments on ani- 
 mals there was good reason to believe 
 that the disastrous effects of the opera- 
 tion which sometimes followed goitre 
 could be avoided in man by the same pro- 
 
 cedure. Accordiugly the thyroid gland 
 of a sheep was transplanted in a number 
 of instances under the skin, or in some 
 cases into the abdominal cavity. In 
 both cases there was improvement for 
 a time; but eventually the majority of 
 the cases suffered from cretinism or 
 myxcedema, 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 myxoe- 
 dema, and now we are able to relieve 
 patients from goitre and yet, by leaving 
 enough of the gland, prevent any bad 
 results following the operation. 
 
 These results led also to a careful 
 study of the effects of giving an extract 
 of the thyroid gland to human beings. 
 Some of the most brilliant results 
 that have ever been obtained in medi- 
 cine have followed the administration 
 of the thyroid extract to cretins in whom 
 the disease had not been produced by 
 operations for goitre, but arose naturally. 
 In certain forms of goitre 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 estab- 
 lished remedy, which in even a large 
 percentage of cases is followed by great 
 benefit and often 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 uncommon. 
 The only hope of such patients is in re- 
 moving the entire larynx or voice box. 
 Before attempting this for the first time 
 on man, Billroth, of Vienna, and his 
 assistant Czerny, now the distinguished 
 
 11 
 
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 re- 
 peated scores and scores of times as a 
 result of these few experiments on dogs. 
 
 THE LUNGS. 
 
 A beginning 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 animals parts of the 
 lungs have been cut out with a view of 
 discovering the possibility of cutting out 
 diseased portions of lung, the seat of tu- 
 mors, consumption and other disorders, 
 and a few operations have been done 
 upon man, with a fair percentage of suc- 
 cess. Not uncommonly abscesses of the 
 lungs which were perfectly inaccessible 
 a few years ago have been reached and 
 opened. Sometimes coins and other for- 
 eign bodies get into the bronchial tubes, 
 and can only be reached through most 
 difficult and dangerous operations. Sev- 
 eral surgeons have experimented upon 
 animals to determine the safest method 
 of removing such bodies, but with only 
 partial success. Is it not evidently our 
 duty 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? 
 
 THE LIVER. 
 
 In 1S90 Ponfick, of Germany, showed 
 that in rabbits the removal of a 
 quarter of the liver caused a slight de- 
 terioration in the condition of the animal; 
 removal of one-half was followed by 
 much more serious symptoms, 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 suit- 
 able time, and studying microscopically 
 the liver tissue at ditterent periods of 
 time after operation— a procedure mani- 
 festly only possible in animals — he 
 showed that there was a reparative 
 power in the liver, which before then 
 was unknown. 
 
 Up to that date less than a dozen sur- 
 geons had operated on tumors of the 
 liver. In only two of them was any 
 considerable portion of the liver re- 
 moved. After the paper by Ponfick, 
 which showed how much could be re- 
 moved, surgeons immediately operated 
 with much more confidence, and removed 
 considerable portions of the liver. Up to 
 lSljy 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 15 per cent. One who is 
 not a surgeon can scarcely appreciate 
 hoAV differently 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 SPLEEN. 
 
 The same story that has been told of 
 the liver can be told of the spleen, 
 though with much less good results. 
 As a result of studies, partly by acci- 
 dent, in man (as when in consequence 
 of a stab-wound or other injury a spleen 
 would protrude through the wall of the 
 abdomen, and would have to be re- 
 moved i. but chiefly as a result of the 
 
careful studies of removal of the spleeu 
 in animals, beginning practically with 
 Schindeler's experiments in 1ST0, we 
 are now in a position definitely to say 
 that in man the whole of the spleen can 
 be removed, and he can not only sur- 
 vive the operation, but get along com- 
 fortably without any spleen. A very 
 considerable number of such operations 
 have now been successfully performed. 
 
 THE KIDNEY. 
 
 On August 2, 1869, Professor Simon, 
 of Heidelberg, laid the foundation of 
 the modern surgery of the kidney by 
 removing a healthy kidney from a 
 healthy woman. The reason 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 kidney 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 continual escape of urine over her 
 person. After a number of unsuccess- 
 ful attempts to close this external open- 
 ing, it finally occurred to him that the 
 only way to cure her was to remove 
 the kidney on that side. Whether 
 a human being would recover and could 
 live with only one kidney 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 which 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 kidney— whether through the ab- 
 domen 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 
 Human being could live with only one 
 kidney; studied on the cadaver the best 
 way of doing the operation, and on 
 August 2, 1869, removed this healthy 
 kidney through the loin and saved the 
 patient's life and made her perfectly 
 comfortable. She died in 1877, after 
 eight years of healthy life. 
 
 As I have said, these new experiments 
 laid the foundation of the modern sur- 
 gery of the kidney. Now hundreds of 
 kidneys have been removed successful- 
 ly. Finding this operation so feasible, 
 surgeons were led to practice other oper- 
 ations; some hundreds of abscesses in 
 the kidney have been opened; scores of 
 stones have been removed from the kid- 
 neys; floating (i. e., loose) kidney has 
 been sewed fast in hundreds of cases; 
 many cases of tuberculosis of the kid- 
 ney have been relieved or cured; tu- 
 mors of the kidney are successfully at- 
 tacked; even the cut ureter has been 
 spliced and stones 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 un- 
 known. Would it not be gross cruelty 
 to man to prevent such beneficent re- 
 searches ? 
 
 13 
 
THE PROGRESS OF SURGERY AS INFLUENCED BY 
 
 VIVISECTION 
 
 PART 11 
 
 THE STOMACH. 
 
 Were I limited to the progress of the 
 surgery of the stomach alone by vivisec- 
 tion there would be quite enough ma- 
 terial for this entire paper. Until 1875 
 practically there was no surgery of the 
 stomach. As occasional Cesarean sec- 
 tions have been done in the past, so oc- 
 casional operations on the stomach were 
 done when the surgeon was obliged to 
 do them. Now, however, it is a mat- 
 ter of routine procedure, to the vast 
 benefit of the human race. Had vivi- 
 section contributed nothing else to the 
 progress of surgery than its services in 
 the surgery 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 intestiues in 35 dogs, 
 with 29 recoveries— a startling result when 
 compared with the former fatality of such 
 operations. This was the starting point 
 in the new gastro-intestinal surgery. The 
 next year Gussenbauer aud Winiwarter cut 
 out a piece of the stomach in only seven 
 dogs. We scarcely can appreciate at this 
 day. though these experimeuts are so re- 
 cent, how many new questions had to be 
 answered. After their first unsuccessful 
 experiment they naively remark that cer- 
 tain facts were established by the experi- 
 ment, among them, '"that the surfaces of 
 the stomach have a real tendency toward 
 union by first intention, . . . just as do 
 wounds of the skin." (!) Whether this 
 would be correct of man as well as of ani- 
 mals 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 
 followed by recovery, and showed not only 
 that such an operation could be successful- 
 ly done, but that the narrowing caused 
 by the scar did not interfere with the 
 
 'In quoting this I have popularized some of the medical terms there used. 
 
 14 
 
functions of the stomach, either as to its modern surgery. Suffice it to sav that 
 movement or its secretion of the digestive iT ' ., *? ,. . J , „ 
 juices, and that the removal of the pylorus am png them are the following, all of 
 was not followed either by the too early which owe more to vivisection experi- 
 escape of tne i-ood into the intestines, or ments than to anv other single aeencv 
 by the reflux of the intestinal contents into -r „„„„„ ~ , ; , & . J ' 
 the stomach. The dog was killed five In cancer o £ the oesophagus or m the 
 months later and the post-mortem showed constriction of the oesophagus, which so 
 no contraction, by reason of the scar, and often follows the accidental or intention- 
 no digestion of the edges, and his perfect a l swallowing of Iva or a pin*«s ntn ,n that 
 health after the operation showed that the ai s ^ an , 0M mg ot lye 01 acicls ' etc -' s0 tnat 
 movements of the stomach and its digestive no fooa - can get into the stomach, 
 functions had not been interfered with, we now open the abdomen, open the 
 Then again, the question whether catgut stomach, introduce a tube or construct 
 or other suture material was the best, and ' . J; ". Llxuc Ui , uut 
 what kind of a knot and what kind of a a passageway into the stomach, and 
 suture would best answer were subjects of feed the patient through this outside 
 debate. •.-.■. oesophagus, as it were. In case the nar- 
 
 Our anti-vivisection friends, who so often _„„,•„„ „* + >^ ™„«,o» «.„,,„ • *. * 
 
 declare that experiments upon animals have r0 ™g of the oesophagus is not from 
 
 never contributed anything to the progress cancer the patient can live his natural 
 
 of surgical science, may well be challenged span of life. In case of cancer his re- 
 
 to account for the remarkable progress in maining days are rendered relativelv 
 
 the surgery of the stomach which imme- * , , ' . ., ; ■ 
 
 diately followed these fruitful experiments, comfortable, since the operation pre- 
 
 The dogs that died did not die in vain, vents his starving to death. When we 
 
 They showed the correct methods and indi- have cancer at the opposite end of the 
 
 cated errors in technic, and directly led up Qt h (fh nv i nri1< ,\ ~ n fha + thp fnnH 
 
 to the modern surgery of the stomach and s t° macn . tfne pyloius}, so that the tood. 
 
 the intestine in man, as follows: In the though it can be swallowed, cannot get 
 
 very same year, 1876, Hueter cut out a part out of the stomach, one of two courses 
 
 °t~l he n bowel, though without success In is followed, both of which have been 
 
 18(7 Czerny for the first time sewed up „ „ ' ,. , . ,, , . . 
 
 the intestine and dropped it into the ab- carefully studied in the lower animals 
 
 dominal cavity, with recovery; followed and then adapted to man. First, the 
 
 almost immediately by Billroth, who did portion of the stomach and bowel in- 
 
 the first successful suture of the stomach vf> i VPf i ; n ^p Pfll1PPr i<5 Pllf mit nrifl fh(X 
 
 and total removal of a portion of the bowel. J "™ m tne cancer is cut out and the 
 
 In 1878 Forelli operated for a wound of the bowel united to the stomach directly, or, 
 
 stomach, and in 1879 Cavazzani removed a in other cases, an opening is made in 
 
 portion of the stomach for tumor In the the sto mach and one in the bowel lower 
 
 same vear Pean did the first removal of the -, -, , u . . , 
 
 pvlorus. In 1880 Rvdvgier did the second, down , and the two openings are sewed 
 
 and in 1881 Billroth did the third and first together, thus allowing the food to pass 
 
 successful one, without a knowledge of the from the stomach directly into the bowel 
 
 preceding operations. beyond the cancer. The mere question 
 
 Then followed various operations on of how the stomach and bowel shall be 
 
 the stomach to which I will allude later, most successfully united in these cases, 
 
 and finally the successful removal of particularly the best method to prevent 
 
 the entire stomach. It is quite impos- fatal leakage, has required very 
 
 sible to give the details of all the vari- many series of experiments, especially 
 
 ous operations now done on the stom- in this country, by Senn, Abbe, Brock- 
 
 ach and indicate minutely the part that aw, Ashton, Murphy and others. As a 
 
 vivisection has had in developing this result of their labors sometimes we have 
 
 extraordinarily successful branch of learned how not to do the operation be- 
 
 15 
 
cause of unexpected difficulties: some- 
 times how to better our procedure, un- 
 til now we are in possession of satis- 
 factory methods, as has been proved by 
 the successful operations on man many 
 times over. Even the sewing together 
 of the stomach and bowel alone had 
 been done up to 1898 in 550 cases which 
 have been published. I have no doubt 
 that since then this number has almost 
 been doubled. The mortality of this op- 
 eration from 1881 to 1885 was 05.71 
 per cent.; from 1880-90, the mortality 
 had fallen to 40.47 per cent.; from 1891 
 it had again fallen to 33.91 per cent., 
 and recently in twenty-seven cases an 
 Italian surgeon (Carle) has had a mor- 
 tality of only 7.4 per cent. 
 
 Moreover, the experiments on ani- 
 mals, having shown how safe various 
 operations are, have emboldened us to 
 enlarge the sphere of our operations and 
 do others that were before not dreamed 
 of — a good instance of the partly indi- 
 rect good results from vivisection. A 
 brief enumeration of some of the vari- 
 ous operations done upon the stom- 
 ach, together with their mortality, is as 
 follows : 
 
 (1) Where the stomach is bound down 
 by adhesions (which often produce the 
 most serious digestive disturbances, de- 
 stroying comfort and even threatening 
 life), we now open the abdomen, cut or 
 tear the adhesions, and practically all 
 of the patients recover. 
 
 (2) "Where there are foreign bodies in 
 the stomach (or in some cases foreign 
 bodies that have stuck in the oesophagus 
 low <l<»wn, near the stomach i, we open 
 the stomach, remove the foreign body 
 (often inserting the entire arm to reach 
 it in the oesophagus), sew up tne 
 stomach and the abdominal wall, and 
 the patients generally recover. In some 
 
 cases as many as 192 staples, buttons. 
 screws, horse shoe nails, etc., weighing 
 over a pound and a half, have been re- 
 moved, and the patients have recovered. 
 
 (3) Where the oesophagus has been 
 narrowed by the swallowing of lye, etc., 
 instead of making a permanent opening 
 in the stomach (as before described), 
 sometimes by having the patient swal- 
 low a perforated shot which will carry 
 a string down into the stomach, we can 
 open the stomach temporarily, seize 
 and draw out the shot, attach a coni- 
 cal dilator to the string, and. after hav- 
 ing dilated the constriction of the 
 (esophagus, remove the string, sew up 
 the stomach and the abdominal wall 
 and cure the patient permanently. 
 
 (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 ill- 
 ness 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 
 almost as though the operation must 
 be abandoned when, in 1875, the first 
 operative recovery occurred. From 
 then until 1884 in 103 cases there were 
 J 33 deaths— a mortality of 81.00 per 
 cent. At the present time the mortalitv 
 is only about 25 per cent, in cases of 
 cancer, and in the non-malignant cases 
 not over 10 per cent. 
 
 (0) As I have indicated, in certain con- 
 ditions we make an opening in the stom- 
 ach and another in the bowel and sew 
 
 16 
 
the two together. In some eases 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 decreasing 
 from 65.71 to 33.91 per cent, in general, 
 and in the statistics 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 m 1879. The mortality was 
 very great, and still is large, ranging 
 from 27.2 per cent, in simple cases to 
 72.7 per cent, when there are extensive 
 adhesions. 
 
 (8) When the pylorus is simply nar- 
 rowed, 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 open- 
 ing of the pylorus. This was first done in 
 1886. Up to 1894 the mortality was 
 20.7 per cent. Recently Carle has re- 
 ported fourteen cases, with a mortality 
 of only 7 per cent. 
 
 (9) In not a few disorders the s-tornach 
 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 displaced, we sew it 
 fast, and practically in all cases re- 
 covery follows. 
 
 (11) Sometimes the stomach is di- 
 vided into two parts, like a dumb-bell 
 with a very short handle. The first 
 operation for relieving this condition 
 was done in 1893 by making an open- 
 
 ing 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 recovery 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, be- 
 cause through 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 
 is a wholly unexpected and indirect re- 
 sult of improvement in air pumps as one 
 of the chief factors of progress. 
 THE INTESTINES. 
 
 Very much the same story can be told 
 ot the surgery of the bowel. Indeed, 
 the surgery of the stomach involves 
 largely that of the bowel. I need, there- 
 fore, only recall a very few points. 
 When a tumor or cancer exists in the 
 bowel, of course, in a little while it ob- 
 structs the passage of the intestinal con- 
 tents; and if this obstruction becomes 
 
 17 
 
complete and is not quickly removed the 
 patient must necessarily die. As a re- 
 sult Of many experiments upon animals 
 i more especially by Senn. Parkes and 
 other American surgeons) we now know 
 how to deal with this condition. 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 ex- 
 perimentation upon animals to discover 
 the best method of doing this otherwise 
 perilous operation. The slightest leakage 
 of intestinal contents produces a fatal 
 peritonitis. Where the cancer cannot be 
 removed, in order to prolong the pa- 
 tient's life and lessen his terrible pains 
 we make an opening above the obstruc- 
 tion and another one below and 
 sew the two openings together. Here 
 again many experiments were needed to 
 determine whether an animal could live 
 with the intestinal contents thus '"side- 
 tracked," and if life could be maintained, 
 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 some- 
 thing could not be done to remedy this 
 frightful mortality Gross many years 
 ago performed some experiments to de- 
 termine the best treatment of such 
 wounds. Later Parkes etherized a num- 
 ber of dogs, shot them, opened the abdo- 
 men and treated the wounds in various 
 ways; and in consequence of this and 
 other series of experiments, at the pres- 
 ent time many instances of recovery 
 
 have been reported in which multiple 
 wounds even to the number of seventeen 
 have been found closed by methods de- 
 termined by vivisection to be the best, 
 and the patients have recovered. To 
 reach this result it had to be determined 
 by accurate observation on animals 
 what was the best method of closing 
 such wounds; what material is the best 
 for use as a thread; under what condi- 
 tions 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 oc- 
 curred 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 sometimes a perforation 
 similar to the hole made by a bullet 
 occurs, and the contents of the intestines 
 or of the stomach are poured out into 
 the abdominal cavity. Of course, every 
 one knows that if this went on for a 
 brief time death would necessarily fol- 
 low. In the lower animals we cannot 
 produce exactly the conditions following 
 gastric ulcer and typhoid fever; but, in 
 consequence of the knowledge acquired 
 by experimenting upon gunshot and in- 
 cised wounds of the stomach and bowel 
 in the lower animals, in 1S84, we finally 
 woke up to the fact that a perforation 
 after such an ulcer, either in the stom- 
 ach or in the bowel from typhoid fever, 
 ought to be closed. In 156 cases of 
 such perforation of the stomach opera- 
 tion has been done, and the recoveries 
 have been 46.80 per cent. But in the 
 last 54 of these operations done from 
 1896 to 1898 the percentage of recoveries 
 had risen to 64.82 per cent. In 158 
 such operations done for perforation of 
 the bowel in typhoid fever collected in 
 
 lb 
 
1898 the recovery rate was 23.41 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 opera- 
 tion done. To save one-half or even one- 
 third is a surgical triumph. 
 
 1 have several times alluded to cut- 
 ting out a portion of the bowel and unit- 
 ing 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 inadmissible 
 to test such operations (which always 
 involve life) on man when they can be 
 tested accurately and more quickly by 
 experiments on animals and without in- 
 volving human life. 
 
 I have stated that by many experi- 
 ments 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 re- 
 quired us to decide the question, in man. 
 As a result of the knowledge derived 
 from animal experimentation I saw four 
 
 years ago in Montreal a man from whom 
 Shepherd had removed over one-third 
 of the entire length of the bowel (eight 
 feet) which was involved in a large tu- 
 mor; and yet the patient was in capital 
 health a long time after the operation. 
 
 HYDROPHOBIA. 
 
 The search for the germ of this dread- 
 ful disease has as yet been fruitless ; but 
 happily the search for the means of pre- 
 vention has been crowned with success. 
 Of every hundred persons bitten about 
 fifteen contract hydrophobia, and of 
 those bitten on the head and face at 
 least 80 per cent, die of hydrophobia. 
 The Pasteur treatment, which is entirely 
 the result of animal experimentation, 
 by preventing its occurrence, has re- 
 duced the mortality to less than one 
 per cent.; and yet the establishment of 
 Pasteur Institutes for the benefit of the 
 human race has been resisted most stren- 
 uously by those opposed to vivisection. 
 
 TRANSPLANTATION OF BONE. 
 
 In 1867, Oilier, a celebrated French 
 surgeon, who recently died, by exper- 
 iments on animals showed that the mem- 
 brane which covers the bones (the per- 
 iosteum) could be peeled off a bone and 
 transplanted to a distance into the tis- 
 sues of the same animal, or even of 
 another animal, and that it would there 
 live and produce new bone. These ex- 
 periments, very crudely described in 
 these few words, have been extraordi- 
 narily fruitful in several directions. 
 
 First, in certain cases it is necessary 
 to remove diseased or dead bone. These 
 experiments showed us that if in remov- 
 ing the bone the periosteum was care- 
 fully 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 em- 
 
 19 
 
ployes of phosphorus match factories. 
 the dead hone has been removed, but 
 the periosteum has been preserved and 
 a new jawbone has been reproduced. 
 Another result has been that, instead 
 of amputating, for example, an arm 
 when the elbow is diseased, we can re- 
 move 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 portion where the chief 
 blood supply enters the flap. The bone 
 is then forcibly broken at this unehis- 
 eled portion and turned back, the perios 
 teum 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 replac- 
 ing the flap, the scalp sewed in place 
 and the integrity of the skull is restored. 
 One can see that this is an immense ad- 
 vantage over having a great hole left 
 in the side of one's skull. 
 
 In some cases, in which, in conse- 
 quence 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 opening. 
 
 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 de- 
 formity or remedying an otherwise in- 
 curable fracture. 
 
 Again, a certain small number of chil- 
 dren are born without any bone at the 
 back of the spine in the neck or the 
 
 loin (spina bifida). Through this open- 
 ing 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 close the open- 
 ing, or in other cases take a bit of bone 
 from one of the lower animals to fill 
 the opening and cure the patient. 
 
 Again, m certain cases of fracture of 
 the arm bone (humerus) the nerve going 
 to the muscles on the back of the fore- 
 arm, which winds close around the bone 
 in 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 remedy the trouble. First we find 
 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 
 lias been destroyed that the two ends 
 cannot be brought together we now de- 
 liberately remove an inch or two of the 
 arm bone, thus shortening the arm 
 so as to bring the two ends of the nerve 
 together, and in a good percentage of 
 cases we can again restore the hand 
 to usefulness after months and occa- 
 sionally even after years. 
 
 A still more remarkable transplanta- 
 tion of the bone is accomplished in some 
 operation 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 op- 
 eration which has necessitated this re- 
 moval of bone may require an hour 
 
 120 
 
and a half or two hours. If we want 
 to replace the bone so as not to leave 
 an opening in the skull through which 
 the brain may easily be dangerously 
 injured, we put it in a basin of hot 
 salt solution or weak antiseptic solu- 
 tion, and by keeping it at a proper tem- 
 perature, at the end of the operation, 
 when it has been totally detached from 
 the body for so long a time, we re- 
 place 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 advantage 
 of our patients, are the direct or remote 
 results of the experiments of Oilier and 
 others on the transplantation of perios- 
 teum and of bone. The indirect results 
 are quite as valuable, and sometimes 
 more valuable, than the direct results of 
 such experiments. 
 
 An illustration of the indirect 
 results of Ollier's experiments 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 has 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 un- 
 dergo 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 structure as 
 bone, could be entirely 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 in- 
 stead of flabby noses. This has led us cf 
 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 cat little bits of skin only as big 
 as a pin's head from the arm or the 
 thigh, uot quite skin deep, and planted 
 them on any raw surface which did 
 not heal readily. These grafts under 
 proper treatment adhere and form new 
 centres' from which healing of the 
 wound takes place. Emboldened by 
 this, Krause and other surgeons have 
 taken very large pieces of skin, includ- 
 ing often the whole thickness of the 
 skin, and transplanted them. For ex- 
 ample, in some cases of extensive can- 
 cer in which a very large portion of 
 skin must be removed, now, while the 
 patient is under the influence of the 
 anesthetic, we take strips of skin an 
 inch wide and several inches long from 
 the thigh, or, in other cases, from an- 
 other person Avho 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 tumor, and 
 as they do not lose their vitality but 
 grow fast to the tissues under them, 
 the wound 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 extensive burn, 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 some- 
 times take months, sometimes years, to 
 heal, and in not a few cases never heal, 
 no matter what is done. Now, as a re- 
 sult of our experience, first with the per- 
 iosteum and bone and then with small 
 bits and then larger bits of skin, we 
 transplant strips of skin as just de- 
 
 21 
 
scribed, and heal such wounds in a very 
 short time. One sees in the newspapers 
 every now and then accounts of some 
 woman whose long hair has been caught 
 in machinery and almost all of the scalp 
 torn away. These wounds are healed 
 by transplanting skin in a similar man- 
 ner. 
 
 THE BLOOD. 
 
 We are at present only just beginning 
 to appreciate how much we can learn 
 from examination of the blood, especial- 
 ly by new methods lately introduced. 
 Almost every intelligent person knows 
 that the blood consists, roughly speak- 
 ing, of a fluid in which float small cir- 
 cular disks, about 1-3000 part of an 
 inch in diameter, called the red blood 
 (•ells. In addition to these there is in 
 the blood another kind of cell called the 
 white blood cell. The red blood cells 
 are made up chiefly of a substance 
 called hemoglobin, which gives the color 
 to the blood. Some of the investiga- 
 tions, which are really only at present 
 at the beginning of their usefulness, are 
 as follows. They are good illustrations 
 of how inductive science begins by as- 
 certaining facts. If they are valueless 
 they are disregarded; if of value they 
 are studied still further. It is not un- 
 likely that the blood may soon be one cf 
 the most fruitful sources of the knowl- 
 edge by which surgery may profit 
 greatly: 
 
 First, 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 
 to five millions, and the number of 
 white blood cells is 8000 to 10,000. 
 
 If one has an abscess the white blood 
 cells as a rule will rise to 15,000, 20,000. 
 25,000 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 the body in 
 which the diagnosis is very difficult to 
 make) if the leucocytosis or its absence 
 wili 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 just above the right 
 groin. In appendicitis the pain and 
 tenderness exist in the same region, and 
 in not a few cases it is extremely dif- 
 ficult to distinguish between these two 
 diseases. Especially is this true at the 
 beginning of such an illness, just when 
 it is most important to make the risrht 
 diagnosis and institute the correct treat- 
 ment. If the presence of leucocyto- 
 sis will show us distinctly that it is ap- 
 pendicitis, and the absence of leucocyto- 
 sis that it is typhoid fever, an immense 
 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 learn it too quickly. It seems 
 to me very reasonable, therefore, that 
 experiments should be made in the low- 
 er animals by producing abscesses and 
 determining whether under many vary- 
 ing conditions leucocytosis is always 
 present when there is an abscess and 
 always absent when there is no abscess. 
 Second Hemoglobin.— The hemoglobin, 
 which makes up the bulk of the red 
 
 22 
 
blood cells, is the means by which oxy- 
 gen is carried to all parts of the tis- 
 sues. Whenever an anesthetic, such 
 as ether or chloroform, is given, 
 the amount of hemoglobin is distinctly 
 diminished, and by this means the oxy- 
 genation of the blood is hindered. In 
 certain conditions of the system the per- 
 centage of hemoglobin is diminished to 
 00, 50 or even as low as 25 of the 
 normal. If an anesthetic is giv- 
 en to a person with an already di- 
 minished percentage of hemoglobin this 
 percentage is still further diminished, 
 and the oxygenation of the blood still 
 further hindered. If, then, the percen- 
 tage of hemoglobin is very small before 
 an operation the danger of giving an 
 anesthetic is very marked; if the hemo- 
 globin is as low as 30 per cent, it is very 
 likely that the patient may die upon the 
 table irrespective of the operation, sim- 
 ply because 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 hemoglo- 
 bin is below 50 per cent. Others have 
 placed the limit as low as 30 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 por- 
 
 tion of blood drawn by a prick of the 
 finger enables us to determine these 
 four conditions — i. e., (1) the presence or 
 absence and degree of leucocytosis; 
 (2) the percentage of hemoglobin; (3) 
 the freezing temperature of the blood, 
 and (4) the coagulation time of the blood. 
 We are beginning 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 accurately 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; after surgical operations 
 have been done upon them; after an an- 
 esthetic is given to them; when the an- 
 esthetic is administered for a short time, 
 for a longer time, for a very long time, 
 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 importance 
 that 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 human 
 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 cer- 
 tain modifications due to the slight dif- 
 ferences between man and animals the 
 conclusions drawn from experiments on 
 animals apply to man. 
 
 Let me give one instance which con- 
 fronts the surgeon not infrequently. An 
 abdominal section is occasionally fol- 
 lowed by very great and, it may be, dan- 
 gerous and alarming depression. One of 
 the most difficult things to determine 
 
 23 
 
in some oases is whether this condition 
 is due to the shock of the operation or 
 to internal hemorrhage. This hemor- 
 rhage differs frorn that which may fol- 
 low an amputation or removal of a tu- 
 mor from the neck, etc., by the fact 
 that it is concealed within the abdomen. 
 and its existence 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 hem- 
 orrhage, we must instantly reopen the 
 abdomen and tie the bleeding vessel. To 
 do the latter operation when the pa- 
 tient is only suffering from shock might 
 prove fatal: not to do it, if hemorrhage 
 is the cause of the depression, is cer- 
 tainly fatal. Xo one not a surgeon can 
 appreciate the anxiety, the careful 
 weighing of evidence, the intense longing 
 for some positive menus by which ;i 
 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 absence of leucoeytosis. 
 by determining the percentage of the 
 hemoglobin, or possibly even the coagu- 
 lation time and the freezing temperature 
 of the blood in a number of operations 
 in human beings, we might be able posi- 
 tively to determine the difference be- 
 tween shock and internal hemorrhage, 
 but only after making many blunders, 
 each of which would cost a human life. 
 In an animal we can open a blood ves- 
 sel in the abdomen and let it bleed for 
 a longer or shorter time, and determine 
 positively the leueoeytosis. the hemo- 
 globin, etc.. the animal meantime suffer- 
 ing nothing because it would be under 
 an anesthetic. Which is the right, which 
 the kindest, which the most humane way 
 
 of finding out the truth? This is an il- 
 lustration of the harmlessness to ani- 
 mals of such experiments and their 
 priceless value to human beings. 
 
 EXPERIMENTS TO ENABLE US TO MAKE A 
 RELIABLE AND SPEEDY DIAGNOSIS. 
 
 In some rases in which the diagnosis 
 is difficult, or may require considerable 
 time, experiment upon animals aids us 
 greatly, and so is of immense value to 
 man. Thus in supposed anthrax, or 
 wool-sorter's disease, a most dangerous 
 malady, by inoculating a guinea pig with 
 the discharge the diagnosis can be clear- 
 ed up quickly and proper treatment in- 
 stituted. If a case suspected to be one 
 of bubonic plague arises the diagnosis 
 can be established within 24 or 3(3 hours 
 by a similar injection into a rat or a 
 guinea pig, the apprehensions of a com- 
 munity (to say nothing of the patient 
 and his friends) relieved and the greatest 
 damage to its commerce averted by dis- 
 covering that it is not the dreaded 
 pestilence, or, if it is the plague, by 
 showing the necessity for most stringent 
 measures of prevention. I do not think 
 any community will or ought to allow 
 sympathy with the unavoidable suffering 
 of a few rats or guinea pigs to weigh 
 in the balance for a moment against 
 the safety of many human lives or 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 supposed to be rabid. 
 The Duke was a Vice 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 experiments upon animals, 
 
he took the dog to Mr. Horsley, in Lon- 
 don, and had the experiment done. 
 
 By similar means anthrax and actino- 
 mycosis (or lumpy-jaw, which spreads to 
 man as well as to herds) among cattle 
 are diagnosticated and eradicated; glan- 
 ders in horses is recognized and stamped 
 out and tuberculosis in cows is eradi- 
 cated, 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 
 chicken cholera, hog cholera, Texas 
 fever and many other diseases of cattle, 
 sheep, horses, hogs, poultry and other 
 animals have had their causes discov- 
 ered and the means of prevention or of 
 cure demonstrated. The Reports of the 
 Bureau of Animal Industry at Wash- 
 ington 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 General Hospital on October 
 10, 1815, 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 
 modern progress in surgery have been 
 prevented? I hardly ever look on my 
 patients in the blessed ether sleep with- 
 out being 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 re- 
 searches? 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 opera- 
 tions it is essential to do so; for it is 
 impossible to do such an operation on an 
 auiinal struggling from pain. Not only, 
 therefore, does sentiment lead the vivi- 
 sectionist 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 re- 
 quire us to determine the presence or ab- 
 sence of sensation, cannot be done with 
 an anesthetic; but these experiments are 
 few and far between. Some ex- 
 periments also (for instance, those 
 on lock-jaw, to which I have al- 
 ready alluded) by producing the dis- 
 ease, necessarily make the animal suf- 
 fer; but if by the suffering of a few 
 animals, human beings suffering from 
 lock-jaw 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 suf- 
 fering? 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 the fran- 
 tic effort to bring surgical assistance, I 
 am sure no one would accuse us of 
 cruelty, although we had inflicted tor- 
 ture upon the horse. So this infliction 
 of pain on a small percentage of animals 
 experimented on is not cruelty, but is 
 the greatest kindness to other animals 
 and to a much higher animal — man him- 
 self. 
 
 I have been able in this paper only to 
 select a few illustrations of the progress 
 that surgery has made by experimenta- 
 tion on animals. Practically, as I said 
 at the beginning, nearly all of these have 
 occurred during my professional life, and 
 I speak, therefore, of what I know. Al- 
 though I myself am not a vivisection- 
 ist, yet I could not do the work I do 
 every day and accomplish results I do 
 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 methods of 
 tying blood vessels in the early part of 
 the last century, nor of Sir Charles 
 Bell's experiments by which he deter- 
 mined the functions of the two different 
 roots of the nerves just as they emerge 
 from the spinal cord, nor of the circula- 
 tion of the blood as discovered by Har- 
 vey. 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 pre- 
 ferred rather to take modern 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 
 fostered and not hindered; should be 
 encouraged and not abolished. 
 
 26 
 
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