COLUMBIA LIBRARIES OFFSITE HEALTH SCIENCES STANDARD HX64099539 QP45 .G29 A vindication olviv RECAF A VINDICATION OF VIVISECTION A COURSE OF LECTURES ON ANIMAL EXPERIMENTATION BY MEN OF THE HIGHEST AUTHORITY' IN T.m MEDICAL AND OTHER PROFESSIONS GIVEN UNDER THE AUSPICES OF THE GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE IN GASTON HALL OF GEORGETOWN UNIVERSITY. MARCH 28 TO MAY 16. 1920 FRANCIS A. TONDORF. S. J., PH. D. WASHINGTON, D. C. 1920 Columbia ^nitjersittp intI)fCttpoflrttil|ork CoOcsc of ^ijpgitianji anb g>uraeona; Eifararp A VINDICATION OF VIVISECTION A COURSE OF LECTURES ON ANIMAL EXPERIMENTATION BY MEN OF THE HIGHEST AUTHORITY IN THE MEDICAL AND OTHER PROFESSIONS GIVEN UNDER THE AUSPICES OF THE GEORGETOWN UNIVERSITY SCHOt^L OF MEDICINE IN GASTON HALL OF GEORGETOWN UNIVERSITY. MARCH 28 TO MAY 16, 1920 FRANCIS A. TONDORF, S. J., PH. D. WASHINGTON, D. C. 1920 Digitized by tine Internet Arcliive in 2010 witli funding from Open Knowledge Commons (for the Medical Heritage Library project) htijS^www.archive.org/details/vindicationofvivOOgeor TABLE OF CONTENTS. A VINDICATION OF VIVISECTION. PREFACE 4 LECTURE I.— "A VINDICATION OF ANIMAL EXPERIMEN- TATION." Based upon the work of the Rockefeller Institute for Medical Research in New York Citj'. Bv Simon Flexner, Director, M. D., So. D., LL. D ' 5-17 LECTURE II.— THE LEGAL ASPECTS OF VIVISECTION. By William Creighton WooDW.^RD, M. D., LL. M. Health Commis- sioner of'Boston, Mass., Professor of Medical Jurisprudence George- town University 18-25 LECTURE III.— SOME OF THE ETHICAL ASPECTS OF ANI- MAL EXPERIMENTATION. By Wm. H. Arthur, M. D., F. A. C. S. Late Commandant Army Medical School 36-31 LECTURE IV.— WHAT ANIMAL EXPERIMENTATION HAS DONE FOR GYNECOLOGY AND ABDOMINAL SURGERY. By Thomas S. Cullen, M. D. Professor of Clinical Gynecology, Johns Hopkins Hospital 31-40 LECTURE v.— ACHIEVEMENTS OF ANIMAL EXPERIMENTA- TION IN GENERAL SURGERY. By Geor-e Tully Vaughan, M. D., LL. D., F. A. S. Professor of Surgery Georgetown University 40-47 LECTURE VI— ACHIEVEMENTS OF THE MEDICAL CORPS OF THE ARMY IN PREVENTIVE MEDICINE. By George B. Foster. Jr., M. D., Dr. P. H. Major Medical Corps, United S tates Army 47-58 LECTURE VII.— THE LABORATORY WORK OF THE UNITED STATES PUBLIC HEALTH SERVICE. By A. M. Stimson, Surgeon U. S. P. H. S. Assistant Director, Hygienic Laboratory, Washington, D. C £8-64 LECTURE VIII— THE ECONOMIC ADVANTAGES DERIVED FROM ANIMAL EXPERIMENTATION. By Ernest Ch.\rles ScHROEDER, Ml D., D. V. M. Superintendent Experiment Station L'nited Spates Bureau of Animal Industry, Bethesda, Md 61^79 LECTURE IX.— THE ACHIEVEMENTS OF DENTAL MEDICINE AND ORAL HYGIENE. By Ralph A. Hamilton. M. D. Prof- essor of Bacteriology and Pathology Georgetown University Medi- cal School 79-84 CONCLUDING REMARKS TO THE COURSE OF LECTURES ON VIVISECTION. By George M. Kober, M. D., LL. D. Dean of the Georgetown University School of Medicine _ 84-86 MORAL ASPECTS OF VIVISECTION. A Digest of the Statement of Rev. Francis A. Tondoef, S. J., Ph. D. Professor of Physiology, Georgetown University School of Medicine, before the Subcommittee of the Commmittee on the Judiciary of the United States Senate on November 4, 1919 '.. 87-88 GENERAL STATEMENT IN PROTEST AGAINST THE ENACT- MENT OF S. 1258 ; a Bill to Prohibit Experiments upon Living Dogs in the District of Columbia, before the same Committee. By George M. Kober, M. D., LL. D 88-93 A PLEA FOR SANITY IN LEGISLATION ON ANIMAL EXPERI- MENTATION (With special reference to the Dog). By Murray Galt Motter, M. D. Formerly Professor of Physiology George- town University Medical Scliool _ 94-97 PREFACE. To see life steadily and to see it whole is the serious duty of every true philosopher. And, after all, what is philosophy save unadulterated common sense amplified and systematized. Elence your real sensible man will approach the subject of animal experimentation dispassion- ately and weigh it in its proper relation to the good of the human race. Let him disregard these prime postulates of sound reason and he is headed straight for unbalanced sentimentality and irrational hysteria. The stereotyped arguments advanced against the practice of animal experimentation are two, to wit, brutality and total lack of demonstrable and tangible results as might warrant the physical pain occasioned following the most clever scientifically regulated methods of vivisection. It is the modest purpose of this brochure to make available for the general public a discussion of such accusations and the pertinent responses made by experienced research workers in a series of public lectures given under the auspices of the Georgetown University. School of Medicine in Gaston Hall of the Georgetown University from March 28 to May IGth of the year nineteen hundred and twenty. To profit by the content of these pages the reader must divest himself of every prejudice or partisanship and focus his attention not on feeling but on the issue. He must recall that our cynophile friends are persistently dogmatizing that this is a moral question and then evaluate our ethical arguments against theirs. He must learn that their perverted commentary of the text which tells of the findings of medical researches envolving animal experimentation belies the original. He must read into this text the salus popuh, the lex suprema. Then may we look for a fair judgment. Francis A. ToNnoRF, S. J., Ph. D., Editor, Head of the Dcpartuient of Physiology. Georgetozvii University School of Medicine. June 30th, 1920. A VINDICATION OF ANIMAL EXPERIMENTATION. Based u["ork was begun at the Harvard Medical School and completed at the Rockefeller Institute for Medical Research. Dr. Flexner stated that he had given a single concrete instance, but the instances could easily be multiplied, through which the benefi- cent use of the results of experiments on animals could be shown. He declared that by animal experimentation we have not only benefited man, but investigation into the disease of animals has led to the eradi- cation of many of the diseases of animals with incalculable economic returns. Our knowledge of yellow fever would probably have been delayed for many years if the work of the Bureau of Animal Industry of the United States on Texas fever had not been done. The Lecturer emphasized the important work done by the Federal Government for animal industry, all of which involved animal experi- mentation, and called attention to the Department of Animal Pathology of the Rockefeller Institute, established a few years ago on a farm of 400 or 500 acres, near Princeton, N. J., with laboratories, stables and other appurtenances, and a highly skilled scientific staff installed for the intensive study of diseases of animals themselves. Could the eco- nomic wastage caused by disorders of cattle, poultry, etc., be con- trolled or reduced, the cost of living, now such a matter of serious con- cern, would be materially diminished. In addition to diseases of eco- nomic animals we have, he said, a real interest in diseases of domestic animal pets, which are themselves the victims of many severe and fatal diseases, such as distemper among dogs. The study of this disease by the experimental method is not only indicated, but it is fair to say that if we learn to control distemper, we should throw new light on the pneumonia problem ; and he was tempted to add that had the lower animals the power of voice, they might well ask to be saved from those who appear to be their friends. Contrasting the ancient use of drugs with the manner in which they are employed at the present time he showed how their specific action has been determined by the employment of animals for experi- mental study. Beginning with a tribute to the pioneer work of Pasteur, Koch and other pioneer-research workers, the lecturer traced the various steps in the development of the great branch of bacteriology that em- braces all that we know of the cause, the prevention and treatment of all infectious diseases, including serums and vaccines, and ends at the present time with the researches by Noguchi on the organism of yellow fever As an instance of the curative powers of antitoxins he cited the vast reduction in mortality following the employment of diphtheria antitoxin, which is now less than one quarter of the death rate before the introduction of the antitoxin. Cerebro-Spinal Meningitis. Dr. Flexner said he had been asked to say a few words about the benefits of animal experimentation in relation to epidemic cerebro- spinal meningitis. This disease, also known as cerebro-spinal fever and spotted fever, was described as early as 1805 and has appeared in epi- demic form at various intervals in Europe, in the United States and other parts of the globe. Hirsch distributes the epidemic occurrence of this disease through four periods, namely, 1805-1830, 1807-1850, 1854-1875, 1876 to date. In the first period it appeared in isolated epidemics in Europe and to a much greater extent in the United States. After its primary appearance in Massachusetts in 1806, according to some epidemologists, it continued throughout New England in various localities for the next ten years. During the second period widespread epidemics occurred in France, Italy, Algeria, Denmark and the United States ; during the third period it prevailed in Europe, Asia, Africa, South America and the United States. During the last period it has been specially marked in Germany, Italy and the United States. The disease prevailed in an epidemic form in 1904 and continued to be more or less active until 1910; since then, although less active, it has not entirely disappeared and became again active during the recent. war. The organism causing this disease, thanks to animal experimenta- tion, had been isolated and described by Weischselbaum in 1887 under the name of diplococcus intracellitlaris meningitidis, and although per- fectly familiar with the cause and nature of the disease, the medical profession was helpless in the way of treating this acute infectious dis- ease quite fatal in- its tendency. Dr. Flexner in 1904- during the epidemic along the Atlantic sea- board and from there inland, studied the disease at the Rockefeller Institute and proved by inoculation experiments that it was communi- cable to animals. This was an enormous step forward, for it gave him a basis for the hope of being able to treat the disease successfully by means of immunized serum. The work was done on monkeys, and subsequent experimentation proved that not only could the disease be re]:)rbduced in these animals, but also successfully treated with immune serum. Later this treatment was and is now being used in the treat- ment of cerebro-spinal meningitis in man. Dr. Flexner said that 25 monkeys had been used in this work. (It has been estimated by Professor Welsh and other competent critics that before this method of serum treatment was employed, out of every one hundred patients seventy-five died, while under the serum treatment the mortality has been reduced from seventy-five to twenty-five per cent. It is not gen- erally known that this demonstration based upon animal experimenta- tion is regarded as one of the most important contributions ever made to scientific medicine and has secured for Dr. Flexner, the Rockefeller Institute and American medicine a place of honor in the medical world. — Editor.) Poliomyelitis. Dr. Flexner recalled the work of the Rockefeller Institute with reference to the etiology and pathology of poliomyelitis, popularly known as infantile paralysis, and explained how they had been able to transmit the disease from monkey to monkey through the secretions of the nasal-pharyngeal mucous membrane and thus secured important information as to the mode of transmitting the disease He said in part : In the United States we are becoming increasingly familiar with epidemics of poliomyelitis. Prior to 1907 infantile paralysis was a rare disease in this country ; since then it has prevailed fitfully every summer and autumn, and in one notable instance at least also in the winter season, claiming victims by the score or hundred, until in 1916 an outbreak of unprecedented severity, with its center of violence in New York State, swept over a considerable number of States. Our knowledge of poliomyelitis has grown since Wickman's epochal clinical studies published in 1907. Thanks to animal experimentation we are in possession of precise information covering essential data with regard to the nature of the inciting microorganism, notwithstanding its very minute size, and also concerning the manner in which it leaves the infected or contaminated body within the secretions of the nasopharynx chiefly, and gains access to another human being by means of the corre- sponding mucous membranes and apparently in no other way. More- over, the inciting virus, so called, up to the present time and notwith- standing many and assiduous efforts, has not been detected apart from the infected or merely contaminated human being, and there is there- fore no foundation in ascertained fact for an assumption that the virus is conveyed to persons otherwise than by other persons who harbor it. Control of Yellow Fever Epidemics. As an example of the manner in which an epidemic disease may be eradicated he briefly related the history of the conquest of yellow fever and expressed his satisfaction that the causal organism had been discovered before the complete disappearance of the scourge. If so, it will be the first disease to so disappear since recorded history. We no longer fear yellow fever in New York, Philadelphia and other Northern districts of the United States in which formerly it was a serious pest, claiming victims by the thousands. We are now sufficiently informed of the conditions of its origin and spread to main- tain effective safeguards. The everthreatening hotbeds of yellow fever at Havana and in Brazil are now under control, and can be kept so if We do not relax our vigilance. Prior to the beginning of the present century yellow fever was a peril because no one knew the exact conditions favoring its spread. In 1900 a commission of officers from the United States Army, headed by Dr. Walter Reed, with Drs. James Carroll, Jesse W. Lazear and Aristides' Agramonte went to Havana where the fever flourished, and made a series of studies and came to the conclusion that there must be a living organism in the blood of yellow-fever patients in the early days of the disease. They found that a mosquito could act as inter- mediary in conveying the disease. They did not spare themselves, and following the bite of a purposely infected mosquito, Carroll became ill of yellow fever, while Lazear died after a short illness. Reed died in 1902, and his memory lives in the great Walter Reed Hospital at 10 Washington. From this knowledge of the mosquito as a carrier of yellow fever it became clear that the way to prevent the spread of the disease was either by keeping the mosquito from patients in the early stages of their illness through proper screening of windows and doors, or by killing and destroying their breeding places. All these measures were applied in Havana by General Gorgas. They have since been practiced in New Orleans, Vera Cruz and Rio de Janeiro. In the Southern States, however, while the old, aimless and largely futile struggles against the disease when once it had gained a foothold can never come again, there is always the liability of costly and increas- ing local outbreaks so long as permanent nests of the disease exist in countries- with which direct social or economic intercourse is main- tained. The everthreatening hotbeds of yellow fever at Havana and m Brazil are now in control and can be kept so at the price of intelligent and unremitting vigilance. But here and there in Mexico and South America and on the west coast of Africa it still lurks unguarded. It is the aim of the International Health Board of the Rockefeller Founda- tion to discover and clean up the remaining lurking places for germs of this disease, along the lines already inaugurated in the fight against hookworm and the eradication of malaria in different parts of the globe. At the request about a year and a half ago from Ecuador for counsel and assistance in solving the problems of yellow fever at Guayaquil, the Rockefeller Foundation and the Rockefeller Institute cheerfully sent General Gorgas and his associates of the International Health Board to study conditions in that country. The Commission was accompanied by Dr. Hideyo Noguchi, the accomplished Japanese bacteriologist, on the staff of the Rockefeller Institute for Medical Research Dr. No- guchi apart from his command of cultural technique and great patience was also well acquainted with a disease called infectious jaundice, which resembles yellow fever. It is one of the diseases whose origin has only recently been traced. The inciting germ, called Leptospira, is a spiral motile organism,, parasitic in rats and other animals. In insanitary places frequented by these animals it may gain access to the bodies of humans and incite serious and fatal disease. Noguchi suc- ceeded in inducing in guinea pigs by transference of a small quantity of the blood of yellow-fever patients, symptoms comparable with yel- low fever in the human race. The blood of these experimental ani- mals, when conveyed to other guinea pigs, produced the same disease, and in this infected guinea pig blood, a minute organism resembling the Leptospira of infectious jaundice was detected. Young dogs and monkeys were also found to be susceptible to inoculation with yellow fever blood. Noguthi also succeeded in cultivating from the blood at first of his artificially infected pigs and then of man a hving organism which he carried through many successive generations in his culture tubes, and from which by inoculation he could induce the identical fatal dis- 11 ease in the guinea pig. Noguchi called this germ "Leptospira icte- roides." Work is now being carried on by animal experimentation for the solution of unsolved problems, including the perfection of a suitable serum for this disease. It is hoped this work will be entirely successful and ]5rove a blessing to mankind. Control .^xn ^Management of Other Epidemic Diseases. On this important topic Dr. Flexner reviewed our knowledge of epidemic diseases and the practical hygienic measures, based on this knowledge, which have heretofore been applied, or which in the ordi- nary course of events may be applied with a reasonable hope of pre- venting the spread of these epidemics. The Lecturer expressed the hope that by a careful review of what has been accomplis'necl in the past we may form a judgment of the efficiency of such measures and arrive possibly at new points of view from which to launch a more decisive attack. ( Dr. Flexner is evidently a stanch advocate of the doctrine that disease germs have their origin somewhere, and scientific medicine demands that all epidemics must be traced backward to their starting point, and when found the original seedbeds must be stamped out. In support of this doctrine, which is now practically applied by the International Health Board of the Rockefeller Foundation, he spoke in part as follows: — Editor.) Regarding epidemic diseases in general we assume the introduc- tion from without, and usually from a distant locality of a special kind of organism which is held directly responsible for the epidemic ensuing. In the case of influenza wide divergences of opinion re- garding the nature of the inciting microorganisms and the manner of infection still prevail. The reason for these difTerences are several, but the most important perhaps relates to the common observation of the manner of spread or attack of the disease. While other epidemics proceed from bad to worse, with at least progressive increases of in- tensity, influenza seems to overwhelm communities over even wide stretches of territory as by a single stupendous blow. While in the one case the gradually accelerating rate of speed of extension may be taken to indicate personal conveyance of the provoking microrgan- ism ; in the other case, the sudden wide onset appears to be the very negation of personal communication. Hence the invoking of mysterious influences, the revival of th<~ notion of miasm and similar agencies, to account for this phenomenon. Indeed, the public mind in general lends itself readily to such formless concepts, for the reason that there still resides in the mass of the people a large uneradicated residue of superstition regarding disease. One does not need to look far or to dig deep to uncover the source of this superstition. \\'e have only recently emerged from a past in which 12 knowledge of the origin of disease was scant, and such views as were commonly held and exploited were mostly fallacious. It is, indeed, very recently, if the transformation can be said to be perfect even now, that the medical profession as a whole has been completely emancipated. All this is very far from being a matter of remote importance only, since in the end the successful imposition of sanitary regulations involves wide cooperation, and until the majority of indi- viduals composing a community is brought to a fair level of under- standing of and belief in the measures proposed, serious and sustained endeavor to enforce them is scarcely to be expected. Influenza. No better instance of a communicable disease could perhaps be invoked than influenza to exorcise the false idea of the mysterious origin of epidemics. To dwell solely on the sudden and overwhelming stroke of the disease is to wholly overlook the significant incidents that precede the mass infection, because they are of such ordinary nature and lack the dramatic quality. Accurate observers noted long ago that influenza in its epidemic form did not constitute an exception to the common rule regarding epidemic diseases, which are obviously associated with persons and their migrations. What the early stu- dents made out by tracing the epidemic backward to its point of de- parture more modern observers have confirmed by carefully kept rec- ords, often geographically compiled, as in the excellent instance of the Munich records covering the epidemic of 1889-92, which' can now. be supplemented by a number of similarly constructed records of the epidemic just passed. These records show convincingly a period of invasion during which there is a gradual rise in the number of cases to culminate, within a period variously estimated at from one to three weeks, in a widespread, so-called '"explosive" outbreak of the disease. It happens that the early cases of influenza tend not to be severe, chiefly because they are rarely attended by pneumonia and hence are frequently mistaken, and the confusion in diagnosis is resolved only when the full intensity of the epidemic is realized. In the meantime rich opportunity has been aft'orded for the free and unrestricted com- mingling of the sick and well, of doubtless healthy carriers of the inciting agent and others, until so high a degree of dissemination of the provoking microorganism has been secured as to expose the entire susceptible element of the population, which happens to be large, to an almost simultaneous response to the efi^ects of the infecting microbe. Deductions of like import can be drawn from the geographical movements of an influenza epidemic. In Eastern Russia and Turke- stan influenza spreads with the pace of a caravan, in Europe and America with the speed of an e.xpress train, in the world at large with 13 the rapidity of an ocean liner ; if one project forward the outcome of the means of intercommunication of the near future, we may pre- dict that the next pandemic, should one arise, will extend with the velocity of an airship. It is desirable, in the interest of clear thinking, to carry this con- sideration of the characteristics of epidemic influenza a step farther. A feature of the epidemic disease of particular significance is the tendency to recur ; that is, to return to a stricken region after an inter- val, usually of months, of relative quiescence Thus the beginnings of the last pandemic in Western Europe and the United States have been traced to sporadic cases appearing in April, May and June, pos- sibly even earlier in certain places, while the destructive epidemic raged during September, October and November of 1918. The dis- ease also prevailed, more or less, in the United States during 1919 and again during the present year. The epidemic of 1918-19 cost more in a few months in human lives than were killed during the five years duration of the great war. The statistics from India alone show something like 6,000,000 deaths. In this country the estimates so far have varied from 600,000 to 800,000, and you can carry that pro- portion around the world. There are very good reasons for believing that influenza is not in itself a serious disease, but that its sinister character is given by the remarkable frequency with which it is followed in particular instances by a concomitant or secondary pneumonic infection, to which the severe effects and high mortality are traceable. Now, it is this high incidence of pneumonia, the product of invasion of the respiratory organs with bacteria commonly present on the upper respiratory mucous membranes — streptococci, pneumococci, staphylococci, Pfeiffer's ba- cilli, and even meningococci — that stamp the recurrent waves of the epidemic with its bad name. If we compare the pneumonic complications, of influenza with those that arose in the cantonments in 1917-18, first as attendants of measles and later as an independent infection, we note immediately that in both instances the severe effects and high fatalities arose, not from bacteria brought or imposed from without, but from their repre- sentatives which are commonly resident upon the membranes of the nose and throat in health. Whatever we may have to learn of the microorganisms inducing measles, still undiscovered, and of influenza, still under dispute, and their mode of invasion in the body, no one would question that the bacteria inducing pneumonia are personally 1)01 ne. Streptococcus Pneumonia. In discussing this subject the lecturer pointed out that during the winter of 1917-18 there occurred in several localities within the United States, and also, but in a less degree, in France, at least a great increase 14 in the incidence of a type of pneumonia which previously had been very infrequent. It appears also that the greatest number of cases and of fatalities arose in the United States in the military cantonments ; that the disease first prevailed, as already stated, as a secondary pneumonia following measles ; but before long the severity of the infection was such that cases of primary streptococcus pneumonia began to arise. Moreover, at this juncture the disease spread from the military to the civil populations. The nature of the microorganism inducing this form of epidemic pneumonia is indicated in the name which the disease has come to bear. The difficulty in this instance has not been in finding out the inciting microbe, but, rather, in differentiating the streptococci responsible for the epidemic disease from streptococci possessing the ordinary pathogenic properties, or even from those of saprophytic nature so commonly present on the upper respiratory mucous mem- branes without provoking widespread disease. However, numerous studies of the bacteriology of this epidemic of pneumonia, at distinct and often widely remote cantonments, involving much animal experi- mentation, showed that the microbic incitant was in almost every in- stance streptococcus hemolyticus. Moreover, because of the wide oc- currence of the epidemic pneumonia, this type of streptococcus could be found in normal throats and as a secondary invading microorganism in the lungs in cases of ordinary lobar pneumonia. Thus far very little progress has been made in the classification of streptococci, which form a class apparently even more heterogeneous than the pneumococci and will involve much arduous experimental laboratory work. With these various considerations before us we may now discuss the question of the efficiency of our public-health measure in diminishing the incidence of epidemic diseases. It is evident that in diseases in which the inciting microorganism enters the body by way of the air passages, although not necessarily, as in poliomyelitis, directly injuring those parts, protection is not to be secured by applying sanitary meas- ures on a wide scale to an extraneous and inanimate source of the which the inciting microorganism enters the body by way of the air dejecta of typhoid patients, or even to inferior animal species such as the mosquito or the rat, which act as intermediaries in conveying the germs of yellow fever or of infectious jaundice ; but it is alone to be attained by methods of personal hygiene, applied on the Individual scale of safeguarding one person from another, the most difficult of all hygienic regulations to enforce. As a result of animal experimentation in epidemic poliomyelitis we may fairly claim that we are in possession of the essential facts which, if widely applicable, should enable us to control the sjDread of that disease. Epidemic diseases in the commonly accepted sdnse have fixed lo- cations — the so-called epidemic homes of the diseases. In those homes they survive without usually attracting special attention often over 15 long periods of time. But from time to time, and for reasons not entirely clear, these dormant foci of the epidemics take on an un- wonted activity, the evidence of which is the more frequent appear- ance of cases of the particular disease among the native population, and sooner or later an extension of the disease beyond its endemic con- fines. Thu-s there are excellent reasons for believing that an endemic focus of poliomyelitis has been established in Northwestern Europe from which the recent epidemic waves have emanated. Similarly there are excellent reasons for regarding the endemic home of influenza to be Eastern Europe, and in particular the border region between Russia and Turkestan. Many recorded epidemics have been shown more or less clearly to emanate from that area, while the epidemics of recent history have been traced there with a high degree of conclusiveness. From this eastern home, at intervals of two or three decades, a migrating epidemic influenza begins, moving east- ward and westward, with the greater velocity in the latter direction. Now, since the combatting of these two epidemic diseases, when they become widely and severely pandemical, is attended with such very great difficulty and is of such dubious success, and this notwith- standing the prodigious public-health contests which are waged against them in which the advantages are all in favor of the invading micro- organismal hosts, it would seem as if an effort of central rather than peripheral control might be worth discussion. According to this proposal, an effort at control amounting even to eventual eradication of the diseases in the regions of their endemic survival should be under- taken, an effort, indeed, not occasional and intensively spasmodic, as during the pandemical excursions, but continuous over relatively long periods, in the hope that the seed beds, as it were, of the diseases might be destroyed. That such an effort at the eradication of a serious epidemic dis- ease may be carried through successfully the experience with yellow fever abundantly proves. In attacking the disease the combat was not put off until its epidemic spread had begun and until new territory, such as New Orleans, Jacksonville, Memphis, etc., had been invaded ; but the attack was made on its sources at Havana, Panama, and now Guayaquil, to which endemic points the extension into new and neu- tral territory had been traced. Such a plan is now in process *of elaboration bv the Rockefeller Institute. Encephalitis Lethargica. Another disease that demands animal experimentation and inten- sive study is lethargic encephalitis, apparently only recently introduced in, and already widely distributed through, this country. It is highly desirable that the main facts known should be given publicity ; and it 16 may be well that the experience, gained with poliomyelitis, may serve us in dealing more effectively with the encephalitis peril. It appears that the first cases of that disease recognized in the United States occurred in the winter of 1918-19. In contradistinction ' to epidemic poliomyelitis, there is no reason to suppose that this epi- demic affection of the central nervous system ever before existed in America. The point is an important one. At present the disease seems to be widely distributed, as cases have been reported from many States. It is possible to trace the cases of lethargic, or epidemic encephal- itis, now arising in this country, to an outbreak which occurred in Vienna and neighboring parts of Austria in the winter of 1916. Be- cause of war conditions, knowledge of this unusual disease did not at once reach Western Europe and the United States ; but nevertheless cases of the disease occurred in England and France in the early months of 1918, and in America about one year later. Both in Austria and in England, in which countries the first cases were observed, respectively, in eastern and western Europe the disease was first mis- takenly attributed to food intoxications. In Austria the early cases were ascribed to sausage poisoning; in England to botulism arising from various foods. This error is not perhaps as remarkable as might at first appear. In the first place, both countries were laboring under unprecedented conditions of food shortage, preserved foods were employed on a scale never before equaled, and, of course, waste and refuse were reduced to a minimum. Furthermore, an early symptom of this encephalitis is third- nerve paralysis — giving rise to diplopia, ptosis, etc. — which happens also to be an early symptom in certain forms of food poisoning and notable in botulism. Ultimately, in both countries the notion of food origin became untenable, and the disease was recognized as arising independently of diet and other usual con- ditions of life, and come to be viewed as probably of microbic origin and of communicable nature. It is now sufficiently obvious why the popular name of "sleeping sickness" has been applied to this malady. The disease is, of course, wholly distinct from African sleeping sickness, which is a trypanosomal iniection carried from person to person by means of an insect vector — the tsetse fly. When an apparently new disease arises, it is always important to iixjuire whether the particular set of symptoms that are taken to characterize it has been observed and recorded before. In the present instance there are significant records which may easily refer to a similar and possibly identical disease. The first one dates from 1712 and refers to an outbreak of so-called sleeping sick- ness centering about Tubingen in Germany. The second record dates from 1890 and deals with a puzzling malady called nona, which is described rather in the lay than the medical literature of the time and seems to have prevailed in the territory bounded by Austria, Italy and Switzerland. In respect to neither instance, however, do the records 17 contain the minuter data which would admit of a certain identification of the disease described with the encephahc malady we are consider- ing. One circumstance is, however, significantly suggestive. The location of the 1890 afi^ection "nona," which was characterized by somnolence, stupor and coma, coincides roughly at least with that of the first cases reported in the present epidemic. The question may, therefore, well be raised whether the endemic home of this epidemic variety of encephalitis may not be that corner of southeastern Europe overlapping the three countries mentioned. If this should prove to be probable, the next question to arise would relate to the circumstances under which the disease slumbered on in ordinary times, and to the conditions that favored a greater activity and a wider spread about the year 1916. To deal with the first one will require particular and intensive studies carried out with the especial object in view to disclose hidden cases in the region originally affected. An answer can in the mean- time be hazarded to the second question. The depressing effects of war, acting by way of hunger, cold, migrations of populations and general insanitation, might initiate the conditions through which a low endemic might well be converted into a higher epidemic incidence of [he disease. It is now a matter of great importance to determine the precise nature or etiology of lethargic encephalitis. Many unsuccessful at- tempts have been made to communicate the disease to monkeys and other animals through the inoculation of nervous tissues showing the particular lesions in the manner so readily and successfully employed in monkeys for poliomyelitis. This circumstance alone would serve to distinguish this epidemic encephalitis from epidemic poliom3'elitis. But in two or three instances, what are stated to be successful trans- missions of the disease to animals have been reported. It is still too soon to say whether or not we are now at the thresh- old of clearing up, by way of animal experimentation, the etiology and mode of transmission of this menacing disease, as was accom- plished so recently, and also by animal experimentation in the case of poliomyelitis. But at this moment, and while waiting for the ultimate and convincing experimental results, one need entertain no doubt of the infectious and communicable nature of lethargic encephalitis. In conclusion Dr. Flexner remarked that time would not permit him to discuss many of the problems now awaiting solution or to refer to the work carried on by the staff of the Rockefeller Institute for Medical Research in all of its departments, but expressed the fervent liope that in the interests of the human race and the animals themselves, the progress of scientific medicine would not be impeded try imneces- sary legislation. 18 THE LEGAL ASPECTS OF VIVISECTION. By :. William Creighton Woodward, M. D., LL. M. Health Commissioner of Boston, Mass. Professor of Medical Jurisprudence Georgetown University. After the exposition that has just been made of the inestimable benefits in the interest of human heahh and happiness that have been achieved through animal experimentation, and that would have been impossible without it, no one of you can fail to see the danger inherent in any. attempt to restrict that field of research or to hamper operations within it. Certainly any needless restriction and hindrance would be hardly short of criminal, and the burden of showing the necessity for any such restriction or hindrance as may be proposed rests clearly upon the proponents. In the absence of clear evidence of a wrong to be righted, no legis- lation to restrict and hinder animal experimentation is justifiable ; and if wrong be shown, then such remedial legislation as may be proposed should have some direct and demonstrable relation to the end to be accomplished and should go no further than is necessary to accom- plish that end. Let us see what the facts are with respect to the legis- lation now pending in Congress to prohibit absolutely and forever, in the District of Columbia and in the Territorial and insular possessions of the United States, all experiments upon living dogs, unless the ex- periment has for its sole purpose the healing or curing of some physical ailment of the very dog experimented upon.o The alleged motive of the proposed legislation is set forth in the preamble of the bill ; the enactment of such legislation is, "an act of right and justice to the dog," because "the dog has made a wonderful war record," and "because he has been decorated for bravery, serving his country, follov^ing its flag, and dying for its cause." But some doubt seems to be thrown, I am sorry to say, on the sincerity of this preamble by a statement made by one of the leading proponents of the bill, to the effect that "We are so modest that we are beginning with the thin edge of the wedge. We want to save dogs, and later on we will probably try to save other animals. "Zj If dogkind is now to be honored a A bill to prohibit experiments upon living dogs in the District of Columbia or in any of the Territorial or insular possessions of the United States, and providing a penalty for violation thereof. S. 1258, 66th Congress, 1st session. b Hearing before the subcommittee of the Committee on the Judi- ciary, United States Senate, 66th Congress, 1st session, on S. 1358, page 25. 19 in the manner proposed in this bill, because of the distinguished serv- ices rendered by dogs during the war, it is not quite clear why similar honor should be bestowed upon other species that did not render such service ; such a course would certainly cheapen the honor bestowed on the dog! And if other species did render such distinguiihed war service, it would seem as though they, equally with the dog, should be honored now in the pending legislation rather than ayked to wait for their honors. The horse and the mule, that did such noble v/ork in transportation ; the carrier pigeon, that did such remarkable messenger service; the steer, the sheep, the hog, the chicken, and even the fish, that gave up their lives that the army and the people might live ; maybe even the cat, who did her bit in the protection of food supplies from rodent depredations ; and most assuredly, the modest guinea pig, that endured so much in testing and standardization of medical supplies — certainly the righteous claims of all of these cannot justly be ignored and lightly brushed aside if the real purpose of this bill is to grant in perpetuity as a reward for war service freedom from all experimen- tation. Waving, however, possible question as to the motive of this bill and proceeding to a study of its text and of the hearing on it, we fail to discover any evidence of "the wonderful war record" of the dog notwithstanding the fact that that record would seem from the pveamble to form the very heart of the demand that all dogkind be relieved for all time of its obligation to repay to man in some small degree the affection, care, and effort that man has bestowed upon him, and of the demand implied in it, to transfer to other species the burden that the dog might equitably be expected to share with ^heni, of submitting to experimentatiun in the interest of mankind and of animals generally. That some dogs manifested faithfulness and courage during the war (to the extent that such virtues can be translated from mankind to the brute creation), no one will deny; but that all dogs tried out in war service distinguished themselves by such conduct has never, so far as I am informed, been asserted, nor even that faithfulness and courage were distinguishing characteristics of most of them. And yet this bill proposes to doi homage to all dogs alike ; not merely to the faithful, but also to the traitor ; not merely to the coura- geous, but also to the cowardly ; not merely to the dog that saw war service, but also to the pampered pet in the fashionable, steam-heated apartment house or palace, that lived on the fat of the land, and occu- pied the time of his mistress and maybe a nurse maid or two, that had better been devoted to the welfare! of the men in the trenches ; and that the honors may be entirely even, they extend even to the sheep- killing mongrel that did his best to keep down the meat supply and the wool supply of the country during war time. Finally, as if the present generation of dogs were not numerous enough, and big enough, and strong enough to carry the honors that the proponents of this bill •20 would heap upon the species, it is proposed that such honors be spread over generations of dogs as yet unborn, from now on henceforth for- evermore. Certainly, if the attribute of courage can rightly be attrib- uted to dogkind, no self-respecting dog that did its bit during the war would ask for his offspring forever that it be exempted from all lia- bility to one of the most important services it can render mankind — and brutekind, too, for that matter ; for experiments on dogs, con- tribute to the well being not only of human beings but of domestic animals as well, including dogs themselves. Even if we were to agree with the proponents of the legislation now under consideration, that for the reasons stated in the preamble honor should be conferred upon dogkind, there would still lie before us a wide field for discussion and debate as to just what honor and how much honor should be conferred. Discussion and debate of this kind would, however, take us so far afield as to render impossible any profit- able result within the time at our command, and the proponents of this legislation, by naming in it a single and very definite form of honor have virtually limited discussion to that form. After the enactment of the proposed legislation it is to be unlawful in the District of Colum- bia or in any of the Territorial or insular possessions of the United States "for any person to experiment or operate in any manner what- soever, upon any living dog, for any purpose other than the healing or curing of said dog of physical ailments" ; and the bill is entitled "A bill to prohibit experiments upon living dogs in the District of Columbia or in any of the Territorial or insular possessions of the United States, and providing a penalty for violation thereof." To be sure of our ground, it may be well to make certain just what an "experiment" is, and the Standard Dictionary is probably a safe guide upon this point. To experiment is, according to the Standard Dictionary, to make an experiment, test, or trial ; to submit a thing or person to any process or ordeal, as for purpose of investigation or discovery. And an experi- ment is an act or operation to discover, test, or illustrate some truth, principle, or effect. Manifestly, then, the enactment of the proposed legislation would make unlawful any test or trial upon any living dog for any purpose whatsoever, other than the healing or curing of said dog of some physical ailment. A dog without a physical ailment could not be sub- jected to any experiment, test, or trial, of any kind. A dog suffering from a physical ailment could be subjected only to an experiment, test, or trial that was designed to remove that particular ailment from that particular dog. Whether the experiment, test, or trial was calculated to add to the dog's comfort, to give it pain, or to give it pleasure would be utterly immaterial for the purpose of determining whether the ex- periment was or was not punishable under the law. Probably, how- ever, we can for present purposes ignore the proposed prohibition of comfort-giving and pleasurable experiments, tests, and trials, which 2\ maybe the proponents of this bill did not reall)- intend to prohibit — although it would have been much better for them to have expressed their ideas more clearly if that is the case; and we can limit our con- sideration of the matter to the general class of experiments that cause varying amounts of inconvenience and possibly even some pain to the dog experimented upon, varying from the prick of a hypodermic needle to the pain that may be suffered after recovering from the anesthetic administered during some more or less serious and important experi- ment, made in the interest of humanity or of animal kind generally. Is there, or is there not, need for any legislation to prevent the infliction of such pain and inconvenience upon dogs in the District of Columbia and in the Territorial and insular possessions of the United States? Within the time at my command, I have not had the opportunity of examining the laws in force in the various Territorial and insular possessions of the United States relating to the infliction of pain and discomfort on animals. If such laws are adequate there is no need for further legislation ; and the burden of proving inadequacy rests upon the proponents of the legislation now before us. If the legislative bodies of those several jurisdictions have fallen short of their duty, evidence of that fact should be produced before Congress is asked to assert its jurisdiction in the premises. And I may add incidentally, the record shows no demand for this proposed legislation from the people of the Territories and the insular possessions — nor from the people of the District of Columbia either, for that matter. The pres- sure for its enactment seems to come largely from persons residing in jurisdictions that cannot be affected by it, and in these jurisdictions they have not succeeded, and possibly have not even tried, in procuring the enactment of such legislation as they now suggest be imposed on communities to which they are in large part strangers. That so far as the District of Columbia is concerned there are laws for the punishment of persons guilty of cruelty to animals is too well known to need comment. Prosecutions are being brought con- tinually under such laws. There is, however, in the law, as in common speech, a distinction between cruelty and the mere imposition of dis- comfort or pain. The imposition of discomfort or pain constitutes cruelty and is punishable only when it is not inflicted for a justifiable end. The determination of the matter now before us, in so far as the adequacy of existing law in the District of Columbia is concerned hinges, then, on the question whether the ends sought by experimenta- tion on dogs are justifiable ends, and whether in connection with such experiments, if the ends sought are justifiable, such pain as is inflicted is or is not a necessary element of the experiment. If, all things con- sidered, the ends sought by such experiments are justifiable, then clearly the experiments should not be prohibited ; and if pain is a necessary element in such experiments, then to prohibit pain is to pro- hibit the experiments. A brief examination of the law in force in 22 the District shows that all of these considerations have passed in care- ful review before the legislative authorities of the District of Columbia and that they have been wisely acted upon. Public morals have been, duly safeguarded, the humane treatment of animals definitely insisted upon, the rights and opportunities of investigators reasonably safe-" guarded, and extraordinary provisions made for the enforcement of the law. The law governing experimentation upon animals in the District of Columbia was enacted by the Legislative Assembly in 1871 and is set out at length in Abert's Statutes in Force in the District of Colum- bia, pages 540 et seq.a. It makes it unlawful to inflict unnecessary cruelty upon any animal or to authorize or permit any unnecessary torture, suffering, or cruelty of any kind. And if there were any doubt as to whether the provisions of this law were or were not appli- cable to cases in which pain might be inflicted in connection with ani- mal experimentation, it would be very definitely dispelled by the fol- lowing provision : "Section 15. Nothing in this act contained shall be construed to prohibit or interfere with any properly conducted scientific experi- ments or investigations, which experiments shall be performed only under the authority of the faculty of some regularly incorporated medi- cal college, university or scientific society." Stated in other words, no infliction of pain is to be tolerated unless the experiment is of a scientific nature and properly conducted ; and in ■ order that there may be some assurance that such experiments as are performed are presumptively of this character, they may lawfully be performed only under the authority of some competent, responsible organization, which in effect stands back of the experiment either b}' authorizing the particular experiment that is to be made or else by vouching, as it were, for the judgment and qualifications of the ex- perimentor to engage generally in that field of work. But in order to guard against the possible incompetence or care- lessness of experimenters, medical colleges, universities, and scientific societies with respect to this matter, it is made the express duty of all police officers and of any member of the Washington Humane Society to prosecute all violations of the act that come to their notice or knowl- edge. And if any member of the Washington Humane Society be- lieves and has reasonable cause to believe that the laws in relation to cruelty to animals have been or are being violated in any particular building or place, he is upon oath or affirmation to that effect, and due application, entitled to a search warrant. And as though to insure beyond the peradventure of a doubt that the provisions of the law would be carried out, it is provided that fines and forfeitures collected upon or resulting from the complaint or information of any member rf the Washington Humane Society shall inure to and be paid over to that society. a For the pertinent parts of this Statute see Appendix. 23 On the face of things, the law as set forth above certainly seems ample to prevent cruelty to animals, including within the meaning of the word cruelty all such pain as may be inflicted in connection with unnecessary experimentation and all such as may be needlessly in- flicted in connection with experimentation thafis in itself necessary and proper. Dogs and all other animals seem to be amply protected. And when it is remembered that this law has been in eflrect for almost half a century it seems certain that if there has been any unnecessary inflic- tion of pain in connection with experimentation on animals there must be within that half century some record of prosecutions which, if the law be effective, must have resulted in convictions and punishments and, if the law be ineffective, must have left upon the records of the courts of the District of Columbia evidence of that fact. I had occasion in the year 1900 to look carefully into this matter, the law having been then in force for more than a quarter of a century, and I was then unable to find any evidence of a single prosecution having been brought, either upon the initiative of any private citizen, or of any police officer, or of any member of the Washington Humane Society. No record could be found of a single search warrant having been applied for under the act or of any effort ever having been made to institute any prosecutions under it. It follows, of course, that there was no record of any court ever having construed this law as inappli- cable to cases involving the infliction of unnecessary cruelty in connec- tion with animal experimentation. All of these facts were made pub- lic at the time, and certainly should have served to stimulate the issue of search warrants and to stimulate prosecutions, if reasonable suspi- cion or concrete evidence of violations of the law were at hand. Ever since this situation was made public, the year 1900, I have been inti- mately in touch with thq situation, and during all that time I have known of no effort to obtain a search warrant under the law, of no attempted prosecution under it, and, of course, of no court decision indicating the ineft'ectiveness of the law to accomplish its manifest pur- pose. It seems safe to say, therefore, that there is in the District of Columbia no experimentation upon dogs or other animals that is not regulated by existing law, duly safeguarded by the watchful and spe- cial authority of the Washington Humane Society itself. The conclusion just set forth seems too definite and too clearly , supported to need reinforcement. If, however, reinforcement be deemed necessary, it may be found by reference to the records of the numerous hearings that have been held from time to time since 1899, before Congressional committees, in connection with bills that have been introduced for the purpose of regulating or preventing experi- mentation upon animals in the District of Columbia. Certainly, if any such bill could ever have found support in the least degree upon evi- dence of any specific instance or instances of cruel experimentation on animals in the District, that evidence would have been forthcoming. 24 for there could be no other evidence of so much weight, and yet I can recall no single instance in which any such evidence has been adduced. It might be argued, however, that even though there be no wrong to be righted by the proposed legislation, yet that its enactment would do no harm and that it would be a very inexpensive way of paying a supposed debt to all dogkind. At best it would be a paying of a sup- posed indebtedness to dogkind by saddling upon other animals the service now rendered by dogs, which would be a most unjust thing to do, since many other species have rendered to mankind in the war and at all other times service far beyond that rendered by the dog. As a matter of fact, however, those who are best qualified to speak with respect to the subject will tell you that certain experiments in the interests of mankind and of animals generally cannot be as well per- formed upon other animals as they can be upon dogs. Moreover, one of the witnesses adduced by the proponents of the measure frankly announces that this bill is but the small end of the wedge with which it may be possible to stop all animal experimentation. Under the cir- cumstances, and in view of the lucid statement made by the preceding speaker as to the wonderful benefits that have accrued from animal experimentation, the passage of this bill could never be condoned on the ground that it was at least harmless — for it is not. The bare fact, however, that the enactment of this bill is unneces- sary, and even the fact that its passage would work harm, is not suffi- cient to prevent the bill from becoming a law. There are persons of wealth, of social standing, and of intellectual standing who believe in it and who have worked and will work actively for its passage. Sen- ators and representatives who will be called upon to consider it are men busy with large aflFairs of national and international importance, who have but little time for personal research into the merits of measures such as this, and who may be misled by the plausible arguments of the proponents of the bill unless there be an intelligent and energetic cam- paign to place before these senators and representatives the facts of the situation. It is in such a campaign that Georgetown University is now assuming a position of leadership, and vmder its banner I ask all of you to enlist and to 'fight for the cause. 25 Appendix. Extract from section one of an Act of the Legislative Assembly OF the District of Columbia, entitled: "An act for the more effectual prevention of cruelty to animals in the Territorv of the District of Columbia," approved Angitst 23, 1871. "Whoever, having the charge or custody of any animal, either as owner or otherwise, inflicts unnecessary cruelty upon the same * * * shall for every such offense be punished by imprisonment in jail not exceeding one year, or by fine not exceeding two hundred and fifty dollars, or by both such fine and imprisonment. "Every owner, possessor, or person having the charge or custody of any animal, who * * * knowingly and wilfully authorizes or permits the same to be subject to unnecessary torture, suffering, or cruelty of any kind, shall be punished for every such oft'ense in the manner provided in Section 1. "Whenever complaint is made by any member of the Association for the Prevention of Cruelty to Animals (Washington Humane So- ciety) on oath or affirmation, to any magistrate authorized to issue warrants in criminal cases, that the complainant believes, and has reasonable cause to believe, that the laws in relation to cruelty to ani- mals have been or are being violated in any particular building or place, such magistrate, if satisfied that there is reasonable cause for such belief, shall issue a search warrant, authorizing any marshal, deputy marshal, constable, police officer, or any member of the Association for the Prevention of Cruelty to Animals (Washington Humane So- ciety), to search such building or place. "It shall be the duty of all marshals, deputy marshals, constables, police officers, or any member of the Association for the Prevention of Cruelty to Animals (Washington Humane Society), to prosecute all violations of the provisions of this Act which shall come to their notice or knowledge, and fines and forfeitures collected upon or re- sulting from the complaint or information of any member of the Asso- ciation for the Prevention of Cruelty to Animals (Washington Humane Society) under this Act shall inure to and be paid over to said associa- tion, in aid of the benevolent objects for which it was incorpo- rated. * * * "Nothing in this Act contained shall be construed to prohibit or interfere with any properly conducted scientific experiments or inves- tigations, which experiments shall be performed only under the au- thority of the faculty of some regularly incorporated medical college, university or scientific society." 36 ■ • SO]\IE OF THE ETHICAL ASPECTS OF ANBIAL I'lXrjiRI- MENTATION. By Wm. H. Arthur, M. D., F. A. C. S., Colonel, U. S. Armv, Retired. Medical Director Georgetozvn University Hospital. Lale Commandant Army Medical School. In a world full of sickness and suffering, in which are daily occurring many thousand premature and unnecessary deaths ; with a constant struggle going on in the effort to accumulate money, which is to-day the generally accepted measure of success, there are some unselfish men who, giving up all prospect of pecuniary rewards, or of reputation outside the limits of their own profession, are devoting their lives to reducing the sum total of human and animal disease, alleviating pain and prolonging life. The work in this field has achieved already magnificent results but much yet remains to be accomplished. Very few people begin to realize what humanitj^ already owes to these investigators, past and present, and will owe to those to come unless irresponsible interference from outside ends their efforts. Yet while the names of great military commanders or men who have accumulated enormous wealth are familiar to everyone, these great benefactors of their kind are known by name only to the medical profession. Let me illustrate. How many non-medical men or women know who Leishman was or LofHer or Pasteur or Lister or Walter Reed? These men (and there are many others) who have conferred the greatest possible benefits on the race, are little known to the world generally. Yet the first named, Leishman, devised a method of con- trolling the most common, dreaded and fatal of camp diseases,- typhoid fever, which saved at least 290,000 of our troops in the great war, ten divisions, from three or four months invalidism, with 30,000 deaths. The morbidity and mortality from this disease that would certainly have occurred in the great army assembled for this war but for preventive inoculation are calculated on what actually did take place during the Spanish war, before this method of preventing typhoid fever was discovered and introduced. Lofifiler paved the way for an anti-toxin which annually saves hundreds of thousands of child- ren from death or crippling from diphtheria. The combined work of Pasteur and Lister has made modern surgery with all its magni- ficent triumphs possible ; and the last, Walter Reed rescued our South Atlantic and Gulf Coasts from the annual terror of yellow fever, which had ever since the colonization of the country become epidemic at frequent intervals, killed thousands of people, and demoralized commerce every year by the enforcement of the April to ,November quarantine. All of these great benefits to humanity would have been impossible but for animal experimentation. 27 The word 'vivisection' is unfortunate, misleading and inapplicalVe to what it is intended to describe. It means simply cutting living tissue. Every surgical operation, involving the making of an in- cision, is a vivisection, but it is done under an anesthetic, local or general, and the same is true of the research laboratory, but the word to the sympathetic, emotional misinformed man or women brings up a vivid and distressing mental picture of a helpless animal tied down, struggling and groaning, while a brutal doctor tortures it, with no other object (for it is claimed, that no useful purpose is accomplished) than the gratification of a morbid, insane pleasure in inflicting and witnessing suffering. This is true only of criminal degenerates and is a very false conception of what actually takes place in these laboratories. Instead of 'vivisection' the term 'animal e.xperimentation" might be used, but even that does not entirely cover the ground, for animals must be used in laboratory diagnosis and in the preparation and testing of certain anti-toxins, sera and ^■accines, that have long ago passed the experimental stage, and now provide the sanitarian and the practising physician with their most powerful means of preventing and curing certain very fa al infectious diseases. ^lany thousand deaths, now easily avoidable, would result if the suppl}- of this material should be cut off, as it would be if the use of animals in scientific work should be pro- hibited by law. The suffering inflicted in the t)'pe of laborator}' under discussion is grossly exaggerated. A very large majority of the so-called 'vivisections' consist of a prick with a hypodermic needle and an in- jection of the material to be tested or the supplying to or the with- holding from animals of certain food elements. Anesthetics are always used in procedures that would otherwise inflict pain. I am not myself and never have been a laboratory investigator, but I have had under my inspection and control a number of laboratories of this kind in this country and in the Philippines, and have seen a great deal of the work of my subordinates, and I have never witnessed the harrowing scenes so graphically described by the antivivisectionists, most of whom have never entered a labora- tory. The men engaged in this kind of work are normal men, not at all lacking in the ordinary feeling of humanity, quite as merciful as the average non-medical man of the educated class immeasurably more merciful than the sportsman, who hunts for his own amuse- ment, or the trapper who catches animals to secure furs for personal adornment. How often have you heard a big game hunter boast, that though he failed to bring in a deer, he is sure his shot took effect, for the animal limped badly as it escaped and there was blood on the trail ? That deer probably, with a shattered hip or shoulder or some even more serious injury, lingered for days in intolerable suffering, finally dying of starvation or exhaustion. At the cost of 28 . \ what untold suffering were secured the furs of the fox, beaver, marten or other animal, that even the most tender hearted anti- vivisectionist does not hesitate to buy or wear? Yet what is done for sport or vanity seems to be considered perfectly proper and natural, while great indignation is expressed at the relatively negli- gible suffering inflicted in the laboratory, with the highest possible motive, ihe search for means for reducing" the sum total of human misery, and also the suffering of other animals, for animal ex- perimentation saves in cattle, swine, sheep, poultry and dogs, in- finitely more suffering than is inflicted on guinea pigs, rabbits etc. in the laboratory. The bureau of animal industry, the farmer, the stock raiser or poultry man are dependent on animal experimenta- tion for the study of animal diseases. Any scientific veterinarian will bear me out in this statement. It is a very safe assertion that the suffering inflicted on animals in the laborator}' is infinitesimal as compared with the suffering other animals are saved as a result of this kind of research. The protestants against the use of the lower animals in scientific research, as well as in diagnosis and in the preparation and testing of material of thoroughly proven and enormous value, base their attack on two assertions, both false : First : That intolerable cruelty is wantonly practised in the laboratory. Second : That no useful purpose has ever been secured by this method of research. As said before, I venture to assert that more animal suft'ering results from one day's sport or from a trapper's successful catch, than is inflicted in years in the busiest research laboratory. Yet no one, so far as I know, opposes big or little game hunting, or refuses to wear furs, because they have been secured at the cost of so much suffering: for imagine a fox, beaver or other animal caught in a spring trap, in cold weather, with a shattered leg, slowly freezing to death, unless as often happens the unfortunate animal, to the trapper's disap- pointment, secures his freedom by gnawing off his shattered leg. Nothing comparable with that ever happens in a laboratory, but it is a common occurrence in trapping fur-bearing animals. The second statement that nothing of importance has ever been developed by animal experimentation can be believed only by people incapable of understanding facts or being convinced by absolute proof, or actual demonstration. The whole science oi physiology, the study of the working of the animal mechanism, is built up on animal experimentation. But for it we should know nothing of the circulation of the blood, the functions of the viscera, or the brain, spinal cord and nervous system generally. We should be no further advanced in knowledge of this subject than were Paracelsus or Avicenna, or than is now the old fashioned Chinese doctor, who teaches his students that the intellect resides in the spleen, and the soul- in the left kidney. No new drug used by the physician could 29 be safely employed in treating sick human beings, till its effects were tried out on lower animals. Anesthesia, one of the greatest of benefits to mankind ever devised, would never have been intro- duced and used as it is to-day, with incalculable saving of suffering (animal as well as human) but for the use of animals in testing its safety and its general effect. The whole of bacteriology and modern surgery have been slowly worked up to their present position among the sciences by animal experimentation. No surgeon would dare to remove a kidney or suture the intestine, no matter how badly damaged, unless it had been shown it could be done in anesthetized animals with perfect safety, and without suffering. Remember, in passing, that even if all in- vestigators in this field were entirely devoid of the ordinary human instincts, which of course is nonsense (what logicians call a "violent supposition") it would be impossible to do a delicate dissection on an unanesthetized struggling animal. Aseptic surgery, one of the greatest triumphs of modern times, would be impossible without animal experiments. I am old enough and young enough to be able to contrast the surgical conditions of forty years ago with the magnificent surgical successes of to-day, impossible without animal experimentation The study of the ultimate cause of diseases, which is the first step in finding means to prevent and cure them, has made enormous progress but much still remains to be done. An intensive study is going on all over the world to find the cause, prevention and cure of cancer. There is still much to be learned of small-pox. The ultimate cause of scarlatina, measles and muinps are unknown, that of influenza not definitely determined. There are many other problems of this kind to be solved. Put a stop to animal experi- mentation and the search must be abandoned. Incaculable dis- aster to the human race and to the lower animals w'ould result, many epidemics now controllable would spread unchecked. The result- ing misery and death no man can begin to calculate, and medical progress would be completely arrested. It is undeniably true that medicine and surgery owe the bulk of what they have accomplished in the last fifty years to animal experimentation. Let me state from my own observation and experience what was accomplished in the eradication of disease in the Philippines in nine years, most of it the result of animal experiments, and methods developed and worked out in the laboratories of different countries, largely by animal experimentation. When I left JManilla, after two years stay there, in 1902, the hospital I commanded contained about 500 very sick men (all light or convalescent cases were sent to a convalescent hospital). These cases included smatljpox, plague, beri-beri, Asiatic cholera, typhoid fever, and a great many of tropical amebic dysentery. On my return nine years later as Chief Surgeon 30 of the Philippines I inspected the same hospital. There were 73 cases being treated then and not one case of communicable disease. . The changed conditions were the result of American Sanitation, inaugurated by military and carried on by civilian health officers, but ' the methods b}- which that improvement was made possible, were the result, in the final anah^sis, of animal experimentation. Take one disease as an illustration. Beri-beri (known to medical men as disseminated peripheral polyneuritis) was a disease at first unfamiliar to doctors who had had no tropical experience. It affects the nerve endings, causes extensive paralysis, and some of the most frightful cripplings you can imagine. At first this was supposed to be an infectious disease. It very rarely occurred among our troops, but was a scourge among the natives, and most of them who did not die from it -would have been much better off if they had, for many muscles became permanently paralyzed, opposing muscles dragged the unfortu- nate sufferers into the most distressing permanent contortions. The cases were all isolated, and not one of them, or very few, indeed, got well. Two years later during the Japanese-Russian War, the Japanese Navy suffered badly from beri-beri. The surgeon general of that serv- ice proposed a change of diet, and the cases improved and new cases ceased to appear. Later on the matter was seriously studied, and Ved- der, of the U. S. Army Medical Corps, made a series of experiments on fowls, simply restricting their diet to polished rice, which forms the bulk of the subsistence of the Filipinos and the Japanese. He found that chickens developed symptoms of beri-beri which promptly disap- peared when rice polishings were added to their diet. Now beri-beri is almost unknown in the Philippines. In three years I spent there, 1911-1914, I never saw a single case. The fact that it was a dietetic disease, a deprivation neuritis, was definitely proved on a dozen fowl, and by insisting on the natives eating unpolished rice the disease has practically disappeared, for there is some element in the husk or the pericarp of the rfce grain that contains an essential food principle, found in the ordinary diet of all persons except those whose food is almost entirely starch. This is a good illustration of what may be accomplished by animal experimentation. Simply restricting the diet of a few fowls for a time proved positively the cause of this disease. One of the methods of proving Vedder's theory was to give the fowls rice polishings as soon as symptoms of paralysis developed, when they very soon disappeared. If I were allowed thirty hours instead of thirty minutes, I should find the time too limited to enable me to enumerate and describe the great benefits to the race that these great investigators have bestowed upon it through animal experimentation. Should not every intelligent man or woman, worthy to be called civilized, do all in his power to encourage and help these unselfish benefactors of the race? Can you conceive of people calling them- 31 selves educated or intelligent, so misguided as to misrepresent, hamper- and even to make every effort to put a stop to a kind of scientific work that has already conferred incalculable benefits on the human race and domesticated animals, and is full of promise of even more than it has already achieved. Yet there actually are such people. If they would confine them- selves to anything remotely resembling the actual facts, they could easily be silenced, but they harrow up the feelings of unthinking emo- tional people with the most absurd and extravagant misstatements. Only a few days ago in this city one of these propagandists luade the assertion that medical students were forced to witness the torture of dogs, in order to make them callous to the sight of suffering, harden them morally and eliminate all humane instincts from embryo medical men. Can there be approximately intelligent people, who can listen patiently to and even believe such fantastic nonsense? The answer is "no," for to credit such absurdities is in itself proof of the nonexist- ence of any intelligence at all. WHAT ANIMAL EXPERIMENTATION HAS DONE FOR GYNECOLOGY AND ABDOMINAL SURGERY. By Thomas S. Cullen, M. D., Professor of Clinical Gynecology. Johns Hopkins Hospital. To discuss adequately this important subject would require more time than your patience would allow, and I am reminded of the statement made by President Hadley, of Yale, that no one is converted after twenty minutes. Consequently, in the time at my disposal I shall give you only a panoramic view of the advances in abdominal surgery and gynecology during the last thirty years. We are continually reminded of the wonderful way in which nature has developed our bodies, and in no part of the human economy is this more evident than in the abdomen. It would be impossible for any man, no matter how skilled he was, to pack away in a small com- partment so many vital structures, and to so arrange them that no one organ seems to be crowding out the other. If we examine the abdominal cavity, we find that it is in large measure filled by the gastro-intestinal tract. The upper part of this is the stomach. Next comes the duodenum which is only a few inches long and is continuous with the small intestine which is many feet in length. This, in turn, passes into the large bowel through a valve-like opening, in the vicinity of which is the appendix. The large bowel is a few feet in length and terminates in the rectum. The intestines as a whole are over twenty-two feet long. 32 . ■ Occupying the right upper abdomen and lying chiefly under the ribs is the liver and snuggled up under the edge of this organ is the gall-bladder. In the left upper abdomen is the spleen, and lying prac-. tically behind the stomach is the pancreas. In the female the pelvis contains the uterus, tubes and ovaries. Lying outside the peritoneal cavity on either side are the kidneys and from each a small tube, the ureter, passes downward to the base of the bladder. Such is the general topography of the abdomen. Some of the older members of my audience, will probably remember rhat thirty years ago one rarely heard of an abdominal operation except for the removal of an ovarian cyst. At that time we had cases of typhilitis, a term used to designate inflammation around the appendix, or were told that a patient had liver trouble or an inflammation of the gall-bladder, but no operation was suggested or performed for any of these important conditions. During those dreadful epidemics of typhoid fever that from time to time passed over a community like a prairie fire, a perforation of a typhoid ulcer was diagnosed and that meant almost certain death, as the surgeon was unaware that operation could be of any value. As we glance back to former days we remember that many of our friends were chronic invalids, and we looked upon their permanent disability as a matter of course, little realizing what might have been accomplished had they the advantages of the wonderful advances in abdominal surgery made during the last quarter of a century. Just imagine the dilemma we should be in today if none of our appendix or gall-stone cases could be operated upon ! The normal appendix is about as big around as a small lead pencil and varies from two to three or more inches in length. It is a very innocent looking object, and one would not for a moment think it could do harm. Nevertheless, it is the "stormy petrel" of the abdo- men. It is lined with the same velvety membrane as that of the large bowel, and its lumen which is about the size of the lead in a lead pencil is continuous with the cavity of the bowel. We all know how quickly a nostril will close if we catch the slightest cold. If there be a slight inflammation of the large bowel this often extends to the appendix, and its opening into the bowel speedily closes. It is now a closed sac, and if the inflammation persists the appendix swells up and finally gives way at some point allowing its foul contents to escape into the -abdomen. General peritonitis often results and the patient dies. Appendicitis was the "inflammation of the bowels" of former days. Many of you will doubtless wonder why the various stages in the development of appendicitis were not thoroughly understood long be- fore, but when we remember that abdominal operations for this con- dition were not performed and that when the abdomen was opened 33 after death in the cases in which peritonitis had developed, pus was found everywhere, we cannot wonder that the true cause was usually overlooked. If one is in a house when it catches fire he is usually in a position to tell how it started, hut when the whole building is ablaze when he reaches the scene it is very difficult, or impossible, to determine the starting point. To Louis Pasteur, the people of the world owe an eternal debt of gratitude for his discovery of the usual causes of infection or blood poisoning ; it was he who pointed the way to avoid infections. His discovery was promptly embraced by Joseph Lister who applied it to surgery. As a result of the labors of these two men it was soon possible to open an abdomen with little or no fear of subsequent infec- tion. This opened up to the surgeon an entirely new field, one here- tofore in large measure forbidden ground. It likewise enabled him to explore the abdominal cavity in very early stages of various abdominal diseases. Hei was thus not only able to follow the disease from its beginning but, what was more important, was often able, figuratively speaking, to confine the fire to one room and to extinguish it effectually. When a new country is thrown open to the public the desirable farm land is soon taken. Small villages spring up, roads are located, and in due course the community is thoroughly organized and takes its proper place in the State. Precisely the same thing has taken place m abdominal surgery. At first the appendix and gall-bladder were given special attention because in these originate the two most impor- tant and most frequent abdominal maladies that the abdominal surgeon has to deal with. After these had been thoroughly mastered other and less frequent abdominal diseases were given due consideration. Perhaps I may be able in a few words to give you a comprehen- sive idea of the more common abdominal conditions with which the surgeon has to deal. In the stomach we have vilcers. These may cause alarming hem- orrhage or perforation may occur. The surgeon makes an opening between the stomach and intestine in such a way that the food does, not pass the ulcer. This leaves it quiescent and gives it a chance to heal. If a perforation has occurred, he at once sews up the hole and drains the abdominal cavity to get rid of the stomach contents that have escaped. When cancer of the stomach is detected early he removes a por- tion of this organ and usually attaches the remaining part of the stom- ach to the intestine, in such a manner that the contents can readily pass along their way. Ulcer of the duodenum is of common occurrence. Here practi- cally the same operation is performed as for ulcer of the stomach. Throughout various portions of the small and large intestine tumors may develop. The necessary segment of the bowel is cut out. 34 the cut ends are approximated, and in many cases the patient makes a perfect recovery. In the female we often find pus in the tubes connected with; the uterus, and it is usually necessary to remove these if the patient is to' regain her health. It is a significant fact that pus tubes are infinitely less frequent in the well-to-do than they were a decade ago. This is undoubtedly due to the better education of the public and to the fact that women in the higher walks of life will have nothing to do with their husbands if the latter be infected. The next decade will un- doubtedly show the same attitude on the part of the women in other walks of life. These facts were emphasized by Dr. Roland Hill in his recent Presidential address delivered before the Western Surgical Association in Kansas City. They are most significant. Uterine and ovarian tumors in their development often push the blood vessels, the tubes from the kidneys to the bladder and other structures, far out of place so that the surgeon finds it difficult to get his landmarks. In such cases he is often like the mariner traversing an uncharted sea. Sometimes the tumors reach a very large size and grow so fast to the intestines and large blood vessels that it is necessary to remove parts of the intestine and occasionally portions of the impor- tant blood vessels together with the growth. Now and again a crisis arises and almost certain disaster seems imminent. It is then that the surgeon must act with instant decision and with the utmost coolness. He cannot back out, and any minute may be on the rocks. When in such a predicament I have been re- minded of the man in the signal tower. The limited was coming rapidly toward him and beyond control. A moment's delay and a head-on collision would occur. He thought quickly — 'better one wreck than two' — pulled the lever and sent the limited into a mud bank. No man has any right to do abdominal surgery unless he is pre- pared to do any abdominal operation that may be necessary, and unless he is ready to cope with any abdominal emergency at a mo- ment's notice. You may be able to duplicate a train — you can never reproduce the same individual. An abdominal surgeon must in the first place be a man with a good fundamental knowledge of medicine. He must be a good diagnosti- cian ; he must be thoroughly familiar with the gross appearance of all abdominal lesions and also with the appearance of these structures under the microscope. He must be a good bacteriologist so that he can carry out the technique of the operation in such a way that there will be little or no chance of subsequent infection. He must be able to join up intestines so that they will not leak or will not allow gas to escape. He must be able to join blood vessels so securely that the 'blood stream will be continuous, and he must approxi- mate parts in such a manner that they are left perfectly smooth. In 35 short, in addition to his scientific qualifications he must be a good plumber and gas fitter, and a first-class tailor. The successful surgeon does not confine his knowledge to medicine and surgery alone, but embraces every opportunity to learn all he can about business in general, and especially concerning manufacturing plants of all sorts. In this way he picks up many points that are in- valuable to him in his chosen field. Above all a liberal supply of good horse sense is his most valuable asset. Problems. Nearly all manufacturing plants retain a corps of experts who are continually on the look out for new things and who are suggesting new methods whereby the existing products are improved and produced with less cost. Precisely the same applies to abdominal -surgery. Our methods are as a result of experiments rendered more effective and as a result of animal experimentation we are rapidly reducing the cost — in lives. The experimental intestinal work of Halstead, Mall, Murphy and others upon dogs has been of the greatest value. They have given us methods of so bringing the bowel ends together that we now rarely have a leak after the ends have been approximated. As a result of experimental work we are now able to bring to- gether the ends of blood vessels with the assurance that the blood will continue to pass normally through this spliced vessel. In some operations the tube from the kidney to the bladder has been cut across during the operation, not through any fault of the operator, but because it has been carried far from its normal position by a tumor. As a result of experimentation on animals we now know how to join up effectually the ends of the cut tube and thus save the kidney which would otherwise have to be sacrificed. . In former days when a patient had a strangulated hernia which had existed for four or five days he would usually die even after we had released the bowel. Animal experimentation has taught us that the death was due to poisons absorbed from the temporarily paralyzed bowel. We now open the bowel above the point of the hernia, allow the poisonous intestinal contents to escape and achieve success where failure usually followed. As a result of experiments on animals we have learned that chlo- roform causes widespread necrosis of the liver ; hence this anesthetic has been practically discarded in this country, except in obstetrical cases where it is employed only for a few moments. As a result of experiments on animals we have been able to dis- cover how much intestine can be removed and the patient still live. As a result of experimentation a knowledge of the stomach juices was learned. 36 These are but a few of the fundamental truths that have been ascertained as a result of operations on animals — truths that have enabled the surgeon to save myriads of lives. The question is often asked, "Why use the dog?" In many laboratory experiments mice, rats, guinea-pigs, rabbits and other ani- mals have been employed. In experimental work dealing with the advancement of abdominal surgery we have to use a larger animal, an animal whose abdominal organs resemble in some degree those' of the human being, and the dog is the only animal that we can satisfactorily employ. It may be of interest to describe briefly the method of operating on dogs. The instruments are carefully sterilized by boiling. The sponges and dressings are prepared in precisely the same manner that they are in a hospital operating room. The operator and his assist- ants scrub up and go through the same solutions that they employ in preparing for a regular- abdominal operation. A trained assistant is selected to put the dog to sleep and the abdominal preparation of the animal is carried out with the utmost care. The operation itself is carried out with the same precision that is in vogue in any well-organized operating room, and the operator is keen to see if he can successfully perform the new operation that will in the future enable him to relieve conditions in the human being that have heretofore baffled the surgeons. As soon as the operation has been completed the dog is placed in a comfortable cage and given morphia or some other drug that will in large measure relieve his suffering. His diet is also carefully super- vised until he is able to be up and around again. This scrupulous care of the animal is absolutely essential otherwise many of these valuable and successful experiments would end in failure. It is interesting to note that, when the animal operating room at the Rockefeller Institute was established, the head nurse of one of the best operating rooms in the country was selected to take charge of this department. When a physician who was visiting the Rockefeller Institute dropped in to see the dogs that had been operated on they immediately started to bark furiously, but as soon as the surgeon who had per- formed the operations and watched them subsequently, appeared their barking ceased and the dogs wagged their tails furiously. The dogs, of course, did not know that the surgeon had produced their suffering. They were asleep. They only knew that he had been kind to them when suffering. Further comment is unnecessary. The Training of Young Surgeons. — The public has a right to de- mand the best surgical service obtainable. In the early days many a man after years of general practice gradually drifted into operating. The surgery of today requires such perfection in diagnosis, such a knowledge of pathology, operative technique and after treatment that 37 the embryo surgeon must after spending one or two years in a medicaL clinic start at the bottom rung of the surgical ladder and work up. He will begin as a junior assistant taking histories on the wards, mak- ing the necessary routine laboratory examinations, handling instru- ments at operations, and in looking after the patients that have been operated upon. After a year in such work he may become a second assistant. His responsibilities are now greater, and he may be allowed to do minor operations. When he has won his spurs he is advanced to be first assistant, and finally becomes the resident surgeon in the hospital. The assistant learns much from his chief, and in due time is able to perform complicated operations, but there are some that he can rarely if ever successfully perform the first time. This is perfectly natural. The plumber's assistant might watch his employer success- fully weld joints for months without being able to do so himself. In order to become a master plumber it is necessary for him to do some of the welding himself, and some of his first attempts in this direction are doomed to failure. With the plumber's apprentice this does not matter much ; he can try over again, and if necessary secure new pipes. When the surgical assistant attempts for the first time to bring the two ends of a bowel together and so suture them that the joint is absolutely water and air tight he is often doomed to failure and the patient, it a human being, usually succumbs. It is essential that he do the opera- tion on dogs first and after from one to four or five trials he can with ease make a perfect joint. The same applies where he has to join up the small tube that con- nects the kidney with the bladder. It also is applicable in several other abdominal emergencies. When we look at the subject squarely it resolves itself into this — in the first few operations in which abdominal tubes are to be joined up failures are bound to result and death ensues. Is it, better to lose a few dogs or a corresponding number of people while the surgeon is securing the necessary skill in the performance of these important and difficult procedures ? Surgeons are often thought to be lacking in sympathy, but I have never met a more warm-hearted group of men. The nature of their calling, however, does not allow them to let their feelings run away with their judgment. They are often called upon to operate upon their nearest and dearest relatives, at times not knowing whether they will be able to get them off the table alive. There is nothing in this world that pulls harder on the heart strings of any man than such an ordeal, and yet throughout the entire operation the surgeon must com- bine consummate judgment with absolute coolness, otherwise he can- not do his best. There is little wonder that the busy surgeon must take frequent vacations otherwise he would snap under the strain. To physicians and surgeons the innermost life of the community is 38 , laid bare. The veneer and camouflage of society are torn aside, and the true Hfe of society as it actually is stands out in bold relief before him. Could any man except one with a heart of stone under such circumstances fail to develop to a large degree an unbounded synipath.y with mankind ? All surgeons have been small boys, and it is the exception to find, a lad who does not love animals and above all dogs. Well do I remember the mongrel dog that was my boon companion, just after I had learned to toddle around. The pranks of my large New Found- land dog, Ponto, will always linger in my memory. That splendid thorough-bred collie, Toby, was a delight to us all, but like some of his race he occasionally exhibited diabolical qualities, and like a flash would bite members of the family. In a moment his anger subsided, and for days he would in every way manifest his sor- row for the outburst. When it became necessary to put him to sleep on account of his being a menace to the neighbors there was a sadness in the family akin to the loss of one's very own. Late one warm July night in 1906, long after we had retired the door bell rang, and the expressman brought in a small crate. On opening the door of this a small, shaggy mite four weeks old and not over six inches long toddled out. At first he was very shy, but after drinking a saucer of milk became friendly In a few days he owned the house. He had the usual children's diseases, such as distemper and intestinal upsets, and in each of these was tenderly nursed. Like all young children, he manifested a tendency to run away, and on one occasion was missing for two days. Scotties are no beau- ties, and an advertisement for "an ugly-looking little black dog" brought him back promptly. When four or five years old he was des- perately ill, and we feared for his life. He was at once taken over to the Hunterian Laboratory — the dog hospital of the Johns Hopkins Medical School — and put under the care of the young surgeon in charge. Appropriate treatment was at once instituted, and when we left him there, those wistful and pleading eyes followed us to the door. No human being could have spoken more plainly. Next morning we went over to the hospital expecting to find him dead. Imagine our joy and surprise to see him running around the cage and wagging his tail furiously. One summer we went to Europe and he was put out to boird. On our return a. more seedy and bedraggled little animal could not be found. That settled it, he has his own trunk, and each year he travels with the family to the back woods of Canada where for two months he is continually busy in chasing chipmunks, digging holes and in locathig bones that he had buried in previous years. For a long period he and I lived alone, and each night he was faith- fully waiting for me at the head of the stairs, and each night he and I went for a walk before retiring. Sometimes, when an emergency op- 39 eration has detained me late into the night, our stroll has been deferred until 1 or 2 o'clock in the morning, but he never misses it when I am home. Killie is now nearly fourteen years old. He cannot climb as he once could, he has a cataract in one eye, and he is an old man, but he is still an inseparable member of the family and beloved by all. He has brought untold happiness to the household and is a most valued friend. As I write this he is lying at my feet. If one of my family were desperately ill, and if it were necessary to try some animal experiment with the hope of saving their life, and if it were impossible to secure another dog for the purpose, then 1 should with great reluctance be forced to operate on Killie. Physi- cians and surgeons in the past have not only risked but given their lives for their patients and will continue to do so in the future. We can well imagine the agony in the heart of Abraham when he was prepar- ing to offer up his son, Isaac, as a sacrifice. When considering the subject of vivisection I am continually re- minded of the woman who was visiting an asylum. In her curiosity she opened a door and saw a man riding a broomstick. Though some- what startled she said "I see you are riding a horse." The man replied, "No, it is a hobby, if it were a horse I could get off." We all have our hobbies, or should have them. It is the man or woman who has a hobby that accomplishes things, but in following out our hobbies let us view the subject from every standpoint, let us see if we are on the right track. In the Hunterian Laboratory at Hopkins and catching ones eye as he enters the building is a conspicuous list of rules which are and have been rigidly enforced for years. Among other rules is the following: "Any attendant who strikes a dog is to be discharged at once." Every precaution for the humane treatment of animals has been scrupulously observed. We should be as careful and considerate of animals as we are of people, but if by the experimentation on a few animals we can save many lives, is it not our duty to do so? Would you be willing to lose one of your dear ones rather than have the surgeon sacrifice a few dogs — you certainly would not when the acid test came What would you think of an apprentice carpenter being given valuable mahogany to work on. You would consider it absurd. He should practice on the cheapest kind of lumber until he has gained sufficient skill to handle adequately the rare and more costly woods. Human beings are the mahogany of surgery. Why is it that American surgeons when ill abroad and needing surgical operations, if possible, take the first boat for America? It is because they feel that they can get better surgical treatment in this country than anywhere else in the world. The wonderful advances in 40 American surgery have in no small measure been due to the careful and painstaking animal experiments carried on in the United States. The people of the world owe a tremendous debt to Louis Pasteur, to Joseph Lister and to the results of animal experimentation. Myri- ■ ads of useful men and women, now alive and well, would have lorrg since passed to their eternal resting place had it not been for the funda- mental discoveries of Pasteur and Lister, and for the new and better methods revealed to us by experiments on dogs. The citizens of the United States, when ill, rely absolutely on the judgment' of their surgeon and place themselves and their families under the care of these surgeons, knowing full well that they will receive the best possible surgical care. Such being the case, the public can with confidence rely on the surgeon to be careful, conscientious and humane in his experimentation on dogs, which is absolutely essen- tial to the continued advancement of this important branch and to Medicine as a whole. ACHIEVEMENTS OF ANIMAL EXPERIMENTATION IN GENERAL SURGERY. By George Tully Vaughan, M. D., LL. D., F. A. C. S. Professor of Surgery, Georgetotvn University. Man in the beginning was given control of all inferior animals for use, but not for abuse, and this right to use extends to confining the animals in captivity, making them work for him, and even taking their lives for any good and sufficient reason. Man gives his own life and often sustains great hardship and suf- fering in support of a worthy cause, or for the benefit of his kind ; then why should he hesitate to use the lower animals, who have been given into his keeping, for any worthy purpose ? I am as much opposed to cruelty in the true meaning of that word as the most violent and senseless antivivisectionist, but the use of ani- mals and their sacrifice at times even with sufifering, when done for the benefit of the human race, is not cruelty. I have read a number of attacks on all who believe in the prin- ciples I have just stated, and especially on the members of the medical profession, but the most remarkable and amusing of them all is a book by Stephen Coleridge. Stephen Coleridge, in his book entitled "Vivisection — A Heartless Science," 1916, feels it his duty to attack vivisection as he is a repre- sentative in the fourth generation from the one who wrote the "An- 41 cient Mariner," and modestly continues, "I may claim with some par- donable pride to have acquired my convictions from three generations of ancestors, whose title to distinction in the fields of law and letters cannot be gainsaid." After reading his book one is compelled to believe that however much he may know of "law and letters," his knowledge of physiology is woefully deficient. To select one from the numerous examples of erroneous deduction, ignorantly or wilfully made, read his criticism of certain experiments made on animals by keeping them continually under the influence of alcohol, as showing his idea of cruelty : "Surely it is time that all decent men and women in England raised their voices in solemn protest against these dreadful claims of physi- ology, claims that revolt the heart and shock the conscience." Coming from a man of such pride in his logic, education, and hereditary convictions, this hysterical outburst is surprising over a condition in which the animal is blissfully unconscious of worry and certainly free from all pain. The issue, he writes, is "whether vivisection as practiced is right, not whether it is useful to science." What sophistry — the killing of a man in the abstract is not right, yet it is universally conceded that circumstances often make it right. He attacks the support or aid of medical schools by hospitals, criticiz- ing Lord Lister's approval, and pays his respects especially to the affairs of St. Bartholomew's Hospital, conclusive evidence that he fails to see the benefit which the schools with their students and physicians bring to the hospital, and showing his prejudiced and distorted opinion of the medical profession. The deductions from Sir Victor Horsley's answers to questions by the Royal Commission on Vivisection are unfair and unwarranted ; the insinuation that men like Brunton, Powers, Schaefer, Morris, Swazey, Bruce, Osier and others obtained their honors by practicing or supporting what he regards as an infamous practice, is slanderous ; but the tribute to the leading lights of science in America, in the sug- gestion that asses' ears be grafted on the heads of the operators, is amusing, as "the idea instantly occurs to the reader that the head of the author would be much more appropriate for adornment with these emblems of unreasonable obstinacy and stupidity. To read the author's own account of how he has punctured the inflated arguments of his opponents with his irresistible .logic, marks him as a regular Boanerges in control of the lightning and thunder, and to oppose his judgment or opinion is to invite destruction. The charge of megalocephaly (bigheadedness) made against Sir Edward Schaefer is another instance of transferring one's own pecu- liarities to the shoulders of another. The entire tone of the book forces the conclusion that the author is a man whose self-conceit is colossal, whose skill in distorting language from its honest meaning to suit his 43 purpose is phenomenal, but whose faith in the integrity of those who differ with him is pitiable, and whose logic is ridiculous. Let us hear now some of truth and soberness : After the Royal Commission on Vivisection had concluded its sessions and the examina- tion of numerous advocates and opponents of vivisection, the Earl of Cromer, who might be regarded as an unprejudiced party, thus ex- presses his opinions : "I felt strongly that the vivisectionists and not their opponents were the true humanitarians. * * * The argument that the re- searches of the vivisectionists have been barren of results ought to be finally discarded by all save those who are not open to conviction. * * * The case of the antivivisectionists, when submitted to the test of cross-examination, broke down helplessly." A word now regarding some of the benefits we enjoy from animal experimentation. Seventy-five years ago little was known as to the exact relations between the anatomy and the functions of the brain, spinal cord and nerves. Watson in 1845 (Head) said: "The structure of the nervous system has no perceptible or understood subservience to its functions," and he believed that the brain was the seat of a sort of generalized function with no special centers. Now we know, thanks to the experi- ments of Ferrier, Hitzig, Sherrington, Greenbaum and others, on the brains of monkeys that every motion and sensation in the body has its center or little group of cells in the brain which control it, so that any stimulation or injury to that center in the brain is shown by a certain sensation or movement of the muscles of the part so controlled. It is an ordinary event now, in injury or disease of the brain for the surgeon by observing, for example, movements or paralysis of the muscles of the foot, hand, eye, mouth, etc., to know exactly in what part of the brain to look for the blood clot, tumor or whatever may be causing the trouble. This was illustrated in the case of a prominent presidential candi- date, when twitchings or paralysis began in one of his feet, the surgeon knew just where to look for the cause in the brain, namely, the center controlling that foot, so he opened the skull and found and removed a tumor. It was Charles Bell's experiments on a donkey about 1811 that established the difference in function between the fifth and seventh cranial nerves and thus enabled us to operate successfully on thousands of cases of neuralgia of the face. The surgery of the thyroid gland and the intelligent treatment of goitre was worked out by animal experimentation; even great anato- mists like Luschka having no appreciation of the f-unctions of the thyroid or parathyroid glands and their important relation to life and health. In the first operations sometimes all of the thyroid and para- thyroid glands were removed, when the patient either died in convul- 43 sions or lived a short, crippled life with bloated features, cold and thickened skin, intellectual stupidity, ending in imbecility. By investiga- tion on animals it was found that when all of the parathyroids were removed, the animal dies of tetany, so that now in surgical operations for goitre we are always careful to leave at least one parathyroid gland. Before removing the larynx for cancer in man, Czerny experi- mented on dogs and found that they survived the operation and con- tinued in good health and now it is an established life-saving opera- tion for man. Likewise Simon in 1869, before removing a kidney from man, established the fact that dogs survived the loss of one kidney without any detriment to their health, and that is now a very common opera- tion for malignant tumors, tuberculosis, abscess, stone, etc., and the man lives and enjoys life seemingly as well off with one kidney as with two. In 1867 Oilier proved by experiments on animals that bone or periosteum would live and grow and make new bone if transplanted from one part to another of the same animal, or if transplanted from one animal to another animal. From the knowledge obtained in this manner have come the numerous and wonderful operations on bones. In older times surgeons could make a new nose (for one whose nose had been destroyed) by turning a flap down from his forehead or getting a flap from his arm, but it was a soft, mushy nose. Now, when this is necessary, we transplant a piece of bone to stiffen the soft parts, obtained from the outer table of the skull, from the end of a finger or from one of the ribs. Parts of the skull are sometimes destroyed by wounds leaving the brain covered only by the soft parts which may cause fits or lead too easily to injury to the brain. These defects in the skull are filled in now, not by silver or celluloid plates, as was formerly done, but by bone obtained by splitting off a piece of the outside table of the skull near the defect or by cartilage obtained from the ends of the patient's ribs. A long bone partially destroyed may have the gap filled in by transplanting a fragment from some bone large enough to spare it — placing and fixing the fragment between the ends of the two fragments and holding it in place until union occurs. Where the thumb has been lost or all the fingers, a substitute for the thumb for the fingers to press against, or a substitute for the fingers for the thumb to press against, has been made by transplant- ing a suitable bone or fragment and fixing it in its new position. For the treatment of tuberculosis of the spine, which leads to hunchback, a fragment taken from the larger bone in the leg is transplanted into the part of the spine which is diseased in order to hold the parts at rest until cure takes place and prevent the deformity of hunchback. Even entire joints, as the knee, have been transplanted success- fully — the diseased joint is cut out and a healthy joint of proper size from a recently amputated limb is fixed in its place until union occurs. 44 Metchnikoff in 1903 inoculated apes with syphilis, and in 1905 . Schaudin and Hoffmann discovered the germ of the disease. A few years later, in 1910, Ehrlich discovered his famous 606, or salvarsan, ■ after 605 other remedies had been tried unsuccessfully. In 1876 Gussenbauer and Winiwarter experimented on dogs' stomachs and were surprised and pleased to find after cutting out pieces and sewing them together that the parts united and grew together as kindly as do wounds of the skin, instead of being digested or destroyed by the gastric juice as was the common belief. In 1861 Billroth did the first successful pylorectomy (excision of a portion of the stomach) on the human being. In 1881 few surgeons were bold enough to open the abdomen even for the treatment of gun- shot wounds. Then it was that Parkes, at Chicago, experimented on thirty-seven dogs by. shooting them through the bowels while etherized, then operating on the wounds and proved that opening the abdomen and sewing up the bullet holes was the best method of treatment. This has led to the saving of thousands of lives, and the surgeon of today who fails to operate in such cases would be negligent of his duty. Not only do we operate for wounds of the stomach and bowels, but for many diseases, such as cancer and ulcer. A portion of the stomach containing the cancer is cut out and the ends sewed together, or the ends may be closed by stitches and a new opening made between the stomach and the bowel. When the disease is so far advanced that removal is impossible, the stomach or the bowel above, and the bowel below the disease, which causes obstruction are united, "short circuited" as it is called, so that the obstruction is relieved and the patient's life prolonged and made more comfortable. It was also found that the entire; stomach could be removed and the patient live. Schlatter at Zurich, Switzerland, did the first successful complete removal of the stomach in 1897, and the patient lived about one year, dying of a return of the disease (cancer) in some other form. Since then the operation has been done many times with go'od results. Forty years ago no one had dared to operate on a human heart. If it was penetrated by a knife or bullet, the patient was permitted to die without any interference on the pai't of the surgeon. Even with this method of no treatment some patients recovered, and in 1867 Fischer published a list of 456 wounds of the heart with an estimated recovery of 5 to 10 per cent ; but as- no operation was done, it is prob- able that most of the recoveries were in those in whom the heart had not been wounded, and it would be nearer correct to assume that recov- eries from penetrating wounds of the heart treated by the "watchful waiting" plan would not exceed 5 per cent. In 1895 Rosenthal and Del Vacchio made a number of experiments on dogs and found that they could be cured when the heart was wounded by opening the chest and sewing up the wound in the heart. The next year Farina, of Rome, sewed up a wound in the heart of a 45 man, and the man lived six days and died of pneumonia. During the same year Rehn performed the first completely successful operation of sewing up a wound in the heart. Twelve years ago (1908) I col- lected 150 cases in which wounds of the heart had been sewed up and 35 per cent (52) of the patients recovered — a gain of about 30 per cent over the do-nothing method. Since that time many other patients with wounds of the heart have been saved by operation. All of us hope to see the time when diseases of the heart can be operated on and cured in the same way. In diseases of the heart, the valves often become too small, or the natural openings by which one chamber opens into another or into the great blood vessels, become too large or too small, so a leak occurs. Carrel and his co-laborers at the Rockefeller Institute have demon- strated the fact that in dogs the valves in the heart and the natural openings can be sewed up, enlarged, or reduced in size without killing the animal. In the same way large blood vessels which have been wounded have been preserved by sewing up the wounds, or where they have been divided by sewing the ends together, or where much of the vessel has been destroyed, by transferring a piece of another ves- sel which can be spared to take the place of the portion which has been 'destroyed. In several cases one lobe (that is nearly half) of one lung has been successfully removed, and in one case Lilienthal removed almost the entire lung with recovery of the patient. I cannot do better in closing than to quote the words of Dr. W. W. Keen, the Nestor of American surgery, in comparing the achievements of the friends of experimentation with the achievements of its oppo- nents. Under Experiaientation. "1. They have discovered and developed the antiseptic method, and so have made possible all the wonderful results of modern surgery. "2. They have made possible practically all modern abdominal surgery, including operations on the stomach, intestines, appendix, liver, gallbladder, pancreas, spleen, kidneys, etc. "3. They have made possible all the modern surgery of the brain. "4. They have recentty made possible a new surgery of the chest, including the surgery of the heart, lungs, aorta, oesophagus, etc. "5. They have almost entirely abolished lockjaw, after operations, and even after accidents. "6. They have reduced the deathrate after compound fractures from two out of three ; i. e., 66 in a hundred to less than 1 in a hundred. "7. They have reduced the deathrate of ovariotomy from 2 out of 3 or 66 in a hundred to 2 or 3 out of a hundred. "8. They have made the deathrate after operations like hernia, amputation of the breast, and of most tumors a negligible factor. 46 "9. They have abohshed yellow fever — a wonderful triumph. "10. They have enormously diminished the ravages of the deadly malaria, and its abolition is only a matter of time. "11. They have reduced the deathrate of hydrophobia from 12 to 14 per cent of persons bitten to 0.77 per cent. "13. They have devised a method of direct transfusion of blood which has already saved many lives. "13. They have cut down the deathrate in diphtheria all over the civilized world. In 19 European and American cities it has fallen from 79.9 per hundred thousand of population in 1894, when the anti- toxin treatment was begun, to 19 deaths per hundred thousand in 1905 — less than one-quarter of the deathrate before the introduction of the antitoxin. "14. They have reduced the mortality of the epidemic form of cerebro-spinal meningitis from 75 or even 90-odd per cent to 20 per cent and less. "15. They have made operating for goitre almost perfectly safe. "16. They have assisted in cutting down the death rate of tuber- culosis by from 30 to 50 percent, for Koch's discovery of the tubercle bacillus is the cornerstone of all our modern sanitary achievements. "17. In the British Army and Navy they have abolished Malta fever, which, in 1905, before their researches, attacked nearly 1,300 soldiers and sailors. In 1907 there were in the army only 11 cases; in 1908, 5 cases ; in 1909, 1 case. "18. They have almost abolished childbed fever, the chief former peril of maternity, and have reduced its mortality from 5 or 10 up even to 57 in every hundred mothers to 1 in 1,250 mothers. "19. They have very recently discovered a remedy which bids fair to protect innocent wives and unborn children, besides many others in the community at large, from the horrible curse of syphilis. "20. They have discovered a vaccine against typhoid fever, which among soldiers in camps has totally abolished typhoid fever, as Presi- dent Taft has so recently and so convincingly stated. The improved sanitation which has helped to do this is itself largely the result of bacteriologic experimentation. "21. They are gradually nearing the discovery of the cause, and then we hope of the cure, of those dreadful scourges of humanity, cancer, infantile paralysis and other children's diseases. Who that loves his fellow creatures would dare to stay the hands of the inen who may lift the curse of infantile paralysis, scarlet fever, and measles from our children and of cancer from the whole race? If there be such cruel creatures, enemies of our children and of humanity, let them stand up and be counted. "22. As Sir Frederick Treves has stated, it has been by experi- ments on animals that our knowledge of the pathology, methods of 47 transmission, and the means of treatment of the fatal 'sleeping sick- ness' has been obtained and is being increased. "33. They have enormously benefited animals by discovering the causes and, in many cases, the means of preventing tuberculosis, rin- derpest, anthrax, glanders, hog cholera, chicken cholera, lumpy jaw, and other diseases of animals, some of which also attack man. If suf- fering dumb creatures could but speak, they, too, would pray that this good work should still continue unhindered." On the other hand, what have the foes of experimentation achieved ? "1. Not a single human life has been saved by their efforts. "2. Not a single beneficent discovery has been made by them. "3. Not a single disease has been abated or abolished by them, either in animals or man. "4. All that they have done is to resist progress — to spend S-500,- 000 in 30 years in Great Britain alone, and very large amounts of money in the United States — and to conduct a campaign of abuse and gross misrepresentation. "5. They apparently care little or nothing for the continued suf- fering and death of human beings, the grief and not seldom the ensuing poverty of their families, provided that 26 out of every 1,000 dogs and cats, monkeys and guinea pigs, mice and frogs experimented on shall escape some physical suffering. "6. They insist, therefore, that all experimental research on ani- mals shall stop, and — astounding cruelty — that thousands of human beings shall continue year after year to sufTer and to die." ACHIEVEMENTS OF THE MEDICAL CORPS OF THE ARMY IN PREVENTIVE MEDICINE. A VINDICATION OF ANIMAL EXPERIMENTATION. By George B. Foster, Jr., M. D., Dr. P. H. Major, Medical Corps, U. S. Army. I have been asked to discuss animal experimentation in its relation to the advances that have been made in preventive medicine through the work of military surgeons. It is not my intention to approach this subject in a controversial way, as I feel that the scientific achievements of the Medical Corps of the Army ofifer, in themselves, an argument that is incontrovertible. 1 shall endeavor to outline briefly two of the more important problems that have been solved, leaving entirely to your judgment the question as to whether they have contributed to the safety, happiness, and pros- perity of mankind. 4-8 In considering the relation that animal experimentation— and lab- . oratory methods in general — bears to great sanitary triumphs, one must remember that no great achievement has been the work of one man or of one institution. To Marshal Foch has been attributed the remark that "battles are won with scraps." This applies equally in the field of preventive medicine. Magendie, the great French physiologist,' likened himself to a chiffonier — a rag-picker — wandering through the realms of science, picking up fragments of knowledge, piecing them together and applying them to his own problems as he went along. Many times the observations of clinicians at the bedside or of epi- demiologists in the field furnish the clue that leads to some epoch- making discovery in the laboratory ; while, au contraire, in innumerable instances the truths elucidated in laboratories, applied practically by sanitarians and clinicians, have resulted in the conquest of disease. Now let us see what has been accomplished. Typhoid Fever. The great scourge of armies during the nineteenth century was typhoid fever. At the beginning of the Franco-Prussian War, the infection existed in every corps of the German Army and was epidemic in at least one division. After mobilization the disease spread like wild-fire, especially among the troops besieging Metz and Paris. Within two months after mobilization typhoid had spread so rapidly among some of the German troops that one man out of every six was sick of this disease. The total cases of typhoid in the German Army during that vvar was 73,396, or nearly 10 per cent of the average strength. In the Afghan War of 1878-80 typhoid fever developed at nearly every station occupied by British troops, although some of these re- gions were practical^ uninhabited. During the Oran campaign, in 1885, the French troops camped in desert stations never before occupied, and yet typhoid fever not only occurred, but the outbreaks assumed the proportions of alarming epidemics. Many similar instances might be cited where troops were furnished drinking water of unimpeachable quality and occupied ideal cainp sites that could not possibly have been typhoid polluted previously, yet typhoid invariably occurred. The only explanation of such outbreaks is that an army carries its typhoid with it in the form of mild undetected cases, or of the so-called "healthy carriers" of the disease — individuals who have had typhoid and recovered, but who still harbor and excrete from their intestinal tracts virulent typhoid germs capable of infecting others. The infec- tion is then passed on from man to man by direct or through some in- termediary — the usual intermediaries being, as we now know, "food, fintjers and flies." In our Civil War the army suffered severely from typhoid, espe- cially the Army of the Potomac. In the four years between July 1, 1862, and June 30, 1866, there were 57,400 cases, resulting in 5,360 deaths. Another tragic page in medical history is that of typhoid fever in the Spanish War. Every regiment constituting the First, Second, Third, Fourth, Fifth and Seventh Army Corps developed the disease. More than 90 per cent of the volunteer regiments were heavily infected within eight weeks after going into camp. Typhoid was almost equally prevalent in some of the regular regiments. The disease occurred in small camps as well as large, and in the north as well as in the south. There were 20,738 cases in a little army of 107,973 men ; nearly one- fifth of the army contracting the disease. The toll paid to typhoid in that war was 1,580 lives, or 86 per cent of the mortality from all causes. Had the war been a real one with a powerful enemy at our doors, military effort would have been largely frustrated, we would have been subjected to invasion and perhaps ultimately to defeat. Remembering that what has just been said applies to armies in the pre-vaccination days, let us pass on for a moment to a brief considera- tion of the development of preventive inoculation against typhoid fever. From the discovery of the typhoid bacillus in 1880, and its suc- cessful cultivation in artificial media by Gaffky, a Prussian army sur- geon, in 1884, the investigation of methods for the control of typhoid fever have been greatly advanced by the work of army surgeons ; the whole matter of protective inoculation — experimental and applied — having been elucidated for the most part in armies. Widal, a French army surgeon, working with Chantemesse in 1888, first demonstrated that white mice could be made immune to the pathogenic effects of the typhoid bacillus by previously inoculating them beneath the skin with sterilized cultures. Incidentally, while conduct- ing these experiments, Widal discovered the phenomenon of aggluti- nation of bacteria in immune serum — a reaction now bearing his name and of great value in the laboratory diagnosis of typhoid and other diseases. Carrying further the work of Widal, Sir Almroth Wright, of Dub- lin, Ireland, a British Army officer and professor of pathology at the Army Medical School at Netley, after much preliminary experimental work on laboratory animals, demonstrated for the first time, in 1896-97, through the results obtained in the experimental inoculation of over 3,000 soldiers in India, that vaccination of man was practicable. Dur- ing the following three years the lessons were applied practically in the preventive inoculation of the British troops in South Africa. In 1909, preventive inoculation against typhoid was introduced in our army by Major (now Colonel) F. F. Russell, Medical Corps. He went to Europe, studiously investigated the French, British and Ger- man methods in vogue at the time, and, returning to the Army Medical 50 School in this city, organized and established a vaccine laboratory, in which all the vaccine since used by our army has been prepared. Each batch of this vaccine is carefully tested for sterility by injection into mice, and its immunizing properties are ascertained by the inoculation, of rabbits. These animals are indispensable to the standardization of the vaccine. At the beginning vaccination was voluntary — the first volunteers being officers and enlisted men of the Medical Department — and only a part of the entire army was vaccinated during this period. It was first made compulsory for the 20,000 men mobilized as the Maneuver Division at San Antonio, Texas, in the spring of 1911. During the months that these 20,000 men lived under war conditions there were but two cases of typhoid fever among them — one occurring in a non- . vaccinated civilian teamster and the other in a Hospital Corpsman, who confessed to me while ill that he had only received one of the three inoculations prescribed, and that he had evaded the remaining two by falsifying the records. Following this conclusive demonstration of the efficacy of protective inoculation the procedure was made compulsory for the entire army in 1912. In 1909 there were 173 cases of typhoid in the army, while in 1912, the first year that inoculation became uni- versally compulsory, the statistics dropped to nine cases with a single death. The peace-time army from then on remained practically free from typhoid. Now we come to the recent World War. Let us consider the statistics of the American Army, now protected by anti-typhoid vacci- nation. Prefacing these statistics, however, I desire to bring home the fact that, with the exception that these troops had been immunized by protective inoculation, conditions favoring the development of typhoid were exceedingly comparable to those existing in the Spanish War. The army was composed almost entirely of troops hastily drafted from civil pursuits- — comparable to the volunteers of 1898 — and the citizeh soldiers of the National Guard. They were hastily mobilized and sent to camps, many of which geographically were in close proximity to the plague spots of '98, and in many instances adequate sanitary ar- rangements had not been completed before the arrival of troops. That portion of the army that subsequently went to France suf- fered great overcrowding for many days in improvised transports, and, upon arrival at ports of debarkation, were herded into box cars and rushed to the front. The earlier troops, during the fall of 1917 and winter of 1917-18, were billeted in insanitary surroundings, the condition of which can be appreciated only by those who were there. I remember the very amusing incident of a French peasant woman in- dignantly demanding that the American soldiers billeted in her barn be removed as they talked at night and kept the sheep awake. The proximity of outhouses to water supplies may be imagined from the request made by the peasants in another locality that the Americans 51 interdict the use of disinfectants in their latrines as this procedure imparted a disagreeable taste to their drinking water. The conditions in the trenches would have been a sanitary re- proach had it been possible to correct them. Later, as trench warfare developed into open battles of- movement, the troops at times lived under sanitary conditions that are indescribable. At Chateau-Thierry, for example, our troops moved into territory just evacuated by the retreating Germans that were nasty beyond description — dead bodies, dead horses, pools of feces and myriads of flies. In the Argonne, transportation difficulties, the nature of the terrain, and the dispersion of troops often made it impossible to furnish properly treated water at all times, and the troops drank from stagnant pook, collections of water in shell holes and whatnot. Nor were the troops stationed in towns in the rear free from danger of infection. Systematic bacteriological exanimation of the water supplies in various parts of France showed that over 80 per cent of these were polluted and not fit for drinking purposes without pre- vious chlorination or boiling. In many instances the water was veritable sewage and could not be used even after treatment. Yet, during the two years of the World War, in which approxi- mately 4,000,000 men served in the Army, half of whom saw service in France, there were but 1,065 cases of typhoid fever. In the Spanish War there occurred one case of typhoid among each six men ; in this war one case in every 3,756 men. The official statistics of the Sur- geon General's Office for the period September 1, 1917, to May 2, 1919, show that there were but 213 deaths from this disease. Had the death rates of the Spanish War prevailed, 51,133 deaths would have occurred, and had the Civil War rates applied, 68,164 lives would have been sacrificed. We of the Army Aledical Corps are thrilled with pride at this achievement of one of our colleagues. The mothers, wives, sisters and sweethearts of the 50,000 men whose lives were saved by anti- typhoid vaccination should breathe a prayer thanking God that there was a Russell — and animal experimentation. These are the results of preventive inoculation against typhoid fever. I ask you, do they compensate for the lives of the laboratory animals sacrificed experimentally in perfecting this procedure ? Yellow Fever. Perhaps the most spectacular achievement of the Medical Corps of the Army is the epoch-making discovery of the transmission of yellow fever by the mosquito. Yellow fever, peculiarly a disease of the American continent, is one of the most fatal to which the human race is subject. The early colonists suft"ered severely from this disease, and it had an important bearing upon colonization in the Western Hemisphere. Its ravages in tropical America made this section a veritable plague spot for white . men, resulting in the settlement and development of the temperate regions rather than the tropics. Untold agricultural and mineral; wealth was diverted from the world's markets for 1-50 years by this grim reaper of human lives. As Vaughan so graphically states, "A certain dread and romance attaches to its history." Formerly the disease existed perpetually in Havana, and from there it made frequent devastating incursions into the United States. Outbreaks occurred along the eastern seaboard as far north as Boston. It wrought its greatest havoc, however, in the Southern cities, where, during the great epidemic of 1878 — only 43 years ago — 16,000 persons died, and the economic loss was estimated at $100,000,000. This catastrophe focused public attention for a time and resulted in the birth of a National Board of Health to protect the United States from another invasion. As most of the epidemics that had visited the United States were imported from Havana, it was evident to sanitarians that great pro- tection would be afiforded the United States were it possible to eradi- cate yellow fever at its source. The opportunity so long desired arrived when Havana came into our possession in 1898. At this time nothing was definitely known as to the cause of yellow fever, or the means of its transmission. Sanarelli, an Italian doctor, had just announced the discovery of an organism which he called Bacillus icteroides, and he claimed it as the specific cause of this disease. Immediately keen interest was evinced in this discovery, and General George M. Sternberg, Surgeon General of the Army, him- self a pioneer investigator in yellow fever, who had paved the way for subsequent workers, appointed an Army Board, consisting- of Maj. Walter Reed and Dr. James Carroll, to investigate and report upon the relation of bacillus icteroides to yellow fever. This was in 1897. Reed and Carroll, through numerous experiments on swine and other animals, proved conclusively that Sanarelli's bacillus is a variety of the common hog cholera bacillus and has nothing to do with yellow fever. In 1899, when yellow fever appeared among the American troops stationed in Havana, Reed and Carroll again, with Drs. J. W. Lazear and Aristides Agramonte, constituted a commission sent to Cuba to investigate its cause and transmission. Shortly after arrival Reed was afforded an opportunity to study an epidemic of yellow fever among our troops at Pinar del Rio, and he became convinced, through his observations there, that the theory then governing all preventive measures, that transmission occurred through infected utensils, clothing, bedding, etc., was erroneous. He determined to give up, for the time being, further search for the spe- cific cause of the disease and to devote all his efiforts to the immediate 53 pressing need of the elucidation of the means of transmission in order that effectual preventive measures might be instituted. The belief that the disease was transmitted by mosquitoes, ex- pressed by Dr. Carlos Finlay, of Havana, nearly twenty years before, appealed to Reed as the most logical theory to investigate. The only way of proving or disproving this theory was to permit infected mos- quitoes to bite susceptible persons as laboratory animals were thought to be immune. After weighing the terrible responsibility of carrying out such experiments on human beings, the commission decided that if they succeeded in transmitting the disease experimentally through mosquitoes, the benefit to humanity would justify the hazard. They agreed, however, that in justice and fairness they themselves should be included among the volunteers. Female mosquitoes of the variety known as stegomyia fasciata were obtained from Dr. Finlay, infected by feeding on patients acutely ill with yellow fever, and then applied to the volunteers. The first experiments were carried out by Lazear as Reed had been recalled temporarily to the United States. Lazear's first atteinpt to infect himself was unsuccessful. Later he was bitten by a mosquito while collecting blood from a patient in a yellow fever ward, and he purposely jjermitted the mosquito to take his fill. Several days later he became ill of yellow fever and died. In the meantime Lazear had applied infected mosquitoes to Carroll, and this resulted in the first successful experimental inoculation. It can best be described in the words of Carroll himself : "The insect, which had been hatched and reared in the laboratory, had been caused to feed upon four cases of yellow fever, two of them severe and two mild. The first patient, a severe case, was bitten twelve days before, the second, third and fourth patients had been bitten six, four and two days previously, and their attacks were mild, severe and mild, respectively. In writing to Dr. Reed on the night after the incident, I remarked jokingly that if there were anything in the mos- quito theory I should have a good dose ; and so it happened. After having slight premonitory symptoms for two days, I was taken sick on August 31, and on September 1, I was carried to the yellow fever camp. My life was in the balance for three days, and my chart shows that on the fifth, sixth and seventh days my urine contained eight-tenths and nine-tenths of moist albumin. On the day that I was taken sick, August 31, 1900, Dr. Lazear applied the same mosquito, with three others, to another individual who suffered a comparatively mild attack, and was well before I left my bed. Thus it happened that I was the first person to whom the mosquito was proved to convey the disease. On the eighteenth day of September, five days after I was permitted to leave my bed. Dr. Lazear was stricken and died in convulsions jusf one week later, after several days of delirium with black vomit. Such is yellow fever." This experiment on Dr. Carroll was followed by eleven others, nine of which were negative and two positive, and, upon this evidence' Reed felt justified in pronouncing, without hesitatiton, that "the mos- quito acts as the intermediate host for the parasite of yellow fever."- " The experiments did not stop here, however. The idea of mos- quito transmission was contrary to what a great many men believed, and it aroused a storm of adverse comment and criticism. Reed and his colleagues decided, therefore, to repeat and simplify the experiments under conditions that would leave no doubt as to their conclusiveness. They established an experimental station, a mile removed from the nearest habitations, and surrounded it with an armed guard. No intercourse was permitted with the town except through an immune ambulance driver and an immune hospital steward who transported supplies from Camp Columbia. The personnel and such susceptible individuals as were admitted for experimentation were sheltered in tents placed twenty feet apart. This station was named Camp Lazear. A small frame building was built, 14 x 20 feet, so screened with- wire netting that mosquitoes could not get in or out. The interior of the building was divided into two compartments by a partition made of wire netting running down the center. Two susceptible persons were put in this building — one in each compartment. Breathing the same air and subjected in every way to the same conditions ; biit entirely separated by the wire netting, they lived and slept in these compart- ments for several days to show that there was no yellow fever infection in the building. Reed then put fifteen infected mosquitoes in one of the compartments, left a man in the compartment for thirty minutes, and announced that this compartment was now infected. He took the man out of this infected compartment, but left two men in the compart- ment on the other side of the wire netting. The man from the infected compartment returned for twenty minutes in the afternoon of the same days, and again, for fifteen minutes on the following day. During these three visits he was bitten by mosquitoes fifteen times. At the end of the fourth day the man from the infected compartment was down with yellow fever and the two men who had remained in the other compartment separated only by the wire netting and breathing the same air, were perfectly well. Reed then announced that he would disinfect the infected com- partment simply by catching and removing the fifteen mosquitoes. Following the removal of the infected mosquitoes a nonimmune soldier was again placed in each compartment, left there several days and they remained perfectly well. Although the experiment created a profound impression and the skeptics now admitted that the disease could be transmitted by the mosquito, they still maintained' that it could be, and generally was transmitted in other ways, such as by soiled clothing, bedding, and by contact with persons sick with the disease, etc. Reed then had constructed another small building that was almost air-tight — practically devoid of ventilation. In this building he placed material from the yellow fever hospital at Las Animas — mattresses on which yellow fever patients had died, sheets, pillows and pillow cases liberally smeared with black vomit, excreta and discharges ; and even the pajamas worn by yellow fever patients throughout their illnesses. This material was opened up and spread out in this close room, and Reed asked for volunteers to sleep in the room. Dr. R. P. Cook, of the Army, and several soldiers responded. These men wore the paja- mas mentioned and slept on the bedding for twenty. consecutive nights. All the men remained well — not a single case of yellow fever developed from this exposure. This demonstrated, once and for all, the fallacy of the filth or fomites theory of the transmission of yellow fever. The experiments were generally accepted as proving beyond question that yellow fever is conveyed from man to man by the mosquito alone and in no other way. The Board conducted further experiments demonstrating that the virus of yellow fever exists in the patient's blood only during the first three days of the disease ; that the virus is ultramicroscopic, being capable of passing through a porcelain filter that holds back ordinary bacteria, and that it is killed by a temperature of 55° C. in ten minutes. They also showed that the female mosquito, only, can convey the dis- ease ; that after biting an infected person a period of twelve to twenty days must elapse before the mosquito is capable of transmitting it to another; and that following the bite another period of from three to six days elapses before the patient develops the disease. These experiments are the foundation upon which all sanitary campaigns against yellow fever are now based. Let us now consider what they have done for humanity. ■ For nearly two years prior to the conclusion of Reed's experi- ments the Army had been in entire control of sanitary- affairs in Ha- vana. Our cleverest sanitarians, among them Victor C. Vaughan, of the University of Michigan, probably the foremost American epidemi- ologist, had failed dismally in controlling yellow fever by means of methods based on the filth theory of disease. Following Reed's demonstration that the disease is transmitted solely by the mosquito, the sanitarians paid no more attention to fomites, but proceeded to apply practically Reed's experimental evi- dence in the following ways: (1) A strict quarantine was established to keep infected persons from entering the city. (2) A daily inspec- tion of all nonimmune persons was made in order to detect new cases during the first three days of the disease — the only period, you will remember, during which the virus is in the blood. (3) All persons sick of yellow fever were immediately screened and isolated so that mosquitoes could not bite them. (4) A vigorous antimosquito .cam- paign was instituted aiming at the destruction of all mosquitoes — kill- 56 ing the insects in habitations by wholesale fumigation and energeti- cally searching out and doing away with their breeding places. Considerable effort, anxiety and experimentation were extended in perfecting the methods, but on September 26, 1901, seven months! after the; institution of these methods, the last case of yellow fever occurred, and Havana was free from this disease for the first time in 140 years. During that 140 years not a single month had passed with- out a death from yellow fever, nor had there passed a day in which there had not been some person sick of yellow fever within the city. Conquest of Yellow Fever in Panama. Soon after the conquest of yellow fever in Havana, our Govern- ment began outlining plans for one of the greatest, if not the greatest engineering project in history — namely, the construction of the Pana- ma Canal. Early in 1902, while still stationed in Havana, where he had di- rected the sanitary work that had rid the city of yellow fever, Major (now Ala j or General, retired and recently Surgeon General) William C. Gorgas, of the Medical Corps, invited General Sternberg's attention to the enormous loss of life from tropical diseases that had occurred among the French while working at Panama ; emphasized the fact that these fatalities had resulted for the most part from yellow fever and malaria; apd suggested that the methods that had been so effective in Havana, if carried out in Panama, would greatly reduce the mortality that might be anticipated among American workers on the Isthmus. General Sternberg concurred in this opinion and recommended that Major Gorgas, on account of his previous experience in Havana, be placed in charge of the sanitary work in Panama. The contemplated route of the Panama Canal lay through a low, swampy, densely vegetated country, alternating with rugged moun- tainous regions, where the rainfall was excessive and yellow fever and malaria prevailed to an alarming extent. The French attempt, in the eighties, to unite the waters of the Atlantic and Pacific by this isthmian route, although directed by one of the greatest engineering geniuses of all time — Ferdinand de Les- seps — had to be given up because of the enormous price paid in human lives. The French lost 22,189 laborers by death and sunk millions of dollars. It is said that the price paid in building the old Panama rail- road was a human life for each tie laid. One of the towns on this railroad was named Matachin, from the Spanish words meaning "dead chinaman," because a thousand imported Chinese laborers and a thousand African negroes laid down their lives at this point in six months. Colon at one end of the canal was a veritable white man's graveyard ; while the town of Panama at the other end bore the un- savory reputation ■ of being the plague spot of the universe. There 57 was poverty, there was vice, there was every noisome thing that crawls and creeps. There were pestilences, and the greatest of these were yellow fever and malaria — another mosquito-borne disease. Then came Gorgas with his trained corps of sanitarians — fresh from their victory in Havana. The story of the sanitation of Panama under the administrative direction of Gorgas is a long one, and I shall not bore you with details. Suffice is to state that by instituting sani- tary measures similar to those used in Havana — destroying mosquitoes, making habitations and hospitals mosquito-proof by screening, isolat- ing all suspected cases of yellow fever and malaria, removing under- brush, filling and obliterating stagnant pools and swamps, paving and guttering streets, and installing sanitary water supplies and sewerage systems, Gorgas entirely eradicated yellow fever within a year, and there has not been a single case of this disease in the Canal Zone since May, 1906. Coincidentally with the disappearance of yellow fever there was a drop in the incidence of malaria. At the beginning of this great sanitary campaign 800 cases of malaria occurred annually in each thousand workers. By 1913 the rate had been reduced to 76 per thou- sand. The general annual death rate in the Canal Zone from all dis- eases at the present time is about 20 per thousand — a figure comparing very favorably with that of New York or Washington. The work of Gorgas alone made possible the building of the Panama Canal. But this is not the greatest benefit derived from that tremendous task, so spectacularly and effectively accomplished. By salvaging the Isthmus of Panama through sanitation the great lesson learned is that the tropics can be made as habitable for white men as the temperate zone. How different would have been the history of the Americas had it been learned 300 years earlier. In contemplating this^^the greatest achievement of modern times — let us not forget Walter Reed — and experimentation. The triumphs over typhoid and yellow fevers have not been the only scientific achievements of the Medical Corps of the Army. Did the time allotted to me permit I would tell you of the work of Stern- berg, the first American bacteriologist, discoverer of the diplococcus of pneumonia, pioneer worker in yellow fever, author of important treatises on infection, immunity and disinfection, founder of the Army Medical School, and a former surgeon general of the Army ; of the demonstration by Ashburn and Craig that dengue fever is due to a filterable virus and that it is transmitted by the mosquito and amenable to prevention by the methods successfully used in malaria and yellow fever ; and of the work of Chamberlain and Vedder, who, by experi- ments on fowls, disarmed the tropical disease beri-beri — tearing from it its mysticism, robbing it of its terrors and placing it in the category of curable as well as preventable diseases. The conquest of hook-worm disease in Porto Rico, work based largely on the demonstration by experiments on animals that the para- 58 site enters the body through the skin, is the work of Bailey K. Ashford, a medical officer of the Army and a graduate of your own university — Georgetown. Many other instances might be enumerated of scientific endeavor redounding to the benefit of humanity. Those cited, however, should be sufficient to show that all advances in preventive medicine have their basis in experimentation — on animals as a rule, but on men when necessary and justifiable. Without animal experimentation we must inevitably stagnate, and many pressing questions as to the cause and prevention of devastating epidemics of transmissible diseases — influenza is one of these — must remain unanswered. I submit to you — shall animal experimentation be prohibited or no ? THE LABORATORY WORK OF THE UNITED STATES PUBLIC HEALTH SERVICE. By A. AI. Stimson, Surgeon, U.S. P. H. S. Assistant Director, Hygienic Laboratory, Washington, D. C. In an attempt to familiarize you with some of the laboratory re- searches of the U. S. Public Health Service, I find it necessary to select certain illustrative examples from an almost endless list. The Public Health Service did not launch into existence, on any definite date, save in name. Its development was gradual. From time to time as the emergency arose, Congress assigned it new duties and granted it fur- ther power. The purpose of the Service in general may be stated to be the promotion of public welfare by conserving and improving the health of the inhabitants of the country. In order to carry out intel- ligently and efficiently the duties laid upon it by law, the Service has had to engage in a great deal of laboratory work. In the course of this work it has been absolutely essential to use the lower animals. Before taking up in detail a discussion of the particular functions of the Service, it is necessary to make clear what is meant by "the experimental method." If we review the works of the ancients, we find that there was no lack of intellectual acumen among them ; in literature and in the arts they give abundant evidence of high mental powers. Why was it, then, that in matters of science they made very little) progress, and that for centuries medical science especially was in a state of almost complete stagnation ? The difference, I believe, is readily traceable to the lack of proper methods. Just as in mathe- 59 matics the lack of the calculus prevented the solution of a certain math- ematical problem, so in the physical sciences the lack of the experi- mental method effectually barred the door to progress. We can easily imagine that primitive man was satisfied with the explanation of a thunderstorm that it was due to a combat between devils fighting above the clouds. His explanation of disease was akin to this with the one exception that the conflict was limited to his own interior. In ancient India the Brahmins have accumulated some very interesting anatomical information ; for example, they stated that in the human body there are 100,000 vessels, each divided into seven tubes, which carry ten different kinds of gases to all portions of the body. Moreover, the origin of the pulse they located in the abdomen ; it was said to be two hands high and three hands wide, and from it little tubes radiate to all parts of the body. When Greece was in her prime her philosophers had elab- orated a most intricate system of medical doctrine ; indeed, their theo- ries curried favor far down into the period following the Rennaissance. Disease was due to the conflict of various humors and spirits which cir- culated throughout the body. It will be noted that all of the philos- ophers up to this time had approached disease from a purely theoreti- cal standpoint. Investigation on the body by dissection and experi- ment had been resorted to very rarely and very superficially, and the practical knowledge of the prevention and cure of disease was, to all purposes, negligible. Let us contrast this mode of introspective philosophy with the method used by William Harvey, discover of the circulation of the blood. This great scientist, who was one of the earliest to use the experimental method in its perfection, actually dissected the body of man and of the lower animals ; he conducted experiments on the living bodies of animals, and only after he had carried on his investigations for more than ten years did he venture to make public the results. These findings were so at variance with the accepted doctrines which had been handed down from the Greeks that Harvey was derided and maligned, but it is gratifying to note that within his own lifetime his views were accepted and his practices emulated. The remarkable progress of recent years in the medical sciences is directly tracealile to the methods of experimental investigation introduced by William Har- vey and other men of courage who were unwilling to sponsor unsup- ported tradition and who had to see with their own eyes before they tabulated conclusions. The U. S. Public Health Service has, of course, found much of its information concerning disease ready made. Other data it has established by experimental methods, and it is important to see that not only in beginning work related to public health is it necessary to use information gleaned from experimental methods involving the use of animals, but that in the actual continuation of the work after routine ■ fashion, it is imperative to rely upon the same. 60 ■ • Bubonic Plague. I have selected as the first illustration of the laboratory work of ■ the Service its operations in connection with a disease which probably has solicited the attention of but very few persons in this audience. Bubonic plague, to the average person, is looked upon as a distant, tropi- cal, exotic disease little to be worried about, and my reason for select- ing it is the fact that were it not for the employment of methods which were learned from experimentation this plague might very well be in our midst today. Daniel Defoe has handed us a pen picture of a plague epidemic in London ; that this was not overdrawn has subse- quently been proven by many historic recurrences. Fancy a city dis- tracted, the inhabitants rushing about in a frantic effort to escape the pestilence, only to be met at the borders of the city by armed guards stationed to prevent their exit ; unburied bodies line the streets and abandoned children are left to starve ; traffic and commerce is dis- organized, famine follows close upon pestilence. Such occurred in the days before science pointed out the cause of the plague and of its spread and suggested a rational, effectual mode of combating the disease. At the present time there is an infection of this plague in one of our larger American cities, yet no panic reigns, tourists visit the city in large numbers, and all is apparently prosperous. This because there is constantly being carried on in that city a quiet, eft'ective campaign to meet the emergency. The experimental investigations have shown that plague is essentially a disease of rats ; that it is conveyed from rat to rat, and may be communicated from rat to man through the flea. With this known it is found to be practicable to prevent the spread of plague by systematic examinations of rats captured in all portions of the city. When a plague rat is trapped intensive antirat operations are carried on at the place where this rat was apprehended, and thus an incipient focus of plague infection is wiped out before gaining head- way. The claim that general methods of sanitation will effectually prevent plague epidemics is unsubstantiated ; they merely limit rat infestation. Diphtheria. Turning now to a disease more familiar to us I shall review the work of the Service on diphtheria. Diphtheria continues to be preva- lent, chiefly because the germ which causes it may be carried about in the noses and throats of perfectly healthy persons. Since it is im- possible to examine an entire population in order to discover who these so-called "carriers" are, and since it would be impossible to quarantine them all when apprehended, the efforts of health officials have been only in Dart successful toward eliminating the disease, but by method? 61 which were devised by animal experimentation it is possible to reduce the death rate from this disease to a very favorable hgure. For ex- ample, the method of making an early diagnosis by laboratory methods has enabled us to treat cases earlier and more effectually and to pre- vent infection of those who associate with these cases. Diphtheria antitoxin also is one of the most remarkably efficient remedies known to man. But suppose no supervision were exercised over the manu- facture of this antitoxin, and that inert and worthless samples of the product were freely marketed, we can readily estimate how many lives would in consequence be sacrificed. The Pubhc Health Service controls the manufacture of antitoxin, making sure, by methods of animal experimentation, that this product as it is sold in the drug store is potent and reliable. Furthermore, by animal experimentation a method has been devised for examining the bacteria which cling to the throats of patients following their convalescense to determine whether they are dangerous to others or not. Serums and Vaccines. The Service supervises in like manner the commercial production of many other serums and vaccines which are used for the treatment of various diseases. I may mention in this connection the serum for tetanus, or lockjaw, through which many a soldier in the trenches was saved to the nation. Typhoid vaccine, a product of great efficiency, is standardized by methods in which animals are used ; rabies vaccine more familiarly known as the Pasteur, treatment for Hydrophobia, is prepared by the Service, and its preparation necessitated the use of animals. This list might be prolonged indefinitely, but it is safe to say that there is scarcely any useful product of this general class which has not necessitated the experimental use of animals, either in its dis- covery, in its preparation, or in its standardization. ^ - At the present time there is being conducted throughout the United"" States an energetic crusade against venereal diseases. While these diseases involve a moral problem for all, to the sanitarian they present also a purely medical problem. Hence it is essential that every person known to be infected from syphilis should be treated to prevent his being a menace to those with whom he may come in contact. To effect this arsphenamine is preeminently efficient. The preparation of this substance is difficult, and, unless the greatest care is taken, a product may be issued for distribution which is unduly poisonous and would, if- administered to patients, beget most disastrous results. The Public Health Service is charged with the duty of examining each batch of this substance offered for sale. To do this the lower animals must be used. From time to time reports reach the Bureau of the U. S. Pubhc Health Service of the occurrence, in this or that part of the country, of 62 a new or rare disease. This calls for an immediate investigation to ascertain whether this condition is likely to spread and become serious, or possibly to end in a nation-wide menace. Such have been pellagra, Rocky Mountain spotted fever, the so-called "deer-fly disease," and a disease called after its discoverer. Dr. Brill. In nearly all of these instances it was imperative to make extensive inoculations of animals in order to determine the nature and cause of the disease, to find out what animals beside man might be afflicted with it, and, in some in- stances, to devise a remedial agent. During the war a considerable number of cases of anthrax, or malignant pustule, occurred among soldiers, and an investigation, in which the use of animals became necessary, showed that these cases were due to a natural infection of shaving brushes through the hair from which they were made. Regu- lations were immediately issued to inhibit the use of harmful material in the manufacture of these articles. Tuberculosis. We have with us at all times a disease which is so common that we perhaps do not fully appreciate what a tax it entails on the economy, the health and the happiness of the populace ; tuberculosis occurs ac- tively in perhaps 1 per cent of the population and occasions at least one out of every ten deaths. If this occurred in an isolated epidemic we should be appalled. Great as have been our advances in the knowl- edge of this condition, there rerhains much to be investigated and learned. We have been obliged to experiment upon animals in ob- taining our present information and this practice will necessarily con- tinue, if we are to find out more. The Service is at present engaged in an experimental investigation of tuberculosis with the view to dis- covering some method which will aid in tlie fight against this insidious malady. Every now and then a new and wonderful cure for tuber- culosis is ushered* in with much sound of trumpets and flaring head- lines in the newspapers. Some of these so-called "remedies" are little less than unadulterated, heartless fakes ; others are somewise bolstered by scientific plausibility ; unless the public be informed by a reliable authority as to the true merits of these "cures" a most pitiable state of affairs is likely to transpire. Sufferers from all parts of the country, many of them in the last stages of the disease, many having spent their last cent for railroad fare, flock to the center where this new remedy is obtainable, only to share disappointment, and frequently to die from exhaustion. It is felt that the Service in investigating and furnishing the public with reliable information on the subject of certain of these reputed "cures" has rendered a valuable service to the country. In such investigations it is necessary to use experimental animals, as it is, indeed, in arriving at a diagnosis in many suspected cases of tubercu- losis. 63 Other Problems. Probably no drug is more freely prescribed in diseases of the heart than is digitalis. Yet unless this remedy is of a standard c|ual- ity, it is apt to be harmful rather than beneficial. Accordingly, with the aid of animal experimentation, the Service has formulated a test which unquestionably establishes the strength and purity of the drug. It has been recently estimated that there are perhaps a million persons in the United States who are addicted in some degree to the use of habit-forming drugs. The pernicious efifect of these drugs on the individual himself and on the civilization of which he is a unit are well known ; and yet there is a real need for the alleviation of pain and other symptoms of drugs which have an action similar to the habit-forming drug, but free from this distressing feature. Some progress has already been made in devising suitable substitutes, and in this work an indispensable factor has been the use of animals. Those opposed to vivisection and, indeed, to animal experimenta- tion generally, are accustomed to characterize many of the investiga- tions carried out by scientific, men as being due to idle curiosity. It is true that investigations are made into various phases of the disease problem without there being at the time any apparent way in which the information gained can be practically applied. Nevertheless, such information sooner or later is almost certain to merit its place in devis- ing something of value to humanity. One instance, as an example of this, is anaphylaxis. If horse serum be injected into a guinea pig, even in large amount, it ordinarily provokes no appreciable effect, but an investigator noticed that if, after an interval of ten days or more, another injection of horse serum be given the same animal, it acts as an acute poison, often killing the animal within a few minutes. This finding invited the closest research. No immediate practical benefit to mankind was at first anticipated, but, as a matter of fact, the infor- mation thus gained has been of great value in diagiiosing hitherto obscure disease conditions in man and in suggesting preventions and cures. Another example : During the examination of the bodies of rats for plague infection, a disease of quite different origin, but closely simulating plague in the lesions caused, was unexpectedly brought to light. Through animal experimentation the bacterium causing this disease was cultivated. No immediate bearing of this fact on human health or happiness could be foreseen, yet within a very few, years.it was discovered that many could suft'er a distressing infection due to this same organism. Problems regarding measles, infantile paralysis, hookworm and the like placed before this Service for solution might very profitably be called to your attention, but time forbids. In concluding I beg leave to advise you that the benefits which have accrued to man con- sequent to animal experimentation have touched not only physical 64 but aslo his moral well being. It is true that vice predisposes to disease, but it is no less true that disease, innocently contracted, brands as a criminal one who otherwise would have been a useful citizen. There so appears here a vicious circle between disease and crimi- '. nality ; there are those that would break the continuity of this circle in the reformation of all criminals, and we wish them well, but surely it is not a step toward the wrong if, with the means at our disposal, we, too, interrupt this closed line, ridding the community of' the dis- eases, which, directly or indirectly, are responsible for a great part of it. THE ECONOMIC ADVANTAGES DERIVED FROM ANIMAL EXPERIMENTATION By Ernest Charles Schroeder, M. D., D. V. M. Superintendent, Expcriuicnt Station, U. S. Bureau of Animal Industry, Bethesda, Md. The economic advantages derived from animal experimentation are so abundant and diverse that it is impossible in the time I am privileged to discuss them to do more than indicate their far-reaching importance. To verify this statement I need ask only a few questions like the following : Is it an economic advantage to have the Panama Canal ? Is the defeat of Pan-Germanism an economic advantage? Is it an economic advantage to have food and clothing in sufficient quantities to insure health ? The Standard Dictionary defines economics as "the science that treats of the development of material resources, or the production preservation and distribution of wealth, or the means of living well for the state, the family and the individual." If we accept this definition we may conclude that anything, not an actual, inseparable part of ourselves, that contributes to the better development of the human race and tends to make life more desirable, is an economic advantage ; hence, the rational answers to the several questions must be affirmative. The Panama Canal would not have been built if animal experimen- tation had not revealed the etiology of yellow fever. The French failed to build it, not because they lacked intelligence, courage or perse- verance, but because they did not know how to combat yellow fever. Under the same conditions the Americans would have failed. If the Canal had been constructed with no better knowledge about yellow fever than was available at the time the French abandoned the gigantic project, after they had sacrificed more than twenty-thousand lives. 65 success would have cost so many valuable lives that the very thought of it is horror inspiring, and the established short-cut between the Atlantic and Pacific Oceans probably would have proved so perniciously unwholesome and destructive to those who used it that it soon would have earned a name for itself something like, "The water-lane of the yellow death." What the Canal has done and promises to do in the conservation of man-power, time, shipping, fuel, etc., and how much it will facilitate the development of the world and particularly the countries on the western coast of the two Americans, I leave to your imagination. If animal experimentation had not provided vaccines, bacterins and antitoxic sera ; if it had not aided in the development of new methods of surgery and the discovery of reliable means to diagnose infectious diseases, and had not taught us how to use war gases and how to defend our soldiers against them, the recent war would have cost many additional thousands of lives and would have produced many additional thousands of cripples ; it would almost certainly have been prolonged and it is seriously questionable whether Pan-Germanism, with its numerous, villainous atrocities, could have been defeated. The economic significance of its prolongation, leaving morbidity and mortality out of consideration, may be judged from the estimate that the war cost the human race three hundred billion dollars, and about the economic meaning of defeat we should suspend judgment until we have tried to visualize the world under the domination of a victory- elated despot, whose megalomania, fostered by an exultant, reaction- ary, Prussian aristocracy, would have prompted him to assume the rank of a divinity. If animal experimentation had not taught us how to cure many diseases of the lower animals and how to suppress appallingly de- structive animal plagues, the hunger and starvation now prevalent in many parts of the world would be practically universal. I might say, however, if animal experimentation had not provided the means to control human diseases like small-pox, Asiatic cholera, bubonic plague, typhus fever, yellow fever, etc., it is not at all likely that the population of the world would have become great enough to make the spread of food-destroying diseases like rinderpest, foot and mouth disease, anthrax, Texas fever, hog cholera, surra, swine erysipelas, contagious pleuro-pneumonia of cattle, sheep scab, etc., economically very im-i portant, as food has no value for those who are dead and those who fail to be born. Vegetarians, who do not recognize the need for abundant supplies of meats, animal fats, wool and hides, and persons who hold extreme views on animal rights, may mistake this statement as an exaggeration. Their attention should be called to the fact that it is questionable whether sufficient food for the present population of the world could be produced without the use of animals to convert coarse, vegetable 66 • . substances, unfit for human stomachs, into easily digested; nutritious food, and to the fact that, in addition to serving as indispensable sources of food, clothing, power and pleasure, domestic animals are so importantly, related to the production of vegetable foods and textile fibers that practical agriculturists are convinced that the cultivation of the soil without animals is economically impossible. The spiritual and intellectual nature of man requires that we should look upon him as a unique and unparalleled being, but materially, that is physically and chemically, he is not fundamentally unlike the higher mammals ; consequently, most knowledge valuable for the protection of man's health and the treatment of his diseases is similarly valuable for the lower animals, and discoveries, like the circulation of the blood ; the capillary circulation ; the vasomotor mechanism ; the functions of the nervous system generally ; the flow of the chyle in the lacteals and its passage through the lymph ducts into the venous circulation; the nature of the digestive fluids and the chemical transformation of food through their action; the functions of the liver, lungs, kidneys and other organs, the reaction of the cells to various kinds of stimuli ; the significance of the endocrin glands ; the natui-e of inflammation and other pathological processes, and practically every other discovery in physiology, pathology and biochemistry, are as serviceable in the work of the animal husbandman and veterinarian as in that of the hygienist and physician, and in this sense have great, material, economic value. The discoveries referred to, and many others, too numerous to mention, were all made through animal experimentation, and could have been made in no other way that has ever been defined. Veterinarians and physicians use drugs, and if the pharmacopoeia contains valuable drugs about which our knowledge has not been enriched through animal experimentation, I must confess that I do not know what they are. A superficial and insufficient knowledge of the actions of some drugs was admittedly obtained through accidental or unintentional, unguarded and undesirable occurrences among per- sons and animals, but the precise knowledge we have of the therapeutic, physiologic and toxic actions of the innumerable substances from which our useful drugs have been selected, is all the product of care- fully planned, intelligent animal experimentation. If wc did not know through animal experimentation how the drugs now in use act, on the body. as a whole, on special parts of the body, directly or indirectly through the nervous system, and whether their action is immediate or cumulative, the death rate among persons and animals would be griev- ously multiplied, and the greater losses among the latter would prove a factor of serious, economic disadvantage. Before experimental methods were used to study Hving organisms in health and disease, the practice of medicine was little better than a presumptive art, based on disconnected and largely misinterpreted observations, and sick persons and animals were tortured as often, if not oftener, than they were helped by the measures taken to restore their health. Since then, fortunately for all sentient beings, medicine has become a true science, and those who practice it make real, un- mistakable contributions to recovery from sickness, the preservation of health and the prevention of suffering. In animal industry this means fewer losses and greater productivity, or, in other words, better and less expensive food and apparel. I wish to emphasize that nearly every discovery thai has thrown light on the nature of the human body and its relation to its environ- ment has also thrown light on the nature of the bodies of the lower animals and their relation to their environment, as this fact enables us to recognize that even that portion of animal experimentation, primarily undertaken to secure knowledge for the prevention and better treatment of human diseases, rarely fails to confer benefits on the lower animals ; hence, if the proportion between the pain animal experi- mentation has caused and prevented among animals alone was taken as the major factor in determining whether animal experimentation is or is not morally sound, we would not be left in doubt a single moment, as the pain that has been caused is insignificant in comparison to that which has been and is being prevented. The men who treat diseases among animals probably relieve more paiii every day than animal experimentation causes in a score of years, and they do this through the agency of the knowledge animal experimentation has supplied. Diseases of animals like those of persons may be divided into two kinds, the infectious and the non-infectious, or those caused by para- sites and those due to other causes. The economic advantages derived from animal experimentation, through the light it has thrown on the infectious diseases of domestic animals, are of astounding value, and this can be shown in no better way than by discussing several of them separately. I will begin with Texas fever of cattle, which has the distinction of being the first disease proved to attack its victims exclusively through the agency of intermediate host or carrier of its causative germ or niicroparasite. It is a member of a large group of exceedingly de- structive, infectious but not contagious, diseases ; oth_r members of the group are malaria, yellow, fever, typhus fever, Rocky mountain spotted fever, African sleeping sickness, spirillosis of fowls, nagana, African coast fever of cattle, piroplasmosis of horses and sheep and dogs, etc. The intermediate host of Texas fever is the Southern cattle tick, a blood-sucking parasite which absorbs the germs of the disease with its food when it lives on the bodies of infected cattle. The female ticks, after they reach maturity, drop to the ground, produce two thousand or more eggs, the eggs hatch and the young ticks inoculate the susceptible cattle to which they attach themselves. It is perfectly safe to permit healthy cattle to association with those that are affected with Texas fever, provided no cattle ticks are present, and cattle ticks do not convey or cause the disease unless they are the progeny ■ of ticks that matured on the bodies of infected cattle. Infected cattle, when we deal with Texas fever, means all cattle that are either actively : affected with the disease or that have apparently recoverd from it, as the Texas fever microparasite, once it has entered the blood of cattle, evidently remains as a permanent contamination. In one of the lectures of the present series Dr. Simon Flexner of the Rockfeller Institute for Medical Research expressed the opinion that our knowledge of yellow fever would in all likelihood have been delayed if the work of the Bureau of Animal Industry oi the U. S. Department of Agriculture on Texas fever had not been done. I have already pointed out that the Panama Canal would not have been constructed without the knowledge animal experimentation gave us on the etiology of yellow fever. Think of the modest investigator whose patient study of a mysterious cattle disease proved a great pioneer work in the field of medical research, and incidentally opened the door to knowledge required for the junction of two oceans at a point thousands of miles removed from where nature permitted their waters to mingle. Draw a mental picture of the man and his work ; it will give you an inspiring view of intellect successfully combatting evil. But it is unnecessary in speaking about Texas fever to dwell longer on the role of animal experimentation in the accomplishment of a great engineering feat, as there are other impressive and exceedingly impoi"tant things to talk about in connection with this disease that must also be credited to animal experimentation. Less than fifteen years ago the prevalence of Texas fever and cattle ticks in our Southern States necessitated the maintenance of a cattle quarantine which included an area larger than three quarters of ai million square miles, known as the permanently infected area. In this area, more than three and one-half times as large as the French Republic and nearly three and one-half times as large as the former German Empire, the losses caused by Texas fever and its carriers were enormous, to say nothing about the frequent, troublesome spread of the disease northward. Most of the cattle raised were undersized, large-boned, unthrifty mongrels and inferior producers of milk, meat and hides. Much of the food they consumed was worse than wasted, as it was diverted from sharing in their growth and development, after their bodies had been taxed with digesting and converting it into blood, to feed the ticks which irritated the surfaces of their bodies and the microparasites which lived beneath the surface. A fairly reliable idea may be formed of the losses caused by ticks alone when we know that female cattle ticks multiply their size and weight by about ten-thousand during the approximately four weeks they remain attached to the skin and feed on the blood of their hosts ; 69 that the adult female tick is about as large as the terminal joint of a woman's little finger, and that ticks of all ages and sizes, often in unbelievable numbers, are present on the bodies of the cattle in the infected territory during the greater part of the year. A light infestation with ticks has been proved to reduce the milk yield of dairy cows 18%, and a heavy infestation reduces it more than 40%. Think of the loss, to which must be added the loss in beef pro- duction, the lower value of roughened and scarred hides and the deaths due to Texas fever, which latter, averaged for eleven states, amounted to 13%, or a half per cent more than one-eightW of the total cattle. The reason cattle could be raised at all in the infected and infested territory is that Texas fever in calves rarely is the severe, acute, highly fatal disease it commonly is in susceptible ■ adult cattle. It attacks the calves, has a mild, chronic course, plants its microparasites permanently in their blood and gives them a high degree of immunity against severe attacks later on. Agriculture may be compared to a complex machine ; there are many parts to it, and if one part gets out of order all the others are affected. The cattle industry is as necessary to American agriculture as tires are to an automobile, and to practice agriculture with cattle ticks, Texas fevef and a cattle quarantine, resembles driving an automobile over a rough road, littered with cutting and puncturing objects and under- going constant repairs that require long detours. Hence, it is not surprising that agriculture in many parts of the quarantined area was unprosperous and that the farmers and breeders were discouraged and depressed. In the year 1906, the methods for eradicating Texas fever and cattle ticks, revealed through animal experimentation, were put into practice by the U. S. Bureau of Animal Industry, and since then, over half a million square miles, a territory one-hundred thousand square miles larger than the combined areas of the French Republic and the former German Empire, have been cleaned of the disease and its carriers and released from quarantine, and in only a few years more the two related plagues will have been wiped entirely out of our Country. Fully to appreciate what this means, and to measure its economic value, we must know that the formerly infected and infested, quaran- tined territory includes some of the best agricultural and cattle lands in the world, and that it has begun to produce cattle that compete successfully, and on terms of equality, with the finest that enter our stockyards, and that recently it has produced cattle that captured blue ribbons at National livestock shows. The farmers and breeders have taken heart and are working with renewed courage, and increased prosperity and contentment are widely evident. The choice, well- bred, healthy, heavy and profitable cattle are being produced at no greater expenditure of labor and forage than the undersized, sufifering ro runts required, as cattle raising and feeding has ceased to mean raising and feeding a combination of cattle, cattle ticks and Texas fever parasites. It is now safe to send cattle from the North into the rich pasture lands of the South, where, a little while ago, it was unsafe, ■ notwithstanding difficult precautions, to send thoroughbred animals for breeding purposes. Think of the economic advantage. Think of the increased produc- tion of food, think of it with the fact in mind that well-informed men assert that the morbidity and mortality in the world directly due to tmdernourished are so great in many places that they over-shadow the horrors of the war. Those who are not informed about the evils incident to under-nourishment and long continued dependence on food that lacks essential nutritive elements, and how serious the food shortage in the world is today, may find it difficult to believe that millions of human beings in this so-called civilized age, beings and feelings, affections and souls like our own, are being stunted spiritually and physically and are being hurried prematurely out of life because they cannot get enough to eat or enough of the right kind of food, and yet this evidently is the truth. In the United States the population has increased faster than the number of domestic animals, and this probably is one of the causes for the high price of food. In Europe the war has reduced the number of domestic animals so much that a replenishment from Countries, ours included, in which the animal industry was less severely injured, is urgently needed. Let us take a look at another disease, about which much unfruitful guessing was done until the truth was learned through animal experi- mentation : the commonest and most widely disseminated of all diseases, namely, tuberculosis. Animal experimentation proved that the manifestations of tubercu- losis in different portions of the body and in the bodies of different species of animals all have one, essential cause ; it proved that the disease is contagious ; it showed how and why it is contagious ; it led to the discovery of the tubercle bacillus ; it proved that the tubercle bacillus in nature is an obligatory parasite ; it proved that the bacillus is quickly destroyed by light and may long remain alive and virulent in dark places ; it proved that there are three types of tubercle bacilli, the human, the bovine and the avian ; it proved that human and avian types have no important significance for cattle ; it proved that the avian type is not an important cause of disease among mammals ; it proved that the human type is the commoner cause of tuberculosis in human beings ; it proved that children often are attacked by the bovine type ; it proved that the bovine type is the commonest cause of tuberculosis among domestic mammals ; it led to the discovery of tuberculin, without which, used as a diagnostic agent, the control and eradication of tuberculosis among food-producing animals would be impossible, etc. 71 If animal experimentation had not proved that tuberculosis among cattle can be eradicated, wholly exterminated, and its recurrence pre- vented, without regard to its continued persistence among human beings, the cattle tuberculosis eradication work, for which Congress now appropriates one and one-half million dollars annually, would have the character of a hopeless and ridiculous project, unless utterly unreasonable measures were taken to prevent the reinfection of cattle with tubercle bacilli from human sources. One of the difficulties in combatting tuberculosis, among persons as well as the lower animals, arises from its usually insidious, slowly- progressive nature, through which its subjects often become dissemina- tors of its germs long before their dangerous condition is suspected. Until tuberculin was discovered and its diagnostic value proved, no means were available to detect more than a small proportion of the existing cases of tuberculosis among cattle, and the overlooked and neglected cases, through their unavoidable introduction into healthy herds, insured a further, rapid spread of the disease. Just what this means in terms of economy may be judged from the fact that tubercu- losis among the cattle of some of the older and more densely popu- lated countries of Europe is from four to five times as common as it is among the cattle of our Country, and that it is from fifteen to twenty times as common among the cattle of our older and more densely populated, than it is among those of our newer and less densely popu- lated states. Through the use of tuberculin the cattle tuberculosis eradication work is making excellent progress, and this should be gratifying, as the disease is a food destroying evil which shoilld not be left as a. burdensome heritage to coming and more populous generations of mankind, who, no doubt, will find the production of sufficient food, even under normal as distinct from war conditions, more difficult than we and past generations have found it to be. The food producing area of the world is fairly constant ; actually it does not change much from generation to generation ; relatively it grows smaller as the population increases. Tuberculosis among animals in the United States alone, on the basis of the lowest estimate, which I am convinced is entirely too low, destroys at least twenty-five million dollars worth of urgently needed food per annum. This estimate was made before the war, at a time when milk cost the consumer eight and not eighteen cents per quart, and when prime, roast beef and porterhouse steak retailed at from eighteen to twenty-five cents per pound. What I have said about seemingly harmless but seriously dangerous disseminators of disease germs in speaking about tuberculosis applies also to other infectious disease ; hence, the discovery of methods that help to distinguish more certainly between safe and dangerous animals reduces the difficulties that confront our efl'orts to control and eradicate 72 other costly animal plagues, and this is a field in which the economic advantages derived from animal experimentation are particulrly valuable. If the various biological tests for diseases, discovered during the last thirty years, had been in use a century or two ago, the importa- tion of several destructive animal plagues, now causing heavy losses in the United States, could have been prevented. For exarnple, our Government is successfully eradicating a disease among horses known as dourine, which entered the United States and gained a foothold because its virus is at times carried by horses which show no symptoms of their dangerous condition. The closest study of such infected horses during the period of time imported animals are subjected to quaran- tine does not lead to their detection ; the complement fixation test for dourine detects them at once ; the test was not known until after the unfortunate importation of the disease. This plague would continue to spread rapidly unless impossible sums of money were spent to check it if the apparently innocent carriers and disseminators of its causative microparasites could not be distinguished through the agency of the test animal experimenta- tion has supplied. Horses may not be as indispensable today as they were before tractors, motor-trucks and other types of automobiles came into use, but the prices asked for them indicate that it will be sometime before we can get along without their services or afl^ord to neglect their diseases. To offset the example I have given of an instance in which a bio- logical test was discovered too late to exclude an animal plague from our Country, though early enough to insure its eradication, I will give one in which a test was available early enough to exclude a more serious plague. The disease in this instance is surra, a pernicious evil, indigenous in the southern portion of Asia, from which it has been spread to several other portions of the world, and which is not at all choice in its victims, as it may attack such widely different species of animals as cattle, horses, sheep, goats, camels, elephants, monkeys, rats, etc. In cattle surra may run a mild course, but once they are atacked they are apt to carry its microparasites in their blood and to remain sources from which the disease spreads for a long time. A little more than a dozen years ago an attempt was made to in- troduce a herd of about fifty East India cattle into the United States, to b'e used in Texas, where it was believed the native cattle could be made resistant to southern cattle ticks by crossing them with the Indian cattle, which are alleged to be strongly tick resistant. Repeated examinations of the blood of the Indian cattle were made before their departure from Asia and while they were en route to and after their arrival in the United States, and nothing to arouse suspicion was found ; but, while they were in quarantine, rabbit inoculation tests gave absolute proof that their blood was infected with the germs of surra. The economic advantages derived in this instance from animal experimentation, a pattern of things that repeat themselves over and over again, are so great, irrespective of whether we estimate them in money, in food saved or in suffering prevented, that they stagger belief. A somewhat similar story can be told about a threatened in- troduction, into the United States, with a shipment of milk goats, of Malta or Mediterranean fever, a disease of both persons and animals, which may exist in goats in a form that cannot be detected through other means than the use of a test which animal experimentation has given us. Personal experience which stamp lasting impressions on our minds often make instructive illustrations. About thirty-five years ago I witnessed the examination, condemnation, slaughter and autopsy of a magnificent, handsome, vigorous, sleek and apparently healthy horse, owned by a wealthy man who maintained a stable of four or five horses for family use. Horse after horse in his stable had contracted acute, easily diagnosed glanders and had been condemned, killed and replaced, only this one fine animal seemed immune, until suspicion was directed to it as the probable source of infection, but not until seven or eight valuable horses had been lost. The owner expressed himself to the veterinarian in charge of his stable to the following effect: "If you believe that the circumstantial evidence which points to this horse as the source of infection is strong enough, I am willing that it should be killed, though it has never been sick during the time I have owned it, excepting that on one or two occasions it had a slight cold with a meager, clear, watery discharge from its nostrils." The autopsy revealed a group of small, perfectly typical glanders ulcers on the wall of the larynx and a few small, chronic nodules in the lungs, so located that they could not be detected in the living animal. During two years following the removal of this originally unsuspected source of infection from the stable, after which I have no record, no further cases of glanders occurred. If the mallein or complement fixation test for glanders, later products of animal experi- mentation, had been available at that time, every horse in the stable would have been tested imniediately after the first case of glanders was discovered, and the seemingly healthy spreader of the disease found and prevented from causing further losses. Glanders is transmissible to man, and a hopeless, painful and disgusting disease when it attacks man. Its frequency among horses has enormously declined since it has become possible to pick out the seemingly healthy carriers and dis- seminators of its microparasite through the use of special tests which must be credited to animal experimentation. Think a moment and realize the significance of the following state- ment : If the narrow and ridiculous requirement was made that nothing should be favorably credited to animal experimentation but the pain 74 against which it has safeguarded the lower animals through" the use of the tests it has given us to discover otherwise undiscoverable sources of infection, we would be obliged to admit that it has paid for itself thousands upon thousands of times over again. Hog cholera is another disease that merits attention, as the losses due to it in some past years have amounted to a hundred million, dollars, and in one year are alleged to have reached the two hundred million dollar mark. A serum and a virus to protect hogs against cholera have been developed through animal experimentation by the United States Bureau of Animal Industry, and are now widely used with excellent, economic results. Before they were available many hog breeders and feeders believed that it was a good business policy to assume that their crop of hogs would be destroyed by cholera and be a total loss, on a general average, about once every five or six years. The losses did not occur at regular, determinable intervals, so that a feeling of security could be enjoyed during the four or five years following a loss year. On the contrary, it could not be predicted in any year from the occurrence of previous years whether the hogs would go to market or whether the cholera would get them. This uncertainty did not encourage maximum production ; the hog breeding and feeding business was unattractive to conservative men ; it was too much like investing money in debatable securities that promise high rates of interest and too often prove utterly worthless. And, bear in mind, when the high rates were paid on money invested in the hog industry, it was the consumer who settled the bill. How much animal experimentation has affected the price of pork products may be judged from a statement made by the Secretary of Agriculture and recently published in a News Letter of his Depart- ment. This statement asserts that the losses from hog cholera in the United States have been reduced sixty per cent since the year 1913, and that this equals a saving of forty-one million dollars per annum. Let us measure this in food terms. Forty-one million dollars worth of hogs, assuming that the average retail price of pork products is forty cents, per pound, amounts to one pound each of nutritious meat or fat on every one of the 365 days in a year for 280,820 human beings. The assumed average price of pork products probably is a little too high ; make, it lower and the number of human beings benefited in- creases. The importance of the hog as a source of human food ranks next to that of the dairy cow. The money saved in the United States in one year, through the economic advantages the hog industry alone has derived from animal experimentation, invested in Victory bonds, would yield an annual income greater than the sum annually appropriated by Congress for the study and control of all the plagues that occur among the domestic animals of our Country. This is a fact which should be kept in mind by those persons who claim that our Government is more eager to 75 fly to the rescue of the sick hog than it is to care for the sick child. The clear-minded men in our Congress who are behind the appro- priations made for the protection of our animal industry are not moved by sentimental consideration for hogs or other kinds of livestock ; not even by consideration for the breeders and feeders of domestic animals, or for any special industry or class of men. They know what a relaxation of the fight against the existing and possible evils that destrby food-producing animals would mean to the whole people of the Country, and that the health and welfare of a nation depend on no one thing quite as much as an abundant supply of wholesome food. Lengthy dissertations, similar to the brief statements I have made about Texas fever, tuberculosis, dourine, surra, Malta fever, glanders and hog cholera, to show the value of the economic advantages derived from animal experimentation, could be made about other animal plagues, such as contagious pleuro-pneumonia, rinderpest, foot and mouth disease, anthrax, blackleg, sheep scab, etc., but our time is too short. Contagious pleuro-pneumonia of cattle was imported into the United States seventy-seven years ago. Animal experimentation, which definitely proved its contagiousness and further proved that various, seemingly feasible rhethods of control were useless, led to the adop- tion of the methods through which it was speedily eradicated. If we had been tardy about applying the knowledge animal experimentation gave us, the losses from this plague soon would have mounted to hundreds of millions of dollars. Rinderpest, a terribly destructive disease of ruminants, which has repeatedly spread from its native place in Asia into and over Europe during and after wars, but has fortunately never reached the United States, is being controlled by a method similar to that which is effective against hog cholera. Permit me to give you a few statistics on this plague, as they will help you to comprehend how large the food problems are with which animal experimentation deals, and will show you that the question, whether such experimentation should or should not be hampered by legislation, cannot reasonably be settled by possibly well-intentioned but uninformed and emotionally misguided persons. Introduced into France after the Franco-Prussian war, rinderpest killed 56,533 cattle in two years. Introduced into Great Britian in 18G5, it killed 500,000 cattle in 18 months. Introduced into Italy towards the end of the 18th century, it killed 3,000,000 cattle in three years. Introduced into South Africa it killed 980,000 cattle in the Transvaal in 1897 and 1,300,000 in Cape Colony during 1897 and 1898. Since I have touched on the subject of statistics, let me give you a few about other diseases. Anthrax, which is most fatal to sheep and cattle but also attacks a variety of other animals, including man, is 76 being controlled through the agency of a vaccine supplied by animal experimentation. In France, vaccination reduced the death rate due ' to this disease among sheep from 10% to 0.94% and among cattle from- . 5% to 0.34%. Rouget or swine erysipelas is a widespread disease in • Europe, the losses from which were reduced through vaccination from 20% to 1.45%. Think of the enormous losses before vaccination; think of the more than 90% reduction in these losses. In one region in Europe, in which tetanus or lockjaw is endemic and apt to follow wounds of all kinds, 259 cases occurred among untreated horses, and not one among 7,000 which received injections of tetanus antitoxine. I advise the anti-vivisectionist who visits this region and accidentally steps on a rusty nail not to fight too hard against the preventive treat- ment for tetanus or lockjaw, because its discovery cost the lives of a number of experiment animals. Blackleg, like anthrax, is caused by a spore-forming, vegetable microparasite. The spores of both diseases live and retain their viru- lence long periods of time when they enter the soil, and on infected soil it is economically impossible to raise sheep and cattle unless they are immunized. The United States Department of Agriculture an- nually distributes from two to four million doses of blackleg vaccine, because the men who raise cattle in portions of our country where the infection exists have learned through experience that the losses from blackleg among their young stock, unless it is immunized, are tmbear- able. Practical men do not look upon the use of antitoxic sera, vac- cines, bacterins and other biological products as an academic question or a subject for sentimental speculation. With them a thing must pay ; else it is discarded. Quack remedies may receive a trial but are soon 'discredited, and when thousands of level-headed business men demand and use the same agent year after year, it must have real virtue. About foot-and-mouth disease we know relatively little, although we do J