CONCERNING Human Vivisection A CONTROVERSY /. Letter of Hon. James M. Brown, President of The American Humane Association, to William W. Keen, M.D. II. Letter of William W. Keen, M.D., LL.D., Late Presi- dent American Medical Association, to President fames M. Brown. Ill The Reality of Human Vivisection : A Review of Dr. Keen ' s Pamphlet. PUBLISHED BY THE AMERICAN HUMANE ASSOCIATION 1901 CONCERNING Human Vivisection A CONTROVERSY /. Letter of Hon. James M. Brown, President of The American Humane Association, to William W. Keen, M.D. II. Letter of William W. Keen, M.D., LL.D., Late Presi- dent American Medical Association, to President James M. Brown. III. The Reality of Human Vivisection : A Review of Dr. Keen' s Pamphlet. PUBLISHED BY THE AMERICAN HUMANE ASSOCIATION igoi \|>>-3« INTRODUCTION. What are the facts concerning the practice of Human Vivisection, or the use of human beings — chiefly women and children — as "material" for painful or dangerous investi- gations that have no relation to their personal benefit? The following pages pertain to an important controversy on this question. In a pamphlet entitled Human Vivisection, issued two years since, the American Humane Association, — acting in behalf of those who cannot protect themselves, — invited public attention to this growing abuse. The evidence thus pre- sented has been recently attacked by. a Philadelphia surgeon, Prof. William W. Keen, M.D., who not only cast doubt upon its reliability, but also ventured, to a certain extent, to sug- gest excuses for those charged with making such experi- ments. A reply to Dr. Keen's widely-circulated pamphlet at < nice appeared. Issued without the sanction of any Humane Society, — unsupported even by the name of its author, — this review of Dr. Keen's attack illustrated his methods of argu- ment, made apparent a significant tendency to apologize for experiments upon man, and proved beyond question the validity of the evidence he had impugned. It has seemed to many that the importance of this reply to Dr. Keen calls for its immediate reprint and widest possible circulation. It has, therefore, been carefully examined and revised under the direction of a special committee, and is now issued under the authority of the American Humane Association. In one respect Dr. Keen's attack has undoubtedly advanced the cause of humanity, the interests of truth, and the advent of reform. By his scepticism concerning the evidences of human vivisection previously published, by his imputation 4 Introduction. that proofs of the practice are vague and insufficient, and by suggestion of excuses for offenders, Dr. Keen has made it impossible for us to permit the matter to rest in the slightest degree undetermined or doubtful in the public mind. At any cost of publicity we believe the further unveiling of these atrocious deeds should now proceed. There must be a more complete exposure, fortified by evidence that even the most brilliant audacity will hesitate to impeach. If this exposure shall involve names which have thus far escaped publicity, they have only to thank Dr. Keen for an attack upon evi- dence, which makes it necessary to submit further proof. By some of his friends and admirers, Dr. Keen's attack has been regarded as a crushing blow, to which answer was quite impossible. The estimate placed upon it by The American Humane Association cannot be more clearly evinced than by the fact that as an act of justice it prints herewith, his pamphlet in full. We believe that the Review which immediately follows will demonstrate the completeness of his failure in attack, and the impotence of his defense. For Human Vivisection is not a myth but an awful reality, — a crime against Civilization, which demands the condemna- tion of every friend of Humanity and the reprobation of every honest man. By order of the Sub-Executive Committee of the American Humane Association. JOHN G. SHORTALL, Chairman. July i, 1901. I. President James M. Brown to Dr. W. W. Keen. THE AMERICAN HUMANE ASSOCIATION: Societies of the United States Organized for the Prevention of Cruelty to Animals and Children. Toledo, Ohio, Oct. 4, 1900. Prof. William W. Keen, M.D., late President of the American Medical Association, Jefferson Medical College, Philadelphia. Dear Sir: — My attention has just been called to a passage in the pub- lished Report of the Hearing before the Senate committee, held at Washington last February, on the bill for regulation of vivisection. In this volume the following conversation between Senator Gallinger and yourself is recorded : Senator Gallinger — What knowledge have you of the advances made by vivi- sectionists that have led them to progress from the brute creation to the human crea- tion in making these so-called vivisection experiments ? Dr. Keen — I presume you refer to a pamphlet issued by the American Humane Society. I have only to say in reference to it that there were a number of experiments which I would utterly condemn. Of the experiments narrated in that pamphlet, I have looked up every one that I could. Only two are alleged to have been done in America. Many of them are so vague and indefinite that I could not look them up, but as to those that I could, some are garbled and inaccurate; not all of them, observe, A statement of this character, based upon such authority, it is impos- sible to ignore. Proceeding from one less eminent than yourself in that profession which you represent and adorn, it might pass without notice, but coming from you, sir, such a charge must be investigated and probed to the fullest extent. Its importance is evident, and in testing its accu- racy you will give me, I trust, every assistance within your power. First: Regarding the cases of experimentation upon human beings recorded in our pamphlet, "Human Vivisection," you informed the Senate committee that "Many of them are so vague and indefinite that I could not look them up." We challenge the accuracy of that state- ment, and ask for proof. Of the various series of experiments upon human beings, made for the most part upon women and children in hospitals and infirmaries, the authorities given in this pamphlet are as follows : 6 The Human Vivisection Controversy. 1. Bulletin of the Johns Hopkins Hospital for July, 1897. 2. Boston Medical and Surgical Journal for Aug. 6 and 13, 1896; The Philadelphia Polyclinic for Sept. 5, 1896. 3. New York Medical Record for Sept. 10, 1892. 4. The British Medical Journal for July 3, 1897; the 7Ww England Medical Monthly for March, 1898. 5. The Medical Press for December 5, 1888; the British Medical Jour- nal for Aug. 29, 1891 ; the London Times for June 27, 1891, (and other journals). 6. The Medical Brief for June, 1899. 7. Ringer's Therapeutics, pp. 585, 588, 590, 591, 498, 503 ; the London Lancet for Nov. 3, 1893. 8. The Newcastle Daily Chronicle for Sept. 21, 1888. 9. The Medical Press and Circular for March 29, 1899; The London Lancet for May 6, 1899, p. 1261. 10. The Allg. Wiener med. Zeitung, Nos. 50 and 51. 11. Deutsche med. Wochcnschrift, Nos. 46 and 48 of year 1894. 12. Deutsche med. Wochenschrift, of Feb. 19, 1891. 13. Lecture before Medical Society of Stockholm, Sweden, May 12, 1891. 14. The British Medical Journal for Oct. 15, 1881 ; Medical Reprints for May 16, 1893; the Nineteenth Century for Dec, 1895. For one series of experiments in the above list, those made by Dr. Janson upon children of the "Foundlings' Home" — with the "kind per- mission" of the head physician, Professor Medin — because, as he said, "calves were so expensive," it appears that the only authority given was a reference to his lecture delivered before a Swedish medical society upon a certain date. Although, so far as known, the facts there stated. have never been denied, yet the reference may, perhaps, be called indefinite. But one case is not "many." To what other of the refer- ences above given did you refer when you informed the Senate com- mittee that "many of them were so vague and indefinite that I could not look them up?" Had you stated that your library — ample as it is — did not contain, and could not be expected to contain, all of the foreign authorities to which reference was made, there would have been nothing to criticize. I must assume, sir, that you have not put forth an aspersion of another's reliability merely to save acknowledgment of the inadequacy of your sources of reference ; that the proofs of your statement, cov- ering "many" cases, are available, and, in the interest of accuracy, I ask you to produce them. Second: There is yet another point to which I ask your attention. You made the statement before the Senate committee that in regard to our published account of cases of human vivisection, "many of them are so vague and indefinite that I could not look them up; but as to those that I could, some are garbled and inaccurate ; not all of them, observe." This, sir, is a most serious charge. You distinctly declared that of the cases personally investigated by yourself, as quoted in the pamphlet on "Human Vivisection," some are "garbled and inaccurate." We deny Letter of President Brown. 7 the charge, and again challenge production of evidence upon which it is made. A "garbled" quotation is one which, by reason of omission and per- versions, is essentially unfair. Sometimes it is a statement from which parts are omitted or transposed for the purpose of conveying a false impression. To omit quotation of parts not directly bearing upon the question for the sake of brevity — this is not "garbling," for all quotation would then be impossible. We assert that in quoting accounts of the cases of human vivisection no omissions of essential facts have been made sufficient to impair the accuracy or fairness of the quotation. Let us put the matter to the test. Point out, if you can, the "some cases" which you found "garbled and inaccurate," and in proof of the charge quote the omitted sentences or words which, had they been inserted, would cause you and the general public to justify and approve the experiments on human beings which we have so severely condemned. Third: You stated, sir, before the Senate committee that only two experiments upon human beings "are alleged to have been done in America." I question, sir, whether that remark is quite in accord with the highest ideals of truth; it is the language of doubt; it seems to signify and imply that even you are aware of no other experiments upon human beings than "two cases" which are thus "alleged." I am very confident, sir, that you will not venture formally to assert — what you have seemed to imply — that you know of but two experiments upon human beings made in this country and recorded in the medical litera- ture of the United States. There is indeed need of further enlighten- ment, if the medical profession of this country, so worthily represented by yourself, is ignorant of what has been done by men without pity and without conscience. Trusting to have response from you at an early date, I am, Yours most truly, James M. Brown, President. II. Dr. W. W. Keen to President James M. Brown. 1729 Chestnut Street, Philadelphia, Pa., Jan. 21, 1901. James M. Browx, Esq., President American Humane Association, Toledo, Ohio. Dear Sir: — Your letter of October 4 reached me promptly, but as I then notified you would be the case, very pressing engagements, absence, etc., prevented an earlier reply. Now that I have a little leisure, I can answer your letter and furnish you in detail the proofs for which you ask. There are two pamphlets, both entitled "Pluman Vivisection." First, one of thirty pages, "printed for the American Humane Association, 1899 ;" the other of seven pages, "published by the Humane Society, Washington, D. C," without date, but from its contents published a little later, as it is chiefly a synopsis of the same instances reported more fully in the larger pamphlet. Hereafter when I speak of "the pamphlet" I mean the larger one, unless I specifically mention the smaller one. This larger pamphlet consists of two parts : first, (pp. 3-12) a reprint of a portion of "Senate Document No. 78" and the rest of it of various quotations, translations and comments. No name is attached to either part to indicate who is responsible for the accuracy of the references, the translations or the quotations. As the whole is preceded by an open letter signed by the president and secretary of the American Humane Association, and as you refer to the pamphlet as "ours," I presume the association holds itself responsible for such accuracy, espe- cially as you, as its new president, challenge me for proof. The pamphlet purports to furnish a reprint of a portion of "Senate Document No. 78," and refers to this document in a way that would lead uninformed readers to suppose that this is a document expressing the sentiments of the United States Senate. It is, therefore, important to call your attention to the fact that Senate Document No. 78 is simply a collection of statements and papers by various persons, printed by order of the Senate, but in no sense expressing the opinions or convictions of that body. The last paper in this document is one on "Human Vivisec- tion," by "A. Tracy." In two respects "A. Tracy" has a right to complain that the reprint is inaccurate : First, it omits to print the name of the author "A. Tracy." Surely he — or she (?) — should receive whatever credit there is attaching to his work. Secondly, on page 30, line 8, of Senate Document No. 78, I read "A. Tracy's comment. ["This patient, therefore, was scien- tificially murdered."]' This statement the reprint very wisely omits — but there are no indications of the omission. Of this, more hereafter. Your letter challenges the accuracy of my statements in three particu- lars : I. I stated that many of the references in the pamphlet are "vague and indefinite." 2. I said that some of the accounts of the experiments are "garbled and inaccurate. 3. I stated that of the experiments nar- rated in the pamphlet only two were alleged to have been performed in America. Letter of Dr. W. W. Keen. 9 You will pardon me if I indignantly resent your imputation of untruth- fulness in regard to this last statement. You entirely misinterpret my statement, which had no reference to my knowledge or ignorance of any other American experiments. I said that the pamphlet only contained two instances of such experiments which were alleged to have been done in America. These are recorded on pages 4 and 5 of the pamphlet. All the rest were done in Europe, South America, and Hawaii, years before it came into our possession. If you still question the accuracy of my statement and believe that there is a third instance of experiments done in America and described in the pamphlet, point it out by page and paragraph. Turning to the other two really important matters referred to in your letter, let me again state clearly the question at issue. It is not whether the experiments meet with my approval, but solely whether the reports of them in the pamphlet issued by the American Humane Association are reliable and accurate both as to their sources and substance. I. MANY OF THE REFERENCES ARE VAGUE AND INDEFINITE. The references are so vague and indefinite in many cases that the statements and quotations made can not be verified by consulting the originals. The preface of your president and secretary states that "in each case the authority is given," and what sort of "authority" do you depend upon? Newspaper medicine and surgery are notoriously inac- curate. I have personally had so much experience and observation of this that I am always certain that at least one-half or more of the state- ments in newspapers in reference to medical matters are inaccurate, not purposely, but only because the writers are not medical men. Yet you depend for the accuracy of your statements upon newspapers as follows (I follow the inaccurate spelling of foreign names in your pamphlet) : 1. The Vienna correspondent of the London Morning Leader, Jan. 26, 1899 (p. 3), of whom more hereafter. 2. The Deutsche Volksblatt , Jan. 25, 1899, (p. 3.) 3. The Washington correspondent of the Boston Transcript, Sept. 24, 1897 (p. 9), of whom more hereafter. 4. The N. Y. Independent, Dec. 12, 1895 (p. n). 5. The London Times, June 27, 1891 (p. 16). 6. The Tagliche Rundschau of Berlin (p. 17) ; no year, month or day being given. 7. The Vossische Zeitung of Berlin, no year, month or day being given (p. 18). 8. The Vorwartz, no year, month or day being given (p. 18). 9. The Danziger Zeitung, July 23, 1891 (p. 18). 10. The Schlesische Volkszeitung, July 24, 1891 (p. 18). 11. The Hamburger Nachrichten, July 1S91, no day stated (p. 19). 12. A correspondent of the Newcastle (England ?) daily Chronicle, Sept. 21, 18S8- (p. 22). 13. Dr. R. E. Dudgeon, in the Abolitio7iist , April 15, 1899 (p. 24). 14. A letter by Dr. Edward Berdoe to the London Chronicle, without year, month, or day (p. 29). Few of these fourteen newspaper references can be consulted in this country; five of them (Nos. 6, 7, 8, 11, and 14) are impossible of con- sultation for want of any date whatever. In no case would I be willing to admit a newspaper paragraph, a non- professional and usually unsigned statement — even if correctly quoted — as a sufficient authority for a grave charge against an individual or the profession. 10 The Hitman Vivisection Controversy. Look for a moment what stuff Senator Gallinger stated at the "Hear- ing" he had himself caused to be printed. It is published on page 31 of the "Hearing" and on page 3 of the pamphlet. It consists of cable dispatches printed in some newspaper — Senator Gallinger did not even remember its name. The author of the dispatch from London is utterly unknown. The dispatch states that "the Vienna correspondent of the [London] Morning Leader says" so and so. Who and how reliable is the Vienna correspondent? He says that "the physicians in the free hospitals of Vienna" do so and so. Who are the physicians? In what hospitals were these deeds of darkness done? And upon such evidence it is seriously proposed to indict the medical profession! Whether these dispatches are "garbled and inaccurate" in their alleged facts who can find out? If a lawyer tried to convict a man of petty larceny on such testimony, he would be laughed out of court. And yet a senator of the United States and the American Humane Association actually adduce such statements as evidences of the gravest charges and spread them broad- cast! I now add six other "vague and indefinite" references not to news- papers. 15. On page 13 there is a quotation from Tertullian. The reference in the foot-note is "Tertullian, De Anima, Vol. ii, pp. 430, 433, Tran., by Holmes." I have compared the quotation with Clark's Edinburgh edition of the Translation of Tertullian by Holmes, the date of the edition being 1870. No such quotation exists on pages 430-433. Possibly it may be that the quotation is from another edition. No edition is named in the pamphlet ; another instance of a "vague and indefinite" reference. 16. On page 17 a formal accusation is quoted as made by a Dr. Eugen Leidig against certain surgeons. No reference whatever to any book or journal is given by which the accuracy of the quotation can be tested. Is not this again "vague and indefinite?" 17. On page 24 is a reference to a paper by "Professor E. Finger, of Vienna (Allg. Weiner Med. Zcitnng, Nos. 50 and 51)." No year is given, a somewhat essential part of the reference, as there are over forty volumes of this journal, each with the weekly numbers 50 and 51. No such paper by Finger is published in that journal, at least from 1890 to the present time. The reference is quoted from a paper by Dr. R. E. Dudgeon in the Abolitionist — an English journal — of April 15, 1899. I have been unable to consult this journal. If Dudgeon gave the year, then the Humane Association pamphlet has misquoted him. If he did not, then both the Association's pamphlet and he have been "vague and indefinite." 18. On page 25 again is a reference to a statement in a "lecture before the Medical Society of Stockholm," by Dr. Jansen, of the Charity Hospi- tal, reporting certain experiments. No reference whatever is given even to a newspaper, much less to any medical journal. As the statement is in quotation marks it purports to be the exact words used and ought to have had some source to which a reference was possible, especially as the preface of the pamphlet says : "In each case the authority is given." I am glad to see that in your letter you recognize this as one in which the reference is really inadequate. I notice, however, that even in your letter you do not supply this missing reference. You say the facts asserted in the Jansen paragraph have never been denied. Of course not. The first requisite is to know whether they are correctly quoted. Turning now from the larger pamphlet to the smaller one, which was spread broadcast by house to house distribution in Washington at the time when the hearing on this matter took place last winter, I find repeated in this a number of the same vague and indefinite references Letter of Dr. W. W. Keen. 1 1 and garbled and inaccurate quotations already or to be described, to which are to be added the following : 19. On page 3, an extract from a report referring to experiments upon insane patients is printed in quotation marks. The only reference is to a "published report" in 1890 of the "Medical Staff of the Public Insane Asylum in Voralberg, Austria." The librarian of the Surgeon General's office informs me that there are two small insane asylums in the Voralberg, namely, at Hall and Valduna. Some reports of the former are in the library and in them no account of the experiments referred to can be found. No reply has been received to a letter addressed to this asylum as named in the pamphlet and written over a year ago.* 20. On the same page is an account of some experiments on bacteria from boils, and the reference is to the "Deutsches Volksblatt ;" no day, no month, no number, no page, nor even the year is given. If this is not "vague and indefinite," what is? 21. On page 24 there is an account of Kroenig's experiments, to which I shall recur later. No reference whatever is given to the source from which the account is taken. 2. SOME OF THE STATEMENTS ARE GARBLED AND INACCURATE. To be vague and indefinite in charges affecting the morals and the reputation not only of individuals, but, in fact, of a whole profession is bad enough, but to make statements that are "garbled and inaccurate" is, as your letter recognizes, a much more serious matter. Let me con- sider the instances in detail. 1. "Vivisection Experiments Upon the Insane," pages 4 and 5: In the following quotation, the words of the original, which I enclose in brackets, are omitted. "To these patients the thyroid tablets [each pill representing five grains of the fresh sheep's gland] were administered," etc. This omission is of moment, because any one familiar with the administration of thyroid extract knows that the doses used by Dr. Berkley are frequently given to human patients, including the insane, without producing symptoms dangerous to life, but on the contrary with benefit. I have myself given such tablets to patients with goiter for weeks together in larger doses than Dr. Berkley used. In the following paragraph the quotation is garbled by omitting the words which I enclose in brackets : "Two patients became frenzied and of these one died before the excitement had subsided [the imme- diate cause of the exitus being an acute disseminated tuberculosis]." And again in the next paragraph giving a report of the same case, the pamphlet quotes : "The thyroid extract was now discontinued, but the excitement kept up. . . . for seven weeks, at the end of which time she died." One would think this was the end of the sentence and that she died from the effects of the thyroid tablets. Not at all. The original continues as follows : She died "with the clinical evidences of acute military tuberculosis" — galloping consumption. Does this not come within the definition of garbling given in your letter? "A 'garbled' quotation is one which, by reason of omission and perversions, is essen- tially unfair." To say that this patient, who actually died of galloping consumption, died from the effects of the thyroid extract, which had not been given for seven weeks before death, is as absurd as it would be to say she had died from the effects of moderate doses of laudanum given seven weeks before. Yet "A. Tracy's" comment on this case is: "[This patient was, therefore, scientifically murdered]." Your Asso- ciation mutilates its reprints by wisely omitting this piece of absurdity, though the omission is not indicated. Moreover, the pamphlet states: * This letter was written by myself and not by the librarian. 12 The Human Vivisection Controversy. "there is no intimation that the administration of the poisonous substance was given for any beneficial purpose to the patients, for he took care to select patients that were probably incurable." On the contrary, Berkley's original paper expressly states that instead of being incurable, one (Case i) was cured and another (No. 3) was improved. Besides this, though the pamphlet is dated 1899, it omits all reference to Dr. Berk- ley's letter to the British Medical Journal for October 30, 1897, in reply to your friend Dr. Berdoe, which shows that, as a result of the admin- istration of the thyroid tablets to these eight patients — a well recognized remedy for insanity,* not one died from the effects of the drug, but that, on the contrary, two of those alleged "incurables" were cured — 25 per cent. In his admirable letter to Life — Dec. 6, 1900 — Dr. Berkley says : "The purpose for which the article was written was to show to the medical profession that a certain medicament in common use was not free from objection, and should not be given in unsuitable cases. In proper ones the results are among the most resplendent attained by modern medi- cine, converting the drooling dwarf into an intelligent, well-grown man or woman ; or in other instances, as in myxedematous insanity, afford- ing the otherwise hopelessly insane with almost a specific to recover their reason." [See the addendum at the end of this letter.] 2. The Cases of Lumbar Puncture, by Dr. Wentworth, of Boston, (p. 5) : "Lumbar puncture," I may remind you, is the simple insertion of a hypodermic needle between the vertebrae into the sheath of the spinal cord, but below the cord itself, to obtain a few drops of the cerebro- spinal fluid for diagnosis. The pamphlet gives what is called a "brief abstract" of five of the experiments related. The abstracts are indeed brief, so brief as to give a wholly erroneous impression as to the causes of the patient's death. The omissions are glaring instances of what the logicians call a sup- prcssio veri equivalent to a snggestio falsi. Let me point this out in detail. Case 2. It is correctly quoted that the last puncture (where there were several punctures I only give the last date) was made "Feb. 16, on the day of patient's death." The pamphlet fails to add, however, the important fact stated by Dr. Wentworth that the post-mortem showed an empyema [abscess in the chest] which had burst into the lung, pneu- monia, and inflammation of the brain with pus as the cause of death. Case 3. The pamphlet correctly says "puncture Jan. 17, 1896; patient died Jan. 22." What Dr. Wentworth adds is omitted, namely: "No symptoms attended or followed the operation." Moreover, the post- mortem showed that the patient died from the widespread changes com- mon to infantile wasting. Case 5. The pamphlet says: "Puncture Feb. 3. 1896; patient died Feb. 4." It omits to state what immediately afterward follows, that the post-mortem showed "primary tuberculosis of the intestine. Double pneumonia," as the causes of death. Case 6. The pamphlet quotes "Puncture Feb. 1 ; patient died in convulsions three weeks later." It neglects to state, what Dr. Went- worth particularly mentions, "no reaction on the part of the patient attended the operation," and it also fails to state that the child was seen only once and that the diagnosis then made was tubercular menin- * I quote the following from the eighth edition of Hare's Therapeutics, as to the use of thyroid extract : " In the dose of from 5 to 20 grains (0.35-1.3) three times a day [i. e. 15 to 60 grains a day] according to the degree to which it produces its effects, it has proved of value in acute mania and melancholia, puerperal and climacteric insani- ties and in stuporous states with primary dementia." Berkley's maximum dose was 15 grains a day. Letter of Dr. W. W. Keen. 1 3 gitis, which was clearly the cause of the child's death, three weeks later. Case 7. The pamphlet quotes "Punctured Feb. 27; patient died Feb. 28. It omits the fact that the post-mortem showed that the child died from defective development of the brain and other causes ; and that the history showed that the child, who was seven months of age, had "frequent convulsions which began when he was about three months old. While in the hospital the convulsions occurred not less than twenty times a day. Oftentimes he had several in an hour." The inference from the pamphlet's "brief abstracts" of these cases is clearly, and it seems to me by these omissions was meant to be, that the deaths were due to the lumbar punctures, whereas the evidence is that the deaths were due to other causes and in two instances the operation is expressly stated not to have done any harm. Are not these abstracts "garbled and inaccurate?" 3. On page 7 the pamphlet refers to some experiments on the inocula- tion of lepers with syphilis, made in Hawaii, but published in the N. Y. Medical Record of Sept. 10, 1892. It is stated that the patients "were already suffering from one incurable disease and the object of the experiment was to ascertain whether with another, and even worse dis- order, they might not be infected." This statement is incorrect. Most writers recognize only three stages of syphilis, primary, secondary and tertiary. The writer of the article in question believed that leprosy was a fourth and final stage of syphilis and not an independent disease. It is a well recognized fact by all scientific writers that a patient suffering from syphilis in any stage is immune to an inoculation of the virus ; that is to say, the inoculation will not "take" if he is already a syphilitic. It was for the purpose of determining whether leprosy was a fourth stage of syphilis that the attempt was made. None of those inoculated took the disease. 4. Sanarelli's Experiments on the Inoculation of Yellow Fever, page 8 : The references here are to the British Medical Journal for July 3, 1897, and the New England Medical Monthly, March, 1898. The extracts marked with quotation marks are from the New England Medical Monthly. Between the first and the second sentences of the quotation there should be some stars to note an omission, but none such appear. The omitted words state that not the germs of the disease, but the carefully filtered and sterilized germ-free fluid was used. Besides this and many other minor inaccuracies many of the scientific terms are changed into non-medical terms, which is not objectionable in itself. But such changes and inaccuracies should exclude quotation marks, for when used they mean that the words quoted are the ipsissima verba of the author, if in the same language, or an exact translation if from a foreign language. But this is the least of all. The pamphlet says that the injection pro- duced certain symptoms, among which are mentioned "the jaundice, the delirium, the final collapse," the last three words being in italics in the pamphlet to call special attention to them. In the British Medical Journal and in the New England Medical Monthly the words "the final" are not to be found. We see not a few patients suffering from "jaundice, delirium and collapse" who recover, but when the expres- sion is changed to "the final" collapse it means to every one that the patient died. Moreover, the end of the quotation is as follows : "I have seen [the symptoms of yellow fever] unrolled before my eyes thanks to the potent influence of the yellow fever poison made in my laboratory." This entire sentence does not occur either in the British Medical Journal or in the New England Medical Monthly. Whether it is quoted from some other source not indicated, or has been deliberately added, I leave you or "A. Tracy" to explain. 14 'The Human Vivisection Controversy. Moreover, immediately afterward, on the authority of the Washington correspondent of the Boston Transcript, it is stated: "It is understood that some, if not all, of the persons inoculated died of the disease," and then seven times afterward are repeated "the final collapse," the "unroll- ing before the eyes," "scientific assassination," "death," and "murder" quoted from a public speech before the American Humane Association. Let us see if these were "murders." In the two references given there is no indication whether any of these patients died or not. How, therefore, "it is understood that some, if not all, of them died," I do not know. As a matter of fact none of the human beings inoculated by Sanarelli died, as any one desirous of learning the truth could have ascertained by consulting Sanarelli's origi- nal publication reporting his experiments with full details. (Annali d'lgieue Sperimcntale, 1897, vol. vii, Fascic. iii, pp. 345 and 433.) What hysterical oratory about "the final collapse," which was not final; "scientific assassination," which did not assassinate; and "mur- der" of those who were so disobliging as still to live ! And this on the authority of the Washington correspondent of the Boston Transcript, who the pamphlet assures us is a person "who would seem to be unusu- ally well informed in matters of science !" An excellent example of "newspaper medicine" and a good reason for my refusal to accept it as evidence, especially from other correspondents who may not be as "unusually well informed." May I ask whether "the Vienna corre- spondent of the London Morning Leader" is also one of those who, in your opinion, is "unusually well informed in matters of science," and whether his testimony is as wholly false as the one under considera- tion ? 5. On page 23, the pamphlet quotes an account of some experiments of Dr. Neisser from the "Medical Press and Circular [England], of March 29, 1899." This is an instance again of misquotation and omis- sion which can scarcely be other than intentional. The last sentence of the first quotation states : "of these eight girls, four developed syphilis." No stars indicate that any words have been omitted. The original reads : "of these eight girls [five were prostitutes, and of these five] four developed syphilis." The words in brackets are entirely omitted in the pamphlet. They make a deal of difference, for what is more probable than that four out of five prostitutes should develop syphilis? Whether it makes any differences or not, however, is at present not the question. The issue is whether the quotation is "garbled and inaccurate." Does it not fulfill another of the definitions of "garb- ling" given in your letter, viz : "omissions of essential facts .... sufficient to impair the accuracy or fairness of the quotation?" Moreover the pamphlet's comment upon this case is as follows : "Does the London journal which reports these awful experiments denounce them as a crime against every law of morality? Not at all. It simply says that "it would be difficult to acquit Dr. Neisser of a large measure of responsibility in respect of the causation of syphilis in these cases !' Could reproof be more gentle?" Is that really all that the Medical Press and Circular "simply says?" On turning to that journal, after the above sentence, which is correctly quoted, the editorial continues thus: "We, however, are less concerned in establishing the culpability of Dr. Neisser than in condemning"the spirit which prompted such experiments. All measures, even if novel, which may reasonably be expected to assist in bringing about the recovery of the patient without injury to his health may legitimately be resorted to with the consent of the patient, but measures, whether by drugs or by operation, which have not for direct object the cure of the patient and which may prove inimical to his health or condition, are inadmissible under an}- circumstances and must expose the perpetrator to professional ostracism and to penal rebuke." Letter of Dr. W. W. Keen. i 5 Is "professional ostracism and penal rebuke" a reproof than which nothing could be "more gentle?" If this statement is not "garbled and inaccurate," what do words mean? How could this misrepresentation be otherwise than intentional? 6. On page 24 again, reference is made to the experiments of Menge.* The extracts being in quotation marks would purport to be exact trans- lations. This is not the case. The collocation of the paragraphs, also — especially in the smaller pamphlet — is such that it would be supposed even by a careful reader that the babies experimented upon were inocu- lated with the germs taken "from the pus in the abdominal cavity of a person who had died of peritonitis," without any precautions or pre- liminary experiments, and that, therefore, these babies were exposed to a fatal infection. This is not true. Four columns of text in the original intervene between the first and the second paragraphs alleged to be quoted, and these detail experiments which proved that the inocu- lations which he then carried out would almost certainly be harmless. The result showed that he was right, for not the slightest ill effects fol- lowed. I have only words of condemnation for Menge's experiments, but to misrepresent these experiments is scarcely less culpable than to perform them. 7. Then follows a brief account of Kroenig's experiments. The objects of these, the pamphlet says, were "to observe the surest way of breeding purulent bacteria." This is not true. On the contrary, his object, like Menge's, was to determine how these bacteria are normally destroyed in the part of the body in which the experiments were made. In only a single instance did any ill effects follow, and in this case the inflammation was brief and not dangerous either to life or health. In fact, the very titles of these two papers proclaim the destruction of the bacteria and not the surest way of breeding them, as Menge's title reads : "On a quality ( Verhalten) of the vaginal secretion in non-preg- nant females, which is hostile to bacteria," and Kroenig's is on the same peculiarity in pregnant women. In the comment of these two series of experiments, they are spoken of as inoculations "with loathsome diseases," which would suggest to any one that the patients were successfully inoculated with syphilis or other similar diseases. This was not the case. Only inflammation would follow even had the inoculations been successful. Moreover, to show the vague looseness of the alleged quotations, the two paragraphs on the experiments of Menge are in quotation marks and are introduced by the words, "He says : The bacteria I used, etc.," as if they were exact continuous translations. "He says" nothing of the kind. Instead of being exact translations, the first paragraph is made up of partly correct and partly incorrect translations from page 891 near the top of the second column and near its middle ; and the second paragraph of partly correct and partly incorrect translations from page 907 near the bottom of the first column. No reference whatever is given to Kroenig's paper either by number, date or page. Is not this "vague and indefinite?" As a matter of fact it is the same journal (No. 43, p. 819) as Menge's paper, but published three weeks earlier. 8. On page 25 is one of the most outrageous instances of garbling, and mistranslation, or worse, which I have ever known to be perpetrated, even in antivivisectionist publications. It relates to observations and experiments of Professor Schreiber, reported in the Deutsche medi- cinische Wffchenschrift of Feb. 19, 1891. The subject is introduced with the startling caption : "Inoculations with Tuberculin and Germs of Con- sumption." In the smaller pamphlet the caption is simply: "Injected Germs of Consumption." What was injected was not the "germs of consumption" at all, but tuberculin, a substance which at the date of * Deutsche medicinishe Wochenschrift \ 1894, Nos. 46 to 48. 1 6 The Human Vivisection Controversy. Professor Schreiber's publication was engaging the attention of physi- cians throughout the civilized world as a therapeutic and diagnostic agent. To describe inoculations with tuberculin as "inoculations with the germs of consumption" can be attributed only either to gross ignor- ance or to wilful disregard of the truth. In the first paragraph occurs the sentence : "He began with one decimilligram and continued to inject the tuberculin in ever-increasing quantities, until he at last injected as much as 5 centigrams, about 50 times as much as Kock said was the maximum dose for children of three to five years old." Any fair presentation of these experiments would have included Professor Schreiber's sentence, which he prints in bold- face type: "But even with so large a dose injected at one time, the children snowed no trace of a reaction." It would perhaps be too much to expect your society to have indicated on what grounds Profes- sor Schreiber was led to the employment of such large doses, and that his observations demonstrated for young infants an exceptional tolerance of tuberculin, a phenomenon for which there are analogies with other drugs. But the worst falsification is the succeeding account, in the form of what purports to be an exact translation, of Schreiber's inoculation of a boy with tuberculin. The alleged quotation begins : "I am sorry to say that it is very difficult to obtain subjects for such experiments. There are, of course, plenty of healthy children in consumptive families, but the parents are not always willing to give them up." The words : "I am sorry to say that," and the entire next sentence, "There are, of course, plenty of healthy children," etc., are not in the original, but are additions made out of the whole cloth. The next following sentences contain many inaccuracies, such as the translation of the German words betrdchtlich anschwollen as "swelled up enormously," instead of "swelled up considerably." But the worst is the deliberate insertion of the following sentence, italicized in the pamphlet, which also does not occur in the original: "I can not yet say whether the boy will be con- sumptive in consequence of my treatment." The correct translation of Schreiber's words at the point where this closing sentence appears in the pamphlet is as follows : "I could discover no other alterations in the otherwise apparently healthy boy." [Andere V er'dnderungen konnte ich an dem soust gesund schcinenden Knaben nicht entdecken."] While I have said enough about this case to substitute my charge of garbling and inaccuracy, I can not refrain from utilizing it also to show the utter misapprehension which the citation of detached sentences and paragraphs from the medical articles is calculated to create in the mind of a non-medical reader. Even when the words are quoted correctly, they are likely, when detached from the context, to give rise to entirely false impressions. This is a criticism which applies not only to other examples cited in this pamphlet, but to a very large number of reports of experiments and of quotations from medical journals and books cur- rent in anti-vivisectionist writings, and the resulting dissemination of erroneous conceptions is often greater even than that caused by inaccu- rate or garbled quotations. A brief explanation of the present example will show the justification of this charge. For what purpose did Professor Schreiber inoculate the boy with tuberculin? His article leaves no doubt as to the answer. He points out the importance of the earliest possible recognition of tuberculosis in a patient in order to secure the best curative results. The boy's mother had consumption and the author calls attention to the frequency of unrecognized tuberculosis in the offspring of tuberculous parents. The boy received a small dose — 1 milligram — of tuberculin, which if he were free from tuberculosis would produce no effect but which if he had unsuspected tuberculosis would produce a transient — though possibly a severe — fever, and a local reaction indicative of tuberculosis. Such Letter of Dr. IV. W. Keen. 1 7 reaction followed the injection of tuberculin, and the diagnosis of tuber- culosis, which had not been, and very likely could not have been, made in any other way, was established. I do not know what could have been more fortunate for this boy than the recognition in its incipiency of a disease previously unsuspected and which, recognized thus early, should in all probability be cured by proper treatment. This tuberculin test is constantly employed to prevent the spread of tuberculosis in out cattle. In our children it enables us to discover the same disease in an early, curable stage. Shall we care for our cattle better than for our children? Its use is not properly to be called an "experiment" at all. As I write this, I find in the Journal of the American Medical Association for Jan. 12, 1901, page 75, three cases of the use of tuberculin in human beings by Prof. J. M, Anders, who points out its value in enabling us to diagnosticate consumption "in latent forms and dubious cases, how- ever incipient," long before percussion or the stethoscope will reveal the disease. I can imagine his surprise if he were charged with making three horribly cruel "experiments" and injecting the "germs of con- sumption !" It is euphemism to call such an alleged quotation, in which words and one entire sentence are interpolated and another wholly changed in meaning, a "mistranslation" or even a "garbled and inaccurate" account. Does it not amount to literary forgery? It is another illus- tration of the fact that when an anti-vivisectionist attempts to say any- thing about scientific experiments either the moral sense is blunted or the truth-telling faculty is in abeyance. A good English example is the misstatements in Miss Frances Power Cobbe's book, laid bare by Victor Horsley, and Schreiber's and Sanarelli's cases will serve as excellent examples of American misrepresentation — if so long a word is needed to describe them. I am sorry my reply is so long, but in fewer words I could not explain the many and gross errors to be pointed out. I have given you indeed "many" instances in which the references are "vague and inaccurate," and "some" in which the accounts are "garbled and inaccurate." These adjectives are, I submit, very mild ones to apply to such a pamphlet. You can hardly be surprised after the extraordinary and repeated interpolations, mistranslations and worse which I have demonstrated in this letter that I am unwilling to accept any alleged quotation or trans- lation emanating from the American Humane Association as accurate and truthful unless I can compare it with the source from which it is derived. In conclusion let me commend to the "Humane" Association the closing words of President Eliot's letter, to be found on pages 218-9 of the "Hearing" : "Any attempt to interfere with the necessary pro- cesses of medical investigation is, in my judgment, in the highest degree inexpedient and is fundamentally inhuman." I shall take the liberty of publishing my reply. I suppose that you will not object to the publication of your letter with it in order to explain the reason for the reply. Very respectfully yours, William W. Keen, M.D. ADDENDUM. Since this letter was written I have seen an article in "Gould's Year Book of Medicine and Surgery," 1901 (Medical Volume, p. 327), from the Archives of Pediatrics for June, 1900. p. 431, by H. Oliphant Nichol- son of Edinburgh, Scotland, reporting the case of Annie C, a girl of two years and eight months old. 1 8 The Human Vivisection Controversy. Dr. Keen proceeds to quote further particulars regarding the medical treatment employed and the results obtained by Dr. Nicholson in his interesting case of cretinism. We omit, partly because this Addendum was not included in Dr. Keen's letter to President Brown, but prin- cipally because this case of legitimate medical treatment has not the slightest relation to matters in controversy. Dr. Keen concludes as follows : "If Dr. Berkley's use of the thyroid extract, which cured two out of eight patients, was an experiment, and its administration by Dr. Nicholson also was an experiment, the more of such happy experi- ments we could have, the better." III. The Reality of Human Vivisection A REVIEW OF DR. KEEN'S LETTER. At last we have from the pen of a physician and surgeon widely known throughout the United States, what is practically an apology for the practice of Human Vivisection. Purporting merely to criticize a pamphlet exposing the atrocity in question, he spares no argument that might tend to exonerate those charged with this offense, or that would cast odium upon those who have unveiled to the public eye the horrors of hospital experimentation upon the helpless and the poor. The appearance of this defense, — we can give it no other name, — is of peculiar and painful significance, and fully justifies the apprehensions which have long been felt in regard to this atrocious practice. The evolution of this defense is of interest. At the "Hearing" before a Senate Committee in Washington, February 21, 1900, Senator Gallinger called the attention of Dr. William W. Keen, then under examination, to certain phases of scientific experimentation upon human beings. "I pre- sume," said Dr. Keen in reply, "you refer to a pamphlet issued by the American Humane Association. I have only to say in reference to it that there were a number of experiments which I would utterly con- demn. Of the experiments narrated in that pamphlet I have looked up every one that I could. Only two are alleged to have been done in America. Many of them are so vague and indefinite that I could not look them up, but as to those that I could, some are garbled and inaccurate, not all of them, observe." 1 How skillfully is vague repre- hension, — without one single specification, — mixed with insinuation of unreliability and literary fraud ! The president of the American Humane Association challenged Dr. Keen by letter to make good his words; and after some months' delay, he has published his reply Review of Dr. Keen's Letter. 19 in the Journal of the American Medical Association of February 23, 1901, and printed it for distribution in pamphlet form. It is a document which it is difficult to characterize. By minutest criticism of words, by disparagement and detraction in all conceivable ways, or by actual misstatements of fact, he has endeavored to convey the impression that the charges of experimentation upon human beings are, on the whole, incredible and absurd; that legitimate methods of medical and surgical treatment have been viciously or ignorantly exaggerated into "experiments," — when there was no experiment; — and that no cause exists for denouncing the men who have been charged with these horrible deeds. Of one series of experiments only (the unspeakably vile and atrocious investigations of Menge), does Dr. Keen affirm his condemnation; but the intensity of his disapproval he at once permits us to measure by the statement that "to misrepresent these experiments is scarcely less culpable than to perform them!" Here, assuredly, Dr. Keen speaks his mind; and we have no doubt that these inoculations of new-born babes, — wrapped at their birth in sterile towels and conveyed from the bedside to the laboratory for experimentation — "sofort nach der Geburt in sterile Tiicher gehiilt, und ini Laboratorium su den Versuchen verwendet," 2 — stand in his judgment on a moral equality with the misconceptions of a translator, or the mistakes of a copyist ! The impression of a careful reader of Dr. Keen's letter may be that in these apologetic references to human vivisectors he has gone a little too far. But should we not remember that he is writing in defense of others? To what extent an advocate in discharging his duty may be allowed to overstep those bounds of fairness or of veracity which ordinarily govern the conduct of honorable men, is a question upon which the highest authorities are not agreed; but it is certain that he may go very far. Lord Brougham, before he became the Lord Chancellor of England, in one of the greatest of his speeches delivered before the House of Lords, laid down the law by which he was governed, in the following terms : " An advocate, by the sacred duty which he owes his client, knows in the discharge of that office but one person in the world, — that client and none other. To save that client by all means and expedients, to protect that client at all hazards and costs to all others, — and among others, to himself, is the highest and most unquestioned of his duties ; and he must not regard the alarm — the suffering — the torment — the de- struction which he may bring upon any other. Nay, separating the duties of a patriot from those of an advocate and casting them, if need be, to the wind, he must go on, reckless of consequence, if his fate it should unhappily be to involve his country in confusion for his client's protection." 3 Human vivisection may be said to be on trial before Public Opinion. It has been impeached as opposed to the spirit of Christianity on account of its cruelty and for its absolute disregard of human rights, and Dr. Keen, let us suppose, is counsel for the defense. In the criticisms we propose to make of Dr. Keen's paper, certain clear distinctions should 20 The Human Vivisection Controversy. therefore be kept in mind. For Professor Keen, the surgeon and mem- ber of a leading Christian denomination, we may have, of course, great respect; but for the specious apologist of human vivisectors, we shall not be sparing in criticism and reproof. If we show that for the sake of human vivisectors he has hesitated at no device of apologetic sug- gestion in defense of unspeakable outrages upon the weak and defense- less, let it be understood that we are denouncing merely the advocate and not the man. If such advocacy has imposed silence where we had hoped for outspoken condemnation; if he has abundant epithets of scorn and vituperation for the errors of a translator, but no words of mildest censure for some of the vilest crimes against Humanity, — the inoculation of innocent children with foul disease, the grafting of cancers into the healthy breasts of unconscious women by men of his profession, or the inoculation of hospital patients with yellow fever; if unbounded zeal has sometimes seemed to carry him even beyond the borders of truth, and caused him to rely upon petty tricks of duplicity and equivocation, we shall assume that it is due to that mistaken advo- cacy which he so unwisely undertook. The vileness of the practice, which he seems to defend by interposition of his professional repute, no words can express. For whatever endeavors he has put forth to turn aside the execration sure to overtake it when the facts are fully known, we believe that Dr. Keen will one day experience the bitterest regret. We wish to do Dr. Keen no injustice in the criticisms we -are about to make. He will doubtless protest loudly that he sufficiently voiced his condemnation of the practice in that reply to Senator Gallinger, which we have just quoted. But such words of vague reprehension, unaccompanied as they were, by any word of specific reproof, resem- ble precisely the denunciations of that prudent puritan, who preached most vigorously against "the exceeding sinfulness of sin." Such methods of condemnation touch the sensibilities of no offender. One by one, in careful examination of details Dr. Keen has weighed some ■of the worst conceivable experiments upon women and children, related in the pamphlet Human Vivisection; which experimenter of them all has he dared to denounce? Not one has he named, or even referred to in any such way as would hinder the man from grasping his hand in gratitude and tacit appreciation. No reader of Dr. Keen's paper can doubt for a moment where his sympathies lie. No "condem- nation" of his, which mingles one word of mild disapprobation with a thousand of strenuous defense, is of the slightest weight. No con- demnation can have value which refers to crime with apology, and mentions criminals with respect. For plainness of speech or emphasis of condemnation we shall offer no apology; the subject requires it. Again and again, as a method of defense, Dr. Keen has insinuated against the American Humane Association, charges of literary dishonesty, the utter falsity of some of which — as we shall demonstrate, — he should have known. Such methods of controversy demand plain speech. We shall utter no words Review of Dr. Keens Letter. 21 that have not truth for their basis; we shall demonstrate, rather than assert; we shall be fair and just, but there shall be no cause on the part of human vivisectors or their apologists to complain that our meaning is vague or obscure. In attempting to nullify the disclosures regarding Hospital experi- mentation made by the American Humane Association in the pamph- let on Human Vivisection, Dr. Keen has directed his attack along vari- ous lines. We propose to meet him, and to consider : I. The Question of Vague and Indefinite Quotation. Were "many" of the experiments related in the pamphlet "Human Vivisection" so vague and indefinite that Dr. Keen could not look them up? Is human vivisection a reality or a myth? II. The Question of Garbled Quotation. Brevity of quotation zuas necessary. Were the omissions made by the compilers of that pamphlet of vital importance for determining either the fact of such experimentation, or the morality of the acts condemned, or zvere they on the contrary absolutely non-essential to any such judg- ment? III. The Question of Controversial Ethics. Has human vivisection been palliated by the suggestion of conclusions contrary to fact? These are practically the only points at issue. We propose to show that although some mistakes were made by copyists or translators, they were of a character that could not in a single case, change condemna- tion into approval, or lessen the abhorrence due to crime. We shall illustrate the method by which the offenses of human vivisectors may be palliated by the shrewd suggestion of conclusions manifestly false. We intend to prove beyond all question that human vivisection is a reality and not a myth ; and that of the experiments related in that pamphlet, "many" were not so indefinite and vague that Dr. Keen could not look them up. All this assumption of ignorance regarding experiments which have been, — and are, — the open scandal of the medical world, is pretence as unreal as that of the Tammany politician who questions the prevalence of vice, or the existence of vicious resorts, flourishing, it may be, on his own block. I. The Question of Vague Quotation. In his reply to Senator Gallinger, before quoted, Dr. Keen declared regarding the experiments narrated in that pamphlet that many "are so vague and indefinite that I could not look them up." In other words, regarding "many of the experiments" he could not find proof that they 22 The Human Vivisection Controversy. had been made ! That statement was challenged. It was pointed out by the President of the American Humane Association that, with one exception, every phase of experimentation specifically mentioned had some reference to a medical authority. Now, how is this issue met by Dr. Keen? It is met by evasion. Instead of acknowledging his error, Dr. Keen, arbitrarily, and without permission of anyone, changes the issue. "I stated/' he says in his reply to President Brown, "that many of the references were vague and indefinite." Absolutely untrue; he stated nothing of the kind ; we quoted his words at the outset, precisely as they stand— revised by himself, — in the Report of the Hearing. Does he claim that they mean the same thing? Then why did he change them? It is easy to see. As an illustration of what is meant by experiments so "vague and indefinite" that one cannot look them up, let us glance at the horrible "cancer-grafting" cases of certain European surgeons, to which the pamphlet Human J'ivisection first directed attention on this side of the Atlantic. To a hospital in France a poor woman was brought one day suffering from cancer of the breast. An operation was necessary; she consented, and was put under the influence of chloroform. After the operation, and while the patient was still unconscious from the effect of the anaesthetic, the operating surgeon, Dr. Doyen, carefully inserted a bit of the cancer he had just removed into the healthy breast of the victim. The wound healed ; nothing at first excited the patient's appre- hension or alarm. Then, some weeks after, she found, doubtless to her unspeakable horror and despair, a new cancer in the opposite breast ! And the crime was repeated. Let us give a brief summary of these two scientific experiments in Dr. Cornil's own words: (italics ours.) " L'operateur, apres avoir enleve cette tumeur, en a sectionne un tres petit frag- ment, et l'a insere sous la peau du sein du cote oppose qui etait parfaitment normal. L' operation avait ete faite pendant le sommeil chloroformique avec les precautions antiseptiques." The second case was almost exactly the same : " Apres l'ablation du sein malade et pendant le sommeil c/iloroformiqiie, le chirur- gien insera dans le tissu glandulaire du sein du cote oppose, un petit fragment de la tumeur enlevee. La greffe suivit la meme evolution.' -4 When Prof. Cornil read an account of these human vivisections before the Academy of Medicine in Paris, at the meeting of June 23, 1891, the members, — horrified by such disclosures. — hastened to record their deep- est condemnation. "In the name of French surgery, in the name of morality, I cannot too emphatically protest against this experiment," exclaimed Dr. Leon Le Fort. "It is surgical immorality," cried Dr. Larrey. "It is an essentially criminal act." said Dr. Moutard-Martin. Then in the outcry of abhorrence that arose throughout Europe, it was Review of Dr. Keen's Letter. 23 discovered that exactly similar experiments had not only been made in Germany, but — worst of all, — they had been openly described at meet- ings of physicians and surgeons, one of which was the 18th Congress of the German Medical Association ! The special correspondent of the British Medical Journal wrote thus from Berlin : " The question whether a surgeon is justified in inoculating a patient with minute particles of cancer is being as much discussed in medical circles in Berlin as it is in Paris. A Dr. Leidig — not a medical man but a lawyer, — has, in the public press accused Professors Hahn and von Bergmann of having inoculated carcinomatous patients with particles of cancer, in places where they were not diseased and of hav- ing thus artificially produced new cancerous foci. In proof of his accusation, Dr. Leidig quoted the following passages, from the Deutsche rnedicinische Wochenschrift- 1. Meeting of the Berlin Medical Society (Medicinische Gesellschaft) of Nov. 2, 1887. " Herr E. Hahn believes that he has proved by experiment that cancer is trans- ferable. He had removed particles of three nodules from a female patient suffering from carcinome dissemine with scissors, and had implanted them in different spots of the body. All three particles increased in size developing in cancer :" 2. Eighteenth Congress, German Medical Society, April 25, 1889. " Herr E. Hahn called attentiofi to the experiment performed by him two years ago, in which an ex- cised piece of caticer nodule from a female patient with incurable caiicer, was im- planted in a distant part of the body and covered with healthy skin. The nodule developed and increased to five times its size ; the surrounding tissue showed clearly the typical structure of cancer. Herr von Bergmann (of Berlin) has repeated Hahn' 1 s experiment with a similar result. " No answer having been made to Dr. Leidig' s accusation by Profs. Hahn and von Bergmann, the Cultus Minister intervened, and a few days ago demanded an imme- diate answer from both gentlemen." 5 For Dr. Keen's special benefit, we now quote the original report of Dr. Hahn's remarks, thus referred to by Dr. Leidig : " Herr E. Hahn glaubt durch ein Experiment die Uebertragbarkeit des Carcinoms erwiesen zu haben. Er hat einer Patientin die an Carcinome dissemine litt von drei Knotchen mit einer Scheere auf Art der Reverdin' schen Transplantation Thiele ent- fernt und an ganz entfernten Stetten implantirt. Alle drei K?wtchen sind fortge- ivachsen und habe/i sich als Carcinome iveiter enlwichelt.''' 6 It was the surgical scandal of all Europe. The British Medical Jour- nal editorially denounced the French surgeon's experiments in cancer- grafting as "an outrage, not only upon the unhappy persons referred to, but upon the whole medical profession." 7 The daily press discussed these abominable investigations with various expressions of popular abhorrence and condemnation. Certainly if any question affects the welfare of every woman, it is this. What wife, mother or sister under- going a surgical operation, would be safe, if, while unconscious, such "experiments" may be made, and the crime tacitly condoned, by all failure to condemn the perpetrators? Every medical man with any general education whatever is perfectly aware of this phase of human vivisection. Only two years ago, one of the most eminent of living American surgeons, Dr. Roswell Park, in a 24 The Human Vivisection Controversy. paper read before the New York State Medical Society, not only spoke of these cancer-grafting experiments of Dr. Doyen, but alluded to other crimes of the same nature, not yet made publicly known. After referring to various experiments upon animals, Dr. Park says : " But of still greater interest are the inoculations of cancer/r