Brunton, making use of the sphygmograph found that during a spasm of breast pang the intra-arterial tension was greatly increased; increased so much that the anguish of his patient might well be due to the resistance opposed to the systole of the left ventricle of the heart. Pondering on this fact it occurred to him that the agony should, then, be relieved if the smaller arteries could be dilated. Brandy, ether, chloroform, ammonia, and other remedies had been used over and over again in similar cases and with little benefit. He thought of Gamgee's experiments with amyl nitrite, and his chief in the Edinburgh Infirmary, Dr. Hughes Bennett, gave him permission to try it; the result stated in his own words was,* "my hopes were completely fulfilled. On pouring from five to ten drops of the nitrite on a cloth and giving it to the patient to inhale, the physiological action took place in from thirty to sixty seconds, and simultaneously with the flushing of the face the pain entirely disappeared. * * Occasionally it began to return about five minutes after its first disappearance; but on giving a few drops more it again disappeared and did not return.” The subsequent pharmacological researches of Brunton, of Wood, of Amez Dioz have justified the therapeutic conception which led to the first administration of amyl nitrite; and have suggested its use, with good results, in other diseases whose prominent symptom is vaso-motor convulsions.

*

Although it may and does fail in certain cases, there still remains the fact that many men and women who lived in terror, never knowing when a spasm of angina pectoris might agonize them, now go about their daily duties in peace, because they carry with them a tiny phial of amyl nitrite. To quote the words of Wood, "it seems useless to speculate how the nitrite acts in many cases; but there is now abundant evidence of its value in relieving, almost instantly, agony which has resisted all other treatment."

I should only weary you were I to repeat the story of other valuable additions to the materia medica due to pharmacological and physiological research; it would be to most of you but an old tale. It is, moreover, hardly necessary to point out that the story of the past, thoughtfully read, is the safest guide for the future. When, bearing this story in mind, we think also of the activity of modern chemistry, especially on its synthetic side, and realize that almost daily there are created in the chemical laboratories of the world new compounds, whose action on the animal body may be as potent, and,

*Lancet, 1867. Vol. II. p. 98.

in disease, as beneficial as that of chloral or strychnia; and that not one in a hundred of such compounds is now tested as to its possible therapeutic value; when we bear, I say, all these facts in mind, can there be any among us who does not feel eager to encourage and promote pharmacological research?

There are at present a small number of laboratories devoted entirely to such work on the continent of Europe; not one, I think, in the United States. Such investigations are of course often made here in physiological laboratories, but usually as a secondary matter and for purposes with no direct therapeutic end in view. I believe that as regards the advancement of medical art, there is nothing at present more desirable than an increase of well-equipped workshops, in which men already trained in chemistry, in physiology, in pathology, shall investigate the action of substances, with a view to discover whether they may be useful as medicines, and in what pathological conditions they may be rationally expected to prove of benefit.

Pharmacology depends on experiments on living animals. The whole history of the materia medica teaches that until such experiments were systematically made, drugs were selected and prescribed in accordance with erroneous and often fanciful notions. Its history also teaches that the action of no substance can be discovered by a priori reasoning. The attempt to do so leads only to such absurdities as the doctrine of signatures. The art of medicine advances by observation and experiment, rarely by accident.

Are we to experiment in the first case on men and women, or on the lower animals? It is incomprehensible that any one should hesitate as to the answer!

Test the new substance on the frog, on the rabbit, on the dog; and when we have thus gained a knowledge of the organs on which it acts and the mode in which it affects them, then, but not till then, try it on man. Repeated experience has taught us that in the vast majority of cases we may argue with much certainty from the influence of drugs on lower animals to their effect on human beings; therefore, we refuse to test first on man or woman a new remedy, though even the Bishop of Oxford and the editor of the Spectator protest that we have no right to sacrifice frogs or rabbits for the promotion of human welfare. To the physician, the preservation of human life is the most sacred of all duties. It is one to which all sentiments must yield, save those of truth and honor!

There is one great fallacy which invalidates most of the reasoning

of the anti-vivisectionists. They assume that physical pain is the greatest of evils. Some of the more extreme among them maintain that we have no right to kill a dog to save a man's life! These need no answer; they belong to the great army of "cranks," and the common sense of mankind will render them harmless. By the remainder, those who dispute our right to make man happier at the expense of lower animals, the question is not stated so plainly. They maintain that we may not hurt an animal in order that we may save man from pain. Were this a fair and full statement of the case, some of us might hesitate before dissenting from their view of the matter. There are men in the world whose sufferings I might rather witness than inflict the same on a dog. But physical pain is, after all, a relatively trivial matter; it is disagreeable, and it is one of our greatest rewards to be able in many cases to remove or alleviate it; but it is by no means the worst of ills. Many persons gladly submit to it for some mere gain in personal appearance, as the removal of supernumerary hairs from the face, or the extraction of an unsightly tooth. Not merely do men and women themselves undergo very severe pain for such purposes, but they cause their children to submit to it; thus emphasizing their conviction that there are things much worse than physical suffering.

It is not mere physical suffering that we labor to diminish. We labor to save life-human life with all its ties. Were I to see a man tortured with facial neuralgia, and knew that I could relieve him by inflicting equal pain on a dog or horse, I hardly know what my decision would be. I suppose I should decide in favor of the man. But that is not the question which faces our profession in regard to experiments on animals; it is how we may better our knowledge and increase our power to save the life of husband and father-of wife and mother-of the child in whose life the hearts and hopes of its parents are bound.

Certain of our opponents have their sympathies greatly excited by the occasional cry of a dog enduring pain from pharmacological experiment. Have they listened to the wail of the new-made widow? Some of them use their fiercest invective to calumniate those who have kept animals alive a few days after an experiment, that the causation of disease may be better understood and its prevention made possible. Have they realized the years of penury and misery too often the lot of the orphan? They have not felt personal responsibility for the life of the bread-winner, or they would surely say

with us, kill a hundred, kill a thousand animals if you have any reasonable hope of thereby preserving to one wife her husband; to one child its mother.

The history of experimental pharmacology teaches us that we have abundant ground for such hope.

No doubt many of you have sat up all night with a patient dying of tetanus-have seen convulsion follow convulsion and feared each one would be the last, yet almost hoped so, that the suffering might end. I shall never forget the night I spent by such a bedside. Harrowed by the agony before me, convinced that abnormal excitability of the gray matter of the spinal cord was its cause; certain that there was some drug, if I only knew it, which could act specifically on the nerve cells of this gray matter, and paralyze them long enough to give the system a chance to overcome the disease: reduced to despair, and suffering perhaps as much as the patient before me, from the torturing consciousness of my ignorant impotence-I felt then and feel now that this man's life should have been spared to his wife and children. We knew what the disease was; more earnest pharmacological research could and would have taught its cure.

As we look around, we see the fields white for the harvest! Is life or death to reap them? Truly the laborers are few, and if we toil not day and night to increase our knowledge and power to prevent and heal disease, the crop will nevertheless be garnered; a ghastly reaper who gathers where he has not strewn will be tirelessly at work; and his name is premature death.

To those who impede our work we answer: look around you and see the daily suffering due to disease. We are striving, and with greater success each year, to control and to diminish it; you can help us if you will; you can use your influence to ensure that sanitary laws be known and obeyed; that the hungry child has wholesome food; that the laborer shall not arise each morning so enervated by sleeping in an over-crowded room as to be driven to drink.

When through your efforts in such directions, supplemented by our investigations, it comes to pass that human disease no longer exists, and death is known only as the result of accident or old age, then we may listen to you if you ask us not to experiment on the lower animals. Until then we close our ears to your protests and, looking neither to the right nor left, press onward!

REPORT OF THE SECTION ON SURGERY.

ROBERT W. JOHNSON, M.D., Chairman.

Mr. President and Gentlemen:

Following the traditions of this Society, which time and experience have shown to be wise, your Section on Surgery beg leave to report some of the advances made in this department of medicine since the last annual meeting. We say some, advisedly, for so great is the ardor for novelty, so desirous are surgeons of the fame attached to new operations or procedures, that your time would be more than consumed did you hear a tithe of the surgical adventures of the last year. It has become our pleasant duty to cull from this mass a few of the more deserving grains, leaving the chaff.

Next to saving life our greatest function is the relief of pain. In the line of anesthesia we can report great advance. Your corneæ have of late been so deluged with 4 per cent. solutions of muriate of cocaine, through the press, that your ears shall be spared any lengthy detail of its qualifications; but to touch on anæsthesia without mentioning this wonderful local pain killer would be unpardonable. That the eye will be the most brilliant field for its use we must admit, but already the mucous avenues of the body have felt its magic touch. Lithotrities have been done under its influence, and a distinguished surgeon went so far as to say, that should he have to undergo lithotomy, cocaine would be his selection; an opinion those who have used it hypodermnatically do not think exaggerated.

An older ally-ether-has had a new application given it. Not finding inhalation all that was desired, the rectum has been surcharged and anæsthesia thus produced. To this new departure we can give but lukewarm praise. It can be seldom necessary, and does not compare in ease and comfort to inhalation. When the actual cautery is to be used along the air passages it may be applicable from the explosive nature of ether gas, but we cannot believe that the rectum will supplant the lungs as its receptacle.