Professor EUGEN STEINACH, M.D., of the Biological Institute of the Academy of Sciences, and of the University of Vienna. REJUVENATION AND THE PROLONGATION OF HUMAN EFFICIENCY Experiences with the Steinach-Operation on Man and Animals BY DR. PAUL KAMMERER With an Introduction by DR. HARRY BENJAMIN ILLUSTRATED NEW YORK BONI AND LIVERIGHT 1923 Copyright, 192S, by Boni and Livzright, Inc. PRINTED IN I HE UNITED STATES OF AMERICA DEDICATED to DR. HARRY BENJAMIN as a token of sincere friendship and appreciation of his distinguished services in introducing and applying the Steinach Method of Rejuvenation in the United States. PREFACE At the beginning of the second half of the last century, the proof of the theory of evolution— that simple forms of life develop into more com- plex ones—was established by the publication of Charles Darwin’s most important work on “Ori- gin of Species.” Darwin’s contemporaries were able to observe how the idea of evolution, branch- ing out from its original source—biological re- search—irresistibly encompassed almost all the other realms of human knowledge and accom- plishments, be they ever so remote. Today, to all appearances, we once more find ourselves at the beginning of a similar process of conquest, penetration, and transmutation insti- gated by biology in general, and particularly by Eugen Steinach’s epochal treatise on “Verjungung durch experimentelle Neubelebung der alternden Pubertatsdriise” (Rejuvenation by Revivifying the Aging Puberty Gland). In this treatise, the idea of rejuvenation—germinating from the theory of evolution to which it is closely related —is presented to the world for the first time in a scientifically substantiated form and, in spite of all opposition, is forging ahead on the road to victory. VII VIII PREFACE May I not be permitted to prove this assertion with at least one instance? What seems farther removed from applied science than the fine arts? Nevertheless, shortly after Darwin’s imposing appearance, literature developed a distinctly new form in the so-called Evolution Novel. Exactly analogous to what happened then, our present time has brought forth the Rejuvenation Novel of which Gertrude Atherton’s remarkable book, “Black Oxen,” is an example within closest reach. Still another symptom, commonly inherent to the irresistibly penetrating strength of humanity’s highest aspiration, which frequently manifests itself in the history of mankind is the fact that these aspirations usually require a maturing period of many centuries before they finally assert themselves. The theory of evolution established by Darwin was generally accepted by the old Greek philosophers, like Anaximandros (546 B.C.), Herakleitos (500 B. C.), and Empedoklos (450 B.C.) . . . just to mention a few of them. Suppressed during the Middle Ages, the idea was reborn and gradually gained in strength at the end of the eighteenth and the beginning of the nineteenth centuries, in the writings of Oken, Treviranus, Goethe, Lamarck, Erasmus, and Dar- win. But it took another half century to collect sufficient scientific data that might be used as props and proofs for the theory of evolution which, until then, had mostly been approached from an abstract, philosophical angle. Charles PREFACE IX Darwin’s life work consisted in collecting an enor- mous amount of empirical evidence, thus endeav- oring to ward off opposition of any kind and, whenever possible, to suppress it at the very outset. Similarly, the triumph of the idea of rejuve- nation may logically be expected at a time when sufficient new achievements within the realm of natural science substantiate the purely mental con- ception of rejuvenation which had previously at- tained dizzy heights. Evidently this time has now arrived. If we could say of the idea of evolution that its roots reach as far back as the classical ages, then the idea of rejuvenation—or rather let us say the dream of rejuvenation—is as old as mankind itself. All of those beliefs revolving around the idea of resurrection, the transmigra- tion of souls, and eternal life are fundamentally nothing but manifestations of the one unquench- able desire to regain lost youth. So is the Ecpy- rosis of Herakleitos and the Stoics, the Apocatas- tasis of the Apostolic Fathers and the Evangelical Orthodox and the Pantheistic Mystics, the Ori- ental myth of the phoenix rising from the ashes, and the Teutonic saga of the Old Women’s Mill and the Fountain of Youth. In the course of the history of mankind, num- berless persons have come forward claiming to be able to fulfill this desire, to make true this dream. In Old China, it was the sect of the Taosses with their secret potion of Kin-Tan, which was said X PREFACE to endow one with eternal life. In Europe, it was Count de St. Germaine with his “elixir of life”; Graham with his “celestial bed”; Boerhave with his “Gerocomy,” which already had been practiced by the old Hebrews and Romans and which is based on the theory that old men sur- rounded by youths would be rejuvenated simply by living in an atmosphere of youth. And last, but not least, there is Ponce de Leon who searched Florida for the Fountain of Youth. There was an inexhaustible number of quacks and unworldly dreamers until, finally, during the second half of the nineteenth century, the inner secretion of the ductless glands was discovered by Claude Bernard and Brown-Sequard, which en- abled the latter to establish the theory of rejuve- nation on a sufficiently founded basis for scientific application. The relation of Brown-Sequard to Steinach is about the same as the relation of Lamarck to Darwin. Lamarck and Brown-Sequard are both forerunners; the first within the realm of evolu- tion, the latter as regards the idea of rejuvenation. Both of them were on the right path, but they did not attain the consummating phases. The finishing touch, the last unassailable, provable evidence based on methodical research, was still missing. In short, there always existed a flaw or imperfection to prevent a definite victory and, as it was left to Darwin to attain this consum- mation in regard to evolution, so it apparently PREFACE XI fell to the lot of Eugen Steinach to achieve this consummation in connection with rejuvenation. Just as soon as a theory together with the practical achievements attain this phase of de- velopment and popularization, the general public is entitled to receive authentic information on the subject. Revolutionary discoveries—especially when they so vitally concern the course of human life as does Steinach’s discovery—cannot be retained as the carefully guarded secret of a lim- ited caste of scientists. Certainly, the great masses cannot be prevented from eventually learn- ing all the facts. But only too often the informa- tion reaching the world at large is very much distorted, overdrawn, and even forged. Fre- quently, exaggerated hopes are raised on insecure foundations, and, just as often, these hopes are destroyed without warrant down to the very root. Subsequently, suspicion and aversion arise not only against the discovery itself, but against science as a whole. For this reason, the responsibility rests with science to spread among the laity the true facts of every far-reaching discovery. In consideration of this duty, I have undertaken to explain popu- larly, in this book, the present state of rejuve- nation possibilities as they are based on Steinach’s discovery. Two years ago, I published a book in German —“Ueber Verjiingung und Verlangerung des personlichen Lebens” (On Rejuvenation and Pro- XII PREFACE longation of the Individual Life)—and it would seem logical simply to translate this first essay from the German into English. But as the publi- cation of the aforementioned book quite naturally resulted in extensive research work along the lines of rejuvenation, and in numerous controlling tests and extensions of Steinach’s original experiments, my first book very soon became antiquated to such a degree that a revision based on the original compilation of the material would have been difficult. To justify a thorough rewriting of the book, I need only direct the reader’s attention to the extraordinary multiplication of clinical rejuvena- tion cases since the publication of my first essay on the subject. While engaged in writing this first book, scientific rejuvenation was based almost exclusively on animal experiments. The applica- tion of the Steinach Method on man had just begun to show signs of success and was rightfully subjected to innumerable objections. Today, the situation is entirely changed, as is proved espe- cially through the number of cases in the clinical supplement of the present publication. In con- trast with the illustrations in my former book, animal experiments are in many respects sup- planted in this present volume and are crowded into the background in favor of the enormous progress and improvement of the surgical treat- ment in men and, of late, in women also. Thus, with the aid of friendly advice, I came PREFACE XIII to the conclusion that a new compilation of the whole subject would bring more satisfactory re- sults than a mere revision of the German edition, which would never have entirely fitted into present-day American conditions and necessities. However, a number of arguments which justified the publication of the German edition also hold good regarding the current American publication. These may be stated as follows: Firstly, it seemed reasonable to conclude that a book from the pen of a collaborator with Steinach would be quite welcome—of a co-worker who observed the development of Steinach’s dis- covery with his very own eyes; an eye-witness who knows the actual specimens and does not have to depend on description alone. Secondly, I deemed it feasible to enliven a popular presentation of the subject with illustra- tions, which, as far as I know, had not been pre- viously done. In the present volume, thanks to obliging fellow students and surgeons, I am able to submit actual photographs of rejuvenated men, showing in each case the patient before and after the Steinach Operation, thus enabling the reader, by means of comparison, to draw his own con- clusions. Thirdly, a good deal of the present-day litera- ture on the subject of rejuvenation belongs to a class of “literature” scarcely higher than that which, to a certain extent, caters to the same audi- ence to which frivolous and vapid plays and XIV PREFACE jokes appeal and which believes that rejuvenation is—as Professor Steinach humorously expressed it—the “burlesque-like retro-development,” the impossible transformation of a tottering old man into a dashing youth, even an infant. For this reason, it seemed necessary to approach this newly opened realm of science with fitting seri- ousness. Right here, I beg leave to correct a mistake, thus preventing it from spreading among my American audience. The New York Times, under date of June 3, 1923, said: “For ten years Dr. Kammerer was associated with the noted professor, Eugen Steinach. ... It was Kammerer who contributed much of the biologi- cal research that resulted in his colleague’s method of rejuvenation for the retardation of senility. ...” This incorrect statement gave rise, in some quarters, to the conception that not only the biological basic facts, but the discovery of rejuvenation itself, was mine and not Stein- ach’s achievement. I wish to make it quite plain here that, as far as the entire subject of rejuvenation is con- cerned—its suppositions as well as its present-day results—credit is not at all due me. On the con- trary, all credit for methodical research work belongs to Steinach, and is Steinach’s mental property. I have never been Steinach’s assistant, but have had the good fortune to work together with him in the Institute for Biological Research PREFACE XV of the Academy of Sciences of Vienna and have been favored with his friendship and full confi- dence. I merely took lively interest in his research work right from the beginning; and, in the course of time, I had occasion to observe many a result which remained hidden to others for quite some time. Steinach and I together published a treatise on “Klima und Mannbarkeit” (Climate and Viril- ity) which, however, has little to do with the rejuvenation problem. This publication, which is signed by the two of us, contains the breeding experiments and microscopic anatomical research work supplied solely by Steinach, while it fell to my lot to fit these facts into the general scope of biology, to supply controlling cases from the tropical fauna, and write the supplementing anthropological part of the book. My collaboration on Steinach’s life work is generally limited to popularizing and compiling presentations of his findings, whereby these find- ings, first known to a comparatively small circle of colleagues, eventually became the property of the general public, thus bringing to Steinach the understanding and the credit he rightfully de- serves. What Steinach thinks of my most humble achievements may be deduced from a letter of his addressed to me, the following part of which is quoted below Steinach’s picture: “ . . . You have greatly advanced our research work . . . and to me personally you have rendered a service XVI PREFACE in more than one way. Because of your lucidity, many things became clearer to me. I am now able better to observe and apprehend the intricate biological connections. ...” May this quotation be a motto and a message of godspeed for my present publication! May the present publication accomplish within a wider scope that twhich, according to the above quota- tion, a celebrated savant ascribes as its merits! But I would not have been able to achieve this goal without the unselfish, devoted collaboration of a number of helpful friends, among whom Dr. Harry Benjamin, New York, to whom this book is dedicated, I have to thank for the Introduction and valuable material. To Dr. Peter Schmidt, Berlin, I am deeply indebted for his kindness in permitting me to reproduce the photos of the controlling tests of his highly interesting case No. 6. Last, but not least, my sincerest thanks and most candid appreciation is due Mr. A. Paul Maerker-Branden, for his painstaking translation and intelligent interpretation of my book. Paul Kammerer. Vienna, November, 1923. CONTENTS PAGE Preface vii Introduction 19 CHAPTER I. Aging 23 II. Can Aging Be Combated? ... 27 III. Inner Secretion and Ductless Glands 34 IV. The Generative Gland .... 40 V. The Rejuvenation Problem ... 45 VI. Steinach’s Forerunners .... 47 VII. The Transplantation of Glands . . 50 VIII. Rejuvenation from Foreign Sources . 57 IX. Rejuvenation from One’s Own Sources 65 X. The Steinach Operation .... 68 XI. Experiments on Animals .... 72 XII. Rejuvenation and Agriculture . . 82 XIII. When to be Rejuvenated .... 86 XIV. Successful Rejuvenations of Men . 92^ XV. Improvement of Complaints of Old Age 103 XVII XVIII CONTENTS CHAPTER PAGE XVI. Rejuvenation in Women . . . hi XVII. Is Rejuvenation Unnatural? . . . 125 XVIII. Rejuvenation Without Steinach . . 130 XIX. Rejuvenation or Recuperation? . . 135 XX. Natural Aging or Aging from Disease 140 XXI. Is the Steinach Operation Dangerous? 145 XXII. Is Premature Decay Brought About by Rejuvenation? 151 XXIII. Too Few Cases? 155 XXIV. Is Rejuvenation Merely Delusion? . 159 XXV. Is “Rejuvenation” No Rejuvenation? 168 XXVI. Is Rejuvenation Something New? . 172 XXVII. Is Unintentional Rejuvenation Pos- sible? 176 XXVIII. Is Rejuvenation Immoral? . . . 183 XXIX. Is Rejuvenation a Social Danger? . 187 XXX. General Rejuvenation or “Partial” Rejuvenation Only? .... 190 XXXI. Rejuvenation and the Nervous System 198 XXXII. Rejuvenation and the Prolongation of Life . . 205 XXXIII. Repeated Rejuvenation .... 212 XXXIV. The Future of Rejuvenation ... 216 CONTENTS XIX CHAPTER PACK XXXV. Rejuvenation Induced by Other Glands 219 XXXVI. Clinical Supplement 227 References 242 Index 250 ILLUSTRATIONS Professor Eugen Steinach, M.D Frontispiece Dr. Paul Kammerer Facing Page 18 Lower Jaw “ “ 25 Concaved Preparation Slide ... “ “30 Tissue Culture “ “ 30 Schematic Chart of the Endocrine System “ “34 Feminizing Guinea Pigs .... “ “52 Masculinizing Guinea Pigs ... “ “52 Human Male Generative Gland . “ “ 62 Schematic Chart Showing Spermatic Ducts “ “68 Generative Glands of Senile Male Rats “ “70 Fifty-six Year Old “Rejuvenate” . “ “ 86 Seventy Year Old “Rejuvenate” . “ “ 96 Nerve and Ganglion Cells ... “ “ 200 Black Rats, Twin Brothers ... “ “ 208 Fifty-four Year Old Packer ... “ “ 230 XXI INTRODUCTION It was in the summer of 1921; I had gone up to the beautiful Semmering mountains, near Vi- enna, to visit Professor Eugen Steinach. After spending a very pleasant day with him, during which he explained to me at length the theory and the fundamental experiments of his method of rejuvenation, I expressed a desire to see his famous specimens of animals that gave evidence of his ingenious work. The Professor consented immediately, telling me that his collaborator for many years, Dr. Paul Kammerer, who was in Vienna at the time, would demonstrate the speci- mens to me, and he gave me a letter of introduc- tion to him. The next day I met Kammerer. Attired in a well worn laboratory coat, he was working all alone at the Biological Institute, which the Viennese call the “Vivarium.” Its spacious halls were almost empty and deserted, and Kammerer’s lonely scientific work greatly impressed upon me the dire need of Austrian sci- ence after the World War. I found the doctor to be a very impressive, serious man. In his exact scientific manner, he pointed out to me the famous specimens of those guinea pigs whose sex had been changed by Steinach’s ingenious methods, and 17 18 INTRODUCTION others that had been rejuvenated, and others again which proved beyond doubt the determining influence of the generative glands on the sex development of these animals. I met Kammerer several times after that—not only that year, but also two summers later—and was again and again impressed by his great sin- cerity and devotion to his scientific work, not only in his own line of biological research (i.e., the Inheritance of Acquired Characteristics), but also as Steinach’s collaborator, whose great achieve- ments he always emphasized. Little did I dream at that time that I would ever be in the fortunate position of writing the introduction to his first book published in the United States. There is certainly no one more competent to write on Steinach’s achievements than Dr. Kammerer, because there is no one who knows the subject more intimately and who is more convinced of the importance, truth, and reality of Steinach’s life work. In discussing the subject of rejuvenation, the layman is mostly interested in the question: What will the Steinach Operation do for me? As a physician I may be permitted to answer this ques- tion from a clinical point of view. Broadly speak- ing, the Steinach Operation strengthens the endo- crine system. What does that mean? On account of the inter-relationship of the different glands with an internal secretion and the DR. PAUL KAMMF.RER University of Vienna INTRODUCTION 19 influence these glands have over the nervous sys- tem, the strengthening of the glandular system will result in a reenergizing of the physical and mental capacities. Naturally, such a strength- ening should be resorted to if a glandular weak- ness or inferiority exists. What, now, may be the cause of such weakness or inferiority? If we enumerate these causes we will have the logical reasons for the performance of the Stein- ach Operation or treatment. A weakness of the endocrine system may be caused by three prin- cipal factors: I: A congenital, inherited inferiority. In these cases the Steinach Operation could be performed on relatively young men, or the X-ray treatment applied to relatively young women. II: A weakness through overwork. Perhaps this forms the largest group and is one in which Americans will be mostly interested. These men and women who undergo the treat- ment are often in the prime of life, but overwork has undermined their health, exhausted their glandular system, and aged them prematurely. Ill: Weakness through actual old age. Here, in very responsive cases, a real rejuve- nation may occur. Here the progress of senility can be retarded; sometimes even more than only “within modest limits,” as Steinach so conserva- tively expressed it. There is naturally no sharp borderline between 20 INTRODUCTION these three groups. One will frequently merge into the other. Like any startling discovery, rejuvenation in its different phases is now quickly becoming public property. Not only are medical journals, in articles and editorials, discussing the subject, but the daily newspapers, as well, have become deeply interested—some, unfortunately, from a purely sensational point of view; others, of a more seri- ous type, from the social and economic standpoint. The stage and literature have also begun to ex- ploit the subject in its modern realistic form, where formerly more fantastic ideas prevailed to express the age-old longing for a renewal of youth. This longing is, and always has been, so intense that the faintest ray of hope is immedi- ately magnified, and exaggerated—the wish being father to the thought. Disappointments are therefore bound to follow, unless the limitations as well as the possibilities of modern rejuvenation methods are known. This knowledge Kammerer clearly conveys to the conscientious reader of his book. Let every reader, therefore, be a conscientious one. Harry Benjamin, M.D. New York, November, 1923. REJUVENATION AND THE PRO- LONGATION OF HUMAN EFFICIENCY REJUVENATION AND THE PRO- LONGATION OF HUMAN EFFICIENCY I AGING Age implacably attacks us, at least so it seems. The organs of our body are being used up; metabolism (the process of assimi- lating food), and blood circulation become sluggish. Remnants of insufficient metabo- lism impede the proper functioning of vital organs by clogging the tissue, partly in a mechanical way, partly by chemical reac- tion. Auto-intoxication, developing slowly but constantly, paralyzes the tissue, penetrat- ing into its infinitesimal parts—the micro- scopic cells. The most sensitive tissues in this way are eventually destroyed, and are only incompletely replaced by other less vital tis- 23 24 REJUVENATION sues, mostly connective. Because of this gen- eral atrophy of tissue, the bodily organs are reduced in size and, as each one shrinks by itself, the body in which they constitute vital parts also shrivels. Wrinkles appear, shoul- LOWER JAWS Left, from a Young Adult; Right,, from a Senile Individual, Illustrating How the Various Organs of the Body Shrink with Age. Note Reduced Size of Toothless Jaw of Senile Individual Which Condition, However, Is not Due to the Fact That Teeth Are Lost. (Lip sc hiit z) ders are bent, the whole posture becomes stooped. The organs are not only reduced in size, but they also tend to harden and, as a result of the proliferation of connective tissue, to grow less elastic. Moreover, calcium be- comes imbedded in the walls of the arteries and a process generally known as hardening AGING 25 of the arteries sets in. Though connective tis- sue and calcium strive to replace the loss which the different organs suffered of their own substance, they prove absolutely inade- quate to overcome this shortage. As soon as the loss of the organs’ original substance be- comes too marked and its replacement by sub- stance not their own is too great, the parts of the machinery of life thus affected are put out of commission. In such a case, symptoms in- cidental to aging, manifesting themselves in certain tissues (especially in the nerve tissue of the continuation of the spinal cord—the medulla oblongata—where respiration and the pulsation of the heart is regulated) have brought about death. How then is it possible at all that remnants of one’s own process of metabolism are able to accumulate to such a degree and clog the tissues? Apparently nature has carefully pro- vided for the purification of the body. The coarsest waste matter is excreted by way of the alimentary canal. Refuse or finer substance is expelled by way of respiration and with the 26 REJUVENATION assistance of oxygen. Kidneys and sweat glands destroy impurities through chemical reaction. But all these expedients prove to be insufficient in the long run. They may be able to postpone to a lesser or greater degree an accumulation of unabsorbed sediments, but they can never stop this accumulation alto- gether. The question now arises as to whether we can come to the assistance of nature, working so imperfectly in this case? Is there a possi- bility of improving the conditions of those or- gans and glands which take care of digestion, excretion, respiration, and the general puri- fication of the body? In short, could we not improve metabolism in general? II CAN AGING BE COMBATED? As a matter of fact, medicine has never striven towards any goal other than the com- bat of age. Everything medicine tries to ac- complish amounts practically to nothing else than an attempt to prolong life. And as meta- bolism is the most elementary necessity of life, all medical measures amount to one thing— to improve metabolism and keep it going. One of the first questions the physician asks a patient pertains to his digestion. He then uses the stethoscope to examine heart and / lungs, and makes the necessary analysis of the urine. The physician is mostly concerned with the condition of these essential purifying organs of the body, as these organs have to be in the best of condition or restored to perfect condition as soon as possible, if the health of the patient is to be regained at all. 27 28 REJUVENATION According to a saying of Seneca, the great Roman philosopher, (“Senectus ipsa mor- bus”), “Age itself is a disease.” If we admit that the process of aging—be it ever so slightly perceptible—can be retarded, if we agree that aging and dying are brought about by a progressing imperfection of metabolism which could be combated by perfecting this most vital process of our body, we admit im- plicitly that “natural aging” and “natural death” occur prematurely and are “unnat- ural,” as paradoxical as that may sound. Tis- sues and organs could remain in working con- dition much longer. They do not stop func- tioning because of an inevitable law, nor be- cause their vitality is exhausted like the resil- ience of a watch spring that has not been re- wound in some time. They cease functioning because there is a deplorable absence of “team- work” between the different organs. Due to this lack of cooperation, the system is over- charged with more poison than it can absorb and excrete, and in this way vitality is reduced and life is eventually brought to a standstill. The correctness of this conception is proved CAN AGING BE COMBATED? 29 by two outstanding achievements of modern biological research: first, by transplantation; and cecondly, by so-called tissue culture. Transplantation consists of an experiment of implanting into a living body pieces of tis- sue (fragments of the skin or of any one of the several glands) removed from a body im- mediately after death. While the dead native body is already in a process of progressing decomposition, these fragments will blend with the living foreign body and continue to function. The vitality of the new abode of these tissue fragments favors their metabo- lism and thus makes for a more thorough puri- fication than in the diseased and aged body from which they were taken. This goes to prove that the vitality of tissue as such does not necessarily have to be exhausted when a body, as a whole, is unable to continue living. By tissue-cultures, we understand a differ- ent experiment. Again diminutive fragments (of the skin, spleen, connective-, muscle-, nerve- or other tissues) removed from a body immediately after death, are preserved in a drop of frequently changed blood serum, and 30 REJUVENATION kept in an incubator at normal blood tempera- ture (98.6 F). These fragments will continue to grow because their metabolism is so much better than that of their native body; as they are frequently rinsed with a weak salt water solution, an accumulation of metabolistic poi- sons does not occur. For this reason, these tissue-cultures continue to live in spite of the decomposition of their native body. They even grow now, whereas, when still part of that body, atrophy (a wasting away from want of proper nourishment) had already set in. It is not at all surprising that, after having prolonged the life of parts of the body be- yond those boundaries apparently set by na- ture, the question arises: Could not a similar success be achieved if all parts of the body would remain in their natural connection? Could not a prolongation of vitality, which is an achieved fact as far as parts of the body are concerned, be applied to the body as a whole? At first glance, earnest endeavor along these lines seems to be quite a thankless task, as it would apparently only tend to prolong the CONCAVED PREPARATION SLIDE AS USED FOR TISSUE CULTURES Upper Picture, Full View; Lower Picture, Side View with Cover- Glass Attached. Note “Culture in a Hanging Drop of Blood-serum” Inside of the Concavity. (Carrel) TISSUE-CULTURE IN A HANG- ING DROP OF BLOOD-SERUM (Greatly Magnified) In the Center the Original Tissue Fragment, Now Decomposed, Sur- rounded by Circular Layers of New Growth. The Concentric Cir- cles Consist of Layers of New Growth as They Develop After Each Rinsing of Tissue Fragment and the Changing of the Nourish- ing Blood-Serum. (Carrel) CAN AGING BE COMBATED? 31 decay of a body; would only, so to speak, make for “the conservation of a living corpse.” In this light, prolongation of life does not seem, as Hamlet says, “a consummation devoutly to be wished.” But fortunately, detached and transplanted fragments of tissue not only sur- vive the native body, but also continue to de- velop. Improved metabolism rejuvenates these tissue-cultures and even re-develops them into a stage of almost embryonic condi- tion, the very condition that once before ren- dered their growth and normal development feasible. The distinct desire to regain youth was al- ways underlying the various experiments car- ried on in the interest of the prolongation of life. Experiments along this line are most probably as old as mankind, certainly as old as civilization. It has been one of the fairest dreams of mankind to retain and reclaim youth. The folk lore of all the nations is full of this longing for eternal youth, full of a yearning for resurrection and immortality. Quacks and charlatans exploited this longing, and to them people flocked just as eagerly as 32 REJUVENATION they flocked around alchemists and astrologers. But what those quacks and charlatans had to offer to a credulous crowd was nothing but stimulants, certain draughts that accelerated pulsation, intensified the blood circulation, and in this way tended to purify the tissue. A distinct feeling of returning vitality was cre- ated by this, but only too soon reaction set in and there was nothing left of this temporarily regained strength. It would even leave the patient more exhausted than he had been be- fore the “cure.” Another means to the same end consisted in the administering of laxatives which, of course, could do no more than rid the body of intestinal poisons. As absurd as those super- stitions may have been that promised return of youthful strength, an iota of truth underlay the theory of stimuli as well as that of laxa- tives. It was clearly understood how essential it was to cleanse the system of the by-products of metabolism. The cleansing of the organ- ism, internally as well as externally, is the starting point for every endeavor to prolong life and intensify its efficiency* CAN AGING BE COMBATED? 33 But the greatest damage inflicted by these quacks and charlatans with their deceptive cures consisted in a general discrediting of all serious and honest attempts to solve the prob- lem of rejuvenation. Savants of all times and in all parts of the world, who refused to re- sign themselves to the inescapability of aging, have been sneered at and mocked. But the progress of true science cannot be stopped! In spite of attacks from their own ranks, val- iant scientists have striven, and are still striv- ing, to forge ahead towards this fairyland of Ponce de Leon’s dreams. And why should not the human mind, which has learned to harness the heaven’s lightning and to conquer floods, which has made steam and electricity its obe- dient slaves, eventually succeed in attaining supremacy over its own life? And why should not the inventive human mind, which has found any number of ways and means to fight death in its various forms, eventually succeed in combating the process of aging to such a degree that useful life will be prolonged far beyond its present length of years? Ill INNER SECRETION AND DUCTLESS GLANDS Modern methods of rejuvenation are based on a number of organs which, until only a short while ago, kept the scientist puzzled. We now know that these organs play a very essential part in the growth and purification of our bodies, and are universally known as “ductless glands”—that is, glands with an in- ternal secretion, also called “endocrine glands.” To enumerate a few of them: The Pineal Gland, located in the brain; the Pituitary Gland (Hypophysis) at the base of the brain; the Thyroid Gland and behind it the Para- Thyroid Glands, at both sides of the larynx; the Thymus Gland, which rests on the trachea, commonly known as the wind pipe, at the spot where the latter forks into the bronchial tubes; the Adrenal Glands, on top of the kid- neys, and some other glands. They all have 34 PINEAL PITUITARY PARATHYROID THYROID THYMUS MILK GLAND ’(IN FEMALE) SPLEEN LIVER ADRENAL ■PANCREAS KIDNEY GENERATIVE (FEMALE) PROSTATE GLAND GENERATIVE " (MALE) SCHEMATIC CHART Of the Endocrine System DUCTLESS GLANDS 35 the characteristic of discharging their secre- tion into the system directly—that means with- out passing the secretion through a duct or channel. As there is no vessel in the body where the secretion could accumulate, the se- cretion itself is invisible. We assume from the structure of the organ only that it is a gland. We also see, under the microscope, that the cells of the gland tissue secrete some- thing; but we do not see enough of what they secrete to determine the color, consistency, and other characteristics of the secretion. The sweat and sebaceous glands, on the other hand, carry their visible and well-known secretions through special excretory canals to the skin. The stomach and salivary glands convey theirs in the same way into the alimen- tary canal. Likewise, the liver transmits its secretion, which is stored away provisionally in the gall-bladder, by means of the bile-duct. But if these aforementioned organs are genu- ine glands, only “glands without an excretory duct,” what then becomes of their secretion and where does it finally go? Now, these ductless glands, like all other 36 REJUVENATION organs, are necessarily connected with the blood circulation. They are surrounded by blood and lymph vessels which support them with nourishment and oxygen and at the same time carry away the products that originate in the glands. To differentiate them from the plain external secretion (for instance of a sweat or saliva gland) their function is named “internal secretion,” or briefly “incretion.” The internal secretion necessarily changes the composition of the blood as it hurries to distant parts of the body to take care, every- where, of the distribution of nourishment and oxygen and to carry away by-products and carbon dioxide. Naturally, the inner secre- tory products contained in the blood will have an influence on all those organs that are nour- ished by the blood. Therefore, the products of the ductless glands are not without conse- quence for the health and growth of the rest of the body. Sometimes their influence pro- motes health, sometimes it retards; but always as long as a normal, healthy balance prevails in the system, they work in behalf of harmony and beauty. DUCTLESS GLANDS 37 During the last decade, biological research has revealed to us a new world of wonder as we come more fully to an understanding of the endocrine system—the system comprising all the glands of internal secretion. Though these glands seem to be without a means of discharge, they communicate with each other and with all the other parts of the body by means of the hormones which are contained in the circulating blood. This appellation is applied to the internal secretion of any gland and is derived from the Greek, meaning “something that spurs into action.” As a mat- ter of fact, these hormones not only stimulate the various parts of the body, but they also play the role of messengers within the body. Until biological research discovered this prop- erty of the hormones, we knew of only one agent that made for unification in the working of the body; namely, the nervous system. In the polyglandular system we came to know a second means of interchange; namely, a sys- tem working on many glands with its effect based on chemical reaction. How dwarfed a human being remains if 38 REJUVENATION his thyroid gland does not function properly! If only the natural physical growth of the in- dividual were dwarfed, it would not be so very bad; but there is one organ which must be especially well irrigated with the thyroid secretion (Thyreodin) in order to mature properly, and that is the cerebrum. What is the good of the most ideal mental tendencies latent in the cerebrum, if the quantity and na- ture of the thyroid secretion does not suffice to awake them to action? The thyroid gland, on the other hand, will attain its normal size and power only if the generative gland achieves normal develop- ment. Together these two glands—the thy- roid and the generative—control another or- gan with inner secretoric capacities; that is, the pituitary gland on which depends the growth of the skeleton, as well as the accumu- lation of fats. Another organ of this nature is the thymus gland which has effect on the body only during the years of childhood, and is controlled and ultimately destroyed by the generative and thyroid glands. The thymus gland is slowly absorbed by the maturing body DUCTLESS GLANDS 39 and in normally developed individuals is scarcely noticeable any more around the time of complete maturity. Friends and foes, therefore, find themselves within the “Incre- tory Association.” Assistance and antagonism both are contributory (as long as the health of the body is not disturbed) in reaching the final goal which is already fixed as the duty of the ductless gland system; i.e., to achieve the har- mony of the parts and to build a perfect whole from them. It is not always an easy matter to distinguish between ductless glands, that is, glands with an inner secretion (incretion) and glands with an external secretion. Quite often it hap- pens that a gland which possesses visible ducts at the same time pours certain secretions into the body through invisible channels. One of these glands is the pancreas (commonly called the “sweetbread”), a whitish, conglomerate gland of irregular shape, situated deep in the abdomen beneath the stomach, and pouring its secretion into the alimentary canal during digestion. It is one of the most important of the digestive organs. IV THE GENERATIVE GLAND A SECOND example is the generative or sex gland, also called gonad. The human gonad (which is the testicle in the male and the ovary in the female), contains two principal groups of cells. The first group performs the func- tion of external secretion, i.e., furnishes the sperm cells—those elements which are neces- sary for the propagation of the race. These sperm cells are discharged from the body by way of a canal called spermatic duct or Vas Deferens. The second group of cells are the so-called interstitial or Leydig cells, in their entirety called the interstitial gland (or, by Steinach, puberty gland). These cells produce the in- ternal secretion, the gonadal hormone, which is most essential for the individual’s normal sex characteristics, thus differentiating male 40 THE GENERATIVE GLAND 41 and female in their physical as well as mental make-up. This gonadal hormone is also of highest importance for the general well-being, as we will hear later on. The question is not yet solved as to whether a definite differentiation is possible between the glands that generate only external secre- tions and those which, being mixed glands, possess visible ducts, but at the same time pour their secretions directly into the blood or lymph. This is especially doubtful as far as the generative gland is concerned, the ques- tion culminating in the argument as to whether the hormone is produced by the generative tissue or by the interstitial tissue. It is by all means possible that the generative tissue produces hormone, together with sperm cells, and it is also possible that the interstitial tissue originates from atrophied generative cells; but the latter is certainly not in a condition to produce mature sperm cells. As far as incretion as such is concerned, these two most important tissues of the gener- ative gland are able to replace each other. The normal generative gland quite often is 42 REJUVENATION deficient in interstitial tissue. As a matter of fact, this gland is sometimes so lacking in this substance that it seems hardly possible that it could still work properly. On the other hand, sometimes disturbances develop within the body which displace, temporarily or perma- nently, the generative tissue. In a case like this, the interstitial tissue replaces the gener- ative tissue. Whenever this happens, no de- crease in the incretional effects of the genera- tive gland is noticed; on the contrary, very often the effect of generative glandular incre- tion is intensified. It seems quite possible that in a case like this the interstitial tissue alone, or almost alone, assumes the incretoric function of the entire generative gland. The question whether the incretoric func- tion is the task of the one or the other of the two different tissues of the generative gland, and to what extent the one or the other is the tissue which produces the hormone is a ques- tion which, within the general argument about the “rejuvenation question,” plays quite a role. As a matter of fact, this question has assumed such proportions that it is becloud- THE GENERATIVE GLAND 43 ing the issue ot rejuvenation, as such, in a very- unnecessary and futile manner. That pioneer of rejuvenation, Professor Eugen Steinach of the Biological Institute of the Academy of Sciences, University of Vienna, assigns the leading part of the incre- toric function of the generative gland to the interstitial cells, which he calls in its entirety, the puberty gland. Professor Steinach derives his belief from his long years of research work, during which he gradually and syste- matically arrived at the possibility of rejuve- nation. Others dissent from his opinion that the interstitial tissue plays the leading part in the production of the hormone, and in the heat of the argument about this unimportant ques- tion, his opponents forget altogether that the essential thing is not which part of the gen- erative gland brings about rejuvenation, but rather the fact that rejuvenation is actually brought about by Professor Steinach’s Method. We are not going to enter into an argument regarding the “Theory of the Puberty Gland”; that is a question which belongs to 44 REJUVENATION a scientific forum. It is, perhaps, sufficient to say that so far as the question of rejuvena- tion is concerned, the role that is assigned to the interstitial tissue of the generative gland is greatly overrated. In connection with its incretoric effects, we are going to consider the generative gland as a whole. It is not neces- sary to waste time over the question as to which of its components plays the leading and ex- clusive part (under normal and abnormal con- ditions) when it comes to the production of internal secretion. V THE REJUVENATION PROBLEM To recapitulate briefly: what happens to the organs of life when age approaches? They become reduced in size; they shrink or wither; they lose more and more of their very own substance, because the growth of their cells ceases and the cells themselves degener- ate. The invasion of proliferating connective tissue gradually develops into a real calamity, because it hardens the organs and makes it impossible for them to function properly. Together with the deterioration of these or- gans of life, the ductless glands wither. Re- membering that it is the task of the ductless glands to purify and vitalize the whole body, the conclusion is obvious that, with the ad- vancing of age, the simultaneously progress- ing deterioration of the ductless glands is so much more serious as it hastens the termina- tion of life. Another very important issue is 45 46 REJUVENATION the fact that all the ductless glands, even though one or the other of them may oppose each other, belong together and that every one of them is important to the general well-being of the whole body. If one of these organs is diseased, all the other organs suffer in turn. If one of them is successfully restored to health, all the others will participate in this benefit. It seems quite obvious to apply this theory to the symptoms of advancing age as exhibited in the ductless glands. If in only one of these so essential organs the symptoms of age could be successfully combated, if a new and coun- ter-impetus could be given to an already ceas- ing or retrogressing development, all the other organs would most probably participate in the improvement. New life would flow from the regenerated gland to stimulate all other glands and ultimately, through the glandular system as a whole, to permeate the entire body. The main questions, then, are: How shall we best stimulate a ductless gland; and which of all the glands is most easily approached and, with the least complications, put to use in the direction of rejuvenation? VI steinach’s forerunners The generative gland is, at least according to the present dictum of science, the most easily approached for the purpose of reenergizing an aging, or aged, body. As one of the very first who studied the laws of inner secretion and valued its phenomena rightly, Brown- Sequard, about the end of the eighties of the last century, undertook to test the hormone of the generative gland with respect to its value as a means of rejuvenation. Brown- Sequard prepared an extract of the generative gland of an animal and, using himself for his experiments, injected this extract into his own body. He soon observed remarkable phenomena of rejuvenation. His muscle power increased, his brain functioned more quickly, and his endurance in general and in every respect was greatly enhanced. 47 48 REJUVENATION When in 1889 in the “Comptes Rendus de la Societe Biologique de France” he published his findings, they created so tremendous a sen- sation that would-be “rejuvenates” simply be- sieged his house in such a manner that he had to flee to London before the rush. It is a sign of the times in which we live that today when experiments are continued with much more fitting means than the French savant had at his disposal, nothing approach- ing the sensation in Paris in 1889 is created. That is partly the fault of the skepticism usu- ally incurred by sensational discoveries, and the indifference of the public which has so often been disappointed when “miraculous cures” made their rounds through the daily press. Brown-Sequard was on the right road with his experiments, but any extract injected into the body will be assimilated very soon and, for this reason, the effect of an injection can hardly ever be more than temporary. It is quite plausible that repeated injections may bring about something like permanent im- provement for the simple reason that, by stim- STEINACH’S FORERUNNERS 49 ulating the most deficient gland and improv- ing its condition, the whole glandular system in turn is improved and this again will ulti- mately put the first gland in a normal condi- tion, so that further injection can be dispensed with. VII THE TRANSPLANTATION OF GLANDS It stands to reason that an improvement of the ductless gland system of the body could be brought about with much greater effi- ciency, if one would succeed in reviving the deficient ductless gland so that this gland itself would furnish the body with the vitalizing incretion, thus dispensing with injections which sometimes are bothersome and hard to gauge. Working on this theory, science grad- ually arrived at the conclusion that transplant- ing of glands would be much more efficient than the injection of incretoric substances. A youthful gland was simply to be transplanted into the body, to make up for the deficiency of a degenerated gland. There are two different kinds of transplan- tation : Autoplastic transplantation, i.e., transplantation within the same body, and he- 50 TRANSPLANTATION OF GLANDS 51 teroplastic transplantation, i.e., transplanta- tion from one body to another. While the ex- pression transplantation is usually applied to the performance as a whole, the term implan- tation is used when referring to the actual in- serting of the transplanted organ into its new location. Professor Eugen Steinach, before he was ever interested in the rejuvenation problem, was the first scientist to prove on mammals that insufficiency of glandular incretion can be overcome by transplantation. To test and prove his belief, he deprived young rats and guinea pigs of their generative glands, at the average age of about four weeks. It soon be- came apparent that the absence of these im- portant organs from the bodies of the animals checked the development of certain other or- gans. Animals robbed of their generative glands remained in a stage of immaturity or even retrograded into immaturity, if they had already passed this stage. However, as soon as these same detached glands were replaced, the symptoms of under-development or even retrogression passed away both in the male 52 REJUVENATION and in the female. If the rats and guinea pigs Were left without a generative gland until the symptoms of this deficiency showed and then foreign glands were implanted, the symptoms also disappeared, even if they had been ob- served in the animals for quite some length of time. But what happened when, at the time of restoring the glands to the animals, these glands were interchanged—that is, that the male generative gland was implanted into the female and vice versa? Steinach discovered that the sex of the ani- mal always responded to the sex of the gener- ative gland; that the female implanted with the male gland will be a male with all of his characteristics; and that the male implanted with a female generative gland will develop into a full-fledged female. By implanting a male and a female generative gland simultan- eously into the body of an animal, Steinach and Sand produced hybrids (hermaphro- dites). The same results were achieved by Moore and Pezard by implanting into a nor- mal male the generative glands of a female or FEMINIZING GUINEA PIGS (Side View) From Top Down: (t) Normal Brother; (2) Normal Sister; (3) Castrated Brother; (4) Feminized Brother MASCULINIZING GUINEA PIGS (Side View) From Top Down: (i) Normal Brother; (2) Normal Sister; (3) Sister With Her Ovaries Extirpated (castrated) ; (4) Masculinized Sister. TRANSPLANTATION OF GLANDS 53 implanting the generative glands of a male into a normal female. In the course of these experimentations, the scientists succeeded in bringing about all the intermediate stages be- tween male and female. These experiments shed light on three dif- ferent and very important facts: First, they proved that it is not at all necessary to reinstate a detached gland at the very spot from which it was removed. Not only will a gland blend with the foreign body, it will also become part of its native, or the foreign, body if re- instated at a spot which is not the proper one. The effect will not only show under compara- tively favorable conditions, but very often the transplanted gland will even improve and thrive at the foreign spot in a foreign body— a fact that cannot be observed in other than glandular organs. Dr. Edward Uhlenhuth, of the Rockefeller Institute, New York, proved that he could remove an eye from a toad and graft it on a foreign spot; for example, on the neck where it will root and grow with the rest of the body. But it will never be of any use as an eye un- 54 REJUVENATION less it is reinstated into its proper place (in this case, into the socket of the eye, as Kop- panyi proved) because only there can it con- nect with the proper nerves and attach itself to the right muscles. As far as a ductless gland is concerned, however, the attachment to the nervous system is of no importance. It is merely essential that this gland shall be en- cased in and penetrated by blood vessels. Then it is not only nourished by the body, but at the same time is able to pour its secretion into the blood which will carry it all through the body, with a stimulating effect on all the organs. A part of the body which lends itself admirably to the implanting of generative glands is the peritoneum, on account of its general texture. It was proved also by the experiments on rats and guinea pigs that the transplanted generative gland changes in its composition. That is to say that the generative and the in- terstitial tissue undergo changes as far as the quantity of the one and the other is concerned. Through transplantation, the greater part of TRANSPLANTATION OF GLANDS 55 the very sensitive generative tissue is de- stroyed ; and to the same extent to which this generative tissue is destroyed, the interstitial tissue gains ground within the generative gland. As the interstitial tissue is possessed of incretoric properties, as pointed out before, the function of the generative gland as a duct- less gland is not merely undisturbed; it is quite frequently even intensified. Finally, by these experiments on rats and guinea pigs, the road was opened for the ap- plication of the method of transplantation on man. In quite a number of cases, generative glands which had been lost in the Great War or through accidents were replaced, and in this way improvement or even recovery of a patient was brought about. Similar improve- ments and cures were achieved in cases where the generative gland had to be removed on account of being tubercular. In other cases, through the implantation of a generative gland, congenital deficiency of this gland was overcome. Among the scientists who did re- markable research work in connection with 56 REJUVENATION transplantation are the American surgeons, Lydston, Stanley and Kelker; Lichtenstern in Vienna and Muehsam in Berlin. In cases where congenital deficiency mani- fested itself in an hybridal condition of the generative gland, where the physiological make-up of an individual was contrary to his psychological make-up, and where intermedi- ate stages of sex existed, Seinach, Lichten- stern, Muehsam, and Pfeiffer succeeded in correcting this abnormal condition by replac- ing the deficient generative gland with a nor- mal one. VIII REJUVENATION FROM FOREIGN SOURCES As mentioned before, the experiments of Steinach, which were the first to open the road to these far-reaching possibilities, were per- formed on young, immature rats and guinea pigs, which at the time of experimentation had not yet achieved procreative powers. It seemed quite logical to try the same experi- ments on rats which had already lost their procreative powers, that is on rats which were senile. The extension of these experiments seemed so much more logical as some, not all, of the symptoms incident to the loss of the generative gland strongly resemble the symp- toms of old age. The conclusion did not seem far fetched at all, that the same operation which cured the effects of the loss of the gen- erative gland could be applied successfully to 57 58 REJUVENATION overcome symptoms of aging; the neteroplas- tic transplantation of youthful generative glands bringing about a new youth. Soon enough Steinach, experimenting with rats in this case; Harms, experimenting with guinea pigs and dogs; and Voronoff, trying the trans- plantation method on rams, achieved miracu- lous rejuvenation effects. Senile female rats, operated on by Steinach, were again able to bear young, even though they had been completely sterile for a long time. The generative glands (ovaries) grafted on them revived their own ovaries, which had withered long before, and their generative tissue again developed active germ cells. Female rats rejuvenated in this way behaved exactly like young mothers. They built nests for the care of the expected off- springs and were in the best of condition to nurse their young sufficiently. This shows that in the rejuvenated rats, numerous instincts and faculties were resurrected that had been practically dead for some time. The young rats grew to be especially well developed specimens, invested with normal FROM FOREIGN SOURCES 59 procreative powers. They gave no evidence that they were the offsprings of “recondi- tioned” mothers. Harms operated on a male dog, seventeen years old, which was almost in a dying condi- tion when the operation was performed. Some time later, he was able to jump out of a box which was given him to sleep in, the sides of which were about eighteen inches high. His loose teeth grew firm again and he could gnaw hard bones. His growth of shaggy hair improved to a surprising degree and numerous sebaceous tumors disappeared. The dog once more proved himself well- trained; kept his box clean, and was at all times prepared to defend himself although he had been exceedingly meek before. Now the very pertinent question arises: Could these transplantation experiments, with rejuvenation as the distinct aim, be applied to man? In a number of cases, Lydston, Vor- onoff, and Lichtenstern succeeded in overcom- ing symptoms of old age in men by implant- ing reviving generative tissue. To alleviate complaints incident to the change of life in 60 REJUVENATION women, several celebrated gynocologists— among them Morris, Glass, Dudley, Cramer, and Kroenig—successfully resorted to the transplantation of tissue of the ovaries. But all the applications of this seemingly obvious method of heteroplastic transplantation en- countered great difficulties. In the first place, there is little doubt that aged tissue lends it- self none too favorably as a basis for grafting foreign tissue. In the majority of cases, youthful tissue implanted on aged tissue does not blend with the latter but withers and is destroyed. In the second place, in connection with the application of the transplantation method on human beings, the question arises: Where to get youthful organs to stimulate aged and aging ones? The very same difficulty was en- countered when, as mentioned before, defi- cient generative glands were to be replaced by efficient ones. Of course, only a very small percentage of mankind suffers from congeni- tal deficiency of the generative gland, and cases where this deficiency is brought about by sickness or accidents are quite rare. FROM FOREIGN SOURCES 61 Age, on the other hand, is a disease that nobody can escape. For this reason, enormous quantities of transplantation material would be necessary if this method should be applied generally. There are, however, a few sources from which to secure transplantation material. For example, in the case of a man whose gen- erative gland has to be removed on account of a faulty position; if this generative gland is normal, it can be used advantageously to im- prove the condition of some other man suf- fering from a deficiency of the same organ. Most of the operations performed by Lichten- stern and Muehsam were of this kind but were not undertaken as a means of rejuvenation. Another source of securing transplantation material offers itself if the generative gland of a young man who died by accident, or of a man executed by law, can be obtained and util- ized, as has been done by Lydston, Stanley, and Kelker. A third source arises if a man in the prime of health offers the needed organ, either from the goodness of his heart to save the life of a REJUVENATION 62 dear one, or sells it for mercenary reasons— this latter method opening the possibility of a despicable traffic in organs. There are known cases where legal papers were actually drawn up for transactions of this kind, and other cases have been mentioned in the press where men were knocked unconscious and then robbed of the long-sought-for organ. Of course, all the organs which might be utilized for heteroplastic implantations are paired; if one of them is removed the other immediately gets ready for compensatory over-work. However, as will be shown later on, the loss of one of a pair of organs becomes a serious encroachment on the possibility of a later attempt at rejuvenation, and endangers the individual considerably in case of sick- ness or disease. Whether the methods of acquiring a human organ to replace a deficient one are ethical or not, whether they are feasible or not, it would eventually scarcely be possible to procure the necessary material if transplanting should ever become general. It would soon be neces- sary to utilize the organs of animals to replace deficient human organs. HUMAN MALE GENERATIVE GLAND (Greatly Magnified Section) During the Development of the Body This Gland Did Not Descend into the Scrotum But Was Retained in the Region of the Groin. There It Was Almost in the Same Situation as a Transplanted Gland on Account of Being Exposed to the Pressure or the Surrounding Organs. Therefore, the Interstitial Tissue (Mz) Proliferated at the Expense of the Generative Tissue (SK—Seminal Canals). (Steinach) SK h MZ MZ SK MZ MZ 1. SK h FROM FOREIGN SOURCES 63 But this method of rejuvenation presents marked difficulties, in that the farther apart tissues are in relationship, the less likely they are to blend. The best results in blending are achieved by tissues of the same individual. The next best results come from the blending of tissues of different individuals of the same kind. In only a few cases has there been a satisfactory blending of tissue of different kinds. In spite of this handicap, Voronoff has followed this method. After rejuvenat- ing senile rams, he applied his method to man by using monkey glands. It is reported that he achieved remarkable results, and that one of his “rejuvenates” is the Belgian poet, Mau- rice Maeterlinck. Of course, only time will show whether this method brings about any- thing like a permanent result. For the time being, an opinion regarding the possibilities of rejuvenation by transplan- tation could be based on the following estab- lished observations: Steinach’s implanting young ovaries into old female rats has proved, as the most important result of implantation, that the aged, original ovaries were stimulated into new activity. There is a probability that, 64 REJUVENATION in cases where the implantation method is ap- plied to man, a similar result could be achieved—that is, that an animal gland, by stimulating the human glandular system, could bring about rejuvenation. And when that is done the animal gland would have ex- hausted its usefulness; it would not even be necessary for it to be kept intact. Its duties will have been assumed by the organs of the patient and the animal gland may now safely be allowed to deteriorate. The method of transplantation is somewhat similar to the injection method, since in both cases something is introduced into the body which is expected to be absorbed by the sys- tem. The material grafted into the body by heteroplastic transplantation will, of course, persist for a longer time than the substance which is injected, and most probably will work long enough to give the body an impetus sufficient to carry on the beneficial develop- ment thus begun. IX REJUVENATION FROM ONE’S OWN SOURCES How much more advantageous it would be if, for the purpose of rejuvenation, the body could be made independent of the utilization of foreign matter and substances whose condi- tion is always doubtful and whose acquisition very often is not an easy matter; if the organ- ism could draw on itself to produce the means of rejuvenation out of its own resources. The autoplastic transplantation of glands is an ideal method of rejuvenation, and the question is still to be settled whether one would not be quite right in speaking of a “rejuvenation from one’s own sources” in a case of the trans- planting of the patient’s own generative gland from its native abode to some other place, say between the muscles of the abdomen or some- where under the skin. It has been stated already that the trans- 65 66 REJUVENATION plantation of a gland—if it only be within the same organism—always results in a certain rejuvenation of that gland. The incretion of this gland is intensified, in turn improving the incretion of the entire glandular system which, in the end, amounts to nothing less than a re- juvenation of the whole body. The difficulty in procuring foreign material for rejuvena- tion purposes would be overcome if we only changed the location of a patient’s own gland. But a new difficulty now arises from the fact that aged, or aging tissue is in itself a very unsatisfactory material. A more serious condition arises when the transplanted gland itself is in an aging, or aged, condition. Not only is this general manifestation of progress- ing age detrimental to the chances of success- ful rejuvenation, but the operation as such, being a so-called major operation, would very often overtax an aged patient’s strength, since even young patients are often unable to under- go the ordeal. Even though transplantation has been successfully performed on animals, it seems too much of a risk to subject man to an operation of such seriousness. FROM ONE’S OWN SOURCES 67 As explained before, the generative gland begins to undergo a change in its composition as soon as it is transplanted. The generative tissue diminishes while the interstitial tissue expands—“proliferates,” as the technical term is. Steinach concluded from this fact (which, by the way, is not uncontended, as has been explained before) that, by means of the pro- liferation of the interstitial tissue, which starts as soon as the gland’s abode is changed, a sur- plus of vitalizing tissue is created which is necessary to bring about symptoms of rejuve- nescence. It was only logical to try to find a way to achieve the same rejuvenating prolif- eration of the interstitial tissue upon aging and aged people without taking recourse to transplantation. X THE STEINACH OPERATION LOOKING around for such an expedient, Steinach quite independently hit upon the idea of testing an operation which had al- ready been performed by such scientists as Bouin and Ancel, but for an entirely differ- ent purpose. This operation consists in sever- ing the duct of the generative gland in such a manner that it will not be possible for the severed ends to join again. For this reason, a simple severing of the duct would not be sufficient, because without providing for a permanent separation of the severed ends, they would knit again and the secretion again would be discharged. Another difficulty would arise from the possibility that from one severed end of the duct, the secretion would leak into the abdominal cavity. As it is im- portant that there shall be no discharge of 68 SCHEMATIC CHART Showing Spermatic Ducts of Rat Which Has Undergone Vasoligature, i and 2, Places Where the Ligation Was Performed; 3, Resected Part of Spermatic Duct (Vasec- tomy) ; 4, Place Where a Second Vasectomy" Could Be Performed Which Would Leave the Animal Still Potent, Though Sterile; 5 and 6 Places Where a Third and Fourth Vasectomy Could Be Performed. THE STEINACH OPERATION 69 secretion whatever, it seemed wise not only to sever the spermatic duct but also to ligate it in two places and thus close this duct per- manently. Besides a fragment from between these two places of ligation is removed, long enough to make a union of the severed ends impossible. The permanent severing of the duct of the male generative gland is a minor operation which can be performed very quickly and without any danger to the patient. It is called “Vasoligature,” meaning a ligation (a bind- ing or restriction) of the Vas Deferens, which is the medical term for the spermatic duct and is often referred to simply as Vas. Sometimes the operation is also referred to as Vasectomy, but usually only in cases when the fact is stressed that the operation consists of a resec- tion of a part of the Vas Deferens. Most of the time this method of rejuvenation is called the Steinach Operation, because Steinach was the first to employ this operation with the de- cided aim to bring about rejuvenation, while his forerunners performed it merely to study the change of tissue texture of the generative 70 REJUVENATION gland, which is brought about by vasoliga- ture. To be sure, the operation had been em- ployed quite frequently—though not always successfully—before Steinach used it, but only to remedy urinary disorders. By order of a court of justice, the operation was performed to sterilize criminals and the insane in a way which would not impair their general health. Now, it may be asked: How is it possible that a ligation of the spermatic duct of the generative gland brings about atrophy of the generative tissue and a proliferation of the interstitial tissue? Because as soon as the se- cretion of the generative gland is checked, this secretion is stored up in that part of the severed duct that is still connected with the gland. In this way, more and more secretion is stored up until the accumulating fluid ulti- mately reaches the generative gland itself where the duct originates. The stored-up se- cretion induces pressure which makes itself felt at first on the generative tissue itself— the very place where the secretion is gener- ated. In the end, the generative tissue, more sensitive than the interstitial tissue, has to give GENERATIVE GLANDS OF SENILE MALE RATS {Microscopical Section) Upper Picture Denoting Senile Condition; Lo