OLD MEN GROW - YOUNG-. - WHEN _Dr. Eugen Steinach _of

Vienna „had. _worked out the . effect of theeransplantation of glands in animals,, making:

males and females reverse their habits and proclivities, and turning old animals into young, he left the practice of trans- plantation to Voronoff and went on to discover a much simpler method of rejuvenation. It is to Voronoff that the sensa- tional " monkey-gland " treatment is due ; Steinach's new operation was " vasectomy." He divided and tied up the spermatic duct in the animal. Decrepit old rats " suddenly , took on a new lease of life—their fur came back, they grew fatter, they became agile and pugnacious again." They jumped off high beams and climbed up heights to get morsels of bacon ; before they had merely gazed at the morsels or made feeble efforts and fallen back exhausted.

The ducts of old dogs were similarly tied, dogs as old as seventeen years who could only lie down on the floor and look up with dim eyes, or slink about with downcast head. Here is a record of one dog, a white poodle fourteen years old. " The dog was quite senile, with tremors of the hind legs ; the condition of the coat was bad, the skin covered all over with black warts, all interest in life gone. Despite an earlier attack of apoplexy, double ligation (vasectomy) was performed. . . . Six weeks later the dog looked healthier and the heart action, at first rapid, had quieted down, the tremors of the hind legs had remitted very considerably. The weight increased. A few weeks later the warts dis- appeared. . . . In the spring he manifested a lively interest in bitches. The growth of hair has now become so beautiful and thick that he can be clipped again in poodle -fashion. His movements are lively and strong. The tremors occur

seldom, only when he. is excited, and then they are slight." Old bulls, rabbits, guinea-pigs, and cocks were, in a similar way, restored to the height of their vigour.

Obviously the next step was to apply the same principle to the rejuvenation of man—especially since the operation, as Dr. Norman Haire says, is " a small operation which need not even confine him to bed. It may be done under a local anaesthetic, and entails no more pain or inconvenience than is attendant on, say, a cut finger, and is followed by no ill- effects." From the experiments on animals, at any rate, it seemed that there was no reason to fear lest the stimulation of the body should be followed by a more rapid decay ; for animals which had been rejuvenated by vasectomy lived longer than they would normally have lived. There may be ground for believing that the transplantation of glands has, in the end, unfortunate effects ; but it is of very great importance to realize how differently Steinach and Voronoff proceed. The cases of vasectomy performed definitely for the rejuvenation of men go back only five years, but in those five years no ill effects have been observed. For a long time, moreover, the operation has been performed to prevent the spread of bacterial infection, and the twofold operation, the tying of both ducts, has been practised in America for the sterilization of lunatics, alcoholics and criminals. On the publication of Steinach's results doctors reviewing their cases found that they confirmed Steinach's theories, that there were marked instances of rejuvenation, and that " the operation can cause no harm of any kind to body and mind."

Dr. Peter Schmidt has very ably stated the theory of the Steinach operation, and has reported on one hundred cases of vasectomy performed by him on men. The results have been astonishing. Let us quote a case of Vecki. He operated upon a man of eighty " in a state of hopeless decay, and frequently afflicted by attacks of fainting and giddiness. He suffered from loss of memory ; he was quite helpless. I advised Steinach's operation, to make life bearable for him. Two months after the double-sided ligation I found my patient as the chief guest at a big reception ; he made a very witty speech. . . . His subjective feeling of well-being was increased ; his family informed me that the attacks- of

giddiness had quite ceased ; he again took an interest in everything and could go for long walks." Di. Schmidt himself reports the case of a waiter of sixty-eight, who for

twenty years had been in and out of hospitals for digestive trouble. He was reduced to skin and bone, his hair was white, he was totally incapable of work. In six months people were pointing out to him how much better he looked. His hair and beard grew more quickly ; it had changed to grey, and even in places to greyish-brown. He is now working a ten-hour day as waiter in a popular restaurant, and astonishes the younger waiters by the amount of work he does without any evidence of fatigue.

Some of Dr. Schmidt's cases were failures, and he sets them down frankly, but they make only a small proportion of the whole, and we could not expect that all organic disorders and decays should be cured by such means. There is a thoroughly convincing array of cases in which astonishing symptoms of rejuvenation occur, and the most sceptical should feel compelled to accept Dr. Steinach's theory. Exactly what that theory is in itself Dr. Schmidt explains very clearly and fully ; but if we are to understand it in its whole bearing on the constitution and health of the body, we shall do well to read Dr. Weil's book, The Internal Secretions. It will be rather a difficult task for the layman, for it is intended as a text-book for medical students and physicians. The subject, however, is of great interest ; it has side-bearings upon sociology, criminology and even psychology and the research into the internal secretions has resulted in the most spectacular triumphs of modern medicine.

It was till recently the classical theory that the whole working of the body was carried out by the nerves at the dictation of the brain, and it was very rarely suspected that there was another system, of equal importance, automatic and independent of the nervous system, which not only carried on processes of its own, but could also stimulate and affect the brain itself. It has now been proved that the ductless glands pour straight into the blood various secretions which themselves stimulate the organs of the body. These secretions (or ineretions) are called hormones, or messengers, because they travel round the body in the blood-stream and tell the organs, as it were, what they are to do. Deficiencies or abnormalities in the production of hormones may produce grave disorders—we need only specify diabetes, cretinism, and probably dementia praecox. In addition to the ductless glands, there are two glands which are known to have two functions ; they secrete their ordinary products through their ducts, and they add their specific hormones to the blood. They are the pancreas and the gonads.

Professor Banting, when he was searching for a convenient way of obtaining insulin, an extract from sheep's pancreas, in order to relieve diabetes, found that if he tied the duct and prevented the pancreas from secreting its ordinary gastric juice, its production of hormones was increased. It is in precisely the same way that Dr. Steinach, in tying the duct of the male gonads, prevented the secretion of sperm cells, and increased the production of hormones. The part of the gonad which forms the sperm cells therefore atrophies ; but the whole energy of the gland is given to the multiplica- tion of interstitial cells which pour out hormones. Of course, a diabetic patient cannot have his pancreas tied up, for the gastric juice which it secretes is all-important for his digestion. But the whole diminution made by vasectomy in the usual functions of the body is that, if one duct is tied, -he produces less sperm cells, if both are tied he is sterile.

But the hormones of the gonad are of primary value.

It appears that, by their own action and by their influence upon other glands, they are responsible for the maseulization of the body, for growth of hair, for depth of voice, for strength and for the erotic nature. It is mainly these hormones that give vitality and cheerfulness and energy to mind and body. And it is their decrease that induces all the distressing signs of senility, lack-lustre eyes, dry skin and withered body, depression, querulousness and failure of interest.

No miracle takes place after the operation of vasectomy.

It is probable that there is a. maximum effect of these hormones, and that to multiply them beyond that point is useless. What the operation can do is to restore a man to his best normal state of health and vigour, and enliven his mind to the highest efficiency of which it is capable.

JAMES ALLISON SELBY.