Chapter VI: The Contributions of Biology and Physiology (3)

E. Payr[187] calls attention to the fact that Steinach’s puberty glands, which correspond to the Leydig cells, are those that secrete internally and that it is these that act so powerfully upon secondary sex qualities and bring what often appears to be a renewal of youth. His operation is especially indicated in the case of subjects with healthy internal organs who are growing prematurely old and who give evidence of loss of function of secondary sexual characteristics.

G. F. Lydston[188] describes nine cases of men with atrophied testes, injured, or removed, which were replaced _in situ_ surgically by those from the bodies of boys recently dead. The glands from the boys were removed within a few hours after death and generally subjected to cold storage for some hours and then ingrafted upon the older patient. The boys from whom they were taken were healthy boys who had suffered sudden or violent death and there might be an interval of many hours not only between the death and the removal but between the latter and the implantation. In all these cases Lydston reports more or less improvement by the operation, which in a few cases was marked. The transplanted glands atrophy and disappear more rapidly when the recipient has more or less well developed testes of his own. Apparently permanent local results were best obtained in those cases in which the patient had very little gland tissue. Lydston thinks that there may be a sort of parasitic action of the patient’s own glands upon the transplanted ones. His own organs probably contribute the nutritive pabulum otherwise available for the implanted ones but the therapeutic results are obtained and sustained even when the implanted gland eventually disappears. He thinks that the notable result obtained by Dr. I. L. Stanley, where the glands from a Negro hanged for murder were implanted in the scrotum of a white moron, apparently with remarkable results, suggests that atrophy may take place more slowly when the donor is of the same race as the recipient. The author doubts whether there is much advantage in anastomosis as to either betterment of nutrition or preservation of the spermogenetic function. He thinks “we run more risk of failure of the implant from the greater traumatization of the tissue necessary for anastomosis.” He thinks, too, that the spermogenetic epithelium of the testes degenerates in all cases rather promptly.[189]

In his book, _Impotence, Sterility and Sex Gland Implantation_ (1917), which seems somewhat ill-digested, Lydston claims priority on eight points and formulates twenty-one conclusions. It seems to me that he has not sufficiently assimilated the best European work in this field or profited as much as he might have done by the far greater refinements of technique of Steinach; while such results as he claims are, as he himself admits, always wide open to criticism.

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Serge Voronoff, like Metchnikoff, combines research with humanism and gives free rein to his idealism. He is professor in the medical school of the _Collège de France_ and deals with old age and death from the standpoint of endocrinology or the study of the glands of internal secretion. Accepting Weismann’s doctrine of the continuity of germ plasm, he says that the nameless and ever unassuaged horror that everybody really feels for death is “because an intimate memory of our immortality” survives or because we recollect creation’s first intention as expressed in plasmal immortality. Man has inherited this longing from the deathless unicellular creatures from which he descended not only in the form of quests for elixirs of life here but in all his manifold beliefs of a life beyond the grave, at the same time for this life accepting the gospel of renunciation to death as something inevitable. The ghastly thought of death not only clouds all our life but predisposes even most scientists to think that research in this field cannot be successful.

The background view of the work in Voronoff’s field, roughly stated, is as follows. Somatic cells, having lost the power to propagate the whole body, as they develop and multiply become more and more special, not only in form but in function, until they finally lose the power of multiplication or of regeneration. These are higher and perform the most particularized functions. Besides these most individualized cells, so characteristic of every organ that a cytologist can at once distinguish cells that form the epithelium, intestines, brain, muscle, glands, etc., there always remain other far less differentiated or more primitive cells, chiefly leucocytes or white blood corpuscles and the connective tissue cells. The former float in the blood and can pass out through the thin walls of the capillaries into other tissues. The latter constitute all the firmer supportive framework of every organ. They are very robust, fecund proletarians and are largely made up of the former. From birth they wage unceasing war upon the nobler, more professional and expert, but less independent cells which have sacrificed most of their cruder, pristine powers for service to the body corporate. These higher cells represent the extreme division of labor within our bodies. They are no longer sufficient unto themselves but each class of them depends upon the work of others. The low, banal, barbaric but vigorous cells of the conjunctive tissue, on the other hand, always strive to destroy and to themselves take the place of the higher cells and it is this process slowly going on everywhere that constitutes old age and all its processes of hardening, atrophy, disintegration, etc., for these lower cells cannot discharge the functions of the higher ones they have supplanted and hence comes anarchy within the organ or body. We die because nature tends so strongly to develop the cruder type of cell that makes up the connective tissue.

Now, secretions of the thyroid gland check this aggression of the lower upon the higher cells, as is shown in the studies of cretinism, which is in so many respects nothing but premature old age brought on because the thyroid fluid, the special function of which was to retard this process, was not supplied; and when it fails, old age comes on precipitately and even children often look and act much like prematurely old men and women. On the other hand, the Metchnikoff ferments of the large intestine weaken the higher cells and leave them with less power of resistance, so that they become more easily the prey of the lower cells of the connective tissue. The enemy, however, for the endocrinologist is not primarily a microbe entering from without but a more formidable and subtle foe that springs up within. The difficulty in meeting the situation is immensely enhanced by the fact that the cells of the conjunctive tissue are not only useful but indispensable for the work and the development of every organ at first and continue to be so as long as they do not transcend this their original function and trespass outside it. The white corpuscles, although the source of the connective tissue cells, are themselves our chief defenders. It is they who attack and devour invading microbes but they consume not only these but also higher cells that have, by the action of microbes or otherwise, become debilitated. They are, however, on the whole, so serviceable that we cannot intervene against them but only against our more dangerous and insidious enemy, the conjunctive tissue cells.

Not only the thyroid but yet more the tiny parathyroid glands secrete a fluid, the absence of which brings convulsions and death. A knowledge of the function of these glands, no larger than a pinhead, as well as that of the adrenals or of the far more complex pituitary body (hypophysis), each lobe of which plays its own particular rôle, has been nothing less than revolutionary. The effects due either to excess or deficit of the secretion of these glands, which have been studied experimentally in animals and observed in man, show that they have great power even to arrest or accelerate growth itself. It is they that do much to keep us young or make us old. In a sense they furnish the power that makes about all the organs do their work efficiently, as an electric current from a battery may start, or its absence stop, the most diverse kinds of electric machinery. Thus glands have come to play a great rôle in physiology, medicine, and even psychology, and their activities have come to be recognized in very many phenomena both of health and disease, which till recent years no one had suspected. Some of these glands contain a relatively small number of cells but do a vast amount of work and manufacture fluids that no chemist can duplicate and that seem almost magic in their effects. We owe to them growth, health, and vitality.

Most important of all, and the chief source of human energy in man, are the sex glands, which distribute energy to all the sixty trillion cells of the body, making each carry out the function assigned it. Voronoff made personal studies of eunuchs in the East and among the many traits so often mentioned he finds them not only arrested along various lines of bodily and psychic growth but short-lived and perhaps old before they are forty. They are often selfish and crafty. Sex glands stimulate not merely amorousness but all kinds of cerebral and muscular energy, pouring into the blood a species of vital fluid, and give a sense of vigor and well-being and plenitude of life, which later vanish when their source begins to run dry in age. Can this wonderful source of human energy be placed, in any sense, in man’s control? It has already been proven that trituration of the sex glands does not produce its entire product and particularly lacks the active element. Moreover, all preparations of this liquid change very rapidly and may even become toxic. This method has passed beyond the stage of ingestion in the stomach or subcutaneous ingestions.

Voronoff undertook to graft young sex glands themselves into bodies older than those from which they came and if they lived and throve in the body of the host, the product they secreted would be complete and also vital. He says of the testes: “To graft this gland is to participate at first hand in the work of creation, to imitate nature in the procedures which she has elaborated in order to secure the harmonious functioning of our body”[190] (p. 65). He published his first results in 1912. He then showed a lamb born of an ewe whose ovaries he had removed, replacing them with the ovaries of her younger sister. His most important paper was read in October, 1919, on “Testicular Grafts.” He had been experimenting on flocks of sheep and goats, grafting the whole gland in twenty-five, large fragments in fifty-eight, and small ones in thirty-seven individuals. Transplantation was effected subcutaneously sixty-five times, in the scrotum itself thirty-two times, and twenty-three times in the peritoneum. Anastomosis did not follow; nor was it necessary. Testicular tissue, he thinks, has remarkable aptitude for transplantation and a microscopist, M. Retterer, shows us with abundant illustrations just what takes place. The nutrition of the small fragments was more easily assured than that of the large fragments or the whole. Sometimes where sex power is restored in old animals so that they bear young, the parental instinct seems weakened, but the rejuvenation effects of this process, as his many photographs show, are marked. The old and debilitated animals become well, lively, vigorous, and belligerent.

Voronoff is very candid in admitting that his interest and enthusiasm may cause him unconsciously to overestimate the rejuvenating effects of his grafts, and he also admits that he does not yet know how long the beneficial effects will last. That they have done so for two or even three years is beyond question. He is conscious of the incredulity of biological experts but reminds them that a society of physicists, when first shown the phonograph, insisted that it was ventriloquism. He calls attention to the great difficulties in his field, due not only to prejudice but to laws that forbid the taking of organs of healthy men killed by accident. He does not expect surgery will ever remove glands or even portions of them from the living young to revitalize the old, in human subjects, although he thinks that perhaps “the restoration of the vital energy and the productive power of Pasteur may well be worth the slight pain inflicted on the robust porter.” Most men, however, would prefer to lose an eye rather than one of these glands, as the price proposed by a few who offered themselves for this purpose shows.

Voronoff sees a great future possible for glandular transplantation and grafting between men and animals but shows that this can never be very effective for man save with apes, to whom he is so much more closely related, even in the makeup and properties of his blood, than to any other species. Thus the organ of an ape transplanted to man will find there nutritive and other conditions very like those it was used to. Surgery has done much and wonderful grafting in the war, even of bones, and now man, “the talented ape,” as Huxley called him, is recognizing his simian ancestry in a new way. A fibula congenitally missing in a child was successfully transplanted from an ape, and the radiogram showed complete intussusception, no absorption, and it functioned well. Voronoff transplanted the thyroid gland of an ape into the neck of a boy of fourteen, who was lapsing to cretinism, with remarkable results which he describes in detail and with photographs, although the ape from which the thyroid was taken died. The transplanted gland was not merely tolerated and then expelled as a foreign body or resorbed but the graft seemed to really take and its effects to be permanent and not temporary, like those due to the ingestion of thyroid tablets. The boy changed in his habits, his school work improved remarkably, and the last heard from him was that he was a soldier at the front. Here the beneficial effects were marked and traced for six years and seemed to promise permanence. Other grafts from apes for cretinism have been made, but because chimpanzees, which are best for this purpose, are very hard to procure in sufficient numbers, this process must always be limited. Voronoff has, however, made no grafts, even of thyroids, from parent to child save in one case; and here, although the young imbecile was nearly twenty when the operation was performed, marked improvement took place. The ape is, in a sense, however, superior to man, as represented by the quality of these organs, owing perhaps to a more robust physical constitution; or it may be due to the fact that with the first boy the graft was from a young ape and the latter from his mature mother.

For woman, for whom old age has perhaps even greater terrors than for man, such restoration has not yet been made. Indeed, ovariotomy has less effects upon young women than does castration upon man, so that here we face a new problem that cannot yet be solved. The problem now is whether we can generalize yet from these special studies, including bone grafting and the surgery of transplantation of other organs. Kidney grafting has been successful as yet only on cats and dogs but opotherapy or the administration of glandular extracts of animals when our own fail is in its infancy, although it does seem to give promise of deferring death and increasing the vigor of human life. Indeed, he thinks that the renewal of worn-out glandular mechanisms by grafting may even become a commonplace. The vital fluid supplied by these organs “restores energy in all cells and spreads happiness and a feeling of well-being and the plenitude of life throughout our organism.” The idea of controlling this marvelous force and placing it at our service when the natural sources of our energy begin to dry up with the advance of age has long haunted the minds of investigators, and Paul Bert and Ollier decades ago dreamed of a day when old organs might be set aside like worn-out clothes and replaced by new ones. “Several of these animals operated upon have exceeded the age limit which animals of their species generally attain and, instead of showing signs of decrepitude and senility, they give promise of astonishing vigor.”

Louis Berman, M.D.,[191] tells us that infancy is the epoch of the thymus, childhood of the pineal, adolescence of whatever gland is left in control as the result of the life struggle, and senility is the epoch of gradual endocrine insufficiency. The discovery of the effects of endocrine secretions he compares with that of radium and thinks that by control of this function we may be able to modify the rigidity of Weismann’s dogma and affect heredity itself. He draws a very long bow and even attempts to characterize important personages and races according to the predominance of thyroid, pituitary, or adrenal secretions and sees here the fundamental determinants of human character and conduct. Well informed and expert as he is in this field, his views, though bold and interesting, are, it must be admitted, more or less speculative in the present state of our knowledge, and he devotes little consideration to old age or to the methods of deferring it.

If we conceive life as the sum total of all the forces that resist death and death in its essence as the queller of life, it is to biology, not to theology or philosophy, that we must look for our most authoritative and normative ideas of both life and death. We must examine not only the now very copious data that this science already supplies but also the instrument that defines, delivers, and interprets them, namely, the mind, so that psychology must henceforth have a place here second only to biology in formulating conclusions. Now, psychology teaches not only that there are certain determining tendencies that always, in part at least below the threshold of consciousness, direct the course of thought, slowly build up centers of apperception and interest, and that must always be reckoned with sooner or later not only in the treatment of any subject in which their action is involved but also when almost any scientific laws of nature are formulated, but also that, quite apart from their primary significance for the field in which they arose, they have a secondary anagogic value in other fields, in which they become symbols, often of great efficacy. Only the lower alchemists sought to evolve gold from baser metals and this quest we now know was always and everywhere really subordinate to the effort to evolve the _summum bonum_ in human life. So the modern sciences that deal with life and death, health and disease, are really directed far more than they know, even in those researches upon the lower forms of life and most abnormal processes, by the deeper, determining motivation to know better and to influence more the conditions of human life. Thus a truer and larger self-knowledge for man is, in this sense, their ultimate goal.

In view of this, what psychologist can for a moment doubt that the old problem which F. W. H. Myers called the most insistent that ever haunted the mind of man has contributed very much to stimulate interest in Weismann’s doctrine of the immortality of the germ plasm and for a wide lay public has given a zest and interest in phenomena that can hardly be observed at all save through a microscope and by an expert. If we had an analysis of Weismann’s own consciousness from his first conception of this idea to its full development we should doubtless find the same factor. True, we search his writings in vain for any intimation that he recognized any such influence, but I think there can be no doubt that had he been a psychologist interested in the sources of his own motivations and had he left us an autobiography as intimate as that of Spencer, Wundt, or even Darwin, we should have seen that he realized that he was only giving a new answer to the oldest of all culture problems. Of course, no psychoanalyst or geneticist would claim that Weismann was seeking an _elixir vitæ_ or a new fountain of youth for himself or for others, but it would be equally extreme, on the other hand, to deny that in the very use of the concept and term immortal, as he applied them to germ plasm and protozoa, he was propounding a new if partial surrogate answer to the problem of a larger life for man. Indeed, we might go further and suggest that in his extreme pronouncements against the inheritance of acquired qualities he gave way to the same basal disposition or diathesis that made theologians so exiguous in formulating conceptions of the inviolability of divine decrees.

Another underlying psychic determinant is found in the intense popular interest in investigations like those of Voronoff, Steinach, and Carrel, of which the latter is perhaps least conscious while the former is almost as tinglingly so throughout as Haeckel was of these older concepts. That highly differentiated and complex somatic tissues removed from the body and given a more fit medium, and kept from all products of decomposition, etc., can keep on functioning and growing for years, better than they had done in the body in which they originated, neither has nor is ever likely to have any real practical utility for prolonging or intensifying human life. The fact may have a certain moral for cleanliness and even for nutrition but we can never wash out the tissues of the body or keep each of its cells in an optimum environment. Yet even here the mind finds a faint if, all things considered, somewhat pathetic element of hope that old age and death may sometime be deferred.

Nor can we ever hope to ward death off by keeping the tissues of the body young and growing to the end of life and breaking the law, to which nearly all species are subject, of attaining their maximum size long before age and decline set in. It has long been realized that one of the first signs of the advent of the chronic hereditary diseases in children is the arrest of growth but man can never, of course, hope to approximate immortality by attaining gigantic size. Nor can we hope to advance toward the old idea of macrobiotism by permanently lowering the temperature within the body, as experimenters show can be done with great increase of life for certain of its lower forms, especially those called cold-blooded which take the temperature of the medium in which they live. And yet here man has a very old instinct, reinforced by modern hygiene, to avoid excessive heat, an instinct that perhaps originally impelled him to leave tropic regions and haunt the edge of retreating glaciers. Nor can we ever expect to rejuvenate man by bringing about a dedifferentiation of organs or functions because just this is the price we pay for progress, evolution, and individuation. But this concept, too, has many prelusive forms in the early developmental history of human consciousness and it has its own obvious anagogic meaning. If we follow these trends they lead us, of course, straight to Pantheism and give us a painful sense of the limitations inherent in personality itself. As to the conclusion of Loeb, that life departs with breath because the absence of a fresh supply of oxygen lets loose dissolutive chemical changes its presence prevented, the pragmatic layman can only point to the recognition that in a few generations has become world-wide, of the value of ventilation, deep breathing, and the adequate oxidation of tissues. This shows that man felt that life was closely bound up with oxygen long before he could prove it. So the biological evidence that it is the brain or nervous system that dies first and determines the death of all the other parts and functions, if it has any culture correlate, finds it probably in the hazy quarter truths of the doctrines of the mental healers, that far more human ills and far more deaths and preventions and postponements of death than we know are amenable to mind cure because they are mind-made.

The only practical hope of easement from the hardships of senescence and for the postponement of death now tenable is that now arising faintly and tentatively that, some day, some mitigation of the terrors of old age and death may be found by glandular implantation or perhaps even by the injection of the secretions of certain glands. We know that the germinal glands, and especially their products, have a unique vitality of their own and also that they exert a remarkable and all-pervasive influence upon all the organs and functions of the body; and that thyroid extract retards and its absence precipitates all the processes of aging. The new studies in this field suggest that glands may be the sovereign masters of life. These studies are yet, however, in their infancy and it will be, at the best, a long time before we can know whether they are able to fulfill their promise to the human heart and to the will to live.

I deem it, however, very significant that contemporaneously with the discovery and exploitation of endocrine functions, and especially those of the sex glands, from another field and quite independently have come the discovery and exploitation of the unconscious and the recognition that its chief content is sexual. The analogies between these two lines of advance and their real relation with each other have not yet been fully recognized, much less wrought out. But already there is promise of a new and more stimulating rapport between biology and analytic and genetic psychology. If researches in the former field ever have the therapeutic value already so abundantly illustrated in the latter, we shall indeed be fortunate. Just now this seems not probable for a long time. But the physiological dominance of sex glands and their products, and the immense rôle played by sex life, especially in man, suggest that it is in this field that the cure of his most grievous ills must be sought, just as the oldest and most persistent myths and legends have so long taught that it was in this field that the so-called fall of man took place.