disturbed so that the advancing wave of con-
traction meets a contracted instead of an
inhibited area conditions are present which
may well bring about a distension sufficient
He gives
to account for the pain of colic.
many other illustrations of pathological con-
ditions which may find a plausible explana-
tion on the assumption of a disorder or dis-
harmony in the law of contrary innervation.
How far Dr. Meltzer was correct in the appli-
cations of his theory it is not possible to say.
In all probability some of the specific in-
stances that he cites in support of his views
are amenable now to other explanations. But
it is a fact, I believe, that he was much in
advance of his earlier contemporaries in the
emphasis he placed upon the significance of
inhibition in the general activities of the
body. The story is far from being told but
it may be said that physiological thought
since 1883 has tended more and more toward
some such general conception of the rôle of
inhibition as was in Meltzer's mind. For him
at least it was a rewarding theory, it played,
as he expressed it, a dominating part in all
of his researches. One can not wholly ap-
preciate his work nor understand his position
on controversial points unless this attitude is
born in mind. His theory of shock for ex-
ample to which he held tenaciously was that
"the various injuries which are capable of
bringing on shock do so by favoring the
development of the inhibitory side of all the
functions of the body." There is a shifting
of the normal balance toward the side of
inhibition.
The most important of his contributions in later years will be found in three series of researches, one dealing with the action of adrenalin upon the blood-vessels and the pupillary muscles; one with the inhibitory action of magnesium sulphate and the antagonistic effect of the calcium salts, and one with the development of his method or artificial respiration by pharyngeal and intratracheal insufflation. The first series consists of eight or nine papers, mostly in collaboration with his daughter. They showed in this work that the temporary action of adrenalin
upon the blood-vessels may be converted i a long-lasting effect, in the case of the vessels, if these vessels are first denerva by section of the vaso-motor fibers in the s pathetic and the third cervical
more striking result still was obtained for
iris. In the mammal subcutaneous injecti
of adrenalin in moderate doses have no ef
upon the size of the pupil, but if the supe
cervical ganglion is first excised then, a
a certain interval, subcutaneous inject
bring on a marked and long-lasting dilatat
His explanation of these phenomena
made in terms of his theory of inhibit
Whether or not his views in regard to
relations of the cervical ganglion to pu
lary dilatation will stand the test of fu
experimental work it is to be noted that
a signifi
observation itself constitutes
instance of a kind of independent phy
logical activity on the part of a periph
ganglion. The bearing of these facts u
the prevalent conception of the rapid dest
tion of epinephrin in the tissues was bro
out especially in a paper with Auer in w
it was shown that if adrenalin is injected
a ligated limb and an hour or so after
the ligature is removed the dilatation of
pupil quickly follows, thus demonstrating
for this long period the adrenalin had
mained unaffected by the tissues. Incide
results of this series of experiments were
discovery of the use of the frog's eye
biological reagent for the detection of s
concentrations of epinephrin and the rap
of absorption in intramuscular as comp
with subcutaneous injections.
The work upon the inhibitory and ane
tic effects of magnesium salts gave rise t
less than twenty five papers, most of
published in collaboration with one or
other of his associates but chiefly with
Auer. The peculiar inhibitory action
magnesium sulphate had attracted his a
tion as far back as 1899, and he reported
it incidentally in a communication to
American Physiological Society. But
1904-05, influenced again by his general
ception of the importance of the inhib
processes he took up with Auer a careful
physiological study of its action. The results
were most interesting and important. When
given subcutaneously in certain doses the
magnesium sulphate produces a condition of
complete unconsciousness and muscular paral-
ysis or relaxation, which is reversible, in the
sense that when the animal is given proper
care it recovers. Later he was able to show
that out of this condition of profound de-
pression or inhibition the animal may be
restored to complete consciousness and motil-
ity with miraculous suddenness by the intra-
vascular injection of small amounts of cal-
cium chloride. No one who was fortunate
enough to see this demonstration as given by
Dr. Meltzer will forget its dramatic effect
upon his audience. A healthy vigorous rabbit
was brought quickly to a condition of com-
plete immobility and apparent death by the
magnesium sulphate and then even more sud-
denly raised from the dead and restored to
its normal tranquil existence by the injection
Meltzer and his
of some calcium chloride.
collaborators investigated various phases of
this action of magnesium sulphate and all of
the results obtained tended to strengthen in
his mind the conviction that in magnesium
he had discovered the element in the body
that is especially concerned in the processes
of inhibition. The antagonistic action of the
calcium although exhibited in such a striking
way was not in his opinion specific. His own
experiments in connection with the results
reported by other observers led him to the
general view that calcium serves to balance
the abnormal activity of the other kations,
potassium, sodium and magnesium, whether
this abnormal action is in the direction of
excitation or of inhibition.
Modern work upon the physiological significance of the inorganic constituents of the body fluids which was begun in Ludwig's laboratory, but was given its main inpetus by the striking contributions of Ringer had concerned itself chiefly with the salts of potassium, sodium and calcium, which alone seemed to be sufficient to maintain normal conditions of irritability. Meltzer's work has shown that
magnesium also has its place in this ancient balance of powers through which the functional activity of protoplasm is controlled. One can understand that in arriving at these results he must have felt that he was approximating at least a demonstration of the correctness of his general conception of the rôle of inhibition in functional activity. In this as in all of his experimental work Meltzer was eager to give his results a practical application to the art of medicine. The possibilities of the use of magnesium salts as an anesthetic agent in surgical operations were tested with some success on human beings and more important still its efficacy in controlling the spasms of tetanus has had a wide and promising application.
His last extensive series of researches dealt with anesthetization and artificial respiration through pharyngeal and intratracheal insufflation. Something like twenty-eight papers, most of them in collaboration with pupils or assistants, were devoted to this subject. His interest in this topic seems to have been stimulated by the fact that in his use of magnesium sulphate for anesthetic purposes the chief danger lay in the inhibition of the activity of the respiratory center. To meet this diffipaper culty he undertook a study of the methods of artificial respiration. The initial 1909 by Meltzer and Auer described a method of artificial respiration by continuous insufflation of the lungs through a tracheal catheter. It was found that by this means not only could an animal be kept alive without the action of the respiratory movements to fill and empty the lungs, but that it furnished also a convenient and efficient method for anesthetization. The use of this method in animal experimentation and especially its use in human surgery of the thorax and facial region was apparent and on many occasions Meltzer sought to make known its advantages and to ask for an adequate trial of its merits at the hands of the practical surgeons. method has found some acceptance and the application of the principle involved will no 'doubt be extended in the future as the technique of thoracic surgery improves. It was
in recognition of the importance of this work
that the American Association for Thoracic
Surgery asked him, a physician and labora-
as their first presi-
tory worker, to serve
dent. It was natural that this work should
have led him to consider the whole matter of
artificial respiration in its relations to resusci-
tation after accidents of various sorts. His
general paper in the Medical Record for 1917
giving a history and critical anlysis of the
methods of resuscitation is an interesting and
valuable contribution. He gives experimental
data to prove that his device of intratracheal
insufflation is the most efficient method of
artificial respiration both for man and ani-
mals. But he realized that it is a method
which requires special knowledge and training
for its successful execution, and his broaden-
ing acquaintance with and interest in the
practical aspects of resuscitation led him to
experiment with the less efficient and less
safe method of pharyngeal insufflation. He
a member of the three national com-
missions on resuscitation and served as chair-
man of the third commission. In connection
with the duties of this service he devised
a simple portable form of apparatus for
pharyngeal insufflation which can be used
with very little previous instruction and he
demonstrated, with entire success I believe,
that this form of apparatus is much more
efficient than any of the so-called manual
methods of resuscitation, or than any of the
special machines for this purpose, pulmotors
and lungmotors, which have been exploited
commercially during the past few years. It
was, I imagine, a sore disappointment to
him that he was not able to convince his
colleagues on the third commission that this
apparatus met all the requirements for in-
It is probably the
dustrial and military use.
simplest and best instrument yet devised for
artificial respiration as applied to man, and
in institutions or industrial establishments
where the need for artificial respiration may
arise frequently and where special individuals
may be instructed in its use it can be em-
ployed to great advantage. But it does re-
quire some little amount of training to use
it properly-the average uninstructed ma woman can not be trusted to apply it in gently, and for this reason the commis felt that it was wise to urge adoption manual method as the form of first aid w may be applied most successfully under nary conditions.
While the researches that I have attem to summarize represent his most impo contribution to physiological science, Meltzer kept in close touch with the pro in almost all branches of experimental r cine. He gave evidence of this interes the publication of occasional papers on rious topics or in articles of a general acter. Shock, cardiac arrhythmias, ther tics of self-repair, hemolysis, thyroid the edema are among the subjects upon v he wrote, but probably the most original helpful of his general papers is his known Harvey Lecture, 1906, on "The tors of Safety in Animal Structure and mal Economy." He applied this engine term in a convincing way to describe th serve powers possessed by many of mechanism of the body. Doubtless the eral conception involved had occurred to others, but no one before him, so far know, had developed the idea so compr sively and made of this provision a le factor in the adaptation of the economy environment. The happy phrase that h ployed served to precipitate the loose th upon the subject, and its frequent recur since in medical literature is proof tha conception which it expresses has found acceptance in scientific circles. It is ev that his own thoughts were turned in direction by the work of Chittenden upo While he acc minimum protein diet.
of course, the facts demonstrated by th server in regard to the possibility of m nance upon a low protein diet he was no ing to believe that a minimum diet i an optimum diet in relation to the v metabolic stresses to which the body m subjected. The experiences of the grea may serve to show that he was corre taking this position.
To do full justice to the influence exerted upon contemporary medical research by Meltzer's work would require a careful analysis of the entire medical literature of the period, for, as I have tried to indicate, his sympathies were very broad and his activity was great. In some measure, either as interpreter or contributor, this influence was felt at many of the points of contact between medical science and medical practise. The border land between these subjects was in fact his special field of work. He had the spirit and ideals of the scientist, and knew at first hand what research work really means. He had experienced the labor and care and devotion required of those who aspire to increase knowledge. On the other hand he had a personal realization of the difficulties and necessities of medical practise and so was especially fitted to act as a sort of liaison officer between the two great wings of the medical army, the investigators who have the difficult task of discovering new truths, and the practitioners who must learn to apply these truths to the preservation of health and the protection from disease. No one in our generation, I venture to say, was more useful in this country in bringing about a helpful and sympathetic understanding between the laboratory worker and the physician. As a physiologist he enjoyed the best opportunities and training of his period. He was equipped with the methods and technique that the subject owes to the great masters of the latter half of the nineteenth century. The more modern methods of physics and chemistry which seem to be essential for the new generation of physiological workers he did not possess, but he did not let this deficiency discourage him nor diminish in any way his activity in research. He had the wisdom to understand that the
armamentarium with which he was provided was adequate for the accomplishment of much important and necessary investigation. He was no faint-hearted seeker after truth. There never was a time, I fancy, in his active life when his mind was not full of problems that he wished to solve and which he intended
to solve in part at least with the aid of his experimental methods.
Dr. Meltzer was elected to membership in the American Physiological Society at its first annual meeting held in Philadelphia in December, 1888. From that time until his death he was perhaps its most faithful member in attendance, in the presentation of papers and in participation in the discussions and social intercourse. Other less heroic spirits might weary under the load of papers and seek respite and fresh air by frequent disappearances between acts, but this was never the case with Meltzer. He loved the meetings, he loved to listen to the papers and to take part in the discussions.. He had something to say of value on almost every paper that was read. It is small wonder therefore that his position and influence in the society constantly increased in importance. He served as president from 1911 to 1913, but the older members know that before that time and since his advice was paramount in matters of policy as well as in the selection of officers. He was sincerely and deeply interested in the welfare of the society and believed in its importance as one of the major agencies concerned in the advancement of the cause of physiological research. What he had to say in regard to its policies was always said in the opening meetings and in the plainest of terms, and if in his opinion it was necessary to be critical of either persons or things he never hesitated to express what was in his mind. His courage in stating his position in matters in which some personal criticism necessarily played a part in the discussion has often aroused my admiration. He did not indulge in circumlocutions or euphemisms, but was entirely frank and direct. There could be no mistake as to what he thought and yet no matter how plainly and bluntly he might speak there was as a rule no offense taken, because it was evident to every one that what concerned him was not personalities but the principles involved. The American Physiological Society owes much to him for the sound policies and wholesome traditions which have characterized its his
tory. I have not so much direct knowledge
of the influence exerted by Dr. Meltzer in
the numerous other societies of which he was
a member. In the case of the Society for
Experimental Biology and Medicine we know
that he was its chief founder and for many
years its primum movens-it was long known
the
familiarly among scientific men
I have no doubt that in
Meltzer Verein.
every organization with which he was con-
nected his influence was always exerted on
the side of the highest scientific ideals-no
other position was possible for him. He was
high-minded, courageous, sincere and opti-
mistic. Age oftentimes lays a stiffening hand
upon the scientific worker, causing him to
shrink from the laborious routine of research,
but with Meltzer there was never any indica-
sense of failure. In
tion of weariness or
spite of much ill-health and physical suffer-
ing in his later years he was full of hope and
energy and determination in the pursuit of
his scientific ideals and problems. Death
came to him, as he would have chosen, while
in his study and at his work. He was a good
and faithful servant in the cause of medical
research. Rewards came to him in the form
of academic honors and membership in the
most important medical and scientific so-
cieties, but I am confident that he found his
greatest recompense in the joy of the work
and in the affectionate appreciation of his
many scientific friends.
THE RELATIONS OF PSYCHOLOGY TO
MEDICINE1
A SUFFICIENT excuse for this discussion
of an old theme is the notable rapid prog-
ress of both psychology and medicine, and
the consequent changes in their actual and
prospective relations. Fresh consideration
of the question what should be the relation
of psychology to medicine may benefit
alike the sciences and the art concerned.
1 Address of retiring vice-president and chairman of Section I, American Association for the Advancement of Science, Chicago, 1920.
The discussion may not be exhaustive
stead, it must be limited to an outli
the theme and the indication of
characteristics of the two principal sub
which are preeminently important as
ditions of profitable working relations
Medicine as an art strives to mainta
restore the health of the human
The object of the physician's concer
patient, ordinarily is both active and
scious. It is therefore desirable tha
practitioner be thoroughly grounded
facts and principles of human action
experience. Although this may seem
evident, it has not been accepted gen
in medical education. The histor
medicine indicates that it has long s
to attain a reliable and adequate sci
basis for the practise. Naturally e
knowledge of structure was first
sought, and in consequence, the scie
gross anatomy developed. Subseque
gave rise to histology, cytology, em
ogy, pathological anatomy, and ba
ogy, all of which are now recogni
essential morphological bases for the
medicine. Paralleling the growth
knowledge of structure, although son
more recently and more slowly dev
are the various sciences which dea
organic functions. Among these,
physiology was first chronologicall
first in importance to medicine. F
eral centuries it has grown steadily
ually extending its inquiries to most
important types of organic process.
it have arisen a number of special
of function and its alteration, as,
ample, in immunology, patholog
certain aspects of pharmacolog
to take possession of those large a
strangely enough, physiology has
portant groups of phenomena in
life which are designated by the
behavior, conduct, experience, and
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