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THE PRACTICE. WOMEN

At Dr. Brinkley's hospital, a beautifully appointed private residence, it is a comfort to women patients to have the doctor's wife, herself a competent surgeon if necessary, at hand during the actual operation. Mrs. Brinkley administers the local anesthetic, or the general anesthetic, if that is called for, as it sometimes is. While the bulk of the operations performed on both men and women are gland-transplantations, a diseased condition of tubes and ovaries has sometimes made a laporotomy necessary, and many major operations have been successfully performed in the white-enameled operating room. At such times a woman clings to the presence of a woman, and Mrs. Brinkley's kind and pleasant manner is usually sufficient to banish all nervousness from the woman patient.

In ordinary cases of gland-transplantation into women, where the patient is in good physical condition, with no disease of the organs, the operation is as simple as in the case of the man. The speculum discloses the condition of the vagina, and the insertion of the new ovary is into the mucous membrane of the vagina, leaving the goat-ovary about four inches distant from the woman's. The only incision made is a small one, about one inch long, painless under local anesthetic, the purpose of the incision being to get a blood supply for the goat-ovary. Sometimes one ovary is implanted, sometimes two; invariably the new ovary is trimmed to a reduction in size. Invariably it is implanted within twenty minutes of its removal from the nanny-goat. Unfortunately for the goat, the removal of her ovaries usually costs her her life. She mopes for a few days, refuses to eat, and dies. She is always given a general anesthetic, and the removal is painless at least, if fatal. Pursuing the conclusions drawn from his long experience, Dr. Brinkley has found that women derive more instant benefit from the glands than men with respect to their awakened enthusiasm, improved appearance, and recovery of the feeling of poise and well-being. Very noticeable is the change of figure which follows the implanting of the new ovaries in the case of a fat woman. The change is equally marked in the case of a fat man. A man of abnormal weight, 250 lbs., lost fifty pounds in two weeks following the operation, during which time he remained at the hospital, feeling well and strong, but shrinking in girth amazingly. When he left the hospital his clothes hung about him in bags and folds. The fat woman's spirits seem to rise as her weight decreases, and she feels as if she had indeed regained the buoyancy of her youth.

Dr. Brinkley by no means asserts that the woman whose ovaries have been removed by surgical operation will grow two new ovaries after the transplantation has been made, but he cites the case of a woman whose ovaries had been removed by surgical operation some years previous, the uterus remaining intact, in whom he implanted two goat-ovaries, and whose periods shortly afterwards returned on a four-day basis, with twenty-eight-day interval. He does not say that the goat-ovaries transplanted into the woman have grown new ovaries, but there remains the phenomenon of the renewed menstruation, and this is very difficult to account for. In barren women, from twenty-eight to thirty-five years of age, in whom he has found not a diseased, but an atrophied, condition of the ovaries, the transplantation has invariably been attended with success to the removal of the barrenness, the new glands evidently bringing about the development of ova. Nor does Dr. Brinkley say that in the case of a man who has had both glands removed by surgical operation, the transplantation will produce new glands for the man, and yet he has had two successes to offset several failures in this very result, without any clue to why the success followed in the one case and not in the other. The work is yet in its infancy stage, and Dr. Brinkley is the first to admit that there is far more about it to be known than he has yet succeeded in knowing. He is averse to experimenting upon women patients at this stage of his knowledge, and has many times refused to transplant the glands for women who have requested him to perform the operation for them. One such case was at the hospital during the writer's visit there in April. She was a paralysis case, quite fat, unable to walk except by putting forward one foot at a time, supported by the arm of someone on each side of her. She was driven to the hospital in an automobile, accompanied by her husband and daughter, from the farm--two hundred miles away! Dr. Brinkley strongly urged her not to have the gland operation performed at all, but she insisted upon giving it a trial. It is too soon yet to speak of results in this case, but in Dr. Brinkley's view it is asking too much of the glands to expect them to produce favorable results in a case of this severity. Yet, at this time, there was in the hospital a young woman suffering from Dementia Praecox, whose mother had been watching over her for twelve years, and on whom the affliction of her daughter had so weighed that she told the writer she wished God would take one or the other of them, because it was more than she could bear. This young woman had been confined in the State Hospital for the Insane, and had been treated by specialists for many years, without any benefit at all. There was some homicidal mania, much depression, and attempts at suicide. She could not be left alone in her room for a moment. But the day after the transplantation of the glands this young woman embraced her mother, and talked so rationally to her that she called in Dr. Brinkley, and with tears repeated what her daughter had just said. Dr. Brinkley advised her that the results were altogether too sudden to build upon. "There will certainly be ups and downs yet," he said. "You must expect good days and bad days, when you will doubt if your daughter is any better. But, to make a normal recovery, she +ought+ to show an alternation of good and bad days, with the good days gradually drawing ahead and becoming more frequent and more marked. I look for her to recover entirely in a year's time, but she will always retain her sensitiveness and a certain amount of hysteria, so that things that would not bother you or me will hurt her grievously. You must be prepared to expect this to happen. But I see no reason at all why she should not in the near future become a happy wife and mother." The blessings of this good mother were a reward in themselves, and were so received by the doctor and his wife. When such results as this are obtained it becomes very difficult to draw a line and say, "The goat-glands will do no good here." Physicians of the best standing had said to this poor mother before she took her daughter to Kansas, "So you're determined to try the goat-glands? You are wasting your time and money. Brinkley is nothing but a fake. If there were any help for your daughter we could cure her. We can do nothing. There is no help for her!" This was repeated to the writer by the mother, and he vouches for its truth. Is it not evident that a better understanding of the goat-gland operation is highly desirable among physicians and surgeons today?

Quite a frequent style of inquiry from women to the doctor runs like this: "I am in good health, and in every way normal; age 35. I want to remain as I am, and grow no older in appearance than I am today. Do you think that the goat-gland operation would keep me from getting any older?" To this kind of inquiry Dr. Brinkley makes a stereotyped reply, something as follows: "If you are today in good health I should not advise the goat-gland operation, but would advise it in your case as soon as you have passed the change of life, in ten or fifteen years from now." To the writer he said, "I cannot conscientiously advise this woman to submit to this operation, because I don't know that the glands would advantage her in any way. They might, or they might not. I don't know. It is therefore experimental work, and I cannot take her money for an experiment. I must have something definite in the way of experience to go upon. There must be some evident condition of ill-health to be set right. But, on the other hand, though I will not advise these people to take the gland operation, there may be something in her idea that the glands will arrest age and hold it back. I have never been in a position where I could afford to experiment on young and healthy human beings, and this point can only be settled by such experiment upon healthy and young human beings. I should say at a guess that the operation would do her no good, but you understand that this is a guess only. I do not know anything about it. All such things as this we shall learn by degrees by further experiment. At present I am kept busy attending to cases of real sickness, or defined conditions of arrest of function, where I have experience to guide me in saying that the gland-operation will be of benefit, but, if I could afford to perform a few of these experimental operations for nothing, at no cost to the patient, I should be glad of the chance. There is so much yet to be learned in this work."