will almost certainly be unsuccessful, and on account of the cost involved, as well as for the saving of time and trouble for the patient, it is in the highest degree unwise to go contrary to this rule. If the glands are transplanted during very hot weather they will almost certainly slough, which means re-operating later.

In many cases that are brought to me I do not operate or even advise that the goat-glands be transplanted later. I cannot go into details of such cases in these pages, but might cite the case of a man, syphilitic, who was sent to me. Certainly I have never made the statement anywhere, at any time, that this operation would cure syhpilis. The man is being treated now for syphilis, and should not have been sent to me at all.

I quote the case of a woman of forty, who is normal in every way, and the picture of health at the present time. Her desire is that she may never grow to look any older than she does at this moment, and she asks me if this gland-operation will hold her at the point she has now reached. Frankly, this is pure experiment. I do not know. After another ten years of work in this gland-surgery I might be able to give her a definite opinion, but not at this stage, seeing that my oldest cases go back only three years. On one point only I can speak with positiveness, namely, if I cannot answer this question there is no man living who can answer it, because I am the only man alive who can give an opinion on this work that is founded on first-hand knowledge. We learn in this work only by experience, and we draw just conclusions only from quantity of

experience. No other man alive has had this experience in sufficient quantity to justify him in forming a conclusion derived from his facts. This is my answer not only to those who listen to encouraging advice regarding the effects of this operation tendered by surgeons who are embarking in this goat-gland operation, but also to those general practitioners who inform patients asking their opinion in the matter that the operation is useless because the glands are certain to slough, I hold that they are not qualified to speak on the subject because they have no knowledge. I have the most positive knowledge that when the operation is rightly performed the glands do NOT slough, and my knowledge is founded upon the hard facts of much experience. In another ten years I shall know more than I know today because I shall have added to my facts, and among those facts there may be some which confirm the hope of the woman of forty alluded to above that this gland transplantation may hold the condition of youth steady as something static, which will not be suffered to pass. At present I do not know, and if I offer an opinion it is to be understood that it is only a guess. My guess, then, would be that in this case the operation would be a waste, producing no effect whatever, neither adding to nor detracting from the condition of health and normal function which is present today.


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