Virile Lorenz

Over an operating table in Manhattan stood a huge old man. His surgeon's gown hung straight from broad shoulders. Its sleeves ended in neat, starched bands about his wrists, just above monstrously big and bony hands, hands that opened, closed with sinuous, powerful contractions, extensions. The surgeon was about to go to work.

On the operating table lay a little girl. One leg was shorter than the other. One hip was dislocated, had been so from her birth. The doctor was going to help her. He was going to make her like other little girls, whose rompings she had so envied. So she looked up at her benefactor, hopefully, trustfully.

She saw, above the white neckband of the operating gown, a kindly old face, a face pinker than her own wan, suffering-drawn features. She saw blue eyes clear and gentle and compassionate. About those eyes she saw tiny wrinkles and knew for certain that the doctor could laugh, would gladly romp with her when she was well; and the tight feeling of fear about her beard! How nicely it ran down longer afraid. How "she would like to run her fingers through his silky beard. Plow nicely it ran down from his white hair past his big ears and around his chin! He was like a cleaned-up Santa Claus. And his big mustache was hanging like a curtain below his fleshy hooked nose. That nose was like the snout of an amiable tapir.

The surgeon motioned to his assistants to complete preparations for the operation. Graduate surgeons and doctors, students and pressmen drew back out of the way, craned their heads forward to watch the technique. The surgeon grasped hold of the child's crippled leg with his powerful fingers, flexed the knee, rotated the thigh, brought it up and then down with a motion as slow and tremendous as that of a caterpillar tractor. There was a snapping of adhesions, a sickening cracking. The two legs were together, were bandaged into immobility with the hips. The surgeon straightened up. His blue eyes, which had just now been so coldly serious, started to twinkle as the spectators pressed about him with their astonished exclamations, with their compliments.

The tall, grey, compassionate, merry surgeon was Dr. Adolf Lorenz, Austrian orthopedist.

Dr. Lorenz returned to the U. S. two months ago (TIME. Jan. 18). He came boldly. Withal in the back of his mind was memory of distress. On his previous visit in 1921 and 1922 the U. S. medical profession had thrown such obloquy over him that for a time his good humor became only a mask. He had come to repay with his surgical skill the protection and aid U. S. munificence had afforded Austrian War-emaciated children. His method of correcting congenital deformity of the hip was "bloodless," that is, he did not use the knife. His procedure was scientific, although it differed from that of Dr. Edward Hickling Bradford,* surgeon, orthopedist and Dean of the Harvard Medical School. The professional opposition to him raged, not against his operative principles and methods, rather against the noisy publicity newspapers gave him. The press touted him as a miracle worker, a Messiah come to redeem the halt and the lame. Cameramen got him, always genial and accommodating, to pose in ridiculous circumstances. One picture showed him kinked over and looking solemnly at the twisted head of a boy whom he had cured. The doctor, in his overcoat and without his hat. looked exactly like a small-time ventriloquist with a dummy on his lap. Such blatancy, even though involuntary, was not ethical, and the U. S. profession damned him.

Two months ago smart pressmen crowded on shipboard about returning Dr. Lorenz. He looked chipper and gay. But the back-fence gossipers noted not his appearance. They wanted some slick phrase on which they could hang a story. Dr. Lorenz gave it to them: "Enjoy all vices in moderation." Fine! The phrase could be wrung into a salacious connotation. Far down in the story one could explain that the doctor meant that folk should work, play, sleep in moderation. The pressmen darted to their writing machines.

Also, on shipboard other aging passengers squinted shaggy eyes at this old man who was so sprightly, who held himself so chirky. Two or three of these oldsters remembered him 24 years before when in Chicago he cured the then Lolita Armour (now Mrs John J. Mitchell Jr.) and so gained his U. S. fame. At that time he was beginning to look seedy, to show signs of weariness (his manual operation requires terrific force). What had made him grow so vital, so virile? True he was slightly deaf. But otherwise he seemed a man in full prime. Dr. Lorenz laughed at them, laughed with an inner secret.

Last week some of those ex-passengers read in Liberty, a weekly magazine, the story they had been too stupid to put together for themselves.

Dr. Lorenz has had himself rejuvenated. He had the operation performed five years ago, some six months before his last visit to the U. S. Dr. Victor Blum did it in Vienna. Dr. Harry Benjamin could have done it for him in Manhattan. This was the Steinach operation.

There exists considerable murkiness about this operation in the public mind. Almost every one thinks that the fresh testes of a living goat or monkey are hung onto the male genitals in place of worn-out glands. This ignorance results from a bashful obscurantism which keeps the public from acquiring exact facts about the procreative processes. They do not know that the Steinach method is altogether different.

The Steinach theory recognizes that the testes create spermatozoa (the male sexual cells, which keep up the endless cycle of life). At the same time, the theory supposes** that the testes form an internal secretion. This secretion pours into the blood stream by way of the veins leading from the ductless (in this case also ducted) glands, carries with it hormones, messengers. In the male these are male hormones, in the female "female sex" hormones, "ovarian" hormones, and so on according to the causation view held by the research reporter. These hormones influence the secondary sex characteristics-body build, hair distribution, masculinity, femininity.

Now, according to the theory, if the energy of the glands is deflected from the manufacture of spermatozoa then there remains energy to produce hormones in magnificent quantity. In the male the gland can be blocked off and the escape of the spermatozoa prevented very easily-a slight incision, scarcely more than a scratch, into the conveniently accessible scrotum, a tying off of the two-foot long vas deferens of one or both of the testes, and the job is done. Thus reproduction potentiality is mechanically stopped in half or in full. Sexual continence, of course, gives approximately the same beneficial results.

This operation is not castration. In that the procreative testes are cut off entirely. Nothing remains to create the sex hormones. So the individual, the eunuch, grows into a being that lacks the male secondary characteristics. Queer pads of fat develop. His hips enlarge. So too his breasts. His voice becomes a squeaky falsetto; his facial hair missing or very scant. His character is cold, emotionless, qualmless; his intelligence calculating, keen, subtle. He is not a man. He is not a woman. He is an intermediate animal.

In the female such blocking off is very difficult, practically impossible. Yet results comparable to those from the Steinach operation on men have been obtained for women by use of the Xray. The X-ray is extremely penetrating, throws shadows of the anatomy on suitably placed photographic films, which the physician may study for better diagnosis. To get such a photograph the patient is exposed to the rays for only some seconds. Prolonged exposure causes. destruction of tissue. So this latter phenomenon physicians use to devitalize cancerous growths-and on the ovaries to bring on artificial menopause.

An intermediate exposure time of the ovaries and their related bodies, Dr. Steinach as far back as 1920 theorized, would slow up or stop the ova production of a patient and at the same time permit the continued creation of the sex hormones, stimulate the women. In the U. S. Dr. Harry Benjamin cautiously put this theory to practice. He uses a stimulation dose of X-ray one-seventh to one-tenth as strong as needed to produce erythema (redness). His conservative decision was that moderate, carefully regulated exposures of the ovarian sites to the X-rays induced good body and mental tone and vigor.

In the man, the results of preventing the emission of spermatozoa, of leaving to the testes the duty of producing only the male sex hormones, have been extremely satisfying, as in the case of Dr. Lorenz. The Steinach operation is performed, however, on young men-the potential fathers, heads of families-with great reluctance. In some cases-from sexual excesses, from overwork, from disease-spermatozoa production has fallen off or ceased entirely. In "older" men, usually in those who have reached their sixties, similar falling off or cessation occurs. For such the operation is beneficial. They will pep up, with all the connotations this vulgate word implies.

Already in the U. S. some 8,000 men have undergone this operation. Many of the operations were performed by Dr. Harry Benjamin of Manhattan. This young man (aged 41) is an imaginative surgeon. His face is powerful (jaw muscles firm; lips a straight, decisive line; eyes boring). He combines knowledge with insight, skill with daring. He shuns publicity from his knowledge of stupidly inaccurate reporting and from respect for his professional ideals. In a recent professional paper he reported on 114 of his cases. He told that 77% showed positive results, improvement, that 7% showed negative results, that 16% were doubtful. As in Dr. Lorenz's case, which he did not handle, improvement in bodily and mental vigor endures at least five or six years, perhaps longer.

Thus Dr. Lorenz felt last week-able and active, thank you! And he had yet another occasion for a chuckle. No longer was he hooted at by his profession in the U. S. Clinical Medicine, a monthly magazine for practicing doctors, described him in solemn terms, made him the subject of its leading article. "Also geht Schmahung uber," he must have thought, for he thinks better in his native German.

*Dr. Bradford is now 78. five years older than Dr. Lorenz. They studied the correction of congenital hip malformation together. Bradford worked out a technique with the scalpel. Lorenz preferred to use his muscles. Dr. Bradford has been Dean since 1912 and Professor of Orthopedic Surgery since 1903. In 1895 he issued his expertise on Orthopedic Surgery an authoritative' text.

**The question, remains in mild doubt among research workers, as does the entire question of influence and interrelation of all the ductless glands.

AIso, they could have read this story in the New York Times for Feb. 26. 1922 had they looked there.