Part 28

Having given these subjects much study I wish to state here what has already been done and what we may hope to accomplish. As a matter of fact we do not yet know how to construct living cells; the forms obtained with mineral substances by Errera, Stephane Leduc, and others, have only a remote resemblance to those of life; neither do we know how to prevent death; but yet it is interesting to know that it is possible to prolong for some time the life of organs, tissues, and cells after they have been removed from the organism.

The idea of preserving the life of greater or lesser parts of an organism occurred at about the same time to a number of persons, and though the ends in view have been quite different, the investigations have led to essentially similar results. The surgeons who for a long time have transplanted various organs and grafted different tissues, bits of skin among others, have sought to prolong the period during which the grafts may be preserved alive from the time they are taken from the parent individual until they are implanted either upon the same subject or upon another. The physiologists have attempted to isolate certain organs and preserve them alive for some time in order to simplify their experiments by suppressing the complex action of the nervous system and of glands which often render difficult a proper interpretation of the experiments. The cytologists have tried to preserve cells alive outside the organism in more simple and well-defined conditions. These various efforts have already given, as we shall see, very excellent results both as regards the theoretical knowledge of vital phenomena and for the practise of surgery.

It has been possible to preserve for more or less time many organs in a living condition when detached from the organism. The organ first tried and which has been most frequently and completely investigated is the heart. This is because of its resistance to any arrest of the circulation and also because its survival is easily shown by its contractility. In man the heart has been seen to beat spontaneously and completely 25 minutes after a legal decapitation (Renard and Loye, 1887), and by massage of the organ its beating may be restored after it has been arrested for 40 minutes (Rehn, 1909). By irrigation of the heart and especially of its coronary vessels the period of revival may be much prolonged.

The first experiments with artificial circulation in the isolated heart were made in Ludwig's laboratory, but they were limited to the frog and the inferior vertebrates. Since then experiments on the survival of the heart have multiplied and become classic. Artificial circulation has kept the heart of man contracting normally for 20 hours (Kuliabko, 1902), that of the monkey for 54 hours (Hering, 1903), that of the rabbit for 5 days (Kuliabko, 1902), etc. It has also enabled us to study the influence upon the heart of physical factors, such as temperature, isotonia; chemical factors, such as various salts and the different ions; and even complex pharmaceutical products. Kuliabko (1902) was even able to note contractions in the heart of a rabbit that had been kept in cold storage for 18 hours, and in the heart of a cat similarly kept after 24 hours. The other muscular organs have naturally been investigated in a manner analogous to that which has been used for the heart; and for the same reason, because it can be readily seen whether or not they are alive. The striated muscles survive for quite a long time after removal, especially if they are preserved at the temperature of the body and care is taken to prevent their drying. By this method many investigations have been made of muscular contractions in isolated muscles. Landois has noted that the muscles of a man may be made to contract two hours and a half after removal, those of the frog and the tortoise 10 days after. Recently Burrows (1911) has noted a slight increase in the myotomes of the embryo chick after they have been kept for 2 to 6 days in coagulated plasma.

Non-muscular organs may also survive a removal from the parent organism, but the proofs of their survival are more difficult to establish because of the absence of movements. Carrel (1906) grafted fragments of vessels that had been in cold storage for several days upon the course of a vessel of a living animal of the same species; in 1907 he grafted upon the abdominal aorta of a cat a segment of the jugular vein of a dog removed 7 days previously, also a segment of the carotid of a dog removed 20 days before; the circulation was reestablished normally; these experiments have, however, been criticized by Fleig, who thinks that the grafted fragments were dead and served merely as supports and directors for the regeneration of the vessels upon which they were set. In 1909 Carrel removed the left kidney from a bitch, kept it out of the body for 50 minutes, and then replaced it; the extirpation of the other kidney did not cause the death of the animal, which remained for more than a year normal and in good health, thus proving the success of the graft. In 1910 Carrel succeeded with similar experiments on the spleen.

Taken altogether, these experiments show that the greater part, if not all, of the bodily organs are able to survive for more or less time after removal from the organism when favorable conditions are furnished. There is no doubt but what the observed times of survival may be considerably prolonged when we have a better knowledge of the serums that are most favorable and the physical and chemical conditions that are most advantageous.

If we can preserve the organs, we may expect to also keep alive the tissues and cells of which they are composed. Biologists have studied these problems, too, and have also obtained in this department some very interesting results.

The cells which live naturally isolated in the organism, such as the corpuscles of the blood and spermatozoa, were the first studied. Since 1910 experiments on the survival of tissues have multiplied and at the same time more knowledge has been obtained concerning the conditions most favorable to survival and the microscopical appearances of the tissues so preserved. In 1910 Harrison, having placed fragments of an embryo frog in a drop of coagulated lymph taken from an adult, saw them continue their development for several weeks, the muscles and the epithelium differentiating, the nervous rudiments sending out into the lymph filaments similar to nerve fibers. Since 1910 with the aid of Dr. Minot, I have succeeded in preserving alive the nerve cells of the spinal ganglia of adult dogs and rabbits by placing them in defibrinated blood of the same animal, through which there bubbled a current of oxygen. At zero and perhaps better at 15°-20°, the structure of the cells and their colorable substance is preserved without notable change for at least four days; moreover, when the temperature is raised again to 39°, certain of the cells give a proof of their survival by forming new prolongations, often of a monstrous character. At 39° some of the ganglion cells which have been preserved rapidly lose their colorability and then their structure breaks up, but a certain number of the others form numerous outgrowths extremely varied in appearance. We have, besides, studied the influence of isotony, of agitation, and of oxygenation, and these experiments have enabled me to ascertain the best physical conditions required for the survival of nervous tissue. In 1910, Burrows, employing the technique of Harrison, obtained results similar to his with fragments of embryonic chickens. Since 1910 Carrel and Burrows applied the same method to what they call the "culture" of the tissues of the adult dog and rabbit; they have thus preserved and even multiplied cells of cartilage, of the thyroid, the kidney, the bone marrow, the spleen, of cancer, etc. Perhaps Carrel and his collaborators may be criticized for calling "culture" that which is merely a survival, but there still remains in their work a great element of real interest.

Such are, too briefly summarized, the experiments which have been made up to the present time. We can readily imagine the practical consequences which we may very shortly hope to derive from them, and the wonderful applications of them which will follow in the domain of surgery. Without going so far as the dream of Dr. Moreau depicted by Wells, since grafts do not succeed between animals of different species, we may hope that soon, in many cases, the replacing of organs will be no longer impossible, but even easy, thanks to methods of conservation and survival which will enable us to have always at hand material for exchange.

The dream of to-day may be reality to-morrow.

There are also other consequences which will follow from these researches. I hope that they will permit us to study the physical and chemical factors of life under much simpler conditions than heretofore, and it is toward this end that I am directing my researches. They will enable us to approach much nearer the solution of the old insoluble problem of life and death. What indeed is the death of an organism all of whose parts may yet survive for some time?

These, then, are the researches made in this domain, fecund from every point of view, and the great increase in the number of experts who are taking them up, while it is a proof of their interest, gives hope for their rapid progress.

THE OVERTHROW OF TURKEY

THE FIRST BALKAN WAR A.D. 1912

J. ELLIS BARKER FREDERICK PALMER Prof. STEPHEN P. DUGGAN

Turkey's _opéra-bouffe_ war with Italy in 1911 plunged her into a far more terrible and sanguinary struggle. Seeing her weakness, the little Balkan States seized the opportunity to unite and attack her. Each of the Balkan allies had once been crushed by Turkey and had fought for freedom. Each was jealous and suspicious of all the others. Each people hoped that in the break-up of Turkey their own land would be enlarged. Each saw members of their own race oppressed in the Macedonian region still held by Turkey. In face of their great opportunity, however, all the four States--Bulgaria, Greece, Servia, and Montenegro--hushed their own quarrels and joined in attacking their common enemy.

Of the causes of the war, Mr. J. Ellis Barker, the noted English authority on Turkey, here gives a brief account. The tale of the first glorious campaign, with its big battles of Kirk-Kilesseh and Lule-Burgas, is then told by Mr. Frederick Palmer, the foremost of American war correspondents upon the scene. The confused negotiations for peace are then detailed by Prof. Stephen P. Duggan, our American authority upon the Balkan States.

J. ELLIS BARKER

A short time ago I read an interesting account of Sir Max Waechter's recent journey to the capitals of Turkey and all the other Balkan States. He had visited these towns wit the object of laying before the Sovereigns of the Balkan States and their Ministers proposals for abolishing war by the creation of a European Federation of States. All the Balkan Sovereigns and Ministers whom he had seen had expressed themselves sympathetically and favorably and had agreed to accept the _status quo_. A month later all the Balkan States were at war; Russia, Austria-Hungary, and Italy were arming, and people were anxiously discussing the possibility of a world war. The sudden transition from peace to war appears inexplicable to those unacquainted with the realities of foreign policy.

In July, 1908, the Turkish Revolution broke out. It was a great and immediate success. Never in the world's history had there been so successful a revolution or one so bloodless. As by magic, Turkey was changed from a medieval State into a modern democracy. The Turkish masses were rejoicing. Old feuds were forgotten. Mohammedans and Christians fraternized. The words Liberty, Equality, Fraternity, Parliamentarism, and Democracy were on all lips. Over night a new Turkey had arisen. Soon the leaders of Young Turkey began to assert the right and claims of the new-born State. We were told that European intervention in the affairs of Turkey would no longer be tolerated, and that those parts of the Turkish Empire which, though nominally subject to the Sultan, were no longer under Turkish control, would have to be handed back. Great Britain was to restore Egypt and Austria-Hungary Bosnia and Herzegovina. Many Englishmen indorsed these claims, and told us that a new era had opened in the East. At that time only a few people ventured to doubt whether the Turkish Revolution would be a lasting success. I think I was the only British publicist who immediately and unhesitatingly foretold that Parliamentary Government in Turkey was bound to be a failure, and that it would inevitably lead to the formation of a Balkan Confederation which would attack Turkey. I said then:

"European Turkey has about 6,000,000 inhabitants, of whom only about one-third are Turks.

"The Young Turks have the choice of two evils. They must either follow a Liberal or a Conservative policy. If they follow a Liberal policy, if they introduce Parliamentary representation, self-government, and majority rule in Turkey in general, and in Macedonia in particular, the Christians will be the majority, and it seems likely that they will then oust the Turkish minority and convert the ruling race into a ruled race. A Liberal policy will, therefore, bring about the rapid disintegration of the Turkish Empire.

"Foreseeing the danger of allowing the alien elements to be further strengthened, many patriotic Turks have demanded that a vigorous Conservative policy should be pursued which will abolish the national differences among the alien races and between the alien races and the Turks. They demand that a Turkish national policy should be initiated, that the aliens should be nationalized in Turkish national schools, that Turkish shall be the language of Turkey, that the Greek, Bulgarian, and other schools shall be closed. Will Bulgaria, Greece, and Servia quietly look on while the work of a generation is being undone? Will the Greeks, Serbs, and Bulgarians residing in Turkey allow themselves to be denationalized more or less forcibly? Besides, can they be denationalized against their will except by destroying the Parliamentary and democratic Government, the Constitution of yesterday, and by reintroducing the ancient absolutism in an aggravated form? Two hundred years ago the Turks could easily have nationalized the alien races by means of the church and the school, but it seems that it is now too late to make an attempt at turning the subject races into Turks.

"In endeavoring to settle the conflicts among the alien nationalities and between the aliens and the Turks, the path of the new Turkish Government will scarcely be smooth. _The Balkan States_ are watching events with attention. Although they congratulated the new Turkish Government, they have no interest in Turkey's regeneration, and they are bound to oppose the Ottomanization of their compatriots in Turkey. Therefore, they _may be expected to draw the sword and to face Turkey unitedly if they see their plans of expansion threatened by the nationalization of the alien elements in Turkey_."

Unfortunately, my forecast has come true in every particular. The failure of New Turkey was natural. It was unavoidable. Ancient States are ponderous and slow-moving bodies. Their course can be deflected and their character be altered only by gradual evolution, by slow and almost imperceptible changes spread over a long space of time. Democracy, like a tree, is a thing of slow growth, and it requires a congenial soil. It can not be created over night in Turkey, Persia, or China. The attempt to convert an ancient Eastern despotism, firmly established on a theocratic basis, a country in which the Koran and the Multeka are the law of the land, into a Western democracy based on the secular speculations of Rousseau, Montesquieu, Bentham, Mill, and Spencer was ridiculous. The revolution effected only an outward change. It introduced some Western innovations, but altered neither the character of the Government nor that of the people. Turkish Parliamentarism became a sham and a make-believe. The cruel absolutism of Abdul Hamid was speedily followed by the scarcely less cruel absolutism of a secret committee.

The new rulers of the country were mostly very young men, who were conspicuous for their enthusiasm and their daring but not for their judgment and experience. They had picked upon the boulevards and in the Quartier Latin of Paris and in Geneva the sonorous phrases of Western democracy and demagogy, and with these they impressed, not only their fellow citizens, but also the onlookers in Europe. Having obtained power, they embarked upon a campaign of nationalization. However, instead of trying to nationalize the non-Turkish millions slowly and gradually by kind and just treatment coupled with a moderate amount of nationalizing pressure, they began ruthlessly to make war upon the language, and to suppress the churches, schools, and other institutions of the non-Turkish citizens, whom they disarmed and deprived of their ancient rights. The complaints and remonstrances of the persecuted were answered with redoubled persecution, with violence, and with massacre, and soon serious revolts broke out in all parts of the Empire. The Young Turks followed faithfully in Abdul Hamid's footsteps. However, Abdul Hamid was clever enough always to play off one nationality or race against the other. In his Balkan policy, for instance, he encouraged Greek Christians to slay Christian Bulgarians and Servians, and allowed Bulgarian bands to make war upon Servians and Greeks, supporting, on principle, one nationality against the other. But the Young Turks persecuted indiscriminately and simultaneously all non-Turkish races, Albanians, Bulgarians, Servians, and Greeks, and thus they brought about the union of the Balkan States against themselves.

The outbreak of the war could scarcely have been prevented by the European Powers. It was bound to come. It was as inevitable as was the breakdown of the Young Turkish _régime_. Since the earliest times the Turks have been a race of nomadic warriors. Their policy has always been to conquer nations, to settle among the conquered, and to rule them, keeping them in strict and humiliating subjection. They have always treated the subject peoples harshly and contemptuously. Unlike other conquerors, they have never tried to create among the conquered a great and homogeneous State which would have promised permanence, but, nomad-like, have merely created military settlement among aliens. Therefore, the alien subjects of the Turks have remained aliens in Turkey. They have not become citizens of the Empire. As the Turks did not try to convert the conquered to Islam--the Koran forbids proselytism by force--and to nationalize them, the subjected and ill-treated alien masses never amalgamated with the ruling Turks, but always strove to regain their liberty by rebellion. Owing to the mistakes made in its creation, the Turkish Empire has been for a long time an Empire in the process of disintegration. Its later history consists of a long series of revolts, of which the present outbreak is the latest, but scarcely the last, instance.

The failure of the new Turkish _régime_ has increased to the utmost the century-old antagonism between the ruling Turks and their Christian subjects. The accounts of the sufferings of their brothers across the borderline, inflicted upon them by Constitutional Turkey, which had promised such great things, had raised the indignation of the Balkan peoples to fever heat and had made an explosion of popular fury inevitable. The war fever increased when it was discovered that Servians, Bulgarians, and Greeks were at last of one mind, and that Turkey's strength had been undermined by revolts in all parts of the Empire and by the Turkish-Italian war. The Turks, on the other hand, were not unnaturally indignant with the perfidy of the Christian Powers, which, instead of supporting Turkey in her attempts at reform, had snatched valuable territories from her immediately after her revolution. Not unnaturally, they attributed the failure of the new _régime_ and the revolts of their subjects to the machinations of the Christian States, and the Balkan troubles to the hostile policy of the Balkan States. The tension on both sides became intolerable. If the Balkan States had not mobilized, a revolution would have broken out in Sofia and Belgrade, for the people demanded war. If the Turkish Government had given way to the Balkan States, a revolution would have broken out in Constantinople. The instinct of self-preservation forced the Balkan Governments and Turkey into war. The passions of race-hatred had become uncontrollable.

FREDERICK PALMER[1]

[Footnote 1: Reprinted by permission from an article in _Everybody's Magazine_.]

Against any one of his little Christian neighbors the Turk had superior numbers, and had only to concentrate on a single section of his many-sided frontier line. It had never entered his mind that the little neighbors would form an alliance. He had trusted to their jealousies to keep them apart. United, they could strike him on the front and both sides simultaneously. He was due for an attack coming down the main street and from alleys to the right and left.

In this situation he must temporarily accept the defensive. Meanwhile, he foresaw the battalions of "chocolate soldiers" beating themselves to pieces against the breastworks of his garrisons, and Greek turning on Serb and Serb on Bulgar after a taste of real war. Against divided counsels would be one mind, which, with reenforcements of the faithful from Asia Minor, would send the remnants of the _opéra bouffe_ invasion flying back over their passes.

But the allies fully realized the danger of quarreling among themselves, which would have been much harder to avert if their armies had been acting together as a unit under a single command. Happily, each army was to make a separate campaign under its own generals; each had its own separate task; each was to strike at the force in front of its own borders. Prompt, staggering blows before the Turkish reserves could arrive were essential.

The Montenegrins in the northwest, who had the side-show (while Bulgaria, Servia, and Greece had the three rings under the main tent), did their part when they invested the garrison of Scutari.

Advancing northward, the Greeks, with strong odds in their favor, easily took care of the Turkish force at Elassona and continued their advance toward Salonika.

Advancing southward, the Serbs, one hundred thousand strong (that is, the army of their first line), moved on Kumanova among the hills, where the forty thousand Turks defending the city of Uskub would make their stand as inevitably as a board of army engineers would select Sandy Hook as a site for some of the defenses of New York harbor. Confidently, the Turkish commander staked all on the issue.

The Serbs did not depend alone on mass or envelopment by flank. They murderously and swiftly pressed the attack in the front as well as on the sides; and the cost of victory was seven or eight thousand casualties. Two or three fragments of the Turkish army escaped along the road; otherwise, there was complete disintegration.