So after Mary Rafferty’s death, Dr. Bartholow sent the results of
his experiment off to be published and it quickly created a bit of
an uproar in the scientific community. Farrier had a few criticisms
of Bartholow and Farrier was the one who had been doing the studies
on animal models such as monkeys and dogs. He said that Bartholow
pushed the needles into the brain substance while he applied the
electrodes to the cortical surface. Because Bartholow’s needles
were so far into the brain, the electric current could diffuse
farther and activate parts of the brain that he was not trying to
study. Bartholow also pushed the needles deep enough to activate the
cerebral centers of the tactile nerves, which would explain why
Rafferty was in so much pain.
However, Farrier
concluded that Bartholow’s study was a complete parallel to his
own findings, and generally spoke of it favorably.
The Cincinnati
Medical News, under the title “Human Vivisection”, wrote this:
Whereas Dr.
Bartholow of Cincinnati, Ohio, in his zeal for scientific research,
has recently made a series of experiments with electricity upon the
brain of a patient by inserting needles into the substance thereof
and passing currents from these to different parts of the body,
causing thereby pain, convulsions, and probably hastening death. And
whereas we are ever ready and willing to record the greatest praise
and honor to the original investigator in any part of the domain of
medicine, yet these experiments are so in conflict with the spirit of
the profession and opposed to our feelings of humanity, that we
cannot allow them to pass unnoticed. Resolved in that our opinion, no
member of the medical profession is justified in experimenting upon
his patient, except for the purpose and with the hope of saving said
patient’s life, or the life of a child in utero.
The condemnation of
the Cincinnati Medical News did cause Bartholow to write an apology
letter, of sorts. Here is a quick summary. Never calling Rafferty by
name, Bartholow made 5 points. The first 3, he had already made in
his primary report: that the patient was hopelessly diseased and that
her rapidly extending ulcer threatened an early extinction of life.
That she consented to the experiments, and that Bartholow believed
that fine insulated needles could be introduced without injury that
would affect the progress and termination of the case. Because her
brain had been incised to permit the escape of pus, a notable and
successful example of which had recently occurred in London, and
because portions of the brain substance had been lost and yet the
patient survived. Basically, he used the fact that the ulcer was
pretty well progressed in decay to justify his experiment. And to
these points he added two more: that Faradic current was used, which
has, as is well known, no electrolytic action, and that the patient’s
death was due to the progress of the epithelioma and the thrombus
found postmortem in the longitudinal sinus, and could not have been
caused by the needles which were introduced some distance from the
sinus on each side, even though as discussed in the previous podcast,
it is entirely possible that the electric current could have caused
that thrombus.
Bartholow did admit
that he was mistaken to suppose that small insulated needles could be
introduced without injury into the cerebral substance, but that to
repeat such experiments knowing now the injury that it would cause,
although they did not cause the fatal result in my own case, would be
in the highest degree criminal, and that he could only now express
his regret that facts which I had hoped would further in some slight
degree the progress of knowledge were obtained at the expense of some
injury to the patient.
So in the end,
Bartholow acknowledged that, however unintentionally, he had caused
some injury and in reference to his comments on Faradic current, he
also failed to admit that he had set up an experiment for the
perceived as more dangerous Galvanic current close to when Rafferty
died.
One of Bartholow’s
contemporaries, Dr. DuPoy, wrote a criticism as published in the
Medical Times and Gazette, saying that for Bartholow, the study was
an experimentum in corpore vili. Basically, that phrase means that
Bartholow’s experiment was an experiment on a worthless body, and
it goes back to a story where a fugitive from France was falling ill
in a foreign city and he went to doctors for help. The doctors were
discussing what to do about him in Latin, not thinking that he would
understand because he was just some guy off the street who wouldn’t
know the language of the educated people. They said, in Latin, let us
try and experiment on this worthless body, and to their surprise, the
guy off the street replied: will you call worthless someone for whom
Christ did not disdain to die? So by making this comparison, DuPoy
was saying that Bartholow pretty much just saw Rafferty as just a
worthless body to be used for scientific experimentation. And in
direct response to DuPoy, Bartholow asked: whether it is more inhuman
to practice vivisections on dumb brutes who can only protest by cries
and struggles against the proceedings of the experimenter, or to
operate on a woman whose race being nearly run consents to have some
experiments made? Which, if I might add my opinion, seems very
reductive as to what was actually done with Mary Rafferty.
Bartholow also tried
to compare his work by comparing it to a Massachusetts case in which
a tamping iron was driven through the brain, the patient recovering
and dying many years after of another malady. This was in reference
to Phineas Gage, who while relatively physically healthy after the
incident, certainly experienced severe psychological illness after
the brain injury.
Bartholow’s study
was also discussed at the 25th annual convention of the
American Medical Association. MS Davis, who was the current president
of the society, acknowledged that Bartholow’s experiment may have
overthrown many of the opinions regarded as well founded that the
cortex was unexcitable. However, he rejected the results due to the
same criticism that Farrier had that the Faradic current would have
spread out and activated other parts of the brain, especially because
Mary Rafferty’s autopsy revealed that Bartholow had pushed the
electrolytic needles from 1 to 1 ½ inches into the cerebral
substance. A similar critique read: I only beg the reader to notice
that the needles being insulated up to their extremities and
introduced into a depth of 1 ½ inch into the substance of the brain,
the aim of the experiment has been lost sight of, as no cortical
matter could have possibly been irritated.
Another American
neurologist, Dr. Scarf, concluded of the study: Although of
considerable historic interest, this case yielded almost no
information of scientific value regarding the localization of
function in the human brain, except to reconfirm in a general way the
contralateral representation of function in the hemispheres. That of
course is in reference to when the electric current was done on one
side of the brain, the opposite side of her body reacted.
So, after all of
this criticism, what happened to Dr. Bartholow? Was he chased out of
Cincinnati with torches and pitchforks, was his license revoked, did
he keep his job? Well, he did leave Cincinnati, but only because he
had recently published Materia Medica and Therapeutics, a roaring
success of a book that landed him a job in Jefferson Medical College
of Philadelphia, and a position in the Philadelphia hospital.
Bartholow was also invited to establish the American Neurological
Association. He was invited to be a member of the American
Philosophical society. He was given honorary membership in the Royal
Medical Society of Edinburgh, and in 1881, he was the president of
the American Neurological Association. When he passed, his obituaries
were generally full of glowing references to Materia Medica. Not one
made any reference to Mary Rafferty.
Pretty much the only
punishment that he faced was he was censured by the American Medical
Association right after the experiments. It’s somewhat interesting
to me that Bartholow’s obituary is readily available online and so
is a lot of other information about his other work and the time with
the college, but about Mary Rafferty we really don’t know much more
than what’s described in his papers. We don’t know how her family
responded to this, because she had multiple brothers and sisters
around. We don’t know if the family was really given any recompense
or what her funeral was like or really anything about what their
response to all this was. And I did a bit of looking, and I wasn’t
able to find anything, but if I do find anything more, I can make an
update episode.
And unfortunately,
this is somewhat another running theme through a lot of these cases
of unethical human experimentation, in that the doctors or scientists
or government officials etc that take a part in it don’t really
ever face any immediate consequences. There might be an apology
statement made many years later, or money changing hands, or things
like that, but it’s very very rare to see any sort of legal
punishment for this kind of thing. So, overall, in the end Dr.
Bartholow gets to sort of just live on and have a successful career
and do well in his research and Mary Rafferty is somewhat lost to the
passage of time as no more than a footnote in this guy’s Wikipedia
page.
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