ar iOFScmsl BIOGRAPHY 9 



as in all of his experimental work, Meltzer was eager to give his results a practical application 

 to the art of medicine. The possibilities of the use of magnesium salts as an anesthetic agent 

 in surgical operations were tested with some success on human beings and more important still, 

 their efficacy in controlling the spasms of tetanus has been attempted and gives promise of being 

 useful under certain conditions. One outcome of this work which he did not foresee, but which 

 has been exceedingly useful to the diagnostician, is its application to the procedure of obtaining 

 specimens of bladder bile for bacteriological examination. By the local application of solutions 

 of magnesium sulphate to Vater's papilla in the duodenum the sphincter of the bile duct is 

 inhibited so that bile is emptied into the intestine and can be aspirated off for examination. 



His last extensive series of researches dealt with anesthetization and artificial respiration 

 through pharyngeal and intratracheal insufflation. Something like 28 papers, most of them in 

 collaboration with pupils or assistants, were devoted to this subject. His interest in this topic 

 seems to have been stimulated by the fact that in his use of magnesium sulphate for anesthetic 

 purposes the chief danger lay in the inhibition of the activity of the respiratory center. To 

 meet this difficulty he undertook a study of the methods of artificial respiration. The initial 

 paper in 1909 by Meltzer and Auer described a method of artificial respiration by continuous 

 insufflation of the lungs through a tracheal catheter. It was found that by this means not only 

 could an animal be kept alive without the action of the respiratory movements to fill and empty 

 the lungs, but that it furnished also a convenient and efficient method for anesthetization. The 

 use of this method in animal experimentation, and especially its use in human surgery of the 

 thorax and facial region, was apparent, and on many occasions Meltzer sought to make known 

 its advantages and to ask for an adequate trial of its merits at the hands of practical surgeons. 

 The method has found some acceptance, and the application of the principle involved will no 

 doubt be extended in the future as the technique of thoracic surgery improves. It was in recog- 

 nition of the importance of this work that the American Association for Thoracic Surgery asked 

 him, a physician and laboratory worker, to serve as their first president. It was natural that 

 this work should have led him to consider the whole matter of artificial respiration in its relations 

 to resuscitation after accidents of various sorts. His general paper in the Medical Record for 

 1917, giving a history and critical analysis of the methods of resuscitation, is an interesting and 

 valuable contribution. He gives experimental data to prove that his device of intratracheal 

 insufflation is the most efficient method of artificial respiration both for man and animals. But 

 he realized that it is a method which requires special knowledge and training for its successful 

 execution, and his broadening acquaintance with and interest in the practical aspects of resusci- 

 tation led him to experiment with the less efficient and less safe method of pharyngeal insufflation. 

 He was a member of the three national commissions on resuscitation and served as chairman of 

 the third commission. In connection with the duties of this service he devised a simple portable 

 form of apparatus for pharyngeal insufflation which can be used with very little previous instruc- 

 tion, and he demonstrated, with entire success I believe, that this form of apparatus is much 

 more efficient than any of the so-called manual methods of resuscitation, or than any of the special 

 machines for this purpose, pulmotors and lung motors, which have been exploited commercially 

 during the past few years. It was, I imagine, a sore disappointment to him that he was not able 

 to convince his colleagues on the third commission that this apparatus met all the requirements 

 for industrial and military use. ' It is probably the simplest and best instrument yet devised for 

 artificial respiration as applied to man, and in institutions or industrial establishments where the 

 need for artificial respiration may arise frequently and where special individuals may be 

 instructed in its use it can be employed to great advantage. But it does require some little 

 amount of training to use it properly. The average uninstructed man or woman can not be 

 trusted to apply it intelligently, and for this reason the commission felt constrained to recom- 

 mend the adoption of a manual method as the form of first aid which may be used most suc- 

 cessfully under ordinary conditions. 



It will be evident even from this incomplete review that Doctor Meltzer's work constituted 

 an important contribution to physiological science, and, as has been stated above, his contact 

 with the practice of medicine and his frequent use of medical journals for his publications 



