USA > Maine > Maine; a history, Volume IV > Part 28
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A perusal of the papers written by Dr. Holt shows that he has been both aggressive and progressive, some announcing new methods, while others recorded the treatment of remark- able cases with comments upon the same. In the very first papers read upon the ear, Dr. Holt advocated a new method of inflating the middle ear by using air from the lungs to fill the mouth and pharynx or by forcing it through the lips as in blowing out a light and thereby cause the soft palate to shut off the upper from the lower pharyngical space, while at the same time air is forced into one nostril with the other closed, thus effectually inflating the middle ear, a remedy of paramount importance in the treat- ment of affections of that organ involving its sound conducting apparatus.
In his paper on strabismus, especially when the eyes are badly crossed and when the sight is very poor, he showed that he had devised a new method of operation for the cure of such cases and had successfully practiced it in scores of cases before he had ventured to present it to the New England Ophthalmological Society and the American Ophthalmological Society, accompanied with a model which he had made for showing the action of the muscles of the eyes and how the operation remedied the defect. Dr. Hay, the nestor of the former society, in referring to this paper the next year after it was read, told its members that while it was not favorably received by them, the method advocated and practiced when tried out in Europe had caused Dr. Holt's name to be listed among the distinguished oph- thalmologists of the world. When it was read before the latter society, the learned Dr. Knapp of New York undertook to show by his statistics that it had no place in ophthalmology. However, the next year he read a paper upon the subject saying he had investigated the method, found them practicing it in Europe, and had practiced
it himself, and spoke in the highest terms of it. The principles of the operation are in universal use now though the technique of the operation has been modified by many surgeons.
When Dr. Holt began the practice of medicine, it was taught in the schools and text books that when an eye was penetrated by steel ncar the margin of the cornea on either side of it called the "dangerous zone" and the steel remained in it, the eye should be removed, for the injury was likely to cause not only the loss of sight of that eye but the loss of the sight in the other eye by sympathetic inflammation. History of cases were given to show the necessity of fol- lowing this advice in order to avoid such a dis- astrous result. Of course, it would be a terrible thing to have a person get blind in both eyes when from removing an eye injured in this way the other could be saved; nevertheless, Dr. Holt had eyes wounded in this way, in which he could look into the eye with the ophthalmoscope and see the steel and he reasoned on the other hand that it was a terrible sacrifice to remove such an eye. He therefore devised and practiced a method of removing the steel successfully from the in- terior of the eye by the electro-magnet. He
reported the first series of cases trcated in this way successfully to the American Ophthalmo- logical Society. As other members of the so- ciety did not have any such number of cases of this kind, although living in the vicinity of greater numbers of men engaged in hazardous occupations, they did not see how so many cases came to Dr. Holt. Moreover, they were not dis- posed to break away from the teachings of that time and predicted later disastrous results from such operations, but they never came. The ex- planation of Dr. Holt's series of successful cases of the removal of steel from the interior of the eye with the saving of sight is made from the fact that when he saved the eye and sight of one man injured in this way, others from his locality knew of it and came immediately, while in other States, when a man got his eye injured in this way he went to his family physician, who, if a surgeon, removed the eye, or if not a surgeon he took his patient to a surgeon who removed the eye because that was what was taught and what was in the text books; hence the few spec- ialists in the country at that time saw but a few of these cases. When, however, it became known that an eye wounded in this way could be saved with sight, the other specialists located in greater industrial centers began to have cases commen- surate with this fact; so that it has long since
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become the practice to remove the steel first and try and save the eye with sight. Failing in this, the eye could be removed as a last resort, but happily this is very seldom necessary. A careful following of these series of cases re- ported, with many others not reported, show dis- astrous results have not followed the practice inaugurated by Dr. Holt.
As a large percentage of the blindness in the world comes from inflammation of the eyes of the new born, Dr. Holt not only secured the pas- sage of the law for the prevention of blindness, but he devised a method which has been the means of saving many eyes. Its discovery illus- trates the old saying that "necessity is the mother of invention." One night after the last train from Bath had arrived, a mother with her only babe came to see Dr. Holt with a letter from the late Dr. E. M. Fuller, of Bath, in which he said that, in spite of everything he could do, the eyes of the baby had grown steadily worse and he feared blindness to be inevitable. In going to the Infirmary with the mother and baby, Dr. Holt said his mind reverted to the efficacy of hot water in reducing inflammation. He imme- diately put this treatment into operation, adding salt to the hot water to make it like the tears, and applying it beneath the lids in sufficient quantity to clear them of all discharge by the use of the smallest point of a Davidson's syringe and repeating it during the night, the object be- ing to remove the discharge and to reduce the enormously swollen lids to a condition where an operation might be done early in the morning for the purpose of relieving the pressure of the lids on the eyeballs and better cleansing the dis . charge from beneath the eyelids. This treat- ment relieved the condition of the swollen lids, and the eyes could be freed of the discharge so readily that no operation was performed and they made an uninterrupted recovery with good sight. This result was achieved with such rapidity that the treatment was instituted in all succeeding cases, and a paper giving the details of this method was read before the New England Ophthalmological Society and the Section of Ophthalmology of the American Medical Asso- ciation. The meetings of the former society were held at the Massachusetts Charitable Eye and Ear Infirmary, and it was customary to present cases and discuss all the clinical features of such cases which would come under the subject of the paper for the evening. On this occasion a most exhaustive consideration of the subject had been made previous to the reading of Dr.
Holt's paper in which he had designated the "Douche in the Treatment of Ophthalmia N'eonatorium," which was entirely new to all the members and an agreeable surprise that the desperate cases of this terrible scourge could be so effectually cured by such treatment.
Among the many papers written by Dr. Holt which attracted wide attention, might be men- tioned the one on "Boiler Makers' Deafness and Hearing in a Noise," which included the sta- tistics of an examination of the boiler-makers and employes of the Portland Company, which showed that all persons working in a noise sooner or later became deaf. He also indis- putably proved that a noise never actually im- proved the hearing power of persons who are partially deaf. At the meeting of the American Otological Society where this paper was read in 1882, Dr. Roosa, of New York, contended that the hearing power was actually improved by a noise, in certain persons, as he had set forth in his book on diseases of the ear. He was so sure of this that he was to demonstrate it by such persons, but he never did, and finally ad- mitted that the improvement in the hearing of some persons by a noise was only apparent, not real.
A paper entitled "Complete Closure of Both External Auditory Canals by Bone" in a patient having good hearing power with a previous his- tory of having had an abscess in each ear fol- lowed by a chronic discharge, was read before the American Otological Society in 1889. This condition was so contrary to the prevailing ideas of members of that society that upon express- ing a desire to see the patient, Dr. Holt had him visit them in different parts of the country at his own expense.
The paper, however, that attracted the greatest attention perhaps, was the one read at the Fifty- second Stated Meeting of the Maine Academy of Medicine and Science held in April, 1902, en- titled "Ablation of both mastoids for chronic suppurative inflammation of the middle ear, fol- lowed by extreme variations in the temperature of the different parts of the body at the same time, and of the whole body at different times, of more than twenty degrees Fahrenheit, there existed extreme high temperature in the mouth (114+°F., 45.5+°℃.) with extreme low tempera- ture in the rectum (94°-F., 34.4°-C.), then changing to low temperature in the mouth with extreme high temperature in the rectum, again changing to extreme high temperature in both the mouth and rectum, to be followed by extreme
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low temperature in both the mouth and rec- tum, the extremes of temperature not being measured by any available thermometers that reg- istered from 94°F. to 114ºF., and four ther- mometers were broken by the intense heat. Later amblyopia developed in both eyes. Com- plete recovery."
This title gives a good idea of the nature of the case, the clinical features of which were care- fully observed and recorded and verified by a large number of the members of the staff and consultants of the Maine Eye and Ear Infirmary where the case was treated.
The nomenclature and classification of diseases early engaged Dr. Holt's attention. As execu- tive surgeon in compiling the statistics of the diseases treated at the Maine Eye and Ear In- firmary he had an opportunity to cultivate a knowledge of the subject, which he did with such discriminating care that an International Committee, organized for the special purpose of correcting existing defects and devising a stand- ard for universal use, made special mention of the reports of this institution. Naturally one interested in the correct nomenclature and clas- sification of diseases would be interested in the changes going on in the English language under the caption of simplified spelling. The World War brought out an astonishing amount of ig- norance of our language existing among our for- eign born population. Simplified spelling would do much towards removing this condition, for it would enable foreigners to more readily ac- quire our language, an essential condition for the assimilation and Americanization of all who dwell among us. The World War also showed the necessity for the adoption of the metric system which is in universal use in all the coun- tries except those speaking the English lan- guage. Dr. Holt adopted the metric system at the very beginning of his professional life and he also used the centigrade thermometer which has been adopted in the countries referred to and which is quite as much an advance over the Fahrenheit thermometer as the metric system is an advance over the old system in use.
Dr. Holt has well matured views as to the subject of general and special medicine. The tendency to prescribe medicine and perform operations as a routine without duc regard to hygiene, diet, exercise, batlis, sleep, and the voca- tional conditions of life is deprecated by an overwhelming majority of the medical profes- sion, but too often that overwhelming majority of the medical profession do not, for one reason
or another, sustain this view in actual practice. The exigency of the conditions met in actual practice, too often give rise to the short cut of prescribing medicine, or performing an op : - tion, which may meet the immediate urgent symp- toms so well that this method of giving relief becomes an habitual practice without due regard for the underlying cause of the ailment. It is for this reason that Dr. Holt could never sanc- tion the routine practice of cutting the muscles of the eyes for the relief of their disabilities, or the incision of the drum head for car ache, or the removal of the tonsils and adenoids, for his experience, based upon his own cases and the observation of those treated by others, forced him to the conclusion that what might be called a more rational treatinent did all that could be done for at least nine-tenths of such cases, and thus avoided the dangers and defects incident to such operations.
As a clerk and bookkeeper in a country store with such men as Albion Thorne, a graduate of Tufts College; John P. Swasey, who represented the Second District of Maine in Congress; an. 1 Otis Hayford, who was on the State Board of Assessors for eighteen years, Dr. Holt had a great opportunity to study and learn the ways of the world. The country store then kept every- thing to meet the demands of the community, and in the narcotic line, tea, coffee, snuff, to- bacco, crude opium and alcohol, when it had the liquor agency. As a teacher in the district school and as teacher and principal of the City Reform School of Boston at Deer Island, where the house of correction for men and women is located, and finally in the treatment of thou- sands of those who came to dispensaries and clinics, Dr. Holt had an unusual opportunity to observe the conditions of the unfortunate and the causes which produced them. With the boy who has gone wrong, the first step in his down- ward course was when he began to practice deception to his parents or those whom he should hold in due respect, by denying he has been using tobacco and making false statements about it. Since the coming of the cigarette this now occurs, on an average, in mid-childhood or at about the age of ten. This leads to bad associations. After a time the stimulating effect of the drug is not so pronounced and for the feeling of depression that comes on, another drug is sought which is usually some form of alcohol. With both of these habits well cstab- lislied the boy is usually lost. He often ar- quires vene cal diseases and goes from bad to
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worse until he is taken into custody for some infraction of the law. Dr. Holt has traced so many such cases that he has come to look upon tobacco as more frequently the primary cause of lost boys than any other one thing. Then, too, it is notorious that it stunts the growth and detracts measureably from their mental ef- ficiency. The child should be taught the truth about the harmful effects of tobacco upon the mind and body, just the same as he should con- tinue to be taught the truth about alcohol and venereal diseases and for the same reason, be- cause each one of these evils pollutes his sys- tem, lowers his efficiency, stunts his growth and prevents him from becoming that strong, healthy, manly man that should be the ambition of every boy. Dr. Holt's experience teaches him that there are a large number of men who if th ... were thoroughly convinced that the use of to- bacco was detrimental to their health they would stop using it. He thinks it incumbent upon those who would persist in using it, notwith- standing this information, to keep its use from the gaze of the child as much as possible, who really has no desire to use it but reasons that if it is good for his father, or the deacon of the church, or the minister, to use tobacco, it must be good for him and he wants to just try it and see how it affects him. This fixes the habit upon him before he is really aware of it. As Dr. Holt's experience and observation have taught him that tobacco is by far the largest single factor in the downfall of boys and girls he feels that those who indulge in its use open- ly, on the street and public places, are con- tributing in no small degree to that downfall and should for the sake of humanity avoid this prac- tice as much as possible. Dr. Holt has records of many persons who came to him on account of dizziness, who, when informed that it might be due to the use of tobacco, broke out into bois- terous laughter. Upon making observations they found they were so much affected with dizzi- ness by the smoking of one cigarette that they could not drive their automobile with safety. After leaving off the use of tobacco they had no dizziness, but upon resuming its use the old dizziness would return, thus proving beyond a doubt that it was due to the use of tobacco. As those who assayed to use a flying inachine smoked cigarettes it is fair to assume that at least some of the mysterious fatal accidents were due to the use of tobacco.
On account of age, Dr. Holt was ineligible to enter the Medical Corps of the United States
Army, but he was nominated by the Council of the National Defense and appointed sv President Wilson a member of the Medical Corps and given the rank of first lieutenant and assigned to duty as Medical Aide to Governor Milliken in forming and supervising the Medical Advisory Boards which were to act, as their name implies, in an advisory capacity to the Local Boards which had been formed for the purpose of examining and classifying registrants for the army. The Selective Service Law and Regula- tions were drawn up hastily and contain dirt- perfections, some of which Dr. Holt got amended. The efficiency of the examinations and classifications of the registrants was the means by which the work of one Local Board could be compared with that of another. Dr. Holt's efforts were directed towards standardiz- ing this work, when he was assigned to duty to the Bureau of War Risk Insurance in addition to duty as Medical Aide to the Governor. As the new draft was coming on when he was about to go to Washington he resigned as Medical Aide to Governor Milliken so he could nominate some- one and have him appointed to attend to these duties. Dr. Holt was thus left free to proceed to Washington to fulfill the duties of his as- signment "for the development and establishment of disability rating" at the Bureau of War Risk Insurance under the direction of Colonel Charles E. Banks, Chief Medical Advisor.
Dr. Holt demonstrated the principles and methods of rating disabilities as set forth in his work on "Physical Economics," and soon had the members of the Bureau rating by it. He developed tables and wrote a manual accom- panied with a computation rating scale which he devised for the purpose of facilitating the work. He accompanied Colonel Banks to New York, where he gave addresses before the Na- tional Compensation Service Bureau on Physical Economics and the method therein advocated for the purpose of rating disabilities from injury or disease in a manner equitable to all concerned. On the completion of the duty assigned him, Dr. Holt had the satisfaction of being assured by the Government experts that he had per- formed a service for the Government of the United States that no one else was prepared to perform.
Dr. Holt married Mary Brooks Dyer, Octobr- 9, 1876, and they have six children: I. Lucinda Maribel, who is a graduate of Smith College and Tufts College Medical School. She married Leon V. Walker, and they have three children:
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Dorothy Page, Leon V., Jr., and Winthrop Brooks. 2. Clarence Blake, a graduate of Har- vard University, who married Miss Stickney of Augusta, and they have one child, Erastus Eugene (3rd). 3. Roscoe Thorne, a graduate of Harvard University and of the Law School, who married Miss Thurston. 4. Erastus Eugene, Jr., a graduate of Bowdoin College and Bow- doin Medical School, who married Miss Munsey, and they have one child, Mary Sheppard. 5. Dorothy Kent, a graduate of Miss Marshall's School of Philadelphia. 6. Benjamin Bradstreet Dyer, a graduate of Bowdoin College and Har- vard University Law School, who married Miss Payson. They reside in Cleveland, Ohio, where he practices law.
Of Dr. Holt's sons, Roscoe T. and Benjamin B. attended the Plattsburg camps. When war was declared the former went into the navy with the rank of lieutenant, and the latter, though he had obtained the rank of a captain at Platts- burg, resigned it and accepted the rank of sec- ond lieutenant in order to get to France earlier, where he was in active service in 1918.
In the sketch thus far we have referred to the papers written by Dr. Holt, and incidentally to their method of production. A quotation from "The President's Address" delivered at the annual meeting of the Maine Medical Associa- tion will show that this paper must have had a gradual growth during his whole professional life.
Forty-two years ago I was elected a member of this Association. This makes my membership longer and my age greater than that of any former president. and I have the honor of being the first specialist ever elected to this office. I have attended every meeting since that time except three, two of which I was out of the state, and at the time of the other one, I was ill. Of the eighty-five papers that I have written upon medical subjects during these forty-two years, nine of them have been read before this Association and pub- lished in its transactions. I have also contributed to the discussion of a score of papers read before this Association.
Few of the men who were active at the meeting of the Association forty-two years ago are here with us today. Their number must necessarily grow less every year. Their places are being taken by men who have had greater advantages in the study of the science and art of medicine and therefore they should assume a greater responsibility for its advancement.
It would be impossible to consider in a few minutes the many things which have contributed to that revo- lution which has taken place in medicine during the past forty-two years. This retrospect will take us back to the time of laudable pus, pyaemia, erysipelas, gangrene and all the conditions prior to the introduc- tion of antiseptic surgery by Lister. Nearly three- quarters of the nineteenth century had passed into history. If from this vantage ground we look across the space of time to see what had taken place to presage these phenomenal changes, we discern in the darkness of medical history one star of the first magni-
tude representing the discovery of vaccination by Ed- ward Jenner in the closing years of the eighteenth century. In comparison to this discovery we must pass by all others to those of the fourth decade, namely, to the discovery of the method of perfecting the com- pound microscope by Lord Lister's father; to the discovery of the cause of itch conveyed to Paris by a medical student from Poland; to Paget's discovery of the trichina spiralis which comes from infected pork ; and to the vegetable organisms which cause the disease of the scalp known as favus; to the fifth decade to Morton's great discovery of the anaesthetic properties of ether; to the sixth decade to the work of Lonis Pasteur and the invention of the ophthalmoscope by Helmholz and the utilization of its principle in various other instruments; to the seventh decade to the con- tinuation of the great work of Pasteur and the utiliza- tion of the same by Lister in antiseptic surgery; to the eighth decade to the continuation of the great dis- coveries of Pasteur and the acceptance of antiseptic surgery as taught by Lister; to the ninth decade to the crowning discovery of Pasteur of the cure for hydrophobia, in recognition for which he was presented with the Pasteur Institute; the complete adoption of Lister's antiseptic surgery with its consequent revolu- tion in the practice of surgery throughout the world; Koch's discovery of the tubercle bacillus, his use of tuberculin, his contributions on cholera, typhoid, ma- laria, and sleeping sickness, together with his technique in culture media and the use of differential stains which were the making of bacteriology; to Roux's discovery of diphtheria antitoxin: to the tenth and last decade to some of the epoch-making discoveries, such as the X-ray, which founded an entirely new depart- ment in science, radium, which founded another; the law of osmosis with its fundamental explanation of the phenomena of liquids, ion chemistry, the electron (1) or the ion electrified, which is seventeen hundred times smaller than the hydrogen atom; the explana- tion of the cell activity of the brain, which underlies the process of thought and the analysis of the chemical properties of living matter which carries us closely to life itself.
The discovery of Jenner had stood as a challenge to the medical profession for four score years. If we look for the means which was destined to meet and answer this challenge, we find it was the perfecting of the compound microscope at the close of the third de- cade of the last century. Although the compound mi- croscope was invented in the sixteenth century, yet it could not be called an instrument of precision. How- ever, the perfecting of this instrument made it so and one of the greatest of any age.
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