battlefield wounds, and if traumatic skin lacerations could reliably heal
after sewing the edges together with silk and catgut sutures, could deeper
structures (muscles, tendons, organs, even bones?) also heal after being
connected or stabilized? To answer these questions, Gluck continued his
animal experimentation, finding that separated tissues could be brought
together and heal, in a process he called “autoplasticity.”^2 During the
Serbian-Bulgarian war (1885), Gluck was able to treat a soldier’s femur
fracture with two steel plates and screws, amazed at the rapid recovery and
early motion afforded by his intervention. The next logical philosophical
leap would be the introduction of other foreign materials in the body as
substitutes for bones, taking autoplasticity to previously unimagined (and
potentially catastrophic) echelons.
Science fiction writers can, on occasion, resemble prophets. Jules Verne
said, “Anything one man can imagine, other men can make real,” and it’s
possible that it was Dr. Frankenstein who animated Dr. Gluck’s inkling
about tissue regeneration. In the late 1880s, Gluck’s animal studies
concentrated on tissue replacements, and his attempts to develop what he
termed “guide rails” for regrowth of diseased or damaged tissues turned
his hand to aluminum, wood, glass, nickel-plated steel, and ivory. We now
know that the primary mineral content of ivory, hydroxyapatite, is
identical to the dentin of teeth and the main non-collagenous substrate of
bone, but in Gluck’s time, the visual similarities and abundant supply (the
Ivory Coast was then a German colony) of ivory made it an obvious
selection for investigation. Ivory became his material of choice for bone
substitution, and in short order, in 1890, he began implanting carved and
machined pieces of ivory into diseased joints, starting with a knee
replacement in a seventeen-year-old girl, followed by a wrist replacement
three weeks later. He reported performing fourteen arthroplasties that year
(including knee, hip, wrist, and elbow), with all patients suffering from TB
receiving an artificial joint.^3
The initial results of Gluck’s ivory joint arthroplasties were remarkable.
Patients were pain-free and movement had been restored. Gaining
confidence, Gluck was eager to present his short-term successes to the
Berlin Medical Society, but trouble was brewing. Surgeons in Germany
already regarded his use of silk sutures to repair tendon injuries as
scandalous, and now, this madman was proposing a presentation on his
series of joint replacements. All of his patients had previously endured