Medical scientists also call attention to another injury not infrequently suffered by boxers: the punctate (small) hemorrhages in the pons and medulla, probably caused by the jamming of cerebrospinal fluid. Again, where such hemorrhages destroy nerve tissue the damage is permanent, though this need not imply that malfunction of the brain ensues. Such a symptom would be a matter of extent and degree. The possibilities for brain damage appear to be as multiple as the organ is delicate.
What are the noticeable results of brain injury? The most sensational, if not the most tragic, is death, generally associated with hemorrhage. Depending on how one reads statistics, will one conclude with Dr. Arthur H. Steinhaus, former chief of the Division of Physical Education and Health Activities of the U.S. Office of Education, that "professional boxing is 83 times more deadly than high school football and 50 times more deadly than college football"? Or with T. A. Gonzales that "32 years of boxing competitions...have produced fewer deaths in proportion to the number of participants than occur in baseball or football"? The point is not clear.
But if death is a relative rarity, the same does not seem to be true of brain damage. In 1928 H. S. Maitland concluded his discussion of the punch-drunk syndrome with the statement that 50% of fighters will develop the condition in mild or severe form if they stay in the game long enough, and that this "seems to be good evidence that some special brain injury due to their occupation exists." Dr. Edward J. Carroll Jr., who came to know fighters intimately through professional and nonprofessional contacts, estimated that after five years of boxing 60% of the boxers will develop mental and emotional changes which are obvious to people who know them. He stated (American Journal of The Medical Sciences, 1936) that "no head blow is taken with impunity and...each knockout causes definite and irreparable damage. If such trauma is repeated for a long enough period, it is inevitable that nerve cell insufficiency will develop ultimately...." The recent work of La Cava in Italy and Pampus in Bonn tends to substantiate these claims. Findings such as these received fresh emphasis by sparring partner Ben Skelton's report (SI, Sept. 24) that Liston's left jab is so hard "that for a week after being hit with it I was taking pills to kill the pain."
Dr. Steinhaus has been so impressed with the medical evidence concerning brain damage in boxing that he feels a second foul line must be created at the shoulder. He cites a noted brain surgeon with wide experience with boxers as contending that every head-pommeling is likely to leave some small portion of the brain tissue permanently damaged, even though this may not be noticed for some time. The treacherous aspect of such injury is that it apparently does not manifest itself clinically until rather late in the degenerative process. Furthermore, there are obvious reasons why professional fighters would be reluctant to report symptoms of brain damage.
When one reads these statements—and there are many more of the same—one has an indefinable sense of uneasiness, of inconclusiveness. There is almost the sense of being in the presence of a crusader. Is it really this bad? Could it be that the admirable tendency of the doctor to regard any disease or injury as too much has expanded these statements? H. A. Kaplan (The Journal of the American Medical Association, 1959) contends that "a blow from a human being with a padded gloved fist probably is not forceful enough to produce any direct damage to the brain." In an area such as this, the theologian admits to hopeless incompetence. To complete his understanding of professional boxing he must rely completely on medical specialists. With this in mind I submitted the following statement, attributed to a prominent brain specialist, to 10 of the top neurosurgeons in the U.S. and Canada: "The brain is so constructed that it cannot suffer a series of head blows over the years in boxing without certainly or at least very probably incurring thereby some permanent injury." These experts agreed that the statement could be endorsed as a general statement. One was at pains to indicate that the statement, while it is probably correct, is poorly written. He could not accept the inference in it that malfunction of the brain follows brain damage. Such a symptom would be a matter of degree.
If these specialists are incorrect in their estimate about brain damage, then the moral theologian would desire to reexamine certain aspects or emphases of his argumentation, as we shall see. But it is this type of evidence that makes one take a long second look at the words of Abe Simon, former heavyweight contender: "...jarring of the brain. That's what causes the trouble—my headaches and those of every fighter who has taken punishment. It's not a single punch; it's the constant jarring.... [The fighter] is always soothed by the falsehood that he will be just as good as new after a short rest. He never is, and no fighter living today who has had 50 or more reasonably hard fights can honestly make the claim."
Such a medical review was necessary preparation for a moral estimate. Since everyone familiar with the sport concedes its advantages, the moral discussion boils down to this: Are the arguments against professional boxing conclusive? Of the many moral objections one hears, the most serious are reducible to three.
1) The knockout. It is simply unrealistic to deny that most professional fighters aim for a knockout. This is regarded as the most decisive and impressive way to win a fight. It is what the fighter wants and very often what the fans want. The long climb to contender status or the comeback often hinges on it. As Nat Fleischer wrote in The Heavyweight Championship of Louis' comeback tour after his 1936 loss to Max Schmeling: "There was only one way to do that—to roll up victory after victory over the knockout route."
Not a few moral theologians find it difficult to admit that the knockout is justifiable. They frequently formulate this as follows: directly and violently to deprive oneself or another of the use of reason is morally reprehensible except for a sufficient cause. It is the rational faculties, intellect and free will that distinguish man from the brute. Directly to deprive man of these faculties without a sufficient reason is to dehumanize. These theologians are reluctant to admit that sport, money, fame qualify as sufficient reason. If such violent deprivation of higher controls is reprehensible, then the intent to do so is equally reprehensible. Hence a sport in which this intent plays such an integral role must be condemned.
Is the argument convincing? I do not believe it is. First of all, the knockout is understood in the rather limited sense of "rendering unconscious." This is not a necessary sense of the word. A knockout is, more realistically, beating a fighter to the point where he is physically incapable of continuing. This is what the ordinary professional desires. Deprivation of the use of reason is not essential to this. Hence, practically, it is hard to show how the knockout in this limited sense is an essential aim of most fighters. Second, even if it were the fighter's aim, it would be difficult to show how the knockout of itself (independent of injury) is sufficient to condemn the sport. It can be argued that, generally, deprivation of the use of reason lasts only a few seconds at most (8 to 10 usually) and that this is so little as to be negligible. If this were the only thing at stake, it is highly doubtful that there would be as much objection to boxing as there seems to be.