- Email: [email protected]
COLLOIDAL COPPER INJECTIONS IN MALIGNANT DISEASE.
1348
COLLOIDAL COPPER INJECTIONS IN MALIGNANT DISEASE.
overshadowed all else in the public mind. Like so many other things achieved just prior to the war, Sir Thomas Horder remarks, nothing has been done with regard to the Committee’s recommendations so far, and then proceeds to survey the law in relation to secret remedies, which, he said, showed very clearly that in Great Britain the loosest possible control was exercised, far looser than in the majority of foreign Noneof the Acts of Parliament, nor countries. departments of State, nor statutory bodies controls in any particular, save that of selling poisons without declaring their presence, the vast trade done in patent medicines. The State seems to limit its responsibility to the public to accepting a stamp duty, the scale of which has remained unchanged since 1804. Two significant anomalies may be mentioned : {1) That the Sale of Food and Drugs Act, under which it became an offence to give with any article sold a label falsely describing such article, specifically states that an offence shall not be deemed to be committed " where the drug or food is a proprietary medicine or is the subject of a patent in force " ; and (2) that the Indecent Advertisements Act specifically excludes advertisements in newspapers. It was revealed by the Committee’s report that no department of State officially concerns itself with the sale and advertisement of secret remedies. The Home Secretary has no powers or duties, and proceedings for fraud against the proprietors or vendors on the ground that they cannot cure the diseases they mention are practically unknown. The dimensions of the trade thus uncontrolled are stupendous. The annual turnover of the proprietor of " Beecham’s Pills," selling over a million pills a day, was, Sir Thomas The owners of Horder states, about £360,000. " Mother Siegel’s Syrup " paid upwards of £40,000 a " Wincarnis " spent £50,000 a year in wages alone. in its advertising bureau. As for the profits year made, these run often into fabulous sums, as can be seen from the fact that the proprietor of "Dr. NATilli-ams’s Pink Pills for Pale People "-George Taylor Fulford-left a fortune of £1,111,000. In the face of vested interests of such magnitude it is clear that any interference on the part of the press calls for no small amount of courage and no little confidence in the ultimate good sense of the public. THE EXPECTATION OF LIFE AFTER RECOVERY FROM AN EMPYEMA.
A
discharge from hospital. In most of these cases the empyema had been acute, presumably metapneumonic. A comparison of the deaths among these patients with the expected death-rate of the total population at the same age showed that the mortality among these ex-empyema patients was about 20 per cent. above normal. This rise in the mortality-rate began about five years after the empyema was contracted and continued during the following five years ; ten years after .recovery from an empyema it would seem that the expectation of life is practically the same as for the total population. This increased mortality did not seem to depend much, if at all, on tuberculosis ; among the 128 patients who were traced, there were 19 who were found to have died, and of these 19 only three were certainly known to have died of tuberculosis. There were, however, five deaths due to unknown causes which in one case may have been tuberculosis, but four tuberculosis deaths out of a total of 19 deaths is not a comparatively high tuberculosis-rate, at any rate in Helsingfors, where, in 1916, 26-5 per cent. of all the deaths were due to tuberculosis. To illuminate the problem from another angle, Dr. Saltzman and Dr. Sievers have in vestigated the case-records of 3557 patients treated in a sanatorium for pulmonary tuberculosis. In only four of these cases was there a record of an empyema developing before the onset of signs of pulmonary tuberculosis. Paxadoxical as it may seem, the ultimate prognosis, according to the investigations of these Scandinavian authorities, including Allard and Koster, is much worse for a simple serous pleurisy requiring no operative treatment or merely aspiration, than it is for the patient who recovers from a stormy purulent empyema necessitating the intervention of the surgeon. COLLOIDAL COPPER INJECTIONS IN MALIGNANT DISEASE. IN the course of a presidential address delivered before the Cardiff Medical Society on Nov. llth, Dr. E. E. Brierley expressed a conviction that many patients who had undergone operations for carcinoma would have had a better chance of survival if a course of colloidal copper injections had been given after operative treatment. He gave notes of patients in whom this treatment appeared to be successful. Two cases of nodular growths in the breast with secondary glands in the axilla, in which operation was refused, were treated by him with intramuscular injections of colloidal copper; the growths and the glands disappeared after a course of injections extending a little Both patients are still alive and well, over a year. ten and seven years after the commencement of the treatment. A patient with a large scirrhus carcinoma of the breast had her breast removed and the axilla cleared in November, 1916. The supraclavicular glands on the same side were found to be enlarged when she was seen by him in February, 1918. Intramuscular injections of colloidal copper were given over a period of eight months ; the glands disappeared and the patient is still alive and well. A patient, aged 62, who gave a history of hsemorrhagic vaginal discharge over a period of two years, called him in on account of excessive flooding. Vaginal examination demonstrated the clinical signs of cancer of the cervix. Operation was refused but consent was given for intramuscular’ injections of colloidal copper. After seven injections the haemorrhage and discharge had ceased and the patient refused further injections. On examination the cervix was found to be healed and smooth. This patient died away from home nine months later from a stroke," no return of the vaginal discharge having occurred. A patient who had her breast removed and the axilla cleared out for medullary cancer in August, 1919, dreaded a recurrence ; she submitted
THERE is still some uncertainty, from the life insurance point of view, about the future of persons who have recovered from a non-tuberculous pleural empyema. It is believed in some quarters that these persons are more likely to develop pulmonary tuberculosis than others, and that for this reason they are not acceptable as first-class lives. Some life insurance societies attach the same prognostic significance to a history of non-tuberculous empyema as they do to one of serous pleurisy, and in so doing they bracket the former with one of the most ominous precursors of pulmonary tuberculosis. For, as Allard and Koster have shown, over 42 per cent. of persons with a history of serous pleurisy develop pulmonary tuberculosis within 16 years of the onset of the pleurisy. But are we justified in lumping purulent and serous pleurisy - together as far as the expectation of life is concerned ? The answer is in the negative, to judge by a paper recently published by Dr. F. Saltzman and Dr. 0. Sievers.1 They investigated in 1922 and 1923 the subsequent fates of the patients treated in the period 1902-1912 for empyema in two surgical hospitals in Helsingfors. They excluded from their investigations the cases terminating fatally in hospital and those which were already of a tuberculous character, confining themselves to the cases in which a complete recovery was effected as far as the empyema was to a course of colloidal copper injections over a period concerned. There were 201 such cases, the subsequent of three months. The patient has had no recurrence fate of 128 being ascertained from 10 to 20 years after and is alive and well. Another patient had the right for medullary axilla breast removed and the cleared 1 Finska Läkaresällskapets Handlingar, September-October, As there was a small cancer on Feb. lst, 1920. 1924, p. 718. "
MEAT POISONING IN PRUSSIA.
1349
nodular lump in the left breast with enlarged glands 1914, 4,500,000 kilos of animal carcasses and decomin the axilla, and the patient did not wish a second posed meat was dealt with, while in 1923 the correoperation, a course of colloidal copper injections were sponding amount was only 730,000 kilos. The natural given over a period of three months ; the nodular lump suggestion that during this later period proportionately and glands disappeared. In September, 1923, the fewer animals departed this life is countered by the patient returned on account of some enlarged glands in statement that during and after the war, especially the right supraclavicular region. After a course of during the inflation time in Berlin, a great deal more colloidal copper injections over a period of four months glands subsided. The patient is alive at the
the
in excellent health, and no glands can Two cases of advanced and inoperable carcinoma of the rectum had been treated bv him ; one improved and put on weight but died in 12 months, Dr. Brierley referred the other received no benefit. also to a case of inoperable cancer of the rectum treated by colloidal copper and selenium, reported by Lionel Norbury in the Proceedings of the Royal Society of Medicine, June, 1923. After treatment for over two years no growth or ulceration could be seen or felt and the general health of the patient was good. Dr. Brierley urged the trial of colloidal copper after operations for cancer and in inoperable cases, emphasising the need of perseverance in the treatment, even if there was no immediate improvement, until the patient was cured or refused further treatment, or until his condition became hopeless.
present time, be felt.
MEAT POISONING IN PRUSSIA. A RECENT articlel by Prof. 0. Lentz supplies a good deal of information upon outbreaks of meat poisoning occurring in Prussia between 1907 and 1924 and incidentally throws some sidelights upon the shortage of meat in that country during and after the war. By virtue of an enactment of August, 1905, outbreaks of meat poisoning in Prussia have to be reported by the district medical officers to the appropriate These reports, although Government department. showing some omissions, are available for a survey of the causes and course of these outbreaks. Lentz gives the following table :-
*
First four months.
While the majority of outbreaks are ascribed to infection with bacilli of the paratyphoid-enteritidis group, eight are credited to B. proteus and 24 as .examples of botulism. In only one of the latter, however, was B. botulinus isolated with certainty, while in two others anaerobes of the type of this ,organism were present.
The causation of this serious rise in the number of outbreaks is discussed by Lentz. While admittedly some of the outbreaks were associated with the use of food which was perfectly sound, in the majority the meat consumed was derived from animals definitely diseased. In pre-war times such food was very rarely passed and allowed to be eaten, but in consequence of the great shortage of meat during the war and in the .after-war period, especially during the years of inflation, more and more necessity-slaughtered meat and meat which eluded inspection altogether was sold for human food. According to Lentz, this assumed very large proportions, and he quotes various reports as bearing out this contention. For example, in the Berlin Kadaververwertungsanstalt during the year
1
O.
Hygiene
Lentz: Ueber Fleischvergiftungen, 1924, Zeitschr. und Infekt., ciii., Part 2, p. 321.
f.
sausage meat
was actually consumed. Negligent inspection must, in Prof. Lentz’s view, bear a large part of the blame for this increase in meat poisoning. In many cases, in spite of offensive septic and other conditions in the animals, the meat had been stamped as fit for food. He gives an instance of a veterinary inspector passing the meat of a cow, in spite of the presence of a much enlarged spleen and small haemorrhages upon the serous membranes. Two of the slaughtermen concerned subsequently fell ill with anthrax and one died. In spite of repeated reminders from the central authority, bacteriological investigations of suspicious cases are seldom resorted to, and usually the guide utilised is merely the colour and consistency of the flesh. Another instance given is one in which the meat inspector passed meat as fit for use which was definitely suspicious, the only test employed being that he and his family ate a piece of it, his only proviso that it was
to be meat
well
cooked.
This meat caused
poisoning, due to B.
an
outbreak of
enteritidis, involving
62 persons. In only two instances from the many reports is it mentioned that severe offences against the regulations have resulted in the removal of the meat inspector from his office. Legal proceedings against offenders have been quite ineffectual. Lentz presses strongly the need for routine bacteriological examination of all necessity-slaughtered animals before being passed for human consumption. These facts suggest the reflection that the relaxation cfa rigid system of meat inspection amongst a people accustomed to be guided by rule is likely to be fraught with greater risk of disaster than a limited inexact system of inspection amongst a community forced to exercise discrimination of their
own.
____.
THE VISCOSITY OF PROTOPLASM. THE physical properties of protoplann continue to exercise the minds of research workers year by year in the light of new knowledge. Especially important at the present time is the increased study of all histological processes by means of physical methods, witness the whole range of research which has been produced by the introduction of the dark-ground illumination apparatus. The current number of the British Journal of Experimental Biology (October, 1924) contains an article by Mr. William Seipiz on a method of studying the elastic properties of protoplasm which throws further light on the viscosity of this substance. Briefly put, the method used consists in suspending a minute particle of a magnetic needle, with the aid of microneedles, in the colloidal protoplasm. By means of an electro-magnet the particle is then attracted until the colloid is stretched to a maximum amount, whilst on release of the magnetic force the particle will return to its original position. The distance over which the particle has travelled in one direction is a measure of the stretching capacity of the substance. The force necessary to produce this stretching is a measure of the elasticity. Of course, a special arrangement of microdissection instrument, microscope and magnet, is necessary for the experiment. The metal particles used were obtained from nickel powder, and the protoplasm selected was the mature unfertilised egg of the sand-dollar, Echinaracliraius parma, which is resistant to ill-treatment. As the writer himself points out, the difficulty which confronts the worker on protoplasm is that of deciding with certainty whether the protoplasm is living and normal at the time of observation or not. Numerous safeguards were, therefore, necessary before the author could arrive at the result of 9 µ as the stretching value of this particular kind of protoplasm, whilst the force applied could only tentatively be estimated.
COLLOIDAL COPPER INJECTIONS IN MALIGNANT DISEASE.
overshadowed all else in the public mind. Like so many other things achieved just prior to the war, Sir Thomas Horder remarks, nothing has been done with regard to the Committee’s recommendations so far, and then proceeds to survey the law in relation to secret remedies, which, he said, showed very clearly that in Great Britain the loosest possible control was exercised, far looser than in the majority of foreign Noneof the Acts of Parliament, nor countries. departments of State, nor statutory bodies controls in any particular, save that of selling poisons without declaring their presence, the vast trade done in patent medicines. The State seems to limit its responsibility to the public to accepting a stamp duty, the scale of which has remained unchanged since 1804. Two significant anomalies may be mentioned : {1) That the Sale of Food and Drugs Act, under which it became an offence to give with any article sold a label falsely describing such article, specifically states that an offence shall not be deemed to be committed " where the drug or food is a proprietary medicine or is the subject of a patent in force " ; and (2) that the Indecent Advertisements Act specifically excludes advertisements in newspapers. It was revealed by the Committee’s report that no department of State officially concerns itself with the sale and advertisement of secret remedies. The Home Secretary has no powers or duties, and proceedings for fraud against the proprietors or vendors on the ground that they cannot cure the diseases they mention are practically unknown. The dimensions of the trade thus uncontrolled are stupendous. The annual turnover of the proprietor of " Beecham’s Pills," selling over a million pills a day, was, Sir Thomas The owners of Horder states, about £360,000. " Mother Siegel’s Syrup " paid upwards of £40,000 a " Wincarnis " spent £50,000 a year in wages alone. in its advertising bureau. As for the profits year made, these run often into fabulous sums, as can be seen from the fact that the proprietor of "Dr. NATilli-ams’s Pink Pills for Pale People "-George Taylor Fulford-left a fortune of £1,111,000. In the face of vested interests of such magnitude it is clear that any interference on the part of the press calls for no small amount of courage and no little confidence in the ultimate good sense of the public. THE EXPECTATION OF LIFE AFTER RECOVERY FROM AN EMPYEMA.
A
discharge from hospital. In most of these cases the empyema had been acute, presumably metapneumonic. A comparison of the deaths among these patients with the expected death-rate of the total population at the same age showed that the mortality among these ex-empyema patients was about 20 per cent. above normal. This rise in the mortality-rate began about five years after the empyema was contracted and continued during the following five years ; ten years after .recovery from an empyema it would seem that the expectation of life is practically the same as for the total population. This increased mortality did not seem to depend much, if at all, on tuberculosis ; among the 128 patients who were traced, there were 19 who were found to have died, and of these 19 only three were certainly known to have died of tuberculosis. There were, however, five deaths due to unknown causes which in one case may have been tuberculosis, but four tuberculosis deaths out of a total of 19 deaths is not a comparatively high tuberculosis-rate, at any rate in Helsingfors, where, in 1916, 26-5 per cent. of all the deaths were due to tuberculosis. To illuminate the problem from another angle, Dr. Saltzman and Dr. Sievers have in vestigated the case-records of 3557 patients treated in a sanatorium for pulmonary tuberculosis. In only four of these cases was there a record of an empyema developing before the onset of signs of pulmonary tuberculosis. Paxadoxical as it may seem, the ultimate prognosis, according to the investigations of these Scandinavian authorities, including Allard and Koster, is much worse for a simple serous pleurisy requiring no operative treatment or merely aspiration, than it is for the patient who recovers from a stormy purulent empyema necessitating the intervention of the surgeon. COLLOIDAL COPPER INJECTIONS IN MALIGNANT DISEASE. IN the course of a presidential address delivered before the Cardiff Medical Society on Nov. llth, Dr. E. E. Brierley expressed a conviction that many patients who had undergone operations for carcinoma would have had a better chance of survival if a course of colloidal copper injections had been given after operative treatment. He gave notes of patients in whom this treatment appeared to be successful. Two cases of nodular growths in the breast with secondary glands in the axilla, in which operation was refused, were treated by him with intramuscular injections of colloidal copper; the growths and the glands disappeared after a course of injections extending a little Both patients are still alive and well, over a year. ten and seven years after the commencement of the treatment. A patient with a large scirrhus carcinoma of the breast had her breast removed and the axilla cleared in November, 1916. The supraclavicular glands on the same side were found to be enlarged when she was seen by him in February, 1918. Intramuscular injections of colloidal copper were given over a period of eight months ; the glands disappeared and the patient is still alive and well. A patient, aged 62, who gave a history of hsemorrhagic vaginal discharge over a period of two years, called him in on account of excessive flooding. Vaginal examination demonstrated the clinical signs of cancer of the cervix. Operation was refused but consent was given for intramuscular’ injections of colloidal copper. After seven injections the haemorrhage and discharge had ceased and the patient refused further injections. On examination the cervix was found to be healed and smooth. This patient died away from home nine months later from a stroke," no return of the vaginal discharge having occurred. A patient who had her breast removed and the axilla cleared out for medullary cancer in August, 1919, dreaded a recurrence ; she submitted
THERE is still some uncertainty, from the life insurance point of view, about the future of persons who have recovered from a non-tuberculous pleural empyema. It is believed in some quarters that these persons are more likely to develop pulmonary tuberculosis than others, and that for this reason they are not acceptable as first-class lives. Some life insurance societies attach the same prognostic significance to a history of non-tuberculous empyema as they do to one of serous pleurisy, and in so doing they bracket the former with one of the most ominous precursors of pulmonary tuberculosis. For, as Allard and Koster have shown, over 42 per cent. of persons with a history of serous pleurisy develop pulmonary tuberculosis within 16 years of the onset of the pleurisy. But are we justified in lumping purulent and serous pleurisy - together as far as the expectation of life is concerned ? The answer is in the negative, to judge by a paper recently published by Dr. F. Saltzman and Dr. 0. Sievers.1 They investigated in 1922 and 1923 the subsequent fates of the patients treated in the period 1902-1912 for empyema in two surgical hospitals in Helsingfors. They excluded from their investigations the cases terminating fatally in hospital and those which were already of a tuberculous character, confining themselves to the cases in which a complete recovery was effected as far as the empyema was to a course of colloidal copper injections over a period concerned. There were 201 such cases, the subsequent of three months. The patient has had no recurrence fate of 128 being ascertained from 10 to 20 years after and is alive and well. Another patient had the right for medullary axilla breast removed and the cleared 1 Finska Läkaresällskapets Handlingar, September-October, As there was a small cancer on Feb. lst, 1920. 1924, p. 718. "
MEAT POISONING IN PRUSSIA.
1349
nodular lump in the left breast with enlarged glands 1914, 4,500,000 kilos of animal carcasses and decomin the axilla, and the patient did not wish a second posed meat was dealt with, while in 1923 the correoperation, a course of colloidal copper injections were sponding amount was only 730,000 kilos. The natural given over a period of three months ; the nodular lump suggestion that during this later period proportionately and glands disappeared. In September, 1923, the fewer animals departed this life is countered by the patient returned on account of some enlarged glands in statement that during and after the war, especially the right supraclavicular region. After a course of during the inflation time in Berlin, a great deal more colloidal copper injections over a period of four months glands subsided. The patient is alive at the
the
in excellent health, and no glands can Two cases of advanced and inoperable carcinoma of the rectum had been treated bv him ; one improved and put on weight but died in 12 months, Dr. Brierley referred the other received no benefit. also to a case of inoperable cancer of the rectum treated by colloidal copper and selenium, reported by Lionel Norbury in the Proceedings of the Royal Society of Medicine, June, 1923. After treatment for over two years no growth or ulceration could be seen or felt and the general health of the patient was good. Dr. Brierley urged the trial of colloidal copper after operations for cancer and in inoperable cases, emphasising the need of perseverance in the treatment, even if there was no immediate improvement, until the patient was cured or refused further treatment, or until his condition became hopeless.
present time, be felt.
MEAT POISONING IN PRUSSIA. A RECENT articlel by Prof. 0. Lentz supplies a good deal of information upon outbreaks of meat poisoning occurring in Prussia between 1907 and 1924 and incidentally throws some sidelights upon the shortage of meat in that country during and after the war. By virtue of an enactment of August, 1905, outbreaks of meat poisoning in Prussia have to be reported by the district medical officers to the appropriate These reports, although Government department. showing some omissions, are available for a survey of the causes and course of these outbreaks. Lentz gives the following table :-
*
First four months.
While the majority of outbreaks are ascribed to infection with bacilli of the paratyphoid-enteritidis group, eight are credited to B. proteus and 24 as .examples of botulism. In only one of the latter, however, was B. botulinus isolated with certainty, while in two others anaerobes of the type of this ,organism were present.
The causation of this serious rise in the number of outbreaks is discussed by Lentz. While admittedly some of the outbreaks were associated with the use of food which was perfectly sound, in the majority the meat consumed was derived from animals definitely diseased. In pre-war times such food was very rarely passed and allowed to be eaten, but in consequence of the great shortage of meat during the war and in the .after-war period, especially during the years of inflation, more and more necessity-slaughtered meat and meat which eluded inspection altogether was sold for human food. According to Lentz, this assumed very large proportions, and he quotes various reports as bearing out this contention. For example, in the Berlin Kadaververwertungsanstalt during the year
1
O.
Hygiene
Lentz: Ueber Fleischvergiftungen, 1924, Zeitschr. und Infekt., ciii., Part 2, p. 321.
f.
sausage meat
was actually consumed. Negligent inspection must, in Prof. Lentz’s view, bear a large part of the blame for this increase in meat poisoning. In many cases, in spite of offensive septic and other conditions in the animals, the meat had been stamped as fit for food. He gives an instance of a veterinary inspector passing the meat of a cow, in spite of the presence of a much enlarged spleen and small haemorrhages upon the serous membranes. Two of the slaughtermen concerned subsequently fell ill with anthrax and one died. In spite of repeated reminders from the central authority, bacteriological investigations of suspicious cases are seldom resorted to, and usually the guide utilised is merely the colour and consistency of the flesh. Another instance given is one in which the meat inspector passed meat as fit for use which was definitely suspicious, the only test employed being that he and his family ate a piece of it, his only proviso that it was
to be meat
well
cooked.
This meat caused
poisoning, due to B.
an
outbreak of
enteritidis, involving
62 persons. In only two instances from the many reports is it mentioned that severe offences against the regulations have resulted in the removal of the meat inspector from his office. Legal proceedings against offenders have been quite ineffectual. Lentz presses strongly the need for routine bacteriological examination of all necessity-slaughtered animals before being passed for human consumption. These facts suggest the reflection that the relaxation cfa rigid system of meat inspection amongst a people accustomed to be guided by rule is likely to be fraught with greater risk of disaster than a limited inexact system of inspection amongst a community forced to exercise discrimination of their
own.
____.
THE VISCOSITY OF PROTOPLASM. THE physical properties of protoplann continue to exercise the minds of research workers year by year in the light of new knowledge. Especially important at the present time is the increased study of all histological processes by means of physical methods, witness the whole range of research which has been produced by the introduction of the dark-ground illumination apparatus. The current number of the British Journal of Experimental Biology (October, 1924) contains an article by Mr. William Seipiz on a method of studying the elastic properties of protoplasm which throws further light on the viscosity of this substance. Briefly put, the method used consists in suspending a minute particle of a magnetic needle, with the aid of microneedles, in the colloidal protoplasm. By means of an electro-magnet the particle is then attracted until the colloid is stretched to a maximum amount, whilst on release of the magnetic force the particle will return to its original position. The distance over which the particle has travelled in one direction is a measure of the stretching capacity of the substance. The force necessary to produce this stretching is a measure of the elasticity. Of course, a special arrangement of microdissection instrument, microscope and magnet, is necessary for the experiment. The metal particles used were obtained from nickel powder, and the protoplasm selected was the mature unfertilised egg of the sand-dollar, Echinaracliraius parma, which is resistant to ill-treatment. As the writer himself points out, the difficulty which confronts the worker on protoplasm is that of deciding with certainty whether the protoplasm is living and normal at the time of observation or not. Numerous safeguards were, therefore, necessary before the author could arrive at the result of 9 µ as the stretching value of this particular kind of protoplasm, whilst the force applied could only tentatively be estimated.