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AN APPARATUS FOR CONTINUOUS PROCTOCLYSIS.
1078 admits as beneficial in the future.
convalescent cookery are for the most part’ admirable, but we do not think that’the directions given for making an adequately illustrated, and is omelette on p. 36 would result in the production of a really It is a useful and readable good omelette. One dessertspoonful of butter would not be exposition of sound medical teaching in the field with which enough for two eggs, and the stirring about in the pan would it deals. result in a mixture much more like buttered eggs than an omelette. But the art of making an omelette is not to be Notes on Dental Anatomy. By G. A. PEAKE. London : learned from a book ; to describe the proper method of Claudius Ash, Sons, and Co. 1908. Pp. 104.-These are one is almost impossible in writing, a practical cooking the notes of Mr. Peake’s lectures, and they contain an wanted. enormous mass of information about the teeth. The illustration is always highly condensed information is generally sound; except that the author’s ideas of the development of the jaws are a little archaic, and it is perhaps unwise to call the newt and frog reptiles as he does on p. 26. Mr. Peake says that the notes have been published at the request of dental students, but we doubt the wisdom of granting the request. Students AN APPARATUS FOR CONTINUOUS PROCTOCLYSIS. are much too fond of "potted knowledge," and few can THE plan of continuous administration of warm saline retain it beyond the date of an examination. A book twice solution by the rectum, introduced by Dr. J. B. Murphy as long, containing half the facts, would have been more of Chicago is in my opinion one of the greatest valuable. advances in abdominal surgery which have been made within recent years. Its routine adoption leads, I believe, das beim Ueber Verhalten hdinolytise7ter Ser1tmsto.lfe to more rapid, and certainly to more comfortable, conHaemogesqt,nden 1lnd 7tranken Kind. (On the Qiaitities of valescence after coeliotomy, and its beneficial effects in lytic Sitbstances contained in the Ser1Mn of Ohildren in .LeLt7t cases of general septic peritonitis would have surprised and Disease.) By Dr. ERNST MORO, Privat-docent and me had I not been prepared for them by hearing from Oberarzt in the Children’s Clinic of the University at Dr. Murphy’s own lips of the wonderful results which Munich. Wiesbaden: J. F. Bergmann. 1908. Pp. 100. he has obtained in the treatment of this serious conPrice 3s.-It is well known that the process of haemolysis dition since the adoption of the practice of continuous proctoclysis. Success in using the Murphy method depends n an immunised animal is carried out by two separate subon attention to detail, and stances-the immune body (amboceptor or copula) and the the two most important complement. Dr. Moro endeavoured to ascertain the points are : first, the regulation of the flow from the amounts of each of these substances in the blood of supply-can by gravity alone, children. He found that in new-born infants the immune and not by- constriction of body by which foreign blood corpuscles are attacked the delivery tube; and, is present only in small amount, and that there is also a secondly, the maintenance of smaller quantity of the complement than in adults, the actual the saline at a constant and amount varying in different individuals at all ages. The i appropriate temperature. To obviate the latter difficulty most interesting part of the pamphlet is, however, the comI have had an apparatus parison of the amounts of complement present in the serum made which does away with of different classes of atrophic children. The author found the necessity for constant that in infants who suffered from atrophy due to inability to supervision. The apparatus assimilate artificial food the amount of complement was very consists of an electro-plated douche can which holds small, whereas in others suffering from alimentary intoxicaIn the about five pints. tion the amount was actually increased, as in infective front of the can are a therdiseases. Injection of normal saline solution leads to an mometer and a gauge glass, increased formation of complement in patients who have by the side of which the can is graduated in half pints, so good powers of resistance. The failure of this increase that the amount of saline seems to be a sign of bad prognosis, and may perhaps prove entering the rectum can be to be a test possessing some clinical value. Further studie readily estimated. The saline are in progress as to variations in the amount of immune leaves the can through a body present in different diseases. delivery tube with a half inch bore, to which is lnvalid Cookerya Handbook of Cookery for the Sio7z Room. attached three feet of rubber By Miss PEARSON and Mrs. BYRDE. London : W. Thacker tubing connected with a and Co. ; Calcutta : Thacker, Spink, and Co. 1909. Pp. 39. large rectal tube. Under Is. 6d.-Take it all round this is an the bottom of the can is an electric heater, which can be Price 1 rupee. excellent little book. We are particularly pleased to note connected with any electric supply of suitable voltage by the sensible remarks about water for the sick with which means of a flexible cord and wall plug. The can is suspended on an adjustable stand, mounted on castors, so that it can be Part 1 opens. Even in these modern days every medical man wheeled up to the bedside. I have found by experireadily will bear witness to the widespread delusion that cold ment that with a ward temperature of from 650 to 700 F. water is harmful for a sick person, and Miss Pearson and Mrs. the solution in the can must be kept at a uniform temperaByrde have done well to point out that water is most bene- ture of 106° in order to insure that the saline enters the ficial. In the recipe for barley water, too, they have done rectum at a temperature of from 990 to 100°. The electric " heater is so made that if the saline solution is put into the right to mention the fact that the expression " barley water can at a temperature of 106° the temperature remains means at least three different kinds of fluid. We notice that almost constant so as the current is switched on. long in the recipe for white wine whey the authors are led into The apparatus, which has been made for me by Messrs. looseness of expression, for they say that all the solids of Allen and Hanburys, answers its purpose admirably and can the milk are removed in the curd." This, of course, is be left for several hours without any attention. incorrect, for the whey contains salts and sugar. This error HERBERT J. PATERSON, M.B., B.C. Cantab., F.R.C.S. Eng. should be corrected in a future edition. The recipes Upper Wimpole-street, W.
total and subtotal gastrectomy.
useful, and likely
to prove still The book is well got up and written in an agreeable style.
Pylorectomy he
more
.
New Inventions.
I
for
THE ENZYME TREATMENT OF CANCER.
place
in the
already
too
1079
lengthy
list of
alleged
cures
for
Although it is as useless as any other reputed surgical treatment, it may hardly be dislodged from its place in the lay mind until the progress of investigation reveals to the physician and surgeon rational substitutes for, or adjuvants to, operation. With regard to such alleged remedies it is essential, however, that the medical profession should have clear and sound views as to why they have been LONDON: SATURDAY, OCTOBER 9, 1909. condemned as useless. The possession of this knowledge and of the convictions based upon it, on the part of those who may be importuned to employ such remedies, is of as The Enzyme Treatment of Cancer.1 great importance to the practitioner himself as it is to HAD the enzyme treatment of cancer been able to achieve his patients. For this reason we have only the highest for a painstaking and elaborate report on the ,any of the exploits attributed to it we should expect that the praise outpourings in the press on both sides of the Atlantic systematic submission of 100 cases of cancer to " the enzyme about three years ago would be by now finding justification treatment of cancer " during the past three years in the New in the publication of properly authenticated therapeutical York Skin and Cancer Hospital. Undeterred by the discredit triumphs. But all that has followed justifies both the into which the methods of some of its exponents had brought scepticism originally accorded to the statements of the rival the theory, Dr. WM. SEAMAN BAINBRIDGE, the author of discoverers of the treatment and the verdict which quickly this report, has fulfilled his undertaking to give the treatfollowed, that trypsin, whether exhibited with or without ment a fair trial, both in operable and in inoperable cases. amylopsin, is not a cure for cancer. The lapse of time has Many of the patients have been followed to their homes, shifted the attention of those interesting themselves in the and nurses provided, after leaving hospital, while everyalleged relation of ferments to cancer from ’’ trypsin " to thing possible has been done to make the clinical and patho4’antitrypsin," through the agency of which attempts are logical observations complete. The list of patients and the being made to obtain a quicker or more certain diagnosis of account of the results given by Dr. BAINBRIDGE are records the presence of the disease ; but unfortunately the antici- of the miserable failure of the treatment ; but they are pations aroused by the earlier positive statements of the monuments of industry which will be of service in the diagnostic value of what has been styled the "antitryptic" interests of sufferers from cancer. We recommend the index have been damped by the establishment of the fact perusal of this report to all who may have to inform themthat an increase in the power of the serum to neutralise the selves of the value of the treatment of cancer by trypsin and activity of trypsin is not specific to cancer, but common to amylopsin. We would point out as a proof of the straightforward many infective diseases, the phenomenon being explained as of the enquiry that throughout touch seems to have character coincident with the disintegration of leucocytes and liberation of their contents. It would appear that in the history been kept with Dr. J. BEARD, whose views were more parof cancer the chapter on the vogue of the ferments and anti- ticularly being put to the test, and everything was done to ferments will be an exposition of the danger of hastily meet the requirements of the modifications he suggested in the applying in practical medicine the nebulous notions born treatment. Of general interest is the fact that the injection of imperfectly assimilated knowledge. Less is known about of the most powerful solutions of trypsin is not followed by the inhibition of ferment action than about ferment action toxic symptoms assignable to the products of digestion itself, and the flight of the enthusiasts from the realm of of tissues. As much as 100 minims of the strong solution the ferments to the realm of the anti.ferments appears to be I (special quadruple X) could be given for days without a portent that of all things caution is needed in appraising untoward effects. Dr. BAINBRIDGE adds: From this it the value of any positive statements which may be made will be seen how absurd were some of the earlier claims with regard to the bearing of this line of inquiry either on ofcures’ as well as the strange symptoms andterrific’ the treatment or the diagnosis of cancer. results from the small doses employed." The amelioration We do not ignore the activity centring round ferments of symptoms was in some cases as effectively induced by the and anti-ferments in their supposed bearings upon injection of sterilised distilled water. No wonder the report cancer ; rather would we emphasise the seriousness concludes that trypsin does not check the cancer process, with which all investigations of the kind should be does not prevent metastases-in short, does not cure cancer. undertaken, and the need for their conduct or control The negative result of the investigation is to be regretted, by persons properly equipped for a most difficult study, but the courageous persistence in its conduct in the face beset with more than the average number of pitfalls. of discouragement, and the care with which the tests have Once a positive statement finds currency of the value been carried out in all particulars by Dr. BAINBRIDGE for of any alleged remedy it is difficult or impossible to the New York Skin and Cancer Hospital, may serve as a banish it from practical therapeutics. The patient will model to other institutions. A negative result of this kind insist upon trying it in spite of the protests of the has the great value we have indicated, in that the medical medical attendant. Thus trypsin has come to take a profession have before them chapter and verse for their no faith in trypsin and none in 1 Scientific persons who persist Report Investigations with reference to the Treatment placing of Cancer, No. I., New York, 1909. in advocating its use by repeating stories of alleged "cures" cancer.
substitute for
THE LANCET.
"
"
on
convalescent cookery are for the most part’ admirable, but we do not think that’the directions given for making an adequately illustrated, and is omelette on p. 36 would result in the production of a really It is a useful and readable good omelette. One dessertspoonful of butter would not be exposition of sound medical teaching in the field with which enough for two eggs, and the stirring about in the pan would it deals. result in a mixture much more like buttered eggs than an omelette. But the art of making an omelette is not to be Notes on Dental Anatomy. By G. A. PEAKE. London : learned from a book ; to describe the proper method of Claudius Ash, Sons, and Co. 1908. Pp. 104.-These are one is almost impossible in writing, a practical cooking the notes of Mr. Peake’s lectures, and they contain an wanted. enormous mass of information about the teeth. The illustration is always highly condensed information is generally sound; except that the author’s ideas of the development of the jaws are a little archaic, and it is perhaps unwise to call the newt and frog reptiles as he does on p. 26. Mr. Peake says that the notes have been published at the request of dental students, but we doubt the wisdom of granting the request. Students AN APPARATUS FOR CONTINUOUS PROCTOCLYSIS. are much too fond of "potted knowledge," and few can THE plan of continuous administration of warm saline retain it beyond the date of an examination. A book twice solution by the rectum, introduced by Dr. J. B. Murphy as long, containing half the facts, would have been more of Chicago is in my opinion one of the greatest valuable. advances in abdominal surgery which have been made within recent years. Its routine adoption leads, I believe, das beim Ueber Verhalten hdinolytise7ter Ser1tmsto.lfe to more rapid, and certainly to more comfortable, conHaemogesqt,nden 1lnd 7tranken Kind. (On the Qiaitities of valescence after coeliotomy, and its beneficial effects in lytic Sitbstances contained in the Ser1Mn of Ohildren in .LeLt7t cases of general septic peritonitis would have surprised and Disease.) By Dr. ERNST MORO, Privat-docent and me had I not been prepared for them by hearing from Oberarzt in the Children’s Clinic of the University at Dr. Murphy’s own lips of the wonderful results which Munich. Wiesbaden: J. F. Bergmann. 1908. Pp. 100. he has obtained in the treatment of this serious conPrice 3s.-It is well known that the process of haemolysis dition since the adoption of the practice of continuous proctoclysis. Success in using the Murphy method depends n an immunised animal is carried out by two separate subon attention to detail, and stances-the immune body (amboceptor or copula) and the the two most important complement. Dr. Moro endeavoured to ascertain the points are : first, the regulation of the flow from the amounts of each of these substances in the blood of supply-can by gravity alone, children. He found that in new-born infants the immune and not by- constriction of body by which foreign blood corpuscles are attacked the delivery tube; and, is present only in small amount, and that there is also a secondly, the maintenance of smaller quantity of the complement than in adults, the actual the saline at a constant and amount varying in different individuals at all ages. The i appropriate temperature. To obviate the latter difficulty most interesting part of the pamphlet is, however, the comI have had an apparatus parison of the amounts of complement present in the serum made which does away with of different classes of atrophic children. The author found the necessity for constant that in infants who suffered from atrophy due to inability to supervision. The apparatus assimilate artificial food the amount of complement was very consists of an electro-plated douche can which holds small, whereas in others suffering from alimentary intoxicaIn the about five pints. tion the amount was actually increased, as in infective front of the can are a therdiseases. Injection of normal saline solution leads to an mometer and a gauge glass, increased formation of complement in patients who have by the side of which the can is graduated in half pints, so good powers of resistance. The failure of this increase that the amount of saline seems to be a sign of bad prognosis, and may perhaps prove entering the rectum can be to be a test possessing some clinical value. Further studie readily estimated. The saline are in progress as to variations in the amount of immune leaves the can through a body present in different diseases. delivery tube with a half inch bore, to which is lnvalid Cookerya Handbook of Cookery for the Sio7z Room. attached three feet of rubber By Miss PEARSON and Mrs. BYRDE. London : W. Thacker tubing connected with a and Co. ; Calcutta : Thacker, Spink, and Co. 1909. Pp. 39. large rectal tube. Under Is. 6d.-Take it all round this is an the bottom of the can is an electric heater, which can be Price 1 rupee. excellent little book. We are particularly pleased to note connected with any electric supply of suitable voltage by the sensible remarks about water for the sick with which means of a flexible cord and wall plug. The can is suspended on an adjustable stand, mounted on castors, so that it can be Part 1 opens. Even in these modern days every medical man wheeled up to the bedside. I have found by experireadily will bear witness to the widespread delusion that cold ment that with a ward temperature of from 650 to 700 F. water is harmful for a sick person, and Miss Pearson and Mrs. the solution in the can must be kept at a uniform temperaByrde have done well to point out that water is most bene- ture of 106° in order to insure that the saline enters the ficial. In the recipe for barley water, too, they have done rectum at a temperature of from 990 to 100°. The electric " heater is so made that if the saline solution is put into the right to mention the fact that the expression " barley water can at a temperature of 106° the temperature remains means at least three different kinds of fluid. We notice that almost constant so as the current is switched on. long in the recipe for white wine whey the authors are led into The apparatus, which has been made for me by Messrs. looseness of expression, for they say that all the solids of Allen and Hanburys, answers its purpose admirably and can the milk are removed in the curd." This, of course, is be left for several hours without any attention. incorrect, for the whey contains salts and sugar. This error HERBERT J. PATERSON, M.B., B.C. Cantab., F.R.C.S. Eng. should be corrected in a future edition. The recipes Upper Wimpole-street, W.
total and subtotal gastrectomy.
useful, and likely
to prove still The book is well got up and written in an agreeable style.
Pylorectomy he
more
.
New Inventions.
I
for
THE ENZYME TREATMENT OF CANCER.
place
in the
already
too
1079
lengthy
list of
alleged
cures
for
Although it is as useless as any other reputed surgical treatment, it may hardly be dislodged from its place in the lay mind until the progress of investigation reveals to the physician and surgeon rational substitutes for, or adjuvants to, operation. With regard to such alleged remedies it is essential, however, that the medical profession should have clear and sound views as to why they have been LONDON: SATURDAY, OCTOBER 9, 1909. condemned as useless. The possession of this knowledge and of the convictions based upon it, on the part of those who may be importuned to employ such remedies, is of as The Enzyme Treatment of Cancer.1 great importance to the practitioner himself as it is to HAD the enzyme treatment of cancer been able to achieve his patients. For this reason we have only the highest for a painstaking and elaborate report on the ,any of the exploits attributed to it we should expect that the praise outpourings in the press on both sides of the Atlantic systematic submission of 100 cases of cancer to " the enzyme about three years ago would be by now finding justification treatment of cancer " during the past three years in the New in the publication of properly authenticated therapeutical York Skin and Cancer Hospital. Undeterred by the discredit triumphs. But all that has followed justifies both the into which the methods of some of its exponents had brought scepticism originally accorded to the statements of the rival the theory, Dr. WM. SEAMAN BAINBRIDGE, the author of discoverers of the treatment and the verdict which quickly this report, has fulfilled his undertaking to give the treatfollowed, that trypsin, whether exhibited with or without ment a fair trial, both in operable and in inoperable cases. amylopsin, is not a cure for cancer. The lapse of time has Many of the patients have been followed to their homes, shifted the attention of those interesting themselves in the and nurses provided, after leaving hospital, while everyalleged relation of ferments to cancer from ’’ trypsin " to thing possible has been done to make the clinical and patho4’antitrypsin," through the agency of which attempts are logical observations complete. The list of patients and the being made to obtain a quicker or more certain diagnosis of account of the results given by Dr. BAINBRIDGE are records the presence of the disease ; but unfortunately the antici- of the miserable failure of the treatment ; but they are pations aroused by the earlier positive statements of the monuments of industry which will be of service in the diagnostic value of what has been styled the "antitryptic" interests of sufferers from cancer. We recommend the index have been damped by the establishment of the fact perusal of this report to all who may have to inform themthat an increase in the power of the serum to neutralise the selves of the value of the treatment of cancer by trypsin and activity of trypsin is not specific to cancer, but common to amylopsin. We would point out as a proof of the straightforward many infective diseases, the phenomenon being explained as of the enquiry that throughout touch seems to have character coincident with the disintegration of leucocytes and liberation of their contents. It would appear that in the history been kept with Dr. J. BEARD, whose views were more parof cancer the chapter on the vogue of the ferments and anti- ticularly being put to the test, and everything was done to ferments will be an exposition of the danger of hastily meet the requirements of the modifications he suggested in the applying in practical medicine the nebulous notions born treatment. Of general interest is the fact that the injection of imperfectly assimilated knowledge. Less is known about of the most powerful solutions of trypsin is not followed by the inhibition of ferment action than about ferment action toxic symptoms assignable to the products of digestion itself, and the flight of the enthusiasts from the realm of of tissues. As much as 100 minims of the strong solution the ferments to the realm of the anti.ferments appears to be I (special quadruple X) could be given for days without a portent that of all things caution is needed in appraising untoward effects. Dr. BAINBRIDGE adds: From this it the value of any positive statements which may be made will be seen how absurd were some of the earlier claims with regard to the bearing of this line of inquiry either on ofcures’ as well as the strange symptoms andterrific’ the treatment or the diagnosis of cancer. results from the small doses employed." The amelioration We do not ignore the activity centring round ferments of symptoms was in some cases as effectively induced by the and anti-ferments in their supposed bearings upon injection of sterilised distilled water. No wonder the report cancer ; rather would we emphasise the seriousness concludes that trypsin does not check the cancer process, with which all investigations of the kind should be does not prevent metastases-in short, does not cure cancer. undertaken, and the need for their conduct or control The negative result of the investigation is to be regretted, by persons properly equipped for a most difficult study, but the courageous persistence in its conduct in the face beset with more than the average number of pitfalls. of discouragement, and the care with which the tests have Once a positive statement finds currency of the value been carried out in all particulars by Dr. BAINBRIDGE for of any alleged remedy it is difficult or impossible to the New York Skin and Cancer Hospital, may serve as a banish it from practical therapeutics. The patient will model to other institutions. A negative result of this kind insist upon trying it in spite of the protests of the has the great value we have indicated, in that the medical medical attendant. Thus trypsin has come to take a profession have before them chapter and verse for their no faith in trypsin and none in 1 Scientific persons who persist Report Investigations with reference to the Treatment placing of Cancer, No. I., New York, 1909. in advocating its use by repeating stories of alleged "cures" cancer.
substitute for
THE LANCET.
"
"
on